bluuebunny/crossref_metadata_2025 huggingface dataset:
Integrated dual-cycle energy recovery using thermoelectric conversion and an organic Rankine bottoming cycle
Authors: Miller E W , Hendricks T J , Wang H , Peterson R B
Published: May 2011

Hot engine exhaust represents a resource that is often rejected to the environment without further utilization. This resource is most prevalent in the transportation sector, but stationary engine—generator systems also typically do not utilize this resource. Engine exhaust is considered high-grade heat and can potentially be utilized by various approaches to produce electricity or to drive heating and cooling systems. One idea for this application is to combine an organic Rankine cycle and thermoelectric conversion. This approach is being developed to more fully utilize the thermal energy contained in hot exhaust streams. The model developed here is composed of a high-temperature heat exchanger which extracts thermal energy for driving the thermoelectric conversion elements and a closely integrated bottoming cycle to capture the large amount of remaining thermal energy in the exhaust stream. Many interacting parameters that define combined system operation are employed in the model to determine the overall system performance including output power, efficiency, and total energy utilization factors. In addition, the model identifies a maximum power operating point for the combined system. The model can identify the optimal amount of heat to remove from the exhaust flow to drive the thermoelectric elements for maximizing the combined cycle output. The model has been developed such that heat exchanger UAH (heat transfer coefficient multiplied by heat transfer area) values, thermal resistances, and the thermoelectric figure of merit ( ZT) can be investigated in the context of system operation. The model also has the ability to simultaneously determine the effect of each cycle design parameter on the performance of the overall system, thus giving the ability to utilize as much waste heat as possible. Results of exercising the model give system performance and inter-relationships between various design parameters as they affect overall performance.
A simple process modelling for a dry-feeding entrained bed coal gasifier
Authors: Lee H , Choi S , Paek M
Published: May 2011

A dry-feeding entrained bed coal gasifier was numerically modelled by simultaneously solving the rate equations for chemical reactions of the solid and gas phases. This model describes simplified physical and chemical processes in the entrained bed coal gasifier. Chemical reaction processes for coal gasification and combustion are considered along with the simplified gas flow passage in the reactor, so that progress of reactions at the designated spatial location is represented. Gasification phenomena of coal particles were separated into devolatilization, gas-phase, and solid-phase reactions. Coal gasifier geometry was simplified to a pseudo-two-dimensional (pseudo-2D) reactor model based on the 1D plug flow concept. The dimension in the pseudo-2D model was conceptually divided by considering the recirculation effect. As a result, carbon conversion, cold gas efficiency, and temperature distribution were obtained at variable oxygen to coal mass ratio, steam to coal mass ratio, and operating pressure. Operating conditions could be appropriately controlled by knowing the degree of reaction in the reactor.
Component-level fault diagnostics of a bevel gear using a wavelet packet transform
Authors: Hong Y-S , Ahn S-H , Song C-K , Cho Y-M
Published: May 2011

This article presents a novel diagnostic algorithm based on wavelet packet transform. Although existing fault diagnostic techniques may detect the occurrence of failure or excessive malfunction in a system, they rarely reveal such detailed information as fault position, not to mention their reduced effectiveness in a system whose fault feature is not so pronounced. The proposed algorithm takes advantage of time—frequency localized features of wavelet packets in order to classify the system condition and pinpoint the fault position. Fisher's linear discriminant is used to classify system conditions, all the wavelet packets are exhaustively searched in order to unravel the optimal base (or packet) that discriminates different system conditions based on the Fisher value. It is the time—frequency localized feature of the wavelet packet that further makes it possible to detect fault position and even faulty component in the bevel gear. The proposed algorithm is validated using a machine fault simulator that consists of a motor, a bevel gear, and a bearing, where the condition of the bevel gear may be varied to simulate normal, cracked, and broken conditions using vibration signal. It turns out that the proposed algorithm precisely locates fault position as well as identifies system conditions.
Profiling the venom gland transcriptomes of Costa Rican snakes by 454 pyrosequencing
Authors: Durban Jordi , Juárez Paula , Angulo Yamileth , Lomonte Bruno , Flores-Diaz Marietta , Alape-Girón Alberto , Sasa Mahmood , Sanz Libia , Gutiérrez José M , Dopazo Joaquín , Conesa Ana , Calvete Juan J
Published: May 2011

Background

A long term research goal of venomics, of applied importance for improving current antivenom therapy, but also for drug discovery, is to understand the pharmacological potential of venoms. Individually or combined, proteomic and transcriptomic studies have demonstrated their feasibility to explore in depth the molecular diversity of venoms. In the absence of genome sequence, transcriptomes represent also valuable searchable databases for proteomic projects.

Results

The venom gland transcriptomes of 8 Costa Rican taxa from 5 genera (Crotalus, Bothrops, Atropoides, Cerrophidion, and Bothriechis) of pitvipers were investigated using high-throughput 454 pyrosequencing. 100,394 out of 330,010 masked reads produced significant hits in the available databases. 5.165,220 nucleotides (8.27%) were masked by RepeatMasker, the vast majority of which corresponding to class I (retroelements) and class II (DNA transposons) mobile elements. BLAST hits included 79,991 matches to entries of the taxonomic suborder Serpentes, of which 62,433 displayed similarity to documented venom proteins. Strong discrepancies between the transcriptome-computed and the proteome-gathered toxin compositions were obvious at first sight. Although the reasons underlaying this discrepancy are elusive, since no clear trend within or between species is apparent, the data indicate that individual mRNA species may be translationally controlled in a species-dependent manner. The minimum number of genes from each toxin family transcribed into the venom gland transcriptome of each species was calculated from multiple alignments of reads matched to a full-length reference sequence of each toxin family. Reads encoding ORF regions of Kazal-type inhibitor-like proteins were uniquely found in Bothriechis schlegelii and B. lateralis transcriptomes, suggesting a genus-specific recruitment event during the early-Middle Miocene. A transcriptome-based cladogram supports the large divergence between A. mexicanus and A. picadoi, and a closer kinship between A. mexicanus and C. godmani.

Conclusions

Our comparative next-generation sequencing (NGS) analysis reveals taxon-specific trends governing the formulation of the venom arsenal. Knowledge of the venom proteome provides hints on the translation efficiency of toxin-coding transcripts, contributing thereby to a more accurate interpretation of the transcriptome. The application of NGS to the analysis of snake venom transcriptomes, may represent the tool for opening the door to systems venomics.
Novel transposable elements from Anopheles gambiae
Authors: Fernández-Medina Rita D , Struchiner Cláudio J , Ribeiro José MC
Published: May 2011

Background

Transposable elements (TEs) are DNA sequences, present in the genome of most eukaryotic organisms that hold the key characteristic of being able to mobilize and increase their copy number within chromosomes. These elements are important for eukaryotic genome structure and evolution and lately have been considered as potential drivers for introducing transgenes into pathogen-transmitting insects as a means to control vector-borne diseases. The aim of this work was to catalog the diversity and abundance of TEs within the Anopheles gambiae genome using the PILER tool and to consolidate a database in the form of a hyperlinked spreadsheet containing detailed and readily available information about the TEs present in the genome of An. gambiae.

Results

Here we present the spreadsheet named AnoTExcel that constitutes a database with detailed information on most of the repetitive elements present in the genome of the mosquito. Despite previous work on this topic, our approach permitted the identification and characterization both of previously described and novel TEs that are further described in detailed.

Conclusions

Identification and characterization of TEs in a given genome is important as a way to understand the diversity and evolution of the whole set of TEs present in a given species. This work contributes to a better understanding of the landscape of TEs present in the mosquito genome. It also presents a novel platform for the identification, analysis, and characterization of TEs on sequenced genomes.
Alternative splicing of the human gene SYBL1 modulates protein domain architecture of longin VAMP7/TI-VAMP, showing both non-SNARE and synaptobrevin-like isoforms
Authors: Vacca Marcella , Albania Lara , Ragione Floriana Della , Carpi Andrea , Rossi Valeria , Strazzullo Maria , De Franceschi Nicola , Rossetto Ornella , Filippini Francesco , D'Esposito Maurizio
Published: May 2011

Background

The control of intracellular vesicle trafficking is an ideal target to weigh the role of alternative splicing in shaping genomes to make cells. Alternative splicing has been reported for several SolubleN-ethylmaleimide-sensitive factor Attachment protein REceptors of the vesicle (v-SNAREs) or of the target membrane (t-SNARES), which are crucial to intracellular membrane fusion and protein and lipid traffic in Eukaryotes. However, splicing has not yet been investigated in Longins, i.e. the most widespread v-SNAREs. Longins are essential in Eukaryotes and prototyped by VAMP7, Sec22b and Ykt6, sharing a conserved N-terminal Longin domain which regulates membrane fusion and subcellular targeting. Human VAMP7/TI-VAMP, encoded by gene SYBL1, is involved in multiple cell pathways, including control of neurite outgrowth.

Results

Alternative splicing of SYBL1 by exon skipping events results in the production of a number of VAMP7 isoforms. In-frame or frameshift coding sequence modifications modulate domain architecture of VAMP7 isoforms, which can lack whole domains or domain fragments and show variant or extra domains. Intriguingly, two main types of VAMP7 isoforms either share the inhibitory Longin domain and lack the fusion-promoting SNARE motif, or vice versa. Expression analysis in different tissues and cell lines, quantitative real time RT-PCR and confocal microscopy analysis of fluorescent protein-tagged isoforms demonstrate that VAMP7 variants have different tissue specificities and subcellular localizations. Moreover, design and use of isoform-specific antibodies provided preliminary evidence for the existence of splice variants at the protein level.

Conclusions

Previous evidence on VAMP7 suggests inhibitory functions for the Longin domain and fusion/growth promoting activity for the Δ-longin molecule. Thus, non-SNARE isoforms with Longin domain and non-longin SNARE isoforms might have somehow opposite regulatory functions. When considering splice variants as "natural mutants", evidence on modulation of subcellular localization by variation in domain combination can shed further light on targeting determinants. Although further work will be needed to characterize identified variants, our data might open the route to unravel novel molecular partners and mechanisms, accounting for the multiplicity of functions carried out by the different members of the Longin proteins family.
Altered expression of microRNA in the airway wall in chronic asthma: miR-126 as a potential therapeutic target
Authors: Collison Adam , Herbert Cristan , Siegle Jessica S , Mattes Joerg , Foster Paul S , Kumar Rakesh K
Published: May 2011

Background

The role of microRNAs (miRNAs) in regulating gene expression is currently an area of intense interest. Relatively little is known, however, about the role of miRNAs in inflammatory and immunologically-driven disorders. In a mouse model, we have previously shown that miRNAs are potentially important therapeutic targets in allergic asthma, because inhibition of miR-126, one of a small subset of miRNAs upregulated in the airway wall, effectively suppressed Th2-driven airway inflammation and other features of asthma. In the present study, we extended investigation of the therapeutic potential of miRNA inhibition to our well-established model of chronic asthma.

Methods

Female BALB/c mice were systemically sensitised with ovalbumin (OVA) and chronically challenged with low mass concentrations of aerosolised OVA for up to 6 weeks. Airway tissue was obtained by blunt dissection and RNA was isolated for miRNA profiling. On the basis of the results obtained, animals were subsequently treated with either an antagomir to miR-126 (ant-miR-126) or a scrambled control antagomir once weekly during the 6 weeks of chronic challenge, and the effects on airway inflammation and remodelling were assessed using established morphometric techniques.

Results

Compared to naïve mice, there was selective upregulation of a modest number of miRNAs, notably miR-126, in the airway wall tissue of chronically challenged animals. The relative increase was maximal after 2 weeks of inhalational challenge and subsequently declined to baseline levels. Compared to treatment with the scrambled control, ant-miR-126 significantly reduced recruitment of intraepithelial eosinophils, but had no effect on the chronic inflammatory response, or on changes of airway remodelling.

Conclusions

In this model of chronic asthma, there was an initial increase in expression of a small number of miRNAs in the airway wall, notably miR-126. However, this later declined to baseline levels, suggesting that sustained changes in miRNA may not be essential for perpetuation of chronic asthma. Moreover, inhibition of miR-126 by administration of an antagomir suppressed eosinophil recruitment into the airways but had no effect on chronic inflammation in the airway wall, or on changes of remodelling, suggesting that multiple miRNAs are likely to regulate the development of these lesions.
Multi tyrosine kinase inhibitor dasatinib as novel cause of severe pre-capillary pulmonary hypertension?
Authors: Hennigs Jan K , Keller Gunhild , Baumann Hans Jörg , Honecker Friedemann , Kluge Stefan , Bokemeyer Carsten , Brümmendorf Tim H , Klose Hans
Published: May 2011

Background

Pulmonary hypertension (PH) is a life-threatening disease with poor prognosis. Encouraging efforts have been made to target the main vasoproliferative aspects of the disease. Promising emerging therapeutics are tyrosine kinase inhibitors such as imatinib.

Case presentation

Here, we discuss the relevance of previously published cases and add another well-characterised patient who developed pre-capillary PH under long-term therapy with the multi-tyrosine kinase inhibitor dasatinib approved for therapy of chronic myeloic leukaemia (CML) and Philadelphia chromosome positive acute lymphocytic leukaemia (mean time of all patients on dasatinib: 26 months). Hence, we discuss the possibility of dasatinib itself causing PH after long-term therapy and turn specialist's attention to this possible severe side effect.

At present, the true incidence of dasatinib-associated PH remains illusive and systematic data regarding haemodynamics are missing.

Conclusion

We therefore recommend systematic screening of dasatinib-treated patients for pulmonary hypertension and subsequent collection of haemodynamic data.
Screening of soy protein-derived hypotriglyceridemic di-peptides in vitro and in vivo
Authors: Inoue Nao , Nagao Koji , Sakata Kotaro , Yamano Naomi , Gunawardena Pathma Elgoda Ranawakage , Han Seo-Young , Matsui Toshiro , Nakamori Toshihiro , Furuta Hitoshi , Takamatsu Kiyoharu , Yanagita Teruyoshi
Published: May 2011

Background

Soy protein and soy peptides have attracted considerable attention because of their potentially beneficial biological properties, including antihypertensive, anticarcinogenic, and hypolipidemic effects. Although soy protein isolate contains several bioactive peptides that have distinct physiological activities in lipid metabolism, it is not clear which peptide sequences are responsible for the triglyceride (TG)-lowering effects. In the present study, we investigated the effects of soy protein-derived peptides on lipid metabolism, especially TG metabolism, in HepG2 cells and obese Otsuka Long-Evans Tokushima fatty (OLETF) rats.

Results

In the first experiment, we found that soy crude peptide (SCP)-LD3, which was prepared by hydrolyze of soy protein isolate with endo-type protease, showed hypolipidemic effects in HepG2 cells and OLETF rats. In the second experiment, we found that hydrophilic fraction, separated from SCP-LD3 with hydrophobic synthetic absorbent, revealed lipid-lowering effects in HepG2 cells and OLETF rats. In the third experiment, we found that Fraction-C (Frc-C) peptides, fractionated from hydrophilic peptides by gel permeation chromatography-high performance liquid chromatography, significantly reduced TG synthesis and apolipoprotein B (apoB) secretion in HepG2 cells. In the fourth experiment, we found that the fraction with 0.1% trifluoroacetic acid, isolated from Frc-C peptides by octadecylsilyl column chromatography, showed hypolipidemic effects in HepG2 cells. In the final experiment, we found that 3 di-peptides, Lys-Ala, Val-Lys, and Ser-Tyr, reduced TG synthesis, and Ser-Tyr additionally reduced apoB secretion in HepG2 cells.

Conclusion

Novel active peptides with TG-lowering effects from soy protein have been isolated.
Differences and similarities of postprandial lipemia in rodents and humans
Authors: Panzoldo Natalia B , Urban Aline , Parra Eliane S , Oliveira Rogério , Zago Vanessa S , da Silva Lívia R , de Faria Eliana C
Published: May 2011

Background

The rat has been a mainstay of physiological and metabolic research, and more recently mice. This study aimed at characterizing the postprandial triglyceride profile of two members of the Muridae family: the Wistar rats (Rattus norvegicus albinus) and C57BL/6 mice (Mus musculus) plus comparing them to the profile obtained in humans.

Methods

Thirty-one male and twelve female Wistar rats, ten C57BL/6 male and nine female mice received a liquid meal containing fat (17%), protein (4%) and carbohydrates (4%), providing 2 g fat/Kg. Thirty-one men and twenty-nine women received a standardized liquid meal containing fat (25%), dextromaltose (55%), protein (14%), and vitamins and minerals (6%), and providing 40 g of fat per square meter of body surface. Serial blood samples were collected at 2, 4, 6, 8 and 10 h after the ingestion in rats, at 1, 2, 3, 4, 5 and 6 h in mice and in humans at 2, 4, 6 and 8 h. Wilcoxon and Mann-Whitney tests were used.

Results/Discussion

The triglyceride responses were evaluated after the oral fat loads. Fasting and postprandial triglyceridemia were determined sequentially in blood sample. AUC, AUIC, AR, RR and late peaks were determined.

Conclusions

Rats are prone to respond in a pro-atherogenic manner. The responses in mice were closer to the ones in healthy men. This study presents striking differences in postprandial triglycerides patterns between rats and mice not correlated to baseline triglycerides, the animal baseline body weight or fat load in all animal groups.
LiCl induces TNF-α and FasL production, thereby stimulating apoptosis in cancer cells
Authors: Kaufmann Larissa , Marinescu Gabriela , Nazarenko Irina , Thiele Wilko , Oberle Carolin , Sleeman Jonathan , Blattner Christine
Published: May 2011

Background

The incidence of cancer in patients with neurological diseases, who have been treated with LiCl, is below average. LiCl is a well-established inhibitor of Glycogen synthase kinase-3, a kinase that controls several cellular processes, among which is the degradation of the tumour suppressor protein p53. We therefore wondered whether LiCl induces p53-dependent cell death in cancer cell lines and experimental tumours.

Results

Here we show that LiCl induces apoptosis of tumour cells bothin vitroandin vivo. Cell death was accompanied by cleavage of PARP and Caspases-3, -8 and -10. LiCl-induced cell death was not dependent on p53, but was augmented by its presence. Treatment of tumour cells with LiCl strongly increased TNF-α and FasL expression. Inhibition of TNF-α induction using siRNA or inhibition of FasL binding to its receptor by the Nok-1 antibody potently reduced LiCl-dependent cleavage of Caspase-3 and increased cell survival. Treatment of xenografted rats with LiCl strongly reduced tumour growth.

Conclusions

Induction of cell death by LiCl supports the notion that GSK-3 may represent a promising target for cancer therapy. LiCl-induced cell death is largely independent of p53 and mediated by the release of TNF-α and FasL.

Key words: LiCl, TNF-α, FasL, apoptosis, GSK-3, FasL
Mutation of the elongin C binding domain of human respiratory syncytial virus non-structural protein 1 (NS1) results in degradation of NS1 and attenuation of the virus
Authors: Straub Claire P , Lau Wei-Har , Preston Faith M , Headlam Madeleine J , Gorman Jeffery J , Collins Peter L , Spann Kirsten M
Published: May 2011

Background

Human respiratory syncytial virus (RSV) is an important cause of lower respiratory tract disease in the paediatic population, immunocompromised individuals and the elderly worldwide. However, despite global efforts over the past several decades there are no commercially available vaccines. RSV encodes 2 non-structural proteins, NS1 and NS2, that are type I interferon antagonists. RSV restricts type I interferon signaling and the expression of antiviral genes by degrading STAT2. It has been proposed that NS1 binds to elongin C to form a ubiquitin ligase (E3) complex that targets STAT2 for ubiquitination and proteosomal degradation.

Results

Here, we have engineered a live recombinant RSV in which the 3 consensus amino acids of the NS1 elongin C binding domain have been replaced with alanine (NS1F-ELCmut). Mutation of this region of NS1 resulted in attenuation of RSV replication in A549 cells to levels similar to that observed when the NS1 gene is completely deleted (ΔNS1). This mutation also resulted in moderate attenuation in Vero cells. Attenuation was correlated to intracellular degradation of the mutated NS1 protein. Time course analysis showed that mutant NS1 protein accumulated in cytoplasmic bodies that contained the lysosomal marker LAMP1. However lack of cleavage of LC3 suggested that autophagy was not involved. Induction of IFN-β mRNA expression also was observed in association with the degradation of NS1 protein and attenuation of viral growth.

Conclusions

These results indicate that the elongin C binding region of NS1 is crucial for survival of the protein and that disruption of this region results in the degradation of NS1 and restriction of RSV replication.
Recurrence patterns of locally advanced head and neck squamous cell carcinoma after 3D conformal (chemo)-radiotherapy
Authors: Oksuz Didem C , Prestwich Robin J , Carey Brendan , Wilson Stuart , Senocak Mustafa S , Choudhury Ananya , Dyker Karen , Coyle Catherine , Sen Mehmet
Published: May 2011

Background

To establish recurrence patterns among locally advanced head and neck non-nasopharyngeal squamous cell carcinoma (HNSCC) patients treated with radical (chemo-) radiotherapy and to correlate the sites of loco-regional recurrence with radiotherapy doses and target volumes

Method

151 locally advanced HNSCC patients were treated between 2004-2005 using radical three-dimensional conformal radiotherapy. Patients with prior surgery to the primary tumour site were excluded. The sites of locoregional relapses were correlated with radiotherapy plans by the radiologist and a planning dosimetrist.

Results

Median age was 59 years (range:34-89). 35 patients had stage III disease, 116 patients had stage IV A/B. 36 patients were treated with radiotherapy alone, 42 with induction chemotherapy, 63 with induction and concomitant chemoradiotherapy and 10 concomitant chemoradiotherapy. Median follow-up was 38 months (range 3-62). 3-year cause specific survival was 66.8%. 125 of 151 (82.8%) achieved a complete response to treatment. Amongst these 125 there were 20 local-regional recurrence, comprising 8 local, 5 regional and 7 simultaneous local and regional; synchronous distant metastases occurred in 7 of the 20. 9 patients developed distant metastases in the absence of locoregional failure. For the 14 local recurrences with planning data available, 12 were in-field, 1 was marginal, and 1 was out-of-field. Of the 11 regional failures with planning data available, 7 were in-field, 1 was marginal and 3 were out-of-field recurrences.

Conclusion

The majority of failures following non-surgical treatment for locally advanced HNSCC were loco-regional, within the radiotherapy target volume. Improving locoregional control remains a high priority.
Delayed endovascular treatment of descending aorta stent graft collapse in a patient treated for post- traumatic aortic rupture: a case report
Authors: Nano Giovanni , Mazzaccaro Daniela , Malacrida Giovanni , Occhiuto Maria Teresa , Stegher Silvia , Tealdi Domenico G
Published: May 2011

Background

We report a case of delayed endovascular correction of graft collapse occurred after emergent Thoracic Endovascular Aortic Repair (TEVAR) for traumatic aortic isthmus rupture.

Case presentation

In 7th post-operative day after emergent TEVAR for traumatic aortic isthmus rupture (Gore TAG® 28-150), a partial collapse of the endoprosthesis at the descending tract occurred, with no signs of visceral ischemia. Considering patient's clinical conditions, the graft collapse wasn't treated at that time. When general conditions allowed reintervention, the patient refused any new treatment, so he was discharged.

Four months later the patient complainted for severe gluteal and sural claudication, erectile disfunction and abdominal angina; endovascular correction was performed. At 18 months the graft was still patent.

Discussion and Conclusion

Graft collapse after TEVAR is a rare event, which should be detected and treated as soon as possible. Delayed correction of this complication can be lethal due to the risk of visceral ischemia and limbs loss.
Insurance type and sepsis-associated hospitalizations and sepsis-associated mortality among US adults: A retrospective cohort study
Authors: O'Brien James M , Lu Bo , Ali Naeem A , Levine Deborah A , Aberegg Scott K , Lemeshow Stanley
Published: May 2011

Introduction

Socio-demographic and clinical factors associated with increased sepsis risk, including older age, non-white race and specific co-morbidities, are more common among patients with Medicare or Medicaid or no health insurance. We hypothesized that patients with Medicare and/or Medicaid or without health insurance have a higher risk of sepsis-associated hospitalization or sepsis-associated death than those with private health insurance.

Methods

We performed a retrospective cohort study of records from the 2003 Nationwide Inpatient Sample. We stratified the study cohort by Medicare age-qualification (18 to 64 and 65+ years old). We examined the association between insurance category and sepsis diagnosis and death among admissions involving sepsis. We used validated diagnostic codes to determine the presence of sepsis, co-morbidities and organ dysfunction and to provide risk-adjustment.

Results

Among patients 18 to 64 years old, those with Medicaid (adjusted odds ratio (AOR) 1.50), Medicare (AOR 1.96), Medicaid + Medicare (AOR 2.22) and the uninsured (AOR 1.18) had significantly higher risk-adjusted odds of a sepsis-associated admission than those with private insurance (all P < 0.0001). Those with Medicaid (AOR 1.17, P < 0.001) and those without insurance (AOR 1.45, P < 0.001) also had significantly higher adjusted odds of sepsis-associated hospital mortality than those with private insurance. Among those 65+ years old, those with Medicaid (AOR 1.43), Medicare alone (AOR 1.13) or Medicaid + Medicare (AOR 1.62) had significantly higher risk-adjusted odds of sepsis-associated admission than those with private insurance and Medicare (all P < 0.0001). Among sepsis patients 65+, uninsured patients had significantly higher risk-adjusted odds (AOR 1.45, P = 0.0048) and those with Medicare alone had significantly lower risk-adjusted odds (AOR 0.92, P = 0.0072) of hospital mortality than those with private insurance and Medicare. Lack of health insurance remained associated with sepsis-associated mortality after stratification of hospitals into quartiles based on rates of sepsis-associated admissions or mortality in both age strata.

Conclusions

Risks of sepsis-associated hospitalization and sepsis-associated death vary by insurance. These increased risks were not fully explained by the available socio-demographic factors, co-morbidities or hospital rates of sepsis-related admissions or deaths.
Nodal Status and Clinical Outcomes in a Large Cohort of Patients With Triple-Negative Breast Cancer
Authors: Hernandez-Aya Leonel F. , Chavez-MacGregor Mariana , Lei Xiudong , Meric-Bernstam Funda , Buchholz Thomas A. , Hsu Limin , Sahin Aysegul A. , Do Kim-Anh , Valero Vicente , Hortobagyi Gabriel N. , Gonzalez-Angulo Ana Maria
Published: May 2011

Purpose

To evaluate the clinical outcomes and relationship between tumor size, lymph node status, and prognosis in a large cohort of patients with confirmed triple receptor–negative breast cancer (TNBC).

Patients and Methods

We reviewed 1,711 patients with TNBC diagnosed between 1980 and 2009. Patients were categorized by tumor size and nodal status. Kaplan-Meier product limit method was used to calculate overall survival (OS) and relapse-free survival (RFS). A Sidak adjustment was used for multiple group comparisons. Cox proportional hazards models were fit to determine the association of tumor size and nodal status with survival outcomes after adjustment for other patient and disease characteristics.

Results

Median age was 48 years (range, 21 to 87 years). At a median follow-up of 53 months (range, 0.7 to 317 months), there were 614 deaths and 747 recurrences. The 5-year OS was 80% for node-negative patients (N0), 65% for one to three positive lymph nodes (N1), 48% for four to nine positive lymph nodes (N2), and 44% for ≥ 10 positive lymph nodes (N3; P < .0001). The 5-year RFS rates were 67% for N0, 52% for N1, 36% for N2, and 33% for N3 (P < .0001). Pairwise comparison by nodal status showed that when comparing N0 with node-positive disease, there was a significant difference in OS and RFS (P < .001 all comparisons). However, when comparing N1 with N2 and N3 disease regardless of tumor size, there were no significant differences in OS or RFS.

Conclusion

In patients with TNBC, once there is evidence of lymph node metastasis, the prognosis may not be affected by the number of positive lymph nodes.
Strangers to the Mother Tongue: Spenser's Shepheardes Calender and Early Anglo-Saxon Studies
Authors: Crawforth Hannah
Published: May 2011

This essay pays long overdue attention to E.K's glosses of native English words in Edmund Spenser's The Shepheardes Calender (1579). Spenser's practice of using native English words is indebted to the emerging discipline of Anglo-Saxon studies, especially to the methodology of Archbishop Matthew Parker and his scholars, who sought precedents in Anglo-Saxon legal and ecclesiastical sources that would support their progressive agenda to return to the model of the church in the English past rather than seek any new reformation of the contemporary church. Spenser in his poem seeks to show the interrelationship between doctrinal innovation and tradition through an allegorical use of the English language itself. By revealing the strange familiarity existing between Old English and the vernacular that E.K. calls the “mother tonge,” Spenser creates a rhetoric of linguistic estrangement in the Calender. He uses this unfamiliar history to satirical effect in his ecclesiastical eclogues in order to express veiled criticism of the Elizabethan Church.
Restoring eye size in Astyanax mexicanus blind cavefish embryos through modulation of the Shh and Fgf8 forebrain organising centres
Authors: Pottin Karen , Hinaux Hélène , Rétaux Sylvie
Published: May 2011

The cavefish morph of the Mexican tetra (Astyanax mexicanus) is blind at adult stage, although an eye that includes a retina and a lens develops during embryogenesis. There are, however, two major defects in cavefish eye development. One is lens apoptosis, a phenomenon that is indirectly linked to the expansion of ventral midline sonic hedgehog (Shh) expression during gastrulation and that induces eye degeneration. The other is the lack of the ventral quadrant of the retina. Here, we show that such ventralisation is not extended to the entire forebrain because fibroblast growth factor 8 (Fgf8), which is expressed in the forebrain rostral signalling centre, is activated 2 hours earlier in cavefish embryos than in their surface fish counterparts, in response to stronger Shh signalling in cavefish. We also show that neural plate patterning and morphogenesis are modified in cavefish, as assessed by Lhx2 and Lhx9 expression. Inhibition of Fgf receptor signalling in cavefish with SU5402 during gastrulation/early neurulation mimics the typical surface fish phenotype for both Shh and Lhx2/9 gene expression. Fate-mapping experiments show that posterior medial cells of the anterior neural plate, which lack Lhx2 expression in cavefish, contribute to the ventral quadrant of the retina in surface fish, whereas they contribute to the hypothalamus in cavefish. Furthermore, when Lhx2 expression is rescued in cavefish after SU5402 treatment, the ventral quadrant of the retina is also rescued. We propose that increased Shh signalling in cavefish causes earlier Fgf8 expression, a crucial heterochrony that is responsible for Lhx2 expression and retina morphogenesis defect.
Of Medicine, Law and Lawyers – the Expert's view
Authors: Carter Simon St C , Mansell Martin A
Published: May 2011

The world of clinical negligence is facing and will continue to face major upheavals in the delivery of justice. The speciality depends on a heady witch's brew of claimants, doctors, experts, lawyers and judiciary, not to mention the political interests of the legislature, the financial interests of the accountants and, finally and most importantly, the moral interests of society. From our jaded perspective of about 40 years joint experience in the medico-legal skin trade we offer the benefits of our wisdom. In the dark moments late at night, answering difficult questions from lawyers, we do understand that ‘Medical experts are like sewers – what you get out of them depends on what you put into them’ (after Tom Lehrer) but we believe that the ideal instructing lawyer is able to prepare the scene in such a way that we can produce prompt, excellent and clear advice to our legal colleagues. In this article we set out to explore the relationship between medical experts and lawyers by examining the characteristics of the bad lawyer, as it was in the past, is now and might be in the future.
Mechanical Behavior of Aluminum Alloys During Small Punch Test
Authors: Sanders Matthew , Di Bella Frank , Liang Hong
Published: May 2011

Small Punch Tests (SPTs) were conducted in order to determine material properties and understand their mechanical behavior. Equations were derived to calculate the yield strength, ultimate tensile strength, modulus of elasticity, and hardness of five aluminum alloys. A greater understanding of the mechanisms of the SPT and how specimens behave during testing is also discussed. It was found that the 2024-T3 and 7075-T651 aluminum alloys were shown to have the highest maximum small punch force before failure. The relationship between the SPT parameters and the yield strength, tensile strength, elastic modulus, and hardness is shown to be linear. The empirical equation developed here is suitable for aluminum alloys.
Introduction
Authors: Blatt Martin
Published: May 2011

These four essays critique Ken Burns's PBS documentary series The National Parks: America's Best Idea. Burns has over the last several decades established himself as the central producer of PBS multi-part documentaries, addressing such topics as the Civil War, baseball, jazz, and World War II. National Park Service (NPS) leadership recognized the promotional opportunities for the NPS and aligned themselves closely with Burns and PBS. Critical discussion in the essays focuses in three areas: the treatment of Native Americans; the reverential treatment of “nature” in the national parks, and the distorted focus on the natural park in the West as the embodiment of the National Park system.
Psychiatric care in the Brazilian context
Authors: Pinho Leandro Barbosa de , Kantorski Luciane Prado
Published: May 2011

This study seeks to present an updated discussion concerning psychiatric care in Brazil. It is based upon a historical review of psychiatric knowledge and practices within the Brazilian context and knowledge about the phenomenon of madness. It discusses the appearance of modern medical science as an area of knowledge designed for the treatment and comprehension of mental suffering. It also presents a discussion on psychiatric reform, stressing how it is a movement that seeks to redefine the significance of knowledge and practices about the phenomenon of madness, by concentrating on the application of such knowledge and practices in the psychiatric hospital. This paper concludes with a brief critical reflection on prevailing mental healthcare in Brazil, singling out the potential and the difficulties faced within the scope of health policies and the day-to-day working life of professionals of the area.
Saúde mental e ansiedade em agentes comunitários que atuam em saúde da família em Uberlândia (MG, Brasil)
Authors: Resende Marineia Crosara de , Azevedo Erika Guimarães Soares , Lourenço Larissa Ribeiro , Faria Léa de Souza , Alves Natália Fonseca , Farina Natalia Peixoto , Silva Nathália Coutinho da , Oliveira Simone Lopes de
Published: May 2011

Esta pesquisa, realizada com agentes comunitários de saúde (ACS), objetivou: (1) avaliar a saúde mental em ACS; (2) descrever os eventos vitais vivenciados no último ano por ACS; (3) averiguar o nível de ansiedade apresentado por ACS; (4) correlacionar saúde mental, ansiedade e eventos vitais em ACS. Participaram 116 ACS. Instrumentos: questionário sociodemográfico, Questionário de Saúde Geral de Goldberg, Escala de Eventos Vitais, Inventário de Ansiedade Traço-Estado. A maioria dos ACS apresentou grau de ansiedade moderado e saúde mental positiva e relatou ter vivenciado poucos eventos estressantes no último ano, embora a maioria tenha tido problemas de saúde. O fato de estarem presentes níveis de ansiedade, mesmo moderados, sugere uma provável interferência de características específicas da profissão. Entretanto, o fato de a pessoa identificar subjetivamente a ansiedade e classificá-la em um determinado nível pressupõe que esteja usando estratégias de controle, fato esse que auxilia a manter a saúde mental.
The Determinants and Performance Effects of Managers' Performance Evaluation Biases
Authors: Bol Jasmijn C
Published: May 2011

This study examines the determinants and performance effects of centrality bias and leniency bias. The results show that managers respond to their own incentives and preferences when subjectively evaluating performance. Specifically, information-gathering costs and strong employee-manager relationships positively affect centrality bias and leniency bias. The findings also indicate that performance evaluation biases affect not only current performance ratings, but also future employee incentives. Inconsistent with predictions based on the agency perspective, the results show that managers' performance evaluation biases are not necessarily detrimental to compensation contracting. Although centrality bias negatively affects performance improvement, the evidence does not reveal a significant negative relation between leniency bias and performance. Rather, leniency bias is positively associated with future performance, which is consistent with the behavioral argument that bias can improve perceived fairness and, in turn, employee motivation.

Data Availability: Data used in this study cannot be made public due to a confidentiality agreement with the participating firm.
Cost Pool Classification and Judgment Performance
Authors: Mastilak M. Christian
Published: May 2011

Managers must understand relations among costs in order to make decisions. Prior literature assumes managers' use of cost accounting system output is affected by the information coming from the system, but not by the design of the cost system itself. This study examines how the classification of costs into cost pools affects the accuracy of individuals' understanding of relations among costs. I hypothesize that individuals will estimate relations between costs in the same cost pool first and thus more accurately than relations across different pools, because cost pools provide strong cues that meaningful relations are likely to exist within, but not across, pools. I also hypothesize that cost location (within- versus across-pool) has a greater effect on individuals' judgment accuracy when relations among costs are negative than when they are positive. Experimental results are generally consistent with these hypotheses. This experiment shows that cost pool classification choices not only affect the information managers receive, but also their interpretation and use of that information.

Data Availability: Contact the author.
Stent Grafting–Related Acute Type B Redissection
Authors: Riambau Vincent , Guerrero Francisco , Murillo Ivan , Rivadeneira Miguel , Montaña Xavier , Matute Purificación
Published: May 2011

The purpose of this article is to report two distal dissections resulting as a complication of endovascular aneurysm repair (EVAR) in two cases of type B aortic dissection (TBAD) and its relationship with prosthetic alignment at the distal landing zone. Two patients affected by aneurysm formation of a chronic type B dissection underwent EVAR. During postoperative follow-up, at 48 and 39 months, respectively, a new chest pain episode recommended a new computed tomographic angiography examination. New false lumen reperfusion and increased aortic diameter distally to the prosthesis were demonstrated. The distal end of each stent graft showed an angulated alignment to the proximal descending aorta at the point of the secondary entry site. Both patients were successfully treated after deployment of a distal endograft. Prosthetic alignment with the aortic axis is important to avoid wall stress and secondary perforation in patients treated for TBAD. The distal landing point at the descending aortic straight segment is recommended.
Is F 18 Fluorodeoxyglucose Positron Emission Tomography Too Sensitive for the Diagnosis of Vascular Endograft Infection?
Authors: Zimmerman Pamela M. , Cherr Gregory S. , Angelos George C. , Gona Jayakumari , Dosluoglu Hasan H.
Published: May 2011

We report a case of a false positive fluorodeoxyglucose positron emission tomography (FDG-PET) scan in a patient who presented with abdominal pain, and gastrointestinal bleeding accompanied by elevation of inflammatory markers, seven weeks after a proximal type I endoleak repair with a cuff extension. Aortoenteric fistula and endograft infection was ruled out by laparotomy. FDG-PET image may have a role in diagnosis of infection, but false positive results are possible and caution is necessary if other data are non-confirmatory.
Comparative Study of the Management of Diabetic versus Nondiabetic Patients with Atherosclerosis Obliterans of the Lower Extremities
Authors: Mutirangura Pramook , Ruangsetakit Chanean , Wongwanit Chumpol , Sermsathanasawadi Nuttawut , Chinsakchai Khamin
Published: May 2011

The aim of this study was to identify the influence of diabetes mellitus on patients with atherosclerosis obliterans (ASO) of the lower extremities. A prospective study was designed to compare differences between ASO patients with and without diabetes mellitus in regard to clinical characteristics and outcomes of management. Two hundred fifty-three consecutive (61.1%) diabetic and 161 (38.9%) nondiabetic patients were included in this study. Crural artery occlusion occurred more frequently in diabetic patients (tibioperoneal segment 26.5% vs 14.3%; p = .003). Diabetic patients had higher comorbidities, such as ischemic heart disease, disabling stroke, and renal failure. Infection requiring urgent surgical intervention was higher in diabetic patients (39.1% vs 24.2%; p = .001). This required primary major amputation in limb-threatening ischemia superimposed with infection (27.6% vs 17.7%; p = .037). The feasibility (67.2% vs 69.8%; p = .651) and success (74.4% vs 79.0%; p = .481) of revascularization between the two groups were comparable. Diabetic patients often needed more distal revascularization for limb salvage (34.4% vs 18.5%; p = .019). The mortality rate after revascularization was higher in diabetic patients (13.3% vs 2.5%; p = .009). Diabetes mellitus per se has no direct impact on limb salvageability in limb-threatening ischemia. The parity of feasibility and success in revascularization between the two groups should encourage attempts at limb salvage revascularization in diabetic patients.
Underestimation of Carotid Stenosis in Bradycardia
Authors: Ratchford Elizabeth V. , Salameh Maya J. , Morrissey Nicholas J.
Published: May 2011

Bradycardia may lead to an underestimation of carotid stenosis by duplex ultrasonography. An 83-year-old man with asymptomatic bradycardia was referred to our institution after magnetic resonance angiography revealed greater than 90% stenosis of the proximal left internal carotid artery (ICA). Two separate carotid duplex examinations were subsequently performed at different vascular laboratories within our institution. Both studies showed elevated (but borderline for the highest category of stenosis) peak systolic velocities with relatively low end-diastolic velocities (EDVs). Angiography demonstrated more than 90% stenosis of the left ICA. Carotid endarterectomy was then performed. In conclusion, interpreting physicians and vascular ultrasound technologists should be aware of the spurious decrease in EDV that accompanies bradycardia. Further imaging may be warranted when revascularization is a consideration for bradycardic patients with borderline results on carotid duplex ultrasonography.
Superficial Femoral Artery Aneurysm: A Rare Complication of Wegener Granulomatosis
Authors: Luebke Thomas , Aleksic Marko , Brunkwall Jan
Published: May 2011

Wegener granulomatosis (WG) is a systemic disease of unknown etiology characterized by necrotizing granulomatous inflammation, tissue necrosis, and variable degrees of vasculitis, typically in small and medium-sized blood vessels. The classic clinical pattern is a triad involving the upper airways, lungs, and kidneys. However, large vessel aneurysm is an extremely rare finding in WG. We describe a 67-year-old Caucasian male with formerly proven WG who presented with a progressively growing superficial femoral artery aneurysm. Histologic findings revealed necrotizing granulomatous vasculitis involving this artery.