bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient characteristics that influence efficacy of prophylaxis with rFVIII‐FS three times per week: a subgroup analysis of the LIPLONG study
Authors: Lalezari S. , COPPOLA A. , Lin J. , Enriquez M. M. , Tseneklidou‐Stoeter D. , Powell J. , Ingerslev J. ,   The LIPLONG Investigators
Published: November 2013

Summary

Prospective data on the efficacy of secondary prophylaxis in adults with haemophilia A are limited. To analyse bleeding outcomes in the sucrose‐formulated recombinant factor VIII [rFVIII‐FS (control)] arm of the LIPLONG study, a randomized, double‐blind, 52‐week trial was conducted in patients with severe haemophilia A receiving prophylaxis with the investigational product BAY 79‐4980 or rFVIII‐FS. The per‐protocol population of previously treated patients with severe haemophilia A without a history of inhibitors (n = 68 males; mean age, 34.4 years) received 25 IU kg−1 rFVIII‐FS three times per week for a median of 50.7 weeks. Annualized bleeding rates were assessed and analysed according to predefined target joint status at study start, prestudy treatment type (prophylaxis vs. on demand), age (<30 or ≥30 years), geographical region, bleeding frequency during the previous 6 months and physical activity status during the study using the Student t‐test. The annualized median (range) number of bleeds was 2.2 (0.0–23) bleeds per year. The median (range) number of bleeds per year was significantly lower in patient subgroups without vs. with target joints [0.5 (0.0–17.1) vs. 4.2 (0.0–22.8); P = 0.02] and in those with ≤9 vs. >9 bleeds during the previous 6 months [1.1 (0.0–19.2) vs. 5.3 (0.0–22.8); P = 0.01]. Following randomization to prophylaxis with rFVIII‐FS, bleeding frequency was effectively reduced. Absence of target joints and prestudy bleeding frequency were predictors of a low bleeding frequency during prophylaxis treatment.
Dengue virus infection: current concepts in immune mechanisms and lessons from murine models
Authors: Guabiraba Rodrigo , Ryffel Bernhard
Published: November 2013

Dengue viruses (DENV), a group of four serologically distinct but related flaviviruses, are responsible for one of the most important emerging viral diseases. This mosquito‐borne disease has a great impact in tropical and subtropical areas of the world in terms of illness, mortality and economic costs, mainly due to the lack of approved vaccine or antiviral drugs. Infections with one of the four serotypes of DENV (DENV‐1–4) result in symptoms ranging from an acute, self‐limiting febrile illness, dengue fever, to severe dengue haemorrhagic fever or dengue shock syndrome. We reviewed the existing mouse models of infection, including the DENV‐2‐adapted strain P23085. The role of CC chemokines, interleukin‐17 (IL‐17), IL‐22 and invariant natural killer T cells in mediating the exacerbation of disease in immune‐competent mice is highlighted. Investigations in both immune‐deficient and immune‐competent mouse models of DENV infection may help to identify key host–pathogen factors and devise novel therapies to restrain the systemic and local inflammatory responses associated with severe DENV infection.
Negative pressure wound therapy: past, present and future
Authors: Orgill Dennis P , Bayer Lauren R
Published: November 2013

Negative pressure wound therapy (NPWT), which was introduced as a commercial product (V.A.C.® Therapy, KCI USA, Inc., San Antonio, TX) less than 20 years ago, has revolutionised the treatment of complex wounds. Indicated for wide variety of wound types, NPWT is an adjunctive therapy that can be used safely in a range of care settings. Current research indicates that there are four primary NPWT mechanisms of action: macrodeformation, microdeformation, fluid removal and environmental control of the wound. The interaction of the primary mechanisms results in secondary effects through cell signalling (e.g. granulation tissue formation, cell proliferation and modulation of inflammation). Better understanding of the mechanisms of action also provides insight into future directions for NPWT research that could create better solutions for patients with complex wounds.
Cell-mediated immune responses of lambs to challenge with bovine respiratory syncytial virus
Authors: SHARMA A K , WOLDEHIWET Z
Published: November 2013

The lamb is a good model to study the pathogenesis and immune responses to infections with respiratory syncytial virus (RSV) as lambs experimentally infected with bovine or human RSV may develop overt clinical disease. In the present study the development of cellular cytotoxic responses was studied in splenic, pulmonary and peripheral blood mononuclear cells obtained from lambs after primary and secondary infection with bovine RSV. Infection with bovine RSV was followed by the appearance of cytotoxic cells in the peripheral blood, the spleen and lung lavage fluids. These effector cells lysed virus-infected targets in a self-restricted manner. Depletion techniques revealed that cytotoxic activity was largely due to OvCD8+ cells. When effector cells obtained from primed lambs were stimulated with inactivated bovine RSV or with virus-infected cells in vitro, virus-specific cytotoxicity was significantly increased.
Comparison of two types of intravenous immunoglobulins in the treatment of neonatal sepsis
Authors: HAQUE K N , REMO C , BAHAKIM H
Published: November 2013

In a prospective double-blind study, standard intravenous immunoglobulin (IVIG) was compared with an IgM-enriched IVIG in the treatment of neonatal sepsis. The two treatment groups were also compared with matched controls. One hundred and thirty babies (65 in each group) ranging from 0 to 24 days old, 480 to 4200 g in weight and born between 24 and 42 weeks of gestation who had, or were suspected of having, sepsis were given either standard IVIG or IgM-enriched IVIG (250 mg/kg per day) for 4 days in addition to supportive and antibiotic therapy. A further 65 babies who received similar supportive, antibiotic and fluids but not IVIG were used as matched controls. Mortality from infection in ‘culture proven sepsis’ was 3/44 (6·8%) in the IgM-enriched IVIG group, 6/42 (14·2%) in the standard IVIG group, and 11/43 (25·5%) in the control group (P = 0·017, IgM versus control, P = 019 standard IVIG versus control). There was no statistical difference in the outcome between the two immunoglobulin therapy groups (P = 0·25). The study indicates that IVIG improves outcome in neonatal sepsis when used as an adjunct to supportive and antibiotic therapy, but larger studies are required to confirm this.
Production of immunoglobulins by human sIgD+ and sIgD− human blood B lymphocytes in response to stimulation with activated T cells and agonistic antibodies; effect of IL-10, IL-2 and mode of activation of T cells
Authors: LING N R , BROWN B , HARDIE D
Published: November 2013

Production of IgM, IgG and IgA was induced from human blood B lymphocytes by culturing with a CD40 MoAb and IL-2 for 9 days. Replacement of IL-2 by IL-10 markedly enhanced production of all three isotypes. High levels of immunoglobulin production also occurred when activated irradiated autologous T cells replaced the CD40 MoAb, and when IL-10 replaced IL-2 in these cultures a spectacular increase in IgG production occurred. The effectiveness of the T cell stimulus depended on the mode of purification of the T cells and the nature of the stimulant used to activate them. Differences in the kinetics and level of expression of CD40L on the various T cell preparations were observed, but did not account for variations in immunoglobulin-inducing efficiency. Immunoglobulin production from sIgD+ and sIgD− B cells was investigated. IgG and IgA were found in sIgD+ cultures, indicating that some isotype switching had occurred, but the major part of the IgG and IgA secreted was from cells already committed to these isotypes. Anti-IgD or anti-IgM MoAbs enhanced the proliferation of B cells induced by anti-CD40 antibody, but immunoglobulin production was not enhanced. Factors affecting the balance of proliferation and differentiation are discussed.
DISEASE PROGRESSION IN STAGE A PROSTATE CANCER
Authors: Amakasu Makoto , Akimoto Susumu , Akakura Koichiro , Masai Motoyuki , Shimazaki Jun
Published: November 2013

To study the disease progression in stage A prostate cancer, 212 patients with stage A from a group of 3370 patients who underwent transurethral resection of the prostate, or subcapsular prostatectomy during the period 1972–1991 were followed. The stage A cases were subdivided into 103 A1 patients and 109 A2 patients and their subsequent course was followed for an average of 41.7 months (6–174 months). Progression to clinical cancer was found in 12 patients, 2 from A1 and 10 from A2 groups. This progression was evident 40.5 months (14–130 months) after prostatectomy. Eight (67%) of these cases responded to endocrine therapy. The rate of expression of ras p21, and the number of argyrophilic nucleolar organizer regions in stage A cancer cells were greater in progressing than in non‐progressing cases. These results indicate that stage A cancer with progression arises mainly from the A2 subgroup and exhibits a distinctly proliferative potential even at small foci.
MANAGEMENT OF CHRONIC ORCHIALGIA OF UNKNOWN ETIOLOGY
Authors: Yamamoto Masanori , Hibi Hatsuki , Katsuno Satoshi , Miyake Koji
Published: November 2013

The treatment of patients with chronic unilateral or bilateral orchialgia, defined as intermittent or constant testicular pain of greater than 3 months and of unclear cause, is difficult. This pain significantly interferes with the daily activities of the patient. We have seen 12 patients with chronic orchialgia of unknown etiology and each had a normal history, physical examination and normal scrotal sonogram. Three patients were treated with nonsteroidal anti‐inflammatory drugs and obtained partial pain relief. Three patients underwent spermatic cord nerve blockade using a combination of 1% lidocaine and 40 mg methylprednisolone and experienced partial pain relief. Four patients underwent inguinal orchiectomy after failing conservative management: three reported complete relief of pain, and the other partial relief. Two patients had bilateral transrectal injections of local anesthetic (5 ml bupivacaine) and methylprednisolone into the region of the pelvic plexus under transrectal ultrasound guidance. They were successfully treated with this injection technique. On the basis of our results, we recommend transrectal blockade of nerves from the pelvic plexus or inguinal orchiectomy as the procedure of choice for patients in whom medical treatment fails.
Ibandronate and Ventricular Arrhythmia Risk
Authors: BONILLA INGRID M. , VARGAS‐PINTO PEDRO , NISHIJIMA YOSHINORI , PEDRAZA‐TOSCANO ADRIANA , HO HSIANG‐TING , LONG VICTOR P. , BELEVYCH ANDRIY E. , GLYNN PATRIC , HOUMSSE MAHMOUD , RHODES TROY , WEISS RAUL , HUND THOMAS J. , HAMLIN ROBERT L. , GYÖRKE SANDOR , CARNES CYNTHIA A.
Published: November 2013

Ibandronate‐Induced Proarrhythmia

Introduction

Bisphosphonates, including ibandronate, are used in the prevention and treatment of osteoporosis.

Methods and Results

We report a case of suspected ibandronate‐associated arrhythmia, following a single dose of ibandronate in a 55‐year‐old female. ECG at presentation revealed frequent ectopy and QT/QTc interval prolongation; at follow‐up 9 months later the QT/QTc intervals were normalized. Proarrhythmic potential of ibandronate was assessed with a combination of in vivo and in vitro approaches in canines and canine ventricular myocytes. We observed late onset in vivo repolarization instability after ibandronate treatment. Myocytes superfused with ibandronate exhibited action potential duration (APD) prolongation and variability, increased early afterdepolarizations (EADs) and reduced Ito (P < 0.05), with no change in IKr. Ibandronate‐induced APD changes and EADs were prevented by inhibition of intracellular calcium cycling. Ibandronate increased sarcoplasmic reticulum calcium load; during washout there was an increase in calcium spark frequency and spontaneous calcium waves. Computational modeling was used to examine the observed effects of ibandronate. While reductions in Ito alone had modest effects on APD, when combined with altered RyR inactivation kinetics, the model predicted effects on APD and SR Ca2+ load consistent with observed experimental results.

Conclusion

Ibandronate may increase the susceptibility to ventricular ectopy and arrhythmias. Collectively these data suggest that reduced Ito combined with abnormal RyR calcium handling may result in a previously unrecognized form of drug‐induced proarrhythmia.
Females suffer a reduction in the viability of stored sperm following an immune challenge
Authors: McNamara K. B. , van Lieshout E. , Simmons L. W.
Published: November 2013

Despite the ubiquitous nature of sperm storage in invertebrates, relatively little is known about its costs, or the impact that immune activation can have on a female's ability to maintain viable sperm stores. We explored the effects of an immune challenge on sperm storage under food‐limited and ad libitum conditions in the field cricket, Teleogryllus oceanicus, by injecting mated adult females with either a LD5 dose of live bacteria or a nonpathogenic immune elicitor [lipopolysaccharide (LPS)] and then scoring the viability of their stored sperm. Females that were infected with bacteria showed a reduction in the viability of stored sperm 48 h after infection; interestingly, this pattern was not evident when females were injected with LPS. Reduction in sperm viability post‐infection may reflect a reproductive trade‐off between immune function and sperm store maintenance, as only females injected with bacteria showed an elevated antibacterial immune (lytic) response. Alternatively, bacteria may act directly on sperm quality. Dietary manipulations showed that lytic activity in females is condition dependent, irrespective of their immune challenge treatment. Diet affected the ability of females to maintain the viability of stored sperm, suggesting that sperm storage is condition dependent. That bacterial infection associated with a reduction in stored sperm quality has potentially important implications for the outcomes of sperm competition in T. oceanicus and in other species in which females store sperm between matings.
Safety of percutaneous endoscopic gastrostomy in high‐risk patients
Authors: Chang Wei‐Kuo , Hsieh Tsai‐Yuan
Published: November 2013

Percutaneous endoscopic gastrostomy (PEG) is a minimally invasive procedure. However, failure to transilluminate the anterior wall of the stomach or visualize the indentation of the physician's finger represents the most frequent obstacles encountered by the endoscopist in safely completing PEG tube placement. We described several methods to safely assess PEG placement in high‐risk patients. An abdominal plain film after gastric insufflated with 500 mL of air is obtained before PEG in patients. The body of the stomach near the angularis, equidistant from the greater and lesser curves, was defined as the optimal gastric puncture point. The location of the puncture points varied greatly, being situated over the right upper quadrant in 31% of patients, left upper in 59%, left lower in 5%, and right lower quadrant in 5% of patients. If there is any question of safe puncture site selection, safe track technique can be used to provide the information of depth and angle of the puncture tract. Computed tomography can provide detailed anatomy and orientation along the PEG tube and show detailed anatomical images along the PEG tract. Computed tomography‐guided PEG tube placement is used when there is difficulty either insufflating the stomach, or the patients had previous surgery, or anatomical problems. Full assessment of the position of the stomach and adjacent organs prior to gastric puncture may help minimize the risk for potential complications and provide safety for the high‐risk patients.
Diet and exercise in management of obesity and overweight
Authors: Fock Kwong Ming , Khoo Joan
Published: November 2013

According to World Health Organization, in 2010 there were over 1 billion overweight adults worldwide with 400 million adults who were obese. Obesity is a major risk factor for diabetes, cardiovascular disease, musculoskeletal disorders, obstructive sleep apnea, and cancers (prostate, colorectal, endometrial, and breast). Obese people may present to the gastroenterologists with gastroesophageal reflux, non‐alcoholic fatty liver, and gallstones. It is important, therefore, to recognize and treat obesity.

The main cause of obesity is an imbalance between calories consumed and calories expended, although in a small number of cases, genetics and diseases such as hypothyroidism, Cushing's disease, depression, and use of medications such as antidepressants and anticonvulsants are responsible for fat accumulation in the body.

The main treatment for obesity is dieting, augmented by physical exercise and supported by cognitive behavioral therapy. Calorie‐restriction strategies are one of the most common dietary plans. Low‐calorie diet refers to a diet with a total dietary calorie intake of 800–1500, while very low‐calorie diet has less than 800 calories daily. These dietary regimes need to be balanced in macronutrients, vitamins, and minerals. Fifty‐five percent of the dietary calories should come from carbohydrates, 10% from proteins, and 30% from fats, of which 10% of total fat consist of saturated fats. After reaching the desired body weight, the amount of dietary calories consumed can be increased gradually to maintain a balance between calories consumed and calories expended. Regular physical exercise enhances the efficiency of diet through increase in the satiating efficiency of a fixed meal, and is useful for maintaining diet‐induced weight loss. A meta‐analysis by Franz found that by calorie restriction and exercise, weight loss of 5–8.5 kg was observed 6 months after intervention. After 48 months, a mean of 3–6 kg was maintained.

In conclusion, there is evidence that obesity is preventable and treatable. Dieting and physical exercise can produce weight loss that can be maintained.
Ischemic neurons activate astrocytes to disrupt endothelial barrier via increasing VEGF expression
Authors: Li Ying‐Na , Pan Rong , Qin Xu‐Jun , Yang Wei‐Lin , Qi Zhifeng , Liu Wenlan , Liu Ke Jian
Published: November 2013

Blood–brain barrier (BBB) disruption occurring within the first few hours of ischemic stroke onset is closely associated with hemorrhagic transformation following thrombolytic therapy. However, the mechanism of this acute BBB disruption remains unclear. In the neurovascular unit, neurons do not have direct contact with the endothelial barrier; however, they are highly sensitive and vulnerable to ischemic injury, and may act as the initiator for disrupting BBB when cerebral ischemia occurs. Herein, we employed oxygen–glucose deprivation (OGD) and an in vitro BBB system consisting of brain microvascular cells and astrocytes to test this hypothesis. Neurons (CATH.a cells) were exposed to OGD for 3‐h before co‐culturing with endothelial monolayer (bEnd 3 cells), or endothelial cells plus astrocytes (C8‐D1A cells). Incubation of OGD‐treated neurons with endothelial monolayer alone did not increase endothelial permeability. However, when astrocytes were present, the endothelial permeability was significantly increased, which was accompanied by loss of occludin and claudin‐5 proteins as well as increased vascular endothelial growth factor (VEGF) secretion into the conditioned medium. Importantly, all these changes were abolished when VEGF was knocked down in astrocytes by siRNA. Our findings suggest that ischemic neurons activate astrocytes to increase VEGF production, which in turn induces endothelial barrier disruption.

image

Little is known about the contribution of neurons to blood–brain barrier (BBB) injury following cerebral ischemia. Using co‐culture model of neurons, astrocytes and endothelial cells, we found that ischemic neurons activated astrocytes to increase vascular endothelial growth factor (VEGF) secretion that in turns acted on tight junction proteins to increase BBB permeability. These results clearly suggest an important role of neurons in ischemic BBB damage.
Lived experience of Hispanic new graduate nurses – a qualitative study
Authors: Morales Esther G
Published: November 2013

Aims and objectives

To seek understanding of lived experience from the voice of Hispanic new graduate nurses.

Background

Nurse educators and leaders have called for a more diverse nursing workforce while the body of the literature and knowledge about Hispanic registered nurses in the United States appears underdeveloped.

Design

A qualitative approach with a phenomenological methodology was used.

Methods

A purposive sampling of Hispanic new graduate nurses (n = 7) completed a demographic questionnaire and semi‐structured interviews. The study setting was within the Midwest and the south‐west of the United States.

Results

There were seven general themes: (1) being an employee, (2) an orientation with or without preceptors, (3) a transition, (4) shadows of doubt, (5) being Hispanic, (6) being bilingual and being pulled, and (7) blessed. Hispanic new graduates would prefer Hispanic preceptors and anticipated that their first employment would be in a hospital setting.

Conclusion

Hispanic new graduate nurses anticipate, desire and expect orientation programmes and preceptors in acute care and outpatient healthcare settings to aid in their transition from student to professional nurse. Hispanic new graduate nurses described an experience of transition typical of new graduate nurses in the United States, but with added dimensions such as cultural understandings and language proficiency with Spanish.

Relevance to clinical practice

Appropriate support and interventions for all new graduate nurses across multiple employment settings may retain a diverse nursing workforce appropriately positioned to serve vulnerable populations.
Green tea extract inhibits the onset of periodontal destruction in rat experimental periodontitis
Authors: Yoshinaga Y. , Ukai T. , Nakatsu S. , Kuramoto A. , Nagano F. , Yoshinaga M. , Montenegro J. L. , Shiraishi C. , Hara Y.
Published: November 2013

Background and Objective

Green tea extract exerts a variety of biological effects, including anti‐inflammatory activities. However, there has been no report on the effect of green tea extract on loss of attachment, which is an important characteristic of periodontitis. Here, we examined the inhibitory effects of green tea extract on the onset of periodontitis in a rat model.

Material and Methods

Rats were immunized intraperitoneally with Escherichia coli lipopolysaccharide (LPS). The LPS group (n = 12) received a topical application of LPS onto the palatal gingival sulcus every 24 h. The green tea extract group (n = 12) received a topical application of LPS mixed with green tea extract, sunphenon BG, every 24 h. The phosphate‐buffered saline (PBS) group (n = 6) received a topical application of PBS every 24 h. The levels of anti‐LPS immunoglobulin G (IgG) in serum were determined using ELISA. Rats in the LPS and green tea extract groups were killed after the 10th and 20th applications. Rats in the PBS group were killed after the 20th application. Loss of attachment, level of alveolar bone and inflammatory cell infiltration were investigated histopathologically and histometrically. RANKL‐positive cells and the formation of immune complexes were evaluated immunohistologically.

Results

There was no significant difference in the serum levels of anti‐LPS IgG between the LPS group and the green tea extract group. In contrast, loss of attachment, level of alveolar bone, inflammatory cell infiltration and RANKL expression in the green tea extract group were significantly decreased compared with those in the LPS group.

Conclusion

These findings demonstrate that green tea extract suppresses the onset of loss of attachment and alveolar bone resorption in a rat model of experimental periodontitis.
Neonatal anesthesia with limited resources
Authors: Bösenberg Adrian T.
Published: November 2013

Neonates are the most vulnerable age group in terms of anesthetic risk and perioperative mortality, especially in the developing world. Prematurity, malnutrition, delays in presentation, and sepsis contribute to this risk. Lack of healthcare workers, poorly maintained equipment, limited drug supplies, absence of postoperative intensive care, unreliable water supplies, or electricity are further contributory factors.

Trained anesthesiologists with the skills required for pediatric and neonatal anesthesia as well as basic monitoring equipment such as pulse oximetry will go a long way to improve the unacceptably high anesthetic mortality.
The sporangiophore of Phycomyces blakesleeanus: a tool to investigate fungal gravireception and graviresponses
Authors: Galland P.
Published: November 2013

The giant sporangiophore of the single‐celled fungus, Phycomyces blakesleeanus, utilises light, gravity and gases (water and ethylene) as environmental cues for spatial orientation. Even though gravitropism is ubiquitous in fungi (Naturwissenschaftliche Rundschau, 1996, 49, 174), the underlying mechanisms of gravireception are far less understood than those operating in plants. The amenability of Phycomyces to classical genetics and the availability of its genome sequence makes it essential to fill this knowledge gap and serve as a paradigm for fungal gravireception. The physiological phenomena describing the gravitropism of plants, foremost adherence to the so‐called sine law, hold even for Phycomyces. Additional phenomena pertaining to gravireception, specifically adherence to the novel exponential law and non‐adherence to the classical resultant law of gravitropism, were for the first time investigated for Phycomyces. Sporangiophores possess a novel type of gravisusceptor, i.e. lipid globules that act by buoyancy rather than sedimentation and that are associated with a network of actin cables (Plant Biology, 2013). Gravitropic bending is associated with ion currents generated by directed Ca2+ and H+ transport in the growing zone (Annals of the New York Academy of Sciences, 2005, 1048, 487; Planta, 2012, 236, 1817). A set of behavioural mutants with specific defects in gravi‐ and/or photoreception allowed dissection of the respective transduction chains. The complex phenotypes of these mutants led to abandoning the concept of simple linear transduction chains in favour of interacting networks with molecular modules of physically interacting proteins.
CITES at Forty: Never Too Late to Make Lifestyle Changes
Authors: Couzens Ed
Published: November 2013

This article argues that an under‐recognized weakness of the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES) is that it continues to take the approach of ‘categorizing’ species, which was the dominant feature of early wildlife‐related conventions such as the 1900 London Convention on the Preservation of Wild Animals, Birds and Fish in Africa. It argues that this approach has in the past been problematic for efforts to protect wildlife and that as long as it continues to be a primary feature of efforts to protect wildlife in the face of modern understandings of the complexities inherent in ecosystems, CITES will never be fully effective. A gradual move toward an (admittedly radical) alternative approach is advocated – at least as far as commercial trade is concerned.
A Tale of Two CITES: Divergent Perspectives upon the Effectiveness of the Wildlife Trade Convention
Authors: Bowman Michael
Published: November 2013

The question concerning the overall functional effectiveness of the Convention on International Trade in Endangered Species (CITES) has attracted a range of sharply contrasting responses. These divergent assessments appear to correlate closely with the fundamentally different philosophies of conservation which are currently espoused within the international community, and are themselves shaped by the disparate psychological predilections from which they emerge. Although the concept of ‘sustainable utilization’ features prominently in the supporting rhetoric of most constituencies, much depends upon whether it is the aspect of ‘sustainability’ or ‘utilization’ that commands motivational priority. In certain quarters, an essentially individualistic, materialistic and libertarian perspective predominates, with the result that especially strong justifications are expected for constraints upon use. Since this standpoint is so deeply ingrained within human psychology, it is essential that it be accommodated within conservation regimes. Yet at the same time, it cannot be overlooked that this very inclination has done much to precipitate the biodiversity crisis in the first place, and must therefore be balanced by a more holistic and ecocentric perspective. In that respect, a widespread lack of effective understanding remains evident in policy‐making circles, and a variety of well‐entrenched myths and misconceptions still represent a significant impediment to progress.
Pulmonary vascular limitation to exercise and survival in idiopathic pulmonary fibrosis
Authors: van der Plas Mart N. , van Kan Coen , Blumenthal Judith , Jansen Henk M. , Wells Athol U. , Bresser Paul
Published: November 2013

Background and objective

Pulmonary hypertension is frequently observed in advanced idiopathic pulmonary fibrosis (IPF) and is associated with poor prognosis. Cardiopulmonary exercise testing (CPET) can be used to detect less advanced pulmonary vascular impairment, and therefore may be of prognostic use. We studied the predictive value of non‐invasive exercise parameters that were associated with elevated systolic pulmonary artery pressure (sPAP) for survival in IPF patients.

Methods

From our interstitial lung disease database, we reviewed records of consecutive patients with IPF in whom CPET and echocardiography were performed within 2 weeks (n = 38).

Results

Eleven patients (29%) had increased sPAP (≥40 mm Hg). From all non‐invasive CPET parameters, only the ventilatory equivalent for CO2 (V'E/V'CO2) at anaerobic threshold differed significantly between patients with and without sPAP ≥ 40 mm Hg. The receiver‐operator characteristic curve for V'E/V'CO2 resulted in areas under the curve of 0.77 (95% CI: 0.569–0.970; P = 0.026), with a cut‐off value for predicting sPAP ≥ 40 mm Hg of >45.0. Patients with V'E/V'CO2 > 45.0 had significantly worse survival compared with patients with V'E/V'CO2 ≤ 45.0 (P = 0.001). In contrast, sPAP did not predict survival.

Conclusions

V'E/V'CO2, the only CPET parameter associated with elevated sPAP, appears a potentially useful non‐invasive marker for early detection of pulmonary vascular impairment, and therefore may be of use for a more accurate prognostic assessment in IPF patients.
Understanding “Green Germany” through Images and Film: A Critical Literacy Approach
Authors: Ryshina‐Pankova Marianna
Published: November 2013

This article reports on the ways of incorporating paintings, posters, and film into an advanced German content‐ and language‐integrated course calledGreen Germany. It demonstrates how these visual media can be employed for enriching the exploration of various aspects of the course's environmental themes. In line with the research on the development of visual literacies (Cope & Kalantzis,; Unsworth,), the approach helps equip German learners with the tools to analyze the socially and culturally constructed nature of, in this instance, German public discourse on the environment, and thus develop their critical literacy abilities. In particular, it is demonstrated how leading learners towards interpretation of the visual media within a genre‐based and systemic‐functional framework (Halliday,; Kress and van Leeuwen,; Martin,,) facilitates critical distance from the solely referential information in these examples of public discourse. The article concludes with a brief examination of an analysis by one of the class participants, showing how she applies the proposed critical literacy tools.
Third-Order Continuous-Discrete Filtering for a Nonlinear Dynamical System
Authors: Patel Hiren G. , Sharma Shambhu N.
Published: November 2013

Approximate higher-order filters are more attractive and popular in control and signal processing literature in contrast to the exact filter, since the analytical and numerical solutions of the nonlinear exact filter are not possible. The filtering model of this paper involves stochastic differential equation (SDE) formalism in combination with a nonlinear discrete observation equation. The theory of this paper is developed by adopting a unified systematic approach involving celebrated results of stochastic calculus. The Kolmogorov–Fokker–Planck equation in combination with the Kolmogorov backward equation plays the pivotal role to construct the theory of this paper “between the observations.” The conditional characteristic function is exploited to develop “filtering” at the observation instant. Subsequently, the efficacy of the filtering method of this paper is examined on the basis of its comparison with extended Kalman filtering and true state trajectories. This paper will be of interest to applied mathematicians and research communities in systems and control looking for stochastic filtering methods in theoretical studies as well as their application to real physical systems.
Effect of Clamping Load on the Performance of Proton Exchange Membrane Fuel Cell Stack and Its Optimization Design: A Review of Modeling and Experimental Research
Authors: Zhang Wei , Wu Cheng-wei
Published: November 2013

When individual proton exchange membrane fuel cells (PEMFCs) are assembled together to form a stack and provide energy for practical applications, an appropriate clamping load is usually required to render the stack high efficiency, high reliability, and excellent durability. From both modeling and experimental aspects, this article first highlights the effect of clamping load on the electron transfer, mass (water and reactant gases) transfer, and heat transfer in a PEMFC stack and then puts the attentions on the optimization design of clamping load with emphases on the optimal clamping load and the homogenous distribution of clamping load. This summary may deepen our understanding of the assembly of a PEMFC stack and provide referential information for the designer and manufacturer.
Mechanics Meets Medicine
Authors: Guck Jochen , Chilvers Edwin R.
Published: November 2013

A new high-throughput measurement technique by Tse
et al
. (this issue) moves mechanical phenotyping of cells in malignant pleural effusions closer to the clinic.
Rapid Intrinsic Fluorescence Method for Direct Identification of Pathogens in Blood Cultures
Authors: Walsh John D. , Hyman Jay M. , Borzhemskaya Larisa , Bowen Ann , McKellar Caroline , Ullery Michael , Mathias Erin , Ronsick Christopher , Link John , Wilson Mark , Clay Bradford , Robinson Ron , Thorpe Thurman , van Belkum Alex , Dunne W. Michael
Published: November 2013

A positive blood culture is a critical result that requires prompt identification of the causative agent. This article describes a simple method to identify microorganisms from positive blood culture broth within the time taken to perform a Gram stain (<20 min). The method is based on intrinsic fluorescence spectroscopy (IFS) of whole cells and required development of a selective lysis buffer, aqueous density cushion, optical microcentrifuge tube, and reference database. A total of 1,121 monomicrobial-positive broth samples from 751 strains were analyzed to build a database representing 37 of the most commonly encountered species in bloodstream infections or present as contaminants. A multistage algorithm correctly classified 99.6% of unknown samples to the Gram level, 99.3% to the family level, and 96.5% to the species level. There were no incorrect results given at the Gram or family classification levels, while 0.8% of results were discordant at the species level. In 8/9 incorrect species results, the misidentified isolate was assigned to a species of the same genus. This unique combination of selective lysis, density centrifugation, and IFS can rapidly identify the most common microbial species present in positive blood cultures. Faster identification of the etiologic agent may benefit the clinical management of sepsis. Further evaluation is now warranted to determine the performance of the method using clinical blood culture specimens.

IMPORTANCE
Physicians often require the identity of the infective agent in order to make life-saving adjustments to empirical therapy or to switch to less expensive and/or more targeted antimicrobials. However, standard identification procedures take up to 2 days after a blood culture is signaled positive, and even most rapid molecular techniques take several hours to provide a result. Other techniques are faster (e.g., matrix-assisted laser desorption ionization–time of flight [MALDI-TOF] mass spectrometry) but require time-consuming manual processing steps and expensive equipment. There remains a clear need for a simple, inexpensive method to rapidly identify microorganisms directly from positive blood cultures. The promising new method described in this research article can identify microorganisms in minutes by optical spectroscopy, thus permitting the lab to simultaneously report the presence of a positive blood culture and the organism’s identity.
Association between parenteral fluids and symptoms in hospital end-of-life care: an observational study of 280 patients
Authors: Fritzson Anna , Tavelin Björn , Axelsson Bertil
Published: November 2013

Objectives

To investigate whether dying patients receiving parenteral fluids (PF) suffer from more or less symptoms than patients who do not receive PF. Today's evidence on how PF affects palliative patients’ symptoms is very scarce. Nevertheless, 40% of the patients who die expectedly in Swedish hospitals receive PF during their last 24 h of life.

Methods

A historical cohort study of medical records was performed. Of the 530 patients who were reported to have died expectedly at hospital in Västerbotten county (Sweden) between 1 January 2011 and 30 June 2012, 140 cases who had received PF and 140 controls who had not received PF were identified by stratified randomisation and matched by age, sex and main disease. The groups were compared regarding documented presence of dyspnoea, respiratory secretions, anxiety, nausea and confusion during the last 24 h and the last week of life.

Results

The prevalence of documented dyspnoea in the PF groups was higher than in the non-PF groups (51% vs 22% last 24 h, p<0.0001; 70% vs 45% last 7 days, p<0.001). The proportions of patients suffering from dyspnoea increased with larger administered volume. Although our main hypothesis—that the prevalence of respiratory secretions would be higher in the PF group—was not confirmed, we found a tendency in that direction (63% vs 50% last week, p=0.072). No clinically significant differences in anxiety, nausea or confusion were found.

Conclusions

There is an association between PF administration and increased frequency of documented dyspnoea for terminally ill patients in their last week of life.
ON FRACTAL DIMENSION OF A FRACTURE SURFACE BY VOLUME COVERING METHOD
Authors: ZHOU H. W. , XUE D. J. , JIANG D. Y.
Published: November 2013

An accurate calculation of the fractal dimension of a fracture surface is of prime significance for the quantitative evaluation of mechanical behavior. A laser profilometer is employed to measure a surface roughness of a large sandstone sample. Based on the definition of Minkowski dimension, a new method, referred to as the volume covering method, is proposed to estimate fractal dimension by accurately calculating the number of virtual cell needed to cover prism-like volume. It is indicated that the method can fully use laser scanning-based elevation data of the surface and make an accurate estimation of fractal dimension of a fracture surface. Furthermore, another method related to the opposite corner is adopted to estimate the same rough surface with little error of the fractal dimension. A comparison analysis indicates that the volume covering method has the advantage of high accuracy and good applicability for a real fracture surface.
Staging Investigations in Breast Cancer: Collective Opinion of UK Breast Surgeons
Authors: Chand N. , Cutress R. I. , Oeppen R. S. , Agrawal A.
Published: November 2013

Introduction. Certain clinicopathological factors are associated with a higher likelihood of distant metastases in primary breast cancer. However, there remains inconsistency in which patients undergo formal staging for distant metastasis and the most appropriate investigation(s).Aims. To identify UK surgeon preferences and practice with regard to staging investigations for distant metastases.Methods. A survey was disseminated to members of the Association of Breast Surgery by e-mail regarding surgeon/breast unit demographics, use of staging investigations, and local policy on pre/postoperative staging investigations. Several patient scenarios were also presented.Results. 123 of 474 (25.9%) recipients completed the survey. Investigations routinely employed for patients diagnosed with early breast cancer included serological/haematological tests (72% respondents), axillary ultrasound (67%), liver ultrasound (2%), chest radiograph (36%), and computed tomography (CT) (1%). Three areas contributed to decisions to undertake staging by CT scan: tumour size, axillary nodal status, and plan for chemotherapy. There was widespread variation as to criteria for CT staging based on tumour size and nodal status, as well as the choice of staging investigation for the clinical scenarios presented.Conclusions. There remains variation in the use of staging investigations for distant disease in early breastcancer despite available guidelines.
A Rare Case of Congenital Rhabdomyosarcoma with Review of the Literature
Authors: Singh Gautam Bir , Arora Rubeena , Kumar Deepak , Jain Manjula , Puri Vandana
Published: November 2013

We present a rare case of rhabdomyosarcoma of lip in a neonate with multiple lesions within the head and necksub site hitherto unreported in the medical literature. This case report also reviews the scant medical literature on neonatal rhabdomyosarcoma.
MHD Flow with Hall Current and Ion-Slip Effects due to a Stretching Porous Disk
Authors: El-Fayez Faiza M. N.
Published: November 2013

A partially ionized fluid is driven by a stretching disk, in the presence of a magnetic field that is strong enough to produce significant hall current and ion-slip effects. The limiting behavior of the flow is studied, as the magnetic field strength grows indefinitely. The flow variables are properly scaled, and uniformly valid asymptotic expansions of the velocity components are obtained. The leading order approximations show sinusoidal behavior that is decaying exponentially, as we move away from the disk surface. The two-term expansions of the radial and azimuthal surface shear stress components, as well as the far field inflow speed, compare well with the corresponding finite difference solutions, even at moderate magnetic fields. The effect of mass transfer (suction or injection) through the disk is also considered.
An Improved Nonlinear Five-Point Model for Photovoltaic Modules
Authors: Bogning Dongue Sakaros , Njomo Donatien , Ebengai Lessly
Published: November 2013

This paper presents an improved nonlinear five-point model capable of analytically describing the electrical behaviors of a photovoltaic module for each generic operating condition of temperature and solar irradiance. The models used to replicate the electrical behaviors of operating PV modules are usually based on some simplified assumptions which provide convenient mathematical model which can be used in conventional simulation tools. Unfortunately, these assumptions cause some inaccuracies, and hence unrealistic economic returns are predicted. As an alternative, we used the advantages of a nonlinear analytical five-point model to take into account the nonideal diode effects and nonlinear effects generally ignored, which PV modules operation depends on. To verify the capability of our method to fit PV panel characteristics, the procedure was tested on three different panels. Results were compared with the data issued by manufacturers and with the results obtained using the five-parameter model proposed by other authors.
An Inventory Decision Model When Demand Follows Innovation Diffusion Process under Effect of Technological Substitution
Authors: Aggarwal K. K. , Jaggi Chandra K. , Kumar Alok
Published: November 2013

The concept of marketing literature, especially innovation diffusion concept, plays a pivotal role in developing EOQ models in the field of inventory management. The integration of marketing parameters, especially the idea of diffusion of new products with the inventory models, makes the models more realistic which is most essential while building the economic ordering policies of the products. Also, because of rapid technological development, the diffusion of technology can also be viewed as an evolutionary process of replacement of an old technology by a new one. Therefore, the effect of technological substitution along with the diffusion of new products must be taken into account while formulating economic ordering policies in an inventory model. In this paper, a mathematical model has been developed for obtaining the Economic Order Quantity (EOQ) in which the demand of the product is assumed to follow an innovation diffusion process as proposed by Fourt and WoodLock (1960). The idea of effect of technological substitution of products has been incorporated in the demand model to make the economic ordering policies more realistic. A numerical example with sensitivity analysis of the optimal solution with respect to different parameters of the system is performed to illustrate the effectiveness of the model.
Proteomics of Cancer Cell Lines Resistant to Microtubule-Stabilizing Agents
Authors: Albrethsen Jakob , Angeletti Ruth H. , Horwitz Susan Band , Yang Chia-Ping Huang
Published: November 2013

Despite the clinical success of microtubule-interacting agents (MIA), a significant challenge for oncologists is the inability to predict the response of individual patients with cancer to these drugs. In the present study, six cell lines were compared by 2D DIGE proteomics to investigate cellular resistance to the class of MIAs known as microtubule-stabilizing agents (MSA). The human lung cancer cell line A549 was compared with two drug-resistant daughter cell lines, a taxol-resistant cell line (AT12) and an epothilone B (EpoB)-resistant cell line (EpoB40). The ovarian cancer cell line Hey was compared with two drug-resistant daughter cell lines, an EpoB-resistant cell line (EpoB8) and an ixabepilone-resistant cell line (Ixab80). All 2D DIGE results were validated by Western blot analyses. A variety of cytoskeletal and cytoskeleton-associated proteins were differentially expressed in drug-resistant cells. Differential abundance of 14-3-3σ, galectin-1 and phosphorylation of stathmin are worthy of further studies as candidate predictive biomarkers for MSAs. This is especially true for galectin-1, a β-galactose–binding lectin that mediates tumor invasion and metastasis. Galectin-1 was greatly increased in EpoB- and ixabepilone-resistant cells and its suppression caused an increase in drug sensitivity in both drug-sensitive and -resistant Hey cells. Furthermore, the growth medium from resistant Hey cells contained higher levels of galectin-1, suggesting that galectin-1 could play a role in resistance to MSAs. Mol Cancer Ther; 13(1); 260–9. ©2013 AACR.