bluuebunny/crossref_metadata_2025 huggingface dataset:
Facial Expressions and Ability to Recognize Emotions From Eyes or Mouth in Children
Authors: Guarnera Maria , Hichy Zira , Cascio Maura I. , Carrubba Stefano
Published: May 2015

This research aims to contribute to the literature on the ability to recognize anger, happiness, fear, surprise, sadness, disgust and neutral emotions from facial information. By investigating children’s performance in detecting these emotions from a specific face region, we were interested to know whether children would show differences in recognizing these expressions from the upper or lower face, and if any difference between specific facial regions depended on the emotion in question. For this purpose, a group of 6-7 year-old children was selected. Participants were asked to recognize emotions by using a labeling task with three stimulus types (region of the eyes, of the mouth, and full face). The findings seem to indicate that children correctly recognize basic facial expressions when pictures represent the whole face, except for a neutral expression, which was recognized from the mouth, and sadness, which was recognized from the eyes. Children are also able to identify anger from the eyes as well as from the whole face. With respect to gender differences, there is no female advantage in emotional recognition. The results indicate a significant interaction ‘gender x face region’ only for anger and neutral emotions.
Factors Associated with Employment Status in Individuals with Multiple Sclerosis
Authors: Cadden Margaret , Arnett Peter
Published: May 2015

Background: Unemployment is common in individuals with multiple sclerosis (MS) and is associated with substantial socioeconomic burden. Several MS-related factors have been found to be associated with employment status, including fatigue, depression, cognitive problems, and motor difficulties. However, few studies have examined these factors collectively in predicting employment. The present study aimed to explore these variables together in predicting employment status in MS.

Methods: Fifty-three individuals with MS participating in a research study of cognitive, emotional, and social factors related to MS were examined. Composite scores were created using factor analysis that represented cognition, fatigue, depression, and motor function. These composite scores, along with the Expanded Disability Status Scale score, were explored as predictors of employment status (working, not working) via logistic regression. Models of mediation were also investigated.

Results: A model including composite scores of motor function, cognition, depression, and fatigue significantly distinguished those who are unemployed versus employed. However, only the cognitive, motor, and fatigue composite scores were found to be significantly associated with unemployment individually. Results of a mediation analysis using 1000 bootstrap samples indicated that the cognitive and fatigue composite scores significantly mediated the effect of disability on work status.

Conclusions: Cognitive function and fatigue mediate the effect of MS disability on employment status. Interventions targeting cognitive difficulties and fatigue in MS may be effective in helping individuals maintain employment.
Politics and Letters: The ‘Soviet Literary Controversy’ in Britain
Authors: Harker Ben
Published: May 2015

In the course of the so-called Soviet Literary Controversy of 1946, ‘decadent’ writers were expelled from the Writers' Union and cosmopolitan literary journals were closed down. The Controversy was widely reported in the British media and provoked extensive debate across literary periodicals. This article revisits this moment, paying particular attention to responses from John Lewis, J. B. Priestley, Cyril Connolly and the young Raymond Williams. Recovering the Controversy yields a new level of detail about the politico-cultural realignments of the mid 1940s by challenging the sometimes hindering period frames—the thirties, the forties, the war, the Cold War, the Old Left, the New Left—through which mid-century cultural history is most usually mapped and viewed.
Role of Osteopathic Manipulative Treatment in the Management of Stiff Person Syndrome
Authors: Rajaii Roxanne M. , Cox Gregory J. , Schneider Robert P.
Published: May 2015

Stiff person syndrome (SPS) is a rare and disabling central nervous system disorder first described in 1956 and characterized by fluctuating rigidity and stiffness, gait impairment, and painful spasms of the axial and limb musculature. Although an underlying mechanism of impaired synaptic γ-aminobutyric acid–ergic inhibition has been proposed, the exact mechanism remains unclear. The glutamic acid decarboxylase antibody, a marker for SPS, is a strong indication of disease and has been reported in approximately 70% of patients. The current treatment of choice is benzodiazepines and baclofen, both of which reduce motor unit potential firing and, therefore, decrease stiffness and spasms. However, patients continue to have substantial disability with pharmacologic therapy alone. This case report demonstrates the potential of osteopathic manipulative treatment as an adjunct to medication in the management of SPS. By decreasing somatic dysfunction and reducing the frequency of exacerbations, osteopathic manipulative treatment may alleviate the symptoms and overall morbidity associated with this disease.
Reassessing the educational environment among undergraduate students in a chiropractic training institution: A study over time
Authors: Palmgren Per J. , Sundberg Tobias , Laksov Klara Bolander
Published: May 2015

Objective

The aim of the study was twofold: (1) to compare the perceived educational environment at 2 points in time and (2) to longitudinally examine potential changes in perceptions of the educational environment over time.

Methods

The validated Dundee Ready Educational Environment Measure (DREEM), a 50-item, self-administered Likert-type inventory, was used in this prospective study. Employing convenience sampling, undergraduate chiropractic students were investigated at 2 points in time: 2009 (n = 124) and 2012 (n = 127). An analysis of 2 matching samples was performed on 27% (n = 34) of the respondents in 2009.

Results

A total of 251 students (79%) completed the inventory, 83% (n = 124) in 2009 and 75% (n = 127) in 2012. The overall DREEM scores in both years were excellent: 156 (78%) and 153 (77%), respectively. The students' perceptions of teachers differed significantly between the 2 cohort years, decreasing from 77% to 73%. Three items received deprived scores: limited support for stressed students, authoritarian teachers, and an overemphasis on factual learning; the latter significantly decreased in 2012. In the longitudinal sample these items also displayed scores below the expected mean.

Conclusion

Students viewed the educational environment as excellent both in 2009 and 2012. The perceptions of teachers declined with time; however, this could be attributed to teachers' new roles. Certain aspects of the educational environment factored prominently during the comparative points in time, as well as longitudinally, and these ought to be further investigated and addressed to provide an enhanced educational environment.
Role of Percutaneous Transhepatic Biliary Drainage in Patients With Complications After Gastrectomy
Authors: Kim Ki-Han , Lee Ho-Byoung , Kim Sung-Heun , Kim Min-Chan , Jung Ghap-Joong
Published: May 2015

The aim of this study was to elucidate the role of percutaneous transhepatic biliary drainage (PTBD) in patients with duodenal stump leakage (DSL) and afference loop syndrome (ALS) postgastrectomy for malignancy or benign ulcer perforation. Percutaneous transhepatic biliary drainage (PTBD) is an interventional radiologic procedure used to promote bile drainage. Duodenal stump leakage (DSL) and afferent loop syndrome (ALS) can be serious complications after gastrectomy. From January 2002 through December 2014, we retrospectively reviewed 19 patients who underwent PTBD secondary to DSL and ALS postgastrectomy. In this study, a PTBD tube was placed in the proximal duodenum near the stump or distal duodenum in order to decompress and drain bile and pancreatic fluids. Nine patients with DSL and 10 patients with ALS underwent PTBD. The mean hospital stay was 34.3 days (range, 12 to 71) in DSL group and 16.4 days (range, 6 to 48) in ALS group after PTBD. A liquid or soft diet was started within 2.6 days (range, 1 to 7) in the ALS group and within 3.4 days (range, 0 to 15) in the DSL group after PTBD. One patient with DSL had PTBD changed, and 2 patients with ALS underwent additional surgical interventions after PTBD. The PTBD procedure, during which the tube was inserted into the duodenum, was well-suited for decompression of the duodenum as well as for drainage of bile and pancreatic fluids. This procedure can be an alternative treatment for cases of DSL and ALS postgastrectomy.
Testing the dynamic coupling of the core‐mantle and inner core boundaries
Authors: Driscoll Peter E.
Published: May 2015

The proposal that the seismically observed hemispherical asymmetry of Earth's inner core is controlled by the heat flux structure imposed on the outer core by the lower mantle is tested with numerical dynamo models driven by mixed thermochemical convection. We find that models driven by a single core‐mantle boundary (CMB) spherical harmonic of degree and mode 2, the dominant mode in lower mantle seismic shear velocity tomography, produce a similar structure at the inner core boundary (ICB) shifted 30∘ westward. The sensitivity of the ICB to the CMB is further tested by increasing the CMB heterogeneity amplitude. In addition, two seismic tomographic models are tested: first with CMB resolution up to degree and order 4, and second with resolution up to degree and order 8. We find time‐averaged ICB heat flux in these cases to be similar at large scale, with small‐scale differences due to higher CMB harmonics (above degree 4). The tomographic models produce “Earth‐like” magnetic fields, while similar models with twice the CMB heat flow amplitudes produce less Earth‐like fields, implying that increasing CMB heterogeneity forces the model out of an Earth‐like regime. The dynamic ICB heat fluxes are compared to the proposed translation mode of the inner core to test whether the CMB controls inner core growth and structure. This test indicates that, although CMB tomography is unlikely to be driving inner core translation, the ICB heat flux response is weak enough to not interfere with the most unstable translation mode, if it is occurring.
Simulated climatology and evolution of aridity in the 21st century
Authors: Lin Lei , Gettelman Andrew , Feng Song , Fu Qiang
Published: May 2015

Future changes in aridity, defined as the ratio of annual precipitation to potential evapotranspiration (PET), are analyzed using simulations from the Community Earth System Model (CESM) Large Ensemble (LE) and the phase 5 of the Coupled Model Intercomparison Project (CMIP5) during the period 1980–2080. Both CESM and CMIP5 ensembles can reproduce the observed temporal and spatial variability of aridity. On the interannual time scale, annual average PET is sensitive to the variability of relative humidity, net surface energy flux, and surface air temperature, while the precipitation variability is the dominant component of annual average aridity sensitivity. For the long‐term trends, differences between the two ensembles illustrate that the impact of the internal variability is smaller than that of the model structural uncertainty with the trends from the CMIP5 ensemble of models having a much larger spread than those from the single‐model CESM‐LE. The annual mean aridity averaged over global land increases (becomes drier) by 6.4% in 2055–2080 relative to 1980–2005. Aridity trends differ by region in the ensemble mean. In the future, increasing precipitation leads to decreasing aridity over northwest China and central (or tropical) Africa, while decreasing precipitation leads to drying (increasing aridity) in the subtropics, northern and southern Africa, and the Amazon. Increases in PET can lead to increasing aridity even in regions with increasing precipitation.
Changes in the position of the Subtropical Front south of New Zealand since the last glacial period
Authors: Bostock Helen C. , Hayward Bruce W. , Neil Helen L. , Sabaa Ashwaq T. , Scott George H.
Published: May 2015

This study fills an important gap in our understanding of past changes in the Southern Subtropical Front (S‐STF) in the southwest Pacific Ocean. Paleo‐sea surface temperatures (SST) were estimated from planktic foraminiferal census counts from cores straddling the modern S‐STF in the Solander Trough, south of New Zealand. The estimated SST were compared for 6 time slices; glacial period (25–21 ka), Last Glacial Maximum (LGM; 21–18 ka), early deglaciation (18–16 ka), late deglacial/early Holocene period (14–8 ka), mid‐Holocene period (8–4 ka), and late Holocene period (4–0 ka). The position of the S‐STF was determined by two methods: (1) the location of the 10°C isotherm and (2) the location of the highest SST gradients. These new results suggest that the S‐STF was not continuous between east and west of New Zealand during the glacial period. Steep SST gradients indicate that a strong S‐STF rapidly shifted south during the LGM and early deglaciation. During the late deglacial and Holocene periods the position of the S‐STF differs between the two methods with reduced SST gradients, suggesting a more diffuse S‐STF in the Solander Trough at this time. The glacial SST data suggest that the S‐STF shifted north to the west of New Zealand, while to the east there was a stronger SST gradient across the front. This was possibly the result of an increased wind stress curl, which could have been caused by stronger, or more northerly Southern Hemisphere westerly winds (SHWW), or a merging of the SHWW split jet in this region.
Wave normal angle and frequency characteristics of magnetosonic wave linear instability
Authors: Chen Lunjin
Published: May 2015

Magnetosonic waves, also known as equatorial noise emission, can be unstable in the presence of ion ring velocity distribution of ring current population. Earlier studies have demonstrated that such instability can occur near proton harmonic frequencies and near perpendicular propagation with a narrow range of wave normal angle about 90° and that the waves may contribute significantly to electron acceleration in the radiation belt. However, this effect is sensitive to the values of wave normal angles. Instability characteristics in the regime of weak instability, in particular the dependence on the wave frequency and wave normal angle, is investigated for an ion ring distribution modeled by subtraction of two anisotropic Maxwellian distributions. It is found that two types of instabilities, resonant and nonresonant, occur near 90° wave normal angles. Physics of the two instabilities is explained and discussed. The resonant instability, occurring at a finite parallel wave number k∥, is caused by resonant protons near 90° pitch angle, while the nonresonant instability, occurring for a vanishing k∥, is driven by all thermal protons. A formula for the linear nonresonant instability is derived and generalized for an arbitrary ion distribution.
Deformation Behavior and Microstructural Evolution of Cu–Ag Alloys Processed by High‐Pressure Torsion
Authors: Kormout Karoline S. , Yang Bo , Pippan Reinhard
Published: May 2015

In this study, different Cu–Ag alloys (Cu‐10/25/50/75/90 wt%Ag) are produced by powder consolidation and subsequent high‐pressure torsion processing. The microstructural evolution of the material state is investigated by SEM and TEM. Additionally, mechanical properties are characterized by Vickers microhardness measurements. The deformation mechanism changes from homogenous co‐deformation in the very beginning of the process to shear banding. When the hardness reaches a saturation level, all compositions show grain sizes below 100 nm with a very high defect density and hardness compared to pure ultrafine‐grained Cu or Ag. Single‐phase solid solutions are reached at both high and low Ag content, in the medium composition range a mixture of single‐ and two‐phase regions is observed.
The matter‐antimatter interpretation of Kerr spacetime
Authors: Villata Massimo
Published: May 2015

Repulsive gravity is not very popular in physics. However, one comes across it in at least two main occurrences in general relativity: in the negative‐r region of Kerr spacetime, and as the result of the gravitational interaction between matter and antimatter, when the latter is assumed to be CPT‐transformed matter. Here we show how these two independent developments of general relativity are perfectly consistent in predicting gravitational repulsion and how the above Kerr negative‐r region can be interpreted as the habitat of antimatter. As a consequence, matter particles traveling along vortical geodesics can pass through the throat of a rotating black hole and emerge as antimatter particles (and vice versa). An experimental definitive answer on the gravitational behavior of antimatter is awaited in the next few years.

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Simultaneous removal of CO, NOx, and HC emitted from gasoline engine in a nonthermal plasma‐driven catalysis system
Authors: He Chi , Xu Bitao , Jiang Zeyu , Xu Yang , Zhao Jinglian , Pan Hua
Published: May 2015

The performances of nonthermal plasma‐driven catalysis system (NTP‐C) for real gasoline engine tail gas purification were studied with different supported catalysts (i.e. La0.8 K0.2MnOx/5A, La0.8 K0.2MnOx/γ‐Al2O3, La0.9 K0.1CoOx/5A, and La0.9 K0.1CoOx/γ‐Al2O3) prepared by a high‐temperature solid state reaction method. To clarify the effectiveness of the NTP‐C system, a NTP reactor was employed, which has the same inner structure as the NTP‐C but without catalyst. The removal efficiency of studied pollutants is following the order of HC > NOx > CO in all NTP‐C coupling system. Active phase component has crucial effects on the removal efficiency of pollutant. NTP coupled with La0.9 K0.1CoOx/5A catalyst shows the best pollutant removal efficiency with 65%, 75%, and 85% of CO, HC, and NOx converted at 1400 J/L, respectively. Oxygen content in the tail gas has significant influences on pollutant decomposition, and the active oxygen atom makes a vital contribution to the higher HC removal efficiency. It can be expected that lots of chemical reactions induced by multicomponent precursors in practical vehicle tail gas reduce the pollutant removal efficiency, especially for CO and NOx. © 2015 Curtin University of Technology and John Wiley & Sons, Ltd.
A new energy source from the anaerobic co‐digestion (acd) treatment of oleo chemical effluent with glycerin pitch
Authors: Chow Wei Ling , Chan Yi Jing , Chong Mei Fong
Published: May 2015

The high‐strength wastes generated from the oleo chemical industry, namely oleo chemical effluent (OCE) and glycerin pitch (GP), have raised a serious disposal problem. An aerobic digestion after chemical pre‐treatment and costly incineration/landfill disposal is the only currently available treatment method for OCE and GP, respectively. Due to the high alkalinity and organic content of GP, there is a potential to anaerobically co‐digest OCE with GP, which can be used to neutralise OCE's acidity while providing the required organic strength for biogas production. The objective of this study is to evaluate the feasibility of anaerobic co‐digestion (ACD) of OCE and GP based on their maximum available energy potential. This study was evaluated based on 85% chemical oxygen demand removal efficiency. The study disclosed that GP is able to generate maximum potential methane production of 6716 m3/d and energy of 0.097 MW/h, which are two times higher than that in OCE. The cost benefit analysis also revealed that with the establishment of ACD, a cost saving of USD 1 693 716/year from disposal and an earning profit of USD 54 544/year from energy generation can be achieved. Therefore, it could be concluded that ACD of OCE and GP is feasible to produce a reduced strength of final effluent with enhanced methane production. © 2015 Curtin University of Technology and John Wiley & Sons, Ltd.
Synthesis and Anticonvulsant Activity of Substituted‐1,3‐diazaspiro[4.5]decan‐4‐ones
Authors: Aboul‐Enein Mohamed Nabil , El‐Azzouny Aida Abdel Sattar , Saleh Ola Ahmed , Amin Kamilia Mahmoud , Maklad Yousreya Ali , Hassan Rasha Mohamed
Published: May 2015

A series of novel spiroimidazolidinone derivatives 6a–d and 8a–x were synthesized and biologically evaluated for their anticonvulsant activity in the maximal electroshock seizure (MES) assay and the subcutaneous pentylenetetrazole (scPTZ) screening test. Compound 8w was the most active derivative in the scPTZ screening test with an ED50 value by about 5‐ and 83.6‐fold lower than those of phenobarbital and ethosuximide as reference drugs, respectively. Most of the tested compounds exhibited moderate to weak activity in the MES screen test, except for 8a which displayed 100% protection at 0.09 mmol/kg. Moreover, all the test compounds did not show any minimal motor impairment in the neurotoxicity test.
Teaching and Generalizing Pretend Play in Children with Autism Using Video Modeling and Matrix Training
Authors: MacManus Cormac , MacDonald Rebecca , Ahearn William H.
Published: May 2015

Children with autism spectrum disorder often lack play skills. Video modeling has been effective in producing play; however, this play is often lacking in novelty. The purpose of the present study was to combine video modeling and matrix training to teach children with autism to engage in sequences of play with 30 vocalizations and 40 actions. Matrix training was used in an attempt to enhance generalization, specifically in recombining elements of play across play scenarios. Three participants were trained on three play scenarios for three play sets and materials using video modeling. Play scenarios were arranged in a 3‐dimensional matrix, which also depicted the possible recombined sequences that could emerge. Probes were then conducted to determine whether different combinations of play would occur. Results for all participants showed that after training on three video modeling play scenarios, learned vocalizations and actions were recombined across previously unlearned combinations of play sets and materials. Results also showed that after video modeling began, novel play that was not seen in baseline sessions emerged for all participants. Copyright © 2015 John Wiley & Sons, Ltd.
Comparative pharmacokinetics of catalpol and acteoside in normal and chronic kidney disease rats after oral administration of Rehmannia glutinosa extract
Authors: Zhao Min , Qian Dawei , Liu Pei , Shang Er‐xin , Jiang Shu , Guo Jianming , Su Shu‐lan , Duan Jin‐ao , Du Leyue , Tao Jinhua
Published: May 2015

In this study, a sensitive and robust ultra‐performance liquid chromatography–mass spectrometry method with multiple‐reaction monitoring mode was developed, validated, and applied to determine pharmacokinetics of catalpol and acteoside in normal and doxorubicin‐induced chronic kidney disease rats after oral administration of Rehmannia glutinosa extract. The lower limits of quantification for catalpol and acteoside in rat plasma were 2.62 and 0.61 ng/mL, with a signal‐to‐noise ratio of ≥10. Precision and accuracy studies showed that catalpol and acteoside plasma concentrations were within the 10% range in all studies. The extraction recoveries of catalpol and acteoside were both >68.24% and the matrix effects ranged from 96.59 to 101.62%. The method was successfully applied to the pharmacokinetic study of catalpol and acteoside after oral administration of RG extract to normal and model rats, respectively. This study might further support the traditional use of RG to treat kidney diseases clinically. Copyright © 2015 John Wiley & Sons, Ltd.
Determination of astragaloside III in rat plasma by liquid chromatography–tandem mass spectrometry and its application to a rat pharmacokinetic study
Authors: Zhai Yongsong , Li Pengyue , Wang Manyuan , Gong Muxin , Qiu Feng
Published: May 2015

Astragaloside III (AST III), a naturally occurring saponin compound isolated from Radix Astragali, has been demonstrated to have anti‐gastric ulcer, immunomodulatory and antitumor effects. To evaluate its pharmacokinetics in rats, a rapid, sensitive and specific high‐performance liquid chromatography–tandem mass spectrometric (HPLC‐MS/MS) method has been developed and validated for the quantification of astragaloside III in rat plasma. Samples were pretreated using a simple protein precipitation with methanol–acetonitrile (50:50, v/v) and the chromatographic separation was performed on a C18 column by a gradient elution using a mobile phase consisting of water containing 0.1% formic acid and acetonitrile containing 0.1% formic acid. Astragaloside III and the internal standard (buspirone) were detected using a tandem mass spectrometer in positive multiple reaction monitoring mode. Method validation revealed excellent linearity over the range of 5.00–5000 ng/mL together with satisfactory intra‐ and inter‐day precision, accuracy and recovery. Stability testing showed that astragaloside III spiked into rat plasma was stable for 24 h at 20°C temperature, for up to 30 days at −80°C, and during three freeze–thaw cycles. The method was successfully used to investigate the pharmacokinetic profile of AST III after oral (10 mg/kg) and intravenous (1.0 mg/kg) administration in rats. The oral absolute bioavailability of AST III was calculated to be 4.15 ± 0.67% with an elimination half‐life value of 2.13 ± 0.11 h, suggesting its poor absorption and/or strong metabolism in vivo. Copyright © 2015 John Wiley & Sons, Ltd.
Continuous removal of endocrine disruptors by versatile peroxidase using a two‐stage system
Authors: Taboada‐Puig Roberto , Lu‐Chau Thelmo A. , Eibes Gemma , Feijoo Gumersindo , Moreira Maria T. , Lema Juan M.
Published: May 2015

The oxidant Mn3+‐malonate, generated by the ligninolytic enzyme versatile peroxidase in a two‐stage system, was used for the continuous removal of endocrine disrupting compounds (EDCs) from synthetic and real wastewaters. One plasticizer (bisphenol‐A), one bactericide (triclosan) and three estrogenic compounds (estrone, 17β‐estradiol, and 17α‐ethinylestradiol) were removed from wastewater at degradation rates in the range of 28–58 µg/L·min, with low enzyme inactivation. First, the optimization of three main parameters affecting the generation of Mn3+‐malonate (hydraulic retention time as well as Na‐malonate and H2O2 feeding rates) was conducted following a response surface methodology (RSM). Under optimal conditions, the degradation of the EDCs was proven at high (1.3–8.8 mg/L) and environmental (1.2–6.1 µg/L) concentrations. Finally, when the two‐stage system was compared with a conventional enzymatic membrane reactor (EMR) using the same enzyme, a 14‐fold increase of the removal efficiency was observed. At the same time, operational problems found during EDCs removal in the EMR system (e.g., clogging of the membrane and enzyme inactivation) were avoided by physically separating the stages of complex formation and pollutant oxidation, allowing the system to be operated for a longer period (∼8 h). This study demonstrates the feasibility of the two‐stage enzymatic system for removing EDCs both at high and environmental concentrations. © 2015 American Institute of Chemical Engineers Biotechnol. Prog., 31:908–916, 2015
A reappraisal of adult thoracic and abdominal surface anatomy via CT scan in Chinese population
Authors: Shen Xin‐Hua , Su Bai‐Yan , Liu Jing‐Juan , Zhang Gu‐Muyang , Xue Hua‐Dan , Jin Zheng‐Yu , Mirjalili S. Ali , Ma Chao
Published: May 2015

Accurate surface anatomy is essential for safe clinical practice. There are numerous inconsistencies in clinically important surface markings among and within contemporary anatomical reference texts. The aim of this study was to investigate key thoracic and abdominal surface anatomy landmarks in living Chinese adults using computed tomography (CT). A total of 100 thoracic and 100 abdominal CT scans were examined. Our results indicated that the following key surface landmarks differed from current commonly–accepted descriptions: the positions of the tracheal bifurcation, azygos vein termination, and pulmonary trunk bifurcation (all below the plane of the sternal angle at vertebral level T5–T6 in most individuals); the superior vena cava formation and junction with the right atrium (most often behind the 1st and 4th intercostal spaces, respectively); and the level at which the inferior vena cava and esophagus traverse the diaphragm (T10 and T11, respectively). The renal arteries were most commonly at L1; the midpoint of the renal hila was most frequently at L2; the 11th rib was posterior to the left kidney in only 29% of scans; and the spleen was most frequently located between the 10th and 12th ribs. A number of significant sex‐ and age‐related differences were noted. The Chinese population was also compared with western populations on the basis of published reports. Reappraisal of surface anatomy using modern imaging tools in vivo will provide both quantitative and qualitative evidence to facilitate the clinical application of these key surface landmarks. Clin. Anat. 29:165–174, 2016. © 2015 Wiley Periodicals, Inc.
PI3K/AKT pathway regulates E‐cadherin and Desmoglein 2 in aggressive prostate cancer
Authors: Barber Alison G. , Castillo‐Martin Mireia , Bonal Dennis M. , Jia Angela J. , Rybicki Benjamin A. , Christiano Angela M. , Cordon‐Cardo Carlos
Published: May 2015

Reduced expression of both classical and desmosomal cadherins has been associated with different types of carcinomas, including prostate cancer. This study aims to provide a comprehensive view of the role and regulation of cell–cell adhesion in prostate cancer aggressiveness by examining the functional implications of both E‐cadherin and Desmoglein 2 (DSG2). E‐cadherin expression was first examined using immunofluorescence in 50 normal prostate tissues and in a cohort of 414 prostate cancer patients. Correlation and survival analyses were performed to assess its clinical significance. In primary prostate cancer patients, reduced expression of both E‐cadherin and DSG2 is significantly associated with an earlier biochemical recurrence. Transgenic DU145 E‐cadherin knockdown and constitutively active AKT overexpression lines were generated. Functional implications of such genetic alterations were analyzed in vitro and in vivo, the latter by using tumorigenesis as well as extravasation and metastatic tumor formation assays. We observed that loss of E‐cadherin leads to impaired primary and metastatic tumor formation in vivo, suggesting a tumor promoter role for E‐cadherin in addition to its known role as a tumor suppressor. Activation of AKT leads to a significant reduction in E‐cadherin expression and nuclear localization of Snail, suggesting a role for the PI3K/AKT signaling pathway in the transient repression of E‐cadherin. This reduced expression may be regulated by separate mechanisms as neither the loss of E‐cadherin nor activation of AKT significantly affected DSG2 expression. In conclusion, these findings illustrate the critical role of cell–cell adhesion in the progression to aggressive prostate cancer, through regulation by the PI3K pathway.
Outcome in TAVI patients with symptomatic aortic stenosis not fulfilling PARTNER study inclusion criteria
Authors: Sedaghat Alexander , Al‐Rashid Fadi , Sinning Jan‐Malte , Wendt Daniel , Thielmann Matthias , Grube Eberhard , Nickenig Georg , Erbel Raimund , Werner Nikos , Kahlert Philipp
Published: May 2015

Background

Transcatheter aortic valve implantation (TAVI) has rapidly evolved to the standard‐of‐care for inoperable patients with severe, symptomatic aortic valve stenosis, and to an alternative treatment option for high‐risk patients. However, the randomized PARTNER trial excluded patients with conditions frequently encountered in daily clinical practice.

Methods

From 2006 to 2011, 467 high‐risk patients, who underwent transfemoral TAVI (Edwards Sapien n = 166; Medtronic CoreValve n = 301) at two German centers were divided into a “PARTNER‐like” (n = 227) and a “Real‐World” cohort (n = 240), based on the original PARTNER trial in‐ and exclusion criteria. Differences in 30‐day and 2‐year mortality and morbidity were assessed.

Results

Mean age of patients was 80 ± 8 years with a logistic EuroSCORE of 22 ± 16%. The most frequent exclusion criteria were previous PCI (15.4%), prior valve surgery (13.7%), chronic renal failure (12.0%), and severe mitral regurgitation (10.8%). Despite significant differences in baseline data, estimated perioperative mortality in terms of STS and logistic EuroScore was identical between both groups. However, patients in the “Real‐World” cohort had a non‐significant trend towards a higher 30‐day mortality (10.0% vs. 6.7%, P = 0.088) and a significantly higher 2‐year mortality (23.3% vs. 14.5%, P = 0.016) compared with patients of the “PARTNER‐like” cohort.

Conclusion

Patients meeting PARTNER study exclusion criteria had an acceptable outcome at 30 days and 2 years, however, with significant differences to “PARTNER‐like” patients. Still, our results indicate that also real‐life patients with relevant comorbidities, who would have been excluded from the randomized PARTNER trials, benefit from TAVI with acceptable short‐ and long‐term outcome. © 2015 Wiley Periodicals, Inc.
Retrograde non trans‐septal balloon mitral valvotomy in mitral stenosis with interrupted inferior vena cava, left superior vena cava, and hugely dilated coronary sinus
Authors: Nath Ranjit Kumar , Soni Dheeraj Kumar
Published: May 2015

A 22‐year‐old woman with severe mitral stenosis was referred to us for further evaluation and management. She was found to have severe mitral stenosis, severe tricuspid regurgitation with dilated right atrium and right ventricle with persistent left superior vena cava and hugely dilated coronary sinus. Valve was suitable for balloon mitral valvotomy. Cardiac catheterization showed interrupted inferior vena cava with azygos continuation to right atrium and large left superior vena cava draining to coronary sinus which was very much dilated. Right trans‐jugular approach was tried for balloon mitral valvotomy, but was unsuccessful due to a very large right atrium and coronary sinus. Retrograde non trans‐septal approach was used and balloon valvotomy was done successfully using a 24 mm × 40 mm TYSHAK balloon without any major complication. Reduction in the transmitral pressure gradient on cardiac catheterization data and transthoracic echocardiography confirmed successful procedure. Balloon mitral valvotomy can be done successfully in patients with the above unusual cardiac anatomy with no major procedural complications. © 2015 Wiley Periodicals, Inc.
Transcatheter closure of postmyocardial infarction, iatrogenic, and postoperative ventricular septal defects: The Mayo Clinic experience
Authors: Egbe Alexander C. , Poterucha Joseph T. , Rihal Charanjit S. , Taggart Nathaniel W. , Cetta Frank , Cabalka Allison K. , Pollak Peter M. , Reeder Guy S. , Hagler Donald J.
Published: May 2015

Objectives

To determine event‐free survival after transcatheter closure of ventricular septal defect (VSD), and to identify predictors of adverse events (AE) in post myocardial infarction VSD (post‐MI VSD) subgroup.

Background

There are limited data on mid‐term follow‐up after transcatheter VSD closure.

Methods

Retrospective review of 27 cases of transcatheter VSD closure (post‐MI = 18 and non‐ischemic = 9) performed from 1999 to 2013. We defined AE as death, device embolization, hemolysis requiring blood transfusion, heart block and reintervention.

Results

In the post‐MI VSD subgroup, mean age and follow‐up was 69 ± 11 and 7.3 ± 7 years, respectively. AE occurred in 8 (44%) patients (death‐3, device embolization‐1, hemolysis‐1, surgical VSD closure‐2, reintervention‐1). Event‐free survival was 56% at 1 month and 5 years, and all AE occurred in the periprocedural period. Cardiogenic shock (HR: 3.21, CI: 1.82–5.41, P = 0.002), and VSD closure in acute phase (HR: 2.14, CI: 1.12–4.31, P = 0.004) were independent predictors of AE. In the non‐ischemic VSD subgroup, mean age and follow‐up was 49 ± 15 and 8.7 ± 8 years, respectively. AE occurred in 3 (33%) patients (late death‐1, surgical VSD closure‐2). For the entire cohort, freedom from death was 89% and 85% at 1 month and 5 years, and event‐free survival was 70% and 61% at 1 month and 5 years.

Conclusions

Transcatheter closure of post‐MI VSD carries a moderate risk of periprocedural complications but low event rates afterwards. By comparison, device closure of non‐ischemic VSD has lower periprocedural morbidity but some patients continued to experience AE during follow‐up. © 2015 Wiley Periodicals, Inc.
Segmented Flow‐Based Multistep Synthesis of Cadmium Selenide Quantum Dots with Narrow Particle Size Distribution
Authors: Misuk Viktor , Schmidt Maxim , Braukmann Sandra , Giannopoulos Konstantinos , Karl Dominik , Loewe Holger
Published: May 2015

A continuous‐flow microreactor was used to synthetize II–VI semiconductor quantum dots (CdSe). In order to improve the size distribution of the nanoparticles, the synthesis was carried out in a two‐step procedure. A seed solution was obtained in a separate nucleation step, followed by a controllable growth step. Quantum dots that are synthesized with the two‐step method show a much narrower size distribution in comparison to those obtained in a conventional batch synthesis.
Impact of aggressive management and palliative care on cancer costs in the final month of life
Authors: Cheung Matthew C. , Earle Craig C. , Rangrej Jagadish , Ho Thi H. , Liu Ning , Barbera Lisa , Saskin Refik , Porter Joan , Seung Soo Jin , Mittmann Nicole
Published: May 2015

BACKGROUND

A significant share of the cost of cancer care is concentrated in the end‐of‐life period. Although quality measures of aggressive treatment may guide optimal care during this timeframe, little is known about whether these metrics affect costs of care.

METHODS

This study used population data to identify a cohort of patients who died of cancer in Ontario, Canada (2005‐2009). Individuals were categorized as having received or having not received aggressive end‐of‐life care according to quality measures related to acute institutional care or chemotherapy administration in the end‐of‐life period. Costs (2009 Canadian dollars) were collected over the last month of life through the linkage of health system administrative databases. Multivariate quantile regression was used to identify predictors of increased costs.

RESULTS

Among 107,253 patients, the mean per‐patient cost over the final month was $18,131 for patients receiving aggressive care and $12,678 for patients receiving nonaggressive care (P < .0001). Patients who received chemotherapy in the last 2 weeks of life also sustained higher costs than those who did not (P < .0001). For individuals receiving end‐of‐life care in the highest cost quintile, early and repeated palliative care consultation was associated with reduced mean per‐patient costs. In a multivariate analysis, chemotherapy in the 2 weeks of life remained predictive of increased costs (median increase, $536; P < .0001), whereas access to palliation remained predictive for lower costs (median decrease, $418; P < .0001).

CONCLUSIONS

Cancer patients who receive aggressive end‐of‐life care incur 43% higher costs than those managed nonaggressively. Palliative consultation may partially offset these costs and offer resultant savings. Cancer 2015;121:3307–3315. © 2015 American Cancer Society.
Performance of amplify forward and decode forward cooperative strategies for body surface communications in UWB Body Area Networks
Authors: Rout Deepak Kumar , Gurrala Kiran Kumar , Das Susmita
Published: May 2015

Body area networks (BAN) are being developed for telemonitoring of patients. Ultra wideband (UWB) is the most preferred choice for the physical layer of the BAN as it provides high data rate at low power consumption along with a simple transceiver structure. But because of high fading characteristics of the human body channel, the range of UWB will be limited, and a reliable communication cannot be guaranteed. In that case, cooperative communications may be applied to BAN for improving system performance and link quality.

The paper proposes a novel approach by applying amplify and forward, and decode and forward cooperative relaying strategies with maximal ratio combining for BAN. The performance of single relay AF and DF relaying have been compared with direct transmission. Further, the efficacy of the proposed strategies has been validated by transmitting electrocardiogram signals and magnetic resonance imaging images. Simulations and validations have been carried out on Institute of Electrical and Electronics Engineers designated CM3 channel model for BAN designed from real time measurements data. A signal‐to‐noise ratio gain of at least 3 dB is clearly observed from simulation results. Thus, transmit power requirement can be minimized, which in turn improves the battery life of body sensor nodes. Copyright © 2015 John Wiley & Sons, Ltd.
Maternal effects and maternal selection arising from variation in allocation of free amino acid to eggs
Authors: Newcombe Devi , Hunt John , Mitchell Christopher , Moore Allen J.
Published: May 2015

Maternal provisioning can have profound effects on offspring phenotypes, or maternal effects, especially early in life. One ubiquitous form of provisioning is in the makeup of egg. However, only a few studies examine the role of specific egg constituents in maternal effects, especially as they relate to maternal selection (a standardized selection gradient reflecting the covariance between maternal traits and offspring fitness). Here, we report on the evolutionary consequences of differences in maternal acquisition and allocation of amino acids to eggs. We manipulated acquisition by varying maternal diet (milkweed or sunflower) in the large milkweed bug,Oncopeltus fasciatus. Variation in allocation was detected by examining two source populations with different evolutionary histories and life‐history response to sunflower as food. We measured amino acids composition in eggs in this 2 × 2 design and found significant effects of source population and maternal diet on egg and nymph mass and of source population, maternal diet, and their interaction on amino acid composition of eggs. We measured significant linear and quadratic maternal selection on offspring mass associated with variation in amino acid allocation. Visualizing the performance surface along the major axes of nonlinear selection and plotting the mean amino acid profile of eggs from each treatment onto the surface revealed a saddle‐shaped fitness surface. While maternal selection appears to have influenced how females allocate amino acids, this maternal effect did not evolve equally in the two populations. Furthermore, none of the population means coincided with peak performance. Thus, we found that the composition of free amino acids in eggs was due to variation in both acquisition and allocation, which had significant fitness effects and created selection. However, although there can be an evolutionary response to novel food resources, females may be constrained from reaching phenotypic optima with regard to allocation of free amino acids.
New echocardiographic predictors of clinical outcome in patients presenting with heart failure and a preserved left ventricular ejection fraction: a subanalysis of the Ka (Karolinska) Ren (Rennes) Study
Authors: Donal Erwan , Lund Lars H. , Oger Emmanuel , Hage Camilla , Persson Hans , Reynaud Amélie , Ennezat Pierre‐Vladimir , Bauer Fabrice , Drouet Elodie , Linde Cecilia , Daubert Claude ,   on behalf of the KaRen investigators
Published: May 2015

Objectives

To identify electrocardiographic and echocardiographic predictors of mortality and hospitalizations for heart failure (HF) in the KaRen study.

Background

KaRen is a prospective, observational study of the long‐term outcomes of patients presenting with heart failure and a preserved ejection fraction (HFpEF).

Method

We identified 538 patients who presented with acute cardiac decompensation, a >100 pg/mL serum b‐type natriuretic peptide (BNP) or >300 pg/mL N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) concentration and a left ventricular ejection fraction (LVEF) >45%. After 4–8 weeks of standard treatment, 413 patients (mean age = 76 ± 9 years, 55.9% women) returned for analyses of their clinical status, laboratory screen, and detailed electrocardiographic and Doppler echocardiographic recordings. They were followed for a mean of 28 months thereafter. The primary study endpoint was time to death from all causes or first hospitalization for heart failure.

Results

Mean LVEF was 62.4 ± 6.9% and median NT‐proBNP 1410 pmol/L. PR interval >200 ms was present in 11.2% of patients and 14.9% had a >120 ms QRS duration, with left bundle branch block in only 6.3%. Over a mean follow‐up of 28 months, 177 patients (42.9%) reached a primary study endpoint, including 61 deaths and 116 hospitalizations for heart failure. After adjustment for age, gender, New York Heart Association class, atrial fibrillation history, creatinine, sodium, BNP, ejection fraction, and right ventricular fractional shortening, only E/e′ remained as a predictor, with a hazard ratio = 1.49 and P = 0.0012.

Conclusion

The incidence of hospitalizations for HF and deaths in KaRen was high and E/e′ predicted adverse clinical outcomes. These observations should help in the risk stratification and therapy of HFpEF.
Factors associated with pain and disability reduction following exercise interventions in chronic whiplash
Authors: Ludvigsson M. L. , Peterson G. , Dedering Å. , Falla D. , Peolsson A.
Published: May 2015

Background

Some studies support the prescription of exercise for people with whiplash‐associated disorders (WAD); however, the response is highly variable. Further research is necessary to identify factors which predict response.

Methods

This is a secondary analysis of a randomized, multicentre controlled clinical trial of 202 volunteers with chronic WAD (grades 2 and 3). They received either neck‐specific exercise with, or without a behavioural approach, or prescription of physical activity for 12 weeks. Treatment response, defined as a clinical important reduction in pain or disability, was registered after 3 and 12 months, and factors associated with treatment response were explored using logistic regression.

Results

Participation in the neck‐specific exercise group was the only significant factor associated with both neck pain and neck disability reduction both at 3 and 12 months. Patients in this group had up to 5.3 times higher odds of disability reduction and 3.9 times higher odds of pain reduction compared to those in the physical activity group. Different baseline features were identified as predictors of response depending on the time point examined and the outcome measure selected (pain vs. disability).

Conclusion

Factors associated with treatment response after exercise interventions differ in the short and long term and differ depending on whether neck pain or disability is considered as the primary outcome. Participation in a neck‐specific exercise intervention, in contrast to general physical activity, was the only factor that consistently indicated higher odds of treatment success. These results support the prescription of neck‐specific exercise for individuals with chronic WAD.