bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic Value of Incremental Lactate Elevations in Emergency Department Patients With Suspected Infection
Authors: Puskarich Michael A. , Kline Jeffrey A. , Summers Richard L. , Jones Alan E.
Published: August 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19:983–985 © 2012 by the Society for Academic Emergency Medicine

Objectives:  Previous studies have confirmed the prognostic significance of lactate concentrations categorized into groups (low, intermediate, high) among emergency department (ED) patients with suspected infection. Although the relationship between lactate concentrations categorized into groups and mortality appears to be linear, the relationship between lactate as a continuous measurement and mortality is uncertain. This study sought to evaluate the association between blood lactate concentrations along an incremental continuum up to a maximum value of 20 mmol/L and mortality.

Methods:  This was a retrospective cohort analysis of adult ED patients with suspected infection from a large urban ED during 2007–2010. Inclusion criteria were suspected infection evidenced by administration of antibiotics in the ED and measurement of whole blood lactate in the ED. The primary outcome was in‐hospital mortality. Logistic and polynomial regression were used to model the relationship between lactate concentration and mortality.

Results:  A total of 2,596 patients met inclusion criteria and were analyzed. The initial median lactate concentration was 2.1 mmol/L (interquartile range [IQR] = 1.3 to 3.3 mmol/L) and the overall mortality rate was 14.4%. In the cohort, 459 patients (17.6%) had initial lactate levels >4 mmol/L. Mortality continued to rise across the continuum of incremental elevations, from 6% for lactate <1.0 mmol/L up to 39% for lactate 19–20 mmol/L. Polynomial regression analysis showed a strong curvilinear correlation between lactate and mortality (R = 0.72, p < 0.0001).

Conclusions:  In ED patients with suspected infection, we found a curvilinear relationship between incremental elevations in lactate concentration and mortality. These data support the use of lactate as a continuous variable rather than a categorical variable for prognostic purposes.
A Prospective, Randomized, Controlled Study Demonstrating a Novel, Effective Model of Transfer of Care between Physicians: The 5 Cs of Consultation
Authors: Kessler Chad S. , Afshar Yalda , Sardar Gurkiran , Yudkowsky Rachel , Ankel Felix , Schwartz Alan
Published: August 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19:968–974 © 2012 by the Society for Academic Emergency Medicine

Objectives:  The objective was to evaluate whether a standardized consultation model in the emergency department (ED), the 5 Cs of Consultation (Contact, Communicate, Core Question, Collaboration, and Closing the Loop), would improve physicians’ ability to relay appropriate information and communicate successfully during a consultation.

Methods:  This was a prospective, randomized study at a large, academic, urban, tertiary care medical center in Chicago. Forty‐three emergency medicine (EM) and EM/internal medicine (EM/IM) residents were randomized into two groups, an intervention group and an unstructured group, stratified by postgraduate year (PGY). Intervention group participants received an interactive educational session on the 5 Cs of Consultation, a standardized consultation model. Intervention and unstructured groups placed two simulated consultation phone calls, based on pretested simulated patient cases, to a standardized consultant. Three raters, naive to the consultation model and blinded to group assignments, individually assessed recordings of each call using a seven‐item, five‐point global rating scale (GRS). Finally, an attending surgeon and an attending psychiatrist each rated respective cases using a single global rating to provide validity evidence for the scale.

Results:  Residents trained with the 5 Cs model communicated significantly better, regardless of PGY and clinical case. The intervention group had significantly higher mean GRS scores than the unstructured group (4.1 vs. 3.5, F(1,39) = 33.5, p < 0.0001). Secondary analysis of the recordings suggested that encounters with more 5 Cs behaviors tended to receive higher GRS scores.

Conclusions:  A standardized educational model increased the effectiveness of consultation communication from the ED. Residents trained with the 5 Cs of Consultation scored better on consultation assessments compared with untrained residents. Training programs should consider adopting standardized consultation models.
Early Maladaptive Schemas and Aggressive Sexual Behavior: A Preliminary Study with Male College Students
Authors: Sigre-Leirós Vera Lúcia , Carvalho Joana , Nobre Pedro
Published: August 2012

Introduction

The influence of adverse early attachment experiences on the development of aggressive sexual behavior has been demonstrated. Nonetheless, there is a gap in the literature regarding the conceptualization of this behavior according to developmental psychopathology models.

Aim

The purpose of the present study was to investigate a potential association between Early Maladaptive Schemas (EMSs) and aggressive sexual behavior.

Methods

A total of 166 male college students participated in the study. Participants were divided into two comparative groups according to data from the Sexual Experiences Survey—Short Form Perpetration (SES-SFP): Group of individuals with history of aggressive sexual behavior (N = 37) and Group of individuals without history of aggressive sexual behavior (N = 129).

Main Outcome Measures

Aggressive sexual behavior was measured by the SES-SFP, and EMSs were measured by the Young Schema Questionnaire (YSQ-S3).

Results

Results showed that students who have committed any form of sexually aggressive behavior exhibited significantly higher levels of EMSs from the Disconnection and Rejection domain (namely, Mistrust/Abuse schema), from the Impaired Autonomy and Performance domain (namely, Dependence/Incompetence schema), and from the Overvigilance and Inhibition domain (namely, Negativity/Pessimism schema).

Conclusions

These preliminary findings suggest that the EMSs were associated with aggressive sexual behavior, but further investigation is warranted.
H2S Relaxes Vas Deferens Smooth Muscle by Modulating the Large Conductance Ca2+-Activated K+ (BKCa) Channels via a Redox Mechanism
Authors: Li Yan , Zang Yuanwei , Fu Shanshan , Zhang Hongyuan , Gao Lu , Li Jingxin
Published: August 2012

Introduction

Hydrogen sulfide (H2S) is generated in mammalian cells mainly by one of the two pyridoxal-5′-phosphate-dependent enzymes, cystathione-γ-lyase (CSE), and cystathione-β-synthase (CBS) using L-cysteine as the main substrate. In previous studies, we found that CBS and CSE were functionally expressed in vas deferens (VD) and H2S-mediated VD smooth muscle relaxation. However, the detail mechanisms that H2S-relaxed VD smooth muscle were unknown so far.

Aim

The aim of this study is to explore the molecular target sites of H2S in VD smooth muscle.

Methods

Isolated rat VD smooth muscle strips were used for tension recording in vitro. Double immunofluorescence staining was used to identify the localization of large conductance Ca2+-activated K+ (BKCa) channels.

Main Outcome Measures

Changes in tonic contraction of isolated rat VD smooth muscle strip were measured after the treatment of drugs. The expression of BKca channels in rat VD smooth muscle cells was also assessed.

Results

The results showed that L-NG-nitroarginine methyl ester (a nitric oxide synthase inhibitor) did not affect the response of VD to sodium hydrosulphide (NaHS), suggesting that nitric oxide pathway was not involved. Further studies revealed that transient receptor potential (TRP) channels did not contribute to the NaHS-induced relaxant effect. Glibenclamide, an ATP-sensitive K channel blocker, did the same thing, whereas BKCa channel blockers iberiotoxin or tetraethylammonium largely reversed the relaxant effect, suggesting that H2S may target BKCa channels. We also confirmed that BKCa channels were localized in VD smooth muscle cells. Then, studies revealed that NaHS-induced VD smooth muscle relaxation was abolished by N-ethylmaleimide, which was widely used as a sulfhydryl alkylation compound protecting thiols from oxidation, whereas DL-Dithiothreitol, a strong reducing agent, did not affect the response of VD to NaHS.

Conclusions

We concluded that H2S relaxed the VD smooth muscle by targeting BKCa channels via redox-mediated mechanism.
The Neuroprotective Effect of Platelet-rich Plasma on Erectile Function in Bilateral Cavernous Nerve Injury Rat Model
Authors: Wu Chien-Chih , Wu Yi-No , Ho Hsiu-O , Chen Kuo-Chiang , Sheu Ming-Thau , Chiang Han-Sun
Published: August 2012

Introduction

Neurogenic erectile dysfunction resulting from cavernous nerve (CN) injury is a major complication caused by radical prostatectomy. The use of platelet-rich plasma (PRP) on the nerve-injured site has shown promising results for the nerve regeneration. However, the effects of PRP injection in corpus cavernosum after bilateral CN injury have never been investigated.

Aim

To assess the neuroprotective effect of PRP injection in corpus cavernosum after bilateral CN injury.

Methods

Male Sprague-Dawley rats were randomly divided into three groups: Group I underwent sham operation, while the remaining two groups underwent bilateral CN crush. Crush injury groups were treated at the time of injury with an application of PRP or normal saline only injection in the corpus cavernosum, respectively. Four weeks later, erectile function (EF) was assessed by CN electrosimulation, and CNs as well as penile tissue were collected for histology.

Main Outcome Measures

Intracavernous pressure (ICP) monitored during electrical stimulation of CNs; myelinated axons number of CNs and dorsal penile nerve; collagen type change, number of apoptotic cells, and mRNA expression of caspase-3 and transforming growth factor-β1 (TGF-β1) in the corpus cavernosum.

Results

Four weeks after surgery, in the vehicle-only group, the functional evaluation showed a lower mean maximal ICP than that in the sham group (P < 0.05). PRP treatments resulted in significant recovery of EF, as compared with the vehicle-only group (P < 0.05). Histologically, the PRP-treated group had a significant preservation of myelinated axons of CNs compared with the vehicle-only group (P < 0.05) and reduced the apoptotic index. The mRNA expression of TGF-β1 in the corpus cavernosum tissue was significantly decreased in the PRP group compared with the vehicle-only group (P < 0.05).

Conclusions

PRP injection in the corpus cavernosum increased the number of myelinated axons and facilitated recovery of EF in the bilateral CN injury rat model.
The 21-cm radiation from minihaloes as a probe of small primordial non-Gaussianity
Authors: Chongchitnan Sirichai , Silk Joseph
Published: August 2012

We present a new probe of primordial non-Gaussianity via the 21-cm radiation from minihaloes at high redshifts. We calculate the fluctuations in the brightness temperature (measured against the cosmic microwave background) of the 21-cm background from minihaloes containing H i at redshift ∼6–20, and find a significant enhancement due to small non-Gaussianity with amplitude fNL ≲ 1. This enhancement can be attributed to the non-linear bias which is strongly increased in the presence of non-Gaussianity. We show that our results are robust against changes in the assumed mass function and some physical aspects of minihalo formation, but are nevertheless sensitive to the presence of strong radiation sources within or around the minihaloes. Our findings are relevant for constraining and searching for small primordial non-Gaussianity with upcoming radio telescopes such as Low-Frequency Array (LOFAR) and Square Kilometre Array (SKA).
A Systematic Review of Patient Self‐Reported Barriers of Adherence to Antihypertensive Medications Using the World Health Organization Multidimensional Adherence Model
Authors: AlGhurair Suliman A. , Hughes Christine A. , Simpson Scot H. , Guirguis Lisa M.
Published: August 2012

J Clin Hypertens (Greenwich). 2012;14:877–886. ©2012 Wiley Periodicals, Inc.

Multiple barriers can influence adherence to antihypertensive medications. The aim of this systematic review was to determine what adherence barriers were included in each instrument and to describe the psychometric properties of the identified surveys. Barriers were characterized using the World Health Organization (WHO) Multidimensional Adherence Model with patient, condition, therapy, socioeconomic, and health care system/team‐related barriers. Five databases (Medline, Embase, Health and Psychological Instruments, CINHAL, and International Pharmaceutical Abstracts [IPA]) were searched from 1980 to September 2011. Our search identified 1712 citations; 74 articles met inclusion criteria and 51 unique surveys were identified. The Morisky Medication Adherence Scale was the most commonly used survey. Only 20 surveys (39%) have established reliability and validity evidence. According to the WHO Adherence Model domains, patient‐related barriers were most commonly addressed, while condition, therapy, and socioeconomic barriers were underrepresented. The complexity of adherence behavior requires robust self‐report measurements and the inclusion of barriers relevant to each unique patient population and intervention.
Resistance, Aerobic, and Combination Training on Vascular Function in Overweight and Obese Adults
Authors: Ho Suleen S. , Radavelli‐Bagatini Simone , Dhaliwal Satvinder S. , Hills Andrew P. , Pal Sebely
Published: August 2012

J Clin Hypertens (Greenwich). 2012; 14:848–854. ©2012 Wiley Periodicals, Inc.

The authors investigated the effects of moderate‐intensity resistance, aerobic, or combined exercise on blood pressure and arterial stiffness in overweight and obese individuals compared with no exercise. Participants were randomized to 4 groups: control, aerobic, resistance, and combination. Assessments were made at baseline, week 8, and week 12. In participant‐designated responders, those in the intervention groups who had improved levels of systolic blood pressure (SBP) or augmentation index (AI), we observed a significant decrease of SBP in aerobic (−4%, P=.027), resistance (−5.1%, P=.04), and combination groups (−6.3%, P=.000) at week 8 and in the combination group (−6.3%, P=.005) at week 12, compared with baseline. AI was significantly lower at week 12 in the aerobic (−12%, P=.047), resistance (−9.5%, P=.036), and combination (−12.7%, P=.003) groups compared with baseline, as well as in the combination group (−10.7%, P=.047) compared with the control group. We did not observe significant changes in SBP, DBP, or AI between the interventions when assessing the entire cohort, although there were significant improvements in a subgroup of responders. Thus, some but not all overweight and obese individuals can improve blood pressure and arterial stiffness by participating in regular combination exercise, decreasing the risk of developing cardiovascular disease.
Assessing Legal Strains and Risk of Suicide Using Archived Court Data
Authors: Cook Thomas Bradley
Published: August 2012

Relatively little is known about legal entanglements and suicide risk. This matched case–control study estimated the risk of suicide associated with legal strains using online court archives, a novel source of exposure data. Court records linked to suicide deaths (N = 315), controls (N = 630), and unintentional injury and poisoning deaths (N = 630) for an urban county from 2000 to 2005 revealed that nearly a third of suicide victims had recent court involvement, twice the proportion among controls. Misdemeanors, car accidents, and foreclosures were each associated with a threefold risk of suicide. Implications for suicide prevention and research are discussed.
How Does Product Market Competition Interact with Internal Corporate Governance?: Evidence from the Korean Economy*
Authors: Byun Hee Sub , Lee Ji Hye , Park Kyung Suh
Published: August 2012

In this study, we empirically test whether firms that belong to a business group (chaebol) behave differently from stand‐alone firms in their decisions regarding internal corporate governance, given product market competition. The existing literature has ignored the possibility that firm characteristics may differentially affect this relationship. We find that the member firms of chaebol maintain better internal corporate governance in a non‐competitive environment, whereas stand‐alone firms do so in a competitive environment. We also find that the positive effects of internal corporate governance on firm value are stronger in a non‐competitive environment for stand‐alone firms, but not for affiliated firms. We ascribe the detected differences in corporate behavior and performance to differences in the level of competitive pressure to which firms are exposed. When we classify the firms by asset size or product market leadership, we observe a similar pattern, which also supports our conjecture.
Do Investors Price Accruals Quality? A Reexamination in the Implied Cost of Equity Capital*
Authors: Hwang Lee‐Seok , Lim Seung‐Yeon
Published: August 2012

This study investigates whether accruals quality (AQ) influences the expected returns of stock investors. We employ estimates of the implied cost of equity capital (ICOE) as the expected returns of stock investors because they are well specified ex ante without the need for noisy realized returns. Extending a current debate on AQ pricing, we control for several properties of analysts’ forecasts and find that AQ is positively and significantly related to ICOE. In addition, AQ is more closely related to the innate component than to the discretionary component. However, even after controlling for innate factors, we find that investors also price the discretionary component. Finally, we show that the relationship between AQ and ICOE is more pronounced for firms in poor information environments, such as small firms and firms with a low analyst following, implying that a firm’s information environment influences the relationship between AQ and ICOE.
ITMs versus OTMs*
Authors: Yoon Sun‐Joong , Kang So Hyun
Published: August 2012

By comparing liquidity and price discovery effects, the market microstructure literature insists that in‐the‐money options (ITMs) are informationally inferior to out‐of‐the‐money options. However, such an argument is at odds with the anecdotal point that ITMs may be more effective for hedging future volatility risk. ITMs are driven by institutional investors, who are considered to be informed traders, and can provide significant hedging benefits such that a hedging with ITMs requires fewer options and less frequent rebalancing. To clear this suspicion, we compare implied risk‐neutral densities, implied risk aversions and volatility forecasting performances. Contrary to the anecdotal evidence, our findings show the inferiority of ITMs in forecasting future volatilities, even after adjusting for the risk attitude of investors. These findings offer support for the arguments made in the extant market microstructure literature.
Therapeutic implications of endothelin and thrombin G-protein-coupled receptor transactivation of tyrosine and serine/threonine kinase cell surface receptors
Authors: Kamato Danielle , Burch Micah L , Osman Narin , Zheng Wenhua , Little Peter J
Published: August 2012

Objectives

This review discusses the latest developments in G protein coupled receptor (GPCR) signalling related to the transactivation of cell surface protein kinase receptors and the therapeutic implications.

Key findings

Multiple GPCRs have been known to transactivate protein tyrosine kinase receptors for almost two decades. More recently it has been discovered that GPCRs can also transactivate protein serine/threonine kinase receptors such as that for transforming growth factor (TGF)-β. Using the model of proteoglycan synthesis and glycosaminoglycan elongation in human vascular smooth muscle cells which is a component of an in vitro model of atherosclerosis, the dual tyrosine and serine/threonine kinase receptor transactivation pathways appear to account for all of the response to the agonists, endothelin and thrombin.

The broadening of the paradigm of GPCR receptor transactivation explains the broad range of activities of these receptors and also the efficacy of GPCR antagonists in cardiovascular therapeutics. Deciphering the mechanisms of transactivation with the aim of identifying a common therapeutic target remains the next challenge.
Magnetic Field-Assisted Finishing of Silicon Microelectromechanical Systems Micropore X-Ray Optics
Authors: Riveros Raul E. , Yamaguchi Hitomi , Boggs Taylor , Mitsuishi Ikuyuki , Mitsuda Kazuhisa , Takagi Utako , Ezoe Yuichiro , Ishizu Kensuke , Moriyama Teppei
Published: August 2012

An alternating magnetic field assisted finishing (MAF) technique has been developed to finish the 5–20 μm wide pore sidewalls of micropore X-ray focusing optics fabricated using microelectromechanical systems (MEMS) techniques. To understand the material removal mechanism, this MAF technique is used to finish a silicon MEMS micropore X-ray optic that had previously undergone a hydrogen annealing treatment. Compared to the unfinished surface, distinctive surface features are observed on the finished surfaces using scanning electron microscopy, optical profilometry, and atomic force microscopy (AFM). This demonstrates the finishing characteristics and reveals material removal on the nanometer scale. Moreover, the representative unfinished and finished micropore sidewall surfaces show a reduction in roughness due to finishing from 1.72 to 0.18 nm Rq.
Design Optimization of a Wearable Artificial Pump-Lung Device With Computational Modeling
Authors: Ertan Taskin M. , Zhang Tao , Fraser Katharine H. , Griffith Bartley P. , Wu Zhongjun J.
Published: August 2012

The heart-lung machine has commonly been used to replace the functions of both the heart and lungs during open heart surgeries or implemented as extracorporeal membrane oxygenation (ECMO) to provide cardiopulmonary support of the heart and lungs. The traditional heart-lung system consists of multiple components and is bulky. It can only be used for relatively short-term support. The concept of the wearable artificial pump-lung is to combine the functions of the blood pumping and gas transfer in a single, compact unit for cardiopulmonary or respiratory support for patients suffering from cardiac failure or respiratory failure, or both, and to allow patients to be ambulatory. To this end, a wearable artificial lung (APL) device is being developed by integrating a magnetically levitated centrifugal impeller with a hollow fiber membrane bundle. In this study, we utilized a computational fluid dynamics based performance optimization with a heuristic scheme to derive geometrical design parameters for the wearable APL device. The configuration and dimensions of the impeller and the diffuser, the required surface area of fiber membranes and the overall geometrical dimensions of the blood flow path of the APL device were considered. The design optimization was iterated based on the fluid dynamic objective parameters (pressure head, pressure distribution, axial force acting on the impeller, shear stress), blood damage potential (hemolysis and platelet activation), and mass transfer (oxygen partial pressure and saturation). Through the design optimization, an optimized APL device was computationally derived. A physical prototype of the designed APL device was fabricated and tested in vitro. The experimental data showed that the optimized APL can provide adequate blood pumping and oxygen transfer over the range of intended operating conditions.
Cl atom recombination on silicon oxy-chloride layers deposited on chamber walls in chlorine–oxygen plasmas
Authors: Khare Rohit , Srivastava Ashutosh , Donnelly Vincent M.
Published: August 2012

Chlorine atom recombination coefficients were measured on silicon oxy-chloride surfaces deposited in a chlorine inductively coupled plasma (ICP) with varying oxygen concentrations, using the spinning wall technique. A small cylinder embedded in the walls of the plasma reactor chamber was rapidly rotated, repetitively exposing its surface to the plasma chamber and a differentially pumped analysis chamber housing a quadruple mass spectrometer for line-of-sight desorbing species detection, or an Auger electron spectrometer for in situ surface analysis. The spinning wall frequency was varied from 800 to 30 000 rpm resulting in a detection time, t (the time a point on the surface takes to rotate from plasma chamber to the position facing the mass or Auger spectrometer), of ∼1–40 ms. Desorbing Cl2, due to Langmuir–Hinshelwood (LH) Cl atom recombination on the reactor wall surfaces, was detected by the mass spectrometer and also by a pressure rise in one of the differentially pumped chambers. LH Cl recombination coefficients were calculated by extrapolating time-resolved desorption decay curves to t = 0. A silicon-covered electrode immersed in the plasma was either powered at 13 MHz, creating a dc bias of −119 V, or allowed to electrically float with no bias power. After long exposure to a Cl2 ICP without substrate bias, slow etching of the Si wafer coats the chamber and spinning wall surfaces with an Si-chloride layer with a relatively small amount of oxygen (due to a slow erosion of the quartz discharge tube) with a stoichiometry of Si:O:Cl = 1:0.38:0.38. On this low-oxygen-coverage surface, any Cl2 desorption after LH recombination of Cl was below the detection limit. Adding 5% O2 to the Cl2 feed gas stopped etching of the Si wafer (with no rf bias) and increased the oxygen content of the wall deposits, while decreasing the Cl content (Si:O:Cl = 1:1.09:0.08). Cl2 desorption was detectable for Cl recombination on the spinning wall surface coated with this layer, and a recombination probability of γCl = 0.03 was obtained. After this surface was conditioned with a pure oxygen plasma for ∼60 min, γCl increased to 0.044 and the surface layer was slightly enriched in oxygen fraction (Si:O:Cl = 1:1.09:0.04). This behavior is attributed to a mechanism whereby Cl LH recombination occurs mainly on chlorinated oxygen sites on the silicon oxy-chloride surface, because of the weak Cl–O bond compared to the Cl–Si bond.
Congenital orbital fibrosis associated with fibrosis of extraocular muscle
Authors: Li YangJun , Han Jing , Yan Hong , Li Jing , Wang Dan , Xu Shuang
Published: August 2012

Congenital orbital fibrosis is a non-familial, unilateral, distinct clinical entity, characterised by the presence of a diffusely infiltrating orbital mass and is extremely a rare disease. Congenital orbital fibrosis with combined fibrosis of extraocular muscles have not been reported previously. We treated an 8-year-old boy with the presence of a diffusely infiltrating orbital mass and fibrosis of extraocular muscles with secondary involvement of extraocular muscles. Clinical examination revealed left exotropia, hypotropia and fibrosis of extraocular muscle, an irregular, retrobulbar mass located within the orbit, incorporating the optic nerve, medial, superior, inferior and lateral rectus muscle. The CT, MRI and light microscopic studies confirmed the diagnosis. We performed exploration of the orbit, release and biopsy of scar tissue and strabismus surgery. Unlike other reported cases, our case was a progressive congenital disorder with combined fibrosis of extraocular muscle.
A breast surgeons’ paranoia pays off: the importance of keen clinical acumen in a case of postradiotherapy breast angiosarcoma
Authors: Zafar Adeel , Neary Peter , O'Donoghue Gerrard , Fiuza-Castinieria Constantino
Published: August 2012

A 72-year-old woman underwent left wide local excision and an axillary node sampling in 2005 for a T2, N0, M0 invasive ductal carcinoma followed by adjuvant chemotherapy, radiotherapy and hormonal therapy. In 2011, she developed spontaneous blue breast discolouration. Initial examination revealed global breast firmness, skin thickening and eechymosis. Despite no evidence of recurrent disease, the patient was scheduled for fortnightly review. This review demonstrated marked worsening discolouration and new nipple areolar complex blood-filled blisters. Despite concurrent antiplatelet therapy as a possible cause, the breast clinician's clinical concern of angiosarcoma led to a skin punch biopsy, revealing only non-specific lymphocytic infiltrate. Interval mammographic assessment demonstrated non-specific architectural distortion. Regardless of these benign findings, a breast MRI was performed demonstrating possible breast angiosarcoma. Ultrasound-guided biopsy demonstrated low-grade breast angiosarcoma. The patient underwent completion mastectomy, for a 150 mm high-grade postradiotherapy angiosarcoma. Annual clinical review and contralateral mammography is planned.
Neuropsychiatric manifestation after a stroke: newly developed symptoms or side-effect of drug?
Authors: Tan Eng Chai , Aziz Noor Azah , Ahmad Saharuddin
Published: August 2012

A 55-year-old woman presented with sudden onset of left-sided body weakness and numbness, which was diagnosed as multifocal cerebral infarct with right thalamic bleed. She had concurrent hypertension, diabetes mellitus and chronic kidney disease. She suffered from central poststroke pain and reactive depression as poststroke complications, for which amitriptyline was prescribed. Unfortunately, she developed symptoms suggestive of mania and psychosis upon initiation of medications, which resolved upon withdrawal of amitriptyline. Amitriptyline is effective for treatment of poststroke pain and particularly useful in concomitant depression. Unexpectedly, this patient developed new psychopathologies after initiation of this medication. This case highlights the development of new psychopathologies that could be due to the antidepressant, underlying bipolar disorder or a complication of the stroke itself. Primary care providers need to actively enquire regarding neuropsychiatric symptoms because they can adversely affect the patient's quality of life as well as impede rehabilitation efforts.
Tuberculous meningitis: treat upon suspicion
Authors: Sonneveld Myrthe Elisabeth , Zinkstok SM , Nellen FJB , Holleboom Adriaan G
Published: August 2012

A 58-year-old man from Surinam was referred because of nausea, vomiting, weight loss, ascites and an altered mental state. Tuberculous meningitis was suspected upon examination of the cerebrospinal fluid and antituberculous treatment was initiated. However, the patient did not recover but developed haemiplegia with recurrent aspiration pneumonias. This case illustrates that empiric antituberculous treatment is warranted upon clinical suspicion, since no fast, sensitive diagnostic tests are available to date.
Refractory calcinosis in a patient with dermatomyositis: response to intravenous immune globulin
Authors: Shahani Lokesh
Published: August 2012

Dermatomyositis is an inflammatory myopathy and commonly presents with progressive, symmetric proximal muscle weakness and cutaneous findings. Calcinosis is a severe manifestation that can be debilitating. The cutaneous manifestations of dermatomyositis may also develop in the absence of detectable muscle disease, and can persist after the successful treatment of myositis. The author reports a 30-year-old woman with biopsy-proven dermatomyositis who had failed previous trials of azathioprine and methotrexate. Her muscle weakness was controlled with mycophenolate mofetil and prednisone; however,  she had recurrent attacks of painful calcinosis. The patient responded to intravenous immune globulin (IVIG) along with intravenous methylprednisone, followed by IVIG for 2 consecutive days each month. This regimen has been effective in preventing recurrence of her calcinosis. This case illustrates the cutaneous manifestation of dermatomyositis, which is often more refractory to treat as compared to the muscle involvement and require additional approaches such as IVIG.
WARRANTY AND OPTIMAL UPGRADE STRATEGY FOR USED SYSTEMS: AN ELECTRIC DRILL CASE STUDY
Authors: SHAFIEE MAHMOOD , CHUKOVA STEFANKA , FINKELSTEIN MAXIM
Published: August 2012

Offering warranty for a second-hand item stimulates the sales of the item, but at the same time, it accumulates additional warranty servicing cost. This additional cost can be reduced through actions that improve the reliability of the item, such as overhaul and upgrade. An upgrade action brings the second-hand item to an improved functional state and it effectively reduces the age of the item. In this paper, we propose a model aiming to determine the optimal upgrade action strategies that achieve a sensible trade-off between the cost of an upgrade action and the reduction of the expected warranty cost due to this action. A practical application case on electric drills is used to illustrate our findings.
Development of Cu Etching Using O2 Cluster Ion Beam under Acetic Acid Gas Atmosphere
Authors: Suda Takanori , Toyoda Noriaki , Hara Ken-ichi , Yamada Isao
Published: August 2012

Cu etching was carried out at a low substrate temperature using a gas cluster ion beam (GCIB) under an acetic acid gas atmosphere. A very shallow Cu surface was oxidized by O2-GCIB irradiation. Reactions between copper oxide and acetic acid occurred, and the reaction products were desorbed by local heating owing to the O2-GCIB irradiation. Thus, Cu etching at a low substrate temperature (<60 °C) was achieved. By introducing acetic acid gas during O2-GCIB irradiation, the etching depth of Cu became almost 29 times higher than the depth achieved when the etching was carried out using O2-GCIB alone at an acceleration voltage of 5 kV. In addition to the etching of Cu, there was no surface roughening after O2-GCIB irradiation under acetic acid atmosphere.
Characteristics of TiO2Thin Film Surfaces Treated by Helium and Air Dielectric Barrier Discharge Plasmas
Authors: Kawakami Retsuo , Niibe Masahito , Takeichi Atsushi , Mori Yuta , Konishi Masashi , Kotaka Takuya , Matsunaga Fumihiko , Takasaki Toshihide , Kitano Takanori , Miyazaki Takahiro , Inaoka Takeshi , Tominaga Kikuo
Published: August 2012

The characteristics of TiO2thin film surfaces treated with He and air dielectric barrier discharge (DBD) plasmas at different gas pressures are investigated. There is a difference between the two DBD plasma characteristics: for He-DBD, which is an atmospheric pressure glow discharge (APGD), the breakdown voltage and discharge current hardly change with increasing gas pressure, whereas for air-DBD, which is basically a filamentary discharge, they increase with increasing gas pressure. There is also a difference between the characteristics of TiO2surfaces treated with the two DBDs. The surface roughness for He-DBD is lower than the roughness of the as-grown surface, whereas that for air-DBD is higher. The surface hydrophilicity for He-DBD is more enhanced than the hydrophilicity of the as-grown surface regardless of UV irradiation. The hydrophilicity for air-DBD is dependent on UV irradiation. It is more enhanced with UV irradiation; it is not improved adequately without UV irradiation.
Spatial Distribution of Light Emission in Microplasma under 100 µm Gaps
Authors: Blajan Marius , Shimizu Kazuo
Published: August 2012

Emission spectroscopy analysis was used to study the microplasma phenomena. The microplasma discharge in Ar, N2/Ar, and O2/Ar was analyzed in the discharge gap area, and the spatial distribution of active species was also measured outside the electrodes. The spatial distribution in the discharge gap showed a higher intensity of the N2second positive band system (N2SPS) peak towards the grounded electrode (anode). The measurement of OH peak at 308.9 nm proved the existence of this excited species 1 mm outside the electrodes area. Images of the discharges at various gaps showed that the diameter of streamers derived from microdischarges was about 10 µm at the 100 µm gap, then decreased relative to the decrease in gap width. For gas mixtures containing N2in Ar, a more diffuse discharge was observed with the decrease in the amount of N2in Ar. The results are necessary for optimizing microplasma processes such as surface treatment and biomedical applications.
Growth of Microcrystalline Diamond Films on Textured Si Substrates to Enhance the Electron Field Emission Properties
Authors: Shih Wen-Ching , Huang Pin-Chang , Chen Huang-Chin , Lin I-Nan
Published: August 2012

In this study, we grew a microcrystalline diamond film on a textured Si substrate (MCD/textured Si) and demonstrated the improved electron field emission (EFE) properties of the film. We used a simple wet chemical etching method to fabricate the textured Si substrate and then grew the MCD film by microwave plasma enhanced chemical vapor deposition. Although the Raman spectroscopy profile of the MCD film was essentially unchanged, the surface morphology of the MCD film was altered markedly owing to the utilization of the textured substrate as a template. Hillocks of nanodiamond aggregates, rather than large grain granular structures, were formed for the MCD/textured Si films. The turn-on field for the EFE of the MCD/textured Si film was as small as 3.2 V/µm, with a current density as large as 751 µA/cm2 (at an applied field of 8.8 V/µm). The enhanced EFE properties of the thus-obtained MCD/textured Si film, along with the simplicity and cost-effectivity of the substrate texturing process, renders the MCD/textured Si film a good candidate for application as an electron field emitter.
Synthesis of Platinum Nanodots Using Organ-Metal Solutions
Authors: Ohshima Tamiko , Tanaka Ryota , Kawasaki Hiroharu , Suda Yoshiaki , Yagyu Yoshihito , Aoqui Shin-ichi
Published: August 2012

In this study, platinum (Pt) nanodots with diameters of 73–142 nm were prepared using organ-metal solutions on silicon substrates by a heating process. The influence of heating conditions such as heating temperature and ambient gas pressure on the structural properties of the Pt nanodots was investigated. The size and shape of the Pt nanodots were measured using scanning electron microscopy and image analysis software. The results suggest that the diameter and shape of the Pt nanodots can be controlled by heating temperature. In addition, X-ray diffraction and X-ray photoelectron spectroscopy measurement results suggest that the crystallinity and atomic composition of the Pt nanodots can also be controlled by varying ambient gas pressure. Changing the ambient gas pressure while maintaining a constant temperature affected the growth of Pt and platinum silicide (PtSi) crystals in the Pt nanodots. Under atmospheric pressure and an ambient Ar pressure of 5000 Pa, a single Pt crystal was formed in the Pt nanodots. On the other hand, under low vacuum and an ambient Ar pressure of 700 Pa, Pt and PtSi crystals coexisted in the Pt nanodots.
Real-Time Write Strategy Optimization Method for Optical Discs
Authors: Takeshita Nobuo , Kishigami Tomo , Ikuta Koichi , Tsujimoto Hiroaki
Published: August 2012

An optimization method of the write strategy for optical discs to realize stable recording within the whole area of each optical disc is proposed. In this method, the write strategy is continuously optimized in the real-time base during the recording operation against the variation of recording characteristics in optical discs, in accordance with the recording position in the radial direction and environmental conditions. The optimization algorithm to select the suitable write strategy parameters to be optimized was established with reference to the database previously prepared. The effectiveness and lack of side effects in this method are experimentally confirmed using optical discs.
Modal Analysis of Optical Disk Rotating at 15,000 rpm Close to a Rigid Wall
Authors: Oh Wonseok , Lim Seungho , Ko Byunghan , Park Kyoung-Su , Park No-Cheol , Park Young-Pil , Lee Han-Baek
Published: August 2012

The rotational speed of optical disks must be above 15,000 rpm owing to the required high data-transfer rates. At these speeds, the airflow between the rotating disk and a rigid wall is important when identifying the dynamic characteristics of the disk in a slim optical disk drive. This airflow is simulated using a numerical model and examined by a closed-form modal analysis. The calculated dynamic characteristics of the rotating disk can be used to predict the nonrepeatable runout for the servo controller design.
Read Data Transfer Rate Estimation in Optical Phase Multilevel Recording
Authors: Kikukawa Atsushi , Mikami Hideharu , Ide Tatsuro , Osawa Kentaro , Watanabe Koichi
Published: August 2012

The feasibility of increasing the read data transfer rate (DTR) by introducing optical phase multilevel recording technology was investigated using computer simulations. The signals read back from phase marks suffer from strong intersymbol interference (ISI) when the phase marks are recorded with a linear symbol density comparable to that of current optical disc systems; thus, the partial response most-likely (PRML) method is essential. The increase in the decoder size is a serious problem when applying the PRML method to multilevel signal decoding; however, it was shown that this can be resolved by applying run-length limited (RLL) modulations. With these, it was shown that it is possible to decode 4-ary phase-modulated signals with satisfactory performance using PRML. Therefore, we conclude that it is possible to at least double the read DTR by introducing the optical phase multilevel recording technology.
Study of GaSb Layers Grown on Ga/Si(111)-√3×√3 by Scanning Tunneling Microscopy
Authors: Hara Shinsuke , Machida Ryuto , Yagishita Kazuki , Irokawa Katsumi , Miki Hirofumi , Kawazu Akira , Fujishiro Hiroki I.
Published: August 2012

GaSb layers grown on a Ga-terminated Si(111) surface have been studied by ultrahigh-vacuum scanning tunneling microscopy. Two types of two-dimensional islands are locally formed on the initial GaSb growth layer on Ga/Si(111)-√3×√3 at a Ga coverage of about 1.2 ML and a Ga/Sb ratio of 4.4. The first type of island is higher than the initial growth layer by a bi-atomic step height. The triangular protrusions on this island correspond to those on the initial GaSb layer. A hexagonal pattern that is higher than the initial growth layer by double the height of the bi-atomic step is observed on the second type of island. Protrusions in the pattern are arrayed at approximately 0.8 nm intervals, which is the distance between twice the unit cell length of Si and GaSb, along the intrinsic direction of the Si(111) surface. Defect lines similar to the misfit dislocation network are observed on the island. These results suggest that the island corresponds to the slightly lattice-relaxed GaSb third layer. A three-dimensional island is formed on the third GaSb layer as GaSb coverage increases. These results indicate that the third GaSb layer is the nucleation site of the three-dimensional GaSb island on Si(111).
Nanomechanical Thermal Analysis of Indium Films Using Silicon Microcantilevers
Authors: Yim Changyong , Yun Minhyuk , Kim Seonghwan , Jung Namchul , Lim Sang-Hoon , Lee Moonchan , Rhee Shi-Woo , Thundat Thomas , Jeon Sangmin
Published: August 2012

Indium thin films of different thicknesses were vacuum-deposited onto silicon microcantilevers. The temperature-dependent variations in the resonance frequency and deflection of the cantilevers were measured simultaneously and were used to determine the melting and crystallization temperatures of the indium films. The melting temperatures of the indium films were identical to that of bulk indium, whereas the crystallization temperatures decreased as the film thickness decreased. The reduction in crystallization temperature with decreasing thickness can be attributed to the tendency of thin films to homogeneously nucleate on nonwetting surfaces. Finally, the temperature-dependent variations in the Young's modulus and surface stress of the indium film were calculated.
Development of Beetle-Type Robot with Sub-Micropipette Probe
Authors: Takami Tomohide , Deng Xiao Long , Son Jong Wan , Park Bae Ho , Kawai Tomoji
Published: August 2012

We have developed a motion system with tripod piezo tube legs, which is called the beetle-type or Besocke-type system, in order to control the position of a sub-micropipette. The stick-slip lateral motion of the beetle-type robot achieved a minimum step size of 600±200 nm by applying a sawtooth pulse at a voltage of 30 V and a pulse width of 10 ms. The sliding motion for the insertion and extraction of the sub-micropipette was controlled by a piezoactuator, and inverse sawtooth pulses were applied to the actuator to have more precise step motion than the specifications of the actuator, and a minimum step size of 480±80 nm at a pulse width of 0.17 ms was achieved. Nonlinear responses of the step size with sawtooth pulse widths were observed in both lateral motion and pipette insertion/extraction motion.
The Public Trust Doctrine: Where Ecology Meets Natural Resources Management
Authors: Sagarin Raphael D. , Turnipseed Mary
Published: August 2012

The public trust doctrine (PTD) is a legal concept with ancient roots, and it is increasingly being examined as a framework for modern conservation. At its core, the PTD is based on the idea that certain natural resources cannot be fairly or effectively managed by private owners. Rather, these resources should be held in trust by government, which must manage their consumptive use and protection on behalf of present and future citizens. Although historically the PTD applied to a limited set of natural resources such as shellfish beds and submerged lands, courts and legal scholars have expanded the definition of trust resources to include wildlife, oceans, and ecosystem services generally. The wide range of interpretations of the PTD is seen as both a weakness (because it leads to uncertainty in property ownership) and a strength (because it can adapt to accommodate emerging science about what it takes to protect ecosystems).
Federal Reserve Liquidity Provision during the Financial Crisis of 2007–2009
Authors: Fleming Michael J.
Published: August 2012

This review examines the Federal Reserve's (or Fed's) unprecedented liquidity provision during the financial crisis of 2007–2009. It first reviews how the Fed provides liquidity in normal times. It then explains how the Fed's new and expanded liquidity facilities were intended to enable the central bank to fulfill its traditional lender-of-last-resort role during the crisis while mitigating stigma, broadening the set of institutions with access to liquidity, and increasing the flexibility with which institutions could tap such liquidity. The review then assesses the growing empirical literature on the effectiveness of the facilities and provides insights as to where further research is warranted.
Regime Changes and Financial Markets
Authors: Ang Andrew , Timmermann Allan
Published: August 2012

Regime-switching models can match the tendency of financial markets to often change their behavior abruptly and the phenomenon that the new behavior of financial variables often persists for several periods after such a change. Although the regimes captured by regime-switching models are identified by an econometric procedure, they often correspond to different periods in regulation, policy, and other secular changes. In empirical estimates, the means, volatilities, autocorrelations, and cross-covariances of asset returns often differ across regimes in a manner that allows regime-switching models to capture the stylized behavior of many financial series including fat tails, heteroskedasticity, skewness, and time-varying correlations. In equilibrium models, regimes in fundamental processes, such as consumption or dividend growth, strongly affect the dynamic properties of equilibrium asset prices and can induce nonlinear risk-return trade-offs. Regime switches also lead to potentially large consequences for investors' optimal portfolio choice.