bluuebunny/crossref_metadata_2025 huggingface dataset:
‘Indeterminate for malignancy’ (Tir3/Thy3 in the Italian and British systems for classification) thyroid fine needle aspiration (FNA) cytology reporting: morphological criteria and clinical impact
Authors: Pagni F. , Prada M. , Goffredo P. , Isimbaldi G. , Crippa S. , Di Bella C. , Leone B. E. ,   The San Gerardo Hospital collaborators group
Published: August 2013

Background

The British system (Thy1–5), the Bethesda system for reporting thyroid cytopathology (BSRTC) and the Italian Society of Anatomic Pathology and Cytology (SIAPEC) classification represent the most important international classifications for thyroid cytopathology. Irrespective of the system used, the ‘indeterminate’ categories are still debated among cytopathologists, particularly with regard to diagnostic criteria, clinical impact of subclassification and role of molecular techniques.

Aim

We aimed to find answers to the following questions: Are there shared criteria in cytological preparations that allow the division of indeterminate follicular lesions into subcategories? What is the true clinical impact of this possible subclassification?

Methods

Among 1150 consecutive thyroid fine needle aspiration (FNA) specimens, 80 patients had nodules with a final cytological report of Tir3 (SIAPEC)/Thy3. These 80 cases were re‐evaluated and subclassified according to morphological criteria into three groups: pure follicular proliferations, Hürthle cell follicular lesions and atypical proliferations.

Results

Sixteen (20%) cases were categorized as pure follicular proliferations, 40 (50%) as Hürthle cell follicular lesions and 24 (30%) as atypical proliferations. Surgery was performed in 57 cases (71%). Cyto‐histological correlation showed that follicular adenoma was the most frequent final diagnosis in the cases treated by surgery (24/57, 42%). The overall malignancy rate in the Tir3 category was 28% (16/57). Atypical proliferations were more often malignant than either of the follicular groups (53% versus 19%, P = 0.019).

Conclusions

A five‐tiered classification, subdividing the ‘indeterminate for malignancy’ class into ‘follicular proliferations’ and ‘atypical lesions’ could be adopted. As a result of their higher risk of malignancy, surgical management of the atypical lesions would be justified. In future, the introduction of a genetic panel might contribute to their stratification, to the determination of a more accurate risk of malignancy of the atypical lesions and to the verification of follicular proliferations that are benign.
PEGylated insulin Lispro, (LY2605541)—a new basal insulin analogue
Authors: Caparrotta T. M. , Evans M.
Published: August 2013

There is a clinical rationale for a basal insulin with a predictable action and low inter‐ and intra‐individual variability coupled with an improved side effect and metabolic profile. Since insulin therapy is anabolic and its initiation is commonly associated with weight gain, an insulin preparation associated with a beneficial weight profile would represent a particularly valuable therapeutic entity. LY2605541, or PEGylated insulin Lispro, has a large hydrodynamic size while still exerting the metabolic effects of insulin. This may reduce absorption and clearance of the compound following subcutaneous administration. A number of preclinical and clinical studies have been constructed to evaluate the utility of this novel insulin. The currently available data from preclinical, phase I and phase II studies suggests LY2605541 has a non‐inferior glucose‐lowering efficacy compared to insulin glargine in people with type 1 and type 2 diabetes and may afford a weight‐loss advantage. Pre‐clinical studies indicate that LY2605541 has low mitogenic potency, exerting a preferential hepatic effect on glucose homeostasis. LY2605541 appears to cause elevated transaminases and derangement of lipid profiles. On the basis of these initial observations, LY2605541 requires further extensive clinical evaluation to fully assess its risk/benefit profile in the management in people with diabetes.
Carotid Intima‐Media Thickness Assessment in Refinement of the Framingham Risk Score: Can It Predict ST‐Elevation Myocardial Infarction? A Pilot Study
Authors: Kabra Ash , Neri Lori , Weiner Hillel , Khalil Yasser , Matsumura Martin E.
Published: August 2013

Patients who suffer a first ST‐elevation myocardial infarction (STEMI) typically have fewer identifiable risk factors than those who suffer other types of acute coronary syndromes. As such, risk assessment tools such as the Framingham Risk Score (FRS) often fail to classify these patients as high risk. In this study, we tested the ability of assessment of carotid intima‐media thickness (CIMT) to enhance the ability to identify patients who are at risk for STEMI, using a CIMT‐derived “vascular age” in place of chronologic age in the calculation of FRS. We applied a CIMT‐based vascular age to the assessment of FRS in a cohort of patients who presented with a first STEMI. Using CIMT‐derived vascular age in place of chronologic age increased both the mean FRS and predicted 10 year cardiovascular event rate of the cohort. More importantly, the use of a CIMT‐derived vascular age in the calculation of FRS significantly improved the ability to identify patients with STEMI as high risk and candidates for statin therapy based on ATPIII criteria (19.2% vs. 57.7%, P = 0.010). The use of CIMT to derive a vascular age may improve the ability of FRS to identify patients at risk for STEMI.
The Confederal Comeback: Rediscovering the Confederal Form for a Transnational World
Authors: Cuyvers Armin
Published: August 2013

This contribution approaches the EU as a modified confederal system. It subsequently suggests that such modified confederal arrangements form a prima facie attractive model for transnational government more generally. To this end the EU is comparatively contrasted with the US Confederation, which was established directly after American independence, on the one hand and with its subsequent evolution into a federate state on the other—a comparison that demonstrates how the EU has combined a confederal foundation with some crucial federate reinforcements in its constitutional superstructure. Subsequently it is demonstrated how these modifications have addressed several of the classic weaknesses of the confederal form and may further help to open up the potential inherent in the confederal form for complementary transnational government more generally.
Europe Entrapped
Authors: Offe Claus
Published: August 2013

The EU in 2013 finds itself at the crossroads of either something considerably better or something much worse than the status quo; in other words, in a crisis. That much is nearly universally understood, both within Europe and widely beyond. So I am certainly not alone in believing that the current crisis, a crisis that is the cumulative outcome of a financial market, sovereign debt and EU integration/democratic deficit crises, is an extremely serious and unprecedented one, frightening due to its complexity and uncertainty. If it cannot soon be resolved (but nobody knows how soon is ‘soon enough’) through a major institutional overhaul of the EU, both the political project of European integration and the global economy will suffer badly—to say nothing about the massive social suffering it has caused already in the countries of the European periphery.
A single dose of interleukin‐31 (IL‐31) causes continuous itch‐associated scratching behaviour in mice
Authors: Arai Iwao , Tsuji Minoru , Takeda Hiroshi , Akiyama Nobutake , Saito Saburo
Published: August 2013

We investigated the effects of a single dose of mouse interleukin‐31 (IL‐31) on scratching behaviour in comparison with spontaneous skin‐lesion‐ or serotonin (5‐HT)‐ induced scratching behaviour in NC/Nga and BALB/c mice. Intradermal (i.d.) injection of IL‐31 caused a gradual increase in long‐lasting scratching (LLS, over 1.5 s) about 3 h after administration followed by a gradual decrease for over 24 h after administration. I.d. injection of IL‐31 significantly increased the total LLS counts/24 h but not short‐lasting scratching (SLS, 0.3–1.5 s). In skin‐lesioned NC/Nga mice, the LLS but not SLS counts were significantly higher than those in non‐skin‐lesioned NC/Nga mice. We also investigated 5‐HT‐induced scratching in BALB/c mice, SLS but not LLS increased immediately after the injection and then decreased to baseline after at 20 min. These results suggest that IL‐31 may participate in the sensation of itching and promote scratching behaviour in skin‐lesioned NC/Nga mice, an animal model of atopic dermatitis (AD).
Low environmental humidity induces synthesis and release of cortisol in an epidermal organotypic culture system
Authors: Takei Kentaro , Denda Sumiko , Kumamoto Junichi , Denda Mitsuhiro
Published: August 2013

Dry environmental conditions induce a variety of skin pathologies and a recent report indicating that cortisol synthesis in epidermis was increased during wound healing led us to hypothesize that environmental dryness might induce increased cortisol secretion in epidermis. Therefore, we incubated a skin equivalent model under dry (relative humidity: less than 10%) and humid (relative humidity: approximately 100%) conditions for 48 hours and evaluated cortisol secretion and mRNA levels of cortisol‐synthesizing enzyme (steroid 11β‐hydroxylase, CYP11B1) and IL‐1β. Cortisol secretion was increased threefold, and CYP11B1 and IL‐1β mRNAs were increased 38‐fold and sixfold, respectively, in the dry condition versus the humid condition. Occlusion with a water‐impermeable plastic membrane partially blocked the increases in cortisol secretion and CYP11B1 and IL‐1β mRNA expression in the dry condition. Thus, environmental dryness might induce increased cortisol secretion in epidermis of diseased skin characterized by epidermal barrier dysfunction, potentially influencing mental state and systemic physiology.
Optimising hydrological conditions to sustain wintering waterbird populations in Poyang Lake National Natural Reserve: implications for dam operations
Authors: Wang Yuyu , Jia Yifei , Guan Lei , Lu Cai , Lei Guangchun , Wen Li , Liu Guanhua
Published: August 2013

Poyang Lake is the largest freshwater lake in China and is of global importance for the conservation of migratory waterbirds of the East Asian – Australasian Flyway. Recent dam construction on the Yangtze River and its tributaries for agriculture and hydroelectric power has affected the hydrological regimes in downstream lakes. The Three Gorges Dam changed the hydrological regime of downstream lakes by reducing wet season flooding and expanding water storage in the dry season.

Despite the critical role of Poyang Lake in regional and global biodiversity conservation and the potential adverse ecological impacts of the Three Gorges Dam on downstream lakes, there have been few studies of the hydrological requirements of wintering waterbirds in the middle Yangtze floodplains.

We assembled a predictor matrix including three hydrological variables (annual inflow, maximum water level in high water season or MaxWL and minimum water level in low water season or MinWL) and two climatic variables (annual rainfall and biological cumulative temperature or BioT). Using the predictor matrix and annual waterbird census, we built group‐specific generalised additive models (GAM) to investigate how waterbird population variations were related to climatic and hydrological factors in the Poyang Lake National Natural Reserve. We then used the modelled predictor–response curves to identify the optimal lake water levels for each waterbird group.

The community‐level model selected group and the group‐varying‐coefficient term of BioT, Inflow and MaxWL as explanatory variables. At group level, tuber eaters and sedge foragers responded positively to BioT and MinWL. Seed eaters, invertebrate eaters and fish eaters responded positively to Inflow and negatively to MaxWL and MinWL. Based on the modelled predictor–response curves, we propose the following optimal water level ranges for Poyang Lake wintering waterbird conservation: a) maximum high water season level should be less than 17.4 m; and b) minimum low water level should be between 8.2 m and 8.8 m.
Biochemical properties and antioxidant activity of myofibrillar protein hydrolysates obtained from patin (Pangasius sutchi)
Authors: Najafian Leila , Jafarzade Mahtab , Said Mamot , Babji Abdul S.
Published: August 2013

Antioxidant activities of myofibrillar protein hydrolysates (MPH) prepared from patin (Pangasius sutchi) using papain and Alcalase® 2.4 L with different degrees of hydrolysis (DH) were investigated. With a DH of 65.83%, the hydrolysate prepared with papain exhibited the maximum of 1,1‐diphenyl‐2‐picrylhydrazyl (DPPH) radical‐scavenging activity (71.14%) with a reducing power of 0.310. At a concentration of 1 mg mL−1, the papain‐MPH exhibited a Trolox equivalent antioxidant capacity (TEAC) of 70.50 ± 1.22 μmol g−1 protein. With a DH of 83.6%, the Alcalase‐MPH had the highest metal‐chelating activity. Low molecular weight peptides showed higher antioxidant activities than high molecular weight peptides. Both papain‐MPH and Alcalase‐MPH contained high amounts of the essential amino acids (48.71% and 48.10%, respectively) with glutamic acid, aspartic acid and lysine as the dominant amino acids. These results suggest that the protein hydrolysates derived from patin may be used as an antioxidative ingredient in both functional food and nutraceutical applications.
Bioactive compounds vs. organoleptic assessment of ‘smoothies’‐type products prepared from selected fruit species
Authors: Teleszko Mirosława , Wojdyło Aneta
Published: August 2013

The aim of this study was to determine the usability of fruits of selected species growing in Europe for the smoothies production. The organoleptic assessment, analysis of polyphenols and vitamin C content and antioxidant activity of products were determined. The panellists were most in favour of the smoothies containing cranberry, black currant and bilberry purees as well as juice from dog rose. Polymerised proanthocyanidins were found to predominate in most of the products, except for the black currant smoothies (B3) where the main group of polyphenols were anthocyanins. The content of proanthocyanidins was higher in the smoothies containing dog rose juice. The analysed products differed significantly in the content of vitamin C, as the highest content of ascorbic acid was determined in black currant smoothies with dog rose juice and bilberry puree (168.98 mg/100 g).
The evaluation of patient self-completion concordance forms used in community pharmacy: a comparison of two European countries
Authors: Geurts Marlies M E , Zuydgeest Iris A , Walser Sabine , Kijlstra Nico B , Petkova Valentina , de Gier Johan J
Published: August 2013

Objectives

To evaluate the use of patient self-completion concordance forms in Dutch and Bulgarian pharmacies. Second, to show any differences in pharmacy practice and patient behaviour in two European countries: the Netherlands and Bulgaria.

Methods

A random sample of 500 pharmacies were approached per country. Patients at the start of a chronic treatment were invited to participate. At the first dispensing patients received a self-completion concordance form (SCCF). Patients were asked to fill in the SCCF at home and bring it to the appointment for their consultation at the second dispensing. After the consultations patients and pharmacists were asked to fill in a questionnaire.

Key findings

Twenty-four Dutch pharmacies (99 patients) and 41 Bulgarian pharmacies (241 patients) sent back study results. A higher proportion of Bulgarian patients answered questions on the SCCF compared to Dutch patients. Patients from both countries are satisfied with the SCCF, consultation and newly started medicine.

Conclusions

Although differences between pharmacies from the Netherlands and Bulgaria exist, the SCCF can be used at the start of chronic treatment. More research in other European countries will be necessary to further develop the use of the SCCF in community pharmacies. Eventually this could be used to develop indicators to measure patient involvement in pharmaceutical care.
Important information regarding reporting of adverse drug reactions: a qualitative study
Authors: Rolfes Leàn , Wilkes Sarah , van Hunsel Florence , van Puijenbroek Eugène , van Grootheest Kees
Published: August 2013

Objective

To give an overview of the views of different types of reporters (patients and healthcare professionals (HCPs)) and assessors of adverse drug reactions (ADRs) on what they consider important information regarding an ADR report.

Methods

A semi-structured interview was conducted among reporters and assessors of ADRs in the Netherlands. All interviews were audiotaped and transcribed verbatim. Content analysis was used on the data. All transcripts were coded individually by two researchers. A list was drafted of all elements of information mentioned during the interviews.

Key findings

In total 16 interviews were conducted. Elements of information that were explicitly brought up during the interviews were the impact of the ADR on the patient's daily life and information regarding causality. Furthermore, the correctness of reported information was found important by assessors of ADRs. Generally, patient reporting was seen as a very positive development for pharmacovigilance.

Conclusion

Patients reported that the severity of ADRs and their impact on daily life were important subjects. In the interviews with HCPs, either reporters or assessors, the focus was mainly on causality. The correctness of the given information is considered by ADR assessors to be very important. Regarding patient reporting the overall view was positive. Because HCPs and patients have different views regarding ADR reporting, in daily practice it is important to receive reports from both groups to assess the true nature of the ADR.
Information needs of people with asthma
Authors: Kong Ming Ley , Armour Carol , LeMay Kate , Smith Lorraine
Published: August 2013

Objectives

To describe the information needs of a group of Australians with asthma and the extent to which their needs had been met.

Methods

A self-administered survey was completed by people with asthma either presenting at community pharmacies or registered with a medical research institute database. The survey questions were developed based on a review of the literature, and included questions regarding participants’ information needs about their asthma, their sources of asthma information and the extent to which these information needs had been met. The responses concerning information needs were analysed thematically. Responses concerning sources of asthma information and the extent to which needs were met were analysed using descriptive and correlational statistics.

Key findings

Seventy-one people completed the survey. Key information needs that were identified included medications, management of asthma, asthma triggers, cure, aetiology of asthma and latest research. A third of participants reported having only ‘very little’, ‘a little’ or ‘some’ of their information needs met. The most common source of information was from a doctor (94% respondents), followed by a pharmacist or pharmacy assistant (56%).

Conclusion

Insights into the information needs of people with asthma have been provided. In light of the level of unmet information needs of people with asthma, and the types of information sought, pharmacists are in an ideal position to close the information gap and promote optimal asthma self-management practices.
Infant dental enucleation in an East African population in Sweden: a cross‐sectional study on dental records
Authors: Barzangi Jir , Unell Lennart , Söderfeldt Björn , Bond Jasmin , Ahmed Musse Ifrah , Arnrup Kristina
Published: August 2013

Aim

To examine the prevalence of infant dental enucleation (IDE) of primary canines, an East African traditional remedial procedure, in a multiethnic population of children in Sweden.

Design

A cross‐sectional study was conducted of dental records of 1133 patients (mean age 4.6 years, SD ± 1.4) attending one public dental service clinic in Sweden. The clinic was located in an area with a large multiethnic community. All were born within the years 2002–2006 and had received a check‐up in one of the years 2007–2009. A registry was made of missing primary canines where no reason could be found. In documented cases, information about ethnic origin was extracted. Statistical grouping was made according to known East African ethnicities.

Results

At least 36 ethnicities were recorded. Twenty‐four (2.1%) patients were missing one or more canines according to the criteria for IDE. Significant difference was seen when comparison was made between patients of known East African ethnicities, of whom 20.8% (21/101) manifested findings consistent with the criteria, and the rest of the population (3/1032; P < 0.001).

Conclusions

Prevalence of cases suggestive of IDE among patients of East African origin points to a need for increased awareness within dental and healthcare communities.
Free riders: the rise of alternative unionism inDenmark
Authors: Ibsen Flemming , Høgedahl Laust , Scheuer Steen
Published: August 2013

In this article we analyse some disturbing trends in theDanish labour market: while collective bargaining coverage is still relatively high, union density has been declining and—worse than that—there has been a substantial shift away from recognised and in favour of alternative unionism. The alternative unions are not parties to collective agreements, and they offer membership much cheaper than the recognised unions, in effect taking a free ride on the institutional supports that used to be effective only for the recognised unions. The article explains this conundrum by pointing to the political and institutional backgrounds to this development, which threatens to erode the very basis for theDanish collective bargaining system. On the background of general statistics and of a general employee survey, we point out the reasons behind the challenges confronting the recognised unions, pointing out that the recognised unions must become both more efficient in the member services and more cost efficient, if they wish to halt the present downhill trend.
Arisaema claviforme sp. nov. and a new record of Arisaema (Araceae) from Vietnam
Authors: Bruggeman Pascal , Vuong Truong Ba , Rybková Romana , Ponert Jan
Published: August 2013

Arisaema claviforme P. Bruggeman, T. B. Vuong, R. Rybková & J. Ponert, a new species of Araceae, belonging to section Anomala, from Hòn Bà Nature Reserve, Khánh Hòa province in southern Vietnam is described, illustrated and compared with related taxa. Additionally, Arisaema simaicum Gagn., a species hitherto regarded as an endemic to southern Thailand is published as a new record for Vietnam and a short description and an illustration of this species is provided.
Bacterial motility confers fitness advantage in the presence of phages
Authors: Taylor T. B. , Buckling A.
Published: August 2013

Dispersal provides the opportunity to escape harm and colonize new patches, enabling populations to expand and persist. However, the benefits of dispersal associated with escaping harm will be dependent on the structure of the environment and the likelihood of escape. Here, we empirically investigate how the spatial distribution of a parasite influences the evolution of host dispersal. Bacteriophages are a strong and common threat for bacteria in natural environments and offer a good system with which to explore parasite‐mediated selection on host dispersal. We used two transposon mutants of the opportunistic bacteria, Pseudomonas aeruginosa, which varied in their motility (a disperser and a nondisperser), and the lytic bacteriophage ФKZ. The phage was distributed either in the central point of colony inoculation only, thus offering an escape route for the dispersing bacteria; or, present throughout the agar, where benefits of dispersal might be lost. Surprisingly, we found dispersal to be equally advantageous under both phage conditions relative to when phages were absent. A general explanation is that dispersal decreased the spatial structuring of host population, reducing opportunities for parasite transmission, but other more idiosyncratic mechanisms may also have contributed. This study highlights the crucial role the parasites can play on the evolution of dispersal and, more specifically, that bacteriophages, which are ubiquitous, are likely to select for bacterial motility.
Uninvited Guests at the Table – A Consumer Intervention for Safe Poultry Preparation
Authors: Bearth Angela , Cousin Marie‐Eve , Siegrist Michael
Published: August 2013

The goal of this longitudinal study was to investigate the efficacy of an intervention to increase awareness of food safety during the preparation of raw poultry in a sample of first year college students. At the first measurement point, baseline variables were assessed, and participants were randomly assigned to one of three conditions: two experimental groups and a control group. At the second measurement point, the two experimental groups received the intervention. At the final measurement point, a month after the intervention, follow‐up variables were assessed. The major outcome variables investigated were knowledge and self‐reported safe poultry preparation behavior. Despite the high overall knowledge at the first measurement point, the participants exhibited numerous knowledge gaps, which were successfully overcome by the intervention. Providing knowledge was essential in motivating participants to pay more attention to certain actions related to safely preparing poultry, while the cues played only a minor role in changing participants' behaviors.

Practical Applications

Home‐cooked poultry is believed to be the most common transmission route of the bacteria Campylobacter to humans. Despite efforts to reduce the contamination rate at the poultry production stage, contamination rates remain high, and hence endanger the consumer. Evidently, consumers are unaware of and do not practice basic precautions when preparing dishes with raw poultry. In the present research, the consumer perspective was investigated. It is necessary to communicate the risks of unsafe poultry preparation to the consumer in order to facilitate informed decisions and behavior, and reduce incidence rates of foodborne illnesses. The results offer support for the efficacy of providing knowledge to correct people's misconceptions and increase their awareness of food safety issues. Moreover, it provides pointers for future risk communication related to the topic of safe domestic food handling.
Treatment decision‐making for post‐partum hemorrhage using dynamic contrast‐enhanced computed tomography
Authors: Kawamura Yosuke , Kondoh Eiji , Hamanishi Junzo , Kawasaki Kaoru , Fujita Kohei , Ueda Akihiko , Kawamura Akeo , Mogami Haruta , Konishi Ikuo
Published: August 2013

Aim

Post‐partum hemorrhage (PPH) is the leading cause of maternal mortality. Identification of the precise bleeding site is generally important to control hemorrhage, but such an approach has not been fully established in the context of PPH. We postulated that visualization of bleeding sites could aid treatment decisions in the management of PPH.

Methods

We conducted a prospective review of 26 patients who underwent dynamic computed tomography (CT) for PPH.

Results

A total of 17 cases presented with uterine bleeding, eight with vaginal hematomas, and one with hemoperitoneum. Overall, dynamic CT identified contrast media extravasation in the arterial phase in 12 of 26 (46.2%) cases: the upper (n = 4) and the lower uterine segment including the cervix (n = 2), subfascial space (n = 1) and vagina (n = 5). Identification of precise arterial bleeding sites using CT provided informative guidance about where to place balloons for intractable uterine bleeding, and how to manage hemoperitoneum and vaginal hematomas. In addition, dynamic CT revealed the existence of a subtype of uterine atony, which is characterized by focal active arterial bleeding in the upper uterine segment. Furthermore, negative contrast extravasation extracted cases of PPH that were well controlled without the need for surgical or radiological intervention. No patient required emergency hysterectomy to control PPH.

Conclusion

Dynamic CT has potential clinical utility in treatment decision‐making for PPH.
Case of maternal and fetal deaths due to severe congenital thrombotic thrombocytopenic purpura (Upshaw–Schulman syndrome) during pregnancy
Authors: Tanaka Hirokazu , Tenkumo Chiaki , Mori Nobuhiro , Kokame Koichi , Fujimura Yoshihiro , Hata Toshiyuki
Published: August 2013

Upshaw–Schulman syndrome (USS) involves a congenital deficiency of von Willebrand factor‐cleaving metalloprotease (ADAMTS13) activity due to gene mutations. Female patients develop overt thrombotic thrombocytopenic purpura (TTP) caused by a decline of ADAMTS13 activity in pregnancy. A 23‐year‐old nulliparous Japanese woman died due to severe, rapid progression of TTP with intrauterine fetal death at 20 weeks of gestation after its onset, even though she underwent intensive treatment which included plasma exchange. She had a history of idiopathic thrombocytopenic purpura at the age of 3 years. The patient's ADAMTS13 activity was of very low level. It should be borne in mind that there is the possibility of rapidly progressive fulminant USS during pregnancy.
Differences in collagen ultrastructure of human first trimester decidua basalis and parietalis: Implications for trophoblastic invasion of the placental bed
Authors: Sinai Talaulikar Vikram , Kronenberger Katrin , Bax Bridget E. , Moss Raymond , Manyonda Isaac
Published: August 2013

Aim

The human embryo–maternal interface in the first trimester of pregnancy is an area of extensive tissue remodeling. Because collagen is the most abundant constituent of the extracellular matrix of the placental bed, successful invasion must involve its rapid turnover. We compared the nature and distribution of collagen fibrils in decidua basalis and parietalis.

Methods

We used a direct‐vision hysteroscopic technique to obtain biopsies of the decidua basalis and parietalis from 11 women undergoing pregnancy termination in the first trimester. The biopsies were subjected to light, transmission and scanning electron microscopy, and immunohistochemical studies using mouse monoclonal antibodies against cytokeratin 7 and collagen types I, III and V.

Results

Collagen fibrils in the stroma of decidua basalis were significantly thicker when compared to those in decidua parietalis (56.48 ± 1.37 nm vs 45.64 ± 0.85 nm; P < 0.0001 [mean ± standard error]) between 9 and 12 weeks gestation, but this difference in thickness was not observed at gestations below 9 weeks. In basalis, the fibrils appeared disrupted at most places surrounding the decidual/trophoblast cells while a uniform regular arrangement was preserved throughout most of parietalis.

Conclusion

There are differences in the ultrastructure of collagen fibrils between basalis and parietalis, with thicker and disrupted fibrils within abundant amorphous tissue in basalis, and thinner uniform fibrils in parietalis. These differences may reflect an adaptive response by decidua or a direct consequence of the invading trophoblast cells.
Universal Suffrage as Counter‐Revolution? Electoral Mobilisation under the Second Republic in France, 1848–1851
Authors: Crook Malcolm
Published: August 2013

The advent of mass, male suffrage in France in 1848 is usually regarded as a great success. There was a huge turnout in elections for a Constituent Assembly, but the outcome disappointed republicans, who failed to win a majority and blamed a backward peasantry. This paper suggests that the electoral system was at fault rather than the electorate. A hastily devised procedure, based on collective voting and the absence of declared candidatures, enabled notables to dominate the new regime. Radicals revised their tactics with some success in 1849, but soon succumbed to the plebiscitary democracy of Louis‐Napoleon. Universal suffrage might well mean counter‐revolution.
Trust in Physicians Among Rural Medicaid‐Enrolled Smokers
Authors: Nelms Emory , Wang Ling , Pennell Michael , Wewers Mary Ellen , Seiber Eric , Adolph Michael D. , Paskett Electra D. , Ferketich Amy K.
Published: August 2013

Purpose

Associations have been found between trusting patient‐physician relationships and use of preventive care and a greater adherence to prescribed care. The objectives of this study were to assess the level of trust rural Medicaid smokers have in their physicians and whether trust was related to patient characteristics or physician behavior.

Methods

This was a cross‐sectional study of smokers who were enrolled in a tobacco‐dependence treatment program. Participants were rural Medicaid‐enrolled adults, age 18 and older, who were current smokers. Participants were enrolled from 8 primary care clinics as they came in for an appointment with their physician. The Trust in Physician Scale was completed at the baseline visit. One week later, an interview was conducted with the smoker to determine whether the physician provided tobacco‐dependence treatment counseling at the visit. Mixed models were used to model the relationship between trust and participant characteristics and physician behaviors.

Findings

Medicaid smokers in this study exhibited a high level of trust in their health care provider, as levels were similar to those reported in the general population of patients. Trust was significantly higher among individuals with better self‐reported health.

Conclusions

Rural Medicaid smokers appeared to have similar levels of trust in their physician as other patients. Future research should explore the role trust plays in shaping interactions between underserved populations and physicians within the context of smoking cessation counseling.
Chronic hepatitis E: a review of the literature
Authors: Fujiwara S. , Yokokawa Y. , Morino K. , Hayasaka K. , Kawabata M. , Shimizu T.
Published: August 2013

In 1978, the first case of hepatitis E was identified as non‐A, non‐B hepatitis. Hepatitis E virus (HEV) infection is believed to be one of the common causes of enterically transmitted acute hepatitis in developing countries and is rare in developed countries, except in patients with a history of travel. However, an increasing number of chronic HEV infection cases have recently been reported in developed countries. In these countries, immunosuppressed patients with HEV infection, such as organ transplant recipients, human immunodeficiency virus (HIV)‐infected patients or patients with haematological malignancies, could develop chronic hepatitis E (CHE) infection. Approximately 60% of HEV infections in immunocompromised patients after solid organ transplantation evolve to CHE without antiviral treatment. Clinical manifestations of CHE are often nonspecific symptoms. Many patients with CHE infection are asymptomatic, but some have jaundice, fatigue, abdominal pain, fever and asthenia. Several extrahepatic manifestations have also been reported. Although chronic HEV infection can result in progressive severe liver failure and cirrhosis, diagnosis is often controversial because of the lack of specific diagnostic criteria. Many CHE cases are diagnosed by HEV RNA‐positive serum or stool for >6 months. Immunosuppressive drugs, interferon‐alpha and ribavirin have been used for treatment. Diagnostic reverse‐transcription polymerase chain reaction is useful for estimating treatment efficacy. Preventive measures for HEV infection have been discussed, while systematic guidelines have not yet been reported.
Estimation of the dispersal of a major pest of maize by cline analysis of a temporary contact zone between two invasive outbreaks
Authors: Bermond Gérald , Blin Aurélie , Vercken Elodie , Ravigné Virginie , Rieux Adrien , Mallez Sophie , Morel‐Journel Thibaut , Guillemaud Thomas
Published: August 2013

Dispersal is a key factor in invasion and in the persistence and evolution of species. Despite the importance of estimates of dispersal distance, dispersal measurement remains a real methodological challenge. In this study, we characterized dispersal by exploiting a specific case of biological invasion, in which multiple introductions in disconnected areas lead to secondary contact between two differentiated expanding outbreaks. By applying cline theory to this ecological setting, we estimatedσ, the standard deviation of the parent–offspring distance distribution, of the western corn rootworm,Diabrotica virgifera virgifera, one of the most destructive pests of maize. This species is currently invading Europe, and the two largest invasive outbreaks, in northern Italy and Central Europe, have recently formed a secondary contact zone in northern Italy. We identified vanishing clines at 12 microsatellite loci throughout the contact zone. By analysing both the rate of change of cline slope and the spatial variation of linkage disequilibrium at these markers, we obtained twoσestimates of about 20 km/generation1/2. Simulations indicated that these estimates were robust to changes in dispersal kernels and differences in population density between the two outbreaks, despite a systematic weak bias. These estimates are consistent with the results of direct methods for measuring dispersal applied to the same species. We conclude that secondary contact resulting from multiple introductions is very useful for the inference of dispersal parameters and should be more widely used in other species.
Ancient trade routes shaped the genetic structure of horses in eastern Eurasia
Authors: Warmuth Vera M. , Campana Michael G. , Eriksson Anders , Bower Mim , Barker Graeme , Manica Andrea
Published: August 2013

Animal exchange networks have been shown to play an important role in determining gene flow among domestic animal populations. The Silk Road is one of the oldest continuous exchange networks in human history, yet its effectiveness in facilitating animal exchange across large geographical distances and topographically challenging landscapes has never been explicitly studied. Horses are known to have been traded along the Silk Roads; however, extensive movement of horses in connection with other human activities may have obscured the genetic signature of the Silk Roads. To investigate the role of the Silk Roads in shaping the genetic structure of horses in eastern Eurasia, we analysed microsatellite genotyping data from 455 village horses sampled from 17 locations. Using least‐cost path methods, we compared the performance of models containing the Silk Roads as corridors for gene flow with models containing single landscape features. We also determined whether the recent isolation of former Soviet Union countries from the rest of Eurasia has affected the genetic structure of our samples. The overall level of genetic differentiation was low, consistent with historically high levels of gene flow across the study region. The spatial genetic structure was characterized by a significant, albeit weak, pattern of isolation by distance across the continent with no evidence for the presence of distinct genetic clusters. Incorporating landscape features considerably improved the fit of the data; however, when we controlled for geographical distance, only the correlation between genetic differentiation and the Silk Roads remained significant, supporting the effectiveness of this ancient trade network in facilitating gene flow across large geographical distances in a topographically complex landscape.
Perception and pain thresholds for cutaneous heat and cold, and rectal distension: associations and disassociations
Authors: Horing B. , Kugel H. , Brenner V. , Zipfel S. , Enck P.
Published: August 2013

Background

Hypersensitivity to somatic or visceral pain has been reported in numerous clinical conditions such as fibromyalgia or the irritable bowel syndrome, and general hypersensitivity has been proposed to be the underlying mechanism. However, cross‐modal relationships especially between somatic and visceral pain have rarely been investigated even in healthy volunteers. Furthermore, psychological influences on pain have rarely been characterized across modalities.

Methods

Sixty‐one healthy participants underwent testing of perception and pain thresholds for cutaneous thermode heat and cold, as well as for rectal balloon distension. Psychological testing for anxiety, depression, and pain experience (including catastrophizing and coping) as well as cardiac interoception was performed. Measurement quality and the correlations between the different modalities were examined.

Key Results

Significant correlations existed between the perception thresholds for cold/heat (τB = −0.28, p = 0.002) and cold/distension (τB = −0.21, p = 0.03) and for the pain thresholds for cold/heat (r = −0.61, p < 0.001) and heat/distension (r = 0.33, p = 0.01). No association was found between pain thresholds and anxiety, depression, psychological experience with and processing of pain, or cardiac interoception. Retest reliabilities for pain measurements were satisfying after short intertrial intervals (all intraclass correlation coefficients >0.8), but less so after longer intervals. The individuals contributing to the respective correlations differ between measurements.

Conclusions & inferences

Moderate associations were found for pain thresholds across modalities. The strength of the associations and their stability over time warrants further investigation and might serve to increase the understanding of conditions affecting multiple pain modalities.
Effect of surface sensory and motor electrical stimulation on chronic poststroke oropharyngeal dysfunction
Authors: Rofes L. , Arreola V. , López I. , Martin A. , Sebastián M. , Ciurana A. , Clavé P.
Published: August 2013

Background

Chronic poststroke oropharyngeal dysfunction (OD) is a common condition, leading to severe complications, including death. Treatments for chronic poststroke OD are scarce. The aim of our study was to assess and compare the efficacy and safety of treatment with surface electrical stimulation (e‐stim) at sensory and motor intensities in patients with chronic poststroke OD.

Methods

Twenty chronic poststroke patients with OD were randomly assigned to (i) sensory e‐stim (treatment intensity: 75% of motor threshold) or (ii) motor e‐stim (treatment intensity: motor threshold). Patients were treated during 10 days, 1 h/day. Videofluoroscopy was performed at the beginning and end of the study to assess signs of impaired efficacy and safety of swallow and timing of swallow response.

Key Results

Patients presented advanced age (74.95 ± 2.18), 75% were men. The mean days poststroke was 336.26 ± 89.6. After sensory stimulation, the number of unsafe swallows was reduced by 66.7% (p < 0.001), the laryngeal vestibule closure time by 22.94% (p = 0.027) and maximal vertical hyoid extension time by 18.6% (p = 0.036). After motor stimulation, the number of unsafe swallows was reduced by 62.5% (p = 0.002), the laryngeal vestibule closure time by 38.26% (p = 0.009) and maximal vertical hyoid extension time by 24.8% (p = 0.008). Moreover, the motor stimulus reduced the pharyngeal residue by 66.7% (p = 0.002), the upper esophageal sphincter opening time by 39.39% (p = 0.009), and increased bolus propulsion force by 211.1% (p = 0.008). No serious adverse events were detected during the treatment.

Conclusions & Inferences

Surface e‐stim is a safe and effective treatment for chronic poststroke dysphagic patients.
Non‐celiac gluten sensitivity: clinical relevance and recommendations for future research
Authors: Mooney P. D. , Aziz I. , Sanders D. S.
Published: August 2013

Background

There has been increasing interest in the entity of Non‐Celiac Gluten Sensitivity (NCGS) in recent years; however, it still remains a controversial topic and its pathogenesis is not well understood. Celiac Disease, in contrast, is a well‐studied condition that has become increasingly recognized as a prevalent condition arising from a heightened immunological response to gluten. Wheat allergy is an IgE‐mediated condition capable of causing a variety of gastrointestinal symptoms. However, the number of patients who have neither celiac disease nor wheat allergy, but appear to derive benefit from a gluten‐free diet, is also increasing substantially. The use of the term NCGS as a way of describing this condition has become increasingly prevalent in recent years.

Purpose

In this review, we will focus on gastrointestinal manifestations of NCGS and discuss the evidence for the condition and its putative pathogenesis. We will discuss areas of controversy and areas for potential future research.
Ectomycorrhizas with Paxillus involutus enhance cadmium uptake and tolerance in Populus × canescens
Authors: MA YONGLU , HE JIALI , MA CHAOFENG , LUO JIE , LI HONG , LIU TONGXIAN , POLLE ANDREA , PENG CHANGHUI , LUO ZHI‐BIN
Published: August 2013

Ectomycorrhizas (EMs), which are symbiotic organs formed between tree roots and certain fungi, can mediate cadmium (Cd) tolerance of host plants, but the underlying physiological and molecular mechanisms are not fully understood.
Populus × canescens was inoculated with or without
Paxillus involutus (strain MAJ) and subsequently exposed to 0 or 50 μM
CdSO4

. Higher net
Cd2+

influx in EMs well corresponded to higher transcript levels of genes involved in
Cd2+

uptake, transport and detoxification processes than those in nonmycorrhizal roots. Higher
CO2

assimilation, improved nutrient and carbohydrate status, and alleviated oxidative stress were found in mycorrhizal compared to nonmycorrhizal poplars despite higher
Cd2+

accumulation.
What Do Child Daycare Center Teachers Know About Atopic Dermatitis?
Authors: Akcay Ahmet , Tamay Zeynep , Ones Ulker , Guler Nermin
Published: August 2013

Atopic dermatitis (AD) is the most common childhood inflammatory skin disorder. The purpose of this study was to elucidate the knowledge level of daycare center teachers about AD and related factors. Study subjects were 297 teachers (287 female, 10 male) from 20 randomly selected daycare centers in Istanbul. The knowledge level of teachers was assessed using a questionnaire with 21 questions about AD. The teachers were asked nine additional questions about demographic and other characteristics of the child care centers and about themselves. The mean age of the teachers was 26.4 ± 8.1 years (range 20–53 yrs). The mean score for the 21 questions was 71.4 ± 12.1 (68%) from a maximum of 105 points. The response rate of teachers rate for each question ranged from 54% to 90%. The completely true response rate for each question ranged from 3.0% to 66.7%. The knowledge level of the teachers was related to the number of children in the daycare center, but not to sex, age, education level, family history of atopy, teacher's monthly salary, location, or whether the daycare center was public or private. Although teachers in daycare centers have some knowledge about AD, widespread educational programs for teachers about AD may help to improve the understanding of the disease and the quality of life of affected children in daycare centers.
Role of Trichoscopy in Children's Scalp and Hair Disorders
Authors: Lencastre André , Tosti Antonella
Published: August 2013

Hair and scalp disorders in children may originate from the hair itself, scalp skin, or infectious causes and be congenital or acquired. The most common sign is alopecia, frequently brought on by tinea capitis, patchy alopecia areata, or trichotillomania. Sometimes less frequent and clinically more elusive conditions such as initial androgenetic alopecia, congenital triangular alopecia, or alopecia areata incognita may be responsible for hair loss. The noninvasive technique known as trichoscopy is being used more frequently, aiding in the prompt differential diagnosis and follow‐up of many of these diseases, oftentimes providing further examination before a treatment decision is made. This review of trichoscopy of the main scalp and hair disorders afflicting children and adolescents discusses the most important dermoscopic criteria and the usefulness of this technique.