bluuebunny/crossref_metadata_2025 huggingface dataset:
Determination of 25 Trace Element Concentrations in Biological Reference Materials by ICP-MS following Different Microwave-Assisted Acid Digestion Methods Based on Scaling Masses of Digested Samples
Authors: Enamorado-Báez S. M. , Abril J. M. , Gómez-Guzmán J. M.
Published: June 2013

The use of normalized procedures designed for soil and sediment samples (like US-EPA 3051) to chemically prepare some kind of organic samples is a common practice in some laboratories. However, the performance of this method for other matrices has to be demonstrated. Three microwave-assisted digestion procedures with 0.5 g of sample and simplified reagents (10 mL HNO3 alone and mixtures of HNO3/HCl- and HNO3/H2O2 procedures A, B, and C, resp.) were compared for quantitative determination of 25 elements (Be, B, Al, Ti, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, As, Se, Sr, Mo, Ag, Cd, Sb, Cs, Ba, Tl, Pb, Th and U) in three biological reference materials provided by NIST (mussel tissue (MT), tomato leaves (TL), and milk powder (MP)) by ICP-MS. From scaling masses (from 0.1 up to 0.9 g at 0.1 g interval) in procedure A, a linear relationship among instrumental signal and mass of digested sample could be constructed at 99% CL for most of the target analytes. The slope of this linear fit provided the estimation of sample concentration, while the ordinate in origin allowed the identification of matrix interferences which were absent in the reagent blank.
High-Fidelity Visualization of Large Medical Datasets on Commodity Hardware
Authors: Gallo Luigi , Placitelli Alessio Pierluigi
Published: June 2013

Recent advances in CT and MRI static and dynamic scanning techniques have led to great improvements in the resolution and size of volumetric medical datasets, and this trend is still ongoing. However, the explosion of dataset size prevents clinicians from taking advantage of an interactive, high-resolution exploration of volumetric medical data on commodity hardware, due to the memory constraints of modern graphics cards. This paper presents a hybrid CPU-GPU volume ray-casting method and some hybrid-based inspection tools aimed at providing interactive, medical-quality visualization using an ordinary desktop PC. Experimental results show that the hybrid method provides a near-interactive high-fidelity visualization of large medical datasets even if only limited hardware resources are available.
Cyclin G1 Expands Liver Tumor-Initiating Cells by Sox2 Induction via Akt/mTOR Signaling
Authors: Wen Wen , Han Tao , Chen Cheng , Huang Lei , Sun Wen , Wang Xue , Chen Shu-Zhen , Xiang Dai-Min , Tang Liang , Cao Dan , Feng Gen-Sheng , Wu Meng-Chao , Ding Jin , Wang Hong-Yang
Published: June 2013

Recurrence and chemoresistance of liver cancer has been attributed to the existence of liver tumor-initiating cells (T-ICs). It is important to decipher the molecular mechanism for acquisition of drug resistance and to design combinatorial therapeutic strategies. Cyclin G1 has been shown to play a pivotal role in initiation and metastasis of hepatocellular carcinoma. In this study, we found that enhanced cyclin G1 expression was associated with drug resistance of hepatoma cells and higher recurrence rate in hepatocellular carcinoma patients. Expression of cyclin G1 was elevated in liver T-ICs and closely correlated with the expression of liver T-IC markers. Forced cyclin G1 expression remarkably enhanced self-renewal and tumorigenicity of hepatoma cells. Cyclin G1 overexpression dramatically upregulated the expression of Sox2 both in vitro and in vivo, which was impaired by chemical inhibitors of Akt/mTOR signaling. Furthermore, blockade of Akt/mTOR signaling or interference of Sox2 expression suppressed cyclin G1–enhanced self-renewal, chemoresistance, and tumorigenicity of hepatoma cells, indicating that cyclin G1 expands liver T-ICs through Sox2 induction via Akt/mTOR signaling pathway. These results suggest that cyclin G1–induced liver T-IC expansion contributes to the recurrence and chemoresistance of hepatoma, and cyclin G1 may be a promising biomarker for individualized therapy of hepatocellular carcinoma patients. Mol Cancer Ther; 12(9); 1796–804. ©2013 AACR.
Learning Minimally Invasive Mitral Valve Surgery
Authors: Holzhey David M. , Seeburger Joerg , Misfeld Martin , Borger Michael A. , Mohr Friedrich W.
Published: June 2013

Background—

Learning curves are vigorously discussed and viewed as a negative aspect of adopting new procedures. However, very few publications have methodically examined learning curves in cardiac surgery, which could lead to a better understanding and a more meaningful discussion of their consequences. The purpose of this study was to assess the learning process involved in the performance of minimally invasive surgery of the mitral valve using data from a large, single-center experience.

Methods and Results—

All mitral (including tricuspid, or atrial fibrillation ablation) operations performed over a 17-year period through a right lateral mini-thoracotomy with peripheral cannulation for cardiopulmonary bypass (n=3907) were analyzed. Data were obtained from a prospective database. Individual learning curves for operation time and complication rates (using sequential probability cumulative sum failure analysis) and average results were calculated. A total of 3895 operations by 17 surgeons performing their first minimally invasive surgery of the mitral valve operation at our institution could be evaluated. The typical number of operations to overcome the learning curve was between 75 and 125. Furthermore, >1 such operation per week was necessary to maintain good results. Individual learning curves varied markedly, proving the need for good monitoring or mentoring in the initial phase.

Conclusions—

A true learning curve exists for minimally invasive surgery of the mitral valve. Although the number of operations required to overcome the learning curve is substantial, marked variation exists between individual surgeons. Such information could be very helpful in structuring future training and maintenance of competence programs for this kind of surgery.
Zygoidy, a new nomenclatural concept
Authors: DUBOIS Alain
Published: June 2013

In zoological taxonomy, unambiguous and universal designation of a given taxon at a given rank in a given classification requires to establish its valid nomen and the correct spelling of the latter. Consequently, a need to resolve the situations of conflict that may exist between available nomina and spellings arises. These situations of nomenclatural conflict are here designated as zygoidy. They are of three kinds: zygonymy (conflicts of  omonymy or synonymy between nomina for validity), zygography (conflicts of parography between spellings for correctness) and zygophory (conflicts of airetophory between onomatophore designations for validity). The resolution of these conflicts relies on several basic Principles already formulated in the Code (the Principles of Homonymy, Priority and “First-Reviser”, here renamed “Airesy”), as well as additional ones not yet recognized in this text: the Principles of Zygoidy, Proedry, Nomography and Sozoidy. A detailed analysis of these  ituations is provided. It allows to identify in which cases and under which conditions these Principles apply. This  omplete inventory of possible situations and solutions will be of great usefulness for a forecoming  utomatisation and computerization of the Rules of the Code in forthcoming databases and Web applications.
Implementation of an Urban Parameterization Scheme into the Regional Climate Model COSMO-CLM
Authors: Trusilova Kristina , Früh Barbara , Brienen Susanne , Walter Andreas , Masson Valéry , Pigeon Grégoire , Becker Paul
Published: June 2013

As the nonhydrostatic regional model of the Consortium for Small-Scale Modelling in Climate Mode (COSMO-CLM) is increasingly employed for studying the effects of urbanization on the environment, the authors extend its surface-layer parameterization by the Town Energy Budget (TEB) parameterization using the “tile approach” for a single urban class. The new implementation COSMO-CLM+TEB is used for a 1-yr reanalysis-driven simulation over Europe at a spatial resolution of 0.11° (~12 km) and over the area of Berlin at a spatial resolution of 0.025° (~2.8 km) for evaluating the new coupled model. The results on the coarse spatial resolution of 0.11° show that the standard and the new models provide 2-m temperature and daily precipitation fields that differ only slightly by from −0.1 to +0.2 K per season and ±0.1 mm day−1, respectively, with very similar statistical distributions. This indicates only a negligibly small effect of the urban parameterization on the model's climatology. Therefore, it is suggested that an urban parameterization may be omitted in model simulations on this scale. On the spatial resolution of 0.025° the model COSMO-CLM+TEB is able to better represent the magnitude of the urban heat island in Berlin than the standard model COSMO-CLM. This finding shows the importance of using the parameterization for urban land in the model simulations on fine spatial scales. It is also suggested that models could benefit from resolving multiple urban land use classes to better simulate the spatial variability of urban temperatures for large metropolitan areas on spatial scales below ~3 km.
Airborne Flux Measurements of BVOCs above Californian Oak Forests: Experimental Investigation of Surface and Entrainment Fluxes, OH Densities, and Damköhler Numbers
Authors: Karl T. , Misztal P. K. , Jonsson H. H. , Shertz S. , Goldstein A. H. , Guenther A. B.
Published: June 2013

Airborne flux measurements of isoprene were performed over the Californian oak belts surrounding the Central Valley. The authors demonstrate for the first time 1) the feasibility of airborne eddy covariance measurements of reactive biogenic volatile organic compounds; 2) the effect of chemistry on the vertical transport of reactive species, such as isoprene; and 3) the applicability of wavelet analysis to estimate regional fluxes of biogenic volatile organic compounds. These flux measurements demonstrate that instrumentation operating at slower response times (e.g., 1–5 s) can still be used to determine eddy covariance fluxes in the mixed layer above land, where typical length scales of 0.5–3 km were observed. Flux divergence of isoprene measured in the planetary boundary layer (PBL) is indicative of OH densities in the range of 4–7 × 106 molecules per cubic centimeter and allows extrapolation of airborne fluxes to the surface with Damköhler numbers (ratio between the mixing time scale and the chemical time scale) in the range of 0.3–0.9. Most of the isoprene is oxidized in the PBL with entrainment fluxes of about 10% compared to the corresponding surface fluxes. Entrainment velocities of 1–10 cm s−1 were measured. The authors present implications for parameterizing PBL schemes of reactive species in regional and global models.
Recognition and the constitution of epochal change
Authors: Onuf Nicholas
Published: June 2013

For two decades, political theorists have granted recognition a great deal of attention. However, theorists of international relations have not, despite a common interest in identity politics. Instead, the latter take recognition for granted as a long-standing practice enabling states to engage in relations, as equals, under law. I hold that recognition is an unexplored way of addressing the constitution of epochal change in the modern world. I develop this claim first by reviewing what political theorists say about recognition. Not sharing their preoccupation with identity, I also draw on a secondary but still important theme in this literature – recognition’s relation to justice. I then turn to the relations of states to show how international society has always exemplified the very processes of recognition that political theorists would like to find within their late modern societies. I conclude with some comments on the enduring properties of international society.
A retrospective comparison of blood transfusion requirements during cardiopulmonary bypass with two different small adult oxygenators
Authors: Lahanas A , Argerakis PW , Johnson KA , Burdan ML , Ozdirik JE
Published: June 2013

A low haematocrit during cardiopulmonary bypass (CPB) is associated with adverse outcomes and often results in homologous blood transfusions. Oxygenators with improved venous reservoir designs aid in reducing the priming volume. Recently, we changed our small adult oxygenator model from the D905 EOS oxygenator (Dideco, Mirandola, Italy) to the Capiox FX1540 (Terumo Corporation, Tokyo, Japan). We conducted a retrospective study of 42 patents to evaluate the impact of the Capiox FX 1540 on blood transfusion requirements in small patients (body surface area (BSA) up to 1.8 m2). The D905 EOS group had a lower minimum intraoperative haematocrit than the FX1540 group (20 ± 3 v 22 ± 4, p = 0.029) with 73% of the patients receiving intraoperative blood transfusions compared with 30% in the FX 1540 group (p = 0.012). Patients in the D905 EOS group received one blood transfusion more during CPB than the FX 1540 patients (p = 0.002). The haematocrits at the end of CPB and in the early postoperative period were identical in both groups. The postoperative ventilation time, length of stay in the intensive care unit and postoperative chest drain bleeding were similar in both groups. In conclusion, the Capiox FX1540 was effective in reducing intraoperative packed red cell transfusions.
Analysis of the compressive behaviour of the three-dimensional printed porous titanium for dental implants using a modified cellular solid model
Authors: Gagg Graham , Ghassemieh Elaheh , Wiria Florencia E
Published: June 2013

A set of cylindrical porous titanium test samples were produced using the three-dimensional printing and sintering method with samples sintered at 900 °C, 1000 °C, 1100 °C, 1200 °C or 1300 °C. Following compression testing, it was apparent that the stress–strain curves were similar in shape to the curves that represent cellular solids. This is despite a relative density twice as high as what is considered the threshold for defining a cellular solid. As final sintering temperature increased, the compressive behaviour developed from being elastic–brittle to elastic–plastic and while Young’s modulus remained fairly constant in the region of 1.5 GPa, there was a corresponding increase in 0.2% proof stress of approximately 40–80 MPa. The cellular solid model consists of two equations that predict Young’s modulus and yield or proof stress. By fitting to experimental data and consideration of porous morphology, appropriate changes to the geometry constants allow modification of the current models to predict with better accuracy the behaviour of porous materials with higher relative densities (lower porosity).
Addressing missing covariates for the regression analysis of competing risks: Prognostic modelling for triaging patients diagnosed with prostate cancer
Authors: Escarela Gabriel , Ruiz-de-Chavez Juan , Castillo-Morales Alberto
Published: June 2013

Competing risks arise in medical research when subjects are exposed to various types or causes of death. Data from large cohort studies usually exhibit subsets of regressors that are missing for some study subjects. Furthermore, such studies often give rise to censored data. In this article, a carefully formulated likelihood-based technique for the regression analysis of right-censored competing risks data when two of the covariates are discrete and partially missing is developed. The approach envisaged here comprises two models: one describes the covariate effects on both long-term incidence and conditional latencies for each cause of death, whilst the other deals with the observation process by which the covariates are missing. The former is formulated with a well-established mixture model and the latter is characterised by copula-based bivariate probability functions for both the missing covariates and the missing data mechanism. The resulting formulation lends itself to the empirical assessment of non-ignorability by performing sensitivity analyses using models with and without a non-ignorable component. The methods are illustrated on a 20-year follow-up involving a prostate cancer cohort from the National Cancer Institutes Surveillance, Epidemiology, and End Results program.
Clozapine and agranulocytosis: re-assessing the risks
Authors: Drew Leslie
Published: June 2013

Objective:

The aim of the study was to estimate the maximum incidence of agranulocytosis which clozapine would have caused between 2006 and 2010 had there been no blood monitoring system; and to determine the number of clozapine-associated cases of agranulocytosis and related deaths recorded between 1993 and 2011.

Method:

Records associating clozapine use with white blood cell deficiency (WBCD), in the Therapeutic Goods Administration’s Case Line Listing of adverse drug reactions, were examined. The figure of 11,000 was used as the population on clozapine each year from 2006–2010.

Results:

Between 2006 and 2010 there were 209 cases of clozapine-associated WBCD recorded, probably caused by clozapine in 141 cases. WBCD caused by clozapine could have progressed to agranulocytosis if clozapine had not been withdrawn. The risk of WBCD/agranulocytosis decreased with increasing duration of clozapine use. Between 1993 and 2011 there were 141 recorded cases of agranulocytosis, and four deaths, from clozapine-associated WBDC.

Conclusions:

During 2006–2010, without any monitoring system, the maximum annual incidence of agranulocytosis caused by clozapine would have been 0.26%. The risks of agranulocytosis, and related deaths, decreased with length of time on clozapine. During 1993–2011 141 cases of agranulocytosis, with four deaths, were recorded in association with clozapine use. The monitoring system could have successfully prevented relatively few deaths.
Hallux Metatarsophalangeal Joint Arthrodesis With a Hybrid Locking Plate and a Plantar Neutralization Screw
Authors: Doty Jesse , Coughlin Michael , Hirose Christopher , Kemp Travis
Published: June 2013

Background:

Many techniques have been described for arthrodesis of the first metatarsophalangeal (MTP) joint. The purpose of this study was to determine the results of fixation using a low-profile dorsal titanium plate with locking screws in the phalanx, nonlocking screws in the metatarsal, and a plantar neutralization screw.

Methods:

Forty-nine consecutive patients (51 feet) underwent a first MTP joint arthrodesis during an enrollment period of 1 year from October 2010 to November, 2011. All patients were evaluated preoperatively for primary pathology, pain, function, radiographic findings, AOFAS scores, and physical exam findings. First MTP joint arthrodesis was performed with a precontoured dorsal titanium plate with preset valgus and dorsiflexion after the joint surfaces were prepared with dome-shaped power reamers to achieve congruous cancellous bone surfaces. At a minimum of 1-year follow-up, patients returned for postoperative evaluation of pain, function, radiographic findings, satisfaction, AOFAS scores, and physical exam findings.

Results:

Forty-six of 49 (48 feet) patients returned for final follow-up examination at least 12 months after operative intervention. Forty-one patients (89%) reported good to excellent results. Visual analog pain scores improved from an average of 6.6 preoperatively to an average of 1.6 postoperatively ( t = −9.3339, df = 45, P < .001). Functional capacity scores improved from a preoperative mean of 2.5 to a postoperative mean of 1.4 ( t = −5.2648, df = 46, P < .001). AOFAS hallux MTP joint scores improved from a preoperative mean of 45 to a postoperative mean of 77 ( t = 9.9498, df = 46, P < .003). Eighteen of 48 great toes (38%) had preoperative pronation whereas, 2 of 48 great toes (4%) had postoperative pronation. Eleven of 46 patients (24%) were unable to perform preoperative toe rise, and 8 of 46 (17%) were unable to perform postoperative toe rise. Twenty-five of 46 patients (54%) had gait improvement, while 19 patients (44%) had no change in gait, and 2 patients (4%) had gait deterioration. The mean preoperative hallux valgus angle of 27 degrees improved to a mean postoperative angle of 13 degrees ( t = −6.1982, df = 46, P < .001). The mean preoperative 1-2 intermetatarsal angle of 12 degrees improved to a mean postoperative angle of 9 degrees ( t = −5.2614, df = 46, P < .001). There was 1 delayed union (2%) and 1 nonunion (2%).

Conclusion:

Our outcome scores indicate that first MTP joint arthrodesis with a precontoured dorsal titanium plate with locking screws in the phalanx and nonlocking screws in the first metatarsal is both reliable and reproducible with a very high bony union rate.

Level of Evidence:

Level IV, prospective case series.
Pasteurella Multocida Infection in Cats
Authors: Lloret Albert , Egberink Herman , Addie Diane , Belák Sándor , Boucraut-Baralon Corine , Frymus Tadeusz , Gruffydd-Jones Tim , Hartmann Katrin , Hosie Margaret J , Lutz Hans , Marsilio Fulvio , Möstl Karin , Pennisi Maria Grazia , Radford Alan D , Thiry Etienne , Truyen Uwe , Horzinek Marian C
Published: June 2013

Overview:

Pasteurella species are part of the normal oral flora of cats. They are also a common cause of infection in this species and an important zoonotic agent.

Infection in cats:

Pasteurella species are commonly isolated from subcutaneous abscesses and pyothorax in cats. They may also cause secondary lower respiratory tract infection and have been associated with spinal empyema and meningoencephalomyelitis.

Infection in humans:

Disease in humans mainly occurs after a cat bite or scratch, but may also be transmitted via respiratory secretions from cats in close contact with a person. Signs of local infection after a cat bite appear in a few hours (3–6 h). Severe disease and a fatal outcome mostly occur in immunocompromised people, but have also been reported in immunocompetent healthy individuals. Cat ownership by immunocompromised people may carry a risk.
Duration of acute kidney injury and mortality in critically ill patients: a retrospective observational study
Authors: Han Seung Seok , Kim Sejoong , Ahn Shin Young , Lee Jeonghwan , Kim Dong Ki , Chin Ho Jun , Chae Dong-Wan , Na Ki Young
Published: June 2013

Background

The addition of relevant parameters to acute kidney injury (AKI) criteria might allow better prediction of patient mortality than AKI criteria alone. Here, we evaluated whether inclusion of AKI duration could address this issue.

Methods

AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines in 2,143 critically ill patients, within 15 days of patient admission. AKI cases were categorized according to tertiles of AKI duration: 1st tertile, 1–2 days; 2nd tertile, 3–5 days; and 3rd tertile, ≥6 days. The hazard ratios (HRs) for overall survival rates in three groups were calculated after adjustment for multiple covariates compared with ICU patients without AKI as the reference group. The predictive ability for mortality was assessed by calculating the area under the curve (AUC) of the receiver operating characteristic curve.

Results

AKI increased the HRs for overall mortality, and the mortality rate increased with AKI duration: the adjusted HRs were 1.99 (1st tertile), 2.67 (2nd tertile), and 2.85 (3rd tertile) compared with the non-AKI group (all Ps < 0.001). The AUC of the ROC curve for overall mortality based on the AKI duration groups (0.716) was higher than the AUC of AKI staging using the KDIGO guidelines (0.696) (P = 0.001). When considering KDIGO stage and AKI duration together, the AUC (0.717) was also significantly higher than that using the KDIGO stage alone (P < 0.001).

Conclusions

AKI duration is an additional parameter for the prediction of mortality in critically ill patients. The inclusion of AKI duration could be considered as a refinement of the AKI criteria.
Quantifying longitudinal right ventricular dysfunction in patients with old myocardial infarction by using speckle-tracking strain echocardiography
Authors: Konishi Katsuhisa , Dohi Kaoru , Tanimura Muneyoshi , Sato Yuichi , Watanabe Kiyotaka , Sugiura Emiyo , Kumagai Naoto , Nakamori Shiro , Nakajima Hiroshi , Yamada Tomomi , Onishi Katsuya , Nakamura Mashio , Nobori Tsutomu , Ito Masaaki
Published: June 2013

Background

We investigated longitudinal right ventricular (RV) function assessed using speckle-tracking strain echocardiography in patient with myocardial infarction (MI), and identified the contributing factors for RV dysfunction.

Methods

We retrospectively studied 71 patients with old MI (the OMI group) and 45 normal subjects (the Control group) who underwent a transthoracic echocardiography. Global and free wall RV peak systolic strains (PSSs) in the longitudinal direction were measured by using speckle-tracking strain echocardiography. Left ventricular (LV) PSSs were measured in the longitudinal, radial and circumferential directions. Cardiac hemodynamics including peak systolic pulmonary artery pressure was also assessed non-invasively. Plasma brain natriuretic peptide (BNP) levels were measured in all patients.

Results

In the OMI group, 73% of the patients had a normal estimated peak systolic pulmonary artery pressure of less than 35 mmHg. Global and free wall RV PSS were impaired in the OMI group compared with the Control group, and these RV systolic indices were significantly associated with heart rate, logarithmic transformed plasma BNP, greater than 1 year after onset of MI, Doppler-derived estimated pulmonary vascular resistance, LV systolic indices, LV mass index, infarcted segments within a territory of the left circumflex artery and residual total occlusion in the culprit right coronary artery. Multivariable linear regression analysis indicated that reduced longitudinal LV PSS in the 4-chamber view and BNP levels ≥500 pg/ml were independently associated with reduced global and free wall RV PSS. Moreover, when patients were divided into 3 groups according to plasma BNP levels (BNP <100 pg/ml; n = 31, 100 ≤BNP <500 pg/ml; n = 24, and BNP ≥500 pg/ml; n = 16), only patients with BNP ≥500 pg/ml had a strong correlation between RV PSS and longitudinal LV PSS in the 4-chamber view (r = 0.78 for global RV PSS and r = 0.71 for free wall RV PSS, p <0.05).

Conclusion

Longitudinal RV systolic strain depends significantly on longitudinal LV systolic strain especially in patients with high plasma BNP levels, but not on estimated peak systolic pulmonary artery pressure. These results indicate that process of RV myocardial dysfunction following MI may be governed by neurohormonal activation which causing ventricular remodeling rather than increased RV afterload.
The feasibility of nurse practitioner-performed, telementored lung telesonography with remote physician guidance - ‘a remote virtual mentor’
Authors: Biegler Nancy , McBeth Paul B , Tiruta Corina , Hamilton Douglas R , Xiao Zhengwen , Crawford Innes , Tevez-Molina Martha , Miletic Nat , Ball Chad G , Pian Linping , Kirkpatrick Andrew W
Published: June 2013

Background

Point-of-care ultrasound (POC-US) use is increasingly common as equipment costs decrease and availability increases. Despite the utility of POC-US in trained hands, there are many situations wherein patients could benefit from the added safety of POC-US guidance, yet trained users are unavailable. We therefore hypothesized that currently available and economic ‘off-the-shelf’ technologies could facilitate remote mentoring of a nurse practitioner (NP) to assess for recurrent pneumothoraces (PTXs) after chest tube removal.

Methods

The simple remote telementored ultrasound system consisted of a handheld ultrasound machine, head-mounted video camera, microphone, and software on a laptop computer. The video output of the handheld ultrasound machine and a macroscopic view of the NP's hands were displayed to a remote trauma surgeon mentor. The mentor instructed the NP on probe position and US machine settings and provided real-time guidance and image interpretation via encrypted video conferencing software using an Internet service provider. Thirteen pleural exams after chest tube removal were conducted.

Results

Thirteen patients (26 lung fields) were examined. The remote exam was possible in all cases with good connectivity including one trans-Atlantic interpretation. Compared to the subsequent upright chest radiograph, there were 4 true-positive remotely diagnosed PTXs, 2 false-negative diagnoses, and 20 true-negative diagnoses for 66% sensitivity, 100% specificity, and 92% accuracy for remotely guided chest examination.

Conclusions

Remotely guiding a NP to perform thoracic ultrasound examinations after tube thoracostomy removal can be simply and effectively performed over encrypted commercial software using low-cost hardware. As informatics constantly improves, mentored remote examinations may further empower clinical care providers in austere settings.
Growth hormone exacerbates diabetic renal damage in male but not female rats
Authors: Whitney Jennifer L , Bilkan Christine Maric , Sandberg Kathryn , Myers Adam K , Mulroney Susan E
Published: June 2013

Background

Human and animal studies support the idea that there are sex differences in the development of diabetic renal disease. Our lab and others have determined that in addition to Ang II (through the AT1R), growth hormone (GH) contributes to renal damage in models of renal failure; however, the impact of sex and GH on the mechanisms initiating diabetic renal disease is not known. This study examined the effect of sex and GH on parameters of renal damage in early, uncontrolled streptozotocin (STZ)-induced diabetes.

Methods

Adult male and female Sprague–Dawley rats were injected with vehicle (control), STZ, or STZ + GH and euthanized after 8 weeks.

Results

Mild but significant glomerulosclerosis (GS) and tubulointerstitial fibrosis (TIF) was observed in both kidneys from male and female diabetic rats, with GH significantly increasing GS and TIF by 30% and 25% in male rats,but not in female rats. STZ increased TGF-β expression in both kidneys from male and female rats; however, while GH had no further effect on TGF-β protein in diabetic females, GH increased TGF-β protein in the male rat’s kidneys by an additional 30%. This sex-specific increase in renal injury following GH treatment was marked by increased MCP-1 and CD-68+ cell density. STZ also reduced renal MMP-2 and MMP-9 protein expression in both kidneys from male and female rats, but additional decreases were only observed in GH-treated diabetic male rats. The sex differences were independent of AT1R activity.

Conclusions

These studies indicate that GH affects renal injury in diabetes in a sex-specific manner and is associated with an increase in pro-inflammatory mediators.
High-resolution view of compound promiscuity
Authors: Hu Ye , Bajorath Jürgen
Published: June 2013

Compound promiscuity is defined as the ability of a small molecule to specifically interact with multiple biological targets. So-defined promiscuity is relevant for drug discovery because it provides the molecular basis of polypharmacology, which is increasingly implicated in the therapeutic efficacy of drugs. Recent studies have analyzed different aspects of compound promiscuity on the basis of currently available activity data. In this commentary, we present take-home messages from these studies augmented with new results to generate a detailed picture of compound promiscuity that might serve as a reference for further discussions and research activities.
PROJECT DEVELOPMENT OF PROFESSIONAL STANDARD “EDUCATIONAL ORGANIZATION MANAGEMENT” (part 2)
Authors: Шкляева  , Shklyaeva Nadezhda
Published: June 2013

The bibliographical analysis of research, dedicated to definition of professional standard intension as well as overview of the sources related to this theme is given in this article. The author directs the group of

regional professional standard development. The research results on specifi cation of educational institution director job functions are presented

in this article too. The author proposes to discuss the project of regional professional standard “Educational Organization Management».
Audit of budgeting system related to personnel’s training and evolution process on the basis of knowledge management business model
Authors: Цаплина  , Tsaplina Olga
Published: June 2013

The key elements which influence the budgeting strategy of personnel’s training and evolution in organization are discussed in this article. The author offers the step-by-step plan of existing cost management system analysis on the basis of corporate business model related to knowledge management. It is possible to use this approach both in case of audit, and at the initial stage of strategic development of budget related to personnel’s training and evolution, that allows answer important questions: what is the knowledge control system in your company? What priorities in articles of expenses for training? What strategy and what type of expenses is the most effective for your business model?
Weaving Straw into Gold: Managing Organizational Tensions Between Standardization and Flexibility in Microfinance
Authors: Canales Rodrigo
Published: June 2013

This article explores how organizations balance the pressures to pursue efficiency through standardization with the need to remain responsive to local needs. The study combines rich ethnography with detailed loan data to show that both standardization and flexibility through relational ties provide substantial organizational benefits but also carry significant costs; thus, no strategy is inherently superior, and their coexistence generates the best results. Such coexistence, however, creates contradictions that must be managed. Here, I use microfinance as a strategic setting and gain analytic leverage from the random assignment across branches of loan officers who exhibit significant heterogeneity in rule enforcement styles: some enforce rules strictly, whereas others frequently bend them to respond to client needs. I find that loan officers with relational styles exercise discretion productively to enhance organizational performance. Yet their effectiveness is contingent on the presence of rule-enforcing peers, as evidenced by the significant underperformance of branches with a high concentration of officers of either type. In contrast, branches that contain discretionary diversity, or a balance between enforcement styles, perform best. This is not due to diversity per se, but because loan officers process decisions in local credit committees. Committees that contain discretionary diversity generate a productive tension that induces participants to justify decisions along broader organizational goals, thus maintaining a productive balance between standardization and flexibility. Implications for organizational theory and practice are discussed.
The Structure of Competition: How Competition Between One’s Rivals Influences Imitative Market Entry
Authors: Hsieh Kai-Yu , Vermeulen Freek
Published: June 2013

This paper investigates how the pattern of encounters between a firm’s competitors affects the firm’s inclination to follow its competitors into a new market. We theorize that direct encounters between a firm’s rivals lead to a herding effect, making imitative market entry more likely. Past mutual forbearance between a firm’s competitors (resulting from asymmetric multimarket competition) further strengthens this herding effect, by enhancing the firm’s expectations of market attractiveness. In contrast, aggressive past rivalry between the competitors (resulting from symmetric multimarket contact) dampens these expectations, producing a competition effect that makes herding less probable. We test our idea in two distinct contexts—the Chinese pharmaceutical industry and the Taiwanese computer hardware industry—and find consistent support in both settings. We discuss how our analysis of what we call the “structure of competition” can be extended to research on other forms of firm behavior.
The accuracy of current methods in determining the timing of epiphysiodesis
Authors: Lee S. C. , Shim J. S. , Seo S. W. , Lim K. S. , Ko K. R.
Published: June 2013

We compared the accuracy of the growth remaining method of assessing leg-length discrepancy (LLD) with the straight-line graph method, the multiplier method and their variants. We retrospectively reviewed the records of 44 patients treated by percutaneous epiphysiodesis for LLD. All were followed up until maturity. We used the modified Green–Anderson growth-remaining method (Method 1) to plan the timing of epiphysiodesis. Then we presumed that the other four methods described below were used pre-operatively for calculating the timing of epiphysiodesis. We then assumed that these four methods were used pre-operatively. Method 2 was the original Green–Anderson growth-remaining method; Method 3, Paley’s multiplier method using bone age; Method 4, Paley’s multiplier method using chronological age; and Method 5, Moseley’s straight-line graph method. We compared ‘Expected LLD at maturity with surgery’ with ‘Final LLD at maturity with surgery’ for each method. Statistical analysis revealed that ‘Expected LLD at maturity with surgery’ was significantly different from ‘Final LLD at maturity with surgery’. Method 2 was the most accurate. There was a significant correlation between ‘Expected LLD at maturity with surgery’ and ‘Final LLD at maturity with surgery’, the greatest correlation being with Method 2. Generally all the methods generated an overcorrected value. No method generates the precise ‘Expected LLD at maturity with surgery’. It is essential that an analysis of the pattern of growth is taken into account when predicting final LLD. As many additional data as possible are required.

Cite this article: Bone Joint J 2013;95-B:993–1000.
Argyria following the use of silver-coated megaprostheses
Authors: Glehr M. , Leithner A. , Friesenbichler J. , Goessler W. , Avian A. , Andreou D. , Maurer-Ertl W. , Windhager R. , Tunn P-U.
Published: June 2013

The aims of this study were to evaluate the incidence of local argyria in patients with silver-coated megaprostheses and to identify a possible association between argyria and elevated levels of silver both locally and in the blood. Between 2004 and 2011, 32 megaprostheses with silver coatings were implanted in 20 female and 12 male patients following revision arthroplasty for infection or resection of a malignant tumour, and the levels of silver locally in drains and seromas and in the blood were determined. The mean age of the patients was 46 years (10 to 81); one patient died in the immediate post-operative period and was excluded.

Seven patients (23%) developed local argyria after a median of 25.7 months (interquartile range 2 to 44.5). Patients with and without local argyria had comparable levels of silver in the blood and aspiration fluids. The length of the implant did not influence the development of local argyria. Patients with clinical evidence of local argyria had no neurological symptoms and no evidence of renal or hepatic failure. Thus, we conclude that the short-term surveillance of blood silver levels in these patients is not required.

Cite this article: Bone Joint J 2013;95-B:988–92.
Under-coracoid-around-clavicle (UCAC) loop in type II distal clavicle fractures
Authors: Soliman O. , Koptan W. , Zarad A.
Published: June 2013

In Neer type II (Robinson type 3B) fractures of the distal clavicle the medial fragment is detached from the coracoclavicular ligaments and displaced upwards, whereas the lateral fragment, which is usually small, maintains its position. Several fixation techniques have been suggested to treat this fracture. The aim of this study was to assess the outcome of patients with type II distal clavicle fractures treated with coracoclavicular suture fixation using three loops of Ethibond. This prospective study included 14 patients with Neer type II fractures treated with open reduction and coracoclavicular fixation. Ethibond sutures were passed under the coracoid and around the clavicle (UCAC loop) without making any drill holes in the proximal or distal fragments. There were 11 men and three women with a mean age of 34.57 years (29 to 41). Patients were followed for a mean of 24.64 months (14 to 31) and evaluated radiologically and clinically using the Constant score. Fracture union was obtained in 13 patients at a mean of 18.23 weeks (13 to 23) and the mean Constant score was 96.07 (91 to 100). One patient developed an asymptomatic fibrous nonunion at one year. This study suggests that open reduction and internal fixation of unstable distal clavicle fractures using UCAC loops can provide rigid fixation and lead to bony union. This technique avoids using metal hardware, preserves the acromioclavicular joint and provides adequate stability with excellent results.

Cite this article: Bone Joint J 2013;95-B:983–7.
A radiological and cadaveric study of oblique lumbar interbody fixation in patients with normal spinal anatomy
Authors: Wu A. M. , Tian N. F. , Wu L. J. , He W. , Ni W. F. , Wang X. Y. , Xu H. Z. , Chi Y. L.
Published: June 2013

The purpose of this study was to determine whether it would be feasible to use oblique lumbar interbody fixation for patients with degenerative lumbar disease who required a fusion but did not have a spondylolisthesis.

A series of CT digital images from 60 patients with abdominal disease were reconstructed in three dimensions (3D) using Mimics v10.01: a digital cylinder was superimposed on the reconstructed image to simulate the position of an interbody screw. The optimal entry point of the screw and measurements of its trajectory were recorded. Next, 26 cadaveric specimens were subjected to oblique lumbar interbody fixation on the basis of the measurements derived from the imaging studies. These were then compared with measurements derived directly from the cadaveric vertebrae.

Our study suggested that it is easy to insert the screws for L1/2, L2/3 and L3/4 fixation: there was no significant difference in measurements between those of the 3-D digital images and the cadaveric specimens. For L4/5 fixation, part of L5 inferior articular process had to be removed to achieve the optimal trajectory of the screw. For L5/S1 fixation, the screw heads were blocked by iliac bone: consequently, the interior oblique angle of the cadaveric specimens was less than that seen in the 3D digital images.

We suggest that CT scans should be carried out pre-operatively if this procedure is to be adopted in clinical practice. This will assist in determining the feasibility of the procedure and will provide accurate information to assist introduction of the screws.

Cite this article: Bone Joint J 2013;95-B:977–82.
Double-bundle medial patellofemoral ligament reconstruction with hamstring tendon autograft and mediolateral patellar tunnel fixation
Authors: Singhal R. , Rogers S. , Charalambous C. P.
Published: June 2013

Medial patellofemoral ligament (MPFL) reconstruction is used to treat patellar instability and recurrent patellar dislocation. Anatomical studies have found the MPFL to be a double-bundle structure. We carried out a meta-analysis of studies reporting outcomes of patellofemoral reconstruction using hamstring tendon autograft in a double-bundle configuration and patellar fixation via mediolateral patellar tunnels.

A literature search was undertaken with no language restriction in various databases from their year of inception to July 2012. The primary outcome examined was the post-operative Kujala score. We identified 320 MPFL reconstructions in nine relevant articles. The combined mean post-operative Kujala score was 92.02 (standard error (se) 1.4, p = 0.001) using a fixed effects model and 89.45 (se 37.9, p = 0.02) using random effect modelling. The reported rate of complications with MPFL reconstruction was 12.5% (40 of 320) with stiffness of the knee being the most common. High-quality evidence in assessing double-bundle MPFL reconstruction is lacking. The current literature consists of a mixture of prospective and retrospective case series. High-quality randomised trials evaluating this procedure are still awaited.

Cite this article: Bone Joint J 2013;95-B:900–5.
FT-IR Standoff Detection of Thermally Excited Emissions of Trinitrotoluene (TNT) Deposited on Aluminum Substrates
Authors: Castro-Suarez John R. , Pacheco-Londoño Leonardo C. , Vélez-Reyes Miguel , Diem Max , Tague Thomas J. , Hernandez-Rivera Samuel P.
Published: June 2013

A standoff detection system was assembled by coupling a reflecting telescope to a Fourier transform infrared spectrometer equipped with a cryo-cooled mercury cadmium telluride detector and used for detection of solid-phase samples deposited on substrates. Samples of highly energetic materials were deposited on aluminum substrates and detected at several collector-target distances by performing passive-mode, remote, infrared detection measurements on the heated analytes. Aluminum plates were used as support material, and 2,4,6-Trinitrotoluene (TNT) was used as the target. For standoff detection experiments, the samples were placed at different distances (4 to 55 m). Several target surface temperatures were investigated. Partial least squares regression analysis was applied to the analysis of the intensities of the spectra obtained. Overall, standoff detection in passive mode was useful for quantifying TNT deposited on the aluminum plates with high confidence up to target–collector distances of 55 m.
Optical Detection of Meat Spoilage Using Fluorescence Spectroscopy with Selective Excitation Wavelength
Authors: Pu Yang , Wang Wubao , Alfano Robert R.
Published: June 2013

The native fluorescence (FL) spectra of muscle foods (meat) stored at 4 °C (refrigerated) and 25 °C (at room temperature) were measured with the selected excitation wavelength of 340 nm as a function of storage time to detect the meat spoilage status. The contributions of the principal biochemical components to the FL spectra were extracted using Multivariate Curve Resolution with Alternating Least-Squares (MCR-ALS). The change of the reduced nicotinamide adenine dinucleotide (NADH) content was found from the measured FL spectra and the MCR-ALS analysis, which reflects the microbial spoilage of muscle foods involved in the metabolic processes. This study presents the possibility that the change of relative content of NADH determined by native FL spectroscopy may be used as a “fingerprint” or criterion for monitoring the spoilage status of muscle foods.
Adapting Raman Spectra from Laboratory Spectrometers to Portable Detection Libraries
Authors: Weatherall James C. , Barber Jeffrey , Brauer Carolyn S. , Johnson Timothy J. , Su Yin-Fong , Ball Christopher D. , Smith Barry T. , Cox Rick , Steinke Robert , McDaniel Patricia , Wasserzug Louis
Published: June 2013

Raman spectral data collected with high-resolution laboratory spectrometers are processed into a format suitable for importing as a user library on a 1064 nm DeltaNu first generation, field-deployable spectrometer prototype. The two laboratory systems used are a 1064 nm Bruker Fourier transform (FT)-Raman spectrometer and a 785 nm Kaiser dispersive spectrometer. The steps taken to adapt for device-dependent spectral resolution, wavenumber shifts between instruments, and relative intensity response are described. Effects due to the differing excitation laser wavelengths were found to be minimal, indicating—at least for the near-infrared (NIR)—that data can be ported between different systems, so long as certain measures are taken with regard to the reference and field spectra.