bluuebunny/crossref_metadata_2025 huggingface dataset:
Duplex kidney: Not just a drooping lily
Authors: Doery Ashlea J , Ang Eileen , Ditchfield Michael R
Published: February 2015

Introduction

Duplex kidneys are common, mostly asymptomatic and of no clinical significance. However, they can be associated with significant pathology, often with long‐term morbidity. There is minimal literature on the review of the duplex kidney, its associated anomalies and complications. The purpose of this paper is to review our experience of imaging the spectrum of abnormalities associated with duplex kidneys in the paediatric population and correlate this with contemporary literature.

Method

A retrospective review of the radiology database in a tertiary paediatric centre was performed. A word search of the Radiology Information System for ‘duplex’ of patients under the age of 16 was undertaken and limited to studies performed between 2006 and 2013.

Results

Two hundred seventy‐four patients were identified (age range 0–16, median 3 years, gender 59.9% female) who had 836 studies: ultrasound 598/836 (71.6%), nuclear medicine 180/836 (21.5%), micturating cystourethrogram 52/836 (6.2%), MRI 5/836 (<1%) and CT scan 1/836 (<1%). Patients were categorised as duplex and no complication (151/274 = 55.1%), upper moiety obstruction, lower moiety reflux/scarring, multicystic dysplastic kidney, abnormal ureteric insertion and other pathology.

Conclusion

Duplex kidneys are common and often not clinically significant. However, this study demonstrates almost 50% of paediatric patients investigated for duplex kidneys had complications requiring treatment. The most common complications were upper moiety obstruction associated with a ureterocele and lower moiety vesicoureteric reflux. Ultrasound was the most common modality for early detection of these complications.
Intra‐tumour 18F‐FDG uptake heterogeneity decreases the reliability on target volume definition with positron emission tomography/computed tomography imaging
Authors: Dong Xinzhe , Wu Peipei , Sun Xiaorong , Li Wenwu , Wan Honglin , Yu Jinming , Xing Ligang
Published: February 2015

Introduction

This study aims to explore whether the intra‐tumour 18F‐fluorodeoxyglucose (FDG) uptake heterogeneity affects the reliability of target volume definition with FDG positron emission tomography/computed tomography (PET/CT) imaging for nonsmall cell lung cancer (NSCLC) and squamous cell oesophageal cancer (SCEC).

Methods

Patients with NSCLC (n = 50) or SCEC (n = 50) who received 18F‐FDG PET/CT scanning before treatments were included in this retrospective study. Intra‐tumour FDG uptake heterogeneity was assessed by visual scoring, the coefficient of variation (COV) of the standardised uptake value (SUV) and the image texture feature (entropy). Tumour volumes (gross tumour volume (GTV) ) were delineated on the CT images (GTVCT), the fused PET/CT images (GTVPET‐CT) and the PET images, using a threshold at 40% SUVmax (GTVPET40%) or the SUV cut‐off value of 2.5 (GTVPET2.5). The correlation between the FDG uptake heterogeneity parameters and the differences in tumour volumes among GTVCT, GTVPET‐CT, GTVPET40% and GTVPET2.5 was analysed.

Results

For both NSCLC and SCEC, obvious correlations were found between uptake heterogeneity, SUV or tumour volumes. Three types of heterogeneity parameters were consistent and closely related to each other. Substantial differences between the four methods of GTV definition were found. The differences between the GTV correlated significantly with PET heterogeneity defined with the visual score, the COV or the textural feature‐entropy for NSCLC and SCEC.

Conclusions

In tumours with a high FDG uptake heterogeneity, a larger GTV delineation difference was found. Advance image segmentation algorithms dealing with tracer uptake heterogeneity should be incorporated into the treatment planning system.
Analysis of lymph node impact on conversion of complete thoracoscopic lobectomy to open thoracotomy
Authors: Li Yun , Wang Jun
Published: February 2015

Background

The aim of the study was to analyze the influence of lymph nodes in conversion thoracotomy and its measurements.

Method

BetweenSeptember 2006 toApril 2013, 1006 patients (545 men, 461 women, median age 60 years, range: 13 to 86 years) received a complete thoracoscopic lobectomy. The main procedure was complete video‐assisted anatomical lobectomy with mediastinal lymphadenectomy.

Results

All procedures were carried out smoothly without serious complication. Eighty‐three cases were converted to thoracotomy (8.2%), including 70 cases of initiative conversion and 13 of passive conversion, in which 59 cases had interference by doornail lymph nodes. The average operative time was significantly longer (272.7 ± 67.2 vs. 186.9 ± 58.1 minutes,P= 0.001); the average blood loss was significantly increased (564.2 ± 507.7 ml vs. 158.0 ± 121.0 ml,P= 0.001); and the drainage time and postoperative hospital stay were significantly longer (8.9 ± 5.0 vs. 6.6 ± 3.5 days,P= 0.001; 12.5 ± 7.7 vs. 9.2 ± 5.8 days,P= 0.001, respectively) in the conversion thoracotomy compared with the complete endoscopic surgery group.

Conclusion

Interference of the lymph nodes was the main reason for conversion to thoracotomy on video‐assisted thoracoscopic lobectomy, which prolonged operative time, increased the blood loss during surgery, and delayed postoperative recovery. Selecting the proper indication of conversion thoracotomy may reduce the negative effects.
Predicting ground temperatures across European landscapes
Authors: Gunton Richard M. , Polce Chiara , Kunin William E.
Published: February 2015

Ambient temperatures in natural environments can vary widely over short distances, especially on rugged ground where exposure to solar radiation depends on slope and aspect. Temperatures can also fluctuate rapidly, reaching values not revealed by climate data. Such fine‐scale variation raises challenges for modelling species distributions under changing climates.

To avoid misunderstanding current species distributions and future changes, temperatures must be modelled at high resolutions. Most existing methods either require extensive parameterization or are pre‐parameterized for restricted localities and current conditions; here, we describe a more versatile method intended for European landscapes under a wide range of scenarios.

The availability of high‐resolution topographic data makes possible the use of projected solar irradiation to help predict local diurnal ground temperatures. Using time series from 83 points across Europe, we fitted statistical models for soil surface temperature based on geographical characteristics of the sites along with atmospheric variables obtained from a publicly available data base. The sites ranged from 40°N to 60°N and 2°W to 25°E, and from 43 to 1500 m in elevation.

We compare models for monthly mean and daily afternoon temperatures, for open and tree‐covered habitats. The effect of topography was greatest for the daily predictions, and generally more important in open than in tree‐covered sites. Tests with data collected from other European locations in a different time period suggest that our models can predict monthly means with an error standard deviation of about 2.3°C. We provide an R function that implements our models on the basis of readily available data.

Our mean‐temperatures model should be useful for understanding organisms’ niches, dispersal possibilities and community dynamics, and for predicting species’ refugia, range shifts and opportunities for adaptation under projected climate change.
No Coolidge effect in the Australian field cricket Teleogryllus oceanicus (Orthoptera: Gryllidae)
Authors: Thomas Melissa L , Simmons Leigh W
Published: February 2015

A progressive decline in a male's propensity to mate with the same female, combined with a heightened sexual interest in new females, is known as the Coolidge effect. The Coolidge effect has been reported in a number of taxa and is thought to be adaptive, as males distribute sperm evenly across multiple females thereby maximising fitness. Here we looked for the Coolidge effect in the Australian field cricket, Teleogryllus oceanicus (Le Guillou). We found that males did not show greater sexual interest in novel females compared with their previous mates. Moreover, we did not find any decline in the quality of ejaculates transferred by males when mating sequentially with the same female, or an increase in ejaculate quality when males were presented with novel females. Our results are in contrast with findings investigating the Coolidge effect in other insects, which may reflect differences among species in the fitness benefits associated with mating repeatedly with the same female. We argue that examinations of the Coolidge effect need to be incorporated routinely into studies that examine the benefits of polyandry for females, because of the potential impact of reduced ejaculate expenditure by males in monandrous treatments.
What the Demolition of Public Housing Teaches Us about the Impact of Racial Threat on Political Behavior
Authors: Enos Ryan D.
Published: February 2015

How does the context in which a person lives affect his or her political behavior? I exploit an event in which demographic context was exogenously changed, leading to a significant change in voters' behavior and demonstrating that voters react strongly to changes in an outgroup population. Between 2000 and 2004, the reconstruction of public housing in Chicago caused the displacement of over 25,000 African Americans, many of whom had previously lived in close proximity to white voters. After the removal of their African American neighbors, the white voters' turnout dropped by over 10 percentage points. Consistent with psychological theories of racial threat, their change in behavior was a function of the size and proximity of the outgroup population. Proximity was also related to increased voting for conservative candidates. These findings strongly suggest that racial threat occurs because of attitude change rather than selection.
Ethnic, socio‐demographic and socio‐economic differences in surgical treatment of breast cancer in New Zealand
Authors: Seneviratne Sanjeewa , Scott Nina , Lawrenson Ross , Campbell Ian
Published: February 2015

Background

Indigenous Māori are known to experience inferior quality cancer care compared with non‐Indigenous Europeans in New Zealand. However, limited data are available on ethnic/socio‐economic differences in surgical treatment of breast cancer, or reasons for such variations within the local context. We investigated ethnic/socio‐economic differences in rates of mastectomy, sentinel node biopsy (SNB), post‐mastectomy breast reconstruction and definitive local therapy for breast cancer in New Zealand.

Methods

A retrospective review of prospective data in the Waikato Breast Cancer Register for women diagnosed during 1999–2012 was performed. Differences in rates of mastectomy (for stage I/II, T1/T2 cancers), SNB (for stage I/II, T1/T2, cN0 cancers), post‐mastectomy breast reconstruction (for non‐metastatic cancers in women <70 years) and definitive local therapy (for stage I/II cancers) were analysed in univariate and multivariate regression models, adjusting for covariates.

Results

Significantly lower mastectomy and higher reconstruction rates were associated with younger age, private compared with public hospital care and screen compared with non‐screen detection. Compared with NZ Europeans, Māori (41% versus 33%, P = 0.025) were significantly more likely to undergo mastectomy for cancers, which were potentially amenable for breast conserving surgery, but were significantly less likely to undergo post‐mastectomy breast reconstruction (12% versus 35%, P < 0.001). No significant ethnic or socio‐economic differences were observed in rates of SNB or definitive local therapy.

Conclusions

This study has demonstrated lower rates of breast conserving surgery and reconstructions in Māori compared with NZ European women, and highlight the need for future research to focus on understanding the reasons behind these findings.
Marginal artery stump pressure in left colic artery‐preserving rectal cancer surgery: a clinical trial
Authors: Guo Yuchen , Wang Daguang , He Liang , Zhang Yang , Zhao Shishun , Zhang Luyao , Sun Xuan , Suo Jian
Published: February 2015

Background

The aim of this clinical trial is to evaluate the influence of high and low ligation of the inferior mesenteric artery with apical lymph node dissection on the anastomotic blood supply, lymph node retrieval rate, operative time and anastomotic leakage rate in rectal cancer surgery.

Methods

A total of 57 Chinese patients were randomly distributed into group A and group B and underwent radical resection of rectal cancer. Patients in group A underwent high ligation of the inferior mesenteric artery, and patients in group B underwent apical lymph node resection around the root of the inferior mesenteric artery with preservation of the left colic artery. The marginal artery stump pressure was measured after colon and artery reconstruction. Systemic pressure, distal colon length, operative time and lymph node retrieval rate were measured and recorded. The results were analysed and related to patient characteristics and post‐operative complications.

Results

The anastomotic blood supply negatively and linearly correlated with age and distal colon length and showed a positive linear correlation with systemic pressure. Patients who received low ligation with apical lymph node dissection had a better anastomotic blood supply than those who received high ligation. No differences were found in lymph node retrieval rate, operative time and anastomotic leakage rate. Anastomotic leakage was associated with a worse anastomotic blood supply.

Conclusions

Low ligation with apical lymph node dissection in rectal cancer treatment provides better anastomotic blood supply but is not associated with differences in node retrieval rate or operation time.
Characteristics and contributions of hyperandrogenism to insulin resistance and other metabolic profiles in polycystic ovary syndrome
Authors: Huang Rong , Zheng Jun , Li Shengxian , Tao Tao , Ma Jing , Liu Wei
Published: February 2015

Objective

To investigate the different characteristics in Chinese Han women with polycystic ovary syndrome, and to analyze the significance of hyperandrogenism in insulin resistance and other metabolic profiles.

Design

A cross‐sectional study.

Setting

Medical university hospital.

Population

A total of 229 women with polycystic ovary syndrome aged 18–45 years.

Methods

Women with polycystic ovary syndrome, diagnosed by Rotterdam criteria, were divided into four groups according to the quartile intervals of free androgen index levels.

Main outcome measures

Comparisons between groups were performed using one‐way analysis of variance. Stepwise logistic regression analysis was performed to investigate the association between homeostasis model assessment‐insulin resistance and independent variables.

Results

Within the four phenotypes, women with phenotype 1 (hyperandrogenism, oligo/anovulation, and polycystic ovaries) exhibited higher total testosterone, free androgen index, androstenedione, low‐density lipoprotein, and lower quantitative insulin sensitivity check index (p < 0.05); women with phenotype 4 (oligo/anovulation and polycystic ovaries) showed lower total cholesterol, low‐density lipoprotein, and homeostasis model assessment‐insulin resistance, but higher high‐density lipoprotein (p < 0.05). The levels of triglycerides, total cholesterol, low‐density lipoprotein, and homeostasis model assessment‐insulin resistance significantly increased, but high‐density lipoprotein and quantitative insulin sensitivity check index decreased with the elevation of free androgen index intervals. After adjustment for lipid profiles, free androgen index was significantly associated with homeostasis model assessment‐insulin resistance in both lean and overweight/obese women (odds ratio 1.302, p = 0.039 in lean vs. odds ratio 1.132, p = 0.036 in overweight/obese).

Conclusions

Phenotypes 1 and 4 represent groups with the most and least severe metabolic profiles, respectively. Hyperandrogenism, particularly with elevated free androgen index, is likely a key contributing factor for insulin resistance and for the aggravation of other metabolic profiles.
Risk factors for persistent pain and its influence on maternal wellbeing after cesarean section
Authors: Niklasson Boel , Georgsson Öhman Susanne , Segerdahl Märta , Blanck Agneta
Published: February 2015

Objectives

To investigate the overall incidence and risk factors for persistent pain and its interference with daily life after cesarean section.

Design

Prospective long‐term follow‐up study.

Setting

Karolinska University Hospital, Stockholm, Sweden.

Population

260 healthy women who underwent elective cesarean section.

Methods

Information on demographics, medical history, postoperative pain and analgesic requirements was collected. A questionnaire consisting of the Brief Pain Inventory was posted at 3, 6 and 12 months after surgery. Women rated pain intensity as well as interference with factors related to general function and quality of life.

Main outcome measures

The overall incidence and risk factors for persistent postoperative pain at three time points. Persistent pain was considered a secondary outcome.

Results

At 3, 6 and 12 months respectively 40, 27 and 22% of patients reported pain in one or more locations, in the surgical site as well as in other areas. A psychological indication, as well as a first cesarean section, increased the risk for pain at 3 months. Severe postoperative pain in the immediate postoperative period or undergoing a first cesarean section were significant independent risk factors for the development of persistent pain up to 6 months after cesarean section. Parameters related to quality of life were significantly impaired in women with persistent pain.

Conclusion

Several factors, including severe postoperative pain, were shown to influence the risk for persistent pain after cesarean section. Long‐term pain markedly affected women's wellbeing.
Molybdenum deprivation, purine ingestion and an astrocyte‐associated motor neurone syndrome in sheep: assumed clinical effects of inosine
Authors: Bourke CA
Published: February 2015

Background

An astrocyte‐associated motor neurone syndrome was produced in molybdenum‐deprived sheep fed xanthosine. Mo‐deprived sheep fed inosine, adenosine or guanosine would be also expected to develop astrocyte‐associated motor neurone syndromes, because all these purine nucleosides can act as neuromodulators and all depend on the Mo‐associated enzyme xanthine oxidase‐dehydrogenase for their catabolism.

Design

To investigate the relationship between inosine ingestion and low Mo concentration, eight sheep were fed lucerne chaff with a Mo value <0.10 ppm and the Mo antagonist, sodium tungstate, for 21 weeks, with inosine (35 mg/kg/day) fed for the last 18 of these weeks. This clinical study was uncontrolled.

Results

An astrocyte‐associated motor neurone syndrome was produced in three sheep 18–27 months later. It was characterised by diaphragmatic, laryngeal, lingual and pharyngeal muscle weakness. The diaphragmatic muscle weakness was the most severe and potentially lethal.

Conclusion

These findings suggest that purinergic neuromodulation of respiration, vocalisation and swallowing is different to that of limb movement. The syndrome produced, and assumed to be caused by the treatment given, has not been reported in livestock. A similar syndrome is seen in human motor neurone disease, but not in equine motor neurone disease, and this is consistent with it being an upper, not a lower, motor neurone effect.
A population‐based study of prognosis in advanced stage follicular lymphoma managed by watch and wait
Authors: El‐Galaly Tarec Christoffer , Bilgrau Anders E. , de Nully Brown Peter , Mylam Karen J. , Ahmad Syed A. , Pedersen Lars M. , Gang Anne O. , Bentzen Hans H. , Juul Maja B. , Bergmann Olav J. , Pedersen Robert S. , Nielsen Berit J. , Johnsen Hans E. , Dybkær Karen , Bøgsted Martin , Hutchings Martin
Published: February 2015

Watch and wait (WAW) is a common approach for asymptomatic, advanced stage follicular lymphoma (FL), but single‐agent rituximab is an alternative for these patients. In this nationwide study we describe the outcome of patients selected for WAW. A cohort of 286 out of 849 (34%) stage III‐IVA FL patients seen between 2000 and 2011, were managed expectantly and included. The 5‐year progression‐free survival (PFS) was 35% [95% confidence interval (CI) 29–42]. The 10‐year overall survival (OS) was 65% (95%CI 54–78), and the cumulative risk of dying from lymphoma within 10 years of diagnosis was 13% (95%CI 7–20). Elevated lactate dehydrogenase and > four nodal regions involved were associated with a higher risk of lymphoma treatment and death from lymphoma. The WAW patients and a matched background population had similar OS during the first 50 months after diagnosis (P = 0·7), but WAW patients had increased risk of death after 50 months (P < 0·001). The estimated loss of residual life after 10 years was 6·8 months. The 10‐year cumulative risk of histological transformation was 22% (95%CI 15–29) and the 3‐year OS after transformation was 71% (95%CI 58–87%). In conclusion, advanced stage FL managed by WAW had a favourable outcome and abandoning this strategy could lead to overtreatment in some patients.
Entinostat, a novel histone deacetylase inhibitor is active in B‐cell lymphoma and enhances the anti‐tumour activity of rituximab and chemotherapy agents
Authors: Frys Sarah , Simons Zachary , Hu Qiang , Barth Matthew J. , Gu Juan J. , Mavis Cory , Skitzki Joseph , Song Liu , Czuczman Myron S. , Hernandez‐Ilizaliturri Francisco J.
Published: February 2015

Histone deacetylases (HDACs) inhibitors are active in T‐cell lymphoma and are undergoing pre‐clinical and clinical testing in other neoplasms. Entinostat is an orally bioavailable class I HDAC inhibitor with a long half‐life, which is under evaluation in haematological and solid tumour malignancies. To define the activity and biological effects of entinostat in B‐cell lymphoma we studied its anti‐tumour activity in several rituximab‐sensitive or ‐resistant pre‐clinical models. We demonstrated that entinostat is active in rituximab‐sensitive cell lines (RSCL), rituximab‐resistant cell lines (RRCL) and primary tumour cells isolated from lymphoma patients (n = 36). Entinostat exposure decreased Bcl‐XL (BCL2L1) levels and induced apoptosis in cells. In RSCL and RRCL, entinostat induced p21 (CDKN1A) expression leading to G1 cell cycle arrest and exhibited additive effects when combined with bortezomib or cytarabine. Caspase inhibition diminished entinostat activity in some primary tumour cells suggesting that entinostat has dual mechanisms‐of‐action. In addition, entinostat increased the expression of CD20 and adhesion molecules. Perhaps related to these effects, we observed a synergistic activity between entinostat and rituximab in a lymphoma‐bearing severe combined immunodeficiency (SCID) mouse model. Our data suggests that entinostat is an active HDAC inhibitor that potentiates rituximab activity in vivo and supports its further clinical development in B‐cell lymphoma.
Relationship between illness uncertainty, anxiety, fear of progression and quality of life in men with favourable‐risk prostate cancer undergoing active surveillance
Authors: Parker Patricia A. , Davis John W. , Latini David M. , Baum George , Wang Xuemei , Ward John F. , Kuban Deborah , Frank Steven J. , Lee Andrew K. , Logothetis Christopher J. , Kim Jeri
Published: February 2015

Objectives

To evaluate prospectively the associations between illness uncertainty, anxiety, fear of progression and general and disease‐specific quality of life (QoL) in men with favourable‐risk prostate cancer undergoing active surveillance (AS).

Patients and Methods

After meeting stringent enrollment criteria for an AS cohort study at a single tertiary care cancer centre, 180 men with favourable‐risk prostate cancer completed questionnaires at the time of enrollment and every 6 months for up to 30 months. Questionnaires assessed illness uncertainty, anxiety, prostate‐specific QoL (using the Expanded Prostate Cancer Index Composite [EPIC] scale) and general QoL (using the 12‐time short‐form health survey [SF‐12]) and fear of progression. We used linear mixed‐model analyses and multilevel mediation analyses.

Results

Sexual scores on the EPIC scale significantly declined over time (P < 0.05). Illness uncertainty was a significant predictor of all EPIC summary scores, SF‐12 physical component summary (PCS) scores, mental component summary (MCS) scores and fear of progression scores (all P < 0.05), after controlling for demographic and clinicopathological factors. Anxiety predicted all EPIC summary, MCS and fear of progression scores (all P < 0.05) but not PCS scores (P = 0.08). Scores on PCS, MCS, EPIC summary scales (except sexual scale), and fear of progression did not change significantly over the study period (all P > 0.10).

Conclusion

Over the 2.5‐year follow‐up, QoL remained stable; only sexual function scores significantly declined. Illness uncertainty and anxiety were significant predictors of general and prostate‐specific QoL and fear of progression. Interventions to reduce uncertainty and anxiety may enhance QoL for men with prostate cancer on AS.
Diagnosis and treatment of chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome: a consensus guideline
Authors: Rees Jon , Abrahams Mark , Doble Andrew , Cooper Alison ,   the Prostatitis Expert Reference Group (PERG)
Published: February 2015

Objectives

To improve awareness and recognition of chronic bacterial prostatitis (CBP) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) among non‐specialists and patients. To provide guidance to healthcare professionals treating patients with CBP and CP/CPPS, in both non‐specialist and specialist settings. To promote efficient referral of care between non‐specialists and specialists and the involvement of the multidisciplinary team (MDT).

Patients and Methods

The guideline population were men with CBP or CP/CPPS (persistent or recurrent symptoms and no other urogenital pathology for ≥3 of the previous 6 months). Consensus recommendations for the guidelines were based on a search to identify literature on the diagnosis and management of CBP and CP/CPPS (published between 1999 and February 2014). A Delphi panel process was used where high‐quality, published evidence was lacking.

Results

CBP and CP/CPPS can present with a wide range of clinical manifestations. The four main symptom domains are urogenital pain, lower urinary tract symptoms (LUTS – voiding or storage symptoms), psychological issues and sexual dysfunction. Patients should be managed according to their individual symptom pattern. Options for first‐line treatment include antibiotics, α‐adrenergic antagonists (if voiding LUTS are present) and simple analgesics. Repeated use of antibiotics, such as quinolones, should be avoided if there is no obvious symptomatic benefit from infection control or cultures do not support an infectious cause. Early use of treatments targeting neuropathic pain and/or referral to specialist services should be considered for patients who do not respond to initial measures. An MDT approach (urologists, pain specialists, nurse specialists, specialist physiotherapists, general practitioners, cognitive behavioural therapists/psychologists, and sexual health specialists) is recommended. Patients should be fully informed about the possible underlying causes and treatment options, including an explanation of the chronic pain cycle.

Conclusion

Chronic prostatitis can present with a wide variety of signs and symptoms. Identification of individual symptom patterns and a symptom‐based treatment approach are recommended. Further research is required to evaluate management options for CBP and CP/CPPS.
The tectono‐stratigraphic evolution of the Austral Basin and adjacent areas against the background of Andean tectonics, southern Argentina, South America
Authors: Sachse V. F. , Strozyk F. , Anka Z. , Rodriguez J. F. , di Primio R.
Published: February 2015

The Austral Basin (or Magallanes Basin) in southern Argentina is situated in a highly active tectonic zone. The openings of the South Atlantic and the Drake Passage to the east and south, active subduction in the west, and the related rise of the Andes have massively influenced the evolution of this area. To better understand the impacts of these tectonic events on basin formation to its present‐day structure we analysed 2D seismic reflection data covering about 95 000 km² on‐ and 115 000 km² offshore (Austral ‘Marina’ and Malvinas Basin). A total of 10 seismic horizons, representing nine syn‐ and post‐ rift sequences, were mapped and tied to well data to analyse the evolution of sedimentary supply and depocenter migration through time. 1D well backstripping across the study area confirms three main tectonic stages, containing (i) the break‐up phase forming basement graben systems and the evolution of the Late Jurassic – Early Cretaceous ancient backarc Austral/Rocas Verdes Basin (RVB), (ii) the inversion of the backarc marginal basin and the development of the foreland Austral Basin and (iii) the recent foreland Austral Basin. Synrift sedimentation did not exceed the creation of accommodation space, leading to a deepening of the basin. During the Early Cretaceous a first impulse of compression due to Andes uplift caused rise also of parts of the basin. Controlling factors for the subsequent tectonic development are subduction, balanced phases of sedimentation, accumulation and erosion as well as enhanced sediment supply from the rising Andes. Further phases of rock uplift might be triggered by cancelling deflection of the plate and slab window subduction, coupled with volcanic activity. Calculations of sediment accumulation rates reflect the different regional tectonic stages, and also show that the Malvinas Basin acted as a sediment catchment after the filling of the Austral Basin since the Late Miocene. However, although the Austral and Malvinas Basin are neighbouring basin systems that are sedimentary coupled in younger times, their earlier sedimentary and tectonic development was decoupled by the Rio Chico basement high. Thereby, the Austral Basin was affected by tectonic impacts of the Andes orogenesis, while the Malvinas Basin was rather affected by the opening of the South Atlantic.
Complex interplay of faulting, glacioeustatic variations and halokinesis during deposition of upper Viséan units over thick salt in the western Cumberland Basin of Atlantic Canada
Authors: Jutras P. , McLeod J. , MacRae R. A. , Utting J.
Published: February 2015

The late Palaeozoic Cumberland Basin of Nova Scotia and New Brunswick (eastern Canada) developed as a strike‐slip basin in the aftermath of the Middle Devonian Acadian Orogeny. Following deposition of thick salt during the middle Viséan (middle Mississippian), this basin mainly accommodated fault‐controlled continental deposits during the late Viséan, which generated halokinesis from clastic loading. The Mississippian halokinetic history of this basin is cryptic, as it was severely distorted by subsequent tectonic and halokinetic overprints. After minor structural restoration, the study of upper Viséan minibasin units in wide coastal sections and deep wells allowed a fairly detailed reconstruction of the Mississippian halokinetic setting to be made. Paleoenvironments and depositional settings in the western part of the basin include sectors that were proximal to three fault‐bounded source areas and characterized by alluvial fan systems transitioning laterally into gravelly to sandy braidplain environments. More central areas of the basin were characterized by tidal flats transitioning laterally into shallow marine environments. Because of halokinesis, the marine body was eventually forced to subdivide into three separate salt expulsion minibasins. Although late Viséan marine incursions were short‐lived in the rest of eastern Canada due to ongoing glacioeustatic variations, there are sedimentologic and stratigraphic lines of evidence for the long‐lasting entrapment of restricted marine bodies in salt expulsion minibasins of the western Cumberland Basin. In one minibasin that was characterized by especially high accommodation rates, NE of Hopewell Cape (New Brunswick), the proximal conglomerates and marine carbonates of a fan‐delta setting transition laterally into thick sulphate over a short distance, away from freshwater inputs from the source area. The vertical continuity of the latter sulphate succession suggests that this entrapped evaporitic basin was cut‐off from significant marine influxes, even at times of glacioeustatic highstands. This is in contrast with salt expulsion minibasins in open marine shelf settings, which always remain open to global marine transgressions and regressions.
Intracellular signals of lung cancer cells as possible therapeutic targets
Authors: Tanaka Kiyomichi , Kumano Keiki , Ueno Hiroo
Published: February 2015

In recent years, several molecularly targeted therapies have been developed as part of lung cancer treatment; they have produced dramatically good results. However, among the many oncogenes that have been identified to be involved in the development of lung cancers, a number of oncogenes are not covered by these advanced therapies. For the treatment of lung cancers, which is a group of heterogeneous diseases, persistent effort in developing individual therapies based on the respective causal genes is important. In addition, for the development of a novel therapy, identification of the lung epithelial stem cells and the origin cells of lung cancer, and understanding about candidate cancer stem cells in lung cancer tissues, their intracellular signaling pathways, and the mechanism of dysregulation of the pathways in cancer cells are extremely important. However, the development of drug resistance by cancer cells, despite the use of molecularly targeted drugs for the causal genes, thus obstructing treatment, is a well‐known phenomenon. In this article, we discuss major causal genes of lung cancers and intracellular signaling pathways involving those genes, and review studies on origin and stem cells of lung cancers, as well as the possibility of developing molecularly targeted therapies based on these studies.
Common mental disorders among women, social circumstances and toddler growth in rural Vietnam: a population‐based prospective study
Authors: Fisher J. , Tran T. , Nguyen T. T. , Nguyen H. , Tran T. D.
Published: February 2015

Background

Common mental disorders (CMD) and adverse social circumstances are widespread among mothers of infants and toddlers in resource‐constrained settings. These can undermine early childhood development through compromised caregiving and insufficient access to essential resources. The aim was to examine the effect of maternal CMD and social adversity in the post‐partum year on toddler's length‐for‐age index in a rural low‐income setting.

Methods

A population‐based prospective cohort study of women in Ha Nam province, Vietnam who completed baseline assessments in either late pregnancy or 4–6 weeks post partum and were followed up, with their toddlers, 15 months later. CMD were assessed at both points by psychiatrist‐administered Structured Clinical Interviews for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Diagnoses. Anthropometric indices were calculated from toddler's age, sex, weight and length using World Health Organization Child Growth Standards. Social adversities were assessed by study‐specific questions and locally validated psychometric instruments. The hypothesized model of factors governing toddler's length‐for‐age Z score (LAZ) was tested using path analysis.

Results

In total, 211/234 (90.1%) mother–toddler pairs provided complete data. Baseline prevalence of CMD among women was 33.6% and follow‐up was 18.5%. The mean LAZ among toddlers was −1.03 and stunting prevalence (LAZ < −2) was 15.6%. Maternal CMD at baseline were indirectly related to toddler LAZ via maternal CMD at follow‐up (regression coefficient = −0.05, 95% CI −0.11 to −0.01). Maternal CMD at follow‐up was associated significantly with toddler LAZ (regression coefficient = −0.15, 95% CI −0.28 to −0.05). Poorer quality of marital relationship, mothers' experiences of childhood abuse and <30 days dedicated post‐partum care were associated indirectly with lower toddler LAZ via maternal CMD.

Conclusions

Maternal post‐natal CMD are associated with child growth measured by LAZ in this resource‐constrained setting. Social adversities affect child growth indirectly through increasing the risk of maternal CMD. Interventions to reduce stunting in low‐income settings may need to address maternal CMD and social adversities in order to improve impact.
The waiting room as a relational space: young patients and their families' experience in a day hospital
Authors: Corsano P. , Majorano M. , Vignola V. , Guidotti L. , Izzi G.
Published: February 2015

Background

Waiting in hospital is a condition of high stress for patients and their families, especially in childhood. The literature has investigated the emotional experiences of patients and their families, recognizing the need for a comfortable environment, attention from the staff, information and sharing emotions with others. Waiting time in day hospitals is a topic that has not yet been investigated in the literature, but is nevertheless interesting for researchers. This exploratory study investigates the experience of waiting young patients and their families go through during treatments in day hospitals.

Method

Fifty children and adolescents from ages 7 to 15 years, admitted to the day hospital of a paediatric haematology and oncology ward of an Italian hospital, completed the Emotional Reaction Instrument (ERI) and the Child Drawing: Hospital. Their parents or relatives completed a semi‐structured interview on waiting.

Results

The data showed that the young patients displayed a low level of anxiety and negative emotion. In contrast, the adults' experience of waiting in the day hospital entailed boredom, anxiety and concern for the emotional state of their children. These conditions can be alleviated by relationships and sharing emotions with other adults.

Conclusions

This study has shown that day hospital waiting rooms should be organized and should be experienced by adults and children as relational spaces. This could provide useful suggestions in order to improve the organization of day hospital waiting rooms.
Basophil allergen threshold sensitivity and component‐resolved diagnostics improve hazelnut allergy diagnosis
Authors: Brandström J. , Nopp A. , Johansson S. G. O. , Lilja G. , Sundqvist A.‐C. , Borres M. P. , Nilsson C.
Published: February 2015

Background

IgE sensitization to hazelnut is common, especially in birch endemic areas. However, its clinical significance often needs to be confirmed by a food challenge.

Objective

To evaluate the clinical significance of IgE antibodies to hazelnut components and basophil allergen threshold sensitivity (CD‐sens) to hazelnut, in relation to double‐blind placebo‐controlled food challenge (DBPCFC) in children with a suspected hazelnut allergy.

Methods

Forty children underwent a DBPCFC. CD‐sens to hazelnut as well as IgE antibodies to hazelnut and its components Cor a 1, Cor a 8, Cor a 9 and Cor a 14 were analysed. Serum tryptase was measured before, during and after DBPCFC.

Results

Eight children had a positive DBPCFC, and all of them had a high CD‐sens value to hazelnut. Of the 32 children that passed the DBPCFC, 31 were very low or negative in CD‐sens. A positive DBPCFC corresponded with significantly higher CD‐sens values (median 8.9, range 3.3–281) compared to children negative in challenge (median 0.05, range 0–34.7, P < 0.0001). Children positive in challenge also had higher levels of IgE‐ab to Cor a 9 and Cor a 14 (P < 0.01 and P < 0.001, respectively) compared with those with a negative challenge. In relation to the results from DBPCFC, the sensitivity of CD‐sens and IgE‐ab to Cor a 14 was excellent (100%) and the specificity was very high (> 97% and > 94%, respectively). Five of the eight patients positive at challenge showed an increase in tryptase > 20% compared to tryptase baseline levels.

Conclusions and Clinical Relevance

CD‐sens and component‐resolved diagnostics to hazelnut, used separately or in combination, may improve the diagnostic accuracy and safety and reduce overdiagnosis of hazelnut allergy.
Direct contact between dendritic cells and bronchial epithelial cells inhibits T cell recall responses towards mite and pollen allergen extracts in vitro
Authors: Papazian D , Wagtmann V R , Hansen S , Würtzen P A
Published: February 2015

Airway epithelial cells (AECs) form a polarized barrier along the respiratory tract. They are the first point of contact with airborne antigens and are able to instruct resident immune cells to mount appropriate immune responses by either soluble or contact-dependent mechanisms. We hypothesize that a healthy, polarized epithelial cell layer inhibits inflammatory responses towards allergens to uphold homeostasis. Using an in-vitro co-culture model of the airway epithelium, where a polarized cell layer of bronchial epithelial cells can interact with dendritic cells (DCs), we have investigated recall T cell responses in allergic patients sensitized to house dust mite, grass and birch pollen. Using allergen extract-loaded DCs to stimulate autologous allergen-specific T cell lines, we show that AEC-imprinted DCs inhibit T cell proliferation significantly of Bet v 1-specific T cell lines as well as decrease interleukin (IL)-5 and IL-13 production, whereas inhibition of Phl p 5-specific T cells varied between different donors. Stimulating autologous CD4+ T cells from allergic patients with AEC-imprinted DCs also inhibited proliferation significantly and decreased production of both T helper type 1 (Th1) and Th2 cytokines upon rechallenge. The inhibitory effects of AECs’ contact with DCs were absent when allergen extract-loaded DCs had been exposed only to AECs supernatants, but present after direct contact with AECs. We conclude that direct contact between DCs and AECs inhibits T cell recall responses towards birch, grass and house dust mite allergens in vitro, suggesting that AECs-DC contact in vivo constitute a key element in mucosal homeostasis in relation to allergic sensitisation.
Human monocyte subsets exhibit divergent angiotensin I-converting activity
Authors: Rutkowska-Zapała M , Suski M , Szatanek R , Lenart M , Węglarczyk K , Olszanecki R , Grodzicki T , Strach M , Gąsowski J , Siedlar M
Published: February 2015

Immune cells may take part in the renin–angiotensin–aldosterone system (RAAS), which plays a pivotal role in the regulation of vascular tone and blood pressure. The aim of the study was to analyse the expression and activity of angiotensin-converting enzyme type 1 (ACE1) and ACE2 in human monocytes (MO) and their subsets. The highest relative level of ACE1-, as well as ACE2-mRNA expression, was observed in CD14++CD16− (classical) MO. Moreover, in these cells, mean level of ACE2-mRNA was almost two times higher than that of ACE1-mRNA (11.48 versus 7.073 relative units, respectively). In peripheral blood mononuclear cells (PBMC), MO and classical MO, ACE1 and ACE2 protein expression was stronger compared to other MO subpopulations. The highest level of Ang II generated from Ang I in vitro was observed in classical MO. In this setting, generation of Ang-(1–9) by PBMC and classical MO was higher when compared to the whole MO population (P < 0·05). The generation rate of vasoprotective Ang-(1–7) was comparable in all analysed cell populations. However, in CD14+CD16++ (non-classical) MO, formation of Ang-(1–7) was significantly greater than Ang II (P < 0·001). We suggest that in physiological conditions MO (but also lymphocytes forming the rest of PBMC pool) may be involved in the regulation of vessel wall homeostasis via the RAAS-related mechanisms. Moreover, non-classical MO, which are associated preferentially with the vascular endothelium, express the vasoprotective phenotype.
Causes of the failure and the revision methods for congenital scoliosis due to hemivertebra
Authors: Shi Zhicai , Li Quan , Cai Bin , Yu Baoqing , Feng Yuan , Wu Jibin , Li Ming , Ran Bo
Published: February 2015

The purpose of this study was to retrospectively investigate the causes of failure in the first operation and the revision procedure for patients with congenital scoliosis due to hemivertebra. Nineteen patients who underwent the revision operations because of failure in the first operation were included in this study. All the malformations were identified as fully segmented hemivertebra, including 16 cases in thoracolumbar vertebra (T10: three patients; T12: seven patients; L1: six patients), and three cases in thoracic vertebra (T8). The causes of failure in the first operation and the outcome of revision procedure for patients were retrospectively analyzed. All patients were successfully performed the personalized revision surgeries. The failure reasons of the first operation included limitations of the first operation procedure, no or incomplete resection of the malformed hemivertebra, improper operation during surgery, improper internal fixation material, and improper internal fixation scope. The average postoperative scoliosis Cobb's angle and kyphosis Cobb's angle were corrected from 54.1° preoperatively to 23.1° postoperatively, and 59.3° preoperatively to 25.8° postoperatively, respectively. The average postoperative distance between the C7 plumb line and the center sacral vertical line was decreased from 2.5 cm preoperatively to 1.5 cm postoperatively. The average follow‐up period was 2.2 years. No serious complication was observed. The cause of the failure of the first operations for the congenital scoliosis due to hemivertebra is verified. Our study may provide a basis for the treatment of congenital scoliosis due to hemivertebra.
Small cell‐ versus large cell‐sized metal stent in endoscopic bilateral stent‐in‐stent placement for malignant hilar biliary obstruction
Authors: Lee Jae Min , Lee Sang Hyub , Chung Kwang Hyun , Park Jin Myung , Paik Woo Hyun , Woo Sang Myung , Lee Woo Jin , Ryu Ji Kon , Kim Yong‐Tae
Published: February 2015

Background and Aim

Although the large cell‐sized biliary stent facilitates contralateral stent deployment through the mesh of the first metallic stent for stent‐in‐stent (SIS) technique, there are concerns about its vulnerability to tumor ingrowth. The aim of the present study was to compare the clinical outcomes of endoscopic bilateral SIS placement according to the cell size of a self‐expandable metallic stent (SEMS).

Methods

A total of 58 patients were enrolled who underwent endoscopic bilateral SIS placement of SEMS for malignant hilar biliary obstruction as a result of cholangiocarcinoma or gallbladder cancer. Finally, 43 patients who underwent successful stent insertion were included in the analysis and divided into the small cell‐sized stent (SCS; n = 21) and the large cell‐sized stent (LCS; n = 22) groups. We retrospectively compared comprehensive clinical and laboratory data in both groups.

Results

There were no significant differences between the two groups in successful drainage (SCS vs LCS, 100% vs 100%, respectively), early complications (38.1% vs 18.2%), late complications (14.3% vs 22.7%), stent occlusion (42.9% vs 45.5%), tumor ingrowth (33.3% vs 45.5%) or overgrowth (9.5% vs 0%). Duration of stent patency and overall survival were not significantly different between the two groups (P = 0.086 and P = 0.320, respectively).

Conclusions

Endoscopic bilateral SIS placement for malignant hilar biliary obstruction shows no differences in stent patency, survival, complications and clinical course according to the cell size of SEMS.