bluuebunny/crossref_metadata_2025 huggingface dataset:
Contemporary Risk Estimates of Three HbA1c Variables for Myocardial Infarction in 101,799 Patients Following Diagnosis of Type 2 Diabetes
Authors: Olsson Marita , Schnecke Volker , Cabrera Claudia , Skrtic Stanko , Lind Marcus
Published: May 2015

OBJECTIVE

This study evaluated the risk of myocardial infarction (MI) by impaired glycemic control in a contemporary large cohort of patients with type 2 diabetes followed from diagnosis.

RESEARCH DESIGN AND METHODS

Patients with type 2 diabetes diagnosed between 1995 and 2011 were retrieved from the Clinical Practice Research Datalink in the U.K., and followed from diagnosis until event of MI or end of study in 2013. Two subcohorts were defined: an early cohort with those diagnosed from 1997 to 2004 and a recent cohort with those diagnosed from 2004 to 2011. Association between each of three HbA1c metrics and MI was estimated using adjusted proportional hazards models.

RESULTS

In the overall cohort (n = 101,799), the risk increase for MI per 1% (10 mmol/mol) increase in HbA1c was higher for updated latest and updated mean HbA1c of 1.11 (95% CI 1.09–1.13) and 1.15 (1.13–1.18) than for baseline HbA1c of 1.05 (1.03–1.06). In the early subcohort, the corresponding risk estimates were greater than those in the recent subcohort. When categorized, the updated latest variable showed an increased risk for HbA1c <6% (42 mmol/mol), relative category 6–7%, in the recent but not in the early subcohort, with hazard ratios of 1.23 (1.08–1.40) and 1.01 (0.84–1.22), respectively.

CONCLUSIONS

The two time-updated HbA1c variables show a stronger relation with MI than baseline HbA1c. The risk association between HbA1c and MI has decreased over time. In recently diagnosed patients with type 2 diabetes, an increased risk of MI exists at a current HbA1c of <6.0% (42 mmol/mol).
Impact of Physical Activity on Glycemic Control and Prevalence of Cardiovascular Risk Factors in Adults With Type 1 Diabetes: A Cross-sectional Multicenter Study of 18,028 Patients
Authors: Bohn Barbara , Herbst Antje , Pfeifer Martin , Krakow Dietmar , Zimny Stefan , Kopp Florian , Melmer Andreas , Steinacker Jürgen M. , Holl Reinhard W.
Published: May 2015

OBJECTIVE

Physical activity (PA) can improve cardiovascular risk in the general population and in patients with type 2 diabetes. Studies also indicate an HbA1c-lowering effect in patients with type 2 diabetes. Since reports in patients with type 1 diabetes are scarce, this analysis aimed to investigate whether there is an association between PA and glycemic control or cardiovascular risk in subjects with type 1 diabetes.

RESEARCH DESIGN AND METHODS

A total of 18,028 adults (≥18 to <80 years of age) from Germany and Austria with type 1 diabetes from the Diabetes-Patienten-Verlaufsdokumentation (DPV) database were included. Patients were stratified according to their self-reported frequency of PA (PA0, inactive; PA1, one to two times per week; PA2, more than two times per week). Multivariable regression models were applied for glycemic control, diabetes-related comorbidities, and cardiovascular risk factors. Data were adjusted for sex, age, and diabetes duration. P values for trend were given. SAS 9.4 was used for statistical analysis.

RESULTS

An inverse association between PA and HbA1c, diabetic ketoacidosis, BMI, dyslipidemia (all P < 0.0001), and hypertension (P = 0.0150), as well as between PA and retinopathy or microalbuminuria (both P < 0.0001), was present. Severe hypoglycemia (assistance required) did not differ in PA groups (P = 0.8989), whereas severe hypoglycemia with coma was inversely associated with PA (P < 0.0001).

CONCLUSIONS

PA seemed to be beneficial with respect to glycemic control, diabetes-related comorbidities, and cardiovascular risk factors without an increase of adverse events. Hence, our data underscore the recommendation for subjects with type 1 diabetes to perform regular PA.
Clinical prediction model for acute inpatient complications after traumatic cervical spinal cord injury: a subanalysis from the Surgical Timing in Acute Spinal Cord Injury Study
Authors: Wilson Jefferson R. , Arnold Paul M. , Singh Anoushka , Kalsi-Ryan Sukhvinder , Fehlings Michael G.
Published: May 2015

Object

While the majority of existing reports focus on complications sustained during the chronic stages after traumatic spinal cord injury (SCI), the objective in the current study was to characterize and quantify acute inpatient complications. In addition, the authors sought to create a prediction model using clinical variables documented at hospital admission to predict acute complication development.

Methods

Analyses were based on data from the Surgical Timing in Acute Spinal Cord Injury Study (STASCIS) data registry, which contains prospective information on adult patients with cervical SCIs who were enrolled at 6 North American centers over a 7-year period. All patients who underwent a standardized American Spinal Injury Association (ASIA) neurological examination within 24 hours of injury and whose follow-up information was available at the acute hospital discharge were included in the study. For purposes of classification, complications were divided into 5 major categories: 1) cardiopulmonary, 2) surgical, 3) thrombotic, 4) infectious, and 5) decubitus ulcer development. Univariate statistical analyses were performed to determine the relationship between complication occurrence and individual demographic, injury, and treatment variables. Multivariate logistic regression was subsequently performed to create a complication prediction model. Model discrimination was judged according to the area under the receiver operating characteristic curve.

Results

Complete complication information was available for 411 patients at the acute care discharge. One hundred sixty patients (38.9%) experienced 240 complications. The mean age among those who experienced at least one complication was 45.9 years, as compared with 43.5 years among those who did not have a complication (p = 0.18). In the univariate analysis, patients with complications were less likely to receive steroids at admission (p = 0.01), had a greater severity of neurological injury as indicated by the ASIA Impairment Scale (AIS) grade at presentation (p < 0.01), and a higher frequency of significant comorbidity (p = 0.04). In a multivariate logistic regression model, a severe initial AIS grade (p < 0.01), a high-energy injury mechanism (p = 0.07), an older age (p = 0.05), the absence of steroid administration (p = 0.02), and the presence of comorbid illness (p = 0.02) were associated with a greater likelihood of complication development during the period of acute hospitalization. The area under the curve value for the full model was 0.75, indicating acceptable predictive discrimination.

Conclusions

These results will help clinicians to identify patients with cervical SCIs at greatest risk for complication development and thus allowing for the institution of aggressive complication prevention measures.
North American Clinical Trials Network for the Treatment of Spinal Cord Injury: goals and progress
Authors: Grossman Robert G. , Toups Elizabeth G. , Frankowski Ralph F. , Burau Keith D. , Howley Susan
Published: May 2015

The North American Clinical Trials Network (NACTN) for the Treatment of Spinal Cord Injury is a consortium of 10 neurosurgery departments, a data management center, and a pharmacological center. The NACTN was established with the goal of bringing recent molecular and cell-based discoveries in neuroprotection and regeneration from the laboratory into clinical trials that optimize meaningful data outcomes and maximum safety to patients. The requirements of planning and executing clinical trials in spinal cord injury (SCI) and the steps that the NACTN has taken to address these requirements are discussed and illustrated in articles in this issue of the Journal of Neurosurgery: Spine. The progress that the NACTN has made in meeting these goals can be summarized as organizing a network of hospitals capable of enrolling a sufficient number of patients for conducting Phase I and II trials; creating a Data Management Center and a database of the natural history of recovery after SCI (at the time of this writing 485 patients were enrolled in the database); creating a database of the incidence and severity of complications that occur during acute and subacute treatment after SCI; developing a Pharmacological Center capable of performing pharmacokinetic and pharmacodynamic studies of therapeutic drugs; completing enrollment of 36 patients in NACTN's first clinical trial, a Phase I study of riluzole, a neuroprotective drug; and performing pharmacokinetic and pharmacodynamic studies of riluzole in acute SCI.
Incidence and severity of acute complications after spinal cord injury
Authors: Grossman Robert G. , Frankowski Ralph F. , Burau Keith D. , Toups Elizabeth G. , Crommett John W. , Johnson Michele M. , Fehlings Michael G. , Tator Charles H. , Shaffrey Christopher I. , Harkema Susan J. , Hodes Jonathan E. , Aarabi Bizhan , Rosner Michael K. , Guest James D. , Harrop James S.
Published: May 2015

Object

The aim of this multicenter, prospective study was to determine the spectrum, incidence, and severity of complications during the initial hospitalization of patients with spinal cord injury.

Methods

The study was conducted at 9 university-affiliated hospitals that comprise the clinical centers of the North American Clinical Trials Network (NACTN) for Treatment of Spinal Cord Injury. The study population comprised 315 patients admitted to NACTN clinical centers between June 25, 2005, and November 2, 2010, who had American Spinal Injury Association (ASIA) Impairment Scale grades of A–D and were 18 years of age or older. Patients were managed according to a standardized protocol.

Results

The study population was 79% male with a median age of 44 years. The leading causes of injury were falls (37%) and motor vehicle accidents (28%). The distribution of initial ASIA grades were A (40%), B (16%), C (15%), and D (29%). Fifty-eight percent of patients sustained 1 or more severe, moderate, or mild complications. Complications were associated with more severe ASIA grade: 84% of patients with Grade A and 25% of patients with Grade D had at least 1 complication. Seventy-eight percent of complications occurred within 14 days of injury. The most frequent types of severe and moderate complications were respiratory failure, pneumonia, pleural effusion, anemia, cardiac dysrhythmia, and severe bradycardia. The mortality rate was 3.5% and was associated with increased age and preexisting morbidity.

Conclusions

Knowledge of the type, frequency, time of occurrence, and severity of specific complications that occur after spinal cord injury can aid in their early detection, treatment, and prevention. The data are of importance in evaluating and selecting therapy for clinical trials.
Quality of life in persons with spinal cord injury: comparisons with other populations
Authors: Boakye Maxwell , Leigh Barbara C. , Skelly Andrea C.
Published: May 2015

Object

The aim of this study was to identify the quality of life (QOL) measures commonly used to assess patients with spinal cord injury (SCI) and to summarize studies using common QOL measures that have been validated in SCI populations to compare scores in persons with SCI with those in a control population.

Methods

A systematic search of PubMed was conducted to identify studies using common QOL measures in persons with SCI and those comparing scores for QOL measures in an SCI population with scores in other populations. The authors sought comparative studies utilizing QOL measures for which validity and reliability analyses had been done.

Results

Of 28 QOL measures found, validity and reliability studies had been conducted in patients with SCI for 5 measures. Twelve comparative studies compared QOL in SCI patients with QOL in healthy controls or in patients with other disabilities, or with normative data. The 36-Item Short Form Health Survey (SF-36) and the short version of the WHOQOL (WHOQOL-BREF) were the most widely used QOL instruments. Patients with SCI had a decreased QOL as compared with that in healthy controls or normative data, with the most pronounced deficits in the domains of physical functioning and physical role limitations. In 3 studies, patients with tetraplegia had a lower physical domain QOL than did those with paraplegia. Overall, however, the impact of injury level and injury completeness on QOL after SCI remains unclear due to a lack of longitudinal studies.

Conclusions

The SF-36 and WHOQOL-BREF are validated instruments that should be considered for use in SCI QOL studies. Future analysis of deficits in QOL among patients with SCI would benefit from the development of a QOL instrument specifically targeted to SCI. Longitudinal studies to assess the impact of injury level and injury completeness on SCI QOL are also needed.
What do we currently know about thoracic spinal cord injury recovery and outcomes? A systematic review
Authors: Bransford Richard J. , Chapman Jens R. , Skelly Andrea C. , VanAlstyne Ellen M.
Published: May 2015

Object

The purpose of this paper was to systematically review and critically appraise the evidence for whether there are differences in outcomes or recovery after thoracic spinal cord injuries (SCIs) based on the spinal level, the timing of intervention, or cause of SCI.

Methods

Systematic searches were conducted using PubMed/MEDLINE through January 5, 2012. From 486 articles identified, 10 included data on the population of interest. Included studies were assigned a level of evidence (LOE) rating based on study quality, and an overall strength of evidence was assessed. To estimate the effect of injury level on patient outcomes, the relative risk and risk difference were calculated when data were available.

Results

From 486 citations identified, 3 registry studies and 7 retrospective cohort studies met the inclusion criteria. All were rated as being of poor quality (LOE III). Limited literature exists on the epidemiology of traumatic and nontraumatic SCI. Few studies evaluated outcomes based on SCI level within the thoracic spine. Pulmonary complications and thromboembolic events were less common in persons with lower thoracic SCI (T7–12) than in those with higher thoracic SCI (T1–6) in 2 large studies, but no differences were found in functional outcomes in 4 smaller studies. Patients undergoing earlier surgery (< 72 hours) may have fewer ventilator, ICU, and hospital days than those undergoing later surgery. One small study of SCI during repair of aortic aneurysm compared with traumatic SCI reported similar outcomes for both groups. There are substantial deficiencies in the scientific literature on thoracic SCI in regard to assessment, outcomes ratings, and effectiveness of therapy.

Conclusions

The overall strength of evidence for all outcomes reported is low. Definitive conclusions should not be drawn regarding the prognosis for outcome and recovery after thoracic SCI. From a physiological standpoint, additional methodologically rigorous studies that take into consideration various levels of injury in more anatomically and physiologically relevant form are needed. Use of validated, comprehensive outcomes tools are important to improve our understanding of the impact of thoracic SCI and aid in examining factors in recovery from thoracic SCI.
Intraorbital meningioma: resection through modified orbitozygomatic craniotomy
Authors: Cohen-Gadol Aaron A.
Published: May 2015

Intraorbital meningiomas are challenging lesions to excise because of their location and the restricted surgical corridor available due to the presence of important neighboring structures. Lesions located in the posterior one-third of the orbit require skull base approaches for their exposure and safe resection.

Frontoorbital and modified orbitozygomatic (OZ) craniotomies may facilitate the exposure and resection of masses in the posterior intraorbital space. Specifically, the one-piece modified OZ craniotomy provides many advantages of the “full” OZ craniotomy (which includes a more extensive zygomatic osteotomy). The modified OZ approach minimizes the extent of frontal lobe retraction and provides ample amount of space for the surgeon to exploit all the working angles to resect the tumor.

The following video presentation discusses the nuances of technique for resection of an intraorbital meningioma through modified OZ approach and optic nerve decompression. The nuances of technique will be discussed.

The video can be found here: http://youtu.be/fP5X2QNr5qk.
Endoscopic endonasal transplanum transtuberculum approach for resection of retrochiasmatic craniopharyngioma
Authors: Liu James K. , Eloy Jean Anderson
Published: May 2015

Retrochiasmatic craniopharyngiomas are formidable cranial base tumors to resect because of their intimate relationship with neighboring critical neurovascular structures, particularly the undersurface of the optic chiasm and hypothalamus. Radical resection offers the best chance of minimizing tumor recurrence, although this may be associated with significant surgical morbidity. Although various transcranial approaches have been utilized (transbasal subfrontal, frontobasal interhemispheric, pterional, orbitozygomatic, and petrosal) for resection of retrochiasmatic craniopharyngiomas, each is associated with some degree of brain retraction, and direct visualization of the retrochiasmatic region is often incomplete, therefore resulting in blind dissection. The endoscopic endonasal transplanum transtuberculum approach provides the most direct route to the retrochiasmatic region while affording unmatched visualization of the undersurface of the optic chiasm, third ventricle, and hypothalamus. This advantage allows for direct bimanual tumor dissection off of these critical structures by using microsurgical principles. The endonasal route also has the advantage of avoiding brain retraction and risk of cerebral edema that can be associated with transcranial approaches. In this operative video atlas report, the authors demonstrate their step-by-step techniques for resection of a suprasellar retrochiasmatic craniopharyngioma using a purely endoscopic endonasal transplanum transtuberculum approach. They describe and illustrate the operative nuances and surgical pearls to safely and efficiently perform the approach, tumor resection, and multilayered reconstruction of the cranial base defect.

The video can be found here: http://youtu.be/ZIbJvAyRxYU.
Laser-assisted microsurgical resection of thoracic intramedullary spinal cord ependymoma
Authors: Liu James K.
Published: May 2015

The surgical management of intramedullary spinal cord ependymomas remains a formidable challenge amongst neurosurgeons because of the potential risk of surgical morbidity. From on an oncological perspective, complete resection—if technically feasible—should be the goal of surgery, since this can result in excellent local control and progression-free survival. Advances in microsurgical techniques, intraoperative neurophysiological monitoring, and the use of lasers have contributed to our ability to achieve gross-total resection. This is also largely dependent on the presence of an identifiable surgical plane of dissection between the tumor and spinal cord, which appears to have a positive prognosis with overall neurological improvement. In this operative video manuscript, the author demonstrates an illustrative step-by-step technique for microsurgical resection of a thoracic intramedullary spinal cord ependymoma (T-3 to T-5) associated with an extensive cervicothoracic syrinx. The application of a handheld non-contact CO2 laser for performing the midline myelotomy is also highlighted. The operative technique and surgical nuances, including the surgical approach, intradural tumor removal, and closure, are illustrated in this video atlas.

The video can be found here: http://youtu.be/itE2tuBFmgw.
Thoracoscopic transdiaphragmatic approach for ventral decompression and reconstruction of metastatic spine disease
Authors: Schmidt Meic H.
Published: May 2015

The management of metastatic spine disease is complex, but usually involves radiation therapy and/or surgical treatment. Surgery followed by radiation has a significant role in select patients presenting with metastatic spinal cord compression. Ventral decompression can be achieved through several surgical approaches including posterior, posterolateral, and anterior surgical approaches. Although open thoracotomy is the most common approach for ventral decompression, it is associated with significant spinal access morbidity. This video illustrates a thoracoscopic transdiaphragmatic approach for symptomatic L-1 metastatic spinal cord compression. This approach allows for a minimal incision in the diaphragm to expose the thoracolumbar junction and allows for corpectomy, spinal canal decompression, vertebral body replacement, and spinal stabilization via four small incisions along the chest wall. The step-by-step technique illustrates operative nuances and surgical pearls to safely perform this approach in a patient with thoracolumbar L-1 metastatic spinal cord compression.

The video can be found here: http://youtu.be/w8fanV9bq-E.
Minimally invasive lumbar intradural extramedullary tumor resection
Authors: Lee Brian , Hsieh Patrick C.
Published: May 2015

Intradural, extramedullary schwannomas have long been treated with open midline incision, laminectomy, and dural opening to expose and resect the lesion. While this technique is well established, today new surgical techniques can be utilized to perform the same procedure while minimizing pain, size of incision, and trauma to adjacent tissues. In cases of intradural surgery, minimally invasive surgery limits the degree of soft tissue disruption. As a result, there is significant decreased dead space within the surgical cavity that may decrease the rate of CSF leak complications. Minimally invasive techniques have continuously improved over the years and have reached a point where they can be used for intradural surgeries. In this case presentation, we demonstrate a minimally invasive approach to the lumbar spine with resection of an intradural schwannoma. Surgical techniques and the nuances of the minimally invasive approach to intradural tumors compared to the standard open procedure will be discussed.

The video can be found here: http://youtu.be/XXrvAIq_H48.
Resection of an anterior spinal cord AVM through a far-lateral approach
Authors: Michael L. Madison , Sorenson Jeffrey M.
Published: May 2015

A small arteriovenous malformation near the craniocervical junction with contributions from the anterior spinal artery was discovered in a young developmentally-delayed woman after she presented with altered mental status and evidence of subarachnoid hemorrhage. The malformation could not be completely treated with endovascular therapy, so it was resected through a far-lateral approach. This stereoscopic video demonstrates how to gain the exposure needed to address a lesion in this area.

The video can be found here: http://youtu.be/ByjPGm_eXLc.
Endoscopic endonasal craniopharyngioma resection
Authors: Kenning Tyler J. , Beahm D. David , Farrell Christopher J. , Schaberg Madeleine R. , Rosen Marc R. , Evans James J.
Published: May 2015

The authors present the case of a 21-year-old female with a progressive bitemporal hemianopsia. Cranial MR imaging revealed a large cystic suprasellar, retrochiasmatic lesion consistent with craniopharyngioma. The lesion was fully resected through an endoscopic endonasal transsphenoidal and transplanum approach. Closure of the resultant dural defect was performed with a bilayer fascia lata button and autologous mucoperichondrial nasoseptal flap. Each portion of this procedure was recorded and is presented in an edited high-definition format.

The video can be found here: http://youtu.be/i3-qieLlbVk.
Endoscopic endonasal repair of spontaneous CSF fistulae
Authors: Tormenti Matthew J. , Paluzzi Alessandro , Pinheiro-Neto Carlos D. , Fernandez-Miranda Juan C. , Snyderman Carl H. , Gardner Paul A.
Published: May 2015

The authors present a fully endoscopic endonasal repair of a spontaneous CSF leak caused by a defect in the anterior fossa floor. Patients were positioned supine in a Mayfield headholder in slight extension. A complete ethmoidectomy was performed to expose the defect. The middle turbinate was removed to increase visualization and allow for more working room. The defect was identified and exposed. A nasoseptal flap was raised and placed over the defect. A free-mucosal graft fashioned from the removed middle turbinate was placed on the nasoseptal donor site.

The video can be found here: http://youtu.be/gAN2cvQVXCE.
Dorsal variant blister aneurysm repair
Authors: Couldwell William T. , Chamoun Roukoz
Published: May 2015

Dorsal variant proximal carotid blister aneurysms are treacherous lesions to manage. It is important to recognize this variant on preoperative angiographic imaging, in anticipation of surgical strategies for their treatment. Strategies include trapping the involved segment and revascularization if necessary. Other options include repair of the aneurysm rupture site directly. Given that these are not true berry aneurysms, repair of the rupture site involves wrapping or clip-grafting techniques. The case presented here was a young woman with a subarachnoid hemorrhage from a ruptured dorsal variant blister aneurysm. The technique used is demonstrated in the video and is a modified clip-wrap technique using woven polyester graft material. The patient was given aspirin preoperatively as preparation for the clip-wrap technique.

It is the authors' current protocol to attempt a direct repair with clip-wrapping and leaving artery sacrifice with or without bypass as a salvage therapy if direct repair is not possible. Assessment of vessel patency after repair is performed by intraoperative Doppler and indocyanine green angiography. Intraoperative somatosensory and motor evoked potential monitoring is performed in all cases.

The video can be found here: http://youtu.be/crUreWGQdGo.
Endoscopic endonasal approach for a tuberculum sellae meningioma
Authors: Fernandez-Miranda Juan C. , Pinheiro-Neto Carlos D. , Gardner Paul A. , Snyderman Carl H.
Published: May 2015

The authors present the technical and anatomical nuances needed to perform an endoscopic endonasal removal of a tuberculum sellae meningioma. The patient is a 47-year-old female with headaches and an incidental finding of a small tuberculum sellae meningioma with no vascular encasement, no optic canal invasion, but mild inferior to superior compression of the cisternal segment of the left optic nerve. Neuroophthalmology assessment revealed no visual defects. Treatment options included clinical observation with imaging follow-up studies, radiosurgery, and resection. The patient elected to undergo surgical removal and an endonasal endoscopic approach was the preferred surgical option.

Preoperative radiological studies showed the presence of an osseous ring between the left middle and anterior clinoids, the so-called carotico-clinoidal ring. The surgical implications of this finding and its management are illustrated. The surgical anatomy of the suprasellar region is reviewed, including concepts such as the chiasmatic sulcus and limbus sphenoidale, medial and lateral optico-carotid recesses, and the paraclinoidal and supraclinoidal segments of the internal carotid artery. Emphasis is made in the importance of exposing the distal dural ring of the internal carotid artery and the precanalicular segment of the optic nerve for adequate intradural dissection. The endonasal route allows for early coagulation of the tumor meningeal supply and extensive resection of dural attachments, and importantly, provides an inferior to superior access to the infrachiasmatic region that facilitates complete tumor removal without any manipulation of the optic nerve. The lateral limit of dural removal is formed by the distal dural ring, which is gently coagulated after the tumor is resected. A 45° scope is used to inspect for any residual tumor, in particular at the entrance of the optic nerve into the optic canal and at the most anterior margin of the exposure (limbus sphenoidale). The steps for reconstruction are detailed and include intradural placement of dural substitute and extradural placement of the nasoseptal flap. The nuances for proper harvesting, positioning, and reinforcement of the flap are described. No lumbar drain was used.

The patient had an uneventful recovery with no CSF leak or any other complications. Imaging follow-up at 6 months showed complete removal of the tumor. The patient had no sinonasal or neurological symptoms, and olfaction was fully preserved.

The video can be found here: http://youtu.be/kkuV-yyEHMg.
Integrating Life Cycle Energy into the Design of Façade Refurbishment for a Post-War Residential Building in The Netherlands
Authors: Loussos Paressa , Konstantinou Thaleia , Van den Dobbelsteen Andy , Bokel Regina
Published: May 2015

The existing building stock has been in the focus of European Union policies for energy savings. Nevertheless, energy certification schemes refer mostly to operational energy and usually do not consider aspects related to the life cycle of the building. To look at the overall energy cost during the lifespan of a building, the energy used to produce and assemble the building materials also needs to be included. This paper develops a design methodology for existing residential buildings that aims at decreasing the life cycle energy use as much as possible. This approach was applied on a case study of an existing post-war residential building in Utrecht, The Netherlands. The main focus of this study is to find a design solution for façade retrofitting that considers both embodied and operational energy. The design approach is based on comparing different strategies for the use of façade materials. This design methodology can be replicated in other projects, as the conclusions and recommendations can also be used for future refurbishment projects for which a low operational energy and materials with a low embodied energy are desired.
Recent Advances in Elucidating the Genetic Mechanisms of Nephrogenesis Using Zebrafish
Authors: Cheng Christina , Verdun Valerie , Wingert Rebecca
Published: May 2015

The kidney is comprised of working units known as nephrons, which are epithelial tubules that contain a series of specialized cell types organized into a precise pattern of functionally distinct segment domains. There is a limited understanding of the genetic mechanisms that establish these discrete nephron cell types during renal development. The zebrafish embryonic kidney serves as a simplified yet conserved vertebrate model to delineate how nephron segments are patterned from renal progenitors. Here, we provide a concise review of recent advances in this emerging field, and discuss how continued research using zebrafish genetics can be applied to gain insights about nephrogenesis.
Biomass Resource Assessment and Existing Biomass Use in the Madhya Pradesh, Maharashtra, and Tamil Nadu States of India
Authors: Natarajan Karthikeyan , Latva-Käyrä Petri , Zyadin Anas , Chauhan Suresh , Singh Harminder , Pappinen Ari , Pelkonen Paavo
Published: May 2015

India is experiencing energy crisis and a widening gap between energy supply and demand. The country is, however, endowed with considerable, commercially and technically available renewable resources, from which surplus agro-biomass is of great importance and a relatively untapped resource. In the policy making process, knowledge of existing biomass use, degree of social reliance, and degree of biomass availability for energy production is unequivocal and pre-conditional. Field observations, documentation, and fill-in sheet tools were used to investigate the potential of biomass resources and the existing domestic, commercial, and industrial uses of biomass in selected Indian states. To do so, a team of field observers/supervisors visited three Indian states namely: Maharashtra (MH), Madhya Pradesh (MP), and Tamil Nadu (TN). Two districts from each state were selected to collect data regarding the use of biomass and the extent of biomass availability for energy production. In total, 471 farmers were interviewed, and approximately 75 farmers with various land holdings have been interviewed in each district. The existing uses of biomass have been documented in this survey study and the results show that the majority of biomass is used as fodder for domestic livestock followed by in-site ploughing, leaving trivial surplus quantities for other productive uses. Biomass for cooking appeared to be insignificant due to the availability and access to Liquefied Petroleum Gas (LPG) cylinders in the surveyed districts. Opportunities exist to utilize roadside-dumped biomass, in-site burnt biomass, and a share of biomass used for ploughing. The GIS-based maps show that biomass availability varies considerably across the Taluks of the surveyed districts, and is highly dependent on a number of enviromental and socio-cultural factors. Developing competitive bioenergy market and enhancing and promoting access to more LPG fuel connections seem an appropriate socio-economic and environmental approach to reduce the use of biomass for indoor cooking and increasing the share of surplus biomass for energy production.
Flux Growth and Crystal Structure Refinement of Calcite Type Borate GaBO3
Authors: Wang Shichao , Ye Ning , Poeppelmeier Kenneth
Published: May 2015

A single crystal of gallium borate, GaBO3, 4 × 4 × 0.2 mm3 in size has been grown by spontaneous crystallization with a molten flux based on a Bi2O3-3B2O3 solvent. From single crystal X-ray diffraction measurement, GaBO3 was found to crystallize in the trigonal calcite type, space group R-3c, with cell dimensions a = 4.56590(10) and c = 14.1764(4) Å, Z = 6. Layers of distorted [GaO6] octahedra are interleaved by layers of triangular planar [BO3] unites. The transmission spectrum on a single crystal indicated that the band gap of GaBO3 is 3.62 eV.
Ethylene Separation via Hydrate Formation in W/O Emulsions
Authors: Pan Yong , Liu Huang , Li Zhi , Liu Bei , Ma Qinglan , Chen Guangjin , Sun Changyu , Yang Lanying , Gao Xueteng
Published: May 2015

An hybrid absorption-hydration method was adopted to recover C2H4 from C2H4/CH4 binary gas mixtures and the hydrate formation conditions of C2H4/CH4 mixtures was studied experimentally in diesel in water (w/o) emulsions. Span 20 at a concentration of 1.0 wt% in the aqueous phase was added to form water in diesel emulsions before hydrate formation and then hydrate in diesel slurry was separated after hydrate formation. The influences of initial gas-liquid volume ratio (53–142), pressure (3.4–5.4 MPa), temperature (274.15–278.15 K), water cuts (10–30 vol%), and the mole fraction of C2H4 in feed gas (13.19–80.44 mol%) upon the C2H4 separation efficiency were systematically investigated. The experimental results show that ethylene can be enriched in hydrate slurry phase with high separation factor (S) and recovery ratio (R). Most hydrate formation finished in 20 min, after that, the hydrate formation rate became very slow. The conclusion is useful for determining the suitable operation conditions when adopting an absorption-hydration method to separate C2H4/CH4.
Thermal Performance of Ventilated Double Skin Façades with Venetian Blinds
Authors: Parra Jordi , Guardo Alfredo , Egusquiza Eduard , Alavedra Pere
Published: May 2015

Venetian blinds (VB) are shading devices of widespread use in residential and corporate buildings. They can reflect or transmit light into buildings and at the same time allow daylighting and exterior views. They can also efficiently block radiative heat from entering the building, and if combined with a heat dissipation system such as forced ventilation, they can improve the thermal performance of double skin façades (DSF). Computational Fluid Dynamics (CFD) has proven to be a useful tool for modeling flow and heat transfer in DSF, including conduction, convection and radiation heat transfer phenomena. The aim of this work is to evaluate, by means of CFD, the influence of several optical, construction and operation parameters of a DSF (such as optical properties of the materials, geometrical relations of the VB or flow stream conditions) in terms of energy savings, measured as a reduction of the solar load entering the building. Results obtained show that parameters such as the proximity of the VB to the exterior skin of the façade or a differentiated surface treatment for the exterior and interior faces of the VB louvers can notably affect the thermal performance of the DSF and hence the heat gains experienced by the building.
Magnetic Field Equivalent Current Analysis-Based Radial Force Control for Bearingless Permanent Magnet Synchronous Motors
Authors: Zhu Huangqiu , Li Hui
Published: May 2015

Bearingless permanent magnet synchronous motors (BPMSMs), with all advantages of permanent magnet motors (PMSMs) and magnetic bearings, have become an important research direction in the bearingless motor field. To realize a stable suspension for the BPMSM, accurate decoupling control between the electromagnetic torque and radial suspension force is indispensable. In this paper, a concise and reliable analysis method based on a magnetic field equivalent current is presented. By this analysis method, the operation principle is analyzed theoretically, and the necessary conditions to produce a stable radial suspension force are confirmed. In addition, mathematical models of the torque and radial suspension force are established which is verified by the finite element analysis (FEA) software ANSYS. Finally, an experimental prototype of a 2-4 poles surface-mounted BPMSM is tested with the customized control strategy. The simulation and experimental results have shown that the motor has good rotation and suspension performance, and validated the accuracy of the proposed analysis method and the feasibility of the control strategy.
The Role of Vitamin D in Inflammatory Bowel Disease
Authors: Bancil Aaron , Poullis Andrew
Published: May 2015

Vitamin D is known to be vital in maintaining bone health, mineralisation and for fracture prevention. It has also been implicated in a number of autoimmune diseases and has therefore been studied for its potential role in Inflammatory Bowel Disease (IBD). This review looks at the current literature on the role of vitamin D and its potential role as an immunomodulator, disease modifier and bone health in IBD patients. There is substantial supporting evidence of an important role from epidemiological, genetic and immunological studies, but there is also conflicting evidence and nothing proving to be definitive from clinical studies. There are also a number of confounders with IBD patients, as their lifestyles and medications may affect vitamin D levels. Murine studies have added vast amounts to our knowledge of vitamin D and its antimicrobial role, as well as its effect on immune cell proliferation other inflammatory molecules, such as Tumour Necrosis Factor-α (TNFα). It is clear that larger trials investigating the effects of oral supplementation of vitamin D in IBD patients are necessary.
Assessment of Electromagnetic Interference with Active Cardiovascular Implantable Electronic Devices (CIEDs) Caused by the Qi A13 Design Wireless Charging Board
Authors: Seckler Tobias , Jagielski Kai , Stunder Dominik
Published: May 2015

Electromagnetic interference is a concern for people wearing cardiovascular implantable electronic devices (CIEDs). The aim of this study was to assess the electromagnetic compatibility between CIEDs and the magnetic field of a common wireless charging technology. To do so the voltage induced in CIEDs by Qi A13 design magnetic fields were measured and compared with the performance limits set by ISO 14117. In order to carry this out a measuring circuit was developed which can be connected with unipolar or bipolar pacemaker leads. The measuring system was positioned at the four most common implantation sites in a torso phantom filled with physiological saline solution. The phantom was exposed by using Helmholtz coils from 5 µT to 27 µT with 111 kHz sine‑bursts or by using a Qi A13 design wireless charging board (Qi‑A13‑Board) in two operating modes “power transfer” and “pinging”. With the Helmholtz coils the lowest magnetic flux density at which the performance limit was exceeded is 11 µT. With the Qi‑A13‑Board in power transfer mode 10.8% and in pinging mode 45.7% (2.2% at 10 cm distance) of the performance limit were reached at maximum. In neither of the scrutinized cases, did the voltage induced by the Qi‑A13‑Board exceed the performance limits.
Cardiovascular Mortality Associated with Low and High Temperatures: Determinants of Inter-Region Vulnerability in China
Authors: Yang Xunfeng , Li Lianfa , Wang Jinfeng , Huang Jixia , Lu Shijun
Published: May 2015

The objectives of this study were to estimate the effects of temperature on cardiovascular mortality in 26 regions in the south and west of China from 2008 to 2011, and to identify socioeconomic and demographic factors contributing to such inter-region variation in the temperature effect. A separate Poisson generalized additive model (GAM) was fitted to estimate percent changes in cardiovascular mortality at low and high temperatures on a daily basis for each region. The model used the smooth functions to model the nonlinear effects of temperature and humidity and to control for the seasonal factor using the calendar time variable. Given variation in the magnitude of the temperature effect on cardiovascular mortality, we employed a Bayesian network (BN) to identify potential region-specific socioeconomic and demographic factors that may explain the variation. In most regions, an increasing trend in high or low temperature was associated with an increase in cardiovascular mortality, with variation in the magnitude of the temperature effects across regions. Three factors, including per capita years of education (as an indicator of economic status), percentage of the population over 65 years of age and percentage of women had direct impact on cold-related cardiovascular mortality. Number of hospital beds (as an indicator of the availability of medical resources), percentage of population engaged in industrial occupations, and percentage of women showed direct impact on heat-related cardiovascular mortality. Due to the socioeconomic and demographic inequalities between regions, the development of customized prevention and adaptation programs to address the low/high temperatures in vulnerable regions should be prioritized.
Dysregulation of PAK1 Is Associated with DNA Damage and Is of Prognostic Importance in Primary Esophageal Small Cell Carcinoma
Authors: Gan Jinfeng , Zhang Yuling , Ke Xiurong , Tan Chong , Ren Hongzheng , Dong Hongmei , Jiang Jiali , Chen Shaobin , Zhuang Yixuan , Zhang Hao
Published: May 2015

Primary esophageal small cell carcinoma (PESCC) is a rare, but fatal subtype of esophageal carcinoma. No effective therapeutic regimen for it. P21-activated kinase 1 (PAK1) is known to function as an integrator and an indispensable node of major growth factor signaling and the molecular therapy targeting PAK1 has been clinical in pipeline. We thus set to examine the expression and clinical impact of PAK1 in PESCC. The expression of PAK1 was detected in a semi-quantitative manner by performing immunohistochemistry. PAK1 was overexpressed in 22 of 34 PESCC tumors, but in only 2 of 18 adjacent non-cancerous tissues. Overexpression of PAK1 was significantly associated with tumor location (p = 0.011), lymph node metastasis (p = 0.026) and patient survival (p = 0.032). We also investigated the association of PAK1 with DNA damage, a driven cause for malignancy progression. γH2AX, a DNA damage marker, was detectable in 18 of 24 (75.0%) cases, and PAK1 expression was associated with γH2AX (p = 0.027). Together, PAK1 is important in metastasis and progression of PESCC. The contribution of PAK1 to clinical outcomes may be involved in its regulating DNA damage pathway. Further studies are worth determining the potentials of PAK1 as prognostic indicator and therapeutic target for PESCC.
1,8-Cineole Ameliorates Steatosis of Pten Liver Specific KO Mice via Akt Inactivation
Authors: Murata Soichiro , Ogawa Koichi , Matsuzaka Takashi , Chiba Mitsuru , Nakayama Ken , Iwasaki Kenichi , Kurokawa Tomohiro , Sano Naoki , Tanoi Tomohito , Ohkohchi Nobuhiro
Published: May 2015

Hepatocyte-specific Phosphatase and tensin homolog (Pten)-knockout (KO) mice exhibit hepatic lesions analogous to non-alcoholic steatohepatitis (NASH). 1,8-cineole is a monoterpene oxide and it has several biological effects including hepatoprotective effects. In this study we revealed that 1,8-cineole ameliorates NASH of Pten KO mice. Pten KO mice were assigned to a control group without any medication or to a 1,8-cineole group injected with 50 mg/kg i.p. twice per week for eight weeks. At eight weeks, livers from each group were processed to measure triglyceride (TG) content, gene expression analysis, western blot analysis, and histological examination including Oil red O staining. 1,8-cineole ameliorated hepatic steatosis in Pten KO mice, revealed by TG content and Oil red O staining. Moreover, 1,8-cineole downregulated collagen 1a1 expression and improved liver fibrosis. Thus, 1,8-cineole has potential as a candidate to treat NASH by inactivating the Akt/PI3-kinase pathway.
Human Adipose-Derived Mesenchymal Progenitor Cells Engraft into Rabbit Articular Cartilage
Authors: Wang Wen , He Na , Feng Chenchen , Liu Victor , Zhang Luyi , Wang Fei , He Jiaping , Zhu Tengfang , Wang Shuyang , Qiao Weiwei , Li Suke , Zhou Guangdong , Zhang Li , Dai Chengxiang , Cao Wei
Published: May 2015

Mesenchymal stem cells (MSCs) are known to have the potential for articular cartilage regeneration, and are suggested for the treatment of osteoarthritis (OA). Here, we investigated whether intra-articular injection of xenogeneic human adipose-derived mesenchymal progenitor cells (haMPCs) promoted articular cartilage repair in rabbit OA model and engrafted into rabbit articular cartilage. The haMPCs were cultured in vitro, and phenotypes and differentiation characteristics of cells were evaluated. OA was induced surgically by anterior cruciate ligament transection (ACLT) and medical meniscectomy of knee joints. At six weeks following surgery, hyaluronic acid (HA) or haMPCs was injected into the knee joints, the contralateral knee served as normal control. All animals were sacrificed at the 16th week post-surgery. Assessments were carried out by macroscopic examination, hematoxylin/eosin (HE) and Safranin-O/Fast green stainings and immunohistochemistry. The data showed that haMPC treatment promoted cartilage repair. Signals of human mitochondrial can be directly detected in haMPC treated cartilage. The haMPCs expressed human leukocyte antigen I (HLA-I) but not HLA-II-DR in vivo. These results suggest that intra-articular injection of haMPCs promotes regeneration of articular cartilage in rabbit OA model, and support the notion that MPCs are transplantable between HLA-incompatible individuals.