bluuebunny/crossref_metadata_2025 huggingface dataset:
Tuning of gravity-dependent and gravity-independent vertical angular VOR gain changes by frequency of adaptation
Authors: Yakushin Sergei B.
Published: March 2012

The gain of the vertical angular vestibulo-ocular reflex (aVOR) was adaptively increased and decreased in a side-down head orientation for 4 h in two cynomolgus monkeys. Adaptation was performed at 0.25, 1, 2, or 4 Hz. The gravity-dependent and -independent gain changes were determined over a range of head orientations from left-side-down to right-side-down at frequencies from 0.25 to 10 Hz, before and after adaptation. Gain changes vs. frequency data were fit with a Gaussian to determine the frequency at which the peak gain change occurred, as well as the tuning width. The frequency at which the peak gravity-dependent gain change occurred was approximately equal to the frequency of adaptation, and the width increased monotonically with increases in the frequency of adaptation. The gravity-independent component was tuned to the adaptive frequency of 0.25 Hz but was uniformly distributed over all frequencies when the adaptation frequency was 1–4 Hz. The amplitude of the gravity-independent gain changes was larger after the aVOR gain decrease than after the gain increase across all tested frequencies. For the aVOR gain decrease, the phase lagged about 4° for frequencies below the adaptation frequency and led for frequencies above the adaptation frequency. For gain increases, the phase relationship as a function of frequency was inverted. This study demonstrates that the previously described dependence of aVOR gain adaptation on frequency is a property of the gravity-dependent component of the aVOR only. The gravity-independent component of the aVOR had a substantial tuning curve only at an adaptation frequency of 0.25 Hz.
Fabrication of an inexpensive, implantable cooling device for reversible brain deactivation in animals ranging from rodents to primates
Authors: Cooke Dylan F. , Goldring Adam B. , Yamayoshi Itsukyo , Tsourkas Phillippos , Recanzone Gregg H. , Tiriac Alex , Pan Tingrui , Simon Scott I. , Krubitzer Leah
Published: March 2012

We have developed a compact and lightweight microfluidic cooling device to reversibly deactivate one or more areas of the neocortex to examine its functional macrocircuitry as well as behavioral and cortical plasticity. The device, which we term the “cooling chip,” consists of thin silicone tubing (through which chilled ethanol is circulated) embedded in mechanically compliant polydimethylsiloxane (PDMS). PDMS is tailored to compact device dimensions (as small as 21 mm3) that precisely accommodate the geometry of the targeted cortical area. The biocompatible design makes it suitable for both acute preparations and chronic implantation for long-term behavioral studies. The cooling chip accommodates an in-cortex microthermocouple measuring local cortical temperature. A microelectrode may be used to record simultaneous neural responses at the same location. Cortex temperature is controlled by computer regulation of the coolant flow, which can achieve a localized cortical temperature drop from 37 to 20°C in less than 3 min and maintain target temperature to within ±0.3°C indefinitely. Here we describe cooling chip fabrication and performance in mediating cessation of neural signaling in acute preparations of rodents, ferrets, and primates.
Tracheostomal Myiasis: A Case Report and Review of the Literature
Authors: Prasanna Kumar S. , Ravikumar A. , Somu L. , Vijaya Prabhu P. , Mundakannan Subbaiya Periyasamy Subbaraj Rajavel
Published: March 2012

“Myiasis” is considered in Hindu mythology as “God's punishment for sinners.” It is known to infest live human or animal tissue. Literature abounds with reports of myiasis affecting the nasal cavity, ear, nonhealing ulcers, exophytic malignant growth, and cutaneous tissue. But report of myiasis of the tracheal stoma is rare. Only a few cases of tracheal myiasis have been reported in literature. We report a case of tracheostomal myiasis in an elderly male. The species which had infested the stoma was identified asChrysomya bezziana, an obligate parasite. This is to our knowledge the first case report of an obligate parasite (Chrysomya bezziana) infestation of the tracheostoma from India.
Modeling Impacts of Climate Change on Giant Panda Habitat
Authors: Songer Melissa , Delion Melanie , Biggs Alex , Huang Qiongyu
Published: March 2012

Giant pandas (Ailuropoda melanoleuca) are one of the most widely recognized endangered species globally. Habitat loss and fragmentation are the main threats, and climate change could significantly impact giant panda survival. We integrated giant panda habitat information with general climate models (GCMs) to predict future geographic distribution and fragmentation of giant panda habitat. Results support a major general prediction of climate change—a shift of habitats towards higher elevation and higher latitudes. Our models predict climate change could reduce giant panda habitat by nearly 60% over 70 years. New areas may become suitable outside the current geographic range but much of these areas is far from the current giant panda range and only 15% fall within the current protected area system. Long-term survival of giant pandas will require the creation of new protected areas that are likely to support suitable habitat even if the climate changes.
Global Stability of Two‐Group Epidemic Models with Distributed Delays and Random Perturbation
Authors: Fan Xiaoming , Wang Zhigang , Xu Xuelian
Published: March 2012

We discuss a two‐group SEIR epidemic model with distributed delays, incorporating random fluctuation around the endemic equilibrium. Our research shows that the endemic equilibrium of the model with distributed delays and random perturbation is stochastically asymptotically stable in the large. In addition, a sufficient stability condition is obtained by constructing suitable Lyapunov function.
Plakoglobin: Role in Tumorigenesis and Metastasis
Authors: Aktary Zackie , Pasdar Manijeh
Published: March 2012

Plakoglobin (γ-catenin) is a member of the Armadillo family of proteins and a homolog ofβ-catenin. As a component of both the adherens junctions and desmosomes, plakoglobin plays a pivotal role in the regulation of cell-cell adhesion. Furthermore, similar toβ-catenin, plakoglobin is capable of participating in cell signaling. However, unlikeβ-catenin that has well-documented oncogenic potential through its involvement in the Wnt signaling pathway, plakoglobin generally acts as a tumor/metastasis suppressor. The exact roles that plakoglobin plays during tumorigenesis and metastasis are not clear; however, recent evidence suggests that it may regulate gene expression, cell proliferation, apoptosis, invasion, and migration. In this paper, we describe plakoglobin, its discovery and characterization, its role in regulating cell-cell adhesion, and its signaling capabilities in regulation of tumorigenesis and metastasis.
Enabling Collaborative Musical Activities through Wireless Sensor Networks
Authors: Barro Santiago J. , Fernández-Caramés Tiago M. , Escudero Carlos J.
Published: March 2012

In professional audio production the setup of electronic musical devices is a time-consuming and error-prone process, as it involves manual operations like establishing local configurations and carrying cables for each device. Such is the case of MIDI (musical instrument digital interface), which is widely used in the context of musical applications. On the other hand, the capabilities of WSN (wireless sensor networks) allow developers to build up more complex applications, since nodes have the ability of autoidentifying, autoconfiguring, and establishing associations with other nodes, behaving in a smarter way than other networks. In this paper, we propose the use of an optimized WSN network for interconnecting MIDI devices. This network has been named collaborative musical wireless network (CMWN): it eases device configuration, enables musical collaboration, and allows artists to explore new ways of expression. The paper also presents the hardware and performance results of a prototype able to create CMWNs.
Nutrient Release from Disturbance of Infiltration System Soils during Construction
Authors: Treese Daniel P. , Clark Shirley E. , Baker Katherine H.
Published: March 2012

Subsurface infiltration and surface bioretention systems composed of engineered and/or native soils are preferred tools for stormwater management. However, the disturbance of native soils, especially during the process of adding amendments to improve infiltration rates and pollutant removal, may result in releases of nutrients in the early life of these systems. This project investigated the nutrient release from two soils, one disturbed and one undisturbed. The disturbed soil was collected intact, but had to be air-dried, and the columns repacked when soil shrinkage caused bypassing of water along the walls of the column. The undisturbed soil was collected and used intact, with no repacking. The disturbed soil showed elevated releases of nitrogen and phosphorus compared to the undisturbed soil for approximately 0.4 and 0.8 m of runoff loading, respectively. For the undisturbed soil, the nitrogen release was delayed, indicating that the soil disturbance accelerated the release of nitrogen into a very short time period. Leaving the soil undisturbed resulted in lower but still elevated effluent nitrogen concentrations over a longer period of time. For phosphorus, these results confirm prior research which demonstrated that the soil, if shown to be phosphorus-deficient during fertility testing, can remove phosphorus from runoff even when disturbed.
Methodological Triangulation Using Neural Networks for Business Research
Authors: Walczak Steven
Published: March 2012

Artificial neural network (ANN) modeling methods are becoming more widely used as both a research and application paradigm across a much wider variety of business, medical, engineering, and social science disciplines. The combination or triangulation of ANN methods with more traditional methods can facilitate the development of high-quality research models and also improve output performance for real world applications. Prior methodological triangulation that utilizes ANNs is reviewed and a new triangulation of ANNs with structural equation modeling and cluster analysis for predicting an individual's computer self-efficacy (CSE) is shown to empirically analyze the effect of methodological triangulation, at least for this specific information systems research case. A new construct, engagement, is identified as a necessary component of CSE models and the subsequent triangulated ANN models are able to achieve an 84% CSE group prediction accuracy.
Ta/Ti-and Nb/Ti-Mixed Oxides as Efficient Solar Photocatalysts: Preparation, Characterization, and Photocatalytic Activity
Authors: Znad Hussein , Ang Ming H. , Tade Moses O.
Published: March 2012

Ta/TiO2- and Nb/TiO2-mixed oxides photocatalysts were prepared by simple impregnation method at different TiO2 : Nb or Ta mass ratios of 1 : 0.1, 1 : 0.5, and 1 : 1, followed by calcination at 500∘C. The prepared powders have been characterized by XRD, XPS, UV-Vis spectra, and SEM. The photocatalytic activity was evaluated under natural solar light for decolorization and mineralization of azo dye Orange II solution. The results showed that Nb/TiO2- and Ta/TiO2-mixed oxides have higher activity than the untreated TiO2under natural solar light. The maximum activity was observed for Nb/TiO2sample (at mass ratio of 1 : 0.1), which is characterized by the smallest crystalline size (17.79 nm). Comparing with the untreated TiO2, the solar decolorization and mineralization rates improved by about 140% and 237%, respectively, and the band gap reduced to 2.80 eV. The results suggest that the crystal lattices of TiO2powder are locally distorted by incorporating Nb5+species into TiO2, forming a new band energy structure, which is responsible for the absorption in the visible region. Unlike Ta/TiO2, the Nb/TiO2-mixed oxides can prevent the grain size growth of the treated TiO2, which is important to achieve high solar photoactivity.
On Particle Swarm Optimization for MIMO Channel Estimation
Authors: Knievel Christopher , Hoeher Peter Adam
Published: March 2012

Evolutionary algorithms, in particular particle swarm optimization (PSO), have recently received much attention. PSO has successfully been applied to a wide range of technical optimization problems, including channel estimation. However, most publications in the area of digital communications ignore improvements developed by the PSO community. In this paper, an overview of the original PSO is given as well as improvements that are generally applicable. An extension of PSO termed cooperative PSO (CPSO) is applied for MIMO channel estimation, providing faster convergence and, thus, lower overall complexity. Instead of determining the average iterations needed empirically, a method to calculate the maximum number of iterations is developed, which enables the evaluation of the complexity for a wide range of parameters. Knowledge of the required number of iterations is essential for a practical receiver design. A detailed discussion about the complexity of the PSO algorithm and a comparison to a conventional minimum mean squared error (MMSE) estimator are given. Furthermore, Monte Carlo simulations are provided to illustrate the MSE performance compared to an MMSE estimator.
Series Solution for Steady Three‐Dimensional Flow due to Spraying on Inclined Spinning Disk by Homotopy Perturbation Method
Authors: Dinarvand Saeed
Published: March 2012

The steady three‐dimensional flow of condensation or spraying on inclined spinning disk is studied analytically. The governing nonlinear equations and their associated boundary conditions are transformed into the system of nonlinear ordinary differential equations. The series solution of the problem is obtained by utilizing the homotopy perturbation method (HPM). The velocity and temperature profiles are shown and the influence of Prandtl number on the heat transfer and Nusselt number is discussed in detail. The validity of our solutions is verified by the numerical results. Unlike free surface flows on an incline, this through flow is highly affected by the spray rate and the rotation of the disk.
Generalized Lower and Upper Approximations in Quantales
Authors: Xiao Qimei , Li Qingguo
Published: March 2012

We introduce the concepts of set‐valued homomorphism and strong set‐valued homomorphism of a quantale which are the extended notions of congruence and complete congruence, respectively. The properties of generalized lower and upper approximations, constructed by a set‐valued mapping, are discussed.
Role of UropathogenicEscherichia coliVirulence Factors in Development of Urinary Tract Infection and Kidney Damage
Authors: Bien Justyna , Sokolova Olga , Bozko Przemyslaw
Published: March 2012

UropathogenicEscherichia coli(UPEC) is a causative agent in the vast majority of urinary tract infections (UTIs), including cystitis and pyelonephritis, and infectious complications, which may result in acute renal failure in healthy individuals as well as in renal transplant patients. UPEC expresses a multitude of virulence factors to break the inertia of the mucosal barrier. In response to the breach by UPEC into the normally sterile urinary tract, host inflammatory responses are triggered leading to cytokine production, neutrophil influx, and the exfoliation of infected bladder epithelial cells. Several signaling pathways activated during UPEC infection, including the pathways known to activate the innate immune response, interact with calcium-dependent signaling pathways. Some UPEC isolates, however, might possess strategies to delay or suppress the activation of components of the innate host response in the urinary tract. Studies published in the recent past provide new information regarding how virulence factors of uropathogenicE. coliare involved in activation of the innate host response. Despite numerous host defense mechanisms, UPEC can persist within the urinary tract and may serve as a reservoir for recurrent infections and serious complications. Presentation of the molecular details of these events is essential for development of successful strategies for prevention of human UTIs and urological complications associated with UTIs.
Mutator-Like Elements with Multiple Long Terminal Inverted Repeats in Plants
Authors: Ferguson Ann A. , Jiang Ning
Published: March 2012

Mutator-like transposable elements (MULEs) are widespread in plants and the majority have long terminal inverted repeats (TIRs), which distinguish them from other DNA transposons. It is known that the long TIRs ofMutatorelements harbor transposase binding sites and promoters for transcription, indicating that the TIR sequence is critical for transposition and for expression of sequences between the TIRs. Here, we report the presence of MULEs with multiple TIRs mostly located in tandem. These elements are detected in the genomes of maize, tomato, rice, andArabidopsis. Some of these elements are present in multiple copies, suggesting their mobility. For those elements that have amplified, sequence conservation was observed for both of the tandem TIRs. For one MULE family carrying a gene fragment, the elements with tandem TIRs are more prevalent than their counterparts with a single TIR. The successful amplification of this particular MULE demonstrates that MULEs with tandem TIRs are functional in both transposition and duplication of gene sequences.
A Fuzzy Logic System for Seizure Onset Detection in Intracranial EEG
Authors: Rabbi Ahmed Fazle , Fazel-Rezai Reza
Published: March 2012

We present a multistage fuzzy rule-based algorithm for epileptic seizure onset detection. Amplitude, frequency, and entropy-based features were extracted from intracranial electroencephalogram (iEEG) recordings and considered as the inputs for a fuzzy system. These features extracted from multichannel iEEG signals were combined using fuzzy algorithms both in feature domain and in spatial domain. Fuzzy rules were derived based on experts' knowledge and reasoning. An adaptive fuzzy subsystem was used for combining characteristics features extracted from iEEG. For the spatial combination, three channels from epileptogenic zone and one from remote zone were considered into another fuzzy subsystem. Finally, a threshold procedure was applied to the fuzzy output derived from the final fuzzy subsystem. The method was evaluated on iEEG datasets selected from Freiburg Seizure Prediction EEG (FSPEEG) database. A total of 112.45 hours of intracranial EEG recordings was selected from 20 patients having 56 seizures was used for the system performance evaluation. The overall sensitivity of 95.8% with false detection rate of 0.26 per hour and average detection latency of 15.8 seconds was achieved.
Limiting Behavior of the Maximum of the Partial Sum for Linearly Negative Quadrant Dependent Random Variables under Residual Cesàro Alpha‐Integrability Assumption
Authors: Wang Jiangfeng , Wu Qunying
Published: March 2012

Linearly negative quadrant dependence is a special dependence structure. By relating such conditions
to residual Cesàro alpha‐integrability assumption, as well as to strongly residual Cesàro
alpha‐integrability assumption, some Lp‐convergence and complete convergence results of the maximum of the partial sum are derived, respectively.
A New Ruthenium Sensitizer Containing Benzo[1,9]quinolizino(acridin-2-yl)vinyl-2,2′-bipyridine Ligand for Effective Nanocrystalline Dye-Sensitized Solar Cells
Authors: Kim Jeum-Jong , Yoon Jeonghun , Kim Eun Jung , Kim Bo Ram , Yoon Yong-Jin , Kang Mangu
Published: March 2012

Novel ruthenium bipyridyl sensitizer incorporating conjugated benzo[1,9]quinolizino-(acridin-2-yl)vinyl-2,2′-bipyridine ligand [JJ-12] has been synthesized and demonstrated as efficient sensitizer in dye-sensitized solar cells. A mesoporous titania film stained withJJ-12exhibits a remarkable incident monochromatic photon-to-current conversion efficiency of 82%. Under standard AM 1.5 sunlight, the solar cell using a liquid-based electrolyte consisting of 0.6 M 1,2-dimethyl-3-propylimidazolium iodide (DMPII), 0.05 M I2, 0.1 M LiI, and 0.5 Mtert-butylpyridine in acetonitrile exhibits a short-circuit photocurrent density of 16.47 mA/cm2, an open-circuit voltage of 0.71 V, and a fill factor of 0.71, corresponding to an overall conversion efficiency of 8.34 %.
New Configurations of Low-Cost Dual-Polarized Printed Antennas for UWB Arrays
Authors: Valerio Guido , Mazzocchi Simona , Galli Alessandro , Ciattaglia Matteo , Zucca Marco
Published: March 2012

A novel class of structures is proposed to realize ultra-wide-band radiating elements for large arrays, providing dual polarization, beam scanning, and compact and inexpensive realization based on suitable rhombic arrangements of dipoles printed on low-cost layered substrates. In a first implementation, four rhombic shapes, orthogonally placed on the same layer, provide two orthogonal polarizations. In a second implementation, the two polarizations are excited by two rhombic shapes printed on two different layers in a stacked-patch-like arrangement. This latter structure leads to a better lateral shielding of the single radiating element, in order to reduce mutual interactions among adjacent elements in array environment. The behavioral features of these antennas have been tested with various parametric analyses. Practical aspects have been addressed such as the choice of appropriate feeding and of commercially available dielectric layers. The resulting antennas are matched at the input ports in an extremely wide range of frequencies (5–25 GHz), covering various microwave applications, such as aircraft surveillance, weather polarimetric radars, and control and communications systems. Good radiating features, in terms of pattern shape and gain, are observed in a large band of frequencies. The basic scanning performance of large and small array configurations is finally investigated.
Processor Energy Characterization for Compiler‐Assisted Software Energy Reduction
Authors: Gauthier Lovic , Ishihara Tohru
Published: March 2012

Energy consumption is a fundamental barrier in
taking full advantage of today and future semiconductor manufacturing
technologies. The paper presents our recent research
activities and results on characterizing and reducing the energy
consumption in embedded systems. Firstly, a technique for
characterizing the energy consumption of embedded processors
during an application execution is presented. The technique
trains a per‐processor linear approximation model for fitting
it to the energy consumption of the processor obtained by
postlayout simulation. Secondly, based on the energy model
mentioned above, the paper shows techniques for reducing the
energy consumption by optimally mapping program code, stack
frames, and data items to the scratch‐pad memory (SPM) of the
processor memory space.
Carleson Measure Theorems for Large Hardy-Orlicz and Bergman-Orlicz Spaces
Authors: Charpentier Stéphane , Sehba Benoît
Published: March 2012

We characterize those measuresμfor which the Hardy-Orlicz (resp., weighted Bergman-Orlicz) spaceHΨ1(resp.,AαΨ1) of the unit ball ofCNembeds boundedly or compactly into the Orlicz spaceLΨ2(BN¯,μ)(resp.,LΨ2(BN,μ)), when the defining functionsΨ1andΨ2are growth functions such thatL1⊂LΨjforj∈{1,2}, and such thatΨ2/Ψ1is nondecreasing. We apply our result to the characterization of the boundedness and compactness of composition operators fromHΨ1(resp.,AαΨ1) intoHΨ2(resp.,AαΨ2).
Modeling of Magnetoelectric Interaction in Magnetostrictive-Piezoelectric Composites
Authors: Bichurin M. I. , Petrov V. M.
Published: March 2012

The paper dwells on the theoretical modeling of magnetoelectric (ME) effect in layered and bulk composites based on magnetostrictive and piezoelectric materials. Our analysis rests on the simultaneous solution of elastodynamic or elastostatic and electro/magnetostatic equations. The expressions for ME coefficients as the functions of material parameters and volume fractions of components are obtained. Longitudinal, transverse, and in-plane cases are considered. The use of the offered model has allowed to present the ME effect in ferrite cobalt-barium titanate, ferrite cobalt-PZT, ferrite nickel-PZT, and lanthanum strontium manganite-PZT composites adequately.
Chloride Balance in Preterm Infants during the First Week of Life
Authors: Iacobelli Silvia , Kermorvant-Duchemin Elsa , Bonsante Francesco , Lapillonne Alexandre , Gouyon Jean-Bernard
Published: March 2012

Objective. To describe the chloride balance in infants born 25–32-week gestation, analyze the association of chloride changes with hydroelectrolytic status and their relationship with perinatal conditions, morbidities, and neurological outcome.Methods. For 7 days after birth, sodium and chloride balance, plasma potassium, phosphate, and total carbon dioxide (tCO2) were prospectively determined and strong ion difference (SID) calculated. Three multivariate regression analyses were performed to identify factors associated with high plasma chloride concentration, low SID, and low tCO2.Results. 107 infants were studied. Plasma chloride concentration was significantly positively associated with plasma sodium concentration. Higher plasma chloride and lower SID were significantly associated with lower plasma tCO2. Chloride intake was the main independent factor associated with high plasma chloride, low SID, and low plasma tCO2, with lesser contribution of sodium intake and low gestational age (GA). Also, patent ductus arteriosus and birth weight loss were independent factors affecting plasma chloride and SID. Neither high chloride levels nor low SID were associated to impaired neurological outcome.Conclusions. In preterm infants, chloride balance is influenced by GA and by interrelationship between sodium and chloride intake. High chloride levels are associated with metabolic acidosis but not related to increased risk of impaired neurological outcome.
Actin Dynamics Associated with Focal Adhesions
Authors: Ciobanasu Corina , Faivre Bruno , Le Clainche Christophe
Published: March 2012

Cell-matrix adhesion plays a major role during cell migration. Proteins from adhesion structures connect the extracellular matrix to the actin cytoskeleton, allowing the growing actin network to push the plasma membrane and the contractile cables (stress fibers) to pull the cell body. Force transmission to the extracellular matrix depends on several parameters including the regulation of actin dynamics in adhesion structures, the contractility of stress fibers, and the mechanosensitive response of adhesion structures. Here we highlight recent findings on the molecular mechanisms by which actin assembly is regulated in adhesion structures and the molecular basis of the mechanosensitivity of focal adhesions.
Translation Initiation Factor eIF4E Is a Target for Tumor Cell Radiosensitization
Authors: Hayman Thomas J. , Williams Eli S. , Jamal Muhammad , Shankavaram Uma T. , Camphausen Kevin , Tofilon Philip J.
Published: March 2012

A core component in the cellular response to radiation occurs at the level of translational control of gene expression. Because a critical element in translation control is the availability of the initiation factor eIF4E, which selectively enhances the cap-dependent translation of mRNAs, we investigated a regulatory role for eIF4E in cellular radiosensitivity. eIF4E silencing enhanced the radiosensitivity of tumor cell lines but not normal cells. Similarly, pharmacologic inhibition of eIF4E with ribavirin also enhanced tumor cell radiosensitivity. eIF4E attenuation did not affect cell-cycle phase distribution or radiation-induced apoptosis, but it delayed the dispersion of radiation-induced γH2AX foci and increased the frequency of radiation-induced mitotic catastrophe. Radiation did not affect 4E-BP1 phosphorylation or cap-complex formation but it increased eIF4E binding to more than 1,000 unique transcripts including many implicated in DNA replication, recombination, and repair. Taken together, our findings suggest that eIF4E represents a logical therapeutic target to increase tumor cell radiosensitivity. Cancer Res; 72(9); 2362–72. ©2012 AACR.
Outcome of Repeat Supratrigonal Obstetric Vesicovaginal Fistula Repair after Previous Failed Repair
Authors: Gupta N.P. , Mishra Saurabh , Mishra Archana , Seth Amlesh , Anand Ajay
Published: March 2012

Introduction: Currently, surgical repair for vesicovaginal fistula (VVF) provides excellent results, but the recurrent VVF is difficult to treat as compared to primary. Patients and Methods: Sixty-eight patients (44 primipara and 24 multipara) with recurrent VVF repair from January 2002 to December 2007 were included in present study. The mean size of fistula was 2.8 cm (1.0–6.5). The previous surgical repair was through the abdominal route in 50 patients (73.53%) and through the vaginal route in the remaining 18 patients (26.47%). Results: The procedure was successful in 62 of 68 patients (91.17%). The mean duration of surgery was 146.6 min (100–210). Mean blood loss was 160 ml (110–400) and mean hospital stay was 5.6 days (4–10). Eight patients developed complications. Conclusion: Recurrent VVF is difficult to treat, but excellent results can still be achieved by strictly sticking to the principals of surgical repair for VVF.
Nephrostomy Tube-Free versus Nephrostomy Tube for Renal Drainage after Percutaneous Nephrolithotomy: A Systematic Review and Meta-Analysis
Authors: Shen Pengfei , Liu Yong , Wang Jia
Published: March 2012

Background: Historically, percutaneous nephrostomy drainage following percutaneous nephrolithotomy (PNL) has been considered the standard of care. More recently, however, an increasing number of centers are performing tubeless (with insertion of JJ ureteric stent) or totally tubeless (with no internal or external drainage) PNL with impressive outcome data. Objective: This systematic review is to compare the clinical therapeutic efficacy and safety of nephrostomy tube-free (NT-free) and standard PNL. Materials and Methods: We searched PubMed (1966 to April 2011), Embase (1966 to April 2011), and the Cochrane Library without language restriction. All randomized controlled trials that compared NT-free PNL (using a double-J stent) with standard PNL were enrolled in this review. The Cochrane Collaboration’s RevMan5.0.2 software was used for statistical analysis. Results: Nine studies involving 547 patients were included. Patients were divided into 4 groups: NT-free group, small tube group (8–9 Fr), middle tube group (16–18 Fr), and large tube group (20–24 Fr). Meta-analysis showed that: (1) with regard to hospital stay (h) and visual analog scale scores for postoperative pain on day 1, there was no significant difference between the NT-free group and the small tube group, but there were differences between the NT-free group versus the middle and large tube groups; (2) for puncture site urinary leakage, no significant difference was found between the NT-free group and the small and middle tube groups; (3) no significant difference was found with regard to transfusion, fever or infection, operative time between the NT-free group and the 3 tube groups. Conclusions: The clinical efficacy and safety of NT-free and small tube are similar in all measurements. Compared with the middle and large tubes, NT-free PNL could reduce hospital stay and postoperative analgesia requirement without increasing other complications.
Oral Ibuprofen versus Intravenous Ibuprofen or Intravenous Indomethacin for the Treatment of Patent Ductus Arteriosus in Preterm Infants: A Systematic Review and Meta-Analysis
Authors: Neumann Roland , Schulzke Sven M. , Bührer Christoph
Published: March 2012

Background: Pharmacological closure of patent ductus arteriosus (PDA) is commonly achieved by intravenous (IV) administration of ibuprofen or indomethacin. Occasionally, oral ibuprofen is used for PDA treatment although its efficacy and safety are unclear. Objectives: To systematically review randomized and quasi-randomized trials comparing oral ibuprofen with IV ibuprofen or IV indomethacin for closure of PDA in preterm infants. Methods: The standard search methods of the Cochrane Neonatal Review Group were used. Results: We identified two studies (n = 166) of good methodological quality comparing oral ibuprofen with IV ibuprofen and three small trials (n = 92) of moderate methodological quality comparing oral ibuprofen to IV indomethacin. Meta-analysis showed higher PDA closure rate of oral ibuprofen versus IV ibuprofen but no difference between oral ibuprofen and IV indomethacin. Meta-analysis did not indicate a significant difference in adverse effects. Conclusion: Oral ibuprofen for PDA closure appears to be as effective as IV ibuprofen and IV indomethacin. Due to small sample size, lack of data in extremely preterm neonates, and methodological limitations of reviewed trials, definitive conclusions cannot be drawn. Randomized trials with a low risk of bias and adequate sample size in extremely preterm infants are urgently needed.
Knowledge of Risk Factors and Stroke Symptoms among Nonstroke Patients
Authors: Wiszniewska Małgorzata , Głuszkiewicz Marcin , Kobayashi Adam , Włodek Agata , Jezierska-Ostapczuk Agnieszka , Fryze Waldemar , Członkowska Anna
Published: March 2012

Background and Purpose: This study aimed to evaluate knowledge of stroke warning signs, risk factors, treatment and prevention among patients not suffering from stroke. Methods: Patients admitted to one of five Neurology Departments in Poland for diseases other than stroke were asked to answer a questionnaire regarding awareness of cerebrovascular risk factors and stroke. The study was performed between November 1 and December 31,2008. Results: 481 patients were included in the study (59.7% women). Proper definition of stroke and transient ischemic attack was given by 90.3 and 60.5% of respondents, respectively. Hypertension was reported as a risk factor by 91.1% of participants. Approximately 70% knew that hypercholesterolemia and smoking are risk factors of stroke, but only one third identified diabetes mellitus as a risk factor. Cardiac arrhythmia was recognized as a risk factor by 8.4%. Twenty-five percent of participants did not know any symptom of stroke. Identification of stroke signs was worse by participants from rural areas. Ten percent identified disturbances of consciousness, numbness, and dizziness as stroke symptoms. Conclusions: The knowledge of fundamental risk factors was sufficiently good, but recognition of cardiac arrhythmia and diabetes mellitus was unsatisfactory. The knowledge of stroke symptoms was unsatisfactory, particularly in rural areas. Additional education programs are necessary.
Medial Lemniscus Lesion in Pediatric Hemiplegic Patients without Corticospinal Tract and Posterior Thalamic Radiation Lesion
Authors: Jung Yong Jae , Jang Sung Ho , Yeo Sang Seok , Lee Eunsil , Kim Saeyoon , Lee Dong Gyu , Kim Han Sun , Son Su Min
Published: March 2012

Objectives: Using diffusion tensor imaging (DTI), we investigated the state of medial lemniscus (ML), corticospinal tract (CST), and posterior thalamic radiation (PTR), which were expected as probable reasons for clinical hemiplegia in pediatric patients, especially those who showed impaired fine motor control and proprioception, but no definite motor weakness or spasticity. Methods: We recruited 13 hemiplegic patients and 8 age-matched healthy control subjects. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) for the bilateral ML, CST, and PTR were calculated and compared between the affected hemisphere of the patient (AP), the unaffected hemisphere of the patient (UP), and the mean value of the bilateral hemispheres in control subjects (MC). Results: FA and ADC values for the CST and PTR did not differ significantly between the AP, UP, and MC subgroups (p > 0.05). However, the FA value for the ML in AP showed a significant decrease, compared with that in UP (p = 0.012) and MC (p = 0.047). DTT for the CST and PTR showed preserved integrity and ML in the UP also had continuity to the cortex; however, ML in AP showed disruption. Conclusions: Using DTI, we demonstrated that the ML lesion might be related to clinical hemiplegia in pediatric patients.
Equivalent Effects on Fecal Reactive Oxygen Species Generation with Oral Supplementation of Three Iron Compounds: Ferrous Sulfate, Sodium Iron EDTA and Iron Polymaltose
Authors: Orozco Monica N. , Arriaga Claudia , Solomons Noel W. , Schümann Klaus
Published: March 2012

Background: In any context of iron supplementation in the prenatal prophylaxis or therapeutic dosage range, a large amount will remain unabsorbed and pass through the intestinal tract into the colonic digesta possibly causing increased oxidation. Aim: To compare the generation of fecal reactive oxygen species (ROS) in situ after daily consumption of 100 mg of elemental iron in three frequently used forms of iron supplements. Methods: Ten healthy, iron-repleted adult males were investigated before and during supplementation with three oral iron compounds: 100 mg of oral iron were given as ferrous sulfate, Na Fe-EDTA and iron polymaltose for 6 days to each subject in an individually stratified sequence. Stool samples were collected and analyzed for iron content and the in situ generation of fecal ROS. Results: Significant increases in fecal ROS generation were observed during oral iron supplementation. No statistical differences were seen in either residual concentrations of non-heme iron in stool or the level of fecal ROS generation between the three Fe compounds. There was, however, a significant association between the iron concentration in the stool and ROS generation. Conclusion: In spite of the differences in their chemical characteristics, none of the three distinct iron complexes reduced oxidative stress in the intestinal lumen.
Multiple Basal Cell Carcinomas in a 38-Year-Old Woman with Goltz Syndrome
Authors: Patrizi Annalisa , Tabanelli Michela , Grzeschik Karl-Heinz , Misciali Cosimo , Neri Iria , Happle Rudolf
Published: March 2012

Background: Focal dermal hypoplasia (FDH) or Goltz syndrome is a rare genetic multisystem disorder characterized by hypoplasia of ectodermally and mesodermally derived tissues. No cases of development of basal cell carcinomas in patients affected by FDH have previously been reported. Methods: We followed a 38-year-old woman with FDH who developed, within a period of 3 years, 14 atypical pigmented lesions. All of them were surgically removed and pathologically assessed. In 2007, this patient underwent molecular examination with the multiple amplifiable probe hybridization technique. Results: Histopathological examination showed 6 basal cell carcinomas, 2 basaloid proliferations, 2 tumours of follicular infundibulum and 2 solar lentigines. Molecular examination showed that only 1 copy of the coding exons of PORCN and EBP, respectively, was present, reflecting a microdeletion of one of her X chromosomes, eliminating at least the neighbouring genes PORCN and EBP. Conclusions: No other cases of association between FDH and multiple cutaneous basal cell carcinomas have previously been reported, so it could be interesting to take into consideration this aspect in the molecular assessment of these patients to improve information on the disease. This is a single case experience, and especially the molecular results need confirmation and validation by other groups involved in the diagnosis.
Endogenous Opioid and Cannabinoid Mechanisms Are Involved in the Analgesic Effects of Celecoxib in the Central Nervous System
Authors: Rezende R.M. , Paiva-Lima P. , Dos Reis W.G.P. , Camêlo V.M. , Faraco A. , Bakhle Y.S. , Francischi J.N.
Published: March 2012

Background/Aims: In this study we analyzed the mechanisms underlying celecoxib-induced analgesia in a model of inflammatory pain in rats, using the intracerebroventricular (i.c.v.) administration of selective opioid and cannabinoid antagonists. Methods and Results: Analgesic effects of celecoxib were prevented by selective µ-(β-funaltrexamine) and δ-(naltrindole), but not ĸ-(nor-binaltorphimine) opioid antagonists, given i.c.v. 30 min before celecoxib. Similar pretreatment with AM 251, but not SR 144528, cannabinoid CB1 and CB2 receptor antagonists, respectively, prevented celecoxib-induced analgesia. The fatty acid amide hydrolase inhibitor, URB 597, also prevented celecoxib-induced analgesia. Conclusions: Our data provided further evidence for the involvement of endogenous opioids and revealed a new cannabinoid component of the mechanism(s) underlying celecoxib-induced analgesia.
Clock Test Deficits Related to the Global Cognitive State in Alzheimer’s and Parkinson’s Disease
Authors: Saur Ralf , Maier Claudia , Milian Monika , Riedel Ellen , Berg Daniela , Liepelt-Scarfone Inga , Leyhe Thomas
Published: March 2012

Background/Aims: Clock drawing (CD) seems to be impaired quite early in the process of cognitive decline in Parkinson’s disease (PD). Methods: We assessed performance on the CD test (CDT), clock setting test (CST) and clock reading test (CRT) in 32 elderly healthy controls, 41 patients with PD, 23 patients with amnestic mild cognitive impairment (aMCI) and 40 patients with Alzheimer’s dementia (AD). Our focus was on comparing the performance of PD and aMCI/AD patients in relation to their global cognitive states (operationalized by the Mini Mental Status Examination). We also analyzed qualitative differences in errors of drawing, setting and reading clocks. Results: We found that performance in CDT, but not in the CST or CRT, was impaired earlier in PD than in aMCI/AD. Incorrect placement of the minute hand was the most prominent error in both patient groups. We found no specific influence of visuospatial dysfunction in PD on clock drawing. Conclusion: Our findings suggest that executive function related to retrieval of semantic memory about the minute hand is compromised early in PD.
A randomised assessment of the pharmacokinetic, pharmacodynamic and safety interaction between apixaban and enoxaparin in healthy subjects
Authors: Wang Jessie , Song Yan , Pursley Janice , Wastall Philip , Wright Robert , LaCreta Frank , Frost Charles , Barrett Yu
Published: March 2012

Following major orthopaedic surgery, guidelines usually recommend continued thromboprophylaxis after hospitalisation. The availability of an effective oral anticoagulant with an acceptable safety profile that does not require routine clinical monitoring may lead clinicians to switch patients from subcutaneous to an oral therapy either during hospitalisation or at discharge. The purpose of this study was to assess the effect of enoxaparin on the pharmacokinetics, pharmacodynamics and safety of apixaban, an oral, direct inhibitor of coagulation factor Xa. In this four-period, crossover study, 20 healthy subjects were randomised to receive single doses of apixaban 5 mg orally; enoxaparin 40 mg subcutaneously; apixaban 5 mg and enoxaparin 40 mg concomitantly; and apixaban 5 mg followed 6 hours (h) after by enoxaparin 40 mg. Pharmacokinetics of apixaban were not affected by enoxaparin. Average peak pharmacodynamic effect, measured by anti-Xa activity, was 1.36 U/ml after administration of apixaban and was 0.42 U/ml after enoxaparin. Following co-administration of apixaban and enoxaparin, peak anti-Xa activity was 42% higher than for apixaban alone. Following administration of enoxaparin 6 h after apixaban, peak anti-Xa activity was 15% higher than for apixaban alone. In conclusion, enoxaparin had no effect on the pharmacokinetics of apixaban. The increase in anti-Xa activity after co-administration was modest and appeared to be additive. Peak anti-Xa activity increases are mitigated by separating administration of subcutaneous anticoagulation and apixaban when switching between therapies; the potential for pharmacodynamic interaction may be further mitigated by transitioning at the next scheduled dose (12 h).
Variability of fibrinogen measurements in post-myocardial infarction patients
Authors: Baumert Jens , Karakas Mahir , Greven Sonja , Rückerl Regina , Peters Annette , Koenig Wolfgang
Published: March 2012

Elevated fibrinogen levels are strongly and consistently associated with incident coronary heart disease (CHD). A possible causal contribution of fibrinogen in the pathway leading to atherothrombotic cardiovascular disease complications has been suggested. However, for implementation in clinical practice, data on validity and reliability, which are still scarce, are needed that are still scarce, especially in subjects with a history of CHD. For the present study, levels of plasma fibrinogen were measured in 200 post-myocardial infarction (post-MI) patients aged 39–76 years, with approximately six blood samples collected at monthly intervals between May 2003 and March 2004, giving a total of 1,144 samples. Inter-individual variability (between-subject variance component, VCb and coefficient of variation, CVb), intra-individual and analytical variability (VCw+a and CVw+a), intraclass correlation coefficient (ICC) and the number of measurements required for an ICC of 0.75 were estimated to assess the reliability of serial fibrinogen measurements. Mean fibrinogen concentration of all subjects over all samples was 3.34 g/l (standard deviation 0.67). Between-subject variation for fibrinogen was VCb = 0.34 (CVb,=17.5%) whereas within-subject and analytical variation was estimated as VCw+a = 0.14 (CVw+a=11.0%). The variation was mainly explained by between-subject variability, shown by the proportion of total variance of 71.3%. Two different measurements were required to reach sufficient reliability, if subjects with extreme values were not excluded. The present study indicates a fairly good reproducibility of serial individual fibrinogen measurements in post-MI subjects.
Two missense mutations identified in venous thrombosis patients impair the inhibitory function of the protein Z dependent protease inhibitor
Authors: Birch Nigel P. , Browett Peter J. , Coughlin Paul B. , Horvath Anita J. , Van de Water Neil S. , Ockelford Paul A. , Harper Paul L. , Young Laura K.
Published: March 2012

Protein Z-dependent protease inhibitor (ZPI) is a plasma inhibitor of factor (F)Xa and FXIa. In an earlier study, five mutations were identified within the ZPI gene of venous thrombosis patients and healthy controls. Two of these were nonsense mutations and three were missense mutations in important regions of the protein. Here we report that two of these latter three mutations, F145L and Q384R, impair the inhibitory function of ZPI in vitro. Recombinant wild-type and mutant proteins were prepared; stability in response to thermal challenge was similar. Inhibition of FXa in the presence of the cofactor protein Z was reduced 68-fold by the Q384R mutant; inhibition of FXIa by the F145L mutant was reduced two- to three-fold compared to the wild-type ZPI. An analysis of all five ZPI mutations was undertaken in a cohort of venous thrombosis patients (n=550) compared to healthy controls (n=600). Overall, there was a modest increase in incidence of these mutations in the thrombosis group (odds ratio 2.0, 1.05–3.7, p=0.044). However, in contrast to W324X (nonsense mutation), the Q384R missense mutation and R88X nonsense mutation were evenly distributed in patients and controls; F145L was rare. The final mutation (S143Y) was also rare and did not significantly alter ZPI function in laboratory studies. The F145L and particularly the Q384R mutation impaired the function of the coagulation inhibitor ZPI; however, there was no convincing association between these mutations and venous thrombosis risk. The functional role for ZPI in vivo has yet to be clarified.