bluuebunny/crossref_metadata_2025 huggingface dataset:
Downregulation of Integrins in Cancer Cells and Anti-Platelet Properties Are Involved in Holothurian Glycosaminoglycan-Mediated Disruption of the Interaction of Cancer Cells and Platelets in Hematogenous Metastasis
Authors: Qian Wenhui , Tao Li , Wang Yingyu , Zhang Feng , Li Mengqiu , Huang Shile , Wang Aiyun , Chen Wenxing , Yue Zhiqiang , Chen Lei , Liu Yuping , Huang Chenhu , Zhang Lei , Li Yao , Lu Yin
Published: October 2015

Activated platelets have been recognized as an accessory character in the cascade of tumor hematogenous metastasis, and intervention of tumor cell attachment to the activated platelets or microemboli formation might be a leading strategy to prevent tumor cells surviving in the blood vessels and sequential metastasis. Recently, we have demonstrated that holothurian glycosaminoglycan (hGAG), a sulfated polysaccharide with potent anticoagulant activity extracted from the sea cucumber Holothuria leucospilota Brandt, was highly efficacious against tumor metastasis. In this study, we identified the potential effects of hGAG on the disruption of interactions of cancer cells and platelets and the underlying mechanisms, which were supported by the following evidence: hGAG (1) inhibited thrombin-induced platelet activation and aggregation, (2) reduced adhesion between platelet and breast cancer cells, and abrogated platelets/cancer cells adhering to fibrinogen, (3) attenuated platelet-cancer cell complex formation (the number and size of aggregates) and (4) suppressed both mRNA and protein levels of β1 and β3 integrins, matrix metalloproteinase (MMP)-2 and MMP-9, while increasing the expression of the MMP inhibitor, tissue inhibitor of metalloproteinase (TIMP)-1 in MDA-MB-231 cells. These results suggested that both the antiplatelet properties and mitigation of the levels of cellular adhesion molecules contributed to the anticancer effects of hGAG, and might thus be exploited for clinical adjuvant therapy to attenuate tumor hematogenous metastasis.
New Insight into Old Bacillus Lipase: Solvent Stable Mesophilic Lipase Demonstrating Enzyme Activity towards Cold
Authors: Khurana Jyoti , Kumar Rakesh , Kumar Arbind , Singh Kashmir , Singh Ranvir , Kaur Jagdeep
Published: October 2015

Background:Bacillus lipases are grouped in subfamily 1.4, which are the smallest known lipases having a molecular mass of 19.6 kDa. Lipases active in a wide range of temperatures, specifically at low temperatures, have an advantage under low water conditions for industrial application. Methods: The lipase gene was cloned and expressed in Escherichia coli. The protein was purified and biochemically characterized in detail. Results: A lipase gene was cloned from a mesophilic Bacillus isolate. Sequence analysis revealed an open reading frame of 633 bp in length. The predicted molecular mass of protein was 22.6 kDa. The purified enzyme displayed optimal activity at 35°C and pH 8.0. Interestingly, this mesophilic enzyme was also cold active showing retention of 75 and 55% relative enzyme activity at 20 and 10°C, respectively. The purified lipase was stable in various organic solvents (50% v/v) and ionic liquids (5% v/v). The enzyme displayed maximum activity with paranitrophenyl laurate (C12). kcat/Km values for the purified lipase were calculated to be 5.8 ± 0.6 × 10-6. Conclusions: The lipase showed tolerance to various solvents as well as activity at low temperature. Therefore, this lipase might be of great potential to be employed in various industrial applications.
Cavernous Hemangiomas of the Pediatric Calvaria
Authors: Salazar Davern Monica , Lovell Mark A. , Wilkinson C. Corbett
Published: October 2015

This series reports 2 pediatric cases of calvarial cavernous hemangioma (cavernoma, cavernous malformation) treated surgically at Children's Hospital Colorado between 2008 and 2010. Both cases presented as painless bony masses which enlarged over time. Both patients underwent surgical resection without complication and have remained recurrence free since surgery. Because so few cases have been reported among pediatric populations, little is known regarding the epidemiology and prognosis of calvarial cavernous hemangiomas in children. These cases represent interesting additions to the small body of literature on these rare tumors.
Use of in vivo Expression Technology for the Identification of Putative Host Adaptation Factors of the Lyme Disease Spirochete
Authors: Casselli Timothy , Bankhead Troy
Published: October 2015

The causative agent of Lyme disease, Borrelia burgdorferi, is an obligate parasite that requires either a tick vector or a mammalian host for survival. Identification of the bacterial genes that are specifically expressed during infection of the mammalian host could provide targets for novel therapeutics and vaccines. In vivo expression technology (IVET) is a reporter-based promoter trap system that utilizes selectable markers to identify promoters of bacterial host-specific genes. Using previously characterized genes for in vivo and in vitro selection, this study utilized an IVET system that allows for selection of B. burgdorferi sequences that act as active promoters only during murine infection. This promoter trap system was able to successfully distinguish active promoter sequences both in vivo and in vitro from control sequences and a library of cloned B. burgdorferi genomic fragments. However, a bottleneck effect during the experimental mouse infection limited the utility for genome-wide promoter screening. Overall, IVET was demonstrated as a tool for the identification of in vivo-induced promoter elements of B. burgdorferi, and the observed infection bottleneck apparent using a polyclonal infection pool provides insight into the dynamics of experimental infection with B. burgdorferi.
Association between Ocular Axial Length-Related Genes and High Myopia in a Han Chinese Population
Authors: Li Ya-Ting , Xie Ming-Kun , Wu Jin
Published: October 2015

Aims: A previous genome-wide association study of high myopia identified five genome-wide loci for ocular axial length (C3orf26, ZC3H11B, RSPO1, GJD2, and ZNRF3). The aim of our study was to investigate the association between high myopia and genetic variants in the five loci in Han Chinese subjects. Methods: Five single nucleotide polymorphisms were genotyped in 296 unrelated high-myopia subjects and 300 matched emmetropic controls by the SNaPshot method. The distribution of genotypes in the cases and controls was compared in codominant, dominant, and recessive genetic models by using SNPStats online software. Results: Significant associations between rs994767 near ZC3H11B (p = 0.001), rs4074961 in RSPO1 (p < 0.001), and rs11073058 in GJD2 (p = 0.029) and high myopia were observed. Odds ratios (95% confidence intervals) were 1.532 (1.200-1.955), 1.603 (1.267-2.029), and 1.290 (1.027-1.621) for the rs994767 T allele, rs4074961 T allele, and rs11073058 T allele, respectively. But rs9811920 in C3orf26 and rs12321 in ZNRF3 were not associated with high myopia. Conclusion: Our findings suggested that genetic variants in ZC3H11B, RSPO1, and GJD2 are associated with susceptibility to the development of high myopia in a Han Chinese population. Functional roles of ZC3H11B, RSPO1, and GJD2 in the pathology of high myopia need to be further investigated.
National Analysis of Short-Term Outcomes and Volume-Outcome Relationships for Transcatheter Aortic Valve Replacement in the Era of Commercialization
Authors: de Biasi Andreas R. , Paul Subroto , Nasar Abu , Girardi Leonard N. , Salemi Arash
Published: October 2015

Objectives: We queried the 2012 National Inpatient Sample in order to (1) further describe the short-term outcomes for transcatheter aortic valve replacement (TAVR) and (2) characterize possible volume-outcome relationships and other prognostic factors for this procedure. Methods: Demographics and inhospital outcomes were tabulated for all patients, as were hospital characteristics and procedural-volume data for all centers at which patients underwent TAVR. Logistic regression analyses were performed to identify independent risk factors for mortality or morbidity. Results: 7,635 patients aged ≥18 years received TAVR during the study period; 84.5% (n = 6,450) underwent transfemoral TAVR and the rest were treated transapically. The median age was 83 years (IQR 77-88 years) and cardiovascular comorbidities were widespread. Overall inhospital mortality was 5.0% (n = 380), and 1.4% (n = 105) of the patients experienced a stroke. All-cause procedure-related morbidity was 24.7% (n = 1,885). Annual hospital TAVR volume did not predict inhospital mortality or morbidity (OR 1.00, 95% CI 0.99-1.00, p = 0.111 and OR 1.00, 95% CI 0.99-1.00, p = 0.947, respectively). Conclusions: Our analysis helps to confirm the short-term safety profile of TAVR and further demonstrates that inhospital outcomes have remained acceptable as this procedure has become commercialized.
Conscious Sedation Using Midazolam and Sequential Flumazenil in Cirrhotic Patients for Prophylactic Endoscopic Variceal Ligation
Authors: Kim Shin Il , Jin Young-Joo , Lee Seung Ho , Lee Jin-Woo , Lee Don Haeng , Lee Daehyung
Published: October 2015

Background/Aims: This study investigated the safety of endoscopic variceal ligation (EVL) under conscious sedation with midazolam and sequential flumazenil after procedure in these patients. Methods: A total of 279 patients who underwent secondary prophylactic EVL at our institution between April 2012 and June 2014, were enrolled. Conscious sedation was achieved using intravenous midazolam, and flumazenil was routinely used as an antidote immediately after EVL. Patients with sleep (n = 165) and non-sleep (n = 55) endoscopy were matched using propensity score analysis (3:1). Frequencies of overt hepatic encephalopathy (HEP) and patient' satisfactions with EVL were compared between the 2 groups. Results: Of the 279 patients, 155 (55.6%) were of Child-Turcotte-Pugh (CTP) class, B or C, and 224 (80.3%) patients underwent sleep endoscopy. After propensity score analysis, overt HEP was observed in 1 (0.4%) of the 165 patients in the sedated group, but not found in any in the non-sedated group. Patient' satisfaction with EVL was better in the sedated group (p < 0.001). Twenty-nine (65.9%) of the 44 patients with CTP class C underwent sleep endoscopy, and only one (3.4%) experienced overt HEP. Conclusions: Prophylactic EVL under conscious sedation using midazolam and flumazenil is probably safe in cirrhotic patients without experience of HEP, even in those of CTP class C.
Should the Dose of Antiplatelet Drugs Be Adjusted for Body Weight? The Example of Vorapaxar
Authors: Serebruany Victor L. , Fortmann Seth D. , Kim Moo Hyun
Published: October 2015

Background: In contrast to the vast majority of pharmaceuticals on the market, antiplatelet agents are widely prescribed in a uniform, ‘one size fits all' manner, without conventional dose adjustments. However, strong evidence yielded from clinical trials repeatedly suggests that patients with a low body weight (LBW), the elderly and those with renal or hepatic impairment may benefit from reduced doses, while younger, heavier patients, males and diabetics may benefit from a dose escalation. Vorapaxar, a thrombin protease-activated receptor-1 inhibitor, has been tested in the TRA2P and TRACER clinical trials, but its efficacy and safety in patients with a LBW is unclear. Objective: To determine the impact of LBW on primary end point rates (PER) and bleeding risk after vorapaxar, as yielded from the TRA2P and TRACER secondary FDA review. Results: The LBW (<60 kg) groups in TRA2P (n = 1,852; 7%) and TRACER (n = 1,046; 8%) were small. However, the PER repeatedly suggested inferiority of vorapaxar over placebo in both the successful TRA2P study (10.6 vs. 8.4%; p = 0.012) and the failed TRACER study (19.3 vs. 18.2%; p = not significant). In TRA2P, the PER monotonically escalated with increasing weight for placebo, while those in the vorapaxar arm formed a flat U- or J-shaped distribution across the weight quintiles. In TRACER, the PER by weight quintile appear much higher, but also more random than in TRA2P. The bleeding rates in TRA2P were higher for the 2 lowest-weight quintiles with both placebo and vorapaxar. In TRACER, bleeding rates were more than doubled when compared to TRA2P, and they varied little by weight quintile, with a slight decrease for the heaviest patients in the placebo population and being the highest in the 2 lowest-weight quintiles after vorapaxar. Conclusion: The FDA analyses revealed no definite proof that LBW is associated with reduced efficacy of vorapaxar. While these data are striking, they can be explained by better outcomes in LBW placebo patients already sufficiently treated with dual-antiplatelet therapy. In contrast to efficacy, both TRA2P and TRACER definitely suggest that bleeding rates after vorapaxar are higher in patients with LBW. Dose adjustment for antiplatelet agents may soon become a reality.
Profiling Surgical Staplers: Does Staple Direction Affect the Strength of the Anastomosis?
Authors: Kimura Masahiro , Takahashi Hiroki , Tanaka Tatsuya , Sagawa Hiroyuki , Takeyama Hiromitsu
Published: October 2015

Background: Few studies have been conducted regarding the optimal staple direction in gastrointestinal anastomosis. The purpose of this study was to evaluate the burst pressure of the anastomosis depending on the firing direction of the stapler. Methods: Pig esophagus and small bowel were used for all experiments. The small intestine represented a thin intestinal tract and the esophagus represented a thick intestinal tract. A side-to-side anastomosis was performed using a linear stapler, and the burst pressure was measured. A leak test on the anastomosis was then performed and burst pressures measured. Results: Burst pressures after anastomosis using a GIA™ 100-3.8 were 47.4 ± 10.4 mm Hg. With the same GIA, the burst pressure was significantly greater when the staples were driven from the small intestine into the esophagus (83.3 ± 17.3 mm Hg). Using the GIA™ 100-4.8, it was found that the burst pressure was significantly greater when the staplers were driven into the small intestine versus the esophagus (51.6 ± 7.1 vs. 68.6 ± 16.1 mm Hg). There was no significant difference between the different GIAs when fired in the same direction. Conclusion: Burst pressures were significantly greater when the staplers were driven from the small intestine into the esophagus. The direction of the staple line influences the strength of the anastomosis.
The Utility of Neutrophil-to-Lymphocyte Ratio as a Severity Predictor of Acute Appendicitis, Length of Hospital Stay and Postoperative Complication Rates
Authors: Kelly Michael E. , Khan Asif , Riaz Mudassar , Bolger Jarlath C. , Bennani Fidal , Khan Waqar , Waldron Ronan , Khan Iqbal Z. , Barry Kevin
Published: October 2015

Background: Numerous screening tools have been reported to aid in diagnosing appendicitis, but have poor severity prediction and lack accurate estimation of postoperative complications or total length of hospital stay (LOS). Aim: This study aims at evaluating the utility of neutrophil-to-lymphocyte (NLR) ratio in predicting the severity of appendicitis, LOS and 30-day complication rates. Methods: Patients who underwent appendicectomy over a 4-year period were evaluated. Demographics, blood results, severity of appendicitis, LOS and 30-day complications were recorded. Recommended cut-off values of NLR and C-reactive protein (CRP) for severity of appendicitis were determined using receiver operating characteristic analysis. The Mann-Whitney test was performed to assess the correlations between LOS and 30-day complications with NLR. Results: A total of 663 patients were included in the study of which 57.3% (n = 380) were male with mean patient age of 23.6 years, and 461 appendix specimens (69.6%) had simple inflammation on histological evaluation. A NLR of >6.35 or CRP of >55.6 were statistically associated with severe acute appendicitis, with a median of one extra hospital day admission (p < 0.0001). Mean NLR was statistically higher in patients with postoperative co(13.69 for severe vs. 7.29 for simple appendicitis group, p = 0.016). Conclusion: We advocate that NLR is a useful adjunct in predicting severity of appendicitis. It aids in delineating severe inflammation requiring surgery without substantial delay.
Non-Random Distribution of 5S rDNA Sites and Its Association with 45S rDNA in Plant Chromosomes
Authors: Roa Fernando , Guerra Marcelo
Published: October 2015

5S and 45S rDNA sites are the best mapped chromosome regions in eukaryotic chromosomes. In this work, a database was built gathering information about the position and number of 5S rDNA sites in 784 plant species, aiming to identify patterns of distribution along the chromosomes and its correlation with the position of 45S rDNA sites. Data revealed that in most karyotypes (54.5%, including polyploids) two 5S rDNA sites (a single pair) are present, with 58.7% of all sites occurring in the short arm, mainly in the proximal region. In karyotypes of angiosperms with only 1 pair of sites (single sites) they are mostly found in the proximal region (52.0%), whereas in karyotypes with multiple sites the location varies according to the average chromosome size. Karyotypes with multiple sites and small chromosomes (<3 µm) often display proximal sites, while medium-sized (between 3 and 6 µm) and large chromosomes (>6 µm) more commonly show terminal or interstitial sites. In species with holokinetic chromosomes, the modal value of sites per karyotype was also 2, but they were found mainly in a terminal position. Adjacent 5S and 45S rDNA sites were often found in the short arm, reflecting the preferential distribution of both sites in this arm. The high frequency of genera with at least 1 species with adjacent 5S and 45S sites reveals that this association appeared several times during angiosperm evolution, but it has been maintained only rarely as the dominant array in plant genera.
Effects of Propofol on the Dynamic Properties of Sensory Information Processing in the Mouse Cerebellar Cortical Molecular Layer in vivo
Authors: Jin Wen-Zhe , Shi Jin-Di , Liu Heng , Lan Yan , Chu Chun-Ping , Qiu De-Lai
Published: October 2015

Propofol is a global central nervous system depressant that affects information processing in the central nervous system. However, the effects of propofol on sensory information processing in the cerebellar cortical molecular layer are unknown. In this study, we examined the effects of propofol on the dynamics of sensory stimulation-evoked responses in the cerebellar molecular layer in urethane-anesthetized mice, using electrophysiological and pharmacological methods. Our results showed that cerebellar surface perfusion of propofol (10-1,000 μmol/l) significantly decreased amplitude and area under the curve (AUC) of the sensory stimulation-evoked inhibitory component (P1) but increased the rise time and decay time of P1. In contrast, administration of propofol significantly enhanced the sensory stimulation-evoked excitatory component (N1), which exhibited increases in amplitude and AUC, as well as increases in rise time and decay time. By blocking the GABAA receptor activity, propofol failed to increase the amplitude and the AUC of the excitatory postsynaptic component (N2) of PCs. Our present results suggest that propofol modulates the dynamic properties of the sensory information processing in the cerebellar molecular layer through the modulation of GABAA receptors activity in the adult mouse.
Hepatorenal Acute Kidney Injury and the Importance of Raising Mean Arterial Pressure
Authors: Velez Juan Carlos Q. , Kadian Manish , Taburyanskaya Margarita , Bohm Nicole M. , Delay Tracie A. , Karakala Nithin , Rockey Don C. , Nietert Paul J. , Goodwin Andrew J. , Whelan Timothy P.
Published: October 2015

Background: The efficacy of vasoconstrictors in hepatorenal syndrome (HRS) is variable. We hypothesized that the effectiveness of vasoconstrictor therapy in improving kidney function ultimately relates to the magnitude of the achieved mean arterial pressure (MAP) increase. Methods: A retrospective study was conducted to identify cirrhotic individuals treated with vasoconstrictors for acute kidney injury (AKI) presumably caused by HRS to examine the relationship between change in MAP and change in serum creatinine (sCr) using multivariate mixed linear regression. Results: Among 73 patients treated with midodrine/octreotide, change in MAP inversely correlated with change in sCr (p = 0.0005). The quartile with the greatest increase in MAP (+15.9 to +29.4 mm Hg) was associated with a subsequent absolute decrease in sCr. The strength of the correlation increased when the analysis was restricted to those who met the HRS criteria (n = 27, p = 0.002), where the third (+5.3 to +15.6 mm Hg) and fourth (+15.9 to +20.9 mm Hg) quartiles of MAP change were associated with a decrease in sCr. A similar but stronger correlation was found among 14 patients treated with norepinephrine either after failing midodrine/octreotide (n = 10) or de novo (n = 4; p = 0.002), where a rise in MAP of +19.2 to 25 mm Hg was associated with a larger reduction in sCr. Associations remained significant after adjustment for baseline parameters. Conclusions: The magnitude of MAP rise during HRS therapy with midodrine/octreotide or norepinephrine correlated with a reduction in sCr concentration. Our results suggest that achieving a pre-specified target of MAP increase might improve renal outcomes in hepatorenal AKI.
Evaluation of Choroidal Vascular Changes in Patients with Multiple Sclerosis Using Enhanced Depth Imaging Optical Coherence Tomography
Authors: Esen Ebru , Sizmaz Selcuk , Demir Turgay , Demirkiran Meltem , Unal Ilker , Demircan Nihal
Published: October 2015

Objective: To evaluate the choroidal thickness in patients with multiple sclerosis (MS) using enhanced depth imaging optical coherence tomography (EDI-OCT). Methods: In this observational comparative study, 68 eyes of 34 MS patients and 60 eyes of 30 healthy subjects were evaluated. All participants underwent complete ophthalmologic examination and OCT scanning. Choroidal thickness measurements were performed at seven points. Results: The mean subfoveal choroidal thickness was reduced significantly in MS patients (310.71 ± 61.85 μm) versus healthy controls (364.85 ± 41.81 μm) (p < 0.001). The difference was also significant at all six measurement points (p < 0.001 for all). Choroidal thickness measurements revealed no significant difference between MS eyes with a prior optic neuritis (ON) history (MS ON) and those without ON history (MS non-ON). Subfoveal choroidal thickness did not correlate with retinal nerve fiber layer and Expanded Disability Status Scale score, but reduced choroidal thickness was associated with longer disease duration (r = -0.28, p = 0.019) in MS patients. Conclusion: In MS patients, choroidal structural changes occur both in MS ON and MS non-ON eyes. The decreased choroidal thickness might provide evidence to support a potential role of vascular dysregulation in the pathophysiology of MS.
Ultrasound-Guided Tissue Core Biopsies in Supraclavicular Lymph Nodes in Patients with Suspected Thoracic Malignancies
Authors: Stigt Jos A. , Boers James E. , Boomsma Martijn F.
Published: October 2015

Background: Supraclavicular (SC) lymph node metastases are important in the analysis of thoracic malignancies for staging as well as for diagnosing purposes. Ultrasound (US) guidance visualises lesions very precisely, enabling tissue biopsies in real-time mode. Objectives: To report on the diagnostic qualities of SC tissue core biopsies (TCB). Methods: A retrospective database analysis was performed in TCB performed under US guidance in SC nodes in patients suspected of having a thoracic malignancy. Clinical characteristics and results of diagnostic evaluations were analysed. Results: Between October 2008 and October 2014, 67 sessions for TCB in 65 patients were performed. The diagnostic accuracy of TCB for all diagnoses is 90%, with a sensitivity of 89%. For malignant diagnoses, the sensitivity of US-guided TCB is 93%. In 20 patients, molecular analysis for EGFR and KRAS was performed, with a diagnostic success rate of 95%. One patient suffered a moderate haemorrhage after TCB. Conclusion: TCB of SC nodes in the analysis of suspected thoracic malignancy is safe and has a high diagnostic accuracy in determining tumour subtype as well as molecular analysis.
Prevalence of and Attitudes towards Smoking among Spanish Health Professionals
Authors: Jiménez-Ruiz Carlos A. , Riesco Miranda Juan Antonio , Ramos Pinedo Angela , de Higes Martinez Eva , Marquez Francisca Lourdes , Palomo Cobos Luis , Solano Reina Segismundo , de Granda Orive Jose Ignacio , de Lucas Ramos Pilar
Published: October 2015

Background: The MPOWER strategy encourages suitable monitoring of the tobacco epidemic among health professionals in all countries. Objective: To analyse the prevalence of and attitudes towards tobacco use among Spanish health professionals. Methods: A study was conducted based on an online survey. The study population consisted of health professionals (primary care physicians, specialist physicians and nurses). The questionnaire used included questions about tobacco consumption, knowledge of and attitudes towards smoking. The sample size was calculated according to a database with 9,500 e-mail addresses and listings of health centres and hospitals all over Spain. Statistical analysis was done using the SPSS software programme. Results: The study group comprised a total of 612 health professionals: 322 were women (52.6%), 196 were nurses and 416 were physicians. 11.7% of health professionals were smokers (9.6% regular smokers and 2.1% occasional smokers) and 41.3% were ex-smokers. Within the group of daily smokers, differences were observed between the nurses and the physicians: 11.2 versus 8.9% (p = 0.009). Smoking was recognized as a chronic disorder by 58.2% of health professionals, and 54.6% knew that the most effective intervention to help quit is a combination of psychological and pharmacological treatment. 56% of health professionals always asked their patients about their tobacco consumption. Conclusions: 11.7% of Spanish health professionals are smokers. We found that they have low knowledge about strategies to quit smoking and that there is a low level of therapeutic intervention on smokers.
Neuroimaging Evaluation for First Attack of Unprovoked Nonfebrile Seizure in Pediatrics: When to Order?
Authors: Sadeq Hussain , Karim Jumanah , Marwan Yousef , AlSaleem Talal
Published: October 2015

Objective: To assess the value of neuroimaging studies in evaluating pediatric patients presenting with a first attack of nonfebrile seizure. Method: We reviewed the medical records of pediatric patients aged 28 days to 12 years who were admitted between 1 January and 31 December 2013 with a first attack of unprovoked, afebrile seizure. These patients had undergone neuroimaging studies. The exclusion criterion was patients with known predisposing conditions for seizure. The computed tomography (CT) scan and magnetic resonance imaging (MRI) results were either normal or abnormal, and the abnormal ones were further classified into clinically insignificant or significant. Descriptive analysis was performed to summarize the data. Result: Fifty children were identified with a mean age of 5.2 ± 3.8 years. Of the 50 subjects, 29 (58.0%) were males and 21 (42.0%) were females. Sixteen patients (32.0%) had abnormal neuroimaging studies (CT scan, MRI or both); however, only 1 was considered to have a clinically significant abnormality, later diagnosed as Moyamoya disease. Conclusion: In this study, the neuroimaging studies were found not to be useful in evaluating pediatric patients presenting with a first attack of unprovoked, nonfebrile seizures.
9p21.3 Coronary Artery Disease Risk Variants Disrupt TEAD Transcription Factor–Dependent Transforming Growth Factor β Regulation of p16 Expression in Human Aortic Smooth Muscle Cells
Authors: Almontashiri Naif A. M. , Antoine Darlène , Zhou Xun , Vilmundarson Ragnar O. , Zhang Sean X. , Hao Kennedy N. , Chen Hsiao-Huei , Stewart Alexandre F. R.
Published: October 2015

Background—

The mechanism whereby the 9p21.3 locus confers risk for coronary artery disease remains incompletely understood. Risk alleles are associated with reduced expression of the cell cycle suppressor genes CDKN2A (p16 and p14) and CDKN2B (p15) and increased vascular smooth muscle cell proliferation. We asked whether risk alleles disrupt transcription factor binding to account for this effect.

Methods and Results—

A bioinformatic screen was used to predict which of 59 single nucleotide polymorphisms at the 9p21.3 locus disrupt (or create) transcription factor binding sites. Electrophoretic mobility shift and luciferase reporter assays examined the binding and functionality of the predicted regulatory sequences. Primary human aortic smooth muscle cells (HAoSMCs) were genotyped for 9p21.3, and HAoSMCs homozygous for the risk allele showed reduced p15 and p16 levels and increased proliferation. rs10811656 and rs4977757 disrupted functional TEF-1 TEC1 AbaA domain (TEAD) transcription factor binding sites. TEAD3 and TEAD4 overexpression induced p16 in HAoSMCs homozygous for the nonrisk allele, but not for the risk allele. Transforming growth factor β, known to activate p16 and also to interact with TEAD factors, failed to induce p16 or to inhibit proliferation of HAoSMCs homozygous for the risk allele. Knockdown of TEAD3 blocked transforming growth factor β–induced p16 mRNA and protein expression, and dual knockdown of TEAD3 and TEAD4 markedly reduced p16 expression in heterozygous HAoSMCs.

Conclusions—

Here, we identify a novel mechanism whereby sequences at the 9p21.3 risk locus disrupt TEAD factor binding and TEAD3-dependent transforming growth factor β induction of p16 in HAoSMCs. This mechanism accounts, in part, for the 9p21.3 coronary artery disease risk.
Effect of Switching From Statin Monotherapy to Ezetimibe/Simvastatin Combination Therapy Compared With Other Intensified Lipid‐Lowering Strategies on Lipoprotein Subclasses in Diabetic Patients With Symptomatic Cardiovascular Disease
Authors: Le Ngoc‐Anh , Tomassini Joanne E. , Tershakovec Andrew M. , Neff David R. , Wilson Peter W. F.
Published: October 2015

Background

Patients with diabetes mellitus and cardiovascular disease may not achieve adequate low‐density lipoprotein cholesterol (
LDL
‐C) lowering on statin monotherapy, attributed partly to atherogenic dyslipidemia. More intensive
LDL
‐C–lowering therapy can be considered for these patients. A previous randomized, controlled study demonstrated greater
LDL
‐C lowering in diabetic patients with symptomatic cardiovascular disease who switched from simvastatin 20 mg (S20) or atorvastatin 10 mg (A10) to combination ezetimibe/simvastatin 10/20 mg (ES10/20) therapy, compared with statin dose‐doubling (to S40 or A20) or switching to rosuvastatin 10 mg (R10). The effect of these regimens on novel biomarkers of atherogenic dyslipidemia (low‐ and high‐density lipoprotein particle number and lipoprotein‐associated phospholipase A2 [Lp‐PLA
2
]) was assessed.

Methods and Results

Treatment effects on low‐ and high‐density lipoprotein particle number (
by NMR
) and Lp‐PLA
2
(by
ELISA
) were evaluated using plasma samples available from 358 subjects in the study. Switching to ES10/20 reduced low‐density lipoprotein‐particle number numerically more than did statin dose‐doubling and was comparable with R10 (−133.3, −94.4, and −56.3 nmol/L, respectively;
P
>0.05). Increases in high‐density lipoprotein particle number were significantly greater with switches to ES10/20 versus statin dose‐doubling (1.5 and −0.5 μmol/L;
P
<0.05) and comparable with R10 (0.7 μmol/L;
P
>0.05). Percentages of patients attaining low‐density lipoprotein particle number levels <990 nmol/L were 62.4% for ES10/20, 54.1% for statin dose‐doubling, and 57.0% for R10. Switching to ES10/20 reduced Lp‐PLA
2
activity significantly more than did statin dose‐doubling (−28.0 versus −3.8 nmol/min per mL,
P
<0.05) and was comparable with R10 (−28.0 versus −18.6 nmol/min per mL;
P
>0.05); effects on Lp‐PLA
2
concentration were modest.

Conclusions

In diabetic patients with dyslipidemia, switching from statins to combination ES10/20 therapy generally improved lipoprotein subclass profile and Lp‐PLA
2
activity more than did statin dose‐doubling and was comparable with R10, consistent with its lipid effects.

Clinical Trial Registration

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00862251.
К вопросу об отношениях между дальневосточными железнодорожниками и Советским руководством с начала 1930-х до 1945 гг
Authors: Gnatovskaya Elena Nikolaevna , Kim Alexander Alexeevich
Published: October 2015

This work presents new research on the everyday life of railroad workers in the Soviet Far East and their relations with the authorities beginning in the 1930s to 1945. The authors present their findings from a number of archival materials that are examined here for the first time in a scholarly manner. The article examines aspects of labor organization, socialist competition, labor discipline, and workers’ participation in various railway political and ideological campaigns during these years. The authors also give significant attention to the reactions of the workers to the policy of the Communist Party of the Soviet Union (cpsu), laborers’ behavior in the workplace, and the history of various mass campaigns.
Private governance and accounting for sustainability networks
Authors: Thistlethwaite Jason , Paterson Matthew
Published: October 2015

Accounting rules and practices have become an important component of the governance of sustainability, notably in the field of corporate environmental, social, and governance reporting. This paper analyses the emergence and character of private governance initiatives regarding sustainability accounting. It does so using social network analysis in order to be able to conceptualize the patterns of connection across these different initiatives, and thus contribute to three specific ways that these initiatives are understood theoretically—as privatized neoliberal governance, via notions of professional epistemic authority, and through the concept of experimentation and experimental governance.
Organizational change within medical research in Sweden: on the role of the individuals and institutions
Authors: Zukauskaite Elena
Published: October 2015

The focus of this paper is on how organizational change within medical research evolves and is influenced by different types of institutions at different geographical levels, as well as what characteristics of the key individuals are important in enacting institutional opportunities and overcoming hindrances. The paper reveals the complexity of institutions influencing change processes. First, the relations between institutions can be complementary, reinforcing or contradicting, suggesting that individuals initiating change should consider possible responses to institutions contradictory to the initial opportunities, as well as take advantage of reinforcing and complementary norms, rules, and procedures. Second, although different types and levels of institutions have a joint impact on change processes, some institutions are more prominent than others in different phases of the process. Individuals can take advantage of institutional opportunities and overcome hindrances due to their personal qualities and position in the organization.
The art of imitating life: The potential contribution of biomimicry in shaping the future of our cities
Authors: Taylor Buck Nick
Published: October 2015

This paper discusses the significance of biomimicry as a design methodology within the context of urban infrastructure planning and design. The application of biomimicry principles to urban infrastructure problems is examined by analysing case studies that used biomimicry inspired designs rather than ‘mainstream’ infrastructure approaches. Biomimicry is presented as an ontology of the city that fosters innovative and collaborative urban infrastructure design and management, supplements dominant future city paradigms like the ‘smart’ city and is worthy of further, detailed study.
“You Still Got to See Where She’s Coming From”: Using Photovoice to Understand African American Female Adolescents’ Perspectives on Sexual Risk
Authors: Sidibe Turquoise , Turner Kea , Sparks Alicia , Woods-Jaeger Briana , Lightfoot Alexandra
Published: October 2015

African Americans have the highest rate of new HIV infection in the United States. This photovoice study explored the perspectives and experiences of African American female youth and sought to understand how adolescent development impacts HIV risk. This study used the photovoice methodology with seven African American or Biracial female youth, in Grades 8 through 12, residing in North Carolina. Study findings indicate that African American female adolescents struggle to navigate adolescence, specifically in coping with race- and gender-related stressors. The photovoice study demonstrated that African American early adolescent females face unique challenges that influence sexual health and HIV risk. There is a need for HIV prevention programs that support positive racial and gender identity development and teach early adolescents how to cope with race- and gender-related stressors. Our findings suggest it is important for youth to be sources of positive support for their peers.
Hypoxia triggers high-altitude headache with migraine features: A prospective trial
Authors: Broessner Gregor , Rohregger Johanna , Wille Maria , Lackner Peter , Ndayisaba Jean-Pierre , Burtscher Martin
Published: October 2015

Background

Given the high prevalence and clinical impact of high-altitude headache (HAH), a better understanding of risk factors and headache characteristics may give new insights into the understanding of hypoxia being a trigger for HAH or even migraine attacks.

Methods

In this prospective trial, we simulated high altitude (4500 m) by controlled normobaric hypoxia (FiO2 = 12.6%) to investigate acute mountain sickness (AMS) and headache characteristics. Clinical symptoms of AMS according to the Lake Louise Scoring system (LLS) were recorded before and after six and 12 hours in hypoxia. O2 saturation was measured using pulse oximetry at the respective time points. History of primary headache, especially episodic or chronic migraine, was a strict exclusion criterion.

Findings

In total 77 volunteers (43 (55.8%) males, 34 (44.2%) females) were enrolled in this study. Sixty-three (81.18%) and 40 (71.4%) participants developed headache at six or 12 hours, respectively, with height and SpO2 being significantly different between headache groups at six hours ( p < 0.05). Binary logistic regression model revealed a significant association of SpO2 and headache development ( p < 0.05, OR 1.123, 95% CI 1.001–1.259). In a subgroup of participants, with history of migraine being a strict exclusion criterion, hypoxia triggered migraine-like headache according to the International Classification of Headache Disorders (ICHD-3 beta) in n = 5 (8%) or n = 6 (15%), at six and 12 hours, respectively.

Interpretation

Normobaric hypoxia is a trigger for HAH and migraine-like headache attacks even in healthy volunteers without any history of migraine. Our study confirms the pivotal role of hypoxia in the development of AMS and beyond that suggests hypoxia may be involved in migraine pathophysiology.
Nurses improve migraine management in primary care
Authors: Veenstra Petra , Kollen Boudewijn J , de Jong Gosse , Baarveld Frans , van den Berg JS Peter
Published: October 2015

Introduction

Migraine is a common disorder with a high burden. Adequate treatment results in improvement of quality of life. Migraine patients are mainly treated by general practitioners (GPs), but there is still room for improvement. This study investigated whether primary care nurses could improve the treatment of migraine patients compared to usual care as provided by the GPs.

Participants and methods

We conducted a non-randomized controlled prospective trial in 235 patients diagnosed with migraine with or without aura according to ICHD-II criteria, aged between 18 and 65 years. Patients with migraine treated only by their GP were compared to management by a nurse supervised by a GP.

Results

In the intervention group, fewer migraine patients were referred to a neurologist ( p < 0.001). The reduction in monthly migraine days compared to baseline was more apparent in the intervention group at six ( p = 0.09) and nine months ( p = 0.006). There was no significant change in dichotomized HIT score ( p = 0.076). Change in satisfaction of patients did not differ significantly ( p = 0.070).

Conclusions

The care administered by a headache nurse in the primary care setting supervised by a GP resulted in fewer referrals to the neurologist and more migraine-free days per month, but no change in HIT score. There was no difference in satisfaction scores between both groups.
Platelet activating factor in allergies
Authors: Pałgan Krzysztof , Bartuzi Zbigniew
Published: October 2015

The platelet-activating factor (PAF) produced and released by mast cells, basophils, neutrophils, eosinophils, fibroblasts, platelets, endothelial cells, and even cardiac muscle cells plays an important role in inflammatory and thrombotic diseases. PAF has been shown to be an important mediator in anaphylaxis. Serum level of the factor correlates with the severity of systemic reactions. PAF is also involved in asthamatic patients’ bronchoconstriction, mucus hypersecretion, and inflammation of bronchi. Furthermore, increased plasma levels of PAF have been reported in patients with urticarial. Studies have shown that PAF increases the permeability of skin’s capillaries and indices the development of wheals, flare, and inflammatory reactions in the skin.

This review focuses on the actions of the PAF on the eosinophiles and mast cells. Following that pathophysiological mechanism of the PAF in anaphylaxis bronchial asthma and urticaria was discussed.
Preparation and characterization of high dielectric calcium copper titanate/polyimide composite films
Authors: Du Jing , Zhou Meng Meng , Ma Ling Ling , Cao Fei , Xiao Ji Jun , Yu Zhi Ping , Qiu Xiao Long , Wang Mei Mei
Published: October 2015

Calcium copper titanate (CaCu3Ti4O12; CCTO)/polyimide (PI) composite films were synthesized by 4,4′-oxydianiline, CCTO, and 3,3′,4,4′-biphenyltetracarboxylic dianhydride through ultrasonic dispersion in situ polymerization. Scanning electron microscopic images clearly confirmed that 10 wt% CCTO particles dispersed uniformly in composite films. When the content was 20–80 wt%, CCTO particles were coated by PI in good condition, and globular particles dispersed in the composite films. PI and CCTO/PI were found to exhibit excellent thermal stability. The addition of CCTO has influence on the thermal properties of PI. Weight loss temperatures (5% and 10%) of the composite films containing 70 wt% CCTO reached 612°C and 673.9°C, respectively. The strong interfacial interaction between PI and CCTO improved the dielectric properties of the composite films. The dielectric permittivity and conductivity of the CCTO/PI composite films increase with the increase of CCTO content. In addition, the dielectric permittivity of films containing 40–70 wt% increased rapidly.
Migration, migrant integration and support for social spending: The case of Switzerland
Authors: Spies Dennis , Schmidt-Catran Alexander
Published: October 2015

An extensive body of scholarship has claimed that the relationship between migration and the welfare state is a potentially troublesome one, because the native population might be concerned about the fiscal, economic and cultural threats this poses. At the same time, studies have argued that ‘migrants differ’, not only in their actual numbers but also in their similarities or differences compared with the native population. Taking these differences into account, we analyse the effect of the integration of migrants for natives’ support for welfare. In detail, we test for the possibility that the integration of migrants might have a direct impact on the economic and cultural difficulties which natives associate with migration and in this way will have an indirect effect on their support for social spending. Our results show that the objective integration of migrants has only limited relevance for the relationship between migration and welfare support and point to the need to focus on subjectively perceived migration- and integration-related attitudes of natives.
Acoustic spectroscopy of magnetic fluids based on transformer oil
Authors: Kúdelčík Jozef , Hardoň Štefan , Bury Peter , Kopčanský Peter , Timko Milan
Published: October 2015

The structural changes in transformer oil–based magnetic fluids with magnetite nanoparticles, FeO·Fe2O3, of different diameters upon the effect of an external magnetic field were studied by acoustic spectroscopy. The corresponding changes of the acoustic wave attenuation as a function of magnetic field were measured. Over the linear increasing magnetic field, the interaction between the magnetic field and the magnetic moments of the nanoparticles led to the aggregation of magnetic nanoparticles and following chain or cluster formation. These structures enlarged with the magnetic field and this process had the influence on the value of the acoustic attenuation. The remarkable changes in the acoustic attenuation were also observed in the magnetic fluid subjected to a jumped magnetic field observed for a given time. After the back change of magnetic field to zero, the attenuation drastically decreases because the lifetime of big clusters is in this case small. The anisotropy of the acoustic attenuation in external magnetic field was measured and analyzed at various temperatures, and the cluster radius, the number density of the colloidal nanoparticles, and some other parameters of magnetic nanoparticles could be determined from experimental results.
The consent process: Enabling or disabling patients’ active participation?
Authors: Doherty Carole , Stavropoulou Charitini , Saunders Mark NK , Brown Tracey
Published: October 2015

Standards expected by doctors’ regulatory bodies in respect of the process of consent to treatment have arguably sought to restructure the nature of the doctor–patient relationship from one of the paternalism to that of shared decision-making. Yet, few studies have explored empirically, from patients’ perspectives, the extent to which the process of consent to treatment enables or disables patients’ participation in medical decision-making. Our article examines patients’ attitudes towards the consent process, exploring how and why these attitudes influence patients’ active participation in decision-making and considering possible consequent medico-legal issues. Data were collected longitudinally using semi-structured interviews and field observations involving 35 patients and 19 of their caregivers, in an English hospital between February and November 2014. These indicate that generally patients defer to the doctor in respect of treatment decision-making. Although most patients and their caregivers wanted detailed information and discussion, they did not necessarily expect that this would be provided. Furthermore, patients perceived that signing the consent form was an obligatory routine principally to protect doctors from legal action should something go wrong. Our study suggests that patients’ predominantly paternalistic perceptions of the consent process can not only undermine attempts by doctors to involve them in decision-making but, as patients are now considered in law as informed actors, their perceptions of the consent form as not being in their interests could be a self-fulfilling prophecy if signing is undertaken without due consideration to the content.