bluuebunny/crossref_metadata_2025 huggingface dataset:
Inoculum effects on community composition and nitritation performance of autotrophic nitrifying biofilm reactors with counter‐diffusion geometry
Authors: Terada Akihiko , Lackner Susanne , Kristensen Ken , Smets Barth F.
Published: June 2010

The link between nitritation success in a membrane‐aerated biofilm reactor (MABR) and the composition of the initial ammonia‐ and nitrite‐oxidizing bacterial (AOB and NOB) population was investigated. Four identically operated flat‐sheet type MABRs were initiated with two different inocula: from an autotrophic nitrifying bioreactor (Inoculum A) or from a municipal wastewater treatment plant (Inoculum B). Higher nitritation efficiencies (NO2‐‐N/NH4+‐N) were obtained in the Inoculum B‐ (55.2–56.4%) versus the Inoculum A‐ (20.2–22.1%) initiated reactors. The biofilms had similar oxygen penetration depths (100–150 µm), but the AOB profiles [based on 16S rRNA gene targeted real‐time quantitative PCR (qPCR)] revealed different peak densities at or distant from the membrane surface in the Inoculum B‐ versus A‐initiated reactors, respectively. Quantitative fluorescence in situ hybridization (FISH) revealed that the predominant AOB in the Inoculum A‐ and B‐initiated reactors were Nitrosospira spp. (48.9–61.2%) versus halophilic and halotolerant Nitrosomonas spp. (54.8–63.7%), respectively. The latter biofilm displayed a higher specific AOB activity than the former biofilm (1.65 fmol cell−1 h−1 versus 0.79 fmol cell−1 h−1). These observations suggest that the AOB and NOB population compositions of the inoculum may determine dominant AOB in the MABR biofilm, which in turn affects the degree of attainable nitritation in an MABR.
Painful foot drop; a presentation of diabetic muscle infarction
Authors: Karalliedde J. , Vijayanathan S. , Thomas S.
Published: June 2010

Diabet. Med. 27, 958–959 (2010)

Background  Macro‐ and microvascular complications of diabetes are varied and can present with a range of clinical signs and symptoms. Diabetic muscle infarction is a rare vascular complication of diabetes that is often not recognized.

Case report  We report a case of diabetic muscle infarction, where a 65‐year‐old woman with Type 2 diabetes presented with acute‐onset severe pain in her right leg and foot drop.

Conclusions  Her foot drop was a result of a concomitant compression nerve injury as a consequence of the muscle oedema following infarction. Our case highlights the importance of early recognition and investigation of atypical presentations of vascular complications of diabetes.
What drives the positive correlation between human population density and bird species richness in Australia?
Authors: Luck Gary W. , Smallbone Lisa , McDonald Simon , Duffy Deanna
Published: June 2010

Aim To test six hypotheses that could explain or mediate the positive correlation between human population density (HPD) and bird species richness while controlling for biased sampling effort. These hypotheses were labelled as follows: productivity (net primary productivity, NPP); inherent heterogeneity (diversity of vegetation types); anthropogenic heterogeneity (diversity of land uses); conservation policy (proportion of conservation land); increased productivity (human‐induced productivity increases); and the reduced‐slope hypothesis (which predicts that humans have a negative impact on species numbers across the full range of variation in HPD).

Location Australia.

Methods All data were collected at a spatial resolution of 1° across mainland Australia. Bird species richness was from 2007 atlas data and random subsampling was used to account for biased sampling effort. HPD was from the 2006 census. All other data were from government produced geographic information system layers. The most important biotic or abiotic factors influencing patterns in both species richness and HPD were assessed using simultaneous autoregressive models and an information theoretic approach.

Results NPP appeared to be one of the main factors driving spatial congruence between bird species richness and HPD. Inherent habitat heterogeneity was weakly related to richness and HPD, although an interaction between heterogeneity and NPP indicated that the former may be an important determinant of species richness in low‐productivity regions. There was little evidence that anthropogenic landscape heterogeneity or human‐induced changes in productivity influenced the relationship between species richness and HPD, but conservation policy appeared to act as an important mediating factor and species richness was positively related to the proportion of conservation land only in regions of high HPD.

Main conclusions The spatial congruence between bird species richness and HPD occurs because both respond positively to productivity and, in certain circumstances, habitat heterogeneity. Our results suggest that conservation policy could mediate this relationship, but further research is required to determine the importance of conservation reserves in supporting species in regions densely populated by humans.
Carbon dynamics of terrestrial ecosystems on the Tibetan Plateau during the 20th century: an analysis with a process‐based biogeochemical model
Authors: Zhuang Q. , He J. , Lu Y. , Ji L. , Xiao J. , Luo T.
Published: June 2010

Aim  The Tibetan Plateau accounts for about a quarter of the total land area of China and has a variety of ecosystems ranging from alpine tundra to evergreen tropics. Its soils are dominated by permafrost and are rich in organic carbon. Its climate is unique due to the influence of the Asian monsoon and its complex topography. To date, the carbon dynamics of the Tibetan Plateau have not been well quantified under changes of climate and permafrost conditions. Here we use a process‐based biogeochemistry model, the Terrestrial Ecosystem Model (TEM), which was incorporated with a soil thermal model, to examine the permafrost dynamics and their effects on carbon dynamics on the plateau during the past century.

Location  The Tibetan Plateau.

Methods  We parameterize and verify the TEM using the existing data for soil temperature, permafrost distribution and carbon and nitrogen from the region. We then extrapolate the model and parameters to the whole plateau.

Results  During the 20th century, the Tibetan Plateau changed from a small carbon source or neutral in the early part of the century to a sink later, with a large inter‐annual and spatial variability due to changes of climate and permafrost conditions. Net primary production and soil respiration increased by 0.52 and 0.22 Tg C year−1, respectively, resulting in a regional carbon sink increase of 0.3 Tg C year−1. By the end of the century, the regional carbon sink reached 36 Tg C year−1 and carbon storage in vegetation and soils is 32 and 16 Pg C, respectively. On the plateau, from west to east, the net primary production, soil respiration and net ecosystem production increased, due primarily to the increase of air temperature and precipitation and lowering elevation. In contrast, the decrease of carbon fluxes from south to north was primarily controlled by precipitation gradient. Dynamics of air temperature and associated soil temperature and active layer depth resulted in a higher plant carbon uptake than soil carbon release, strengthening the regional carbon sink during the century.

Main conclusions  We found that increasing soil temperature and deepening active layer depth enhanced soil respiration, increasing the net nitrogen mineralization rate. Together with the effects of warming air temperature and rising CO2 concentrations on photosynthesis, the stronger plant nitrogen uptake due to the enhanced available nitrogen stimulates plant carbon uptake, thereby strengthening the regional carbon sink as the rate of increase net primary production was faster than that of soil respiration. Further, the warming and associated soil thermal dynamics shifted the regional carbon sink from the middle of July in the early 20th century to early July by the end of the century. Our study suggests that soil thermal dynamics should be considered for future quantification of carbon dynamics in this climate‐sensitive region.
Expanded view of the local–regional richness relationship by incorporating functional richness and time: a large‐scale perspective
Authors: Canning‐Clode João , Maloney Kelly O. , McMahon Sean M. , Wahl Martin
Published: June 2010

Aim  We investigate the relationship between local and regional richness in marine fouling assemblages using an expanded and globally replicated approach by incorporating two dimensions of diversity (taxonomic and functional) and different successional stages.

Location  Global.

Methods  In eight different biogeographic regions (Australia, Brazil, Chile, England, Italy, Japan, Portugal and Sweden) 68 polyvinylchloride (PVC) panels (15 × 15 × 0.3 cm) were deployed for colonization. Communities colonizing panels were analysed by measuring percentage cover at each of four different successional ages: 2, 4, 6 and 8 months. Local richness was assessed as the average number of species and functional groups (FGs) per panel and regional richness was evaluated as the estimated (Jack2) asymptote of the sample‐accumulation curves for species and FG on experimental panels.

Results  We found that the shape of the relationship between local and regional richness depended on successional stage and the type of richness considered, i.e. taxonomic or functional richness. Hardly any relationship was detectable between local taxonomic richness and regional taxonomic richness at any successional stage. In contrast, the relation between local functional and regional functional richness shows a unimodal pattern of change during succession, passing through the stages ‘independent’, ‘unsaturated rising’, ‘saturated rising’ and once again ‘independent’.

Main conclusions  The relationship between local and regional richness, whether taxonomic or functional, frequently displays independence of the two scales, particularly in early and late phases of the successional process.
Weak climatic associations among British plant distributions
Authors: Chapman Daniel S.
Published: June 2010

Aim Species distribution models (SDMs) are used to infer niche responses and predict climate change‐induced range shifts. However, their power to distinguish real and chance associations between spatially autocorrelated distribution and environmental data at continental scales has been questioned. Here this is investigated at a regional (10 km) scale by modelling the distributions of 100 plant species native to the UK.

Location UK.

Methods SDMs fitted using real climate data were compared with those utilizing simulated climate gradients. The simulated gradients preserve the exact values and spatial structure of the real ones, but have no causal relationships with any species and so represent an appropriate null model. SDMs were fitted as generalized linear models (GLMs) or by the Random Forest machine‐learning algorithm and were either non‐spatial or included spatially explicit trend surfaces or autocovariates as predictors.

Results Species distributions were significantly but erroneously related to the simulated gradients in 86% of cases (P< 0.05 in likelihood‐ratio tests of GLMs), with the highest error for strongly autocorrelated species and gradients and when species occupied 50% of sites. Even more false effects were found when curvilinear responses were modelled, and this was not adequately mitigated in the spatially explicit models. Non‐spatial SDMs based on simulated climate data suggested that 70–80% of the apparent explanatory power of the real data could be attributable to its spatial structure. Furthermore, the niche component of spatially explicit SDMs did not significantly contribute to model fit in most species.

Main conclusions Spatial structure in the climate, rather than functional relationships with species distributions, may account for much of the apparent fit and predictive power of SDMs. Failure to account for this means that the evidence for climatic limitation of species distributions may have been overstated. As such, predicted regional‐ and national‐scale impacts of climate change based on the analysis of static distribution snapshots will require re‐evaluation.
Hidden patterns of phylogenetic non‐stationarity overwhelm comparative analyses of niche conservatism and divergence
Authors: Diniz‐Filho José Alexandre Felizola , Terribile Levi Carina , da Cruz Mary Joice Ribeiro , Vieira Ludgero Cardoso G.
Published: June 2010

Aim Despite the importance of the niche concept in ecological and evolutionary theory, there are still many discussions about its definition and operational evaluation, especially when dealing with niche divergence and conservatism in an explicit phylogenetic context. Here we evaluate patterns of niche evolution in 67 New World Carnivora species, measured using Hellinger distances based on MAXENT models of species distribution. We show how inferences on niche conservatism or divergence depend on the way phylogenetic patterns are analysed using matrix comparison techniques.

Innovation Initially we used the simplest approach of Mantel tests to compare Hellinger distances (N) derived from MAXENT and phylogenetic distances (P) among species. Then we extended the Mantel test to generate a multivariate correlogram, in which phylogenetic patterns are analysed at multiple levels in the phylogeny and can reveal nonlinearity in the relationship between divergence and time. Finally, we proposed a new approach to generate ‘local’ (or ‘specific’) leverages of components for Mantel correlation, evaluating the non‐stationarity in the relationship betweenNandPfor each species. This new approach was used to show if some lineages are more prone to niche shift or conservatism than others.

Main conclusions Standard Mantel tests indicated a poor correspondence betweenNandPmatrices, discarding the idea of niche conservatism for Carnivora, but the correlogram supports that closely related species tend to be more similar than expected by chance. Moreover, the variance among Hellinger distances between pairs of closely phylogenetically related species is much larger than for the entire clade. Phylogenetic non‐stationarity analysis shows that in some Carnivora families the niche tends to divergence (Mustelidae and Canidae), whereas in others it tends to conservatism (Procyonidae and Mustelidae) at short phylogenetic distances. Our analyses clearly show that misleading results may appear if niche divergence is analysed only by simple matrix correlations not taking into account complex patterns of phylogenetic nonlinearity and non‐stationarity.
The prevalence and trends of overweight, obesity and nutrition‐related non‐communicable diseases in the Arabian Gulf States
Authors: Ng S. W. , Zaghloul S. , Ali H. I. , Harrison G. , Popkin B. M.
Published: June 2010

This paper reviews studies on the prevalence of overweight, obesity and related nutrition‐related non‐communicable diseases in Bahrain, Kuwait, Qatar, Oman, Saudi Arabia and the UAE. Obesity is common among women; while men have an equal or higher overweight prevalence. Among adults, overweight plus obesity rates are especially high in Kuwait, Qatar and Saudi Arabia, and especially among 30–60 year olds (70–85% among men; 75–88% among women), with lower levels among younger and elderly adults. The rate of increase in obesity was pronounced in Saudi Arabia and Kuwait. Prevalence of obesity is high among Kuwaiti and Saudi pre‐schoolers (8–9%), while adolescent overweight and obesity are among the highest in the world, with Kuwait having the worst estimates (40–46%); however, comparison of child data is difficult because of differing standards. Among nutrition‐related non‐communicable diseases, hypertension and diabetes levels are very high and increase with age, with the UAE performing the worst because of a rapid rate of increase between 1995 and 2000. Additional monitoring of the prevalence of metabolic syndrome and cancers is necessary. Nationally representative longitudinal surveys with individual, household and community‐level information are needed to determine the importance of various factors that contribute to these troubling trends.
The Politics of Local Presence: Is there a Case for Descriptive Representation?
Authors: Childs Sarah , Cowley Philip
Published: June 2010

The case for greater descriptive representation of groups such as women and ethnic minorities has become widely, though not wholly, accepted in much of the academic literature and in the ‘real world’ of politics in most advanced democracies. In the UK the goal of greater descriptive representation of women has often become framed as a zero-sum game against men, especially local men, with consequences for the descriptive representation of women. This article examines whether claims made for the descriptive representation of women and black candidates can and should apply to local candidates, whatever their sex or race. It draws a distinction between the representation of a territory (common to most representative systems) and the representation of a territory by someone from that territory, a similar distinction to the difference common in the gender and politics literature between the representation of women by an elected representative and the representation of women by women representatives. The article also distinguishes between a hard and a soft form of this argument. The latter applies to almost every constituency in the UK, but it is a claim not based on arguments for the presence of the disadvantaged. However, the case for a local candidate to represent a more disadvantaged constituency, the harder form of the argument, can be made on almost all of the criteria applied to other excluded groups identified in the politics of presence literature.
Rites of Passage: Discursive Strategies in the 2008 Human Fertilisation and Embryology Bill Debate
Authors: Kettell Steven
Published: June 2010

The transformational impact of the ideational turn in political science has been profound, but academic inquiry into the role of discursive strategies has remained limited. This article examines this issue through a study of the 2008 Human Fertilisation and Embryology Bill. The debate surrounding the Bill was characterised by two competing discourses of ‘hope’ and ‘fear’. Established during previous debates over the regulation of research using human embryos, these contrasted the potential medical benefits to be derived with the social and ethical dangers of an unregulated science. This article deconstructs these discursive strategies and considers their impact on both the course of the debate as well as the mechanics of the Bill's passage through Parliament itself. It maintains that discursive and institutional contexts are mutually constitutive.
Relative Risk Estimated from the Ratio of Two Median Unbiased Estimates
Authors: Carter Rickey E. , Lin Yan , Lipsitz Stuart R. , Newcombe Robert G. , Hermayer Kathie L.
Published: June 2010

Clinical trials often include binary end points. In some cases, no successes are observed and the usual large sample estimates of relative risk are undefined. The paper proposes an estimator for relative risk based on the median unbiased estimator. The relative risk estimator proposed is well defined and performs satisfactorily for a wide range of data configurations. To facilitate the use of the estimator, a deterministic bootstrap confidence interval is also proposed, and an SAS macro is available to perform the necessary calculations. An on-going randomized clinical trial motivated the development of the estimator and is used to illustrate the approach.
An Application of Hidden Markov Models to the French Variant Creutzfeldt–Jakob Disease Epidemic
Authors: Chadeau-Hyam Marc , Clarke Paul S. , Guihenneuc-Jouyaux Chantal , Cousens Simon N. , Will Robert G. , Ghani Azra C.
Published: June 2010

In 1996, the discovery of variant Creutzfeldt–Jakob disease in the UK raised serious concerns about a large-scale epidemic. These concerns have been heightened by the recent discovery of people in Britain who were infected through blood transfusion. The outbreak of variant Creutzfeldt–Jakob disease in France emerged more recently with 23 cases observed to date. We use a hidden Markov model to predict the scale of the epidemic in France. As accurate data on the most important epidemiological parameters are scarce, we incorporate estimates from previous studies. Parameter estimation is performed by using Markov chain Monte Carlo methods from which credible intervals for our predictions are obtained. The sensitivity of these predictions to important assumptions regarding population exposure is assessed.
BREAKING THE IMPEDIMENTS TO BUDGETARY REFORMS: EVIDENCE FROM EUROPE
Authors: FABRIZIO STEFANIA , MODY ASHOKA
Published: June 2010

In addition to the known effects of government fractionalization, we find that larger deficits are associated with a reduced likelihood of budgetary reforms. In a war of attrition setting, larger deficits signify stronger entitlements on the budget, generating unwillingness to impose self‐discipline. A sense of crisis emerges only when macroeconomic imbalances appear. However, while a crisis creates the opportunity for reform, policy credibility is important for effectively using that opportunity. We find that one way of establishing credibility is by undertaking measures in opposition to the government's known ideological position – these presumably signal motivation by broader social welfare considerations.
15. The Breeding Habits of the Angel‐Fish (Pteroyhyllum scalare)
Authors: Sladden Dorothy E.
Published: June 2010

Amazon Angel‐fish (Pterophyllum scalare) bred in the Zoological Society's Aquarium for the first time in June 1936. The spawning took place in a 50‐gallon tank at a temperature ranging from 80 to 82°° F., and in slightly acid water, pH 6.8. Markings on the head and body of the male, which may be an indication that it is in breeding condition, were observed. 150–200 eggs were deposited, 45–50 young hatched, and of these 30 per cent. were reared. Both parents took part in caring for the young. On hatching, the fry resembled the young of other Cichlids, but at the age of one month the typical adult form was assumed.
Influence of Shock Pre‐Compression Stress and Tensile Strain Rate on the Spall Behaviour of Mild Steel
Authors: Wang G. Y.
Published: June 2010

Abstract:  A series of plate‐impact spall experiments were conducted to investigate the influence of shock pre‐compression stress and tensile strain rates on the dynamic tensile fracture (or spall) behaviour of shocked mild steel. The shock pre‐compression stress amplitude and tensile strain rate were controlled independently to ensure that only one single‐loading parameter varied for each experiment. A push–pull type velocity interferometer system for any reflector (VISAR) was used to measure the free surface velocity profiles of samples. It is observed from experimental results that the influence of shock pre‐compression stress amplitude on the spall strength is less significant in the range attained in these experiments, whereas with increasing tensile strain rate, an evident 65% increase of spall strength is determined in the present tensile strain rate range of 104 to 106 s−1. VISAR data are compared with finite‐difference calculations employing a modified damage function model with a percolation–relaxation function, and a good agreement between the calculation and the experiments was obtained. Preliminary simulation results also revealed that a critical damage exists, which physically corresponds to the critical intervoid ligament distance for triggering the onset of void coalescence, and may be regarded as a material parameter for describing the dynamic tensile fracture and independent of the loading conditions.
Study on Failure Characteristic of Rock‐Like Materials With an Open‐Hole Under Uniaxial Compression
Authors: Zhao C. , Matsuda H. , Morita C. , Shen M. R.
Published: June 2010

Abstract:  The failure strength model of brittle materials with a pre‐existing open‐hole defect is proposed in this paper. A modified Sammis–Ashby model is deduced, in which it can be used to calculate the peak strength of brittle materials. It shows the law between peak strength σp and independent variable μ, which is the ratio of open‐hole radius (a) to half‐width of the specimen (t). Moreover, numerical and experimental investigations on failure process of rock‐like materials with an open‐hole imperfection were carried out. In the experiments, 3D‐digital image correlation method, an optical technique which utilises the full‐field and non‐contact measurement, was employed. A progressive elastic damage method realistic failure process analysis (RFPA) was used in the numerical investigation to inspect and verify the modified model and simulate the failure process. The investigation finds that there are good correlations between the experimental, numerical and theoretical results. Moreover, because of the influences of boundary conditions, shear failure type was obtained both experimentally and numerically.
Experimental Study of the Creep Lifetime of the 1.25Cr 0.5Mo Steel Pipes
Authors: Vakili‐Tahami F. , Sajjadpour M. , Attari P.
Published: June 2010

Abstract:  In this paper, physical parameters for the creep constitutive equations of the low alloy ferritic steel 1.25Cr0.5Mo have been determined using experimental data. This alloy is used mostly in power generation and petrochemical industries because of its high temperature creep resistance. Test samples have been obtained from a new super‐heater pipe wall of a steam‐generating boiler in Tabriz Petrochemical Plant according to the ASTM standards. By conducting creep rupture tests for 1.25Cr0.5Mo steel, creep behaviour and creep‐rupture properties were examined for this material. Creep rupture tests have been carried out at four temperatures of 700, 725, 750 and 800 °C, under applied uni‐axial stresses of 30, 35, 40 and 50 MPa. The experimental data have been used to obtain the constitutive parameters using numerical optimisation techniques. Also the temperature and stress dependency of the creep lifetime for this alloy has been investigated using Larson–Miller and Monkman–Grant parameters. The results show good agreement with other test data such as ASTM and API. Finally, these constitutive equations have been used to study the creep behaviour of the super‐heater pipe. The results show that the super‐heater tube has been over designed in terms of the creep lifetime and this is in accordance with the in‐plant observations.
Mandrel Peeling of a Flexible Laminate With a Pressure‐Sensitive Adhesive: Comparison of Experiment with Numerical Analysis
Authors: Williams J. A. , Kauzlarich J. J.
Published: June 2010

Abstract:  Mandrel peel tests with mandrels or rollers of varying diameters have been carried out using Mylar backing of several thicknesses and a commercial synthetic acrylic adhesive. The results are critically compared with the numerical predictions of the peeling software package ICPeel. In addition, a finite element model of the mandrel peeling process has been completed which gives good agreement with experiment provided appropriate mechanical properties of adherend and adhesive are used which must include the effects of adherent constraint. The influence of the thickness of the backing is also considered and both experiment and analysis confirm that there is a backing thickness at which the peel force for a laminate of this sort will show a maximum.
Lamb Waves for Damage Localisation in Panels
Authors: Wandowski T. , Kudela P. , Malinowski P. , Ostachowicz W.
Published: June 2010

Abstract:  In this study, Lamb wave propagation phenomena have been used to localise discontinuities in aluminium and composite panels. For that purpose, piezoelectric transducers have been used to excite and register Lamb waves in the panels. Excited waves that propagate and reflect from the panel edges and discontinuities were registered by piezoelectric sensors as voltage changes in time. Three different experiments have been conducted to investigate the wave propagation phenomena. In the first experiment, the attenuation and dispersion of Lamb waves in the aluminium panel has been studied. The second experiment has been oriented to localise an additional mass attached to the same panel. A dedicated signal‐processing algorithm has been developed to aid the localisation procedure that allowed to extract relevant features of the discontinuity. The algorithm has been tested on signals from the panel with and without the additional mass. The results obtained have been compared to find the position of the discontinuity. The third experiment concerned a more realistic damage scenario when piezoelectric transducers have been arranged as a clock‐like array to find a crack in a composite panel.
Stability of Microstructure of Ultrafine‐Grained Copper Under Fatigue and Thermal Exposition
Authors: Kunz L. , Lukáš P. , Pantělejev L. , Man O.
Published: June 2010

Abstract:  Effect of cyclic loading and thermal exposition on microstructure of bulk ultrafine‐grained Cu prepared by equal channel angular pressing was experimentally investigated by means of electron backscattering diffraction and by transmission electron microscopy. Stability of the microstructure under stress‐controlled cyclic loading with a tensile mean stress of 200 MPa was shown to be high. Neither dynamic grain coarsening nor development of bimodal microstructure was observed. However, annealing at 250 °C for 30 min resulted in formation of bimodal microstructure. Consequently, fatigue strength of annealed specimens was low.
Initial Clinical Experience With the HeartMate II Ventricular Assist System in a Pediatric Institution
Authors: Owens William R. , Bryant III Roosevelt , Dreyer William J. , Price Jack F. , Morales David L.S.
Published: June 2010

In many adult cardiac programs, intracorporeal mechanical circulatory support has become a routine treatment for end‐stage cardiac failure. For the pediatric population, options are often limited by a small body habitus. Even when an adolescent's weight may suggest adequate space for device implant, most intracorporeal adult devices remain too large for adolescents. The Thoratec HeartMate II (HM II) (approved by the FDA in April of 2008) is a small, noiseless device that is easily operated and monitored. By having an uncomplicated operating system and small percutaneous drive line, the HM II provides an opportunity for these patients to aggressively rehabilitate to become a better transplant candidate and also provides the potential to be discharged home. The two youngest patients ever to utilize the HM II are also the first two cases of using the HM II at a freestanding pediatric hospital. A 12‐year‐old, 53 kg, girl with dilated cardiomyopathy was supported for 85 days before receiving her heart transplant. The second patient, a 13‐year‐old, 149 kg, Hispanic male suffering from morbid obesity and dilated cardiomyopathy, was supported for 128 days. The HM II allowed for rehabilitation and nutritional education, resulting in this patient losing 50 kg before heart transplant. Despite both of these patients' size, their thoracic cavities were that of a preadolescent and thus techniques were developed to avoid morbidities like chest wall abrasion and bleeding. Because of differences between adult and pediatric patients and institutions, these cases provided unique challenges. However, as pediatric device therapy is now maturing, pediatric programs such as Texas Children's Hospital have begun to develop strategies for mechanical support that factor in patient's size and need for long‐term or temporary support, utilizing the growing number of devices (i.e., Jostra Rotoflow, Tandem Heart PTVA, Thoratec CentriMag, Berlin Heart EXCOR, etc.) that are now available to children.
A Novel Possible Strategy Based on Self‐Assembly Approach to Achieve Complete Periodontal Regeneration
Authors: Yang Zhen‐Hua , Jin Fang , Zhang Xiao‐Jun , Liu Xin , Zhang Yun‐Fei , Liu Jia‐Qiang , Duan Yin‐Zhong , Jin Yan
Published: June 2010

Limitations of current regeneration modalities underscore the importance of restoring the three‐dimensional (3D) microenvironment of periodontal development, which is able to elicit the intrinsic capacity of mesenchymal stem cells to proceed to engage in a redevelopment‐like program. With increased attention for the potential therapeutic applications of periodontal ligament stem cells (PDLSCs) in periodontal regeneration, it has been proposed that bone marrow mesenchymal stem cells (BMMSCs) are very likely another cell source of physiological repair of periodontal tissues. With this in mind, enlightened from the research targeting the fabrication of laminar structures such as liver and kidney with heterotypic stratification of cell sheets, we proposed a novel possible strategy based on self‐assembly approach, which is akin to the physiological phenomenon that occurs during organogenesis, to enhance complete reconstruction of functional complex periodontium‐organ systems. We assumed that in this strategy, using the intrinsic capacity of monodispersed cells to self‐assemble into a microtissue such as a 3D spheroid, bilayered cell pellet constructs comprising calcified bone‐forming cell pellets (i.e., BMMSCs) and cementum/PDL‐forming cell pellets (i.e., PDLSCs) would be fabricated in vitro in a tissue‐mimicking way and then implanted into periodontal defects. We hypothesize that this novel strategy might open new options to reconstruct extended periodontal defects and then achieve the ultimate goal of predictable and complete regeneration of the periodontium.
Proinflammatory Cytokines, Hepatocyte Growth Factor and Adipokines in Peritoneal Dialysis Patients
Authors: Lee Chien‐Te , Ng Hwee‐Yeong , Hsu Chung‐Yao , Tsai Yu‐Che , Yang Yu‐Kun , Chen Te‐Chuan , Chiou Terry Ting‐Yu , Kuo Chien‐Chun , Lee Wen‐Chin , Hsu Kao‐Tai
Published: June 2010

Chronic inflammation is a well‐recognized complication in dialysis patients and a potential role of the adipose tissue as an important tissue of origin contributing to inflammation has been proposed. Stable peritoneal dialysis (PD) patients were enrolled to investigate the relationship between serum levels of proinflammatory cytokines and adipokines. Our results revealed that there was a strong association between high sensitivity C‐reactive protein and interleukin (IL)‐6 and tumor necrosis factor‐alpha (TNF‐α) but not with IL‐10 and IL‐18. IL‐6 correlated with TNF‐α, IL‐10, and IL‐18. No association was found between IL‐10 and IL‐18. Adiponectin was positively correlated with all proinflammatory cytokines, except IL‐10. No significant association was found between resistin and proinflammatory cytokines. Hepatocyte growth factor (HGF) was directly related to proinflammatory cytokines but not with adipokines. The presence of residual kidney function (RKF) affected IL‐6, TNF‐α, and HGF levels. The peritoneal transport property did not influence inflammatory cytokine and adipokine levels. In conclusion, there was a close relationship between proinflammatory cytokines and adipokines. HGF correlated with proinflammatory cytokines but not with adipokines. The PD‐related factors such as RKF, peritoneal property and dialysis glucose load affected levels of proinflammatory cytokines. Body mass index was an important determinant of leptin and adiponectin in PD patients.
Transcranial Magnetic Stimulation for Migraine: A Safety Review
Authors: Dodick David W. , Schembri Carol T. , Helmuth Michele , Aurora Sheena K.
Published: June 2010

(Headache 2010;50:1153‐1163)

Objective.— To review potential and theoretical safety concerns of transcranial magnetic stimulation (TMS), as obtained from studies of single‐pulse (sTMS) and repetitive TMS (rTMS) and to discuss safety concerns associated with sTMS in the context of its use as a migraine treatment.

Methods.— The published literature was reviewed to identify adverse events that have been reported during the use of TMS; to assess its potential effects on brain tissue, the cardiovascular system, hormone levels, cognition and psychomotor tests, and hearing; to identify the risk of seizures associated with TMS; and to identify safety issues associated with its use in patients with attached or implanted electronic equipment or during pregnancy.

Results.— Two decades of clinical experience with sTMS have shown it to be a low risk technique with promise in the diagnosis, monitoring, and treatment of neurological and psychiatric disease in adults. Tens of thousands of subjects have undergone TMS for diagnostic, investigative, and therapeutic intervention trial purposes with minimal adverse events or side effects. No discernable evidence exists to suggest that sTMS causes harm to humans. No changes in neurophysiological function have been reported with sTMS use.

Conclusions.— The safety of sTMS in clinical practice, including as an acute migraine headache treatment, is supported by biological, empirical, and clinical trial evidence. Single‐pulse TMS may offer a safe nonpharmacologic, nonbehavioral therapeutic approach to the currently prescribed drugs for patients who suffer from migraine.
Headaches After Concussion in US Soldiers Returning From Iraq or Afghanistan
Authors: Theeler Brett J. , Flynn Frederick G. , Erickson Jay C.
Published: June 2010

(Headache 2010;50:1262‐1272)

Objectives.— To determine the prevalence, characteristics, impact, and treatment patterns of headaches after concussion in US Army soldiers returning from a deployment to Iraq or Afghanistan.

Methods.— A cross‐sectional study was conducted with a cohort of soldiers undergoing postdeployment evaluation during a 5‐month period at the Madigan Traumatic Brain Injury Program at Ft. Lewis, WA. All soldiers screening positive for a deployment‐related concussion were given a 13‐item headache questionnaire.

Results.— A total of 1033 (19.6%) of 5270 returning soldiers met criteria for a deployment‐related concussion. Among those with a concussion, 957 (97.8%) reported having headaches during the final 3 months of deployment. Posttraumatic headaches, defined as headaches beginning within 1 week after a concussion, were present in 361 (37%) soldiers. In total, 58% of posttraumatic headaches were classified as migraine. Posttraumatic headaches had a higher attack frequency than nontraumatic headaches, averaging 10 days per month. Chronic daily headache was present in 27% of soldiers with posttraumatic headache compared with 14% of soldiers with nontraumatic headache. Posttraumatic headaches interfered with duty performance in 37% of cases and caused more sick call visits compared with nontraumatic headache. In total, 78% of soldiers with posttraumatic headache used abortive medications, predominantly over‐the‐counter analgesics, and most perceived medication as effective.

Conclusions.— More than 1 in 3 returning military troops who have sustained a deployment‐related concussion have headaches that meet criteria for posttraumatic headache. Migraine is the predominant headache phenotype precipitated by a concussion during military deployment. Compared with headaches not directly attributable to head trauma, posttraumatic headaches are associated with a higher frequency of headache attacks and an increased prevalence of chronic daily headache.
Atypical Spontaneous Intracranial Hypotension With a Head‐Shaking Headache
Authors: Seok Hung Youl , Eun Mi‐Yeon , Choi Jeong‐Yoon , Roh Jee Hoon , Park Moon Ho , Park Kun Woo , Kwon Do‐Young
Published: June 2010

Spontaneous intracranial hypotension (SIH) is typically characterized by orthostatic headache; however, various atypical manifestations of SIH have been reported recently. We report here the case of a 46‐year‐old man with headache secondary to SIH, which was nonorthostatic, triggered only when the patient shook his head. We suggest that SIH should be suspected in patients with headache induced by head‐shaking, even without orthostatic features, especially when the headache is accompanied by other symptoms commonly associated with SIH.
The Shared Genetics of Migraine and Anxious Depression
Authors: Ligthart Lannie , Nyholt Dale R. , Penninx Brenda W.J.H. , Boomsma Dorret I.
Published: June 2010

(Headache 2010;50:1549‐1560)

Objectives.— To investigate (1) whether shared genetic factors influence migraine and anxious depression; (2) whether the genetic architecture of migraine depends on anxious depression; (3) whether the association between migraine and anxious depression is causal.

Background.— Migraine and anxious depression frequently occur together, but little is known about the mechanisms causing this association.

Methods.— A twin study was conducted to model the genetic architecture of migraine and anxious depression and the covariance between them. Anxious depression was also added to the model as a moderator variable to examine whether anxious depression affects the genetic architecture of migraine. Causal models were explored with the co‐twin control method.

Results.— Modest but significant phenotypic (rP = 0.28), genetic (rG = 0.30), and nonshared environmental (rE = 0.26) correlations were found between the 2 traits. Interestingly, the heritability of migraine depended on the level of anxious depression: the higher the anxious depression score, the lower the relative contribution of genetic factors to the individual differences in migraine susceptibility. The observed risk patterns in discordant twins are most consistent with a bidirectional causal relationship.

Conclusions.— These findings confirm the genetic association between migraine and anxious depression and are consistent with a syndromic association between the 2 traits. This highlights the importance of taking comorbidity into account in genetic studies of migraine, especially in the context of selection for large‐scale genotyping efforts. Genetic studies may be most effective when migraine with and without comorbid anxious depression are treated as separate phenotypes.
A Survey of Neurologists on the Likeability of Headaches and Other Neurological Disorders
Authors: Evans Randolph W. , Evans Rochelle E.
Published: June 2010

(Headache 2010;50:1126‐1129)

Background.— A pilot survey of 94 neurologists attending a continuing medical education meeting was performed to assess whether neurologists like to treat headaches and other common disorders and evaluate their personal prevalence of the disorders.

Methods.— Physicians were asked to respond to the following statement using a 5‐point Likert scale (from 1, strongly disagree to 5, strongly agree): “I like to treat patients with this disease or symptom.”

Results.— The response rate was 46% with a mean age of 52.5 years. The respondents liked to treat migraine (mean = 4.32) similarly to carpal tunnel syndrome and Parkinson's disease. Cluster headaches (mean = 3.90) are less liked than migraine similar to epilepsy and multiple sclerosis and respondents are neutral to treating chronic daily headaches (mean = 3.02) similarly to insomnia and low back pain. The lifetime prevalence of migraine among respondents is 48% with those with and without migraine comparably liking to treat migraineurs.

Conclusions.— Neurologists like to treat migraine more than cluster headaches and are neutral in treating chronic daily headaches.
Standard‐ versus high‐dose lenograstim in adults with hematologic malignancies for peripheral blood progenitor cell mobilization
Authors: Romeo Azzurra , Chierichini Anna , Spagnoli Alessandra , Vittori Mariangela , Vacca Michele , Gozzer Maria , Spadea Antonio , Anaclerico Barbara , Dessanti Maria Laura , D'Andrea Mariella , Toglia Giuseppe , Annino Luciana , Petti Maria Concetta , Mengarelli Andrea , Arcese William ,   on behalf of the Rome Transplant Network
Published: June 2010

BACKGROUND:The aim of this retrospective, multicenter study was to compare high‐ versus standard‐dose lenograstim after chemotherapy in collecting target dose of CD34+ peripheral blood progenitor cells (PBPCs) in adult candidates for autologous transplant.

STUDY DESIGN AND METHODS:A total of 166 consecutive patients (28 acute leukemias [ALs], 77 lymphomas, 61 multiple myeloma [MM]) underwent 182 mobilization procedures. Only the first were analyzed. The CD34+ cell target was at least 2 × 106, 4 × 106, and 8 × 106/kg and lenograstim started on days +19, +1, and +5 from the end of chemotherapy for AL, lymphomas, and MM, respectively. Eighty‐seven and 79 patients, respectively, received 5 and 10 µg/kg/day lenograstim subcutaneously (sc). An analysis to evaluate factors predicting satisfactory procedures and outcome of transplants performed with first‐mobilization‐procedure PBPCs was conducted. Most patients received 6 mg of pegfilgrastim or 5 µg/kg/day lenograstim sc after transplant.

RESULTS:In multivariate analysis, high‐dose lenograstim (p = 0.053) in MM and male sex (p = 0.028) were positive predictive factors for reaching cell target. Fludarabine negatively influenced stimulation length (p = 0.002). Apheresis, CD34+ cells mobilized and collected, blood volume processed, side effects, transplants performed, and engraftment time were similar between lenograstim cohorts. Pegfilgrastim versus lenograstim delayed platelet (PLT) recovery times (13 days vs. 11 days, p = 0.036).

CONCLUSIONS:High‐dose lenograstim more efficiently mobilized MM patients requiring the highest PBPC target but did not influence transplants performed and engraftment time. Male patients mobilized more efficiently. Fludarabine negatively influenced stimulation length. Finally, pegfilgrastim seems to delay PLT recovery.
Modeling the risk of an emerging pathogen entering the Canadian blood supply
Authors: Kleinman Steven , Cameron Claire , Custer Brian , Busch Michael , Katz Louis , Kralj Boris , Matheson Ian , Murphy Ken , Preiksaitis Jutta , Devine Dana
Published: June 2010

BACKGROUND: As part of its risk management process, Canadian Blood Services (CBS) constructed mathematical models of how newly emerging pathogens might affect blood transfusion recipients.

STUDY DESIGN AND METHODS: CBS convened an expert panel including medical, health economics, analytical, risk management, and insurance professionals to examine multiple data sources. The model for emerging pathogen risk included separate modules to calculate the frequency and severity of infections from transfusion‐transmitted agents that could cause either acute transient or chronic persistent infection. Important model input variables were annual number of components transfused, the presumed incidence and prevalence of a new agent, the time interval of recipient risk, recipient age and sex, projected recipient survival, rate of secondary infection, pathogen‐induced morbidity, and the associated medical costs of such morbidity.

RESULTS: In the 5‐year time frame considered in the model, it was estimated that approximately 3500 recipient infections (two‐SD range of 0 to 11,370 infections) could occur from an emerging pathogen that establishes a chronic infection in donors, with 60% of these due to red blood cell transfusion. The medical costs associated with recipient outcomes due to a catastrophic emerging pathogen could be lowered by 20% if an effective pathogen reduction method for either platelets or plasma were in place.

CONCLUSION: This modeling exercise offers a framework for other blood services to construct similar models. It also provides a useful way to model the implementation of new blood safety interventions (e.g., pathogen reduction) on emerging pathogen risk.