bluuebunny/crossref_metadata_2025 huggingface dataset:
Hospitalization Subsequent to Diagnosis in Young Patients With Diabetes in Chicago, Illinois
Authors: Estrada Carmela L. , Danielson Kirstie K. , Drum Melinda L. , Lipton Rebecca B.
Published: August 2009

OBJECTIVES: Rehospitalization after a diabetes diagnosis in youth signals the failure of outpatient management. We examined risk factors for rehospitalization among young patients with diabetes.

PATIENTS AND METHODS: We queried 535 participants diagnosed before 18 years of age from the Chicago Childhood Diabetes Registry. Demographic, social, and clinical data were used in logistic models of diabetes-related rehospitalization, as well as, among those rehospitalized, frequent (≥ once per 2 years' duration) versus infrequent rehospitalization rates.

RESULTS: Mean (range) duration was 5.1 years (0.1–19.2 years). The sample was 55% non-Hispanic black, 11% non-Hispanic white, 26% Hispanic, and 7% other/mixed race; 86% had presumed type 1 diabetes; and 47% were underinsured. Overall, 46% reported rehospitalization for diabetes. In multivariable logistic regression, ever being rehospitalized was significantly associated with diabetes duration (per year, odds ratio [OR]: 1.26; P < .01), female gender (OR: 1.67; P = .01), underinsurance (versus private insurance; OR: 1.79; P < .01), presumed phenotype (non–type 1 diabetes versus type 1; OR: 0.32; P < .01), and diagnosis at a community hospital (versus tertiary care facility; OR: 1.96; P < .01) and tended to be higher for those of nonwhite race (OR: 1.94; P = .07). Among those rehospitalized, multivariable associations with frequent rehospitalization were presumed phenotype (non–type 1 diabetes versus type 1; OR: 2.74; P = .04), head of household not working (versus employed; OR: 1.88; P = .02), and younger age at questionnaire (per year; OR: 0.94; P = .01).

CONCLUSIONS: Rehospitalization is common in young patients with diabetes, especially for those with limited resources, indicating the need for improved outpatient services. Comprehensive initial education and support available to young patients with diabetes diagnosed at tertiary care facilities and their families may have lasting protective effects.
Moisture Isotherms and Heat of Desorption of Pistachio (Kaleghochi Var.)
Authors: Gazor Hamid Reza , Bassiri Ali Reza , Minaei Saied
Published: August 2009

Moisture desorption isotherms (EMC/ERH) of Iranian pistachio variety of Kaleghochi were determined at 45, 60, 75 and 90°C using the standard gravimetric static method over a range of relative humidity from 10% to 82%. The experimental desorption curves were fitted under the following different equations: modified Henderson, modified Chung-Pfost, modified Halsaey and modified Oswin. The modified Oswin model was found to be a suitable model for describing the desorption isotherms of pistachio. The net isosteric heat of desorption of pistachio was also determined from the equilibrium data at different temperatures. Furthermore, the net isosteric heat of desorption of pistachio varied between 13.2  2.2kJ/mol at moisture varying between 2.5  15% (d.b).
The incidence class and the hierarchy of orbits
Authors: Fehér László , Patakfalvi Zsolt
Published: August 2009

R. Rimányi defined the incidence class of two singularities η and ζ as [η]|ζ, the restriction of the Thom polynomial of η to ζ. He conjectured that (under mild conditions) [η]|ζ ≠ 0 ⇔ ζ ⊂ $$
\bar \eta
$$. Generalizing this notion we define the incidence class of two orbits η and ζ of a representation. We give a sufficient condition (positivity) for ζ to have the property that [η]|ζ ≠ 0 ⇔ ζ ⊂ $$
\bar \eta
$$ for any other orbit η. We show that for many interesting cases, e.g. the quiver representations of Dynkin type positivity holds for all orbits. In other words in these cases the incidence classes completely determine the hierarchy of the orbits. We also study the case of singularities where positivity doesn’t hold for all orbits.
Periodic harmonic functions on lattices and points count in positive characteristic
Authors: Zaidenberg Mikhail
Published: August 2009

This survey deals with pluri-periodic harmonic functions on lattices with values in a field of positive characteristic. We mention, as a motivation, the game “Lights Out” following the work of Sutner [20], Goldwasser- Klostermeyer-Ware [5], Barua-Ramakrishnan-Sarkar [2, 19], Hunzikel-Machiavello-Park [12] e.a.; see also [22, 23] for a more detailed account. Our approach uses harmonic analysis and algebraic geometry over a field of positive characteristic.
History of Anatomy
Authors: Siddiquey AK Shamsuddin , Husain SM Shahzaman , Laila Syeda Zamila Hasan
Published: August 2009

doi: 10.3329/bja.v7i1.3008Bangladesh Journal of Anatomy January 2009, Vol. 7 No. 1 pp. 1-3
Rehabilitation of Stroke Patients - Effects of Early Intervention of Physical Therapy on Functional Outcome
Authors: Nessa Jebun , Khaleque Md Abdul , Begum Shahanaz , Ahmed AH Hamid , Islam Shafiqul , Afsan Md
Published: August 2009

Context: Early initiation of rehabilitation procedures in stroke patients can enable greater return of neurological functions and prevents complication, thereby improves long term outcome and quality of life. Functional Independence measure (FIM) score is one of the commonest scale used to measure outcome. Study design: Prospective type of study. Place of study: Dept. of Physical Medicine and Rehabilitation, BSMMU. Method: 48 acute onset first episode stroke patients were assessed Rehabilitation procedures started immediately after attending the Dept. According to a comprehensive rehabilitation plan physical therapy, speech therapy, occupational therapy was given and continued for 8 weeks, with proper education to the patient and the attendant. Result: Outcome was measured and the result showed significant improvements (p value <0.001) in early treatment group of patients. Key words: Stroke, FIM, Outcome.   doi: 10.3329/bja.v7i1.3028 Bangladesh Journal of Anatomy January 2009, Vol. 7 No. 1 pp. 62-67
Testing of the OMERACT 8 Draft Validation Criteria for a Soluble Biomarker Reflecting Structural Damage in Rheumatoid Arthritis: A Systematic Literature Search on 5 Candidate Biomarkers
Authors: SYVERSEN SILJE W. , LANDEWE ROBERT , van der HEIJDE DÉSIRÉE , BATHON JOAN M. , BOERS MAARTEN , BYKERK VIVIAN P. , FITZGERALD OLIVER , GLADMAN DAFNA D. , GARNERO PATRICK , GEUSENS PIET , EL-GABALAWY HANI , INMAN ROBERT D. , KRAUS VIRGINIA , KVIEN TORE K. , MEASE PHILIP J. , ØSTERGAARD MIKKEL , RITCHLIN CHRISTOPHER J. , TAK PAUL-PETER , TAYLOR WILLIAM J. , MAKSYMOWYCH WALTER P.
Published: August 2009

Objective.

To test the OMERACT 8 draft validation criteria for soluble biomarkers by assessing the strength of literature evidence in support of 5 candidate biomarkers.

Methods.

A systematic literature search was conducted on the 5 soluble biomarkers RANKL, osteoprotegerin (OPG), matrix metalloprotease (MMP-3), urine C-telopeptide of types I and II collagen (U-CTX-I and U CTX-II), focusing on the 14 OMERACT 8 criteria. Two electronic voting exercises were conducted to address: (1) strength of evidence for each biomarker as reflecting structural damage according to each individual criterion and the importance of each individual criterion; (2) overall strength of evidence in support of each of the 5 candidate biomarkers as reflecting structural damage endpoints in rheumatoid arthritis (RA) and identification of omissions to the criteria set.

Results.

The search identified 111 articles. The strength of evidence in support of these biomarkers reflecting structural damage was low for all biomarkers and was rated highest for U-CTX-II [score of 6.5 (numerical rating scale 0–10)]. The lowest scores for retention of specific criteria in the draft set went to criteria that refer to the importance of animal studies, correlations with other biomarkers reflecting damage, and an understanding of the metabolism of the biomarker.

Conclusion.

Evidence in support of any of the 5 tested biomarkers (MMP-3, CTX-I, CTX-II, OPG, RANKL) was inadequate to allow their substitution for radiographic endpoints in RA. Three of the criteria in the draft criteria set might not be required, but few omissions were identified.
Reappraisal of OMERACT 8 Draft Validation Criteria for a Soluble Biomarker Reflecting Structural Damage Endpoints in Rheumatoid Arthritis, Psoriatic Arthritis, and Spondyloarthritis: The OMERACT 9 v2 Criteria
Authors: MAKSYMOWYCH WALTER P. , LANDEWÉ ROBERT , TAK PAUL-PETER , RITCHLIN CHRISTOPHER J. , ØSTERGAARD MIKKEL , MEASE PHILIP J. , EL-GABALAWY HANI , GARNERO PATRICK , GLADMAN DAFNA D. , FITZGERALD OLIVER , ALETAHA DANIEL , BYKERK VIVIEN P. , BATHON JOAN M. , SYVERSEN SILJE W. , BOERS MAARTEN , GEUSENS PIET , INMAN ROBERT D. , KRAUS VIRGINIA B. , KVIEN TORE K. , TAYLOR WILLIAM J. , WELLS GEORGE A. , van der HEIJDE DÉSIRÉE
Published: August 2009

Objectives.

A draft set of criteria for the validation of soluble biomarkers reflecting damage endpoints was proposed at OMERACT 8. At OMERACT 9 we aimed to scrutinize the necessity for each of these criteria according to the objectives of the working group.

Methods.

The OMERACT 8 draft criteria and the principle objectives of the validation process were clarified at a meeting of the working group in London, December 2007. A new framework was proposed after the following steps were conducted: (A) A systematic review of the literature focusing on the draft criteria and a preselected group of biomarkers (MMP3, CTX-II, RANKL, OPG, CTX-I) followed by a Delphi consensus exercise addressing the importance of individual criteria and identification of omissions in the draft set. (B) Formal debate as well as group discussion centered on the key arguments for inclusion/exclusion of specific criteria. (C) Onsite interactive electronic voting on the importance of specific criteria. The framework was presented and discussed at OMERACT 9 in both breakout and plenary sessions followed by a vote on its acceptance.

Results.

The objectives of rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis biomarkers in relation to their predictive validity for damage endpoints was clarified and supported by OMERACT 9 participants. The OMERACT 8 draft validation criteria were reformulated into an essential category focused on criteria addressing the OMERACT Filter elements of discrimination (incorporating truth) and feasibility, and a desirable but nonessential category of other criteria addressing truth. This revised draft set was endorsed by participants at OMERACT 9.

Conclusion.

A revised set of validation criteria has been drafted by consensus at OMERACT 9 that focuses on the performance characteristics of biomarker assays, the importance of addressing potential confounders, and the essential requirement for clinical validation studies.
The OMERACT MRI Inflammatory Arthritis Group: Advances and Future Research Priorities
Authors: CONAGHAN PHILIP G. , BIRD PAUL , McQUEEN FIONA , PETERFY CHARLES , BØYESEN PERNILLE , GANDJBAKHCH FRÉDÉRIQUE , DUER-JENSEN ANNE , HAAVARDSHOLM ESPEN A. , EJBJERG BO , WIELL CHARLOTTE , COATES LAURA , HERMANN KAY-GEERT A. , O’CONNOR PHILIP , LASSERE MARISSA , FREESTON JANE E. , ANANDARAJAH ALLEN , GENANT HARRY , EMERY PAUL , ØSTERGAARD MIKKEL
Published: August 2009

The OMERACT magnetic resonance imaging (MRI) in inflammatory arthritis group previously developed the rheumatoid arthritis MRI score (RAMRIS) for use in clinical studies, evaluated the use of extremity MRI, and initiated development of a psoriatic arthritis MRI score (PsAMRIS). At OMERACT 9 the group looked at clarifications of applying the RAMRIS, and presented data from a study examining how the contrast agent gadolinium affects RAMRIS outcomes. Much of the group’s effort has been aimed at the iterative development of its PsA score, and reported exercises examining this score demonstrated encouraging results, allowing subsequent presentation of a preliminary PsAMRIS. The large amount of data presented were followed by discussions with the wider audience highlighting constructive suggestions for future research priorities, including further feasibility studies, understanding imaging remission, and further improvements to PsAMRIS.
Reducing Invasiveness, Duration, and Cost of Magnetic Resonance Imaging in Rheumatoid Arthritis by Omitting Intravenous Contrast Injection — Does It Change the Assessment of Inflammatory and Destructive Joint Changes by the OMERACT RAMRIS?
Authors: ØSTERGAARD MIKKEL , CONAGHAN PHILIP G. , O’CONNOR PHILIP , SZKUDLAREK MARCIN , KLARLUND METTE , EMERY PAUL , PETERFY CHARLES , GENANT HARRY , McQUEEN FIONA M. , BIRD PAUL , LASSERE MARISSA , EJBJERG BO
Published: August 2009

Objective.

Gadolinium (Gd)-enhanced magnetic resonance imaging (MRI) provides highly sensitive assessment of inflammatory and destructive changes in rheumatoid arthritis (RA) joints, but intravenous (IV) Gd injection prolongs examination time and increases cost, invasiveness, and patient discomfort. We explored to what extent RA joint pathologies in wrists and metacarpophalangeal (MCP) joints can be reliably assessed by unenhanced MRI images compared with Gd-enhanced MRI as the reference method.

Methods.

MRI data sets from 2 RA substudies were scored according to preliminary OMERACT RA MRI scoring system (RAMRIS): Substudy A included 1.0 T/1.5 T MR images from 40 RA patients, which were scored twice by 2 experienced readers. Substudy B included 0.2 T dedicated extremity MRI (E-MRI) images from 55 patients, scored twice by one experienced reader. The first reading included only unenhanced images, whereas complete image sets were available for the second reading.

Results.

Gd contrast injection appeared unimportant to MRI scores of bone erosions and bone edema in RA wrist and MCP joints. However, when post-Gd MRI was considered the standard reference, MRI without Gd provided only moderate to high agreement concerning assessment of synovitis, and omitting the post-Gd acquisitions increased the interreader variation on synovitis scores. Low-field (0.2 T) E-MRI in these exercises provided a lower sensitivity of unenhanced imaging for synovitis than MRI using higher-field strengths.

Conclusion.

Omitting IV contrast injection did not change scores of bone erosions and bone edema, but decreased the reliability of synovitis scores. However, this disadvantage may for some purposes be outweighed by the possibility to assess more joints and/or greater feasibility.
The C-Type Lectin-Like Receptor CLEC-1, Expressed by Myeloid Cells and Endothelial Cells, Is Up-Regulated by Immunoregulatory Mediators and Moderates T Cell Activation
Authors: Thebault Pamela , Lhermite Natacha , Tilly Gaëlle , Le Texier Laëtitia , Quillard Thibaut , Heslan Michele , Anegon Ignacio , Soulillou Jean-Paul , Brouard Sophie , Charreau Beatrice , Cuturi Maria-Cristina , Chiffoleau Elise
Published: August 2009

C-type lectin receptors have recently been described as playing crucial roles in immunity and homeostasis since these proteins are able to recognize pathogens as well as self-Ags. We identified the C-type lectin-like receptor-1, CLEC-1, as being overexpressed in a model of rat allograft tolerance. We previously described in this model the expression of numerous cytoprotective molecules by graft endothelial cells and their interplay with regulatory CD4+CD25+ T cells. In this study, we demonstrate that CLEC-1 is expressed by myeloid cells and specifically by endothelial cells in tolerated allografts and that CLEC-1 expression can be induced in endothelial cells by alloantigen-specific regulatory CD4+CD25+ T cells. Analysis of CLEC-1 expression in naive rats demonstrates that CLEC-1 is highly expressed by myeloid cells and at a lower level by endothelial cells, and that its expression is down-regulated by inflammatory stimuli but increased by the immunoregulators IL-10 or TGFβ. Interestingly, we demonstrate in vitro that inhibition of CLEC-1 expression in rat dendritic cells increases the subsequent differentiation of allogeneic Th17 T cells and decreases the regulatory Foxp3+ T cell pool. Additionally, in chronically rejected allograft, the decreased expression of CLEC-1 is associated with a higher production of IL-17. Taken together, our data suggest that CLEC-1, expressed by myeloid cells and endothelial cells, is enhanced by regulatory mediators and moderates Th17 differentiation. Therefore, CLEC-1 may represent a new therapeutic agent to modulate the immune response in transplantation, autoimmunity, or cancer settings.
Impaired Lung Dendritic Cell Migration and T Cell Stimulation Induced by Immunostimulatory Oligonucleotides Contribute to Reduced Allergic Airway Inflammation
Authors: Constabel Hannelore , Stankov Metodi V. , Hartwig Christina , Tschernig Thomas , Behrens Georg M. N.
Published: August 2009

CpG-containing oligonucleotides (CpG) have been shown to reduce key features of allergic airway inflammation in mouse models. Given the inhibitory effects of CpG treatment on Ag presentation of subsequently encountered Ags via MHC class I and II molecules by dendritic cells (DC), we hypothesized that intranasal CpG treatment would lead to reduced Ag-specific T cell stimulation in the lung-draining lymph nodes, thereby reducing the inflammatory response in sensitized mice. Intranasal CpG administration led to phenotypic maturation of lung and mediastinal lymph node DC as determined by expression of MHC class II, CD80, and CD86. This was accompanied by a significant reduction in the proliferation of adoptively transferred Ag-specific CD4+ and CD8+ T cells in mediastinal lymph nodes, when CpG was given before inhalative OVA challenges. DC obtained from mediastinal lymph nodes of CpG-treated mice before OVA inhalation led to reduced T cell stimulation via MHC class I and II molecules. In addition, CpG diminished airway eosinophilia and pulmonary infiltration after sensitization or following adoptive transfer of Ag-specific Th2 cells. These results were explained by reduced CCL21 expression and inhibition of lung DC migration following CpG administration, which could be restored by transfer of bone marrow-derived DC, because CpG had no major impact on the constitutive MHC class II Ag presentation of protein-derived Ag by lung tissue-derived DC. We conclude that CpG treatment can effectively impair the DC-mediated Ag transport from the lungs to the lymph nodes, resulting in reduced T cell activation and blunted airway inflammation.
The Gli3 Transcription Factor Expressed in the Thymus Stroma Controls Thymocyte Negative Selection Via Hedgehog-Dependent and -Independent Mechanisms
Authors: Hager-Theodorides Ariadne L. , Furmanski Anna L. , Ross Susan E. , Outram Susan V. , Rowbotham Nicola J. , Crompton Tessa
Published: August 2009

The Hedgehog (Hh) responsive transcription factor Gli3 is required for efficient thymocyte development in the fetus. In this study we show that Gli3, not detected in adult thymocytes, is expressed in the murine fetal and adult thymus stroma. PCR array analysis revealed Cxcl9, Rbp1, and Nos2 as novel target genes of Gli3. We show that Gli3 positively regulates the expression of these genes, most likely by suppressing an intermediate repressor. Deletion of autoreactive thymocytes depends on their interactions with the thymus stroma. Repression of the proapoptotic gene Nos2 in Gli3 mutants coincides with reduced apoptosis of double positive thymocytes undergoing negative selection in vitro and in vivo, and the production of autoreactive thymocytes. Taken together these data indicate that Gli3 controls thymocyte apoptosis and negative selection possibly via the regulation of Nos2. Defective Gli3 expression in the thymus stroma also resulted in decreased CD5 expression on mature thymocytes and inappropriate production of MHC class I-selected CD4+ cells, both consistent with reduced TCR signal strength. Overall our data indicate that Gli3 expressed in the thymus stroma regulates negative selection and TCR signal strength via Hh-dependent and -independent mechanisms, with implications for autoimmunity.
Jagged1 on Dendritic Cells and Notch on CD4+ T Cells Initiate Lung Allergic Responsiveness by Inducing IL-4 Production
Authors: Okamoto Masakazu , Matsuda Hiroyuki , Joetham Anthony , Lucas Joseph J. , Domenico Joanne , Yasutomo Koji , Takeda Katsuyuki , Gelfand Erwin W.
Published: August 2009

Jagged1, a Notch ligand, and Notch have been implicated in Th2 differentiation, but their role in initiating IL-4 production and Th2 differentiation in vivo and the development of allergic airway responses has not been defined. In this study, we show that Jagged1 is up-regulated on bone marrow-derived dendritic cells (BMDCs) pulsed with allergen and that the transfer of these BMDCs before allergen challenge induces airway hyperresponsiveness (AHR) and eosinophilic airway inflammation. Treatment of CD4+ T cells with a γ-secretase inhibitor (GSI), which inhibits Notch signaling, resulted in decreased cytokine production when the cells were cocultured with allergen-pulsed, Jagged1-expressing BMDCs and, after the transfer of allergen-pulsed BMDCs, IL-4-deficient (IL-4−/−) recipients of GSI-treated naive CD4+ T cells developed lower levels of AHR, reduced numbers of eosinophils, and lower Th2 cytokine levels when challenged with allergen. In vivo treatment of wild-type mice with Jagged1-Fc enhanced AHR and airway inflammation, whereas the transfer of BMDC transfected with Jagged1 small interfering RNA (siRNA) cells into WT or IL-4−/− mice before transfer of CD4+ T cells resulted in decreased AHR, inflammation, and Th2 cytokines, indicating the critical role for Jagged1 expression on APCs. These data identify the essential role of the interactions between Notch on CD4+ T cells and Jagged1 on APCs in the initiation of IL-4 production and Th2 differentiation for the development of AHR and allergic airway inflammation.
γ-Aminobutyric Acid Transporter 1 Negatively Regulates T Cell Activation and Survival through Protein Kinase C-Dependent Signaling Pathways
Authors: Wang Ying , Luo Qingqiong , Xu Yan , Feng Dechun , Fei Jian , Cheng Qi , Xu Lingyun
Published: August 2009

γ-aminobutyric acid transporter 1 (GAT-1), as the major regulator in maintaining a γ-aminobutyric acid reservoir in the CNS, plays negative roles in experimental autoimmune encephalomyelitis pathogenesis. Our previous study has revealed that, besides its wide expression in the CNS, GAT-1 expression can be induced on activated T cells triggered by Ag. However, the function of GAT-1 in T cell activation is unclear. In this study, we show that GAT-1 deficiency induces more vigorous cell cycle entry and less cell apoptosis in T cells, thus leading to enhanced cell proliferation. GAT-1 deficiency promotes T cell division and survival by down-regulating cyclin dependent kinase inhibitor p27kip1, differentially regulating the pro- and anti-apoptotic proteins Bcl-2, Bcl-xl, and Bad and activating transcription factor NF-κB through induction of translocation and phosphorylation of protein kinase C (PKC) θ. In addition, our data reveal that GAT-1 expression on T cells is modulated by PKC activation. Taken together, the data show that GAT-1 negatively regulates T cell activation and survival through PKC-dependent signaling pathways.
Genetic Complementation Results in Augmented Autoantibody Responses to Lupus-Associated Antigens
Authors: Sim Davis L. , Bagavant Harini , Scindia Yogesh M. , Ge Yan , Gaskin Felicia , Fu Shu Man , Deshmukh Umesh S.
Published: August 2009

Lupus-prone female New Zealand Mixed (NZM)2328 mice develop high titers of anti-nuclear and anti-dsDNA autoantibodies. Despite high expression of type I IFNs, these mice do not develop autoantibodies to the small nuclear ribonucleoprotein (snRNP) complex. Thus, additional genetic factors must regulate the generation of anti-snRNP autoantibodies. In contrast, despite much lower expression of type 1 IFNs, the diabetes-prone NOD mice spontaneously make anti-snRNP autoantibodies, albeit at a low incidence. To determine whether combination of high type I IFN response of NZM mice with appropriate susceptibility genes of NOD mice would result in anti-snRNP Ab response, cohorts of (NZM2328 × NOD)F1 mice were generated and characterized for development of autoimmunity. In comparison with parental strains, the PBMCs from F1 mice showed intermediate expression of type I IFN-responsive genes and augmented expression of IL-6 transcripts. TLR7 expression was similar in all strains. The F1 mice had very high incidence and titer of anti-snRNP autoantibodies, anti-nuclear Abs, and anti-dsDNA autoantibodies. The levels of anti-snRNP autoantibody correlated with the expression levels of type I IFN-responsive genes. None of the F1 mice developed diabetes, and only female mice developed severe renal disease. Our data demonstrate that only in presence of appropriate susceptibility genes, anti-snRNP autoantibodies are induced and type I IFNs amplify this response. A synergy between IL-6 and type I IFNs might be critical for amplifying overall autoantibody responses in systemic lupus erythematosus. In NZM/NOD F1 mouse, genetic complementation between NZM and NOD genes leads to expression of phenotypes similar to those seen in certain lupus patients.
Activation-Induced Cytidine Deaminase Expression and Activity in the Absence of Germinal Centers: Insights into Hyper-IgM Syndrome
Authors: Kuraoka Masayuki , Liao Dongmei , Yang Kaiyong , Allgood Sallie D. , Levesque Marc C. , Kelsoe Garnett , Ueda Yoshihiro
Published: August 2009

Somatic hypermutation normally occurs as a consequence of the expression of activation-induced cytidine deaminase (AID) by Ag-activated, mature B cells during T cell-dependent germinal center responses. Nonetheless, despite their inability to express CD154 and initiate GC responses, patients with type 1 hyper-IgM syndrome (HIGM1) support populations of IgM+IgD+CD27+ B cells that express mutated Ig genes. The origin of these mutated B cells is unknown; the IgM+IgD+CD27+ cells do not express AID and appear to acquire mutations independent of stringent selection by Ag. Here, we demonstrate that immature/transitional 1 B cells from the bone marrow of CD154-deficient mice express AID and acquire Ig mutations that lack the hallmarks of antigenic selection via BCR signaling. Comparable levels of AID expression was found in developmentally immature B cells recovered from murine fetal liver and from human immature/transitional 1 B cells recovered from umbilical cord blood. AID expression in human fetal liver was also robust, approaching that of human tonsil tissue and the human germinal center B cell line, Ramos. These observations led us to conclude that AID expression in developing human B cells is the origin of the mutated IgM+IgD+CD27+ B cells present in HIGM1 patients, and we propose that both mice and humans share a latent, AID-dependent pathway for the preimmune diversification of B lymphocytes that is more prominent in chicken, sheep, and rabbits.
Brachial Artery-To-Brachial Vein Arterio-Venous Fistula in a Pediatric Patient
Authors: Nezakatgoo Nosrahtollah , Sanders John T. , Jones Deborah P.
Published: August 2009

The National Kidney Foundation's Disease Outcome Quality Initiative (NKF-DOQI) guidelines, produced in 1997, emphasized the superiority of arterio-venous fistulae (AVF) as vascular access in patients on chronic hemodialysis. Challenges in pediatric hemodialysis patients include poor superficial venous vasculature.

We describe an approach to brachial artery to brachial vein AVF creation in a pediatric dialysis patient.

The fistula is patent for greater than one year after creation. A great deal of passion and enthusiasm is a prerequisite for successful and technically challenging cases such as the one described.
Proposal of a Methodology for Multidisciplinary Design of Multifunctional Vehicle Structures including an Acoustic Sensitivity Study
Authors: Cameron Christopher J. , Lind Eleonora , Wennhage Per , Göransson Peter
Published: August 2009

In this paper, a design methodology is proposed, wherein tools and knowledge from the areas of structural design, numerical optimization, and noise, vibration and harshness (NVH) engineering are combined into a single toolbox for vehicle design. The methodology attempts to address the topic of sustainable development from both economic and environmental perspectives within the vehicle industry. A brief review of the topics of NVH and numerical optimization is given for the purposes of disseminating knowledge. Finite element codes for predicting structural and acoustic response are implemented within the iterative design methodology, which is explained for generic problems. Specific focus is placed on the need for understanding functional requirements of the entire system rather than its components. The methodology is implemented in an automotive case study. The results in terms of design solution and development framework are evaluated and discussed. As part of this evaluation, and integral to the design process, an acoustic sensitivity analysis of the final solution is performed and the results are presented.
Complex Eigenvalue Analysis of Windscreen Wiper Chatter Noise and its Suppression by Structural Modifications
Authors: Awang Ibrahim Marzukie , AbuBakar Abd Rahim , Ghani Badri Abd , Rahman Roslan Abd , Md Zain Mohd Zarhamdy
Published: August 2009

This paper presents an approach to predict automotive windscreen wiper chatter noise using the finite element method. In this study, a 3-dimensional finite element model of a real wiper blade is developed and then validated using experimental modal analysis. In order to assess stability of the wiper blade assembly, complex eigenvalue analysis is performed using ABAQUS. The positive real parts of a complex eigenvalue indicate an unstable system. The baseline model is first simulated and stability of the system is examined. Having found a predicted unstable frequency that generates chatter noise, various structural modifications are proposed in order to reduce the vibration.
Dependence of initial cluster aggregation kinetics on shear rate for particles of different sizes under turbulence
Authors: Ehrl Lyonel , Soos Miroslav , Morbidelli Massimo , Bäbler Matthäus Ulrich
Published: August 2009

Initial aggregation kinetics for three particle sizes and broad range of Péclet numbers were investigated under turbulent conditions in stirred tank. This allowed us to observe the transition from diffusion‐controlled to purely shear‐induced aggregation. The evolution of the root‐mean‐square radius of gyration, zero‐angle intensity of scattered light, and obscuration was obtained by small‐angle static light scattering. For a given particle size the measured evolution of all integral quantities obtained for various volume average shear rates 〈G〉, scales with a dimensionless time, τexp = αexp × 〈G〉 × ϕ × t. The experimentally obtained aggregation efficiency αexp, follows the power law αexp = Pe−n, where Pe is the primary particle Péclet number. With increasing particle size a decrease in n is observed in accordance with theory and literature data. As previously predicted by population balance equation simulations three aggregation regimes were observed experimentally. © 2009 American Institute of Chemical Engineers AIChE J, 2009
Secondary clonal cytogenetic abnormalities following successful treatment of acute promyelocytic leukemia
Authors: Batzios Crisoula , Hayes Lachlan A. , He Simon Z. , Quach Hang , McQuilten Zoe K. , Wall Meaghan , Campbell Lynda J.
Published: August 2009

To identify patients who developed secondary clonal cytogenetic aberrations (CCA) following therapy for acute promyelocytic leukemia (APL), we retrospectively analyzed cytogenetic results from 123 patients diagnosed with APL between 1995 and 2007, who had ongoing cytogenetic analysis undertaken in our laboratory. During follow‐up for APL we identified 12 patients (9.8%) who developed CCA, not detected at diagnosis of APL and unrelated to their original APL karyotype. All patients had received all‐trans retinoic acid (ATRA) and chemotherapy and were in complete remission for APL when secondary CCA were identified. The median latency period between diagnosis of APL and emergence of secondary CCA was 27.5 months (range: 2–54 months). To date, four patients with CCA have been diagnosed with therapy‐related myelodysplastic syndrome (t‐MDS)/acute myeloid leukemia (t‐AML), giving a median t‐MDS/AML free survival of 78 months, with follow‐up ranging between 20 and 136 months from APL diagnosis. Three patients have died: two patients died of t‐AML and another developed relapsed APL with persistence of his secondary clone but no diagnosis of t‐MDS/AML and died from transplant‐related complications. Two patients are alive with t‐MDS. Seven patients with CCA are alive with no morphological evidence of MDS at the time of their last known follow‐up; thus median survival has not been reached. The appearance of these abnormalities in the absence of morphological evidence of MDS in the majority of patients is unusual, and highlights the importance of continued cytogenetic follow‐up in these patients. Am. J. Hematol., 2009. © 2009 Wiley‐Liss, Inc.
Variations in the mechanical properties of Alouatta palliata molar enamel
Authors: Darnell Laura A. , Teaford Mark F. , Livi Kenneth J.T. , Weihs Timothy P.
Published: August 2009

Teeth have provided insights into many topics including primate diet, paleobiology, and evolution, due to the fact that they are largely composed of inorganic materials and may remain intact long after an animal is deceased. Previous studies have reported that the mechanical properties, chemistry, and microstructure of human enamel vary with location. This study uses nanoindentation to map out the mechanical properties of Alouatta palliata molar enamel on an axial cross‐section of an unworn permanent third molar, a worn permanent first molar, and a worn deciduous first molar. Variations were then correlated with changes in microstructure and chemistry using scanning electron microscopy and electron microprobe techniques. The hardness and Young's modulus varied with location throughout the cross‐sections from the occlusal surface to the dentin‐enamel junction (DEJ), from the buccal to lingual sides, and also from one tooth to another. These changes in mechanical properties correlated with changes in the organic content of the tooth, which was shown to increase from ∼6% near the occlusal surface to ∼20% just before the DEJ. Compared to human enamel, the Alouatta enamel showed similar microstructures, chemical constituents, and magnitudes of mechanical properties, but showed less variation in hardness and Young's modulus, despite the very different diet of this species. Am J Phys Anthropol 2010. © 2009 Wiley‐Liss, Inc.
The location of white matter lesions and gait—A voxel‐based study
Authors: Srikanth Velandai , Phan Thanh G. , Chen Jian , Beare Richard , Stapleton Jennifer M. , Reutens David C.
Published: August 2009

Little is known about the influence of cerebral white matter lesion (WML) location on gait. We applied partial least squares regression in brain magnetic resonance imaging scans (n = 385) to evaluate which WML voxel systems were independently associated with a composite gait score and identified affected tracts using a diffusion tensor imaging template. Bilateral frontal and periventricular WML‐affected voxels corresponding to major anterior projection fibers (thalamic radiations, corticofugal motor tracts) and adjacent association fibers (corpus callosum, superior fronto‐occipital fasciculus, short association fibers) showed the greatest covariance with poorer gait. WMLs probably contribute to age‐related gait decline by disconnecting motor networks served by these tracts. ANN NEUROL 2010;67:265–269
Development of a virtual reality training curriculum for laparoscopic cholecystectomy
Authors: Aggarwal R , Crochet P , Dias A , Misra A , Ziprin P , Darzi A
Published: August 2009

Background

Training within a proficiency-based virtual reality (VR) curriculum may reduce errors during real surgical procedures. This study used a scientific methodology for development of a VR training curriculum for laparoscopic cholecystectomy.

Methods

Inexperienced (had performed fewer than ten laparoscopic cholecystectomies), intermediate (20–50) and experienced (more than 100) surgeons were recruited. Construct validity was defined as the ability to differentiate between the three levels of experience, based on simulator-derived metrics for nine basic skills, four procedural tasks and full laparoscopic cholecystectomy on a high-fidelity VR simulator. Inexperienced subjects performed ten repetitions for learning curve analysis. Proficiency measures were based on the performance of experienced surgeons.

Results

Thirty inexperienced, 11 intermediate and 16 experienced operators were recruited. Eight of nine basic skills and three of four procedural tasks were found to be construct valid. The full procedure revealed significant intergroup differences for time (1541, 673 and 816 s; P = 0·002), movements (1021, 595 and 638; P = 0·006) and path length (2038, 1235 and 1303 cm; P = 0·033). Learning curves plateaued between the second and ninth sessions.

Conclusion

This study shows that it is possible to define and develop a whole-procedure VR training curriculum for laparoscopic cholecystectomy using structured scientific methodology.
Laparoscopic and open treatment of hepatocellular carcinoma in patients with cirrhosis
Authors: Belli G , Limongelli P , Fantini C , D'Agostino A , Cioffi L , Belli A , Russo G
Published: August 2009

Background

Few studies have compared survival and recurrence rates between laparoscopic and open liver resection for hepatocellular carcinoma in patients with cirrhosis.

Methods

A retrospective analysis of a prospectively maintained database of 179 liver resections performed for HCC in cirrhotic liver between 2000 and 2007 was performed.

Results

Fifty-four patients underwent a laparoscopic resection and 125 patients had open surgery. Histopathological features were largely comparable in the two groups. Tumours operated laparoscopically were smaller than those removed at open operation and laparoscopic liver resection was less extensive. Laparoscopic surgery had a lower morbidity rate than open surgery (19 versus 36·0 per cent; P = 0·020), whereas 30-day mortality was similar (2 versus 4·0 per cent; P = 0·615). After a median follow-up of 24 months, 1- and 3-year survival rates were 94 and 67 per cent in the laparoscopic group. Recurrence rates were similar after laparoscopic and open procedures (45 versus 52·5 per cent; P = 0·381), as was disease-free survival (P = 0·864).

Conclusion

Laparoscopic resection of HCC in cirrhotic liver is feasible and safe in selected patients. Adequate long-term survival and recurrence is achieved compared with open surgery, when stratified for tumour characteristics known to be related to survival outcome.
Factors influencing survival after complete resection of pulmonary metastases from colorectal cancer
Authors: Watanabe K , Nagai K , Kobayashi A , Sugito M , Saito N
Published: August 2009

Background

The aim of this retrospective study was to determine the efficacy of complete (R0) resection for pulmonary metastases of colorectal carcinoma, and to clarify prognostic factors for survival that could be used to identify patients likely to benefit most from pulmonary resection.

Methods

Data on 113 patients who underwent R0 resection of pulmonary metastases from colorectal cancer were reviewed. Overall median follow-up was 49 (range 1–140) months. Clinical and pathological factors were reviewed, and prognostic factors influencing survival were identified.

Results

The overall 5-year survival rate was 67·8 per cent. Multivariable Cox hazard regression analysis revealed that the prethoracotomy serum carcinoembryonic antigen (CEA) level and lymphatic invasion by pulmonary tumour correlated significantly with survival. The 5- and 7-year survival rates of patients with a prethoracotomy CEA level below 5 ng/ml and no lymphatic invasion by pulmonary tumour were 94 and 79 per cent respectively. Pathological features of the primary colorectal cancer, previous hepatectomy for liver metastasis and repeated thoracotomy had no impact on survival.

Conclusion

Long-term survival can be expected after R0 resection of pulmonary metastases from colorectal cancer, particularly in patients with a prethoracotomy CEA level below 5 ng/ml and no lymphatic invasion by pulmonary tumour.
Production of Hydrogen from Dimethyl Ether over Supported Rhodium Catalysts
Authors: Halasi Gyula , Bánsági Tamás , Solymosi Frigyes
Published: August 2009

Infrared (IR) spectroscopy revealed that dimethyl ether (DME) undergoes partial dissociation on pure and rhodium‐containing CeO2 at 300 K to yield methoxy and methyl species. This process is promoted by the presence of rhodium. By means of thermal desorption measurements (TPD), the adsorption of DME on Rh/CeO2 at 300 K and subsequent decomposition of DME (Tp≈370 K), releasing H2, CO, CO2, and CH4, with Tp between 420 and 673 K, were ascertained. Rh/CeO2 is an effective catalyst for the decomposition of DME to give H2 (29–35 %), CO (27–30 %) and CH4 (32–38 %) as major products with complete conversion at 673–723 K. Adding water to DME changed the product distribution and increased the selectivity of H2 formation from 30–35 % to 58 % at 723 K. In situ IR spectroscopy showed absorption bands of CO at 2034 and 1893 cm−1 during the reaction at 673–773 K. Deactivation of the catalyst did not occur at 773 K during the time measured (approximately 10 h). Rh deposited on carbon Norit also exhibited a high activity towards the decomposition of DME, but the selectivity towards hydrogen was lower.
Peristaltic transport and heat transfer of a MHD Newtonian fluid with variable viscosity
Authors: Nadeem S. , Akbar Noreen Sher , Hameed M.
Published: August 2009

The influence of temperature‐dependent viscosity and magnetic field on the peristaltic flow of an incompressible, viscous Newtonian fluid is investigated. The governing equations are derived under the assumptions of long wavelength approximation. A regular perturbation expansion method is used to obtain the analytical solutions for the velocity and temperature fields. The expressions for the pressure rise, friction force and the relation between the flow rate and pressure gradient are obtain. In addition to analytical solutions, numerical results are also computed and compared with the analytical results with good agreement. The results are plotted for different values of variable viscosity parameter β, Hartmann number M, and amplitude ratio ϕ. It is found that the pressure rise decreases as the viscosity parameter β increases and it increases as the Hartmann number M increases. Finally, the maximum pressure rise (σ=0) increases as M increases and β decreases. Copyright © 2009 John Wiley & Sons, Ltd.
Working memory in early Alzheimer's disease: a neuropsychological review
Authors: Huntley J. D. , Howard R. J.
Published: August 2009

Background

Reports of the extent of working memory (WM) impairment in early Alzheimer's disease (AD) have been inconsistent. Using the model of WM proposed by Baddeley, neuropsychological evidence for the impairment of WM in early AD is evaluated.

Method

Literature searches were performed using Medline, PsycINFO and Embase databases. Individual papers were then examined for additional references not revealed by computerised searches.

Results

Phonological loop function is intact at the preclinical and early stages of AD, becoming more impaired as the disease progresses. In mild AD, there is impairment on tasks assessing visuospatial sketchpad (VSS) function; however, these tasks also require executive processing by the central executive system (CES). There is evidence that the CES is impaired in mild AD and may be affected in the earlier preclinical stage of the disease. Episodic buffer function may be impaired but further research is required.

Conclusions

Future research into central executive functioning at the earliest stages of the disease, combined with further longitudinal studies, needs to be carried out. Tasks to assess the proposed functions of the episodic buffer and specific tests of the VSS suitable for AD subjects need to be developed and validated. Learning more about these processes and how they are affected in AD is important in understanding and managing the cognitive deficits seen in the early stages of AD. Copyright © 2009 John Wiley & Sons, Ltd.
Anterolateral thigh flap
Authors: Wong Chin‐Ho , Wei Fu‐Chan
Published: August 2009

The anterolateral thigh (ALT) flap is a versatile soft tissue flap. It can be harvested as a fasciocutaneous or myocutaneous flap. Vascularized fascia can be included or the pedicle may be harvested as a flow‐through flap. The flap can also be harvested incorporating multiple skin islands or as a chimeric flap incorporating separate skin and muscle components. When a large flap is needed, the entire lateral thigh can be harvested by combining the ALT with either the tensor fascia lata or the anteromedial thigh flap as a conjoined flap. Morbidity is remarkably minimal despite the availability of such generous amounts of tissue. The purported difficulty with the use of this flap is because of the anatomical variations that may render this flap unreliable. This paper clarifies the vascular anatomy of the flap and elaborates an approach to flap harvest that can be used to reliably harvest the flap in spite of the anomalies that may be encountered. © 2009 Wiley Periodicals, Inc. Head Neck, 2010
Current concepts and new horizons in conservation laryngeal surgery: An important part of multidisciplinary care
Authors: Holsinger F. Christopher , Nussenbaum Brian , Nakayama Meijin , Saraiya Sonal , Sewnaik Aniel , Ark Nebil , Ferris Robert L. , Tufano Ralph P. , McWhorter Andrew J.
Published: August 2009

Background

New surgical techniques in conservation laryngeal surgery (CLS) have emerged over the past 20 years and now offer a viable “organ‐preservation” approach for patients with laryngeal cancer. We review traditional and new CLS procedures and summarize the functional and oncologic outcomes of CLS in both primary and salvage settings.

Methods

We searched the literature by accessing Medline for articles from 1991 to 2007 on primary or salvage surgery (open and transoral) for laryngeal neoplasms.

Conclusion

Our review of the literature suggests that proper selection of patients for CLS can yield long‐term local control rates equal to or better than those obtained using radiation‐based approaches. We believe that CLS should be directly compared with radiation or chemoradiation to further refine the indications for each kind of treatment in cases of primary and recurrent/refractory laryngeal cancer. © 2009 Wiley Periodicals, Inc. Head Neck, 2010