bluuebunny/crossref_metadata_2025 huggingface dataset:
An International View of How Recent‐onset Atrial Fibrillation Is Treated in the Emergency Department
Authors: Rogenstein Carly , Kelly Anne‐Maree , Mason Suzanne , Schneider Sandra , Lang Eddy , Clement Catherine M. , Stiell Ian G.
Published: November 2012

Objectives

This study was conducted to determine if there is practice variation for emergency physicians’ (EPs) management of recent‐onset atrial fibrillation (RAF) in various world regions (Canada, United States, United Kingdom, and Australasia).

Methods

The authors completed a mail and e‐mail survey of members from four national emergency medicine (EM) associations. One prenotification letter and three survey letters were sent to members of the Canadian Association of Emergency Physicians (CAEP; Canada—1,177 members surveyed), American College of Emergency Physicians (ACEP; United States—500), College of Emergency Medicine UK (CEM; United Kingdom—1,864), and Australasian College for Emergency Medicine (ACEM; Australasia—1,188) as per the modified Dillman technique. The survey contained 23 questions related to the management of adult patients with symptomatic RAF (either a first episode or paroxysmal‐recurrent) where onset is less than 48 hours and cardioversion is considered a treatment option. Data were analyzed using descriptive and chi‐square statistics.

Results

Response rates were as follows: overall, 40.5%; Canada, 43.0%; United States, 50.1%; United Kingdom, 38.1%; and Australasia, 38.0%. Physician demographics were as follows: 72% male and mean (±SD) age 41.7 (±8.39) years. The proportions of physicians attempting rate control as their initial strategy are United States, 94.0%; Canada, 70.7%; Australasia, 61.1%; and United Kingdom, 43.1% (p < 0.0001). Diltiazem is the predominant agent for rate control in Canada (65.36%) and the United States (95.22%), while metoprolol is used in Australasia (65.94%) and the United Kingdom (67.64%). Cardioversion is attempted at varying rates in Canada (65.9%), Australasia (49.9%), United Kingdom (49.5%), and the United States (25.9%) (p < 0.0001). Pharmacologic cardioversion is attempted first in all regions, with the preferred drug being procainamide in Canada (61.93%) and amiodarone in Australasia (63.39%), the United Kingdom (47.97%), and the United States (22.41%; p < 0.0001). If drugs fail, electrical cardioversion is then attempted in Canada (70.64%), Australasia (46.19%), the United States (29.69%), and the United Kingdom (27.78%; p < 0.0001).

Conclusions

There is much variation in emergency department (ED) management of RAF among world regions, most markedly for use of rate versus rhythm control, choice of drugs, and use of electrical cardioversion. Canadians are more likely to use an aggressive approach for management of RAF, whereas Americans are more likely to employ conservative management. U.K. and Australasian EPs fall somewhere in the middle. These differences demonstrate the need for better evidence, or better synthesis of existing knowledge, to create guidelines to guide ED management of this common dysrhythmia.
Emergency Medicine Journal Impact Factor and Change Compared to Other Medical and Surgical Specialties
Authors: Reynolds Joshua C. , Menegazzi James J. , Yealy Donald M.
Published: November 2012

Objectives

A journal impact factor represents the mean number of citations per article published. Designed as one tool to measure the relative importance of a journal, impact factors are often incorporated into academic evaluation of investigators. The authors sought to determine how impact factors of emergency medicine (EM) journals compare to journals from other medical and surgical specialties and if any change has taken place over time.

Methods

The 2010 impact factors and 5‐year impact factors for each journal indexed by the Thomson Reuters ISI Web of Knowledge Journal Citation Reports (JCR) were collected, and EM, medical, and surgical specialties were evaluated. The maximum, median, and interquartile range (IQR) of the current impact factor and 5‐year impact factor in each journal category were determined, and specialties were ranked according to the summary statistics. The “top three” impact factor journals for each specialty were analyzed, and growth trends from 2001 through 2010 were examined with random effects linear regression.

Results

Data from 2,287 journals in 31 specialties were examined. There were 23 EM journals with a current maximum impact factor of 4.177, median of 1.269, and IQR of 0.400 to 2.176. Of 23 EM journals, 57% had a 5‐year impact factor available, with a maximum of 4.531, median of 1.325, and IQR of 0.741 to 2.435. The top three EM journals had a mean standard deviation (±SD) impact factor of 3.801 (±0.621) and median of 4.142 and a mean (±SD) 5‐year impact factor of 3.788 (±1.091) and median of 4.297, with a growth trend of 0.211 (95% confidence interval [CI] = 0.177 to 0.245; p < 0.001). By any criterion analyzed, EM journals ranked no higher than 24th among 31 specialties.

Conclusions

Emergency medicine journals rank low in impact factor summary statistics and growth trends among 31 medical and surgical specialties.
The D2/3 dopamine receptor in pathological gambling: a positron emission tomography study with [11C]‐(+)‐propyl‐hexahydro‐naphtho‐oxazin and [11C]raclopride
Authors: Boileau Isabelle , Payer Doris , Chugani Bindiya , Lobo Daniela , Behzadi Arian , Rusjan Pablo M. , Houle Sylvain , Wilson Alan A. , Warsh Jerry , Kish Stephen J. , Zack Martin
Published: November 2012

Aims

Pathological gambling (PG) shares diagnostic features with substance use disorder (SUD), but the neurochemical mechanisms underlying PG are poorly understood. Because dopamine (DA), a neurotransmitter implicated in reward and reinforcement, is probably involved, we used positron emission tomography (PET) to test whether PG is associated with abnormalities in D2 and D3 receptor levels, as observed in SUD.

Design

Case–control study comparing PG to healthy control (HC) subjects.

Setting

Academic research imaging centre.

Participants

Thirteen non‐treatment‐seeking males meeting DSM‐IV criteria for PG, and 12 matched HC (11 of whom completed PET).

Measurements

Two PET scans (one with the D3 receptor preferring agonist [11C]‐(+)‐propyl‐hexahydro‐naphtho‐oxazin (PHNO) and the other with [11C]raclopride) to assess D2/3 DA receptor availability, and behavioural measures (self‐report questionnaires and slot‐machine game) to assess subjective effects and relationships to PET measures.

Findings

Binding of both radiotracers did not differ between groups in striatum or substantia nigra (SN) (all P > 0.1). Across PG, [11C]‐(+)‐PHNO binding in SN, where the signal is attributable primarily to D3 receptors, correlated with gambling severity (r = 0.57, P = 0.04) and impulsiveness (r = 0.65, P = 0.03). In HC, [11C]raclopride binding in dorsal striatum correlated inversely with subjective effects of gambling (r = −0.70, P = 0.03) and impulsiveness (r = −0.70, P = 0.03).

Conclusions

Unlike with substance use disorder, there appear to be no marked differences in D2/D3 levels between healthy subjects and pathological gamblers, suggesting that low receptor availability may not be a necessary feature of addiction. However, relationships between [11C]‐(+)‐PHNO binding and gambling severity/impulsiveness suggests involvement of the D3 receptor in impulsive/compulsive behaviours.
Pan trap catches of pollinator insects vary with habitat
Authors: Saunders Manu E , Luck Gary W
Published: November 2012

Coloured pan trapping is a simple and efficient method for collecting flying insects, yet there is still discussion over the most effective bowl colour to use for particular target groups (e.g. pollinator insects). The success of particular colours can vary across bioregions and habitats. Most published pan trap studies have been conducted in the northern hemisphere, and very few investigated the effects of habitat on pan trap catches. Our study is one of the first to (1) sample for potential pollinators in Australian mallee vegetation and almond orchards and (2) investigate whether habitat interacts with trap colour to influence pan trap catches. We sampled Hymenoptera and Diptera using yellow, white and blue pan traps in native mallee vegetation and two types of managed almond orchards (monoculture and plant‐diverse) in the Murray Mallee bioregion of north‐western Victoria, Australia. Yellow traps caught the most insects across all habitats, although catches in each colour trap varied with habitat. For all insect groups combined, blue traps caught more individuals in mallee habitats than in almond orchards. For native hymenopterans, yellow traps caught more individuals in plant‐diverse orchards than in native sites, while blue traps caught more individuals in native sites. Our results highlight the importance of considering the habitat of individual pan trapping surveys, as no one trap colour is likely to be suitable for trapping target insects across all habitats.
Enucleation in Iceland 1992–2004: study in a defined population
Authors: Geirsdottir Asbjorg , Agnarsson Bjarni A. , Helgadottir Gudleif , Sigurdsson Haraldur
Published: November 2012

Purpose:  To determine the incidence rate as well as causative diagnoses and surgical indications of enucleation in Iceland during the years 1992–2004.

Methods:  A retrospective population‐based incidence study involving the entire population of Iceland. Medical records of all patients who underwent enucleation in Iceland from January 1992 through December 2004 were reviewed. The annually updated Icelandic census was used as a denominator data.

Results:  Fifty‐six eyes were enucleated during 1992–2004. No eviscerations were done, and the three exenterations performed were not included in the study. The mean annual age‐adjusted incidence rate of enucleation in Iceland was 1.48 enucleations per 100 000 population in comparison with 2.66 enucleations per 100 000 for the time period 1964–1991. With advancing age, a significant increasing linear trend existed (p < 0.001). The median age at enucleation was 51 years (SD 22; mean 55 years; 16–91 years). The three most common surgical indications for enucleation were blind painful eye, suspected ocular malignancy and acute trauma. The most common causative diagnosis for enucleation was traumatic lesion (39%). The annual incidence was 2.00 enucleations per 100 000 for men and 0.95 for women. There were significantly more men in the traumatic lesion group (p < 0.001), but no gender predominance was found in the other groups of causative diagnoses (p = 0.8).

Conclusion:  The overall mean annual incidence of enucleation in Iceland is continually decreasing, although the incidence of severe ocular trauma and ocular malignancy is fairly stable.
Antimicrobial susceptibility testing of Streptococcus pneumoniae and Haemophilus influenzae – Internal quality control as a quality tool on a national level
Authors: Kärpänoja Pauliina , Nissinen Antti , Huovinen Pentti , Sarkkinen Hannu ,   The Finnish Study Group for Antimicrobial Resistance, Fire Network
Published: November 2012

Knowledge of the quality and conformity of antimicrobial resistance data is important for comparing resistance rates regionally and over time. In this study, we have evaluated these features of the Finnish national susceptibility surveillance data for two respiratory tract pathogens, Streptococcus pneumoniae and Haemophilus influenzae. For this purpose internal quality control results for two isolates (S. pneumoniae ATCC 49619 and H. influenzae ATCC 49247) were analyzed from 21 clinical microbiology laboratories over a 3‐year period. The results show that standardization of the susceptibility testing methods has proceeded well. The number of protocols used for susceptibility testing has declined (from seventeen methods to two with S. pneumoniae and from eleven to three with H. influenzae) and the reproducibility is good. Nevertheless, we noticed that a few laboratories test and report susceptibility results without defined break‐points and even include antimicrobials with questionable therapeutic effect. Another non‐compliance with the standard was a lack of a regular control system to verify the attainment of the intended quality of results in some laboratories. Interlaboratory analysis of quality control results is a good way to evaluate the quality and conformity of national resistance data. Finnish laboratories have produced very reproducible and accurate susceptibility results in the pre‐EUCAST period, which ended in 2011.
Association of toll‐like receptor 4 polymorphisms with type 2 diabetes mellitus
Authors: Cai Huayin , Cai Junfeng , Tao Geng
Published: November 2012

Toll‐like receptor 4 (TLR4) plays important roles in modulating innate immunity. Type 2 diabetes mellitus (T2DM) is a chronic and complex disease that is characterized by impaired insulin resistance and dysregulated immune response. In the current study, we investigated whether TLR4 polymorphisms were correlated with susceptibility to T2DM in the Chinese population. Four TLR4 polymorphisms (−2431T/C, Asp299Gly, Thr399Il3, and +3725G/C) were genotyped in 936 T2DM patients and 978 healthy controls. Results showed that the prevalence of TLR4 +3725GC and CC genotypes was significantly decreased in T2DM cases than those in controls [odds ratio (OR) = 0.68, 95% confidence interval (CI) = 0.55–0.84, p = 0.0003, and OR=0.46, 95% CI = 0.32–0.67, p = 3.71 × 10−5, respectively). Also, the frequency of TLR4 +3725C allele was significantly lower in T2DM patients (p = 2.50 × 10−8). The −2431T/C did not reveal any significant differences between cases and controls. We did not detect Asp299Gly and Thr399Il3 polymorphisms in our study group. Stratification analysis of the clinical features in the patients demonstrated that frequency of +3725CC genotype was lower in patients older than 50 years old (p = 0.047). In conclusion, these results indicate that TLR4 +3725G/C polymorphism may be a novel protective factor against T2DM in the Chinese population.
Effects of intravenous ghrelin injection on plasma growth hormone, insulin and glucose concentrations in calves at weaning
Authors: Fukumori Rika , Mita Takako , Sugino Toshihisa , Hasegawa Yoshihisa , Kojima Masayasu , Kangawa Kenji , Obitsu Taketo , Taniguchi Kohzo
Published: November 2012

Ghrelin action, which stimulates growth hormone (GH) secretion, may alter during the weaning period in calves. Our objective was to compare the effects of intravenous ghrelin injection on plasma GH, insulin and glucose concentrations in calves around the weaning period. Four Holstein bull calves were fed whole milk and allowed free access to solid feeds, and weaned at 7 weeks of age. Measurements were performed at weeks 1, 2, 4, 6, 7, 9, 11 and 13, when calves were intravenously injected with ghrelin (1.0 μg/kg body weight (BW)) through a catheter, and jugular blood samples were obtained temporally relative to the injection time. Estimated digestible energy intake per metabolic BW transiently decreased at week 7 because of low solid intake immediately after weaning, and thereafter gradually increased. Plasma insulin and glucose concentrations were not affected by ghrelin injection at all ages. In contrast, plasma GH concentrations increased with ghrelin injection at all ages. The incremental area of GH at week 7 was greatest and significantly higher compared with weeks 2, 4, 6 and 9. This result suggests that nutrient insufficiency immediately after weaning enhances GH responsiveness to ghrelin.
Drug induced QT prolongation: the measurement and assessment of the QT interval in clinical practice
Authors: Isbister Geoffrey K. , Page Colin B.
Published: November 2012

There has been an increasing focus on drug induced QT prolongation including research on drug development and QT prolongation, following the removal of drugs due to torsades de pointes (TdP). Although this has improved our understanding of drug‐induced QT prolongation there has been much less research aimed at helping clinicians assess risk in individual patients with drug induced QT prolongation. This review will focus on assessment of drug‐induced QT prolongation in clinical practice using a simple risk assessment approach. Accurate measurement of the QT interval is best done manually, and not using the measurement of standard ECG machines. Correction for heart rate (HR) using correction formulae such as Bazett's is often inaccurate. These formulae underestimate and overestimate the duration of cardiac repolarization at low and high heart rates, respectively. Numerous cut‐offs have been suggested as an indicator of an abnormal QT, but are problematic in clinical practice. An alternative approach is the QT nomogram which is a plot of QT vs. HR. The nomogram has an ‘at risk’ line and QT‐HR pairs above this line have been shown in a systematic study to be associated with TdP and the line is more sensitive and specific than Bazett's QTc of 440 ms or 500 ms. Plotting the QT‐HR pair for patients on drugs suspected or known to cause QT prolongation allows assessment of the QT interval based on normal population QT variability. This risk assessment then allows the safer commencement of drugs therapeutically or management of drug induced effects in overdose.
Efficacy and safety of bendamustine for the treatment of patients with recurring Hodgkin lymphoma
Authors: Corazzelli Gaetano , Angrilli Francesco , D'Arco Alfonso , Ferrara Felicetto , Musto Pellegrino , Guarini Attilio , Cox Maria Christina , Stelitano Caterina , Storti Sergio , Iannitto Emilio , Falorio Simona , Califano Catello , Amore Alfonso , Arcamone Manuela , De Filippi Rosaria , Pinto Antonio
Published: November 2012

The management of patients with Hodgkin lymphoma (HL) recurring after stem cell transplantation (SCT) and multiply relapsed disease remains challenging. We report on 41 such patients who received bendamustine hydrochloride, a bifunctional mechlorethamine derivative mechanistically unrelated to traditional alkylators, after a median of four prior chemotherapy lines, including SCT in 85% of cases. Bendamustine was given at doses of 90–120 mg/m2 every 21 or 28 d. At first assessment (2–4 cycles), the overall response rate (ORR) was 78% with 12 (29%) complete (CR) and 20 (49%) partial responses (PR). Upon treatment prolongation to 6–8 courses, 40% of PRs progressed, yielding a final ORR of 58% with 31% of CRs. Eight patients (two CRs, six PRs) were subsequently allotransplanted. Median progression‐free and overall survival exceeded 11 and 21 months respectively; complete responders displayed a median disease‐free survival above 9 months with a relapse rate of only 30%. Outcomes were independent of disease chemosensitivity, previous transplant and bendamustine dose‐intensity. No life‐threatening or unexpected adverse events occurred. Within the limits of a retrospective analysis and schedule heterogeneity, these results appear very encouraging and prompt prospective trials to confirm bendamustine as a valuable option in the palliative setting and in cytoreductive strategies before allotransplantation.
Lung cancer with loss of BRG1/BRM, shows epithelial mesenchymal transition phenotype and distinct histologic and genetic features
Authors: Matsubara Daisuke , Kishaba Yuka , Ishikawa Shumpei , Sakatani Takashi , Oguni Sachiko , Tamura Tomoko , Hoshino Hiroko , Sugiyama Yukihiko , Endo Shunsuke , Murakami Yoshinori , Aburatani Hiroyuki , Fukayama Masashi , Niki Toshiro
Published: November 2012

BRG1 and BRM, two core catalytic subunits in SWI/SNF chromatin remodeling complexes, have been suggested as tumor suppressors, yet their roles in carcinogenesis are unclear. Here, we present evidence that loss of BRG1 and BRM is involved in the progression of lung adenocarcinomas. Analysis of 15 lung cancer cell lines indicated that BRG1 mutations correlated with loss of BRG1 expression and that loss of BRG1 and BRM expression was frequent in E‐cadherin‐low and vimentin‐high cell lines. Immunohistochemical analysis of 93 primary lung adenocarcinomas showed loss of BRG1 and BRM in 11 (12%) and 16 (17%) cases, respectively. Loss of expression of BRG1 and BRM was frequent in solid predominant adenocarcinomas and tumors with low thyroid transcription factor‐1 (TTF‐1, master regulator of lung) and low cytokeratin7 and E‐cadherin (two markers for bronchial epithelial differentiation). Loss of BRG1 was correlated with the absence of lepidic growth patterns and was mutually exclusive of epidermal growth factor receptor (EGFR) mutations. In contrast, loss of BRM was found concomitant with lepidic growth patterns and EGFR mutations. Finally, we analyzed the publicly available dataset of 442 cases and found that loss of BRG1 and BRM was frequent in E‐cadherin‐low, TTF‐1‐low, and vimentin‐high cases and correlated with poor prognosis. We conclude that loss of either or both BRG1 and BRM is involved in the progression of lung adenocarcinoma into solid predominant tumors with features of epithelial mesenchymal transition and loss of the bronchial epithelial phenotype. BRG1 loss was specifically involved in the progression of EGFR wild‐type, but not EGFR‐mutant tumors.
Ascertaining the wishes and feelings of young children: social workers' perspectives on skills and training
Authors: Handley Gill , Doyle Celia
Published: November 2012

The research was undertaken in the context of the ongoing debate about child care social work training and children's participation. Its aim was to explore the views of qualified child care social workers about their skills in eliciting the wishes and feelings of younger children and the relevance of social work training for this task. Questionnaires, focusing on their skills and training, were completed by 70UKchild care practitioners from theChildren andFamiliesCourtAdvisory andSupportService, voluntary agencies and local authorities. On average, practitioners felt able to ascertain the feelings and wishes of children as young as 4 years old. Nevertheless, at qualifying level, only 30% had training in communicating with young children, 16% in ascertaining children's feelings and wishes, and 66% in child development. Many had subsequently relied on in‐service training and their own initiatives to acquire further skills and understanding. In conclusion, most participants were experienced practitioners working in supportive organizations and had developed considerable communication skills. However, concerns remain because they identified deficits in child care social work qualifying and post‐qualifying training. Consequently, more effective training at all levels is required if social workers are to engage younger children successfully and facilitate their participation.
Pelizaeus–Merzbacher disease as a chromosomal disorder
Authors: Yamamoto Toshiyuki , Shimojima Keiko
Published: November 2012

Pelizaeus–Merzbacher disease (PMD) is a congenital hypomyelination disorder caused by alterations affecting the proteolipid protein 1 gene (PLP1) located on Xq22.2. Generally, patients with PLP1 missense mutations show the most severe form of PMD (connatal form); however, two‐thirds of patients with PMD carry PLP1 duplications and present typical manifestations of the disorder, recognized as the classical form. Other rare PLP1 abnormalities have been also identified, including X‐chromosome translocations, triplications, and a partial duplication, all involving PLP1. The genomic structure of the distal end of the PLP1 locus, characterized by repeated genomic segments, contributes to the chromosomal rearrangements around PLP1 and the manifestation of PMD. Thus, PMD is recognized as a chromosomal disorder.
The genetics of type 2 diabetes and its clinical relevance
Authors: Pal A , McCarthy MI
Published: November 2012

The increasing worldwide prevalence of type 2 diabetes (T2D) motivates efforts to use genetics to define key pathways involved in disease predisposition, and thereby to improve management of the disease. Research over the past 5 years has taken the total number of genetic loci implicated in T2D susceptibility beyond 60, and the emphasis is now shifting to the translation of these genetic insights into clinical value. Clinical translation may flow from the identification of novel therapeutic targets, but opportunities also exist with respect to individual prediction, diagnostic biomarkers and therapeutic optimization. To date, the main clinical impact has been seen for relatively rare, monogenic forms of diabetes rather than common T2D. However, the advent of high throughput sequencing approaches may herald discovery of rare and low frequency variants that offer greater translational potential.
Perspectives of clinical genetics professionals toward genome sequencing and incidental findings: a survey study
Authors: Lemke AA , Bick D , Dimmock D , Simpson P , Veith R
Published: November 2012

The introduction of clinical genome‐wide sequencing raises complex issues regarding the management of incidental findings. However, there is a lack of empirical studies assessing views of providers involved in potential disclosure of such findings. In an anonymous survey of 279 clinical genetics professionals, we found that the vast majority of participants agreed that they were interested in knowing about clinically actionable incidental findings in themselves (96%) and their child (99%), and they reported that these types of findings should be disclosed in adult (96%) and minor (98%) patients. Approximately three‐fourths agreed that they were personally interested in knowing about an adult‐onset clinically actionable disease (78%) and a childhood‐onset non‐clinically actionable disease (75%) in their child. A similar percentage of participants (70%) felt that these two types of findings should be disclosed to patients. Forty‐four percent of participants wanted to know about an incidental finding that indicates an adult‐onset non‐clinically actionable condition in themselves and 31% wanted to know about this type of information in their child. Findings from this study revealed participants' views highly dependent on clinical actionability. Further research is needed with a broader population of geneticists to increase generalizability, and with diverse patients to assess their perspectives about results disclosure from clinical sequencing.
Qualitative content analysis of online news media coverage of weight loss surgery and related reader comments
Authors: Glenn N. M. , Champion C. C. , Spence J. C.
Published: November 2012

The media has the ability to affect public opinion and policy direction. Prevalence of morbid obesity in Canada is increasing; as is the only effective long‐term treatment, weight loss surgery (WLS). Limited research has explored media re/presentations of WLS. The purpose of this study was to examine national online news coverage (and reader comments) of WLS using content analysis. We sought to understand the dominant messages being conveyed within the news texts and reader comments, specifically whose voice was represented, who was the intended audience and what was the overall tone. Articles and comments were retrieved from the Canadian Broadcasting Corporation news web site and analysed using line‐by‐line techniques. Articles were predominantly ‘positive/supportive’ (63%) in tone and frequently presented the voices and opinions of ‘experts’ conveying a biomedical perspective. Comments were overwhelmingly ‘negative’ (56%) and often derogatory including such language as ‘piggy’ and ‘fatty’. Comments were almost exclusively anonymous (99%) and were frequently directed at other commenters (33%) and ‘fat’ people (6%). The potentially problematic nature of media framing and reader comments, particularly as they could relate to weight‐based stigmatization and discrimination is discussed.
Environmental contributions to preschoolers' semantic fluency
Authors: Kavé Gitit , Shalmon Moran , Knafo Ariel
Published: November 2012

Semantic fluency was examined in Hebrew‐speaking 5‐year‐old monozygotic and dizygotic twins (N = 396, 198 pairs), 22% of them with mother‐reported speech‐related problems. There were positive correlations of similar magnitudes among monozygotic, same‐sex dizygotic, and opposite‐sex dizygotic twins. Analyses showed no genetic effects, alongside significant shared (39%) and non‐shared environmental (61%) effects on fluency scores. The presence of speech‐related problems in one twin affected the fluency score of the co‐twin. A multivariate regression analysis revealed that parental education and length of stay at daycare significantly predicted fluency scores. We suggest that semantic fluency performance is highly affected by environmental factors at age 5 although genetic effects might emerge later on.
The clinical utility of an SCN1A genetic diagnosis in infantile‐onset epilepsy
Authors: BRUNKLAUS ANDREAS , DORRIS LIAM , ELLIS RACHAEL , REAVEY ELEANOR , LEE ELIZABETH , FORBES GORDON , APPLETON RICHARD , CROSS J HELEN , FERRIE COLIN , HUGHES IMELDA , JOLLANDS ALICE , KING MARY D , LIVINGSTON JOHN , LYNCH BRYAN , PHILIP SUNNY , SCHEFFER INGRID E , WILLIAMS RUTH , ZUBERI SAMEER M
Published: November 2012

Aim  Genetic testing in the epilepsies is becoming an increasingly accessible clinical tool. Mutations in the sodium channel alpha 1 subunit (SCN1A) gene are most notably associated with Dravet syndrome. This is the first study to assess the impact of SCN1A testing on patient management from both carer and physician perspectives.

Method  Participants were identified prospectively from referrals to the Epilepsy Genetics Service in Glasgow and contacted via their referring clinicians. Questionnaires exploring the consequences of SCN1A genetic testing for each case were sent to carers and physicians.

Results  Of the 244 individuals contacted, 182 (75%) carried a SCN1A mutation. Carers of 187 (77%) patients responded (90 females, 97 males; mean age at referral 4y 10mo; interquartile range 9y 1mo). Of those participants whose children tested positive for a mutation, 87% reported that genetic testing was helpful, leading to treatment changes resulting in fewer seizures and improved access to therapies and respite care. Out of 187 physicians, 163 responded (87%), of whom 48% reported that a positive test facilitated diagnosis earlier than with clinical and electroencephalography data alone. It prevented additional investigations in 67% of patients, altered treatment approach in 69%, influenced medication choice in 74%, and, through medication change, improved seizure control in 42%.

Interpretation  In addition to confirming a clinical diagnosis, a positive SCN1A test result influenced treatment choice and assisted in accessing additional therapies, especially in the very young.
Efficacy of Various “Classic” Echocardiographic and Laboratory Indices in Distinguishing the “Gray Zone” between Athlete's Heart and Hypertrophic Cardiomyopathy: A Pilot Study
Authors: Pagourelias Efstathios D. , Efthimiadis Georgios K. , Kouidi Evangelia , Zorou Paraskevi , Giannoglou Georgios , Deligiannis Asterios , Athyros Vasilis G , Karagiannis Asterios , Geleris Paraschos
Published: November 2012

Left ventricular hypertrophy (LVH) with intraventricular septum thickness (IVST) between 1.2 and 1.5 cm in athletes represents a “gray zone” between physiologic adaptation and mild hypertrophic cardiomyopathy (HCM). Various echo and laboratory parameters have been reported till now in the literature to discriminate the “gray zone” entities. Aim of this study was to assess the efficacy of these “classic” parameters in differentiating physiologic LVH in athletes from mild HCM in a highly selected population. Nine highly trained athletes with IVST (1.28 ± 0.07 cm), 9 patients with mild HCM (1.38 ± 0.11 cm), and 26 athletes without LVH (1.06 ± 0.09 cm; P < 0.0005) underwent echocardiographic study, cardiopulmonary treadmill exercise stress test, and brain natriuretic peptide (BNP) measurement before and after exercise. Among all parameters tested, 7 were found to significantly differ between “gray zone” groups. After bootstrapping analysis, it was found that athletes with left ventricular end‐diastolic diameter <4.74 cm, mitral deceleration time >200 ms, isovolumic relaxation time >94 ms, tricuspid E/A < 1.63, septum Em < 9.5 cm/sec, relative wall thickness >0.445, and a BNP value at rest >9.84 pg/mL had a greater possibility for having underlying cardiomyopathy. A 10‐point score based on these parameters showed accuracy (area under the curve = 0.958 [95%CI: 0.738–1.0; P = 0.00005, standard error = 0.0342]) for revealing HCM in a gray zone athletic population. Differentiation of adaptive LVH versus HCM in a gray zone population could be facilitated by recognition of certain features referring to LV dimensions, diastolic function, and BNP.
Intramyocardial Dissecting Hematoma and Postinfarction Cardiac Rupture
Authors: Vargas‐Barrón Jesús , Roldán Francisco‐Javier , Romero‐Cárdenas Ángel , Vázquez‐Antona Clara‐Andrea
Published: November 2012

Potentially fatal cardiac rupture is a complication of myocardial infarction (MI), which can appear in the first hours of the acute event and during the course of the first week. The intramyocardial dissecting hematoma might appear as a component of the rupture during the evolution process. The description of the myocardium as a helical muscular band facilitates the explanation of the fiber dissection. With echocardiography, it is possible to diagnose intramyocardial dissecting hematomas (IDH), determine its location, progression, potential complications, and in some cases its reabsorption. It is necessary to search for neocavitations in the infarcted myocardium and identify the intramyocardial edge that surrounds the defect, as well as the flow inside the myocardial dissection, the pathway of the dissection, and its communication with ventricular cavities, and also to look for the complete or partial reabsorption of the cavitary image. The greater the myocardial dissection is, the worse the prognosis. If the dissecting hematoma is confined to the apical segments, it is more likely to reabsorb spontaneously. Tissue characterization with magnetic resonance during an acute myocardial infarction allows identification of reperfusion injuries with altered microcirculation and intramyocardial hemorrhage (IMH). It is necessary to search for IMH in reperfused patients with ventricular arrhythmias, stunned myocardium, and no reflow. These patients may develop an increased stiffness in the infarcted wall and a major likelihood to develop a parietal rupture. Everything seems to indicate that we are facing the same physiopathological process which can be characterized by 2 complementary imaging methods, echocardiography and magnetic resonance.
Fracture resistance of simulated immature maxillary anterior teeth restored with fiber posts and composite to varying depths
Authors: Seto Brandon , Chung Kwok‐Hung , Johnson James , Paranjpe Avina
Published: November 2012

Background

Traumatized immature teeth present a unique challenge during treatment, both endodontically as well as restoratively. Hence, the purpose of this study is to evaluate the type and depth of restoration that would be effective in simulated immature maxillary anterior teeth in terms of fracture resistance and mode of failure.

Materials and methods

Seventy‐five extracted human maxillary anterior teeth were used in this study that was standardized to a length of 13 mm. Instrumentation of the canals was performed after which a Peezo no. 6 was taken 1 mm past the apex to simulate an incompletely formed root. MTA apexification was simulated after which all the teeth were mounted and a 3‐mm‐diameter engineering twist drill extended the preparation 3 and 7 mm below the facial cemento–enamel junction (CEJ) to simulate Cvek's stage 3. These teeth were divided into seven different groups: Group 1: Negative control: intact teeth; Group 2: Positive control: 3 mm, no restoration; Group 3: Positive control: 7 mm, no restoration; Group 4: 3‐mm composite; Group 5: 3‐mm quartz fiber post; Group 6: 7‐mm composite; Group 7: 7‐mm quartz fiber post. Fracture resistance was performed at 130° to the long axis of the tooth with a chisel‐shaped tip at the cingulum with a cross‐head speed of 5 mm min−1, and the maximum load at which the fracture occurred was recorded.

Results

Group 1 that was the negative control showed the highest fracture resistance. Among the experimental groups, 4 and 5 showed the highest fracture resistance, which were significantly different from groups 6 and 7, respectively.

Conclusions

Within the limitations of this in vitro study, it can be concluded that using either dual‐cure composite or a quartz fiber post with composite resin to a depth of 3 mm would significantly strengthen the roots in immature teeth.
Characteristics of effective clinical teachers identified by dental students: a qualitative study
Authors: Jahangiri L. , McAndrew M. , Muzaffar A. , Mucciolo T. W.
Published: November 2012

This qualitative research study identified criteria for clinical teacher quality preferences as perceived by dental students. Third and fourth year dental students at New York University College of Dentistry were given a two question, open‐ended survey asking what qualities they liked most and least in a clinical teacher. Responses were collected until data saturation was achieved. A total of 157 respondents provided a total of 995 written comments. Descriptive words within the responses were coded and grouped into key words, according to similar relationships, and further refined into 17 defined categories. Three core themes, Character, Competence and Communication, emerged from these 17 categories, which were validated according to specific references found in the existing educational literature. ‘Character’ comprised nine of the 17 defined categories: (caring, motivation, empathy, patience, professionalism, available, fairness, happiness, patient‐centred) and yielded 59.1% of total student responses; ‘Competence’ consisted of five categories: knowledgeable, expertise, efficient, skilful, effective (29.2%); and ‘Communication’ represented the remaining three categories: feedback, approachable and interpersonal communication (11.7%). Positive and negative responses related to the defined category of caring were cited by 59.2% of all students. Motivation was the next highest category, cited by 45.9% of students. Non‐cognitive attributes, especially those in the Character theme, comprised the majority of student comments. Because students' perceptions are so critical to understanding clinical teaching effectiveness in dental education, these findings can be used to develop assessments to measure clinical teaching effectiveness, to create criteria for the hiring and promotion of clinical faculty and to plan faculty development programming.
Predictors of academic performance of first year dental undergraduates in Sri Lanka: a re‐evaluation following curriculum changes
Authors: Ariyasinghe S. , Pallegama R.
Published: November 2012

The dentistry course in Sri Lanka is conducted in English, a second language for its students. A decade ago, English language proficiency was the key factor in predicting the academic performance of first year dental undergraduates. Since then, changes have been introduced to the teaching programme and examination format to minimise the effect of language proficiency on their performance. This study aimed at re‐evaluating the factors influencing academic performance in a similar academic cohort. A total of 306 first year students in five consecutive academic years ranging in age from 20 to 24 years (77% of the total number registered, 36.3% men) were recruited, and a questionnaire was used to collect data regarding demographics, previous academic ability and perceived levels of difficulty of the first year course, English language and its sub‐skills. Performances of the English language test and cumulative GPA of the first year course were used as objective indicators of language competency and academic performance respectively. The data were analysed using SPSS 11.5. Hierarchical Regression Analysis revealed that English language proficiency, gender and previous academic ability were the significant predictors of GPA. Students who received a lower GPA perceived English as considerably more difficult compared to the academic course itself; however, students who obtained a higher GPA perceived the opposite. Students' language competency remains the major predictor of academic performance, although previous academic ability and gender emerge as significant predictors. The perceived difficulty, however, of the dental course and of studying in English may also be predictors of student academic performance.
Tensile stimuli increase nerve growth factor in human dermal fibroblasts independent of tension‐induced TGFβ production
Authors: Kim Mina , Shin Dong Wook , Shin Hyunjun , Noh Minsoo , Shin Jennifer H.
Published: November 2012

Human dermal fibroblasts (HDFs) regulate wound‐healing processes in human skin, including the regeneration of skin sensory fibres, in response to various mechanical stimuli. Because nerve growth factor (NGF) has an essential role in sensory regeneration, we evaluated the possible association of NGF with mechanical stimulus‐dependent cellular responses in HDFs. A cyclic tensile stimulus increased both NGF and transforming growth factor (TGF) β2 production, yet with different gene transcription and signal desensitization profiles. Neutralizing TGFβ with antibodies did not affect the tension‐induced NGF upregulation, with significant inhibition of endogenous TGFβ2 transcription. The treatment with LY294002, SP600125 or U0126 hindered the tension‐induced TGFβ2 upregulation, although the increase in NGF was regulated only by SP600125 or U0126, indicating the involvement of three signalling kinase pathways in the upregulation of TGFβ2. However, the upregulation of NGF was shown to be independent of PI3K, demonstrating the independent regulation of tension‐induced NGF and TGFβ production in HDFs.
Prevalence of torus mandibularis among a group of elderly Japanese and its relationship with occlusal force
Authors: Yoshinaka Masaki , Ikebe Kazunori , Furuya‐Yoshinaka Masako , Maeda Yoshinobu
Published: November 2012

Objective

To examine the prevalence of torus mandibularis (TM) and identify clinical factors associated with its presence.

Materials and methods

A total of 664 Japanese adults over age 60 were studied by means of a questionnaire and clinical examination.

Results

In all, 197 subjects (29.7%) had TM. We found a significant association between the presence of TM and torus palatinus (TP; 45.1% vs. 26.5%, p < 0.001). Moreover, occlusal force with TM was significantly higher than without TM (p < 0.05). Logistic regression adjusted for age and occlusal force revealed a significant relationship between TM and occlusal force and TP [p = 0.005, odds ratio (OR) = 2.44; p < 0.001, OR = 2.66, respectively].

Conclusion

This study suggests that there is a relationship between TM and factors related to occlusal factor.
Dual blockade of angiotensin‐II and aldosterone suppresses the progression of a non‐diabetic rat model of steatohepatitis
Authors: Noguchi Ryuichi , Yoshiji Hitoshi , Ikenaka Yasuhide , Kaji Kosuke , Aihara Yosuke , Shirai Yusaku , Namisaki Tadashi , Kitade Mitsuteru , Douhara Akitoshi , Moriya Kei , Fukui Hiroshi
Published: November 2012

Aim

Both angiotensin‐II (AT‐II) and aldosterone (Ald) play pivotal roles in the pathogenesis of diseases in several organs including the liver. We previously reported that suppression of AT‐II and Ald with angiotensin‐converting enzyme inhibitor (ACE‐I) and selective Ald blocker (SAB), respectively, attenuated the rat liver fibrogenesis and hepatocarcinogenesis. The aim of our current study was to elucidate the combined effects of ACE‐I and SAB in the progression of a non‐diabetic rat model of steatohepatitis, and the possible mechanisms involved.

Methods

In the choline‐deficient L‐amino acid‐defined (CDAA) diet‐induced model, the effects of ACE‐I and SAB on liver fibrosis development and hepatocarcinogenesis were elucidated, especially in conjunction with neovascularization.

Results

Treatment with both ACE‐I and SAB suppressed the development of liver fibrosis and glutathione‐S‐transferase placental form (GST‐P) positive pre‐neoplastic lesions. The combined treatment with both agents exerted more inhibitory effects as compared with either a single agent along with suppression of the activated hepatic stellate cells (Ac‐HSC) and neovascularization, both of which play important roles in these processes. Our in vitro study showed that AT‐II type 1 receptor blocker (ARB) and SAB inhibited Ac‐HSC proliferation and in vitro angiogenesis along with suppression of the in vivo studies.

Conclusion

Dual blockade of AT‐II and Ald suppresses the progression of a non‐diabetic rat model of steatohepatitis. Because both agents are widely and safely used in clinical practice, this combination therapy could be an effective new strategy against steatohepatitis in the future.
The Role of Affect in the Relationship Between Distributive Justice Expectations and Applicants' Recommendation and Litigation Intentions
Authors: Geenen Brigitte , Proost Karin , van Dijke Marius , de Witte Karel , von Grumbkow Jasper
Published: November 2012

This paper examined the moderating role of positive and negative affect in the relationship between distributive justice expectations and applicants' intentions to recommend the organization or to litigate. Specifically, it was suggested and supported in two samples of, respectively, 1,409 and 486 applicants, that the positive relationship between distributive justice expectations and recommendation intentions was stronger for applicants high in positive affect. In the second sample, it was further found that the negative relationship between distributive justice expectations and litigation intentions was stronger among applicants high in negative affect. This research is the first to identify the distinct roles of positive and negative affect in shaping responses to expectations of (un)fairness in the personnel selection literature. Theoretical and practical implications are discussed.
Assessing Innovation: A 360‐degree appraisal study
Authors: Potočnik Kristina , Anderson Neil
Published: November 2012

This study examines the evaluation of innovation in a wider competency framework and within a 360‐degree rating procedure among managerial‐level job holders. The total sample of 2,979 individuals consisted of 296 target employees and their 318 bosses, 1208 peers, 828 direct reports, and 329 others who provided ratings on a competency framework. The results showed significant differences in innovation‐related competence ratings between different raters. Self‐ratings were significantly lower compared to the overall observer ratings and were correlated only with peer ratings. Different patterns of results were found for the lower and upper quartiles based on self‐ratings. For instance, no correlations were observed between self‐ratings and the ratings of any observers in the group of best self‐rated individuals. Implications for practice and future research in assessment and evaluation of innovation are discussed in conclusion.