bluuebunny/crossref_metadata_2025 huggingface dataset:
Frequent exacerbators – a distinct phenotype of severe asthma
Authors: Kupczyk M. , ten Brinke A. , Sterk P. J. , Bel E. H. , Papi A. , Chanez P. , Nizankowska‐Mogilnicka E. , Gjomarkaj M. , Gaga M. , Brusselle G. , Dahlén B. , Dahlén S.‐E. ,   the BIOAIR investigators
Published: July 2013

Background

Exacerbations represent a major source of morbidity and mortality in asthma and are a prominent feature of poorly controlled, difficult‐to‐treat disease.

Objective

The goal of our study was to provide a detailed characterization of the frequent exacerbator phenotype and to identify risk factors associated with frequent and seasonal exacerbations.

Methods

Ninety‐three severe asthmatics (SA) and 76 mild‐to‐moderate patients (MA) were screened and prospectively followed up for 1 year (NCT00555607). Medical history, baseline clinical data and biomarkers were used to assess risk factors for frequent exacerbations.

Results

During the study, 104 exacerbations were recorded in the SA group and 18 in the MA. Frequent exacerbators were characterized by use of higher doses of inhaled (1700 vs. 800 μg) and oral (6.7 vs. 1.7 mg) glucocorticosteroids, worse asthma control (ACQ score 2.3 vs. 1.4), lower quality of life (SGRQ score 48.5 vs. 33.3), higher sputum eosinophils (25.7% vs. 8.2%) and a more rapid decline in FEV1/FVC ratio (−0.07 vs. −0.01 ΔFEV1/FVC, frequent vs. non‐frequent, respectively, P < 0.05). Exhaled NO > 45 p.p.b. and a history of smoking were associated with an increased risk of frequent exacerbations (odds ratios: 4.32 and 2.90 respectively).

Conclusion and Clinical Relevance

We were able to distinguish and characterize a subphenotype of asthma subjects – frequent exacerbators – who are significantly more prone to exacerbations. Patients with FeNO > 45 p.p.b. and a history of smoking are at increased risk of frequent exacerbations and require careful monitoring in clinical practice.
Novel B3GALTL mutations in classic Peters plus syndrome and lack of mutations in a large cohort of patients with similar phenotypes
Authors: Weh E. , Reis L.M. , Tyler R.C. , Bick D. , Rhead W.J. , Wallace S. , McGregor T.L. , Dills S.K. , Chao M.‐C. , Murray J.C. , Semina E.V.
Published: July 2013

Peters plus syndrome (PPS) is a rare autosomal‐recessive disorder characterized by Peters anomaly of the eye, short stature, brachydactyly, dysmorphic facial features, developmental delay, and variable other systemic abnormalities. In this report, we describe screening of 64 patients affected with PPS, isolated Peters anomaly and PPS‐like phenotypes. Mutations in the coding region of B3GALTL were identified in nine patients; six had a documented phenotype of classic PPS and the remaining three had a clinical diagnosis of PPS with incomplete clinical documentation. A total of nine different pathogenic alleles were identified. Five alleles are novel including one frameshift, c.168dupA, p.(Gly57Argfs*11), one nonsense, c.1234C>T, p.(Arg412*), two missense, c.1045G>A, p.(Asp349Asn) and c.1181G>A, p.(Gly394Glu), and one splicing, c.347+5G>T, mutations. Consistent with previous reports, the c.660+1G>A mutation was the most common mutation identified, seen in eight of the nine patients and accounting for 55% of pathogenic alleles in this study and 69% of all reported pathogenic alleles; while two patients were homozygous for this mutation, the majority had a second rare pathogenic allele. We also report the absence of B3GALTL mutations in 55 cases of PPS‐like phenotypes or isolated Peters anomaly, further establishing the strong association of B3GALTL mutations with classic PPS only.
Rehabilitation of Edentulous Mandibles by Means of Osseointegrated Implants: A 5‐Year Follow‐Up Study on One or Two‐Stage Surgery, Number of Implants, Implant Surfaces, and Age at Surgery
Authors: Friberg Bertil , Jemt Torsten
Published: July 2013

Background

In three former reports, the present team has presented the 1‐year outcome of four different treatment procedures handling the edentulous mandible; that is, two‐stage and one‐stage surgery with turned Brånemark System® (Nobel Biocare AB, Gothenburg, Sweden) implants (Group 1 and 2) and one‐stage surgery using either 5 or 4 TiUnite™ (Nobel Biocare AB, Gothenburg, Sweden) implants (Group 3 and 4).

Purpose

The aim of the present investigation was to follow up these patients for a period of 5 years with regard to implant/prosthesis cumulative survival rates, marginal bone loss calculations, clinical complications, and results related to age at surgery.

Materials and Methods

A total of 385 patients, provided with 1,838 implants, were originally included in the four patient groups. All patients received fixed prostheses. The overall majority of patients had each five implants placed. Radiographs were obtained at prosthesis delivery, at the 1 and 5‐year follow‐up.

Results

A total of 1,230 implants in 259 patients (67%) were possible to follow up for 5 years. Implant Cumulative Survival Rates (CSR) in 5 years for Groups 1–4 were 99.7, 97.0, 98.5, and 98.6%. The corresponding prosthesis treatment CSR was 100, 99.3, 98.5, and 98.6%, respectively. Significantly, more patients (p < .05) lost turned implants after one‐stage surgery (Group 2). Frequency distributions of implants revealed that >1.2 mm bone loss was observed around 75 implants (6.4%). The moderately rough central (midline) implant showed more bone loss than other placed implants (Group 3; p < .05). The youngest half of included patients at surgery (Youngest50%; n = 193) presented significantly higher mortality than older patients as well as compared to normal population (p < .05). Patients in the Younger50% group showed also an association to patients with complete loss of all implants and patients with most implants with obvious bone loss after 5 years.

Conclusions

All four treatment procedures served well during the 5 years of follow‐up and only eight patients (2.1%) were complete failures or showed obvious bone loss (>1.8 mm) at several implants (>2 implants), mostly observed in younger patients. The few complications in relation to implant failure and/or obvious bone loss could be associated to both local impact factors (surface, implant site, surgical protocol) as well as to host response factors (systemic health).
Osteoinductive and Osteopromotive Variability among Different Demineralized Bone Allografts
Authors: Wei Lingfei , Miron Richard J. , Shi Bin , Zhang Yufeng
Published: July 2013

Objective

The purpose of this investigation was to compare the osteoinductive and osteopromotive potential of two widely used demineralized freeze‐dried bone allografts (DFDBA) (Osteotech® DFDBA and LifeNet® DFDBA).

Material and Methods

Twenty‐seven male Wistar rats (mean body weight 200 g) were treated with either DFDBA from Osteotech and LifeNet or control for femoral and intramuscular defects and assigned to histological analysis at 2, 4, and 8 weeks postimplantation. Hematoxylin and eosin (H&E), Safranin‐O, tartrate‐resistant acid phosphatase (TRAP), and osteopontin (OPN) staining were performed. Quantitative analysis of mineralized new bone to total volume (BV/TV) was assessed by micro‐computed tomography.

Results

Both allografts demonstrated osteoinductive potential at 2 weeks as assessed by intramuscular bone formation. LifeNet DFDBA displayed continual new bone formation at 4 and 8 weeks, whereas Osteotech particles were fully resorbed by 4 weeks postimplantation. Femur defects demonstrated significantly greater BV/TV at 4 and 8 weeks with higher expression of OPN staining around LifeNet DFDBA particles. TRAP‐positive cells were visible in and around both allograft materials.

Conclusion

The results from the present study indicate that variability among allografts exists. In the present, LifeNet DFDBA supported more new bone formation. Further larger animal models or clinical trials are required to validate these findings.
Correlation between the Bone Density Recorded by a Computerized Implant Motor and by a Histomorphometric Analysis: A Preliminary In Vitro Study on Bovine Ribs
Authors: Iezzi Giovanna , Scarano Antonio , Di Stefano Danilo , Arosio Paolo , Doi Kazuya , Ricci Laura , Piattelli Adriano , Perrotti Vittoria
Published: July 2013

Purpose

The purpose of the present preliminary in vitro study on bovine ribs was to validate a new intraoperative site‐specific classification of bone Density Index (IDI), obtained by an innovative computerized implant motor, by correlating these data with the data obtained by the histomorphometrical evaluation of the same samples.

Materials and Methods

Five segments of bovine ribs were used, and a total of 22 perforations were performed. A computerized implant motor (“Torque Measuring Motor”) was used to evaluate the bone density, which was classified into four classes: ID1, ID2, ID3, and ID4. Histomorphometrical analysis of bone density, expressed as percentage of bony trabeculae over the total biopsy area, was also performed. The data of bone density obtained by the implant motor were statistically correlated with the histomorphometrical results.

Results

A significant positive correlation was found between the bone density measured by the implant motor and the bone density assessed by histomorphometry (r = 0.89, p < .0001). Moreover, a significant positive correlation in D1, D2, and D4, whereas a negative, not significant correlation in D3 was found.

Conclusion

Within the limitations of this in vitro study, the intraoperative site‐specific classification of bone density, obtained with this innovative system, could be helpful for the clinician to tailor the surgical protocol to the different situations in implant dentistry.
Whole body, regional fat accumulation, and appetite‐related hormonal response after hypoxic training
Authors: Morishima Takuma , Kurihara Toshiyuki , Hamaoka Takafumi , Goto Kazushige
Published: July 2013

The present study was conducted to determine change in regional fat accumulation and appetite‐related hormonal response following hypoxic training. Twenty sedentary subjects underwent hypoxic (n = 9, HYPO, FiO2 = 15%) or normoxic training (n = 11, NOR, FiO2 = 20·9%) during a 4‐week period (3 days per week). They performed a 4‐week training at 55% of maximal oxygen uptake (O2max) for each condition. Before and after the training period, O2max, whole body fat mass, abdominal fat area, intramyocellular lipid content (IMCL), fasting and postprandial appetite‐related hormonal responses were determined. Both groups showed a significant increase in O2max following training (P<0·05). Whole body and segmental fat mass, abdominal fat area, IMCL did not change in either group. Fasting glucose and insulin concentrations significantly reduced in both groups (P<0·05). Although area under the curve for the postprandial blood glucose concentrations significantly decreased in both groups (P<0·05), the change was significantly greater in the HYPO group than in the NOR group (P<0·05). Changes in postprandial plasma ghrelin were similar in both groups. A significant reduction of postprandial leptin response was observed in both groups (P<0·05), while postprandial glucagon‐like peptide‐1 (GLP‐1) concentrations increased significantly in the NOR group only (P<0·05). In conclusion, hypoxic training for 4 weeks resulted in greater improvement in glucose tolerance without loss of whole body fat mass, abdominal fat area or IMCL. However, hypoxic training did not have synergistic effect on the regulation of appetite‐related hormones.
Validity and reliability of an ultrasound system for estimating adipose tissue
Authors: Loenneke Jeremy P. , Barnes Jeremy T. , Wagganer Jason D. , Wilson Jacob M. , Lowery Ryan P. , Green Cody E. , Pujol Thomas J.
Published: July 2013

When health professionals measure the fitness levels of clients, body composition is usually estimated. In field settings, body composition is commonly estimated with skinfolds or bioelectrical impedance analysis. Recently, a portable ultrasound device has been manufactured to estimate what percentage of body mass is composed of adipose tissue (AT%). A reported advantage of using ultrasound is that inter‐ and intrarater variations may be minimized when compared with the skinfold technique. Therefore, the purpose of this pilot study was twofold; 1) to determine the validity of a portable ultrasound device compared with skinfolds and 2) determine the reliability of the portable ultrasound device. Participants had their measurements taken in the following order: urine specific gravity, body mass, height, skinfolds and ultrasound determined. Participants had their urine specific gravity and ultrasound determined AT% estimates measured again 48 h later. The current pilot study found that the ultrasound was not a valid estimate of AT% when compared with the skinfold estimate (TE > 4%). In addition, the 1‐site estimate from the ultrasound was more reliable than the 3‐site estimate of AT%. These data are of importance to practitioners because it demonstrates that while the ultrasound is not a valid estimate compared with skinfolds, the 1‐site estimate may be able to track changes in AT% over time, making the ultrasound an option for assessing changes in body composition.
The effect of donor‐recipient gender mismatch on short‐ and long‐term graft survival in kidney transplantation: a systematic review and meta‐analysis
Authors: Zhou Jing‐Yi , Cheng Jun , Huang Hong‐Feng , Shen Yi , Jiang Yan , Chen Jiang‐Hua
Published: July 2013

Background

There is no limitation of gender matching in renal transplantation. This study was intended to evaluate its effect on short‐ and long‐term graft survival.

Methods

PubMed, the Web of Knowledge, Medline, the Cochrane Library, and two additional Chinese databases were searched. The data were then abstracted and meta‐analyzed.

Results

14 studies involving 445 279 patients were included. Each study reported data on the four gender matches (male donor‐male recipient, MDMR; male donor‐female recipient, MDFR; female donor‐male recipient, FDMR; female donor‐female recipient, FDFR). The pooled risk ratios (RRs) for 0.5‐, 1‐, 2‐, 3‐, 5‐, and 10‐yr graft survival rates showed that the FDMR group had the worst outcomes, and when recipients were female, short‐term graft survival was worse, but long‐term graft survival was better. The differences between groups changed with time.

Conclusions

FDMR patients showed poor graft survival. The female recipients had worse short‐term graft survival but the best long‐term graft survival. This study introduces an important consideration into donor‐recipient matching in renal transplantation.
Cutaneous side effects of combined therapy with sorafenib and pegylated interferon alpha‐2b in metastatic melanoma (phase II DeCOG trial)
Authors: Degen Annette , Weichenthal Michael , Ugurel Selma , Trefzer Uwe , Kilian Katharina , Garbe Claus , Egberts Friederike , Poppe Lìdia Marilia , Hauschild Axel , Gutzmer Ralf
Published: July 2013

Background and objectives

During a clinical study with combined therapy of sorafenib and pegylated interferon alpha‐2b (SoraPeg study) of the German Dermatologic Oncology Group (ADO/DeCOG), multiple and severe cutaneous side effects were observed. This study sought to analyze these cutaneous side effects, particularly because future studies with combinations of interferon alpha and targeted therapies are planned.

Patients and methods

In a multicenter phase‐II‐DeCOG study (NCT00623402) in 10 dermato‐oncology centers, 55 patients with metastatic melanoma received a combination of sorafenib (2 x 400 mg/day orally) and pegylated interferon alpha‐2b (3 μg/kg body weight 1 x/week subcutaneously). All cutaneous side effects were documented.

Results

Forty‐one patients (74.5 %) developed cutaneous side effects, particularly exanthems (51.2 %), hand‐foot syndrome (36.5 %), alopecia (36.5 %) and pruritus (24.4 %). Due to the cutaneous side effects, dose reductions were required in 10 patients, interruption of therapy in 10 cases and permanent discontinuation of therapy and in one patient with extensive follicular‐cystic lesions. Exanthems were seen more frequently in women (76.2 %) than in men (23.8 %). The occurrence of cutaneous side effects was not correlated with clinical outcome or prognosis.

Conclusions

The combination of sorafenib/pegylated interferon alpha‐2b caused more cutaneous side effects than have been reported for single agents. Despite intensive dermatologic management of the cutaneous side effects 24 % of patients required a dose modification.
Rapid hippocampal network adaptation to recurring synchronous activity – a role for calcineurin
Authors: Casanova J. R. , Nishimura M. , Le J. , Lam T. T. , Swann J. W.
Published: July 2013

Neuronal networks are thought to gradually adapt to altered neuronal activity over many hours and days. For instance, when activity is increased by suppressing synaptic inhibition, excitatory synaptic transmission is reduced. The underlying compensatory cellular and molecular mechanisms are thought to contribute in important ways to maintaining normal network operations. Seizures, due to their massive and highly synchronised discharging, probably challenge the adaptive properties of neurons, especially when seizures are frequent and intense – a condition common in early childhood. In the experiments reported here, we used rat and mice hippocampal slice cultures to explore the effects that recurring seizure‐like activity has on the developing hippocampus. We found that developing networks adapted rapidly to recurring synchronised activity in that the duration of seizure‐like events was reduced by 42% after 4 h of activity. At the same time, the frequency of spontaneous excitatory postsynaptic currents in pyramidal cells, the expression of biochemical biomarkers for glutamatergic synapses and the branching of pyramidal cell dendrites were all dramatically reduced. Experiments also showed that the reduction in N‐methyl‐D‐aspartate receptor subunits and postsynaptic density protein 95 expression were N‐methyl‐D‐aspartate receptor‐dependent. To explore calcium signaling mechanisms in network adaptation, we tested inhibitors of calcineurin, a protein phosphatase known to play roles in synaptic plasticity and activity‐dependent dendrite remodeling. We found that FK506 was able to prevent all of the electrophysiological, biochemical, and anatomical changes produced by synchronised network activity. Our results show that hippocampal pyramidal cells and their networks adapt rapidly to intense synchronised activity and that calcineurin play an important role in the underlying processes.
Expression of cyclo‐oxygenases‐1 and ‐2, and microsomal prostaglandin E synthase‐1 in penile and preputial papillomas and squamous cell carcinomas in the horse
Authors: van den Top J. G. B. , Harkema L. , Ensink J. M. , Barneveld A. , Martens A. , van de Lest C. H. A. , van Weeren P. R. , Gröne A.
Published: July 2013

Reasons for performing study

Penile and preputial papilloma and squamous cell carcinoma (SCC) are commonly diagnosed in horses. Papillomas have the potential to progress to potentially lethal SCC. Knowledge of pathogenetic mechanisms may help in prevention and definition of treatment targets.

Study design

Retrospective study using archived material.

Objectives

To determine the expression of cyclo‐oxygenase 1 (COX‐1), cyclo‐oxygenase 2 (COX‐2) and microsomal prostaglandin E synthase‐1 (mPGES‐1) in penile and preputial normal tissue, papilloma and SCC in horses, and whether expression of these enzymes is influenced by degree of inflammation and differentiation grade.

Methods

Tumour differentiation grade, degree of inflammation and COX‐1, COX‐2 and mPGES‐1 expression in 75 formalin‐fixed paraffin embedded samples of penile and preputial papilloma and SCC of 68 horses were investigated by histopathology and immunohistochemistry.

Results

Inflammation was more prominent in SCC compared with papilloma. No correlation between expression of COX‐1 or COX‐2 and inflammation was found. Expression of mPGES‐1 was weakly correlated with inflammation. Expression of COX‐1, COX‐2 and mPGES‐1 was found in 42.6%, 50.7% and 96.0% of lesions respectively, but less than 1% of cells were immunopositive for COX‐1 and COX‐2 in 59.4% and 84.2% of cases respectively. Expression of COX‐1 was moderately negatively correlated with differentiation grade, COX‐2 was not correlated and mPGES‐1 was poorly negatively correlated.

Conclusions

Expression of COX‐1 and COX‐2 in penile and preputial SCC in the horse is poor and COX inhibitors may thus be of little value for prevention or treatment. Microsomal PGES‐1 is more prominently expressed in well‐differentiated tissue compared with poorly differentiated tissue. Further research on the role of mPGES‐1 in carcinogenesis is needed to assess its potential use as a treatment target. Knowledge of arachidonic pathway enzyme expression and their role in equine penile and preputial carcinogenesis may help in developing preventive and therapeutic strategies.
ModulatoryATPbinding to the E2 state of maize plasma membrane H+‐ATPase indicated by the kinetics of vanadate inhibition
Authors: Wang Xiaozhi , Qian Xiaoqing , Stumpf Beate , Fatima Ammara , Feng Ke , Schubert Sven , Hanstein Stefan
Published: July 2013

P‐typeATPases, as major consumers of cellularATPin eukaryotic cells, are characterized by the formation of a phosphorylated enzyme intermediate (E2P), a process that is allosterically coupled to translocation of cations against an electrochemical gradient. The catalytic cycle comprises binding of Mg‐ATPat the nucleotide‐binding domain, phosphorylation of the E1 state (E1), conformational transition to the E2P state, and dephosphorylation through the actuator domain and re‐establishment of the E1 state. Recently, it has been suggested that, for several P‐typeATPases, Mg‐ATPbinds to the phosphorylated enzyme, thereby accelerating the transition to the E1 state, before then becoming the enzyme's catalytic substrate. Here, we provide evidence supporting this viewpoint. We employed kinetic models based on steady‐state kinetics in the presence and absence of the reversible inhibitor orthovanadate. Vanadate is generally considered to be a conformational probe that specifically binds to the E2 state, arresting the enzyme in a state analogous to the E2P state. Hydrolytic H+‐ATPase activities were measured in inside‐out plasma membrane vesicles isolated from roots and shoots of maize plants. For root enzymes, kinetic models of vanadate inhibition that allow simultaneous binding of Mg‐ATPand vanadate to the same enzyme state were most plausible. For shoot enzymes, application of the competitive inhibitor Mg‐freeATPattenuated vanadate inhibition, which is consistent with a model in which either Mg‐freeATPor Mg‐ATPis bound to the enzyme when vanadate binds. Therefore, data from roots and shoots indicate that binding ofATPspecies before transition to the E1 state plays an important role in the catalytic cycle of plant plasma membrane H+‐ATPase.
Geology, fluid inclusion, and isotope constraints on ore genesis of the Neoproterozoic Jinshan orogenic gold deposit, South China
Authors: Zhao C. , Ni P. , Wang G.‐G. , Ding J.‐Y. , Chen H. , Zhao K.‐D. , Cai Y.‐T. , Xu Y.‐F.
Published: July 2013

The Jinshan gold deposit is located in the Neoproterozoic Jiangnan orogen between the Yangtze and Cathaysia blocks. Gold‐bearing disseminated ores are associated with the earlier stage of NWW‐trending ductile zone, and auriferous quartz vein‐type ores show an intimate relationship with the later stage of NE‐trending brittle‐ductile zones. Fluid‐inclusion studies were conducted on the quartz veins. Three types of fluid inclusions can be identified: H2O–CO2 inclusions (type I), CO2‐rich inclusions (type II), and aqueous inclusions (type III). The pre‐ore stage, quartz‐pyrite veins primarily contain type I inclusions with constant CO2 bubble volumetric proportions. The main gold mineralization‐stage veins have all three types of inclusions with variable gas‐phase ratios and CO2 contents. The post‐ore stage carbonate±chlorite veinlets only contain type III inclusions. Type I inclusions in the pre‐ore stage display homogenization temperatures (Th) of 285–340°C, with salinities of 1.4–6.1 wt.% NaCl equivalent. In the main gold mineralization stage, type II and III inclusions show similar Th at 208–277°C, but contrasting salinity values with 0.6–3.6 and 3.5–8.9 wt.% NaCl equivalent, and type I inclusions show variable CO2‐phase proportions and have Th of 241–292°C and salinities of 1.0–7.0 wt.% NaCl equivalent. In the post‐ore stage, type III inclusions yield Th of 109–201°C and salinities of 1.1–6.4 wt.% NaCl equivalent. Petrological observations and microthermometric results show that fluid immiscibility primarily occurred during the gold mineralization stages. The oxygen and hydrogen isotope compositions (δ18 O = +6.9‰ to +11.2‰, δD = −71‰ to −46‰) of inclusion water in quartz grains imply that ore fluids were principally metamorphic in origin. The sulfur and lead values of sulfide from the ores are analogous to those from the basement strata, suggesting a predominantly crustal source of the ore sulfides. The Jinshan deposit is a typical orogenic gold deposit.
Dose–response meta‐analysis on coffee, tea and caffeine consumption with risk of Parkinson's disease
Authors: Qi Hui , Li Shixue
Published: July 2013

Aims

A dose–response meta‐analysis was carried out between Parkinson's disease (PD) risk, and coffee, tea and caffeine consumption.

Methods

A comprehensive search was carried out to identify eligible studies. The fixed or random effect model was used based on heterogeneity test. The dose–response relationship was assessed by restricted cubic spline.

Results

A total of 13 articles involving 901 764 participants for coffee, eight articles involving 344 895 participants for tea and seven articles involving 492 724 participants for caffeine were included. A non‐linear relationship was found between coffee consumption and PD risk overall, and the strength of protection reached the maximum at approximately 3 cups/day (smoking‐adjusted relative risk: 0.72, 95% confidence interval 0.65–0.81). A linear relationship was found between tea and caffeine consumption, and PD risk overall, and the smoking‐adjusted risk of PD decreased by 26% and 17% for every two cups/day and 200 mg/day increments, respectively. The association of coffee and tea consumption with PD risk was stronger for men than that for women, and the association of caffeine consumption with PD risk was stronger for ever users of hormones than that for never users of hormones among postmenopausal women. The aforementioned associations were weaker for USA relative to Europe or Asia.

Conclusions

A linear dose‐relationship for decreased PD risk with tea and caffeine consumption was found, whereas the strength of protection reached a maximum at approximately 3 cups/day for coffee consumption overall. Further studies are required to confirm the findings. Geriatr Gerontol Int 2014; 14: 430–439.
Examination of Unmet Treatment Needs Among Persons With Episodic Migraine: Results of the American Migraine Prevalence and Prevention (AMPP) Study
Authors: Lipton Richard B. , Buse Dawn C. , Serrano Daniel , Holland Starr , Reed Michael L.
Published: July 2013

Background

Despite the expanding therapeutic armamentarium, many people with episodic migraine (EM) have unmet acute treatment needs.

Objective

To determine the relative frequency of prespecified types of “unmet treatment needs” in persons with EM in a US population‐based sample.

Methods

Eligible participants completed the 2009 American Migraine Prevalence and Prevention Study survey and met International Classification of Headache Disorders‐2nd edition (ICHD‐2) criteria for migraine with an average headache day frequency of <15 days per month (EM). We identified 5 domains of unmet treatment needs: (1) dissatisfaction with current acute treatment using 3 summary items from the Patient Perception of Migraine Questionnaire‐revised edition (PPMQ‐R); (2) moderate or severe headache‐related disability defined by a Migraine Disability Assessment Scale score of ≥11; (3) excessive use of opioids or barbiturates defined as use on ≥4 days/month or by meeting Diagnostic and Statistical Manual for Mental Disorders‐4th edition criteria for dependence; (4) recurrent use of the emergency department or urgent care clinic for headache defined by ≥2 visits in the preceding year for headache; and (5) history of cardiovascular events indicating a possible contraindication to triptan use. For each respondent, we identified their unmet treatment needs in each category and classified them as having no unmet needs or 1 or more unmet needs.

Results

Of 5591 respondents with EM, 2274 (40.7%) had 1 or more unmet needs; 1467 (26.2%) had exactly 1 unmet need, and 807 (14.4%) had 2 or more unmet needs. Among those with at least 1 unmet need, 1069 (47.0%) had moderate or severe headache‐related disability, 851 (37.4%) were dissatisfied with their acute treatment regimen, 728 (32.0%) had excessive opioid or barbiturate use and/or probable dependence, 595 (26.2%) had a history of cardiovascular events, and 129 (5.7%) reported ≥2 visits in the preceding year to the emergency department/urgent care clinic for headache. Persons with more headache days, depression, or generalized anxiety were more likely to have unmet treatment needs.

Conclusion

In a population sample of individuals with EM, more than 40% have at least 1 unmet need in the area of acute treatment. The leading reasons for unmet needs, which include headache‐related disability and dissatisfaction with current acute treatment, suggest opportunities for improving outcomes for persons with EM.
Clinical profile of primary biliary cirrhosis with features of autoimmune hepatitis: Importance of corticosteroid therapy
Authors: Yoshioka Youko , Taniai Makiko , Hashimoto Etsuko , Haruta Ikuko , Shiratori Keiko
Published: July 2013

Aim

The aim of this study was to elucidate the clinical and histological features, response to corticosteroid therapy and long‐term outcome of primary biliary cirrhosis (PBC) with features of autoimmune hepatitis (AIH).

Methods

Among 280 PBC patients under ursodeoxycholic acid administration, we identified 28 patients with AIH features fulfilling the following criteria: sustained high levels of serum aminotransferases and high immunoglobulin G levels with positivity for antinuclear antibodies or anti‐smooth muscle antibodies (ASMA) and/or histological features of moderate to severe interface hepatitis or moderate to severe lobular hepatitis. We analyzed PBC patients with AIH features, focusing mainly on therapeutic responses to corticosteroids.

Results

Patients with PBC with AIH features included 26 women (93%). Their median age was 55 years, and the median follow‐up period was 7.5 years. Eight of these 28 patients were not actually treated with corticosteroids due to medical conditions. Among the 20 patients receiving corticosteroid therapy, 15 were responders and five were non‐responders. A high alkaline phosphatase (ALP) level, negativity for ASMA and positivity for gp210 were identified as risk factors for lack of a response to corticosteroid therapy. Among 28 PBC patients with AIH features, the responders to corticosteroids had an excellent prognosis, while those who could not be treated with corticosteroids and non‐responders to corticosteroids had a poor outcome.

Conclusion

Patients with PBC with AIH features benefit from corticosteroid therapy. Features of PBC such as high ALP level, negativity for ASMA and positivity for gp210 appear to predict a poor response to corticosteroids.
Do patients with mild to moderate psoriasis really have a sedentary lifestyle?
Authors: Demirel Reha , Genc Abdurrahman , Ucok Kagan , Kacar Seval Dogruk , Ozuguz Pinar , Toktas Muhsin , Sener Umit , Karabacak Hatice , Karaca Semsettin
Published: July 2013

The aim of this study was to compare aerobic exercise capacity, daily physical activity, pulmonary functions, resting metabolic rate, and body composition parameters in patients with psoriasis and healthy controls. A total of 60 participants (30 [15 men, 15 women] patients with psoriasis, and 30 [15 men, 15 women] healthy controls) ranging in age from 22–57 were included in the study. Maximal aerobic capacity was determined by Astrand exercise protocol. Daily physical activity was measured with an accelerometer. Resting metabolic rate was determined with an indirect calorimeter. Pulmonary function tests were performed with a portable spirometer. Body composition was established with a bioelectric impedance analysis system. Skinfold thicknesses and body circumference measurements were carried out. Short Form 36 quality of life questionnaire was applied to all participants. In both genders, daily physical activity parameters were found to be higher in the psoriasis group compared to the control. Maximal aerobic capacity, resting metabolic rate, pulmonary function tests, body fatness, body fat distributions, and quality of life were not statistically different between patients with psoriasis and controls in males and females. We suggest that patients with psoriasis who do not have psoriatic arthritis or severe psoriasis are well in performing daily physical activities. In addition, we suggest that this lifestyle helped to prevent impairments of body fatness, body fat distributions, resting metabolic rate, pulmonary functions, and quality of life in patients with mild to moderate psoriasis.
Comparison of analytical methods for measuring proanthocyanidins in wines and their relationship with perceived astringency
Authors: Cáceres‐Mella Alejandro , Peña‐Neira Álvaro , Narváez‐Bastias Jaime , Jara‐Campos Carla , López‐Solís Remigio , Canals Joan M.
Published: July 2013

The concentration of proanthocyanidins from twenty red wines from cv. Cabernet Sauvignon, five rosé wines from cv. Cabernet Sauvignon and five white wines from cv. Sauvignon Blanc was quantified using four analytical methodologies, and their relationship with the perceived astringency was investigated. Proanthocyanidin concentrations were determined by a methylcellulose precipitation assay, a protein precipitation assay and two colourimetric methods (Bate‐Smith and vanillin assay). The four methodologies showed high repeatability but differed widely in proanthocyanidin concentrations. The methylcellulose and protein precipitation assays could not quantify proanthocyanidins in rosé and white wines. The protein precipitation assay gave the lowest concentration of proanthocyanidins in all of the red wines. The methylcellulose precipitation assay (r = 0.7725; r2 = 0.59) and the protein precipitation assay (r = 0.6828; r2 = 0.47) showed a strong correlation with the perceived astringency compared with the colourimetric methods. The strong correlation of the methylcellulose precipitation method with the perceived astringency could be a useful tool to estimate red wine astringency.
Effect of durum wheat varieties on bread quality
Authors: Mastromatteo Marcella , Danza Alessandra , Lecce Lucia , Spinelli Sara , Lampignano Vincenzo , Laverse Janine , Contò Francesco , Del Nobile Matteo Alessandro
Published: July 2013

In this study, the effect of different durum wheat varieties on the sensorial and nutritional quality of bread was assessed. In particular, bread manufactured with six wheat cultivars was compared with bread based on commercial semolina mixtures. X‐ray microtomography was used to characterise the final cellular structure of the baked bread. The textural properties of baked bread and doughs were also investigated. In addition, the glucose equivalent (GE) of bread was also evaluated. Finally, the microstructural, sensorial and textural parameters were correlated with each other. Results highlighted that Cappelli and Saragolla bread samples showed higher protein and total soluble fibre content, respectively, in comparison with the reference samples. Moreover, the GE of the Cappelli, Claudio and Saragolla bread samples was similar to that of the reference samples and lower than that of the other samples. However, the sensorial properties of all bread samples showed a very positive score (up to 7.7).
Life after Stroke – is Palliative Care Relevant?
Authors: Mead Gillian E. , Cowey Eileen , Murray Scott A.
Published: July 2013

Only about 50% of people who have a stroke survive to five-years. Clinicians should identify those most at risk of dying, and gradually integrate palliative care. Such holistic and anticipatory care will be of benefit to patients and their family carers; should reduce futile treatments, medications, or unsuccessful resuscitation attempts; and help more people die how and where they choose. Research is exploring how best to provide palliative and end-of-life care in acute stroke units, but how best to improve holistic, ongoing care in the community is poorly understood. The concept of fluctuating illness trajectories might help clinicians meet the multidimensional needs of stroke survivors at different time points. ‘Illness trajectory’ research in cancer has suggested that social decline mirrors the physical decline, while psychological and existential distress tended to be most acute at diagnosis, returning home after treatment, disease recurrence, and in the last days. Further research is needed to explore how best to provide palliative care at different stages of the ‘stroke journey’, and the nature of illness trajectories after stroke.
Zum Vergleich der Leberläppchentypen einschließlich des RAPPAPORTschen Acinus beim Schwein
Authors: WÜNSCHE ANITA
Published: July 2013

Having isolated (Wünsche, 1982) the three‐dimensional shape of the classical central vein lobules of Kiernan (1833) in the pig's liver, the ink‐injected lobular branches of the portal vein were investigated. The findings agree with the notion that the perilobular connective tissue septa break up the lobule. Inter‐ and intraspecific comparisons of these lobules with those of the other three types (bile lobule of Sabourin, 1882; portal vein lobule of Mall, 1906; and terminal branch lobule of Rappaport, 1954) show the equivalence of shape, function and supply of all four types, demonstrated on cross sections of central vein lobules.

Alle 4 Leberläppchentypen (Zentralvenen‐, Gallen‐, Portal‐ und Endastläppchen) sind beim Schwein in doppelter Weise als Form‐, Funktions‐ und Versorgungseinheiten vorhanden. In basalen Bereichen von zusammengesetzten Läppchen liegt eine direkte Vergleichbarkeit mit den anderen Spezies vor. In den Bereichen mit ausgebildeten Bindegewebsscheidewänden wird das Zentralvenenläppchen besonders deutlich, während die anderen 3 Läppchentypen durch das Bindegewebe in 3 (Gallen‐ und Portalläppchen) oder 2 (Endastläppchen) Läppchenteile zerschlagen werden. Beim Endastläppchen kommt im Bereich der Bindegewebsscheidewand eine starke Variabilität der Rr. terminales als versorgende Endäste hinzu. Diese Variabilität steht mit dem mechanischen Einfluß des Bindegewebes auf die Zentralvenenläppchen der Schweineleber im Einklang. Von einer pathologisch‐abnormen oder atypischen Form der Schweineleber kann keine Rede sein.

Sur la comparaison des unités structurales du Foie, dont l'Acinus de RAPPAPORT, chez le Porc

Les quatre types d'unités structurales hépatiques (lobule hexagonal — à veine centrale —, unité biliaire, unité portale et unité des rameaux vasculaires terminaux) sont présents chez le Porc, sous le double aspect d'emités morpho‐fonctionnelles et d'entités vasculaires. Dans les régions basales des lobules adjacents, une comparaison directe est possible avec les autres espèces. Dans les zones pourvues de cloisons conjonctives importantes, le lobules hexagonal, à veine centrale, est particulièrement évident, alors que les trois autres unités structurales se trouvent réduites par l'élément conjonctif, en simples territoires lobulaires, au nombre, soit de 3 (avec l'unité biliaire et l'unité portale) soit de 2 (avec l'unité des rameaux vasculaires terminaux). Dans cette dernière unité, on note en outre, au niveau de la cloison conjonctive, une forte variabilité des rameaux afférents terminaux. Cette variabilité est en rapport avec l'influence mécanique du tissu conjonctif sur les lobules hexagonaux. Toute éventualité de déformation pathologique ou de forme atypique se trouve écartée.
Chlorhexidine solutions in histological and histochemical techniques1
Authors: HEYDEN GUY , ARWILL TORE , LILJA JAN , MAGNUSSON BENGT C.
Published: July 2013

Abstract. Chlorhexidine solutions have been tested to determine their usefulness as media for the transport of biopsy specimens for diagnosis in order to facilitate the use of cold microtome sectioning and enzyme histochemical techniques in routine histopathological diagnostic practice. The drug was chosen for its antibacterial and protein “preserving” capacities. Tissue morphology, chemical components and enzyme activities were found to be retained well in specimens from human gingiva when stored in a cold solution, pH 7.2, containing 2.2 mM chlorhexidine gluconate, 0.19 M cacodylate buffer and 7.5 % polyvinylpyrrolidone. The procedure allowed reliable enzyme activity evaluations to be performed under the light microscope within 48 hours after excision of the tissues. Fresh frozen tissues served as controls. In an additional electron microscopic study, morphology of the cells was found to be reasonably well preserved after transport in the solution.
Effect of aging on the marmoset periodontium
Authors: LEVY BARNET M. , DREIZEN SAMUEL , BERNICK SOL
Published: July 2013

The periodontium of old marmosets is characterized by a narrow, serrated cribriform plate of alveolar bone, a loss of tinctorial identification of Sharpey's fibers and a decrease in the cellular elements of the periodontal ligament. The attachment fibers are frequently calcified. In contrast to the blue periodontal ligament and pink alveolar bone in alcian blue‐PAS stained sections of adult marmosets, the periodontal ligament stains pink and the alveolar bone deep red in old animals. Aged marmosets also have degenerative changes in the periodontal vasculature not seen in younger adults. The changes are similar to those described in aged human periodontal tissues.
Cloud Computing in Support of Supply Chain Information System Infrastructure: Understanding When to go to the Cloud
Authors: Wu Yun , Cegielski Casey G. , Hazen Benjamin T. , Hall Dianne J.
Published: July 2013

Research suggests that there are other, more granular factors within the domain of innovation diffusion theory that influence the adoption of technological innovations. In this study, the circumstances that affect a firm's intention to adopt cloud computing technologies in support of its supply chain operations are investigated by considering tenets of classical diffusion theory as framed within the context of the information processing view. We posit that various aspects of an organization and its respective environment represent both information processing requirements and capacity, which influence the firm's desire to adopt certain information technology innovations. We conducted an empirical study using a survey method and regression analysis to examine our theoretical model. The results suggest that business process complexity, entrepreneurial culture and the degree to which existing information systems embody compatibility and application functionality significantly affect a firm's propensity to adopt cloud computing technologies. The findings support our theoretical development and suggest complementarities between innovation diffusion theory and the information processing view. We encourage other scholars to refine our model in future supply chain innovation diffusion research. The findings of this study might also be used by industry professionals to aid in making more informed adoption decisions in regard to cloud computing technologies in support of the supply chain.
The Identification of Acute Stroke: An Analysis of Emergency Calls
Authors: Jones Stephanie P. , Carter Bernie , Ford Gary A. , Gibson Josephine M. E. , Leathley Michael J. , McAdam Joanna J. , O'Donnell Mark , Punekar Shuja , Quinn Tom , Watkins Caroline L.
Published: July 2013

Background

Accurate dispatch of emergency medical services at the onset of acute stroke is vital in expediting assessment and treatment. We examined the relationship between callers' description of potential stroke symptoms to the emergency medical dispatcher and the subsequent classification and prioritisation of emergency medical services response.

Aim

To identify key ‘indicator’ words used by people making emergency calls for suspected stroke, comparing these with the subsequent category of response given by the emergency medical dispatcher.

Method

A retrospective chart review (hospital and emergency medical services) in North West England (October 1, 2006 to September 30, 2007) identified digitally recorded emergency medical services calls, which related to patients who had a diagnosis of suspected stroke at some point on the stroke pathway (from the emergency medical services call taker through to final medical diagnosis). Using content analysis, words used to describe stroke by the caller were recorded. A second researcher independently followed the same procedure in order to produce a list of ‘indicator’ words. Description of stroke-specific and nonstroke-specific problems reported by the caller was compared with subsequent emergency medical services dispatch coding and demographic features.

Results

Six hundred forty-three calls were made to emergency medical services of which 592 (92%) had complete emergency medical services and hospital data. The majority of callers were female (67%) and family members (55%). The most frequently reported problems first said by callers to the emergency medical dispatcher were collapse or fall (26%) and stroke (25%). Callers who identified that the patient was having a stroke were correct in 89% of cases. Calls were dispatched as stroke in 45% of cases, of which 83% had confirmed stroke. Of the first reported problems, Face Arm Speech Test stroke symptoms were mentioned in less than 5% of calls, with speech problems being the most common symptom. No callers mentioned all three Face Arm Speech Test symptoms.

Conclusion

Callers who contacted emergency medical services for suspected stroke and said stroke as the first reported problem were often correct. Calls categorised as stroke by the emergency medical dispatcher were commonly confirmed as stroke in the hospital. Speech problems were the most commonly reported element of the Face Arm Speech Test test to be reported by callers. Recognition of possible stroke diagnosis in fall and other presentations should be considered by emergency medical dispatchers. Further development and training are needed in the community to improve prehospital stroke recognition in order to expedite hyperacute stroke care.
Corporations and Non‐Agential Moral Responsibility
Authors: Dempsey James
Published: July 2013

Abstract 

One of the core challenges presented by ascriptions of moral responsibility to corporations is to identify who or what is being held responsible. A significant source of controversy in attempts to answer this challenge is whether or not responsibility can fall on a ‘corporate entity’ distinct from the individuals that make it up. In this article I argue that both sides of this debate have incorrectly assumed that the possession of moral agency is a necessary condition for holding moral responsibility. I go on to argue that it is sufficient for a corporate entity to be a ‘morally significant system’, that is a non‐agential system created by moral agents, and I develop an account of such systems. I conclude by setting out the implications of this analysis for our practices of holding corporations morally responsible.