bluuebunny/crossref_metadata_2025 huggingface dataset:
Communicating with Clinicians: The Experiences of Surrogate Decision‐Makers for Hospitalized Older Adults
Authors: Torke Alexia M. , Petronio Sandra , Purnell Christianna E. , Sachs Greg A. , Helft Paul R. , Callahan Christopher M.
Published: August 2012

Objectives

To describe communication experiences of surrogates who had recently made a major medical decision for a hospitalized older adult.

Design

Semistructured interviews about a recent hospitalization.

Setting

Two hospitals affiliated with one large medical school: an urban public hospital and a university‐affiliated tertiary referral hospital.

Participants

Surrogates were eligible if they had recently made a major medical decision for a hospitalized individual aged 65 and older and were available for an interview within 1 month (2–5 months if the patient died).

Measurements

Interviews were audio‐recorded, transcribed, and analyzed using methods of grounded theory.

Results

Thirty‐five surrogates were interviewed (80% female, 44% white, 56% African American). Three primary themes emerged. First, it was found that the nature of surrogate–clinician relationships was best characterized as a relationship with a “team” of clinicians rather than individual clinicians because of frequent staff changes and multiple clinicians. Second, surrogates reported their communication needs, including frequent communication, information, and emotional support. Surrogates valued communication from any member of the clinical team, including nurses, social workers, and physicians. Third, surrogates described trust and mistrust, which were formed largely through surrogates' communication experiences.

Conclusion

In the hospital, surrogates form relationships with a “team” of clinicians rather than with individuals, yet effective communication and expressions of emotional support frequently occur, which surrogates value highly. Future interventions should focus on meeting surrogates' needs for frequent communication and high levels of information and emotional support.
Prevalence of Cognitive Impairment in Older Adults with Heart Failure
Authors: Gure Tanya R. , Blaum Caroline S. , Giordani Bruno , Koelling Todd M. , Galecki Andrzej , Pressler Susan J. , Hummel Scott L. , Langa Kenneth M.
Published: August 2012

Objectives

To determine the prevalence of cognitive impairment in older adults with heart failure (HF).

Design

Cross‐sectional analysis of the 2004 wave of the nationally representative Health and Retirement Study linked to 2002 to 2004 Medicare administrative claims.

Setting

United States, community.

Participants

Six thousand one hundred eighty‐nine individuals aged 67 and older.

Measurements

An algorithm was developed using a combination of self‐ and proxy report of a heart problem and the presence of one or more Medicare claims in administrative files using standard HF diagnostic codes. On the basis of the algorithm, three categories were created to characterize the likelihood of a HF diagnosis: high or moderate probability of HF, low probability of HF, and no HF. Cognitive function was assessed using a screening measure of cognitive function or according to proxy rating. Age‐adjusted prevalence estimates of cognitive impairment were calculated for the three groups.

Results

The prevalence of cognitive impairment consistent with dementia in older adults with HF was 15%, and the prevalence of mild cognitive impairment was 24%. The odds of dementia in those with HF were significantly higher, even after adjustment for age, education level, net worth, and prior stroke (odds ratio = 1.52, 95% confidence interval = 1.14–2.02).

Conclusion

Cognitive impairment is common in older adults with HF and is independently associated with risk of dementia. A cognitive assessment should be routinely incorporated into HF‐focused models of care.
First Eye Cataract Surgery and Hospitalization from Injuries Due to a Fall: A Population‐Based Study
Authors: Meuleners Lynn B. , Lee Andy H. , Ng Jonathon Q. , Morlet Nigel , Fraser Michelle L.
Published: August 2012

Objectives

To assess the association between first eye cataract surgery and hospitalization from injuries due to a fall in older adults at the population level.

Design

Retrospective population‐based study.

Setting

Western Australian Hospital Morbidity Data System and Western Australian mortality data.

Participants

Six hundred individuals aged 60 and older hospitalized from injuries due to a fall between 2004 and 2008 in Western Australia.

Measurements

Hospital admission from injuries due to a fall.

Results

Of the 15,295 individuals who underwent cataract surgery in one eye only, 600 (3.9%) were involved in 625 hospital admissions from injuries due to a fall 1 year before (n = 273) or 1 year after (n = 352) first eye cataract surgery; 30% of these hospitalizations were for femoral neck fractures. Poisson generalized estimating equations confirmed 27% more (adjusted risk ratio = 1.27, 95% confidence interval = 1.04–1.56 P = .02) hospitalizations from injuries due to a fall in the year after first eye cataract surgery than in the year before.

Conclusion

First eye cataract surgery was associated with more hospital admissions from injuries due to a fall in the year after cataract surgery than in the year before. Further research is needed to determine the underlying causes and reasons.
Venous Thromboembolism in Nursing Home Residents: Role of Selected Risk Factors
Authors: Leibson Cynthia L. , Petterson Tanya M. , Smith Carin Y. , Bailey Kent R. , Ashrani Aneel A. , Heit John A.
Published: August 2012

Objectives

To provide nursing home (NH)‐specific estimates to assess whether venous thromboembolism (VTE) risk factors identified for the general population apply to NH residents.

Design

Population‐based case–control study.

Setting

Olmsted County, Minnesota.

Participants

All county residents with symptomatic objectively diagnosed incident VTE while resident in a NH from 1988 through 2000 (N = 182) and two age‐, sex‐, calendar‐year‐matched non‐VTE Olmsted County NH residents per case (N = 364).

Measurements

Provider‐linked medical records were reviewed to obtain information on active malignancy and recent hospitalization, surgery, trauma, or fracture as of index date (case's VTE date; respective provider registration date for controls). Risk factor prevalence and VTE‐associated odds ratios (OR) were estimated and compared with previously obtained data for all Olmsted County residents from 1988 through 2000. For analyses, both groups were limited to individuals aged 65 and older.

Results

In NH residents, active malignancy, recent hospitalization, and recent surgery significantly increased VTE risk, but the magnitude of risk appeared much lower than general population estimates (e.g., for major surgery, OR = 2.5, 95% confidence interval (CI) = 1.4–4.3 for NH residents vs OR = 11, 95% CI = 7.0–17 for general population). In general, the prevalence of all evaluated VTE risk factors appeared much higher in NH controls than in general population controls. Thromboprophylaxis rates appeared higher for NH cases and controls than in the general population; disconcertingly, 47% of NH cases received prophylaxis.

Conclusion

Although general population VTE risk factors (active cancer and recent hospitalization or surgery) can identify NH residents at higher risk for VTE, these exposures do not adequately stratify VTE risk for thromboprophylaxis recommendations. Further research into NH‐specific risk factors and prophylaxis effectiveness is required.
A Descriptive Study of the Equine Proximal Interphalangeal Joint Using Magnetic Resonance Imaging, Contrast Arthrography, and Arthroscopy
Authors: Kamm J. Lacy , Goodrich Laurie R. , Werpy Natasha M. , McIlwraith C. Wayne
Published: August 2012

Objective

To describe regions of the thoracic and pelvic limb proximal interphalangeal (PIP) joints that are arthroscopically accessible and identify soft tissue structures that should be avoided during arthroscope and instrument placement.

Study Design

Experimentalex vivodescriptive study.

Animals

Horses (n = 15).

Methods

Cadaver limbs (n = 36) were used for anatomic modeling, magnetic resonance imaging (MRI) with MRI‐compatible needles, computed tomography with contrast arthrography, and arthroscopy of the PIP joint. Two arthroscopic approaches to the dorsal joint pouch were compared.

Results

With arthroscopy, 62.4% of the joint perimeter could be observed from the dorsal and palmar/plantar joint pouches with no significant difference in the amount of joint observed when using the more proximal or distal approach to the dorsal joint pouch (P=.59).

Conclusion

The dorsal and palmar/plantar joint pouches provide adequate arthroscopic visibility for the axial portions of the articular surface of the proximal and middle phalanx. The abaxial portions of the articular surface were difficult to view because of narrowing of the joint pouches abaxially. When comparing the proximal and distal approach to the dorsal joint pouch, arthroscope insertion 1.5 cm proximal to the joint allowed the easiest manipulation of the arthroscope. Palmar/plantar portals were placed dorsal to the neurovascular bundle, proximal to the epicondyle of the middle phalanx to prevent tendon and ligament injury.
Shoulder Arthrodesis in14 Dogs
Authors: Fitzpatrick Noel , Yeadon Russell , Smith Thomas J. , Johnson Jacqueline , Baltzer Wendy I. , Amils Raquel , Farrell Michael , Frost Alastair , Holsworth Ian G.
Published: August 2012

Objectives

To report surgical technique and clinical outcome of shoulder arthrodesis in dogs.

Study Design

Multicenter clinical case series.

Animals

Dogs (n = 14).

Methods

Shoulder arthrodesis featured craniolateral plate and screw application, with application of a 2nd plate and screws craniolaterally or caudolaterally in 5 shoulders. Implants included the locking string of pearls (SOP)™ plate in 7 shoulders. Subjective preoperative, 5–8 weeks postoperative, and 11–16 weeks postoperative clinical and radiographic findings were documented. Owner questionnaire evaluation of outcome was performed 6–20 months postoperatively.

Results

Mean angle of arthrodesis was 114° (range 102°–122°). Progression of arthrodesis was noted in 13/14 cases at both the 5–8 and 11–16 weeks postoperative radiographic assessments. Nine complications occurred in 7/14 dogs, graded as catastrophic in 2/9, major in 2/9, and minor in 5/9. Where morbidity was successfully managed, 11–16‐week and 6–10‐month postoperative limb function was positive on both veterinary and owner evaluations in almost all cases, and in several, functional lameness was considered sufficiently mild as to be imperceptible on subjective veterinary evaluation. Where present, limb circumduction was noted as the major feature of persistent lameness.

Conclusions

Shoulder arthrodesis in dogs results in acceptable limb function and should be considered for the management of debilitating shoulder pathology despite a high incidence of complications. Application of theSOPplate to aid shoulder arthrodesis warrants further study.
Low‐shear red blood cell oxygen transport effectiveness is adversely affected by transfusion and further worsened by deoxygenation in sickle cell disease patients on chronic transfusion therapy
Authors: Detterich Jon , Alexy Tamas , Rabai Miklos , Wenby Rosalinda , Dongelyan Ani , Coates Thomas , Wood John , Meiselman Herbert
Published: August 2012

BACKGROUND: Simple chronic transfusion therapy (CTT) is a mainstay for stroke prophylaxis in sickle cell anemia, but its effects on hemodynamics are poorly characterized. Transfusion improves oxygen‐carrying capacity, reducing demands for high cardiac output. While transfusion decreases factors associated with vasoocclusion, including percent hemoglobin (Hb)S, reticulocyte count, and circulating cell‐free Hb, it increases blood viscosity, which reduces microvascular flow. The hematocrit‐to‐viscosity ratio (HVR) is an index of red blood cell oxygen transport effectiveness that varies with shear stress and balances the benefits of improved oxygen capacity to viscosity‐mediated impairment of microvascular flow. We hypothesized that transfusion would improve HVR at high shear despite increased blood viscosity, but would decrease HVR at low shear.

STUDY DESIGN AND METHODS: To test this hypothesis, we examined oxygenated and deoxygenated blood samples from 15 sickle cell patients on CTT immediately before transfusion and again 12 to 120 hours after transfusion.

RESULTS: Comparable changes in Hb, hematocrit (Hct), reticulocyte count, and HbS with transfusion were observed in all subjects. Viscosity, Hct, and high‐shear HVR increased with transfusion while low‐shear HVR decreased significantly.

CONCLUSION: Decreased low‐shear HVR suggests impaired oxygen transport to low‐flow regions and may explain why some complications of sickle cell anemia are ameliorated by CTT and others may be made worse.
Pediatric apheresis with a novel apheresis device with electronic interface control
Authors: Sörensen Jan , Jarisch Andrea , Smorta Carmelo , Köhl Ulrike , Bader Peter , Seifried Erhard , Bönig Halvard
Published: August 2012

BACKGROUND: Cancer in children, and specifically cancer requiring autologous stem cell transplantation, is rare. As a consequence, though, experience with pediatric stem cell apheresis collections is limited. Challenges of apheresis in small children (<20 kg) include small total blood volume, issues with venous access, concerns about tolerable anticoagulant doses, and limitations in product volumes that can safely be collected.

STUDY DESIGN AND METHODS: This article presents a small series of autologous “stem cell” apheresis procedures in infants and toddlers weighing between 5.5 and 20 kg, the first ones performed with a novel leukapheresis device (Spectra Optia MNC v.3.0, Terumo BCT) to be reported. Some features of the system are described that can be used to achieve favorable apheresis outcomes in small children.

RESULTS: Apheresis procedures were uneventful and successful with similar extraction efficiencies (median preapheresis collection efficiency [CE2], 36%) as in adult patients. At 58%, platelet attrition was considerable.

CONCLUSION: Our data indicate that stem cell apheresis with the Spectra Optia MNC v.3.0 in very small donors is feasible, safe, and associated with very small product volumes.
Intraoperative cell salvage in a combat support hospital: a prospective proof of concept study
Authors: Bhangu Aneel , Nepogodiev Dmitri , Doughty Heidi , Bowley Douglas M.
Published: August 2012

BACKGROUND: Provision of transfusion support is an important element of contemporary military operations, but presents a considerable logistic burden. Intraoperative blood salvage (IBS) offers the potential to reduce dependency on donated red blood cell (RBC) supply. The aim of this study was to assess the feasibility of IBS in an operational environment.

STUDY DESIGN AND METHODS: A “salvage‐only” IBS feasibility study was undertaken in a deployed, Anglo‐American combat support hospital. All adult patients admitted with combat‐related injuries likely to require more than 10 units of RBCs in 12 hours were included. The volume of salvaged blood available for reinfusion was collated with injury type.

RESULTS: A total of 130 patients were admitted having sustained combat‐related injury. Twenty‐nine fulfilled the criteria, of which 27 were identified on admission. Eighteen cases were selected for IBS and salvage was completed in 17. From these 17, the mechanism of injury was 24% gunshot wound (GSW) and 76% blast injury, and injury type was 47% body cavity and 53% extremity. A total of 5578 g RBC mass was salvaged and prepared for reinfusion, representing 7.6% of total requirement. The proportion of RBC mass salvaged to that required was greatest in those with GSWs and cavity injuries, being 39% (673 g/1733 g) and 16% (243 g/1497 g), respectively.

CONCLUSION: Salvage is most successful in patients with GSWs and cavity injuries and less appropriate for limb and blast injuries. However, the results of this study present more arguments against IBS than for it, and further research is needed to determine its safety in combat settings.
Fidelity of Implementation and Instructional Alignment in Response to Intervention Research
Authors: Hill David R. , King Seth A. , Lemons Christopher J. , Partanen Jane N.
Published: August 2012

In this review, we explore the extent to which researchers evaluating the efficacy of Tier 2 elementary reading interventions within the framework of Response to Intervention reported on fidelity of implementation and alignment of instruction between tiers. A literature search identified 22 empirical studies from which conclusions were drawn. Results suggest that fidelity of implementation is typically monitored at Tier 2 and that alignment between tiers of intervention is often apparent yet not explicitly stated. However, researchers frequently neglect to report on fidelity of intervention in Tier 1, potentially limiting claims that can be made about the efficacy of subsequent Tier 2 intervention. Limitations and implications for future research are discussed.
Austerity is Strangling Europe
Authors: SCHRÖDER GERHARD
Published: August 2012

Because they have failed to address the fundamental economic imbalances within Europe obscured by the single currency, each effort by European leaders so far to resolve the euro crisis has only deepened it. Without a decisive move toward fiscal and political union, accompanied by policies that push productivity and competitiveness toward convergence while closing the democratic deficit, the Eurozone will disintegrate.

To discuss the way forward, the Nicolas Berggruen Institute's Council on the Future of Europe met in Rome on May 28 with Italian Prime Minister Mario Monti. In this section we publish the contributions from that meeting by the former European leaders, scholars and Nobel laureates who are members of the Council.
Mutualizing Europe's Debts
Authors: VERHOFSTADT GUY
Published: August 2012

Because they have failed to address the fundamental economic imbalances within Europe obscured by the single currency, each effort by European leaders so far to resolve the euro crisis has only deepened it. Without a decisive move toward fiscal and political union, accompanied by policies that push productivity and competitiveness toward convergence while closing the democratic deficit, the Eurozone will disintegrate.

To discuss the way forward, the Nicolas Berggruen Institute's Council on the Future of Europe met in Rome on May 28 with Italian Prime Minister Mario Monti. In this section we publish the contributions from that meeting by the former European leaders, scholars and Nobel laureates who are members of the Council.
Now the Elected Islamists Must Deliver
Authors: FULLER GRAHAM E.
Published: August 2012

The revolutions of the Arab Spring are twisting and turning on a troubled course. After an uprising overthrew Mubarak last year, elections were held in June in which the Muslim Brotherhood dominated—only to have the military once again assert its authority over any new parliament and constitution. What is at stake is whether Egypt will remain a secular state like Turkey, or take on a moretheocratic bent if ruled by Islamists.

In this section, the Arab world's only Nobel laureate in science offers his views about Egypt's future. The Turkish president argues for a secularism that tolerates all religions in Egypt. The CIA's former top analyst on the Muslim world questions whether Islamist parties can deliver once in power instead of opposition.
Elevated expression of calcineurin subunits during active mineralization of developing mouse molar teeth
Authors: Oshima Shohei , Watanabe Masahiko
Published: August 2012

Calcineurin is a Ca2+/calmodulin‐dependent protein phosphatase consisting of two subunits – catalytic subunit A (CnA) and regulatory subunit B (CnB) – and plays a critical role in transducing Ca2+ signals into cellular responses. In this study, we investigated the expression of calcineurin in the mouse developing tooth. In‐situ hybridization detected mRNAs for the CnAα and CnAβ isoforms of CnA and for the CnB1 isoform of CnB in the upper molar tooth germ at embryonic day 15. Immunohistochemistry with antibodies specific for CnAα, CnAβ, and CnB1 showed strong immunoreactivity of these proteins in secretory‐stage ameloblasts and in odontoblasts during dentin formation. CnAβ and CnB1 were strongly immunoreactive in ruffle‐ended ameloblasts at the enamel‐maturation stage. In ameloblasts and odontoblasts, we also noted different subcellular distributions of CnAα and CnAβ. From these data, temporal profiles of calcineurin expression appear to correlate with active mineralization in tooth development. Furthermore, the distinct subcellular distribution of the two CnA subunits may reflect their distinct substrates or responsive sites within single cells, thus contributing to the diversity of calcineurin‐dependent cellular responses during active tooth mineralization.
Effects of bamboo charcoal and bamboo vinegar as antibiotic alternatives on growth performance, immune responses and fecal microflora population in fattening pigs
Authors: CHU Gyo Moon , JUNG Cheol Kyu , KIM Hoi Yun , HA Ji Hee , KIM Jong Hyun , JUNG Min Seob , LEE Shin Ja , SONG Yuno , IBRAHIM Rashid Ismael Hag , CHO Jae Hyeon , LEE Sung Sill , SONG Young Min
Published: August 2012

This study was carried out to investigate the effects of bamboo charcoal and bamboo vinegar as alternatives of antibiotics in the diet of fattening pigs and their influence on growth performance, immune responses and fecal microflora populations. Crossed pigs (n = 144, 79 kg body weight) were divided into 12 heads per pen, four diets and three replications. The basal diet (negative control: NC) was supplemented with 0.3% antibiotics (positive control: PC), 0.3% bamboo charcoal (BC) and 0.3% bamboo vinegar (BV). Average daily weight gain and feed efficiency were higher (P < 0.05) in PC, BC and BV. The concentration of lactate dehydrogenase and cortisol were lower (P < 0.05), but the concentration of immunoglobulin G (IgG) and IgA were higher (P < 0.05) in PC, BC and BV. Counts of coliform bacteria and Salmonella spp. were lower (P < 0.05), while the counts of fecal anaerobic total bacteria and lactic acid bacteria were higher (P < 0.05) in PC, BC and BV. A reasonable inclusion of bamboo charcoal or bamboo vinegar as antibiotics in the diet of fattening pigs leads to a better growth performance, immune responses and fecal microflora populations. The results of the present study suggest that bamboo charcoal or bamboo vinegar could be a potential additives in animal production as an alternative to antibiotics.
Support Vector Machine and Relevance Vector Machine for Prediction of Alumina and Pore Volume Fraction in Bioceramics
Authors: Gopinath Kangeyanallore Govindaswamy Shanmugam , Pal Soumen , Samui Pijush , Sarkar Bimal Kumar
Published: August 2012

The determination of wt% alumina (wa) and pore volume fraction (pv) in alumina‐based bioceramics is important in ceramic engineering. This article adopts support vector machine (SVM) and relevance vector machine (RVM) for prediction of wa and pv based on SiC. SVM is firmly based on theory of statistical learning. RVM is based on a Bayesian formulation of a linear model with an appropriate prior that results in a sparse representation. The developed SVM and RVM give equations for prediction of wa and pv. This article gives robust models based on SVM and RVM for prediction of wa and pv.
Overview of: “The Differential Short‐Term Impacts of Executions on Felony and Non‐Felony Homicides”
Authors: Land Kenneth C. , Teske Raymond H. C. , Zheng Hui
Published: August 2012

Research Summary

Social scientists have debated about whether the death penalty and/or executions deter homicides and thus save lives for at least half a century. Recent empirical analyses by Kovandzic, Vieraitis, and Boots (2009) and Land, Teske, and Zheng (2009) implied that if a deterrent effect of executions exists, it is small in magnitude and relatively short term. Discussions of Kovandzic et al. (2009) by Donahue (2009) and Rubin (2009) led to the question studied in this article: Do executions impact felony and non‐felony homicides similarly? To address this question and build on recent studies, monthly time‐series data on counts of executions and felony‐type and non–felony‐type homicides in Texas for the years 1994–2007 are analyzed. The results indicate a modest reduction, a deterrence effect, of approximately 1.96 non–felony‐type homicides in the month after an execution followed by a rebound in the following second month with a net effect of 1.4 during a 12‐month period. By comparison, the corresponding analyses of the felony‐type homicide events series produce an estimated increase, a brutalization effect, in the month after an execution of approximately 0.5 homicide events. Combining these two counterbalancing effects produces a slight short‐lived deterrent effect of an execution on all homicides taken together. This finding is consistent with the previous findings of Land et al.'s (2009) analyses of all homicides grouped together and with findings from prior studies of felony‐ and non–felony‐type homicides.

Policy Implications

These findings provide additional evidence that the deterrent effects of executions are modest and short term. In addition, they imply that there would be little, if any, deterrence of homicides in Texas if executions were not used frequently. Recently however, Texas has been a state with (a) a large population, (b) a large number of capital murders and convictions, (c) a continuing stream of convicted murderers sentenced to death, and (d) a willingness to use executions extensively. Whether the modest, short‐term deterrent effects of executions found in Texas occur in other states is an open question. But it is evident that few other U.S. states have these four characteristics. At the same time, the downside of the use of executions extensively in Texas is a partially counterbalancing brutalization effect—a slight, short‐term increase in the frequency with which perpetrators of felony crimes such as robbery kill in the process of committing the crime. And none of this speaks to ethical or cost–benefit issues in the use of capital punishment as a public policy.
Hematopoietic stem cell mobilization into the peripheral circulation in patients with chronic liver diseases
Authors: Ghanem Lobna Y , Nosseir Mona MF , Lotfi Abeya A , Mohamed Ayat S , Ibrahim Refaat A , Hassanein Moutaz H , Mansour Eman , Makhlouf Manal M , Fouad Yasser M , El‐Khayat Hisham R
Published: August 2012

Objective

The present study was aimed to investigate and compare the kinetics of bone marrow‐derived hematopoietic stem cells (BMHSC) migration in the peripheral blood and liver in response to liver injury in patients with chronic liver disease (CLD).

Methods

In all, 45 CLD patients staged with Child–Pugh A, B and C and 15 healthy participants were evaluated for the concentration of circulating BMHSC by a flow cytometric analysis of CD133+/CD34+ cells. In addition, homing BMHSC and hepatic progenitors were assessed by the immunohistochemical detection of CD133+ and OV6+ cells in liver biopsy specimens from Child–Pugh A and B patients.

Results

No significant difference in the percentage of circulating CD133+/CD34+ cells was observed among all groups of patients. In liver tissues, OV6+ cells increased significantly in Child–Pugh B cases (P < 0.05), while CD133+ cells were distributed sparsely in the periportal region in Child–Pugh A and B patients. OV6+ cells were significantly correlated with CD34+ cells but not with CD133+ cells in Child–Pugh A and B patients (P < 0.01 and P < 0.05, respectively).

Conclusions

Various degrees of severity in CLD neither evoked the mobilization of BMHSC into the circulation nor triggered their homing into liver tissue, thus excluding extrahepatic stem cell‐mediated repair. The recovery process seems to be dependent on proliferating endogenous liver progenitors (OV6+ cells).
A Simple Process‐Based Snowmelt Routine to Model Spatially Distributed Snow Depth and Snowmelt in the SWAT Model1
Authors: Fuka Daniel R. , Easton Zachary M. , Brooks Erin S. , Boll Jan , Steenhuis Tammo S. , Walter M. Todd
Published: August 2012

Abstract:  We present a method to integrate a process‐based (PB) snowmelt model that requires only daily temperature and elevation information into the Soil and Water Assessment Tool (SWAT) model. The model predicts the spatiotemporal snowpack distribution without adding additional complexity, and in fact reduces the number of calibrated parameters. To demonstrate the utility of the PB model, we calibrate the PB and temperature‐index (TI) SWAT models to optimize agreement with stream discharge on a 46‐km2 watershed in northwestern Idaho, United States, for 10 individual years and use the calibrated parameters for the year with the best agreement to run the model for 15 remaining years. Stream discharge predictions by the PB and TI model were similar, although the PB model simulated snowmelt more accurately than the TI model for the remaining 15‐year period. Spatial snow distributions predicted by the PB model better matched observations from LandSat imagery and a SNOTEL station. Results for this watershed show that including PB snowmelt in watershed models is feasible, and calibration of TI‐based watershed models against discharge can incorrectly predict snow cover.
System Dynamics to Sustainable Water Resources Management in the Eastern Snake Plain Aquifer Under Water Supply Uncertainty1
Authors: Ryu Jae H. , Contor Bryce , Johnson Gary , Allen Richard , Tracy John
Published: August 2012

Abstract:  Water supply uncertainty continues to threaten the reliability of regional water resources in the western United States. Climate variability and water dispute potentials induce water managers to develop proactive adaptive management strategies to mitigate future hydroclimate impacts. The Eastern Snake Plain Aquifer in the state of Idaho is also facing these challenges in the sense that population growth and economic development strongly depend on reliable water resources from underground storage. Drought and subsequent water conflict often drive scientific research and political agendas because water resources availability and aquifer management for a sustainable rural economy are of great interest. In this study, a system dynamics approach is applied to address dynamically complex problems with management of the aquifer and associated surface‐water and groundwater interactions. Recharge and discharge dynamics within the aquifer system are coded in an environmental modeling framework to identify long‐term behavior of aquifer responses to uncertain future hydrological variability. The research shows that the system dynamics approach is a promising modeling tool to develop sustainable water resources planning and management in a collaborative decision‐making framework and also to provide useful insights and alternative opportunities for operational management, policy support, and participatory strategic planning to mitigate future hydroclimate impacts in human dimensions.
Geomorphic‐Ecological Relationships Highly Variable between Headwater and Network Mountain Streams of Northern Idaho, United States1
Authors: Sullivan S. Mažeika P.
Published: August 2012

Abstract:  Headwater streams are critical repositories of biodiversity and are important sources of water, nutrients, and energy to downstream rivers. I investigated relationships between stream geomorphology and habitat, benthic macroinvertebrates, and fish assemblages between headwater and network streams (n = 18) of mountain drainages in northern Idaho, United States. I found that a stream geomorphic condition assessment (rapid geomorphic assessment, RGA) designed to evaluate channel adjustment explained more variation in habitat assessment scores in headwater (R2 = 0.79) than in larger streams (R2 = 0.51). Results from redundancy analysis indicated that geomorphic‐biotic relationships were stronger in headwater than in network streams. For aquatic macroinvertebrates, relationships in headwaters were largely related to sediment size and slope. Fish‐geomorphic associations in both headwater and network streams were quite variable, although the RGA was correlated with fish diversity in both systems. Large wood was related to macroinvertebrate and fish descriptors in both headwater and network streams, but in distinct ways. This work supports an ecogeomorphic approach to the conservation of headwater streams including the use of tailored stream geomorphic assessment protocols.
First insight into the probabilistic evacuation criteria in the Netherlands
Authors: Wojciechowska K.A. , Kok M.
Published: August 2012

Preventive evacuation can save human lives, but it also incurs costs. In some cases, the costs can exceed the benefits of preventive evacuation, making it economically undesirable. To assist authorities in decision making concerning preventive evacuation, probabilistic evacuation decision criteria are derived within the context of flood risk in the Netherlands using values emerging from a cost‐benefit analysis of flood protective measures in this country. The criteria consist of minimal flooding probabilities, which are defined as the ratio of the costs of preventive evacuation to the benefits of this measure. When flooding probability, within a certain time window, exceeds the minimal flooding probability, preventive evacuation is cost‐effective.
How to remove subretinal fluid?
Authors: POURNARAS CJ
Published: August 2012

Purpose Rhegmatogenous retinal detachments (RRD) can be repaired surgically using non‐drainage techniques. However,removal of subretinal fluid (SRF) remains an important surgical step in retinal detachments treated by scleral buckling, particularly in cases of bullous detachments, inferior breaks, proliferative vitreoretinopathy, high myopia, chronic detachments, cases with poor retinal pigment epithelium function and eyes intolerant to sustained intraocular pressure rise.

Methods Conventional drainage techniques include passive needle drainage of subretinal fluid through a 3 to 4 mm radial sclerotomy within the bed of the buckle and closure with a preplaced suture. Many modified SRF drainage techniques have been described. Internal subretinal fluid drainage with simultaneous automated air‐fluid infusion is an important part of modern vitreoretinal surgery.

Results Needle drainage, where the needle shaft is observed using an indirect ophthalmoscope, seemed to be associated with a higher success rate than conventional drainage. The most common complications of subretinal fluid drainage include subretinal hemorrhage, retinal incarceration, and retinal perforation. Using perfluorocarbon liquid or infusion of low‐molecular weight silicone oil as a peroperative tool, retinal flattening posterior to equator is an important step of the vitreoretinal approach and internal drainage for the treatment of RRD. Subretinal fluid is drained through a preexisting retinal break or an intentionally created drainage retinotomy using an extrusion cannula. It allows the immediate and complete reattachment of the retina and enables laser endocoagulation of the breaks. If the original retinal break can be treated by laser photocoagulation or cryopexy, the subretinal fluid is not necessarily removed completely.
Infectious uveitis
Authors: KESTELYN P
Published: August 2012

Abstract not provided
Herpes and zoster keratitis
Authors: LABETOULLE M
Published: August 2012

The two leading causes of viral infection of the cornea with potential severely impaired visual acuity are the Herpes Simplex Virus (HSV) and the Varicella‐zoster Virus (VZV). Both of them are able to become latent in the trigeminal ganglia, before reactivation and migration along the trigeminal fibers innervating the cornea. The clinical settings of keratitis may vary from an epithelial defect (dendritic of geographic) to a more severe disease involving the stroma and/or the endothelium. Most of first episodes of HSV keratitis occur from the second to the fifth decade of life, and associated skin lesions are not frequent. In contrast, VZV keratitis mostly occurs after the sixth decade, as an associated finding of herpes zoster ophthalmicus (HZO). However, recent studies have highlighted the possibility of HSV keratitis in elderly, while other studies reported VZV keratitis in children, either isolated or associated with HZO. The curative options for treatment of HSV keratitis are now well established, but the preventive regimens of antiviral drugs still have to be optimized, since the most popular treatment, based on the results of the HEDS study, only reduces the rate of relapses in a two‐fold manner. For VZV, vaccines against chickenpox and HZO may significantly change the epidemiologic data when they will be more frequently used in European countries.
Visual field examination in daily practice
Authors: ZEYEN T
Published: August 2012

Automated perimetry is the most important functional test in glaucoma patients. This course will teach which programs and strategies to use, how to instruct patients and avoid artifacts, and how to use the available software to interpret worsening of visual field defects and calculate rates of change. Finally, consensus statements will be provided on the usefulness of non‐conventional perimetric tests.
Congenital pigmented lesions
Authors: BECHRAKIS NE
Published: August 2012

A systematic description of congenital pigmented lesions is presented. These include congenital anomalies of the RPE such as hypertrophy, hyperplasia and hamartomas. The differential diagnosis of combined hamartoma of the retina and the RPE is presented, as well as congenital melanosis of the ocular fundus.
How to achieve optimal visualization in vitreoretinal surgery
Authors: BLATSIOS G
Published: August 2012

Purpose of this presentation is not only to describe the various viewing systems, endoillumination possibilities and dyes, but also to give some useful tips on how to practically deal with anterior and posterior segment problems that may interfere with visualisation during vitreoretinal surgery.
Concentration gradient of endogenous noradrenaline from periphery to centre in the rabbit cornea
Authors: FIGUEIRA L , MATOS J , SERRAO P , FALCAO‐REIS F , MOURA D
Published: August 2012

Purpose The source of endogenous catecholamines that activate corneal adrenoceptors is largely unknown. Since the cornea is a densely innervated tissue we hypothesized that the major source would be the neuronal release of noradrenaline (NA) from intrinsic sympathetic nerves rather than circulating or non‐neuronal local production.

Methods Three concentric segments (central, intermediate, peripheral) were obtained by double trephination (9.5‐7.25 mm) performed on corneas harvested from 3‐4 month old rabbits, along with aqueous humor and blood samples. Endogenous catecholamines were quantified by HPLC‐EC. Results are means±SEM. ANOVA was used for statistical analysis.

Results NA and adrenaline (AD) were identified in all corneal segments (n=15/16) at the following concentrations: 101.3±24.1 pmol/g for NA, 4.8±2.7 pmol/g for AD in the centre; 76.8±18.8 pmol/g for NA, 23.0±11.1 pmol/g for AD in the intermediate segment; 317.0±135.7 pmol/g for NA and11.1±6.1 pmol/g for AD in the periphery. Statistically significant (P<0.05) were the differences between: 1) NA concentrations in peripheral segments and those either in central or intermediate segments; 2) NA and AD concentrations in all segments. In the aqueous humor concentrations of NA were 77.0±9.8 nmol/L (n=6) and no AD was found. Plasma concentrations (n=4) were 28.0±2,5 μmol/L for NA, 36.2±8.5 μmol/L for AD.

Conclusion There is a concentration gradient for NA decreasing from the corneal periphery towards the centre. In contrast, no such gradient exists for AD. Moreover, NA is the most abundant of the two catecholamines in all segments, whereas in the plasma AD predominates. Taken together, these results suggest that corneal NA is mostly of neuronal origin.
Mini‐pump revisited for ocular drug delivery
Authors: HUMAYUN M
Published: August 2012

Abstract not provided
Electroporation for ocular drug delivery
Authors: BEHAR‐COHEN F
Published: August 2012

Abstract not provided
Serum‐free cornea culture with hydroxyethyl starch as a deswelling agent
Authors: HERMEL M , SALLA S , BAUER L , HAMSLEY N , STEINFELD P , WALTER P
Published: August 2012

Purpose Varying states of hydration during organ culture and subsequent dehydration of corneas with Dextran prior to transplantation cause endothelial cell damage. Hydroxyethyl starch 130 (HES) has been suggested as a permanent dehydrating agent in serum‐free cornea culture. This study compares corneas stored in a synthetic medium containing HES with corneas stored and dehydrated under standard conditions.

Methods Twenty pairs of human donor corneas were cultivated in MEM with antibiotics at 31°C for 16 days (groups A and B) or 28 days (groups C and D, n=10). Media contained 2%FCS in group A and C, and 7.5 % HES 130 plus 1mU/l human insulin in groups B and D. On day 15 or 27, corneas from group A and C were placed in dehydration medium (MEM + antibiotics + 2%FCS + 5% dextran 500). Endothelial cell density and morphology were investigated at the beginning and end of culture. Corneal thickness was assessed by pachymetry. Keratocyte viability was assessed by TUNEL and Annexin V staining.

Results Endothelial cell loss was higher in group A (278.5+/‐184.2) vs. B (156.6+/‐154; p=0.0293), and in group C (490+/‐156.3) vs. D (301.8+/‐189.6; p=0.0195), with similar morphology. Final corneal thickness was 882+119µm and 914+119µm in groups A and B, and 889+99µm and 957+87µm in groups C and D, resp. (n.s.). No significant differences were found in TUNEL and Annexin staining.

Conclusion The synthetic medium supplemented with HES 130 and insulin improves endothelial cell survival during cornea culture, without adverse effects ion keratocyte viability. It is thus feasible to store donor corneas in fully synthetic medium without the chemically undefined FCS and without the need for dehydration, resulting in increased safety and faster transplant availability.
Tocilizumab for anterior uveitis and juvenile idopathic arthritis – a case report
Authors: KNOLL A , LUTZ T , GRULICH‐HENN J , MACKENSEN F
Published: August 2012

Purpose We report a case of Juvenile Idiopathic Arthritis (JIA) and Anterior Uveitis (AU) responding well to Tocilizumab, a new humanized monoclonal antibody against the IL‐6 receptor, after having been refractory to classical immunosuppressive agents as well as to TNF‐α inhibitors.

Methods The Patient was treated in our center from 2007‐2012. Collected data included: visual acuity (VA), anterior chamber cells and –flare, flaremeter measurements, intraocular pressure (IOP), presence of macular edema (ME) and cataract, topical and systemic medications, number and site of affected joints, laboratory inflammation parameters.

Results Patient was born 1996, diagnosed with JIA 1998 and with AU 2005. Inflammation was initially controlled with methotrexate and corticosteroids, VA fluctuated between 20/40‐20/15(OD) and 20/20(OS). In 2007 VA decreased to 20/200(OD) as ME developed. Additional systemic therapy included between 2008 and 2009: Ciclosporin, Adalimumab, Mycophenolate, Leflunomide, and Infliximab. Control of ocular and/or joint inflammation was always insufficient or short lived. Between 2008 and 2010 ME required multiple periocular Triamcinolone injections. IOP first rose in 2008 to 34mmHg(OD), requiring combined topical and systemic therapy and finally trabeculectomy in 2010. Cataract developed on both eyes. Tocilizumab therapy was started in 02/2010. Since then AU and joints are free from inflammation. Cataract‐surgery and implantation of an artificial lens in OD was performed successfully in 2011. Systemic steroids could be reduced to 2 mg/d. IOP is <20mmHg; VA is stable at 20/32(OD) and 20/50(OS).

Conclusion Tocilizumab may be another treatment option for JIA‐associated uveitis which is refractory to established immunosuppressants.
ILM peeling in macular surgery: benefits
Authors: CREUZOT C
Published: August 2012

Internal limiting membrane (ILM) peeling should be beneficial to improve the anatomic and functional outcomes in macular surgery. In macular hole surgery, it seems to be an additive tool to improve the closing rate especially in large macular hole. In epiretinal membrane surgery, it should be considered either to improve the functional outcome but also to decrease the recurrence of epiretinal membrane on the remaining ILM. However, the characteristics of the peeling (ie area, control with dye) should be given in all clinical trials to obtain more homogeneous surgical criteria.
The flicker ERG and retinal blood flow relationship in diabetic patients without retinopathy
Authors: ZUEVA M , KOLCHIN A , KISELEVA T , LESENKO M , TSAPENKO I , RYABINA M
Published: August 2012

Purpose To evaluate the association between functional and hemodynamic alterations of the retina in diabetes mellitus (DM) without retinopathy (NDR).

Methods 15 patients (63±6.3 years) with DM type II (duration 6±3.5years) and NDR, and 40 age matched controls were examined. Color Doppler Imaging (CDI) was conducted to visualize blood flow in ophthalmic artery (OA), central retinal artery (CRA), medial and lateral posterior ciliary arteries brevis (PCAB). Photopic and scotopic flicker ERGs (p‐FERG and s‐FERG) were recorded at 8.3, 10, 12, 30 Hz flickering.

Results In NDR, the increase of the blood flow peak systolic velocity (V syst) and end diastolic velocity (Vdiast) was noted in AO. The most significant changes in blood flow were observed in CRA and PCAB. A reliable correlations were shown between Vdiast, the resistance index RI in CRA and insulin levels (r=0.64), serum C‐peptide (r=0.60) and the index of insulin resistance IR (r=0.65); between Vdiast, RI in PCAB and insulin levels, the C‐peptide level and IR (r=0.59, 0.56, 0.59, respectively). The amplitude of light and dark adapted FERG at 8.3‐12 Hz declined in more than 60% eyes up to 69‐80%. The p‐FERGs at 24 and 30 Hz did not differ from the control; but we found a sharp increase in s‐FERG (155.5±15.3 ‐ 319.9±21.4% for 24 ‐ 30 Hz respectively). Significant correlation was shown between the 10Hz‐FERG amplitude (but not the 24Hz or 30Hz‐FERG) and Vdiast in CRA and PCAB (r=0.51; r=0.50).

Conclusion There is a significant relationship between the retina hemodynamics and physiological effects of insulin, leading to metabolic disorders. Signs of blood flow deficiency in CRA and PCAB in NDR correlated with an early alteration in the photoreceptor function.