bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of elevated serum alcohol level on the outcome of severely injured patients
Authors: Scheyerer Max J , Dütschler Joel , Billeter Adrian , Zimmermann Stefan M , Sprengel Kai , Werner Clement M L , Simmen Hans-Peter , Wanner Guido A
Published: July 2013

Background

The influence of high blood alcohol level (BAL) on the outcome of severely injured patients and the corresponding pathophysiological changes is a controversial issue.

Objective

To carry out a prognostic study to compare the physiological values and short-term outcome of severely injured patients depending on their serum alcohol level.

Methods

A total of 383 severely injured patients with an Injury Severity Score (ISS) ≥17 were admitted to the trauma division between October 2008 and December 2009 and enrolled into this study. Patients were grouped according to their BAL (>0.5‰,‘BAL positive’ vs <0.5‰,‘BAL negative’). Trauma mechanism, pattern of injury and its treatment, and a course of intensive care treatment, physiological parameters and outcome with respect to mortality were analysed.

Results

Both groups had similar ISS. In comparison with the BAL-negative group, patients in the BAL-positive group had a significantly lower Glasgow Coma Scale score (9.64 vs 12 points; p=0.005) and, although not significant, a trend towards higher values of the Abbreviated Injury Score for the head (3.29 vs 2.81 points; p=0.146). Furthermore, significantly higher lactate (3.11 mmol/L vs 2.02 mmol/L; p<0.001) levels and lower median arterial pressure values (87.9 mm Hg vs 99.4 mm Hg; p=0.006) were seen in the BAL-positive group at day of admission. However, the overall in-hospital mortality was comparable to that in BAL-negative patients (19.6% vs 21.5%). Similarly, hospital stay (15.29 vs 17.55 days) and duration of intensive care unit treatment (8.53 vs 8.36 days) were not significantly affected by a high BAL upon admission.

Conclusions

Severely injured patients with a raised BAL have a higher incidence of severe traumatic brain injury and worse initial physiological parameters. However, the survival rate and in-hospital stay is not influenced. This supports the theory of a neuroprotective role of alcohol.
E-052 Ear Arteriovenous Malformation Management
Authors: Yakes W
Published: July 2013

Objective

To determine the efficacy of Ethanol Endovascular Repair of Ear Arteriovenous Malformation (AVMs).

Methods

Ten patients (7 female, 3 males; age range 6–39 years; mean age: 22 years) with ear AVMs presented for therapy. Two patients had failed prior embolisations (PVA/coils/nBCA/steroids) and 2 patients had other therapies (laser/excisions/grafting). All presented with grossly enlarged painful ear with intermittent bleeding. All patients underwent transcatheter direct puncture ethanol Rx (86 procedures).

Results

All 10 patients were cured of the AVM at long-term follow-up (mean follow-up: 52 months). One patient had transient partial VII nerve palsy. Two patients had minor blisters and ear injuries.

Conclusions

Ethanol endovascular repair of Ear AVMs can effect cures in this vexing lesion that previously was treated with resection of the ear and high recurrence rates. This series documents long-term cures of AVMs of the ear and scalp. Only one publication on ethanol curative treatment of Ear AVMs (AJNR 2009; Oct; 30 (9):1679–84) exists in the world’s literature to whom I taught this technique. Their curative experience duplicates my experience. No recurrences occurred in my patient series as well.

Disclosures

W. Yakes: None.
E-054 Mandibular AVM Diagnosis and Curative Treatment
Authors: Yakes W
Published: July 2013

Purpose

To determine optimal management strategies for the treatment of mandibular AVM.

Materials and Methods

Twelve patients (9 females, 3 males), age 9–14; mean age 10, underwent endovascular therapy to treat their mandibular AVMs. Nine patients had distinct intraosseous AVMs. Three had multiple facial and intra-maxillary AVMs requiring treatment. Outside institutions recommended massive hemifacial resections in these patients. Four patients had prior PVA and gel foam embolisation, one patient had a lip graft, one had prior mandible surgery, all that had failed.

Results

All twelve patients have demonstrated MR and angiographic cure of their AVMs. One patient’s therapy is not completed and is on-going. The follow-up is 11 months-41 months, with a mean follow-up of 29 months. No complications were noted.

Conclusions

Endovascular approaches to manage mandibular AVM can be curative. The intraosseous variety is largely a fistula between artery and vein within the bone. All respond well to endovascular ethanol therapy alone. Surgery was not required in any patient. Surprisingly, no complications were encountered in this patient series. Long-term cures are noted in this patient series with endovascular approaches alone. No massive surgical resections in any patient, even in patients with multiple AVMs of the soft tissues, mandible and maxilla, were required to effect cures.

Disclosures

W. Yakes: None.
E-059 Seizure prophylaxis in aneurysmal subarachnoid haemorrhage: a survey of leading cerebrovascular centres
Authors: Dewan M , Mocco J
Published: July 2013

Introduction

Seizure in the days following subarachnoid haemorrhage occurs in 6–18% of patients with a ruptured intracranial aneurysm. Not only may seizure confound the neurologic exam, but it may also place patients with an unsecured lesion at increased risk for re-rupture. Seizure prophylaxis in this patient population is controversial, and there remains no level I data regarding the effectiveness of seizure prophylaxis after subarachnoid haemorrhage.

Methods

A brief 8-question survey was sent to 20 major US centres with cerebrovascular neurosurgical specialisation. Respondents were asked about institutional practices regarding seizure prophylaxis, including preferred medications and duration of therapy, as well as seizure surveillance with electroencephalography.

Results

All 20 survey requests were completed and returned. 10 respondents (50%) reported routine use of anti-convulsant for seizure prophylaxis, while 10 (50%) did not. Among respondents using prophylaxis, levetiracetam was the drug of choice for most (80%), while phenytoin was used to a varying degree by two centres. The duration of levetiracetam prophylaxis ranged from 1–30 days following SAH. No centres employed EEG routinely, however most supported EEG use when the neurologic exam was unreliable or inexplicably declining. Nineteen (95%) respondents agreed that a trial randomising patients to levetiracetam or no anti-seizure medication is warranted at this time, and all 20 (100%) believed that such a trial would be ethical.

Conclusions

The routine use of seizure prophylaxis following aneurysmal subarachnoid haemorrhage is controversial. Among a sampling of 20 major academic centres, one half administers seizure prophylaxis, while the other half does not. The majority believes a trial randomising patients to receive seizure prophylaxis is both timely and ethical.

Disclosures

M. Dewan: None. J. Mocco: None.
E-073 Transarterial Venous Sinus Occlusion for Cranial Dural Arteriovenous Fistulas
Authors: Rabinov J , Yoo A , Leslie-Mazwi T , Ogilvy C , Hirsch J
Published: July 2013

Purpose

To present trans-arterial venous sinus occlusion technique for dural arteriovenous fistulas of the transverse and sigmoid sinuses.

Materials and Methods

Nine cases of dural arteriovenous sinus fistula of the transverse and sigmoid sinuses were treated with trans-arterial closure of the arterial supply and the venous sinus using ethylene vinyl alcohol copolymer (ONYX). Five patients were male and four were female. Age range was30–73. Patients presented with stroke, intracranial haemorrhage, seizure, headache or memory changes. Six patients had patent sinuses and three patients had fistulas involving isolated sinus segments which were Cognard IIa + b and Cognard IIb respectively. Criteria for selection for this treatment included complex multi-hole fistulas involving a broad surface of the sinus. External carotid artery branches could be directly embolised when considered safe. High risk arterial supply from ICA parenchymal vessels of the brain or ECA cranial nerve were embolised via retrograde collaterals. The affected venous sinus was a non-dominant or co-dominant sinus. Vein of Labbe had to be spared.

Results

ONYX embolisation DAVF closure was accomplished in all nine patients with a total of 15 embolisation procedures. No cranial nerve neuropathies or strokes occurred related to arterial embolisation. No patients incurred strokes related to the venous sinus embolisation. DAVF closure was found to be durable at three months in eight patients with one patient pending follow up.

Conclusion

Trans-arterial closure of transverse and sigmoid sinus provides an alternative to venous sinus coil occlusion, surgical skeletonization or radiosurgery. High risk arterial collaterals can be closed via artery-artery or artery-sinus-artery embolisation. In this small cohort, closure of dural AV fistulas was durable at three months with low complication rates.

Disclosures

J. Rabinov: None. A. Yoo: None. T. Leslie-Mazwi: None. C. Ogilvy: None. J. Hirsch: None.
E-001 Update on the PISTE trial (Pragmatic Ischaemic Stroke Thrombectomy Evaluation)
Authors: White P , Muir K , Ford G , Brown M , Clifton A
Published: July 2013

Background

The KEY current clinical question in acute stroke management is whether a treatment policy of modern intra-arterial thrombectomy (IAT) added to IV thrombolysis (IVT) improve clinical outcomes over IVT alone. If the answer is yes and it applies to most patients with large vessel occlusive stroke, then the implications for acute stroke care and health services are enormous.

Methods

PISTE is a UK based prospective, randomised controlled multicentre parallel group trial (PROBE design) of adjunctive modern mechanical thrombectomy (stentrievers with use of conscious sedation where possible) compared with intravenous thrombolysis in patients with acute ischaemic stroke due to an occluded anterior circulation major intracranial vessel. Concealed allocation. Funded by grant from the Stroke Association with some support from industry. Angiographic secondary outcomes will be blinded to allocation and independently adjudicated.

Abstract E-001 Table 1Primary outcomemRS 0–2 versus 3–6 at 3mSecondary outcomes24h Recanalisation rate Early major neurological improvement (8 points NIHSS) Days at home by 90 daysFull recovery (mRS 0–1)Safety outcomesSICH (ECASS 2)24–48h MortalityAny ICH Extracranial bleeding

Results

This is a RCT in active recruitment phase but information on progress to date and aggregated cohort recruited will be presented.

The pre-planned PRISMA compliant meta-analysis of ongoing European academic IAT trials will be outlined.

Conclusion

Pragmatic treatment policy trials are essential in hyperacute stroke intervention and are feasible within acceptable timeframes.

Disclosures

P. White: 1; C; Covidien, Codman, Microvention, Acandis. 2; C; Microvention, Codman. K. Muir: 1; C; Covidien, Codman, Acandis. G. Ford: None. M. Brown: None. A. Clifton: None.
O-006 Advanced Age Remains a Strong Independent Predictor of Neurologic Outcome Despite Core Infarct Imaging for Patient Selection
Authors: Heck D , Brown M
Published: July 2013

Body Age is a consistent independent predictor of outcome in ischaemic stroke trials. From January 2011 until December of 2012, 85 patients at our institution underwent ischaemic stroke intervention in the anterior circulation in a community based practice at a hospital currently designated as a Comprehensive Stroke Center. All patients were prospectively entered into our ischaemic stroke intervention database. Patients were selected for intervention based on non-invasive imaging confirmation of a large vessel occlusion (LVO) and core infarct imaging, mostly with MRI, and in some cases with CTA/Aspects score. Most patients were treated with mechanical intervention. In 2011, patients were treated preferentially with general anaesthesia, but in 2012 local anaesthesia became the preference. All patients were admitted to a neuroscience intensive care unit staffed by fellowship-trained neurointensivists and received inpatient or outpatient rehabilitation as deemed appropriate. Ninety day MRS was determined on 84 of 85 patients by a practitioner certified in the MRS, with one patient lost to follow-up. The overall mortality at 90 days was 32%. The mortality in patients younger than 75 (n=47) was lower than those 75 or older (n=37) (27% vs 44%). Symptomatic haemmorhagic stroke conversion occurred in 4 patients (5%), 3 over the age of 80 and one 57 year old, and was fatal in all. Good neurologic outcome (MRS 0–2) was obtained in 42% of patients overall, 51% of the younger patients compared with just 29% of the older patients. The baseline NIHSS was just one point lower in the younger group (Mean 16.5 and 17.5, Median 17 and 18, respectively). Revascularisation rates in the younger group were not superior to the older group (TICI 2B or higher 77% and 81%, respectively). There was also no difference in utilisation of general anaesthesia (58% in the younger group and 54% in the older group). In summary, despite the use of advanced imaging to select patients for interventional stroke management, and similar revascularisation rates amongst older and younger patients, age remains a very strong predictor of neurologic outcome. Patients 75 and older had a much higher mortality at 90 days and were much less likely to have a favourable neurologic outcome. These differences may be multifactorial. It is of course possible that an absolute improvement in outcome from stroke intervention can be maintained across the age spectrum, despite overall less favourable outcomes in older patients. Future randomised trials might consider lower age limits than historically utilised to maximise the chance of demonstrating improved outcomes with interventional stroke management.

Disclosures

D. Heck: None. M. Brown: None.
E-040 Initial Multi-Centre Experience with the Penumbra PC 400 Detachable Coil
Authors: Patel A , Moyle H , Chaudry I , Frei D , Bellon R , Huddle D , Baxter B , Quarfordt S , Turner R , Turk A
Published: July 2013

Introduction/Purpose

Aneurysm coil technology has changed considerably since the introduction of the GDC coil. We evaluated our initial clinical experience with a novel 0.020 Penumbra PC 400 coil to determine device safety and acute performance.

Materials and Methods

Between 2/2011 and 9/2012, 133 aneurysms were coiled with Penumbra PC 400 coils; 84 elective and 49 ruptured, at four high volume centres.

Results

Average aneurysm size was 8 mm with 28% PCOM, 43% other ICA locations, 21% ACOM and the remaining Basilar, MCA and Vertebral. 15% of the cases were treated with balloon assisted coiling, 18% were stent assisted coiling, and 4% utilised both balloons and stents. Packing density could be accurately calculated in 97 aneurysms. Average packing density was 38.7%. 32% of the cases achieved an initial Raymond Scale of 1, 24% achieved a Raymond scale of 2, and 43% were Raymond Scale of 3. Almost half (66) of the patients have angiographic follow up at the time of this abstract. Based on the same/better/worse scale, vast majority of aneurysms showed stable or improved angiographic outcomes at 6 months and one year. Thirty-six had improved, 24 remained unchanged and 6 worsened, 0 patients required re-treatment. We experienced a 5% rate of peri-procedural adverse events. 3 (2%) were thromboembolic, all 3 patients were SAH cases, of which 2 had no clinical sequelae. 4 (3%) were aneurysm perforations, 3 with no clinical sequelae, and one SAH H/H grade 4 patient died, resulting in an overall morbidity and mortality of 2 (1.5%). We continue to use the coils and accrue follow up and will update results at the time of the meeting.

Conclusion

The new Penumbra PC 400 coils are unique 0.020 coils that show very high average packing density and long term occlusion rates with a safe profile.

Disclosures

A. Patel: 3; C; Penumbra, Inc. H. Moyle: None. I. Chaudry: 3; C; Penumbra, Inc. D. Frei: 3; C; Penumbra, Inc. R. Bellon: None. D. Huddle: None. B. Baxter: 3; C; Penumbra, Inc. S. Quarfordt: None. R. Turner: None. A. Turk: 3; C; Penumbra, Inc.
E-041 Is there an Interventional Role in Thyrotoxic Crisis?
Authors: Morgan R , Best S , Connor C , Johnson P , Madarang J
Published: July 2013

Learning Objectives

Provide a clinical review of thyrotoxic crisis (thyroid storm).

Review the limited published data currently available on thyroid arterial embolisation as treatment of thyrotoxic crisis.

Provide pictorial anatomic review of thyroid arterial supply.

Present a case of thyrotoxic crisis refractory to medical management and unsuitable for surgical intervention, which underwent thyroid arterial embolisation.

Background

Thyrotoxic crisis is an acute exacerbation of thyrotoxicosis, which can be precipitated by a multitude of causes. It has an overall mortality rate of20–30%, however if treatment is delayed the mortality rate increases up to approximately 75%. Treatment requires vigorous medical management and while thyroidectomy is often necessary, the severity of the exacerbation often makes this patient population poor surgical candidates. A limited number of published case reports demonstrate thyroid arterial embolisation as a treatment options for unstable patients with thyrotoxic crisis. Embolisation is via the bilateral superior and inferior thyroid arteries.

Clinical Findings/Procedure Details

This poster presents will review a case of a 69 year old male with intractable thyrotoxic crisis, despite appropriate medical management. The patient was not a surgical candidate due to prior episodes of cardiac and respiratory arrest secondary to sustained ventricular fibrillation. Given the patient’s overall poor prognosis and lack of treatment options, arterial embolisation of the thyroid was considered. The patient underwent bilateral superior and inferior thyroid artery embolisations using 500 to 700 micron embospheres. Following embolisation there was interval increase in T4 and T3, as previously reported, but no further episodes of sustained ventricular fibrillation occurred and a curative thyroidectomy was performed one week later.

Conclusion

The case report in combination with the limited published data suggests thyroid embolisation may have a role in treatment of nonsurigical refractory thyrotoxic crisis. Further research is needed to determine if thyroid embolisation could help reduce the high mortality rate associated with thyrotoxic crisis.

Disclosures

R. Morgan: None. S. Best: None. C. Connor: None. P. Johnson: None. J. Madarang: None.
Physical activity among preschoolers during indoor and outdoor childcare play periods
Authors: Vanderloo Leigh M. , Tucker Patricia , Johnson Andrew M. , Holmes Jeffrey D.
Published: July 2013

Preschoolers’ (n = 31) physical activity (PA) levels during indoor and outdoor childcare hours were explored using accelerometers. Participants engaged in 0.54 min/h (SD = 0.59) of moderate-to-vigorous PA (MVPA) and 14.42 min/h (SD = 6.78) of total PA (TPA) indoors compared with 5.03 min/h (SD = 4.92) of MVPA and 31.68 min/h (SD = 0.83) of TPA outdoors. Boys and girls engaged in significantly more TPA outdoors; however, only boys demonstrated a significant increase in MVPA outdoors.
Quercetin provides greater cardioprotective effect than its glycoside derivative rutin on isoproterenol-induced cardiac fibrosis in the rat
Authors: Li Min , Jiang Yichuan , Jing Wuhui , Sun Bo , Miao Chunsheng , Ren Liqun
Published: July 2013

Quercetin exhibits numerous pharmacological effects, including the capacity for cardioprotection. This study aimed to investigate whether quercetin or its glycoside derivative rutin has any protective action against isoproterenol (ISO) induced cardiac fibrosis, and investigate the structure–activity relationship. Male Wistar rats were injected subcutaneously with ISO (15 mg·(kg body mass)−1) to induce experimental cardiac fibrosis. The cardioprotective effect of co-treatment with quercetin (25 or 50 mg·kg−1) or rutin (25 or 50 mg·kg−1) was investigated in ISO-induced cardiac fibrosis in rats. The administration of quercetin and rutin signifcantly decreased the cardiac weight index and myocardial enzyme activity, increased the activity of superoxide dismutase in the serum, and inhibited the ISO-induced increase in angiotensin II and aldosterone in the plasma. Furthermore, overexpression of transforming growth factor β1 (TGF-β1), connective tissue growth factor (CTGF), and excessive deposition of extracellular matrix (ECM) in isoproterenol-treated myocardial tissues were normalized by quercetin and rutin. Our results suggest that both quercetin and rutin exhibited cardioprotective effects in cardiac fibrosis induced by ISO in the rat heart. Moreover, the effects of rutin are weaker than quercetin at the same dose. The mechanism of these effects may be related to antioxidative stress, inhibition of the renin–angiotensin–aldosterone system, decrease in the expression of TGF-β1 and CTGF, and the subsequent reduction in the deposition of the ECM.
PUBLIC OPINION FORMATION MODEL BASED ON OPINION ENTROPY
Authors: WU YUE , HU YONG , HE XIAO-HAI
Published: July 2013

In this paper, we introduce the concept of opinion entropy based on Shannon entropy, which is used to describe the uncertainty of opinions. With opinion entropy, we further present a public opinion formation model, and simulate the process of public opinion formation under various controlled conditions. Simulation results on the Holme–Kim network show that the opinion entropy will reduce to zero, and all individuals will hold the opinion of agreeing with the topic, only by adjusting the cons' opinions with a high control intensity. Controlling the individuals with big degree can bring down the opinion entropy in a short time. Besides, extremists do not easily change their opinion entropy. Compared with previous opinion clusters, opinion entropy provides a quantitative measurement for the uncertainty of opinions. Moreover, the model can be helpful for understanding the dynamics of opinion entropy, and controlling the public opinion.
AUTHENTICATION OF FINGERPRINT BIOMETRICS ACQUIRED USING A CELLPHONE CAMERA: A REVIEW
Authors: KHALIL MOHAMMED S. , KURNIAWAN FAJRI , SALEEM KASHIF
Published: July 2013

Over the past decade, there have been dramatic increases in the usage of mobile phones in the world. Currently available smart mobile phones are capable of storing enormous amounts of personal information/data. The smart mobile phone is also capable of connecting to other devices, with the help of different applications. Consequently, with these connections comes the requirement of security to protect personal information. Nowadays, in many applications, a biometric fingerprint recognition system has been embedded as a primary security measure. To enable a biometric fingerprint recognition system in smart mobile phones, without any additional costs, a built-in high performance camera can be utilized. The camera can capture the fingerprint image and generate biometric traits that qualify the biometric fingerprint authentication approach. However, the images acquired by a mobile phone are entirely different from the images obtained by dedicated fingerprint sensors. In this paper, we present the current trend in biometric fingerprint authentication techniques using mobile phones and explore some of the future possibilities in this field.
ABSENCE OF BLACK HOLES INFORMATION PARADOX IN GROUP FIELD COSMOLOGY
Authors: FAIZAL MIR
Published: July 2013

In this paper we will analyze the black hole information paradox in group field cosmology. We will first construct a group field cosmology with third quantized gauge symmetry. Then we will argue that in this group field cosmology the process that changes the topology of spacetime is unitarity process. Thus, the information paradox from this perspective appears only because we are using a second quantized formalism to explain a third quantized process. A similar paradox would also occur if we analyze a second quantized process in first quantized formalism. Hence, we will demonstrate that in reality there is no information paradox but only a breakdown of the second quantized formalism.
DYNAMICS OF A NON-AUTONOMOUS HIV-1 INFECTION MODEL WITH DELAYS
Authors: WANG XIA , LIU SHENGQIANG , SONG XINYU
Published: July 2013

In this paper, following a previous paper ([32] Permanence and extinction of a non-autonomous HIV-1 model with two time delays, preprint) on the permanence and extinction of a delayed non-autonomous HIV-1 within-host model, we introduce and investigate a delayed HIV-1 model including maximum homeostatic proliferation rate of CD4+T-cells and varying coefficients. By applying the asymptotic analysis theory and oscillation theory, we show: (i) the system will be permanent when the threshold value R*> 1, and for this case we also obtain the explicit estimate of the eventual lower bound of the HIV-1 virus load; (ii) the threshold value R* < 1 implies the extinction of the virus. Furthermore, we obtain that the threshold dynamics is in agreement with that of the corresponding autonomous system, which extends the classic results for the system with constant coefficients. Numerical simulations are also given to illustrate our main results, and in particular, some sensitivity test of R*is established.
Adaptive response of vascular endothelial cells to an acute increase in shear stress frequency
Authors: Zhang Ji , Friedman Morton H.
Published: July 2013

Local shear stress sensed by arterial endothelial cells is occasionally altered by changes in global hemodynamic parameters, e.g., heart rate and blood flow rate, as a result of normal physiological events, such as exercise. In a recently study ( 41 ), we demonstrated that during the adaptive response to increased shear magnitude, porcine endothelial cells exhibited an unique phenotype featuring a transient increase in permeability and the upregulation of a set of anti-inflammatory and antioxidative genes. In the present study, we characterize the adaptive response of these cells to an increase in shear frequency, another important hemodynamic parameter with implications in atherogenesis. Endothelial cells were preconditioned by a basal-level sinusoidal shear stress of 15 ± 15 dyn/cm2 at 1 Hz, and the frequency was then elevated to 2 Hz. Endothelial permeability increased slowly after the frequency step-up, but the increase was relatively small. Using microarrays, we identified 37 genes that are sensitive to the frequency step-up. The acute increase in shear frequency upregulates a set of cell-cycle regulation and angiogenesis-related genes. The overall adaptive response to the increased frequency is distinctly different from that to a magnitude step-up. However, consistent with the previous study, our data support the notion that endothelial function during an adaptive response is different than that of fully adapted endothelial cells. Our studies may also provide insights into the beneficial effects of exercise on vascular health: transient increases in frequency may facilitate endothelial repair, whereas similar increases in shear magnitude may keep excessive inflammation and oxidative stress at bay.
Microneurographic evidence in healthy middle-aged humans for a sympathoexcitatory reflex activated by atrial pressure
Authors: Millar Philip J. , Murai Hisayoshi , Morris Beverley L. , Floras John S.
Published: July 2013

Atrial mechanoreceptors, stimulated by increased pressure or volume, elicit in healthy humans a net sympathoinhibitory response. The co-existence of an atrial reflex eliciting muscle sympathoexcitation has been postulated but undetected by conventional multi-unit muscle sympathetic nerve activity (MSNA). We hypothesized that in response to a selective increase in atrial pressure, single-unit MSNA would reveal a subpopulation of efferent sympathetic neurons with firing patterns opposite to the integrated multi-unit MSNA envelope. Multi- and single-unit MSNA recordings were acquired in eight healthy middle-aged subjects (age, 57 ± 8 years; body mass index, 25 ± 2 kg/m2) submitted to selective decreases or increases in atrial pressure by nonhypotensive lower body negative pressure (LBNP; −10 mmHg) or nonhypertensive lower body positive pressure (LBPP; +10 mmHg), respectively. Single-unit MSNA firing responses were classified as anticipated if spike frequency and incidence increased with LBNP or decreased with LBPP and paradoxical if they decreased with LBNP or increased with LBPP. LBNP decreased (3.2 ± 2.8 to 1.4 ± 3.1 mmHg, P < 0.01) and LBPP increased (3.3 ± 2.7 to 4.9 ± 2.8 mmHg, P < 0.01) estimated central venous pressure without affecting stroke volume, systemic pressure, or resistance. Multi-unit MSNA increased with LBNP (31 ± 17 to 38 ± 19 bursts/min, P < 0.01) and diminished with LBPP (33 ± 15 to 28 ± 15 bursts/min, P < 0.01). Of 21 single-units identified, 76% exhibited firing responses to both LBNP and LBPP concordant with multi-unit MSNA, whereas 24% demonstrated discordant or paradoxical responses. The detection of two subpopulations of single-units within the multi-unit MSNA recording, exhibiting opposite firing characteristics, establishes the first evidence in humans for the existence of an excitatory cardiac-muscle sympathetic reflex activated by increasing atrial pressure.
Fluid shear stress induces the clustering of heparan sulfate via mobility of glypican-1 in lipid rafts
Authors: Zeng Ye , Waters Michele , Andrews Allison , Honarmandi Peyman , Ebong Eno E. , Rizzo Victor , Tarbell John M.
Published: July 2013

The endothelial glycocalyx plays important roles in mechanotransduction. We recently investigated the distribution and interaction of glycocalyx components on statically cultured endothelial cells. In the present study, we further explored the unknown organization of the glycocalyx during early exposure (first 30 min) to shear stress and tested the hypothesis that proteoglycans with glycosaminoglycans, which are localized in different lipid microdomains, respond distinctly to shear stress. During the initial 30 min of exposure to shear stress, the very early responses of the glycocalyx and membrane rafts were detected using confocal microscopy. We observed that heparan sulfate (HS) and glypican-1 clustered in the cell junctions. In contrast, chondroitin sulfate (CS), bound albumin, and syndecan-1 did not move. The caveolae marker caveolin-1 did not move, indicating that caveolae are anchored sufficiently to resist shear stress during the 30 min of exposure. Shear stress induced significant changes in the distribution of ganglioside GM1(a marker for membrane rafts labeled with cholera toxin B subunit). These data suggest that fluid shear stress induced the cell junctional clustering of lipid rafts with their anchored glypican-1 and associated HS. In contrast, the mobility of CS, transmembrane bound syndecan-1, and caveolae were constrained during exposure to shear stress. This study illuminates the role of changes in glycocalyx organization that underlie mechanisms of mechanotransduction.
Achieving Synchronization in Arrays of Coupled Differential Systems with Time-Varying Couplings
Authors: Yi Xinlei , Lu Wenlian , Chen Tianping
Published: July 2013

We study complete synchronization of the complex dynamical networks described by linearly coupled ordinary differential equation systems (LCODEs). Here, the coupling is timevarying in both network structure and reaction dynamics. Inspired by our previous paper (Lu et al. (2007-2008)), the extended Hajnal diameter is introduced and used to measure the synchronization in a general differential system. Then we find that the Hajnal diameter of the linear system induced by the time-varying coupling matrix and the largest Lyapunov exponent of the synchronized system play the key roles in synchronization analysis of LCODEs with identity inner coupling matrix. As an application, we obtain a general sufficient condition guaranteeing directed time-varying graph to reach consensus. Example with numerical simulation is provided to show the effectiveness of the theoretical results.
The Role of Adrenomedullin in the Renal NADPH Oxidase and (Pro)renin in Diabetic Mice
Authors: Hayashi Michio , Tojo Akihiro , Shimosawa Tatsuo , Fujita Toshiro
Published: July 2013

Adrenomedullin has an antioxidative action and protects organs in various diseases. To clarify the role of adrenomedullin in diabetic nephropathy, we investigated the NADPH oxidase expression, renin-secreting granular cell (GC) hyperplasia, and glomerular matrix expansion in the streptozotocin (STZ)-induced diabetic adrenomedullin gene knockout (AMKO) mice compared with the STZ-diabetic wild mice at 10 weeks. The NADPH oxidase p47phox expression and lipid peroxidation products were enhanced in the glomeruli of the diabetic mice compared with that observed in the controls in both wild and AMKO mice. These changes were more obvious in the AMKO mice than in the wild mice. Glomerular mesangial matrix expansion was more severe in the diabetic AMKO mice than in the diabetic wild mice and exhibited a positive correlation with the degree of lipid peroxidation products in the glomeruli. Proteinuria was significantly higher in the diabetic AMKO mice than in the diabetic wild mice. The GC hyperplasia score and the renal prorenin expression were significantly increased in the diabetic AMKO mice than in the diabetic wild mice, and a positive correlation was observed with the NADPH oxidase expression in the macula densa. The endogenous adrenomedullin gene exhibits an antioxidant action via the inhibition of NADPH oxidase probably by suppressing the local renin-angiotensin system.
Motor Skill Training Promotes Sensorimotor Recovery and Increases Microtubule-Associated Protein-2 (MAP-2) Immunoreactivity in the Motor Cortex after Intracerebral Hemorrhage in the Rat
Authors: Santos M. V. , Pagnussat A. S. , Mestriner R. G. , Netto C. A.
Published: July 2013

Motor skill learning may induce behavioral and neurophysiological adaptations after intracerebral hemorrhage (ICH). Learning a new motor skill is associated with dendritic reorganization and requires protein synthesis and expression of MAP-2. The purpose of this study was to evaluate motor performance and expression of MAP-2 in the motor cortex of rats submitted to intracerebral hemorrhage model (ICH) and skill task training (SK) or unskilled training (US) during 4 weeks. The Staircase test was used for behavioral evaluation, and relative optical densities and morphometrical analysis were used to estimate MAP-2 immunoreactivity and parameters of brain tissue in both motor cortices. Results show that skill task training performed with the impaired forelimb was able to increase MAP-2 immunoreactivity in the motor cortex either in sham or in ICH groups in both cortices: ipsilesional [F(5,35) = 14.25 (P<0.01)] and contralesional hemispheres [F(5,35) = 9.70 (P<0.01)]. ICH alone also increased MAP-2 immunoreactivity despite the absence of functional gains. Behavioral evaluation revealed that ICH-SK group performed better than ICH and ICH-US animals in the Staircase test. Data suggest that motor skill training induces plastic modifications in both motor cortices, either in physiological or pathological conditions and that skill motor training produces higher brain plasticity and positive functional outcomes than unskilled training after experimental intracerebral hemorrhage.
Molecular Characterization of the Porcine Group A Rotavirus NSP2 and NSP5/6 Genes from São Paulo State, Brazil, in 2011/12
Authors: Barbosa Bruna Rocha Passos , Bernardes Nara Thiers Cacciatori Galleti , Beserra Laila Andreia Rodrigues , Gregori Fábio
Published: July 2013

Rotaviruses are responsible for the acute diarrhea in various mammalian and avian species. The nonstructural proteins NSP2 and NSP5 are involved in the rotavirus replication and the formation of viroplasm, cytoplasmic inclusion bodies within which new viral particles morphogenesis and viral RNA replication occur. There are few studies on the genetic diversity of those proteins; thus this study aims at characterizing the diversity of rotavirus based on NSP2 and NSP5 genes in rotaviruses circulating in Brazilian pig farms. For this purpose, 63 fecal samples from pig farms located in six different cities in the São Paulo State, Brazil, were screened by nested RT‐PCR. Seven strains had the partial nucleotide sequencing for NSP2, whereas in six, the total sequencing for NSP5. All were characterized as genotype H1 and N1. The nucleotide identity of NSP2 genes ranged from 100% to 86.4% and the amino acid identity from 100% to 91.5%. For NSP5, the nucleotide identity was from 100% to 95.1% and the amino acid identity from 100% to 97.4%. It is concluded that the genotypes of the strains circulating in the region of study are in agreement with those reported in the literature for swine and that there is the possibility of interaction between human and animal rotaviruses.
A Case of Bipolar Affective Disorder and Aspiration Pneumonia
Authors: Gerada Alessandro , Dell'Erba Gaetano
Published: July 2013

Adults with mental illness are at a higher risk of aspiration pneumonia than the general population. We describe the case of a patient with bipolar affective disorder and two separate episodes of aspiration pneumonia associated with acute mania. We propose that he had multiple predisposing factors, including hyperverbosity, sedative medications, polydipsia (psychogenic and secondary to a comorbidity of diabetes insipidus), and neuroleptic side effects.
Heat and Mass Transfer Effect on MHD Flow of a Viscoelastic Fluid through a Porous Medium Bounded by an Oscillating Porous Plate in Slip Flow Regime
Authors: Sahoo S. N.
Published: July 2013

Unsteady flow of an eclectically conducting and incompressible viscoelastic liquid of the Walter model with simultaneous heat and mass transfer near an oscillating porous plate in slip flow regime under the influence of a transverse magnetic field of uniform strength is presented. The governing equations of the flow field are solved by a regular perturbation method for small elastic parameter, and the expressions for the velocity, temperature, concentration, skin friction , the heat flux in terms of the Nusselt number , and the rate of mass transfer in terms of the Sherwood number are obtained. The effects of the important flow parameters on the dynamics are discussed. Findings of the study reveal that the rarefaction parameter accelerates the fluid particles in the flow domain. Elastic parameter contributes to sudden fall of the velocity near the plate. Magnetic force contributes to greater skin friction as the time elapses. Destructive reaction reduces, whereas generative reaction enhances the concentration distribution.
Pharmacodynamic Effect of Clopidogrel in Patients Undergoing Transcatheter Aortic Valve Implantation
Authors: Tousek Petr , Kocka Viktor , Sulzenko Jakub , Bednar Frantisek , Linkova Hana , Widimsky Petr
Published: July 2013

The aim of this study was to analyze periprocedural and mid-term effect of clopidogrel on platelet function using the VerifyNow P2Y12point-of-care assay in patients undergoing TAVI. Platelet reactivity was measured at the beginning of the procedure after 300 mg clopidogrel bolus administration and during the follow-up (at 1 month after the procedure) in 52 patients undergoing TAVI using the Medtronic CoreValve prosthesis (Medtronic CoreValve). A cutoff value of 240 PRU was used to identify nonresponders to clopidogrel treatment with high residual platelet reactivity (HRPR). Baseline HRPR was identified in 80% of patients and in 72% of patients during 6-month follow-up. There was no significant difference in the pharmacodynamic effects of clopidogrel on platelet reactivity from baseline to 6-months follow-up (297±57vs.275±62;P=0.058). Ischemic event occurred only in 3 patients (5.8%) from the study group. In conclusion, majority of patients undergoing TAVI had high residual platelet reactivity after pretreatment with 300 mg of clopidogrel and during the 6-month follow-up at dual antiplatelet treatment. The noneffectiveness of clopidogrel in the TAVI population raises the question of the routine use of dual antiplatelet treatment in this setting.
Relationship between Circulating BAFF Serum Levels with Proliferating Markers in Patients with Multiple Myeloma
Authors: Alexandrakis Michael G. , Roussou Parascevi , Pappa Constantina A. , Messaritakis Ippokratis , Xekalou Athina , Goulidaki Nektaria , Boula Anna , Tsirakis George
Published: July 2013

In multiple myeloma, there are many factors influencing the growth of the malignant clone in direct and indirect manners. BAFF is a growth factor for myeloma cells. The aim of the study was to measure its circulating levels in 54 pretreatment patients, along with serum levels of other proliferation markers, such as interleukins-6, -10, and -15, CRP, and beta-2 microglobulin, as well as bone marrow plasma cell infiltration and expression of Ki-67 PI, in various stages of the disease and after effective treatment in 28 of them. Serum levels of the previously mentioned factors were measured by ELISA, whereas bone marrow plasma cell infiltration and Ki-67 expression were estimated immunohistochemically. All measured parameters were higher in pretreated myeloma patients compared to healthy population and were also increasing with the progression of the disease. They all also decreased after effective therapy. Furthermore, all pretreatment values correlated to each other. BAFF seems to be an important growth factor for myeloma plasma cells. Measuring its serum levels, along with the previously mentioned cytokines, may provide important information regarding the degree of myeloma cells’ proliferation. Therefore, they all could be used as markers of proliferation and disease activity.
A Resource Reservation Protocol with Linear Traffic Prediction for OBS Networks
Authors: Karamitsos Ioannis , Bowerman Chris
Published: July 2013

This paper addresses the issue of providing resource reservation mechanism for OBS networks. We propose a linear prediction mechanism based on least mean square (LMS) method to reduce the burst delay at edge nodes. A reservation method is proposed to increase the reservation probability and to improve the delay reduction performance.
How Can Stress Be Controlled in Endodontically Treated Teeth? A 3D Finite Element Analysis
Authors: Yıkılgan İhsan , Bala Oya
Published: July 2013

The aim of this study was to analyze the stresses that develop by oblique and vertical forces in endodontically treated maxillary second premolars that were restored with resin composite. Additionally, in our study the effects of the different restorative approaches and use of different base materials on stress formation were analyzed using three‐dimensional finite element stress analysis. For restoration, the models representing both cusp capping, palatinal cusp capping, standard MOD restoration, and use of woven fiber in occlusal part were prepared. In all models, oblique forces caused more stress than did vertical forces. Materials with low elastic moduli cause high amounts of stress, whereas materials with elastic moduli similar to that of dental tissues cause low amounts of stress. Additional approaches such as cusp capping, functional cusp capping, and woven fiber use do not affect stress formation on the tooth after endodontic treatment.
β‐Tricalcium Phosphate Micron Particles Enhance Calcification of Human Mesenchymal Stem Cells In Vitro
Authors: Nakagawa Yusuke , Muneta Takeshi , Tsuji Kunikazu , Ichinose Shizuko , Hakamatsuka Yasuharu , Koga Hideyuki , Sekiya Ichiro
Published: July 2013

β‐Tricalcium phosphate (β‐TCP) micron particles whose diameters range from 1 μm to 10 μm have been recently developed, however, their biological effects remain unknown. We investigated the biological effects of β‐TCP micron particles on proliferation, cytotoxicity, and calcification of human synovial mesenchymal stem cells (MSCs). MSCs were cultured without dexamethasone, β‐glycerophosphate, or ascorbic acid. 1.0 mg/mL β‐TCP micron particles inhibited proliferation of MSCs significantly and increased dead cells. In the contact condition, 0.1 mg/mL β‐TCP micron particles promoted calcification of MSCs evaluated by alizarin red staining and enhanced mRNA expressions of runx2, osteopontin, and type I collagen. In the noncontact condition, these effects were not observed. 0.1 mg/mL β‐TCP micron particles increased calcium concentration in the medium in the contact condition, while 1.0 mg/mL β‐TCP micron particles decreased calcium and phosphorus concentrations in the medium in the noncontact condition. By transmission electron microscopy, β‐TCP micron particles were localized in the phagosome of MSCs and were dissolved. In conclusion, β‐TCP micron particles promoted calcification of MSCs and enhanced osteogenesis‐related gene expressions in vitro.
What Is the Incidence of Intracranial Bleeding in Patients with Mild Traumatic Brain Injury? A Retrospective Study in 3088 Canadian CT Head Rule Patients
Authors: Albers C. E. , von Allmen M. , Evangelopoulos D. S. , Zisakis A. K. , Zimmermann H. , Exadaktylos A. K.
Published: July 2013

Objective. Only limited data exists in terms of the incidence of intracranial bleeding (ICB) in patients with mild traumatic brain injury (MTBI).Methods. We retrospectively identified 3088 patients (mean age 41 range (7–99) years) presenting with isolated MTBI and GCS 14-15 at our Emergency Department who had undergone cranial CT (CCT) between 2002 and 2011. Indication for CCT was according to the “Canadian CT head rules.” Patients with ICB were either submitted for neurosurgical treatment or kept under surveillance for at least 24 hours. Pearson’s correlation coefficient was used to correlate the incidence of ICB with age, gender, or intake of coumarins, platelet aggregation inhibitors, or heparins.Results. 149 patients (4.8%) had ICB on CCT. No patient with ICB died or deteriorated neurologically. The incidence of ICB increased with age and intake of anticoagulants without clinically relevant correlation (R=0.11;P<0.001;R=-0.06;P<0.001).Conclusion. Our data show an incidence of 4.8% for ICB after MTBI. However, neurological deterioration after MTBI seems to be rare, and the need for neurosurgical intervention is only required in selected cases. The general need for CCT in patients after MTBI is therefore questionable, and clinical surveillance may be sufficient when CCT is not available.
Isolation and Molecular Identification of Keratinophilic Fungi from Public Parks Soil in Shiraz, Iran
Authors: Pakshir Keyvan , Rahimi Ghiasi Moosa , Zomorodian Kamiar , Gharavi Ali Reza
Published: July 2013

Introduction. Keratinophilic fungi are an important group of fungi that live in soil. The aim of this study was to isolate and identify keratinophilic fungi from the soil of different parks in Shiraz.Materials and Methods. A total of 196 soil samples from 43 parks were collected. Isolation of the fungi was performed by hair bait technique. The isolated colonies were identified by morphologic feature of macro- and microconidia and molecular method, using DNA sequence analysis. ITS region of ribosomal DNA was amplified and the PCR products were sequenced.Results. 411 isolates from 22 genera were identified.Fusarium(23.8%),Chrysosporium(13.13%),Acremonium(12.65%),Penicillium(12.39%),Microsporum gypseum(1.94%),Bionectria ochroleuca(1.21%),Bipolaris spicifera(1.21%),Scedosporium apiospermum(0.82%),Phialophora reptans(0.82%),Cephalosporium curtipes(0.49%),Scedosporium dehoogii(0.24%),Ochroconis constricta(0.24%),Nectria mauritiicola(0.49%),Chaetomium(0.49%),Scopulariopsis(0.24%),Malbranchea(0.24%), andTritirachium(0.24%) were the most important isolates. Most of the fungi were isolated from the soils with the PH range of 7 to 8.Conclusion. Our study results showed that many keratinophilic fungi isolated from the parks soil are important for public health and children are an important group at a high risk of being exposed to these fungi.