bluuebunny/crossref_metadata_2025 huggingface dataset:
Controlled Performance Evaluation of the DiversiLab Repetitive-Sequence-Based Genotyping System for Typing Multidrug-Resistant Health Care-Associated Bacterial Pathogens
Authors: Deplano Ariane , Denis Olivier , Rodriguez-Villalobos Hector , De Ryck Raf , Struelens Marc J. , Hallin Marie
Published: August 2011

Fast, reliable, and versatile typing tools are essential to differentiate among related bacterial strains for epidemiological investigation and surveillance of health care-associated infection with multidrug-resistant (MDR) pathogens. The DiversiLab (DL) system is a semiautomated repetitive-sequence-based PCR system designed for rapid genotyping. The DL system performance was assessed by comparing its reproducibility, typeability, discriminatory power, and concordance with those of pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) and by assessing its epidemiological concordance on well-characterized MDR bacterial strains (
n
= 165). These included
vanA Enterococcus faecium
, extended-spectrum β-lactamase (ESBL)-producing strains of
Klebsiella pneumoniae
,
Escherichia coli
, and
Acinetobacter baumannii
, and ESBL- or metallo-β-lactamase (MBL)-producing
Pseudomonas aeruginosa
strains. The DL system showed very good performance for
E. faecium
and
K. pneumoniae
and good performance for other species, except for a discrimination index of <95% for
A. baumannii
and
E. coli
(93.9% and 93.5%, respectively) and incomplete concordance with MLST for
P. aeruginosa
(78.6%) and
E. coli
(97.0%). Occasional violations of MLST assignment by DL types were noted for
E. coli
. Complete epidemiological concordance was observed for all pathogens, as all outbreak-associated strains clustered in identical DL types that were distinct from those of unrelated strains. In conclusion, the DL system showed good to excellent performance, making it a reliable typing tool for investigation of outbreaks caused by study pathogens, even though it was generally less discriminating than PFGE analysis. For
E. coli
and
P. aeruginosa
, MLST cannot be reliably inferred from DL type due to phylogenetic group violation or discordance.
Functional Interactions between Polydnavirus and Host Cellular Innexins
Authors: Marziano N. K. , Hasegawa D. K. , Phelan P. , Turnbull M. W.
Published: August 2011

Polydnaviruses are double-stranded DNA viruses associated with some subfamilies of ichneumonoid parasitoid wasps. Polydnavirus virions are delivered during wasp parasitization of a host, and virus gene expression in the host induces alterations of host physiology. Infection of susceptible host caterpillars by the polydnavirus
Campoletis sonorensis
ichnovirus (CsIV) leads to expression of virus genes, resulting in immune and developmental disruptions. CsIV carries four homologues of insect gap junction genes (innexins) termed vinnexins, which are expressed in multiple tissues of infected caterpillars. Previously, we demonstrated that two of these, VinnexinD and VinnexinG, form functional gap junctions in paired
Xenopus
oocytes. Here we show that VinnexinQ1 and VinnexinQ2, likewise, form junctions in this heterologous system. Moreover, we demonstrate that the vinnexins interact differentially with the Innexin2 orthologue of an ichnovirus host,
Spodoptera frugiperda
. Cell pairs coexpressing a vinnexin and Innexin2 or pairs in which one cell expresses a vinnexin and the neighboring cell Innexin2 assemble functional junctions with properties that differ from those of junctions composed of Innexin2 alone. These data suggest that altered gap junctional intercellular communication may underlie certain cellular pathologies associated with ichnovirus infection of caterpillar hosts.
Membrane Perturbation Elicits an IRF3-Dependent, Interferon-Independent Antiviral Response
Authors: Noyce Ryan S. , Taylor Kathryne , Ciechonska Marta , Collins Susan E. , Duncan Roy , Mossman Karen L.
Published: August 2011

We previously found that enveloped virus binding and penetration are necessary to initiate an interferon-independent, IRF3-mediated antiviral response. To investigate whether membrane perturbations that accompany membrane fusion-dependent enveloped-virus entry are necessary and sufficient for antiviral-state induction, we utilized a reovirus fusion-associated small transmembrane (FAST) protein. Membrane disturbances during FAST protein-mediated fusion, in the absence of additional innate immune response triggers, are sufficient to elicit interferon-stimulated gene induction and establishment of an antiviral state. Using sensors of membrane disruption to activate an IRF3-dependent, interferon-independent antiviral state may provide cells with a rapid, broad-spectrum innate immune response to enveloped-virus infections.
Loss of Protease Dimerization Inhibition Activity of Darunavir Is Associated with the Acquisition of Resistance to Darunavir by HIV-1
Authors: Koh Yasuhiro , Aoki Manabu , Danish Matthew L. , Aoki-Ogata Hiromi , Amano Masayuki , Das Debananda , Shafer Robert W. , Ghosh Arun K. , Mitsuya Hiroaki
Published: August 2011

Dimerization of HIV protease is essential for the acquisition of protease's proteolytic activity. We previously identified a group of HIV protease dimerization inhibitors, including darunavir (DRV). In the present work, we examine whether loss of DRV's protease dimerization inhibition activity is associated with HIV development of DRV resistance. Single amino acid substitutions, including I3A, L5A, R8A/Q, L24A, T26A, D29N, R87K, T96A, L97A, and F99A, disrupted protease dimerization, as examined using an intermolecular fluorescence resonance energy transfer (FRET)-based HIV expression assay. All recombinant HIV
NL4-3
-based clones with such a protease dimerization-disrupting substitution failed to replicate. A highly DRV-resistant
in vitro-
selected HIV variant and clinical HIV strains isolated from AIDS patients failing to respond to DRV-containing antiviral regimens typically had the V32I, L33F, I54M, and I84V substitutions in common in protease. None of up to 3 of the 4 substitutions affected DRV's protease dimerization inhibition, which was significantly compromised by the four combined substitutions. Recombinant infectious clones containing up to 3 of the 4 substitutions remained sensitive to DRV, while a clonal HIV variant with all 4 substitutions proved highly resistant to DRV with a 205-fold 50% effective concentration (EC
50
) difference compared to HIV
NL4-3
. The present data suggest that the loss of DRV activity to inhibit protease dimerization represents a novel mechanism contributing to HIV resistance to DRV. The finding that 4 substitutions in PR are required for significant loss of DRV's protease dimerization inhibition should at least partially explain the reason DRV has a high genetic barrier against HIV's acquisition of DRV resistance.
Phase transformation of calcium phosphates in the presence of glutamic acid
Authors: Tsai Tim W. T. , Chen Wei-Ya , Tseng Yao-Hung , Chan Jerry C. C.
Published: August 2011

This work describes a phase-transformation pathway of calcium phosphate in the presence of glutamic acid. The route follows the order starting from amorphous calcium phosphate and brushite, then octacalcium phosphate (OCP), and finally hydroxyapatite (HAp). The preferred growth direction of the intermediate OCP and the final HAp phases lies along the c axis. On the basis of our scanning electron microscopy, X-ray powder diffraction, and31P solid-state NMR data, we suggest that the transformation is via the dissolution–reprecipitation process, which is facilitated in the presence of glutamic acid. The effect on the transformation kinetics is rationalized by the disruption of the water layer bound on the crystal surface.
BRIDGING JEFFREY'S RULE, AGM REVISION AND DEMPSTER CONDITIONING IN THE THEORY OF EVIDENCE
Authors: MA JIANBING , LIU WEIRU , DUBOIS DIDIER , PRADE HENRI
Published: August 2011

Belief revision characterizes the process of revising an agent's beliefs when receiving new evidence. In the field of artificial intelligence, revision strategies have been extensively studied in the context of logic-based formalisms and probability kinematics. However, so far there is not much literature on this topic in evidence theory. In contrast, combination rules proposed so far in the theory of evidence, especially Dempster rule, are symmetric. They rely on a basic assumption, that is, pieces of evidence being combined are considered to be on a par, i.e. play the same role. When one source of evidence is less reliable than another, it is possible to discount it and then a symmetric combination operation is still used. In the case of revision, the idea is to let prior knowledge of an agent be altered by some input information. The change problem is thus intrinsically asymmetric. Assuming the input information is reliable, it should be retained whilst the prior information should be changed minimally to that effect. To deal with this issue, this paper defines the notion of revision for the theory of evidence in such a way as to bring together probabilistic and logical views. Several revision rules previously proposed are reviewed and we advocate one of them as better corresponding to the idea of revision. It is extended to cope with inconsistency between prior and input information. It reduces to Dempster rule of combination, just like revision in the sense of Alchourrón, Gärdenfors, and Makinson (AGM) reduces to expansion, when the input is strongly consistent with the prior belief function. Properties of this revision rule are also investigated and it is shown to generalize Jeffrey's rule of updating, Dempster rule of conditioning and a form of AGM revision.
Real-time measurement of the length of a single sarcomere in rat ventricular myocytes: a novel analysis with quantum dots
Authors: Serizawa Takahiro , Terui Takako , Kagemoto Tatsuya , Mizuno Akari , Shimozawa Togo , Kobirumaki Fuyu , Ishiwata Shin'ichi , Kurihara Satoshi , Fukuda Norio
Published: August 2011

As the dynamic properties of cardiac sarcomeres are markedly changed in response to a length change of even ∼0.1 μm, it is imperative to quantitatively measure sarcomere length (SL). Here we show a novel system using quantum dots (QDs) that enables a real-time measurement of the length of a single sarcomere in cardiomyocytes. First, QDs were conjugated with anti-α-actinin antibody and applied to the sarcomeric Z disks in isolated skinned cardiomyocytes of the rat. At partial activation, spontaneous sarcomeric oscillations (SPOC) occurred, and QDs provided a quantitative measurement of the length of a single sarcomere over the broad range (i.e., from ∼1.7 to ∼2.3 μm). It was found that the SPOC amplitude was inversely related to SL, but the period showed no correlation with SL. We then treated intact cardiomyocytes with the mixture of the antibody-QDs and FuGENE HD, and visualized the movement of the Z lines/T tubules. At a low frequency of 1 Hz, the cycle of the motion of a single sarcomere consisted of fast shortening followed by slow relengthening. However, an increase in stimulation frequency to 3–5 Hz caused a phase shift of shortening and relengthening due to acceleration of relengthening, and the waveform became similar to that observed during SPOC. Finally, the anti-α-actinin antibody-QDs were transfected from the surface of the beating heart in vivo. The striated patterns with ∼1.96-μm intervals were observed after perfusion under fluorescence microscopy, and an electron microscopic observation confirmed the presence of QDs in and around the T tubules and Z disks, but primarily in the T tubules, within the first layer of cardiomyocytes of the left ventricular wall. Therefore, QDs are a useful tool to quantitatively analyze the movement of single sarcomeres in cardiomyocytes, under various experimental settings.
Angiotensin II utilizes Janus kinase 2 in hypertension, but not in the physiological control of blood pressure, during low-salt intake
Authors: Banes-Berceli Amy K. L. , Al-Azawi Hind , Proctor Daniel , Qu Harvey , Femminineo Dominic , Hill-Pyror Crystal , Webb R. Clinton , Brands Michael W.
Published: August 2011

Janus kinase (JAK) 2 is activated by ANG II in vitro and in vivo, and chronic blockade of JAK2 by the JAK2 inhibitor AG-490 has been shown recently to attenuate ANG II hypertension in mice. In this study, AG-490 was infused intravenously in chronically instrumented rats to determine if the blunted hypertension was linked to attenuation of the renal actions of ANG II. In male Sprague-Dawley rats, after a control period, ANG II at 10 ng·kg−1·min−1was infused intravenously with or without AG-490 at 10 ng·kg−1·min−1iv for 11 days. ANG II infusion (18 h/day) increased mean arterial pressure from 91 ± 3 to 168 ± 7 mmHg by day 11. That response was attenuated significantly in the ANG II + AG-490 group, with mean arterial pressure increasing only from 92 ± 5 to 127 ± 3 mmHg. ANG II infusion markedly decreased urinary sodium excretion, caused a rapid and sustained decrease in glomerular filtration rate to ∼60% of control, and increased renal JAK2 phosphorylation; all these responses were blocked by AG-490. However, chronic AG-490 treatment had no effect on the ability of a separate group of normal rats to maintain normal blood pressure when they were switched rapidly to a low-sodium diet, whereas blood pressure fell dramatically in losartan-treated rats on a low-sodium diet. These data suggest that activation of the JAK/STAT pathway is critical for the development of ANG II-induced hypertension by mediating its effects on renal sodium excretory capability, but the physiological control of blood pressure by ANG II with a low-salt diet does not require JAK2 activation.
Oncostatin M is a novel inhibitor of TGF-β1-induced matricellular protein expression
Authors: Sarközi Rita , Hauser Christine , Noppert Susie-Jane , Kronbichler Andreas , Pirklbauer Markus , Haller Viktoria Maria , Grillari Johannes , Grillari-Voglauer Regina , Mayer Gert , Schramek Herbert
Published: August 2011

Matricellular proteins in the kidney have been associated with the development of tubulointerstitial fibrogenesis and the progression of renal disease. This study investigated potential antifibrotic effects of the cytokine oncostatin M (OSM) in human proximal tubule cells (PTC), particularly with regard to inhibition of profibrotic events initiated by TGF-β1. In human PTC, OSM diminished transforming growth factor (TGF)-β1-induced expression of the transcriptional epithelial-mesenchymal transition mediator FoxC2. Furthermore, exposure to OSM attenuated basal and TGF-β1-induced expression of the matricellular proteins SPARC, TSP-1, TNC, and CTGF regardless of the sequence of ligand administration. OSM was shown to result in rapid and sustained phosphorylation of both Stat1 and Stat3 and also in transient phosphorylation of Smad2/3 in contrast to TGF-β1, which demonstrated a gradually building phosphorylation of Smad2/3 and a brief phosphorylation of Smad1/5/8. Utilizing receptor-blocking molecules, we found the inhibitory effect of OSM on TGF-β1-induced CTGF mRNA expression occurs independently of Smad2/3 signaling and present evidence that this effect may be partially driven by OSM receptor-mediated Stat1 and/or Stat3 signaling pathways, thereby providing a mechanism whereby OSM can contribute to tubulointerstitial protection.
Tolvaptan inhibits ERK-dependent cell proliferation, Cl−secretion, and in vitro cyst growth of human ADPKD cells stimulated by vasopressin
Authors: Reif Gail A. , Yamaguchi Tamio , Nivens Emily , Fujiki Hiroyuki , Pinto Cibele S. , Wallace Darren P.
Published: August 2011

In autosomal dominant polycystic kidney disease (ADPKD), arginine vasopressin (AVP) accelerates cyst growth by stimulating cAMP-dependent ERK activity and epithelial cell proliferation and by promoting Cl−-dependent fluid secretion. Tolvaptan, a V2 receptor antagonist, inhibits the renal effects of AVP and slows cyst growth in PKD animals. Here, we determined the effect of graded concentrations of tolvaptan on intracellular cAMP, ERK activity, cell proliferation, and transcellular Cl−secretion using human ADPKD cyst epithelial cells. Incubation of ADPKD cells with 10−9M AVP increased intracellular cAMP and stimulated ERK and cell proliferation. Tolvaptan caused a concentration-dependent inhibition of AVP-induced cAMP production with an apparent IC50of ∼10−10M. Correspondingly, tolvaptan inhibited AVP-induced ERK signaling and cell proliferation. Basolateral application of AVP to ADPKD cell monolayers grown on permeable supports caused a sustained increase in short-circuit current that was completely blocked by the Cl−channel blocker CFTRinh-172, consistent with AVP-induced transepithelial Cl−secretion. Tolvaptan inhibited AVP-induced Cl−secretion and decreased in vitro cyst growth of ADPKD cells cultured within a three-dimensional collagen matrix. These data demonstrate that relatively low concentrations of tolvaptan inhibit AVP-stimulated cell proliferation and Cl−-dependent fluid secretion by human ADPKD cystic cells.
Neuronal integration and the depolarizing effects of axonal GABAA receptors
Authors: Younts Thomas J. , Makani Sachin
Published: August 2011

Despite their presence throughout the central nervous system, the impact of axonally expressed gamma-amino-butyric acid type-A receptors (GABAARs) on neuronal signaling is just beginning to be understood. A recently published article (Pugh JR and Jahr CE, J Neurosci 31: 565–574, 2011) tackled this important issue by investigating GABAAR-mediated function in axons of cerebellar granule cells. The results of Pugh and Jahr indicate parallel fiber GABAARs enhance neurotransmitter release probability and boost axonal and somatic excitability.
Serotonin regulates voltage-dependent currents in type Ie(A)and Iiinterneurons ofHermissenda
Authors: Jin Nan Ge , Crow Terry
Published: August 2011

Serotonin (5-HT) has both direct and modulatory actions on central neurons contributing to behavioral arousal and cellular-synaptic plasticity in diverse species. In Hermissenda, 5-HT produces changes in intrinsic excitability of different types of identified interneurons in the circumesophageal nervous system. Using whole cell patch-clamp techniques we have examined membrane conductance changes produced by 5-HT that contribute to intrinsic excitability in two identified classes of interneurons, types Iiand IeA. Whole cell currents were examined before and after 5-HT application to the isolated nervous system. A 4-aminopyridine-sensitive transient outward K+current [ IK(A)], a tetraethylammonium-sensitive delayed rectifier K+current [ IK(V)], an inward rectifier K+current [ IK(IR)], and a hyperpolarization-activated current ( Ih) were characterized. 5-HT decreased the amplitude of IK(A)and IK(V)in both type Iiand IeAinterneurons. However, differences in 5-HT's effects on the activation-inactivation kinetics were observed in different types of interneurons. 5-HT produced a depolarizing shift in the activation curve of IK(V)and a hyperpolarizing shift in the inactivation curve of IK(A)in type Iiinterneurons. In contrast, 5-HT produced a depolarizing shift in the activation curve and a hyperpolarizing shift in the inactivation curve of both IK(V)and IK(A)in type IeAinterneurons. In addition, 5-HT decreased the amplitude of IK(IR)in type Iiinterneurons and increased the amplitude of Ihin type IeAinterneurons. These results indicate that 5-HT-dependent changes in IK(A), IK(V), IK(IR), and Ihcontribute to multiple mechanisms that synergistically support modulation of increased intrinsic excitability associated with different functional classes of identified type I interneurons.
RAFT Synthesis and Self-Assembly of Free-Base Porphyrin Cored Star Polymers
Authors: Wu Lin , McHale Ronan , Feng Guoqiang , Wang Xiaosong
Published: August 2011

Reversible addition fragmentation chain transfer (RAFT) synthesis and self-assembly of free-base porphyrin cored star polymers are reported. The polymerization, in the presence of a free-base porphyrin cored chain transfer agent (CTA-FBP), produced porphyrin star polymers with controlled molecular weights and narrow polydispersities for a number of monomers includingN,N-dimethylacrylamide (DMA) and styrene (St). Well-defined amphiphilic star block copolymers, P-(PS-PDMA)4and P-(PDMA-PS)4(P: porphyrin), were also prepared and used for self-assembly studies. In methanol, a selective solvent for PDMA, spherical micelles were observed for both block copolymers as characterized by TEM. UV-vis studies suggested star-like micelles were formed from P-(PS-PDMA)4, while P-(PDMA-PS)4aggregated into flower-like micelles. Spectrophotometric titrations indicated that the optical response of these two micelles to external ions was a function of micellar structures. These structure-related properties will be used for micelle studies and functional material development in the future.
M2M Communications in the Smart Grid: Applications, Standards, Enabling Technologies, and Research Challenges
Authors: Tan Siok Kheng , Sooriyabandara Mahesh , Fan Zhong
Published: August 2011

We present some of the ongoing standardisation work in M2M communications followed by the application of machine-to-machine (M2M) communications to smart grid. We analyse and discuss the enabling technologies in M2M and present an overview of the communications challenges and research opportunities with a focus on wireless sensor networks and their applications in a smart grid environment.
Design and Simulation of a Fully Digitized GNSS Receiver Front‐End
Authors: Yu Yuan , Chang Qing , Chen Yuan
Published: August 2011

In the near future, RF front‐ends of GNSS receivers may become very complicated when multifrequency signals are available from at least four global navigation systems. Based on the direct RF sampling technique, fully digitized receiver front‐ends may solve the problem. In this paper, a direct digitization RF front‐end scheme is presented. At first, a simplified sampling rate selection method is adopted to determine the optimal value. Then, the entire spectrum of GNSS signal is directly digitized through RF sampling at a very fast sampling rate. After that, the decimation and filtering network is designed to lower the sampling rate efficiently. It also realizes the digital downconversion of the signal of interest and the separation of narrow band signals from different navigation systems. The scheme can be flexibly implemented in software. Its effectiveness is proved through the experiment using simulated and true signals.
Bayes Estimation of Change Point in Discrete Maxwell Distribution
Authors: Pandya Mayuri , Pandya Hardik
Published: August 2011

A sequence of independent lifetimes X1, …, Xm, Xm+1, …, Xn
was observed from Maxwell distribution with reliability r1(t) at time t but later, it was found that there was a change in the system at some point of time m and it is reflected in the sequence after Xm by change in reliability r2(t) at time t. The Bayes estimators of m, θ1, θ2 are derived under different asymmetric loss functions. The effects of correct and wrong prior information on the Bayes estimates are studied.
Long-Term Significance of the Number of Hours until Surgical Repair of Penile Fractures
Authors: Kozacioglu Zafer , Degirmenci Tansu , Arslan Murat , Yuksel Mehmet B. , Gunlusoy Bulent , Minareci Suleyman
Published: August 2011

Objectives: We investigated whether a delay in time until surgery, in terms of hours, has any effect on the overall long-term results of surgical repair of penile fractures. Methods: Between 2001 and 2009, we operated on 56 patients with penile fractures. We evaluated 43 patients sorted into 3 groups according to the time interval until surgery. We applied the validated Turkish version of the International Index of Erectile Function (IIEF) questionnaire 3 times: for the time period before the fracture, 1 year after the fracture, and at the time of the study. An erectile dysfunction score was calculated for every patient. Results: Overall, the mean follow-up was 46.1 ± 19.2 months. The mean number of hours from trauma to surgery was 11.3 ± 8.5. There was no statistically significant difference between the 3 groups in terms of age and length of tears. The results of the IIEF questionnaires of each group for time periods and for individual patients in each separate group were statistically similar. Conclusions: Surgical repair has a good functional outcome and low complication rates in the long term. Neither serious deformities nor erectile dysfunction occur as a consequence of a delay in surgery in the long term in patients with no urethral involvement within a given period of time.
Iatrogenic Splenectomy during Left Nephrectomy: A Single-Institution Experience of Eight Years
Authors: Tan Kenny , Lewis Gareth R. , Chahal Rohit , Browning Anthony J. , Sundaram Subramanian K. , Weston Philip M.T. , Harrison Simon C.W. , Biyani Chandra Shekhar
Published: August 2011

Introduction: Iatrogenic injury to the spleen is not an uncommon complication. Left nephrectomy has been reported as the second commonest cause of iatrogenic splenectomy with a reported incidence between 1.3 and 24%. Iatrogenic splenectomy is associated with significant morbidity and mortality. Aims: We reviewed the occurrence of iatrogenic splenectomy during left nephrectomy at our centre. Our aims were to determine the incidence of iatrogenic splenectomy within the Mid Yorkshire Hospitals NHS Trust in order to understand the nature of the splenic injury and the morbidity and mortality associated with it. Methods: All splenectomy and nephrectomy histology reports from January 2000 to December 2007 were reviewed retrospectively. Indications for splenectomy and nephrectomy were identified. Patients’ demographic data, tumour characteristics, operative details, length of hospital stay and any reported morbidity or mortality were collected. Results: A total of 447 nephrectomies were identified which included 234 left nephrectomies. Within the same period 136 cases of splenectomy were performed. Thirty-four cases were iatrogenic splenectomies and 12 were caused by left nephrectomy. The incidence was 5.13%. The male to female ratio was 1:1 with an average age of 66 years. Grade 2 and stage pT2 renal cancer were the commonest tumour characteristics. All iatrogenic injuries occurred during mobilisation of the colon or division of adhesion. The average operative time was 4.7 h. Average length of hospital stay was 14 days. Five patients had postoperative complications and 1 died of respiratory failure and sepsis. Conclusion: Splenic injury during left nephrectomy is a morbid complication. A good understanding of anatomy and surgical approach may reduce the incidence, morbidity and mortality of iatrogenic splenectomy during left nephrectomy.
Key Areas in the Learning Curve for Robotic Urological Surgery: A Spanish Multicentre Survey
Authors: Moreno Sierra Jesús , Fernández Pérez Cristina , Ortiz Oshiro Elena , Silmi Moyano Angel
Published: August 2011

Background: The number of robotic-assisted procedures offered in Spain is rapidly increasing despite a lack of consensus criteria for training and credentialling. Objective: This national multicentre study was designed to analyze the different areas of the robotic urological surgery learning curve. Material and Methods: A questionnaire was sent to all 13 urology units in Spain with an active robotics programme requesting information on training and problems encountered. Results: In most centres (n = 11, 84.6%), training programmes were animal-based; cadavers were used at only 2 (15.4%). Proctoring in initial procedures was practiced by 12 groups (92.3%). When initiating the robotics programme, the console was shared at 8 units (61.5%). Prior experience in open and/or laparoscopic surgery was reported by 10 of the groups (76.9%), and experience in open surgery only by 2 (15.4%) or robotic surgery alone by 1 (7.7%). The procedure with which the robotics programme was started in all 13 participating units was radical prostatectomy. The number of cases needed to complete the learning curve for this procedure was 20–25 cases according to 8 (61.5%) surgery teams. Conclusions: Up until March 26, 2010, 1,692 operations, mostly radical prostatectomies, were conducted using the da Vinci robot in our country.
Outcome of Intravenous Thrombolysis in Stroke Patients Weighing over 100 kg
Authors: Sarikaya H. , Arnold M. , Engelter S.T. , Lyrer P.A. , Mattle H.P. , Michel P. , Odier C. , Weder B. , Siebel P. , Mueller F. , Ballinari P. , Georgiadis D. , Baumgartner R.W.
Published: August 2011

Background: Intravenous thrombolysis with alteplase for ischemic stroke is fixed at a maximal dose of 90 mg for safety reasons. Little is known about the clinical outcomes of stroke patients weighing >100 kg, who may benefit less from thrombolysis due to this dose limitation. Methods: Prospective data on 1,479 consecutive stroke patients treated with intravenous alteplase in six Swiss stroke units were analyzed. Presenting characteristics and the frequency of favorable outcomes, defined as a modified Rankin scale (mRS) score of 0 or 1, a good outcome (mRS score 0–2), mortality and symptomatic intracranial hemorrhage (SICH) were compared between patients weighing >100 kg and those weighing ≤100 kg. Results: Compared to their counterparts (n = 1,384, mean body weight 73 kg), patients weighing >100 kg (n = 95, mean body weight 108 kg) were younger (61 vs. 67 years, p < 0.001), were more frequently males (83 vs. 60%, p < 0.001) and more frequently suffered from diabetes mellitus (30 vs. 13%, p < 0.001). As compared with patients weighing ≤100 kg, patients weighing >100 kg had similar rates of favorable outcomes (45 vs. 48%, p = 0.656), good outcomes (58 vs. 64%, p = 0.270) and mortality (17 vs. 12%, p = 0.196), and SICH risk (1 vs. 5%, p = 0.182). After multivariable adjustment, body weight >100 kg was strongly associated with mortality (p = 0.007) and poor outcome (p = 0.007). Conclusion: Our data do not suggest a reduced likehood of favorable outcomes in patients weighing >100 kg treated with the current dose regimen. The association of body weight >100 kg with mortality and poor outcome, however, demands further large-scale studies to replicate our findings and to explore the underlying mechanisms.
Sun Exposure, Vitamin D Intake and Progression to Disability among Veterans with Progressive Multiple Sclerosis
Authors: McDowell Tzu-Yun , Amr Sania , Culpepper William J. , Langenberg Patricia , Royal Walter , Bever Christopher , Bradham Douglas D.
Published: August 2011

Background: Early life events have been suggested to influence multiple sclerosis (MS) susceptibility, and to potentially modulate its clinical course. We assessed vitamin D-related exposures from childhood to disease onset and their associations with MS progression. Methods: Among veterans in the Multiple Sclerosis Surveillance Registry, 219 reported having the progressive form and met the inclusion criteria. Participants reported their past sun exposure, vitamin D-related intake and age at disability milestones using the Patient-Determined Disease Steps (PDDS). The Cox proportional hazards model was used to examine the association between vitamin D-related exposures and time (years) to disability. Results: Low average sun exposure in the fall/winter before disease onset was associated with an increased risk of progressing to a PDDS score of 8 (hazard ratio, HR: 2.13, 95% confidence interval, CI: 1.20–3.78), whereas use of cod liver oil during childhood and adolescence was associated with a reduced risk (HR: 0.44, 95% CI: 0.20–0.96). Conclusions: These results suggest that exposure to vitamin D before MS onset might slow disease-related neurodegeneration and thus delay progression to disability among patients with the progressive subtype.
Local Head and Neck Cooling Leads to Hypothermia in Healthy Volunteers
Authors: Kallmünzer Bernd , Beck Alexander , Schwab Stefan , Kollmar Rainer
Published: August 2011

Background: Prehospital cooling of acute stroke patients would be ideal when associated with minor or no side effects. Therefore, we evaluated a cooling cap for the surface of head and cervical regions in awake volunteers. Methods: 10 healthy volunteers were treated by external cooling for 190 min using a gel-based cooling device. Vital signs, rectal temperature, tympanic temperature, the extent of shivering and individual perception of frostiness and discomfort were measured. Results: All participants (median age 35 years) successfully completed the treatment and experienced only mild to moderate discomfort. No serious adverse events and no shivering were noticed. There was a significant drop in the tympanic temperature to 34.68°C (difference from baseline: 1.7°C, 95% CI: 0.61–2.7°C, p = 0.001), in the rectal temperature to 36.65°C (difference from baseline: 0.65°C, 95% CI: 0.06–1.2°C, p = 0.019) and in the heart rate (difference from baseline: 15 beats/min, 95% CI: 0.63–30 beats/min, p = 0.035). Conclusion: Treatment with the cooling device was well tolerated by all participants. The technique had measurable effects on core body temperature (rectal) and tympanic temperature (may reflect temperature at the external ear and skin rather than intracranial). It can be considered as a simple therapeutic approach to patients with suspected stroke in the prehospital setting.
Laryngeal Fracture due to Blunt Trauma Presenting with Pneumothorax and Pneumomediastinum
Authors: Narcı Adnan , Embleton Didem Baskın , Ayçiçek Abdullah , Yücedağ Fatih , Çetinkurşun Salih
Published: August 2011

Aim: Injuries due to traffic accidents are frequent in childhood, and they have high mortality and morbidity. Laryngeal injury due to a traffic accident is a rare pathology and might be missed if not suspected. Here we present a laryngeal fracture in a child after a blunt chest trauma during a traffic accident that presented with pneumomediastinum and pneumothorax. Case: A 14-year-old girl was referred for pneumomediastinum. Her physical examination was normal except subcutaneous emphysema, edema and tenderness in the cervical area, hoarseness, facial and extremity abrasions and ecchymoses. Chest tomography revealed pneumothorax and pneumomediastinum, and cranial tomography revealed maxillofacial fractures. Upper airway damage was suspected, flexible endoscopy revealed right vocal cord paralysis and cervical tomography revealed thyroid cartilage fracture. The fracture was repaired and tracheotomy was performed. She was discharged on postoperative day 6. Facial fractures were repaired in another center. Tracheotomy was removed on postoperative day 20. Her hoarseness, although decreased, still persists. Conclusion: Pneumomediastinum is a rare result of a laryngeal fracture and if not suspected, the fracture can easily be missed. It should be kept in mind after blunt cervical trauma with pneumomediastinum and/or pneumothorax. Direct endoscopy and cervical tomography may be necessary for the differential diagnosis.
Cariogenic Microorganisms and Oral Conditions in Asthmatic Children
Authors: Botelho M.P.J. , Maciel S.M. , Cerci Neto A. , Dezan C.C. , Fernandes K.B.P. , de Andrade F.B.
Published: August 2011

This study evaluated the caries risk of asthmatic patients on the basis of mutans streptococci (MS) and lactobacilli levels in saliva samples as well as the index of oral hygiene and dental caries (DMFT index). The study population was composed of 80 asthmatic children, aged 3–15 years, who use specific medication, and 80 matched, healthy control children. The parents were interviewed about oral health-related factors. The World Health Organization criteria were used for dental examinations. The Köhler and Bratthal methodology was used to detect salivary MS levels and dilutions of saliva were done for lactobacilli counting. No differences between asthma and control groups were observed for caries prevalence in children aged 3–6 and 7–10 years, except in severe cases in the younger group. However, higher caries prevalence for permanent dentition was observed in 11- to 15-year-old asthmatic children. An increased dental biofilm was observed in the asthma group, as well as salivary levels of MS. No differences were observed in levels of lactobacilli. No statistical correlations were found between medication, frequency of treatment, method of consumption and caries experience, dental biofilm and salivary levels of MS or lactobacilli. However, there was a correlation between MS levels and treatment duration. The logistic regression revealed that MS level is an important risk factor for increased caries experience. Asthma should be evaluated as a risk factor for caries experience because it can increase the levels of MS and the dental biofilm.
Onset Patterns and Initial Symptoms of Dementia with Lewy Bodies: Possible Pathophysiological Diversities Deduced from a SPECT Study
Authors: Fukui T. , Hori K. , Yoshimasu H.
Published: August 2011

Background/Aims: The aim of this study was to investigate onset patterns and initial symptoms in patients with dementia with Lewy bodies (DLB) and their association with SPECT findings. Methods: We studied 29 probable and 12 possible DLB patients. Onset was defined as ‘acute’ when symptoms (in various combinations) present within a few weeks or ‘chronic’ when a few symptoms present and progress during a longer period of time. Initial symptoms were dichotomized into ‘cognitive’ and ‘non-cognitive’. We conducted voxel-to-voxel statistical analyses of SPECT, and uptake deviations from age-matched controls were depicted with Z-scores. Results: In acute patients, decreases were more apparent in the bilateral frontal and temporal lobes, whereas chronic patients showed decreases in the bilateral occipital, posterior cingulate and precuneal regions. Differences in the left frontal and left posterior cingulate were significant and those in the left temporal region showed a tendency toward significance. Patients with cognitive symptoms demonstrated more marked decreases in the bilateral temporal, parietal, occipital, cingulate and precuneal regions. Differences in the left parietal area reached significance and the total decreases were larger in patients with cognitive than non-cognitive symptoms, with a trend toward significance. Conclusions: The multiplicity of onset patterns and initial symptoms may possibly be based on pathophysiological diversities in DLB.
Comparison of Scores of Application Methods of the Epworth Sleepiness Scale: Self Administered or Nurse Administered
Authors: Ugur Kadriye Serife , Ark Nebil , Kurtaran Hanifi , Ozol Duygu , Kurt Kenan , Mutlu Cemil
Published: August 2011

Purpose of the Study: The aim of this study was to investigate the impact of two different application methods (self or nurse administered) on Epworth Sleepiness Scale (ESS) scores and compare the scores according to their correlations between polysomnographic findings. Procedures: 114 patients agreed to participate by completing the Turkish version of the ESS with 2 different methods of application, but the complete results of polysomnography (PSG) were available for 101 patients. Results: The scores of the nurse-administered ESS were clinically significantly correlated with the apnea-hypoapnea index. Scores of the self-administered ESS were not correlated with any of the demographic and PSG parameters. In the reliability analysis, the scores of the self-administered and the nurse-administered ESS were quite consistent. Conclusion and Message: We considered that to complete the ESS with the method of nurse administration could change the reliability and sensitivity. In conclusion, the ESS may be a more reliable tool for measuring the severity of excessive daytime sleepiness or obstructive sleep apnea by a change in the administration method.
Urinary Neutrophil Gelatinase-Associated Lipocalin Measured on Admission to the Intensive Care Unit Accurately Discriminates between Sustained and Transient Acute Kidney Injury in Adult Critically Ill Patients
Authors: de Geus Hilde R.H. , Woo Jessica G. , Wang Yu , Devarajan Prasad , Betjes Michiel G. , le Noble Jos L.M.L. , Bakker Jan
Published: August 2011

Background: First we aimed to evaluate the ability of neutrophil gelatinase-associated lipocalin (NGAL) and cystatin-C (CyC) in plasma and urine to discriminate between sustained, transient and absent acute kidney injury (AKI), and second to evaluate their predictive performance for sustained AKI in adult intensive care unit (ICU) patients. Methods: A prospective cohort study of 700 patients was studied. Sample collection was performed over 8 time points starting on admission. Results: After exclusion 510 patients remained for the analysis. All biomarkers showed significant differentiation between sustained and no AKI at all time points (p ≤ 0.0002) except for urine CyC (uCyC) on admission (p = 0.06). Urine NGAL (uNGAL) was the only biomarker significantly differentiating sustained from transient AKI on ICU admission (p = 0.02). Individually, uNGAL performed better than the other biomarkers (area under the curves, AUC = 0.80, 95% confidence interval, CI = 0.72–0.88) for the prediction of sustained AKI. The combination with plasma NGAL (pNGAL) showed a nonsignificant improvement (AUC = 0.83, 95% CI = 0.75–0.91). The combination of individual markers with a model of clinical characteristics (MDRD eGFR, HCO3– and sepsis) did not improve its performance significantly. However, the integrated discrimination improvement showed significant improvement when uNGAL was added (p = 0.04). Conclusions: uNGAL measured on ICU admission differentiates patients with sustained AKI from transient or no-AKI patients. Combining biomarkers such as pNGAL, uNGAL and plasma CyC with clinical characteristics adds some value to the predictive model.
The Annual Cycle of Earth Radiation Budget from Clouds and the Earth’s Radiant Energy System (CERES) Data
Authors: Mlynczak Pamela E. , Smith G. Louis , Doelling David R.
Published: August 2011

The seasonal cycle of the Earth radiation budget is investigated by use of data from the Clouds and the Earth’s Radiant Energy System (CERES). Monthly mean maps of reflected solar flux and Earth-emitted flux on a 1° equal-angle grid are used for the study. The seasonal cycles of absorbed solar radiation (ASR), outgoing longwave radiation (OLR), and net radiation are described by use of principal components for the time variations, for which the corresponding geographic variations are the empirical orthogonal functions. Earth’s surface is partitioned into land and ocean for the analysis. The first principal component describes more than 95% of the variance in the seasonal cycle of ASR and the net radiation fluxes and nearly 90% of the variance of OLR over land. Because one term can express so much of the variance, principal component analysis is very useful to describe these seasonal cycles. The annual cycles of ASR are about 100 W m−2 over land and ocean, but the amplitudes of OLR are about 27 W m−2 over land and 15 W m−2 over ocean. The magnitude of OLR and its time lag relative to that of ASR are important descriptors of the climate system and are computed for the first principal components. OLR lags ASR by about 26 days over land and 42 days over ocean. The principal components are useful for comparing the observed radiation budget with that computed by a model.
Profiles of individually defined recovery of people with major psychiatric problems
Authors: van Gestel-Timmermans J. A. W. M. , Brouwers E. P. M. , Bongers I. L. , van Assen M. A. L. M. , van Nieuwenhuizen Ch.
Published: August 2011

Background:

Research on factors associated with individually defined recovery is limited. Several phases of recovery have been described in the literature. Individuals in these distinct phases have different characteristics and problems.

Aims:

To identify classes of people with major psychiatric problems who have comparable profiles of individually defined recovery, to relate these classes to the phases of recovery as described by Spaniol, Wewiorsky, Gagne, and Anthony (2002), and to associate the classes to demographic and psychiatric characteristics, and health-related variables.

Methods:

Data of 333 participants with major psychiatric problems were used. A latent class analysis was conducted on the mean scores of four proxy measures of recovery.

Results:

Three well-defined classes were found that differed on the recovery measures. The classes differed significantly on variables corresponding to Spaniol’s phases of recovery (Spaniol et al., 2002) and on health care utilization, health care needs and anxiety disorder, but not on demographic variables.

Conclusions:

It is possible to identify classes of people with major psychiatric problems who have comparable profiles of individually defined recovery that seem to correspond to phases of recovery. More knowledge of the characteristics of people in different phases of recovery will contribute to more fine-tuned and recovery-oriented health care.
Spinning of fibers from polypropylene/silica composite resins
Authors: Srisawat Natee , Nithitanakul Manit , Srikulkit Kawee
Published: August 2011

Isotactic polypropylene (iPP)/silica (SiO2) composites were prepared by solution (toluene) mixing followed by either sonication or autoclaving to disaggregate the silica agglomerates. The obtained composite resins were then spun into monofilament fibers using a ThermoHaake's single screw extruder. The obtained fibers were characterized by morphological analyses (scanning electron microscope, atomic force microscopy (AFM), and Raman), crystallization profile (differential scanning calorimetry), and hot-stage microscopy. AFM images and Raman analysis maps revealed that silica particles of a submicron size range were present on the surface. The inclusion of silica particles into the resins resulted in a higher crystallization temperature ( Tc) and shrinkage resistance of the composite fiber when compared to those of the neat or toluene-prepared PP fibers, which were attributed to the nucleating effect of the silica filler with an effective reinforcement. In addition, the silica loadings (0.25–1 wt%) increased the tensile strength attributable to its change in shape from round to elongated and flattened after spinning process, except that the greatest increase (1.4-fold) was seen at 0.25 wt% silica. However, the variances were large, resulting from diameter variation arising from free-fall fibers obtained by gravitational force only. Interestingly, the surface hydrophobicity of the composite fibers was found to be higher than the neat fibers due to the increase in the surface roughness arising from the presence of particles on the surface.
A modified anisotropic PUFF equation of state for composite materials
Authors: Huang Xia , Tang Wenhui , Jiang Banghai
Published: August 2011

A modified anisotropic PUFF equation of state for composite materials under elastic and plastic condition is proposed in this paper, which can not only calculate the non-linear behavior of volume change but also reveal anisotropic strength effect of material under compression and dilation. Taking the 2D impact problem and thermal shock wave problem under X-ray radiation of orthotropic composite material for example, a numerical simulation is completed using the finite element program, and the pressures calculated by traditional and modified PUFF equation of state are compared. The results show that the two pressures have obvious difference at low compression and tension state, but with the increase of pressure the difference reduces and the pressures tend to be consistent gradually. These conclusions are coincident with the theory that the anisotropic material tends to be isotropic at high pressure and exhibits anisotropic property at low pressure.