bluuebunny/crossref_metadata_2025 huggingface dataset:
Nonfluoroscopic Catheter Ablation of Cardiac Arrhythmias in Adults: Feasibility, Safety, and Efficacy
Authors: RAZMINIA MANSOUR , MANANKIL MARIAN F. , ERYAZICI PAULA L.S. , ARRIETA‐GARCIA CARLOS , WANG THEODORE , D'SILVA OLIVER J. , LOPEZ CHRISTIAN S. , CRYSTAL GEORGE J. , KHAN SABA , STANCU MIHAELA M. , TURNER MARIANNE , ANTHONY JOSEPH , ZHEUTLIN TERRY A. , KEHOE RICHARD F.
Published: May 2012

Nonfluoroscopic Catheter Ablation of Cardiac Arrhythmias in Adults Background: Catheter ablations are traditionally performed using fluoroscopic guidance, exposing both patients and medical staff to the risks of radiation. Nonfluoroscopic catheter ablation has been used successfully to treat limited types of arrhythmias in children, but whether this approach has broad application in adults is uncertain. The purpose of this study was to evaluate the feasibility, safety, and efficacy of fluoroless catheter ablation in adults being treated for a range of arrhythmias.

Methods and Results:
Retrospective analysis was performed in 2 patient groups (both n = 60): (1) the nonfluoroscopy (NF) group consisting of consecutive adult patients, in which catheter positioning was accomplished exclusively with intracardiac electrograms (IE), electroanatomic mapping (EAM), and intracardiac echocardiography (ICE); and (2) the fluoroscopy (F) group, in which catheter positioning was additionally guided by fluoroscopy. The patients in the F group were selected to match the types of arrhythmias in the NF group. All ablation procedures were performed by one operator. The total procedure time did not differ between groups for any specific type of arrhythmia ablated. Acute procedural success was similar in both groups (NF, 59/60 [98%] and F, 60/60 [100%]). The complications were limited to a groin pseudoaneurysm in the NF group, and pericardial effusion and groin hematoma in the F group.

Conclusion:
Catheter ablations were efficiently and effectively performed in adults with a variety of arrhythmias using only IE, EAM, and ICE for catheter guidance. This nonfluoroscopic technique was feasible, posed no additional safety concerns, and should be readily implementable in most electrophysiology laboratories. (J Cardiovasc Electrophysiol, Vol. 23 pp. 1078‐1086, October 2012)
Preparation, Microstructure, and Mechanical Properties of TiB2 Using Ti3AlC2 as a Sintering Aid
Authors: Zheng Liya , Li Fangzhi , Zhou Yanchun
Published: May 2012

Titanium diboride (TiB2) was successfully hot‐pressed at 1500°C using titanium aluminum carbide (Ti3AlC2) as a sintering aid. The mechanisms for the improved sinterability of TiB2 by the addition of Ti3AlC2 involve, first, the Al coming from the decomposition of Ti3AlC2 can eliminate the oxide layer on the surface of TiB2; second, the TiCx (also from the decomposition of Ti3AlC2) has a positive influence on the densification of TiB2 due to its plasticity at high temperatures. TEM observations reveal that the interface between TiB2 and TiCx is coherent and strong, free of amorphous layers and oxide phases. An optimized composition of TiB2‐10 wt% Ti3AlC2 was obtained with the unique combination of mechanical properties, including the elastic modulus of 567 GPa, the fracture toughness of 4.8 MPa·m1/2, the flexural strength of 711 MPa, and the hardness of 25 GPa.
Study of Phase Transformation and Microstructure in Sintering of Mechanically Activated Cordierite Precursors
Authors: Fotoohi Babak , Blackburn Stuart
Published: May 2012

A cordierite precursor mixture of talc, boehmite, and kaolin was studied with respect to the influence of dry milling intensity per unit time on phase transformation pathways and microstructural development. Three milling methods (ball, ring, and planetary) were used, and the effects of mechanical action and milling times were investigated at different temperatures. Sintering at 1000°C for 2 h resulted in the development of significant mechanically assisted phase transformations specifically related to formation of mullite in the most highly activated materials. Mullite transformation to precordierite mineralogy and the formation of magnesium aluminum silicate were also found to be dependent on the degrees and methods of mechanical processing. Planetary milling resulted in the highest densification of the material, which when sintered at 1300°C for 2 h produced a ceramic body rich in cordierite composition.
PV1 down‐regulation via shRNA inhibits the growth of pancreatic adenocarcinoma xenografts
Authors: Deharvengt Sophie J. , Tse Dan , Sideleva Olga , McGarry Caitlin , Gunn Jason R. , Longnecker Daniel S. , Carriere Catherine , Stan Radu V.
Published: May 2012

PV1 is an endothelial‐specific protein with structural roles in the formation of diaphragms in endothelial cells of normal vessels. PV1 is also highly expressed on endothelial cells of many solid tumours. On the basis of in vitro data, PV1 is thought to actively participate in angiogenesis. To test whether or not PV1 has a function in tumour angiogenesis and in tumour growth in vivo, we have treated pancreatic tumour‐bearing mice by single‐dose intratumoural delivery of lentiviruses encoding for two different shRNAs targeting murine PV1. We find that PV1 down‐regulation by shRNAs inhibits the growth of established tumours derived from two different human pancreatic adenocarcinoma cell lines (AsPC‐1 and BxPC‐3). The effect observed is because of down‐regulation of PV1 in the tumour endothelial cells of host origin, PV1 being specifically expressed in tumour vascular endothelial cells and not in cancer or other stromal cells. There are no differences in vascular density of tumours treated or not with PV1 shRNA, and gain and loss of function of PV1 in endothelial cells does not modify either their proliferation or migration, suggesting that tumour angiogenesis is not impaired. Together, our data argue that down‐regulation of PV1 in tumour endothelial cells results in the inhibition of tumour growth via a mechanism different from inhibiting angiogenesis.
Hormonal contraception and venous thromboembolism
Authors: LIDEGAARD ØJVIND , MILSOM IAN , GEIRSSON REYNIR TOMAS , SKJELDESTAD FINN EGIL
Published: May 2012

Background. New studies about the influence of hormonal contraception on the risk of venous thromboembolism (VTE) have been published. Aim. To evaluate new epidemiological data and to propose clinical consequences. Design. A literature survey. Methods. Studies assessing the risk of specific types of hormonal contraception were evaluated, compared and set into a clinical perspective. Results. The majority of newer studies have demonstrated a threefold increased risk of VTE in current users of medium‐ and low‐dose combined oral contraceptives (COCs) with norethisterone, levonorgestrel (LNG) or norgestimate compared with non‐users. The same studies have demonstrated a sixfold increased risk of VTE in users of combined pills with desogestrel, gestodene, drospirenone or cyproteroneacetate, and in users of the contraceptive vaginal ring, compared with non‐users. The rate ratio of VTE between users of COCs with newer progestogens compared with users of COCs with LNG was 1.5–2.8 in seven studies and 1.0 in two studies. Progestogen‐only contraception did not confer an increased risk of VTE in any study. The incidence rate of VTE in non‐pregnant women aged 15–49 years using non‐hormonal contraception is three per 10 000 years. Conclusions. For women starting on hormonal contraception, we recommend medium‐ or low‐dose combined pills with norethisterone, LNG or norgestimate as first‐choice preparations. For the many women who are users of COCs with newer progestogens, although the absolute risk of VTE is low, a change to combined pills with norethisterone, LNG or norgestimate may halve their risk of VTE. Finally, we recommend COCs with 20 μg estrogen combined with the older progestogens to be launched in the Scandinavian countries. Women at an increased risk of VTE should consider progestogen‐only contraception or non‐hormonal contraception.
Evidence of the receptor‐mediated influence of melatonin on pancreatic glucagon secretion via the Gαq protein‐coupled and PI3K signaling pathways
Authors: Bähr Ina , Mühlbauer Eckhard , Albrecht Elke , Peschke Elmar
Published: May 2012

Abstract:  Melatonin has been shown to modulate glucose metabolism by influencing insulin secretion. Recent investigations have also indicated a regulatory function of melatonin on the pancreatic α‐cells. The present in vitro and in vivo studies evaluated whether melatonin mediates its effects via melatonin receptors and which signaling cascade is involved. Incubation experiments using the glucagon‐producing mouse pancreatic α‐cell line αTC1 clone 9 (αTC1.9) as well as isolated pancreatic islets of rats and mice revealed that melatonin increases glucagon secretion. Preincubation of αTC1.9 cells with the melatonin receptor antagonists luzindole and 4P‐PDOT abolished the glucagon‐stimulatory effect of melatonin. In addition, glucagon secretion was lower in the pancreatic islets of melatonin receptor knockout mice than in the islets of the wild‐type (WT) control animals. Investigations of melatonin receptor knockout mice revealed decreased plasma glucagon concentrations and elevated mRNA expression levels of the hepatic glucagon receptor when compared to WT mice. Furthermore, studies using pertussis toxin, as well as measurements of cAMP concentrations, ruled out the involvement of Gαi‐ and Gαs‐coupled signaling cascades in mediating the glucagon increase induced by melatonin. In contrast, inhibition of phospholipase C in αTC1.9 cells prevented the melatonin‐induced effect, indicating the physiological relevance of the Gαq‐coupled pathway. Our data point to the involvement of the phosphatidylinositol 3‐kinase signaling cascade in mediating melatonin effects in pancreatic α‐cells. In conclusion, these findings provide evidence that the glucagon‐stimulatory effect of melatonin in pancreatic α‐cells is melatonin receptor mediated, thus supporting the concept of melatonin‐modulated and diurnal glucagon release.
Substance use among elite adolescent athletes: Findings from the GOAL Study
Authors: Diehl K. , Thiel A. , Zipfel S. , Mayer J. , Schneider S.
Published: May 2012

Elite athletes often find themselves in a dilemma between maintaining optimal health to be successful and accepting health risks by pushing their physical limits. For elite adolescent athletes, this dilemma becomes a trilemma as they are also confronted with developmental challenges typical for adolescence. As many adolescents encounter different substances during this critical period of development, we analyzed prevalence of substance use to identify determinants related to these behaviors and to compare the prevalences with nonelite athletes. Our main data were drawn from the German Young Olympic Athletes’ Lifestyle and Health Management Study (GOAL Study) including 1138 elite adolescent athletes (14–18 years). For comparisons, the data were combined with data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Beside uni‐ and bivariate analyses, we conducted (conditional) logistic regression analyses. Eighty‐six percent had consumed alcohol at least once. Binge drinking was performed by 24% during the last month. Alcohol consumption was positively associated with age, education, technical sports, lower squads, and attending boarding schools. Binge drinking was higher in males, older adolescents, and in technical sports. Smoking (3%) and marijuana use (3%) were less prevalent. Compared with nonelite athletes, they showed less risky behavior except for binge drinking. As we could identify risk groups, prevention and health promotion programs could be developed for this specific target group.
ADDING GRAPE SEED EXTRACT TO WINE AFFECTS ASTRINGENCY AND OTHER SENSORY ATTRIBUTES
Authors: CLIFF MARGARET A. , STANICH KAREEN , EDWARDS JENNIFER E. , SAUCIER CEDRIC T.
Published: May 2012

This research note explored the sensory and analytical effects of adding grape seed extract (GSE; 0.0, 0.5, 1.0, 2.5 and 5.0 g/L) to a commercial red wine. Total phenol, color intensity and hue analyses were conducted. Sensory profiling, using 12 trained judges, evaluated the intensity of astringency, fruity and woody/earthy aromas, and red color of the wines. Special care was taken to avoid perceptual biases among the sensory attributes, by conducting the astringent, aromatic and color determinations independently of one another. Analyses of variance were used to evaluate the sensory effects, while regression analyses were used to relate the mean sensory attributes to the GSE concentrations. Positive linear regressions were observed between GSE and astringency (R2 = 0.841), woody/earthy aroma (R2 = 0.933) and color (R2 = 0.925), while a negative linear regression was observed for fruity aroma (R2 = 0.911). The presence of GSE significantly enhanced the woody/earthy aroma and suppressed the fruity aroma.

PRACTICAL APPLICATIONS

This research note demonstrated that GSE not only influenced the mouthfeel of a wine, but also the color and aroma. Because the perceived sensory attributes (astringency, color, fruity and woody/earthy) are highly correlated [|0.801| ≤ R ≤ |0.982|] and dependent on the type of wine and GSE, winemakers are advised to conduct in‐house trials prior to tannin adjustments in the cellar. As demonstrated in this research note, the sensory changes can be successfully modeled using linear regression to allow winemakers to predict the change in aroma, color and astringent attributes, associated with the addition of GSE.
Are Physical Education‐Related State Policies and Schools' Physical Education Requirement Related to Children's Physical Activity and Obesity?
Authors: Kim Jinsook
Published: May 2012

BACKGROUND: This study examines whether the extent of states' physical education (PE) requirement policies and the prevalence of schools requiring PE are associated with children's physical activity (PA) and obesity.

METHODS: Two cycles (2002–2003 and 2006–2007) of cross‐sectional data with individual‐ and state‐level information were analyzed. Information on states' PE requirement was from the 2003 and 2006 Physical Education‐Related State Policy Classification System, and the prevalence of schools requiring PE was from the 2002 and 2006 School Health Profiles. The individual‐level sample includes 11‐ to 17‐year‐old children from the 2003 (N = 25,251) and 2007 (N = 23,728) National Survey of Children's Health. The associations of states' PE requirement and schools' PE requirement with children's PA and obesity were examined, controlling for individual, family, and state covariates. Variation in the associations by individual and family characteristics was also tested.

RESULTS: States' PE requirement was not associated with any outcome. In cycle 1, overall, a 10% increase in the percentage of schools requiring PE was associated with a 28% increase in the number of days having vigorous PA per week. In cycle 2, the association was not significant. However, significant variation in the association by gender in cycle 2 suggests an influence of schools' PE requirement on girls' PA only. No association was found between schools' PE requirement and obesity.

CONCLUSIONS: Gaps exist between state PE‐related policies and implementation in schools. However, schools' PE requirement seems to improve children's PA with some gender variation. The association between schools' PE requirement and children's weight is less clear.
Burden of Stroke in the Philippinesr
Authors: Loo Keat Wei , Gan Siew Hua
Published: May 2012

Based on disability-adjusted life-years, stroke is the second leading cause of death and among the top five diseases with the greatest burden. Although two community-based studies have been conducted to determine the prevalence of stroke in the Philippines, the incidence has not been nationally recorded to date. The prevalence ranged from 1·9% to 6·59%, and ‘Wiihabilitation’, a rehabilitation stroke therapy, is widely practiced. A clinical trial for stroke rehabilitation using the Chinese Medicine NeuroAid®, which consists of several herbs, is ongoing in many hospitals across the Philippines. Due to their ready availability, phytomedicines are widely used, especially in the rural areas, for the treatment of hypertension, diabetes mellitus, and hypercholesterolemia, which are predisposing factors for stroke in the Philippines. Due to the increasing number of stroke cases annually, the government of the Philippines should emphasize primary and secondary prevention strategies.
Educational Campaign on Stroke in an Urban Population in Northern Germany: Influence on Public Stroke Awareness and Knowledge
Authors: Worthmann Hans , Schwartz Andreas , Heidenreich Fedor , Sindern Eckhart , Lorenz Reinhard , Adams Hans-Anton , Flemming Andreas , Luettje Klaus , Walter Ulla , Haertle Birgit , Dengler Reinhard
Published: May 2012

Background

Public stroke awareness and knowledge may be supportive for stroke prevention and emergency care-seeking behavior after the acute event, which is highly important for early treatment onset.

Aims

In an urban population in Northern Germany (Hannover), a six-month stroke educational campaign was conducted. We expected an increase in stroke knowledge and awareness thereafter.

Methods

Computer-assisted telephone interviews were randomly conducted among 1004 representative participants before and 1010 immediately after the educational multimedia campaign. The computer-assisted telephone interviews focused on questions about stroke knowledge and interventions remembered.

Results

Knowledge of stroke risk factors increased during the campaign for overweight, physical inactivity, old age, and stroke in family ( P < 0·05). The knowledge of stroke warning signs was low, although it significantly increased during the campaign ( P < 0·001) as paresis/weakness (46%) and speech problems (31%) were most frequently named. The majority of respondents indicated that the first action after suffering from stroke should be calling emergency care (74% before vs. 84% after campaign, P < 0·001).

Conclusions

Our data indicate that stroke knowledge and awareness, which could provide earlier presentation to the emergency unit for timely treatment onset, are still low in urban Northern Germany but may decisively be increased by educational campaigns.
Stressful Life Events as Triggers of Ischemic Stroke: A Case-Crossover Study
Authors: Guiraud Vincent , Touzé Emmanuel , Rouillon Frédéric , Godefroy Olivier , Mas Jean-Louis
Published: May 2012

Background

Acute stressors, such as stressful life events, might trigger ischemic stroke.

Aims

Our objective was to investigate the association between life events exposure and ischemic stroke onset.

Methods

Consecutive patients were interviewed about life events exposure (e.g. bereavement) using the Interview for Recent Life Events. Using a case-crossover approach, life events exposure within one month of stroke onset (hazard period) was compared with exposure during five control periods of one month preceding the hazard period. Similarly, life events exposure within one week of stroke onset was compared with exposure during three control periods of one week. Odds ratios and 95% confidence intervals were calculated using conditional logistic regression.

Results

Two hundred forty-seven patients were interviewed within a median time of five days (interquartile range 3–7). Life events belonging to bereavement, health, and other categories accounted for half of life events. Over the six-month period, 187 patients were exposed to ≥1 life events. Patients were exposed to ≥1 life events more often during the first month preceding stroke onset than during the five control periods (odds ratio = 2·96; 95% confidence interval, 2·19–4·00). Over the four-week period, 97 patients were exposed to ≥1 life events. Patients were exposed to ≥1 life events more often during the first week preceding stroke onset than during the three control periods (odds ratio = 2·10; 1·40–3·17).

Conclusions

Recent life events exposure is associated with an increased risk of ischemic stroke.
Population-Based Study of Acute- and Long-Term Care Costs after Stroke in Patients with AF
Authors: Luengo-Fernandez Ramon , Yiin Gabriel S.C. , Gray Alastair M. , Rothwell Peter M.
Published: May 2012

Background

New treatments for atrial fibrillation patients have been shown to be effective at reducing subsequent vascular event recurrence. However, there are few data on stroke costs in atrial fibrillation patients to allow the cost-effectiveness of these treatments to be assessed.

Aims

Using data from a population-based study, we assessed the acute and long-term costs of stroke in atrial fibrillation patients.

Methods

Health-care costs one-year before and five-years after stroke were obtained from a large population-based study (Oxford Vascular study). Costs were assessed for the three-months poststroke (acute period) and annually thereafter (postacute period). Annual postacute costs were compared with annual baseline costs. Based on patients' living arrangements, costs of institutionalization after the event were included.

Results

A total of 191 strokes occurred in 153 patients with known prior atrial fibrillation. Mean health-care costs after stroke were £10 413 (standard deviation 15 105) in the acute phase, with annual postacute health-care costs nonsignificantly smaller than those incurred before the event (£2400 vs. £3356, respectively; P = 0·198). However, for the 136 strokes surviving past the 90-day acute period, costs were nonsignificantly higher than those incurred in the year before the event (£3370 vs. £2566, respectively; P = 0·333). After stroke, 25 (13%) patients were newly admitted into long-term warden, nursing, or residential care, resulting in annual costs of £6880 (standard deviation 15 600) averaged across the 136 stroke cases surviving past the acute period.

Conclusions

Although annual post acute phase hospital and primary health-care costs in stroke patients with prior atrial fibrillation were not significantly different to those incurred before the stroke, long-term nursing/residential care costs were substantial.
A Review of Source Control of Urban Stormwater Runoff1
Authors: pratt C. j.
Published: May 2012

Stormwater management, based upon techniques located at or close to where rain falls, is reviewed and two categories (at the ground surface and below‐ground) are illustrated. The management of stormwater by these source control techniques requires both quantity and quality design criteria to be employed, and for maintenance provision to be clearly in‐built. Source control techniques have been studied in projects since the 1980s, and it is suggested that the present emphasis upon sustainable development should encourage their incorporation within environmental/catchment management strategies to assist in addressing a number of identified problems from the uncontrolled discharges of stormwater.
Translating Research into Operational Practice1
Authors: tebbutt T. h. y.
Published: May 2012

The paper reviews the role of research and development in an industrial context. It stresses the importance of a business‐led approach to the formulation of research and development strategies, and highlights the need for end‐user involvement at all stages of a project. Operational and market needs must be primary driving forces for a research and development project, and their inputs are vital for the successful implementation of the end product.

Options for undertaking research and development and managing its implementation are discussed, with the emphasis on obtaining ‘value for money’ from investment in the subject. Illustrations of the successful translation of research and development into practice are given in examples drawn from the water industry.
A Case History of Odour Control Using Chemical Scrubbers1
Authors: drust J. , deacon R.
Published: May 2012

A combination of the Environmental Protection Act 1990 and the water companies being more in the public eye since privatization seems to have heightened public awareness and sensitivities to unpleasant odours emanating from sewage‐treatment works. The incorporation of odour‐control measures is therefore increasingly becoming a condition of planning consent.

The selection of the correct odour‐control system for each application is of paramount importance, and the two principal criteria are that (i) it should be effective in its performance, and (ii) it should be cost effective to install and operate.

This paper does not explore the advantages and disadvantages of the various types of odour‐control system, but concentrates on the case study of one particular application where these criteria have been met by using multi‐stage chemical scrubbing. The source and nature of the odours, containment, ventilation, treatment and performance are described, concluding in an assessment of ‘cost of ownership’.
Nestin Expression Identifies Ependymoma Patients with Poor Outcome
Authors: Milde Till , Hielscher Thomas , Witt Hendrik , Kool Marcel , Mack Stephen C. , Deubzer Hedwig E. , Oehme Ina , Lodrini Marco , Benner Axel , Taylor Michael D. , von Deimling Andreas , Kulozik Andreas E. , Pfister Stefan M. , Witt Olaf , Korshunov Andrey
Published: May 2012

Ependymomas are primary brain tumors found throughout the central nervous system (CNS) in children and adults. Currently, many treatment protocols stratify grade I and II ependymomas as low‐risk tumors, whereas grade III anaplastic ependymomas are considered high‐risk tumors. The prognostic significance of World Health Organization (WHO) grade II or III, however, remains debated, and it is furthermore increasingly recognized that the pathologic differentiation between grades II and III is arbitrary in daily practice, thus resulting in imprecise risk stratification. Therefore, prognostic markers enabling more precise stratification to guide treatment decisions are urgently needed. An analysis of n = 379 tumor samples revealed that protein expression of nestin, a marker for neural stem and progenitor cells established as a routine staining in most neuropathology centers, is associated with poor outcome in intracranial ependymomas. Most importantly, nestin‐positive grade II ependymomas have the same prognosis as grade III ependymomas. Multivariable analysis demonstrates that nestin positivity is an independent marker for poor progression‐free survival (PFS) and overall survival (OS). Gene expression analysis for transcriptionally co‐regulated genes revealed a strong association of developmental and epigenetic processes with nestin. In summary, our data implicate nestin as a useful novel marker for intracranial ependymoma risk stratification easily implementable in routine diagnostics.
Parental Meta‐Emotion Philosophy: A Review of Research and Theoretical Framework
Authors: Katz Lynn Fainsilber , Maliken Ashley C. , Stettler Nicole M.
Published: May 2012

The concept of parental meta‐emotion philosophy (PMEP)—the idea that parents have an organized set of beliefs, thoughts, and feelings about their own and their children's emotions—was introduced in 1996. Since then, empirical studies have examined the validity of the PMEP construct in relation to children's psychosocial adjustment and parent and child characteristics. This article reviews the current state of knowledge regarding PMEP, summarizing what the field has learned, and identifying critical directions for future research.
I–O Psychology and Intelligence: A Starting Point Established
Authors: Hanges Paul J. , Scherbaum Charles A. , Goldstein Harold W. , Ryan Rachel , Yusko Kenneth P.
Published: May 2012

The goal of our focal article was to initiate a conversation on how I–O psychology can reengage in research on intelligence. We are encouraged by the ways in which the commentators have furthered this conversation. We discuss 4 overarching themes in the set of commentaries: the extent that I–O psychology is contributing to the intelligence field, outsiders' impressions of I–O psychology's contributions to intelligence research, ways I–O psychology can contribute to intelligence research, and ideas about what prevents us from doing this research. We hope this collection of articles serves to truly ignite research by our field on this critical construct.
Bilateral Simultaneous Frozen Shoulder: A Possible Adverse Event of the Folfox Chemotherapy Regime?
Authors: Patel Krashna , Patel Nirav , Curtis Mark
Published: May 2012

A 51-year-old female underwent an uncomplicated resection of a sigmoid adenocarcinoma. Postoperatively, 12 cycles of the FOLFOX chemotherapy regime were completed, consisting of a combination of folinic acid, 5-fluorouracil and oxaliplatin over a 24 week period. Following chemotherapy, the patient developed simultaneous adhesive capsulitis in both shoulder joints, as radiologically confirmed by magnetic resonance imaging. Bilateral adhesive capsulitis is rare and usually associated with a systemic cause. This case highlights a possible previously unreported association between the widely used FOLFOX chemotherapy regime and bilateral adhesive capsulitis. Oncologists and orthopaedic surgeons should be aware of such presentations in FOLFOX patients to facilitate prompt investigation and management.
Group person‐based cognitive therapy for chronic depression: A pilot randomized controlled trial
Authors: Strauss Clara , Hayward Mark , Chadwick Paul
Published: May 2012

Objective.  This pilot randomized controlled trial (RCT) assesses Person‐Based Cognitive Therapy (PBCT), an integration of cognitive therapy and mindfulness, as a treatment for chronic depression.

Method.  Twenty‐eight participants with chronic depression were randomly allocated to treatment as usual (TAU) or PBCT group plus TAU. Assessments of depression (Beck Depression Inventory, BDI‐II) and mindfulness (Southampton Mindfulness Questionnaire) were conducted before and after therapy.

Results.  Intention‐to‐treat analysis found significant group by time interactions for both depression and mindfulness. Secondary analyses showed depression and mindfulness scores significantly improved for PBCT participants but not for TAU participants, with 64% of PBCT participants showing reliable improvement in depression, compared with 0% of TAU participants.

Conclusions.  PBCT is a promising treatment for chronic depression. Findings suggest a full RCT would be warranted.
Extracellular matrix proteoglycan plays a pivotal role in sensitization by low pH of mechanosensitive currents in nociceptive sensory neurones
Authors: Kubo Asako , Katanosaka Kimiaki , Mizumura Kazue
Published: May 2012

Key points

Tissue acidosis is caused in many pathological and physiological conditions (e.g. ischaemia, inflammation and exercise) and induces pain and mechanical hyperalgesia.

An augmented mechanical response of thin‐fibre afferents by low pH has been reported, but the sensitizing mechanism has not been determined.

In this study we examined whether mechanically activated (MA) currents recorded from the soma of cultured sensory neurones were augmented by low pH application.

We showed that low pH mainly sensitized MA currents of IB4‐positive neurones expressing an extracellular matrix proteoglycan, versican, and this sensitization was attenuated by manipulating the extracellular matrix proteoglycan, but not by blocking intracellular signalling pathways.

These results show us a novel sensitizing mechanism involving extracellular matrix proteoglycans, which is different from currently popular sensitizing mechanisms involving intracellular signalling pathways.

Abstract  Ischaemia, inflammation, and exercise lead to tissue acidosis, which induces pain and mechanical hyperalgesia. Corresponding to this, enhanced thin‐fibre afferent responses to mechanical stimulation have been recorded in vitro at low pH. However, knowledge about how this sensitization by low pH occurs is lacking. In this study, we found that all three types (rapidly adapting (RA), intermediately adapting and slowly adapting) of mechanically activated currents recorded with the whole cell patch‐clamp method were sensitized by low pH in rat cultured dorsal root ganglion neurones. This sensitization was mainly observed in neurones positively labelled with isolectin B4 (IB4), which binds to versican, a chondroitin sulfate proteoglycan. Inhibitors of acid‐sensitive channels (amiloride and capsazepine) did not block sensitization by low pH except in RA neurones, and extracellular calcium was not involved even in the sensitization of this type of neurone. A broad spectrum kinase inhibitor and a phospholipase C inhibitor (staurosporine and U73122) failed to block pH‐induced sensitization in IB4‐positive neurones, suggesting that these intracellular signalling pathways are not involved. Notably, both excess chondroitin sulfate in the extracellular solution and pretreatment of the neurone culture with chondroitinase ABC attenuated this low pH‐induced sensitization in IB4‐positive neurones. These findings suggest that a change in interaction between mechanosensitive channels and/or their auxiliary molecules and the side chain of versican on the cell surface causes this sensitization, at least in IB4‐positive neurones. This report proposes a novel mechanism for sensitization that involves extracellular proteoglycans (versican).
Setting the main circadian clock of a diurnal mammal by hypocaloric feeding
Authors: Mendoza Jorge , Gourmelen Sylviane , Dumont Stephanie , Sage‐Ciocca Dominique , Pévet Paul , Challet Etienne
Published: May 2012

Key points

Timed hypocaloric feeding alters the main circadian clock, the suprachiasmatic nucleus (SCN), in nocturnal rodents.

The endogenous oscillatory mechanism in the SCN is similar between nocturnal and diurnal mammals.

In this study we report that in the diurnal rodent Arvicanthis ansorgei, a timed hypocaloric feeding (HF) entrains and shifts behavioural and molecular circadian rhythms in the SCN. Nevertheless, instead of phase advancing the clock as in nocturnal rodents, HF phase delays the Arvicanthis SCN pacemaker.

Thus, HF modifies the circadian system of the diurnal rodent Arvicanthis ansorgei differentially from nocturnal rodents.

The present results will help us to better understand the circadian system in diurnal species and how feeding cues can synchronize daily rhythms.

Abstract  Caloric restriction attenuates the onset of a number of pathologies related to ageing. In mammals, circadian rhythms, controlled by the hypothalamic suprachiasmatic (SCN) clock, are altered with ageing. Although light is the main synchronizer for the clock, a daily hypocaloric feeding (HF) may also modulate the SCN activity in nocturnal rodents. Here we report that a HF also affects behavioural, physiological and molecular circadian rhythms of the diurnal rodent Arvicanthis ansorgei. Under constant darkness HF, but not normocaloric feeding (NF), entrains circadian behaviour. Under a light–dark cycle, HF at midnight led to phase delays of the rhythms of locomotor activity and plasma corticosterone. Furthermore, Per2 and vasopressin gene oscillations in the SCN were phase delayed in HF Arvicanthis compared with animals fed ad libitum. Moreover, light‐induced expression of Per genes in the SCN was modified in HF Arvicanthis, despite a non‐significant effect on light‐induced behavioural phase delays. Together, our data show that HF affects the circadian system of the diurnal rodent Arvicanthis ansorgei differentially from nocturnal rodents. The Arvicanthis model has relevance for the potential use of HF to manipulate circadian rhythms in diurnal species including humans.
On the Thrust Bearing Characteristics in Turbulent Flow
Authors: Venkateswarlu K. , Rodkiewicz Cz. M.
Published: May 2012

A theoretical analysis was made of the effects of the inclusion of inertia, viscous, and turbulence terms in hydrodynamic lubrication theory is applied to a thrust bearing. The solution to the governing equations is obtained by an iterative numerical method. An improved eddy viscosity model is employed to evaluate the turbulence term. Results are compared with existing measurements made in bearing models and also with other theoretical solutions. The contribution of inertia and viscous terms is discussed in light of the obtained results.
Radial Deformation of Cylinders Due to Torsion
Authors: Sekhar Padhee Srikant , Harursampath Dineshkumar
Published: May 2012

Classical literature on solid mechanics claims existence of radial deformation due to torsion but there is hardly any literature on analytic solutions capturing this phenomenon. This paper tries to solve this problem in an asymptotic sense using the variational asymptotic method (VAM). The method makes no ad hoc assumptions and hence asymptotic correctness is assured. The VAM splits the 3D elasticity problem into two parts: A 1D problem along the length of the cylinder which gives the twist and a 2D cross-sectional problem which gives the radial deformation. This enables closed form solutions, even for some complex problems. Starting with a hollow cylinder, made up of orthotropic but transversely isotropic material, the 3D problem has been formulated and solved analytically despite the presence of geometric nonlinearity. The general results have been specialized for particularly useful cases, such as solid cylinders and/or cylinders with isotropic material.
Generalized Finite-Volume Theory for Elastic Stress Analysis in Solid Mechanics—Part I: Framework
Authors: Cavalcante Marcio A. A. , Pindera Marek-Jerzy
Published: May 2012

A generalized finite-volume theory is proposed for two-dimensional elasticity problems on rectangular domains. The generalization is based on a higher-order displacement field representation within individual subvolumes of a discretized analysis domain, in contrast with the second-order expansion employed in our standard theory. The higher-order displacement field is expressed in terms of elasticity-based surface-averaged kinematic variables, which are subsequently related to corresponding static variables through a local stiffness matrix derived in closed form. The novel manner of defining the surface-averaged kinematic and static variables is a key feature of the generalized finite-volume theory, which provides opportunities for further exploration. Satisfaction of subvolume equilibrium equations in an integral sense, a defining feature of finite-volume theories, provides the required additional equations for the local stiffness matrix construction. The theory is constructed in a manner which enables systematic specialization through reductions to lower-order versions. Part I presents the theoretical framework. Comparison of predictions by the generalized theory with its predecessor, analytical and finite-element results in Part II illustrates substantial improvement in the satisfaction of interfacial continuity conditions at adjacent subvolume faces, producing smoother stress distributions and good interfacial conformability.
Extended Survival of Glioblastoma Patients After Chemoprotective HSC Gene Therapy
Authors: Adair Jennifer E. , Beard Brian C. , Trobridge Grant D. , Neff Tobias , Rockhill Jason K. , Silbergeld Daniel L. , Mrugala Maciej M. , Kiem Hans-Peter
Published: May 2012

Gene therapy using P140K-modified hematopoietic progenitor cells is chemoprotective, enabling glioblastoma patients to withstand myelotoxic doses of chemotherapy.
Mixed Chimerism and Growth Factors Augment β Cell Regeneration and Reverse Late-Stage Type 1 Diabetes
Authors: Wang Miao , Racine Jeremy J. , Song Xiaoping , Li Xiaofan , Nair Indu , Liu Hongjun , Avakian-Mansoorian Alina , Johnston Heather F. , Liu Can , Shen Christine , Atkinson Mark , Todorov Ivan , Kandeel Fouad , Forman Stephen , Wilson Brian , Zeng Defu
Published: May 2012

Combination therapy that induces mixed chimerism and augments both β cell neogenesis and replication reverses late-stage type 1 diabetes in NOD mice.
What’s a Genome Worth?
Authors: Kohane Isaac S. , Shendure Jay
Published: May 2012

A recent study (Roberts
et al
.) explores considerations in estimating the current and potential clinical utility of whole-genome sequencing for individual patients.
Smoking Gets Ahold of Your Genes
Authors: Methe Heiko
Published: May 2012

Methylation intensity of
F2RL3
is lower in smokers and predicts mortality in patients with coronary heart disease.
The Primary Target Organ of Cryptococcus gattii Is Different from That of Cryptococcus neoformans in a Murine Model
Authors: Ngamskulrungroj Popchai , Chang Yun , Sionov Edward , Kwon-Chung Kyung J.
Published: May 2012

Cryptococcosis is caused by the opportunistic pathogen
Cryptococcus neoformans
or by the primary pathogen
Cryptococcus gattii
. Epidemiological studies suggest that patients infected with
C. gattii
mainly present with pulmonary disease, while those infected with
C. neoformans
commonly manifest meningoencephalitis. We compared the pathogenesis of the two species using the
C. neoformans
H99 and
C. gattii
R265 strains in a murine inhalation model.
C. neoformans
grew faster in the brain and caused death by meningoencephalitis, while
C. gattii
grew faster in the lungs and caused death without producing fulminating meningoencephalitis. Despite the consistent failure to recover R265 cells from blood, a fraction of the R265 population was detected in the extrapulmonary organs, including the brain. Upon intravenous (i.v. ) inoculation of 10
4
cells via the tail vein, however,
C. gattii
produced severe meningoencephalitis, demonstrating that
C. gattii
cells can efficiently cross the blood-brain barrier. Interestingly, i.v. inoculation with five cells caused brain infection in only 10% of
C. gattii
-infected mice, compared to 60% of mice infected with
C. neoformans
. In mice that had been initially inoculated via the pulmonary route and subsequently challenged intravenously, a protective effect was observed only in mice infected with
C. gattii
.
C. neoformans
cells grew 10 to 100 times faster than
C. gattii
cells in blood or serum collected from naive mice. The paucity of meningoencephalitis upon inhalation of
C. gattii
, therefore, may be partly due to an unknown factor(s) in the host’s blood coupled with immune protection that reduces dissemination to the brain and fosters lung infection.

IMPORTANCE
While
Cryptococcus neoformans
is the most common cause of fatal meningoencephalitis, especially in HIV patients,
Cryptococcus gattii
causes disease mainly in non-HIV patients. Clinical studies revealed that most patients infected with
C. gattii
VGII strains have lung infections with minimal brain involvement. Despite extensive clinicopathological studies on cryptococcosis in animal models, only a few have included
C. gattii
. We compared the pathogenesis of the two species in mice using an inhalation model. Similar to infection in humans, even though
C. gattii
can cross the blood-brain barrier, it failed to cause fatal meningoencephalitis but caused fatal lung infection. We show that growth of
C. gattii
in mouse blood is significantly slower than that of
C. neoformans
and that a secondary protective phenomenon, though weak, manifests itself only in
C. gattii
infection. Our study provides a model for understanding the clinicopathological differences between these two closely genetically related pathogens.
Impact of Surgical Intervention and Postoperative Pain on Electrical Skin Resistance at Acupuncture Points: An Exploratory Study
Authors: Kramer Sybille , Zaps Daniela , Kutz Dieter F , Wiegele Bernhard , Kolb Florian P , Zimmer Katrin , Lehmeyer Lukas , Fleckenstein Johannes , Becker Ursula , Lang Philip M , Irnich Dominik
Published: May 2012

Objectives

One theory about acupuncture suggests that pathological processes can cause measurable changes in electrical skin resistance (ESR) at acupuncture points (APs). Although the theory has yet to be proven, ESR measurements (ESRMs) form a frequently used part of contemporary acupuncture. The aim of this study was to test the so-called ‘electrical responsiveness’ of APs in the setting of a defined operative trauma.

Methods

ESRMs (n=424) were performed at the APs and surrounding skin of GB34 and ST38 in 163 participants using an impedance meter array developed for the purpose of ESRMs. For each group the percentage of measurements with a significantly different ESR between the APs and the surrounding skin was calculated and compared with each other. Measurements of four groups were compared: healthy control subjects (n=30) and patients after ophthalmic (n=29), hip (n=42) and shoulder (n=30) surgery. The influence of postoperative pain intensity was also assessed.

Results

Group comparison showed no significant differences for ST38. The ESRMs at GB34 had a significantly higher percentage of measurements with an increased ESR after ophthalmic (23.2%) and hip (22.2%) surgery, but not after shoulder surgery (7.5%). Subgroup analysis showed that an increase in pain intensity tended to lead to a decrease in the number of APs with ESR changes.

Conclusion

These results suggest that reactive changes in ESR at APs might exist. Pain and alertness seem to have an impact on ESR at APs. However, the current data do not allow for conclusions to be drawn concerning the clinical use of ESRMs.
Factors predicting change in hospital safety climate and capability in a multi-site patient safety collaborative: a longitudinal survey study
Authors: Benn Jonathan , Burnett Susan , Parand Anam , Pinto Anna , Vincent Charles
Published: May 2012

Objective

The study had two specific objectives: (1) To analyse change in a survey measure of organisational patient safety climate and capability (SCC) resulting from participation in the UK Safer Patients Initiative and (2) To investigate the role of a range of programme and contextual factors in predicting change in SCC scores.

Design

Single group longitudinal design with repeated measurement at 12-month follow-up.

Setting

Multiple service areas within NHS hospital sites across England, Wales, Scotland and Northern Ireland.

Participants

Stratified sample of 284 respondents representing programme teams at 19 hospital sites.

Intervention

A complex intervention comprising a multi-component quality improvement collaborative focused upon patient safety and designed to impact upon hospital leadership, communication, organisation and safety climate.

Measures

A survey including a 31-item SCC scale was administered at two time-points.

Results

Modest but significant positive movement in SCC score was observed between the study time-points. Individual programme responsibility, availability of early adopters, multi-professional collaboration and extent of process measurement were significant predictors of change in SCC. Hospital type and size, along with a range of programme preconditions, were not found to be significant.

Conclusion

A range of social, cultural and organisational factors may be sensitive to this type of intervention but the measurable effect is small. Supporting critical local programme implementation factors may be an effective strategy in achieving development in organisational patient SCC, regardless of contextual factors and organisational preconditions.