bluuebunny/crossref_metadata_2025 huggingface dataset:
Preparation of Conductive PANI/PVA Composites via an Emulsion Route
Authors: Wang Xiang-Qin , Xin Bin-Jie , Xu Jian
Published: November 2013

A facile and novel strategy for preparing polyaniline/polyvinyl alcohol (PANI/PVA) composite emulsion is reported wherein the reaction is carried out via the emulsion polymerization using ammonium peroxydisulfate (APS) as the oxidizing agent and dodecylbenzene sulfonic acid (DBSA) as the protonic acid. The PANI/PVA composite membranes have been characterized using optical microscope, scanning electron microscope (SEM), thermogravimetric analysis (TGA), Fourier transform infrared spectroscopy (FTIR), and electrochemical workstation. It is interesting that the electrical conductivity of the PANI/PVA composites is estimated to be as high as 1.28 S/cm. The experimental results show that the surface of PANI/PVA composite membranes exhibits good integrity. The PANI particles at the nanoscale are dispersed in the PVA matrix, and the electrochromic behaviors of PANI/PVA composites obtained at different polymerization temperatures can be compared based on cyclic voltammetry (CV) curves, revealing that PANI/PVA composites synthesized at room temperature are better than those synthesized at low temperature.
Hypergraph Modeling and Approximation Algorithms for the Minimum Length Link Scheduling in Multiuser MIMO Networks
Authors: Shen Hu , Lv Shaohe , Dong Xuan , Deng Junquan , Wang Xiaodong , Zhou Xingming
Published: November 2013

This paper investigates the problem of the minimum length link scheduling (MLLS) in multiuser MIMO (MU-MIMO) networks. Generally, in the networks with MU-MIMO capability, the number of concurrent transmissions can be as large as that of antenna elements at the receiver. As a result, link interference is no longer binary but demonstrates a strong correlation among multiple links, which cannot be captured by the conventional conflict graph interference model. Hence, we propose a novel hypergraph interference model, which can accurately and efficiently characterize the relationship of multiple interferences induced by concurrent transmissions, and provide a tractable formalization of the minimum length link scheduling in MU-MIMO networks (MU-MIMO MLLS). Afterwards, we prove that the MU-MIMO MLLS problem is NP-hard and introduce two approximation algorithms to find the near-optimal feasible schedule. Finally, extensive simulation experiments are presented.
Predictive Factors for Impaired Renal Function following Nephroureterectomy in Upper Urinary Tract Urothelial Cell Carcinoma
Authors: Rodríguez Faba O. , Palou J. , Breda A. , Maroto P. , Fernández Gómez J.M. , Wong A. , Villavicencio H.
Published: November 2013

Objectives: Despite the uncertain value of adjuvant chemotherapy after radical nephroureterectomy (RNU) it is clear that impaired renal function represents a contraindication to its administration. The objective of this study was to identify possible predictive clinical factors for impaired renal function following RNU in patients with upper urinary tract urothelial cell carcinoma (UUT-UCC). Patients and Methods: A retrospective analysis was conducted of 546 patients who underwent RNU between 1992 and 2008 at our institution. Data of interest for this study included estimated glomerular filtration rate (eGFR), age, pathological stage and preoperative hydronephrosis (HN). The predictive value of HN, age and pathological stage for impaired renal function after RNU was calculated by multivariate linear regression analysis. Results: In total, 138 patients met the criteria for inclusion, including 108 men (78%). Mean age at surgery was 67 ± 10 years. There was a significant correlation (p < 0.001) between pre- and postoperative eGFR (decrease of 21% after NU). Preoperative HN was present in 51 patients (37%). On linear regression analysis, preoperative eGFR ≤60 ml/min (p = 0.012; OR = 4.60) and HN (p = 0.027; OR = 10.34) were confirmed to be predictive factors for a postoperative eGFR ≤60 ml/min. When postoperative eGFR ≤45 ml/min was used as the criterion for impaired renal function, predictive factors proved to be preoperative eGFR ≤45 ml/min (p < 0.0001; OR = 18.53), HN (p = 0.038; OR = 0.380) and age ≥70 years (p < 0.0001; OR = 0.169). Conclusions: Preoperative HN, older age and preoperative eGFR <60 ml/min were proven to be predictive factors for impaired renal function after RNU. In these settings, neoadjuvant chemotherapy may be considered.
Clinical Manifestations and Spinal Cord Magnetic Resonance Imaging Findings in Chinese Neuromyelitis Optica Patients
Authors: Lin Aiyu , Zhu Jiting , Yao Xiaoping , Lin Shifang , Murong Shenxing , Li Zhiwen
Published: November 2013

Neuromyelitis optica (NMO) is a disease distinct from multiple sclerosis in terms of clinical and magnetic resonance imaging (MRI) manifestations. Antibody to aquaporin-4 (AQP4) has been identified as a specific biomarker and part of the diagnostic criteria for NMO. Although it is relatively common in Asia, a comprehensive clinical and imaging evaluation of NMO has not been reported in Chinese patients. Here, we reviewed data from 57 Chinese cases. The patients had an obvious female preponderance (female/male = 8.5:1), and transverse myelitis (82.5%) and optic neuritis (56.1%) were the most common manifestations. In MRI, longitudinally extensive transverse myelitis (6.9 ± 2.3 segments) dominated the spinal cord lesions, which were mainly (69.7%) distributed in cervical and thoracic cord. However, the length of the lesions was not correlated with onset age, paralysis severity, relapse rate, or duration. Among 29 patients who underwent AQP4 antibody assay, 17 (58.6%) were positive. There was no difference between seropositive and seronegative patients in terms of female preponderance, onset age, relapse rate, and Expanded Disability Status Scale score. However, seropositive patients had significantly more damaged segments (8.3 ± 3.5) than did seronegative patients (4.5 ± 1.6) (p < 0.001). The data revealed the clinical and MRI characteristics and AQP4 antibody status of NMO in Chinese patients and the correlations between them, which may have important implications for the diagnosis of the disease.
Different Risk Factor Profiles between Transient Global Amnesia and Transient Ischemic Attack: A Large Case-Control Study
Authors: Jang Jae-Won , Park So Young , Hong Jeong-Ho , Park Young Ho , Kim Jung E. , Kim SangYun
Published: November 2013

Background: The pathophysiology of transient global amnesia (TGA) is not fully understood. This study was conducted to identify the cardiovascular risk factors of TGA compared to those of transient ischemic attack (TIA) and normal controls, using a large number of subjects. In addition to the comparison of risk factors, an association between the observed cardiovascular risk factors in the current study and a pathophysiological mechanism recently investigated was speculated upon. Materials and Methods: We performed a retrospective case-control study that compared 293 TGA patients to 632 TIA patients and 293 age- and sex-matched normal controls. Demographic details and cardiovascular risk factors were carefully recorded. Results: TGA patients had a significantly higher prevalence of ischemic heart disease and hyperlipidemia; however, they had a lower prevalence of hypertension, diabetes mellitus, ischemic stroke and atrial fibrillation when compared to TIA patients. When compared to age- and sex-matched normal controls, TGA patients also had a significantly higher prevalence of hyperlipidemia, previous ischemic stroke and ischemic heart disease. Conclusion: The cardiovascular risk factors identified in TGA patients in this study were different from those of previously reported studies. This disproportionate prevalence of cardiovascular risk factors may constitute possible evidence that TGA and TIA differ in their pathophysiological mechanism. In addition, some cardiovascular risk factors, such as hyperlipidemia and ischemic heart disease, should be regarded as possible risk factors of TGA.
Assessment of the Noise-Protective Action of the Olivocochlear Efferents in Humans
Authors: Wolpert Stephan , Heyd Andreas , Wagner Wolfgang
Published: November 2013

It has been demonstrated in different mammals that the medial olivocochlear efferents (MOC) exert a noise-protective effect on the cochlea. In humans such an effect has not unambiguously been shown as of yet. The objective of this study was to assess the relationship between MOC activity and susceptibility of the cochlea to noise-induced hearing loss in humans. In 40 normally hearing human subjects, we measured the following: (1) magnitude of temporary threshold shift (TTS) after exposure to 60 min broadband noise of 94 dB SPL and (2) contralateral suppression (CS) of distortion product otoacoustic emissions (which reflects MOC activity) using two different measurement paradigms. CS was measured in duplicate on 2 measurement days. The relationship between TTS and CS was assessed. Individual TTS in the most affected frequencies (4 > 3 > 8 kHz) ranged from 9 to 28 dB HL, with an average maximum TTS of 18.4 dB HL. The amount of CS ranged between 0.3 and 3 dB. The repeatability of CS, evaluated by Cronbach's α value, ranged from 0.76 (acceptable repeatability) to 0.86 (good repeatability). One of the two different measurement paradigms showed a statistically significant inverse correlation between CS magnitude and amount of TTS, which was hypothesized. This is the first study on the relationship between TTS and CS in humans employing TTS induced under controlled laboratory conditions and two different MOC paradigms. The findings are compatible with the hypothesis that MOC activity is noise protective in humans. Future perspectives include modified CS paradigms, longitudinal cohort studies or efforts to also monitor lateral efferent effects in humans.
Anti-Osteoporotic Drugs and Vascular Calcification: The Bidirectional Calcium Traffic
Authors: Yavropoulou Maria P. , Pikilidou Maria , Yovos John G.
Published: November 2013

During the last years, numerous epidemiological studies have demonstrated a direct relationship between vascular calcification and low bone mineral density. This observation is in line with experimental data demonstrating the osteogenic characteristics of calcified arteries. Various common risk factors have been suggested to link vascular calcification and bone loss, including aging, estrogen deficiency, vitamin D and K deficiency, diabetes mellitus, renal failure, smoking, chronic inflammation and oxidative stress. Although the underlying pathogenetic mechanisms are not yet clear, current research is focusing on anti-osteoporotic agents that could potentially affect the deposition of calcium in the arterial wall and thus provide an additional therapeutic strategy in elderly osteoporotic women prone to calcific cardiovascular disease.
Prosodic Marking, Pitch and Intensity in Spontaneous Lexical Self-Repair in Dutch
Authors: Plug Leendert , Carter Paul
Published: November 2013

This paper presents results of a phonetic analysis of instances of lexical selfrepair drawn from a corpus of spontaneous Dutch speech. The analysis addresses questions concerning the phonetic details of prosodic marking in self-repair and its conditioning factors. In particular, it examines the relevance of semantic, temporal and frequency-related factors in modelling f0 and intensity measures and auditory judgements of whether repairs are prosodically marked. It addresses the extent to which observations made in studies using experimentally-elicited speech can be expected to generalise to repairs drawn from uncontrolled spontaneous speech. The results suggest that prosodic marking is rare in spontaneous lexical self-repair, and that semantic, temporal and frequency factors play a limited role only in conditioning speakers' choices for or against prosodic marking, although several weak tendencies can be observed.
Evaluation of the Antipruritic Effects of Topical Pimecrolimus in Non-Atopic Prurigo Nodularis: Results of a Randomized, Hydrocortisone-Controlled, Double-Blind Phase II Trial
Authors: Siepmann Dorothee , Lotts Tobias , Blome Christine , Braeutigam Matthias , Phan Ngoc Quan , Butterfass-Bahloul Trude , Augustin Matthias , Luger Thomas A. , Ständer Sonja
Published: November 2013

Background: In the treatment of atopic dermatitis, pimecrolimus has high antipruritic effects. Objective: To investigate the efficacy of 1% pimecrolimus cream in comparison to 1% hydrocortisone cream in non-atopic prurigo nodularis (PN). Methods: A randomized, controlled, double-blind study with intraindividual randomization was done in 30 patients (17 females, 13 males; mean age 58.5 years) with PN. Results: Pruritus intensity decreased significantly (p < 0.001) on both treated sides as early as after 10 days of treatment; scratch lesions improved (p < 0.001). Quality of life as assessed by the Dermatology Life Quality Index improved significantly. However, a significant advantage of pimecrolimus over hydrocortisone was not found. Conclusion: The results suggest that the non-steroid pimecrolimus is an effective alternative for PN treatment.
Mild Ovarian Stimulation for in vitro Fertilization: Are We Ready to Change? A Meta-Analysis
Authors: Matsaseng Thabo , Kruger Thinus , Steyn Wilhelm
Published: November 2013

Objective: To compare the efficacy of mild ovarian stimulation versus conventional stimulation in in vitro fertilization (IVF). Design: Meta-analysis. Search Strategy: A systemic literature search was carried out for prospective randomised clinical trials. We electronically searched using PubMed, Medline and Embase for all the studies published from 1990 to December 2011. Interventions: Mild ovarian stimulation IVF that uses lower doses and/or shorter duration of gonadotrophins in GnRH antagonist co-treated cycle compared with conventional stimulation IVF. Main Outcome Measures: Live birth rates per started cycle and ongoing pregnancy rates per started cycle of IVF. Results: On live birth rate, there was a significant difference in favour of the conventional stimulation [70/444 (15.7%) mild vs. 78/325 (24%) conventional] (OR 0.59, CI 0.41-0.85, p = 0.004). Similar findings were observed in the ongoing pregnancy data [140/696 (20%) mild vs. 144/547 (26%) in favour of conventional stimulation] (OR 0.72, CI 0.55-0.93, p = 0.01). The sub-analysis of two studies showed a statistically significant reduction of hyperstimulation syndrome in favour of the mild stimulation (OR 0.27, CI 0.11-0.66). Conclusion: This analysis presents strong evidence in favour of conventional stimulation IVF, which therefore should currently be considered a treatment of choice for patients requiring IVF treatment.
Dermoscopy of Acral Melanoma: A Multicenter Study on Behalf of the International Dermoscopy Society
Authors: Braun Ralph P. , Thomas L. , Dusza S.W. , Gaide O. , Menzies S. , Dalle S. , Blum A. , Argenziano G. , Zalaudek I. , Kopf A. , Rabinovitz H. , Oliviero M. , Perrinaud A. , Cabo H. , Pizzichetta M. , Pozo L. , Langford D. , Tanaka M. , Saida T. , Perusquia Ortiz A.M. , Kreusch J. , De Giorgi V. , Piccolo D. , Grichnik J.M. , Kittler H. , Puig S. , Malvehy J. , Seidenari S. , Stanganelli I. , French L. , Marghoob A.A.
Published: November 2013

Background: Most studies on dermoscopy of acral lesions were conducted in Asian populations. In this study, we analyzed these features in a predominantly Caucasian population. Objective: Estimate the prevalence of dermoscopic features in acral lesions, and assess their level of agreement between observers. Methods: In this retrospective multicenter study, 167 acral lesions (66 melanomas) were evaluated for 13 dermoscopic patterns by 26 physicians, via a secured Internet platform. Results: Parallel furrow pattern, bizarre pattern, and diffuse pigmentation with variable shades of brown had the highest prevalence. The agreement for lesion patterns between physicians was variable. Agreement was dependent on the level of diagnostic difficulty. Conclusion: Lesions with a diameter >1 cm were more likely to be melanoma. We found as well that a benign pattern can be seen in parts of melanomas. For this reason one should evaluate an acral lesion for the presence of malignant patterns first.
Methicillin-Resistant Staphylococcus aureus Keratitis after Descemet's Stripping Automated Endothelial Keratoplasty
Authors: Miyamoto Tatsuro , Eguchi Hiroshi , Tserennadmid Ehkhmaa , Mitamura-Aizawa Sayaka , Hotta Fumika , Mitamura Yoshinori
Published: November 2013

Purpose: We report a case of methicillin-resistant Staphylococcus aureus (MRSA) keratitis after Descemet's stripping automated endothelial keratoplasty (DSAEK). Case Report: An 87-year-old woman who had undergone a DSAEK 4 months previously was referred to Tokushima University Hospital with a diagnosis of infectious keratitis after DSAEK. A white abscess and infiltration in the inferior cornea of the right eye were observed. We started an empiric therapy using topical levofloxacin and chloramphenicol on the basis of the microscopic findings of the corneal scraping concurrently with cultivation of the cornea. Results: A strain of MRSA was isolated from the corneal sample. Although the strain was susceptible to chloramphenicol, it was resistant to quinolone. The keratitis improved rapidly due to empiric therapy, and topical steroids could be resumed 6 days after initiation of the empiric therapy. Conclusions: To our knowledge, this is the first case of MRSA keratitis, and the second case of bacterial keratitis, after DSAEK. MRSA keratitis can occur following uneventful DSAEK. The empiric therapy on the basis of results from a light microscopic examination of a Gram-stained corneal scraping and restarting topical steroids in the early stages of medication contributed to the good clinical course of this case.
Refraction Correction in 3D Transcranial Ultrasound Imaging
Authors: Lindsey Brooks D. , Smith Stephen W.
Published: November 2013

We present the first correction of refraction in three-dimensional (3D) ultrasound imaging using an iterative approach that traces propagation paths through a two-layer planar tissue model, applying Snell’s law in 3D. This approach is applied to real-time 3D transcranial ultrasound imaging by precomputing delays offline for several skull thicknesses, allowing the user to switch between three sets of delays for phased array imaging at the push of a button. Simulations indicate that refraction correction may be expected to increase sensitivity, reduce beam steering errors, and partially restore lost spatial resolution, with the greatest improvements occurring at the largest steering angles. Distorted images of cylindrical lesions were created by imaging through an acrylic plate in a tissue-mimicking phantom. As a result of correcting for refraction, lesions were restored to 93.6% of their original diameter in the lateral direction and 98.1% of their original shape along the long axis of the cylinders. In imaging two healthy volunteers, the mean brightness increased by 8.3% and showed no spatial dependency.
Foster children who decide to be called by a new first name: links to extreme defences, identity and attachment
Authors: Ostler Teresa
Published: November 2013

This case-based study describes three foster children in the US, who decided to be called by a new first name at a time when hopes of reunification were fading and parental rights were being terminated. Two children decided on their own to be called by a different first name. The third child accepted the idea, which was suggested by her foster mother. Children embraced the name changes because they felt lost and wanted to fit in. For two children, the decision represented an extreme defence. With the name change, the children were able to ward off extreme anxiety and pain set in train by the impending decision about termination, but they also cut themselves off prematurely from their identities and from powerful attachment feelings. Encouraged in therapy to talk about feelings and memories associated with her real name, the third child was better able to integrate past and present, and to move forward. A sudden decision on the part of a foster child to be called by a new first name should alert others to the possible precarious state of the child’s sense of identity and attachment relationships. Helping the child in therapy to access, explore and experience feelings about the name change may have important benefits in integration and help to avoid identity foreclosure.
Preparation of Cu–Cr–Zr alloy billets by horizontal electromagnetic continuous stirring
Authors: Fu Y. B. , Cui J.
Published: November 2013

The addition of Cr and Zr into the Cu base is applied to overhead contact wires and lead frames due to its high tensile stress and electrical conductivity. Results show that the length of 45 m for Cu–Cr–Zr alloy billets can be successfully prepared by horizontal electromagnetic continuous stirring. The optimised parameters on Cu–Cr–Zr billets with 87 mm diameter are as follows: the current is 50 A, the frequent is 30 Hz and the casting speed is 108 mm min−1. The rotating magnetic field (RMF) can decrease the casting temperature by 22°C. The average grain size with RMF is 1·35 mm, reduced by 55 compared to that without RMF. The tensile stress is 212 MPa, and elongation is 33. The microstructure with RMF on non-vacuum casting is similar to that of the vacuum. At the same time, RMF makes Cr, Zr and Cu atoms uniformly distributed.
Laser and GTAW torch processing of Fe–Cr–B coatings on steel
Authors: Md Idriss A. N. , Mridha S. , Baker T. N.
Published: November 2013

A comparison of a coating of Fe–Cr–B alloy powder processed on a plain carbon steel by surface melting using either laser or gas tungsten arc welding (GTAW) torch was made. The alloy powder was injected in laser melted surface, while the preplaced powder was melted using the GTAW technique. The topography of the GTAW tracks showed a relatively smooth surface, but the laser track surface was very rough. Because of high energy input, the GTAW method produced very wide and deep tracks with a high dilution compared to those of the laser tracks. Pores and fine cracks were seen in laser tracks; the cracks were elongated across the track width, and some of them propagated down to the melt depth. The GTAW track produced at a low energy was free from any cracking, but a centreline crack was present when processed at a high energy input.
Preparation and healing property evaluation of self-repairing polymer coating
Authors: Liao L. P. , Zhang W. , Zhao Y.
Published: November 2013

The self-repairing polymer coating based on microencapsulated epoxy resin agent and catalyst was prepared. Defects in the coating were successfully healed when epoxy resin was released from the microcapsules, which were ruptured under simulated mechanical action. Polymer healed area was found to prevent corrosion of the substrate, which was analysed by scanning electron microscopy. The healing efficiency was determined using electrochemical impedance spectroscopy. The local corrosion activity of the damaged coating on the carbon steel was evaluated. The impedance spectroscopy of the self-healing coating showed measurable improvements of anticorrosion performance after defect creation.
Effect of deposition pressure on mechanical properties of Al–Mg–B thin films
Authors: Kang R. F. , Bai Y. Z. , Qin F. W. , Zhao Y. , Pang J. Q. , Zhao J.
Published: November 2013

This work explored the effect of deposition pressure on the properties of the ternary Al–Mg–B thin films deposited on Si substrate at high deposition temperature (600°C) by magnetron sputtering system with one pure boron target and one Al/Mg co-target. The influences of the deposition pressure on the elemental contents, deposition rate, surface roughness, structure and mechanical properties were investigated by Electron microprobe analysis (EPMA), 3D surface profiler, X-ray diffraction (XRD), Fourier transforms infrared spectroscopy (FTIR), and nanoindentation experiments respectively. Experimental results indicated that the amorphous thin films deposited at 0·5 Pa had a smooth surface and displayed the maximum hardness and Young's modulus of 35 and 322 GPa respectively. From the results of this work, high quality Al–Mg–B hard thin films can be obtained by magnetron sputtering under an optimum deposition pressure of 0·5 Pa.
Texture etching of monocrystalline silicon surface with sodium hypochlorite
Authors: Lounas A. , Nait Bouda A. , Menari H. , Belkacem Y. , Gabouze N.
Published: November 2013

Silicon etching in alkaline solutions has been employed for many years, in the fabrication of solar cells. Surface texturisation of crystalline silicon was performed by using different etching solutions. Recently, a strong oxidising reagent NaOCl has been used successfully by several authors to texture the silicon surface. In this work, the effect of the etching parameters such as solution composition on the silicon surface morphology is studied. The surface of etched samples was analysed by scanning electron microscopy (SEM), spectrophotometry and secondary ion mass spectroscopy (SIMS). The results clearly show that the presence of ethanol in the solution leads to the formation of pyramids, while its absence induces the formation of nanostructures (nanowire or nanoneedle).
HOXC9 directly regulates distinct sets of genes to coordinate diverse cellular processes during neuronal differentiation
Authors: Wang Xiangwei , Choi Jeong-Hyeon , Ding Jane , Yang Liqun , Ngoka Lambert C , Lee Eun J , Zha Yunhong , Mao Ling , Jin Bilian , Ren Mingqiang , Cowell John , Huang Shuang , Shi Huidong , Cui Hongjuan , Ding Han-Fei
Published: November 2013

Background

Cellular differentiation is characterized by the acquisition of specialized structures and functions, cell cycle exit, and global attenuation of the DNA damage response. It is largely unknown how these diverse cellular events are coordinated at the molecular level during differentiation. We addressed this question in a model system of neuroblastoma cell differentiation induced by HOXC9.

Results

We conducted a genome-wide analysis of the HOXC9-induced neuronal differentiation program. Microarray gene expression profiling revealed that HOXC9-induced differentiation was associated with transcriptional regulation of 2,370 genes, characterized by global upregulation of neuronal genes and downregulation of cell cycle and DNA repair genes. Remarkably, genome-wide mapping by ChIP-seq demonstrated that HOXC9 bound to 40% of these genes, including a large number of genes involved in neuronal differentiation, cell cycle progression and the DNA damage response. Moreover, we showed that HOXC9 interacted with the transcriptional repressor E2F6 and recruited it to the promoters of cell cycle genes for repressing their expression.

Conclusions

Our results demonstrate that HOXC9 coordinates diverse cellular processes associated with differentiation by directly activating and repressing the transcription of distinct sets of genes.
Adjunctive aerosolized colistin for multi-drug resistant gram-negative pneumonia in the critically ill: a retrospective study
Authors: Doshi Neha M , Cook Charles H , Mount Kari L , Stawicki Stanislaw P , Frazee Erin N , Personett Heather A , Schramm Garrett E , Arnold Heather M , Murphy Claire V
Published: November 2013

Background

The incidence of multi-drug resistant (MDR) gram-negative (GN) organisms including Pseudomonas and Acinetobacter spp has increased in the last decade, prompting re-evaluation of colistin for the management of these infections. Aerosolized colistin as an adjunct to intravenous therapy is a current option for the management of MDR-GN pneumonia, although data supporting this practice is limited. This study evaluates the efficacy of adjunctive aerosolized colistin in combination with intravenous colistin in critically ill patients with MDR-GN pneumonia.

Methods

A retrospective multi-center cohort analysis comparing critically ill patients with MDR-GN pneumonia who received intravenous colistin (IV) alone or in combination with adjunctive aerosolized colistin (IV/AER) with a primary endpoint of clinical cure at the end of colistin therapy. Secondary endpoints included microbiologic cure, duration of mechanical ventilation, length of stay, and hospital mortality. A post-hoc subgroup analysis was performed for patients with high quality cultures used for diagnosis of MDR-GN pneumonia. Dichotomous data were compared using Fisher’s exact test while the student’s t-test or Mann–Whitney U test were used for continuous variables.

Results

Ninety-five patients met criteria for evaluation with 51 patients receiving IV and 44 receiving IV/AER. Baseline characteristics were similar between the two groups. Twenty patients (39.2%) receiving IV and 24 (54.5%) receiving IV/AER achieved clinical cure (p = 0.135). There was no difference in microbiologic cure rates between the IV and IV/AER colistin groups (40.7vs. 44.4%, p = 0.805). The IV group demonstrated a trend towards higher pneumonia attributable mortality (70.4 vs. 40%, p = 0.055). In the subgroup analysis of patients with high quality respiratory cultures, there was a significantly lower clinical cure rate for those in the IV group as compared to the IV/AER group (31.3 vs. 57.1%, p = 0.033).

Conclusions

Addition of aerosolized colistin to IV colistin may improve clinical cure and mortality for patients with MDR-GN pneumonia. Larger, prospective trials are warranted to confirm the benefit of adjunctive aerosolized colistin in critically ill patients with MDR-GN pneumonia.
Vitamin D-responsive SGPP2 variants associated with lung cell expression and lung function
Authors: Reardon Brian J , Hansen Joyanna G , Crystal Ronald G , Houston Denise K , Kritchevsky Stephen B , Harris Tamara , Lohman Kurt , Liu Yongmei , O’Connor George T , Wilk Jemma B , Mezey Jason , Gao Chuan , Cassano Patricia A
Published: November 2013

Background

Vitamin D is associated with lung health in epidemiologic studies, but mechanisms mediating observed associations are poorly understood. This study explores mechanisms for an effect of vitamin D in lung through an in vivo gene expression study, an expression quantitative trait loci (eQTL) analysis in lung tissue, and a population-based cohort study of sequence variants.

Methods

Microarray analysis investigated the association of gene expression in small airway epithelial cells with serum 25(OH)D in adult non-smokers. Sequence variants in candidate genes identified by the microarray were investigated in a lung tissue eQTL database, and also in relation to cross-sectional pulmonary function in the Health, Aging, and Body Composition (Health ABC) study, stratified by race, with replication in the Framingham Heart Study (FHS).

Results

13 candidate genes had significant differences in expression by serum 25(OH)D (nominal p < 0.05), and a genome-wide significant eQTL association was detected for SGPP2. In Health ABC, SGPP2 SNPs were associated with FEV1 in both European- and African-Americans, and the gene-level association was replicated in European-American FHS participants. SNPs in 5 additional candidate genes (DAPK1, FSTL1, KAL1, KCNS3, and RSAD2) were associated with FEV1 in Health ABC participants.

Conclusions

SGPP2, a sphingosine-1-phosphate phosphatase, is a novel vitamin D-responsive gene associated with lung function. The identified associations will need to be followed up in further studies.
St Gallen molecular subtypes in primary breast cancer and matched lymph node metastases - aspects on distribution and prognosis for patients with luminal A tumours: results from a prospective randomised trial
Authors: Falck Anna-Karin , Fernö Mårten , Bendahl Pär-Ola , Rydén Lisa
Published: November 2013

Background

The St Gallen surrogate molecular subtype definitions classify the oestrogen (ER) positive breast cancer into the luminal A and luminal B subtypes according to proliferation rate and/or expression of human epidermal growth factor receptor 2 (HER2) with differences in prognosis and chemo-responsiveness. Primary tumours and lymph node metastases might represent different malignant clones, but in the clinical setting only the biomarker profile of the primary tumour is used for selection of adjuvant systemic treatment. The present study aimed to classify primary breast tumours and matched lymph node metastases into luminal A, luminal B, HER2-positive and triple-negative subtypes and compare the distributions.

Methods

Eighty-five patients with available tumour tissue from both locations were classified. The distribution of molecular subtypes in primary tumours and corresponding lymph node metastases were compared, and related to 5-year distant disease-free survival (DDFS).

Results

The St Gallen molecular subtypes were discordant between primary tumours and matched lymph node metastases in 11% of the patients (p = 0.06). The luminal A subtype in the primary tumour shifted to a subtype with a worse prognostic profile in the lymph node metastases in 7 of 45 cases (16%) whereas no shift in the opposite direction was observed (0/38) (p = 0.02). All subtypes had an increased hazard for developing distant metastasis during the first 5 years after diagnosis in both primary breast tumours and matched lymph node metastases, compared with the luminal A subtype.

Conclusion

The classification according to the St Gallen molecular subtypes in primary tumours and matched lymph node metastases, implicates a shift to a more aggressive subtype in synchronous lymph node metastases compared to the primary breast tumour. The selection of systemic adjuvant therapy might benefit from taking the molecular subtypes in the metastatic node into account.
Children’s sedentary behaviour: descriptive epidemiology and associations with objectively-measured sedentary time
Authors: Klitsie Tessa , Corder Kirsten , Visscher Tommy LS , Atkin Andrew J , Jones Andrew P , van Sluijs Esther MF
Published: November 2013

Background

Little is known regarding the patterning and socio-demographic distribution of multiple sedentary behaviours in children. The aims of this study were to: 1) describe the leisure-time sedentary behaviour of 9–10 year old British children, and 2) establish associations with objectively-measured sedentary time.

Methods

Cross-sectional analysis in the SPEEDY study (Sport, Physical activity and Eating behaviour: Environmental Determinants in Young people) (N=1513, 44.3% boys). Twelve leisure-time sedentary behaviours were assessed by questionnaire. Objectively-measured leisure-time sedentary time (Actigraph GT1M, <100 counts/minute) was assessed over 7 days. Differences by sex and socioeconomic status (SES) in self-reported sedentary behaviours were tested using Kruskal-Wallis tests. The association between objectively-measured sedentary time and the separate sedentary behaviours (continuous (minutes) and categorised into 'none’ 'low’ or 'high’ participation) was assessed using multi-level linear regression.

Results

Sex differences were observed for time spent in most sedentary behaviours (all p ≤ 0.02), except computer use. Girls spent more time in combined non-screen sedentary behaviour (median, interquartile range: girls: 770.0 minutes, 390.0-1230.0; boys: 725.0, 365.0 - 1182.5; p = 0.003), whereas boys spent more time in screen-based behaviours (girls: 540.0, 273.0 - 1050.0; boys: 885.0, 502.5 - 1665.0; p < 0.001). Time spent in five non-screen behaviours differed by SES, with higher values in those of higher SES (all p ≤ 0.001). Regression analyses with continuous exposures indicated that reading (β = 0.1, p < 0.001) and watching television (β = 0.04, p < 0.01) were positively associated with objectively-measured sedentary time, whilst playing board games (β = -0.12, p < 0.05) was negatively associated. Analysed in categorical form, sitting and talking (vs. none: 'low’ β = 26.1,ns; 'high’ 30.9, p < 0.05), playing video games (vs. none: 'low’ β = 49.1, p < 0.01; 'high’ 60.2, p < 0.01) and watching television (vs. lowest tertile: middle β = 22.2,ns; highest β = 31.9, p < 0.05) were positively associated with objectively-measured sedentary time whereas talking on the phone (vs. none: 'low’ β = -38.5, p < 0.01; 'high’ -60.2, p < 0.01) and using a computer/internet (vs. none: 'low’ β = -30.7, p < 0.05; 'high’ -4.2,ns) were negatively associated.

Conclusions

Boys and girls and children of different socioeconomic backgrounds engage in different leisure-time sedentary behaviours. Whilst a number of behaviours may be predictive of total sedentary time, collectively they explain little overall variance. Future studies should consider a wide range of sedentary behaviours and incorporate objective measures to quantify sedentary time where possible.
Patients’ socioeconomic status and their evaluations of primary care in Hong Kong
Authors: Owolabi Onikepe , Zhang Zhenzhen , Wei Xiaolin , Yang Nan , Li Haitao , Wong Samuel YS , Wong Martin CS , Yip Winnie , Griffiths Sian M
Published: November 2013

Background

Strengthening primary care is key to Hong Kong’s ongoing health system reform. Primary care remains unregulated, private sector dominated and financed mainly out-of-pocket. This study sought to examine the association between patients’ socioeconomic status (SES), source of health payments and the quality of primary care they accessed to inform policy discussions.

Methods

Data was collected from 1,994 respondents in a stratified random telephone survey with a 68% response rate, using the validated primary care assessment tool (PCAT). Education, household-income and type of housing were selected as indicators of SES. Multivariable ordinal logistic regression models were created to examine associations between indicators of SES and scores of quality.

Results

Higher household-income was most significantly associated with better experiences of quality. Respondents with HK$ 15000–39999 (USD1934-5158) and HK$ 40000 (USD5159) and above were 47% (OR 1.47, 95% CI 1.10-1.96) and 2 times (OR 2.07, 95% CI 1.38-3.09) more likely to experience better quality than the lowest-income group respectively. Income group HK$ 40000 (USD5159) and above was 84% more likely to have better utilization (OR 1.84, 95% CI (1.21-2.78), and 2 times more likely to receive better comprehensiveness (OR 1.90, 95% CI 1.26-2.87). Patients who used only private insurance were 80% (OR 1.80, 95% CI 1.20-2.68) more likely to experience better quality than those who paid out-of-pocket.

Conclusions

Our results show that the quality of primary care experienced in HK tended to be higher for those who had higher income and private insurance, and were able to pay out-of-pocket for the care. This indicated that the inequality in primary care is likely to be related with the private dominated primary care system in Hong Kong. More public responsibility on primary health care should be sought for in HK and similar contexts to reduce the inequality in primary care.
Healthier choices in an Australian health service: a pre-post audit of an intervention to improve the nutritional value of foods and drinks in vending machines and food outlets
Authors: Bell Colin , Pond Nicole , Davies Lynda , Francis Jeryl Lynn , Campbell Elizabeth , Wiggers John
Published: November 2013

Background

Vending machines and shops located within health care facilities are a source of food and drinks for staff, visitors and outpatients and they have the potential to promote healthy food and drink choices. This paper describes perceptions of parents and managers of health-service located food outlets towards the availability and labelling of healthier food options and the food and drinks offered for sale in health care facilities in Australia. It also describes the impact of an intervention to improve availability and labelling of healthier foods and drinks for sale.

Methods

Parents (n = 168) and food outlet managers (n = 17) were surveyed. Food and drinks for sale in health-service operated food outlets (n = 5) and vending machines (n = 90) in health care facilities in the Hunter New England region of NSW were audited pre (2007) and post (2010/11) the introduction of policy and associated support to increase the availability of healthier choices. A traffic light system was used to classify foods from least (red) to most healthy choices (green).

Results

Almost all (95%) parents and most (65%) food outlet managers thought food outlets on health service sites should have signs clearly showing healthy choices. Parents (90%) also thought all food outlets on health service sites should provide mostly healthy items compared to 47% of managers. The proportion of healthier beverage slots in vending machines increased from 29% to 51% at follow-up and the proportion of machines that labelled healthier drinks increased from 0 to 26%. No outlets labelled healthier items at baseline compared to 4 out of 5 after the intervention. No changes were observed in the availability or labelling of healthier food in vending machines or the availability of healthier food or drinks in food outlets.

Conclusions

Baseline availability and labelling of healthier food and beverage choices for sale in health care facilities was poor in spite of the support of parents and outlet managers for such initiatives. The intervention encouraged improvements in the availability and labelling of healthier drinks but not foods in vending machines.
In vitro piperaquine susceptibility is not associated with the Plasmodium falciparum chloroquine resistance transporter gene
Authors: Pascual Aurélie , Madamet Marilyn , Bertaux Lionel , Amalvict Rémy , Benoit Nicolas , Travers Dominique , Cren Julien , Taudon Nicolas , Rogier Christophe , Parzy Daniel , Pradines Bruno ,   The French National Reference Centre for Imported Malaria Study Group
Published: November 2013

Background

Dihydroartemisinin-piperaquine is a new ACT that is administered as single daily dose for three days and has been demonstrated to be tolerated and highly effective for the treatment of uncomplicated Plasmodium falciparum malaria. Piperaquine was used alone to replace chloroquine as the first-line treatment for uncomplicated malaria in China in response to increasing chloroquine resistance in the 1970s. However, the rapid emergence of piperaquine-resistant strains that resulted in the cessation of its use in China in the 1980s, suggests that there is cross-resistance between piperaquine and chloroquine. Very few data are available on cross-resistance between piperaquine and chloroquine, and the data that do exist are often contradictory.

Methods

In total, 280 P. falciparum isolates, collected between April 2008 and June 2012 from patients hospitalized in France with imported malaria from a malaria-endemic country, were assessed ex vivo for piperaquine and chloroquine susceptibilities by using the standard 42-hour 3H-hypoxanthine uptake inhibition method. The chloroquine resistance-associated mutation K76T in pfcrt was also investigated for the 280 isolates.

Results

The IC50 for piperaquine ranged from 9.8 nM to 217.3 nM (mean = 81.3 nM. The IC50 for chloroquine ranged from 5.0 nM to 1,918 nM (mean = 83.6 nM. A significant but low correlation was observed between the Log IC50 values for piperaquine and chloroquine (r = 0.145, p < 0.001). However, the coefficient of determination of 0.021 indicates that only 2.1% of the variation in the response to piperaquine is explained by the variation in the response to chloroquine. The mean value for piperaquine was 74.0 nM in the Pfcrt K76 wild-type group (no = 125) and 87.7 nM in the 76 T mutant group (no = 155). This difference was not significant (p = 0.875, Mann Whitney U test).

Conclusions

The present work demonstrates that there was no cross-resistance between piperaquine and chloroquine among 280 P. falciparum isolates and that piperaquine susceptibility is not associated with pfcrt, the gene involved in chloroquine resistance. These results confirm the efficacy of piperaquine in association with dihydroartemisinin and support its use in areas in which parasites are resistant to chloroquine.
Time-frequency analysis of band-limited EEG with BMFLC and Kalman filter for BCI applications
Authors: Wang Yubo , Veluvolu Kalyana C , Lee Minho
Published: November 2013

Background

Time-Frequency analysis of electroencephalogram (EEG) during different mental tasks received significant attention. As EEG is non-stationary, time-frequency analysis is essential to analyze brain states during different mental tasks. Further, the time-frequency information of EEG signal can be used as a feature for classification in brain-computer interface (BCI) applications.

Methods

To accurately model the EEG, band-limited multiple Fourier linear combiner (BMFLC), a linear combination of truncated multiple Fourier series models is employed. A state-space model for BMFLC in combination with Kalman filter/smoother is developed to obtain accurate adaptive estimation. By virtue of construction, BMFLC with Kalman filter/smoother provides accurate time-frequency decomposition of the bandlimited signal.

Results

The proposed method is computationally fast and is suitable for real-time BCI applications. To evaluate the proposed algorithm, a comparison with short-time Fourier transform (STFT) and continuous wavelet transform (CWT) for both synthesized and real EEG data is performed in this paper. The proposed method is applied to BCI Competition data IV for ERD detection in comparison with existing methods.

Conclusions

Results show that the proposed algorithm can provide optimal time-frequency resolution as compared to STFT and CWT. For ERD detection, BMFLC-KF outperforms STFT and BMFLC-KS in real-time applicability with low computational requirement.
rAAV2/7 vector-mediated overexpression of alpha-synuclein in mouse substantia nigra induces protein aggregation and progressive dose-dependent neurodegeneration
Authors: Oliveras-Salvá Marusela , Van der Perren Anke , Casadei Nicolas , Stroobants Stijn , Nuber Silke , D’Hooge Rudi , Van den Haute Chris , Baekelandt Veerle
Published: November 2013

Background

Alpha-synuclein is a key protein implicated in the pathogenesis of Parkinson's disease (PD). It is the main component of the Lewy bodies, a cardinal neuropathological feature in the disease. In addition, whole locus multiplications and point mutations in the gene coding for alpha-synuclein lead to autosomal dominant monogenic PD. Over the past decade, research on PD has impelled the development of new animal models based on alpha-synuclein. In this context, transgenic mouse lines have failed to reproduce several hallmarks of PD, especially the strong and progressive dopaminergic neurodegeneration over time that occurs in the patients. In contrast, viral vector-based models in rats and non-human primates display prominent, although highly variable, nigral dopaminergic neuron loss. However, the few studies available on viral vector-mediated overexpression of alpha-synuclein in mice report a weak neurodegenerative process and no clear Lewy body-like pathology. To address this issue, we performed a comprehensive comparative study of alpha-synuclein overexpression by means of recombinant adeno-associated viral vectors serotype 2/7 (rAAV2/7) at different doses in adult mouse substantia nigra.

Results

We noted a significant and dose-dependent alpha-synucleinopathy over time upon nigral viral vector-mediated alpha-synuclein overexpression. We obtained a strong, progressive and dose-dependent loss of dopaminergic neurons in the substantia nigra, reaching a maximum of 82% after 8 weeks. This effect correlated with a reduction in tyrosine hydroxylase immunoreactivity in the striatum. Moreover, behavioural analysis revealed significant motor impairments from 12 weeks after injection on. In addition, we detected the presence of alpha-synuclein-positive aggregates in the remaining surviving neurons. When comparing wild-type to mutant A53T alpha-synuclein at the same vector dose, both induced a similar degree of cell death. These data were supported by a biochemical analysis that showed a net increase in soluble and insoluble alpha-synuclein expression over time to the same extent for both alpha-synuclein variants.

Conclusions

In conclusion, ourin vivodata provide evidence that strong and significant alpha-synuclein-induced neuropathology and progressive dopaminergic neurodegeneration can be achieved in mouse brain by means of rAAV2/7.