bluuebunny/crossref_metadata_2025 huggingface dataset:
The Men who would be King
Authors: Salomon Richard
Published: June 2012

A critical examination of dynastic genealogies for pre-Islamic India derived from literary, epigraphic and numismatic sources reveals that they regularly suppress fraternal conflicts and other irregularities in the lineages. Although normative texts such as the Arthasastra and various Dharmasastra treatises present succession by the king’s eldest son as the norm, reading between the lines shows that this principle was often overruled or ignored. Some Indian dynasties of Iranian and Central Asian descent, notably the Western Ksatrapas, followed a system of collateral, brother-to-brother succession which is characteristic of Central Asian polities, but here too a critical scrutiny shows that this principle was subject to various irregularities. In effect if not in principle, both systems, primogeniture and collateral succession, provide mechanisms to prevent or at least minimize the damage from fraternal conflicts, but both were evidently limited in their actual effects.
The Gupta–Vakataka Relationship
Authors: Bakker Hans
Published: June 2012

The stone inscription found in the Kevala Narasimha Temple on top of the Ramagiri (Ramtek, Maharashtra) is an unusual personal document telling the story of a Vakataka princess (Atibhavati) who was married to her maternal uncle (Ghatotkacagupta), viceroy in Vidisa (first half of the fifth century ce). This Ghatotkaca lost the succession war against Skandagupta, after which the princess’s brother, the Vakataka king Pravarasena II, brought the widowed princess back home to Vidarbha. The inscription is incomplete; only one third of the original text is readable. A step-by-step analysis and reconstruction of the prasasti part of the inscription reveals the dynastic interrelation of the Gupta and Vakataka dynasties, the construction of which was motivated by political considerations Rrather than by considerations of lawfulness (dharma).
Rethinking the Upanisadic Vamsas
Authors: Black Brian
Published: June 2012

This paper takes a literary approach to the major vamsas in the Brahmanas and Upanisads. I will demonstrate that the vamsas follow a number of structural and compositional conventions, which are employed to construct sacred histories, indicate different branches of descent, combine different lineages, and claim authoritative transmissions vis-à-vis other lineages. By treating the vamsas as a literary genre, rather than as an empirical historical record, I hope to invite a new appreciation for their form and creativity, as well as to open up new ways for reading them.
Calcium phosphate coating on Ti6Al4V by autocatalytic route
Authors: Mohammed Hadeer I. , Abdel-Fattah Wafa I. , Sallam Mohamed A. , El-Sayed Mahmoud E. , Talaat Mona S. E. H. , Faerber Jacques , Pourroy Genevieve , Roland Thierry , Carradò Adele
Published: June 2012

The authors present a study for the first time, an alternative coating route based on an autocatalytic process on metal alloy, to induce Ca–P layer in a way similar to the process of natural bone formation. Ti6Al4V (High-grade titanium aluminium vanadium alloy) substrates were subjected to several pretreatment steps, such as alkali and heat treatments. Afterwards, they were immersed in autocatalytic baths under certain conditions to form Ca–P layers. To check their biochemical stability, the treated substrates were immersed in SBF (simulated body fluid) for 4 days. The biolayers were investigated by FESEM-EDS (field emission scanning electron microscope—energy dispersive x-ray spectroscopy) and FT-IR (Fourier trasform infra-red spectroscopy), before and after immersion in SBF. Biochemical analyses were also performed to evaluate the calcium and phosphorous content in SBF. In autocatalytic baths, Ca–P precipitates on the pretreated substrates after only 2 h. Moreover, after being immersed for 4 days in SBF, the phosphates begin to dissolve and to be replaced by carbonates.
Influence of microfillers on molecular alignment and tensile stress fracture in thermotropic liquid crystalline polymer
Authors: Romo-Uribe Angel , Flores Osvaldo , Campillo Bernardo , Flores Araceli , Jaffe Michael
Published: June 2012

This research focuses on the influence of microfillers on mechanical properties, molecular orientation, and fracture behavior of reinforced thermotropic liquid crystalline polymers (LCPs). The LCPs are random copolyesters based on 1,4-hydroxybenzoic acid (B) and 2,6-hydroxynaphthoic acid (N) with composition 73:27 mol%. Glass fibers, graphite, and mineral fillers were used as microfillers. The influence of filler was investigated, up to 30 wt % filler concentration. Tensile tests revealed that the strain at failure of the neat LCP occurred within 3% deformation. The addition of microfillers initially decreased the Young’s modulus and the strain at failure below that of the neat LCP. However, the combination of graphite/glass fibers did increase the Young’s modulus, and increased the yield stress but at the cost of reducing, significantly, the strain at failure. The x-ray patterns of the molded neat LCP showed that the molecular chains were preferentially oriented along the injection molding axis. However, addition of microfillers randomized the molecular orientation, as measured by the order parameter, P–2, where glass fiber-based fillers were more effective to reduce P–2. The reduction in molecular alignment appeared to be the key property to deteriorate Young’s modulus along the shear axis. Moreover, the reduction in modulus could be compensated by adding more microfillers and offers the benefit of homogenizing the mechanical properties. Analysis of fractured samples suggests that the main mechanism for fracture was the loss of adhesion between the microfillers and the polymer matrix, this effect being more evident when using glass fiber.
A mathematical function to represent S-shaped relationships for geotechnical applications
Authors: Liu Martin D. , Xu K. J. , Horpibulsuk Suksun
Published: June 2012

In this paper a new mathematical function is proposed for describing the S-shape relationship in both normal x and y scale and the semi-logarithmic x and y scale. Basic features of the proposed function have been demonstrated. The proposed function has then been used to simulate the S-shape relationship for seven categories of engineering phenomena. It is seen that the proposed mathematical function has a great potential for representing various S-shape relationships and provides a powerful tool for characterising properties of materials or response of systems; it is thus useful for further numerical analysis.
Retaining wall behaviour in Dublin's estuarine deposits, Ireland
Authors: Long Michael , Menkiti Christopher , Skipper Jacqueline , Brangan Carl , Looby Michael
Published: June 2012

Practising engineers in the Dublin, Ireland, area have much experience in dealing with the boulder clay which underlies much of the city. However, significant deposits of estuarine soils, some of them soft, exist along the east side of the city and in particular in Dublin docklands. Some construction difficulties have previously been encountered in these materials and significant developments, including a large tunnel project, are planned in the area overlying these deposits. Few published data exist on retaining wall schemes in the deposits. Data from nine sites, including three detailed case histories, are presented which confirm that construction of deep propped excavations and cantilever walls up to 7·5 m are feasible in these deposits and can perform well. A key issue is the soil that is located at excavation level and competent deposits here are essential to prevent large displacements or possible instability. The resulting movement will also be sensitive to the overall system stiffness. There seems to be scope for more efficient future design, including more use of cantilever walls, particularly for temporary works purposes. Beam-on-spring type computer analyses tend to give conservative results for these deposits and more sophisticated finite-element analyses may be warranted for future schemes.
Palm Jumeirah, Dubai: cone penetrometer testing data from the carbonate sand fill
Authors: Lees Andrew , King Derek A. , Mimms Stan
Published: June 2012

Palm Jumeirah was the first of the iconic Palm Islands to be reclaimed from the sea off the Dubai coastline. Extensive cone penetrometer testing (CPT) of the hydraulic fill was undertaken, both pre- and post-vibro-compaction, in order to evaluate the effectiveness of the ground improvement. A study of these data, together with standard penetration test (SPT) and shear wave velocity results, is presented for this shelly carbonate sand fill. Large peaks in cone resistance qc were recorded at the start of penetration, which were not considered representative of the undisturbed fill. These were possibly caused by crushing of the friable shelly particles during cone penetration, leading to the formation of a high-density soil plug around the cone. Secondary compression or other ageing mechanism may have occurred at depth in the fill, as well as an apparent longer-term increase in cone resistance with time in the fill above and around groundwater level. However, at a nearby site, in the short term, an apparent decrease in cone resistance with time was observed at the same depth in a similar fill material. In addition, the effect of vibro-compaction point spacing on post-densification CPT results is presented, along with the effect of mean particle size on SPT–CPT correlation.
Termination criteria for jacked precast high-strength prestressed concrete pipe piles
Authors: Liu Junwei , Zhang Zhongmiao , Yu Feng , Yang Qingda
Published: June 2012

Precast high-strength prestressed concrete pipe piles installed by the jacking method have received wide use as deep foundations in China. Adoption of appropriate termination criteria during installation is the key issue to ensure design capacity or avoid conservative design for jacked piles. A database including 1228 field load tests on jacked concrete pipe piles is collected in this study to establish empirical correlations between the final jacking force and the ultimate capacity. Using the pile slenderness ratio as the fundamental parameter, a total of 14 correlations are derived to apply for various categories of soil conditions. Among them, the ratio of pile capacity to jacking force for piles in stiff clay and firm clay exhibits the greatest magnitude and trend of increase with increasing pile slenderness ratio. Moreover, two jacked concrete pipe piles in silty clay are instrumented and load-tested as an independent case to examine the consistency of the proposed correlations. The two test piles are installed in accordance with a double-control termination criterion that involves the requirements of both final penetration and final jacking force. The load transfer behaviour of the piles has revealed that their performances satisfy all the design requirements.
Light-weight deflectometer for mechanistic quality control of base course materials
Authors: Ebrahimi Ali , Edil Tuncer B.
Published: June 2012

The light-weight deflectometer presents significant potential for compaction quality control and for determining in situ resilient modulus of pavement layers during construction. Data collected from a laboratory large-scale model experiment and two light-weight deflectometer devices (Keros and Zorn) were used to develop a means of estimating the resilient modulus of various base course materials. The procedure can be used for validating the input parameters in design. Measured surface elastic deflections of a layered pavement system from the LWD devices must be corrected for the effect of subgrade deflection and the differences in the state of stresses. A power function represents the relationship between the corrected elastic deflection from the light-weight deflectometers and the resilient modulus of the base course layer from the large-scale model experiment. This study provides a basis for use of the light-weight deflectometer in estimating as-constructed resilient modulus of a base course layer involving natural and recycled unbound materials as well as fly ash stabilised materials.
Effects of test conditions on shear behaviour of composite soil
Authors: Li Yanrong , Chan Lung S. , Yeung Albert T. , Xiang Xiqiong
Published: June 2012

Test conditions, such as shearing rate and normal stress, have been long recognised as influencing the measured shear strength of clays and sands. However, their influence on composite soils, which have a wide range of particle sizes, has attracted much less attention from researchers. In this study, a total of 35 direct shear tests at different shearing rates under different normal stresses were conducted on specimens prepared by mixing different proportions of kaolin and glass beads. The changes in volume and water content of sheared specimens and the mesostructure of shear surfaces were studied. The results reveal a positive correlation between volume change and deviation of water content between the shear zone and outer zones, suggesting that the shear-induced volume change occurred primarily in the shear zones. Moreover, high normal stress and low shearing rate produced a relatively small void ratio in the shear zones, facilitating volumetric contraction of the specimen and the development of polished and evenly slickensided shear surfaces. In addition, the residual friction angle of the specimens tested was found to decrease with the increase in normal stress. The high shearing rate caused an increase in residual strength in specimens with low fines fraction, and reduced it in specimens with high fines fraction.
Bored pile design in stiff clay II: mechanisms and uncertainty
Authors: Vardanega Paul J. , Williamson Michael G. , Bolton Malcolm D.
Published: June 2012

The soil mechanics related to pile design in clay has been the subject of substantial engineering research. In a companion paper, various codes of practice were reviewed showing the effect on pile capacity of the different global factors of safety that emerge from the various partial factor combinations for the ultimate limit state. Factors of safety are generally specified based on the opinions of experts. In this paper an assessment will be made of various objective procedures that can be used to reduce uncertainty in the design process, especially regarding the adoption of a pile resistance model and the selection of a soil strength profile as part of a ultimate limit state check, and the estimation of pile head settlement in the context of a serviceability limit state check. It is shown that both total stress and effective stress calculation methods are applicable in London Clay. Estimates of settlement using a non-linear soil stress–strain relationship are made and compared with published data. It is shown that the compression of the concrete dominates the settlement of long piles. Given the low settlements observed, recommendations are made for a reduction in standard factors of safety for bored pile design in stiff clays.
The use of a cluster analysis in a Ménard pressuremeter survey
Authors: Monnet Jaques , Broucke Maryse
Published: June 2012

Cluster analysis is a statistical method used for grouping data that have similar mathematical characteristics in subsets with common or homogeneous values. This method can be used in various fields of data for which no division is known a priori and can be useful for identification of soil horizons for site characterisation. Cluster analyses for in situ applications are composed of the following six steps: selection of variables; standardisation of the data; development of a resemblance distance matrix; choice of a clustering technique; determination of the number of clusters; and interpretation of cluster results. Various types of in situ test data can be treated in this way, such as cone penetration testing data. A Ménard pressuremeter data analysis by cluster is presented here, which uses as the statistical variables: pLM; E; E/EM; EM/p*LM. The results relate to the relevance of these variables in identification of soil horizons, and to the best possible combination of data to characterise the various geological layers of the site of the northern tunnel of Grenoble.
Retaining walls in Dublin Boulder Clay, Ireland
Authors: Long Michael , Brangan Carl , Menkiti Christopher , Looby Michael , Casey Patrick
Published: June 2012

A good number of deep excavations have been recently completed in Dublin Boulder Clay, Ireland. These have included propped walls up to 25 m deep and permanent cantilevers 7·5 m high. Experience elsewhere in the world was used to design and construct these walls. However, case history data have shown that the behaviour of the walls in Dublin Boulder Clay is very rigid and much stiffer than comparable systems worldwide. It appears this behaviour is due to the inherent natural strength and stiffness of the soil and the slow dissipation of excavation-induced depressed pore pressures or suctions. There appears to be scope for developing more efficient designs and in particular for reducing propping requirements. For temporary works, the use of undrained parameters in serviceability limit state calculations together with implementation of the observational approach on site could be considered for future schemes.
Retaining wall behaviour in Dublin's fluvio-glacial gravel, Ireland
Authors: Long Michael , Daynes Philip , Donohue Shane , Looby Michael
Published: June 2012

Practising engineers in the Dublin, Ireland, area have significant experience in dealing with the Boulder Clay which underlies much of the city. However, the 45 m deep buried pre-glacial channel north of the River Liffey is infilled with fluvio-glacial deposits which behave very differently from an engineering point of view. Case history data from eight sites and a detailed examination of the retaining wall behaviour at two of the sites show that retaining wall movements appear to be governed by system stiffness (i.e. a combination of wall stiffness and support configuration). It seems that relatively simple beam–spring type computer programs will provide data for reasonably accurate designs of retaining walls for basements of up to two levels. Input parameters such as K0, φ‘ and soil stiffness need to be carefully specified. Groundwater inflows can be significant but can be dealt with by providing a good cut-off into the underlying glacial till or bedrock and by conventional pumping techniques. Geophysical techniques such as multichannel analysis of surface waves, S/P waves and resistivity can be very useful for the determination of soil properties, such as degree of saturation, density and stiffness, and for material characterisation (i.e. distinguishing the presence of these materials in contrast to the Boulder Clay).
Mechanical behaviour of a steel fibre reinforced concrete ground slab
Authors: Alani Amir , Beckett Derrick , Khosrowshahi Farzad
Published: June 2012

Concrete ground slabs are essential components of modern buildings and structures. This common structural element has been used in great numbers in buildings and structures of various forms and sizes throughout the world for decades. The utilisation of fibre reinforced concrete for ground slab purposes has gained significant momentum in recent years. The third edition of report TR34, published by the UK Concrete Society in 2003, has paid attention to the design of concrete ground slabs with significant emphasis on the use of steel and synthetic fibres as an alternative to fabric reinforcement. TR34 is currently under review and this paper attempts to contribute towards a better understanding of the mechanical behaviour of steel fibre reinforced concrete slabs under step loading conditions. This work reports on tests carried out at different locations (centre, edges and corners) of a 6·0 × 6·0 × 0·15 m steel fibre reinforced concrete slab. A significant difference was found between the test results and theoretical values derived using available design codes.
Behaviour of reinforced concrete dapped-end beams
Authors: Lu Wen-Yao , Lin Ing-Jaung , Yu Hsin-Wan
Published: June 2012

The test results of 24 reinforced concrete dapped-end beams are reported. The main variables studied were the compressive strength of concrete, the shear span-to-depth ratio and the horizontal load. The test results indicate that the shear strength of dapped-end beams increases with an increase in concrete compressive strength. The shear strength of dapped-end beams also increases with decreases in shear span-to-depth ratio and horizontal load. The smaller the shear span-to-depth ratio of dapped-end beams, the greater their stiffness and ultimate load. Both the stiffness and the ultimate load of dapped-end beams increase with increasing concrete compressive strength, but decrease with an increase in horizontal load. The extension of the softened strut-and-tie model for predicting the shear strength of dapped-end beams with a shear span-to-depth ratio greater than unity is examined in this paper. The shear strength predicted by the proposed model, the strut-and-tie model of the American Concrete Institute (ACI) and the approach of the Precast/Prestressed Concrete Institute (PCI) are compared with available test results. The comparison shows that the proposed model and the strut-and-tie model can predict the shear strength of reinforced concrete dapped-end beams more accurately than the PCI approach.
The Relationship between Flow and Bacteria in Streams
Authors: Chin David A.
Published: June 2012

A method is proposed to relate the statistics of in‐stream bacteria concentrations to the surface‐runoff fraction of stream flow. The parameters of this relationship include the characteristic concentration of bacteria in surface runoff and the characteristic concentration of bacteria in the base flow, and these parameters can be derived from synoptic bacteria and flow measurements. The effectiveness of the proposed method is demonstrated at several U.S. locations for both Escherichia coli and fecal coliform bacteria. Application of the proposed method at a particular location showed that the method can be used to identify the most effective bacteria source controls and that conventional application of the load‐duration curve might lead to erroneous identification of target sources.
Childhood Obesity, Unrecognized Public Health Challenge in Nepal
Authors: Aryal M
Published: June 2012

No abstract available.DOI: http://dx.doi.org/10.3126/kumj.v8i4.6229 Kathmandu Univ Med J 2010;8(4):358-9
Positive Mental Health, Need for Holistic Approach
Authors: Sharma P P
Published: June 2012

No abstract available.DOI: http://dx.doi.org/10.3126/kumj.v8i4.6230 Kathmandu Univ Med J 2010;8(4):360-1
Evaluation of Lipid Peroxidation and Antioxidants’ Status in Metabolic Syndrome
Authors: Shrestha S , Chandra L , Aryal M , Das B K L , Pandey S , Baral N
Published: June 2012

Background Metabolic syndrome is a constellation of physical conditions and metabolic abnormalities, commonly occurring together, that increases an individual’s risk for development of type 2 diabetes mellitus and cardiovascular diseases. Oxidative stress is associated with diabetes, hypertension and other cardiovascular diseases while the role of oxidative stress in pathogenesis of MS is not clearlydefined. Objectives The study aims to find out the prevalence of metabolic syndrome in faculty and staff members at BP Koirala Institute of Health Sciences, Dharan, Nepal and to evaluate oxidative stress levels insubjects with metabolic syndrome. Methods 118 healthy participants working at B. P. Koirala Institute of Health Sciences, Dharan, Nepal were selected at random for this cross-sectional study and blood samples were collected for the estimation of the following biochemical analytes; fasting glucose; triglycerides; total cholesterol; high density lipoprotein cholesterol; Albumin; uric acid; Bilirubin; Malondialdehyde; Catalase; Glutathione peroxidase; Superoxide Dismutase; Glutathione; vitamin C; and lastly vitamin E. Results In this cross-sectional study, 39% subjects were diagnosed with metabolic syndrome , particularly in sedentary subjects. There was no difference in oxidative stress except significant rises in serum uric acid levels and catalase activity in subjects diagnosed with metabolic syndrome . Conclusion The prevalence of metabolic syndrome is higher without oxidative stress in this study, which suggests that oxidative stress does not contribute to the pathogenesis of MS in otherwise healthy subjects.http://dx.doi.org/10.3126/kumj.v8i4.6236 Kathmandu Univ Med J 2010;8(4):382-6
Risk factors of Multidrug Resistant Tuberculosis in central Nepal: A pilot study
Authors: Marahatta S B , Kaewkungwal J , Ramasoota P , Singhasivanon P
Published: June 2012

Introduction Tuberculosis is the most widespread infectious disease in Nepal and poses a serious threat to the health and development of the country. Incidences of drug resistant tuberculosis in Nepal are increasing and this tuberculosisis a major threat to successfully controlling tuberculosis . Objective The general objective of the study was to assess the risk factors of multi-drug resistant tuberculosis among the patients attending the National Tuberculosis Centre, Bhaktpur Nepal. Methods An observational study/ case-control study with a Atotal number of 55 multi-drug resistant tuberculosis cases and 55 controls. The study was conducted among the patient attending in the National Tuberculosis Centre , Bhaktpur Nepal for six months, between May–October 2010. sImulti-drug resistant tuberculosis wasThe collected data was analysed in SPSS 11.5 version. The association between categorical variables were analysed by chi-square tests, OR and their 95% CI were measured. Results The total number of patients used for the study was 110, of which among them 55 were cases and 55 were controls . Our study revealed that there were significant associations between history of prior TB MDR-TB OR =2.799 (95 % CI 1.159 to 6.667) (p=0.020); smoking habit OR =2.350 and (95%CI 1.071 to 5.159) (p=0.032); social stigma social stigma OR 2.655 (95%CI r 1.071 to 5.159) (p=0.013); knowledge on MDR-TB OR =9.643 (95% CI 3.339 to 27.846) (p < 0.001)and knowledge on DOTS Plus OR=16.714 (95% CI is ranging from 4.656 to 60.008) (p< 0.001). However, there was no association found between alcohol drinking habits and ventilation in the room. Conclusion Our study revealed that there were significant associations between history of prior tuberculosis, smoking habit social stigma social stigma, knowledge on multi-drug resistant tuberculosis and knowledge on DOTS Plus with multi-drug resistant tuberculosis However there was no association between alcohol drinking habit and ventilation in room with multi-drug resistant tuberculosis. http://dx.doi.org/10.3126/kumj.v8i4.6238 Kathmandu Univ Med J 2010;8(4):392-7
Unusual Site of Metastasis of Bronchogenic Carcinoma
Authors: Pant P , Sedhain A , D'Souza S , Renuka B G
Published: June 2012

Metastasis of bronchogenic carcinoma to the chest wall and axillary lymphnodes is a rare occurence. This study reports the case of a patient presenting with chest wall swelling as initial symptom which on evaluation was found to be a lymphnode metastasis. The patient also had axillary lymphnode metastasis on the same side as the chest swelling with a contralateral pleural effusion. Here, we discuss the pathways and possible mechanisms of contra lateral auxillary and chest wall lymphnode involvement without ispilateral nodal involvement in bronchogenic carcinoma.http://dx.doi.org/10.3126/kumj.v8i4.6243 Kathmandu Univ Med J 2010;8(4):420-22
Neonatal Abstinence Syndrome
Authors: Kirtisudha Mishra K , Chopra N , Dudeja A , Datta V , Saili A , Dutta A K
Published: June 2012

Intrauterine exposure to drugs by mothers is not an uncommon finding ine our society. Due to the mother’s suppression of a medical history, the diagnosis of neonatal abstinence syndrome is often missed. We report a case of a term, female, newborn, who presented with the following features;e restlessness, inconsolable crying, along with sweating, vigorous sucking; andadiarrhoea. No conclusion was derived from routine investigations. Eventually, with a high degree of suspicion regarding maternal drug addiction, her history was reviewed and it was discovered that the mother was a heroin addict. The baby was diagnosed as a case of Neonatal Abstinence Syndrome. The neonate was successfully managed thereafter and discharged.http://dx.doi.org/10.3126/kumj.v8i4.6245 Kathmandu Univ Med J 2010;8(4):426-8
Telomeres and Telomerase: The Commitment Theory of Cellular Ageing Revisited
Authors: Holliday Robin
Published: June 2012

It is not always realised that separate fibroblast populations of the same strain have very different lifespans, that is, over a million-fold range. This is best documented for human strains WI-38 and MRC-5. There is evidence that it is the molecular clock of telomere shortening which determines the growth potential of these cells. However, if a clock is set and runs its course one would expect parallel cultures to have similar lifespans. The commitment theory of fibroblast ageing proposes that commitment occurs during early cell divisions with a given probability, and after that there is then a constant number of divisions until growth ceases. This constant number could be determined by the gradual loss of telomeres. The stochastic feature of the theory is the probability of the loss of the last uncommitted cells or the youngest committed cells. These cells have the longest lifespan and will give rise to the final population.
New 19-Oxygenated Steroids from the Soft Coral Nephthea chabrolii
Authors: Wang Shang-Kwei , Puu Shyh-Yueh , Duh Chang-Yih
Published: June 2012

In order to search for novel bioactive substances from marine organisms, we investigated the acetone extract of the soft coral Nephthea chabrolii collected at San-Hsian-Tai, Taitong County, Taiwan. From this extract three new 19-oxygenated steroids, nebrosteroids N–P (1–3) were isolated. The structures of these compounds were elucidated by extensive spectroscopic analyses.
Porous Copolymer Resins: Tuning Pore Structure and Surface Area with Non Reactive Porogens
Authors: Mohamed Mohamed H. , Wilson Lee D.
Published: June 2012

In this review, the preparation of porous copolymer resin (PCR) materials via suspension polymerization with variable properties are described by tuning the polymerization reaction, using solvents which act as porogens, to yield microporous, mesoporous, and macroporous materials. The porogenic properties of solvents are related to traditional solubility parameters which yield significant changes in the surface area, porosity, pore volume, and morphology of the polymeric materials. The mutual solubility characteristics of the solvents, monomer units, and the polymeric resins contribute to the formation of porous materials with tunable pore structures and surface areas. The importance of the initiator solubility, surface effects, the temporal variation of solvent composition during polymerization, and temperature effects contribute to the variable physicochemical properties of the PCR materials. An improved understanding of the factors governing the mechanism of formation for PCR materials will contribute to the development and design of versatile materials with tunable properties for a wide range of technical applications.
Risk Factors and Outcome of Contamination in Patients on Peritoneal Dialysis—A Single-Center Experience of 15 Years
Authors: Yap Desmond Y.H. , Chu Wai Ling , Ng Flora , Yip Terence Pok Siu , Lui Sing Leung , Lo Wai Kei
Published: June 2012

♦ Objective

Contamination is an important risk factor for peritoneal dialysis (PD)–related peritonitis. The present study outlines the clinical characteristics and outcomes of PD patients experiencing touch contamination.

♦ Methods

We reviewed the case records of PD patients from 1995 to 2010. Patients who experienced contamination of their PD system were identified and stratified into “dry” and “wet” contamination groups. Risk factors, microbiology, and clinical outcomes were compared.

♦ Results

Of 548 episodes of touch contamination, 246 involved dry contamination, and 302, wet contamination. After contamination, 17 episodes of peritonitis (3.1%) developed; all episodes occurred in the wet contamination group ( p < 0.001). The incidence of peritonitis after wet contamination was 5.63%. Prophylactic antibiotics significantly reduced the risk of peritonitis (1 of 182 episodes, p < 0.001). Half the patients experiencing peritonitis had either culture-negative or staphylococcal episodes, and most of those episodes responded to intraperitoneal antibiotics. In 2 patients, peritonitis was attributable to Pseudomonas, and in 3, to Acinetobacter. In these latter patients, outcomes were less favorable, with catheter removal being required in 4 of the 5 episodes.

♦ Conclusions

The overall rate of peritonitis was low after contamination. Wet contamination was associated with a much higher risk of peritonitis. Prophylactic antibiotics after wet contamination were effective in preventing peritonitis.
A Multidimensional Model of Fatigue in Patients with Rheumatoid Arthritis
Authors: NICASSIO PERRY M. , ORMSETH SARAH R. , CUSTODIO MARA K. , IRWIN MICHAEL R. , OLMSTEAD RICHARD , WEISMAN MICHAEL H.
Published: June 2012

Objective.

To evaluate a multidimensional model testing disease activity, mood disturbance, and poor sleep quality as determinants of fatigue in patients with rheumatoid arthritis (RA).

Method.

The data of 106 participants were drawn from baseline of a randomized comparative efficacy trial of psychosocial interventions for RA. Sets of reliable and valid measures were used to represent model constructs. Structural equation modeling was used to test the direct effects of disease activity, mood disturbance, and poor sleep quality on fatigue, as well as the indirect effects of disease activity as mediated by mood disturbance and poor sleep quality.

Results.

The final model fit the data well, and the specified predictors explained 62% of the variance in fatigue. Higher levels of disease activity, mood disturbance, and poor sleep quality had direct effects on fatigue. Disease activity was indirectly related to fatigue through its effects on mood disturbance, which in turn was related to poor sleep quality. Mood disturbance also indirectly influenced fatigue through poor sleep quality.

Conclusion.

Our findings confirmed the importance of a multidimensional framework in evaluating the contribution of disease activity, mood disturbance, and sleep quality to fatigue in RA using a structural equation approach. Mood disturbance and poor sleep quality played major roles in explaining fatigue along with patient-reported disease activity.
Improved Health-related Quality of Life and Physical Function in Patients with Refractory Chronic Gout Following Treatment with Pegloticase: Evidence from Phase III Randomized Controlled Trials
Authors: STRAND VIBEKE , KHANNA DINESH , SINGH JASVINDER A. , FORSYTHE ANNA , EDWARDS N. LAWRENCE
Published: June 2012

Objective.

To assess the efficacy of pegloticase on pain, physical function, and health-related quality of life (HRQOL) in patients with refractory chronic gout.

Methods.

Subjects in 2 replicate, 6-month, randomized controlled phase III trials received intravenous infusions of pegloticase 8 mg twice monthly (biweekly group), pegloticase alternating with placebo (8-mg monthly group), or placebo. Medical Outcomes Study Short Form-36 (SF-36), Health Assessment Questionnaire-Disability Index (HAQ-DI), patient global assessment of disease activity (PtGA), and pain by visual analog scale were completed at weeks 1 (baseline), 13, 19, and 25. Prespecified pooled analyses of patient-reported outcomes were performed by combining values for each treatment group (biweekly treatment, monthly treatment, and placebo) at Week 25.

Results.

Of 212 patients enrolled, 157 (74.1%) completed treatment. At entry, mean age was 55.4 years (range 23–89 yrs) and mean plasma uric acid was 9.7 mg/dl; most were male (81.6%) and white (67.5%). Subjects reported an average of 9.8 flares in the previous 18 months. Baseline SF-36 physical component summary (PCS) scores were > 1.5 SD below US normative values. At Week 25, mean changes from baseline in PtGA, pain, HAQ-DI, and PCS scores were statistically significant and exceeded minimum clinically important differences (MCID) in the biweekly treatment group, compared with little to no improvement in placebo group. Statistically significant improvements greater than or equal to MCID were reported in 6 of 8 SF-36 domains. Monthly pegloticase resulted in significantly improved PtGA, HAQ-DI, PCS, and 3 SF-36 domains.

Conclusion.

Pegloticase therapy resulted in statistically significant and clinically meaningful improvements in PtGA, pain, physical function, and HRQOL.
Vascular Leak Is a Central Feature in the Pathogenesis of Systemic Sclerosis
Authors: FRECH TRACY M. , REVELO MONICA P. , DRAKOS STAVROS G. , MURTAUGH MAUREEN A. , MARKEWITZ BOAZ A. , SAWITZKE ALLEN D. , LI DEAN Y.
Published: June 2012

Objective.

The main histopathological focus of systemic sclerosis (SSc) has concentrated on fibrotic changes. We investigated the microvasculature alterations in the skin of patients with SSc at various stages of disease duration with whole-field digital microscopy.

Methods.

Twenty consecutive patients with SSc, 1 with Raynaud’s phenomenon (RP) without SSc, and 4 healthy controls underwent punch biopsy on the medial forearm. Eighteen patients were included in the primary analysis. Two with recent-onset diffuse cutaneous disease, 1 repeat SSc biopsy, and 1 patient with RP without SSc were also evaluated. All specimens were processed with histochemical stains and immunohistochemistry. We analyzed microvasculature abnormalities in an objective and systematic manner taking advantage of recent advances in whole-field digital microscopy. This analysis was coupled with ultrastructural evaluation performed with transmission electron microscopy (TEM).

Results.

Whole-field digital microscopy and TEM of SSc skin biopsies revealed that endothelial abnormalities are a universal feature regardless of clinical features and/or duration of disease. These features were not seen in any healthy control specimens or in the single RP patient samples. Whole-field digital microscopy identified increased interstitial edema (31.0% ± 9.6% vs 17.6% ± 3.3% in controls; p = 0.009) and fibrosis (75.6% ± 5.7% vs 66.1% ± 9.8% in controls; p = 0.02) in all patients with SSc. Lower CD34 staining was seen in SSc compared to healthy controls (0.32% ± 0.22% vs 1.31% ± 0.34%; p < 0.0001) and within the SSc population with interstitial lung disease (0.55% ± 0.22% vs 0.15% ± 0.16%; p = 0.01). Perivascular and interstitial infiltrate of mast cells was present in all SSc specimens.

Conclusion.

Whole-field digital microscopy offers a means of rapidly carrying out objective, fully quantitative, and reproducible measurements of microscopic features of SSc microvascular change. The universal morphologically abnormal endothelial cells and interstitial edema in all patients with SSc biopsied suggests that SSc may be intrinsically a disease of the endothelium characterized by vascular leak.
Relations of Serum COMP to Cardiovascular Risk Factors and Endothelial Function in Patients with Rheumatoid Arthritis Treated with Methotrexate and TNF-α Inhibitors
Authors: HJELTNES GUNNBJØRG , HOLLAN IVANA , FØRRE ØYSTEIN , WIIK ALLAN , LYBERG TORSTEIN , MIKKELSEN KNUT , AGEWALL STEFAN
Published: June 2012

Objective.

To examine whether serum level of cartilage oligomeric matrix protein (S-COMP) is related to methotrexate (MTX) or to MTX and tumor necrosis factor-α (TNF-α) combination treatment for rheumatoid arthritis (RA); and to investigate whether S-COMP is related to cardiovascular risk factors including endothelial dysfunction and level of anticitrullinated protein antibodies (ACPA) in patients with RA.

Methods.

Clinical and laboratory measures, including S-COMP and reactive hyperemic index (RHI), were examined in 55 consecutive patients with RA starting with either MTX (n = 34) or MTX and anti-TNF-α treatment (n = 21) at baseline, and after 6 weeks and 6 months.

Results.

S-COMP was similar in the 2 treatment regimens during followup. We found a positive relationship between S-COMP at baseline and the use of disease-modifying antirheumatic drugs the last year preceding the study (p = 0.001), and a negative relation to current use of systemic glucocorticosteroids (p = 0.044). The nonsignificant change in S-COMP between baseline and the 6-month followup was positively and independently related to change in ACPA level (p = 0.009). There was no significant association between RHI and level of S-COMP at baseline.

Conclusion.

The cartilage turnover marker S-COMP did not change significantly after 6 months’ treatment with MTX with or without a TNF-α inhibitor in patients with RA. The positive association between S-COMP and ACPA suggests that these factors might interact, and could both be contributors to an unknown link between inflammation and cartilage destruction in patients with RA. S-COMP was not related to endothelial function in patients with RA, or to other cardiovascular risk factors studied. Clinical Trials registration numberNCT00902005.
Preventing Friction-induced Chondrocyte Apoptosis: Comparison of Human Synovial Fluid and Hylan G-F 20
Authors: WALLER KIMBERLY A. , ZHANG LING X. , FLEMING BRADEN C. , JAY GREGORY D.
Published: June 2012

Objective.

Symptomatic osteoarthritis (OA) is a common painful disease with limited treatment options. A rising number of patients with OA have been treated with intraarticular injections of hyaluronic acid, including the high-molecular-weight hylan G-F 20, which is injected following arthrocentesis. We investigated the effectiveness of hylan G-F 20 to lower coefficient of friction (COF) and prevent chondrocyte apoptosisin vitro.

Methods.

A disc-on-disc bovine cartilage bearing was used to measure the static and kinetic COF when lubricated with hylan G-F 20, human synovial fluid (HSF), and phosphate buffered saline (PBS). Following friction testing, we stained paraffin-embedded sections of these cartilage bearings for activated caspase-3, a marker of apoptosis.

Results.

Bearings lubricated with hylan G-F 20 had kinetic COF values that were similar to bearings lubricated with PBS, but significantly higher than those lubricated with HSF. There were no significant differences in static COF values in bearings lubricated with hylan G-F 20 as compared to PBS or HSF. However, bearings lubricated with HSF had significantly lower static COF values compared to bearings lubricated with PBS. The mean percentage of caspase-3-positive chondrocytes in the superficial and upper intermediate zones of bearings lubricated with hylan G-F 20 was significantly higher compared to that of bearings lubricated with HSF or unloaded controls, but significantly lower than in those lubricated with PBS.

Conclusion.

These findings indicate that joint lubrication may prevent chondrocyte apoptosis by lowering the COF. Further, removal of synovial fluid prior to hylan G-F 20 injection may be detrimental to cartilage health.
Patient-acceptable Symptom State as an Outcome Measure in the Daily Care of Patients with Ankylosing Spondylitis
Authors: RODRÍGUEZ-LOZANO CARLOS , GANTES MARÍA-ÁNGELES , GONZÁLEZ BEATRIZ , HERNÁNDEZ-BERIAIN JOSÉ A. , NARANJO ANTONIO , HERNÁNDEZ VANESA , QUEVEDO-ABELEDO JUAN C. , FALCÓN M. JOSÉ , MACHÍN SERGIO , DESCALZO MIGUEL A.
Published: June 2012

Objective.

We assessed the prevalence of patients with ankylosing spondylitis (AS), rating their state as acceptable (patient-acceptable symptom state; PASS), among 190 patients with AS seen in daily practice. Factors associated with PASS status and PASS thresholds for outcome measures were also analyzed.

Methods.

The characteristics of patients with affirmative and negative assignment to PASS were compared. Associated factors were estimated by logistic regression models and PASS thresholds by the 75th percentile and receiver-operating characteristic curve methods.

Results.

A total of 77% of patients rated their state as acceptable (95% CI 62–91). These patients were taking fewer nonsteroidal antiinflammatory drugs and corticosteroids, practiced more exercise, had less anxiety and depression, and had lower values of all patient-reported outcome measures, physicians’ assessment, AS Disease Activity Score (ASDAS) and C-reactive protein. Lower values of Bath AS Disease Activity Index and physician’s global assessment were independent factors associated with acceptable symptom state. High rates of anxiety and depression were found in patients not in PASS. The thresholds with the 75th percentile approach were 4.55 for the BASDAI and 2.84 for the ASDAS. Fifty-three percent of patients in PASS had a high or very high disease activity state according to ASDAS cutoff values.

Conclusion.

A high percentage of patients with AS in daily practice declared that their symptom state was acceptable. PASS status correlated with physician global assessment and BASDAI. PASS thresholds for common recommended outcome measures were relatively high and many patients in PASS had unacceptably high disease activity states according to ASDAS. Other factors such as psychological problems may influence a negative PASS state.
Colchicine Use Is Associated with Decreased Prevalence of Myocardial Infarction in Patients with Gout
Authors: CRITTENDEN DARIA B. , LEHMANN R. AARON , SCHNECK LAURA , KEENAN ROBERT T. , SHAH BINITA , GREENBERG JEFFREY D. , CRONSTEIN BRUCE N. , SEDLIS STEVEN P. , PILLINGER MICHAEL H.
Published: June 2012

Objective.

The ability of antiinflammatory strategies to alter cardiovascular risk has not been rigorously examined. Colchicine is an antiinflammatory agent that affects macrophages, neutrophils, and endothelial cells, all of which are implicated in the pathogenesis of cardiovascular disease. We examined whether colchicine use was associated with a reduced risk of myocardial infarction (MI) in patients with gout.

Methods.

We conducted a retrospective, cross-sectional study of all patients with an International Classification of Diseases, 9th ed, code for gout in the electronic medical record (EMR) of the New York Harbor Healthcare System Veterans Affairs network and ≥ 1 hospital visit between August 2007 and August 2008. Hospital pharmacy data were used to identify patients who had filled at least 1 colchicine prescription versus those who had not. Demographics and CV comorbidities were collected by EMR review. The primary outcome was diagnosis of MI. Secondary outcomes included all-cause mortality and C-reactive protein (CRP) level.

Results.

In total, 1288 gout patients were identified. Colchicine (n = 576) and no colchicine (n = 712) groups had similar baseline demographics and serum urate levels. Prevalence of MI was 1.2% in the colchicine versus 2.6% in the no-colchicine group (p = 0.03). Colchicine users also had fewer deaths and lower CRP levels, although these did not achieve statistical significance. Colchicine effects persisted when allopurinol users were excluded from the analysis.

Conclusion.

In this hypothesis-generating study, gout patients who took colchicine had a significantly lower prevalence of MI and exhibited trends toward reduced all-cause mortality and lower CRP level versus those who did not take colchicine.