bluuebunny/crossref_metadata_2025 huggingface dataset:
Laparoscopic Versus Open Incisional and Ventral Hernia Repair: A Systematic Review and Meta‐analysis
Authors: Zhang Yanyan , Zhou Haiyang , Chai Yunsheng , Cao Can , Jin Kaizhou , Hu Zhiqian
Published: April 2014

Background

Laparoscopic incisional and ventral hernia repair (LIVHR) is an alternative approach to conventional open incisional and ventral hernia repair (OIVHR). A consensus on outcomes of LIVHR when compared with OIVHR has not been reached.

Methods

As the basis for the present study, we performed a systematic review and meta‐analysis of all randomized controlled trials comparing LIVHR and OIVHR.

Results

Eleven studies involving 1,003 patients were enrolled. The incidences of wound infection were significantly lower in the laparoscopic group than that in the open group (laparoscopic group 2.8 %, open group 16.2 %; RR = 0.19, 95 % CI 0.11–0.32; P < 0.00001). The rates of wound drainage were significantly lower in the laparoscopic group than that in the open group (laparoscopic group 2.6 %, open group 67.0 %; RR = 0.06, 95 % CI 0.03–0.09; P < 0.00001). However, the rates of bowel injury were significantly higher in the laparoscopic group than in the open group (laparoscopic group 4.3 %, open group 0.81 %; RR = 3.68, 95 % CI 1.56–8.67; P = 0.003). There were no significant differences between the two groups in the incidences of hernia recurrence, postoperative seroma, hematoma, bowel obstruction, bleeding, and reoperation. Descriptive analyses showed a shorter length of hospital stay in the laparoscopic group.

Conclusions

Laparoscopic incisional and ventral hernia repair is a feasible and effective alternative to the open technique. It is associated with lower incidences of wound infection and shorter length of hospital stay. However, caution is required because it is associated with an increased risk of bowel injury compared with the open technique. Given the relatively short follow‐up duration of trials included in the systematic review, trials with long‐term follow‐up are needed to compare the durability of laparoscopic and open repair.
Beyond Deficits: Intimate Partner Violence, Maternal Parenting, and Child Behavior Over Time
Authors: Greeson Megan R. , Kennedy Angie C. , Bybee Deborah I. , Beeble Marisa , Adams Adrienne E. , Sullivan Cris
Published: April 2014

Exposure to intimate partner violence (IPV) has negative consequences for children's well‐being and behavior. Much of the research on parenting in the context of IPV has focused on whether and how IPV victimization may negatively shape maternal parenting, and how parenting may in turn negatively influence child behavior, resulting in a deficit model of mothering in the context of IPV. However, extant research has yet to untangle the interrelationships among the constructs and test whether the negative effects of IPV on child behavior are indeed attributable to IPV affecting mothers’ parenting. The current study employed path analysis to examine the relationships among IPV, mothers’ parenting practices, and their children's externalizing behaviors over three waves of data collection among a sample of 160 women with physically abusive partners. Findings indicate that women who reported higher levels of IPV also reported higher levels of behavior problems in their children at the next time point. When parenting practices were examined individually as mediators of the relationship between IPV and child behavior over time, one type of parenting was significant relationship, such that IPV lead to higher authoritative parenting and lower child behavior problems. On the other hand, there was no evidence that higher levels of IPV contributed to more child behavior problems due to maternal parenting. Instead, IPV had a significant cumulative indirect effect on child behavior via the stability of both IPV and behavior over time. Implications for promoting women's and children's well‐being in the context of IPV are discussed.
Lipoic acid biosynthesis defects
Authors: Mayr Johannes A. , Feichtinger René G. , Tort Frederic , Ribes Antonia , Sperl Wolfgang
Published: April 2014

Lipoate is a covalently bound cofactor essential for five redox reactions in humans: in four 2‐oxoacid dehydrogenases and the glycine cleavage system (GCS). Two enzymes are from the energy metabolism, α‐ketoglutarate dehydrogenase and pyruvate dehydrogenase; and three are from the amino acid metabolism, branched‐chain ketoacid dehydrogenase, 2‐oxoadipate dehydrogenase, and the GCS. All these enzymes consist of multiple subunits and share a similar architecture. Lipoate synthesis in mitochondria involves mitochondrial fatty acid synthesis up to octanoyl‐acyl‐carrier protein; and three lipoate‐specific steps, including octanoic acid transfer to glycine cleavage H protein by lipoyl(octanoyl) transferase 2 (putative) (LIPT2), lipoate synthesis by lipoic acid synthetase (LIAS), and lipoate transfer by lipoyltransferase 1 (LIPT1), which is necessary to lipoylate the E2 subunits of the 2‐oxoacid dehydrogenases. The reduced form dihydrolipoate is reactivated by dihydrolipoyl dehydrogenase (DLD). Mutations in LIAS have been identified that result in a variant form of nonketotic hyperglycinemia with early‐onset convulsions combined with a defect in mitochondrial energy metabolism with encephalopathy and cardiomyopathy. LIPT1 deficiency spares the GCS, and resulted in a combined 2‐oxoacid dehydrogenase deficiency and early death in one patient and in a less severely affected individual with a Leigh‐like phenotype. As LIAS is an iron–sulphur‐cluster‐dependent enzyme, a number of recently identified defects in mitochondrial iron–sulphur cluster synthesis, including NFU1, BOLA3, IBA57, GLRX5 presented with deficiency of LIAS and a LIAS‐like phenotype. As in DLD deficiency, a broader clinical spectrum can be anticipated for lipoate synthesis defects depending on which of the affected enzymes is most rate limiting.
Disclosure of Genetic Research Results to Members of a Founder Population
Authors: Anderson Rebecca L. , Murray Kathleen , Chong Jessica X. , Ouwenga Rebecca , Antillon Marina , Chen Peixian , Diaz de Leon Lorena , Swoboda Kathryn J. , Lester Lucille A. , Das Soma , Ober Carole , Waggoner Darrel J.
Published: April 2014

There is currently extensive discussion and debate in the literature on how, when, and to whom genetic research results should be returned (see Genetics in Medicine, April 2012 issue). Here, we describe our experience in disclosing genetic information on Mendelian disorders discovered during the course of our research in the Hutterites. We first assessed attitudes toward the disclosure of carrier results, which revealed that many individuals wanted carrier information and that many intended to use the information in family planning. Based on this information, we developed a pilot study to test and disclose cystic fibrosis (CF) carrier status. Next, a larger scale project was developed in order to disclose genetic research results for 14 diseases to those interested in receiving the information. We developed brochures, offered a live interactive educational program, conducted a consent process, and disclosed results in letters mailed to the consented individuals. Overall, ~80 % of individuals who participated in the educational program signed consent forms for the release of their results for 14 diseases. We describe our experience with returning individual genetic research results to participants in a population‐based research study.
Lipidomic Analyses of Female Mice Lacking Hepatic Lipase and Endothelial Lipase Indicate Selective Modulation of Plasma Lipid Species
Authors: Yang Yanbo , Kuwano Takashi , Lagor William R. , Albert Carolyn J. , Brenton Siobhan , Rader Daniel J. , Ford David A. , Brown Robert J.
Published: April 2014

Hepatic lipase (HL) and endothelial lipase (EL) share overlapping and complementary roles in lipoprotein metabolism. The deletion of HL and EL alleles in mice raises plasma total cholesterol and phospholipid concentrations. However, the influence of HL and EL in vivo on individual molecular species from each class of lipid is not known. We hypothesized that the loss of HL, EL, or both in vivo may affect select molecular species from each class of lipids. To test this hypothesis, we performed lipidomic analyses on plasma and livers from fasted female wild‐type, HL‐knockout, EL‐knockout, and HL/EL‐double knockout mice. Overall, the loss of HL, EL, or both resulted in minimal changes to hepatic lipids; however, select species of CE were surprisingly reduced in the livers of mice only lacking EL. The loss of HL, EL, or both reduced the plasma concentrations for select molecular species of triacylglycerol, diacylglycerol, and free fatty acid. On the other hand, the loss of HL, EL, or both raised the plasma concentrations for select molecular species of phosphatidylcholine, cholesteryl ester, diacylglycerol, sphingomyelin, ceramide, plasmanylcholine, and plasmenylcholine. The increased plasma concentration of select ether phospholipids was evident in the absence of EL, thus suggesting that EL might exhibit a phospholipase A2 activity. Using recombinant EL, we showed that it could hydrolyse the artificial phospholipase A2 substrate 4‐nitro‐3‐(octanoyloxy)benzoic acid. In summary, our study shows for the first time the influence of HL and EL on individual molecular species of several classes of lipids in vivo using lipidomic methods.
Assessment of Alcohol-related Memory Deficits: A Comparison between the Rivermead Behavioural Memory Test and the California Verbal Learning Test
Authors: Wester Arie J. , Roelofs Renée L. , Egger Jos I.M. , Kessels Roy P.C.
Published: April 2014

Objectives: Neuropsychological assessment of memory disorders is an important prerequisite in the treatment of patients with alcohol-related cognitive disorders. Although many memory tests are available in clinical practice, a question remains regarding which test is most appropriate for this purpose. Our study's goal was to evaluate the discriminative power of indices of a standard memory test (the California Verbal Learning Test; CVLT) versus the subtests of an ecologically valid everyday memory test (the Rivermead Behavioural Memory Test; RBMT) in patients with alcohol-use disorder.

Method: The patients included 136 with Korsakoff's syndrome (KS), 73 alcoholics with cognitive impairment (CI) not fulfilling the criteria for KS, and 24 cognitively unimpaired alcoholics (ALC).

Results: KS patients performed significantly lower on all RBMT and CVLT variables than CI patients. ALC patients performed significantly better than CI patients on only one RBMT subtest, and had a significantly lower rate of forgetting and higher scores on free recall on CVLT. A combination of RBMT subtests and CVLT indices was able to discriminate KS patients from CI and ALC patients. The RBMT subtests could not significantly distinguish ALC from CI patients. Both rate of forgetting and a comparison between free and cued recall testing on the CVLT showed the largest between-group differences.

Conclusion: Although the RBMT provides information about everyday memory performance, the CVLT indices are better able to distinguish between uncomplicated alcoholics and those with cognitive impairment or KS.
Explaining Political Judgement
Authors: 6 Perri
Published: April 2014

What is political judgement? Why do politicians exhibit such contrasting thought styles in making decisions, even when they agree ideologically? What happens when governments with contrasting thought styles have to deal with each other? In this book Perri 6 presents a fresh, rigorous explanatory theory of judgement, its varieties and its consequences, drawing upon Durkheim and Douglas. He argues that policy makers will understand - and misunderstand - their problems and choices in ways that reproduce their own social organisation. This theory is developed by using the Cuban Missile Crisis of 1962 as an extended case study, examining the decision-making of the Kennedy, Castro and Khrushchev regimes. Explaining Political Judgement is the first comprehensive study to show what a neo-Durkheimian institutional approach can offer to political science and to the social sciences generally.
Work in Times of Slavery, Colonialism, and Civil War: Labor Relations in Angola from 1800 to 2000
Authors: Vos Jelmer
Published: April 2014

In Angola, a trend towards labor commodification, set in motion under the impact of the nineteenth-century produce trade and colonial rule, has been reversed in the decades since independence. Angolans have always worked mainly in the reciprocal sphere, but with the growing commercialization of the economy after the abolition of the slave trade, self-employment has also become a constant in Angolan labor history. By 2000, the rural population was thrown back to subsistence farming, while the larger part of the urban population has tried to survive by self-employment in the informal economy. Wage labor, widespread under colonialism, has become less common.
Flow topology in the wake of a cyclist and its effect on aerodynamic drag
Authors: Crouch T. N. , Burton D. , Brown N. A. T. , Thompson M. C. , Sheridan J.
Published: April 2014

Three-dimensional flows around a full-scale cyclist mannequin were investigated experimentally to explain the large variations in aerodynamic drag that are measured as the legs are positioned around the $360^\circ $ crank cycle. It is found that the dominant mechanism affecting drag is not the small variation in frontal surface area over the pedal stroke but rather due to large changes in the flow structure over the crank cycle. This is clearly shown by a series of detailed velocity field wake surveys and skin friction flow visualizations. Two characteristic flow regimes are identified, corresponding to symmetrical low-drag and asymmetrical high-drag regimes, in which the primary feature of the wake is shown to be a large trailing streamwise vortex pair, orientated asymmetrically in the centre plane of the mannequin. These primary flow structures in the wake are the dominant mechanism driving the variation in drag throughout the pedal stroke. Topological critical points have been identified on the suction surfaces of the mannequin’s back and are discussed with velocity field measurements to elucidate the time-average flow topologies, showing the primary flow structures of the low- and high-drag flow regimes. The proposed flow topologies are then related to the measured surface pressures acting on the suction surface of the mannequin’s back. These measurements show that most of the variation in drag is due to changes in the pressure distribution acting on the lower back, where the large-scale flow structures having the greatest impact on drag develop.
An exact representation of the nonlinear triad interaction terms in spectral space
Authors: Cheung Lawrence C. , Zaki Tamer A.
Published: April 2014

Spectral analysis of the Navier–Stokes equations requires treatment of the convolution of pairs of Fourier transforms $\hat{f}$ and $\hat{g}$. An exact, tractable representation of the nonlinear terms in spectral space is introduced, and relies on the definition and manipulation of a combination matrix. A spectral energy equation is derived where the nonlinear triad interactions are expressed using the combination matrix. The formulation is applied to the problem of homogeneous, isotropic turbulence. By finding the solution in an appropriate canonical basis, the energy spectrum in the inertial range $E(k)\sim \epsilon ^{2/3}k^{-5/3}$ is derived from the Navier–Stokes equations without invoking dimensional scaling arguments.
Bulldozing of granular material
Authors: Sauret A. , Balmforth N. J. , Caulfield C. P. , McElwaine J. N.
Published: April 2014

We investigate the bulldozing motion of a granular sandpile driven forwards by a vertical plate. The problem is set up in the laboratory by emplacing the pile on a table rotating underneath a stationary plate; the continual circulation of the bulldozed material allows the dynamics to be explored over relatively long times, and the variation of the velocity with radius permits one to explore the dependence on bulldozing speed within a single experiment. We measure the time-dependent surface shape of the dune for a range of rotation rates, initial volumes and radial positions, for four granular materials, ranging from glass spheres to irregularly shaped sand. The evolution of the dune can be separated into two phases: a rapid initial adjustment to a state of quasi-steady avalanching perpendicular to the blade, followed by a much slower phase of lateral spreading and radial migration. The quasi-steady avalanching sets up a well-defined perpendicular profile with a nearly constant slope. This profile can be scaled by the depth against the bulldozer to collapse data from different times, radial positions and experiments onto common ‘master curves’ that are characteristic of the granular material and depend on the local Froude number. The lateral profile of the dune along the face of the bulldozer varies more gradually with radial position, and evolves by slow lateral spreading. The spreading is asymmetrical, with the inward progress of the dune eventually arrested and its bulk migrating to larger radii. A one-dimensional depth-averaged model recovers the nearly linear perpendicular profile of the dune, but does not capture the finer nonlinear details of the master curves. A two-dimensional version of the model leads to an advection–diffusion equation that reproduces the lateral spreading and radial migration. Simulations using the discrete element method reproduce in more quantitative detail many of the experimental findings and furnish further insight into the flow dynamics.
‘The Hospital was just like a Home’: Self, Service and the ‘McCord Hospital Family’
Authors: Noble Vanessa , Parle Julie
Published: April 2014

For more than a century, McCord Hospital, a partly private and partly state-subsidised mission hospital has provided affordable health-care services, as well as work and professional training opportunities for thousands of people in Durban, a city on the east coast of South Africa. This article focuses on one important aspect of the hospital’s longevity and particular character, or ‘organisational culture’: the ethos of a ‘McCord Family’, integral to which were faith and a commitment to service. While recognising that families – including ‘hospital families’ like that at McCord – are contentious social constructs, with deeply embedded hierarchies and inequalities based on race, class and gender, we also consider however how the notion of ‘a McCord family’ was experienced and shared in complex ways. Indeed, during the twentieth century, this ethos was avidly promoted by the hospital’s founders and managers and by a wide variety of employees and trainees. It also extended to people at a far geographical remove from Durban. Moreover, this ethos became so powerful that many patients felt that it shaped their convalescence experience positively. This article considers how this ‘family ethos’ was constructed and what made it so attractive to this hospital’s staff, trainees and patients. Furthermore, we consider what ‘work’ it did for this mission hospital, especially in promoting bonds of multi-racial unity in the contexts of segregation and apartheid society. More broadly, it suggests that critical histories of the ways in which individuals, hospitals, faith and ‘families’ intersect may be of value for the future of hospitals as well as of interest in their past.
New Patterns of Disclosure: How HIV-Positive Support Group Members from KwaZulu-Natal Speak of their Status in Oral Narratives
Authors: Denis Philippe
Published: April 2014

This paper examines the representations and emotions associated with disclosure and stigma in Pietermaritzburg, KwaZulu-Natal, seven years after the start of the South African government’s ARV roll-out programme on the basis of in-depth oral history interviews of HIV-positive support group members. It argues that the wider availability of ARV treatment, the ensuing reduced fatality rate and the increased number of people, including men, who receive counselling and testing, may mean that HIV/AIDS is less stigmatised and that disclosure has become easier. This does not mean that stigma has disappeared and that the confusion created by competing world-views and belief systems has dissipated. Yet the situation of extreme denial and ideological confusion observed, for example, by Deborah Posel and her colleagues in 2003 and 2004 in the Mpumalanga province seems to have lessened. The interviews hint at the possibility that people living with HIV may have, more than a decade before, a language to express the emotions and feelings associated with HIV/AIDS. They were also found to be more assertive in matters of gender relations. These new attitudes would make disclosure easier and stigma more likely to recede.
‘A Matter of Conscience’: The Moral Authority of the World Medical Association and the Readmission of the South Africans, 1976–1994
Authors: Mbali Mandisa
Published: April 2014

This article describes the role of transnational anti-apartheid activism in South Africa, Britain and the United States in generating international moral outrage over the readmission of the Medical Association of South Africa (MASA) to the World Medical Association (WMA), which had taken place in 1981 after it had withdrawn from that body in 1976. It discusses an example of a controversy where an international health organisation (IHO) lost moral authority as a result of being accused of white supremacy and a pro-American engagement in Cold War politics. At the time of its readmission to the WMA, the MASA was controversial because of its failure to strike off its membership roll one of the doctors implicated the death in detention of Black Consciousness leader Steve Biko in 1977. It details how these activists viewed the American Medical Association as having campaigned for the MASA’s readmission. The WMA’s readmission of the MASA cost the former its relationships with the World Health Organisation (WHO) and the British Medical Association – a dispute which continued until South Africa’s democratic transition of 1994. With its focus on transnational activism in relation to the WMA and the effects of activists’ allegations of racism on its internal politics, this article contributes to the literature on the history of IHOs. Ultimately, this controversy shows the deficiency of international medical professional associations as ethical arbitrators of last resort.
The Returns to Office in a “Rubber Stamp” Parliament
Authors: TRUEX RORY
Published: April 2014

Are there returns to office in an authoritarian parliament? A new dataset shows that over 500 deputies to China’s National People’s Congress are CEOs of various companies. Entropy balancing is used to construct a weighted portfolio of Chinese companies that matches companies with NPC representation on relevant financial characteristics prior to the 11th Congress (2008–2012). The weighted fixed effect analysis suggests that a seat in the NPC is worth an additional 1.5 percentage points in returns and a 3 to 4 percentage point boost in operating profit margin in a given year. Additional evidence reveals that these rents stem primarily from the “reputation boost” of the position, and not necessarily formal policy influence. These findings confirm the assumptions of several prominent theories of authoritarian politics but suggest the need to further probe the nature of these institutions.
Delivering Stability—Primogeniture and Autocratic Survival in European Monarchies 1000–1800
Authors: KOKKONEN ANDREJ , SUNDELL ANDERS
Published: April 2014

Building a strong autocratic state requires stability in ruler-elite relations. From this perspective the absence of a successor is problematic, as the elite have few incentives to remain loyal if the autocrat cannot reward them for their loyalty after his death. However, an appointed successor has both the capacity and the motive to challenge the autocrat. We argue that a succession based on primogeniture solves the dilemma, by providing the regime with a successor who can afford to wait to inherit the throne peacefully. We test our hypothesis on a dataset covering 961 monarchs ruling 42 European states between 1000 and 1800, and show that fewer monarchs were deposed in states practicing primogeniture than in states practicing alternative succession orders. A similar pattern persists in the world's remaining absolute monarchies. Primogeniture also contributed to building strong states: In 1801 all European monarchies had adopted primogeniture or succumbed to foreign enemies.
Was Weber Right? The Role of Urban Autonomy in Europe's Rise
Authors: STASAVAGE DAVID
Published: April 2014

Do strong property rights institutions always help, or might they sometimes actually hinder development? Since Max Weber and before, scholars have claimed that the presence of politically autonomous cities, controlled by merchant oligarchies guaranteeing property rights, helped lead to Europe's rise. Yet others suggest that autonomous cities were a hindrance to growth because rule by merchant guilds resulted in restrictions that stifled innovation and trade. I present new evidence and a new interpretation that reconcile the two views of city autonomy. I show that politically autonomous cities initially had higher population growth rates than nonautonomous cities, but over time this situation reversed itself. My evidence also suggests why autonomous cities eventually disappeared as a form of political organization. Instead of military weakness, it may have been their political institutions that condemned them to become obsolete.
Double-blind, randomised, placebo-controlled intervention trial to evaluate the effects ofBifidobacterium longumCECT 7347 in children with newly diagnosed coeliac disease
Authors: Olivares Marta , Castillejo Gemma , Varea Vicente , Sanz Yolanda
Published: April 2014

Interactions between the immune system and the intestinal microbiota may play a role in coeliac disease (CD). In the present study, the potential effects ofBifidobacterium longumCECT 7347 in children with newly diagnosed CD were evaluated. A double-blind, randomised, placebo-controlled trial was conducted in thirty-three children who received a capsule containing eitherB. longumCECT 7347 (109colony-forming units) or placebo (excipients) daily for 3 months together with a gluten-free diet (GFD). Outcome measures (baseline and post-intervention) included immune phenotype of peripheral blood cells, serum cytokine concentration, faecal secretory IgA (sIgA) content, anthropometric parameters and intestinal microbiota composition. Comparisons between the groups revealed greater height percentile increases (P= 0·048) in theB. longumCECT 7347 group than in the placebo group, as well as decreased peripheral CD3+T lymphocytes (P= 0·004) and slightly reduced TNF-α concentration (P= 0·067). Within-group comparisons of baseline and final values did not reveal any differences in T lymphocytes and cytokines in the placebo group, while decreased CD3+(P =0·013) and human leucocyte antigen (HLA)-DR+T lymphocytes (P =0·029) and slightly reduced TNF-α concentration (P= 0·085) were detected in theB. longumCECT 7347 group. Comparison between the groups showed that the administration ofB. longumCECT 7347 reduced the numbers of theBacteroides fragilisgroup (P= 0·020) and the content of sIgA in stools (P= 0·011) compared with the administration of placebo. Although this is a first exploratory intervention with limitations, the findings suggest thatB. longumCECT 7347 could help improve the health status of CD patients who tend to show alterations in gut microbiota composition and a biased immune response even on a GFD.
Dietary supplementation with fish oil alters the expression levels of proteins governing mitochondrial dynamics and prevents high-fat diet-induced endothelial dysfunction
Authors: Sun Ruifang , Wang Xiaoming , Liu Yan , Xia Min
Published: April 2014

Diets supplemented with fish oil (FO), which is rich in n-3 PUFA, have been shown to modify several key risk factors for CVD. The purpose of the present study was to determine the effect of FO supplementation on mitochondrial dynamic protein expression in the endothelium and on endothelial cell function. Male apoE-deficient (apoE− / −) mice (8 weeks old, n 12 per group) were fed a high-fat diet containing 45 % fat (HFD group) or a HFD with partial replacement of lard with 10 % (w/w) FO (FO group) (total EPA and DHA content 64·1 g/kg) for 8 weeks. ApoE− / − mice in the FO group had a greater endothelium-dependent vasorelaxation response to acetylcholine (Ach) than those in the HFD group. The atherosclerotic lesion volume in the aortic sinus of mice in the FO group was 54 % lower than that in the HFD group (P< 0·01). In addition, the aortas isolated from mice in the FO group had higher expression levels of Mfn2 and Opa1 but lower expression levels of Fis1 than those from the HFD group. Compared with mice fed the HFD, those fed the FO diet showed significantly lower levels of mitochondrial oxidative stress, cytochrome c release and caspase-3 activity (each P< 0·05). Furthermore, FO-fed mice displayed increased NO release and availability and enhanced endothelial NO synthase activity compared with HFD-fed mice. Taken together, these results reveal a novel mechanism by which FO protects against endothelial cell dysfunction, which may result in improved mitochondrial dynamics.
Hsp90: a chaperone for HIV-1
Authors: LOW JUN SIONG , FASSATI ARIBERTO
Published: April 2014

HIV-1 replication has been intensively investigated over the past 30 years. Hsp90 is one of the most abundant proteins in human cells, important in the formation and function of several protein complexes that maintain cell homeostasis. Remarkably, the impact of Hsp90 on HIV-1 infection has started to be appreciated only recently. Hsp90 has been shown to (a) promote HIV-1 gene expression in acutely infected cells, (b) localize at the viral promoter DNA, (c) mediate enhanced replication in conditions of hyperthermia and (d) activate the P-TEFb complex, which is essential for efficient HIV-1 transcription. Hsp90 has been implicated in buffering deleterious mutations of the viral core and in the regulation of innate and acquired immune responses to HIV-1 infection. Therefore, Hsp90 is an important host factor promoting several steps of the HIV-1 life cycle. Several small Hsp90 inhibitors are in Phase II clinical trials for human cancers and might potentially be used to inhibit HIV-1 infection at multiple levels.
Advances in the diagnosis ofAscaris suuminfections in pigs and their possible applications in humans
Authors: VLAMINCK JOHNNY , LEVECKE BRUNO , VERCRUYSSE JOZEF , GELDHOF PETER
Published: April 2014

Ascariasis is one of the most common parasitic diseases in both humans and pigs. It has been shown to cause growth deficits in both species and to impair cognitive development in children. Notwithstanding its substantial impact on pig economy and public health, diagnosis of ascariasis has mostly relied on the detection of eggs in stool and further development of novel, more sensitive methods has been limited or non-existent. Here, we discuss the currently available techniques for the diagnosis of ascariasis in pigs, their caveats, and the implications of a new serological detection technique for the evaluation of both pig and human ascariasis.
Disruption of vitellogenesis and spermatogenesis by triclabendazole (TCBZ) in a TCBZ-resistant isolate of Fasciola hepatica following incubation in vitro with a P-glycoprotein inhibitor
Authors: SAVAGE J. , MEANEY M. , BRENNAN G. P. , HOEY E. , TRUDGETT A. , FAIRWEATHER I.
Published: April 2014

A study has been carried out to investigate whether the action of triclabendazole (TCBZ) against Fasciola hepatica is altered by inhibition of P-glycoprotein (Pgp)-linked drug efflux pumps. The Sligo TCBZ-resistant fluke isolate was used for these experiments and the Pgp inhibitor selected was R(+)-verapamil [R(+)-VPL]. In the first experiment, flukes were initially incubated for 2 h in R(+)-VPL (100 μm), then incubated in R(+)-VPL+triclabendazole sulphoxide (TCBZ.SO) (50 μg mL−1, or 133·1 μm) until flukes ceased movement (at 9 h post-treatment). In a second experiment, flukes were incubated in TCBZ.SO alone and removed from the incubation medium following cessation of motility (after 15 h). In the third experiment, flukes were incubated for 24 h in R(+)-VPL on its own. Changes to the testis tubules and vitelline follicles following drug treatment and following Pgp inhibition were assessed by means of light microscope histology and transmission electron microscopy. Incubation of the Sligo isolate in either R(+)-VPL or TCBZ.SO on their own had a limited impact on the morphology of the two tissues. Greater disruption was observed when the drugs were combined, in terms of the block in development of the spermatogenic and vitelline cells and the apoptotic breakdown of the remaining cells. Sperm formation was severely affected and abnormal. Large spaces appeared in the vitelline follicles and synthesis of shell protein was disrupted. The results of this study support the concept of altered drug efflux in TCBZ-resistant flukes and indicate that drug transporters may play a role in the development of drug resistance.
Fecundity compensation and fecundity reduction among populations of the three-spined stickleback infected bySchistocephalus solidusin Alaska
Authors: HEINS DAVID C. , BAKER JOHN A.
Published: April 2014

We surveyed nine populations of the three-spined stickleback infected by the diphyllobothriidean cestodeSchistocephalus solidusfrom south-central Alaska for two apparent forms of tolerance to infection in females capable of producing egg clutches notwithstanding large parasite burdens. Seven populations exhibited fecundity reduction, whereas two populations showed fecundity compensation. Our data suggest that fecundity reduction, a side effect resulting from nutrient theft, occurs in two phases of host response influenced by the parasite : host body mass (BM) ratio. The first is significantly reduced ovum mass without significant reduction in clutch size, and the second one involves significant reductions in both ovum mass and clutch size. Thus, ovum mass of host females who are functionally being starved through nutrient theft seems to be more readily influenced by parasitism and, therefore, decreased before clutch size is reduced. This inference is consistent with expectations based on the biology of and effect of feeding ration on reproduction in stickleback females. Fecundity compensation appears to be uncommon among populations of three-spined stickleback in Alaska and rare among populations throughout the northern hemisphere. Fecundity reduction seems to be common, at least among stickleback populations in Alaska.
RISKS IN THE IMPLEMENTATION AND USE OF SMART PUMPS IN A PEDIATRIC INTENSIVE CARE UNIT: APPLICATION OF THE FAILURE MODE AND EFFECTS ANALYSIS
Authors: Manrique-Rodríguez Silvia , Sánchez-Galindo Amelia C , López-Herce Jesús , Calleja-Hernández Miguel Ángel , Iglesias-Peinado Irene , Carrillo-Álvarez Ángel , Sáez María Sanjurjo , Fernández-Llamazares Cecilia M
Published: April 2014

Objectives: The aim of this study was to identify risk points in the different stages of the smart infusion pump implementation process to prioritize improvement measures.

Methods: Failure modes and effects analysis (FMEA) in the pediatric intensive care unit (PICU) of a General and Teaching Hospital. A multidisciplinary team was comprised of two intensive care pediatricians, two clinical pharmacists and the PICU nurse manager. FMEA was carried out before implementing CareFusion infusion smart pumps and eighteen months after to identify risk points during three different stages of the implementation process: creating a drug library; using the technology during clinical practice and analyzing the data stored using Guardrails® CQI v4.1 Event Reporter software.

Results: Several actions for improvement were taken. These included carrying out periodical reviews of the drug library, developing support documents, and including a training profile in the system so that alarms set off by real programming errors could be distinguished from those caused by incorrect use of the system. Eighteen months after the implementation, these measures had helped to reduce the likelihood of each risk point occurring and increase the likelihood of their detection.

Conclusions: Carrying out an FMEA made it possible to detect risk points in the use of smart pumps, take action to improve the tool, and adapt it to the PICU. Providing user training and support tools and continuously monitoring results helped to improve the usefulness of the drug library, increased users’ compliance with the drug library, and decreased the number of unnecessary alarms.
MENTORING A HEALTH TECHNOLOGY ASSESSMENT INITIATIVE IN KAZAKHSTAN
Authors: Muratov Sergei , Hailey David , Foerster Vicki , Brady Bruce , Juzwishin Don , la Fleur Philip , McGowan Jessie
Published: April 2014

Objectives: The aim of this study was to assist in the development of a health technology assessment (HTA) program for the Ministry of Health (MOH) of the Republic of Kazakhstan

Methods: Mentoring of an initial HTA program in Kazakhstan was provided by the Canadian Society for International Health (CSIH) by means of a partnership with the Kazakhstan MOH. HTA materials, courses, and one-on-one support for the preparation of a series of initial HTA reports by MOH HTA staff were provided by a seven-member CSIH team over a 2.5-year project.

Results: Guidance documents on HTA and institutional strengthening were prepared in response to an extensive set of deliverables developed by the MOH and the World Bank. Introductory and train-the-trainer workshops in HTA and economic evaluation were provided for MOH staff members, experts from Kazakhstan research institutes and physicians. Five short HTA reports were successfully developed by staff in the Ministry's HTA Unit with assistance from the CSIH team. Challenges that may be relevant to other emerging HTA programs included lack of familiarity with some essential underlying concepts, organization culture, and limited time for MOH staff to do HTA work.

Conclusions: The project helped to define the need for HTA and mentored MOH staff in taking the first steps to establish a program to support health policy decision making in Kazakhstan. This experience offers practical lessons for other emerging HTA programs, although these should be tailored to the specific context.
VALUE OF DATABASES OTHER THAN MEDLINE FOR RAPID HEALTH TECHNOLOGY ASSESSMENTS
Authors: Lorenzetti Diane L. , Topfer Leigh-Ann , Dennett Liz , Clement Fiona
Published: April 2014

Objectives:The objective of this study was to explore the degree to which databases other than MEDLINE contribute studies relevant for inclusion in rapid health technology assessments (HTA).

Methods:We determined the extent to which the clinical, economic, and social studies included in twenty-one full and four rapid HTAs published by three Canadian HTA agencies from 2007 to 2012 were indexed in MEDLINE. Other electronic databases, including EMBASE, were then searched, in sequence, to assess whether or not they indexed studies not found in MEDLINE. Assessment topics ranged from purely clinical (e.g., drug-eluting stents) to those with broader social implications (e.g., spousal violence).

Results:MEDLINE contributed the majority of studies in all but two HTA reports, indexing a mean of 89.6 percent of clinical studies across all HTAs, and 88.3 percent of all clinical, economic, and social studies in twenty-four of twenty-five HTAs. While EMBASE contributed unique studies to twenty-two of twenty-five HTAs, three rapid HTAs did not include any EMBASE studies. In some instances, PsycINFO and CINAHL contributed as many, if not more, non-MEDLINE studies than EMBASE.

Conclusions:Our findings highlight the importance of assessing the topic-specific relative value of including EMBASE, or more specialized databases, in HTA search protocols. Although MEDLINE continues to be a key resource for HTAs, the time and resource limitations inherent in the production of rapid HTAs require that researchers carefully consider the value and limitations of other information sources to identify relevant studies.
Rapid assessment of historic, current and future habitat quality for biodiversity around UK Natura 2000 sites
Authors: VOGIATZAKIS I. N. , STIRPE M. T. , RICKEBUSCH S. , METZGER M. J. , XU G. , ROUNSEVELL M. D. A. , BOMMARCO R. , POTTS S. G.
Published: April 2014

Changes in landscape composition and structure may impact the conservation and management of protected areas. Species that depend on specific habitats are at risk of extinction when these habitats are degraded or lost. Designing robust methods to evaluate landscape composition will assist decision- and policy-making in emerging landscapes. This paper describes a rapid assessment methodology aimed at evaluating land-cover quality for birds, plants, butterflies and bees around seven UK Natura 2000 sites. An expert panel assigned quality values to standard Coordination of Information on the Environment (CORINE) land-cover classes for each taxonomic group. Quality was assessed based on historical (1950, 1990), current (2000) and future (2030) land-cover data, the last projected using three alternative scenarios: a growth-applied strategy (GRAS), a business-as-might-be-usual (BAMBU) scenario, and sustainable European development goal (SEDG) scenario. A quantitative quality index weighted the area of each land-cover parcel with a taxa-specific quality measure. Land parcels with high quality for all taxonomic groups were evaluated for temporal changes in area, size and adjacency. For all sites and taxonomic groups, the rate of deterioration of land-cover quality was greater between 1950 and 1990 than current rates or as modelled using the alternative future scenarios (2000–2030). Model predictions indicated land-cover quality stabilized over time under the GRAS scenario, and was close to stable for the BAMBU scenario. The SEDG scenario suggested an ongoing loss of quality, though this was lower than the historical rate of c. 1% loss per decade. None of the future scenarios showed accelerated fragmentation, but rather increases in the area, adjacency and diversity of high quality land parcels in the landscape.
Assessment of therapeutic biomarkers in the treatment of children with postural tachycardia syndrome and vasovagal syncope
Authors: Lin Jing , Jin Hongfang , Du Junbao
Published: April 2014

Background: Postural tachycardia syndrome and vasovagal syncope are common causes of orthostatic intolerance in children. The supplementation with water, or salt, or midodrine, or β-blocker was applied to children with postural tachycardia syndrome or vasovagal syncope. However, the efficacy of such medication varied and was not satisfied. This review aimed to summarise the current biomarkers in the treatment of the diseases. Data sources: Studies were collected from online electronic databases, including OVID Medline, PubMed, ISI Web of Science, and associated references. The main areas assessed in the included studies were clinical improvement, the cure rate, and the individualised treatment for postural tachycardia syndrome and vasovagal syncope in children. Results: Haemodynamic change during head-up tilt test, and detection of 24-hour urinary sodium excretion, flow-mediated vasodilation, erythrocytic H2S, and plasma pro-adrenomedullin as biological markers were the new ways that were inexpensive, non-invasive, and easy to test for finding those who would be suitable for a specific drug and treatment. Conclusion: With the help of biomarkers, the therapeutic efficacy was greatly increased for children with postural tachycardia syndrome and vasovagal syncope.
Inverted left atrial appendage in an infant during cardiac surgery
Authors: Onan Ismihan S. , Haydin Sertac , Yeniterzi Mehmet
Published: April 2014

Inverted left atrial appendage is an unusual complication associated with congenital cardiac surgery. Inversion of the left atrial appendage may occur during the surgical procedure or afterwards. The left atrial appendage may invert iatrogenically or as a result of the negative pressure during placement or removal of the left atrial vent or during deairing manoeuvres. This event can be life-threatening because of the mass effect of the atrial appendage within the left atrial cavity.
Clinical and angiographic follow-up of coronary artery fistula interventions in children: techniques and classification revisited
Authors: Thakkar Bhavesh , Patel Nehal , Poptani Vishal , Madan Tarun , Saluja Tarandip , Shukla Anand , Oswal Nilesh , Bisnoi Arvind
Published: April 2014

Background: Transcatheter closure of coronary artery fistula has emerged as a safe and effective alternative to surgery. However, follow-up angiographic data after closure of the coronary artery fistula is extremely limited. We report our clinical and angiographic follow-up of children who underwent either transcatheter or surgical closure. Method: Clinical profile, echocardiography parameters, and closure technique were retrospectively reviewed from the hospital charts. Since 2007, 15 children have been intervened and followed up with electrocardiography, echocardiography, and angiography. Results: A total of 15 children (six girls), with mean age of 6.7±5.4 years and weighing 16.3±9.8 kg, underwent successful closure (transcatheter=13, surgical=2) without periprocedural complication. Coronary artery fistula arose from the right (n=7) and left coronary artery (n=8) and drained into the right atrium or the right ventricle. Transcatheter closure was carried out using a duct occluder. Of the patients, two underwent surgical closure of the fistula on a beating heart. At 31.8±18.7 months follow-up, all the children were asymptomatic and had no evidence of myocardial ischaemia or infarction. However, follow-up angiography revealed thrombotic occlusion of fistula with the patent parent coronary artery in those having branch coronary artery fistula, and five of seven patients with parent coronary artery fistula had near-complete occlusion of fistula extending into the native coronary artery. Conclusion: Follow-up angiography revealed a high incidence of parent artery occlusion when the fistula was arising from the native artery and not from one of its branches. Coronary artery fistula intervention of the parent coronary artery fistula always carries the potential risk of ischaemia, unless the distal-most exiting segment is the primary site of occlusion.
Absence of association of FCGR2A gene polymorphism rs1801274 with Kawasaki disease in Greek patients
Authors: Chatzikyriakidou Anthoula , Aidinidou Louiza , Giannopoulos Andreas , Papadopoulou-Legbelou Kyriaki , Kalinderi Kallirhoe , Fidani Liana
Published: April 2014

Kawasaki disease is an acute, febrile syndrome in infancy, characterised by vasculitis of medium-sized arteries, and affects predominantly young children. Family-based studies on Kawasaki disease supports the contribution of genetic factors in disorder manifestation. In a recent genome-wide association study, the polymorphism rs1801274 of FCGR2A [Fc fragment of immunoglobulin G, low-affinity IIa, receptor] gene has been implicated in disease pathogenesis. The aim of the present study was to explore the association of this variant, for the first time, in a group of Kawasaki-diseased patients of Greek origin. A total of 47 Kawasaki-diseased children and 50 control subjects were enrolled in the study. Polymerase chain reaction–restriction fragment length polymorphism assay was performed in rs1801274 genotyping. No association was observed between this polymorphism genotypes’ or alleles’ distribution between Kawasaki-diseased patients and controls. Furthermore, no association was revealed between this polymorphism and cardiovascular complications in Kawasaki-diseased patients. In the literature, the reported data over this polymorphism association with Kawasaki disease in Caucasian patients are contradictory. In addition, the disease shows low prevalence in the Caucasian populations. Therefore, the independent genetic association studies on rs1801274 with Kawasaki disease in various Caucasian groups increase the amount of genetic data, which could be used in a future meta-analysis, increasing the statistical power of the resultant conclusions.