bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of aerosol hygroscopic growth on the single-scattering albedo and its application on the NO2 photolysis rate coefficient
Authors: Tao J. C. , Zhao C. S. , Ma N. , Liu P. F.
Published: November 2014

Abstract. Hygroscopic growth of aerosol particles can significantly affect their single-scattering albedo (ω), and consequently alters the aerosol effect on tropospheric photochemistry. In this study, the impact of aerosol hygroscopic growth on ω and its application to the NO2 photolysis rate coefficient (JNO2) are investigated for a typical aerosol particle population in the North China Plain (NCP). The variations of aerosol optical properties with relative humidity (RH) are calculated using a Mie theory aerosol optical model, on the basis of field measurements of number–size distribution and hygroscopic growth factor (at RH values above 90%) from the 2009 HaChi (Haze in China) project. Results demonstrate that ambient ω has pronouncedly different diurnal patterns from ω measured at dry state, and is highly sensitive to the ambient RHs. Ambient ω in the NCP can be described by a dry state ω value of 0.863, increasing with the RH following a characteristic RH dependence curve. A Monte Carlo simulation shows that the uncertainty of ω from the propagation of uncertainties in the input parameters decreases from 0.03 (at dry state) to 0.015 (RHs > 90%). The impact of hygroscopic growth on ω is further applied in the calculation of the radiative transfer process. Hygroscopic growth of the studied aerosol particle population generally inhibits the photolysis of NO2 at the ground level, whereas accelerates it above the moist planetary boundary layer. Compared with dry state, the calculated JNO2 at RH of 98% at the height of 1 km increases by 30.4%, because of the enhancement of ultraviolet radiation by the humidified scattering-dominant aerosol particles. The increase of JNO2 due to the aerosol hygroscopic growth above the upper boundary layer may affect the tropospheric photochemical processes and this needs to be taken into account in the atmospheric chemical models.
Sulfur-containing particles emitted by concealed sulfide ore deposits: an unknown source of sulfur-containing particles in the atmosphere
Authors: Cao J. , Li Y. , Jiang T. , Hu G.
Published: November 2014

Abstract. Sources of sulfur dioxide, sulfates, and organic sulfur compounds, such as fossil fuels, volcanic eruptions, and animal feeding operations, have attracted considerable attention. In this study, we collected particles carried by geogas flows ascending through soil, geogas flows above the soil that had passed through the soil, and geogas flows ascending through deep faults of concealed sulfide ore deposits and analyzed them using transmission electron microscopy. Numerous crystalline and amorphous sulfur-containing particles or particle aggregations were found in the ascending geogas flows. In addition to S, the particles contained O, Ca, K, Mg, Fe, Na, Pb, Hg, Cu, Zn, As, Ti, Sr, Ba, Si, etc. Such particles are usually a few to several hundred nanometers in diameter with either regular or irregular morphology. The sulfur-containing particles originated from deep-seated weathering or faulting products of concealed sulfide ore deposits. The particles suspended in the ascending geogas flow migrated through faults from deep-seated sources to the atmosphere. This is a previously unknown source of the atmospheric particles. This paper reports, for the first time, the emission of sulfur-containing particles into the atmosphere from concealed sulfide ore deposits. The climatic and ecological influences of these sulfur-containing particles and particle aggregations should to be assessed.
Transport of anthropogenic and biomass burning aerosols from Europe to the Arctic during spring 2008
Authors: Marelle L. , Raut J.-C. , Thomas J. L. , Law K. S. , Quennehen B. , Ancellet G. , Pelon J. , Schwarzenboeck A. , Fast J. D.
Published: November 2014

Abstract. During the POLARCAT-France airborne campaign in April 2008, pollution originating from anthropogenic and biomass burning emissions was measured in the European Arctic. We compare these aircraft measurements with simulations using the WRF-Chem model to investigate model representation of aerosols transported from Europe to the Arctic. Modeled PM2.5 is evaluated using EMEP measurements in source regions and POLARCAT aircraft measurements in the Scandinavian Arctic, showing a good agreement, although the model overestimates nitrate and underestimates organic carbon in source regions. Using WRF-Chem in combination with the Lagrangian model FLEXPART-WRF, we find that during the campaign the research aircraft sampled two different types of European plumes: mixed anthropogenic and fire plumes from eastern Europe and Russia transported below 2 km, and anthropogenic plumes from central Europe uplifted by warm conveyor belt circulations to 5–6 km. Both modeled plume types had significant wet scavenging (> 50% PM10) during transport. Modeled aerosol vertical distributions and optical properties below the aircraft are evaluated in the Arctic using airborne LIDAR measurements. Evaluating the regional impacts in the Arctic of this event in terms of aerosol vertical structure, we find that during the 4 day presence of these aerosols in the lower European Arctic (< 75° N), biomass burning emissions have the strongest influence on concentrations between 2.5 and 3 km altitudes, while European anthropogenic emissions influence aerosols at both lower (~1.5 km) and higher altitudes (~4.5 km). As a proportion of PM2.5, modeled black carbon and SO4= concentrations are more enhanced near the surface. The European plumes sampled during POLARCAT-France were transported over the region of springtime snow cover in Northern Scandinavia, where they had a significant local atmospheric warming effect. We find that, during this transport event, the average modeled top of atmosphere (TOA) shortwave direct and semi-direct radiative effect (DSRE) north of 60° N over snow and ice-covered surfaces reaches +0.58 W m−2, peaking at +3.3 W m−2 at noon over Scandinavia and Finland.
Investigation of variable threshold level approaches for hydrological drought identification
Authors: Beyene B. S. , Van Loon A. F. , Van Lanen H. A. J. , Torfs P. J. J. F.
Published: November 2014

Abstract. Threshold level approaches are widely used to identify drought events in time series of hydrometeorological variables. However, the method used for calculating the threshold level can influence the quantification of drought events or even introduce artefact drought events. In this study, four methods of variable threshold calculation have been tested on catchment scale, namely (1) moving average of monthly quantile (M_MA), (2) moving average of daily quantile (D_MA), (3) thirty days moving window quantile (30D) and (4) fast Fourier transform of daily quantile (D_FF). The levels obtained by these methods were applied to hydrometeorological variables that were simulated with a semi-distributed conceptual rainfall-runoff model (HBV) for five European catchments with contrasting catchment properties and climate conditions. There are no physical arguments to prefer one method over the other for drought identification. The only way to investigate this is by applying the methods and visually inspecting the results. Therefore, drought statistics (i.e. number of droughts, mean duration, mean deficit) and time series plots were studied to compare drought propagation patterns determined by different threshold calculation methods. We found that all four approaches are sufficiently suitable to quantify drought propagation in contrasting catchments. Only the D_FF approach showed lower performance in two catchments. The 30D approach seems to be optimal in snow-dominated catchments, because it follows fast changes in discharge caused by snow melt more accurately. The proposed approaches can be successfully applied by water managers in regions where drought quantification and prediction are essential.
Hydro-morphodynamic modelling in Mediterranean storms – errors and uncertainties under sharp gradients
Authors: Sánchez-Arcilla A. , García-León M. , Gracia V.
Published: November 2014

Abstract. This paper deals with the limits in hydrodynamic and morphodynamic predictions for semi-enclosed coastal domains subject to sharp gradients (in bathymetry, topography, sediment transport and coastal damages). It starts with an overview of wave prediction limits (based on satellite images and buoy records) in a restricted domain, namely the Mediterranean basin, followed by an in-depth analysis of the Catalan coast, one of its land boundaries. The morphodynamic modelling for such regions is next discussed, based on the impact of a characteristic storm. The driving wave and surge conditions produce a morphodynamic response that is validated against the pre- and post-storm emerged beach state, recovered from two lidar images. The quality of the fit is discussed in terms of the physical processes and the suitability of the employed modelling suite. From here an assessment of errors and uncertainties is presented, with the aim of establishing the prediction limits for flooding and erosion analyses, key elements for coastal engineering decisions.
Sterilization using Electrolyzed Water Highly Retains the Biological Properties in Tissue-Engineered Porcine Liver Scaffold
Authors: Hussein Kamal H. , Park Kyung M. , Teotia Pankaj K. , Hong Seok H. , Yang Se R. , Park Sung M. , Ahn Cheol , Woo Heung M.
Published: November 2014

Purpose

The aims of this study were to investigate the effects of sterilization with peracetic acid (PAA) and ethanol on the biological activity of porcine liver scaffolds and to develop a new technique for sterilization using slightly acidic electrolyzed water (SAEW).

Methods

Decellularization of liver slices was performed using 0.1% sodium-dodecyl-sulfate, then evaluated by histological and polymerase chain reaction analyses. Decellularized slices were treated with either PAA or ethanol or SAEW, and then DNA content was quantified. We determined sterilization efficiency by culturing scaffolds in culture medium and on blood agar. We next analyzed the glycosaminoglycan and collagen contents of the scaffolds. Finally, we tested the cytotoxicity of the scaffolds as well as the effects of sterilization on host cell attachment and proliferation.

Results

Complete cell and antigenic epitopes removal emphasized the decellularization efficiency. PAA and SAEW treatments achieved the highest efficiency of sterilization compared to that of the ethanol treated scaffolds, and were able to remove a considerable fraction of DNA from decellular-ized livers. The retained glycosaminoglycan content decreased in all treatments in the following order: SAEW, ethanol, and PAA. Ethanol caused a significant loss in collagen content compared to the other groups. A cytotoxicity evaluation revealed that all scaffolds were nontoxic. SAEW-treated scaffolds supported cell attachment and proliferation at a significantly higher rate than other groups.

Conclusions

These data suggest that SAEW is highly efficient for sterilizing scaffolds and allowed the scaffolds to retain their bioactivity in addition to its high efficiency for cell remnant removal.
IABP Timing and Ventricular Performance - Comparison between a Compliant and a Stiffer Aorta: A Hybrid Model Study Including Baroreflex
Authors: Fresiello Libera , Khir Ashraf W. , Di Molfetta Arianna , Kozarski Maciej , Ferrari Gianfranco
Published: November 2014

Introduction

The aim of this study was to investigate the effects of the intra aortic balloon pump (IABP) and of aortic compliance on left ventricular performance, including the effects of baroreflex control.

Methods

The study was conducted using a hybrid cardiovascular simulator, including a computational cardiovascular sub-model, a hydraulic sub-model of the descending aorta, and a baroreflex computational sub-model. A 40 cc balloon was inserted into a rubber tube component of the hydraulic sub-model. A comparative analysis was conducted for two aortic compliances (C1 = 2.4 and C2 = 1.43 cm3/mmHg, corresponding to an aortic pulse pressure of 23 mmHg and 35 mmHg, respectively), driving the balloon for different trigger timings.

Results

Under C1 conditions, the IABP induced higher effects on baroreflex activity (decrement of sympathetic efferent activity: 10% for C1 and 14.7% for C2) and ventricular performance (increment of cardiac output (CO): 3.7% for C1 and 5.2% for C2, increment of endocardial viability ratio (EVR): 24.8% for C1 and 55% for C2). The best balloon timing was different for C1 and C2: inflation trigger timing (from the dicrotic notch) -0.09 s for C1 and -0.04 s for C2, inflation duration 0.25 s for C1 and 0.2 s for C2.

Conclusions

Early inflation ensures better EVR, CO, and an increment of the afferent nerve activity, hence causing peripheral resistance and heart rate to decrease. The best balloon timing depends on aortic compliance, thus suggesting the need for a therapy tailored to the specific conditions of individual patients.
Extracorporeal Life Support and Left Ventricular Unloading in a Non-Intubated Patient as Bridge to Heart Transplantation
Authors: Peterss Sven , Pfeffer Christian , Reichelt Angela , Born Frank , Franz Wolfgang , Netz Heinrich , Kaczmarek Ingo , Hagl Christian , Khaladj Nawid
Published: November 2014

Introduction

Veno-arterial extracorporeal life support (ECLS) is a well-established bridging therapy in patients with cardiac or pulmonary failure to maintain organ function and is frequently performed in patients who are not intubated. However, severly impaired cardiac function can occur pulmonary edemy in these patients, necessitating left ventricular unloading.

Methods and Results

In this study we report a 37-year old female patient with familiar dilated cardiomyopathy suffering from acute biventricular heart failure. After implantation of a peripheral ECLS, the decreased ventricular led to refractory pulmonary edema. To unload the left ventricle, an percutaneous balloon atrioseptostomy was performed without intubating the patient. The left ventricle was vented by the venous cannula resting inside the atrioseptostomy. After twelve days on ECLS, the patient underwent orthotopic heart transplantation. The postoperative course was uneventful and the patient discharged from intensive care unit four days after surgery.

Conclusions

In this report we present a patient in which the hybrid technique of ECLS with secondary left ventricular unloading was successfully used as a bridge to transplant therapy. This procedure may offer an alternative bridge-to-decision options in selected patients, including those that were not intubated or anaesthetized.
Dosing of Vancomycin in Patients with Continuous-Flow Left Ventricular Assist Devices: A Clinical Pharmacokinetic Analysis
Authors: Jennings Douglas L. , Makowski Charles T. , Chambers Rachel M. , Lanfear David E.
Published: November 2014

Purpose

To describe the pharmacokinetics of vancomycin in patients with continuous-flow left ventricular assist devices (CF-LVADs).

Methods

Eligible patients were ≥18 years old, implanted with a Heart Mate II CF-LVAD during January 2008-April 2012, and treated with vancomycin ≥48 hours for infection. Key exclusion criteria were unstable renal function, acute heart failure exacerbation, hemodynamic instability, and recent surgery. First-order elimination rate constant (Ke) and volume of distribution (Vd) were estimated using ideal (IBW), adjusted (AdjBW), actual (ABW), and fixed body weights. Estimated parameters were compared with measured pharmacokinetic parameters, which were calculated from steady state peak and trough vancomycin levels using one-compartment model equations.

Results

Twelve patients were included (age 44.9 ± 15 years, 91.7% male, 58.3% obese, CLcr 79.2 ± 27 mL · min-1). Common treatment indications were health-care associated pneumonia (41.7%), driveline infection (25%), and sepsis (16.7%). All methods of predicting Ke provided overestimates (p<0.05), ranging from 47 to 79%, depending on body habitus. Methods of predicting Vd using ABW in obese patients yielded overestimates of 74.5% (p<0.05), where IBW predictive Vd equations provided accurate assessments regardless of body habitus.

Conclusions

General population methods may not accurately estimate the pharmacokinetic parameters of vancomycin for compensated heart failure patients implanted with CF-LVADs.
A Novel Artificial Anal Sphincter System in an in Vitro and in Vivo Experiment
Authors: Ke Lei , Yan Guo-Zheng , Liu Hua , Jiang Ping-Ping , Liu Zhi-Qiang , Wang Yong-Bing , Ding Zai-Xian
Published: November 2014

This paper presents some of the latest progress in the development of a novel artificial anal sphincter system (AASS) to treat severe fecal incontinence. We have redesigned and integrated an intelligent, remote-controlled artificial anal sphincter based on biological signal feedback mechanisms. The device consists of an external telemetry unit, an internal artificial anal sphincter (IAAS), and a transcutaneous energy transfer system (TETS). The mechanical medical micropump of the IAAS can realize bidirectional flow with a maximum flow rate of 8.5 ml/min and can build backpressure up to 170 kPa. The design of the prosthesis reduces occlusion pressure and allows for low inflation volumes (9 mL-10.5 mL); operating pressures between 4.05 kPa and 7.16 kPa indicate that the risk of ischemic injury to the bowel is minimal. Furthermore, the rechargeable battery based on TETS puts the operation time at an estimated 2 days. The performance characteristics of the AASS and its efficiency in achieving continence and sensing the stool inside the anorectum were evaluated in vitro and in vivo in a pig model. Experimental results confirm that the system can maintain continence and build the sense of defecation successfully. Moreover, this innovation can be integrated into not only severe fecal incontinence, erectile dysfunction, and therapy-resistant reflux disease, but also morbid adiposity therapeutic AASS applications.
Ultrastructural Analysis of Nanoparticles and Ions Released in Periprosthetic Membranes
Authors: Sabbatini Maurizio , Gatti Giorgio , Renò Filippo , Bosetti Michela , Marchese Leonardo , Cannas Mario
Published: November 2014

Purpose

The distribution and relationship of hydroxyapatite debris, nanometric organic and metal wear particles and metal ions on periimplant interface membranes following aseptic and septic arthroplastic loosening were investigated.

Methods

Scanning electron microscopy and X-ray spectroscopic analysis were used to analyze debris and ion distribution.

Results

Hydroxyapatite debris appeared with different morphology in a particular distribution among several membranes. These differences may reflect the occurrence of different friction forces taking place between prosthesis and bone interface in the several types of prostheses studied. Metal wear particles were detected in greater numbers in membranes from noncemented prostheses compared with those from cemented ones. In contrast, more organic particles were present in membrane from cemented prosthesis. No differences were observed between aseptic and septic membranes.

Conclusion

Our findings support the need to evaluate the occurrence of friction forces that periprosthetic bone debris production may induce to exacerbate cellular reactivity. Furthermore, cellular engulfment of debris and the high level of different ions released indicate the occurrence of a toxic environment that may induce failure of any reparative pathways.
Short-Term Effects of Microstructured Surfaces: Role in Cell Differentiation toward a Contractile Phenotype
Authors: Boccafoschi Francesca , Rasponi Marco , Ramella Martina , Ferreira Ana Marina , Vesentini Simone , Cannas Mario
Published: November 2014

Cell adhesion plays a key role in cell behavior, in terms of migration, proliferation, differentiation and apoptosis. All of these events concur with tissue regeneration and remodeling mechanisms, integrating a complex network of intracellular signaling modules. Morphogenetic responses, which involve changes in cell shape, proliferation and differentiation, are thought to be controlled by both biochemical and biophysical cues. Indeed, the extracellular matrix not only displays adhesive ligands necessary for cell adhesion but also plays an essential biomechanical role — responsible, for instance, for the acquisition of the contractile phenotype. The substrate topography around the forming tissues and the associated mechanical stresses that are generated regulate cellular morphology, proliferation and differentiation. Thus, the ability to tailor topographical features around cells can be a crucial design parameter in tissue engineering applications, inducing cells to exhibit the required performances.

In this work, we designed micropillared substrates using highly spaced arrays (interspacing equal to 25 μm) to evaluate the effects of topography on C2C12 myoblasts' adhesion and differentiation. Optical and fluorescence microscopy images were used to observe cell adhesion, together with Western blot analysis on vinculin and focal adhesion kinase (FAK) expression, a protein highly involved in adhesive processes. Differentiation marker (Myf5, myogenin and myosin heavy chain [MHC]) expression was also studied, in relation to the effect of different substrate topographies on the enhancement of a contractile phenotype. Our results demonstrated that microstructured surfaces may play a key role in the regeneration of functional tissues.
Influence of Pastes Containing Casein Phosphopeptide-amorphous Calcium Phosphate on Surface of Demineralized Enamel
Authors: Peric Tamara O. , Markovic Dejan L.J. , Radojevic Vesna J. , Heinemann Radmila M. Jancic , Petrovic Bojan B. , Lamovec Jelena S.
Published: November 2014

Purpose

The purpose of the study was to evaluate the surface characteristics of demineralized enamel after treatment with pastes containing casein phosphopeptide–amorphous calcium phosphate (CPP-ACP) or casein phosphopeptide–amorphous calcium fluoride phosphate (CPP-ACFP) and to compare their efficacy with that of 0.05% NaF.

Methods

Following formation of the artificial carious lesion, enamel slabs were divided into 4 groups (CPP-ACP, CPP-ACFP, 0.05% NaF and control) and submitted to a chemical caries model. Remineralization potential was examined using scanning electron microscope, energy-dispersive spectroscopy (EDS) and microhardness test. Scanning electron microphotographs were analyzed for area, minimal, maximal and mean diameter, perimeter, roundness and number of enamel defects and percentage of tooth surface affected by defects.

Results

Treatment with 0.05% NaF partly reduced the appearance of enamel defects when compared with irregular demineralized enamel. Treatment with CPP-ACP or CPP-ACFP resulted in occlusion of defects which produced more flattened enamel surface. Image analysis revealed reduction of the dimensions of the defects in the 3 experimental groups. Treatment with CPP-ACFP decreased the number of enamel defects when compared with demineralized enamel. The EDS analysis did not show differences in Ca/O, P/O and Ca/P ratios between the groups (P>0.05). Microhardness test revealed significant effects of CPP-ACP and CPP-ACFP (P<0.05).

Conclusions

Pastes containing CPP-ACP or CPP-ACFP showed potential to remineralize enamel surface lesions.
Cerebellar Degeneration-Related Autoantigen 1 (CDR1) Gene Expression in Prostate Cancer Cell Lines
Authors: Salemi Michele , Fraggetta Filippo , Galia Antonio , Pepe Pietro , Cimino Laura , Condorelli Rosita A. , Calogero Aldo E.
Published: November 2014

Prostate cancer (PCa) is the most frequent cancer among men in many developing countries, and the second leading cause of cancer-related death in men. A genetic component has been implicated in PCa onset and development. The cerebellar degeneration-related autoantigen 1 ( CDR1) gene, mapping in Xq26-q27.2, is expressed in cerebrum, cerebellum, heart, lung, liver, and kidney. In addition, CDR1 expression has been detected in neuroblastoma, renal carcinoma cell lines, and other cancer cell lines.

In this study, we investigated the expression of the CDR1 gene in the LNCaP and PC-3 PCa cell lines, and in the PNT1A normal prostate cell line. CDR1 mRNA expression was evaluated by qRT-PCR. We found that the CDR1 gene was overexpressed in the LNCaP and PC-3 PCa cell lines as compared with the PNT1A normal prostate cell line. These data suggest that CDR1 could be a new biomarker for PCa identification.
The Impact of CDA A79C Gene Polymorphisms on the Response and Hematologic Toxicity in Gemcitabine-Treated Patients: A Meta-Analysis
Authors: Li Hui , Wang Xiangling , Wang Xiuwen
Published: November 2014

Purpose

To investigate the impact of the cytidine deaminase (CDA) A79C polymorphism on both the response to gemcitabine in non-small cell lung cancer (NSCLC) patients and the risk of hematologic toxicities in patients bearing any kind of cancer taking gemcitabine.

Methods

The PubMed and Embase databases were searched from the first available article to January 2013. Eligible studies included clinical trials that contained the keywords “gemcitabine” or “cytidine deaminase” and information about response rate of NSCLC patients or hematologic toxicities in patients with any kind of cancer. Relative risk (RR) of different genotypes and 95% confidence intervals (CI) were calculated.

Results

A total of 7 articles (623 patients from 6 studies) were included. The results showed that patients with wild type CDA (AA and AC) had a significantly lower rate of severe anemia than the homozygote mutant type CC (RR=0.308; 95%CI, 0.113-0.021, p=0.021). However, the rate of severe neutropenia, thrombocytopenia, and the response rate were identical between different CDA genotypes.

Conclusion

The A79C CDA polymorphism did not show a significant impact on the response rate to gemcitabine in NSCLC patients, while the wild type CDA genotype was indeed correlated to a lower rate of incidence of severe anemia in patients taking gemcitabine.
Epigenetic Changes of TIMP-3, GSTP-1 and 14-3-3 Sigma Genes as Indication of Status of Chronic Inflammation and Cancer
Authors: Wang Yan-jun , He Ling , Yuan Ming , Tsang William W.N. , Hao Liang , Wang Min , Chow Louis W.C. , Cheung Mary N.B. , Liu Qing , Ng Elizabeth L.Y. , Loo Wings T.Y. , Chow Christopher Y.C. , Bai Lan-jun , Yang Zheng
Published: November 2014

Objectives

This study aimed to compare the epigenetic changes via hypermethylation status of TIMP-3, GSTP-1 and 14-3-3σ genes, between healthy subjects and patients with reversible chronic inflammatory disease, and between healthy subjects and patients with irreversible malignant disease, to highlight the genetic changes that occur in the progression from an inflammatory condition to irreversible genetic changes commonly observed in cancer patients.

Methods

DNA was extracted from the blood of 680 healthy subjects, and tissues and blood of 110 patients with chronic inflammation disease of the gums, as well as neoplastic tissues of 108 breast cancer patients. Methylation-specific polymerase chain reaction (PCR) for TIMP-3, GSTP-1 and 14-3-3σ was performed, and hypermethylation status was analyzed and compared between the 3 groups.

Results

The hypermethylation frequencies of TIMP-3 and GSTP-1 of reversible chronic inflammatory gum disease and the control group were similar, but both were significantly lower than those for malignant disease patients (p<0.0001). The methylation frequency of 14-3-3σ in chronic inflammatory gum disease was higher than in the cancer and control groups (p<0.0001). The methylation of CpG islands in TIMP-3 and GSTP-1 in chronic inflammation patients occurred as frequently as in the control group, but less frequently than in breast cancer patients. However, the epigenetic silencing of 14-3-3σ occurred more frequently in the chronic inflammation group than in cancer patients and healthy controls.

Conclusions

The epigenetic silencing of 14-3-3σ might be essential for chronic inflammatory gum disease. The epigenetic changes presented in chronic inflammation patients might demonstrate an irreversible destruction in the tissues or organs similar to cancer.
Implantation Rate Remains Unaffected in Women with Endometriosis Compared to Tubal Factor Infertility
Authors: Matalliotakis Ioannis M. , Sakkas Denny , Illuzzi Jessica , Matalliotaki Charikleia , Arici Aydin
Published: November 2014

Purpose

To reconsider the implantation and delivery rates which occurred six years later in women with endometriosis from the Yale IVF Programme.

Methods

Five hundred and ninety-seven consecutive IVF and ICSI treatment cycles were analyzed retrospectively. Patients with endometriosis (n=130; 258 cycles) were compared with an age-matched control group with tubal infertility (n=104; 206 cycles) and also with a group with male infertility (n=59; 133 cycles). Data from the endometriosis group were analyzed further in minimal-mild (144 cycles) and moderate-severe (114 cycles) subgroups. All the patients underwent laparoscopy prior to IVF treatment.

Results

Fewer oocytes were retrieved and similar fertilization (59% vs. 61%), implantation (12.3% vs. 16%), and delivery (23.7% vs. 26.3%) rates were found in patients with endometriosis compared to tubal infertility. A trend towards reduced pregnancy rate per transfer (17.5%) in the male infertility vs. endometriosis or tubal infertility groups (34% and 37.8% respectively) was observed. The number of embryos transferred in each group was comparable. Analysis of first cycles only across all groups revealed that the implantation rate did not have any statistically significant differences in the endometriosis versus the tubal or male infertility groups. Within the endometriosis group, the implantation, pregnancy, and delivery rates were similar in subgroups.

Conclusions

We conclude that in patients with endometriosis, implantation, pregnancy, and delivery rates are similar with tubal factor infertility, and higher compared to male infertility. Our results suggest that embryo quality and uterine receptivity remain unaffected in women with endometriosis.
Aneurysm Formation and Infection in AV Prosthesis
Authors: Lazarides Miltos K. , Georgiadis George S. , Argyriou Christos
Published: November 2014

In contrast to autogenous arteriovenous (AV) fistulae where true aneurysms are the most frequent type, aneurysms in prosthetic AV grafts are mostly false aneurysms and less frequently anastomotic ones. Indications for repair comprise false aneurysms exceeding twofold the graft diameter, those with rapid enlargement or with skin thinning or erosion, the ruptured, those causing pain or severely limiting the cannulable area and the infected ones. They can be managed either with conventional surgery or with endovascular techniques; However, conventional surgery represents the current standard treatment consisting of either aneurysm resection and interposition graft in situ or resection/exclusion and bypass via a new route to avoid a potentially contaminated area.
Radiological Assessment of Vascular access in Haemodialysis Patients
Authors: Kamper Lars , Frahnert Michael , Grebe Scott-Oliver , Haage Patrick
Published: November 2014

Clinical examination is still the most important diagnostic tool and duplex ultrasonography is the imaging method of first choice. Radiological assessment of vascular access for haemodialysis includes preoperative analysis of vessel anatomy and postoperative surveillance for access maturation as well as diagnosis in vascular access insufficiency. Compared to ultrasonography digital subtraction angiography is superior for the evaluation of the central veins and allows diagnosis and treatment in one session. Computed tomography should only be used in patients with inconclusive ultrasonography results, for example, for the assessment of the central veins and visualization of the vascular tree. Gadolinium-enhanced magnetic resonance imaging is no longer recommended in dialysis patients, because it may trigger nephrogenic systemic fibrosis. In patients with a history of previous central venous catheters additional preoperative imaging of the central veins should be performed. In this article we review the different radiological imaging methods for preoperative assessment and suspected vascular access dysfunction.
Anesthesia for Vascular access Surgery
Authors: Shemesh David , Raikhinstein Yefim , Orkin Dina , Goldin Ilya , Olsha Oded
Published: November 2014

The type of anesthesia chosen is an integral part of the decision-making process for arteriovenous access construction. We discuss the different types of anesthesia used, with emphasis on brachial plexus block, which is potentially safer than general anesthesia in this fragile patient population with end-stage renal disease. Brachial plexus block is superior to local anesthesia and enables the use of a tourniquet to minimize potential damage to the blood vessels during anastomosis using microsurgery techniques, and does not lead to the vasospasm that may be seen with local anesthesia. Regional anesthesia has a beneficial sympathectomy-like effect that causes vasodilation with increased blood flow during surgery and in the fistula postoperatively that may prevent early thrombosis and potentially improve outcome.
Complex Central Venous Catheter Insertion for Hemodialysis
Authors: Powell Steven , Belfield Jane
Published: November 2014

Despite the introduction of payment by results in the UK, there has been no decrease in central venous catheter (CVC) use. In part, this may relate to a requirement to dialyse through a CVC while autogenous access matures. Mortality data have improved in parallel and patients on hemodialysis live longer, which may lead to an increased exposure to CVCs. Exposure to CVCs carries a significant risk of infection and occlusion requiring their repositioning or exchange. The mid to long-term sequelae of CVC use is central venous occlusion leaving clinical teams with an ever increasing challenge to find adequate venous access.

In this article, we will discuss the challenges faced by operators inserting CVCs into the hemodialysis-dependent patient who has exhausted more tradition insertion sites. These include translumbar caval catheters, transocclusion and transcollateral catheters, transjugular Inferior Vena Cava catheter postioning, and transhepatic catheters. We will demonstrate the techniques employed, complications, and anticipated longevity of function.
Endovascular Techniques for Cannulation Difficulties in Dialysis Access
Authors: Powell Steven , Chan Tze
Published: November 2014

Although the arteriovenous fistula (AVF) is the access of choice for dialysis, its success as an access is limited by its high rate of failing to mature and its development of venous stenoses. This makes cannulation difficult or even impossible for dialysis staff. A variety of endovascular techniques exist for improving cannulation rates in AVFs. These include coil embolization of tributaries and balloon-assisted maturation in immature fistulae and fistuloplasty, stents and thrombus removal in mature failing access. This article aims to discuss the methods and evidence related to these techniques.
Prostate I 125 Brachytherapy: Critical Evaluation of Mid Term Oncologic and Functional Results after 250 Cases
Authors: Gastaldi Emilio , Chiono Luciano , Gallo Fabrizio , Giberti Claudio
Published: November 2014

Background.

Even if Brachytherapy (BT) in low-risk prostate cancer (CaP) is a common practice since more than 20 and 10 years in USA and Italy, respectively, it is still an uncommon procedure because of the problems related to the organization and collaboration among urologists, radiotherapists and physics, to the competition of alternative therapies, to dogmatic and educational beliefs, and to the poor knowledge of this technique.

Methods.

Between May 1999 and September 2010, 250 patients with low risk CaP underwent l125BT using a “real time” approach; the seeds implantation was performed using Mick applicator, in the first 190 patients, and the “Quick-Link” technique in the last 60 cases. Oncologic results were reported in the first 150 cases with a mean follow-up of 95 months, while functional outcomes and complications were assessed in all the patients at different time points with a mean follow-up of 65 months.

Results.

A good quality implantation was assessed in 88% of patients (D90 >140 Gy). Overall, a biochemical failure was assessed, in accordance with Phoenix criteria, in 10 patients (6.6%). Among these patients, the prostatic biopsy showed a CaP in 6/10 patients, who underwent retropubic radical prostatectomy (4 pts) and external RT (2 pts); only one patient developed a systemic progression with secondary bone lesions and died after 122 months and 36 months from BT and RRP, respectively. The 4/10 patients with negative biopsy were treated with total androgen blockade (2 pts) and with watchful waiting (2 pts). Regarding functional results, we assessed a moderate incidence of irritative disorders (70%) during the first six months and a good recovery of erectile function after one year from surgery (78.8%).

Conclusions.

Brachytherapy in the low-grade risk prostatic cancer represents a good alternative to RRP with excellent functional and oncologic results.
Treatment of Lithiasis with Infundibular Axis at an Acute Angle to the Calyx Entry in PCNL
Authors: Serra Simona , Corona Andrea , De Lisa Antonello
Published: November 2014

Introduction

In the treatment of pyelo multi calyceal renal lithiasis, although we utilize both rigid and flexible instruments, the greatest challenge when trying to achieve a stone-free status after the procedure with a single access, is represented by the presence of residual caliceal stones difficult to reach for the length of the infundibular system in which they are localized, and major axis of it at an acute angle with respect to the axis of the cannula entrance. We describe our technique of treatment in these cases with no second access.

Materials and Methods

55 cases of multiple lithiasis of the lower calyx at the end of PCNL for complex lithiasis were treated with the following technique. Using ultrasound and fluoroscopic guidance a puncture of the calyx adjacent to the cannula was performed. A standard Lubriglide guide (0.038″, right or J) was introduced until the renal pelvis. Through a nephroscopic guidance, the guide was retrieved with a clamp and was taken out from the cannula; then the two leaders were locked together by a mosquito-mounted clamp. The guide traction towards the cannula allowed identifying, through the rigid nephroscope, the infundibulum where the lithiasis was located. The infundibulum was sectioned with monopolar electrode and it was possible to access the calyx affected by the lithiasis.

Results

In all treated cases it was possible to reach the lithiasis from the single initial percutaneous access and to eliminate them. Small bleedings were dominated by monopolar electrode. The Urography or uro-CT performed after three months showed no residual lithiasis; the infundibulum resumed its morphological characteristics.

Discussion

The described technique allows for a complete resolution of the lithiasis with no need of a second access or a retrograde approach, in situations where the combined use of flexible instruments does not allow solving the pathology.
Application of Perineal Ultrasound Measurement and Urodynamic Study in the Diagnosis and Typing of Stress Urinary Incontinence Ultrasound and Urodynamic Study
Authors: Zhang Xiutao , Chen Zhong , Song Xiaodong , Yuan Xiaoyi , Cai Dan , Chen Jiang , Li Lina , Du Guanghui , Yang Weimin , Ye Zhangqun
Published: November 2014

AIMS

To explore the value of perineal ultrasound and urodynamic study in the clinical diagnosis with the morphological and functional changes and evaluation of clinical type in female patients with stress urinary incontinence (SUI).

Methods

The records of 64 female patients with SUI were reviewed. Fifty females with urinary frequency but with no SUI symptoms served as controls. All of them underwent ultrasound and urodynamic measurement. P<0.05 was considered statistically significant.

Results

The maximum flow rate (Q max) was significantly higher in the patients than in the control group, but the maximal urethral pressure (MUP), maximal urethral closing pressure (MUCP) and functional urethral length (FUL) were significantly lower than in the control group. Ultrasound measurements showed that the rotation angle and movement of urethrovesical junction, funneling of bladder neck and posterior urethrovesical angle (PUVA) at rest and during straining were greater in patients than in the control group. Patients with higher abdominal leak point pressure (ALPP) had higher maximal urethral closing pressure (MUCP), greater rotation angle and movement of urethrovesical junction. Patients with higher MUCP had higher ALPP, greater rotation angle and movement of urethrovesical junction.

Conclusions

The urodynamic study and perineal ultrasound have a great significance in the diagnosis and typing of SUI.
Technology innovations in global medical education
Authors: Sutherland Deborah
Published: November 2014

The loss of 400,00 lives annually due to preventable, adverse outcomes is believed to be the third leading cause of death in the United States, after heart disease and cancer.

The leadership of the University of South Florida, Center for Advanced Medical Learning and Simulation (CAMLS) has heard this concern and developed a national model for improving medical education and patient safety, as well as aggressive and needed healthcare solutions through the use of cutting edge technology, innovation, and simulation.

CAMLS' goal is to use technology, simulated environments, and team training to transition medical education from an apprenticeship model to an evidence-based competency model that improves patient outcomes and reduces medical errors.

The processes used at CAMLS are reflective of the instructional design process and team training approach used successfully in aviation and the military.
Leibniz: liberdade e verdade
Authors: Lacerda Tessa Moura
Published: November 2014

Não há, para Leibniz, separação entre uma esfera ética, na qual seriam consideradas as ações voluntárias dos homens e sua busca pelo bem, e uma esfera epistemológica, pela qual se explicaria a busca pela verdade. Procuramos mostrar, primeiro, em que sentido se pode dizer que o conhecimento é uma ação voluntária; e, segundo, como a ação moral só é verdadeiramente livre se fundamentada no conhecimento do verdadeiro, por isso o modelo de homem livre é o homem sábio.
Carta sobre a liberdade de indiferença
Authors: Zilber Kontic Sacha
Published: November 2014

Nessa carta de 1707 endereçada a Pierre Coste, o tradutor das obras de Locke para o francês, Leibniz examina o problema de saber se há uma liberdade de indiferença, ou seja, se entre duas coisas às quais somos indiferentes, podemos escoher livremente uma delas em detrimento da outra. Essa carta retoma e aprofunda temas desenvolvidos nos Novos Ensaios. escritos entre 1703 e 1704 (principalmente nos capítulos XX e XXI do livro II) e que posteriormente são retomados na Teodiceia, publicada em 1710 (especialmente nos §324-325).
Determinação e diferença: considerações sobre a razão suficiente segundo Leibniz
Authors: Ferro Nuno
Published: November 2014

Entre os muitos textos em que Leibniz introduz e apresenta o princípio de razão suficiente está, como se sabe, o do parágrafo 7 dos Princípios da Natureza e da Graça. O texto diz: "Jusqu'icy nous n'avons parlé qu'en simples Physiciens: maintenant il faut s'elever à la Metaphysique, en nous servant du Grand Principe, peu employé communement, qui porte que rien ne se fait sans raison suffisante, c'est à dire que rien n'arrive, sans qu'il soit possible à celuy qui connoitroit assés les choses, de rendre une Raison qui suffise pour determiner, pourquoy il en est ainsi, et non pas autrement. Ce principe posé, la premiere question qu'on a droit de faire, sera, Pourquoy il y a plustôt quelque chose que rien? Car le rien est plus simple et plus facile que quelque chose. De plus, supposé que des choses doivent exister, il faut qu'on puisse rendre raison, pourquoy elles doivent exister ainsi, et non autrement" (LEIBNIZ, 1978a, 602). O texto é evidentemente muito denso e inclui uma enorme multiplicidade de aspectos que deveriam ser analisados, por exemplo, o pouco uso que se faz de um princípio que, todavia, está sempre presente em tudo o que pensamos e fazemos; o facto de ter de haver uma razão para haver algo e para haver o que há; o facto de o nada ser mais fácil do que o ente; que se entende, afinal, por razão, que é que queremos dizer quando dizemos que há razão para qualquer coisa; que é que a noção de suficiência acrescenta (ou não acrescenta) à noção de razão (isto é, uma razão insuficiente é, nalgum sentido do termo, ainda uma razão?), etc. O problema é, aliás, bem actual. D. Parfit, em On What Matters, escreve logo na primeira página do primeiro capítulo: "It is hard to explain the concept of reason, or what the phrase 'a reason' means. Facts give us reasons, we might say, when they count in favour of our having some attitude, or our acting in some way. But 'counts in favour of' means roughly 'gives a reason for'. Like some other fundamental concepts (…), the concept of a reason is indefinable in the sense that it cannot be helpfully explained merely by using words"(PARFIT, 2011, p. 31). Ou seja, não é claro a que é que corresponde a noção de razão, e apesar de Parfit ignorar tranquilamente o que a tradição pensou sobre o assunto, pode valer a pena regressar a Leibniz, também porque Leibniz se vangloria com frequência de dizer que o princípio de razão suficiente é o seu princípio.
Restricciones de la aplicación del principio de sustituibilidad de los idénticos salva veritate en Leibniz
Authors: Esquisabel Oscar
Published: November 2014

O princípio de intersubstituição dos idênticos salva veritate, que constitui uma peça de importância central para a teoria leibniziana da demostração, para não falar de suas implicações ontológicas, recebeu a crítica de que encerra uma confusão entre uso e menção. Em contraste com essa crítica, o presente trabalho defende a tese de que o princípio não está suscetível a essa pretensa confusão, utilizando, para tanto, a distinção leibniziana entre “a consideração do modo de conceber” e a “consideração da coisa mesma”. A introdução dessa distinção, porém, vem acompanhada com a necessidade de estabelecer restrições à aplicação do mencionado princípio.
Contingência e complexidade infinita: o problema da prova sortuda
Authors: Da Rocha Marques Edgar
Published: November 2014

Apresento e desenvolvo neste artigo o problema da prova sortuda, analisando duas soluções para ele presentes na literatura. A primeira delas consistira em alegar que mostrar que o predicado está contido no sujeito não basta como demonstração da verdade de uma proposição, sendo preciso que se prove ainda que a noção relativa ao sujeito é logicamente consistente. A segunda repousaria em uma hierarquização modal, por assim dizer, dos pre- dicados integrantes de uma noção individual. Após exibir as razões que me levam a rejeitar essas duas soluções, apresento os traços fundamentais de uma interpretação que me parece resolver o problema de maneira satisfatória. Minha posição envolve conceder ao Princípio da Razão Suficiente um papel central na compreensão do que significa, para Leibniz, provar que um determinado predicado está contido na noção relativa a um certo indivíduo.
Da espontaneidade da natureza à liberdade do espírito
Authors: Cardoso Adelino
Published: November 2014

O objetivo principal deste artigo consiste em evidenciar a continuidade entre natureza e espírito no pensamento leibniziano. De fato, a adesão de Leibniz à ciência moderna é acompanhada de uma metafísica espiritualista, que o autor corrige no sentido de uma correspondência perfeita entre dois planos de fenómenos funcionando de acordo com princípios distintos. O elo de ligação entre esses dois planos é a noção de espontaneidade, que caracteriza a atividade da natureza e é elevada ao seu grau supremo através da liberdade dos espíritos.