bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparisons of prognostic factors between young and elderly patients with chronic heart failure
Authors: Sato Takamasa , Yamauchi Hiroyuki , Kanno Yuki , Suzuki Satoshi , Yoshihisa Akiomi , Yamaki Takayoshi , Sugimoto Koichi , Kunii Hiroyuki , Nakazato Kazuhiko , Suzuki Hitoshi , Saitoh Shu‐ichi , Takeishi Yasuchika
Published: April 2014

Aim

The purpose in the present study was to compare prognostic risk factors between older and younger chronic heart failure (CHF) patients.

Methods

We examined 598 consecutive CHF patients (476 men and 122 women, mean age 61.4 ± 14.3 years) who underwent cardiopulmonary exercise testing, echocardiography and blood examination. We divided the 598 patients into two groups: the elderly group (age ≥75 years, n = 123) and the young group (age <75, n = 475). We compared blood testing data, exercise capacity, cardiac function and prognosis between the two groups. Patients were followed up (median 782 days) to register cardiac deaths or rehospitalization as a result of worsening heart failure.

Results

Patients in the elderly group were associated with higher frequencies of atrial fibrillation and diuretic use than those in the young group. Patients in the elderly group had lower hemoglobin concentration, more impaired renal function, higher plasma B‐type natriuretic peptide (BNP) levels, smaller left ventricular volume, longer deceleration time of early mitral wave and lower exercise capacity than those in the young group. There were 199 cardiac events during follow‐up periods. As expected, Kaplan–Meier analysis showed that patients in the elderly group had higher cardiac event rates than those in the young group. In the young group, multivariable Cox hazard analysis showed that hemoglobin concentration, log BNP and peak VO2 were independent predictors related to cardiac events. In contrast, in the elderly group, estimated glomerular filtration rate, atrial fibrillation and peak VO2 were independent factors to predict adverse clinical outcomes.

Conclusions

Prognostic factors were different between the elderly and young patients in CHF. Geriatr Gerontol Int 2015; 15: 435–442.
Modified penile disassembly technique for boys with epispadias and those undergoing complete primary repair of exstrophy: Long‐term outcomes
Authors: Anwar Ahmed Zaki Mohamed , Mohamed Mamdouh Abdel‐Hamid , Hussein Alayman , Shaaban Alaa Mohammed
Published: April 2014

Objectives

To describe our experience performing the modified penile disassembly technique for boys with epispadias and for those undergoing complete primary repair of exstrophy.

Methods

Between January 2004 and July 2009, 34 boys underwent the modified penile disassembly technique at our institution. The first group included 15 boys with bladder exstrophy who underwent complete primary repair of exstrophy. The second group comprised 11 boys with penopupic epispadias after previous closure of bladder exstrophy. The third group included 8 boys with isolated complete epispadias.

Results

The age range was 3 months to 8 years (median, 9 months). The follow‐up time ranged from 36 months to 8 years (mean, 63 months). A conical‐shaped glans with the absence of any ischemic changes occurred in 94% of patients. A mild degree of penile dorsal tilt occurred in 11.7% of patients, urethrocutanous fistula in 17.6% and meatal stenosis 5.8%. In cases of complete primary repair of exstrophy, hydronephrosis occurred in 66.6% of patients. Vesicoureteral reflux appeared in 60% of patients; despite suppressive antibiotic therapy, 33.3% are awaiting reimplantation. Continence with volitional voiding with dry intervals of ≥3 h was achieved in 40% of patients.

Conclusions

The modified penile disassembly technique can be used in epispadias and complete primary repair of exstrophy with excellent cosmetic results. Preservation of the distal urethral plate along with both hemiglans avoids shortening and prevents occurrence of hypospadias. Complete primary repair of exstrophy is a feasible technique with positive effects on continence with preservation of kidney function.
Surgical periodontal therapy with and without initial scaling and root planing in the management of chronic periodontitis: a randomized clinical trial
Authors: Aljateeli Manar , Koticha Tapan , Bashutski Jill , Sugai James V. , Braun Thomas M. , Giannobile William V. , Wang Hom‐Lay
Published: April 2014

Aim

To compare the outcomes of surgical periodontal therapy with and without initial scaling and root planing.

Methods

Twenty‐four patients with severe chronic periodontitis were enrolled in this pilot, randomized controlled clinical trial. Patients were equally allocated into two treatment groups: Control group was treated with scaling and root planing, re‐evaluation, followed by Modified Widman Flap surgery and test group received similar surgery without scaling and root planing. Clinical attachment level, probing depth and bleeding on probing were recorded. Standardized radiographs were analysed for linear bone change from baseline to 6 months. Wound fluid inflammatory biomarkers were also assessed.

Results

Both groups exhibited statistically significant improvement in clinical attachment level and probing depth at 3 and 6 months compared to baseline. A statistically significant difference in probing depth reduction was found between the two groups at 3 and 6 months in favour of the control group. No statistically significant differences in biomarkers were detected between the groups.

Conclusions

Combined scaling and root planing and surgery yielded greater probing depth reduction as compared to periodontal surgery without initial scaling and root planing.
Second Transcatheter Aortic Valve Implantation for Treatment of Suboptimal Function of Previously Implanted Prosthesis: Review of the Literature
Authors: WITKOWSKI ADAM , JASTRZEBSKI JAN , DABROWSKI MACIEJ , CHMIELAK ZBIGNIEW
Published: April 2014

Objectives

To systematically review reported cases of second transcatheter aortic valve deployment within a previously implanted prosthesis (TAV‐in‐TAV).

Background

TAV‐in‐TAV deployment is one of the rescue strategies undertaken due to an unsuccessful or suboptimal transcatheter aortic valve implantation (TAVI) result. Currently, there are no clear indications for second valve implantation and outcomes of patients with 2 prostheses deployed remain poorly known.

Methods

The MEDLINE and PubMed databases were searched for cases of TAV‐in‐TAV implantations of aortic valve.

Results

Forty‐three articles reporting on TAV‐in‐TAV deployment were included in the review. The most frequently observed indication for second valve implantation was aortic regurgitation (AR) occurring shortly after TAVI. There was a strong dominance of paravalvular over intravalvular AR, with prosthesis malposition being the main underlying cause of TAVI failure (81% of all identified cases). Perioperative echocardiographic images are crucial in identifying causes of failure and helpful in optimal rescue strategy selection. Success rate of TAV‐in‐TAV implantation varies from 90% to 100% with mortality rate of 0–14.3% at 30 days. Despite similar aortic valve function in follow‐up, TAV‐in‐TAV may be an independent predictor of increased cardiovascular mortality.

Conclusions

TAV‐in‐TAV implantation is feasible and results in favorable short‐ and mid‐term outcomes in patients with acute failure of TAVI without recourse to open‐heart surgery. Further studies are needed to establish algorithm of the management of unsuccessful or suboptimal implantation results. (J Interven Cardiol 2014;27:300–307)
Obstructive sleep apnea is associated with increased arterial stiffness in severe obesity
Authors: Seetho Ian W. , Parker Robert J. , Craig Sonya , Duffy Nick , Hardy Kevin J. , Wilding John P. H.
Published: April 2014

Obstructive sleep apnea is associated with obesity and metabolic syndrome, leading to greater cardiovascular risk. Severely obese patients with obstructive sleep apnea may still be at risk of adverse health outcomes, even without previous cardiovascular disease. Pulse wave analysis non‐invasively measures peripheral pulse waveforms and derives measures of haemodynamic status, including arterial stiffness, augmentation pressure and subendocardial viability ratio. We hypothesized that the presence of obstructive sleep apnea in severe obesity, even in the absence of an antecedent history of cardiovascular disease, would affect measurements derived from pulse wave analysis. Seventy‐two severely obese adult subjects [obstructive sleep apnea 47 (body mass index 42 ± 7 kg m−2), without obstructive sleep apnea (non‐OSA) 25 (body mass index 40 ± 5 kg m−2)] were characterised using anthropometric, respiratory and cardio‐metabolic parameters. Groups were similar in age, body mass index and gender. More subjects with obstructive sleep apnea had metabolic syndrome [obstructive sleep apnea 60%, without obstructive sleep apnea (non‐OSA) 12%]. Those with obstructive sleep apnea had greater arterial stiffness, augmentation pressure and decreased subendocardial viability ratio (all P < 0.001), with significantly higher systolic (P = 0.003), diastolic (P = 0.04) and mean arterial pressures (P = 0.004) than patients without obstructive sleep apnea (non‐OSA). Arterial stiffness correlated with mean arterial blood pressure (P = 0.003) and obstructive sleep apnea severity (apnea–hypopnea index; P < 0.001). apnea–hypopnea index significantly predicted arterial stiffness in multiple regression analysis, but components of the metabolic syndrome did not. Thus, patients with obstructive sleep apnea with severe obesity have increased arterial stiffness that may potentially influence cardiovascular risk independently of metabolic abnormalities. The presence of obstructive sleep apnea in severe obesity identifies a group at high cardiovascular risk; clinicians should ensure that risk factors are managed appropriately in this group whether or not treatment of obstructive sleep apnea is offered or accepted by patients.
Impact of living with pulmonary hypertension: A qualitative exploration
Authors: Yorke Janelle , Armstrong Iain , Bundock Sarah
Published: April 2014

Little is known about the impact of living with pulmonary hypertension. This paper reports data exploring the experience of living with pulmonary hypertension. Qualitative, semistructured, one‐to‐one interviews were conducted in participants' homes to understand their experiences of living with pulmonary hypertension. Thematic analysis was used to identify codes and generate themes from the interview data. The identification of initial codes was conducted independently by the first author, and checked by the second. Thirty patients recruited through the pulmonary hypertension descriptions of living with pulmonary hypertension are presented under five themes that center on the invisibility of pulmonary hypertension, and its complex treatment are presented: (i) living with a hidden illness; (ii) being on a symptomology rollercoaster; (iii) expectations from treatments; (iv) treatment burden; and (v) awareness of financial burden of treatments. Key findings included daily challenges of living with a rare condition that is largely “hidden” and its related complex treatment regimes. People with pulmonary hypertension would benefit if more healthcare professionals, as well as family and friends, would validate their condition and provide them with appropriate support.
Can China Avoid the Thucydides Trap?
Authors: BRZEZINSKI ZBIGNIEW
Published: April 2014

Despite grand visions of a cosmopolitan planet living in peace, the first globalization at the turn of the 20th century descended into World War I as the old empires scrambled to preserve themselves as others sought self‐determination. Powers on the losing end of that war reasserted themselves in yet another worldwide calamity within decades.

After World War II, in the early 1950s, with the victorious American‐led alliance in the driver's seat, institutions such as the United Nations and the Bretton Woods arrangements created a global stability that enabled peace, prosperity and the “rise of the rest.”

In 2014, the world order is shifting again with the rise of China reviving in Asia the very kind of nationalist rivalries that led Europe to war twice in the 20th century.

Will we be able to build new institutions that accommodate the new powershift without resorting to war, or will the second globalization collapse as well? Top strategists from the US, Japan and China respond to this momentous question.
US and China Must Share Power and China Must Make Japan Feel Safe
Authors: KEATING PAUL J.
Published: April 2014

Despite grand visions of a cosmopolitan planet living in peace, the first globalization at the turn of the 20th century descended into World War I as the old empires scrambled to preserve themselves as others sought self‐determination. Powers on the losing end of that war reasserted themselves in yet another worldwide calamity within decades.

After World War II, in the early 1950s, with the victorious American‐led alliance in the driver's seat, institutions such as the United Nations and the Bretton Woods arrangements created a global stability that enabled peace, prosperity and the “rise of the rest.”

In 2014, the world order is shifting again with the rise of China reviving in Asia the very kind of nationalist rivalries that led Europe to war twice in the 20th century.

Will we be able to build new institutions that accommodate the new powershift without resorting to war, or will the second globalization collapse as well? Top strategists from the US, Japan and China respond to this momentous question.
Revolt Against the Global Super‐Rich Is Underway
Authors: FREELAND CHRYSTIA
Published: April 2014

The double whammy of job‐displacing technological advance and wage‐deflating globalization has demoted the American middle class, even as the rich get richer from access to global markets and from their slice of profits from managing massive global financial flows. The specter of growing inequality is haunting free‐market capitalism as never before since the early days of the Industrial Revolution. What is happening? What is to be done? Top economists take a hard look at a hard reality.
Will Your Job Disappear?
Authors: BRYNJOLFSSON ERIK , MCAFEE ANDREW , MANYIKA JAMES
Published: April 2014

The double whammy of job‐displacing technological advance and wage‐deflating globalization has demoted the American middle class, even as the rich get richer from access to global markets and from their slice of profits from managing massive global financial flows. The specter of growing inequality is haunting free‐market capitalism as never before since the early days of the Industrial Revolution. What is happening? What is to be done? Top economists take a hard look at a hard reality.
Coupling of the radiosensitivity of melanocyte stem cells to their dormancy during the hair cycle
Authors: Ueno Makiko , Aoto Takahiro , Mohri Yasuaki , Yokozeki Hiroo , Nishimura Emi K.
Published: April 2014

Current studies have revealed that stem cells are more radiosensitive than mature cells. As somatic stem cells are mostly kept in a quiescent state, this conflicts with Bergonié and Tribondeau's law that actively mitotic cells are the most radiosensitive. In this study, we focused on hair graying to understand the stress‐resistance of melanocyte stem cells (McSCs). We used Dct‐H2B‐GFP transgenic mice which enables the stable visualization of McSCs and an anti‐Kit monoclonal antibody which selectively eradicates amplifying McSCs. The results demonstrate that quiescent McSCs are rather radiosensitive, but the coexistence of non‐quiescent McSCs provides the stem cell pool with radioresistance. The irradiated quiescent McSCs prematurely differentiate in the niche upon their activation without sufficiently renewing themselves for cyclic hair pigmentation. These data indicate that tissue radiosensitivity is largely dependent on the state of somatic stem cells under their local microenvironment.
Perforation of enteric duplication during chemotherapy for osteosarcoma
Authors: Morishima Tatsuya , Kato Itaru , Umeda Katsutsugu , Hiramatsu Hidefumi , Okamoto Shinya , Furuta Akihiro , Nakamata Takeharu , Adachi Souichi , Heike Toshio , Watanabe Ken‐ichiro
Published: April 2014

A 9‐year‐old boy undergoing chemotherapy for conventional osteosarcoma complained of severe abdominal pain associated with rebound tenderness and muscular defense. Abdominal computed tomography indicated intraperitoneal free air. On surgical investigation, a diverticulum‐like lesion, perforated at the base, was found on the sidewall of the ileum. The anatomic location of the lesion was indicative of enteric duplication. Although the frequency of complications is very rare, perforations of the digestive tract should be considered in patients suffering severe abdominal pain while receiving chemotherapy.
Streptococcus gallolyticus subsp. pasteurianus meningitis in an infant
Authors: Takahashi Yoshiko , Ishiwada Naruhiko , Tanaka Junko , Okusu Kiyofumi , Ichimura Sadahiro , Hishiki Haruka , Ota Setsuo , Kohno Yoichi
Published: April 2014

Streptococcus gallolyticus subsp. pasteurianus was formerly classified as S. bovis biotype II/2, which is recognized as a rare cause of neonatal sepsis and meningitis. Since the taxonomy classification change, there have not been many reports of meningitis due to S. gallolyticus subsp. pasteurianus. Moreover, the pathogenesis of late onset S. gallolyticus subsp. pasteurianus meningitis in infants is unclear. Here we report a case of meningitis in a 5‐week‐old infant with preceding diarrhea. S. bovis biotype II/2 was isolated from the blood, cerebrospinal fluid and stool, and then was identified as S. gallolyticus subsp. pasteurianus on 16S rRNA gene sequencing. Isolates from all three sample types had identical profiles on pulsed‐field gel electrophoresis. The intestinal tract was thought to be the source of the infection.
Influence of variation potential on resistance of the photosynthetic machinery to heating in pea
Authors: Sukhov Vladimir , Surova Lyubov , Sherstneva Oksana , Vodeneev Vladimir
Published: April 2014

Electrical signals [action potentials (APs) and variation potentials (VPs)] induced by local stimuli are a mechanism that underlies rapid plant response to environmental factors. Such signals induce a number of functional responses, including changes in photosynthesis. Ultimately, these responses are considered to increase plant resistance to stress factors, but this question has been poorly investigated. We studied the influence of VP on photosynthesis and resistance of the photosynthetic machinery to heating in leaves of pea (Pisum sativum). Localized burning induced a VP that decreased photosynthesis parameters [CO2 assimilation rate and quantum yields of photosystem I (PSI) and photosystem II (PSII)]. The photosynthetic response was initiated by a decrease in photosynthesis dark‐stage activity, which in turn increased resistance of PSI to heating. Three results supported this hypothesized mechanism: (1) the magnitude of VP‐induced decrease in CO2 assimilation and enhanced PSI resistance to heating were highly correlated; (2) the VP influence on PSI resistance to heating was suppressed under a low external CO2 concentration and (3) decreasing external CO2 concentration imitated the VP‐induced photosynthetic response and increased PSI resistance to heating.
Effect of Leptin on In Vivo Goat Embryo Production
Authors: Batista AM , Gomes WA , Carvalho CCD , Monteiro PLJ , Silva FLM , Almeida FC , Soares PC , Carneiro GF , Guerra MMP
Published: April 2014

Contents

The aim of this study was to evaluate the effect of leptin administration during superovulation on in vivo goat embryo production. Ten mature does were superovulated with 133 mg follicle‐stimulating hormone (FSH) i.m. in six descending doses at 12‐h intervals. The goats received 4.8 μg/kg human recombinant leptin s.c. (leptin group, n = 5) or phosphate‐buffered saline (PBS) (control group, n = 5) with the first and second FSH doses. The does were mated and subjected to embryo collection by transcervical technique 6 days later. The total number of cells per embryo and the number of cells with fragmented DNA were assessed in selected blastocysts by combining Hoechst 33342 and terminal dUTP nick‐end labelling (TUNEL) staining. Plasma concentrations of oestradiol (E2) and progesterone (P4) were determined by electrochemiluminescence from the day of FSH treatment, on the day of superovulatory oestrus and on the day before embryo collection. Compared with the control group, the does that received leptin had a higher number of transferable embryos (p < 0.005), fewer embryos classified as degenerated (p < 0.001) and fewer TUNEL‐positive cells/blastocyst (p < 0.001). The number of transferable embryos was positively correlated with E2 concentrations on day of oestrus (r = 0.562; p < 0.01) and P4 concentrations on the day of embryo collection (r = 0.912; p < 0.001). We concluded that in vivo leptin administration during FSH treatment improved embryo quality and affected ovarian steroidogenesis in superovulated goats.
Remote ischemic preconditioning delays fatigue development during handgrip exercise
Authors: Barbosa T. C. , Machado A. C. , Braz I. D. , Fernandes I. A. , Vianna L. C. , Nobrega A. C. L. , Silva B. M.
Published: April 2014

Ischemic preconditioning (IPC) of one or two limbs improves performance of exercise that recruits the same limb(s). However, it is unclear whether IPC application to another limb than that in exercise is also effective and which mechanisms are involved. We investigated the effect of remote IPC (RIPC) on muscle fatigue, time to task failure, forearm hemodynamics, and deoxygenation during handgrip exercise. Thirteen men underwent RIPC in the lower limbs or a control intervention (CON), in random order, and then performed a constant load rhythmic handgrip protocol until task failure. Rates of contraction and relaxation (ΔForce/ΔTime) were used as indices of fatigue. Brachial artery blood flow and conductance, besides forearm microvascular deoxygenation, were assessed during exercise. RIPC attenuated the slowing of contraction and relaxation throughout exercise (P < 0.05 vs CON) and increased time to task failure by 11.2% (95% confidence interval: 0.7–21.7%, P <0.05 vs CON). There was no significant difference in blood flow, conductance, and deoxygenation between conditions throughout exercise (P > 0.05). In conclusion, RIPC applied to the lower limbs delayed the development of fatigue during handgrip exercise, prolonged time to task failure, but was not accompanied by changes in forearm hemodynamics and deoxygenation.
Extraction with 0.01 m CaCl2 underestimates the concentration of phosphorus in the soil solution
Authors: Sánchez‐Alcalá I. , del Campillo M. C. , Torrent J.
Published: April 2014

The aim of this paper was to compare the concentration of P in soil extracts prepared with water and a ‘soil solution proxy’ (‘SSP’, that is, a salt solution similar in ionic composition and strength to the actual soil solution) with that in 0.01 m CaCl2 extracts, which is usually taken as a measure of soil P intensity. Seventy widely ranging agricultural soils from the Mediterranean part of Spain were used. Soil/solution ratio was 1:10 and extraction time 3 days. For 0.01 m CaCl2, a short extraction time of 30 min was also used as the reference method. CaCl2‐P(3 days) and CaCl2‐P(30 min) were not significantly different for the 40 noncalcareous soils group, but CaCl2‐P(3 days) was significantly larger than CaCl2‐P(30 min) for the 30 calcareous soils group. The Water‐P/CaCl2‐P(30 min) ratio was not significantly related to any soil property, its mean being 6.3 for the noncalcareous and 5.8 for the calcareous soils group. The mean SSP‐P/CaCl2‐P(30 min) ratio was 2.6 for the noncalcareous and 3.1 for the calcareous soils group, and decreased slightly with increasing ionic strength of the soil solution in the noncalcareous soils group. These results are consistent with the promoting influence of the Ca ion and ionic strength on P adsorption by permanent‐charge soils. The fact that extraction with 0.01 m CaCl2 generally results in underestimation of the actual concentration of P in the soil solution should be considered when CaCl2‐P is used as a soil P test.
In the PINK1
Authors: Hurtley Stella M.
Published: April 2014

Mitochondria lacking a Parkinson’s disease–associated kinase harbor a functionally important phosphorylation defect.
Pattern Recognition Receptor Antagonism
Authors: VanHook Annalisa M.
Published: April 2014

A pathogenic fungus activates two C-type lectin receptors to skew the T cell response to one favorable to infection.
Quantification and Validation of Ertapenem Using a Liquid Chromatography-Tandem Mass Spectrometry Method
Authors: van Rijn S. P. , Wessels A. M. A. , Greijdanus B. , Touw D. J. , Alffenaar J. W. C.
Published: April 2014

Ertapenem, a carbapenem, relies on time-dependent killing. Therapeutic drug monitoring (TDM) should be considered, when ertapenem is used in specific populations, to achieve optimal bactericidal activity and optimize drug-dosing regimens. No validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) method has been reported using deuterated ertapenem as the internal standard. A new simple and robust LC-MS/MS method using a quadrupole mass spectrometer was developed for analysis of ertapenem in human plasma, using deuterated ertapenem as the internal standard. The calibration curve was linear over a range of 0.1 (lower limit of quantification [LLOQ]) to 125 mg/liter. The calculated accuracy ranged from −2.4% to 10.3%. Within-run coefficients of variation (CV) ranged from 2.7% to 11.8%, and between-run CV ranged from 0% to 8.4%. Freeze-thaw stability had a bias of −3.3% and 0.1%. Storage of QC samples for 96 h at 4°C had a bias of −4.3 to 5.6%, storage at room temperature for 24 h had a bias of −10.7% to −14.8%, and storage in the autosampler had a bias between −2.9% and −10.0%. A simple LC-MS/MS method to quantify ertapenem in human plasma using deuterated ertapenem as the internal standard has been validated. This method can be used in pharmacokinetic studies and in clinical studies by performing TDM.
Efficacy and Safety of AVP-21D9, an Anthrax Monoclonal Antibody, in Animal Models and Humans
Authors: Malkevich Nina V. , Hopkins Robert J. , Bernton Edward , Meister Gabriel T. , Vela Eric M. , Atiee George , Johnson Virginia , Nabors Gary S. , Aimes Ronald T. , Ionin Boris , Skiadopoulos Mario H.
Published: April 2014

Anthrax is an acute infectious disease caused by the spore-forming bacterium
Bacillus anthracis
. Timely administration of antibiotics approved for the treatment of anthrax disease may prevent associated morbidity and mortality. However, any delay in initiating antimicrobial therapy may result in increased mortality, as inhalational anthrax progresses rapidly to the toxemic phase of disease. An anthrax antitoxin, AVP-21D9, also known as Thravixa (fully human anthrax monoclonal antibody), is being developed as a therapeutic agent against anthrax toxemia. The efficacy of AVP-21D9 in
B. anthracis
-infected New Zealand White rabbits and in cynomolgus macaques was evaluated, and its safety and pharmacokinetics were assessed in healthy human volunteers. The estimated mean elimination half-life values of AVP-21D9 in surviving anthrax-challenged rabbits and nonhuman primates (NHPs) ranged from approximately 2 to 4 days and 6 to 11 days, respectively. In healthy humans, the mean elimination half-life was in the range of 20 to 27 days. Dose proportionality was observed for the maximum serum concentration (
C
max
) of AVP-21D9 and the area under the concentration-time curve (AUC). In therapeutic efficacy animal models, treatment with AVP-21D9 resulted in survival of up to 92% of the rabbits and up to 67% of the macaques. Single infusions of AVP-21D9 were well tolerated in healthy adult volunteers across all doses evaluated, and no serious adverse events were reported. (This study has been registered at ClinicalTrials.gov under registration no. NCT01202695.)
Site-Dependent Recruitment of Inflammatory Cells Determines the Effective Dose of Leishmania major
Authors: Ribeiro-Gomes Flavia L. , Roma Eric Henrique , Carneiro Matheus B. H. , Doria Nicole A. , Sacks David L. , Peters Nathan C.
Published: April 2014

The route of pathogen inoculation by needle has been shown to influence the outcome of infection. Employing needle inoculation of the obligately intracellular parasiteLeishmania major, which is transmitted in nature following intradermal (i.d.) deposition of parasites by the bite of an infected sand fly, we identified differences in the preexisting and acute cellular responses in mice following i.d. inoculation of the ear, subcutaneous (s.c.) inoculation of the footpad, or inoculation of the peritoneal cavity (intraperitoneal [i.p.] inoculation). Initiation of infection at different sites was associated with different phagocytic populations. Neutrophils were the dominant infected cells following i.d., but not s.c. or i.p., inoculation. Inoculation of the ear dermis resulted in higher frequencies of total and infected neutrophils than inoculation of the footpad, and these higher frequencies were associated with a 10-fold increase in early parasite loads. Following inoculation of the ear in the absence of neutrophils, parasite phagocytosis by other cell types did not increase, and fewer parasites were able to establish infection. The frequency of infected neutrophils within the total infected CD11b+population was higher than the frequency of total neutrophils within the total CD11b+population, demonstrating that neutrophils are overrepresented as a proportion of infected cells. Employing i.d. inoculation to model sand fly transmission of parasites has significant consequences for infection outcome relative to that of s.c. or i.p. inoculation, including the phenotype of infected cells and the number of parasites that establish infection. Vector-borne infections initiated in the dermis likely involve adaptations to this unique microenvironment. Bypassing or altering this initial step has significant consequences for infection.
Giardia duodenalis Cathepsin B Proteases Degrade Intestinal Epithelial Interleukin-8 and Attenuate Interleukin-8-Induced Neutrophil Chemotaxis
Authors: Cotton James A. , Bhargava Amol , Ferraz Jose G. , Yates Robin M. , Beck Paul L. , Buret Andre G.
Published: April 2014

Giardia duodenalis(syn.G. intestinalis,G. lamblia) infections are a leading cause of waterborne diarrheal disease that can also result in the development of postinfectious functional gastrointestinal disorders via mechanisms that remain unclear. Parasite numbers exceed 106trophozoites per centimeter of gut at the height of an infection. Yet the intestinal mucosa ofG. duodenalis-infected individuals is devoid of signs of overt inflammation.G. duodenalisinfections can also occur concurrently with infections with other proinflammatory gastrointestinal pathogens. Little is known of whether and how this parasite can attenuate host inflammatory responses induced by other proinflammatory stimuli, such as a gastrointestinal pathogen. Identifying hitherto-unrecognized parasitic immunomodulatory pathways, the present studies demonstrated thatG. duodenalistrophozoites attenuate secretion of the potent neutrophil chemoattractant interleukin-8 (CXCL8); these effects were observed in human small intestinal mucosal tissues and from intestinal epithelial monolayers, activated through administration of proinflammatory interleukin-1β orSalmonella entericaserovar Typhimurium. This attenuation is caused by the secretion ofG. duodenaliscathepsin B cysteine proteases that degrade CXCL8 posttranscriptionally. Furthermore, the degradation of CXCL8 viaG. duodenaliscathepsin B cysteine proteases attenuates CXCL8-induced chemotaxis of human neutrophils. Taken together, these data demonstrate for the first time thatG. duodenalistrophozoite cathepsins are capable of attenuating a component of their host's proinflammatory response induced by a separate proinflammatory stimulus.
Lumbar hernia: a diagnostic dilemma
Authors: Ahmed Syed Tausif , Ranjan Rajeeva , Saha Subhendu Bikas , Singh Balbodh
Published: April 2014

Lumbar hernia is one of the rare cases that most surgeons are not exposed to. Hence the diagnosis can be easily missed. This leads to delay in the treatment causing increased morbidity. We report a case of lumbar hernia in a middle-aged woman. It was misdiagnosed as lipoma by another surgeon. It was a case of primary acquired lumbar hernia in the superior lumbar triangle. Clinical and MRI findings were correlated to reach the diagnosis. We also highlight the types, the process of diagnosis and the surgical repair of lumbar hernias. We wish to alert our fellow surgeons to keep the differential diagnosis of the lumbar hernia in mind before diagnosing any lumbar swelling as lipoma.
Associations between primary healthcare and unplanned medical admissions in Norway: a multilevel analysis of the entire elderly population
Authors: Deraas Trygve S , Berntsen Gro R , Jones Andy P , Førde Olav H , Sund Erik R
Published: April 2014

Objective

To examine if individual risk of unplanned medical admissions (UMAs) was associated with municipality general practitioner (GP) or long-term care (LTC) volume among the entire Norwegian elderly population.

Design

Cross-sectional population-based study.

Setting

428 of 430 Norwegian municipalities in 2009.

Participants

All Norwegians aged ≥65 years (n=721 915; 56% women—15% of the total population).

Main outcome measure

Individual risk of UMA.

Results

Using a multilevel analytical framework, consisting of individuals (N=722 464) nested within municipalities (N=428), nested within local hospital areas (N=52) we found no association between municipality GP or LTC volume and UMAs. However, we found that higher LTC levels of provision were associated with fewer hospitalisations among the older age groups. A modest geographical variability was observed for UMA in adjusted analysis.

Conclusions

A higher primary healthcare volume was only associated with fewer UMAs among the oldest old in a universally accessible healthcare system.
Collaborative care for comorbid depression and diabetes: a systematic review and meta-analysis
Authors: Atlantis Evan , Fahey Paul , Foster Jann
Published: April 2014

Objective

The collaborative care model is recommended for depression in adults with a chronic physical health problem like diabetes. We sought to systematically assess the effect of collaborative care on depression and glycaemia in adults with comorbid depression and diabetes to inform guidelines and practice.

Design

Systematic review and meta-analysis.

Data sources

We searched PubMed, Scopus, Cochrane Library, CINAHL, Health Source Nursing, MEDLINE, PsychINFO and reference lists of retrieved articles published before August 2013.

Inclusion criteria

Randomised controlled trials (RCTs) on collaborative care (ie, coordinated multidisciplinary model of care) for depression that reported the effects on depression and glycaemic outcomes in adults with comorbid clinically relevant depression and diabetes were eligible.

Data extraction and analysis

Data on the mean difference in depression and glycaemic outcomes were extracted and pooled using random effects meta-analysis.

Results

Seven RCTs included for review reported effects on depression outcomes in 1895 participants, and glycated haemoglobin (HbA1c) level in 1556 participants. Collaborative care significantly improved the depression score (standardised mean difference was −0.32 (95% CI −0.53 to −0.11); I2=79%) and HbA1c level (weighted mean difference was −0.33% (95% CI −0.66% to −0.00%); I2=72.9%) compared with control conditions. Depression remission did not predict better glycaemic control across studies.

Conclusions

Limited evidence from short-to-medium term RCTs predominantly conducted in the USA suggests that collaborative care for depression significantly improves both depression and glycaemia outcomes, independently, in people with comorbid depression and diabetes.
Computerised provider order entry combined with clinical decision support systems to improve medication safety: a narrative review
Authors: Ranji Sumant R , Rennke Stephanie , Wachter Robert M
Published: April 2014

Background

Adverse drug events (ADEs) are a major cause of morbidity in hospitalised and ambulatory patients. Computerised provider order entry (CPOE) combined with clinical decision support systems (CDSS) are being widely implemented with the goal of preventing ADEs, but the effectiveness of these systems remains unclear.

Methods

We searched the specialised database Agency for Healthcare Research and Quality (AHRQ) Patient Safety Net to identify reviews of the effect of CPOE combined with CDSS on ADE rates in inpatient and outpatient settings. We included systematic and narrative reviews published since 2008 and controlled clinical trials published since 2012.

Results

We included five systematic reviews, one narrative review and two controlled trials. The existing literature consists mostly of studies of homegrown systems conducted in the inpatient setting. CPOE+CDSS was consistently reported to reduce prescribing errors, but does not appear to prevent clinical ADEs in either the inpatient or outpatient setting. Implementation of CPOE+CDSS profoundly changes staff workflow, and often leads to unintended consequences and new safety issues (such as alert fatigue) which limit the system's safety effects.

Conclusions

CPOE+CDSS does not appear to reliably prevent clinical ADEs. Despite more widespread implementation over the past decade, it remains a work in progress.
Republished: Non-alcoholic fatty liver disease: non-invasive investigation and risk stratification
Authors: Dyson J K , McPherson S , Anstee Q M
Published: April 2014

Non-alcoholic fatty liver disease (NAFLD) encompasses a histological spectrum of liver disease, from simple steatosis through to cirrhosis. As the worldwide rates of obesity have increased, NAFLD has become the commonest cause of liver disease in many developed countries, affecting up to a third of the population. The majority of patients have simple steatosis that carries a relatively benign prognosis. However, a significant minority have non-alcoholic steatohepatitis, and have increased liver related and cardiovascular mortality. Identifying those at risk of progressive disease is crucial. Liver biopsy remains the gold standard investigation for assessing stage of disease but its invasive nature makes it impractical for widespread use as a prognostic tool. Non-invasive tools for diagnosis and disease staging are required, reserving liver biopsy for those patients where it offers clinically relevant additional information. This review discusses the non-invasive modalities available for assessing steatosis, steatohepatitis and fibrosis. We propose a pragmatic approach for the assessment of patients with NAFLD to identify those at high risk of progressive disease who require referral to specialist services.
PLATFORM LEADERSHIP OF INCUMBENT TELECOMMUNICATIONS OPERATORS: THE CASE OF BT 21ST CENTURY NETWORK (BT21CN)
Authors: SATO CARLOS EDUARDO YAMASAKI
Published: April 2014

This paper addresses the problem of survival and growth of incumbent telecommunication operators. In particular, this paper investigates the extent to which the platform-based approach is appropriate for the internationalisation strategy (platform leadership) of incumbent telecommunications operators in the context of the transition to the Next Generation Network (NGN). It examines the case of BT in the UK, as a large-scale first mover in this transition, exploring the major transformation project BT 21st Century Network (BT21CN). The case demonstrates how the platform-based approach can be used to promote business transformation of an incumbent telecom operator in a turbulent environment. The platform architecture integrates two main features that are usually treated in different contexts and time frames in the literature: (i) the reusability of components and sub-systems (typically in the automotive industry); and (ii) the openness of the platform to external actors in order to drive innovation in the industry (typically in the ICT industry). BT21CN emerged as an industry platform, made possible by the maturation of the Internet Protocol (IP) as a "common technology" able to transport not only data, but also real time voice and video, with an acceptable quality of service (QoS). Reusability can help reducing costs and decreasing time-to-market for new products and services. However, openness of the platform to external actors has still limited impact due to the limited success of BT (and incumbent telecom operators in general) in their process of internationalisation. Thus, in the context of BT (and of potentially other incumbent telecom operators), the limitations in their process of internationalisation have a negative impact on the evolutionary dynamics of the platform-based approach.
ORGANOMETAL HALIDE PEROVSKITE PHOTOVOLTAICS: A DIAMOND IN THE ROUGH
Authors: GRÄTZEL MICHAEL , PARK NAM-GYU
Published: April 2014

The sun finds a diamond in the rough, which is the organo-metal halide perovskite. Thanks to exceptional optoelectronic characteristics, solar cells employing perovskite demonstrated first a power conversion efficiency (PCE) of 9.7% in the middle of 2012, which rose steeply to an amazing 16% at the end of 2013. Perovskite-based photovoltaics have several advantages over conventional semiconductor p-n junction devices because high efficiency can be achieved from sub-micrometer-thick very cheap perovskite layers that can be formed by solution processing at temperatures below 150°C, rendering the perovskite solar cell versatile in its application. If photo- and thermal stability as well as tolerance to humidity can be achieved, commercial application on the large scale appear to be feasible.
WATER-IMMERSION DEEP-SUBWAVELENGTH SURFACE PLASMON VIRTUAL PROBES
Authors: WANG QIAN , WEI SHIBIAO , YUAN GUANGHUI , YUAN XIAO-CONG
Published: April 2014

In this paper, we report the observation of surface plasmon virtual probes in water by using near-field scanning optical microscope. The full-width half-maximum of the probe is as small as λ0/5.5. Such deep-subwavelength sized plasmonic virtual probe may lead to many potential applications, such as super-resolution fluorescence optical imaging and optical manipulation.
Connecting with oceans using underwater acoustic networks
Authors: Zuba Michael
Published: April 2014

Oceans cover a majority of our planet and are currently lacking in regards to exploration and technological innovations. One technology that can help enable more aquatic applications is underwater acoustic networks (UANs). This article discusses the current status of UANs, the new applications that can be provided, and the challenges faced by this technology.
A high-speed, real-time mobile gait rehabilitation system
Authors: Zhang Wenlong , Wei Yi-Hung , Leng Quan , Han Song
Published: April 2014

Combining advanced technologies in real-time wireless communication, control theory, sensor and actuator design, and rehabilitation science.
Painting-to-3D model alignment via discriminative visual elements
Authors: Aubry Mathieu , Russell Bryan C. , Sivic Josef
Published: April 2014

This article describes a technique that can reliably align arbitrary 2D depictions of an architectural site, including drawings, paintings, and historical photographs, with a 3D model of the site. This is a tremendously difficult task, as the appearance and scene structure in the 2D depictions can be very different from the appearance and geometry of the 3D model, for example, due to the specific rendering style, drawing error, age, lighting, or change of seasons. In addition, we face a hard search problem: the number of possible alignments of the painting to a large 3D model, such as a partial reconstruction of a city, is huge. To address these issues, we develop a new compact representation of complex 3D scenes. The 3D model of the scene is represented by a small set of
discriminative visual elements
that are automatically learned from rendered views. Similar to object detection, the set of visual elements, as well as the weights of individual features for each element, are learned in a discriminative fashion. We show that the learned visual elements are reliably matched in 2D depictions of the scene despite large variations in rendering style (e.g., watercolor, sketch, historical photograph) and structural changes (e.g., missing scene parts, large occluders) of the scene. We demonstrate an application of the proposed approach to automatic rephotography to find an approximate viewpoint of historical paintings and photographs with respect to a 3D model of the site. The proposed alignment procedure is validated via a human user study on a new database of paintings and sketches spanning several sites. The results demonstrate that our algorithm produces significantly better alignments than several baseline methods.
Ink-and-ray
Authors: Sýkora Daniel , Kavan Ladislav , Čadík Martin , Jamriška Ondřej , Jacobson Alec , Whited Brian , Simmons Maryann , Sorkine-Hornung Olga
Published: April 2014

We present a new approach for generating global illumination renderings of hand-drawn characters using only a small set of simple annotations. Our system exploits the concept of bas-relief sculptures, making it possible to generate 3D proxies suitable for rendering without requiring side-views or extensive user input. We formulate an optimization process that automatically constructs approximate geometry sufficient to evoke the impression of a consistent 3D shape. The resulting renders provide the richer stylization capabilities of 3D global illumination while still retaining the 2D hand-drawn look-and-feel. We demonstrate our approach on a varied set of hand-drawn images and animations, showing that even in comparison to ground-truth renderings of full 3D objects, our bas-relief approximation is able to produce convincing global illumination effects, including self-shadowing, glossy reflections, and diffuse color bleeding.
Geometrical Variable Weights Buffer GM(1,1) Model and Its Application in Forecasting of China’s Energy Consumption
Authors: Li Wei , Xie Han
Published: April 2014

In order to improve the application area and the prediction accuracy of GM(1,1) model, a novel Grey model is proposed in this paper. To remedy the defects about the applications of traditional Grey model and buffer operators in medium- and long-term forecasting, a Variable Weights Buffer Grey model is proposed. The proposed model integrates the variable weights buffer operator with the background value optimized GM(1,1) model to implement dynamic preprocessing of original data. Taking the maximum degree of Grey incidence between fitting value and actual value as objective function, then the optimal buffer factor is chosen, which can improve forecasting precision, make forecasting results embodying the internal trend of original data to the maximum extent, and improve the stability of the prediction. To verify the effectiveness of the proposed model, the energy consumption in China from 2002 to 2009 is used for the modeling to forecast the energy consumption in China from 2010 to 2020, and the forecasting results prove that the GVGM(1,1) model has remarkably improved the forecasting ability of medium- and long-term energy consumption in China.