bluuebunny/crossref_metadata_2025 huggingface dataset:
GaN-based light-emitting diodes by laser lift-off with micro- and nano-sized reflectors
Authors: Jung Younghun , Hyun Kim Sung , Kim Jihyun , Wang Xiaotie , Ren Fan , Jin Choi Kyoung , Pearton Stephen J.
Published: August 2012

GaN-based light-emitting diodes (LEDs) were grown on a patterned sapphire substrate (PSS) containing hemispheres on the growth surface. Free-standing LED structures were obtained by removing the PSS using laser lift-off technique. The N-face GaN surface with micron-sized concave hemisphere structures, which had been located between the sapphire and the GaN film, was then exposed and photo-electrochemically etched using a 2M KOH solution to create nano-sized pyramids. Aluminum was deposited on the roughened N-face GaN as a reflective layer. The roughened aluminum reflectors, consisting of micron-sized hemisphere structures and nano-sized pyramids, enhanced the light extraction efficiency through multiple scattering events of photons and randomized the directions of the photons. The subsequent enhancement in electroluminescence was 13% compared with an untextured control LED.
Neurexin and Neuroligin Mediate Retrograde Synaptic Inhibition in
C. elegans
Authors: Hu Zhitao , Hom Sabrina , Kudze Tambudzai , Tong Xia-Jing , Choi Seungwon , Aramuni Gayane , Zhang Weiqi , Kaplan Joshua M.
Published: August 2012

Keep on Neurexin

Mutations altering neurexin and neuroligin have been linked to several psychiatric disorders, including autism and schizophrenia. However, it remains uncertain how these mutations alter neural circuit development and function. Working in the nematode
Caenorhabditis elegans
,

Hu
et al.

(p.
980
, published online 2 August) found that neurexin and neuroligin function downstream of a muscle microRNA (miR-1), mediating a retrograde synaptic signal that inhibits neurotransmitter release. This retrograde signal inhibited transmission by adjusting the rate and duration of synaptic vesicle release.
Atropine sulphate: rescue therapy for pyloric stenosis
Authors: Owen Richard Peter , Almond Sarah L , Humphrey Gill M E
Published: August 2012

Infantile hypertrophic pyloric stenosis (IHPS) is a common condition which presents with non-bilious vomiting and failure to thrive secondary to gastric outlet obstruction. In the UK, management is by fluid resuscitation followed by pyloromyotomy. Incomplete myotomy complicates 0.3% of cases necessitating further surgery and exposing the patient to further risk. Medical management of IHPS with antimuscarinics to promote pyloric relaxation is a well-described treatment modality that is used as first-line therapy in some countries. The use of this technique is limited by the need for extended hospital admission with parenteral nutrition administration. We describe a case of IHPS complicated by incomplete pyloromyotomy and subsequently managed successfully by atropine sulphate therapy.
Congenital omental cyst
Authors: Gupta Rakesh Kumar , Sah Suresh , Sah Panna Lal , Shah Birendra Prasad
Published: August 2012

Congenital omental cysts are rare intra-abdominal pathology, which are difficult to diagnose preoperatively; as such a high index of suspicion is required for accurate preoperative diagnosis. We present a case of congenital omental cyst in a 3-year-old girl who presented with huge abdominal distension. We performed diagnostic examinations including ultrasonography and CT of the abdomen. An omental cyst was diagnosed because of its position and connection to the surrounding tissues. She was operated and cyst was excised completely. Histological examination revealed an omental cyst with endothelial lining and haemorrhagic fluid inside. She had an uneventful recovery and doing well, without recurrence at follow-up of 24 months. Clinicians must rigorously pursue a preoperative diagnosis, as it may prevent a surprise upon laparotomy and result in proper management.
Reductions in hospital admissions and mortality rates observed after integrating emergency care: a natural experiment
Authors: Boyle Adrian A , Ahmed Vazeer , Palmer Christopher R , Bennett Tom J H , Robinson Susan M
Published: August 2012

Objectives

Reducing emergency admissions is a priority for the NHS. A single hospital's emergency care system was reorganised with the principles of front-loaded investigations, integration of specialties, reduced duplication, earlier decision making by senior clinicians and a combined emergency assessment area. The authors relocated our Medical Assessment Unit into our emergency department in 2006. The authors evaluated changes in admissions and mortality before and after 2006, compared with other similar hospitals.

Design

Quasi-experimental before and after study using routinely collected data.

Setting and participants

1 acute hospital in England, the intervention site, was compared with 23 other English hospitals between 2001 and 2009.

Outcome measures

Our outcome measures were hospital standardised mortality ratios (HSMRs) for non-elective admissions and standardised admission ratios (SARs).

Results

The authors observed a statistically and clinically significant decrease in HSMR and SAR. The intervention hospital had the lowest HSMR and SAR of all the hospitals in our sample. This was statistically significant, p=0.0149 and p=0.0002, respectively.

Conclusion

Integrating emergency care in one location is associated with a meaningful reduction in mortality and emergency admissions to hospital.
A fluorescence-based assay for monitoring clinical drug resistance
Authors: Deniset-Besseau Ariane , Miannay François-Alexandre , Laplace-Builhé Corinne , Vielh Philippe , Lécart Sandrine , Lwaleed Bashir A , Eschwege Pascal , Fontaine-Aupart Marie-Pierre
Published: August 2012

Background and aims

Multidrug resistance (MDR) limits effectiveness in treating malignancy by modifying internalisation and/or externalisation of drugs through cancer cell membranes. In this study we describe an assay to monitor patients’ responses to chemotherapy.

Methods

The assay is based on the fluorescent properties of doxorubicin alone as well as in combination with methotrexate, vinblastine, doxorubicin and cisplatin (MVAC). The slide-based cell imaging technique was first optimised using a panel of breast and urothelial cancer cell lines and then extended to fine needle breast aspiration biopsy and urine cytology.

Results

The drug fluorescence behaviour observed on smears of clinical specimens is identical to that obtained using fixed cultured cells. The fluorescence of sensitive cells to chemotherapy is mainly localised in the nucleus, whereas resistant cells show a weak fluorescence signal localised in the cytoplasm. The difference in terms of fluorescence intensity is also highlighted through fluorescence spectra.

Conclusions

The results suggest that the assay provides clinically valuable information in predicting responses to doxorubicin and/or MVAC therapy. Originally set up on a confocal microscope, the assay was also effective using a standard epifluorescence microscope; as such it is technically simple, reliable and inexpensive.
Prognostic and predictive significance of proliferation in 867 colorectal cancers
Authors: Fodor Imola K , Hutchins Gordon G , Espiritu Carmina , Quirke Philip , Jubb Adrian M
Published: August 2012

Aim

Recently, the Oncotype DX recurrence score, which measures a gene expression signature including markers of tumour proliferation, was validated as a prognostic signature in colorectal cancer. This study aimed to evaluate whether the Ki67 proliferation index can provide similar prognostic and predictive information.

Methods

Tissue microarrays were constructed from triplicate cores of colorectal cancer. Immunohistochemistry for Ki67 was performed with the SP6 antibody and the percentage of positive tumour cells scored. Prognostic significance was evaluated in 867 cancers (601 events) using Cox proportional hazards models.

Results

The Ki67 labelling index, divided at the median, was not a statistically or clinically significant prognostic factor in univariate analyses of 5-year overall survival (HR 0.98, 95% CI 0.84 to 1.15, p=0.84). Multivariate analyses were similarly non-significant. However, in Dukes’ stage C patients, the high Ki67 subgroup derived a greater 5-year overall survival benefit from chemotherapy (HR 0.32, 95% CI 0.21 to 0.51, p<0.0001) than the low subgroup (HR 0.57, 95% CI 0.37 to 0.89, p=0.011).

Conclusions

The Ki67 proliferation index is not a useful prognostic factor in colorectal cancer, but deserves further evaluation as a predictive factor for the incremental benefit derived from adjuvant chemotherapy.
Point-of-care monitoring of vitamin K-antagonists: validation of CoaguChek XS test strips with International Standard thromboplastin
Authors: van den Besselaar Anton M H P , Péquériaux Nathalie C V , Ebben Marij , van der Feest Joke , de Jong Kerst , Ganzeboom Maria B J , van Ooijen Jetty , Postema Ferna , Witteveen Evelina , van der Meer Felix J M
Published: August 2012

Aims

Many patients treated with vitamin K-antagonists (VKA) use point-of-care (POC) whole blood coagulometers for self-testing. The majority of patients in the Netherlands use one type of POC coagulometer, that is, the CoaguChek XS. Each new lot of test strips for the CoaguChek XS is validated by a group of collaborating thrombosis centres. We assessed the International Normalised Ratio (INR) differences between each of 51 new lots of test strips and the International Standard for thromboplastin rTF/95 or its successor rTF/09.

Methods

Each year, a particular lot of CoaguChek XS test strips was used as reference lot. The reference lot was validated by comparison to the International Standard, yielding a relationship between the reference lot INR and International Standard INR. Successive lots of test strips were compared to the reference lot by three centres using 19–29 capillary blood samples obtained from VKA-treated patients. Each patient provided two blood drops from the same finger prick, one for the reference lot strip and one for the new lot.

Results

The mean INR differences between each lot and the International Standard varied between −8% and +4%. The mean absolute values of the relative differences varied between 2.4% and 8.1%. There were small but clinically unimportant differences in INR between the first and second drop of blood.

Conclusions

Accuracy of CoaguChek XS INR determinations can be assessed by a group of collaborating centres using a limited number of capillary blood samples. As the mean INR differences with the International Standard were smaller than 10%, the lots were approved for use by the Netherlands Thrombosis Services.
Seasonal variation in cardiovascular disease risk factors in a subarctic population: the Tromsø Study 1979–2008
Authors: Hopstock Laila Arnesdatter , Barnett Adrian Gerard , Bønaa Kaare Harald , Mannsverk Jan , Njølstad Inger , Wilsgaard Tom
Published: August 2012

Background

Seasonal changes in cardiovascular disease (CVD) risk factors may be due to exposure to seasonal environmental variables like temperature and acute infections or seasonal behavioural patterns in physical activity and diet. Investigating the seasonal pattern of risk factors should help determine the causes of the seasonal pattern in CVD. Few studies have investigated the seasonal variation in risk factors using repeated measurements from the same individual, which is important as individual and population seasonal patterns may differ.

Methods

The authors investigated the seasonal pattern in systolic and diastolic blood pressure, heart rate, body weight, total cholesterol, triglycerides, high-density lipoprotein cholesterol, C reactive protein and fibrinogen. Measurements came from 38 037 participants in the population-based cohort, the Tromsø Study, examined up to eight times from 1979 to 2008. Individual and population seasonal patterns were estimated using a cosinor in a mixed model.

Results

All risk factors had a highly statistically significant seasonal pattern with a peak time in winter, except for triglycerides (peak in autumn), C reactive protein and fibrinogen (peak in spring). The sizes of the seasonal variations were clinically modest.

Conclusions

Although the authors found highly statistically significant individual seasonal patterns for all risk factors, the sizes of the changes were modest, probably because this subarctic population is well adapted to a harsh climate. Better protection against seasonal risk factors like cold weather could help reduce the winter excess in CVD observed in milder climates.
Progesterone, pregnanediol‐3‐glucuronide, relaxin and oestrone sulphate concentrations in saliva, milk and urine of female alpacas (Vicugna pacos) and their application in pregnancy diagnosis
Authors: Volkery J. , Gottschalk J. , Sobiraj A. , Wittek T. , Einspanier A.
Published: August 2012

The pregnancy‐associated hormones, progesterone (P4), pregnanediol‐3‐glucuronide (PdG), relaxin (RLN) and oestrone sulphate (E1S) in plasma, saliva, milk and urine of alpacas were measured in order to assess their potential use for pregnancy diagnosis. Samples were obtained from 36 female alpacas before mating and at different stages throughout pregnancy (confirmed by ultrasonography). The hormone concentrations were determined using enzyme immunoassays. Milk samples were also tested using a commercial on‐farm P4 kit, designed for dairy cattle. Although the concentration of P4 in plasma, milk and urine, and the concentration of PdG in urine were significantly higher in pregnant than in non‐pregnant alpacas, there was no difference in the concentrations of P4 or PdG in saliva. The on‐farm milk P4 kit showed a sensitivity of 90 per cent for diagnosis of pregnancy and a specificity of 69 per cent for non‐pregnancy. The concentration of RLN in plasma increased significantly after the second month, and concentration of E1S in plasma and urine during the last month of pregnancy, whereas, there were no significant differences in RLN or E1S concentrations in saliva and milk between pregnant and non‐pregnant alpacas. Values of P4, RLN and E1S in plasma, and PdG and E1S in urine are comparable with the previous reports in alpacas and, therefore, can be confirmed as an indicator for pregnancy. This is the first study to include determination of pregnancy‐associated hormones in the saliva and milk of alpacas. However, saliva seems to be unsuitable for pregnancy diagnosis in alpacas, whereas, P4 in milk, as well as PdG and E1S in urine, seem to be adequate tools for diagnosis.
HIGH SPEED PHOTODETECTOR USING ACCELERATED PARTICLES CONTROLLED BY LIGHT
Authors: UEAMANAPONG S. , SRITHANACHAI I. , NIEMCHAROEN S. , YUPAPIN P. P.
Published: August 2012

In this paper, we propose a new design device that can be used to solve the performance degradation of a diode due to after-fabrication process problems which involves the silicon bulk defects. The optical tweezer technique has been used to control the movement of electrons, specifically an electron's speed using a PANDA ring. The PANDA microring is a new form of a modified add-drop filter that can be used to improve the switching speed of a diode by using the optical tweezers for trapping electrons' movement from anode contact to cathode contact. The trapping probe can be adjusted to fit for atom size of 200 pm (picometer) to 1.4 nm (nanometer) by controlling the ring parameters. The goal of this paper is to present the use of a PANDA microring for improving photodetector performance which can be used further for many applications.
ECOSYSTEM SERVICES CRITERIA FOR SUSTAINABLE DEVELOPMENT IN URBAN REGIONS
Authors: SÖDERMAN TARJA , KOPPEROINEN LEENA , SHEMEIKKA PETRI , YLI-PELKONEN VESA
Published: August 2012

The ecosystem services criteria for strategic decision-making combine conceptualisation and concretisation of ecologically sustainable development. A concrete basis for the measurement, valuation, and assessment of ecological sustainability was created through the development of two-level criteria for ecosystem services, which were linked to indicators based on spatial and statistical data from the Monitoring System of Spatial Structure (MSSS) and the CORINE Land Cover database. The criteria were designed for middle-sized urban regions because urban areas face the greatest land changes, threats, and management and co-operation needs related to maintenance of ecosystem services. Two urban regions were piloting the criteria in an iterative process between researchers and project groups of urban planners. Data availability and poor capacity to deliver data for the regions affected the choice of final indicators. This highlights the need for development of planning tools for practical planning and impact assessment for ecological sustainability of all urban regions.
Effects of Low Temperature Electronic Cyclotron Resonance Hydrogen Plasma Treatment and Annealing on the Electrical Properties of Ti and Ni Contacts to 4H-SiC
Authors: Huang Lingqin , Zhu Qiaozhi , Gao Mingchao , Qin Fuwen , Wang Dejun
Published: August 2012

The effects of low temperature electronic cyclotron resonance microwave hydrogen plasma pretreatment and post-annealing on the electrical properties of Ti and Ni contacts to 4H-SiC were investigated. The HPT improves the Ohmic behavior of Ti/4H-SiC contact significantly. In contrast, it remarkably enhances the rectifying behavior of Ni/4H-SiC contact. The properties of Ti Ohmic contact and Ni rectifying contact improve with increasing annealing temperature up to 400 °C. However, they are deteriorated above 400 °C. X-ray photoelectron spectroscopy measurements confirm that the surface Fermi level (E
F
s) moves toward the conduction band edge by the HPT. It almost attains the bulk Femi level position after annealing at 400 °C with the surface states density (D
s) as low as 4.43×1011 cm-2 eV-1. However, after annealing above 400 °C, E
F
s moves back closer to midgap with an increase of D
s. The experimental results are found to obey the barrier height theory of Cowley and Sze.
Counter Dipole Layer Formation in Multilayer High-k Gate Stacks
Authors: Hibino Shinya , Nishimura Tomonori , Nagashio Kosuke , Kita Koji , Toriumi Akira
Published: August 2012

Dipole layer formation at the high-k/SiO2 interface is now recognized to be the dominant origin of threshold voltage (V
TH) shift in metal gate high-k complementary metal–oxide–semiconductor (CMOS) devices, although the dipole formation mechanism is still controversial. Whatever the mechanism is, the dipole effect is practically used for V
TH tuning in the band-edge metal/high-k gate stack CMOS. The optimum conditions may be found by changing the material and/or process conditions, but there is still a missing fact in the high-k/SiO2 dipole formation experiment. It is the dipole cancelling effect (counter dipole formation) in SiO2/high-k/SiO2/Si gate stacks, where the dipole effect in principle should disappear owing to the formation of two dipoles in opposing directions. In this paper, we report our experimental results on the counter dipole effect and then discuss the interface characteristics between two different high-k layers as well.
Anisotropy and Damping in Co2FeAl0.5Si0.5 via Electrical Detection of Ferromagnetic Resonance
Authors: Bai Lihui , Tezuka Nobuki , Kohda Makoto , Nitta Junsaku
Published: August 2012

The authors have investigated spin dynamics properties and magnetic anisotropy parameters of epitaxial Co2FeAl0.5Si0.5 (CFAS) thin films using electrical detection of ferromagnetic resonance on basis of spin rectification effect. The samples of CFAS were grown on (001) MgO substrate by sputtering, and patterned into stripes with a length of 760 m and various widths between 5 and 40 µm for the electric detection. Analysis of the angle dependent FMR allows the anisotropy field, K
1 to be determined (1.04 ×105 erg/cm3). By analyzing the line width vs the resonant frequency, a damping constant α, of 0.005 is obtained.
Dynamic cardiac output regulation at rest, during exercise, and muscle metaboreflex activation: impact of congestive heart failure
Authors: Ichinose Masashi , Sala-Mercado Javier A. , Coutsos Matthew , Li ZhenHua , Ichinose Tomoko K. , Dawe Elizabeth , Fano Dominic , O'Leary Donal S.
Published: August 2012

We tested whether mild and moderate dynamic exercise and muscle metaboreflex activation (MMA) affect dynamic baroreflex control of heart rate (HR) and cardiac output (CO), and the influence of stroke volume (SV) fluctuations on CO regulation in normal (N) and pacing-induced heart failure (HF) dogs by employing transfer function analyses of the relationships between spontaneous changes in left ventricular systolic pressure (LVSP) and HR, LVSP and CO, HR and CO, and SV and CO at low and high frequencies (Lo-F, 0.04–0.15 Hz; Hi-F, 0.15–0.6 Hz). In N dogs, both workloads significantly decreased the gains for LVSP-HR and LVSP-CO in Hi-F, whereas only moderate exercise also reduced the LVSP-CO gain in Lo-F. MMA during mild exercise further decreased the gains for LVSP-HR in both frequencies and for LVSP-CO in Lo-F. MMA during moderate exercise further reduced LVSP-HR gain in Lo-F. Coherence for HR-CO in Hi-F was decreased by exercise and MMA, whereas that in Lo-F was sustained at a high level (>0.8) in all settings. HF significantly decreased dynamic HR and CO regulation in all situations. In HF, the coherence for HR-CO in Lo-F decreased significantly in all settings; the coherence for SV-CO in Lo-F was significantly higher. We conclude that dynamic exercise and MMA reduces dynamic baroreflex control of HR and CO, and these are substantially impaired in HF. In N conditions, HR modulation plays a major role in CO regulation. In HF, influence of HR modulation wanes, and fluctuations of SV dominate in CO variations.
Influence of exercise intensity on pulmonary oxygen uptake kinetics in young and late middle-aged adults
Authors: McNarry Melitta A. , Kingsley Michael I. C. , Lewis Michael J.
Published: August 2012

It is unclear whether pulmonary oxygen uptake (V̇o2) kinetics demonstrate linear, first-order behavior during supra gas exchange threshold exercise. Resolution of this issue is pertinent to the elucidation of the factors regulating oxygen uptake (V̇o2) kinetics, with oxygen availability and utilization proposed as putative mediators. To reexamine this issue with the advantage of a relatively large sample size, 50 young (24 ± 4 yr) and 15 late middle-aged (54 ± 3 yr) participants completed repeated bouts of moderate and heavy exercise. Pulmonary gas exchange, heart rate (HR), and cardiac output (Q̇) variables were measured throughout. The phase II τ was slower during heavy exercise in both young (moderate: 22 ± 9; heavy: 29 ± 9 s; P ≤ 0.001) and middle-aged (moderate: 22 ± 9; heavy: 30 ± 8 s; P ≤ 0.001) individuals. The HR τ was slower during heavy exercise in young (moderate: 33 ± 10; heavy: 44 ± 15 s; P ≤ 0.05) and middle-aged (moderate: 30 ± 12; heavy: 50 ± 20 s; P ≤ 0.05) participants, and the Q̇ τ showed a similar trend (young moderate: 21 ± 13; heavy: 28 ± 16 s; middle-aged moderate: 32 ± 13; heavy: 40 ± 15 s; P ≥ 0.05). There were no differences in primary component V̇o2 kinetics between age groups, but the middle-aged group had a significantly reduced V̇o2 slow component amplitude in both absolute (young: 0.25 ± 0.09; middle-aged: 0.11 ± 0.06 l/min; P ≤ 0.05) and relative terms (young: 15 ± 10; middle-aged: 9 ± 4%; P ≤ 0.05). Thus V̇o2 kinetics do not demonstrate dynamic linearity during heavy intensity exercise. Speculatively, the slower phase II τ during heavy exercise might be attributable to reduced oxygen availability. Finally, the primary and slow components of V̇o2 kinetics appear to be differentially influenced by middle age.
Hyperfiltration and effect of nitric oxide inhibition on renal and endothelial function in humans with uncomplicated type 1 diabetes mellitus
Authors: Cherney David Z. I. , Reich Heather N. , Jiang Shan , Har Ronnie , Nasrallah Rania , Hébert Richard L. , Lai Vesta , Scholey James W. , Sochett Etienne B.
Published: August 2012

Studies of experimental diabetes mellitus (DM) suggest that increased nitric oxide (NO) bioactivity contributes to renal hyperfiltration. However, the role of NO in mediating hyperfiltration has not been fully elucidated in humans. Our aim was to examine the effect of NO synthase inhibition on renal and peripheral vascular function in normotensive subjects with uncomplicated type 1 DM. Renal function and brachial artery flow-mediated vasodilatation (FMD) were measured before and after an intravenous infusion of the NO synthase inhibitor NG-nitro-l-arginine methyl ester (l-NMMA) in 21 healthy control and 37 type 1 DM patients. Measurements in DM participants were made under clamped euglycemic conditions. The effect of l-NMMA on circulating and urinary NO metabolites (NOx) and cGMP and on urinary prostanoids was also determined. Baseline characteristics were similar in the two groups. For analysis, the DM patients were divided into those with hyperfiltration (DM-H, n = 18) and normal glomerular filtration rate (GFR) levels (DM-N, n = 19). Baseline urine NOxand cGMP were highest in DM-H. l-NMMA led to a decline in GFR in DM-H (152 ± 16 to 140 ± 11 ml·min−1·1.73 m−2) but not DM-N or healthy control participants. The decline in effective renal plasma flow in response to l-NMMA (806 ± 112 to 539 ± 80 ml·min−1·1.73 m−2) in DM-H was also exaggerated compared with the other groups (repeated measures ANOVA, P < 0.05), along with declines in urinary NOxmetabolites and cGMP. Baseline FMD was lowest in DM-H compared with the other groups and did not change in response to l-NMMA. l-NMMA reduced FMD and plasma markers of NO bioactivity in the healthy control and DM-N groups. In patients with uncomplicated type 1 DM, renal hyperfiltration is associated with increased NO bioactivity in the kidney and reduced NO bioactivity in the systemic circulation, suggesting a paradoxical state of high renal and low systemic vascular NO bioactivity.
Exercise intensity typical of mountain climbing does not exacerbate acute mountain sickness in normobaric hypoxia
Authors: Schommer Kai , Hammer Moritz , Hotz Lorenz , Menold Elmar , Bärtsch Peter , Berger Marc M.
Published: August 2012

Physical exertion is thought to exacerbate acute mountain sickness (AMS). In this prospective, randomized, crossover trial, we investigated whether moderate exercise worsens AMS in normobaric hypoxia (12% oxygen, equivalent to 4,500 m). Sixteen subjects were exposed to altitude twice: once with exercise [3 × 45 min within the first 4 h on a bicycle ergometer at 50% of their altitude-specific maximal workload (maximal oxygen uptake)], and once without. AMS was evaluated by the Lake Louise score and the AMS-C score of the Environmental Symptom Questionnaire. There was no significant difference in AMS between the exposures with and without exercise, neither after 5, 8, nor 18 h (incidence: 64 and 43%; LLS: 6.5 ± 0.7 and 5.1 ± 0.8; AMS-C score: 1.2 ± 0.3 and 1.1 ± 0.3 for exercise vs. rest at 18 h; all P > 0.05). Exercise decreased capillary Po2(from 36 ± 1 Torr at rest to 31 ± 1 Torr), capillary arterial oxygen saturation (from 72% at rest to 67 ± 2%), and cerebral oxygen saturation (from 49 ± 2% at rest to 42 ± 1%, as assessed by near-infrared spectroscopy; P < 0.05), and increased ventilation (capillary Pco227 ± 1 Torr; P < 0.05). After exercise, the increase in ventilation persisted for several hours and was associated with similar levels of capillary and cerebral oxygenation at the exercise and rest day. We conclude that moderate exercise at ∼50% maximal oxygen uptake does not increase AMS in normobaric hypoxia. These data do not exclude that considerably higher exercise intensities exacerbate AMS.
Catecholamine-induced opening of intrapulmonary arteriovenous anastomoses in healthy humans at rest
Authors: Laurie Steven S. , Elliott Jonathan E. , Goodman Randall D. , Lovering Andrew T.
Published: August 2012

The mechanism or mechanisms that cause intrapulmonary arteriovenous anastomoses (IPAVA) to either open during exercise in subjects breathing room air and at rest when breathing hypoxic gas mixtures, or to close during exercise while breathing 100% oxygen, remain unknown. During conditions when IPAVA are open, plasma epinephrine (EPI) and dopamine (DA) concentrations both increase, potentially representing a common mechanism. The purpose of this study was to determine whether EPI or DA infusions open IPAVA in resting subjects breathing room air and, subsequently, 100% oxygen. We hypothesized that these catecholamine infusions would open IPAVA. We performed saline-contrast echocardiography in nine subjects without a patent foramen ovale before and during serial EPI and DA infusions while breathing room air and then while breathing 100% oxygen. Bubble scores (0–5) were assigned based on the number and spatial distribution of bubbles in the left ventricle. Pulmonary artery systolic pressure (PASP) was estimated using Doppler ultrasound, while cardiac output (QC) was measured using echocardiography. Bubble scores were significantly greater during EPI infusions of 80–320 ng·kg−1·min−1 compared with baseline when subjects breathed room air; however, bubble scores did not increase when they breathed 100% oxygen. At comparable QC and PASP, intravenous DA (16 μg·kg−1·min−1) and EPI (40 ng·kg−1·min−1) resulted in identical bubble scores. Subsequent studies revealed that β-blockade did not prevent hypoxia-induced opening of IPAVA. We suggest that increases in QC or PASP (or both) secondary to EPI or DA infusions open IPAVA in normoxia. The closing mechanism associated with breathing 100% oxygen is independent from the opening mechanisms.
Multidrug-Resistant Tuberculosis in an Adult with Cystic Fibrosis
Authors: Manika K. , Giouleka P. , Zarogoulidis K. , Kioumis I.
Published: August 2012

Mycobacterium tuberculosis infection in patients with cystic fibrosis (CF) is rare. We report a 22-year-old CF patient with high fever, dyspnea and weight loss that progressively worsened over 2 weeks before admission. The patient suffered from liver cirrhosis, was colonized with Pseudomonas aeruginosa and had been repeatedly hospitalized for pulmonary infections. The patient was treated initially as for an exacerbation of P. aeruginosa infection, but tuberculosis (TBC) was suspected due to lack of improvement. A CT of the chest revealed enlarged bilateral cavities in the upper and middle lobes. A tuberculin skin test was positive, and M. tuberculosis nucleic acid was isolated from sputum samples. After receiving first-line anti-TBC drugs for 1 month, the patient's condition continued to worsen so molecular drug susceptibility testing was performed. Multidrug-resistant TBC was discovered, leading to a change in regimen. The patient was treated with ethionamide, moxifloxacin, linezolid, amikacin, imipenem/cilastatin and rifabutin and showed a remarkable clinical improvement. Although nontuberculous mycobacteria are more common in CF, the possibility of TBC should not be ignored. In that setting, early suspicion of infection due to resistant M. tuberculosis can be life saving.
Complete Duplication of the Bladder and Urethra in the Coronal Plane: Case Report with Review of the Literature
Authors: Pirinççi Necip , Geçit İlhan , Güneş Mustafa , Tanık Serhat , Ceylan Kadir
Published: August 2012

Complete duplication of the bladder and urethra without other congenital anomalies is a very rare congenital anomaly. We report the case of an 8-year-old boy with complete duplication of the bladder and urethra in the coronal plane, without any other associated congenital anomalies and without complaint associated with the urinary tract.
Diet Modulates Endogenous Thrombin Generation, A Biological Estimate of Thrombosis Risk, Independently of the Metabolic Status
Authors: Sanchez Caroline , Poggi Marjorie , Morange Pierre-Emmanuel , Defoort Catherine , Martin Jean-Charles , Tanguy Stéphane , Dutour Anne , Grino Michel , Alessi Marie-Christine
Published: August 2012

Objective—

High endogenous thrombin potential (ETP) is associated with venous and arterial thrombosis. Better knowledge of environmental influences on ETP may help to prevent thrombosis.

Methods and Results—

Weaning rats exhibited high ETP values that decreased in low-fat diet and remained elevated on high-fat diet. In adult rats, high-fat diet–induced ETP increase was independent of coagulation factors, obesity, and insulin resistance and negatively associated with polyunsaturated fatty acid levels. Switching from high-fat diet to low-fat diet reversed the procoagulant phenotype with a slower kinetic than the normalization of hyperinsulinemia. In humans, ETP was independent of body weight whereas it was negatively associated with nutritional markers such as the percentage of energy provided by proteins, the protein:fat ratio, circulating phenolic compounds, and omega-3 polyunsaturated fatty acid. A recommended 3-month healthy diet with reduced energy density, including lipids, decreased ETP (−21%;
P
<0.0001). Changes in ETP were not associated with body weight, insulin sensitivity, or coagulation factor variations, but correlated negatively with plasma docosahexaenoic acid, a nutritional status sensitive fatty acid, and compounds reflecting vegetable intake.

Conclusion—

Diet plays a pivotal role in regulating ETP, independently of obesity and insulin resistance. Global nutritional recommendations could be useful in primary prevention of venous thrombosis.
P300/CBP Associated Factor Regulates Nitroglycerin-Dependent Arterial Relaxation by N
ε
-Lysine Acetylation of Contractile Proteins
Authors: Colussi Claudia , Scopece Alessandro , Vitale Serena , Spallotta Francesco , Mattiussi Stefania , Rosati Jessica , Illi Barbara , Mai Antonello , Castellano Sabrina , Sbardella Gianluca , Farsetti Antonella , Capogrossi Maurizio C. , Gaetano Carlo
Published: August 2012

Objective—

To address the role of epigenetic enzymes in the process of arterial vasorelaxation and nitrate tolerance, in vitro and in vivo experiments were performed in the presence or absence of glyceryl trinitrate (GTN) or histone deacetylases/histone acetylases modulators.

Methods and Results—

In vitro single GTN administration rapidly increased cGMP synthesis and protein N
ε
-lysine acetylation in rat smooth muscle cells, including myosin light chain and smooth muscle actin. This phenomenon determined a decrease in myosin light chain phosphorylation and actomyosin formation. These effects were abolished by prolonged exposure to GTN and rescued by treatment with trichostatin A. In vivo, adult male rats were treated for 72 hours with subcutaneous injections of GTN alone or in combination with the histone deacetylases inhibitors trichostatin A, suberoylanilide hydroxamic acid, MS-27–275, or valproic acid. Ex vivo experiments performed on aortic rings showed that the effect of tolerance was reversed by all proacetylation drugs, including the p300/CREB binding protein–associated factor activator pentadecylidenemalonate 1b (SPV106). Any response to GTN was abolished by anacardic acid, a potent histone acetylases inhibitor.

Conclusion—

This study establishes the following points: (1) GTN treatment increases histone acetylases activity; (2) GTN–activated p300/CREB binding protein–associated factor increases protein N
ε
-lysine acetylation; (3) N
ε
-lysine acetylation of contractile proteins influences GTN–dependent vascular response. Hence, combination of epigenetic drugs and nitroglycerin may be envisaged as a novel treatment strategy for coronary artery disease symptoms and other cardiovascular accidents of ischemic origin.
Determining the Absolute Requirement of G Protein–Coupled Receptor Kinase 5 for Pathological Cardiac Hypertrophy
Authors: Gold Jessica I. , Gao Erhe , Shang Xiying , Premont Richard T. , Koch Walter J.
Published: August 2012

Rationale:

Heart failure (HF) is often the end phase of maladaptive cardiac hypertrophy. A contributing factor is activation of a hypertrophic gene expression program controlled by decreased class II histone deacetylase (HDAC) transcriptional repression via HDAC phosphorylation. Cardiac-specific overexpression of G proteinen–coupled receptor kinase-5 (GRK5) has previously been shown to possess nuclear activity as a HDAC5 kinase, promoting an intolerance to in vivo ventricular pressure overload; however, its endogenous requirement in adaptive and maladaptive hypertrophy remains unknown.

Objective:

We used mouse models with global or cardiomyocyte-specific
GRK5
gene deletion to determine the absolute requirement of endogenous GRK5 for cardiac hypertrophy and HF development after chronic hypertrophic stimuli.

Methods and Results:

Mice with global deletion of
GRK5
were subjected to transverse aortic constriction. At 12 weeks, these mice showed attenuated hypertrophy, remodeling, and hypertrophic gene transcription along with preserved cardiac function. Global
GRK5
deletion also diminished hypertrophy and related gene expression due to chronic phenylephrine infusion. We then generated mice with conditional, cardiac-specific deletion of
GRK5
that also demonstrated similar protection from pathological cardiac hypertrophy and HF after transverse aortic constriction.

Conclusions:

These results define myocyte GRK5 as a critical regulator of pathological cardiac growth after ventricular pressure overload, supporting its role as an endogenous (patho)-physiological HDAC kinase. Further, these results define GRK5 as a potential therapeutic target to limit HF development after hypertrophic stress.
Cerebral White Matter Lesions and Lacunar Infarcts Contribute to the Presence of Mild Parkinsonian Signs
Authors: de Laat Karlijn F. , van Norden Anouk G.W. , Gons Rob A.R. , van Uden Inge W.M. , Zwiers Marcel P. , Bloem Bastiaan R. , van Dijk Ewoud J. , de Leeuw Frank-Erik
Published: August 2012

Background and Purpose—

Mild parkinsonian signs (MPS) are common in elderly people and may be an early stage of parkinson(ism). They might be related to cerebral small-vessel disease, although this association remains incompletely understood. To identify subjects at early stages of the disease, we investigated whether the presence of MPS was dependent on the severity and location of small-vessel disease, including white matter lesions and lacunar infarcts.

Methods—

Four hundred thirty individuals, with small-vessel disease, aged between 50 and 85 years, without dementia or parkinsonism, were included in this analysis and underwent MRI scanning. The number and location of lacunar infarcts were rated. White matter lesion volume was assessed by manual segmentation with automated delineating of different regions. Presence of MPS was based on the motor section of the Unified Parkinson's Disease Rating Scale. Associations were determined using logistic regression analysis adjusted for age, sex, and total brain volume.

Results—

Severe white matter lesions and the presence of lacunar infarcts were independently associated with the presence of MPS (OR, 2.6; 95% CI, 1.3–4.9 and OR, 1.8; 95% CI, 1.0–3.0). Frontal and parietal white matter lesions and, to a lesser extent, lacunar infarcts in the thalamus were associated with a higher risk of MPS. The presence of lacunar infarcts was independently related to the bradykinesia category of parkinsonian signs.

Conclusions—

This study shows that severe small-vessel disease, especially at certain locations, is associated with MPS signs in older adults. Our findings suggest that small-vessel disease interrupts basal ganglia–thalamocortical circuits involving both the frontal and parietal lobes and hence may result in MPS.
SMASH-U
Authors: Meretoja Atte , Strbian Daniel , Putaala Jukka , Curtze Sami , Haapaniemi Elena , Mustanoja Satu , Sairanen Tiina , Satopää Jarno , Silvennoinen Heli , Niemelä Mika , Kaste Markku , Tatlisumak Turgut
Published: August 2012

Background and Purpose—

The purpose of this study was to provide a simple and practical clinical classification for the etiology of intracerebral hemorrhage (ICH).

Methods—

We performed a retrospective chart review of consecutive patients with ICH treated at the Helsinki University Central Hospital, January 2005 to March 2010 (n=1013). We classified ICH etiology by predefined criteria as structural vascular lesions (S), medication (M), amyloid angiopathy (A), systemic disease (S), hypertension (H), or undetermined (U). Clinical and radiological features and mortality by SMASH-U (Structural lesion, Medication, Amyloid angiopathy, Systemic/other disease, Hypertension, Undetermined) etiology were analyzed.

Results—

Structural lesions, namely cavernomas and arteriovenous malformations, caused 5% of the ICH, anticoagulation 14%, and systemic disease 5% (23 liver cirrhosis, 8 thrombocytopenia, and 17 various rare conditions). Amyloid angiopathy (20%) and hypertensive angiopathy (35%) were common, but etiology remained undetermined in 21%. Interrater agreement in classifying cases was high (κ, 0.89; 95% CI, 0.82–0.96). Patients with structural lesions had the smallest hemorrhages (median volume, 2.8 mL) and best prognosis (3-month mortality 4%), whereas anticoagulation-related ICHs were largest (13.4 mL) and most often fatal (54%). Overall, median ICH survival was 5½ years, varying strongly by etiology (
P
<0.001). After adjustment for baseline characteristics, patients with structural lesions had the lowest 3-month mortality rates (OR, 0.06; 95% CI, 0.01–0.37) and those with anticoagulation (OR, 1.9; 1.0–3.6) or other systemic cause (OR, 4.0; 1.6–10.1) the highest.

Conclusions—

In our patients, performing the SMASH-U classification was feasible and interrater agreement excellent. A plausible etiology was determined in most patients but remained elusive in one in 5. In this series, SMASH-U based etiology was strongly associated with survival.
Latent Heating and Cooling Rates in Developing and Nondeveloping Tropical Disturbances during TCS-08: Radar-Equivalent Retrievals from Mesoscale Numerical Models and ELDORA*
Authors: Park Myung-Sook , Penny Andrew B. , Elsberry Russell L. , Billings Brian J. , Doyle James D.
Published: August 2012

Latent heating and cooling rates have a critical role in predicting tropical cyclone formation and intensification. In a prior study, Park and Elsberry estimated the latent heating and cooling rates from aircraft Doppler radar [Electra Doppler Radar (ELDORA)] observations for two developing and two nondeveloping tropical disturbances during the Tropical Cyclone Structure 2008 (TCS-08) field experiment. In this study, equivalent retrievals of heating rates from two mesoscale models with 1-km resolution are calculated with the same radar thermodynamic retrieval. Contoured frequency altitude diagrams and vertical profiles of the net latent heating rates from the model are compared with the ELDORA-retrieved rates in similar cloud-cluster regions relative to the center of circulation.

In both the developing and nondeveloping cases, the radar-equivalent retrievals from the two models tend to overestimate heating for less frequently occurring, intense convective cells that contribute to positive vorticity generation and spinup in the lower troposphere. The model maximum cooling rates are consistently smaller in magnitude than the heating maxima for the nondeveloping cases as well as the developing cases. Whereas in the model the cooling rates are predominantly associated with melting processes, the effects of evaporative cooling are underestimated in convective downdraft regions and at upper levels. Because of the net warming of the columns, the models tend to overintensify the lower-tropospheric circulations if these intense convective cells are close to the circulation center. Improvements in the model physical process representations are required to realistically represent the evaporative cooling effects.
Diagnosing Forecast Errors in Tropical Cyclone Motion
Authors: Galarneau Thomas J. , Davis Christopher A.
Published: August 2012

This paper reports on the development of a diagnostic approach that can be used to examine the sources of numerical model forecast error that contribute to degraded tropical cyclone (TC) motion forecasts. Tropical cyclone motion forecasts depend upon skillful prediction of the environment wind field, and by extension, the synoptic-scale weather systems nearby the TC. While previous research suggests that the deep-layer mean (DLM) steering flow typically approximates the actual TC motion, it is shown that the motion of even mature TCs can depart from the DLM steering flow. An optimal environmental steering flow is defined, which varies the vertical extent of the steering layer and the radius over which TC vorticity and divergence are removed.

Errors in predicted TC motion are quantified using a diagnostic equation that accounts for not only differences in the synoptic-scale flow, but also differences in the depth and radius used to define the steering flow. Differences in the latter two parameters are interpreted in terms of errors in predicted TC structure or errors in proximate mesoscale flow features. Results from an analysis of 24-h forecasts from the Advanced Hurricane Weather Research and Forecasting Model during the 2008–10 North Atlantic TC seasons show that forecast motion errors are dominated by errors in the environment wind field. Contributions from other terms are occasionally large and are interpreted from a vorticity perspective. The utility of this new diagnostic equation is that it can be used to assess TC motion forecasts from any numerical modeling system.
Bondability of TC410 composites: the surface analysis and wetting properties of an atmospheric plasma-treated siloxane-modified cyanate ester composite
Authors: Zaldivar RJ , Salfity J , Steckel G , Morgan B , Patel D , Nokes JP , Kim HI
Published: August 2012

Atmospheric plasma treatment (APT) has been used on a number of composite systems as an effective surface preparation technique for adhesive bonding. Recently, a new class of siloxane-modified polycyanurate resin systems (TC410) has been developed for use as a matrix material in composites utilized for space applications. The effect of APT on a TC410/M55J fiber composite was evaluated. Contact angle measurements exhibited a sharp reduction in wetting angle with exposure. An increase in the polar surface energy component with treatment coincides with Fourier transform infrared and X-ray photoelectron spectroscopy (XPS) results, which verify the formation of an oxidized carbonate species formed on the composite surface. A solvent rinse removes the majority of the oxidized species and results in an increase in contact angle, due to the removal of a fine ash. XPS and energy-dispersive x-ray spectroscopy verify the distribution of a siloxane component throughout the resin, which was oxidized during APT and forms a silicate. A 24% increase in bond strength was realized after six passes in comparison to abraded specimens. Higher treatment levels resulted in a decrease in strength; however, a solvent rinse of the APT surface gave rise to some recovery in strength due to the removal of the weakly bonded interlayer.
Restoring Trust in Banking
Authors: Armstrong Angus
Published: August 2012

Trust allows financial transactions to take place when contracts are incomplete and the cost of negotiating too great for the parties involved. Banking covers many different types of transactions in assets with different levels of incomplete contracts. Investment banks have traditionally dealt with assets with incomplete contracts and often traded on informal and opaque markets. The creation of new global banks combined know-how, capital and collateral to generate enormous growth in these markets. While global banks developed trust with counterparties in specific markets, the opacity combined with limited liability structures also created principal-agent problems. The scandals which emerged are a reflection of these agency problems and have left trust in the banks greatly diminished. If levels of trust remain so low, this will be consistent with ongoing bank vulnerability, less lending to finance risky but profitable investment projects, and consequently lower economic activity. Regulation can support private incentives to accept codes of conduct which enhance trust.