bluuebunny/crossref_metadata_2025 huggingface dataset:
Race and Imperial Defence in the British World, 1870–1914
Authors: Mitcham John C.
Published: March 2016

The first comprehensive account of the cultural and racial origins of the imperial security partnership between Britain, Canada, Australia, New Zealand, and South Africa. Drawing on research from every corner of the globe, John C. Mitcham merges studies of diplomacy, defense strategy, and politics with a wider analysis of society and popular culture, and in doing so, poses important questions about race, British identity, and the idea of empire. The book examines diverse subjects such as the South African War, the Anglo-German naval arms race, Queen Victoria's Diamond Jubilee, and the birth of the Boy Scout Movement, and positions them within the larger phenomenon of British race patriotism that permeated the fin de siècle. Most importantly, Mitcham demonstrates how this shared concept of 'Britishness' gradually led to closer relations between the self-governing states of the empire, and ultimately resulted in a remarkably unified effort during the First World War.
China's Crisis Behavior
Authors: He Kai
Published: March 2016

Since the end of the Cold War, China has experienced several notable interstate crises: the 1999 'embassy bombing' incident, the 2001 EP-3 mid-air collision with a United States aircraft, and the Diaoyu/Senkaku dispute with Japan. China's response to each incident, however, has varied considerably. Drawing from a wealth of primary sources and interviews, this book offers a systematic analysis of China's crisis behavior in order to identify the factors which determine when Chinese leaders decide to escalate or scale down their response to crises. Inspired by prospect theory - a Nobel Prize-winning behavioural psychology theory - Kai He proposes a 'political survival prospect' model as a means to understand the disparities in China's behavior. He argues that China's response depends on a combination of three factors that shape leaders' views on the prospects for their 'political survival status', including the severity of the crisis, leaders' domestic authority, and international pressure.
Excommunication for Debt in Late Medieval France
Authors: Lange Tyler
Published: March 2016

Late medieval church courts frequently excommunicated debtors at the request of their creditors. Tyler Lange analyzes over 11,000 excommunications between 1380 and 1530 in order to explore the forms, rhythms, and cultural significance of the practice. Three case studies demonstrate how excommunication for debt facilitated minor transactions in an age of scarce small-denomination coinage and how interest-free loans and sales credits could be viewed as encouraging the relations of charitable exchange that were supposed to exist between members of Christ's body. Lange also demonstrates how from 1500 or so believers gradually turned away from the practice and towards secular courts, at the same time as they retained the moralized, economically irrational conception of indebtedness we have yet to shake. The demand-driven rise and fall of excommunication for debt reveals how believers began to reshape the institutional Church well before Martin Luther posted his theses.
Sixties Ireland
Authors: Daly Mary E.
Published: March 2016

This provocative new history of Ireland during the long 1960s exposes the myths of Ireland's modernisation. Mary E. Daly questions traditional interpretations which see these years as a time of prosperity when Irish society – led by a handful of key modernisers – abandoned many of its traditional values in its search for economic growth. Setting developments in Ireland in a wider European context, Daly shows instead that claims for the economic transformation of Ireland are hugely questionable: Ireland remained one of the poorest countries in western Europe until the end of the twentieth century. Contentious debates in later years over contraception, divorce, and national identity demonstrated continuities with the past that long survived the 1960s. Spanning the period from Ireland's economic rebirth in the 1950s to its entry into the EEC in 1973, this is a comprehensive reinterpretation of a critical period in Irish history with clear parallels for Ireland today.
Soil thermal and productive responses of biodegradable mulch materials in a processing tomato (Lycopersicon esculentum Mill.) crop
Authors: Moreno Marta M. , Cirujeda Alicia , Aibar Joaquín , Moreno Carmen
Published: March 2016

Mulch materials of different origin and colour are available in the agricultural sector as sustainable alternatives to the use of polyethylene (PE). Mulching modifies soil temperature and consequently affects crop yields. This work assessed the thermal and productive responses of different mulch materials in two different geo-climatic conditions during a 3-year integrated field study on processing tomato (Lycopersicon esculentum Mill.). Two biodegradable plastic mulches (BD1, BD2), one oxo-degradable material (OB), two types of paper (PP1, PP2) and one barley-straw cover (BS) were compared with two control treatments: black PE and manual weeding (MW). Soil temperature variables (maximum, minimum and mean temperature, soil growing degree-days and soil temperature amplitude) and production variables (marketable and total yield, mean fruit weight) were considered. Thermally, PE could be considered an atypical mulch causing higher temperatures in the soil, but it is not associated with a higher yield. Responses of PE, PP2 and MW were independent of the geo-environmental conditions, whereas OB, BD1 and BD2 had similar thermal and productive responses to each other in different environments. Tomato yield was correlated positively only with the minimum soil temperature, especially when excluding PE.
IL-17A plays a central role in the expression of psoriasis signature genes through the induction of IκB-ζ in keratinocytes
Authors: Muromoto Ryuta , Hirao Toru , Tawa Keisuke , Hirashima Koki , Kon Shigeyuki , Kitai Yuichi , Matsuda Tadashi
Published: March 2016

In psoriasis lesions, a diverse mixture of cytokines is up-regulated that influence each other generating a complex inflammatory situation. Although this is the case, the inhibition of IL-17A alone showed unprecedented clinical results in patients, indicating that IL-17A is a critical inducer of psoriasis pathogenesis. To elucidate IL-17A-driven keratinocyte-intrinsic signaling pathways, we treated monolayers of normal human epidermal keratinocytes in vitro with a mixture of six cytokines (IL-17A, TNF-α, IL-17C, IL-22, IL-36γ and IFN-γ) involved in psoriasis to mimic the inflammatory milieu in psoriasis lesions. Microarray and gene set enrichment analysis revealed that this cytokine mixture induced similar gene expression changes with the previous transcriptome studies using psoriasis lesions. Importantly, we identified a set of IL-17A-regulated genes in keratinocytes, which recapitulate typical psoriasis genes exemplified by DEFB4A, S100A7, IL19 and CSF3, based on the differences in the expression profiles of cells stimulated with six cytokines versus cells stimulated with only five cytokines lacking IL-17A. Furthermore, a specific IL-17A-induced gene, NFKBIZ, which encodes IκB-ζ, a transcriptional regulator for NF-κB, was demonstrated to have a significant role for IL-17A-induced gene expression. Thus, we present novel in vitro data from normal human keratinocytes that would help elucidating the IL-17A-driven keratinocyte activation in psoriasis.
Auscultation versus Point-of-care Ultrasound to Determine Endotracheal versus Bronchial Intubation
Authors: Ramsingh Davinder , Frank Ethan , Haughton Robert , Schilling John , Gimenez Kimberly M. , Banh Esther , Rinehart Joseph , Cannesson Maxime
Published: March 2016

AbstractAbstract

This prospective, randomized, double-blinded, crossover trial compared the accuracy of detecting bronchial intubation between point-of-care ultrasound and auscultation in 42 adult subjects. The point-of-care ultrasound was a reliable technique to detect bronchial intubation by demonstrating absent contralateral pleural lung sliding on the unintubated side.

Supplemental Digital Content is available in the text.

Background

Unrecognized malposition of the endotracheal tube (ETT) can lead to severe complications in patients under general anesthesia. The focus of this double-blinded randomized study was to assess the accuracy of point-of-care ultrasound in verifying the correct position of the ETT and to compare it with the accuracy of auscultation.

Methods

Forty-two adult patients requiring general anesthesia with ETT were consented. Patients were randomized to right main bronchus, left main bronchus, or tracheal intubation. After randomization, the ETT was placed via fiber-optic visualization. Next, the location of the ETT was assessed using auscultation by a separate blinded anesthesiologist, followed by an ultrasound performed by a third blinded anesthesiologist. Ultrasound examination included assessment of tracheal dilation via cuff inflation with air and evaluation of pleural lung sliding. Statistical analysis included sensitivity, specificity, positive predictive value, negative predictive value, and interobserver agreement for the ultrasound examination (95% CI).

Results

In differentiating tracheal versus bronchial intubations, auscultation showed a sensitivity of 66% (0.39 to 0.87) and a specificity of 59% (0.39 to 0.77), whereas ultrasound showed a sensitivity of 93% (0.66 to 0.99) and specificity of 96% (0.79 to 1). Identification of tracheal versus bronchial intubation was 62% (26 of 42) in the auscultation group and 95% (40 of 42) in the ultrasound group (P = 0.0005) (CI for difference, 0.15 to 0.52), and the McNemar comparison showed statistically significant improvement with ultrasound (P < 0.0001). Interobserver agreement of ultrasound findings was 100%.

Conclusion

Assessment of trachea and pleura via point-of-care ultrasound is superior to auscultation in determining the location of ETT.
Treatment of subperiosteal abscesses in children: is drainage of the intramedullary canal required?
Authors: Montgomery Corey O. , Porter Austin , Sachleben Brant , Suva Larry J. , Rabenhorst Brian
Published: March 2016

Acute osteomyelitis can be successfully treated with antibiotics alone. Surgery is utilized after failure of antibiotic treatment or if an abscess is present. Limited evidence exists with regard to whether intramedullary drainage is required in addition to the drainage of the subperiosteal abscess. We reviewed our 9-year experience of treating subperiosteal abscesses identifying 68 patients. Thirty patients underwent both intramedullary and abscess drainage, whereas 38 patients underwent drainage of the abscess alone at the initial procedure. Our analysis demonstrated a statistical significance (P=0.012) and odds ratio of 6.46 in favor of an intramedullary drainage to decrease risk for need for repeat surgical treatment.
Dietary patterns and colorectal cancer risk: a meta-analysis
Authors: Feng Yu-Liang , Shu Long , Zheng Pei-Fen , Zhang Xiao-Yan , Si Cai-Juan , Yu Xiao-Long , Gao Wei , Zhang Lun
Published: March 2016

The analysis of dietary patterns has recently drawn considerable attention as a method of investigating the association between the overall whole diet and the risk of colorectal cancer. However, the results have yielded conflicting findings. Here, we carried out a meta-analysis to identify the association between dietary patterns and the risk of colorectal cancer. A total of 40 studies fulfilled the inclusion criteria and were included in this meta-analysis. The highest category of ‘healthy’ dietary pattern compared with the lowest category was apparently associated with a decreased risk for colorectal cancer [odds ratio (OR)=0.75; confidence interval (CI): 0.68–0.83; P<0.00001]. An increased risk of colorectal cancer was shown for the highest compared with the lowest category of a ‘western-style’ dietary pattern (OR=1.40; CI: 1.26–1.56; P<0.00001). There was an increased risk of colorectal cancer in the highest compared with the lowest category of ‘alcohol-consumption’ pattern (OR=1.44; CI: 1.13–1.82; P=0.003). The results of this meta-analysis indicate that a ‘healthy’ dietary pattern may decrease the risk of colorectal cancer, whereas ‘western-style’ and ‘alcohol-consumption’ patterns may increase the risk of colorectal cancer.
Metformin and the risk of renal cell carcinoma: a case–control analysis
Authors: Becker Claudia , Jick Susan S. , Meier Christoph R. , Bodmer Michael
Published: March 2016

Metformin use has been associated previously with a decreased risk of cancer, but its association with renal cell carcinoma has not yet been investigated in observational studies. We aimed to explore the association between the use of metformin and other antidiabetic drugs and the risk of renal cell carcinoma (RCC). We carried out a case–control analysis in the UK-based Clinical Practice Research Datalink. We included individuals with an incident RCC between January 1995 and December 2013 younger than the age of 90 years. Six controls per case were matched on age, sex, calendar time, general practice, and number of years of active history in the Clinical Practice Research Datalink before the index date. We included BMI, smoking, alcohol consumption, hypertension, and diabetes mellitus as potential confounders in a multivariate model using conditional logistic regression to calculate odds ratios with 95% confidence intervals, and we carried out a sensitivity analysis restricted only to diabetic cases and controls. Long-term use of metformin was not associated with an altered relative risk of RCC (≥30 prescriptions, adjusted odds ratio 1.18, 95% confidence interval 0.88–1.58), nor was use of other antidiabetic drugs. Results in the sensitivity analysis including only diabetic cases and controls were largely the same. Use of metformin or other antidiabetic drugs was not associated with a materially altered risk of RCC. Further studies are warranted.
Neoadjuvant Therapy for Pancreatic Cancer
Authors: Verma Vivek , Li Jinluan , Lin Chi
Published: March 2016

The purpose of this review was to assess whether neoadjuvant chemotherapy and chemoradiotherapy (CRT) result in differential postoperative morbidity and mortality as compared with pancreatic tumor resection surgery alone. Using PRISMA guidelines and the PubMed search engine, we reviewed all prospective phase II trials of neoadjuvant chemotherapy and CRT for pancreatic cancer that examined postoperative morbidities and mortalities. A total of 30 articles were identified, collated, and analyzed. Risks of postoperative complications vary based on trial. With surgery alone, the most common postoperative complications included delayed gastric emptying (DGE) (17% to 24%), pancreatic fistula (10% to 20%), anastomotic leaks (0% to 15%), postoperative bleeding (2% to 13%), and infections/sepsis (17% to 20%). With surgery alone, the mortality was <5%. Neoadjuvant chemotherapy showed comparable fistula rates (3% to 4%), leaks (3% to 11%), infection (3% to 7%), with mortality 0% to 4% in all but 1 study. CRT for resectable/borderline resectable patients also showed comparable complication rates: DGE (6% to 15%), fistulas (2% to 3%), leaks (3% to 7%), bleeding/hemorrhage (2% to 13%), infections/sepsis (3% to 19%), with 9/13 studies showing a mortality of ≤4%. As compared with initially borderline/resectable tumors, CRT for initially unresectable tumors (despite less data) showed higher complication rates: DGE (13% to 33%), fistulas (3% to 25%), infections/sepsis (3% to 16%). However, the confounding factor of the potentially higher tumor burden as an associative agent remains. The only parameters slightly higher than historical surgery-only complication rates were leaks and bleeding/hemorrhage (13% to 20%). Mortality rates in these patients were consistently 0%, with 2 outliers. Hence, neoadjuvant chemotherapy/CRT is safe from a postoperative complication standpoint, without significant increases in complication rates compared with surgery alone. Resectable and borderline resectable patients have fewer complications as compared with unresectable patients, although data for the latter are lacking.
Trabeculectomy Outcomes by Supervised Trainees in a Veterans Affairs Medical Center
Authors: Biggerstaff Kristin S. , Vincent Ryan D. , Lin Albert P. , Orengo-Nania Silvia , Frankfort Benjamin J.
Published: March 2016

Purpose:

To evaluate the outcomes of trabeculectomy performed in an ophthalmology training program.

Design:

Retrospective study.

Participants:

A total of 160 patients undergoing trabeculectomy performed by a resident or fellow under attending supervision.

Materials and Methods:

Trabeculectomy surgeries performed by a supervised resident or fellow surgeon between October 2000 and April 2010 were reviewed. Success was considered to be complete or partial if intraocular pressure (IOP)-lowering medications were not or were required to achieve IOP≤21 mm Hg, respectively. Failure was defined as IOP>21 mm Hg on 2 consecutive visits, loss of light perception vision, IOP≤5 on 2 consecutive visits with associated visual acuity loss of ≥2 lines, or need for surgical intervention. Trabeculectomy survival was determined using Kaplan-Meier analysis through 60 months of follow-up.

Main Outcome Measures:

Final IOP, success/failure rate.

Results:

Complete success was achieved in 65 patients (41%). The average final IOP of this group was 9.1±3.7 mm Hg. Qualified success was achieved in 56 patients (35%). The average final IOP of this group was 11.5±6.4 mm Hg. At 60 months, the estimated cumulative probability of survival for complete and qualified successes was 28.9% and 63.7%, respectively.

Conclusions:

Among patients undergoing trabeculectomy by supervised residents or glaucoma fellows in a large Veterans Affairs Medical Center, IOP reduction was significant and similar to published studies. Trabeculectomy remains a successful intervention to lower IOP, with satisfactory success rates in the hands of trainee surgeons.
Suture Trabeculotomy Ab Interno for Secondary Glaucoma Combined With Scleromalacia
Authors: Manabe Shin-ichi , Sawaguchi Shoichi , Hayashi Ken
Published: March 2016

Purpose:

To report 2 cases of secondary glaucoma combined with scleromalacia that were successfully treated with trabeculotomy ab interno.

Design:

Retrospective case report

Methods:

Trabeculotomy ab interno was used to treat secondary glaucoma combined with scleromalacia, which occurred due to refractory scleritis, in 2 cases. In case 2, goniosynechialysis was performed before the trabeculotomy to identify the trabecular meshwork. The sclera and conjunctiva were not incised in either case.

Results:

The patients’ postoperative intraocular pressure (IOP) levels (which were achieved without medication) were lower than their preoperative IOP levels (which were recorded during the administration of the maximum tolerable medication dosage); that is, they had dropped from 24 to 12 mm Hg in case 1 and from 33 to 11 mm Hg in case 2 by 12 postoperative months. No recurrent scleritis or postoperative worsening of the patient’s scleromalacia was seen in either case.

Conclusions:

Trabeculotomy ab interno is a very valuable treatment for secondary glaucoma combined with scleromalacia.
The mitochondrial metabolic checkpoint and aging of hematopoietic stem cells
Authors: Mohrin Mary , Chen Danica
Published: March 2016

Purpose of review

Cell-cycle checkpoints are surveillance mechanisms in eukaryotic cells that monitor the condition of the cell, repair cellular damages, and allow the cell to progress through the various phases of the cell cycle when conditions become favorable. We review recent advances in hematopoietic stem cell (HSC) biology, highlighting a mitochondrial metabolic checkpoint that is essential for HSCs to return to the quiescent state.

Recent findings

As quiescent HSCs enter the cell cycle, mitochondrial biogenesis is induced, which is associated with increased mitochondrial protein folding stress and mitochondrial oxidative stress. Mitochondrial unfolded protein response and mitochondrial oxidative stress response are activated to alleviate stresses and allow HSCs to exit the cell cycle and return to quiescence. Other mitochondrial maintenance mechanisms include mitophagy and asymmetric segregation of aged mitochondria.

Because loss of HSC quiescence results in the depletion of the HSC pool and compromised tissue regeneration, deciphering the molecular mechanisms that regulate the mitochondrial metabolic checkpoint in HSCs will increase our understanding of hematopoiesis and how it becomes dysregulated under pathological conditions and during aging. More broadly, this knowledge is instrumental for understanding the maintenance of cells that convert between quiescence and proliferation to support their physiological functions.
Expression of Cancer Stem Cell Markers OCT4 and CD133 in Transitional Cell Carcinomas
Authors: Sedaghat Shirin , Gheytanchi Elmira , Asgari Mojgan , Roudi Raheleh , Keymoosi Hossein , Madjd Zahra
Published: March 2016

Background:

Treatment failure, recurrence, and metastasis in bladder cancer are attributed to a subset of tumor cells expressing cancer stem cell (CSC) markers. This study aimed to explore the expression levels and the clinical significance of putative CSC markers OCT4 and CD133 in bladder cancer.

Materials and Methods:

Tissue microarray-based immunohistochemical analysis was applied to investigate the expression patterns of potential CSC markers OCT4 and CD133 in bladder cancer samples. The correlation between the expressions of each marker and clinicopathologic parameters was then analyzed.

Results:

There was a significant association between OCT4 expression and the TNM stage of bladder cancer (P<0.001). Our analysis demonstrated a significant association between the intensity of staining and the presence of lamina propria and muscularis propria invasion (P=0.02 and 0.02, respectively), whereas a relative inverse correlation was found between CD133 expression with lamina propria invasion (P=0.051) and muscularis propria invasion (P=0.07).

Conclusions:

The correlation of OCT4, but not CD133, with the invasiveness of bladder cancer revealed that OCT4 can be considered as a key regulator of tumor progression, aggressive behavior, and metastasis; therefore, OCT4 can be a potential marker for targeted therapy of bladder cancer.
Immunohistochemistry for 2-Succinocysteine (2SC) and Fumarate Hydratase (FH) in Cutaneous Leiomyomas May Aid in Identification of Patients With HLRCC (Hereditary Leiomyomatosis and Renal Cell Carcinoma Syndrome)
Authors: Buelow Benjamin , Cohen Jarish , Nagymanyoki Zoltan , Frizzell Norma , Joseph Nancy M. , McCalmont Timothy , Garg Karuna
Published: March 2016

Hereditary leiomyomatosis and renal cell carcinoma syndrome (HLRCC) is caused by germline mutations in the fumarate hydratase (FH) gene and predisposes to cutaneous and uterine leiomyomas and renal cell carcinoma (RCC). HLRCC-associated renal tumors are clinically aggressive, and patients would benefit from surveillance and early detection. Cutaneous leiomyomas that occur in association with HLRCC typically present early and are multiple. Thus far, the presence of certain morphologic features (large eosinophilic macronucleoli surrounded by halos and eosinophilic cytoplasmic inclusions) in RCC and uterine leiomyomas has been shown to correlate with FH mutations. Immunohistochemistry (IHC) for 2-succinocysteine (2SC) and FH has also been shown to correlate well with FH gene mutation status in RCC and uterine leiomyomas. The aim of this study was to assess the effectiveness of morphologic features and IHC at predicting FH gene mutations in cutaneous leiomyomas. We identified 22 patients with multiple cutaneous leiomyomas (40 total MCLs) and 25 patients with single leiomyomas (25 SCLs). Mutations in the FH gene were detected in 11 of 13 (85%) sequenced MCLs and 1 of 11 (9%) SCLs. A strong association was observed between 2SC positivity by IHC and presence of FH gene mutation (P=0.0028 for 2SC) but not with FH loss by IHC (P=0.4 for FH). All 11 MCLs with an FH mutation showed positive staining for 2SC, whereas 6 of 11 showed complete loss of FH staining. Our study suggests that the presence of MCLs should raise the possibility of HLRCC. IHC for FH and 2SC is helpful in detection of FH gene mutations and should be considered in all newly diagnosed cutaneous leiomyomas.
Can Telemedicine Improve Adherence to Resuscitation Guidelines for Critically Ill Children at Community Hospitals? A Randomized Controlled Trial Using High-Fidelity Simulation
Authors: Yang Chris P. , Hunt Elizabeth A. , Shilkofski Nicole , Dudas Robert , Egbuta Chinyere , Schwartz Jamie M.
Published: March 2016

Objectives

Children transferred from community hospitals lacking specialized pediatric care are more seriously ill than those presenting to pediatric centers. Pediatric consultation and adherence to management guidelines improve outcomes. The aims of the study were (1) to assess whether telemedicine consultation in critical situations is feasible and (2) to compare the impact of pediatric critical care medicine (PCCM) consultation via telemedicine versus telephone on community hospital adherence to resuscitation guidelines through a randomized controlled telemedicine trial.

Methods

In situ, high-fidelity simulation scenarios of critically ill children presenting to a community hospital and progressing to cardiopulmonary arrest were performed. Scenarios were randomized to PCCM consultation via telephone (control) or telemedicine (intervention). Primary outcome measure was proportion of teams who successfully defibrillated in 180 seconds or less from presentation of pulseless ventricular tachycardia.

Results

The following 30 scenarios were completed: 15 control and 15 intervention. Only 11 (37%) of 30 teams, defibrillated in 180 seconds or less from presentation of pulseless ventricular tachycardia; control: 6 (40%) of 15 versus intervention: 5 (33%) of 15, P = 0.7. Request for or use of backboard during cardiopulmonary resuscitation occurred in 24 (80%) of 30 scenarios; control: 9 (60%) of 15 versus intervention: 15 (100%) of 15, P = 0.006. Request for or use of stepstool during cardiopulmonary resuscitation occurred in 6 (20%) of 30 scenarios; control: 1 (7%) of 15 versus intervention: 5 (33%) of 15, P = 0.07.

Conclusions

This study demonstrates the feasibility of using telemedicine to support acute management of children who present to community hospitals. Neither study arm adhered to current resuscitation guidelines and telemedicine consultation with PCCM experts was not associated with improvement. However, further research on optimizing telemedicine impact on the quality of pediatric care at community hospitals is warranted.
Membrane association of SadC enhances its diguanylate cyclase activity to control exopolysaccharides synthesis and biofilm formation in Pseudomonas aeruginosa
Authors: Zhu Bin , Liu Cuilan , Liu Shiheng , Cong Hengjiang , Chen Yihuan , Gu Lichuan , Ma Luyan Z.
Published: March 2016

Cyclic diguanosine monophosphate (c‐di‐GMP) is one of the most important bacterial second messengers that controls many bacterial cellular functions including lifestyle switch between plankton and biofilm. Surface attachment defective (SadC) is a diguanylate cyclase (DGC) involved in the biosynthesis of c‐di‐GMP in Pseudomonas aeruginosa, an opportunistic pathogen that can cause diverse infections. Here we report the crystal structure of GGDEF domain from SadC and the critical role of the trans‐membrane (TM) domain of SadC with regard to biofilm formation, exopolysaccharide production and motility. We showed that over‐expression of SadC in P. aeruginosa PAO1 totally inhibited swimming motility and significantly enhanced the production of exopolysaccharide Psl. SadC lacking TM domains (SadC300–487) could not localize on cytoplasmic membrane and form cluster, lost the ability to inhibit the swimming and twitching motility, and showed the attenuated activity to promote Psl production despite that SadC300–487 was able to catalyze the synthesize of c‐di‐GMP in vitro and in vivo. The GGDEF domain of SadC has a typical GGDEF structure and the α‐helix connected the TM domains with SadC GGDEF domain is essential for SadC to form DGC oligomers. Our data imply that membrane association of SadC promotes its DGC activity by affecting the formation of active DGC oligomers.
Spontaneous intracranial hypotension following epidural anesthesia: a case report
Authors: An X. , Wu S. , He F. , Li C. , Fang X.
Published: March 2016

We report a case of refractory spontaneous intracranial hypotension (SIH) following epidural anesthesia. In this case, typical clinical symptoms and concomitant use of regional anesthesia led to the misdiagnosis of SIH as post‐dural puncture headache (PDPH). A 56‐year‐old man received a successful appendectomy under epidural anesthesia performed at a T11–T12 intravertebral space. About 20 h later, the patient started complaining about orthostatic headache when getting up from his lying position, then a PDPH was diagnosed. However, the patient did not respond well to conservative treatment. Three months later, the first epidural blood patch was performed at the L3–L4 level, however, the patient still had an orthostatic headache. Five days later, spine magnetic resonance imaging showed multiple meningeal diverticulum in the cervicothoracic junction, and computerized tomography myelography demonstrated a C5–C6 spinal dural tear suggesting cerebrospinal fluid leaks. Finally, the patient was diagnosed as SIH and received a second epidural blood patch at the T2–T3 level and responded with improvements in symptomatology. The patient was then discharged, and at a 2‐year follow‐up, he had fully recovered except for some remaining neck stiffness. This case illustrates that SIH was misdiagnosed as PDPH because of the common clinical symptoms and potentially confounding events (epidural/spinal anesthesia and assumption that it was a case of PDPH). It is important to carefully observe patients in such conditions and promptly conduct suitable diagnostic tests. For a successful treatment of SIH, a timely epidural blood patch should be considered as soon as the diagnosis is established.
Usability of dexmedetomidine for deep sedation in infants and small children with respiratory morbidities
Authors: Najafi N. , Veyckemans F. , Van de Velde A. , Poelaert J.
Published: March 2016

Background

Children with respiratory morbidities are at increased risk of developing adverse respiratory events while undergoing deep sedation. Dexmedetomidine possesses sedative properties with minimal respiratory depression. This report aimed to determine the usability of dexmedetomidine in children with significant respiratory morbidities who require deep sedation.

Methods

Medical records of children with ASA classification III who had at least three characteristics of respiratory morbidities and who received dexmedetomidine sedation for magnetic resonance imaging (MRI) between January 2014 and May 2015 were retrospectively reviewed. Dexmedetomidine was administered as a bolus of 1 μg/kg over 10 min followed by 1 μg/kg/h infusion. If necessary, an additional bolus dose was given and the infusion rate was increased to 2 μg/kg/h. Respiratory morbidities, haemodynamic parameters, total dexmedetomidine dose, adverse cardiorespiratory events and sedation characteristics were analysed.

Results

Nineteen out of 642 children who underwent MRI were eligible for evaluation. Seventeen children (89%) had at least four characteristics of respiratory morbidities. The median [IQR] age was 9 months [3.5–14]. All patients completed MRI scans while breathing spontaneously via the native airway. No episodes of adverse respiratory events or haemodynamic instability were observed. Children who were administered a lower dexmedetomidine dose and had a shorter sedation time were more likely to be younger than 1 year of age.

Conclusion

These data demonstrate that dexmedetomidine deep sedation was well‐tolerated in children with significant respiratory morbidities. Moreover, children younger than 1 year of age were administered lower dexmedetomidine dose than children older than 1 year of age for the same sedation level.

Trial registration

ClinicalTrials.gov identifier NCT02555605.
Laparoscopic revision of Roux‐en‐Y gastric bypass to sleeve gastrectomy: A ray of hope for failed Roux‐en‐Y gastric bypass
Authors: Lakdawala Muffazal , Limas Peter , Dhar Shilpa , Remedios Carlyne , Dhulla Neha , Sood Amit , Bhasker Aparna Govil
Published: March 2016

Introduction

Roux‐en‐Y gastric bypass (RYGB) is the most commonly performed bariatric operation across the world, but sometimes revision is necessary. Inadequate weight loss, weight regain, and complications such as dumping syndrome are common reasons for revision. We report the 1‐year outcomes of five patients who underwent laparoscopic conversion of RYGB to sleeve gastrectomy during surgical revision.

Methods

Mean age was 38.8 ± 9.1 years. Mean BMI at primary surgery was 57.9 ± 8.1 kg/m2. Two patients were diabetic and sleep apneic. One was hypertensive. All patients underwent a RYGB as the primary weight loss procedure. Mean weight loss was 36.8 ± 8.6 kg (excess weight loss  = 39.8 ± 14.9%) at 2 years. At the end of 5 years, these patients regained 10.9 ± 4.1 kg (31.5 ± 13.6% of excess weight loss). Primary indications for revision surgery were failure to lose weight, weight regain, and intractable dumping syndrome. Mean duration between primary and revision surgery was 6.2 ± 1.1 years. RYGB was converted to sleeve gastrectomy as a first stage in all cases.

Results

Mean duration of revision surgery was 120.0 ± 15.5 min. Mean blood loss was 70 ± 50 mL. One year after revision surgery, a mean weight loss of 21.5 ± 10.5 kg was achieved (mean excess weight loss = 35.8 ± 8.8%). Two patients with type 2 diabetes mellitus and the one with hypertension achieved remission. Dumping was resolved. There were no complications.

Conclusion

Laparoscopic conversion of RYGB to sleeve gastrectomy as a first stage may be considered as an additional option in the armamentarium of revision procedures after RYGB.
The Role of NGOs in Ameliorating Sweatshop‐like Conditions in the Global Supply Chain: The Case of Fair Labor Association (FLA), and Social Accountability International (SAI)
Authors: Sethi S. Prakash , Rovenpor Janet L.
Published: March 2016

Over the last 20+ years, globalization has made international trade and investment more efficient and productive. In the absence of coordinated global regulatory regimes, it has also made multinational corporations (MNCs) impervious to social concerns in the countries where they operate. There is considerable debate in the academic, political, and business arena as to the causes of the apparently inequitable distribution of benefits between labor and capital. Notwithstanding, the relative merits of this debate, and facing tremendous societal pressure, companies have adopted voluntary codes of conduct to ensure that workers making products for them in poor and developing countries are protected from hazardous working conditions and receive wages that meet local laws and market conditions. These codes, however, suffer from a lack of credibility and proof of substantive compliance. A new type of nongovernmental organization (NGO) has emerged that monitors a company's compliance with prespecified standards and provides assurance to the external stakeholders that the company has fulfilled its voluntary obligations. From an historical perspective, this has been an innovative phenomenon where the monitoring organization purports to act as an honest broker to ensure all concerned that the company/industry has fulfilled its obligations. In this article, we undertake a thorough examination of two such organizations, that is, Fair Labor Association, and Social Accountability International, that have played a pioneering role in bridging the gap between societal expectations and corporate performance. We examine their governance structures, operating procedures, monitoring standards, and public disclosure of findings, and above all, their success in improving the level of corporate compliance with their self‐created codes or standards. Unfortunately, our findings and conclusions are disappointing. In our view, the two groups have mostly failed to meet their avowed goals. Rather than using their NGO status to help companies improve their code compliance, they have suffered from managerial capture and have been reduced to corporate apologists.
Alpha‐Synuclein as a Biomarker for Parkinson's Disease
Authors: Atik Anzari , Stewart Tessandra , Zhang Jing
Published: March 2016

Parkinson's disease (PD) is a common neurodegenerative disorder, characterized pathologically by the presence of α‐synuclein (α‐syn)‐rich Lewy bodies. As clinical diagnosis of PD is challenging, misdiagnosis is common, highlighting the need for disease‐specific and early stage biomarkers. Both early diagnosis of PD and adequate tracking of disease progression could significantly improve outcomes for patients, particularly in regard to existing and future disease modifying treatments. Given its critical roles in PD pathogenesis, α‐syn may be useful as a biomarker of PD. The aim of this review is, therefore, to summarize the efficacy of tissue and body fluid α‐syn measurements in the detection of PD as well as monitoring disease progression. In comparison to solid tissue specimens and biopsies, biofluid α‐syn levels may be the most promising candidates in PD diagnosis and progression based on specificity, sensitivity and availability. Although α‐syn has been tested most extensively in cerebrospinal fluid (CSF), the relatively invasive procedure for collecting CSF is not suitable in most clinical settings, leading to investigation of plasma, blood and saliva as alternatives. The exploration of combined biomarkers, along with α‐syn, to improve diagnostic accuracy is also likely required.
Effect of previous vaccination with pneumococcal conjugate vaccine on pneumococcal polysaccharide vaccine antibody responses
Authors: Schaballie H , Wuyts G , Dillaerts D , Frans G , Moens L , Proesmans M , Vermeulen F , De Boeck K , Meyts I , Bossuyt X
Published: March 2016

During the past 10 years, pneumococcal conjugate vaccine (PCV) has become part of the standard childhood vaccination programme. This may impact upon the diagnosis of polysaccharide antibody deficiency by measurement of anti-polysaccharide immunoglobulin (Ig)G after immunization with unconjugated pneumococcal polysaccharide vaccine (PPV). Indeed, contrary to PPV, PCV induces a T-dependent, more pronounced memory response. The antibody response to PPV was studied retrospectively in patients referred for suspected humoral immunodeficiency. The study population was divided into four subgroups based on age (2–5 years versus ≥ 10 years) and time tested (1998–2005 versus 2010–12). Only 2–5-year-old children tested in 2010–12 had been vaccinated with PCV prior to PPV. The PCV primed group showed higher antibody responses for PCV–PPV shared serotypes 4 and 18C than the unprimed groups. To a lesser extent, this was also found for non-PCV serotype 9N, but not for non-PCV serotypes 19A and 8. Furthermore, PCV-priming elicited a higher IgG2 response. In conclusion, previous PCV vaccination affects antibody response to PPV for shared serotypes, but can also influence antibody response to some non-PCV serotypes (9N). With increasing number of serotypes included in PCV, the diagnostic assessment for polysaccharide antibody deficiency requires careful selection of serotypes that are not influenced by prior PCV (e.g. serotype 8). Further research is needed to identify more serotypes that are not influenced.
The experience of women living with Congenital Adrenal Hyperplasia: impact of the condition and the care given
Authors: Engberg Hedvig , Möller Anders , Hagenfeldt Kerstin , Nordenskjöld Agneta , Frisén Louise
Published: March 2016

Context

Congenital adrenal hyperplasia (CAH) is caused most often by mutations in theCYP21A2gene, resulting in cortisol and aldosterone deficiency and increased production of androgens.

Objective

To describe how women withCAHexperience their condition and the care given.

Design, setting and participants

Semi‐structured interviews with 13 adult Swedish women withCAHwere transcribed. Data were analysed by qualitative content analysis to describe the variability in the experiences.

Main outcome measures

Qualitative evaluation of the participants’ life experiences.

Results

The participants’ experiences of havingCAHare described in four different categories. 1. Information comprises the experiences of interaction with healthcare providers, knowledge acquisition and information disclosure. 2. Exposure encompasses the experiences of genital examinations, the medical focus on the genitalia and of being photographed repeatedly. 3. Health covers the self‐perceived experiences of having a medical condition that requires pharmacological treatment and sometimes surgery. 4. Research comprises the experiences of having a scientifically well‐studied condition. Different experiences of shame reoccur in all categories, thus forming the latent theme.

Conclusion

The experience of living with congenital adrenal hyperplasia can be facilitated by increased information and by acknowledging that women withCAHare a heterogeneous group with individual needs. Shame may be counterbalanced by increased parental support and increased knowledge among healthcare personnel aimed at providing children with continuous support and coping strategies during their upbringing. Based on the identified themes in this study, there are several research avenues to pursue in the future.
‘For the Elections, We Want Women!’: Closing the Gender Gap in Zambian Politics
Authors: Evans Alice
Published: March 2016

This article examines the causes of women's rising political participation in Zambia. It argues that women's historical paucity in politics was largely the result of widely‐shared gender stereotypes. These are now weakening due to growing flexibility in gender divisions of labour, which has been catalysed by worsening economic security. By performing work previously presumed to be beyond their abilities and valorized because of its association with masculinity, such women are increasingly perceived as equally capable of leadership. This gradual erosion of gender beliefs has fostered women's political participation and leadership in Zambia.
Why Gross National Disposable Income Should Replace Gross National Income
Authors: Capelli Clara , Vaggi Gianni
Published: March 2016

Unilateral transfers, and notably remittances, are a growing source of income for developing countries. However, Gross National Income (GNI), which is widely used as an indicator for living standards, does not record them. Gross National Disposable Income (GNDI), by contrast, includes both income and unilateral transfers, thus providing a more exhaustive account of people's available income in an open economy. Yet, GNDI is rarely available in major reports and is sometimes confused with the GNI. This article calculates the GNDI for 27 countries amongst the world's top remittance receivers and demonstrates the usefulness of this measure for analysis and policy making in developing countries. The article also provides some critical insights into the role of income and unilateral transfers in the balance of payments.
Glucose and lipid effects of the ileal apical sodium‐dependent bile acid transporter inhibitor GSK2330672: double‐blind randomized trials with type 2 diabetes subjects taking metformin
Authors: Nunez D. J. , Yao X. , Lin J. , Walker A. , Zuo P. , Webster L. , Krug‐Gourley S. , Zamek‐Gliszczynski M. J. , Gillmor D. S. , Johnson S. L.
Published: March 2016

Aims

To investigate the pharmacodynamics, pharmacokinetics and safety/tolerability of blocking reuptake of bile acids using the inhibitor GSK2330672 (GSK672) in patients with type 2 diabetes (T2D).

Methods

Subjects with T2D taking metformin were enrolled in two studies in which they took metformin 850 mg twice daily for 2 weeks prior to and during the randomized treatment periods. In the first crossover study (n = 15), subjects received GSK672 45 mg, escalating to 90 mg, twice daily, or placebo for 7 days. The second parallel‐group study (n = 75) investigated GSK672 10–90 mg twice daily, placebo or sitagliptin for 14 days.

Results

In both studies, GSK672 reduced circulating bile acids and increased serum 7‐α‐hydroxy‐4‐cholesten‐3‐one (C4), an intermediate in the hepatic synthesis of bile acids. Compared with placebo, in the parallel‐group study 90 mg GSK672 twice daily reduced fasting plasma glucose [FPG; −1.21 mmol/l; 95% confidence interval (CI) −2.14, −0.28] and weighted‐mean glucose area under the curve (AUC)0–24 h (−1.33 mmol/l; 95% CI −2.30, −0.36), as well as fasting and weighted‐mean insulin AUC0–24 h. GSK672 also reduced cholesterol (LDL, non‐HDL and total cholesterol) and apolipoprotein B concentrations; the maximum LDL cholesterol reduction was ∼40%. There was no change in HDL cholesterol but there was a trend towards increased fasting triglyceride levels in the GSK672 groups compared with placebo. In both studies, the most common adverse events associated with GSK672 were gastrointestinal, mostly diarrhoea (22–100%), which appeared to be independent of dose.

Conclusions

In subjects with T2D on metformin, GSK672 improved glucose and lipids, but there was a high incidence of gastrointestinal adverse events.
Myrmecophilous butterflies utilise ant–treehopper associations as visual cues for oviposition
Authors: MOTA LUÍSA L. , OLIVEIRA PAULO S.
Published: March 2016

1. Selection of a safe oviposition site is important for herbivorous insects whose immature stages have limited mobility. Female herbivores rely on environmental cues for this choice, and presence of natural enemies or mutualistic partners may be important in this process.

2. Some butterflies have mutualistic interactions with ants (myrmecophily), in which caterpillars offer a nutritional liquid and gain protection against natural enemies. Participants in butterfly–ant mutualisms may utilise signals to initiate interactions, but the use of visual cues by ovipositing myrmecophilous butterflies remains uncertain.

3. Larvae of facultatively myrmecophilous Parrhasius polibetes (Lycaenidae) feed on Schefflera vinosa, and females prefer to oviposit near aggregations of the ant‐tended treehopper Guayaquila xiphias, where caterpillars survive better due to increased ant attendance. Given the conspicuousness of ant–treehopper associations, it was investigated whether butterflies use them as visual cues for oviposition and, if so, which participants of the association are used as cues: ants, treehoppers, or both.

4. Experiments using dried insects on paired branches revealed that females visually recognise ants and ant–treehopper associations, using them for egg‐laying decisions. However, presence of a treehopper aggregation alone had no effect on oviposition choices.

5. This is a first insight into the importance of visual discrimination for ovipositing myrmecophilous butterflies. The results show that facultative mutualisms can be important enough to promote a behavioural adaptation (visual detection of ants) reinforcing the interaction. Our research highlights the importance of the behavioural interface within complex multispecies systems.