bluuebunny/crossref_metadata_2025 huggingface dataset:
026 Retrospective study of eye swabs sent from the emergency department of the Royal Hospital for Sick Children, Glasgow
Authors: Wallace M , Russell F
Published: September 2011

Objectives and Background

Conjunctivitis is a common presentation to both adult and paediatric emergency departments. A Cochrane review updated in 2007 demonstrated an improvement in symptoms with administration of topical antibiotics in adult patients with suspected bacterial conjunctivitis and suggested that empirical topical antibiotic use was appropriate. This study aimed to determine if swabbing the eyes of children with conjunctivitis changed clinical practice.

Methods

The microbiology department retrospectively identified all eye swabs received for investigation from the emergency department of the Royal Hospital for Sick Children, Glasgow over the course of 1 year.

Results

233 patient episodes of suspected conjunctivitis generated a total of 300 swabs. 240 swabs were sent to bacteriology and 60 to virology. The age range was 7 days to 12 years, of which 71% were under 2 years. Of the bacteriology swabs, 139/240 (57.9%) were positive and 101/240 (42.1%) were negative. 8 positive swabs grew two organisms. All pathogens identified were sensitive to Chloramphenicol, which is first line topical treatment for suspected bacterial conjunctivitis in this department. 16 pathogens were identified by PCR: 7 Chlamydia, 6 Adenovirus and 3 HSV. 29 swabs were sent from children under 1 month of age. Of these, 24.1% were positive for Chlamydia.

Conclusion

Results of bacteriology swabs in suspected conjunctivitis do not change clinical practice. Virology eyes swabs should be sent in neonates with conjunctivitis or patients with suspected HSV. Significant processing costs and staff time dealing with results can be saved.
029 Clinical decision rules for children with minor head injury: a systematic review
Authors: Pickering A , Harnan S , Fitzgerald P , Pandor A , Goodacre S
Published: September 2011

Objectives and Background

Clinical decision rules aid clinicians with the management of head injured patients. This study aimed to identify clinical decision rules for children with minor head injury and compare their diagnostic accuracy for detection of intracranial injury (ICI) and injury requiring neurosurgical intervention (NSI).

Methods

Relevant studies were identified by an electronic search of key databases. Papers in English were included with a cohort of at least 20 children suffering minor head injury (GCS 13–15). Studies of a decision rule derived to identify patients at risk of ICI or NSI had to include a proportion of the cohort undergoing imaging. Study quality was assessed using the QUADAS checklist.

Results

16 publications, representing 14 cohorts, with 79 740 patients were included. Only four rules were tested in more than one cohort. Of the validated rules the paediatric emergency care applied research network (PECARN) rule was most consistent (sensitivity 98%; specificity 58%). For neurosurgical injury all had high sensitivity (98–100%) but the children's head injury algorithm for the prediction of important clinical events (CHALICE) rule had the highest specificity (86%) in its derivation cohort. The positive predictive value (PPV) for each rule were calculated. Of the large cohorts studied (>10 000 subjects) CHALICE had PPV of 5.4% compared with 2.0% for PECARN for ICI. For NSI the PPV calculated were 4.2% and 0.4% respectively.

Conclusion

Of the current decision rules for minor head injury the PECARN rule appears the best for children and infants, with the largest cohort, highest sensitivity and acceptable specificity for clinically significant ICI. Application of this rule in the UK would probably result in an unacceptably high rate of CT scans per injury, and continued use of the CHALICE- based NICE guidelines represents an appropriate alternative.
003 Whole Body CT scanning for severe blunt multitrauma: analysis of the TARN database 2005–2010
Authors: Hunt P , Lecky F , Bouamra O
Published: September 2011

Objectives and Backgrounds

There is growing evidence to recommend the use of “Whole Body” CT (WBCT) scanning in the early management of severe blunt multitrauma patients. A recent study [Lancet2009;373:1455–61] reported a survival advantage with WBCT compared to a non-WBCT approach. We present the results of our analysis of a large retrospective case series taken from the Trauma Audit and Research Network (TARN) database.

Methods

We utilised retrospective, multicentre data of severe blunt multitrauma (ISS >15) direct ED admissions aged >15 years recorded in the UK TARN database to compare survival at 30 days between two groups of patients: (1) those who underwent WBCT scans, and (2) those who received a focused CT scan approach as part of their initial management in the Emergency Department. A total of 12 792 cases were included in the final dataset.

Results

2822 (22%) of 12 792 cases underwent WBCT from the ED. The median ISS for the WBCT group was 22 (IQR 14–33) compared to 16 (IQR 9–25) for the focused CT group. The calculated crude mortality rate for the WBCT group was 10.1% compared to 8.7% in the focused CT group (p=0.0124). Multivariate analysis with adjustments for potential confounding factors demonstrated an OR of 1.313 (95% CI 1.083 to 1.592, p=0.006) in favour of survival in the WBCT group.

Conclusions

Despite the crude mortality rates appearing to demonstrate a poorer outcome in the WBCT group, correcting for confounding factors revealed an around 30% improvement in survival for the WBCT group. However, when also correcting for the potential effect of clustering, the benefit of WBCT is less clear, with an around 20% improvement in survival and a lower level of significance (p=0.084). Overall, the results of our investigation appear to suggest a potential survival benefit from the use of WBCT in severe blunt multitrauma.
030 Multi-centre study of the emergency management of allergic reactions and anaphylaxis
Authors: Helin H , Perkin M , Gumm R
Published: September 2011

Objectives and Background

The Royal College of Paediatrics and Child Health (RCPCH) recently published its care pathway for anaphylaxis incorporating an algorithm with the stages of ideal care and a set of competences required to diagnose, treat and optimally manage anaphylaxis. In order to assess current practice we investigated the quality of documented assessment and treatment of paediatric allergies in Accident and Emergency (A&E).

Methods

Retrospective case review of children presenting with allergic reactions to A&E at two large teaching hospitals during 1 year.

Results

Total number of cases included was 187 (96 hospital A, 15% severe, 91 hospital B, 12% severe). Urticaria, angiooedema and pruritus were the main presenting symptoms. Enquiry of previous allergies was not recorded in 31%/38% (A/B) of cases. Recording of ABCD assessment of all and the most severe reactions (systemic symptoms) varied between hospitals (Abstract 030 table 1). Types of medications used were similar with antihistamines (55%/67% A/B), steroids (26%/38% A/B) and bronchodilators (4% both) being the main treatments. Number of admissions (to paediatric assessment unit and wards) differed 16%/5% (A/B). Both hospitals had low recorded referral rates to allergy clinic (8%/11% A/B) and allergen avoidance advice (8%/12% A/B). Medication on discharge was given to 29%/59% (A/B), mainly antihistamines.

Conclusion

The RCPCH care pathway sets best practice. While we reviewed written notes which may not fully reflect actual consultations, current practice would appear to be falling significantly short of the ideal care proposed.
004 Does the use of the A&E theatre reflect the demise in the surgical skills of the emergency physician?
Authors: Cooper J , Hannah J , Brown W
Published: September 2011

Objectives and Backgrounds

The College of Emergency Medicine has evolved from the Casualty Surgeons Association formed in 1967. At that time most of the expertise in the Accident and Emergency (A&E) Department was surgical and consequently many Departments had an operating theatre in which to carry out a variety of procedures. From this background the specialty of Emergency Medicine (EM) has arisen and developed. Many Departments no longer use, or have lost, their theatre as the workload and expertise has become more medical in nature. However, sound basic surgical skills are very important to the modern Emergency Physician and many feel these are still best taught in theatre. To date the Emergency Department of Aberdeen Royal Infirmary (ARI) has retained the use of its theatre and therefore to the training opportunity it provides. This study aimed to evaluate the number and type of cases passing through this facility to study trends and to evaluate what the future may be for the A&E theatre.

Methods

This was a retrospective cohort study of the A&E theatre usage in ARI, a large teaching hospital in the North East of Scotland from 1995 to 2010. Cases were identified from theatre log books, relevant demographics extracted and analysed.

Results

A total of 8785 procedures were performed during the study period of which the most common were fracture manipulation, abscess drainage and foreign body removal. There was a steady decline in theatre usage: 1078 cases in 1995; 828 cases in 2000; 368 cases in 2005 and only 214 cases in 2010. The reduction was most dramatic in the number of wrist fractures manipulated and in the number of perianal and pilonidal abscess operated on.

Conclusions

Use of the A&E theatre is reducing. The reasons for this are complex and include: changing surgical practices; reduced anaesthetic presence in remote sites within the hospital and, most importantly, the change in the skill mix of the staff in the Emergency Department. Sound General Surgical and Orthopaedic basic surgical skills are valuable to the Emergency Physician but experience in these specialties is no longer required in EM training. Thought should be given to whether these skills could be learnt in the A&E theatre before such facilities disappear completely.
Comparison of unscheduled re-attendance and contraception at discharge, among women having the final stage of early medical abortion at home and those remaining in hospital
Authors: Astle Hannah , Cameron Sharon T , Johnstone Anne
Published: September 2011

Introduction

Throughout Great Britain, increasing numbers of women having an early medical abortion are choosing to go home soon after administration of misoprostol, to expel the pregnancy at home (early medical discharge, EMD), rather than remain upon the hospital premises (day case). However, data are lacking on how this impacts upon an abortion service in terms of unscheduled re-attendance rates and contraception provision at discharge.

Methods

A retrospective audit was carried out of women undergoing medical abortion (up to 64 days' gestation) over 9 months at a National Health Service hospital in Scotland, to determine (1) unscheduled re-attendance rates within 6 weeks of the procedure for an abortion-related complication and (2) method of contraception provided at discharge.

Results

Over the audit period 1128 women had an early medical abortion of whom 590 (52%) chose EMD. There was no significant difference in unscheduled re-attendance rates between EMD (n=23, 4%) and day case groups (n=20, 4%). There was no significant difference in the proportion of women in each group who left hospital with an effective method of contraception (n=362, 61% andn=355, 60% for EMD and day case groups, respectively).

Conclusions

Women undergoing early medical abortion who choose to expel the pregnancy at home are no more likely to re-attend hospital with a post-abortal complication and are just as likely to receive effective contraception than those who remain on hospital premises.
THE EXCITATION DISCHARGE RHYTHM OF SMALL-WORLD BIOLOGICAL NEURAL NETWORKS WITH LATERAL INHIBITION MECHANISM
Authors: YANG RENHUAN , SONG AIGUO , XU BAOGUO
Published: September 2011

Research is conducted on the discharge rhythm properties of an artificial biological neural network with lateral inhibition mechanism, which is modeled by Hodgkin–Huxley (HH) equations and coupled by small-world (SW) network. The results show that the excitation frequency increases almost linearly along with increasing stimulation intensity, conversely, the average excitation intensity decreases near linearly with the increase of stimulation intensity, when the current stimulation intensity exceeds threshold value. In addition, the influence of coupling strength on excitation properties is noticeable under relatively weak stimulation. The stronger is the coupling strength, the lower is the excitation frequency, whereas the stronger is the coupling strength the greater is the excitation intensity. However, the influence of coupling strength on excitation properties is unnoticeable under relatively strong stimulation. For comparison, discharge rhythm properties of the neural networks under random connection and full connection are also investigated.
BIOCOMPATIBILITY AND MECHANICAL PROPERTY OF LARS ARTIFICIAL LIGAMENT WITH TISSUE INGROWTH
Authors: WANG CHO-LIN , HSIAO CHIH-KUN , HSU AR-TYAN , DUNG CHING-ZE , CHANG CHIH-HAN
Published: September 2011

Tissue ingrowth into the implanted artificial ligaments is to be expected after reconstructive procedures and several groups have reported soft tissue ingrowth of the implanted LARS (Ligament Augmentation and Reconstruction System, Dijon, France) artificial ligament. Up to now the influence of the tissue ingrowth on the mechanical properties of the artificial ligament is uncertain. The purpose of this research was to study the mechanical property after tissue ingrowth on LARS artificial ligament. Five LARS ligaments were implanted subcutaneously in the abdomen of five pigs. After six months of implantation, four successful implants were explanted and tested. The results showed that fibroblasts and collagen fibers had grown into the unknotted middle part of the LARS. However, 12.2 ± 2.2% of fibres were surrounded by foreign body giant cells. Tensile tests showed that the explanted LARS possessed similar elastic characteristics as native ligaments. The tensile strength of the explanted LARS decreased by 23.53 ± 18.04% (p < 0.001) and the elongation of the middle part of the explanted LARS increased by 69.84 ± 38.38% (p < 0.002) in comparison with unimplanted control ligaments. Since there were not apparent surface cracking on the LARS fibers, it was inferred that activities of foreign-body giant cells might have weakened the strength and adversely affected the mechanical properties of the fibers of the LARS.
BOUBAKER POLYNOMIALS EXPRESSION TO THE MAGNETIC PHASE-SHIFT INDUCED IN LEON–VIGMOND 3D-MODEL OF THE HUMAN HEART
Authors: DADA M. , AWEDA M. A. , AWOJOYOGBE O. B. , BOUBAKER K.
Published: September 2011

The heart is simulated as an electrically controlled fluid pump which operates by mechanical contraction. Human heart modeling is undoubtedly a computationally daunting task which must incorporate magnetic, plastic, mechanic and electric patterns. In this paper, a polynomial mathematical formulation for the magnetic field phase shift in a particular heart 3D-model is proposed. The developed model can give an insight into the local and global complex dynamics of the heart magnetic field under controlled excitation as guides to monitoring i.e., the transition from normal to abnormal myocardial activity or collateral dysfunctions. The used protocol allowed handling the boundary conditions in a smooth way.
COMPUTATIONAL MODELING OF FORMATION OF A CEREBRAL ANEURYSM UNDER THE INFLUENCE OF SMOOTH MUSCLE CELL RELAXATION
Authors: NABAEI MALIKEH , FATOURAEE NASSER
Published: September 2011

The mechanics of cerebral aneurysm pathogenesis, evolution and rupture are not yet well understood. This paper presents a numerical analysis of the formation of a saccular cerebral aneurysm in for the first time in a 3D model of the basilar artery bifurcation under normal and hypertensive blood pressure. Due to the excessive endothelium derived nitric oxide produced in high wall shear stress, we assumed that smooth muscle cell relaxation is the origin of the aneurysm formation. Arterial wall remodeling under constant tension was considered to be the other mechanism of disease evolution. The wall was constructed from two elastic and hyperelastic isotropic regions. The flow was considered steady, laminar, Newtonian, and incompressible. The fully coupled fluid and structure models were solved with the finite elements package ADINA 8.5. The wall shear stress, effective stress and deformation distributions under normal and hypertensive blood pressure were compared to a healthy bifurcation. The model shows that although the malfunction of the endothelial cell layer and the corresponding smooth muscle cell-related loss of vascular tone is important to the inception of the disease; A saccular aneurysm may not be formed by this mechanism alone, and also requires the fiber-related arterial wall remodeling for further development.
HYPER-ELASTIC PARAMETER ESTIMATION OF HUMAN HEEL-PAD: A FINITE ELEMENT AND EVOLUTIONARY BASED ALGORITHM
Authors: KHANI M. M. , KATOOZIAN H. , AZMA K. , NASEH I. , SALIMI A. H.
Published: September 2011

The heel-pad as a biological shock absorber has an important role in the initial contact phase of gait cycle dissipating the impact forces resulted in locomotion. An axisymmetric finite element model of human heel-pad has been generated and the heel-pad experimental data deduced from a published force-deflection graph of the same specimen (Iain R. Spears, Janice E. Miller-Young), Iterative identification task has been used to extract nonlinear material properties describing hyper-elastic behavior of heel-pad. The genetic algorithm was incorporated into estimation process using an interface program. Two parameters of hyper-elastic materials potential energy function represented by Mooney–Rivlin were determined by using the genetic algorithm technique to minimize the displacement error between the experimental data and the corresponding finite element results after a considerable number of iterations. The result can be used for design and construction of synthetic heel-pad and therapeutic foot wear as well as insoles, especially for diabetic patients.
RECURRENCE QUANTIFICATION ANALYSIS OF BODY RESPONSE TO FUNCTIONAL ELECTRICAL STIMULATION ON HEMIPLEGIC SUBJECTS
Authors: ACHARYA U. RAJENDRA , YU WENWEI , CHATTOPADHYAY SUBHAGATA , ZHU KUANYI , NG E. Y. K. , SWAPNA G.
Published: September 2011

Hemiplegia means paralysis of half of the body. It commonly occurs following "stroke", which is due to impedance of blood supply to the brain, hence also termed as "cerebrovascular accident" (CVA). As a consequence of this, the brain tissues suffer from ischemic damage resulting in several symptoms, such as mere weakness, numbness to complete loss of power (paralysis). In order to restore or improve the lost functional movement of the body of the stroke-affected and hemiplegic subjects, a method called functional electrical stimulation (FES) has often been employed as the measure of rehabilitation. FES makes use of low levels of electrical current to activate the nerves and then the muscles, affected. The response of the body to this electrically triggered nervous stimulation could be recorded through different bio-signals. In our work, we measured the accelerometers of hemiplegic patient in two states; with FES and without FES. The nonlinear and nonstationary walking-function-related accelerometers are analyzed using recurrence plots (RP), which helps to visualize the dynamic behavior of the signals. The RPs of electromyography (EMG) signals with stimulation showed distinct periodicity and rhythm when compared to that without stimulation. In addition, we extracted recurrence quantification analysis (RQA) parameters from RP to quantify the obtained information from the RP. Lower values were observed for most of the RQA parameters with FES than obtained without FES. This also confirmed the fact that FES is very useful in bringing more order, rhythm and better control in the physical activities of hemiplegic people.
NONINVASIVE POWER SPECTRUM ANALYSIS OF RADIAL PRESSURE WAVEFORM FOR ASSESSMENT OF VASCULAR SYSTEM
Authors: WU QUAN-YU , MA ZU-CHANG , SUN YI-NING
Published: September 2011

Wrist pulse diagnosis has been used in traditional Chinese medicine (TCM) for thousands of years, because pulse pressure signal contains a large number of physiological and pathological information of people. In this research, a systematic approach was proposed to analyze the computerized radial pressure waveform, with the focus placed on the power spectrum. We gained the power spectrum by using a modified fast Fourier transform, and the power-spectral characteristics were analyzed and compared. The analyzing program calculated the first peak frequency (F1) and the second peak (F2) automatically, and gained the time of phase shift between two frequencies. They could provide a simple noninvasive means for studying changes in the elastic properties of the vascular system depending on the age and the disease. Namely, the frequency analysis of radial pressure waveform gives new insight into the dynamics of cardiovascular system.
IMPACT OF FINGERTIP ACTIONS ON TOTAL POWER OF SURFACE ELECTROMYOGRAPHY FROM EXTRINSIC HAND MUSCLES
Authors: YANG D. D. , HOU W. S. , WU X. Y. , ZHENG J. , ZHENG X. L. , JIANG Y. T. , MA L.
Published: September 2011

Quantizing the relationship between finger force and multitendoned extrinsic hand muscles could be useful for understanding the control strategies that underlie the coordination of finger movements and forces. The objective of this study is to explore the relationship of fingertip force production and total power of surface electromyography (sEMG) recorded on extrinsic hand muscles under isometric voluntary contraction. Thirteen healthy volunteers were recruited to participate in this study. In the designed force-tracking tasks, all volunteers were required to produce a certain force with either index finger or middle finger to match the target force for 5 s. Meanwhile, the sEMG signals were acquired from two extrinsic hand muscles: extensor digitorum (ED) and flexor digitorum superficialis (FDS). For each trial, sEMG of the effective force segment was extracted; then, the power spectrum was estimated based on autoregressive (AR) model and from which the corresponding total power of sEMG was computed. The experimental results reveal that the total power of sEMG linearly increases with force level regardless of the task finger and extrinsic hand muscle. It is also found that the total power obtained from index finger is significantly less than that of middle finger for FDS at the same force level (p < 0.05), while this kind of statistical significance cannot be found for ED. However, with respect to the measurement of total power, the type of extrinsic hand muscle has not exhibited significantly different contribution to the task finger under a certain fingertip force level. The findings of this study indicate that the total power of the extrinsic hand muscle's sEMG can be used to characterize finger's activities.
Blood pressure in a hypertensive mouse model of SLE is not salt-sensitive
Authors: Mathis Keisa W. , Venegas-Pont Marcia , Masterson Chester W. , Wasson Katie L. , Ryan Michael J.
Published: September 2011

Systemic lupus erythematosus (SLE) is a risk factor for hypertension. Previously, we demonstrated that an established mouse model of SLE (female NZBWF1 mice) develops hypertension with renal inflammation and oxidative stress, both characteristics known as contributing mechanisms to the development of salt-sensitive hypertension. On the basis of this model, we hypothesized that blood pressure in SLE mice would be salt-sensitive. Thirty-week-old female SLE and control mice (NZW/LacJ) were fed 8% high-salt (HS) diet or normal diet (0.4% salt) for 4 wk. Plasma levels of double-stranded DNA (dsDNA) autoantibodies, a marker of SLE disease activity, were increased in SLE mice compared with controls (472 ± 148 vs. 57 ± 17 U/ml × 1,000, P < 0.001). HS did not alter dsDNA autoantibody levels in SLE or control mice. Mean arterial pressure was increased in SLE mice compared with controls (132 ± 3 vs. 118 ± 2 mmHg, P < 0.001) and was not significantly altered by the HS diet in either group. Similarly, albuminuria was higher in SLE mice compared with controls (10.7 ± 9.0 vs. 0.3 ± 0.1 mg/day) but was not significantly increased in SLE or control mice fed a HS diet. In summary, blood pressure during SLE is not salt-sensitive, and the HS diet did not adversely affect SLE disease activity or significantly augment albuminuria. These data suggest that renal inflammation and oxidative stress, characteristics common to both SLE and models of salt-sensitive hypertension, may have diverging mechanistic roles in the development of hypertension.
Characteristics of sodium currents in rat geniculate ganglion neurons
Authors: Nakamura Shiro , Bradley Robert M.
Published: September 2011

Geniculate ganglion (GG) cell bodies of chorda tympani (CT), greater superficial petrosal (GSP), and posterior auricular (PA) nerves transmit orofacial sensory information to the rostral nucleus of the solitary tract. We have used whole cell recording to investigate the characteristics of the Na+ channels in isolated Fluorogold-labeled GG neurons that innervate different peripheral receptive fields. GG neurons expressed two classes of Na+ channels, TTX sensitive (TTX-S) and TTX resistant (TTX-R). The majority of GG neurons expressed TTX-R currents of different amplitudes. TTX-R currents were relatively small in 60% of the neurons but were large in 12% of the sampled population. In a further 28% of the neurons, TTX completely abolished all Na+ currents. Application of TTX completely inhibited action potential generation in all CT and PA neurons but had little effect on the generation of action potentials in 40% of GSP neurons. Most CT, GSP, and PA neurons stained positively with IB4, and 27% of the GSP neurons were capsaicin sensitive. The majority of IB4-positive GSP neurons with large TTX-R Na+ currents responded to capsaicin, whereas IB4-positive GSP neurons with small TTX-R Na+ currents were capsaicin insensitive. These data demonstrate the heterogeneity of GG neurons and indicate the existence of a subset of GSP neurons sensitive to capsaicin, usually associated with nociceptors. Since there are no reports of nociceptors in the GSP receptive field, the role of these capsaicin-sensitive neurons is not clear.
Steady-state stiffness of utricular hair cells depends on macular location and hair bundle structure
Authors: Spoon Corrie , Moravec W. J. , Rowe M. H. , Grant J. W. , Peterson E. H.
Published: September 2011

Spatial and temporal properties of head movement are encoded by vestibular hair cells in the inner ear. One of the most striking features of these receptors is the orderly structural variation in their mechanoreceptive hair bundles, but the functional significance of this diversity is poorly understood. We tested the hypothesis that hair bundle structure is a significant contributor to hair bundle mechanics by comparing structure and steady-state stiffness of 73 hair bundles at varying locations on the utricular macula. Our first major finding is that stiffness of utricular hair bundles varies systematically with macular locus. Stiffness values are highest in the striola, near the line of hair bundle polarity reversal, and decline exponentially toward the medial extrastriola. Striolar bundles are significantly more stiff than those in medial (median: 8.9 μN/m) and lateral (2.0 μN/m) extrastriolae. Within the striola, bundle stiffness is greatest in zone 2 (106.4 μN/m), a band of type II hair cells, and significantly less in zone 3 (30.6 μN/m), which contains the only type I hair cells in the macula. Bathing bundles in media that break interciliary links produced changes in bundle stiffness with predictable time course and magnitude, suggesting that links were intact in our standard media and contributed normally to bundle stiffness during measurements. Our second major finding is that bundle structure is a significant predictor of steady-state stiffness: the heights of kinocilia and the tallest stereocilia are the most important determinants of bundle stiffness. Our results suggest 1) a functional interpretation of bundle height variability in vertebrate vestibular organs, 2) a role for the striola in detecting onset of head movement, and 3) the hypothesis that differences in bundle stiffness contribute to diversity in afferent response dynamics.
Human proprioceptive adaptations during states of height-induced fear and anxiety
Authors: Davis Justin R. , Horslen Brian C. , Nishikawa Kei , Fukushima Katie , Chua Romeo , Inglis J. Timothy , Carpenter Mark G.
Published: September 2011

Clinical and experimental research has demonstrated that the emotional experience of fear and anxiety impairs postural stability in humans. The current study investigated whether changes in fear and anxiety can also modulate spinal stretch reflexes and the gain of afferent inputs to the primary somatosensory cortex. To do so, two separate experiments were performed on two separate groups of participants while they stood under conditions of low and high postural threat. In experiment 1, the proprioceptive system was probed using phasic mechanical stimulation of the Achilles tendon while simultaneously recording the ensuing tendon reflexes in the soleus muscle and cortical-evoked potentials over the somatosensory cortex during low and high threat conditions. In experiment 2, phasic electrical stimulation of the tibial nerve was used to examine the effect of postural threat on somatosensory evoked potentials. Results from experiment 1 demonstrated that soleus tendon reflex excitability was facilitated during states of height-induced fear and anxiety while the magnitude of the tendon-tap-evoked cortical potential was not significantly different between threat conditions. Results from experiment 2 demonstrated that the amplitudes of somatosensory-evoked potentials were also unchanged between threat conditions. The results support the hypothesis that muscle spindle sensitivity in the triceps surae muscles may be facilitated when humans stand under conditions of elevated postural threat, although the presumed increase in spindle sensitivity does not result in higher afferent feedback gain at the level of the somatosensory cortex.
The Effects of Fractions from Shiitake Mushroom on Composition and Cariogenicity of Dental Plaque Microcosms in an In Vitro Caries Model
Authors: Zaura Egija , Buijs Mark J. , Hoogenkamp Michel A. , Ciric Lena , Papetti Adele , Signoretto Caterina , Stauder Monica , Lingström Peter , Pratten Jonathan , Spratt David A. , Wilson Michael
Published: September 2011

The aim of the current study was to investigate the anticariogenic potential of the (sub)fractions obtained from the edible mushroom shiitake (Lentinula edodes) in in vitro caries model. We used a modified constant depth film fermentor (CDFF) with pooled saliva as the inoculum and bovine dentin as a substratum. The test compounds were low molecular weight fraction (MLMW) of the shiitake extract and subfractions 4 and 5 (SF4 and SF5) of this fraction. Chlorhexidine (CHX) and water served as a positive and a negative control, respectively. Dentin mineral loss was quantified (TMR), microbial shifts within the microcosms were determined (qPCR), and the acidogenicity of the microcosms was assessed (CIA). From the compounds tested, the SF4 of shiitake showed strong inhibiting effect on dentin demineralization and induced microbial shifts that could be associated with oral health. The acid producing potential was increased, suggesting uncoupling of the glycolysis of the microbiota by the exposure to SF4. In conclusion, the results suggest that SF4 of shiitake has an anticariogenic potential.
Identifying a Global Optimizer with Filled Function for Nonlinear Integer Programming
Authors: Wang Wei-Xiang , Shang You-Lin , Zhang Lian-Sheng
Published: September 2011

This paper presents a filled function method for finding a global optimizer of integer programming problem. The method contains two phases: the local minimization phase and the filling phase. The goal of the former phase is to identify a local minimizer of the objective function, while the filling phase aims to search for a better initial point for the first phase with the aid of the filled function. A two‐parameter filled function is proposed, and its properties are investigated. A corresponding filled function algorithm is established. Numerical experiments on several test problems are performed, and preliminary computational results are reported.
A Scale Model of Tension Structures in Road Tunnels to Optimize the Use of Solar Light for Energy Saving
Authors: Peña-García Antonio , Gil-Martín Luisa-María , Escribano Roberto , Espín-Estrella Antonio
Published: September 2011

Shifting the threshold zone of road tunnels with semitransparent tension structures has shown itself to be an effective way of saving energy in regards to electricity consumption, maintenance, and construction materials used in the electrical lighting, thus lessening negative environmental impacts. Even though the shape of the tension structure has a major influence on energy savings, the optimal type of structure for each tunnel is often difficult to determine, because experiments using real tunnels are extremely expensive. It is thus necessary to find methods of doing this that are both reliable as well as economical. In this research study, three candidate structures were set up at the portal of a scale model of a real tunnel. The energy savings in each case were analyzed and compared. As a result, it was possible to formulate a new equation that calculates the energy savings in the threshold zone.
Necrosis of the 4th and 5th Digits after Intra-Articular Injection of Diazepam into the Wrist
Authors: Iblher Niklas , Stark Gerd Bjoern , Penna Vincenzo
Published: September 2011

A 75-year-old woman presented with progressing pain, cyanosis, and hypaesthesia in her left hand after an intra-articular injection with diazepam into the wrist for osteoarthritis-related pain. Due to an iatrogenic intra-arterial injection, malperfusion of the ulnar digits developed. Angiography revealed blockage of perfusion of the 4th and 5th digits. Despite intra-arterial lysis, heparinisation, and vasodilatation, perfusion could not be reinstalled. Necrosis of the distal phalanges of the 4th and 5th digits developed, which had to be treated with amputation. The pathomechanism of tissue damage and the treatment options after intra-arterial injections are reviewed and discussed.
Computational Design of a DNA- and Fc-Binding Fusion Protein
Authors: Winkler Jonas , Armano Giuliano , Dybowski J. Nikolaj , Kuhn Oliver , Ledda Filippo , Heider Dominik
Published: September 2011

Computational design of novel proteins with well-defined functions is an ongoing topic in computational biology. In this work, we generated and optimized a new synthetic fusion protein using an evolutionary approach. The optimization was guided by directed evolution based on hydrophobicity scores, molecular weight, and secondary structure predictions. Several methods were used to refine the models built from the resulting sequences. We have successfully combined two unrelated naturally occurring binding sites, the immunoglobin Fc-binding site of the Z domain and the DNA-binding motif of MyoD bHLH, into a novel stable protein.
Context-Aware Scheduling of Distributed DL-Reasoning Tasks in Wireless Sensor Networks
Authors: Verstichel Stijn , Volckaert Bruno , Dhoedt Bart , Demeester Piet , De Turck Filip
Published: September 2011

Wireless sensor networks (WSNs) provide a means to acquire lots of raw data from vast amounts of easy-to-deploy sensors. Ontologies facilitate structuring data into information and support automatic inference mechanisms. The combination of wireless sensor networks and ontologies can bring significant added value to intelligently process the raw data into meaningful information. In an ontology-based system, this process is referred to as description logics (DL) reasoning. However, the sensors might not be able to execute the reasoning process locally because of resource constraints. Additionally, the usage of the radio interface consumes a lot of power. Therefore, a balance has to be found between local processing and transmission towards the more powerful nodes. In this paper, we present our collaboration platform to bring together wireless sensor networks and distributed ontology A-Box reasoning. This platform should support the adoption of ontology-based methodologies and DL-Reasoning in a distributed setting. We detail a number of algorithms to optimise both bandwidth utilisation and power consumption. These algorithms have been evaluated on a real-life wireless sensor and mesh network test bed, namely WiLab.t. The results show that significant savings of up to 92% in terms of bandwidth utilisation can result from our approach.
Online Implementation of Inequality Constraints Monitoring in Dynamical Systems
Authors: Zanzouri Nadia , Ben Messaoud Ramzi , Ksouri Mekki
Published: September 2011

This paper deals with fault detection in dynamical systems where the state variables evolutions are constrained by inequality constraints. The latter corresponds either to physical limitations or to safety specification. Two classical residual generation approaches are studied, namely, parity space and unknown input observer approaches, and are extended to monitor the inequality constraints. A practical implementation on a real process is performed and permits to validate the relevance of the proposed methods.
Presynaptic Ionotropic Receptors Controlling and Modulating the Rules for Spike Timing-Dependent Plasticity
Authors: Verhoog Matthijs B. , Mansvelder Huibert D.
Published: September 2011

Throughout life, activity-dependent changes in neuronal connection strength enable the brain to refine neural circuits and learn based on experience. In line with predictions made by Hebb, synapse strength can be modified depending on the millisecond timing of action potential firing (STDP). The sign of synaptic plasticity depends on the spike order of presynaptic and postsynaptic neurons. Ionotropic neurotransmitter receptors, such as NMDA receptors and nicotinic acetylcholine receptors, are intimately involved in setting the rules for synaptic strengthening and weakening. In addition, timing rules for STDP within synapses are not fixed. They can be altered by activation of ionotropic receptors located at, or close to, synapses. Here, we will highlight studies that uncovered how network actions control and modulate timing rules for STDP by activating presynaptic ionotropic receptors. Furthermore, we will discuss how interaction between different types of ionotropic receptors may create “timing” windows during which particular timing rules lead to synaptic changes.
Natural Convection of Nanofluids in a Square Enclosure with a Protruding Heater
Authors: Guiet J. , Reggio M. , Vasseur P.
Published: September 2011

This paper reports a numerical study on natural convection from a protruding heater located at the bottom of a square cavity filled with a copper-water nanofluid. The vertical walls of the cavity are cooled isothermally; the horizontal ones are adiabatic, and the heater is attached to the bottom wall. The heat source is assumed either to be isothermal or to have a constant heat flux. The effective viscosity and thermal conductivity of the nanofluid are modeled according to Brinkman and Patel, respectively. Numerical solutions of the full-governing equations, based on the lattice Boltzmann method, are obtained for a wide range of the governing parameters: the Rayleigh number, Ra; the Prandtl number, Pr; the geometrical parameters specifying the heater; the volume fraction of nanoparticles, Φ. For a particular geometry, it has been found that, for a given Ra, heat transfer is enhanced with increasing Φ, independently of the thermal boundary condition applied on the heater.
The Characteristics of Vascular Growth in VX2 Tumor Measured by MRI and Micro-CT
Authors: Qi X.-L. , Liu J. , Burns P. N. , Wright G. A.
Published: September 2011

Blood supply is crucial for rapid growth of a malignant tumor; medical imaging can play an important role in evaluating the vascular characterstics of tumors. Magnetic resonance imaging (MRI) and micro-computed tomography (CT) are able to detect tumors and measure blood volumes of microcirculation in tissue. In this study, we used MR imaging and micro-CT to assess the microcirculation in a VX2 tumor model in rabbits. MRI characterization was performed using the intravascular contrast agent Clariscan (NC100150-Injection); micro-CT with Microfil was used to directly depict blood vessels with diameters as low as 17 um in tissue. Relative blood volume fraction (rBVF) in the tumor rim and blood vessel density (rBVD) over the whole tumor was calculated using the two imaging methods. Our study indicates that rBVF is negatively related to the volume of the tumor measured by ultrasound (R=0.90). rBVF in the tissue of a VX2 tumor measured by MRIin vivowas qualitatively consistent with the rBVD demonstrated by micro-CTin vitro(R=0.97). The good correlation between the two methods indicates that MRI studies are potentially valuable for assessing characteristics or tumor vascularity and for assessing response to therapy noninvasively.
Cell-Cycle Regulator Cks1 Promotes Hepatocellular Carcinoma by Supporting NF-κB–Dependent Expression of Interleukin-8
Authors: Lee Eun-Kyoung , Kim Dae-Ghon , Kim Jang-Seong , Yoon Yeup
Published: September 2011

The cell-cycle regulator Cks1 has recently been implicated in Skp2-mediated ubiquitination of the tumor suppressor protein p27. In this article, we report that Cks1 exerts a Skp2-independent regulation of NF-κB that promotes interleukin-8 (IL-8) expression, which is critical to hepatocellular carcinoma (HCC) growth. Cks1 was upregulated frequently in human HCC tissues and cell lines. Cks1 knockdown in HCC cells elevated p27 levels and decreased tumorigenicity in a manner that was also associated with a strong downregulation of IL-8 expression. IL-8 downregulation was not phenocopied by either RNAi-mediated knockdown of Skp2 or ectopic overexpression of p27. However, attenuation of IL-8 expression itself was sufficient to blunt HCC growth. Mechanistic investigations revealed that IL-8 was controlled at a transcriptional level by Cks1 targeting of the NF-κB regulator IκBα, which led to NF-κB activation and IL-8 expression, through a p27-independent regulation of IκB kinase complex components. Collectively, our findings support the hypothesis that Cks1 supports hepatocarcinogenesis by NF-κB–mediated regulation of IL-8 expression, broadening the function of Cks1 in cancer beyond its role as a Skp2 cofactor in p27 ubiquitination. Cancer Res; 71(21); 6827–35. ©2011 AACR.
On the Road to Combinations of Targeted Therapies: PPM1H Phosphatase as a Suppressor of Trastuzumab Resistance
Authors: Aceto Nicola , Bentires-Alj Mohamed
Published: September 2011

Lee-Hoeflich and colleagues use RNA interference screening to identify the serine/threonine phosphatase PPM1H as an inhibitor of trastuzumab resistance in vitro. This finding extends the molecular portrait of trastuzumab-resistant cells and provides a rationale when searching for potential therapeutic targets among regulators of PPM1H and/or its substrates. Cancer Discovery; 1(4): 285–6. ©2011 AACR.

Commentary on Lee-Hoeflich et al., p. 326.
Ischemic Stroke Survivors’ Opinion Regarding Research Utilizing Exception from Informed Consent
Authors: Kleindorfer Dawn , Lindsell Christopher J. , Alwell Kathleen , Woo Daniel , Flaherty Matthew L. , Eilerman Jane , Khatri Pooja , Adeoye Opeolu , Ferioli Simona , Kissela Brett M.
Published: September 2011

Introduction: ‘Exception from informed consent for research’ (EFIC) is a rigorous procedure regulated by the FDA that requires community assent but allows enrollment without patient or family consent. Recently, several acute stroke trials have explored the use of EFIC to improve enrollment. We obtained ischemic stroke survivors’ opinions regarding hypothetical enrollment into a clinical trial at the time of their stroke without personal or proxy consent. Methods: During 2005, 460 ischemic stroke patients (or their proxy) who met case criteria were prospectively interviewed and followed. After 2 years, patients were asked to think back to the time of their stroke and indicate whether they would have wished to be enrolled in an acute stroke research study before individual or proxy consent could be obtained, understanding that consent would be sought as soon as possible thereafter, and they rated how agreeable they would have been to acute stroke research with different levels of invasiveness. Predictors of a positive opinion regarding the hypothetical research were analyzed using logistic regression. Variables included in the model were age, race, sex, education, initial NIHSS, modified Rankin Scale prior to stroke and 30 days after stroke, and proxy versus patient responder. Results: At 2 years after stroke, after excluding patient deaths, missing data or refusals, there were 194 patient/proxy responses included in this analysis. Overall, 72–79% of responses were favorable for chart review or blood draw without consent. The proportions answering agreeably to questions about medications or invasive strategies were smaller (62.9 and 59.8%). Older subjects were less likely to offer an agreeable response regarding use of medications [OR 0.97 per year (95% CI 0.94–0.99)] and invasive procedures [OR 0.97 per year (95% CI 0.94–0.99)]. Nonblacks tended to be more agreeable than blacks to invasive procedures. Men had twice the odds of being agreeable to blood draws than women. Conclusions: We found that the majority of interviewed ischemic stroke patients were agreeable to being enrolled in acute stroke research with exception from informed consent, although the rates of agreement were lower than we expected among a cohort of patients who had already agreed to research. Older subjects, black race, and women were less likely to agree to blood draws or treatment strategies.
Phase I Dose-Finding Study of Vandetanib in Combination with Gemcitabine in Locally Advanced Unresectable or Metastatic Pancreatic Adenocarcinoma
Authors: Saletti Piercarlo , Sessa Cristiana , De Dosso Sara , Cerny Thomas , Renggli Verena , Koeberle Dieter
Published: September 2011

Objectives: Vandetanib is an oral inhibitor of vascular endothelial growth factor receptor, epidermal growth factor receptor and RET (REarranged during Transfection) signaling. The primary objective of this open-label phase I trial was to determine the maximum tolerated dose (MTD) and recommended dose (RD) of vandetanib in combination with gemcitabine in patients with unresectable, locally advanced or metastatic pancreatic adenocarcinoma (PAC). Methods: Patients received vandetanib (100 or 300 mg/day) plus gemcitabine (1,000 mg/m2 i.v. on days 1, 8 and 15 per 28-day cycle) until disease progression, unacceptable toxicity or withdrawal of patient consent. The MTD was determined by the assessment of dose-limiting toxicity (DLT) during the first 28 days of treatment. Results: Fifteen patients were treated. No DLTs occurred in the first cohort of vandetanib 100 mg (n = 3) and recruitment continued at the 300-mg dose level. At the 300-mg dose, 3 out of 12 patients (including 2 in the expansion cohort) experienced DLTs (aphasia, elevated liver enzymes and neutropenia; all of them grade 3), thus exceeding the MTD. No objective responses were observed, with stable disease being the best response in 78% of evaluable patients. Conclusions: Vandetanib 100 mg/day is the RD in combination with gemcitabine in the treatment of patients with advanced PAC.