bluuebunny/crossref_metadata_2025 huggingface dataset:
Multidisciplinary Team Developed and Implemented Protocols to Assist Mechanical Ventilation Weaning: A Systematic Review of Literature
Authors: White Vicki , Currey Judy , Botti Mari
Published: August 2010

Aim: The aim of this review was to determine if ventilation‐weaning protocols developed and implemented by multidisciplinary teams (MDTs) reduced the duration of mechanical ventilation in adult intensive care patients compared to usual care.

Method: A systematic review was conducted to review published research studies from January 1999 to June 2009 to identify and analyse the best available evidence on MDT‐based weaning protocols in adult intensive care patients. All relevant studies based on electronic searches of MEDLINE, EMBASE, CINAHL, the Cochrane Controlled Trials Registry and the Cochrane Database of Systematic Reviews were included. Where possible data were pooled and a meta‐analysis performed. A narrative synthesis of data was conducted to provide a critical appraisal of nonrandomised controlled trials included in the review.

Results: Three pre‐ and postinterventional studies were identified for inclusion in this review. Results show equivocal support for weaning protocols developed and implemented by MDTs for reducing duration of mechanical ventilation.

Conclusion: Communication and organizational processes must be addressed for multidisciplinary protocols to be effective. Due to methodological limitations of included studies, large randomised controlled trials are required to provide high‐level evidence of the effects of MDT‐based protocols on duration of mechanical ventilation.
Proteoglycans in health and disease: the multiple roles of syndecan shedding
Authors: Manon‐Jensen Tina , Itoh Yoshifumi , Couchman John R.
Published: August 2010

Proteolytic processes in the extracellular matrix are a major influence on cell adhesion, migration, survival, differentiation and proliferation. The syndecan cell‐surface proteoglycans are important mediators of cell spreading on extracellular matrix and respond to growth factors and other biologically active polypeptides. The ectodomain of each syndecan is constitutively shed from many cultured cells, but is accelerated in response to wound healing and diverse pathophysiological events. Ectodomain shedding is an important regulatory mechanism, because it rapidly changes surface receptor dynamics and generates soluble ectodomains that can function as paracrine or autocrine effectors, or competitive inhibitors. It is known that the family of syndecans can be shed by a variety of matrix proteinase, including many metzincins. Shedding is particularly active in proliferating and invasive cells, such as cancer cells, where cell‐surface components are continually released. Here, recent research into the shedding of syndecans and its physiological relevance are assessed.
Proteoglycans in health and disease: new concepts for heparanase function in tumor progression and metastasis
Authors: Barash Uri , Cohen‐Kaplan Victoria , Dowek Ilana , Sanderson Ralph D. , Ilan Neta , Vlodavsky Israel
Published: August 2010

Heparanase is an endo‐β‐d‐glucuronidase capable of cleaving heparan sulfate side chains at a limited number of sites, yielding heparan sulfate fragments of still appreciable size. Importantly, heparanase activity correlates with the metastatic potential of tumor‐derived cells, attributed to enhanced cell dissemination as a consequence of heparan sulfate cleavage and remodeling of the extracellular matrix and basement membrane underlying epithelial and endothelial cells. Similarly, heparanase activity is implicated in neovascularization, inflammation and autoimmunity, involving the migration of vascular endothelial cells and activated cells of the immune system. The cloning of a single human heparanase cDNA 10 years ago enabled researchers to critically approve the notion that heparan sulfate cleavage by heparanase is required for structural remodeling of the extracellular matrix, thereby facilitating cell invasion. Progress in the field has expanded the scope of heparanase function and its significance in tumor progression and other pathologies. Notably, although heparanase inhibitors attenuated tumor progression and metastasis in several experimental systems, other studies revealed that heparanase also functions in an enzymatic activity‐independent manner. Thus, inactive heparanase was noted to facilitate adhesion and migration of primary endothelial cells and to promote phosphorylation of signaling molecules such as Akt and Src, facilitating gene transcription (i.e. vascular endothelial growth factor) and phosphorylation of selected Src substrates (i.e. endothelial growth factor receptor). The concept of enzymatic activity‐independent function of heparanase gained substantial support by the recent identification of the heparanase C‐terminus domain as the molecular determinant behind its signaling capacity. Identification and characterization of a human heparanase splice variant (T5) devoid of enzymatic activity and endowed with protumorigenic characteristics, elucidation of cross‐talk between heparanase and other extracellular matrix‐degrading enzymes, and identification of single nucleotide polymorphism associated with heparanase expression and increased risk of graft versus host disease add other layers of complexity to heparanase function in health and disease.
RETRACTED: Comparative proteomic analysis identifies proteins associated with the development and progression of colorectal carcinoma
Authors: Zhao Liang , Wang Hui , Sun Xuegang , Ding Yanqing
Published: August 2010

To better understand the mechanism underlying colorectal carcinoma (CRC) genesis or metastasis, and to search for potential markers for CRC prognosis, a comparative proteomic analysis was performed on CRC tissue. Proteins were extracted from normal colorectal mucosa, non‐metastatic CRC (nmCRC) and metastatic CRC (mCRC) tissue samples. Protein profiling of each sample was performed by two‐dimensional electrophoresis coupled with MALDI‐TOF MS, followed by confirmation by Western blotting. Thirty‐one proteins were found to be differentially expressed between normal mucosa, nmCRC and mCRC tissue. In 126 paraffin‐embedded CRC samples, three differentially expressed proteins, identified as LASP‐1, S100A9 and RhoGDI by proteomic analysis, were detected by immunohistochemical staining to determine the clinicopathological characteristics of these proteins in CRC. Increased expression levels of these proteins were found in CRC, especially mCRC, compared with normal mucosa. The results provide the basis for searching for potential markers for CRC genesis and metastasis, and also provide clues for elucidating the mechanism of CRC progression. The pattern changes identified have the potential to be used for the design of marker panels for assistance in diagnostic and therapeutic strategies in CRC.
Crystal structures of isomaltase from Saccharomyces cerevisiae and in complex with its competitive inhibitor maltose
Authors: Yamamoto Keizo , Miyake Hideo , Kusunoki Masami , Osaki Shigeyoshi
Published: August 2010

The structures of isomaltase from Saccharomyces cerevisiae and in complex with maltose were determined at resolutions of 1.30 and 1.60 Å, respectively. Isomaltase contains three domains, namely, A, B, and C. Domain A consists of the (β/α)8‐barrel common to glycoside hydrolase family 13. However, the folding of domain C is rarely seen in other glycoside hydrolase family 13 enzymes. An electron density corresponding to a nonreducing end glucose residue was observed in the active site of isomaltase in complex with maltose; however, only incomplete density was observed for the reducing end. The active site pocket contains two water chains. One water chain is a water path from the bottom of the pocket to the surface of the protein, and may act as a water drain during substrate binding. The other water chain, which consists of six water molecules, is located near the catalytic residues Glu277 and Asp352. These water molecules may act as a reservoir that provides water for subsequent hydrolytic events. The best substrate for oligo‐1,6‐glucosidase is isomaltotriose; other, longer‐chain, oligosaccharides are also good substrates. However, isomaltase shows the highest activity towards isomaltose and very little activity towards longer oligosaccharides. This is because the entrance to the active site pocket of isomaltose is severely narrowed by Tyr158, His280, and loop 310–315, and because the isomaltase pocket is shallower than that of other oligo‐1,6‐glucosidases. These features of the isomaltase active site pocket prevent isomalto‐oligosaccharides from binding to the active site effectively.
Association of RNase L with a Ras GTPase‐activating‐like protein IQGAP1 in mediating the apoptosis of a human cancer cell‐line
Authors: Sato Akira , Naito Tomoharu , Hiramoto Akiko , Goda Kazato , Omi Takuya , Kitade Yukio , Sasaki Takuma , Matsuda Akira , Fukushima Masakazu , Wataya Yusuke , Kim Hye‐Sook
Published: August 2010

Mammalian intracellular ribonuclease L (RNase L) is a latent endoribonuclease that functions against viral infections as an apoptosis‐inducing protein, and its activity requires intracellular 5′‐end‐triphosphorylated‐2′,5′ oligoadenylates (2‐5A) as an activator. Previously, we showed that RNase L can be activated in human cancer cell line HT1080 by an RNA polymerase I inhibitor, 1‐(3‐C‐ethynyl‐β‐d‐ribo‐pentofuranosyl)cytosine (3′‐ethynylcytidine; ECyd). In ECyd‐treated cells, knockdown of the RNase L resulted in a marked decrease in c‐jun N‐terminal kinase (JNK) phosphorylation, thereby inhibiting apoptosis. We investigate RNase L binding partners by focused proteomic approach using immunoprecipitation with anti‐RNase L IgG and mass spectrometry. We found that the IQ motif‐containing Ras GTPase‐activating‐like protein 1 (IQGAP1) can associate with RNase L, and that phosphorylation occurs on the IQGAP1. ECyd‐induced JNK phosphorylation and apoptosis were inhibited when IQGAP1 was knocked down with a small interfering RNA. These results raise the interesting possibility that the RNase L–IQGAP1 association may regulate JNK phosphorylation in RNase L‐madiated apoptosis. It is likely IQGAP1 works as a regulator in apoptosis.

Structured digital abstract

MINT‐7990574: RNaseL (uniprotkb:Q05823) physically interacts (MI:0914) with Kinesin‐like protein KIF23 (uniprotkb:Q02241) and Ras GTPase‐activating‐like protein IQGAP1 (uniprotkb:P46940) by anti bait coimmunoprecipitation (MI:0006)

MINT‐7990598: RNaseL (uniprotkb:Q05823) physically interacts (MI:0915) with IQGAP1 (uniprotkb:P46940) by anti bait coimmunoprecipitation (MI:0006)
Quality of life and sexual function of women with urinary incontinence
Authors: OZKAN Sevgi , OGCE Filiz , CAKIR Dilek
Published: August 2010

Aim:  The aim of this study was to examine the urinary incontinence (UI) types on the sexual function and quality of life (QOL) of women with UI and the correlation between sexual function and QOL.

Methods:  The sample for this descriptive study was comprised of 122 women who presented to obstetrics and gynecology and urology outpatient clinics at university hospitals in Denizli and Izmir, Turkey, who had UI, who were sexually active, who volunteered to participate in the study, and who were chosen by a convenience sampling method. A sociodemographic data collection form, the Female Sexual Function Index (FSFI), and the Incontinence Quality of Life (I‐QOL) questionnaire were used for data collection in the study.

Results:  The mixed type of incontinence had an effect on the women's quality of life, mixed and stress incontinence affected the FSFI's pain subscale, and the total sexual functioning score was lower for the women with mixed incontinence. Even though the correlation values were low, it was clear that there was a positive correlation between sexual function and quality of life.

Conclusions:  Among the incontinence types, a significant difference was determined by the FSFI and I‐QOL. Urinary incontinence seems to be the predictor of sexual function and quality of life. As a result, a comprehensive assessment of patients with UI is recommended because this condition has a negative influence on their sexual function and quality of life.
The Impact of Erectile Dysfunction on the Quality of Life of Men Undergoing Hemodialysis and Its Association with Depression
Authors: Fernandes Gisele Vajgel , Dos Santos Rondineli Roberto , Soares Waldênio , De Lima Louize Gomes , De Macêdo Breno Santiago , Da Fonte João Eduardo , De Carvalho Bruno Silva Peixoto , Coelho Sandra Neiva , Calado Adriano Almeida
Published: August 2010

Introduction

Erectile dysfunction (ED) is highly prevalent among men undergoing hemodialysis.

Aim

This study was performed to identify the influence of ED on the patient’s quality of life (QoL) and to evaluate the influence of depression on erectile function of these patients.

Main Outcome Measures

For this multicenter cross-sectional study, 275 patients were interviewed through questionnaires: the five-item version of the International Index of Erectile Function was used for diagnosing and classifying ED; the Medical Outcomes Study Questionnaire 36-Item Short Form Health Survey (SF-36) for scoring QoL; and the Hospital Anxiety and Depression Scale (HADS) to evaluate depressive symptoms. Linear regression was used to examine the associations between some of the variables and ED. Predialytic biochemical and hematological parameters were determined during the longer interdialytic period.

Results

Patients had a mean age of 48.6 ± 12.8 years, and the ED prevalence was 72.3%. Advanced age, diabetes and depression score were independent risk factors for the development of ED as confirmed by linear regression (P <0.001, P = 0.002, and P <0.001, respectively). QoL was worse among patients with any degree of ED, and the scores were statistically significant for overall health rating (P = 0.016), physical composite score (P = 0.003), bodily pain (P = 0.042), physical functioning (P <0.001), and vitality (P = 0.005). Furthermore, more severe forms of ED were associated with a lower QoL. After adjustment for some variables, such as age, time under dialysis, hemoglobin, albumin, parathyroid hormone, Kt/V, and depression, linear regression showed that domains related to poorer physical functioning (P = 0.047) and decreased vitality (P = 0.009) were significantly related to ED.

Conclusion

Depression is an important trigger for the development of ED in hemodialysis patients, and this sexual condition is an independent risk factor for their poor QoL.
Efficacy and Safety of an Orodispersible Vardenafil Formulation for the Treatment of Erectile Dysfunction in Elderly Men and Those with Underlying Conditions: An Integrated Analysis of Two Pivotal Trials
Authors: Sperling Herbert , Gittelman Marc , Norenberg Christiane , Ulbrich Ernst , Ewald Silke
Published: August 2010

Introduction

Men with erectile dysfunction (ED) are typically older and have one or more underlying cardiovascular conditions.

Aim

To determine the efficacy and safety of a new orodispersible tablet (ODT) formulation of vardenafil for the treatment of ED, and whether age, or the presence of underlying conditions affects treatment outcomes.

Methods

This is an integrated analysis of data from two phase III, double-blind, multicenter, randomized, parallel-group, placebo-controlled studies that compared 10 mg on-demand vardenafil ODT with placebo in a general population of men with ED, stratified so that approximately 50% of patients were aged ≥65 years. Results were reported by age (<65 vs. ≥65 years) and presence/absence of diabetes, dyslipidemia, or hypertension.

Main Outcome Measures

Primary measures were the erectile function domain of the International Index of Erectile Function (IIEF-EF) and Sexual Encounter Profile questions 2 (SEP2) and 3 (SEP3).

Results

Of the 701 men randomized (51% aged ≥65 years), 686 were included in the intent-to-treat population (placebo, n = 334; vardenafil ODT, n = 352). Vardenafil ODT was significantly superior to placebo for all primary efficacy measures, regardless of age, baseline ED severity, or underlying condition (P < 0.0001 for vardenafil vs. placebo for each endpoint). IIEF-EF scores and SEP2/3 success rates in older patients and men with underlying conditions were not significantly different to those of younger patients or men without underlying conditions. Adverse events (AEs) were mostly mild to moderate in severity, occurring with higher incidence in the vardenafil vs. placebo group. The most frequently reported drug-related AEs in the vardenafil group were headache, flushing, nasal congestion, dizziness, and dyspepsia, consistent with the known safety profile of phosphodiesterase type 5 inhibitors.

Conclusions

Vardenafil ODT significantly improves erectile function in men with ED regardless of age, baseline ED severity, or underlying condition.
The Female Factor: Predicting Compliance with a Post-Prostatectomy Erectile Preservation Program
Authors: Moskovic Daniel J. , Mohamed Osama , Sathyamoorthy Kumaran , Miles Brian J. , Link Richard E. , Lipshultz Larry I. , Khera Mohit
Published: August 2010

Introduction

Early post-radical prostatectomy (RP) erectile preservation (EP) therapy may be critical to preserve erections after surgery.

Aim

To assess if pre-RP female sexual function predicts of partner compliance with an EP protocol.

Main Outcome Measures

Compliance, defined as use of localized penile EP therapy (intracavernosal injections [ICIs], vacuum erection device [VED], or alprostadil) at 3 and 6 months after RP.

Methods

Records of patients enrolled in our EP program from April 2007 to June 2008 were reviewed. Before surgery, patients completed the Sexual Health Inventory for Men (SHIM) and their female partners completed the Female Sexual Function Index (FSFI) questionnaire. Prior to surgery, patients were advised to take sildenafil 25 mg every nightly and use a 250-µg alprostadil suppository three times/week. At 1 month, additional daily use of a VED was encouraged. All patients unable to achieve erections sufficient for penetration were encouraged to initiate ICI of Trimix (phentolamine, papaverine, and PGE1) twice weekly after 3 months following surgery. Data were analyzed using binary logistic regression analysis holding all input variables constant.

Results

Twenty-nine patients had preoperative SHIM > 7 and pre-RP partner FSFI data available. After a 4-week follow-up, compliance with alprostadil suppository declined and both ICI and VED usage increased. At 6 months, six (25.0%) patients had return of natural erectile function and 22 (91.7%) were achieving assisted erections. Higher preoperative partner FSFI scores were associated with greater compliance to the localized penile therapy component of our EP protocol (risk ratio 3.8, P = 0.05).

Conclusions

Preoperative female sexual function correlated with greater partner compliance with the localized component of our EP protocol. Consideration of a female partner’s preoperative sexual function in predicting patient erectile function recovery after RP is warranted. Future studies are necessary to determine the clinical significance of this factor.
Validation of the Sexual Interest and Desire Inventory-Female in Hypoactive Sexual Desire Disorder
Authors: Clayton Anita H. , Goldmeier David , Nappi Rossella E. , Wunderlich Glen , Lewis-D’Agostino Diane J. , Pyke Robert
Published: August 2010

Introduction

The Sexual Interest and Desire Inventory-Female (SIDI-F) is a 13-item scale developed as a clinician-administered assessment tool to measure hypoactive sexual desire disorder (HSDD) severity in women.

Aim

To estimate the reliability and validity of the SIDI-F as a measure of HSDD severity.

Methods

Women, aged 18–65 years, with primary HSDD, Female Sexual Arousal Disorder (FSAD), or no Female Sexual Dysfunction (no FSD) participated in two nontreatment studies (in North America and Europe). On days 0 and 28, subjects were assessed using the SIDI-F, Female Sexual Function Index (FSFI), Changes in Sexual Functioning Questionnaire-Female (CSFQ-F), Locke–Wallace Marital Adjustment Test (MAT) and the Female Sexual Distress Scale (FSDS).

Main Outcome Measures

Discriminant validity, convergent validity, divergent validity, test–retest validity, and internal consistency of the SIDI-F.

Results

The North American study enrolled women with HSDD (N=113), FSAD (N=49) and no FSD (N=61); the European study enrolled women with HSDD (N=130) and no FSD (N=124). In both studies, mean SIDI-F total score for women with HSDD was lower than for those with no FSD (P <0.001, for all) demonstrating discriminant validity. Further, mean SIDI-F total score for women with HSDD was lower than for those with FSAD in the North American study (P <0.001). Convergent validity with the FSFI and CSFQ-F and divergent validity with MAT were demonstrated. Test–retest reliability and internal consistency were high.

Conclusions

The SIDI-F is a valid and reliable measure of HSDD severity in women.
Ultrastructure of sequestered chloroplasts in sacoglossan gastropods with differing abilities for plastid uptake and maintenance
Authors: Curtis Nicholas E. , Schwartz Julie A. , Pierce Sidney K.
Published: August 2010

Abstract.Many sacoglossan sea slugs incorporate intact, functional chloroplasts from their algal food sources into specialized cells lining the digestive diverticulum. The chloroplasts in adults ofElysia clarkiare photosynthetically functional for many months. Members of this species feed on algae in the Ulvophyceae, including species ofPenicillusandBryopsis. However, other sacoglossans (Elysia patina, Elysia rufescens, andPlacida kingstoni) use similar algal food sources as do adults ofE. clarki, but are unable to maintain the chloroplasts for more than a week, with individuals ofP. kingstoniapparently being unable to maintain chloroplasts for >24 h. We have examined chloroplast sequestering cells of these species looking for morphological differences that may help explain the variation in chloroplast sequestration and maintenance among them. Our results indicate thatP. kingstonidoes not actively sequester chloroplasts at all, digesting them instead. However, the plastid sequestering mechanisms of individuals ofE. patinaandE. rufescensare similar to those ofE. clarki, and the degradation of chloroplasts by specimens ofE. patinais ultrastructurally similar to the same process inE. clarki, although chloroplast degradation occurs much more slowly in individuals ofE. clarki. Our results suggest that species‐level differences in the digestive capability of the phagosomes involved in the uptake of chloroplasts account for variation in the length of these kleptoplastic associations.
Research Article: Synthetic Peptide Vaccine Development: Designing Dual Epitopes into a Single Pilin Peptide Immunogen Generates Antibody Cross‐reactivity between Two Strains of Pseudomonas aeruginosa
Authors: Hackbarth Clifton , Hodges Robert S.
Published: August 2010

One of the main challenges of Pseudomonas aeruginosa vaccine development is the design of an antigen that elicits cross‐reactive antibodies against multiple virulent strains. Using a rational design approach, we have developed a single 17‐residue peptide immunogen that generates antibodies that target the receptor‐binding domain of the type IV pilus of more than one strain of P. aeruginosa. Using the receptor‐binding domain sequence, of native strain PAO as a template, we have systematically changed up to five residues in the PAO sequence of the peptide immunogen into that of the PAK sequence. We show by indirect and competitive ELISA that the mutant peptide immunogens elicit the development of polyclonal sera that is cross‐reactive to both native strain PAO and PAK pilin. We further show that there are at least two separate antibody populations in the polyclonal sera that possess closely related epitopes but which are each strain specific. Moreover, part of the epitope for the PAO‐specific antibodies consists of several residues outside the disulfide loop of the receptor‐binding domain. This allows us to create two unique epitopes within the same receptor‐binding domain sequence.
Research Article: Quantitative Sequence–Kinetics Relationship in Antigen–Antiboby Interaction Kinetics Based on a Set of Descriptors
Authors: Rong‐Kai Xie , Hai‐Xia Long , Xiao‐Ming Cheng , Yuan‐Qiang Wang , Yong Lin , Ying Yang , Bo Zhu , Zhi‐Hua Lin
Published: August 2010

The interaction between recombinant Fab57P and the coat protein of tobacco mosaic virus was studied using quantitative structure–activity relationship (QSAR) method. The development of quantitative multivariate model has shown to be a promising approach for unraveling protein–protein interactions by designed mutations in peptide sequence. This approach makes it possible to stereo‐chemically determine which residue properties contribute most to the interaction. A set of side‐chain descriptors was proposed and applied in structural characterization of three positions (positions 142, 145 and 146) in the peptide antigen. Quantitative sequence–kinetics relationship (QSKR) models describing the dissociation rates (log kd) were developed successfully using orthogonal signal correction–partial least squares method. The results showed that peptides will have high log kd values when the amino acids in position 142 and 145 have high net charge index, and when residue 145 has high hydrophobicity and residue 146 has low hydrophobicity.
State entrapment
Authors: Ho Hock Lai
Published: August 2010

This paper addresses a cluster of issues. What is state entrapment? Why is it objectionable? Is it wrong to prosecute the entrapped? What should the court do when the case is brought before it? These questions are intertwined. To know what is wrong with state entrapment, we must be clear about what it is; our understanding of what constitutes state entrapment, with its negative connotation, is shaped by what we think is distinctively wrong with it; and, we cannot know how the court should deal with state entrapment unless we identify the precise problem to which a judicial response may be required. The right response is a permanent stay of proceedings. A stay should be granted because the executive does not come to court with clean hands. It lacks the standing to blame the entrapped for what he or she did, and the state lacks the standing to condemn the person for the same.
Renewed Interest in Chlorthalidone: Evidence From the Veterans Health Administration
Authors: Ernst Michael E. , Lund Brian C.
Published: August 2010

J Clin Hypertens (Greenwich).

Thiazide‐type diuretics are recommended in national hypertension treatment guidelines, but these guidelines do not give preference to a specific thiazide. Recently, increased use of chlorthalidone has been advocated. The authors reviewed national outpatient prescription data from the Veterans Health Administration from 2003 to 2008 to describe the prescribing trends within the thiazide class, focusing on hydrochlorothiazide and chlorthalidone. Among total thiazide users, the proportion who received hydrochlorothiazide remained stable (95.6% in 2008), but the number of new users of hydrochlorothiazide decreased nearly 30% during this period. In contrast, the proportion of chlorthalidone use among total thiazide users more than doubled (1.1% in 2003 to 2.4% in 2008), and the number of new chlorthalidone users increased by more than 40%. At the time of initiation, chlorthalidone was more likely to be added to an existing antihypertensive regimen; one quarter (25.1%) of new hydrochlorothiazide starts were in patients not receiving concurrent antihypertensive medications, compared with only 12.1% for chlorthalidone (odds ratio, 0.44; 95% confidence interval, 0.42–0.46). Evaluation of national prescribing trends indicates that hydrochlorothiazide remains the most commonly prescribed thiazide, but there appears to be a shift toward more new users of chlorthalidone. J Clin Hypertens (Greenwich). 2010;12:927–934. © 2010 Wiley Periodicals, Inc.
Non‐surgical palatal expansion in adult patient: a clinical case report
Authors: Pithon M.M.
Published: August 2010

Aim:  The objective of the present study was to report a case of non‐surgical palatal expansion in an adult patient.

Report of case:  A Hyrax‐type expander was mounted onto the six upper teeth of the patient who was instructed to activate the orthodontic appliance twice a day at 12 h intervals.

Results:  After 15 days, suture separation was observed, which was confirmed by the presence of midline diastema and widening of the radiolucent image of the suture on occlusal radiograph. Based on this observation, the appliance was further activated for 7 days, thus totalising 21 days of activation and expander screw opening of 10.5 mm.

Conclusion:  One can conclude that in specific cases, it is possible to obtain an opening of the midpalatal suture in adult patients, thus avoiding surgical procedures.
Symptoms related to glaucomatous visual field abnormalities among male Japanese workers in a population‐based setting
Authors: Tatemichi Masayuki , Nakano Tadashi , Hayashi Takeshi , Tanaka Katsutoshi , Hiro Hisanori , Miyamoto Toshiaki , Aratake Miho , Nishinoue Norihide , Yamazaki Akira , Nakadate Toshio , Sugita Minoru
Published: August 2010

Purpose:  To identify symptoms potentially related to glaucomatous visual field abnormalities (VFAs) in a population‐based setting, and to assess the applicability of using these symptoms to identify persons at risk of developing glaucoma.

Methods:  In this study, 10 214 Japanese male general workers (mean age, 45.3 ± 8.8 years) filled out a self‐administered questionnaire and underwent frequency doubling technology (FDT) perimetry testing. The questionnaire inquired about whether the participant was suffering from any of nine symptoms, with scores for each response graded on a four‐item Likert scale: 0 (none), 1 (rarely), 2 (sometimes), and 3 (always). Results from the questionnaire were compared among three groups: participants without any VFAs (9767), participants with VFAs as determined by the FDT test (FDT‐VFA; 447), and 227 participants (of the 447 FDT‐VFA participants) with glaucomatous VFAs who were newly diagnosed by ophthalmologic examinations.

Results:  The mean summed scores for the total items were significantly (p < 0.01) higher in FDT‐ and glaucomatous VFA groups than in normal subjects. In particular, responses citing the symptoms ‘feeling of something in the front of the eye’ and ‘feeling of hardness to see in dark places’ were significantly (p < 0.05) more frequent in subjects with FDT‐ and glaucomatous VFAs than among normal participants. However, the respective areas under the receiver operating characteristic curve of summed scores for the nine total items and for the two items which showed significant differences for the glaucoma groups were 0.57 (95% confidence interval = 0.53–0.60) and 0.58 (95% confidence interval = 0.54–0.61).

Conclusion:  Although the symptoms ‘feeling of hardness to see in dark places’ and ‘feeling of something in the front of the eye’ could be associated with glaucomatous VFA in a population‐based setting, inquiring about symptoms is of little aid in identifying subjects with glaucomatous VFA as a strategy for public health.
Thladiantha tomentosa (Cucurbitaceae) comb. nov. from southwestern China
Authors: Jiang Wei , Li De‐Zhu , Wang Hong
Published: August 2010

In this paper, we propose that Thladiantha cordifolia (Blume) Cogn. var. tomentosa A. M. Lu & Z. Y. Zhang should be recognized at species rank as Thladiantha tomentosa (A. M. Lu & Z. Y. Zhang) W. Jiang & H. Wang. This species is similar to T. cordifolia and T. angustisepala W. J. de Wilde & Duyfjes, from which it differs mainly by having ovate bracts, linear sepals, and ellipsoidal, rostrate, ribbed verrucose fruits.
Animal Health Policy Principles for Highly Pathogenic Avian Influenza: Shared Experience from China and Canada
Authors: Stephen C. , Ninghui L. , Yeh F. , Zhang L.
Published: August 2010

Animal health policy for highly pathogenic avian influenza (HPAI) must, for the time being, be based on expert opinion and shared international experience. We used the intellectual capital and knowledge of experienced Chinese and Canadian practitioners and policy makers to inform policy options for China and find shared policy elements applicable to both countries. No peer‐reviewed comprehensive evaluations or systematic regulatory impact assessments of animal health policies were found. Sixteen guiding policy principles emerged from our thematic analysis of Chinese and Canadian policies. We provide a list of shared policy goals, targets and elements for HPAI preparedness, response and recovery. Policy elements clustered in a manner consistent with core public health competencies. Complex situations like HPAI require complex and adaptive policies, yet policies that cross jurisdictions and are fully integrated across agencies are rare. We encourage countries to develop or deploy capacity to undertake and publish regulatory impact assessments and policy evaluation to identify policy needs and provide a basis for evidence‐based policy development.
Differential Pricing for Information Sharing Under Competition
Authors: Jain Aditya , Seshadri Sridhar , Sohoni Milind
Published: August 2010

We consider a two‐echelon supply chain with a manufacturer supplying to multiple downstream retailers engaged in differentiated Cournot competition. Each retailer has private information about uncertain demand. The manufacturer is the Stackelberg leader who sets the contract terms with the retailers, and benefits from retailers sharing their private information. When all retailers are given the same wholesale price, truthful information sharing is not an equilibrium outcome. We propose two variants of differential pricing mechanisms that induce truthful information sharing by all retailers. The first variant rewards a retailer for providing optimistic information and achieves truthful information sharing as a unique equilibrium. The differential pricing mechanism is optimal in the class of linear‐price, incentive‐compatible, direct mechanisms. The second variant, which incorporates provision for a fixed payment in addition to wholesale prices, preserves all the equilibrium properties of the first variant and additionally “nearly coordinates” the supply chain. Our analysis of differential pricing with a fixed payment provides interesting observations regarding the relationship between product substitutability, number of retailers, information precision, and market power. As products become closer substitutes and/or number of retailers increase, the manufacturer's market power increases, enabling her to extract a larger fraction of the supply chain surplus.
Proton irradiation effects on AlN/GaN high electron mobility transistors
Authors: Lo C. F. , Chang C. Y. , Chu B. H. , Kim H.-Y. , Kim J. , Cullen David A. , Zhou Lin , Smith David. J. , Pearton S. J. , Dabiran Amir , Cui B. , Chow P. P. , Jang S. , Ren F.
Published: August 2010

AlN/GaN high electron mobility transistors (HEMTs) were irradiated with 5 MeV protons at fluences from 2×1011 to 2×1015 protons/cm2. Changes from 10% to 35% of the saturation drain current and the source-drain resistances were observed for the HEMTs exposed to the proton irradiations due to radiation-induced carrier scattering and carrier removal. Both forward and reverse bias gate currents were increased after proton irradiation and affected the drain current modulation in the positive gate bias voltage range. There was almost no gate-lag observed for the HEMT exposed to 2×1011 protons/cm2 irradiation and minimal changes for the higher doses, which implied that few surface traps were created by the high energy proton irradiation.
Spatially weighted mutual information image registration for image guided radiation therapy
Authors: Park Samuel B. , Rhee Frank C. , Monroe James I. , Sohn Jason W.
Published: August 2010

Purpose:

To develop a new metric for image registration that incorporates the (sub)pixelwise differential importance along spatial location and to demonstrate its application for image guided radiation therapy (IGRT).

Methods:

It is well known that rigid‐body image registration with mutual information is dependent on the size and location of the image subset on which the alignment analysis is based [the designated region of interest (ROI)]. Therefore, careful review and manual adjustments of the resulting registration are frequently necessary. Although there were some investigations of weighted mutual information (WMI), these efforts could not apply the differential importance to a particular spatial location since WMI only applies the weight to the joint histogram space. The authors developed the spatially weighted mutual information (SWMI) metric by incorporating an adaptable weight function with spatial localization into mutual information. SWMI enables the user to apply the selected transform to medically “important” areas such as tumors and critical structures, so SWMI is neither dominated by, nor neglects the neighboring structures. Since SWMI can be utilized with any weight function form, the authors presented two examples of weight functions for IGRT application: A Gaussian‐shaped weight function (GW) applied to a user‐defined location and a structures‐of‐interest (SOI) based weight function. An image registration example using a synthesized 2D image is presented to illustrate the efficacy of SWMI. The convergence and feasibility of the registration method as applied to clinical imaging is illustrated by fusing a prostate treatment planning CT with a clinical cone beam CT (CBCT) image set acquired for patient alignment. Forty‐one trials are run to test the speed of convergence. The authors also applied SWMI registration using two types of weight functions to two head and neck cases and a prostate case with clinically acquired CBCT/MVCT image sets. The SWMI registration with a Gaussian weight function (SWMI‐GW) was tested between two different imaging modalities: CT and MRI image sets.

Results:

SWMI‐GW converges 10% faster than registration using mutual information with an ROI. SWMI‐GW as well as SWMI with SOI‐based weight function (SWMI‐SOI) shows better compensation of the target organ's deformation and neighboring critical organs’ deformation. SWMI‐GW was also used to successfully fuse MRI and CT images.

Conclusions:

Rigid‐body image registration using our SWMI‐GW and SWMI‐SOI as cost functions can achieve better registration results in (a) designated image region(s) as well as faster convergence. With the theoretical foundation established, we believe SWMI could be extended to larger clinical testing.
Fast‐MICP for frameless image‐guided surgery
Authors: Lee Jiann‐Der , Huang Chung‐Hsien , Wang Sheng‐Ta , Lin Chung‐Wei , Lee Shin‐Tseng
Published: August 2010

Purpose:

In image‐guided surgery (IGS) systems, image‐to‐physical registration is critical for reliable anatomical information mapping and spatial guidance. Conventional stereotactic frame‐based or fiducial‐based approaches provide accurate registration but are not patient‐friendly. This study proposes a frameless cranial IGS system that uses computer vision techniques to replace the frame or fiducials with the natural features of the patient.

Methods:

To perform a cranial surgery with the proposed system, the facial surface of the patient is first reconstructed by stereo vision. Accuracy is ensured by capturing parallel‐line patterns projected from a calibrated LCD projector. Meanwhile, another facial surface is reconstructed from preoperative computed tomography (CT) images of the patient. The proposed iterative closest point (ICP)‐based algorithm [fast marker‐added ICP (Fast‐MICP)] is then used to register the two facial data sets, which transfers the anatomical information from the CT images to the physical space.

Results:

Experimental results reveal that the Fast‐MICP algorithm reduces the computational cost of marker‐added ICP (J.‐D. Lee et al., “A coarse‐to‐fine surface registration algorithm for frameless brain surgery,” in Proceedings of International Conference of the IEEE Engineering in Medicine and Biology Society, 2007, pp. 836–839) to 10% and achieves comparable registration accuracy, which is under 3 mm target registration error (TRE). Moreover, two types of optical‐based spatial digitizing devices can be integrated for further surgical navigation. Anatomical information or image‐guided surgical landmarks can be projected onto the patient to obtain an immersive augmented reality environment.

Conclusion:

The proposed frameless IGS system with stereo vision obtains TRE of less than 3 mm. The proposed Fast‐MICP registration algorithm reduces registration time by 90% without compromising accuracy.
The accuracy and safety aspects of a novel robotic needle guide manipulator to perform transrectal prostate biopsies
Authors: Schouten Martijn G. , Ansems Janneke , Renema W. Klaas Jan , Bosboom Dennis , Scheenen Tom W. J. , Fütterer Jurgen J.
Published: August 2010

Purpose:

To introduce a new in‐house developed pneumatically controlled magnetic field compatible manipulator as an aid to perform magnetic resonance (MR)‐guided biopsies of the prostate.

Methods:

A pneumatic controlled manipulator with five degrees of freedom constructed of plastic to achieve magnetic field compatibility was developed to guide biopsies. A risk analysis, mechanical tests, and RF safety tests with respect to needle tip heating were performed to assure future patient safety and to meet standard safety requirements for the use in a medical environment. The accuracy of needle positioning with the needle guide manipulator to sample a predefined target was measured in agar phantoms on a 3 T whole body MR system. The in‐plane error was used to evaluate the accuracy, which is defined as the orthogonal distance between target and biopsy needle. The time for each step in the biopsy procedure was recorded to evaluate the procedure time. The influence of the insertion angle with respect to the static field of the MR scanner on the needle artifact was investigated.

Results:

The risk analyses met patient safety requirements. No RF induced local heating around the needle tip was observed. The average in‐plane error in 19 measurements was 3.0 mm (range 0–5.6 mm). The average time needed for manipulation to place the needle guide in the desired position was 5 min (range 3–8 min). Total procedure time was 30 min. The needle artifact size increases with the insertion angle with respect to the static field of the MR scanner.

Conclusions:

The new MR compatible manipulator can be used safely for patient care. It showed a high accuracy and short total procedure time, demonstrating great potential to improve the transrectal prostate biopsy procedure.
Waveguide detuning caused by transverse magnetic fields on a simulated in‐line 6 MV linac
Authors: St. Aubin J. , Steciw S. , Fallone B. G.
Published: August 2010

Purpose:

Due to the close proximity of the linear accelerator (linac) to the magnetic resonance (MR) imager in linac‐MR systems, it will be subjected to magnet fringe fields larger than the Earth's magnetic field of. Even with passive or active shielding designed to reduce these fields, some magnitude of the magnetic field is still expected to intersect the linac, causing electron deflection and beam loss. This beam loss, resulting from magnetic fields that cannot be eliminated with shielding, can cause a detuning of the waveguide due to excessive heating. The detuning, if significant, could lead to an even further decrease in output above what would be expected strictly from electron deflections caused by an external magnetic field. Thus an investigation of detuning was performed through various simulations.

Methods:

According to the Lorentz force, the electrons will be deflected away from their straight course to the target, depositing energy as they impact the linac copper waveguide. The deposited energy would lead to a heating and deformation of the copper structure resulting in resonant frequency changes.PARMELA was used to determine the mean energy and fraction of total beam lost in each linac cavity. The energy deposited into the copper waveguide from the beam losses caused by transverse magnetic fields was calculated using the Monte Carlo program DOSRZnrc. From the total energy deposited, the rise in temperature and ultimately the deformation of the structure was estimated. The deformed structure was modeled using the finite element method program COMSOL MULTIPHYSICS to determine the change in cavity resonant frequency.

Results:

The largest changes in resonant frequency were found in the first two accelerating cavities for each field strength investigated. This was caused by a high electron fluence impacting the waveguide inner structures coupled with their low kinetic energies. At each field strength investigated, the total change in accelerator frequency was less than a manufacturing tolerance of 10 kHz and is thus not expected to have a noticeable effect on accelerator performance.

Conclusions:

The amount of beam loss caused by magnetic fringe fields for a linac in a linac‐MR system depends on the effectiveness of its magnetic shielding. Despite the best efforts to shield the linac from the magnetic fringe fields, some persistent magnetic field is expected which would result in electron beam loss. This investigation showed that the detuning of the waveguide caused by additional electron beam loss in persistent magnetic fields is not a concern.
Magnetic decoupling of the linac in a low field biplanar linac‐MR system
Authors: St. Aubin J. , Steciw S. , Fallone B. G.
Published: August 2010

Purpose:

The integration of a low field biplanar magnetic resonance (MR) imager and linear accelerator (linac) causes magnetic interference at the linac due to the MR fringe fields. In order to eliminate this interference, passive and active magnetic shielding designs are investigated.

Methods:

The optimized design of passive magnetic shielding was performed using the finite element method. The design was required to achieve no greater than a 20% electron beam loss within the linac waveguide and electron gun, no greater than 0.06 T at the multileaf collimator (MLC) motors, and generate a distortion of the main MR imaging volume of no greater than 300 ppm. Through the superposition of the analytical solution for a single current carrying wire loop, active shielding designs in the form of three and four sets of coil pairs surrounding the linac waveguide and electron gun were also investigated. The optimized current and coil center locations that yielded the best cancellation of the MR fringe fields at the linac were determined using sequential quadratic programming.

Results:

Optimized passive shielding in the form of two steel cylinders was designed to meet the required constraints. When shielding the MLC motors along with the waveguide and electron gun, the thickness of the cylinders was less than 1 mm. If magnetically insensitive MLC motors are used, no MLC shielding would be required and the waveguide shield (shielding the waveguide and electron gun) became 1.58 mm thick. In addition, the optimized current and coil spacing for active shielding was determined for both three and four coil pair configurations. The results of the active shielding optimization produced no beam loss within the waveguide and electron gun and a maximum MR field distortion of 91 ppm over a 30 cm diameter spherical volume.

Conclusions:

Very simple passive and active shielding designs have been shown to magnetically decouple the linac from the MR imager in a low field biplanar linac‐MR system. The MLC passive shielding produced the largest distortion of the MR field over the imaging volume. With the use of magnetically insensitive motors, the MR field distortion drops substantially since no MLC shield is required. The active shielding designs yielded no electron beam loss within the linac.