bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative investigation on clinical outcomes of robot‐assisted radical prostatectomy between experienced open prostatic surgeons and novice open surgeons in a laparoscopically naïve center with a limited caseload
Authors: Sumitomo Makoto , Kanao Kent , Kato Yoshiharu , Yoshizawa Takahiko , Watanabe Masahito , Zennami Kenji , Nakamura Kogenta
Published: February 2015

Objectives

To compare perioperative, oncological and functional outcomes of robot‐assisted radical prostatectomy between experienced and novice open radical prostatectomy surgeons in a laparoscopically naïve center with a limited caseload.

Methods

Six surgeons carried out robot‐assisted radical prostatectomy in 154 patients, which were divided into the following three groups: group 1 (n = 90), including patients operated on by a surgeon with experience in both open radical prostatectomy and robot‐assisted radical prostatectomy; group 2 (n = 36), including patients operated on by two surgeons with experience in open radical prostatectomy only; and group 3 (n = 28), including patients operated on by three surgeons with limited experience in both open radical prostatectomy or robot‐assisted radical prostatectomy.

Results

Groups 2 and 3 did not differ significantly in their median values of external blood loss (P = 0.165) or console time (P = 0.103). Positive surgical margin rates for pT2 patients were also similar in these two groups: 21.2% (7/33) in group 2 and 22.7% (5/22) in group 3 (P = 0.894). Kaplan–Meier analysis showed that 12 months after robot‐assisted radical prostatectomy the prostate‐specific antigen‐free rate for pT2 patients was 96.0% in group 2 and 100% in group 3, but the pad‐free continence rate was just 91.0% in group 1, 88.0% in group 2 and 75.5% in group 3 (group 1 vs group 3, P = 0.037; group 2 vs group 3, P = 0.239). The major complication rate after robot‐assisted radical prostatectomy was 3.3% (3/90) in group 1, 11.1% (4/36) in group 2 and 17.9% (5/28) in group 3 (group 1 vs group 3, P = 0.008; group 2 vs group 3; P = 0.441).

Conclusions

Robot‐assisted radical prostatectomy offers satisfactory postoperative outcomes even when carried out by surgeons with limited experience in open radical prostatectomy.
Validation of a patient‐specific simulator for laparoscopic renal surgery
Authors: Makiyama Kazuhide , Yamanaka Hiroyuki , Ueno Daiki , Ohsaka Kimito , Sano Futoshi , Nakaigawa Noboru , Yao Masahiro , Kubota Yoshinobu
Published: February 2015

Objectives

To describe and to validate a novel patient‐specific virtual‐reality based simulator for laparoscopic surgery.

Methods

Three surgeons carried out 13 preoperative simulations at Yokohama City University Hospital, Yokohama, Kanagawa, Japan, from 2011 to 2012. The procedures included seven nephrectomies, four partial nephrectomies and two pyeloplasties. We evaluated whether the anatomies reproduced by the simulator matched those encountered during the actual operations. Furthermore, the surgeons were asked to use visual analog scales (from 1 to 5; higher scores are better) to evaluate the anatomical integrity and utility of the simulations, and their intraoperative confidence during the subsequent surgical procedures.

Results

The simulator reproduced the patients’ anatomies almost perfectly. Only a few minor mistakes were identified. Regarding the surgeons’ evaluations of the system, the mean scores for the anatomical integrity and utility of the simulations, and the surgeons’ intraoperative confidence were 3.4, 4.2 and 4.1, respectively. In all 13 cases, the surgeons were able to carry out preoperative training with ease, and they stated that the simulator was useful for producing preoperative images.

Conclusions

A patient‐specific simulator for laparoscopic renal surgery has been successfully developed. This system correctly reproduces anatomical structures, and it seems to be a useful preoperative training tool.
A novel leptin antagonist peptide inhibits breast cancer growth in vitro and in vivo
Authors: Catalano Stefania , Leggio Antonella , Barone Ines , De Marco Rosaria , Gelsomino Luca , Campana Antonella , Malivindi Rocco , Panza Salvatore , Giordano Cinzia , Liguori Alessia , Bonofiglio Daniela , Liguori Angelo , Andò Sebastiano
Published: February 2015

The role of the obesity cytokine leptin in breast cancer progression has raised interest in interfering with leptin's actions as a valuable therapeutic strategy. Leptin interacts with its receptor through three different binding sites: I–III. Site I is crucial for the formation of an active leptin–leptin receptor complex and in its subsequent activation. Amino acids 39‐42 (Leu‐Asp‐Phe‐Ile‐ LDFI) were shown to contribute to leptin binding site I and their mutations in alanine resulted in muteins acting as typical antagonists. We synthesized a small peptide based on the wild‐type sequence of leptin binding site I (LDFI) and evaluated its efficacy in antagonizing leptin actions in breast cancer using in vitro and in vivo experimental models. The peptide LDFI abolished the leptin‐induced anchorage‐dependent and ‐independent growth as well as the migration of ERα‐positive (MCF‐7) and ‐negative (SKBR3) breast cancer cells. These results were well correlated with a reduction in the phosphorylation levels of leptin downstream effectors, as JAK2/STAT3/AKT/MAPK. Importantly, the peptide LDFI reversed the leptin‐mediated up‐regulation of its gene expression, as an additional mechanism able to enhance the peptide antagonistic activity. The described effects were specific for leptin signalling, since the developed peptide was not able to antagonize the other growth factors' actions on signalling activation, proliferation and migration. Finally, we showed that the LDFI pegylated peptide markedly reduced breast tumour growth in xenograft models. The unmodified peptide LDFI acting as a full leptin antagonist could become an attractive option for breast cancer treatment, especially in obese women.
Evaluation of the tolerability and safety of a 0.015% ingenol mebutate gel compared to 5% 5‐fluorouracil cream for the treatment of facial actinic keratosis: a prospective randomized trial
Authors: Samorano L.P. , Torezan L.A. , Sanches J.A.
Published: February 2015

Background

Five per cent 5‐fluorouracil (5‐FU) cream is a well‐established treatment for actinic keratosis (AK), and ingenol mebutate gel (IMB) is a novel topical field‐directed therapy.

Objective

To compare the tolerability and safety of IMB with that of 5‐FU for the treatment of facial AK.

Methods

An open‐label, prospective, randomized, controlled clinical trial with 100 patients with AKs within a 25‐cm2 contiguous field on the face was conducted. IMB was applied daily for three consecutive days. 5‐FU was applied twice a day for 4 weeks. The treatment effect and the adverse events were evaluated at baseline and on days 2, 3, 4, 8, 15, 22, 29, 36 and 43 for intent‐to‐treat populations.

Results

The mean (±SD) maximum local skin reactions (LSR) for patients treated with IMB was 10.85 (± 3.12), compared with 10.86 (± 3.55) for those who received 5‐FU. Patients in the IMB group presented LSR that peaked at day 4 and almost completely regressed after 15 days. Differently, in the 5‐FU group, the LSR peaked at day 29 and lasted until visit 36. Additionally, the area under the curve (LSR × visit) was significantly smaller for IMB. No differences between the treatments for pruritus, pain, tearing, conjunctival hyperaemia or headaches were noted, but the eyelid oedema rate was higher for IMB group. No significant difference in the proportion of dropouts was observed between groups. Both treatments demonstrated a suitable safety profile.

Conclusion

For treating AKs, the local skin reactions in the IMB group were more short‐lived compared with those of 5‐FU, but both treatments seemed to be safe and tolerable.
Effect of Toothbrushing on Color Changes of Esthetic Restorative Materials
Authors: Bezgin Tuğba , Özer Levent , Tulga Öz Firdevs , Özkan Pelin
Published: February 2015

Purpose

The aim of this study was to evaluate the effects of various drinks and toothbrushing on the color changes of esthetic restorative materials used in pediatric dentistry.

Materials and Methods

Forty specimens were prepared from each of three restorative materials (compomer [Dyract AP], glass ionomer cement [Ionofil Molar AC, Voco], composite resin [Filtek Z 250]). Specimens were divided into four groups for immersion in three different staining solutions (cherry juice, cola, chocolate milk) and distilled water. Each group was subdivided into brushing and non‐brushing groups. The specimens in the brushing subgroups were brushed with toothpaste once a day using an electric toothbrush. Color was measured using a colorimeter, and color changes were calculated between baseline and 1, 7, 30, 60 days. Data was analyzed using Kruskal–Wallis, Mann–Whitney U, Wilcoxon, and Wilcoxon Signed Rank tests.

Results

All the solutions evaluated yielded color changes, and these changes were significantly greater for composite resin than for glass ionomer cement or compomer (p < 0.006). Brushing significantly decreased the color changes of restorative materials (p < 0.004).

Conclusion

Brushing significantly influenced the color stability of esthetic restorative materials. The results of this study also showed that glass ionomer cements and compomers had higher color stability than composite resins.

Clinical Significance

The color stability values after brushing may better reflect the discoloration of the esthetic restorative materials. Any color stability study model should consider the effects of toothbrushing that can remove the adsorbed colorants. The results of this study also showed that glass ionomer cements and compomers can be used in anterior restorations of children with their higher color stability than composite resins.
Molecular evidence for the coexistence of two sibling species in Pylaiella littoralis (Ectocarpales, Phaeophyceae) along the Brittany coast
Authors: Geoffroy Alexandre , Mauger Stéphane , De Jode Aurélien , Le Gall Line , Destombe Christophe
Published: February 2015

The great phenotypic variability and the lack of diagnostic characters in the genus Pylaiella render the systematic study of this genus problematic. In this study, we investigated the diversity of Pylaiella littoralis along the Brittany (France) coast using a DNA barcoding multilocus approach with mitochondrial (cox1, nad1, and atp9) and chloroplastic (rbcL and atpB) markers associated with a population genetics approach using 10 microsatellite markers. In addition, spatio‐temporal sampling was conducted along the Brittany coast. We sampled 140 individuals from four sites located between Saint‐Malo and Concarneau (380 km) from April to October. Mitochondrial sequence data revealed the occurrence of two sibling species, with a minimum of 2.4% divergence between them. Microsatellite genotypic data congruently revealed two well‐supported clusters matching the two mitochondrial clades of Pylaiella. Although gene flow is limited between species, occurrence of genetic admixtures in some populations suggested that reproductive isolation is not complete. Our study highlighted the complementarity of barcoding and population genetics approaches to shed light on the evolutionary processes that lead to speciation.
Insomnia and incident depression: role of objective sleep duration and natural history
Authors: Fernandez‐Mendoza Julio , Shea Sarah , Vgontzas Alexandros N. , Calhoun Susan L. , Liao Duanping , Bixler Edward O.
Published: February 2015

Longitudinal studies that have examined the association of insomnia with incident depression using objective sleep measures are very limited. The aim of this study was to examine the predictive role of the severity of insomnia for incident depression in a general population sample using psychometric and polysomnographic data. From a random, general population sample of 1741 individuals of the Penn State Adult Cohort, 1137 adults without depression were followed up with a structured telephone interview after 7.5 years. All subjects completed a full medical evaluation, 1‐night polysomnogram and Multiphasic Minnesota Personality Inventory at baseline. The incidence of depression was 15%. Poor sleep (odds ratio = 1.5, P = 0.001) and insomnia (odds ratio = 1.9, P = 0.031) were significantly associated with incident depression. The odds of incident depression were highest (odds ratio = 2.2, P = 0.019) in insomnia with objective short sleep duration and independent of Multiphasic Minnesota Personality Inventory Ego Strength scores, an index of poor coping resources. The persistence of insomnia and worsening of poor sleep into insomnia significantly increased the odds of incident depression (odds ratios ranged from 1.8 to 6.3), whereas their full remission did not (odds ratio ranged from 1.2 to 1.8). Insomnia with short sleep duration is associated with incident depression independent of poor coping resources, whereas the association of insomnia with normal sleep duration with incident depression was mediated by poor coping resources. Persistence and worsening of poor sleep or insomnia, but not their full remission, are significant predictors of incident depression. These data suggest that there is a significant relationship between the severity of insomnia and incident depression.
Diagnostics for resource‐limited settings in the era of interferon‐free HCV therapy
Authors: Cooke G. S. , Hill A. M.
Published: February 2015

The field of hepatitis C (HCV) therapy is moving inexorably towards a time when interferon is no longer part of routine HCV treatment. 2015 will see at least two interferon‐free directly acting antiviral (DAA) treatments licensed in Europe and the USA. For those parts of the world that can afford it, this will mean the potential for treatment of those who have either failed interferon‐based therapy or have been unable to tolerate the side‐effects that commonly accompany treatment.
Recreating Virginity in Iran: Hymenoplasty as a Form of Resistance
Authors: Ahmadi Azal
Published: February 2015

Hymenoplasty is a controversial surgery in Iran, where a woman's failure to present herself as virginal for marriage may result in severe social repercussions. Critical literature surrounding this clandestine surgery is sparse. During ethnographic fieldwork in Tehran, I interviewed women who have and have not undergone hymenoplasty and physicians who perform it. Using a Foucauldian framework, I argue that the medicalization of virginity is a form of female social control in Iran. The resulting narratives and discourses suggest that hymenoplasty is a covert form of resistance against socioculturally prescribed sexual inegalitarianism that restricts women to the social sphere of premarital chastity. By manipulating the medicalization of virginity, women inadvertently resist dichotomous gendered classifications that constrain them as either the deviant woman who has premarital sex or the normal woman who remains virginal until marriage. These women deviate from a fixed notion of gender embodiment, eroding socioculturally constituted categorical boundary markers regarding femininity.
In vitro antifungal susceptibilities of isolates of Candida spp. and Aspergillus spp. from China to nine systemically active antifungal agents: data from the SENTRY antifungal surveillance program, 2010 through 2012
Authors: Pfaller Michael A. , Castanheira Mariana , Messer Shawn A. , Jones Ronald N.
Published: February 2015

We report the in vitro activity of nine systemically active antifungal agents against 237 contemporary clinical isolates of yeast and moulds obtained from 13 laboratories in China during 2010 through 2012. Susceptibility testing was performed using CLSI methods. Sequencing of fks hot spots was performed for echinocandin non‐wild‐type (WT) strains. Isolates included 220 from eight species of Candida, 15 from four species of Aspergillus and one isolate each of Rhodotorula mucilaginosa and Trichosporon asahii. Resistance to amphotericin B (0.0%), flucytosine (0.0–1.7%) and the echinocandins (0.0–3.4%) was distinctly uncommon among C. albicans, C. parapsilosis, C. tropicalis, C. glabrata and C. pelliculosa. Three C. albicans isolates showed resistance to echinocandins and one harboured a mutation in HS1 of fks1. Resistance to the azoles was much more common with resistance to fluconazole, voriconazole and posaconazole detected among isolates of C. glabrata and C. tropicalis. Both C. parapsilosis and C. pelliculosa exhibited decreased susceptibility to fluconazole. Amphotericin B, the mould‐active azoles and the echinocandins were all quite active against isolates of A. fumigatus and A. flavus. Consistent with previous studies from China, resistance to fluconazole is prominent among Candida spp. isolates in this country.
When circles become triangular: how transsaccadic predictions shape the perception of shape
Authors: Herwig Arvid , Weiß Katharina , Schneider Werner X.
Published: February 2015

Human vision is characterized by a consistent pattern of saccadic eye movements. With each saccade, internal object representations change their retinal position and spatial resolution. This raises the question as to how peripheral perception is affected by imminent saccadic eye movements. Here, we suggest that saccades are accompanied by a prediction of their perceptual consequences (i.e., the foveation of the target object). Accordingly, peripheral perception should be biased toward previously associated foveal input. In this study, we first exposed participants to an altered visual stimulation where one object systematically changed its shape during saccades. Subsequently, participants had to judge the shape of briefly presented peripheral saccade targets. The results showed that targets were perceived as less curved for objects that previously changed from more circular in the periphery to more triangular in the fovea. Similarly, shapes were perceived as more curved for objects that previously changed from triangular to circular. Thus, peripheral perception seems to depend not solely on the current input but also on memorized experiences, enabling predictions about the perceptual consequences of saccadic eye movements.
Hypertonic saline for the management of raised intracranial pressure after severe traumatic brain injury
Authors: Mangat Halinder S. , Härtl Roger
Published: February 2015

Hyperosmolar agents are commonly used as an initial treatment for the management of raised intracranial pressure (ICP) after severe traumatic brain injury (TBI). They have an excellent adverse‐effect profile compared to other therapies, such as hyperventilation and barbiturates, which carry the risk of reducing cerebral perfusion. The hyperosmolar agent mannitol has been used for several decades to reduce raised ICP, and there is accumulating evidence from pilot studies suggesting beneficial effects of hypertonic saline (HTS) for similar purposes. An ideal therapeutic agent for ICP reduction should reduce ICP while maintaining cerebral perfusion (pressure). While mannitol can cause dehydration over time, HTS helps maintain normovolemia and cerebral perfusion, a finding that has led to a large amount of pilot data being published on the benefits of HTS, albeit in small cohorts. Prophylactic therapy is not recommended with mannitol, although it may be beneficial with HTS. To date, no large clinical trial has been performed to directly compare the two agents. The best current evidence suggests that mannitol is effective in reducing ICP in the management of traumatic intracranial hypertension and carries mortality benefit compared to barbiturates. Current evidence regarding the use of HTS in severe TBI is limited to smaller studies, which illustrate a benefit in ICP reduction and perhaps mortality.
Lifestyle and dental attendance as predictors of oral health‐related quality of life
Authors: Almoznino G , Aframian DJ , Sharav Y , Sheftel Y , Mirzabaev A , Zini A
Published: February 2015

Objectives

To evaluate the impact of health‐related behaviors and dental attendance on oral health‐related quality of life (OHRQoL).

Methods

One hundred and ninety‐two individuals presenting for dental treatment were included in a cross‐sectional survey using a self‐administered questionnaire that assessed demographics, smoking and alcohol consumption, physical activity habits, dental attendance, and dental pain utilizing a numeric rating scale (NRS). Results of the Oral Health Impact Profile (OHIP)‐14 questionnaire were considered as the dependent variable. A conceptual hierarchical data analysis model from distal to proximal determinants of the median OHIP‐14 total score was adopted.

Results

Analysis of the OHIP‐14 domains and total score revealed several significant protector characteristics: younger age, academic education, no alcohol consumption, regular physical activity, fewer smoking pack years, routine dental attendance, and lower NRS scores. Routine dental attendance was related to lower NRS scores (P < 0.001) which in turn were associated with lower OHIP‐14 scores (P = 0.018). Better health‐related behaviors (P = 0.039) and routine dental attendance (P = 0.029) also correlated directly with lower OHIP‐14 scores.

Conclusions

Better health‐related behaviors and routine dental attendance have a protective effect on OHRQoL. Clinicians should assess these behaviors during routine diagnostic workups. Global health authorities need to integrate oral and general health care and improve both OHrQoL and HrQoL.
Survival rates after surgical salvage procedures using mandible external pin fixation
Authors: Smolka W. , Cornelius C.‐P. , Mast G.
Published: February 2015

Aim

The aim of this study was to evaluate if temporary application of a mandible external pin fixator is a helpful tool in salvage surgery of recurrent squamous cell carcinoma (SCC) including segmental mandibulectomy.

Material and methods

Salvage surgery including continuity mandibular resection was performed for treatment of recurrent SCC in 10 patients. The bone defects were bridged using a mandible external fixator. In cases of histologically proven tumour‐free margins, secondary reconstruction was performed. In cases of R1‐resection, re‐resection was performed until R0‐resection was achieved. The mandible was reconstructed in a further procedure using regional or distant flaps. Data regarding tumour persistence, re‐recurrence, survival rate and complications were analysed retrospectively.

Results

Application of a mandible external pin fixator was possible in all cases. Six patients needed re‐resection prior to reconstructive procedures. Reconstruction could be performed in eight patients. Local re‐recurrence occurred in one patient. Recurrence within cervical lymph nodes appeared in three patients. The survival rate after a mean follow‐up of 42.2 months was 50%.

Conclusions

Temporary external pin fixation of the mandible is a helpful tool for enlarged re‐resections. The risk of tumour persistence and early local re‐recurrence prior to advanced mandibular reconstruction can be minimised. There is no influence on the survival rate of patients with recurrent SCC of the oral cavity.
Cryopreservation of cord blood CD34+ cells before or after thrombopoietin expansion differentially affects early platelet recovery in NOD SCID mice
Authors: van Hensbergen Yvette , van der Garde Mark , Brand Anneke , Slot Manon C. , de Graaf‐Dijkstra Alice , Watt Suzanne , Zwaginga Jaap Jan
Published: February 2015

BACKGROUND

Expansion of human cord blood (CB) CD34+ cells with thrombopoietin (TPO) can accelerate delayed platelet (PLT) recovery after transplantation into immunodeficient mice. Clinical implementation, however, will depend on practical and effective protocols. The best timing of TPO expansion in relation to cryopreservation in this respect is unknown.

STUDY DESIGN AND METHODS

In this study, we evaluated whether the order of cryopreservation and TPO expansion affected the expansion rate and numbers of clonogenic hematopoietic progenitor cells in vitro or PLT and longer‐term hematopoietic repopulation in NOD SCID mice in vivo.

RESULTS

Our results demonstrate higher expansion rates and the generation of higher numbers of multilineage and megakaryocytic progenitors (granulocyte, erythrocyte, monocyte, megakaryocyte colony‐forming units and megakaryocyte colony‐forming units) in vitro when freshly isolated CB CD34+ cells are first cultured with TPO and then cryopreserved and thawed as compared to TPO expansion after CD34+ cell cryopreservation. In contrast, the cells produced with the latter strategy showed higher expression of CD62L and a superior stromal cell–derived factor‐1α–mediated migration. This might play a role in an also observed superior early PLT recovery after transplantation of these cells into NOD SCID mice. The hematopoietic engraftment in the marrow 6 weeks after transplantation was not different between the two strategies.

CONCLUSION

Although TPO expansion before cryopreservation would yield higher nucleated cell and clonogenic myeloid and megakaryocyte cell numbers and enable earlier availability, CB TPO expansion after cryopreservation is likely to be clinically more effective, despite the lower number of cells obtained after expansion. Moreover, the latter strategy is logistically more feasible.
Under‐sown cover crops and post‐harvest mowing as measures to control Elymus repens
Authors: Ringselle B , Bergkvist G , Aronsson H , Andersson L
Published: February 2015

Two potential control methods for Elymus repens, which do not disturb the soil, are post‐harvest mowing and competition from under‐sown cover crops. Our aim was to quantify the effect of cover crop competition and mowing on E. repens and to evaluate the potential for combining the two methods. We present a two‐factorial split‐plot experiment conducted at three locations in Sweden, in two experimental rounds conducted in 2011–2012 and 2012–2013. A spring cereal crop was under‐sown with perennial ryegrass, red clover or a mixture of the two (subplots). Under‐sown crops were either not mowed, or mowed once or twice post‐harvest (main plots). This was followed by ploughing and a new spring cereal crop the next year. Mowing twice reduced autumn shoot biomass by up to 66% for E. repens and 50% for cover crops compared with the control, twice as much as mowing once. Pure ryegrass and mixture treatments reduced E. repens shoot biomass by up to 40% compared with the control. Mowing twice reduced rhizome biomass in the subsequent year by 35% compared with the control, while the pure red clover treatment increased it by 20–30%. Mowing twice and treatments including red clover resulted in higher subsequent grain yields. We concluded that repeated mowing has the potential to control E. repens, but a low‐yielding cover crop has insufficient effect on rhizome biomass. Clover–grass mixtures are of interest as cover crops, because they have the potential to increase subsequent crop yield and even at low levels they reduce E. repens above‐ground autumn growth.
High-Efficiency Gamma-Beta Blind Alpha Spectrometry for Nuclear Energy Applications
Authors: Webster Jeffrey A. , Hagen Alexander , Archambault Brian C. , Hume Nicholas , Taleyarkhan Rusi
Published: February 2015

A novel, centrifugally tensioned metastable fluid detector (CTMFD) sensor technology has been developed over the last decade to demonstrate high selective sensitivity and detection efficiency to various forms of radiation for wide-ranging conditions (e.g., power, safeguards, security, and health physics) relevant to the nuclear energy industry. The CTMFD operates by tensioning a liquid with centrifugal force to weaken the bonds in the liquid to the point whereby even femtoscale nuclear particle interactions can break the fluid and cause a detectable vaporization cascade. The operating principle has only peripheral similarity to the superheated bubble chamber-based superheated droplet detectors (SDD). Instead, CTMFDs utilize mechanical “tension pressure” instead of thermal superheat, offering a lot of practical advantages. CTMFDs have been used to detect a variety of alpha- and neutron-emitting sources in near real time. The CTMFD is blind to gamma photons and betas allowing for detection of alphas and neutrons in extreme gamma/beta background environments such as spent fuel reprocessing plants. The selective sensitivity allows for differentiation between alpha emitters including the isotopes of plutonium. Mixtures of plutonium isotopes have been measured in ratios of 1∶1, 2∶1, and 3∶1 Pu-238:Pu-239 with successful differentiation. Due to the lack of gamma-beta background interference, the CTMFD is inherently more sensitive than scintillation-based alpha spectrometers or SDDs and has been proved capable to detect below femtogram quantities of plutonium-238. Plutonium is also easily distinguishable from neptunium, making it easy to measure the plutonium concentration in the NPEX stream of a UREX reprocessing facility. The CTMFD has been calibrated for alphas from americium (5.5 MeV) and curium (∼6  MeV) as well. Furthermore, the CTMFD has, recently, also been used to detect spontaneous and induced fission events, which can be differentiated from alpha decay, allowing for detection of fissionable material in a mixture of isotopes. This paper discusses these transformational developments, which are also being considered for real-world commercial use.
Value of hepatic elastography and Doppler indexes for predictions of esophageal varices in liver cirrhosis
Authors: Bintintan Adriana , Chira Romeo Ioan , Bintintan Vasile Virgil , Nagy Georgiana , Manzat-Saplacan Roberta Maria , Lupsor Platon Monica , Stefanescu Horia , Duma Maria Magdalena , Valean Simona Doina , Mircea Petru Adrian
Published: February 2015

Aims: Non-invasive methods are required to diagnose presence and grading of esophageal varices in patients with he- patic cirrhosis and in this respect we have evaluated the role of transient elastography and abdominal ultrasound parameters. Material and methods: Cirrhotic patients were prospectively evaluated by transient elastography and Doppler ultrasound for diagnosis of presence and grading of esophageal varices, the results being compared with the findings of the esophagogas- troduodenoscopy. Results: Sixty patients with hepatic cirrhosis were analysed. The parameters that reached statistical signifi- cance for diagnosis of esophageal varices were: liver stiffness (LSM) > 15 kPa, hemodynamic liver index (PVr1) ≥ 0.66, portal vascular resistance (PVR) > 17.66 and splenoportal index (SPI) > 4.77. The only parameter that reached statistical power for the diagnosis of large esophageal varices was LSM at a cut-off value of 28.8 kPa. Conclusions: Assessment of LSM in patients with liver cirrhosis can predict both the presence of esophageal varices and of large esophageal varices. The PVr1, PVR and SPI Doppler indexes can be used to diagnose the presence of esophageal varices but have no role in the prediction of large esophageal varices. Further studies are required to confirm these results and offer a stronger clinical significance.
Is ultrasound changing the way we understand rheumatology? Including ultrasound examination in the classification criteria of polymyalgia rheumatica and gout.
Authors: Codreanu Catalin , Enache Luminita
Published: February 2015

Ultrasonography (US) is widely used in the diagnosis of rheumatic conditions, and its value for the classification criteria of rheumatic diseases has been recently suggested. According to the EULAR/ACR provisional criteria for polymyalgia rheu- matica, adding US to the clinical and serological features will significantly improve the sensitivity of proposed criteria. The ability of high resolution US to detect crystalline deposits of monosodium urate in joints and soft tissues is well recognized. For the first time, the new 2014 ACR/EULAR set of proposed criteria for gout includes advanced imaging techniques for the detection of disease: US and dual-energy computed tomography. Due to low costs and affordability, use of US evaluation for patients with suspected gout will increase both specificity and sensibility of classification criteria. The recent inclusion of US in the classification criteria of various rheumatic diseases, such as PMR and gout, implies that this imaging technique is not only useful as a valued diagnostic tool for individual cases, but also on a larger scale, it will improve doctors’ ability to classify diseases. Its use is thus changing our understanding of rheumatic diseases allowing further advances in research and clinical practice.
Ultrasound and CT imaging features in a patient with salivary duct carcinoma of the parotid gland: a case report with literature review.
Authors: Fenesan Diana Ioana , Lenghel Manuela , Baciut Grigore , Vacaras Sergiu , Botar-Jid Carolina , Vasilescu Dan , Dudea Sorin Marian
Published: February 2015

The aim of this paper was to present the ultrasound (US) and computed tomography (CT) appearance of a patient with salivary duct carcinoma of the parotid gland. US showed a voluminous mass of the parotid gland, with multiple calcifications. Furthermore, it revealed regional multiple lymph nodes with malignant characters. Sonoelastography of the lesion and lymph nodes detected increased rigidity. Contrast enhanced CT scan of the neck completed the data description regarding the mass expansion and invasion of surrounding tissues. US and CT imaging features played a key role in establishing the malignant character of the mass and lymph nodes.
Anatomical variation of the liver with elongated left lobe may be a trap forthe ultrasound detection of focal liver lesion.
Authors: Wu Size , Tu Rong , Liu Guangqing , Nan Ruixia , Guan Ying , Zheng Enhai , Zhao Yanyan
Published: February 2015

Aims: The aim of this study was to evaluate the impact of anatomical variations of the elongated left lobe of the liver on the ultrasound detection of focal liver lesions. Materials and methods: We evaluated, by ultrasonography (US), 296 patients with elongated left lobe of the liver and 30 patients with focal lesions in the normal length left lobe of the liver. Those patients had undergone prior computed tomography (CT) evaluation. Results: Of the 296 patients evaluated, 34 patients had focal lesions (the size range 11- 20 mm) in the distal region of the elongated left lobe of the liver, and none of the lesions was visualized at US examination (p<0.001). All the focal lesions in the normal length left lobe of the liver of the 30 patients were visualized by US without significant difference between the dimensions established by CT and US (p=0.136). Conclusion: Focal lesions in the distal region of elongated left lobe of the liver are difficult to be detected by conventional US examination and the main reason is the impact of anatomical localization on the examination protocol.
Bee declines driven by combined stress from parasites, pesticides, and lack of flowers
Authors: Goulson Dave , Nicholls Elizabeth , Botías Cristina , Rotheray Ellen L.
Published: February 2015

Conserving pollinator services for crops

If pollination fails, ecosystems are eroded and we will lose reliable sources of many critical foodstuffs. Focusing on the pollination services provided by bees, Goulson
et al.
review the stresses bees are experiencing from climate change, infectious diseases, and insecticides. We can mitigate some of the stress on bees by improving floral resources and adopting quarantine measures, and by surveillance of bee populations. Crucially, we need to resolve the controversy surrounding prophylactic use of pesticides.

Science
, this issue
10.1126/science.1255957
Uncovering disease-disease relationships through the incomplete interactome
Authors: Menche Jörg , Sharma Amitabh , Kitsak Maksim , Ghiassian Susan Dina , Vidal Marc , Loscalzo Joseph , Barabási Albert-László
Published: February 2015

A network approach to finding disease modules

Shared genes represent a powerful but limited representation of the mechanistic relationship between two diseases. However, the analysis of protein-protein interactions has been hampered by the incompleteness of interactome maps. Menche
et al.
formulated the mathematical conditions needed to allow a disease module (a localized region of connections between disease-related proteins) to be observed. Only diseases with data coverage that exceeds a specific threshold have identifiable disease modules. The network-based distance between two disease modules revealed that disease pairs that are predicted to have overlapping modules had statistically significant molecular similarity. These similarities encompassed their protein components, gene expression, symptoms, and morbidity. Molecular-level links between diseases lacking shared disease genes could also be identified.

Science
, this issue
10.1126/science.1257601
Two-pore channels control Ebola virus host cell entry and are drug targets for disease treatment
Authors: Sakurai Yasuteru , Kolokoltsov Andrey A. , Chen Cheng-Chang , Tidwell Michael W. , Bauta William E. , Klugbauer Norbert , Grimm Christian , Wahl-Schott Christian , Biel Martin , Davey Robert A.
Published: February 2015

Channeling Ebola virus entry into the cell

The current outbreak of Ebola virus in West Africa highlights the need for antiviral therapies. One strategy would be to block the Ebola virus's ability to enter host cells. Cells engulf Ebola virus particles, which then traffic into the cell in structures called endosomes. Sakurai
et al.
now report that the Ebola virus requires calcium channels called two-pore channels (TPCs) in endosomal membranes for successful entry (see the Perspective by Falzarano and Feldmann). The Ebola virus could not enter cells lacking TPCs or cells treated with a TPC inhibitor. Blocking TPCs therapeutically allowed 50% of mice to survive an ordinarily lethal Ebola virus infection.

Science
, this issue p.
995
; see also p.
947
Stochastic electron acceleration during spontaneous turbulent reconnection in a strong shock wave
Authors: Matsumoto Y. , Amano T. , Kato T. N. , Hoshino M.
Published: February 2015

Shocking! Particle accelerators in space

The acceleration of charged particles to high energies has been a major mystery, with a number of competing theories based on plasma physics. Many include the concept of turbulence, but with different roles. For example, shock-based theories emphasize the importance of turbulence developed from an unstable shock layer, whereas turbulent reconnection theories emphasize interactions of multiple reconnection sites. Matsumoto
et al.
present results of a large particle-in-cell simulation and examine how electrons are accelerated in the transition layer of a fast nonrelativistic shock (see the Perspective by Ji and Zweibel). Surprisingly, they find that when the shock is strong enough, charged particles (electrons in this case) are efficiently accelerated by turbulent reconnection within a turbulent shock layer containing multiscale structures.

Science
, this issue p.
974
; see also p.
944
Comment on “Late Pleistocene human skeleton and mtDNA link Paleoamericans and modern Native Americans”
Authors: Prüfer Kay , Meyer Matthias
Published: February 2015

Chatters
et al
. (Reports, 16 May 2014, p. 750) reported the retrieval of DNA sequences from a 12,000- to 13,000-year-old human tooth discovered in an underwater cave in Mexico’s Yucatan peninsula. They propose that this ancient human individual’s mitochondrial DNA (mtDNA) belongs to haplogroup D1. However, our analysis of postmortem damage patterns finds no evidence for an ancient origin of these sequences.
As new botulism threat implodes, more questions
Authors: Enserink Martin
Published: February 2015

Secrecy around “toxin H” hampered research, government scientists say.
Japan looks to instill global mindset in grads
Authors: Normile Dennis
Published: February 2015

New program to internationalize universities hopes to put nation on more competitive footing.
What's in a name?
Authors: Erard Michael
Published: February 2015

Naming research animals may improve their well-being—or bias experiments.
Coping with earthquakes induced by fluid injection
Authors: McGarr A. , Bekins B. , Burkardt N. , Dewey J. , Earle P. , Ellsworth W. , Ge S. , Hickman S. , Holland A. , Majer E. , Rubinstein J. , Sheehan A.
Published: February 2015

Hazard may be reduced by managing injection activities
Draft Genome Sequence of Talaromyces cellulolyticus Strain Y-94, a Source of Lignocellulosic Biomass-Degrading Enzymes
Authors: Fujii Tatsuya , Koike Hideaki , Sawayama Shigeki , Yano Shinichi , Inoue Hiroyuki
Published: February 2015

Talaromyces cellulolyticus (formerly Acremonium cellulolyticus) is a promising fungus for cellulase production. Here, we present the draft genome sequence of T. cellulolyticus strain Y-94. The genome is 36.4 Mbp long and contains genes for several enzymes involved in the degradation of lignocellulosic biomass, including cellulases, hemicellulases, pectinases, and amylases.
Analysis of the Complete Mycoplasma hominis LBD-4 Genome Sequence Reveals Strain-Variable Prophage Insertion and Distinctive Repeat-Containing Surface Protein Arrangements
Authors: Calcutt Michael J. , Foecking Mark F.
Published: February 2015

The complete genome sequence of
Mycoplasma hominis
LBD-4 has been determined and the gene content ascribed. The 715,165-bp chromosome contains 620 genes, including 14 carried by a strain-variable prophage genome related to
Mycoplasma fermentans
MFV-1 and
Mycoplasma arthritidis
MAV-1. Comparative analysis with the genome of M. hominis PG21
T
reveals distinctive arrangements of repeat-containing surface proteins.
Whole-Genome Sequences of the Archetypal K1 Escherichia coli Neonatal Isolate RS218 and Contemporary Neonatal Bacteremia Clinical Isolates SCB11, SCB12, and SCB15
Authors: Day Michael W. , Jackson Lydgia A. , Akins Darrin R. , Dyer David W. , Chavez-Bueno Susana
Published: February 2015

Neonatal bacteremia
Escherichia coli
strains commonly belong to the K1 capsular type. Their ability to cause invasive neonatal disease appears to be determined by other virulence factors that have yet to be identified. We report here the genome sequences of four
E. coli
neonatal bacteremia isolates, including that of the archetypal strain RS218.
HEALTH PROMOTING APPROACHES TO PALLIATIVE CARE: REDUCING THE LONGER TERM IMPACT OF ADVANCED CANCER
Authors: Baker N , Armour K , Meystre C , Redwood S , Dawson A
Published: February 2015

Introduction

A diagnosis of advanced cancer has a profound impact on the whole family. However, research has mainly focused on patient and carers needs or short-term interventions; with little emphasis on their own coping strategies or the wider impact on health.

Aim(s) and method(s)

27 semi-structured interviews were conducted with patients with advanced breast, colorectal or lung cancer and their close relatives. Questions focused on their experiences, coping strategies and the impact of these on cancer beliefs and attitudes. Interviews were transcribed verbatim and data analysed using the constant comparison method.

Results

Patients had more positive attitudes to cancer than relatives, whilst adapting to and accepting dying. They described multiple approaches to coping which centred on regaining control. These included seeking and accessing information, adopting positive attitudes to living with progressive disease, increasing connectedness to their loved ones and leaving a legacy. A legacy was often a hope that their situation would positively impact on others in the future. Relatives, in contrast, described multiple levels of fear and helplessness, which led to strongly fatalistic beliefs about cancer and cancer information avoidance, in spite of an increasing perception of their own vulnerability.

Conclusions

A health promoting approach to palliative care, based on supporting self-management and empowering patients' own coping strategies, could have multiple benefits. These may include reducing fatalistic beliefs about cancer, which are associated with lack of receptivity to cancer prevention messages and delayed diagnosis.
ECONOMIC ANALYSIS OF COSTS FOR PATIENTS WITH END STAGE LIVER DISEASE OVER THE LAST YEAR OF LIFE
Authors: Gola A , Davis S , Greenslade L , Hopkins K , Low J , Marshall A , Thorburn D , Vickerstaff V , Jones L
Published: February 2015

Introduction

Liver disease is the third largest cause of death in the UK in people under the age of 65. With predicted increases in alcohol consumption, viral hepatitis and obesity, it is anticipated that the economic burden on the healthcare system will continue to rise.

Aim(s) and method(s)

To evaluate costs of hospital admissions for patients with end-stage liver disease over the 12 months prior to death obtained from hospital records and case-note audit. The analysis includes all costs incurred during the admission, such as bed and board, nursing, specialist consultations, medications, investigations and surgery.

We also compared costs of care for a cohort with terminal hospital admission and costs of care for those who spent the last days at a hospice.

Results

The mean cost per patient in the twelve months prior to death was £18,458, (SD=15,267), the mean total cost per hospital admission was £6,863 (SD=£6,631), the mean cost for individual admissions that ended in the patient's death i.e. the terminal admission, was £9,615 (SD=£8,443). Comparatively, for the patients who had a terminal admission at a hospice, the mean cost per terminal admission was £4,598 (SD=£5,818). There was no statistically significant difference in costs between patients with and without alcohol-related liver disease.

Conclusion(s)

Our analysis underlines the significant economic burden placed on the healthcare system by patients with end stage liver disease. On average, compared to costs associated with hospice death, costs for hospital deaths were double. With rates of liver disease set to increase, government policy needs to address challenges for future funding of care.
HOW DO PATIENTS SHARE NEWS OF A CANCER DIAGNOSIS WITH FAMILY/FRIENDS; NEW UNDERSTANDINGS OF THE PROCESS AFTER BAD NEWS HAS BEEN BROKEN
Authors: Ewing G , Ngwenya N , Farquhar M , Benson J , Gilligan D , Seymour J , Bailey S
Published: February 2015

The study was funded by a grant from Dimbleby Cancer Care.

Introduction

Extensive research exists on how bad news is broken by physicians to patients, but little is known about the subsequent stage: when patients face the difficult task of sharing this news with family members and friends.

Aim(s)

To understand the experience of sharing news of a lung cancer diagnosis with wider family members and friends to inform a supportive intervention to prepare patients for sharing bad news.

MethodsQualitative interviews with 20 patients with lung cancer and 17 family members/friends present at diagnosis-giving to explore experiences of receiving their diagnosis and how news was shared with wider family/friends.Thematic framework analysis was conducted.

Results

Three key findings: (1) sharing bad news happened over time, at any point along the illness trajectory—it was a process, not a discrete event;

(2) timing of sharing bad news was very individual—people needed to feel ready to share their diagnosis and had to prepare themselves to do so;

(3) regardless of when news was shared it had consequences in terms of the reactions of those told, which required managing. Illustrative timelines of processes of early and later sharing of bad news will be presented.

Conclusion(s)

Understanding sharing bad news as a process which happens over time is a significant finding for design and delivery of a supportive intervention. Preparing patients to share news of a lung cancer diagnosis, which often presents at an advanced stage, is highly relevant for future palliative care delivery.