bluuebunny/crossref_metadata_2025 huggingface dataset:
Potential impact of propofol immediately after motor vehicle accident on later symptoms of posttraumatic stress disorder at 6-month follow up: a retrospective cohort study
Authors: Usuki Masato , Matsuoka Yutaka , Nishi Daisuke , Yonemoto Naohiro , Matsumura Kenta , Otomo Yasuhiro , Kim Yoshiharu , Kanba Shigenobu
Published: October 2012

Introduction

Critically injured patients are at risk of developing posttraumatic stress disorder (PTSD). Propofol was recently reported to enhance fear memory consolidation retrospectively. Thus, we investigated here whether administration of propofol within 72 h of a motor vehicle accident (MVA) affects the subsequent development of PTSD symptoms.

Methods

We examined data obtained from a prospective cohort study of MVA-related injured patients, admitted to the intensive care unit of a general hospital. We investigated the effect of propofol administration within 72 h of MVA on outcome. Primary outcome was diagnosis of full or partial PTSD as determined by the Clinician-Administered PTSD Scale (CAPS) at 6 months. Secondary outcomes were diagnosis of full or partial PTSD at 1 month and CAPS score indicating PTSD at 1 and 6 months. Multivariate analysis was conducted adjusting for being female, age, injury severity score (ISS), and administration of ketamine or midazolam within 72 h of MVA.

Results

Among 300 patients recruited (mean ISS, 8.0; median Glasgow Coma Scale (GCS) score, 15.0; age, 18 to 69 years), propofol administration showed a higher risk for full or partial PTSD as determined by CAPS at 6 months (odds ratio = 6.13, 95% confidence interval (CI): 1.57 to 23.85, P = 0.009) and at 1 month (odds ratio = 1.31, 95% CI: 0.41 to 4.23, P = 0.647) in the multivariate logistic regression. Multivariate regression analysis showed a trend toward adverse effects of propofol on PTSD symptom development at 6 months after MVA (β = 4.08, 95% CI: -0.49 to 8.64, P = 0.080), but not at 1 month after MVA (β = -0.42, 95% CI: -6.34 to 5.51, P = 0.890).

Conclusions

These findings suggest that using propofol in the acute phase after MVA might be associated with the development of PTSD symptoms 6 months later. However, since the design of this study was retrospective, these findings should be interpreted cautiously and further study is warranted.
Fluid overload is associated with an increased risk for 90-day mortality in critically ill patients with renal replacement therapy: data from the prospective FINNAKI study
Authors: Vaara Suvi T , Korhonen Anna-Maija , Kaukonen Kirsi-Maija , Nisula Sara , Inkinen Outi , Hoppu Sanna , Laurila Jouko J , Mildh Leena , Reinikainen Matti , Lund Vesa , Parviainen Ilkka , Pettilä Ville ,   The FINNAKI study group
Published: October 2012

Introduction

Positive fluid balance has been associated with an increased risk for mortality in critically ill patients with acute kidney injury with or without renal replacement therapy (RRT). Data on fluid accumulation prior to RRT initiation and mortality are limited. We aimed to study the association between fluid accumulation at RRT initiation and 90-day mortality.

Methods

We conducted a prospective, multicenter, observational cohort study in 17 Finnish intensive care units (ICUs) during a five-month period. We collected data on patient characteristics, RRT timing, and parameters at RRT initiation. We studied the association of parameters at RRT initiation, including fluid overload (defined as cumulative fluid accumulation > 10% of baseline weight) with 90-day mortality.

Results

We included 296 RRT-treated critically ill patients. Of 283 patients with complete data on fluid balance, 76 (26.9%) patients had fluid overload. The median (interquartile range) time from ICU admission to RRT initiation was 14 (3.3 to 41.5) hours. The 90-day mortality rate of the whole cohort was 116 of 296 (39.2%; 95% confidence interval 38.6 to 39.8%). The crude 90-day mortality of patients with or without fluid overload was 45 of 76 (59.2%) vs. 65 of 207 (31.4%), P < 0.001. In logistic regression, fluid overload was associated with an increased risk for 90-day mortality (odds ratio 2.6) after adjusting for disease severity, time of RRT initiation, initial RRT modality, and sepsis. Of the 168 survivors with data on RRT use at 90 days, 34 (18.9%, 95% CI 13.2 to 24.6%) were still dependent on RRT.

Conclusions

Patients with fluid overload at RRT initiation had twice as high crude 90-day mortality compared to those without. Fluid overload was associated with increased risk for 90-day mortality even after adjustments.
Differential DNA methylation in discrete developmental stages of the parasitic nematode Trichinella spiralis
Authors: Gao Fei , Liu Xiaolei , Wu Xiu-Ping , Wang Xue-Lin , Gong Desheng , Lu Hanlin , Xia Yudong , Song Yanxia , Wang Junwen , Du Jing , Liu Siyang , Han Xu , Tang Yizhi , Yang Huanming , Jin Qi , Zhang Xiuqing , Liu Mingyuan
Published: October 2012

Background

DNA methylation plays an essential role in regulating gene expression under a variety of conditions and it has therefore been hypothesized to underlie the transitions between life cycle stages in parasitic nematodes. So far, however, 5'-cytosine methylation has not been detected during any developmental stage of the nematode Caenorhabditis elegans. Given the new availability of high-resolution methylation detection methods, an investigation of life cycle methylation in a parasitic nematode can now be carried out.

Results

Here, using MethylC-seq, we present the first study to confirm the existence of DNA methylation in the parasitic nematode Trichinella spiralis, and we characterize the methylomes of the three life-cycle stages of this food-borne infectious human pathogen. We observe a drastic increase in DNA methylation during the transition from the new born to mature stage, and we further identify parasitism-related genes that show changes in DNA methylation status between life cycle stages.

Conclusions

Our data contribute to the understanding of the developmental changes that occur in an important human parasite, and raises the possibility that targeting DNA methylation processes may be a useful strategy in developing therapeutics to impede infection. In addition, our conclusion that DNA methylation is a mechanism for life cycle transition in T. spiralis prompts the question of whether this may also be the case in any other metazoans. Finally, our work constitutes the first report, to our knowledge, of DNA methylation in a nematode, prompting a re-evaluation of phyla in which this epigenetic mark was thought to be absent.
Cytosine methylation and hydroxymethylation mark DNA for elimination in Oxytricha trifallax
Authors: Bracht John R , Perlman David H , Landweber Laura F
Published: October 2012

Background

Cytosine methylation of DNA is conserved across eukaryotes and plays important functional roles regulating gene expression during differentiation and development in animals, plants and fungi. Hydroxymethylation was recently identified as another epigenetic modification marking genes important for pluripotency in embryonic stem cells.

Results

Here we describe de novo cytosine methylation and hydroxymethylation in the ciliate Oxytricha trifallax. These DNA modifications occur only during nuclear development and programmed genome rearrangement. We detect methylcytosine and hydroxymethylcytosine directly by high-resolution nano-flow UPLC mass spectrometry, and indirectly by immunofluorescence, methyl-DNA immunoprecipitation and bisulfite sequencing. We describe these modifications in three classes of eliminated DNA: germline-limited transposons and satellite repeats, aberrant DNA rearrangements, and DNA from the parental genome undergoing degradation. Methylation and hydroxymethylation generally occur on the same sequence elements, modifying cytosines in all sequence contexts. We show that the DNA methyltransferase-inhibiting drugs azacitidine and decitabine induce demethylation of both somatic and germline sequence elements during genome rearrangements, with consequent elevated levels of germline-limited repetitive elements in exconjugant cells.

Conclusions

These data strongly support a functional link between cytosine DNA methylation/hydroxymethylation and DNA elimination. We identify a motif strongly enriched in methylated/hydroxymethylated regions, and we propose that this motif recruits DNA modification machinery to specific chromosomes in the parental macronucleus. No recognizable methyltransferase enzyme has yet been described in O. trifallax, raising the possibility that it might employ a novel cytosine methylation machinery to mark DNA sequences for elimination during genome rearrangements.
Fasting-Induced FGF21 Is Repressed by LXR Activation via Recruitment of an HDAC3 Corepressor Complex in Mice
Authors: Archer Amena , Venteclef Nicolas , Mode Agneta , Pedrelli Matteo , Gabbi Chiara , Clément Karine , Parini Paolo , Gustafsson Jan-Åke , Korach-André Marion
Published: October 2012

The liver plays a pivotal role in the physiological adaptation to fasting and a better understanding of the metabolic adaptive responses may give hints on new therapeutic strategies to control the metabolic diseases. The liver X receptors (LXRs) are well-established regulators of lipid and glucose metabolism. More recently fibroblast growth factor 21 (FGF21) has emerged as an important regulator of energy homeostasis. We hypothesized that the LXR transcription factors could influence Fgf21 expression, which is induced in response to fasting. Wild-type, LXRα−/−, and LXRβ−/− mice were treated for 3 d with vehicle or the LXR agonist GW3965 and fasted for 12 h prior to the killing of the animals. Interestingly, serum FGF21 levels were induced after fasting, but this increase was blunted when the mice were treated with GW3965 independently of genotypes. Compared with wild-type mice, GW3965-treated LXRα−/− and LXRβ−/− mice showed improved insulin sensitivity and enhanced ketogenic response at fasting. Of note is that during fasting, GW3965 treatment tended to reduce liver triglycerides as opposed to the effect of the agonist in the fed state. The LXR-dependent repression of Fgf21 seems to be mainly mediated by the recruitment of LXRβ onto the Fgf21 promoter upon GW3965 treatment. This repression by LXRβ occurs through the recruitment and stabilization of the repressor complex composed of retinoid-related orphan receptor-α/Rev-Erbα/histone deacetylase 3 onto the Fgf21 promoter. Our data clearly demonstrate that there is a cross talk between the LXR and FGF21 signaling pathways in the adaptive response to fasting.
Cellular Robotic Architecture
Authors: Pan Cheng-An , Jeng Taysheng
Published: October 2012

An emerging need for interactive architecture is currently making buildings mutable, flexible in use, and adaptable to changes in climate by introducing robotic systems. However, the feasibility of the seamless integration of building construction details and kinetic robotics has become a critical issue for developing robotic architecture. The objective of this work is to develop a robotic architecture with an emphasis on the integration of cellular robotics with a distributed kinetic building surface. The kinetic building surface integrates an actuating system, a localization and remote control system, which become part of the kinetic building system. This paper presents a systematic framework by reviewing theories and related work of robotic architecture and automated control. An architectural design scheme is proposed to simulate a scenario of application in a physical space. The functionality of the electrical and control system and the integration of the effects of actual construction were examined by a prototype of a kinetic surface. Our prototype presents a feasible construction method, and a prominent energy-saving effect. The potential strength and restrictions of the cellular robotic approach to architectural applications are discussed. The applicability of the prototype system and issues about controlling the behavior of spatial robots are demonstrated in this paper.
The Agency of Responsive Envelopes: Interaction, Politics and Interconnected Systems
Authors: Thün Geoffrey , Velikov Kathy , O'Malley Mary , Sauvé Lisa
Published: October 2012

This article positions the territory of responsive envelopes within the context of contemporary disciplinary questions surrounding the politics of the architectural envelope on one hand, and the agency of material explication of environmental, social and spatial performance on the other. Two recent prototype-based responsive envelope projects undertaken by the authors, the Stratus Project and Resonant Chamber, are described in detail relative to the reciprocity between the development of their materiality, form, production methods and their dynamic interaction with external forces, environments and inhabitants. An argument is made that responsive envelopes, in their capacity to structure continually evolving energetic, material and information exchanges between humans, buildings and the wider environment, have the potential to actively construct and enable political participation through spatial transformation, data driven processing and informatics. These envelopes are positioned as agents within wider ecologies and social systems, and as sites for the design of robotic architectures to engage such questions.
Robotic Construction by Contour Crafting: The Case of Lunar Construction
Authors: Leach Neil , Carlson Anders , Khoshnevis Behrokh , Thangavelu Madhu
Published: October 2012

Contour Crafting is a digitally controlled construction process invented by Professor Behrokh Khoshnevis that fabricates components directly from computer models, using layered fabrication technology. By obviating the need for formwork used in traditional concrete construction, CC can reduce costs and construction times significantly. The technique has great potential as a robotic form of construction reliant on relatively minimal human labor as a form of construction in relatively hazardous environments, such as the Moon with its radiation levels that can prove highly damaging. Current research funded by NASA has been exploring the potential for using CC on the Moon to build structures making use of readily available regolith that is found in great abundance on the surface of the Moon. This article offers an overview of this research and evaluates the merits of using CC on the Moon.
Parametric Representation and Shape Optimization of Flapping Micro Air Vehicle Wings
Authors: Stewart Eric C. , Patil Mayuresh J. , Canfield Robert A. , Snyder Richard D.
Published: October 2012

The effects of wing planform on the aerodynamic performance of a rigid wing in forward flapping flight and hovering configurations were investigated in this paper. The planform design space was parameterized using a new, modified Zimmerman method based on low aspect ratio Zimmerman planform designs. The aerodynamic forces on the wing were calculated using Peters' aerodynamics with an assumed inflow coupled with blade element theory. A multiobjective optimization approach was taken to find the best planform designs for three objectives: wing area, peak power input, and an aerodynamic force based on the kinematic configuration – lift for hovering and thrust for forward flight. A gradient-based optimizer and the ε-constraint method were used to find the Pareto front of optimal designs with the aerodynamic force as the primary objective function. The choice of primary and secondary objective functions is important in determining the optimal planform. The Pareto optimal planforms for the case when only area is considered as a secondary objective function drastically differ from the optimal planforms when only power is taken as a secondary objective function. As the secondary objective ε values change over the design space, so do the optimal planform shapes.
Dual Antiplatelet Agent—Induced Spontaneous Liver Hematoma
Authors: Darwish Omar S , Iqbal Erum
Published: October 2012

OBJECTIVE:

To report a case of a spontaneous liver hematoma in a patient receiving dual antiplatelet therapy for 5 years after coronary stent implantation.

CASE SUMMARY:

A 76-year-old man with coronary artery disease presented to the hospital with acute right upper quadrant pain. He had been taking clopidogrel 75 mg/day, a P2Y12 inhibitor, and aspirin 81 mg/day for 5 years after having a drug-eluting stent (DES) placed. Given a drop in hemoglobin (from 13.0 g/dL to 8.6 g/dL) and elevated liver enzymes, subsequent studies were performed and revealed a large liver hematoma. Clopidogrel and aspirin were discontinued. Aspirin was restarted 1 month later; there was no recurrence of bleeding.

DISCUSSION:

Current guidelines recommend that a P2Y12 inhibitor and aspirin after DES implantation be given for at least 12 months. However, because of concern for late stent thrombosis, some clinicians encourage patients to continue taking dual antiplatelet therapy beyond this period as long as the risk of bleeding is low. An objective causality assessment suggested that the liver hematoma was possibly related to the combination of clopidogrel and aspirin. To our knowledge, this is the first report of a patient who developed a liver hematoma while on aspirin and clopidogrel. Some recent studies have shown that the use of dual antiplatelet therapy for longer than 12 months does not reduce the rate of myocardial infarction or death from cardiac cause compared with aspirin monotherapy.

CONCLUSIONS:

It may be safer to maintain dual antiplatelet therapy for no more than 12 months after DES placement.
Development of Malaysian Animation from the Perspective of Pioneer Animator Hassan Muthalib
Authors: Lent John A.
Published: October 2012

I met Malaysia s premier animator by chance. I had interviewed print cartoonists Rejab Had and Jaafar Taib all day July 21, 2000, and was escorted back to my hotel by Rejab. I was ready to relax after a tiring day.
Thai Animation's Great Strides: A Report
Authors: Lent John A.
Published: October 2012

Thai animation has come a long way in a short time. Writing the chapter on Thai animation for Animation in Asia and the Pacific in the late 1990s, I said one man, Payut Ngaokrachang, was responsible for much of the development of the field. That, he was, for Payut was one of the two
earliest animators, directed the first and only feature-length animation, "Sudsakorn," in 1979, and trained many of those who followed. More recently, he has been largely responsible for Thai Anima 2003: The First International Animation Festival, has helped in the conceptualization
of an animation association, and has lent his name to an annual award for best animation sponsored by Thai Film Foundation.
Natural Culturalism in The Ballad of Narayama: A Study of Shohei Imamura's Thematic Concerns
Authors: Hung Lee Wood
Published: October 2012

In 1958, Keisuke Kinoshita adapted Shichiro Fukasawa's Narayamabushi-ko into a movie with a strong flavor of classical kabuki, an attempt which met with great success. Some 25 years later, Shohei Imamura adapted the same novel for the screen with the same title, hereafter referred to
by its English title, The Ballad of Narayama, which was awarded the grand prize at the Cannes Film Festival in France in 1983. Keiko McDonald (1994: 124) comments that compared to Kinoshita's classical theatrical approach, Imamura's version is deeply rooted in realism.
Philippine Movies in 2001: The Film Industry Is Dead! Long Live Philippine Cinema!
Authors: Mundo Jr. Clodualdo del
Published: October 2012

The Philippine movie industry has been reported dying for several decades now. It was reported dead in the 1960s with the advent of fly-by-night companies and the proliferation of sex movies called bomba in 1970. It died again, according to reports, in the 1990s with the reincarnation
of bomba into bold movies and the rising competition of humongous Hollywood high-concept movies.
The Japanese Puppet Animation Master: Kihachiro Kawamoto
Authors: Masao Yokota
Published: October 2012

Kihachiro Kawamoto was born in Tokyo in 1925. He has made puppets since his childhood. In middle age, he started to create his animations by mainly using puppets. His puppet animations are descended from a Japanese puppet show, Bunraku. Jiri Trnka, Czech animation director, advised
Kawamoto to learn it while Kawamoto was staying in Prague. Kawamoto realized that souls were inspired into puppets, when Japanese puppeteers operated them. In Kawamoto's animations, passions doomed to die were put into puppets. His animations were awarded many times in several world animation
festivals.
Towards a body-mind spirituality: The practice of yoga and the case of Air
Authors: Kapsali Maria
Published: October 2012

Yoga is a widespread psychophysical discipline considered to cultivate the spirituality of its practitioners. Various forms of the practice can be accessed in the public arena and are increasingly common in dance and performing arts education programmes. Although the discipline has
been examined from both a historical and ethnographical point of view, its spiritual dimension has received little attention from scholars. This article critically discusses the way in which yoga, as it is practiced and disseminated within contemporary western environments, is thought to facilitate
the practitioner's spiritual development. It will be argued here that some aspects of yoga's pedagogy may, in fact, hinder this endeavour. This article also discusses the creation of a theatre piece that was based on the practice. Drawing on the working methods used in the devising of the
piece, this article will further contend that in order for the spiritual dimension of the discipline to be realized, contemporary yoga practices should be supplemented with activities that engage the practitioner's imagination and encourage reflection.
Dancing n/om
Authors: Keeney Hillary , Keeney Bradford
Published: October 2012

For the Ju/'hoansi Bushmen (San) of southern Africa, embodied ecstatic expression is inseparable from their healing dance. But more than any particular kind of improvisation or choreography, their dance is orchestrated by infusion with what they call n/om, the purported life force they
claim arises from an awakened heart. This is similar to what the Spanish flamenco tradition calls duende, the ineffable passionate expression that makes a dance performance come to life. Celebrating the growing interest among dancers and somatic therapists in the relationship between dance,
spirited experience and healing, we discuss how examining the Bushman relationship to n/om brings attention to an under-examined aspect of the discourse on dance and healing.
Embodying the dynamics of the five elements: A practice dialogue between Body-Mind Centering® and Tibetan Buddhist philosophy
Authors: Sargent-Wishart Kim
Published: October 2012

This article presents a contemplative dance/movement research practice, based in the somatic approach of Body-Mind Centering® (BMCSM), exploring the dynamics of the five elements (space, air, fire, water and earth) according to Tibetan Buddhist philosophy. This research practice
is a component of the author's current doctoral study in performance, which includes a dialogue between Tibetan Buddhist perspectives on the dynamics of the body's formation, and the BMC approach to embodied embryology. The article briefly outlines the significance of embryology as a field
of study within BMC and Tibetan Buddhism, and introduces the Buddhist pedagogical model of the three prajnas as a framework for experiential research. It describes a research methodology in which dance/movement practice, and the direct kinaesthetic experience of dance/movement practitioners,
is the site of investigation, suggesting movement research as a method of both bringing theory into physical practice and generating theory from that practice. The final section details the studio research practice itself, including an introduction to the dynamics of the five elements, examples
of how these were investigated in movement research, and excerpts from participants' reflective writing.
'What you cannot imagine': Spirituality in Akram Khan's Vertical Road
Authors: Stevens Jayne
Published: October 2012

This article considers the interface between artistic and spiritual enquiry through an examination of Vertical Road (2010), an ensemble performance work by the British contemporary choreographer Akram Khan. Khan is well known for his cross-cultural explorations, critical appreciation
of which has tended to focus on the hybrid nature of his movement vocabulary and aesthetic. This article considers the intercultural nature of his work in terms of the ideas, beliefs and values that it embodies. In particular, it examines Vertical Road in relation to some key tenets of contemporary
progressive spirituality. It suggests that Vertical Road provides a poetic and insightful reflection on our contemporary spiritual condition.
Spiritual origins and belly dance: how and when artistic leisure becomes spiritual
Authors: Kraus Rachel
Published: October 2012

Belly dance is spiritual for some people who participate in this artistic dance form. Utilizing interviews with nineteen female belly dancers in the Midwestern part of the United States, this project examines when and how dancers begin to experience spirituality within belly dance.
Results show dancers who situate spirituality within the music, physical movement or connections with other dancers experience spirituality soon after they get involved in belly dance. However, spirituality within the dance takes time to develop for those dancers who find spiritual significance
in their connections with audience members during performances. These findings suggest that when a practitioner begins defining belly dance as spiritually meaningful is partly related to the particular aspects of belly dance a dancer associates with spirituality.
'Can They Dance?' towards a philosophy of bodily becoming
Authors: LaMothe Kimerer L.
Published: October 2012

Deleuze and Guattari in One Thousand Plateaus, Jane Bennett in Vibrant Matter and David Abram in his Becoming Animal all set out to dismantle the mind over body logics common in the modern western world that continue to justify the pursuit of spiritual values at the expense of the earth
and its inhabitants. They each coin a non-dualistic concept of materiality with the intention of changing how we think about bodies and how we experience bodies. To their concepts of materiality this article poses a question borrowed from Friedrich Nietzsche: Can they dance? In the process
of investigating each, LaMothe fleshes out how and why a local, lived philosophy of bodily becoming can move us farther along the path these writers tread towards an appreciation of dance as a practice and resource for earth-friendly ways of thinking and believing.
Iconic syntax: Jacob A. Riis and the communication of The Other Half
Authors: Petersson Dag
Published: October 2012

In this article, the post-war institutional interpretation of Jacob A. Riis' photographs is measured against their nineteenth-century capacity for mass media communication. The conventions that today determine the proper meaning and origin of these celebrated photos first emerged with
an exhibition held in 1947. The ensuing, and dominant, mode of interpretation is shown here to be fundamentally at odds with the conditions for image use in early mass media communication. This article examines the clash and argues for an alternative mode of interpretation that is capable
of accounting for the distinct production of iconic meaning afforded by the media that Riis employed.
Pseudo-Adversarialism: A Theoretical Comparison Between the U.S. and Japanese Criminal Procedures
Authors: Nakao Keisuke , Tsumagari Masatoshi
Published: October 2012

This article offers a unified theoretical framework to address two distinctive forms of adversarial procedure: the bona fide adversarial system and the pseudo-adversarial system. In the former, a harsh contest between the prosecution and the defense is promoted, and an acquittal is rendered with substantial likelihood. In the latter, the prosecution overpowers the defense so that defendants are almost always convicted. We explain this procedural dichotomy as a result of optimal incentive designs institutionalized through controlling a judge's standard of proof beyond a reasonable doubt, a prosecutor's discretionary rule for indictment, and a defendant's right to counsel. Our theory suggests that the bona fide adversarial system performs suitably with jury trials, publicly-elected prosecutors, and government-based defense systems, while the pseudo-adversarial system is shaped by bench trials, career prosecutors, and court-appointed defense counsels. The Japanese pseudo-adversarial system might still be influenced by the defunct inquisitorial system initiated during the Meiji Restoration.
Identification and quantification of hemoglobins in whole blood: the analytical and organizational aspects of Capillarys 2 Flex Piercing compared with agarose electrophoresis and HPLC methods
Authors: Altinier Sara , Varagnolo Mariacristina , Zaninotto Martina , Plebani Mario
Published: October 2012

Background: The present study was conducted to evaluate the analytical performance and the organizational aspects of Capillarys 2 Flex Piercing system (CFP) respect to agarose electrophoresis and HPLC methods in hemoglobinopathies screening.

Methods: The measurement of imprecision in HbA2 and HbF quantification was verified on HbA2 CFP control and on three samples; 74 whole blood samples were used to evaluate migration time imprecision of hemoglobin variants S, C and E (HbS, HbC, and HbE); to compare methods, 451 samples were tested on CFP and HPLC; reference values were verified as value distribution in 160 blood donors and at ROC curve analysis on 449 samples from routine analysis.

Results: Imprecision: the analytical CV%s ranged from 1.25 to 3.9 at HbA2 quantification, the CV% was 3.78 at HbF quantification; the running time imprecision for HbS and HbC and HbE ranged from 0.20 to 0.69%. Method comparison: at regression analysis findings were HbA2: CFP=1.21×HPLC–0.64, HbF: CFP=1.31×HPLC-0.75, HbS: CFP=1.10×HPLC-3.24. Reference values: the HbA2 95th percentile range was 2.5–2.8; HbF was undetectable in 154 out 160 samples tested; at ROC curve analysis the best combination of sensitivity and diagnostic efficiency was obtained using 2.2 and 3.0, as reference values, for HbA2 and 1.1 as the upper reference limit for HbF. Organizational aspects: with respect to the procedures currently implemented in our laboratory CFP requires 2 h less time and obviates the need for some manual steps.

Conclusions: The quantification, reproducibility and diagnostic efficiency provided by CFP in identification and quantification of hemoglobins appear accurate. In addition, the use of primary tubes allows improved safety, and the avoidance of some manual steps, that prolong working time and are a source of possible errors.
Preanalytical quality improvement: in quality we trust
Authors: Lippi Giuseppe , Becan-McBride Kathleen , Behúlová Darina , Bowen Raffick A. , Church Stephen , Delanghe Joris , Grankvist Kjell , Kitchen Steve , Nybo Mads , Nauck Matthias , Nikolac Nora , Palicka Vladimir , Plebani Mario , Sandberg Sverre , Simundic Ana-Maria
Published: October 2012

Total quality in laboratory medicine should be defined as the guarantee that each activity throughout the total testing process is correctly performed, providing valuable medical decision-making and effective patient care. In the past decades, a 10-fold reduction in the analytical error rate has been achieved thanks to improvements in both reliability and standardization of analytical techniques, reagents, and instrumentation. Notable advances in information technology, quality control and quality assurance methods have also assured a valuable contribution for reducing diagnostic errors. Nevertheless, several lines of evidence still suggest that most errors in laboratory diagnostics fall outside the analytical phase, and the pre- and postanalytical steps have been found to be much more vulnerable. This collective paper, which is the logical continuum of the former already published in this journal 2 years ago, provides additional contribution to risk management in the preanalytical phase and is a synopsis of the lectures of the 2nd European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)-Becton Dickinson (BD) European Conference on Preanalytical Phase meeting entitled “Preanalytical quality improvement: in quality we trust” (Zagreb, Croatia, 1–2 March 2013). The leading topics that will be discussed include quality indicators for preanalytical phase, phlebotomy practices for collection of blood gas analysis and pediatric samples, lipemia and blood collection tube interferences, preanalytical requirements of urinalysis, molecular biology hemostasis and platelet testing, as well as indications on best practices for safe blood collection. Auditing of the preanalytical phase by ISO assessors and external quality assessment for preanalytical phase are also discussed.
Clinical applications of maternal plasma fetal DNA analysis: translating the fruits of 15 years of research
Authors: Kwun Chiu Rossa Wai , Dennis Lo Yuk Ming
Published: October 2012

The collection of fetal genetic materials is required for the prenatal diagnosis of fetal genetic diseases. The conventional methods for sampling fetal genetic materials, such as amniocentesis and chorionic villus sampling, are invasive in nature and are associated with a risk of fetal miscarriage. For decades, scientists had been pursuing studies with goals to develop non-invasive methods for prenatal diagnosis. In 1997, the existence of fetal derived cell-free DNA molecules in plasma of pregnant women was first demonstrated. This finding provided a new source of fetal genetic material that could be obtained safely through the collection of a maternal blood sample and provided a new avenue for the development of non-invasive prenatal diagnostic tests. Now 15 years later, the diagnostic potential of circulating fetal DNA analysis has been realized. Fruitful research efforts have resulted in the clinical implementation of a number of non-invasive prenatal tests based on maternal plasma DNA analysis and included tests for fetal sex assessment, fetal rhesus D blood group genotyping and fetal chromosomal aneuploidy detection. Most recently, research groups have succeeded in decoding the entire fetal genome from maternal plasma DNA analysis which paved the way for the achievement of non-invasive prenatal diagnosis of many single gene diseases. A paradigm shift in the practice of prenatal diagnosis has begun.
Botulinum toxin for the treatment of achalasia in pregnancy
Authors: Fels Heather , Stohl Hindi E. , Lee Richard H. , Aghajanian Paola
Published: October 2012

There is a paucity of data on the perinatal management of achalasia, an esophageal dysmotility disorder involving an abnormal relaxation of the lower esophageal sphincter. Botulinum toxin A is a well-described treatment for achalasia in the non-pregnant state but has been infrequently used for treatment of this condition in pregnancy. We describe a case of a successful treatment of achalasia in the first trimester of pregnancy with botulinum toxin A, and a subsequently uncomplicated pregnancy course and pregnancy outcome.
Can Centralization of Cancer Surgery Improve Social Welfare?
Authors: Ho Vivian , Short Marah N. , Ku-Goto Meei-Hsiang
Published: October 2012

The empirical association between high hospital procedure volume and lower mortality rates has led to recommendations for the centralization of complex surgical procedures. Yet redirecting patients to a select number of high-volume hospitals creates potential negative consequences for market competition. We use patient-level data to estimate the association between hospital procedure volume and patient mortality and costs. We also estimate the association between hospital market concentration and mortality, cost, and prices. We use our estimates to simulate the change in social welfare resulting from redirecting patients at low-volume hospitals to high-volume facilities. We find that a higher procedure volume leads to significant reductions in mortality for patients undergoing surgery for pancreatic cancer, but not colon cancer. Procedure volume also influences costs for both surgeries, but in a nonlinear fashion. Increased market concentration is associated with higher costs and prices for colon cancer, but not pancreatic cancer patients. Simulations indicated that centralizing pancreatic cancer surgery is unambiguously welfare enhancing. In contrast, there is less evidence to suggest that centralizing colon cancer surgery would be welfare improving.
A Reexamination of the Costs of Medical R&D Regulation
Authors: Philipson Tomas J. , Sun Eric , Goldman Dana , Jena Anupam B.
Published: October 2012

Recent evidence suggests that the economic value of increased health has been enormous, with most of these gains being driven by medical R&D. The R&D process for pharmaceuticals is particularly expensive and time consuming, with well-known studies from the Tufts Center for the Study of Drug Development suggesting that developing a single successful drug costs around $1 billion and takes roughly 12 years. We argue that these estimates are incomplete because they do not incorporate the social costs imposed by the regulatory process, namely the costs to producers in terms of forgone profits and the costs to consumers in terms of delayed access to drugs. In this article, we develop a framework to estimate the social costs imposed by the regulatory process. Under this framework, delays in drug development are socially costly because of reduced consumer surplus (due to delayed access to beneficial therapies), reduced producer variable profits, and increased R&D expenditures. We apply this framework to the case of therapies aimed at treating AIDS, non-Hodgkin’s lymphoma, and breast cancer. In each case, we find that the effects of drug delays on consumer surplus and variable producer profits are far larger than the effects on R&D costs. These findings suggest that patients, not firms, would be the primary beneficiaries from any improvements in streamlining the drug development process.
Dynamics for the focusing, energy-critical nonlinear Hartree equation
Authors: Miao Changxing , Wu Yifei , Xu Guixiang
Published: October 2012

By Li, Miao and Zhang (2009) and Miao, Xu and Zhao (2009),
the dynamics of the solutions for
the focusing energy-critical Hartree equation have been classified
when E(u
0) < E(W), where W is the ground state. In this paper, we
continue the study on the dynamics of the radial solutions with the
threshold energy under the assumption of the nondegeneracy of the
linearized operator near ground state. Our arguments closely follow
those of Duyckaerts and Merle (2008, 2009), Duyckaerts and Roudenko (2010)
and
Li and Zhang (2009, 2011). The new ingredient is that we show that the
positive solution of the nonlocal elliptic equation in
L
2d/(d-2)(ℝ
d
) is regular and unique by the moving plane
method in its global form, which plays an important role in the
spectral theory of the linearized operator and the dynamics behavior
of the threshold solution. Moreover, the nondegeneracy property of
the linearized operator can be shown in the Newtonian's potential
case (that is, d = 6).
The effect of fermented soy (FSWW08) on blood hematology and cachexia in cancer patients
Authors: Rohr Uwe D. , Li Wu Wen , Ziqiang Huang , Wainright Walter , Schindler Adolf Eduard
Published: October 2012

In cancer patients, appetite and immune status are significantly weakened. Two experimental fermented formulations without (group A, named as FSWW08) and with (group B, FSWW08) an extract from yam root were investigated against a placebo formulation with casein (group C) in a clinical study conducted in six cancer hospitals where cancer patients underwent radio or chemotherapy (patients undergoing radiation therapy n=78, patients undergoing chemotherapy n=184, total 262). IgG and IgA were increased by formulation A in patients despite receiving radio- or chemotherapy. Group A experienced statistically significant increases in lymphocyte transformation rates, whereas group B and group C did not. Formulations A and B either inhibited or lessened statistically significant decreases in white blood counts, whereas the placebo group experienced substantial decreases. Hemoglobin and platelet decreases were inhibited in group A, although not statistically significantly. Patients in group A received no blood transfusions, whereas many patients from the placebo group received blood transfusions. Appetite loss was reduced in group A from 57.9% to 13.3% and in group B from 70% to 35.8%. In the placebo group, an increase in appetite loss was detected under chemo and radiation therapy from 41.8% to 70.9%.
Possible role of a septin, SEPT1, in spreading in squamous cell carcinoma DJM-1 cells
Authors: Mizutani Yoko , Ito Hidenori , Iwamoto Ikuko , Morishita Rika , Kanoh Hiroyuki , Seishima Mariko , Nagata Koh-ichi
Published: October 2012

We performed biochemical, histochemical and cell biological characterization of septins by focusing on SEPT1 in human skin tissues and a squamous cell carcinoma (SCC) cell line DJM-1. In immunoblotting, SEPT1, together with other septins, was detected in normal human epidermis, SCC and DJM-1. In immunohistochemical analyses, SEPT1 was detected diffusely in the cytoplasm of human epidermal cells and eccrine gland epithelial cells, and the protein level was increased in some skin tumors. In DJM-1 cells, SEPT1 together with other members of SEPT2-subgroup, SEPT4 and SEPT5, was enriched in lamellipodia and the localization was dependent on the cortical actin structure. SEPT1 distribution at lamellipodia was also observed in melanoma B16 cells. SEPT9, SEPT11 and SEPT14, in contrast, were localized along with microtubules in DJM-1 cells. In immunoprecipitation assays, SEPT1 and SEPT5 were found to form a complex in DJM-1 cells, whereas SEPT9, SEPT11 and SEPT14 formed a distinct complex with other septins including SEPT7, SEPT8 and SEPT10, in which SEPT5 was not included. When SEPT1 was silenced in DJM-1 cells, cell spreading was inhibited. These results suggest that SEPT1 may participate in cell-cell and/or cell-substrate interaction in DJM-1 and exert its function in a coordinated manner with other septins.
Cellular microcompartments constitute general suborganellar functional units in cells
Authors: Holthuis Joost C.M. , Ungermann Christian
Published: October 2012

All cells are compartmentalized to facilitate enzymatic reactions or cellular dynamics. In eukaryotic cells, organelles differ in their protein/lipid repertoire, luminal ion composition, pH, and redox status. In addition, organelles contain specialized subcompartments even within the same membrane or within its lumen. Moreover, the bacterial plasma membrane reveals a remarkable degree of organization, which is recapitulated in eukaryotic cells and often linked to cell signaling. Finally, protein-based compartments are also known in the bacterial and eukaryotic cytosol. As the organizing principle of such cellular subcompartments is likely similar, previous definitions like rafts, microdomains, and all kinds of ‘-somes’ fall short as a general denominator to describe such suborganellar structures. Within this review, we will introduce the term cellular microcompartment as a general suborganellar functional unit and discuss its relevance to understand subcellular organization and function.
Oxidation and Evaporation Behaviors of Cr, Cu and As During Incineration of Wood Treated by Chromated Copper Arsenate Preservative
Authors: Matsumoto Takahiko , Matsuura Hiroyuki , Tsukihashi Fumitaka
Published: October 2012

Woody materials treated by chromated copper arsenate (CCA) preservative containing copper, chromium and arsenic had been widely used, and thus it is anticipated that a lot of wood waste treated by CCA will be generated as the industrial waste in the future. The environmental pollution by the released heavy metals becomes a serious problem when the wood treated by CCA was incinerated inadequately. There needs the investigation for the behaviors of heavy metals during incineration of wood treated by CCA.

The wood sample treated by CCA was incinerated at temperature range between 873 and 1673 K with the oxygen partial pressure between 0.21 and 0.40 atm completely. The proportion of evaporated arsenic increased with increasing temperature and most of arsenic evaporated at about 1600 K. It was suggested that arsenic evaporated as As2O3 or As4O6 during the incineration. On the other hand, most of copper and chromium remained in the bottom ash. The evaporation behaviors of arsenic largely depended on the incineration temperature, while the effects of the oxygen partial pressure of inlet gas and gas flow rate on those were small. Powder XRD analysis of bottom ash revealed that copper and chromium existed as CuCr2O4 and CuCrO2. CuCr2O4 was mainly contained in the bottom ash incinerated at temperature below 1273 K, whereas the ratio of CuCrO2 increased with increasing incineration temperature above 1273 K. Therefore, most of copper and chromium were bivalent and trivalent, respectively, in the bottom ash, and some copper was converted to a monovalent over 1273 K. Almost all arsenic was contained as pentavalent Cu3(AsO4)2, and arsenic was not identified in bottom ash incinerated at temperature above 1273 K.
Study on blood glucose concentration in patients with diabetes undergoing dental extraction under local anesthesia with and without adrenaline
Authors: Haji Irfan ul Hassan , Siddiq Mohamed , Rao Sripathi , Rai Gunachandra , Hiregoudar Jagadish S. , Pitale Unnati
Published: October 2012

Background: The aim of this study was to compare the effect of adrenaline on blood glucose concentration in patients with diabetes undergoing tooth extraction under local anesthesia and also to find out whether blood glucose concentration differs if local anesthetics are injected in clinical doses with and without adrenaline.

Methods: Patients included had a tooth in need of extraction, were in the 25–55 years age group, had a random blood sugar level ≤140 mg/dL and were on oral antidiabetic drugs. The 25 patients in Group A were injected with 2 mL of lignocaine hydrochloride without adrenaline (xylocaine 2%) and the other 25 patients (Group B) were injected with 2 mL lignocaine hydrochloride along with adrenaline 1:80,000. Serial blood glucose estimations were made at regular intervals of 10 min before local anesthesia and subsequently 10 and 20 min after local anesthesia.

Results: A statistically significant difference of the mean blood glucose concentration was noticed at three different time intervals between the two groups.

Conclusions: Dental local anesthetic solutions containing adrenaline may safely be used in patients with diabetes who had taken their hypoglycemic medications preoperatively.