bluuebunny/crossref_metadata_2025 huggingface dataset:
Examination of Learning Trajectories for Simulated Lumbar Puncture Training Using Hand Motion Analysis
Authors: Yeo Caitlin T. , Davison Colleen , Ungi Tamas , Holden Matthew , Fichtinger Gabor , McGraw Robert
Published: September 2015

Objectives

A prospective cohort study was conducted using hand motion analysis (HMA) to assess the acquisition and retention of technical proficiency among first‐year medical students learning the lumbar puncture (LP) skill in a simulated setting.

Methods

Twenty‐five subjects attended three or four simulation sessions at 6‐week intervals. The initial session consisted of an introduction to the procedure and a baseline HMA assessment. This was followed by a session involving deliberate practice and evaluation using HMA. Subject HMA metrics were followed over time and compared to performance benchmarks to determine the volume of practice required to achieve and maintain technical proficiency in the simulated setting. Performance benchmarks were derived from the assessment of experts using HMA.

Results

Subject baseline metrics were significantly different from expert (p < 0.01). At the outset of session 2, none of the subjects achieved the performance benchmarks. At the outset of sessions 3 and 4, 40 and 60% of subjects, respectively, demonstrated retention of technical proficiency. However, there was evidence of significant skill erosion between sessions (p < 0.01). The mean number of practice attempts required to achieve technical proficiency declined between sessions. Regression analysis indicated that there was a significant training effect for all students (overall negative slopes) over time. When examining the group as a whole, the speed at which students reached the expert benchmark was not significantly associated with number of practices in the first three sessions, although for some individuals these factors did appear associated. A total of 76% of subjects retained technical proficiency by session 4 and required a mean of 14 practices (range = 5 to 19).

Conclusions

These results show that the majority of students require three to four sessions of deliberate practice to achieve a sustainable level of proficiency in the LP procedure. There is considerable variation in learning progression and retention of technical proficiency. These results have important implications for the design and resource requirements of a competency‐based medical education program targeting LP training.
Lessons from integrating behaviour and resource selection: activity‐specific responses ofAfrican wild dogs to roads
Authors: Abrahms B. , Jordan N. R. , Golabek K. A. , McNutt J. W. , Wilson A. M. , Brashares J. S.
Published: September 2015

Understanding how anthropogenic features affect species' abilities to move within landscapes is essential to conservation planning and requires accurate assessment of resource selection for movement by focal species. Yet, the extent to which an individual's behavioural state (e.g. foraging, resting, commuting) influences resource selection has largely been ignored. Recent advances in Global Positioning System (GPS) tracking technology can fill this gap by associating distinct behavioural states with location data. We investigated the role of behaviour in determining the responses of an endangered species of carnivore, theAfrican wild dogLycaon pictus, to one of the most widespread forms of landscape alteration globally: road systems. We collected high‐resolutionGPSand activity data from 13 wild dogs in northernBotswana over a 2‐year period. We employed a step selection framework to measure resource selection across three behavioural states identified from activity data (high‐speed running, resting and travelling) and across a gradient of habitats and seasons, and compared these outputs to a full model that did not parse for behaviour. The response of wild dogs to roads varied markedly with both the behavioural and the landscape contexts in which roads were encountered. Specifically, wild dogs selected roads when travelling, ignored roads when high‐speed running and avoided roads when resting. This distinction was not evident when all movement data were considered together in the full model. When travelling, selection for roads increased in denser vegetative environments, suggesting that roads may enhance movement for this species. Our findings indicate that including behavioural information in resource selection models is critical to understanding wildlife responses to landscape features and suggest that successful application of resource selection analyses to conservation planning requires explicit examination of the behavioural contexts in which movement occurs. Thus, behaviour‐specific step selection functions offer a powerful tool for identifying resource selection patterns for animal behaviours of conservation significance.
Environmental enrichment facilitates cocaine‐cue extinction, deters reacquisition of cocaine self‐administration and alters AMPAR GluA1 expression and phosphorylation
Authors: Gauthier Jamie M. , Lin Amy , Nic Dhonnchadha Bríd Á. , Spealman Roger D. , Man Heng‐Ye , Kantak Kathleen M.
Published: September 2015

This study investigated the combination of environmental enrichment (EE) with cocaine‐cue extinction training on reacquisition of cocaine self‐administration. Rats were trained under a second‐order schedule for which responses were maintained by cocaine injections and cocaine‐paired stimuli. During three weekly extinction sessions, saline was substituted for cocaine but cocaine‐paired stimuli were presented. Rats received 4‐h periods of EE at strategic time points during extinction training, or received NoEE. Additional control rats received EE or NoEE without extinction training. One week later, reacquisition of cocaine self‐administration was evaluated for 15 sessions, and then GluA1 expression, a cellular substrate for learning and memory, was measured in selected brain regions. EE provided both 24 h before and immediately after extinction training facilitated extinction learning and deterred reacquisition of cocaine self‐administration for up to 13 sessions. Each intervention by itself (EE alone or extinction alone) was ineffective, as was EE scheduled at individual time points (EE 4 h or 24 h before, or EE immediately or 6 h after, each extinction training session). Under these conditions, rats rapidly reacquired baseline rates of cocaine self‐administration. Cocaine self‐administration alone decreased total GluA1 and/or pSer845GluA1 expression in basolateral amygdala and nucleus accumbens. Extinction training, with or without EE, opposed these changes and also increased total GluA1 in ventromedial prefrontal cortex and dorsal hippocampus. EE alone increased pSer845GluA1 and EE combined with extinction training decreased pSer845GluA1 in ventromedial prefrontal cortex. EE might be a useful adjunct to extinction therapy by enabling neuroplasticity that deters relapse to cocaine self‐administration.
National estimates of Australian gambling prevalence: f indings from a dual‐frame omnibus survey
Authors: Dowling N. A. , Youssef G. J. , Jackson A. C. , Pennay D. W. , Francis K. L. , Pennay A. , Lubman D. I.
Published: September 2015

Background, aims and design

The increase in mobile telephone‐only households may be a source of bias for traditional landline gambling prevalence surveys. Aims were to: (1) identify Australian gambling participation and problem gambling prevalence using a dual‐frame (50% landline and 50% mobile telephone) computer‐assisted telephone interviewing methodology; (2) explore the predictors of sample frame and telephone status; and (3) explore the degree to which sample frame and telephone status moderate the relationships between respondent characteristics and problem gambling.

Setting and participants

A total of 2000 adult respondents residing in Australia were interviewed from March to April 2013.

Measurements

Participation in multiple gambling activities and Problem Gambling Severity Index (PGSI).

Findings

Estimates were: gambling participation [63.9%, 95% confidence interval (CI) = 61.4–66.3], problem gambling (0.4%, 95% CI = 0.2–0.8), moderate‐risk gambling (1.9%, 95% CI = 1.3–2.6) and low‐risk gambling (3.0%, 95% CI = 2.2–4.0). Relative to the landline frame, the mobile frame was more likely to gamble on horse/greyhound races [odds ratio (OR) = 1.4], casino table games (OR = 5.0), sporting events (OR = 2.2), private games (OR = 1.9) and the internet (OR = 6.5); less likely to gamble on lotteries (OR = 0.6); and more likely to gamble on five or more activities (OR = 2.4), display problem gambling (OR = 6.4) and endorse PGSI items (OR = 2.4‐6.1). Only casino table gambling (OR = 2.9) and internet gambling (OR = 3.5) independently predicted mobile frame membership. Telephone status (landline frame versus mobile dual users and mobile‐only users) displayed similar findings. Finally, sample frame and/or telephone status moderated the relationship between gender, relationship status, health and problem gambling (OR = 2.9–7.6).

Conclusion

Given expected future increases in the mobile telephone‐only population, best practice in population gambling research should use dual frame sampling methodologies (at least 50% landline and 50% mobile telephone) for telephone interviewing.
Scale‐specific processes shape plant community patterns in subtropical coastal grasslands
Authors: da Silva Menezes Luciana , Müller Sandra Cristina , Overbeck Gerhard Ernst
Published: September 2015

Processes responsible for shaping community patterns act at specific spatial scales. In this study, we aimed at disentangling the effects of climate, soil and space as drivers of variation in a coastal grassland plant community. We were specifically interested in evaluating the relative influence of those processes at broad and fine spatial scales as well as when considering species groups with good and poor long‐distance dispersal capacity. We sampled grassland vegetation at 16 sites distributed along a latitudinal gradient of more than 500 km in subtropical southern Brazil and used variation partitioning procedures to ascertain the relative influence of climatic, edaphic and spatial processes on variation in species composition at different spatial scales, considering the entire community and subsets with only species from the Asteraceae family (good long‐distance dispersal) and Poaceae (poor long‐distance dispersal). Climatic filters were the most responsible for shaping grassland community composition at the broad scale, while edaphic filters showed higher importance at the fine scale. When not considering the influence of spatial scale, we observed higher influence of climate structured in space. Composition patterns of species with poor long‐distance dispersal (Poaceae) were more closely related to spatial variables than those of species with effective dispersal (Asteraceae). Our results stressed the importance of addressing different spatial scales to rightly ascertain the magnitude that different drivers exert on plant community assembly. Dividing the community into groups with different dispersal abilities proved useful for a more detailed understanding of the community assembly processes.
Vulnerability of Australian tropical savanna birds to climate change
Authors: Reside April E. , VanDerWal Jeremy , Garnett Stephen T. , Kutt Alex S.
Published: September 2015

Assessments of species vulnerability to climate change should increase the effectiveness of interventions in the current decline in biodiversity. Species vulnerability to climate change is a consequence of their sensitivity and adaptive capacity, in combination with their exposure to climate change. We apply a vulnerability assessment framework to 243 bird species inhabiting the tropical savannas of northern Australia. We build on previous vulnerability studies by including detailed data for variables relating to species sensitivity to change (relative abundance, clutch size, sensitivity to fire and distribution area), species adaptive capacity (movement behaviour and dietary breadth) and proportional changes predicted for their geographic range (i.e. exposure to climate change). These are integrated to provide a ranking of vulnerability. Our analysis found that birds of Australian tropical savannas cluster together with high sensitivity, with a few wide‐ranging increasing species with very low sensitivity. Australian tropical savanna birds have a range of adaptive capacities, and the impact of climate change on these species is predicted to be substantial. Two already endangered species are among the most vulnerable. Species largely restricted to Cape York Peninsula (a geographically distinct region) had the greatest overall vulnerability; these species were, in general, sensitive due to small distributions, sensitivity to fire frequency and had a lower capacity for dispersal. It will be important for the future of Australian tropical savanna birds to mitigate ecological threats and maintain extensive areas of suitable habitat to facilitate species dispersal.
Risk for girls can be adversely affected post‐term due to underestimation of gestational age by ultrasound in the second trimester
Authors: Björkman Katarina , Wesström Jan
Published: September 2015

Introduction

Post‐term pregnancies are associated with greater risks for mother and child. Accurate determination of gestational age is necessary for safe care. Female fetuses have been shown to be smaller than males at the time of second‐trimester ultrasound (US) examination, leading to underestimation of their age and, potentially, greater impacts of perinatal complications in post‐term girls than in post‐term boys. The purpose of this study was to investigate the sex ratio of post‐term births and differences in perinatal complications (stillbirth, low Apgar score, low birthweight, meconium aspiration and low umbilical artery pH) between post‐term boys and girls according to dating method [second‐trimester US and last menstrual period (LMP)].

Material and methods

Data from gestational week ≥39 to delivery of 13 338 singleton pregnancies between 13 February 2006 and 15 January 2014, were collected from the Obstetrix® (Siemens Healthcare) medical records system in Dalarna County, Sweden.

Results

The neonatal male:female ratio increased with gestational age after week 40, as dated by US, reaching 1.69 in gestational week 42. This ratio remained 1 throughout gestation according to dating by the LMP. Post‐term pregnancy increased the risks of meconium aspiration and low Apgar score, with no sex difference observed.

Conclusions

US gestational dating indicated that more boys than girls were born post‐term, whereas dating according to LMP revealed no sex difference. These results support the hypothesis that female fetuses are smaller than males, leading to underestimation of their gestational age, at the time of second‐trimester US examination.
Renal and Adrenal Ultrasonography: a valuable diagnostic tool in the salt‐wasting infant
Authors: Reynolds Ben Christopher , Schenk Daniel , Kambalimath Manjunath , Jackson Michael , Cheetham Tim
Published: September 2015

The major differential diagnosis in ‘salt‐wasting’ infants (characterised by hyponatraemia and hyperkalaemia) is that of an adrenal or renal disorder. Appropriate management relies on rapid diagnosis, but existing guidelines do not highlight the role of ultrasonography. We describe how ultrasound may lead to a more rapid diagnosis in disorders of sex development (DSD) and other potential ‘salt‐wasting’ infants.

Conclusion

Ultrasonography as a diagnostic tool in infants with salt‐wasting or DSD needs to be more widely recognised.
Stable isotope‐labelled intravenous microdose for absolute bioavailability and effect of grapefruit juice on ibrutinib in healthy adults
Authors: de Vries Ronald , Smit Johan W. , Hellemans Peter , Jiao James , Murphy Joseph , Skee Donna , Snoeys Jan , Sukbuntherng Juthamas , Vliegen Maarten , de Zwart Loeckie , Mannaert Erik , de Jong Jan
Published: September 2015

Aims

Ibrutinib, an inhibitor of Bruton's tyrosine kinase, is used in the treatment of mantle cell lymphoma or chronic lymphocytic leukaemia. Ibrutinib undergoes extensive rapid oxidative metabolism mediated by cytochrome P450 3A both at the level of first pass and clearance, which might result in low oral bioavailability. The present study was designed to investigate the absolute bioavailability (F) of ibrutinib in the fasting and fed state and assess the effect of grapefruit juice (GFJ) on the systemic exposure of ibrutinib in order to determine the fraction escaping the gut (Fg) and the fraction escaping hepatic extraction (Fh) in the fed state.

Methods

All participants received treatment A [560 mg oral ibrutinib, under fasting conditions], B (560 mg PO ibrutinib, fed, administered after drinking glucose drink) and C (140 mg oral ibrutinib, fed, with intake of GFJ before dosing). A single intravenous (i.v.) dose of 100 μg 13C6‐ibrutinib was administered 2 h after each oral dose.

Results

The estimated ‘F’ for treatments A, B and C was 3.9%, 8.4% and 15.9%, respectively. Fg and Fh in the fed state were 47.0% and 15.9%, respectively. Adverse events were mild to moderate in severity (Grade 1–2) and resolved without sequelae by the end of the study.

Conclusion

The absolute oral bioavailability of ibrutinib was low, ranging from 3.9% in the fasting state to 8.4% when administered 30 min before a standard breakfast without GFJ and 15.9% with GFJ. Ibrutinib was well tolerated following a single oral and i.v. dose, under both fasted and fed conditions and regardless of GFJ intake status.
Minocycline Attenuates Depressive‐Like Behaviour Induced by Rat Model of Testicular Torsion: Involvement of Nitric Oxide Pathway
Authors: Saravi Seyed Soheil Saeedi , Mousavi Seyyedeh Elaheh , Saravi Seyed Sobhan Saeedi , Dehpour Ahmad Reza
Published: September 2015

Testicular torsion/detorsion (T/D) can induce depression in pre‐ and post‐pubertal patients. This study was conducted to investigate the psychological impact of testicular torsion and mechanism underlying its depressive‐like behaviour, as well as antidepressant‐like activity of minocycline and possible involvement of nitric oxide (NO)/cyclic GMP pathway in this paradigm in male rats undergoing testicular T/D. Unilateral T/D was performed in 36 male adult Wistar rats, and different doses of minocycline were injected alone or combined with Nω‐nitro‐l‐arginine methyl ester (l‐NAME), non‐specific NO synthase (NOS) inhibitor; aminoguanidine (AG), specific inducible NOS inhibitor; l‐arginine, an NO precursor; and selective PDE5I, sildenafil. After assessment of locomotor activity in open‐field test, immobility times were recorded in the forced swimming test (FST). Moreover, 30 days after testicular T/D, testicular venous testosterone and serum nitrite concentrations were measured. A correlation was observed between either a decrease in plasma testosterone or an increase in serum nitrite concentrations with prolongation in immobility time in the testicular T/D‐operated rats FST. Minocycline (160 mg/kg) exerted the highest significant antidepressant‐like effect in the operated rats in the FST (p < 0.001). Furthermore, combination of subeffective doses of minocycline (80 mg/kg) and either l‐NAME (10 mg/kg) or AG (50 mg/kg) demonstrated a significant robust antidepressant‐like activity in T/D group (p < 0.01). Consequently, NO/cGMP pathway was involved in testicular T/D‐induced depressive‐like behaviour and antidepressant‐like activity of minocycline in the animal model. Moreover, a contribution was observed between either decreased testosterone or elevated serum nitrite levels and depressive‐like behaviour following testicular T/D.
Desynchronization in EEG during perception of means‐end actions and relations with infants' grasping skill
Authors: Yoo Kathryn H. , Cannon Erin N. , Thorpe Samuel G. , Fox Nathan A.
Published: September 2015

The current study examined age‐related differences in electroencephalogram (EEG) activity during perception of means‐end actions and production of grasps, and how EEG activity may relate to infants' motor competence. We collected data from 9‐ and 12‐month‐old infants during perception of means‐end actions made with a tool and during execution of their own grasps. We computed event‐related desynchronization (ERD) during perception and production events and assessed infants' reach‐grasp competence by looking at their latency to complete grasps. Although we found greater ERD during perception of means‐end actions in 9‐month‐olds compared with 12‐month‐olds, we found the relation between ERD during perception and emerging reach‐grasp competence to be specific for 12‐month‐olds and not for 9‐month‐olds. These results provide evidence for an emerging neural system that supports the coupling of action and perception with infants' emerging motor competence in the first year of life.
Wheat‐dependent exercise‐induced anaphylaxis
Authors: Scherf K. A. , Brockow K. , Biedermann T. , Koehler P. , Wieser H.
Published: September 2015

Wheat‐dependent exercise‐induced anaphylaxis (WDEIA) is a rare, but potentially severe food allergy exclusively occurring when wheat ingestion is accompanied by augmenting cofactors. It is clinically characterized by anaphylactic reactions ranging from urticaria and angioedema to dyspnoea, hypotension, collapse, and shock. WDEIA usually develops after ingestion of wheat products followed by physical exercise. Other cofactors are acetylsalicylic acid and other non‐steroidal anti‐inflammatory drugs, alcohol, and infections. The precise mechanisms of WDEIA remain unclear; exercise and other cofactors might increase gastrointestinal allergen permeability and osmolality, redistribute blood flow, or lower the threshold for IgE‐mediated mast cell degranulation. Among wheat proteins, ω5‐gliadin and high‐molecular‐weight glutenin subunits have been reported to be the major allergens. In some patients, WDEIA has been discussed to be caused by epicutaneous sensitization with hydrolysed wheat gluten included in cosmetics. Diagnosis is made based on the patient's history in combination with allergy skin testing, determination of wheat‐specific IgE serum antibodies, basophil activation test, histamine release test, and/or exercise challenge test. Acute treatment includes application of adrenaline or antihistamines. The most reliable prophylaxis of WDEIA is a gluten‐free diet. In less severe cases, a strict limitation of wheat ingestion before exercise and avoidance of other cofactors may be sufficient.
Undetected residual cement on standard or individualized all‐ceramic abutments with cemented zirconia single crowns – a prospective randomized pilot trial
Authors: Kappel Stefanie , Eiffler Constantin , Lorenzo‐Bermejo Justo , Stober Thomas , Rammelsberg Peter
Published: September 2015

Objective

To assess the frequency and amount of residual cement after attachment of monolithic zirconia crowns to standard and individualized ceramic abutments.

Material and methods

Twenty patients (mean age 58.9 years at inclusion in the study; 30% male) were randomized to receive either a standard or an individualized abutment on a bone‐level implant. Monolithic zirconia single crowns were attached to abutments by use of permanent glass–ionomer cement. Crowns were fabricated with an occlusal hole to enable unscrewing of the abutment–crown complex. Immediately after cementation, superstructures were removed and both the peri‐implant soft tissue and the abutment–crown complex were photographed in a standardized manner, to detect residual cement. Photographs were analyzed using Corel Photo Paint X7, and residual cement‐to‐total abutment and residual cement‐to‐peri‐implant soft tissue area ratios were calculated.

Results

Residual cement was observed for 9 of 10 (90%) individualized abutments, compared with 4 of 10 (40%) standard abutments (OR = 13.5, P = 0.049). Twenty‐seven of 40 (68%) individualized abutment surfaces were affected, compared with 12 of 40 (30%) standard abutment surfaces. The probability of observing residual cement was approximately five times higher for the surfaces of individualized abutments than for those of standard abutments (P = 0.005). The mean amount of sulcus surface covered by cement was 1.17% (SD 2.85) for the individualized abutments and 3.78% (SD 7.40) for the standard abutments. The position of the margin significantly affected the amount of residual cement.

Conclusion

Both individualized and standard all‐ceramic abutments result in small amounts of subgingival residual cement on abutment and sulcus surfaces. However, use of individualized abutments does not guarantee complete avoidance of undetected cement rests. Undetected residual cement might be avoided by use of all‐ceramic abutments with visible abutment shoulders.
Perineal body anatomy seen by three‐dimensional endovaginal ultrasound of asymptomatic nulliparae
Authors: Santoro G. A. , Shobeiri S. A. , Petros P. P. , Zapater P. , Wieczorek A. P.
Published: September 2015

Aim

The perineal body (PB) plays an important role in supporting the pelvic floor and the posterior vaginal wall, but its attachments and relationships are still debated. This study aimed to assess the normal anatomy of the PB using high‐resolution three‐dimensional endovaginal ultrasound (3D‐EVUS) in asymptomatic nulliparae.

Method

To validate the identification of perineal structures, 3D‐EVUS was initially performed on nulliparous cadavers. Fresh frozen pelves were prepared and echogenic structures thought to be the PB, the external anal sphincter, the superficial and deep transverse perineii, pubovaginalis, puboperinealis, puboanalis, puborectalis and iliococcygeus muscles were tagged with biopsy needles, and marked with indigo carmine dye for localization during dissection. In the second part of the study, consecutive asymptomatic nulliparae were prospectively imaged with the same ultrasound modality. Interrater reproducibility was assessed off‐line from stored 3D US volumes using a standardized technique.

Results

Five fresh frozen pelves and 44 asymptomatic nulliparae were assessed with 3D‐EVUS. The PB was seen as an ovoid structure of mixed echogenicity between the rectum and vagina. It appeared to be divided into a superficial level, in contact with the external anal sphincter, the bulbospongiousus and the superficial transverse perineii muscle and a deep level, in contact with puboperinealis and puboanalis muscles. Interobserver repeatability was excellent for the measurements of PB height [intraclass correlation coefficient (ICC) 0.927], PB depth (ICC 0.969) and PB width (ICC 0.932).

Conclusion

The PB is divided into two levels with different anatomical relationships with the pelvic floor muscles. 3D‐EVUS yields reproducible assessment of this complex structure.
Definitive seton management for transsphincteric fistula‐in‐ano: harm or charm?
Authors: Rosen D. R. , Kaiser A. M.
Published: September 2015

Aim

The treatment of transsphincteric anal fistula requires a balance between eradication of the disease and preservation of faecal control. A cutting seton is an old tool that is now out of vogue for many surgeons. We hypothesized that the concept remains reliable and safe with results that exceed those reported for many of the more recently described methods.

Method

A retrospective review was conducted of real‐time electronic health records (single institution, single surgeon) of patients presenting during the 14 years between 2001 and 2014 with a transsphincteric anal fistula who were treated with a cutting seton. Excluded were patients with Crohn's disease, fistulae related to malignancy or a previous anastomosis and patients whose fistula was treated by another method including a loose draining seton. Data collection included demographics, duration of the disease, duration of the treatment, outcome and continence.

Results

In all, 121 patients (80 men) of mean age 40.2 ± 12.2 years (range 18–76) with a mean follow‐up of 5.1 ± 3.3 (1–24) months were included in the analysis. The median duration of symptoms was 6 (1–84) months; 36% had failed other fistula surgery, 12% had a complex fistula with more than one track and 35% had some form of comorbidity. The median time to healing was 3 (1–18) months; 7.4% required further surgery, but eventually 98% had complete fistula healing. The incontinence rate decreased postoperatively to 11.6% from 19% before treatment with 17/121 with pre‐existing incontinence resolved and 8/107 new cases developing.

Conclusion

Despite its retrospective non‐comparative design, the study has demonstrated that a cutting seton is a safe, well tolerated and highly successful treatment for transsphincteric anal fistula and is followed overall by improved continence. The results compare very favourably with other techniques.
Prognostic role of FEV1 for survival in bronchiolitis obliterans syndrome after allogeneic hematopoietic stem cell transplantation
Authors: Ahn Jee Hwan , Jo Kyung‐Wook , Song Jin Woo , Shim Tae Sun , Lee Sei Won , Lee Jae Seung , Kim Dae‐Young , Lee Je‐Hwan , Lee Jung‐Hee , Choi Yunsuk , Lee Kyoo‐Hyung
Published: September 2015

Background

Bronchiolitis obliterans syndrome (BOS) can occur after hematopoietic stem cell transplantation (HSCT) and is associated with significant mortality. We investigated the role of forced expiratory volume in one s (FEV1) as a prognostic marker in BOS after HSCT.

Methods

Among all patients who underwent HSCT between December 1993 and November 2013 at a tertiary center in South Korea, 1187 patients were enrolled. Patient medical records were retrospectively analyzed to evaluate the prognostic factors associated with survival in these cases.

Results

During a median follow‐up period of 30.7 months after HSCT, 82 patients (6.9%) were diagnosed with BOS. The mean FEV1 of the BOS patients was 34.7% of predicted, and the mean FEV1 of 31 of these patients (37.8%) was <30% of predicted. The estimated overall survival rate for BOS patients excluding three patients who received lung transplantation was 74% at three yr from BOS diagnosis. Multivariate analysis showed that diagnosis of BOS within six months and FEV1 < 30% of predicted at the time of BOS diagnosis were associated with shorter survival.

Conclusions

An FEV1 < 30% of predicted at the time of diagnosis is significantly associated with an increased risk of death in patients with BOS after HSCT.
Managing Engineering Design for Competitive Sourcing in Closed‐Loop Supply Chains
Authors: Aydinliyim Tolga , Murthy Nagesh N.
Published: September 2015

We examine the strategic interplay between a buyer's design decision and the ensuing competition between suppliers in a three‐tier closed‐loop supply chain setting with significant recycling considerations. The nature of the engineering design decision in our research entails choice of integral versus modular design that has direct implications for the input raw material waste and ensuing competition between suppliers (i.e., incumbent and new). Whereas the integral design requires a large blank and generates excessive material scrap, the modular design reduces the generated scrap, and enhances cut‐to‐fit modularity, but incurs joining cost and yield loss. The incumbent supplier who supports the status quo choice of integral design can effectively recycle excessive material waste, as it is strategically located close to the source of material. The engineering design team at our study firm is currently exploring the option to source from alternative suppliers that can support either integral or modular designs, but have significantly lower effectiveness in recycling scrap material. We characterize the buyer's price sensitivity levels, component characteristics, supply chain configurations, and virgin and scrap specialty material prices that yield various design and sourcing policy alternatives. The buyer's optimal policy choice, the ensuing price–demand dynamics, and the resulting recycling implications demonstrate that the buyer can benefit from strategically tailoring his design decisions to affect the suppliers' material requirements and costs. We show that utilizing an alternative supply option is particularly valuable for components made from a material with a low price differential in virgin and scrap forms in supply chains wherein the new supplier base can recycle effectively. In such cases, the buyer induces severe price competition by dual sourcing the integral design, and competition may negate the seemingly obvious benefits of operational improvements (e.g., higher scrap material return rate).
Cardiac Computed Tomography versus Echocardiography in the Assessment of Stenotic Rheumatic Mitral Valve
Authors: Unal Aksu Hale , Gorgulu Sevket , Diker Mustafa , Celik Omer , Aksu Huseyin , Ozturk Derya , Kırıs Adem , Kalkan Ali Kemal , Erturk Mehmet , Bakır İhsan
Published: September 2015

Purpose

There are different clinical cardiac applications of dual source computed tomography (DSCT). Here, we aimed to compare the DSCT with the transthoracic echocardiography (TTE) for evaluating the Wilkins score and planimetric mitral valve area (MVA) of a rheumatic stenotic mitral valve.

Materials and Methods

We prospectively evaluated mitral valvular structure and function in 31 patients with known mitral stenosis undergoing electrocardiogram‐gated, second‐generation DSCT, in our heart center for different indications. Mitral valve was evaluated using Wilkins score, and also, the planimetric MVA was assessed.

Results

We found a significant difference between MVAs determined by DSCT (average 1.42 ± 0.44 cm2) and MVAs determined by TTE (average 1.35 ± 0.43 cm2; difference 0.07 ± 0.16 cm2; P = 0.018). Linear regression analysis revealed a good correlation between the two techniques (r = 0.934; P < 0.0001). The limits of agreement for DSCT and TTE in the Bland–Altman analysis were ±0.31 cm2. DSCT using TTE as the reference enabled good discrimination between mild and moderate‐to‐severe stenosis and had an area under the ROC curve of 0.967 (CI 0.912–1.023; P < 0.0001). Wilkins scores obtained by DSCT (7.51 ± 1.17, range 5–10) and TTE (8.16 ± 1.27, range 6–10) had a moderate correlation (r = 0.686; P < 0.0001).

Conclusion

We found that planimetric MVA measurements assessed by DSCT were closely correlated with MVA calculations by TTE. The moderate correlation was observed for the Wilkins score.
Leptin/adiponectin ratio predicts poststroke neurological outcome
Authors: Carbone Federico , Burger Fabienne , Roversi Gloria , Tamborino Carmine , Casetta Ilaria , Seraceni Silva , Trentini Alessandro , Padroni Marina , Bertolotto Maria , Dallegri Franco , Mach François , Fainardi Enrico , Montecucco Fabrizio
Published: September 2015

Background and aims

Different adipokines have been associated with atherosclerotic plaque rupture and cardiovascular events, such as acute ischaemic stroke (AIS). However, the potential role of these molecules in postischaemic brain injury remains largely unknown.

Methods and methods

We performed a substudy analysis on nonobese patients with first atherothrombotic stroke (n = 35) from a recently published prospective cohort. Primary endpoint was to investigate the predictive value of serum leptin/adiponectin ratio on neurological recovery at 90 days after AIS. The secondary endpoint was the predictive value of serum adipokine levels of clinical and radiological outcomes at a shorter follow‐up (at days 1 and 7 after AIS). The radiological evaluation included ischaemic lesion volume and haemorrhagic transformation (HT). The clinical examination was based on National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS).

Results

At day 1 after AIS, serum leptin and leptin/adiponectin ratio were increased and inversely correlated with both radiological and clinical parameters at all follow‐up time points. Once identified the best cut‐off points by receiver operating characteristic (ROC) analysis, risk analysis showed that higher circulating leptin improved neurological recovery at day 90. In addition, leptin/adiponectin ratio maintained statistical significance after adjustment for age, gender and thrombolysis, also predicting the occurrence of HT in the first 7 days after AIS (adjusted OR 0·15 [95% CI 0·03–0·83); P = 0·030]).

Conclusions

Higher leptin/adiponectin ratio at day 1 predicted better neurological outcomes in patients with atherothrombotic AIS and might be potentially useful as a prognostic biomarker of the disease.
Fracture resistance of simulated immature teeth filled with Biodentine and white mineral trioxide aggregate – an in vitro study
Authors: Elnaghy Amr M. , Elsaka Shaymaa E.
Published: September 2015

Background

The purpose of this study was to evaluate the long‐term fracture resistance of simulated immature teeth filled with Biodentine (BD) and white mineral trioxide aggregate (WMTA) as pulp space barriers for regenerative endodontic procedures (REPs).

Materials and methods

Sixty extracted human maxillary anterior teeth were divided into four groups of 15 teeth each. Positive control teeth received no treatment. The remaining teeth were prepared until a size 6 Peeso (1.7 mm) could be passed 1 mm beyond the apex. Then, an engineering twist drill of 3 mm diameter was used to extend the preparation of the canal 3 mm below CEJ. The root canals were irrigated and disinfected according to AAE considerations for REPs. The canals were filled with either BD or WMTA. The negative control canals were left unfilled. The coronal access cavities were restored with glass ionomer followed by composite resin. The teeth were placed in phosphate‐buffered saline solution and stored for 12 months. Each specimen was then subjected to fracture testing using a universal testing machine. The peak load to fracture and the fracture resistance were recorded, and the data were analysed statistically.

Results

The positive control group had the highest fracture resistance and differed significantly (P < 0.05) from the other experimental groups. No significant difference was found between BD and WMTA (P > 0.05).

Conclusions

Considering the risk of cervical root fracture for pulpless infected immature teeth treated with REPs, after 12 months, there was no difference between WMTA and BD regarding the resistance to root fracture.
Low‐dose cyclophosphamide effectively mobilizes peripheral blood stem cells in patients with autoimmune disease
Authors: Blank Norbert , Lisenko Katharina , Pavel Petra , Bruckner Thomas , Ho Anthony D. , Wuchter Patrick
Published: September 2015

For patients with severe and refractory autoimmune diseases, high‐dose chemotherapy and autologous hematopoietic stem cell transplantation has been established as a considerable therapeutic option in recent years. In this retrospective single‐center analysis, we assessed the feasibility and efficacy of peripheral blood stem cells (PBSC) mobilization and collection in 35 patients with refractory autoimmune disease (AID). The mobilization data of 15 patients with systemic sclerosis (SSc), 11 patients with multiple sclerosis (MS), and 9 patients with other AID were analyzed. Stem cell mobilization with cyclophosphamide chemotherapy 2 × 2 g/m2 (n = 16) or 1 × 2 g/m2 (n = 17) and G‐CSF followed by PBSC collection was performed between 1999 and 2015. Leukapheresis was performed in 16 inpatients and 19 outpatients. All patients reached their collection goal and no collection failures were observed. The median PBSC collection result was 12.2 (SSc), 8.0 (MS), and 8.2 (other AID) × 106 CD34+ cells/kg, respectively. Twenty‐five of 35 (71%) patients achieved a sufficient collection with one leukapheresis session, while 6 patients (17%) required two and 4 patients (11%) required three or more leukapheresis sessions. No correlation of the collected PBSC number was observed regarding age, body weight, diagnosis, disease duration, skin sclerosis, or previous cyclophosphamide. Mobilization chemotherapy with cyclophosphamide 2 × 2 g/m2 and 1 × 2 g/m2 delivered comparable mobilization results with leukapheresis on day 13 or 14. In summary, we demonstrate that PBSC collection is safe and feasible in patients with AID. Mobilization chemotherapy with cyclophosphamide 1 × 2 g/m2 and 2 × 2 g/m2 is equally effective in those patients.
The Mediating Role of Knowledge Acquisition on the Relationship Between External Social Capital and Innovativeness
Authors: Parra‐Requena Gloria , Ruiz‐Ortega María José , García‐Villaverde Pedro Manuel , Rodrigo‐Alarcón Job
Published: September 2015

In this paper we analyse how external social capital affects innovativeness through knowledge acquisition. Specifically, we test the effect of density, trust and cognitive proximity on the innovativeness of firms and the mediating role of external knowledge acquisition to explain these relationships. We focus our empirical study upon the footwear industry in Spain, using partial least squares to test the proposed hypotheses. The main contribution of this study is to demonstrate how knowledge acquisition leads the firm's external social capital to innovativeness.
Effectiveness of managed gene flow in reducing genetic divergence associated with captive breeding
Authors: Waters Charles D. , Hard Jeffrey J. , Brieuc Marine S. O. , Fast David E. , Warheit Kenneth I. , Waples Robin S. , Knudsen Curtis M. , Bosch William J. , Naish Kerry A.
Published: September 2015

Captive breeding has the potential to rebuild depressed populations. However, associated genetic changes may decrease restoration success and negatively affect the adaptive potential of the entire population. Thus, approaches that minimize genetic risks should be tested in a comparative framework over multiple generations. Genetic diversity in two captive‐reared lines of a species of conservation interest, Chinook salmon (Oncorhynchus tshawytscha), was surveyed across three generations using genome‐wide approaches. Genetic divergence from the source population was minimal in an integrated line, which implemented managed gene flow by using only naturally‐born adults as captive broodstock, but significant in a segregated line, which bred only captive‐origin individuals. Estimates of effective number of breeders revealed that the rapid divergence observed in the latter was largely attributable to genetic drift. Three independent tests for signatures of adaptive divergence also identified temporal change within the segregated line, possibly indicating domestication selection. The results empirically demonstrate that using managed gene flow for propagating a captive‐reared population reduces genetic divergence over the short term compared to one that relies solely on captive‐origin parents. These findings complement existing studies of captive breeding, which typically focus on a single management strategy and examine the fitness of one or two generations.
DUSP16 ablation arrests the cell cycle and induces cellular senescence
Authors: Zhang Haibin , Zheng Hai , Mu Wenjing , He Zhiying , Yang Bo , Ji Yuan , Hui Lijian
Published: September 2015

Dual‐specificity phosphatases (DUSPs) are a family of protein phosphatases that dephosphorylate both phosphotyrosine and phosphoserine/phosphothreonine residues. DUSPs are de‐regulated in many human diseases, including cancers. However, the function of DUSPs in tumorigenesis remains largely unknown. Here, using short hairpin RNA‐based gene knockdown, we found that several members of the DUSP family play critical roles in regulating cell proliferation. In particular, we showed that DUSP16 ablation leads to a G1/S transition arrest, reduced incorporation of 5‐bromodeoxyuridine, enhanced senescence‐associated β‐galactosidase activity, and formation of senescence‐associated heterochromatic foci. Mechanistically, DUSP16 silencing causes cellular senescence by activating the tumor suppressors p53 and Rb. The phosphatase activity of DUSP16 is necessary for antagonizing cellular senescence. Importantly, the expression levels of DUSP16 are up‐regulated in human liver cancers, and are positively correlated with tumor cell proliferation. Taken together, our findings indicate that DUSP16 plays a role in tumorigenesis by protecting cancer cells from senescence.
Local Culture and Dividends
Authors: Ucar Erdem
Published: September 2015

I empirically investigate whether geographical variations in local culture, as proxied by local religion, affect dividend demand and corporate dividend policy for a large sample of US firms. Firms located in Protestant counties are more likely to be dividend payers, initiate dividends, and have higher dividend yields, while firms located in Catholic counties are less likely to be dividend payers and have lower dividend yields. There is a geographically varying dividend clientele effect consistent with the variations in risk aversion among different cultural groups. My results suggest that firms largely held by local investors determine their corporate policies in line with local culture.
Modelling the food web for assessment of the impact of stock supplementation in a reservoir ecosystem in India
Authors: Khan M. F. , Preetha P. , Sharma A. P.
Published: September 2015

Comparative estimates of trophic status and energy flow were carried out in a tropical reservoir ecosystem in India to assess the impact of fish stocking. Mass‐balanced models of the reservoir ecosystem were constructed for two periods – 1982–1983 and 2002–2003 – using ecopath software to determine the impacts on different groups before and after stocking. Mixed trophic impact (MTI) analyses indicated that phytoplankton and detritus have a positive impact on most groups. There was a decrease in nutrient flow through the system from pre‐stocking to post‐stocking (22.28%). The baseline was higher by 0.29% in the post‐stock phase indicating maturity. The ecosystem indices tested indicate that the reservoir was in a more resilient state post‐stocking than during the pre‐stocking phase. The ‘health’ of the ecosystem showed an improvement, which indicates a positive impact of stocking.
Influences of gear type and analytical methodology on fish assemblage characterisations in temperate lakes
Authors: Sullivan C. J. , Coulter D. P. , Feiner Z. S. , Donabauer S. B. , Höök T. O.
Published: September 2015

A variety of gears and analytical methods can be used to characterise lentic fish assemblages; however, the combined influence of gear type and analysis can affect conclusions about assemblage patterns. Fish assemblages sampled with night electric fishing, gillnets and trapnets from 153 lakes were evaluated using summary indices of species composition, pairwise community similarity comparisons and multivariate ordination. For a given amount of effort, electric fishing had the highest species richness, while gillnets had higher diversity and evenness. Pairwise comparisons between gears revealed that (1) richness was positively correlated among all gears, (2) diversity and evenness were generally not correlated across gears and (3) electric fishing and trapnets captured more similar species than all other pairwise comparisons. Gear‐specific multivariate correlation and ordination revealed that gillnet and electric fishing samples more similarly characterised variation in assemblages among lakes, while trapnets characterised assemblages along different gradients of species composition. These results indicate that either electric fishing or trapnetting can be used when assessing shallow‐water assemblages for diversity or evenness, gillnets and either electric fishing or trapnets should be used for whole‐lake assessments, and either gillnets or electric fishing should be used when evaluating regionwide variation in lake assemblages.