bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sparing of the Second Lumbrical in a Riche–Cannieu Anastomosis
Authors: Brown Joseph V. , Landau Mark E. 
Published: May 2013

Abstract
The Riche–Cannieu anastomosis (RCA) is an anatomic variant wherein a deep branch of the distal ulnar nerve innervates muscles of the thenar eminence. A few cases in the literature describe an “all-ulnar hand” when the muscles of the thenar eminence get innervation solely from the ulnar nerve without any contribution from the median nerve. Clinically, patients with ulnar mononeuropathies in the setting of an RCA would also have weakness/atrophy of thenar muscles. Conversely, patients with median mononeuropathies would have sparing of these muscles. This case highlights RCA in the setting of carpal tunnel syndrome and documents the persistent innervation of the second lumbrical by the median nerve. No anatomic dissections have disclosed innervation of the second lumbrical by the deep ulnar nerve, negating the concept of the all-ulnar hand.
A Family With 2 Different Hereditary Diseases Leading to Early Cardiac Involvement
Authors: Nzwalo Hipólito , Conceição Isabel , Pereira Pedro , Santos Rosário , Evangelista Teresinha 
Published: May 2013

Abstract
Autosomal dominant limb-girdle muscular dystrophy type 1B (LGMD 1B) is caused by mutations in the LMNA gene. The disorder is associated with potentially fatal cardiac arrhythmias. Brugada syndrome (BS) is an autosomal dominant channelopathy linked to mutations in the SCN5A gene. BS is also associated with increased risk of sudden cardiac death. We reported a family in which a novel gene mutation, a missense mutation (c.80C>T) in exon 1 of the LMNA gene causing autosomal dominant LGMD 1B, occurred in association with SCN5A gene mutation causing BS. After the diagnosis of BS, 4 patients received implantable cardioverter–defibrillator therapy. Eight members of the family deceased at early age before the diagnosis. We emphasized the co-occurrence of 2 different conditions predisposing to sudden cardiac death: LGMD 1B caused by a novel mutation and BS.
Radiotherapy dose calculation on KV cone‐beam CT image for lung tumor using the CIRS calibration
Authors: Ma Changsheng , Cao Jianping , Yin Yong , Zhu Jian 
Published: May 2013

AbstractOn‐board kilovoltage (KV) cone‐beam computed tomography (CBCT) images are used predominantly for the setup of patients' positioning. The image data can also potentially be used for dose calculation with the precise calibration of Hounsfield units (HU) to electron density (HU‐density). CBCT calibration was analyzed in this study. A clinical treatment planning system was employed for CT and KV CBCT image to dose calculations and subsequent comparisons. Two HU‐density tables were generated using the Computerized Imaging Reference Systems (CIRS) phantom. The results showed that a maximum ∼4% dose discrepancy was observed for inserts. The single field isodose curves were very close. The lung clinical patient study indicated that the volume of lung tumor that achieved the prescribed dose in CBCT was lower than in the CT plan. Our study showed that the dosimetric accuracy of CBCT‐based dose calculation for lung tumor is acceptable only for the purpose of dosimetric checks with calibration applied. KV CBCT images cannot replace traditional CT images for dose calculation accuracy.
Increased susceptibility to streptozotocin and impeded regeneration capacity of beta‐cells in adult offspring of malnourished rats
Authors: Goosse K. , Bouckenooghe T. , Sisino G. , Aurientis S. , Remacle C. , Reusens B. 
Published: May 2013

AbstractBackgroundEpidemiological studies related poor maternal nutrition and subsequent growth retardation in the progeny to the development of diabetes later in life. Low‐protein diet during gestation altered the beta‐cell development of the rat progeny by decreasing beta‐cell proliferation and increasing their sensitivity to nitric oxide and cytokines in the foetus. This disturbed maternal environment had long‐lasting consequences because the higher beta‐cell vulnerability was maintained at adulthood.AimThe aim of this study was to determine whether early malnutrition influences the vulnerability and the regeneration capacity of beta‐cells after streptozotocin (STZ) damage at adulthood.MethodsGestating rats were fed either a control or a low‐protein diet until weaning. Adult female offspring received injections of Freund's adjuvant weekly for 5 weeks followed 24 h later by STZ. Half of the cohort was killed at d34, whereas the other half was maintained until d48 to analyse the regeneration capacity of the beta‐cells.ResultsAlthough control and low‐protein rats had equivalent pancreatic insulin content and beta‐cell volume density at d34, hyperglycaemia appeared earlier and was more dramatic in low‐protein rats than in control rats. STZ treatment increased beta‐cell proliferation similarly in both groups. At d48, apoptotic rate was higher in the low‐protein group. Regeneration appeared in control, but not in the low‐protein rats, where beta‐cell aggregates/surface area and Reg1‐positive area were decreased compared to control.ConclusionMaternal malnutrition programmes a more vulnerable endocrine pancreas in the progeny which is unable to regenerate after injury, therefore predisposing it to develop glucose intolerance and diabetes later in life.
Immunosuppressive Effect of Silymarin on Mitogen‐Activated Protein Kinase Signalling Pathway: the Impact on T Cell Proliferation and Cytokine Production
Authors: Gharagozloo Marjan , Jafari Shirin , Esmaeil Nafiseh , Javid Elahe N. , Bagherpour Bahram , Rezaei Abbas 
Published: May 2013

AbstractSilymarin, a polyphenolic flavonoid derived from milk thistle (Silybum marianum), is known to have anti‐inflammatory, hepatoprotective and anticarcinogenic effects. In this study, the in vitro immunomodulatory effect of silymarin was investigated using human CD4+ T cells. Peripheral blood mononuclear cells (PBMC) from healthy individuals were activated with anti‐CD3 (5 μg/ml) plus anti‐CD28 (2 μg/ml) and treated with 10, 50 and 100 μM silymarin. Cells were incubated 72 hr for proliferation assay using MTT and for viability analysis using PI staining and flow cytometry. Naive CD4+ T cell was also isolated from PBMC, activated with PHA/anti‐CD28 and treated with 100 μM silymarin for 72 hr. MAPKs’ activity of cell lysate from activated naive CD4+ T cells was assessed using an ELISA‐based MAPKinase activity kit, and Th1/Th2/Th17‐related cytokine expression was determined by Multi‐analyte ELISA array kit. Results indicated a significant inhibition in proliferation of activated PBMC after 48‐hr incubation with 100 μM silymarin without causing cell death. Moreover, MAPKs’ activity (ERK1/2 and P38) and Th1‐related cytokines (IL‐2, TNF‐α, IFN‐γ) were significantly reduced in silymarin‐treated cells compared with control after 72 hr. This study shows that silymarin has the ability to inhibit T cell proliferation and pro‐inflammatory cytokine secretion in vitro. Furthermore, silymarin is able to inhibit ERK1/2 and P38 pathway activation in T cells stimulated through TCR engagement, a property that is likely associated with its ability to inhibit T cell proliferation and cytokine secretion. Therefore, silymarin, as an immune‐response modifier, might be a valuable drug in therapeutic situations in which immunosuppression is required.
Phase II trial of panobinostat, an oral pan‐deacetylase inhibitor in patients with primary myelofibrosis, post–essential thrombocythaemia, and post–polycythaemia vera myelofibrosis
Authors: DeAngelo Daniel J. , Mesa Ruben A. , Fiskus Warren , Tefferi Ayalew , Paley Carole , Wadleigh Martha , Ritchie Ellen K. , Snyder David S. , Begna Kebede , Ganguly Siddhartha , Ondovik Michael S. , Rine Jessica , Bhalla Kapil N. 
Published: May 2013

SummaryMyelofibrosis (MF) is a Philadelphia chromosome–negative stem cell myeloproliferative neoplasm (MPN) associated with cytopenias, splenomegaly, constitutional symptoms, and poor prognosis. MF patients commonly express JAK2 V617F mutation and activation of Janus kinase (JAK)/signal transducer and activator of transcription (STAT) signalling. Agents targeting the JAK/STAT pathway have demonstrated efficacy in patients with MF. This study evaluated panobinostat, a pan‐deacetylase inhibitor that depletes JAK2 V617F levels and JAK/STAT signalling in MPN cells, in patients with primary MF, post–essential thrombocythaemia MF, and post–polycythaemia vera MF. Patients received panobinostat 40 mg administered three times per week. Dose reductions were permitted for toxicities. The primary endpoint was response rate at 6 months using International Working Group for Myelofibrosis Research and Treatment (IWG‐MRT) consensus criteria. Analyses of peripheral blood cells from treated patients revealed that panobinostat inhibited JAK/STAT signalling, decreased inflammatory cytokine levels, and decreased JAK2 V617F allelic burden. However, panobinostat was poorly tolerated at the dose and schedule evaluated, and only 16 of 35 patients completed ≥2 cycles of treatment. One patient (3%) achieved an IWG‐MRT response. Common adverse events were thrombocytopenia (71·4%) and diarrhoea (80·0%). Although molecular correlative analyses suggested that panobinostat inhibits key intracellular targets, limited clinical activity was observed because of poor tolerance.
Relative effectiveness of robot‐assisted and standard laparoscopic prostatectomy as alternatives to open radical prostatectomy for treatment of localised prostate cancer: a systematic review and mixed treatment comparison meta‐analysis
Authors: Robertson Clare , Close Andrew , Fraser Cynthia , Gurung Tara , Jia Xueli , Sharma Pawana , Vale Luke , Ramsay Craig , Pickard Robert 
Published: May 2013

Objective
To compare the effectiveness of robot‐assisted and standard laparoscopic prostatectomy.
Methods
A care pathway was described.
We performed a systematic literature review based on a search of Medline, Medline in Process, Embase, Biosis, Science Citation Index, Cochrane Controlled Trials Register, Current Controlled Trials, Clinical Trials, WHO International Clinical Trials Registry and NIH Reporter, the Health Technology Assessment databases, the Database of Abstracts of Reviews of Effects, and relevant conference abstracts up to 31st October 2010). Additionally, reference lists were scanned, an expert panel consulted, and websites of manufacturers, professional organisations, and regulatory bodies were checked.
We selected randomised controlled trials (RCTs) and non‐randomised comparative studies, published after 1st January 1995, including men with localised prostate cancer undergoing robot‐assisted or laparoscopic prostatectomy compared with the other procedure or with open prostatectomy. Studies where at least 90% of included men had clinical tumour stages T1 to T2 and which reported at least one of our specified outcomes were eligible for inclusion.
A mixed‐treatment comparison meta‐analysis was performed to generate comparative statistics on specified outcomes.
Results
We included data from 19 064 men across one RCT and 57 non‐randomised comparative reports.
Robotic prostatectomy had a lower risk of major intra‐operative harms such as organ injury [0.4% robotic vs 2.9% laparoscopic], odds ratio ([OR] {95% credible interval [CrI]} 0.16 [0.03 to 0.76]), and a lower rate of surgical margins positive for cancer [17.6% robotic vs 23.6% laparoscopic], OR [95% CrI] 0.69 [0.51 to 0.96]). There was no evidence of a difference in the proportion of men with urinary incontinence at 12 months (OR [95% CrI] 0.55 [0.09 to 2.84]). There were insufficient data on sexual dysfunction.
Surgeon learning rates for the procedures did not differ, although data were limited.
Conclusions
Men undergoing robotic prostatectomy appear to have reduced surgical morbidity, and a lower risk of a positive surgical margin, which may reduce rates of cancer recurrence and the need for further treatment, but considerable uncertainty surrounds these results.
We found no evidence that men undergoing robotic prostatectomy are disadvantaged in terms of early outcomes.
We were unable to determine longer‐term relative effectiveness.
Comparison of peri‐operative outcomes of robot‐assisted vs laparoscopic partial nephrectomy: a meta‐analysis
Authors: Zhang Xiaohua , Shen Zhoujun , Zhong Shan , Zhu Zhaowei , Wang Xianjin , Xu Tianyuan 
Published: May 2013

Objective
To conduct a meta‐analysis of the literature on the peri‐operative outcomes of both robot‐assisted partial nephrectomy (RAPN) and laparoscopic partial nephrectomy (LPN).
Materials and Methods
An electronic database search of MEDLINE, EMBASE, Google Scholar and the Cochrane Library was performed for publications up to 8 January 2013.
All studies comparing RAPN with LPN were included. The outcome measures were demographic and peri‐operative results, including operating time, warm ischaemia time, blood loss, length of hospital stay, conversion rates, positive surgical margins and complications.
A meta‐analysis of the results was conducted.
Results
A total of 766 patients were included, 425 patients in the RAPN group and 341 patients in the LPN group. There was no significant difference between the two groups in any of the demographic variables (age: P = 0.89; sex: P = 0.31; malignant pathology: P = 0.54; tumour size: P = 0.99; tumour laterality: P = 0.06).
There was no difference between the two groups regarding operating times (P = 0.75), estimated blood loss (P = 0.75), conversion rates (P = 0.52), positive surgical margins (P = 0.61), complications (P = 0.27) or length of hospital stay (P = 0.27), but the RAPN group had significantly shorter warm ischaemia times than the LPN group (P = 0.01; weighted mean difference: −3.65; 95% confidence interval, −6.46 to −0.83).
Conclusion
This meta‐analysis shows that RAPN provides equivalent peri‐operative outcomes to those of LPN, with the added advantage of a significantly shorter warm ischaemia time.
Networked learning in complex policy spaces: A practitioner's reflection on the open method of coordination
Authors: Townsend Thomas 
Published: May 2013

AbstractOpen method of coordination (OMC) mechanisms have not gained much acceptance in Canada in spite of evidence that they could improve policy making and implementation. In Canada, “learning,” in particular at the political level, occurs somewhat differently from how it was envisaged in the intellectual underpinnings of the OMC because of the ethos of intergovernmental relations. The provinces, territories and the federal government might, however, improve policy learning by approaching the process in a somewhat different fashion while still benefiting from the European experience. The market for learning may exist less at the level of governments and more at a localized practitioner level. Canada may benefit from taking an indirect approach to the issue and creating institutional arrangements that will allow civil society groups to engage in mutual learning more easily.
Low-dose growth hormone for 40 weeks induces HIV-1-specific T cell responses in patients on effective combination anti-retroviral therapy
Authors: Herasimtschuk A A , Hansen B R , Langkilde A , Moyle G J , Andersen O , Imami N 
Published: May 2013

SummaryRecombinant human growth hormone (rhGH) administered to combination anti-retroviral therapy (cART)-treated human immunodeficiency virus-1 (HIV-1)-infected individuals has been found to reverse thymic involution, increase total and naive CD4 T cell counts and reduce the expression of activation and apoptosis markers. To date, such studies have used high, pharmacological doses of rhGH. In this substudy, samples from treated HIV-1+ subjects, randomized to receive either a physiological dose (0·7 mg) of rhGH (n = 21) or placebo (n = 15) daily for 40 weeks, were assessed. Peptide-based enzyme-linked immunospot (ELISPOT) assays were used to enumerate HIV-1-specific interferon (IFN)-γ-producing T cells at baseline and week 40. Individuals who received rhGH demonstrated increased responses to HIV-1 Gag overlapping 20mer and Gag 9mer peptide pools at week 40 compared to baseline, whereas subjects who received placebo showed no functional changes. Subjects with the most robust responses in the ELISPOT assays had improved thymic function following rhGH administration, as determined using CD4+ T cell receptor rearrangement excision circle (TREC) and thymic density data from the original study. T cells from these robust responders were characterized further phenotypically, and showed decreased expression of activation and apoptosis markers at week 40 compared to baseline. Furthermore, CD4 and CD8 T cell populations were found to be shifted towards an effector and central memory phenotype, respectively. Here we report that administration of low-dose rhGH over 40 weeks with effective cART resulted in greater improvement of T lymphocyte function than observed with cART alone, and provide further evidence that such an approach could also reduce levels of immune activation.
Autoimmune hemolytic anemia in a teenager: a wolf in sheep's clothing
Authors: Halbrich Michelle , Ben‐Shoshan Moshe , McCusker Christine 
Published: May 2013

AbstractThis case report describes a 14‐year‐old boy who presented to the emergency department with symptoms of severe anemia. He was diagnosed with autoimmune hemolytic anemia, and on further investigation, it was noted that he had no functioning T cells. Despite no antecedent history of severe infection, he was worked up for a severe combined immunodeficiency, and was found to have a compound hypomorphic mutation in an enzyme responsible for recombination of the B‐ and T‐cell receptors. He was subsequently diagnosed with severe combined immunodeficiency, presenting with autoimmunity, and received a bone marrow transplant. As our knowledge of the immune system continues to expand, we are learning that dysregulation can occur in any one of the complex immune pathways, and may have a variety of clinical presentations. A high index of suspicion for immune defects should be maintained in cases of atypical or severe infections, autoimmunity or malignancy, particularly by the general practitioner, who is often the first to encounter these challenging patients.
Evaluating the relative conservation value of fully and partially protected marine areas
Authors: Sciberras Marija , Jenkins Stuart R , Mant Rebecca , Kaiser Michel J , Hawkins Stephen J , Pullin Andrew S 
Published: May 2013

AbstractThe establishment of marine protected areas (MPAs), particularly of no‐take areas, is often viewed as a conflict between conservation and fishing. Partially protected areas (PPAs) that restrict some extractive uses are often regarded as a balance between biodiversity conservation and socio‐economic viability. Few attempts have been made to generalize the ecological effects of PPAs. We synthesized the results of empirical studies that compared PPAs to (i) no‐take reserves (NTRs) and (ii) to open access (Open) areas, to assess the potential benefits of different levels of protection for fish populations. Response to protection was examined in relation to MPA parameters and the exploitation status of fish. Our syntheses suggest that while PPAs significantly enhance density and biomass of fish relative to Open areas, NTRs yielded significantly higher biomass of fish within their boundaries relative to PPAs. The positive response to protection was primarily driven by target species. There was a large degree of variability in the magnitude of response to protection, although the size of the PPA explained some of this variability. The protection regime within the PPA provided useful insights into the effectiveness of partial MPAs. We conclude that MPAs with partial protection confer advantages, such as enhanced density and biomass of fish, compared to areas with no restrictions, although the strongest responses occurred for areas with total exclusion. Thus, MPAs with a combination of protection levels are a valuable spatial management tool particularly in areas where exclusion of all activities is not a socio‐economically and politically viable option.
God Can Wait – New Migrants in Germany Between Early Adaptation and Religious Reorganization
Authors: Diehl Claudia , Koenig Matthias 
Published: May 2013

AbstractWe analyse migration‐related changes in religiosity among new Polish and Turkish migrants in Germany by using data from an international project onSocio‐Cultural Integration Processes of New Immigrants in Europe(SCIP). The study confirms that after migration, both groups experience a decrease in religious practices that is more pronounced among Muslim Turks than among Catholic Poles and more pertinent for worship attendance than for prayer. Among new Polish immigrants, religious decrease is greater for individuals with stronger social ties to the secular German mainstream and there are no signs that religious practices are resumed after the disruptive first couple of months. For Turks, however, our study shows that initial religious decrease is followed by a process of religious reorganization, independent of social assimilation. We discuss the role that “bright” symbolic boundaries against Islam may play in explaining these group‐specific patterns.
From Neoliberalism to Pluralism: A Response to Mulheirn and Jacobs
Authors: Finlayson Alan 
Published: May 2013

AbstractThis essay puts into context the debate between Michael Jacobs and Ian Mulheirn, exploring the theories and themes underpinning their arguments, published in issue 84 1 of the Political Quarterly. It discusses, firstly, the roots of Mulheirn's approach in European neoliberalism and, secondly, the roots of Jacobs' approach in a range of sources currently contending for authority over debates within the Labour party. These include themes drawn, broadly, from Polanyi, Keynes, Schumpeter and Schumacher. In a conclusion the article makes the case for a ‘pluralistic’ to the organisation of political and economic power in the UK.
Investigating the production of sexual resting structures in a plant pathogen reveals unexpected self‐fertility and genotype‐by‐environment effects
Authors: Tollenaere C. , Laine A.‐L. 
Published: May 2013

AbstractThe sexual stage of pathogens governs recombination patterns and often also provides means of surviving the off‐season. Despite its importance for evolutionary potential and between‐season epidemiology, sexual systems have not been carefully investigated for many important pathogens, and what generates variation in successful sexual reproduction of pathogens remains unexplored. We surveyed the sexually produced resting structures (chasmothecia) across 86 natural populations of fungal pathogenPodosphaera plantaginis(Ascomycota) naturally infectingPlantago lanceolatain theÅland archipelago, southwesternFinland. For this pathosystem, these resting structures are a key life‐history stage, as more than half of the local pathogen populations go extinct every winter. We uncovered substantial variation in the level of chasmothecia produced among populations, ranging from complete absence to presence on all infected leaves. We found that chasmothecia developed within clonal isolates (single‐strain cultures). Additionally, these clonal isolates all contained bothMAT1‐1‐1 andMAT1‐2‐1 genes that characterize mating types inAscomycetes. Hence, contrary to expectations, we conclude that this species is capable of haploid selfing. In controlled inoculations, we discovered that pathogen genotypes varied in their tendency to produce chasmothecia. Production of chasmothecia was also affected by ambient temperature (E) and by the interaction between temperature and pathogen genotype (G × E). TheseG,EandG × Eeffects found both at aEuropean scale and within theÅland archipelago may partly explain the high variability observed among populations in chasmothecia levels. Consequently, they may be key drivers of the evolutionary potential and epidemiology of this highly dynamic pathosystem.