bluuebunny/crossref_metadata_2025 huggingface dataset:
A study of the throughflow of nucleating steam in a turbine stage by a time-marching method
Authors: Bakhtar F , Mohsin R
Published: May 2013

In the course of expansion in turbines, steam first supercools and then nucleates to become a two-phase mixture. The fluid then consists of a very large number of extremely small droplets which are carried by and interact with the parent vapour. The formation and subsequent behaviour of the liquid phase cause problems which lower the performance of the wet stages of steam turbines. To treat such flows the general conservation equations governing the whole field are combined with those describing droplet nucleation and growth and the set treated numerically. The article examines the solution of throughflows of nucleating steam in a turbine stage using a time-marching technique. The treatment which is the refinement of an earlier one has been applied to the flow in a turbine stage. Comparisons are presented between the results of theoretical solutions and direct measurements upstream and downstream of the nucleating stage and the agreement obtained is good.
Modeling high-speed angular contact ball bearing under the combined radial, axial and moment loads
Authors: Wang Wen-Zhong , Hu Lang , Zhang Sheng-Guang , Kong Ling-Jia
Published: May 2013

In this paper, a method based on coordinate equivalence was presented to investigate the characteristic parameters of angular contact ball bearing such as contact angle and contact force between ball and raceways subjected to the combined radial, axial and moment loads, with considering the effects of centrifugal force and gyroscopic moment in high-speed conditions. The radial, axial and angular displacements are solved based on Newton–Raphson method rather than as the known variables. The method simplifies the procedure involved in determining derivatives for Newton–Raphson method. The results show good agreement with existent model and can be used to analyze the bearing performance, especially for high-speed condition. It was also shown that the inertial loads resulting from the high-speed condition have significant effect on the contact angle and contact force between ball and raceways and have to be considered in the bearing design and performance analysis.
Negative perceptions about condom use in a clinic population: comparisons by gender, race and age
Authors: Crosby R , Shrier L A , Charnigo R , Sanders S A , Graham C A , Milhausen R , Yarber W L
Published: May 2013

We sought to elucidate the associations of 13 items assessing negative perceptions about condom use with gender, age and race in a sample of clinic attendees. Patients from four clinics, in three US cities, were recruited ( N = 928). Data were collected using audio-computer-assisted self-interviewing. The primary measure was a 13-item adapted version of the Condom Barriers Scale. Logistic regression and chi-square tests were employed to relate the 13 items to gender, age and race. Gender, race and age all had significant associations with negative perceptions of condoms and their use. A primary finding was a large number of significant differences between men and women, with negative perceptions more common among women than among men. For African Americans, especially women, negative perceptions were more common among older participants than among younger participants. In conclusion, important demographic differences regarding negative perceptions may inform the tailoring of intervention efforts that seek to rectify negative perceptions about condoms and thus promote condom use among individuals at risk for sexually transmitted infections (STIs) in the USA. On the other hand, our findings also suggest that the majority of STI clinic attendees may hold positive perceptions about condoms and their use; maintaining and building upon these positive perceptions via education, counselling, and access is also important.
Does increased hepatitis B vaccination dose lead to a better immune response in HIV-infected patients than standard dose vaccination: a meta-analysis?
Authors: Ni J D , Xiong Y Z , Wang X J , Xiu L C
Published: May 2013

Human immunodeficiency virus (HIV)-infected patients often fail to produce protective antibodies to hepatitis B virus (HBV) vaccine. Some reports have suggested that increased-dose vaccination improves immune response to HBV vaccine in HIV-infected patients. To assess the efficacy of increased-dose HBV vaccination in HIV-infected patients, a systematic review of the literature and meta-analysis of clinical trials was conducted. We only included trials that compared the response rate at completion of HBV vaccine schedules in patients who had increased-dose HBV vaccine courses with controls (standard-dose HBV vaccine vaccination schedule). The fixed-effects model, with heterogeneity and sensitivity analyses, was used in this study. We identified five studies involving 883 HIV-positive vaccine recipients. Pooling of study results showed a significant increase in response rates among high-dose patients versus control patients; the pooled odds ratio (OR) was 1.96 (95% confidence interval [CI]: 1.47; 2.61). Four out of five identified studies included only vaccine-naive patients. The overall OR was 1.82 (95% CI: 1.35–2.47). No study heterogeneity was found. Our meta-analysis showed that increasing the dosage of vaccine may significantly improve immune responses in HIV-infected patients.
Incidence of sexually transmitted infections in HIV-infected and HIV-uninfected adolescents in the USA
Authors: Mullins T L K , Rudy B J , Wilson C M , Sucharew H , Kahn J A
Published: May 2013

Little is known about the incidence of bacterial sexually transmitted infections (STIs) among HIV-infected versus HIV-uninfected adolescents. This secondary analysis of a national, multisite study included adolescents aged 12–18 years who were behaviourally HIV-infected ( n = 346) or HIV-uninfected but at-risk ( n = 182). Incidence rates of bacterial STIs (gonorrhoea, chlamydia [CT] and trichomonas [TV; women]) were calculated using Poisson modelling. Factors associated with incident STIs were explored using Cox proportional hazards modelling. HIV-infected versus HIV-uninfected women had higher TV incidence (1.3 versus 0.6/100 person-months; P = 0.002). HIV-uninfected versus HIV-infected women had higher CT incidence (1.6 versus 1.1/100 person-months; P = 0.04). Among women, demographic, behavioural and HIV-related factors were associated with incident STIs. Among men, there were no differences in incident STIs. In this first analysis comparing STI incidence between HIV-infected and HIV-uninfected adolescents, bacterial STI incidence among women significantly differed by HIV status, and factors associated with incident STIs varied by STI and HIV status.
An unexpected cause for aplastic anaemia in an elderly woman
Authors: Phua C K , Marimuthu K , Teo H Y , Ong K H , Leo Y S
Published: May 2013

Aplastic anaemia is a rare clinical syndrome associated with diminished or absent precursors in the bone marrow. Acquired aplastic anaemia secondary to human immunodeficiency virus (HIV) is very rare. We present a 71-year-old woman with severe aplastic anaemia secondary to HIV infection, which was after extensive exclusion of other causes. She achieved undetectable viral load after 5 months of combination antiretroviral therapy but remains profoundly pancytopenic, complicated by recurrent infectious and bleeding complications. HIV infection should be considered in patients with pancytopenia.
Narcissism, Materialism, and Environmental Ethics in Business Students
Authors: Bergman Jacqueline Z. , Westerman James W. , Bergman Shawn M. , Westerman Jennifer , Daly Joseph P.
Published: May 2013

We investigate the relationships between narcissism, materialism, and environmental ethics in undergraduate business students. Data were collected from business students ( n = 405) at an Association to Advance Collegiate Schools of Business–accredited business school at a comprehensive state university. Results indicate that narcissism has an indirect effect on business students’ environmental ethics. Narcissism was significantly related to materialism, and materialism was significantly related to lower levels of environmental ethics. Considering increasing levels of narcissism among business students, we discuss the potential for future research and potential intervention strategies.
A Pilot Test of Videoconferencing to Improve Access to a Stroke Risk-Reduction Programme for Veterans
Authors: Anderson Jane , Godwin Kyler M , Petersen Nancy J , Willson Pamela , Kent Thomas A
Published: May 2013

We conducted a pilot study to determine the feasibility of using videoconferencing for a programme of self-management to prevent stroke (V-STOP). A total of 37 Veterans with a history of stroke, or with multiple risk factors for stroke, were enrolled in the study from two rural sites. The V-STOP intervention consisted of 6 weekly sessions of self-management classes and clinic visits delivered via videoconferencing, with one or two individual telephone counselling sessions. Participants’ mean satisfaction scores were 4.7 out of 5, indicating very high approval of the programme. Attendance was 87%, almost twice as high as at an equivalent in-person programme. Access was improved as participants saved, on average, 160 km by travelling to a community centre instead of the main Veterans Administration facility. Stroke risk knowledge and self-management behaviours such as communication with healthcare providers significantly improved from baseline. Overall, videoconferencing is feasible for delivering self-management classes and clinic visits and the V-STOP programme shows promise as a method for delivery of self-management education and preventive care services to reduce stroke risk.
A Systematic Review of Telemedicine Services for Residents in Long Term Care Facilities
Authors: Edirippulige Sisira , Martin-Khan Melinda , Beattie Elizabeth , Smith Anthony C , Gray Leonard C
Published: May 2013

We conducted a systematic review of the literature on telemedicine use in long-term care facilities (LTCFs) and assessed the quality of the published evidence. A database search identified 22 papers which met the inclusion criteria. The quality of the studies was assessed and if they contained economic data, they were rated according to standard criteria. The clinical services provided by telemedicine included allied health (n = 5), dermatology (3), general practice (4), neurology (2), geriatrics (1), psychiatry (4) and multiple specialities (3). Most studies (17) employed real-time telemedicine using videoconferencing. The remaining five used store and forward telemedicine. The papers focused on economics (3), feasibility (9), stakeholder satisfaction (12), reliability (5) and service implementation (2). Overall, the quality of evidence for telemedicine in LTCFs was low. There was only one small randomised controlled trial (RCT). Most studies were observational and qualitative, and focused on utilisation. They were mainly based on surveys and interviews of stakeholders. A few studies evaluated the cost associated with implementing telemedicine services in LTCFs. The present review shows that there is evidence for feasibility and stakeholder satisfaction in using telemedicine in LTCFs in a number of clinical specialities.
Two conceptions of virtue
Authors: Hill Thomas E
Published: May 2013

The general questions are: what is virtue and how can it be cultivated? The specific focus is on the conceptions of virtue in the works of Immanuel Kant and John Rawls. Kant regarded virtue as a good will that is also strong enough to resist contrary passions, impulses, and inclinations. Childhood training can prepare children for virtue, but becoming virtuous requires an empirically inexplicable commitment and effort that is up to each individual. Rawls explains a sense of justice as a civic virtue that he conjectures will develop naturally, according to certain psychological laws, if the basic structure of society is just. Rawls’ reliance on empirical studies addresses questions left mysterious by Kant, but his theory faces problems of its own.
Body Mass Index, Immune Status, and Virological Control in HIV-Infected Men Who Have Sex with Men
Authors: Blashill Aaron J. , Mayer Kenneth H. , Crane Heidi M. , Grasso Chris , Safren Steven A.
Published: May 2013

Background and Aims:

Prior cross-sectional studies have found inconsistent relationships between body mass index (BMI) and disease progression in HIV-infected individuals.

Methods:

Cross-sectional and longitudinal analyses were conducted on data from a sample of 864 HIV-infected men who have sex with men (MSM) obtained from a large, nationally distributed HIV clinical cohort.

Results:

Of the 864 HIV-infected MSM, 394 (46%) were of normal weight, 363 (42%) were overweight, and 107 (12%) were obese at baseline. The baseline CD4 count was 493 (standard error [SE] = 9), with viral load (log10) = 2.4 (SE = .04), and 561 (65%) were virologically suppressed. Over time, controlling for viral load, highly active antiretroviral therapy (HAART) adherence, age, and race/ethnicity, overweight and obese HIV-infected men possessed higher CD4 counts than that of normal weight HIV-infected men. Further, overweight and obese men possessed lower viral loads than that of normal weight HIV-infected men.

Conclusions:

For HIV-infected MSM, in this longitudinal cohort study, possessing a heavier than normal BMI is longitudinally associated with improved immunological health.
Interrelationship of alcohol misuse, HIV sexual risk and HIV screening uptake among emergency department patients
Authors: Trillo Alexis D , Merchant Roland C , Baird Janette R , Ladd George T , Liu Tao , Nirenberg Ted D
Published: May 2013

Background

Emergency department (ED) patients comprise a high-risk population for alcohol misuse and sexual risk for HIV. In order to design future interventions to increase HIV screening uptake, we examined the interrelationship among alcohol misuse, sexual risk for HIV and HIV screening uptake among these patients.

Methods

A random sample of 18-64-year-old English- or Spanish-speaking patients at two EDs during July-August 2009 completed a self-administered questionnaire about their alcohol use using the Alcohol Use Questionnaire, the Alcohol Use Disorders Identification Test (AUDIT), and the HIV Sexual Risk Questionnaire. Study participants were offered a rapid HIV test after completing the questionnaires. Binging (≥ five drinks/occasion for men, ≥ four drinks for women) was assessed and sex-specific alcohol misuse severity levels (low-risk, harmful, hazardous, dependence) were calculated using AUDIT scores. Analyses were limited to participants who had sexual intercourse in the past 12 months. Multivariable logistic regression was used to assess the associations between HIV screening uptake and (1) alcohol misuse, (2) sexual risk for HIV, and (3) the intersection of HIV sexual risk and alcohol misuse. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were estimated. All models were adjusted for patient demographic characteristics and separate models for men and women were constructed.

Results

Of 524 participants (55.0% female), 58.4% identified as white, non-Hispanic, and 72% reported previous HIV testing. Approximately 75% of participants reported drinking alcohol within the past 30 days and 74.5% of men and 59.6% of women reported binge drinking. A relationship was found between reported sexual risk for HIV and alcohol use among men (AOR 3.31 [CI 1.51-7.24]) and women (AOR 2.78 [CI 1.48-5.23]). Women who reported binge drinking were more likely to have higher reported sexual risk for HIV (AOR 2.55 [CI 1.40-4.64]) compared to women who do not report binge drinking. HIV screening uptake was not higher among those with greater alcohol misuse and sexual risk among men or women.

Conclusions

The apparent disconnection between HIV screening uptake and alcohol misuse and sexual risk for HIV among ED patients in this study is concerning. Brief interventions emphasizing these associations should be evaluated to reduce alcohol misuse and sexual risk and increase the uptake of ED HIV screening.
Systematically reviewing and synthesizing evidence from conversation analytic and related discursive research to inform healthcare communication practice and policy: an illustrated guide
Authors: Parry Ruth H , Land Victoria
Published: May 2013

Background

Healthcare delivery is largely accomplished in and through conversations between people, and healthcare quality and effectiveness depend enormously upon the communication practices employed within these conversations. An important body of evidence about these practices has been generated by conversation analysis and related discourse analytic approaches, but there has been very little systematic reviewing of this evidence.

Methods

We developed an approach to reviewing evidence from conversation analytic and related discursive research through the following procedures:

• reviewing existing systematic review methods and our own prior experience of applying these

• clarifying distinctive features of conversation analytic and related discursive work which must be taken into account when reviewing

• holding discussions within a review advisory team that included members with expertise in healthcare research, conversation analytic research, and systematic reviewing

• attempting and then refining procedures through conducting an actual review which examined evidence about how people talk about difficult future issues including illness progression and dying

Results

We produced a step-by-step guide which we describe here in terms of eight stages, and which we illustrate from our ‘Review of Future Talk’. The guide incorporates both established procedures for systematic reviewing, and new techniques designed for working with conversation analytic evidence.

Conclusions

The guide is designed to inform systematic reviews of conversation analytic and related discursive evidence on specific domains and topics. Whilst we designed it for reviews that aim at informing healthcare practice and policy, it is flexible and could be used for reviews with other aims, for instance those aiming to underpin research programmes and projects. We advocate systematically reviewing conversation analytic and related discursive findings using this approach in order to translate them into a form that is credible and useful to healthcare practitioners, educators and policy-makers.
Potentially inappropriate medications used by the elderly: prevalence and risk factors in Brazilian care homes
Authors: Vieira de Lima Thaís Jaqueline , Garbin Cléa Adas Saliba , Garbin Artênio José Ísper , Sumida Dóris Hissako , Saliba Orlando
Published: May 2013

Background

The use of potentially inappropriate medications (PIM) among the elderly is a serious public health problem because it is intrinsically linked to increased morbidity and mortality, causing high costs to public health systems. This study’s objective was to verify the prevalence of and the factors associated with the use of PIMs by elderly Brazilians in institutional settings.

Methods

We performed a transversal study, by consulting the case files of elderly people living in Long Term Care for the Elderly (LTC) in towns in the State of São Paulo, Brazil, as well as structured interviews with the nurses responsible for them.

We identified PIMs using the list of recently updated Beers criteria developed by a group of specialists from the American Geriatrics Society (AGS), who reviewed the criteria based on studies with high scientific evidence levels. We defined the factors studied to evaluate the association with PIM use prior to the statistical analyses, which were the chi-square test and multiple logistic regression.

Results

Among the elderly who used drugs daily, 82.6% were taking at least one PIM, with antipsychotics (26.5%) and analgesics (15.1%) being the most commonly used. Out of all the medications used, 32.4% were PIMs, with 29.7% of these being PIMs that the elderly should avoid independent of their condition, 1.1% being inappropriate medication for older adults with certain illnesses or syndromes, and 1.6% being medications that older adults should use with caution. In the multivariate analysis, the factors associated with PIM use were: polypharmacy (p = 0.0187), cerebrovascular disease (p = 0.0036), psychiatric disorders (p < 0.0001) and dependency (p = 0.0404).

Conclusions

The results of this study showed a high prevalence of PIM use in institutionalized elderly Brazilian patients. and the associated factors were polypharmacy, psychiatric disorders, cerebrovascular diseases and dependency.
Emergence of 16S rRNA methylase-producing Acinetobacter baumannii and Pseudomonas aeruginosa isolates in hospitals in Vietnam
Authors: Tada Tatsuya , Miyoshi-Akiyama Tohru , Kato Yasuyuki , Ohmagari Norio , Takeshita Nozomi , Hung Nguyen Viet , Phuong Doan Mai , Thu Truong Anh , Binh Nguyen Gia , Anh Nguyen Quoc , Nga Tran Thi Thanh , Truong Pham Hong , Xuan Phan Thi , Thu Le Thi Anh , Son Nguyen Truong , Kirikae Teruo
Published: May 2013

Background

16S rRNA methylase-producing Gram-negative bacteria are highly resistant to all clinically important aminoglycosides. We analyzed clinical strains of 16S rRNA methylase-producing Acinetobactor baumannii and Pseudomonas aeruginosa obtained from clinical isolates in medical settings in Vietnam.

Methods

From 2008 to 2011, 101 clinical strains of A. baumannii and 15 of P. aeruginosa were isolated from patients in intensive care units (ICUs) in two medical settings in Vietnam. Antimicrobial susceptibilities were determined using the microdilution method and epidemiological analysis was performed by pulsed-field gel electrophoresis and MLST. Genes encoding the 16S rRNA methylases, OXAs and CTX-Ms were analyzed by PCR and sequence analysis.

Results

16S rRNA methylase-producing Gram-negative pathogens were detected in two hospitals in Vietnam. Of the 101 clinical isolates of A. baumannii and the 15 of P. aeruginosa isolated from two ICUs in these hospitals, 72 (71.3%) were highly resistant to amikacin, arbekacin and gentamicin, with MICs greater than 1,024 mg/L. The 16S rRNA methylases ArmA and RmtB were produced by 61 and 9 isolates of A. baumannii, respectively, and RmtB was produced by 2 isolates of P. aeruginosa. Moreover, 52 of the A. baumannii isolates producing 16S rRNA methylases harbored both blaOXA-23-like and blaOXA-51-like genes. Most A. baumannii isolates producing 16S rRNA methylase obtained in hospital A in Hanoi were ST91 and ST231, whereas most from hospital B in Ho Chi Minh City were ST136, ST195, and ST254.

The two P. aeruginosa isolates harboring rmtB showed different patterns on PFGE, one each corresponding to ST217 and ST313.

Conclusions

Gram-negative bacteria producing the 16S rRNA methylases ArmA and RmtB are emerging in medical settings in Vietnam. A. baumannii isolates in northern and southern regions of Vietnam may be of different lineages.
Hyaluronan fragments induce IFNβ via a novel TLR4-TRIF-TBK1-IRF3-dependent pathway
Authors: Black Katharine E , Collins Samuel L , Hagan Robert S , Hamblin Mark J , Chan-Li Yee , Hallowell Robert W , Powell Jonathan D , Horton Maureen R
Published: May 2013

Background

The extracellular matrix plays a critical role in insuring tissue integrity and water homeostasis. However, breakdown products of the extracellular matrix have emerged as endogenous danger signals, designed to rapidly activate the immune system against a potential pathogen breach. Type I interferons play a critical role in the immune response against viral infections. In the lungs, hylauronan (HA) exists as a high molecular weight, biologically inert extracellular matrix component that is critical for maintaining lung function. When lung tissue is injured, HA is broken down into lower molecular weight fragments that alert the immune system to the breach in tissue integrity by activating innate immune responses. HA fragments are known to induce inflammatory gene expression via TLR-MyD88-dependent pathways.

Methods

Primary peritoneal macrophages from C57BL/6 wild type, TLR4 null, TLR3 null, MyD88 null, and TRIF null mice as well as alveolar and peritoneal macrophage cell lines were stimulated with HA fragments and cytokine production was assessed by rt-PCR and ELISA. Western blot analysis for IRF3 was preformed on cell lysates from macrophages stimulate with HA fragments

Results

We demonstrate for the first time that IFNβ is induced in murine macrophages by HA fragments. We also show that HA fragments induce IFNβ using a novel pathway independent of MyD88 but dependent on TLR4 via TRIF and IRF-3.

Conclusions

Overall our findings reveal a novel signaling pathway by which hyaluronan can modulate inflammation and demonstrate the ability of hyaluronan fragments to induce the expression of type I interferons in response to tissue injury even in the absence of viral infection. This is independent of the pathway of the TLR2-MyD88 used by these matrix fragments to induce inflammatory chemokines. Thus, LMW HA may be modifying the inflammatory milieu simultaneously via several pathways.
Gene regulation by the act of long non-coding RNA transcription
Authors: Kornienko Aleksandra E , Guenzl Philipp M , Barlow Denise P , Pauler Florian M
Published: May 2013

Long non-protein-coding RNAs (lncRNAs) are proposed to be the largest transcript class in the mouse and human transcriptomes. Two important questions are whether all lncRNAs are functional and how they could exert a function. Several lncRNAs have been shown to function through their product, but this is not the only possible mode of action. In this review we focus on a role for the process of lncRNA transcription, independent of the lncRNA product, in regulating protein-coding-gene activity in cis. We discuss examples where lncRNA transcription leads to gene silencing or activation, and describe strategies to determine if the lncRNA product or its transcription causes the regulatory effect.
LEDGINs inhibit late stage HIV-1 replication by modulating integrase multimerization in the virions
Authors: Desimmie Belete Ayele , Schrijvers Rik , Demeulemeester Jonas , Borrenberghs Doortje , Weydert Caroline , Thys Wannes , Vets Sofie , Van Remoortel Barbara , Hofkens Johan , De Rijck Jan , Hendrix Jelle , Bannert Norbert , Gijsbers Rik , Christ Frauke , Debyser Zeger
Published: May 2013

Background

LEDGINs are novel allosteric HIV integrase (IN) inhibitors that target the lens epithelium-derived growth factor (LEDGF)/p75 binding pocket of IN. They block HIV-1 integration by abrogating the interaction between LEDGF/p75 and IN as well as by allosterically inhibiting the catalytic activity of IN.

Results

Here we demonstrate that LEDGINs reduce the replication capacity of HIV particles produced in their presence. We systematically studied the molecular basis of this late effect of LEDGINs and demonstrate that HIV virions produced in their presence display a severe replication defect. Both the late effect and the previously described, early effect on integration contribute to LEDGIN antiviral activity as shown by time-of-addition, qPCR and infectivity assays. The late effect phenotype requires binding of LEDGINs to integrase without influencing proteolytic cleavage or production of viral particles. LEDGINs augment IN multimerization during virion assembly or in the released viral particles and severely hamper the infectivity of progeny virions. About 70% of the particles produced in LEDGIN-treated cells do not form a core or display aberrant empty cores with a mislocalized electron-dense ribonucleoprotein. The LEDGIN-treated virus displays defective reverse transcription and nuclear import steps in the target cells. The LEDGIN effect is possibly exerted at the level of the Pol precursor polyprotein.

Conclusion

Our results suggest that LEDGINs modulate IN multimerization in progeny virions and impair the formation of regular cores during the maturation step, resulting in a decreased infectivity of the viral particles in the target cells. LEDGINs thus profile as unique antivirals with combined early (integration) and late (IN assembly) effects on the HIV replication cycle.
See it with my eyes: artificial stream research communicated by an artist
Authors: Rinn Anne , Kivelitz Christoph , Berghahn Rüdiger
Published: May 2013

Artist Anne Rinn takes the reader on an excursion to an indoor and outdoor artificial pond and stream mesocosm system. This device was constructed and put into operation in 2001 in order to carry out scientific investigations concerning the aquatic environment, with the main focus on fate and effects of pollutants. Both technical features of the facility and the work and ideas for scientists and technicians were translated by her into an art exhibition which also included a film. This report on the project consists of two different text parts, one by the third author, who is an aquatic toxicologist, and one by the second author, an art historian. Their different backgrounds are reflected in different thinking and styles of expression. The text is rounded off by the photos of the first author, the artist.
Early alterations of B cells in patients with septic shock
Authors: Monserrat Jorge , de Pablo Raul , Diaz-Martín David , Rodríguez-Zapata Manuel , de la Hera Antonio , Prieto Alfredo , Alvarez-Mon Melchor
Published: May 2013

Introduction

It has recently been proposed that B lymphocytes are involved in sepsis pathogenesis. The goal of this study is to investigate potential abnormalities in a subset distribution and activation of circulating B lymphocytes in patients with septic shock.

Methods

This observational prospective study was conducted in a medical-surgical ICU. All patients with septic shock were eligible for inclusion. B-cell phenotypes (CD19+CD69+, CD19+CD23+, CD19+CD5+, CD19+CD80, CD19+CD86+, CD19+CD40 and CD19+CD95+) were assessed by quantitative flow cytometry upon admission to the ICU and 3, 7, 14 and 28 d later.

Results

Fifty-two patients were included. Thirty-six healthy volunteers matched for age and sex were used as controls. The patients had lymphopenia that was maintained during 28 d of follow-up. In patients with septic shock who died, the percentage of CD19+CD23+ was lower during the 7 d of follow-up than it was in survival patients. Moreover, the percentage of CD80+ and CD95+ expression on B cells was higher in patients who died than in survivors. Receiver operating characteristic curve analysis showed that a CD19+CD23+ value of 64.6% at ICU admission enabled discrimination between survivors and nonsurvivors with a sensitivity of 90.9% and a specificity of 80.0% (P = 0.0001).

Conclusions

Patients with septic shock who survive and those who don't have different patterns of abnormalities in circulating B lymphocytes. At ICU admission, a low percentage of CD23+ and a high of CD80+ and CD95+ on B cells were associated with increased mortality of patients with septic shock. Moreover, a drop in circulating B cells persisted during 28 d of ICU follow-up.
Anion-controlled Aggregation of a Porphyrin at Solid–Liquid Interfaces: A Distinguished Effect of Different Aggregates in Dye-sensitized Solar Cells
Authors: Arai Yonbon , Segawa Hiroshi
Published: May 2013

Simultaneous formation of H- and J-type aggregates of meso-tetrakis(4-sulfonatophenyl)porphyrin diacid at the interfaces of nanocrystalline TiO2–electrolytes and the remarkable compositional change of the aggregates by varying the electrolyte anion are demonstrated. Dye-sensitized solar cell studies demonstrate much higher photon-to-electron conversion efficiency of the J-type aggregate than the H-type aggregate and substantially different performance depending on the type of electrolyte anion.
Structural Analysis of a Polymeric Micelle Made from AB3-type Multiarmed Star-like Block Copolymer in an Aqueous Solution
Authors: Sanada Yusuke , Sakamoto Shunsuke , Akiba Isamu , Takaki Toshihiko , Sakurai Kazuo
Published: May 2013

To clarify the micellar structure of the AB3-type polyethylene (A)–poly(ethylene glycol) (B) block copolymer, small-angle X-ray scattering and light scattering coupled with field flow fractionation were carried out. The micelle did not take the spherical form that has been observed for most polymeric micelles. The best model to fit the SAXS data was a cubic core model, presumably, relating to that the core consists of the crystallite of PE.
Preparation of Trifluorovinyl Compounds by Lithium Salt-promoted Monoalkylation of Tetrafluoroethene
Authors: Ohashi Masato , Kamura Ryohei , Doi Ryohei , Ogoshi Sensuke
Published: May 2013

Treatment of tetrafluoroethene (TFE) with diethylzinc in the presence of lithium iodide gave 1,1,2-trifluoro-1-butene in moderate yield. In the absence of lithium iodide, however, the nucleophilic addition of diethylzinc to TFE proceeded very slowly to afford ethyl 1,1,2,2-tetrafluorobutylzinc. The addition of lithium iodide to a solution of ethyl-1,1,2,2-tetrafluorobutylzinc resulted in a smooth transformation into 1,1,2-trifluoro-1-butene. In the presence of lithium chloride, the reaction of TFE with benzyl or allyl Grignard reagents afforded the corresponding monosubstituted products in good to excellent yields.
Nickel-catalyzed [2 + 2] Cycloaddition Reaction of Bulky Enones with Simple Alkynes. The Effect of Bulkiness of Substituent Attached at β-Carbon
Authors: Abulimiti Abudoukadeer , Nishimura Akira , Ohashi Masato , Ogoshi Sensuke
Published: May 2013

In the presence of a catalytic amount of [Ni(cod)2] and PCy3, the [2 + 2] cycloaddition of enones bearing a bulky substituent group at the β-position with simple alkynes occurs to give cyclobutenes. The bulky group at the β-position can suppress the insertion of either an enone to give a cyclohexene or an alkyne to give a cyclohexadiene.
Facile One-pot Synthesis of Naphthoquinone–1,3-Dithioles via 2,3-Dichloro-1,4-naphthoquinone and Amines Involving CS2
Authors: Huang Huanming , Han Jing , Xu Fang , Li Yujin , Dong Huaqing , Yu Wubin , Gao Jianrong
Published: May 2013

An efficient, simple, and facile one-pot approach of synthesizing naphthoquinone–1,3-dithioles via 2,3-dichloro-1,4-naphthoquinone and amines involving CS2 was investigated. Both amino acid esters and aliphatic primary amines were applicable to this reaction and gave the corresponding heterocycles in good yields through the two-step sulfur-attack process.
Outcomes and complications of total hip replacement in super-obese patients
Authors: Rajgopal R. , Martin R. , Howard J. L. , Somerville L. , MacDonald S. J. , Bourne R.
Published: May 2013

The purpose of this study was to examine the complications and outcomes of total hip replacement (THR) in super-obese patients (body mass index (BMI) > 50 kg/m2) compared with class I obese (BMI 30 to 34.9 kg/m2) and normal-weight patients (BMI 18.5 to 24.9 kg/m2), as defined by the World Health Organization.

A total of 39 THRs were performed in 30 super-obese patients with a mean age of 53 years (31 to 72), who were followed for a mean of 4.2 years (2.0 to 11.7). This group was matched with two cohorts of normal-weight and class I obese patients, each comprising 39 THRs in 39 patients. Statistical analysis was performed to determine differences among these groups with respect to complications and satisfaction based on the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index, the Harris hip score (HHS) and the Short-Form (SF)-12 questionnaire.

Super-obese patients experienced significantly longer hospital stays and higher rates of major complications and readmissions than normal-weight and class I obese patients. Although super-obese patients demonstrated reduced pre-operative and post-operative satisfaction scores, there was no significant difference in improvement, or change in the score, with respect to HHS or the WOMAC osteoarthritis index.

Super-obese patients obtain similar satisfaction outcomes as class I obese and normal-weight patients with respect to improvement in their scores. However, they experience a significant increase in length of hospital stay and major complication and readmission rates.

Cite this article: Bone Joint J 2013;95-B:758–63.
Apixaban
Authors: Cada Dennis J. , Levien Terri L. , Baker Danial E.
Published: May 2013

Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are sent in print and are also available on-line. Monographs can be customized to meet the needs of a facility. A drug class review is now published monthly with The Formulary Monograph Service. Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. For more information about The Formulary Monograph Service, call The Formulary at 800-322-4349. The June 2013 monograph topics are dimethyl fumarate (BG-12) delayed-release capsules, canagliflozin, ospemifene, aripiprazole extended-release injectable, and dabrafenib. The DUE/MUE is on dimethyl fumarate.
Recommendations for Smooth Career Transitions in Pharmacy Leadership
Authors: Mebel Elaine R. , Ortega Melissa , Massey Lindsay R. , Martin Kelly , Martin Christina , Mark Scott
Published: May 2013

The Director's Forum is designed to guide pharmacy leaders in establishing patient-centered services in hospitals and health systems. This article focuses on the process of preparing leaders for future career transitions. Both new and seasoned leaders are confronted with the tasks of overcoming environmental issues, ensuring alignment in all directions during the first 90 days, and implementing change. By gaining a thorough understanding of the expectations during the transition phase, the new pharmacy leader will ensure future successes that maximize department initiatives and support the rapidly changing health care environment.
Could you use a Multidisciplinary Care Team App?
Authors: Felkey Bill G. , Fox Brent I.
Published: May 2013

Information technology generally serves 1 of 2 purposes: to replace tedious tasks or to extend the capabilities of the user. In health care, we are fortunate to have numerous opportunities to extend our capabilities. In this article, we explore how mobile and Web-based technologies can address the growing need to collaborate with all those concerned in care provision.
Aspherical plastic lens injection molding warpage and opto-mechanical analysis
Authors: Hsu Ming-Ying , Chang Shenq-Tsong , Huang Ting-Ming
Published: May 2013

The aspherical plastic lens is commonly used in commercial optical products. The injection molding process introduces warpage and stress residue into the aspherical plastic lens. Mold flow software is generally used in injection molding simulation and successfully predicts molding warpage results. This paper attempts to link mold flow and optical design software by opto-mechanical analysis. The lens surface warpage can apply the Zernike polynomial and transform it to the optical aberration. Meanwhile, the injection molding process and the operation parameters also affect the plastic lens warpage value. Thus, according to optical software, the injection molding process parameters will affect lens optical performance. The plastic lens aberration results can evaluate the lens warpage effect and optimize the injection molding process parameters. Further, by reversing lens warpage aberration in the plastic lens model, it can preliminarily compensate for the warpage error in the lens design process.
Transparent Restrictions on Beliefs and Forward-Induction Reasoning in Games with Asymmetric Information
Authors: Battigalli Pierpaolo , Prestipino Andrea
Published: May 2013

Abstract: We analyze forward-induction reasoning in games with asymmetric information assuming some commonly understood restrictions on beliefs. Specifically, we assume that some given restrictions Δ on players’ initial or conditional first-order beliefs are transparent, that is, not only do the restrictions Δ hold but there is also common belief in Δ at every node. Most applied models of asymmetric information are covered as special cases whereby Δ pins down the probabilities initially assigned to states of nature. But the abstract analysis also allows for transparent restrictions on beliefs about behavior, e.g. independence restrictions or restrictions induced by the context behind the game. Our contribution is twofold. First, we use dynamic interactive epistemology to formalize assumptions that capture foward-induction reasoning given the transparency of Δ, and show that the behavioral implications of these assumptions are characterized by the Δ-rationalizability solution procedure of Battigalli (1999, 2003). Second, we study the differences and similarities between this solution concept and a simpler solution procedure put forward by Battigalli and Siniscalchi (2003). We show that the two procedures are equivalent if Δ is “closed under compositions” a property that holds in all the applications considered by Battigalli and Siniscalchi (2003). We also show that when Δ is not closed under compositions, the simpler solution procedure of Battigalli and Siniscalchi (2003) may fail to characterize the behavioral implications of forward-induction reasoning.
Glycogen phosphorylase isoenzyme BB plasma kinetics is not related to myocardial ischemia induced by exercise stress echo test
Authors: Dobric Milan , Giga Vojislav , Beleslin Branko , Ignjatovic Svetlana , Paunovic Ivana , Stepanovic Jelena , Djordjevic-Dikic Ana , Kostic Jelena , Nedeljkovic Ivana , Nedeljkovic Milan , Tesic Milorad , Dajak Marijana , Ostojic Miodrag
Published: May 2013

Background: Glycogen phosphorylase BB (GPBB) is released from cardiac cells during myocyte damage. Previous studies have shown contradictory results regarding the relation of enzyme release and reversible myocardial ischemia. The aim of this study was to determine the plasma kinetics of GPBB as a response to the exercise stress echocardiographic test (ESET), and to define the relationship between myocardial ischemia and enzyme plasma concentrations.

Methods: We studied 46 consecutive patients undergoing ESET, with recent coronary angiography. In all patients, a submaximal stress echo test according to Bruce protocol was performed. Concentration of GPBB was measured in peripheral blood that was sampled 5 min before and 10, 30 and 60 min after ESET.

Results: There was significant increase of GPBB concentration after the test (p=0.021). Significant increase was detected 30 min (34.9% increase, p=0.021) and 60 min (34.5% increase, p=0.016) after ESET. There was no significant effect of myocardial ischemia on GPBB concentrations (p=0.126), and no significant interaction between sampling intervals and myocardial ischemia, suggesting a similar release profile of GPBB in ischemic and non-ischemic conditions (p=0.558). Patients in whom ESET was terminated later (stages 4 or 5 of standard Bruce protocol; n=13) had higher GPBB concentrations than patients who terminated ESET earlier (stages 1, 2 or 3; n=33) (p=0.049). Baseline GPBB concentration was not correlated to any of the patients’ demographic, clinical and hemodynamic characteristics.

Conclusions: GPBB plasma concentration increases after ESET, and it is not related to inducible myocardial ischemia. However, it seems that GPBB release during ESET might be related to exercise load/duration.
Rigidity and stability of Einstein metrics for quadratic
curvature functionals
Authors: Gursky Matthew J. , Viaclovsky Jeff A.
Published: May 2013

We investigate rigidity and stability properties
of critical points of quadratic curvature functionals
on the space of Riemannian metrics. We show it is possible to “gauge” the
Euler–Lagrange equations, in a self-adjoint fashion,
to become elliptic. Fredholm theory may then be used to describe
local properties of the moduli space of critical metrics. We show a number
of compact examples are infinitesimally rigid, and
consequently, are isolated critical points in the space of
unit-volume Riemannian metrics.
We then give examples of critical metrics which are strict local
minimizers (up to diffeomorphism and scaling).
A corollary is a local “reverse Bishop's inequality”
for such metrics. In particular,
any metric g in a C
2,α-neighborhood of
the round metric (Sn
,gS
) satisfying
Ric(g) ≤ Ric(gS
) has volume
Vol(g) ≥ Vol(gS
), with equality holding if and
only if g is isometric to gS
.
Mori dream spaces of Calabi–Yau type and
log canonicity of Cox rings
Authors: Kawamata Yujiro , Okawa Shinnosuke
Published: May 2013

We prove that a Mori dream space over a field of characteristic zero is of Calabi–Yau type
if and only if its Cox ring has at worst log canonical singularities.
By slightly modifying the arguments we also reprove the characterization of
varieties of Fano type by log terminality of their Cox rings.
Simple and efficient synthesis of substituted pyrimido[2,1-b][1,3]thiazines
Authors: Vartale Sambhaji P. , Sirsat Shivraj B. , Halikar Nilesh K.
Published: May 2013

Simple and efficient synthesis of a novel fused bicyclic heterocyclic compound 3 by the reaction of ethyl 2-cyano-3,3-bis(methylthio)acrylate and thiourea in the presence of potassium carbonate in dimethylformamide under reflux conditions is reported. The optimized molar ratio of the substrates is 2:1. The parent compound was used for further derivatization by using a synthetic strategy that is based on suitability of the substituted pyrimido[2,1-b][1,3]thiazine system to react as a bis-electrophilic species with various nucleophiles. Products 4a–e and 5a–e were obtained in good yields (65–76%).
Production of Silicon from SiH4 in a Fluidized Bed, Operation and Results
Authors: Filtvedt Werner O. , Mongstad Trygve , Holt Arve , Melaaen Morten , Klette Hallgeir
Published: May 2013

Abstract: For an installed silicon-based solar cell panel, about 40% of the energy needed for fabrication is consumed for production of the silicon feedstock. Reducing the energy consumption in this step is therefore crucial in order to minimize the energy payback time and cost of the technology. The most promising alternative to the conventional methods is to use fluidized bed reactors. In this article, we report the results from a novel reactor layout with a selectively cooled distribution arrangement. Important aspects of fludized bed monitoring and operation are described. Two different operation regimes are stated yielding hence porous and dense growth. Further, the method of encapsulating fines by means of more dense depositions is verified, and the nature of the scavenged material is characterized. Also, two different types of fines formation are identified and accounted for.
Optimization of l-Asparaginase Production by Isolated Aspergillus niger C4 from Sesame (black) Oil Cake under SSF using Box–Behnken Design in Column Bioreactor
Authors: Uppuluri Kiran Babu , V. R. Dasari Ravi Kumar , Sajja Vinod , Jacob Annie Shanan , Sri Rami Reddy D.
Published: May 2013

l-Asparaginase production was investigated in the isolated Aspergillus niger C4 on sesame (black) oil cake using solid state fermentation in a column bioreactor. The main objective of the present study is optimizing the environmental conditions for l-Asparaginase production in a column bioreactor. In order to determine the effect of process variables on the yield of l-Asparaginase, by the way of response surface methodology, an experimental plan (Box–Behnken design) involving a design matrix of 15 trails was sketched. The design results were fitted with response surfaces. Empirical quadratic equations were fitted to the experimental data (BBD) relevant to the yields of l-Asparaginase, with three chosen variables (aeration, bed thickness and temperature). The statistical analysis revealed a maximum l-Asparaginase yield of 310 U/gds at the points where aeration, bed thickness and temperature were 0.44 vvm, 17.35 cm and 29.31°C, respectively.