bluuebunny/crossref_metadata_2025 huggingface dataset:
Randomised controlled trial of the effects of two rigid gas permeable (RGP) contact lens materials and two surface cleaners on straylight values
Authors: Fortuin Marten F. , Schilperoort John , Evans Bruce J. W. , Edgar David F. , Van Den Berg Tom J. T. P. , Kiers Henri
Published: August 2009

Purpose:  In a double‐masked randomized controlled crossover study we investigated both the retinal responses to straylight, and the effects of lens cleaners on straylight values, in two different RGP contact lens materials.

Methods:  Thirty patients (20–59 years) wearing RGP lenses were refitted with new lenses made of Boston XO material in one eye and made of Comfort O2 (ONSI‐56) material in the other eye. Reported wetting angles for the Boston XO material (103°) and for the ONSI‐56 material (7.2°) were obtained by sessile drop measurements. After refitting, the study comprised three 5‐week trial periods. In Period 1 half of the participants (Group A) wore Boston XO lenses in their right eye and Comfort O2 (ONSI‐56) lenses in their left eye, and the other half (Group B) vice versa. In Period 2 Group A wore Comfort O2 (ONSI‐56) lenses in their right eye and Boston XO lenses in their left, and Group B vice versa. All participants used Miraflow cleaner during periods 1 and 2. In Period 3, during which all participants used Boston cleaner, Group A wore Boston XO lenses in their right eye and Comfort O2 (ONSI‐56) lenses in their left eye and Group B vice versa. Straylight data (log S) were obtained with and without contact lenses using the Oculus C‐Quant straylight meter in all three periods. Central corneal thickness (CCT) was measured in the second and third periods.

Results:  When not wearing lenses (n = 60 eyes) at the end of the second 5 week trial period straylight was measured twice with averages of 1.07 log S, and the corrected CCT measurements averaged 546 μm. Straylight values with Comfort O2 (ONSI‐56) reached 1.15 log S at the end of both the second (n = 25 eyes) and third periods (n = 23 eyes). Straylight values with Boston XO were 1.17 log S (n = 26 eyes) at the end of the second period, and 1.16 log S (n = 25 eyes) at the end of the third period.

Conclusions:  Existing RGP lens wearers refitted with new lenses with different contact angles, made of Boston XO and Comfort O2 (ONSI‐56) showed, over three 5 week periods, relatively small increases in straylight, which were functionally comparable, irrespective of the type of lens material or lens cleaner used. At every visit, straylight values and CCTs returned to baseline levels after RGP lens removal, confirming that the straylight fluctuations were mainly due to scattering from the RGP lenses; or tear film interaction; or a combination of both.
Analysis of optimized profiles for ‘aberration‐free’ refractive surgery
Authors: Arba‐Mosquera Samuel , De Ortueta Diego
Published: August 2009

Purpose:  To provide a model of an aberration‐free profile and to clinically evaluate the impact of treatments based upon these theoretical profiles in the post‐operative cornea.

Methods:  Aberration‐free profiles were deduced from the Zernike expansion of the difference between two corneal cartesian‐ovals. Compensation for the focus‐shift effects of removing corneal tissue were incorporated by preserving the location of the optical focus of the anterior corneal surface. Simulation of the surgical performance of the profile was performed by means of simulated ray‐tracing through a cornea described by its anterior surface and pachymetry. Clinical evaluation was retrospectively analysed in terms of visual outcomes, corneal wavefront aberration and asphericity changes at 3‐month follow‐up compared to the baseline on 100 eyes treated for compound myopic astigmatism.

Results:  The proposed ‘aberration‐free’ profiles theoretically preserve aberrations, becoming more oblate asphericity after myopic treatments, and more prolate after hyperopic ones. In the clinical evaluation, 94% of eyes were within ±0.50 D of emmetropia. BSCVA improved significantly (p < 0.001). Induced corneal aberrations at 6‐mm were below clinically relevant levels: 0.123 ± 0.129 μm for HO‐RMS (p < 0.001), 0.065 ± 0.128 μm for spherical aberration (p < 0.001) and 0.058 ± 0.128 μm for coma (p < 0.01), whereas the rate of induced aberrations per achieved D of correction were −0.042, −0.031, and −0.030 μm D−1 for HO‐RMS, SphAb, and coma (all p < 0.001). Induction of positive asphericity correlated to achieved correction (p < 0.001) at a rate 3× theoretical prediction.

Conclusions:  ‘Aberration‐free’ patterns for refractive surgery as defined here together with consideration of other sources of aberrations such as blending zones, eye‐tracking, and corneal biomechanics yielded results comparable to those of customisation approaches. Having close‐to‐ideal profiles should improve clinical outcomes decreasing the need for nomograms, and diminishing induced aberrations after surgery.
TOWARDS A QUANTITATIVE PETROGRAPHIC DATABASE OF KHMER STONE MATERIALS—KOH KER STYLE SCULPTURE
Authors: CARÒ F. , DOUGLAS J. G. , IM S.
Published: August 2009

A comprehensive quantitative petrographic database of sandstones used by the Khmers for sculptural purposes would be a helpful tool for archaeologists, museum curators and others interested in pursuing research on early stone usage, geological source and provenance. Towards that end, this paper presents quantitative petrographic analysis of stone materials used in the production of some free‐standing sculptures and architectural elements in the Koh Ker style of the 10th century from the collections of the National Museum of Cambodia and The Metropolitan Museum of Art. These materials are compared to samples from the quarry of Thmâ Anlong near the foothills of the Phnom Kulen, Sieam Reap province. Primary and secondary detrital modes and key grain‐size parameters are used to identify three sandstone types. The free‐standing sculptures are carved from feldspathic arenite and feldspato‐lithic to litho‐feldspathic arenite. Finely carved lintels are worked from a quartz arenite, which is significantly richer in quartz grains and of a finer grain size. The geological source of the two other lithotypes will have to await detailed geological survey of the Koh Ker area accompanied by petrographic study of selected samples from documented quarries. The significance and potentiality of quantitative petrographic study of Khmer stone materials are shown in supporting and integrating archaeological investigations in South‐East Asia.
SCIENTIFIC CHARACTERIZATION OF THE POHORJE MARBLES, SLOVENIA
Authors: JARC S. , MANIATIS Y. , DOTSIKA E. , TAMBAKOPOULOS D. , ZUPANCIC N.
Published: August 2009

As a former part of the great Roman Empire, Slovenia has many archaeological sites featuring buildings and objects entirely or partly constructed from marble whose provenance is doubtful. In Slovenia, the most probable source of such marble is the Pohorje Mountains. For the purpose of supporting further provenance studies, these marbles are fully scientifically characterized. The techniques used are petrographic and geochemical analysis, stable isotope ratio analysis and EPR spectroscopy. The results show that the Pohorje marbles are highly heterogeneous in both their isotopic and geochemical parameters as well as grain sizes. The parameters of the different Pohorje marble outcrops are compared between themselves and with the parameters of known ancient quarries in the Mediterranean and Austria. The use of a multi‐technique approach with combined parameters allows the best possible discrimination.
Clinical and Therapeutic Approach to Childhood Acne: An Update
Authors: Antoniou C. , Dessinioti Clio , Stratigos A. J. , Katsambas A. D.
Published: August 2009

Abstract:  There is a limited literature reporting on acne in childhood. Childhood acne can be classified in neonatal, infantile, mid‐childhood, and prepubertal acne, depending on the age of onset. In this review we will present an update on the clinical approach and therapeutic options when facing prepubertal acne in a child. The use of tetracyclines is contraindicated in children younger than 8 years, and oral isotretinoin is not recommended in children younger than 12 years of age according to the FDA and the European Commission. Nevertheless, there are case reports of 10 patients successfully treated with oral isotretinoin for recalcitrant infantile acne with scarring. Further studies are needed to investigate whether isotretinoin may improve the long‐term prognosis of infantile acne, which may be associated with more severe acne in adolescence.
Blueberry Muffin Rash as the Presenting Sign of Aicardi–Goutières Syndrome
Authors: Brisman Stacey , Gonzalez Mercedes , Morel Kimberly D.
Published: August 2009

Abstract:  A 36‐week gestation singleton male infant was born with hypoglycemia, thrombocytopenia, transaminitis, microcephaly, and a generalized eruption of bluish‐red nonblanching macules and papules. Head computed tomography showed intracranial calcifications and enlarged ventricles. Skin biopsy was consistent with extramedullary hematopoiesis, with no evidence of neoplastic infiltrate. Family history was notable for parental consanguinity and twin sisters with the diagnosis of Aicardi–Goutières syndrome, a rare autosomal recessive progressive encephalopathy. Although the infant’s clinical presentation at birth suggested an infectious etiology, extensive testing for infection, including TORCH titers, was negative. Cerebrospinal fluid analysis revealed persistent lymphocytosis and an elevated interferon alpha level, consistent with the diagnosis of Aicardi–Goutières syndrome. Although there have been no reported cases of a blueberry muffin rash in Aicardi–Goutières syndrome, it is biologically plausible for this cutaneous manifestation to occur in the setting of a genetic condition that mimics the clinical phenotype of a congenital viral infection. As the capacity to test for different infectious etiologies and genetic syndromes increases, so must the differential diagnosis of a neonatal blueberry muffin rash. It is important to identify these rare syndromes because of their prognostic implications, risk of recurrence with future pregnancies and need for prompt genetic counseling.
Multiple Nevoid Hypertrichosis as An Isolated Developmental Defect
Authors: Sotiriadis Dimitrios , Patsatsi Aikaterini , Lazaridou Elizabeth , Sotiriou Eleni , Devliotou‐Panagiotidou Despina
Published: August 2009

Abstract:  A 3‐year‐old girl presented with longer hair on the left side of her scalp, coarse hair of abnormal length on her extremities, and a tuft of hair in the lumbosacral region, with all hair distributed on normally pigmented skin. Neither similar or relevant family history nor associated extracutaneous abnormalities was detected after a thorough examination. Clinical diagnosis of patchy nevoid hypetrichosis was confirmed by histology. Nevoid hypertrichosis is a rare hair growth disorder that usually presents at or soon after birth. It is characterized by patches of hypertrichosis distributed in a segmental pattern. It may be accompanied by mental, ocular, or myoskeletal abnormalities. Cases of nevoid hypertrichosis with multiple patches presenting as a solitary developmental defect have been rarely described in the literature.
Palmar Hyperhidrosis: Long‐term Follow‐up of Nine Children and Adolescents Treated with Botulinum Toxin Type A
Authors: Coutinho dos Santos Lúcia H. , Gomes Ariadne Miranda , Giraldi Susana , Abagge Kerstin Taniguchi , Marinoni Leide Parolim
Published: August 2009

Abstract:  Primary palmar hyperhidrosis in children and adolescents may be severe enough to affect school and physical activities, causing emotional problems, stress in the patient’s life, and a compromised quality of life. Nine patients with palmar hyperhidrosis underwent treatment with botulinum A. Before the session, and in the 1‐, 3‐, 6‐, 9‐, and 12‐month post‐session follow‐ups, the patients were administered the Minor test, gravimetry, the Scales of Frequency and Severity, and the Questionnaire of Quality of Life. The mean age was 11 years, with seven girls and two boys. Each patient was administered at least one treatment of botulinum toxin in the palm of the hands (75–150 U for palm), with the mean number of sessions 2.2 (range: 1–4). All sessions in the patients resulted in drying of the hands, with a mean duration of effect of 7 months. Botulinum toxin A controls excessive sweat in the palms of children and adolescents who have primary palmar hyperhidrosis, with an improvement in the quality of life. The therapy is safe and effective in this pediatric group and can be considered before surgical interventions.
Intravenous Immunoglobulin Therapy for Hypocomplementemic Urticarial Vasculitis Associated with Systemic Lupus Erythematosus in a Child
Authors: Yamazaki‐Nakashimada Marco A. , Duran‐Mckinster Carola , Ramírez‐Vargas Nadia , Hernandez‐Bautista Victor
Published: August 2009

Abstract: Hypocomplementemic urticarial vasculitis is a type of urticarial vasculitis with multisystemic involvement and poor prognosis, sometimes associated with systemic lupus erythematosus. Several therapies have been attempted with no consensus on an effective therapeutic regimen. Intravenous immunoglobulin has been used in severe manifestations of systemic lupus erythematosus and recently in hypocomplementemic urticarial vasculitis. We present a 7‐year‐old girl with hypocomplementemic urticarial vasculitis associated with systemic lupus erythematosus and pneumonia who responded favorably to intravenous immunoglobulin.
Ligneous Conjunctivitis with Oral Mucous Membrane Involvement and Decreased Plasminogen Level
Authors: El‐Darouti Mohamed , Zayed Amira A. , El‐Kamah Ghada Y. , Mostafa Mostafa I.
Published: August 2009

Abstract:  Ligneous conjunctivitis (MIM 217090) is a rare autosomal recessive hereditary disorder. We report a case with both ligneous conjunctivitis and ligneous periodontitis in association with plasminogen type I deficiency. Diagnosis was based on the clinical and histological findings and most importantly, decreased serum level of plasminogen type I.
Oral Lichenoid Drug Eruption: A Report of a Pediatric Case and Review of the Literature
Authors: Woo Victoria , Bonks Julia , Borukhova Lyubov , Zegarelli David
Published: August 2009

Abstract:  Lichenoid drug eruptions are seen most frequently on the skin and seldomly affect the mucosal surfaces. Oral involvement—known as oral lichenoid drug eruption—is more common in the adult population and has been associated with numerous medications. Pediatric‐onset oral lichenoid drug eruption is an exceptionally rare finding with only isolated cases published in the literature. The nonspecific appearance and latent presentation of pediatric oral lichenoid drug eruption can cause confusion in diagnosis and treatment. We report a case of oral lichenoid drug eruption occurring in a 15‐year‐old and explore challenges in the clinical and histologic recognition of this condition.
Treatment of Focal Epithelial Hyperplasia with Topical Imiquimod: Report of Three Cases
Authors: Yasar Sirin , Mansur Ayse Tulin , Serdar Zehra Asiran , Goktay Fatih , Aslan Canan
Published: August 2009

Abstract:  Focal epithelial hyperplasia (Heck disease) is a rare disorder caused by specific types of HPV. It mainly involves oral mucosa and children are affected more frequently. It may persist for years, producing a significant reduction in quality of life. Several treatment modalities such as surgical excision, laser ablation, cryotherapy, electrocauterization, topical, intralesional, systemic interferon, and systemic retinoic acid have been used with inconsistent results and many side effects. Here we report three children of Turkish origin with focal epithelial hyperplasia successfully treated with imiquimod 5% cream. No serious side effects were observed and recurrence did not occur during the 1‐year follow‐up period.
Trichoblastoma in a Child
Authors: KANG TAE WOOK , KANG HOON , KIM HYUNG OK , SONG KYE YONG , PARK YOUNG MIN
Published: August 2009

Abstract:  A trichoblastoma is a benign adnexal neoplasm composed of follicular germinative cells. It most commonly presents as a solitary nodule on the scalp, face, or perineum and occurs equally in males and females. It is diagnosed most commonly between the fourth and the sixth decades, and it is extremely rare in childhood. To our knowledge there is no prior case report of a primary trichoblastoma occurring outside the setting of a nevus sebaceous of Jadassohn in a child before adolescence. Herein we report a case of trichoblastoma of the right cheek in an 11‐year‐old Korean girl.
Childhood Cutaneous Leiomyosarcoma
Authors: BLAISE GÉRALDINE , NIKKELS ARJEN F. , QUATRESOOZ PASCALE , HERMANNS‐LÊ T. , PIÉRARD GÉRALD E.
Published: August 2009

Abstract:  Cutaneous leiomyosarcoma is a soft tissue neoplasm exhibiting an aggressive local behavior and a potential for distant metastases. It is rare during childhood and diagnosis can be challenging both clinically and histologically. Surgical excision with wide lateral and deep margins is the treatment of choice, whereas radiotherapy and chemotherapy are contraindicated. Long‐term follow‐up is necessary as recurrences are not infrequent.
The Predilection of Chickenpox Exanthema to Influenza Vaccine Injection Site
Authors: BEN‐SHOSHAN MOSHE , LEJTENYI CHRISTINE , PRIMEAU MARIE‐NOËL
Published: August 2009

Abstract:  Annual influenza immunization of children is highly recommended and is usually well tolerated. We report the first case of chickenpox exanthema localized to the influenza vaccination site in a boy with known egg allergy.
Bullous Congenital Ichthyosiform Erythroderma: A Sporadic Case Produced by a New KRT10 Gene Mutation
Authors: BETLLOCH ISABEL , LUCAS COSTA ANNA , MATAIX JAVIER , PÉREZ‐CRESPO MARIA , BALLESTER IRENE
Published: August 2009

Abstract:  Bullous congenital ichthyosiform erythroderma is an unusual type of inherited ichthyosis by mutations in the genes that encode K1 and K10. We report the case of a girl with typical clinical and histopathologic findings of bullous congenital ichthyosiform erythroderma, who was found to have a new mutation in KRT10 gene, Glu445Lys at position 445, affecting the 2B region of the KRT10 protein, the end of the rod domain, where many other keratin mutations associated with hereditary skin disease have been reported. This new mutation contributes to add to the catalog of bullous congenital ichthyosiform erythroderma mutations known.
Pachyonychia Congenita Type I Presenting with Subtle Nail Changes
Authors: IORIZZO MATILDE , VINCENZI COLOMBINA , SMITH FRANCES J.D. , WILSON NEIL J. , TOSTI ANTONELLA
Published: August 2009

Abstract:  Pachyonychia congenita type I is an autosomal dominant disorder where nail abnormalities are a constant feature and develop during childhood. We report here a family with pachyonychia congenita type I and very mild nail changes to underline that this diagnosis should be considered even in the absence of severe nail thickening.
Generalized Erythema Multiforme after Localized Allergic Dermatitis from Dark Henna Tattoo
Authors: NERI IRIA , GIACOMINI FREDERICA , RAONE BEATRICE , PATRIZI ANNALISA
Published: August 2009

Letters to the Editor are welcomed for publication (subject to editing). Letters must be signed by all authors, and must not exceed two pages of text including references. Letters should not duplicate material submitted or published in other journals. Prepublication proofs will not be provided.
Renal Function in Older Hospital Patients Is More Accurately Estimated Using the Cockcroft‐Gault Formula Than the Modification Diet in Renal Disease Formula
Authors: Péquignot Renaud , Belmin Joël , Chauvelier Sophie , Gaubert Jean‐Yves , Konrat Cécile , Duron Emmanuelle , Hanon Olivier
Published: August 2009

OBJECTIVES: To compare the accuracy of the two most popular creatinine clearance (CrCl) estimation formulae (Cockcroft‐Gault (CG) and Modification Diet in Renal Disease (MDRD)) in older hospitalized patients.

DESIGN: Prospective, cross‐sectional, observational study.

SETTING: Two hospital geriatric wards.

PARTICIPANTS: Consecutive patients aged 70 and older with an indwelling urinary catheter for the purpose of care.

MEASUREMENTS: CrCl was determined according to three methods: measured CrCl from plasma and urine creatinine and 24‐hour urine volume, CG (CG‐CrCl), and MDRD (MDRD‐CrCl). Results were expressed as median and interquartile range (IQR). Moderate and severe renal impairment were defined as a CrCl between 30.0 and 59.9 mL/min and less than 30.0 mL/min, respectively.

RESULTS: One hundred twenty‐one patients were included (46% male). Mean age was 86.1±6.7 (range 72–100). Median measured CrCl was 43.8 mL/min (IQR 33.6–61.1 mL/min), CG‐CrCl was 40.9 mL/min (IQR 31.0–52.6 mL/min), and MDRD‐CrCl was 61.3 mL/min (IQR 49.4–77.0 mL/min). The biases of CG‐CrCl and MDRD were −3.5±22.5 and 20.1±28.2, respectively (P<.001). Misclassification of renal impairment (absent/moderate/severe) occurred in 33% of patients according to CG‐CrCl, and concordance was mild to moderate (kappa=0.50). Misclassification occurred in 50% of patients according to MDRD‐CrCl, and concordance was poor (kappa=0.33). Bias was significantly related to bed confinement for both formulae and to plasma creatinine for MDRD.

CONCLUSION: In elderly hospitalized patients, CG slightly underestimates CrCl, and MDRD strongly overestimates it. CG gave a better prediction of measured CrCl than MDRD.
Understanding Advance Care Planning as a Process of Health Behavior Change
Authors: Fried Terri R. , Bullock Karen , Iannone Lynne , O'Leary John R.
Published: August 2009

OBJECTIVES: To explore whether models of health behavior change can help to inform interventions for advance care planning (ACP).

DESIGN: Qualitative cross‐sectional study.

SETTING: Community.

PARTICIPANTS: Sixty‐three community‐dwelling persons aged 65 and older and 30 caregivers with experience as surrogate decision‐makers.

MEASUREMENTS: In focus groups conducted separately with older persons and caregivers, participants were asked to discuss ways they had planned for future declines in health and why they had or had not engaged in such planning. Transcripts were analyzed using grounded theory.

RESULTS: Four themes illustrated the potential of applying models of health behavior change to improve ACP. (1) Participants demonstrated variable readiness to engage in ACP and could be in different stages of readiness for different components of ACP, including consideration of treatment goals, completion of advance directives, and communication with families and physicians. (2) Participants identified a wide range of benefits of and barriers to ACP. (3) Participants used a variety of processes of change to progress through stages of readiness, and ACP was only one of a broader set of behaviors that participants engaged in to prepare for declines in their health or for death. (4) Experience with healthcare decision‐making for loved ones was a strong influence on perceptions of susceptibility and engagement in ACP.

DISCUSSION: The variability in participants' readiness, barriers and benefits, perceptions of susceptibility, and use of processes to increase readiness for participating in each component of ACP suggests the utility of customized, stage‐specific interventions based on individualized assessments to improve ACP.
Targeting Nursing Homes Under the Quality Improvement Organization Program's 9th Statement of Work
Authors: Stevenson David G. , Mor Vincent
Published: August 2009

In the Quality Improvement Organization (QIO) program's latest Statement of Work, the Centers for Medicare and Medicaid Services (CMS) is targeting its nursing home activities toward facilities that perform poorly on two quality measures—pressure ulcers and restraint use. The designation of target facilities is a shift in strategy for CMS and a direct response to criticism that QIO program resources were not being targeted effectively to facilities or clinical areas that most needed improvement. Using administrative data, this article analyzes implications of using narrowly defined criteria to identify facilities that need improvement, particularly in light of considerable evidence showing that nursing home quality is multidimensional and may change over time. The analyses show that one in four facilities is targeted for improvement nationally but that approximately half of some states' facilities are targeted while other states have almost none targeted. The analyses also convey deeper limitations to using threshold values on individual measures to identify poorly performing homes. Target facilities can be among the top performers on a range of other quality measures, and their performance on targeted measures themselves may change over time. The implication of these features is that a very different group of facilities would have been chosen had the QIO program targeted other measures or examined performance at a different point in time. Ultimately, CMS has chosen a blunt instrument to identify poorly performing nursing homes, and supplemental strategies—such as soliciting input from state survey agencies and more closely aligning quality improvement and quality assurance efforts—should be considered to address potential limitations.
IMMUNOHEMATOLOGY: Understanding loss of donor white blood cell immunogenicity after pathogen reduction: mechanisms of action in ultraviolet illumination and riboflavin treatment
Authors: Jackman Rachael P. , Heitman John W. , Marschner Susanne , Goodrich Raymond P. , Norris Philip J.
Published: August 2009

BACKGROUND:Donor white blood cells (WBCs) present in transfusion products can lead to immune sequelae such as production of HLA antibodies or graft‐versus‐host disease in susceptible transfusion recipients. Eliminating the immunogenicity of blood products may prove to be of clinical benefit, particularly in patients requiring multiple transfusions in whom allosensitization is common. This study examines a method of pathogen reduction based on ultraviolet light illumination in the presence of riboflavin. In addition to pathogens, WBCs treated with this system are affected and fail to stimulate proliferation of allogeneic peripheral blood mononuclear cells (PBMNCs) in vitro.

STUDY DESIGN AND METHODS:This study sought to determine the mechanisms regulating this loss of immunogenicity. Treated cells were examined for surface expression of a number of molecules involved in activation and adhesion, viability, cell‐cell conjugation, and ability to stimulate immune responses in allogeneic PBMNCs.

RESULTS:Compared with untreated controls, ultraviolet (UV)‐irradiated antigen‐presenting cells showed slightly reduced surface expression of HLA Class II and costimulatory molecules and had more significant reductions in surface expression of a number of adhesion molecules. Furthermore, treated cells had a severe defect in cell‐cell conjugation. The observed loss of immunogenicity was nearly complete, with UV‐irradiated cells stimulating barely measurable interferon‐γ production and no detectable STAT‐3, STAT‐5, or CD3‐ε phosphorylation in allospecific primed T cells.

CONCLUSION:These results suggest that defective cell‐cell adhesion prevents UV‐irradiated cells from inducing T‐cell activation.
BLOOD COMPONENTS: A novel approach to pathogen reduction in platelet concentrates using short‐wave ultraviolet light
Authors: Mohr Harald , Steil Leif , Gravemann Ute , Thiele Thomas , Hammer Elke , Greinacher Andreas , Müller Thomas H. , Völker Uwe
Published: August 2009

BACKGROUND:Transfusion of platelet concentrates (PCs) is the basic treatment for severe platelet disorders. PCs carry the risk of pathogen transmission, especially bacteria. Pathogen reduction (PR) by addition of photochemical reagents and irradiation with visible or ultraviolet (UV) light can significantly reduce this risk. We present a novel approach for PR in PCs employing UVC light alone.

STUDY DESIGN AND METHODS:UVC PR was evaluated by bacteria and virus infectivity assays. PC quality was investigated by measuring pH, lactate, glucose, hypotonic shock response, platelet aggregation, CD62P expression, and annexin V binding as in vitro parameters. The impact of UVC PR on the platelet proteome was assessed by differential in‐gel electrophoresis and compared with changes caused by UVB and gamma‐irradiation, respectively.

RESULTS:Vigorous agitation of loosely placed PCs generated thin fluid layers that allow penetration of UVC light for inactivation of the six bacteria and six of the seven virus species tested. HIV‐1 was only moderately inactivated. UVC light at the dose used (0.4 J/cm2) had a minor impact on in vitro parameters and on storage stability of treated PCs. Proteome analysis revealed a common set of 92 (out of 793) protein spots being affected by all three types of irradiation. Specific alterations were most pronounced for gamma‐irradiation (45 spots), followed by UVB (11 spots) and UVC (2 spots).

CONCLUSION:UVC irradiation is a potential new method for pathogen reduction in PCs. The data obtained until now justify further development of this process.
COMMENTARY: Relative safety of pooled whole blood–derived versus single‐donor (apheresis) platelets in the United States: a systematic review of disparate risks
Authors: Vamvakas Eleftherios C.
Published: August 2009

BACKGROUND: Risks of transfusion‐transmitted infections (TTIs), transfusion‐associated sepsis (TAS), and transfusion‐related acute lung injury (TRALI) were compared between pooled whole blood–derived (PWBD) and single‐donor platelets (PLTs) transfused in the United States.

STUDY DESIGN AND METHODS: The literature was searched for estimates of the risk of TTIs and TAS and of the effect on bacterial contamination of PLTs of process improvements, bacterial culture, and surrogate methods to detect bacteria. Seven studies published between January 2005 and December 2008 and comparing bacterial contamination frequency between PWBD and single‐donor PLTs after implementing bacterial culture testing of both components were subjected to meta‐analysis. The three retrieved studies diagnosing TRALI based on the 2004 consensus definition in settings transfusing both PWBD and single‐donor PLTs were not amenable to meta‐analysis and were assessed qualitatively.

RESULTS: Under a best‐case scenario, if 100% (from the current 12.5%) of PLT doses were provided as PWBD PLTs, the number of additional transmissions of human immunodeficiency virus, hepatitis C virus, hepatitis B virus, bacteria, or a novel pathogen annually could be 1.2, 1.3, 9.0, 105.3, or 69.2 to 252.6, respectively. Compared with single‐donor PLTs, US PLT pools of five concentrates have a 5.6‐fold higher risk of bacterial contamination (summary odds ratio, 5.58; 95% confidence interval, 2.60‐11.98; p < 0.05). The three studies that diagnosed TRALI based on the consensus definition did not demonstrate a difference in risk between PWBD and single‐donor PLTs.

CONCLUSIONS: TTIs and TAS determine the relative safety of PWBD versus single‐donor PLTs. The available limited data do not support a higher risk of TRALI from single‐donor (compared with PWBD) PLTs.
TRANSFUSION COMPLICATIONS: Bacterial contamination of pediatric whole blood transfusions in a Kenyan hospital
Authors: Hassall Oliver , Maitland Kathryn , Pole Lewa , Mwarumba Salim , Denje Douglas , Wambua Kongo , Lowe Brett , Parry Christopher , Mandaliya Kishor , Bates Imelda
Published: August 2009

BACKGROUND: Hospitalized children in sub‐Saharan Africa frequently receive whole blood transfusions for severe anemia. The risk from bacterial contamination of blood for transfusion in sub‐Saharan Africa is not known. This study assessed the frequency of bacterial contamination of pediatric whole blood transfusions at a referral hospital in Kenya.

STUDY DESIGN AND METHODS: This was an observational study. Over the course of 1 year, bacteriologic cultures were performed on 434 of the 799 blood packs issued to children by the blood bank of Coast Provincial General Hospital, Mombasa. Clinical outcome was not assessed.

RESULTS: Forty‐four bacterial contaminants were isolated from 38 blood packs—an overall contamination frequency of 8.8% (95% confidence interval, 6.1%‐11.4%). Sixty‐four percent of the bacteria isolated were Gram‐negative. Many of the isolates are usually found in the environment and the most likely source of contamination was considered to be the hospital blood bank.

CONCLUSION: Bacterial contamination of whole blood may be a significant but unrecognized hazard of blood transfusion for children in sub‐Saharan Africa. Further work is needed to clarify the extent of the problem and its clinical consequences. Increased awareness and adherence to basic principles of asepsis in the hospital blood bank may be important immediate interventions.
Low‐Temperature Fabrication of Oxide Composites for Solid‐Oxide Fuel Cells
Authors: He Hongpeng , Huang Yingyi , Regal Juleiga , Boaro Marta , Vohs John M. , Gorte Raymond J.
Published: August 2009

Composites of yttria‐stabilized zirconia (YSZ) with Sr‐doped LaCrO3 (LSC) and Sr‐doped LaMnO3 (LSM) were prepared by impregnation of a porous YSZ matrix with aqueous solutions of the appropriate metal salts, followed by sintering to various temperatures. XRD measurements showed that perovskite phases formed after sintering at 1073 K, a temperature well below that at which solid‐state reactions with YSZ occur. The conductivities of the LSC–YSZ and LSM–YSZ composites prepared in this way were maximized at a sintering temperature of 1373 K for LSC–YSZ and 1523 K for LSM–YSZ, although reasonable conductivities were achieved at much lower temperatures. The conductivities of the two composites increased much more rapidly with the content of the conductive oxide than has been found with conventional composites formed by mixing and sintering the oxide powders. The implications for using this approach to develop novel electrodes for SOFC applications are discussed.
In Situ Synthesis and Microstructures of Tungsten Carbide‐Nanoparticle‐Reinforced Silicon Nitride‐Matrix Composites
Authors: Iizuka Tateoki , Kita Hideki , Hyuga Hideki , Hirai Takene , Osumi Kazuo
Published: August 2009

A W2C‐nanoparticle‐reinforced Si3N4‐matrix composite was fabricated by sintering porous Si3N4 that had been infiltrated with a tungsten solution. During the sintering procedure, nanometer‐sized W2C particles grew in situ from the reaction between the tungsten and carbon sources considered to originate mainly from residual binder. The W2C particles resided in the grain‐boundary junctions of the Si3N4, had an average diameter of ∼60 nm, and were polyhedral in shape. Because the residual carbon, which normally would obstruct sintering, reacted with the tungsten to form W2C particles in the composite, the sinterability of the Si3N4 was improved, and a W2C–Si3N4 composite with almost full density was obtained. The flexural strength of the W2C–Si3N4 composite was 1212 MPa, ∼34% higher than that of standard sintered Si3N4.
Metal‐Urea Complex—A Precursor to Metal Nitrides
Authors: Qiu Yu , Gao Lian
Published: August 2009

A novel and general route to synthesize various metal nitrides (AlN, CrN, and ζ‐Fe2N) from metal–urea complexes is presented. These complexes, especially metal–urea chloride, have proved to be useful precursors to metal nitrides, because urea molecules construct a coordination sphere around the metal atom and form a stable structure, compared with the air‐sensitive halide. Different anions in the second coordination sphere determine the reaction mechanism. The transformation from metal–urea chloride to nitride is thought to follow a nucleation–growth mechanism, while that from metal–urea nitrate is thought to follow a nitridation mechanism. We anticipate that this metal–urea complex will find applications in the fabrication of other, more complex, nitrides.
Monoclinic Zirconia Bodies by Thermoplastic Ceramic Extrusion
Authors: Scheying Gerd , Wührl Ingrid , Eisele Ulrich , Riedel Ralf
Published: August 2009

Two ultrafine, undoped ZrO2 powders with median primary particle sizes of 9 and 25 nm were used to prepare ceramic suspensions for thermoplastic extrusion. The organic vehicle consisted of an industrial‐grade poly(ethylene‐co‐vinyl acetate) (EVA) or polyethylene (PE‐HD) and decanoic acid as a dispersing agent. The powder volume loadings achieved were 44% and 52% by volume for the two powders, respectively. The amount of dispersant needed was calculated from a new model based on available chemisorption sites on the powder surface. Mixing and extrusion were conducted using a conventional modular plastic processing unit. Green bodies were dewaxed up to 450°C in an inert atmosphere and sintered to full density in air at 1060° and 1100°C, respectively. Analysis of the ceramic phase content and the microstructure of the bodies is presented.
Evolution of the Morphology of Zinc Oxide/Silica Particles Made by Spray Combustion
Authors: Tani Takao , Takatori Kazumasa , Pratsinis Sotiris E.
Published: August 2009

Pure and mixed ZnO–SiO2 particles were made by flame‐spray pyrolysis of zinc acetate and hexamethyldisiloxane or SiO2 sol dispersed in methanol or water‐in‐oil emulsion, respectively. The product particles were characterized by nitrogen adsorption, infrared absorption, and X‐ray diffraction. The evolution of solid or hollow particle formation along the flame axis was unraveled by transmission electron microscopy after collection by thermophoretic sampling. The effects of silicon precursor and solvent on product particle characteristics were evaluated. The characteristics of the product particles were controlled by the Si precursor and solvent.
XPS Analysis of Submicrometer Barium Titanate Powder
Authors: Wegmann Markus , Watson Lewis , Hendry Alan
Published: August 2009

A commercial submicrometer BaTiO3 powder was analyzed using X‐ray photoelectron spectroscopy. The analysis revealed the powder surfaces to be covered with a layer of physisorbed H2O and chemisorbed –OH ions. A BaCO3 residual not detected with XPS was shown to be present in the powder using X‐ray diffraction, suggesting that the carbonate takes the form of discrete particles rather than of a continuous surface layer. A relaxed surface phase detected in previous XPS analyses of bulk BaTiO3 was also shown to be present. Depth profiling revealed the powder surfaces to be Ti‐rich, confirming the presence of a phase, or phases, to stoichiometrically balance the barium carbonate.
Influence of Precursor Solutions on the Ferroelectric Properties of Sol‐Gel‐Derived Lanthanum‐Modified Lead Titanate (PLT) Thin Films
Authors: Bhaskar S. , Majumder S. B. , Fachini E. R. , Katiyar R. S.
Published: August 2009

Precursor chemistry was found to have a dominant effect on the electrical properties of sol‐gel‐derived Pb0.85La0.15TiO3 (PLT15) thin films prepared using different precursor sources for lanthanum, namely, lanthanum acetate dissolved in acetic acid (LAA) and lanthanum 2‐methoxyethoxide in 2‐methoxyethanol (LMM). The LMM‐derived PLT15 films had lower dielectric constants (KLMM= 394, KLAA= 548, measured at 100 kHz, applying 500 mV oscillation voltage), poorer polarization hysteresis characteristics, and higher leakage current densities (JLMM∼ 1.5 × 10−7 A/cm2, JLAA∼ 2 × 10−9 A/cm2, measured at 10 kV/cm field). Differential thermal analysis (DTA) and thermogravimetric analysis (TGA) measurements in conjunction with Fourier transformed infrared spectroscopy (FTIR) and X‐ray photoelectron spectroscopy (XPS) analyses indicate that better removal of C–O moieties are the key step to yield improved electrical properties in these films. Possibly, C–O moieties reduce the metallic oxides to their corresponding metals and the presence of the metallic constituent(s) (e.g., lead), in turn deteriorate the electrical properties. In line with these postulations it was found that, when the pyrolysis temperature is increased from 450° to 550°C, the organic contents of LMM‐derived films are reduced and their electrical properties are indeed comparable to that of the LAA‐derived films.
Charge‐Compensating Defect in Ceria‐Doped Strontium Barium Niobate by Electron Energy‐Loss Spectroscopy and X‐ray Photoelectron Spectroscopy
Authors: Shiue Jyh‐Tzong , Fang Tsang‐Tse
Published: August 2009

Undoped and CeO2‐doped Sr0.5Ba0.5Nb2O6 (SBN) powders were synthesized using the solid‐state reaction method. The lattice parameters of undoped and CeO2‐doped SBN were evaluated using X‐ray diffractometry. The valence state of the cerium ion in Ce‐doped SBN was identified using X‐ray photoelectron spectroscopy (XPS), and the valence of 3+ was confirmed. The charge‐compensated defect of the cerium doping in SBN ceramics, i.e., excessive oxygen ions occupying the vacant O(4) or O(5) site, was further evidenced using electron energy‐loss spectroscopy (EELS) and XPS. The relationships of charge‐compensated defect, structure, binding energy, and temperature of the maximum of the relative permittivity (Tm) were discussed.
Solubility of Silver and Palladium in BaTiO3
Authors: Shih Shao‐Ju , Tuan Wei‐Hsing
Published: August 2009

Silver, palladium, and their alloys are frequently used as electrode materials for BaTiO3 (BT) based dielectrics. However, the electrodes and dielectrics usually are cofired at high temperatures, and silver and palladium can dissolve into the BT during cofiring. In the present study, the solubility of silver and palladium into BT after cofiring was determined. Three measurement techniques were used to determine solubility: chemical analysis, structural analysis, and dielectric analysis. The solubility of the silver in the BT was low, 450 ppm, after cofiring at 1290°C for 2 h in air. The diffusion distance of the silver ions into the BT was >5 μm. The solubility of the palladium in the BT was even lower, 50 ppm at 1290°C, and the diffusion distance was ∼1 μm. The solubility of both the silver and the palladium in the BT decreased as the oxygen partial pressure of the sintering atmosphere decreased. These results demonstrated that both silver and palladium solutes act as acceptors for BT.
Effects of Thin Mullite Coating on the Environmental Stability of Sintered Si3N4
Authors: Tsarenko Irina , Du Henry H. , Lee Woo Y.
Published: August 2009

We investigated the effects of a chemically‐vapor‐deposited mullite coating (∼100 nm) on the oxidation resistance of sintered Si3N4 in air and steam environments. The coating was sacrificially incorporated into the thermally grown oxide (TGO) on Si3N4 during isothermal oxidation in air at 1400°C, leading to significantly reduced TGO growth as well as markedly improved TGO morphology. This improvement can be attributed to the refractory and viscous nature of the SiO2‐Al2O3 system, compared with SiO2, when under the influence of alkali and/or alkaline‐earth fluxing elements. However, the mullite coating had little effect on the stability of the ceramic in the steam environment at 1200°C, due likely to high activity of SiO2 in mullite.
Ta2O5/Nb2O5 and Y2O3 Co‐doped Zirconias for Thermal Barrier Coatings
Authors: Raghavan Srinivasan , Wang Hsin , Dinwiddie Ralph B. , Porter Wallace D. , Vaβen Robert , Stöver Detlev , Mayo Merrilea J.
Published: August 2009

Zirconia doped with 3.2–4.2 mol% (6–8 wt%) yttria (3–4YSZ) is currently the material of choice for thermal barrier coating topcoats. The present study examines the ZrO2‐Y2O3‐Ta2O5/Nb2O5 systems for potential alternative chemistries that would overcome the limitations of the 3–4YSZ. A rationale for choosing specific compositions based on the effect of defect chemistry on the thermal conductivity and phase stability in zirconia‐based systems is presented. The results show that it is possible to produce stable (for up to 200 h at 1000°–1500°C), single (tetragonal) or dual (tetragonal + cubic) phase chemistries that have thermal conductivity that is as low (1.8–2.8W/m K) as the 3–4YSZ, a wide range of elastic moduli (150–232 GPa), and a similar mean coefficient of thermal expansion at 1000°C. The chemistries can be plasma sprayed without change in composition or deleterious effects to phase stability. Preliminary burner rig testing results on one of the compositions are also presented.
Faceting of High‐Angle Grain Boundaries in Titanium‐Excess BaTiO3
Authors: Cho Young Kyu , Yoon Duk Yong
Published: August 2009

The grain boundaries in BaTiO3 with excess Ti of 0.5, 0.3, and 0.1 at.% sintered at 1300° or 1250°C have been examined by scanning electron microscopy (SEM), electron backscattered diffraction pattern (EBSP), and transmission electron microscopy (TEM). In the 0.1% Ti‐excess specimen, large grains growing abnormally form high‐angle grain boundaries when they impinge on each other as verified by EBSP. A large fraction of these grain boundaries are faceted with hill‐and‐valley shapes. In the 0.5% Ti‐excess specimen, large grains growing abnormally are elongated in the directions of their {111} double twins. These grains often form flat grain boundaries parallel to their {111} planes with the fine matrix grains, and the grain‐boundary segments between the large impinging grains with high misorientation angles are often also parallel to the {111} planes of one of the grains. These grain boundaries are expected to be singular. Most of the grain boundaries between the randomly oriented fine‐matrix grains in the 0.3 at.% Ti‐excess specimen are also faceted with hill‐and‐valley shapes at finer scales when observed under TEM. The facet planes are parallel to {111}, {011}, and {012} planes of one of the grain pairs and are also expected to be singular. These high‐angle grain boundaries lying on low index planes of one of the grain pairs are similar to those observed in other oxides and metals.
Surface Roughening Transition and Coarsening of NbC Grains in Liquid Cobalt‐Rich Matrix
Authors: Cho Young Kyu , Yoon Duk Yong , Kim Byoung‐Kee
Published: August 2009

When NbC–30 wt% Co powder compact is sintered at various temperatures where NbC grains (with small amounts of Co) coexist with a liquid Co–NbC matrix, the NbC grains undergo a surface roughening transition with temperature increase and the grain growth changes from abnormal to normal growth. When sintered at 1400°C, the grains are polyhedral with sharp edges (and corners) and grow abnormally because their singular surfaces move by nucleation of surface steps. When sintered at 1600°C, the edges become round, indicating the surface roughening transition. The grains still grow abnormally, but their number density is larger than that at 1400°C because of the smaller surface step free energy. When sintered at 1820°C, the grains are nearly spherical, but the flat‐surface segments still remain. The grain growth at this temperature is nearly normal because of very small surface step free energy. The surface roughening transition is reversed when a specimen initially sintered at 1820°C is heat‐treated again at 1400°C, but some grains show transition shapes with nearly flat edges and slope discontinuities (shocks).
Facet–Defacet Transition of Grain Boundaries in Alumina
Authors: Kim Mi Jin , Cho Young Kyu , Yoon Duk Yong
Published: August 2009

Grain boundaries in pure alumina powder compacts sintered at 1400°C are smoothly curved, indicating that they have atomically rough structures. When these specimens are heat‐treated at temperatures between 900° and 1100°C, a small fraction of the grain boundaries develop either hill‐and‐valley or kinked shapes with flat segments. Some of these flat boundary segments lie on the {011[Twomacr]} plane of one of the grain pairs. These grain boundaries thus appear to become singular at these temperatures. When a corundum crystal with a basal surface is sintered in alumina powder at 1400°C, all grain boundaries formed between the corundum basal surface and small grains, as well as those between the small grains, are smoothly curved, indicating their rough structure. When heat‐treated at 900°C for 3 days, about 30% of the grain boundaries between the corundum basal surface and the small grains develop kinks with flat boundary segments, and some of these flat segments lie on the basal plane of the corundum. When heat‐treated again at 1400°C, all grain boundaries are curved, indicating that they become reversibly rough. These observations show that at least some of the grain boundaries in alumina undergo roughening‐singular transitions at temperatures between 900° and 1100°C.