bluuebunny/crossref_metadata_2025 huggingface dataset:
The Efficacy and the Safety of Prophylactic N-Butyl-2-Cyanoacrylate Injection for Gastric Varices Using a Modified Injection Technique
Authors: Ni Zhen , Chen Hongbin , Tang Shanhong , Zeng Weizheng , Xu Hui
Published: July 2016

Background:

Primary prophylactic N-butyl-2-cyanoacrylate (NBC) injection for nonbleeding gastric varices (GVs) remains controversial. In addition, there is still no consensus concerning the technique, its safety, and long-term results.

Aim:

To analyze the safety and the efficacy of NBC for primary prophylaxis of GVs using a modified injection technique.

Methods:

Between February 2004 and June 2014, a total of 72 patients with GVs with a high risk of bleeding, who received undiluted NBC injection using a modified “sandwich” method for primary prophylaxis in General Hospital of Chengdu Military Command, were enrolled in this retrospective study. All patients were followed up at 1 to 2 weeks, 3 months, 6 months, and thereafter every 6 months or whenever required, using endoscope detection. The rate of obliteration, bleeding, recurrence, and complications was evaluated.

Results:

According to the standard Sarin classification, 28 patients were IGV1 and 44 patients were GEV2. Hepatitis B virus infection was the major cause of portal hypertension. The mean number of sessions were 1.4 (1 to 3) and the mean volume of NBC per session was 3.5 mL (1 to 6 mL). One injection per session was used in 41 patients (56.9%) and 2 or more injections were used in the remaining 31 patients (43.1%). During the follow-up (27 mo; range, 12 to 67 mo), complete obliteration of GVs was achieved in 93.1% of the patients (67/72). One session of NBC injection was enough to obliterate GVs in 49 patients (68.1%), and 2 or more sessions were needed in 23 patients (31.9%). In addition, the bleeding and the recurrence rate were 11.1% (8/72) and 15.3% (11/72), respectively, during the follow-up. The cumulative bleeding-free rate at 1, 3, and 5 years was 95.8%, 91.7%, and 88.9%, respectively. Worsening of esophageal varices was observed in 13 patients (9 in GEV2 and 4 in IGV1). No serious complications, such as distal embolism, were observed in all patients.

Conclusions:

Prophylactic endoscopic NBC injection using a modified injection technique may be a safe and effective treatment for gastric fundal varices with a high risk of bleeding.
Recent developments in muscle imaging of neuromuscular disorders
Authors: Fischer Dirk , Bonati Ulrike , Wattjes Mike P.
Published: July 2016

Purpose of review

In this update, we describe recent findings on imaging techniques used for the analysis and quantification of affected muscles, advances in pattern recognition, and quantitative muscle imaging in clinical studies.

Recent findings

Whole-body muscle MRI and meta-analytical approaches, so-called (hierarchical) heat maps of affected muscles are promising advances compared with commonly applied lower leg pattern recognition approaches. Muscle fat fraction assessments measuring chemical shift differences and T2-relaxation times of separated fat and water components in skeletal muscle are currently the most reliable quantitative muscle imaging techniques. Quantitative muscle MRI detects subclinical disease progression in muscular dystrophies and is a powerful surrogate outcome measure in clinical trials.

Diagnostic and quantitative muscular imaging techniques are increasingly important for diagnostic workup and for interventional studies in patients with inherited myopathies.
Parents' perspectives on a collaborative approach to the application of the Handwriting Without Tears® programme with children with Down syndrome
Authors: Patton Sandra , Hutton Eve
Published: July 2016

Background

The active involvement of parents and children in goal setting and intervention is integral to contemporary occupational therapy process models. However, parental perspectives on collaborative handwriting intervention are limited. This paper presents parental perspectives on a three‐way collaboration involving teachers, parents and an occupational therapist in the application of Handwriting Without Tears® (HWT®) with children with Down syndrome.

Methods

Within a larger mixed methods study, 44 parents completed purpose‐designed questionnaires and six parents participated in a focus group, post 8 months of programme implementation. Both methods gathered parent's perspectives on the usefulness and limitations of applying HWT®. The focus group explored collaboration in depth. Analysis involved triangulation of data from descriptive analysis of numerical data with content analysis of open‐ended questions and focus group data.

Findings

Enablers of parent–child engagement in HWT® were identified as; the parent–child‐friendly aspects of HWT®, the teacher involvement ensuring continuity which eased demands on parents, the ongoing support/guidance of the occupational therapist and the child's involvement in HWT® group intervention. The occupational therapists' involvement was reported as essential to encouraging teacher/parent involvement. Barriers to child–parent engagement included fluctuations in child health, mood, attention span and time limitations including the child's involvement in other therapy programmes.

Conclusions

Parents perceived the HWT® and the three‐way collaborative approach as enabling active parent–child engagement in handwriting intervention. This approach warrants further investigation. Findings have the potential to inform practice guidelines and pre‐ and post‐graduation education related to collaborative handwriting intervention with children with Down syndrome and their families.
Transient scrotal hyperthermia affects human sperm DNA integrity, sperm apoptosis, and sperm protein expression
Authors: Rao M. , Xia W. , Yang J. , Hu L.‐X. , Hu S.‐F. , Lei H. , Wu Y.‐Q. , Zhu C.‐H.
Published: July 2016

This prospective randomized clinical study is aimed to evidence the reproductive impairment of frequent scrotal heat exposure. A total of 20 normozoospermic subjects were randomly divided into two groups to undergo testicular warming in a 43 °C water bath 10 times, for 30 min each time; the subjects in group 1 underwent testicular warming for 10 consecutive days and those in group 2 once every 3 days. Sperm chromatin structure assay (SCSA), sperm mitochondrial membrane potential (MMP), apoptosis, and seminal plasma‐soluble Fas (sFas) were analyzed before treatment and every 2 weeks after, for a total of 10 times. In group 1, some critical proteins involved in heat stress, hypoxia, structure, and function of sperm mitochondria and flagella were evaluated before hyperthermia and 2, 6, 10, and 16 weeks after hyperthermia. Both groups showed a reversible increase in the proportion of spermatozoa with a disrupted MMP (both p < 0.05 when the minimums were compared with baseline levels, the same below), sperm apoptosis (both p < 0.01) and high DNA stainability (both p < 0.05). The sFas concentration in both groups showed no obvious changes except one: the value at week 2 was significantly increased over baseline in group 1 (p = 0.036). The level of Bcl‐2 decreased significantly at weeks 6 and 10 (p = 0.017 and 0.05, respectively) and recovered to baseline at week 16. Proteins involved in heat stress and mitochondria functions were up‐regulated, whereas in flagella structure and function was down‐regulated (all p < 0.05). This study demonstrated that transient and frequent scrotal hyperthermia severely and reversibly damaged spermatogenesis, consecutive heat exposure had more serious effects than intermittent exposure, whereas intermittent exposure led to a later recovery of sperm damage.
Pre‐Feedback Risk Expectancies and Reception of Low‐Risk Health Feedback: Absolute and Comparative Lack of Reassurance
Authors: Gamp Martina , Renner Britta
Published: July 2016

Background

Personalised health‐risk assessment is one of the most common components of health promotion programs. Previous research on responses to health risk feedback has commonly focused on the reception of bad news (high‐risk feedback). The reception of low‐risk feedback has been comparably neglected since it is assumed that good news is reassuring and readily received. However, field studies suggest mixed responses to low‐risk health feedback. Accordingly, we examine whether pre‐feedback risk expectancies can mitigate the reassuring effects of good news.

Methods

In two studies (N = 187, N = 565), after assessing pre‐feedback risk expectancies, participants received low‐risk personalised feedback about their own risk of developing (the fictitious) Tucson Chronic Fatigue Syndrome (TCFS). Study 2 also included peer TCFS risk status feedback. Afterwards, self‐ and peer‐related risk perception for TCFS was assessed.

Results

In both studies, participants who expected to be at high risk but received good news (unexpected low‐risk feedback) showed absolute lack of reassurance. Specifically, they felt at significantly greater TCFS risk than participants who received expected good news. Moreover, the unexpected low‐risk group even believed that their risk was as high as (Study 1) or higher (Study 2) than that of their peers (comparative lack of reassurance).

Conclusion

Results support the notion that high pre‐feedback risk expectancies can mitigate absolute and comparative reassuring effects of good news.
Rail‐suicide prevention: Systematic literature review of evidence‐based activities
Authors: Barker Emma , Kolves Kairi , De Leo Diego
Published: July 2016

Background

Rail‐related suicide is a relatively rare but extremely lethal method of suicide that can have far‐reaching consequences.

Objective

The aim of the systematic literature review was to analyze the existing literature on the effectiveness of rail‐suicide prevention activities.

Data sources

Databases used were Scopus, Medline, and ProQuest.

Search terms

The search terms used were “suicid*,” “prevent*,” “rail*,” or “train.”

Eligibility criteria

English‐language studies published in peer‐reviewed journals between 1 January 1990 and 30 April 2015 that presented an overview of rail‐related suicide prevention activities and included an analysis of effectiveness were used.

Results

We retrieved 1,229 results in the original search with nine papers presenting empirical evidence. Three studies in the review analyzed the effectiveness of platform screen doors and another three analyzed the installation of blue lights, two papers analyzed the effectiveness of suicide pits, and one included the influence of media reporting guidelines.

Conclusion

Platform screen doors, suicide pits, blue lights, and improved media guidelines all have the potential to reduce rail‐related suicide events and deaths.

Limitations

The review was restricted to English‐language peer‐reviewed papers published within the chosen time period.
Blood pressure‐lowering effects of sulodexide depend on albuminuria severity: post hoc analysis of the sulodexide microalbuminuria and macroalbuminuria studies
Authors: Olde Engberink Rik H. G. , Heerspink Hiddo J. L. , de Zeeuw Dick , Vogt Liffert
Published: July 2016

Aims

It has been suggested that sulodexide is able to lower blood pressure (BP). This may be attributed to its ability to restore the endothelial surface layer (ESL). As ESL perturbation is known to be related to the degree of kidney damage, we investigated whether albuminuria, reflecting ESL status, modified the BP‐lowering potential of sulodexide.

Methods

A post hoc analysis of the double‐blind, randomized, placebo‐controlled sulodexide microalbuminuria (Sun‐MICRO) and macroalbuminuria (Sun‐MACRO) studies, including 1056 microalbuminuric and 843 macroalbuminuric subjects with type 2 diabetes receiving maximal tolerated renin–angiotensin‐aldosterone system inhibitor therapy, was carried out. We compared the effect of placebo and sulodexide on systolic BP (SBP) among albuminuria groups.

Results

Analysis of covariance, including data from both trials, showed that baseline urine albumin‐to‐creatinine ratio (UACR) was the only modifier of the SBP response (interaction with treatment P = 0.001). In subjects with an UACR >1000 mg g–1, sulodexide lowered SBP by 4.6 mmHg [95% confidence interval (CI) 3.6, 5.6; P < 0.001] compared with placebo, whereas a 2.3 mmHg (95% CI 0.9,3.7; P = 0.001) reduction was seen in subjects with a UACR of 300–1000 mg g–1. Sulodexide did not lower SBP in subjects with a UACR <300 mg g–1 (−0.2 mmHg, 95% CI −0.8, 0.5; P = 0.60). SBP‐lowering effects were not accompanied by changes in body weight.

Conclusion

The BP‐reducing potency of sulodexide is modified by the degree of albuminuria in subjects with type 2 diabetes. As ESL status deteriorates with increasing albuminuria and nephropathy severity, this suggests that ESL restoration may represent a new target for BP treatment in subjects with diabetic nephropathy.
Cesarean Birth Regret and Dissatisfaction: A Qualitative Approach
Authors: Burcher Paul , Cheyney Melissa J. , Li Kalie N. , Hushmendy Shazeen , Kiley Kevin C.
Published: July 2016

Background

The most consistently noted difference between unplanned cesarean and vaginal births is patient dissatisfaction or regret. This has been explored in multiple quantitative studies. However, the causes of this dissatisfaction remain elusive as a result of the limitations of survey instruments that restrict possible choices.

Methods

Using open‐ended, semi‐structured interviews (n = 14), the purpose of this study was to identify potentially alterable factors that contribute to cesarean section regret when the surgery is performed during labor. In interviews that took place between 2 and 6 weeks postpartum, patients who had undergone an unscheduled cesarean birth during labor and had volunteered for the study were asked to share the story of their birth. Each participant was prompted to describe her understanding of the indication for her cesarean, and reflect on what felt positive and negative about her experience. Using consensus coding, three investigators independently evaluated the transcribed interviews, identifying recurring themes that were then discussed until consensus on the major themes was achieved.

Results

Four key themes emerged from patients’ unplanned cesarean narratives: poor communication, fear of the operating room, distrust of the medical team, and loss of control. Lack of or incomplete trust in care providers was a new factor not previously recognized as a cause of distress or dissatisfaction in the literature to date.

Conclusion

The four factors identified in this study are all potentially ameliorable, suggesting that changes in physician behavior may reduce patient dissatisfaction with unplanned cesarean birth.
Inflammation, vitamin D and dendritic cell precursors in chronic kidney disease
Authors: Paul K , Franke S , Nadal J , Schmid M , Yilmaz A , Kretzschmar D , Bärthlein B , Titze S , Koettgen A , Wolf G , Busch M
Published: July 2016

Decreased blood dendritic cell precursors (DCP) count is linked with atherosclerotic disease, while reduction of circulating DCP is also seen in patients with chronic kidney disease (CKD). As poor vitamin D status could be linked to a compromised innate immune response, we hypothesized that vitamin D status might be involved in the decrease in circulating DCP in CKD. Moreover, the potential role of inflammation was considered. Circulating myeloid (mDCP), plasmacytoid (pDCP) and total DCP (tDCP) were analysed using flow cytometry in 287 patients with CKD stage 3. Serum 25(OH)D and 1,25(OH)2D levels were measured using enzyme-linked immunosorbent assays (ELISA), interleukin (IL)-6, IL-10 and tumour necrosis factor (TNF)-α using cytometric bead array, C-reactive protein (CRP) using a high-sensitivity (hs) ELISA. Contrary to our hypothesis, there was no association between vitamin D levels and DCP, although their number was decreased significantly in CKD (P < 0·001). Instead, mDCP (r = −0·211) and tDCP (r = −0·188,) were associated slightly negatively with hsCRP but positively with the estimated glomerular filtration rate (eGFR, r = 0·314 for tDCP). According to multivariate linear regression, only higher hsCRP concentration and the presence of diabetes mellitus had a significant negative influence on DCP count (P < 0·03, respectively) but not vitamin D, age and eGFR. A significant impact of vitamin D on the reduction of circulating DCP in CKD 3 patients can be neglected. Instead, inflammation as a common phenomenon in CKD and diabetes mellitus had the main influence on the decrease in DCP. Thus, a potential role for DCP as a sensitive marker of inflammation and cardiovascular risk should be elucidated in future studies.
The Role of Group II Metabotropic Glutamate Receptors in the Striatum in Electroacupuncture Treatment of Parkinsonian Rats
Authors: Jia Yan‐Jun , Deng Jia‐Hui , Zhang Wen‐Zhong , Sun Zuo‐Li , Yang Jian , Yu Yan , Gong Xiao‐Li , Jia Jun , Wang Xiao‐Min
Published: July 2016

Aims

Glutamatergic transmission may play a critical role in the pathogenesis of Parkinson's disease (PD). Electroacupuncture (EA) has been demonstrated to effectively alleviate PD symptoms. In this study, a potential glutamate‐dependent mechanism underlying the therapeutic action of EA was investigated.

Methods

The effects of EA stimulation on motor behaviors, dopamine contents, glutamate release, and group II metabotropic glutamate receptor (mGluR2/3) expression in unilateral 6‐hydroxydopamine (6‐OHDA)‐lesioned rats were examined.

Results

Unilateral 6‐OHDA lesions of the nigrostriatal system caused a marked increase in glutamate content in the ipsilateral cortex and striatum. mGluR2/3 protein expression and mGluR3 mRNA expression were reduced in the striatum. Noticeably, prolonged EA stimulation at 100 Hz significantly reversed these changes in the striatal glutamate system. Behaviorally, EA improved the motor deficits induced by 6‐OHDA lesions. Intrastriatal infusion of an mGluR2/3 antagonist APICA blocked the improving effect of EA.

Conclusions

These data collectively demonstrate that the group II mGluR‐mediated glutamatergic transmission in the striatum is sensitive to dopamine depletion and may serve as a substrate of EA for mediating the therapeutic effect of EA in a rat model of PD.
Developing a theory of change for a community‐based response to illegal wildlife trade
Authors: Biggs Duan , Cooney Rosie , Roe Dilys , Dublin Holly T. , Allan James R. , Challender Dan W.S. , Skinner Diane
Published: July 2016

The escalating illegal wildlife trade (IWT) is one of the most high‐profile conservation challenges today. The crisis has attracted over US$350 million in donor and government funding in recent years, primarily directed at increased enforcement. There is growing recognition among practitioners and policy makers of the need to engage rural communities that neighbor or live with wildlife as key partners in tackling IWT. However, a framework to guide such community engagement is lacking. We developed a theory of change (ToC) to guide policy makers, donors, and practitioners in partnering with communities to combat IWT. We identified 4 pathways for community‐level actions: strengthen disincentives for illegal behavior, increase incentives for wildlife stewardship, decrease costs of living with wildlife, and support livelihoods that are not related to wildlife. To succeed the pathways, all require strengthening of enabling conditions, including capacity building, and of governance. Our ToC serves to guide actions to tackle IWT and to inform the evaluation of policies. Moreover, it can be used to foster dialogue among IWT stakeholders, from local communities to governments and international donors, to develop a more effective, holistic, and sustainable community‐based response to the IWT crisis.
Safety of hyperbaric oxygen therapy for management of central airway stenosis after lung transplant
Authors: Mahmood Kamran , Kraft Bryan D. , Glisinski Kristen , Hartwig Matthew G. , Harlan Nicole P. , Piantadosi Claude A. , Shofer Scott L.
Published: July 2016

Background

Central airway stenosis (CAS) is common after lung transplantation and causes significant post‐transplant morbidity. It is often preceded by extensive airway necrosis, related to airway ischemia. Hyperbaric oxygen therapy (HBOT) is useful for ischemic grafts and may reduce the development of CAS.

Methods

The purpose of this study was to determine whether HBOT could be safely administered to lung transplant patients with extensive necrotic airway plaques. Secondarily, we assessed any effects of HBOT on the incidence and severity of CAS.

Patients with extensive necrotic airway plaques within 1–2 months after lung transplantation were treated with HBOT along with standard care. These patients were compared with a contemporaneous reference group with similar plaques who did not receive HBOT.

Results

Ten patients received HBOT for 18.5 (interquartile range, IQR 11–20) sessions, starting at 40.5 (IQR 34–54) days after transplantation. HBOT was well tolerated. Incidence of CAS was similar between HBOT‐treated patients and reference patients (70% vs 87%, respectively; P=.34), but fewer stents were required in HBOT patients (10% vs 56%, respectively; P=.03).

Conclusions

This pilot study is the first to demonstrate HBOT safety in patients who develop necrotic airway plaques after lung transplantation. HBOT may reduce the need for airway stent placement in patients with CAS.
Key donor factors associated with graft loss among liver transplant recipients with human immunodeficiency virus
Authors: Campos‐Varela Isabel , Dodge Jennifer L. , Stock Peter G. , Terrault Norah A.
Published: July 2016

Background

Human immunodeficiency virus (HIV)‐infected liver transplant (LT) recipients have higher risk of graft loss than HIV‐uninfected recipients. As the original donor risk index excluded HIV‐positive patients, donor factors associated with graft loss in HIV‐positive recipients are unknown.

Methods

Identifying all HIV‐positive patients in the Scientific Registry of Transplant Recipients, supplemented by all HIV‐infected patients in the solid organ transplantation in HIV: Multi‐Site Study (HIV‐TR), we evaluated donor factors associated with graft loss among HIV‐positive recipients transplanted between March 2002 and August 2012.

Results

A total of 249 HIV‐positive LT recipients were followed for median 2.4 (interquartile range [IQR]: 0.8–4.9) years. In univariate analysis, donor diabetes (HR=2.09; P=.002) and donor hypertension (HR=1.43; P=.048) were significantly associated with graft loss, and African‐American (AA) recipient:non‐AA donor race mismatch (HR=1.60; P=.07), other cause of donor death compared to trauma (HR=2.02; P=.09), and donor age 30 years or older (HR=1.53; P=.05) were of borderline significance. In multivariate analysis, donor diabetes (HR=2.12; 95% CI: 1.33–3.38; P=.002) was the only significant predictor of graft loss.

Conclusion

In HIV‐positive LT recipients, risk of graft loss is strongly influenced by donor diabetes. This information may be useful to transplant physicians seeking to optimize overall graft survival in their HIV‐positive LT recipients.
Extracorporeal life support in lung and heart–lung transplantation for pulmonary hypertension in adults
Authors: Kortchinsky Talna , Mussot Sacha , Rezaiguia Saïda , Artiguenave Margaux , Fadel Elie , Stephan François
Published: July 2016

After bilateral lung and heart–lung transplantation in adults with pulmonary hypertension, hemodynamic and oxygenation deficiencies are life‐threatening complications that are increasingly managed with extracorporeal life support (ECLS). The primary aim of this retrospective study was to assess 30‐day and 1‐year survival rates in patients managed with vs without post‐operative venoarterial ECLS in 2008–2013. The secondary endpoints were the occurrence rates of nosocomial infection, bleeding, and acute renal failure. Of the 93 patients with pulmonary hypertension who received heart‐lung (n=29) or bilateral lung (n=64) transplants, 28 (30%) required ECLS a median of 0 [0–6] hours after surgery completion and for a median of 3.0 [2.0–8.5] days. Compared to ECLS patients, controls had higher survival at 30 days (95.0% vs 78.5%; P=.02) and 1 year (83% vs 64%; P=.005), fewer nosocomial infections (48% vs 79%; P=.0006), and fewer bleeding events (17% vs 43%; P=.008). The need for renal replacement therapy was not different between groups (11% vs 17%; P=.54). Venoarterial ECLS is effective in treating pulmonary graft dysfunction with hemodynamic failure after heart‐lung or bilateral lung. However, ECLS use was associated with higher rates of infection and bleeding.
Nutritional versus genetic correlates of caste differentiation in a desert ant
Authors: AMOR FERNANDO , VILLALTA IRENE , DOUMS CLAUDIE , ANGULO ELENA , CAUT STEPHANE , CASTRO SARA , JOWERS MICHAEL J. , CERDÁ XIM , BOULAY RAPHAËL
Published: July 2016

1. In many ant species, caste differentiation stems from trophic differences at the larval stage. Adult workers that feed larvae have great control over the allocation of colony resources to growth (production of workers) versus reproduction (production of queens). However, larval caste fate may also be constrained very early on through direct genetic effects or non‐genetic maternal effects.

2. Here, we combined isotopic and genetic analyses to study the developmental origin of queens and workers in a desert‐dwelling ant, Cataglyphis tartessica (Amor & Ortega, 2014). Queens do not found new colonies alone but rather disperse with workers. As the latter are always wingless, selection pressures on specific queen traits such as flight ability have become relaxed. Though the phylogenetically related species, C. emmae (Forel, 1909) only produces winged queens much larger than workers, C. tartessica produces two types of small queens relative to workers: brachypterous (short‐winged) queens and permanently apterous ergatoid (wingless and worker‐like) queens.

3. Upon emergence, workers and ergatoids have similar δ15N isotopic values, which were lower than those of brachypters, suggesting the latter are fed more protein as larvae. Microsatellite analyses indicated that: (i) colonies are mostly monogynous and monandrous; (ii) both ergatoids and brachypters are equally related to workers; and (iii) in the few polyandrous colonies, patrilines were evenly represented across workers, brachypters and ergatoids.

4. Overall, there was no evidence of genetic caste determination. We suggest that, in contrast to brachypters, ergatoids are selfish individuals that escape the nutritional castration carried out by workers and develop into queens in spite of the colony's collective interests.
A new clinical score for the prognosis of status epilepticus in adults
Authors: González‐Cuevas M. , Santamarina E. , Toledo M. , Quintana M. , Sala J. , Sueiras M. , Guzman L. , Salas‐Puig J.
Published: July 2016

Background and purpose

The severity of status epilepticus (SE) has an important impact in clinical outcomes. The Status Epilepticus Severity Score (STESS) is a score for predicting mortality in SE at admission. The baseline modified Rankin Scale (mRS) might be a prognostic factor for assessing the short‐tem outcomes of SE. Therefore, our aim was to evaluate the effectiveness of mRS and whether its addition to the STESS improves the prediction of mortality.

Methods

Consecutive patients with SE and aged >16 years were recruited during 3 years. Receiver operating characteristic curves and a logistic regression model were developed to estimate the scores of the new score, designated as modified STESS (mSTESS), and it was subsequently compared with the STESS.

Results

In all, 136 patients were included. Mean age was 62.01 ± 17.62 (19–95) years, and 54% were male. The capacity of the STESS to predict mortality was 74.3% (95% confidence interval 63.8%–81.8%), whilst the capacity of the mRS to predict mortality was 65.2% (95% confidence interval 54.2%–76.2%). The logistic regression model and receiver operating characteristic curves enabled the classification of mRS as follows: 0, mRS = 0; 1, mRS = 1–3; and 2, mRS > 3. These values, when added to the other items of the STESS, resulted in the mSTESS with scores between 0 and 8 points. The capacity of the mSTESS to predict mortality was 80.1%. An mSTESS > 4 established an overall accuracy of 81.8% for predicting mortality, which was considerably higher than the overall accuracy of STESS ≥ 3 (59.6%).

Conclusions

The baseline mRS was associated with high mortality risk. It is proposed to use mSTESS to improve the prediction of mortality risk in SE.
Nerve conduction velocity in CMT1A: what else can we tell?
Authors: Manganelli F. , Pisciotta C. , Reilly M. M. , Tozza S. , Schenone A. , Fabrizi G. M. , Cavallaro T. , Vita G. , Padua L. , Gemignani F. , Laurà M. , Hughes R. A. C. , Solari A. , Pareyson D. , Santoro L. ,   the CMT‐TRIAAL and CMT‐TRAUK Group
Published: July 2016

Background and purpose

Charcot‐Marie‐Tooth disease (CMT) type 1A is characterized by uniformly reduced nerve conduction velocity (NCV) that is fully penetrant since the first years of life, remains fairly stable through the life and does not correlate with disability whereas compound muscular action potential (CMAP) amplitude does. The aim of the present study was to analyze the large amount of electrophysiological data collected in the ascorbic acid trial in Italy and the UK (CMT‐TRIAAL/CMT‐TRAUK) and to use these data to gain insights into the pathophysiology of NCV in CMT1A.

Methods

Baseline electrophysiological data from 271 patients were analysed. Electrophysiological recordings were taken from the motor ulnar, median and peroneal nerves and the sensory ulnar nerve. Distal motor latency (DML), motor (MNCV) and sensory (SNCV) nerve conduction velocity, and amplitudes of CMAPs and sensory action potentials were assessed. Electrophysiological findings were correlated with age of patients at examination and the Charcot–Marie−Tooth Examination Score (CMTES).

Results

NCV was markedly and uniformly reduced. CMAP amplitudes were overall reduced but more severely in lower limbs. DML decreased and MNCV and SNCV increased with age of the patients, whereas CMAP amplitudes worsened with age and also correlated with CMTES.

Conclusions

This is the largest sample of electrophysiological data obtained so far from CMT1A patients. Axonal degeneration as assessed by means of CMAP amplitude reflected clinical impairment and was consistent with a slowly progressive length‐dependent neuropathy. All patients typically had markedly slowed NCV that did, however, slightly increase with age of the patients. The improvement of NCV might depend on myelin thickness remodelling that occurs during the adult life of CMT1A patients.
Grazing intensity significantly affects belowground carbon and nitrogen cycling in grassland ecosystems: a meta‐analysis
Authors: Zhou Guiyao , Zhou Xuhui , He Yanghui , Shao Junjiong , Hu Zhenhong , Liu Ruiqiang , Zhou Huimin , Hosseinibai Shahla
Published: July 2016

Livestock grazing activities potentially alter ecosystem carbon (C) and nitrogen (N) cycles in grassland ecosystems. Despite the fact that numerous individual studies and a few meta‐analyses had been conducted, how grazing, especially its intensity, affects belowground C and N cycling in grasslands remains unclear. In this study, we performed a comprehensive meta‐analysis of 115 published studies to examine the responses of 19 variables associated with belowground C and N cycling to livestock grazing in global grasslands. Our results showed that, on average, grazing significantly decreased belowground C and N pools in grassland ecosystems, with the largest decreases in microbial biomass C and N (21.62% and 24.40%, respectively). In contrast, belowground fluxes, including soil respiration, soil net N mineralization and soil N nitrification increased by 4.25%, 34.67% and 25.87%, respectively, in grazed grasslands compared to ungrazed ones. More importantly, grazing intensity significantly affected the magnitude (even direction) of changes in the majority of the assessed belowground C and N pools and fluxes, and C : N ratio as well as soil moisture. Specifically,light grazing contributed to soil C and N sequestration whereas moderate and heavy grazing significantly increased C and N losses. In addition, soil depth, livestock type and climatic conditions influenced the responses of selected variables to livestock grazing to some degree. Our findings highlight the importance of the effects of grazing intensity on belowground C and N cycling, which may need to be incorporated into regional and global models for predicting effects of human disturbance on global grasslands and assessing the climate‐biosphere feedbacks.
Large‐scale chemical stratification of fluids in the crust: hydraulic and chemical data from the geothermal research site Urach, Germany
Authors: Bucher K. , Stober I.
Published: July 2016

The Urach 3 research borehole in SW Germany has been drilled through a sedimentary cover sequence and reached gneisses of the Variscan crystalline basement at 1604 m below surface. An additional 2840 m has been drilled through fractured basement rocks. The borehole has been used for hydraulic tests in the context of a ‘hot dry rock’ (HDR) project. The sedimentary cover ranges from the Carboniferous to the Middle Jurassic (Dogger) in age and comprises mostly clastic sediments in the Paleozoic and limestone and shale in the Mesozoic. Water composition data from 10 different depths include samples from all major lithological units. The total dissolved solids (TDS) increases from the surface to about 650 m where it reaches 4.1 g l−1 in Triassic limestone. In lower Triassic sandstones, TDS increases very sharply to 28.5 g l−1 and the water is saturated with pure CO2 gas. With increasing depth, TDS does not change much in the clastic sediments of the Permian and Carboniferous. The crystalline basement is marked by a very sharp increase in TDS to 55.5 g l−1 at about 1770 m depth. TDS increases within the basement to more than 78.5 g l−1 at about 3500 m depth. The data suggest that there is limited vertical chemical communication over long periods of time. The CO2 gas cap in the lower Triassic sandstones requires a gastight cover. The chemical stratification of the fluids relates to the permeability structure of the crust at the Urach site and fits well with hydraulic and thermal data from the site.
Do Top 10 Lists of Daily Stock Returns Attract Investor Attention? Evidence from a Natural Experiment
Authors: Peng Diefeng , Rao Yulei , Wang Mei
Published: July 2016

Using the upper price limit‐hitting events, in the Shanghai Stock Exchange in China, as the basis for comparison, we find that limit‐hitting stocks in the top 10 ranking list of daily returns attract more investors' attention, and bring about significant abnormal return in excess of those list‐excluded limit‐hitting stocks. The result is robust after controlling for firm characteristics and market states. Furthermore, the attention distinction caused by the ranking lists is unlikely to be distracted by simultaneous events. Overall, the previous empirical evidence about the ranking lists basically supports the investor attention hypothesis.
Pulmonary changes in Norwegian fatal cases of pandemic influenza H1N1 (2009) infection: a morphologic and molecular genetic study
Authors: Voltersvik Pål , Aqrawi Lara A. , Dudman Susanne , Hungnes Olav ,   Norwegian Lung Pathology Group, Bostad Leif , Brokstad Karl A. , Cox Rebecca J.
Published: July 2016

Background

During the pandemic outbreak of the 2009 swine influenza (A(H1N1)pdm09), 32 fatal cases occurred in Norway and 19 of these were included in this study.

Objectives

We characterised pulmonary changes in these fatal Norwegian cases.

Patients and Methods

Upon hospitalisation, detailed clinical information and specimens from the upper and lower respiratory pathways were collected. At post‐mortem, lung tissue was collected, formalin‐fixed and paraffin‐embedded. Immunohistochemical and light microscopic examination was performed to visualise the local expression of the A(H1N1)pdm09 virus. Reverse transcription‐polymerase chain reaction (RT‐PCR) and pyrosequencing of the non‐fixed specimens allowed the identification of mutations in the influenza virus surface glycoprotein (haemagglutinin gene) particularly at position 222.

Results and Conclusions

The overall course of illness lasted from 2 to 40 days (median 9 days). Diffused alveolar damage (DAD) was evident in 11 cases, 4 of which had no apparent underlying illness. Obesity was prominent in 12 cases, where three individuals were classified as otherwise healthy. The HA D222G mutation was detected in six cases, 3 of which had no underlying illness. Immunohistochemistry showed the A(H1N1)pdm09 virus to be prominent at the site of inflammation both in close proximity to and inside alveolar structures in the lung tissue. In addition to a possible role for the HA D222G mutation, our findings indicate that host factors and underlying conditions in the infected individuals are fundamental for disease outcome in many cases. This study increases our understanding of determinants for the clinical outcome of pandemic influenza, which could guide future treatment.
On the volatility of blood inventories
Authors: Clay Nigel M. , Abbasi Babak , Eberhard Andrew , Hearne John
Published: July 2016

Past research underestimates the volatility of blood inventories. Models are calibrated to be correct on average, but average behavior does not capture the risk of blood inventories to experience outdates or shortages. Volatility in blood inventories arises from stochastic supply, stochastic demand, perishability and blood‐issuing policies. However, these are not exhaustive as the logistics or the supply chain can cause dynamic behavior even without stochastic supply and demand. We use system dynamics to illustrate the response of the blood supply chain to disturbances. This approach captures delays and feedback not previously incorporated into blood supply models. First, we show that the structure of the system itself can cause volatility. Then, we propose a modification to ameliorate volatility. It is hoped that similar changes to real blood inventory systems might improve the robustness of the blood supply chain to shocks, thereby reducing shortages and outdates.
Interankle Systolic Blood Pressure Difference Is a Marker of Prevalent Stroke in Chinese Adults: A Cross‐Sectional Study
Authors: Guo Hong , Sun Fengyu , Zhang Haiyu , Dong Lihang , Gu Xingbo , Tian Ye
Published: July 2016

This cross‐sectional study carried out from November 2014 to December 2014 aimed to determine whether the interankle systolic blood pressure (SBP) difference is an independent marker of prevalent stroke. Simultaneous four‐limb blood pressure measurements (oscillometric devices) and calculated SBP difference between the lower limbs were collected from 1485 participants aged 35 years and older. Questionnaires about traditional stroke risk factors were completed. Interankle SBP difference ≥7 mm Hg was independently associated with a history of stroke after adjusting for traditional stroke risk factors (odds ratio, 1.64; 95% confidence interval, 1.53–3.59; P=.0123). Net reclassification improvement analysis showed that adding the interankle SBP difference to traditional risk factors improved the predictive ability for stroke risk by 18.5% (P<.001). In conclusion, an interankle SBP difference ≥7 mm Hg could be an independent marker of stroke history in Chinese adults. It could offer an extra benefit in identifying individuals with risk of stroke beyond conventional clinical features.
Different roles of the small GTPases Rac1, Cdc42, and RhoG in CALEB/NGC‐induced dendritic tree complexity
Authors: Schulz Jana , Franke Kristin , Frick Manfred , Schumacher Stefan
Published: July 2016

Rho GTPases play prominent roles in the regulation of cytoskeletal reorganization. Many aspects have been elaborated concerning the individual functions of Rho GTPases in distinct signaling pathways leading to cytoskeletal rearrangements. However, major questions have yet to be answered regarding the integration and the signaling hierarchy of different Rho GTPases in regulating the cytoskeleton in fundamental physiological events like neuronal process differentiation. Here, we investigate the roles of the small GTPases Rac1, Cdc42, and RhoG in defining dendritic tree complexity stimulated by the transmembrane epidermal growth factor family member CALEB/NGC. Combining gain‐of‐function and loss‐of‐function analysis in primary hippocampal neurons, we find that Rac1 is essential for CALEB/NGC‐mediated dendritic branching. Cdc42 reduces the complexity of dendritic trees. Interestingly, we identify the palmitoylated isoform of Cdc42 to adversely affect dendritic outgrowth and dendritic branching, whereas the prenylated Cdc42 isoform does not. In contrast to Rac1, CALEB/NGC and Cdc42 are not directly interconnected in regulating dendritic tree complexity. Unlike Rac1, the Rac1‐related GTPase RhoG reduces the complexity of dendritic trees by acting upstream of CALEB/NGC. Mechanistically, CALEB/NGC activates Rac1, and RhoG reduces the amount of CALEB/NGC that is located at the right site for Rac1 activation at the cell membrane. Thus, Rac1, Cdc42, and RhoG perform very specific and non‐redundant functions at different levels of hierarchy in regulating dendritic tree complexity induced by CALEB/NGC.

image

Rho GTPases play a prominent role in dendritic branching. CALEB/NGC is a transmembrane member of the epidermal growth factor (EGF) family that mediates dendritic branching, dependent on Rac1. CALEB/NGC stimulates Rac1 activity. RhoG inhibits CALEB/NGC‐mediated dendritic branching by decreasing the amount of CALEB/NGC at the plasma membrane. Palmitoylated, but not prenylated form of the GTPase Cdc42 decreases dendritic branching. CALEB/NGC and Cdc42 are not directly interconnected in regulating dendritic branching. Thus, CALEB/NGC organizes a Rho GTPase signaling module at the plasma membrane for shaping dendritic trees.
Feasibility and acceptability of a mobile app in an ecological momentary assessment of early breastfeeding
Authors: Demirci Jill R. , Bogen Debra L.
Published: July 2016

Ecological momentary assessment (EMA) is a novel data collection method that samples subject experiences in real‐time – minimizing recall bias. Here, we describe the feasibility of EMA to track breastfeeding behaviour through a mobile phone app. During their birth hospitalization, we approached healthy, first‐time mothers intending to exclusively breastfeed for at least 2 months to participate in a study tracking breastfeeding through 8 weeks postpartum. Participants downloaded a commercially available smartphone app, entered information and thoughts about breastfeeding as they occurred, and emailed this data weekly. We called participants at 2 and 8 weeks to assess breastfeeding status. At the 8‐week call, we also assessed participants' experiences using the app. Of the 61 participants, 38% sent complete or nearly complete feeding data, 24% sent some data, and 38% sent no data; 58% completed at least one free‐text breastfeeding entry, and five women logged daily or near daily entries. Compared with women who sent no data, those who sent any were more likely to be married, highly educated, intend to breastfeed more than 6 months, have a more favourable baseline attitude towards breastfeeding, and less likely to have used formula during hospitalization. There was a high degree of agreement between participant‐reported proportion of breast milk feeds via app and interview data at 2 weeks (ICC 0.97). Experiences with the app ranged from helpful to too time‐consuming or anxiety‐provoking. Participants and researchers encountered technical issues related to app use and analysis, respectively. While our data do not support the feasibility of stand‐alone app‐based EMA to track breastfeeding behaviour, it may provide rich accounts of the breastfeeding experience for certain subgroups of women. © 2016 John Wiley & Sons Ltd
Correlation between subclinical hypothyroidism and renal function in patients with diabetes mellitus
Authors: Zhang Lin , Yang Guangran , Su Zhiyan , Yang Jinkui
Published: July 2016

Aim

To evaluate the incidence of and risk factors for subclinical hypothyroidism (SCH) in patients with type 2 diabetes mellitus (T2D), and determine the association of SCH with renal function.

Methods

T2D patients hospitalized between June 2007 and July 2008 were cross‐section ally assessed. Clinical indicators and renal function were compared between the SCH and normal thyroid function groups. Risk factors for SCH and diabetic renal injury (albuminuria) were evaluated by univariate and multivariate analyses.

Results

Subclinical hypothyroidism prevalence was significantly higher in women, with a male to female ratio of 1:2.7. Age (62.56 ± 10.79 vs. 59.09 ± 10.82 years, P = 0.008), systolic blood pressure (138.80 ± 18.85 vs. 131.29 ± 16.97, P = 0.000), TC (5.22 ± 1.20 vs. 4.83 ± 1.03 mmol/L; P = 0.008), LDL‐C (3.35 ± 0.96 vs. 3.06 ± 0.87 mmol/L; P = 0.007), creatinine (84.54 ± 47.05 vs. 74.49 ± 29.96 µmol/L; P = 0.01), urinary albumin excretion rate [18.6 (7.58–326.78) vs. 10.69 (5.79–40.8) µg/min; P = 0.001], and thyrotropin [4.92 (4.37–6.27) vs. 1.4 (0.92–2.09) μIU/mL; P = 0.000] were significantly higher in the SCH group; meanwhile, TBIL (12.05 ± 5.20 vs. 13.98 ± 5.32 µmol/L; P = 0.008), DBIL (2.54 ± 1.20 vs. 2.88 ± 1.17 µmol/L; P = 0.033), IDBIL (9.51 ± 4.62 vs. 11.10 ± 4.72 µmol/L; P = 0.013), and total glomerular filtration rate [46.96 (35–68.26) vs. 71.74 (50.13–83.36) mL/min; P = 0.000] were significantly lower in SCH patients. Macroalbuminuria prevalence was significantly higher in the SCH group (18.2 vs. 11.4%; P < 0.001). Interestingly, SBP (OR = 1.050; 95%CI 1.034–1.066; P = 0.000), DR (OR = 5.248; 95%CI 2.816–9.777; P = 0.000), SCH (OR = 2.256; 95%CI 1.184–4.299; P = 0.013), and TC (OR = 1.389; 95%CI 1.108–1.742; P = 0.004) were found to be independent risk factors for macroalbuminuria.

Conclusion

These findings demonstrate an association of SCH with renal injury in diabetic patients.
Overview of major molecular alterations during progression from Barrett's esophagus to esophageal adenocarcinoma
Authors: Kalatskaya Irina
Published: July 2016

Esophageal adenocarcinoma (EAC) develops in the sequential transformation of normal epithelium into metaplastic epithelium, called Barrett's esophagus (BE), then to dysplasia, and finally cancer. BE is a common condition in which normal stratified squamous epithelium of the esophagus is replaced with an intestine‐like columnar epithelium, and it is the most prominent risk factor for EAC. This review aims to impartially systemize the knowledge from a large number of publications that describe the molecular and biochemical alterations occurring over this progression sequence. In order to provide an unbiased extraction of the knowledge from the literature, a text‐mining methodology was used to select genes that are involved in the BE progression, with the top candidate genes found to be TP53, CDKN2A, CTNNB1, CDH1, GPX3, and NOX5. In addition, sample frequencies across analyzed patient cohorts at each stage of disease progression are summarized. All six genes are altered in the majority of EAC patients, and accumulation of alterations correlates well with the sequential progression of BE to cancer, indicating that the text‐mining method is a valid approach for gene prioritization. This review discusses how, besides being cancer drivers, these genes are functionally interconnected and might collectively be considered a central hub of BE progression.