bluuebunny/crossref_metadata_2025 huggingface dataset:
The Alberta Stroke Prevention in TIAs and Mild Strokes (ASPIRE) Intervention: Rationale and Design for Evaluating the Implementation of a Province-Wide TIA Triaging System
Authors: Jeerakathil Thomas , Shuaib Ashfaq , Majumdar Sumit R. , Demchuk Andrew M. , Butcher Kenneth S. , Watson Tim J. , Dean Naeem , Gordon Deb , Edmond Cathy , Coutts Shelagh B. ,   for the ASPIRE Investigators
Published: October 2012

Rationale

Stroke risk after transient ischaemic attack is high and, it is a challenge worldwide to provide urgent assessment and preventive services to entire populations.

Aims

To determine whether a province-wide transient ischaemic attack Triaging algorithm and transient ischaemic attack hotline (the Alberta Stroke Prevention in transient ischaemic attacks and mild strokes intervention) can reduce the rate of stroke recurrence following transient ischaemic attack across the population of Alberta, Canada (population 3·7 million, 90-day rate of post-stroke transient ischaemic attack currently 9·5%). It also seeks to improve upon current transient ischaemic attack triaging rules by incorporating time from symptom onset as a predictive variable.

Design

The transient ischaemic attack algorithm and hotline were developed with a broad consensus of clinicians, patients, policy-makers, and researchers and based on local adaptation of the work of others and research and insights developed within the province. Because neither patient-level nor region-level randomization was possible, we conducted a quasi-experimental design examining changes in the post-transient ischaemic attack rate of stroke recurrence before and after the 15-month implementation period using an interrupted time-series regression analysis. The design controls for changes in case-mix, co-interventions, and secular trends. A prospective transient ischaemic attack cohort will also be concurrently created with telephone follow-up at seven-days and 90 days as well as passive follow-up over the longer term using linkages to provincial healthcare administrative databases.

Study Outcomes

The primary outcome measure is the change in recurrence rate of stroke following transient ischaemic attack at seven-days and 90 days, comparing a period of two-years before vs. two-years after the intervention is implemented. All cases of recurrent stroke will be validated. Secondary outcomes include functional status, hospitalizations, morbidity, and mortality.

Conclusions

We are undertaking a rigorous evaluation of a population-based approach to improving quality of transient ischaemic attack care. Whether positive or negative, our work should provide important insights for all potential stakeholders.
Total Phenolics, Carotenoids, Ascorbic Acid, and Antioxidant Properties of Fresh‐cut Mango (Mangifera indica L., cv. Tommy Atkin) as Affected by Infrared Heat Treatment
Authors: Sogi D. S. , Siddiq M. , Roidoung S. , Dolan K. D.
Published: October 2012

Abstract:  Mango (Mangifera indica L.) is a major tropical fruit that has not been exploited for fresh‐cut or minimally processed products on a scale similar to apples, pineapples, or melons. The objective of this study was to investigate the effect of infrared (IR) treatment on total phenolics, carotenoids, ascorbic acid, and antioxidant properties of fresh‐cut cubes from ‘Tommy Atkin’ mangoes. Mango cubes were IR treated (5, 10, 15 min) and evaluated at 4‐d intervals during 16‐d storage at 4 ± 1 °C. Total phenolics, carotenoids, and ascorbic acid content in fresh‐cut control mango cubes were 43.33, 1.37, and 15.97 mg/100 g FW, respectively. IR treatments increased total phenolics (59.23 to 71.16 mg/100 g FW) and decreased ascorbic acid (12.14 to 15.38 mg/100 g, FW). Total carotenoids showed a mixed trend (1.13 to 1.66 mg/100 g, FW). The IR treatment showed a significant positive impact on antioxidant properties (μM TE/100 g, FW) of mango cubes, as assayed by ABTS (261.5 compared with 338.0 to 416.4), DPPH (270.5 compared with 289.4 to 360.5), and ORAC (6686 compared with 8450 to 12230). Total phenolics, carotenoids, ascorbic acid, and antioxidant capacity decreased over 16‐d storage. However, IR treated samples had consistently higher ABTS, DPPH, and total phenolics during storage. It was demonstrated that IR treatment can be effectively used in improving antioxidant properties of fresh‐cut mangoes with minimal effect on the visual appearance.

Practical Application:  Various methods/treatments are in use for extending the quality of fresh‐cut fruits, including mild heat treatment. This study explored the application of infrared (IR) heat for processing fresh‐cut mango cubes and evaluated its effect on vitamin C and antioxidant capacity during 16‐d storage. This is the first study reporting on the use of IR heat in fresh‐cut fruits. IR treatment was shown to be effective in retaining antioxidant properties of fresh‐cut mango cubes with minimal effect on the visual appearance.
Porosity and Water Activity Effects on Stability of Crystalline β‐Carotene in Freeze‐Dried Solids
Authors: Harnkarnsujarit Nathdanai , Charoenrein Sanguansri , Roos Yrjö H.
Published: October 2012

Abstract:  Stability of entrapped crystalline β‐carotene as affected by water activity, solids microstructure, and composition of freeze‐dried systems was investigated. Aliquots (1000 mm3, 20% w/w solids) of solutions of maltodextrins of various dextrose equivalents (M040: DE6, M100: DE11, and M250: DE25.5), M100‐sugars (1:1 glucose, fructose and sucrose), and agar for gelation with dispersed β‐carotene were frozen at −20, −40, or −80 °C and freeze‐dried. Glass transition and α‐relaxation temperatures were determined with differential scanning calorimetry and dynamic mechanical analysis, respectively. β‐Carotene contents were monitored spectrophotometrically. In the glassy solids, pore microstructure had a major effect on β‐carotene stability. Small pores with thin walls and large surface area allowed β‐carotene exposure to oxygen which led to a higher loss, whereas structural collapse enhanced stability of β‐carotene by decreasing exposure to oxygen. As water plasticized matrices, an increase in molecular mobility in the matrix enhanced β‐carotene degradation. Stability of dispersed β‐carotene was highest at around 0.2 aw, but decreasing structural relaxation times above the glass transition correlated well with the rate of β‐carotene degradation at higher aw. Microstructure, aw, and component mobility are important factors in the control of stability of β‐carotene in freeze‐dried solids

Practical Application:  β‐Carotene expresses various nutritional benefits; however, it is sensitive to oxygen and the degradation contributes to loss of nutritional values as well as product color. To increase stability of β‐carotene in freeze‐dried foods, the amount of oxygen penetration need to be limited. The modification of freeze‐dried food structures, for example, porosity and structural collapse, components, and humidity effectively enhance the stability of dispersed β‐carotene in freeze‐dried solids.
Religion as Cultural Power: The Role of Religion in Influencing Americans’ Symbolic Boundaries around Gender and Sexuality
Authors: Tranby Eric , Zulkowski Samantha E.
Published: October 2012

In this article, we describe recent research that explores the power of religion to influence understandings of gender and sexuality in the United States. We argue that sociologists of religion should draw from symbolic boundaries theory, a theoretical innovation in the sociology of culture. In particular, we discuss a rich body of research in the sociology of religion to show how Americans use religious tools to draw boundaries around ideal and stigmatized gender norms, family forms and sexual identification. We combine symbolic boundaries literature and this literature to show that religion is a source of cultural power that assigns meaning to, and draws boundaries around, certain cultural categories. We end by describing some productive directions for future research in this area.
Arantius’ ligament approach for the left extrahepatic Glissonean pedicle in pure laparoscopic left hemihepatectomy
Authors: Cho Akihiro , Yamamoto Hiroshi , Kainuma Osamu , Ota Takumi , Park SeongJin , Yanagibashi Hiroo , Arimitsu Hidehito , Ikeda Atsushi , Souda Hiroaki , Nabeya Yoshihiro , Takiguchi Nobuhiro , Nagata Matsuo
Published: October 2012

Introduction

Laparoscopic hemihepatectomy has not yet become widely accepted because of the technical difficulties in controlling each Glissonean pedicle laparoscopically.

Materials and Surgical Technique

The subjects in the present study included 12 patients who underwent laparoscopic left hemihepatectomy between August 2007 and June 2011. Arantius' ligament was divided. Retracting the caudal stump of the ligament revealed a space between the left Glissonean pedicle and the liver parenchyma. The left Glissonean pedicle could be easily encircled by using an Endo Retract Maxi. No Glissonean injuries, including bleeding or biliary leakage, occurred in any of the 12 patients.

Discussion

Therefore, the Arantius' ligament approach for the left extrahepatic Glissonean pedicle appears to be feasible and safe for successfully performing pure laparoscopic left hemihepatectomy.
Detecting offence paralleling behaviours in a medium secure psychiatric unit
Authors: Kadra Giouliana , Daffern Michael , Campbell Colin
Published: October 2012

Purpose

Offence paralleling behaviour (OPB) is a relatively new concept that emphasizes the assessment and modification of behavioural patterns that parallel criminal offending. Extant empirical research into OPB has typically focussed on the similarity between aggressive behaviours observed in custody and violent index offences perpetrated in the community; the results of these studies have been inconsistent, with the degree of similarity varying within subjects and across studies; (Daffern, Howells, Stacey, Hogue, & Mooney, 2008; Daffern, Howells, Mannion, & Tonkin, 2009). The aim of this study was to establish the level of similarity between OPB predictions and actual in‐patient aggressive behaviours.

Method

This prospective pilot study used a novel practice algorithm (Jones, 2010a) to develop a reference formulation from which OPBs and Pro‐social alternate behaviours (PABs), the pro‐social variants of OPBs, were predicted. Participants were five mentally disordered offenders resident in a UK medium secure psychiatric unit. Following generation of a reference formulation and OPB and PAB predictions the participants were monitored for 6 months. The degree of similarity between predicted and actual OPBs and PABs was calculated using Jaccard's coefficient.

Results

Results indicated considerable similarity between matched (pairing predictions and their corresponding actual behaviours) OPBs, which were also more similar than random pairs (pairing randomly selected predictions and aggressive behaviours).

Conclusion

This study revealed the existence of OPB in mentally disordered offenders and has provided the first test of a novel practice algorithm, revealing its potential to guide OPB formulations.
Ceramic Dusting Corrosion of Yttria‐Stabilized Zirconia in Ultra High Temperature Reverse‐Flow Pyrolysis Reactors
Authors: Chun ChangMin , Desai Sanket , Hershkowitz Frank , Ramanarayanan Trikur A.
Published: October 2012

A reverse‐flow reactor enables the pyrolysis of hydrocarbons, at temperatures ranging from 1500°C to 2000°C, to high‐value petrochemical products through acetylene intermediate. Materials in the hottest regions of the reactor, exposed to such extreme temperatures, are subject to oxidative cycling over a period of several seconds between a regeneration (heat addition) step that is mildly oxidizing and a pyrolysis (cracking) step that is strongly reducing, accompanied by high carbon activity. Experimental results obtained from single crystal and polycrystalline yttria‐stabilized zirconia (YSZ) ceramics of different porosities show that the pyrolysis reaction triggers the carburization of YSZ by diffusion of carbon through the lattice, the grain boundaries, and the pores. Subsequently graphite deposition occurs on the carburized surface. During the regeneration step, some of the graphite and (oxy)carbide are reoxidized. Corrosion advances in subsequent cycles by a repetition of oxide‐carbide interconversion, carbon precipitation, and reoxidation steps. Since degradation involves the breakup of the bulk ceramic structure into powder or “dust” and is reminiscent of metal dusting corrosion observed in metallic materials in carbon‐supersaturated environments, we name this corrosion “ceramic dusting.” Details of the corrosion mechanism and the steps leading to such degradation are discussed.
Metabolic Syndrome Enhances Prostate Contractility and In Vitro Phenylephrine‐induced α1‐Adrenoceptor Protein Expression in the Fructose‐fed Rat
Authors: CHEN I‐Hung , CHUNG Hsien‐Hui , CHENG Juei‐Tang , TONG Yat‐Ching
Published: October 2012

Objectives: To study the effects of metabolic syndrome on prostate α‐adrenergic contractile function using fructose‐fed rats (FR).

Methods: Age‐matched male Wistar rats were divided into two groups: group I, normal control rats; and group II, 9‐week FR. Animal body weight, blood pressure and serum metabolic parameters were monitored. The prostate was removed 9 weeks after induction of metabolic syndrome in the FR. The contractile responses of prostatic strips to phenylephrine (10−7 to 10−6 M) and KCl (50 mM) were tested. Prostate α1‐adrenoceptor (α1‐AR) protein expression was studied by Western blotting analysis with a polyclonal antiserum.

Results: At week 9, the FR showed significant increases in body weight, blood pressure, plasma glucose, insulin and triglyceride levels. The FR prostate weight was significantly higher than that of the controls (610.5 ± 13.2 vs 422.3 ± 7.7 mg, P < 0.05 for n = 8). FR prostate contractile responses to phenylephrine and KCl were both significantly increased. Interestingly, prostate α1‐AR protein expression level was lower in the FR. However, after in vitro 10−6 M phenylephrine stimulation, FR prostate α1‐AR protein expression was significantly increased.

Conclusion: Metabolic syndrome in FR significantly increases prostate contractile responses to KCl and α‐adrenergic stimulation. Paradoxically, FR prostate α1‐AR protein expression is decreased, but significantly enhanced after in vitro phenylephrine stimulation.
A unique gender difference in early onset melanoma implies that in addition to ultraviolet light exposure other causative factors are important
Authors: Liu Feng , Bessonova Leona , Taylor Thomas H. , Ziogas Argyrios , Meyskens Frank L. , Anton‐Culver Hoda
Published: October 2012

Using US SEER17 Registry data, age‐specific melanoma incidence rates were calculated and comparisons were made between males and females. Relative Risk (RR) for males and females in each age group was computed and compared with that from Nordic Cancer Registry data set and to that for non‐melanoma skin cancer (NMSC). For age groups 44 and younger, females showed higher incidence rates, with a peak difference at age 20–24 (RR = 2.01, 95% CI = 1.21–3.33). Males exhibited higher incidence rates after age 44. The same bimodal gender difference was confirmed by the Nordic Cancer Registry data set, but it was not observed for NMSC, which is known to be strongly associated with cumulative exposure to solar UV radiation. We conclude that exposure to solar ultraviolet (UV) radiation is the major causative factor for melanoma at older age (>44 yr), but that other factors may play a role in early onset melanomas, particularly in females.
Exercise efficiency is reduced by mitochondrial uncoupling in the elderly
Authors: Conley Kevin E. , Jubrias Sharon A. , Cress M. Elaine , Esselman Peter
Published: October 2012

New Findings

What is the central question of this study?

A key part of the debilitation that comes with age is the decline in exercise efficiency. This study examines the role of metabolic efficiency in this decline.

What is the main finding and its importance?

Here we show that mitochondrial energy inefficiency is the basis of the decline in exercise efficiency with age. These findings identify mitochondrial dysfunction as a key factor in the reduced exercise efficiency with age and also identify mitochondria as the target for intervention to reverse this source of debilitation in the elderly.

A reduction in exercise efficiency accompanies ageing in humans. Here we evaluated the impact of changes in the contractile‐coupling and mitochondrial‐coupling efficiencies on the reduction in exercise efficiency in the elderly. Nine adult (mean, 38.8 years old) and 40 elderly subjects (mean, 68.8 years old) performed a cycle ergometer test to measure O2 uptake and leg power output up to the aerobic limit (). Reduced leg power output per unit O2 uptake was reflected in a drop in delta efficiency (ɛD) from 0.27 ± 0.01 (mean ± SEM) in adults to 0.22 ± 0.01 in the elderly group. Similar declines with age were apparent for both the leg power output at and the ATP generation capacity (ATPmax) determined in vivo using 31P magnetic resonance spectroscopy. These similar declines resulted in unchanged contractile‐coupling efficiency values (ɛC) in the adult (0.50 ± 0.05) versus the elderly group (0.58 ± 0.04) and agreed with independent measures of muscle contractile‐coupling efficiency in human quadriceps (0.5). The mitochondrial‐coupling efficiency calculated from the ratio of delta to contractile‐coupling efficiencies in the adults (ɛD/ɛC= 0.58 ± 0.08) corresponded to values for well‐coupled mitochondria (0.6); however, ɛD/ɛC was significantly lower in the elderly subjects (0.44 ± 0.03). Conversion of ATPmax per mitochondrial volume (ATPmax/Vv[mt,f]) reported in these groups into thermodynamic units confirmed this drop in mitochondrial‐coupling efficiency from 0.57 ± 0.08 in adults to 0.41 ± 0.03 in elderly subjects. Thus, two independent methods revealed that reduced mitochondrial‐coupling efficiency was a key part of the drop in exercise efficiency in these elderly subjects and may be an important part of the loss of exercise performance with age.
Cerebral network disorders after stroke: evidence from imaging‐based connectivity analyses of active and resting brain states in humans
Authors: Rehme Anne K. , Grefkes Christian
Published: October 2012

Abstract  Stroke causes a sudden disruption of physiological brain function which leads to impairments of functional brain networks involved in voluntary movements. In some cases, the brain has the intrinsic capacity to reorganize itself, thereby compensating for the disruption of motor networks. In humans, such reorganization can be investigated in vivo using neuroimaging. Recent developments in connectivity analyses based on functional neuroimaging data have provided new insights into the network pathophysiology underlying neurological symptoms. Here we review recent neuroimaging studies using functional resting‐state correlations, effective connectivity models or graph theoretical analyses to investigate changes in neural motor networks and recovery after stroke. The data demonstrate that network disturbances after stroke occur not only in the vicinity of the lesion but also between remote cortical areas in the affected and unaffected hemisphere. The reorganization of motor networks encompasses a restoration of interhemispheric functional coherence in the resting state, particularly between the primary motor cortices. Furthermore, reorganized neural networks feature strong excitatory interactions between fronto‐parietal areas and primary motor cortex in the affected hemisphere, suggesting that greater top‐down control over primary motor areas facilitates motor execution in the lesioned brain. In addition, there is evidence that motor recovery is accompanied by a more random network topology with reduced local information processing. In conclusion, Stroke induces changes in functional and effective connectivity within and across hemispheres which relate to motor impairments and recovery thereof. Connectivity analyses may hence provide new insights into the pathophysiology underlying neurological deficits and may be further used to develop novel, neurobiologically informed treatment strategies.
Thermo-Wetting and Friction Reduction Characterization of Microtextured Superhydrophobic Surfaces
Authors: Kim Tae Jin , Kanapuram Ravitej , Chhabra Arnav , Hidrovo Carlos
Published: October 2012

Microtextured superhydrophobic surfaces have shown potential in friction reduction applications and could be poised to make a significant impact in thermal management applications. The purpose of this paper is to account for the thermal effects of the heated fluid flowing in superhydrophobic microfluidic channels. Through microscopic observation and flow rate measurements it was observed that (1) heating may prolong the Cassie state even under elevated pressure drops by increasing the temperature in the gas layer and that (2) excessive heating may pinch the microchannel flow due to the air layer invading into the liquid layer.
Second Law Characterization of Confined Turbulent Flows
Authors: Naterer G. F. , Adeyinka O. B.
Published: October 2012

In this paper, a new measurement technique for turbulent entropy production is developed and applied to confined channel flows. Past methods of dimensional analysis, Clark gradient, and Smagorinsky models for subgrid turbulent stresses are examined to determine the flow irreversibilities throughout the flow field. The new experimental method obtains the turbulent irreversibilities up to a certain particle image velocimetry (PIV) cut-off wavelength, very close to the wall of the channel. Measured results of turbulence dissipation and entropy production at varying Reynolds numbers are presented and compared successfully against results from direct numerical simulations. The subgrid scale models of turbulent flow irreversibilities are shown to provide an effective alternative to direct PIV averaging of turbulent stresses, particularly close to the wall, where PIV resolution makes it difficult to precisely determine the averaged turbulence fluctuations. This paper develops a new PIV based method that enables the whole-field measurements of turbulent entropy production, and it presents new experimental data for entropy production in channel flows.
Comment on “Chronic Traumatic Encephalopathy in Blast-Exposed Military Veterans and a Blast Neurotrauma Mouse Model”
Authors: Tisdall Martin , Petzold Axel
Published: October 2012

In a case study, the authors report an increase in phosphorylated neurofilament heavy chain, a marker of neuroaxonal damage, in the plasma of a blast-exposed patient immediately after injury. They suggest that this phosphoprotein may be a useful body fluid indicator of acute blast traumatic brain injury.
Schistosoma mansoni Hemozoin Modulates Alternative Activation of Macrophages via Specific Suppression of Retnla Expression and Secretion
Authors: Truscott Martha , Evans D. Andrew , Gunn Matt , Hoffmann Karl F.
Published: October 2012

The trematodeSchistosoma mansoniis one of the etiological agents of schistosomiasis, a key neglected tropical disease responsible for an estimated annual loss of 70 million disability-adjusted life years. Hematophagy represents the primary nutrient acquisition pathway of this parasite, but digestion of hemoglobin also liberates toxic heme. Schistosomes detoxify heme via crystallization into hemozoin, which is subsequently regurgitated into the host's circulation. Here we demonstrate that during experimental schistosomiasis, hemozoin accumulating in the mouse liver is taken up by phagocytes at a time coincident with the development of the egg-induced T-helper 2 (Th2) granulomatous immune response. Furthermore, the uptake of hemozoin also coincides with the hepatic expression of markers of alternative macrophage activation. Alternatively activated macrophages are a key effector cell population associated with protection against schistosomiasis, making hemozoin well placed to play an important immunomodulatory role in this disease. To systematically explore this hypothesis,S. mansonihemozoin was purified and added toin vitrobone marrow-derived macrophage cultures concurrently exposed to cytokines chosen to reflect the shifting state of macrophage activationin vivo. Macrophages undergoing interleukin-4 (IL-4)-induced alternative activation in the presence of hemozoin developed a phenotype specifically lacking inRetnla, a characteristic alternatively activated macrophage product associated with regulation of Th2 inflammatory responses. As such, in addition to its important detoxification role during hematophagy, we propose that schistosome hemozoin also provides a potent immunomodulatory function in the coevolved network of host-parasite relationships during schistosomiasis.
Modulation of Kingella kingae Adherence to Human Epithelial Cells by Type IV Pili, Capsule, and a Novel Trimeric Autotransporter
Authors: Porsch Eric A. , Kehl-Fie Thomas E. , St. Geme Joseph W.
Published: October 2012

Kingella kingae
is an emerging bacterial pathogen that is being recognized increasingly as an important etiology of septic arthritis, osteomyelitis, and bacteremia, especially in young children. Colonization of the posterior pharynx is a key step in the pathogenesis of
K. kingae
disease. Previous work established that type IV pili are necessary for
K. kingae
adherence to the respiratory epithelium. In this study, we set out to identify additional factors that influence
K. kingae
interactions with human epithelial cells. We found that genetic disruption of the gene encoding a predicted trimeric autotransporter protein called Knh (

K
ingella

N
hhA
h
omolog) resulted in reduced adherence to human epithelial cells. In addition, we established that
K. kingae
elaborates a surface-associated polysaccharide capsule that requires a predicted ABC-type transporter export operon called
ctrABCD
for surface presentation. Furthermore, we discovered that the presence of a surface capsule interferes with Knh-mediated adherence to human epithelial cells by nonpiliated organisms and that maximal adherence in the presence of a capsule requires the predicted type IV pilus retraction machinery, PilT/PilU. On the basis of the data presented here, we propose a novel adherence mechanism that allows
K. kingae
to adhere efficiently to human epithelial cells while remaining encapsulated and more resistant to immune clearance.

IMPORTANCE
Kingella kingae
is a Gram-negative bacterium that is being recognized increasingly as a cause of joint and bone infections in young children. The pathogenesis of disease due to
K. kingae
begins with bacterial colonization of the upper respiratory tract, and previous work established that surface hair-like fibers called type IV pili are necessary for
K. kingae
adherence to respiratory epithelial cells. In this study, we set out to identify additional factors that influence
K. kingae
interactions with respiratory epithelial cells. We discovered a novel surface protein called Knh that mediates
K. kingae
adherence and found that a surface-associated carbohydrate capsule interferes with the Knh-mediated adherence of organisms lacking pili. Further analysis revealed that pilus retraction is necessary for maximal Knh-mediated adherence in the presence of the capsule. Our results may lead to new strategies to prevent disease due to
K. kingae
and potentially other pathogenic bacteria.
Müllerianosis: a rare cause of acute renal colic
Authors: Ndokera Rufaro , Brewster Simon , Dhar Sunanda
Published: October 2012

A 50-year-old woman presented to the urology department with an acute history suggestive of left-sided renal colic. There were no other associated symptoms, but urine dipstick revealed non-visible haematuria. CT-KUB revealed a soft tissue mass at the left vesico-ureteric junction. Flexible cystoscopy demonstrated a mass intruding into the posterior bladder. A transurethral resection of the bladder ‘tumour’ was undertaken, and it was noted that the mass was not macroscopically consistent with transitional cell carcinoma. Histology demonstrated Müllerianosis, a rare lesion characterised by locally invasive growth of tissue originating from the Müllerian (paramesonephric) duct. The patient was seen by gynaecologist who initiated hormone treatment with an lutenising hormone - releasing hormone (LH-RH) analogue. Urological follow-up 3 months later highlighted ongoing pelvic pain but no further colicky loin pain. Repeat cystoscopy showed the mass had become smaller and the left ureter was laterally displaced. Further gynaecological input is planned if symptoms are ongoing.
A cough conundrum in a patient with a previous history of BCG immunotherapy for bladder cancer
Authors: Mehta Arpan R , Mehta Puja R , Mehta Rajesh L
Published: October 2012

We describe a non-smoker who presented with a persistent cough, weight loss and general malaise, and had a medical history of bladder carcinoma that had been successfully treated with intravesical BCG immunotherapy. Radiology revealed hilar lymphadenopathy, a predominantly mid-zone and lower-zone lung parenchymal nodular pattern with a perilymphatic distribution, a few thickened interlobular septae, and small pleural effusions bilaterally. The T-SPOT.TBblood test was negative. Video-assisted thoracoscopic surgery showed multiple pleural nodules, the histopathology of which showed multiple well-defined non-caseating granulomata. The patient was started on antituberculosis medication for presumed BCGosis—a systemic complication of previous BCG immunotherapy—and the patient showed an excellent clinical and radiological response. This case further adds to previous reports and reinforces the recommendation that all patients should be made fully aware of the potential systemic and delayed complications of BCG immunotherapy when they are consented for treatment.
Childhood mortality in sub-Saharan Africa: cross-sectional insight into small-scale geographical inequalities from Census data
Authors: Kazembe Lawrence , Clarke Aileen , Kandala Ngianga-Bakwin
Published: October 2012

Objectives

To estimate and quantify childhood mortality, its spatial correlates and the impact of potential correlates using recent census data from three sub-Saharan African countries (Rwanda, Senegal and Uganda), where evidence is lacking.

Design

Cross-sectional.

Setting

Nation-wide census samples from three African countries participating in the 2010 African Census round. All three countries have conducted recent censuses and have information on mortality of children under 5 years.

Participants

111 288 children under the age of 5 years in three countries.

Primary and secondary outcome measures

Under-five mortality was assessed alongside potential correlates including geographical location (where children live), and environmental, bio-demographic and socioeconomic variables.

Results

Multivariate analysis indicates that in all three countries the overall risk of child death in the first 5 years of life has decreased in recent years (Rwanda: HR=0.04, 95% CI 0.02 to 0.09; Senegal: HR=0.02 (95% CI 0.02 to 0.05); Uganda: HR=0.011 (95% CI 0.006 to 0.018). In Rwanda, lower deaths were associated with living in urban areas (0.79, 0.73, 0.83), children with living mother (HR=0.16, 95% CI 0.15 to 0.17) or living father (HR=0.38, 95% CI 0.36 to 0.39). Higher death was associated with male children (HR=1.06, 95% CI 1.02 to 1.08) and Christian children (HR=1.14, 95% CI 1.05 to 1.27). Children less than 1 year were associated with higher risk of death compared to older children in the three countries. Also, there were significant spatial variations showing inequalities in children mortality by geographic location. In Uganda, for example, areas of high risk are in the south-west and north-west and Kampala district showed a significantly reduced risk.

Conclusions

We provide clear evidence of considerable geographical variation of under-five mortality which is unexplained by factors considered in the data. The resulting under-five mortality maps can be used as a practical tool for monitoring progress within countries for the Millennium Development Goal 4 to reduce under-five mortality in half by 2015.
Surgical endoscopy training: the Joint Advisory Group on gastrointestinal endoscopy national review
Authors: Hammond John S , Watson Nicholas F S , Lund Jon N , Barton J Roger
Published: October 2012

Background and aims

Endoscopy performance is dependent on the technical ability and experience of the operator. There is anxiety among surgical trainees that certification to perform independent endoscopy to agreed national standards by the date of award of certificate of completion of training is not achievable. The aim of this study was to evaluate the delivery of endoscopy training to UK-based general surgery trainees.

Materials and methods

An electronic survey of general surgery trainees holding a national training number or in a locum appointment to training post between July and September 2010 was undertaken.

Results

Two hundred and thirty-three trainees responded from all UK training regions. Stated subspeciality interests included coloproctology (47%), oesophagogastric/bariatric (22%) and hepatobiliary/pancreatic (10%) general surgery. 92% of trainees were training or planned to train in endoscopy, 62% of whom had registered with the Joint Advisory Group (JAG). Thirteen trainees had JAG certification in diagnostic upper GI endoscopy and eight in colonoscopy. There were high rates of dissatisfaction with endoscopy training nationally. Two thirds of trainees had no scheduled training lists. Conflicting elective/emergency commitments, competition and absence of training lists were the most common reasons for a failure to access endoscopy training.

Conclusions

Higher surgical trainees are failing to achieve national standards for endoscopy practice. There is an urgent need to address the deficiencies in endoscopy training to ensure a competent cohort of surgical endoscopists.
Duration of unemployment and suicide in Australia over the period 1985–2006: an ecological investigation by sex and age during rising versus declining national unemployment rates
Authors: Milner Allison , Page Andrew , LaMontagne Anthony D
Published: October 2012

Background

The relationship between unemployment and suicide may be sensitive to demographic factors, national unemployment rates, and length of time without employment. This study investigated these factors in relation to suicide in Australia for the period 1985–2006, in an ecological study.

Methods

The outcome variable was annual suicide rate by age group, sex and the eight states and territories over 22 years of observation (total observations=1760). The main predictor variable was the average duration of unemployment in the population, categorised into three time periods (<2 weeks, 2–4 weeks, >4 weeks). Poisson regression models were used to investigate the relationship between duration of unemployment and suicide over the years 1985–2006 in a series of cross-sectional analyses. Interaction analyses indicated significant differences during periods of declining or increasing labour market opportunity and by age group.

Results

During periods of declining unemployment rates in the country, longer durations of unemployment were associated with higher male suicide rates. During periods of increasing unemployment in the country, longer unemployment duration was associated with lower male suicide rates. Effect modification was also apparent by age-group, with stronger associations between unemployment duration and male suicide evident in those aged 25–34 and 55–64, and weaker associations in those aged 15–24 and 44–54 years. Longer length of unemployment was not associated with an increase in female suicide rates.

Conclusions

The labour market opportunities in Australia modified the effect of duration of unemployment on suicide, and the effect was more prominent in men and older age groups. This may reflect social norms and acceptability about unemployment, as well as life-stage influences associated with transitions into and out of the labour market.
Grey matter correlates of clinical variables in amyotrophic lateral sclerosis (ALS): a neuroimaging study of ALS motor phenotype heterogeneity and cortical focality
Authors: Bede Peter , Bokde Arun , Elamin Marwa , Byrne Susan , McLaughlin Russell L , Jordan Norah , Hampel Harald , Gallagher Laura , Lynch Catherine , Fagan Andrew J , Pender Niall , Hardiman Orla
Published: October 2012

Background

Body region of onset and functional disability are key components of disease heterogeneity in amyotrophic lateral sclerosis (ALS).

Objectives

To evaluate patterns of grey matter pathology in the motor cortex and correlate focal structural changes with functional disability.

Methods

We conducted a single-centre neuroimaging study of a cohort of 33 cognitively normal patients with amyotrophic lateral sclerosis (ALS) and 44 healthy controls. A voxel-wise generalised linear model was used to investigate the distribution of disease burden within the motor cortex in relation to clinical disability.

Results

Patients with bulbar onset have bilateral focal atrophy in the bulbar segment of the motor homunculus compared with patients with limb onset who have focal cortical changes in the limb segment of their motor strip. Furthermore, the extent to which different body regions are affected in ALS corresponds to the extent of focal grey matter loss in the primary motor cortex. Cortical ALS pathology also extends beyond the motor cortex affecting frontal, occipital and temporal regions.

Conclusions

Focal grey matter atrophy within the motor homunculus corresponds with functional disability in ALS. The findings support the existing concepts of cortical focality and motor phenotype heterogeneity in ALS.
Therapeutic strategies for tau mediated neurodegeneration
Authors: Yoshiyama Yasumasa , Lee Virginia M Y , Trojanowski John Q
Published: October 2012

Based on the amyloid hypothesis, controlling β-amyloid protein (Aβ) accumulation is supposed to suppress downstream pathological events, tau accumulation, neurodegeneration and cognitive decline. However, in recent clinical trials, Aβ removal or reducing Aβ production has shown limited efficacy. Moreover, while active immunisation with Aβ resulted in the clearance of Aβ, it did not prevent tau pathology or neurodegeneration. This prompts the concern that it might be too late to employ Aβ targeting therapies once tau mediated neurodegeneration has occurred. Therefore, it is timely and very important to develop tau directed therapies. The pathomechanisms of tau mediated neurodegeneration are unclear but hyperphosphorylation, oligomerisation, fibrillisation and propagation of tau pathology have been proposed as the likely pathological processes that induce loss of function or gain of toxic function of tau, causing neurodegeneration. Here we review the strategies for tau directed treatments based on recent progress in research on tau and our understanding of the pathomechanisms of tau mediated neurodegeneration.
Point-of-care tests for the diagnosis ofNeisseria gonorrhoeaeinfection: a systematic review of operational and performance characteristics
Authors: Watchirs Smith Lucy Alexandra , Hillman Richard , Ward James , Whiley David M , Causer Louise , Skov Steven , Donovan Basil , Kaldor John , Guy Rebecca
Published: October 2012

Objectives

Systematic review of the performance and operational characteristics of point-of-care (POC) tests for the diagnosis ofNeisseria gonorrhoeae.

Methods

We searched PubMed and Embase until August 2010 using variations of the terms: ‘rapid test’, ‘Neisseria gonorrhoeae’ and ‘evaluation’.

Results

We identified 100 papers, 14 studies were included; nine evaluated leucocyte esterase (LE) dipsticks and three immunochromatographic strips, and two clinical audits of microscopy were identified. Of the field evaluations the gold standard was nucleic acid amplification technology in six studies and bacterial culture in the other six. In four studies, 50% or more of the patients were symptomatic. The median sensitivity of LE dipsticks was 71% (range 23–85%), median specificity was 70% (33–99%), median positive predictive value (PPV) was 19% (5–40%) and median negative predictive value (NPV) was 95% (56–99%). One LE study found a sensitivity of 23% overall, increasing to 75% in symptomatic women. LE dipsticks mostly involved three steps and took under 2 min. The median sensitivity of immunochromatographic tests (ICT) was 70% (60–94%), median specificity was 96% (89–97%), median PPV was 56% (55–97%) and median NPV was 93% (92–99%). Immunochromatic strips involved five to seven steps and took 15–30 min. Specificity of microscopy ranged from 38% to 89%.

Conclusions

ICT and LE tests had similar sensitivities, but sensitivity results may be overestimated as largely symptomatic patients were included in some studies. ICT had a higher specificity in women than LE tests. The findings highlight the need for improved POC tests for diagnosis ofN gonorrhoeaeand more standardised evaluations.
Antifungal activity of extracts from endophytic fungi associated with Smallanthus maintained in vitro as autotrophic cultures and as pot plants in the greenhouse
Authors: Rosa Luiz H. , Tabanca Nurhayat , Techen Natascha , Pan Zhiqiang , Wedge David E. , Moraes Rita M.
Published: October 2012

The endophytic fungal assemblages associated with Smallanthus sonchifolius (Poepp.) H. Rob. and Smallanthus uvedalius (L.) Mack. ex Small growing in vitro autotrophic cultures and in the greenhouse were identified and evaluated for their ability to produce bioactive compounds. A total of 25 isolates were recovered that were genetically closely related to species of the genera Bionectria , Cladosporium , Colletotrichum , Fusarium , Gibberella , Hypocrea , Lecythophora , Nigrospora , Plectosphaerella , and Trichoderma . The endophytic assemblages of S. sonchifolius presented a greater diversity than the group isolated from S. uvedalius and demonstrated the presence of dominant generalist fungi. Extracts of all fungi were screened against the fungal plant pathogens. Ten extracts (41.6%) displayed antifungal activities; some of them had a broad antifungal activity. The phylotypes Lecythophora sp. 1, Lecythophora sp. 2, and Fusarium oxysporum were isolated from in vitro autotrophic cultures and displayed antifungal activity. The presence of bioactive endophytic fungi within S. sonchifolius and S. uvedalius suggests an ecological advantage against pathogenic attacks. This study revealed reduced numbers of endophytes in association with both Smallanthus species in controlled cultivation conditions compared with the endophytic communities of hosts collected in the wild environments. Even as reduced endophytic communities, these fungi continue to provide chemical protection for the host.
Effect of 300 mT static and 50 Hz 0.1 mT extremely low frequency magnetic fields onTuber borchiimycelium
Authors: Potenza Lucia , Saltarelli Roberta , Polidori Emanuela , Ceccaroli Paola , Amicucci Antonella , Zeppa Sabrina , Zambonelli Alessandra , Stocchi Vilberto
Published: October 2012

The present work aimed to investigate whether exposure to static magnetic field (SMF) and extremely low frequency magnetic field (ELF-MF) can induce biomolecular changes on Tuber borchii hyphal growth. Tuber borchii mycelium was exposed for 1 h for 3 consecutive days to a SMF of 300 mT or an ELF-MF of 0.1 mT 50 Hz. Gene expression and biochemical analyses were performed. In mycelia exposed to ELF-MF, some genes involved in hyphal growth, investigated using quantitative real-time polymerase chain reaction, were upregulated, and the activity of many glycolytic enzymes was increased. On the contrary, no differences were observed in gene expression after exposure to SMF treatment, and only the activities of glucose 6-phosphate dehydrogenase and hexokinase increased. The data herein presented suggest that the electromagnetic field can act as an environmental factor in promoting hyphal growth and can be used for applicative purposes, such as the set up of new in vitro cultivation techniques.
Deletion of TerD-domain-encoding genes: effect on Streptomyces coelicolor development
Authors: Sanssouci Édith , Lerat Sylvain , Daigle François , Grondin Gilles , Shareck François , Beaulieu Carole
Published: October 2012

TerD-domain-encoding genes (tdd genes) are highly represented in the Streptomyces coelicolor genome. One of these, the tdd8 gene, was recently shown to have a crucial influence on growth, differentiation, and spore development of this filamentous bacterium. The investigation of the potential role of tdd genes has been extended here to tdd7 (SCO2367) and tdd13 (SCO4277). Both genes are highly expressed in bacteria grown in liquid-rich medium (tryptic soy broth). However, the deletion of these genes in S. coelicolor showed contrasting effects regarding developmental patterns, sporulation, and antibiotic production. Deletion of the tdd7 gene induced a reduction of growth in liquid medium, wrinkling of the mycelium on solid medium, and poor spore and actinorhodin production. On the other hand, deletion of the tdd13 gene did not significantly affect growth in liquid medium but induced a small colony phenotype on solid medium with abundant sporulation and overproduction of undecylprodigiosin. Although their exact functions remain undefined, the present data suggest a major involvement of TerD proteins in the proper development of S. coelicolor.
OPTIMAL SCHEDULING OF RANDOM WORKS WITH RELIABILITY APPLICATION
Authors: CHEN MINGCHIH , NAKAGAWA TOSHIO
Published: October 2012

This paper addresses a scheduling problem with random processing time when the operating system is subject to stochastic failure. First, scheduling of a single job is reviewed and the expected cost rate is obtained. Single scheduling time and multiple scheduling times for one job are discussed and the expected cost functions are obtained to setup the optimal due date. Numerical example is given to demonstrate the scheme of multiple scheduling times. Next, the scheduling problems of N tandem jobs and N parallel jobs are formulated and the expected cost functions are also derived. The optimal scheduling times which minimize the expected cost functions are discussed analytically.
SCHEDULING JOBS WITH PROCESSING TIMES DEPENDENT ON POSITION, STARTING TIME, AND ALLOTTED RESOURCE
Authors: WANG JI-BO , WANG MING-ZHENG , JI PING
Published: October 2012

We consider single-machine scheduling problem in which the processing time of a job is a function of its position in a sequence, its starting time, and its resource allocation. The objective is to find the optimal sequence of jobs and the optimal resource allocation separately. We concentrate on two goals separately, namely, minimizing a cost function containing makespan, total completion time, total absolute differences in completion times, and total resource cost; minimizing a cost function containing makespan, total waiting time, total absolute differences in waiting times, and total resource cost. The problem is modeled as an assignment problem, and thus can be solved in polynomial time. Some extensions of the problem are also shown.
AN IMPROVED REDUCTION METHOD FOR THE ROBUST OPTIMIZATION OF THE ASSIGNMENT PROBLEM
Authors: YOU BYUNGJUN , YOKOYA DAISUKE , YAMADA TAKEO
Published: October 2012

We are concerned with a variation of the assignment problem, where the assignment costs differ under different scenarios. We give a surrogate relaxation approach to derive a lower bound and an upper bound quickly, and show that the pegging test known for zero–one programming problems is also applicable to this problem. Next, we discuss how the computation time for pegging can be shortened by taking the special structure of the assignment problem into account. Finally, through numerical experiments we show that the developed method finds exact solutions for instances with small number of scenarios in relatively small CPU time, and good approximate solutions in case of many scenarios.