bluuebunny/crossref_metadata_2025 huggingface dataset:
Trace Detection of Pentaerythritol Tetranitrate Using Electrochemical Gas Sensors
Authors: Sekhar Praveen K. , Zhou Jie , Wang Hui , Hamblin Eric R.
Published: December 2014

Selective and sensitive detection of trace amounts of pentaerythritol tetranitrate (PETN) is demonstrated. The screening system is based on a sampling/concentrator front end and electrochemical potentiometric gas sensor as the detector. A single sensor is operated in the dominant hydrocarbon (HC) and nitrogen oxides (NOx) mode by varying the sensor operating condition. The potentiometric sensor with integrated heaters was used to capture the signature of PETN. Quantitative measurements based on hydrocarbon and nitrogen oxide sensor responses indicated that the detector sensitivity scaled proportionally with the mass of the explosives (10 μg down to 200 ng). The ratio of the HC integrated peak area to the NOxintegrated peak area is identified as an indicator of selectivity. The HC/NOxratio is unique for PETN and has a range from 1.7 to 2.7. This detection technique has the potential to become an orthogonal technique to the existing explosive screening technologies for reducing the number of false positives/false negatives in a cost-effective manner.
Osteoclastic Giant Cell Rich Squamous Cell Carcinoma of the Uterine Cervix: A Case Report and Review of the Literature
Authors: Alemán-Meza Lucía , Gómez-Macías Gabriela Sofía , Barboza-Quintana Oralia , Garza-Guajardo Raquel , Loya-Solis Abelardo
Published: December 2014

Cervical carcinoma is the most common malignancy of the female genital tract and represents the second most common malignancy in women worldwide. Histologically 85 to 90% of cervical cancers are squamous cell carcinoma. Osteoclastic giant cell rich squamous cell carcinoma is an unusual histological variant of which only 4 cases have been reported. We present the case of a 49-year-old woman with a 6-month history of irregular vaginal bleeding. Examination revealed a 2.7 cm polypoid mass in the anterior lip of the uterine cervix. The patient underwent hysterectomy with bilateral salpingo-oophorectomy. Microscopically the tumor was composed of infiltrative nests of poorly differentiated nonkeratinizing squamous cell carcinoma. Interspersed in between these tumor cells were numerous osteoclastic giant cells with abundant eosinophilic cytoplasm devoid of nuclear atypia, hyperchromatism, or mitotic activity. Immunohistochemistry was performed; CK and P63 were strongly positive in the squamous component and negative in the osteoclastic giant cells, while CD68 and Vimentin were strongly positive in the giant cell population and negative in the squamous component. The patient received chemo- and radiotherapy for recurrent disease identified 3 months later on a follow-up CT scan; 7 months after the surgical procedure the patient is clinically and radiologically disease-free.
Serum Levels of TNF-α, IL-12/23p40, and IL-17 in Plaque Psoriasis and Their Correlation with Disease Severity
Authors: Kyriakou Aikaterini , Patsatsi Aikaterini , Vyzantiadis Timoleon-Achilleas , Sotiriadis Dimitrios
Published: December 2014

A case-control study was performed to assess the serum levels of TNF-α, IL-12/23p40, and IL-17 in patients with plaque psoriasis, compare them with healthy controls, and correlate them with disease severity, as represented by Psoriasis Area Severity Index (PASI). 32 consecutively selected, untreated patients with active, chronic plaque psoriasis were recruited and compared to 32 age- and sex-matched healthy controls. Serum cytokine levels were determined by solid phase sandwich enzyme linked immunosorbent assay (R&D Systems Europe, Ltd.). The mean serum levels of TNF-αwere significantly higher in psoriatic patients compared to those of controls (Mann-WhitneyUtest;P=0.000). However, the median serum levels of neither IL-12/23p40 nor IL-17 differ significantly between the 2 groups (Mann-WhitneyUtest;P=0.968andP=0.311, resp.). No significant correlations were found between PASI and any of the cytokine serum levels (Spearman’s rank test;P>0.05). Despite the well-evidenced therapeutic efficacy of biologic agents targeting TNF-α, IL-12/23p40, and IL-17, serum levels of TNF-α, IL-12/23p40, and IL-17 do not seem to correlate with the severity of psoriatic skin disease in untreated patients, as represented by PASI. Further investigation may add more data on the pathogenetic cascade of psoriasis.
Fast Release of Sulfosalicylic Acid from Polymer Implants Consisting of Regenerated Cellulose/γ-Ferric Oxide/Polypyrrole
Authors: Chowdhury Nargis A. , Robertson John , Al-Jumaily Ahmed , Ramos Maximiano V.
Published: December 2014

This work presents a comparative study on the rate of drug release from implantable matrices induced by electric and magnetic fields separately for better biomedical applications. The matrices were prepared by coating γ-ferric oxide dispersed regenerated cellulose film by polypyrrole doped with sulfosalicylic acid as an anti-inflammatory drug. The drug release mechanisms were studied under both the electric and the magnetic fields separately in an acetate buffer solution with pH 5.5 and temperature 37°C during a period of 5 hours. The amount of drug released was analysed by UV-Vis spectrophotometry. The mechanism of drug release from the matrices under electric field includes expansion of conductive polymer chain and the electrostatic force between electron and drug. The drug release mechanism from the matrices under magnetic field is based on the fact that the heat produced locally by magnetic particles loosens the polymer (polypyrrole) chain surrounding the particles. As a result, the drugs attached to the polypyrrole chain come out to the release medium. The matrices showed fast release of drug, that is, more than 60% of the loaded drug was released within 1 h, and are ideal for the treatment of illness in an emergency care.
Dimensions of Situatedness for Digital Public Displays
Authors: José Rui , Otero Nuno , Cardoso Jorge C. S.
Published: December 2014

Public displays are often strongly situated signs deeply embedded in their physical, social, and cultural setting. Understanding how the display is coupled with on-going situations, its level of situatedness, provides a key element for the interpretation of the displays themselves but is also an element for the interpretation of place, its situated practices, and its social context. Most digital displays, however, do not achieve the same sense of situatedness that seems so natural in their nondigital counterparts. This paper investigates people’s perception of situatedness when considering the connection between public displays and their context. We have collected over 300 photos of displays and conducted a set of analysis tasks involving focus groups and structured interviews with 15 participants. The contribution is a consolidated list of situatedness dimensions that should provide a valuable resource for reasoning about situatedness in digital displays and informing the design and development of display systems.
Genital Schistosomiasis: A Report on Two Cases of Ovarian Carcinomas Containing Viable Eggs ofSchistosoma mansoni
Authors: Gonçalves Amorim Andressa , Alves Barbosa Pagio Fernanda , Neves Ferreira Rodrigo , Chambô Filho Antônio
Published: December 2014

Schistosomiasis is a parasitic infection that is highly prevalent worldwide, with a variety of species being responsible for causing the disease. In Brazil, however, the only identified species isSchistosoma mansoni. The adult parasites inhabit the blood vessels of the hepatic portal system of the main host. The disease may range from being asymptomatic to provoking liver damage or portal hypertension. Furthermore, ectopic schistosomiasis may develop, and several hypotheses have been raised to explain the occurrence of the disease. This paper describes two cases, one in a 39-year-old woman and the other in a 47-year-old woman. Both had similar symptoms of pain and abdominal distension caused by a large abdominal/pelvic mass. Histopathology of the ovary showed a mucinous cystadenocarcinoma of the intestinal type in the first patient and a papillary serous carcinoma in the second, with both tumors containing viable eggs ofSchistosoma mansoni. The neoplasms probably serve as a migratory route for the adult parasites and the embolization of eggs. Nevertheless, there is insufficient evidence to confirm the malignization of a benign lesion due to the presence ofSchistosoma mansoni. Few cases have been reported in the international literature on the association between ovarian schistosomiasis and neoplasms.
Thermal, Structural, and Physical Properties of Freeze Dried Tropical Fruit Powder
Authors: Athmaselvi K. A. , Kumar C. , Balasubramanian M. , Roy Ishita
Published: December 2014

This study evaluates the physical properties of freeze dried tropical (guava, sapota, and papaya) fruit powders. Thermal stability and weight loss were evaluated using TGA-DSC and IR, which showed pectin as the main solid constituent. LCR meter measured electrical conductivity, dielectric constant, and dielectric loss factor. Functional groups assessed by FTIR showed presence of chlorides, and O–H and N–H bonds in guava, chloride and C–H bond in papaya, and chlorides, and C=O and C–H bonds in sapota. Particle size and type of starch were evaluated by X-ray diffraction and microstructure through scanning electronic microscopy. A semicrystalline profile and average particle size of the fruit powders were evidenced by X-ray diffraction and lamellar/spherical morphologies by SEM. Presence of A-type starch was observed in all three fruits. Dependence of electric and dielectric properties on frequency and temperature was observed.
Cross Correlation for Condition Monitoring of Variable Load and Speed Gearboxes
Authors: McBain Jordan , Timusk Markus
Published: December 2014

The ability to identify incipient faults at an early stage in the operation of machinery has been demonstrated to provide substantial value to industry. These benefits for automated, in situ, and online monitoring of machinery, structures, and systems subject to varying operating conditions are difficult to achieve at present when they are run in operationally constrained environments that demand uninterrupted operation in this mode. This work focuses on developing a simple algorithm for this problem class; novelty detection is deployed on feature vectors generated from the cross correlation of vibration signals from sensors mounted on disparate locations in a power train. The behavior of these signals in a gearbox subject to varying load and speed is expected to remain in a commensurate state until a change in some physical aspect of the mechanical components, presumed to be indicative of gearbox failure. Cross correlation will be demonstrated to generate excellent classification results for a gearbox subject to independently changing load and speed. It eliminates the need to analyze the highly complex dynamics of this system; it generalizes well across untaught ranges of load and speed; it eliminates the need to identify and measure all predominant time-varying parameters; it is simple and computationally inexpensive.
Fatty Acid Composition of Egg Yolk from Chickens Fed a Diet including Marigold (Tagetes erectaL.)
Authors: Altuntaş A. , Aydin R.
Published: December 2014

The objective of this study was to determine the effects of diet supplemented with marigold on egg yolk fatty acid composition and egg quality parameters. Sixty hens were assigned into three groups and fed diets supplemented with 0 (control), 10 g kg−1, or 20 g kg−1marigold for 42 days. Eggs collected at the 6th week of the study were analyzed for fatty acid analysis. Laying performance, egg quality parameters, and feed intake were also evaluated. Yolk color scores in the group fed the 20 g kg−1marigold-supplemented diet were found greater than control (10.77 versus 9.77). Inclusion of 20 g kg−1marigold in diet influenced egg weights adversely compared to the control. Diet supplemented with 10 g kg−1or 20 g kg−1marigold increased the levels of C16:0 and C18:0 and decreased levels of C16:1 (n-7) and C18:1 (n-9) in the egg yolk. Also, diet including marigold increased total saturated fatty acids (SFA) and decreased monounsaturated fatty acids (MUFA) in the egg yolk.
Outer Membrane Proteome Analysis of Indian Strain ofPasteurella multocidaSerotype B:2 by MALDI-TOF/MS Analysis
Authors: Prasannavadhana A. , Kumar Santosh , Thomas Prasad , Sarangi Laxmi Narayan , Gupta Santosh Kumar , Priyadarshini Adyasha , Nagaleekar Viswas Konasagara , Singh Vijendra Pal
Published: December 2014

Identification of outer membrane proteins (OMPs) is important to understand the bacteria structure and function, host-pathogen interaction, development of novel vaccine candidates, and diagnostic antigens. But till now the key antigens ofP. multocidaB:2 isolate causing haemorrhagic septicaemia (HS) in animals are not clearly defined. In this study, P52 strain ofP. multocidaserotype B:2 was grownin vitrounder iron-rich and iron-limited condition. The OMPs were extracted by sarkosyl method followed by SDS-PAGE and the proteins were identified by MALDI-TOF/MS analysis. In total, 22 proteins were identified, of which 7 were observed exclusively under iron-limited condition. Most of the high molecular weight proteins (TbpA, HgbA, HgbB, HasR, IroA, and HemR) identified in this study were involved in iron acquisition. Some hypothetical proteins (HP-KCU-10206, HP and AAUPMB 08244, HP AAUPMB 21592, HP AAUPMB 19766, AAUPMB 11295) were observed for the first time in this study which could be unique to serotype B:2. Further functionalin vivostudy of the proteins identified are required to explore the utility of these proteins in developing diagnostics and vaccine against HS.
Passive Posterior Tibial Subluxation on Routine Knee MRI as a Secondary Sign of PCL Tear
Authors: Degnan Andrew J. , Maldjian Catherine , Adam Richard J. , Harner Christopher D.
Published: December 2014

The posterior drawer test is an accurate clinical test to diagnose posterior cruciate ligament (PCL), indicating laxity of the PCL that allows posterior tibial translation. This study aimed to determine whether posterior tibial translation relative to the femur on routine MRI could serve as an additional sign of PCL tear. Routine knee MRI in eleven patients (7 males, 4 females) with arthroscopically confirmed isolated PCL tears were reviewed independently by two musculoskeletal radiologists. Measurements of tibial translation were made in the medial and lateral compartments of patients and controls (10 males, 12 females) without clinical or MRI evidence of ligament injury. Significant medial compartment posterior tibial translation was present in patients with PCL tear compared to controls (+2.93 mm versus +0.03 mm,P=0.002) with excellent interobserver agreement (intraclass correlation coefficient (ICC) = 0.94). No significant difference in lateral compartment tibial translation was observed (+0.17 mm versus −0.57 mm,P=0.366) despite excellent interobserver agreement (ICC = 0.96). Posterior tibial translation in the midmedial compartment may be a secondary sign of isolated PCL tear on routine knee MRI with passive extension without manipulation or weight bearing. Additional work in a larger cohort may better address the accuracy of this finding.
Research of Joining Brittle Nonmetallic Materials with an Active Solder
Authors: Koleňák Roman , Prach Michal
Published: December 2014

This paper deals with soldering high-purity brittle, nonmetallic materials such as SiO2, Si, and C (graphite). However, these materials exert poor wettability when using tin solder. Therefore, to reduce the wetting angle, an Sn solder alloyed with active Ti element was used. At a soldering temperature of 860°C and 15 min soldering time, the wetting angle on SiO2ceramics was 30°, on silicon 42°, and on graphite 52°. All these wetting angles are below 90° and are acceptable for soldering. It has been shown that the bond in all joined materials (SiO2, Si, and C) was of a diffusion character. New intermetallic products were formed on the boundary with nonmetal, thus allowing bond formation. The shear strength of SiO2ceramics attained an average value of 17 MPa.
The Combined Internal and Principal Parametric Resonances on Continuum Stator System of Asynchronous Machine
Authors: Li Baizhou , Zhang Qichang
Published: December 2014

With the increasing requirement of quiet electrical machines in the civil and defense industry, it is very significant and necessary to predict the vibration and noise characteristics of stator and rotor in the early conceptual phase. Therefore, the combined internal and principal parametric resonances of a stator system excited by radial electromagnetic force are presented in this paper. The stator structure is modeled as a continuum double-shell system which is loaded by a varying distributed electromagnetic load. The nonlinear dynamic equations are derived and solved by the method of multiple scales. The influences of mechanical and electromagnetic parameters on resonance characteristics are illustrated by the frequency-response curves. Furthermore, the Runge-Kutta method is adopted to numerically analyze steady-state response for the further understanding of the resonance characteristics with different parameters.
Sustainability Literacy of Older People in Retirement Villages
Authors: Xia Bo , Zuo Jian , Skitmore Martin , Buys Laurie , Hu Xin
Published: December 2014

With many developed countries experiencing the aging of the population, older people play a large role in contributing to environmental problems but also to environmental solutions. The purpose of this research is to understand the awareness and behavior of current older people living in retirement villages towards sustainability development. To achieve this, a sustainability literacy survey was conducted with 65 older residents of a private retirement village located 10 Km outside the Brisbane, Australia’s central business district (CBD). Most of residents recognized the importance of environment protection and would like to lead a more environmentally friendly lifestyle. In addition, the majority were willing to pay higher prices for a living environment with sustainable features. The importance of positive social communications was emphasized with most residents having established good relationships with others in the village. The findings provide an important insight into consumer perspectives regarding the sustainable features that should and can be incorporated into the village planning and development.
Retropubic, Laparoscopic, and Robot-Assisted Radical Prostatectomy: Surgical, Oncological, and Functional Outcomes: A Systematic Review
Authors: De Carlo Francesco , Celestino Francesco , Verri Cristian , Masedu Francesco , Liberati Emanuele , Di Stasi Savino Mauro
Published: December 2014

Objectives: Despite the wide diffusion of minimally invasive approaches, such as laparoscopic (LRP) and robot-assisted radical prostatectomy (RALP), few studies compare the results of these techniques with the retropubic radical prostatectomy (RRP) approach. The aim of this study is to compare the surgical, functional, and oncological outcomes and cost-effectiveness of RRP, LRP, and RALP. Methods: A systematic review of the literature was performed in the PubMed and Embase databases in December 2013. A ‘free-text' protocol using the term ‘radical prostatectomy' was applied. A total of 16,085 records were found. The authors reviewed the records to identify comparative studies to include in the review. Results: 44 comparative studies were identified. With regard to the perioperative outcome, LRP and RALP were more time-consuming than RRP, but blood loss, transfusion rates, catheterisation time, hospitalisation duration, and complication rates were the most optimal in the laparoscopic approaches. With regard to the functional and oncological results, RALP was found to have the best outcomes. Conclusion: Our study confirmed the well-known perioperative advantage of minimally invasive techniques; however, available data were not sufficient to prove the superiority of any surgical approach in terms of functional and oncologic outcomes. On the contrary, cost comparison clearly supports RRP.
Cerebral Oxygenation during Intermittent Hypoxemia and Bradycardia in Preterm Infants
Authors: Schmid Manuel B. , Hopfner Reinhard J. , Lenhof Susanne , Hummler Helmut D. , Fuchs Hans
Published: December 2014

Background: Episodes of hypoxemia and bradycardia frequently occur with apnea of prematurity in preterm infants. Little is known about the impact of different event types on the brain. Objectives: To describe the influence of hypoxemia and bradycardia, either isolated or in combination, on cerebral oxygenation. Methods: In 16 preterm infants with intermittent hypoxemia and/or bradycardia, cerebral tissue oxygen saturation (StO2, as measured by near-infrared spectroscopy), heart rate and pulse oximetric saturation (SpO2) were recorded simultaneously for 16 h. Events were classified as isolated bradycardia (type 1), isolated hypoxemia (type 2) or combined (simultaneous, type 3; bradycardia first, type 4; hypoxemia first, type 5). Primary outcome was a score representing the area below baseline for cerebral StO2 desaturation during an event. Secondary outcomes were duration and depth of cerebral desaturation. Results: Patients had a median (range) gestational age of 25.9 (22.6-30.4) weeks and a postnatal age of 32.5 (7-58) days. The median (quartiles) number of events was 49 (34-58). Isolated hypoxemias were the most frequent events (24; 9-36) and isolated bradycardias the least common (0; 0-1). Cerebral StO2 baseline was not different between event types. Cerebral desaturation score, duration of event and depth of cerebral desaturation were smallest for isolated bradycardias and largest for combined events, especially for those starting with hypoxemia followed by bradycardia. Regardless of event type, 12/16 infants maintained cerebral StO2 >60% despite severe SpO2 desaturations. Conclusions: Isolated bradycardias had the lowest impact on cerebral desaturation, and combined events had the highest. Most infants preserved cerebral oxygenation >60% during events.
Amyloid-β Immunotherapy Reduces Amyloid Plaques and Astroglial Reaction in Aged Domestic Dogs
Authors: Neus Bosch Maria , Pugliese Marco , Andrade Carmen , Gimeno-Bayón Javier , Mahy Nicole , Rodriguez Manuel J.
Published: December 2014

Background: Alzheimer's disease (AD) is characterized by the dynamic accumulation of extracellular amyloid deposits from the interplay between amyloid-β (Aβ) plaques, reactive astrocytes and activated microglia. Several immunotherapies against Aβ have been shown to reduce amyloid neuropathology. However, the role of the associated glia in the recovery process requires clarification. Previously, we described the safety and effectiveness in aged domestic canine with cognitive dysfunction syndrome of a new active vaccine candidate for the treatment of AD in humans. Objective: The aim of this article is to gain a better understanding of how immunotherapy modifies the amyloid burden and its effects on astroglial and microglial reactivity in immunized dogs. Methods: In order to achieve this, we compared and quantified amyloid plaques and astroglial and microglial reactions in the frontal cortex of unimmunized and immunized aged domestic dogs. Results: We found amyloid plaques from immunized dogs to be smaller and more compact than those from unimmunized dogs. In these new plaques, the associated astrocytes were closer and less immunoreactive to the β subunit of S100 protein (S100B). We also found no modification in the microglial reaction associated with immunization. Conclusion: The anti-Aβ immunotherapy developed in our laboratory modifies the equilibrium between soluble and insoluble Aβ in aged dogs in close correlation with S100B-negative astrocytosis and microglial reaction.
Mucosal Immunosenescence in the Gastrointestinal Tract: A Mini-Review
Authors: Sato Shintaro , Kiyono Hiroshi , Fujihashi Kohtaro
Published: December 2014

It has been shown that pathogen-specific secretory IgA (SIgA) antibody (Ab) is the major player at mucosal surfaces for host defense. However, alterations in the mucosal immune system occur in advanced aging, which results in a failure of induction of SIgA Abs for the protection from infectious diseases. Signs of mucosal senescence first appear in the gut immune system. Further, changes in the intestinal microbiota most likely influence mucosal immunity. To overcome the immunological aging decline in mucosal immunity, several adjuvant systems including mucosal dendritic cell targeting have been shown to be attractive and effective immunological strategies. Similarly, microfold (M) cells involved in the antigen (Ag) uptake are ideal targets for facilitating Ag-specific mucosal immune responses. However, the numbers of M cells are reduced in aged mice. In this regard, Spi-B, an essential transcription factor for the functional and structural differentiation of M cells, could be a potent strategy for the induction of effective mucosal immunity in aging.
Mitochondrial Aging: Focus on Mitochondrial DNA Damage in Atherosclerosis - A Mini-Review
Authors: Sobenin Igor A. , Zhelankin Andrey V. , Sinyov Vasily V. , Bobryshev Yuri V. , Orekhov Alexander N.
Published: December 2014

Atherosclerosis is a complex disease which can be described as an excessive fibrofatty, proliferative, inflammatory response to damage to the artery wall involving several cell types such as smooth muscle cells, monocyte-derived macrophages, lymphocytes, dendritic cells and platelets. On the other hand, atherosclerosis is a typical age-related degenerative pathology, which is characterized by signs of cell senescence in the arterial wall including reduced cell proliferation, irreversible growth arrest and apoptosis, increased DNA damage, the presence of epigenetic modifications, shortening of telomere length and mitochondrial dysfunction. The most prominent characteristics of mitochondrial aging are their structural alterations and mitochondrial DNA damage. The mechanisms of mitochondrial genome damage in the development of chronic age-related diseases such as atherosclerosis are not yet well understood. This review focuses on the latest findings from studies of those mutations of the mitochondrial genome which may play an important role in the development of atherosclerosis and which are, at the same time, also markers of mitochondrial aging and cell senescence.
Evidence of an Association between Age-Related Functional Modifications and Pathophysiological Changes in Zebrafish Heart
Authors: Sun Yanyi , Fang Yuehua , Xu Xiaolei , Lu Guoping , Chen Zhenyue
Published: December 2014

Background: Zebrafish have become a valuable model for the study of developmental biology and human disease, such as cardiovascular disease. It is difficult to discriminate between disease-related and age-related alterations. Objective: This study was aimed to investigate the effects and potential mechanisms of age-related cardiac modifications in an older zebrafish population. Methods: In this study, we calculated the survival rate and measured the spinal curvature through the aging process. A swimming challenge test was performed and showed that swimming capacity and endurance dramatically dropped in older fish groups. Results: To find out the effect of stress on zebrafish during the aging process, we recorded electrocardiograms on zebrafish and showed that during stress, aging not only led to a significant reduction in heart rate, but also caused other age-related impairments, such as arrhythmias and ST-T depression. Echocardiography showed a marked increase in end-diastolic ventricular dimensions and in isovolumic relaxation time and a notably slower mean and peak velocity of the bulboventricular valve in older zebrafish, but stroke volume and cardiac output were not different in young and old zebrafish. Both nppa and nppb (cardiac fetal genes for natriuretic factor) expression detected by real-time polymerase chain reaction analysis increased in older fish compared to the younger group. Histological staining revealed fibrosis within cardiomyocytes and an increase in ventricular myocardial density and a decrease in epicardial vessel dimensions in older fish hearts that may correlate with a deterioration of cardiac function and exercise capacity. Conclusion: These data suggest that cardiac functional modifications in zebrafish are comparable to those in humans and may partly be due to changes in the cardiovascular system including cardiac fetal gene reprogramming, myocardial density, and epicardial vessel dimensions.
A New Pediatric Protocol for Rapid Desensitization to Monoclonal Antibodies
Authors: Caimmi Silvia Maria Elena , Caimmi Davide , Riscassi Sara , Marseglia Gian Luigi
Published: December 2014

Monoclonal antibodies are important therapeutic tools, but their usefulness may be limited when patients experience acute hypersensitivity reactions. Patients reporting a history of adverse allergic reaction are likely to discontinue their therapeutic protocol or be switched to an alternative drug, which is sometimes less effective than that originally prescribed. Drug desensitization has proven to be a highly effective strategy to readminister a drug in a patient who has experienced a hypersensitivity reaction. It involves forcing the patient's immune system to accept and tolerate the allergen. Nevertheless, such a procedure is still empiric for monoclonal antibodies and not common in the pediatric population. The aim of our study is to demonstrate the clinical success of a new protocol of rapid desensitization to infliximab in a pediatric patient affected by ulcerative colitis, who developed an anaphylaxis to the drug. We used a protocol of rapid desensitization consisting of 13 steps, with the first being 1/1,000,000 of the cumulative and total dose. Such a protocol has proven to be able to induce a temporary tolerance to infliximab, allowing the patient to achieve complete control of his disease.
Stationäre und teilstationäre DBT-Angebote für Patienten mit Borderline-Persönlichkeitsstörung - Ergebnisse einer deutschlandweiten Umfrage
Authors: Richter Christoph , Steinacher Bruno , zum Eschenhoff Anna , Bermpohl Felix
Published: December 2014

Hintergrund: Deutschlandweite, retrospektive Erfassung der stationären und tagesklinischen DBT-Versorgung von Patienten mit Borderline-Persönlichkeitsstörung (BPS) für das Jahr 2011: Anzahl der Behandlungsplätze; Patienten pro Jahr; Wartezeit; Behandlungsdauer; Subspezialisierung; Vernetzung stationärer, tagesklinischer bzw. ambulanter Therapieangebote. Methoden: Fragebogenversendung über E-Mail-Verteiler des DBT-Dachverbands. Ergebnisse: 42 Krankenhäuser und Tageskliniken gaben Rückmeldung (Rücklaufquote: 75%, 527 Therapieplätze, 2310 behandelte Patienten). Die mittlere Wartezeit betrug 14,3 Wochen. Die mittlere Behandlungsdauer betrug ≥9,6 Wochen und ≤20,3 Wochen. 52,2% der antwortenden Einrichtungen waren durch den Dachverband zertifiziert (allerdings nur 7,1% der Tageskliniken). 57,1% boten eine Subspezialisierung an, 14,3% eine separierte Diagnose- und Behandlungsphase, 92,1% sahen ein tagesklinisches Angebot als wünschenswert an, aber nur 28,6% besaßen ein solches. 38,1% boten einen Wechsel zwischen stationären, tagesklinischen oder ambulanten Therapieoptionen an (Therapeutenwechsel in 61% der Fälle). In Bezug auf die Übernahme höherer Behandlungskosten, die durch die DBT entstanden waren, hatten nur 4,8% der Einrichtungen spezielle Vertragsvereinbarungen mit Krankenkassen. Schlussfolgerungen: Grundlage dieses Beitrags ist eine erste systematisierte Umfrage im deutschsprachigen Raum. Im Jahr 2011 gab es in Deutschland hochgerechnet 700 vollstationäre und tagesklinische DBT-Behandlungsplätze für etwa 3000 Patienten mit BPS. Das Verhältnis von einem DBT-Platz zu 191 Patienten pro Jahr sowie die lange Wartezeit waren Indikatoren für ein zu geringes Angebot (teil)stationärer DBT, das die Nachfrage bei Weitem nicht decken konnte; gleichzeitig bestand eine ambulante Versorgungslücke.
Phytotherapie in den medizinischen S3-Leitlinien der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften - eine systematische Übersichtsarbeit
Authors: Klose Petra , Kraft Karin , Cramer Holger , Lauche Romy , Dobos Gustav , Langhorst Jost
Published: December 2014

Phytotherapy in the German Medical AWMF S3 Guidelines - a Systematic OverviewIn Deutschland werden an die interdisziplinär, evidenz- und konsensbasiert erstellten S3-Leitlinien der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) höchste wissenschaftliche Ansprüche gestellt; sie prägen die Gestaltung der Patientenversorgung. Phytotherapeutika haben in der medizinischen Versorgung im deutschsprachigen Raum eine große Tradition. Zunehmend existiert Evidenz für ihre Wirksamkeit bei verschiedenen Erkrankungen. Die vorliegende Übersichtsarbeit untersucht, in welchem Ausmaß pflanzliche Arzneimittel in den aktuellen S3-Leitlinien Berücksichtigung finden. Mittels Überprüfung aller verfügbaren S3-Leitlinien der AWMF wurden die Empfehlungen/Statements zu phytotherapeutischen Therapieoptionen von 2 unabhängigen Experten identifiziert und in 3 Kategorien eingeteilt: positive, negative und offene. Darüber hinaus wurden Ausführungen zu Nebenwirkungen und Interaktionen recherchiert. In 40 (31,3%) der 128 Leitlinien wird Phytotherapie benannt. In 55 Leitlinien (42,9%), in denen grundsätzlich phytotherapeutische Therapieoptionen bestehen, werden pflanzlichen Arzneimittel nicht berücksichtigt. Von insgesamt 204 Empfehlungen zu Phytotherapeutika fallen 139 (68,1%) negativ aus oder bleiben ergebnisoffen. Phytotherapie wird in 27 Leitlinien (67,5%) im jeweiligen Kapitel zu komplementären und alternativen Verfahren und/oder unter Sonstiges eingeordnet, in 7 Leitlinien (17,5%) steht sie am Ende der Empfehlungen zur medikamentösen Therapie, in 8 Leitlinien (20%) zwischen den Empfehlungen zu konventionellen Verfahren. Hinweise zu Neben- und Wechselwirkungen finden sich zu 70 der 204 Empfehlungen (34,3%). Weit weniger als die Hälfte der verfügbaren AWMF-S3-Leitlinien beinhalten eine Recherche zu Phytotherapeutika, nur in 17 S3-Leitlinien finden sich aktuell positive Empfehlungen. Eine systematische Aufarbeitung der vorhandenen Evidenz ist notwendig, um die adäquate Berücksichtigung der Phytotherapie in den medizinischen Leitlinien zu gewährleisten.
Is Prehospital Treatment of Acute Stroke too Expensive An Economic Evaluation Based on the First Trial
Authors: Dietrich Martin , Walter Silke , Ragoschke-Schumm Andreas , Helwig Stefan , Levine Steven , Balucani Clotilde , Lesmeister Martin , Haass Anton , Liu Yang , Lossius Hans-Morten , Fassbender Klaus
Published: December 2014

Background: Recently, a strategy for treating stroke directly at the emergency site was developed. It was based on the use of an ambulance equipped with a scanner, a point-of-care laboratory, and telemedicine capabilities (Mobile Stroke Unit). Despite demonstrating a marked reduction in the delay to thrombolysis, this strategy is criticized because of potentially unacceptable costs. Methods: We related the incremental direct costs of prehospital stroke treatment based on data of the first trial on this concept to one year direct cost savings taken from published research results. Key parameters were configuration of emergency medical service personnel, operating distance, and population density. Model parameters were varied to cover 5 different relevant emergency medical service scenarios. Additionally, the effects of operating distance and population density on benefit-cost ratios were analyzed. Results: Benefits of the concept of prehospital stroke treatment outweighed its costs with a benefit-cost ratio of 1.96 in the baseline experimental setting. The benefit-cost ratio markedly increased with the reduction of the staff and with higher population density. Maximum benefit-cost ratios between 2.16 and 6.85 were identified at optimum operating distances in a range between 43.01 and 64.88 km (26.88 and 40.55 miles). Our model implies that in different scenarios the Mobile Stroke Unit strategy is cost-efficient starting from an operating distance of 15.98 km (9.99 miles) or from a population density of 79 inhabitants per km2 (202 inhabitants per square mile). Conclusion: This study indicates that based on a one-year benefit-cost analysis that prehospital treatment of acute stroke is highly cost-effective across a wide range of possible scenarios. It is the highest when the staff size of the Mobile Stroke Unit can be reduced, for example, by the use of telemedical support from hospital experts. Although efficiency is positively related to population density, benefit-cost ratios can be greater than 1 even in rural settings.
Ventricular Tachycardia in Cardiac Sarcoidosis
Authors: Kumar Saurabh , Barbhaiya Chirag , Nagashima Koichi , Choi Eue-Keun , Epstein Laurence M. , John Roy M. , Maytin Melanie , Albert Christine M. , Miller Amy L. , Koplan Bruce A. , Michaud Gregory F. , Tedrow Usha B. , Stevenson William G.
Published: December 2014

Background—

Cardiac sarcoid–related ventricular tachycardia (VT) is a rare disorder; the underlying substrate and response to ablation are poorly understood. We sought to examine the ventricular substrate and outcomes of catheter ablation in this population.

Methods and Results—

Of 435 patients with nonischemic cardiomyopathy referred for VT ablation, 21 patients (5%) had cardiac sarcoidosis. Multiple inducible VTs were observed with mechanism consistent with scar-mediated re-entry in all VTs. Voltage maps showed widespread and confluent right ventricular scarring. Left ventricular scarring was patchy with a predilection for the basal septum, anterior wall, and perivalvular regions. Epicardial right ventricular scar overlay and exceeded the region of corresponding endocardial scar. After ≥1 procedures, ablation abolished ≥1 inducible VT in 90% and eliminated VT storm in 78% of patients; however, multiple residual VTs remained inducible. Failure to abolish all inducible VTs was because of septal intramural circuits or extensive right ventricular scarring. Multiple procedure VT-free survival was 37% at 1 year, but VT control was achievable in the majority of patients with fewer antiarrhythmic drugs compared with preablation (2.1±0.8 versus 1.1±0.8;
P
<0.001).

Conclusions—

Patients with cardiac sarcoidosis and VT exhibit ventricular substrate characterized by confluent right ventricular scarring and patchy left ventricular scarring capable of sustaining a large number of re-entrant circuits. Catheter ablation is effective in terminating VT storm and eliminating ≥1 inducible VT in the majority of patients, but recurrences are common. Ablation in conjunction with antiarrhythmic drugs can help palliate VT in this high-risk population.
Accessory Atrioventricular Pathways Refractory to Catheter Ablation
Authors: Scanavacca Maurício Ibrahim , Sternick Eduardo Back , Pisani Cristiano , Lara Sissy , Hardy Carina , d’Ávila André , Correa Frederico Soares , Darrieux Francisco , Hachul Denise , Marcial Miguel Barbero , Sosa Eduardo A.
Published: December 2014

Background—

Epicardial mapping and ablation of accessory pathways through a subxiphoid approach can be an alternative when endocardial or epicardial transvenous mapping has failed.

Methods and Results—

We reviewed acute and long-term follow-up of 21 patients (14 males) referred for percutaneous epicardial accessory pathway ablation. There was a median of 2 previous failed procedures. All patients were highly symptomatic, 8 had atrial fibrillation (3 with cardiac arrest) and 13 had frequent symptomatic episodes of atrioventricular reentrant tachycardia. Six patients (28.5%) had a successful epicardial ablation. Five patients (23.8%) underwent a successful repeated endocardial mapping, and ablation after epicardial mapping yielded no early activation site. Epicardial mapping was helpful in guiding endocardial ablation in 2 patients (9.5%), showing that the earliest activation was simultaneous at the epicardium and endocardium. Four patients (19%) underwent successful open-chest surgery after failing epicardial/endocardial ablation. Two patients (9.5%) remained controlled under antiarrhythmic drugs after unsuccessful endocardial/epicardial ablation. Two patients had a coronary sinus diverticulum and one a right atrium to right ventricle diverticulum. Three patients acquired postablation coronary sinus stenosis. There was no major complication related to pericardial access.

Conclusions—

Percutaneous epicardial approach is an alternative when conventional endocardial or transvenous epicardial ablation fails in the elimination of the accessory pathway. A new attempt by endocardial approach was successful in a significant number of patients. Open-chest surgery may be required in symptomatic cases refractory to endocardial–epicardial approach.
A new genus and species of Serpulidae (Annelida, Polychaeta, Sabellida) from the Caribbean Sea
Authors: PRENTISS NANCY K. , VASILEIADOU KATERINA , FAULWETTER SARAH , ARVANITIDIS CHRISTOS , HOVE HARRY A. TEN
Published: December 2014

A new genus and species of Serpulidae (Annelida, Polychaeta) from the Caribbean Sea. Turbocavus secretus (gen. nov. and sp. nov.) is described from shallow hard substrates (0.5–3 m) in wind-sheltered bays of St. John, U.S. Virgin Islands and Curaçao, as well as from diving depths (46−49 m) around Bonaire (Leeward Antilles), Caribbean Sea. The new taxon, which has from 7 to 19 thoracic chaetigers and up to 335 abdominal chaetigers, bears a unique type of thoracic chaeta which is multifolded at the base and continues with a groove tapering to the capillary tip. The new serpulid has unique 18S rRNA sequences and genetic analysis of the 18S rRNA gene situates the new genus at the basis of the serpulid cladogram, well separated from other genera, and close to Filograna/Salmacina and Protula.
Nitrogen Availability Reduces CMIP5 Projections of Twenty-First-Century Land Carbon Uptake*
Authors: Zaehle Sönke , Jones Chris D. , Houlton Benjamin , Lamarque Jean-Francois , Robertson Eddy
Published: December 2014

Coupled carbon cycle–climate models in the Coupled Model Intercomparison Project, phase 5 (CMIP5), Earth system model ensemble simulate the effects of changes in anthropogenic fossil-fuel emissions and ensuing climatic changes on the global carbon (C) balance but largely ignore the consequences of widespread terrestrial nitrogen (N) limitation. Based on plausible ranges of terrestrial C:N stoichiometry, this study investigates whether the terrestrial C sequestration projections of nine CMIP5 models for four representative concentration pathways (RCPs) are consistent with estimates of N supply from increased biological fixation, atmospheric deposition, and reduced ecosystem N losses. Discrepancies between the timing and places of N demand and supply indicated increases in terrestrial N implicit to the projections of all nine CMIP5 models under all scenarios that are larger than the estimated N supply. Omitting N constraints leads to an overestimation of land C sequestration in these models between the years 1860 and 2100 by between 97 Pg C (69–252 Pg C; RCP 2.6) and 150 Pg C (57–323 Pg C; RCP 8.5), with a large spread across models. The CMIP5 models overestimated the average 2006–2100 fossil-fuel emissions required to keep atmospheric CO2 levels on the trajectories described in the RCP scenarios by between 0.6 Pg C yr−1 (0.4–2.2 Pg C yr−1; RCP 2.6) and 1.2 Pg C yr−1 (0.5–3.3 Pg C yr−1; RCP 8.5). If unabated, reduced land C sequestration would enhance CO2 accumulation in the ocean and atmosphere, increasing atmospheric CO2 burden by 26 ppm (16–88 ppm; RCP 2.6) to 61 ppm (29–147 ppm; RCP 8.5) by the year 2100.
Evaluating Global Streamflow Simulations by a Physically Based Routing Model Coupled with the Community Land Model
Authors: Li Hong-Yi , Leung L. Ruby , Getirana Augusto , Huang Maoyi , Wu Huan , Xu Yubin , Guo Jiali , Voisin Nathalie
Published: December 2014

Accurately simulating hydrological processes such as streamflow is important in land surface modeling because they can influence other land surface processes, such as carbon cycle dynamics, through various interaction pathways. This study aims to evaluate the global application of a recently developed Model for Scale Adaptive River Transport (MOSART) coupled with the Community Land Model, version 4 (CLM4). To support the global implementation of MOSART, a comprehensive global hydrography dataset has been derived at multiple resolutions from different sources. The simulated runoff fields are first evaluated against the composite runoff map from the Global Runoff Data Centre (GRDC). The simulated streamflow is then shown to reproduce reasonably well the observed daily and monthly streamflow at over 1600 of the world’s major river stations in terms of annual, seasonal, and daily flow statistics. The impacts of model structure complexity are evaluated, and results show that the spatial and temporal variability of river velocity simulated by MOSART is necessary for capturing streamflow seasonality and annual maximum flood. Other sources of the simulation bias include uncertainties in the atmospheric forcing, as revealed by simulations driven by four different climate datasets, and human influences, based on a classification framework that quantifies the impact levels of large dams on the streamflow worldwide.
Impact of Different Satellite Wind Lidar Telescope Configurations on NCEP GFS Forecast Skill in Observing System Simulation Experiments
Authors: Ma Zaizhong , Riishøjgaard Lars Peter , Masutani Michiko , Woollen John S. , Emmitt George D.
Published: December 2014

The Global Wind Observing Sounder (GWOS) concept, which has been developed as a hypothetical space-based hybrid wind lidar system by NASA in response to the 2007 National Research Council (NRC) decadal survey, is expected to provide global wind profile observations with high vertical resolution, precision, and accuracy when realized. The assimilation of Doppler wind lidar (DWL) observations anticipated from the GWOS is being conducted as a series of observing system simulation experiments (OSSEs) at the Joint Center for Satellite Data Assimilation (JCSDA). A companion paper (Riishøjgaard et al.) describes the simulation of this lidar wind data and evaluates the impact on global numerical weather prediction (NWP) of the baseline GWOS using a four-telescope configuration to provide independent line-of-sight wind speeds, while this paper sets out to assess the NWP impact of GWOS equipped with alternative paired configurations of telescopes. The National Centers for Environmental Prediction (NCEP) Gridpoint Statistical Interpolation (GSI) analysis system and the Global Forecast System (GFS) were used, at a resolution of T382 with 64 layers, as the assimilation system and the forecast model, respectively, in these lidar OSSEs. A set of 45-day assimilation and forecast experiments from 2 July to 15 August 2005 was set up and executed.

In this OSSE study, a control simulation utilizing all of the data types assimilated in the operational GSI/GFS system was compared to three OSSE simulations that added lidar wind data from the different configurations of telescopes (one-, two-, and four-look configurations). First, the root-mean-square error (RMSE) of wind analysis is compared against the nature run. A significant reduction of the stratospheric RMSE of wind analyses is found for all latitudes when lidar wind profiles are used in the assimilation system. The forecast impacts of lidar data on the wind and mass forecasts are also presented. In addition, the anomaly correlations (AC) of geopotential height forecasts at 500 hPa were evaluated to compare the control and different GWOS telescope configuration experiments. The results show that the assimilation of lidar data from the GWOS (one, two, or four looks) can improve the NCEP GFS wind and mass field forecasts. The addition of the simulated lidar wind observations leads to a statistically significant increase in AC scores.