bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification and expression profiling of Spodoptera litura OR18, a gene with a potential role in olfactory recognition
Authors: Zheng Kaidi , Lin Xinda , Du Yongjun
Published: December 2013

The full‐length cDNA of the gene SlituOR18, encoding a candidate olfactory receptor in the antennae of the tobacco cutworm, Spodoptera litura (Fabricius) (Lepidoptera Noctuidae), was identified through homology cloning strategies using RACE (rapid amplification of cDNA ends) and PCR (polymerase chain reaction). The protein of SlituOR18 shared >80% sequence identity and the same seven transmembrane domains with other olfactory receptor 18 (OR18) proteins sequenced from noctuid moths. SlituOR18 also had a similar structure to SlituORco, encoding the olfactory co‐receptor in S. litura. The sequence between transmembrane segments IV and V was longer than other sequences between transmembrane segments, and the N‐terminus was intracytoplasmic. Analysis by qRT‐PCR showed SlituOR18 was predominantly expressed in adult moths and there was higher expression in female antennae than in male antennae. Weak expression of SlituOR18 was observed in eggs and no expression was observed in the antennae of fourth instars and 5‐day‐old pupae. In situ hybridization experiments revealed that expression of these receptor types was clearly restricted to the bases of trichodea‐type olfactory sensilla (sensillum trichodeum), that are known to contain neurons sensitive to food odor or pheromones. Our data demonstrated that both SlituORco and SlituOR18 showed diurnal changes in their relative expression level. Expression of SlituOR18 varied among geographic populations of S. litura that had been trapped in the field using synthetic pheromone lures. The mRNA expression level of SlituOR18 was similar among S. litura populations from Sichuan, Guangxi, and Hunan, and higher than in populations from Shanghai and Ningbo. We suggest that OR18 could play a critical role in olfaction in noctuid moths and is a potential target for novel pest management strategies in the future.
Effects of predation risk and plant resistance on Manduca sexta caterpillar feeding behaviour and physiology
Authors: THALER JENNIFER S. , CONTRERAS HEIDY , DAVIDOWITZ GOGGY
Published: December 2013

Because predation risk typically alters how prey forage for food, interactions between predation risk and food availability are commonly found. Less is known about how host plant quality and predation risk interact to affect prey behaviour and physiology.

Using the caterpillar, Manduca sexta, and its predator, Podisus maculiventris, the effects of predation risk and host plant quality on caterpillar feeding, growth, assimilation efficiency, and resting metabolic rate were tested.

Overall, caterpillars on low‐resistance tomato plants (jasmonate‐insensitive) gained 14% more mass than caterpillars on high‐resistance plants (wild‐type tomato). On low‐resistance plants, the presence of predators caused caterpillars to eat 32% less, but they gained the same mass as unthreatened caterpillars (i.e. a 19% increase in assimilation efficiency). In addition, caterpillars showed a 17% increase in resting metabolic rate in the presence of predators. On high‐resistance plants, predation risk caused a decrease in feeding, but did not alter assimilation efficiency or resting metabolic rate.

The reduction in physiological responses to predation risk on high‐ versus low‐resistance plants demonstrates a tradeoff between the ability to respond to predation risk and the ability to grow, especially on well‐defended plants.
Site‐specific regulation of adult neurogenesis by dietary fatty acid content, vitamin E and flight exercise in European starlings
Authors: Hall Zachary J. , Bauchinger Ulf , Gerson Alexander R. , Price Edwin R. , Langlois Lillie A. , Boyles Michelle , Pierce Barbara , McWilliams Scott R. , Sherry David F. , MacDougall‐Shackleton Scott A.
Published: December 2013

Exercise is known to have a strong effect on neuroproliferation in mammals ranging from rodents to humans. Recent studies have also shown that fatty acids and other dietary supplements can cause an upregulation of neurogenesis. It is not known, however, how exercise and diet interact in their effects on adult neurogenesis. We examined neuronal recruitment in multiple telencephalic sites in adult male European starlings (Sturnus vulgaris) exposed to a factorial combination of flight exercise, dietary fatty acids and antioxidants. Experimental birds were flown in a wind tunnel following a training regime that mimicked the bird's natural flight behaviour. In addition to flight exercise, we manipulated the composition of dietary fatty acids and the level of enrichment with vitamin E, an antioxidant reported to enhance neuronal recruitment. We found that all three factors – flight exercise, fatty acid composition and vitamin E enrichment – regulate neuronal recruitment in a site‐specific manner. We also found a robust interaction between flight training and vitamin E enrichment at multiple sites of neuronal recruitment. Specifically, flight training was found to enhance neuronal recruitment across the telencephalon, but only in birds fed a diet with a low level of vitamin E. Conversely, dietary enrichment with vitamin E upregulated neuronal recruitment, but only in birds not flown in the wind tunnel. These findings indicate conserved modulation of adult neurogenesis by exercise and diet across vertebrate taxa and indicate possible therapeutic interventions in disorders characterized by reduced adult neurogenesis.
The learning profile of persistent mild cognitive impairment (MCI): a potential diagnostic marker of persistent amnestic MCI
Authors: Klekociuk S. Z. , Summers M. J.
Published: December 2013

Background and purpose

Previous research examining mild cognitive impairment (MCI) has highlighted the heterogeneity of outcome in MCI sufferers. MCI is associated with greater risk of progression to dementia; however, a substantial proportion of those identified with MCI have alternative outcomes including recovery to unimpaired status. This heterogeneity may in part reflect insufficient sensitivity and specificity in identifying subclinical memory impairment.

Method

The present study examined learning in a sample of 109 adults aged 61–91 years with persistent amnestic MCI, persistent non‐amnestic MCI, recovered MCI and healthy controls. At the final assessment point, learning for words recalled across each trial of the Rey Auditory Verbal Learning Test was examined for each group.

Results

It was found that persistent amnestic MCI participants displayed significantly lower learning compared with recovered MCI and healthy control groups.

Discussion

The results of this study indicated that poor learning across trials may be a defining feature of persistent amnestic MCI. Further research is required to establish the predictive utility of within trial list learning performance to identify individuals with persistent and progressive variants of MCI.
Top‐down and bottom‐up control of periphyton by benthivorous fish and light supply in two streams
Authors: Winkelmann Carola , Schneider Jana , Mewes Daniela , Schmidt Susanne I. , Worischka Susanne , Hellmann Claudia , Benndorf Jürgen
Published: December 2013

We conducted a paired large‐scale predation experiment over 32 months in two streams being seasonally shaded by deciduous riparian trees, using the benthivorous fish species gudgeon (Gobio gobio) and stone loach (Barbatula barbatula) as top predators. The biomass of benthic grazers and periphyton in the presence/absence of fish was measured and the periphyton production was compared with the consumption rates using a model‐based approach.

A three‐level trophic cascade from benthivorous fish via benthic grazers to periphyton was evident from the field experiment. Integrated over the whole study period, fish reduced the biomass of benthic grazers and indirectly increased the periphyton biomass.

Scenario analyses, using a simple dynamic model, indicated top‐down control of periphyton to be strongest during autumn, when periphyton growth was light‐limited, and weaker in the spring, when periphyton growth was not light‐limited. The seasonal light supply variation was caused by shading due to deciduous riparian trees during the vegetation period.

This asymmetry in temporal processes weakened the top‐down control in a natural benthic community. Even though grazer biomass is naturally reduced in summer, due to the emergence of the most abundant species (mayflies), a grazer biomasses high enough to reduce the spring periphyton peak could not be sustained by the low summer periphyton growth.

We suppose that the temporal decoupling of grazer biomass from periphyton biomass might be caused by the very short generation time of the primary producers (days) compared with the long generation time of the primary consumers (mostly 1 year).
Pleomorphic lobular carcinoma in situ of the breast: clinicopathological review of 47 cases
Authors: Khoury Thaer , Karabakhtsian Rouzan G , Mattson David , Yan Li , Syriac Susanna , Habib Fadi , Liu Song , Desouki Mohamed M
Published: December 2013

Aims

Pleomorphic lobular carcinoma in situ (PLCIS) of the breast is a distinctive entity, but its behaviour and management are unclear. The purpose of this study was to review a relatively large number of cases and to evaluate the risk of recurrence.

Methods and results

Cases of PLCIS (n = 47) from a 12‐year period were reviewed. The clinical, radiological and pathological findings were recorded. Immunohistochemistry for oestrogen receptor (ER), progesterone receptor (PR) and HER2 was performed. Thirty‐one patients had no concurrent breast cancer or past history of breast cancer, and six (19.4%) of these had local recurrence; all tumours (four invasive carcinoma and two PLCIS) were ipsilateral. Younger age at presentation was a risk factor for local recurrence: patients with recurrence had a mean age (range) of 52.5 years (44–59 years), versus 60.6 years (40–81 years) for those without (P = 0.03). Three of 31 patients were treated with radiation therapy (RT), and none of these developed local recurrence. PLCIS had an adverse ER/PR/HER2 molecular profile, with at least 41.2% of the cases overexpressing HER2. Moreover, at least 11.7% of the cases were triple‐negative.

Conclusions

This study included the largest number of patients who had no concurrent breast cancer or past history of breast cancer with the longest clinical follow‐up, providing insights into management practices for PLCIS and the risk of recurrence.
Exposure to accents and pronunciation modelling: A case study of a secondary school in Hong Kong
Authors: Chan Jim Y. H.
Published: December 2013

This study seeks to explore the controversial issue of pronunciation modelling in the secondary classroom in association with the medium‐of‐instruction (MOI) policy in Hong Kong. The investigation centres on two dimensions: (1) students' exposure to English accents throughout their weekly school timetable by means of a data log sheet and (2) the phonological differences between the speech of local subject and English language teachers. The findings suggest that students' main source of English exposure at school is the English pronunciation of both English language and content‐area teachers in English‐medium lessons, who shared numerous Hong Kong English (HKE) features although in differing proportions. The paper concludes by prioritising the educated HKE vowel and consonant features and promoting an internationally intelligible endonormative model in the globalised world.
Differential activation of CD57‐defined natural killer cell subsets during recall responses to vaccine antigens
Authors: White Matthew J. , Nielsen Carolyn M. , McGregor Reuben H. C. , Riley Eleanor M. , Goodier Martin R.
Published: December 2013

Natural killer (NK) cells contribute to the effector phase of vaccine‐induced adaptive immune responses, secreting cytokines and releasing cytotoxic granules. The proportion of responding NK cells varies between individuals and by vaccine, suggesting that functionally discrete subsets of NK cells with different activation requirements may be involved. Here, we have used responses to individual components of the DTP vaccine [tetanus toxoid (TT), diphtheria toxoid (DT), whole cell inactivated pertussis] to characterize the NK cell subsets involved in interleukin‐2‐dependent recall responses. Culture with TT, DT or pertussis induced NK cell CD25 expression and interferon‐γ production in previously vaccinated individuals. Responses were the most robust against whole cell pertussis, with responses to TT being particularly low. Functional analysis of discrete NK cell subsets revealed that transition from CD56bright to CD56dim correlated with increased responsiveness to CD16 cross‐linking, whereas increasing CD57 expression correlated with a loss of responsiveness to cytokines. A higher frequency of CD56dim CD57− NK cells expressed CD25 and interferon‐γ following stimulation with vaccine antigen compared with CD56dim CD57+ NK cells and made the largest overall contribution to this response. CD56dim CD57int NK cells represent an intermediate functional phenotype in response to vaccine‐induced and receptor‐mediated stimuli. These findings have implications for the ability of NK cells to contribute to the effector response after vaccination and for vaccine‐induced immunity in older individuals.
Encouraging patients to self‐care – the preliminary development and validation of the VeLUSET©, a self‐efficacy tool for venous leg ulcer patients, aged 60 years and over
Authors: Brown Annemarie , Kendall Sally , Flanagan Madeleine , Cottee Michaela
Published: December 2013

Venous leg ulceration has a high recurrence rate. Patients with healed or frequently recurring venous ulceration are required to perform self‐care behaviours to prevent recurrence or promote healing, but evidence suggests that many find these difficult to perform. Bandura's self‐efficacy theory is a widely used and robust behaviour change model and underpins many interventions designed to promote self‐care in a variety of chronic conditions. By identifying areas where patients may experience difficulty in performing self‐care, interventions can be developed to strengthen their self‐efficacy beliefs in performing these activities successfully. There are currently a variety of self‐efficacy scales available to measure self‐efficacy in a variety of conditions; but not a disease‐specific scale for use with venous ulcer patients. The aim of this study, therefore, was to develop and validate a disease‐specific, patient‐focused self‐efficacy scale for patients with healed venous leg ulceration. This scale will need further validation studies; however, it is ready for use in clinical practice and will enable practitioners to identify those patients who may need additional support in performing self‐care activities to prevent recurrence.
e‐ageing: Development and evaluation of a flexible online geriatric medicine educational resource for diverse learners
Authors: Watson Natasha , Massarotto Alicia , Caputo Lisa , Flicker Leon , Beer Christopher
Published: December 2013

Aims

To determine preferred content and format for online education modules in aged care among inter‐professional learners; to develop resources that meet user preferences.

Methods

Stakeholders were interviewed. A survey was administered to all health/medical students and teachers at The University of Western Australia. An iterative process was used to develop modules, and user feedback was collated.

Results

The educational needs of each discipline related primarily to foundation level knowledge in major aged care topics. Stakeholders sought modules incorporating communication skills, cultural and social issues and the importance of a multidisciplinary approach to aged care. Students from all disciplines sought online materials that are interactive, engaging, case‐based and locally relevant. Online modules were developed. Evaluation of the modules by users has been strongly positive.

Conclusion

There was consensus regarding the major curricular areas that online resources should encompass. The e‐ageing modules developed in this project have been evaluated positively by users.
Microstructure and Ionic Conductivity of Yttria‐Stabilized Zirconia Thin Films Deposited on MgO
Authors: Jiang Jun , Hu Xiaocao , Ye Ning , Hertz Joshua L.
Published: December 2013

A number of reports have suggested that nanometric thin films of yttria‐stabilized zirconia (YSZ) deposited on MgO can support high ionic conductivity, but the results remain controversial and difficult to repeat. In this work, sub‐100‐nm‐thick YSZ films have been deposited on single‐crystal MgO substrates with different crystallographic orientations and sourced from different companies. The growth of YSZ on MgO (100) was found to be unstable: both (111)‐oriented films with polycrystalline structure and (100)‐oriented films with cube‐on‐cube epitaxy were observed despite seemingly identical deposition conditions. On MgO (110) and MgO (111) substrates, the growth of YSZ was more stable with high degrees of texture in the (110) and (111) film directions, respectively. Ionic conductivities of the films were measured with impedance spectroscopy, and conductivity values were consistently near or slightly below that of a YSZ single crystal.
Structural Investigations on the Compositional Anomalies in Lanthanum Zirconate System Synthesized by Coprecipitation Method
Authors: Prusty Debadutta , Pathak Abhishek , Chintha Apparao , Mukherjee Bratindranath , Chowdhury Anirban
Published: December 2013

The study set out to investigate the compositional inconsistency in lanthanum zirconate system revealed the presence of nonstoichiometry in lanthanum zirconate powders when synthesized by coprecipitation route. X‐ray diffraction (XRD) and high‐resolution transmission electron microscopy (HRTEM) investigations confirmed the depletion of La3+ ions in the system. Analysis using Vegard's law showed the La/Zr mole ratio in the sample to be around 0.45. An extra step of ultrasonication, introduced during the washing stage followed by the coprecipitation reaction, ensured the formation of stoichiometric La2Zr2O7. Noteworthy is also the difference between crystal sizes in the samples prepared by with and without ultrasonication step. This difference has been explained in light of the formation of individual nuclei and their scope of growth within the precipitate core. The differential scanning calorimetry (DSC) analyses revealed that optimum pH for the synthesis of La2Zr2O7 is about 11. The ultrasonication step was pivotal in assuring consistency in mixing and composition for the lanthanum zirconate powders.
Effective Thermal Conductivity of Soda‐Lime Silicate Glassmelts with Different Iron Contents Between 1100°C and 1500°C
Authors: Pilon Laurent , Janos Filip , Kitamura Rei
Published: December 2013

This study presents a simple method for retrieving the effective thermal conductivity of semitransparent glassmelts from measured temperature profiles. Effective thermal conductivity of molten glass at high temperature is an important thermophysical property that affects the glassmelting and forming processes and thus the quality of the final glass products. In semitransparent glassmelts, heat is transferred by both conduction and radiation. In the limiting case of optically thick glassmelts, typically featuring high iron content, thermal radiation can be treated as a diffusion process. The total heat flux can be expressed as the sum of a phononic and a radiative heat fluxes based on Fourier's law. For weakly absorbing glassmelts, the temperature profile may be strongly nonlinear particularly neat container walls due to the contribution from emission and absorption. Steady‐state measurement techniques, such as the linear heat flux method, have been developed to measure glassmelt effective thermal conductivity at high temperatures. However, they typically use only three temperatures measurements and assume linear temperature profile in the glassmelt. The new retrieval method addresses these drawbacks particularly for weakly absorbing glassmelts featuring nonlinear temperature profiles. It is demonstrated with experimental data collected for soda‐lime silicate glasses with iron content ranging from 0.008 to 1.1 wt% and temperatures between 1100°C and 1550°C.
Fabrication of Highly Porous Chromium Carbide with Multiple Pore Structure
Authors: Dong Ziqiang , Zhang Qinya , Chen Weixing
Published: December 2013

A unique process, which consists of camphene‐based freeze‐casting and reactive sintering, has been developed to fabricate highly porous Cr3C2 ceramics, which were featured with a well‐defined multisize porous structure, consisting of large pore channels throughout the sample and small pores on the porous struts. The porous structure was found to be affected by the solid loading content and the casting temperature. Decreasing the solid loading content or increasing the freezing temperature increased the size of large pore channels. However, the size of small pore was not significantly influenced by the variation in the freeze‐casting parameters. Compared with other techniques reported for the fabrication of porous ceramics, high porosity can easily be achieved by this method. The sintering mechanism of the formation of the porous structure was also discussed in this study.
Towards environmentally responsible nursing: a critical interpretive synthesis
Authors: Kangasniemi Mari , Kallio Hanna , Pietilä Anna‐Maija
Published: December 2013

Aim

To provide a synthesis of studies on the environmental issues in nursing.

Background

Interest in the environmental issues affecting health sciences has been increasing in recent decades. Health care is one of the largest publicly provided services and it share of the environmental burden is high. Nurses play an important role in environmental health issues as they are the largest group of healthcare staff and are most directly connected to the use of energy and materials. Despite this, previous studies on nurses' roles in environmental issues have been presented in a relatively fragmented way.

Design and data sources

Systematic literature searches of peer‐reviewed papers published between 2002–2012 were carried out using the CINAHL, Science Direct and PubMed electronic databases.

Review method

Critical interpretive synthesis was then undertaken to provide a comprehensive overview of the topic.

Results

Eleven studies were included. Based on our synthesis, environmentally responsible nursing can be identified in relation to the: (1) theoretical framework; (2) background arguments; (3) role of responsible stakeholders; and (4) targets of environmental management. A fifth element: (5) tools for practical environmental responsibility, was also presented.

Conclusion

Awareness of environmental issues is starting to encourage nursing services to seek sustainable practices. Nurses themselves are naturally in a key position to promote and develop environmentally responsible nursing. Environmentally responsible nursing helps to promote healthy environmental practices. It also reduces undesirable practices that can burden the environment and have a negative impact on health.
Deregulated microRNAs in CD4+ T cells from individuals with latent tuberculosis versus active tuberculosis
Authors: Fu Yurong , Yi Zhengjun , Li Jianhua , Li Ruifang
Published: December 2013

The mechanisms of latent tuberculosis (TB) infection remain elusive. Roles of microRNA (miRNA) have been highlighted in pathogen–host interactions recently. To identify miRNAs involved in the immune response to TB, expression profiles of miRNAs in CD4+ T cells from patients with latent TB, active TB and healthy controls were investigated by microarray assay and validated by RT‐qPCR. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were used to analyse the significant functions and involvement in signalling pathways of the differentially expressed miRNAs. To identify potential target genes for miR‐29, interferon‐γ (IFN‐γ) mRNA expression was measured by RT‐qPCR. Our results showed that 27 miRNAs were deregulated among the three groups. RT‐qPCR results were generally consistent with the microarray data. We observed an inverse correlation between miR‐29 level and IFN‐γ mRNA expression in CD4+ T cells. GO and KEGG pathway analysis showed that the possible target genes of deregulated miRNAs were significantly enriched in mitogen‐activated protein kinase signalling pathway, focal adhesion and extracellular matrix receptor interaction, which might be involved in the transition from latent to active TB. In all, for the first time, our study revealed that some miRNAs in CD4+ T cells were altered in latent and active TB. Function and pathway analysis highlighted the possible involvement of miRNA‐deregulated mRNAs in TB. The study might help to improve understanding of the relationship between miRNAs in CD4+ T cells and TB, and laid an important foundation for further identification of the underlying mechanisms of latent TB infection and its reactivation.
Use of clinical practice guidelines and factors related to their uptake: a survey of health professionals in Spain
Authors: Kotzeva Anna , Guillamón Imma , Gracia Javier , Díaz del Campo Petra , Gich Ignasi , Calderón Enrique , Gaminde Idoia , Louro‐González Arturo , Martínez Flora , Orrego Carola , Rotaeche Rafa , Salcedo Flavia , Alonso‐Coello Pablo ,   Spanish CPGs Working Group
Published: December 2013

Rationale, aims and objective

This study aims to assess the use of clinical practice guidelines (CPGs) among health professionals and factors related to their uptake in clinical practice.

Methods

Cross‐sectional study based on an online survey conducted among primary care (PC) and hospital‐based care (HC) doctors in Spain in 2011. Questionnaire development included adaptation of similar surveys and contextualization through a qualitative study. After a pilot study and review, the final survey contained five domains: demographics, involvement in CPGs, consultation of CPGs, perceptions and attitudes regarding CPGs and Spanish NHS CPGs Programme. Professionals from selected health care centres in seven regions were contacted by email with an invitation and link to the Web‐based questionnaire. We analysed between‐group differences and explored potential predictors of CPGs use by means of a logistic regression.

Results

Six hundred seventy‐six doctors responded to the survey (27.7% response rate). 47.1% were PC and 49.5% were HC doctors. 32.5% stated previous involvement in CPGs and 56.5% stated training in research methodology. 67.5% of the surveyed professionals reported using CPGs more than one time per week. The use of a system for classifying the quality of evidence (62.3%) and for grading the strength of the recommendations (58.6%), as well as the use of a rigorous methodology (49.6%), were the most frequently reported aspects related to CPG credibility. The lack of time (56.4%), especially in PC (65.3% versus 49.5% in HC; P < 0.001), and the absence of brief and easily accessible format (42.2%) were the main reported barriers to using CPGs. None of the studied factors showed statistically significant association in the logistic regression model.

Conclusions

Study results suggest that, in general, Spanish doctors trust and use CPGs frequently. To improve uptake by health professionals and to overcome existing barriers, CPGs should be rigorously developed and made accessible at the point‐of‐care in user‐friendly electronic formats. Due to the low response rate, findings should be extrapolated with caution.
Stathmin overexpression identifies high risk for lymphatic metastatic recurrence in pN0 esophageal squamous cell carcinoma patients
Authors: Akhtar Javed , Wang Zhou , Jiang Wen Peng , Bi Ming Ming , Zhang Zhi Ping
Published: December 2013

Background and Aim

Common patterns of the operative failure after Ivor‐Lewis esophagectomy in esophageal squamous cell carcinoma (ESCC) patients are locoregional lymph node metastasis. It is clinically significant to investigate the biological markers to predict the subset of patients who are at higher risk of lymphatic metastatic recurrence. Our research aimed to investigate the association between the Stathmin (STMN‐1) gene expression and lymphatic metastatic recurrence in pN0 ESCC patients after surgery.

Methods

One hundred seventy‐four patients who suffered from mid‐thoracic ESCC and completely resected with Ivor‐Lewis esophagectomy were enrolled in our study. The entire patients were restricted to pN0 ESCC. Tissue specimens were examined for STMN‐1 expression levels by immunohistochemistry and Western blotting methods. The correlation of STMN‐1 levels with clinicopathological variables, prognosis, and metastatic potential was analyzed.

Results

One hundred patients had STMN‐1 protein overexpression (57.47%), and the patients with overexpression were accompanied by significantly higher rate of lymphatic metastatic recurrence as compared with patients who had low STMN‐1 expression (P = 0.003). Multivariable Cox regression analysis revealed that the STMN‐1 protein expression and T classification were independent factors to predict the lymphatic metastatic recurrence (P = 0.007, P = 0.000, respectively).

Conclusions

Even pN0 ESCC are a potential to lymphatic metastatic recurrence. Stathmin overexpression can be used as a marker to identify those patients who are at high risk for lymphatic metastatic recurrence in pN0 ESCC after an Ivor‐Lewis esophagectomy.
Primary hepatic angiosarcoma and potential treatment options
Authors: Zheng Ya‐wen , Zhang Xin‐wei , Zhang Jia‐li , Hui Zhen‐zhen , Du Wei‐jiao , Li Run‐mei , Ren Xiu‐bao
Published: December 2013

Angiosarcomas account for a mere 2–3% of adult soft tissue sarcomas, with an overall poor outcome. Depending on the primary site, angiosarcomas have distinct prognosis. Primary hepatic angiosarcomas (PHAs) are much rare tumors, with worse prognosis compared with other angiosarcomas. PHA is reported to be associated with vinyl chloride, but the majority of patients were still with unknown etiology. As PHA lacks specific symptoms, signs, or images, pathological diagnosis is necessary. The review summarizes 25 articles published from January 2000 to December 2012, including 64 cases of PHA with detailed information. Survival curves are estimated using the Kaplan–Meier method by SPSS 21.0. We find that the median survival time is 5 months; local excision alone or combination with adjuvant therapy is the optimal choice, with median survival time of 17 months. In addition, liver transplant is abandoned for high recurrence rate; emergent transcatheter arterial embolization is thought to be an efficient method for controlling intra‐abdominal bleeding; and transcatheter arterial chemoembolization and chemotherapy may be helpful in improving survival.
Long‐term outcome of patients with gastric varices treated by balloon‐occluded retrograde transvenous obliteration
Authors: Naeshiro Noriaki , Aikata Hiroshi , Kakizawa Hideaki , Hyogo Hideyuki , Kan Hiromi , Fujino Hatsue , Kobayashi Tomoki , Fukuhara Takayuki , Honda Yohji , Ohno Atsushi , Miyaki Daisuke , Kawaoka Tomokazu , Tsuge Masataka , Hiraga Nobuhiko , Hiramatsu Akira , Imamura Michio , Kawakami Yoshiiku , Takahashi Shoichi , Awai Kazuo , Chayama Kazuaki
Published: December 2013

Background and Aim

To assess the short‐ and long‐term outcome of patients with gastric varices (GV) after balloon‐occluded retrograde transvenous obliteration (B‐RTO) by comparing bleeding cases with prophylactic cases.

Methods

Consecutive 100 patients with GV treated by B‐RTO were enrolled in this retrospective cohort study. We compared the technical success, complications, and survival rates between bleeding and prophylactic cases.

Results

Of 100 patients, 61 patients were bleeding cases and 39 patients were prophylactic cases. Technical success was achieved in 95% of bleeding case and in 100% of prophylactic case, with no significant difference between these groups (overall technical success rate, 97%). The survival rates at 5 and 10 years were 50% and 22% in bleeding case, and 49% and 36% in prophylactic case, respectively. There was also no significant difference (P = 0.420). By multivariate analysis, survival rates correlated significantly with liver function (hazard ratio 2.371, 95% CI 1.457–3.860, P = 0.001) and hepatocellular carcinoma development (HR 4.782, 95% CI 2.331–9.810, P < 0.001). The aggravating rates of esophageal varices (EV) were 21%, 50%, and 54% at 12, 60, and 120 months after B‐RTO. By multivariate analysis, aggravating rates significantly correlated with EV existing before B‐RTO (HR 18.114, 95% CI 2.463–133.219, P = 0.004).

Conclusion

B‐RTO for GV could provide the high rate of complete obliteration and favorable long‐term prognosis even in bleeding cases as well as prophylactic cases. Management of EV after B‐RTO, especially in coexisting case of GV and EV, would be warranted.
Endotoxemia unrequired in the pathogenesis of pediatric nonalcoholic steatohepatitis
Authors: Yuan Jianye , Baker Susan S , Liu Wensheng , Alkhouri Razan , Baker Robert D , Xie Jianqun , Ji Guang , Zhu Lixin
Published: December 2013

Background and Aim

Nonalcoholic steatohepatitis (NASH), the severe form of nonalcoholic fatty liver disease, is a serious liver complication associated with obesity. Several studies suggest that endotoxemia is associated with nonalcoholic fatty liver disease and NASH. We aimed to study the correlation of gut microbiome composition and the incidence of endotoxemia in obese patients and NASH patients in comparison with normal controls.

Methods

The abundance of Gram‐negative bacteria in the gut microbiomes of normal controls, obese patients with normal liver, and biopsy‐proven NASH patients were assessed using 16S rRNA pyrosequencing data. Serum endotoxin was determined by endpoint limulus amebocyte lysate assay.

Results

Higher abundance of Gram‐negative bacteria in gut microbiome was observed in obese and NASH patients in comparison with normal controls, but no difference was detected between obese and NASH patients. Serum endotoxin is higher in the NASH group than the normal controls. In addition, the obese and NASH patients had a higher incidence of endotoxemia compared with normal controls. However, Spearman's test found no correlation between the abundance of Gram‐negative bacteria and serum endotoxin levels. The majority of the NASH patients and the obese patients had low serum endotoxin level. Among NASH patients, serum endotoxin is not correlated with disease severity.

Conclusions

Our data suggest that the gut microbiome composition does not contribute to the incidence of endotoxemia in NASH, and endotoxemia is not required in the pathogenesis of NASH. Our observations highlight the current concept that multiple factors contribute to the development of NASH.
Association of greater intravenous volume infusion with shorter hospitalization for patients with post‐ERCP pancreatitis
Authors: Sagi Sashidhar V , Schmidt Suzette , Fogel Evan , Lehman Glen A , McHenry Lee , Sherman Stuart , Watkins James , Coté Gregory A
Published: December 2013

Background and Aim

There are no data specifically correlating early intravenous volume infusion (IVI) with the length of hospitalization for postendoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP).

Methods

We conducted a retrospective cohort study of patients admitted within 24 h after ERCP to our institute with PEP. IVI during the first 24 h after ERCP was assessed. Primary outcome was severity of PEP, defined by length of hospitalization according to consensus guidelines: mild ≤ 3, moderate 4–10, and severe > 10 days.

Results

Of 72 eligible patients, 41 (56.9%) had mild and 31 (43.1%) moderate/severe PEP. Both groups had comparable demographics, indications, and procedural factors except patients with moderate/severe PEP were older (median age 49 vs 36 years, P = 0.05) and more likely to be discharged and readmitted within the first 24 h (41.9% vs 14.6%, P < 0.01). Patients with mild PEP received significantly greater IVI during the first 24 h (2834 mL [2046, 3570] vs 2044 mL [1227, 2875], P < 0.02) and 50% more fluid post‐ERCP (2270 mL [1435, 2961] vs 1515 [950–2350], P < 0.02) compared with those with at least moderate PEP.

Conclusion

In patients with PEP, greater IVI during the first 24 h after ERCP is associated with reduced length of hospitalization. Lower IVI was more commonly observed in individuals who were discharged and then readmitted during the first 24 h.
Evaluation of pigtail macaques as a model for the effects of copper intrauterine devices on HIV infection
Authors: Engel Robyn M. , Morris Monica , Henning Tara , Ritter Jana M. , Jones Tara L. , Dietz Sharon , Ayers Jessica , Vishwanathan Sundaram A. , Jenkins Leecresia , Zaki Sherif , Wildemeersch Dirk , Garber David , Powell Nathaniel , Michael Hendry R. , McNicholl Janet , Kersh Ellen N.
Published: December 2013

Background

Long‐acting, hormonal contraception may increase HIV risk. Copper intrauterine devices (IUDs) could serve as non‐hormonal alternatives. We pilot a pigtail macaque model for evaluating HIV susceptibility factors during copper IUD use.

Methods

Frameless and flexible GyneFix® copper IUDs were surgically implanted into three SHIVSF162p3‐positive macaques via hysterotomy and monitored for up to 4 months. Four macaques served as non‐IUD controls.

Results

All animals retained the devices without complications. No consistent change in vaginal viral RNA or inflammatory cytokines was seen. Two animals had altered menstrual cycles and experienced marked thinning of vaginal epithelium after IUD insertion. Histological examination of uterine tissue at necropsy revealed endometrial ulceration and lymphocytic inflammation with glandular loss at sites of direct IUD contact.

Conclusions

Although the need for insertion surgery could limit its usefulness, this model will allow studies on copper IUDs and SHIV shedding, disease progression, and HIV susceptibility factors.
Incidence and risk factors for winged scapula after surgical treatment for breast cancer
Authors: Mastrella Adriana de S , Freitas‐Junior Ruffo , Paulinelli Régis R , Soares Leonardo R
Published: December 2013

Aims and objectives

To evaluate the incidence of winged scapula following surgical breast cancer treatment, determine its evolution over time and correlate factors that might influence this incidence.

Background

Winged scapula is a complication that may occur as a result of exposing the long thoracic nerve during axillary lymphadenectomy for the treatment for breast cancer. There is no consensus in the literature about the incidence of this complication after surgical treatment for breast cancer, and complication rates range from 1·5–74%.

Design

This is a prospective cohort study.

Methods

A prospective cohort study was conducted including 57 patients with breast cancer who underwent surgical treatment. Each patient was assessed before and after the surgery, by means of Hoppenfeld manoeuvre. The incidence rate of winged scapula was calculated at four different times.

Results

At the preoperative assessment, none of the patients presented with winged scapula, while 16 patients (28·1%) were shown to have this complication after the procedure. The incidence of winged scapula decreased over time. Factors associated with winged scapula were as follows: patients younger than 50 years, clinical stage I and II and no neoadjuvant chemotherapy. Other factors that were evaluated, such as type of surgery, number of lymph nodes compromised and removed, as well as body mass index, were not associated with the risk of winged scapula.

Conclusions

This study demonstrated that the incidence of winged scapula is low and decreased over time. Furthermore, a greater incidence of winged scapula was noted in young women at an initial stage of the disease who had not been treated with neoadjuvant chemotherapy.

Relevance to clinical practice

The result of this work may have great impact, for demonstrating what risk factors are significantly associated with winged scapula after surgical treatment for breast cancer.
Anxiety and fear in patients with short waiting times before coronary artery bypass surgery – a qualitative study
Authors: Feuchtinger Johanna , Burbaum Christina , Heilmann Claudia , Imbery Claudia , Siepe Matthias , Stotz Ulrike , Fritzsche Kurt , Beyersdorf Friedhelm
Published: December 2013

Aims and objectives

To obtain qualitative information on fears and anxieties of coronary artery bypass grafting patients with short waiting periods (up to a maximum of four weeks) before surgery.

Background

Coronary artery bypass grafting is a standard procedure in cardiac surgery. However, many patients suffer significant anxiety and fear before the operation. Preoperative anxiety and fear correlate with adverse outcomes, but there is a lack of data on the emotional stressors for patients with short waiting periods as applicable in Germany. This knowledge would be a prerequisite for the development of in‐hospital interventions to reduce patients' anxieties and fears.

Design

An exploratory study was chosen to learn about patients' anxieties and fears.

Method

The day before coronary artery bypass grafting, 24 patients were examined with respect to their emotional experience using semi‐structured interviews. The results were categorised by inductive content analysis.

Results

The overall waiting time for coronary artery bypass grafting was 6 ± 6 days. According to the analysis, the patients' statements were grouped in ‘fears', ‘negation of fears' and ‘other emotional and physical conditions'. The interviews could cover all categories simultaneously. Eighteen patients mentioned fears, and most of them referred to specific issues. However, 16 of the 18 patients also named nonspecific fears and uncertainties. Fifteen patients negated fear. Twenty‐three patients described their emotions and/or somatic conditions.

Conclusions

Patients with short waiting periods before coronary artery bypass grafting experience specific as well as nonspecific fears on the day before surgery. In contrast to patients with long waiting (longer than four weeks), uncertainty and frustration about waiting time and feelings of disability are no concerns.

Relevance to clinical practice

The detailed insight into the emotional experiences of patients with a short waiting time before coronary artery bypass grafting surgery is a basis for targeted anxiety‐reducing interventions.
Nurse's perspectives on care provided for patients with gamma‐hydroxybutyric acid and gamma‐butyrolactone abuse
Authors: Lundahl Maja‐Klara , Olovsson Karl Johan , Rönngren Ylva , Norbergh Karl‐Gustaf
Published: December 2013

Aims and objectives

To describe registered nurses' views and experiences providing care for gamma‐hydroxybutyric acid and gamma‐butyrolactone abuse inpatients in a psychiatric unit.

Background

Gamma‐hydroxybutyric acid and gamma‐butyrolactone are illegal drugs with potentially fatal outcomes that are entering wider use in Scandinavia. Gamma‐hydroxybutyric acid‐dependent persons with withdrawal symptoms often require forceful withdrawal treatment provided in psychiatric units.

Design

A qualitative study with a purposive sample including interviews from registered nurses.

Methods

Data were collected from interviews with 15 registered nurses working in specialised dependency units in psychiatric wards. The data collected were analysed through a descriptive, qualitative analysis.

Results

The registered nurses' narratives revealed four main areas of convergence: feelings of anxiety and despair, preparation for unpredictable and precarious situations, striving for good relationship and striving to optimise and develop nursing care. The interviews revealed that registered nurses reflect on and discuss their feelings about their patients' situations with colleagues; prepare themselves for potential aggressiveness and unpredictable situations; improve their care through conscious attitude adjustment and relationship‐forming behaviours; and strive to increase their personal knowledge, maintain a hopeful outlook and exhibit a positive approach. These themes were found in all nine categories and sixteen subcategories.

Discussion

The findings based on the registered nurses' narratives indicated that the registered nurses experienced their work situation when caring for these patients to be very complex and demanding.

Conclusion

The study revealed that registered nurses worked extensively to craft their approach and attitude towards their patients. It is clear that registered nurses use themselves as tools or instruments for the creation of good relationships, thus providing the best care possible.

Relevance to clinical practice

Registered nurses should be given more education, clearer guidelines and better guidance to assist them in facing such challenging and often problematic situations. One‐on‐one shadowing provides the possibility to create and develop relationship.
Maternal parental self‐efficacy in newborn care and social support needs in Singapore: a correlational study
Authors: Shorey Shefaly , Chan Sally Wai‐Chi , Chong Yap Seng , He Hong‐Gu
Published: December 2013

Aim and objective

To examine the correlation between maternal parental self‐efficacy and social support as well as predictors of self‐efficacy in the early postpartum period.

Background

Maternal parental self‐efficacy is important for mothers’ adaptation to motherhood. Lack of support could result in decreased maternal parental self‐efficacy in newborn care. Limited studies have focused on maternal parental self‐efficacy in the postpartum period in Asia and none in Singapore.

Study design

A correlational study design was adopted.

Methods

Data were collected from both primiparas and multiparas during the first to third days postpartum in a public hospital, using the Perceived Maternal Parental Self‐efficacy and Perinatal Infant Care Social Support Scales. The data were analysed using descriptive and inferential statistics.

Results

Maternal parental self‐efficacy in newborn care and the level of social support that mothers received were moderate. In terms of the social support subscales, informational and instrumental support was lower than emotional and appraisal support. Informal support from husbands, parents and parents‐in‐law was the main source of support. A significant correlation was found between maternal parental self‐efficacy and total social support in addition to the informational, instrumental and appraisal subscales of functional support. The predictors of maternal parental self‐efficacy were parity, social support and maternal age.

Conclusion

The findings highlight the predictors and correlates of maternal parental self‐efficacy in newborn care and the social support needs of mothers in the early postpartum period. Healthcare professionals could provide more information and instrumental support and involve family members to enhance maternal parental self‐efficacy.

Relevance to clinical practice

Because maternal parental self‐efficacy and social support in the early postpartum period are interrelated components, they could be assessed to identify at‐risk mothers. There is a need to develop perinatal educational programmes to provide culturally competent individualised support to mothers in need.