bluuebunny/crossref_metadata_2025 huggingface dataset:
The Top 10 . . . or Rather the Top 11 Highlights of 2010-11
Authors: Galemore Cynthia A.
Published: June 2011

NASN has worked tirelessly in 2010-2011 to increase the organization’s vision, voice, and visibility under the direction of Sandi Delack, immediate past president. The current officers, staff, and NASN School Nurse Editorial Advisory Board identified what they believed to be the top 11 highlights of the past year. This feature is provided as a complement to the lengthier article titled “NASN 2011: Our Annual Checkup—A Look at the Organization’s Vital Statistics,” published in this same issue.
Real-time combined heat and power operational strategy using a hierarchical optimization algorithm
Authors: Yun K , Cho H , Luck R , Mago P J
Published: June 2011

Existing attempts to optimize the operation of combined heat and power (CHP) systems for building applications have two major limitations: the electrical and thermal loads are obtained from historical weather profiles; and the CHP system models ignore transient responses by using constant equipment efficiencies. This article considers the transient response of a building combined with a hierarchical CHP optimal control algorithm to obtain a real-time integrated system that uses the most recent weather and electric load information. This is accomplished by running concurrent simulations of two transient building models. The first transient building model uses current as well as forecast input information to obtain short-term predictions of the thermal and electric building loads. The predictions are then used by an optimization algorithm (i.e. a hierarchical controller that decides the amount of fuel and of electrical energy to be allocated at the current time step). In a simulation, the actual physical building is not available and, hence, to simulate a real-time environment, a second, building model with similar but not identical input loads are used to represent the actual building. A state-variable feedback loop is completed at the beginning of each time step by copying (i.e. measuring, the state variable from the actual building and restarting the predictive model using these ‘measured’ values as initial conditions). The simulation environment presented in this article features non-linear effects such as the dependence of the heat exchanger effectiveness on their operating conditions. The results indicate that the CHP engine operation dictated by the proposed hierarchical controller with uncertain weather conditions has the potential to yield significant savings when compared with conventional systems using current values of electricity and fuel prices.
Heterotopic Pregnancy in a Patient Not on Fertility Treatment
Authors: King Brittany Ann
Published: June 2011

Heterotopic pregnancy is a combination of an intrauterine pregnancy and an ectopic pregnancy. This is a rare event but has increased in incidence as in vitro fertilization becomes more common. This type of pregnancy is challenging to image and diagnose with sonography. This case reports a heterotopic pregnancy involving a woman in her late 20s who presented to the emergency room with acute abdominal pain, vomiting, and decreased blood pressure. The ectopic pregnancy was not visualized on an earlier dating scan. This case study discusses the etiology, diagnosis, sonographic appearance, and treatment of heterotopic pregnancy.
Neuroendocrine Tumor (Carcinoid) of the Appendix With Mucocele
Authors: Imari Ahmed Al , Vajpeyi Rajkumar
Published: June 2011

Acute right lower quadrant pain is a common emergency department presentation. Medical imaging has a main role to rule out appendicitis. Distinguishing between appendicitis and the other two major appendix pathologies, mucocele and carcinoid tumors, is not easy, but it is important for medical and surgical management planning. Appendix mobility is not usually assessed during sonography, but is it helpful? When comparing sonography and computerized tomography with histopathology findings to distinguish appendiceal pathologies, appendix mobility was found to be a key component. Appendix diameter, wall thickness, hyperemia, and surrounding echogenic fat are signs of an inflammatory process that will fix the appendix. Appendiceal carcinoids and mucoceles, on the other hand, will not initially have an inflammatory component for years, and thus patients present with only mild recurrent vague abdominal pain, normal blood work, and mild or borderline imaging findings. Sonography should be the first-choice medical imaging modality to rule out appendiceal pathologies because appendix mobility should be assessed and reported.
Burkitt Lymphoma of the Heart
Authors: Desgranges Zana P. , Deubner Heike , Broudy Virginia C. , Chen Michael A.
Published: June 2011

The incidence of non-Hodgkin lymphoma has increased over the past 10 years, particularly in association with human immunodeficiency virus (HIV) infection. Burkitt lymphoma is a highly aggressive non-Hodgkin lymphoma that involves the heart in up to a third of cases. This case describes an HIV-positive patient with cardiac involvement of Burkitt lymphoma who presented with atrial flutter and heart failure with pulmonary edema. Transthoracic echocardiography showed extensive heterogeneous lymphomatous infiltration of the heart (including the right atrium), with associated wall motion abnormalities. Within a day of starting chemotherapy, the patient had converted to normal sinus rhythm. His heart failure rapidly improved, and a repeat echocardiogram performed on day 5 of chemotherapy showed a significant reduction in myocardial tumor burden and improved cardiac function. This case demonstrates how echocardiography plays a significant role in diagnosis, management, and follow-up of lymphoma (in this case Burkitt) with cardiac involvement.
SHP2 tyrosine phosphatase stimulates CEBPA gene expression to mediate cytokine-dependent granulopoiesis
Authors: Zhang Li , Friedman Alan D.
Published: July 2011

G-CSF signals contribute to granulocyte lineage specification. We previously found that G-CSF induces SHP2 tyrosine phosphorylation and that chemical inhibition of SHP1/SHP2 reduces CFU-G and prevents G-CSF but not M-CSF activation of ERK. We now find that SHP2 shRNA knockdown in the 32Dcl3 granulocytic line reduces ERK activation, diminishes CEBPA protein and RNA expression and promoter histone acetylation, and inhibits granulopoiesis. Exogenous, shRNA-resistant SHP2 rescues these effects of SHP2 knockdown, exogenous C/EBPα rescues granulocytic markers, and exogenous RUNX1 rescues C/EBPα. 32Dcl3 lines with knockdown of ERK1 and ERK2 retain normal levels of C/EBPα and differentiate normally in G-CSF despite also having reduced proliferation. SHP2 knockdown reduces CEBPA levels in lineage-negative murine marrow cells cultured in TPO, Flt3 ligand, and SCF, without affecting the rate of cell expansion. On transfer to IL-3, IL-6, and SCF to induce myelopoiesis, levels of granulocytic RNAs are reduced and monocyte-specific RNAs are increased by SHP2 knockdown, and there is a reduction in the percentage of CFU-G that form in methylcellulose and of granulocytes that develop in liquid culture. In summary, SHP2 is required for induction of C/EBPα expression and granulopoiesis in response to G-CSF or other cytokines independent of SHP2-mediated ERK activation.
Cytokine-induced osteopoietic differentiation of transplanted marrow cells
Authors: Otsuru Satoru , Rasini Valeria , Bussolari Rita , Hofmann Ted J. , Dominici Massimo , Horwitz Edwin M.
Published: June 2011

Transplantation of whole bone marrow (BMT) leads to engraftment of both osteoprogenitor cells and hematopoietic cells; however, the robust osteopoietic chimerism seen early after BMT decreases with time. Using our established murine model, we demonstrate that a post-BMT regimen of either granulocyte-colony stimulating factor, growth hormone, parathyroid hormone, or stem cell factor each stimulates greater donor osteoblast chimerism at 4 months posttransplantation than saline-treated controls and approximates the robust osteopoietic chimerism seen early after BMT; however, only growth hormone led to significantly more donor-derived osteocytes than controls. Importantly, there were no adverse hematologic consequences of the different treatments. Our data demonstrate that these cytokines can stimulate the differentiation of transplanted donor marrow cells into the osteopoietic lineage after BMT. Post-BMT cytokine therapy may generate durable osteopoietic engraftment, which should lead to sustained clinical benefit and render BMT more applicable to bone disorders.
MicroRNA function in myeloid biology
Authors: O'Connell Ryan M. , Zhao Jimmy L. , Rao Dinesh S.
Published: July 2011

The past 5 years have seen an explosion of knowledge about miRNAs and their roles in hematopoiesis, cancer, and other diseases. In myeloid development, there is a growing appreciation for both the importance of particular miRNAs and the unique features of myelopoiesis that are being uncovered by experimental manipulation of miRNAs. Here, we review in detail the roles played by 4 miRNAs, miR-125, miR-146, miR-155, and miR-223 in myeloid development and activation, and correlate these roles with their dysregulation in disease. All 4 miRNAs demonstrate effects on myelopoiesis, and their loss of function or overexpression leads to pathologic phenotypes in the myeloid lineage. We review their functions at distinct points in development, their targets, and the regulatory networks that they are embedded into in the myeloid lineage.
Reproductive health for refugees by refugees in Guinea IV: Peer education and HIV knowledge, attitudes, and reported practices
Authors: Woodward Aniek , Howard Natasha , Souare Yaya , Kollie Sarah , von Roenne Anna , Borchert Matthias
Published: July 2011

Background

Both conflict and HIV affect sub-Saharan Africa, and supportive approaches for HIV prevention among refugees are crucial. Peer education has been associated with improved HIV outcomes, though relatively little research has been published on refugee settings. The primary objective of this study was to assess whether exposure to refugee peer education was associated with improved HIV knowledge, attitudes, or practice outcomes among refugees in Guinea. Secondary objectives were to assess whether gender, age, or formal education were more strongly associated than peer education with improved HIV outcomes.

Methods

Data was collected by cross-sectional survey from 889 reproductive-age men and women in 23 camps in the Forest Region of Guinea. Selected exposures (i.e. peer education, gender, formal education, age) were analysed for associations with HIV outcomes using logistic regression odds ratios (OR).

Results

Most participants (88%) had heard of HIV, particularly those exposed to peer or formal education. Most correctly identified ways to protect themselves, while maintaining misconceptions about HIV transmission. Women and those exposed to either peer or formal education had significantly fewer misconceptions. Half of participants considered themselves at risk of HIV, women with 52% higher odds than men (adjusted OR 1.52, 95%CI 1.01-2.29). Participants exposed to peer education had more than twice the odds of reporting having made HIV-avoidant behavioural changes than unexposed participants (72% versus 58%; adjusted OR 2.49, 95%CI 1.52-4.08). While women had 57% lower odds than men of reporting HIV-avoidant behavioural changes (OR 0.43, 95%CI 0.31-0.60), women exposed to peer education had greater odds than exposed men of reporting HIV-avoidant changes (OR 2.70 versus OR 1.95). Staying faithful (66%) was the most frequent behavioural change reported.

Conclusions

Peer education was most strongly associated with reported HIV-avoidant behaviour change. Gender was most associated with HIV knowledge and risk perception. Refugee women had fewer misconceptions than men had, but were more likely to report HIV risk and less likely to report making behavioural changes. Peer education appears promising for HIV interventions in chronic-emergency settings, if gender disparities and related barriers to condom usage are also addressed.
An unusual case of congenital melanocytic nevus presenting as neurocutaneous melanoma coexisting with Tuberous Sclerosis complex: A case report
Authors: Rai Santosh , Kalakoti Piyush , Syed MM Aarif , Thacker Purujit J , Jain Rishi , Kalra Gaurav
Published: July 2011

Introduction

Congenital melanocytic nevi are among the several known risk factors for the development of melanoma. Neurocutaneous melanosis is a rare, congenital, non-hereditary disorder characterized by the presence of multiple and/or giant congenital melanocytic nevi. It is a rare condition, with fewer than 200 cases reported in the literature. Its association with tuberous sclerosis complex, a form of the neurocutaneous syndrome, is an unusual finding which, to the best of our knowledge, has not been documented in the English literature so far. Herein we present the first case documenting such an association in a 16-year-old post-pubertal Indian girl.

Case presentation

In this report, we describe the case of a 16-year-old Indian girl who presented to our hospital with swelling on the scalp which had progressed from the hairline to just above the left brow, causing mechanical ptosis. She was born with a black-pigmented triangular patch covered with hair over the scalp which had increased in size over a period of eight years after birth. An X-ray of her skull and ultrasonography revealed soft tissue swelling in the left temporofrontoparietal region. Magnetic resonance imaging of her brain showed the presence of 8.99 cm × 2.26 cm abnormal signal intensity involving the scalp, a few small tubers with cortical dysplasia in the left frontoparietal region with asymmetric dilatation, and the presence of calcified subependymal nodules within the left lateral ventricle. These findings were suggestive of tuberous sclerosis. A histopathological examination of the swelling was suggestive of congenital melanocytic nevi. The patient underwent surgery. Excision of the tumor with primary skin grafting was done, with the graft being taken from the medial aspect of the right thigh.

Conclusion

This case warrants further research to provide concrete evidence of an association of neurocutaneous melanoma with tuberous sclerosis complex. Research should be conducted to prove whether this is an unusual association or a new syndrome. Also, similar cases in other parts of the globe should be documented, as they would provide substantial support for such an association.
Developmental evolution of flowering plant pollen tube cell walls: callose synthase (CalS) gene expression patterns
Authors: Abercrombie Jason M , O'Meara Brian C , Moffatt Andrew R , Williams Joseph H
Published: July 2011

Background

A number of innovations underlie the origin of rapid reproductive cycles in angiosperms. A critical early step involved the modification of an ancestrally short and slow-growing pollen tube for faster and longer distance transport of sperm to egg. Associated with this shift are the predominantly callose (1,3-β-glucan) walls and septae (callose plugs) of angiosperm pollen tubes. Callose synthesis is mediated by callose synthase (CalS). Of 12 CalS gene family members in Arabidopsis, only one (CalS5) has been directly linked to pollen tube callose. CalS5 orthologues are present in several monocot and eudicot genomes, but little is known about the evolutionary origin of CalS5 or what its ancestral function may have been.

Results

We investigated expression of CalS in pollen and pollen tubes of selected non-flowering seed plants (gymnosperms) and angiosperms within lineages that diverged below the monocot/eudicot node. First, we determined the nearly full length coding sequence of a CalS5 orthologue from Cabomba caroliniana (CcCalS5) (Nymphaeales). Semi-quantitative RT-PCR demonstrated low CcCalS5 expression within several vegetative tissues, but strong expression in mature pollen. CalS transcripts were detected in pollen tubes of several species within Nymphaeales and Austrobaileyales, and comparative analyses with a phylogenetically diverse group of sequenced genomes indicated homology to CalS5. We also report in silico evidence of a putative CalS5 orthologue from Amborella. Among gymnosperms, CalS5 transcripts were recovered from germinating pollen of Gnetum and Ginkgo, but a novel CalS paralog was instead amplified from germinating pollen of Pinus taeda.

Conclusion

The finding that CalS5 is the predominant callose synthase in pollen tubes of both early-diverging and model system angiosperms is an indicator of the homology of their novel callosic pollen tube walls and callose plugs. The data suggest that CalS5 had transient expression and pollen-specific functions in early seed plants and was then recruited to novel expression patterns and functions within pollen tube walls in an ancestor of extant angiosperms.
Increased B-type natriuretic peptide and decreased proteinuria might reflect decreased capillary leakage and is associated with a better outcome in patients with severe burns
Authors: de Leeuw Karina , Nieuwenhuis Marianne K , Niemeijer Anuschka S , Eshuis Hans , Beerthuizen Gerard IJM , Janssen Wilbert M
Published: July 2011

Introduction

It is difficult to adjust fluid balance adequately in patients with severe burns due to various physical changes. B-type natriuretic peptide (BNP) is emerging as a potential marker of hydration state. Proteinuria is used as a predictor of outcome in severe illness and might correlate to systemic capillary leakage. This study investigates whether combining BNP and proteinuria can be used as a guide for individualized resuscitation and as a predictor of outcome in patients with severe burns.

Methods

From 2006 to 2009, 38 consecutive patients (age 47 ± 15 years, 74% male) with severe burns were included and followed for 20 days. All had normal kidney function at admission. BNP and proteinuria were routinely measured. Ordered and actually administered fluid resuscitation volumes were recorded. The Sequential Organ Failure Assessment (SOFA) score was used as the measure of outcome.

Results

BNP increased during follow-up, reaching a plateau level at Day 3. Based on median BNP levels at Day 3, patients were divided into those with low BNP and those with high BNP levels. Both groups had comparable initial SOFA scores. Patients with high BNP received less fluid from Days 3 to 10. Furthermore, patients with a high BNP at Day 3 had less morbidity, reflected by lower SOFA scores on the following days. To minimize effects of biological variability, proteinuria on Days 1 and 2 was averaged. By dividing the patients based on median BNP at Day 3 and median proteinuria, patients with high BNP and low proteinuria had significantly lower SOFA scores during the entire follow-up period compared to those patients with low BNP and high proteinuria.

Conclusions

Patients with higher BNP levels received less fluid. This might be explained by a lower capillary leakage in these patients, resulting in more intravascular fluid and consequently an increase in BNP. In combination with low proteinuria, possibly reflecting minimal systemic capillary leakage, a high BNP level was associated with a better outcome. BNP and proteinuria have prognostic potential in severely burned patients and may be used to adjust individual resuscitation.
Editorial: Counting the carbs: a memory B cell makeover
Authors: Treanor Bebhinn , Cancro Michael P
Published: June 2011

Discussion on new data showing that a differential glycosylation marker identifies human memory B cells.
Continuity of supply of psychiatric medicines for newly received prisoners
Authors: Hassan Lamiece , Senior Jane , Edge Dawn , Shaw Jenny
Published: June 2011

Aims and method

A retrospective case-note review was undertaken at five English prisons between June 2008 and March 2009 to estimate the proportion of psychiatric medicines (antidepressants, antipsychotics and hypnotics/anxiolytics) reported at prison reception that are discontinued on entry to prison.

Results

Of the 1006 records sampled, the review showed that 18% of prisoners had been prescribed psychiatric medication before being placed in custody. Altogether, 240 separate psychiatric medicines were recorded among prisoners at reception. Of these, 47% were not prescribed during the first week of custody. In only 11% of cases where medication was discontinued had psychiatric assessment been completed.

Clinical implications

Prison mental health policy states that psychiatric medication should not be withdrawn in custody without proper clinical assessment. Denial of medication in the absence of clinical assessment during early custody has the potential to create additional stress in individuals during a period of increased vulnerability and risk.
Reduction of Thyroid Nodule Volume by Levothyroxine and Iodine Alone and in Combination: A Randomized, Placebo-Controlled Trial
Authors: Grussendorf M. , Reiners C. , Paschke R. , Wegscheider K.
Published: June 2011

Context:

Nodular goiter is common worldwide, but there is still debate over the medical treatment.

Objective:

The objective of the study was the measurement of the effect of a treatment with (nonsuppressive) T4, iodine, or a combination of both compared with placebo on volume of thyroid nodules and thyroid.

Design:

This was a multicenter, randomized, double-blind trial in patients with nodular goiter in Germany [LISA (Levothyroxin und Iodid in der Strumatherapie Als Mono-oder Kombinationstherapie) trial].

Setting:

The study was conducted in outpatient clinics in university hospitals and regional hospitals and private practices.

Participants:

One thousand twenty-four consecutively screened and centrally randomized euthyroid patients aged 18–65 yr with one or more thyroid nodules (minimal diameter 10 mm) participated in the study.

Intervention:

Intervention included placebo, iodine (I), T4, or T4+I for 1 yr. T4 doses were adapted for a TSH target range of 0.2–0.8 mU/liter.

Outcome Measures:

The primary end point was percent volume reduction of all nodules measured by ultrasound, and the main secondary end point was a change in goiter volume.

Results:

Nodule volume reductions were −17.3% [95% confidence interval (CI) −24.8/−9.0%, P < 0.001] in the T4+I group, −7.3% (95% CI −15.0/+1.2%, P = 0.201) in the T4 group, and −4.0% (95% CI −11.4/+4.2%, P = 0.328) in the I group as compared with placebo. In direct comparison, the T4+I therapy was significantly superior to T4 (P = 0.018) or I (P = 0.003). Thyroid volume reductions were −7.9% (95% CI −11.8/−3.9%, P < 0.001), −5.2% (95% CI −8.7/−1.6%, P = 0.024) and −2.5% (95% CI −6.2/+1.4%, P = 0.207), respectively. The T4+I therapy was significantly superior to I (P = 0.034) but not to T4 (P = 0.190).

Conclusion:

In a region with a sufficient iodine supply, a 1-yr therapy with a combination of I and T4 with incomplete suppression of thyrotropin reduced thyroid nodule volume further than either component alone or placebo.
Selective and CO-Retentive Addition Reactions of Acid Chlorides to Terminal Alkynes in Synthesis of β-Chloro-α,β-unsaturated Ketones Using ZnO
Authors: Hosseini-Sarvari Mona , Mardaneh Zahra
Published: July 2011

The addition reaction of acid chlorides with terminal alkynes to afford β-chloro-α,β-unsaturated ketones using ZnO as catalyst has been studied under solvent-free conditions. All the reactions were done at room temperature and β-chloro-α,β-unsaturated ketones were obtained with selectivity in high yields.
First Report on Thermally Stable Cadmium Carbonyl Complex Containing an Interesting Chloroaryl Bridge: Isolation and Characterization
Authors: Dey Subrata K , Shit Shyamapada , Dey Sankar P , Mitra Samiran , Malik K M Abdul
Published: July 2011

A novel thermally stable tetranuclear cadmium carbonyl complex [Cd(CO)3(C6H3Cl)]4·2H2O has been synthesized for the first time through a green path with an overall yield of 35%. The synthetic route features a new pathway, creating the two ortho-positions with respect to the chlorine atom in the aryl rings for bridging two cadmium metal centers. The title complex has been characterized by microanalytical, infrared spectroscopic, and thermal methods while its structure has been established by single-crystal X-ray diffraction supported by 1H, 13C, and 113Cd NMR data.
Syntheses, Crystal Structures, and Photoluminescent Properties of PdII Complexes Containing a Disulfanenitrile Ligand
Authors: Fujii Takayoshi , Sakagami Michiyasu , Suzuki Yasuhito
Published: July 2011

The bidendate ligand Ph2S(=N–(Ph2)S≡N)2 (ndsdsd) was used to prepare new PdII complexes. The homoleptic complex, [Pd(ndsdsd)2]Cl2 (1) and the heteroleptic complexes, [Pd(diimine)(ndsdsd)]Cl2 (diimine: 2,2′-bipyridine (2), 1,10-phenanthroline (3a), and 4,7-diphenyl-1,10-phenanthroline (3b)) were prepared, and the molecular structures of 1–3 were characterized. The complexes 2 and 3 are not emissive at ambient temperature in the solid state, but the homoleptic complex 1 shows an unstructured emission bond (λmax = 690 nm).
Cui bono? Can feminist ethics show a path in complex decision-making where ‘classical’ theories cannot?
Authors: Brierley Joe , Larcher Vic
Published: June 2011

We present the case of a six-year-old child with a fatal brainstem tumour, who was left in a ‘locked-in state’ post-decompressive biopsy. A discussion of the ethical dilemma this situation presents, together with the deliberations of the ethics service when consulted about the optimal course of action, follow. The issues raised highlight an important conflict between the parental view of what is in the child's best interests and what may appear, prima facie, to clinical staff, to be in that child's best interests. We discuss how creative ethical thinking may facilitate resolution of seemingly insoluble situations.
Ethical issues in live donor kidney transplantation: attitudes of health-care professionals and patients towards marginal and elderly donors
Authors: Mazaris Evangelos M , Crane Jeremy S , Warrens Anthony N , Smith Glenn , Tekkis Paris , Papalois Vassilios E
Published: June 2011

Acceptance of elderly or marginal health individuals as kidney donors is debated, with practices varying between centres. Transplant recipients, live kidney donors and health-care professionals caring for patients with renal failure were surveyed regarding their views on live donor kidney transplantation (LDKT) of marginal health (diabetes, hypertension, atherosclerosis, obesity, etc.) and elderly donors. Participants were recruited within a tertiary renal and transplant centre and invited to participate in focus groups and structured interviews. They also completed an anonymous questionnaire. Of 464 participants who completed the questionnaire (36% health-care professionals and 64% patients), 49% and 64%, respectively, stated that marginal and elderly donors should be accepted for LDKT. In the structured interviews, emphasis was given to presenting to donor, recipient and their respective families a calculated risk regarding the effect that either a nephrectomy or transplant has on long-term quality of life. Participants stated that an independent third party in addition to the transplant team should discuss involved risks. Issues of ‘how desperate’ the recipient's situation is should also be considered. Health-care professionals stated that regardless of the strength of will of an individual to donate a kidney (despite age, health problems or personal risk), they should always have the right to say ‘no’ if performing a specific LDKT was against their professional and ethical values. About half of those surveyed considered that marginal health and elderly donors were acceptable for LDKT. Emphasis was given to the explanation to donors and recipients of the risks involved in such transplantation.
Emergency Respiratory Admissions: Influence of Practice, Population and Hospital Factors
Authors: Purdy Sarah , Griffin Thomas , Salisbury Chris , Sharp Debbie
Published: June 2011

Objective

To determine the influence of population, hospital and general practice characteristics on practice admission rates for asthma and chronic obstructive pulmonary disease (COPD) in England.

Methods

Cross sectional study using Hospital Episode Statistics (HES), routine population data and primary care data. Admissions for all general practices in England during 2005-06, adjusted for age and sex composition of practice population. Univariable analysis of population, practice and hospital care provision variables, including prevalence and quality data. Significant factors included in multiple regression Poisson model.

Results

Admissions from 8169 practices were included. Risk of admission for each condition increased with deprivation, prevalence and smoking. Admission rates were higher in urban than rural practices. Hospital bed availability and distance to the nearest emergency department were also significantly associated with risk of admission. The associations with practice factors including practice size and quality markers varied across conditions.

Conclusions

Practice population, geographic and hospital supply factors are consistently associated with asthma and COPD admissions. Higher smoking rates among such patients in a practice are associated with higher admission rates. There is little evidence from this study that other modifiable general practice factors are important in influencing admission rates.
Sustainable Health Care
Authors: Light Kate , Harden Melissa , Stirk Lisa
Published: June 2011

Issues concerning our impact on the environment are constantly in the news and people are becoming more aware of the contribution of health care to the situation. This edition of ‘What's on the web’ reviews sites that provide information about the ways health care facilities can mitigate their effects on the environment.

If you would like to alert readers to useful web pages or suggest topics for this column, please send details to:
Carbon Isotope Evidence for Ordovician Marine Hydrocarbon Source Rocks in Ordos Basin, North China
Authors: Chen Qiang , Li Wenhou , Hao Songli , Liu Zhuo , Xu Jian
Published: June 2011

Ordos Basin is the second largest sedimentary basin in China with gigantically thick Paleozoic marine sedimentary strata. Geochemical analyses show that the carbon isotope compositions of the Ordovician are less influenced by post-depositional diagenesis and basically accordant with that of the global Ordovician. δ13C values range from – 7.30‰ to 2.26‰ with a mean value of −0.30‰. Temporally, δ13C values are gradually increased from the Early to Late Ordovician with a significant positive excursion between the Middle and Late Ordovician, indicated by increase of the mean value from —0.36 ‰ in the Majiagou Formation to 0.15 ‰ in the Pingliang Formation and up to 0.68 ‰ in the Beiguoshan Formation. There is a good relationship between carbon isotopes and organic carbon contents in the Ordos Basin. The positive carbon isotope excursion indicates higher productivity and organic carbon burial, which can consider as a geochemical index for generation of hydrocarbon source rocks. Based on analysis of carbon isotope and sedimentary environment, it is suggested that the central-eastern part of Ordos Basin is unlikely to form a large-scale efficient hydrocarbon source rocks. The Upper Ordovician Pingliang Formation, Wulalike Formation and Beiguoshan Formation in the southwestern margin are the most important and efficient hydrocarbon source rocks in the Lower Paleozoic in the Ordos Basin. In addition, the Middle Ordovician Kelimoli Formation in the western margin is another important source rocks, and the Fengfeng Formation in the southern margin also has a certain account of hydrocarbon generation potential. Viewing from the development of source-reservoir-cap assemblage, the southwestern margin of Ordos Basin has great exploration potential. Dingbian – Etuokeqi area and Linyou – Tongchuan area, located on the west and south side of Central Paleouplift, respectively, is favorable areas for gas exploration in the Lower Paleozoic in the Ordos Basin.
Assessing Integrated Risks of Offshore Wind Projects: Moving towards Gigawatt-Scale Deployments
Authors: Ram Bonnie
Published: June 2011

This article looks at the potential risks and uncertainties associated with siting, constructing, and operating offshore wind facilities within a gigawatt-scale deployment strategy in North America. The U.S. electricity generation system, about 70 % fossil fuels and 20 % nuclear, is undergoing a sea change (EIA 2010). Two difficulties stand out in siting any utility-scale power plant and its delivery infrastructure anywhere; the potential catastrophic risks associated with oil and gas drilling and nuclear technologies, and the need to quickly expand low carbon, cost-effective energy supplies to meet expected demand under climate change scenarios in the next decade. Offshore wind has the potential to play a pivotal role in the low carbon energy supplies needed on the east coast and Great Lakes of the U.S. (DOE 2008, Musial and Ram 2010). The Department of Energy (DOE) estimated that the U.S. electricity sector could avoid 825 million tons of CO2 by integrating 20% wind energy (including 54 GW of offshore wind) into the U.S. electricity system by 2030 (DOE 2008a). The benefits of wind energy in mitigating climate change and other energy issues need to be considered together with the negative impacts in estimating and comparing risks involved in different energy sources (NRC 2009a). The European Community has shown the pathway with gigawatt-scale deployments operating, under construction, and planned in the Baltic, North and Irish Seas (Global Offshore Wind Farms Database 2011).

This article argues that a new paradigm with a more systematic approach, beyond the engineering, policy, and financial market barriers, is essential to better inform gigawatt-scale wind decision makers and stakeholders. The diverse community of players and decision makers in the offshore wind industry requires a robust, integrated knowledge base. The knowledge base can help avoid surprises that impede and delay siting projects while laying the base for effective and fair approaches for communities along our coasts and Lakes. A new paradigm is proposed, an integrated risk analysis, as an effective approach to complex siting and community engagement issues.
Assessment of Wind Turbine Performance in Alpine Environments
Authors: Barber Sarah , Chokani Ndaona , Abhari Reza S.
Published: June 2011

The performance of the wind turbine at the Guetsch Alpine Test Site, Switzerland, is analysed using 10-minute averaged data over the period of a year, following IEC 64100-12-1 recommendations. The predicted Annual Energy Production using the manufacturer's power curve is found to be 20% larger than the measured production, which represents a large investment risk. This could be minimised by applying a correction to the power curve during the project development stage. Through photographic analysis of icing events on the blades at the Guetsch Alpine Test Site, icing is found to cause only a 1.6% reduction in Annual Energy Production. Analysis shows that the energy production is 62% −180% higher than the annual average when temperatures are between −1 and −9°C, and a 50% reduction is estimated if the wind conditions remain at the 10°C levels for the entire year. This indicates the benefit of lower temperatures at this site and provides a strong argument for the further development of wind farm projects in alpine environments. A power curve correction technique for the accurate prediction of performance in alpine environments is thus being developed through controlled experiments.
Preliminary Assessment of Wind Turbine Blade Lift Control via Plasma Actuation
Authors: Versailles Philippe , Ghosh Shubhankar , Vo Huu Duc , Masson Christian
Published: June 2011

This paper presents an experimental and computational study to assess the potential of plasma actuators to alter the lift of airfoils in view of controlling the output power of wind turbines under high wind conditions. Plasma actuators are electro-fluidic devices that create a jet adjacent to the surface. The proposed concept involves installing an actuator on the blade suction surface pointing in the upstream direction to induce and control boundary layer separation. Experiments have been carried in a subsonic wind tunnel, at angles of attack (AOA) in the range 0–15°, for velocities of 12.60 and 16.30 m/s, on a 6-inch chord untwisted 2–D blade. The aerodynamic balance force measurements show a reduction of lift coefficient for all the AOA. Flow fields obtained by PIV demonstrate that depending of the AOA, the actuator thickens the boundary layer, induces or amplifies its separation. The CFD simulations reproduce the experimental trends. Thus, plasma actuators are potentially efficient devices for lift control over a wind turbine blade.
Inverse Airfoil Design Method for Low-Speed Straight-Bladed Darrieus-Type VAWT Applications
Authors: Saeed F. , Paraschivoiu I. , Trifu O. , Hess M. , Gabrys C.
Published: June 2011

The paper demonstrates the application of inverse airfoil design method to improve performance of a low-speed straight-bladed Darrieus-type VAWT. The study shows that an appropriate tailoring of the airfoil surface using the inverse airfoil design technique can help improve performance by eliminating undesirable flow field characteristics at very low Re, such as early transition due to presence of separation bubbles. The increase aerodynamic efficiency then translates into an improved aerodynamic performance of VAWTs specifically at very low chord Reynolds numbers. The study employs an interactive inverse airfoil design method (PROFOIL) that allows specification of velocity and boundary-layer characteristics over different segments of the airfoil subject to constraints on the geometry (closure) and the flow field (far field boundary). Additional constraints to satisfy some desirable features, such as pitching moment coefficient, thickness, camber, etc., along with a merit of performance of the VAWT, such as the required power output for a given tip-speed ratio, are specified as part of the inverse problem. Performance analyses of the airfoil and the VAWT are carried out with the aid of state-of-the-art analyses codes, XFOIL and CARDAAV, respectively. XFOIL is a panel method with a coupled boundary-layer scheme and is used to obtain the aerodynamic characteristics of resulting airfoil shapes. The final airfoil geometry is obtained through a multi-dimensional Newton iteration. A design example is presented to demonstrate the merits of the technique in improving performance of small VAWTs at low speeds. The main findings of the study suggests that the strength of the method lies in the inverse design methodology whereas its weaknesses is in reliably predicting aerodynamic characteristics of airfoils at low Reynolds numbers and high angles of attack. This weakness can, however, be overcome by assessing relative performance of the VAWT with the assumption that the changes in airfoil characteristics be kept small. The results indicate that a 10–15% increase in the relative performance of the VAWT can be achieved with this method.
Wind Speed Prediction for a Target Station Using Neural Networks and Particle Swarm Optimization
Authors: Poitras Gérard , Cormier Gabriel
Published: June 2011

In this study, artificial neural networks (ANN) and particle swarm optimization (PSO) were applied to predict the average daily wind speed measured at a meteorological tower installed June 2005 at the Greater Moncton Sewerage Commission, in Moncton, New Brunswick, Canada. Wind speeds were collected covering the period between June 2005 and December 2008. Five reference airport meteorological stations were used as input for the neural network and PSO. The artificial neural network modeling was done using the Matlab® neural network toolbox, while the PSO algorithm is an in-house program written in Matlab®. The daily wind speeds generated by the ANN model and PSO were compared with the actual measured data. It was found that with six months of input data, both the ANN and the PSO were able to predict the short term daily wind speed for the following 36 months at the target station. The PSO obtained a smaller error compared to the neural network. The PSO algorithm was also able to find the best combination of input variables automatically, while the ANN used manually-selected input variables.
Thermal Radiation Effects on Thermal Explosion in Polydisperse Fuel Spray-Probabilistic Model
Authors: Navea Ophir , Gol'dshtein Vladimir , Lehavi Yaron , Bykov Vitcheslav
Published: June 2011

We investigate the effect of thermal radiation on the dynamics of a thermal explosion of polydisperse fuel spray with a complete description of the chemistry via a single-step two-reactant model of general order. The polydisperse spray is modeled using a Probability Density Function (PDF). The thermal radiation energy exchange between the evaporation surface of the fuel droplets and the burning gas is described using the Marshak boundary conditions. An explicit expression of the critical condition for thermal explosion limit is derived analytically and represents a generalization of the critical parameter of the classical Semenov theory. Because we investigated the model in the range where the temperature is very high, the effect of the thermal radiation is significant.
Simulations of Particle Dispersion around Multiple Circular Cylinders via an Immersed Boundary Method
Authors: Luo Kun , Fan Jianren , Feng Ji
Published: June 2011

A modified immersed boundary method is extended to study fine particle dispersion in particle-laden wake flows around multiple stationary circular cylinders, with a Reynolds number of 250. The fixed Cartesian grid is applied and the no-slip condition near the surface of circular cylinders is satisfied through a direct forcing technique. The governing equations for fluid flow are directly solved using high-order finite difference schemes and the dispersed fine particles are tracked in the Lagrangian framework based on point-source assumption. The numerical algorithms are first validated by simulating flows around a single circular cylinder. For flows around two side-by-side circular cylinders, three typical flow regimes are observed for different gap ratios. For flow around three staggered circular cylinders, the coherent structures first appear in symmetrical mode with large recirculation zones, but then change to asymmetrical mode and finally develop into a complex single vortex street. The particle dispersion is found to be closely related to the number of the circular cylinder and the gap ratio, in addition to the particle Stokes number. For various numbers of circular cylinder and gap ratios, the flow displays different coherent structures, resulting in different particle distributions. But for a fixed number of circular cylinder and gap ratio, the particle Stokes number becomes the controlling parameter.
d-Dimer Testing in Laboratory Practice
Authors: Tripodi Armando
Published: June 2011

BACKGROUND

d-dimer is a reliable and sensitive index of fibrin deposition and stabilization. As such, its presence in plasma should be indicative of thrombus formation. There are many conditions unrelated to thrombosis in which d-dimer concentrations are high, however, making its positive predictive value rather poor.

CONTENT

Notwithstanding these limitations, d-dimer can be regarded as a most valuable laboratory tool to diagnose and manage a vast array of thrombosis-related clinical conditions, including (a) diagnosis of venous thromboembolism (VTE), (b) identification of individuals at increased risk of first thrombotic event (both arterial and venous), (c) identification of individuals at increased risk of recurrent VTE, (d) establishment of the optimal duration of secondary prophylaxis after a first episode of VTE, (e) pregnancy monitoring, and (f) diagnosis/monitoring of disseminated intravascular coagulation (DIC). This article is aimed at reviewing the merits and pitfalls of these applications.

From my analysis of the literature, I draw the following conclusions. (a) d-dimer, as measured by a sensitive test, can be safely used to exclude VTE in symptomatic outpatients, provided that it is used in combination with the pretest clinical probability. (b) High concentrations of d-dimer are associated with an increased risk of recurrent VTE. (c) Patients who present with d-dimer above cutoff after stopping the regular course of oral anticoagulation benefit from extended prophylaxis. (d) Finally, d-dimer can be used as a fibrin-related degradation marker for the diagnosis/management of patients with DIC.
A critical review and meta-analysis of the association between overt hyperthyroidism and mortality
Authors: Brandt Frans , Green Anders , Hegedüs Laszlo , Brix Thomas H
Published: July 2011

Background

Overt hyperthyroidism has been associated with cardiac arrhythmias, hypercoagulopathy, stroke, and pulmonary embolism, all of which may increase mortality. Some, but not all, studies show an increased mortality in patients with hyperthyroidism. This inconsistency may be due to differences in study design, characteristics of participants, or confounders. In order to test whether hyperthyroidism influences mortality, we performed a critical review and statistical meta-analysis.

Methods

Based on an electronic PubMed search, using the Medical Subject Heading words such as hyperthyroidism, thyrotoxicosis, and mortality or survival, case–control and cohort studies were selected and reviewed. Using meta-analysis, an overall relative risk (RR) of mortality was calculated.

Results

Eight studies fulfilled the inclusion criteria, six of which showed an increased all-cause mortality; seven studies, including 31 138 patients and 4 00 000 person years at risk, allowed calculation of mortality in a meta-analysis. Based on this, the RR of overall mortality was 1.21 (95% confidence interval: 1.05–1.38). Analyses including studies considering setting, treatment, and control for co-morbidity did not significantly alter this finding. As the measured heterogeneity (I2) ranges from 89.1 to 98.3%, which is much higher than the 50% generally viewed on as a threshold, the statistical heterogeneity is very pronounced in the included studies.

Conclusion

In patients diagnosed with hyperthyroidism, mortality is increased by ∼20%. Future studies need to address the cause of hyperthyroidism, impact of type of therapy, time dependency, as well as the potential influence of confounding or genetic susceptibility before the question of causality can be answered.
Ectopic thyroid tissue: anatomical, clinical, and surgical implications of a rare entity
Authors: Noussios George , Anagnostis Panagiotis , Goulis Dimitrios G , Lappas Dimitrios , Natsis Konstantinos
Published: June 2011

Ectopic thyroid tissue is a rare entity resulting from developmental defects at early stages of thyroid gland embryogenesis, during its passage from the floor of the primitive foregut to its final pre-tracheal position. It is frequently found around the course of the thyroglossal duct or laterally in the neck, as well as in distant places such as the mediastinum and the subdiaphragmatic organs. Although most cases are asymptomatic, symptoms related to tumor size and its relationship with surrounding tissues may also appear. Any disease affecting the thyroid gland may also involve the ectopic thyroid, including malignancy. The clinician must distinguish between ectopic thyroid and metastatic deposits emerging from an orthotopic gland, as well as other benign or malignant masses. Thyroid scintigraphy plays the most important role in diagnosing ectopy, but ultrasonography contributes as well. In cases of symptomatic disease, surgery is the treatment of choice, followed by radioiodine ablation and levothyroxine suppression therapy in more refractory cases. This review provides current understanding about the wide clinical spectrum of this rare condition, also referring to optimal diagnostic approach, differential diagnosis, and management strategies.