bluuebunny/crossref_metadata_2025 huggingface dataset:
Organizational Structures for International Universities
Authors: Edwards Ron , Crosling Glenda , Lim Ngat-Chin
Published: July 2013

One significant form of transnational higher education is the International Branch Campus (IBC), in effect an “outpost” of the parent institution located in another country. Its organizational structure is alignable with offshore subsidiaries of multinational corporations (MNCs). The implications of organizational structure for academic freedom in teaching and research are discussed in this article. Drawing on examples from the literature, the investigation shows that over time as the IBC establishes its reputation locally, there is pressure for an increase in the academic freedom of academic staff. Our study suggests that over time and depending on the strategic choice of the parent university, the maturity of the offshore institution can be reflected in the increased academic freedom afforded to academic staff. In the interim, the limits to academic freedom and organizational constraints to intercampus collegiality can often lead to conflict.
Contextual synchronization for efficient social collaborations in enterprise computing: A case study on TweetPulse
Authors: Jung Jason J
Published: July 2013

It is important to be aware of user contexts for supporting efficient collaborations among them. The goal of this article is to present a social collaboration platform where we can understand (1) how the user contexts are dynamically changing over time and (2) how the user contexts are mixed with multiple sub-contexts together. Therefore, we have implemented TweetPulse, which is a Twitter-based tool for context monitoring and propagation system in a given social network. TweetPulse can match contexts of the users (and integrate them) to find the most relevant users. Eventually, collaborations among users are contextually synchronized by dynamically organizing a number of communities. A set of users in each community can share their skills and core competencies with each other. We have shown the experimental results collected from a collaborative information searching system in terms of (1) setting thresholds, (2) searching performance, and (3) robustness testing.
Transitional Cell Carcinoma of the Retrorectal Space Arisen in Tailgut Cyst
Authors: Vinciguerra Gian Luca Rampioni , Mercantini Paolo , La Torre Marco , Pilozzi Emanuela , Ziparo Vincenzo , Vecchione Andrea
Published: July 2013

Tailgut cysts, also known as retrorectal cystic hamartomas, are congenital lesions derived by an abnormal remnant of the postanal primitive hindgut, consisting of unilocular or multilocular cysts usually lined by squamous, transitional, or glandular epithelium. Malignant transformation is an uncommon event, and it mainly involves the neuroendocrine or glandular epithelium; other histotypes are sporadic. Here, we report, for the first time, the clinicopathological features of a transitional cell carcinoma that arose in a tailgut cyst.
Age, Actuarial Risk, and Long-Term Recidivism in a National Sample of Sex Offenders
Authors: Nicholaichuk Terry P. , Olver Mark E. , Gu Deqiang , Wong Stephen C. P.
Published: July 2013

Age at release has become an increasing focus of study with regard to evaluating risk in the sex offender population and has been repeatedly shown to be an important component of the risk assessment equation. This study constitutes an extension of a study of sex offender outcomes prepared for the Evaluation Branch, Correctional Service of Canada. The entire cohort of 2,401 male federally incarcerated sexual offenders who reached their warrant expiry date (WED) within 1997/1998, 1998/1999, and 1999/2000 fiscal years were reviewed for the study. Sexual and violent reconviction information was obtained from CPIC criminal records over an average of 12.0 years ( SD = 1.7) follow-up. This study focused upon the cohort of sex offenders who were 50 years or older at time of release ( N = 542). They were stratified according to risk using a brief actuarial scale (BARS) comprising six binary variables. For the most part, older offenders showed low base rates of sexual recidivism regardless of the risk band into which they fell. The exception was a small group of elderly offenders ( n = 20) who fell into the highest risk band, and who showed high levels of sexual recidivism. The results of this combination of cross-sectional and longitudinal analyses of elderly sexual offenders may have important implications for offender management, particularly in light of the increasing numbers of offenders in Canada who fall into the over 50 age cohort.
Health Care Costs Associated With Parent-Reported ADHD: A Longitudinal Australian Population–Based Study
Authors: Sciberras Emma , Lucas Nina , Efron Daryl , Gold Lisa , Hiscock Harriet , Nicholson Jan M.
Published: July 2013

Objective: To examine the health care costs associated with ADHD within a nationally representative sample of children. Method: Data were from Waves 1 to 3 (4-9 years) of the Longitudinal Study of Australian Children ( N = 4,983). ADHD was defined by previous diagnosis and a measure of ADHD symptoms (Strengths and Difficulties Questionnaire [SDQ]). Participant data were linked to administrative data on health care costs. Analyses controlled for demographic factors and internalizing and externalizing comorbidities. Results: Costs associated with health care attendances and medications were higher for children with parent-reported ADHD at each age. Cost differences were highest at 8 to 9 years for both health care attendances and medications. Persistent symptoms were associated with higher costs ( p < .001). Excess population health care costs amounted to Aus$25 to Aus$30 million over 6 years, from 4 to 9 years of age. Conclusion: ADHD is associated with significant health care costs from early in life. Understanding the costs associated with ADHD is an important first step in helping to plan for service-system changes.
Does the ‘Teddy Bear Hospital’ enhance preschool children’s knowledge? A pilot study with a pre/post-case control design in Germany
Authors: Leonhardt Corinna , Margraf-Stiksrud Jutta , Badners Larissa , Szerencsi Andrea , Maier Rolf F
Published: July 2013

The ‘Teddy Bear Hospital’ is a medical students’ project, which has been increasingly established in many countries. To evaluate this concept, we examined the effects of a German Teddy Bear Hospital on children’s knowledge relating to their body, health and disease. Using a quasi-experimental pre/post design, we examined 131 preschool children from 14 German kindergartens with pictorial interview-based scales. The analysis of covariance revealed that the children who visited the Teddy Bear Hospital had a significantly better knowledge concerning their body, health and disease than the children from the control group. This German Teddy Bear Hospital is a good health education vehicle for preschool children.
Measurement properties of the Danish version of the Illness Perception Questionnaire–Revised for patients with colorectal cancer symptoms
Authors: Hvidberg Line , Jensen Line F , Pedersen Anette F , Aro Arja R , Vedsted Peter
Published: July 2013

The aim of this study was to validate the measurement properties of the Danish version of the Illness Perception Questionnaire–Revised adapted to measure symptom representations among patients with colorectal cancer symptoms. A total of 488 colorectal cancer patients completed a questionnaire derived from the Illness Perception Questionnaire–Revised to retrospectively assess cognitive and emotional representations of experienced symptoms. A confirmatory factor analysis indicated no good comparative fit with the Illness Perception Questionnaire–Revised. Using exploratory factor analysis, a 7-factor structure was conducted, which fairly supported the Illness Perception Questionnaire–Revised. The modified Illness Perception Questionnaire–Revised is a promising tool for measuring symptom representations among Danish colorectal cancer patients.
The personal experience of dysmenorrhoea: An interpretative phenomenological analysis
Authors: Burbeck Rachel , Willig Carla
Published: July 2013

This study explored six women’s experiences of primary dysmenorrhoea using semi-structured interviews analysed using interpretative phenomenological analysis. Rather than focusing on pain, participants broadened the study focus to coping with the menstrual process as a whole. This was seen to be mediated by menstrual taboos and by the theme of ‘order’, arising from a strong feeling of a menstrual timetable and the need for rational explanation. Another theme was pain as a separate entity, which was connected to the theme of order. Placing dysmenorrhoea in its context may be useful for health-care professionals treating women with the condition.
Relaxation and guided imagery used with 12-year-olds during venipuncture in a school-based screening study
Authors: Forsner Maria , Norström Fredrik , Nordyke Katrina , Ivarsson Anneli , Lindh Viveca
Published: July 2013

Needle-related procedures are reported to be problematic for children. In a school-based celiac disease screening, 12-year-olds’ experiences with relaxation and guided imagery (R-GI) during venipuncture were investigated. One group tried nurse-led R-GI ( n = 60) and another group received standard care (SC; n = 49). A mixed method design was applied using short written narratives, facial affective scale (FAS), and visual analog scale (VAS) for pain intensity. Qualitative content analysis highlighted that diversity and contradictions when facing blood tests. FAS scores were significantly lower in the SC group before ( p = 0.01), during ( p = 0.01), and after ( p = 0.01) venipuncture. VAS scores did not differ between the groups. The blood test was mostly experienced as unproblematic, and GI during venipuncture did not decrease pain or affect. However, the fact that a number of children scored high FAS indicates a need for effective methods to help children cope with needle-related school-based procedures.
Risk-stratified imputation in survival analysis
Authors: Kennedy Richard E , Adragni Kofi P , Tiwari Hemant K , Voeks Jenifer H , Brott Thomas G , Howard George
Published: July 2013

Background

Censoring that is dependent on covariates associated with survival can arise in randomized trials due to changes in recruitment and eligibility criteria to minimize withdrawals, potentially leading to biased treatment effect estimates. Imputation approaches have been proposed to address censoring in survival analysis; while these approaches may provide unbiased estimates of treatment effects, imputation of a large number of outcomes may over- or underestimate the associated variance based on the imputation pool selected.

Purpose

We propose an improved method, risk-stratified imputation, as an alternative to address withdrawal related to the risk of events in the context of time-to-event analyses.

Methods

Our algorithm performs imputation from a pool of replacement subjects with similar values of both treatment and covariate(s) of interest, that is, from a risk-stratified sample. This stratification prior to imputation addresses the requirement of time-to-event analysis that censored observations are representative of all other observations in the risk group with similar exposure variables. We compared our risk-stratified imputation to case deletion and bootstrap imputation in a simulated dataset in which the covariate of interest (study withdrawal) was related to treatment. A motivating example from a recent clinical trial is also presented to demonstrate the utility of our method.

Results

In our simulations, risk-stratified imputation gives estimates of treatment effect comparable to bootstrap and auxiliary variable imputation while avoiding inaccuracies of the latter two in estimating the associated variance. Similar results were obtained in analysis of clinical trial data.

Limitations

Risk-stratified imputation has little advantage over other imputation methods when covariates of interest are not related to treatment. Risk-stratified imputation is intended for categorical covariates and may be sensitive to the width of the matching window if continuous covariates are used.

Conclusions

The use of the risk-stratified imputation should facilitate the analysis of many clinical trials, in which one group has a higher withdrawal rate that is related to treatment.
Multiparameter single-cell profiling of human CD4+FOXP3+ regulatory T-cell populations in homeostatic conditions and during graft-versus-host disease
Authors: Dong Shen , Maiella Sylvie , Xhaard Aliénor , Pang Yuanyu , Wenandy Lynn , Larghero Jérome , Becavin Christophe , Benecke Arndt , Bianchi Elisabetta , Socié Gérard , Rogge Lars
Published: July 2013

Key Points

Single-cell heterogeneity, rather than lineage reprogramming, explains the remarkable complexity and functional diversity of human Tregs. Altered homeostasis of Treg subpopulations in patients developing acute graft-versus-host disease.
Murine NK-cell licensing is reflective of donor MHC-I following allogeneic hematopoietic stem cell transplantation in murine cytomegalovirus responses
Authors: Sungur Can M. , Tang-Feldman Yajarayma J. , Zamora Anthony E. , Alvarez Maite , Pomeroy Claire , Murphy William J.
Published: July 2013

Key Points

Licensed NK cells based on the donor MHC-I haplotype show greater anti-MCMV resistance than unlicensed cells in allogeneic HSCT. Ly49H+ licensed NK-cell expansion based on donor MHC-I with greater IFNγ production than unlicensed NK cells is seen after MCMV infection.
Evolution of Hoxgene clusters in deuterostomes
Authors: Pascual-Anaya Juan , D’Aniello Salvatore , Kuratani Shigeru , Garcia-Fernàndez Jordi
Published: July 2013

Hox genes, with their similar roles in animals as evolutionarily distant as humans and flies, have fascinated biologists since their discovery nearly 30 years ago. During the last two decades, reports on Hox genes from a still growing number of eumetazoan species have increased our knowledge on the Hox gene contents of a wide range of animal groups. In this review, we summarize the current Hox inventory among deuterostomes, not only in the well-known teleosts and tetrapods, but also in the earlier vertebrate and invertebrate groups. We draw an updated picture of the ancestral repertoires of the different lineages, a sort of “genome Hox bar-code” for most clades. This scenario allows us to infer differential gene or cluster losses and gains that occurred during deuterostome evolution, which might be causally linked to the morphological changes that led to these widely diverse animal taxa. Finally, we focus on the challenging family of posterior Hox genes, which probably originated through independent tandem duplication events at the origin of each of the ambulacrarian, cephalochordate and vertebrate/urochordate lineages.
Mini-Mental State Examination in patients with hepatic encephalopathy and liver cirrhosis: a prospective, quantified electroencephalography study
Authors: Koziarska Dorota , Wunsch Ewa , Milkiewicz Małgorzata , Wójcicki Maciej , Nowacki Przemysław , Milkiewicz Piotr
Published: July 2013

Background

Mini-Mental State Examination (MMSE) is one of the most commonly used methods in the assessment of cognitive mental status. MMSE has been used in hepatology but its usefulness in the evaluation of hepatic encephalopathy (HE) has never been properly assessed. The aim of the study was to investigate the value of MMSE in detection of HE in patients with cirrhosis.

Methods

One hundred and one consecutive patients with liver cirrhosis underwent neurological examination, MMSE and electroencephalography (EEG). Spectral analysis of EEG was done with calculation of mean dominant frequency (MDF) and relative power of delta, theta, alpha and beta rhythms. Minimal HE was diagnosed in patients with normal neurological status and alterations in spectral EEG. Statistical analysis included Fisher’s exact and Anova analysis. Categorical data were compared using Levene’s test for equality of variances. Correlation-coefficient analysis was performed by the Pearson’s r or Z-test, as needed. Tests performance was assessed by the calculating the area under the ROC curve (AUC) and evaluating its difference from reference area (AUC=0.5). Apvalue <0.05 was considered statistically significant.

Results

Overt HE was identified in 49 (48.5%) and minimal HE in 22 (21.8%) patients. Although there were significant correlations between both severity of liver disease (Child-Pugh classification), overt HE (West-Haven criteria) and various MMSE items, MDF showed no correlation with any of MMSE items as well as MMSE summary score. MMSE (score and items) did not discriminate patients without HE and minimal HE. The only significant differences between patients without HE and with overt HE were seen in respect of MMSE score (p<0.02), orientation to place (p<0.003), repetition (p<0.01) and complex commands-understanding (p<0.02). Test performance analysis has shown that MMSE has no value as a prediction method in determining minimal HE and in respect of overt HE has a sensitivity of 63% and specificity of 52% by a cut-off level at 27.5 points to diagnose overt HE.

Conclusions

In conclusion, although MMSE score and single items are altered in patients with overt HE, MMSE has no value in the assessment of minimal HE. Because MMSE could be impaired in several cognitive dysfunctions, more specific test should be used for measuring HE.
Variants at the 9p21 locus and melanoma risk
Authors: Maccioni Livia , Rachakonda Panduranga Sivaramakrishna , Bermejo Justo Lorenzo , Planelles Dolores , Requena Celia , Hemminki Kari , Nagore Eduardo , Kumar Rajiv
Published: July 2013

Background

The influence of variants at the 9p21 locus on melanoma risk has been reported through investigation ofCDKN2Avariants through candidate gene approach as well as by genome wide association studies (GWAS).

Methods

In the present study we genotyped, 25 SNPs that tag 273 variants on chromosome 9p21 in 837 melanoma cases and 1154 controls from Spain. Ten SNPs were selected based on previous associations, reported in GWAS, with either melanocytic nevi or melanoma risk or both. The other 15 SNPs were selected to fine map theCDKN2Agene region.

Results

All the 10 variants selected from the GWAS showed statistically significant association with melanoma risk. Statistically significant association with melanoma risk was also observed for the carriers of the variant T-allele of rs3088440 (540 C>T) at the 3’ UTR ofCDKN2Agene with an OR 1.52 (95% CI 1.14-2.04). Interaction analysis between risk associated polymorphisms and previously genotypedMC1Rvariants, in the present study, did not show any statistically significant association. Statistical significant association was observed for the interaction between phototypes and the rs10811629 (located in intron 5 ofMTAP). The strongest association was observed between the homozygous carrier of the A–allele and phototype II with an OR of 15.93 (95% CI 5.34-47.54).

Conclusions

Our data confirmed the association of different variants at chromosome 9p21 with melanoma risk and we also found an association of a variant with skin phototypes.
Evaluating an implementation strategy in cardiovascular prevention to improve prescribing of statins in Germany: an intention to treat analysis
Authors: Keller Heidemarie , Hirsch Oliver , Kaufmann-Kolle Petra , Krones Tanja , Becker Annette , Sönnichsen Andreas C , Baum Erika , Donner-Banzhoff Norbert
Published: July 2013

Background

The prescription of statins is an evidence-based treatment to reduce the risk of cardiovascular events in patients with elevated cardiovascular risk or with a cardiovascular disorder (CVD). In spite of this, many of these patients do not receive statins.

Methods

We evaluated the impact of a brief educational intervention in cardiovascular prevention in primary care physicians’ prescribing behaviour regarding statins beyond their participation in a randomised controlled trial (RCT). For this, prescribing data of all patients > 35 years who were counselled before and after the study period were analysed (each n > 75000). Outcome measure was prescription of Hydroxymethylglutaryl-CoA Reductase Inhibitors (statins) corresponding to patients’ overall risk for CVD. Appropriateness of prescribing was examined according to different risk groups based on the Anatomical Therapeutic Chemical Classification System (ATC codes).

Results

There was no consistent association between group allocation and statin prescription controlling for risk status in each risk group before and after study participation. However, we found a change to more significant drug configurations predicting the prescription of statins in the intervention group, which can be regarded as a small intervention effect.

Conclusion

Our results suggest that an active implementation of a brief evidence-based educational intervention does not lead to prescription modifications in everyday practice. Physician’s prescribing behaviour is affected by an established health care system, which is not easy to change.

Trial registration

ISRCTN71348772
Impact of risk factors, activities and psychological disorders on the health of patients with chronic obstructive pulmonary disease in China: a cross-sectional study
Authors: Zhang Lei , Lou Peian , Zhu Yanan , Chen Peipei , Zhang Pan , Yu Jiaxi , Zhang Ning , Chen Na , Wu Hongmin , Zhao Jing
Published: July 2013

Background

Patients with chronic obstructive pulmonary disease (COPD) often have organ dysfunction and resulting poor quality of life; however, in China little information is available regarding factors that affect their health. Here, the relationship between risk factors, activities and psychological disorders and health of patients with COPD in rural areas of Xuzhou, China was assessed.

Methods

A cross-sectional study of 7597 COPD patients randomly selected by place of residence from 24,641 COPD patients who had been identified by screening of the 1.10 million health records of all residents of the target area was carried out to evaluate the relationships between risk factors, activities, psychological disorders and the ADO index (age, dyspnea, and airflow obstruction). The participants were assessed by spirometry and by administering a newly designed face-to-face questionnaire, which included items on general factors, risk factors, activities and psychological disorders. Correlations between the ADO index and the items addressed by the questionnaire were calculated.

Results

The mean score of the ADO index was 3.7 ± 1.6. The ADO indices of current smokers, ex-smokers, and non-smokers were 3.9 ± 2.1, 3.7 ± 1.9, and 3.2 ± 1.5, respectively (P < 0.001). The ADO indices of cooks and non-cooks were 4.0 ± 2.2 and 3.5 ± 1.7, respectively (P < 0.001). The correlation coefficient between self-assessment of health status and ADO index was 0.976 (P < 0.001). Only 5.7% of patients reported no limitation of their daily living activities. The correlation coefficient between daily living activities and ADO index was 0.981 (P < 0.001). Only 5.5% of patients reported no limitation of social activities. The correlation coefficient between social activities and ADO index was 0.989 (P < 0.001), between the assessed anxiety score and ADO index 0.972 (P < 0.001), and between the assessed depression score and ADO index 0.989 (P < 0.001).

Conclusions

COPD severity was significantly correlated with behavior (especially regarding smoking and cooking with biofuel in confined spaces), physical strength, daily living activities, social activities, anxiety and depression. Comprehensive approaches are required for the prevention and treatment of COPD.
A preliminary investigation of the relationship between water quality and Anopheles gambiae larval habitats in western Cameroon
Authors: Sanford Michelle R , Ramsay Steven , Cornel Anthony J , Marsden Clare D , Norris Laura C , Patchoke Salomon , Fondjo Etienne , Lanzaro Gregory C , Lee Yoosook
Published: July 2013

Background

Water quality and anopheline habitat have received increasing attention due to the possibility that challenges during larval life may translate into adult susceptibility to malaria parasite infection and/or insecticide resistance.

Methods

A preliminary study of Anopheles gambiae s.s. larval habitats in the north-west and south-west regions of Cameroon was conducted in order to detect associations between An. gambiae s.s. molecular form and 2La inversion distributions with basic water quality parameters. Water quality was measured by temperature, pH, conductivity, total dissolved solids (TDS) at seven sites in Cameroon and one site in Selinkenyi, Mali.

Results

Principal components and correlation analyses indicated a complex relationship between 2La polymorphism, temperature, conductivity and TDS. Cooler water sites at more inland locations yielded more S form larvae with higher 2La inversion polymorphism while warmer water sites yielded more M form larvae with rare observations of the 2La inversion.

Discussion

More detailed studies that take into account the population genetics but also multiple life stages, environmental data relative to these life stages and interactions with both humans and the malaria parasite may help us to understand more about how and why this successful mosquito is able to adapt and diverge, and how it can be successfully managed.
Effects of Neurally Adjusted Ventilatory Assist (NAVA) levels in non-invasive ventilated patients: titrating NAVA levels with electric diaphragmatic activity and tidal volume matching
Authors: Chiew Yeong Shiong , Chase J Geoffrey , Lambermont Bernard , Roeseler Jean , Pretty Christopher , Bialais Emilie , Sottiaux Thierry , Desaive Thomas
Published: July 2013

Background

Neurally adjusted ventilatory assist (NAVA) delivers pressure in proportion to diaphragm electrical activity (Eadi). However, each patient responds differently to NAVA levels. This study aims to examine the matching between tidal volume (Vt) and patients’ inspiratory demand (Eadi), and to investigate patient-specific response to various NAVA levels in non-invasively ventilated patients.

Methods

12 patients were ventilated non-invasively with NAVA using three different NAVA levels. NAVA100 was set according to the manufacturer’s recommendation to have similar peak airway pressure as during pressure support. NAVA level was then adjusted ±50% (NAVA50, NAVA150). Airway pressure, flow and Eadi were recorded for 15 minutes at each NAVA level. The matching of Vt and integral of Eadi (ʃEadi) were assessed at the different NAVA levels. A metric, Range90, was defined as the 5-95% range of Vt/ʃEadi ratio to assess matching for each NAVA level. Smaller Range90 values indicated better matching of supply to demand.

Results

Patients ventilated at NAVA50 had the lowest Range90 with median 25.6 uVs/ml [Interquartile range (IQR): 15.4-70.4], suggesting that, globally, NAVA50 provided better matching between ʃEadi and Vt than NAVA100 and NAVA150. However, on a per-patient basis, 4 patients had the lowest Range90 values in NAVA100, 1 patient at NAVA150 and 7 patients at NAVA50. Robust coefficient of variation for ʃEadi and Vt were not different between NAVA levels.

Conclusions

The patient-specific matching between ʃEadi and Vt was variable, indicating that to obtain the best possible matching, NAVA level setting should be patient specific. The Range90 concept presented to evaluate Vt/ʃEadi is a physiologic metric that could help in individual titration of NAVA level.
Fabrication of inverted zinc oxide photonic crystal using sol–gel solution by spin coating method
Authors: Huang Kuo-Min , Ho Chong-Lung , Chang Heng-Jui , Wu Meng-Chyi
Published: July 2013

Inverted zinc oxide photonic crystal structures were fabricated from polystyrene sphere (PSS) template using the sol–gel solution of ZnO by spin-coating method. It is easily able to control and fabricate the photonic crystal structures using the self-organized PSS with a size of 193 nm. The inverted ZnO photonic crystal structures observed show the (111) tendency of the hexagonal compact arrangement formation. The resulting structures possess the photonic band gaps in the near-ultraviolet range and exhibit an enhanced photoluminescence spectrum. The technology can effectively increase the light output intensity or efficiency for the applications of optoelectronic devices.
Factors associated with patient, and diagnostic delays in Chinese TB patients: a systematic review and meta-analysis
Authors: Li Ying , Ehiri John , Tang Shenglan , Li Daikun , Bian Yongqiao , Lin Hui , Marshall Caitlin , Cao Jia
Published: July 2013

Background

Delay in seeking care is a major impediment to effective management of tuberculosis (TB) in China. To elucidate factors that underpin patient and diagnostic delays in TB management, we conducted a systematic review and meta-analysis of factors that are associated with delays in TB care-seeking and diagnosis in the country.

Methods

This review was prepared following standard procedures of the Cochrane Collaboration and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and checklist. Relevant studies published up to November 2012 were identified from three major international and Chinese literature databases: Medline/PubMed, EMBASE and CNKI (China National Knowledge Infrastructure).

Results

We included 29 studies involving 38,947 patients from 17 provinces in China. Qualitative analysis showed that key individual level determinants of delays included socio-demographic and economic factors, mostly poverty, rural residence, lack of health insurance, lower educational attainment, stigma and poor knowledge of TB. Health facility determinants included limited availability of resources to perform prompt diagnosis, lack of qualified health workers and geographical barriers.

Quantitative meta-analysis indicated that living in rural areas was a risk factor for patient delays (pooled odds ratio (OR) (95% confidence interval (CI)): 1.79 (1.62, 1.98)) and diagnostic delays (pooled OR (95% CI): 1.40 (1.23, 1.59)). Female patients had higher risk of patient delay (pooled OR (95% CI): 1.94 (1.13, 3.33)). Low educational attainment (primary school and below) was also a risk factor for patient delay (pooled OR (95% CI): 2.14 (1.03, 4.47)). The practice of seeking care first from Traditional Chinese Medicine (TMC) providers was also identified as a risk factor for diagnostic delay (pooled OR (95% CI): 5.75 (3.03, 10.94)).

Conclusion

Patient and diagnostic delays in TB care are mediated by individual and health facility factors. Population-based interventions that seek to reduce TB stigma and raise awareness about the benefits of early diagnosis and prompt treatment are needed. Policies that remove patients’ financial barriers in access to TB care, and integration of the informal care sector into TB control in urban and rural settings are central factors in TB control.
Examining the safety of colon anastomosis on a rat model of ischemia-reperfusion injury
Authors: Czeiger David , Osyntsov Anton , Osyntsov Lidia , Ball Chad G , Gigi Roy , Shaked Gad
Published: July 2013

Introduction

Intestinal ischemia and reperfusion can impair anastomotic strength.

The purpose of this study was to evaluate the safety of delayed colon anastomosis following remote ischemia-reperfusion (IR) injury.

Methods

Rats divided into two groups underwent bilateral groin incisions, however only the study group had femoral artery clamping to inflict IR injury. Twenty-four hours following this insult, the animals underwent laparotomy, incision of the transverse colon and reanastomosis. End points included anastomotic leakage, strength and histopathological features.

Results

Anastomotic leak among IR animals (22.2%) was not statistically different in comparison to the controls [10.5% (p = 0.40)]. Anastomotic mean burst pressures showed no statistically significant difference [150.6 ± 15.57 mmHg in the control group vs. 159.9 ± 9.88 mmHg in the IR group (p = 0.64)]. The acute inflammatory process in the IR group was similar to controls (p = 0.26), as was the chronic repair process (p = 0.88). There was no significant difference between the inflammation:repair ratios amongst the two groups (p = 0.67).

Conclusion

Primary colon repair is safe when performed 24 hours following systemic IR injury.
Postoperative differences between colonization and infection after pediatric cardiac surgery-a propensity matched analysis
Authors: Lex Daniel J , Tóth Roland , Cserép Zsuzsanna , Breuer Tamás , Sápi Erzsébet , Szatmári András , Gál János , Székely Andrea
Published: July 2013

Background

The objective of this study was to identify the postoperative risk factors associated with the conversion of colonization to postoperative infection in pediatric patients undergoing cardiac surgery.

Methods

Following approval from the Institutional Review Board, patient demographics, co-morbidities, surgery details, transfusion requirements, inotropic infusions, laboratory parameters and positive microbial results were recorded during the hospital stay, and the patients were divided into two groups: patients with clinical signs of infection and patients with only positive cultures but without infection during the postoperative period. Using propensity scores, 141 patients with infection were matched to 141 patients with positive microbial cultures but without signs of infection. Our database consisted of 1665 consecutive pediatric patients who underwent cardiac surgery between January 2004 and December 2008 at a single center. The association between the patient group with infection and the group with colonization was analyzed after propensity score matching of the perioperative variables.

Results

179 patients (9.3%) had infection, and 253 patients (15.2%) had colonization. The occurrence of Gram-positive species was significantly greater in the colonization group (p = 0.004). The C-reactive protein levels on the first and second postoperative days were significantly greater in the infection group (p = 0.02 and p = 0.05, respectively). The sum of all the positive cultures obtained during the postoperative period was greater in the infection group compared to the colonization group (p = 0.02). The length of the intensive care unit stay (p < 0.001) was significantly longer in the infection group compared to the control group.

Conclusions

Based on our results, we uncovered independent relationships between the conversion of colonization to infection regarding positive S. aureus and bloodstream results, as well as significant differences between the two groups regarding postoperative C-reactive protein levels and white blood cell counts.
Endothelial cells derived from embryonic stem cells respond to cues from topographical surface patterns
Authors: Hatano Rachel , Mercurio Kevin , Luna Jesus Isaac , Glaser Drew E , Leppert Valerie J , McCloskey Kara E
Published: July 2013

The generation of micro- and nano-topography similar to those found in the extra cellular matrix of three-dimensional tissues is one technique used to recapitulate the cell-tissue physiology found in the native tissues. Despite the fact that ample studies have been conducted on the physiological significance of endothelial cells alignment parallel to shear stress, as this is the normal physiologic arrangement for healthy arterial EC, very few studies have examined the use of topographical signals to initiate endothelial cell alignment. Here, we have examined the ability for our mouse embryonic stem cell-derived endothelial cells (ESC-EC) to align on various microchip topographical systems. Briefly, we generated metal molds with ‘wrinkled’ topography using 1) 15 nm and 2) 30 nm of gold coating on the pre-strained polystryene (PS) sheets. After thermal-induced shrinkage of the PS sheets, polydimethylsiloxane (PDMS) microchips were then generated from the wrinkled molds. Using similar Shrink™-based technology, 3) larger selectively crazed acetone-etched lines in the PS sheets, and 4) fully crazed acetone-treated PS sheets of stochastic topographical morphology were also generated. The 15 nm and 30 nm gold coating generated ‘wrinkles’ of uniaxial anisotropic channels at nano-scaled widths while the crazing generated micron-sized channels. The ESC-EC were able to respond and align on the 320 nm, 510 nm, and the acetone-etched 10.5 μm channels, but not on the fully ‘crazed’ topographies. Moreover, the ESC-EC aligned most robustly on the wrinkles, and preferentially to ridge edges on the 10.5 μm-sized channels. The ability to robustly align EC on topographical surfaces enables a variety of controlled physiological studies of EC-EC and EC-ECM contact guidance, as well as having potential applications for the rapid endothelialization of stents and vascular grafts.
Cold shock CspA and CspB protein production during periodic temperature cycling in Escherichia coli
Authors: Ivancic Tina , Jamnik Polona , Stopar David
Published: July 2013

Background

Temperature is an important environmental factor which can dramatically affect biochemical processes in bacteria. Temperatures above optimal cause heat shock, while low temperatures induce cold shock. Since the physiological response of the bacterium Escherichia coli to slow temperature fluctuation is not well known, we investigated the effect of periodic temperature cycling between 37° and 8°C with a period of 2 h on proteome profile, cold shock CspA and CspB protein and gene production.

Results

Several proteins (i.e. succinyl-CoA synthetase subunit alpha, periplasmic oligopeptide-binding protein, maltose-binding periplasmic protein, outer membrane porin protein, flavodoxin-1, phosphoserine aminotransferase) were up or down regulated during temperature cycling, in addition to CspA and CspB production. The results indicate that transcription of cspA and cspB increased during each temperature downshift and consistently decreased after each temperature upshift. In sharp contrast CspA-FLAG and CspB-FLAG protein concentrations in the cell increased during the first temperature down-shift and remained unresponsive to further temperature fluctuations. The proteins CspA-FLAG and CspB-FLAG were not significantly degraded during the temperature cycling.

Conclusion

The study demonstrated that slow periodic temperature cycling affected protein production compared to cells constantly incubated at 37°C or during classical cold shock. Bacterial cspA and cspB mRNA transcript levels fluctuated in synchrony with the temperature fluctuations. There was no corresponding pattern of CspA and CspB protein production during temperature cycling.
The prevalence of platelet activating factor acetylhydrolase single nucleotide polymorphisms in relationship to necrotizing enterocolitis in Northwest Louisiana infants
Authors: Sankararaman Senthilkumar , Yanamandra Krishna , Napper Dawn , Caldito Gloria , Dhanireddy Ramasubbareddy
Published: July 2013

Purpose

Studies documented that platelet activating factor (PAF) and the enzyme platelet activating factor acetylhydrolase (PAFAH) play a very important role in the pathogenesis of neonatal necrotizing enterocolitis (NEC). In this retrospective, case-controlled pilot study, the authors investigated the prevalence of single nucleotide polymorphisms (Ile198Thr and Ala379Val) of the PAFAH gene.

Subjects and methods

We screened 570 blood samples from both Caucasian and African-American preterm infants in the Northwest Louisiana population for the above mentioned PAFAH gene polymorphisms. Out of 570 infants, 36 had stage I or II NEC based on diagnostic coding, the International Classification of Diseases, 9th revision, Clinical Modification, 2009 (ICD-9-CM). The remaining infants without an ICD-9-CM diagnosis of NEC were recruited as control population. The DNA was isolated and restriction fragment length polymorphism microplate polymerase chain reaction assay was performed.

Results

Variants of the PAFAH gene polymorphism (Ile198Thr and Ala379Val) frequencies were not significantly different between the infants with NEC and the control group (Pvalue of 0.26 by either multiple logistic regression analysis or the Cochran-Mantel-Haenszel test).

Conclusions

This is the first study of its kind in exploring the relationship between NEC and single nucleotide polymorphisms in the coding genes of the enzyme PAFAH. Our preliminary data demonstrated that adjusted for the effect of race, PAFAH polymorphisms (Ile198Thr and Ala379Val) have no significant effect on NEC.
Epistasis with HLA DR3 implicates the P2X7 receptor in the pathogenesis of primary Sjögren's syndrome
Authors: Lester Susan , Stokes Leanne , Skarratt Kristen K , Gu Ben J , Sivils Kathy L , Lessard Christopher J , Wiley James S , Rischmueller Maureen
Published: July 2013

Introduction

The aim of this study was to examine the association between functional polymorphisms in the pro-inflammatory P2X7 receptor and the Ro/La autoantibody response in primary Sjögren's syndrome (pSS).

Methods

Twelve functional P2RX7 polymorphisms were genotyped in 114 pSS patients fulfilling the Revised American-European Consensus Criteria for pSS, and 136 controls. Genotyping of the A1405G (rs2230912) polymorphism was performed on a replication cohort consisting of 281 pSS patients and 534 controls. P2X7 receptor function in lymphocytes and monocytes was assessed by measurement of ATP-induced ethidium+ uptake. Serum IL-18 levels were determined by ELISA.

Results

The minor allele of P2RX7 A1405G is a tag for a common haplotype associated with gain in receptor function, as assessed by ATP-induced ethidium+ uptake. A positive association between 1405G and anti-Ro±La seropositive pSS patients was observed in Cohort 1. Although not replicated in Cohort 2, there was a consistent, significant, negative epistatic interaction effect with HLA-DR3 in seropositive pSS patients from both cohorts, thereby implicating this gain of function variant in the pathogenesis of pSS. Serum IL-18 was elevated in seropositive pSS patients, but was not influenced by P2RX7 A1405G.

Conclusions

The P2RX7 1405G gain-of-function haplotype may be a risk factor for seropositive pSS in a subset of subjects who do not carry HLA risk alleles, but has no effect in subjects who do (epistasis). Potential mechanisms relate to autoantigen exposure and inflammatory cytokine expression. The observed elevation of IL-18 levels is consistent with P2X7 receptor activation in seropositive pSS patients. Collectively these findings implicate P2X7 receptor function in the pathogenesis of pSS.
Mouse neutrophils express the decoy type 2 interleukin-1 receptor (IL-1R2) constitutively and in acute inflammatory conditions
Authors: Martin Praxedis , Palmer Gaby , Vigne Solenne , Lamacchia Céline , Rodriguez Emiliana , Talabot-Ayer Dominique , Rose-John Stefan , Chalaris Athena , Gabay Cem
Published: July 2013

The proinflammatory activities of IL-1 are tightly controlled at different levels. IL-1R2 acts as a decoy receptor and has been shown to regulate the biological effects of IL-1 in vitro and in vivo. However, little is known about its natural expression in the mouse in physiologic and pathologic conditions. In this study, we examined IL-1R2 mRNA and protein expression in isolated cells and tissues in response to different stimulatory conditions. Data obtained using ex vivo CD11b+Ly6G+ peripheral blood cells and in vitro-differentiated CD11b+Ly6G+ BMG indicated that neutrophils are the major source of constitutively expressed IL-1R2 in the mouse. The expression of IL-1R2 on BMG and ex vivo Ly6G+ peripheral blood cells was highly up-regulated by HC. IL-1R2 pull-down experiments showed that mouse rIL-1β binds to BMG IL-1R2, whereas binding of IL-1Ra could not be detected. Furthermore, LPS treatment induced shedding of IL-1R2 from the neutrophil membrane in vitro and in vivo, executed mainly by ADAM17. Finally, in in vivo models of inflammation, including thioglycolate-induced acute peritonitis and acute lung injury, infiltrating Ly6G+ neutrophils, expressed IL-1R2. Our data show that in the mouse, neutrophils mainly express the decoy receptor IL-1R2 under naïve and inflammatory conditions. These data suggest that neutrophils may contribute to the resolution of acute inflammation.
Tolerance induction by hair-specific keratins in murine alopecia areata
Authors: Erb Ulrike , Freyschmidt-Paul Pia , Zöller Margot
Published: July 2013

AA is a presumptive autoimmune disease, severely damaging the hair follicle. Hair- and nail-specific keratins are discussed as potential candidates, which we controlled in C3H/HeJ mice that develop AA spontaneously or after skin transplantation. From nine keratins, K71 and K31 peptides supported T cell activation when presented by DCs to syngeneic naive T cells, and young C3H/HeJ mice receiving s.c. injections of peptide-loaded DC developed AA. The frequency of K71- and K31-specific CD4+ and CD8+ T cells increased four- to fivefold by vaccination, which corresponds with the frequency seen in skin transplantation-induced AA mice. Also, accessory molecule expression, the cytokine profile with a dominance of IFN-γ-expressing T cells, the proliferative response against AA lysate or peptide-loaded DCs, as well as peptide-specific cytotoxic T cells were similar in keratin peptide- and skin transplantation-induced AA. Instead, vaccination with soluble K71 or K31 peptides significantly retarded AA induction and prevented progression. Soluble peptide vaccination did not provoke immunosuppression but induced long-lasting T cell anergy with unresponsiveness to DC-presented K71 and K31 peptides. Thus, keratins K71 and K31 contribute to AA induction, and peptide application in a nonimmunogenic form serves as an efficient therapeutic.
Cocaine exposure enhances permissiveness of quiescent T cells to HIV infection
Authors: Kim Sohn G , Jung James B , Dixit Dhaval , Rovner Robert , Zack Jerome A , Baldwin Gayle C , Vatakis Dimitrios N
Published: July 2013

In vivo and in vitro exposure to stimulants has been associated with increased levels of HIV infection in PBMCs. Among these lymphocyte subsets, quiescent CD4+ T cells make up the majority of circulating T cells in the blood. Others and we have demonstrated that HIV infects this population of cells inefficiently. However, minor changes in their cell state can render them permissive to infection, significantly impacting the viral reservoir. We have hypothesized that stimulants, such as cocaine, may perturb the activation state of quiescent cells enhancing permissiveness to infection. Quiescent T cells isolated from healthy human donors were exposed to cocaine and infected with HIV. Samples were harvested at different time-points to assess the impact of cocaine on their susceptibility to infection at various stages of the HIV life cycle. Our data show that a 3-day exposure to cocaine enhanced infection of quiescent cells, an effect that appears to be mediated by σ1R and D4R. Overall, our results indicate that cocaine-mediated effects on quiescent T cells may increase the pool of infection-susceptible T cells. The latter underscores the impact that stimulants have on HIV-seropositive individuals and the challenges posed for treatment.