bluuebunny/crossref_metadata_2025 huggingface dataset:
Safe‐steering of batch process systems
Authors: Aumi Siam , Mhaskar Prashant
Published: August 2009

This work considers the problem of controlling batch processes to achieve a desired final product quality subject to input constraints and faults in the control actuators. Specifically, faults are considered that cannot be handled via robust control approaches, and preclude the ability to reach the desired end‐point, necessitating fault‐rectification. A safe‐steering framework is developed to address the problem of determining how to utilize the functioning inputs during fault rectification to ensure that after fault‐rectification, the desired product properties can be reached upon batch termination. To this end, first a novel reverse‐time reachability region (we define the reverse time reachability region as the set of states from where the desired end point can be reached by batch termination) based MPC is formulated that reduces online computations, as well as provides a useful tool for handling faults. Next, a safe‐steering framework is developed that utilizes the reverse‐time reachability region based MPC in steering the state trajectory during fault rectification to enable (upon fault recovery) the achieving of the desired end point properties by batch termination. The proposed controller and safe‐steering framework are illustrated using a fed‐batch process example. © 2009 American Institute of Chemical Engineers AIChE J, 2009
Architecture and performance of mesoporous silica‐lipase hybrids via non‐covalent interfacial adsorption
Authors: Lu Shan , He Jing , Guo Xin
Published: August 2009

To investigate the effects of surface property of mesoporous supports on the lipase immobilization and the performance of immobilized lipase, the mesoporous molecular sieve SBA‐15 is functionalized with three organic moieties, dimethyl (DM), diisopropyl (DIP), and diisobutyl (DIB), respectively, by post‐synthesis grafting and one‐pot synthesis methods. Porcine pancreas lipase (PPL) is immobilized on SBA‐15 supports through hydrogen bonding and hydrophobic interaction. The hydrophobic adsorption involves no active sites of PPL, and neither hyper‐activation nor total inactivation occurs. The study on the intrinsic stability of PPL, including thermal stability, pH stability, and storage stability, indicates that the entrapment in mesoporous supports, and especially in organic‐functionalized supports, makes PPL more resistant to temperature increment but more sensitive to pH change. The reusability investigation shows that the organic modification of mesoporous surface inhibits the enzyme leaching to some extent, resulting in a better operational stability. © 2009 American Institute of Chemical Engineers AIChE J, 2010
Terminal and transient drop rise velocity of single toluene droplets in water
Authors: Wegener Mirco , Kraume Matthias , Paschedag Anja R.
Published: August 2009

The knowledge of the drop rise velocity in dispersed systems is of fundamental importance. Especially, the residence time is needed for calculation of mass transfer rates in extraction columns. This work deals with fluid dynamic measurements of toluene droplets rising in water ranging from 1.0 to 7.0 mm, with the premise of high purity of the used chemicals. The toluene/water‐system is widely used as a test system with high interfacial tension. A semiempirical correlation for pure systems to predict the terminal velocity of single rising/falling droplets based on experimental data is presented. Results show that a distinction between maximum and characteristic mean values of the drop rise velocity is necessary, especially in the diameter range 2.4–3.0 mm where unexpected velocity fluctuations occur. Two distinct terminal rise velocities were observed for 3 mm droplets. Furthermore, comparisons of the Weber‐Reynolds‐correlation and the drag coefficient with correlations from literature show good agreement. © 2009 American Institute of Chemical Engineers AIChE J, 2009
Numerical study of solid particle erosion on the tubes near the side walls in a duct with flow past an aligned tube bank
Authors: Wang Zeli , Fan Jianren , Luo Kun
Published: August 2009

Computational fluid dynamic (CFD) tool has been applied to investigate the erosion of duct walls and that of tubers (10 × 10 aligned tube bank in the duct) near side walls, which is caused by coal ash particle impaction. The flow field is obtained by using direct numerical simulation (DNS) method. The coupling between tubes and flows are made through the immersed boundary technique. Particles are tracked by using Lagrangian approach and further coupled with gas phase. Four coal ash particles are considered 6.2, 20, 80, and 200 μm. In the end, the erosion of the duct walls and that of the tubes near side walls has been well predicted and characterized. © 2009 American Institute of Chemical Engineers AIChE J, 2010
HFE, SLC40A1, HAMP, HJV, TFR2, and FTL mutations detected by denaturing high‐performance liquid chromatography after iron phenotyping and HFE C282Y and H63D genotyping in 785 HEIRS Study participants
Authors: Barton James C. , LaFreniere Susie A. , Leiendecker‐Foster Catherine , Li Honggui , Acton Ronald T. , Press Richard D. , Eckfeldt John H.
Published: August 2009

We sought to identify mutations that could explain iron phenotype heterogeneity in adults with previous HFE genotyping to detect C282Y and H63D. HEIRS Study participants genotyped for C282Y and H63D were designated as high transferrin saturation (TS) and/or serum ferritin (SF) (high TS/SF), low TS/SF, or controls. We grouped 191 C282Y homozygotes as high TS/SF, low TS/SF, or controls, and 594 other participants by race/ethnicity as high TS/SF or controls. Using denaturing high‐performance liquid chromatography (DHPLC), we screened 20 regions of HFE, SLC40A1, HAMP, HJV, TFR2, and FTL in each participant. DHPLC analyses were successful in 99.3% of 791 participants and detected 117 different mutations. In C282Y homozygotes, 4.0% of high TS/SF participants had SLC40A1 Q248H, HAMP ‐72C>T, or HAMP R59G heterozygosity (0% Controls; P = 0.1200). In whites, 4.1% with high TS/SF and 1.3% of controls had HFE S65C or E168Q (P = 0.3049). HJV c.‐6C>G and FTL L55L frequencies were greater in whites with high TS/SF than controls (0.0811 vs. 0.0200, P = 0.0144; 0.5743 vs. 0.4400, P = 0.0204, respectively). One Hispanic with high TS/SF (1.3%) had HAMP G71D heterozygosity. In blacks, SLC40A1 Q248H frequencies did not differ significantly between high TS/SF and control participants. Among Asians, 2.8% with high TS/SF were HFE V295A heterozygotes. Mutations other than HFE C282Y and H63D reported to be pathogenic were infrequently detected in high TS/SF participants. Genetic regions in linkage disequilibrium with HJV c.‐6C>G and FTL L55L could partly explain high TS/SF phenotypes in whites. Am. J. Hematol., 2009. Published 2009 Wiley‐Liss, Inc.
Southern French Neolithic populations: Isotopic evidence for regional specificities in environment and diet
Authors: Herrscher Estelle , Le Bras‐Goude Gwenaëlle
Published: August 2009

The Middle Neolithic of the Northwestern Mediterranean area (∼4500–3500 BC cal) is characterized by the development of food production techniques as well as by increasing social complexity. These characteristics could have had an impact on human dietary patterns. To evaluate human dietary practices and lifeways of the Middle Neolithic populations from the South of France, stable carbon and nitrogen isotope analysis was carried out on 57 human and 53 faunal bones from seven archaeological sites located in the Languedoc and Garonne regions between 20 and 100 km from the Mediterranean Sea, respectively. Results show regional differences in carbon isotope values. Animal and human bones from the Languedoc region are significantly enriched in 13C relative to the Garonne. Conversely, human and dog bones from the Garonne region are significantly enriched in 15N compared to human and dog bones from the Languedoc region. These results highlight the importance of the local ecosystem in human and animal diet as well as a regional differentiation of palaeodietary behavior, which probably relates to economic and social factors. The comparison of stable isotope data with archaeological and biological evidence does not show any significant intra‐ or interpopulation differences. However, the presence of human outliers suggests that migration probably occurred, perhaps in relation to the trade of animals and/or materials. This study also highlights the importance of investigating local animal stable isotope values for the interpretation of human palaeodiet. Am J Phys Anthropol 2010. © 2009 Wiley‐Liss, Inc.
Lumbar vertebral morphology and isthmic spondylolysis in a British medieval population
Authors: Ward Carol V. , Mays Simon A. , Child Stephanie , Latimer Bruce
Published: August 2009

The British medieval population from Wharram Percy, England, has a greater prevalence of isthmic spondylolysis (11.9% of skeletons, 8.5% at the L5 level) than in modern populations (3%–6%). This may in part be due to differences in activity patterns between groups. However, Ward and Latimer (Spine 30 [2005] 1808–1814) proposed that the likelihood of developing and maintaining spondylolytic defects is also influenced by a lack of sufficient increase in mediolateral separation between articular processes in the lowest lumbar segments, given the human lumbar lordosis. Here, we demonstrate that spondylolytic individuals from Wharram Percy tend to have a less pronounced difference between mediolateral facet joint spacing of adjacent segments in the lowest lumbar region than do unaffected individuals, as seen in modern clinical and skeletal populations. These comparisons suggest that regardless of lifestyle, insufficient mediolateral increase in facet spacing predisposes people to spondylolytic defects, and so interfacet spacing patterns may have predictive utility in a clinical context. We also compare the Wharram Percy sample to a modern sample from the Hamann Todd collection with a typically modern prevalence rate. Data do not support the hypothesis that the Wharram Percy individuals had a less pronounced interfacet increase than the Hamann Todd, although they do have narrower lumbar facet spacing at the lowest three levels. Further investigation of anatomical variation underlying population‐specific prevalence rates needs to be conducted. Am J Phys Anthropol 2010. © 2009 Wiley‐Liss, Inc.
Technical note: Forearm pronation efficiency analysis in skeletal remains
Authors: Galtés Ignasi , Jordana Xavier , Malgosa Assumpció , Manyosa Joan
Published: August 2009

This work presents an original methodology for analyzing forearm‐pronation efficiency from skeletal remains and its variation with regard to changes in the elbow position. The methodology is based on a biomechanical model that defines rotational efficiency as a mathematical function expressing a geometrical relationship between the origin and insertion of the pronator teres. The methodology uses humeral distal epiphysis photography, from which the geometrical parameters for the efficiency calculus can be obtained. Rotational efficiency is analyzed in a human specimen and in a living nonhuman hominoid (Symphalangus syndactylus) for a full elbow extension (180°) and an intermediate elbow position (90°). In both specimens, the results show that this rotational‐efficiency parameter varies throughout the entire rotational range and show a dependency on the elbow joint position. The rotational efficiency of the siamang's pronator teres is less affected by flexion of the forearm than that of the human. The fact that forearm‐pronation efficiency can be inferred, even quantified, allows us to interpret more precisely the functional and evolutionary significance of upper‐limb skeletal design in extant and fossil primate taxa. Am J Phys Anthropol 2009. © 2009 Wiley‐Liss, Inc.
Historical perspective: Neurological advances from studies of war injuries and illnesses
Authors: Lanska Douglas J.
Published: August 2009

Early in the 20th century during the Russo‐Japanese War and World War I (WWI), some of the most important, lasting contributions to clinical neurology were descriptive clinical studies, especially those concerning war‐related peripheral nerve disorders (eg, Hoffmann‐Tinel sign, Guillain‐Barré‐Strohl syndrome [GBS]) and occipital bullet wounds (eg, the retinal projection on the cortex by Inouye and later by Holmes and Lister, and the functional partitioning of visual processes in the occipital cortex by Riddoch), but there were also other important descriptive studies concerning war‐related aphasia, cerebellar injuries, and spinal cord injuries (eg, cerebellar injuries by Holmes, and autonomic dysreflexia by Head and Riddoch). Later progress, during and shortly after World War II (WWII), included major progress in understanding the pathophysiology of traumatic brain injuries by Denny‐Brown, Russell, and Holbourn, pioneering accident injury studies by Cairns and Holbourn, promulgation of helmets to prevent motorcycle injuries by Cairns, development of comprehensive multidisciplinary neurorehabilitation by Rusk, and development of spinal cord injury care by Munro, Guttman, and Bors. These studies and developments were possible only because of the large number of cases that allowed individual physicians the opportunity to collect, collate, and synthesize observations of numerous cases in a short span of time. Such studies also required dedicated, disciplined, and knowledgeable investigators who made the most out of their opportunities to systematically assess large numbers of seriously ill and injured soldiers under stressful and often overtly dangerous situations. Ann Neurol 2009;66:444–459
Neuroplasticity predicts outcome of optic neuritis independent of tissue damage
Authors: Jenkins Thomas M. , Toosy Ahmed T. , Ciccarelli Olga , Miszkiel Katherine A. , Wheeler‐Kingshott Claudia A. , Henderson Andrew P. , Kallis Constantinos , Mancini Laura , Plant Gordon T. , Miller David H. , Thompson Alan J.
Published: August 2009

Objectives

To determine whether lateral occipital complex (LOC) activation with functional magnetic resonance imaging (fMRI) predicts visual outcome after clinically isolated optic neuritis (ON). To investigate the reasons behind good recovery following ON, despite residual optic nerve demyelination and neuroaxonal damage.

Methods

Patients with acute ON and healthy volunteers were studied longitudinally over 12 months. Structural MRI, visual evoked potentials (VEPs), and optical coherence tomography (OCT) were used to quantify acute inflammation, demyelination, conduction block, and later to estimate remyelination and neuroaxonal loss over the entire visual pathway. The role of neuroplasticity was investigated using fMRI. Multivariable linear regression analysis was used to study associations between vision, structure, and function.

Results

Greater baseline fMRI responses in the LOCs were associated with better visual outcome at 12 months. This was evident on stimulation of either eye (p = 0.007 affected; p = 0.020 fellow eye), and was independent of measures of demyelination and neuroaxonal loss. A negative fMRI response in the LOCs at baseline was associated with a relatively worse visual outcome. No acute electrophysiological or structural measures, in the anterior or posterior visual pathways, were associated with visual outcome.

Interpretation

Early neuroplasticity in higher visual areas appears to be an important determinant of recovery from ON, independent of tissue damage in the anterior or posterior visual pathway, including neuroaxonal loss (as measured by MRI, VEP, and OCT) and demyelination (as measured by VEP). ANN NEUROL 2010;67:99–113
Abnormal activity in reward brain circuits in human narcolepsy with cataplexy
Authors: Ponz Aurélie , Khatami Ramin , Poryazova Rositsa , Werth Esther , Boesiger Peter , Bassetti Claudio L. , Schwartz Sophie
Published: August 2009

Objective

Hypothalamic hypocretins (or orexins) regulate energy metabolism and arousal maintenance. Recent animal research suggests that hypocretins may also influence reward‐related behaviors. In humans, the loss of hypocretin‐containing neurons results in a major sleep‐wake disorder called narcolepsy‐cataplexy, which is associated with emotional disturbances. Here, we aim to test whether narcoleptic patients show an abnormal pattern of brain activity during reward processing.

Methods

We used functional magnetic resonance imaging in 12 unmedicated patients with narcolepsy‐cataplexy to measure the neural responses to expectancy and experience of monetary gains and losses. We statistically compared the patients' data with those obtained in a group of 12 healthy matched controls.

Results and Interpretation

Our results reveal that activity in the dopaminergic ventral midbrain (ventral tegmental area) was not modulated in narcolepsy‐cataplexy patients during high reward expectancy (unlike controls), and that ventral striatum activity was reduced during winning. By contrast, the patients showed abnormal activity increases in the amygdala and in dorsal striatum for positive outcomes. In addition, we found that activity in the nucleus accumbens and the ventral‐medial prefrontal cortex correlated with disease duration, suggesting that an alternate neural circuit could be privileged over the years to control affective responses to emotional challenges and compensate for the lack of influence from ventral midbrain regions. Our study offers a detailed picture of the distributed brain network involved during distinct stages of reward processing and shows for the first time, to our knowledge, how this network is affected in hypocretin‐deficient narcoleptic patients. ANN NEUROL 2010;67:190–200
Developmental plasticity connects visual cortex to motoneurons after stroke
Authors: Basu Anna , Graziadio Sara , Smith Martin , Clowry Gavin J. , Cioni Giovanni , Eyre Janet A.
Published: August 2009

We report motor cortical function in the left occipital cortex of a subject who suffered a left middle cerebral artery stroke early in development. Transcranial magnetic stimulation of the left occipital cortex evoked contraction of right hand muscles. Electroencephalogram recorded over the left occipital cortex showed: 1) coherence with electromyogram from a right hand muscle; 2) a typical sensorimotor Mu rhythm at rest that was suppressed during contraction of right hand muscles. This is the first evidence that cortical plasticity extends beyond reshaping of primary sensory cortical fields to respecification of the cortical origin of subcortically projecting pathways. ANN NEUROL 2010;67:132–136
Overall crystallization behavior of polypropylene–clay nanocomposites; Effect of clay content and polymer/clay compatibility on the bulk crystallization and spherulitic growth
Authors: Perez C. J. , Alvarez V. A.
Published: August 2009

The effect of clay nanoparticles on the overall crystallization (isothermal crystallization, spherulitic growth, and nonisothermal crystallization) behavior of polypropylene (PP) was studied by means of differential scanning calorimetry and polarized light optical microscopy. In addition, the changes produced by the compatibility between the filler and the matrix were analyzed by using more hydrophobic clays or incorporating PP grafted with maleic anhydride (PP‐g‐MA). Different models were used to predict the relative degree of crystallinity and several parameters were analyzed. A clear nucleating effect of clay nanoparticles was found on the experimental behavior (induction time, half‐crystallization time, and overall crystallization time) and also deducted from the models parameters (Avrami exponent, rate constant, nucleation activity, activation energy). The effect was also related with the matrix/clay compatibility. In addition, the polarized light optical microscopy showed that the number of spherulites increased and their size decreased when clay was incorporated, which is also an indication of the heterogeneous nucleating behavior of such particles. We also noted faster spherulitic growth and increasing Kg (the model parameter). © 2009 Wiley Periodicals, Inc. J Appl Polym Sci, 2009
Nielsen thermal conductivity model for single filler carbon/polypropylene composites
Authors: Gaxiola Daniel Lopez , Keith Jason M. , King Julia A. , Johnson Beth A.
Published: August 2009

In this study, three different carbon fillers (Thermocarb TC‐300 synthetic graphite, Ketjenblack EC‐600 JD carbon black, and Hyperion Catalysis International's FIBRIL™ carbon nanotubes) were added to a polypropylene matrix to produce single filler composites with filler concentrations of up to 80 wt % synthetic graphite (61.6 vol %), 15 wt % carbon black (8.1 vol %), and 15 wt % carbon nanotubes (7.4 vol %). The through‐plane thermal conductivity for each formulation was measured. For the synthetic graphite, carbon black, and carbon nanotubes composites, the Nielsen model was applied to the experimental through‐plane thermal conductivity data. The Nielsen Model presented in this work showed very good agreement with experimental data. The model parameters were similar to those used in the literature for these fillers in other polymers. © 2009 Wiley Periodicals, Inc. J Appl Polym Sci, 2009
Blends of novel L‐tyrosine‐based polyurethanes and polyphosphate for potential biomedical applications
Authors: Shah Parth N. , Lopina Stephanie T. , Yun Yang H.
Published: August 2009

Elastomeric biodegradable polyurethanes and polyphosphate have been developed using an L‐ tyrosine‐based diphenolic monomer desaminotyrosine‐tyrosine hexyl ester (DTH). Soft segments, which are polycaproloctone diol (PCL) and polyethylene glycol (PEG) have been used for the synthesis of two biodegradable L‐tyrosine polyurethanes (LTUs), which are PEG‐C‐DTH and PCL‐C‐DTH. An investigation of the physico‐chemical properties shows that these polymers have dramatically different properties. By blending LTUs with L‐tyrosine polyphosphate (LTP), we hope to produce a family of materials with a wide range of thermal, morphological, surface, and degradative properties. Examination of the blends shows a smooth surface morphology with a partially phase‐separated structure. These findings are consistent with the results obtained from thermal analysis of the blends. Hydrophilic nature of PEG imparts the PEG‐based blends (PEG‐C‐DTH/LTP) with a significantly higher surface and bulk hydrophilicity compared with the PCL‐based blends (PCL‐C‐DTH/LTP). Finally, the blends demonstrate a rapid initial hydrolytic degradation in phosphate buffered saline (PBS) followed by a significantly slower, prolonged degradation. The observed trend may occur due to the rapid hydrolytic degradation rate of the polyphosphate polymer followed by the degradation of the polyurethane component. Thus, tuning the physical properties by blending LTUs with LTP may be useful for drug delivery device and soft tissue engineering scaffold applications. © 2009 Wiley Periodicals, Inc. J Appl Polym Sci, 2009
Mechanical properties, flame retardancy, hot‐air ageing, and hot‐oil ageing resistance of ethylene‐vinyl acetate rubber/hydrogenated nitrile‐butadiene rubber/magnesium hydroxide composites
Authors: Chen Shuguo , Zhang Yong , Wang Ruyin , Yu Haiyang , Hoch Martin , Guo Sharon
Published: August 2009

The mechanical properties, flame retardancy, hot‐air ageing, and hot‐oil ageing resistance of ethylene‐vinyl acetate rubber (EVM)/hydrogenated nitrile‐butadiene rubber (HNBR)/magnesium hydroxide (MH) composites were studied. With increasing HNBR fraction, elongation at break and tear strength of the EVM/HNBR/MH composites increased, whereas the limited oxygen index and Shore A hardness decreased slightly. Hot‐air ageing resistance and hot‐oil ageing resistance of the composites became better with increasing HNBR fraction. Thermal gravimetric analysis results demonstrated that the presence of MH and low HNBR fraction could improve the thermal stability of the composites. Differential scanning calorimeter revealed that the glass transition temperature (Tg) of the composites shifted toward low temperatures with increasing HNBR fraction, which was also confirmed by dynamic mechanical thermal analysis. Atomic force microscope images showed MH has a small particle size and good dispersion in the composites with high HNBR fraction. The flame retardancy, extremely good hot‐oil ageing, and hot‐air ageing resistance combined with good mechanical properties performance in a wide temperature range (−30°C to 150°C) make the EVM/HNBR/MH composites ideal for cables application. © 2009 Wiley Periodicals, Inc. J Appl Polym Sci, 2009
Endoscopic retroperitoneal neurectomy for chronic pain after groin surgery
Authors: Giger U , Wente M N , Büchler M W , Krähenbühl S , Lerut J , Krähenbühl L
Published: August 2009

Background

Chronic postoperative pain after inguinal surgery remains a difficult problem. The role of minimally invasive surgery in this complex setting is still unexplored.

Methods

Between January 1997 and January 2007, 34 men and five women with a mean(s.d.) age of 47(16) years underwent endoscopic retroperitoneal neurectomy (ERN) for chronic neuropathic groin pain due to genitofemoral nerve with or without ilioinguinal nerve entrapment. Follow-up data were obtained 1 and 12 months after surgery.

Results

At both timepoints after ERN, the severity of chronic postoperative groin pain at rest and during daily activities, and the rate of occupational disability, were significantly decreased in 27 of the 39 patients compared with preoperative values (all P < 0·001).

Conclusion

ERN for chronic postoperative genitofemoral nerve entrapment neuropathy was successful in the majority of patients selected for the procedure. This minimally invasive approach allows simultaneous neurectomy of genitofemoral and ilioinguinal nerves.
Outcomes following repair of traumatic cloacal deformities
Authors: Hollingshead J R F , Warusavitarne J , Vaizey C J , Northover J M A
Published: August 2009

Background

Severe obstetric injury can result in a defect similar to a congenital cloacal deformity, with associated faecal incontinence and sexual dysfunction. The aim of this study was to assess the efficacy of surgical repair of such injuries.

Methods

Patients were identified retrospectively from hospital records. Long-term follow-up data were collected by telephone interview.

Results

Outcomes in 31 consecutive patients seen over a 14-year period were reviewed. An overlapping external sphincter repair, with repair of the anorectum and vagina, was performed in 29 patients. Detailed long-term follow-up data were available for 20 patients at a median of 5 years after surgery. Three patients had a stoma at presentation. Surgical repair reduced incontinence to solid stool from seven of 17 to none of 20 patients, to liquid stool from 14 of 17 to ten of 20, and to flatus from 17 of 17 to 12 of 20. Nine patients reported improvement in sexual function.

Conclusion

Surgical repair of a cloacal injury is associated with significant improvements in faecal incontinence and sexual function. Outcomes are similar to those seen with repair of less severe injuries, and may be maintained in the long term.
Randomized clinical trial of folate supplementation in patients with peripheral arterial disease
Authors: Khandanpour N , Armon M P , Jennings B , Finglas P M , Willis G , Clark A , Meyer F J
Published: August 2009

Background

The aim was to determine whether folate supplementation improved arterial function in patients with peripheral arterial disease (PAD).

Methods

Individuals with PAD were randomly assigned to receive 400 µg folic acid (45 patients) or 5-methyltetrahydrofolate (5-MTHF) (48) daily, or placebo (40) for 16 weeks. Primary endpoints were changes in plasma total homocysteine (tHcy), ankle : brachial pressure index (ABPI) and pulse wave velocity (PWV). Secondary outcomes were changes in plasma inflammatory markers.

Results

Plasma tHcy was significantly reduced in folic acid and 5-MTHF groups compared with controls: median difference: − 2·12 (95 per cent confidence interval − 3·70 to − 0·75) µmol/l (P = 0·002) and − 2·07 (−3·48 to − 0·54) µmol/l (P = 0·007) respectively. ABPI improved significantly: median difference 0·07 (0·04 to 0·11) (P < 0·001) and 0·05 (0·01 to 0·10) (P = 0·009) respectively. Brachial–knee PWV (bk-PWV) decreased significantly in individuals receiving 5-MTHF and tended to be reduced in those taking folic acid compared with controls: median difference: − 1·10 (−2·20 to − 0·20) m/s (P = 0·011) and − 0·90 (−2·10 to 0·00) m/s (P = 0·051) respectively. Plasma levels of inflammatory markers were not affected.

Conclusion

Folate administration reduced plasma homocysteine, and slightly improved ABPI and bk-PWV.
Systematic review and meta-analysis of interferon after curative treatment of hepatocellular carcinoma in patients with viral hepatitis
Authors: Breitenstein S , Dimitroulis D , Petrowsky H , Puhan M A , Müllhaupt B , Clavien P-A
Published: August 2009

Background

A combined antiviral and tumoricidal effect of interferon (IFN) is assumed to occur after resection or ablation of hepatocellular carcinoma (HCC).

Methods

An electronic search of the Medline, Embase and Central databases from January 1998 to October 2007 was conducted to identify randomized controlled trials evaluating adjuvant effects of IFN after curative treatment of HCC. A meta-analysis was performed to estimate the effects of IFN on 2-year outcome.

Results

Seven trials enrolling a total of 620 patients were included in the meta-analysis. Adjuvant treatment with IFN significantly reduced the 2-year mortality rate after curative treatment of HCC, with a pooled risk ratio of 0·65 (95 per cent confidence interval 0·52 to 0·80); P < 0·001) in absence of any significant heterogeneity (I2 = 0 per cent, P = 0·823 for χ2). The effect on reduction of tumour recurrence was less pronounced but still significant (pooled risk ratio 0·86 (95 per cent c.i. 0·76 to 0·97); P = 0·013). IFN had to be discontinued in 8–20 per cent of patients.

Conclusion

IFN has a significant beneficial effect after curative treatment of HCC in terms of both survival and tumour recurrence.
Development of working competence items for mechatronics with graphical monitoring and control
Authors: Shyr Wen‐Jye
Published: August 2009

The purpose of this study was to identify the working competence items which considered important for mechatronics with graphical monitoring and control for industry requirements. The data were collected by document analysis, expert interview, and Delphi technique surveys. The Delphi technique involved three questionnaire surveys of field experts and scholars followed by Kendall coefficient of concordance analysis to evaluate the Chi‐Square value and examine the consistency of respondent opinions to check the items whether reach the level of significance. Further, a Kolmogorov–Smirnov one‐sample test examined working competence items using 31 items divided into 7 domains. The survey items were selected according to consensus opinions of 10 experts by Delphi survey technique. The findings of this study provide guidelines for assessing professional working competence for mechatronics by applying graphical monitoring and control systems. The research findings reveal the practical competency requirements for students in a technology institute program, and a relevant curriculum is suggested. © 2009 Wiley Periodicals, Inc. Comput Appl Eng Educ 20: 88–92, 2012
Suppressed Native Hydrolytic Activity of a Lipase to Reveal Promiscuous Michael Addition Activity in Water
Authors: Svedendahl Maria , Jovanović Biljana , Fransson Linda , Berglund Per
Published: August 2009

Suppression of the native hydrolytic activity of Pseudozyma antarctica lipase B (PalB) (formerly Candida antarctica lipase B) in water is demonstrated. By replacing the catalytic Ser 105 residue with an alanine unit, promiscuous Michael addition activity is favored. A Michael addition reaction between methyl acrylate and acetylacetone was explored as a model system. For the PalB Ser 105 Ala mutant, the hydrolytic activity was suppressed more than 1000 times and, at the same time, the Michael addition activity was increased by a factor of 100. Docking studies and molecular dynamics simulations revealed an increased ability of the PalB Ser 105 Ala mutant to harbor the substrates close to a catalytically competent conformation.
Quantitative frame by frame analysis of regional contraction and lengthening on left ventricular cineangiograms: Application to the study of normal left ventricles and left ventricles with mitral valve prolapse
Authors: Colle J.‐P. , Le Goff G. , Ohayon J. , Bonnet J. , Bricaud H. , Besse P.
Published: August 2009

This work attempted to study the segmental wall motion on left ventriculograms, in terms of segmental shortening, velocity of segmental shortening, and temporal sequences of various events in systole as well as in diastole. The ability of such a method to characterize patterns of normal regional wall motion and to detect mild abnormalities such as isolated asynchronisms, was tested on two groups of patients. Group I included 25 patients presenting evidence of a normal left ventricle (LV) after left heart catheterization. Group II consisted of 21 patients suffering from an isolated pure idiopathic mitral valve prolapse (MVP), with no mitral insufficiency and with an unaffected global LV function. In all patients left ventriculography was filmed in the right anterior oblique view at a rate of 50 frames/s. For each patient a cycle was chosen, distant from any premature beat, with acceptably contrasted outlines, and a quantitative frame by frame study of the motion of 10 segments was performed using a semiautomated method derived from the Stanford method. In the control group (Group I), analysis of the segmental motion by means of this method demonstrates a mild nonuniformity of the normal wall motion. This is principally marked by a stronger and faster contraction in anterolateral segments (segments 7, 8, 9) and by a shorter duration of the contraction in this region. In contrast the MVP group (Group II), exhibited a frank asynergy of the anterolateral region occurring from end systole to early diastole. In the anterolateral region, asynergy of the MVP group is characterized mainly by a poor shortening velocity (2.8 ± 0.4 circ/s in segment 8 in Group II vs. 3.4 ± 0.7 circ/s in Group I, p<0.001), an early end of contraction (segment 8: 94.5 ± 4% of systolic time interval in Group II vs. 97.4 ± 3% in Group I, p<0.01), an early beginning of outward motion (shortening velocity of segment 9 at end systole: ‐ 0.58 ± 0.44 in Group II vs. 0 ± 0.48 circ/s in Group I, p<0.01), and finally an altered velocity of lengthening. A subjective estimate provided by a visual inspection of LV cineangiogram is not reliable for evaluating such phenomena. Our method proved a good ability to detect mild abnormalities in the temporal sequence of segmental contraction lengthening. We think that such quantitative methods using a high temporal resolution (0.02 s) are required for an accurate description of nonuniformity phenomena, and could allow early detection of local contractility impairments or local relaxation compliance.
Prognostic significance of 24‐hour ambulatory electrocardiographic monitoring in patients with dilative cardiomyopathy: A prospective study
Authors: Ikegawa T. , Chino M. , Hasegawa H. , Usuba F. , Suzuki S. , Ookura M. , Nishikawa K.
Published: August 2009

We studied 33 patients with dilative cardiomyopathy to evaluate the predicting factors for sudden death occurring within one year. The information on each of the patients included history, physical examinations, two‐dimensional echocardiograms, 24‐h ambulatory electrocardiograms, and cardiac catheterization or autopsy. Patients were followed up for one year. Univariate analysis showed maximum number of premature ventricular complexes per hour (PVCs/h)(p= .0012), maximum beats per episode of ventricular tachycardia (VTmax) (p=.0012), and left ventricular end‐diastolic pressure (p=.046) to be significant prognostic risk indicators of sudden death within one year. To select the best combination of factors that predict sudden death, multivariate stepwise logistic regression analysis was performed. By this method, only PVCs/h and VTmax were selected as the best combination. Probability of sudden cardiac death was 80% in patients showing both frequent (> 100/h) PVCs and presence of VT (VTmax≤3), and 6% in patients with neither or both. We concluded that PVCs/h and VTmax are independent and significant prognostic factors in patients with dilative cardiomyopathy.
Serum lipoproteins during antihypertensive therapy with beta blockers and diuretics: A controlled long‐term comparative trial
Authors: Middeke M. , Weisweiler P. , Schwandt P. , Holzgreve H.
Published: August 2009

The influence of hydrochlorothiazide and atenolol on serum lipoproteins was investigated in a randomized, prospective study on 68 men with essential hypertension. Cholesterol, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDH) cholesterol, triglycerides, and the apolipoproteins AI and B were followed up to 42 months after starting therapy. Following atenolol serum (HDL) cholesterol decreased and serum triglycerides increased significantly (p < 0.01) from 6 to 42 months. After hydrochlorothiazide serum triglycerides, LDL cholesterol and total cholesterol all increased significantly (p < 0.01) from 12 to 42 months. The changes were more pronounced under higher doses with beta blockade, but not with diuretics. Thus, both atenolol and hydrochlorothiazide have adverse but different effects on serum lipoproteins after long‐term administration. Continuing investigation is necessary to determine whether these side effects decrease the benefit of blood pressure reduction in patients with hypertension.
Acute pulmonary edema as the inaugural symptom of Becker's muscular dystrophy in a 19‐year‐old patient
Authors: Borgeat A. , Goy J. J. , Sigwart U.
Published: August 2009

A 19‐year‐old male presenting with acute pulmonary edema and severe biventricular heart failure was diagnosed as having Becker's muscular dystrophy. This case is remarkable in that congestive heart failure had not been largely preceded by neuromuscular symptoms.
Percutaneous transluminal coronary angioplasty by high‐volume and low‐volume operators
Authors: Finci L. , Meier B. , Steffenino G. , Urban P. , Noble J. , Gabathuler J. , Rutishauser W.
Published: August 2009

We retrospectively compared the results of percutaneous transluminal coronary angioplasty (PTCA) of three low‐volume opertors (1.3 PTCAs/month) to those of a relatively high‐volume operator (14.9 PTCAs/month) in 396 consecutive procedures (358 patients). PTCA for multiple vessels, total occlusions, or evolving acute myocardial infarction had been excluded. For low‐volume operators experienced assistance was considered present when the high‐volume operator participated as second operator. The three low‐volume operators performed 42, 38, and 24 PTCAs, respectively. Success rates per procedure for these operators were 88%, 84%, and 83%, and the complications rates 5%, 3%, and 13%, respectively. The success rates for assisted vs. nonassisted procedures were 89% vs. 88%, 100% vs. 78%, and 90% vs. 71%, and the complications rates were 6% vs. 4%, and 0% vs. 21%, respectively. The high‐volume operator performed 292 PTCAs, with a success rate of 93%, and a complication rate of 5%. The cumulated success rate of the three low‐volume operators of 85% was significantly (p<0.05) lower than the 93% success rate of the high‐volume operator, while the complication rates of 6% and 5%, respectively, were not significantly different. Low‐volume operators in an experienced center can perform PTCA safely even without assistance by a high‐volume operator. However, their success rate is lower.
The eccentric coronary atherosclerotic plaque: Morphologic observations and clinical relevance
Authors: Waller B. F.
Published: August 2009

Five hundred consecutive coronary artery segments histologically narrowed 76 to 95% in cross‐sectional area by atherosclerotic plaque were classified into concentric and eccentric luminal types. Of the 500 segments, 365 (73%) were eccentric and 185 (27%) were concentric. Of the eccentric lesions, an are of disease‐free wall accounted for 2.3 to 32% (mean 16.6%) of the circumference of the internal elastic membrane. The average thickness of the coronary artery media was thinner in diseased segments (mean 88.4 μm) compared to disease‐free wall segments in the same vessel (mean 202.9 μm). The presence of disease‐free wall segments has clinical importance in at least three areas: (1) the accuracy with which angiography reflects the morphologic features of the diseased vessel, (2) coronary artery spasm, and (3) the mechanism of coronary balloon angioplasty and subsequent “restenosis” of previously dilated vessels.
Echocardiographic monitoring of mental stress test in ischemic heart disease
Authors: Modena M. G. , Corghi F. , Fantini G. , Mattioli G.
Published: August 2009

Mental stress testing can induce ischemia in coronary patients, but often may not induce chest pain and/or electrocardiographic changes. Therefore, we tested the utility of echocardiography to increase the sensitivity of the method. For this purpose, 56 patients under‐took arithmetic mental stress tests and then were subjected co coronary angiography. During the test we evaluated left ventricular function, electrocardiography results, and emotional involvement measured by STAI (State Trait Anxiety Inventory). Echocardiography was positive in 21 patients, and electrocardiogram only in 2 patients. No patient complained of chest pain. The remaining 35 patients were negative. Comparing echo data with coronary angiography, in all the cases, sensitivity was 73.5%, specificity 73.3%. Analysis of the STAI revealed that the negative we observed could be due to a low stressor efficacy. In conclusion, echocardiography in mental stress testing permits improved sensitivity, with loss of specificity in comparison with conventional electrocardiographic monitoring.
The relationship between intraoperatively assessed atrial and ventricular insertions of accessory pathways
Authors: Blomstrom P. , Jonsson R.
Published: August 2009

To gain insight into the complex problems regarding the extension of the atrial and ventricular insertions of anomalous pathways, the activation patterns obtained from intraoperative epicardial mapping in 23 patients with Wolff‐Parkinson‐White syndrome were carefully analyzed. The atrial and ventricular activation times along the atrioventricular groove were measured at 15 predefined anatomical landmarks. The width of the region of earliest atrial and ventricular activation times and the extent of atrial and ventricular overlap were assessed. The relationship between the atrial and ventricular insertions was studied by predicting the ventricular insertions from the observed atrial insertions and vice versa. The mean extension of an atrial and a ventricular insertion at surgery was 1.9±0.2 (SE) and 1.6±0.2 (SE) anatomical landmarks, respectively. The width of the region of early atrial and ventricular activation times measured 2.7±0.3 (SE) landmarks, thus indicating an overlap of the atrial and ventricular insertions. The lateral distance between the sites of earliest atrial and ventricular activation times was, on average, 1.7±0.3 (SE) landmarks. The predicted atrial insertion from a known ventricular insertion, and vice versa was found to cover 4 to 6 anatomical landmarks. These observations suggest that wide surgical dissections along the atrioventricular groove are warranted even if epicardial mapping discloses only a single accessory pathway.
Coronary artery spasm induced by anesthesia: A case report and review of the literature
Authors: Soto E. , Duvernoy W. F. C. , David S. , Small D. , Nair M. R. S.
Published: August 2009

Anesthesia–induced coronary vasospasm has been reported only rarely. We report a case, without previous cardiac history, in which immediately after anesthesia induction a marked ST elevation was noted on the EKG monitor. Premature ventricular contractions as well as nonsustained ventricular tachycardia were noted. These changes resolved immediately after nitroglycerin infusion and 75 mg of lidocaine were given. A coronary angiogram revealed normal coronary arteries and left ventriculogram. Ergonovine stimulation was not performed. The patient was discharged home on calcium entry blockers and nitrates. Exercise stress test two weeks after discharge was negative for ischemia. Induction of anesthesia triggering coronary spasm has been reported rarely, and to our knowledge never in the presence of angiographically normal coronary anatomy. Coronary vasospasm with typical EKG changes——namely, ST elevation and ventricular arrhythmias——has to be included as a possible complication of general anesthesia. Recongnition of this syndrome allows prompt treatment and prevention of future episodes.
A pilot study of paramedic‐administered, prehospital thrombolysis for acute myocardial infarction
Authors: Sherrid M. , Greenberg H. , Marsella R. , Mathisen D. , Lynn S. , Dwyer E.
Published: August 2009

We have implemented a pilot program of supervised paramedic administration of thrombolysis in the field. This program was begun on a small scale by training and equipping one paramedic service of one hospital. Four patients with acute myocardial infarction were rapidly and appropriately treated in the field. We compared these patients with 21 patients who were brought to hospital by ambulance, but treated with thrombolysis conventionally in the emergency department. The patients in the field were treated an average of 86 minutes sooner than the patients treated in the emergency department.
Topography of atherosclerotic coronary artery disease
Authors: Waller Bruce , Waller B. F.
Published: August 2009

This article reviews several issues relevant to current interest in coronary angioplasty, acute reperfusion, and the use of new interventional devices (stents, probes, atherectomy devices, etc.): diffuse versus focal nature of plaque, the number of vessels severely diseased, quantitation of luminal stenosis and length of stenosis, and the distribution of plaque in the four major coronary arteries in various clinical ischemic subsets.
Left ventricular aneurysm associated with apical hypertrophic cardiomyopathy
Authors: Partanen J. , Kupari M. , Heikkilä J. , Keto P.
Published: August 2009

A 47‐year‐old man with apical hypertrophic cardiomyopathy and an apical left ventricular aneurysm with palpitation as the initial manifestation is described. There was no intraventricular pressure gradient. The aneurysm is suggested to be a part of the myocardial disease or to be caused by myocardial bridging of the left anterior descending coronary artery demonstrated by angiography. The 24‐hour ambulatory ECG recording showed only isolated ventricular ectopic beats and the clinical course has been favorable during 20 months without therapy.
Pharmacological management of acute myocardial infarction
Authors: Jain Praveer , Vlay Stephen C.
Published: August 2009

The routine medical management of patients with acute myocardial infarction (AMI) has undergone major changes in the last decade. Several large‐scale trials have firmly established the effectiveness of thrombolytic therapy, beta blockers, and aspirin in the treatment of AMI. The critical issues include reducing myocardial oxygen demand and restoring adequate blood supply to the ischemic regions of the myocardium. As a result, the ability to intervence in patients with AMI has improved significantly. The purpose of this review is to discuss briefly the results of major trials of primary and secondary pharmacological intervention which had a direct impact on the care of patients with AMI. It concludes with current recommendations for the management of patients with AMI.