bluuebunny/crossref_metadata_2025 huggingface dataset:
Maternal obesity and excess of fetal growth in pre‐eclampsia
Authors: Rasmussen S , Irgens LM , Espinoza J
Published: March 2014

Objective

To assess whether the reported excess of large for gestational age (LGA) neonates in pre‐eclamptic women delivering at term is attributable to maternal obesity.

Design, setting and population

Population‐based observational study including 77 294 singleton pregnancies registered in the Medical Birth Registry of Norway between 2007 and 2010.

Methods

Comparison of birthweight percentiles and z‐scores between women with and without pre‐eclampsia.

Main outcome measures

Odds ratio (OR) of LGA and z‐scores of birthweight in relation to pre‐eclampsia.

Results

Pre‐eclamptic women delivering at term had increased risk of having LGA neonates. Unadjusted ORs with 95% confidence interval (95% CI) of LGA above the 90th and 95th birthweight centiles were 1.4, 95% CI 1.2–1.6 and 1.6, 95% CI 1.3–1.9, respectively. The excess of LGA persisted after including gestational diabetes and diabetes types 1 and 2 in a multivariate analysis (corresponding ORs 1.3, 95% CI 1.1–1.5 and 1.4, 95% CI 1.2–1.7), but disappeared after adjusting for maternal prepregnant body mass index (ORs 1.1, 95% CI 0.9–1.2 and 1.1, 95% CI 0.9–1.3).

Conclusions

This study suggests accelerated fetal growth in a subset of pre‐eclamptic women delivering at term. The excess of LGA neonates is attributable to maternal obesity among pre‐eclamptic women delivering at term. The maternal obesity epidemic may lead to an increased prevalence of both pre‐eclampsia and LGA neonates among women delivering at term.
The impact of stillbirth on consultant obstetrician gynaecologists: a qualitative study
Authors: Nuzum D , Meaney S , O'Donoghue K
Published: March 2014

Objective

To explore the personal and professional impact of stillbirth on consultant obstetrician gynaecologists.

Design

Semi‐structured in‐depth qualitative interviews.

Setting

A tertiary university maternity hospital in Ireland with a birth rate of c. 9000 per annum and a stillbirth rate of 4.6/1000.

Sample

Purposive sample of eight consultant obstetrician gynaecologists (50% of consultant obstetrician gynaecologists in the hospital).

Methods

Semi‐structured in‐depth interviews analysed by Interpretative Phenomenological Analysis. (IPA) IPA is a methodology for exploring human experience and its meaning for the individual.

Main outcome measures

The lived experiences, personal feelings and professional impact of stillbirth on consultant obstetrician gynaecologists.

Results

Stillbirth was identified as amongst the most difficult experiences for consultants. Two superordinate themes emerged: the human response to stillbirth and the weight of responsibility. The human response to stillbirth was characterised by the personal impact of stillbirth for consultants and, in turn, how that shapes the care they provide. The weight of professional responsibility was characterised by the sense of professional burden and the possibility of a medico‐legal challenge—mostly for those who are primarily gynaecologists resulting in the question ‘what have I missed?’.

Conclusions

Despite the impact of stillbirth, no consultant has received formal training in perinatal bereavement care. This study highlights a gap in training and the significant impact of stillbirth on obstetricians, professionally and personally. The provision of support, ongoing education, bereavement training and self‐care is recommended. Medico‐legal concerns following stillbirth potentially impact on care, warranting further research.
Samuel Pepys and Corruption
Authors: Knights Mark
Published: March 2014

Picking up a theme that runs through David Hayton's work, this article examines corruption in the later Stuart period through a case study of Samuel Pepys. The latter's diary can be read alongside the public record of parliamentary inquiries and vilification in the press, allowing us a rare opportunity to study corruption simultaneously through the eyes of a perpetrator and his critics. Pepys reveals ambiguities in how corruption was defined and defended. At the same time as he criticized corruption in others, he took bribes and extorted favours but either lied about them when confronted, or excused them as lawful gifts from friends and those grateful for his services, arguing that his acceptance of them never worked against the king's interest. His critics, on the other hand, queried the compatibility of his private advantage and the public interest, and depicted him as greedy, hypocritical and unjust. Pepys thus illustrates contested notions of corrupt behaviour. The attack on Pepys also shows the political motives behind campaigns against corruption: the libel published against him was part of the murky world of popish plot intrigue, with clear overtones of both catholic and sexual misdemeanour. Popery and lust were associated with corrupt behaviour. Pepys's story was part of a larger one about long‐term shifts in the nature of officeholding, state formation, the public interest, patronage and the culture of gift‐giving that needs further exploration.
The Glorious Revolution, Parliament, and the Making of the First Industrial Nation
Authors: Beckett John
Published: March 2014

Historians have traditionally viewed the Glorious Revolution as essentially a political event, but in recent decades the growing recognition of just how extensively it impacted on British society has led to various reappraisals of its significance. This article argues that the structure of post‐1689 parliamentary activity encouraged both MPs and peers to take a greater interest in the concerns of their constituencies and constituents. In turn, this led to the promotion of private legislation, and these developments together provided the conditions for underpinning the infrastructural developments needed to encourage investment in industrial processes. Thus, the legacy of the Glorious Revolution in relation to parliamentary proceedings was of great importance to the establishment of the circumstances in which industrialisation could flourish, conditions which did not exist prior to 1689 but which subsequently enabled Britain to become the first industrial nation.
Securing the Hanoverian Succession in Ireland: Jacobites, Money and Men, 1714–16
Authors: McGrath Charles Ivar
Published: March 2014

This article examines the connection between issues of security, finance and the army in Ireland in the years 1714–16. The death of Queen Anne and succession of the first Hanoverian monarch, George I, in August 1714, offered renewed hope to the supporters of the jacobite cause in Ireland, Scotland, England and beyond. However, the threat of a Stuart restoration by force of arms served to galvanise the efforts of government in both England and Ireland in support of the Hanoverian succession, though the necessary military preparations and precautions resulted in increased public expenditure. In Ireland, the government's need to find new sources of revenue meant that parliament would have to be convened, which, in turn, necessitated compliance with a series of constitutional practices which had evolved since the 1690s in relation to Poynings' Law and supply legislation. Yet, despite a threatened jacobite invasion, factional political manœuvring, as ever, demanded compromise, though, ultimately, the wholly protestant Irish parliament took the necessary precautions to secure Ireland for the new Hanoverian regime by voting new taxes and facilitating the creation of a national debt in order to raise new regiments for the army. The coalescing of the issues of security, finance and the army thereby led to innovations in Irish parliamentary and financial practice which were to become key components of the constitutional framework in Ireland until legislative independence in 1782.
The House of Lords and the Excise Crisis: The Storm and the Aftermath, 1733–5
Authors: Jones Clyve
Published: March 2014

The excise crisis of 1733 was the first major parliamentary crisis Sir Robert Walpole's ministry faced in the house of commons. As a result of the huge public outcry, the proposal was dropped in the Commons, but the opposition to it in the house of lords was so great that the opposition lords switched their attack in 1734 to the accounts of the South Sea Company, and the ministry lost a crucial division in the Lords (the first such loss by any ministry for a generation). Walpole, with the king's approval, tried to discipline the members of the upper chamber by sacking some erstwhile supporters from their offices and the colonelcy of their regiments (the latter of which was considered by many to be an attack on property). This attempt to gain control alienated a further batch of lords who continued their opposition in the Lords well into 1735, particularly over the Scots' petition in that year against the ministry's conduct of the election of the Scottish representative peers in the summer of 1734. Some of the disciplined peers returned to the ministerial fold, but a number continued their opposition, some for the rest of the life of Walpole's ministry. The 1734–5 crisis in the Lords, which initially arose over the excise proposals, continued, largely fuelled by Walpole's treatment of some of the ministry's former supporters, and, in fact, can be considered a second separate crisis triggered by Walpole's treatment of the peerage.
The Attack of the Creolian Powers: West Indians at the Parliamentary Elections of Mid‐Georgian Britain, 1754–74
Authors: Gauci Perry
Published: March 2014

This article seeks to build upon recent work on the impact of empire in mid‐18th‐century Britain by study of the electoral experience of parliamentary candidates who had lived in the West Indies and could boast a direct familiarity with the Caribbean. By 1750, a significant number of rich planters had relocated to Britain, and, in common with the Indian nabobs, their efforts to enter parliament aroused much adverse commentary at the elections of 1754–74. While these attacks were damaging to their interest, and occasioned the most thorough review of Caribbean society to date, the West Indians were able to respond by adapting their political campaigns to assuage metropolitan sensibilities, thereby ensuring that they were not bracketed with the nabobs or rebellious North Americans as imperial sources of domestic upheaval. Their success highlights the possibilities for successful imperial integration in mid‐Georgian Britain, although the West Indians could not rely on the same strategies to combat the abolitionist movement after 1787.
256‐MDCT for evaluation of urolithiasis: Iterative reconstruction allows for a significant reduction of the applied radiation dose while maintaining high subjective and objective image quality
Authors: Veldhoen Simon , Laqmani Azien , Derlin Thorsten , Karul Murat , Hammerle Diego , Buhk Jan‐Hendrik , Sehner Susanne , Nagel Hans D. , Chun Felix , Adam Gerhard , Regier Marc
Published: March 2014

Purpose

Multidetector CT (MDCT) is the established imaging modality in diagnostics of urolithiasis. The aim of iterative reconstruction (IR) is to allow for a radiation dose reduction while maintaining high image quality. This study evaluates its performance in MDCT for assessment of urolithiasis.

Materials and Methods

Fifty‐two patients underwent non‐contrast abdominal MDCT. Twenty‐six patients were referred to MDCT under suspicion of urolithiasis, and examined using a dose‐reduced scan protocol (RDCT). Twenty‐six patients, who had undergone standard‐dose MDCT, served as reference for radiation dose comparison. RDCT images were reconstructed using an IR system (iDose4™, Philips Healthcare, Cleveland, OH, USA). Objective image noise (OIN) was recorded and five radiologists rated the subjective image quality independently. Radiation parameters were derived from the scan protocols.

Results

The CTDIvol could be reduced by 50% to 5.8 mGy (P < 0.0001). The same reduction was achieved for DLP and effective dose to 253 ± 27 mGy*cm (P < 0.0001) and 3.9 ± 0.4 mSv (P < 0.0001). IR led to a reduction of the OIN of up to 61% compared with classic filtered back projection (FBP) (P < 0.0001). The OIN declined with increasing IR levels. RDCT with FBP showed the lowest scores of subjective image quality (2.32 ± 0.04). Mean scores improved with increasing IR levels. iDose6 was rated with the best mean score (3.66 ± 0.04).

Conclusion

The evaluated IR‐tool and protocol may be applied to achieve a considerable radiation dose reduction in MDCT for diagnostics of urolithiasis while maintaining a confident image quality. Best image quality, suitable for evaluation of the entire abdomen concerning differential diagnoses, was achieved with iDose6.
4D CT and lung cancer surgical resectability: A technical innovation
Authors: Troupis John M , Pasricha Sundeep S , Narayanan Harish , Rybicki Frank J , Pick Adrian W
Published: March 2014

A 74‐year‐old man presents with a left upper lobe lung adenocarcinoma, which demonstrated a wide base intimately with the aortic arch. We utilised 4D CT technique with a wide field of view CT unit to preoperatively determine likely surgical resectability. We propose that 4D CT may be of use in further investigating lung cancer with likely invasion of adjacent structures.
Micro‐bubble transcranial Doppler ultrasound for exclusion of right‐to‐left circulatory shunts: Why should we provide the service?
Authors: Chiu Albert H. , Haluszkiewicz Elvie , McAuliffe William
Published: March 2014

Micro‐bubble transcranial Doppler ultrasound is a study used for the identification and quantification of a right‐to‐left circulatory shunt which can be implicated in stroke. It is an underused technique in many centres. Micro‐bubble transcranial Doppler ultrasound is non‐invasive, innocuous, quick and requires no fasting or sedation. Published literature also suggests almost perfect concordance with transoesophageal echocardiography and potentially greater sensitivity. We believe there is a great potential for neuroradiologists to provide this service as part of the diagnostic workup in patients with cryptogenic stroke.
Transarterial chemoembolisation and radioembolisation for the treatment of primary liver cancer and secondary liver cancer: A review of the literature
Authors: Bester Lourens , Meteling Baerbel , Boshell David , Chua Terence C. , Morris David L.
Published: March 2014

Liver‐directed therapies are continuing to evolve in the field of interventional oncology and are gaining increasing use in the treatment of unresectable primary and secondary liver cancers. In this article, we review two liver‐directed therapies that are currently used for the palliative treatment of primary and secondary hepatic tumours: transcatheter arterial chemoembolisation (TACE), including a new type of TACE with drug‐eluting beads (DEB‐TACE), and radioembolisation. The concept of these transcatheter intraarterial therapies is to selectively deliver high doses of anticancer treatment to the tumour. While TACE delivers one or more chemotherapeutic drugs into the hepatic arteries supplying the tumour, radioembolisation uses non‐embolic microspheres incorporating the radioactive isotope 90Y. In this article, we discuss some technical aspects, patient selection, current clinical evidence, and future directions of TACE, TACE with drug‐eluting beads (DEB‐TACE) and radioembolisation for primary and secondary liver cancer.
“Blurred Lines?” Sexual Aggression and Barroom Culture
Authors: Graham Kathryn , Bernards Sharon , Wayne Osgood D. , Abbey Antonia , Parks Michael , Flynn Andrea , Dumas Tara , Wells Samantha
Published: March 2014

Background

Meeting potential sexual/romantic partners for mutual pleasure is one of the main reasons young adults go to bars. However, not all sexual contacts are positive and consensual, and aggression related to sexual advances is a common experience. Sometimes such aggression is related to misperceptions in making and receiving sexual advances while other times aggression reflects intentional harassment or other sexually aggressive acts. This study uses objective observational research to assess quantitatively gender of initiators and targets and the extent that sexual aggression involves intentional aggression by the initiator, the nature of responses by targets, and the role of third parties and intoxication.

Methods

We analyzed 258 aggressive incidents involving sexual advances observed as part of a larger study on aggression in large capacity bars and clubs, using variables collected as part of the original research (gender, intoxication, intent) and variables coded from narrative descriptions (invasiveness, persistence, targets' responses, role of third parties). Hierarchical linear modeling analyses were used to account for nesting of incidents in evening and bars.

Results

Ninety percent of incidents involved male initiators and female targets, with almost all incidents involving intentional or probably intentional aggression. Targets mostly responded nonaggressively, usually using evasion. Staff rarely intervened; patron third parties intervened in 21% of incidents, usually to help the target but sometimes to encourage the initiator. initiators' level of invasiveness was related to intoxication of the targets, but not their own intoxication, suggesting intoxicated women were being targeted.

Conclusions

Sexual aggression is a major problem in bars often reflecting intentional sexual invasiveness and unwanted persistence rather than misperceptions in sexual advances. Prevention needs to focus on addressing masculinity norms of male patrons and staff who support sexual aggression and better management of the highly sexualized and sexist environments of most bars.
Actions and Interactions of Alcohol and Transforming Growth Factor β1 on Prepubertal Hypothalamic Gonadotropin‐Releasing Hormone
Authors: Srivastava Vinod K. , Hiney Jill K. , Dees William L.
Published: March 2014

Background

Alcohol (ALC) diminishes gonadotropin‐releasing hormone (GnRH) secretion and delays puberty. Glial transforming growth factor β1 (TGFβ1) plays a role in glial–neuronal communications facilitating prepubertal GnRH secretion. We assessed the effects of acute ALC administration on TGFβ1‐induced GnRH gene expression in the brain preoptic area (POA) and release of the peptide from the medial basal hypothalamus (MBH). Furthermore, we assessed actions and interactions of TGFβ1 and ALC on an adhesion/signaling gene family involved in glial–neuronal communications.

Methods

Prepubertal female rats were administered ALC or water via gastric gavage at 7:30 am. At 9:00 am, saline or TGFβ1 (100 ng/3 μl) was administered into the third ventricle. At 3:00 pm, the POA was removed and frozen for gene expression analysis and repeated for protein assessments. In another experiment, the MBH was removed from ALC‐free rats. After equilibration, tissues were incubated in Locke's medium only or medium containing TGFβ1 with or without 50 mM ALC for measurement of GnRH peptide released in vitro.

Results

TGFβ1 induced GnRH gene expression in the POA, and this effect was blocked by ALC. We also described the presence and responsiveness of the TGFβ1 receptor in the POA and showed that acute ALC exposure not only altered the TGFβ1‐induced increase in TGFβ‐R1 protein expression but also the activation of receptor‐associated proteins, Smad2 and Smad3, key downstream components of the TGFβ1 signaling pathway. Assessment of an adhesion/signaling family consisting of glial receptor protein tyrosine phosphatase beta and neuronal contactin‐associated protein‐1 (Caspr1) and contactin showed that the neuronal components were induced by TGFβ1 and that ALC blocked these effects. Finally, TGFβ1 was shown to induce release of the GnRH peptide in vitro, an action that was blocked by ALC.

Conclusions

We have demonstrated glial‐derived TGFβ1 induces GnRH gene expression in the POA and stimulates release of the peptide from the MBH, actions necessary for driving the pubertal process. Importantly, ALC acted at both brain regions to block stimulatory effects of TGFβ1. Furthermore, ALC altered neuronal components of an adhesion/signaling family previously shown to be expressed on GnRH neurons and implicated in glial–GnRH neuronal communications. These results further demonstrate detrimental effects of ALC at puberty.
A meta‐analysis of ethnic differences in pathways to care at the first episode of psychosis
Authors: Anderson K. K. , Flora N. , Archie S. , Morgan C. , McKenzie K.
Published: March 2014

Objective

We sought to systematically review the literature on ethnic differences in the likelihood of general practitioner (GP) involvement, police involvement, and involuntary admission on the pathway to care of patients with first‐episode psychosis (FEP).

Method

We searched electronic databases and conducted forward and backward tracking to identify relevant studies. We calculated pooled odds ratios (OR) to examine the variation between aggregated ethnic groups in the indicators of the pathway to care.

Results

We identified seven studies from Canada and England that looked at ethnic differences in GP involvement (n = 7), police involvement (n = 7), or involuntary admission (n = 5). Aggregated ethnic groups were most often compared. The pooled ORs suggest that Black patients have a decreased likelihood of GP involvement (OR = 0.70, 0.57–0.86) and an increased likelihood of police involvement (OR = 2.11, 1.67–2.66), relative to White patients. The pooled ORs were not statistically significant for patients with Asian backgrounds (GP involvement OR = 1.23, 0.87–1.75; police involvement OR = 0.86, 0.57–1.30). There is also evidence to suggest that there may be ethnic differences in the likelihood of involuntary admission; however, effect modification by several sociodemographic factors precluded a pooling of these data.

Conclusion

Ethnic differences in pathways to care are present at the first episode of psychosis.
Economic Stagnation and Crisis in Korea during the Eighteenth and Nineteenth Centuries
Authors: Rhee Young Hoon
Published: March 2014

In contrast to rapid economic growth in the twentieth century, Korea suffered a long economic decline in the eighteenth and nineteenth centuries, with the failure accelerating from 1850 to 1890. According to 36 different harvest records, rice productivity continuously declined from the early eighteenth to the late nineteenth centuries due to deforestation and increase in natural disasters. Contraction of rural markets after the interruption of trade with Japan also contributed to the decrease in rice production. The third reason for the nineteenth‐century crisis was the dissolution of the government‐led grain storage and redistribution system. Finally, the ultimate culprit for the crisis could be found in Confucianism with which the Joseon Dynasty was unable to properly understand and respond to the crisis.
Angiogenic factors and uterine Doppler velocimetry in early‐ and late‐onset preeclampsia
Authors: Tobinaga Clarissa M. , Torloni Maria R. , Gueuvoghlanian‐Silva Bárbara Y. , Pendeloski Karen P.T. , Akita Patrícia A. , Sass Nelson , Daher Silvia
Published: March 2014

Objective

To assess correlations between maternal serum levels of pro‐ and anti‐angiogenic factors with uterine perfusion in women with early‐ compared with late‐onset preeclampsia, and in healthy pregnant women.

Design

Case‐control study.

Setting

Antenatal care clinic located within a hospital (São Bernardo do Campo, Brazil).

Population

We enrolled 54 preeclamptic and 54 healthy control women who were coming for routine ultrasound at 28–36 weeks' gestation.

Methods

All participants had uterine artery and umbilical Doppler studies and a blood sample to assess maternal serum levels of soluble fms‐like tyrosine kinase‐1, soluble endoglin, adiponectin and plasminogen activator inhibitor‐1. All angiogenic factors were measured using enzyme‐linked immunosorbent assay.

Main outcome measures

Levels of pro‐ and anti‐angiogenic factors in maternal serum, and uterine artery Doppler findings.

Results

Concentrations of soluble fms‐like tyrosine kinase‐1 and soluble endoglin were significantly higher in preeclamptic than control women (p < 0.0001 and p < 0.0001, respectively), especially in those with early‐onset (<34 weeks) preeclampsia. These two anti‐angiogenic mediators were significantly correlated with increased uterine artery Doppler in the preeclamptic women. Plasminogen activator inhibitor‐1 levels were significantly higher in preeclampsia (p = 0.03) but unrelated to uterine artery resistance. Adiponectin levels were similar in cases and controls, independent of body mass index and unrelated to uterine artery resistance.

Conclusion

Preeclamptic patients have increased soluble fms‐like tyrosine kinase‐1 and soluble endoglin serum levels and this increase is directly correlated with uterine artery resistance, especially in those with early‐onset preeclampsia.
Sustaining the Financial Value of Global CSR: Reconciling Corporate and Stakeholder Interests in a Less Regulated Environment
Authors: Blodgett Mark S. , Hoitash Rani , Markelevich Ariel
Published: March 2014

In this article we examine the association between corporate social responsibility (CSR) and firm value. This line of research is important since firms continue to invest in CSR even though past studies reveal a limited linkage between financial value and CSR. However, the business case for CSR or “doing good while making a profit,” appears to be advancing within the business ethics literature as a preferred conception of CSR. We conjecture that the greater unification and refinement of both profit maximization and stakeholder interests through corporate acts, not statements alone, will sustain the financial value of CSR in a less regulated global business environment. We study the triangle of what companies say, what companies do, and firm financial performance. We analyze Fortune 250 firms and find a positive association between what companies do based on KLD Research and Analytics, Inc. (KLD) ratings, and what companies state about ethics in their CSR statements. We then employ regression analysis and find that companies’ socially responsible acts are positively associated with overall firm value and financial performance. Yet we do not find a statistically significant association between what companies say regarding ethics in their CSR statements and their financial outcomes. These results suggest that firm value and financial performance is associated with what companies do and not what they say. Our results seem to be driven by multinational corporations (MNCs) and not by non‐MNCs. This is possibly because MNCs generally operate in a less regulated global business environment that often necessitates strong ethical corporate leadership to further stakeholder interests. Overall, these results help reconcile corporate and stakeholder objectives since evidence of a link between financial performance and doing good sustains global CSR.
Environmental Concerns in the Marcellus Shale
Authors: Beaver William
Published: March 2014

Hydraulic fracturing used to remove natural gas from the Marcellus Shale has raised environmental concerns in the region both in terms of air and water pollution. This article will examine those concerns and how the natural gas industry has responded to them. After discussing the issues related to groundwater contamination and air quality. I discuss industry responses and how the costs and harm associated with fracking could be reduced, with the knowledge that despite opposition from environmental groups, fracking will continue. The hope is that more drillers will begin to operate in a socially responsible manner that will allow companies to be profitable while limiting harm to the environment and to individuals living near drilling sites.
Anti‐infective use in children and pregnancy: current deficiencies and future challenges
Authors: Gwee Amanda , Cranswick Noel
Published: March 2014

There are a number of challenges to using anti‐infective agents in children and pregnant women. There is limited understanding of the altered pharmacokinetics of anti‐infectives in these populations and as a result, optimized dosing regimens are yet to be established. The potential adverse effects of the drug on pregnancy outcome and the developing foetus is a major consideration, and the long term implications of drug side effects must be taken into account when drug exposure occurs early in life. These factors hinder research and licensing of new anti‐infective drugs in these populations. We describe the current deficiencies and future challenges of anti‐infective use in children and pregnant women, providing specific examples.
Two‐year‐olds’ understanding of self‐symbols
Authors: Herold Katherine , Akhtar Nameera
Published: March 2014

This study investigated 48 2.5‐year‐olds’ ability to map from their own body to a two‐dimensional self‐representation and also examined relations between parents’ talk about body representations and their children's understanding of self‐symbols. Children participated in two dual‐representation tasks in which they were asked to match body parts between a symbol and its referent. In one task, they used a self‐symbol and in the other they used a symbol for a doll. Participants were also read a book about body parts by a parent. As a group, children found the self‐symbol task more difficult than the doll‐task; however, those whose parents explicitly pointed out the relation between their children's bodies and the symbols in the book performed better on the self‐symbol task. The findings demonstrate that 2‐year‐old children have difficulty comprehending a self‐symbol, even when it is two‐dimensional and approximately the same size as them, and suggest that parents’ talk about self‐symbols may facilitate their understanding.
Clinical performance of serum isoform [‐2]proPSA (p2PSA), and its derivatives %p2PSA and the Prostate Health Index, in men aged <60 years: results from a multicentric European study
Authors: Fossati Nicola , Lazzeri Massimo , Haese Alexander , McNicholas Thomas , de la Taille Alexandre , Buffi Nicolò Maria , Lughezzani Giovanni , Gadda Giulio Maria , Lista Giuliana , Larcher Alessandro , Abrate Alberto , Mistretta Francesco , Bini Vittorio , Redorta Joan Palou , Graefen Markus , Guazzoni Giorgio
Published: March 2014

Objectives

To test the hypothesis that [‐2]proPSA (p2PSA) and its derivatives are more accurate than total prostate‐specific antigen (tPSA), free prostate‐specific antigen (fPSA) and fPSA as percentage of tPSA (%fPSA) in detecting prostate cancer (PCa) in men aged <60 years.

Patients and Methods

The analysis consisted of a nested case–control study from the PRO‐ PSA Multicentric European Study (PROMEtheuS) project. The primary outcomes were measures of sensibility, specificity and accuracy of serum p2PSA, p2PSA as percentage of fPSA (%p2PSA) and Beckman Coulter prostate health index (PHI) in men aged <60 years who had undergone a prostate biopsy. The potential reduction in the number of unnecessary biopsies and the characteristics of the potentially missed PCa cases were reported as secondary outcomes. Multivariate logistic regression models were complemented by predictive accuracy and decision‐curve analyses.

Results

Of the 1036 patients enrolled in the PROMEtheus project, 238 (22.9%) were aged < 60 years. PCa was found in 67 subjects (28.1%); p2PSA, %p2PSA and PHI values were significantly higher (P < 0.001) among these subjects, while no differences were found in tPSA, fPSA and %fPSA values. On univariate analysis, %p2PSA (area under the curve [AUC]: 0.704) and PHI (AUC: 0.7) were the most accurate predictors, and these significantly outperformed tPSA (AUC: 0.549), fPSA (AUC: 0.511) and %fPSA (AUC: 0.557) in the prediction of PCa at biopsy (P ≤ 0.001). In multivariate logistic regression models, %p2PSA and PHI achieved independent predictor status and significantly increased the accuracy of multivariate models by 6.3 and 7.6%, respectively (P ≤ 0.05).

Conclusion

PHI and %p2PSA are more accurate than the reference standard tests in predicting PCa in young men.
Laparoendoscopic single‐site (LESS) vs laparoscopic living‐donor nephrectomy: a systematic review and meta‐analysis
Authors: Autorino Riccardo , Brandao Luis Felipe , Sankari Bashir , Zargar Homayoun , Laydner Humberto , Akça Oktay , De Sio Marco , Mirone Vincenzo , Chueh Shih‐Chieh J. , Kaouk Jihad H.
Published: March 2014

The aim of this study was to provide a systematic review and meta‐analysis of reports comparing laparoendoscopic single‐site (LESS) living‐donor nephrectomy (LDN) vs standard laparoscopic LDN (LLDN). A systematic review of the literature was performed in September 2013 using PubMed, Scopus, Ovid and The Cochrane library databases. Article selection proceeded according to the search strategy based on Preferred Reporting Items for Systematic Reviews and Meta‐analyses criteria. Weighted mean differences (WMDs) were used to measure continuous variables and odds ratios (ORs) to measure categorical ones. Nine publications meeting eligibility criteria were identified, including 461 LESS LDN and 1006 LLDN cases. There were more left‐side cases in the LESS LDN group (96.5% vs 88.6%, P < 0.001). Meta‐analysis of extractable data showed that LLDN had a shorter operative time (WMD 15.06 min, 95% confidence interval [CI] 4.9–25.1; P = 0.003), without a significant difference in warm ischaemia time (WMD 0.41 min, 95% CI –0.02 to 0.84; P = 0.06). Estimated blood loss was lower for LESS LDN (WMD −22.09 mL, 95% CI –29.5 to –14.6; P < 0.001); however, this difference was not clinically significant. There was a greater likelihood of conversion for LESS LDN (OR 13.21, 95% CI 4.65–37.53; P < 0.001). Hospital stay was similar (WMD –0.11 days, 95% CI –0.33 to 0.12; P = 0.35), as well as the visual analogue pain score at discharge (WMD –0.31, 95% CI –0.96 to 0.35; P = 0.36), but the analgesic requirement was lower for LESS LDN (WMD –2.58 mg, 95% CI –5.01 to –0.15; P = 0.04). Moreover, there was no difference in the postoperative complication rate (OR 1.00, 95% CI 0.65–1.54; P = 0.99). Renal function of the recipient, as based on creatinine levels at 1 month, showed similar outcomes between groups (WMD 0.10 mg/dL, –0.09 to 0.29; P = 0.29). In conclusion, LESS LDN represents an emerging option for living kidney donation. This procedure offers comparable surgical and early functional outcomes to the conventional LLDN, with a lower analgesic requirement. However, it is more technically challenging than LLDN, as shown by a greater likelihood of conversion. The role of LESS LDN remains to be defined.
Confederates and Yankees under the Southern Cross
Authors: SILVA CÉLIO ANTONIO ALCANTARA
Published: March 2014

Following the Civil War in the United States of America, colonies that were predominately ‘Yankee’ and Confederate sprang up in Brazil. In contrast to the subject's historiography, we seek to show how these colonies were the result of in the first case, the actions of Imperial diplomacy and in the second case, spontaneous interest by Southerners due to the existence of slavery in Brazil. This proposition is supported by primary sources, as they indicate the presence of significant teams of slaves in the Confederate colonies in Brazil, while slavery was prohibited in their ‘Yankee’ counterparts.
Gene expression profiling of Epstein–Barr virus‐positive diffuse large B‐cell lymphoma of the elderly reveals alterations of characteristic oncogenetic pathways
Authors: Kato Harumi , Karube Kennosuke , Yamamoto Kazuhito , Takizawa Jun , Tsuzuki Shinobu , Yatabe Yasushi , Kanda Teru , Katayama Miyuki , Ozawa Yukiyasu , Ishitsuka Kenji , Okamoto Masataka , Kinoshita Tomohiro , Ohshima Koichi , Nakamura Shigeo , Morishima Yasuo , Seto Masao
Published: March 2014

Epstein–Barr virus (EBV)‐positive diffuse large B‐cell lymphoma (DLBCL) of the elderly (EBV[+]DLBCL‐E) is classified as a subtype of DLBCL. Until now, its molecular pathogenesis has remained unknown. To identify pathways characteristic of EBV(+)DLBCL‐E, gene expression profiling of five EBV(+)DLBCL‐E and seven EBV‐negative DLBCL (EBV[−]DLBCL) cases was undertaken using human oligonucleotide microarray analysis. Gene set enrichment analysis and gene ontology analysis showed that gene sets of the Janus kinase‐signal transducer and activator of transcription (JAK‐STAT) and nuclear factor kappa B (NF‐κB) pathways were enriched in EBV(+)DLBCL‐E cases. To confirm the results of the expression profiles, in vitro analysis was performed. Expression profiling analysis showed that high activation of the JAK‐STAT and NF‐κB pathways was induced by EBV infection into DLBCL cell lines. Activation of the NF‐κB pathway was confirmed in EBV‐infected cell lines using an electrophoretic mobility shift assay. Western blot analysis revealed an increased protein expression level of phosphorylated signal transducer and activator of transcription 3 (STAT3) in an EBV‐infected cell line. Protein expression of phosphorylated STAT3 was frequently observed in lymphoma cells of EBV(+)DLBCL‐E clinical samples using immunohistochemistry (EBV[+]DLBCL‐E: 80.0% [n = 20/25] versus EBV[−]DLBCL: 38.9% [n = 14/36]; P = 0.001). The results of the present study suggest that activation of the JAK‐STAT and NF‐κB pathways was characteristic of EBV(+)DLBCL‐E, which may reflect the nature of EBV‐positive tumor cells. Targeting these pathways as therapies might improve clinical outcomes of EBV(+)DLBCL‐E.
Biobanks and personalized medicine
Authors: Olson J.E. , Bielinski S.J. , Ryu E. , Winkler E.M. , Takahashi P.Y. , Pathak J. , Cerhan J.R.
Published: March 2014

We provide a mini‐review of how biobanks can support clinical genetics in the era of personalized medicine. We discuss types of biobanks, including disease specific and general biobanks not focused on one disease. We present considerations in setting up a biobank, including consenting and governance, biospecimens, risk factor and related data, informatics, and linkage to electronic health records for phenotyping. We also discuss the uses of biobanks and ongoing considerations, including genotype‐driven recruitment, investigations of gene–environment associations, and the re‐use of data generated from studies. Finally, we present a brief discussion of some of the unresolved issues, such as return of research results and sustaining biobanks over time. In summary, carefully designed biobanks can provide critical research and infrastructure support for clinical genetics in the era of personalized medicine.
Building a Language‐Independent Discourse Parser using Universal Networking Language
Authors: Navaneethakrishnan Subalalitha Chinnaudayar , Parthasarathi Ranjani
Published: March 2014

Discourse parsing has become an inevitable task to process information in the natural language processing arena. Parsing complex discourse structures beyond the sentence level is a significant challenge. This article proposes a discourse parser that constructs rhetorical structure (RS) trees to identify such complex discourse structures. Unlike previous parsers that construct RS trees using lexical features, syntactic features and cue phrases, the proposed discourse parser constructs RS trees using high‐level semantic features inherited from the Universal Networking Language (UNL). The UNL also adds a language‐independent quality to the parser, because the UNL represents texts in a language‐independent manner. The parser uses a naive Bayes probabilistic classifier to label discourse relations. It has been tested using 500 Tamil‐language documents and the Rhetorical Structure Theory Discourse Treebank, which comprises 21 English‐language documents. The performance of the naive Bayes classifier has been compared with that of the support vector machine (SVM) classifier, which has been used in the earlier approaches to build a discourse parser. It is seen that the naive Bayes probabilistic classifier is better suited for discourse relation labeling when compared with the SVM classifier, in terms of training time, testing time, and accuracy.
Application of single shot free‐breathing fast imaging employing steady state sequence in cardiac magnetic resonance imaging
Authors: Wang Lidong , Cheng Liuquan , Fang Fang , Han Xiaodong , Liu Aishi , Ma Lin , Gao Peiyi , Niu Guangming
Published: March 2014

Objective

To investigate the imaging quality of single shot (SS) fast imaging employing steady state (FIESTA) sequence in contrast‐enhanced cardiac magnetic resonance (MR) examination, in comparison with the segmented inversion recovery 2D fast gradient echo (IR FGRE) sequence.

Materials and methods

Fifty‐two cases with suspected or known heart disease were enrolled in this study, including 24 patients who had enhanced myocardium in myocardial delayed enhancement (MDE). We analyzed the imaging quality of the sequences by measuring the myocardium and blood pool signal‐to‐noise ratios (SNR) and the contrast‐to‐noise ratios (CNR) of blood pool relative to normal myocardium and of enhanced myocardium relative to normal myocardium and compared the new sequences with traditional sequence.

Results

The scanning time of SS FIESTA was significantly shortened as compared to IR FGRE. The differences in the image quality scores, enhanced myocardium (EM) mass and percentages, SNR(bp), SNR(myo), CNR(myo/bp) and CNR(l/bg) were not statistically significant between SS FIESTA and IR FGRE (P>0·05). However, the difference in CNR(em/myo) was statistically significant between SS FIESTA and IR FGRE (P<0·0001), with CNR(em/myo) of IR FGRE higher than SS FIESTA.

Conclusion

Single shot FIESTA speeded up the acquisition time, halving it to (27·6 ± 1·8 s) instead of 146 + 13·8 s (IR FGRE), it had higher SNR and CNR, and its image quality did not differ significantly from IR FGRE. The SS FIESTA is more suitable for patients with severely heart diseases or those unable to hold breath. 3D IR FGRE sequence had higher SNR(myo) than the others and it is suitable for displaying the subendocardial scar. However, it has more artefacts and poor imaging quality than IR FGRE.
Histologically proven non‐alcoholic fatty liver disease and clinically related factors in recipients after liver transplantation
Authors: Kim Hyeyoung , Lee Kyoungbun , Lee Kwang‐Woong , Yi Nam‐Joon , Lee Hae Won , Hong Geun , Choi YoungRok , You Tae , Suh Suk‐Won , Jang Ja June , Suh Kyung‐Suk
Published: March 2014

Non‐alcoholic fatty liver disease (NAFLD) affects a substantial proportion of the world population, and its prevalence has been increasing. The study was aimed at evaluating the prevalence and peri‐transplant risk factors for post‐liver transplantation (LT) NAFLD. A retrospective review was performed for adult recipients who underwent late protocol biopsy (>1 yr after LT) between August 2010 and December 2012. Hepatic steatosis was reviewed and graded by hepatopathologists, and the peri‐transplant factors were analyzed for relationships to histologically proven NAFLD. Total 166 biopsies had been performed in 156 recipients. NAFLD was present in 27.1% at a mean period of 35.4 months between LT and biopsy, moderate and severe steatosis (≥33%) consisted of 28.9%. In multivariate analysis, pre‐LT alcoholic cirrhosis (odds ratio [OR] 8.031, p = 0.003), obesity at biopsy (OR 3.873, p = 0.001), and preexisting donor graft steatosis (OR 3.147, p = 0.022) were significant risk factors for post‐LT NAFLD. In conclusion, NAFLD represented a considerable portion of recipients, but this prevalence was not higher than those for general population. Three risk factors were significantly related to post‐LT NAFLD, and recipients with those factors should be monitored for NAFLD. Furthermore, possible progression to non‐alcoholic steatohepatitis (NASH) or fibrosis and metabolic syndrome should be considered in future studies.
Risk of serious gastrointestinal bleeding in living kidney donors
Authors: Thomas Sonia M. , Lam Ngan N. , Huang Anjie , Nash Danielle M. , Prasad G. V. , Knoll Gregory A. , Koval John J. , Lentine Krista L. , Kim S. Joseph , Alam Ahsan , Lok Charmaine E. , Treleaven Darin J. , Garg Amit X. ,   the Donor Nephrectomy Outcomes Research (DONOR) Network
Published: March 2014

Individuals with moderate‐to‐severe reduced renal function have greater risk of gastrointestinal bleeding than those with normal renal function. We conducted a retrospective matched cohort study to assess whether living kidney donors share a similar risk. We reviewed pre‐donation charts for living kidney donations from 1992 to 2009 in Ontario, Canada, and linked this information to healthcare databases. We selected healthy non‐donors from the general population and matched ten non‐donors to every donor. Of the 2009 donors and 20 090 matched non‐donors, none had evidence of gastrointestinal bleeding prior to cohort entry. The cohort was followed for a median of 8.4 yr (maximum 19.7 yr; loss to follow‐up <7%). There was no significant difference in the rate of hospitalization with gastrointestinal bleeding in donors compared to non‐donors (18.5 vs. 14.9 events per 10 000 person‐years; rate ratio 1.24; 95% confidence interval [CI] 0.85–1.81). Similar results were obtained when we assessed the time to first hospitalization with gastrointestinal bleeding (hazard ratio 1.25, 95% CI 0.87–1.79). In conclusion, we found living kidney donation was not associated with a higher risk of hospitalization with gastrointestinal bleeding. These results are reassuring for the safety of the practice.
Histopathologic features of transplant glomerulopathy associated with response to therapy with intravenous immune globulin and rituximab
Authors: Kahwaji Joseph , Najjar Reiad , Kancherla Deepika , Villicana Rafael , Peng Alice , Jordan Stanley , Vo Ashley , Haas Mark
Published: March 2014

Transplant glomerulopathy (TG) is associated with poor long‐term allograft survival and is often accompanied by microcirculation inflammation. Histopathologic scoring may inform prognosis and help guide therapy. We retrospectively assessed 33 patients with biopsy‐proven TG. All biopsies were given a glomerulitis (g) and peritubular capillaritis (ptc) score. We determined allograft survival and serum creatinine stability in three different score groups: g < 2 and ≥ 2, ptc < 2 and ≥ 2, and (g + ptc) < 4 and ≥ 4. We assessed the impact of treatment with intravenous immune globulin (IVIG) and rituximab on outcomes. Graft survival and serum creatinine stability did not differ in each of the histopathologic score groups. Higher‐score groups were associated with the presence of concomitant antibody‐mediated rejection and were more likely to receive IVIG and rituximab. Treatment with IVIG and rituximab resulted in stability of serum creatinine within the higher‐score groups, but not in the lower‐score groups. Stabilization of serum creatinine was associated with an improvement in donor‐specific antibody. Histopathologic scoring in kidney allograft biopsies with TG may help guide treatment. The combination of IVIG and rituximab appears to be beneficial in patients whose biopsies have moderate or severe microvascular injury.
Genetic polymorphisms in IL‐2,IL‐10,TGF‐β1, and IL‐2RB and acute rejection in renal transplant patients
Authors: Chen Zhigang , Bouamar Rachida , Van schaik Ron H.N. , De Fijter Johan W. , Hartmann Anders , Zeier Martin , Budde Klemens , Kuypers Dirk R.J. , Weimar Willem , Hesselink Dennis A. , Van Gelder Teun
Published: March 2014

Acute rejection (AR) remains a concern for kidney transplantation. Cytokines are key mediators in the induction and effector phases of all immune and inflammatory responses. Single nucleotide polymorphisms (SNPs) in cytokines and their receptors may relate to AR. We investigated the relation between AR and SNPs in the genes encoding for IL‐2(–330G>T), IL‐10(−592C>A and −1082G>A), TGF‐β1(915G>C), and IL‐2RB(rs228942 C>A and rs228953 C>T) in 325 renal transplant patients during the first year after transplantation. The overall incidence of AR was 15.4%. In multivariate analysis, only the use of induction therapy was correlated with AR (odds ratio 1.9; 95% confidence interval 1.1–3.7; p = 0.04). No statistically significant associations between the SNPs studied and AR were observed. SNPs in the investigated cytokines and their receptors were not associated with the risk of AR. Genotyping patients for these SNPs is unlikely to aid the clinician in adjusting the immunosuppressive therapy for individual patients.