bluuebunny/crossref_metadata_2025 huggingface dataset:
Climate Change Effects on Hydropower Potential in the Alcantara River Basin in Sicily (Italy)
Authors: Aronica G. T. , Bonaccorso B.
Published: May 2013

In recent years, increasing attention has been paid to hydropower generation, since it is a renewable, efficient, and reliable source of energy, as well as an effective tool to reduce the atmospheric concentrations of greenhouse gases resulting from human activities. At the same time, however, hydropower is among the most vulnerable industries to global warming, because water resources are closely linked to climate changes. Indeed, the effects of climate change on water availability are expected to affect hydropower generation with special reference to southern countries, which are supposed to face dryer conditions in the next decades. The aim of this paper is to qualitatively assess the impact of future climate change on the hydrological regime of the Alcantara River basin, eastern Sicily (Italy), based on Monte Carlo simulations. Synthetic series of daily rainfall and temperature are generated, based on observed data, through a first-order Markov chain and an autoregressive moving average (ARMA) model, respectively, for the current scenario and two future scenarios at 2025. In particular, relative changes in the monthly mean and standard deviation values of daily rainfall and temperature at 2025, predicted by the Hadley Centre Coupled Model, version 3 (HadCM3) for A2 and B2 greenhouse gas emissions scenarios, are adopted to generate future values of precipitation and temperature. Synthetic series for the two climatic scenarios are then introduced as input into the Identification of Unit Hydrographs and Component Flows from Rainfall, Evapotranspiration and Streamflow Data (IHACRES) model to simulate the hydrological response of the basin. The effects of climate change are investigated by analyzing potential modification of the resulting flow duration curves and utilization curves, which allow a site's energy potential for the design of run-of-river hydropower plants to be estimated.
Homogeneity of the Subgrid-Scale Turbulent Mixing in Large-Eddy Simulation of Shallow Convection
Authors: Jarecka Dorota , Grabowski Wojciech W. , Morrison Hugh , Pawlowska Hanna
Published: May 2013

This paper presents an approach to locally predict homogeneity of the subgrid-scale turbulent mixing in large-eddy simulation of shallow clouds applying double-moment warm-rain microphysics. The homogeneity of subgrid-scale mixing refers to the partitioning of the cloud water evaporation due to parameterized entrainment between changes of the mean droplet radius and changes of the mean droplet concentration. Homogeneous and extremely inhomogeneous mixing represent two limits of possible scenarios, where the droplet concentration and the mean droplet radius remains unchanged during the microphysical adjustment, respectively. To predict the subgrid-scale mixing scenario, the double-moment microphysics scheme is merged with the approach to delay droplet evaporation resulting from entrainment. Details of the new scheme and its application in the Barbados Oceanographic and Meteorological Experiment (BOMEX) shallow convection case are discussed. The simulated homogeneity of mixing varies significantly inside small convective clouds, from close to homogeneous to close to extremely inhomogeneous. The mean mixing characteristics become more homogeneous with height, reflecting increases of the mean droplet size and the mean turbulence intensity, both favoring homogeneous mixing. Model results are consistent with microphysical effects of entrainment and mixing deduced from field observations. Mixing close to homogeneous is predicted in volumes with the highest liquid water content (LWC) and strongest updraft at a given height, whereas mixing in strongly diluted volumes is typically close to extremely inhomogeneous. The simulated homogeneity of mixing has a small impact on mean microphysical characteristics. This result agrees with the previous study applying prescribed mixing scenarios and can be explained by the high humidity of the clear air involved in the subgrid-scale mixing.
Ensemble Representation of Uncertainty in Lagrangian Satellite Rainfall Estimates
Authors: Bellerby T. J.
Published: May 2013

A new algorithm called Lagrangian Simulation (LSIM) has been developed that enables the interpolation uncertainty present in Lagrangian satellite rainfall algorithms such as the Climate Prediction Center (CPC) morphing technique (CMORPH) to be characterized using an ensemble product. The new algorithm generates ensemble sequences of rainfall fields conditioned on multiplatform multisensor microwave satellite data, demonstrating a conditional simulation approach that overcomes the problem of discontinuous uncertainty fields inherent in this type of product. Each ensemble member is consistent with the information present in the satellite data, while variation between members is indicative of uncertainty in the rainfall retrievals. LSIM is based on the combination of a Markov weather generator, conditioned on both previous and subsequent microwave measurements, and a global optimization procedure that uses simulated annealing to constrain the generated rainfall fields to display appropriate spatial structures. The new algorithm has been validated over a region of the continental United States and has been shown to provide reliable estimates of both point uncertainty distributions and wider spatiotemporal structures.
Low concentrations of copper in drinking water increase AP-1 binding in the brain
Authors: Lung Shyang , Li Huihui , Bondy Stephen C , Campbell Arezoo
Published: May 2013

Copper (Cu) in trace amounts is essential for biological organisms. However, dysregulation of the redox-active metal has been implicated in different neurological disorders such as Wilson’s, Menkes’, Alzheimer’s, and Parkinson’s diseases. Since many households use Cu tubing in the plumbing system, and corrosion causes the metal to leach into the drinking water, there may be adverse effects on the central nervous system connected with low-level chronic exposure. The present study demonstrates that treatment with a biologically relevant concentration of Cu for 3 months significantly increases activation of the redox-modulated transcription factor AP-1 in mouse brains. This was independent of an upstream kinase indicated in AP-1 activation. Another redox-active transcription factor, NF-κB, was not significantly modified by the Cu exposure. These results indicate that the effect of Cu on AP-1 is unique and may involve direct modulation of DNA binding.
Helping Families With Russian Adoptees
Authors: Pronchenko-Jain Yulia , Fernando Delini M.
Published: May 2013

With the increase in children adopted from Russia, family therapists in the United States face the dilemma of helping adoptive families care for their child and build a healthy family unit. This article familiarizes family therapists with children’s unique experiences in Russian institutionalized care and its impact on children’s social–emotional development, behavior, and attachment patterns. Implications for family therapists working with families adopting Russian orphans are discussed.
Perioperative Fluid Management for Pulmonary Resection Surgery and Esophagectomy
Authors: Chau Edmond Hung Leong , Slinger Peter
Published: May 2013

Perioperative fluid management is of significant importance during pulmonary resection surgery and esophagectomy. Excessive fluid administration has been consistently shown as a risk factor for lung injury after thoracic procedures. Probable causes of this serious complication include fluid overload, lung lymphatics and pulmonary endothelial damage. Along with new insights regarding the Starling equation and the absence of a third space, current evidence supports a restrictive fluid regimen for patients undergoing pulmonary resection surgery and esophagectomy. Multiple minimally invasive hemodyamic monitoring devices, including pulse pressure/stroke volume variation, esophageal Doppler, and extravascular lung water measurement, were evaluated for optimizing perioperative fluid therapy. Further research regarding the prevention, diagnosis, and treatment of acute lung injury after pulmonary resection and esophagectomy is required.
Twenty Years of Cognitive Work Analysis in Health Care
Authors: Jiancaro Tizneem , Jamieson Greg A. , Mihailidis Alex
Published: May 2013

Improving patient safety, within the context of a complex system, forms one of the key challenges in health care today. Cognitive work analysis (CWA) is one way to analyze complex systems, and although it has been applied to health care for 20 years, little is known about its effectiveness or future research needs. This article presents a review of CWA studies in health care, addressing questions of use, usefulness, challenges, and opportunities. Results of the review make clear that the research agenda is largely confined to acute care. Of the 39 articles reviewed, 28 relate to this setting. There appears to be a growing interest in medical informatics, error investigation, and decision support. Conversely, work in physiological monitoring has slowed, associated with the uncertainties of modeling “biological” systems. Studies related to “organic” social systems are similarly challenged, although there is a recognition that important opportunities exist, such as studying work flow processes between teams. Other opportunities relate to new methods to enhance CWA; new technologies, such as auditory displays; and new applications, such as requests for proposals and incident investigation. Ultimately, the capacity to foster an understanding into the deep structures of a system may prove to be the greatest contribution of CWA to health care today.
Scaphoid nonunions in skeletally immature adolescents
Authors: Behr B. , Heffinger C. , Hirche C. , Daigeler A. , Lehnhardt M. , Bickert B.
Published: May 2013

Scaphoid nonunions in children requiring operative treatment are rare. The aim of this study was to analyze our own patient population of the last 13 years to assess the postoperative outcome of these operations. Seven patients, under aged 14 years, were treated for scaphoid nonunions. Patients were clinically and radiologically examined and subjective outcomes were measured, such as the visual analogue pain scale (VAPS), Disability of the Arm, Shoulder and Hand (DASH) score, and Krimmer score. All patients showed an excellent outcome, as determined by the DASH score, Krimmer score, and VAPS. No differences between grip strength and range of motion between the operated and non-operated hand were observed. Therefore, we propose that scaphoid nonunions in skeletally immature adolescents can be treated satisfactorily with excision of the nonunion and bone grafting.
Epithelial cytoprotection sustains ectopic expression of tissue-restricted antigens in the thymus during murine acute GVHD
Authors: Dertschnig Simone , Nusspaumer Gretel , Ivanek Robert , Hauri-Hohl Mathias M. , Holländer Georg A. , Krenger Werner
Published: May 2013

Key Points

Acute GVHD predisposes to autoimmune chronic GVHD, but it is currently unclear how autoimmunity is linked to antecedent alloimmunity. Loss of central tolerance induction that occurs via functional compromise of thymic epithelial cells may provide such a pathogenic link.
The Rac activator DOCK2 regulates natural killer cell–mediated cytotoxicity in mice through the lytic synapse formation
Authors: Sakai Yusuke , Tanaka Yoshihiko , Yanagihara Toyoshi , Watanabe Mayuki , Duan Xuefeng , Terasawa Masao , Nishikimi Akihiko , Sanematsu Fumiyuki , Fukui Yoshinori
Published: May 2013

Key Points

DOCK2-deficienct NK cells fail to effectively kill leukemia cells in vitro and major histocompatibility complex class I–deficient bone marrow cells in vivo. Activating NK receptor–mediated Rac activation and the lytic synapse formation are severely impaired in DOCK2-deficient NK cells.
The venus kinase receptor (VKR) family: structure and evolution
Authors: Vanderstraete Mathieu , Gouignard Nadège , Ahier Arnaud , Morel Marion , Vicogne Jérôme , Dissous Colette
Published: May 2013

Background

Receptor tyrosine kinases (RTK) form a family of transmembrane proteins widely conserved in Metazoa, with key functions in cell-to-cell communication and control of multiple cellular processes. A new family of RTK named Venus Kinase Receptor (VKR) has been described in invertebrates. The VKR receptor possesses a Venus Fly Trap (VFT) extracellular module, a bilobate structure that binds small ligands to induce receptor kinase activity. VKR was shown to be highly expressed in the larval stages and gonads of several invertebrates, suggesting that it could have functions in development and/or reproduction.

Results

Analysis of recent genomic data has allowed us to extend the presence of VKR to five bilaterian phyla (Platyhelminthes, Arthropoda, Annelida, Mollusca, Echinodermata) as well as to the Cnidaria phylum. The presence of NveVKR in the early-branching metazoan Nematostella vectensis suggested that VKR arose before the bilaterian radiation. Phylogenetic and gene structure analyses showed that the 40 receptors identified in 36 animal species grouped monophyletically, and likely evolved from a common ancestor. Multiple alignments of tyrosine kinase (TK) and VFT domains indicated their important level of conservation in all VKRs identified up to date. We showed that VKRs had inducible activity upon binding of extracellular amino-acids and molecular modeling of the VFT domain confirmed the structure of the conserved amino-acid binding site.

Conclusions

This study highlights the presence of VKR in a large number of invertebrates, including primitive metazoans like cnidarians, but also its absence from nematodes and chordates. This little-known RTK family deserves to be further explored in order to determine its evolutionary origin, its possible interest for the emergence and specialization of Metazoa, and to understand its function in invertebrate development and/or reproductive biology.
A large-scale assessment of hand hygiene quality and the effectiveness of the “WHO 6-steps”
Authors: Szilágyi László , Haidegger Tamás , Lehotsky Ákos , Nagy Melinda , Csonka Erik-Artur , Sun Xiuying , Ooi Kooi Li , Fisher Dale
Published: May 2013

Background

Hand hygiene compliance is generally assessed by observation of adherence to the “WHO five moments” using numbers of opportunities as the denominator. The quality of the activity is usually not monitored since there is no established methodology for the routine assessment of hand hygiene technique. The aim of this study was to objectively assess hand rub coverage of staff using a novel imaging technology and to look for patterns and trends in missed areas after the use of WHO’s 6 Step technique.

Methods

A hand hygiene education and assessment program targeted 5200 clinical staff over 7 days at the National University Hospital, Singapore. Participants in small groups were guided by professional trainers through 5 educational stations, which included technique-training and UV light assessment supported by digital photography of hands. Objective criteria for satisfactory hand hygiene quality were defined a priori. The database of images created during the assessment program was analyzed subsequently. Patterns of poor hand hygiene quality were identified and linked to staff demographic.

Results

Despite the assessment taking place immediately after the training, only 72% of staff achieved satisfactory coverage. Failure to adequately clean the dorsal and palmar aspects of the hand occurred in 24% and 18% of the instances, respectively. Fingertips were missed by 3.5% of subjects. The analysis based on 4642 records showed that nurses performed best (77% pass), and women performed better than men (75% vs. 62%, p<0.001). Further risk indicators have been identified regarding age and occupation.

Conclusion

Ongoing education and training has a vital role in improving hand hygiene compliance and technique of clinical staff. Identification of typical sites of failure can help to develop improved training.
MicroRNA regulation and its effects on cellular transcriptome in Human Immunodeficiency Virus-1 (HIV-1) infected individuals with distinct viral load and CD4 cell counts
Authors: Duskova Karolina , Nagilla Pruthvi , Le Hai-Son , Iyer Priyadarshini , Thalamuthu Anbupalam , Martinson Jeremy , Bar-Joseph Ziv , Buchanan William , Rinaldo Charles , Ayyavoo Velpandi
Published: May 2013

Background

Disease progression in the absence of therapy varies significantly in HIV-1 infected individuals. Both viral and host cellular molecules are implicated; however, the exact role of these factors and/or the mechanism involved remains elusive. To understand how microRNAs (miRNAs), which are regulators of transcription and translation, influence host cellular gene expression (mRNA) during HIV-1 infection, we performed a comparative miRNA and mRNA microarray analysis using PBMCs obtained from infected individuals with distinct viral load and CD4 counts.

Methods

RNA isolated from PBMCs obtained from HIV-1 seronegative and HIV-1 positive individuals with distinct viral load and CD4 counts were assessed for miRNA and mRNA profile. Selected miRNA and mRNA transcripts were validated using in vivo and in vitro infection model.

Results

Our results indicate that HIV-1 positive individuals with high viral load (HVL) showed a dysregulation of 191 miRNAs and 309 mRNA transcripts compared to the uninfected age and sex matched controls. The miRNAs miR-19b, 146a, 615-3p, 382, 34a, 144 and 155, that are known to target innate and inflammatory factors, were significantly upregulated in PBMCs with high viral load, as were the inflammatory molecules CXCL5, CCL2, IL6 and IL8, whereas defensin, CD4, ALDH1, and Neurogranin (NRGN) were significantly downregulated. Using the transcriptome profile and predicted target genes, we constructed the regulatory networks of miRNA-mRNA pairs that were differentially expressed between control, LVL and HVL subjects. The regulatory network revealed an inverse correlation of several miRNA-mRNA pair expression patterns, suggesting HIV-1 mediated transcriptional regulation is in part likely through miRNA regulation.

Conclusions

Results from our studies indicate that gene expression is significantly altered in PBMCs in response to virus replication. It is interesting to note that the infected individuals with low or undetectable viral load exhibit a gene expression profile very similar to control or uninfected subjects. Importantly, we identified several new mRNA targets (Defensin, Neurogranin, AIF) as well as the miRNAs that could be involved in regulating their expression through the miRNA-mRNA interaction.
Claudin 1 expression in basal-like breast cancer is related to patient age
Authors: Blanchard Anne A , Ma Xiuli , Dueck Kevin J , Penner Carla , Cooper Steven C , Mulhall Drew , Murphy Leigh C , Leygue Etienne , Myal Yvonne
Published: May 2013

Background

Defects in tight junctions, gate-keepers of the integrity of the epidermal barrier function, are known to contribute to cancer development. As such, enhancing our understanding of how the expression of proteins involved in these junctions is regulated in cancer, remains a priority. Although the expression of one of these proteins, claudin 1, is down regulated in most invasive human breast cancers (HBC), we have recently shown that high levels of claudin 1, characterized tumors belonging to the very aggressive basal-like breast cancer (BLBC) subtype. In these tumors, the claudin 1 protein, usually localized in the cell membrane, is often mislocalized to the cytoplasm.

Methods

To examine the clinical relevance of this observation, we have generated and analyzed an invasive HBC tissue microarray consisting of 151 breast tumor samples; 79 of which presented a basal-like phenotype (i.e. ER-ve, PR-ve HER2-ve, CK5/6 or EGFR+ve). We also interrogated the outcome of claudin 1 knockdown in a human BLBC cell line, BT-20.

Results

Immunohistochemical analysis of this patient cohort revealed a significant association between high claudin 1 expression and BLBCs in women 55 years of age and older. Interestingly, no significant association was found between claudin 1 and nodal involvement, tumor grade or tumor size. Regression analysis however, showed a significant positive association between claudin 1 and claudin 4, even though claudin 4 did not significantly correlate with patient age. Claudin 1 knockdown in BT-20 cells resulted in decreased cell migration. It also significantly altered the expression of several genes involved in epithelial-mesenchymal-transition (EMT); in particular, SERPINE 1 (PAI1) and SSP1 (osteopontin), known to inhibit EMT and cancer cell migration. Conversely, genes known to maintain EMT through their interaction, SNAIL2, TCF4 and FOXC2 were significantly down regulated.

Conclusions

The association of high claudin 1 protein levels observed in tumors derived from older women with BLBC, suggests that claudin 1 has the potential to serve as a marker which can identify a specific subgroup of patients within the BLBC subtype and thus, further contribute to the characterization of these ill-defined breast cancers. More importantly, our studies strongly suggest that claudin 1 directly participates in promoting breast cancer progression, possibly through the alteration of expression of EMT genes.
Exploring changes in open defecation prevalence in sub-Saharan Africa based on national level indices
Authors: Galan Deise I , Kim Seung-Sup , Graham Jay P
Published: May 2013

Background

In sub-Saharan Africa, it is estimated that 215 million people continue to engage in open defecation. This practice facilitates the transmission of diarrheal diseases – one of the leading causes of mortality in children under 5 in sub-Saharan Africa. The main purpose of this study is to: estimate changes in open defecation prevalence between 2005 and 2010 across countries in sub-Saharan Africa; examine the association between national level indices and changes in open defecation prevalence; and assess how many countries can achieve ‘open defecation free status’ by 2015.

Methods

After applying selection criteria, this study analyzed country-level data for 34 sub-Saharan African countries. Seven country-level indices were collected: 1) presence of a national sanitation policy; 2) budget line for sanitation; 3) budget allocated to sanitation; 4) annual per capita GDP; 5) GDP growth; 6) implementation of total sanitation approaches; and 7) per capita aid disbursement for water supply and sanitation. The relationships between these country-level indices and the change in open defecation from 2005 to 2010 were investigated using Wilcoxon Signed-Rank test and Spearman's rank correlation test.

Results

Only 3 countries (i.e. Ethiopia, Angola and Sao Tome and Principe) decreased open defecation by 10% or more between 2005 and 2010. No significant associations were observed between the change in open defecation prevalence and all of national level indices except per capita aid disbursement. Per capita aid disbursement for water and sanitation was positively associated with a reduction in open defecation (p-value = 0.02) for a subset of 29 low-income countries from 2005 to 2010. Only one country in our analysis, Angola, is on track to end open defecation by 2015 based on their performance between 2000 and 2010.

Conclusions

Most of the national level indices, including a country’s economic status, were not associated with the change in the open defecation prevalence. Based on current trends, the goal of ending open defecation in the majority of sub-Saharan African countries by 2015 will not be achieved. Our findings may be limited by the exploratory nature of this analysis, and future research is required to identify and characterize national level factors specific to reducing open defecation in sub-Saharan Africa.
Development of a salmon-derived crosslinked atelocollagen sponge disc containing osteogenic protein-1 for articular cartilage regeneration: in vivo evaluations with rabbits
Authors: Mori Hiroyuki , Kondo Eiji , Kawaguchi Yasuyuki , Kitamura Nobuto , Nagai Nobuhiro , Iida Hirokazu , Yasuda Kazunori
Published: May 2013

Background

We have developed crosslinked salmon-derived atelocollagen sponge, which has a denaturation temperature of 47 degrees Celsius. The purpose of this study is to evaluate the fundamental in vivo efficacy of the osteogenic protein (OP) -1 containing salmon-derived collagen sponge disc (SCS) on cartilage regeneration, using a rabbit model.

Methods

A total of 24 rabbits were used in this study. In each animal, a full-thickness osteochondral defect was created in each femoral trochlea. Then, each 12 rabbits were randomly divided into the two groups. In Group I, an OP1-SCS disc was implanted into the defect in the right knee. In Group II, a SCS disc without OP-1 was implanted into the defect in the right knee. A control group of 12 rabbits was assembled from randomly-selected left knees from among the first two groups. In Group-III, we applied no treatment for a defect in the left knee to obtain the untreated control. All rabbits were sacrificed at 12 weeks after surgery. In each group, 10 animals were used for histological and immunohistological evaluations, and the remaining 2 were used for real-time polymerase chain reaction (PCR) analyses.

Results

In Group I, a regenerated cartilage tissue rich in proteoglycan and type-2 collagen was found at 12 weeks, although the width was thicker than that of Group II. In Group II, the defect was filled with thick inhomogeneous tissues, including cartilage, fibrous, and bone tissues at 12 weeks. Concerning the gross observation and histological scores at 12 weeks, the ANOVA showed significant differences (p < 0.0001, and p < 0.0001, respectively). The post-hoc test indicated that the gross observation and histological scores of Group I was significantly greater than those of Groups II (p = 0.035, and p = 0.0104, respectively) and III (p < 0.0001, and p < 0.0001, respectively), while Group II was significantly greater than Group III (p = 0.0069, and p = 0.005, respectively). The real time PCR analysis showed that gene expression of type-2 collagen and aggrecan of Group I was greater than that of Group II.

Conclusions

The present study clearly demonstrated that the implantation of the OP1-SCS disc without any cultured cells may induce spontaneous hyaline-like cartilage regeneration to greater degrees than implantation of only the salmon-derived collagen sponge disc.
Cerebral iodized lipid embolization via a pulmonary arteriovenous shunt: rare complication of transcatheter arterial embolization for hepatocellular carcinoma
Authors: Bánsághi Zoltán , Kaposi Pál Novák , Lovas Gábor , Szentmártoni Gyöngyvér , Várallyay György , Bata Pál , Kalina Ildikó , Futácsi Balázs , Bérczi Viktor
Published: May 2013

We report the first European case of cerebral iodized lipid embolism post transcatheter arterial embolization for hepatocellular carcinoma. Lipiodol emboli and corresponding multifocal brain ischemia were documented with computed tomography (CT) and magnetic resonance (MR) in the acutely symptomatic patient. Transcranial Doppler sonography with contrast indicated a right-to-left shunt, while on a follow-up CT scan lipiodol embolization was detected in both lungs. Dilated pulmonary vessels and thick vascular channels were seen in the vicinity of the right diaphragm suggestive of pulmonary arteriovenous shunt. The patient symptoms regressed with supportive care alone, but he died 5 months later due to hepatic failure unrelated to the procedure.
Television screen time, but not computer use and reading time, is associated with cardio-metabolic biomarkers in a multiethnic Asian population: a cross-sectional study
Authors: Nang Ei Ei Khaing , Salim Agus , Wu Yi , Tai E Shyong , Lee Jeannette , Van Dam Rob M
Published: May 2013

Background

Recent evidence shows that sedentary behaviour may be an independent risk factor for cardiovascular diseases, diabetes, cancers and all-cause mortality. However, results are not consistent and different types of sedentary behaviour might have different effects on health. Thus the aim of this study was to evaluate the association between television screen time, computer/reading time and cardio-metabolic biomarkers in a multiethnic urban Asian population. We also sought to understand the potential mediators of this association.

Methods

The Singapore Prospective Study Program (2004–2007), was a cross-sectional population-based study in a multiethnic population in Singapore. We studied 3305 Singaporean adults of Chinese, Malay and Indian ethnicity who did not have pre-existing diseases and conditions that could affect their physical activity. Multiple linear regression analysis was used to assess the association of television screen time and computer/reading time with cardio-metabolic biomarkers [blood pressure, lipids, glucose, adiponectin, C reactive protein and homeostasis model assessment of insulin resistance (HOMA-IR)]. Path analysis was used to examine the role of mediators of the observed association.

Results

Longer television screen time was significantly associated with higher systolic blood pressure, total cholesterol, triglycerides, C reactive protein, HOMA-IR, and lower adiponectin after adjustment for potential socio-demographic and lifestyle confounders. Dietary factors and body mass index, but not physical activity, were potential mediators that explained most of these associations between television screen time and cardio-metabolic biomarkers. The associations of television screen time with triglycerides and HOMA-IR were only partly explained by dietary factors and body mass index. No association was observed between computer/ reading time and worse levels of cardio-metabolic biomarkers.

Conclusions

In this urban Asian population, television screen time was associated with worse levels of various cardio-metabolic risk factors. This may reflect detrimental effects of television screen time on dietary habits rather than replacement of physical activity.
Real-time three-dimensional transesophageal echocardiography to predict artificial chordae length for mitral valve repair
Authors: Huang Huan-lei , Xie Xu-jing , Fei Hong-wen , Xiao Xue-jun , Liu Jing , Zhuang Jian , Lu Cong
Published: May 2013

Background

Artificial chordae replacement is an effective technique for mitral valve repair, however, it is difficult to accurately determine the length of artificial chordae. This study aimed to assess the reliability and accuracy of real-time three-dimensional transesophageal echocardiography (TEE) to predict the length of artificial chordae preoperatively.

Methods

From December 2008 to December 2010, 48 patients with severe mitral regurgitation successfully underwent mitral valve repair using artificial chordae replacement. The patients were divided into a TEE pre-measurement group (n = 26) and a direct measurement group (n = 22), according to the method used to determine the length of artificial chordae. Cardiopulmonary bypass time, aortic cross-clamp time, and the recurrence rate of moderate or severe mitral regurgitation were compared between the two groups.

Results

There were no operative deaths in either group. The mean cardiopulmonary bypass time was 113.0 ± 18.7 min and 127.0 ± 28.9 min (p < 0.05), and the aortic cross-clamp time was 70.0 ± 16.6 min and 86.0 ± 20.7 min (p < 0.05) in the TEE pre-measurement group and direct measurement group, respectively. The difference between the pre-measured artificial chordal length and actual constructed artificial chordal length was not significant in the TEE pre-measurement group (p > 0.05). Although the difference in the incidence of moderate or severe mitral regurgitation between the two groups was not significant (p > 0.05), the incidence in the TEE pre-measurement group (3.8%) was lower than that in the direct measurement group (18.2%).

Conclusions

Real-time three-dimensional transesophageal echocardiography can accurately predict the length of artificial chordae required for mitral valve repair, and shortens cardiopulmonary bypass time and aortic cross-clamp time while improving the results of mitral valve repair.
Temperature, relative humidity and sunshine may be the effective predictors for occurrence of malaria in Guangzhou, southern China, 2006–2012
Authors: Li Tiegang , Yang Zhicong , Wang Ming
Published: May 2013

Malaria has been endemic in Guangzhou for more than 50 years. The goal of this study was to use a negative binomial regression to identify the relationship between meteorological variables and malaria reported. Our results revealed that each 1°C rise of temperature corresponds to an increase of 0.90% in the monthly number of malaria cases. Likewise, a one percent rise in relative humidity led to an increase of 3.99% and a one hour rise in sunshine led to an increase of 0.68% in the monthly number of cases. Our findings may be useful for developing a simple, precise malaria early warning system.
A novel approach to improve hand hygiene compliance of student nurses
Authors: Salmon Sharon , Wang Xiao Bei , Seetoh Theresa , Lee Siu Yin , Fisher Dale A
Published: May 2013

Background

The National University Hospital, Singapore routinely undertakes standardized Hand Hygiene auditing with results produced by ward and by staff type. In 2010 concern was raised over consistently low compliance by nursing students averaging 45% (95% CI 42%–48%) prompting us to explore novel approaches to educating our next generation of nurses to improve their hand hygiene practice.

We introduced an experiential learning assignment to final year student nurses on attachment to NUH inclusive of hand hygiene auditor training followed by a period of hand hygiene observation. The training was based on the World Health Organisation (WHO) “My 5 moments for hand hygiene” approach. Upon completion students completed an anonymous questionnaire to evaluate their learning experience.

Findings

By 2012, nursing students were 40% (RR: 1.4, 95% CI 1.3–1.5, p<0.001) more likely to comply with hand hygiene practices. 97.5% (359/368) of nursing students felt that the experience would enhance their own hand hygiene practice and would recommend participating in audits as a learning instrument.

Conclusions

With consideration of all stakeholders a sustainable, flexible, programme was implemented. Experiential learning of hand hygiene was a highly valued educational tool and in our project was directly associated with improved hand hygiene compliance. Feedback demonstrated popularity amongst participants and success in achieving its program objectives. While this does not guarantee long term behavioural change it is intuitive that instilling good habits and messages at the early stages of a career will potentially have significant long-term impact.
Immunohistochemistry is highly sensitive and specific for detection of BRAF V600E mutation in pleomorphic xanthoastrocytoma
Authors: Ida Cristiane M , Vrana Julie A , Rodriguez Fausto J , Jentoft Mark E , Caron Alissa A , Jenkins Sarah M , Giannini Caterina
Published: May 2013

Background

High frequencies of the BRAF V600E mutation have been reported in pleomorphic xanthoastrocytoma (PXA). Recently, a BRAF V600E mutation-specific antibody has been developed and validated. We evaluated the immunohistochemical (IHC) detection of BRAF V600E mutation in PXA by comparing to gold standard molecular analysis and investigating the interobserver variability of the IHC scoring. We performed BRAF V600E IHC in 46 cases, of which 37 (80%) cases had sufficient tumor tissue for molecular analysis. IHC detection was performed using monoclonal mouse antibody VE1 (Spring Bioscience). IHC slides were scored independently by four reviewers blind to molecular data, including a primary (gold standard) and three additional reviewers. BRAF V600E mutation status was assessed by allele-specific polymerase chain reaction (PCR) with fragment analysis.

Results

All 46 cases showed interpretable BRAF V600E IHC results: 27 (59%) were positive (strong cytoplasmic staining), 19 (41%) were negative (6 of these cases with focal/diffuse weak cytoplasmic staining, interpreted as nonspecific by the primary reviewer). By molecular analysis, all 37 cases that could be tested had evaluable results: 22 (59%) cases were positive for BRAF V600E mutation and were scored as “IHC-positive”, and 15 (41%) were negative (including 11 cases scored as “IHC-negative” and 4 cases scored as negative with minimal nonspecific staining). IHC detection of BRAF V600E mutant protein was congruent in all 37 cases that were successfully evaluated by molecular testing (sensitivity and specificity of 100%). Agreement for IHC scoring among the 4 reviewers was almost perfect (kappa 0.92) when cases were scored as “positive/negative” and substantial (kappa 0.78) when minimal nonspecific staining was taken into account.

Conclusions

We conclude that detection of BRAF V600E mutation by immunohistochemistry is highly sensitive and specific. BRAF V600E IHC interpretation is usually straightforward, but awareness of possible nonspecific staining is necessary and training is recommended. It is a practical rapid method that may avoid the need of labor-intensive molecular testing and may be most valuable in small biopsies unsuitable for molecular analysis.
Regulation of centrosome movements by Numb and the Collapsin Response Mediator Protein during Drosophila sensory progenitor asymmetric division
Authors: Jauffred Bertrand , Llense Flora , Sommer Bernhard , Wang Zhimin , Martin Charlotte , Bellaiche Yohanns
Published: May 2013

Asymmetric cell division generates cell fate diversity during development and adult life. Recent findings have demonstrated that during stem cell divisions, the movement of centrosomes is asymmetric in prophase and that such asymmetry participates in mitotic spindle orientation and cell polarization. Here, we have investigated the dynamics of centrosomes during Drosophila sensory organ precursor asymmetric divisions and find that centrosome movements are asymmetric during cytokinesis. We demonstrate that centrosome movements are controlled by the cell fate determinant Numb, which does not act via its classical effectors, Sanpodo and α-Adaptin, but via the Collapsin Response Mediator Protein (CRMP). Furthermore, we find that CRMP is necessary for efficient Notch signalling and that it regulates the duration of the pericentriolar accumulation of Rab11-positive endosomes, through which the Notch ligand, Delta is recycled. Our work characterizes an additional mode of asymmetric centrosome movement during asymmetric divisions and suggests a model whereby the asymmetry in centrosome movements participates in differential Notch activation to regulate cell fate specification.
Specification of hepatopancreas progenitors in zebrafish by hnf1ba and wnt2bb
Authors: Lancman Joseph J. , Zvenigorodsky Natasha , Gates Keith P. , Zhang Danhua , Solomon Keely , Humphrey Rohan K. , Kuo Taiyi , Setiawan Linda , Verkade Heather , Chi Young-In , Jhala Ulupi S. , Wright Christopher V. E. , Stainier Didier Y. R. , Dong P. Duc Si
Published: May 2013

Although the liver and ventral pancreas are thought to arise from a common multipotent progenitor pool, it is unclear whether these progenitors of the hepatopancreas system are specified by a common genetic mechanism. Efforts to determine the role of Hnf1b and Wnt signaling in this crucial process have been confounded by a combination of factors, including a narrow time frame for hepatopancreas specification, functional redundancy among Wnt ligands, and pleiotropic defects caused by either severe loss of Wnt signaling or Hnf1b function. Using a novel hypomorphic hnf1ba zebrafish mutant that exhibits pancreas hypoplasia, as observed in HNF1B monogenic diabetes, we show that hnf1ba plays essential roles in regulating β-cell number and pancreas specification, distinct from its function in regulating pancreas size and liver specification, respectively. By combining Hnf1ba partial loss of function with conditional loss of Wnt signaling, we uncover a crucial developmental window when these pathways synergize to specify the entire ventrally derived hepatopancreas progenitor population. Furthermore, our in vivo genetic studies demonstrate that hnf1ba generates a permissive domain for Wnt signaling activity in the foregut endoderm. Collectively, our findings provide a new model for HNF1B function, yield insight into pancreas and β-cell development, and suggest a new mechanism for hepatopancreatic specification.
Ahsa1 and Hsp90 activity confers more severe craniofacial phenotypes in a zebrafish model of hypoparathyroidism, sensorineural deafness and renal dysplasia (HDR)
Authors: Sheehan-Rooney Kelly , Swartz Mary E. , Zhao Feng , Liu Dong , Eberhart Johann K.
Published: May 2013

The severity of most human birth defects is highly variable. Our ability to diagnose, treat and prevent defects relies on our understanding of this variability. Mutation of the transcription factor GATA3 in humans causes the highly variable hypoparathyroidism, sensorineural deafness and renal dysplasia (HDR) syndrome. Although named for a triad of defects, individuals with HDR can also exhibit craniofacial defects. Through a forward genetic screen for craniofacial mutants, we isolated a zebrafish mutant in which the first cysteine of the second zinc finger of Gata3 is mutated. Because mutation of the homologous cysteine causes HDR in humans, these zebrafish mutants could be a rapidly available and effective animal model for understanding the role of gata3 in the HDR disease spectrum. We demonstrate that, unexpectedly, the chaperone proteins Ahsa1 and Hsp90 promote severe craniofacial phenotypes in our zebrafish model of HDR syndrome. The strengths of the zebrafish system, including rapid development, genetic tractability and live imaging, make this an important model for variability.
Enhancement of Hydrothermal Oxidation of Chlorobenzene by the Fenton-type Reaction Using Cu(II)-grafted Tungsten Trioxide Catalyst
Authors: Kometani Noritsugu , Sumiyoshi Yasuaki
Published: May 2013

The catalytic and photocatalytic hydrothermal oxidation of chlorobenzene has been examined at reaction temperatures ranging from 25 to 400 °C and at a fixed pressure of 30 MPa, using Cu(II)-grafted tungsten trioxide (Cu/WO3) as the catalyst and hydrogen peroxide as the oxidizing reagent. The decomposition efficiency of chlorobenzene is dramatically promoted with the aid of Cu/WO3, and approximately 100% decomposition efficiency has been achieved in the dark at a reaction temperature of 200 °C. It is proposed that the formation of hydroxyl radicals from hydrogen peroxide via the Fenton-type reaction catalyzed by Cu ions is subjected to substantial acceleration under subcritical conditions of water at around 200–300 °C, resulting in enhancement of the decomposition efficiency. Irradiation of catalysts with near-UV–visible light also facilitates the decomposition of chlorobenzene because of the photocatalytic action.
C(sp3)–N(sp) Bond Cleavage of Isocyanides at a Cationic [CCH] Subunit in a Bisdisphenoidal Eight-atom Tetrairon–Tetracarbon Cluster
Authors: Taniwaki Wataru , Okazaki Masaaki
Published: May 2013

Reaction of [(η5-C5H4Me)4Fe4(HCCH)(HCC–NC4H4N)](PF6)2 (1) with tert-butyl isocyanide led to C(sp3)–N(sp) bond activation to give [(η5-C5H4Me)4Fe4(HCCH)(HCC–CN)](PF6) (2). The resulting tert-butyl cation was trapped as the adduct with pyrazine. Reactions of 1 with 2,6-dimethylphenyl isocyanide and cyclohexyl isocyanide led to the coordination of the isocyanides to the cationic [CCH] subunit. Thermolysis of [(η5-C5H4Me)4Fe4(HCCH)(HCC–CNCy)](PF6)2 (6) yielded 2.
Paradoxical immune reconstitution inflammatory syndrome due to toxoplasmic encephalitis: two cases and review of initiation of antiretroviral timing in toxoplasmic encephalitis IRIS
Authors: DiNardo Andrew R , Lewis Douglas Smoot , Koo Hoonmo L , Goodman J Clay , Chiao Elizabeth , Andrade Roberto
Published: May 2013

Toxoplasma encephalitis immune reconstitution inflammatory syndrome (TE-IRIS) is rare and usually occurs in an unmasking, rather than paradoxical form. To the best of our knowledge, only two cases of paradoxical TE-IRIS and nine cases of unmasking TE-IRIS have been previously described. We present two additional cases of histopathology-consistent paradoxical TE-IRIS, after early initiation of antiretroviral therapy (ART), and review the literature on TE-IRIS. Three of the four reported cases of paradoxical TE-IRIS were associated with early (within one week) initiation of ART, an issue that was not addressed in the 2009 US Department of Health and Human Services guidelines for the treatment of opportunistic infections.
Simultaneousversusstaged bilateral unicompartmental knee replacement
Authors: Chen J. Y. , Lo N. N. , Jiang L. , Chong H. C. , Tay D. K. J. , Chin P. L. , Chia S-L. , Yeo S. J.
Published: May 2013

We prospectively followed 171 patients who underwent bilateral unicompartmental knee replacement (UKR) over a period of two years. Of these, 124 (72.5%) underwent a simultaneous bilateral procedure and 47 (27.5%) underwent a staged procedure. The mean cumulative operating time and length of hospital stay were both shorter in the simultaneous group, by 22.5 minutes (p < 0.001) and three days (p < 0.001), respectively. The mean reduction in haemoglobin level post-operatively was greater by 0.15 g/dl in the simultaneous group (p = 0.023), but this did not translate into a significant increase in the number of patients requiring blood transfusion (p = 1.000). The mean hospital cost was lower by $8892 in the simultaneous group (p < 0.001). There was no significant difference in the rate of complications between the groups, and at two-year follow-up there was no difference in the outcomes between the two groups.

We conclude that simultaneous bilateral UKR can be recommended as an appropriate treatment for patients with bilateral medial compartment osteoarthritis of the knee.

Cite this article: Bone Joint J 2013;95-B:788–92.
Additional surgical factors affecting the recurrence of hallux valgus after Ludloff osteotomy
Authors: Choi G. W. , Choi W. J. , Yoon H. S. , Lee J. W.
Published: May 2013

We reviewed 91 patients (103 feet) who underwent a Ludloff osteotomy combined with additional procedures. According to the combined procedures performed, patients were divided into Group I (31 feet; first web space release), Group II (35 feet; Akin osteotomy and trans-articular release), or Group III (37 feet; Akin osteotomy, supplementary axial Kirschner (K-) wire fixation, and trans-articular release). Each group was then further subdivided into severe and moderate deformities.

The mean hallux valgus angle correction of Group II was significantly greater than that of Group I (p = 0.001). The mean intermetatarsal angle correction of Group III was significantly greater than that of Group II (p < 0.001). In severe deformities, post-operative incongruity of the first metatarsophalangeal joint was least common in Group I (p = 0.026). Akin osteotomy significantly increased correction of the hallux valgus angle, while a supplementary K-wire significantly reduced the later loss of intermetatarsal angle correction. First web space release can be recommended for severe deformity. Additionally, K-wire fixation (odds ratio (OR) 5.05 (95% confidence interval (CI) 1.21 to 24.39); p = 0.032) and the pre-operative hallux valgus angle (OR 2.20 (95% CI 1.11 to 4.73); p = 0.001) were shown to be factors affecting recurrence of hallux valgus after Ludloff osteotomy.

Cite this article: Bone Joint J 2013;95-B:803–8.