bluuebunny/crossref_metadata_2025 huggingface dataset:
Sensorless Viscosity Measurement in a Magnetically‐Levitated Rotary Blood Pump
Authors: Hijikata Wataru , Rao Jun , Abe Shodai , Takatani Setsuo , Shinshi Tadahiko
Published: April 2015

Controlling the flow rate in an implantable rotary blood pump based on the physiological demand made by the body is important. Even though various methods to estimate the flow rate without using a flow meter have been proposed, no adequate method for measuring the blood viscosity, which is necessary for an accurate estimate of the flow rate, without using additional sensors or mechanisms in a noninvasive way, has yet been realized. We have developed a sensorless method for measuring viscosity in magnetically levitated rotary blood pumps, which requires no additional sensors or mechanisms. By applying vibrational excitation to the impeller using a magnetic bearing, we measured the viscosity of the working fluid by measuring the phase difference between the current in the magnetic bearing and the displacement of the impeller. The measured viscosity showed a high correlation (R2 > 0.992) with respect to a reference viscosity. The mean absolute deviation of the measured viscosity was 0.12 mPa·s for several working fluids with viscosities ranging from 1.18 to 5.12 mPa·s. The proposed sensorless measurement method has the possibility of being utilized for estimating flow rate.
Pulsatility Produced by the Hemodialysis Roller Pump as Measured by Doppler Ultrasound
Authors: Fulker David , Keshavarzi Gholamreza , Simmons Anne , Pugh Debbie , Barber Tracie
Published: April 2015

Microbubbles have previously been detected in the hemodialysis extracorporeal circuit and can enter the blood vessel leading to potential complications. A potential source of these microbubbles is highly pulsatile flow resulting in cavitation. This study quantified the pulsatility produced by the roller pump throughout the extracorporeal circuit. A Sonosite S‐series ultrasound probe (FUJIFILM Sonosite Inc., Tokyo, Japan) was used on a single patient during normal hemodialysis treatment. The Doppler waveform showed highly pulsatile flow throughout the circuit with the greatest pulse occurring after the pump itself. The velocity pulse after the pump ranged from 57.6 ± 1.74 cm/s to −72 ± 4.13 cm/s. Flow reversal occurred when contact between the forward roller and tubing ended. The amplitude of the pulse was reduced from 129.6 cm/s to 16.25 cm/s and 6.87 cm/s following the dialyzer and venous air trap. This resulted in almost nonpulsatile, continuous flow returning to the patient through the venous needle. These results indicate that the roller pump may be a source of microbubble formation from cavitation due to the highly pulsatile blood flow. The venous air trap was identified as the most effective mechanism in reducing the pulsatility. The inclusion of multiple rollers is also recommended to offer an effective solution in dampening the pulse produced by the pump.
Change in corneal hysteresis over time in normal, glaucomatous and diabetic eyes
Authors: Hussnain Syed Amal , Alsberge Joseph B. , Ehrlich Joshua R. , Shimmyo Mitsugu , Radcliffe Nathan M.
Published: April 2015

Purpose

Corneal hysteresis (CH) is lower in glaucomatous eyes. The aim of this study was to determine and compare the change in CH over time between normal, open angle glaucoma (POAG) and diabetic subjects.

Methods

We retrospectively analysed records of patients undergoing assessment with the Ocular Response Analyzer (Reichert, Corp., New York, NY, USA). Right eyes with at least 7 measurements were included. Patients with ocular pathology other than POAG were excluded. Two‐sample t‐tests, chi‐squared and logistic regression were used to analyse data.

Results

A total of 1418 normal and 322 POAG patients were included. Patients with POAG were significantly older (70.73 ± 11.33 vs. 61.59 ± 16.56 years; p < 0.001), had a longer follow‐up (4.14 ± 1.34 vs. 2.72 ± 1.49 years; p < 0.001) and had lower CH (9.58 ± 2.17 vs. 9.95 ± 2.19 mmHg p = 0.01), but there were no gender differences between groups (61.5 vs. 57.7% female; p = 0.21). We observed a significantly greater decrease in CH among patients with POAG (−0.11 ± 0.73 vs. 0.07 ± 2.31 mm Hg/year; p = 0.02). The relation between ∆CH/year and diagnosis persisted after adjusting for age and follow‐up time (OR 0.90; 95% CI 0.82, 0.99; p = 0.03). We found CH to be higher in diabetics vs. non‐diabetics (10.34 ± 2.04 vs. 9.88 ± 2.19; p = 0.02), but ∆CH/year was not different (0.07 ± 1.27 vs. 0.03 ± 2.10; p = 0.77).

Conclusions

Patients with POAG in this study had a significantly greater rate of CH decline compared to normal. There was no significant difference in rate of CH change in diabetic and non‐diabetic patients.
Cohort profile of the GOALS study: A large‐scale research of physical activity in Dutch students
Authors: de Groot Renate H.M. , van Dijk Martin L. , Kirschner Paul A.
Published: April 2015

The GOALS study (Grootschalig Onderzoek naar Activiteiten van Limburgse Scholieren [Large‐scale Research of Activities in Dutch Students]) was set up to investigate possible associations between different forms of physical activity and inactivity with cognitive performance, academic achievement and mental well‐being. It was conducted at a secondary school in the south of the Netherlands. Data collection took place during normal school weeks from October 2011 to March 2012, and 1 year later from October 2012 to May 2013. The study was approved by the local Ethical Committee of the Open University of the Netherlands. All students in grades 7 and 9 of senior general secondary education and university preparatory education were invited to participate (n = 526). At baseline, a sample of 440 Dutch‐speaking adolescents was willing to participate (83.7%). Of these, 344 participated in the follow‐up. Physical activity was measured objectively by an ActivPal3TM accelerometer (Paltechnologies, Glasgow, UK). Cognitive performance was measured by the d2 Test of Attention and the Symbol Digit Modalities Test. Academic achievement was determined using the mean of school grades in Dutch, English and Mathematics. Several well‐validated instruments were used to determine mood/depressive symptoms, self‐esteem and goal orientation. Information on several covariates such as sex, academic year, school level, ethnicity, socio‐economic status, body mass index, pubertal status, smoking, drinking, viewing television, computer use, etc., are available.
Spectrum of adult Parvovirus B19 infection according to the underlying predisposing condition and proposals for clinical practice
Authors: Wolfromm Alice , Rodriguez Christophe , Michel Marc , Habibi Anoosha , Audard Vincent , Benayoun Emmanuel , Rogier Olivier , Challine Dominique , Chosidow Olivier , Lelièvre Jean‐Daniel , Chevalier Xavier , Le Bras Fabien , Pautas Cécile , Imbert Michèle , Pawlotsky Jean‐Michel , Wagner‐Ballon Orianne
Published: April 2015

The virological diagnosis of Parvovirus B19 (PvB19) infection is currently based on sero‐diagnosis, molecular methods or both, yet without clear recommendations. We retrospectively identified patients with polymerase chain reaction‐positive PvB19 and/or positive serological assay between 2007 and 2013. Eighty‐two adults with at least one diagnostic criterion of recent PvB19 infection (IgM antibodies, viral DNA in blood and/or in marrow) were included and classified into three homogeneous groups: 30 patients had no underlying predisposing condition, 25 a hereditary haemolytic anaemia, 27 an underlying immunodeficiency. The classical PvB19‐related manifestations were less frequent in immunocompromised than in immunocompetent patients (arthromyalgia: 5 vs. 14; erythema: 4 vs. 17, respectively). Only 41·4% of patients with no underlying disease were anaemic. Bicytopenia and pancytopenia were observed mainly in immunocompromised patients. Classical pure red cell aplasia was observed in only 9 of the 27 marrow smears performed. Specific IgM were found in 93% of immunocompetent patients, whereas only 58% had detectable viral DNA in blood. IgM and DNA were present alone or together in all patients with hereditary haemolytic anaemia. In immunocompromised patients, the diagnosis was confirmed by marrow analysis in 91% of cases. We make some proposals based on this large series of PvB19‐infected patients.
Antibody‐mediated transfusion‐related acute lung injury; from discovery to prevention
Authors: Peters Anna L. , Van Stein Danielle , Vlaar Alexander P. J.
Published: April 2015

Transfusion‐related acute lung injury (TRALI), a syndrome of respiratory distress caused by blood transfusion, is the leading cause of transfusion‐related mortality. The majority of TRALI cases have been related to passive infusion of human leucocyte antigen (HLA) and human neutrophil antigen (HNA) antibodies in donor blood. In vitro, ex vivo and in vivo animal models have provided insight in TRALI pathogenesis. The various classes of antibodies implicated in TRALI appear to have different pathophysiological mechanisms for the induction of TRALI involving endothelial cells, neutrophils, monocytes and, as very recently has been discovered, lymphocytes. The HLA and HNA‐antibodies are found mainly in blood from multiparous women as they have become sensitized during pregnancy. The incidence of TRALI has decreased rapidly following the introduction of a male‐only strategy for plasma donation. This review focuses on pre‐clinical and clinical studies investigating the pathophysiology of antibody‐mediated TRALI.
A meta‐analysis of human disturbance impacts on Antarctic wildlife
Authors: Coetzee Bernard W. T. , Chown Steven L.
Published: April 2015

Evidence‐based assessments are increasingly recognized as the best‐practice approach to determine appropriate conservation interventions, but such assessments of the impact of human disturbance on wildlife are rare. Human disturbance comprises anthropogenic activities that are typically non‐lethal, but may cause short‐ and/or longer‐term stress and fitness responses in wildlife. Expanding human activity in the Antarctic region is of particular concern because it increases the scope and potential for increased human disturbance to wildlife in a region that is often thought of as relatively untouched by anthropogenic influences. Here, we use a meta‐analytical approach to synthesise research on human disturbance to wildlife over the last three decades in the Antarctic and sub‐Antarctic region. We combine data from 62 studies across 21 species on the behavioural, physiological and population responses of wildlife to pedestrian, vehicle and research disturbances. The overall effect size indicated a small, albeit statistically significant negative effect of disturbance (−0.39; 95% CI: −0.60 to −0.18). Negative effects were found for both physiological and population responses, but no evidence was found for a significant impact on wildlife behavioural responses. Negative effects were found across pedestrian, vehicle and research disturbances. Significant and high among‐study heterogeneity was found in both disturbance and response sub‐groups. Among species, it remains unclear to what extent different forms of disturbance translate into negative population responses. Most current guidelines to limit wildlife disturbance impacts in Antarctica recommend that approaches be tailored to animal behavioural cues, but our work demonstrates that behavioural changes do not necessarily reflect more cryptic, and more deleterious impacts, such as changes in physiology. In consequence, we recommend that pedestrian approach guidelines in the Antarctic region be revisited. Due to the high heterogeneity in effects, management guidelines for different sites and species will need to be developed on a case‐by‐case basis, ideally in conjunction with carefully designed experiments. Guidelines to reduce the impact of research activities per se require development to reduce the potential impacts of conducting research. We identify research questions that, if answered, will further improve the evidence base for guidelines to manage human disturbance in Antarctica.
Diagnosis and treatment of inherited thrombocytopenias
Authors: Pecci A.
Published: April 2015

Knowledge in the field of inherited thrombocytopenias (ITs) has greatly improved over the last 15 years. Several new genes responsible for thrombocytopenia have been identified leading to the definition of novel nosographic entities and to a much better characterization of the phenotypes of these diseases. To date, ITs encompass 22 disorders caused by mutations in 24 genes and characterized by different degrees of complexity and great variability in prognosis. Making a definite diagnosis is important for setting an appropriate follow‐up, choosing the best treatments and providing proper counseling. Despite the abovementioned progress, diagnosis of ITs remains difficult and these disorders are still underdiagnosed. The purpose of this review is to provide an updated guide to the diagnosis of ITs based on simple procedures. Moreover, the currently available therapeutic options for these conditions are recapitulated and discussed.
The risk of contralateral breast cancer in daughters of women with and without breast cancer
Authors: Narod S.A. , Kharazmi E. , Fallah M. , Sundquist K. , Hemminki K.
Published: April 2015

We aimed to estimate the 15‐year and lifetime risks of contralateral breast cancer in breast cancer patients according to the age of diagnosis of the first cancer and the history of breast cancer in the mother. The risks of contralateral breast cancer were estimated for all 78,775 breast cancer patients in the Swedish Family‐Cancer Database (age at diagnosis of first breast cancer <70 years). The risk of experiencing a contralateral breast cancer within 15 years of diagnosis was 8.4% [95% confidence interval (CI): 8.1–8.7%] for women with an unaffected mother, was 12% (95%CI: 11–13%) for a woman with a mother with unilateral breast cancer and was 13% (95%CI: 9.5–17%) for women with a mother with bilateral breast cancer. In early‐onset diagnosed women (<50 years) with an unaffected mother, the risk of contralateral breast cancer until age 80 was 23% (95%CI: 20–26%) and for late‐onset (50–69 years) diagnosed women it was 17% (95%CI: 14–21%). In a woman with a mother with an early‐onset unilateral breast cancer, risk of contralateral breast cancer by age 80 was 35% (95%CI: 25–46%). Women with a mother with early‐onset bilateral breast cancer had 31% (95%CI: 12–67%) lifetime risk of contralateral breast cancer. The risk of contralateral breast cancer is higher for daughters of breast cancer patients than for daughters of women without breast cancer. Maternal cancer history and age at onset of first breast cancer in women should be taken into account when counseling breast cancer patients about their risk of contralateral breast cancer.
Impact of tacrolimus and mycophenolate mofetil regimen vs. a conventional therapy with steroids on cardiovascular risk in liver transplant patients
Authors: Cuervas‐Mons Valentín , Herrero J. Ignacio , Gomez Miguel A. , González‐Pinto Ignacio , Serrano Trinidad , de la Mata Manuel , Fabregat Joan , Gastaca Mikel , Bilbao Itxarone , Varo Evaristo , Sánchez‐Antolín Gloria , Rodrigo Juan , Espinosa María Dolores
Published: April 2015

The aim of this study was to evaluate the impact of a steroid‐free regimen with tacrolimus and mycophenolate mofetil (modified therapy) vs. a standard regimen of tacrolimus and steroids on the cardiovascular risk score of liver transplant recipients. Patients who received a liver transplant were randomized to a modified therapy (n = 58) or a standard regimen (n = 59). Both groups were balanced at baseline, except for a higher prevalence of diabetes mellitus (DM) (p < 0.01) and a higher serum creatinine concentration (p < 0.05) in the modified therapy group. After 12 months, the prevalence of new‐onset DM, arterial hypertension, hypercholesterolemia, hypertriglyceridemia, and changes in cardiovascular risk factors was similar in both groups. The increase in serum creatinine (mg/dL) compared to baseline at one yr post‐transplantation was numerically lower in the modified therapy group (0.22 ± 0.42) than in the standard regimen group (0.41 ± 0.67) (p = 0.068). Although estimated cardiovascular risk score did not vary significantly compared to baseline in either group, there was a slight reduction in the modified regimen (−0.27 ± 2.87) vs. a mild increase (0.17 ± 2.94) in the standard regimen (p = 0.566). In conclusion, a steroid‐free regimen with tacrolimus and mycophenolate mofetil was associated with a trend toward better preservation of kidney function and reduction of cardiovascular risk score.
Variation in kinematic and spatiotemporal gait parameters by Gross Motor Function Classification System level in children and adolescents with cerebral palsy
Authors: Õunpuu Sylvia , Gorton George , Bagley Anita , Sison‐Williamson Mitell , Hassani Sahar , Johnson Barbara , Oeffinger Donna
Published: April 2015

Aim

The aim of this study was to examine differences in gait kinematics and spatiotemporal parameters in ambulatory children and adolescents with bilateral spastic cerebral palsy (BSCP) among Gross Motor Function Classification System (GMFCS) levels I‐III.

Method

A retrospective review was conducted of individuals with BSCP who had three‐dimensional motion analysis (3DGA) at one of seven pediatric hospitals. Means and standard deviations of each gait parameter were stratified by GMFCS levels (I‐III) and for a typically developing comparison group.

Results

Data from 292 children and adolescents with BSCP (189 males, 103 females; mean age 13y) were compared to a typically developing comparison group (24 male, 26 female; mean age 10y 6mo). Gait patterns differed from typically developing in all GMFCS levels, with increasing deviation as GMFCS level increased in 21 out of 28 parameters. Despite significant differences in selected mean kinematic parameters among GMFCS levels such as knee angle at initial contact of 24°, 29°, and 41° in GMFCS levels I, II and III respectively, there was also substantial overlap among GMFCS levels.

Interpretation

GMFCS levels cannot be identified using specific gait kinematics. Treatment decisions should be guided by comprehensive 3DGA that allows measurement of gait impairments at the joint level for each individual.
Inhibiting or antagonizing glucagon: making progress in diabetes care
Authors: Lefèbvre P. J. , Paquot N. , Scheen A. J.
Published: April 2015

Absolute or relative hyperglucagonaemia has been recognized for years in all experimental or clinical forms of diabetes. It has been suggested that excess secretion of glucagon by the islet α cells is a direct consequence of intra‐islet insulin secretory defects. Recent studies have shown that knockout of the glucagon receptor or administration of a monoclonal specific glucagon receptor antibody make insulin‐deficient type 1 diabetic rodents thrive without insulin. These observations suggest that glucagon plays an essential role in the pathophysiology of diabetes and that targeting the α cell and glucagon are innovative approaches in the management of diabetes. Despite active research and identification of promising compounds, no one selective glucagon antagonist is presently used in the treatment of diabetes. Interestingly, besides insulin, several drugs used today in the management of diabetes appear to exert their effects, in part, by inhibiting glucagon secretion (glucagon‐like peptide‐1 receptor agonists, dipeptidyl peptidase‐4 inhibitors, α‐glucosidase inhibitors and, possibly, sulphonylureas) or glucagon action (metformin). The potential risks associated with total glucagon suppression include α‐cell hyperplasia, increased mass of the pancreas, increased susceptibility to hepatosteatosis and hepatocellular injury and increased risk of hypoglycaemia, and these should be considered in the search and development of new compounds reducing glucagon receptor signalling. More than 40 years after its initial description, hyperglucagonaemia in diabetes can no longer be ignored or minimized, and its correction represents an attractive way to improve diabetes management.
Range and niche shifts in response to past climate change in the desert horned lizardPhrynosoma platyrhinos
Authors: Jezkova Tereza , Jaeger Jef R. , Oláh‐Hemmings Viktória , Jones K. Bruce , Lara‐Resendiz Rafael A. , Mulcahy Daniel G. , Riddle Brett R.
Published: April 2015

During climate change, species are often assumed to shift their geographic distributions (geographic ranges) in order to track environmental conditions – niches – to which they are adapted. Recent work, however, suggests that the niches do not always remain conserved during climate change but shift instead, allowing populations to persist in place or expand into new areas. We assessed the extent of range and niche shifts in response to the warming climate after the Last Glacial Maximum (LGM) in the desert horned lizardPhrynosoma platyrhinos, a species occupying the western deserts of North America. We used a phylogeographic approach with mitochondrial DNA sequences to approximate the species range during the LGM by identifying populations that exhibit a genetic signal of population stability versus those that exhibit a signal of a recent (likely post‐LGM) geographic expansion. We then compared the climatic niche that the species occupies today with the niche it occupied during the LGM using two models of simulated LGM climate. The genetic analyses indicated thatP. platyrhinospersisted within the southern Mojave and Sonoran deserts throughout the latest glacial period and expanded from these deserts northwards, into the western and eastern Great Basin, after the LGM. The climatic niche comparisons revealed thatP. platyrhinosexpanded its climatic niche after the LGM towards novel, warmer and drier climates that allowed it to persist within the southern deserts. Simultaneously, the species shifted its climatic niche towards greater temperature and precipitation fluctuations after the LGM. We concluded that climatic changes at the end of the LGM promoted both range and niche shifts in this lizard. The mechanism that allowed the species to shift its niche remains unknown, but phenotypic plasticity likely contributes to the species ability to adjust to climate change.
Fine‐scale coexistence patterns along a productivity gradient in wet meadows: shifts from trait convergence to divergence
Authors: Mudrák Ondřej , Janeček Štěpán , Götzenberger Lars , Mason Norman W. H. , Horník Jan , de Castro Indra , Doležal Jiří , Klimešová Jitka , de Bello Francesco
Published: April 2015

Semi‐natural meadows host a great number of species coexisting at fine spatial scales. Different assembly mechanisms, related to differences in functional traits between species, can influence such coexistence. Coexisting species could be either functionally dissimilar to occupy different niches (‘divergence’) or functionally similar due to exclusion of species with traits less adapted to the prevailing abiotic and biotic conditions (‘convergence’). Various theories differently predict how trait convergence and divergence should differ due to disturbance, along productivity gradients, and across different functional traits. We tested such theories in 21 wet meadows of different productivity in central Europe. In each meadow, four 1 × 1 m plots were established in which disturbance by mowing was combined with fertilization. Species presence was recorded in 100 quadrats 10 × 10 cm in size within the plots over five years. Convergence and divergence were assessed at very fine spatial scales (10 × 10 cm) to focus on the processes driven by the interactions for similar resources. Convergence emerged as the dominant pattern for all traits and across all years. It was particularly strong in the least productive conditions while divergence emerged in some of the most productive meadows. Mowing increased convergence in meadows with low productivity, but increased divergence in productive meadows. Fertilization generally increased convergence, with this increase being more pronounced in mown plots. Convergence in unproductive conditions could be caused by either higher fitness of stress‐tolerant species (more abundant in the species pool of these sites) or by functionally similar species sharing similar patches within fine‐scale heterogeneous plots. This outcome also suggests abiotic filters can have an important role at fine scales, where plant‐ecological theory usually predicts the prevalence of biotic processes.
‘People form their own support systems – like forming their own families’: the role of parents and friends in the first year at dental school
Authors: McMillan W.
Published: April 2015

Most students experience the transition from school to university as challenging. Students from backgrounds with little or no experience of higher education are most vulnerable in the transition, and most at risk of academic failure or early departure. This study examined the role that parents and friends play in the transition to university and in the first academic year. The study examines the mechanisms of this support so as to understand the ways in which support is provided. It examines whether – and if so, how – support mechanisms differed for first‐generation students and those with family familiarity of university. Data were collected through focus group and individual interviews with dentistry students in their first and second academic years at a Faculty of Dentistry in South Africa. Concepts from psychology literature – attachment and friendship quality – provided the analytical framework. Findings from the study suggest that the social relationships which students have access to during the transition and the first academic year have the potential to provide emotional resources which ease transition and practical information about appropriate ways of being and doing at university. First‐generation university students are less likely to have access to the latter because their parents have no experience of university. The study concludes with suggestions for ways in which universities and their teachers might provide support for all first‐year students.
The classic P300 encodes a build‐to‐threshold decision variable
Authors: Twomey Deirdre M. , Murphy Peter R. , Kelly Simon P. , O'Connell Redmond G.
Published: April 2015

The P300 component of the human event‐related potential has been the subject of intensive experimental investigation across a five‐decade period, owing to its apparent relevance to a wide range of cognitive functions and its sensitivity to numerous brain disorders, yet its exact contribution to cognition remains unresolved. Here, we carry out key analyses of the P300 elicited by transient auditory and visual targets to examine its potential role as a ‘decision variable’ signal that accumulates evidence to a decision bound. Consistent with the latter, we find that the P300 reaches a stereotyped amplitude immediately prior to response execution and that its rate of rise scales with target detection difficulty and accounts for trial‐to‐trial variance in RT. Computational simulations of an accumulation‐to‐bound decision process faithfully captured P300 dynamics when its parameters were set by model fits to the RT distributions. Thus, where the dominant explanatory accounts have conceived of the P300 as a unitary neural event, our data reveal it to be a dynamically evolving neural signature of decision formation. These findings place the P300 at the heart of a mechanistically principled framework for understanding decision‐making in both the typical and atypical human brain.
Wildfire‐induced alterations of topsoil organic matter and their recovery in Mediterranean eucalypt stands detected with biogeochemical markers
Authors: Faria S. R. , De La Rosa J. M. , Knicker H. , González‐Pérez J. A. , Villaverde J. , Keizer J. J.
Published: April 2015

This study addressed fire‐induced changes in topsoil organic matter (SOM) from a eucalypt plantation in Portugal over 2 years by using three complementary biogeochemical techniques: elemental analysis, analysis of biomarkers from the total extractable lipids (TLE) and solid state 13C nuclear magnetic resonance (NMR) spectroscopy. Direct wildfire effects included a marked decrease in soil total organic carbon (TOC) and total nitrogen (TN) content. However, both contents seem to have recovered during the 2 years. Fire also substantially reduced the TLE, producing noticeable changes in its composition. These included the thermal breakdown and cracking of n‐alkyl compounds. Ratios of short‐to‐long n‐alkanes and n‐fatty acid methyl esters (FAMEs) increased and typical carbon number predominance indices for n‐alkanes (odd‐to‐even) and n‐FAMEs (even‐to‐odd) were altered. Furthermore, the relative abundances of certain markers that are plant‐species specific were modified, especially by decreasing terpenoids such as epiglobulol, ledol and globulol, which are characteristic of Eucalyptus globulus. Other differences observed in the burnt soil were the appearance of levoglucosan, a typical marker for the thermal alteration of polysaccharides, larger relative abundances of lignin‐derived compounds (vanillin and methoxyphenols) and the presence of N‐heteroaromatic structures, which suggested the accumulation of ‘black nitrogen’. The 13C NMR spectra indicated that the wildfire produced a considerable increase in the aromaticity and aromatic condensation of the topsoil SOM. This was reflected in a broadening of the signal of aromatic compounds at the expense of O‐alkyl and alkyl‐C compounds. The continuation of these differences in SOM quality during the 2‐year study suggested a slow recovery of soil properties, possibly influenced by a limited recovery of the vegetation after the fire combined with the fire‐enhanced losses of soil.
Descriptive epidemiology of epilepsy in the U.S. population: A different approach
Authors: Helmers Sandra L. , Thurman David J. , Durgin Tracy L. , Pai Akshatha Kalsanka , Faught Edward
Published: April 2015

Objective

Determine prevalence and incidence of epilepsy within two health insurance claims databases representing large sectors of the U.S. population.

Methods

A retrospective observational analysis using Commercial Claims and Medicare (CC&M) Supplemental and Medicaid insurance claims data between January 1, 2007 and December 31, 2011. Over 20 million continuously enrolled lives of all ages were included. Our definition of a prevalent case of epilepsy was based on International Classification of Diseases, Ninth Revision, Clinical Modification–coded diagnoses of epilepsy or seizures and evidence of prescribed antiepileptic drugs. Incident cases were identified among prevalent cases continuously enrolled for ≥2 years before the year of incidence determination with no epilepsy, seizure diagnoses, or antiepileptic drug prescriptions recorded.

Results

During 2010 and 2011, overall age‐adjusted prevalence estimate, combining weighted estimates from all datasets, was 8.5 cases of epilepsy/1,000 population. With evaluation of CC&M and Medicaid data separately, age‐adjusted prevalence estimates were 5.0 and 34.3/1,000 population, respectively, for the same period. The overall age‐adjusted incidence estimate for 2011, combining weighted estimates from all datasets, was 79.1/100,000 population. Age‐adjusted incidence estimates from CC&M and Medicaid data were 64.5 and 182.7/100,000 enrollees, respectively. Incidence data should be interpreted with caution due to possible misclassification of some prevalent cases.

Significance

The large number of patients identified as having epilepsy is statistically robust and provides a credible estimate of the prevalence of epilepsy. Our study draws from multiple U.S. population sectors, making it reasonably representative of the U.S.‐insured population.
Advanced hair damage model from ultra‐violet radiation in the presence of copper
Authors: Marsh J. M. , Davis M. G. , Flagler M. J. , Sun Y. , Chaudhary T. , Mamak M. , McComb D. W. , Williams R. E. A. , Greis K. D. , Rubio L. , Coderch L.
Published: April 2015

Synopsis

Objective

Damage to hair from UV exposure has been well reported in the literature and is known to be a highly complex process involving initiation via absorption of UV light followed by formation and propagation of reactive oxygen species (ROS). The objective of this work was to understand these mechanisms, explain the role of copper in accelerating the formation of ROS and identify strategies to reduce the hair damage caused by these reactive species.

Methods

The location of copper in hair was measured by Transmission electron microscopy–(TEM) X‐ray energy dispersive spectroscopy (XEDS) and levels measured by ICP‐OES. Protein changes were measured as total protein loss via the Lowry assay, and MALDI ToF was used to identify the biomarker protein fragments. TBARS assay was used to measure lipid peroxide formation. Sensory methods and dry combing friction were used to measure hair damage due to copper and UV exposure and to demonstrate the efficacy of N,N' ethylenediamine disuccinic acid (EDDS) and histidine chelants to reduce this damage.

Results

In this work, a biomarker protein fragment formed during UV exposure is identified using mass spectrometry. This fragment originates from the calcium‐binding protein S100A3. Also shown is the accelerated formation of this peptide fragment in hair containing low levels of copper absorbed from hair during washing with tap water containing copper ions. Transmission electron microscopy (TEM) X‐ray energy dispersive spectroscopy (XEDS) studies indicate copper is located in the sulphur‐poor endo‐cuticle region, a region where the S100A3 protein is concentrated. A mechanism for formation of this peptide fragment is proposed in addition to the possible role of lipids in UV oxidation. A shampoo and conditioner containing chelants (EDDS in shampoo and histidine in conditioner) is shown to reduce copper uptake from tap water and reduce protein loss and formation of S100A3 protein fragment. In addition, the long‐term consequences of UV oxidation and additional damage induced by copper are illustrated in a four‐month wear study where hair was treated with a consumer relevant protocol of hair colouring treatments, UV exposure and regular shampoo and conditioning.

Conclusions

The role of copper in accelerating UV damage to hair has been demonstrated as well as the ability of chelants such as EDDS and histidine in shampoo and conditioner products to reduce this damage.
Critical limits for urgent clinician notification at South African intensive care units
Authors: Schapkaitz E. , Levy B.
Published: April 2015

Background

Critical value policies are used by clinical laboratories to decide when to notify caregivers of life‐threatening results. There, however, remains much debate regarding which tests should be included in critical value lists and clinically relevant limits.

Method

An electronic survey was designed to determine the critical value policies of specialists for haematology tests in South African intensive care units. Data collected included a demographic component, critical value policies and critical value reporting.

Results

There were 68 respondents who represented a range of specialists from different disciplines. Four key critical values were identified, namely white cell count (WCC), haemoglobin, platelet count and international normalised ratio (INR). Median low and high adult and paediatric critical limits for the most frequently listed tests were as follows: haemoglobin <7 and >20 g/dL, platelet count <50 and >1000 × 109/L, WCC < 2 and >20 × 109/L and INR > 4. Specific critical limits for neonates were reported by 20 of the respondents. Of the respondents, 95.92% indicated that it was important to be contacted with first‐time critical results and approximately half for repeat critical values. The majority preferred that the person notified of the critical value be the caregiver directly involved with the patient's care.

Conclusion

It is important for critical value policies to be reviewed by each discipline to ensure cut‐offs are clinically relevant.
MEDICAL DIAGNOSES IN ONE THOUSAND DOMICILED VETERANS
Authors: ANDERSON RICHARD J. , PRICE A. COOPER , HARRINGTON L. GARTH
Published: April 2015

This report concerns 1,000 veterans domiciled in the Veterans Administration Facility at Biloxi, Mississippi. Domiciliary facilities provide care for veterans who are disabled and in need of attention, and represent neither a custodial “old soldiers' home” nor a hospital for acute treatment. A series of research studies by the staff of the Psychology Service (1, 2) has shown the relationships of factors like alcoholism and previous education to various aspects of this domiciliary situation. The present study attempts to correlate the medical diagnoses with the type of patients involved, and to evaluate the resulting implications.
HUMANIZING INSTITUTIONAL CARE FOR THE AGED
Authors: SAVITZ HARRY A.
Published: April 2015

“Thou shalt rise up before the hoary head, and honour the face of the old man” (Leviticus 19: 32.)
DISTINGUISHING CHARACTERISTICS OF THE AGING FROM A CLINICAL VIEWPOINT*
Authors: FORD AMASA B.
Published: April 2015

DR. LORENZE: Our next speaker, who will deal with the topic from a clinical viewpoint, is Dr. Amasa Ford. He is a graduate of Harvard Medical School, Assistant Professor of Medicine at Western Reserve and Clinical Director of The Benjamin Rose Hospital in Cleveland.
DISTINGUISHING CHARACTERISTICS OF THE AGING FROM A MEDICAL EDUCATION VIEWPOINT*
Authors: READER GEORGE G.
Published: April 2015

DR. LORENZE: Our fourth and last presentation this morning will be from a medical education point of view. Dr. George Reader, who has arranged this entire program, will present the paper. Dr. Reader is a Professor of Medicine at Cornell University College of Medicine, New York.
PROBLEMS AND PROGRESS IN GERIATRICS*
Authors: STRAUS BERNARD
Published: April 2015

The problems of old age demand better attempts at solution. Some factors to be considered are: the difference between chronological and biological aging; the multiplicity, duplicity and chronicity of the diseases associated with old age (the law of geriatrics); the high incidence of drug reactions among elderly patients; and the possibility of overlooking acute illnesses in old people. Examples are given. Some recent advances in the treatment of disorders of carbohydrate, lipid and uric acid metabolism, and of the cardiovascular, renal and musculoskeletal systems are outlined. However, injudicious neglect is a continuing danger to the older patient, and calls for further efforts in research and its applications, with increasing emphasis on the holistic approach to therapeutic management.
MYCOPLASMAS (PPLO) AND DISEASE: SERUM ANTIBODY TITERS IN A HOSPITAL POPULATION OF ELDERLY PATIENTS
Authors: COLEMAN SYLVIA E. , COLE MILTON B. , ROBERTS FRANCES E. , McGAUGHEY FAY S.
Published: April 2015

In a random sample of sera from a predominantly male group of hospital patients with an average age of 67, complement‐fixing antibodies were found in 20 per cent to M. hominis type 1, in 16 per cent to Unknown Strain CE 5, in 1 per cent to M. pharyngis and in 2 per cent to M. pneumoniae.

These percentages are lower than those reported in the literature for younger populations of patients. Thus the immunological experience with mycoplasmas (pleuropneumonia‐like organisms) varies from one population to another. In general, however, the incidence of mycoplasmal infection seems to be lower in older than in younger populations.

The findings also indicate that the mere isolation of these organisms from the sera of patients who manifest a disease process does not constitute evidence of an etiological relationship unless other correlates can be established.
NEUROMUSCULAR SYNDROMES ASSOCIATED WITH CARCINOMA
Authors: Siddiqui N. H.
Published: April 2015

Abstract

The nonmetastatic neurological and neuromuscular syndromes associated with carcinoma are reviewed under the classifications of encephalopathies (multiple and diffuse), myelopathies (chronic and subacute necrotic), neuropathies (sensory and peripheral sensorimotor) and muscular disorders (polymyopathy, myasthenic‐myopathic syndrome, myasthenia gravis, polymyositis and dermatomyositis). Little is known about the etiology of these syndromes, but auto‐immune reaction, virus infections and nutritional disorders have been suggested as factors.
LOCAL ANESTHESIA FOR GASTRIC SURGERY IN AGED PATIENTS
Authors: Murphy John W. , Riu Ramon , Ponka Joseph L.
Published: April 2015

Abstract

Case reports are presented on 3 surgical‐emergency patients (age range, 79–81 years) in whom the risk of general anesthesia was considered excessive. Local anesthesia was used in the performance of a gastric resection, gastro‐jejunostomy and tube‐gastrostomy respectively. Each patient made a good recovery after operation.

Surgeons and other physicians dealing with the elderly should not forget local anethesia when considering major surgical procedures in certain seriously ill aged patients.
USE OF ISOTOPES FOR DEMONSTRATION OF LESIONS IN JOINTS AND BONES AS AN AID IN DIFFERENTIAL DIAGNOSIS
Authors: STRASSER NOEL F. , THRIFT CHESTER B.
Published: April 2015

Abstract: Scintillation scans of the joints were obtained after intravenous injection of radioiodine in patients with rheumatoid arthritis, lupus, scleroderma, gout and osteoarthritis. Distinct radioactivity (correlated with the severity of the disorder) was observed in the first four diseases, but not in osteoarthritis.

In a 72‐year‐old man with prostatic carcinoma and back pain, x‐ray examination of the lumbar region failed to reveal metastases, whereas they were indicated by strontium85 scanning of that area and confirmed at autopsy.

Thus scintillation scanning after the injection of a suitable isotope can be of value in differential diagnosis and in estimating the severity of disease. However, the scan must always be interpreted in the light of the clinical situation.
SYNOVIAL FLUID: DIAGNOSTIC FEATURES AND METHODS FOR EXAMINATION
Authors: SCHMID FRANK R.
Published: April 2015

Abstract: The functions of synovial membrane and synovial fluid are described, as well as the changes that occur during inflammation, particularly in gout and rheumatoid arthritis. Methods for examination of the synovial fluid are given in detail, involving the gross appearance of the fluid, the collection of the specimen, the cytology, fibrin clot formation, mucin clot formation, viscosity, detection of crystals, and simultaneous determination of blood and synovial fluid glucose. Interpretations are discussed.

A fairly complete examination of synovial fluid is possible with a minimum of equipment and within a reasonable time. The significance of the findings outweighs the effort of the analysis. Proper interpretation of synovianalysis will greatly aid in diagnosis, offer some insight concerning prognosis, provide a measure of the therapeutic response and add to understanding of the pathogenesis of synovial‐tissue inflammation.
THE ROLE OF SURGERY IN TREATMENT OF ARTHRITIS OF THE HIP
Authors: STEVENS JACK
Published: April 2015

Abstract: Osteoarthritis and rheumatoid arthritis of the hip are each discussed with regard to clinical considerations, radiographic findings, and available operative procedures.

While search continues for an entirely satisfactory hip arthroplasty operation, the careful selection of the appropriate available procedure can be of great benefit to the arthritic patient. Osteotomy, arthroplasty and arthrodesis have fully proved their worth.

For patients with rheumatoid arthritis, selection is the more important and difficulties arise from a lack of the same extensive background of clinical experience against which to review a particular patient's clinical state. Increasing interest in this field is manifest, however, and more patients are being helped by surgery than heretofore.

It is worth emphasizing again, the importance of a team approach to the arthritic patient, with participation in the team by a rheumatologist or internist, orthopedic surgeon, physical therapist, occupational therapist, social service worker and vocational rehabilitation counsellor. That there is a pressing need for specialized teams of this sort in modern American medicine is obvious to any who have become involved in the field to anything more than a superficial degree.
OTORHINOLARYNGOLOGIC ASPECTS OF RHEUMATOID DISEASE
Authors: LEDERER FRANCIS L. , MER S. BRUCE
Published: April 2015

Abstract. Several otorhinolaryngologic aspects of rheumatoid diseases are pointed out. With regard to rheumatic fever and rheumatoid arthritis, the removal of tonsils or other foci of infection will not alter the course of the disease or prevent recurrence. Arthritis of the cricoarytenoid joint may progress to the point of acute respiratory distress and even death. Such antirheumatic drugs as salicylates, phenylbutazone and gold salts have certain otologic and oral toxic effects. Salicylate‐induced hearing loss is usually reversible. Salicylate hypersensitivity should be kept in mind. Other diseases that produce symptoms referable to the head and neck are discussed.
LIFE HISTORY OF THE STROKE SYNDROME
Authors: MILLER MICHAEL B.
Published: April 2015

Abstract: A case report is given to illustrate the combination of minor and major strokes in one life history. Recovery of function, prognosis and mortality rates are discussed, with inclusion of data from some of the better reports in the literature.

The clinical life history of the stroke syndrome and meaningful studies on prognosis are almost impossible to carry out completely in general medical practice, in community hospitals, or in specialized rehabilitation centers as currently constituted. When criteria for admission to health‐care facilities exclude patients with any degree of organic brain syndrome as being “poor risks” or having “poor rehabilitation potential,” this obviously results in biased studies.

Since patients with cerebral infarcts and organic brain syndrome comprise an important segment of the stroke problem, their inclusion in clinical studies dealing with stroke rehabilitation and prognosis is mandatory. All facilities in which the stroke patient may be domiciled, proprietary or voluntary, short‐term and/or long‐term, should be brought into the mainstream of medical knowledge if significant studies of the physical, psychiatric and social problems of stroke patients are to be evaluated properly.

A standardized nomenclature for the various syndromes of cerebral ischemia is long overdue.

We still need a much more complete understanding of this age‐old phenomenon.
EMOTIONAL CORRELATES OF ANGINA PECTORIS
Authors: Wendkos Martin H. , Wolff Kurt
Published: April 2015

Abstract

An analysis of the personality traits of 13 patients with proven angina pectoris and 7 patients with authentic rheumatic heart disease but no angina showed that, psychodynamically, there were significant differences between the two groups. The features which characterized the anginal patients included compulsiveness, repressed hostility, unfulfilled oral needs and a strong superego. In contrast, the non‐anginal patients with rheumatic heart disease were passive, non‐hostile persons whose oral needs seem to have been adequately fulfilled. Such factors should be carefully considered in designing a therapeutic program for the rehabilitation of patients with angina pectoris.
MORTALITY FROM MYOCARDIAL INFARCTION BEFORE AND AFTER ESTABLISHMENT OF A CORONARY CARE UNIT
Authors: Fagin I. Donald , Rajagopal R.
Published: April 2015

Abstract

In a study involving 657 patients, a retrospective comparison was made of the mortality rates for myocardial infarction during respective one‐year periods, before and after the establishment of a coronary care unit in the hospital. No significant changes were observed.

The mortality rates for patients with myocardial infarction admitted to the coronary care unit for the initial portion of their hospital stay were not significantly different from the mortality rates for patients admitted directly to the general medical service during the same year.

Salvage of cardiac‐arrest patients in the coronary care unit was much higher than in the general medical wards. This factor alone would justify the establishment of these special units.