bluuebunny/crossref_metadata_2025 huggingface dataset:
A Novel Test Method for Ultrafast Pulse Response Characteristics of ZnO Varistor Ceramics
Authors: Shi Wei , Xie Guangyong
Published: March 2013

A ZnO varistors in series connected with a semi‐insulating GaAs photoconductive switches (SI‐GaAs PCSS's), a test method for ultrafast pulse response characteristics of ZnO varistor ceramics with DC bias was presented for the first time. The DC voltage distribution of the PCSS's and the varistors was measured in a dark state and the pulse response characteristics of the ZnO varistor ceramics was examined by a nanosecond laser pulse illuminating the PCSS's. The results indicate that the electric pulse output from the varistors includes capacitive current and conduction current and there is a time delay between their peaks. It is revealed that ZnO varistors has a nonlinear conductivity for the nanosecond electric impulse excitation and the barrier capacitance decay constant of the ceramics sample is 105 ns, which is explained through the analysis of examining the material structure and the conductive mechanisms.
Transparent Y3Al5O12: Li,Ce Ceramics for Thermal Neutron Detection
Authors: Chen Shi , Zhang Lihua , Kisslinger Kim , Wu Yiquan
Published: March 2013

To exploit the potential applications of thermal neutron detection, yttrium aluminum garnet co‐doped with 1 mol% Ce3+ and 5 mol% Li+ was vacuum sintered into a transparent ceramic through solid‐state reaction. The transmittance of a 2 mm thick sample was measured to be as high as 80.3% in the visible range and the microstructural characterization indicated that Li ions could also act as a sintering aid. Excitation and emission spectra data further supported the assumption that the Li ions have substituted into the garnet lattice. Excitation and emission spectra data of the prepared ceramic were also obtained for use in the characterization of optical properties.
Exceptionally High Dielectric Constant in Ceramic Pr2CuO4
Authors: Salame Paresh H. , Prakash Om , Kulkarni A. R.
Published: March 2013

The pristine layered cuprate Pr2CuO4 samples of >95% density were fabricated as thin disks. The samples, analyzed by X‐ray diffraction and Scanning electron microscopy, showed clean T′‐type phase with Rietveld refined lattice parameters a = b = 3.95805(±5) Å and c = 12.2262(±5) Å. The measured dielectric properties of the Pr2CuO4 ceramics, in the temperature range −100°C–150°C and frequencies (ν) 0.1 Hz–1 MHz, showed extremely high εr′ > 104 (above −30°C), and dissipation (tan δ = εr′′/εr′) between 0.1 and 5 (for 500 Hz ≤ ν ≤ 1 MHz, and −100 ≤ T ≤ 150°C). The ac conductivity of Pr2CuO4 ceramics ranged between 10−6 and 10−3 Scm−1 for the measured frequencies and temperatures, and showed frequency‐dependent double power law behavior akin to a modified Jonscher's power law.
The family experience following bone marrow or blood cell transplantation
Authors: Young Linda
Published: March 2013

Aim

To explore how families with children at home managed 4–12 months after an adult family member was discharged from the hospital to home following bone marrow or blood cell transplantation.

Background

Studies of these families have been limited in number. The Family Management Style Framework offers a conceptual framework relevant to families with children who have an adult member who has undergone a bone marrow or blood cell transplant.

Design

This was a descriptive, qualitative, one‐point‐in‐time study.

Method

Content analysis in relation to the three conceptual components of the Family Management Style Framework was employed; inductive thematic analysis determined the emergent conceptual dimensions present in the data. The sample was composed of 29 participants: 15 transplant recipients and 14 significant others who met the study criteria in 2008 and 2009. Each patient and his or her significant other were interviewed; the audio‐recorded interviews were analysed after transcription.

Findings

The three conceptual components of the Family Management Style Framework: (1) definition of the situation; (2) management behaviours; and (3) perceived consequences, were validated as relevant for this sample across all participants. New conceptual dimensions were also present, inclusive of recovery view, support base, financial picture, management domains, perceived consequences to the whole family, and perceived consequences to the dyad relationships.

Conclusion

There are several overarching findings in this study, notably that recovery at home is a family experience. Implications for nursing practice include the need for effective transitional care for the patient and family.
Structural equation model testing the situation‐specific theory of heart failure self‐care
Authors: Vellone Ercole , Riegel Barbara , D'Agostino Fabio , Fida Roberta , Rocco Gennaro , Cocchieri Antonello , Alvaro Rosaria
Published: March 2013

Aim

To test the situation‐specific theory of heart failure self‐care with structural equation modelling.

Background

Several authors have proposed theories on heart failure self‐care, but only the situation‐specific theory of heart failure self‐care by Riegel and Dickson is focused on the process that patients use to perform self‐care. This theory has never been tested with structural equation modelling.

Design

A secondary analysis of data from a cross‐sectional study.

Methods

Patients with heart failure were recruited in 21 cardiovascular centres across Italy during 2011. Data were collected with a sociodemographic questionnaire, chart abstraction for clinical data and the Self‐Care of Heart Failure Index v.6·2.

Results

A sample of 417 participants was enrolled in the study (59% males, mean age 72 years). The following propositions were tested and supported: Symptom monitoring correlates with treatment adherence; symptom monitoring and treatment adherence have a direct, positive relationship with symptom recognition and evaluation that in turn have a direct, positive relationship with treatment implementation; treatment implementation has a direct, positive relationship with treatment evaluation. In addition, the following three relationships were found: Symptom monitoring has a direct, positive relationship with treatment implementation; symptom recognition and evaluation have direct, positive relationships with treatment evaluation and symptom monitoring correlates with treatment evaluation. [Correction added on 9th April 2013, after first online publication: ‘…symptom monitoring correlates with treatment implementation.’ has been corrected to read ‘…symptom monitoring correlates with treatment evaluation.’]

Conclusion

The data support the situation‐specific theory of heart failure self‐care with the addition of three new relationships that emerged from the analysis. Results of this study lend further support to the use of the situation‐specific theory of heart failure self‐care in research and practice.
Locating Existing Best Management Practices Within a Watershed: The Value of Multiple Methods
Authors: Grady Caitlin A. , Reimer Adam P. , Frankenberger Jane , Prokopy Linda Stalker
Published: March 2013

There is an increasing need to document the impacts of conservation‐related best management practices (BMPs) on water quality within a watershed. However, this impact analysis depends upon accurate geospatial locations of existing practices, which are difficult to obtain. This study demonstrates and evaluates three different methods for obtaining geospatial information for BMPs. This study was focused on the Eagle Creek Watershed, a mixed use watershed in central Indiana. We obtained geospatial information for BMPs through government records, producer interviews, and remote‐sensing aerial photo interpretation. Aerial photos were also used to validate the government records and producer interviews. This study shows the variation in results obtained from the three sources of information as well as the benefits and drawbacks of each method. Using only one method for obtaining BMP information can be incomplete, and this study demonstrates how multiple methods can be used for the most accurate picture.
Catheter Ablation of Atrial Fibrillation in Patients at Low Thrombo‐Embolic Risk: Efficacy and Safety of a Simplified Periprocedural Anticoagulation Strategy
Authors: DUYTSCHAEVER MATTIAS , BERTE BENJAMIN , ACENA MARTA , DE MEYER GRIM , BUN SOK‐SITHIKUN , VAN HEUVERSWYN FREDERIC , VANDEKERCKHOVE YVES , TAVERNIER RENE
Published: March 2013

Aspirin and Low Molecular Weight Heparin in Patients Undergoing Catheter Ablation of AF

Background

To prevent thrombo‐embolic (TE) events during ablation of atrial fibrillation (AF), warfarin is recommended in all patients irrespective of baseline TE risk. We evaluated the efficacy and safety of a simplified periprocedural anticoagulation strategy of aspirin (ASA) and low molecular weight heparin (LMWH) in patients at low TE risk.

Methods

We collected data from 214 low TE risk patients (CHADS2 score ≤1 and no warfarin at baseline) undergoing pulmonary vein isolation. After discontinuation of ASA, periprocedural antithrombotic therapy consisted of therapeutic subcutaneous LMWH injections (nadroparin 1 mL/kg once daily) from 10 days before until 10 days after the procedure, followed by ASA in all patients. At the time of procedure, transesophageal echocardiography (TEE) was not performed on a routine basis. During the procedure, unfractionated heparin was administered to achieve an ACT between 350 and 400 seconds. Data on TE events (stroke or transient ischemic attack), cardiac tamponade/perforation, and major vascular access complications within 3 months after the procedure were collected.

Results

Mean CHADS2 was 0.3 ± 0.5. TEE was performed in 3% of patients. No periprocedural TE events occurred. No cardiac tamponade/perforation was observed. Major vascular access complications occurred in 3 patients (1.4%). No permanent injury was observed (0%).

Conclusion

In selected low TE risk patients undergoing ablation for AF, a short period of periprocedural therapeutic anticoagulation with LMWH together with aspirin is an effective and safe strategy to prevent TE events. If confirmed in a randomized trial, this approach might simplify periprocedural antithrombotic management in ablation of selected AF patients.
Using small‐area variations to inform health care service planning: what do we ‘need’ to know?
Authors: Mercuri Mathew , Birch Stephen , Gafni Amiram
Published: March 2013

Rationale, aims and objectives

Allocating resources on the basis of population need is a health care policy goal in many countries. Thus, resources must be allocated in accordance with need if stakeholders are to achieve policy goals. Small area methods have been presented as a means for revealing important information that can assist stakeholders in meeting policy goals. The purpose of this review is to examine the extent to which small area methods provide information relevant to meeting the goals of a needs‐based health care policy.

Methods

We present a conceptual framework explaining the terms ‘demand’, ‘need’, ‘use’ and ‘supply’, as commonly used in the literature. We critically review the literature on small area methods through the lens of this framework.

Results

‘Use’ cannot be used as a proxy or surrogate of ‘need’. Thus, if the goal of health care policy is to provide equal access for equal need, then traditional small area methods are inadequate because they measure small area variations in use of services in different populations, independent of the levels of need in those populations.

Conclusions

Small area methods can be modified by incorporating direct measures of relative population need from population health surveys or by adjusting population size for levels of health risks in populations such as the prevalence of smoking and low birth weight. This might improve what can be learned from studies employing small area methods if they are to inform needs‐based health care policies.
Advanced Age as a Risk Factor for Folate‐Associated Functional Cobalamin Deficiency
Authors: Solomon Lawrence R.
Published: March 2013

Objectives

To determine whether high serum folate levels contribute to metabolite changes in elderly subjects with normal cobalamin levels.

Design

Case series.

Setting

Outpatient clinic at a university‐based staff model health maintenance organization.

Participants

Two hundred thirty‐three ambulatory individuals without diabetes mellitus with normal renal function and normal cobalamin levels evaluated for cobalamin deficiency.

Measurements

Cobalamin, serum folate, methylmalonic acid (MMA), and homocysteine.

Results

Older individuals (≥60) with low‐normal cobalamin levels (201–300 pg/mL) had higher MMA and lower homocysteine levels when serum folate levels were high (>20 ng/mL) than when serum folate levels were normal (P < .02), but serum folate levels within the normal range were not a determinant of either metabolite. In younger subjects with low‐normal cobalamin levels, high serum folate levels were not associated with significant differences in either metabolite. At mid‐normal cobalamin levels (301–600 pg/mL), high serum folate levels were associated with lower homocysteine levels in older adults (P < .001) but not with differences in MMA in either age group. Cobalamin therapy decreased or normalized MMA and homocysteine in 89% or more of participants even at pretherapy cobalamin levels greater than 600 pg/mL.

Conclusion

High serum folate levels are associated with higher MMA levels when cobalamin levels are low‐normal, and this effect is age dependent, not progressive within the normal serum folate range (suggesting a threshold effect), and reversed by cobalamin therapy. Because MMA may be neurotoxic, these findings suggest caution in the use of folic acid supplements in elderly adults.
Diagnostic Choices and Clinical Outcomes in Octogenarians and Nonagenarians with Iron‐Deficiency Anemia in the Netherlands
Authors: Hamaker Marije E. , Acampo Tessa , Remijn Jasper A. , van Tuyl Sebastiaan A.C. , Pronk Apollo , van der Zaag Edwin S. , Paling Heleen A. , Smorenburg Carolien H. , de Rooij Sophia E. , van Munster Barbara C.
Published: March 2013

Objectives

To evaluate current clinical practice for octogenarians with iron‐deficiency anemia (IDA) by assessing referral patterns, diagnostic choices, clinical consequences of omission of endoscopy, and risks and benefits of IDA‐related surgery.

Design

Chart review.

Setting

A regional hospital‐based laboratory in the Netherlands between January 2008 and December 2010.

Participants

All individuals aged 80 and older with newly ascertained IDA.

Measurements

IDA was defined as a hemoglobin level of 11.1 g/dL or less and a ferritin level of 25 μg/L or less.

Results

Four hundred seventy‐one participants were newly diagnosed with IDA during the study period (median age 85.4), 276 of whom (59%) did not undergo any diagnostic procedures for IDA. A cause of anemia was identified during the initial examination in 50% of the 205 investigated participants, including nine (4%) upper and 37 (18%) lower gastrointestinal malignancies. Another 24 malignancies were identified during follow‐up, of which 16 were in the gastrointestinal tract, primarily in participants for whom the initial diagnostic examination was limited or omitted. Perioperative mortality was 15% in individuals with colon cancer. Median survival for participants with colon cancer was 2.2 years, and the survival benefit of surgery over supportive care was not apparent until 1.3 years after ascertainment of IDA.

Conclusion

The omission of endoscopy for IDA and the omission of surgery for colon cancer occur frequently in octogenarians and seem appropriate in the presence of significant comorbidity and in cases in which there is limited life expectancy. Further research is needed to determine which baseline factors should guide decision‐making to optimize treatment outcomes and quality of life.
Pain as a Risk Factor for Disability or Death
Authors: Andrews James S. , Cenzer Irena Stijacic , Yelin Edward , Covinsky Kenneth E.
Published: March 2013

Objectives

To determine whether pain predicts future activity of daily living (ADL) disability or death in individuals aged 60 and older.

Design

Prospective cohort study.

Setting

The 1998 to 2008 Health and Retirement Study (HRS), a nationally representative study of older community‐living individuals.

Participants

Twelve thousand six hundred thirty‐one participants in the 1998 HRS aged 60 and older who did not need help in any ADL.

Measurements

Participants reporting that they had moderate or severe pain most of the time were defined as having significant pain. The primary outcome was time to development of ADL disability or death over 10 yrs, assessed at five successive 2‐year intervals. ADL disability was defined as needing help performing any ADL: bathing, dressing, transferring, toileting, eating, or walking across a room. A discrete hazards survival model was used to examine the relationship between pain and incident disability over each 2‐year interval using only participants who started the interval with no ADL disability. Several potential confounders were adjusted for at the start of each interval: demographic factors, seven chronic health conditions, and functional limitations (ADL difficulty and difficulty with five measures of mobility).

Results

At baseline, 2,283 (18%) participants had significant pain. Participants with pain were more likely (all P < .001) to be female (65% vs 54%), have ADL difficulty (e.g., transferring 12% vs 2%, toileting 11% vs 2%), have difficulty walking several blocks (60% vs 21%), and have difficulty climbing one flight of stairs (40% vs 12%). Over 10 years, participants with pain were more likely to develop ADL disability or death (58% vs 43%, unadjusted hazard ratio (HR) = 1.67, 95% confidence interval (CI) = 1.57–1.79), although after adjustment for confounders, participants with pain were not at greater risk for ADL disability or death (HR = 0.98, 95% CI = 0.91–1.07). Adjustment for functional status almost entirely explained the difference between the unadjusted and adjusted results.

Conclusion

Although there are strong cross‐sectional relationships between pain and functional limitations, individuals with pain are not at higher risk of subsequent disability or death after accounting for functional limitations. Like many geriatric syndromes, pain and disability may represent interrelated phenomena that occur simultaneously and require unified treatment paradigms.
Short‐term body weight fluctuations in older well‐hydrated hospitalised patients
Authors: Vivanti A. , Yu L. , Palmer M. , Dakin L. , Sun J. , Campbell K.
Published: March 2013

Background

The usual daily weight fluctuations of well‐hydrated older hospitalised people have not been documented internationally. To date, dehydration assessments based on a short‐term body weight change defined as >2% have been drawn from healthy population data. The present pilot study aimed to describe usual body weight fluctuation at the same time of day over a 3‐day time frame in well‐hydrated older hospitalised adults.

Methods

An observational study of non‐acute inpatients (n = 10) admitted to a Geriatric and Rehabilitation Unit, aged ≥60 years, assessed as well‐hydrated, mobile, non‐amputee and without conditions that influenced fluid status, was conducted. Participants were weighed hourly over a 9‐h period for 3 days. Food and fluid intake, clothing items added or removed, and urine and faecal output were recorded.

Results

Weight fluctuation for each participant [mean (SD) 80.2 (4.2) years; male 60.0%, n = 10] over 3 days ranged from 1.1% to 3.6%. Over 3 days, 40.0% (4/10) of participants had weight fluctuations of >2% and 20% (2/10) had weight fluctuations of >3%. Time of weigh‐in accounted for 99.8% of the variation in weight fluctuation (P < 0.05), with the lowest fluctuations observed when weights were compared at the same time each day (≤0.4 kg).

Conclusions

Weights recorded at the same time daily had the greatest accuracy. Given that the range 1.1–3.6% was within normal weight fluctuations for well‐hydrated older hospitalised participants, the weight change indicative of dehydration remains to be established in this setting but appears greater than conventionally used figures.
Evaluation of seasonality on total water intake, water loss and water balance in the general population in Greece
Authors: Malisova O. , Bountziouka V. , Panagiotakos D. Β. , Zampelas A. , Kapsokefalou M.
Published: March 2013

Background

Water balance is achieved when water intake from solid and fluid foods and drinking water meets water losses, mainly in sweat, urine and faeces. Seasonality, particularly in Mediterranean countries that have a hot summer, may affect water loss and consequently water balance. Water balance has not been estimated before on a population level and the effect of seasonality has not been evaluated. The present study aimed to compare water balance, intake and loss in summer and winter in a sample of the general population in Greece.

Methods

The Water Balance Questionnaire (WBQ) was used to evaluate water balance, estimating water intake and loss in summer (n = 480) and in winter (n = 412) on a stratified sample of the general population in Athens, Greece.

Results

In winter, mean (SD) water balance was −63 (1478) mL/day−1, mean (SD)water intake was 2892 (987) mL/day−1 and mean (quartile range) water loss was 2637 (1810–3922) mL/day−1. In summer, mean (SD) water balance was −58 (2150) mL/day−1, mean (SD) water intake was 3875 (1373) mL/day−1 and mean (quartile range) water loss was 3635 (2365–5258) mL/day−1. Water balance did not differ between summer and winter (P = 0.96); however, the data distribution was different; in summer, approximately 8% more participants were falling in the low and high water balance categories. Differences in water intake from different sources were identified (P < 0.05).

Conclusions

Water balance in summer and winter was not different. However, water intake and loss were approximately 40% higher in summer than in winter. More people were falling in the low and high water balance categories in summer when comparing the distribution on water balance in winter.
Effect of dietary protein on post‐prandial glucose in patients with type 1 diabetes
Authors: Borie‐Swinburne C. , Sola‐Gazagnes A. , Gonfroy‐Leymarie C. , Boillot J. , Boitard C. , Larger E.
Published: March 2013

Background

In flexible insulin therapy, determination of the prandial insulin dose only takes into account the carbohydrate content of the evening meal, and not the protein content. Protein can, however, contribute to gluconeogenesis. We compared the glycaemic effect of a standard evening meal with that of a test evening meal enriched in protein.

Methods

The present study was conducted in 28 C‐peptide negative patients with type 1 diabetes. Two evening meals that were similar in content, except that one was enriched by the addition of 300 g of 0%‐fat fromage frais, were taken on two consecutive days. Insulin doses were maintained exactly the same before both evening meals. Patients were monitored with a continuous glucose‐monitoring device.

Results

Patients ate similar quantities at both evening meals, except for protein (21.5 g more at the test evening meal). The preprandial insulin dose was 0.96 (0.4) U per 10 g carbohydrates. After correction for differences of interstitial glucose at the start of the evening meals, both interstitial and capillary glucose levels were similar after both evening meals, except for the late‐post‐prandial interstitial glucose level.

Conclusions

We found no effect of dietary protein on post‐prandial‐, overnight‐ or late‐night glucose levels in patients with type 1 diabetes. This confirms that dietary proteins need not be included in the calculation of prandial insulin dose.
Business‐to‐Business Information Technology User Practices at End of Life in the United Kingdom, Germany, and France
Authors: Peagam Richard , McIntyre Kirstie , Basson Lauren , France Chris
Published: March 2013

Business‐to‐business (B2B) electronics account for a significant volume of the electrical and electronic equipment (EEE) put on the market. Very little B2B waste electrical and electronic equipment (WEEE) is reported as collected in the European Union (EU) in compliance with the WEEE Directive, which uses the policy principle of extended producer responsibility (EPR) to ensure that WEEE is managed correctly. This presents a barrier to parties looking for access to the waste. Company practice dictates the channels into which B2B WEEE flows following primary use. This article presents a study that engaged with company actors directly to get a better understanding of business information technology (IT) EEE asset management. Data were collected to determine the barriers current practice could present to the collection of B2B IT EEE at end of life and the implications of these for the development of policies and strategies for EPR. A questionnaire was developed and data were gathered from organizations in three EU countries—the United Kingdom, Germany, and France—stratified by size.

 Some notable findings were that there are several routes by which end‐of‐life B2B WEEE can flow. The recycling and refurbishment of B2B IT units at end of use was shown to be commonplace, but it is likely that these units enter streams where they are not reported. The actors disposing of their units did not have information on the management or disposition of these streams. It is concluded that to achieve the goals of EPR for B2B IT WEEE, the networks and the operational practices of these streams need to be better understood when developing strategies and policies.
Exhumation of oceanic eclogites: thermodynamic constraints on pressure, temperature, bulk composition and density
Authors: Chen Y. , Ye K. , Wu T. F. , Guo S.
Published: March 2013

The exhumation mechanism of high‐pressure (HP) and ultrahigh‐pressure (UHP) eclogites formed by the subduction of oceanic crust (hereafter referred to as oceanic eclogites) is one of the primary uncertainties associated with the subduction factory. The phase relations and densities of eclogites with MORB compositions are modelled using thermodynamic calculations over a P–T range of 1–4 GPa and 400–800 °C, respectively, in the NCKFMASHTO (Na2O–CaO–K2O–FeO–MgO–Al2O3–SiO2–H2O–TiO2–Fe2O3) system. Our modelling suggests that the mineral assemblages, mineral proportions and density of oceanic crust subducted along a cold P–T path are quite different from those of crust subducted along a warm P–T path, and that the density of oceanic eclogites is largely controlled by the stability of low‐density hydrous minerals, such as lawsonite, chlorite, glaucophane and talc. Along a cold subduction P–T path with a geotherm of ~6 °C km−1, lawsonite is always present at 1.1 to >4.0 GPa, and chlorite, glaucophane and talc can be stable at pressures of up to 2.3, 2.6 and 3.6 GPa respectively. Along such a P–T path, the density of subducted oceanic crust is always lower than that of the surrounding mantle at depths shallower than 110–120 km (< 3.3–3.6 GPa). However, along a warm subduction P–T path with a geotherm of ~10 °C km−1, the P–T path is outside the stability field of lawsonite, and the hydrous minerals of chlorite, epidote and amphibole break down completely into dry dense minerals at relatively lower pressures of 1.5, 1.85 and 1.9 GPa respectively. Along such a warm subduction P–T path, the subducted oceanic crust becomes denser than the surrounding mantle at depths >60 km (>1.8 GPa). Oceanic eclogites with high H2O content, oxygen fugacity, bulk‐rock XMg [ = MgO/(MgO + FeO)], XAl [ = Al2O3/(Al2O3 + MgO + FeO)] and low XCa [ = CaO/(CaO + MgO + FeO + Na2O)] are likely suitable for exhumation, which is consistent with the bulk‐rock compositions of the natural oceanic eclogites on the Earth's surface. On the basis of natural observations and our calculations, it is suggested that beyond depths around 110–120 km oceanic eclogites are not light enough and/or there are no blueschists to compensate the negative buoyancy of the oceanic crust, therefore explaining the lack of oceanic eclogites returned from ultradeep mantle (>120 km) to the Earth's surface. The exhumed light–cold–hydrous oceanic eclogites may have decoupled from the top part of the sinking slab at shallow depths in the forearc region and are exhumed inside the serpentinized subduction channel, whereas the dense–hot–dry eclogites may be retained in the sinking slab and recycled into deeper mantle.
Preservation of subduction‐related prograde deformation in lawsonite pseudomorph‐bearing rocks
Authors: Philippon M. , Gueydan F. , Pitra P. , Brun J‐P.
Published: March 2013

Lawsonite pseudomorphs are used to identify and distinguish the kinematic records of subduction and exhumation in blueschist‐facies rocks from Syros (Cyclades; Greece). Lawsonite is a hydrous mineral that crystallizes at high‐pressure and low‐temperature conditions. During decompression, lawsonite is typically pseudomorphed by an aggregate dominated by epidote and paragonite. Such aggregates are easily deformable and if deformation occurs after the lawsonite breakdown, the pseudomorphs are difficult to distinguish from the matrix. The preservation of the lawsonite crystal shape, despite complete retrogression, indicates therefore that the host blueschist rock has not been affected by penetrative deformation during exhumation, thus providing indication of strain‐free conditions. Therefore, tracking the lawsonite growth and destabilization along the P–T path followed by the rocks during a subduction/exhumation cycle provides information about the subduction/exhumation‐related deformation. Using microstructural observations and P–T pseudosections calculated with thermocalc, it is inferred that top‐to‐the‐south sense of shear preserved in lawsonite pseudomorph‐bearing blueschists on Syros occurred during the prograde metamorphic path within the lawsonite stability field, and is therefore associated with subduction. On the contrary, the deformation with a top‐to‐the‐north sense of shear is observed in surrounding rocks, where lawsonite pseudomorphs are deformed or apparently lacking. This deformation occurred after the lawsonite breakdown during exhumation. At the regional scale, exhumation‐related deformation is heterogeneous, allowing the preservation of lawsonite pseudomorphs in significant volumes of blueschists of the central and southern Cyclades. It is argued that such successive shearing deformation events with opposite senses more likely correspond to an exhumation process driven by slab rollback, in which subduction and exhumation are not synchronous.
Structural kinematics, metamorphic P–T profiles and zircon geochronology across the Greater Himalayan Crystalline Complex in south‐central Tibet: implication for a revised channel flow
Authors: Wang J. M. , Zhang J. J. , Wang X. X.
Published: March 2013

A specific question about the Himalayas is whether the orogeny grew by distributed extrusion or discrete thrusting. To place firm constraints on tectonic models for the orogeny, kinematic, thermobarometric and geochronological investigations have been undertaken across the Greater Himalayan Crystalline Complex (GHC) in the Nyalam region, south‐central Tibet. The GHC in this section is divided into the lower, upper and uppermost GHC, with kinematically top‐to‐the‐south, alternating with top‐to‐the‐north shear senses. A new thrust named the Nyalam thrust is recognized between the lower and upper GHC, with a 3 kbar pressure reversion, top‐to‐the‐south thrust sense, and was active after the exhumation of the GHC. Peak temperature reached ∼749 °C in the cordierite zone, and decreased southwards to 633–667 °C in the kyanite and sillimanite‐muscovite zones, and northwards to greenschist facies at the top of the South Tibetan Detachment System (STDS). Pressure at peak temperature reached a maximum value in the kyanite zone of 9.0–12.6 kbar and decreased northwards to ∼4.1 kbar in the cordierite zone. Zircon U‐Pb ages of a sillimanite migmatite and an undeformed leucogranite dyke cutting the mylonitized rocks in the STDS reveal a long‐lived partial melting of the GHC, which initiated at 39.7–34 Ma and ceased at 14.1 Ma. Synthesizing the obtained and collected results, a revised channel flow model is proposed by considering the effect of heat advection and convection by melt and magma migration. Our new model suggests that distributed processes like channel flow dominated during the growth of the Himalayan orogen, while discrete thrusting occurred in a later period as a secondary process.
On semiautomatic estimation of surface area
Authors: DVOŘÁK J. , JENSEN E.B.V.
Published: March 2013

In this paper, we propose a semiautomatic procedure for estimation of particle surface area. It uses automatic segmentation of the boundaries of the particle sections and applies different estimators depending on whether the segmentation was judged by a supervising expert to be satisfactory. If the segmentation is correct the estimate is computed automatically, otherwise the expert performs the necessary measurements manually. In case of convex particles we suggest to base the semiautomatic estimation on the so‐called flower estimator, a new local stereological estimator of particle surface area. For convex particles, the estimator is equal to four times the area of the support set (flower set) of the particle transect. We study the statistical properties of the flower estimator and compare its performance to that of two discretizations of the flower estimator, namely the pivotal estimator and the surfactor. For ellipsoidal particles, it is shown that the flower estimator is equal to the pivotal estimator based on support function measurements along four perpendicular rays. This result makes the pivotal estimator a powerful approximation to the flower estimator. In a simulation study of prolate and oblate ellipsoidal particles, the surfactor also performs well for particles which are not extremely elongated. In particular, the surfactor is not very much affected by the singularity in the surfactor formula or by possible inaccuracies in the necessary angle measurements. We also assess the performance of the semiautomatic procedure in a study of somatostatin positive inhibitory interneurons from mice hippocampi. Only 35% of the cells needed to be analysed manually and an important decrease in workload was obtained by using the semiautomatic approach.
Temperature measurement in the microscopic regime: a comparison between fluorescence lifetime‐ and intensity‐based methods
Authors: PAVIOLO C. , CLAYTON A.H.A. , MCARTHUR S.L. , STODDART P.R.
Published: March 2013

Thermally sensitive fluorescent indicators have been proposed to monitor temperature changes in microfluidic systems, mainly based on fluorescence intensity or lifetime. However, measuring temperature in a structured environment, such as biological tissue, presents additional challenges due to the chemical and structural complexity. Here, we investigate the potential for resolving temperature distributions within the volume of a single cell. Rhodamine B (RhB) dye was employed as a temperature indicator to compare fluorescence intensity‐ and lifetime‐based techniques. The relationship between the fluorescence lifetime and temperature was found to be highly dependent on the biological environment. The intensity‐based method allowed the temperature distribution to be mapped with partial success within the volume of a single cell. Under ideal circumstances, the temperature can be mapped pixel by pixel with a resolution better than ±0.3°C within the cell cytoplasm, but this accuracy was reduced to ±1.8°C by environmental variations. These results suggest that the fluorophore should be encapsulated and immobilized in the biological tissue in order to reduce the influence of environmental factors on temperature measurements at the cellular level.
Challenges in developing novel therapies for peripheral neuropathies: a summary of The Foundation for Peripheral Neuropathy Scientific Symposium 2012
Authors: Höke Ahmet , Simpson David M. , Freeman Roy
Published: March 2013

On March 14–16, 2012, The Foundation for Peripheral Neuropathy organized a scientific meeting that brought together basic and clinical scientists studying peripheral neuropathies and mechanisms of axonal degeneration and representatives from the drug industry, National Institutes of Health, and Federal Drug Administration. This meeting summary covers the main discussion points laid out by the participants that hamper development of novel therapies for peripheral neuropathies and neuropathic pain. In each section of the meeting, the discussion was led by a keynote talk and was followed by a panel of discussants that were asked to bring two key questions in their areas of research. With audience participation, this format led to a lively discussion that pointed out the deficiencies in both animal modeling of human diseases and issues in clinical trial design unique to the peripheral neuropathies and neuropathic pain.
Lenalidomide in patients with chemotherapy‐induced polyneuropathy and relapsed or refractory multiple myeloma: results from a single‐centre prospective study
Authors: Briani Chiara , Torre Chiara Dalla , Campagnolo Marta , Lucchetta Marta , Berno Tamara , Candiotto Laura , Padua Luca , Ermani Mario , Cavaletti Guido , Zambello Renato
Published: March 2013

Lenalidomide, an immunomodulatory drug used in myeloma therapy, has been claimed to be less neurotoxic than thalidomide, but evidence is still weak. We prospectively assessed lenalidomide safety in myeloma patients to evaluate whether it would induce or modify a previously ensued chemotherapy‐induced peripheral neuropathy (CIPN). Thirty consecutive patients (17 men, mean age 63.7 ± 9.4) previously treated with bortezomib and/or thalidomide and starting on lenalidomide (25 mg/day for 21‐day cycles) for relapsed or refractory myeloma were assessed at baseline, 6, and 12 months from the beginning of lenalidomide with Total Neuropathy Score clinical version (TNSc), Eastern Cooperative Oncology Group (ECOG) performance status, and numeric rating scale (NRS) for pain. TNSc >2 was considered significant for CIPN. TNSc changes of at least 4 points from baseline value were considered clinically relevant. At baseline 16 of the 30 patients (53.3%) had CIPN (mean TNSc 5.8, range 3–15). After 6 months, 13 patients were unchanged, 1 improved, and 2 worsened. After 12 months the patient who had improved persisted stable, and the two who had worsened returned to TNSc baseline value. The 14 patients without CIPN at baseline did not develop neuropathy. NRS and ECOG performance status persisted unchanged. Our results demonstrate lenalidomide safety and very low neurotoxicity also in patients with pre‐existing CIPN treated for 1 year.
C3 exoenzyme lacks effects on peripheral axon regeneration in vivo
Authors: Auer Maria , Allodi Ilary , Barham Mohammed , Udina Esther , Neiss Wolfram F. , Navarro Xavier , Klimaschewski Lars
Published: March 2013

Peripheral nerve injury triggers the activation of the small GTPase RhoA in spinal motor and peripheral sensory neurons. C3 transferase, an exoenzyme produced by Clostridium botulinum that inactivates RhoA by ADP‐ribosylation, has been successfully applied in central nervous system (CNS) lesion models to facilitate regeneration functionally and morphologically. Until now it has not been demonstrated if C3bot exerts positive effects on peripheral axon regeneration as well. In organotypic spinal cord preparations, C3bot reduced axonal growth of motoneurons, while no effect on sensory axon outgrowth from dorsal root ganglia (DRG) explants was observed. Enzymatically inactive C3E174Q was ineffective in both culture models. Spinal cord slices exhibited a significant increase in microglia/macrophages after treatment with C3bot suggesting an inflammatory component in the inhibition of axon growth. C3bot or C3E174Q were then applied into conduits implanted after transection of the sciatic nerve in rats. Functional evaluation by electrophysiology, nociception, and walking track tests did not show any significant difference between groups with active or mutant C3E174Q. Transmission electron microscopy of the regenerated nerves revealed no significant differences in the number of myelinated and unmyelinated axons 6 weeks after surgery. Compared to the CNS, the functional significance of RhoA may be limited during nerve regeneration in a growth‐promoting environment.
Association of social support with quality of life in patients with polyneuropathy
Authors: Maxwell Sarah K. , Barnett Carolina , Kokokyi Seint , Leung Joanne C. , Yu Jingjie J. , Bril Vera , Katzberg Hans D.
Published: March 2013

The aim of this study was to examine the impact of social support on quality of life (QoL) in patients with polyneuropathy. One hundred and fifty‐four patients with polyneuropathy were enrolled from a neuromuscular clinic. The QoL Instrument and the Medical Outcome Study‐Social Support Survey (MOS‐SSS) were used to assess QoL and social support, respectively. Disease severity and clinical factors were also assessed. Neuropathy patients had a lower QoL compared to a previously published normative sample (p < 0.0001) and an MOS‐SSS comparable to other patients with chronic disease. Social support correlated weakly with the self esteem and emotional well being mental health dimensions (rs:0.20–0.38) but not the physical health QoL (PH‐QoL) domains. Physical and mental QoL also correlated significantly with presence of pain (rs: −0.39 and −0.42, respectively) and number of autonomic symptoms (rs: −0.39 and −0.30, respectively). Social support independently predicts MH‐QoL when controlling for age, gender, pain, and the Toronto Clinical Neuropathy Score (TCNS; p < 0.0001). TCNS and gender are independently related to PH‐QoL (p < 0.05). This study demonstrates that improved social support serves as an independent predictor of MH‐QoL when controlling for age, gender, pain, and severity of neuropathy. Future studies examining the effects of improving social support on QoL in patients with polyneuropathy are recommended.
Quality assessment of online patient education resources for peripheral neuropathy
Authors: Hansberry David R. , Suresh Ragha , Agarwal Nitin , Heary Robert F. , Goldstein Ira M.
Published: March 2013

Given its practicality, the internet is a primary resource for patients afflicted with diseases like peripheral neuropathy. Therefore, it is important that the readily available online resources on peripheral neuropathy are tailored to the general public, particularly concerning readability. Patient education resources were downloaded from the US National Library of Medicine, Mayo Clinic, National Institute of Neurological Disorders and Stroke, Neuropathy.org, GBS/CIDP Foundation International, Hereditary Neuropathy Foundation, Charcot‐Marie‐Tooth Association, Foundation for Peripheral Neuropathy, and Neuropathy Action Foundation websites. All patient education material related to peripheral neuropathy was evaluated for its level of readability using the Flesch Reading Ease (FRE) and Flesch‐Kincaid Grade Level. The FRE scores averaged 43.4 with only the US National Library of Medicine scoring above 60 (76.5). The Flesch‐Kincaid Grade Level scores averaged 11.0. All scores were above a seventh‐grade level except the US National Library of Medicine, which had a score of a fifth‐grade reading level. Most Americans may not fully benefit from patient education resources concerning peripheral neuropathy education on many of the websites. Only the US National Library of Medicine, which is written at a fifth‐grade level, is likely to benefit the average American.
Corneal confocal microscopy is efficient, well‐tolerated, and reproducible
Authors: Smith Albert Gordon , Kim Gene , Porzio Michael , Allen Blaine , Koach Margaret , Mifflin Mark , Digre Kathleen , Keung Bonnie M. , Singleton John Robinson
Published: March 2013

In order to develop an efficient, reproducible, and well‐tolerated protocol for assessing corneal innervation, 11 normal subjects underwent corneal confocal microscopy (CCM) using a Heidelberg Retinal Tomography III microscope. Five standardized locations were sampled in the left eye and one centrally in the right. The protocol was repeated 1–4 weeks later. A blinded technician measured nerve fiber length (NFL) and tortuosity coefficient (TC). The relationship between image location and NFL and TC was assessed using one‐way analysis of variance, and reproducibility determined using relative intertrial variability and intraclass correlation coefficients. NFL reproducibility was maximized by averaging four or more images from the left eye, or one central image from both eyes. TC was less reproducible. CCM is a rapid, well‐tolerated, and reproducible method for assessing corneal innervation.
Incidence of carpal tunnel syndrome in adult patients with mitochondrial disease
Authors: Whittaker Roger G. , Hall Elizabeth , Mansoor Muhammad K. , Taylor Robert W. , Turnbull Douglass M.
Published: March 2013

Symmetrical polyneuropathy is a common feature of mitochondrial disease. Both axonal and demyelinating types are described, with Schwann cell abnormalities demonstrated on nerve biopsy. Some authors have also suggested an increased incidence of entrapment neuropathy. We identified 738 adult patients with proven mitochondrial disease seen in our centre in the past 25 years. One‐hundred sixty seven of these patients had undergone nerve conduction studies as part of their routine clinical care, and the results of these studies were reviewed. We found an incidence rate of carpal tunnel syndrome (CTS) of 50.7 per 100,000 person‐years; 32.5 per 100,000 person‐years for men and 65.3 per 100,000 person‐years for women. One other patient had evidence of ulnar neuropathy at the elbow. The incidence of CTS in mitochondrial disease is similar to published rates for the UK general population. We found no evidence that mitochondrial disease per se increases the risk of entrapment neuropathy. We suggest that the pathophysiological mechanisms for the development of polyneuropathy in mitochondrial disease are quite distinct from the pathophysiology of CTS. Furthermore, it is essential that patients with mitochondrial disease who present with upper limb paraesthesia be referred for neurophysiological testing, so that treatable CTS is not missed.
Mechanisms underlying transient receptor potential ankyrin 1 (TRPA1)‐mediated hyperalgesia and edema
Authors: Perin‐Martins Andressa , Teixeira Juliana Maia , Tambeli Claudia H. , Parada Carlos Amílcar , Fischer Luana
Published: March 2013

The aim of this study was to investigate the mechanisms that contribute to hyperalgesia and edema induced by TRPA1 activation. The injection of allyl isothiocyanate (AITC, 50, 100, or 300 µg/paw) into the rat's hind paw induced dose and time‐dependent hyperalgesia and edema, which were blocked by the selective TRPA1 antagonist, HC 030031 (1,200 µg/paw), or by treatment with antisense oligodeoxynucleotide (four daily intrathecal injections of 5 nmol). These results demonstrate that the hyperalgesia and edema induced by AITC depend on TRPA1 activation. AITC‐induced hyperalgesia and edema were significantly reduced by treatment with neurokinin 1 (L‐703,606, 38 µg/paw) or calcitonin gene‐related peptide (CGRP8‐37, 5 µg/paw) receptor antagonists, with a mast cell degranulator (compound 48/80, four daily injections of 1, 3, 10, and 10 µg/paw) or with H1 (pyrilamine, 400 µg/paw), 5‐HT1A (wAy‐100,135, 450 µg/paw) or 5‐HT3 (tropisetron, 450 µg/paw) receptor antagonists. Pre‐treatment with a selectin inhibitor (fucoidan, 20 mg/kg) significantly reduced AITC‐induced hyperalgesia, edema, and neutrophil migration. Finally, a cyclooxygenase inhibitor (indomethacin, 100 µg/paw), a β1 (atenolol, 6 µg/paw) or a β2 (ICI 118, 551, 1.5 µg/paw) adrenoceptor antagonist also significantly reduced AITC‐induced hyperalgesia and edema. Together, these results demonstrate that TRPA1 mediates some of the key inflammatory mechanisms, suggesting a key role of this receptor in pain and inflammation.