bluuebunny/crossref_metadata_2025 huggingface dataset:
Determining obstetric patient safety indicators: the differences in neonatal outcome measures between different‐sized delivery units
Authors: Pyykönen A , Gissler M , Jakobsson M , Petäjä J , Tapper A‐M
Published: December 2013

Objective

To study the differences in neonatal outcome and treatment measures in Finnish obstetric units.

Design

A registry study with Medical Birth Register data.

Setting and population

All births (n = 2 94 726) in Finland from 2006 to 2010 with a focus on term, singleton non‐university deliveries.

Methods

All 34 delivery units were grouped into small (below 1000), mid‐sized (1000–2999) and large (3000 or more) units, and the adverse outcome rates in neonates were compared using logistic regression.

Main outcome measures

Early neonatal deaths, stillbirths, Apgar scores, arterial cord pH, Erb's paralysis, respirator treatment, the proportion of post‐term deliveries (gestational age beyond 42 weeks) and the proportion of newborns still hospitalised 7 days after delivery.

Results

From an analysis of term, singleton non‐university deliveries, the early neonatal mortality was significantly higher in the small relative to the mid‐sized delivery units [odds ratio (OR), 2.07; 95% confidence interval (CI), 1.19–3.60]. The rate of Erb's paralysis was lowest in the large units (OR, 0.65; 95% CI, 0.50–0.84). The use of a respirator was more than two‐fold more common in large relative to mid‐sized units (OR, 2.38; 95% CI, 2.00–2.83). The proportion of post‐term deliveries was highest in the large units (OR, 1.36; 95% CI, 1.31–1.42), where a significantly higher percentage of post‐term newborns were still hospitalised after 7 days (OR, 1.50; 95% CI, 1.19–1.89).

Conclusions

There are significant differences in several neonatal indicators dependent on the hospital size. An international consensus is needed on which indicators should be used.
A Decade in Dental Care Utilization among Adults and Children (2001–2010)
Authors: Vujicic Marko , Nasseh Kamyar
Published: December 2013

Objective

To decompose the change in pediatric and adult dental care utilization over the last decade.

Data

2001 through 2010 Medical Expenditure Panel Survey.

Study Design

The Blinder‐Oaxaca decomposition was used to explain the change in dental care utilization among adults and children. Changes in dental care utilization were attributed to changes in explained covariates and changes due to movements in estimated coefficients. Controlling for demographics, overall health status, and dental benefits variables, we estimated year‐specific logistic regression models. Outputs from these models were used to compute the Blinder‐Oaxaca decomposition.

Principal Findings

Dental care utilization decreased from 40.5 percent in 2001 to 37.0 percent in 2010 for adults and increased from 43.2 percent in 2001 to 46.3 percent in 2010 for children (p < .05). Among adults, changes in insurance status, race, and income contributed to a decline in adult dental care utilization (−0.018, p < .01). Among children, changes in controlled factors did not substantially change dental care utilization, which instead may be explained by changes in policy, oral health status, or preferences.

Conclusions

Dental care utilization for adults has declined, especially among the poor and uninsured. Without further policy intervention, disadvantaged adults face increasing barriers to dental care.
What Is Being Promoted? Hospital Nurse Knowledge of Health in Jordan
Authors: Shoqirat Noordeen
Published: December 2013

Purpose

The study examined the level of knowledge of health among hospital nurses in Jordan. Four focus group discussions were carried out with hospital nurses. The findings identified three themes: health as the freedom from illness, health as good social and psychological well‐being, and health as a good environment to live in. The nurses in this study had no knowledge of spiritual and socioeconomic aspects of health. Our study shows that nurses' knowledge of health is often triggered by casework as opposed to a general learning of health‐related issues.

Implications for Nursing Practice

 Hospital nurses in health promotion are unlikely to be very knowledgeable until they fully have a coherent understanding of sociocultural and environmental determinants of health.
Hospital Discharge: Results From an Italian Multicenter Prospective Study Using Blaylock Risk Assessment Screening Score
Authors: Dal Molin Alberto , Gatta Claudia , Derossi Valentina , Guazzini Andrea , Cocchieri Antonello , Vellone Ercole , Alvaro Rosaria , Rasero Laura
Published: December 2013

Purpose

To analyze the predictive validity and reliability of the Blaylock Risk Assessment Screening Score (BRASS) Index in a large group of patients.

Methods

Prospective multicenter observational study was conducted in six Italian hospitals. Data were collected in three phases.

Findings

Seven hundred eleven patients were recruited. The mean length of hospitalization for low‐risk patients was significantly shorter than those in the medium and high‐risk groups. Patients with a BRASS Index lower than 10, unlike those with a higher BRASS Index, were mainly discharged home.

Conclusions

Our results indicate that the BRASS Index is useful to identify patients at risk for prolonged hospitalization.

Clinical Relevance

The use of a validated BRASS instrument can be useful to screen the patients, improving individual discharge planning.
Construction and Validation of an Instrument for Assessment of the Nursing Diagnosis, Risk for Infection, in Patients Following Cardiac Surgery
Authors: Schulz Carla Ethel Filippi , Lopes Camila Takáo , Herdman T. Heather , Lopes Juliana de Lima , de Barros Alba Lucia Bottura Leite
Published: December 2013

Purpose

To construct and validate a data collection instrument (DCI), and a corresponding instructional guide, for assessment of the nursing diagnosis, risk for infection, in patients following cardiac surgery.

Methods

Construction of conceptual and operational definitions for risk factors based on literature, content validation by experts, and clinical validation by clinical nurses.

Findings

There were significant internal consistency and reproducibility in the content validation. In the clinical validation, agreement among nurses was higher than 70% for all risk factors.

Conclusions

The DCI was constructed and validated.

Implications for Nursing Practice

This DCI could be used for assessment of adult patients after cardiac surgeries worldwide because of its detailed cues for risk factors, which facilitate clinical reasoning and diagnostic judgment.

Objetivo

Construir e validar um instrumento de coleta de dados (ICD) e seu roteiro instrucional (RI) para avaliação do diagnóstico de enfermagem Risco de infecção em pacientes pós‐cirurgia cardíaca.

Métodos

Construção de definições conceituais e operacionais dos fatores de risco baseada na literatura, validação de conteúdo por experts e validação clínica por enfermeiras assistenciais.

Resultados

Consistência interna e reprodutibilidade significativas na validação de conteúdo. Na validação clínica, a concordância foi maior que 70% para todos os fatores de risco.

Conclusões

O ICD foi construído e validado.

Implicações Para Prática De Enfermagem

O ICD poderia ser utilizado para avaliação de adultos pós‐cirurgia cardíaca internacionalmente devido às suas pistas detalhadas sobre os fatores de risco, que facilitam o raciocínio clínico julgamento diagnóstico.
Addressing chronic kidney disease in Far North Queensland: gains and opportunities
Authors: Vos Luke , Baer Richard , McDonald Malcolm
Published: December 2013

Objective

To determine whether people seen by the Far North Queensland Specialist Medical Outreach Service (SMOS) with chronic kidney disease (CKD) and proteinuria were treated according to established guidelines.

Design

Audit of SMOS clinical reports from 18th May to 27th July 2012. Clinical markers were compared with the Caring for Australians with Renal Impairment and National Heart Foundation management guidelines.

Setting

Reports covering primary health care centres located in remote communities of Cape York Peninsula and Torres Strait, Far North Queensland.

Main outcome measure(s)

The proportion of people with CKD and proteinuria on appropriate renoprotective treatment with an angiotensin‐converting enzyme inhibitor (ACE‐inhibitor) or angiotensin‐2 receptor blocker (ARB). The proportion of people with CKD and proteinuria reaching blood pressure targets as per National Heart Foundation guidelines. The proportion of people with stage 4 CKD appropriately referred to a specialist renal service.

Results

One hundred and eighty‐six clinical reports were reviewed; 48 people had markers of CKD. Forty‐five of the 48 (94%) had been prescribed an ACE‐inhibitor or ARB according to management guidelines. Nineteen of the 48 (40%) had blood pressures within the target range. Four of six people with late‐stage CKD (stage 4 or 5) had been referred to a specialist renal service.

Conclusions

This audit confirms the high rate of CKD in the people of Far North Queensland, although this is a highly selected sample. It shows appropriate prescribing of renoprotective treatment in most cases. However, it also highlights the need for a more vigorous approach to blood pressure control.
Cost of close the gap for vision of Indigenous Australians: On estimating the extra resources required
Authors: Hsueh Ya‐seng (Arthur) , Brando Alex , Dunt David , Anjou Mitchell D. , Boudville Andrea , Taylor Hugh
Published: December 2013

Objective

To estimate the costs of the extra resources required to close the gap of vision between Indigenous and non‐Indigenous Australians.

Design

Constructing comprehensive eye care pathways for Indigenous Australians with their related probabilities, to capture full eye care usage compared with current usage rate for cataract surgery, refractive error and diabetic retinopathy using the best available data.

Setting

Urban and remote regions of Australia.

Interventions

The provision of eye care for cataract surgery, refractive error and diabetic retinopathy.

Main outcome measures

Estimated cost needed for full access, estimated current spending and estimated extra cost required to close the gaps of cataract surgery, refractive error and diabetic retinopathy for Indigenous Australians.

Results

Total cost needed for full coverage of all three major eye conditions is $45.5 million per year in 2011 Australian dollars. Current annual spending is $17.4 million. Additional yearly cost required to close the gap of vision is $28 million. This includes extra‐capped funds of $3 million from the Commonwealth Government and $2 million from the State and Territory Governments. Additional coordination costs per year are $13.3 million.

Conclusions

Although available data are limited, this study has produced the first estimates that are indicative of the need for planning and provide equity in eye care.
Multidisciplinary team simulation for the operating theatre: a review of the literature
Authors: Tan Shaw Boon , Pena Guilherme , Altree Meryl , Maddern Guy J.
Published: December 2013

Introduction

Analyses of adverse events inside the operating theatre has demonstrated that many errors are caused by failure in non‐technical skills and teamwork. While simulation has been used successfully for teaching and improving technical skills, more recently, multidisciplinary simulation has been used for training team skills. We hypothesized that this type of training is feasible and improves team skills in the operating theatre.

Methods

A systematic search of the literature for studies describing true multidisciplinary operating theatre team simulation was conducted in November and December 2012. We looked at the characteristics and outcomes of the team simulation programmes.

Results

1636 articles were initially retrieved. Utilizing a stepwise evaluation process, 26 articles were included in the review. The studies reveal that multidisciplinary operating theatre simulation has been used to provide training in technical and non‐technical skills, to help implement new techniques and technologies, and to identify latent weaknesses within a health system. Most of the studies included are descriptions of training programmes with a low level of evidence. No randomized control trial was identified. Participants’ reactions to the training programme were positive in all studies; however, none of them could objectively demonstrate that skills acquired from simulation are transferred to the operating theatre or show a demonstrable benefit in patient outcomes.

Conclusion

Multidisciplinary operating room team simulation is feasible and widely accepted by participants. More studies are required to assess the impact of this type of training on operative performance and patient safety.
Preparedness of paediatric international travellers departing from Athens, Greece: an 18‐month airport‐based survey
Authors: Maltezou Helena C , Pavli Androula , Spilioti Athina , Patrinos Stavros , Lymperi Ioanna , Theodoridou Maria
Published: December 2013

Aim

The number of children who travel to tropical and subtropical areas has increased. This study aimed to assess the preparedness of children departing from Greece to Africa and Asia, in terms of vaccination and malaria chemoprophylaxis.

Methods

An 18‐month airport‐based study was conducted in Athens between November 2011 and April 2013.

Results

Of the 183 children studied, 122 (66.7%) had a foreign nationality. Their main destinations were the Indian subcontinent (43.2%), South‐East Asia (30.6%) and sub‐Saharan Africa (14.2%). Just under three‐quarters (73.2%) of the children were travelling to visit friends and relatives. Forty (21.9%) children had received pretravel services. Children visiting friends and relatives sought pretravel services less frequently than those who were not (17.9% versus 32.7%; p = 0.033). Female children and Greek nationals were significantly more likely to seeking pretravel services than males and foreign nationals (p = 0.007 and <0.001, respectively). The rabies and the typhoid fever vaccines were administered inadequately to children travelling to endemic areas, but malaria chemoprophylaxis was generally justified.

Conclusion

Travel medicine services for children in Greece should be improved. There is a particular need to communicate with the parents of children visiting friends and relatives.
Laparoscopic surgery for rectal cancer: Current status and future perspective
Authors: Toda Shigeo , Kuroyanagi Hiroya
Published: December 2013

Although laparoscopic surgery for colon cancer is accepted in the treatment guidelines, the laparoscopic approach for rectal cancer is recommended only in clinical trials. Thus far, several trials have shown favorable short‐term results such as early recovery and short hospital stay, but long‐term results remain a critical concern for laparoscopic rectal cancer surgery. To date, no randomized control trials have shown an increased local recurrence after laparoscopic surgery for rectal cancer. Additionally, according to previous studies, open conversion, which is more frequent in laparoscopic rectal surgery than in laparoscopic colon surgery, may affect short‐term and long‐term survival. The evidence on male sexual function has been contradictory. Long‐term results from ongoing multicenter trials will be available within several years. Based on accumulated evidence from well‐organized clinical trials, laparoscopic surgery will likely be accepted as a treatment choice for rectal cancer. In the future, extended laparoscopic rectal surgery might be feasible for additional procedures such as laparoscopic lateral pelvic lymph node dissection and laparoscopic total pelvic exenteration for rectal cancer invading the adjacent pelvic organ.
A hybrid method to estimate the minimum effective dose for monotone and non‐monotone dose–response relationships
Authors: Wolfsegger Martin J. , Gutjahr Georg , Engl Werner , Jaki Thomas
Published: December 2013

This article proposes a new multiple‐testing approach for estimation of the minimum effective dose allowing for non‐monotonous dose–response shapes. The presented approach combines the advantages of two commonly used methods. It is shown that the new approach controls the error rate of underestimating the true minimum effective dose. Monte Carlo simulations indicate that the proposed method outperforms alternative methods in many cases and is only marginally worse in the remaining situations.
Visceral fat accumulation is associated with different pathological subtypes of renal cell carcinoma (RCC): a multicentre study in China
Authors: Wang Hong‐Kai , Song Xi‐Shuang , Cheng Yue , Qu Yuan‐Yuan , Zhang Shi‐Lin , Dai Bo , Zhang Hai‐Liang , Shen Yi‐Jun , Zhu Yi‐Ping , Shi Guo‐Hai , Qin Xiao‐Jian , Ma Chun‐Guang , Lin Guo‐Wen , Xiao Wen‐Jun , Zhu Yao , Ye Ding‐Wei
Published: December 2013

Objective

To investigate whether visceral obesity is associated with certain histological subtypes of renal cell carcinoma (RCC) in a multicentre Chinese cohort.

Patients and Methods

A kidney tumour database was created using three tertiary centres in China; 487 patients were enrolled presenting with localised RCC and complete computer tomography (CT)/magnetic resonance imaging (MRI) information. A single‐slice CT image was used to measure the area of visceral and subcutaneous adipose tissues in each patient. Statistical methods were used to analyse clear‐cell RCC (ccRCC) and non‐clear‐cell RCC (non‐ccRCC) as they relate to visceral fat area (VFA) and other risk factors, such as age, gender, tumour size, diabetes, hypertension, total fat area (TFA) and body mass index (BMI).

Results

In all, 418 patients had a ccRCC subtype and 69 had a non‐ccRCC subtype. For all the patients with RCC, the mean VFA was 102 cm2, while mean BMI was 24 kg/m2. The mean VFA was greater in ccRCC than non‐ccRCC patients by 25 cm2. There were significant differences in the mean VFA and TFA between patients with ccRCC and those with non‐ccRCC. Multivariate analysis showed that the presence of VFA was more important than the effects of BMI and Type 2 diabetes on pathology prediction. In patients with a normal BMI, those with a higher quartile of VFA were more likely to develop ccRCC than those with a low VFA.

Conclusions

Increased visceral fat was found to be associated with ccRCC and the significance of VFA outweighed the effects of BMI and Type 2 diabetes for the prediction of RCC pathology in multivariate analyses. As a result, VFA could constitute a primary explanation for the link between obesity and ccRCC.
From frog integument to human skin: dermatological perspectives from frog skin biology
Authors: Haslam Iain S. , Roubos Eric W. , Mangoni Maria Luisa , Yoshizato Katsutoshi , Vaudry Hubert , Kloepper Jennifer E. , Pattwell David M. , Maderson Paul F. A. , Paus Ralf
Published: December 2013

For over a century, frogs have been studied across various scientific fields, including physiology, embryology, neuroscience, (neuro)endocrinology, ecology, genetics, behavioural science, evolution, drug development, and conservation biology. In some cases, frog skin has proven very successful as a research model, for example aiding in the study of ion transport through tight epithelia, where it has served as a model for the vertebrate distal renal tubule and mammalian epithelia. However, it has rarely been considered in comparative studies involving human skin. Yet, despite certain notable adaptations that have enabled frogs to survive in both aquatic and terrestrial environments, frog skin has many features in common with human skin. Here we present a comprehensive overview of frog (and toad) skin ontogeny, anatomy, cytology, neuroendocrinology and immunology, with special attention to its unique adaptations as well as to its similarities with the mammalian integument, including human skin. We hope to provide a valuable reference point and a source of inspiration for both amphibian investigators and mammalian researchers studying the structural and functional properties of the largest organ of the vertebrate body.
Cone beam computed tomography evaluation of regenerated buccal bone 5 years after simultaneous implant placement and guided bone regeneration procedures – a randomized, controlled clinical trial
Authors: Jung Ronald E. , Benic Goran I. , Scherrer Daniela , Hämmerle Christoph H. F.
Published: December 2013

Purpose

The aim of this controlled clinical study was to compare a polyethylene glycol membrane (PEG) used for bone regeneration of peri‐implant defects to a collagen membrane with respect to implant survival rate, dimensions of buccal peri‐implant bone and mucosa.

Materials and methods

Thirty‐seven patients who received single tooth implants with simultaneous guided bone regeneration (GBR) in the posterior maxilla or mandible were enrolled in the study. Intra‐operative heights of bone defects were assessed prior to bone augmentation. The defects were augmented with xenogenic bone mineral and randomly covered either with a porcine collagen membrane (control) or with a PEG membrane (test). Five years after implant placement, clinical evaluation and cone beam computed tomography (CBCT) scans were performed. Remaining height of bone defect, horizontal bone thickness, level of mucosal margin, and mucosal thickness were assessed in CBCT images. The difference of height of bone defect at implant placement and at 5‐year follow‐up was calculated. The differences between the two groups were analyzed using two‐sided t‐test and Mann–Whitney U‐test.

Results

After 5 years, 32 patients could be included and exhibited an implant survival rate of 100% for both groups. The buccal vertical bone gain between implant placement and 5‐year follow‐up amounted at 4.3 ± 1.5 (SD) mm and 4.8 ± 2.6 (SD) mm for the control and the test group, respectively (P = 0.493). Neither the bone height nor the thickness reached statistical significant differences between the two groups. The distance between mucosal margin and implant shoulder resulted in 0.8 ± 0.7 (SD) mm in the control and 0.5 ± 0.8 (SD) mm in the test group (P = 0.198). The mucosal thickness reached 1.4 ± 0.5 (SD) mm in the control and 1.3 ± 0.3 (SD) mm in the test group (P = 0.715). There were no significant correlations between height of bone defect at baseline and at follow‐up examination and between different 5‐year parameters.

Conclusion

A polyethylene glycol membrane used for bone regeneration of peri‐implant defects performed as successfully as a collagen membrane with respect to implant survival rate and dimensions of the buccal peri‐implant bone and mucosa after 5 years.
Comparative analysis of dental implant treatment outcomes following mandibular reconstruction with double‐barrel fibula bone grafting or vertical distraction osteogenesis fibula: a retrospective study
Authors: Wang Feng , Huang Wei , Zhang Chenping , Sun Jian , Kaigler Darnell , Wu Yiqun
Published: December 2013

Purpose

The purpose of this study was twofold: (i) to compare vertical bone height (VBH) after tumor resection through grafting with either a double‐barrel fibula (DBF) technique or vertical distraction osteogenesis of the fibula (VDOF); (ii) to compare the performance of loaded dental implants following either DBF or VDOF with special focus on implant survival, implant success, and bone resorption.

Materials and methods

This retrospective clinical study involved 19 patients who underwent implant placement following DBF (group A, n = 9) or VDOF (group B, n = 10) for mandibular reconstruction from March 2006 to May 2008. Clinical and radiographic assessments, including VBH, modified Plaque Index (mPI), modified Sulcus Bleeding Index (mSBI), and marginal bone level (MBL), were taken for both groups after delivery of the final prostheses and annually thereafter.

Results

Nine patients underwent DBF with 24 implants placed and 10 patients underwent VDOF with 27 implants placed for mandibular reconstruction after tumor resection. Overall, all DBF and VDOF procedures were successful for group A and group B. VBH for group A and group B were 20 and 17 mm. There was no statistically significant difference of mSBI scores between group A and group B in the 3‐year follow‐up (P = 0.40). In four cases with eight implants of group A and two cases with three implants of group B, granulomatous soft tissue grew. There was no statistically significant differences of MBL between group A and group B in the 3‐year follow‐up (p = 0.736). The cumulative survival and success rates of implants for group A were 100% and 87.5%, and for group B were 100% and 85.2% in 3‐year follow‐up, respectively.

Conclusions

On the basis of the study of 19 patients who received a total of 51 implants, reconstruction of the mandible with DBF flap or VDOF flap, combined with dental implant therapy, was considered a predictable option. Compared with implants placed in VDOF bone, implants placed in DBF bone had a relative higher incidence of associated gingival inflammation. The DBF bone seems more resistant to peri‐implant resorption processes than VDOF bone during functional loading.
The early diastolic myocardial velocity: a marker of increased risk in patients with coronary heart disease
Authors: Johnson Jonas , Manouras Aristomenis , Bergholm Fredrik , Brodin Lars Åke , Agewall Stefan , Henareh Loghman
Published: December 2013

Objective

Tissue Doppler imaging (TDI) is a promising echocardiographic modality allowing quantification of myocardial performance. However, the prognostic potential ofTDIin patients with acute myocardial infarction (AMI) is not yet investigated. We sought to explore the ability ofTDIin identifying patients at risk for new cardiovascular events afterAMI.

Methods

One hundred and nineteen patients withAMIwere recruited prospectively (mean age 61 years; range 32–81 years of age). Patients with diabetes mellitus (DM) were excluded. Echocardiography was performed 3–12 months afterAMI. Two‐dimensional (2‐D) andTDIvariables were recorded. The patients were followed during a mean period of 4·6 years (range 1–8 years). The primary end‐point was defined as any of the following: death from any cause, non‐fatal reinfarction or stroke, unstable angina pectoris, congestive heart failure requiring hospitalization and coronary revascularization procedure.

Results

Thirty patients had some form of cardiovascular events during follow‐up. Seven patients had cardiovascular death, 13 patients had reinfarction and four patients had a stroke. New angina or unstable angina was recorded in 21 patients. Of these patients, 13 underwent percutaneous coronary angioplasty (PCI) or coronary artery bypass grafting (CABG). The early diastolic myocardial velocity (Em) emerged as the only echocardiographic variable that offered a clear differentiation between patients that presented with new cardiovascular (CV) events as compared to the corresponding group without anyCVevents at follow‐up (P<0·05). In multivariate statistical analysis and after adjustment for age, sex, total cholesterol, body mass index (BMI) and other baseline characteristics, Em remained as independent predictors ofCVevents (HR, 1·18, 95%CI, 1·02–1·36;P<0·05). However, none of the investigated variables evolved as an independent predictor of cardiovascular morbidity and mortality.

Conclusion

Emappears to be a sensitive echocardiographic index in identifying non‐diabetic patients withAMIat risk of new cardiovascular events.
Activin A regulates growth of gastro‐intestinal epithelial cells by mediating epithelial‐mesenchymal interaction
Authors: Fukamachi Hiroshi , Kato Shinko , Asashima Makoto , Ichinose Masao , Yuasa Yasuhito
Published: December 2013

The importance of epithelial–mesenchymal interaction on the development of gastro‐intestinal (GI) organs has been repeatedly reported, but its molecular mechanism has not been fully understood though several factors including hepatocyte growth factor and endothelin‐3 have been shown to mediate it. Activins have been demonstrated to play important roles in the regulation of organogenesis in vertebrates, but their roles in the regulation of growth and differentiation of GI organs remain to be solved. In the present study, we examined expression of activins in developing rat GI tract, and found that inhibin bA encoding activin A was specifically expressed by GI mesenchymes, while inhibin bB encoding activin B was expressed by both epithelial and mesenchymal components. We then examined the effect of activin A on the growth of fetal rat GI epithelial cells in primary culture. We found that activin A inhibited the growth of forestomach and glandular stomach epithelial cells while it stimulated the growth of colonic epithelial cells. These results suggest that activin A secreted from GI mesenchymes region‐specifically regulates the growth of attaching epithelial cells. We thus conclude that activin A mediates epithelial‐mesenchymal interaction in the developing GI tract.
Catheterization Diastolic Pressures Correlate with Diastolic Dyssynchrony in Patients with Single Right Ventricles
Authors: Stiver Corey , Gokhale Janaki , Husain Nazia , Nicholson Lisa , Cordier Joyce , Van Lente Lindsey , Holzer Ralf J. , Cua Clifford L.
Published: December 2013

Introduction

Diastolic dyssynchrony has correlated with pulmonary capillary wedge pressures in patients with normal cardiac anatomy. No data exist in single right ventricle (sRV) patients. Goal of this study was to determine if diastolic dyssynchrony in sRV patients correlates with ventricular end‐diastolic pressures (VEDP).

Methods

Tissue Doppler imaging (TDI) and strain rate (SR) analysis of sRV patients undergoing catheterization were performed. Time interval from onset of QRS to peak TDI e'‐wave was obtained. Differences in intervals were calculated: QRS (RV) − QRS (IVS) and QRS (RV) − QRS (LV). Time interval from onset of QRS to peak strain rate early diastolic wave (SRe) was obtained for the 6 segment model sRV. Standard deviation of the 6 SRe time intervals was calculated. Correlation of VEDP with timing intervals was analyzed.

Results

Forty sRV patients were evaluated. Age was 2.8 ± 3.5 years. Catheterization VEDP of the sRV was 9.3 ± 3.9 mmHg (median 8 mmHg range 4–24 mmHg). QRS (RV) − QRS (IVS) was 22.3 ± 18.1 msec and QRS (RV) − QRS (LV) was 23.7 ± 19.0 msec. SRe standard deviation of the sRV was 61.6 ± 23.9 msec. There was no significant correlation with VEDP and QRS (RV) − QRS (IVS) (r = 0.1, P = NS) or with QRS (RV) − QRS (LV) (r = 0.2, P = NS). There was a significant correlation of VEDP with the SRe standard deviation value (r = 0.4, P < 0.05).

Conclusion

Diastolic dyssynchrony correlated with VEDP in patients with sRV physiology. Future studies are needed to determine the significance of these findings.
Self‐face recognition in the ultra‐high risk for psychosis population
Authors: Jia HongXiao , Yang JingMing , Zhu Hong , Liu Jia , Barnaby Nelson
Published: December 2013

Aim

Phenomenological research indicates that disturbance of the basic sense of self may be a core phenotypic marker of schizophrenia spectrum disorders. Self‐face recognition (SFR) is an experimental paradigm which can assess the basic sense of self. In this study, we used SFR to determine whether basic self‐disturbance is present in the ultra‐high risk (UHR) for psychosis population at the perceptual level.

Methods

Twenty‐three UHR individuals and 23 healthy comparison subjects were administered the SFR task. The study consisted of a 2 × 3 × 2 design: two group levels (UHR for psychosis group and the healthy comparison group); three task levels (self‐famous task, self‐stranger task, famous‐stranger task); and two hand levels (left hand and right hand). Threshold limit values in face recognition were analysed.

Results

The analysis indicated effects for group (F(1, 43) = 5.197, P < 0.05) and interaction effects between group and task (F = 4.767, P < 0.05). An independent samples t‐test was used to compare the threshold limit values of the same task between the two groups. For self‐famous task, the threshold limit values of the UHR group were higher than those of healthy group both in the left and right hands (t = 2.734, P < 0.05; t = 2.864, P < 0.05), but no significant difference was found in self‐stranger task and famous‐stranger task (P > 0.05).

Conclusions

This SFR study indicates that basic self‐disturbance is present in the UHR for psychosis at the behavioural level in comparison with a healthy comparison group.
Internalized stigma, emotional dysfunction and unusual experiences in young people at risk of psychosis
Authors: Pyle Melissa , Stewart Suzanne L.K. , French Paul , Byrne Rory , Patterson Paul , Gumley Andrew , Birchwood Max , Morrison Anthony P.
Published: December 2013

Aims

To investigate the relationship between internalized stigma, depression, social anxiety and unusual experiences in young people considered to be at risk of developing psychosis.

Methods

A total of 288 participants meeting criteria for an at‐risk mental state were recruited as part of a multisite randomized controlled trial of cognitive behavioural therapy for people meeting criteria for an at risk mental state (ARMS). The sample was assessed at baseline and 6 months using measures of at risk mental states, internalized stigma, depression and social anxiety.

Results

The Personal Beliefs about Experiences Questionnaire was validated for use with an ARMS sample. Correlational analyses at baseline indicated significant relationships between internalized stigma and: (i) depression; (ii) social anxiety; (iii) distress associated with unusual psychological experiences; and (iv) suicidal thinking. Regression analysis indicates negative appraisals of unusual experiences contributed significantly to depression scores at 6‐month follow up when controlling for baseline depression and unusual psychological experiences.

Conclusions

These findings suggest that internalized stigma may contribute to the development and maintenance of depression in young people at risk of psychosis.
Activation of primary sensory neurons by the topical application of capsaicin on the epidermis of a re‐innervated organotypic human skin model
Authors: Lebonvallet Nicolas , Pennec Jean‐Pierre , Le Gall‐Ianotto Christelle , Chéret Jérémy , Jeanmaire Christine , Carré Jean‐Luc , Pauly Gilles , Misery Laurent
Published: December 2013

Using an ex vivo skin‐nerve preparation, skin and nerve cells were reconstituted into a single unit and maintained in a nutrient medium bath until required experimentally. Our objective was to use the epidermis as a relay for the induction of an electric current to the neurons following the topical application of capsaicin on the skin epidermis of the skin explant, an agonist of the TRPV1 channel implicated in pruritus and pain. After 10–20 days of coculture to form the re‐innervated skin model, we applied a solution of capsaicin directly on the epidermis of the skin explant (4 μm). The resulting current was recorded using a path‐clamp technique on the neuronal fibres. Following the topical application of capsaicin, spontaneous activity was triggered, as characterised by repetitive spikes with periods of 125, 225 or 275 ms. This study demonstrates that the skin explant and nerve cells preparation may receive stimuli and be used to screen molecules or to study signal transmission.
Continuous high‐dose antigen exposure preferentially induces IL‐10, but intermittent antigen exposure induces IL‐4
Authors: Yamanaka Keiichi , Nakanishi Takehisa , Watanabe Jun , Kondo Makoto , Yamagiwa Akisa , Gabazza Esteban C. , Mizutani Hitoshi
Published: December 2013

IL‐10 plays a critical role in the induction of specific T‐cell tolerance. To date, whether IL‐10 induction by antigen application is dose‐ or time‐dependent remains unclear. In this study, IL‐10 induction by allergen exposure was investigated in the several schedules. Oxazolone was repeatedly applied to mouse ear, and mRNA of inflammatory cytokines in lesional skins was measured. The results indicated that continuous high‐dose antigen exposure induces IL‐4 as well as abundant IL‐10 production. Monocytes/dendritic cells and T cells are major source of IL‐10. Allergen‐specific immunotherapy is resumed before antigen scattering: preseason. We evaluated safe‐loading dose of allergens in preseasonal therapy focusing Tr1 induction. Restarting immunotherapy with high dose effectively augmented IL‐10 expression accompanied with further induction of IL‐4 and inflammatory cytokines. Therefore, the protocol restarting with low‐dose antigen is preferential to obviate the risk of exacerbation or anaphylaxis.
Knockdown of Sec8 promotes cell‐cycle arrest at G1/S phase by inducing p21 via control of FOXO proteins
Authors: Tanaka Toshiaki , Iino Mituyoshi
Published: December 2013

p21Cip1 protein inhibits the activity of cyclins at the G1 checkpoint and influences transition of cells from the G1 to the S phase of the cell cycle. Moreover, expression of members of the FOXO family (active form of forkhead transcription factors of the O class) in dividing cells promotes cell‐cycle arrest at the G1/S boundary via regulation of p21Cip1. Recently, the exocyst complex, including Sec8, has been implicated in various roles independent of its role in secretion, such as cell migration, invadopodia formation, cytokinesis, glucose uptake and neural development. Given the essential roles of the exocyst complex in cellular and developmental processes, disruption of its function may be involved in various diseases such as cancer, diabetes and neuronal disorders. However, the relationship between Sec8 and the cell cycle remains to be elucidated. In this study, knockdown of Sec8 inhibited cell growth and promoted cell‐cycle arrest at the G1/S phase by control of p21 expression and retinoblastoma protein phosphorylation. Furthermore, Sec8 regulated FOXO family proteins via ubiquitin–proteasome degradation by regulating the expression of the murine double minute 2 (Mdm2) protein but not S‐phase kinase‐associated protein 2 (Skp2).
The assistive conservation approach for community‐based lands: the case of La Ventanilla
Authors: Vargas‐del‐Río David
Published: December 2013

The assistive conservation approach includes strategies for conserving community‐based lands based on a complex combination of traditional and modern scientific knowledge. It enjoys broad legitimacy and seems promising for conserving territories with autochthonous populations. However, as a novel strategy, it has been applied mostly to societies and environments that are fragile in conservationist terms. This paper critically analyses the evolution of environmental discourses on nature conservation, assesses their related strategies and methodologies, and shows how emerging discourses have been assimilated to produce a qualitative shift from ‘top‐down’ to ‘bottom‐up’ models of environmental management, but without eliminating considerable dependence. It reviews earlier critiques of the protected areas approach associated with this emerging concept. Finally, it revisits the evolution of an important early case of assistive conservation, La Ventanilla (Oaxaca, Mexico), to assess processes of dependence and this emergent strategy's potential to face challenges of environmental degradation. It concludes that, over time, this concept makes local ecologies more vulnerable to social and environmental degradation, especially as traditional management institutions once responsible for ecological integrity become obsolete.
Chronologic changes of explanted liver volume and the use of ursodeoxycholic acid in patients with end‐stage primary biliary cirrhosis
Authors: Tanaka Tomohiro , Yamashiki Noriyo , Sugawara Yasuhiko , Tamura Sumihito , Nakamura Minoru , Kaneko Junichi , Aoki Taku , Sakamoto Yoshihiro , Hasegawa Kiyoshi , Kokudo Norihiro
Published: December 2013

Aim

The clinical presentation of Primary biliary cirrhosis (PBC) at the time of liver transplantation (LT) may have changed, due to the long‐term use of ursodeoxycholic acid (UDCA). The aim of this retrospective study was to investigate whether the clinical characteristics of LT recipients with PBC have changed over the years.

Methods

Of all 421 adults undergoing LT from 1997 to 2012 at our center, we included 85 recipients with PBC into the present study. The 85 recipients were divided into three groups according to the year LT was performed: group 1 (1997–2001, n = 29), group 2 (2002–2005, n = 29) and group 3 (2006–2012, n = 27).

Results

There were no significant differences in sex, recipient age, Model for End‐Stage Liver Disease score, updated Mayo risk score for PBC, or liver‐related complications except for esophageal varices among the three groups. Patients in group 1 were complicated with esophageal varices less frequently than those in the other two groups. In older cases, the ratio of explanted liver volume to standard liver volume (ELV/SLV) was significantly higher, and the duration of pre‐LT UDCA treatment was significantly shorter. The duration of UDCA treatment was significantly correlated with ELV/SLV.

Conclusion

Recent LT patients were characterized by more frequent portal hypertension and more severe liver atrophy, with longer UDCA therapy prior to LT, which might have prevented the somewhat rapid progression of liver failure characterized by hepatomegaly with insignificant fibrosis or portal hypertension.
Causes and consequences of pre‐laying weight gain in a food‐caching bird that breeds in late winter
Authors: Sechley Talia H. , Strickland Dan , Norris D. Ryan
Published: December 2013

Animals that reside at high latitudes and altitudes year‐round often use cached food to survive over the winter months, but a few species also rely on stored food to sustain them during the breeding season when the nutritional requirements of females are higher than normal. Gray jaysPerisoreus canadensisrely on perishable cached food during the winter and females begin breeding in late winter when fresh food is rarely available. To examine pre‐laying patterns of weight gain, as well as the causes and consequences of weight gain among individuals, we weighed females regularly throughout the pre‐laying period. Females began increasing their weight approximately nine days prior to their first egg date, and on average increased their body weight by 25%, which is on par with other bird species that rely on non‐cached food. Final pre‐laying weight was positively influenced by the percent of conifers on territories, providing some support for previous results showing that coniferous trees are better able to preserve cached food. We also found that both final pre‐laying weight and the rate of weight gain were positively related to female age, supporting the hypothesis that female caching ability improves with age. With increasing final weight, females tended to lay larger clutches and hatched more nestlings, despite the fact that final weight was not influenced by weight at the beginning of the weighing period. Our results confirm that gray jays are able to reach breeding condition while relying primarily on food stored before winter, and suggest a novel mechanism by which habitat‐mediated carry‐over effects and female age may influence reproductive performance in a food‐caching animal.
Heterogeneity of serum gelatinases MMP‐2 and MMP‐9 isoforms and charge variants
Authors: Rossano Rocco , Larocca Marilena , Riviello Lea , Coniglio Maria Gabriella , Vandooren Jennifer , Liuzzi Grazia Maria , Opdenakker Ghislain , Riccio Paolo
Published: December 2013

The matrix metalloproteinases (MMPs) gelatinase A (MMP‐2) and gelatinase B (MMP‐9) are mediators of brain injury in multiple sclerosis (MS) and valuable biomarkers of disease activity. We applied bidimensional zymography (2‐DZ) as an extension of classic monodimensional zymography (1‐DZ) to analyse the complete pattern of isoforms and post‐translational modifications of both MMP‐9 and MMP‐2 present in the sera of MS patients. The enzymes were separated on the basis of their isoelectric points (pI) and apparent molecular weights (Mw) and identified both by comparison with standard enzyme preparations and by Western blot analysis. Two MMP‐2 isoforms, and at least three different isoforms and two different states of organization of MMP‐9 (the multimeric MMP‐9 and the N‐GAL‐MMP‐9 complex) were observed. In addition, 2‐DZ revealed for the first time that all MMP‐9 and MMP‐2 isoforms actually exist in the form of charge variants: four or five variants in the N‐GAL complex, more charge variants in the case of MMP‐9; and five to seven charge variants for MMP‐2. Charge variants were also observed in recombinant enzymes and, after concentration, also in sera from healthy individuals. Sialylation (MMP‐9) and phosphorylation (MMP‐2) contributed to molecular heterogeneity. The detection of charge variants of MMP‐9 and MMP‐2 in MS serum samples illustrates the power of 2‐DZ and demonstrates that in previous studies MMP mixtures, rather than single molecules, were analysed. These observations open perspectives for better diagnosis and prognosis of many diseases and need to be critically interpreted when applying other methods for MS and other diseases.
Between Youth Policy and Employment Policy: The Rise, Limits and Ambiguities of a Corporatist System of Youth Representation within the EU
Authors: Chabanet Didier
Published: December 2013

This article outlines the evolution of youth European policies, in a context marked for over 25 years by a very high level of youth unemployment, exacerbated since 2008 by the economic crisis. It is striking that the European Union (EU) has until recently preferred a transversal approach to youth, considering youth unemployment as an issue among others. Moreover, the difficulty of the EU to co‐operate with a wide spectrum of youth organizations is obvious, especially with those in favour of a far more protective approach against youth employment. However, we seem to witness the rise of a corporatist system in the field of youth, in which a few organizations are considered as legitimate interlocutors, even if they are consulted on issues which are the less sensitive at the expense of youth unemployment policies.
Evaluation of alternatives to expanded polystyrene beads for mosquito control
Authors: Irish S. R. , Chen‐Hussey V.
Published: December 2013

Expanded polystyrene (EPS) beads have been shown to be an effective tool for controlling immature stages of mosquitoes, as well as preventing oviposition by adults. Polystyrene does not biodegrade quickly, resulting in some concerns about its effect on the environment. A potential solution is the use of biodegradable materials that cover the surface of mosquito breeding sites in the same way as EPS beads. Two candidates are polylactic acid (PLA) beads and corn starch shreds. Larval mortality and adult emergence of Culex quinquefasciatus Say (Diptera: Culicidae) were monitored in bowls with each of four treatments: EPS beads, PLA beads, corn starch shreds and a control. The PLA beads were as effective as EPS beads at preventing mosquito emergence, whereas the shredded corn starch treatment resulted in significantly higher rates of emergence to the control. Similarly, EPS and PLA beads resulted in 100% mortality after 10 days, while there was low mortality of larvae in the corn starch (9%) and control treatments (20%). PLA beads provided similar levels of mortality and reduction in adult emergence as EPS beads. However, the production requirements of PLA beads may limit its use in field conditions.