bluuebunny/crossref_metadata_2025 huggingface dataset:
The human polyomaviruses: from orphans and mutants to patchwork family
Authors: Rinaldo Christine Hanssen , Hirsch Hans H.
Published: June 2013

For almost 40 years, polyomavirus JC and BK were the only known human polyomaviruses but in the last 7 years, increased interest and innovative molecular screening techniques have led to the identification of 10 previously unknown polyomaviruses in humans. Two of these, Merkel cell polyomavirus and Trichodysplasia spinulosa polyomavirus, have also been found to cause disease in immunocompromised patients. Seroprevalence studies indicate that human polyomaviruses are transmitted independently of one another in humans and carry different risks of exposure and reexposure throughout life. The potential coexistence of 12 or more different polyomavirus species in the same host and possibly even in the same organ raises the question of potential interactions. Careful review of polyomavirus biology may facilitate new discoveries concerning these formerly underestimated viral agents and their influence on human health.
Desiring more: complicating understandings of sexuality in research processes
Authors: Diprose Gradon , Thomas Amanda C , Rushton Renee
Published: June 2013

Reflexively considering one's position when undertaking research has become commonplace in geographic research and writing. This phenomenon is linked to the increasingly prevalent view that research is a co‐constituted process that involves the participant and researcher both constructing meaning. Yet, curiously, there has been relatively limited discussion around the role that sexual experiences play in the research process. In this article we draw on three experiences to illustrate the complex ways in which unwanted sexual encounters with research participants can affect the research process. Through these stories we show how sexual encounters shaped the research process, unsettled the way we understood and performed our own gendered sexuality, and challenged our understandings of what it means to be ‘good researchers’. We aim to initiate a wider discussion around how we can best prepare emerging researchers for, and support in the wake of, unexpected encounters of desire in the field.
The osseointegration stimulatory effect of macrogeometry‐modified implants: a study in the rabbit
Authors: Chowdhary R. , Jimbo R. , Thomsen C. S. , Carlsson L. , Wennerberg A.
Published: June 2013

Objective

To investigate the bone stimulatory effect of compression forces through histomorphometric analyses of macrothreaded implants with microthreads in between.

Material and methods

Two sets of turned implants with different macrogeometries were prepared. The test group possessed microthreads in between macrothreads, and the control group had macrothreads only. The two‐implant groups were placed in both the femur and the tibiae of 10 rabbits. After 4 weeks, the animals were sacrificed and were subjected to histologic processing and histomorphometry. On the prepared stained sections, the total bone area (BA), new BA and bone‐to‐implant (BIC) were calculated.

Results

The mean new BA% (SD) for the test group in the femur presented significantly higher values compared with the control group, being 32.84 (32.5) ± 6.04 and 27.31 (28.19) ± 5.66, respectively (P = 0.04). There were no differences for the new BA in the tibia or the total BA% for both bone types (P = 0.86, P = 0.131, and P = 0.131, respectively). The mean BIC% (SD) in the femur was 13.66 (11.49) ± 6.86 for the test group and 8.48 (7.92) ± 3.31 for the control group and in the tibia, 11.4 (11.88) ± 4.21 for the test group and 13.91 (12.06) ± 6.07 for the control group, respectively. There was no statistical significance among the groups tested.

Conclusion

The modified implant macrogeometry with microthreads in between promoted effect in the femur. However, no statistical differences could be seen in the tibia, suggesting that the modification may be more effective in bone with poor bone quality, such as in the maxillary bone.
Allergic contact dermatitis from octylisothiazolinone
Authors: Mose Anja P. , Frost Simon , Öhlund Ulf , Andersen Klaus E.
Published: June 2013

Background

Octylisothiazolinone is a biocide that has been reported as a moderate, but rare contact allergen.

Objectives

To investigate the occurrence of octylisothiazolinone contact allergy and allergic contact dermatitis diagnosed and registered in the Allergen Bank at Odense University Hospital during the past 20 years. Octylisothiazolinone has been used for targeted testing only.

Method

All octylisothiazolinone‐patch test results registered in the Allergen Bank between January 1992 and February 2012 were analyzed.

Results

A total of 20 out of 648 patients patch tested with octylisothiazolinone had positive reactions. The majority of the patients (90%) with relevant sensitizations to octylisothiazolinone had been exposed in occupational settings and most patients were painters.

Conclusions

Octylisothiazolinone is a relevant sensitizer.
Ethnicity, medical insurance, and living kidney donation
Authors: Reeves‐Daniel Amber Michelle , Farney Alan C. , Fletcher Alison J. , Assimos Dean , Westcott Carl , Rogers Jeffrey , Stratta Robert J. , Rocco Michael V. , Freedman Barry I.
Published: June 2013

Background

Relationships between race/ethnicity, recipient medical insurance, and living donor kidney transplantation (LKT) are incompletely described.

Methods

Associations between medical insurance and LKT were assessed in 447 recipients at a southeastern US transplant center. Primary and secondary payers were included in the analyses.

Results

A total of 387 deceased donor transplantations and 60 LKTs were performed in 246 (55%) European American (EA), 175 (39.2%) African American (AA), 15 (3.4%) Asian, and 11 (2.5%) Hispanic recipients. Among recipients, 182 (40.8%) were privately insured, 125 (28%) had Medicaid, and the remainder had Medicare, Medicare supplements, or Medicare replacement policies. A higher proportion of patients with private insurance, relative to those without private insurance, received LKT (22% vs. 7.6%, p < 0.0001). Among ethnic groups, LKT with, vs. without, private insurance was 27.5% vs. 12.4% in EAs (p = 0.0028) and 14.3% vs. 0.9% in AAs (p = 0.0005). Medicaid recipients (n = 125) were less likely to receive LKT than those without Medicaid (4.8% vs. 16.8%, p = 0.0003). Among the 69 AA recipients with Medicaid, none received LKT (0 Medicaid vs. 9.5% without Medicaid, p = 0.0065).

Conclusions

Recipient insurance status is associated with LKT, positively with private insurance and negatively with Medicaid. AAs were impacted to a greater extent, potentially contributing to lower rates of LKT.
Do protected areas represent species' optimal climatic conditions? A test usingIberian water beetles
Authors: Sánchez‐Fernández David , Abellán Pedro , Picazo Félix , Millán Andrés , Ribera Ignacio , Lobo Jorge M.
Published: June 2013

Aim

To assess the effectiveness of protected area networks in representing the climatic niche of Iberian water beetle species.

Location

Iberian Peninsula.

Methods

We used distribution data from 133 endemic water beetle species in the Iberian Peninsula. Climatic potential distributions were estimated by applying a multidimensional‐envelope procedure based on climatic data (both current and future) and observed occurrences. Mahalanobis distances were calculated to obtain continuous climatic suitability values within the climatic potential distribution. Two protected area networks were assessed: National Parks (NPs) and Natura 2000 (N2000). The average climatic suitability value for the cells overlapping with protected areas was calculated and compared with the average value of 10,000 random samples from the same number of cells within their entire potential distribution, which allowed to identify species whose climatic niches were optimally or marginally represented.

Results

Fifty‐seven and 104 of the 107 considered taxa were represented with at least one occurrence inNPs andN2000, respectively, and the climatic potential distributions of 93 and all 107 taxa overlapped with NPs and N2000. While the climatic niches of 48 and 38 taxa were marginally represented in NPs and N2000, the climatic niches of only 11 and 29 were optimally represented by these two protected area networks. When predicted future climatic conditions were considered, both the climatic suitability values and the number of species whose potential distribution was represented by protected areas decreased.

Main conclusions

Although the representation of endemic Iberian taxa could be considered adequate, these results show that for most of them the protected networks tend to include areas with climatic conditions close to the species tolerance limit, and the expected climate change only worsened this scenario. Thus, current protected areas cannot be considered to guarantee the long‐term survival of the species considered in this study.
A propensity score matched comparison of different insulin regimens 1 year after beginning insulin in people with type 2 diabetes
Authors: Freemantle N. , Balkau B. , Home P. D.
Published: June 2013

Aim

To compare using propensity score analysis the outcome of beginning insulin therapy with basal, premix, mealtime + basal or mealtime insulin on the basis of data from 3031 people from the observational CREDIT (Cardiovascular Risk Evaluation in People with Type 2 Diabetes on Insulin Therapy) study. This approach overcomes likely confounding in baseline and unknown characteristics common to observational studies.

Methods

Efficacy and safety outcomes were collected at baseline and at 1 year in previously insulin‐naïve people. Propensity score matched groups using all available baseline data were defined to compare outcomes by pairs of insulin regimens.

Results

From 2659 people with available data, propensity score matches were achieved for 686 people starting premix or basal insulin, 542 starting basal + mealtime or premix insulin and 400 starting basal or basal + mealtime. HbA1c reduction did not differ between the three pairs of insulin regimens. However, the relative risk of overall and nocturnal hypoglycaemia was lower (p = 0.010 to p < 0.001) with basal or basal + mealtime compared with premix insulin, and for nocturnal (p = 0.021) but not overall hypoglycaemia for basal compared to basal + mealtime insulin. Body weight increase was less for basal versus premix insulin [–1.3 (95% CI –2.1, –0.6) kg, p < 0.001] or versus basal + mealtime insulin [–1.4 (–2.5, –0.3) kg, p = 0.016], but did not differ between basal + mealtime and premix. Smaller groups matching mealtime insulin had some residual mismatching of HbA1c.

Conclusion

Comparing insulin regimens between individuals matched by propensity scores indicated differences in hypoglycaemia and body weight change, despite similar HbA1c reductions. Our findings are consistent with those from randomized controlled trials.
Characteristics of global potential natural vegetation distribution from 1911 to 2000 based on comprehensive sequential classification system approach
Authors: Feng Qisheng , Liang Tiangang , Huang Xiaodong , Lin Huilong , Xie Hongjie , Ren Jizhou
Published: June 2013

Bioclimatology based vegetation classification models play an important role in the response of terrestrial ecosystems to global climate change. In this paper, three periods (1911–1940, 1941–1970 and 1971–2000) of Potential Natural Vegetation (PNV) maps were created based on the CSCS (Comprehensive Sequential Classification System) model and the CRU_TS 2.1 datasets. A model of the mean center was used to calculate the shift distance and direction for each broad vegetation category during the three periods. Results indicate that: (i) the area of tundra and alpine steppe and desert decreased by 5.1 and 5.5%, while the area of forest and grassland increased by 2.3 and 3.8% from 1911 to 2000 at global scale, respectively. However, there was a significant difference in the magnitude of area change in northern and southern hemispheres. And (ii) the tundra and alpine steppe, semi‐desert, savanna, temperate forest and subtropical forest shifted towards the poles; the frigid desert and temperate humid grassland shifted towards the equator, while the warm desert shifted towards southwest, the tropical forest shifted towards southwest in the northern hemisphere and southeast in the southern hemisphere, and the steppe shifted towards northeast in the northern hemisphere and northwest in the southern hemisphere. The shift distance of the warm desert in the southern hemisphere was the largest among the 10 broad vegetation categories.
Modifiable variables affecting interdialytic weight gain include dialysis time, frequency, and dialysate sodium
Authors: Thomson Benjamin K. A. , Dixon Stephanie N. , Huang Shi‐Han S. , Leitch Rosemary E. , Suri Rita S. , Chan Christopher T. , Lindsay Robert M.
Published: June 2013

Interdialytic weight gain (IDWG) is associated with hypertension, left ventricular hypertrophy, and all‐cause mortality. Dialysate sodium concentration may cause diffusion gradients with plasma sodium and influence subsequent IDWG. Dialysis time and frequency may also influence the outcomes of this Na+ gradient; these have been overlooked. Our objective was to identify modifiable factors influencing IDWG. We performed a retrospective multivariable regression analyses of data from 86 home hemodialysis patients treated by hemodialysis modalities differing in frequency and session duration to determine factors involved that predict IDWG. Age, diabetic status, and residual renal function did not correlate with IDWG in the univariable analysis. However, using a combination of backwards selection and Akaike information criterion to build our model, we created an equation that predicted IDWG on the basis of serum albumin, age, patient sex, dialysis frequency, and the diffusive balance of sodium, represented by the product of the duration of dialysis and the patient plasma to dialysate Na+ gradient. This equation was internally validated using bootstrapping, and externally validated in a temporally distinct patient population. We have created an equation to predict IDWG on the basis of independent factors readily available before a dialysis session. The modifiable factors include dialysis time and frequency, and dialysate sodium. Patient sex, age, and serum albumin are also correlated with IDWG. Further work is required to establish how improvements in IDWG influence cardiovascular and other clinical outcomes.
Preparing the future nurses for nursing research: A creative teaching strategy for RN‐to‐BSN students
Authors: Tsai Hsiu‐Min , Cheng Ching‐Yu , Chang Chia‐Hao , Liou Shwu‐Ru
Published: June 2013

Developing effective teaching strategies to stimulate students' interest and enthusiasm are urgently needed in current research courses. The purposes of the study were to implement the Cookie Experiments teaching strategy in research course and examine the effects of the strategy on students' attitudes towards nursing research. The study was a pretest–post‐test design with 95 students at a Registered Nurses to Bachelor of Science in Nursing (RN‐to‐BSN) program enrolled in the nursing research course. Results indicated that there was a significant effect of the Cookie Experiments teaching strategy on students' attitudes towards research. Although students perceived a median high score of pressure from the research course, they regarded that the pressure is conducive to their learning of research. Students highly suggested to continuously applying this teaching strategy in the future nursing research courses. Developing and using various teaching strategies with attractive and hands‐on methods to motivate nurse students, learning research is strongly recommended.
The role of gap junction proteins in the development of neural network functional topology
Authors: Anava S. , Saad Y. , Ayali A.
Published: June 2013

Gap junctions (GJs) provide a common form of intercellular communication in most animal cells and tissues, from Hydra to human, including electrical synaptic signalling. Cell coupling via GJs has an important role in development in general, and in neural network development in particular. However, quantitative studies monitoring GJ proteins throughout nervous system development are few. Direct investigations demonstrating a role for GJ proteins by way of experimental manipulation of their expression are also rare. In the current work we focused on the role of invertebrate GJ proteins (innexins) in the in vitro development of neural network functional topology, using two‐dimensional neural culture preparations derived from the frontal ganglion of the desert locust, Schistocerca gregaria. Immunocytochemistry and quantitative real‐time PCR revealed a dynamic expression pattern of the innexins during development of the cultured networks. Changes were observed both in the levels and in the localization of expression. Down‐regulating the expression of innexins, by using double‐strand RNA for the first time in locust neural cultures, induced clear changes in network morphology, as well as inhibition of synaptogenesis, thus suggesting a role for GJs during the development of the functional topology of neuronal networks.
Reciprocal Loyalty and Union Mediation
Authors: Panos Georgios A. , Theodossiou Ioannis
Published: June 2013

This study investigates the concept of loyalty in the employment relationship using a stated preference approach and a dataset obtained through purpose‐built questionnaires. Reciprocal loyalty is defined as a gift exchange. Workers' good performance is rewarded by the employer by the provision of a job with a low likelihood of job loss. The study shows that such reciprocal employer–employee loyalty is highly rated by the workers as a desirable job attribute. Loyalty in the employer–employee relationship is differently valued by unionized and nonunionized workers. Overall, the evidence suggests that unionized workers are more receptive to arrangements involving reciprocal loyalty. This may be an outcome of adaptation to internalized norms of union behavior.
Labor Law and Reaching a First Collective Agreement: Evidence From a Quasi‐Experimental Set of Reforms in Ontario
Authors: Riddell Chris
Published: June 2013

This paper examines the effects of a major labor law reform package in the Canadian province of Ontario on the negotiation of first agreements for newly certified bargaining units using a quasi‐experimental research design. The findings indicate that first contract success rates were 8–14 percentage points higher under the regime that included automatic first contract arbitration relative to the comparison regime of “no‐fault” first contract arbitration, despite imposition rates being only 2–4 percentage points higher. Further, in the more hostile‐to‐labor regime, only 38 percent of petitions ultimately reached a first agreement despite the presence of quick‐votes, and “no‐fault” first contract arbitration.
Pediatric case of mesalazine‐induced interstitial nephritis with literature review
Authors: Co Maridine L. , Gorospe Emmanuel C.
Published: June 2013

We present the case of a 14‐year‐old boy with ulcerative colitis who was diagnosed with mesalazine‐induced interstitial nephritis (M‐IIN). Improvement in renal function occurred with discontinuation of mesalazine and corticosteroid therapy. We systematically searched the literature for pediatric cases of M‐IIN. There were eight cases. Majority of the cases were boys (75%) with ulcerative colitis (75%). Average duration of mesalazine use prior to the diagnosis of interstitial nephritis was 24 ± 18 months. The median dose was 1.5 g/day. M‐IIN appears to be an idiosyncratic reaction without any relation to dose or duration of mesalazine use. Although there are no guidelines to recommend routine surveillance of renal function, monitoring of serum creatinine in patients on mesalazine remains an inexpensive and non‐invasive test that may lead to early detection and treatment of renal injury.
Serum Zinc Levels in Patients with Basal‐Cell Carcinoma
Authors: ADLER ALVIN L. , SAFAI BIJAN , WANG YING B. , MENENDEZ‐BOTET CELIA , GOOD ROBERT A.
Published: June 2013

Basal‐cell carcinoma is a malignant epithelial neoplasm that arises from the germinative cells of the epidermis and its appendages. Various causative factors have been implicated in its pathogenesis. In recent years, it has become increasingly apparent that alterations in serum zinc concentration may relate to neoplastic diseases. The objective of this study was to determine whether or not a relationship exists between abnormal serum zinc levels and basal‐cell carcinomas. The data indicate that a statistically significant elevation in mean serum zinc levels is associated with this neoplasm. This may, however, not be of clinical significance because of variation in environmental or statistical sampling factors.
Toward Less Painful Anesthesia: Water, Saline, and Lidocaine
Authors: SPERLING LEONARD C. , WEBER CHARLES B. , RODMAN ORLANDO G.
Published: June 2013

There are several misconceptions about the best methods of achieving comfortable injections of materials for local anesthesia and other purposes, all based on scant or anecdotal information. A double‐blind study was done to determine the relative comfort and efficacy of distilled water, physiologic saline, and a commercial preparation of lidocaine when administered to attain local anesthesia. Distilled water was found to be most painful upon injection, physiologic saline less so, and the commercial prepartion of lidocaine no more painful than physiologic saline. Onset and depth of anesthesia from each were also assayed. It was concluded that the commercial preparation of lidocaine performed best overall.
The Process of Replacement of Vellus Hairs by Coarse Hairs
Authors: INABA MASUMI , McKINSTRY CHIEKO T. , EZAKI TETSUO
Published: June 2013

The authors report a detailed histologic study of the process of replacement of solitary vellus hairs by solitary coarse hairs in the axilla. The replacement process is revealed to be quite different from the ordinary hair cycle. In puberty, hormonal activity causes the vellus hair follicle to become multilobular. The vellus hair expires, and formation of a new bud and a new (coarse) hair begins to develop from the upper isthmal portion of the follicle just below the sebaceous duct. The new hair pegs downward, until the formation of a new hair bulb (matrix) is completed, and then grows upward as a coarse terminal hair.
A New Method to Visualize Langer's Lines
Authors: FAGA ANGELA
Published: June 2013

After reviewing Langer's papers on lines of cleavage in the skin, experiments were done that showed a correspondence between those lines and the directions that hairs stream.
Angiolymphoid Hyperplasia with Eosinophilia
Authors: GARDNER J. HARVEY , AMONETTE REX A. , CHESNEY THOMAS McC.
Published: June 2013

Three cases with the typical clinical and histologic features of angiolymphoid hyperplasia with eosinophilia are presented. Methods of treatment are discussed. Conventional surgical excision with adequate margins is advocated.
An Effective Method of Inducing Analgesia and Anesthesia for Dermatoplastic Surgery in an Office
Authors: PIERCE HAROLD E.
Published: June 2013

Butorphanol tartrate (Stadol® [Bristol]) and diazepam (Valium® [Roche]) given intravenously in combination, in proper doses, and properly monitored are effective and safe to induce analgesia and calmness preliminary to extensive infiltration of local anesthetics that are otherwise painful and distressing. They are particularly good for moderately long and prolonged dermatoplastic procedures, and all the better because their analgesic and calmative effects last well into the postoperative period.
Uses of Dextranomer Absorbent Pads After Cryosurgery of Cutaneous Malignancies
Authors: HERSLE KJELL , MOBACKEN HAKAN
Published: June 2013

Secretion from wounds after cryosurgery of cutaneous malignancies may be excessive and may constitute a problem in management. It was found possible to collect and quantitate such discharges by use of highly hydrophilic dextranomer beads (Debrisan®). They were applied in convenient, small “tea‐bag” pads. The amount and duration of postoperative oozing was approximately proportional to the sizes of the lesions and more impressive in sites of sparse subcutaneous tissue. The absorbent pads also proved to be effective and safe for use as postoperative dressings.
Small‐Cell Neuroepithelial Tumor of Skin: A Merkel‐Cell Neoplasm?
Authors: POLLACK S. V. , GOSLEN J. B.
Published: June 2013

Two patients with small‐cell undifferentiated neuroepithelial tumors of skin are reported. The histologic and ultrastructural features of this neoplasm are presented. Characteristic membrane‐bound, dense‐core neurosecretory granules were seen in the cytoplasm of the tumor cells in both cases. The literature is reviewed in regard to the clinical behavior of these lesions and their possible cell of origin. Dermatologists should be aware of these tumors because they may require electron microscopy for accurate diagnosis. The tumors should be treated aggressively to minimize the chance of local recurrence and nodal or visceral metastases.
Bullae in the Donor Site of a Split‐Thickness Skin Graft
Authors: BERMAIM ALEXANDER
Published: June 2013

A patient developed bullae in a donor site 3 weeks after a split‐thickness skin graft was taken. No reference to blistering in the donor site of a recently taken split‐thickness skin graft could be found in the surgical literature, and a computerized search of the world's medical literature revealed only a single report of a similar case. The mechanism of bulla formation has not been elucidated. We alert physicians to this phenomenon and urge that each case that is seen be studied in an orderly manner by histologic, electron microscopic, and immunofluorescent techniques.
Surgical Management of Primary Carcinomas of the Lower Lip
Authors: KNABEL MARK R. , KORANDA FRANK C. , OLEJKO TERRY D.
Published: June 2013

Carcinomas of lower lips are common neoplasms of the muco‐cutaneous junction. Surgical resection of these tumors has the advantages of permitting histologic examination of the margins, achieving excellent cure rates, and yielding good aesthetic and functional results. We present the fundamental surgical procedures for management of pre‐cancerous and primary cancerous neoplasms of the lower lip with which the surgical dermatologist should be familiar. These procedures may be done with local anesthesia in an outpatient surgical office. The techniques and case examples we describe include vermilionectomy and mucosal advancement, V‐wedge resection, pentagonal wedge resection, and vermilionectomy combined with wedge resection.
Correction of Depressed Scars following Mohs' surgery: The Role of Collagen Implantation
Authors: BAILIN PHILIP L. , BAILIN MARY D.
Published: June 2013

The results of injections of Zyderm™ collagen implant in six patients for correction of depressed scars on the nose resulting from Mohs' surgery are presented. Two cases are illustrated. Three of the six patients achieved 85–100% correction after completion of their series of injections. The one patient who achieved 100% correction subsequently experienced 15–20% regression, although none of the other five patients showed regression of the correction achieved.
Closure of Wedge Excisions of the Lip
Authors: HANEKE E.
Published: June 2013

By a simple modification of the mucosal suture described in many textbooks the disadvantages of the technique can be avoided. After excision of a W‐shaped wedge of the lip, the tunica propria is sutured with catgut from the inside without penetrating the mucous epithelium.
Chemical Potential‐Based Analysis for the Oxidation Kinetics of Si and SiC Single Crystals
Authors: Raj Rishi
Published: June 2013

A one‐dimensional diffusion problem with prescribed boundary conditions for the oxygen potential at the oxygen(gas)–silica and at the silica–substrate interfaces is employed to obtain the parabolic rate constant for oxidation of Si crystals. The results, using the data for diffusion and solubility of molecular oxygen in silica agree reasonably well with the oxidation kinetics results for Si from Deal and Grove (1965). The measurements for SiC crystals (Costello and Tressler, 1985) lie below these results for Si, even though in both instances, diffusion through the silica overlayer is expected to have been rate controlling. This difference is explained in terms of the lower Si activity at the SiC–SiO2 interface than at the Si–SiO2 interface. The implication of the interface structure is discussed in an attempt to explain the higher activation energy for oxidation of the Si‐face (0001), than the C‐face of SiC crystals.
Visualizing Intramyocardial Steam Formation with a Radiofrequency Ablation Catheter Incorporating Near‐Field Ultrasound
Authors: WRIGHT MATTHEW , HARKS ERIK , DELADI SZABOLCS , FOKKENROOD STEVEN , ZUO FEI , VAN DUSSCHOTEN ANNEKE , KOLEN ALEXANDER F. , BELT HARM , SACHER FREDERIC , HOCINI MÉLÈZE , HAÏSSAGUERRE MICHEL , JAÏS PIERRE
Published: June 2013

Visualizing Steam Pops

Introduction

Steam pops are a risk of irrigated RF ablation even when limiting power delivery. There is currently no way to predict gas formation during ablation. It would be useful to visualize intramyocardial gas formation prior to a steam pop occurring using near‐field ultrasound integrated into a RF ablation catheter.

Methods and Results

In an in vivo open‐chest ovine model (n = 9), 86 lesions were delivered to the epicardial surface of the ventricles. Energy was delivered for 15–60 seconds, to achieve lesions with and without steam pops, based on modeling data. The ultrasound image was compared to a digital audio recording from within the pericardium by a blinded observer. Of 86 lesions, 28 resulted in an audible steam pop. For lesions that resulted in a steam pop compared to those that did not (n = 58), the mean power delivered was 8.0 ± 1.8 W versus 6.7 ± 2.0 W, P = 0.006. A change in US contrast due to gas formation in the tissue occurred in all lesions that resulted in a steam pop. In 4 ablations, a similar change in US contrast was observed in the tissue and RF delivery was stopped; in these cases, no pop occurred. The mean depth of gas formation was 0.9 ± 0.8 mm, which correlated with maximal temperature predicted by modeling. Changes in US contrast occurred 7.6 ± 7.2 seconds before the impedance rise and 7.9 ± 6.2 seconds (0.1–17.0) before an audible pop.

Conclusion

Integrated US in an RF ablation catheter is able to visualize gas formation intramyocardially several seconds prior to a steam pop occurring. This technology may help prevent complications arising from steam pops.
Mutation‐Positive Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy: The Triangle of Dysplasia Displaced
Authors: TE RIELE ANNELINE S.J.M. , JAMES CYNTHIA A. , PHILIPS BINU , RASTEGAR NEDA , BHONSALE ADITYA , GROENEWEG JUDITH A. , MURRAY BRITTNEY , TICHNELL CRYSTAL , JUDGE DANIEL P. , VAN DER HEIJDEN JEROEN F. , CRAMER MAARTEN J.M. , VELTHUIS BIRGITTA K. , BLUEMKE DAVID A. , ZIMMERMAN STEFAN L. , KAMEL IHAB R. , HAUER RICHARD N.W. , CALKINS HUGH , TANDRI HARIKRISHNA
Published: June 2013

ARVD/C: The Triangle of Dysplasia Displaced

Introduction

The traditional description of the Triangle of Dysplasia in Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy (ARVD/C) predates genetic testing and excludes biventricular phenotypes.

Methods and Results

We analyzed Cardiac Magnetic Resonance (CMR) studies of 74 mutation‐positive ARVD/C patients for regional abnormalities on a 5‐segment RV and 17‐segment LV model. The location of electroanatomic endo‐ and epicardial scar and site of successful VT ablation was recorded in 11 ARVD/C subjects. Among 54/74 (73%) subjects with abnormal CMR, the RV was abnormal in almost all (96%), and 52% had biventricular involvement. Isolated LV abnormalities were uncommon (4%). Dyskinetic basal inferior wall (94%) was the most prevalent RV abnormality, followed by basal anterior wall (87%) dyskinesis. Subepicardial fat infiltration in the posterolateral LV (80%) was the most frequent LV abnormality. Similar to CMR data, voltage maps revealed scar (<0.5 mV) in the RV basal inferior wall (100%), followed by the RV basal anterior wall (64%) and LV posterolateral wall (45%). All 16 RV VTs originated from the basal inferior wall (50%) or basal anterior wall (50%). Of 3 LV VTs, 2 localized to the posterolateral wall. In both modalities, RV apical involvement never occurred in isolation.

Conclusion

Mutation‐positive ARVD/C exhibits a previously unrecognized characteristic pattern of disease involving the basal inferior and anterior RV, and the posterolateral LV. The RV apex is only involved in advanced ARVD/C, typically as a part of global RV involvement. These results displace the RV apex from the Triangle of Dysplasia, and provide insights into the pathophysiology of ARVD/C.
Communication between residents and attending doctors on call after hours
Authors: Novoselsky Persky Michal A. , Yinnon Amos M. , Freier‐Dror Yossi , Henshke‐Bar‐Meir Ruth
Published: June 2013

Rationale, aims and objectives

Off‐hours medical care in hospitals is provided by residents, while attendings on call are available for assistance. This study evaluated the gap between residents' expectations and professional guidelines' requirements of attendings on call and what actually occurs during night shifts, while comparing surgical and medical specialties.

Methods

Two questionnaires based on professional guidelines were filled by residents. The first queried about residents' expectations of attendings on call, and the second asked about communication with the attendings during actual night shifts.

Results

While 91 (100%) of residents expected the attending on call to be available by phone during the shift, only 44 (48%) expected the attending to initiate contact, and only 17 (19%) expected the attending to visit the ward or emergency department (ED) without being requested to do so. In 127 shifts (84%), some form of communication occurred. Residents called their attendings during 105 shifts (70%). However, attendings initiated contact with residents at the beginning or during the shift in only 67 (44%) and 62 (41%) shifts, respectively, and initiated a visit to the ward/ED during the shift in only 41 cases (27%). Surgical attendings initiated contact in these three ways significantly more frequently than medical attendings [21 (28%) versus 46 (61%), 20 (26%) versus 42 (56%) and 4 (5%) versus 37 (50%), respectively; P < 0.001].

Conclusion

While communication during night shifts between residents and attendings occurs in most shifts, attendings initiate far less contact with residents than is required by the guidelines.
Design Charrette as Methodology for Student Learning Assessment Relative to Building Safety and Security
Authors: Emily A. McLaughlin
Published: June 2013

A clear understanding of design strategies for the enhancement of building safety and security has never been more important for interior designers to comprehend than in recent times. Natural disasters, terrorism, and workplace violence represent but a few of the dangers, which threaten our built environments in unimaginable ways, and jeopardize the foundations of society and personal welfare. The application of building codes and life–safety regulations alone are no longer enough to mitigate for unforeseen disasters. Further practices and methodologies must be introduced in academic institutions to prepare future practitioners for the challenges that await them relative to designing for the safety and security of building occupants, particularly in commercial structures. This exploratory pedagogical study postulates that interior design students who employ safety and security strategies in applied scenarios retain a deeper understanding of the difference between building codes and supplementary techniques relative to enhanced protection of building occupants. This paper advocates for the use of charrette as an instructional method in studio–based coursework to reinforce a contextual understanding of safety and security concepts, and urges educators to be cognizant of charrette as a teaching approach to effectively assess student learning outcomes as well as potentially impact the body of knowledge.
On Journal Ranking: A Conundrum for Interior Design
Authors: Meggs Susan Martin , Gustina Charles F.
Published: June 2013

Systems of journal ranking can be arbitrary and problematic, particularly in highly specialized academic fields where journals are of limited scope and circulation. One field in which journal ranking is problematic is interior design. This article addresses existing ranking systems for academic journals and explores the limitations of these ranking systems. An attempt is made to suggest effective methods that could be developed for ranking interior design journals. The multiple factors that need to be considered in ranking journals in such a specialized field are discussed, including ranking bias, categorical specialization, and geographic and institutional variables. Implications of this review indicate that journal ranking for interior design should be considered within the context of relevant specialized journals rather than the current practice that places interior design in a broad comparative ranking system outside of its field. Multiple cross–referencing measurements, including impact factors, subject–specific citation rates, and acceptance rates, as well as prestige factors based on peer perceptual ranking of interior design journals need to be implemented. Faculty and institutional evaluations need to be based on composite factors that take into account not only a meaningful journal ranking system, but also a broader, and at the same time more accurate, metric to include the actual value of the publication itself, the focus of research, and the goals of the individual and of the institution.
Influence of anxiety on temporomandibular disorders – an epidemiological survey with elders and adults in Southern Brazil
Authors: Boscato N. , Almeida R. C. , Koller C. D. , Presta A. A. , Goettems M. L.
Published: June 2013

The socio‐economic and psychological factors and the use of and need for dental prostheses have been associated with prevalence and severity of temporomandibular disorders (TMD). The aim of this study was to evaluate the association of socio‐economic and psychological factors, use of and need for dental prostheses with the prevalence and severity of signs and symptoms of temporomandibular disorders (TMD). A cross‐sectional study was conducted in Luzerna/Brazil. All individuals aged 35–44 (adults) and 65–74 (elders) were invited to participate in this study. The measuring instrument included a questionnaire application and the clinical evaluation regarding signs and symptoms of TMD. Descriptive analyses, chi‐squared test, unadjusted and adjusted Poisson regression were used for the statistic analysis. The level of statistical significance was given when P ≤ 0·05. In total, 568 individuals (338 adults and 230 elders) were included; among them, 43·5% had absent, 42·6% mild, 11·3% moderate and 2·6% severe TMD. The presence of higher TMD rates was found in females (P = 0·001), and the TMD occurrence increased with anxiety level (P = 0·001). Other socio‐economic factors, such as colour (P = 0·115), family structure (P = 0·478), age (P = 0·143), social class (P = 0·935) and education (P = 0·678) showed no influence. In conclusion, the female gender and individuals with higher levels of anxiety had increased prevalence of signs and symptoms of TMD. Additionally, was not founded association between TMD and use of and need for dental prostheses.
GLOBALIZING KNOWLEDGE: HOW TECHNOLOGICAL OPENNESS AFFECTS OUTPUT, SPATIAL INEQUALITY, AND WELFARE LEVELS
Authors: Bottazzi Giulio , Dindo Pietro
Published: June 2013

Using an analytically solvable model, we study how the spatial distribution of economic activities and the ensuing welfare levels are affected by pecuniary externalities, depending on transportation costs, and localized technological externalities, due to the cost saving effect of intra‐ and interregional knowledge spillovers. Under the assumption of capital mobility and labor immobility, we show that increasing interregional knowledge spillovers, i.e., promoting technological openness, favors a smoother transition between different levels of firms concentration, makes trade globalization less likely to generate catastrophic and irreversible agglomeration, and ultimately leads to a less uneven distribution of welfare.
Is extubation associated with changes in ductal and pulmonary blood flow in extremely preterm neonates?
Authors: Wagh Deepika , Gill Andrew
Published: June 2013

Aim

Early extubation is desirable in preterm neonates to minimise the risk of complications associated with prolonged intubation. The association of significant pulmonary haemorrhage (PH) with extubation in a cluster of very preterm infants instigated an assessment of ductal and pulmonary haemodynamic effects of early extubation.

Method

This is a prospective observational study in 20 neonates (gestation <28 weeks) undergoing early extubation. Echocardiography was performed 5 min pre‐extubation and 20 min post‐extubation to continuous positive airway pressure. Normal cardiac anatomy was ascertained. Left pulmonary artery (LPA) and ductus arteriosus diameter and flows were recorded. Doppler spectral pattern of velocity was recorded over a minimum of four cycles.

Results

Median (range) gestation, birthweight and age at extubation were 26.5 (24.0–28.0) weeks, 932 (595–1260) g and 18 (6–51) h, respectively. There was no significant change in pulmonary flow post‐extubation: ductal size: (pre – 1.2 (0–3.3) mm, post – 1.0 (0–3.5) mm); ductal flow: (pre – 44 (0–515), post – 49 (0–441) mL/kg/min); LPA diameter: (pre – 2.4 (1.9–3.8) mm, post – 2.6 (1.9–3.4) mm); LPA flow: (pre – 112 (59–255), post – 122 (58–188) mL/kg/min. There were 3 out of 20 infants who developed PH at the post‐natal age of 2, 11 and 16 days after extubation. Ductal and LPA flow did not change significantly after extubation in infants with or without PH irrespective of the ductal status.

Conclusions

Early extubation was not associated with a significant change from baseline in ductal and pulmonary flow in extremely preterm infants.
UPPER TRIASSIC POTENTIAL SOURCE ROCKS IN THE QIANGTANG BASIN, TIBET: ORGANIC GEOCHEMICAL CHARACTERISTICS
Authors: Zeng Y. H. , Fu X. G. , Zeng S. Q. , Du G.
Published: June 2013

Upper Triassic coal‐bearing strata in the Qiangtang Basin (Tibet) are known to have source rock potential. For this study, the organic geochemical characteristics of mudstones and calcareous shales in the Upper Triassic Tumengela and Zangxiahe Formations were investigated to reconstruct depositional settings and to assess hydrocarbon potential. Outcrop samples of the Tumengela and Zangxiahe Formations from four locations in the Qiangtang Basin were analysed. The locations were Xiaochaka in the southern Qiangtang depression, and Woruo Mountain, Quemo Co and Zangxiahe in the northern Qiangtang depression.

At Quemo Co in the NE of the basin, calcareous shale samples from the Tumengela Formation have total organic carbon (TOC) contents of up to 1.66 wt.%, chloroform bitumen A contents of up to 734 ppm, and a hydrocarbon generation capacity (Rock‐Eval S1+ S2) of up to 1.94 mg/g. The shales have moderate to good source rock potential. Vitrinite reflectance (Rr) values of 1.30% to 1.46%, and Rock‐Eval Tmax values of 464 to 475 °C indicate that the organic matter is at a highly mature stage corresponding to condensate / wet gas generation. The shales contain Type II kerogen, and have low carbon number molecular compositions with relatively high C21−/C21+ (2.15–2.93), Pr/Ph ratios of 1.40–1.72, high S/C ratios (>0.04) in some samples, abundant gammacerane (GI of 0.50–2.04) and a predominance of C27 steranes, indicating shallow‐marine sub‐anoxic and hypersaline depositional conditions with some input of terrestrial organic matter.

Tumengela and Zangxiahe Formation mudstone samples from Xiaochaka in the southern Qiangtang depression, and from Woruo Mountain and Zangxiahe in the northern depression, have low contents of marine organic matter (Type II kerogen), indicating relatively poor hydrocarbon generation potential. Rr values and Tmax data indicate that the organic matter is overmature corresponding to dry gas generation.
Foot Orgasm Syndrome: A Case Report in a Woman
Authors: Waldinger Marcel D. , de Lint Govert J. , van Gils Ad P.G. , Masir Farhad , Lakke Egbert , van Coevorden Ruben S. , Schweitzer Dave H.
Published: June 2013

Introduction

Spontaneous orgasm triggered from inside the foot has so far not been reported in medical literature.

Aims

The study aims to report orgasmic feelings in the left foot of a woman.

Methods

A woman presented with complaints of undesired orgasmic sensations originating in her left foot. In-depth interview, physical examination, sensory testing, magnetic resonance imaging (MRI-scan), electromyography (EMG), transcutaneous electrical nerve stimulation (TENS), and blockade of the left S1 dorsal root ganglion were performed.

Main Outcome Measures

The main outcomes are description of this clinical syndrome, results of TENS application, and S1 dorsal root ganglion blockade.

Results

Subtle attenuation of sensory amplitudes of the left suralis, and the left medial and lateral plantar nerve tracts was found at EMG. MRI-scan disclosed no foot abnormalities. TENS at the left metatarso-phalangeal joint-III of the left foot elicited an instant orgasmic sensation that radiated from plantar toward the vagina. TENS applied to the left side of the vagina elicited an orgasm that radiated to the left foot. Diagnostic blockade of the left S1 dorsal root ganglion with 0.8 mL bupivacaine 0.25 mg attenuated the frequency and intensity of orgasmic sensation in the left foot with 50% and 80%, respectively. Additional therapeutic blockade of the same ganglion with 0.8 mL bupivacaine 0.50 mg combined with pulsed radiofrequency treatment resulted in a complete disappearance of the foot-induced orgasmic sensations.

Conclusion

Foot orgasm syndrome (FOS) is descibed in a woman. Blockade of the left S1 dorsal root ganglion alleviated FOS. It is hypothesized that FOS, occurring 1.5 years after an intensive care emergency, was caused by partial nerve regeneration (axonotmesis), after which afferent (C-fiber) information from a small reinnervated skin area of the left foot and afferent somatic and autonomous (visceral) information from the vagina on at least S1 spinal level is misinterpreted by the brain as being solely information originating from the vagina.