bluuebunny/crossref_metadata_2025 huggingface dataset:
Implementing the Liverpool Care Pathway for the Dying Patient in Intensive Care Version 12 (LCP ICU V12) across a regional critical care network
Authors: Parsons D. , Gambles M. , Chapman L.
Published: May 2012

Introduction

A pilot project is underway in 11 intensive care units within the Cheshire and Merseyside Critical Care Network (CMCCN) to implement the Liverpool Care Pathway for the Dying Patient in Intensive Care Version 12 (LCP ICU V12). Funded by Merseyside and Cheshire Cancer Network, this project will provide support to ICU's to implement and sustain the LCP ICU V12

Aims and Methods

Implement LCP ICU V12 into 11 sites within the CMCCN and ensure. Processes and policies are in place to support care in the last hours or days of life. Staff are appropriately trained to deliver care. A mechanism for ongoing collection/sharing of data to sustain delivery of quality care is developed. Identify Key Champions within each ICU who will take responsibility locally for implementation. Supported by the Project LCP ICU Facilitator to, deliver robust education and training and facilitate and monitor the implementation process. Key Champions meet monthly with the Project LCP ICU Facilitator to discuss aspects of the project.

Results

Organisational information from each ICU will be collected pre and post implementation. Data from completed LCP ICU's in each unit will be analysed descriptively to provide a comparative benchmark of care delivered across the CMCCN. Reflective diaries kept by Key Champions and the LCP ICU Facilitator throughout the project will be analysed thematically to derive an understanding of the process of implementation, facilitating factors, barriers and challenges.

Conclusion

Findings from all data collected will be presented, discussing implications for wider implementation of the LCP ICU V12.
Reversal of the British trends in place of death
Authors: Gomes B. , Calanzani N. , J. Higginson I.
Published: May 2012

Introduction

Increased attention is being paid to the place where people die in order to provide choice and adequate care for terminally ill patients. Secular trends towards institutionalised dying have been reported in Britain and other developed world regions.

Aims and Methods

To examine British trends in place of death from 2004 to 2010. Time-series analysis of death registration data from the Office for National Statistics for all 3,525,564 deaths registered in England and Wales from 2004 to 2010.

Results

There was a slow but steady increase in the proportion of deaths at home, from 18.3% in 2004 to 20.8% in 2010. Absolute numbers of home deaths increased by 9.1%, whilst overall numbers of deaths decreased by 3.8%. The rise in home deaths was more pronounced in cancer, happened for both genders and across all age groups except for those younger than 14 years and for the aged 65-84 but only up to 2006. The rise was more evident when ageing was accounted for (age-gender standardised proportions of home deaths increased from 20.6% to 23.5%).

Conclusion

Following trends in the USA and Canada, dying is shifting to people's home also in Britain. Home deaths increased for the first time since 1974 amongst people aged 85 years and over. There is an urgent need across nations for comparative evidence on the outcomes and the costs of dying at home.
Improving rapid access to symptom control, psychological, social and spiritual support during out of hours period: Marie Curie Palliative Response Service
Authors: Wilson A.
Published: May 2012

Introduction

Working in partnership with Betsi Cadwaladr University Health Board, Marie Curie Cancer care introduced its Rapid Response Service as an extension to the existing Marie Curie Nursing Service supporting palliative patients throughout Wales.

Aims & Methods

This service is designed to meet key recommendations of the Sugar Report1 including: provision of 24 hour services to enable more patients to die in a place of their choice. The service aims to support patients and their carers by delivering urgent care provided by nurses with expertise and training in assessment, symptom management and care delivery. Marie Curie's experienced Registered Nursing staff deliver rapid nursing interventions to palliative care patients, irrespective of diagnosis, from 10pm to 7am, 7 days a week.

It is integrated with the out of hours teams, working in collaboration with emergency care practitioners, district nurses, palliative care teams, local hospices, care homes and hospitals.

Results

The service has seen an increased percentage of patients with non-cancer diagnosis accessing the service. The majority of recorded clinical input to address crisis has related to advice and support, symptom management, medication and pain management. In first year this service prevented over 600 unscheduled admissions to the acute sector.

Conclusion

Delivering rapid nursing interventions, out of hours, provides patients and their carers with improved access to symptom control, psychological, social and spiritual support.
Patients who do not nominate a preferred place of death are more likely to die in hospital
Authors: Arnold L. , Finucane A. , Oxenham D.
Published: May 2012

Introduction

National end of life care strategies encourage the discussion and recording of the preferred place of death (PPD) of patients approaching end of life. Surveys suggest that the majority of the general population would choose to die at home or in a hospice, with hospital being least preferred.

PPD information is assessed on an ongoing basis, as part of standard care for all patients referred to Marie Curie Hospice Edinburgh. However, not all patients are able to nominate a PPD.

Aims and Methods

We explore where patients receiving specialist palliative care would choose to die; the reasons why some patients do not have a documented PPD; and whether patients without a documented PPD are more likely to die in hospital. Case notes were reviewed retrospectively for 1,127 patients, who died in any location whilst under the care of the service during 2009 and 2010. The majority of patients had cancer as their primary diagnosis (94%). The patient's last recorded PPD was used in this study. The median time between final PPD assessment and death was 6 days.

Results

Seventy-seven percent of patients were able to nominate a PPD (n=863), and a further 21% of patients had documented reasons for PPD remaining unknown (n=233). Patients who did not have a documented PPD were three times more likely to die in hospital, compared to those with a known preference (χ2(1)=37.21, p<0.001).

Conclusion

Patients without a nominated PPD were significantly more likely to die in hospital.
Evaluation of a rehabilitation service for patients living with and beyond cancer: a randomised controlled trial
Authors: Leurent B. , Round J. , Fitzgerald G. , Davis S. , Jones L.
Published: May 2012

Introduction

The Marie Curie Hospice in Hampstead provides a rehabilitative model of day care therapy to support patients living with and beyond cancer. This model was selected as a site of excellence for further attention in the National Cancer Survivorship Initiative 2008. We conducted a randomised controlled trial to evaluate the clinical and cost-effectiveness of this rehabilitation model.

Aims and Methods

To test whether a rehabilitation service for patients living with cancer is clinically and cost-effective. A randomised controlled trial comparing a manualised rehabilitative intervention with a waiting-list control. Participants at the end of a course for treatment for recurrent hematologic or breast cancer were recruited between August 2010 and July 2011 from two London hospitals and followed-up for three months. Clinical outcomes included measures of supportive care needs, distress, continuity of care and quality of life. Cost-effectiveness analysis considered the incremental cost-effectiveness ratio for the intervention and control groups, with outcomes expressed as quality adjusted life years.

Results

Recruitment was slower than expected, with a final number of 41 participants recruited to the trial against a target recruitment of 120. Referral rates were dependent on engagement of clinicians with concepts of hospice-based rehabilitation. Despite small numbers, we report evidence of effectiveness and cost-effectiveness.

Conclusion

This trial used robust methodology to evaluate a complex intervention for patients living with cancer. Although fewer than expected were recruited, results should be indicative of the likelihood that the intervention is clinically and cost-effective, and highlight important methodological challenges faced by investigators working in this area.
The future developments in upper GI cancer
Authors: Barr Hugh , Almond Max
Published: May 2012

The ageing population and changes in incidence of upper gastrointestinal cancer will have profound changes for our management of these patients. There is much debate as how to bring forward the diagnosis of early mucosal cancer that may be curable using endoscopy or by surgery. In the older more frail patients, early disease will often be controlled by endoscopic resection and ablation therapy.
The future developments in nutrition
Authors: Donnellan C F , Lal S
Published: May 2012

Malnutrition is both a cause and consequence of disease. It is imperative that evidence-based approaches to detect and treat malnutrition are embedded into routine practice; these can range from routine malnutrition screening, the safe and appropriate use of enteral feeding and managing more complex patients with intestinal failure. This article outlines service developments over the next 5 years that may enable all hospitals to achieve optimal standards of care for a malnourished patient and examines the role of developments in clinical nutrition over the next 5–10 years.
Isolation of an extremely boron-tolerant strain of Bacillus firmus
Authors: Verce Matthew F. , Stiles Amanda R. , Chong Karen C. , Terry Norman
Published: May 2012

A strain of Bacillus firmus (designated strain KC) isolated from a boron (B) mine in California exhibited extreme tolerance to B, provided it was first acclimated at intermediate B supply concentrations. Strain KC tolerated up to 1000 mmol/L B (boric acid-B) and 1800 mmol/L B (sodium tetraborate-B), and attained the greatest growth (as measured by absorbance) at 300 mmol/L B. Despite its extreme tolerance to high B, there was no evidence that it was able to remove significant quantities of B from the growth media, suggesting that strain KC is not likely to be useful for the removal of B from wastewaters in an engineered bioreactor.
In vitro and in vivo characterization and strain safety of Lactobacillus reuteri NCIMB 30253 for probiotic applications
Authors: Sulemankhil Imran , Parent Mathieu , Jones Mitchell Lawrence , Feng Zhenqian , Labbé Alain , Prakash Satya
Published: May 2012

Lactobacillus reuteri NCIMB 30253 was shown to have potential as a probiotic by reducing the proinflammatory chemokine interleukin-8. Moreover, this strain was evaluated, by in vitro and in vivo techniques, for its safety for human consumption. The identity of the strain was investigated by metabolic profiling and 16S rRNA gene sequencing, and in vitro safety evaluations were performed by molecular and metabolic techniques. Genetic analysis was confirmed by assessing the minimum inhibitory concentration to a panel of antibiotics, showing that the strain was susceptible to 8 antibiotics tested. The ability of the strain to produce potentially harmful by-products and antimicrobial compounds was evaluated, showing that the strain does not produce biogenic amines and does not show bacteriocin activity or reuterin production. A 28-day repeated oral dose study was conducted in normal Sprague–Dawley rats to support the in vivo strain safety. Oral administration of the strain resulted in no changes in general condition and no clinically significant changes to biochemical and haematological markers of safety relative to vehicle control treated animals. This comprehensive assessment of safety of L. reuteri NCIMB 30253 supports the safety of the strain for use as a probiotic.
SEISMIC WAVEGUIDE OF METAMATERIALS
Authors: KIM SANG-HOON , DAS MUKUNDA P.
Published: May 2012

We developed a new method of an earthquake-resistant design to support conventional aseismic system using acoustic metamaterials. The device is an attenuator of a seismic wave that reduces the amplitude of the wave exponentially. Constructing a cylindrical shell-type waveguide composed of many Helmholtz resonators that creates a stop-band for the seismic frequency range, we convert the seismic wave into an attenuated one without touching the building that we want to protect. It is a mechanical way to convert the seismic energy into sound and heat.
ZITTERBEWEGUNG IN THIN FILMS OF TOPOLOGICAL INSULATORS WITH HEXAGONAL LATTICE IRRADIATED BY TERAHERTZ PULSES
Authors: YANYUSHKINA NATALIA N. , ZHUKOV ALEXANDER V. , BELONENKO MIKHAIL B. , GEORGE THOMAS F.
Published: May 2012

We study the Zitterbewegung effect (trembling motion) in thin films of topological insulators with a hexagonal lattice in the presence of terahertz pulse pumping. We derive the analytical expression for the current density, which describes the current induced by the motion of a wave packet of electrons. The electronic subsystem is considered in the long-wavelength approximation, and the electromagnetic field is treated classically in the approximation of a constant pumping. We reveal the possibility to control individual electron wave packets by manipulating with optical pulses.
STRUCTURAL, MECHANICAL AND LATTICE DYNAMICAL STABILITY OFAgCANDAuCCOMPOUNDS: A FIRST PRINCIPLES STUDY
Authors: ATESER ENGIN , OZISIK HAVVA BOGAZ
Published: May 2012

Based on density functional theory, we have studied the structural stability, elastic, mechanical and lattice dynamical properties of AgC and AuC compounds for various structures: NaCl ( B1 ), CsCl ( B2 ), ZnS ( B3 ), wurtzite ( B4 ), WC ( Bh), NiAs ( B81) and CdTe . Generalized gradient approximation has been used for modeling exchange-correlation effects. The second-order elastic constants and related polycrystalline properties (bulk modulus, shear modulus, Young's modulus, Poisson's ratio, Debye temperature and sound velocities) have been calculated and discussed. We have also calculated phonon dispersion and phonon density of states of these compounds in all considered structures. According to the results, we found that, AgC compound is mechanically and dynamically stable in B81, B1 and B4 structures. Our results indicate that B81 and B3 are the candidate stable structures energetically, mechanically and dynamically for AgC and AuC compounds, respectively.
BOUND STATES AND KLEIN PARADOX OF GRAPHENE SYSTEMS IN CONFINING POTENTIALS
Authors: HUANG HAI , HUANG XIA
Published: May 2012

Two-dimensional massive Dirac equation in both potential well and linear potential is discussed. We find that in the case of potential well, the bound states disappear from the spectrum for large enough potential depth. With the linear confining potential, we show that the Dirac equation presents no bound state. Both these results can be identified as fine examples of the Klein paradox. Applications to graphene systems are also discussed.
THE FORCE BETWEEN A MONOLAYER OF MAGNETIC PARTICLES AND A SUPERCONDUCTOR IN THE MIXED STATE
Authors: ALZOUBI F. Y. , AL-KHATEEB H. M. , ALQADI M. K. , SAADEH S. M. , AYOUB N. Y.
Published: May 2012

The interaction between a monolayer of fine ferromagnetic particles and a semi-infinite superconductor has been investigated in the mixed state. The frozen and diamagnetic images model was employed to calculate the levitation force as a function of the levitation height as well as the temperature of the monolayer under the zero-field-cooled (ZFC) and the field-cooled (FC) conditions. Results showed the well-known monotonic decrease of the levitation force as a function of the levitation height while it increases rapidly as a function of temperature up to saturation. As a result of the first order approximation used in our calculations in which the interaction was represented by the forces between the magnetic dipoles and their images, the levitation force was dominated by the diamagnetic properties rather than the flux pinning effects of the superconductor for small values of levitation heights compared to the initial field cooling height.
EXPANDING APPROACH TO INFORMATION RETRIEVAL USING SEMANTIC SIMILARITY ANALYSIS BASED ON WORDNET AND WIKIPEDIA
Authors: ZHAO FENG , FANG FEI , YAN FENGWEI , JIN HAI , ZHANG QIN
Published: May 2012

Performance of information retrieval (IR) systems greatly relies on textual keywords and retrieval documents. Inaccurate and incomplete retrieval results are always induced by query drift and ignorance of semantic relationship among terms. Expanding retrieval approach attempts to incorporate expansion terms into original query, such as unexplored words combing from pseudo-relevance feedback (PRF) or relevance feedback documents semantic words extracting from external corpus etc. In this paper a semantic analysis-based query expansion method for information retrieval using WordNet and Wikipedia as corpus are proposed. We derive semantic-related words from human knowledge repositories such as WordNet and Wikipedia, which are combined with words filtered by semantic mining from PRF document. Our approach automatically generates new semantic-based query from original query of IR. Experimental results on TREC datasets and Google search engine show that performance of information retrieval can be significantly improved using proposed method over previous results.
STUDY ON THE FRACTAL AND CHAOTIC FEATURES OF THE SHANGHAI COMPOSITE INDEX
Authors: WEN FENGHUA , LI ZHONG , XIE CHAOHUA , SHAW DAVID
Published: May 2012

The Hurst exponent derived by the R/S analysis method of Shanghai stock market's logarithmic return series is about 0.6298. This shows that the Shanghai stock market exhibits fractal features, and a long memory cycle of about one-and-a-half years. With the reconstruction of phase space, the Shanghai Stock attractor dimension converges to 1.335, which means that the Shanghai stock market has chaotic features, and constructing a dynamic system of the Shanghai stock market needs at least two variables. The findings from the principal component analysis support the conclusion of the existence of chaotic features of the Shanghai stock market. The fractal and chaotic features of the Shanghai stock market reveal the nonlinear properties of the Chinese stock market, and the nonlinearity perspective will be more conducive to the formulation of countermeasures for the development of the Chinese stock market.
SCAPHOID FRACTURE IN THE ELDERLY: A REVIEW
Authors: Alsawadi Abdulrahman , Stanton Jeremy
Published: May 2012

Although scaphoid fractures are relatively common encounters in orthopaedic and trauma surgery, the demographics of these injuries are not well studied. The classical teaching in the subject limits scaphoid fractures in the age between ten and 60 years (or 70 years in other sources). The incidence or the prevalence of scaphoid fractures in the elderly population is not focused on and not studied or explored.

We reviewed the literature for any available epidemiological studies of scaphoid fractures. We also sought the available data of scaphoid fractures in the elderly population in case series and case reports which have relevant data on the subject. Four epidemiological studies, two case series, and one case report are included. We discuss the available data in these articles and conclude that scaphoid fractures in the elderly, although rare, have been reported. However, there are not enough epidemiological studies to draw figures. Ignorance of this proportion of population could result in missed fractures in the elderly. Therefore, we encourage researchers to carry out epidemiological studies of scaphoid fractures with more focus on this population group.
COMPARISON OF THREE DIFFERENT PERIPHERAL SUTURING TECHNIQUES FOR PARTIAL FLEXOR TENDON LACERATIONS: A CONTROLLED IN-VITRO BIOMECHANICAL STUDY
Authors: Gulihar A. , Hajipour L. , Dias J. J.
Published: May 2012

Surgical repair is advocated for partial flexor tendon lacerations deeper than 70%. We compared gliding resistance with three different peripheral repairs in partial flexor tendon lacerations. Thirty flexor tendons and A2 pulleys were harvested from turkey toes. Gliding resistance was measured for all intact tendons. The tendons were then lacerated to 50% and repaired with a modified Kessler core suture and either a Silfverskiold or Halsted repair or a simple running suture and gliding resistance was measured. Compared to the intact tendon, the increase in gliding resistance after surgical repair was 100% with the Halsted repair, 80% with the Silfverskiold repair and 60% with a running suture (p = 0.05). In conclusion, a simple running suture caused less resistance to gliding compared to the other techniques when repairing partial flexor tendon lacerations and we recommend its use when surgical repair is needed.
SPONTANEOUS DISTAL BICEPS TENDON RUPTURES: ARE THEY RELATED TO STATIN ADMINISTRATION?
Authors: Savvidou Christiana , Moreno Rodrigo
Published: May 2012

The purpose of this study is to identify a possible correlation between statin administration and incidence of spontaneous distal biceps tendon ruptures. We retrospectively reviewed 104 patients with distal biceps tendon rupture that were treated surgically from 2004 to 2010, 102 males and two females with mean age 47 years (range, 22–78). Patients were divided based on the mechanism of injury and statin administration. After statistical analysis, it was found nearly two times more likely to have spontaneous distal biceps tendon rupture with use of statins. Patients in Group 1 (spontaneous tendon rupture) compared to Group 2 (provoked tendon rupture) were older, had weaker postoperative strength but similar postoperative ROM. Patients taking statins compared to those that were not taking statins were older, had same postoperative strength and similar postoperative ROM. Based on the results of our study we conclude that there is a trend of association of spontaneous distal biceps tendon ruptures with statin administration.
OUTCOME OF UNSTABLE DISTAL RADIUS FRACTURES TREATED WITH OPEN REDUCTION AND INTERNAL FIXATION VERSUS EXTERNAL FIXATION
Authors: Estrella Emmanuel P. , Panti Paulo L.
Published: May 2012

The objective of this study was to compare the clinical results of unstable distal radius fractures treated with ORIF with plate and screws compared to EF. Patients with unstable distal radius fractures treated with ORIF or EF from January 2005 to December 2010 were reviewed in terms of the Modified Mayo Wrist Score, range of motion, pain, grip strength, and radiologic parameters. Results showed that there was no difference in the Modified Mayo Wrist Score between ORIF (17 patients) and EF (11 patients) (p = 0.07). The ORIF group had better wrist flexion, wrist extension, pronation and supination compared to the EF group (p < 0.05). There were no significant differences in terms of radial and ulnar deviation, grip strength, pain and postoperative radiologic parameters (p < 0.05). Better wrist flexion, wrist extension and forearm rotation can be expected in ORIF compared to EF in the management of unstable distal radius fractures.
VARIOUS PATTERNS OF TRAUMATIC TRIANGULAR FIBROCARTILAGE COMPLEX TEAR
Authors: Abe Y. , Tominaga Y. , Yoshida K.
Published: May 2012

We demonstrate various patterns of traumatic triangular fibrocartilage complex (TFCC) tears including some atypical that cannot be categorized under Palmer's classification. TFCC traumatic tears in 173 wrists were examined arthroscopically or macroscopically and divided into disk tears (subdivided into four types: slit tear, flap tear, horizontal tear and tear within the distal radioulnar joint) and peripheral tears (subdivided into six types: ulnocarpal ligament tear, dorsal tear, radial tear, ulnar styloid tear, foveal tear and distal radioulnar ligament tear). Combinations of these types were found in 32 wrists. Wrist arthroscopy revealed various traumatic TFCC tears that do not come under Palmer's classification; therefore establishment of a new classification for traumatic TFCC tears seems to be warranted.
THE STUDY OF WORK BEHAVIOURS AND RISKS FOR OCCUPATIONAL OVERUSE SYNDROME
Authors: Laoopugsin Niyom , Laoopugsin Suwannee
Published: May 2012

"Occupational overuse syndrome" is defined as the syndrome of work-related musculoskeletal disorders resulting from repetitive hand posture and motion. We looked at 867 employees in seven different factories to determine the groups suffering from trigger fingers, de Quervain's disease and carpal tunnel syndrome (CTS) from the period of January 2009 to November 2010. The inclusion and exclusion criteria were designated for the subjects in each group. We found the highest prevalence of the syndrome in the rate of CTS development. The differences in the hand spans and the grip strengths between the normal versus the diseased groups were statistically significant. The most common work patterns were a repetitive workload with the hand in a posture of a contracted grasping position. This accounted for 43.1% of the cases of trigger fingers, 38.1% in cases of CTS and this position with a contributing increased speed in the work pattern at 29.8% in the de Quervain's disease patients.
THE BILATERAL ULNAR ARTERY INVOLVEMENT IN TYPE IV EHLERS-DANLOS SYNDROME — A CASE REPORT
Authors: Ikeda Kazuo , Osamura Naoki , Kasashima Satomi
Published: May 2012

Ehlers-Danlos syndrome Type IV, the vascular type, is a rare hereditary condition. Major arteries are often affected in this type. In this paper, we present the first case report in the world in which forearm compartment syndrome caused by the bilateral ulnar artery rupture in this type. Successful treatment such as incision of the forearm fascia and ligation of the ulnar artery was performed.
LINBURG-COMSTOCK SYNDROME: A CASE REPORT
Authors: Furukawa Kayoko , Menuki Kunitaka , Sakai Akinori , Oshige Toshihisa , Nakamura Toshitaka
Published: May 2012

We report a case of Linburg-Comstock syndrome, which is characterized with anomalous tendon slips connecting flexor pollicis longus (FPL) to the flexor digitorum profundus (FDP), usually at the index finger. The present patient started to be a carpenter and was suffering from his disability of flexing the thumb and the index finger independently when he handled the screws in his work. We surgically removed the tendinous connection of the FPL tendon and the index FDP tendon. After surgery, he could work as a carpenter without any difficulty. Surgical disconnection was effective treatment. Dynamic high-resolution ultrasound and three dimensions of computed tomography of the left distal forearm were helpful to confirm the diagnosis.
LINBURG-COMSTOCK PHENOMENON FOLLOWING FOREARM LACERATION
Authors: Lin B. , Sreedharan S. , Chin Andrew Y. H.
Published: May 2012

A 20-year-old man presented with an inability to flex the interphalangeal joint of the right thumb without simultaneous flexion of the distal interphalangeal joint of the index finger following a penetrating injury to the right forearm. With a clinical suspicion of intertendinous adhesions between the flexor pollicis longus and the flexor digitorum profundus to the index finger, surgical exploration under wide-awake anesthesia was performed. Intraoperatively, the intertendinous adhesions were identified and divided completely. Postoperatively, the patient achieved good, independent flexion of the interphalangeal joint of the thumb. This case demonstrates a clinical picture similar to that of Linburg-Comstock syndrome, which occurred following a forearm penetrating injury. We call this the Linburg-Comstock (LC) phenomenon.
BICIPITAL TUBEROSITY OSTEOCHONDROMA CAUSING PAINFUL CLICKING AROUND THE WRIST: CASE REPORT AND LITERATURE REVIEW
Authors: Alsawadi Abdulrahman , Abbas Mustafa , Stanton Jeremy
Published: May 2012

Osteochondromatas of bicipital tuberosity are rare, most commonly occurring as metaphyseal benign tumours of the long bones. The usual presenting symptoms are pain and reduced rotation of the elbow. A painful clunk in the wrist as a presenting symptom has not been described before.

We present a young lady with a two-year history of a painful clunk in her wrist. Her case presented a diagnostic challenge, as the pain and the click originated from her elbow and radiated down her forearm to the wrist. She underwent several radiological studies, and examination under anaesthesia confirmed the diagnosis. Excision was performed resulting in complete resolution of her symptoms.

Along with painful clunk in the wrist originating from the elbow, an enlarged radial tuberosity should raise a high index of suspicion, and MRI scans and examination under image intensification can aid in the diagnosis of radial tuberosity osteochondroma.
WRIST SYNOVIAL CHONDROMATOSIS: CASE REPORT AND LITERATURE REVIEW
Authors: Reverté Vinaixa Maria Mercedes , Singh Rahul , Monyart Joan Minguell , Llado Gemma Duarri , Dominguez Manuel Pérez , Feliu Enric Castellet , Nardi Vilardaga Joan , Palou Enric Caceres
Published: May 2012

Primary synovial chondromatosis is a proliferation of cartilaginous bodies within the synovial membrane, tendon sheath or bursa. It is a rare orthopaedic entity especially when it occurs in the distal radioulnar joint. We report a 27-year-old man with recurrent synovial chondromatosis, nine years after his first operation. Although rare, synovial chondromatosis must be considered in the differential diagnosis in a patient with pain and swelling of the distal radioulnar joint. From our literature review, we report a 17% (5/30) recurrence rate for synovial chondromatosis involving the wrist joint which has not been documented in the medical literature previously.
AVULSION FRACTURE OF THE EXTENSOR CARPI RADIALIS LONGUS TENDON: CASE REPORT AND LITERATURE REVIEW
Authors: Shyamsundar Srinivasan
Published: May 2012

Isolated avulsion fracture of the index finger metacarpal is rare. There have been only a few noted in the English literature. A review of literature shows that these injuries occur as a result of avulsion of the tendon of extensor carpi radialis longus. In our report we present a case of such an avulsion injury where the proximal fragment was pulled about 2 cm down. The patient was treated conservatively with early mobilisation.
RARE DIGITAL TUMOURS: TWO CASE REPORTS AND MINI REVIEW
Authors: Horner C. W. M. , Speller A. , McBride T. , Dias R.
Published: May 2012

Masses within the fingers and hands are a common occurrence affecting patients of all ages. Although most will be benign conditions, rarer more aggressive tumours also occur. Two cases of rare hand tumours, a digital myofibroma and an aggressive digital papillary adenocarcinoma are reported here including a mini-review of the literature.

Although these two cases are quite different they highlight the importance of having a high index of suspicion for the presence of malignant change in masses that have been quiescent for considerable periods of time and thus the need for histological diagnosis in masses resected from the hands. The myofibroma, like other conditions such as giant cell tumours, although benign can have very worrying clinical features, most notably bony destruction. The aggressive digital papillary adenocarcinoma conversely can appear benign clinically but biologically is very aggressive with a high propensity for local and distant spread.
AN UNUSUAL CASE OF SUBUNGAL OSSIFICATION IN THE FINGER
Authors: Tan Colin Weixuan , Tan Puay-Ling , Teoh Lam-Chuan
Published: May 2012

We report the case of a painless deforming subungual mass at the nail tip, progressively enlarging over three months. Radiographs showed an extra-osseous ossification. Intraoperatively this was found to be a bony mass arising from the sterile matrix. Unusual extra-osseous ossification in the finger is rare and this case highlights the need of this benign lesion to be considered when a patient presents with finger swellings.
DORSAL PERCUTANEOUS CANNULATED MINI-SCREW FIXATION FOR FRACTURES OF THE HAMATE HOOK
Authors: Scheufler Oliver , Radmer Sebastian , Andresen Reimer
Published: May 2012

Purpose: Open fixation of acute fractures, delayed union and non-union of the hamate hook through a palmar approach has been reported. Minimal invasive fixation using a dorsal percutaneous approach and a headless cannulated mini-screw is another option not commonly considered. The authors present their case series of patients who underwent dorsal percutaneous fixation of acute fractures and delayed union of the hamate hook.

Methods: This study retrospectively reviewed six consecutive patients (five male patients and one female patient) with non-displaced acute fractures (< 8 weeks) and delayed union (8 to 12 weeks) of the hamate hook treated with dorsal percutaneous cannulated mini-screw fixation. The indications for surgery included wrist pain, patient refusal of conservative treatment, and prevention of non-union and hook excision. Exclusion criteria included displacement or inadequate size of the hamate hook, previous surgery, associated carpal injury, flexor tendon rupture, and median or ulnar nerve lesion in the carpal tunnel and Guyon's canal respectively. Each fracture was visualized by radiography and computed tomography before and after the intervention.

Results: Anatomically correct fixation of the hamate hook with central screw positioning was achieved in all patients. No displacement or disruption of the cortical shell of the hook was observed. The union rate was 100% with all patients being able to resume their pre-injury activities after an average of seven weeks from surgery.

Conclusions: This pilot study demonstrates that non-displaced acute fractures and delayed union of the hamate hook can be treated successfully by dorsal percutaneous cannulated mini-screw fixation with minimal morbidity and complications.
VDR and CYP27B1 are expressed in C2C12 cells and regenerating skeletal muscle: potential role in suppression of myoblast proliferation
Authors: Srikuea Ratchakrit , Zhang Xiping , Park-Sarge Ok-Kyong , Esser Karyn A.
Published: May 2012

1α,25(OH)2D3, the active form of vitamin D3, has been reported to regulate the cell biology of skeletal muscle. However, there has been some controversy about the expression of the vitamin D receptor (VDR) and thus the potential role of vitamin D3 in skeletal muscle. In this study, we isolated and sequenced the full-length Vdr and Cyp27b1 transcripts in C2C12 myoblasts and myotubes. Western blots and immunocytochemistry confirmed protein expression in both myoblasts and myotubes clearly demonstrating that C2C12 cells express VDR and CYP27B1. To determine the vitamin D3 action, we found that C2C12 myoblasts treated with either 1α,25(OH)2D3 or 25(OH)D3 inhibited cell proliferation and this was associated with increased Vdr expression. The observation that treatment of C2C12 myoblasts with the inactive form of vitamin D3, [25(OH)D3], inhibited proliferation suggested that CYP27B1 was functionally active. We used small interfering RNA to knock down Cyp27b1 in myoblasts, and cells were treated with 25(OH)D3. The growth-suppressive effects of 25(OH)D3 were abolished, suggesting that CYP27B1 in myoblasts is necessary for the ability of 25(OH)D3 to affect cell proliferation. Finally, we analyzed expression of VDR and CYP27B1 in regenerating skeletal muscle in vivo. We found that expression of VDR and CYP27B1 increased significantly at day 7 of regeneration, and these results confirm the expression of Vdr and Cyp27b1 in vivo and suggest a potential role for vitamin D3 in skeletal muscle regeneration following injury.
NOX2-dependent ROS is required for HDAC5 nuclear efflux and contributes to HDAC4 nuclear efflux during intense repetitive activity of fast skeletal muscle fibers
Authors: Liu Yewei , Hernández-Ochoa Erick O. , Randall William R. , Schneider Martin F.
Published: May 2012

Reactive oxygen species (ROS) have been linked to oxidation and nuclear efflux of class IIa histone deacetylase 4 (HDAC4) in cardiac muscle. Here we use HDAC-GFP fusion proteins expressed in isolated adult mouse flexor digitorum brevis muscle fibers to study ROS mediation of HDAC localization in skeletal muscle. H2O2 causes nuclear efflux of HDAC4-GFP or HDAC5-GFP, which is blocked by the ROS scavenger N-acetyl-l-cysteine (NAC). Repetitive stimulation with 100-ms trains at 50 Hz, 2/s (“50-Hz trains”) increased ROS production and caused HDAC4-GFP or HDAC5-GFP nuclear efflux. During 50-Hz trains, HDAC5-GFP nuclear efflux was completely blocked by NAC, but HDAC4-GFP nuclear efflux was only partially blocked by NAC and partially blocked by the calcium-dependent protein kinase (CaMK) inhibitor KN-62. Thus, during intense activity both ROS and CaMK play roles in nuclear efflux of HDAC4, but only ROS mediates HDAC5 nuclear efflux. The 10-Hz continuous stimulation did not increase the rate of ROS production and did not cause HDAC5-GFP nuclear efflux but promoted HDAC4-GFP nuclear efflux that was sensitive to KN-62 but not NAC and thus mediated by CaMK but not by ROS. Fibers from NOX2 knockout mice lacked ROS production and ROS-dependent nuclear efflux of HDAC5-GFP or HDAC4-GFP during 50-Hz trains but had unmodified Ca2+ transients. Our results demonstrate that ROS generated by NOX2 could play important roles in muscle remodeling due to intense muscle activity and that the nuclear effluxes of HDAC4 and HDAC5 are differentially regulated by Ca2+ and ROS during muscle activity.
OSR1-sensitive regulation of Na+/H+ exchanger activity in dendritic cells
Authors: Pasham Venkanna , Rotte Anand , Yang Wenting , Zelenak Christine , Bhandaru Madhuri , Föller Michael , Lang Florian
Published: May 2012

The oxidative stress-responsive kinase 1 (OSR1) is activated by WNK (with no K kinases) and in turn stimulates the thiazide-sensitive Na-Cl cotransporter (NCC) and the furosemide-sensitive Na-K-2Cl cotransporter (NKCC), thus contributing to transport and cell volume regulation. Little is known about extrarenal functions of OSR1. The present study analyzed the impact of decreased OSR1 activity on the function of dendritic cells (DCs), antigen-presenting cells linking innate and adaptive immunity. DCs were cultured from bone marrow of heterozygous WNK-resistant OSR1 knockin mice ( osr KI) and wild-type mice ( osr WT). Cell volume was estimated from forward scatter in FACS analysis, ROS production from 2′,7′-dichlorodihydrofluorescein-diacetate fluorescence, cytosolic pH (pHi) from 2′,7′- bis-(2-carboxyethyl)-5-(and-6)-carboxyfluorescein fluorescence, and Na+/H+ exchanger activity from Na+-dependent realkalinization following ammonium pulse and migration utilizing transwell chambers. DCs expressed WNK1, WNK3, NCC, NKCC1, and OSR1. Phosphorylated NKCC1 was reduced in osr KI DCs. Cell volume and pHi were similar in osr KI and osr WT DCs, but Na+/H+ exchanger activity and ROS production were higher in osr KI than in osr WT DCs. Before LPS treatment, migration was similar in osr KI and osr WT DCs. LPS (1 μg/ml), however, increased migration of osr WT DCs but not of osr KI DCs. Na+/H+ exchanger 1 inhibitor cariporide (10 μM) decreased cell volume, intracellular reactive oxygen species (ROS) formation, Na+/H+ exchanger activity, and pHi to a greater extent in osr KI than in osr WT DCs. LPS increased cell volume, Na+/H+ exchanger activity, and ROS formation in osr WT DCs but not in osr KI DCs and blunted the difference between osr KI and osr WT DCs. Na+/H+ exchanger activity in osr WT DCs was increased by the NKCC1 inhibitor furosemide (100 nM) to values similar to those in osr KI DCs. Oxidative stress (10 μM tert-butyl-hydroperoxide) increased Na+/H+ exchanger activity in osr WT DCs but not in osr KI DCs and reversed the difference between genotypes. Cariporide virtually abrogated Na+/H+ exchanger activity in both genotypes and blunted LPS-induced cell swelling and ROS formation in osr WT mice. In conclusion, partial OSR1 deficiency influences Na+/H+ exchanger activity, ROS formation, and migration of dendritic cells.
Functional role of sodium glucose transporter in high glucose-mediated angiotensin type 1 receptor downregulation in human proximal tubule cells
Authors: Yesudas Rekha , Snyder Russell , Abbruscato Thomas , Thekkumkara Thomas
Published: May 2012

Previously, we have demonstrated human angiotensin type 1 receptor (hAT1R) promoter architecture with regard to the effect of high glucose (25 mM)-mediated transcriptional repression in human proximal tubule epithelial cells (hPTEC; Thomas BE, Thekkumkara TJ. Mol Biol Cell 15: 4347–4355, 2004). In the present study, we investigated the role of glucose transporters in high glucose-mediated hAT1R repression in primary hPTEC. Cells were exposed to normal glucose (5.5 mM) and high glucose (25 mM), followed by determination of hyperglycemia-mediated changes in receptor expression and glucose transporter activity. Exposure of cells to high glucose resulted in downregulation of ANG II binding (4,034 ± 163.3 to 1,360 ± 154.3 dpm/mg protein) and hAT1R mRNA expression (reduced 60.6 ± 4.643%) at 48 h. Under similar conditions, we observed a significant increase in glucose uptake (influx) in cells exposed to hyperglycemia. Our data indicated that the magnitude of glucose influx is concentration and time dependent. In euglycemic cells, inhibiting sodium-glucose cotransporters (SGLTs) with phlorizin and facilitative glucose transporters (GLUTs) with phloretin decreased glucose influx by 28.57 ± 0.9123 and 54.33 ± 1.202%, respectively. However, inhibiting SGLTs in cells under hyperglycemic conditions decreased glucose influx by 53.67 ± 2.906%, while GLUT-mediated glucose uptake remained unaltered (57.67 ± 3.180%). Furthermore, pretreating cells with an SGLT inhibitor reversed high glucose-mediated downregulation of the hAT1R, suggesting an involvement of SGLT in high glucose-mediated hAT1R repression. Our results suggest that in hPTEC, hyperglycemia-induced hAT1R downregulation is largely mediated through SGLT-dependent glucose influx. As ANG II is an important modulator of hPTEC transcellular sodium reabsorption and function, glucose-mediated changes in hAT1R gene expression may participate in the pathogenesis of diabetic renal disease.
Sex-dependent hemispheric asymmetries for processing frequency-modulated sounds in the primary auditory cortex of the mustached bat
Authors: Washington Stuart D. , Kanwal Jagmeet S.
Published: May 2012

Species-specific vocalizations of mammals, including humans, contain slow and fast frequency modulations (FMs) as well as tone and noise bursts. In this study, we established sex-specific hemispheric differences in the tonal and FM response characteristics of neurons in the Doppler-shifted constant-frequency processing area in the mustached bat's primary auditory cortex (A1). We recorded single-unit cortical activity from the right and left A1 in awake bats in response to the presentation of tone bursts and linear FM sweeps that are contained within their echolocation and/or communication sounds. Peak response latencies to neurons' preferred or best FMs were significantly longer on the right compared with the left in both sexes, and in males this right-left difference was also present for the most excitatory tone burst. Based on peak response magnitudes, right hemispheric A1 neurons in males preferred low-rate, narrowband FMs, whereas those on the left were less selective, responding to FMs with a variety of rates and bandwidths. The distributions of parameters for best FMs in females were similar on the two sides. Together, our data provide the first strong physiological support of a sex-specific, spectrotemporal hemispheric asymmetry for the representation of tones and FMs in a nonhuman mammal. Specifically, our results demonstrate a left hemispheric bias in males for the representation of a diverse array of FMs differing in rate and bandwidth. We propose that these asymmetries underlie lateralized processing of communication sounds and are common to species as divergent as bats and humans.
MonoMax Suture: A New Long-Term Absorbable Monofilament Suture Made from Poly-4-Hydroxybutyrate
Authors: Odermatt Erich K. , Funk Lutz , Bargon Rainer , Martin David P. , Rizk Said , Williams Simon F.
Published: May 2012

A long-term absorbable monofilament suture was developed using poly-4-hydroxybutyrate (P4HB) made from a biosynthetically produced homopolymer of the natural metabolite 4-hydroxybutyrate. The suture, called MonoMax, has prolonged strength retention. At 12 weeks, a size 3-0 MonoMax suture retains approximately 50% of its initial tensile strengthin vivoand is substantially degraded in one year with minimal tissue reaction. In contrast, PDS II monofilament suture (Ethicon, Inc., Somerville, NJ) has no residual strengthin vivoafter 12 weeks.In vivo, the MonoMax suture is hydrolyzed primarily by bulk hydrolysis, and is then degraded via the Krebs cycle. MonoMax is substantially more compliant than other monofilament sutures, and incorporates an element of elasticity. Its tensile modulus of 0.48 GPa is approximately one-third of the value of the PDS II fiber providing an exceptionally flexible and pliable fiber with excellent knot strength and security. These features are further enhanced by the fiber's elasticity, which also improves knot security and may help prevent wound dehiscence. Because of its performance advantages, this suture may find clinical utility in applications where prolonged strength retention, and greater flexibility are required, particularly in procedures like abdominal wall closure where wound dehiscence is still a significant post-surgical complication.
Frequency Domain Compressive Sampling for Ultrasound Imaging
Authors: Quinsac Céline , Basarab Adrian , Kouamé Denis
Published: May 2012

Compressed sensing or compressive sampling is a recent theory that originated in the applied mathematics field. It suggests a robust way to sample signals or images below the
classic Shannon-Nyquist theorem limit. This technique has led to many applications, and has especially been successfully used in diverse medical imaging modalities such as magnetic resonance imaging, computed tomography, or photoacoustics. This paper first revisits the compressive sampling theory and then proposes several strategies to perform compressive sampling in the context of ultrasound imaging. Finally, we show encouraging results in 2D and 3D, on high- and low-frequency ultrasound images.
On the Causality between Multiple Locally Stationary Processes
Authors: Hirukawa Junichi
Published: May 2012

When one would like to describe the relations between multivariate time series, the concepts of dependence and causality are of importance. These concepts also appear to be useful when one is describing the properties of an engineering or econometric model. Although the measures of dependence and causality under stationary assumption are well established, empirical studies show that these measures are not constant in time. Recently one of the most important classes of nonstationary processes has been formulated in a rigorous asymptotic framework by Dahlhaus in (1996), (1997), and (2000), called locally stationary processes. Locally stationary processes have time-varying spectral densities whose spectral structures smoothly change in time. Here, we generalize measures of linear dependence and causality to multiple locally stationary processes. We give the measures of linear dependence, linear causality from one series to the other, and instantaneous linear feedback, at time t and frequency λ.