bluuebunny/crossref_metadata_2025 huggingface dataset:
Vascular graft infections and role of PET/CT in patients with persistent bacteraemia
Authors: Shahani Lokesh
Published: March 2015

Prosthetic vascular graft infection although a rare complication of vascular reconstruction surgery; has been associated with significant morbidity and mortality. The author presents two patients with prosthetic aortic graft presenting as fever and methicillin sensitiveStaphylococcus aureusbacteraemia without any other localising sign of infection. Both patients had a history of postoperative wound infection after their graft placement. Patients remained persistently bacteraemic on appropriate antimicrobial therapy making the clinician suspicious of a vascular graft infection. A [18 F] fluoro-2-deoxy-dglucose positron emission tomography associated to CT scan was used to identify the prosthetic vascular graft infection and since both patients were high-risk surgical candidates, a conservative medical approach was used. They were treated with 6 weeks of nafcillin and rifampin, followed by long-term doxycycline for suppression. This highlights the importance of considering vascular graft infection in patients with recurrent and persistent bacteraemia despite adequate therapy.
Electric field-controlled semiconductor nanorod assembly in solution: mechanistic insights from non-equilibrium molecular dynamics
Authors: English Niall J.
Published: March 2015

Non-equilibrium molecular dynamics (MD) of small, charged cadmium selenide nanorods have been carried out in the absence and presence of static applied electric fields. In the absence of applied fields, it was found that opposite dipolar alignment (antiferromagnetic) was achieved, along with self-assembly of the nanorods. However, in the case of induced electrophoresis in applied fields, the rods approached each other less readily, while at and above a field intensity of 0.05 V/Å, preferential alignment with the field was achieved for all rods, in contrast to the zero-field case. These results have implications for electric field-mediated control of nanorod assembly in solution, of key importance in a wide range of areas from photovoltaics to energy storage.
Mechanism and regioselectivity of 1,3-dipolar cycloaddition reactions of bicyclic monoterpenes with aryl and heteroaryl nitrile oxides: a DFT study
Authors: Eshghi Hossein , Khojastehnezhad Amir , Moeinpour Farid , Bakavoli Mehdi
Published: March 2015

The reactivity and regioselectivity of 1,3-dipolar cycloaddition reactions of aryl and heteroaryl nitrile oxides (1a–1c) with bicyclic monoterpenes (R)-(+)-a-pinene (2a) and (S)-(–)-b-pinene (2b) have been investigated by using density functional theory based on reactivity indices and activation energy calculations at the B3LYP/6-31G(d) level of theory in the gas phase. The potential energy surface analyses for both reactions are in agreement with the experimental observations. Moreover, our calculations on the geometries, bond orders, and global electron density transfers at the transition state structures shows that these 1,3- dipolar cycloaddition reactions occur via an asynchronous one-step mechanism.
Peristaltic transport of an aqueous solution of silver nanoparticles with convective heat transfer at the boundaries
Authors: Abbasi F.M. , Hayat T. , Ahmad B.
Published: March 2015

Peristaltic transport of water-based silver nanoparticles in a symmetric channel with convective walls is explored. Analysis has been carried out in the presence of heat source–sink, viscous dissipation, and mixed convection. Lubrication approach has been utilized. Resulting coupled system is solved numerically using the shooting method. Graphical analysis for flow quantities and heat transfer has been made. Results show that the addition of silver nanoparticles considerably reduces the velocity and temperature of the fluid. Enhancement in heat transfer rate at the wall for large nanoparticle volume fraction is also reported. Interesting outcomes of this study are summarized.
Current-transport mechanism in Au/V-doped PVC+TCNQ/p-Si structures
Authors: Tecimer H. , Vural Ö. , Kaya A. , Altındal Ş.
Published: March 2015

The forward and reverse bias current–voltage (I–V) characteristics of Au/V-doped polyvinyl chloride+Tetracyanoquino dimethane/porous silicon (PVC+TCNQ/p-Si) structures have been investigated in the temperature range of 160–340 K. The zero bias or apparent barrier height (BH) (Φ ap = Φ Bo ) and ideality factor (n ap = n) were found strongly temperature dependent and the value of n ap decreases, while the Φ ap increases with the increasing temperature. Also, the Φ ap versus T plot shows almost a straight line which has positive temperature coefficient and it is not in agreement with the negative temperature coefficient of ideal diode or forbidden bandgap of Si (α Si = -4.73×10-4 eV/K ). The high value of n cannot be explained only with respect to interfacial insulator layer and interface traps. In order to explain such behavior of Φ ap and n ap with temperature, Φ ap Versus q/2kT plot was drawn and the mean value of (Φ Bo ) and standard deviation (σs) values found from the slope and intercept of this plot as 1.176 eV and 0.152 V, respectively. Thus, the modified ( ln (Io/T2)-(qσs)2/2(kT)2 versus (q/kT) plot gives the Φ Bo and effective Richardson constant A* as 1.115 eV and 31.94 A ⋅(cm⋅K)-2, respectively. This value of A*( = 31.94 A⋅( cm ⋅K)-2) is very close to the theoretical value of 32 A ⋅(cm⋅K)-2 for p-Si. Therefore, the forward bias I–V–T characteristics confirmed that the current-transport mechanism (CTM) in Au/V-doped PVC+TCNQ/p-Si structures can be successfully explained in terms of the thermionic emission (TE) mechanism with a Gaussian distribution (GD) of BHs at around mean BH.
Links and Planar Diagram Codes
Authors: Mastin Matt
Published: March 2015

In this paper we formalize a combinatorial object for describing link diagrams called a Planar Diagram Code (PD-Code). PD-codes are used by the KnotTheory Mathematica package developed by Bar-Natan et al. We present the set of PD-codes as a standalone object and discuss its relationship with link diagrams. We give an explicit algorithm for reconstructing a knot diagram on a surface from a PD-code. We also discuss the intrinsic symmetries of PD-codes (i.e. invertibility and chirality). The moves analogous to the Reidemeister moves are also explored, and we show that the given set of PD-codes modulo these combinatorial Reidemeister moves is equivalent to classical link theory.
Periodic Gibbs measures for models with uncountable set of spin values on a Cayley tree
Authors: Rozikov U. A. , Haydarov F. H.
Published: March 2015

We consider models with nearest-neighbor interactions and with the set [0, 1] of spin values, on a Cayley tree of order k ≥ 1. We show that periodic Gibbs measures are either translation-invariant or periodic with period two. We describe two-periodic Gibbs measures of the model. For k = 1 we show that there is no any periodic Gibbs measure. In case k ≥ 2 we get a sufficient condition on Hamiltonian of the model with uncountable set of spin values under which the model has no periodic Gibbs measure. We construct several models which have at least two periodic Gibbs measures.
The oil and gas industry: the challenge for proper dissemination of knowledge
Authors: Vecchia Pierluigi
Published: March 2015

After the 2012 Emilia–Romagna (Italy) seismic sequence, oil and gas activities have been accused, mainly through the Internet, of being responsible for triggering/inducing local earthquakes; many people consider this information to be true for three reasons: (1) industry and professionals are unable to explain the matter; (2) authorities are too often driven by research of popular consent; and (3) scientists are usually not trained to deal with people. The consequence has been a silence filled with opposition, protest and experts of everything; spin-doctors have easily become ‘geologists’ thanks to the Internet and once the ‘net’ has promoted them, now it is hard to remove this false label. Words like seismicity, fracking, drilling and subsidence have become common, and used without their correct meaning always being known, in the name of supposed environmental protection and sustainability, and with a precautionary approach to the question to always be applied. A smart use of a few keywords gave a number of spin-doctors the opportunity for fame. Any attempt to give correct information was ‘proclaimed by experts to be in conflict of interest’. The industry needs to improve its communication of awareness and sustainability. Petroleum geologists need to answer questions coming from the community, and they have to accept this challenge by disseminating knowledge in a proper and ethical way.
Nestin upregulation characterizes vascular remodeling secondary to hypertension in the rat
Authors: Tardif Kim , Hertig Vanessa , Duquette Natacha , Villeneuve Louis , El-Hamamsy Ismail , Tanguay Jean-François , Calderone Angelino
Published: March 2015

Proliferation and hypertrophy of vascular smooth muscle cells represent hallmark features of vessel remodeling secondary to hypertension. The intermediate filament protein nestin was recently identified in vascular smooth muscle cells and in other cell types directly participated in proliferation. The present study tested the hypothesis that vessel remodeling secondary to hypertension was characterized by nestin upregulation in vascular smooth muscle cells. Two weeks after suprarenal abdominal aorta constriction of adult male Sprague-Dawley rats, elevated mean arterial pressure increased the media area and thickness of the carotid artery and aorta and concomitantly upregulated nestin protein levels. In the normal adult rat carotid artery, nestin immunoreactivity was observed in a subpopulation of vascular smooth muscle cells, and the density significantly increased following suprarenal abdominal aorta constriction. Filamentous nestin was detected in cultured rat carotid artery- and aorta-derived vascular smooth muscle cells and an analogous paradigm observed in human aorta-derived vascular smooth muscle cells. ANG II and EGF treatment of vascular smooth muscle cells stimulated DNA and protein synthesis and increased nestin protein levels. Lentiviral short-hairpin RNA-mediated nestin depletion of carotid artery-derived vascular smooth muscle cells inhibited peptide growth factor-stimulated DNA synthesis, whereas protein synthesis remained intact. These data have demonstrated that vessel remodeling secondary to hypertension was characterized in part by nestin upregulation in vascular smooth muscle cells. The selective role of nestin in peptide growth factor-stimulated DNA synthesis has revealed that the proliferative and hypertrophic responses of vascular smooth muscle cells were mediated by divergent signaling events.
Abnormal Expression of DNA Double-Strand Breaks Related Genes, ATM and GammaH2AX, in Thyroid Carcinoma
Authors: Hu Jin-lin , Hu Si-si , Hou Xiu-xiu , Zhu Xin , Cao Jun , Jiang Lie-hao , Ge Ming-hua
Published: March 2015

ATM andγH2AX play a vital role in the detection of DNA double-strand breaks (DSB) and DNA damage response (DDR). This study aims to investigate ATM andγH2AX expression in thyroid cancer and discuss possible relationship between thyroid function tests and DNA damage. The expression of ATM andγH2AX was detected by immunohistochemistry in 30 cases of benign nodular goiter, 110 cases of well differentiated thyroid cancer, 22 cases of poorly differentiated thyroid cancer, and 21 cases of anaplastic thyroid cancer. Clinicopathological features, including differentiation stages, distant metastasis, lymph node metastasis, T classification, TNM stage, and tests of thyroid functions (TPOAb, Tg Ab, T3, FT3, T4, FT4, TSH, and Tg), were reviewed and their associations withγH2AX and ATM were analyzed.γH2AX and ATM expressed higher in thyroid cancer tissues than in benign nodular goiter and normal adjacent tissues.γH2AX was correlated with ATM in thyroid cancer. BothγH2AX and ATM expression were associated with FT3.γH2AX was also associated with T classification, TNM stage, FT4, TSH, and differentiation status. Therefore both of ATM andγH2AX seem to correlate with thyroid hormones andγH2AX plays a role in the differentiation status of thyroid cancer.
Lung Cancer with Skin and Breast Metastasis: A Case Report and Literature Review
Authors: Bhattarai Bikash , Schmidt Marie Frances , Ghosh Meenakshi , Sinha Ray Abhisekh , Manhas Saveena , Oke Vikram , Agu Chidozie Charles , Basunia Md. Rawshan , Enriquez Danilo , Quist Joseph , Bianchi Catherine , Hans Ravi , Kandel Saroj
Published: March 2015

Lung cancer is one of the most common cancers in America. Frequent sites of metastasis include the Hilar lymph nodes, adrenal glands, liver, brain, and bone. The following case report is of a primary lung cancer with metastases to the breast and skin.Case. A 48-year-old African American male with a past medical history of poorly differentiated left breast cancer status after modified radical mastectomy (MRM), chronic obstructive pulmonary disease, and smoking (20 pack-years) presents to the ER with progressive shortness of breath on exertion, upper back pain, and weight loss for 2 months in duration. On physical examination he is found to have a MRM scar on his left breast and a left periumbilical cutaneous mass. Chest X-ray and chest CT reveal a right upper lobe mass and biopsies from the breast, lung, and the periumbilical mass indicate a poorly differentiated carcinoma of unclear etiology; all tumor markers are negative. The patient is male and a chronic smoker; therefore the diagnosis is made as lung carcinoma with metastases to the breast and skin.Conclusion. A high index of suspicion for cutaneous metastases should be cast when investigating cutaneous pathologies in patients at risk for primary lung malignancy.
A Subordination Principle on Wright Functions and Regularized Resolvent Families
Authors: Abadias Luciano , Miana Pedro J.
Published: March 2015

We obtain a vector-valued subordination principle forgα,gβ-regularized resolvent families which unified and improves various previous results in the literature. As a consequence, we establish new relations between solutions of different fractional Cauchy problems. To do that, we consider scaled Wright functions which are related to Mittag-Leffler functions, the fractional calculus, and stable Lévy processes. We study some interesting properties of these functions such as subordination (in the sense of Bochner), convolution properties, and their Laplace transforms. Finally we present some examples where we apply these results.
Two-Phase Nonturbulent Flow with Applications
Authors: Mitrović Darko , Novak Andrej
Published: March 2015

We model dynamics of two almost immiscible fluids of different densities using the Stokes equations with the Dirac distribution representing the sink or source point. The equations are solved by regularizing the Dirac distribution and then using an iterative procedure based on the finite element method. Results have potential applications in water pollution problems and we present two relevant situations. In the first one, we simulate extraction of a light liquid trapped at the bottom of a pond/lake and, after being disturbed, it rises toward the surface. In the second case, we simulate heavy liquid leaking from a source and slowly dropping on an uneven bottom.
Optic Disc Segmentation by Balloon Snake with Texture from Color Fundus Image
Authors: Sun Jinyang , Luan Fangjun , Wu Hanhui
Published: March 2015

A well-established method for diagnosis of glaucoma is the examination of the optic nerve head based on fundus image as glaucomatous patients tend to have larger cup-to-disc ratios. The difficulty of optic segmentation is due to the fuzzy boundaries and peripapillary atrophy (PPA). In this paper a novel method for optic nerve head segmentation is proposed. It uses template matching to find the region of interest (ROI). The method of vessel erasing in the ROI is based on PDE inpainting which will make the boundary smoother. A novel optic disc segmentation approach using image texture is explored in this paper. A cluster method based on image texture is employed before the optic disc segmentation step to remove the edge noise such as cup boundary and vessels. We replace image force in the snake with image texture and the initial contour of the balloon snake is inside the optic disc to avoid the PPA. The experimental results show the superior performance of the proposed method when compared to some traditional segmentation approaches. An average segmentation dice coefficient of 94% has been obtained.
Biological Motion Perception Is Affected by Age and Cognitive Style in Children Aged 8–15
Authors: Ghanouni Parisa , Memari Amir Hossein , Shayestehfar Monir , Moshayedi Pouria , Gharibzadeh Shahriar , Ziaee Vahid
Published: March 2015

The current paper aims to address the question of how biological motion perception in different social contexts is influenced by age or also affected by cognitive styles. We examined developmental changes of biological motion perception among 141 school children aged 8–15 using point-light displays in monadic and dyadic social contexts. Furthermore, the cognitive styles of participants were investigated using empathizing-systemizing questionnaires. Results showed that the age and empathizing ability strongly predicted improvement in action perception in both contexts. However the systemizing ability was an independent predictor of performance only in monadic contexts. Furthermore, accuracy of action perception increased significantly from 46.4% (SD = 16.1) in monadic to 62.5% (SD = 11.5) in dyadic social contexts. This study can help to identify the roles of social context in biological motion perception and shows that children with different cognitive styles may present different biological motion perception.
Giant Thyroid Abscess Related to Postpartum Brucella Infection
Authors: Akdemir Zülküf , Karaman Erbil , Akdeniz Hüseyin , Alptekin Cem , Arslan Harun
Published: March 2015

Thyroid gland infection, although rare, may be a life threatening disease. Thyroid abscess, arising from acute suppurative thyroiditis (AST), is a rare clinic condition depending on widespread use of antibiotics. Infection may involve one or both lobes and abscess formation may not be apparent until late stage of the progress of illness. Thyroid left lobe is more often affected than the right one. Brucellosis, especially obvious in endemic areas, is a widely seen zoonosis around the world. Although brucella infection can affect many organs through various complications, thyroid gland infection is rare. We aimed to present ultrasonography (USG) and magnetic resonance images (MRI) of a case with an acute thyroiditis which rapidly developed and grew fast on the left half of the neck during the first postpartum month. As far as we know from literature reviewing, our case is the first case report of a thyroid abscess arising from brucella infection which is developed in first postpartum period with images of ultrasonography and MRI.
Antioxidants in Varieties of Chicory (Cichorium intybusL.) and Wild Poppy (Papaver rhoeasL.) of Southern Italy
Authors: Montefusco Anna , Semitaio Giuliana , Marrese Pier Paolo , Iurlaro Andrea , De Caroli Monica , Piro Gabriella , Dalessandro Giuseppe , Lenucci Marcello Salvatore
Published: March 2015

We report the hydrophilic and lipophilic antioxidant activities, as well as the total phenol, flavonoid, tocochromanol (tocopherol and tocotrienol), and carotenoid contents in the edible portion of wild and cultivated varieties of chicory (Cichorium intybusL.) and in the basal rosette leaves of the wild species of poppy (Papaver rhoeasL.), known by natives as “paparina,” collected in the countryside of Salento (South Apulia, Italy). We analyzed (1) two cultivars of chicory, the “Catalogna” harvested in the area between S. Pietro Vernotico and Tuturano (Brindisi) and the “Otrantina” harvested in Otranto (Lecce); (2) two wild chicory ecotypes harvested in S. Pietro Vernotico (Brindisi) and Statte (Taranto), respectively; (3) the basal leaves of wild poppy harvested in Sternatia (Lecce). In all samples, our results showed that the hydrophilic antioxidant activity is, generally, higher than the lipophilic activity. Poppy leaves exhibited the highest hydrophilic and lipophilic antioxidant activities and the highest concentration of total phenols and flavonoids. Tocopherols were detected only as traces. Among the extracted carotenoids, lutein andβ-carotene were the most abundant in all analyzed samples. Total carotenoid content was greater in wild than in cultivated plants.
Beneficial Effects of Coculturing Synovial Derived Mesenchymal Stem Cells with Meniscus Fibrochondrocytes Are Mediated by Fibroblast Growth Factor 1: Increased Proliferation and Collagen Synthesis
Authors: Song Xuanhe , Xie Yaoping , Liu Yang , Shao Ming , Wang Wenbo
Published: March 2015

Meniscus reconstruction is in great need for orthopedic surgeons. Meniscal fibrochondrocytes transplantation was proposed to regenerate functional meniscus, with limited donor supply. We hypothesized that coculture of synovial mesenchymal stem cells (SSC) with meniscal fibrochondrocytes (me-CH) can support matrix production of me-CH, thus reducing the number of me-CH needed for meniscus reconstruction. A pellet coculture system of human SSC and me-CH was used in this study. Enhanced glycosaminoglycans (GAG) in coculture pellets were demonstrated by Alcian blue staining and GAG quantification, when compared to monoculture. More collagen synthesis was shown in coculture pellets by hydroxyproline assay. Increased proliferation of me-CH was observed in coculture. Data from BrdU staining and ELISA demonstrated that conditioned medium of SSCs enhanced the proliferation and collagen synthesis of me-CH, and this effect was blocked by neutralizing antibody against fibroblast growth factor 1 (FGF1). Western blot showed that conditioned medium of SSCs can activate mitogen-activated protein kinase (MAPK) signaling pathways by increasing the phosphorylation of mitogen-activated regulated protein kinase 1/2 (MEK) and extracellular-signal-regulated kinases 1/2 (ERK). Overall, this study provided evidence that synovial MSCs can support proliferation and collagen synthesis of fibrochondrocytes, by secreting FGF1. Coimplantation of SSC and me-CH could be a useful strategy for reconstructing meniscus.
Idiopathic Organ Transplant Chorioretinopathy after Liver Transplantation
Authors: Abalem Maria Fernanda , Carricondo Pedro Carlos , Pimentel Sergio Luis Gianotti , Takahashi Walter Yukihiko
Published: March 2015

Idiopathic organ transplant chorioretinopathy is a rare disease associated with kidney and heart transplantation. We present a case secondary to liver transplantation including its multimodal imaging, differential diagnosis, and physiopathology discussion.
Metabolic Signature Identifies Novel Targets for Drug Resistance in Multiple Myeloma
Authors: Maiso Patricia , Huynh Daisy , Moschetta Michele , Sacco Antonio , Aljawai Yosra , Mishima Yuji , Asara John M. , Roccaro Aldo M. , Kimmelman Alec C. , Ghobrial Irene M.
Published: March 2015

Drug resistance remains a major clinical challenge for cancer treatment. Multiple myeloma is an incurable plasma cell cancer selectively localized in the bone marrow. The main cause of resistance in myeloma is the minimal residual disease cells that are resistant to the original therapy, including bortezomib treatment and high-dose melphalan in stem cell transplant. In this study, we demonstrate that altered tumor cell metabolism is essential for the regulation of drug resistance in multiple myeloma cells. We show the unprecedented role of the metabolic phenotype in inducing drug resistance through LDHA and HIF1A in multiple myeloma, and that specific inhibition of LDHA and HIF1A can restore sensitivity to therapeutic agents such as bortezomib and can also inhibit tumor growth induced by altered metabolism. Knockdown of LDHA can restore sensitivity of bortezomib resistance cell lines while gain-of-function studies using LDHA or HIF1A induced resistance in bortezomib-sensitive cell lines. Taken together, these data suggest that HIF1A and LDHA are important targets for hypoxia-driven drug resistance. Novel drugs that regulate metabolic pathways in multiple myeloma, specifically targeting LDHA, can be beneficial to inhibit tumor growth and overcome drug resistance. Cancer Res; 75(10); 2071–82. ©2015 AACR.
Genomic Complexity Profiling Reveals That HORMAD1 Overexpression Contributes to Homologous Recombination Deficiency in Triple-Negative Breast Cancers
Authors: Watkins Johnathan , Weekes Daniel , Shah Vandna , Gazinska Patrycja , Joshi Shalaka , Sidhu Bhavna , Gillett Cheryl , Pinder Sarah , Vanoli Fabio , Jasin Maria , Mayrhofer Markus , Isaksson Anders , Cheang Maggie C.U. , Mirza Hasan , Frankum Jessica , Lord Christopher J. , Ashworth Alan , Vinayak Shaveta , Ford James M. , Telli Melinda L. , Grigoriadis Anita , Tutt Andrew N.J.
Published: March 2015

Triple-negative breast cancers (TNBC) are characterized by a wide spectrum of genomic alterations, some of which might be caused by defects in DNA repair processes such as homologous recombination (HR). Despite this understanding, associating particular patterns of genomic instability with response to therapy has been challenging. Here, we show that allelic-imbalanced copy-number aberrations (AiCNA) are more prevalent in TNBCs that respond to platinum-based chemotherapy, thus providing a candidate predictive biomarker for this disease. Furthermore, we show that a high level of AiCNA is linked with elevated expression of a meiosis-associated gene, HORMAD1. Elevated HORMAD1 expression suppresses RAD51-dependent HR and drives the use of alternative forms of DNA repair, the generation of AiCNAs, as well as sensitizing cancer cells to HR-targeting therapies. Our data therefore provide a mechanistic association between HORMAD1 expression, a specific pattern of genomic instability, and an association with response to platinum-based chemotherapy in TNBC.

Significance: Previous studies have shown correlation between mutational “scars” and sensitivity to platinums extending beyond associations with BRCA1/2 mutation, but do not elucidate the mechanism. Here, a novel allele-specific copy-number characterization of genome instability identifies and functionally validates the inappropriate expression of the meiotic gene HORMAD1 as a driver of HR deficiency in TNBC, acting to induce allelic imbalance and moderate platinum and PARP inhibitor sensitivity with implications for the use of such “scars” and expression of meiotic genes as predictive biomarkers. Cancer Discov; 5(5); 488–505. ©2015 AACR.

This article is highlighted in the In This Issue feature, p. 453
Neonatal Acid-Base Status in Fetuses with Abnormal Vertebro- and Cerebro-Placental Ratios
Authors: Morales-Roselló José , Khalil Asma , Ferri-Folch Blanca , Perales-Marín Alfredo
Published: March 2015

Objective: A low cerebro-placental ratio (CPR) at term suggests the existence of failure to reach growth potential (FRGP) with a higher risk of poor neonatal acid-base status. This study aimed to evaluate whether similar findings were also seen in the vertebral artery (vertebro-placental ratio, VPR), supplying 30% of the cerebral flow. Methods: We studied term fetuses classified into groups according to birth weight (BW), CPR and VPR. BW was expressed in centiles and ratios in multiples of the median (MoM). Subsequently, associations with neonatal pH values were evaluated by means of regression curves and Mann-Whitney tests. Results: VPR MoM correlated with BW centiles (p < 0.0001, R2 = 0.042) and its distribution resembled that of CPR MoM (p < 0.001). When both arteries were compared, adequate-for-gestational-age (AGA) fetuses with either low CPR or low VPR had lower neonatal venous pH values (p < 0.05, p < 0.01, respectively). However, in case of small-for-gestational-age (SGA) fetuses, only those with low VPR had significantly lower neonatal arterial and venous pH values (p < 0.05). Conclusions: Blood flow in the vertebral artery mimics that in the middle cerebral artery supporting the FRGP model. Both CPR and VPR identify AGA fetuses with lower neonatal pH values, but only VPR identifies SGA with lower pH values. Hypoxemia might be reflected as a generalized cerebral vasodilation demonstrated as low CPR and VPR.
Exhaled Nitric Oxide and Airway Hyperresponsiveness to Adenosine 5′-monophosphate and Methacholine in Children with Asthma
Authors: Perzanowski Matthew S. , Yoo Young
Published: March 2015

Background: There is increasing interest in the role of indirect bronchial challenges because clinical studies have shown that indirect airway hyperresponsiveness (AHR) reflects underlying airway inflammation better than direct AHR. Fractional exhaled nitric oxide (FeNO) appears to be a useful clinical tool for assessing airway inflammation noninvasively. We examined whether FeNO is more closely related to AHR to indirect stimuli than AHR to direct stimuli in children with mild to moderate asthma. Methods: Fifty-nine asthmatic children aged 6-16 years without rhinitis, underwent spirometry, FeNO measurement and blood tests for serum total IgE, blood eosinophil count and serum eosinophil cationic protein (ECP). All subjects underwent methacholine and adenosine 5-monophosphate (AMP) challenge tests at intervals of 3 days. Results: In a univariate linear regression analysis, FeNO was significantly associated with both PC20 AMP (R2 = 0.341, p < 0.001) and PC20 methacholine (R2 = 0.188, p = 0.001). After adjustment for age, sex, serum total IgE and blood eosinophil count, the association between FeNO and PC20 AMP (β = -1.98, p = 0.001) was more robust than that between FeNO and PC20 methacholine (β = -0.87, p = 0.081). The significant correlation between FeNO and PC20 AMP was observed in the steroid-naïve group (β = -2.48, p = 0.001), but not in the steroid-treated group (β = 0.88, p = 0.463). Conclusions: FeNO levels were more closely associated with PC20 AMP than with PC20 methacholine. This relationship could only be seen in the steroid-naïve subjects. These results suggest that FeNO levels in children with asthma may be more closely related to indirect AHR than to direct AHR.
Endocrine Effects of Valproate versus Carbamazepine in Males with Epilepsy: A Prospective Study
Authors: Goldberg-Stern Hadassa , Itzhaki Tomer , Landau Zohar , de Vries Liat
Published: March 2015

Background/Aims: To prospectively evaluate the long-term impact of valproate (VPA) versus carbamazepine (CBZ) on anthropometric, hormonal, and metabolic parameters in young male patients treated for epilepsy. Methods: Of 61 boys with newly diagnosed epilepsy followed up, 24 were excluded from analysis (17 were lost to follow-up and 7 changed therapy within <1 year). Findings were compared by time, treatment (VPA or CBZ), and epilepsy type (generalized or partial) as well as against a matched control group with adequately treated hypothyroidism. Results: Twenty-four boys were treated with VPA and 13 with CBZ. The weight-standard deviation score (SDS) significantly increased during the first 6 months of treatment (p < 0.001), irrespective of the drug type, but decreased between the first and the last visit (p = 0.01). In patients with generalized epilepsy, there was a slight decrease in height- and weight-SDS between the first and the last visit (p = 0.04 and p = 0.01, respectively). The height-SDS at the last visit was comparable to the parental height-SDS. The mean age at puberty onset was 11.2 and 11.4 years in the study and the control group, respectively (p = 0.08). There were no significant differences in the other parameters by treatment or epilepsy type. Conclusions: Long-term therapy with VPA or CBZ has no significant endocrinological or metabolic adverse effect on male children and adolescents with epilepsy.
Endovascular Treatment for Acute Ischemic Stroke: Considerations from Recent Randomized Trials
Authors: Shirakawa Manabu , Yoshimura Shinichi , Yamada Kiyofumi , Uchida Kazutaka , Shindou Seigo
Published: March 2015

Background: Despite increasing use of intravenous recombinant tissue plasminogen activator therapy, the large number of patients ineligible for treatment or for whom treatment is ineffective has become problematic. Summary: The number of endovascular treatments for acute ischemic stroke is increasing each year. This treatment provides higher recanalization rates for occluded vessels but may lead to hemorrhagic complications such as subarachnoid hemorrhage. Results were announced for three randomized controlled trials in 2013, with all failing to show the superiority of endovascular treatment. These results have had a major negative impact, but a new randomized controlled trial, the Multicenter Randomized CLinical trial of Endovascular treatment for Acute ischemic stroke in the Netherlands (MR CLEAN), showed that acute endovascular treatment was superior to standard medical treatment in terms of clinical outcomes. With this positive result, interim analyses from other randomized trials appear likely to show the effectiveness of endovascular treatment. Key Message: Clinical evidence of acute stroke intervention using mechanical devices might be established in the near future.
Psychologische Optimierung von Erwartungen zur Prävention von Nocebo-Nebenwirkungen bei Brustkrebs - 2 Fallberichte
Authors: von Blanckenburg Pia , Schuricht Franziska , Heisig Sarah R. , Shedden-Mora Meike C. , Rehahn-Sommer Sabine , Albert Ute-Susann , Rief Winfried , Nestoriuc Yvonne
Published: March 2015

Hintergrund: Erwartungen können den tatsächlichen Verlauf einer medizinischen Behandlung beeinflussen - im positiven wie im negativen Sinne (Placebo- bzw. Nocebo-Effekt). Anhand zweier Fallberichte wird eine psychologische Kurzzeitintervention vorgestellt, die für Patientinnen mit Brustkrebs zu Beginn der Antihormontherapie konzipiert wurde («Antihormonelle Therapie erfolgreich meistern», ATEM). Den inhaltlichen Schwerpunkt bildet die Optimierung individueller behandlungsrelevanter Erwartungen mit dem Ziel, die Belastung durch Nebenwirkungen während der Medikamenteneinnahme zu verringern und die Lebensqualität zu verbessern. Falldarstellungen: Zwei Patientinnen, die im Rahmen einer randomisierten kontrollierten Studie am ATEM-Präventionsprogramm teilnahmen, werden vorgestellt. Die Kurzzeitintervention, die eine patientenzentrierte Aufklärung zu Nocebo-Effekten, Ressourcenaktivierung und Stärkung der Selbstwirksamkeitserwartungen im Umgang mit individuell befürchteten Symptomen umfasst, wurde qualitativ und quantitativ ausgewertet. Erhoben wurden die Behandlungserwartungen vor und nach der Intervention sowie die tatsächliche Nebenwirkungsbelastung und Lebensqualität vor Beginn der Antihormontherapie und im Follow-up nach 3 und 6 Monaten. Beide Patientinnen berichteten, von dem Programm profitiert zu haben, wobei sich unterschiedliche Schlüsselinterventionen zeigten. Bei beiden Patientinnen verbesserten sich die behandlungsrelevanten Erwartungen, verringerte sich die Nebenwirkungsbelastung und steigerte sich die Lebensqualität. Schlussfolgerung: Die psychologische Unterstützung zum Umgang mit befürchteten Nebenwirkungen erwies sich in beiden Fällen als geeignet, um die Belastung durch Krebsbehandlungen zu reduzieren. Die Optimierung von Behandlungserwartungen könnte einen wertvollen Beitrag zur Verbesserung der Versorgung von Patientinnen mit Brustkrebs leisten.
Technical Difficulties Due to Poor Acoustic Insonation during Transcranial Doppler Recordings in Amerindians and Individuals of European Origin. A Comparative Study
Authors: Nader Juan A. , Andrade María de la Luz , Espinosa Verónica , Zambrano Mauricio , Del Brutto Oscar H.
Published: March 2015

Background: There is no information on transcranial Doppler (TCD) failures due to poor insonation among native inhabitants of Latin America. Methods: Seventy Ecuadorian natives and 70 age- and sex-matched individuals of European origin underwent TCD. The same investigators performed all exams using the same equipment and protocol. Using the McNemar's test for correlated proportions, we compared TCD failures related to poor insonation across ethnic groups. Results: Out of 140 participants, 56 (40%) had one or more suboptimal/absent acoustic windows. These persons were older (p = 0.01) and were more often women (p < 0.0001) than those with all optimal windows (irrespective of race/ethnicity). In the matched-pair analysis, Amerindians were more likely to have suboptimal/absent acoustic windows than individuals of European origin (OR: 2.8, 95% CI: 1.3-6.5, p = 0.006). Conclusion: Amerindians are almost three times more likely to have insonation failures related to poor acoustic windows than their European counterparts.
Patient Blood Management Implementation Strategies and Their Effect on Physicians' Risk Perception, Clinical Knowledge and Perioperative Practice - the Frankfurt Experience
Authors: Fischer Dania P. , Zacharowski Kai D. , Müller Markus M. , Geisen Christof , Seifried Erhard , Müller Heiko , Meybohm Patrick
Published: March 2015

Introduction: A multicomponent, evidence-based and interdisciplinary Patient Blood Management (PBM) program was introduced at the University Hospital Frankfurt in July 2013. The implementation strategy included practical and tactical components aimed to increase knowledge on the risks of preoperative anemia, to standardize hemotherapy, and to facilitate PBM components. Methods: This article analyzes barriers to PBM implementation and outlines a strategy to introduce and manifest PBM. The effects in Frankfurt were measured in a before and after questionnaire study distributed among groups of physicians immediately before and 1 year after PBM implementation. Results: 142 clinicians completed the questionnaire in July 2013 and 101 clinicians in August 2014. Absolute certainty that the treatment of preoperative anemia favorably influences morbidity and mortality rose from 25 to 37%. Transfusion behavior seems to have been affected: In 2014, 56% of clinicians stated that they clinically reassess the patient and analyze hemoglobin following each single red blood cell unit compared to only 38% stating this in 2013. Conclusion: These results show that our implementation strategy was effective in changing physicians' risk perception, attitude, and knowledge on PBM principles. Our experience highlights key success factors for the implementation of a comprehensive PBM program.
Sodium Thiosulfate: An Emerging Treatment for Calciphylaxis in Dialysis Patients
Authors: Yu Zanzhe , Gu Leyi , Pang Huihua , Fang Yan , Yan Hao , Fang Wei
Published: March 2015

Calciphylaxis is a rare but life-threatening complication seen in dialysis patients. We report a case with calciphylaxis and severe secondary hyperparathyroidism. Sodium thiosulfate (STS) was used for treatment in this case. The painful skin ulcers improved significantly soon after treatment, with a slight reduction in the calcium-phosphorus product. Total parathyroidectomy was carried out 6 months after the STS therapy, which successfully solved hyperparathyroidism and the high calcium-phosphorus profiles. Until now, no recurrence of calciphylaxis has been observed during the more than 7 years of follow-up. STS, as a chelating agent for calcium and iron, is an emerging treatment option for calciphylaxis; however, the mechanisms of STS in treating calciphylaxis are not clear. Our case demonstrates that STS treatment did not work through normalizing calcium-phosphorus profiles, although to optimize hyperparathyroidism and to control calcium and phosphorus levels is clearly part of the general treatment of calciphylaxis. The literature on STS treatment for calciphylaxis in dialysis patients was also reviewed.
Angioarchitectural Evolution of Clival Dural Arteriovenous Fistulas in Two Patients
Authors: Pouw Andrew E. , Rabin Richard L. , Karanjia Rustum , Bababeygy Simon R. , Amar Arun P. , Sadun Alfredo A.
Published: March 2015

Dural arteriovenous fistulas (dAVFs) may present in a variety of ways, including as carotid-cavernous sinus fistulas. The ophthalmologic sequelae of carotid-cavernous sinus fistulas are known and recognizable, but less commonly seen is the rare clival fistula. Clival dAVFs may have a variety of potential anatomical configurations but are defined by the involvement of the venous plexus just overlying the bony clivus. Here we present two cases of clival dAVFs that most likely evolved from carotid-cavernous sinus fistulas.
Diurnal Variation of Plasma Brain-Derived Neurotrophic Factor Levels in Women with Functional Hypothalamic Amenorrhea
Authors: Drakopoulos Panagiotis , Casarosa Elena , Bucci Fiorella , Piccinino Manuela , Wenger Jean-Marie , Nappi Rossella Elena , Polyzos Nicholas , Genazzani Andrea Riccardo , Pluchino Nicola
Published: March 2015

Background: Brain-derived neurotrophic factor (BDNF) is strongly related to hormonal networks and is modulated by hypothalamic activity. Objective: To evaluate plasma BDNF concentration in patients with functional hypothalamic amenorrhea (FHA), with reference to the BDNF circadian rhythm and its relation with the cortisol (F) rhythm, and to assess whether the duration of amenorrhea might influence the BDNF:F ratio in FHA. Design: This was an observational study evaluating 36 amenorrheic and 30 eumenorrheic women. Setting: Basal values of BDNF and hormones were examined in blood samples collected from 7:00 to 9:00 h in all the women. Basal BDNF and F levels were determined in blood samples collected in 12 subjects from each group at 8:00, 12:00, 16:00, 20:00, and 24:00 h. Results: BDNF plasma levels are significantly lower in amenorrheic women (p < 0.001) than in the follicular phase of eumenorrheic women. There are no correlations between BDNF values (p > 0.05), sex steroids, and F in FHA. Low plasma BDNF levels in FHA are not significantly correlated with duration of amenorrhea. The 24-hour variation of BDNF in amenorrheic women is significantly lower when compared to the control group, and normal daily variations of BDNF disappeared in FHA patients. F preserved its circadian rhythm in both groups. Conclusions: Interactions between BDNF, the hypothalamus-pituitary-adrenal axis, and sex steroids might be critical in clinical conditions of modified homeostasis/adaptation, such as FHA.
Usefulness of Somatostatin Receptor Scintigraphy (99mTc-[HYNIC, Tyr3]-Octreotide) and 123I-Metaiodobenzylguanidine Scintigraphy in Patients with SDHx Gene-Related Pheochromocytomas and Paragangliomas Detected by Computed Tomography
Authors: Michałowska Ilona , Ćwikła Jarosław B. , Pęczkowska Mariola , Furmanek Mariusz I. , Buscombe John R. , Michalski Wojciech , Prejbisz Aleksander , Szperl Małgorzata , Malinoc Angelica , Moczulski Dariusz , Szutkowski Zbigniew , Kawecki Andrzej , Antoniewicz Jolanta , Pęczkowski Piotr , Lewczuk Anna , Otto Maciej , Cichocki Andrzej , Bednarek-Tupikowska Grażyna , Kabat Marek , Janaszek-Sitkowska Hanna , Przybyłowska Katarzyna , Janas Jadwiga , Neumann Hartmut P.H. , Januszewicz Andrzej
Published: March 2015

Aims: The aim of this study was to assess the usefulness of somatostatin receptor scintigraphy (SRS) using 99mTc-[HYNIC, Tyr3]-octreotide (TOC) and 123I-metaiodobenzylguanidine (mIBG) in patients with SDHx-related syndromes in which paragangliomas were detected by computed tomography and to establish an optimal imaging diagnostic algorithm in SDHx mutation carriers. Methods: All carriers with clinical and radiological findings suggesting paragangliomas were screened by SRS and 123I-mIBG. Lesions were classified by body regions, i.e. head and neck, chest, abdomen with pelvis and adrenal gland as well as metastasis. Results: We evaluated 46 SDHx gene mutation carriers (32 index cases and 14 relatives; 28 SDHD, 16 SDHB and 2 SDHC). In this group, 102 benign tumors were found in 39 studied patients, and malignant disease was diagnosed in 7 patients. In benign tumors, the sensitivity of SRS was estimated at 77% and of 123I-mIBG at 22.0%. The SRS and mIBG sensitivity was found to be clearly region dependent (p < 0.001). The highest SRS sensitivity was found in head and neck paragangliomas (HNP; 91.4%) and the lowest was found in abdominal paragangliomas and pheochromocytomas (40 and 42.9%, respectively). The highest 123I-mIBG sensitivity was found in pheochromocytomas (sensitivity of 100%) and the lowest in HNP (sensitivity of 3.7%). In metastatic disease, SRS was superior to mIBG (sensitivity of 95.2 vs. 23.8%, respectively). Conclusion: SRS and 123I-mIBG single photon emission computed tomography (SPECT) sensitivity in SDHx patients is highly body region dependent. In malignant tumors, SRS is superior to 123I-mIBG SPECT.
Outcomes After Acute Ischemic Stroke in the United States: Does Residential ZIP Code Matter?
Authors: Agarwal Shikhar , Menon Venu , Jaber Wael A.
Published: March 2015

Background

We sought to analyze the impact of socioeconomic status (
SES
) on in‐hospital outcomes, cost of hospitalization, and resource use after acute ischemic stroke.

Methods and Results

We used the 2003–2011 Nationwide Inpatient Sample database for this analysis. All admissions with a principal diagnosis of acute ischemic stroke were identified by using International Classification of Diseases, Ninth Revision codes.
SES
was assessed by using median household income of the residential
ZIP
code for each patient. Quartile 1 and quartile 4 reflect the lowest‐income and highest‐income
SES
quartile, respectively. During a 9‐year period, 775 905 discharges with acute ischemic stroke were analyzed. There was a progressive increase in the incidence of reperfusion on the first admission day across the
SES
quartiles (P‐trend<0.001). In addition, we observed a significant reduction in discharge to nursing facility, across the
SES
quartiles (P‐trend<0.001). Although we did not observe a significant difference in in‐hospital mortality across the
SES
quartiles in the overall cohort (P‐trend=0.22), there was a significant trend toward reduced in‐hospital mortality across the
SES
quartiles in younger patients (<75 years) (P‐trend<0.001). The mean length of stay in the lowest‐income quartile was 5.75 days, which was significantly higher compared with other
SES
quartiles. Furthermore, the mean adjusted cost of hospitalization among quartiles 2, 3, and 4, compared with quartile 1, was significantly higher by $621, $1238, and $2577, respectively. Compared with the lowest‐income quartile, there was a significantly higher use of echocardiography, invasive angiography, and operative procedures, including carotid endarterectomy, in the highest‐income quartile.

Conclusions

Patients from lower‐income quartiles had decreased reperfusion on the first admission day, compared with patients from higher‐income quartiles. The cost of hospitalization of patients from higher‐income quartiles was significantly higher than that of patients from lowest‐income quartiles, despite longer hospital stays in the latter group. This might be partially attributable to a lower use of key procedures among patients from lowest‐income quartile.