bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient satisfaction with nutrition services amongst cancer patients treated with autologous stem cell transplantation: a comparison of usual and extended care
Authors: Hung Y.‐C. , Bauer J. , Horsley P. , Isenring E.
Published: June 2013

Background

This study aimed to determine patient satisfaction with clinical nutrition services delivered by an accredited practicing dietitian amongst cancer patients treated with autologous stem cell transplantation that was provided with usual and extended care at 100 days post‐transplantation.

Methods

Patients were randomised to receive usual nutrition care or extended nutrition care during the course of their stem cell transplantation. After hospital discharge, usual care patients received no further nutrition support, whereas extended care patients received telephone dietary counselling from the same dietitian for up to 100 days post‐transplantation. The patient satisfaction with clinical nutrition service questionnaire was completed anonymously at 100 days post‐transplantation. Group comparisons were made using independent t‐tests.

Results

Thirty‐seven patients consented to participate in the study (54% male; mean age 58.7 ± 9.5 years; median body mass index 26.8 kg m–2, range 16.4–47.6 kg m–2); 33 patients completed the study and 28 patients returned the questionnaire (response rate = 85%). All components of the questionnaire were rated highly by both groups; there was no significant difference between the groups (P > 0.05). Although not statistically significant, extended care patients who received at least three telephone calls rated a higher overall satisfaction compared to those who received less calls; this difference was clinically important (score difference = 0.56).

Conclusions

Cancer patients treated with autologous stem cell transplantation were satisfied with usual and extended nutrition care. Extended care patients who received at least three telephone calls after hospital discharge were more satisfied than those with less frequent intervention. Further exploration regarding the frequency and intensity of nutrition service is required.
An exploration of illness representations and treatment beliefs in heart failure
Authors: MacInnes Julie
Published: June 2013

Aims and objectives

To explore the beliefs patients with heart failure hold about their illness and its treatment using the common‐sense model of illness cognitions and behaviour as the theoretical framework.

Background

Heart failure is a disabling condition, which has a significant impact on individuals, their families and healthcare provision. The common‐sense model provides a framework within which lay beliefs about illness and its treatment can be examined. Previous studies have reported a number of misconceptions in relation to the nature of and treatment for heart failure. Inaccurate beliefs are related to limited self‐care and nonadherence to medication.

Design

A qualitative research design was used in which thematic analysis was used to interpret interview data.

Methods

Semi‐structured interviews were carried out with twelve patients with chronic heart failure in a community setting in South East England. An interview schedule based on the dimensions of the common‐sense model guided data collection. Data were analysed thematically using the framework method.

Results

A cluster of beliefs around a chronic illness with serious consequences was found. However, patients were unable to distinguish between symptoms of heart failure, effects of medication and emotional responses to the illness. The illness was attributed to external factors, especially stressful life events. There was a strong belief in the necessity of medication coupled with the belief that the illness and its symptoms could be controlled by medication. Concerns about drug interactions and side effects were prevalent.

Conclusions

This study highlights the need for nurses to explore illness representations and treatment beliefs in heart failure. Misconceptions should be corrected to influence behaviour change.

Relevance to clinical practice

An understanding of illness representations and treatment beliefs should enable structured interventions to be developed, which improve clinical outcomes in this population.
Attitudes of emergency department patients about handover at the bedside
Authors: Kerr Debra , McKay Kate , Klim Sharon , Kelly Anne‐Maree , McCann Terence
Published: June 2013

Aims and objectives

To explore patients' perspectives of bedside handover by nurses in the emergency department (ED).

Background

International guidelines promote standardisation in clinical handover. Poor handover can lead to adverse incidents and expose patients to harm. Studies have shown that nurses and patients have favourable opinions about handover that is conducted at the bedside in hospital wards; however, there is a lack of evidence for patients' perspective of nursing handover in the ED environment.

Design

Qualitative descriptive study.

Methods

Semi‐structured interviews with 30 ED patients occurred within one hour of bedside handover. Data were analysed using thematic content analysis.

Results

Two main themes were identified in the data. First, patients perceive that participating in bedside handover enhances individual care. It provides the opportunity for patients to clarify discrepancies and to contribute further information during the handover process, and is valued by patients. Patients are reassured about the competence of nurses and continuum of care after hearing handover conversations. Second, maintaining privacy and confidentiality during bedside handover is important for patients. Preference was expressed for handover to be conducted in the ED cubicle area to protect privacy of patient information and for discretion to be used with sensitive or new information.

Conclusions

Bedside handover is an acceptable method of performing handover for patients in the ED who value the opportunity to contribute and clarify information, and are reassured that their information is communicated in a private location.

Relevance to clinical practice

From the patients' perspective, nursing handover that is performed at the bedside enhances the quality and continuum of care and maintains privacy and confidentiality of information. Nurses should use discretion when dealing with sensitive or new patient information.
The Tetrad Test: Looking Back, Looking Forward
Authors: O'Mahony Michael
Published: June 2013

Until recently, the tetrad test was considered an interesting idea but was seldom used. It was not until Ennis and Jesionka revisited the topic of power for discrimination tests, that it was observed that the tetrad test had, theoretically, considerably more power than the triangle test. This made it a suitable candidate as a replacement for the low powered, yet commonly used, triangle method. This has sparked a lot of activity concerning the tetrad and there will be more to come. Yet, the tetrad had been explored beforehand, for the purposes of testing Thurstonian models. Had the authors had the right tools, could they have produced any evidence to support Ennis and Jesionka's observation?

Practical Applications

The use of difference tests where the attribute change is not described to the judge, is especially useful for testing consumers in normal conditions of consumption. In such normal conditions, unlike those for a two‐alternative forced choice (paired comparison), there is no person nearby specifying the nature of the attribute that should be attended to while consuming food samples. The nature of the difference between such food samples has to be discovered by the consumer. Available tests like the triangle or duo‐trio are not statistically powerful and therefore require large samples of data, which can incur greater expense. Yet, the tetrad is more theoretically powerful than these tests and is thus worthy of, and is indeed receiving, further investigation.
Occlusal trauma accelerates attachment loss at the onset of experimental periodontitis in rats
Authors: Nakatsu S. , Yoshinaga Y. , Kuramoto A. , Nagano F. , Ichimura I. , Oshino K. , Yoshimura A. , Yano Y. , Hara Y.
Published: July 2013

Background and Objective

Occlusal trauma is an important factor that influences the progression of periodontitis, but it is unclear whether occlusal trauma influences periodontal destruction at the onset of periodontitis. We established an experimental periodontitis model with both site‐specific loss of attachment and alveolar bone resorption. The purpose of the present study was to investigate the effects of occlusal trauma on periodontal destruction, particularly loss of attachment, at the onset of experimental periodontitis.

Material and Methods

Sixty rats were used in the present study. Forty‐eight rats immunized with lipopolysaccharide (LPS) intraperitoneally were divided into four groups. In the trauma (T) group, occlusal trauma was induced by placing an excessively high metal wire in the occlusal surface of the mandibular right first molar. In the inflammation (I) group, periodontal inflammation was induced by topical application of LPS into the palatal gingival sulcus of maxillary right first molars. In the trauma + inflammation (T+I) group, both trauma and periodontal inflammation were simultaneously induced. The PBS group was administered phosphate‐buffered saline only. Another 12 nonimmunized rats (the n−(T+I) group) were treated as described for the T+I group. All rats were killed after 5 or 10 d, and their maxillary first molars with surrounding tissues were observed histopathologically. Loss of attachment and osteoclasts on the alveolar bone crest were investigated histopathologically. To detect immune complexes, immunohistological staining for C1qB was performed. Collagen fibers were also observed using the picrosirius red‐polarization method.

Results

There were significant increases in loss of attachment and in the number of osteoclasts in the T+I group compared with the other groups. Moreover, widespread distribution of immune complexes was observed in the T + I group, and collagen fibers oriented from the root surface to the alveolar bone crest had partially disappeared in the T, T+I and n−(T+I) groups.

Conclusion

When inflammation was combined with occlusal trauma, immune complexes were confirmed in more expanding areas than in the area of the I group without occlusal trauma, and loss of attachment at the onset of experimental periodontitis was increased. Damage of collagen fibers by occlusal trauma may elevate the permeability of the antigen through the tissue and result in expansion of the area of immune‐complex formation and accelerating inflammatory reaction. The periodontal tissue destruction was thus greater in the T+I group than in the I group.
Evolutionary dynamics of hepatitis C virus NS3 protease domain during and following treatment with narlaprevir, a potent NS3 protease inhibitor
Authors: de Bruijne J. , Thomas X. V. , Rebers S. P. , Weegink C. J. , Treitel M. A. , Hughes E. , Bergmann J. F. , de Knegt R. J. , Janssen H. L. A. , Reesink H. W. , Molenkamp R. , Schinkel J.
Published: June 2013

Narlaprevir, a hepatitis C virus (HCV) NS3/4A serine protease inhibitor, has demonstrated robust antiviral activity in a placebo‐controlled phase 1 study. To study evolutionary dynamics of resistant variants, the NS3 protease sequence was clonally analysed in thirty‐two HCV genotype 1–infected patients following treatment with narlaprevir. Narlaprevir monotherapy was administered for one week (period 1) followed by narlaprevir/pegylated interferon‐alpha‐2b combination therapy with or without ritonavir (period 2) during two weeks, interrupted by a washout period of one month. Thereafter, all patients initiated pegylated interferon‐alpha‐2b/ribavirin combination therapy. Longitudinal clonal analysis was performed in those patients with NS3 mutations. After narlaprevir re‐exposure, resistance‐associated mutations at position V36, T54, R155 and A156 were detected in five patients in >95% of the clones. Narlaprevir retreatment resulted in a 2.58 and 5.06 log10 IU/mL viral load decline in patients with and without mutations, respectively (P = <0.01). After treatment, resistant variants were replaced with wild‐type virus within 2–24 weeks in three patients. However, the R155K mutation was still observed 3.1 years after narlaprevir dosing in two patients in 5% and 45% of the viral population. Resistant variants could be detected early during treatment with narlaprevir. A slower viral load decline was observed in those patients with resistance‐associated mutations detectable by direct population sequencing. These mutations disappeared within six months following treatment with the exception of R155K mutation, which persisted in two patients.
Microparticles in Health and Disease
Authors: Herring J.M. , McMichael M.A. , Smith S.A.
Published: July 2013

Microparticles (MPs), small membrane‐derived vesicles, are derived from many cell types and released into the circulation. Microparticles can express antigens, and contain cell surface proteins, cytoplasmic contents, and nuclear components from their cell of origin that determines their composition, characterization, and transfer of biologic information. Certain prompts for this release include shear stress, complement activation, proapoptotic stimulation, cellular damage, or agonist interaction with cell surface receptors. Release can be physiologic or pathologic and is associated with proinflammatory and procoagulant effects and has been implicated in thrombotic states. Microparticles also contribute to systemic inflammation and cardiovascular, hematologic, and oncologic disease states. The study of MPs in human medicine is rapidly advancing and extends into the physiology of health, the pathophysiology of disease, and the role of MPs in transfusion medicine. In veterinary medicine, published work on MPs has been limited to the area of inherited disorders, blood storage, and leukoreduction (LR). Microparticle research is still in its infancy, and this review should be seen as a snapshot of what is currently known. As research continues important limitations, including variations in preanalytic variables such as collection, storage, or centrifugation, and limitations of quantitation are coming to the forefront. Correlation of quantitation of MPs with assays of activity will hopefully shed light on the true nature of MPs in health and disease. This review will focus on the role of cellular exocytic vesiculation in health, disease, and transfusion medicine.
Bcr1 plays a central role in the regulation of opaque cell filamentation in Candida albicans
Authors: Guan Guobo , Xie Jing , Tao Li , Nobile Clarissa J. , Sun Yuan , Cao Chengjun , Tong Yaojun , Huang Guanghua
Published: June 2013

The human fungal pathogen Candida albicans has at least two types of morphological transitions: white to opaque cell transitions and yeast to hyphal transitions. Opaque cells have historically not been known to undergo filamentation under standard filament‐inducing conditions. Here we find that Bcr1 and its downstream regulators Cup9, Nrg1 and Czf1 and the cAMP‐signalling pathway control opaque cell filamentation in C. albicans. We have shown that deletion of BCR1, CUP9, NRG1 and CZF1 results in opaque cell filamentation under standard culture conditions. Disruption of BCR1 in white cells has no obvious effect on hyphal growth, suggesting that Bcr1 is an opaque‐specific regulator of filamentation under the conditions tested. Moreover, inactivation of the cAMP‐signalling pathway or disruption of its downstream transcriptional regulators, FLO8 and EFG1, strikingly attenuates filamentation in opaque cells of the bcr1/bcr1 mutant. Deletion of HGC1, a downstream gene of the cAMP‐signalling pathway encoding G1 cyclin‐related protein, completely blocks opaque cell filamentation induced by inactivation of BCR1. These results demonstrate that Bcr1 regulated opaque cell filamentation is dependent on the cAMP‐signalling pathway. This study establishes a link between the white‐opaque switch and the yeast‐filamentous growth transition in C. albicans.
A surface‐exposed neuraminidase affects complement resistance and virulence of the oral spirochaete Treponema denticola
Authors: Kurniyati Kurni , Zhang Weiyan , Zhang Kai , Li Chunhao
Published: June 2013

Neuraminidases (sialidases) catalyse the removal of terminal sialic acid from glycoconjugates. Bacterial pathogens often utilize neuraminidases to scavenge host sialic acid, which can be utilized either as a nutrient or as a decorating molecule to disguise themselves from host immune attacks. Herein, a putative neuraminidase (TDE0471) was identified in Treponema denticola, an oral spirochaete associated with human periodontitis. TDE0471 is a cell surface‐exposed exo‐neuraminidase that removes sialic acid from human serum proteins; it is required for T. denticola to grow in a medium that mimics gingival crevice fluid, suggesting that the spirochaete may use sialic acid as a nutrient in vivo. TDE0471 protects T. denticola from serum killing by preventing the deposition of membrane attack complexes on the bacterial cell surface. Animal studies revealed that a TDE0471‐deficient mutant is less virulent than its parental wild‐type strain in BALB/C mice. However, it causes a level of tissue damage similar to the wild type in complement‐deficient B6.129S4‐C3tm1Crr/J mice albeit the damage caused by both bacterial strains is more severe in these transgenic mice. Based on these results, we propose that T. denticola has evolved a strategy to scavenge host sialic acid using its neuraminidase, which allows the spirochaete to acquire nutrients and evade complement killing.
The oral microbiome and nitric oxide homoeostasis
Authors: Hezel MP , Weitzberg E
Published: June 2013

The tiny radical nitric oxide (NO) participates in a vast number of physiological functions including vasodilation, nerve transmission, host defence and cellular energetics. Classically produced by a family of specific enzymes, NO synthases (NOSs), NO signals via reactions with other radicals or transition metals. An alternative pathway for the generation of NO is the nitrate–nitrite–NO pathway in which the inorganic anions nitrate () and nitrite () are reduced to NO and other reactive nitrogen intermediates. Nitrate and nitrite are oxidation products from NOS‐dependent NO generation but also constituents in our diet, mainly in leafy green vegetables. Irrespective of origin, active uptake of circulating nitrate in the salivary glands, excretion in saliva and subsequent reduction to nitrite by oral commensal bacteria are all necessary steps for further NO generation. This central role of the oral cavity in regulating NO generation from nitrate presents a new and intriguing aspect of the human microbiome in health and disease. In this review, we present recent advances in our understanding of the nitrate–nitrite–NO pathway and specifically highlight the importance of the oral cavity as a hub for its function.
Systemic use of non‐biologics in orofacial diseases: 2. Purine synthesis inhibitors
Authors: Georgakopoulou EA , Scully C
Published: June 2013

Systemic non‐biological agents (NBAs) have been extensively used for immunosuppression in clinical medicine, often with considerable efficacy, although sometimes accompanied with adverse effects as with all medicines. With the advent of biological agents, all of which currently are restricted to systemic use, there is a rising need to identify which agents have the better therapeutic ratio. The NBAs include a range of agents, most especially the corticosteroids (corticosteroids). This article reviews the purine synthesis inhibitors (azathioprine and mycophenolate), which are currently the most commonly used systemically immunosuppressive agents in the management of orofacial mucocutaneous diseases. Subsequent articles discuss other corticosteroid‐sparing agents used in the management of orofacial disease, such as calcineurin inhibitors, and the cytotoxic and other immunomodulatory agents.
Prevalence of myopia‐related retinal changes among 12–18 year old Hong Kong Chinese high myopes
Authors: Cheng Sam CK , Lam Carly SY , Yap Maurice KH
Published: June 2013

Purpose

To determine the prevalence and risk factors of myopia‐related retinal changes in Hong Kong Chinese adolescents with high myopia.

Methods

A cross‐sectional study on Hong Kong Chinese teenage subjects with high myopia was conducted between January 2005 and June 2009. Subjects were recruited via newspaper advertisements, invitation letters to schools, leaflets and posters. Data collected included history related to myopia progression and retinal characteristics.

Results

In total, 120 subjects (61 boys and 59 girls) were recruited. The mean age was 14.8 ± 1.6 years (range: 12–18 years). The mean SER of the eyes was −8.41 ± 1.60 D. Ninety four of the 120 adolescents were found to have a retinal change of which 0.8% were sight‐threatening, 2.5% were posterior pole changes, and 61.7% were peripheral retinal changes. The five most frequent retinal changes found were optic nerve crescents (52.5%), white‐without‐pressure (51.7%), lattice degeneration (5.8%), microcystoid degeneration (5%) and pigmentary degeneration (4.2%). After adjusting for myopia over −8 D, age, gender, duration of myopia, family retinal history and intraocular pressure (IOP), binary logistic regressions showed that an axial length longer than 26.5 mm was a significant risk factor for peripheral retinal changes, optic nerve crescents and white‐without‐pressure.

Conclusions

Peripheral retinal degenerative changes and optic nerve crescent were found in a significant proportion of high myopic teenage subjects. There is increased risk of retinal changes in eyes with an axial length >26.5 mm in 12–18 year‐olds.
Rational Choice and the Transitivity of Betterness
Authors: Handfield Toby
Published: June 2013

If A is better than B and B is better than C, then A is better than C, right? Larry Temkin and Stuart Rachels say: No! Betterness is nontransitive, they claim. In this paper, I discuss the central type of argument advanced by Temkin and Rachels for this radical idea, and argue that, given this view very likely has sceptical implications for practical reason, we would do well to identify alternative responses. I propose one such response, which employs the idea that rational agents might regard some options as incommensurate in value, and will reasonably employ a heuristic of status quo maintenance to avoid suboptimal choices from incommensurate goods.
Molecular and biological characterization of Cowpea mild mottle virus isolates infecting soybean in Brazil and evidence of recombination
Authors: Zanardo L. G. , Silva F. N. , Bicalho A. A. C. , Urquiza G. P. C. , Lima A. T. M. , Almeida A. M. R. , Zerbini F. M. , Carvalho C. M.
Published: June 2013

The biological and molecular characterization of six isolates of a new Cowpea mild mottle virus strain (CPMMV; Carlavirus, Betaflexiviridae) are reported. Soybean plants with mosaic and stem necrosis were collected in Bahia, Goiás, Mato Grosso and Minas Gerais states, Brazil. Complete genomes of the CPMMV isolates are 8180–8198 nucleotides (nt) long, excluding the 3′‐polyadenylated tail, and have 67–68% nt sequence identity with a Ghana isolate of CPMMV, the only CPMMV isolate for which the genome has previously been sequenced. The replicase has only 60–61% nt sequence identity with the Ghana CPMMV isolate, and the coat protein (CP) is highly conserved (79% nt sequence identity and 95–96% amino acid sequence identity). The high CP identity and the phylogenetic analyses supported the classification of the Brazilian isolates as CPMMV. Biological and molecular differences with the Ghana CPMMV isolate were found and indicated that the six isolates represent a distinct CPMMV strain denominated as CPMMV‐BR. Furthermore, it is shown that recombination occurred mainly in the polymerase gene, and may occur less frequently in other regions of the CPMMV genome.
Cooled Storage of Canine Semen:in vitroEffects of Different Concentrations of an Antibiotic Combination on Growth of Mollicutes
Authors: Becher AC , Spergser J , Aurich C , Zottler E , Aurich JE , Schäfer‐Somi S
Published: June 2013

Contents

The aim of this study was to examine effects of an antibiotic combination at different concentrations on growth of mycoplasma and ureaplasma during cooled storage of canine semen (n = 20). Semen aliquots were diluted with Tris–citric acid–fructose–egg yolk extender containing either 1.0 g/l streptomycin and 0.6 g/l benzylpenicillin (control) or a combination of gentamycin, tylosin, lincomycin and spectinomycin (GTLS‐1: 0.25, 0.05, 0.15 and 0.3;GTLS‐2: 0.5, 0.1, 0.3 and 0.6;GTLS‐3: 1.0, 0.2, 0.6 and 1.2 g/l). Samples were assessed for motility and membrane integrity by computer‐assisted sperm analysis immediately after dilution and at 24, 48 and 72 h of cooled storage. Morphologically, normal spermatozoa were determined, and bacterial culture was performed at 24 and 72 h.Mycoplasma spp. were detected in 14 of 20 ejaculates (70%) with severe growth in 12 samples. A reduction but not total elimination of mycoplasma growth occurred in allGTLSextenders with the most pronounced reduction in groupGTLS‐3 (control vsGTLS‐1 andGTLS‐2 p < 0.05, control vsGTLS‐3 p < 0.001). Ureaplasmas were detected in four ejaculates, and growth was reduced to the same extent inGTLSand control extender. Progressive motility in all groups, total motility in groupsGTLS1–3 and percentage of membrane‐intact spermatozoa in groupsGTLS2 and 3 decreased slightly (p < 0.05) over time. In conclusion, dilution of canine semen withGTLSextender has no major detrimental effects on spermatozoa during cooled storage. It reduced the growth but did not totally eliminate mycoplasmas and ureaplasmas from cooled‐stored dog semen.
Semen Collection and Polymerase Chain Reaction‐Based Sex Determination of Black‐Headed and Straw‐Necked Ibis
Authors: Kaneko K , Uematsu E , Takahashi Y , Tong B , Takino S , Wajiki Y , Kimura T , Yamashiro H , Kaneko Y , Iwaisaki H , Sugiyama T , Yamada T , Yamagishi S
Published: June 2013

Contents

This study aimed to develop a polymerase chain reaction (PCR)‐based sexing and effective semen collection methods for black‐headed and straw‐necked ibis species. However, most birds are not sexually dimorphic, that is, the sexes appear similar. Therefore, the gender should be determined before semen collection. DNA was extracted from the blood samples of 11 black‐headed and 4 straw‐necked ibis. The sex was determined after PCR amplification of the EE0.6 region of W‐chromosome. The PCR products were separated using gel electrophoresis. A single band indicated the presence of the EE0.6 region and that the individual was a female, while no band indicated that the individual was a male. Further, the single bands from seven specimens were amplified. Semen collection was performed by massage or a combination of massage with electro‐ejaculation and was attempted during all four seasons. The semen was successfully collected in March from male straw‐necked ibis using the massage method. Limited motility, viability and concentration of straw‐necked ibis sperm were observed. The sperm length was 180 μm and that of the nucleus was 30 μm with acrosome located at the tip of the nucleus. Thus, the PCR‐based sexing proved to be an accurate molecular sexing method for black‐headed and straw‐necked ibis. Furthermore, we successfully collected semen and observed the stained sperm nucleus and acrosome of the straw‐necked ibis sperm. We propose that the use of this PCR methodology can be applied as a routine method for sex determination and semen collection in ibis species for future ecological research. However, considering our limited success, further studies on semen collection method are required.
Ethnic Diversity, Political Stability and Productive Efficiency: Empirical Evidence from the African Countries
Authors: Repkine Alexandre
Published: June 2013

While ethnic diversity has been shown to produce numerous negative effects on the economic performance due to disagreement on the production of the public good, nepotism in making employment decisions, increased corruption and rent‐seeking behaviour, its positive effects appear to have received much less attention. We hypothesise and test several explanations why higher levels of ethnic diversity may be associated with better socio‐economic outcomes. We find that productive efficiency will be higher in the societies where ethnicities can benefit from the complementarity of skills. Incentives to engage in an ethnic conflict will be lower and the extent of political stability higher in those countries where the opportunity costs of ethnic conflict are more substantial. We also find some evidence in support of the political aspirations hypothesis that attributes the negative effects of ethnic diversity to the strife by ethnic groups for more political influence.
Oceanographic and eustatic control of carbonate platform evolution and sequence stratigraphy on the Cretaceous (Valanginian–Campanian) passive margin, northern Gulf of Mexico
Authors: Phelps Ryan M. , Kerans Charles , Loucks Robert G. , Da Gama Rui O.B.P. , Jeremiah Jason , Hull David
Published: July 2013

An integrated sequence stratigraphic study based on outcrop, core and wireline log data documents the combined impact of Cretaceous eustacy and oceanic anoxic events on carbonate shelf morphology and facies distributions in the northern Gulf of Mexico. The diverse facies and abundant data of the Comanche platform serve as a nearly complete global reference section and provide a sensitive record of external processes affecting Cretaceous platform development. Regional cross‐sections across the shoreline to shelf‐margin profile provide a detailed record of mixed carbonate–siliciclastic strata for the Hauterivian to lower Campanian stages (ca 136 to 80 Ma). The study window on the slowly subsiding passive margin allows the stratigraphic response to external forcing mechanisms to be isolated from regional structural processes. Three second‐order supersequences comprised of eight composite sequences are recognized in the Valanginian–Barremian, the Aptian–Albian and the Cenomanian–Campanian. The Valanginian–Barremian supersequence transitioned from a siliciclastic ramp to carbonate rimmed shelf and is a product of glacial ice accumulation and melting, as well as variable rates of mid‐ocean ridge volcanism. The Aptian–Albian supersequence chronicles the drowning and recovery of the platform surrounding oceanic anoxic events 1a and 1b. The Cenomanian–Campanian supersequence similarly documents shelf drowning following oceanic anoxic event 1d, after which the platform evolved to a deep‐subtidal system consisting of anoxic/dysoxic shale and chalk in the time surrounding oceanic anoxic event 2. Each period of oceanic anoxia is associated with composite sequence maximum flooding, termination of carbonate shelf sedimentation and deposition of condensed shale units in distally steepened ramp profiles. Composite sequences unaffected by oceanic anoxic events consist of aggradational to progradational shelves with an abundance of grain‐dominated facies and shallow‐subtidal to intertidal environments. Because they are products of eustacy and global oceanographic processes, the three supersequences and most composite sequences defined in the south Texas passive margin are recognizable in other carbonate platforms and published eustatic sea‐level curves.
Infection among adult small bowel and multivisceral transplant recipients in the 30‐day postoperative period
Authors: Primeggia J. , Matsumoto C.S. , Fishbein T.M. , Karacki P.S. , Fredette T.M. , Timpone J.G.
Published: June 2013

Background

Intestinal transplantation is a potential option for patients with short gut syndrome (SGS), and infection is common in the postoperative period. The aim of our study was to identify the incidence and characteristics of bacterial and fungal infections of adult small bowel or multivisceral (SB/MV) transplantation recipients in the 30‐day postoperative period.

Methods

This retrospective chart review assessed the incidence and characteristics of bacterial and fungal infections in patients who underwent SB/MV transplant at our center between April 2004 and November 2008. Patient data were retrieved from computerized databases, flow‐charts, and medical records.

Results

A total of 40 adult patients with a mean age of 38.7 ± 13.4 years received transplants during this period: 27 patients received isolated SB, 12 received MV, and 1 received SB and kidney. Our immunosuppressive regimen included basiliximab for induction, and tacrolimus, sirolimus, and methylprednisolone for maintenance therapy. The most common indications for transplant were SGS, intestinal ischemia, Crohn's disease, trauma, motility disorders, and Gardner's syndrome. We report a 30‐day postoperative infection rate of 57.5% and mean time to first infection of 10.78 ± 8.99 days. A total of 36 infections were documented in 23 patients. Of patients who developed infections, 56.5% developed 1 infection, 30.4% developed 2 infections, and 13% developed 3 infections. The most common site of infection was the abdomen, followed by blood, urine, lung, and wound infection. The isolates were gram‐negative bacteria in 49.3%, gram‐positive bacteria in 39.4%, and 11.3% were fungi. The most common organisms were Pseudomonas (19%), Enterococcus (15%), and Escherichia coli (13%). Overall, 47% of infections were due to drug‐resistant pathogens; 31% of E. coli and Klebsiella species were extended‐spectrum beta‐lactamase‐producing organisms, 36% of Pseudomonas was multidrug resistant (MDR), 75% of Enterococcus was vancomycin resistant, and 100% of Staphylococcus aureus was methicillin resistant.

Conclusion

These findings demonstrate that bacterial and fungal infections remain an important complication in SB/MV transplant recipients within the early postoperative period. Infections due to MDR organisms have emerged as an important clinical problem in this patient population.
Direct regulation of abiotic responses by the Arabidopsis circadian clock component PRR7
Authors: Liu Tiffany , Carlsson Jenny , Takeuchi Tomomi , Newton Linsey , Farré Eva M.
Published: June 2013

Up to 30% of the plant transcriptome is circadian clock‐regulated in different species; however, we still lack a good understanding of the mechanisms involved in these genome‐wide oscillations in gene expression. Here, we show that PSEUDO‐RESPONSE REGULATOR 7 (PRR7), a central component of the Arabidopsis clock, is directly involved in the repression of master regulators of plant growth, light signaling and stress responses. The expression levels of most PRR7 target genes peak around dawn, in an antiphasic manner to PRR7 protein levels, and were repressed by PRR7. These findings indicate that PRR7 is important for cyclic gene expression by repressing the transcription of morning‐expressed genes. In particular we found an enrichment of the genes involved in abiotic stress responses, and in accordance we observed that PRR7 is involved in the oxidative stress response and the regulation of stomata conductance.
Keloid‐derived keratinocytes exhibit an abnormal gene expression profile consistent with a distinct causal role in keloid pathology
Authors: Hahn Jennifer M. , Glaser Kathryn , McFarland Kevin L. , Aronow Bruce J. , Boyce Steven T. , Supp Dorothy M.
Published: July 2013

Keloids are disfiguring scars that extend beyond the original wound borders and resist treatment. Keloids exhibit excessive extracellular matrix deposition, although the underlying mechanisms remain unclear. To better understand the molecular basis of keloid scarring, here we define the genomic profiles of keloid fibroblasts and keratinocytes. In both cell types, keloid‐derived cells exhibit differential expression of genes encompassing a diverse set of functional categories. Strikingly, keloid keratinocytes exhibited decreased expression of a set of transcription factor, cell adhesion, and intermediate filament genes essential for normal epidermal morphology. Conversely, they exhibit elevated expression of genes associated with wound healing, cellular motility, and vascular development. A substantial number of genes involved in epithelial–mesenchymal transition were also up‐regulated in keloid keratinocytes, implicating this process in keloid pathology. Furthermore, keloid keratinocytes displayed significantly higher migration rates than normal keratinocytes in vitro and reduced expression of desmosomal proteins in vivo. Previous studies suggested that keratinocytes contribute to keloid scarring by regulating extracellular matrix production in fibroblasts. Our current results show fundamental abnormalities in keloid keratinocytes, suggesting they have a profoundly more direct role in keloid scarring than previously appreciated. Therefore, development of novel therapies should target both fibroblast and keratinocyte populations for increased efficacy.
Dramatic Effect of the Utilized Theory on Frequency Distribution Function of Carbon Nanotubes
Authors: Elishakoff Isaac , Bekel Yannis , Gomez Thomas
Published: July 2013

In this study, we investigate the modal density of double-walled carbon nanotubes. Emphasis is placed on the effect of the utilized theory. Specifically, we compare the modal density obtained via classical Bernoulli–Euler theory with that obtained by employing the refined Bresse–Timoshenko theory with nonlocal and surface effects taken into account. We show that the effect of refinements is dramatic.
Dynamic Stability of Periodic Pipes Conveying Fluid
Authors: Yu Dianlong , Païdoussis Michael P. , Shen Huijie , Wang Lin
Published: July 2013

In this paper, the stability of a periodic cantilevered pipe conveying fluid is studied theoretically by means of a novel transfer matrix method. This method is first validated by comparing the results to those available in the literature for a uniform pipe, showing that it is capable of high accuracy and displaying good convergence characteristics. Then, the stability of periodic pipes is investigated, with geometric, material-properties periodicity, and a combination of the two, showing that a considerable stabilizing effect may be achieved over different ranges of the mass parameter β (β=mf/(mf+mp), where mf and mp are the fluid and pipe masses per unit length). The effect of other different system parameters is also probed.
Characterization of a novel 2D array dosimeter for patient‐specific quality assurance with volumetric arc therapy
Authors: Stathakis Sotirios , Myers Pamela , Esquivel Carlos , Mavroidis Panayiotis , Papanikolaou Nikos
Published: July 2013

Purpose:

In this study, the authors are evaluating a new, commercially available 2D array that offers 3D dose reconstruction for patient specific intensity modulated radiation therapy quality assurance (IMRT QA).

Methods:

The OCTAVIUS 4D system and its accompanying software (VERISOFT) by PTW were evaluated for the accuracy of the dose reconstruction for patient specific pretreatment IMRT QA. OCTAVIUS 4D measures the dose plane at the linac isocenter as the phantom rotates synchronously with the gantry, maintaining perpendicularity with the beam, by means of an inclinometer and a motor. The measurements collected during a volumetric modulated arc therapy delivery (VMAT) are reconstructed into a 3D dose volume. The VERISOFT application is used to perform the analysis, by comparing the reconstructed dose against the 3D dose matrix from the treatment planning system (TPS) that is computed for the same geometry and beam arrangement as that of the measurement. In this study, the authors evaluated the 3D dose reconstruction algorithm of this new system using a series of tests. Using the Octavius 4D phantom as the patient, dose distributions for various field sizes, beam orientations, shapes, and combination of fields were calculated using the Pinnacle3, TPS, and the respective DICOMRT dose was exported to the VERISOFT analysis software. Measurements were obtained by delivering the test treatment plans and comparisons were made based on gamma index, dose profiles, and isodose distribution analysis. In addition, output factors were measured and the dose linearity of the array was assessed. Those measurements were compared against measurements in water using a single, calibrated ionization chamber as well as calculations from Pinnacle for the same delivery geometries.

Results:

The number of voxels that met the 3%/3 mm criteria for the volumetric 3D gamma index analysis ranged from 92.3% to 98.9% for all the patient plans that the authors evaluated. 2D gamma analysis in the axial, sagittal, and coronal planes produced similar results to those in the 3D gamma analysis. The new detector system does not require an angular dependence correction because it rotates in synchrony with the gantry and the detector array maintains a constant SAD while always perpendicular to the beam axis. Output factors were within 2% when compared to ionization chamber measurements and Pinnacle calculations. Similar agreement was observed when testing the MU linearity (for MU values above 2) as well as dose rate effect.

Conclusions:

The OCTAVIUS 4D system has some unique characteristics that can potentially improve the patient specific pretreatment IMRT QA data collection and analysis. The ability of the software to reconstruct from the measurements the true 3D dose distribution in the phantom, provides a unique perspective for the medical physicist that evaluates a patient's QA plan.
Chorea gravidarum: a rarity in West still haunts pregnant women in the East
Authors: Pathania Monika , Upadhyaya Suneet , Lali Bhagat Singh , Sharma Archana
Published: June 2013

A pregnant woman, in her early 20s, presents with chorea following an emotional outburst. While the family members feel it to be a spirit haunting her, we try to establish the medical diagnosis of the present condition. There is a history of rheumatic fever in the past and examination reveals choreioathetoid jerky movements of her upper limbs with jerky speech, spooning of her limbs and demonstration of milkmaid's grip. Laboratory investigations did not reveal anything interesting. We discuss the diagnosis and management of this patient.
Spontaneous intraperitoneal haemorrhage from short gastric artery avulsion secondary to forceful retching
Authors: Faraj Walid , Alaeddine Mohamed , Haydar Ali , Khalife Mohammad
Published: June 2013

Spontaneous intraperitoneal haemorrhage can occur in any age group. It is defined as presence of free blood in the peritoneal cavity which can results from a non-traumatic and non-iatrogenic cause. Common causes are visceral, coagulopathy related and vascular. The clinical presentation is usually non-specific; it can vary from mild abdominal pain to a shock status. We report a very rare case of a 17-year-old male patient who presented to our institution with spontaneous intraperitoneal bleeding secondary to avulsion of one of the short gastric artery following forceful retching.
Bilateral axillary masses mimicking as accessory breast with multiple fibroadenoma and bilateral gigantomastia in HIV-positive patient
Authors: Singh Saumya , Mishra Anand K , Tewari S , Kumar Sanjeev
Published: June 2013

Accessory breast is a rare entity that can present as asymptomatic masses or can cause symptoms like heaviness, pain, restriction of arm movement and limitation in daily pursuits with allied apprehension and anxiety for the patient. We present a case of bilateral axillary masses mimicking as accessory breast with multiple fibroadenoma in a 28 years, nulliparous, Indian woman who is HIV positive, which proves to be a diagnostic dilemma. Excisional biopsy was diagnostic. The rarity of such cases imposes challenges on the management in terms of diagnosis, prognosis and therapeutic options.
Recurrent venous thrombosis in Ehlers-Danlos syndrome type III: an atypical manifestation
Authors: Jiménez-Encarnación Esther , Vilá Luis M
Published: June 2013

Ehlers-Danlos syndrome (EDS) comprises a group of hereditary connective tissue disorders in which collagen synthesis and fibrogenesis are impaired. Patients with EDS type III have a bleeding tendency manifested by ecchymoses and haematomas. However, thrombotic events are rare in this entity. Herein, we present a 48-year-old Hispanic man with EDS type III who had recurrent cephalic vein thrombophlebitis and thrombosis, and brachial vein thrombosis. Tests for hypercoagulable disorders including antithrombin III activity, protein C activity, protein S activity, anticardiolipin antibodies, homocysteine levels, factor V Leiden mutation and prothrombin gene mutation were negative. The patient required long-term anticoagulation with warfarin. After 3 years follow-up, he did not present further thrombotic events. Clinicians should be aware that patients with EDS might be at risk for hypercoagulable disorders.
Streptococcus agalactiaeendogenous endophthalmitis
Authors: Saffra Norman , Rakhamimov Aleksandr , Husney Robert , Ghitan Monica
Published: June 2013

Streptococcus agalactiae(SA) is a Group BStreptococcus, which is a common pathogen implicated in neonatal and geriatric sepsis. Endogenous bacterial endophthalmitis (EBE) is a condition that results from haematogenous seeding of the globe, during transient or persistent bacteremia. We document a case of a non-septic geriatric patient, who developed EBE after a transient bacteraemia with SA.
IgG4-related disease with atypical laryngeal presentation and Behçet/granulomatous polyangiitis mimicking features
Authors: Shaib Yasmin , Ton Evelien , Goldschmeding Roel , Tekstra Janneke
Published: June 2013

The following report describes two male patients with an ongoing medical history with a predominant laryngeal focus, who were finally diagnosed with IgG4-related disease (IgG4-RD). Their primary symptoms included hoarseness and pain of the throat, and they had undergone multiple laryngeal surgeries and laser treatments due to tumorous growth with limited success. Due to the onset of additional symptoms, they initially received the diagnoses granulomatous polyangiitis (GPA) and Behçet's disease. However, further analysis showed elevated IgG4 levels in serum and infiltration of IgG4-positive plasma cells upon biopsy of laryngeal and pulmonary tissue. Treatment was started with moderate doses of prednisone, leading to a rapid resolution of symptoms.
How to exhaust your bone marrow
Authors: Salomo Louise , Salomo Morten , Andersen Steven A W , Kamper Anne-Lise
Published: June 2013

A 32-year-old man was admitted to the hospital because of oedema and 8 kg of gained weight. The oedema decreased spontaneously over weeks and there was no evidence for a nephrotic syndrome; however, the blood tests revealed a moderate pancytopenia. The patient practiced excessive physical activity at work and in his spare time, and kept a very thorough training and weight diary. Owing to a high intake of energy and protein drinks he tried to optimise his physical performance and kept a normal body mass index  at 23.7. A bone marrow biopsy showed gelatinous bone marrow transformation, normally seen in critically ill patients or those with severe malnutrition. In this case, the cause is presumed to be excessive physical activity/overtraining in combination with relatively insufficient nutrition.
Aneurysmal bone cyst of thoracic spine: case report and brief review of literature
Authors: Jaiswal Anupam , Vijay Varun , Kori Prakash , Shukla Rakesh
Published: June 2013

A 16-year-old girl was admitted with insidious onset, gradually progressive spastic sensori-motor paraparesis, with a sensory level at D10 dermatome without bowel or bladder involvement for the last 2 months following trivial trauma on the lower back. MRI of the spine showed a low-to-intermediate signal intensity, heterogeneous mass with multiple fluid levels. A diagnosis of aneurysmal bone cyst was made. A D8-D9 laminectomy with near total excision of mass was performed. Histopathology of the mass showed cyst cavity filled with haemorrhage surrounded by bony trabeculae confirming the diagnosis. Following excision the patient had excellent recovery. We report this case owing to its rarity and to emphasise the importance of surgery if there is cord compression.