bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic Value of Plasma Neuroendocrine Biomarkers in Patients with Acute Ischaemic Stroke
Authors: Tu W.‐J. , Dong X. , Zhao S.‐J. , Yang D.‐G. , Chen H.
Published: May 2013

Inflammation and activation of the neuroendocrine systems comprise important aspects of stroke pathophysiology. The present study investigated whether baseline plasma brain natriuretic peptide (BNP), N‐terminal pro‐brain natriuretic peptide (NT‐proBNP), cortisol and copeptin levels on admission can predict short‐term outcomes and mortality after acute ischaemic stroke. The study group consisted of 189 patients who had their first acute ischaemic stroke. Plasma levels of BNP, NT‐proBNP, cortisol and copeptin were evaluated to determine their value with respect to predicting functional outcome and mortality within 3 months. As a result of cardiovascular and neurological investigations (including imaging techniques), lesion size, stroke subtype classification and clinical outcome after 3 months were determined. Plasma levels of BNP, NT‐proBNP, cortisol and copeptin were associated with stroke severity, as well as short‐term functional outcomes. After adjusting for all other significant outcome predictors, NT‐proBNP, cortisol and copeptin remained as independent outcome predictors. In the receiver operating characteristic curve analysis, the biomarker panel (including BNP, NT‐proBNP, cortisol and copeptin) predicted functional outcome and death within 90 days significantly more efficiently than the National Institute of Health Stroke Scale (NIHSS) or the biomarker alone. Copeptin showed a significantly greater discriminatory ability as a single biomarker compared to BNP, NT‐proBNP, cortisol and NIHSS score. These results suggest that a biomarker panel may add valuable and time‐sensitive prognostic information in the early evaluation of acute ischaemic stroke. This may provide a channel for interventional therapy in acute stroke.
Vegetative Compatibility, Pathogenicity and Virulence Diversity of Fusarium oxysporum f. sp. melongenae Recovered from Eggplant
Authors: Altinok Hacer Handan , Can Canan , Çolak Hilal
Published: May 2013

Fusarium oxysporum (Schlechtend.: Fr.) f. sp. melongenae (Fomg) recovered from symptomatic eggplants from five eggplant‐growing areas in Turkey, including the south, west, north‐west, north and south‐east regions. The objective of this study was to investigate the genetic diversity of the Fomg isolates from different geographical location by pathogenicity and VCG tests. Three hundred and seventy‐four Fomg isolates were classified as highly virulent, virulent, moderately virulent and low virulent through pathogenicity assays. No correlation was observed between virulence of Fomg isolates and their locations. The nitrate non‐utilizing mutants (nit) were generated as nit1, nit3 and NitM, based on phenotyping of Fomg growth characteristics of the Fomg isolates on diagnostic media with various sources of nitrogen. The majority of nit mutants (39.4%) recovered were nit1 from minimal medium (MM) containing of 2.0% potassium chlorate (MMC). The most of Fomg isolates were identified as heterokaryon self‐compatible (HSC) based on their ability to form a stable heterokaryon, while four isolates were classified as heterokaryon self‐incompatible (HSI). A large amount of Fomg isolates were vegetatively compatible and assigned as members of the same VCG, whereas nit mutants of 10 Fomg isolates that did not complement with tester strains only paired by themselves (HSC), these isolates were termed vegetative incompatible (vic). The complementation of 33 isolates with tester strains was slow and quite weak, but not paired with themselves even though they are HSC. About 96.3% of the Fomg isolates were assigned to VCG 0320, while the remaining 3.7% were classified as vegetative incompatible group.
A Critical Review and Meta‐Analysis of the Efficacy of Whole‐Cell KilledTritrichomonas foetusVaccines in Beef Cattle
Authors: Baltzell P. , Newton H. , O'Connor A.M.
Published: May 2013

This review assesses the efficacy of whole cellTritrichomonas foetusvaccine to prevent and treat trichomoniasis in beef cattle. Three databases were searched in June 2012. Eligible studies compared infection risk, open risk, and abortion risk in heifers or infection risk in bulls that received vaccine compared with no vaccine. Study results were extracted, summary effect measures were calculated, and the quality of the evidence was assessed. From 334 citations identified, 10 were relevant to the review.For heifers, there was limited evidence of moderate quality to assess the impact of vaccination on infection risk (RR, 0.89;P = .16; 95% CI, 0.76–1.05; 6 randomized and 4 nonrandomized studies; 251 animals) and open risk (RR, 0.80;P = .06; 95% CI, 0.63–1.01; 6 randomized and 5 nonrandomized studies; 570 animals). The quality of the body of work describing the impact of vaccination on abortion risk was low (summary RR, 0.57;P = .0003; 95% CI, 0.42–0.78; 3 randomized and 2 nonrandomized studies; 176 animals). The quality of evidence was very low for duration of infection (mean difference, −23.42;P = .003; 95% CI, −38.36 to −7.85; 2 randomized and 3 nonrandomized studies; 163 animals). Although the summary effect measures suggest a benefit to vaccination, due to publication bias the effect reported here is likely an over estimate of efficacy. For bull‐associated outcomes, the evidence base was low or very low quality.
Renal effects of NO‐inhibition in patients with cirrhosis vs. healthy controls: a randomized placebo‐controlled crossover study
Authors: Bech Jesper N. , Aagaard Niels K. , Pedersen Robert S. , Sorensen Tina B. , Vilstrup Hendrik , Pedersen Erling B.
Published: May 2013

Background

Nitric oxide (NO) is an important regulator of renal hemodynamics and sodium excretion. Systemic and splanchnic NO‐synthesis is increased in liver cirrhosis contributing to the characteristic hyperdynamic circulation. The significance of renal NO in human cirrhosis is not clear.

Aims

In order to clarify the role of NO in the regulation of renal hemodynamics and sodium excretion in human cirrhosis, we studied the effects of NG‐monomethyl‐L‐arginine (l‐NMMA) – a nonselective NO‐inhibitor – on blood pressure (MAP), heart rate (HR), GFR, RPF, UNa × V, FENa, FELi and plasma levels of renin, angII, aldo, ANP, BNP and cGMP in 13 patients with cirrhosis (Child gr.A: 8; Child gr.B+C: 5) and 13 healthy controls.

Methods

The study was randomized and placebo‐controlled. Renal hemodynamics were assessed by measuring renal clearance of 51Cr‐EDTA and 125I‐Hippuran for GFR and RPF, respectively.

Results

l‐NMMA induced a similar, significant increase in MAP in both groups and a more pronounced relative decrease in HR in the CIR group (P = 0.0209, anova). l‐NMMA did not change GFR in any group, but RPF decreased significantly in both groups, but most pronouncedly in CIR (P = 0.0478, anova). FENa decreased significantly in both groups after l‐NMMA, but the response was again most pronounced in the CIR group (P = 0.0270, anova). All parameters remained stable after placebo. No significant differences were observed between the effects of l‐NMMA in Child gr.A vs. Child gr. B+C patients.

Conclusion

The data supports the hypothesis that renal NO is enhanced in human cirrhosis.
Evidence for adaptive evolution of low‐temperature stress response genes in a Pooideae grass ancestor
Authors: Vigeland Magnus D. , Spannagl Manuel , Asp Torben , Paina Cristiana , Rudi Heidi , Rognli Odd‐Arne , Fjellheim Siri , Sandve Simen R.
Published: May 2013

Adaptation to temperate environments is common in the grass subfamily Pooideae, suggesting an ancestral origin of cold climate adaptation. Here, we investigated substitution rates of genes involved in low‐temperature‐induced (LTI) stress responses to test the hypothesis that adaptive molecular evolution of LTI pathway genes was important for Pooideae evolution.

Substitution rates and signatures of positive selection were analyzed using 4330 gene trees including three warm climate‐adapted species (maize (Zea mays), sorghum (Sorghum bicolor), and rice (Oryza sativa)) and five temperate Pooideae species (Brachypodium distachyon, wheat (Triticum aestivum), barley (Hordeum vulgare), Lolium perenne and Festuca pratensis).

Nonsynonymous substitution rate differences between Pooideae and warm habitat‐adapted species were elevated in LTI trees compared with all trees. Furthermore, signatures of positive selection were significantly stronger in LTI trees after the rice and Pooideae split but before the Brachypodium divergence (P < 0.05). Genome‐wide heterogeneity in substitution rates was also observed, reflecting divergent genome evolution processes within these grasses.

Our results provide evidence for a link between adaptation to cold habitats and adaptive evolution of LTI stress responses in early Pooideae evolution and shed light on a poorly understood chapter in the evolutionary history of some of the world's most important temperate crops.
Video observation of anesthesia practice: a useful and reliable tool for quality improvement initiatives
Authors: Rampersad Sally E. , Martin Lizabeth D. , Geiduschek Jeremy M. , Weiss Gillian K. , Bates Shelly W. , Martin Lynn D.
Published: May 2013

Aims

Patients with central venous catheters who are transferred out of the Intensive Care Unit to the care of an anesthesiology team for an operation or interventional radiology procedure had excessive rates of catheter associated blood stream infection (CABSI).

Methods

We convened a multi‐disciplinary team to audit anesthesia practice and to develop countermeasures for those aspects of practice that were thought to be contributing to CABSI's. It was noted that provider behavior changed in the presence of an auditor (Hawthorne effect) and so videorecordings were used, in the hope that this Hawthorne effect would be reduced. Clips were chosen from the hours of video (without audio) recordings that showed medication administration, airway management and touching the anesthesia cart of equipment/supplies.

Results

These clips were viewed by three observers and measurements were made to assess intra‐rater and inter‐rater reliability. The clips were then viewed to quantify differences in practice before and after our bundle of “best practices” was introduced.

Conclusions

Although video recording has been used to evaluate adherence to resuscitation protocols in both trauma and in neonatal resuscitation, (Pediatric Emergency Care, 26, 2010, 803; Pediatrics, 117, 2006, 658; Pediatrics, 106, 2000, 654) we believe this is the first time that video has been used to record before and after behaviors for an anesthesia quality improvement initiative.
Electromagnetic Wave Scattering by Two Parallel Infinite Dielectric Cylinders
Authors: Dunster T. M.
Published: May 2013

The case of two parallel infinite dielectric cylinders, of equal diameter and dielectric constant, illuminated by a plane electromagnetic wave is studied. The scattered electric and magnetic fields from both cylinders can be expressed as infinite series involving Hankel functions, and the coefficients of both satisfy coupled systems (which involve Bessel and Hankel functions). It is shown how these systems can be decoupled, and then, in turn, solved explicitly by successive approximations. Under explicit conditions on the physical parameters of the problem, uniform convergence of the successive approximation series is rigorously proven. This is achieved by utilizing certain bounds on Bessel and Hankel functions, which are derived from asymptotic and integral representations.
Defining Single Molecular Forces Required to Activate Integrin and Notch Signaling
Authors: Wang Xuefeng , Ha Taekjip
Published: May 2013

Sensing Tension

Many cellular processes are regulated by mechanical signals. Single-molecule force spectroscopy has been used to probe molecular unfolding or unbinding; however, measuring the single-molecule forces required to activate signaling remains a challenge.
Wang and Ha
(p.
991
) describe a “Tension Gauge Tether” approach to measure the force applied on a single receptor ligand bond. By using tethers with a range of tension tolerances and monitoring activation, the force required to activate signaling could be measured.
Changes in Taste Neurons Support the Emergence of an Adaptive Behavior in Cockroaches
Authors: Wada-Katsumata Ayako , Silverman Jules , Schal Coby
Published: May 2013

Sugar Aversion

Several populations of the German cockroach have become averse to the glucose used as bait in toxic traps, which has severely reduced the traps' effectiveness.

Wada-Katsumata
et al.

(p.
972
) show that this aversion is a result of changes in the peripheral gustatory system, whereby glucose, as well as “sweet” receptors, stimulated an aversive bitter compound receptor.
Comment on “ApoE-Directed Therapeutics Rapidly Clear β-Amyloid and Reverse Deficits in AD Mouse Models”
Authors: Veeraraghavalu Karthikeyan , Zhang Can , Miller Sean , Hefendehl Jasmin K. , Rajapaksha Tharinda W. , Ulrich Jason , Jucker Mathias , Holtzman David M. , Tanzi Rudolph E. , Vassar Robert , Sisodia Sangram S.
Published: May 2013

Cramer
et al
. (Reports, 23 March 2012, p. 1503; published online 9 February 2012) reported that bexarotene rapidly reduces β-amyloid (Aβ) levels and plaque burden in two mouse models of Aβ deposition in Alzheimer’s disease (AD). We now report that, although bexarotene reduces soluble Aβ
40
levels in one of the mouse models, the drug has no impact on plaque burden in three strains that exhibit Aβ amyloidosis.
Antigen Processing Takes a New Direction
Authors: Goonetilleke Nilu , McMichael Andrew J.
Published: May 2013

A vaccine that protects against SIV in monkeys elicits a new kind of T cell response.

[Also see Research Article by

Hansen
et al.

]
A Multiepitope Fusion Antigen Elicits Neutralizing Antibodies against Enterotoxigenic Escherichia coli and Homologous Bovine Viral Diarrhea VirusIn Vitro
Authors: Hashish Emad A. , Zhang Chengxian , Ruan Xiaosai , Knudsen David E. , Chase Christopher C. , Isaacson Richard E. , Zhou Guoqiang , Zhang Weiping
Published: May 2013

Diarrhea is one of the most important bovine diseases. EnterotoxigenicEscherichia coli(ETEC) and bovine viral diarrhea virus (BVDV) are the major causes of diarrhea in calves and cattle. ETEC expressing K99 (F5) fimbriae and heat-stable type Ia (STa) toxin are the leading bacteria causing calf diarrhea, and BVDV causes diarrhea and other clinical illnesses in cattle of all ages. It is reported that maternal immunization with K99 fimbrial antigens provides passive protection to calves against K99 fimbrial ETEC and that BVDV major structural protein E2 elicits antibodies neutralizing against BVDV viral infection. Vaccines inducing anti-K99 and anti-STa immunity would protect calves more effectively against ETEC diarrhea, and those also inducing anti-E2 neutralizing antibodies would protect calves and cattle against diarrhea caused by both ETEC and BVDV. In this study, we used the ETEC K99 major subunit FanC as a backbone, genetically embedded the STa toxoid STaP12Fand the most-antigenic B-cell epitope and T-cell epitope predicted from the BVDV E2 glycoprotein into FanC for the multivalent antigen FanC-STa-E2, and examined immunogenicity of this multivalent antigen to assess vaccine potential against bovine diarrhea. Mice intraperitoneally (i.p.) immunized with this multivalent antigen developed anti-K99, anti-STa, and anti-BVDV antibodies. Moreover, elicited antibodies showed neutralization activities, as they inhibited adherence of K99 fimbrialE. coli, neutralized STa toxin, and prevented homologous BVDV viral infectionin vitro. Results from this study suggest that this multiepitope fusion antigen can potentially be developed as a vaccine for broad protection against bovine diarrhea and that the multiepitope fusion strategy may be generally applied for multivalent vaccine development against heterogeneous pathogens.
Evaluation of the BioPlex 2200 Syphilis System as a First-Line Method of Reverse-Sequence Screening for Syphilis Diagnosis
Authors: Marangoni Antonella , Nardini Paola , Foschi Claudio , Moroni Alessandra , D'Antuono Antonietta , Bacchi Reggiani Letizia , Cevenini Roberto
Published: May 2013

Despite recent technological advances, the diagnosis of syphilis remains a challenging enterprise. Actually, most high-volume laboratories have adopted the “reverse algorithm” due several factors, including the potential to automate testing. Recently, immunoassays processed on random-access systems have been proposed as screening tests. The purpose of this study was to evaluate diagnostic performances of BioPlex 2200 Syphilis IgG and BioPlex 2200 Syphilis IgM, tests based on Multiplex Flow technology, in comparison with the performance of Architect Syphilis TP, a chemiluminescent immunoassay for the detection of IgG and/or IgM anti-Treponema pallidumantibodies. A retrospective study was performed with a panel of 100 blood donor sera, a panel of 350 clinical and laboratory-characterized syphilitic sera, and 170 samples obtained from subjects with potentially interfering conditions. Moreover, 200 unselected samples submitted to the Microbiology Laboratory of St. Orsola Hospital in Bologna for routine screening for syphilis were evaluated. As confirmatory tests,T. pallidumhemagglutination and Western blot assays were used. Considering the IgG Western blot (WB) assay to be the gold standard method, BioPlex 2200 Syphilis IgG specificity was far higher than Architect Syphilis TP specificity (89.7% versus 78.4%, respectively), whereas the sensitivity was 100% for both automated methods. Compared to the IgM WB assay, BioPlex 2200 Syphilis IgM performed with a specificity of 94.9%, whereas the sensitivity was 84.8%. Considering the excellent ease of use and automation, the high sample throughput and its valuable analytical performances, BioPlex Syphilis 2200 IgG could represent a suitable choice for high-volume laboratories. BioPlex Syphilis 2200 IgM could be considered a good addition to IgG testing for uncovering active infections.
Elevated Inflammatory Mediators in Adults with Oculorespiratory Syndrome following Influenza Immunization: a Public Health Agency of Canada/Canadian Institutes of Health Research Influenza Research Network Study
Authors: Al-Dabbagh Mona , Lapphra Keswadee , Scheifele David W. , Halperin Scott A. , Langley Joanne M. , Cho Patricia , Kollmann Tobias R. , Li Yan , De Serres Gaston , Fortuno Edgardo S. , Bettinger Julie A.
Published: May 2013

Oculorespiratory syndrome (ORS) is an infrequent adverse event following influenza vaccination. Its clinical presentation suggests that ORS is an immune-mediated phenomenon, but studies of symptomatic individuals have been few. This study measured cytokine levels in peripheral blood samples following influenza vaccination in those with and without current ORS symptoms. Canadian adults receiving the 2010-2011 seasonal influenza vaccine were recruited and asked to promptly report any adverse effects. ORS symptoms occurring 4 to 48 h after vaccination were identified using previously published criteria. Two blood samples were collected from each subject to measure blood plasma cytokine and hemagglutination inhibition antibody (HAI) titers; visit 1 occurred during the acute disease phase or 4 to 72 h after vaccination for controls, and visit 2 occurred another 21 days postimmunization. Nine ORS cases and 35 controls were enrolled. The median age of ORS cases was 49 years, and 89% were female. Most cases had multiple symptoms, but none required medical care. HAI titers before and after vaccination were similar for the cases and controls. Blood plasma cytokine concentrations did not differ between the ORS cases and controls for most cytokines measured (interleukin 4 [IL-4], IL-5, IL-10, IL-13, IL-1α, IL-8, tumor necrosis factor alpha [TNF-α], gamma interferon [IFN-γ], and IL-17A). However, ORS cases had higher levels of IL-10 and IL-3 than the controls at visits 1 and 2, even after all symptoms had subsided. Persistent higher levels of IL-10 and IL-3 in ORS cases suggest that host factors may have predisposed these individuals to develop ORS following influenza vaccination. Further investigations are warranted, as they might identify subjects who are at risk for ORS prior to vaccination.
Cell-Type-Specific Activation of the Oligoadenylate Synthetase–RNase L Pathway by a Murine Coronavirus
Authors: Zhao Ling , Birdwell L. Dillon , Wu Ashley , Elliott Ruth , Rose Kristine M. , Phillips Judith M. , Li Yize , Grinspan Judith , Silverman Robert H. , Weiss Susan R.
Published: May 2013

Previous studies have demonstrated that the murine coronavirus mouse hepatitis virus (MHV) nonstructural protein 2 (ns2) is a 2′,5′-phosphodiesterase that inhibits activation of the interferon-induced oligoadenylate synthetase (OAS)-RNase L pathway. Enzymatically active ns2 is required for efficient MHV replication in macrophages, as well as for the induction of hepatitis in C57BL/6 mice. In contrast, following intranasal or intracranial inoculation, efficient replication of MHV in the brain is not dependent on an enzymatically active ns2. The replication of wild-type MHV strain A59 (A59) and a mutant with an inactive phosphodiesterase (ns2-H126R) was assessed in primary hepatocytes and primary central nervous system (CNS) cell types—neurons, astrocytes, and oligodendrocytes. A59 and ns2-H126R replicated with similar kinetics in all cell types tested, except macrophages and microglia. RNase L activity, as assessed by rRNA cleavage, was induced by ns2-H126R, but not by A59, and only in macrophages and microglia. Activation of RNase L correlated with the induction of type I interferon and the consequent high levels of OAS mRNA induced in these cell types. Pretreatment of nonmyeloid cells with interferon restricted A59 and ns2-H126R to the same extent and failed to activate RNase L following infection, despite induction of OAS expression. However, rRNA degradation was induced by treatment of astrocytes or oligodendrocytes with poly(I·C). Thus, RNase L activation during MHV infection is cell type specific and correlates with relatively high levels of expression of OAS genes, which are necessary but not sufficient for induction of an effective RNase L antiviral response.
The Comparative Genomics of Human Respiratory Syncytial Virus Subgroups A and B: Genetic Variability and Molecular Evolutionary Dynamics
Authors: Tan Lydia , Coenjaerts Frank E. J. , Houspie Lieselot , Viveen Marco C. , van Bleek Grada M. , Wiertz Emmanuel J. H. J. , Martin Darren P. , Lemey Philippe
Published: May 2013

Genomic variation and related evolutionary dynamics of human respiratory syncytial virus (RSV), a common causative agent of severe lower respiratory tract infections, may affect its transmission behavior. RSV evolutionary patterns are likely to be influenced by a precarious interplay between selection favoring variants with higher replicative fitness and variants that evade host immune responses. Studying RSV genetic variation can reveal both the genes and the individual codons within these genes that are most crucial for RSV survival. In this study, we conducted genetic diversity and evolutionary rate analyses on 36 RSV subgroup B (RSV-B) whole-genome sequences. The attachment protein, G, was the most variable protein; accordingly, the G gene had a higher substitution rate than other RSV-B genes. Overall, less genetic variability was found among the available RSV-B genome sequences than among RSV-A genome sequences in a comparable sample. The mean substitution rates of the two subgroups were, however, similar (for subgroup A, 6.47 × 10
−4
substitutions/site/year [95% credible interval {CI 95%}, 5.56 × 10
−4
to 7.38 × 10
−4
]; for subgroup B, 7.76 × 10
−4
substitutions/site/year [CI 95%, 6.89 × 10
−4
to 8.58 × 10
−4
]), with the time to their most recent common ancestors (TMRCAs) being much lower for RSV-B (19 years) than for RSV-A (46.8 years). The more recent RSV-B TMRCA is apparently the result of a genetic bottleneck that, over longer time scales, is still compatible with neutral population dynamics. Whereas the immunogenic G protein seems to require high substitution rates to ensure immune evasion, strong purifying selection in conserved proteins such as the fusion protein and nucleocapsid protein is likely essential to preserve RSV viability.
Caecal duplication cyst mimicking intussusception
Authors: Verma Shraddha , Bawa Monika , Rao Katragadda Lakshmi Narasimha , Sodhi Kushaljit Singh
Published: May 2013

Cystic caecal duplication is a rare congenital anomaly. We report a case of an infant, who presented with bilious vomiting and abdominal distension. On ultrasonography, intussusception with a cyst as a lead point was present in the right iliac fossa. On exploration, there was no evidence of intussusception, only caecal duplication cyst was found. To date, only three cases of caecal duplication which mimicked intussusception have been reported in the English literature.
An unusual case of gastric outlet obstruction caused by tuberculosis: challenges in diagnosis and treatment
Authors: Padmanabhan Hari , Rothnie Alexander , Singh Pradip
Published: May 2013

Gastroduodenal tuberculosis (GDTB) is rare in the West. Its presentation can be non-specific and often mimics other more common conditions such as peptic ulcer disease, malignancy and Crohn's disease. Our case describes a 33-year-old Indian immigrant who presented with a 3-year history of dyspepsia and underwent balloon dilation for gastric outlet obstruction (GOO). While biopsies from the duodenum revealed only non-caseating granuloma, a high index of suspicion was maintained and colonoscopy, performed despite the absence of lower gastrointestinal symptoms, revealed a single discrete nodular and ulcerated area in the proximal transverse colon; this eventually grewMycobacterium tuberculosis. Our patient avoided undergoing major surgery and was successfully treated with balloon dilation and antitubercular medication. We highlight the importance of having a concerted, proactive approach to diagnosis. We discuss the therapeutic challenges involving this rare condition and explain the rationale for high-dose antisecretory therapy.
Misguidance of peroral rigid laryngoscopy in assessment of difficult airway: two comparable cases in microlaryngeal surgery
Authors: Zhang Xu , Li Wenxian
Published: May 2013

We describe two patients with laryngeal cyst who underwent microlaryngeal surgery. Peroral rigid laryngoscopy, as an indirect endoscopy, performed via the transoral route, was evaluated as a routine screening tool of the difficult airway in patients with laryngeal neoplasm, in our hospital preoperatively. Peroral rigid laryngoscopy had led to two different procedures: One patient was misdiagnosed as having a difficult airway by the ear, nose and throat  surgeon resulting in an unnecessary awake tracheotomy. The other patient was found to be with an unanticipated difficult intubation following routine anaesthesia, successful on the third attempt. As we saw in these two cases, endoscopic examination  alone was inadequate for the assessment of a difficult airway, which may also lack the predictive sensitivity or may cause a high false positive. Usage of video laryngoscopy combined with intubating stylet will improve the intubation success in patients with huge epiglottic cyst.
‘A one-sided affair’: unilateral pulmonary oedema and the role of cardiac MRI in diagnosing premature coronary artery disease in a patient with Prader-Willi syndrome
Authors: Jabbar Avais , Khan Jamal N , Singh Anvesha , McCann Gerry P
Published: May 2013

There is no formal association between premature coronary artery disease (CAD) and Prader-Willi syndrome despite its association with hyperlipidaemia, diabetes mellitus and hypertension. A 36-year-old man with Prader-Willi syndrome presented with acute breathlessness. Inflammatory markers were borderline elevated and chest radiography demonstrated unilateral diffuse alveolar shadowing. Bronchopneumonia was diagnosed and despite treatment with multiple courses of antimicrobial therapy, there was minimal symptomatic and radiographical improvement. A diagnosis of unilateral pulmonary oedema was suspected. Echocardiography was non-diagnostic due to body habitus and coronary angiography was deemed inappropriate due to uncertainty in diagnosis, invasiveness and pre-existing chronic kidney disease. Therefore, cardiac magnetic resonance was performed, confirming severe triple-vessel CAD. This case demonstrates a presentation of heart failure with unilateral chest radiograph changes in a young patient with Prader-Willi syndrome and severe premature CAD detected by multiparametric cardiac magnetic resonance imaging.
Multiorgan failure related to human monocytic ehrlichiosis
Authors: Yachoui Ralph
Published: May 2013

Human monocytic ehrlichiosis (HME) is a tick-born disease that presents predominantly as a mild to moderate acute illness. Severe life-threatening disease has been reported with a case death rate of approximately 3%, often in immunosuppressed persons. A delay in therapy initiation has been proven to increase the morbidity of the disease. We report a case of an elderly immunocompetent man with severe HME disease and multiorgan failure to emphasise on the severity of this disease in the elderly, as well as the importance of early therapy for overall favourable prognosis.
High-dose thiamine improves the symptoms of Friedreich's ataxia
Authors: Costantini Antonio , Giorgi Rafaela , D'Agostino Sonia , Pala Maria Immacolata
Published: May 2013

Friedreich's ataxia (FRDA) is an autosomal recessive inherited disorder characterised by progressive gait and limb ataxia, dysarthria, areflexia, loss of position sense and a progressive motor weakness of central origin. Some observations indicate that all symptoms of FRDA ataxia could be the manifestation of a thiamine deficiency because of enzymatic abnormalities. Two patients with FRDA were under rehabilitative treatment from February 2012 to February 2013. The scale for assessment and rating of ataxia was performed. The patient began an intramuscular therapy with 100 mg of thiamine every 3–5  days. Injection of high-dose thiamine was effective in reversing the motor failure. From this clinical observation, it is reasonable to infer that a thiamine deficiency due to enzymatic abnormalities could cause a selective neuronal damage in the centres that are typically affected by this disease.
Paraganglioma of the thyroid gland: cytologists’ enigma
Authors: Akhtar Kafil , Sen Ray Prasenjit , Ahmad S Shamhsad , Sherwani Rana K
Published: May 2013

Paraganglioma is a neuroendocrine tumour derived from extra-adrenal cells of the neural crest paraganglia of the autonomic nervous system. These rare neoplasms comprise of around 0.012% of head and neck tumours. Paraganglioma arising in the thyroid gland is exceptionally uncommon and can present as a diagnostic challenge on fine-needle aspiration cytology (FNAC). We report a case of primary thyroid paraganglioma in a 19-year-old woman who presented with a solitary thyroid nodule without palpable cervical lymphadenopathy. FNAC from the lesion caused diagnostic dilemma by mimicking follicular neoplasm and C-cell-derived thyroid tumours; final diagnosis was established by histopathology and immunohistochemistry. The main purpose of this case report is to discuss the differential diagnosis and emphasise on the need of immune markers in the diagnosis of thyroid paraganglioma. In view of the uncertain malignant potential of these tumours, a long-term follow-up is recommended.
The quickest way to A&E may be via the Segway
Authors: Barnes J , Webb M , Holland J
Published: May 2013

The Segway, the two-wheeled, motorised self-transport device is becoming increasingly popular across the globe with the trend of Segway tours now starting to hit cities across the UK. However, Segways have been shown to be potentially extremely dangerous. Stumbling from a moving Segway places pressure on the knee joint while it is being medially or laterally stressed. This is the mechanism associated with tibial plateau fractures; complex fractures often associated with other soft tissue injuries, which are easily missed, are challenging to manage and can be very disabling. This is the case of a young, otherwise healthy woman, who tripped from a moving Segway and sustained a lateral depressed tibial plateau fracture. She was managed with a knee brace, physiotherapy and serial check radiographs. The fracture healed well and she has returned to an almost normal level of function with intensive physiotherapy.
Headache in a young male: the clot thickens
Authors: Miller Charles Philip , Stedman Jonathan , Nagaratnam Kiruba , Gray Robert
Published: May 2013

Cerebral venous sinus thrombosis  is a rare but serious cause of headache. In this report, we present a young man with poorly controlled Crohn's disease who presented with a 2-week history of headache and fluctuating left-sided sensory and motor symptoms. CT demonstrated changes consistent with either a subarachnoid haemorrhage or venous sinus thrombosis. The ensuing magnetic resonance venogram confirmed superior sagittal venous sinus thrombosis and an infarct of his right superior frontal lobe. The patient was started on low-molecular weight heparin and steroids. He required multi-disciplinary input from the stroke physicians, neurologists, gastroenterologists, dieticians and physiotherapists. He made a full neurological recovery and is now on long-term azathioprine. The purpose of this report is to highlight the consideration of venous sinus thrombosis in the diagnosis of headache and as a rare extraintestinal complication of Crohn's disease.
Multifocal primary bone lymphoma: durable complete remission after R-CHOP chemotherapy
Authors: Mohamed Muhajir , Brain Terry , Sharma Sharad
Published: May 2013

Primary bone lymphoma (PBL) is a type of non-Hodgkin's lymphoma predominantly affecting the skeletal system. PBL is an extremely rare cancer in adults affecting mainly the axial skeleton. The extent of bone involvement in these patients is variable. Most of the cases reported had single or a few skeletal lesions. We report a patient who had extensive multifocal lymphoma involving the axial skeleton and a very good and durable response to R-CHOP chemotherapy.
Programme science research on medical male circumcision scale-up in sub-Saharan Africa
Authors: Gray Ronald H , Wawer Maria J , Kigozi Godfrey
Published: May 2013

Three randomised trials demonstrate that voluntary medical male circumcision (MMC) reduces male HIV acquisition by 50–60%, and post-trial surveillance has shown that the effects are long lasting. Scale-up of services has been initiated in 14 high-priority sub-Saharan African countries with high rates of HIV and low prevalence of MMC. However, circumcision coverage in the region remains low. Challenges to MMC rollout include suboptimal demand among higher-risk men, the need to expand access and reduce costs of MMC through personnel task shifting and task sharing, assuring and maintaining a high quality of service provision, and the testing and introduction of non-surgical devices. In addition, early infant male circumcision has not been adequately evaluated in Africa. Here, we describe challenges to implementation and discuss the ongoing and future role of implementation and programme science in addressing such challenges.
Comparison of two cohorts of patients presenting with AIDS: patients with previously known HIV diagnoses and true late presenters
Authors: Lee MJ , Rayment M , Scourfield A , Gazzard B
Published: May 2013

Objectives

We aimed to identify the factors associated with developing AIDS 6 months or more after an HIV diagnosis, and to examine how post-HIV diagnosis AIDS (PHDA) patients differed from true late presenters (HIV diagnosed concurrent with the first AIDS presenting event) in their demographics and comorbidities.

Methods

A retrospective analysis was undertaken of all inpatients admitted to a large HIV unit presenting with the following AIDS-defining infections: cryptococcal meningitis, cerebral toxoplasmosis orPneumocystis jiroveciipneumonia between 1 January 2005 and 31 December 2010.

Results

114 HIV-positive patients presented with AIDS-defining infections. Compared with late presenters, PHDA patients had a larger proportion of migrants and visitors (53.7% vs 34.0%, p=0.047), were more likely to inject drugs (9.3% vs 0.0%, p=0.032), had more previous HIV-associated diseases (57.4% vs 12.8%, p=0.000), psychiatric comorbidities (35.2% vs 12.8%, p=0.009), rates of alcohol abuse (24.1% vs 4.3%, p=0.005) and reported social issues (25.9% vs 0.00%, p=0.000). 88.9% of PHDA patients were lost to follow-up for a period of at least 4 months since diagnosis. Common reasons for clinic non-attendance included travel, social issues, transfer of care and treatment avoidance. Common reasons for antiretroviral treatment breaks included drug side effects, negative beliefs about medication, incompatible lifestyles and social issues.

Conclusions

Compared with late presenters, PHDA patients demonstrate clear demographical differences including higher rates of psychiatric comorbidities, social issues, alcohol and substance abuse. Many PHDA patients default follow-up. The retention of HIV patients in care and on treatment must be addressed by clinicians to prevent avoidable morbidity.
Cross-sectional survey of treatment practices for urethritis at pharmacies, private clinics and government health facilities in coastal Kenya: many missed opportunities for HIV prevention
Authors: Mugo Peter M , Duncan Sarah , Mwaniki Samuel W , Thiong'o Alexander N , Gichuru Evanson , Okuku Haile Selassie , van der Elst Elise M , Smith Adrian D , Graham Susan M , Sanders Eduard J
Published: May 2013

Background

While bacterial sexually transmitted infections (STIs) are important cofactors for HIV transmission, STI control has received little attention in recent years. The aim of this study was to assess STI treatment and HIV testing referral practices among health providers in Kenya.

Methods

In 2011 we assessed quality of case management for male urethritis at pharmacies, private clinics and government health facilities in coastal Kenya using simulated visits at pharmacies and interviews at pharmacies and health facilities. Quality was assessed using Ministry of Health guidelines.

Results

Twenty (77%) of 26 pharmacies, 20 (91%) of 22 private clinics and all four government facilities in the study area took part. The median (IQR) number of adult urethritis cases per week was 5 (2–10) at pharmacies, 3 (1–3) at private clinics and 5 (2–17) at government facilities. During simulated visits, 10% of pharmacies prescribed recommended antibiotics at recommended dosages and durations and, during interviews, 28% of pharmacies and 27% of health facilities prescribed recommended antibiotics at recommended dosages and durations. Most regimens were quinolone-based. HIV testing was recommended during 10% of simulated visits, 20% of pharmacy interviews and 25% of health facility interviews.

Conclusions

In an area of high STI burden, most men with urethritis seek care at pharmacies and private clinics. Most providers do not comply with national guidelines and very few recommend HIV testing. In order to reduce the STI burden and mitigate HIV transmission, there is an urgent need for innovative dissemination of up-to-date guidelines and inclusion of all health providers in HIV/STI programmes.
ON COURNOT COMPETITION UNDER RANDOM YIELD
Authors: YAN XIAOMING , WANG YONG
Published: May 2013

We look at a Cournot model in which each firm may be unreliable with random capacity, so the total quantity brought into market is uncertain. The Cournot model has a unique pure strategy Nash equilibrium (NE), in which the number of active firms is determined by each firm's production cost and reliability. Our results indicate the following effects of unreliability: the number of active firms in the NE is more than that each firm is completely reliable and the expected total quantity brought into market is less than that each firm is completely reliable. Whether a given firm joins in the game is independent of its reliability, but any given firm always hopes that the less-expensive firms' capacities are random and stochastically smaller.
CLASSIFICATION OF ORBIT CLOSURES IN THE VARIETY OF THREE-DIMENSIONAL NOVIKOV ALGEBRAS
Authors: BENEŠ THOMAS , BURDE DIETRICH
Published: May 2013

We classify the orbit closures in the variety [Formula: see text] of complex, three-dimensional Novikov algebras and obtain the Hasse diagrams for the closure ordering of the orbits. We provide invariants which are easy to compute and which enable us to decide whether or not one Novikov algebra degenerates to another Novikov algebra.
ON THE SECURITY OF DECOHERENCE-FREE SUBSPACES AND SUBSYSTEMS FOR CLASSICAL INFORMATION CONVEYING THROUGH QUANTUM CHANNELS
Authors: GUEDES ELLOÁ B. , DE ASSIS FRANCISCO M.
Published: May 2013

Decoherence is one of the main obstacles in quantum information processing. In cryptographic scenarios, in particular, decoherence is not only responsible for the loss of the quantum properties but also for information leakage out to a wiretapper. Given that decoherence must be fought in real-world quantum communication systems, we present a scheme, using decoherence-free subspaces and subsystems, to perform secure classical communications through noisy quantum channels. Using quantum information and wiretap theories, we establish a proof of unconditional security of our scheme. We illustrate our proposal with a non-trivial example and discuss some of its impacts on already existing quantum secure message exchange protocols. Furthermore, we present some up-to-date technologies that can be used for practical implementation of the scheme proposed.
Cybercrime, cyberweapons, cyber wars
Authors: Filshtinskiy Stas
Published: May 2013

Where reality stops and perception begins.
Content recommendation on web portals
Authors: Agarwal Deepak , Chen Bee-Chung , Elango Pradheep , Ramakrishnan Raghu
Published: May 2013

How to offer recommendations to users when they have not specified what they want.
Q&A: Cracking the code
Authors: Hoffmann Leah
Published: May 2013

Turing Award recipients Shafi Goldwasser and Silvio Micali talk about proofs, probability, and poker.
Uncovering practices of making energy consumption accountable
Authors: Schwartz Tobias , Stevens Gunnar , Ramirez Leonardo , Wulf Volker
Published: May 2013

Reacting to the discussion on global warming, the HCI community has started to explore the design of tools to support responsible energy consumption. An important part of this research focuses on motivating energy savings by providing feedback tools which present consumption metrics interactively. In this line of work, the configuration of feedback has been mainly discussed using cognitive or behavioral factors. This narrow focus, however, misses a highly relevant perspective for the design of technology that supports sustainable lifestyles: to investigate the multiplicity of forms in which individuals or collectives actually consume energy. In this article, we broaden this focus, by taking a phenomenological lens to study how people use off-the-shelf eco-feedback systems in private households to make energy consumption accountable and explainable. By reconstructing accounting practices, we delineate several constitutive elements of the phenomenon of energy usage in daily life. We complement these elements with a description of the sophisticated methods used by people to organize their energy practices and to give a meaning to their energy consumption. We describe these elements and methods, providing examples coming from the fieldwork and uncovering observed strategies to account for consumption. Based on our results, we provide a critical perspective on existing eco-feedback mechanisms and describe several elements for a design rationale for designing support for responsible energy consumption. We argue that interactive feedback systems should not simply be an end, but rather a resource for the construction of the artful practice of making energy consumption accountable.
Chronic effects of dietary vitamin D deficiency without increased calcium supplementation on the progression of experimental polycystic kidney disease
Authors: Rangan Gopala K. , Schwensen Kristina G. , Foster Sheryl L. , Korgaonkar Mayuresh S. , Peduto Anthony , Harris David C.
Published: May 2013

Increasing evidence indicates that vitamin D deficiency exacerbates chronic kidney injury, but its effects on renal enlargement in polycystic kidney disease (PKD) are not known. In this study, male Lewis polycystic kidney disease (LPK) rats received a normal diet (ND; AIN-93G) supplemented with or without cholecalciferol (vitamin D-deficient diet, VDD; both 0.5% calcium), commenced at either postnatal week 3 (until weeks 10–20; study 1) or from week 10 (until week 20; study 2). Levels of 25-hydroxy vitamin D were reduced in groups receiving the VDD (12 ± 1 nmol/l vs. 116 ± 5 in ND; P < 0.001). In study 1, food intake and weight gain increased by ∼25% in LPK rats receiving the VDD ad libitum, and at week 20 this was associated with a mild reduction in the corrected serum calcium (SCa2+, 7.4%) and TKW:BW ratio (8.8%), and exacerbation of proteinuria (87%) and hypertension (19%; all P < 0.05 vs. ND). When LPK rats were pair-fed for weeks 3–10, there was a further reduction in the SCa2+ (25%) and TKW:BW ratio (22%) in the VDD group ( P < 0.05 vs. ND). In study 2, the VDD did not alter food intake and body weight, reduced SCa2+ (7.7%), worsened proteinuria (41.9%), interstitial monocyte accumulation (26.4%), renal dysfunction (21.4%), and cardiac enlargement (13.2%, all P < 0.05), but there was a trend for a reduction in the TKW:BW ratio (13%, P = 0.09). These data suggest that chronic vitamin D deficiency has adverse long-term actions on proteinuria, interstitial inflammation, renal function, and cardiovascular disease in PKD, and these negate its mild inhibitory effect on kidney enlargement.
Endothelin-1 inhibits sodium reabsorption by ETAand ETBreceptors in the mouse cortical collecting duct
Authors: Jeanette Lynch I. , Welch Amanda K. , Kohan Donald E. , Cain Brian D. , Wingo Charles S.
Published: May 2013

The collecting duct (CD) is a major renal site for the hormonal regulation of Na homeostasis and is critical for systemic arterial blood pressure control. Our previous studies demonstrated that the endothelin-1 gene (edn1) is an early response gene to the action of aldosterone. Because aldosterone and endothelin-1 (ET-1) have opposing actions on Na reabsorption (JNa) in the kidney, we postulated that stimulation of ET-1 by aldosterone acts as a negative feedback mechanism, acting locally within the CD. Aldosterone is known to increase JNain the CD, in part, by stimulating the epithelial Na channel (ENaC). In contrast, ET-1 increases Na and water excretion through its binding to receptors in the CD. To date, direct measurement of the quantitative effect of ET-1 on transepithelial JNain the isolated in vitro microperfused mouse CD has not been determined. We observed that the CD exhibits substantial JNain male and female mice that is regulated, in part, by a benzamil-sensitive pathway, presumably ENaC. ENaC-mediated JNais greater in the cortical CD (CCD) than in the outer medullary CD (OMCD); however, benzamil-insensitive JNais present in the CCD and not in the OMCD. In the presence of ET-1, ENaC-mediated JNais significantly inhibited. Blockade of either ETAor ETBreceptor restored JNato control rates; however, only ETAreceptor blockade restored a benzamil-sensitive component of JNa. We conclude 1) Na reabsorption is mediated by ENaC in the CCD and OMCD and also by an ENaC-independent mechanism in the CCD; and 2) ET-1 inhibits JNain the CCD through both ETAand ETBreceptor-mediated pathways.