bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-term Physical Activity Behavior After Completion of Traditional Versus Fast-track Cardiac Rehabilitation
Authors: Ramadi Ailar , Buijs David M. , Threlfall Tyler G. , Aggarwal Sandeep G. , Arena Ross , Rodgers Wendy M. , Haennel Robert G.
Published: April 2016

Background:

Despite the health benefits associated with regular physical activity (PA), many cardiac patients fail to maintain optimal levels of PA after completing cardiac rehabilitation (CR). The long-term impact of different CR delivery models on the PA habits of cardiac patients is not completely understood.

Objective:

The purpose of this study is to use a multisensor accelerometer to compare the long-term impact of a traditional versus fast-track CR on the PA of patients with coronary artery disease 6 months after CR entry.

Methods:

Forty-four participants attended either traditional (twice a week, 12 weeks; n = 24) or fast-track (once a week, 8 weeks; n = 20) CR. Exercise capacity (ie, 6-minute walk test distance) and PA were assessed at baseline and at 12 weeks and 6 months after CR entry.

Results:

At 12 weeks, exercise capacity increased significantly in both groups and remained elevated by the 6-month follow-up. Sedentary time decreased from baseline to 12 weeks. However, at 6 months, it was comparable with the baseline level. There was no significant change in any other PA marker (ie, steps/day, time in light and moderate-vigorous PA) over the course of the study.

Conclusions:

Findings support the long-term effectiveness of CR on exercise capacity irrespective of the delivery model. However, participation in CR program, whether it be a traditional or fast-track CR exercise program, may not lead to long-term PA behavior change. Thus, CR participants may benefit from structured strategies that promote long-term PA adherence in addition to facilitating exercise capacity improvement.
Using Hemolysis as a Novel Method for Assessment of Cytotoxicity and Blood Compatibility of Decellularized Heart Tissues
Authors: Momtahan Nima , Panahi Tayyebeh , Poornejad Nafiseh , Stewart Michael G. , Vance Brady R. , Struk Jeremy A. , Castleton Arthur A. , Roeder Beverly L. , Sukavaneshvar Sivaprasad , Cook Alonzo D.
Published: April 2016

Developing patient-specific transplantable organs is a promising response to the increasing need of more effective therapies for patients with organ failure. Advances in tissue engineering strategies have demonstrated favorable results, including the use of decellularized hearts as scaffolds for cardiac engineering; however, there is a need to establish methods to characterize the cytotoxicity and blood compatibility of cardiac extracellular matrix (cECM) scaffolds created by decellularization. In this study, porcine hearts were decellularized in an automated perfusion apparatus utilizing sodium dodecyl sulfate (SDS) detergent. Residual SDS was measured by a colorimetric assay. Phosphate-buffered saline, distilled water (DW), and Triton X-100 washes were used to remove SDS. The efficiency of detergent removal was measured as a function of time. It was observed that using Triton-X 100 can nearly double the rate of SDS removal. An assay based on human blood hemolysis was developed to measure the remaining cytotoxicity of the cECM. The results from the hemolysis cytotoxicity assay were consistent with a standard live/dead assay using MS1 endothelial cells incubated with the cECM. This study demonstrated an effective, reliable, and relatively inexpensive method for determining the cytotoxicity and blood compatibility of decellularized cECM scaffolds.
Can an Alternative Outflow Strategy be Utilized for High-Risk Bridged Patients with Previous Cardiac Surgery?
Authors: Danish Timothy F. , Davis Mary E. , Xu Meng , Djunaidi Monica , Danter Matthew R. , Kushwaha Sudhir S. , Stulak John M. , Haglund Nicholas A. , Maltais Simon
Published: April 2016

The HeartWare ventricular assist device (HVAD) is an implantable continuous-flow centrifugal pump that has allowed the development of sternal-sparing techniques, with the use of alternative outflow strategies. We compared early outcomes for patients bridged with the conventional versus alternative outflow graft strategy. From January 2013 to October 2014, 89 patients with HVAD implantation were identified. Survival was analyzed with Kaplan–Meier methods, and a log-rank test was used to compare outcomes between groups. Thirty patients (34%) had ≥1 previous sternotomy before HVAD implantation. Eight patients (27%) were approached using an alternative outflow graft technique with outflow graft connection to the descending aorta (n = 4, 50%) or left subclavian artery (n = 4, 50%), whereas 22 (73%) were implanted via a conventional sternotomy approach with the outflow graft to the ascending aorta. Preoperative characteristics (age, Interagency Registry for Mechanically Assisted Circulatory Support [INTERMACS], and Lietz-Miller score) were comparable between groups (all p > 0.05). Median follow-up was 4.7 (2.8–9.3) months of support. Outcomes were comparable between conventional and alternative outflow groups; survival at 6 months was 74% for the conventional group and 83% in the alternative outflow group. An alternative outflow graft strategy can be utilized to support bridged patients with a history of prior sternotomy.
The Growing Integration of Physician Practices
Authors: Richards Michael R. , Nikpay Sayeh S. , Graves John A.
Published: April 2016

Background:

Strategic alignment and integration is currently in vogue throughout the health care industry, but its diffusion and pace have not been documented in recent years. The full range of downstream implications from greater alignment between hospitals and physicians has also not been completely explored.

Objectives:

We track the organizational landscape among all office-based US physician practices from 2009 to 2015 and document the degree of vertical integration over time. Then, we examine the implications of vertical integration on practices’ acceptance of publicly insured patients.

Research Design:

We use descriptive trends and linear regression models with practice level fixed effects to capture the relationships between within-office changes in integration behavior and changes in public payer acceptance.

Results:

Independent (nonintegrated) physician practices are still the most common organizational type, but their share is declining as the share of practices integrated with a health system increases 3-fold between 2009 and 2015. Although >80% of practices that are part of a health system accept Medicaid, <60% of independent practices will see these patients. Vertically integrating with a health system makes it more likely a practice will start seeing Medicaid patients.

Conclusions:

Integration—and possibly consolidation—appears to be occurring and may be increasing over time in the United States. However, it also seems to increase the number of physician practices participating in the Medicaid program. This beneficial side effect has not been previously documented and should be kept in mind as policymakers weigh the pros and cons of a more integrated health care system.
A Narrative Review of Patient and Family Engagement
Authors: Cené Crystal W. , Johnson Beverley H. , Wells Nora , Baker Beverly , Davis Renee , Turchi Renee
Published: April 2016

Background:

Patient and family engagement (PFE) is vital to the spirit of the medical home. This article reflects the efforts of an expert consensus panel, the Patient and Family Engagement Workgroup, as part of the Society of General Internal Medicine’s 2013 Research Conference.

Objective:

To review extant literature on PFE in pediatric and adult medicine and quality improvement, highlight emerging best practices and models, suggest questions for future research, and provide references to tools and resources to facilitate implementation of PFE strategies.

Methods:

We conducted a narrative review of relevant articles published from 2000 to 2015. Additional information was retrieved from personal contact with experts and recommended sources from workgroup members.

Results:

Despite the theoretical importance of PFE and policy recommendations that PFE occurs at all levels across the health care system, evidence of effectiveness is limited, particularly for quality improvement. There is some evidence that PFE is effective, mostly related to engagement in the care of individual patients, but the evidence is mixed and few studies have assessed the effect of PFE on health outcomes. Measurement issues and the lack of a single comprehensive conceptual model pose challenges to progress in this field. Recommendations for future research and a list of practical tools and resources to facilitate PFE are provided.

Conclusions:

Although PFE appeals to patients, families, providers, and policy-makers, research is needed to assess outcomes beyond satisfaction, address implementation barriers, and support engagement in practice redesign and quality improvement. Partnering with patients and families has great potential to support high-quality health care and optimize outcomes.
Delays in Seeking Health Care: Comparison of Veterans and the General Population
Authors: Lee Doohee , Begley Charles E.
Published: April 2016

Objectives:

Recent reports of delays in receiving care among U.S. Veterans have received national attention. Such delays may have an effect on veterans' propensity to seek healthcare as well, which could be detrimental to their health. There exists no evidence at the national level of the magnitude of perceived care delay in the Veterans Affairs (VA) system and how it compares to populations with other types of insurance coverage in the U.S.

Study Design and Methods:

This cross-sectional study analyzed a recent nationally representative survey database (n = 10,907). Descriptive and multivariate regression analyses were performed to determine how care delay for veterans compares with the general population.

Results:

We found that 17.2% of Americans delayed seeking needed healthcare in 2010-2011, but the figure was 29% for veterans. Also, there was a significant association of care delay with VA health care coverage after adjusting for other personal factors and region of the country.

Conclusions:

Study results suggest a possible link between VA access problems and veterans' behavior in seeking needed healthcare, which may be creating disparities in the effectiveness of care for this vulnerable and deserving population. Our study provides evidence of self-reported care delay among veterans. More studies are necessary to further understand factors in relation to delaying seeking care among veterans.
Sonoelastography in the Evaluation of Plantar Fasciitis Treatment
Authors: Kim Minchul , Choi Yun Sun , You Myung-Won , Kim Jin Su , Young Ki Won
Published: April 2016

Objective

The aim of this study was to investigate whether ultrasound elastography can demonstrate the outcome of the treatment in comparison with gray-scale imaging.

Methods

Sixteen patients (mean age, 46.9 years) with plantar fasciitis were prospectively enrolled after unsuccessful conservative treatment. Individuals graded their heel pain on a 100-mm visual analogue scale (VAS) and underwent gray-scale ultrasonography and sonoelastography. Collagen was injected in the heels. Fascial thickness and hypoechogenicity, perifascial edema, and plantar fascial elasticity were evaluated. Follow-up sonoelastography and VAS grading were done 3 months after the injection. Statistical analyses were performed by the paired t test and the Fisher exact test. A P < 0.05 was considered statistically significant.

Results

Mean plantar fascial thickness showed insignificant decrease on follow-up (from 4.30 [1.37] to 4.23 [1.15] mm, P = 0.662). Fascial hypoechogenicity and perifascial edema did not change significantly after treatment. The mean strain ratio of the plantar fascia was significantly increased (from 0.71 [0.24] to 1.66 [0.72], P = 0.001). Softening of the plantar fascia decreased significantly after injection (from 12 to 3 ft, P = 0.004). Twelve (75%) of 16 patients showed significant VAS improvement at the follow-up.

Conclusions

Sonoelastography revealed a hardening of the plantar fascia after collagen injection treatment and could aid in monitoring the improvement of the symptoms of plantar fasciitis, in cases where gray-scale imaging is inconclusive.
Diagnostic Yield of Fine-Needle Aspiration for Axillary Lymph Nodes During Screening Breast Ultrasound
Authors: Youn Inyoung , Kim Eun-Kyung , Yoon Jung Hyun , Moon Hee Jung , Kim Min Jung
Published: April 2016

The purpose of our study was to assess the positive predictive value (PPV) of ultrasound (US)-guided fine-needle aspiration (FNA) and the cancer detection rate for incidentally detected abnormal axillary lymph node (LN) in patients who underwent screening US. We retrospectively reviewed 72 LNs of 69 patients (mean age, 44.9 years) who underwent US-FNA for incidentally detected abnormal axillary LNs on 50,488 screening US from January 2005 to December 2011. The PPV of US-FNA and the cancer detection rate were calculated. We evaluated US images for lymph node size, abnormal findings (hilum loss, eccentric cortical thickening, round shape, extranodal extension, or marked hypoechoic cortex), and mammography for the identification of abnormal LNs. The PPV of each finding was also calculated. The PPV of US-FNA and the cancer detection rate were 2.8% (2/72) and 0.004% (2/50,488), respectively. The mean (SD) measurements for long-axis, short-axis, and cortical thickening of the LNs were 14.9 (5.9) mm, 8.5 (3.5) mm, and 5.8 (2.8) mm, respectively. Of the positive LNs, US findings of hilum loss, eccentric cortical thickening, and extranodal extension were found, and each corresponding PPV was 6.3% (1/16), 1.8% (1/56), and 14.3% (1/7), respectively. The PPV of mammography was 14.3% (1/7). Our results suggest that the PPVs of US-FNA and the cancer detection rate for incidentally detected abnormal axillary LNs during screening US are too low to recommend axillary US during breast US screening and that follow-up is acceptable for abnormal LNs detected during screening breast US that do not have extranodal extension or are negative on mammography.
Torsed Ovarian Dermoid
Authors: Watson Abby , Winter Thomas
Published: April 2016

Ovarian dermoids constitute the most common ovarian neoplasm and make up approximately 20% of all ovarian neoplasms. Dermoids are most common in the reproductive age group, but unlike other ovarian germ cell tumors, their age distribution is quite broad. Torsion may occur in approximately 15% of cases and is more common during pregnancy and in the 6 weeks immediately after delivery. We present a 17-year-old who came to the emergency department in her puerperium with severe right lower quadrant pain. The diagnosis of a 12-cm dermoid was missed at ultrasound. We discuss the reasons for the mistake on ultrasound and give strategies to prevent this from happening in the future. Three commonly overlooked teaching points regarding dermoids are discussed. Ultrasound and computed tomographic imaging, operative course, and correlative intraoperative and pathological images are presented.
Wedding higher taxonomic ranks with metabolic signatures coded in prokaryotic genomes
Authors: Iraola Gregorio , Naya Hugo
Published: April 2016

Taxonomy of prokaryotes has remained a controversial discipline due to the extreme plasticity of microorganisms, causing inconsistencies between phenotypic and genotypic classifications. The genomics era has enhanced taxonomy but also opened new debates about the best practices for incorporating genomic data into polyphasic taxonomy protocols, which are fairly biased towards the identification of bacterial species. Here we use an extensive dataset of Archaea and Bacteria to prove that metabolic signatures coded in their genomes are informative traits that allow to accurately classify organisms coherently to higher taxonomic ranks, and to associate functional features with the definition of taxa. Our results support the ecological coherence of higher taxonomic ranks and reconciles taxonomy with traditional chemotaxonomic traits inferred from genomes. KARL, a simple and free tool useful for assisting polyphasic taxonomy or to perform functional prospections is also presented (https://github.com/giraola/KARL).
From what we perceive to what we remember: Characterizing representational dynamics of visual memorability
Authors: Khaligh-Razavi Seyed-Mahdi , Bainbridge Wilma A. , Pantazis Dimitrios , Oliva Aude
Published: April 2016

Not all visual memories are equal—some endure in our minds, while others quickly disappear. Recent behavioral work shows we can reliably predict which images will be remembered. This image property is calledmemorability. Memorability is intrinsic to an image, robust across observers, and unexplainable by low-level visual features. However, its neural bases and relation with perception and memory remain unknown. Here we characterize the representational dynamics of memorability using magnetoencephalography (MEG). We find memorability is indexed by brain responses starting at 218ms for faces and 371ms for scenes—later than classical early face/scene discrimination perceptual signals, yet earlier than the late memory encoding signal observed at ~700ms. The results show memorability is a high-level image property whose spatio-temporal neural dynamics are different from those of memory encoding. Together, this work brings new insights into the underlying neural processes of the transformation from what we perceive to what we remember.
HDAC inhibition protects degenerating cone photoreceptorsin vivo
Authors: Trifunović Dragana , Arango-Gonzalez Blanca , Comitato Antonella , Barth Melanie , Sahaboglu Ayse , del Amo Eva M. , Kulkarni Manoj , Hauck Stefanie M. , Ueffing Marius , Urtti Arto , Arsenijevic Yvan , Marigo Valeria , Paquet-Durand François
Published: April 2016

Retinal diseases caused by cone photoreceptor cell death are devastating as the patients are experiencing loss of accurate and color vision. Understanding the mechanisms of cone cell death and the identification of key players therein could provide new treatment options. We studied the neuroprotective effects of a histone deacetylase inhibitor, Trichostatin A (TSA), in a mouse model of inherited, primary cone degeneration (cpfl1). We show that HDAC inhibition protects conesin vitro, in retinal explant cultures. More importantly,in vivoa single TSA injection increased cone survival for up to 10 days post-injection. In addition, the abnormal, incomplete cone migration pattern in thecpfl1retina was significantly improved by HDAC inhibition. These findings suggest a crucial role for HDAC activity in primary cone degeneration and highlight a new avenue for future therapy developments for cone dystrophies and diseases associated with impaired cone migration.
ThePseudomonas aeruginosaPSL polysaccharide is a social but non-cheatable trait in biofilms
Authors: Irie Yasuhiko , Roberts Aled E. L. , Kragh Kasper N. , Gordon Vernita D. , Hutchison Jaime , Allen Rosalind J. , Melaugh Gavin , Bjarnsholt Thomas , West Stuart A. , Diggle Stephen P.
Published: April 2016

Extracellular polysaccharides are compounds secreted by microorganisms into the surrounding environment and which are important for surface attachment and maintaining structural integrity within biofilms. The social nature of many extracellular polysaccharides remains unclear, and it has been suggested that they could function as either co-operative public goods, or as traits that provide a competitive advantage. Here we empirically test the co-operative nature of the PSL polysaccharide, which is crucial for the formation of biofilms inPseudomonas aeruginosa. We show that: (1) PSL is not metabolically costly to produce; (2) PSL provides population level benefits in biofilms, for both growth and antibiotic tolerance; (3) the benefits of PSL production are social and are shared with other cells; (4) the benefits of PSL production appear to be preferentially directed towards cells which produce PSL; (5) cells which do not produce PSL are unable to successfully exploit cells which produce PSL. Taken together, this suggests that PSL is a social but relatively non-exploitable trait, and that growth within biofilms selects for PSL-producing strains, even when multiple strains can interact (low relatedness).
Cytokine and Leukocyte Profiling Reveal Pro-Inflammatory and Autoimmune Features in Frontotemporal Dementia Patients
Authors: Jaeger Philipp A. , Stan Trisha M. , Czirr Eva , Britschgi Markus , Berdnik Daniela , Huang Ruo-Pan , Boeve Bradley F. , Boxer Adam L. , Finch NiCole , Fragiadakis Gabriela K. , Graff-Radford Neill R. , Huang Ruochun , Johns Hudson , Karydas Anna , Knopman David S. , Leipold Michael , Maecker Holden , Miller Zachary , Petersen Ronald C. , Rademakers Rosa , Sun Chung-Huan , Younkin Steve , Miller Bruce L. , Wyss-Coray Tony
Published: April 2016

The growing link between systemic environment and brain function opens the possibility that cellular communication and composition in blood are correlated with brain health. We tested this concept in frontotemporal dementia with novel, unbiased tools that measure hundreds of soluble signaling proteins or characterize the vast immune cell repertoire in blood. With these tools we discovered complementary abnormalities indicative of abnormal T cell populations and autoimmunity in frontotemporal dementia.
The discovery potential of RNA processing profiles
Authors: Pagès Amadís , Dotu Ivan , Pallarès-Albanell Joan , Martí Eulàlia , Guigó Roderic , Eyras Eduardo
Published: April 2016

Small non-coding RNAs are highly abundant molecules that regulate essential cellular processes and are classified according to sequence and structure. Here we argue that read profiles from size-selected RNA sequencing capture the post-transcriptional processing specific to each RNA family, thereby providing functional information independently of sequence and structure. We developed SeRPeNT, the first unsupervised computational method that exploits reproducibility across replicates and uses dynamic time-warping and density-based clustering algorithms to identify, characterize and compare small non-coding RNAs (sncRNAs) by harnessing the power of read profiles. We applied SeRPeNT to: a) generate an extended human annotation with 671 new sncRNAs from known classes and 131 from new potential classes, b) show pervasive differential processing between cell compartments and c) predict new molecules with miRNA-like behaviour from snoRNA, tRNA and long non-coding RNA precursors, potentially dependent on the miRNA biogenesis pathway. Furthermore, we validated experimentally four predicted novel non-coding RNAs: a miRNA, a snoRNA-derived miRNA, a processed tRNA and a new uncharacterized sncRNA. SeRPeNT facilitates fast and accurate discovery and characterization of small non-coding RNAs at unprecedented scale. SeRPeNT code is available under the MIT license athttps://github.com/comprna/SeRPeNT.
Using Ordinary Differential Equations to Explore Cancer-Immune Dynamics and Tumor Dormancy
Authors: Wilkie Kathleen P. , Hahnfeldt Philip , Hlatky Lynn
Published: April 2016

Cancer is not solely a disease of the genome, but is a systemic disease that affects the host on many functional levels, including, and perhaps most notably, the function of the immune response, resulting in both tumor-promoting inflammation and tumor-inhibiting cytotoxic action. The dichotomous actions of the immune response induce significant variations in tumor growth dynamics that mathematical modeling can help to understand. Here we present a general method using ordinary differential equations (ODEs) to model and analyze cancer-immune interactions, and in particular, immune-induced tumor dormancy.
Toxicity Management in CAR T cell therapy for B-ALL: Mathematical modelling as a new avenue for improvement
Authors: Hanson Shalla , Grimes David Robert , Taylor-King Jake P. , Bauer Benedikt , Warman Pravnam I. , Frankenstein Ziv , Kaznatcheev Artem , Bonassar Michael J. , Cannataro Vincent L. , Motawe Zeinab Y. , Lima Ernesto A. B. F. , Kim Sungjune , Davila Marco L. , Araujo Arturo
Published: April 2016

Advances in genetic engineering have made it possible to reprogram individual immune cells to express receptors that recognise markers on tumour cell surfaces. The process of re-engineering T cell lymphocytes to expressChimeric Antigen Receptors(CARs), and then re-infusing the CAR-modified T cells into patients to treat various cancers is referred to as CAR T cell therapy. This therapy is being explored in clinical trials - most prominently for B Cell Acute Lymphoblastic Leukaemia (B-ALL), a common B cell malignancy, for which CAR T cell therapy has led to remission in up to 90% of patients. Despite this extraordinary response rate, however, potentially fatal inflammatory side effects occur in up to 10% of patients who have positive responses. Further, approximately 50% of patients who initially respond to the therapy relapse. Significant improvement is thus necessary before the therapy can be made widely available for use in the clinic.

To inform future development, we develop a mathematical model to explore interactions between CAR T cells, inflammatory toxicity, and individual patients’ tumour burdensin silico. This paper outlines the underlying system of coupled ordinary differential equations designed based on well-known immunological principles and widely accepted views on the mechanism of toxicity development in CAR T cell therapy for B-ALL - and reportsin silicooutcomes in relationship to standard and recently conjectured predictors of toxicity in a heterogeneous, randomly generated patient population. Our initial results and analyses are consistent with and connect immunological mechanisms to the clinically observed, counterintuitive hypothesis that initial tumour burden is a stronger predictor of toxicity than is the dose of CAR T cells administered to patients.

We outline how the mechanism of action in CAR T cell therapy can give rise to such non-standard trends in toxicity development, and demonstrate the utility of mathematical modelling in understanding the relationship between predictors of toxicity, mechanism of action, and patient outcomes.
The hippocampus generalizes across memories that share item and context information
Authors: Libby Laura A. , Ragland J. Daniel , Ranganath Charan
Published: April 2016

Episodic memory is known to rely on the hippocampus, but how the hippocampus organizes different episodes to permit their subsequent retrieval remains controversial. According to one view, hippocampal coding differentiates between similar events to reduce interference, whereas an alternative view is that the hippocampus assigns similar representations to events that share item and context information. Here, we used multivariate analyses of activity patterns measured with functional magnetic resonance imaging (fMRI) to characterize how the hippocampus distinguishes between memories based on similarity of their item and/or context information. Hippocampal activity patterns discriminated between events that shared either item or context information, but generalized across events that shared similar item-context associations. The current findings provide novel evidence that, whereas the hippocampus can resist mnemonic interference by separating events that generalize along a single attribute dimension, overlapping hippocampal codes may support memory for events with overlapping item-context relations.
Diverticulitis: does age matter?
Authors: Horesh Nir , Shwaartz Chaya , Amiel Imri , Nevler Avinoam , Shabtai Esther , Lebedeyev Alexander , Nadler Roi , Rosin Danny , Gutman Mordechai , Zmora Oded
Published: April 2016

Objective

Acute diverticulitis has been traditionally associated with worse outcome in young patients, indicating a more aggressive surgical approach is required for them. The aim of this study was to assess whether acute diverticulitis was more virulent in young patients.

Methods

A retrospective, cross‐sectional study included all patients who were admitted for a first episode of acute diverticulitis between January 2004 and December 2013. The patients were divided into two groups (≤50 years and >50 years) based on their age. Patients' characteristics, clinical and surgical data were recorded and analyzed.

Results

Overall, 636 patients were included in the database, including 177 (27.8%) in the younger group and 459 in the elder group. There were no significant differences between the groups in disease complexity, peritonitis, laboratory work‐up, vital signs on presentation, bowel obstruction or the presence of fistula and abscess in need of drainage. Younger patients had more free extra‐luminal air on computed tomography (CT) scan (P = 0.03). Surgical data, including the intra‐operative modified Hinchey score and the need for emergency and additional surgery did not significantly differ between the two groups. Young patients had more readmissions (P = 0.01) due to acute diverticulitis, diverticular complications and elective surgery. Length of hospital stay (P = 0.0001) was longer and postoperative complications were more common in the elder patients.

Conclusions

The clinical presentation of acute diverticulitis does not seem to be worse in the young population. Younger patients tend to have a more severe presentation on CT scan and more readmissions, but this did not translate to a more severe disease course.
Cyanoacrylate therapy for the treatment of gastric varices: a new method
Authors: Singh Virendra , Singh Ranjan , Bhalla Ashish , Sharma Navneet
Published: April 2016

Objective

Cyanoacrylate (CYA) injection is recommended for bleeding gastric varices (GV) but with significant adverse effects. Transesophageal endoscopic ultrasound‐guided therapy of large GV with a combined coil and CYA injection has shown promising results. However, it is expensive and requires technical expertise. In this study, we aimed to compare the safety and efficacy of a new method with UCYA [undiluated CYA (UCYA) followed by lipiodol‐diluated CYA (DCYA)] in the management of large bleeding GV.

Methods

Fifteen consecutive patients with bleeding from large GV (>1 cm) were prospectively treated with DCYA and another 15 patients treated with UCYA retrospectively. All patients in the DCYA group underwent thoracic computed tomography scan to identify glue embolism.

Results

Baseline characteristics were similar between the two groups. Rates of GV obliteration and rebleeding were 100% vs 93.3% (P = 0.309) and 6.7% vs 33.3% (P = 0.06) in the DCYA and UCYA groups, respectively. One patient in the UCYA group had needle fixation which led to fatal bleeding after forceful needle extraction. In DCYA group none had glue embolism.

Conclusions

Both UCYA and DCYA are effective in treating bleeding from large GV. DCYA has lower rebleeding rates and tends to have fewer adverse events than UCYA injection, although the differences are not statistically significant. Large‐sample‐sized prospective randomized trials are required.
A new integrative framework for large‐scale assessments of biodiversity and community dynamics, using littoral gastropods and crabs of British Columbia, Canada
Authors: Castelin M. , Van Steenkiste N. , Pante E. , Harbo R. , Lowe G. , Gilmore S. R. , Therriault T. W. , Abbott C. L.
Published: April 2016

Improving our understanding of species responses to environmental changes is an important contribution ecologists can make to facilitate effective management decisions. Novel synthetic approaches to assessing biodiversity and ecosystem integrity are needed, ideally including all species living in a community and the dynamics defining their ecological relationships. Here, we present and apply an integrative approach that links high‐throughput, multicharacter taxonomy with community ecology. The overall purpose is to enable the coupling of biodiversity assessments with investigations into the nature of ecological interactions in a community‐level data set. We collected 1195 gastropods and crabs in British Columbia. First, the General mixed Yule‐coalescent (GMYC) and the Poisson Tree Processes (PTP) methods for proposing primary species‐hypotheses based on cox1 sequences were evaluated against an integrative taxonomic framework. We then used data on the geographic distribution of delineated species to test species co‐occurrence patterns for nonrandomness using community‐wide and pairwise approaches. Results showed that PTP generally outperformed GMYC and thus constitutes a more effective option for producing species‐hypotheses in community‐level data sets. Nonrandom species co‐occurrence patterns indicative of ecological relationships or habitat preferences were observed for grazer gastropods, whereas assemblages of carnivorous gastropods and crabs appeared influenced by random processes. Species‐pair associations were consistent with current ecological knowledge, thus suggesting that applying community assembly within a large taxonomical framework constitutes a valuable tool for assessing ecological interactions. Combining phylogenetic, morphological and co‐occurrence data enabled an integrated view of communities, providing both a conceptual and pragmatic framework for biodiversity assessments and investigations into community dynamics.
TEMPLE: analysing population genetic variation at transcription factor binding sites
Authors: Litovchenko Maria , Laurent Stefan
Published: April 2016

Genetic variation occurring at the level of regulatory sequences can affect phenotypes and fitness in natural populations. This variation can be analysed in a population genetic framework to study how genetic drift and selection affect the evolution of these functional elements. However, doing this requires a good understanding of the location and nature of regulatory regions and has long been a major hurdle. The current proliferation of genomewide profiling experiments of transcription factor occupancies greatly improves our ability to identify genomic regions involved in specific DNA–protein interactions. Although software exists for predicting transcription factor binding sites (TFBS), and the effects of genetic variants on TFBS specificity, there are no tools currently available for inferring this information jointly with the genetic variation at TFBS in natural populations. We developed the software Transcription Elements Mapping at the Population LEvel (TEMPLE), which predicts TFBS, evaluates the effects of genetic variants on TFBS specificity and summarizes the genetic variation occurring at TFBS in intraspecific sequence alignments. We demonstrate that TEMPLE's TFBS prediction algorithms gives identical results to PATSER, a software distribution commonly used in the field. We also illustrate the unique features of TEMPLE by analysing TFBS diversity for the TF Senseless (SENS) in one ancestral and one cosmopolitan population of the fruit fly Drosophila melanogaster. TEMPLE can be used to localize TFBS that are characterized by strong genetic differentiation across natural populations. This will be particularly useful for studies aiming to identify adaptive mutations. TEMPLE is a java‐based cross‐platform software that easily maps the genetic diversity at predicted TFBSs using a graphical interface, or from the Unix command line.
The Immunogenicity of CRISP1 Plasmid‐Based Contraceptive Vaccine can be Improved When Using Chitosan Nanoparticles as the Carrier
Authors: Luo Jin , Liu Xue‐li , Zhang Yi , Wang Ya‐qin , Xu Wang‐ming , Yang Jing
Published: April 2016

Problem

To evaluate the effectiveness and security of a contraceptive vaccine using plasmid DNA encoding mouse CRISP1 as antigen and chitosan nanoparticles as the carrier.

Method of study

Chitosan‐pcDNA3.1‐mCRISP1 Nanoparticles (CS‐DNA NPs) were prepared and characterized in terms of morphology, zeta potential, polydispersity index, and binding capacity of pDNA. The cytotoxicity and gene transfer capability of CS‐DNA NPs were assessed in COS‐7 cells compared to Lipofectamine 2000™. Four groups of mice received three injections of 0.9% normal saline, pcDNA3.1 vector, pcDNA3.1‐CRISP1, or CS‐DNA NPs, respectively. ELISA was used to examine the immune responses. Fertility and mean litter size were analyzed by natural mating.

Results

CS‐DNA NPs have a spherical or elliptical shape with a mean diameter of 189.3 nm, positive zeta potential, and good DNA condensation. It also showed high DNAse resistance and good transfection efficiency without cell toxicity. The titers of anti‐mCRISP1 antibodies from CS‐DNA NP‐immunized mice were significantly higher than that of pcDNA3.1‐CRISP1 group. Male and female CS‐DNA NP‐immunized animals were recognized with a statistically significant reduction in their fertility compared with pcDNA3.1‐CRISP1‐immunized mice.

Conclusion

This study demonstrated that using chitosan‐DNA nanoparticles as the carrier can improve the immunogenicity of mCRISP1 DNA contraceptive vaccine with good security.
The relation between executive functioning, reaction time, naming speed, and single word reading in children with typical development and language impairments
Authors: Messer David , Henry Lucy A. , Nash Gilly
Published: April 2016

Background

Few investigations have examined the relationship between a comprehensive range of executive functioning (EF) abilities and reading.

Aims

Our investigation identified components of EF that independently predicted single word reading, and determined whether their predictive role remained when additional variables were included in the regression analyses. This provided information about the EF processes that are related to reading, and the unity and diversity of EF.

Sample

This study consisted of 160 children: 88 were typically developing with no language difficulties; 72 had language impairments.

Method

The assessments involved decoding, 10 measures of EF, reaction time, naming speed, non‐verbal and verbal age‐equivalent scores.

Results and conclusions

In the first regression analysis, which only concerned the EF variables, the following verbal forms of EF had significant relationships with decoding: working memory, fluency, planning, and inhibition. Further regression analyses included additional predictor variables: reaction time, naming speed, and age‐equivalent scores. These analyses indicated that most of the EF variables continued to predict decoding even when entered with competitor variables. Furthermore, after the entry of EF variables, there were no group differences in decoding (typical vs. language difficulties). We discuss the contribution of EF and other variables to reading abilities.
Prevalence and prognosis of a low serum testosterone in men with type 2 diabetes: the Fremantle Diabetes Study Phase II
Authors: Hamilton Emma J. , Davis Wendy A. , Makepeace Ashley , Lim Ee Mun , Yeap Bu B. , Peters Kirsten E. , Davis Timothy M. E.
Published: April 2016

Background

Because published studies have usually involved imprecise assays and selected patients with limited additional data and follow‐up, the consequences of a low serum testosterone in diabetes are unclear. This study assessed the prevalence, associates and prognosis of a low testosterone in community‐dwelling men with type 2 diabetes.

Design

Longitudinal observational study.

Patients

788 men (mean ± SD age: 65·8 ± 11·3 years) followed for 4·0 ± 1·1 years.

Measurements

Serum testosterone, SHBG, erectile dysfunction (ED; Sexual Health Inventory for Men score <22), anaemia (haemoglobin <130 g/l), all‐cause mortality.

Results

The mean ± SD total serum testosterone by liquid chromatography/mass spectrometry was 13·1 ± 5·9 nmol/l (30·6% <10 nmol/l). Most men with a total testosterone <10 nmol/l (67·0%) had a normal/low serum LH. Serum testosterone was independently associated with anaemia (P < 0·001), but not ED (P = 0·80), in logistic regression models. The optimal cut‐point (Youden Index) for anaemia was 9·8 nmol/l (sensitivity 53·6%, specificity 75·4%). During the follow‐up, 102 men (12·9%) died. There was a U‐shaped relationship between total serum testosterone quintiles and death (P = 0·003, log rank test). The middle quintile (>11·1 to ≤13·7 nmol/l) had the lowest risk and there was a 78% increased risk for highest (>16·9 nmol/l) vs lowest (≤8·6 nmol/l) quintile in Cox proportional hazards modelling (P = 0·036). Free serum testosterone and SHBG quintiles were not associated with death.

Conclusions

These data provide some support for the general conventional serum testosterone <10 nmol/l cut‐point in identifying an increased risk of anaemia and the subsequent death in men with type 2 diabetes, but indicate that high‐normal levels are also an adverse prognostic indicator.
Thyroid lobectomy is an effective option for unilateral benign nodular disease
Authors: Lytrivi Maria , Kyrilli Aglaia , Burniat Agnès , Ruiz Patino Maria , Sokolow Youri , Corvilain Bernard
Published: April 2016

Objective

The use of thyroid lobectomy in the treatment of unilateral, benign nodules is limited by the potential of nodular recurrence in the remaining lobe. This study aimed to assess the rate and clinical impact of nodular recurrence in the contralateral lobe after thyroid lobectomy and to identify predictive factors of recurrence.

Design

Single‐centre retrospective study.

Patients

Records of patients that underwent lobectomy for unilateral thyroid nodules between 1991 and 2010 were reviewed and 270 patients were included. Exclusion criteria were: presence of contralateral nodule(s) ≥5 mm on preoperative ultrasound, diagnosis of cancer necessitating completion thyroidectomy or pseudonodules. Recurrence was defined as the occurrence of nodule(s) ≥5 mm in the remaining lobe on at least one postoperative ultrasound. A set of clinical, imaging, histological and biochemical parameters was tested as predictors of recurrence using logistic regression.

Results

After a median follow‐up of 78 months (range, 12–277 months), the global recurrence rate was 42% and recurrence of nodules of a size ≥1 cm occurred in 19%. Reoperation rate was 1·1%. 90% of patients were treated postoperatively by levothyroxine. Median time to nodular recurrence was 4 years. Preoperative contralateral lobe volume and resected thyroid weight were identified as significant predictors of recurrence (P = 0·045 and P = 0·03 respectively).

Conclusions

Thyroid lobectomy is an effective therapeutic strategy for unilateral, benign nodules, resulting in a low rate of clinically relevant nodular relapse in a mildly iodine‐deficient area. Patients with uninodular disease and a contralateral lobe of normal size are particularly good candidates for lobectomy.
Neutral associations of testosterone, dihydrotestosterone and estradiol with fatal and non‐fatal cardiovascular events, and mortality in men aged 17–97 years
Authors: Chan Yi X. , Knuiman Matthew W. , Hung Joseph , Divitini Mark L. , Beilby John P. , Handelsman David J. , Beilin Jonathan , McQuillan Brendan , Yeap Bu B.
Published: April 2016

Context

Lower testosterone (T) is associated with poorer health outcomes in older men, however, the relationship between T, dihydrotestosterone (DHT) and estradiol (E2) with cardiovascular disease (CVD) in younger to middle‐aged men remains unclear.

Objectives

We assessed associations between endogenous sex hormones with mortality (all‐cause and CVD) and CVD events, in a cohort of men aged 17–97 years.

Participants and methods

Sex hormones were assayed using mass spectrometry in 2143 men from the 1994/5 Busselton Health Survey. Outcomes to December 2010 were analysed.

Results

Of the 1804 men included in the analysis, mean age was 50·3 ± 16·8 years and 68·9% of men were aged <60. Mean follow‐up period was 14·9 years. There were 319 deaths, 141 CVD deaths and 399 CVD events. Compared to the full cohort, men who died had lower baseline T (12·0 ± 4·4 vs 13·6 ± 4·9 nmol/l), free T (181·9 ± 52·9 vs 218·3 ± 63·8 pmol/l) and DHT (1·65 ± 0·64 vs 1·70 ± 0·72 nmol/l), but higher E2 (64·0 ± 32 vs 60·1 ± 30·2 pmol/l). After adjustment for risk factors, T was not associated with mortality (adjusted HR = 0·90, 95% CI 0·79–1·04; P = 0·164 for every increase in 1 SD of T), CVD deaths (adjusted HR = 1·04, 95% CI 0·84–1·29; P = 0·708) or CVD events (adjusted HR = 1·03, 95% CI 0·92–1·15, P = 0·661). No associations were found for free T, DHT or E2. Results were similar for men older and younger than 60 years.

Conclusions

In predominantly middle‐aged men, T, DHT and E2 do not influence mortality or CVD outcomes. This neutral association of hormones with CVD contrasts with prior studies of older men.
First report of an aneurysmal bone cyst presenting as subungual mass
Authors: Müller Cornelia Sigrid Lissi , Kim Yoo‐Jin , Koch Katrin , Schneider Günther , Pföhler Claudia , Kohn Dieter , Vogt Thomas , Baumhoer Daniel
Published: April 2016

Painful subungual tumor masses in the toes usually emerge as glomus tumors or subungual exostoses. We present a patient with an aneurysmal bone cyst located subungually in whom the diagnosis was delayed due to inadequate diagnostic procedures, which led to marked destruction of the distal phalanx of the great toe of the right foot. After biopsy, the distal phalanx could not be preserved due to critical soft tissue involvement and the size of the process. Thus, we describe this rare entity to encourage clinicians to establish the diagnosis by biopsy of a tissue swelling of unclear origin and duration that does not resolve after a short time. Imaging examinations are useful in demonstrating periosteal involvement and extension of the lesion and can be helpful in the diagnostic algorithm. An interdisciplinary approach is a top priority to ensure optimal treatment.
Large reorganizations in butterfly communities during an extreme weather event
Authors: De Palma Adriana , Dennis Roger L. H. , Brereton Tom , Leather Simon R. , Oliver Tom H.
Published: April 2016

Drought events are projected to increase in frequency and magnitude, which may alter the composition of ecological communities. Using a functional community metric that describes abundance, life history traits and conservation status, based upon Grime'sCSR(Competitive – Stress tolerant – Ruderal) scheme, we investigated how British butterfly communities changed during an extreme drought in 1995. Throughout Britain, the total abundance of these insects had a significant tendency to increase, accompanied by substantial changes in community composition, particularly in more northerly, wetter sites. Communities tended to shift away from specialist, vulnerable species, and towards generalist, widespread species and, in the year following, communities had yet to return to equilibrium. Importantly, heterogeneity in surrounding landscapes mediated community responses to the drought event. Contrary to expectation, however, community shifts were more extreme in areas of greater topographic diversity, whilst land‐cover diversity buffered community changes and limited declines in vulnerable specialist butterflies.