bluuebunny/crossref_metadata_2025 huggingface dataset:
Adaptive Model Predictive Vibration Control of a Cantilever Beam with Real-Time Parameter Estimation
Authors: Takács Gergely , Polóni Tomáš , Rohal’-Ilkiv Boris
Published: May 2014

This paper presents an adaptive-predictive vibration control system using extended Kalman filtering for the joint estimation of system states and model parameters. A fixed-free cantilever beam equipped with piezoceramic actuators serves as a test platform to validate the proposed control strategy. Deflection readings taken at the end of the beam have been used to reconstruct the position and velocity information for a second-order state-space model. In addition to the states, the dynamic system has been augmented by the unknown model parameters: stiffness, damping constant, and a voltage/force conversion constant, characterizing the actuating effect of the piezoceramic transducers. The states and parameters of this augmented system have been estimated in real time, using the hybrid extended Kalman filter. The estimated model parameters have been applied to define the continuous state-space model of the vibrating system, which in turn is discretized for the predictive controller. The model predictive control algorithm generates state predictions and dual-mode quadratic cost prediction matrices based on the updated discrete state-space models. The resulting cost function is then minimized using quadratic programming to find the sequence of optimal but constrained control inputs. The proposed active vibration control system is implemented and evaluated experimentally to investigate the viability of the control method.
Traditional Birth Attendants and Policy Ambivalence in Zimbabwe
Authors: Choguya Naume Zorodzai
Published: May 2014

This paper analyses the importance of the services rendered by traditional birth attendants (TBAs) to pregnant women in Zimbabwe. It argues that, though an integral part of the health system, the ambivalence in terms of policy on the part of the government leaves them in a predicament. Sociocultural values as well as tradition imbue TBAs power and authority to manage pregnancies and assist in child deliveries. On the other hand, government policies expounded through the Ministry of Health (MoH) programs and policies appear to be relegating them to the fringes of healthcare provision. However, in a country with a failing health system characterized by mass exodus of qualified personnel, availability of drugs, and understaffing of healthcare centres, among others, TBAs remain the lifeline for many women in the country. Instead of sidelining them in healthcare interventions, I argue that their integration, however, problematic and often noted to be with disastrous consequences for traditional medicine, presents the sole viable solution towards achieving MDGs 4 and 5. The government and MoH should capitalize on the availability of and standing working relations of TBAs with the grassroots for better/positive maternal health outcomes. In a country reeling with high maternal deaths, TBAs’ status and position in society make them the best intervention tools.
Histological and Clinical Characteristics of Patients with Chronic Hepatitis C and Persistently Normal Alanine Aminotransferase Levels
Authors: Roshan Bakht , Guzman Grace
Published: May 2014

Patients with chronic hepatitis C virus (HCV) infection and persistently normal alanine aminotransferase (PNALT) are generally described to have mild liver disease. The aim of this study was to compare clinical and histological features in HCV-infected patients with PNALT and elevated ALT. Patients presenting to the University of Illinois Medical Center, Chicago, who had biopsy proven HCV, an ALT measurement at the time of liver biopsy, at least one additional ALT measurement over the next 12 months, and liver biopsy slides available for review were identified. PNALT was defined as ALT ≤ 30 on at least 2 different occasions over 12 months. Of 1200 patients with HCV, 243 met the study criteria. 13% (32/243) of patients had PNALT while 87% (211/243) had elevated ALT. Significantly more patients with PNALT had advanced fibrosis (F3 and F4) compared to those with elevated ALT (P=0.007). There was no significant difference in the histology activity index score as well as mean inflammatory score between the two groups. In conclusion, in a well-characterized cohort of patients at a tertiary medical center, PNALT did not distinguish patients with mild liver disease.
On Bernstein Polynomials Method to the System of Abel Integral Equations
Authors: Jafarian A. , Measoomy Nia S. , Golmankhaneh Alireza K. , Baleanu D.
Published: May 2014

This paper deals with a new implementation of the Bernstein polynomials method to the numerical solution of a special kind of singular system. For this aim, first the truncated Bernstein series polynomials of the solution functions are substituted in the given problem. Using some properties of these polynomials, the solution of the problem is reduced to solve a linear system of algebraic equations. In order to confirm the reliability and accuracy of the proposed method, some weakly Abel integral equations systems with comparisons are solved in detail as numerical examples.
JTT-130, a Novel Intestine-Specific Inhibitor of Microsomal Triglyceride Transfer Protein, Improves Hyperglycemia and Dyslipidemia Independent of Suppression of Food Intake in Diabetic Rats
Authors: Sakata Shohei , Ito Makoto , Mera Yasuko , Sasase Tomohiko , Yamamoto Hiromi , Kakutani Makoto , Ohta Takeshi
Published: May 2014

We investigated the effects of JTT-130 on glucose and lipid metabolism independent of the suppression of feeding by comparing with pair-fed animals. Male Zucker diabetic fatty (ZDF) rats were divided into control, JTT-130 treatment, and pair-fed groups. The rats were fed with a regular powdered diet with or without JTT-130 as a food admixture for 6 weeks. We compared the effects on glucose and lipid metabolism in JTT-130 treatment group with those in pair-fed group.Results. Hyperglycemia in ZDF rats was prevented in both JTT-130 treatment and pair-fed groups, but the prevention in pair-fed group became poor with time. Moreover, reduction in plasma cholesterol levels was observed only in JTT-130 treatment group. JTT-130 treatment group showed improved glucose tolerance at 5 weeks after treatment and significant elevation of portal glucagon-like peptide-1 (GLP-1) levels. The hepatic lipid content in JTT-130 treatment group was decreased as compared with pair-fed group. Furthermore, pancreatic protection effects, such as an increase in pancreatic weight and an elevation of insulin-positive area in islets, were observed after JTT-130 treatment.Conclusions. JTT-130 improves hyperglycemia and dyslipidemia via a mechanism independent of suppression of food intake, which is ascribed to an enhancement of GLP-1 secretion and a reduction of lipotoxicity.
Comparison of Selected Kinematic Facebows Applied to Mandibular Tracing
Authors: Wieckiewicz Mieszko , Zietek Marek , Nowakowska Danuta , Wieckiewicz Wlodzimierz
Published: May 2014

The study focused on the comparison between mechanical and computerized registration methods used by the two selected kinematic facebows. The material consisted of 35 women aged 18 to 35, studied using the Gerber Dynamic Facebow and the computerized ARCUSdigma II axiograph. To compare the devices the condylar path inclination (CPI) was recorded according to the Camper’s line, enabling the acquisition of easily comparable values based on which the devices were objectively and subjectively analyzed. Statistics was performed for the obtained data. The study showed that the values for the CPI registrated by the ARCUSdigma II are significantly higher than those obtained by using the Gerber Dynamic Facebow. The significant difference in the records of the CPI is most likely a result of the differences in the registration techniques assumptions. ARCUSdigma II provides the user with more diagnostic options than Gerber Dynamic Facebow. Mechanical facebow handling has a higher risk of hand-measuring errors in tracing procedure. Due to high discrepancy of achieved results from different systems the authors recommend to use articulator compatible with facebow whose measurement has been done.
Equivalent Circuit Analysis of Photovoltaic-Thermoelectric Hybrid Device with Different TE Module Structure
Authors: Chen Haijun , Wang Ning , He Hongcai
Published: May 2014

Combining two different types of solar cells with different absorption bands into a hybrid cell is a very useful method to improve the utilization efficiency of solar energy. The experimental data of dye-sensitized solar cells (DSSCs) and thermoelectric generators (TEG) was simulated by equivalent circuit method, and some parameters of DSSCs were obtained. Then, the equivalent circuit model with the obtained parameters was used to optimize the structure design of photovoltaic- (PV-) thermoelectric (TE) hybrid devices. The output power(Pout)first increases to a maximum and then decreases by increasing the TE prism size, and a smaller spacing between p-type prism and n-type prism of a TE p-n junction causes a higher output power of TEG and hybrid device. When the spacing between TE prisms is 15 μm and the optimal base side length of TE prism is 40 μm, the maximum theoretical efficiency reaches 24.6% according to the equivalent circuit analysis. This work would give some enlightenment for the development of high-performance PV-TE hybrid devices.
A Multiobjective Interval Programming Model for Wind-Hydrothermal Power System Dispatching Using 2-Step Optimization Algorithm
Authors: Ren Kun , Jihong Qu
Published: May 2014

Wind-hydrothermal power system dispatching has received intensive attention in recent years because it can help develop various reasonable plans to schedule the power generation efficiency. But future data such as wind power output and power load would not be accurately predicted and the nonlinear nature involved in the complex multiobjective scheduling model; therefore, to achieve accurate solution to such complex problem is a very difficult task. This paper presents an interval programming model with 2-step optimization algorithm to solve multiobjective dispatching. Initially, we represented the future data into interval numbers and simplified the object function to a linear programming problem to search the feasible and preliminary solutions to construct the Pareto set. Then the simulated annealing method was used to search the optimal solution of initial model. Thorough experimental results suggest that the proposed method performed reasonably well in terms of both operating efficiency and precision.
Glutamine Supplementation Attenuates Expressions of Adhesion Molecules and Chemokine Receptors on T Cells in a Murine Model of Acute Colitis
Authors: Hou Yu-Chen , Wu Jin-Ming , Wang Ming-Yang , Wu Ming-Hsun , Chen Kuen-Yuan , Yeh Sung-Ling , Lin Ming-Tsan
Published: May 2014

Background. Migration of T cells into the colon plays a major role in the pathogenesis in inflammatory bowel disease. This study investigated the effects of glutamine (Gln) supplementation on chemokine receptors and adhesion molecules expressed by T cells in mice with dextran sulfate sodium- (DSS-) induced colitis.Methods. C57BL/6 mice were fed either a standard diet or a Gln diet replacing 25% of the total nitrogen. After being fed the diets for 5 days, half of the mice from both groups were given 1.5% DSS in drinking water to induce colitis. Mice were killed after 5 days of DSS exposure.Results. DSS colitis resulted in higher expression levels of P-selectin glycoprotein ligand- (PSGL-) 1, leukocyte function-associated antigen- (LFA-) 1, and C-C chemokine receptor type 9 (CCR9) by T helper (Th) and cytotoxic T (Tc) cells, and mRNA levels of endothelial adhesion molecules in colons were upregulated. Gln supplementation decreased expressions of PSGL-1, LFA-1, and CCR9 by Th cells. Colonic gene expressions of endothelial adhesion molecules were also lower in Gln-colitis mice. Histological finding showed that colon infiltrating Th cells were less in the DSS group with Gln administration.Conclusions. Gln supplementation may ameliorate the inflammation of colitis possibly via suppression of T cell migration.
Quantitative Evaluation of the Severity of Acute Illness in Adult Patients with Tick-Borne Encephalitis
Authors: Bogovic Petra , Logar Mateja , Avsic-Zupanc Tatjana , Strle Franc , Lotric-Furlan Stanka
Published: May 2014

The aim of the present study was to quantify the severity of acute illness in patients with tick-borne encephalitis and to ascertain this approach by comparing it to standard clinical assessment. We designed scoring system for quantification of the severity of acute illness in patients with tick-borne encephalitis. Certain number of points was allotted to the presence, intensity, and duration of individual symptoms/signs. According to the obtained score the disease was classified as mild, moderate, and severe. Tick-borne encephalitis was assessed clinically as mild when only signs/symptoms of meningeal involvement were found, moderate in case of monofocal neurological signs and/or mild to moderate signs/symptoms of central nervous system dysfunction, and severe in patients with multifocal neurological signs and/or symptoms of severe dysfunction of central nervous system. By designed scoring system 282 adult patients, 146 males and 136 females, average aged 52.2 ± 15.5 years (range 15–82 years), with confirmed tick-borne encephalitis, were prospectively assessed. In 279/282 (98.9%) patients the severity according to clinical assessment matched with the score ranges for mild, moderate, and severe disease. The proposed approach enables precise and straightforward appraisal of the severity of acute illness and could be useful for comparison of findings within/between study groups.
A Reliable Method for Rhythm Analysis during Cardiopulmonary Resuscitation
Authors: Ayala U. , Irusta U. , Ruiz J. , Eftestøl T. , Kramer-Johansen J. , Alonso-Atienza F. , Alonso E. , González-Otero D.
Published: May 2014

Interruptions in cardiopulmonary resuscitation (CPR) compromise defibrillation success. However, CPR must be interrupted to analyze the rhythm because although current methods for rhythm analysis during CPR have high sensitivity for shockable rhythms, the specificity for nonshockable rhythms is still too low. This paper introduces a new approach to rhythm analysis during CPR that combines two strategies: a state-of-the-art CPR artifact suppression filter and a shock advice algorithm (SAA) designed to optimally classify the filtered signal. Emphasis is on designing an algorithm with high specificity. The SAA includes a detector for low electrical activity rhythms to increase the specificity, and a shock/no-shock decision algorithm based on a support vector machine classifier using slope and frequency features. For this study, 1185 shockable and 6482 nonshockable 9-s segments corrupted by CPR artifacts were obtained from 247 patients suffering out-of-hospital cardiac arrest. The segments were split into a training and a test set. For the test set, the sensitivity and specificity for rhythm analysis during CPR were 91.0% and 96.6%, respectively. This new approach shows an important increase in specificity without compromising the sensitivity when compared to previous studies.
The Excellent Mechanical Properties of Cork: A Novel Approach through the Analysis of Contact Stress
Authors: Díaz-Parralejo Antonio , Cuerda-Correa Eduardo M. , Macías-García Antonio , Sánchez-González José , Díaz-Díez M. Ángeles
Published: May 2014

In many technological applications of cork, this biomaterial is under strongly localized contact stresses, which largely differ from the homogeneous distribution of stresses of the typical uniaxial compression tests. Indentation tests constitute an excellent form of determining the behavior of the materials under localized stresses. In the present study, the applicability of Hertzian and Brinell indentation tests to the evaluation of the mechanical properties of cork is tested. One of the main conclusions of the study is that the elastic anisotropy of the material is related to the anisotropic structure of the different sections cut from a cork sample, a clear difference between the back tangential section and the other sections being observed.
Effect of Fast Freeze-Thaw Cycles on Mechanical Properties of Ordinary-Air-Entrained Concrete
Authors: Shang Huai-shuai , Cao Wei-qun , Wang Bin
Published: May 2014

Freezing-thawing resistance is a very significant characteristic for concrete in severe environment (such as cold region with the lowest temperature below 0°C). In this study, ordinary-air-entrained (O-A-E) concrete was produced in a laboratory environment; the compressive strength, cubic compressive strength of C50, C40, C30, C25, and C20 ordinary-air-entrained concrete, tensile strength, and cleavage strength of C30 ordinary-air-entrained concrete were measured after fast freeze-thaw cycles. The effects of fast freeze-thaw cycles on the mechanical properties (compressive strength and cleavage strength) of ordinary-air-entrained concrete materials are investigated on the basis of the experimental results. And the concise mathematical formula between mechanical behavior and number of fast freeze-thaw cycles was established. The experiment results can be used as a reference in design, maintenance, and life prediction of ordinary-air-entrained concrete structure (such as dam, offshore platform, etc.) in cold regions.
Intravascular Papillary Endothelial Hyperplasia: Diagnostic Sequence and Literature Review of an Orofacial Lesion
Authors: Guledgud Mahima V. , Patil Karthikeya , Saikrishna Degala , Madhavan Abhishek , Yelamali Tejesh
Published: May 2014

Intravascular papillary endothelial hyperplasia or Masson’s tumor is a rare reactive disease of vascular origin characterized by exuberant proliferation of endothelial cells notably occurring within blood vessels of head, neck, and extremities. The importance of this entity is its ability to mimic a variety of diseases both benign and malignant in the orofacial region. Here, we present a case of Masson’s tumor within the masseter muscle in a 40-year-old female with emphasis on the sequential investigative procedures performed to diagnose this entity.
Biochemical and Functional Characterization ofParawixia bistriataSpider Venom with Potential Proteolytic and Larvicidal Activities
Authors: Gimenez Gizeli S. , Coutinho-Neto Antonio , Kayano Anderson M. , Simões-Silva Rodrigo , Trindade Frances , de Almeida e Silva Alexandre , Marcussi Silvana , da Silva Saulo L. , Fernandes Carla F. C. , Zuliani Juliana P. , Calderon Leonardo A. , Soares Andreimar M. , Stábeli Rodrigo G.
Published: May 2014

Toxins purified from the venom of spiders have high potential to be studied pharmacologically and biochemically. These biomolecules may have biotechnological and therapeutic applications. This study aimed to evaluate the protein content ofParawixia bistriatavenom and functionally characterize its proteins that have potential for biotechnological applications. The crude venom showed no phospholipase, hemorrhagic, or anti-Leishmania activities attesting to low genotoxicity and discrete antifungal activity forC. albicans. However the following activities were observed: anticoagulation, edema, myotoxicity and proteolysis on casein, azo-collagen, and fibrinogen. The chromatographic and electrophoretic profiles of the proteins revealed a predominance of acidic, neutral, and polar proteins, highlighting the presence of proteins with high molecular masses. Five fractions were collected using cation exchange chromatography, with the P4 fraction standing out as that of the highest purity. All fractions showed proteolytic activity. The crude venom and fractions P1, P2, and P3 showed larvicidal effects onA. aegypti. Fraction P4 showed the presence of a possible metalloprotease (60 kDa) that has high proteolytic activity on azo-collagen and was inhibited by EDTA. The results presented in this study demonstrate the presence of proteins in the venom ofP. bistriatawith potential for biotechnological applications.
Human Serum Albumin Conjugates of 7-Ethyl-10-hydroxycamptothecin (SN38) for Cancer Treatment
Authors: Sepehri Nima , Rouhani Hasti , Ghanbarpour Ahmad Reza , Gharghabi Mehdi , Tavassolian Faranak , Amini Mohsen , Ostad Seyed Nasser , Ghahremani Mohammad Hossein , Dinarvand Rassoul
Published: May 2014

SN38 (7-ethyl-10-hydroxy-comptothecin) is a potent metabolite of irinotecan, which has been approved for treatment of metastatic colorectal cancer. Considering the notable potency of SN38, it has been introduced as an anticancer candidate. In this study, human serum albumin (HSA) conjugates of SN38 were formulated to overcome the solubility problem beside improving the active form stability and tumor tissue targeting. In this target, two different molar ratios of conjugates (SN38 : HSA 15 : 1 and 60 : 1) were prepared by derivatization of 20-hydroxyl group of SN38 with glycine, followed by addition of succinyl group to glycine through which HSA was covalently attached. The conjugates with particle size of about 100 nm revealed enhanced water solubility and were relatively stable in neutral and acidic solutions. For SN38-HSA-15 and SN38-HSA-60 IC50values were compared with irinotecan in HT-29 human colon cancer cells. Furthermore, biodistribution studies of SN38-HSA conjugate resulted in proper blood concentration level within 4 h. Moreover, blood cytotoxicity assay revealed no toxicity effect on liver and spleen. Collectively, our present investigation offers a water-soluble form of SN38 attached to HSA and suggests using favorable properties as a promising anticancer agent for further preclinical and clinical investigations.
Toward a Drug Development Path That Targets Metastatic Progression in Osteosarcoma
Authors: Khanna Chand , Fan Timothy M. , Gorlick Richard , Helman Lee J. , Kleinerman Eugenie S. , Adamson Peter C. , Houghton Peter J. , Tap William D. , Welch Danny R. , Steeg Patricia S. , Merlino Glenn , Sorensen Poul H.B. , Meltzer Paul , Kirsch David G. , Janeway Katherine A. , Weigel Brenda , Randall Lor , Withrow Stephen J , Paoloni Melissa , Kaplan Rosandra , Teicher Beverly A. , Seibel Nita L. , Smith Malcolm , Üren Aykut , Patel Shreyaskumar R. , Trent Jeffrey , Savage Sharon A. , Mirabello Lisa , Reinke Denise , Barkaukas Donald A. , Krailo Mark , Bernstein Mark
Published: May 2014

Despite successful primary tumor treatment, the development of pulmonary metastasis continues to be the most common cause of mortality in patients with osteosarcoma. A conventional drug development path requiring drugs to induce regression of established lesions has not led to improvements for patients with osteosarcoma in more than 30 years. On the basis of our growing understanding of metastasis biology, it is now reasonable and essential that we focus on developing therapeutics that target metastatic progression. To advance this agenda, a meeting of key opinion leaders and experts in the metastasis and osteosarcoma communities was convened in Bethesda, Maryland. The goal of this meeting was to provide a “Perspective” that would establish a preclinical translational path that could support the early evaluation of potential therapeutic agents that uniquely target the metastatic phenotype. Although focused on osteosarcoma, the need for this perspective is shared among many cancer types. The consensus achieved from the meeting included the following: the biology of metastatic progression is associated with metastasis-specific targets/processes that may not influence grossly detectable lesions; targeting of metastasis-specific processes is feasible; rigorous preclinical data are needed to support translation of metastasis-specific agents into human trials where regression of measurable disease is not an expected outcome; preclinical data should include an understanding of mechanism of action, validation of pharmacodynamic markers of effective exposure and response, the use of several murine models of effectiveness, and where feasible the inclusion of the dog with naturally occurring osteosarcoma to define the activity of new drugs in the micrometastatic disease setting. Clin Cancer Res; 20(16); 4200–9. ©2014 AACR.
TP53 Mutation Spectrum in Breast Cancer Is Subtype Specific and Has Distinct Prognostic Relevance
Authors: Silwal-Pandit Laxmi , Vollan Hans Kristian Moen , Chin Suet-Feung , Rueda Oscar M. , McKinney Steven , Osako Tomo , Quigley David A. , Kristensen Vessela N. , Aparicio Samuel , Børresen-Dale Anne-Lise , Caldas Carlos , Langerød Anita
Published: May 2014

Purpose: In breast cancer, the TP53 gene is frequently mutated and the mutations have been associated with poor prognosis. The prognostic impact of the different types of TP53 mutations across the different molecular subtypes is still poorly understood. Here, we characterize the spectrum and prognostic significance of TP53 mutations with respect to the PAM50 subtypes and integrative clusters (IC).

Experimental Design: TP53 mutation status was obtained for 1,420 tumor samples from the METABRIC cohort by sequencing all coding exons using the Sanger method.

Results: TP53 mutations were found in 28.3% of the tumors, conferring a worse overall and breast cancer-specific survival [HR = 2.03; 95% confidence interval (CI), 1.65–2.48, P < 0.001], and were also found to be an independent marker of poor prognosis in estrogen receptor-positive cases (HR = 1.86; 95% CI, 1.39–2.49, P < 0.001). The mutation spectrum of TP53 varied between the breast cancer subtypes, and individual alterations showed subtype-specific association. TP53 mutations were associated with increased mortality in patients with luminal B, HER2-enriched, and normal-like tumors, but not in patients with luminal A and basal-like tumors. Similar observations were made in ICs, where mutation associated with poorer outcome in IC1, IC4, and IC5. The combined effect of TP53 mutation, TP53 LOH, and MDM2 amplification on mortality was additive.

Conclusion: This study reveals that TP53 mutations have different clinical relevance in molecular subtypes of breast cancer, and suggests diverse roles for TP53 in the biology underlying breast cancer development. Clin Cancer Res; 20(13); 3569–80. ©2014 AACR.
Restoration of miR17/20a in Solid Tumor Cells Enhances the Natural Killer Cell Antitumor Activity by Targeting Mekk2
Authors: Jiang Hong , Wang Ping , Li Xiaohua , Wang Qilong , Deng Zhong-Bin , Zhuang Xiaoying , Mu Jingyao , Zhang Lifeng , Wang Baomei , Yan Jun , Miller Donald , Zhang Huang-Ge
Published: May 2014

Aberrant microRNA (miRNA) expression has been identified in various human solid cancers. However, whether the levels of miRNA expression in tumor cells have any effect on tumor progression has not been determined. In this proof-of-concept study, the restoration of high-level expression of the miR17–92 cluster of miRNAs reveals its function as a tumor suppressor in murine solid cancer cells. Specifically, genetically engineered expression of higher levels of miR17/20a in the miR17–92 cluster in both murine breast cancer and colon cancer cells triggered natural killer (NK)–cell recognition by inhibiting the expression of MHC class I (H-2D) through the Mekk2–Mek5–Erk5 pathway. Results from the mouse tumor studies were recapitulated using samples of human solid tumors. Together, these data indicate that miR17/20a miRNAs function as tumor suppressors by reprogramming tumor cells for NK cell-mediated cytotoxicity. Cancer Immunol Res; 2(8); 789–99. ©2014 AACR.
Exponential Increases in the Prevalence of Disability in the Oldest Old: A Canadian National Survey
Authors: Guay Manon , Dubois Marie-France , Corrada María , Lapointe-Garant Marie-Pierre , Kawas Claudia
Published: May 2014

Background: As most studies generally treat all 85+ year-olds as a homogeneous group, little is known about the specific disabilities of the oldest old population, those aged 90 and older. Objective: To estimate age-specific prevalence of disability in activities of daily living for older Canadians, including the oldest old, those aged 90 and older. Methods: Cross-sectional national survey with a representative sample of noninstitutionalized Canadians aged between 50 and 104 years old (n = 28,406). Disability was self-reported and defined as needing assistance to perform self-care and domestic life activities. Results: The prevalence of disability increased with age, and the rise appeared exponential when considering the oldest old. At age 90, the highest estimated rates of disability were reported for housekeeping (50%), shopping (45%) and transportation (44%), and 21% reported requiring assistance for washing themselves. Compared to the 85-89 age group, the estimated proportion of people reporting disability in the 95+ age group approximately triples for self-care activities and doubles for domestic life activities. Conclusion: Even if we knew that disability increases with age, we can now state that it increases at an accelerated rate beyond age 85. Grouping people aged 85+ into one category leads to substantial underestimates of disability in the oldest old. Accurate estimates are necessary for adequate allocation of care and rehabilitation resources for a rapidly expanding age group.
Serial Changes of Serum Endostatin and Angiopoietin-1 Levels in Preterm Infants with Severe Bronchopulmonary Dysplasia and Subsequent Pulmonary Artery Hypertension
Authors: Kim Do-Hyun , Kim Han-Suk
Published: May 2014

Background: In bronchopulmonary dysplasia (BPD), disrupted angiogenesis may result from an imbalance between pro- and anti-angiogenic factors triggered by inflammation, leading to the late development of pulmonary artery hypertension (PAH). Objectives: To investigate whether the levels of serum endostatin (as an anti-angiogenic factor) and angiopoietin-1 (AP-1; as a pro-angiogenic factor) in early life are associated with the development of PAH in preterm infants with severe BPD. Methods: In this prospective cohort study, the levels of serum endostatin and AP-1 were measured from 56 infants (gestational age <30 weeks or birth weight <1,250 g) including severe BPD with PAH (‘PAH'; 15 infants) or without PAH (‘non-PAH'; 22 infants) and no/mild BPD (19 infants) groups on days 1, 7, 14, and 28 of life. Results: The PAH group consistently underwent more aggressive respiratory management than the non-PAH group, over 1 month after birth. The endostatin level and the ratio of endostatin to AP-1 on day 7 of life were significantly higher in the PAH group than in the non-PAH group or no/mild BPD groups (median 146.6 vs. 102.4/108.0 ng/ml; 62.1 vs. 18.6/14.9). The ratio of endostatin to AP-1 on day 1 was also significantly higher in the PAH group than in the no/mild BPD group (median 31.8 vs. 11.3). Conclusions: An increased serum endostatin to AP-1 ratio may reflect impaired angiogenesis that may preclude the development of PAH.
Mortality and Cause of Death in Multiple Sclerosis: Findings from a Prospective Population-Based Cohort in Bizkaia, Basque Country, Spain
Authors: Rodríguez-Antigüedad Zarranz Alfredo , Mendibe Bilbao Mar , Llarena González Cristina , Audicana Covadonga
Published: May 2014

Background: Mortality studies of multiple sclerosis (MS) patients are scarce. Objective: To assess mortality of MS patients included in a large MS cohort from the county of Bizkaia in Spain. Methods: Patients were collected from a dynamic population-based cohort of patients with MS from the county of Bizkaia (named the ‘Bizkaia cohort') in the Basque Country (Spain). Data from official registries were used for estimating mortality indicators. Results: During a 24-year period (1987-2011), a total of 1,283 patients were included in the Bizkaia cohort. Eighty-nine patients (6.9%) had died before December 31, 2011. The standardized mortality ratio was 2.78 for the whole group (3.26 for men and 2.73 for women), with a decreased life expectancy of 6.53 years. The mean survival from the onset of MS in deceased patients was 22.4 years. Death was related directly or indirectly to MS in 57 patients and unrelated in 27, while the cause of death was unknown in the remaining 5. Respiratory infection and sepsis were the most frequent MS-related causes of death. Differences in survival according to gender or disease course were not observed. Conclusion: Patients with MS included in the ‘Bizkaia cohort' had an almost threefold increase in the risk for death. Life expectancy is reduced by 6-10 years.
Cardiac MRI Improves Identification of Etiology of Acute Ischemic Stroke
Authors: Baher Alex , Mowla Ashkan , Kodali Santhisri , Polsani Venkateshwar R. , Nabi Faisal , Nagueh Sherif F. , Volpi John J. , Shah Dipan J.
Published: May 2014

Background: An accurate subtype classification of acute ischemic stroke is important in clinical practice as it can greatly influence patient care in terms of acute management and devising secondary stroke prevention strategies. Approximately, one third of ischemic strokes are cryptogenic despite a comprehensive workup. Diagnostic workup for detecting cardioaortic sources of cerebral embolism commonly includes transthoracic echocardiography (TTE). However, TTE has a limited diagnostic power to detect some of the cardioaortic abnormalities and additional imaging modalities are often needed to accurately assess such abnormalities. Purpose: We evaluated the feasibility of cardiovascular magnetic resonance (CMR) imaging to detect the cardioaortic sources of ischemic stroke. Methods: A total of 106 patients were included, of which 85 had an ischemic stroke and 21 had a transient ischemic attack (TIA). Routine diagnostic workup (RDW) included brain diffusion-weighted image MRI, telemetry, magnetic resonance angiography/CT angiography of head and neck, carotid duplex ultrasonography, laboratory studies and TTE. Patients additionally underwent CMR. Subtype assignment was performed in accordance with the Stop Stroke Study of the Trial of Org 10172 in Acute Stroke Treatment classification system by a stroke neurologist after reviewing the admission notes and diagnostic test results. A second subtype classification was assigned with an additional criterion defined based on delayed enhancement (DE)-CMR findings. Additionally, the presence of non-coronary artery disease (CAD) scarring was assessed in ischemic stroke patients and compared with the TIA patients as the control group. Results: RDW detected cardioaortic embolism (CAE) stroke in 32 (37.6%) patients and cryptogenic stroke in 23 patients (27.1%). Addition of CMR resulted in a 26.1% reduction in the rate of cryptogenic strokes (6 patients). Furthermore, DE-CMR findings allowed for reclassification of three additional cryptogenic subtypes, resulting in a 39.1% reduction of cryptogenic stroke rate. Non-CAD scarring was detected in 13 (15.3%) stroke patients as opposed to only 1 (4.8%) TIA patient. Conclusions: CMR is a valuable tool for the detection of CAE sources in patients with cryptogenic ischemic stroke and provides clinicians with a unique set of information that may substantially change the long-term management of these patients. DE-CMR also detects non-CAD scarring, which may indicate a predisposition to ischemic stroke. Further studies with larger samples and long-term follow-up are needed to further evaluate the clinical significance of our findings.
Association between Polymorphisms rs1333040 and rs7865618 of Chromosome 9p21 and Sporadic Brain Arteriovenous Malformations
Authors: Sturiale Carmelo Lucio , Fontanella Marco Maria , Gatto Ilaria , Puca Alfredo , Giarretta Igor , DʼArrigo Sonia , Lofrese Giorgio , Rainero Innocenzo , Gallone Salvatore , Pinessi Lorenzo , Ducati Alessandro , Maira Giulio , Pola Roberto
Published: May 2014

Background: The chromosomal locus 9p21 is a novel genetic marker for a variety of cardiovascular and cerebrovascular diseases. In a recent study, we have demonstrated an association between the single nucleotide polymorphism (SNP) rs1333040C>T on chromosome 9p21 and sporadic brain arteriovenous malformations (BAVMs). Here, we extended our analysis to an additional SNP on chromosome 9p21 (rs7865618A>G) and increased our sample size including BAVMs from two different Italian neurosurgical centers. Methods: We studied 206 patients with sporadic BAVMs and 171 unaffected controls. Genomic DNA was isolated from peripheral blood and the rs1333040C>T and rs7865618A>G polymorphisms were assessed by PCR-RFLP using the BsmI and MspI restriction endonucleases, respectively. For each SNP, we performed dominant, recessive, and additive genetic models. Results: The distribution of the three possible genotypes of rs1333040 (TT, TC and CC) was statistically different between cases and controls (p = 0.0008). The TT genotype was significantly associated with BAVMs both in the dominant (p = 0.013) and recessive (p = 0.012) models. The T allele was significantly associated with BAVMs in the additive model (p = 0.002). Also the distribution of the three possible genotypes of rs7865618 (GG, AG and AA) was statistically different between cases and controls (p = 0.005), and the GG genotype and G allele were significantly associated with BAVMs in the dominant (p = 0.032), recessive (p = 0.007), and additive models (p = 0.009). We also detected a significant association between BAVMs with large nidus size and the GG genotype and G allele of rs7865618 and the TT genotype of rs1333040. A deep venous drainage was instead associated with the TT genotype of the rs1333040 and the GG genotype of the rs7865618. The occurrence of bleeding was associated with the TT genotype and T allele of rs1333040, while the presence of seizures appeared associated with the GG genotype of rs7865618. Conclusions: SNPs of the 9p21 region, in addition to be genetic markers for coronary artery disease, stroke, and intracranial aneurysms, are associated with sporadic BAVMs. These results extend and strengthen the role of the 9p21 chromosomal region as a common risk factor for cerebrovascular diseases.
Randomized Comparison Between Polymer-Free Versus Polymer-Based Paclitaxel-Eluting Stent
Authors: Shiratori Yoshitaka , Cola Clarissa , Brugaletta Salvatore , Alvarez-Contreras Luis , Martín-Yuste Victoria , del Blanco Bruno García , Ruiz-Salmeron Rafael , Díaz Jose , Pinar Eduardo , Martí Vicens , García-Picart Juan , Sabaté Manel
Published: May 2014

Background—

Most drug-eluting stents currently in use are coated with a polymer carrying the drug that is released for several weeks. However, a durable polymer may provoke hypersensitive reaction, delayed artery healing, and eventually stent thrombosis. The aim of this study was to investigate the safety and efficacy of a polymer-free paclitaxel-eluting stent (PF-PES) versus a polymer-based PES (PB-PES).

Methods and Results—

Eligible patients undergoing percutaneous coronary intervention were randomized 1:1 to receive either PF-PES or PB-PES. The primary end point was late loss at 9 months. Intravascular ultrasound analysis at 9 months and final 2-year clinical follow-up were also performed. From October 2007 to April 2009, 164 patients were enrolled and randomized into 2 groups (PF-PES: n=84; PB-PES: n=80). Mean in-stent lumen loss was 0.90±0.59 mm for PF-PES and 0.49±0.52 mm for PB-PES (
P
<0.001). Mean neointimal area by intravascular ultrasound was higher in PF-PES than in PB-PES (1.42±1.09 versus 0.51±0.61 mm
2
;
P
<0.001). At 2 years, a composite end point of all-cause death, any myocardial infarction, and target vessel revascularization occurred in 36.9% for PF-PES and 16.3% for PB-PES (
P
=0.004), mainly driven by a higher rate of target vessel revascularization (PF-PES: 35.7%; PB-PES: 13.8%;
P
=0.001). One late stent thrombosis was observed in PF-PES.

Conclusions—

Compared with PB-PES, PF-PES was associated with increased neointimal proliferation and subsequent clinical restenosis. Polymer plays an essential role in the performance of drug-eluting stents.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT01375855.
Long-Term Clinical Outcomes After Everolimus- and Sirolimus-Eluting Coronary Stent Implantation
Authors: Shiomi Hiroki , Kozuma Ken , Morimoto Takeshi , Igarashi Keiichi , Kadota Kazushige , Tanabe Kengo , Morino Yoshihiro , Akasaka Takashi , Abe Mitsuru , Suwa Satoru , Muramatsu Toshiya , Kobayashi Masakazu , Dai Kazuoki , Nakao Koichi , Uematsu Masaaki , Tarutani Yasuhiro , Fujii Kenshi , Simonton Charles A. , Kimura Takeshi
Published: May 2014

Background—

Long-term clinical outcomes of everolimus-eluting stent (EES) compared with sirolimus-eluting stent (SES) have not been evaluated fully yet, especially whether EES implantation could positively affect late adverse events reported after SES implantation occurring >1 year.

Methods and Results—

In this all-comer prospective multicenter randomized open-label trial, 3196 patients were assigned randomly to implant either EES (n=1596) or SES (n=1600). At 3 years, EES was noninferior to SES on the primary safety end point (all-cause death or myocardial infarction; 10.1% versus 11.5%; noninferiority
P
<0.001; and superiority
P
=0.19). Cumulative incidence of definite stent thrombosis was low and was not significantly different between the 2 groups (0.5% versus 0.6%;
P
=0.81). There was no significant difference in the efficacy end point of target-lesion revascularization between the EES and SES groups (6.6% versus 7.9%;
P
=0.16). However, the cumulative incidence of target-lesion failure (cardiac death/target-vessel myocardial infarction/ischemia-driven target-lesion revascularization) was significantly lower in the EES group than in the SES group (8.8% versus 11.4%;
P
=0.01). By a landmark analysis at 1 year, the cumulative incidence of very late stent thrombosis and late target-lesion revascularization was not significantly different between the 2 groups (0.2% versus 0.2%;
P
=0.99 and 2.2% versus 2.9%;
P
=0.21, respectively).

Conclusions—

The efficacy and safety outcomes for this trial after EES implantation remained comparable with those after SES implantation through 3-year follow-up. However, improvement of clinical outcome after EES implantation compared with SES implantation was suggested by the significantly lower cumulative incidences of target-lesion failure, which has been the most widely used primary end point in the stent-versus-stent trials.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT01035450.
Use of Coronary Artery Calcium Testing to Guide Aspirin Utilization for Primary Prevention: Estimates From the Multi-Ethnic Study of Atherosclerosis
Authors: Miedema Michael D. , Duprez Daniel A. , Misialek Jeffrey R. , Blaha Michael J. , Nasir Khurram , Silverman Michael G. , Blankstein Ron , Budoff Matthew J. , Greenland Philip , Folsom Aaron R.
Published: May 2014

Background—

Aspirin for the primary prevention of coronary heart disease (CHD) is only recommended for individuals at high risk for CHD although the majority of CHD events occur in individuals who are at low to intermediate risk.

Methods and Results—

To estimate the potential of coronary artery calcium (CAC) scoring to guide aspirin use for primary prevention of CHD, we studied 4229 participants from the Multi-Ethnic Study of Atherosclerosis who were not on aspirin at baseline and were free of diabetes mellitus. Using data from median 7.6-year follow-up, 5-year number-needed-to-treat estimations were calculated by applying an 18% relative CHD reduction to the observed event rates. This was contrasted to 5-year number-needed-to-harm estimations based on the risk of major bleeding reported in an aspirin meta-analysis. Results were stratified by a 10% 10-year CHD Framingham Risk Score (FRS). Individuals with CAC≥100 had an estimated net benefit with aspirin regardless of their traditional risk status (estimated 5-year number needed to treat of 173 for individuals <10% FRS and 92 for individuals ≥10% FRS, estimated 5-year number needed to harm of 442 for a major bleed). Conversely, individuals with zero CAC had unfavorable estimations (estimated 5-year number needed to treat of 2036 for individuals <10% FRS and 808 for individuals ≥10% FRS, estimated 5-year number needed to harm of 442 for a major bleed). Sex-specific and age-stratified analyses showed similar results.

Conclusions—

For the primary prevention of CHD, Multi-Ethnic Study of Atherosclerosis participants with CAC≥100 had favorable risk/benefit estimations for aspirin use while participants with zero CAC were estimated to receive net harm from aspirin.
Reproduction, growth, mortality and exploitation rate of Penaeus semisulcatus De Haan, 1844 (Decapoda, Penaeidae) from Iskenderun Bay (northeastern Mediterranean)
Authors: Manasirli M. , Kiyaga V. B. , Perker M.
Published: May 2014

Penaeus semisulcatusDe Haan, 1844 was collected in Iskenderun Bay, from November 2009 to October 2010, by monthly bottom trawl operations. The male : female ratio was determined as 1 : 1, and the spawning period was found to be from January to June, while peaking two times a year, namely in January and in March. The andKfor males were estimated at 42.00 mm CL and 1.8 year−1, respectively, and for the females 63.00 mm CL and 1.90 a year−1. Using the andKestimates for both sexes, the instantaneous rate of natural mortality (M) for males and females were calculated as 1.50 and 1.97 year−1, respectively, at 22°C water temperature on average. The instantaneous rates of total mortalities (Z) were 4.04 year−1for males and 6.39 year−1for females, and fishing mortalities (F) for males were 2.24 year−1and for females 4.42 year−1. Thus, the exploitation rates (E) were 0.65 year−1and 0.69 year−1for males and females, respectively. The results clearly indicate overfishing forP. semisulcatusin the study area.
Ceratothoa retusa (Schiœdte & Meinert, 1883) (Isopoda, Cymothoidae), a variable species of fish parasitic marine isopod from the Indian Ocean
Authors: Hadfield Kerry A. , Bruce Niel L. , Szinetár Csaba , Smit Nico J.
Published: May 2014

Ceratothoa retusa (Schiœdte & Meinert, 1883) is redescribed from the lectotype (here designated) collected from Mozambique, and the range is extended to include the Gulf of Suez in the Red Sea. Ceratothoa retusa is distinctive within the genus with a manifestly small head deeply immersed into pereonite 1, which has prominent, but variable, projecting anterolateral margins. Ceratothoa retusa has a tropical and subtropical Indian Ocean distribution, extending from eastern Africa (and now the Red Sea) eastwards to northern Australia and Indonesia. The only known hosts are the halfbeaks, Hemiramphus far (Forsskål, 1775) and H. robustus Günther, 1866 (Hemiraphidae).
Competing Competences in Adjudication: Reviewing the Relationship between the ECOWAS Court and National Courts
Authors: Ojomo Edefe
Published: May 2014

Abstract

This article argues that regional access to justice in West Africa provides an alternative to national access to justice through the institution of the ecowas Community Court of Justice. This gives West Africans the option of pursuing justice in national judicial institutions or in the ecowas Court. Therefore, it reveals a situation where both systems compete for effectiveness in meeting the justice demands of citizens while also encouraging greater complementarity in their institutional activities.
The Personal and the Fitting
Authors: Olson Jonas
Published: May 2014

This paper is a critical notice of a recent significant contribution to the debate about fitting attitudes and value, namely Toni Rønnow-Rasmussen’s Personal Value (Oxford: Oxford University Press, 2011). In this book, Rønnow-Rasmussen seeks to analyse the notion of personal value—an instance of the notion of good for a person—in terms of fitting attitudes. The paper has three main themes: (i) Rønnow-Rasmussen’s discussion of general problems for fitting attitude analyses; (ii) his formulation of the fitting attitude analysis of personal value and the notion of ‘for someone’s sake (fss) attitudes’; and (iii) his critique of the dichotomy between agent-neutral and agent-relative reasons.