bluuebunny/crossref_metadata_2025 huggingface dataset:
Failure Rates in the Hepatocellular Carcinoma Surveillance Process
Authors: Singal Amit G. , Yopp Adam C. , Gupta Samir , Skinner Celette Sugg , Halm Ethan A. , Okolo Eucharia , Nehra Mahendra , Lee William M. , Marrero Jorge A. , Tiro Jasmin A.
Published: July 2012

Hepatocellular carcinoma (HCC) surveillance is underutilized among patients with cirrhosis. Understanding which steps in the surveillance process are not being conducted is essential for designing effective interventions to improve surveillance rates. The aim of our study was to characterize reasons for failure in the HCC surveillance process among a cohort of cirrhotic patients with HCC. We conducted a retrospective cohort study of cirrhotic patients diagnosed with HCC at a large urban safety-net hospital between 2005 and 2011. Patients were characterized by receipt of HCC surveillance over a two-year period before HCC diagnosis. Among patients without HCC surveillance, we classified reasons for failure into four categories: failure to recognize liver disease, failure to recognize cirrhosis, failure to order surveillance, and failure to complete surveillance despite orders. Univariate and multivariate analyses were conducted to identify predictors of failures. We identified 178 patients with HCC, of whom 20% had undergone surveillance. There were multiple points of failure—20% had unrecognized liver disease, 19% had unrecognized cirrhosis, 38% lacked surveillance orders, and 3% failed to complete surveillance despite orders. Surveillance was more likely among patients seen by hepatologists [OR, 6.11; 95% confidence interval (CI), 2.5–14.8] and less likely in those with alcohol abuse (OR, 0.14; 95% CI, 0.03–0.65). Although a retrospective analysis in a safety-net hospital, our data suggest that only one in five patients received surveillance before HCC diagnosis. There are multiple points of failure in the surveillance process, with the most common being failure to order surveillance in patients with known cirrhosis. Future interventions must target multiple failure points in the surveillance process to be highly effective. Cancer Prev Res; 5(9); 1124–30. ©2012 AACR.
Beneficial Effects of High-Dose Atorvastatin Pretreatment on Renal Function in Patients with Acute ST-Segment Elevation Myocardial Infarction Undergoing Emergency Percutaneous Coronary Intervention
Authors: Li Wei , Fu Xianghua , Wang Yanbo , Li Xiangnan , Yang Zengxin , Wang Xuechao , Geng Wei , Gu Xinshun , Hao Guozhen , Jiang Yunfa , Fan Weize , Wu Weili , Li Shiqiang
Published: July 2012

Objectives: To investigate whether preprocedural high-dose atorvastatin decreases the incidence of contrast-induced nephropathy (CIN) and protects the renal function after emergency percutaneous coronary intervention (PCI). Methods: Statin-naive patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing emergency PCI (n = 161) randomly received atorvastatin (80 mg, n = 78, ATOR group) or placebo [n = 83, control (CON) group] followed by long-term atorvastatin (40 mg/day). The primary end point was incidence of CIN. Results: In the ATOR group, 2.6% of the patients developed CIN versus 15.7% in the CON group (p = 0.01). In the ATOR group, postprocedural serum creatinine was significantly lower (93.4 ± 17.1 vs. 112.6 ± 23.3 µmol/l at 48 h and 84.2 ± 14.2 vs. 95.3 ± 17.7 µmol/l at 72 h, both p < 0.0001) and in the CON group, peak serum cystatin C was lower (0.51 ± 0.14 vs. 0.61 ± 0.13 mg/l, p < 0.0001). Atorvastatin pretreatment was independently associated with a decreased risk of CIN (OR 0.084, 95% CI 0.015–0.462, p = 0.004). The proportion of alanine aminotransferase >3 × upper limit of the normal value within 1 month was 3.85 versus 1.20% (ATOR vs. CON group, p = 0.57). Conclusion: Preprocedural high-dose atorvastatin prevents CIN and protects the renal function in patients with acute STEMI undergoing emergency PCI.
Midbrain and Falx in Fetuses with Absent Corpus Callosum at 11–13 Weeks
Authors: Lachmann Robert , Sodre Danielle , Barmpas Michail , Akolekar Ranjit , Nicolaides Kypros H.
Published: July 2012

Objective: To describe the first trimester diagnosis of agenesis of the corpus callosum (ACC). Methods: The midbrain and falx cerebri were examined in stored images of the midsagittal view of the fetal brain at 11+0–13+6 weeks’ gestation from 15 fetuses with ACC and 500 normal controls. The midbrain diameter and falx diameter were measured and their ratio was calculated. The values in fetuses with ACC and normal controls were compared. Results: In the control group, the midbrain and falx diameters increased significantly with crown-rump length (CRL) from respective mean values of 5.1 and 6.9 mm at CRL of 45–6.9 mm and 12.1 mm at CRL of 84 mm. In the ACC group the midbrain diameter was above the 95th percentile of the control group in 8 (53.3%) cases, the falx diameter was below the 5th percentile in 6 (40.0%) cases and the midbrain diameter-to-falx diameter ratio was above the 95th percentile in 13 (86.7%) cases. Conclusions: In the midsagittal view of the fetal brain at 11–13 weeks, the majority of fetuses with ACC have measurable abnormalities in the midbrain and falx area of the brain.
Neurodevelopmental Outcomes in Children With Congenital Heart Disease: Evaluation and Management
Authors: Marino Bradley S. , Lipkin Paul H. , Newburger Jane W. , Peacock Georgina , Gerdes Marsha , Gaynor J. William , Mussatto Kathleen A. , Uzark Karen , Goldberg Caren S. , Johnson Walter H. , Li Jennifer , Smith Sabrina E. , Bellinger David C. , Mahle William T.
Published: July 2012

Background—

The goal of this statement was to review the available literature on surveillance, screening, evaluation, and management strategies and put forward a scientific statement that would comprehensively review the literature and create recommendations to optimize neurodevelopmental outcome in the pediatric congenital heart disease (CHD) population.

Methods and Results—

A writing group appointed by the American Heart Association and American Academy of Pediatrics reviewed the available literature addressing developmental disorder and disability and developmental delay in the CHD population, with specific attention given to surveillance, screening, evaluation, and management strategies. MEDLINE and Google Scholar database searches from 1966 to 2011 were performed for English-language articles cross-referencing CHD with pertinent search terms. The reference lists of identified articles were also searched. The American College of Cardiology/American Heart Association classification of recommendations and levels of evidence for practice guidelines were used. A management algorithm was devised that stratified children with CHD on the basis of established risk factors. For those deemed to be at high risk for developmental disorder or disabilities or for developmental delay, formal, periodic developmental and medical evaluations are recommended. A CHD algorithm for surveillance, screening, evaluation, reevaluation, and management of developmental disorder or disability has been constructed to serve as a supplement to the 2006 American Academy of Pediatrics statement on developmental surveillance and screening. The proposed algorithm is designed to be carried out within the context of the medical home. This scientific statement is meant for medical providers within the medical home who care for patients with CHD.

Conclusions—

Children with CHD are at increased risk of developmental disorder or disabilities or developmental delay. Periodic developmental surveillance, screening, evaluation, and reevaluation throughout childhood may enhance identification of significant deficits, allowing for appropriate therapies and education to enhance later academic, behavioral, psychosocial, and adaptive functioning.
The Contribution of Primary and Secondary Somatosensory Cortices to the Representation of Body Parts and Body Sides: An fMRI Adaptation Study
Authors: Tamè Luigi , Braun Christoph , Lingnau Angelika , Schwarzbach Jens , Demarchi Gianpaolo , Li Hegner Yiwen , Farnè Alessandro , Pavani Francesco
Published: July 2012

Although the somatosensory homunculus is a classically used description of the way somatosensory inputs are processed in the brain, the actual contributions of primary (SI) and secondary (SII) somatosensory cortices to the spatial coding of touch remain poorly understood. We studied adaptation of the fMRI BOLD response in the somatosensory cortex by delivering pairs of vibrotactile stimuli to the finger tips of the index and middle fingers. The first stimulus (adaptor) was delivered either to the index or to the middle finger of the right or left hand, and the second stimulus (test) was always administered to the left index finger. The overall BOLD response evoked by the stimulation was primarily contralateral in SI and was more bilateral in SII. However, our fMRI adaptation approach also revealed that both somatosensory cortices were sensitive to ipsilateral as well as to contralateral inputs. SI and SII adapted more after subsequent stimulation of homologous as compared with nonhomologous fingers, showing a distinction between different fingers. Most importantly, for both somatosensory cortices, this finger-specific adaptation occurred irrespective of whether the tactile stimulus was delivered to the same or to different hands. This result implies integration of contralateral and ipsilateral somatosensory inputs in SI as well as in SII. Our findings suggest that SI is more than a simple relay for sensory information and that both SI and SII contribute to the spatial coding of touch by discriminating between body parts (fingers) and by integrating the somatosensory input from the two sides of the body (hands).
Pragmatics in Action: Indirect Requests Engage Theory of Mind Areas and the Cortical Motor Network
Authors: van Ackeren Markus J. , Casasanto Daniel , Bekkering Harold , Hagoort Peter , Rueschemeyer Shirley-Ann
Published: July 2012

Research from the past decade has shown that understanding the meaning of words and utterances (i.e., abstracted symbols) engages the same systems we used to perceive and interact with the physical world in a content-specific manner. For example, understanding the word “grasp” elicits activation in the cortical motor network, that is, part of the neural substrate involved in planned and executing a grasping action. In the embodied literature, cortical motor activation during language comprehension is thought to reflect motor simulation underlying conceptual knowledge [note that outside the embodied framework, other explanations for the link between action and language are offered, e.g., Mahon, B. Z., & Caramazza, A. A critical look at the embodied cognition hypothesis and a new proposal for grouding conceptual content. Journal of Physiology, 102, 59–70, 2008; Hagoort, P. On Broca, brain, and binding: A new framework. Trends in Cognitive Sciences, 9, 416–423, 2005]. Previous research has supported the view that the coupling between language and action is flexible, and reading an action-related word form is not sufficient for cortical motor activation [Van Dam, W. O., van Dijk, M., Bekkering, H., & Rueschemeyer, S.-A. Flexibility in embodied lexical–semantic representations. Human Brain Mapping, doi: 10.1002/hbm.21365, 2011]. The current study goes one step further by addressing the necessity of action-related word forms for motor activation during language comprehension. Subjects listened to indirect requests (IRs) for action during an fMRI session. IRs for action are speech acts in which access to an action concept is required, although it is not explicitly encoded in the language. For example, the utterance “It is hot here!” in a room with a window is likely to be interpreted as a request to open the window. However, the same utterance in a desert will be interpreted as a statement. The results indicate (1) that comprehension of IR sentences activates cortical motor areas reliably more than comprehension of sentences devoid of any implicit motor information. This is true despite the fact that IR sentences contain no lexical reference to action. (2) Comprehension of IR sentences also reliably activates substantial portions of the theory of mind network, known to be involved in making inferences about mental states of others. The implications of these findings for embodied theories of language are discussed.
Inhibition of Return Impairs Phosphene Detection
Authors: Smith Daniel T. , Ball Keira , Ellison Amanda
Published: July 2012

Efficient visual exploration requires the ability to select possible target locations via spatial attention and to deselect previously inspected locations via inhibition of return (IOR). Although a great deal is known about the effects of spatial attention on processing in visual cortex, much less is known about the effects of IOR on early visual areas. One possibility is that IOR acts in an opposite way to spatial attention, such that, whereas spatial attention enhances target related neural signals in visual cortex, IOR suppress target-related signals. Using a novel dual-coil TMS protocol, we found that IOR reduced the probability of detecting a TMS-induced phosphene in extrastriate cortex (V5). Specifically, a nonpredictive spatial precue presented 500 or 800 msec before stimulation significantly reduced the probability of detecting a phosphene when the precue appeared contralaterally to the site of stimulation (i.e., ipsilaterally to the potential location of the phosphene), compared with ipsilaterally or centrally presented cues. This result demonstrates that IOR facilitates visual exploration by directly affecting the strength of target-related signals in extrastriate visual cortex. This result is consistent with neurophysiological models of attention, which postulate that IOR modulates perception by biasing competition between sensory representations.
The Effect of Aging on the Neural Correlates of Phonological Word Retrieval
Authors: Geva Sharon , Jones P. Simon , Crinion Jenny T. , Price Cathy J. , Baron Jean-Claude , Warburton Elizabeth A.
Published: July 2012

Age has a differential effect on cognition, with word retrieval being one of the cognitive domains most affected by aging. This study examined the functional and structural neural correlates of phonological word retrieval in younger and older adults using word and picture rhyme judgment tasks. Although the behavioral performance in the fMRI task was similar for the two age groups, the older adults had increased activation in the right pars triangularis across tasks and in the right pars orbitalis for the word task only. Increased activation together with preserved performance in the older participants would suggest that increased activation was related to compensatory processing. We validated this hypothesis by showing that right pars triangularis activation during correct rhyme judgments was highest in participants who made overall more errors, therefore being most error-prone. Our findings demonstrate that the effect of aging differ in adjacent but distinct right inferior frontal regions. The differential effect of age on word and picture tasks also provides new clues to the level of processing that is most affected by age in speech production tasks. Specifically, we suggest that right inferior frontal activation in older participants is needed to inhibit errors.
Design flow for the crash box in a vehicle to maximize energy absorption
Authors: Lee Se-Jung , Lee Hyun-Ah , Yi Sang-Il , Kim Dae-Seung , Yang Heui Won , Park Gyung-Jin
Published: July 2012

Vehicle collisions frequently happen at a low speed. Insurance companies and the Research Council for Automobile Repairs both require reduction of repair costs and improvement in occupant safety in a low-speed crash. In order to reduce repair costs, an energy absorbing device such as the crash box is usually installed. The crash box is a thin-walled structure attached between the vehicle bumper structure and the side rail. The determination of the crash box geometry is quite important to absorb the impact energy, since the installation space of the crash box is not very large. In this research, a design procedure to determine the cross-sectional dimensions is proposed to enhance the energy absorption capability of the crash box. The proposed process has two steps. In the first step, the cross-sectional dimensions for the conceptual design are determined in two ways. One is a parameter study using discrete design with an orthogonal array. The cross-sectional dimensions of the crash box are selected among the available cross-sections, such as a circle or a polygon. The cross-sectional dimensions are determined by the analysis of the mean from the discrete design with an orthogonal array. The other is topology optimization, which is performed to determine the cross-section of the crash box to maximize the absorbed strain energy based on the Research Council for Automobile Repairs test conditions. The equivalent static loads method for non linear static response structural optimization is employed to solve the formulated topology optimization problems. The cross sections of the crash box are determined from the results of the conceptual design. In the second step, the detailed design processes are performed by using discrete design with an orthogonal array for the models that are selected in the first step. The detailed shapes of the new crash boxes are determined from the detailed design. The optimization problem for the crash box is formulated considering the geometric constraints of fitting into the given space for the crash box. Three new types of crash box are suggested, with detailed shapes from the proposed design procedure.
Novel incentive-based approaches to adherence
Authors: Kimmel Stephen E , Troxel Andrea B
Published: July 2012

Background

Adherence to medications for chronic conditions is often very low, limiting the benefit to patients, even when the medications are effective and have favorable side effect profiles.

Purpose

This article reviews some of the prior work on treatment adherence, introduces novel concepts from behavioral economics that can be used to design interventions to improve adherence, and proposes new approaches for clinical trials.

Methods

Relevant experience of the authors and insights from the literature were combined to identify key issues and propose methodological improvements. Specific examples regarding adherence to warfarin are provided.

Results

Several new approaches to trial design can be effectively applied in the context of medication adherence. These include tailored intervention strategies and sequential multiple assignment randomized trial (SMART) designs.

Limitations

While we have proposed to use these new approaches for ongoing studies of adherence in behavioral health, practical experience with their application is still somewhat limited.

Conclusions

Behavioral economics offer a variety of concepts that, when used in the design of interventions to improve adherence, may be more successful than traditional approaches. New clinical trial designs can also be adopted to improve the efficiency of studies that assess these approaches.
Does Type of Infant Feeding Affect Phototherapy for Neonatal Hyperbilirubinemia?
Authors: El Sakka Abeer , Imam Safaa S. , El Barbary Mohamed , Ibrahium Wafaa
Published: July 2012

Phototherapy is the most common method used to treat and prevent neonatal hyperbilirubinemia. Breastfeeding compared with formula feeding is associated with an increased risk of jaundice and kernicterus. The main mechanism is failure of successful initiation of breastfeeding. Breast failure jaundice usually leads to significant weight loss resulting in hyperbilirubinemia. The aim was to determine the relation between type of infant feeding and the efficacy of phototherapy for treatment of hyperbilirubinemia in term newborns. The authors included 90 full-term neonates diagnosed with nonhemolytic, unconjugated hyperbilirubinemia. According to their total bilirubin level, they received conventional phototherapy for treatment. They were divided into 3 groups according to type of feeding: group 1, mixed feeding (MF; breast and formula); group 2, formula feeding (FF; formula); and group 3, breastfeeding (BF). Rebound bilirubin was checked 24 hours after stopping phototherapy. The mean duration of phototherapy was more in the BF group, followed by the MF and FF groups (P < .01). There was a significant positive correlation between bilirubin level and weight loss at the start of phototherapy in the groups studied (r = 0.635; P < .001). Rebound bilirubin level was higher in BF followed by FF and MF newborns, with significant differences (P = .005). These results indicate that phototherapy effectively reduces bilirubin levels in BF newborns with hyperbilirubinemia. These infants show a significantly slower response to this treatment than FF or MF newborns. Prevention of breast milk failure would decrease weight loss, which is associated with high bilirubin at the start of phototherapy.
Synthetic genistein derivatives as modulators of glycosaminoglycan storage
Authors: Kloska Anna , Narajczyk Magdalena , Jakóbkiewicz-Banecka Joanna , Grynkiewicz Grzegorz , Szeja Wiesław , Gabig-Cimińska Magdalena , Węgrzyn Grzegorz
Published: July 2012

Background

Mucopolysaccharidoses (MPS) are severe metabolic disorders caused by accumulation of undegraded glycosaminoglycans (GAGs) in lysosomes due to defects in certain lysosomal hydrolases. Substrate reduction therapy (SRT) has been proposed as one of potential treatment procedures of MPS. Importantly, small molecules used in such a therapy might potentially cross the blood–brain barrier (BBB) and improve neurological status of patients, as reported for a natural isoflavone, 5, 7-dihydroxy-3- (4-hydroxyphenyl)-4 H-1-benzopyran-4-one, also known as genistein. Although genistein is able to cross BBB to some extent, its delivery to the central nervous system is still relatively poor (below 10% efficiency). Thus, we aimed to develop a set of synthetically modified genistein molecules and characterize physicochemical as well as biological properties of these compounds.

Methods

Following parameters were determined for the tested synthetic derivatives of genistein: cytotoxicity, effects on cell proliferation, kinetics of GAG synthesis, effects on epidermal growth factor (EGF) receptor’s tyrosine kinase activity, effects on lysosomal storage, potential ability to cross BBB.

Results

We observed that some synthetic derivatives inhibited GAG synthesis similarly to, or more efficiently than, genistein and were able to reduce lysosomal storage in MPS III fibroblasts. The tested compounds were generally of low cytotoxicity and had minor effects on cell proliferation. Moreover, synthetic derivatives of genistein revealed higher lipophilicity (assessedin silico) than the natural isoflavone.

Conclusion

Some compounds tested in this study might be promising candidates for further studies on therapeutic agents in MPS types with neurological symptoms.
A noninvasive mucinous cystic neoplasm with intermediate-grade dysplasia of the pancreas and extensive squamous metaplasia: a case report with clinicopathological correlation
Authors: Li Peifeng , Wang Yingmei , Zhang Qingqing , Liu Yixiong , Lv Yang , Wang Zhe
Published: July 2012

Squamous metaplasia presenting in noninvasive mucinous cystic neoplasm (MCN) of the pancreas is extremely rare. We described a case of 39-year-old Chinese female with a 5-year history of a slow growing mass in the left upper abdomen and an 18-month history of surgical incision exudation. The patient underwent cystojejunostomy, laparotomy and distal pancreatectomy consecutively because of the initial diagnosis of “pancreatic cyst”. The histological section showed columnar mucin-producing epithelium formed small papillary projections and extensively visible squamous metaplasia. Therefore the diagnosis of “noninvasive MCN with intermediate-grade dysplasia of the pancreas and extensive squamous metaplasia” was made finally. The squamous component of the pancreas may be derived from pluripotent stem cells, and may be in association with cystojejunostomy.

Virtual slides

The virtual slide(s) for this article can be found here http://www.diagnosticpathology.diagnomx.eu/vs/1322364365718540
Attenuation of osteoarthritis via blockade of the SDF-1/CXCR4 signaling pathway
Authors: Wei Fangyuan , Moore Douglas C , Li Yanlin , Zhang Ge , Wei Xiaochun , Lee Joseph K , Wei Lei
Published: July 2012

Introduction

This study was performed to evaluate the attenuation of osteoarthritic (OA) pathogenesis via disruption of the stromal cell-derived factor-1 (SDF-1)/C-X-C chemokine receptor type 4 (CXCR4) signaling with AMD3100 in a guinea pig OA model.

Methods

OA chondrocytes and cartilage explants were incubated with SDF-1, siRNA CXCR4, or anti-CXCR4 antibody before treatment with SDF-1. Matrix metalloproteases (MMPs) mRNA and protein levels were measured with real-time polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA), respectively. The 35 9-month-old male Hartley guinea pigs (0.88 kg ± 0.21 kg) were divided into three groups: AMD-treated group (n = 13); OA group (n = 11); and sham group (n = 11). At 3 months after treatment, knee joints, synovial fluid, and serum were collected for histologic and biochemical analysis. The severity of cartilage damage was assessed by using the modified Mankin score. The levels of SDF-1, glycosaminoglycans (GAGs), MMP-1, MMP-13, and interleukin-1 (IL-1β) were quantified with ELISA.

Results

SDF-1 infiltrated cartilage and decreased proteoglycan staining. Increased glycosaminoglycans and MMP-13 activity were found in the culture media in response to SDF-1 treatment. Disrupting the interaction between SDF-1 and CXCR4 with siRNA CXCR4 or CXCR4 antibody attenuated the effect of SDF-1. Safranin-O staining revealed less cartilage damage in the AMD3100-treated animals with the lowest Mankin score compared with the control animals. The levels of SDF-1, GAG, MMP1, MMP-13, and IL-1β were much lower in the synovial fluid of the AMD3100 group than in that of control group.

Conclusions

The binding of SDF-1 to CXCR4 induces OA cartilage degeneration. The catabolic processes can be disrupted by pharmacologic blockade of SDF-1/CXCR4 signaling. Together, these findings raise the possibility that disruption of the SDF-1/CXCR4 signaling can be used as a therapeutic approach to attenuate cartilage degeneration.
Risk factors for onset of hypothermia in trauma victims: The HypoTraum study
Authors: Lapostolle Frédéric , Sebbah Jean Luc , Couvreur James , Koch François Xavier , Savary Dominique , Tazarourte Karim , Egman Gerald , Mzabi Lynda , Galinski Michel , Adnet Frédéric
Published: July 2012

Introduction

Hypothermia is common in trauma victims and is associated with an increase in mortality. Its causes are not well understood. Our objective was to identify the factors influencing the onset of hypothermia during pre-hospital care of trauma victims.

Methods

This was a multicenter, prospective, open, observational study in a pre-hospital setting.

The subjects were trauma victims, over 18 years old, receiving care from emergency medical services (EMS) and transported to hospital in a medically staffed mobile unit.

Study variables included: demographics and morphological traits, nature and circumstances of the accident, victim's presentation (trapped, seated or lying down, on the ground, unclothed, wet or covered by a blanket), environmental conditions (wind, rain, ground temperature and air temperature on site and in the mobile unit), clinical factors, Revised Trauma Score (RTS), tympanic temperature, care provided (including warming, drugs administered, infusion fluid temperature and volume), and EMS and hospital arrival times.

Results

A total of 448 patients were included. Hypothermia (<35°C) on hospital arrival was present in 64/448 patients (14%). Significant factors associated with the absence of hypothermia in a multivariate analysis were no intubation: Odds Ratio: 4.23 (95% confidence interval 1.62 to 1.02); RTS: 1.68 (1.29 to 2.20); mobile unit temperature: 1.20 (1.04 to 1.38); infusion fluid temperature: 1.17 (1.05 to 1.30); patient not unclothed: 0.40 (0.18 to 0.90); and no head injury: 0.36 (0.16 to 0.83).

Conclusions

The key risk factor for the onset of hypothermia was the severity of injury but environmental conditions and the medical care provided by EMS were also significant factors. Changes in practice could help reduce the impact of factors such as infusion fluid temperature and mobile unit temperature.
Neuroventilatory efficiency and extubation readiness in critically ill patients
Authors: Liu Ling , Liu Huogen , Yang Yi , Huang Yingzi , Liu Songqiao , Beck Jennifer , Slutsky Arthur S , Sinderby Christer , Qiu Haibo
Published: July 2012

Introduction

Based on the hypothesis that failure of weaning from mechanical ventilation is caused by respiratory demand exceeding the capacity of the respiratory muscles, we evaluated whether extubation failure could be characterized by increased respiratory drive and impaired efficiency to generate inspiratory pressure and ventilation.

Methods

Airway pressure, flow, volume, breathing frequency, and diaphragm electrical activity were measured in a heterogeneous group of patients deemed ready for a spontaneous breathing trial. Efficiency to convert neuromuscular activity into inspiratory pressure was calculated as the ratio of negative airway pressure and diaphragm electrical activity during an inspiratory occlusion. Efficiency to convert neuromuscular activity into volume was calculated as the ratio of the tidal volume to diaphragm electrical activity. All variables were obtained during a 30-minute spontaneous breathing trial on continuous positive airway pressure (CPAP) of 5 cm H2O and compared between patients for whom extubation succeeded with those for whom either the spontaneous breathing trial failed or for those who passed, but then the extubation failed.

Results

Of 52 patients enrolled in the study, 35 (67.3%) were successfully extubated, and 17 (32.7%) were not. Patients for whom it failed had higher diaphragm electrical activity (48%; P < 0.001) and a lower efficiency to convert neuromuscular activity into inspiratory pressure and tidal volume (40% (P < 0.001) and 53% (P < 0.001)), respectively. Neuroventilatory efficiency demonstrated the greatest predictability for weaning success.

Conclusions

This study shows that a mixed group of critically ill patients for whom weaning fails have increased neural respiratory drive and impaired ability to convert neuromuscular activity into tidal ventilation, in part because of diaphragm weakness.

Trial Registration

Clinicaltrials.gov identifier NCT01065428. ©2012 Liu et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Comparing Empirical and Analytical Estimates of Earthquake Loss Assessment Studies for the City of Dehradun, India
Authors: Lang Dominik H. , Singh Yogendra , Prasad J. S. R.
Published: July 2012

Very few earthquake risk studies exist for cities on the Indian subcontinent. The few studies that do exist typically focus on intensity as the parameter to describe the expected ground motion during an earthquake and on damage observations to represent building vulnerability. In contrast to these empirical studies, analytical loss computations, which are based on capacity spectrum methods (CSM), have recently become popular and are gaining wide acceptance.

Analytical damage and loss computations have been conducted for the test bed Dehradun, a city of 500,000 inhabitants in the foothills of the Himalayas (northern India), and then compared with loss estimates from empirical studies recently performed for the city. The study illustrates the problems associated with trying to generate intensity-compatible ground motion estimates and comparing the damage and loss estimates of both approaches.
Seismic Performance of Pile-Supported Wharf Structures considering Soil-Structure Interaction in Liquefied Soil
Authors: Shafieezadeh Abdollah , DesRoches Reginald , Rix Glenn J. , Werner Stuart D.
Published: July 2012

Many existing pile-supported marginal wharves within ports along the West Coast of the United States were designed in the late 1960s and early 1970s using the seismic design criteria available then, which were much less robust than the current criteria. As a result, structures designed using these criteria have often been severely damaged during the past earthquakes. This paper investigates the modal properties and vulnerability of such structures by using advanced structural and soil modeling procedures to perform two-dimensional nonlinear plane-strain seismic analyses using time histories of ground displacement and excess pore water pressures within the underlying soil embankment. Results show that the wharf structure experiences large permanent deformations and undergoes failure of the piles and pile-deck connections and pullout of batter piles in tension under large seismic events. Such failures were observed at the Port of Oakland during the 1989 Loma Prieta earthquake and also during other earthquakes throughout the world.
The Seismic Microzonation of the City of Catania (Italy) for the Etna Scenario Earthquake (M = 6.2) of 20 February 1818
Authors: Grasso Salvatore , Maugeri Michele
Published: July 2012

Based on the seismic history of the city of Catania (Italy), the Etna earthquake of 20 February 1818 ( IMCS = VIII–IX, MS = 6.2) has been considered as an earthquake scenario. Despite its lower magnitude, the Etna 1818 earthquake can be accounted for in the seismic hazard assessment of Catania, since it may cause heavy damage to the city. The epicenter was located along the southeastern flanks of the Etna Volcano, close to the municipal area of the city of Catania. The ground-response analysis at the surface has been obtained by one-dimensional (1-D) nonlinear models. According to the response spectra obtained through the application of the nonlinear models, the city of Catania has been divided into zones with different peak ground acceleration at the surface. A ground-shaking map for the urban area of the city of Catania was generated via GIS for the 1818 earthquake scenario.
Restoration of Bridge Networks after an Earthquake: Multicriteria Intervention Optimization
Authors: Bocchini Paolo , Frangopol Dan M.
Published: July 2012

This paper presents an optimization procedure for the restoration activities associated with the bridges of a transportation network severely damaged by an earthquake. The design variables are (i) the time intervals between the occurrence of the distress and the start of the interventions on each bridge of the network; and (ii) the restoration pace of the interventions, which represents a measure of the funding allocated to each bridge. The objectives of the optimization are the maximization of the network resilience, the minimization of the time required to reach a target functionality level, and the minimization of the total cost of the restoration activities. Because the first two objectives clearly conflict with the last one, the optimization procedure does not provide a unique solution, but an entire set of Pareto solutions. A numerical example involving a complex, existing transportation network in Santa Barbara, California, illustrates the capabilities of the proposed methodology.
Demonstration of a Practical Method for Seismic Performance Assessment of Structural Systems
Authors: Yang T. Y. , Stojadinovic Bozidar , Moehle Jack
Published: July 2012

Performance-based earthquake engineering aims to describe the seismic performance of a structure using metrics that are of immediate use to both engineers and stakeholders. A rigorous yet practical implementation of performance-based earthquake engineering methodology is used to compare the seismic performance of two steel, concentrically braced structural systems, an inverted-V-braced frame and a suspended zipper-braced frame. The principal difference between these two structural systems is the design approach used to transfer the unbalanced forces when the braces buckle. A probabilistic seismic performance comparison for a three-story office building located in Berkeley, California designed using these two structural systems is presented. The results indicate the suspended zipper-braced frame has lower expected repair cost under different levels of earthquake hazards and is 25% lighter than the corresponding capacity-designed inverted-V-braced frame.
Phase III, Randomized, Double-Blind, Placebo-Controlled Trial of Gemcitabine/Cisplatin Alone or With Sorafenib for the First-Line Treatment of Advanced, Nonsquamous Non–Small-Cell Lung Cancer
Authors: Paz-Ares Luis G. , Biesma Bonne , Heigener David , von Pawel Joachim , Eisen Timothy , Bennouna Jaafar , Zhang Li , Liao Meilin , Sun Yan , Gans Steven , Syrigos Kostas , Le Marie Etienne , Gottfried Maya , Vansteenkiste Johan , Alberola Vincente , Strauss Uwe Phillip , Montegriffo Elaine , Ong Teng Jin , Santoro Armando
Published: July 2012

Purpose

This trial evaluated the efficacy and safety of sorafenib plus gemcitabine/cisplatin in chemotherapy-naive patients with unresectable stage IIIB to IV nonsquamous non–small-cell lung cancer (NSCLC).

Patients and Methods

Between February 2007 and March 2009, 904 patients were randomly assigned to daily sorafenib (400 mg twice a day) or matching placebo plus gemcitabine (1,250 mg/m2 per day on days 1 and 8) and cisplatin (75 mg/m2 on day 1) for up to six 21-day cycles. Because of safety findings from the Evaluation of Sorafenib, Carboplatin and Paclitaxel Efficacy in NSCLC (ESCAPE) trial, patients with squamous cell histology were withdrawn from the trial in February 2008 and excluded from analysis. The primary end point was overall survival (OS), and secondary end points included progression-free survival (PFS) and time-to-progression (TTP).

Results

The primary analysis population consisted of 772 patients (sorafenib, 385; placebo, 387); the two groups had similar demographic and baseline characteristics. Median OS was similar in the sorafenib and placebo groups (12.4 v 12.5 months; hazard ratio [HR], 0.98; P = .401). By investigator assessment, sorafenib improved median PFS (6.0 v 5.5 months; HR, 0.83; P = .008) and TTP (6.1 v 5.5 months; HR, 0.73; P < .001). Grade 3 to 4 drug-related adverse events more than two-fold higher in the sorafenib group included hand-foot skin reaction (8.6% v 0.3%), fatigue (7.3% v 3.6%), rash (5.7% v 0.5%), and hypertension (4.2% v 1.8%). No unexpected toxicities were observed.

Conclusion

This study did not meet its primary end point of improved OS when sorafenib was added to first-line gemcitabine/cisplatin in patients with advanced nonsquamous NSCLC. Identification of predictive biomarkers is warranted in future trials of sorafenib.
Neuropathy Is Not Associated With Clinical Outcomes in Patients Receiving Adjuvant Taxane-Containing Therapy for Operable Breast Cancer
Authors: Schneider Bryan P. , Zhao Fengmin , Wang Molin , Stearns Vered , Martino Silvana , Jones Vicky , Perez Edith A. , Saphner Tom , Wolff Antonio C. , Sledge George W. , Wood William C. , Davidson Nancy E. , Sparano Joseph A.
Published: July 2012

Purpose

Neuropathy is a common and potentially disabling complication of adjuvant taxane therapy. Recent studies have identified candidate single nucleotide polymorphisms associated with taxane-induced neuropathy. Therefore, we sought to determine whether neuropathy was associated with breast cancer recurrence in a clinical trial population who received adjuvant taxane therapy.

Patients and Methods

Trial E1199 included 4,554 eligible women with operable breast cancer who received up to four cycles of doxorubicin and cyclophosphamide every 3 weeks followed by paclitaxel 175 mg/m2 every 3 weeks for four cycles (P3), paclitaxel 80 mg/m2 weekly for 12 cycles (P1), docetaxel 100 mg/m2 every 3 weeks for four cycles (D3), or docetaxel 35 mg/m2 weekly for 12 cycles (D1). A Cox proportional hazards model was used to determine the relationship between neuropathy and disease-free survival (DFS), overall survival (OS), and recurrence-free survival (RFS) by treating neuropathy status as a time dependent covariate and using a landmark analysis.

Results

Of 4,554 patients who received at least one taxane dose, grade 2 to 4 neuropathy developed in 18%, 22%, 15%, and 13% of patients in the P3, P1, D3, and D1 arms, respectively. In a model that included age, race, obesity, menopausal status, tumor size, nodal status, treatment arm, neuropathy, and hyperglycemia, no significant relationship was found between neuropathy and DFS, OS, or RFS.

Conclusion

There was no association between taxane-induced neuropathy and outcome.
Hyperfractionated Versus Conventional Radiotherapy Followed by Chemotherapy in Standard-Risk Medulloblastoma: Results From the Randomized Multicenter HIT-SIOP PNET 4 Trial
Authors: Lannering Birgitta , Rutkowski Stefan , Doz Francois , Pizer Barry , Gustafsson Göran , Navajas Aurora , Massimino Maura , Reddingius Roel , Benesch Martin , Carrie Christian , Taylor Roger , Gandola Lorenza , Björk-Eriksson Thomas , Giralt Jordi , Oldenburger Foppe , Pietsch Torsten , Figarella-Branger Dominique , Robson Keith , Forni Marco , Clifford Steven C. , Warmuth-Metz Monica , von Hoff Katja , Faldum Andreas , Mosseri Véronique , Kortmann Rolf
Published: July 2012

Purpose

To compare event-free survival (EFS), overall survival (OS), pattern of relapse, and hearing loss in children with standard-risk medulloblastoma treated by postoperative hyperfractionated or conventionally fractionated radiotherapy followed by maintenance chemotherapy.

Patients and Methods

In all, 340 children age 4 to 21 years from 122 European centers were postoperatively staged and randomly assigned to treatment with hyperfractionated radiotherapy (HFRT) or standard (conventional) fractionated radiotherapy (STRT) followed by a common chemotherapy regimen consisting of eight cycles of cisplatin, lomustine, and vincristine.

Results

After a median follow-up of 4.8 years (range, 0.1 to 8.3 years), survival rates were not significantly different between the two treatment arms: 5-year EFS was 77% ± 4% in the STRT group and 78% ± 4% in the HFRT group; corresponding 5-year OS was 87% ± 3% and 85% ± 3%, respectively. A postoperative residual tumor of more than 1.5 cm2 was the strongest negative prognostic factor. EFS of children with all reference assessments and no large residual tumor was 82% ± 2% at 5 years. Patients with a delay of more than 7 weeks to the start of RT had a worse prognosis. Severe hearing loss was not significantly different for the two treatment arms at follow-up.

Conclusion

In this large randomized European study, which enrolled patients with standard-risk medulloblastoma from more than 100 centers, excellent survival rates were achieved in patients without a large postoperative residual tumor and without RT treatment delays. EFS and OS for HFRT was not superior to STRT, which therefore remains standard of care in this disease.
Synthesis, Crystal Structure, and Properties of a New Lead Barium Borate, Pb1.13Ba7.87B18O36
Authors: Wu Hongping , Pan Shilie , Jia Dianzeng , Chen Zhaohui , Yu Hongwei
Published: July 2012

A new compound, Pb1.13Ba7.87B18O36, has been synthesized by a solid-state reaction, and its structure was determined by single-crystal X-ray diffraction. It crystallizes in the non-centrosymmetric space group R32. The fundamental building units of Pb1.13Ba7.87B18O36 are the hexagonal B3O6 rings, which are parallel to the (001) plane and stack along the c axis. Pb1.13Ba7.87B18O36 exhibits a short-wavelength absorption onset at 210 nm. Functional groups present in the sample were identified by Fourier transform infrared spectrum.
Public Disagreement
Authors: Sethi Rajiv , Yildiz Muhamet
Published: July 2012

We develop a model of deliberation under heterogeneous beliefs and incomplete information, and use it to explore questions concerning the aggregation of distributed information and the consequences of social integration. We show that when priors are correlated, all private information is eventually aggregated and public beliefs are identical to those arising under observable priors. When priors are independently distributed, however, some private information is never revealed, and communication breaks down entirely in large groups. Interpreting integration in terms of the observability of priors, we show how increases in social integration lead to less divergent public beliefs on average. (JEL D82, D83, Z13)
Coat color determination by miR-137 mediated down-regulation of microphthalmia-associated transcription factor in a mouse model
Authors: Dong Changsheng , Wang Haidong , Xue Linli , Dong Yanjun , Yang Lei , Fan Ruiwen , Yu Xiuju , Tian Xue , Ma Shuhui , Smith George W.
Published: July 2012

Coat color is a key economic trait in wool-producing species. Color development and pigmentation are controlled by complex mechanisms in animals. Here, we report the first production of an altered coat color by overexpression of miR-137 in transgenic mice. Transgenic mice overexpressing miR-137 developed a range of coat color changes from dark black to light color. Molecular analyses of the transgenic mice showed decreased expression of the major target gene termedMITFand its downstream genes, includingTYR,TYRP1, andTYRP2. We also showed that melanogenesis altered by miR-137 is distinct from that affected by UV radiation in transgenic mice. Our study provides the first mouse model for the study of coat color controlled by miRNAs in animals and may have important applications in wool production.
Link to Success: How Blogs Build an Audience by Promoting Rivals
Authors: Mayzlin Dina , Yoganarasimhan Hema
Published: July 2012

Empirically, we find that Web logs (or “blogs”) often link to other blogs in the same category. We present an analytical model that explains why a rational blogger may choose to link to another blog. We allow bloggers to differ along two dimensions: (1) the ability to post news-breaking content, and (2) the ability to find news in other blogs. By linking, a blog signals to the reader that it will be able to direct her to news in other blogs in the future. The downside of a link is that it is a positive signal on the rival's news-breaking ability. We show that linking will be in equilibrium when the heterogeneity on the ability to break news is low relative to the heterogeneity on the ability to find news in other blogs. One implication of the linking mechanism is that blogs that are high on the news-breaking ability are more likely to gain readers. Hence, despite the fact that bloggers link for purely selfish reasons, the macro effects of this activity is that readers' learning is enhanced.

This paper was accepted by J. Miguel Villas-Boas, marketing.
Dividend Smoothing and Predictability
Authors: Chen Long , Da Zhi , Priestley Richard
Published: July 2012

The relative predictability of returns and dividends is a central issue because it forms the paradigm to interpret asset price variation. A little studied question is how dividend smoothing, as a choice of corporate policy, affects predictability. We show that even if dividends are supposed to be predictable without smoothing, dividend smoothing can bury this predictability. Because aggregate dividends are dramatically more smoothed in the postwar period than before, the lack of dividend growth predictability in the postwar period does not necessarily mean that there is no cash flow news in stock price variations; rather, a more plausible interpretation is that dividends are smoothed. Using two alternative measures that are less subject to dividend smoothing—net payout and earnings—we reach the consistent conclusion that cash flow news plays a more important role than discount rate news in price variations in the postwar period.

This paper was accepted by Wei Xiong, finance.