bluuebunny/crossref_metadata_2025 huggingface dataset:
The Acute Effects of Alcohol on Sleep Architecture in Late Adolescence
Authors: Chan Julia K. M. , Trinder John , Andrewes Holly E. , Colrain Ian M. , Nicholas Christian L.
Published: June 2013

Background

Alcohol consumption is prevalent in late adolescence; however, little is known about its effect on sleep in this group. In mature adults, alcohol decreases sleep onset latency (SOL) and sleep efficiency (SE) and increases wake after sleep onset (WASO). It also increases slow wave sleep (SWS) and decreases rapid eye movement (REM) sleep in the first half of the night, with the inverse occurring in the second half. Alcohol's effect on sleep during late adolescence is of interest given that this age group shows both dramatic increases in alcohol consumption and significant developmental changes in the central nervous system. This study examined the effect of alcohol on sleep architecture in women and men aged 18 to 21 years and whether previously reported sleep architecture effects may have been as an artificial result of changes to sleep cycle length.

Methods

Twenty‐four (12 women) healthy 18‐ to 21‐year‐old light social drinkers (19.1 ± 1.0 years) underwent 2 conditions: presleep alcohol (target breath alcohol concentration [BAC] 0.10%) and placebo‐administered under controlled conditions, followed by standard polysomnography.

Results

In the alcohol condition, mean BAC at lights out was 0.084 ± 0.016%. Time in bed, total sleep time, and SOL (all p > 0.05) did not differ between conditions. However, there was less REM (p = 0.011) and more stage‐2 sleep (p = 0.035) in the alcohol condition. Further, alcohol increased SWS (p = 0.02) and decreased REM sleep (p < 0.001) in the first half of the night and disrupted sleep in the second half, with increased WASO (interaction: p = 0.034), and decreased SE (p = 0.04) and SWS (p = 0.01) and no REM sleep rebound in the second half of the night (p = 0.262). Additionally, alcohol had no effect on sleep cycle length (p = 0.598).

Conclusions

The results were broadly consistent with the adult literature with the novel extension that half night sleep architecture effects could not be attributed to changes in sleep cycle length. However, alcohol did not reduce SOL, or result in a REM rebound following reduced REM in the first half of the night. The results suggest that the effects of alcohol on sleep are modified by sleep's prevailing developmental stage.
Colonic diverticulitis in young Asians: a predominantly mild and right‐sided disease
Authors: Tan Ker‐Kan , Wong Jiayi , Yan Zhiyan , Chong Choon‐Seng , Liu Jody Z. , Sim Richard
Published: June 2013

Background

The management of diverticulitis in young Asian patients remains challenging. This study aimed to highlight the issues of managing diverticulitis in young Asians.

Methods

A retrospective review of all patients who were admitted for acute colonic diverticulitis from October 2003 to December 2008 was performed. Patients who were ≤50 year old were considered ‘young’ and formed the study group.

Results

The study group consisted of 142 patients. The majority (n = 126, 88.7%) had right‐sided diverticulitis and most (n = 117, 82.4%) were mild in severity. Most of the patients who underwent emergency surgery were for suspected appendicitis (39/56, 69.6%). When we compared between those aged ≤50 and >50 years, the older group had worse diverticulitis (odds ratio (OR), 4.90, 95% confidence interval (CI), 2.00–11.99), been operated for indications other than suspected appendicitis (OR, 13.08, 95% CI, 5.42–31.56) and undergone a colectomy (OR, 9.96, 95% CI, 4.12–24.10). The younger group had a much higher incidence of right‐sided disease (OR: 7.80, 95% CI: 4.32–14.07). Over a median follow‐up of 40 (6–90) months, 7 (4.9%) patients were readmitted for a total of eight times for recurrent attacks of diverticulitis and all were successfully treated conservatively. Five other patients underwent elective surgery for persistent symptoms.

Conclusion

Diverticulitis in young Asians is often right‐sided and mild in severity. A significant proportion is only diagnosed when operated for presumed appendicitis. Recurrent attacks are uncommon and can often be treated non‐surgically.
Retinal arterial macroaneurysms
Authors: Pitkänen Leena , Tommila Petri , Kaarniranta Kai , Jääskeläinen Juha E , Kinnunen Kati
Published: June 2013

Retinal arterial macroaneurysms are acquired saccular or fusiform dilatations of the large arterioles of the retina, usually within the first three orders of bifurcation. They are associated with systemic vascular conditions such as hypertension and arteriosclerotic disease occurring most commonly in elderly women. The primary reported symptom is a sudden loss of vision due to haemorrhage or oedema affecting the macula. Most of macroaneurysms regress without treatment and without causing decreased visual acuity. Poor visual outcome may occur secondary to foveal exudates and subfoveal haemorrhage.
Neuronal complications of intravitreal silicone oil: an updated review
Authors: Grzybowski Andrzej , Pieczynski Janusz , Ascaso Francisco J.
Published: June 2013

Silicone oil (SiO) has a well‐established role as a long‐term endotamponade agent in the management of complicated retinal detachments. Complications of intraocular SiO include keratopathy, glaucoma, cataract and subretinal migration of the oil droplets. SiO tamponade can also lead to a severe optic neuropathy caused by retrolaminar migration. Nevertheless, intracranial migration of the SiO through the optic nerve posterior to the lamina cribrosa to the optic chiasm and brain is uncommon. The mechanism is still under debate, but it has been suggested elevated intraocular pressure, macrophages or optic nerve head anatomical predispositions as potential explanations. Moreover, central scotoma may develop in eyes with SiO not only at the time of oil removal, but also during the period of tamponade. We performed a PubMed search of neuronal complications of silicone oil over a period of 25 years. This review summarizes our current understanding of the specific pathogenic mechanisms of intraocular SiO neuronal side effects, concluding that pre‐existing glaucoma and optic nerve abnormalities are the main risk factors associated with this damage. In their absence, the risk of extraocular SiO penetration is so low that the use of SiO endotamponade in complex retinal detachment patients does not need to be modified. MRI images to assess extraocular SiO migration are only necessary in very few and special cases, such as patients with optic nerve abnormalities and glaucoma.
Small head circumference at birth and early age at adiposity rebound
Authors: Eriksson J. G. , Kajantie E. , Lampl M. , Osmond C. , Barker D. J. P.
Published: June 2013

Aims

The adiposity rebound is the age in childhood when body mass index is at a minimum before increasing again. The age at rebound is highly variable. An early age is associated with increased obesity in later childhood and adult life. We have reported that an early rebound is predicted by low weight gain between birth and 1 year of age and resulting low body mass index at 1 year. Here, we examine whether age at adiposity rebound is determined by influences during infancy or is a consequence of foetal growth. Our hypothesis was that measurements of body size at birth are related to age at adiposity rebound.

Methods

Longitudinal study of 2877 children born in Helsinki, Finland, during 1934–1944.

Results

Early age at adiposity rebound was associated with small head circumference and biparietal diameter at birth, but not with other measurements of body size at birth. The mean age at adiposity rebound rose from 5.8 years in babies with a head circumference of ≤33 cm to 6.2 in babies with a head circumference of >36 cm (P for trend = 0.007). The association between thinness in infancy and early rebound became apparent at 6 months of age. It was not associated with adverse living conditions. In a simultaneous regression, small head circumference at birth, high mother's body mass index and tall maternal stature each had statistically significant trends with early adiposity rebound (P = 0.002, <0.001, 0.004).

Conclusion

We hypothesize that the small head size at birth that preceded an early adiposity rebound was the result of inability to sustain a rapid intra‐uterine growth trajectory initiated in association with large maternal body size. This was followed by catch‐up growth in infancy, and we hypothesize that this depleted the infant's fat stores.
Bioethics Methods in the Ethical, Legal, and Social Implications of the Human Genome Project Literature
Authors: Walker Rebecca L. , Morrissey Clair
Published: June 2013

While bioethics as a field has concerned itself with methodological issues since the early years, there has been no systematic examination of how ethics is incorporated into research on the Ethical, Legal and Social Implications (ELSI) of the Human Genome Project. Yet ELSI research may bear a particular burden of investigating and substantiating its methods given public funding, an explicitly cross‐disciplinary approach, and the perceived significance of adequate responsiveness to advances in genomics. We undertook a qualitative content analysis of a sample of ELSI publications appearing between 2003 and 2008 with the aim of better understanding the methods, aims, and approaches to ethics that ELSI researchers employ. We found that the aims of ethics within ELSI are largely prescriptive and address multiple groups. We also found that the bioethics methods used in the ELSI literature are both diverse between publications and multiple within publications, but are usually not themselves discussed or employed as suggested by bioethics method proponents. Ethics in ELSI is also sometimes undistinguished from related inquiries (such as social, legal, or political investigations).
LITAF, a BCL6 target gene, regulates autophagy in mature B‐cell lymphomas
Authors: Bertolo Cristina , Roa Sergio , Sagardoy Ainara , Mena‐Varas Maria , Robles Eloy F. , Martinez‐Ferrandis Jose I. , Sagaert Xavier , Tousseyn Thomas , Orta Alberto , Lossos Izidore S. , Amar Salomon , Natkunam Yasodha , Briones Javier , Melnick Ari , Malumbres Raquel , Martinez‐Climent Jose A.
Published: June 2013

We have previously reported that LITAF is silenced by promoter hypermethylation in germinal centre‐derived B‐cell lymphomas, but beyond these data the regulation and function of lipopolysaccharide‐induced tumour necrosis factor (TNF) factor (LITAF) in B cells are unknown. Gene expression and immunohistochemical studies revealed that LITAF and BCL6 show opposite expression in tonsil B‐cell subpopulations and B‐cell lymphomas, suggesting that BCL6 may regulate LITAF expression. Accordingly, BCL6 silencing increased LITAF expression, and chromatin immunoprecipitation and luciferase reporter assays demonstrated a direct transcriptional repression of LITAF by BCL6. Gain‐ and loss‐of‐function experiments in different B‐cell lymphoma cell lines revealed that, in contrast to its function in monocytes, LITAF does not induce lipopolysaccharide‐mediated TNF secretion in B cells. However, gene expression microarrays defined a LITAF‐related transcriptional signature containing genes regulating autophagy, including MAP1LC3B (LC3B). In addition, immunofluorescence analysis co‐localized LITAF with autophagosomes, further suggesting a possible role in autophagy modulation. Accordingly, ectopic LITAF expression in B‐cell lymphoma cells enhanced autophagy responses to starvation, which were impaired upon LITAF silencing. Our results indicate that the BCL6‐mediated transcriptional repression of LITAF may inhibit autophagy in B cells during the germinal centre reaction, and suggest that the constitutive repression of autophagy responses in BCL6‐driven lymphomas may contribute to lymphomagenesis.
When to perform lymph node dissection in patients with renal cell carcinoma: a novel approach to the preoperative assessment of risk of lymph node invasion at surgery and of lymph node progression during follow‐up
Authors: Capitanio Umberto , Abdollah Firas , Matloob Rayan , Suardi Nazareno , Castiglione Fabio , Di Trapani Ettore , Capogrosso Paolo , Gallina Andrea , Dell'Oglio Paolo , Briganti Alberto , Salonia Andrea , Montorsi Francesco , Bertini Roberto
Published: June 2013

Objective

To identify preoperatively patients who might benefit from lymph node dissection (LND).

Patients and Methods

We assessed lymph node invasion (LNI) at final pathology and lymph node (LN) progression during the follow‐up for 1983 patients with RCC, treated with either partial or radical nephrectomy. LN progression was defined as the onset of a new clinically detected lymphadenopathy (>10 mm) in the retroperitoneal lymphatic area.

Logistic regression analyses were used to assess the effect of each potential clinical predictor (age, body mass index, tumour side, symptoms, performance status, clinical tumour size, clinical tumour‐node‐metastasis stage, and albumin, calcium, creatinine, haemoglobin and platelet levels) on the outcome of interest.

The most parsimonious multivariable predictive model was developed, and discrimination, calibration and net benefit were calculated.

Results

The prevalence of LNI was 6.1% (120/1983 patients) and during the follow‐up period, 82 patients (4.1%) experienced LN progression.

On multivariable analyses, the most informative independent predictors were tumour stage (cT3–4 vs cT1–2, odds ratio [OR] 1.52, P = 0.05), clinical nodal status [cN1 vs cN0, OR 7.09, P < 0.001], metastases at diagnosis (OR 3.04, P < 0.001) and clinical tumour size (OR 1.14, P < 0.001).

The accuracy of the multivariable model was found to be 86.9%, with excellent calibration and net benefit at decision‐curve analyses.

Conclusions

By relying on a unique approach, combining the risk of harbouring LNI and/or LN progression during the follow‐up period, we have provided the first clinical presurgery model predicting the need for LND.
Emergent ureteric stent vs percutaneous nephrostomy for obstructive urolithiasis with sepsis: patterns of use and outcomes from a 15‐year experience
Authors: Goldsmith Zachariah G. , Oredein‐McCoy Olugbemisola , Gerber Leah , Bañez Lionel L. , Sopko David R. , Miller Michael J. , Preminger Glenn M. , Lipkin Michael E.
Published: June 2013

Objectives

To characterize the use of emergent JJ ureteric stent placement and percutaneous nephrostomy (PCN) for patients with obstructive urolithiasis with sepsis, and to determine whether outcomes differ between the two treatment methods.

Patients and Methods

A total of 130 patients with obstructive urolithiasis and systemic inflammatory response syndrome criteria were identified retrospectively from a single health system database from 1995 to 2011.

Primary outcomes included stone‐related and clinical variables which predicted the use of each treatment method.

Secondary outcomes included the length of hospital stay, risk of intensive care unit (ICU) admission, and surgical approach used for definitive stone management.

Results

The overall rate of failed procedures was 2.3% (3/130), with one in‐hospital death (0.8%).

Patients treated with PCN had larger stones (10 vs 7 mm, P = 0.031), and were more acutely ill (acute physiology, age, chronic health evaluation [APACHE] II scores of 15 vs 11, P = 0.036) than those treated with JJ stent placement.

Patients treated with PCN were more likely to require ICU admission (odds ratio: 3.23, 95% confidence interval [CI]: 1.24–8.41, P = 0.016), and demonstrated longer length of hospital stay (β: 0.47, 95% CI: 0.20–0.74, P = 0.001), even when adjusting for age, APACHE II score, and Charlson Comorbidity Index score.

After resolution of sepsis, patients treated with PCN were more likely to be treated definitively with a percutaneous approach, while patients treated with JJ stent placement were more likely to be treated ureteroscopically.

Conclusions

Both JJ stent placement and PCN drainage appear effective.

Patients with larger stones and who are more acutely ill are more likely to be treated with PCN.

Additional randomized clinical trials of adequate power are warranted to define the optimum management of these often complex cases.
Transurethral enucleation and resection of the prostate vs transvesical prostatectomy for prostate volumes >80 mL: a prospective randomized study
Authors: Ou Rubiao , Deng Xiangrong , Yang Wenjun , Wei Xinghua , Chen Hui , Xie Keji
Published: June 2013

Objectives

To compare the efficacy and safety of transurethral enucleation and resection of the prostate (TUERP) and transvesical prostatectomy (TVP) for patients with benign prostatic hyperplasia (BPH) and prostate volumes >80 mL.

Patients and Methods

A total of 100 patients with urodynamic obstruction and prostate volume >80 mL were prospectively randomized and enrolled in the study at a tertiary hospital.

Patients underwent TVP or TUERP performed by one of two surgeons with experience of a large number of cases.

All patients were preoperatively evaluated using patient age, prostate volume measurement, clinical characteristics of digital rectal examination, self‐assessment using the International Prostate Symptom Scores (IPSS) questionnaire, a quality‐of‐life (QoL) questionnaire, maximum urinary flow rate (Qmax), post‐void residual urine volume (PVR), urine analysis, blood sample analysis, including determination of prostate‐specific antigen (PSA) and haemoglobin concentration.

All patients were assessed peri‐operatively and postoperatively at 3 and 12 months. All complications were documented.

Results

Of 100 patients eligible to participate, 92 patients completed 12 months of follow‐up.

Patients who underwent TUERP had shorter catheterization times and hospital stays. Operation duration was not significantly different between the two surgical groups (P = 0.107).

The resected adenoma weight in the TVP group was more than that in the TUERP group, but the difference was not significant (P = 0.062).

There were no significant differences in IPSS, PVR, Qmax or QoL scores between the groups at 3 and 12 months. The patients in the TVP group appeared to have a better Qmax at 3 months, however, the difference was not significant (P = 0.081).

Adverse events were similar in the two groups.

Conclusion

We found that TUERP had efficacy and safety equivalent to that of TVP for patients with BPH and prostate volume >80 mL.
MAPping out distribution routes for kinesin couriers
Authors: Atherton Joseph , Houdusse Anne , Moores Carolyn
Published: June 2013

In the crowded environment of eukaryotic cells, diffusion is an inefficient distribution mechanism for cellular components. Long‐distance active transport is required and is performed by molecular motors including kinesins. Furthermore, in highly polarised, compartmentalised and plastic cells such as neurons, regulatory mechanisms are required to ensure appropriate spatio‐temporal delivery of neuronal components. The kinesin machinery has diversified into a large number of kinesin motor proteins as well as adaptor proteins that are associated with subsets of cargo. However, many mechanisms contribute to the correct delivery of these cargos to their target domains. One mechanism is through motor recognition of sub‐domain‐specific microtubule (MT) tracks, sign‐posted by different tubulin isoforms, tubulin post‐translational modifications, tubulin GTPase activity and MT‐associated proteins (MAPs). With neurons as a model system, a critical review of these regulatory mechanisms is presented here, with a particular focus on the emerging contribution of compartmentalised MAPs. Overall, we conclude that – especially for axonal cargo – alterations to the MT track can influence transport, although in vivo, it is likely that multiple track‐based effects act synergistically to ensure accurate cargo distribution.
Microradiography and microcomputed tomography comparative analysis in human bone cores harvested after maxillary sinus augmentation: a pilot study
Authors: Soardi Carlo Maria , Clozza Emanuele , Turco Gianluca , Biasotto Matteo , Engebretson Steven P. , Wang Hom‐Lay , Zaffe Davide
Published: June 2013

Objectives

The aim of this study was to compare microradiography (MR) and microcomputed tomography (μCT) analysis of bone samples following maxillary sinus augmentation at different time periods and determine the relationships between measured area and volume fractions.

Materials and methods

Lateral window sinus grafts were performed on 10 patients using a mineralized human bone allograft (MHBA). At implant placement, 5–13 months after surgery, 10 bone core biopsies were harvested. Prior to histologic sectioning, bone samples were evaluated with μCT. The morphometric parameters computed by MR and μCT were compared using Pearson's correlation and Bland and Altman analysis and included hard tissue fraction (HV/TV:%), soft tissue fraction (SV/TV:%), vital bone fraction (BV/TV:%) and residual graft fraction (GV/TV:%).

Results

Strong positive correlation between MR and μCT was found for HV/TV and SV/TV and BV/TV [r = 0.84, 0.84 and 0.69, respectively] but weak for GV/TV [r = 0.10].

Conclusion

μCT technology shows promising potential as an indicator of bone morphology changes; however, caution should be used in interpreting morphometric parameters, as the different methods reveal important biases.
Where Do Features Come From?
Authors: Hinton Geoffrey
Published: June 2013

It is possible to learn multiple layers of non‐linear features by backpropagating error derivatives through a feedforward neural network. This is a very effective learning procedure when there is a huge amount of labeled training data, but for many learning tasks very few labeled examples are available. In an effort to overcome the need for labeled data, several different generative models were developed that learned interesting features by modeling the higher order statistical structure of a set of input vectors. One of these generative models, the restricted Boltzmann machine (RBM), has no connections between its hidden units and this makes perceptual inference and learning much simpler. More significantly, after a layer of hidden features has been learned, the activities of these features can be used as training data for another RBM. By applying this idea recursively, it is possible to learn a deep hierarchy of progressively more complicated features without requiring any labeled data. This deep hierarchy can then be treated as a feedforward neural network which can be discriminatively fine‐tuned using backpropagation. Using a stack of RBMs to initialize the weights of a feedforward neural network allows backpropagation to work effectively in much deeper networks and it leads to much better generalization. A stack of RBMs can also be used to initialize a deep Boltzmann machine that has many hidden layers. Combining this initialization method with a new method for fine‐tuning the weights finally leads to the first efficient way of training Boltzmann machines with many hidden layers and millions of weights.
Dysanaptic growth of lung and airway in children with post‐infectious bronchiolitis obliterans
Authors: Mosquera Ricardo A. , Hashmi Syed S. , Pacheco Susan E. , Reverdin Alexandra , Chevallier Justyna , Colasurdo Giuseppe N.
Published: June 2013

Rationale

Post‐infectious bronchiolitis obliterans (PBO) is a rare form of chronic obstructive lung disease associated with small airway fibrosis following a severe insult to the lower respiratory tract. It has been suggested that PBO is a non‐progressive disease. However, evidence supporting this statement is limited. In this case series, we sought to determine the changes of pulmonary function tests (PFT) over time in children with PBO.

Methods

Seven children with PBO, ages 6–15 years old, were retrospectively studied between 1994 and 2012. Spirometry and lung volumes tests were performed in accordance with American Thoracic Society (ATS) guidelines and were monitored over time. The average rate of change was calculated using generalized linear mixed models.

Results

The median baseline values for forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), the FEV1/FVC ratio and forced expiratory flow 25%–75% (FEF25%–75%) were 57%, 50%, 87% and 29%, respectively. FVC increased at a rate of 1.8% per year (P = 0.008). There was no significant change in FEV1 over time (P = 0.112). However, the FEV1/FVC ratio decreased by 2.6% per year (P < 0.001).

Conclusion

PFT in childhood PBO was characterized by significant airway obstruction. Over time, FVC (lung parenchyma) increased and FEV1 (airway) remained stable, but FEV1/FVC ratio declined more than expected, suggesting a mismatch in the growth of the airway and lung parenchyma (dysanaptic growth). Further studies in larger populations are needed to validate these observations.
Spirometric reference values for healthy nonsmoking Saudi adults
Authors: Al Ghobain Mohammed O. , Alhamad Esam H. , Alorainy Hassan S. , Al Hazmi Manal , Al Moamary Mohamed S. , Al‐Hajjaj Mohamed S. , Idress Majdy , Al‐Jahdali Hamdan , Zeitouni Mohammed
Published: June 2013

Objectives

To derive prediction equations of spirometric values of healthy Saudi adults and to compare the derived equations with equations reported in selected population.

Methods

Cross‐sectional study of healthy nonsmoking men and women Saudi adults. The measured spirometric values were the forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), peak expiratory flow (PEF) and forced mid‐expiratory flow (FEF 25%–75%).

Results

A total of 621 spirometric tests were done. The prediction equations were derived using the following formula: Predicted spirometric value = constant + (b1 × age) + (b2 × height (cm)), where b1 and b2 represent the regression coefficients for age and height, respectively.

Variable
Constant
Age (years)
Height (cm)
Variable
Constant
Age (years)
Height (cm)

Males (n = 292)

Females (n = 175)

FVC
−2.933
−0.018
0.046
FVC
−3.470
−0.016
0.045

FEV1
−1.886
−0.019
0.036
FEV1
−2.482
−0.018
0.036

FEV1/FVC (%)
98.41
−0.095
−0.068
FEV1/FVC (%)
100.67
−0.142
−0.072

PEF
17.274
−1.243
3.471
PEF
−226.648
−0.499
4.076

FEF25%–75%
0.100
−0.024
0.027
FEF25%−75%
−1.337
−0.021
0.031

The means of the measured FVC and FEV1 were significantly lower than the predicted values derived by the American equations of −7.2% and −4.6% among males, respectively (P value < 0.00001), and −4.7%, and −5.26% among females, respectively (P value < 0.00001).

Conclusion

The reference spirometric values derived in our study were significantly lower than the predicted values derived by the American equations.
Speckle Tracking Echocardiographic Analysis of Left Ventricular Systolic and Diastolic Functions of Young Elite Athletes with Eccentric and Concentric Type of Cardiac Remodeling
Authors: Simsek Ziya , Hakan Tas M. , Degirmenci Husnu , Gokhan Yazıcı A. , Ipek Emrah , Duman Hakan , Gundogdu Fuat , Karakelleoglu Sule , Senocak Huseyin
Published: June 2013

Aims

In individuals who exercise regularly and for extended periods of time, some structural alterations in the heart, called the athlete's heart, develop in time. These alterations vary in type, can be eccentric or concentric, depending on the nature of exercise. Speckle tracking echocardiography (STE) is a novel, angle‐independent method that accurately and reliably measures systolic and diastolic functions of the left ventricle (LV) with considerably lower inter‐operator variability.

Methods and Results

Twenty‐two marathon runners, 24 wrestlers, and 20 healthy sedentary individuals were included in the study. The average age of subjects is 17.5 ± 2.2 in marathon runners, 16.8 ± 1.9 in wrestlers, and 16.4 ± 1.8 in control group. The parameters of LV longitudinal strain (S), LV longitudinal strain rate systolic (SRS), LV longitudinal strain rate diastolic early filling (SRE), and longitudinal strain rate diastolic late filling (SRA) were evaluated by apical two‐, three‐, and four‐chamber grayscale imaging using the global longitudinal strain (GLS) and GLS rate (GLSR). Conventional echocardiographic parameters demonstrated increased LV diameters and wall thickness in the marathon runners and increased wall thickness without increased LV diameters in the wrestlers. Systolic and diastolic functions were comparable between the marathon runners and wrestlers with conventional echocardiography. Analysis with STE, however, yielded higher systolic strain and strain rates in the athletes. Normalized GLS parameters and end‐diastolic volume (EDV) were shown to be correlated.

Conclusion

Overall, conventional echocardiography can detect some differences between young athletes with eccentric and concentric type of athlete's heart but it is incapable of revealing differences in intrinsic myocardial functions. However, analysis using STE demonstrated increased systolic functions in athletes commensurate with increased load, with unaltered diastolic functions.
Adverse events of surgical extrusion in treatment for crown–root and cervical root fractures: a systematic review of case series/reports
Authors: Elkhadem Ahmed , Mickan Sharon , Richards Derek
Published: June 2013

Background

Crown–root and cervical root fractures constitute a restorative challenge due to sub‐gingival position of the fracture margin. Surgical tooth extrusion is one of the treatment options. There is uncertainty regarding the prognosis of such treatment modality.

Objective

To assess adverse events of surgical tooth extrusion in the treatment for crown–root and cervical root fractures in permanent teeth.

Methods

PubMed, Embase, and Google Scholar were searched through 15th of June 2012. Search was limited to English and Arabic languages. Reference list of relevant studies were hand‐searched. Grey literature was searched using Open Grey. Two review authors independently extracted data, while only one assessed trial quality using 8‐point methodological index for non‐randomized studies (MINORS) scale. A sensitivity analysis was performed to exclude studies with suspected patients' duplicates.

Results

Eleven case reports and eight case series involving 226 patients with 243 teeth were identified. No randomized controlled trials were found. The mean quality score for all case series was 9 suggesting a fair quality, while that of all case reports was 5 suggesting poor quality. Non‐progressive root resorption is the most common finding following surgical extrusion with an event rate of 30% (95% CI 24.6–36.7%). This is followed by low event rates of tooth loss (5%), slight mobility (4.6%), marginal bone loss (3.7%), and progressive root resorption (3.3%). No ankylosis occurred to any extruded tooth, while severe tooth mobility showed negligible overall event rate of 0.4%.

Conclusion

The available evidence suggests that surgical tooth extrusion is a valid technique in management of crown–root and cervical root fracture of permanent teeth. Minimal adverse events and good prognosis are expected. Further, surgical extrusion can be considered as a treatment option in teeth suffering sub‐gingival decay.
Glycogen synthase kinase 3 substrates in mood disorders and schizophrenia
Authors: Cole Adam R.
Published: June 2013

The dominant genetic and environmental causes of mood disorders and schizophrenia have not been forthcoming, so alternative approaches are required to elucidate the mechanisms underlying these diseases and to develop improved treatments for use in the clinic. Pharmacological evidence implicates glycogen synthase kinase 3 (GSK3) as a key target of current therapeutics, and this is well supported by genetic studies in animal models. Several upstream regulators of GSK3 are also genetically associated with mood disorders and schizophrenia, further suggesting convergence on GSK3 signalling. Whereas pathways upstream of GSK3 are being elucidated, relatively little progress has been made in identifying targets downstream of GSK3 that mediate its functional effects. This is important, because these substrates themselves could become next‐generation therapeutic targets that are more potent and specific than current therapeutics targeting GSK3. Here, a few likely candidates and their connection to mood disorders and schizophrenia are discussed.
Geography and Biopolitics
Authors: Rutherford Stephanie , Rutherford Paul
Published: June 2013

This article is the second of a two‐part exploration of the question of biopolitics and its importance to social geography. First, this paper examines two main threads—biopolitical geopolitics and vital geographies—to think about the different ways this analytical register has been applied. Next, we draw on our own research and that of others to suggest the possibilities for an affirmative biopolitics. Finally, we contend that geography is well‐placed to continue pushing the boundaries of biopolitical research, with particular reference to an area that has received little attention thus far: biopolitics and the non‐human.
Role of Etv2‐positive cells in the remodeling morphogenesis during vascular development
Authors: Kobayashi Kumiko , Ding Guo , Nishikawa Shin‐Ichi , Kataoka Hiroshi
Published: June 2013

Etv2 is a critical determinant for the commitment of endothelial (EC) and hematopoietic (HPC) cells from mesoderm. Etv2 is assumed to be transiently required for EC commitment but dispensable after most ECs differentiate around E9.5. To confirm the time window of Etv2 requirement, Etv2 was ablated at different time points using ROSA26CreER mice. Unexpectedly, Etv2 ablation at E9.5 caused vascular remodeling defects in cranial and yolk sac vasculature. Immunostaining showed that Etv2+/VE‐cadherin (VECAD)− cells were present around forming vasculature, mostly co‐expressing Flk‐1 with a small number of Etv2+/VECAD+ cells, indicating that Etv2+/Flk‐1+/VECAD− cells are the major Etv2+ population promoting vascular remodeling around E9.5. Gene expression analysis showed up‐regulation of Fgf proteins, Il‐6, Glypican‐3 and matrix metalloproteases in Etv2+/VEDAC− cells over Etv2−/VECAD+ mature ECs. Blockade of those factors caused reduced EC sprouting in ex vivo explant culture from E9.5 embryos, suggesting the functional significance of environmental factors derived from Etv2+ cells. Altogether, we propose that Etv2+/VEDAC− cells around E9.5‐E10.5 provide extracellular factors to complete vascular morphogenesis in addition to becoming differentiated ECs incorporated into vessels. This insight for the new role of Ets protein in perivascular Flk‐1+/VECAD−/(Etv2+) cells to induce expression of angiogenic factors may provide another strategy to control angiogenesis.
University Governance, Leadership and Management in a Decade of Diversification and Uncertainty
Authors: Shattock Michael
Published: June 2013

The last decade has seen an acceleration of change in the way British universities have been governed, led and managed. This has substantially been driven by the instability of the external environment, which has encouraged a greater centralisation of decision‐making leading to less governance and more management, but it is also a consequence of the growing convergence of the governance and management models of the pre‐ and post‐1992 universities. The article identifies a rise in ‘the executive’ at the expense of the traditional components of university governance, governing bodies, senates, academic boards and faculty boards, and a growing tendency to push academic participation to the periphery. It describes the dangers implicit in such developments and suggests that they may lead to a loss in academic vitality and distinctiveness.
Re‐inventing Shared Governance: Implications for Organisational Culture and Institutional Leadership
Authors: Stensaker Bjørn , Vabø Agnete
Published: June 2013

Shared governance has been a key historical characteristic of higher education although this form of governance has come under increased pressure in recent decades. It is often argued that shared governance is less relevant for tackling the challenges related to a more dynamic environment of the sector. This paper discusses underlying premises for the current conceptions of shared governance and analyses how a sample ofNordic universities perceives the place and role of governance in their strategic development. It is found that most universities emphasise leadership and leadership development as a key measure to strengthen their governance capacity and it is argued that most universities seem to overlook the cultural and symbolic aspects of governance along the way. This may have serious consequences for the internal legitimacy and trust when universities enter into demanding change processes.
Governance of Governance in Higher Education: Practices and lessons drawn from the Portuguese case
Authors: Magalhães Antonio , Veiga Amélia , Amaral Alberto , Sousa Sofia , Ribeiro Filipa
Published: June 2013

The implementation of the governance reform of Portuguese higher education has been developed under the influence of ‘new public management’ resulting in the loss of collegial governance. Additionally, the need for meta‐governance of the higher education system and institutions to monitor institutional performance against policy objectives has become evident. By examining the implementation of the legal framework for higher education on the basis of document analysis covering the period from 2007 to 2011 the ‘new governance’ perspective allows a broader interpretation of the governance reform outcomes. This has implications for the enhancement of institutional autonomy induced by governance reforms impacting on European higher education systems and highlights the tools approach in public management.
Parents' decision making and access to preventive healthcare for young children: applying Andersen's Model
Authors: Alexander Karyn E. , Brijnath Bianca , Mazza Danielle
Published: June 2013

Background and objective

Implementing preventive health care for young children provides the best chance of improving health and changing a child's life course. In Australia, despite government support for preventive health care, uptake of preventive services for young children is low. Using Andersen's behavioural model of health‐care utilization, we aimed to understand how parents conceptualized their children's preventive health care and how this impacted on access to preventive health‐care services.

Design

Semi‐structured telephone interviews conducted between May and July 2011.

Setting and participants

Twenty‐eight parents of children aged 3–5 years from three diverse socio‐economic areas of Melbourne, Australia.

Results

Thematic analysis showed parents' access to child preventive health care was determined by birth order of their child, cultural health beliefs, personal health practices, relationship with the health provider and the costs associated with health services. Parents with more than one child placed their own experience ahead of professional expertise, and their younger children were less likely to complete routine preventive health checks. Concerns around developmental delays required validation through family, friends and childcare organizations before presentation to health services.

Conclusions

To improve child preventive health requires increased flexibility of services, strengthening of inter‐professional relationships and enhancement of parents' knowledge about the importance of preventive health in early childhood. Policies that encourage continuity of care and remove point of service costs will further reduce barriers to preventive care for young children. Recent reforms in Australia's primary health care and the expansion of child preventive health checks into general practice present a timely opportunity for this to occur.
Respiratory virus infections in hospitalized children and adults in Lao PDR
Authors: Sentilhes Anne‐Charlotte , Choumlivong Khamla , Celhay Olivier , Sisouk Thongchanh , Phonekeo Darouny , Vongphrachanh Phengta , Brey Paul , Buchy Philippe
Published: June 2013

Background

Acute respiratory infections are an important cause of morbidity and mortality worldwide, with a major burden of disease in developing countries. The relative contribution of viruses in acute lower respiratory infections (ALRI) is, however, poorly documented in Lao PDR.

Objective

The objective of this study is to investigate the etiology of ALRI in patients of all ages in two hospitals of Laos.

Methods

Multiplex PCR/RT‐PCR methods were used to target 18 major common respiratory viruses. Between August 2009 and October 2010, samples from 292 patients presenting with ALRI were collected.

Results and conclusion

Viruses were detected in 162 (55%) samples. In 48% (140/292) of the total ALRI cases, a single virus was detected while coinfections were observed in 8% (22/292) of the samples. The most frequent viruses were rhinovirus/enterovirus (35%), human respiratory syncytial virus (26%), and influenza viruses (13%). Parainfluenza viruses were detected in 9%, adenovirus in 6%, human metapneumovirus in 4%, coronaviruses (229E, NL63, OC43, HKU1) in 4%, and bocavirus in 3% of ALRI specimens. Most viral infections occurred in patients below 5 years of age. The distribution of viruses varied according to age‐groups. No significant correlation was observed between the severity of the disease and the age of patients or the virus species. This study provides the description of viral etiology among patients presenting with ALRI in Lao PDR. Additional investigations are required to better understand the clinical role of the different viruses and their seasonality in Laos.
Vacuum‐assisted closure therapy for vascular graft infection (Szilagyi grade III) in the groin—a 10‐year multi‐center experience
Authors: Verma Himanshu , Ktenidis Kiriakos , George Robbie K , Tripathi Ramesh
Published: June 2013

The aim of the study was to evaluate the benefit of vacuum‐assisted closure (VAC) therapy in the management of deep, alloplastic graft infections (Szilagyi grade III) in the groin. From 2000 to 2009, we identified and included in our study 72 deep inguinal infections in 68 patients, involving native as well as synthetic graft or patch material. There were 29 early graft infections (<30 days after implantation) and 43 late infections (≥30 days after implantation). Among these, 17 cases involved native grafts/patches (12 grafts and 5 patches), while 55 cases involved non‐native grafts/patches [26 polytetrafluorethylene (PTFE) grafts and 24 Dacron grafts (Haemashield, Meadox Medical, Boston Scientific Corporation, Natick, NY; Gelsoft graft, Vascutek, Inchinnan, Renfrewshire, Scotland, UK; Intervascular, Mahwah, NJ); INVISTA, and 5 Vascu‐Guard™ bovine pericardial patches; Synovis Surgical Innovation]. All patients were treated with multiple wound debridements, graft salvage, sartorius myoplasty, intravenous antibiotics and VAC therapy until thorough surface healing was achieved. Exclusion criteria were an alloplastic graft infection with proximal expansion above the inguinal ligament, blood culture positive for septicaemia or septic anastomotic herald or overt bleeding. Nine months after initiation of therapy, overall, graft/patch salvage was achieved in 61 of 72 (84·7%) cases. Of the native graft/patch group, infected graft material was replaced with an autogenous great saphenous vein graft or patch in four patients (23·5%). In the non‐native group, vein or synthetic graft preservation without revision was achieved in 48 of 55 (87·3%) patients. The mean duration of VAC therapy was 16 ± 7·7 days, and postoperative mean hospital stay was 25·3 ± 8·5 days. In 23 of 72 (31·9%) cases, a secondary closure of the wound was achieved; in the other 49 cases, wound healing was achieved by meshed split‐thickness skin grafting. Mean wound healing time for all wounds was 24·3 ± 12·5 days. Specific complications during VAC therapy were wound fluid retention in 2 cases and an increased need for analgesics in 12 cases (16·66%). Negative pressure wound therapy (NPWT) has been reported to be useful in the treatment of severe wound infections. Even in the presence of synthetic vascular graft material, NPWT can greatly simplify challenging wound‐healing problems leading to wound dehiscence and its sequelae. Our long‐term experience demonstrates the safety and effectiveness of VAC therapy in the management of deep graft infections.
Is mechanical bowel preparation in laparoscopic radical prostatectomy beneficial? An analysis of a Japanese national database
Authors: Sugihara Toru , Yasunaga Hideo , Horiguchi Hiromasa , Fujimura Tetsuya , Nishimatsu Hiroaki , Kume Haruki , Ohe Kazuhiko , Matsuda Shinya , Fushimi Kiyohide , Homma Yukio
Published: June 2013

What's known on the subject? and What does the study add?

Recently, the ineffectiveness of bowel mechanical preparation prior to colorectal surgery was focused on. Although its effectiveness was widely accepted in laparoscopic prostatectomy, the data were limited.

This retrospective multicentre study compared laparoscopic prostatectomy cases with and without bowel preparation and did not demonstrate the preparation's preferable effect in operation time and complication incidence, which suggested justification of the omission of bowel preparation.

Objective

To evaluate the effect of mechanical bowel preparation (MBP) prior to laparoscopic radical prostatectomy on peri‐operative outcomes.

Patients and Methods

Patients undergoing laparoscopic radical prostatectomy for T1–T2 tumours between 2008 and 2010 were identified in the Japanese Diagnosis Procedure Combination database.

Patients were classified into a preoperative MBP group and a non‐MBP group.

The effects of MBP were evaluated by multivariate regression analysis of overall complication rate, operation time, postoperative length of stay (PLOS) and total costs with generalized estimating equations adjustment involving age, body mass index, Charlson score, hospital academic status and hospital volume.

Results

Comparing the 154 non‐MBP and 580 MBP patients, overall complication rate, operation time, PLOS and total costs were 6.5% vs 6.9% (P = 0.860), 222 vs 250 min (P = 0.001), 11 vs 10 days (P < 0.001) and 18 941 vs 19 015 US dollars (P = 0.032), respectively.

In the multivariate analyses, no significant differences were observed for the four outcomes (P = 0.961, 0.194, 0.383 and 0.993, respectively).

Complications were more frequently observed in older patients, and operation time tended to be longer in patients with higher body mass index and in hospitals with lower volumes.

Longer PLOS and higher total costs were associated with older age, higher Charlson score and lower hospital volume.

Conclusions

We could not find any superiority of MBP on overall complications, operation time, PLOS and total costs in laparoscopic radical prostatectomy.

The results support that MBP can be omitted prior to laparoscopic radical prostatectomy for T1–T2 prostate cancer.
Are All Credit Default Swap Databases Equal?
Authors: Mayordomo Sergio , Peña Juan Ignacio , Schwartz Eduardo S.
Published: June 2013

We compare the five major sources of corporate Credit Default Swap prices: GFI, Fenics, Reuters, CMA, and Markit, using the most liquid single name 5‐year CDS in the iTraxx and CDX indexes from 2004 to 2010. Deviations from the common trend among prices in the different databases are not random but are explained by idiosyncratic factors, financing costs, global risk, and other trading factors. The CMA quotes lead the price discovery process. Moreover, we find that there is not a full agreement among databases in the results of the price discovery analysis between stock and CDS returns.
CO2 Laser Modification of Mohs' Surgery
Authors: BAILIN PHILIP L. , RATZ JOHN L. , LUTZ‐NAGEY LINDA
Published: June 2013

A variation of Mohs' surgery using the CO2 laser is described. The modification combines the best features of the fresh‐and fixed‐tissue techniques and eliminates their disadvantages.
Extirpation of a Nidus of Infection with Tetanus Bacilli by Chemosurgery
Authors: DE PEDRO ROBERTO L. DÁVILA , MOHS FREDERIC E.
Published: June 2013

Chemosurgery in its original form of serial excisions of tissue fixed by a paste of zinc chloride and later modified to excisions of unfixed fresh tissue was developed for extirpations of cutaneous malignancies under histologic monitoring. The technique is, however, more versatile than that and we herewith report an unusual use of it to eradicate a nidus of infection with tetanus bacilli.