bluuebunny/crossref_metadata_2025 huggingface dataset:
The classical Hodgkin lymphoma tumor microenvironment: macrophages and gene expression-based modeling
Authors: Scott David W. , Steidl Christian
Published: November 2014

Despite the high cure rate in classical Hodgkin lymphoma (CHL), more accurate tailoring of upfront treatment is required to maximize cure while avoiding unnecessary short- and long-term treatment side effects. To this end, the unique tumor microenvironment of CHL has been searched extensively for prognostic biomarkers. Beyond targeted immunohistochemistry (IHC) studies, gene expression profiling (GEP) of diagnostic whole tissue biopsies has allowed a de novo approach to biomarker discovery. Among numerous candidate biomarkers, an association between the number of tumor-associated macrophages in the microenvironment and outcomes after ABVD (doxorubicin + bleomycin + vinblastine + dacarbazine) chemotherapy emerged, and multiple subsequent studies have validated this biological relationship using IHC. These studies have also defined key aspects for macrophage interrogation, including the characteristics of the CD68 and CD163 antibodies, appropriate scoring methodologies, and the identification of specific patient populations in which macrophage IHC may not be prognostic. The GEP studies also led to the development of gene expression-based prognostic models for advanced-stage CHL, with new technologies allowing reliable gene expression quantitation using RNA from routinely produced formalin-fixed paraffin-embedded biopsies. The bridge to predictive biomarkers that can be used reliably to inform upfront treatment selection requires further studies to demonstrate that these biomarkers can identify robustly, at diagnosis, patients at high risk of treatment failure with ABVD and that this risk may be overcome using alternative treatments.
Allogeneic hematopoietic cell transplantation for acute myeloid leukemia in older adults
Authors: Sorror Mohamed L. , Estey Elihu
Published: November 2014

Acute myeloid leukemia (AML) is primarily a disease of the elderly and the numbers of these patients are increasing. Patients ≥60 years of age continue to have poor prognosis. Preliminary results suggest benefit from reduced-intensity allogeneic hematopoietic cell transplantation (HCT) in selected patients 60-80 years of age. However, although patients in this age range comprise >50% of those with AML, they currently constitute only 17% of those offered HCT. In the absence of prospective randomized studies comparing HCT and chemotherapy, the decision to recommend HCT rests on retrospective analyses of the risks of relapse and nonrelapse mortality after each approach. There is strong evidence that pre-HCT comorbidities can predict HCT-related morbidity and mortality. Age alone does not appear predictive and, particularly if the risk of relapse with chemotherapy is high, should not be the sole basis for deciding against HCT. Use of geriatric assessment tools, inflammatory biomarkers, and genetic polymorphism data may further aid in predicting nonrelapse mortality after HCT. Disease status and pretreatment cytogenetics with FLT3-TID, NPM-1, and CEBP-α status are the main factors predicting relapse and these are likely to be supplemented by incorporation of other molecular markers and the level of minimal residual disease after chemotherapy. HLA-matched related and unrelated donor grafts seem preferable to those from other donor sources. Donor age is of no clear significance. Models combining comorbidities with AML risk factors are useful in risk assessment before HCT. In this chapter, we integrated information on AML-specific, HCT-specific, and patient-specific risk factors into a risk-adapted approach to guide decisions about HCT versus no HCT.
Iron age: novel targets for iron overload
Authors: Casu Carla , Rivella Stefano
Published: November 2014

Excess iron deposition in vital organs is the main cause of morbidity and mortality in patients affected by β-thalassemia and hereditary hemochromatosis. In both disorders, inappropriately low levels of the liver hormone hepcidin are responsible for the increased iron absorption, leading to toxic iron accumulation in many organs. Several studies have shown that targeting iron absorption could be beneficial in reducing or preventing iron overload in these 2 disorders, with promising preclinical data. New approaches target Tmprss6, the main suppressor of hepcidin expression, or use minihepcidins, small peptide hepcidin agonists. Additional strategies in β-thalassemia are showing beneficial effects in ameliorating ineffective erythropoiesis and anemia. Due to the suppressive nature of the erythropoiesis on hepcidin expression, these approaches are also showing beneficial effects on iron metabolism. The goal of this review is to discuss the major factors controlling iron metabolism and erythropoiesis and to discuss potential novel therapeutic approaches to reduce or prevent iron overload in these 2 disorders and ameliorate anemia in β-thalassemia.
Detection and management of minimal residual disease in acute lymphoblastic leukemia
Authors: Schrappe Martin
Published: November 2014

The detection of minimal residual disease (MRD) has become part of the state-of-the-art diagnostics to guide treatment both in pediatric and adult acute lymphoblastic leukemia (ALL). This applies to the treatment of de novo and recurrent ALL. In high-risk ALL, MRD detection is considered an important tool to adjust therapy before and after hematopoietic stem cell transplantation. Precise quantification and quality control is instrumental to avoid false treatment assignment. A new methodological approach to analyzing MRD has become available and is based on next-generation sequencing. In principle, this technique will be able to detect a large number of leukemic subclones at a much higher speed than before. Carefully designed prospective studies need to demonstrate concordance or even superiority compared with those techniques in use right now: detection of aberrant expression of leukemia-specific antigens by flow cytometry of blood or bone marrow, or detection of specific rearrangements of the T-cell receptor or immunoglobulin genes by real-time quantitative polymerase chain reaction using DNA of leukemic cells. In some cases with known fusion genes, such as BCR/ABL, reverse transcriptase-polymerase chain reaction has been used as additional method to identify leukemic cells by analyzing RNA in patient samples. MRD detection may be used to modulate treatment intensity once it has been demonstrated at well-defined informative checkpoints that certain levels of MRD can reliably predict the risk of relapse. In addition, MRD is used as end point to determine the activity of a given agent or treatment protocol. If activity translates into antileukemic efficacy, MRD may be considered a surrogate clinical end point.
The evolving genomic landscape of myeloproliferative neoplasms
Authors: Nangalia Jyoti , Green Tony R.
Published: November 2014

Our understanding of the genetic basis of the Philadelphia chromosome-negative myeloproliferative neoplasms (MPNs) has moved forward at a staggering pace over the last decade. With the discoveries of underlying mutations in JAK2, MPL, and, most recently, calreticulin (CALR), that together account for ∼90% of patients with MPNs, these conditions are now among the best characterized of hematological malignancies. While JAK-STAT pathway activation has been shown to be central to the pathogenesis of the MPN phenotype, the mechanism by which mutant CALR alters cellular function to result in myeloid proliferation remains unclear. Other mutations in several epigenetic modifiers, such as ASXL1, DNMT3a, TET2, EZH2, IDH1, and IDH2, as well as in genes involved in mRNA splicing, such as SF3B1 and U2AF2, have also been described in recent years in patients with MPNs, and evidence is emerging as to how these may be contributing to disease biology. From a therapeutic perspective, the discovery of aberrations in JAK2 has rapidly translated into the successful clinical use of JAK inhibitors in MPNs. Mutant calreticulin has the potential to be a tumor-specific therapeutic target because the mutations generate a novel protein C-terminus. In this chapter, we detail the genomic alterations that underlie MPNs, with a focus on the recent discovery of mutations in CALR, and explore the clinical and biological relevance of the altered genomic landscape in MPNs.
Laboratory methods to detect antiphospholipid antibodies
Authors: Krilis Steven A. , Giannakopoulos Bill
Published: November 2014

This chapter reviews several important themes pertaining to the antiphospholipid syndrome (APS), including a description of the clinical features, a discussion of the main autoantigen, beta 2-glycoprotein I (β2GPI), and insights into the characteristics of the pathogenic anti-β2GPI autoantibodies. Evidence-based considerations for when to test for APS are explored, along with the clinical significance of patients testing positive on multiple APS assays, so-called triple positivity. A detailed review of recently published laboratory guidelines for the detection of lupus anticoagulant and the solid-phase anticardiolipin and anti-β2GPI ELISAs is undertaken. Finally, a brief review of nonclassification criteria laboratory assays with potential future diagnostic utility is presented.
Lasting power of new clotting proteins
Authors: Powell Jerry S.
Published: November 2014

Hemophilia is a genetic disease caused by a deficiency of one of the coagulation proteins. The term usually refers to either hemophilia A, factor VIII (FVIII), with an incidence of ∼1 in 5000 male births, or hemophilia B, factor IX (FIX), with an incidence of ∼1 in 30 000 male births. When severe, the disease leads to spontaneous life-threatening bleeding episodes. Current therapy requires frequent intravenous infusions of therapeutic factor concentrates. Most patients administer the infusions at home every few days and must limit their physical activities to avoid bleeding when the factor activity levels are below normal. In March 2014, a new therapeutic FIX preparation was approved for clinical use in Canada and the United States and, in June 2014, a new FVIII preparation was approved for clinical use in the United States. Over the next couple of years, other new factor products for FIX, FVIIa, and FVIII, which are currently in late stages of clinical trials, will likely also be approved. These new factors have been engineered to extend their half-life in circulation, thus providing major therapeutic advances for patients with hemophilia primarily by allowing treatment with fewer infusions per month. In the clinical trials so far, >500 patients have successfully used these extended half-life products regularly for >1 year to prevent spontaneous bleeding, to treat successfully any bleeding episodes, and to provide effective coagulation for major surgery. Essentially all infusions were well tolerated and effective. These promising new therapies should allow patients to use fewer infusions to maintain appropriate clotting factor activity levels in all clinical settings.
Pulmonary hypertension in sickle cell disease: diagnosis and management
Authors: Ataga Kenneth I. , Klings Elizabeth S.
Published: November 2014

The increased survival of patients with sickle cell disease (SCD) into adulthood is associated with an increased incidence of multiorgan dysfunction and a progressive systemic and pulmonary vasculopathy. The high prevalence of an elevated tricuspid regurgitant jet velocity and its association with an increased risk of death in adult patients is well established. However, there has been controversy regarding the prevalence of pulmonary hypertension (PH) and its association with mortality in SCD. Multiple recently published reports demonstrate that PH as diagnosed by right heart catheterization is common in adult SCD patients, with a prevalence of 6%–11%. Furthermore, PH is associated with an increased risk of death in SCD patients. In this chapter, we provide evidence for the high prevalence of PH in SCD and its association with mortality and make recommendations for its evaluation and management. Finally, we provide the rationale for screening for this life-threatening complication in adult patients with SCD.
Red cell exchange: special focus on sickle cell disease
Authors: Kim Haewon C.
Published: November 2014

The primary function of red blood cells (RBCs) is to deliver oxygen from the lungs to tissues. Tissue hypoxia occurs when the oxygen-carrying capacity of RBCs is compromised due primarily to 3 causes: (1) a reduction in circulating RBC mass, (2) an increase in circulating RBC mass, or (3) abnormal hemoglobin (Hb) that either does not sufficiently release oxygen to tissues (high-oxygen-affinity hemoglobin) or occludes the microvasculature due to deformed RBCs (sickled RBCs). To improve oxygenation in patients with reduced or increased RBC mass, RBC administration (simple transfusion) or RBC removal (RBC depletion) is performed, respectively. However, for patients with abnormal Hb, RBCs containing abnormal Hb are removed and replaced by healthy volunteer donor RBCs by red cell exchange (RCE). RCE can be performed by manual exchange or by automated exchange using a blood cell separator (erythrocytapheresis). In this review, indications for RCE in sickle cell disease using the evidence-based American Society for Apheresis categories1 are presented and the rationale for RCE in each disorder are discussed. Simple transfusion versus RCE and manual RCE versus automated RCE are compared. Finally, this review briefly presents some of the challenges of performing erythrocytapheresis in small children and discusses various choices for central venous access during RCE.2
Clinical and laboratory diagnosis of VWD
Authors: Federici Augusto B.
Published: November 2014

VWD is the most common inherited bleeding disorder and is due to a deficiency and/or abnormality of VWF. VWD is inherited in an autosomal-dominant or autosomal-recessive pattern, but women are apparently more symptomatic. Three main criteria are required for correct diagnoses of VWD: (1) positive bleeding history since childhood, (2) reduced VWF activity in plasma, and (3) history of bleeding in the family. The bleeding score, together with baseline VWF levels and family history, have been proposed as more evidence-based criteria for VWD. Measurements of a reduced VWF activity in plasma are essential for the diagnosis of VWD; assays for the evaluation of the interactions between VWF and platelet glycoprotein Ib receptor with or without ristocetin, as well as VWF collagen binding, are currently in use. However, other tests such as VWF antigen, factor VIII, ristocetin-induced platelet agglutination, multimeric analysis, VWF propeptide, VWF/FVIII binding assay, and assessment of biological response to desmopressin are necessary to characterize VWD types. Levels of VWF activities <30 U/dL have been associated with a bleeding phenotype and the presence of mutations in the VWF gene.
Transfusion strategies in hematologic and nonhematologic disease
Authors: Carson Jeffrey L. , Strair Roger
Published: November 2014

Substantial progress has been made in our understanding of the risks and benefits of RBC transfusion through the performance of large clinical trials. More than 7000 patients have been enrolled in trials randomly allocating patients to higher transfusion thresholds (∼9-10 g/dL), referred to as liberal transfusion, or lower transfusion thresholds (∼7-8 g/dL), referred to as restrictive transfusion. The results of most of the trials suggest that a restrictive transfusion strategy is safe and, in some cases, superior to a liberal transfusion strategy. However, in patients with myocardial infarction, brain injury, stroke, or hematological disorders, more large trials are needed because preliminary evidence suggests that liberal transfusion might be beneficial or trials have not been performed at all.
Maximizing GVL in allogeneic transplantation: role of donor lymphocyte infusions
Authors: Nikiforow Sarah , Alyea Edwin P.
Published: November 2014

Donor lymphocyte infusions (DLIs) can induce complete and durable remissions in some patients with hematologic malignancies who have relapsed after allogeneic transplantation, providing definitive evidence of a GVL effect. Despite the great promise initially envisioned for DLI as a method to augment GVL after transplantation, it utility is limited by low response rates in diseases other than chronic myelogenous leukemia and by the development of GVHD, the principal complication of DLI. To maximize GVL potency while minimizing toxicity, cellular effectors active in GVL need to be elucidated. Insight into mechanisms of GVL, such as reversal of in situ T-cell exhaustion, may allow identification of patients who will respond to DLI based on the presence of tumor-infiltrating lymphocytes in the BM. Understanding the clinical factors that influence the effectiveness and abrogate the toxicity of DLI, such as cell dose and timing of DLI after transplantation, will allow further optimization of DLI. This chapter reviews novel strategies that maximize the GVL effect of DLI by enhancing activity while limiting toxicity.
Recent insights into the role of the contact pathway in thrombo-inflammatory disorders
Authors: van Montfoort Maurits L. , Meijers Joost C.M.
Published: November 2014

The contact pathway of coagulation consists of the proteins factor XI, factor XII, prekallikrein, and high-molecular-weight kininogen. Activation of the contact system leads to procoagulant and proinflammatory reactions. The contact system is essential for surface-initiated coagulation, as exemplified by aPTT, but there is probably no role for the contact system in initiating physiologic in vivo coagulation. However, over the last few years, there has been renewed interest, especially because of experimental evidence suggesting that the contact system contributes to thrombosis. Knockout mice deficient in one of the contact proteins were protected against artificially induced thrombosis. Furthermore, inhibiting agents such as monoclonal antibodies, antisense oligonucleotides, and small molecules were found to prevent thrombosis in rodents and primates in both venous and arterial vascular beds. Although it remains to be established whether targeting the contact system will be effective in humans and which of the contact factors is the best target for anticoagulation, it would constitute a promising approach for future effective and safe antithrombotic therapy.
Epidemiologic and clinical data linking factors XI and XII to thrombosis
Authors: Key Nigel S.
Published: November 2014

Currently available evidence supports the contention that elevated levels of factor XI (fXI) are associated with a greater risk of venous thromboembolism and ischemic stroke, but, less convincingly, with myocardial infarction. Conversely, reduced plasma levels of fXI seem to offer some protection from venous thromboembolism and stroke, but not myocardial infarction. Factor XI-deficient patients are at risk for certain types of bleeding, particularly posttraumatic hemorrhage on mucosal surfaces where there is a high endogenous fibrinolytic activity. In contrast, the situation with fXII in human thrombosis remains enigmatic. Deficiency of fXII is clearly not associated with any bleeding risk, but neither does it seem to be protective against thrombosis. The longstanding debate as to whether partial fXII deficiency represents a risk factor for thrombosis remains unresolved, with seemingly conflicting results depending on study design, type of assay used, and analyte evaluated. The possibility that elevated fXII levels represent a risk factor for thrombosis is not borne out in the literature.
Established and novel agents for myelodysplastic syndromes
Authors: Sekeres Mikkael A. , Gerds Aaron T.
Published: November 2014

The myelodysplastic syndromes (MDS) are the most commonly diagnosed myeloid malignancy, with >15 000 new cases identified in the United States yearly. Prognostic scoring systems supplant a formal staging approach and, in general, divide patients into those with lower-risk and those with higher-risk MDS. Although treatment goals for patients with lower-risk disease focus on minimizing transfusions and optimizing quality of life, in higher-risk MDS, the goal is to delay transformation to acute leukemia and to prolong survival. In lower-risk patients, isolated cytopenias are treated with erythropoiesis-stimulating agents or growth factors such as thrombopoietin mimetics. For patients with the del(5q) cytogenetic abnormality or those who fail these initial approaches, lenalidomide may be tried, as can experimental agents. Lower-risk patients with multiple cytopenias may be treated with immunosuppressive drugs or low-dose hypomethylating agents. For patients with higher-risk disease, hypomethylating agents are the preferred initial treatment approach, with evaluation for hematopoietic cell transplantation at diagnosis. Several novel agents are being developed for MDS patients who have failed hypomethylating drugs.
Diagnosis of ‘double hit’ diffuse large B-cell lymphoma and B-cell lymphoma, unclassifiable, with features intermediate between DLBCL and Burkitt lymphoma: when and how, FISH versus IHC
Authors: Swerdlow Steven H.
Published: November 2014

Identification of large B-cell lymphomas that are “extra-aggressive” and may require therapy other than that used for diffuse large B-cell lymphoma, not otherwise specified (DLBCL, NOS), is of great interest. Large B-cell lymphomas with MYC plus BCL2 and/or BCL6 rearrangements, so-called ‘double hit’ (DHL) or ‘triple hit’ (THL) lymphomas, are one such group of cases often recognized using cytogenetic FISH studies. Whether features such as morphologic classification, BCL2 expression, or type of MYC translocation partner may mitigate the very adverse prognosis of DHL/THL is controversial. Classification of the DHL/THL is also controversial, with most either dividing them up between the DLBCL, NOS and B-cell lymphoma, unclassifiable, with features intermediate between DLBCL and Burkitt lymphoma (BCLU) categories or classifying at least the majority as BCLU. The BCLU category itself has many features that overlap those of DHL/THL. Currently, there is growing interest in the use of MYC and other immunohistochemistry either to help screen for DHL/THL or to identify “double-expressor” (DE) large B-cell lymphomas, defined in most studies as having ≥40% MYC+ and ≥50%-70% BCL2+ cells. DE large B-cell lymphomas are generally aggressive, although not as aggressive as DHL/THL, are more common than DHL/THL, and are more likely to have a nongerminal center phenotype. Whether single MYC rearrangements or MYC expression alone is of clinical importance is controversial. The field of the DHL/THL and DE large B-cell lymphomas is becoming more complex, with many issues left to resolve; however, great interest remains in identifying these cases while more is learned about them.
Elevated serum levels of IL-2R, IL-1RA, and CXCL9 are associated with a poor prognosis in follicular lymphoma
Authors: Mir Muhammad A. , Maurer Matthew J. , Ziesmer Steven C. , Slager Susan L. , Habermann Thomas , Macon William R. , Link Brian K. , Syrbu Sergei , Witzig Thomas , Friedberg Jonathan W. , Press Oliver , LeBlanc Michael , Cerhan James R. , Novak Anne , Ansell Stephen M.
Published: November 2014

Key Points

Elevated IL-2R, IL-1RA, and CXCL9 are associated with shorter event-free survival in newly diagnosed FL, treated with chemoimmunotherapy. Increased serum IL-12 and IL-1RA is associated with shorter event-free survival in patients who were observed or treated with rituximab alone.
Healthcare-associated bloodstream infections in critically ill patients: descriptive cross-sectional database study evaluating concordance with clinical site isolates
Authors: Culshaw Nick , Glover Guy , Whiteley Craig , Rowland Katie , Wyncoll Duncan , Jones Andrew , Shankar-Hari Manu
Published: November 2014

Background

Healthcare-associated bloodstream infections are related to both increased antibiotic use and risk of adverse outcomes. An in-depth understanding of their epidemiology is essential to reduce occurrence and to improve outcomes by targeted prevention strategies. The objectives of the study were to determine the epidemiology, source and concordance of healthcare-associated bloodstream infections with clinical site isolates.

Methods

We conducted a descriptive cross-sectional study in critically ill adults admitted to a tertiary semi-closed intensive care unit in England to determine the epidemiology, source and concordance of healthcare-associated bloodstream infections with clinical site isolates. All nosocomial positive blood cultures over a 4-year study period were identified. Pathogens detected and concordances with clinical site are reported as proportions.

Results

Contaminant pathogens accounted for half of the isolates. The most common non-contaminant pathogens cultured were Pseudomonas spp. (8.0%), Enterococcus spp. (7.3%) and Escherichia coli (5.6%). Central venous catheter-linked bloodstream infections represent only 6.0% of the positive blood cultures. Excluding contaminants and central venous line infections, in only 39.5% of the bloodstream infections could a concordant clinical site source be identified, the respiratory and urinary tracts being the most common.

Conclusions

Clinical practice should focus on a) improving blood culture techniques to reduce detection of contaminant pathogens and b) ensuring paired clinical site cultures are performed alongside all blood cultures to better understand the epidemiology and potential implications of primary and secondary discordant health-care associated bloodstream infections.
Multiplex PCR performed of bronchoalveolar lavage fluid increases pathogen identification rate in critically ill patients with pneumonia: a pilot study
Authors: Baudel Jean-Luc , Tankovic Jacques , Dahoumane Redouane , Carrat Fabrice , Galbois Arnaud , Ait-Oufella Hafid , Offenstadt Georges , Guidet Bertrand , Maury Eric
Published: November 2014

Background

In critically ill patients with pneumonia, accurate microorganism identification allows appropriate antibiotic treatment. In patients undergoing bronchoalveolar lavage (BAL), direct examination of the fluid using Gram staining provides prompt information but pathogen identification accuracy is low. Culture of BAL fluid is actually the reference, but it is not available before 24 to 48 h. In addition, pathogen identification rate observed with direct examination and culture is decreased when antibiotic therapy has been given prior to sampling. We therefore assessed, in critically ill patients with suspected pneumonia, the performance of a multiplex PCR (MPCR) to identify pathogens in BAL fluid. This study is a prospective pilot observation.

Methods

We used a MPCR detecting 20 types of microorganisms. Direct examination, culture, and MPCR were performed on BAL fluid of critically ill patients with pneumonia suspicion. The final diagnosis of infective pneumonia was retained after the medical chart was reviewed by two experts. Pathogen identification rate of direct examination, culture, and MPCR in patients with confirmed pneumonia was compared.

Results

Among the 65 patients with pneumonia suspicion, the diagnosis of pneumonia was finally retained in 53 cases. Twenty nine (55%) were community-acquired pneumonia and 24 (45%) were hospital acquired. Pathogen identification rate with MPCR (66%) was greater than with culture (40%) and direct examination (23%) (p =0.01 and p <0.001, respectively). When considering only the microorganisms included in the MPCR panel, the pathogen identification rate provided by MPCR reached 82% and was still higher than with culture (35%, p <0.001) and direct examination (21%, p <0.001). Pathogen identification rate provided by MPCR was not modified in the case of previous antibiotic treatment (66% vs. 64%, NS) and was still better than with culture (23%, p <0.001).

Conclusions

The results of this pilot study suggest that in critically ill patients, MPCR performed on BAL fluid could provide higher identification rate of pathogens involved in pneumonia than direct examination and culture, especially in patients having received antimicrobial treatment.
Influence of upflow velocity on performance and biofilm characteristics of Anaerobic Fluidized Bed Reactor (AFBR) in treating high-strength wastewater
Authors: Jaafari Jalil , Mesdaghinia Alireza , Nabizadeh Ramin , Hoseini Mohammad , kamani Hossein , Mahvi Amir Hossein
Published: November 2014

One of the key parameters in Fluidized Bed reactors is the control of biofilm thickness and configuration. The effect of upflow velocity on performance and biofilm characteristics of an Anaerobic Fluidized Bed Reactor was studied in treating Currant wastewater at various loading rates. The reactor used this study was made of a plexiglass column being 60 mm diameter, 140 cm height, and a volume of 3.95 L. The results demonstrated that the AFBR system is capable of handling an exceptionally high organic loading rate. At organic loading rates of 9.4 to 24.2 (kg COD m−3) at steady state, reactor performances with upflow velocities of 0.5, 0.75 and 1 (m min−1) were 89.3- 63.4, 96.9 – 79.6 and 95 – 73.4 percent, respectively. The average biomass concentration per unit volume of the AFBR (as gVSSatt L−1 expended bed) decreased with the increase of upflow velocity in the range of 0.5–1 m min–1 at all applied organic loading rates. The total biomass in the reactor increased with increases in the organic loading rate. The peak biomass concentration per unit volume (as gVSSatt L−1 expended bed) was observed at the bottom part of the reactor, then it droped off slowly towards the top. The biofilm thickness increased from the bottom to the top of the reactor representing a stratification of the media in the AFBR. The bed porosity increased from the bottom to the top of the reactor.
3D Visualization of thermal resistance and condensation problems using infrared thermography for building energy diagnostics
Authors: Ham Youngjib , Golparvar-Fard Mani
Published: November 2014

Background

Building deteriorations instigated by material degradations or moisture intrusions are the primary causes for energy inefficiency in many existing buildings. For choosing appropriate retrofits, it is important to carefully diagnose and analyze building areas in need of improvements. In addition to reliable sensing and analysis of as-is energy performance, an intuitive recording and visualization of energy diagnostic outcomes are also critical to effectively illustrate the as-is building conditions to homeowners during retrofit decision-making processes.

Method

Toward this goal, this paper presents a thermography-based method to visualize the actual thermal resistance and condensation problems in 3D while taking static occlusions into account. First, several overlapping digital and thermal images are collected from the building areas under inspection. Using a computer vision method– consisting of image-based 3D point cloud and mesh modeling algorithmsactual 3D spatio-thermal actual 3D spatio-thermal models are generated where surface temperature can be queried at the level of 3D points. Based on the resulting 3D spatio-thermal models and by measuring the reflected and dew point temperatures, the actual R-values of building assemblies are calculated, and the condensation issues are analyzed. Taking static occlusions into account, (1) the distribution of the actual thermal resistance over each building assembly, (2) the detected building areas with condensation problems, and (3) the corresponding geometrical and thermal characteristics are jointly visualized within a 3D environment.

Results

To validate the method and investigate the perceived benefits, four experiments have been conducted in existing buildings. Surveys are also conducted by professional energy auditors. The proposed method provides 3D visual representation of the actual thermal resistance distributions and building areas associated with condensation issues at the level of 3D points across geometrical forms while taking static occlusions into account.

Conclusions

The experimental results and the feedback received from the professionals show the promise of the proposed method in facilitating systematic post-examination of building deteriorations and support retrofit decision-makings. Ultimately, converting surface temperature data obtained from an IR camera into 3D visualization of energy performance metrics and possible condensation problems enables practitioners to better understand the as-is building conditions.
Producing pore pressure profiles based on theoretical models in undrilled, deepwater frontier basins
Authors: Green Sam , O’Connor Stephen A. , Cameron Deric E. L. , Carter James E. , Goodman William , Heinemann Niklas , Edwards Alexander P.
Published: November 2014

A working petroleum system was established on the shelf in offshore Labrador with the Bjarni H-81 discovery in 1973 in the Hopedale Basin. The same reservoirs as those targeted on the shelf are present in the deep water, which is currently receiving attention as the result of newly acquired seismic data. To date, only a very small number of wells have been drilled in the deep water, i.e., Blue H-28, Orphan Basin, and none off mainland Labrador. The wells that were drilled in the deep water had encountered significant overpressure, e.g., kicks that indicated overpressures of 26,850 kPa in the Mid-Cretaceous. Therefore, it was reasonable to assume that pore pressures be similarly high for any new deepwater prospects identified. To help reduce the risk in unexplored environments, we developed an approach that can be adopted to model pore pressure in deepwater settings, with Labrador as the main case study area featured, but also we discussed other global examples such as the Vøring Basin, Mid-Norway. Our results indicated, as a first approximation, that seismic velocity-based pore pressures in shale-rich intervals were similar to the geologic model down to the Lower Tertiary. Deep lithologies were, by regional analogue, likely affected by cementation that will act to preserve overpressure generated by disequilibrium compaction by reducing permeability but will not generate additional pore pressure. The cements (and any carbonate or volcanic lithologies) will, however, result in faster shales and will underpredict pore pressure by mimicking low porosity. A theoretical or “geologic modeling” approach can be used to sense-check any pore pressure interpretation from seismic velocity. The geologic approach also can be used to assess the risk for mechanical seal failure by allowing for estimates of the pore pressure, and related fracture pressure, to be made without the effects of cementation that affect the logs and seismic velocity data.
Carbonate reservoir characterization using seismic diffraction imaging
Authors: Decker Luke , Janson Xavier , Fomel Sergey
Published: November 2014

Although extremely prolific worldwide, carbonate reservoirs are challenging to characterize using traditional seismic reflection imaging techniques. We used computational experiments with synthetic models to demonstrate the possibility that seismic diffraction imaging has of overcoming common obstacles associated with seismic reflection imaging and aiding interpreters of carbonate systems. Diffraction imaging improved the horizontal resolution of individual voids in a karst reservoir model and identification of heterogeneous regions below the resolution of reflections in a reservoir-scale model.
The importance of wound documentation and classification
Authors: Russell Linda
Published: November 2014

Good wound documentation has become increasingly important over the last 10 years. Wound assessment provides a baseline situation against which a patient's plan of care can be evaluated. A number of documents have been implemented including the ‘Code of Professional Conduct for Nurses, Midwives and Health Visitors’ (UKCC, 1992), the ‘Post-registration Education Project’ (UKCC, 1997), ‘Standards of Records and Record Keeping’ (UKCC, 1998), and ‘Keeping the Record Straight’ (NHS Executive (NHS E), 1993). These documents require nurses to maintain their professional knowledge and competence, and to recognize any deficiency in their knowledge. Having recognized any deficiency they should read the relevant literature and/or attend a study day on wound care. Nursing records are the first source of evidence investigated when a complaint is made. Wound assessment is very complex and a standardized approach to evaluation needs to be adopted. Such evaluation should encompass colour classification, wound measurement, and classification of tissue type present in the wound. There are numerous methods of measuring wounds; these range from the simple, such as manual estimation by means of a ruler or wound tracing, to the more technical procedures, e.g. computer, image analysis, and colour imaging using hue saturation and intensity. Photography, in conjunction with nursing notes, provides a very good form of wound documentation and can provide clear evidence if required for legal cases.
Transcultural competence: the challenge for nurse education
Authors: Gerrish Kate , Papadopoulos Irena
Published: November 2014

Several recent health policy directives highlight the need to overcome the health disadvantage and discrimination experienced by many members of minority ethnic communities. However, there is ample evidence to indicate that nurses frequently fall short of providing sensitive and appropriate care to minority ethnic patients. If these policy objectives are to be met, it is essential that nurse education provides students with the opportunity to develop transcultural competence. This article examines the current policy context before considering the principles underpinning the development of transcultural competence. It concludes by discussing how nurse education might more effectively prepare nurses to meet the needs of minority ethnic communities.
A nursing report on postoperative management of a cat with multiple jaw fractures
Authors: Griggs Sarah
Published: November 2014

Nursing the jaw fracture patient can present a great challenge for nurses. Patients are often unable to eat sufficient quantities or not able to eat at all and struggle to maintain their meticulous feline grooming regimens. It is important to be aware that these patients often suffer concurrent injuries such as thoracic and head traumas that will also require attention. This article details the care given to a patient with maxillary and mandibular fractures and discusses potential recommendations for future practice
Export Performance of the Croatian Wood Industry and Its Contribution to the Overall Croatian Economy
Authors: Lovrinčević Željko , Buturac Goran , Mikulić Davor
Published: November 2014

This article investigates the contribution of the Croatian wood industry to the overall Croatian economy. The contribution is analyzed in terms of production, employment, and value added, using the input–output method for analysis. The objective of this article is to calculate multipliers for the wood industry in Croatia and benchmark them to the economies of similar European new member states. The model uses the so-called open model calculation, from which households are excluded. It comprises direct and indirect effects only, without induced effects, which is one of the distinguishing features of the so-called closed model. Results are benchmarked to other national economy sectors and similar transition economies. The wood industry output multiplier is the highest in Croatia and Poland. Domestic producers use various domestic and imported inputs in the production process. Input–output multipliers are calculated for both domestic and foreign demand (exports). Exports are profoundly important for Croatia as a small, open economy. Results of this research are useful to a wide range of policymakers and academics.
Examining the feasibility and impact of a graduate public administration course in evidence-informed policy
Authors: Ouimet Mathieu , Lapointe Luc , Léon Grégory
Published: November 2014

A pilot controlled before-and-after design was used to assess the impact of a new master-level course in evidence-informed policy making on students’ basic knowledge in evidence-based practice. The primary outcome variable was the mean percentage of pre-post improvement on the knowledge test. In the treatment group, the mean percentage of pre-post improvement to the knowledge test was 36.9% (SD 27.5), compared to 11.3% (SD 19.1) in the control group composed of students exposed to the traditional graduate-level research methodology course in Political Science. However, the mean score on the post-test for the treatment group was only half of the maximum score.
Changes in capitalism and challenges to social work: a view from Brazil
Authors: Yazbek Maria Carmelita
Published: November 2014

This article outlines a review of literature analysing some of the challenges and perspectives presented to social policy and social work in the early 21st century. It emphasises the need for action to fight poverty and inequality. The context is the societal transformations that characterise contemporary capitalism, and the focus is on the Global South. These transformations intensify and deepen the demands on the social work profession, demands that are related to making the rights of its users concrete.
Overcoming the Regional Cleavage? Political Party Nationalization in Ecuador since the Return to Democracy
Authors: Polga-Hecimovich John
Published: November 2014

This work analyses the evolution of Ecuadorian political parties’ territorial coverage since the return to democracy. It uses district-level electoral returns from between 1979 and 2013 for three different types of elections (presidential, national deputy, provincial deputy) to evaluate the territorial homogeneity of the parties in each period («static» nationalization) as well as the homogeneity of temporal change («dynamic» nationalization). Through use of electoral cartography, as well as mixed model statistical analysis, the results show a high level of volatility along both dimensions of nationalization for all parties, including the government’s ALianza pais. The analysis also reveals that widespread voter support for legislators from a single party is driven by presidential coattails rather than through developing deep roots in districts. The geographical analysis indicates that regionalism has persisted in Ecuadorian political parties since 1979 despite the success of Rafael Correa’s party at the polls.
Immune-regulatory activity of methanolic extract of Acacia confusa heartwood and melanoxetin isolated from the extract
Authors: Ho Shang-Tse , Tung Yu-Tang , Wu Yu-Jung , Lin Chi-Chen , Wu Jyh-Horng
Published: November 2014

The antioxidant, anti-inflammatory, antivirus, uric acid decreasing, and hepatoprotective activities of Acacia
confusa extracts were demonstrated in previous studies. However, there is no scientific evidence concerning the immune-regulatory activity of the heartwood extract of A. confusa. In this study, the effect of a methanolic heartwood extract (MHE) from A. confusa on dendritic cell (DC) activation and function was examined. A. confusa MHE significantly reduced the production of pro-inflammatory cytokine interleukin-6 (IL-6) in lipopolysaccharide (LPS)-stimulated DCs, and the effective concentration (25 μg ml-1) of A. confusa MHE did not affect cell viability. Additionally, the bioactive phytochemical from A. confusa MHE, melanoxetin, was isolated and purified by HPLC. This substance inhibited the production of pro-inflammatory cytokines (tumor necrosis factor-α, IL-6, and IL-12) in LPS-stimulated DC at a concentration of 12.5 μM. Moreover, the expression levels of co-stimulatory molecules such as CD40, CD80, and CD86 also remarkably decreased after treatment with melanoxetin at the same dose. These findings indicate that A. confusa MHE and melanoxetin have excellent immune-suppressive activity and may be potential candidates for further development of natural health supplements.
The potent inhibition of human cytosolic sulfotransferase 1A1 by 17α-ethinylestradiol is due to interactions with isoleucine 89 on loop 1
Authors: Rohn-Glowacki Katie Jo , Falany Charles N.
Published: November 2014

Drug-drug interactions (DDI) with oral contraceptives containing 17α-ethinylestradiol (EE2) have been well characterized with regard to interactions with phase I drug metaolizing enzymes; however, DDI with EE2 and phase II enzymes have not been as thoroughly addressed. Our laboratory recently reported that in vitro EE2 potently inhibits human cytosolic sulfotransferase (SULT) 1A1 while EE2 was not sulfated until micromolar concentrations. Molecular docking studies demonstrated that Tyr169 and isoleucine 89 (Ile89) may play a role in the inhibitory and/or catalytic positioning of EE2 within the active site of SULT1A1. Therefore, the current study focused on determining the role of Ile89 in the inhibition of SULT1A1 utilizing site-directed mutagenesis. Ile89 was mutated to an alanine and the effect of the mutation was characterized using kinetic and binding assays. SULT1A1-Ile89Ala was found to have a Km for EE2 that was 11-fold greater than wild-type enzyme. A decreased affinity (Kd) of EE2 for SULT1A1-Ile89Ala was apparently responsible for the increase in Km, and also resulted in the loss of the potent inhibition. Molecular modeling was used in an attempt to determine the atomic level changes in binding of EE2 to SULT1A1-Ile89Ala. However, analysis of the effect of the single Ile89 mutation on both the open and closed homology models was not consistent with the docking and kinetic results. Overall, the mechanism of inhibition of EE2 for SULT1A1 is apparently the result of interactions of Ile89 with EE2 holding it in a potent inhibitory conformation, and mutation of the Ile89 significantly decreases the inhibition.
Wavelet De-noising of GNSS Based Bridge Health Monitoring Data
Authors: Ogundipe Oluropo , Lee Jae Kang , Roberts Gethin Wyn
Published: November 2014

GNSS signal multipath occurs when the GNSS signal reflects of objects in the antenna environment and arrives at the antenna via multiple paths. A bridge environment is one that is prone to multipath with the bridge structure, as well as passing vehicles providing static and dynamic sources of multipath. In this paper, the Wavelet Transform (WT) is applied to bridge data collected on the Machang cable stayed bridge in Korea. The WT algorithm was applied to the GNSS derived bridge defection data at the mid-span. Up to 41% improvement in RMS was observed afterwavelet shrinkage de-noisingwas applied.Application of this algorithm to the torsion data showed significant improvement with the residual average and RMS decreased by 40% and 45% respectively. This method enabled the generation of more accurate information for bridge health monitoring systems in terms of the analysis of frequency, mode shape and three dimensional defections.
French orphan prepositions revisited
Authors: Authier J.-Marc
Published: November 2014

In this article, I argue, contra Cervoni (1991), Olivier (2007) and others, that French
Clitic production by Portuguese and Capeverdean children: omission in bilingualism
Authors: Costa João , Lobo Maria , Pratas Fernanda
Published: November 2014

Omission of clitics is often considered a critical marker of language development in children. For this reason, clitic omission in language development has been studied crosslinguistically. Results on clitic production reveal that languages differ with respect to the rates at which clitics are omitted by children, as well as on the duration of the clitic omission stages. This paper compares clitic omission by monolingual and bilingual children acquiring European Portuguese – a language with both clitics and null objects – and Capeverdean Creole – a language with clitics in which null objects are ruled out. We show that omission is only found in monolingual Portuguese, and in bilingual Capeverdean. These results confirm earlier findings on the precocious sensitivity to the availability of null objects, and signal object drop as a critical distinguishing factor for differentiating bilinguals and monolinguals.