bluuebunny/crossref_metadata_2025 huggingface dataset:
Spontaneous Formation of Vertically Aligned Lamellae in Thin Films of Block Copolymer–Silica Hybrid Material
Authors: Hara Mitsuo , Nagano Shusaku , Seki Takahiro
Published: August 2013

Vertical alignment of mesoscaled and phase-separated structures in organic–inorganic hybrid materials has significant potential for various applications. However, particular procedures and treatments are required to generate such pattern geometries. We demonstrate herein a simple and spontaneous process for vertical alignment of mesoscopic phase-separated structures in a hybrid material consisting of an amphiphilic block copolymer that possesses a thermotropic liquid crystal framework and silicate sol. By combining the thermotropic and lyotropic liquid crystal properties, the sol–gel condensation in this system spontaneously leads to the vertical alignment of mesoscopic lamellae. Most likely, the vertical molecular orientation formed in the thermotropic smectic liquid crystal domains promotes the vertical alignment of the mesoscaled lyotropic liquid crystalline structure of the hybrid film. The organic block components in the film could be selectively etched by ultraviolet light/ozone treatment and, consequently, provide a topologically undulated silica film that retains the vertical lamella structure of the precursor hybrid film. This approach via the hybridization with a metal oxide sol solution is advantageous in tuning the lateral pitch of the structure simply by adjusting the volume fraction of precursor sol content.
Thrombose der Vena saphena parva
Authors: Mendoza E.
Published: August 2013

Thrombosen der Stammvenen sind meist sehr schmerzhaft. Besonders beim Laufen schmerzt die Thrombose der V. saphena parva, die direkt auf der Wadenmuskulatur aufliegend verläuft. Diese Thrombosen können spontan auftreten oder motiviert nach Zwangshaltungen (Hocke), Beinruhigstellung oder nach Wadenverletzungen. Von einer Thrombose in oberflächli-chen Beinvenen geht eine besondere Gefähr-dung aus, da diese meist über eine breite Mündung mit der tiefen Beinvene verbunden sind und hierüber ein Einwachsen des Thrombus in die tiefe Beinvene möglich ist. Differenzialdiagnostisch muss eine Folge nach Behandlung der V. saphena parva erwogen werden, wie die Sklerotherapie oder endoluminalen Behandlungen (z.B. Venefit oder LASER). Thrombosen oberflächlicher Beinvenen wurden klassisch Phlebitis genannt. Um Verwechslungen mit infektiösen Vorgängen zu vermeiden, wurde die Verwendung des Begriffs „Thrombose der oberflächlichen Beinvene” statt Phlebitis vorgeschlagen.
Imposing Connectivity Constraints in Forest Planning Models
Authors: Carvajal Rodolfo , Constantino Miguel , Goycoolea Marcos , Vielma Juan Pablo , Weintraub Andrés
Published: August 2013

Connectivity requirements are a common component of forest planning models, with important examples arising in wildlife habitat protection. In harvest scheduling models, one way of addressing preservation concerns consists of requiring that large contiguous patches of mature forest are maintained. In the context of nature reserve design, it is common practice to select a connected region of forest, as a reserve, in such a way as to maximize the number of species and habitats protected. Although a number of integer programming formulations have been proposed for these forest planning problems, most are impractical in that they fail to solve reasonably sized scheduling instances. We present a new integer programming methodology and test an implementation of it on five medium-sized forest instances publicly available in the Forest Management Optimization Site repository. Our approach allows us to obtain near-optimal solutions for multiple time-period instances in fewer than four hours.
Opening the “Black Box” of Efficiency Measurement: Input Allocation in Multioutput Settings
Authors: Cherchye Laurens , Rock Bram De , Dierynck Bart , Roodhooft Filip , Sabbe Jeroen
Published: August 2013

We develop a new data envelopment analysis (DEA)-based methodology for measuring the efficiency of decision-making units (DMUs) characterized by multiple inputs and multiple outputs. The distinguishing feature of our method is that it explicitly includes information about output-specific inputs and joint inputs in the efficiency evaluation. This method contributes to opening the “black box” of efficiency measurement in two different ways. First, including information on the input allocation substantially increases the discriminatory power of the efficiency measurement. Second, it allows us to decompose the efficiency value of a DMU into output-specific efficiency values, which facilitates the identification of the outputs the manager should focus on to remedy the observed inefficiency. We demonstrate the usefulness and managerial implications of our methodology by means of a unique data set collected from the activity-based costing (ABC) system of a large service company with 290 DMUs.
A Network Airline Revenue Management Framework Based on Decomposition by Origins and Destinations
Authors: Birbil Ş. İlker , Frenk J. B. G. , Gromicho Joaquim A. S. , Zhang Shuzhong
Published: August 2013

We propose a framework for solving airline revenue management problems on large networks, where the main concern is to allocate the flight leg capacities to customer requests under fixed class fares. This framework is based on a mathematical programming model that decomposes the network into origin-destination pairs so that each pair can be treated as a single flight-leg problem. We first discuss that the proposed framework is quite generic in the sense that not only several well-known models from the literature fit into this framework, but also many single flight-leg models can be easily extended to a network setting through the prescribed construction. Then, we analyze the structure of the overall mathematical programming model and establish its relationship with other models frequently used in practice. The application of the proposed framework is illustrated through two examples based on static and dynamic single-leg models, respectively. These illustrative examples are then benchmarked against several existing methods on a set of real-life network problems.
Idiopathic hypercalcaemia in cats: diagnostic approach and therapy
Authors: Orioles Massimo , De Cecco Silvia
Published: August 2013

Idiopathic hypercalcemia (IHC) in cats has become increasingly recognised since 1990 as a relatively common finding in biochemistry profiles. It is still unknown if increased intestinal calcium absorption, increased bone resorption, or decreased renal calcium excretion plays the main role in the development of the ionised hypercalcemia in this syndrome. This article describes two cases of IHC and provides an in depth discussion on diagnostic approach and treatment.
Endoscopy: part 3 – rigid endoscopy: an overview
Authors: Robertson Elise
Published: August 2013

Over the last few decades, advanced and relatively high-tech medicine, traditionally associated with the human field, is now an available, accepted and widely utilised by many veterinary practitioners worldwide. Up until now, these procedures had been reserved for those practicing in veterinary teaching hospitals and private referral institutions. One of the most exciting of these procedures is the implementation of rigid diagnostic and interventional endoscopy and endosurgery in our daily caseload.
Logical use of antibiotics in canine skin disease
Authors: Craig Mark
Published: August 2013

Antimicrobial resistance in companion animals is a growing problem, and veterinary practitioners must carefully select antimicrobial treatment. In this article, factors affecting antibiotic selection and common reasons for treatment failure in canine skin disease are discussed. A table of antibiotics licensed for sysemic administration in dogs with skin disease is included ( Table 2 ).
A sub fertility problem in dairy heifers
Authors: Crawshaw William Mark
Published: August 2013

A subfertility problem in a group of 23 dairy heifers was investigated. The diagnosis was bovine venereal campylobacteriosis due to Campylobacter fetus subspecies venerealis biovar intermedius. The clinical features of the case, the investigation procedure (including a simple cost:benefit analysis) and the control method advised are presented. In connection with the case reported, bovine venereal campylobacteriosis is briefly reviewed and the pathological significance of the different subspecies and biovars of Campylobacter fetus is briefly discussed.
Update on the diagnosis and management of pituitary pars intermedia dysfunction in horses
Authors: Rendle David
Published: August 2013

While our understanding of pituitary pars intermedia dysfunction (PPID) remains limited a great deal of progress has been made recently in diagnosis and management of the condition. The disease should be considered in all but the youngest horses with laminitis and endocrine testing should be performed. Measurement of adrenocorticotropic hormone (ACTH) and insulin concentrations are recommended and a follow-up thyrotropin-releasing hormone (TRH) stimulation test should be performed if borderline ACTH results are obtained. Pergolide is the only licensed treatment for the condition and the only treatment that is likely to be effective. Horses that are being treated should be monitored clinically and endocrinologically every few months as response to treatment between individuals is variable. The importance of appropriate nutrition and good preventive medicine in horses with PPID cannot be overemphasised.
Surgical treatment of penile and preputial neoplasia in the horse
Authors: Suthers Joanna
Published: August 2013

Between 6 and 10% of all neoplasms in the horse are reported to involve the penis or the prepuce. Penile or preputial neoplasia in the horse can cause discomfort, and in advanced cases can result in systemic disease. Therefore, it is important that the general practitioner is able to advise an owner on the most appropriate treatment for their horse and on any potential complications. This article outlines the approach to a case with penile or preputial neoplasia and describes the surgical treatment options.
Implant survival after deep infection of an instrumented spinal fusion
Authors: Núñez-Pereira S. , Pellisé F. , Rodríguez-Pardo D. , Pigrau C. , Bagó J. , Villanueva C. , Cáceres E.
Published: August 2013

This study evaluates the long-term survival of spinal implants after surgical site infection (SSI) and the risk factors associated with treatment failure.

A Kaplan-Meier survival analysis was carried out on 43 patients who had undergone a posterior spinal fusion with instrumentation between January 2006 and December 2008, and who consecutively developed an acute deep surgical site infection. All were appropriately treated by surgical debridement with a tailored antibiotic program based on culture results for a minimum of eight weeks.

A ‘terminal event’ or failure of treatment was defined as implant removal or death related to the SSI. The mean follow-up was 26 months (1.03 to 50.9). A total of ten patients (23.3%) had a terminal event. The rate of survival after the first debridement was 90.7% (95% confidence interval (CI) 82.95 to 98.24) at six months, 85.4% (95% CI 74.64 to 96.18) at one year, and 73.2% (95% CI 58.70 to 87.78) at two, three and four years. Four of nine patients required re-instrumentation after implant removal, and two of the four had a recurrent infection at the surgical site. There was one recurrence after implant removal without re-instrumentation.

Multivariate analysis revealed a significant risk of treatment failure in patients who developed sepsis (hazard ratio (HR) 12.5 (95% confidence interval (CI) 2.6 to 59.9); p < 0.001) or who had > three fused segments (HR 4.5 (95% CI 1.25 to 24.05); p = 0.03). Implant survival is seriously compromised even after properly treated surgical site infection, but progressively decreases over the first 24 months.

Cite this article: Bone Joint J 2013;95-B:1121–6.
Obesity has no adverse effect on the outcome of unicompartmental knee replacement at a minimum follow-up of seven years
Authors: Cavaignac E. , Lafontan V. , Reina N. , Pailhé R. , Warmy M. , Laffosse J. M. , Chiron P.
Published: August 2013

The significance of weight in the indications for unicompartmental knee replacement (UKR) is unclear. Our hypothesis was that weight does not affect the long-term rate of survival of UKRs.

We undertook a retrospective study of 212 UKRs at a mean follow-up of 12 years (7 to 22). The patients were distributed according to body mass index (BMI; < vs ≥ 30 kg/m2) and weight (< vs ≥ 82 kg). Kaplan-Meier survivorship analysis was performed and ten-year survival rates were compared between the sub-groups. Multimodal regression analysis determined the impact of the various theoretical contraindications on the long-term rate of survival of UKR.

The ten-year rates of survival were similar in the two weight subgroups (≥ 82 kg: 93.5% (95% confidence interval (CI) 66.5 to 96.3); < 82 kg: 92.5% (95% CI 82.5 to 94.1)) and also in the two BMI subgroups (≥ 30 kg/m2: 92% (95% CI 82.5 to 95.3); < 30 kg/m2: 94% (95% CI 78.4 to 95.9)). Multimodal regression analysis revealed that weight plays a part in reducing the risk of revision with a relative risk of 0.387, although this did not reach statistical significance (p = 0.662). The results relating weight and BMI to the clinical outcome were not statistically significant. Thus, this study confirms that weight does not influence the long-term rate of survival of UKR.

Cite this article: Bone Joint J 2013;95-B:1064–8.
Lateral femoral wall thickness
Authors: Hsu C-E. , Shih C-M. , Wang C-C. , Huang K-C.
Published: August 2013

Although the importance of lateral femoral wall integrity is increasingly being recognised in the treatment of intertrochanteric fracture, little attention has been put on the development of a secondary post-operative fracture of the lateral wall. Patients with post-operative fractures of the lateral wall were reported to have high rates of re-operation and complication. To date, no predictors of post-operative lateral wall fracture have been reported. In this study, we investigated the reliability of lateral wall thickness as a predictor of lateral wall fracture after dynamic hip screw (DHS) implantation.

A total of 208 patients with AO/OTA 31-A1 and -A2 classified intertrochanteric fractures who received internal fixation with a DHS between January 2003 and May 2012 were reviewed. There were 103 men and 150 women with a mean age at operation of 78 years (33 to 94). The mean follow-up was 23 months (6 to 83). The right side was affected in 97 patients and the left side in 111. Clinical information including age, gender, side, fracture classification, tip–apex distance, follow-up time, lateral wall thickness and outcome were recorded and used in the statistical analysis.

Fracture classification and lateral wall thickness significantly contributed to post-operative lateral wall fracture (both p < 0.001). The lateral wall thickness threshold value for risk of developing a secondary lateral wall fracture was found to be 20.5 mm.

To our knowledge, this is the first study to investigate the risk factors of post-operative lateral wall fracture in intertrochanteric fracture. We found that lateral wall thickness was a reliable predictor of post-operative lateral wall fracture and conclude that intertrochanteric fractures with a lateral wall thickness < 20.5 mm should not be treated with DHS alone.

Cite this article: Bone Joint J 2013;95-B:1134–8.
Comparison of the HINTEGRA and Mobility total ankle replacements
Authors: Choi G. W. , Kim H. J. , Yeo E. D. , Song S. Y.
Published: August 2013

In a retrospective study we compared 32 HINTEGRA total ankle replacements (TARs) and 35 Mobility TARs performed between July 2005 and May 2010, with a minimum follow-up of two years. The mean follow-up for the HINTEGRA group was 53 months (24 to 76) and for the Mobility group was 34 months (24 to 45). All procedures were performed by a single surgeon.

There was no significant difference between the two groups with regard to the mean AOFAS score, visual analogue score for pain or range of movement of the ankle at the latest follow-up. Most radiological measurements did not differ significantly between the two groups. However, the most common grade of heterotopic ossification (HO) was grade 3 in the HINTEGRA group (10 of 13 TARs, 76.9%) and grade 2 in the Mobility group (four of seven TARs, 57.1%) (p = 0.025). Although HO was more frequent in the HINTEGRA group (40.6%) than in the Mobility group (20.0%), this was not statistically significant (p = 0.065).The difference in peri-operative complications between the two groups was not significant, but intra-operative medial malleolar fractures occurred in four (11.4%) in the Mobility group; four (12.5%) in the HINTEGRA group and one TAR (2.9%) in the Mobility group failed (p = 0.185).

Cite this article: Bone Joint J 2013;95-B:1075–82.
Standardization of LC-MS for Therapeutic Drug Monitoring of Tacrolimus
Authors: Annesley Thomas M , McKeown Denise A , Holt David W , Mussell Christopher , Champarnaud Elodie , Harter Leonie , Calton Lisa J , Mason Donald S
Published: August 2013

BACKGROUND

LC-MS is increasingly used for therapeutic drug monitoring of tacrolimus. A recent summary from an international proficiency-testing scheme demonstrated that the mass spectrometry respondents were the largest method group. However, these methods lack standardization, which may explain the relatively poor interlaboratory agreement for such methods. This study aimed to provide one path toward the standardization of tacrolimus quantification by use of LC-MS.

METHODS

A 40-member whole blood tacrolimus proficiency panel was circulated to 7 laboratories, 4 in the US and 3 in Europe, offering routine LC-MS–based quantification of tacrolimus. All laboratories used a common LC-MS platform and followed the manufacturer's instructions that accompanied an LC-MS reagent kit intended for tacrolimus quantification in whole blood samples. Four patient pools were prepared that had sufficient volume to allow comparison with a tacrolimus reference measurement procedure.

RESULTS

For the 40-member panel, the standardized MassTrak LC-MS assay demonstrated excellent agreement with a validated LC-MS method used by Analytical Services International (y = 1.02x − 0.02; r = 0.99). The CVs for the pooled patient samples ranged from 2.0% to 5.4%. The mean difference from the reference measurement procedure ranged from 0.4% to 4.4%.

CONCLUSIONS

Tacrolimus assay standardization, which must include all facets of the analysis, is necessary to compare patient results between laboratories and to interpret consensus guidelines. LC-MS can provide accurate and precise measurement of tacrolimus between laboratories.
Access Granted: The Phenomenology of Approach in Early Islamic Palatial Architecture
Authors: Damgaard Kristoffer
Published: August 2013

Early Islamic palatial architecture displays certain identifiable and formalized characteristics that have been extensively discussed for decades now, and scholarship is gradually moving towards a coherent understanding of the intrinsic principles behind their conceptualization.

One of the central principles in early Islamic palaces was the use of an axial approach as a structuring architectural principle. This axis was subdivided by physical demarcations that indicated increases in a given space’s social and symbolic importance. The assignment of value to space was based on proximity to the patron, and the architecture is designed to manifest this spatial hierarchy. This article explores the origin of this tradition by analysing the application and development of transitional devices in the late Umayyad palaces of Amman Citadel and Mshatta.

By considering spatial composition as a subtle yet powerful means of stimulating a cognitive recognition of social hierarchies, and the movement between them, a number of pre-Islamic complexes are gauged as possible sources of inspiration for the early Muslim patrons. This includes the identification of certain features and concepts that not only are suggested to be common, deliberate and meaningful, but indeed are key to understanding how the late Umayyad rulers formulated a sustainable materiality of Islamic rule.
Amyloid-like fibrils labeled with magnetic nanoparticles
Authors: Solin Niclas
Published: August 2013

A number of human diseases are associated with the formation of insoluble protein aggregates commonly known as amyloid fibrils or amyloid plaques. Similar materials can be prepared in vitro resulting in so-called amyloid-like fibrils. Herein is discussed how to prepare such fibrils labeled with magnetic nanoparticles. Such materials have the potential to be used as magnetic probes for magnetic resonance imaging applications.
New insights into the activation of sterol regulatory element-binding proteins by proteolytic processing
Authors: Inoue Jun , Sato Ryuichiro
Published: August 2013

Sterol regulatory element-binding proteins (SREBPs) are transcription factors that regulate a wide variety of genes involved in cholesterol and fatty acid synthesis. After transcription, SREBPs are controlled at multiple post-transcriptional levels, including proteolytic processing and post-translational modification. Among these, proteolytic processing is a crucial regulatory step that activates SREBPs, which are synthesized as inactive endoplasmic reticulum membrane proteins. In this review, we focus on recent progress with regard to signaling pathways and small molecules that affect activation of SREBPs by proteolytic processing.
Effects of cyclosporine and phenytoin on biomarker expressions in gingival fibroblasts of children and adults: an in vitro study
Authors: Vahabi Surena , Salman Bahareh Nazemi , Rezazadeh Fahimeh , Namdari Mahshid
Published: August 2013

Background: Both phenytoin (PhT) and cyclosporine (CsA) have been related to gingival overgrowth, but the presence and incidence of cytokines in gingival tissues are associated with different mechanisms. On the basis of a few epidemiologic data, children are more prone to have gingival overgrowth than adults and there is no obvious plausibility to justify this difference. The aim of this study was to investigate the effect of PhT and CsA on the some biological marker expression and compare it among adults and children.

Methods: Gingival fibroblasts that had been harvested from adults and children with normal gingiva were incubated with CsA and PhT and then cultured for 48 h. Matrix metalloproteinases (MMP-1 and MMP-2), tissue inhibitor of metalloproteinases (TIMP), collagen (CoL), elastin (Eln), lysyl oxidase (Lysyl), cathepsin (Cat) L and B, and mRNA levels in culture were determined by reverse transcription polymerase chain reaction. The amounts of transforming growth factor-β (TGF-β) and epidermal growth factor (EGF) were assessed by enzyme-linked immunosorbent assay.

Results: CsA and PhT stimulated TGF-β and Cat B production and inhibited expression of MMP-1 by fibroblasts. CsA suppressed TIMP in children, but PhT stimulated its expression. In adults, both CSA and PHT increased TGF-β, Lysyl, and EGF levels. CsA reduced Eln level, whereas PhT increased it.

Conclusions: The results suggest that CsA and PhT have different effects on biogene marker expression in adults and children, or drug-induced gingival overgrowth is affected by different cellular pathways in children in contrast to that in adults. It seems that in children the MMP-1/TIMP system, and in adults the Lysyl/Eln pathway, plays an important role in impaired CoL metabolism.
Insulin secretion and sensitivity in the prediction of type 1 diabetes in children with advanced β-cell autoimmunity
Authors: Siljander Heli T , Hermann Robert , Hekkala Anne , Lähde Jyrki , Tanner Laura , Keskinen Päivi , Ilonen Jorma , Simell Olli , Veijola Riitta , Knip Mikael
Published: August 2013

Objective

Reduced early insulin response has been shown to predict type 1 diabetes (T1D) in first-degree relatives of diabetic patients, while its role, as well as that of insulin resistance, has remained poorly defined in young children representing the general population. The predictive values of these markers and their relation to other risk factors of T1D were assessed in children with advanced β-cell autoimmunity, i.e. persistent positivity for two or more autoantibodies.

Design and methods

Intravenous glucose tolerance tests (IVGTTs) were carried out in 218 children withHLA-DQB1-conferred disease susceptibility and advanced β-cell autoimmunity. Baseline, metabolic and growth data were compared between children progressing to diabetes and those remaining unaffected. Hazard ratios for the disease predictors and the progression rate of T1D were assessed.

Results

Children developing T1D were younger at seroconversion, progressed more rapidly to advanced β-cell autoimmunity and had lower first-phase insulin response (FPIR) and homeostasis model assessment index for insulin resistance (HOMA-IR) than those remaining non-diabetic. The levels of HOMA-IR/FPIR, islet cell antibodies, insulin autoantibodies (IAA) and islet antigen 2 antibodies (IA-2A) were higher in progressors. BMI SDS, FPIR, age at IVGTT and levels of IAA and IA-2A were predictive markers for T1D.

Conclusions

Young age, higher BMI SDS, reduced FPIR and higher levels of IAA and IA-2A predicted T1D in young children withHLA-DQB1-conferred disease susceptibility and advanced β-cell autoimmunity. Disease risk estimates were successfully stratified by the assessment of metabolic status and BMI. The role of insulin resistance as an accelerator of the disease process was minor.
Clinical characteristics and effects of GH replacement therapy in adults with childhood-onset craniopharyngioma compared with those in adults with other causes of childhood-onset hypothalamic–pituitary dysfunction
Authors: Yuen Kevin C J , Koltowska-Häggström Maria , Cook David M , Fox Janet L , Jönsson Peter J , Geffner Mitchell E , Abs Roger
Published: August 2013

Objective

Adults with childhood-onset (CO) craniopharyngioma (COCP) have poor quality of life (QoL) and clinical outcomes, but few studies have compared these patients with adults with other causes of CO hypothalamic–pituitary dysfunction. In this study, we compared baseline clinical characteristics and patient-reported outcomes before starting GH replacement therapy in adults with GH deficiency (GHD) due to COCP with those of adults either with CO idiopathic/congenital hypopituitarism (COH) or with CO extrasellar (COE) tumours, and evaluated the 1- and 5-year effects of GH replacement therapy.

Subjects and methods

Retrospective analysis of the data recorded in KIMS (Pfizer International Metabolic Database) was carried out. Patients with COCP, COH and COE tumours were evaluated at baseline, and after 1 and 5 years of therapy.

Results

Compared with COH and COE patients, more COCP patients underwent surgery, had greater abnormalities of body composition and higher prevalence of pituitary hormone deficits (allP<0.001), but comparable fasting glucose, HbA1c, total cholesterol and LDL-cholesterol levels, marital status, parenthood, living arrangements, education, employment and annual sick-leave days. After 1 and 5 years of GH replacement therapy, similar changes were evident with regard to body composition, fasting glucose and HbA1c levels, QoL, and the level of and satisfaction with physical activity across the three groups.

Conclusions

Adults with untreated COCP with GHD at baseline demonstrated more co-morbidities including greater abnormalities of body composition, pituitary hormone deficits and visual field defects. Overall, adults with COCP, COH and COE tumours responded comparably to short- and long-term GH replacement therapy, suggesting that patients with GHD due to COCP benefited from GH replacement therapy to a similar degree as those with other causes of CO hypothalamic–pituitary dysfunction did.
AMP-activated protein kinase signaling is upregulated in papillary thyroid cancer
Authors: Vidal Ana Paula , Andrade Bruno M , Vaisman Fernanda , Cazarin Juliana , Pinto Luis Felipe Ribeiro , Breitenbach Marisa Maria Dreyer , Corbo Rossana , Caroli-Bottino Adriana , Soares Fernando , Vaisman Mario , Carvalho Denise P
Published: August 2013

AMP-activated protein kinase (AMPK) is activated by the depletion in cellular energy levels and allows adaptive changes in cell metabolism and cell survival. Recently, our group described that AMPK plays an important role in the regulation of iodide and glucose uptake in thyroid cells. However, AMPK signaling pathway in human thyroid carcinomas has not been investigated so far.

Objective

To evaluate the expression and activity of AMPK in papillary thyroid carcinomas.

Methods

We examined total and phosphorylated AMPK (tAMPK and pAMPK) and phosphorylated acetyl-CoA-carboxylase (pACC) expressions through imunohistochemistry, using a tissue microarray block composed of 73 papillary thyroid carcinomas (PAP CA) or microcarcinomas (PAP MCA) and six adenoma (AD) samples from patients followed at the Federal University Hospital. The expression levels were compared with the non-neoplastic tissues from the same patient. Two different pathologists analyzed the samples and attributed scores of staining intensity and the proportion of stained cells. A total index was obtained by multiplying the values of intensity and the proportion of stained cells (INTxPROP).

Results

tAMPK, pAMPK, and pACC showed a predominant cytoplasmic staining in papillary carcinomas, adenomas, and non-neoplastic thyroid tissues. However, the intensity and the proportion of stained cells were higher in carcinomas, so that a significant increase was found in the INTxPROP score both in PAP CA and PAP MCA, when compared with their respective controls.

Conclusion

Our results show unequivocally that AMPK pathway is highly activated in papillary thyroid carcinomas; however, more studies are necessary to understand the pathophysiological significance of AMPK activation in thyroid carcinogenesis.
Influence of ovarian manipulation on reproductive endocrinology in polycystic ovarian syndrome and regularly cycling women
Authors: Hendriks M L , König T , Soleman R S , Korsen T , Schats R , Hompes P G A , Homburg R , Lambalk C B
Published: August 2013

Objective

Little is known about the function of the ovarian neuronal network in humans. In many species, copulation influences endocrinology through this network. As a first step, the possible influence of ovarian mechanical manipulation on pituitary and ovarian hormones was evaluated in polycystic ovarian syndrome (PCOS) and regularly cycling women.

Design

Prospective case–control study (2008–2010).

Methods

Ten PCOS women (Rotterdam criteria) undergoing ovulation induction with recombinant-FSH and ten normal ovulatory controls were included in an academic fertility clinic. In the late follicular phase blood was drawn every 10 min for 6 h. After 3 h the ovaries were mechanically manipulated by moving a transvaginal ultrasound probe firmly over each ovary ten times. Main outcome measures were LH and FSH pulsatility and ovarian hormones before and after ovarian manipulation.

Results

All PCOS patients showed an LH decline after the ovarian manipulation (before 13.0 U/l and after 10.4 U/l, P<0.01), probably based on a combination of a longer LH pulse interval and smaller amplitude (P=0.07). The controls showed no LH change (before 9.6 U/l and after 9.3 U/l, P=0.67). None of the ovarian hormones (estradiol, progesterone, anti-Müllerian hormone, inhibin B, androstenedione and testosterone) changed in either group.

Conclusions

Ovarian mechanical manipulation lowers LH secretion immediately and typically only in preovulatory PCOS patients. The immediate LH change after the ovarian manipulation without any accompanying ovarian hormonal changes point to nonhormonal communication from the ovaries to the pituitary. A neuronal pathway from the ovaries communicating to the hypothalamic–pituitary system is the most reasonable explanation.
EXTENSIVE EXPERTISE IN ENDOCRINOLOGY: UK stance on adult GH replacement: the economist vs the endocrinologist
Authors: Shalet S M
Published: August 2013

In the UK, through the use of a forced economic model, endocrinologists are in the curious position of offering GH replacement to some patients with severe GH deficiency (GHD) but withholding it from other patients with even more severe GHD. This approach is counter-intuitive to endocrine practice in treating endocrine deficiency states. For all other endocrine deficiencies, one would opt for treating those with the most severe biochemical evidence of deficiency first. If this endocrine approach was applied to adult GH replacement in an era of rationing, one would start with the GHD patients with a pathologically low IGF1 level. Given that the prevalence of subnormal IGF1 levels in a GHD population is age-dependent, this would result in GH replacement being offered to more young adult onset (AO) GHD and childhood onset GHD adults, and less often to middle-aged and elderly AO GHD adults. This in itself has the added advantage that the skeletal benefits appear more real in the former cohort of patients.
Educational Perspectives
Authors: Halamek Louis P.
Published: August 2013

Historically the performance of health-care professionals has been evaluated primarily through assessment of content knowledge retained in memory. Yet human performance is influenced by elements that are both intrinsic and extrinsic to the human being. Intrinsic elements consist of cognitive, technical, and behavioral skill sets. Extrinsic elements are described by the field of ergonomics and include cognitive, physical, and organizational domains. Identifying the requisite skills, defining competent performance in each of these skills, determining appropriate forms of competency assessment for each skill, and designing easy-to-use assessment tools are the key steps to achieving objective, comprehensive, and consistent evaluation of performance. Performance assessments that fail to take into account these complexities are incomplete and simplistic at best, and at worst, inaccurate and misleading. Rigorous assessment of human performance in neonatal-perinatal medicine will greatly enhance the delivery of effective, safe, and efficient neonatal care.
The Role for Prospective Surgical Trials in Neonates
Authors: Sharp Nicole E. , St. Peter Shawn D.
Published: August 2013

Despite agreement that prospective randomized controlled trials offer the best available evidence to guide our practice, there is a remarkable lack of prospective trials in neonatal surgical literature. We, the treating physicians, are responsible for conducting the research that will allow for evidence upon which better care may be based. We have an ethical obligation to provide the highest level of care based on the greatest level of evidence possible. This will only be possible with further prospective trials in fetal and neonatal surgery.
Surgical Necrotizing Enterocolitis
Authors: Raval Mehul V. , Lawrence Moss R.
Published: August 2013

Necrotizing enterocolitis (NEC) is the most common surgical emergency among NICU patients. Patients with NEC requiring surgical intervention have the highest morbidity and mortality and accrue the highest costs. The objective of this review is to provide the neonatologist with an overview of options available for the surgical management of this complex and potentially devastating disease. When evaluating patients with NEC, surgical intervention is reserved for those patients with pneumoperitoneum, confirmed stool or pus in the peritoneal cavity, or worsening clinical status. Options range from peritoneal drain placement to laparotomy with enterostomy creation, anastomoses, or temporizing measures with planned second-look operations. The choice of operation has not been shown to have a significant effect on any clinically important outcomes. The mortality rate for surgically managed NEC remains dependent upon the severity of disease and is directly correlated to gestational age.
Introduction
Authors: Baker Paul
Published: August 2013

Introduction to the Virtual Special Issue of Gender and Language, on corpus approaches. The five papers selected for this virtual special issue have been chosen because they collectively represent recent methodological advances by using corpus linguistics approaches in the analysis of issues pertaining to gender and language. In this short introduction, I summarize each paper and then discuss the ways in which they demonstrate the applicability of corpus approaches to gender and language research.
A method to assess the organizing behaviors used in physicians’ counseling of standardized parents after newborn genetic screening
Authors: Christopher Stephanie A. , Ahmad Nadia Y. , Bradford Lisa , Collins Jenelle L. , Eskra Kerry , La Pean Kirschner Alison , O'Tool Faith O. , Roedl Sara J. , Farrell Michael H.
Published: August 2013

Well-organized conversation can improve people's ability to comprehend and retain information. As part of a long-term effort to adapt Quality Improvement techniques for communication, we developed an explicit criteria method to assess usage of three organizing behaviors (OBs): ‘opening behaviors’ to establish goals; ‘structuring behaviors’ to guide patients through conversation; and ‘emphasizing behaviors’ that signal a need for attention. Pairs of abstractors independently reviewed transcripts in a demonstration sample of conversations between physicians and standardized parents after newborn screening identifies carrier status for sickle cell disease. Criteria for at least one OB were identified in 50/84 transcripts (60%), including 27 with at least one opening behavior (32%), 5 with at least one structuring behavior (6%), and 38 with at least one emphasizing behavior (45%). The limited number of OBs raises concern about communication after newborn screening. Assessment and improvement of OB usage may improve understanding and allow parents to more actively participate in health care.
Supportive relationships – Psychological effects of group counselling in women with polycystic ovary syndrome (PCOS)
Authors: Roessler Kirsten K. , Glintborg Dorte , Ravn Pernille , Birkebaek Camilla , Andersen Marianne
Published: August 2013

The objective of the present study was to examine the psychological impact of a group-oriented approach to disease management and health behaviour in women with polycystic ovary syndrome (PCOS). Seventeen overweight PCOS women were randomised in a crossover design of eight weeks high-intensity aerobic exercise followed by eight weeks of group counselling (n=8) or vice versa (n=9). Interpersonal communication, emotional and relational aspects were observed and analysed throughout the period focusing on changes in health behaviour. The most salient findings showed supportive relationships expressed as group cohesion, exchange of narratives of illness and of disorder-specific aspects. Individual relationships between the participants were important for changes in behaviour, especially those generating feedback from the other participants and reducing social isolation. The results were most encouraging in the group that had initial counselling sessions before the physical intervention. It can be concluded that group counselling sessions focusing on supportive relationships followed by high-intensity aerobic training have beneficial effects on wellbeing, health and exercise behaviour.
Formulation in clinical interviews
Authors: Simonen Mika
Published: August 2013

Formulation, according to Garfinkel and Sacks (1986 [1969]), refers to speakers’ ways of talking about the current interaction. This article explores how formulations are used in clinical assessment interviews as a way of providing evidence of the respondent's capacities that are currently assessed. The videotaped data are drawn from the clinical interviews of unemployed adults and older persons. The data are analyzed using conversation analysis (CA). The article shows how formulation is achieved through vocalized and/or embodied actions (e.g. nodding, index finger pointing), in conjunction with the speaker's gaze directed to the recipient. It argues that these formulations enable access to the shared epistemic domain of the current interaction. This domain is an interactional achievement and, as a resource, it allows the participants to designate viewpoints regarding the respondent's social competence. In sum, the paper demonstrates how participants can show an explicit orientation to the interactional substrate of interview.
Salutations, closings and pronouns: Some aspects of recipient design in online counselling
Authors: Stommel Wyke
Published: August 2013

This article examines recipient design in online counselling. Recipient design has been found to be an important aspect of professional-client interaction (Heritage 2002; Wilkinson 2011). It essentially means that professionals devise their talk for the specific client, which is crucial for building the counselling relationship. This article focuses on the ways in which counsellors and clients design their salutations, closings and pronoun address forms in e-mail with the recipient in mind. It is known that second person pronouns (in languages with informal vs. formal pronouns) invoke a certain social distance between the participants and that greetings play an important role in establishing social relations in e-mail. The analysis, informed by conversation analysis, revealed that while counsellors initially use a formal recipient design in the e-mails, clients frequently use informal salutations, closings and/or the informal second person pronoun (T) to reduce the social distance to the counsellor. Rarely, they also directly request to be addressed more informally. Another finding is that counsellors sometimes fail to recipient-design their e-mails, which seems related to the use of prefabricated text or ‘forgetting’ which client preferred which recipient design.
Gaze behavior of pre-adolescent children afflicted with Asperger Syndrome
Authors: Wiklund Mari
Published: August 2013

Asperger syndrome (AS) is a form of high-functioning autism characterized by qualitative impairment in social interaction. People afflicted with AS typically have abnormal nonverbal behaviors which are often manifested by avoiding eye contact. Gaze constitutes an important interactional resource, and an AS person's tendency to avoid eye contact may affect the fluidity of conversations and cause misunderstandings. For this reason, it is important to know the precise ways in which this avoidance is done, and in what ways it affects the interaction. The objective of this article is to describe the gaze behavior of preadolescent AS children in institutional multiparty conversations. Methodologically, the study is based on conversation analysis and a multimodal study of interaction. The findings show that three main patterns are used for avoiding eye contact: 1) fixing one's gaze straight ahead; 2) letting one's gaze wander around; and 3) looking at one's own hands when speaking. The informants of this study do not look at the interlocutors at all in the beginning or the middle of their turn. However, sometimes they turn to look at the interlocutors at the end of their turn. This proves that these children are able to use gaze as a source of feedback. When listening, looking at the speaker also seems to be easier for them than looking at the listeners when speaking.
All the metaphors you are
Authors: Levinson Julian
Published: August 2013

This article explores how two influential mid-twentieth-century texts incorporated jazz, and bebop in particular, into the context of a literary narrative. Drawing on recent work in linguistics, it argues that ‘Sonny’s Blues’ and On the Road may be distinguished on the basis of the different underlying conceptual metaphors that inform their representation of jazz. Baldwin’s text describes it first as a form of revolt; then as an updating of a coherent blues ethos. Kerouac’s text constructs jazz as a journey outward into the ineffable, a mystical transport beyond the self. Despite these differences, the depictions of jazz in these texts play analogous roles since they enable the narratives to move from problem to solution.
An Unusual Case of Fibromuscular Dysplasia with Bilateral Renal Macroaneurysms: Three-year Outcome After Endovascular Treatment
Authors: Buso Roberta , Rattazzi Marcello , Leoni Matteo , Puato Massimo , Paola Francesco Di , Pauletto Paolo
Published: August 2013

Fibromuscular dysplasia (FMD) is an idiopathic, segmental, non-inflammatory and non-atherosclerotic disease
that affects arterial walls, leading to stenosis of small and medium-sized arteries. FMD mostly involves renal and intracranial
arteries and only in few patients is associated with macroaneurysms (RAAs). We present the case of a 45-years old
woman with recent history of grade 2 hypertension that suffered of subarachnoid haemorrhage due to rupture of a basilar
artery aneurysm. The cerebral aneurysm was immediately treated by coil embolization and an abdominal angio-CT scan
was performed to investigate the presence of renovascular hypertension. The exam showed the presence of FMD of the
renal arteries associated with presence of bilateral RAAs. Due to the high risk of rupture, the bigger aneurysm (2,5 cm diameter)
present on the left artery was immediately treated by coil embolization. The fusiform aneurysm, present on the
right renal artery, was instead treated one year later by using two flow diverter stents. After three years, an angiographic
study showed that both cerebral and renal aneurysms were excluded from the blood flow without evidence of arterial
restenosis.
Effect of Cementation Technique of Individually Formed Fiber-Reinforced Composite Post on Bond Strength and Microleakage
Authors: Makarewicz Dominika , Le Bell-Rönnlöf Anna-Maria B , Lassila Lippo V.J. , Vallittu Pekka K.
Published: August 2013

Objectives:

The aim of this study was to evaluate the effect of two different cementation techniques of individually formed E-glass fiber-reinforced composite (FRC) post on bond strength and microleakage.

Methods:

The crowns of extracted third molars were removed and post preparation was carried out with parapost drills (diameter 1.5 mm). After application of bonding agents individually formed FRC posts (everStick POST, diameter 1.5 mm) were cemented into the post spaces with either ParaCem®Universal or self-adhesive RelyX™Unicem, using two different cementation techniques: 1) an “indirect (traditional) technique” where the post was prepolymerized prior application of luting cement and insertion into the post space or 2) a “direct technique” where the uncured post was inserted to the post space with luting cement and light-polymerized in situ at the same time. After water storage of 48 hours, the roots (n = 10/group) were cut into discs of thickness of 2 mm. A push-out force was applied until specimen fracture or loosening of the post. A microleakage test was carried out on roots which were not subjected to the loading test (n= 32) to evaluate the sealing capacity of the post-canal interface. The microleakage was measured using dye penetration depth under a stereomicroscope.

Results:

Higher bond strength values (p<0.05) and less microleakage (p<0.05) were obtained with the “direct technique” compared to the “indirect technique”. None of the FRC posts revealed any dye penetration between the post and the cement.

Conclusions:

The “direct technique” seems to be beneficial when cementing individually formed FRC posts.