bluuebunny/crossref_metadata_2025 huggingface dataset:
Changing profiles of pediatric epilepsy surgery candidates over time: A nationwide single‐center experience from 1990 to 2011
Authors: Lamberink Herm J. , Boshuisen Kim , van Rijen Peter C. , Gosselaar Peter H. , Braun Kees P. J. ,   the Dutch Collaborative Epilepsy Surgery Program (DCESP)
Published: April 2015

Objective

Over the past decades, the number of epilepsy surgeries in children has increased and indications for surgery have broadened. We studied the changes in patient characteristics between 1990 and 2011 in a nationwide cohort and related these to seizure outcome and postoperative medication status. Second, we tried to identify predictors for seizure outcome after pediatric epilepsy surgery.

Methods

To study changes over time, we divided this retrospective cohort of 234 children into two consecutive time periods of 11 years, and statistically compared the epochs in terms of patient characteristics, surgical variables, complications, seizure outcome, and postoperative medication status. To identify predictors of postoperative seizure freedom, we performed univariable and multivariable logistic regression analyses.

Results

The number of surgeries per year increased from an average of 5 in the first, to 16 in the past epoch. Over time, significantly more surgeries were performed for malformations of cortical development, and more patients underwent magnetoencephalography (MEG) and invasive monitoring. Four percent of patients had a serious complication. Complete seizure freedom (Engel class IA) at 2 years after surgery was achieved in 74% of patients, which did not change significantly over time. The proportion of patients who were free from seizures and antiepileptic medication 2 years after surgery significantly increased from 13% to 32%. Factors predictive of seizure recurrence were preoperative intracranial monitoring, multilobar surgery, etiology, and longer duration of epilepsy before surgery.

Significance

Although more complex cases were operated over time and medication was withdrawn earlier after surgery, success rates at 2 years remained stable. In combination with low complication rates, this underscores the efficacy and safety of pediatric epilepsy surgery. It is important to consider epilepsy surgery early, as longer duration of epilepsy increased the risk of postoperative seizure recurrence.
Respiratory syncytial virus, an ongoing medical dilemma: an expert commentary on respiratory syncytial virus prophylactic and therapeutic pharmaceuticals currently in clinical trials
Authors: Broadbent Lindsay , Groves Helen , Shields Michael D. , Power Ultan F.
Published: April 2015

As the most important viral cause of severe respiratory disease in infants and increasing recognition as important in the elderly and immunocompromised, respiratory syncytial virus (RSV) is responsible for a massive health burden worldwide. Prophylactic antibodies were successfully developed against RSV. However, their use is restricted to a small group of infants considered at high risk of severe RSV disease. There is still no specific therapeutics or vaccines to combat RSV. As such, it remains a major unmet medical need for most individuals. The World Health Organisations International Clinical Trials Registry Platform (WHO ICTRP) and PubMed were used to identify and review all RSV vaccine, prophylactic and therapeutic candidates currently in clinical trials. This review presents an expert commentary on all RSV‐specific prophylactic and therapeutic candidates that have entered clinical trials since 2008.
Informed Decision Making and Abortion: Crisis Pregnancy Centers, Informed Consent, and the First Amendment
Authors: Ahmed Aziza
Published: April 2015

Shifting laws and regulations increasingly displace the centrality of women’s needs in the provision of abortion services. Lawmakers and judges contribute to this environment in two ways: by protecting the right of “Crisis Pregnancy Centers” (CPCs) to give false and misleading information about abortion and by supporting legislation mandating that abortion providers give misleading and unnecessary information for the purposes of informed consent. Litigation on informed consent is further complicated through the mobilization of facts — such as the gestational age or sonogram of the fetus — delivered with the intent to dissuade women from accessing abortion. In other words, factual information utilized for ideological purpose.

First Amendment litigation has done little to help prioritize women’s access to appropriate information about abortion that is calibrated to their needs.
Community Experiments in Public Health Law and Policy
Authors: McGowan Angela K. , Musicant Gretchen G. , Williams Sharonda R. , Niehaus Virginia R.
Published: April 2015

Community-level legal and policy innovations or “experiments” can be important levers to improve health. States and localities are empowered through the 10th Amendment of the United States Constitution to use their police powers to protect the health and welfare of the public. Many legal and policy tools are available, including: the power to tax and spend; regulation; mandated education or disclosure of information, modifying the environment — whether built or natural (e.g., zoning, clean water laws); and indirect regulation (e.g., court rulings, or deregulation). These legal and policy interventions can be targeted to specific needs at the community level and are often relatively low-cost, but high impact interventions. As every community is different, effective laws and policies will vary. This freedom allows states and localities to, as Justice Louis Brandeis argued, truly serve as “laboratories of democracy.”
Domestic Legal Preparedness and Response to Ebola
Authors: Hodge James G. , Penn Matthew S. , Ransom Montrece , Jordan Jane E.
Published: April 2015

While the global threat of Ebola Virus Disease (EVD) in 2014 was concentrated in several West African countries, its effects have been felt in many developed countries including the United States. Initial, select patients with EVD, largely among American health care workers (HCWs) volunteering in affected regions, were subsequently transported back to the states for isolation and treatment in high-level medical facilities. This included Emory University Hospital, which sits adjacent to the federal Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia.

The first domestic case of EVD occurred in late September in Dallas, Texas. Additional exposures of two HCWs generated an array of legal issues for state and local public health authorities, hospitals, and providers. Consideration of these issues led to extensive discussion among lawyers, public health practitioners, and other attendees at a late-breaking session on EVD and Legal Preparedness at the 2014 National Public Health Law conference. In this commentary, session presenters from CDC and Emory University share their expert perspectives on legal and policy issues underlying state and local powers to quarantine and isolate persons exposed to or infected with Ebola, as well as facets of hospital preparedness underlying the successful treatment of patients with EVD.
Lessons from the Residual Newborn Screening Dried Blood Sample Litigation
Authors: Lewis Michelle Huckaby
Published: April 2015

Most babies born each year in the U.S. undergo mandatory newborn screening to detect serious medical conditions that can cause devastating effects if treatment is not initiated prior to the onset of symptoms. Not all of the blood collected from newborns is used during routine newborn screening, and many states retain the residual dried blood samples (DBS). DBS have a broad range of potential uses, from program evaluation to public health and biomedical research unrelated to newborn screening. State laws vary regarding whether parental consent is required to use DBS for secondary research, but federal now requires parental consent for the use of DBS in federally funded research.
Tribal Water Rights: Exploring Dam Construction in Indian Country
Authors: Church Jerilyn , Ekechi Chinyere O. , Hoss Aila , Larson Anika Jade
Published: April 2015

The environment, particularly, land and water, play a powerful role in sustaining and supporting American Indian and Alaska Native communities in the United States. Not only is water essential to life and considered — by some Tribes — a sacred food in and of itself, but environmental water resources are necessary to maintain habitat for hunting and fishing. Many American Indian and Alaska Native communities incorporate locally caught traditional subsistence foods into their diets, and the loss of access to subsistence foods represents a risk factor for food security and nutrition status in indigenous populations. Negative health outcomes, including obesity, diabetes and cancer, have accompanied declines in traditional food use in indigenous communities throughout the United States.
Human Health Impacts of Climate Change: Implications for the Practice and Law of Public Health
Authors: Krueger Jill , Biedrzycki Paul , Hoverter Sara Pollock
Published: April 2015

Reducing greenhouse gas emissions is an urgent priority. While few would argue that action to mitigate the causes of climate change should be led by public health practitioners, public health has a critical role in adaptation efforts. Adaptation seeks to lessen human vulnerability to extreme weather and to increased variability in temperature and precipitation. Climate change as an emerging health issue provides a test case for new approaches to public health: approaches that emphasize both collaboration with other government and private entities and application of innovative legal strategies.
Diffuse small glistening papules in a child
Authors: Pinto‐Almeida Teresa , Fernandes Iolanda Conde , Machado Susana , Alves Rosário , Selores Manuela
Published: April 2015

See Answer
Multiple host shifts by the emerging honeybee parasite, Varroa jacobsoni
Authors: Roberts J. M. K. , Anderson D. L. , Tay W. T.
Published: April 2015

Host shifts are a key mechanism of parasite evolution and responsible for the emergence of many economically important pathogens. Varroa destructor has been a major factor in global honeybee (Apis mellifera) declines since shifting hosts from the Asian honeybee (Apis cerana) > 50 years ago. Until recently, only two haplotypes of V. destructor (Korea and Japan) had successfully host shifted to A. mellifera. In 2008, the sister species V. jacobsoni was found for the first time parasitizing A. mellifera in Papua New Guinea (PNG). This recent host shift presents a serious threat to world apiculture but also provides the opportunity to examine host shifting in this system. We used 12 microsatellites to compare genetic variation of V. jacobsoni on A. mellifera in PNG with mites on A. cerana in both PNG and surrounding regions. We identified two distinct lineages of V. jacobsoni reproducing on A. mellifera in PNG. Our analysis indicated independent host shift events have occurred through small numbers of mites shifting from local A. cerana populations. Additional lineages were found in the neighbouring Papua and Solomon Islands that had partially host shifted to A. mellifera, that is producing immature offspring on drone brood only. These mites were likely in transition to full colonization of A. mellifera. Significant population structure between mites on the different hosts suggested host shifted V. jacobsoni populations may not still reproduce on A. cerana, although limited gene flow may exist. Our studies provide further insight into parasite host shift evolution and help characterize this new Varroa mite threat to A. mellifera worldwide.
Ecological host fitting of Trypanosoma cruzi TcI in Bolivia: mosaic population structure, hybridization and a role for humans in Andean parasite dispersal
Authors: Messenger Louisa A. , Garcia Lineth , Vanhove Mathieu , Huaranca Carlos , Bustamante Marinely , Torrico Marycruz , Torrico Faustino , Miles Michael A. , Llewellyn Martin S.
Published: April 2015

An improved understanding of how a parasite species exploits its genetic repertoire to colonize novel hosts and environmental niches is crucial to establish the epidemiological risk associated with emergent pathogenic genotypes. Trypanosoma cruzi, a genetically heterogeneous, multi‐host zoonosis, provides an ideal system to examine the sylvatic diversification of parasitic protozoa. In Bolivia, T. cruzi I, the oldest and most widespread genetic lineage, is pervasive across a range of ecological clines. High‐resolution nuclear (26 loci) and mitochondrial (10 loci) genotyping of 199 contemporaneous sylvatic TcI clones was undertaken to provide insights into the biogeographical basis of T. cruzi evolution. Three distinct sylvatic parasite transmission cycles were identified: one highland population among terrestrial rodent and triatomine species, composed of genetically homogenous strains (Ar = 2.95; PA/L = 0.61; DAS = 0.151), and two highly diverse, parasite assemblages circulating among predominantly arboreal mammals and vectors in the lowlands (Ar = 3.40 and 3.93; PA/L = 1.12 and 0.60; DAS = 0.425 and 0.311, respectively). Very limited gene flow between neighbouring terrestrial highland and arboreal lowland areas (distance ~220 km; FST = 0.42 and 0.35) but strong connectivity between ecologically similar but geographically disparate terrestrial highland ecotopes (distance >465 km; FST = 0.016–0.084) strongly supports ecological host fitting as the predominant mechanism of parasite diversification. Dissimilar heterozygosity estimates (excess in highlands, deficit in lowlands) and mitochondrial introgression among lowland strains may indicate fundamental differences in mating strategies between populations. Finally, accelerated parasite dissemination between densely populated, highland areas, compared to uninhabited lowland foci, likely reflects passive, long‐range anthroponotic dispersal. The impact of humans on the risk of epizootic Chagas disease transmission in Bolivia is discussed.
Reticulate evolution and sea‐level fluctuations together drove species diversification of slipper orchids (Paphiopedilum) inSouth‐EastAsia
Authors: Guo Yan‐Yan , Luo Yi‐Bo , Liu Zhong‐Jian , Wang Xiao‐Quan
Published: April 2015

South‐East Asia covers four of the world's biodiversity hotspots, showing high species diversity and endemism. Owing to the successive expansion and contraction of distribution and the fragmentation by geographical barriers, the tropical flora greatly diversified in this region during the Tertiary, but the evolutionary tempo and mode of species diversity remain poorly investigated.Paphiopedilum, the largest genus of slipper orchids comprising nearly 100 species, is mainly distributed in South‐East Asia, providing an ideal system for exploring how plant species diversity was shaped in this region. Here, we investigated the evolutionary history of this genus with eight cpDNAregions and four low‐copy nuclear genes. Discordance between gene trees and network analysis indicates that reticulate evolution occurred in the genus. Ancestral area reconstruction suggests that vicariance and long‐distance dispersal together led to its current distribution. Diversification rate variation was detected and strongly correlated with the species diversity in subg.Paphiopedilum(~80 species). The shift of speciation rate in subg.Paphiopedilumwas coincident with sea‐level fluctuations in the late Cenozoic, which could have provided ecological opportunities for speciation and created bridges or barriers for gene flow. Moreover, some other factors (e.g. sympatric distribution, incomplete reproductive barriers and clonal propagation) might also be advantageous for the formation and reproduction of hybrid species. In conclusion, our study suggests that the interplay of reticulate evolution and sea‐level fluctuations has promoted the diversification of the genusPaphiopedilumand sheds light into the evolution of Orchidaceae and the historical processes of plant species diversification in South‐East Asia.
Dressed to impress: impact of environmental adaptation on the Candida albicans cell wall
Authors: Hall Rebecca A.
Published: April 2015

Candida albicans is an opportunistic fungal pathogen of humans causing superficial mucosal infections and life‐threatening systemic disease. The fungal cell wall is the first point of contact between the invading pathogen and the host innate immune system. As a result, the polysaccharides that comprise the cell wall act as pathogen associated molecular patterns, which govern the host–pathogen interaction. The cell wall is dynamic and responsive to changes in the external environment. Therefore, the host environment plays a critical role in regulating the host–pathogen interaction through modulation of the fungal cell wall. This review focuses on how environmental adaptation modulates the cell wall structure and composition, and the subsequent impact this has on the innate immune recognition of C. albicans.
Interactive effects between physical forces and ecosystem engineers on seed burial: a case study using Spartina anglica
Authors: Zhu Zhenchang , Cozzoli Francesco , Chu Nanyang , Salvador Maria , Ysebaert Tom , Zhang Liquan , Herman Peter M. J. , Bouma Tjeerd J.
Published: April 2015

Seed burial (i.e. vertical seed dispersal) has become increasingly valued for its relevance for seed fate and plant recruitment. While ecosystem engineers have been generally considered as the most important drivers of seed burial, the role of physical forces, such as wind or water flow, has been largely overlooked. Using tidal habitats as a model system, and a combination of flume and mesocosm experiments, we investigated the effects of 1) currents, 2) benthic animals with different engineering activities and 3) their interplay on seed burial of a common salt marsh pioneer plant, Spartina anglica. Our results reveal that in such systems, water flow can be of equal or higher importance than ecosystem engineers for seed burial. For passive seed‐burying engineers (PSE), coupling their actions with currents produced synergistic seed burial effects, whereas the interactive effects were only additive for active seed‐burying engineers (ASE). This paper extends current understanding of seed burial and seed bank formation by revealing the need to incorporate physical forces into seed burial mechanisms. We provide the first empirical evidence that physical forces influence seed burial by synergistically interacting with ecosystem engineers, thus highlighting the role of biophysical interactions as important drivers for vertical seed movement.
Rice cyclophilin OsCYP18‐2 is translocated to the nucleus by an interaction with SKIP and enhances drought tolerance in rice andArabidopsis
Authors: Lee Sang Sook , Park Hyun Ji , Yoon Dae Hwa , Kim Beom‐Gi , Ahn Jun Cheul , Luan Sheng , Cho Hye Sun
Published: April 2015

Cyclophilin 18‐2(CYP18‐2) genes, homologues of humanpeptidyl‐prolyl isomerase‐like 1(PPiL1), are conserved across multicellular organisms andSchizosaccharomyces pombe. AlthoughPPiL1is known to interact with ski‐interacting protein (SKIP), a transcriptional co‐regulator and spliceosomal component, there have been no functional analyses ofPPiL1homologues in plants. Rice cyclophilin 18‐2 (OsCYP18‐2) bound directly to amino acids 56–95 ofOsSKIPand its binding was independent of cyclosporinA, a cyclophilin‐binding drug. Moreover,OsCYP18‐2 exhibitedPPIaseactivity regardless of its interaction withOsSKIP. Therefore, the binding site forOsCYP18‐2's interaction withSKIPwas distinct from thePPIaseactive site.OsCYP18‐2's interaction withSKIPfull‐length protein enabledOsCYP18‐2's translocation from the cytoplasm into the nucleus andAtSKIPinteractedin plantawith bothAtCYP18‐2 andOsCYP18‐2. Drought and salt stress induced similar expression ofOsCYP18‐2andOsSKIP. Overexpression ofOsCYP18‐2in transgenic rice andArabidopsis thalianaplants enhanced drought tolerance and altered expression and pre‐mRNAsplicing patterns of stress‐related genes inArabidopsisunder drought conditions. Furthermore,OsCYP18‐2 caused transcriptional activation with/withoutOsSKIPin theGAL4 system of yeast; thus theOsSKIP‐OsCYP18‐2 interaction has an important role in the transcriptional and post‐transcriptional regulation of stress‐related genes and increases tolerance to drought stress.
Measuring Achievement and Shortfall Improvements in a Consistent Way
Authors: Permanyer Iñaki
Published: April 2015

In measuring improvements over time of bounded variables, one can focus on achievements or shortfalls. However, rankings of alternative social states in terms of achievements and shortfalls do not necessarily mirror one another. We characterize axiomatically different families of achievement and shortfall improvement indices, and present the necessary and sufficient conditions under which they rank social states in a consistent way. Empirical illustrations using child mortality data from South Africa suggest that consistency between achievement and shortfall improvements in standards of living is not only a matter of theoretical import but is also a problem that can be encountered in practice to a large extent.
Two cases of transplant renal artery thrombosis and spontaneous rupture caused by mucormycosis
Authors: Zhu X. , Liu H. , Wang W. , Song S. , Jin M. , Hu X. , Zhang X.
Published: April 2015

Mucormycosis is an uncommon infectious complication after renal transplantation and is associated with fatal outcomes. We report 2 cases of transplant renal artery thrombosis and spontaneous rupture caused by mucormycosis. As stenosis, thrombosis, and spontaneous rupture of the transplant renal artery began to occur in both cases after renal transplantation, nephrectomy of the transplanted kidney was performed. Postoperative pathological findings in the transplanted kidney revealed an invasive mucormycosis infection in the renal artery. One patient survived, but the other patient died. This report also presents the diagnosis and treatment processes used for this transplant complication.
Appendicitis in pregnancy: how to manage and whether to deliver
Authors: Weston Polly , Moroz Paul
Published: April 2015

Key content

Appendicitis in pregnancy is common.

Whether to deliver a pregnant woman with appendicitis is a contentious issue.

There are many uncertainties with diagnosis of appendicitis in pregnancy.

Management of pregnant women with appendicitis requires a multidisciplinary approach involving obstetricians, anaesthetists and surgeons.

Learning objectives

To understand the modalities useful in accurate diagnosis of appendicitis in pregnancy.

To learn about the range of clinical presentations and differential diagnoses.

To appreciate the risks involved with different management options, anaesthetic and surgical.

To be able to manage a pregnant woman with suspected appendicitis for the best possible outcome.

Ethical issues

Operative delivery of a pregnant woman with appendicitis may put her at unnecessary risk. How should she best be managed for the best possible outcome for her and the fetus?
Pre‐transplant antibody screening and anti‐CD154 costimulation blockade promote long‐term xenograft survival in a pig‐to‐primate kidney transplant model
Authors: Higginbotham Laura , Mathews Dave , Breeden Cynthia A. , Song Mingqing , Farris Alton Brad , Larsen Christian P. , Ford Mandy L. , Lutz Andrew J. , Tector Matthew , Newell Kenneth A. , Tector A. Joseph , Adams Andrew B.
Published: April 2015

Xenotransplantation has the potential to alleviate the organ shortage that prevents many patients with end‐stage renal disease from enjoying the benefits of kidney transplantation. Despite significant advances in other models, pig‐to‐primate kidney xenotransplantation has met limited success. Preformed anti‐pig antibodies are an important component of the xenogeneic immune response. To address this, we screened a cohort of 34 rhesus macaques for anti‐pig antibody levels. We then selected animals with both low and high titers of anti‐pig antibodies to proceed with kidney transplant from galactose‐α1,3‐galactose knockout/CD55 transgenic pig donors. All animals received T‐cell depletion followed by maintenance therapy with costimulation blockade (either anti‐CD154 mAb or belatacept), mycophenolate mofetil, and steroid. The animal with the high titer of anti‐pig antibody rejected the kidney xenograft within the first week. Low‐titer animals treated with anti‐CD154 antibody, but not belatacept exhibited prolonged kidney xenograft survival (>133 and >126 vs. 14 and 21 days, respectively). Long‐term surviving animals treated with the anti‐CD154‐based regimen continue to have normal kidney function and preserved renal architecture without evidence of rejection on biopsies sampled at day 100. This description of the longest reported survival of pig‐to‐non‐human primate kidney xenotransplantation, now >125 days, provides promise for further study and potential clinical translation.
Pig‐to‐baboon heterotopic heart transplantation – exploratory preliminary experience with pigs transgenic for human thrombomodulin and comparison of three costimulation blockade‐based regimens
Authors: Iwase Hayato , Ekser Burcin , Satyananda Vikas , Bhama Jay , Hara Hidetaka , Ezzelarab Mohamed , Klein Edwin , Wagner Robert , Long Cassandra , Thacker Jnanesh , Li Jiang , Zhou Hao , Jiang Maolin , Nagaraju Santosh , Zhou Huidong , Veroux Massimiliano , Bajona Pietro , Wijkstrom Martin , Wang Yi , Phelps Carol , Klymiuk Nikolai , Wolf Eckhard , Ayares David , Cooper David K. C.
Published: April 2015

Background

Three costimulation blockade‐based regimens have been explored after transplantation of hearts from pigs of varying genetic backgrounds to determine whether CTLA4‐Ig (abatacept) or anti‐CD40mAb+CTLA4‐Ig (belatacept) can successfully replace anti‐CD154mAb.

Methods

All pigs were on an α1,3‐galactosyltransferase gene‐knockout/CD46 transgenic (GTKO.CD46) background. Hearts transplanted into Group A baboons (n = 4) expressed additional CD55, and those into Group B (n = 3) expressed human thrombomodulin (TBM). Immunosuppression included anti‐thymocyte globulin with anti‐CD154mAb (Regimen 1: n = 2) or abatacept (Regimen 2: n = 2) or anti‐CD40mAb+belatacept (Regimen 3: n = 2). Regimens 1 and 2 included induction anti‐CD20mAb and continuous heparin. One further baboon in Group B (B16311) received a modified Regimen 1. Baboons were followed by clinical/laboratory monitoring of immune/coagulation parameters. At biopsy, graft failure, or euthanasia, the graft was examined by microscopy.

Results

Group A baboons survived 15 to 33 days, whereas Group B survived 52, 99, and 130 days, respectively. Thrombocytopenia and reduction in fibrinogen occurred within 21 days in Group A, suggesting thrombotic microangiopathy (TM), confirmed by histopathology. In Group B, with follow‐up for >4 m, areas of myofiber degeneration and scarring were seen in two hearts at necropsy. A T‐cell response was documented only in baboons receiving Regimen 2.

Conclusions

The combination of anti‐CD40mAb+belatacept proved effective in preventing a T‐cell response. The expression of TBM prevented thrombocytopenia and may possibly delay the development of TM and/or consumptive coagulopathy.
A Hybrid Robust Lyapunov Controller for Dynamic Catch, Grasp and Carry Maneuvers
Authors: Yunt Kerim
Published: April 2015

A hybrid Lyapunov based controller for dynamic catch, grasp, and carry tasks of grippers is developed. The Lyapunov controller unifies the trajectory planning and tracking tasks in one, and neither a separate trajectory planning algorithm is needed to run offline nor any type of learning process. The robustness of the controller is demonstrated, through simulations with inertial parametric uncertainties. The concept is presented with the simulations of six degrees-of-freedom (DOF) double revolute (RR) planar manipulator with a 4DOF gripper and a 8DOF triple revolute (RRR) manipulator with a 5DOF gripper.
Inversion of a Capsule Impacting Water: Flip by Resurge Jet
Authors: Lorenz Ralph D. , Paul Michael V. , Olds David W. , Walsh Justin , Bierhaus Edward B.
Published: April 2015

A scale-model blunt-cone capsule intended for ocean splashdown was projected into a water pool to evaluate impact loads and postimpact behavior. In a small region of the speed/angle parameter space, the capsule would reproducibly capsize, flipping forward (pitch-down), despite a pitch-up motion induced at impact. Inspection of high-speed video shows that the resurging central jet of the impact cavity is responsible. Capsize occurs when this jet is energetic enough (for which we develop a simple criterion), and is timed to lift the trailing edge of the vehicle. The same phenomenon was observed on the Apollo capsules, and may be relevant for lifeboat deployment from ships and offshore platforms.
Design of Deployable Membranes Using Conformal Mapping
Authors: Ishida Sachiko , Nojima Taketoshi , Hagiwara Ichiro
Published: April 2015

This paper proposes a new method for designing the crease patterns of deployable membranes that can be wrapped up compactly. The method utilizes conformal mapping and the origami folding technique. The mapping of the flow with circulation can be used to control the angles between the fold lines, produce elements of the same shape, and maintain regularity of the fold lines. The proposed method thus enables the systematic and efficient design of complex patterns based on simple ones. The proposed method was successfully used to produce the patterns of Nojima and other extended new patterns of deployable membranes consisting of discrete equiangular spirals. The patterns were wrapped and used to form pillars such as regular polygonal, rectangular, and diamond pillars. Toward the industrial application of the proposed method, this paper also discusses pattern design for space-saving storage and to reduce the effect of thickness when using versatile materials.
Probabilistic Pressurized Thermal Shocks Analyses for a Reactor Pressure Vessel
Authors: Qian Guian , Niffenegger Markus
Published: April 2015

Both deterministic and probabilistic methods are used to assess the integrity of a reactor pressure vessel (RPV) subjected to pressurized thermal shocks (PTSs). The FAVOR code is applied to calculate the probabilities for crack initiation and failure of the RPV subjected to two transients, by considering crack distributions based on cracks observed in the Shoreham and pressure vessel research user facility (PVRUF) RPVs. The crack parameters, i.e., crack density, depth, aspect ratio, orientation, and location are assumed as random variables following different distributions. KI of the cracks with the same depth increases with its aspect ratio. Both KI and KIc at the crack tip increase with crack depth, which is the reason why a deeper crack does not necessarily lead to a higher failure probability. The underclad crack is the most critical crack and the deeper crack is the least critical one in this study. Considering uncertainties of the transients results in higher failure probabilities.
Optimum Mandrel Configuration for Efficient Down-Hole Tube Expansion
Authors: Al-Abri Omar S. , Pervez Tasneem , Qamar Sayyad Z. , Al-Busaidi Asiya M.
Published: April 2015

In the last decade, traditional tube expansion process has found an innovative application in oil and gas wells drilling and remediation. The ultimate goal is to replace the conventional telescopic wells to monodiameter wells with minimum cost, which is still a distant reality. Further to this, large diameters are needed at terminal depths for enhanced production from a single well while keeping the power required for expansion and related costs to a minimum. Progress has been made to realize slim wells by driving a rigid mandrel of a suitable diameter through the tube either mechanically or hydraulically to attain a desirable expansion ratio. This paper presents a finite element model, which predicts the drawing force for expansion, the stress field in expanded and pre-/postexpanded zones, and the energy required for expansion. Through minimization of energy required for expansion, an optimum mandrel configuration, i.e., shape, size, and angle, was obtained, which can be used to achieve larger in situ expansion. It is found that mandrel with elliptical, hemispherical, and curved conical shapes has minimum resistance during expansion as compared to the widely used circular cross section mandrel with a cone angle of 10 deg. However, further manipulation of shape parameters of the circular cross section mandrel yielded an improved efficiency. The drawing force required for expansion reduces by 7–10% having minimum dissipated energy during expansion. It is also found that these mandrels yield less reduction in tube thickness after expansion, which results in higher postexpansion collapse strength. In addition, rotating a mandrel further reduces the energy required for expansion by another 7%.
Precision Forming of the Straight Edge of Square Section by Die-Less Spinning
Authors: Jia Z. , Xu Q. , Han Z. R. , Peng W. F.
Published: April 2015

Die-less spinning is a forming process to achieve cone shape parts. It is suitable for small batch production because of low costs and short development cycle. In order to increase the forming accuracy of the square section die-less spinning process, the roller path is designed and amended. Using a 5-axis CNC spinning machine, the square section cone is spun and its edge arc degree is calculated. Roller path amendment coefficient is proposed and deduced through the geometric relationship. Based on the experimental result in which the amendment coefficient is employed, the second amendment coefficient is deduced and used to perform another spinning experiment. By comparison of the section edge arc degrees of the workpiece obtained with and without using the amendment coefficients, it is found that the forming accuracy in experiments with the amendment is remarkably enhanced.
Asymmetric apportioning of aged mitochondria between daughter cells is required for stemness
Authors: Katajisto Pekka , Döhla Julia , Chaffer Christine L. , Pentinmikko Nalle , Marjanovic Nemanja , Iqbal Sharif , Zoncu Roberto , Chen Walter , Weinberg Robert A. , Sabatini David M.
Published: April 2015

Stem cells can sort mitochondria by age

The renewal of tissues in aging organisms requires stem cells, which have the unusual ability to divide asymmetrically into one daughter cell that retains stem cell properties and another that differentiates into a particular tissue type. Katajisto
et al.
used photoactivated marker proteins to monitor the age of cell organelles in stemlike cells from human breast tissue and their distribution into daughter cells. Most organelles were evenly distributed, but daughter cells that maintained stem-cell properties received more newly produced mitochondria and fewer old ones.

Science
, this issue p.
340
Psychotropic drug use in adolescents born with an orofacial cleft: a population-based study
Authors: Nilsson Sofia , Merlo Juan , Lyberg-Åhlander Viveka , Psouni Elia
Published: April 2015

Objectives

Being born with an orofacial cleft (OFC) can, due to an incomplete closure of the lip and/or palate, convey a deviant speech and/or deviant facial aesthetics, which may in turn increase the risk for poor psychological health later in life. Previous investigations have been based on small samples and self-reports, not distinguishing between the three different types of OFC: cleft lip (CL), CL and palate (CLP) and cleft palate only (CPO). We present a large population-based study, considering psychotropic drug use as a proxy for poor psychological health and distinguishing between three different types of OFC.

Design and methods

Using theSwedish Medical Birth Register, and linking to it theSwedish Prescribed Drug Register, theNational Mortality Register, theEmigration Registerand theNational Inpatient Register, we identified all singletons born to native mothers in Sweden between 1987 and 1993, alive and residing in Sweden at the end of an 18-year follow-up period (N=626 109). We compared psychotropic drug use among individuals with and without OFC during the individuals’ adolescence (2005–2008) by multiple logistic regressions, using ORs with 95% CIs.

Results

When adjusted for potential confounders, having a CL (OR=1.63, 95% CI 1.08 to 2.46) or a CPO (OR=1.54, 95% CI 1.18 to 2.01) increased the risk of psychotropic drug use. Results were not significant regarding adolescents who had a CLP (OR=1.21, 95% CI 0.81 to 1.80).

Conclusions

Being born with a CL or a CPO increases the risk for psychotropic drug use in adolescence, but not for adolescents born with a CLP. Our findings suggest that, since the three OFC types are associated with different long-term risks of poor psychological health, the three groups should be studied separately concerning long-term psychosocial consequences.
Risk factors for emergency presentation with lung and colorectal cancers: a systematic review
Authors: Mitchell Elizabeth D , Pickwell-Smith Benjamin , Macleod Una
Published: April 2015

Objective

To identify patient and practitioner factors that influence cancer diagnosis via emergency presentation (EP).

Design

Systematic review.

Data sources

MEDLINE, EMBASE, CINAHL, EBM Reviews, Science and Social Sciences Citation Indexes, Conference Proceedings Citation Index-Science and Conference Proceedings Citation Index-Social Science and Humanities. Searches were undertaken from 1996 to 2014. No language restrictions were applied.

Study selection

Studies of any design assessing factors associated with diagnosis of colorectal or lung cancer via EP, or describing an intervention to impact on EP, were included. Studies involving previously diagnosed cancer patients, assessing only referral pathway effectiveness, outcomes related to diagnosis or post-EP management were excluded. The population was individual or groups of adult patients or primary care practitioners. Two authors independently screened studies for inclusion.

Results

22 studies with over 200 000 EPs were included, most providing strong evidence. Five were graded ‘insufficient’, primarily due to missing information rather than methodological weakness. Older patient age was associated with EP for lung and colorectal cancers (OR 1.11–11.03 and 1.19–5.85, respectively). Women were more at risk of EP for lung but not colorectal cancer. Higher deprivation increased the likelihood of lung cancer EP, but evidence for colorectal was less conclusive. Being unmarried (or divorced/widowed) increased the likelihood of EP for colorectal cancer, which was also associated with pain, obstruction and weight loss. Lack of a regular source of primary care, and lower primary care use were positively associated with EP. Only three studies considered practitioner factors, two involving diagnostic tests. No conclusive evidence was found.

Conclusions

Patient-related factors, such as age, gender and deprivation, increase the likelihood of cancer being diagnosed as the result of an EP, while cancer symptoms and patterns of healthcare utilisation are also relevant. Further work is needed to understand the context in which risk factors for EP exist and influence help-seeking.
Industrial hygiene, occupational safety and respiratory symptoms in the Pakistani cotton industry
Authors: Khan Abdul Wali , Moshammer Hanns Michael , Kundi Michael
Published: April 2015

Objectives

In the cotton industry of Pakistan, 15 million people are employed and exposed to cotton dust, toxic chemicals, noise and physical hazards. The aim of this study was to determine the prevalence of health symptoms, particularly respiratory symptoms, and to measure cotton dust and endotoxin levels in different textile factories of Faisalabad, Pakistan.

Methods

A cross-sectional investigation was performed in a representative sample of 47 cotton factories in the Faisalabad region in Punjab, Pakistan. Respiratory symptoms of 800 workers were documented by questionnaire. Occupational safety in the factories was assessed by a trained expert following a checklist, and dust and endotoxin levels in different work areas were measured.

Results

Prevalence of respiratory disease symptoms (fever, shortness of breath, chest tightness and cough) was generally high and highest in the weaving section of the cotton industry (20–40% depending on symptoms). This section also displayed the poorest occupational safety ratings and the highest levels of inhalable cotton dust (mean±SD 4.6±2.5 vs 0.95±0.65 mg/m3in compact units). In contrast, endotoxin levels were highest in the spinning section (median 1521 EU/m3), where high humidity is maintained.

Conclusions

There are still poor working conditions in the cotton industry in Pakistan where workers are exposed to different occupational hazards. More health symptoms were reported from small weaving factories (power looms). There is a dire need for improvements in occupational health and safety in this industrial sector with particular focus on power looms.
Experience with vertebral artery origin stenting and ostium dilatation: results of treatment and clinical outcomes
Authors: Rangel-Castilla Leonardo , Gandhi Sirin , Munich Stephan A , Cress Marshall C , Sonig Ashish , Krishna Chandan , Hopkins L Nelson , Snyder Kenneth V , Levy Elad I , Siddiqui Adnan H
Published: April 2015

Background

The vertebral artery (VA) ostium (VAO) is a common stenosis site. Most patients with VAO stenosis refractory to medical treatment are treated endovascularly using stenting. To optimally cover the ostial plaque, which frequently extends into the adjacent subclavian artery, part of the stent must overhang in the subclavian artery. This configuration makes subsequent VA access very challenging in cases of in-stent or distal vertebrobasilar pathology; it also obstructs the distal subclavian artery.

Objective

To determine whether angioplasty at the ostium with a dual balloon (Flash Ostial) specially designed to allow the subclavian end of the stent to flare might circumvent these problems and, most importantly, provide optimal plaque coverage around the vertebral ostium.

Methods

Between June 2012 and July 2014, 11 patients with symptomatic VAO stenosis refractory to best medical therapy were treated with stenting and dual balloon Flash angioplasty. Demographics, results, and outcomes were reviewed.

Results

A total of 12 VAO stenting–dual balloon angioplasty procedures were performed (mean stenosis, 83.6%; range, 78–90%). Nine patients had mild-to-moderate (40–60%) contralateral VAO stenosis. The initial average modified Rankin Scale (mRS) score was 1.25. In all cases, immediate postangioplasty angiography showed excellent stent apposition against the VA and around the ostium in the subclavian artery. No permanent perioperative complications or deaths occurred. At a mean follow-up of 10.8 months (range 2–24), all patients had symptom resolution and no evidence of symptomatic restenosis on neuroimaging/Doppler studies; the average mRS score was 0.66. Three patients continued to have previously diagnosed mid-cervical VA stenosis; one of them had postprocedure dissection and an asymptomatic in-stent stenosis at 8 months.

Conclusions

Safety and feasibility were demonstrated using the Ostial Flash system for VAO stenting and angioplasty. No permanent perioperative complications were seen.
Patient-reported outcomes as end points in clinical trials in rheumatoid arthritis
Authors: Gossec Laure , Dougados Maxime , Dixon William
Published: April 2015

There is a growing interest in patient-reported outcomes (PROs) in rheumatology, which goes with a global trend for more ‘patient-centred care’. This review considers the use of PROs in trials, including their strengths and limitations. In rheumatoid arthritis (RA) trials, the most frequently used PROs to assess treatments include pain, patient global assessment, assessment of functional status, but also health-related quality of life and less commonly fatigue. Other aspects of importance for patients, such as sleep, psychological well-being or ability to cope, are rarely assessed. PROs as outcome measures in RA trials have strengths as well as limitations. PROs have face validity, they are reproducible and sensitive to change and they bring additional information beyond joint counts or acute phase reactants. However, their predictive validity for later outcomes has been little explored, some PROs show redundancy (they bring similar information) and, due to the apparently moderate link between some PROs such as fatigue and the disease process, the use of some PROs to inform treatment choices has been questioned. We suggest the choice of PROs for trials depends on the study objective and on the viewpoint of the stakeholder. There needs to be agreed prioritisation across all stakeholders about what is most important to collect in a trial, which is why a prioritisation and selection process is necessary. Trials in RA will continue to include PROs and their interpretation will become easier as our knowledge progresses.
Salivary SIgA responses to acute moderate–vigorous exercise in monophasic oral contraceptive users
Authors: Hayashida Harumi , Dolan Nicola J. , Hounsome Charlotte , Alajmi Nawal , Bishop Nicolette C.
Published: April 2015

The purpose of this study was to examine the effect of oral contraceptive (OC) use on salivary secretory immunoglobulin A (SIgA) levels at rest and in response to an acute bout of moderate–vigorous exercise during 2 phases of the 4-week OC cycle corresponding to different phases of the synthetic menstrual cycle. Ten healthy active females completed a cycling at 70% peak oxygen uptake for 45 min at 2 time points of an OC cycle: during the equivalent in time to the mid-follicular phase (day 8 ± 2) and the mid-luteal phase (day 20 ± 2). Timed unstimulated saliva samples were obtained before, immediately postexercise, and 1 h postexercise and analyzed for salivary SIgA. Salivary SIgA secretion rate was 26% (95% confidence limits (CI) 6–46) lower at postexercise compared with pre-exercise during the synthetic follicular phase (p = 0.019) but no differences were observed during the synthetic luteal trial. Saliva flow rate was 11% (95% CI, 8–30) lower at postexercise compared with pre-exercise (main effect for time; p = 0.025). In conclusion, the pattern of salivary SIgA secretion rate response to moderate–vigorous exercise varies across the early and late phases of a monophasic OC cycle, with a transient reduction in salivary SIgA responses during the synthetic follicular phase. These findings indicate that monophasic OC use should be considered when assessing mucosal immune responses to acute exercise.
Effects of breathing patterns and light exercise on linear and nonlinear heart rate variability
Authors: Weippert Matthias , Behrens Kristin , Rieger Annika , Kumar Mohit , Behrens Martin
Published: April 2015

Despite their use in cardiac risk stratification, the physiological meaning of nonlinear heart rate variability (HRV) measures is not well understood. The aim of this study was to elucidate effects of breathing frequency, tidal volume, and light exercise on nonlinear HRV and to determine associations with traditional HRV indices. R–R intervals, blood pressure, minute ventilation, breathing frequency, and respiratory gas concentrations were measured in 24 healthy male volunteers during 7 conditions: voluntary breathing at rest, and metronome guided breathing (0.1, 0.2 and 0.4 Hz) during rest, and cycling, respectively. The effect of physical load was significant for heart rate (HR; p < 0.001) and traditional HRV indices SDNN, RMSSD, lnLFP, and lnHFP (p < 0.01 for all). It approached significance for sample entropy (SampEn) and correlation dimension (D2) (p < 0.1 for both), while HRV detrended fluctuation analysis (DFA) measures DFAα1 and DFAα2 were not affected by load condition. Breathing did not affect HR but affected all traditional HRV measures. D2 was not affected by breathing; DFAα1 was moderately affected by breathing; and DFAα2, approximate entropy (ApEn), and SampEn were strongly affected by breathing. DFAα1 was strongly increased, whereas DFAα2, ApEn, and SampEn were decreased by slow breathing. No interaction effect of load and breathing pattern was evident. Correlations to traditional HRV indices were modest (r from –0.14 to –0.67, p < 0.05 to <0.01). In conclusion, while light exercise does not significantly affect short-time HRV nonlinear indices, respiratory activity has to be considered as a potential contributor at rest and during light dynamic exercise.