bluuebunny/crossref_metadata_2025 huggingface dataset:
A Study of Tip Clearance Effect for a Mixed-Flow Pump on Performance
Authors: Kim Dong Jun , Min Young Uk , Kim Jin Young , Chung Kyung Nam
Published: December 2013

A vertical mixed-flow pump characterized as large flowrate and high efficiency is used for water supply in the power plants and seawater desalination plants. High specific speed pumps, like axial and mixed-flow pumps, tend to present saddled formation “dip” which restricts the operation range of the pumps due to vibration and noise.

In this study, the pump performance test was performed to compare with the numerically simulated results for the mixed-flow pump with specific speed of 780 (m3/min, m, rpm). The impeller tip clearance effect on the pump head and hydraulic efficiency was investigated. The numerically simulated results showed that tip clearance effect changes Q-H curve. It is deduced that altered flow field of outer streamline is related with the prediction of dip phenomenon. Also, possible causes of dip were investigated and a new pump having Q-H curve free from saddled formation was designed.
Validation of Guidelines for CFD Modelling of a Single Tube Row and In-Line Tube Bundles
Authors: Jensen Anna Lyhne , Jensen Claus Uhrenholt , Rasmussen Kristine Møllenbach , Nielsen Simon Sand , Sørensen Henrik , Condra Thomas
Published: December 2013

This paper questions and improves commonly used guidelines for modelling a tube bundle in cross-flow at ReD = 3.4 · 104 and ReD = 1.1 · 105. Especially, when the locations of flow separation are of high interest. A major conclusion of this paper is that near-wall modelling (y+ < 5) is preferable and use of wall functions with y+ > 5 should be avoided in relation to flow separation behind tubes in cross-flow. CFD modelling of a tube bundle may be simplified with the use of symmetric or periodic boundary conditions to account for the full geometry. The present work reveals periodicity in vorticity formation between a double cylinder row, though the wake region behind a single cylinder row is neither characterised as in-phase nor reversed phase. Likewise, periodic boundary conditions may result in a modelling with large wake deflections for a full tube bundle. Furthermore, since there is no unequivocal answer to which turbulence model to apply for tubes in cross-flow, the RNG k-ε, Realizable k-ε, SST k-ω, and RSM turbulence models are tested and compared.
On the possibility to grow zinc oxide-based transparent conducting oxide films by hot-wire chemical vapor deposition
Authors: Abrutis Adulfas , Silimavicus Laimis , Kubilius Virgaudas , Murauskas Tomas , Saltyte Zita , Kuprenaite Sabina , Plausinaitiene Valentina
Published: December 2013

Hot-wire chemical vapor deposition (HW-CVD) was applied to grow zinc oxide (ZnO)-based transparent conducting oxide (TCO) films. Indium (In)-doped ZnO films were deposited using a cold wall pulsed liquid injection CVD system with three nichrome wires installed at a distance of 2 cm from the substrate holder. The wires were heated by an AC current in the range of 0–10 A. Zn and In 2,2,6,6-tetramethyl-3,5-heptanedionates dissolved in 1,2-dimethoxyethane were used as precursors. The hot wires had a marked effect on the growth rates of ZnO, In-doped ZnO, and In2O3 films; at a current of 6–10 A, growth rates were increased by a factor of ≈10–20 compared with those of traditional CVD at the same substrate temperature (400 °C). In-doped ZnO films with thickness of ≈150 nm deposited on sapphire-R grown at a wire current of 9 A exhibited a resistivity of ≈2 × 10−3 Ωcm and transparency of >90% in the visible spectral range. These initial results reveal the potential of HW-CVD for the growth of TCOs.
Augmented warning sound detection for hearing protectors
Authors: Bernstein Eric R. , Brammer Anthony J. , Yu Gongqiang
Published: December 2013

Perception of warning sounds, such as vehicle backup alarms, is reduced when hearing protection devices (HPDs) are worn. A cross-correlation approach is employed to detect a pre-selected warning sound and enable it to bypass the attenuation of the HPD while still attenuating the environmental noise. Computer simulation shows that the algorithm can detect the specified alarm at signal-to-environmental-noise ratios as low as −30 dB. Human subject testing of the algorithm, implemented on a modified commercial HPD, confirms the minimum detection threshold obtained in simulation, and demonstrates a 7 dB improvement in detection threshold compared with the unmodified HPD.
CD4
+
T Cells from IPEX Patients Convert into Functional and Stable Regulatory T Cells by
FOXP3
Gene Transfer
Authors: Passerini Laura , Mel Eva Rossi , Sartirana Claudia , Fousteri Georgia , Bondanza Attilio , Naldini Luigi , Roncarolo Maria Grazia , Bacchetta Rosa
Published: December 2013

FOXP3
gene transfer in
FOXP3
-mutated CD4
+
T cells is feasible and converts IPEX conventional T cells into regulatory T cells.
Two Proteins, One Stone
Authors: Balcells Mercedes
Published: December 2013

Regulation of a single gene mediates recovery from spinal cord injury by optimizing counteracting effectors of axon growth.
Building Inner Strength
Authors: Chow Edward Kai-Hua
Published: December 2013

Transdermal drug delivery is enhanced by nanoparticle-reinforced dissolving microneedles.
MinC, MinD, and MinE Drive Counter-oscillation of Early-Cell-Division Proteins Prior to Escherichia coli Septum Formation
Authors: Bisicchia Paola , Arumugam Senthil , Schwille Petra , Sherratt David
Published: December 2013

Bacterial cell division initiates with the formation of a ring-like structure at the cell center composed of the tubulin homolog FtsZ (the Z-ring), which acts as a scaffold for the assembly of the cell division complex, the divisome. Previous studies have suggested that the divisome is initially composed of FtsZ polymers stabilized by membrane anchors FtsA and ZipA, which then recruit the remaining division proteins. The MinCDE proteins prevent the formation of the Z-ring at poles by oscillating from pole to pole, thereby ensuring that the concentration of the Z-ring inhibitor, MinC, is lowest at the cell center. We show that prior to septum formation, the early-division proteins ZipA, ZapA, and ZapB, along with FtsZ, assemble into complexes that counter-oscillate with respect to MinC, and with the same period. We propose that FtsZ molecules distal from high concentrations of MinC form relatively slowly diffusing filaments that are bound by ZapAB and targeted to the inner membrane by ZipA or FtsA. These complexes may facilitate the early stages of divisome assembly at midcell. As MinC oscillates toward these complexes, FtsZ oligomerization and bundling are inhibited, leading to shorter or monomeric FtsZ complexes, which become less visible by epifluorescence microscopy because of their rapid diffusion. Reconstitution of FtsZ-Min waves on lipid bilayers shows that FtsZ bundles partition away from high concentrations of MinC and that ZapA appears to protect FtsZ from MinC by inhibiting FtsZ turnover.

IMPORTANCE
A big issue in biology for the past 100 years has been that of how a cell finds its middle. In
Escherichia coli
, over 20 proteins assemble at the cell center at the time of division. We show that the MinCDE proteins, which prevent the formation of septa at the cell pole by inhibiting FtsZ, drive the counter-oscillation of early-cell-division proteins ZapA, ZapB, and ZipA, along with FtsZ. We propose that FtsZ forms filaments at the pole where the MinC concentration is the lowest and acts as a scaffold for binding of ZapA, ZapB, and ZipA: such complexes are disassembled by MinC and reform within the MinC oscillation period before accumulating at the cell center at the time of division. The ability of FtsZ to be targeted to the cell center in the form of oligomers bound by ZipA and ZapAB may facilitate the early stages of divisome assembly.
Dissecting the Machinery That Introduces Disulfide Bonds in Pseudomonas aeruginosa
Authors: Arts Isabelle S. , Ball Geneviève , Leverrier Pauline , Garvis Steven , Nicolaes Valérie , Vertommen Didier , Ize Bérengère , Tamu Dufe Veronica , Messens Joris , Voulhoux Romé , Collet Jean-François
Published: December 2013

Disulfide bond formation is required for the folding of many bacterial virulence factors. However, whereas theEscherichia colidisulfide bond-forming system is well characterized, not much is known on the pathways that oxidatively fold proteins in pathogenic bacteria. Here, we report the detailed unraveling of the pathway that introduces disulfide bonds in the periplasm of the human pathogenPseudomonas aeruginosa. The genome ofP. aeruginosauniquely encodes two DsbA proteins (P. aeruginosaDsbA1 [PaDsbA1] and PaDsbA2) and two DsbB proteins (PaDsbB1 and PaDsbB2). We found that PaDsbA1, the primary donor of disulfide bonds to secreted proteins, is maintained oxidizedin vivoby both PaDsbB1 and PaDsbB2.In vitroreconstitution of the pathway confirms that both PaDsbB1 and PaDsbB2 shuttle electrons from PaDsbA1 to membrane-bound quinones. Accordingly, deletion of bothP. aeruginosa dsbB1(PadsbB1) andPadsbB2is required to prevent the folding of severalP. aeruginosavirulence factors and to lead to a significant decrease in pathogenicity. Using a high-throughput proteomic approach, we also analyzed the impact ofPadsbA1deletion on the global periplasmic proteome ofP. aeruginosa, which allowed us to identify more than 20 new potential substrates of this major oxidoreductase. Finally, we report the biochemical and structural characterization of PaDsbA2, a highly oxidizing oxidoreductase, which seems to be expressed under specific conditions. By fully dissecting the machinery that introduces disulfide bonds inP. aeruginosa, our work opens the way to the design of novel antibacterial molecules able to disarm this pathogen by preventing the proper assembly of its arsenal of virulence factors.

IMPORTANCEThe human pathogenPseudomonas aeruginosacauses life-threatening infections in immunodepressed and cystic fibrosis patients. The emergence ofP. aeruginosastrains resistant to all of the available antibacterial agents calls for the urgent development of new antibiotics active against this bacterium. The pathogenic power ofP. aeruginosais mediated by an arsenal of extracellular virulence factors, most of which are stabilized by disulfide bonds. Thus, targeting the machinery that introduces disulfide bonds appears to be a promising strategy to combatP. aeruginosa. Here, we unraveled the oxidative protein folding system ofP. aeruginosain full detail. The system uniquely consists of two membrane proteins that generate disulfide bondsde novoto deliver them toP. aeruginosaDsbA1 (PaDsbA1), a soluble oxidoreductase. PaDsbA1 in turn donates disulfide bonds to secreted proteins, including virulence factors. Disruption of the disulfide bond formation machinery dramatically decreasesP. aeruginosavirulence, confirming that disulfide formation systems are valid targets for the design of antimicrobial drugs.
Angina bullosa haemorrhagica
Authors: Shoor Hitesh , Mutalik Sunil , Pai Keerthilatha M
Published: December 2013

A woman in her early 40s presented with a painless ulceration on the right side of the posterior palate, she had an earlier history of similar lesions after the rupturing of blood filled blisters in the oral cavity. On examination, a diffuse erythematous area and ulcers covered with necrotic slough were noticed on the right and left side of the posterior palate and on the right buccal mucosa. On follow-up visit, a large blood filled blister was noticed in the buccal vestibule. We advised routine haematological investigations to rule out any bleeding disorders and direct immunofluorescence of the affected tissue and perilesional areas to rule out autoimmune blistering conditions. Haematological investigations revealed no abnormalities and immunofluorescence testing was negative. A diagnosis of angina bullosa haemorrhagica was made by excluding all other conditions. Symptomatic treatment was given, patient was educated about the condition and reassured.
An anchoring technique by looping with the tip of a super-stiff wire: may be a solution in patients with anomaly of the aortic arch and tortuous carotid artery disease?
Authors: Barutcu Ahmet , Gazi Emine , Aksu Feyza , Tatli Ersan
Published: December 2013

Vascular anatomy is one of the most important factors for the successful carotid artery interventions, either angioplasty or stenting. We report a new technique for advancing a guiding catheter into the common carotid artery when there is an unfavourable aortic arch anatomy and tortuosity of the carotid artery.
Head injuries among FIS World Cup alpine and freestyle skiers and snowboarders: a 7-year cohort study
Authors: Steenstrup Sophie E , Bere Tone , Bahr Roald
Published: December 2013

Background

Traumatic brain injury is the leading cause of death for skiers and snowboarders. Fatal head injuries have also occurred at the International Ski Federation (FIS) World Cup (WC) level. We therefore wanted to describe the risk of head injuries across disciplines and sex among WC skiers and snowboarders.

Method

We conducted retrospective interviews with FIS WC athletes at the end of seven consecutive seasons (2006–2013) to register injuries sustained during the competitive season. Head injuries were classified as ‘head/face’ injuries and did not include neck or cervical spine injuries. To calculate the exposure, we extracted data from the official FIS website for all WC competitions for each of the athletes interviewed.

Results

A total of 2080 injuries were reported during seven WC seasons. Of these, 245 (11.8%) were head/face injuries. Of the 245 head/face injuries reported, nervous system injuries/concussions were the most common (81.6%) and 58 of these were severe (23.7%). The injury incidence per 1000 competition runs was higher in freestyle (1.8, 95% CI 1.2 to 2.4) than in alpine skiing (0.9, 95% CI 0.6 to 1.2; risk ratio (RR) 2.05, 95% CI 1.25 to 3.46) and snowboard (1.0, 95% CI 0.6 to 1.3; RR 1.85, 95% CI 1.15 to 2.99). Women had a higher injury incidence (5.8, 95% CI 4.8 to 6.9) versus men (3.9, 95% CI 3.2 to 4.6; RR 1.48, 95% CI 1.15 to 1.90) throughout the season (per 100 athletes).

Conclusions

The majority of head/face injuries were nervous system injuries/concussions and one in four injuries was severe. Freestyle skiers had the highest overall head injury incidence. Across all disciplines, the injury incidence was higher in women than in men.
The role of sports physiotherapy at the London 2012 Olympic Games
Authors: Grant Marie-Elaine , Steffen Kathrin , Glasgow Philip , Phillips Nicola , Booth Lynn , Galligan Marie
Published: December 2013

Background

There is a lack of information on the utilisation of physiotherapy services at the Olympic Games.

Aim

To better understand the athlete and non-athlete requirements of the physiotherapy services at the Olympic Village Polyclinic during the London 2012 Olympic Games.

Methods

From 16 July to 14 August 2012, physiotherapy encounters for athletes and non-athletes (National Olympic Committee (NOC) team officials, coaches, team managers, workforce, Olympic family, technical officials and press) were recorded on the ATOS electronic medical records system at the polyclinic in the main Athletes’ Village in Stratford.

Results

Of the 1778 encounters, 1219 (69%) were administered to athletes and 559 (31%) to non-athletes. The anatomical areas most frequently recorded at the first visits for athletes were knee (15.4%), lumbar spine/lower back (15.2%) and upper leg (12.6%) and that for non-athletes were lumbar spine/lower back (19.8%), knee (15.8%) and neck/cervical spine. Muscle (33.3%) and joint injuries (24.8%) were the most common diagnoses in athletes and non-athletes (24.4% and 30.1%). The five most frequently used treatment modalities were therapeutic soft tissue techniques (23.3%), mobilisation techniques (21.8%), taping (8.9%), cryotherapy (6.9%) and exercise prescription (6.4%). The most common cause of athletes’ injuries was overuse (43.6%).

Conclusions

This study of the London 2012 Olympic Games workload highlights the physiotherapy needs of athletes as well as non-athletes and identifies the high numbers of pre-existing and overuse injuries in this setting, providing an insight into the reasons why the athletes seek physiotherapy support during the Olympic Games.
Accountable to whom, for what? An exploration of the early development of Clinical Commissioning Groups in the English NHS
Authors: Checkland Kath , Allen Pauline , Coleman Anna , Segar Julia , McDermott Imelda , Harrison Stephen , Petsoulas Christina , Peckham Stephen
Published: December 2013

Objective

One of the key goals of the current reforms in the English National Health Service (NHS) under the Health and Social Care Act, 2012, is to increase the accountability of those responsible for commissioning care for patients (clinical commissioning groups (CCGs)), while at the same time allowing them a greater autonomy. This study was set out to explore CCG's developing accountability relationships.

Design

We carried out detailed case studies in eight CCGs, using interviews, observation and documentary analysis to explore their multiple accountabilities.

Setting/participants

We interviewed 91 people, including general practitioners, managers and governing body members in developing CCGs, and undertook 439 h of observation in a wide variety of meetings.

Results

CCGs are subject to a managerial, sanction-backed accountability to NHS England (the highest tier in the new organisational hierarchy), alongside a number of other external accountabilities to the public and to some of the other new organisations created by the reforms. In addition, unlike their predecessor commissioning organisations, they are subject to complex internal accountabilities to their members.

Conclusions

The accountability regime to which CCGs are subject to is considerably more complex than that which applied their predecessor organisations. It remains to be seen whether the twin aspirations of increased autonomy and increased accountability can be realised in practice. However, this early study raises some important issues and concerns, including the risk that the different bodies to whom CCGs are accountable will have differing (or conflicting) agendas, and the lack of clarity over the operation of sanction regimes.
Young people's use of NHS Direct: a national study of symptoms and outcome of calls for children aged 0–15
Authors: Cook E J , Randhawa G , Large S , Guppy A , Chater A M , Pang D
Published: December 2013

Objectives

National Health Service (NHS) Direct provides 24/7 expert telephone-based healthcare information and advice to the public in England. However, limited research has explored the reasons to why calls are made on behalf of young people, as such this study aimed to examine call rate (CR) patterns in younger people to enable a better understanding of the needs of this population in England.

Setting

NHS Direct, England, UK.

Participants and methods

CRs (expressed as calls/100 persons/annum) were calculated for all calls (N=358 503) made to NHS Direct by, or on behalf of, children aged 0–15 during the combined four ‘1-month’ periods within a year (July 2010, October 2010, January 2011 and April 2011). χ² Analysis was used to determine the differences between symptom, outcome and date/time of call.

Results

For infants aged <1, highest CRs were found for ‘crying’ for male (n=14, 440, CR=13.61) and female (n=13 654, CR=13.46) babies, which is used as a universal assessment applied to all babies. High CRs were also found for symptoms relating to ‘skin/hair/nails’ and ‘colds/flu/sickness’ for all age groups, whereby NHS Direct was able to support patients to self-manage and provide health information for these symptoms for 59.7% and 51.4% of all cases, respectively. Variations in CRs were found for time and age, with highest peaks found for children aged 4–15 in the 15:00–23:00 period and in children aged <1 in the 7:00–15:00 period.

Conclusions

This is the first study to examine the symptoms and outcome of calls made to NHS Direct for and on behalf of young children. The findings revealed how NHS Direct has supported a range of symptoms through the provision of health information and self-care support which provides important information about service planning and support for similar telephone-based services.
Early Experience with a Hepatobiliary and Pancreatic Quality Improvement Program
Authors: O'Reilly Derek , Edmiston Rachel , Bijoor Pooja , Deshpande Rahul , de'Liguori Carino Nicola , Ammori Basil , J. Sherlock David
Published: December 2013

This project aims to assess the impact of the introduction of a hepatobiliary and pancreatic (HPB) Quality Improvement Program (QIP) on postoperative complications following liver, biliary and pancreatic surgery.

A prospective analysis of postoperative complications over a six month period was performed. Complications were analysed and graded according to internationally agreed definitions. Justification was sought and errors identified. Weekly meetings were performed to review each complication enabling an action plan to be created to prevent future recurrence. Rates were compared with previously audited and published results, using the chi-square test. A total of 326 procedures were performed over the six months including 30 pancreatectomies, 45 liver resections and 251 other procedures. 37 patients developed complications (11.3%) with 47 complications in total including two deaths. Using the ISGPS grading, eight complications were identified; two grade A, four grade B and two grade C. There were three grade A ISGLS complications and one grade B. 30 complications were justified as unavoidable, 16 as avoidable and one as indeterminate. Action plans included continued monitoring (n=41), formulation of new policy (n=3), individual counselling (n=4), educational offering (n=4). When compared with 2010 complication rates, 114 complications occurred in 233 liver operations during the baseline period, compared with 17 complications in 45 liver operations during the QIP period, OR=0.63 (95% CI: 0.33 to 1.22), p=0.17 and 86 complications occurred in 99 pancreatic resections during the baseline period, compared with 20 complications in 30 pancreatic resections during the QIP period OR=0.30 (95% CI: 0.12 to 0.79), p=0.01

The HPB QIP is a rigorous approach to grade every complication and death. A statistically significant reduction in pancreas related complications has already been obtained. Further work is required to determine the persistence and magnitude of this quality improvement.
Implementation of a combined Cardiopulmonary Resuscitation and Treatment Escalation Plan document in a District General Hospital
Authors: Stockdale Claire , Trivedi Bhavi , Jerome Ellen , Salih Samir , Huntley Christopher , Cooke Eleanor , Massey Yolanda , Mella Sophie
Published: December 2013

Documentation of appropriate escalation of treatment was identified as a problem for junior doctors and Critical Care Outreach Nurses at Musgrove Park Hospital. An audit of resuscitation and escalation documentation of all wards found that of the patients who were not for Cardiopulmonary resuscitation (and therefore not for full escalation of care), 78.4% had no documentation of the appropriate level of escalation of treatment should they deteriorate. The majority of junior doctors had experienced cases where they felt that inappropriate treatment had been given, where no escalation plan was documented.

Using several Plan, Do, Study, Act (PDSA) cycles, drawing tools used in other trusts and departments, and the views of clinicians, we developed a treatment escalation plan (TEP) tool, to be included in the resuscitation form. This included consideration of referral to critical care, ward based non-invasive ventilation, and appropriate use of intravenous or oral antibiotics. This then prompted the responsible clinician to consider and document appropriate escalation of treatment.

The CPR-TEP form was trialed using a quasi-experiment design allowing the aim to be tested using two groups – intervention and control. All patients in the intervention group were not for CPR and therefore had their TEP-CPR form filled in fully (n= 68). The control group consisted of patients who were not for CPR but who did not have a TEP form filled in (n=36).

The appropriateness of OOH (out of hours) treatment in those patients who experienced clinical deterioration was judged by questionnaire-based feedback from the in-hours team the following morning. Levels of inappropriate treatment between the two groups were compared to test the aim.

At the end of the study period, questionnaire feedback indicated that 11.1% of patients in the group with the new CPR-TEP document had received inappropriate OOH care compared to 44.4% of patients in the group without the document.

Using the TEP alongside resuscitation documentation prompts the responsible clinician to consistently consider and document the appropriate escalation of care for their patient, improving communication with the out of hours team and appropriate escalation of care in the event of patient deterioration.
Factors influencing decision-making in relation to timing of gastrostomy insertion in patients with motor neurone disease
Authors: Stavroulakis Theocharis , Baird Wendy O , Baxter Susan K , Walsh Theresa , Shaw Pamela J , McDermott Christopher J
Published: December 2013

Objectives

This study aimed to explore the decision-making process leading up to gastrostomy insertion from the perspective of the patients and their informal carers. Gastrostomy feeding is commonly used to support motor neurone disease patients with dysphagia. However, there is no robust evidence to suggest the optimal timing for gastrostomy insertion.

Methods

Retrospective qualitative exploration using semistructured interviews with paired patients and carers in order to elicit their perceptions in relation to gastrostomy timing.

Results

27 patients consented to the study; of these, 23 underwent a successful gastrostomy. Approximately 3 months following a successful gastrostomy, 10 patients and 8 carers were interviewed. Decision-making in relation to the timing of gastrostomy was described as being a difficult process with individual variations and wishes. A range of factors acted as triggers for taking the decision to proceed with gastrostomy such as prolonged, tiring and effortful meals; the task of food preparation; choking and aspiration; and weight loss. Factors such as the reluctance to give up oral feeding, not realising the potential benefits and negative perceptions of gastrostomy influenced a decision to delay the procedure. A tendency for late insertion was identified despite the opposite advice by health professionals.

Conclusions

The advice for early insertion does not outweigh the personal perceptions and psychosocial factors for patients and their carers. Understanding the factors which influence decision-making on an individual basis is important for information and care provision by healthcare professionals in aiding patients, and their carers, to make informed decisions in relation to gastrostomy timing.
Proper compression landmark and depth for cardiopulmonary resuscitation in patients with pectus excavatum: a study using CT
Authors: Lee Ki Hyun , Kim Kun Woo , Kim Eun Young , Kim Hyung Sik , Kim Jeong Ho , Cho Jinseong , Yang Hyuk Jun
Published: December 2013

Objective

To determine by chest CT the proper compression landmark and depth for cardiopulmonary resuscitation in patients with pectus excavatum (PE).

Methods

The chest CT of 22 patients with PE (mean age=27 years; range 16–53 years, 10 male) from March 2002 to September 2011 were retrospectively evaluated as follows: length of sternum, external thickness/internal thickness (ET/IT) of the chest and the intrathoracic structures in the level of lower half (LH) of the sternum. In addition, Haller index (HI) and the degree of leftward displacement of the heart were measured. Finally, variables were also measured in an age/sex-matched control group (n=22) with no evidence of any chest wall deformity.

Results

The sternal length was not different and LH of the sternum was adequate to compress left ventricle (LV) in both groups. Patients had a significant higher HI and showed a greater leftward displacement of LV centre with a mean difference of 11 mm. PE patients showed a lesser ET/IT with a mean difference of approximately 20 mm than controls (mean ET/IT=174±18/70±10 mm vs 199±23/93±15 mm, p<0.001).

Conclusions

The LH of the sternum is an appropriate chest compression landmark in PE patients to compress LV, although the centre of LV shows slightly leftward displacement. Since PE patients have sunken chest, a 3–4 cm may be the proper compression depth in the patients when considering the current compression guideline in normal subjects is 5–6 cm.
The association of serum antiphospholipid antibodies and dilute Russell's viper venom times
Authors: Froom Paul , Saffuri-Elias Enas , Rozenberg Orit , Barak Mira
Published: December 2013

Aims

We hypothesised that there is a threshold value for the association of dilute Russell's viper venom times (dRVVT) with positive immunoglobin G antiphospholipid antibody (IgG-APLA) test results.

Methods

We tested 120 controls and a cohort of 2412 outpatients who had concomitant test results for dRVVT and IgG-APLA (IgG antibodies to cardiolipins and β2-glycoprotein I). We also selected a subgroup who had repeated IgG-APLA tests at least 12 weeks apart (1398 patients with multiple β2-glycoprotein I tests and 672 with multiple aCL tests). We cross tabulated the proportion of IgG-APLA single positive, double positive and persistently positive antibodies with dRVVT values.

Results

The distribution of the dRVVT results from the reference population was consistent with an upper limit of the reference interval of 1.22 to >1.48. A consistent increase in the proportion of IgG-APLA single, double positive and persistently positive antibody tests occurred in the group with a normalised dRVVT ratio of 1.40–1.49. IgG-APLA double positivity was found in 12.5% (4 of 32) patients with a ratio of dRVVT 1.40–1.49 compared with 3.3% (6/181) of those with a ratio of dRVVT 1.20–1.39 (p=0.045).

Conclusions

We conclude that there is an association between dRVVT positivity and elevated proportions of single, double and persistently positive IgG-APLA test results with an apparent threshold effect. These findings may provide a general guide to risk and suggest a way to choose from a wide range of possible upper limits of the reference interval.
Mental health selection and income support dynamics: multiple spell discrete-time survival analyses of welfare receipt
Authors: Kiely Kim M , Butterworth Peter
Published: December 2013

Background

The higher occurrence of common psychiatric disorders among welfare recipients has been attributed to health selection, social causation and underlying vulnerability. The aims of this study were to test for the selection effects of mental health problems on entry and re-entry to working-age welfare payments in respect to single parenthood, unemployment and disability.

Methods

Nationally representative longitudinal data were drawn from the Household Income and Labour Dynamics in Australia survey. Multiple spell discrete-time survival analyses were conducted using multinomial logistic regression models to test if pre-existing mental health problems predicted transitions to welfare. Analyses were stratified by sex and multivariate adjusted for mental health problems, father's occupation, socioeconomic position, marital status, employment history, smoking status and alcohol consumption, physical function and financial hardship. All covariates were modelled as either lagged effects or when a respondent was first observed to be at risk of income support.

Results

Mental health problems were associated with increased risk of entry and re-entry to disability, unemployment and single parenting payments for women, and disability and unemployment payments for men. These associations were attenuated but remained significant after adjusting for contemporaneous risk factors.

Conclusions

Although we do not control for reciprocal causation, our findings are consistent with a health selection hypothesis and indicate that mental illness may be a contributing factor to later receipt of different types of welfare payments. We argue that mental health warrants consideration in the design and targeting of social and economic policies.
Evaluation of WHO screening algorithm for the presumptive treatment of asymptomatic rectal gonorrhoea and chlamydia infections in at-risk MSM in Kenya
Authors: Sanders Eduard J , Wahome Elizabeth , Okuku Haile Selassie , Thiong'o Alexander N , Smith Adrian D , Duncan Sarah , Mwambi John , Shafi Juma , McClelland R Scott , Graham Susan M
Published: December 2013

Objectives

The WHO recommends that men who have sex with men (MSM) reporting unprotected receptive anal intercourse (RAI) and either multiple partners or a partner with a sexually transmitted infection (STI) in the past 6 months should be presumptively treated for asymptomatic rectalNeisseria gonorrhoeae(NG) andChlamydia trachomatis(CT) infections. We evaluated this recommendation in a cohort of ‘high-risk’ MSM in Coastal Kenya.

Methods

We assessed presence of genitourinary and rectal symptoms, and determined prevalence and 3-month incidence of rectal NG and CT infections. We performed nucleic acid amplification testing of urine and rectal swab samples collected from MSM followed prospectively, and assessed predictive values of the WHO algorithm at baseline screening.

Results

Of 244 MSM screened, 240 (98.4%) were asymptomatic, and 147 (61.3%) reported any RAI in the past 6 months. Among 85 (35.4%) asymptomatic MSM meeting criteria for the WHO presumptive treatment (PT) recommendation, we identified 20 with rectal infections (six NG, 12 CT and two NG–CT co-infections). Among 62 asymptomatic MSM who did not meet criteria, we identified seven who were infected. The sensitivity and specificity of the WHO algorithm were 74.1% (95% CI 53.7% to 88.9%) and 45.8% (95% CI 36.7% to 55.2%), respectively. The 3-month incidence of any rectal NG or CT infection in asymptomatic men reporting any RAI was 39.7 (95% CI 24.3 to 64.8) per 100 person-years.

Conclusions

About one-third of asymptomatic MSM were eligible to receive PT for NG and CT infections. Among MSM who would qualify for PT of rectal STIs, the number needed to treat in order to treat one infection was four. Our results support the value of the WHO screening algorithm and recommended PT strategy in this population.
CASIMIR ENERGY AND FORCE INDUCED BY AN IMPENETRABLE FLUX TUBE OF FINITE RADIUS
Authors: GORKAVENKO VOLODYMYR M. , SITENKO YURII A. , STEPANOV OLEXANDER B.
Published: December 2013

A perfectly reflecting (Dirichlet) boundary condition at the edge of an impenetrable magnetic-flux-carrying tube of nonzero transverse size is imposed on the charged massive scalar matter field which is quantized outside the tube. We show that the vacuum polarization effects outside the tube give rise to a macroscopic force acting at the increase of the tube radius (if the magnetic flux is held steady). The Casimir energy and force are periodic in the value of the magnetic flux, being independent of the coupling to the space–time curvature scalar. We conclude that a topological defect of the vortex type can polarize the vacuum of only those quantum fields that have masses which are much less than a scale of the spontaneous symmetry breaking.
THE PERFECT POWER SEMICONDUCTOR SWITCH FOR 21st CENTURY GLOBAL ENERGY ECONOMY
Authors: SHENAI KRISHNA
Published: December 2013

A critical evaluation of high-power electronics switching in semiconductor materials is made from the standpoint of performance, reliability, and commercial viability. This study takes into account recent experimental results obtained from the field-reliability study of silicon power MOSFETs in high-density power supplies where residual material defects present in the space charge region of the device were found to generate local micro plasma that eventually caused power MOSFETs to fail. Based on these results and commercial progress made to date in wide bandgap semiconductor technologies, it is suggested that silicon carbide (SiC) promises to be the preferred material for high-power electronics switching from cost, performance and reliability considerations — this assessment is further strengthened by the near-term potential for developing large-area, low-cost, and defect-free SiC bulk substrates and epitaxial layers. This conclusion is also supported by the feasibility and the need for vertical, MOS-controlled, bipolar power switches in compact and efficient megaWatt-level power converters in order to make transformational changes in the 21st century electrical transmission and distribution infrastructure.
A 0.5–1.2 V PWM CMOS DPS WITH 120 dB DYNAMIC RANGE FOR BIONIC HUMAN EYE IN DEEP SUBMICRON CMOS TECHNOLOGY
Authors: XU JIANGTAO , JIN WEISONG , NIE KAIMING , YAO SUYING
Published: December 2013

In this paper, a CMOS digital pixel sensor (DPS) with pixel-level ADC based on pulse width modulation (PWM) scheme is proposed to overcome the restriction of low supply voltage imposed by device scaling trend. The pixel operates with a dynamic current comparison scheme to avoid using complex in-pixel comparator and achieve a high dynamic range (DR). By adjusting clock frequency for different illumination, DR is further extended due to increasing the maximum detectable photocurrent and lowering the minimum detectable photocurrent. The pixel contains a photodiode (PD), an 11-bit in-pixel SRAM and other 11 transistors, and occupies an area of 7 μm × 7 μm, with a fill factor of 31.3% using a standard 65 nm CMOS technology. Simulation results show that this pixel can work at a supply voltage as low as 0.5 V with 120 dB DR and 80 dB linear DR (LDR). The properties of high DR and logarithmic response make the proposed digital pixel be capable of human eye. Frame rate achieves 246 fps with 640 × 480 pixel array by using in-pixel ADC and SRAM. This makes the digital pixel very suitable for high-speed snap shot digital camera application.
EFFECTS OF UNILATERAL COUPLING BETWEEN TWO CHAOTIC X-BAND GUNN OSCILLATORS
Authors: SARKAR B. C. , SARKAR S. , KOLEY C. , GUIN A. K. , BANERJEE T.
Published: December 2013

Two X-band microwave Gunn oscillators have been separately operated with "below threshold" dc bias voltages under the influence of an injected weak RF field in their respective cavities to generate chaotic oscillations. The output of one such chaotic Gunn oscillator is injected into the other through a controllable coupling network to explore the possibility of synchronization between two oscillators. We establish through numerical simulation that (i) two oscillators with identical design parameters attain a state of complete synchronization and (ii) two oscillators with slightly different design parameters attain a state of generalized synchronization for reasonable value of coupling strengths. The occurrence of generalized synchronization has been proved through the "auxiliary" slave system approach of nonlinear analysis. Results of hardware experiments are incorporated to qualitatively support the observations made through numerical simulation.
Suppression of the GLUT4 adaptive response to exercise in fructose-fed rats
Authors: Goyaram Veeraj , Kohn Tertius A. , Ojuka Edward O.
Published: December 2013

Exercise-induced increase in skeletal muscle GLUT4 expression is associated with hyperacetylation of histone H3 within a 350-bp DNA region surrounding the myocyte enhancer factor 2 (MEF2) element on the Glut4 promoter and increased binding of MEF2A. Previous studies have hypothesized that the increase in MEF2A binding is a result of improved accessibility of this DNA segment. Here, we investigated the impact of fructose consumption on exercise-induced GLUT4 adaptive response and directly measured the accessibility of the above segment to nucleases. Male Wistar rats ( n = 30) were fed standard chow or chow + 10% fructose or maltodextrin drinks ad libitum for 13 days. In the last 6 days five animals per group performed 3 × 17-min bouts of intermittent swimming daily and five remained untrained. Triceps muscles were harvested and used to measure 1) GLUT4, pAMPK, and HDAC5 contents by Western blot, 2) accessibility of the DNA segment from intact nuclei using nuclease accessibility assays, 3) acetylation level of histone H3 and bound MEF2A by ChIP assays, and 4) glycogen content. Swim training increased GLUT4 content by ∼66% ( P < 0.05) but fructose and maltodextrin feeding suppressed the adaptation. Accessibility of the DNA region to MNase and DNase I was significantly increased by swimming (∼2.75- and 5.75-fold, respectively) but was also suppressed in trained rats that consumed fructose or maltodextrin. Histone H3 acetylation and MEF2A binding paralleled the accessibility pattern. These findings indicate that both fructose and maltodextrin modulate the GLUT4 adaptive response to exercise by mechanisms involving chromatin remodeling at the Glut4 promoter.
Characterization of an animal model of pregnancy-induced vitamin D deficiency due to metabolic gene dysregulation
Authors: Goyal Ravi , Zhang Lubo , Blood Arlin B. , Baylink David J. , Longo Lawrence D. , Oshiro Bryan , Mata-Greenwood Eugenia
Published: December 2013

Vitamin D deficiency has been associated with pregnancy complications such as preeclampsia, gestational diabetes, and recurrent miscarriage. Therefore, we hypothesized differences in vitamin D status between healthy [Sprague-Dawley (SD) and Lewis (LW)] and complicated [Brown Norway (BN)] rat pregnancies. In SD, LW, and BN rats, we analyzed the maternal plasma levels of the vitamin D metabolites 25-OH-D and 1,25-(OH)2-D at prepregnancy, pregnancy, and postpartum. Analysis of the active metabolite 1,25-(OH)2-D showed a twofold increase in pregnant SD and LW rats but a nearly 10-fold decrease in pregnant BN rats compared with nonpregnant controls. BN rats had a pregnancy-dependent upregulation of CYP24a1 expression, a key enzyme that inactivates vitamin D metabolites. In contrast, the maternal renal expression of CYP24a1 in SD and LW rats remained constant throughout pregnancy. Analysis of the vitamin D receptor (VDR) indicated that LW and SD but not BN rats experience a pregnancy-induced 10-fold decrease in maternal renal VDR protein levels. Further analysis of bisulfite-converted and genomic DNA indicated that the observed differences in maternal renal regulation of CYP24a1 during pregnancy and lactation are not due to differences in CYP24a1 promoter methylation or single-nucleotide polymorphisms. Finally, supplementation with 1,25-(OH)2-D significantly improved the reproductive phenotype of BN rats by increasing litter size and maternal-fetal weight outcomes. We conclude that BN rats represent a novel animal model of pregnancy-specific vitamin D deficiency that is linked to pregnancy complications. Vitamin D deficiency in BN rats correlates with maternal renal CYP24a1 upregulation followed by CYP27b1 upregulation.
Musculoskeletal and prostate effects of combined testosterone and finasteride administration in older hypogonadal men: a randomized, controlled trial
Authors: Borst Stephen E. , Yarrow Joshua F. , Conover Christine F. , Nseyo Unyime , Meuleman John R. , Lipinska Judyta A. , Braith Randy W. , Beck Darren T. , Martin Jeffrey S. , Morrow Matthew , Roessner Shirley , Beggs Luke A. , McCoy Sean C. , Cannady Darryl F. , Shuster Jonathan J.
Published: December 2013

Testosterone acts directly at androgen receptors and also exerts potent actions following 5α-reduction to dihydrotestosterone (DHT). Finasteride (type II 5α-reductase inhibitor) lowers DHT and is used to treat benign prostatic hyperplasia. However, it is unknown whether elevated DHT mediates either beneficial musculoskeletal effects or prostate enlargement resulting from higher-than-replacement doses of testosterone. Our purpose was to determine whether administration of testosterone plus finasteride to older hypogonadal men could produce musculoskeletal benefits without prostate enlargement. Sixty men aged ≥60 yr with a serum testosterone concentration of ≤300 ng/dl or bioavailable testosterone ≤70 ng/dl received 52 wk of treatment with testosterone enanthate (TE; 125 mg/wk) vs. vehicle, paired with finasteride (5 mg/day) vs. placebo using a 2 × 2 factorial design. Over the course of 12 mo, TE increased upper and lower body muscle strength by 8–14% ( P = 0.015 to <0.001), fat-free mass 4.04 kg ( P = 0.032), lumbar spine bone mineral density (BMD) 4.19% ( P < 0.001), and total hip BMD 1.96% ( P = 0.024) while reducing total body fat −3.87 kg ( P < 0.001) and trunk fat −1.88 kg ( P = 0.0051). In the first 3 mo, testosterone increased hematocrit 4.13% ( P < 0.001). Coadministration of finasteride did not alter any of these effects. Over 12 mo, testosterone also increased prostate volume 11.4 cm3 ( P = 0.0051), an effect that was completely prevented by finasteride ( P = 0.0027). We conclude that a higher-than-replacement TE combined with finasteride significantly increases muscle strength and BMD and reduces body fat without causing prostate enlargement. These results demonstrate that elevated DHT mediates testosterone-induced prostate enlargement but is not required for benefits in musculoskeletal or adipose tissue.
Transcriptome sequencing reveals differences between anagen and telogen secondary hair follicle-derived dermal papilla cells of the Cashmere goat (Capra hircus)
Authors: Zhu Bing , Xu Teng , Zhang Zhipeng , Ta Na , Gao Xiaoyu , Hui Lihua , Guo Xudong , Liu Dongjun
Published: December 2013

Dermal papilla is considered the control center of hair follicle growth and hair cycle. The secondary hair follicle (producing cashmere) growth cycle of the Cashmere goat ( Capra hircus) is circannual, and each growth phase can be easily distinguished by its long duration. To identify gene expression patterns and differences of the dermal papilla cell (DPC) between the anagen and telogen phases, we established two DPC lines: ana-DPCs (DPCs derived from the anagen secondary hair follicle) and tel-DPCs (DPCs derived from the telogen secondary hair follicle). Compared with the ana-DPCs, the tel-DPCs lost the capacity to form cell aggregates and showed lower cell proliferation rate. Transcriptome sequencing revealed that 825 genes were differentially expressed by at least threefold between the two DPC lines. These genes were significantly enriched in cell cycle control, cell division, and chromosome partitioning from the Eukaryotic Orthologous Groups of proteins (KOG) database and in cell cycle, cell adhesion molecules, cytokine-cytokine receptor interaction, and p53 signaling pathway from the Kyoto Encyclopedia of Gene and Genomes (KEGG) database. Enrichment analyses revealed that in the middle of the telogen the DPCs of secondary hair follicles (SHFs) seemed on the one hand to promote the degeneration of SHFs and cessation of cashmere growth, while on the other hand to resist self-apoptosis and prepare for the regeneration or revivification of fully functional dermal papillae. These findings provide a better understanding of hair follicle growth and will be useful for identification of novel molecules associated with the control of hair growth cycle.