bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in the Rates of Reported Pressure Ulcers in Response to a Regional Critical Care Quality Improvement Project
Authors: Thomas Antony N , Taylor Robert J , Berry Andrea
Published: December 2014

We used patient safety incident reports to monitor rates of pressure ulcers in response to a skin care bundle introduced at the start of 2012 across the North West of England. The bundle incorporated skin surface interface, patient positioning, incontinence and skin management and improved nutrition. We compared changes in the rates of index sores (category two to four ulcers involving the sacrum, buttocks, genitals or heals) with other sores and wounds. Rates of all reported pressure ulcers increased from 4.1 to 7.0 per 1,000 days between 2009 and 2012 (p<0.001) while the rate of ‘index sores' decreased from 3.1 to 2.0 per 1,000 days between 2011 and 2012 (p<0.001). There was a wide variation in reported pressure ulcers between different units (interquartile range 2.1 to 9.9 per 1,000 days). A care bundle can reduce the rates of significant pressure ulcers. Without ensuring reliable compliance, wide variation remains between units.
Fatal Atrial Oesophageal Fistula following Pulmonary Vein Isolation: An Unresolved Safety Issue
Authors: Loo Say Yee , Sundararajan Krishnaswamy
Published: December 2014

Atrial fibrillation is a common cardiac arrhythmia that is associated with high morbidity and mortality. Radiofrequency ablation with extensive circumferential pulmonary vein isolation has been recognised as the most commonly employed ablation method to treat recurrent atrial fibrillation that is refractory to drug therapy. Atrial-oesophageal fistula is one of the most devastating complications following this procedure and has implications for intensive care clinicians. We report the clinical course of a patient with an extensive history of recurrent, drug-refractory atrial fibrillation who developed atrial-oesophageal fistula three weeks after pulmonary vein isolation, suffered a series of complications as a consequence, and eventually died.
Development of a Spinal Epidural Abscess Masked by Critical Illness
Authors: Chandler Ben , Francis James , Harper Daniel
Published: December 2014

We describe a case of severe neurological injury secondary to an epidural abscess that developed during the course of critical illness. It was caused by an oesophageal perforation that developed into an invasive abscess while the patient was being treated in the intensive care unit (ICU) for respiratory failure. We discuss spinal epidural abscesses, and the importance of searching for an alternative diagnosis in patients with weakness.
Profound Anaemia in a Jehovah's Witness following Upper Gastrointestinal Haemorrhage: Intensive Care Management
Authors: Chalmers Catriona , Tyson Emma , Walter Edward , Soon Yuen , Creagh-Brown Ben
Published: December 2014

Management of the profoundly anaemic patient who competently refuses blood transfusion will always prove challenging. This article provides a review of treatment strategies based around a recent case of a patient presenting after major gastrointestinal haemorrhage. The main part of management involves providing supportive intensive care, paying particular attention to oxygen delivery and consumption, and minimising further blood loss. Specific treatments, such as pharmacotherapy to promote erythropoiesis, are based largely on indirect evidence or expert opinion. Virtually all aspects of care involve carefully balancing a shifting profile of risks and benefits; a team approach and close communication with the family are essential. This patient's successful outcome has extended our understanding of this area, which is discussed.
Acromegaly Presenting with Diabetic Ketoacidosis and Diabetes Insipidus
Authors: Rose Alastair H , McKinlay Justin
Published: December 2014

A patient presenting with diabetic ketoacidosis and diabetes insipidus was found to have acromegaly. This is an unusual presentation of a rare condition and highlights the need for broad diagnostic skills in intensive care medicine in order to institute effective treatment. Diabetic ketoacidosis is a common reason for admission to hospital and is associated with increased morbidity and mortality. It is likely that an increasing proportion of patients will be admitted to intensive care in view of current guidelines for the management of sever diabetic ketoacidosis. One of the secondary causes of diabetes is acromegaly. This is a rare condition, often associated with a delay from the onset of symptoms to diagnosis, and diabetes is an uncommon presentation. This patient presented with features of both diabetes mellitus and diabetes insipidus, both associated with acromegaly.
Group B Streptococcal Infection — An Emerging Cause of Sepsis in Fit Non-Peripartum Adults
Authors: Gunasekera Pumali , Asumang Annang
Published: December 2014

A previously fit 66-year-old presented to hospital with a history of back pain, decreased level of consciousness and one grand mal seizure. She was ultimately found to have group B streptococcal infection with Streptococcus agalactiae thought to be secondary to spondylodiscitis, possibly secondary to latent infection from an abdominal hysterectomy performed 30 years previously. This case highlights the increasing incidence of group B streptococcal infection in non-peripartum adults, and the implications are discussed.
Cosmetic Contact Lenses and the Pupillary Light Reflex in Trauma
Authors: Sehgal Anamika , Hughes Simon
Published: December 2014

The presence of dilated pupils that have no direct or consensual response to light after traumatic brain injury is an ominous sign, potentially heralding severe intracranial damage. We describe a case in which the presence of tinted contact lenses directly caused misinterpretation of the pupillary light reflex and discuss the clinical importance of this observation.
Effect of Statin Therapy on Mortality in Patients with Ventilator-Associated Pneumonia
Authors: Gill Raj , Leung Ho Yan , Torlinski Tomasz
Published: December 2014

The adjunctive use of simvastatin for patients with ventilator-associated pneumonia (VAP) was associated with an increase in 28-day mortality, although not statistically significant.
Intensive Care: Who Benefits?
Authors: Khan Imraan , Ridley Saxon
Published: December 2014

Intensive care has saved many lives but there are still those patients who are so ill at the time of presentation that the benefit of escalating intensive care support is not clear-cut. To be fair to these patients and the others who can benefit from our services, it is vital that decisions concerning how far organ supporting measures should be pursued are made as reliably and robustly as possible. This review describes some of the prognostic features available at presentation or shortly afterwards, pertaining to five clinical scenarios associated with a perceived poor survival rate (ie, acute-on-chronic liver failure, haematological malignancy, chronic lung disease, cardiac arrest and morbid obesity).
Minimising Warm and Cold Ischaemic Times in Livers Transplanted from Donation after Circulatory Death Donors: Are We Doing Enough?
Authors: Coulter Colin
Published: December 2014

Warm and cold ischaemic times (WIT and CIT) are two modifiable factors known to have a significant impact on transplant graft survival. The aim of this study was to investigate the changes in WIT and CIT in our unit, and to study whether there was any correlation between them and the outcomes of donation after circulatory death (DCD) liver transplantation. Data was collected by a single-centre retrospective review of all DCD livers transplanted at our unit (n=61) from 2004–2011. The outcome measures were graft survival at one week, three months and one year post-transplant. Each year the CIT and WIT remained relatively constant, with no statistically significant change (p=0.3 and p=0.36 respectively). From 2004–2011, one graft failed within seven days of transplant, two grafts failed within three months and four failed within one year. A statistically significant finding was a correlation between WIT and graft failure at one year post-transplant (p=0.02) with an odds ratio of 0.76 (95% confidence interval 0.59–0.98), which suggested that for each additional minute of WIT, the chance of graft failure at one year increased by 24%. This single-centre study demonstrated a failure to effectively minimise WIT and CIT over eight years in this unit. Our results show that reductions in WIT can have a significant impact on the long-term outcome of DCD liver transplantation. This study has identified modifiable factors which can reduce the overall CIT and WIT affecting livers for DCD transplantation.
Deprivation of Liberty in Intensive Care
Authors: Crews Maryam , Garry David , Phillips Claire , Wong Adrian , Troke Ben , Keene Alex Ruck , Danbury Christopher
Published: December 2014

Most patients in intensive care units lack mental capacity to inform decision-making, whether because of drugs or disease. The introduction of the Mental Capacity Act in England and Wales in 2005 has changed the way that doctors and institutions deal with patients who lack capacity. This is especially true when physical, mechanical or pharmacological restraints are used to allow the patient's treatment. Recently, the Supreme Court has ruled that if a person is under continuous supervision and control, and is not free to leave the place they are being treated, then they are deprived of their liberty. This article explains the ramification of this ruling for patients in intensive care whose care must now meet Deprivation of Liberties Standards. The procedures both for staff caring for these patients and for the Trusts where they are receiving care are described.
The Pitfalls of Telephone Advice: Getting it Right
Authors: Devlin Michael
Published: December 2014

This article explores the potential pitfalls of giving professional advice over the telephone, and how to mitigate the possible medico-legal consequences of giving such advice.
Prophylactic Inferior Vena Cava Filters in Trauma: A National Survey of Current Practice
Authors: Revill Adam , Clark Thomas , Appelboam Rebecca
Published: December 2014

A standardised telephone and electronic questionnaire survey was constructed to ascertain current practice in major trauma centres in England regarding the use of inferior vena cava (IVC) filters as thromboprophylaxis in the management of multiply injured patients. The leads for trauma or duty consultants of each of the 22 major trauma centres in England were contacted, with a response rate of 100%. Eight of the 22 units (37%) used prophylactic IVC filters in major trauma patients, and all of these were inserted by a radiologist and designed to be retrievable. Only five units surveyed (18%) were aware of guidance regarding the use of IVC filters. Reported complication rates were low, but only two centres reported no complications. There was no consensus for the time frame for removal of IVC filters. Patients with prolonged immobility secondary to spinal injury or head injury and those with pelvic injuries were considered to be at the highest risk. These results show that there is considerable variation among clinicians who manage multiply injured patients. There is a low level of awareness of international guidelines. This is likely to reflect the paucity of evidence supporting their use.
Occurrence of Pressure Ulcers and Risk Factors in a Mixed Medical-Surgical ICU — A Cohort Study
Authors: Ahtiala Maarit H , Soppi Esa T , Wiksten Anna , Koskela Hanne , Grönlund Juha A
Published: December 2014

In 2010, a three-year research programme was launched to study the occurrence and significance of certain risk factors for pressure ulcers (PUs) in a mixed intensive care unit (ICU), and to find previously unidentified risk factors. A modified Jackson/Cubbin (mJ/C) risk scale was used to formalise PU risk assessment. Adult patients needing intensive or high dependency care were included. The first results of a whole cohort (n=1,629 patients) treated in 2010 are reported. In this cohort, 72% of the patients had a surgical condition and 31% needed treatment for three or more days. The prevalence of PUs was 11.8% and the incidence was 11.1% (181/1,629) or the incidence rate was 3.0/100 ICU days. The most common sites of PUs were the sacrum, heels and nose. Nasal PUs were associated with masks used for noninvasive ventilation. Demographic variables did not differ between patients with or without PUs. Medical patients had the highest incidence of PUs (18.2%). In this group, 46.6% of patients without PU had a mJ/C-score ≤29 and 55.8% of the patients with PUs had a similar score. Patients with longer treatment times (three days or more) and medical patients had increased risk for PU development. The results indicate that the previously published J/C cut-off score of 29 may not be optimal for the identification of high/extremely high-risk patients. Further analysis of the patient populations, their PU risk factors and the significance of individual components of the J/C risk scale are ongoing.
Extracorporeal Carbon Dioxide Removal as an Alternative to Endotracheal Intubation for Non-Invasive Ventilation Failure in Acute Exacerbation of COPD
Authors: Cole Stephen , Barrett Nicholas A , Glover Guy , Langrish Chris IS , Meadows Chris , Daly Kathleen , Agnew Nicola , Gooby Nigel , Ioannou Nicholas
Published: December 2014

Extracorporeal carbon dioxide removal (ECCO2R) is an efficient technique used in the management of hypercapnic respiratory failure. Its application in mechanically ventilated patients has been studied for over 30 years. We describe a case of severe, acute exacerbation of chronic obstructive pulmonary disease (AECOPD) unresponsive to non-invasive ventilation (NIV), where initiation of ECCO2R was used effectively to prevent endotracheal intubation.
Limbic Encephalitis and Refractory Status Epilepticus in the ICU: Classification, Diagnosis and Treatment
Authors: Salter Mark , Lane Andrew Stuart
Published: December 2014

Limbic encephalitis is a rare auto-immune condition that usually presents subacutely with vague symptoms such as headache, confusion and memory loss.1 If not diagnosed early the sequelae can be severe, including refractory status epilepticus. The majority of cases are associated with underlying neoplasia. We present a case of voltage-gated potassium channel limbic encephalitis and its subsequent management during a long ICU admission. We discuss the classification, diagnosis and treatment of limbic encephalitis, review the use of sodium thiopental to achieve burst suppression in refractory status epilepticus, and the use of continuous EEG monitoring in the ICU.
Gas in the Kidneys? Emphysematous Pyelonephritis: A Case Series
Authors: Ashley Elizabeth , Chee Nigel , Hickson Guy , Williams Matthew
Published: December 2014

We examine three cases of emphysematous pyelonephritis that presented to our intensive care unit over a three-year period. The three patients were all female, had co-existing diabetes mellitus, and developed acute kidney injury (AKI), hyponatraemia and thrombocytopenia during the course of their illness. All three were managed by radiological intervention along with medical management. Two of the three patients also had surgical management (nephrectomy), which was carried out at different stages of the acute illness. All three patients survived to hospital discharge. There was an inconsistent approach to the management of this rare condition, both in our cases and in similar cases reported in the medical literature. These cases underline the importance of maintaining open dialogue between the intensive care and the specialist teams to aid the decision-making required in these patients, who have a potentially high mortality.
Volume-Outcome Relationships for Mechanically Ventilated Adult Patients
Authors: Farrands R , Duggleby Philip , Parekh Nilesh
Published: December 2014

For mechanically ventilated patients there is a significant relationship between the annual volume (absolute number) of mechanically ventilated admissions to UK intensive care units and acute hospital mortality. Intensive care units admitting more than 321 ventilated patients per annum demonstrated a statistically significant survival benefit (p<0.02). This relationship was most pronounced among non-surgical admissions.

Level of evidence: Level 2B: retrospective cohort study, but with concerns over validity.
Current Status of Inferior Vena Cava Filters
Authors: Gibson Matthew
Published: December 2014

Pulmonary embolism (PE) is a common cause of death. Treatment and prevention from a known deep venous thrombosis (DVT) is usually by anticoagulation. However, in some patients anticoagulation is not possible or effective and IVC filters are used as an alternative or adjunct. Inferior vena cava (IVC) filters have become widely used but are controversial with limited data on their efficacy, indications and safety.
What Drives the Smile and the Tear: Why Women Are More Emotionally Expressive Than Men
Authors: Fischer Agneta , LaFrance Marianne
Published: December 2014

In this article we examine gender differences in nonverbal expressiveness, with a particular focus on crying and smiling. We show that women cry and smile more as well as show more facial expressiveness in general, but that the size of this gender difference varies with the social and emotional context. We interpret this variation within a contextual framework (see also Brody & Hall, 2008; Deaux & Major, 1987; LaFrance, Hecht, & Paluck, 2003). More specifically, we distinguish three factors that predict the size of gender differences in emotional expressiveness: gender-specific norms, social role and situational constraints, and emotional intensity. These factors interact in different ways for smiling and crying.
Research as Affect-Sphere: Towards Spherogenics
Authors: Iedema Rick , Carroll Katherine
Published: December 2014

This article outlines the main tenets of affect theory and links these to Sloterdijk’s spherology. Where affect foregrounds prepersonal energies and posthuman impulses, spherology provides a lens for considering how humans congregate in constantly reconfiguring socialities in their pursuit of legitimacy and immunity. The article then explores the relevance of “affective spheres” for contemporary social science research. The article’s main argument here is that research of contemporary organisational and professional practices must increasingly be spherogenic, or seeking to build “affective spheres.” The basis of this argument are the in situ complexity and fast-changing nature of practices, and the increasing challenges involved in objectifying or ‘freezing’, and analysing or dissecting such practices. The article draws for its case study on a video-reflexive project conducted in a U.S. health service. The article concludes that the notion of research as spherogenics counterbalances the conventional methodological emphasis on a predetermined stance —whether neutral or political—in our construction and enactment of social science research.
Researching Emotional Reflexivity
Authors: Holmes Mary
Published: December 2014

The everyday novelties of contemporary society require emotional reflexivity (Holmes, 2010a), but how can it be researched? Joint interviews can give more insight into the relational and embodied nature of emotional reflexivity than analysis of text-based online sources. Although textual analysis of online sources might be useful for seeing how people relationally negotiate what to feel when feeling rules are unclear, interviews allow observation of emotional reflexivity as done in interaction, especially if there is more than one interviewee. This highlights not only the relational, but the embodied aspects of emotional reflexivity, and shows how it is a useful concept for researching aspects of emotionality not well addressed by other concepts such as “emotional intelligence” and “emotion work.”
A Rough Road Map to Reflexivity in Qualitative Research into Emotions
Authors: Fitzpatrick Petya , Olson Rebecca E.
Published: December 2014

In qualitative research into emotions, researchers and participants share emotion-laden interactions. Few demonstrate how the analytic value of emotions may be harnessed. In this article we provide an account of our emotional experiences conducting research with two groups: adults living with cystic fibrosis and spouse caregivers of cancer patients. We describe our emotion work during research interviews, and discuss its methodological and theoretical implications. Reflections depict competing emotion norms in qualitative research. Experiences of vulnerability and involuntary “emotional callusing” illustrate the insight into participants’ experiences afforded to us through emotion work. This prompted us to extend Hochschild’s theory to incorporate unconscious activity mediated through habitus, allowing us to demonstrate how the “emotional” nature of emotions research can galvanize analytic insight.
Recognizing Decentered Intersubjectivity in Social Experience
Authors: McKenzie Jordan
Published: December 2014

This article will argue that a decentering process occurs in the intersubjective connections between individuals, and that through the acknowledgement of this process researchers can better understand the potential for distortions to occur in the development of self-understanding. The concept of decentered intersubjectivity discussed in this article is the result of prior research on happiness and contentment, yet a range of emotions such as trust, guilt, shame, and disappointment could also be considered. In each case, the concept of a decentered intersubjectivity can connect the personal and emotional experiences of the individual, with a shared social experience that is deeply sociological in nature.
The Impact of Customer Sacrifice and Attachment Styles on Perceived Hospitality
Authors: Beldona Srikanth , Kher Hemant V.
Published: December 2014

As is the case in service settings where relationships span long periods of time, customers’ attachment styles for brief hotel stays affect their perception of hospitality. Using a newly developed measure of how well guests feel they are treated—perceived hospitality—this study outlines the interplay of customer sacrifice with customer attachment styles. Based on a survey of 307 U.S. consumers who had recently stayed in a hotel, the study finds that attachment avoidance (resisting relationships) has a greater impact on perceived hospitality than does attachment anxiety (desiring relationships), and that customer sacrifice perceptions exert both direct effect on perceived hospitality and also mediate the effects of attachment styles on perceived hospitality. Perceived sacrifice in this context includes direct and indirect sacrifice, including the sacrifice of effort to plan and take the trip, monetary sacrifice, and emotional sacrifice. The implication for hospitality marketers is to understand and acknowledge customer attachment styles, and to address sacrifice where possible so as to better meet customer needs.
Efficacy of 13.3 mg/24 h versus 4.6 mg/24 h rivastigmine patch on activities of daily living in severe Alzheimer’s disease
Authors: Micca Joseph L , Galvin James E , Velting Drew M , Meng Xiangyi
Published: December 2014

Objective:

Investigate efficacy of 13.3 mg/24 h rivastigmine patch in patients with severe Alzheimer’s disease on Alzheimer’s Disease Cooperative Study–Activities of Daily Living Scale–Severe Impairment Version items and domains.

Methods:

Retrospective analysis of the 24-week, randomized, double-blind ACTivities of daily living and cognitION (ACTION) study, using factor analysis to establish “best fit” for Alzheimer’s Disease Cooperative Study–Activities of Daily Living Scale–Severe Impairment Version items into domains. Treatment differences (13.3 vs 4.6 mg/24 h patch) on items and domains were assessed.

Results:

Overall, 632 patients provided Alzheimer’s Disease Cooperative Study–Activities of Daily Living Scale–Severe Impairment Version data. Factor analysis yielded four domains. The 13.3 versus 4.6 mg/24 h patch demonstrated significantly greater efficacy on “Daily function” ( p = 0.038), supported by greatest effect sizes on items within this domain, and trend toward greater efficacy on “Communication” ( p = 0.052). No significant between-group differences were observed on “Independence” ( p = 0.600) or “Environment” ( p = 0.261).

Conclusion:

The 13.3 mg/24 h patch was superior to 4.6 mg/24 h patch on “Daily function” in severe Alzheimer’s disease.
Vitamin D and depression: A case series
Authors: Nadkarni Pallavi S , Odejayi Gbolahan
Published: December 2014

Introduction:

Over two-thirds of Canadians are deficient in vitamin D. Clinical overlap can compound diagnosis of depression in vitamin D deficient individuals. Citing high costs, the Ministry of Health has restricted routine vitamin D screening and hence is not feasible.

Objectives:

The current case series is an attempt to recognise the clinical overlap between depression and vitamin D deficiency in order to avoid unnecessary antidepressant prescriptions and to demonstrate the role of collaborative care in such patients.

Method:

After appropriate ethics approval 62 patients from an outpatient clinic were screened for the diagnosis of treatment resistant depression. Those who had predominant somatic complaints were further screened for organic factors and those with inadequate vitamin D levels were referred to family physicians for supplementation with vitamin D.

Results:

More than 50% were detected deficient in vitamin D after our evaluation. They showed subjective improvement with vitamin D supplements. No modification of antidepressants was needed.

Conclusion:

Vitamin D deficiency should be suspected in depressed patients with prominent somatic symptoms and their treatment resistance should be reconsidered to avoid unnecessary exposure to mood stabilisers. Collaborating with primary care is advocated.

Limitation:

Co-prescription of an antidepressant is a confounder in our case series, and we propose more organised studies with objective rating scales.
Effect of hot dip aluminising on interfacial microstructure and mechanical properties of Ti/Al joint by TIG arc welding brazing
Authors: Wan L. , Lv S. , Huang Y. , Xu Y. , Cui Q.
Published: December 2014

The joint of Al 5A06 and aluminised Ti–6Al–4V dissimilar alloys was achieved by means of tungsten inert gas arc welding brazing. The effect of aluminized coating on the spreading behaviour of filler metal on Ti substrate was studied. The spreadability of liquid filler metal on the Ti substrate was enhanced obviously due to the presence of aluminised coating. The interfacial reaction layer was characterised by a uniform lamellar layer of TiAl3 intermetallic, with a thickness of 1 μm. Sound joints with well appearance were obtained, and the optimised tensile strength of the joint reached 216 MPa. The failure initiated from the interfacial layer at the root face and then propagated within the weld seam at the upper part of the joint. Capable welding parameters were broadened by the presence of aluminised coating for dissimilar metal joining of Ti/Al.
Overview of modelling and simulation of metal powder bed fusion process at Lawrence Livermore National Laboratory
Authors: King W. , Anderson A. T. , Ferencz R. M. , Hodge N. E. , Kamath C. , Khairallah S. A.
Published: December 2014

The metal laser powder bed fusion additive manufacturing process uses high power lasers to build parts layer upon layer by melting fine metal powders. Qualification of parts produced using this technology is broadly recognised as a significant challenge. Physics based process models have been identified as being foundational to qualification of additively manufactured metal parts. In the present article, a multiscale modelling strategy is described that will serve as the foundation upon which process control and part qualification can be built. This includes a model at the scale of the powder that simulates single track/single multilayer builds and provides powder bed and melt pool thermal data. A second model computationally builds a complete part and predicts manufactured properties (residual stress, dimensional accuracy) in three dimensions. Modelling is tied to experiment through data mining.
Effect of current density on morphology of electroplated tin
Authors: Sharma A. , Jang Y. J. , Jung J. P.
Published: December 2014

In this work, tin electroplating from acidic sulphate bath containing stannous sulphate, sulphuric acid and a glycol type additive with a leveller has been studied on steel substrates. The effects of plating current density on microstructural and morphological features are investigated. The structural and morphological characteristics have been studied by X-ray diffraction (XRD), and scanning electron microscopy (SEM). The XRD analysis confirms that the coatings produced by sulphate bath consist of tetragonal (β-Sn) crystal structure. The grain size of the deposits decreases up to a critical current density (∼30 mA cm−2), and then an increase in grain size is noticed. The coating morphology turns irregular and porous at higher current densities (about 40–50 mA cm−2) due to the rapid increase in hydrogen evolution as depicted from the secondary electron SEM images. Line profile analysis across the cross-section of the coatings further confirms the absence of any constituent coming from the bath additives.
Suppression of T-cell lymphomagenesis in mice requires PTEN phosphatase activity
Authors: Newton Ryan H. , Lu Yu , Papa Antonella , Whitcher Greg H. , Kang Youn-Jung , Yan Catherine , Pandolfi Pier Paolo , Turka Laurence A.
Published: December 2014

Key Points

PTEN phosphatase activity, independent of other PTEN functions, is required to prevent T-cell lymphoma.
Schnitzler's syndrome: lessons from 281 cases
Authors: de Koning Heleen D
Published: December 2014

Schnitzler's syndrome is an autoinflammatory disorder characterized by the association of a monoclonal IgM (or IgG) gammopathy, a chronic urticarial rash, and signs and symptoms of systemic inflammation, including fever, arthralgias and bone pain. It was first described in 1972. This review summarizes the clinical features, efficacy of therapies, and follow‐up data of the 281 cases that have been reported to date. Also, the results of skin histology, bone imaging, laboratory investigations, and studies of the pathogenesis will be discussed, including the pivotal role of interleukin‐1 beta in this disorder.
The impact of land use and cover change on above and below-ground carbon stocks of the miombo woodlands since the 1950s: a systematic review protocol
Authors: Syampungani Stephen , Clendenning Jessica , Gumbo Davison , Nasi Robert , Moombe Kaala , Chirwa Paxie , Ribeiro Natasha , Grundy Isla , Matakala Nalukui , Martius Christopher , Kaliwile Moka , Kabwe Gillian , Petrokofsky Gillian
Published: December 2014

Background

Increasingly, forests are on the international climate change agenda as land use and cover changes drive forest and carbon loss. The ability of forests to store carbon has created programs such as Reducing Emissions from Deforestation and Degradation plus (REDD+), in order to provide incentives for particular land uses and forest management practices. A critical element to REDD+ is the ability to know the carbon-storage potential of an ecosystem, and the factors likely to affect the rate of carbon accumulation or the maximum amount stored. Most REDD+ initiatives have focused on humid tropical forests because of their large stocks per unit area. Less attention has been paid to the carbon-storage potential of tropical dry forests, woodlands and savannas. Although these ecosystems support a lower biomass per unit area, they are more widespread than humid forests. This proposed systematic review examines miombo woodlands, which are the most extensive vegetation formation in Africa and support over 100 million people. We ask: To what extent have changes in land use and land cover influenced above- and below-ground carbon stocks of miombo woodlands since the 1950s?

Methods

We will search systematically for studies that document the influence of land use and cover change on above and below ground carbon in miombo woodlands since the 1950s. We will consult bibliographic databases and an extensive grey literature network, including government reports and forestry offices. Relevant studies will examine the impacts of human activities, fire and other land use or cover changes that affect wood biomass or soil carbon in the miombo region. All included studies will be assessed for the soundness and scientific validity of their study design. A quantitative synthesis will tabulate estimates of various parameters necessary to assess carbon stocks and changes across climate and geological factors; and a qualitative analysis will describe the governing land and forest policies. Understanding the impact that land uses and the associated changes have on carbon storage in the miombo woodlands will contribute to more informed forest management policies and better guided strategies for the United Nations Framework Convention on Climate Change.
Progesterone receptor activation downregulates GATA3 by transcriptional repression and increased protein turnover promoting breast tumor growth
Authors: Izzo Franco , Mercogliano Florencia , Venturutti Leandro , Tkach Mercedes , Inurrigarro Gloria , Schillaci Roxana , Cerchietti Leandro , Elizalde Patricia V , Proietti Cecilia J
Published: December 2014

Introduction

The transcription factor GATA3 is involved in mammary gland development and is crucial for the maintenance of the differentiated status of luminal epithelial cells. The role of GATA3 in breast cancer as a tumor suppressor has been established, although insights into the mechanism of GATA3 expression loss are still required.

Methods

Chromatin immunoprecipitation assays were conducted to study progestin modulation of recruitment of transcription factors to GATA3 promoter. We performed western blot and reverse RT-qPCR experiments to explore progestin regulation of GATA3 protein and mRNA expression respectively. Confocal microscopy and in vitro phosphorylation studies were conducted to examine progestin capacity to induce GATA3 serine phosphorylation in its 308 residue. GATA3 participation in progestin-induced breast cancer growth was addressed in in vitro proliferation and in vivo tumor growth experiments.

Results

In this study, we demonstrate that progestin-activated progesterone receptor (PR) reduces GATA3 expression through regulation at the transcriptional and post-translational levels in breast cancer cells. In the former mechanism, the histone methyltransferase enhancer of zeste homolog 2 is co-recruited with activated PR to a putative progesterone response element in the GATA3 proximal promoter, increasing H3K27me3 levels and inducing chromatin compaction, resulting in decreased GATA3 mRNA levels. This transcriptional regulation is coupled with increased GATA3 protein turnover through progestin-induced GATA3 phosphorylation at serine 308 followed by 26S proteasome-mediated degradation. Both molecular mechanisms converge to accomplish decreased GATA3 expression levels in breast cancer cells upon PR activation. In addition, we demonstrated that decreased GATA3 levels are required for progestin-induced upregulation of cyclin A2, which mediates the G1 to S phase transition of the cell cycle and was reported to be associated with poor prognosis in breast cancer. Finally, we showed that downregulation of GATA3 is required for progestin stimulation of both in vitro cell proliferation and in vivo tumor growth.

Conclusions

In the present study, we reveal that progestin-induced PR activation leads to loss of GATA3 expression in breast cancer cells through transcriptional and post-translational regulation. Importantly, we demonstrate that GATA3 downregulation is required for progestin-induced upregulation of cyclin A2 and for progestin-induced in vitro and in vivo breast cancer cell growth.
3D weak-dispersion reverse time migration using a stereo-modeling operator
Authors: Li Jingshuang , Fehler Michael , Yang Dinghui , Huang Xueyuan
Published: December 2014

Reliable 3D imaging is a required tool for developing models of complex geologic structures. Reverse time migration (RTM), as the most powerful depth imaging method, has become the preferred imaging tool because of its ability to handle complex velocity models including steeply dipping interfaces and large velocity contrasts. Finite-difference methods are among the most popular numerical approaches used for RTM. However, these methods often encounter a serious issue of numerical dispersion, which is typically suppressed by reducing the grid interval of the propagation model, resulting in large computation and memory requirements. In addition, even with small grid spacing, numerical anisotropy may degrade images or, worse, provide images that appear to be focused but position events incorrectly. Recently, stereo-operators have been developed to approximate the partial differential operator in space. These operators have been used to develop several weak-dispersion and efficient stereo-modeling methods that have been found to be superior to conventional algorithms in suppressing numerical dispersion and numerical anisotropy. We generalized one stereo-modeling method, fourth-order nearly analytic central difference (NACD), from 2D to 3D and applied it to 3D RTM. The RTM results for the 3D SEG/EAGE phase A classic data set 1 and the SEG Advanced Modeling project model demonstrated that, even when using a large grid size, the NACD method can handle very complex velocity models and produced better images than can be obtained using the fourth-order and eighth-order Lax-Wendroff correction (LWC) schemes. We also applied 3D NACD and fourth-order LWC to a field data set and illustrated significant improvements in terms of structure imaging, horizon/layer continuity and positioning. We also investigated numerical dispersion and found that not only does the NACD method have superior dispersion characteristics but also that the angular variation of dispersion is significantly less than for LWC.
Inversion of ground constant offset loop-loop electromagnetic data for a large range of induction numbers
Authors: Guillemoteau Julien , Sailhac Pascal , Boulanger Charles , Trules Jérémie
Published: December 2014

Ground loop-loop electromagnetic surveys are often conducted to fulfill the low-induction-number condition. To image the distribution of electric conductivity inside the ground, it is then necessary to collect a multioffset data set. We considered that less time-consuming constant offset measurements can also reach this objective. This can be achieved by performing multifrequency soundings, which are commonly performed for the airborne electromagnetic method. Ground multifrequency soundings have to be interpreted carefully because they contain high-induction-number data. These data are interpreted in two steps. First, the in-phase and out-of-phase data are converted into robust apparent conductivities valid for all the induction numbers. Second, the apparent conductivity data are inverted in 1D and 2D to obtain the true distribution of the ground conductivity. For the inversion, we used a general half-space Jacobian for the apparent conductivity valid for all the induction numbers. This method was applied and validated on synthetic data computed with the full Maxwell theory. The method was then applied on field data acquired in the test site of Provins, in the Parisian basin, France. The result revealed good agreement with borehole and geologic information, demonstrating the applicability of our method.
Petrophysics and rock physics modeling of diagenetically altered sandstone
Authors: Hossain Zakir , Zhou Yijie
Published: December 2014

We worked to establish relationships among porosity, permeability, resistivity, and elastic wave velocity of diagenetically altered sandstone. Many such relationships are documented in the literature; however, they do not consider diagenetic effects. Combining theoretical models with laboratory measured data, we derived mathematical relationships for porosity permeability, porosity velocity, porosity resistivity, permeability velocity, velocity resistivity, and resistivity permeability in diagenetically altered sandstone. The effects of clay and cementation were evaluated using introduced coefficients in these relationships. We found that clean sandstone could be modeled with Kozeny’s relation; however, this relationship broke down for clay-bearing and diagenetically altered sandstone. Porosity is the first-order parameter that affects permeability, electrical, and elastic properties; clay and cement cause secondary effects on these properties. Rock physics modeling results revealed that cementation had a greater effect on elastic properties than electrical properties and clay had a larger effect on electrical properties than elastic properties. The relationships we provided can greatly help to determine permeability, resistivity, and velocity from porosity and to estimate permeability from resistivity and velocity as well as to determine resistivity from velocity measurements.
Sex Differences in Biomarkers Associated With Insulin Resistance in Obese Adolescents: Metabolomic Profiling and Principal Components Analysis
Authors: Newbern Dorothee , Gumus Balikcioglu Pinar , Balikcioglu Metin , Bain James , Muehlbauer Michael , Stevens Robert , Ilkayeva Olga , Dolinsky Diana , Armstrong Sarah , Irizarry Krystal , Freemark Michael
Published: December 2014

Objective

Obesity and insulin resistance (IR) predispose to type 2 diabetes mellitus. Yet only half of obese adolescents have IR and far fewer progress to type 2 diabetes mellitus. We hypothesized that amino acid and fatty acid metabolites may serve as biomarkers or determinants of IR in obese teens.

Research Design and Methods

Fasting blood samples were analyzed by tandem mass spectrometry in 82 obese adolescents. A principal components analysis and multiple linear regression models were used to correlate metabolic components with surrogate measures of IR: homeostasis model assessment index of insulin resistance (HOMA-IR), adiponectin, and triglyceride (TG) to high-density lipoprotein (HDL) ratio.

Results

Branched-chain amino acid (BCAA) levels and products of BCAA catabolism were higher (P < .01) in males than females with comparable body mass index (BMI) z-score. In multivariate analyses, HOMA-IR in males correlated positively with BMI z-score and a metabolic signature containing BCAA, uric acid, and long-chain acylcarnitines and negatively with byproducts of complete fatty acid oxidation (R2 = 0.659, P < .0001). In contrast, only BMI z-score correlated with HOMA-IR in females. Adiponectin correlated inversely with BCAA and uric acid (R2 = 0.268, P = .0212) in males but not females. TG to HDL ratio correlated with BMI z-score and the BCAA signature in females but not males.

Conclusions

BCAA levels and byproducts of BCAA catabolism are higher in obese teenage boys than girls of comparable BMI z-score. A metabolic signature comprising BCAA and uric acid correlates positively with HOMA-IR in males and TG to HDL ratio in females and inversely with adiponectin in males but not females. Likewise, byproducts of fatty acid oxidation associate inversely with HOMA-IR in males but not females. Our findings underscore the roles of sex differences in metabolic function and outcomes in pediatric obesity.
Is 18F-Fluorocholine-Positron Emission Tomography/Computerized Tomography a New Imaging Tool for Detecting Hyperfunctioning Parathyroid Glands in Primary or Secondary Hyperparathyroidism?
Authors: Michaud Laure , Burgess Alice , Huchet Virginie , Lefèvre Marine , Tassart Marc , Ohnona Jessica , Kerrou Khaldoun , Balogova Sona , Talbot Jean-Noël , Périé Sophie
Published: December 2014

Context:

Preoperative ultrasonography and scintigraphy using 99mTc-sestamibi are commonly used to localize abnormal parathyroid glands. In cases of discrepant results between scintigraphy and ultrasonography, it is important to rely on another diagnostic imaging modality. 18F-fluorodeoxyglucose (FDG) and 11C-methionine positron emission tomography (PET) have been studied, but are imperfect to detect abnormal parathyroid glands. Recently, first cases of abnormal parathyroid glands taking-up radiolabelled choline were discovered incidentally in men referred to 11C-choline or 18F-fluorocholine (FCH)-PET/CT for prostate cancer. We checked if FCH uptake was a general feature of adenomatous or hyperplastic parathyroid glands.

Methods:

FCH-PET/CT was performed in 12 patients with primary (n = 8) or secondary hyperparathyroidism (1 dialyzed, 3 grafted) and with discordant or equivocal results on preoperative ultrasonography (US) and/or 123I/99mTc-sestamibi dual-phase scintigraphy. The results of the FCH-PET/CT were evaluated, with surgical exploration and histopathologic examination as the standard of truth.

Results:

On a per-patient level, the detection rate of FCH-PET/CT (at least one FCH focus corresponding to an abnormal parathyroid gland in a given patient) was 11/12 = 92%. FCH-PET/CT detected 18 foci interpreted as parathyroid glands and correctly localized 17 abnormal parathyroid glands (7 adenomas and 10 hyperplasias). On a per-lesion level, FCH-PET/CT results were 17 TP, 2 false negative ie, a lesion-based sensitivity of 89%, and 1 false positive.

Conclusion:

As the main result of this pilot study, we show that in patients with hyperparathyroidism and with discordant or equivocal results on scintigraphy or on ultrasonography, adenomatous or hyperplastic parathyroid glands can be localized by FCH-PET/CT with good accuracy. Furthermore, FCH-PET/CT can solve discrepant results between preoperative ultrasonography and scintigraphy and has thus a potential as a functional imaging modality in the detection of abnormal parathyroid glands. Our preliminary results are encouraging and prompt us to further evaluate FCH-PET/CT as a functional imaging agent in patients with biochemical hyperparathyroidism.
Preparation of Carbon Nanofibers by Hydrogenation of Carbon Dioxide on a Nickel Sponge Catalyst
Authors: Wu Naijin , Li Baoshan , Zhang Jie
Published: December 2014

A novel method for preparing carbon nanofibers via catalytic hydrogenation of CO2 on a nickel sponge catalyst at 773 K and under atmospheric pressure is reported. The drop of pressure on the nickel sponge catalyst was small, which revealed that it could save on energy for the preparation of the carbon nanofibers. The diameter of the products was less than 200 nm.
Cooperative Catalysis of p-Aminophenol and Titanocene Dichloride in Direct Mannich Reactions with Acetone
Authors: Zhu Xuyang , Chen Chun , Yu Binxun , Zhang Guofang , Zhang Weiqiang , Gao Ziwei
Published: December 2014

A new binary acid system featuring an air stable organometallic precursor, titanocene dichloride and a simple Brønsted acid–base compound, was developed. The new catalyst system allowed for mild and highly efficient direct three-component Mannich reactions of both aryl ketones and alkyl ketones, in particular, acetone and its derivatives with excellent yields. Mechanistic study elucidated the dramatic synergistic effect of the new binary acid system.
Enhanced Magnetoelastic Behavior of Magnetic Elastomers with Layered Structure
Authors: Oguro Tsubasa , Kanauchi Shunta , Mitsumata Tetsu , Tamesue Shingo , Yamauchi Takeshi
Published: December 2014

We synthesized layered magnetic elastomers with polymer films and investigated the magnetoelastic behavior using dynamic viscoelastic measurements. The storage modulus at 0 mT was nearly independent of the sheets of films, while the storage modulus at 500 mT dramatically increased. The storage modulus at 500 mT for magnetic elastomers with 4 films was 2.1 MPa, which was 1.3 MPa higher than that of magnetic elastomers without layered structure. It can be considered that the stress transfer among imperfect short chains of magnetic particles is enhanced by inserting polymer films.