bluuebunny/crossref_metadata_2025 huggingface dataset:
Viral aetiology and clinical outcomes in hospitalised infants presenting with respiratory distress
Authors: Falkenstein‐Hagander Kathy , Månsson Ann‐Sofie , Redmo Johan , Nilsson Wimar Percy , Widell Anders
Published: March 2014

Aim

To determine the prevalence of various types of viruses in infants hospitalised due to respiratory distress, compare molecular diagnostic tests and evaluate symptom severity.

Methods

All 136 nasopharyngeal aspirates from infants hospitalised for respiratory distress over a 9‐month period were analysed for virus type by in‐house respiratory syncytial virus (RSV) polymerase chain reaction (PCR) microarray‐based and/or Luminex‐based multiplex molecular tests. Medical records were reviewed retrospectively for clinical data.

Results

Viral aetiology was confirmed in 126 subjects (92.6%) with 26 infected by more than one virus. RSVA/B was the most common (50.9%), followed by entero/rhinovirus (21.6%), human metapneumovirus (10.5%), parainfluenza virus (5.9%) and influenza (3.3%). RSV‐infected infants had significantly lower saturation levels (89% versus 92%, p < 0.001), higher demand for oxygen (42.7% versus 21.6%, p = 0.021) and fluids (28% versus 9.8%; p = 0.014) and longer hospital stays (4 versus 3 days, <0.001) than other viruses. Luminex assays gave repeatable, slightly less sensitive results than in‐house RSV PCR. Microarray‐based assays were more sensitive, however, producing some unrepeatable results.

Conclusion

Respiratory syncytial virus dominates as the viral cause in hospitalised infants with respiratory distress in Sweden during the winter season, resulting in a clinical course that is significantly more severe. The multiplex assays produced reasonably concordant results.
Influence of age on leptin induced skeletal muscle signalling
Authors: Guadalupe‐Grau A. , Larsen S. , Guerra B. , Calbet J. A. L. , Dela F. , Helge J. W.
Published: March 2014

Aim

Age associated fat mass accumulation could be because of dysregulation of leptin signalling in skeletal muscle. Thus, we investigated total protein expression and phosphorylation levels of the long isoform of the leptin receptor (OB‐Rb), and leptin signalling through janus kinase 2 (JAK2)/signal transducer and activator of transcription 3 (STAT3), insulin receptor substrate 1 (IRS‐1), AMP‐activated protein kinase (AMPK) and acetyl‐coenzyme A carboxylase (ACC), combined with the leptin signalling inhibitors suppressor of cytokine signalling 3 (SOCS3) and protein tyrosine phosphatase 1B (PTP1B) in human skeletal muscle of different age.

Methods

Vastus lateralis muscle biopsies were obtained from 39 men matched for BMI < 30 kg m−2 and separated into three groups: 13 young (Y, 24 ± 4 years); 14 middle aged (MA, 44 ± 5 years) and 12 aged (A, 58 ± 8 years) subjects.

Results

Whole body fat percentage and plasma leptin were higher (P < 0.05), whereas lean mass, plasma free testosterone and total testosterone were lower (P < 0.05) in A compared to Y. Skeletal muscle OB‐Rb (170 KDa) protein expression and pTyr1141‐OB‐R170 were comparable between groups, whereas pTyr985‐OB‐R170 was lower in A compared to Y (P < 0.05). pSTAT3 levels tended (P = 0.09) to be lower (50%) in A compared to Y. In A, muscle PTP1B was greater and IRS‐1 lower than Y and MA respectively (P < 0.05). PTyr612‐IRS‐1 tended to be lower in A than in Y (P = 0.09). Suppressor of cytokine signalling 3 (SOCS3) protein expression, pJAK2, pSer1101‐IRS‐1, pAMPKα and pACCβ were similar between groups.

Conclusion

Age is associated with dysregulation of the leptin signalling and increased PTP1B protein expression in skeletal muscle.
In silico Characterization of an Atypical MAPK Phosphatase of Plasmodium falciparum as a Suitable Target for Drug Discovery
Authors: Campbell Christopher O. , Santiago Daniel N. , Guida Wayne C. , Manetsch Roman , Adams John H.
Published: March 2014

Plasmodium falciparum, the causative agent of malaria, contributes to significant morbidity and mortality worldwide. Forward genetic analysis of the blood‐stage asexual cycle identified the putative phosphatase from PF3D7_1305500 as an important element of intraerythrocytic development expressed throughout the life cycle. Our preliminary evaluation identified it as an atypical mitogen‐activated protein kinase phosphatase. Additional bioinformatic analysis delineated a conserved signature motif and three residues with potential importance to functional activity of the atypical dual‐specificity phosphatase domain. A homology model of the dual‐specificity phosphatase domain was developed for use in high‐throughput in silico screening of the available library of antimalarial compounds from ChEMBL‐NTD. Seven compounds from this set with predicted affinity to the active site were tested against in vitro cultures, and three had reduced activity against a ∆PF3D7_1305500 parasite, suggesting PF3D7_1305500 is a potential target of the selected compounds. Identification of these compounds provides a novel starting point for a structure‐based drug discovery strategy that moves us closer toward the discovery of new classes of clinical antimalarial drugs. These data suggest that mitogen‐activated protein kinase phosphatases represent a potentially new class of P. falciparum drug target.
Response Variables for Evaluation of the Effectiveness of Conservation Corridors
Authors: GREGORY ANDREW J. , BEIER PAUL
Published: March 2014

Many studies have evaluated effectiveness of corridors by measuring species presence in and movement through small structural corridors. However, few studies have assessed whether these response variables are adequate for assessing whether the conservation goals of the corridors have been achieved or considered the costs or lag times involved in measuring the response variables. We examined 4 response variables—presence of the focal species in the corridor, interpatch movement via the corridor, gene flow, and patch occupancy—with respect to 3 criteria—relevance to conservation goals, lag time (fewest generations at which a positive response to the corridor might be evident with a particular variable), and the cost of a study when applying a particular variable. The presence variable had the least relevance to conservation goals, no lag time advantage compared with interpatch movement, and only a moderate cost advantage over interpatch movement or gene flow. Movement of individual animals between patches was the most appropriate response variable for a corridor intended to provide seasonal migration, but it was not an appropriate response variable for corridor dwellers, and for passage species it was only moderately relevant to the goals of gene flow, demographic rescue, and recolonization. Response variables related to gene flow provided a good trade‐off among cost, relevance to conservation goals, and lag time. Nonetheless, the lag time of 10–20 generations means that evaluation of conservation corridors cannot occur until a few decades after a corridor has been established. Response variables related to occupancy were most relevant to conservation goals, but the lag time and costs to detect corridor effects on occupancy were much greater than the lag time and costs to detect corridor effects on gene flow.

Variables de Respuesta para la Evaluación de la Efectividad de los Corredores de Conservación
Understanding Publication Bias in Reintroduction Biology by Assessing Translocations of New Zealand's Herpetofauna
Authors: MILLER KIMBERLY A. , BELL TRENT P. , GERMANO JENNIFER M.
Published: March 2014

The intentional translocation of animals is an important tool for species conservation and ecosystem restoration, but reported success rates are low, particularly for threatened and endangered species. Publication bias further distorts success rates because the results of successful translocations may be more likely to be published than failed translocations. We conducted the first comprehensive review of all published and unpublished translocations of herpetofauna in New Zealand to assess publication bias. Of 74 translocations of 29 species in 25 years, 35 have been reported in the published literature, and the outcomes of 12 have been published. Using a traditional definition of success, publication bias resulted in a gross overestimate of translocation success rates (41.7% and 8.1% for published and all translocations, respectively), but bias against failed translocations was minimal (8.3% and 6.8%, respectively). Publication bias against translocations with uncertain outcomes, the vast majority of projects, was also strong (50.0% and 85.1% for published and all translocations, respectively). Recent translocations were less likely to be published than older translocations. The reasons behind translocations were related to publication. A greater percentage of translocations for conservation and research were published (63.3% and 40.0%, respectively) than translocations for mitigation during land development (10.0%). Translocations conducted in collaboration with a university were more frequently published (82.7% and 24.4%, respectively). To account for some of this publication bias, we reassessed the outcome of each translocation using a standardized definition of success, which takes into consideration the species’ life history and the time since release. Our standardized definition of translocation success provided a more accurate summary of success rates and allows for a more rigorous evaluation of the causes of translocation success and failure in large‐scale reviews.

Entendiendo el Sesgo de Publicaciones en la Biología de la Reintroducción Mediante el Estudio de Traslocaciones de la Herpetofauna de Nueva Zelanda
The confusing tale of depression and distress in patients with diabetes: a call for greater clarity and precision
Authors: Fisher L. , Gonzalez J. S. , Polonsky W. H.
Published: March 2014

Studies have identified significant linkages between depression and diabetes, with depression associated with poor self‐management behaviour, poor clinical outcomes and high rates of mortality. However, findings are not consistent across studies, yielding confusing and contradictory results about these relationships. We suggest that there has been a failure to define and measure ‘depression’ in a consistent manner. Because the diagnosis of depression is symptom‐based only, without reference to source or content, the context of diabetes is not considered when addressing the emotional distress experienced by individuals struggling with diabetes. To reduce this confusion, we suggest that an underlying construct of ‘emotional distress’ be considered as a core construct to link diabetes‐related distress, subclinical depression, elevated depression symptoms and major depressive disorder (MDD). We view emotional distress as a single, continuous dimension that has two primary characteristics: content and severity; that the primary content of emotional distress among these individuals include diabetes and its management, other life stresses and other contributors; and that both the content and severity of distress be addressed directly in clinical care. We suggest further that all patients, even those whose emotional distress rises to the level of MDD or anxiety disorders, can benefit from consideration of the content of distress to direct care effectively, and we suggest strategies for integrating the emotional side of diabetes into regular diabetes care. This approach can reduce confusion between depression and distress so that appropriate and targeted patient‐centred interventions can occur.
Serum selenium in relation to measures of glucose metabolism and incidence of Type 2 diabetes in an older Swedish population
Authors: Gao H. , Hägg S. , Sjögren P. , Lambert P. C. , Ingelsson E. , van Dam R. M.
Published: March 2014

Aims

The relation between selenium status and risk of Type 2 diabetes is controversial. We aimed to evaluate associations of serum selenium, a marker of dietary selenium, with measures of glucose metabolism and risk of diabetes.

Methods

We used data from a population‐based, longitudinal cohort of 1925 Swedish men who were 50 years old and did not have diabetes at baseline in the 1970s. At baseline, an intravenous glucose tolerance test was performed and, at a follow‐up examination after 20 years, an oral glucose tolerance test and a hyperinsulinaemic euglycaemic clamp for the assessment of insulin sensitivity were conducted.

Results

At baseline, the mean (standard deviation) selenium concentration was 75.6 (14.3) μg/l. During 20 years of follow‐up, 88 incident cases of diabetes occurred in 1024 participants with follow‐up data. Baseline serum selenium levels were not associated with risk of diabetes (odds ratio 1.06; 95% CI 0.83–1.38). Higher selenium levels were associated with lower early insulin response (standardized β –0.08; 95% CI –0.14 to –0.03) at baseline after adjusting for potential confounders, but not with any other measures of β‐cell function or insulin sensitivity at baseline or follow‐up. The association with early insulin response was non‐significant after taking multiple testing into account.

Conclusions

Our results do not support a role of dietary selenium in the development of disturbances in glucose metabolism or diabetes in older individuals.
Type 2 diabetes mellitus and obesity in young adults: the extreme phenotype with early cardiovascular dysfunction
Authors: Wilmot E. G. , Leggate M. , Khan J. N. , Yates T. , Gorely T. , Bodicoat D. H. , Khunti K. , Kuijer J. P. A. , Gray L. J. , Singh A. , Clarysse P. , Croisille P. , Nimmo M. A. , McCann G. P. , Davies M. J.
Published: March 2014

Aim

A pilot study to phenotype young adults (< 40 years) with Type 2 diabetes mellitus.

Methods

Twenty people with Type 2 diabetes (aged 18–40 years), 10 lean and 10 obese control subjects underwent detailed assessment, including tagged cardiac magnetic resonance imaging, inflammatory proteins, lipids, vitamin D and maximal oxygen uptake. Outcomes were compared between the group with Type 2 diabetes and the control group.

Results

Mean (standard deviation) age, Type 2 diabetes duration and BMI in the group with Type 2 diabetes were 31.8 (6.6) years, 4.7 (4.0) years and 33.9 (5.8) kg/m2 respectively. Compared with lean control subjects, those with Type 2 diabetes had more deleterious profiles of hyperlipidaemia, vitamin D deficiency, inflammation and maximal oxygen uptake relative to body mass. However, there was no difference between the group with Type 2 diabetes and the obese control group. The group with Type 2 diabetes had a higher left ventricular mass and a trend towards concentric remodelling compared with the lean control group (P = 0.002, P = 0.052) but not the obese control group (P > 0.05). Peak early diastolic strain rate was reduced in the group with Type 2 diabetes [1.51 (0.24)/s] compared with the lean control [1.97 (0.34)/s, P = 0.001] and obese control [1.78 (0.39)/s, P = 0.042] group.

Conclusions

Young adults with Type 2 diabetes and those with obesity have similar adverse cardiovascular risk profiles, higher left ventricular mass and a trend towards left ventricular concentric remodelling. In addition, those with Type 2 diabetes demonstrate diastolic dysfunction, a known risk marker for future heart failure and mortality.
Democracy and Education in twentieth‐century Latin America
Authors: Eterovic Dalibor S. , Sweet Cassandra M.
Published: March 2014

Do democratic electoral systems strengthen a country's outcomes in education? Does the degree of inclusiveness of a democratic system matter? This article offers evidence that political competition and the inclusion of marginalized populations in electoral systems transformed education over an 80‐year period in Latin America. It finds that democracy has a positive effect on education enrollment and illustrates how current work on democracy and development has overlooked important democratic subcomponents, specifically, who votes and how. Our results deepen current work on democracy, operationalizing the impact of electoral expansion in comparative analysis and showing how democracies respond to specific education demands.
The morphology–diet relationship and its role in the coexistence of two species of annual fishes
Authors: Keppeler Friedrich W. , Lanés Luis Esteban K. , Rolon Ana S. , Stenert Cristina , Lehmann Pablo , Reichard Martin , Maltchik Leonardo
Published: March 2014

Annual fishes, which inhabit temporary pools with extremely limited habitat complexity and niche availability, display remarkable sexual dimorphism, rapid growth, and enormous investment into reproduction, all traits associated with high energy requirement. This study tests three hypotheses for two syntopic annual fishes (Austrolebias minuano and Cynopoecilus fulgens) found in six wetlands of southern Brazil: (i) considerable morphological differences result in low dietary overlap, (ii) sexual dimorphism in both species leads to intraspecific diet segregation, and (iii) dietary richness increases during ontogenetic development, and is narrower in C. fulgens than A. minuano due to morphological limitations imposed by reduced size. The diet of 82 A. minuano and 211 C. fulgens individuals was analyzed over two annual cycles. The morphology was characterized by 26 measurements covering the entire body of both species. There was no evidence of morphological specialization related to food competition and the diet of A. minuano and C. fulgens showed high overlap. High food availability, high predator abundance, and high connectivity of adjacent wetlands are likely the main mechanisms allowing coexistence of both species. Within species, sexual dimorphism did not result in a decrease in dietary overlap, which reinforces the idea that morphological differences between the sexes did not evolve as a mechanism to decrease food competition. Large A. minuano did not have a more diverse diet than the smaller C. fulgens; however, increase in body size allowed both species to ingest larger prey. Morphological variability in both species was mainly related to ontogenetic development and reproduction.
Variation in Cleaner Wrasse Cooperation and Cognition: Influence of the Developmental Environment?
Authors: Wismer Sharon , Pinto Ana I. , Vail Alex L. , Grutter Alexandra S. , Bshary Redouan
Published: March 2014

Deviations from model‐based predictions of strategies leading to stable cooperation between unrelated individuals have raised considerable debate in regards to decision‐making processes in humans. Here, we present data on cleaner wrasse (Labroides dimidiatus) that emphasize the importance of generalizing this discussion to other species, with the aim to develop a coherent theoretical framework. Cleaners eat ectoparasites and mucus off client fishes and vary their service quality based on a clients’ strategic behaviour. Hitherto, cognitive tasks designed to replicate such behaviour have revealed a strong link between cooperative behaviour and game theoretic predictions. However, we show that individuals from a specific location within our study site repeatedly failed to conform to the published evidence. We started exploring potential functional and mechanistic causes for this unexpected result, focusing on client composition, cleaner standard personality measures and ontogeny. We found that failing individuals lived in a socially simple environment. Decision rules of these cleaners ignored existing information in their environment (‘bounded rationality’), in contrast to cleaners living in a socially complex area. With respect to potential mechanisms, we found no correlations between differences in performance and differences in aggressiveness or boldness, in contrast to results on other cooperative species. Furthermore, juveniles from the two habitat types performed similarly, and better than the adults from the socially simple environment. We propose that variation in the costs and benefits of knowledge may affect a cleaners’ information acquisition and storage, which may explain our observed variation in cooperation and cognition.
Role of testis‐specific high‐mobility‐group protein in transcriptional regulation of inducible nitric oxide synthase expression in the liver of endotoxic shock mice
Authors: Liu Zhifeng , Liu Jinghua , Wang Juan , Xu Jia , Liu Yawei , Sun Xuegang , Su Lei , Wang Jiang Huai , Jiang Yong
Published: March 2014

Inducible nitric oxide synthase (iNOS) plays a central role in tissue damage during endotoxic shock. However, the underlying mechanisms that control transcription of iNOS are not completely defined. A screening strategy with DNA pull‐down technology and two‐dimensional difference in gel electrophorcsis (2D‐DIGE) analysis was used to identify regulators that interact with the iNOS promoter. We found 14 proteins that bind to the iNOS promoter in the liver of endotoxic shock mice. After matrix‐assisted laser desorption/ionization time of flight mass spectrometry (MALDI‐TOF MS) analysis, one of these proteins was identified as testis‐specific high‐mobility‐group protein (tsHMG), an alternative splicing isoform encoded by the mitochondrial transcription factor A gene. We identified the binding sites of tsHMG on the iNOS promoter using a LiquiChip system, and further confirmed interactions between tsHMG and iNOS by RT‐PCR, western blotting and immunofluorescence. Functional analysis by over‐expression and RNA interference of tsHMG revealed that tsHMG regulates lipopolysaccharide‐stimulated iNOS expression. These results indicate that tsHMG participates in modulation of iNOS expression in the early stage of endotoxic shock.
Net carbon fluxes at stand and landscape scales from wood bioenergy harvests in the US Northeast
Authors: Mika Anna M. , Keeton William S.
Published: March 2014

The long‐term greenhouse gas emissions implications of wood biomass (‘bioenergy’) harvests are highly uncertain yet of great significance for climate change mitigation and renewable energy policies. Particularly uncertain are the net carbon (C) effects of multiple harvests staggered spatially and temporally across landscapes where bioenergy is only one of many products. We used field data to formulate bioenergy harvest scenarios, applied them to 362 sites from the Forest Inventory and Analysis database, and projected growth and harvests over 160 years using the Forest Vegetation Simulator. We compared the net cumulative C fluxes, relative to a non‐bioenergy baseline, between scenarios when various proportions of the landscape are harvested for bioenergy: 0% (non‐bioenergy); 25% (BIO25); 50% (BIO50); or 100% (BIO100), with three levels of intensification. We accounted for C stored in aboveground forest pools and wood products, direct and indirect emissions from wood products and bioenergy, and avoided direct and indirect emissions from fossil fuels. At the end of the simulation period, although 82% of stands were projected to maintain net positive C benefit, net flux remained negative (i.e., net emissions) compared to non‐bioenergy harvests for the entire 160‐year simulation period.BIO25,BIO50, andBIO100 scenarios resulted in average annual emissions of 2.47, 5.02, and 9.83 Mg C ha−1, respectively. Using bioenergy for heating decreased the emissions relative to electricity generation as did removing additional slash from thinnings between regeneration harvests. However, all bioenergy scenarios resulted in increased net emissions compared to the non‐bioenergy harvests. Stands with high initial aboveground live biomass may have higher net emissions from bioenergy harvest. Silvicultural practices such as increasing rotation length and structural retention may result in lower C fluxes from bioenergy harvests. Finally, since passive management resulted in the greatest net C storage, we recommend designation of unharvested reserves to offset emissions from harvested stands.
Impacts of biogenic CO2 emissions on human health and terrestrial ecosystems: the case of increased wood extraction for bioenergy production on a global scale
Authors: van Zelm Rosalie , Muchada Patience A. N. , van der Velde Marijn , Kindermann Georg , Obersteiner Michael , Huijbregts Mark A. J.
Published: March 2014

Biofuels are a potentially important source of energy for our society. Common practice in life cycle assessment (LCA) of bioenergy has been to assume that any carbon dioxide (CO2) emission related to biomass combustion equals the amount absorbed in biomass, thus assuming no climate change impacts. Recent developments show the significance of contributions of biogenic CO2 emissions during the time they stay in the atmosphere. The goal of this article is to develop a global, spatially explicit method to quantify the potential impact on human health and terrestrial ecosystems of biogenic carbon emissions coming from forest wood extraction for biofuel production. For this purpose, changes in aboveground carbon stock (ΔCforest) due to an increase in wood extraction via changes in rotation time are simulated worldwide with a 0.5° × 0.5° grid resolution. Our results show that both impacts and benefits can be obtained. When the extraction increase is reached by creating a longer rotation time, new growth is allowed resulting in carbon benefits. In a case study, we assessed the life cycle impacts of heat production via wood to determine the significance of including biogenic CO2 emissions due to changes in forest management. Impacts of biogenic CO2 dominate the total climate change impacts from a wood stove. Depending on the wood source country, climate change impacts due to heat production from wood either have an important share in the overall impacts on human health and terrestrial ecosystems, or allow for a large additional CO2 sink.
Differential expression of IMP3 between male and female mature teratomas—immunohistochemical evidence of malignant nature
Authors: Goodman Steven , Zhang Liping , Cheng Liang , Jiang Zhong
Published: March 2014

Aims

Ovarian mature teratoma is a benign tumour, whereas mature teratoma in adult testicular germ cell tumours (TGCTs) is considered to be a malignant tumour. IMP3, an oncofetal protein, plays an important role in embryogenesis and carcinogenesis. IMP3 has been demonstrated to be a malignant biomarker that is mainly expressed in malignant neoplasms rather than benign tissues. The aim of this study was to analyse IMP3 expression in germ cell tumours, and compare its expression between male and female teratomas.

Methods and results

One hundred and seventy‐eight cases (62 TGCTs, 52 ovarian teratomas, 27 metastatic testicular teratomas, and 37 cases of normal testicular tissue) obtained from the archives of two large academic medical centres were examined for IMP3 expression. Of the 62 TGCTs, 30 had mature teratoma components. IMP3 expression was present in 100% (30/30) of testicular mature teratoma components, and in 96% (26/27) of metastatic testicular teratomas. Other TGCT components also expressed IMP3 in 99% of cases (78/79). IMP3 expression was negative in all female mature teratomas.

Conclusions

We describe for the first time an immunostaining marker that has differential expression in male and female mature teratomas, indicating that their pathogenesis differs. High expression of IMP3 in adult mature testicular teratomas supports their malignant nature.
An Original Way to Investigate Silver Migration Through Silicon Carbide Coating in TRISO Particles
Authors: Geng Xin , Yang Fan , Rohbeck Nadia , Xiao Ping
Published: March 2014

Extensive release of the metastable silver nuclide Ag110m from fully intact tristructural‐isotropic (TRISO) particles raises concerns over safety of advanced nuclear reactors. In this study, we propose a new model to interpret the silver migration mechanism in SiC based on experimental observations from both Ag/SiC composite pellets and TRISO particles with an entrapped silver layer. For the Ag/SiC composite pellets heat treated at 1450°C, silicon was detected in the silver phase, amorphous carbon was found, and new β‐SiC had formed at the Ag/SiC interface. The results indicate that Ag in its liquid state reacts with SiC by forming a Ag–Si alloy. Carbon precipitates as a second phase or reacts with the Ag–Si alloy to form new SiC. Results from the heat‐treated TRISO particles trapping Ag show that Ag penetrates through the SiC layer and is present in either “finger‐shape” or “wedge shape” at the SiC grain boundaries. Ag was also found inside abnormally large SiC grains at the trailing edge between Ag and SiC, indicating the recrystallization of SiC. A dissolution‐reaction model was proposed to explain Ag migration through SiC, and this model is supported by thermodynamic calculations.
Investigation of Partial Discharge and Fracture Strength in Piezoelectric Ceramics
Authors: Hang Tian , Glaum Julia , Phung Toan , Hoffman Mark
Published: March 2014

Although piezoelectric ceramics are widely used, the structural reliability of these materials in long‐term service is still a concern. In this study, a nondestructive method for assessing material strength reliability using partial discharge (PD) tests is proposed. The PD inception electric field and the flexure strength are both controlled by the defects in the ceramics which suggests that the PD test can be an alternative nondestructive method for evaluating the structural reliability of piezoelectric ceramics. PD and four‐point flexure tests were carried out on piezoelectric ceramics. The influence of the PD test on samples was investigated by comparing the microstructure and electrical properties before and after the PD test. Samples which were not PD tested were also fractured and compared. It was found that no strength degradation was caused by the PD test. Weibull analysis revealed a correlation between the distribution in values for PD inception electric field and flexure strength.
Androgenetic alopecia is associated with increased arterial stiffness in asymptomatic young adults
Authors: Agac M.T. , Bektas H. , Korkmaz L. , Cetin M. , Erkan H. , Gurbak I. , Hatem E. , Celik S.
Published: March 2014

Background

Association of androgenetic alopecia (AGA) with increased incidence of hypertension, a strong risk factor for coronary artery disease, has been suggested. However, there are no data on arterial stiffness measures of asymptomatic young adults with AGA.

Objective

In this study, we aimed to investigate the association of the AGA with arterial stiffness assessed by cardio‐ankle vascular index (CAVI), in asymptomatic young men.

Methods

A total of 162 asymptomatic men aged between 18 and 45 years were consecutively enrolled to the study. Subjects were considered to have AGA if they have ≥3 grade vertex alopecia according to Hamilton–Norwood scale. Arterial stiffness was assessed by CAVI and defined as abnormal if CAVI is ≥8.

Results

Frequency of abnormal CAVI was higher in patients with AGA (29.3% vs. 10.0%, P = 0.003). Subjects with AGA had higher mean CAVI than subjects without AGA (7.56 ± 0.93 vs. 7.15 ± 0.79, P = 0.004). Binary logistic regression analysis demonstrated that presence of AGA (OR, 5.6; 95% CI, 1.7–20.0, P = 0.006), age (OR, 1.1; 95% CI, 1.0–1.2, P = 0.03) and diastolic blood pressure (OR, 1.1; 95% CI, 1.0–1.3, P = 0.005) were independently associated with abnormal CAVI.

Conclusion

We concluded that, AGA might be an indicator of arterial stiffness in asymptomatic young adults.
Cd‐Metallothioneins in Three Additional Tetrahymena Species: Intragenic Repeat Patterns and Induction by Metal Ions
Authors: Chang Yue , Liu Guanglong , Guo Lina , Liu Hongbo , Yuan Dongxia , Xiong Jie , Ning Yingzhi , Fu Chengjie , Miao Wei
Published: March 2014

Ciliate metallothioneins (MTs) possess many unique features compared to the “classic” MTs in other organisms, but they have only been studied in a small number of species. In this study, we investigated cDNAs encoding subfamily 7a metallothioneins (CdMTs) in three Tetrahymena species (T. hegewischi, T. malaccensis, and T. mobilis). Four CdMT genes (ThegMT1, ThegMT2, TmalMT1, and TmobMT1) were cloned and characterized. They share high sequence similarity to previously identified subfamily 7a MT members. Tetrahymena CdMTs exhibit a remarkably regular intragenic repeat homology. The CdMT sequences were divided into two main types of modules, which had been previously described, and which we name “A” and “B”. ThegMT2 was identified as the first MT isoform solely composed of module “B”. A phylogenetic analysis of individual modules of every characterized Tetrahymena CdMT rigorously documents the conclusion that modules are important units of CdMT evolution, which have undergone frequent and rapid gain/loss and shuffling. The transcriptional activity of the four newly identified genes was measured under different heavy metal exposure (Cd, Cu, Zn, Pb) using real‐time quantitative PCR. The results showed that these genes were differentially induced after short (1 h) or long (24 h) metal exposure. The evolutionary diversity of Tetrahymena CdMTs is further discussed with regard to their induction by metal ions.
Endoscopic ultrasound guided fine needle aspiration with fluorescence in situ hybridization analysis in 104 patients with pancreatic mass
Authors: Ribeiro Afonso , Peng Jinghong , Casas Carmen , Fan Yao‐Shan
Published: March 2014

Background and Aim

Diagnosis of pancreatic malignancy is often based on cytological specimens collected by endoscopic ultrasound guided fine needle aspiration (EUS FNA). Several factors can decrease sensitivity of EUS FNA for pancreatic cancer: well‐differentiated tumors, pancreatitis, blood, necrosis and slides with low cellularity. The objective of this study is to report on the use of fluorescence in situ hybridization (FISH) analysis combined with cytology in pancreatic masses.

Methods

EUS database and medical records of patients referred for EUS between January 2009 through august 2013 were reviewed. Data on cytology, FISH and surgical pathology were reviewed. Surgical pathology, death or extended clinical follow‐up were used to verify correct diagnosis of malignancy. FISH performed using a four‐set DNA probe for chromosomes 3, 7, 17, and band 9p21 in patients with inconclusive immediate cytology reading. Sensitivity of cytology and FISH were compared.

Results

Study cohort comprised of 104 patients with FISH analysis on EUS FNA specimens of pancreatic masses (74 adenocarcinoma, 7 neuroendocrine tumor and 23 benign. Sensitivity of cytology and FISH for carcinoma was respectively: 62% and 81%. Sensitivity of FISH + cytology was 89%. The specificity of FISH and cytology was 100%. The most common abnormality on FISH was a 9p21 deletion seen in 43 patients (58%) followed by polysomy of 7 (46%). FISH detected malignancy in 23 patients with negative cytology.

Conclusions

In patients with inconclusive immediate cytology reading, FISH is superior to cytology and improves overall sensitivity. The 9p21 deletion is the most common abnormality seen in this cohort of patients with pancreatic cancer.
Postsurgery wound assessment and management practices: a chart audit
Authors: Gillespie Brigid M , Chaboyer Wendy , Kang Evelyn , Hewitt Jayne , Nieuwenhoven Paul , Morley Nicola
Published: March 2014

Aims and Objectives

To examine wound assessment and management in patients following surgery and to compare these practices with current evidence‐based guidelines for the prevention of surgical site infection across one healthcare services district in Queensland, Australia.

Background

Despite innovations in surgical techniques, technological advances and environmental improvements in the operating room, and the use of prophylactic antibiotics, surgical site infections remain a major source of morbidity and mortality in patients following surgery.

Design

A retrospective clinical chart audit

Methods

A random sample of 200 medical records of patients who had undergone surgery was undertaken over a two‐year period (2010–2012). An audit tool was developed to collect the data on wound assessment and practice. The study was undertaken across one healthcare services district in Australia.

Results

Of the 200 records that were randomly identified, 152 (76%) met the inclusion criteria. The excluded records were either miscoded or did not involve a surgical incision. Of the 152 records included, 87 (57·2%) procedures were classified as ‘clean’ and 106 (69·7%) were elective. Wound assessments were fully documented in 63/152 (41·4%) of cases, and 59/152 (38·8%) charts had assessments documented on a change of patient condition. Of the 15/152 (9·9%) patients with charted postoperative wound complications, 4/15 (26·6%) developed clinical signs of wound infection, which were diagnosed on days 3 to 5.

Conclusions

The timing, content and accuracy of wound assessment documentation are variable. Standardising documentation will increase consistency and clarity and contribute to multidisciplinary communication.

Relevance to clinical practice

These results suggest that postoperative wound care practices are not consistent with evidence‐based guidelines. Consequently, it is important to involve clinicians in identifying possible challenges within the clinical environment that may curtail guideline use.
A quantitative assessment of patient and nurse outcomes of bedside nursing report implementation
Authors: Sand‐Jecklin Kari , Sherman Jay
Published: March 2014

Aims and objectives

To quantify quantitative outcomes of a practice change to a blended form of bedside nursing report.

Background

The literature identifies several benefits of bedside nursing shift report. However, published studies have not adequately quantified outcomes related to this process change, having either small or unreported sample sizes or not testing for statistical significance.

Design

Quasi‐experimental pre‐ and postimplementation design.

Methods

Seven medical‐surgical units in a large university hospital implemented a blend of recorded and bedside nursing report. Outcomes monitored included patient and nursing satisfaction, patient falls, nursing overtime and medication errors.

Results

We found statistically significant improvements postimplementation in four patient survey items specifically impacted by the change to bedside report. Nursing perceptions of report were significantly improved in the areas of patient safety and involvement in care and nurse accountability postimplementation. However, there was a decline in nurse perception that report took a reasonable amount of time after bedside report implementation; contrary to these perceptions, there was no significant increase in nurse overtime. Patient falls at shift change decreased substantially after the implementation of bedside report. An intervening variable during the study period invalidated the comparison of medication errors pre‐ and postintervention. There was some indication from both patients and nurses that bedside report was not always consistently implemented.

Conclusions

Several positive outcomes were documented in relation to the implementation of a blended bedside shift report, with few drawbacks. Nurse attitudes about report at the final data collection were more positive than at the initial postimplementation data collection.

Relevance to clinical practice

If properly implemented, nursing bedside report can result in improved patient and nursing satisfaction and patient safety outcomes. However, managers should involve staff nurses in the implementation process and continue to monitor consistency in report format as well as satisfaction with the process.
Health economic evaluation of treatments for Alzheimer′s disease: impact of new diagnostic criteria
Authors: Wimo A. , Ballard C. , Brayne C. , Gauthier S. , Handels R. , Jones R. W. , Jonsson L. , Khachaturian A. S. , Kramberger M.
Published: March 2014

The socio‐economic impact of Alzheimer′s disease (AD) and other dementias is enormous, and the potential economic challenges ahead are clear given the projected future numbers of individuals with these conditions. Because of the high prevalence and cost of dementia, it is very important to assess any intervention from a cost‐effectiveness viewpoint. The diagnostic criteria for preclinical AD suggested by the National Institute on Aging and Alzheimer's Association workgroups in combination with the goal of effective disease‐modifying treatment (DMT) are, however, a challenge for clinical practice and for the design of clinical trials. Key issues for future cost‐effectiveness studies include the following: (i) the consequences for patients if diagnosis is shifted from AD‐dementia to predementia states, (ii) bridging the gap between clinical trial populations and patients treated in clinical practice, (iii) translation of clinical trial end‐points into measures that are meaningful to patients and policymakers/payers and (iv) how to measure long‐term effects. To improve cost‐effectiveness studies, long‐term population‐based data on disease progression, costs and outcomes in clinical practice are needed not only in dementia but also in predementia states. Reliable surrogate end‐points in clinical trials that are sensitive to detect effects even in predementia states are also essential as well as robust and validated modelling methods from predementia states that also take into account comorbidities and age. Finally, the ethical consequences of early diagnosis should be considered.
Advances in the prevention of Alzheimer's disease and dementia
Authors: Solomon A. , Mangialasche F. , Richard E. , Andrieu S. , Bennett D. A. , Breteler M. , Fratiglioni L. , Hooshmand B. , Khachaturian A. S. , Schneider L. S. , Skoog I. , Kivipelto M.
Published: March 2014

Background

Definitions and diagnostic criteria for all medical conditions are regularly subjected to reviews and revisions as knowledge advances. In the field of Alzheimer's disease (AD) research, it has taken almost three decades for diagnostic nomenclature to undergo major re‐examination. The shift towards presymptomatic and pre‐dementia stages of AD has brought prevention and treatment trials much closer to each other than before.

Methods

Here we discuss: (i) the impact of diagnostic reliability on the possibilities for developing preventive strategies for AD; (ii) the scientific evidence to support moving from observation to action; (iii) ongoing intervention studies; and (iv) the methodological issues and prospects for balancing strategies for high‐risk individuals with those for broad population‐based prevention.

Results

The associations between neuropathology and cognition are still not entirely clear. In addition, the risk factors for AD dementia and the neuropathological hallmarks of AD may not necessarily be the same. Cognitive impairment has a clearer clinical significance and should therefore remain the main focus of prevention. Risk/protective factors for dementia/AD need to be studied from a life‐course perspective. New approaches in prevention trials include enrichment strategies based on genetic risk factors or beta‐amyloid biomarkers (at least four ongoing pharmacological trials), and multidomain interventions simultaneously targeting various vascular and lifestyle‐related risk factors (at least three ongoing trials). Experience from prevention programmes in other chronic diseases can provide additional methodological improvements.

Conclusions

Building infrastructures for international collaborations is necessary for managing the worldwide public health problem of AD and dementia. The International Database on Aging and Dementia (IDAD) and the European Dementia Prevention Initiative (EDPI) are examples of ongoing international efforts aiming to improve the methodology of preventive studies and provide the basis for larger intervention trials.
Mild cognitive impairment: a concept in evolution
Authors: Petersen R. C. , Caracciolo B. , Brayne C. , Gauthier S. , Jelic V. , Fratiglioni L.
Published: March 2014

The construct of mild cognitive impairment (MCI) has evolved over the past 10 years since the publication of the new MCI definition at the Key Symposium in 2003, but the core criteria have remained unchanged. The construct has been extensively used worldwide, both in clinical and in research settings, to define the grey area between intact cognitive functioning and clinical dementia. A rich set of data regarding occurrence, risk factors and progression of MCI has been generated. Discrepancies between studies can be mostly explained by differences in the operationalization of the criteria, differences in the setting where the criteria have been applied, selection of subjects and length of follow‐up in longitudinal studies. Major controversial issues that remain to be further explored are algorithmic versus clinical classification, reliability of clinical judgment, temporal changes in cognitive performances and predictivity of putative biomarkers. Some suggestions to further develop the MCI construct include the tailoring of the clinical criteria to specific populations and to specific contexts. The addition of biomarkers to the clinical phenotypes is promising but requires deeper investigation. Translation of findings from the specialty clinic to the population setting, although challenging, will enhance uniformity of outcomes. More longitudinal population‐based studies on cognitive ageing and MCI need to be performed to clarify all these issues.
Clinical trials and late‐stage drug development for Alzheimer's disease: an appraisal from 1984 to 2014
Authors: Schneider L. S. , Mangialasche F. , Andreasen N. , Feldman H. , Giacobini E. , Jones R. , Mantua V. , Mecocci P. , Pani L. , Winblad B. , Kivipelto M.
Published: March 2014

The modern era of drug development for Alzheimer's disease began with the proposal of the cholinergic hypothesis of memory impairment and the 1984 research criteria for Alzheimer's disease. Since then, despite the evaluation of numerous potential treatments in clinical trials, only four cholinesterase inhibitors and memantine have shown sufficient safety and efficacy to allow marketing approval at an international level. Although this is probably because the other drugs tested were ineffective, inadequate clinical development methods have also been blamed for the failures. Here, we review the development of treatments for Alzheimer's disease during the past 30 years, considering the drugs, potential targets, late‐stage clinical trials, development methods, emerging use of biomarkers and evolution of regulatory considerations in order to summarize advances and anticipate future developments. We have considered late‐stage Alzheimer's disease drug development from 1984 to 2013, including individual clinical trials, systematic and qualitative reviews, meta‐analyses, methods, commentaries, position papers and guidelines. We then review the evolution of drugs in late clinical development, methods, biomarkers and regulatory issues. Although a range of small molecules and biological products against many targets have been investigated in clinical trials, the predominant drug targets have been the cholinergic system and the amyloid cascade. Trial methods have evolved incrementally: inclusion criteria have largely remained focused on mild‐to‐moderate Alzheimer's disease criteria, recently extending to early or prodromal Alzheimer disease or ‘mild cognitive impairment due to Alzheimer's disease’, for drugs considered to be disease modifying. The duration of trials has remained at 6–12 months for drugs intended to improve symptoms; 18‐ to 24‐month trials have been established for drugs expected to attenuate clinical course. Cognitive performance, activities of daily living, global change and severity ratings have persisted as the primary clinically relevant outcomes. Regulatory guidance and oversight have evolved to allow for enrichment of early‐stage Alzheimer's disease trial samples using biomarkers and phase‐specific outcomes. In conclusion, validated drug targets for Alzheimer's disease remain to be developed. Only drugs that affect an aspect of cholinergic function have shown consistent, but modest, clinical effects in late‐phase trials. There is opportunity for substantial improvements in drug discovery and clinical development methods.