bluuebunny/crossref_metadata_2025 huggingface dataset:
Horizontal distribution of Cladocera in a subtropical lake marginal to a river
Authors: Campanelli Mortari Rafael , Henry Raoul
Published: September 2015

Various abiotic and biotic factors may determine the spatial distribution patterns of Cladocera in a lake. The aim of this study was to examine the horizontal distribution of Cladocera in a lake connected to a river during low and high water phases and the abiotic factors that determine variation in their populations. Microcrustaceans were collected in integrated samples at 40 sites distributed on a lake. The mean abundance of Cladocera was around five times higher in the low water phase than in the high water phase. Only populations of Bosmina hagmanni Stingelin, 1904 and Bosminopsis deitersi Richard, 1895 predominated in the low water phase, while in the high water phase, B. hagmanni, Ceriodaphnia cornuta f. rigaudi (Sars, 1896) Diaphanosoma spinulosum Herbst, 1975 and Moina micrura Kurz, 1875 predominated at some sampling stations. The majority of cladoceran species showed an aggregated distribution in the low water phase, except B. longirostris and D. fluviatile and, B. longirostris, the only ones which presented a uniform distribution pattern in the high water phase. Most of the aggregates of cladoceran species predominated in both the dry and rainy periods on the east side of the lake due to intense easterly wind. Some cladoceran populations formed isolate aggregates in other parts of the lake and near the lake-river connection site. Canonical Correspondence Analysis (CCA) showed that the variables phosphorus, nitrogen and suspended matter (eutrophic conditions) determined distinct patterns of horizontal distribution in some cladoceran populations at some stations in the low water phase, while in others, the patterns of horizontal distribution were determined by environmental conditions as alkalinity, pH, oxygen, depth and water transparency. In the high water phase, CCA revealed that phosphorus and water transparency were positive determining factors in the distribution of some cladoceran species, while alkalinity, depth and suspended matter were negative. Our study showed that the distribution of cladoceran species may vary somewhat between the two distinct water phases depending on the micro-scale variation patterns of environmental factors.
Sediment records of the metal pollution at Chihu Lake near a copper mine at the middle Yangtze River in China
Authors: Yao Shuchun , Xue Bin
Published: September 2015

Two short sedimentary cores were collected in 2012 from Chihu Lake in the middle Yangtze River Basin using a gravity corer. Heavy metals, including Pb, Cu, Zn, Cd, Cr, Co, Ni and Mn, and major elements, including Al, Fe, K, Mg and Ti, were measured. Radionuclides, including 210Pb and 137Cs, were analyzed to date the sediments. The Mn enrichment in the sediments of the two cores did not significantly influence the distribution of the heavy metals. The Pb, Cu, Zn, Cd, Co and Ni contents have increased over the past 30 to 40 years. The decrease in the 206Pb/207Pb ratios toward the surface also indicated increasing mining sources of Pb loading to the lake sediments. The maximum concentration of Cu, Zn and Cd recorded in the 1990s was 2047, 1343 and 60.9 mg kg-1 dry mass, respectively, and the maximum enrichment factors of Cu, Zn and Cd were 62, 16 and 206, respectively. The heavy metal enrichment at Chihu sediment was high overall because of the mining waste discharge. 
Breast Cancer: Conventional Diagnosis and Treatment Modalities and Recent Patents and Technologies
Authors: Nounou Mohamed I. , ElAmrawy Fatema , Ahmed Nada , Abdelraouf Kamilia , Goda Satyanarayana , Syed-Sha-Qhattal Hussaini
Published: September 2015

Breast cancer is the most prevalent cancer among women worldwide. However, increased survival is due to the dramatic advances in the screening methods, early diagnosis, and breakthroughs in treatments. Over the course of the last decade, many acquisitions have taken place in this critical field of research in the pharmaceutical industry. Advances in molecular biology and pharmacology aided in better understanding of breast cancer, enabling the design of smarter therapeutics able to target cancer and respond to its microenvironment efficiently. Patents and research papers investigating diagnosis and treatment strategies for breast cancer using novel technologies have been surveyed for the past 15 years. Various nanocarriers have been introduced to improve the therapeutic efficacy of anticancer drugs, including liposomes, polymeric micelles, quantum dots, nanoparticles, and dendrimers. This review provides an overview of breast cancer, conventional therapy, novel technologies in the management of breast cancer, and rational approaches for targeting breast cancer.

Highlights

Breast cancer is the most common cancer in women worldwide. However, survival rates vary widely, optimistically heading toward a positive trend. Increased survival is due to the drastic shift in the screening methods, early diagnosis, and breakthroughs in treatments. Different strategies of breast cancer classification and staging have evolved over the years. Intrinsic (molecular) subtyping is essential in clinical trials and well understanding of the disease. Many novel technologies are being developed to detect distant metastases and recurrent disease as well as to assess response to breast cancer management. Intensive research efforts are actively ongoing to take novel breast cancer therapeutics to potential clinical application. Most of the recent research papers and patents discuss one of the following strategies: the development of new drug entities that specifically target the breast tumor cells; tailor designing a novel carrier system that can multitask and multifunction as a drug carrier, targeting vehicle and even as a diagnostic tool, direct conjugation of a therapeutic drug moiety with a targeting moiety, diagnostic moiety or pharmacokinetics altering moiety; or the use of innovative nontraditional approaches such as genetic engineering, stem cells, or vaccinations.
Adenomyosis: Pictorial Essay of Two-Dimensional and Three-Dimensional Ultrasonography Findings
Authors: Grigore Mihaela
Published: September 2015

Purpose

Adenomyosis is a common gynecological disease that is defined as the presence of nonneoplastic ectopic endometrial glands and stroma in the myometrium. These characteristics are associated with reactive overgrowth of the musculature. The aim of this pictorial essay was to delineate the specific sonographic features of adenomyosis as seen with twodimensional (2D) and three-dimensional (3D) ultrasonography.

Methods

Evaluation of the adenomyosis is best achieved in daily practice with transvaginal ultrasonography.

Results

The most important features of adenomyosis are anechoic foci, striation, heterogeneous myometrium, and an asymmetrical uterine wall. All of these features were seen in this study by 2D ultrasonography. Three-dimensional ultrasonography allowed visualization of the thickness and disruption of the endometrial-myometrial junction.

Conclusion

Two-dimensional and 3D ultrasonography are valuable tools for diagnosing adenomyosis even in early stages of the disease because they make it possible to evaluate both the myometrium and the endometrial-myometrial junction. The combined information gained from the 2D and 3D ultrasonography examinations not only allows diagnosis of adenomyosis but also pinpoints the current stage of the disease.

How to cite this article

Grigore M. Adenomyosis: Pictorial Essay of Two-Dimensional and Three-Dimensional Ultrasonography Findings. Donald School J Ultrasound Obstet Gynecol 2015;9(2):188-192.
HDlive and Three-Dimensional Imaging in Prenatal Diagnosis of Sirenomelia in the First Trimester: A Case Report and Brief Review of the Literature
Authors: Raga Francisco , Caballero Oscar , Bonilla Francisco , Bonilla-Musoles Fernando , Carlos Castillo Juan
Published: September 2015

Herein a case of sirenomelia diagnosed in week 12 by using HDlive and three-dimensional (3D) imaging. These new technologies allowed for an early diagnosis and also depicting realistic images.

How to cite this article

Bonilla-Musoles F, Caballero O, Castillo JC, Bonilla F Jr, Raga F. HDlive and Three-Dimensional Imaging in Prenatal Diagnosis of Sirenomelia in the First Trimester: A Case Report and Brief Review of the Literature. Donald School J Ultrasound Obstet Gynecol 2015;9(2):193-196.
Knowledge, Attitude and Perception Regarding Organ Donation among the Nursing Students
Authors: Krishnan Nadiya , Ghai Sandhya , Kaur Gagandeep , Kaur Sukhpal , Rana Deepika , Kathania Dimple , Thakur Godawari , Kaur Gurinder
Published: September 2015

A descriptive cross-sectional study was undertaken to assess the knowledge, attitude and perception regarding organ donation among the nursing students. The study was conducted at National Institute of Nursing Education, Postgraduate Institute of Medical Education and Research, Chandigarh. Using stratified systematic random sampling technique, 200 nursing student undergoing graduation and postgraduation courses were enrolled in the study. The tool used for data collection was a self-administered structured questionnaire consisting of three parts, i.e. information profile, assessment of knowledge, and assessment of attitude and perception regarding organ donation. For the assessment of knowledge, 17 multiple choice questions with one correct answer was used. The maximum attainable score was 18. One question had two right answers and was given a score of two. A five point Likert scale consisting of 15 questions was used for assessment of both attitude and perception of subjects regarding organ donation. Maximum attainable score was 65. Data collected was analyzed using descriptive and inferential statistics. The results of study revealed that 74.5% of the subjects had average knowledge, 22% had poor knowledge and only 3.5% had good level of knowledge regarding organ donation. The mean knowledge score of the subjects was 10.56 ± 2.01 with the range of 5 to 17. Regarding attitude and perception toward organ donation, 55.5% had neutral attitude and perception, 43.5% had positive attitude and perception and only 1% had negative attitude and perception.

It was concluded that majority of students had average knowledge about organ donation with neutral or positive attitude and perception. There is need to organize separate educational programs on organ donation for the nursing students other than their classroom teaching.

How to cite this article

Kaur S, Ghai S, Krishnan N, Rana D, Kathania D, Kaur G, Thakur G, Kaur G. Knowledge, Attitude and Perception Regarding Organ Donation among the Nursing Students. J Postgrad Med Edu Res 2015;49(3):105-110.
An Interesting Unusual Case of Hypokalemic Quadriparesis in 48 Years Hypertensive Male Patient: A Liddle's Syndrome
Authors: Mukhopadhyay Jotideb , Roy Manoj Kumar , Chatterjee Apratim , Sarkar Anup , Roy Koushik , Lahiri Durjoy , Agarwal Rakesh , Mukhopadhyay Sumanto
Published: September 2015

In 1963, Liddle et al described a disorder that looks like the features of primary aldosteronism, characterized by severe hypertension and hypokalemia but with negligible secretion of aldosterone. They theorized that this was ‘a disorder in which the renal tubles transport ions with such facility that the end result simulates that of a mineralocorticoid excess’. Liddle's syndrome involves abnormal kidney function, with excess reabsorption of sodium and loss of potassium from the renal tubule, and is treated with a combination of low sodium diet and potassiumsparing diuretic drugs (e.g. amiloride). We are reporting a case of 48 years known hypertensive patient admitted with acute onset quadriparesis, ultimately diagnosed as hypokalemia due to Liddle's syndrome, treated with low sodium salt and potassium sparing diuretics-amiloride responds dramatically.

How to cite this article

Roy MK, Chatterjee A, Sarkar A, Roy K, Lahiri D, Agarwal R, Mukhopadhyay S, Mukhopadhyay J. An Interesting Unusual Case of Hypokalemic Quadriparesis in 48 Years Hypertensive Male Patient: A Liddle's Syndrome. J Postgrad Med Edu Res 2015;49(3):143-145.
Localized Gingival Enlargement induced by Systemic Administration of Phenytoin for the Management of Epidermolysis Bullosa
Authors: Gowda K Smitha , Vinod Shilpa
Published: September 2015

Epidermolysis bullosa (EB) represents a spectrum of diseases that are characterized by increased fragility and blistering of the skin. At present, while there is no specific treatment for EB, the therapeutic approaches are essentially palliative, which aims at achieving an acceptable quality of life. A rare case of EB in a 15-year-old Indian boy who was on phenytoin for its proposed action on collagenase and who developed localized gingival overgrowth as a side effect is reported here. The patient presented with vesiculobullous lesion, anonychia, dental anomalies and high caries activity which are the clinical manifestations of EB.

How to cite this article

Gowda KS, Vinod S. Localized Gingival Enlargement induced by Systemic Administration of Phenytoin for the Management of Epidermolysis Bullosa. Int J Experiment Dent Sci 2015;4(1):58-61.
Comparing solubility algorithms of greenhouse gases in Earth-System modelling
Authors: Vieira V. M. N. C. S. , Sahlée E. , Jurus P. , Clementi E. , Pettersson H. , Mateus M.
Published: September 2015

Abstract. Accurate solubility estimates are fundamental for (i) Earth-System models forecasting the climate change taking into consideration the atmosphere–ocean balances and trades of greenhouse gases, and (ii) using field data to calibrate and validate the algorithms simulating those trades. We found important differences between the formulation generally accepted and a recently proposed alternative relying on a different chemistry background. First, we tested with field data from the Baltic Sea, which also enabled finding differences between using water temperatures measured at 0.5 or 4 m depths. Then, we used data simulated by atmospheric (Meteodata application of WRF) and oceanographic (WW3-NEMO) models of the European Coastal Ocean and Mediterranean to compare the use of the two solubility algorithms in Earth-System modelling. The mismatches between both formulations lead to a difference of millions of tons of CO2, and hundreds of tons of CH4 and N2O, dissolved in the first meter below the sea surface of the whole modelled region.
Assessing the Impact of Analytical Error on Perceived Disease Severity
Authors: Kroll Martin H. , Garber Carl C. , Bi Caixia , Suffin Stephen C.
Published: September 2015

Context

The perception of the severity of disease from laboratory results assumes that the results are free of analytical error; however, analytical error creates a spread of results into a band and thus a range of perceived disease severity.

Objective

To assess the impact of analytical errors by calculating the change in perceived disease severity, represented by the hazard ratio, using non–high-density lipoprotein (nonHDL) cholesterol as an example.

Design

We transformed nonHDL values into ranges using the assumed total allowable errors for total cholesterol (9%) and high-density lipoprotein cholesterol (13%). Using a previously determined relationship between the hazard ratio and nonHDL, we calculated a range of hazard ratios for specified nonHDL concentrations affected by analytical error.

Results

Analytical error, within allowable limits, created a band of values of nonHDL, with a width spanning 30 to 70 mg/dL (0.78–1.81 mmol/L), depending on the cholesterol and high-density lipoprotein cholesterol concentrations. Hazard ratios ranged from 1.0 to 2.9, a 16% to 50% error. Increased bias widens this range and decreased bias narrows it.

Conclusions

Error-transformed results produce a spread of values that straddle the various cutoffs for nonHDL. The range of the hazard ratio obscures the meaning of results, because the spread of ratios at different cutoffs overlap. The magnitude of the perceived hazard ratio error exceeds that for the allowable analytical error, and significantly impacts the perceived cardiovascular disease risk. Evaluating the error in the perceived severity (eg, hazard ratio) provides a new way to assess the impact of analytical error.
Numerical Prediction of Thermal Storage Using Phase Change Material
Authors: Sami S. , Tardy F.
Published: September 2015

A numerical mathematical model has been developed to predict the thermal behavior of phase change material during thermal storage. The model includes the effects of various mechanisms of heat transfer such as conduction, convection as well as fusion of the phase change material. Water/Ice was used as a phase change material. The thermal behavior of the phase change material during cooling has been studied experimentally and analyzed under different conditions. Comparisons were made against experimental data for validation of the predictive model. The model fairly predicted experimental data obtained at various inlet conditions.
Mathematical Modelling of Portable Solar Water Distillation System
Authors: Sahoo U. , Singh S. K. , Kumar R. , Kumar P.
Published: September 2015

Portable Solar Water Distillation (PSWD) system can provide drinking water and hot water simultaneously to households. It utilizes solar radiation to heat the water and produce fresh water out of the saline or brackish water & also produce hot water. The paper focuses mainly on field performance of a new design of PSWD for domestic applications in remote and hilly areas. Field Performance data of PSWD system has been recorded during summer and winter in northern region. It is observed that on Solar Global Radiation 2.3 kWh/ 0.25 m2, maximum output of distilled water generation of 1.2 liters/day per 0.25 m2 was achieved and average temperature of hot brackish water has reached 420C at ambient temperature of 230C within 8 hours. This system is the most efficient and cost effective. It can produce pure, clean fresh water along with hot brackish water from any water source.
Non–Vitamin K Antagonist Oral Anticoagulants: The Clinician’s New Challenge
Authors: Yorkgitis Brian K. , Zhang Jeanette , Rappold Joseph F.
Published: September 2015

Millions of US patients are prescribed oral anticoagulants. Traditionally, oral anticoagulation was achieved with vitamin K antagonists (VKAs). In recent years, non–VKA oral anticoagulants (NOACs) have emerged that provide an effective and convenient alternative to VKAs. These agents possess very different pharmacologic properties from what the medical community has grown accustom to with the VKAs. Thus, a new knowledge base is required for NOACs. One particular challenge with the NOACs is the lack of specific reversal agent, resulting in difficulties correcting the coagulopathy induced by these drugs when needed. A review of the current literature is presented to assist clinicians in gaining knowledge of the NOACs to care for patients.
Intraductal Papillary Mucinous Neoplasm of the Pancreas: Current Perspectives
Authors: Dumlu Ersin Gürkan , Karakoç Derya , Özdemir Arif
Published: September 2015

In this article, we aimed to review the literature on the clinics and management of intraductal papillary mucinous neoplasm (IPMN). Intraductal papillary mucinous neoplasm of the pancreas is a mucin-producing cystic mass originating from the pancreatic ductal system. Approximately 25% of the pancreatic neoplasms resected surgically and 50% of pancreatic cysts detected incidentally are IPMNs. They can be benign or malignant in character, while malignant transformation of benign forms can be encountered. It is important to determine IPMNs in the early stages, implementation of appropriate treatment approaches, and follow-up to provide better prognosis. We reviewed the studies published in the English medical literature through PubMed and summarized the clinical features and current approaches to the treatment and follow-up of the IPMN. Due to the recent advances and widespread implementation of radiological imaging techniques, the incidental detection rate of IPMNs has increased significantly. The effective treatment of the disease is possible via the detailed diagnosis of the disease, determination of the prognostic factors, and a multidisciplinary approach. Recent literature also emphasized the molecular profile determination approaches for assessment of prognosis of patients with IPMN. Current knowledge on IPMN, a clinically important epidemiologic problem, shows that the treatment should be personalized considering the prognostic features and life expectancy of the patient.
On the formation and origin of substorm growth phase/onset auroral arcs inferred from conjugate space‐ground observations
Authors: Motoba T. , Ohtani S. , Anderson B. J. , Korth H. , Mitchell D. , Lanzerotti L. J. , Shiokawa K. , Connors M. , Kletzing C. A. , Reeves G. D.
Published: September 2015

Magnetotail processes and structures related to substorm growth phase/onset auroral arcs remain poorly understood mostly due to the lack of adequate observations. In this study we make a comparison between ground‐based optical measurements of the premidnight growth phase/onset arcs at subauroral latitudes and magnetically conjugate measurements made by the Active Magnetosphere and Planetary Electrodynamics Response Experiment (AMPERE) at ~780 km in altitude and by the Van Allen Probe B (RBSP‐B) spacecraft crossing L values of ~5.0–5.6 in the premidnight inner tail region. The conjugate observations offer a unique opportunity to examine the detailed features of the arc location relative to large‐scale Birkeland currents and of the magnetospheric counterpart. Our main findings include (1) at the early stage of the growth phase the quiet auroral arc emerged ~4.3° equatorward of the boundary between the downward Region 2 (R2) and upward Region 1 (R1) currents; (2) shortly before the auroral breakup (poleward auroral expansion) the latitudinal separation between the arc and the R1/R2 demarcation narrowed to ~1.0°; (3) RBSP‐B observed a magnetic field signature of a local upward field‐aligned current (FAC) connecting the arc with the near‐Earth tail when the spacecraft footprint was very close to the arc; and (4) the upward FAC signature was located on the tailward side of a local plasma pressure increase confined near L ~5.2–5.4. These findings strongly suggest that the premidnight arc is connected to highly localized pressure gradients embedded in the near‐tail R2 source region via the local upward FAC.
Magneto‐ and cyclostratigraphy in the red clay sequence: New age model and paleoclimatic implication for the eastern Chinese Loess Plateau
Authors: Anwar Taslima , Kravchinsky Vadim A. , Zhang Rui
Published: September 2015

The Chinese Loess Plateau red clay sequences display a continuous alternation of sedimentary cycles that represent recurrent climatic fluctuations from 2.58 Ma to the Miocene. Deciphering such a record can provide us with vital information on global and Asian climatic variations. Lack of fossils and failure of absolute dating methods made magnetostratigraphy a leading method to build age models for the red clay sequences. Here we test the magnetostratigraphic age model against cyclostratigraphy. For this purpose we investigate the climate cyclicity recorded in magnetic susceptibility and sedimentary grain size in a red clay section previously dated 11 Myr old with magnetostratigraphy alone. Magnetostratigraphy dating based on only visual correlation could potentially lead to erroneous age model. In this study the correlation is executed through the iteration procedure until it is supported by cyclostratigraphy; i.e., Milankovitch cycles are resolved in the best possible manner. Our new age model provides an age of 5.2 Ma for the Shilou profile. Based on the new age model, wavelet analysis reveals the well‐preserved 400 kyr and possible 100 kyr eccentricity cycles on the eastern Chinese Loess Plateau. Further, paleomonsoon evolution during 2.58–5.2 Ma is reconstructed and divided into three intervals (2.58–3.6 Ma, 3.6–4.5 Ma, and 4.5–5.2 Ma). The upper part, the youngest stage, is characterized by a relatively intensified summer monsoon, the middle stage reflects an intensification of the winter monsoon and aridification in Asia, and the earliest stage indicates that summer and winter monsoon cycles may have rapidly altered. The use of cyclostratigraphy along with magnetostratigraphy gives us an effective method of dating red clay sequences, and our results imply that many presently published age models for the red clay deposits should be perhaps re‐evaluated.
Salt exchange in the Indian‐Atlantic Ocean Gateway since the Last Glacial Maximum: A compensating effect between Agulhas Current changes and salinity variations?
Authors: Simon Margit H. , Gong Xun , Hall Ian R. , Ziegler Martin , Barker Stephen , Knorr Gregor , van der Meer Marcel T. J. , Kasper Sebastian , Schouten Stefan
Published: September 2015

The import of relatively salty water masses from the Indian Ocean to the Atlantic is considered to be important for the operational mode of the Atlantic Meridional Overturning Circulation (AMOC). However, the occurrence and the origin of changes in this import behavior on millennial and glacial/interglacial timescales remains equivocal. Here we reconstruct multiproxy paleosalinity changes in the Agulhas Current since the Last Glacial Maximum and compare the salinity pattern with records from the Indian‐Atlantic Ocean Gateway (I‐AOG) and model simulations using a fully coupled atmosphere‐ocean general circulation model. The reconstructed paleosalinity pattern in the Agulhas Current displays coherent variability with changes recorded in the wider I‐AOG region over the last glacial termination. We infer that salinities simultaneously increased in both areas consistent with a quasi interhemispheric salt‐seesaw response, analogous to the thermal bipolar seesaw in response to a reduced cross‐hemispheric heat and salt exchange during times of weakened AMOC. Interestingly, these hydrographic shifts can also be recognized in the wider Southern Hemisphere, which indicates that salinity anomalies are not purely restricted to the Agulhas Current System itself. More saline upstream Agulhas waters were propagated to the I‐AOG during Heinrich Stadial 1 (HS1). However, the salt flux into the South Atlantic might have been reduced due to a decreased volume transport through the I‐AOG during the AMOC slowdown associated with HS1. Hence, our combined data‐model interpretation suggests that intervals with higher salinity in the Agulhas Current source region are not necessarily an indicator for an increased salt import via the I‐AOG into the South Atlantic.
Spironolactone for People Age 70 Years and Older With Osteoarthritic Knee Pain: A Proof‐of‐Concept Trial
Authors: Mcmurdo Marion E. T. , Sumukadas Deepa , Donnan Peter T. , Cvoro Vera , Rauchhaus Petra , Argo Ishbel , Waldie Helen , Littleford Roberta , Struthers Allan D. , Witham Miles D.
Published: September 2015

Objective

To determine whether spironolactone could benefit older people with osteoarthritis (OA), based on a previous study showing that spironolactone improved quality of life.

Methods

This parallel‐group, randomized, placebo‐controlled, double‐blind trial randomized community‐dwelling people ages ≥70 years with symptomatic knee OA to 12 weeks of 25 mg daily oral spironolactone or matching placebo. The primary outcome was between‐group difference in change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale scores. Secondary outcomes included WOMAC stiffness and physical function subscores, EuroQol 5‐domain (EQ‐5D) 3L score, and mechanistic markers. Analysis was by intent to treat, using mixed‐model regression, adjusting for baseline values of test variables.

Results

A total of 421 people had eligibility assessed, and 86 were randomized. Mean ± SD age was 77 ± 5 years and 53 of 86 (62%) were women. Adherence to study medication was 99%, and all participants completed the 12‐week assessment. No significant improvement was seen in the WOMAC pain score (adjusted treatment effect 0.5 points [95% confidence interval (95% CI) − 0.3, 1.3]; P = 0.19). No improvement was seen in WOMAC stiffness score (0.2 points [95% CI −0.6, 1.1]; P = 0.58), WOMAC physical function score (0.0 points [95% CI −0.7, 0.8]; P = 0.98), or EQ‐5D 3L score (0.04 points [95% CI −0.04, 0.12]; P = 0.34). Cortisol, matrix metalloproteinase 3, and urinary C‐telopeptide of type II collagen were not significantly different between groups. More minor adverse events were noted in the spironolactone group (47 versus 32), but no increase in death or hospitalization was evident.

Conclusion

Spironolactone did not improve symptoms, physical function, or health‐related quality of life in older people with knee OA.
Association of Visceral Fat and Liver Fat With Hyperuricemia
Authors: Yamada Akiko , Sato Kyoko K. , Kinuhata Shigeki , Uehara Shinichiro , Endo Ginji , Hikita Yonezo , Fujimoto Wilfred Y. , Boyko Edward J. , Hayashi Tomoshige
Published: September 2015

Objective

To examine cross‐sectionally whether intraabdominal fat area (IAFA), i.e., visceral fat, and liver fat assessed by computed tomography (CT) are independently associated with hyperuricemia.

Methods

Subjects were 801 Japanese men not taking antidiabetic, antihypertensive, or urate‐lowering medications, without any history of renal disease, cardiovascular disease, or cancer, and with serum creatinine <1.5 mg/dl. Abdominal, thoracic, and thigh fat areas were measured by CT. Total fat area (TFA) was the sum of these fat areas. Total subcutaneous fat area (TSFA) was TFA minus IAFA. Liver fat was assessed by liver‐to‐spleen (L/S) ratio measured by CT. Hyperuricemia was defined as serum uric acid level >7.0 mg/dl. Its association with adiposity was tested using logistic regression.

Results

The prevalence of hyperuricemia was 19.6% (157 men). Both greater IAFA and lower L/S ratio were independently associated with hyperuricemia in models that simultaneously included IAFA and L/S ratio: multiple‐adjusted odds ratios of hyperuricemia for quintiles 3, 4, and 5 of IAFA were 2.16 (95% confidence interval [95% CI] 1.02–4.59), 2.41 (95% CI 1.13–5.16), and 4.00 (95% CI 1.81–8.85), respectively, compared to quintile 1, and the L/S ratios for quintiles 3, 2, and 1 were 2.34 (95% CI 1.16–4.75), 2.15 (95% CI 1.06–4.34), and 2.79 (95% CI 1.35–5.76), respectively, compared to quintile 5. Both IAFA and L/S ratio remained significant even after adjusting for abdominal subcutaneous fat area, TFA, TSFA, body mass index, or waist circumference. Of all fat measurements, IAFA had the strongest association with hyperuricemia by Akaike's information criteria.

Conclusion

Greater amounts of both visceral fat and liver fat were independently associated with hyperuricemia.
Determination of Pain Phenotypes in Knee Osteoarthritis: A Latent Class Analysis Using Data From the Osteoarthritis Initiative
Authors: Kittelson Andrew J. , Stevens‐Lapsley Jennifer E. , Schmiege Sarah J.
Published: September 2015

Objective

Knee osteoarthritis (OA) is a broadly applied diagnosis that may describe multiple subtypes of pain. The purpose of this study was to identify phenotypes of knee OA, using measures from the following pain‐related domains: 1) knee OA pathology, 2) psychological distress, and 3) altered pain neurophysiology.

Methods

Data were selected from a total of 3,494 participants at visit 6 of the Osteoarthritis Initiative study. Latent class analysis was applied to the following variables: radiographic OA severity, quadriceps strength, body mass index, the Charlson Comorbidity Index (CCI), the Center for Epidemiologic Studies Depression Scale, the Coping Strategies Questionnaire‐Catastrophizing subscale, number of bodily pain sites, and knee joint tenderness at 4 sites. The resulting classes were compared on the following demographic and clinical factors: age, sex, pain severity, disability, walking speed, and use of arthritis‐related health care.

Results

A 4‐class model was identified. Class 1 (4% of the study population) had higher CCI scores. Class 2 (24%) had higher knee joint sensitivity. Class 3 (10%) had greater psychological distress. Class 4 (62%) had lesser radiographic OA, little psychological involvement, greater strength, and less pain sensitivity. Additionally, class 1 was the oldest, on average. Class 4 was the youngest, had the lowest disability, and least pain. Class 3 had the worst disability and most pain.

Conclusion

Four distinct pain phenotypes of knee OA were identified. Psychological factors, comorbidity status, and joint sensitivity appear to be important in defining phenotypes of knee OA–related pain.
Relationship Between Disease Characteristics and Oral Radiologic Findings in Systemic Sclerosis: Results From a Canadian Oral Health Study
Authors: Baron Murray , Hudson Marie , Dagenais Marie , Macdonald David , Gyger Geneviève , El Sayegh Tarek , Pope Janet , Fontaine Audrey , Masetto Ariel , Matthews Debora , Sutton Evelyn , Thie Norman , Jones Niall , Copete Maria , Kolbinson Dean , Markland Janet , Nogueira‐Filho Getulio , Robinson David , Fritzler Marvin , Wang Mianbo , Gornitsky Mervyn
Published: September 2015

Objective

Systemic sclerosis (SSc; scleroderma) is associated with a wide periodontal ligament (PDL) and mandibular erosions. We investigated the clinical correlates of SSc with these radiologic abnormalities.

Methods

Subjects from the Canadian Scleroderma Research Group cohort underwent detailed radiologic examinations. Associations between radiologic abnormalities and clinical manifestations of SSc were examined with univariate and multivariate analyses.

Results

The study included 159 subjects; 90.6% were women, the mean ± SD age was 56 ± 10 years, diffuse disease was present in 28.3%, and mean ± SD disease duration was 13.7 ± 8.4 years. Widening of the PDL involving at least 1 tooth was present in 38% of subjects, and 14.5% had at least 1 site in the mandible with an erosion. In analyses adjusting for age, disease duration, sex, smoking, and education, we found significant associations between the number of teeth with widening of the PDL and disease severity assessed by the physician global assessment (PGA) (relative risk [RR] 1.19, 95% confidence interval [95% CI] 1.02–1.39, P = 0.028). Analyses replacing the PGA with the skin score, disease subset, or anti–topoisomerase I antibodies confirmed the relationship with indices of disease severity. There was no relationship between either the number of teeth with periodontal disease or the number of missing teeth, and the number of teeth with wide PDL. A smaller interdental distance (RR 0.89, 95% CI 0.82–0.97, P = 0.006), but not disease severity, facial skin score, or ischemia was associated with a larger number of erosions.

Conclusion

In SSc, a wide PDL may reflect generalized overproduction of collagen, and mandibular erosions are related to local factors in the oral cavity.
Development of Preliminary Remission Criteria for Gout Using Delphi and 1000Minds Consensus Exercises
Authors: de Lautour Hugh , Taylor William J. , Adebajo Ade , Alten Rieke , Burgos‐Vargas Ruben , Chapman Peter , Cimmino Marco A. , da Rocha Castelar Pinheiro Geraldo , Day Ric , Harrold Leslie R. , Helliwell Philip , Janssen Matthijs , Kerr Gail , Kavanaugh Arthur , Khanna Dinesh , Khanna Puja P. , Lin Chingtsai , Louthrenoo Worawit , McCarthy Geraldine , Vazquez‐Mellado Janitzia , Mikuls Ted R. , Neogi Tuhina , Ogdie Alexis , Perez‐Ruiz Fernando , Schlesinger Naomi , Ralph Schumacher H. , Scirè Carlo A. , Singh Jasvinder A. , Sivera Francisca , Slot Ole , Stamp Lisa K. , Tausche Anne‐Kathrin , Terkeltaub Robert , Uhlig Till , van de Laar Mart , White Douglas , Yamanaka Hisashi , Zeng Xuejun , Dalbeth Nicola
Published: September 2015

Objective

To establish consensus for potential remission criteria to use in clinical trials of gout.

Methods

Experts (n = 88) in gout from multiple countries were invited to participate in a web‐based questionnaire study. Three rounds of Delphi consensus exercises were conducted using SurveyMonkey, followed by a discrete‐choice experiment using 1000Minds software. The exercises focused on identifying domains, definitions for each domain, and the timeframe over which remission should be defined.

Results

There were 49 respondents (56% response) to the initial survey, with subsequent response rates ranging from 57% to 90%. Consensus was reached for the inclusion of serum urate (98% agreement), flares (96%), tophi (92%), pain (83%), and patient global assessment of disease activity (93%) as measurement domains in remission criteria. Consensus was also reached for domain definitions, including serum urate (<0.36 mm), pain (<2 on a 10‐point scale), and patient global assessment (<2 on a 10‐point scale), all of which should be measured at least twice over a set time interval. Consensus was not achieved in the Delphi exercise for the timeframe for remission, with equal responses for 6 months (51%) and 1 year (49%). In the discrete‐choice experiment, there was a preference towards 12 months as a timeframe for remission.

Conclusion

These consensus exercises have identified domains and provisional definitions for gout remission criteria. Based on the results of these exercises, preliminary remission criteria are proposed with domains of serum urate, acute flares, tophus, pain, and patient global assessment. These preliminary criteria now require testing in clinical data sets.
Poverty, Depression, or Lost in Translation? Ethnic and Language Variation in Patient‐Reported Outcomes in Rheumatoid Arthritis
Authors: Katz Patricia P. , Barton Jennifer , Trupin Laura , Schmajuk Gabriela , Yazdany Jinoos , Ruiz Pedro J. , Yelin Edward
Published: September 2015

Objective

Despite advances in therapies, disparities in outcomes have been documented for rheumatoid arthritis (RA) patients for both ethnicity and English language proficiency. The goals of these analyses were to compare differences in RA patient‐reported outcomes, by both self‐identification of ethnicity and English language proficiency, and to identify factors that might explain differences among groups.

Methods

Data were collected through structured telephone interviews of a longitudinal cohort with physician‐diagnosed RA (n = 438); only women were included (n = 335). Three groups were defined based on self‐reported ethnicity and English proficiency: white/English (n = 219), Hispanic/English (n = 39), and Hispanic/Spanish (n = 77). Outcomes examined were patient‐reported physical functioning, pain, and presence of moderate or severe fatigue. Multivariate regression analyses compared outcomes among groups, adjusting for sociodemographic characteristics, health and disease factors, and depression.

Results

Hispanic/Spanish women had worse function, pain, and fatigue than either English‐proficient group. Depression was associated with all outcomes (P < 0.0001), and accounted for greater differentials in scores than ethnicity/language proficiency. In interaction analyses, differences between women who were and were not depressed were greater for Hispanic/English than for Hispanic/Spanish. Nondepressed Hispanic/Spanish scores were significantly worse than nondepressed Hispanic/English, i.e., the impact of depression was less for Hispanic/Spanish women because both depressed and nondepressed women in this group reported worse outcomes. After adjustment for sociodemographic factors and depression, language remained significantly associated with outcomes.

Conclusion

Disparities in patient‐reported outcomes may be driven less by ethnicity than by sociodemographic or psychological factors. Measurement instruments that are not culturally appropriate and equivalent may also hamper meaningful analyses of disparities.
A Smooth CH3NH3PbI3 Film via a New Approach for Forming the PbI2 Nanostructure Together with Strategically High CH3NH3I Concentration for High Efficient Planar‐Heterojunction Solar Cells
Authors: Zhang Hong , Mao Jian , He Hexiang , Zhang Di , Zhu Hugh L. , Xie Fengxian , Wong Kam Sing , Grätzel Michael , Choy Wallace C. H.
Published: September 2015

The photovoltaic performance of perovskite solar cells (PVSCs) is extremely dependent on the morphology and crystallization of the perovskite film, which is affected by the deposition method. In this work, a new approach is demonstrated for forming the PbI2 nanostructure and the use of high CH3NH3I concentration which are adopted to form high‐quality (smooth and PbI2 residue‐free) perovskite film with better photovoltaic performances. On the one hand, self‐assembled porous PbI2 is formed by incorporating small amount of rationally chosen additives into the PbI2 precursor solutions, which significantly facilitate the conversion of perovskite without any PbI2 residue. On the other hand, by employing a relatively high CH3NH3I concentration, a firmly crystallized and uniform CH3NH3PbI3 film is formed. As a result, a promising power conversion efficiency of 16.21% is achieved in planar‐heterojunction PVSCs. Furthermore, it is experimentally demonstrated that the PbI2 residue in perovskite film has a negative effect on the long‐term stability of devices.
Prevention of conversion to abnormal transcranial Doppler with hydroxyurea in sickle cell anemia: A Phase III international randomized clinical trial
Authors: Hankins Jane S. , McCarville Mary Beth , Rankine‐Mullings Angela , Reid Marvin E. , Lobo Clarisse L.C. , Moura Patricia G. , Ali Susanna , Soares Deanne P. , Aldred Karen , Jay Dennis W. , Aygun Banu , Bennett John , Kang Guolian , Goldsmith Jonathan C. , Smeltzer Matthew P. , Boyett James M. , Ware Russell E.
Published: September 2015

Children with sickle cell anemia (SCA) and conditional transcranial Doppler (TCD) ultrasound velocities (170–199 cm/sec) may develop stroke. However, with limited available clinical data, the current standard of care for conditional TCD velocities is observation. The efficacy of hydroxyurea in preventing conversion from conditional to abnormal TCD (≥200 cm/sec), which confers a higher stroke risk, has not been studied prospectively in a randomized trial. Sparing Conversion to Abnormal TCD Elevation (SCATE #NCT01531387) was a National Heart, Lung, and Blood Institute‐funded Phase III multicenter international clinical trial comparing alternative therapy (hydroxyurea) to standard care (observation) to prevent conversion from conditional to abnormal TCD velocity in children with SCA. SCATE enrolled 38 children from the United States, Jamaica, and Brazil [HbSS (36), HbSβ0‐thalassemia (1), and HbSD (1), median age = 5.4 years (range, 2.7–9.8)]. Because of the slow patient accrual and administrative delays, SCATE was terminated early. In an intention‐to‐treat analysis, the cumulative incidence of abnormal conversion was 9% (95% CI = 0–35%) in the hydroxyurea arm and 47% (95% CI = 6–81%) in observation arm at 15 months (P = 0.16). In post hoc analysis according to treatment received, significantly fewer children on hydroxyurea converted to abnormal TCD velocities when compared with observation (0% vs. 50%, P = 0.02). After a mean of 10.1 months, a significant change in mean TCD velocity was observed with hydroxyurea treatment (−15.5 vs. +10.2 cm/sec, P = 0.02). No stroke events occurred in either arm. Hydroxyurea reduces TCD velocities in children with SCA and conditional velocities. Am. J. Hematol. 90:1099–1105, 2015. © 2015 Wiley Periodicals, Inc.
Catalytic Borylation using an Air‐Stable Zinc Boryl Reagent: Systematic Access to Elusive Acylboranes
Authors: Campos Jesús , Aldridge Simon
Published: September 2015

The use of borylzinc reagents in palladium‐catalyzed borylation chemistry is described (i.e. a boron analogue of the Negishi coupling), including a one‐pot bench‐top protocol using an air‐ and moisture‐stable bis(boryl)zinc reagent. The steric/electronic properties of the boryl fragment employed enable a systematic method for accessing acylboranes, a rare class of organoboron species with great potential in chemical synthesis. The reactions proceed under mild conditions, use inexpensive commercial sources of palladium, and demonstrate a remarkable functional‐group tolerance.
Femoral Condyle Curvature is Correlated with Knee Walking Kinematics in Ungulates
Authors: Sylvester Adam D.
Published: September 2015

The knee has been the focus of many studies linking mammalian postcranial form with locomotor behaviors and animal ecology. A more difficult task has been linking joint morphology with joint kinematics during locomotor tasks. Joint curvature represents one opportunity to link postcranial morphology with walking kinematics because joint curvature develops in response to mechanical loading. As an initial examination of mammalian knee joint curvature, the curvature of the medial femoral condyle was measured on femora representing 11 ungulate species. The position of a region of low curvature was measured using a metric termed the “angle to low curvature”. This low‐curvature region is important because it provides the greatest contact area between femoral and tibial condyles. Kinematic knee angles during walking were derived from the literature and kinematic knee angles across the gait cycle were correlated with angle to low curvature values. The highest correlation between kinematic knee angle and the angle to low curvature metric occurred at 20% of the walking gait cycle. This early portion of the walking gait cycle is associated with a peak in the vertical ground reaction force for some mammals. The chondral modeling theory predicts that frequent and heavy loading of particular regions of a joint surface during ontogeny will result in these regions being flatter than the surrounding joint surface. The locations of flatter regions of the femoral condyles of ungulates, and their association with knee angles used during the early stance phase of walking provides support for the chondral modeling theory. Anat Rec, 298:2039–2050, 2015. © 2015 Wiley Periodicals, Inc.
Resolution of Skin Fibrosis by Neutralization of the Antifibrinolytic Function of Plasminogen Activator Inhibitor 1
Authors: Lemaire Raphaël , Burwell Timothy , Sun Hong , Delaney Tracy , Bakken Julie , Cheng Lily , Rebelatto Marlon C. , Czapiga Meggan , de‐Mendez Isabelle , Coyle Anthony J. , Herbst Ronald , Lafyatis Robert , Connor Jane
Published: September 2015

Objective

Systemic sclerosis (SSc) is a fibrotic disease characterized by an obliterative vasculopathy with thrombosis and impairment of the coagulation–fibrinolysis balance. Plasminogen activator inhibitor 1 (PAI‐1) is the major inhibitor of profibrinolytic plasminogen activators (PAs). This study was undertaken to evaluate the contribution of PAI‐1 to SSc pathology in the skin.

Methods

PAI‐1 was evaluated in skin from patients with diffuse SSc (dSSc) and those with limited SSc (lSSc) by immunohistochemistry. The contribution of PAI‐1 to SSc pathology was tested in vivo in murine graft‐versus‐host disease (GVHD) and bleomycin models of progressive skin fibrosis and in vitro in dermal human microvascular endothelial cells (HMVECs) using a monoclonal antibody that selectively prevents the binding of PAI‐1 to PA.

Results

Skin from patients with dSSc and those with lSSc showed increased PAI‐1 levels in the epidermis and microvessel endothelium. PAI‐1 neutralization in the GVHD model led to a dramatic, dose‐dependent improvement in clinical skin score, concomitant with vasculopathy resolution, including a reduction in fibrinolysis regulators and vascular injury markers, as well as reduced inflammation. Resolution of vasculopathy and inflammation was associated with resolution of skin fibrosis, as assessed by reduction in collagen content and expression of key profibrotic mediators, including transforming growth factor β1 and tissue inhibitor of metalloproteinases 1. Similar to the GVHD model, PAI‐1 neutralization reduced dermal inflammation and fibrosis in the bleomycin model. PAI‐1 neutralization stimulated plasmin‐mediated metalloproteinase 1 activation in dermal HMVECs.

Conclusion

Our findings indicate that neutralization of the antifibrinolytic function of PAI‐1 resolves skin fibrosis by limiting the extent of initial vascular injury and connective tissue inflammation. These data suggest that PAI‐1 represents an important checkpoint in disease pathology in human SSc.