bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnostic value of HMGAs, p53 and β‐catenin in discriminating adenocarcinoma from adenoma or reactive atypia in ampulla and common bile duct biopsies
Authors: Zakharov Vladislav , Ren Bing , Ryan Charlotte , Cao Wenqing
Published: January 2013

Aims

Biopsies from the ampulla of Vater and the common bile duct often pose diagnostic challenges. The aim of this study was to investigate the expression patterns of HMGA1, HMGA2, β‐catenin and p53 in biopsy specimens, in order to evaluate the potential diagnostic value of these proteins in differentiating adenocarcinoma from reactive atypia or adenoma.

Methods and results

Forty‐eight biopsies (10 from the common bile duct and 38 from the ampulla) were selected for immunohistochemical studies; they included 14 cases of reactive atypia, 12 adenomas, and 22 adenocarcinomas. Expression of HMGA1 was seen in 21% of the reactive atypia cases, 42% of adenomas, and 91% of adenocarcinomas. HMGA2 was positive in 14% of reactive atypias, 42% of adenomas, and 86% of adenocarcinomas. The staining intensity of HMGA1 and HMGA2 was also significantly higher in adenocarcinomas than in adenomas or reactive atypias. Interestingly, coexpression of HMGA1 and HMGA2 was found in 86% of adenocarcinomas, 0% of reactive atypias, and 8% of adenomas. p53 and β‐catenin expression seemed not to provide additional value for discriminating adenocarcinoma from reactive atypia or adenoma.

Conclusions

HMGA1 and HMGA2 might serve to discriminate between reactive atypia, adenoma and adenocarcinoma in ampulla and common bile duct biopsies.
Cystic lymphoid hyperplasia: an orofacial lesion strongly associated with HIV and AIDS
Authors: Meer Shabnum , Dulabh Shailen
Published: January 2013

Aims

Cystic lymphoid hyperplasia (CLH) frequently affects the parotid gland in human immunodeficiency virus (HIV)‐infected patients. This clinicopathological study, comprising 167 cases, aims to define the clinical–pathological parameters of CLH in order to elucidate the aetiopathogenesis.

Methods and results

This retrospective study of 167 archival cases of CLH recorded patients' age, race and gender, and the nature, site and symptoms of CLH. A total of 109 cases were reviewed histologically and analyzed for HIV‐1 p24 antigen immunopositivity using standard procedures. CLH of the parotid gland showed a male predominance, whereas submandibular gland (P = 0.27) and bilateral parotid involvement favoured females (2:1). CLH occurred at a younger mean age in females than males in the parotid gland (P = 0.0035) and in the submandibular gland (P = 0.0032). Intra‐lymph nodal origin was favoured, with 76.1% of cases occurring within entrapped salivary gland remnants. P24 staining revealed ~90% sensitivity in HIV‐associated CLH.

Conclusion

CLH should be used preferentially to describe parotid enlargement in HIV‐infected patients. This study strongly supports the hypothesis that CLH develops following ductal ectasia of entrapped salivary gland inclusions arising within lymph nodes. CLH should be classified as an orofacial lesion associated strongly with HIV and AIDS.
Antigone Claimed: “I Am a Stranger!” Political Theory and the Figure of the Stranger
Authors: Castro Andrés Fabián Henao
Published: January 2013

This paper seeks to destabilize the silent privilege given to the secured juridical‐political position of the citizen as the stable site of enunciation of the problem/solution framework under which the stranger (foreigner, immigrant, refugee) is theoretically located. By means of textual, intertextual, and extratextual readings of Antigone, the paper argues that it is politically and literarily possible to (re)invent her for strangers in the twenty‐first century, that is, for those symbolically produced as not‐legally locatable and who resignify their ambivalent ontological status between life and death as an alternative sociopolitical location of speech and action in equality with “others.”
Quantifying habitat‐specific contributions to insect diversity in agricultural mosaic landscapes
Authors: Diekötter Tim , Crist Thomas O.
Published: January 2013

Agricultural intensification often leads to loss and fragmentation of natural and semi‐natural habitats. As a consequence, biodiversity in intensively managed agro‐ecosystems is often lower than in agricultural landscapes with greater natural and semi‐natural land cover. Different types of semi‐natural habitat may support specific species assemblages thereby increasing landscape‐level biodiversity, but this has seldom been tested, especially for insects that have different functional roles in agro‐ecosystems.

Here, we quantified these habitat‐specific contributions by surveying species richness and composition of wild bees, true bugs and ground beetles and compared them among different types of semi‐natural habitats within two differently structured agricultural landscapes in Switzerland.

We found high shares of habitat specific species and habitat types within landscapes to differ up to fourfold in their specificity (i.e. their contribution to the total landscape species richness). Using statistical null models for habitat specificity and multiplicative beta diversity, we identified habitats that contributed more or less than expected by chance to the overall species diversity at the landscape level.

The observed degree of complementarity among habitats highlights the importance of habitat diversity for insect species richness and potentially ecosystem functioning in agricultural landscapes. By helping to understand better the habitat‐specific contributions to insect diversity in agricultural areas, our results will facilitate targeted conservation measures and sustainable landscape planning. Yet, qualitative differences in habitat specificity and separation of habitat‐specific communities observed between landscapes should be explored further in future studies of multiple landscapes.
Promoting social Europe? The development of European youth unemployment policies
Authors: Lahusen Christian , Schulz Natalia , Graziano Paolo Roberto
Published: January 2013

Since the beginning of the millennium, the institutions of the European Union have intensified their political efforts to combat youth employment. Youth‐specific policy initiatives were launched after the financial and economic crisis of 2008, and the overall subsequent rise of unemployment rates among young people. In this article, we analyse and assess these developments on the basis of an analysis of European policy documents and interviews. Our conclusions are twofold. One, we argue that the Europe 2020 Strategy and its flagship initiatives devoted to youth do not constitute a new policy field or approach, but are rather the outcome of an incrementalist logic of policy development. Two, the European youth strategy is clearly committed to activation, and it pushes policy developments towards a minimalist policy approach of precarious protection. Both developments are explained by the actor constellations and path dependencies of the European policy arena.
Imbalance between matrix metalloproteinase‐1 (MMP‐1) and tissue inhibitor of metalloproteinase‐1 (TIMP‐1) contributes to bladder compliance changes in rabbits with partial bladder outlet obstruction (PBOO)
Authors: Yang Lin , Liu Runming , Wang Xinyang , He Dalin
Published: January 2013

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

A decrease in bladder compliance is known to be correlated with deterioration of renal function after bladder outlet obstruction (BOO). Increased deposition of extracellular matrix (ECM) in the detrusor layer is the primary reason for decreased compliance. In the bladder, as in other organs, ECM deposition is dependent on the balanced activity of proteolytic enzymes, including matrix metalloproteinases (MMPs) and their endogenous inhibitors, tissue inhibitors of metalloproteinases (TIMPs). The imbalance between MMPs and TIMPs is a key regulator in ECM turnover. It has been shown that an altered proteolytic balance between MMP‐1 and TIMP‐1 favours accumulation of ECM and decreases tissue compliance in an ovine fetal BOO model. Also, MMP‐1 was significantly down‐regulated, while TIMP‐1 levels were increased, in a time‐ and pressure‐dependent manner in a smooth muscle cell (SMC) mechanical strain model.

In the present study we measured the bladder compliance of control, sham‐operated and partial BOO (PBOO) rabbits using a UDS‐600 urodynamic testing machine. Collagen deposition between and within the detrusor SM bundles was evaluated using Masson's Trichrome stain and transmission electron microscopy. The expression levels of MMP‐1 and TIMP‐1 were evaluated by Western blot. We found that the imbalance between MMP‐1 and TIMP‐1 favours accumulation of extracellular collagen, the structural components associated with decreased bladder compliance after PBOO.

Objective

To investigate the underlying mechanisms of bladder compliance after partial bladder outlet obstruction (PBOO) and the role of the collagen degradation enzyme matrix metalloproteinase‐1 (MMP‐1) and its endogenous inhibitor tissue inhibitor of metalloproteinase‐1 (TIMP‐1) during this process.

Materials and Methods

Bladder compliance of control, sham‐operated and PBOO rabbits was measured using a UDS‐600 urodynamic testing machine.

Collagen deposition between and within the detrusor smooth muscle bundles was evaluated using Masson's Trichrome stain and transmission electron microscopy.

The expression levels of MMP‐1 and TIMP‐1 were evaluated by Western blot.

Results

Bladder compliance decreased after PBOO.

Collagen deposition increased both between and within the detrusor smooth muscle bundles, and had an inverse relationship with bladder compliance.

MMP‐1 and TIMP‐1 expression negatively correlated with bladder compliance.

Conclusion

These findings indicate that the imbalance between MMP‐1 and TIMP‐1 favours accumulation of extracellular collagen, the structural components associated with decreased bladder compliance after PBOO.
Exploring the ambiguous consensus on public–private partnerships in collective risk preparation
Authors: Steyer Véronique , Gilbert Claude
Published: January 2013

Once considered potential sources of danger, generating industrial risks, companies are now viewed as indispensable partners in preparing risk responses. However, this shift raises the crucial question of the coordination between the various actors, especially as the literature – particularly on public–private partnerships (PPPs) and inter‐organisational collaborations – highlights multiple potential obstacles. This article analyses the conditions and difficulties of this type of collaboration in preparing the response to a major collective risk – the threat of an influenza pandemic – by examining the relations between French public authorities and companies before and during the alert raised by an outbreak of A(H1N1). Shaped by responsibility and legitimacy issues, these relations are problematic and ambiguous, revealing a poorly designed framework which seems to be a source of difficulties rather than conducive to the effective handling of a pandemic threat. Ultimately, the study questions the desirability of a PPP in the specific context of risk management. This study is based on 30 interviews with public and private‐sector actors together with the observation of conferences and the meetings of groups that exchange good practices between companies.
‘I Don't Like My Children to Grow up in this Bad Area’: Parental Anxieties about Living in Informal Settlements
Authors: Meth Paula
Published: January 2013

A growing body of research on informal settlements considers the experiences of children, but seldom outlines the daily parenting experiences of adult men and women. At the same time, policy on housing in South Africa points to the ways in which the ‘eradication’ of informal housing will help provide children with better futures. This article explores the social relation of parenting within an informal settlement in Durban, South Africa, bearing in mind the broader difficulties of parenting in poverty, and points to ways in which the material qualities of informal settlements contribute to feelings of anxiety in parents. It questions how these experiences might differ from or be similar to those of parents who live in generic contexts of poverty (but not necessarily informality). It concludes ultimately that living in an informal settlement does actually contribute to particular parental anxieties, but that there is no guarantee that informal housing eradication will remove these concerns.
The Heartbreak of the Place: Space, Religion and Politics in Post‐9/11 Mosque Controversies
Authors: Bowe Brian J.
Published: January 2013

In recent years, there have been a series of public controversies related to construction of Islamic worship spaces in the U.S. One of these controversies, surrounding a proposal for an Islamic community center in New York City known as Park51, dominated media coverage for several weeks in the summer of 2010 and is one of several high‐profile mosque‐building debates in the U.S. Another contentious debate occurred in the community of Temecula, Calif. These controversies represent the still‐uncertain place Islam holds in the American public sphere. Using framing theory, this article considers the ways in which Islam is portrayed in news media content by political actors and the potential consequences of such framing.
Permission to Stay in “Enemy” Territory?
Authors: Gertz Steven
Published: January 2013

Muslim scholars writing about the legal situation of Muslims living under non‐Muslim rule during the seventh/thirteenth and eighth/fourteenth centuries were primarily concerned with whether Muslims should be allowed to live under non‐Muslim rule or whether they should emigrate (or go on hijra) from it. Two Ḥanbalī legists, Ibn Qudāma (d. 620/1223) and Ibn Mufliḥ (d. 763/1362), both of whom lived and wrote in Damascus (Ayyūbid and Mamlūk, respectively), address this issue in their legal works (fiqh). Their scholarship, when compared with that of the Ḥanbalī scholar Ibn Taymiyya (d. 728/1328), is instructive, particularly when one considers differences between these scholars’ experiences of non‐Muslim rule. A guiding question is how experience may shape (or fail to shape) a jurist's position on hijra, since the events of the time (the Crusades and, later, the Mongol invasions) forced Muslims living under non‐Muslim control to decide whether they must leave such lands. Loyalty to one's school (taqlīd) appears to have influenced the jurists most in their thinking, but experience shaped how they justified their positions on whether a Muslim must emigrate from lands under non‐Muslim control.
Scale Mismatches, Conservation Planning, and the Value of Social‐Network Analyses
Authors: GUERRERO ANGELA M. , McALLISTER RYAN R. J. , CORCORAN JONATHAN , WILSON KERRIE A.
Published: January 2013

Many of the challenges conservation professionals face can be framed as scale mismatches. The problem of scale mismatch occurs when the planning for and implementation of conservation actions is at a scale that does not reflect the scale of the conservation problem. The challenges in conservation planning related to scale mismatch include ecosystem or ecological process transcendence of governance boundaries; limited availability of fine‐resolution data; lack of operational capacity for implementation; lack of understanding of social‐ecological system components; threats to ecological diversity that operate at diverse spatial and temporal scales; mismatch between funding and the long‐term nature of ecological processes; rate of action implementation that does not reflect the rate of change of the ecological system; lack of appropriate indicators for monitoring activities; and occurrence of ecological change at scales smaller or larger than the scale of implementation or monitoring. Not recognizing and accounting for these challenges when planning for conservation can result in actions that do not address the multiscale nature of conservation problems and that do not achieve conservation objectives. Social networks link organizations and individuals across space and time and determine the scale of conservation actions; thus, an understanding of the social networks associated with conservation planning will help determine the potential for implementing conservation actions at the required scales. Social‐network analyses can be used to explore whether these networks constrain or enable key social processes and how multiple scales of action are linked. Results of network analyses can be used to mitigate scale mismatches in assessing, planning, implementing, and monitoring conservation projects.

Discordancia de Escalas, Planificación de la Conservación y el Valor del Análisis de Redes Sociales
Self‐Induced Fatal Air Embolism: Accidental Autoerotic Death or Suicide?
Authors: Modelli Manoel E. S. , Rodrigues Maciel S. , Castro Bruno Z. M. , Corrêa Rodrigo S.
Published: January 2013

Autoeroticism comprises behavior deviations aimed at producing sexual gratification through the manipulation of one's own body. The use of asphyxia and the induction of pain (masochism) are well‐known examples. “Atypical forms” of such behaviors have appeared in the literature as isolated cases. Fatal air embolism is most common in women (causing abortion), being very rare in men (urethral trauma). The authors present a probable case of air embolism associated with signs of autoeroticism, instrumented by the delivery of air through a system formed by a compressor (typical of those used in refrigerators), a syringe barrel, a segment of latex tubing (tourniquet), and a needle, which was found inserted into the glans penis of an adult male. The hypothesis of accidental death was chosen due to the findings at the scene. The body was decomposing when found, which hampered the conduction of examinations.
Waste to hurry: dynamic energy budgets explain the need of wasting to fully exploit blooming resources
Authors: Kooijman S. A. L. M.
Published: January 2013

A comparative study of the energetics of 165 animal species, including representatives of most large phyla and of all 13 chordate classes, reveals a very wide range of specific somatic maintenance costs, when corrected for a common temperature. While a typical value is 20 J d−1 cm−3 at 20°C, some vertebrates have values below 10 J d−1 cm−3 and some small invertebrate planktivores have values exceeding 1 kJ d−1 cm−3; the salp Thalia seems to have around 8 kJ d−1 cm−3. This wide range of values is amazing because some 80–90% of the somatic maintenance costs is generally thought to be used for the turnover of mass and animal species do not differ that much in chemical composition in terms of proteins, lipids and carbohydrates. I present theory‐based arguments to suggest that species waste resources for the purpose of remaining small, growing fast, and responding rapidly with population numbers to temporal and local food abundance.
Cardamine calliphaea sp. nov. (Brassicaceae) from southwestern Greece
Authors: Tan Kit , Giannopoulos Konstantinos , Vold Gert
Published: January 2013

Cardamine calliphaea Kit Tan, G. Vold & Giannopoulos sp. nov. (Brassicaceae) is illustrated and described as a new species endemic to Greece. It occurs in the prefectures of Ilia in western Peloponnese and Etolias‐Akarnanias in western Sterea Ellas and bears some resemblance to C. graeca, differing by its dense greyish–white indumentum and by the absence of leaf auricles. Affinities lie with C. glauca and C. plumieri from which it differs conspicuously, among other characters, by its imparipinnate leaves with the terminal leaflet smaller or equal in size to the lateral pairs.
Tailorable Multicolor Up‐conversion Emissions in Tm3+/Ho3+/Yb3+ Co‐Doped LiLa(MoO4)2
Authors: Li Ting , Guo Chongfeng , Zhao Puju , Li Lin , Jeong Jung Hyun
Published: January 2013

Using a modified sol–gel method, LiLa(MoO4)2: Tm3+/Ho3+/Yb3+ phosphors with tailorable up‐conversion (UC) emission colors were prepared. Under the excitation of a 980 nm laser diode, up‐conversion red and green emissions in Ho3+/Yb3+ co‐doped and blue emission in Tm3+/Yb3+ co‐doped LiLa(MoO4)2 were observed, respectively. The intensities of the RGB (red, green, and blue) emissions could be controlled by varying concentrations of Tm3+ or Ho3+, and the optimal composition was also determined. In Tm3+/Ho3+/Yb3+ co‐doped LiLa(MoO4)2, the UC emission colors could be tuned from blue through white to yellow by adjusting the concentrations of Tm3+ or Ho3+. The UC excitation mechanisms were also investigated based on the power dependence of UC luminescence intensity.
Preparation of Sn‐Doped Zinc Phosphate Amorphous Thin Film and its Emission Properties
Authors: Masai Hirokazu , Miyata Hiroki , Tanimoto Toshiro , Tokuda Yomei , Yoko Toshinobu
Published: January 2013

Using liquid‐phase synthesis, SnO–ZnO–P2O5 amorphous coating films exhibiting broad emission of Sn2+ center were prepared. It is found that the P–O–Zn bonds of the film were generated during the heat‐treatment. The emission property due to Sn2+ depended on the heat‐treatment temperature, which correlated with the residual chloride ion content. Although the peak position of the photoluminescence (PL) excitation band was almost constant, that of PL red‐shifted with increasing amount of SnO, which was quite different from the result observed for SnO–ZnO–P2O5 bulk glass containing Sn2+ center.
Sol–Gel Synthesis and Characterization of Na0.5Bi0.5TiO3–NaTaO3Thin Films
Authors: Kunej Špela , Veber Asja , Suvorov Danilo
Published: January 2013

Thin films with the composition 70 mol% Na0.5Bi0.5TiO3 + 30 mol% NaTaO3 were prepared by sol–gel synthesis and spin coating. The influence of the annealing temperature on the microstructural development and its further influence on the dielectric properties in the low‐ (kHz–MHz) and microwave‐frequency (15 GHz) ranges were investigated. In the low‐frequency range we observed that with an increasing annealing temperature from 550°C to 650°C the average grain size increased from 90 to 170 nm, which led to an increase in the dielectric permittivity from 130 to 240. The temperature‐stable dielectric properties were measured for thin films annealed at 650°C in the temperature range between −25°C and 150°C. The thin films deposited on corundum substrates had a lower average grain size than those on Si/SiO2/TiO2/Pt substrates. The highest average grain size of 130 nm was obtained for a thin film annealed at 600°C, which displayed a dielectric permittivity of 130, measured at 15 GHz.
Functional Characterization of Atrial Electrograms in a Pacing‐Induced Heart Failure Model of Atrial Fibrillation: Importance of Regional Atrial Connexin40 Remodeling
Authors: HSIEH MING‐HSIUNG , LIN YENN‐JIANG , WANG HSUEH‐HSIAO , LO LI‐WEI , CHANG SHIH‐LIN , YAN YI‐LING , CHOU THE‐YING , CHEN SHIH‐ANN , YEH HUNG‐I
Published: January 2013

Cx40 Remodeling in Atrial Fibrillation

Introduction

Heart failure (HF) increases the susceptibility to atrial fibrillation (AF) and is associated with altered cardiomyocyte connexin. The regional remodeling of connexin(s) may contribute to the spatiotemporal organization of AF. This study sought to investigate the regional differences in connexin(s) and fibrosis in specific atrial regions and correlate that with the electrogram properties.

Methods and Results

Biatrial electroanatomic mapping during sinus rhythm (electrogram voltage and velocity) and AF (dominant frequency, DF) was performed in 6 ventricular pacing‐induced HF dogs (at 252 beats/minute for 6 weeks) and 6 controls. Atrial tissues were sampled from 7 specific sites for analysis of the connexin and fibrosis. HF caused marked atrial dilatation, and increased the induced AF duration (P < 0.001). Remodeled connexins, including a lower expression and more lateralization of both connexin40 (Cx40) and Cx43 as well as increased regional dispersion of Cx40, in the presence of diffuse enhanced atrial fibrosis, characterized the atrial substrate of the HF dogs (P < 0.01). Regional analysis showed abnormal velocity and low electrogram voltage in the areas with downregulated Cx40 and Cx43 was enhanced in the presence of marked atrial fibrosis (>30% of area, P < 0.01). During AF, lower expression of the Cx40 was associated with higher DF in areas of less and more fibrosis, respectively (R = 0.67 and 0.58, P < 0.01).

Conclusions

An altered expression of connexins correlated with the electrogram properties in the existence of diffuse enhanced atrial fibrosis associated with HF. The regional remodeling of Cx40 is likely an important factor in the maintenance of AF in HF.
Cooperative effects of Janus and Aurora kinase inhibition by CEP701 in cells expressing Jak2V617F
Authors: Gäbler Karoline , Rolvering Catherine , Kaczor Jakub , Eulenfeld René , Méndez Sergio Álvarez , Berchem Guy , Palissot Valérie , Behrmann Iris , Haan Claude
Published: January 2013

The Janus kinase 2 mutant V617F occurs with high frequency in myeloproliferative neoplasms. Further mutations affecting the Janus kinase family have been discovered mostly in leukaemias and in myeloproliferative neoplasms. Owing to their involvement in neoplasia, inflammatory diseases and in the immune response, Janus kinases are promising targets for kinase inhibitor therapy in these disease settings. Various quantitative assays including two newly developed screening assays were used to characterize the function of different small‐molecule compounds in cells expressing Jak2V617F. A detailed comparative analysis of different Janus kinase inhibitors in our quantitative assays and the subsequent characterization of additional activities demonstrated for the first time that the most potent Jak2 inhibitor in our study, CEP701, also targets Aurora kinases. CEP701 shows a unique combination of both activities which is not found in other compounds also targeting Jak2. Furthermore, colony forming cell assays showed that Janus kinase 2 inhibitors preferentially suppressed the growth of erythroid colonies, whereas inhibitors of Aurora kinases preferentially blocked myeloid colony growth. CEP701 demonstrated a combined suppression of both colony types. Moreover, we show that combined application of a Janus and an Aurora kinase inhibitor recapitulated the effect observed for CEP701 but might allow for more flexibility in combining both activities in clinical settings, e.g. in the treatment of myeloproliferative neoplasms. The newly developed screening assays are high throughput compatible and allow an easy detection of new compounds with Janus kinase 2 inhibitory activity.
Molecular conformation changes along the malignancy revealed by optical nanosensors
Authors: Cinta Pinzaru Simona , Falamas Alexandra , Dehelean Cristina Adriana
Published: January 2013

An interdisciplinary approach employing functionalized nanoparticles and ultrasensitive spectroscopic techniques is reported here to track the molecular changes in early stage of malignancy. Melanoma tissue tracking at molecular level using both labelled and unlabelled silver and gold nanoparticles has been achieved using surface enhanced Raman scattering (SERS) technique. We used skin tissue from ex vivo mice with induced melanoma. Raman and SERS molecular characterization of melanoma tissue is proposed here for the first time. Optical nanosensors based on Ag and Au nanoparticles with chemisorbed cresyl violet molecular species as labels revealed sensitive capability to tissues tagging and local molecular characterization. Sensitive information originating from surrounding native biological molecules is provided by the tissue SERS spectra obtained either with visible or NIR laser line. Labelled nanoparticles introduced systematic differences in tissue response compared with unlabelled ones, suggesting that the label functional groups tag specific tissue components revealed by proteins or nucleic acids bands. Vibrational data collected from tissue are presented in conjunction with the immunohistochemical analysis. The results obtained here open perspectives in applied plasmonic nanoparticles and SERS for the early cancer diagnostic based on the appropriate spectral databank.
Adult female acne: a new paradigm
Authors: Dréno B. , Layton A. , Zouboulis C.C. , López‐Estebaranz J.L. , Zalewska‐Janowska A. , Bagatin E. , Zampeli V.A. , Yutskovskaya Y. , Harper J.C.
Published: January 2013

In the adult female, acne is a chronic condition with a substantial negative psychological, social and emotional impact. Based on time of onset, two subtypes of adult female acne are recognized: ‘persistent acne’ is a continuation of the disease from adolescence, while ‘late‐onset acne’ first presents in adulthood. The morphological characteristics of adult female acne are often distinct from adolescent acne. In adults, inflammatory lesions (particularly papules, pustules and nodules) are generally more prominent on the lower chin, jawline and neck, and comedones are more often closed comedones (micro cysts). Adult acne is mainly mild‐to‐moderate in severity and may be refractory to treatment. A holistic approach to acne therapy should be taken in adult females, which combines standard treatments with adjunctive therapy and cosmetic use. A number of factors specific to the adult female influence choice of treatment, including the predisposition of older skin to irritation, a possible slow response to treatment, a high likelihood of good adherence, whether of child‐bearing age, and the psychosocial impact of the disease. Adherence to therapy should be encouraged through further patient education and a simplified regimen that is tailored to suit the individual patient’s needs and lifestyle. This article reviews the specific characteristics of adult female acne, and provides recommendations for acne therapy in this patient group.
IL28B genotype is not useful for predicting treatment outcome in Asian chronic hepatitis B patients treated with pegylated interferon‐α
Authors: Holmes Jacinta A , Nguyen Tin , Ratnam Dilip , Heerasing Neel M , Tehan Jane V , Bonanzinga Sara , Dev Anouk , Bell Sally , Pianko Stephen , Chen Robert , Visvanathan Kumar , Hammond Rachel , Iser David , Rusli Ferry , Sievert William , Desmond Paul V , Bowden D Scott , Thompson Alexander J
Published: January 2013

Background and Aim

IL28B genotype predicts response to pegylated interferon (peg‐IFN)‐based therapy in chronic hepatitis C. However, the utility of IL28B genotyping in chronic hepatitis B (CHB) cohorts treated with peg‐IFN is unclear. It was investigated whether IL28B genotype is associated with peg‐IFN treatment outcomes in a predominantly Asian CHB cohort.

Methods

This was a retrospective analysis of CHB patients treated with 48 weeks of peg‐IFN monotherapy. IL28B genotype (rs12979860) was determined (TaqMan allelic discrimination kit). Baseline hepatitis B virus (HBV)‐DNA, alanine aminotransferase, and liver histology were available. The primary end‐points were HBV e antigen (HBeAg) seroconversion with HBV‐DNA < 2000 IU/mL 24 weeks post‐therapy (HBeAg‐positive patients) and HBV‐DNA < 2000 IU/mL 24 weeks after peg‐IFN (HBeAg‐negative patients). The association between IL28B genotype and peg‐IFN outcomes was analyzed.

Results

IL28B genotype was determined for 96 patients. Eighty‐eight percent were Asian, 62% were HBeAg positive, and 13% were METAVIR stage F3‐4. Median follow‐up time was 39.3 months. The majority of patients carried the CC IL28B genotype (84%). IL28B genotype did not differ according to HBeAg status. The primary end‐points were achieved in 27% of HBeAg‐positive and 61% of HBeAg‐negative patients. There was no association between IL28B genotype and the primary end‐point in either group. Furthermore, there was no difference in HBeAg loss alone, HBV surface antigen, alanine aminotransferase normalization, or on‐treatment HBV‐DNA levels according to IL28B genotype.

Conclusions

In the context of a small possible effect size and high frequency in Asian populations, IL28B genotyping is likely to have, at best, limited clinical utility for predicting peg‐IFN treatment outcome for CHB patients in the Asia–Pacific region.
Clinical value of multiband mucosectomy for the treatment of squamous intraepithelial neoplasia of the esophagus
Authors: Jin Xi‐Feng , Sun Qing‐Yan , Chai Tong‐Hai , Li Shu‐hui , Guo Yan‐li
Published: January 2013

Background and Aim

To evaluate the clinical value of multiband mucosectomy (MBM) for the treatment of squamous intraepithelial neoplasia of the esophagus.

Methods

A total of 51 lesions located at esophagus from 43 patients were treated with MBM, among which 11 were diagnosed as middle‐grade intraepithelial neoplasia, 25 as high‐grade intraepithelial neoplasia, and 15 as early esophageal cancer pathologically. Primary end‐points were the rate of complete endoscopic resection and the mean operation time; the second end‐points were the postoperative local recurrence rate and acute plus early complications. The histopathological results were compared between pre‐MBM biopsy and MBM specimens. All patients were followed up endoscopically.

Results

A total of 52 MBM procedures with 180 resections were performed in 43 patients. The complete endoscopic resection was achieved in 92.3% (95% confidence interval [CI] 81.8–96.9%). The sizes of the lesions ranged from 10 × 8 mm to 25 × 23 mm. The mean operation time is 37 ± 5 min. The operative acute bleeding complication was 7.6% (95% CI 3–18.1%); no perforations occurred. Early complications consisted of delayed bleeding (one patient 1.9%; 95% CI 0.3–10.1%) and slight esophageal stenosis (one patient). The histopathological diagnosis of 26 cases (51%) was consistent between biopsy and MBM samples, while 20 lesions exhibited higher grade dysplasia. The local recurrence rate was 6.9% (3/43) at 1 year, 9.3% (4/43) at 2 years, and 9.3% at 2.5 years. No death occurred during follow‐up.

Conclusions

MBM is a safe and effective technique for the treatment of early esophageal cancer and precancerous lesions.
Gastroesophageal Reflux Disease Questionnaire (GerdQ) in real‐world practice: A national multicenter survey on 8065 patients
Authors: Bai Yu , Du Yiqi , Zou Duowu , Jin Zhendong , Zhan Xianbao , Li Zhao‐Shen , Yang Yunsheng , Liu Yulan , Zhang Shutian , Qian Jiaming , Zhou Liya , Hao Jianyu , Chen Dongfeng , Fang Dianchun , Fan Daiming , Yu Xiaofeng , Sha Weihong , Nie Yuqiang , Zhang Xiaofeng , Xu Hong , Lv Nonghua , Jiang Bo , Zou Xiaoping , Fang Jingyuan , Fan Jiangao , Li Yan , Chen Weichang , Wang Bangmao , Zou Yiyou , Li Youming , Sun Mingjun , Chen Qikui , Chen Minhu , Zhao Xiaoyan ,   Chinese GerdQ Research Group
Published: January 2013

Background and Aim

Recently, Gastroesophageal Reflux Disease Questionnaire (GerdQ) has been developed for diagnosis of GERD. However, no study investigated its value in real‐world practice. This study aimed to investigate whether GerdQ can be used for diagnosis of GERD in China.

Methods

A national multicenter survey was undertaken; all patients who underwent first diagnostic upper endoscopy for upper gastrointestinal (GI) symptoms were included. Data including the gender, age, symptoms, and endoscopic findings were prospectively recorded. The GerdQ score was measured before endoscopic procedure.

Results

Totally, 8065 patients were included. One thousand four hundred and thirty‐five patients (17.8%) had reflux esophagitis. Among them, 620 (43.2%) patients' GerdQ score was ≥ 8. For 2025 patients with GerdQ ≥ 8, 620 (30.6%) were found to have reflux esophagitis, but the remaining 69.4% (1405/2025) were normal. Proportions of patients with reflux esophagitis increased in cut‐off range from 3–18 for GerdQ. However, 22.2% of the patients with a GerdQ score ≤ 2 also had reflux esophagitis. Twenty‐eight (0.3%) patients were diagnosed to have upper GI malignancies, and 10 out of these 28 (35.7%) patients' GerdQ score was ≥ 8.

Conclusions

The study suggests the proportions of Chinese patients with reflux esophagitis rise up with the increase of GerdQ score, and GerdQ may be used for diagnosis of GERD. However, low GerdQ score cannot exclude the possibility of reflux esophagitis. A minority of Chinese patients has high GerdQ score but is diagnosed with malignancies, even in the absence of alarm features.
Reduction of Belt Restraint Use: Long‐Term Effects of the EXBELT Intervention
Authors: Gulpers Math J. M. , Bleijlevens Michel H. C. , Ambergen Ton , Capezuti Elizabeth , van Rossum Erik , Hamers Jan P. H.
Published: January 2013

Objectives

To assess the long‐term effects of the EXBELT intervention program, which was designed to reduce belt restraint use and was found to be effective immediately after implementation, after 24 months.

Design

Quasi‐experimental longitudinal design.

Setting

Thirteen nursing homes: seven assigned to control group and six to intervention group.

Participants

A panel group (n = 225) of residents present at baseline and 24 months after baseline and a survey group (n = 689) of all residents present 24 months after baseline. The survey group included the panel group.

Intervention

EXBELT included four components: a policy change, an educational program, consultation, and availability of alternative interventions.

Measurements

The use of belt restraints 24 months after baseline was the primary outcome measure. Secondary outcomes included other types of physical restraints. An independent observer collected data four times during a 24‐hour period.

Results

EXBELT resulted in a 65% decrease in belt use between baseline and 24 months after baseline in the panel group (odds ratio 0.35, 95% confidence interval = 0.13–0.93; P = .04). In the survey group, the proportion of residents using belts was 13% in the control and 3% in the intervention group (P < .001) 24 months after baseline. The use of the most restrictive types of restraints was significantly lower in the intervention group than the control group in the panel and survey groups.

Conclusion

The EXBELT intervention was associated with long‐term minimization of belt restraint usage in older nursing home residents. A multicomponent intervention including institutional policy change, education, consultation, and the availability of alternative interventions had an enduring effect on successful restraint reduction.
Aging, Resting Pulse Rate, and Longevity
Authors: Stessman Jochanan , Jacobs Jeremy M. , Stessman‐Lande Irit , Gilon Dan , Leibowitz David
Published: January 2013

Objectives

To examine the relationship between resting pulse rate (RPR) and longevity in individuals aged 70 to 90.

Design

The Jerusalem Longitudinal Cohort Study (1990–2010) is a prospective longitudinal study of a representative cohort born in 1920–21.

Setting

Home‐based comprehensive assessment in 1990, 1998, and 2005.

Participants

Individuals aged 70 (n = 453), 78 (n = 856), and 85 (n = 1,044), with follow‐up to age 90.

Measurements

Comprehensive assessment included average RPR, beta‐blocker usage, and physical activity level. Mortality data were collected from the Ministry of Interior from 1990 to 2010.

Methods

Cox proportional hazards ratios (HRs) were determined for RPR (continuous variable), adjusting for sex, education, diabetes mellitus, ischemic heart disease, congestive heart failure, hypertension, kidney disease, anemia, physical activity, body mass index, self‐rated health, dementia, beta‐blocker use, and an interaction term for RPR by beta‐blocker use.

Results

Mean RPR was 75.1 ± 9.9 at 70, 74.5 ± 10.9 at 78, and 68.5 ± 10.5 at 85 in women and 74.3 ± 10.7 at 70, 73.1 ± 11.2 at 78, and 65.2 ± 10.5 at 85 in men, with a significant decline from 78 to 85 for both sexes. In participants not taking beta‐blockers followed up from 70 to 77, 78 to 84, and 85 to 90, mean RPR was lower in survivors than nonsurvivors for women (75.8 ± 9.2 vs 83.5 ± 10.9, P < .001; 75.2 ± 9.8 vs 79.9 ± 12.6, P =  .004; 71.5 ± 9.9 vs 74.6 ± 10.7, P = .02, respectively) and men (75.2 ± 10.3 vs 75.2 ± 10.9, P = .98; 73.5 ± 10.1 vs 77.2 ± 12.1, P = .005; 67.1 ± 9.5 vs 70.4 ± 11.7, P = .01, respectively). Adjusted HRs for mortality per 10‐beat increase in RPR during follow‐up were 1.13 (95% confidence interval (CI) = 0.87–1.47) for 70 to 77, 1.35 (95% CI = 1.11–1.65) for 78 to 84, and 1.17 (95% CI = 1.01–1.37) for 85 to 90.

Conclusion

RPR declines in the oldest old, and this decline is associated with greater longevity. It may serve as a simple prognostic marker in the oldest old.
Men's experiences of regaining urinary continence following robotic‐assisted laparoscopic prostatectomy (RALP) for localised prostate cancer: a qualitative phenomenological study
Authors: Waller Jo , Pattison Natalie
Published: January 2013

Aims and objectives

To understand how men interpret their experiences of regaining continence following robotic‐assisted laparoscopic prostatectomy (RALP).

Background

RALP is an innovative surgical technique intended to minimise the risk of long‐term postoperative urinary incontinence in localised prostate cancer. Studies have shown that urinary function and quality of life domains can be adversely affected following RALP; however, the impact on men's lives has been hitherto unreported.

Design

A qualitative study using hermeneutic phenomenology

Methods

Face‐to‐face, in‐depth audio‐recorded interviews with seven men (aged 57–71) who had recently undergone RALP and defined themselves as continent of urine. Data were inductively analysed for themes using an adapted version of Diekelmann et al. [1989, The NLN Criteria of Appraisal of Baccalaureate Programs: A Critical Hermeneutic Analysis, 1st edn. National League for Nursing (NLN) Press, New York, NY] framework.

Results

Men's experiences of regaining continence were situated within a wider network of personal and social relationships, and cultural structures. Themes included ‘what was forecast’, ‘after‐sales service’, ‘new plumbing’, ‘sense of self’. Men adopted a variety of practical coping strategies: preventing incontinence; improving incontinence; and dealing with lack of bladder control.

Conclusion

The need to regain a sense of control over their lives resulted in all men developing coping mechanisms in order that they could resume their societal roles, which were salient to their personal identity, inferring that men's ability to cope with incontinence after RALP was dependent on factors other than urinary leakage alone.

Relevance to clinical practice

Knowledge of the potential impact of RALP could help nurses tailor appropriate interventions. Incontinence is individually interpreted and may not be well‐addressed by traditional ‘one‐size fits all’ preoperative programmes or information. Flexible and imaginative options (e.g., activity‐focused interventions; buddy systems; internet programmes; telephone follow‐up) for preoperative and postoperative support and activities for men may improve men's uptake of such services, through specialist nurse or peer support.
Care satisfaction among older people receiving public care and service at home or in special accommodation
Authors: Karlsson Staffan , Edberg Anna‐Karin , Jakobsson Ulf , Hallberg Ingalill R
Published: January 2013

Aims and objectives

To explore care satisfaction in relation to place of living, health‐related quality of life, functional dependency and health complaints among people 65 years or older, receiving public care and service. The concept public care and service concerns formal care from the municipality, including home help, home nursing care, rehabilitation and a special accommodation.

Background

To be able to provide care and service of high quality to older people, knowledge about factors influencing their experience of satisfaction with the care is essential.

Design

Cross‐sectional, including comparison and correlation.

Methods

One‐hundred sixty‐six people receiving public care and service from the municipality were interviewed regarding demography, functional ability, perceived health complaints and care. Health‐related quality of life was measured with SF‐12, and self‐rated care satisfaction was measured with a questionnaire.

Results

Low self‐rated care satisfaction was associated with dependency in Instrumental Activities of Daily Living, blindness, faeces incontinence and anxiety, while high self‐rated care satisfaction was associated with dependency in Personal Activities of Daily Living. Those at home rated an overall higher care satisfaction and were more satisfied with care continuity and personal relations; they thought that the staff had more time and were more respectful and quiet, than the ratings by those in a special accommodation (equivalent to a nursing home).

Conclusions

Care satisfaction and health‐related quality of life among older people was more associated with functional impairment and health complaints than to whether care and service was received at home or in a special accommodation.

Relevance to clinical practice

An approach using intervention focused on functional ability and health complaints is important for development of improved care satisfaction for older people receiving public care and service.
An investigation of the effects of dithranol-induced apoptosis in a human keratinocyte cell line
Authors: George Suja E , Anderson Rosaleen J , Haswell Malcolm , Groundwater Paul W
Published: January 2013

Objectives

Dithranol, one of the most successful topical agents for the treatment of psoriasis, has been shown to exert its therapeutic effect by inducing keratinocyte apoptosis. To gain further insights into dithranol-induced apoptotic events in vitro, a detailed investigation of its time- and dose-dependent effects has been performed through the evaluation of selected apoptotic markers, using a human keratinocyte cell line (HaCaT) as a model.

Methods

The time- and dose-dependent effects of dithranol on a human keratinocyte cell line (HaCaT) were investigated through the evaluation of a series of apoptotic markers; morphological changes (electron microscopy), phosphatidylserine externalisation (flow cytometry), and caspase-3/7 activation.

Key findings

The dithranol-induced apoptotic cascade was found to follow a well-defined dose and time-course, with the concentration and the period of exposure to the drug acting as the two major factors influencing the events and nature of cell death. The earliest apoptotic event detected was caspase activation (after 6 h), followed by the occurrence of phosphatidylserine externalisation (after 9 h) and subsequently the morphological characteristics associated with early and late stage apoptosis/necrosis (after 12 h).

Conclusions

This study has elucidated the dose- and time-response effects of dithranol-induced apoptosis in human keratinocytes in vitro.
Hypervelocity impacts on dry and wet sandstone: Observations of ejecta dynamics and crater growth
Authors: HOERTH Tobias , SCHÄFER Frank , THOMA Klaus , KENKMANN Thomas , POELCHAU Michael H. , LEXOW Bernd , DEUTSCH Alexander
Published: January 2013

Abstract– This study deals with the investigation of highly dynamic processes associated with hypervelocity impacts on porous sandstone. For the impact experiments, two light‐gas accelerators with different calibers were used, capable of accelerating steel projectiles with diameters ranging from 2.5 to 12 mm to several kilometers per second. The projectiles impacted on dry and water‐saturated Seeberger Sandstone targets. The study includes investigations of the influence of pore water on the shape of the ejecta cloud as well as transient crater growth. The results show a significant influence of pore water on ejecta behavior. Steeper ejecta cone angles are observed if the impacts are conducted on wet sandstones. The transient crater grows at a faster rate and reaches a larger diameter if the target is water saturated. In our experiments, target porosity leads to smaller crater sizes compared with nonporous targets. Water within the pore space reduces porosity and counteracts this process. Power law fits were applied to the crater growth curves. The results show an increase in the scaling exponent μ with increasing pore space saturation.