bluuebunny/crossref_metadata_2025 huggingface dataset:
Tasking the everyday: Where mobile and online communication take time
Authors: Burchell Kenzie
Published: December 2014

In the contemporary urban environment, the conditions for communication are in abundance, having shifted and extended to include multiple overlapping possibilities for interaction through mobile devices, personal computers, and online platforms such that traditional domains of activity have been subsumed within a relational domain of communication activity. This involves not only an extension of interaction across spaces of activity but also the remapping of how interpersonal communication practices are woven into the temporality and embodied practices of everyday life. The conditions for networked communication partially emerge through a consistent set of embodied background communication practices. These include practices of the individual maintaining contact with technological objects in their environment and also the habitual rhythms of interface-level practices, which together contribute to the forms of networked connection.

Stemming from qualitative fieldwork with 35 participants during 2010 and 2011, this paper explores the organization and experience of networked interpersonal communication practices within the temporalities of everyday life. The individual’s perceived need for networked connection is proposed as the prerequisite for, but also a condition of, participation in contemporary everyday life. This paper explores the emerging role of networked time: where the constant and multiple embodied rhythms of individual engagement with overlapping media technologies, as objects and interfaces within the material environment, are interwoven with the capacity of those media to partially constitute one’s relationship to, and management of, time in everyday life. The tension between the finite minutes of the individual’s day and the limitless potential of networked connection is explored through the individual’s interface-level practices to avoid being temporally overwhelmed by potential interactions. In this manner, communication is perceived and managed as distinct, quantifiable, but variable units of time in and of themselves: interaction as “tasks” to be addressed and completed through engagement.
Using attitude functions, self-efficacy, and norms to predict attitudes and intentions to use mobile devices to access social media during sporting event attendance
Authors: Wang Xiao
Published: December 2014

The recent years have observed an increased use of social media through mobile devices on different occasions. The present investigation examines why sports spectators use social media (e.g., Facebook and Twitter) while attending sporting events. Based on a cross-sectional survey of 466 participants who generally attended games with friends or family, structural equation modeling analysis revealed that social media use through a mobile device during sporting event attendance served four functions: information-based and game pleasure-based utilitarian functions, an ego-defensive function, and a value-expressive function. The first three functions, descriptive norms, and self-efficacy predicted attitudes toward social media use. When placed within a larger theoretical framework, attitudes, self-efficacy, descriptive norms, and the ego-defensive function predicted intentions to use social media during sporting event attendance. Both theoretical and practical implications are discussed.
Accessing the news in an age of mobile media: Tracing displacing and complementary effects of mobile news on newspapers and online news
Authors: Westlund Oscar , Färdigh Mathias A.
Published: December 2014

Legacy news media have invested substantially in developing digital and mobile news provisioning, alongside the widespread diffusion of information and communication technologies. Amid these developments, many people have shifted the ways they access the news in everyday life, with mobile devices gaining much significance. This has shifted the roles traditionally played by newspapers, television stations, radio broadcasters and news sites, ultimately relating to their democratic functions and the diminishing effect of their business models. This article will describe and explain displacing vis-à-vis complementary effects among age cohorts. It shows how the recent uptake of mobile devices has influenced news consumption via newspapers and news sites. It investigates three research questions, each focusing age cohorts in relation to single-media use, cross-media use, and nonuse. The article presents a statistical analysis of datasets nationally representative to Sweden and the specific case of evening tabloids. The data used originate from scientific omnibus survey projects conducted annually from 1986 to 2012 at the University of Gothenburg. The findings show that the public generally engage in single-media rather than cross-media news consumption, whereas age cohorts have developed divergent forms of single-media use: (a) the 1930s and 1940s age cohort are primarily single-media users in print, (b) the 1950s, 1960s, and 1970s age cohorts are computer-oriented single-media users; and (c) the 1980s and 1990s age cohorts are mainly single-media users via mobile devices, but also cross-media users of mobile devices combined with a computer. As of 2012, the uptake of mobile news and cross-media news consumption reached new records, whereas the single-media use of printed newspapers reached a new low. The integrated theoretical framework proves useful for comprehending such transforming news consumption among age cohorts, and reveals the significance for legacy news media to explore and exploit the opportunities arising from mobile devices and tablets.
Choosing the right app: An exploratory perspective on heuristic decision processes for smartphone app selection
Authors: Dogruel Leyla , Joeckel Sven , Bowman Nicholas D.
Published: December 2014

Decision-making theories have argued that many daily decisions are the result of heuristic rather than systematic processes. Given the ubiquity of smartphones as mobile communication and computing devices along with the vast smartphone app market, our exploratory study aimed to understand how heuristics guide smartphone app selection. Observing 49 smartphone users from the US and Germany viewing 189 total apps from three predetermined categories, the current study identified five decision-making heuristics used to download a variety of smartphone apps. Of these, four were variants of a “Take the First” (TtF) heuristic that allowed smartphone users to quickly navigate the app market, by passing a good deal of other informational cues in order to download apps that were simply highly rated or ranked. Reliance on heuristic processing is useful in helping navigate the app market, but it also results in smartphone users overlooking potentially important app information.
Unusual Presentation of Unroofed Coronary Sinus With Cyanosis After Ventricular Septal Defect Closure
Authors: Yarrabolu Tharakanatha R. , Doshi Unnati H. , Douglas William I. , Aly Ashraf M. , Balaguru Duraisamy
Published: December 2014

Cyanosis after surgical closure of ventricular and/or atrial septal defect is very unusual. We report a case of unroofed coronary sinus in a six-month-old boy who developed cyanosis after surgical closure of ventricular and atrial septal defects. Clinical presentation, diagnosis, and management are discussed.
Absent Pulmonary Valve, Tricuspid Atresia, and Congenital Heart Block
Authors: Juaneda Ignacio , Rychik Jack , Fuller Stephanie , Weinberg Paul M. , Rome Jonathan J. , Mahle William T. , Gaynor J. William
Published: December 2014

We describe management of a patient with a prenatal diagnosis of absent pulmonary valve, tricuspid atresia, ventricular septal defect, and congenital heart block. Initial treatment consisted of temporary pacemaker implantation, and subsequent palliation included a central shunt during the neonatal period and placement of a permanent pacemaker. At seven months of age, a bidirectional Glenn anastomosis was performed. Cardiac catheterization revealed high cavopulmonary pressures and ventricular dysfunction precluding Fontan completion. Heart transplantation was performed at 3.75 years of age. The patient is alive and well 26 months posttransplantation.
Horseshoe Lung With Cor Triatriatum and Partial Atrioventricular Canal Defect
Authors: Garg Pankaj , Mishra Amit , Shah Ritesh , Panchal Jigar , Parmar Divyakant
Published: December 2014

Cor triatriatum with partial atrioventricular canal defect is a rare congenital cardiac anomaly. We report a case of cor triatriatum and partial atrioventricular canal defect in association with horseshoe lung.
Chest Pain on Exertion After the Takeuchi Repair of Anomalous Origin of the Left Coronary Artery
Authors: van der Bijl Pieter , Doruyter Alexander , Decker Rik de , Lawrenson John , Comitis George , Hewitson John
Published: December 2014

Right ventricular (RV) outflow obstruction (in the form of valvar or supravalvular pulmonary stenosis) is a well-known complication of the Takeuchi procedure. We describe a 13-year-old male with exertional chest pain, pulmonary stenosis, RV hypertrophy, and consequent RV ischemia, which was confirmed using stress echocardiography and single-photon emission tomography.
Elective ECMO Support for Pulmonary Artery Stent Placement in a 4.9-kg Shunt-Dependent Patient
Authors: Zampi Jeffrey D. , Rocchini Albert , Hirsch-Romano Jennifer C.
Published: December 2014

Although extracorporeal membrane oxygenation (ECMO) is traditionally used to emergently manage respiratory and/or cardiovascular failure, ECMO can also support cardiorespiratory function in nonemergent settings. Here we present the elective use of ECMO to support a 4.9-kg pediatric patient undergoing a complex percutaneous catheter-based intervention.
Right Juxtaposition and a Tunnel Between the Atrial Appendages in a Patient With Atrial Septal Defect and Pulmonary Valve Stenosis
Authors: Karaçelik Mustafa , Karagöz Uğur , Doyurgan Onur , Özdemir Rahmi , Öztürk Pelin , Sariosmanoğlu Osman Nejat
Published: December 2014

A 13-month-old boy with a diagnosis of atrial septal defect and pulmonary valve stenosis was admitted for corrective surgery. Right juxtaposition of the atrial appendages with a tunnel between the atrial appendages was detected during the surgery. The patient was operated successfully and had an uneventful recovery. Once right juxtaposition of the atrial appendages has been identified, the possibility of a “tunnel” communication between the appendages must be considered and ruled out.
Plasma Exchange on Venovenous Extracorporeal Membrane Oxygenation With Bivalirudin Anticoagulation
Authors: Preston Thomas J. , Dalton Heidi J. , Nicol Kathleen K. , Ferrall Brit R. , Miller Julie C. , Hayes Don
Published: December 2014

A pediatric patient requiring venovenous (VV) extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation developed heparin-induced thrombocytopenia. Unfractionated heparin was discontinued, and a bivalirudin infusion was started. During the lung transplant evaluation, he was found to have allosensitization, requiring treatment with plasma exchange along with pulse methylprednisolone, rituximab, bortezomib, and pooled immunoglobulin infusion. We describe our experience with successful plasma exchange for allosensitization during bivalirudin anticoagulation on VV ECMO in a pediatric patient.
Successful Lysis of Bilateral Renal Vein Thrombosis Following Neonatal Truncus Repair
Authors: Prabhu Sudesh , Ramakrishnan Karthik , Alphonso Nelson , McCaffery Kevin , Anderson Ben , Karl Tom
Published: December 2014

Renal vein thrombosis (RVT) is the most common noncatheter-related thrombosis encountered in infancy, most of which occurs in neonates. The optimal management strategy for neonatal RVT is unclear. Fibrinolytic and heparin therapy may play a role in preventing chronic renal failure in neonates with bilateral RVT. However, the use of fibrinolytics early after any major surgery requires tremendous caution. In this report, we describe the successful use of fibrinolysis in a neonate with bilateral RVT after repair of truncus arteriosus in the early postoperative period.
Vascular Access for Pediatric Coronary Angiography on Extracorporeal Membrane Oxygenation
Authors: Thuys Clarke , MacLaren Graeme , d’Udekem Yves , Eastaugh Lucas
Published: December 2014

Vascular access for catheterization of a pediatric patient on extracorporeal membrane oxygenation (ECMO) was facilitated by adding an accessory limb to the ECMO circuit. This limb was terminated with a hemostatic valve allowing insertion of a catheter. Changes in support parameters compensated for the change in the effective diameter of the ECMO cannula on insertion of the catheter. This method can overcome difficulties in obtaining vascular access for patients on ECMO.
Mixed Type Total Anomalous Pulmonary Venous Connection
Authors: Furlanetto Gláucio , Furlanetto Beatriz H. S. , Henriques Sandra R. C. , Lopes Lilian M. , Miranda Eduardo T. , Porto Carolina M. G. , Pereira Maria Emilia N. T. , Davini Claudia , Espinosa Elssi C.
Published: December 2014

Introduction:

The mixed total anomalous pulmonary connection is a rare type of congenital cardiopathy. The occurrence of multiple connections of the pulmonary veins has important implication in the diagnosis and surgical planning. These types of total anomalous pulmonary venous connection (TAPVC) and the infracardiac have higher surgical mortality.

Methods:

Between December 1994 and July 2013, a total of 58 children underwent surgical treatment of TAPVC. Twenty-five (43.1%) patients had supracardiac connection, 15 (25.8%) patients had intracardiac type, 12 (20.6%) patients had a mixed type, and 6 (10.3%) patients had an infracardiac type. In children with mixed TAPVC, four (33.3%) patients had type I, five (41.6%) patients had type II, and three (25.0%) patients had type III. The diagnosis of TAPVC was performed in all patients using Doppler echocardiography, and they underwent cardiopulmonary bypass with aorta-bicaval cannulation and lately we use mild hypothermia with normal flow. The drainage channels were ligated in all patients.

Results:

The immediate surgical results were as follows: one (16.6%) death in the infracardiac group, four (16.0%) deaths in the supracardiac group, one (8.3%) death in the mixed group, and no death in the cardiac group (no statistical difference, P = .488).

Conclusion:

In this series of patients, the mixed TAPVC could be corrected only with preoperative two-dimensional Doppler echocardiography with good immediate results, and we believe that the use of computed angiotomography combined with three-dimensional reconstruction may improve the surgical outcome mainly in the mixed and infracardiac group of TAPVC.
Surgical Cardiac Denervation Therapy for Treatment of Congenital Ion Channelopathies in Pediatric Patients
Authors: Costello John P. , Wilson Jennifer K. , Louis Clauden , Peer Syed M. , Zurakowski David , Nadler Evan P. , Qureshi Faisal G. , Jonas Richard A. , Greene E. Anne , Berul Charles I. , Moak Jeffrey P. , Nath Dilip S.
Published: December 2014

Background:

Congenital ion channel disorders, including congenital long QT syndrome (LQTS), cause significant morbidity in pediatric patients. When medication therapy does not control symptoms or arrhythmias, more invasive treatment strategies may be necessary. This study examines our institution’s clinical experience with surgical cardiac denervation therapy for management of these arrhythmogenic disorders in children.

Methods:

An institutional review board–approved retrospective review identified ten pediatric patients with congenital ion channelopathies who underwent surgical cardiac denervation therapy at a single institution between May 2011 and April 2014. Eight patients had a diagnosis of congenital LQTS, two patients were diagnosed with catecholaminergic polymorphic ventricular tachycardia (CPVT). All patients underwent sympathectomy and partial stellate ganglionectomy via video-assisted thoracoscopic surgery (VATS).

Results:

Six of the ten patients had documented ventricular arrhythmias preoperatively, and 70% of the patients had preoperative syncope. The corrected QT interval decreased in 75% of patients with LQTS following sympathectomy. Postoperative arrhythmogenic symptoms were absent in 88% of congenital LQTS patients, but both patients with CPVT continued to have symptoms throughout the duration of follow-up. All patients were alive after a median follow-up period of 10 months.

Conclusions:

Surgical cardiac denervation therapy via VATS is a useful treatment strategy for congenital LQTS patients who fail medical management, and its potential benefit in the management of CPVT is unclear. A prospective comparison of the efficacy of surgical cardiac denervation therapy and implantable cardioverter-defibrillator use in congenital ion channelopathies is timely and crucial.
Recurrent Neoaortic Insufficiency After the Switch Back Operation With Previous Repair of Transposition With Ventricular Septal Defect and Aortic Arch Hypoplasia
Authors: Brister Kelly A. , Shores Jennifer C. , Salazar Jorge D. , DiBardino Daniel J. , Wyatt-Ashmead Josephine , Dodge-Khatami Ali
Published: December 2014

Neoaortic insufficiency is not uncommon after the arterial switch operation (ASO) for d-Transposition, yet surgery is rarely required. In a patient with worsening neoaortic regurgitation post-arterial switch and ventricular septal defect (VSD) closure, we performed a successful “switch back” operation with documented aortic valve competence on discharge echocardiography. However, recurrent severe aortic insufficiency required valve replacement, and histopathology of the excised valve indicated abnormal leaflet/vascular wall structure. We question whether the switch back operation is a viable option for neoaortic insufficiency after an ASO in patients with previous d-Transposition and VSD, when the native pulmonary valve may have structural deficiencies.
Adult Congenital Heart Disease Registry at Cairo University
Authors: Farouk Heba , Shaker Amir , El-Faramawy Amr , Mahrous Ahmed , Baghdady Yasser , Adel Ahmed , Soliman Haytham , Abdel-Meguid Mohamed , Elasry Abd-Allah , Sorour Khalid
Published: December 2014

Aims:

To establish a clinical registry for adult patients with congenital heart disease (CHD) managed in Cairo University Hospitals, aiming at description of the pattern and clinical profile of such patients.

Methods:

Patients were recruited from both Cardiovascular Medicine Department Outpatient Clinic and inpatient wards of Cairo University Hospitals. Clinical data were collected from hospital records and directly from patients by treating cardiologists. Collected data were then registered in a dedicated database system and subsequently analyzed.

Results:

Patients (49% males) ranged in age from 16 to 63 years, with a median of 25 years. Fifty-one patients were in the age-group from 20 to 30 years, with only 9% aged 50 years or older. Seventy-eight patients had acyanotic lesions, with atrial septal defect being the most common primary diagnosis (20% of total lesions). The remaining 22 patients had cyanotic heart disease, with tetralogy of Fallot being the predominant diagnosis (45% of cyanotic lesions). Six patients presented with infective endocarditis in the setting of CHD. Four women (8% of females) presented during pregnancy. Forty-six patients were sent for surgical correction/repair, while percutaneous intervention was planned in 20 patients.

Conclusions:

A new registry of adult patients with CHD managed in Cairo University Hospitals provides useful information, including the extent to which congenital heart defects are underdiagnosed and undertreated during infancy and childhood. In addition, those who were previously treated early in life require long-term follow-up in specialized centers. Establishment of a multidisciplinary team with expert physicians (cardiologists, dentists, obstetricians, and psychiatrists), cardiac surgeons, and nurses may be facilitated by development of a dedicated database system. Continuous financial support is a major challenge.
Hybrid Palliation for a Neonate With Functional Single Ventricle and Restrictive Atrial Septal Defect
Authors: Sasaki Takashi , Asou Toshihide , Takeda Yuko , Tominaga Takashi , Onakatomi Yasuko , Ueda Hideaki , Kawataki Motoyoshi
Published: December 2014

We present the case of a neonate who was successfully treated with emergency hybrid palliation soon after birth, including a stent insertion into a severely thickened atrial septum and bilateral pulmonary artery banding. The patient was prenatally diagnosed with severe pulmonary venous hypertension owing to mitral atresia and intact atrial septum associated with functional single ventricle and coarctation of the aorta.
Current Outcomes of the Norwood Operation in Patients With Single-Ventricle Malformations Other Than Hypoplastic Left Heart Syndrome
Authors: Alsoufi Bahaaldin , Slesnick Timothy , McCracken Courtney , Ehrlich Alexandra , Kanter Kirk , Schlosser Brian , Maher Kevin , Sachdeva Ritu , Kogon Brian
Published: December 2014

Background:

Subsequent to increased experience with the Norwood operation in children with hypoplastic left heart syndrome (HLHS), its application has expanded to allow palliation of single-ventricle (SV) malformations other than HLHS. We describe current palliation outcomes in this group of SV patients.

Methods:

Between 2002 and 2012, 65 of the 303 Norwood operations were performed in non-HLHS SV patients. Competing risk analysis modeled events after Norwood and after subsequent Glenn and examined risk factors affecting outcomes.

Results:

Competing risk analysis showed that one year following Norwood, 24% of patients had died or received transplantation, 72% had undergone Glenn, and 4% were alive awaiting Glenn/Kawashima. Five years following Glenn, 9% of patients had died, 68% had undergone Fontan, and 23% were alive awaiting Fontan. Overall seven-year survival following Norwood was 68%. On multivariable analysis, mortality risk factors were unplanned cardiac reoperation (hazard ratio [HR]: 4.0 [1.5-10.6], P = .006), right dominant ventricle morphology (HR: 3.3 [1.3-8.3], P = .012), and postoperative extracorporeal membrane oxygenation (HR: 3.1 [1.1-9.0], P = .035).

Conclusions:

Operative death and interstage mortality continue to be problematic following Norwood palliation for non-HLHS SV variants. Outcomes seem comparable to those reported for HLHS, however they are influenced by underlying pathology; children with dominant left ventricle morphology (tricuspid atresia and double inlet left ventricle) have superior survival compared to those with dominant right ventricle morphology (mitral atresia, unbalanced atrioventricular septal defect, and most patients with atrial isomerism). Unplanned reoperations for technical imperfections diminish survival. Large multicenter studies might be warranted to better identify high-risk patients and provide guidance toward improving their survival.
Closure of Tubular Patent Ductus Arteriosus With the Amplatzer Vascular Plug IV
Authors: Baruteau Alban-Elouen , Lambert Virginie , Riou Jean-Yves , Angel Claude-Yves , Belli Emre , Petit Jérôme
Published: December 2014

Background:

Closure of tubular patent ductus arteriosus remains a challenging procedure. Anecdotal use of Amplatzer Vascular Plug IV for tubular ductus closure has been reported but feasibility and safety in a consecutive patients’ series remain unknown.

Methods:

We performed a monocenter prospective study at the Marie Lannelongue Hospital in Paris, France. From 2009 to 2014, a total of 47 patients (39 infants, 3 children, and 5 adults) underwent ductus closure with the Plug IV.

Results:

Ductus morphology was a type E in 34 (72.3%) patients and a type C in 13 (27.7%) patients. Ductus closure occurred in 39 (83.0%) infants at a median age of seven months (range: 3-23 months) and a median weight of 6.9 kg (range: 4.1-17.0 kg). A past history of prematurity and very low birth weight was found in 33 (70.2%) of them. Twelve (25.5%) patients had pulmonary hypertension. Mean Plug IV diameter was 1.9 ± 0.1 mm larger than the mean maximal ductus diameter. Early complete closure of the ductus was obtained in all patients. Early migration of an undersized Plug IV occurred in one (2.1%) patient and was suitable for percutaneous device retrieval. After a mean follow-up of 3.4 ± 1.4 years, all patients are alive and asymptomatic, no late complication occurred.

Conclusion:

Transcatheter closure of tubular ductus with the Amplatzer Vascular Plug IV can be safe and effective, with a 100% early occlusion rate. This device, suitable for a 4F sheath, is a new alternative for tubular ductus closure in low-body-weight infants.
Late Outcomes of Infants Supported by Extracorporeal Membrane Oxygenation Following the Norwood Operation
Authors: Alsoufi Bahaaldin , Wolf Michael , Botha Phil , Kogon Brian , McCracken Courtney , Ehrlich Alexandra , Kanter Kirk , Deshpande Shriprasad
Published: December 2014

Background:

Hospital survival for infants who require extracorporeal membrane oxygenation (ECMO) following the Norwood operation is 30% to 60%. However, little is known about late outcomes of hospital survivors and their ability to progress through subsequent palliative stages.

Methods:

Between 2002 and 2012, 38 (13.4%) of the 284 neonates with hypoplastic left heart syndrome or other single ventricle variants received ECMO support following Norwood. We examined factors affecting hospital death and compared postdischarge events between hospital survivors who received postoperative ECMO (n = 16 of 38) and a control of hospital survivors who did not receive ECMO (220 of 246).

Results:

Unplanned cardiac reoperation was the only predictor of postoperative ECMO requirement. Overall, 22 (58%) of the 38 patients were weaned from ECMO support and 16 (42%) of the 38 survived to hospital discharge. The ECMO duration was a significant factor for hospital mortality (odds ratio = 1.52 per 1-day increase [1.03-2.24], P = .035). Following discharge, 15 (94%) of the 16 underwent Glenn and 1 (6%) of the 16 had interstage mortality. In the control group, 194 (88%) of the 220 underwent Glenn and 26 (12%) of the 220 had interstage mortality or received transplantation ( P = .499). Following Glenn, 3 (20%) of the 15 patients had interstage mortality or received transplantation and 12 (80%) of the 15 proceeded to Fontan or were alive awaiting Fontan. In the control group, 23 (12%) of the 194 had interstage mortality or received transplantation and 171 (88%) proceeded to Fontan or were alive awaiting Fontan ( P = .357). Overall, 81% of hospital survivors were alive 5 years following discharge in both ECMO and non-ECMO groups.

Conclusions:

ECMO support following Norwood is associated with high probability of hospital death. Nonetheless, interstage mortality, progression to subsequent palliative stages, intermediate survival, and freedom from heart transplantation are comparable to those in patients who did not require postoperative ECMO support.
External Counterpulsation of a Systemic-to-Pulmonary Artery Shunt Increases Coronary Blood Flow in Neonatal Piglets
Authors: DeCampli William M. , Secasanu Virgil , Argueta-Morales I. Ricardo , Cox Kelly , Ionan Constantine , Kassab Alain J.
Published: December 2014

Background:

Systemic-to-pulmonary artery shunt (SPS) palliation reduces coronary blood flow (CBF), which may precipitate myocardial ischemia postoperatively.

Hypothesis:

Counterpulsation (CP) of SPS augments CBF.

Methods:

Seven neonatal piglets (4.3 ± 0.23 kg) underwent sternotomy and ductus ligation. With a 5-mm polytetrafluoroethylene graft, SPS was created from innominate to pulmonary artery. A rigid shell holding a 9.5-mm diameter balloon was placed around the graft for CP. Using electrocardiographic signal, CP was initiated to trigger balloon inflation/deflation during the diastolic/systolic intervals, respectively. Instantaneous proximal and distal pulmonary artery and mid-anterior descending coronary artery flow rates were measured using transit time flow probes. Blood pressure and flow rates were recorded during three states: shunt closed, shunt open, and shunt open with CP.

Statistical Comparison:

Friedman’s test and repeated measures analysis of variance.

Results:

Diastolic pressure decreased significantly with the shunt open (39 ± 8.4 to 28 ± 4.5 mm Hg, P = .05), then increased with CP (33 ± 2.3 mm Hg, P = .03). Median ratio of pulmonary to systemic flow (Qp/Qs) was 1.19, 1.9, and 1.53 with shunt closed, open, and open with CP, respectively. With CP, both diastolic coronary flow per minute ( P = .018) and average diastolic flow rate per diastolic interval ( P = .03) increased as well as total coronary flow per minute ( P = .066; 19.6% ± 11.7%, 25.2% ± 17.0%, and 15.4% ± 13.9% change from shunt open, respectively). The percentage increase in average diastolic flow rate per diastolic interval correlated strongly with Qp/Qs ( R2 = .838).

Conclusions:

In this model of SPS, CP increased diastolic blood pressure and CBF while maintaining significant augmentation of pulmonary blood flow (Qp/Qs). Shunt CP may aid in early postoperative management of palliative congenital heart disease.
Fluorescein Dye-Guided Intraoperative Identification and Closure of Muscular Ventricular Septal Defect
Authors: Bishnoi Arvind Kumar , Garg Pankaj , Desai Manan , Sharma Pranav , Patel Jigar , Prajapati Mrugesh , Malhotra Amber
Published: December 2014

Objective:

Various techniques for intraoperative identification of muscular ventricular septal defects (VSDs) are cumbersome, difficult to use in infants, and inefficient in confirming the completeness of closure. We used simple technique of intraoperative fluorescein saline injection into the left ventricle to locate the muscular VSDs and to confirm their closure.

Methods:

This is a prospective observational study conducted between April 2013 to December 2013, involving 22 patients with multiple VSDs either in isolated form or in association with other congenital cardiac anomalies. Following the closure of all visible VSDs, an 8F infant feeding tube was introduced into the left ventricle through the fossa ovalis and fluorescein saline was injected. Right ventricle was observed for saline leakage and VSD site tracking. Saline injection was repeated till appearance of no significant leak.

Results:

A total of 63 defects were closed in 22 patients. Only two patients required re-endocardialization or septal exclusion technique for Swiss cheese septum. None of them required division of moderator band or major trabeculae. Eleven patients had insignificant residual shunting found on postoperative echocardiography. There were two deaths. In the remaining 20 patients, the mean of intensive care unit (ICU) and hospital stay was 5.4 ± 3.72 and 10.2 ± 4.64 days, respectively. Comparative study between patients with and without residual VSD showed no significant difference in mean inotropic score, ICU, and hospital stay, confirming the absence of significant residual shunting.

Conclusions:

Intraoperative fluorescein saline injection into the left ventricle is safe, effective in precisely localizing muscular VSDs and confirming the completeness of their closure.
Characterisation of microstructure and mechanical properties in two different nanostructured bainitic steels
Authors: Avishan B. , Yazdani S. , Caballero F. G. , Wang T. S. , Garcia-Mateo C.
Published: December 2014

Recently, valuable combinations of mechanical properties with strength of 1.9 GPa accompanied by very decent ductility of 19 and toughness of 31 J, have been achieved in a set of nanostructured bainitic steels. However, it is necessary to elucidate the significance of various microstructural features responsible of that extraordinary mechanical response in more detail. Thus, using two steels, with different Mn, Ni and V contents, and changing the nanostructured bainite isothermal transformation temperatures (200–300°C), has led to a plethora of subtle and essential microstructural variations, necessary to explain how the mechanical response of nanostructured bainite is attained.
MicroRNA-34a functions as an anti-metastatic microRNA and suppresses angiogenesis in bladder cancer by directly targeting CD44
Authors: Yu Gan , Yao Weimin , Xiao Wei , Li Heng , Xu Hua , Lang Bin
Published: December 2014

Background

Metastasis have considered as an important clinical obstacle in the treatment of human cancer including bladder cancer. Post-transcriptional regulation has emerged as robust effectors of metastasis. MiRNAs are involved in cancer development and progression, acting as tumor suppressors or oncogenes. In this study, we focus on it that microRNA-34a functions as an anti-metastatic microRNA and suppress angiogenesis in bladder cancer by directly targeting CD44.

Methods

The expression of mir-34a was detected by quantitative real-time PCR. Oligonucleotide and lentivirus were used to overexpress miR-34a. Tube formation assay and transwell assay were used to examine the effect on bladder cancer tube formation, migration and invasion in vitro. Animal models were used to examine the effect on metastasis and angiogenesis in vivo. Luciferase assay was carried out to verify the precise target of miR-34a.

Results

We not only proved that mir-34a was significantly downregulated in bladder cancer tissues and cell lines but also that circulating miR-34a levels are reduced in bladder cancer, and their levels were positively relevance. Gain-of-function experiments investigated that increased mir-34a expression suppressed tube formation and reduced cell migration and invasion. In vivo metastasis, assays also demonstrated that overexpression of mir34a markedly inhibited bladder cancer metastasis. CD31, an endothelial cell–specific marker which stained in T24 tumors to evaluate for blood vessel density, the immunohistochemistry results showed that blood vessel quantification reduced dramatically in the T24 tumors over-expressing mir-34a. Combining with our previous studies and bioinformatics analysis, we expected that CD44 gene was a direct target of mir-34a, siRNA-mediated knockdown of CD44 partially phenocopied mir-34a overexpression suggesting that the pro-apoptotic role of mir-34a may be mediated primarily through CD44 regulation, whereas restoring the expression of CD44 attenuated the function of mir-34a in bladder cancer cells. Additionally, we identified that EMT (epithelial-mesenchymal transition) related proteins could be regulated by mir-34a which indicated that mir-34a could partially reserve EMT.

Conclusion

Our study defines a major metastasis and angiogenesis suppressive role for mir-34a, a microRNA functions as a tumor suppressor in bladder cancer by directly targeting CD44, which would be helpful as a therapeutic approach to block bladder cancer metastasis.
Standardized uptake value of 18F-fluorodeoxyglucose positron emission tomography for prediction of tumor recurrence in breast cancer beyond tumor burden
Authors: Ahn Sung Gwe , Park Jong Tae , Lee Hak Min , Lee Hak Woo , Jeon Tae Joo , Han Kyunghwa , Lee Seung Ah , Dong Seung Myung , Ryu Young Hoon , Son Eun Ju , Jeong Joon
Published: December 2014

Introduction

18F-fluorodeoxyglucose positron emission tomography (FDG-PET) can reveal the metabolic activity of malignant tumors. Recent advances gained from molecular studies suggest that tumor biology can be a good predictor of prognosis in breast cancer. We compared the ability of maximum standardized uptake values (SUVmax) derived by FDG-PET with tumor burden in predicting tumor recurrence for patients with breast cancer.

Methods

496 patients with breast cancer who underwent preoperative FDG-PET between April 2004 and May 2009 were retrospectively identified. SUVmax was obtained by FDG-PET, and the cutoff point was defined using a time-dependent receiver operating characteristic curve for recurrence-free survival (RFS). The primary endpoint was RFS.

Results

In multivariate analysis for RFS, SUVmax carried independent prognostic significance (hazard ratio, 2.39; 95% confidence interval, 1.20 to 4.76; P = 0.012). When the patients were classified into four groups according to the combined factors of tumor size (≤2 cm versus >2 cm) and SUVmax (<4 versus ≥4), RFS differed significantly (P < 0.001). Similarly, SUVmax had prognostic value in combination with nodal status (negative versus positive) or stage (I versus II and III) (P < 0.001 and P = 0.001, respectively). In hormone receptor–positive disease, SUVmax remained a significant prognostic factor for RFS based on multivariate analysis.

Conclusions

Our results highlight the prognostic value of FDG-PET in prediction of tumor relapse for patients with breast cancer. Particularly in patients with hormone receptor–positive disease, the tumor metabolic information provided by FDG-PET is more significantly correlated with prognosis than tumor burden.
Interleukin-17A promotes functional activation of systemic sclerosis patient-derived dermal vascular smooth muscle cells by extracellular-regulated protein kinases signalling pathway
Authors: Liu Mengguo , Yang Ji , Xing Xiaojing , Cui Xiangxiang , Li Ming
Published: December 2014

Introduction

Dermal vascular smooth muscle cells (DVSMCs) are important for vascular wall fibrosis in microangiopathy of systemic sclerosis (SSc). T helper 17 cell-associated cytokines, particularly interleukin-17A (IL-17A), have been demonstrated to play a role in the pathogenesis of SSc. However, the effect of IL-17A on the DVSMCs in microangiopathy of SSc has not been established. In the present study, we investigated the effect of IL-17A on the SSc patient-derived DVSMCs.

Methods

DVSMCs from patients with SSc and healthy subjects were incubated using IL-17A or serum derived from patients with SSc. Subsequently, the proliferation, collagen synthesis and secretion, and migration of DVSMCs were analysed using a cell counting kit-8 (CCK-8), dual-luciferase reporter assay, real-time reverse transcription-polymerase chain reaction (RT-PCR), Western blot, enzyme-linked immunosorbent assay (ELISA) and transwell assay. The protein phosphorylation of signalling pathways in the process of IL-17A-mediated DVSMC activation was investigated and validated by specific signalling pathway inhibitor.

Results

IL-17A and serum from patients with SSc could promote the proliferation, collagen synthesis and secretion, and migration of DVSMCs. IL-17A neutralising antibody could inhibit the IL-17A-induced activation of DVSMCs. Additionally, IL-17A induced the activation of extracellular-regulated protein kinases 1/2 (ERK1/2) in DVSMCs, and ERK1/2 inhibitor could block the IL-17A-elicited activation of DVSMCs.

Conclusions

Our results suggested that IL-17A derived from patients with SSc might induce the proliferation, collagen synthesis and secretion, and migration of DVSMCs via ERK1/2 signalling pathway, raising the likelihood that IL-17A and ERK1/2 might be promising therapeutic targets for the treatment of SSc-related vasculopathy.
Earned income tax credits, unemployment benefits and wages: empirical evidence from Sweden
Authors: Bennmarker Helge , Calmfors Lars , Seim Anna
Published: December 2014

Although there is a large literature on employment effects of earned income tax credits (EITCs) and unemployment benefits, less is known about wage effects. In our model, the impact is via the net (after-tax) replacement rate. Using a panel of individuals from Sweden, we find a positive relationship between the net replacement rate and wages with semi-elasticities in the range 0.2-0.4. This implies that a one per cent reduction in the unemployment benefit level or a one per cent increase in the net-of-tax rate is associated with a fall in the before-tax wage of 0.1-0.2 per cent. EITCs and unemployment benefit reductions are thus likely to induce wage moderation.

Keywords: Earned income tax credit, Unemployment benefits, Wage formation.
Analysing pedagogic discourse: an approach from genre and register
Authors: Rose David
Published: December 2014

This paper presents a novel analysis of pedagogic discourse using genre and register theory. Curriculum genres are analysed as configurations of pedagogic activities, relations, modalities, knowledge and values. Each of these register variables is realised as discourse semantic patterns, including exchange structures, learning cycles, multimodal sources of meanings, and experiential and interpersonal elements. Each of these discourse patterns can be presented side-by-side, in each unit in a pedagogic exchange, using tables or spreadsheets. The presentation enables the analyst to identify local and global patterns in pedagogic discourse of many kinds, particularly the intricate patterns of classroom exchanges. Analyses are illustrated for each register variable, followed by systems of options for their realisation in discourse. The paper concludes by illustrating a combined analysis of a stretch of classroom discourse.
Linking preferred orientations to elastic anisotropy in Muderong Shale, Australia
Authors: Kanitpanyacharoen Waruntorn , Vasin Roman , Wenk Hans-Rudolf , Dewhurst David. N.
Published: December 2014

The significance of shales for unconventional hydrocarbon reservoirs, nuclear waste repositories, and geologic carbon storage has opened new research frontiers in geophysics. Among many of its unique physical properties, elastic anisotropy had long been investigated by experimental and computational approaches. Here, we calculated elastic properties of Cretaceous Muderong Shale from Australia with a self-consistent averaging method based on microstructural information. The volume fraction and crystallographic preferred orientation distributions of constituent minerals were based on synchrotron x-ray diffraction experiments. Aspect ratios of minerals and pores, determined from scanning electron microscopy, were introduced in the self-consistent averaging. Our analysis suggested that phyllosilicates (i.e., illite-mica, illite-smectite, kaolinite, and chlorite) were dominant with [Formula: see text]. The shape of clay platelets displayed an average aspect ratio of 0.05. These platelets were aligned parallel to the bedding plane with a high degree of preferred orientation. The estimated porosity at ambient pressure was [Formula: see text] and was divided into equiaxial pores and flat pores with an average aspect ratio of 0.01. Our model gave results that compared satisfactorily with values derived from ultrasonic velocity measurements, confirming the validity and reliability of our approximations and averaging approach.
SEARCH: A Phase III, Randomized, Double-Blind, Placebo-Controlled Trial of Sorafenib Plus Erlotinib in Patients With Advanced Hepatocellular Carcinoma
Authors: Zhu Andrew X. , Rosmorduc Olivier , Evans T.R. Jeffry , Ross Paul J. , Santoro Armando , Carrilho Flair Jose , Bruix Jordi , Qin Shukui , Thuluvath Paul J. , Llovet Josep M. , Leberre Marie-Aude , Jensen Markus , Meinhardt Gerold , Kang Yoon-Koo
Published: December 2014

Purpose

To compare the clinical outcomes of sorafenib plus either erlotinib or placebo in patients with advanced hepatocellular carcinoma (HCC) in a multicenter, multinational, randomized, phase III trial.

Patients and Methods

Patients with advanced HCC and underlying Child-Pugh class A cirrhosis, who were naive to systemic treatment (N = 720), were randomly assigned to sorafenib plus either erlotinib (n = 362) or placebo (n = 358). The primary end point was overall survival (OS).

Results

Median OS was similar in the sorafenib plus erlotinib and sorafenib plus placebo groups (9.5 v 8.5 months, respectively; hazard ratio [HR], 0.929; P = .408), as was median time to progression (3.2 v 4.0 months, respectively; HR, 1.135; P = .18). In the sorafenib/erlotinib arm versus the sorafenib/placebo arm, the overall response rate trended higher (6.6% v 3.9%, respectively; P = .102), whereas the disease control rate was significantly lower (43.9% v 52.5%, respectively; P = .021). The median durations of treatment with sorafenib were 86 days in the sorafenib/erlotinib arm and 123 days in the sorafenib/placebo arm. In the sorafenib/erlotinib and sorafenib/placebo arms, the rates of treatment-emergent serious AEs (58.0% v 54.6%, respectively) and drug-related serious AEs (21.0% v 22.8%, respectively) were similar. AEs matched the known safety profiles of both agents, but rates of rash/desquamation, anorexia, and diarrhea were higher in the sorafenib/erlotinib arm, whereas rates of alopecia and hand-foot skin reaction were higher in the sorafenib/placebo arm. Withdrawal rates for AEs during cycles 1 to 3 were higher in the sorafenib/erlotinib arm.

Conclusion

Adding erlotinib to sorafenib did not improve survival in patients with advanced HCC.
Effects of Single-Agent and Combination Chemotherapy for Gestational Trophoblastic Tumors on Risks of Second Malignancy and Early Menopause
Authors: Savage Philip , Cooke Rosie , O'Nions Jenny , Krell Jon , Kwan Amy , Camarata Michelle , Dancy Gairin , Short Dee , Seckl Michael J. , Swerdlow Anthony
Published: December 2014

Purpose

To assess the risks of second malignancy and early menopause in a large cohort of patients with gestational trophoblastic tumor who were treated with chemotherapy.

Patients and Methods

A survey of patients treated at Charing Cross Hospital between 1958 and 2000 was performed in 2006 to assemble incidence data for subsequent malignancies and the age at menopause. Treatment records were reviewed for the regimens and durations, and the incidence of subsequent malignancies was compared with that in the national age-matched population.

Results

Data were obtained for 1,903 patients, with a mean follow-up of 16.9 years. Eighty-six patients developed a subsequent malignancy compared with an expected number of 79 (standardized incidence ratio [SIR], 1.1; 95% CI, 0.9 to 1.3). The overall risk was low for patients treated with single-agent methotrexate and folinic acid (MTX-FA; SIR, 0.7; 95% CI, 0.5 to 1.1) and also for patients treated with etoposide, methotrexate, and dactinomycin followed by cyclophosphamide and vincristine on alternating weeks (EMA-CO) with an SIR of 0.9 (95% CI, 0.4 to 2.2), but there were significantly increased risks of oral cancer, melanoma, meningioma, and leukemia. The cumulative risk of early menopause was low after MTX-FA but was substantial after EMA-CO, reaching 13% by age 40 years and 36% by age 45 years.

Conclusion

Subsequent cancer risks for patients cured of gestational trophoblastic tumors with modern chemotherapy appear similar to those of the normal population with no overall increased risk of malignancy after MTX-FA or EMA-CO. However, there was evidence of an increased risk of leukemia after EMA-CO and some evidence of other site-specific increased risks based on small patient numbers. All major treatments except MTX-FA increased the risk of early menopause.