bluuebunny/crossref_metadata_2025 huggingface dataset:
Exercise Training in Patients with Chronic Heart Failure Promotes Restoration of High-Density Lipoprotein Functional Properties
Authors: Adams Volker , Besler Christian , Fischer Tina , Riwanto Meliana , Noack Friederike , Höllriegel Robert , Oberbach Andreas , Jehmlich Nico , Völker Uwe , Winzer Ephraim B. , Lenk Karsten , Hambrecht Rainer , Schuler Gerhard , Linke Axel , Landmesser Ulf , Erbs Sandra
Published: September 2013

Rationale:

High-density lipoprotein (HDL) exerts endothelial-protective effects via stimulation of endothelial cell (EC) nitric oxide (NO) production. This function is impaired in patients with cardiovascular disease. Protective effects of exercise training (ET) on endothelial function have been demonstrated.

Objective:

This study was performed to evaluate the impact of ET on HDL-mediated protective effects and the respective molecular pathways in patients with chronic heart failure (CHF).

Methods and Results:

HDL was isolated from 16 healthy controls (HDL
healthy
) and 16 patients with CHF-NYHA-III (HDL
NYHA-IIIb
) before and after ET, as well as from 8 patients with CHF-NYHA-II (HDL
NYHA-II
). ECs were incubated with HDL, and phosphorylation of eNOS-Ser
1177
, eNOS-Thr
495
, PKC-βII-Ser
660
, and p70S6K-Ser
411
was evaluated. HDL-bound malondialdehyde and HDL-induced NO production by EC were quantified. Endothelial function was assessed by flow-mediated dilatation. The proteome of HDL particles was profiled by shotgun LC-MS/MS. Incubation of EC with HDL
NYHA-IIIb
triggered a lower stimulation of phosphorylation at eNOS-Ser
1177
and a higher phosphorylation at eNOS-Thr
495
when compared with HDL
healthy
. This was associated with lower NO production of EC. In addition, an elevated activation of p70S6K, PKC-βII by HDL
NYHA-IIIb
, and a higher amount of malondialdehyde bound to HDL
NYHA-IIIb
compared with HDL
healthy
was measured. In healthy individuals, ET had no effect on HDL function, whereas ET of CHF-NYHA-IIIb significantly improved HDL function. A correlation between changes in HDL-induced NO production and flow-mediated dilatation improvement by ET was evident.

Conclusions:

These results demonstrate that HDL function is impaired in CHF and that ET improved the HDL-mediated vascular effects. This may be one mechanism how ET exerts beneficial effects in CHF.
Assessment and Prognostic Relevance of Right Ventricular Contractile Reserve in Patients With Severe Pulmonary Hypertension
Authors: Grünig Ekkehard , Tiede Henning , Enyimayew Esi Otuwa , Ehlken Nicola , Seyfarth Hans-Jürgen , Bossone Eduardo , D’Andrea Antonello , Naeije Robert , Olschewski Horst , Ulrich Silvia , Nagel Christian , Halank Michael , Fischer Christine
Published: September 2013

Background—

This study sought to analyze a new approach to assess exercise-induced pulmonary artery systolic pressure (PASP) increase by means of stress Doppler echocardiography as a possible measure of right ventricular contractile reserve in patients with severe pulmonary hypertension and right heart failure.

Methods and Results—

In this prospective study, patients with invasively diagnosed pulmonary arterial hypertension or inoperable chronic thromboembolic pulmonary hypertension and impaired right ventricular pump function despite a stable targeted pulmonary arterial hypertension medication underwent a broad panel of noninvasive assessments, including stress echocardiography and cardiopulmonary exercise testing. On the basis of the assumption that exercise-induced PASP is a measure of right ventricular contractile reserve, patients were classified into 2 groups according to an exercise-induced PASP increase above or below the median. Patients were followed up for 3.0±1.8 years. Univariate and multivariate analyses were used for factors predicting survival. Of 124 patients, 66 were below the median exercise-induced PASP increase of 30 mm Hg (low PASP), and 58 patients were above the median (high PASP). These groups were not significantly different in terms of medication and resting hemodynamics. Low PASP was associated with a significantly lower 6-minute walking distance, peak

o
2
per kilogram, and 1-, 3-, and 4-year survival rates (92%, 69%, and 48%, respectively, versus 96%, 92%, and 89%). In the multivariate Cox model analysis adjusted for age and sex, PASP increase during exercise and peak

o
2
per kilogram remained independent prognostic markers (hazard ratio, 2.56 for peak

o
2
per kilogram and 2.84 for PASP increase).

Conclusions—

Exercise-induced PASP increase is of high clinical and prognostic relevance in pulmonary hypertension patients and may indicate right ventricular contractile reserve. Stress Doppler echocardiography may be a useful tool for prognostic assessment in pulmonary hypertension patients.
Right Ventricular Diastolic Impairment in Patients With Pulmonary Arterial Hypertension
Authors: Rain Silvia , Handoko M. Louis , Trip Pia , Gan C. Tji-Joong , Westerhof Nico , Stienen Ger J. , Paulus Walter J. , Ottenheijm Coen A.C. , Marcus J. Tim , Dorfmüller Peter , Guignabert Christophe , Humbert Marc , MacDonald Peter , dos Remedios Cris , Postmus Piet E. , Saripalli Chandra , Hidalgo Carlos G. , Granzier Henk L. , Vonk-Noordegraaf Anton , van der Velden Jolanda , de Man Frances S.
Published: September 2013

Background—

The role of right ventricular (RV) diastolic stiffness in pulmonary arterial hypertension (PAH) is not well established. Therefore, we investigated the presence and possible underlying mechanisms of RV diastolic stiffness in PAH patients.

Methods and Results—

Single-beat RV pressure-volume analyses were performed in 21 PAH patients and 7 control subjects to study RV diastolic stiffness. Data are presented as mean±SEM. RV diastolic stiffness (β) was significantly increased in PAH patients (PAH, 0.050±0.005 versus control, 0.029±0.003;
P
<0.05) and was closely associated with disease severity. Subsequently, we searched for possible underlying mechanisms using RV tissue of PAH patients undergoing heart/lung transplantation and nonfailing donors. Histological analyses revealed increased cardiomyocyte cross-sectional areas (PAH, 453±31 μm
2
versus control, 218±21 μm
2
;
P
<0.001), indicating RV hypertrophy. In addition, the amount of RV fibrosis was enhanced in PAH tissue (PAH, 9.6±0.7% versus control, 7.2±0.6%;
P
<0.01). To investigate the contribution of stiffening of the sarcomere (the contractile apparatus of RV cardiomyocytes) to RV diastolic stiffness, we isolated and membrane-permeabilized single RV cardiomyocytes. Passive tension at different sarcomere lengths was significantly higher in PAH patients compared with control subjects (>200%;
P
interaction
<0.001), indicating stiffening of RV sarcomeres. An important regulator of sarcomeric stiffening is the sarcomeric protein titin. Therefore, we investigated titin isoform composition and phosphorylation. No alterations were observed in titin isoform composition (N2BA/N2B ratio: PAH, 0.78±0.07 versus control, 0.91±0.08), but titin phosphorylation in RV tissue of PAH patients was significantly reduced (PAH, 0.16±0.01 arbitrary units versus control, 0.20±0.01 arbitrary units;
P
<0.05).

Conclusions—

RV diastolic stiffness is significantly increased in PAH patients, with important contributions from increased collagen and intrinsic stiffening of the RV cardiomyocyte sarcomeres.
Sultan, Scholar, and Sufi: Authority and Power Relations in al-Suyūṭī’s Fatwā on Waqf
Authors: Skreslet Hernandez Rebecca
Published: September 2013

This essay examines a legal opinion (fatwā) by the accomplished fifteenth-century polymath, Jalāl al-Dīn al-Suyūṭī (d. 911/1505). In his treatise, the author investigates the issue of whose stipend should be given priority in endowed institutions that receive funding from the state Treasury in times of financial crisis. He argues that the scholar should have priority in deference to his learning, even if he does not fulfill the obligations stipulated in the endowment. I argue that al-Suyūṭī’s fatwā, viewed within the context of personal conflicts in his own life, reveals much about the jurist’s efforts to assert moral and persuasive authority, as well as about larger struggles between different sectors of late Mamluk society. Both in his writing and in practice, al-Suyūṭī defends the role of the righteous scholar against the worldly power of the state and against the corruption of the Sufi students under his supervision.
Authoritarian Party Systems: Patterns of Emergence, Sustainability and Survival
Authors: Golosov Grigorii V.
Published: September 2013

Abstract

This article compares competitive authoritarian, one-party authoritarian, and democratic party systems on three parameters: likelihood to emerge, sustainability and durability. By applying a variety of statistical techniques to a comprehensive dataset on post-World War II elections, this study shows that under competitive authoritarianism, elections are less likely to be party-structured than in democracies, and that competitive authoritarian party systems are markedly less sustainable and durable than systems in the other categories, especially in democracies. These findings are in accordance with the theory according to which competitive authoritarian institutions are epiphenomena, reflecting the distribution of power in the polity but not shaping it. Their emergence and survival are consequences rather than causes of the stability and success of contemporary autocracies.
Economic Openness and Domestic Demand for Social Protection: A Multi-Level Analysis of Social Security Preferences between 1990 and 2006
Authors: Dallinger Ursula
Published: September 2013

Abstract

Comparative research revealed that social programs did not suffer significant decline despite globalisation and stiffer international competition. Instead, a striking stability of social expenditure is observed which is explained by voters’ demands for social protection because of new uncertainties connected to economic openness. The domestic demand approach conceives the welfare state as a means to compensate for the risks a globalised economy puts on citizens’ job security, and as a means to foster the acceptance of an open economy. Given the prominence of these assumptions little research has been conducted to test them. Does economic openness actually increase unemployment and feelings of job insecurity? Does this in turn lead to a higher voter demand for social security? This paper analyses the propositions of domestic demand approaches based on a data set comprised of waves of the module “Role of Government” from the International Social Survey Programme (1990, 1996 and 2006) and additional country-level features. The results show that economic openness has a negative effect when other insecurity-causing trends are controlled. Also subjective job insecurity instead of the projected positive effect rather shows a negative relation. Social security demand decreases the more job insecurity people perceive. This is interpreted as a consequence of the fear of those still employed that voting for more expenditures would endanger existing jobs. Moreover, the hypothesis that economic openness now spreads economic risks and feelings of insecurity over a broader social strata rather than remaining mired at the low end of the social spectrum is not confirmed.
Cross-National Variation in Socioeconomic Status and Delinquency: A Comparative Study of Adolescents from 26 European Countries
Authors: Savolainen Jukka , Savolainen Jukka , Hughes Lorine A. , Savolainen Jukka , Hughes Lorine A. , Bjarnason Thoroddur
Published: September 2013

Abstract

This research examined cross-national differences in the association between social class and delinquency. The poverty hypothesis expects socioeconomic disadvantage to exert a causal influence on delinquent behavior. This expectation implies that the individual-level association between family SES and delinquent offending will be attenuated at increased levels of collective social protection. The social selection perspective also assumes a negative relationship between SES and delinquency but explains it away as a spurious consequence of intergenerational transmission of antisocial propensity. In light of comparative research on social stratification, the selection perspective suggests that the association between low parental SES and offspring criminality may be stronger in advanced welfare states due to reduced influence of ascribed characteristics on socioeconomic attainment in these countries. Survey data from 26 European countries (n=78,703) were used to evaluate the validity of these conflicting hypotheses. In support of the selection perspective, results showed that class differences in delinquent offending are larger in more advanced welfare states.
Beyond Anti-Corruptionism: Sociological Imagination and Comparative Study of Corruption
Authors: Zaloznaya Marina
Published: September 2013

Abstract

This article outlines and illustrates a theoretical blueprint for comparative sociology of corruption. The author argues that existing cross-national studies of corruption, influenced by the global political movement for transparency, undermine fundamental sociological principles. At the same time, truly sociological studies of corruption are unfavorable to comparisons due to their emphasis on the singularity of exchange economies in non-Western societies. The author argues that there are three analytical foci that can help researchers resolve the tension between ‘insensitive’ large-N and ‘overly-sensitive’ small-N studies of corruption: the principle of social embeddedness, multiplicity of rationality, and localized power implications. A comparative study of university corruption in Post-Soviet Ukraine and Belarus is used to illustrate the strengths of the proposed analytical framework.
Delta insulin-like growth factor binding protein-1 (ΔIGFBP-1): a marker of hepatic insulin resistance?
Authors: Borai Anwar , Livingstone Callum , Heald Adrian H , Oyindamola Yusuf , Ferns Gordon
Published: September 2013

Background

Insulin-like growth factor binding protein-1 (IGFBP-1) is a hepatically synthesised protein which can be used as a marker of insulin resistance. We hypothesised that the fall in serum IGFBP-1 at 2 h following a glucose load ( ΔIGFBP-10–2h) would be a more robust measure of hepatic insulin resistance than a fasting level alone.

Methods

All subjects had a standard 75 g oral GTT including IGFBP-1 and insulin measurement to enable calculation of ΔIGFBP-10–2h, ΔInsulin0–2h, and insulin sensitivity indices. At a second visit, subjects had a frequently sampled intravenous glucose tolerance test (FSIVGTT) in order to determine the insulin sensitivity index, Si.

Results

Twenty-two individuals had normal glucose tolerance (NGT) and 9 impaired fasting glucose (IFG). ΔIGFBP-10–2h correlated with Si in total subjects ( r = 0.49, p = 0.005) and NGT subjects ( r = 0.50, p = 0.02) but not in IFG subjects ( r = 0.43, p = 0.24). ΔInsulin0–2h/ ΔIGFBP-10–2h correlated significantly with Si in total subjects ( r = −0.68, p < 0.001) and in NGT subjects ( r = −0.57, p = 0.005). Multivariate analysis was fitted using different models while keeping other explanatory variables constant. The fasting IGFBP-1 model was a better predictor of Si ( β = 0.431, p < 0.0001) than the ΔInsulin0–2h/ ΔIGFBP10–2h model ( β = −0.185, p = 0.004).

Conclusions

The dynamic indices ΔIGFBP-10–2h and ΔInsulin0–2h/ ΔIGFBP-10–2h appear suitable markers of (hepatic) insulin resistance with potential clinical utility.
Outliers affecting cardiac troponin I measurement: comparison of a new high sensitivity assay with a contemporary assay on the Abbott ARCHITECT analyser
Authors: Sawyer Nicola , Blennerhassett John , Lambert Ramon , Sheehan Paul , Vasikaran Samuel D
Published: September 2013

Background

False-positive cardiac troponin (Tn) results caused by outliers have been reported on various analytical platforms. We have compared the precision profile and outlier rate of the Abbott Diagnostics contemporary troponin I (TnI) assay with their high sensitivity (hs) TnI assay.

Methods

Three studies were conducted over a 10-month period using routine patients’ samples. TnI was measured in duplicate using the contemporary TnI assay in Study 1 and Study 2 ( n = 7011 and 7089) and the hs–TnI assay in Study 3 ( n = 1522). Critical outliers were defined as duplicate results whose absolute difference exceeded a critical difference (CD =  z x √2 x SDAnalytical) at a probability level of 0.0005, with one of the results on the opposite side of the decision limit to its partner.

Results

The TnI concentration at 10% imprecision (coefficient of variation) for the contemporary TnI assay was 0.034 µg/L (Study 1) and 0.042 µg/L (Study 2), and 0.006 µg/L (6 ng/L) for the hs–TnI assay. The critical outlier rates for the contemporary TnI assay were 0.51% (Study 1) and 0.37% (Study 2) using a cut-off of 0.04 µg/L, and 0% for the hs–TnI assay using gender-specific cut-offs.

Conclusion

The significant number of critical outliers detected using the contemporary TnI assay may pose a risk for misclassification of patients. By contrast, no critical outliers were detected using the hs–TnI assay. However, the total outlier rates for both assays were significantly higher than the expected variability of either assay. The cause of these outliers remains unclear.
Mood disturbance after infection
Authors: Gunaratne Pramudie , Lloyd Andrew R , Vollmer-Conna Ute
Published: September 2013

Objective:

An aetiological link between acute infection and major depression has long been hypothesized, and is increasingly gaining recognition within contemporary literature. This review aims to examine the evidence for such a link, specifically between acute, self-limiting infection and major depression, and to summarize the current understanding of pathophysiological mechanisms underlying this link.

Methods:

Relevant articles were sourced via an online search of published literature from Embase, MEDLINE, PsycINFO and PubMed using a variety of search terms including mood disorder, depression, infection and inflammation. Additionally, a search for articles from the bibliographies of retrieved papers was conducted.

Results:

Findings from retrospective studies suggest an association between infection and subsequent mood disturbance, including major depression. This association has been confirmed by studies employing prospective observational or experimental challenge designs. The available evidence supports a multifactorial basis of vulnerability towards major depression in the context of acute infection. Genetic, neuroendocrine, autonomic and psychosocial factors may interact to potentiate the likelihood of a severe and prolonged depressive response to an immunological stressor in some individuals.

Conclusion:

Mood disturbance is likely to have a host-protective role in the context of an acute sickness response to infection. However, this usually adaptive and reversible response may progress in some vulnerable individuals into a more sustained and severe pattern of behavioural and physiological changes of major depression. Further research is needed to delineate the factors that predispose, precipitate and perpetuate depression in the context of acute infective illness. Such insights will inform effective prevention and treatment strategies.
Primary Care Physicians’ Knowledge of and Confidence in Their Referrals for Special Education Services in 3- to 5-Year-Old Children
Authors: Hastings Elizabeth A. , Lumeng Julie C. , Clark Sarah J.
Published: September 2013

Background. Children 3 to 5 years old with developmental delays are eligible for special education services. Objective. To assess primary care physicians’ (PCPs) knowledge, attitudes, and practices regarding their referrals to the special education system on behalf of children 3 to 5 years old. Design/Methods. Mail survey of 400 office-based general pediatricians and 414 family physicians in Michigan, fielded in fall 2012 and winter 2013, with a response rate of 44%. The 4-page survey included knowledge questions about special education eligibility, PCPs’ role in accessing school-based services, and self-confidence in ability to help patients access these services. Results. PCPs neither fully understood requirements for special education services nor were they very confident in identifying 3- to 5-year-old children eligible for special education services. Conclusions. PCPs recognize interacting with special education as a relative weakness, and they may be accepting of interventions to improve their knowledge and skills.
Assessing Ethical Organizational Culture
Authors: DeBode Jason D. , Armenakis Achilles A. , Feild Hubert S. , Walker Alan G.
Published: September 2013

An important element in discussions of organizational ethicality is the diagnosis of organizational culture. Kaptein developed the Corporate Ethical Virtues Model Scale (CEVMS) to facilitate this task. We build on this work by developing a short form of Kaptein’s scale, the CEVMS–Short Form (CEVMS-SF). In a series of studies, using three independent samples, we (a) developed the CEVMS-SF (Study 1, n = 274), (b) tested the psychometric properties of the short form (Study 2, n = 417), and (c) found validity evidence (Study 3, n = 204) for the measure. The primary implication of this research is that the CEVMS-SF can be combined with existing scales allowing diagnosticians to conduct more comprehensive diagnoses by including ethical culture. We also explain how the CEVMS-SF is applicable in the action research process when conducting a diagnosis or evaluating change interventions during the transformation of an unethical organizational culture to an ethical one.
Pain Fiber Anesthetic Reduces Brainstem Fos after Tooth Extraction
Authors: Badral B. , Davies A.J. , Kim Y.H. , Ahn J.S. , Hong S.D. , Chung G. , Kim J.S. , Oh S.B.
Published: September 2013

We recently demonstrated that pain-sensing neurons in the trigeminal system can be selectively anesthetized by co-application of QX-314 with the TRPV1 receptor agonist, capsaicin (QX cocktail). Here we examined whether this new anesthetic strategy can block the neuronal changes in the brainstem following molar tooth extraction in the rat. Adult male Sprague-Dawley rats received infiltration injection of anesthetic 10 min prior to lower molar tooth extraction. Neuronal activation was determined by immunohistochemistry for the proto-oncogene protein c-Fos in transverse sections of the trigeminal subnucleus caudalis (Sp5C). After tooth extraction, c-Fos-like immunoreactivity (Fos-LI) detected in the dorsomedial region of bilateral Sp5C was highest at 2 hrs ( p < .01 vs. naïve ipsilateral) and declined to pre-injury levels by 8 hrs. Pre-administration of the QX cocktail significantly reduced to sham levels Fos-LI examined 2 hrs after tooth extraction; reduced Fos-LI was also observed with the conventional local anesthetic lidocaine. Pulpal anesthesia by infiltration injection was confirmed by inhibition of the jaw-opening reflex in response to electrical tooth pulp stimulation. Our results suggest that the QX cocktail anesthetic is effective in reducing neuronal activation following tooth extraction. Thus, a selective pain fiber ‘nociceptive anesthetic’ strategy may provide an effective local anesthetic option for dental patients in the clinic.
Bioactive Nanofibrous Scaffolds for Regenerative Endodontics
Authors: Bottino M.C. , Kamocki K. , Yassen G.H. , Platt J.A. , Vail M.M. , Ehrlich Y. , Spolnik K.J. , Gregory R.L.
Published: September 2013

Here we report the synthesis, materials characterization, antimicrobial capacity, and cytocompatibility of novel antibiotic-containing scaffolds. Metronidazole (MET) or Ciprofloxacin/(CIP) was mixed with a polydioxanone (PDS)polymer solution at 5 and 25 wt% and processed into fibers. PDS fibers served as a control. Scanning electron microscopy (SEM), Fourier-transform infrared spectroscopy (FTIR), tensile testing, and high-performance liquid chromatography (HPLC) were used to assess fiber morphology, chemical structure, mechanical properties, and drug release, respectively. Antimicrobial properties were evaluated against those of Porphyromonas gingivalis/Pg and Enterococcus faecalis/Ef. Cytotoxicity was assessed in human dental pulp stem cells (hDPSCs). Statistics were performed, and significance was set at the 5% level. SEM imaging revealed a submicron fiber diameter. FTIR confirmed antibiotic incorporation. The tensile values of hydrated 25 wt% CIP scaffold were significantly lower than those of all other groups. Analysis of HPLC data confirmed gradual, sustained drug release from the scaffolds over 48 hrs. CIP-containing scaffolds significantly ( p < .00001) inhibited biofilm growth of both bacteria. Conversely, MET-containing scaffolds inhibited only Pg growth. Agar diffusion confirmed the antimicrobial properties against specific bacteria for the antibiotic-containing scaffolds. Only the 25 wt% CIP-containing scaffolds were cytotoxic. Collectively, this study suggests that polymer-based antibiotic-containing electrospun scaffolds could function as a biologically safe antimicrobial drug delivery system for regenerative endodontics.
Dental Pulp Tissue Engineering in Full-length Human Root Canals
Authors: Rosa V. , Zhang Z. , Grande R.H.M. , Nör J.E.
Published: September 2013

The clinical translation of stem-cell-based dental pulp regeneration will require the use of injectable scaffolds. Here, we tested the hypothesis that stem cells from exfoliated deciduous teeth (SHED) can generate a functional dental pulp when injected into full-length root canals. SHED survived and began to express putative markers of odontoblastic differentiation after 7 days when mixed with Puramatrix™ (peptide hydrogel), or after 14 days when mixed with recombinant human Collagen (rhCollagen) type I, and injected into the root canals of human premolars in vitro. Roots of human premolars injected with scaffolds (Puramatrix™ or rhCollagen) containing SHED were implanted subcutaneously into immunodeficient mice (CB-17 SCID). We observed pulp-like tissues with odontoblasts capable of generating new tubular dentin throughout the root canals. Notably, the pulp tissue engineered with SHED injected with either Puramatrix™ or rhCollagen type I presented similar cellularity and vascularization when compared with control human dental pulps. Analysis of these data, collectively, demonstrates that SHED injected into full-length human root canals differentiate into functional odontoblasts, and suggests that such a strategy might facilitate the completion of root formation in necrotic immature permanent teeth.
Night lives: Heterotopia, youth transitions and cultural infrastructure in the urban night
Authors: Gallan Ben
Published: September 2013

This paper adapts the concept of heterotopia to understand youth transitions through spaces of night-time cultural infrastructure. While youth transitions in the urban night have been well theorised, what these transitions mean for diverse cultural infrastructure provision has received less attention. Drawing on ethnography of a local punk music scene in the Australian city of Wollongong, the paper analyses how the scene was connected to one specific venue, an alternative ‘haven’ in a monopolised night-time economy. Participants revealed a trend of repetitive yet relatively fleeting association with the local scene and venue, at times a site of hedonism and celebration but also enabling grief and rites-of-passage. Temporal elements of heterotopia are developed to interpret the venue’s valued sense of ‘difference’ during active participation, but also long after association with the space. Such transitions are poorly understood, especially in planning and policy debate, influencing the way night-time cultural infrastructure is provisioned.
Quasi-surgical technique for easy removal of broken tooth roots
Authors: Uppal Nakul , Hong Lim Wai
Published: September 2013

We describe a new technique for the removal of broken tooth roots utilizing existing dental equipment.
Does progressive resistance strength training as additional training have any measured effect on functional outcomes in older hospitalized patients? A single-blinded randomized controlled trial
Authors: Tibaek Sigrid , Andersen Christina W , Pedersen Sigrid F , Rudolf Karen S
Published: September 2013

Objective:

To evaluate the effect of progressive resistance strength training as additional training measured on functional outcomes in older hospitalized patients.

Design:

A single-blinded randomized controlled trial.

Setting:

Department of Geriatric Rehabilitation in university hospital.

Participants:

A sample of 71 patients were successively included and randomized either to the treatment group (TG) ( n = 36) or the control group (CG) ( n = 35). Fifteen participants dropped out (TG n = 7; CG n = 8), leaving 56 participants with a mean age of 79 (SD 7).

Intervention:

Participants in the treatment group were treated in groups with progressive resistance strength training in addition to standard care. Progressive resistance strength training of the lower extremities was performed in three sets of 12–15 repetitions, intensity 60–70% of one repetition maximum, in four 50-minute sessions per week.

Main measures:

The effect was evaluated by timed up & go test, 30-second chair-stand test, 10-m walk test, three tasks (transfer, walking, stairs) of the Barthel Index, and use of walking aids.

Results:

Significant improvements in the 10-m walk test ( P < 0.01) and Barthel Index (walking) ( P = 0.01) were demonstrated within the treatment group but not in the control group. Both groups had significant improvements in timed up & go, 30-second chair-stand (modified) and Barthel Index (transfer and walking). No significant difference was found between groups except for the Barthel Index (stairs) ( P = 0.05). Analysis by the mixed-effects model showed that the treatment group improved more than the control group in all outcome variables.

Conclusion:

The results indicate that for older hospitalized patients progressive resistance strength training as additional training may have an effect compared to standard care, but no statistically significant effects were demonstrated when measured by functional outcomes.
α-[11C] methyl-L tryptophan-PET as a surrogate for interictal cerebral serotonin synthesis in migraine without aura
Authors: Sakai Y , Nishikawa M , Diksic M , Aubé M
Published: September 2013

Background

Alteration in central serotonin biology has been implicated in migraine, and serotonin (5-HT) agonists have been available for more than a decade in the treatment of that condition.

Objectives

To test this hypothesis, we studied in vivo using positron-emission tomography (PET) and α-[11C] methyl-L-tryptophan (α-[11C]MTrp) as a surrogate marker of cerebral 5-HT synthetic rate before and after administration of eletriptan in migraine and control subjects.

Methods

Six nonmenopausal female migraine subjects with migraine without aura (MoA) and six nonmenopausal age-matched female control subjects were scanned at baseline and after oral administration of 40 mg of eletriptan. Migraine subjects at the time of PET had to have been headache free for a minimum of three days. Images of (α-[11C]MTrp) brain trapping were colocalized with individual MRI images in three dimensions and analyzed.

Results

There was no difference in baseline cerebral global 5-HT synthesis between migraine and control subjects. After administration of eletriptan, there was a striking global reduction in cerebral 5-HT synthesis (K*) in the migraine group and in 22 regions of interest (ROIs). In control subjects, no significant changes were found in global cerebral 5-HT synthesis (K*) or in any of the ROIs.

Conclusions

These findings suggest in migraine an interictal alteration in the regulation mechanisms of cerebral 5-HT synthesis.
Anatomic and Radiographic Comparison of Arthroscopic Suprapectoral and Open Subpectoral Biceps Tenodesis Sites
Authors: Johannsen Adam M. , Macalena Jeffrey A. , Carson Eric W. , Tompkins Marc
Published: September 2013

Background:

Arthroscopic suprapectoral and open subpectoral surgical techniques are both commonly utilized approaches for proximal biceps tenodesis of the long head of the biceps brachii. A central limitation to the widespread use of an arthroscopic approach for biceps tenodesis is that the tendon may be tenodesed too proximally in the bicipital groove, leading to persistent pain and tendinopathy.

Purpose/Hypothesis:

The purpose of this study was to determine the in vivo tenodesis location using arthroscopic suprapectoral and open subpectoral techniques for proximal biceps tenodesis in relation to clinically pertinent anatomic and radiographic landmarks. The null hypothesis was that arthroscopic suprapectoral biceps tenodesis would not be significantly different in terms of the location from open subpectoral biceps tenodesis.

Study Design:

Controlled laboratory study.

Methods:

A total of 20 matched pairs of cadaveric shoulder specimens were randomized such that within each pair, 1 shoulder underwent a standard open subpectoral biceps tenodesis and the other underwent an arthroscopic suprapectoral tenodesis. Limited dissection and exposure of the surgical tunnel site and reference landmarks were subsequently performed, and anteroposterior and lateral radiographs were obtained. Direct measurements were performed anatomically using a digital caliper and radiographically using picture archiving and communication system (PACS) software from the proximal lip of the humeral tunnel to regional landmarks.

Results:

Both techniques were able to place the humeral tunnel distal to the bicipital groove in all specimens. On average, the open subpectoral approach placed the tunnel 2.2 cm distal to the arthroscopic suprapectoral approach.

Conclusion:

The arthroscopic suprapectoral biceps tenodesis technique used in this study consistently placed the tenodesis tunnel distal to the bicipital groove, which may allay concerns about the bicipital groove as a pain source after this procedure.

Clinical Relevance:

This anatomic study provides new information on tunnel placement in 2 biceps tenodesis techniques. In addition, it provides clinically relevant anatomic and radiographic guidelines using clinically pertinent landmarks. This information may be useful in preoperative planning, intraoperative technique, and postoperative assessment of both open subpectoral and arthroscopic suprapectoral biceps tenodesis.
Intracranial Arteriopathy in Tuberous Sclerosis Complex
Authors: Boronat Susana , Shaaya Elias A. , Auladell Maria , Thiele Elizabeth A. , Caruso Paul
Published: September 2013

Arterial aneurysms, mostly aortic and intracranial, have been occasionally reported in patients with tuberous sclerosis complex. Brain magnetic resonance imaging reports of 404 patients with definite and 16 patients with either probable or possible tuberous sclerosis complex were revised for intracranial aneurysms. Among these patients, brain images of 220 patients with definite and 16 with probable or possible tuberous sclerosis complex were reviewed. Intracranial aneurysms were reported in 3 of 404 patients with a definite diagnosis (0.74%) (general population: 0.35%), including 2 children. A fourth intracranial aneurysm was found in a patient with probable tuberous sclerosis complex, who did not have tubers or subependymal nodules but had clinical manifestations related to neural crest derivatives, including lymphangioleiomyomatosis and extrarenal angiomyolipomas. The authors hypothesize that neural crest dysfunction can have a major role in intracranial arteriopathy in tuberous sclerosis complex, as smooth muscle cells in the forebrain vessels are of neural crest origin.
Nemaline Myopathy Type 2 (NEM2)
Authors: Gajda Anna , Horváth Emese , Hortobágyi Tibor , Gergev Gyurgyinka , Szabó Hajnalka , Farkas Katalin , Nagy Nikoletta , Széll Márta , Sztriha László
Published: September 2013

Nemaline myopathy is a type of the heterogeneous group of congenital myopathies. Generalized hypotonia, weakness, and delayed motor development are the main clinical features of the typical congenital form. Histopathology shows characteristic nemaline rods in the muscle biopsy. Mutations in at least 7 genes, including nebulin gene ( NEB), proved to be responsible for this muscle disease. We present a boy with nemaline myopathy type 2 (NEM2) caused by compound heterozygosity for 2 novel mutations, a deletion and a duplication in the NEB gene. The deletion was inherited from the father and the duplication from the mother. Testing all family members supports genetic counseling.
Clinical Manifestations and Treatment Response of Steroid in Pediatric Hashimoto Encephalopathy
Authors: Yu Hee Joon , Lee Jeehun , Seo Dae Won , Lee Munhyang
Published: September 2013

Hashimoto encephalopathy is a steroid-responsive encephalopathy associated with elevated titers of antithyroid antibodies. Clinical symptoms are characterized by behavioral and cognitive changes, speech disturbance, seizures, myoclonus, psychosis, hallucination, involuntary movements, cerebellar signs, and coma. The standard treatment is the use of corticosteroids along with the treatment of any concurrent dysthyroidism. Other options are immunoglobulins and plasmapheresis. We described symptoms and outcomes on 3 teenage girls with Hashimoto encephalopathy. Presenting symptoms were seizure or altered mental status. One patient took levothyroxine due to hypothyroidism before presentation of Hashimoto encephalopathy. After confirmation of elevated antithyroid antibodies, all patients were treated with steroids. One patient needed plasmapheresis because of the lack of response to steroids and immunoglobulins. Hashimoto encephalopathy should be considered in any patient presenting with acute or subacute unexplained encephalopathy and seizures. Even though the use of steroids is the first line of treatment, plasmapheresis can rescue steroid-resistant patients.
Congenital Segmental Lymphedema in Tuberous Sclerosis Complex With Associated Subependymal Giant Cell Astrocytomas Treated with Mammalian Target of Rapamycin Inhibitors
Authors: Prato Giulia , Mancardi Maria Margherita , Baglietto Maria Giuseppina , Janis Sara , Vercellino Nadia , Rossi Andrea , Consales Alessandro , Raso Alessandro , Garrè Maria Luisa
Published: September 2013

Tuberous sclerosis complex is a genetic, multisystemic disorder characterized by circumscribed benign lesions (hamartomas) in several organs, including brain. This is the result of defects in the TSC1 and/or TSC2 tumor suppressor genes, encoding the hamartin-tuberin complex that inhibits the mammalian target of rapamycin pathway. Specific inhibitors of this pathway have been shown to reduce the volume of subependymal giant cell astrocytomas associated with tuberous sclerosis. Congenital lymphedema is rarely seen in association with tuberous sclerosis, with only a few reported cases. Although this association can be coincidental, the dysgenetic lymphatic system can represent a hamartia as a consequence of gene mutation. We describe a child with congenital lymphedema in tuberous sclerosis and associated subependymal giant cell astrocytoma who experienced lymphangitis under treatment with mammalian target of rapamycin inhibitors. Because our patient did not show worsening of lymphedema, congenital lymphedema does not seem to be a contraindication for this therapy.
Cerebral Sinovenous Thrombosis Associated With Iron Deficiency Anemia Secondary to Severe Menorrhagia
Authors: Corrales-Medina Fernando F. , Grant Leon , Egas-Bejar Daniela , Valdivia-Ascuna Zoila , Rodriguez Nidra , Mancias Pedro
Published: September 2013

Cerebral sinovenous thrombosis is a rare condition presenting with a wide spectrum of nonspecific symptoms that can make early diagnosis difficult. Cerebral sinovenous thrombosis has been associated with various etiologies. Iron deficiency anemia associated with cerebral sinovenous thrombosis in teenagers is rare. We present a teenage patient with complete thrombosis of the vein of Galen, straight sinus, and left internal cerebral vein associated with iron deficiency anemia due to severe menorrhagia. Mechanisms that can explain the association between iron deficiency anemia and thrombosis are discussed.
A Case Series Using a Care Management Checklist to Decrease Emergency Department Visits and Hospitalizations in Children With Epilepsy
Authors: Patel Anup D.
Published: September 2013

Each year, 1 million people are seen in an emergency department for seizures or epilepsy. We implemented a care management checklist for patients with frequent visits. A database was searched for patients with the highest number of emergency department visits and/or unplanned hospitalizations in 2011. Four patients were selected. A care management checklist was implemented in 2012. Compliance with the office visits, number of emergency department visits and/or hospitalizations, and the associated costs were tracked following implementation of the checklist for 2011 and 2012. These 4 epilepsy patients accounted for 46 visits in the year 2011 with associated health care costs of $380,209. Following a year using a care management checklist, the same patients accounted for 11 visits with a cost reduction of $188,130. Using a care management checklist was useful in these 4 epilepsy patients to decrease emergency department visits and/or unplanned hospitalizations. A limitation of this study is its small numbers.
Validation and mathematical model of workspace Measuring and Positioning System as an integrated metrology system for improving industrial robot positioning
Authors: Xue Bin , Zhu Jigui , Zhao Ziyue , Wu Jun , Liu Zhexu , Wang Qiong
Published: September 2013

This article aims to improve the absolute accuracy of an individual industrial robot by means of integrating itself with the workspace Measuring and Positioning System, which is currently under development at Tianjin University, China. We found that the absolute positioning error persists in the robot base frame, whereas the errors, both in position and orientation, can be reduced by changing the reference frame from the robot to the integrated metrology system, that is, the workspace Measuring and Positioning System. What it needs more is several additional corrective movements. And this correction work just needs roughly calibrated parameters between the robot frame and the workspace Measuring and Positioning System frame. To validate it, we present the experiment which demonstrates that the absolute error of the industrial robot can be less than 0.2 mm by virtue of the workspace Measuring and Positioning System and the convergent corrective movements. Aiming to explain the results, this study deduces the mathematical model in detail about the integration of the robot with the workspace Measuring and Positioning System. The model explains why the integration of the robot with the workspace Measuring and Positioning System applies. First, the model tells that there exists a low requirement, that is, the tolerable rough level of the parameters between the robot frame and the workspace Measuring and Positioning System frame, for assuring the convergence of the corrective movements. Second, the relationship among the relevant factors in the corrective process is given. Finally, besides the workspace Measuring and Positioning System, this model is of general significance for any available metrology systems with which the industrial robot can integrate, and it may also provide theoretical instructions for the improvement of the robot off-line programming, that is, the robot can work at a higher accuracy provided by the integrated metrology system.
A hybrid genetic and imperialist competitive algorithm approach to dynamic cellular manufacturing system
Authors: Bagheri Masoud , Bashiri Mahdi
Published: September 2013

Cellular manufacturing system is an important application of group technology, which deals with grouping the parts and machines into cells, based on their similarity in design or production process. Since a purpose of this article is designing the cells under indefinite demand values up to the end of previous period, a dynamic multi-objective mathematical model based on this condition is proposed, and a heuristic approach has been developed in order to solve the problem. During this procedure, since the proposed model is a nondeterministic polynomial-time-hard problem, a new hybrid meta-heuristic approach called genetic imperialist competitive algorithm is implemented to solve it. Also, an experimental design has been used for tuning essential parameters. The proposed model has been verified by some hypothetical numerical examples with different input parameters and also by a real-world case study taken from a glass mold company. The comparison of results of the proposed genetic imperialist competitive algorithm and the genetic algorithm verifies the efficiency of the proposed solution approach. Also, the results show that the accuracy of the proposed algorithm is comparable with the exact solution methods such as branch and bound algorithm in both solution quality and computational time aspects.
Investigation of formability and surface micro-crack in hot deep drawing by using laser-welded blank of Al–Si and Zn-coated boron steel
Authors: Lee Min Sik , Moon Jung Hwan , Kang Chung Gil
Published: September 2013

Currently, the automobile industry is focusing all its attention to creating high-strength, ultra low-weight car bodies. Many techniques can be used to decrease the thickness of a steel plate in a car body but increase the strength. Among these, the hot stamping process makes use of boron steel to produce ultra high-strength components. On the contrary, this process has a low elongation that causes a decrease in collision absorptiveness. Therefore, this study examined the material and weldability of components with high collision absorptiveness using boron steel plates welded at different thicknesses, where the thinner steel sheet can absorb the collision, whereas the thicker steel sheet can endure it. This study was conducted using boron steel coated with either Al–Si or Zn. The results showed that satisfactory tensile strength and elongation could be obtained when both sides of the coating layer were removed by the laser. The hardness in the welded area of Zn-coated boron steel was greater than 450 Hv, even when the specimen was welded without laser ablation of the coating layer, but the coating layer peeled off when heated for 5 min at 950 °C.
Modeling recast layer and surface finish in the manufacturing of high–aspect ratio micro-tools using the inverse slab electrical discharge milling process
Authors: Gil R , Sánchez Jose A , Plaza S , Ortega N , Izquierdo B , Pombo I
Published: September 2013

Electrical discharge milling–based processes are a good alternative for the manufacturing of micro-tools. However, some limitations must be considered both on the fields of process cost and control of surface characteristics. The inverse slab electrical discharge milling (ISEDM) process is an economic alternative to other high-precision high-cost machining processes because a conventional slab electrical discharge milling (SEDM) machine can be used to produce high–aspect ratio cylindrical tools with diameters as low as 200 µm. In this article, the influence of process variables on the surface integrity generated by the ISEDM process is presented. An experimental model aiming at the prediction of both surface finish and thickness of the recast layer as a function of the spark characteristics is developed. The influence of process variables is then analyzed. The model was validated with a high degree of agreement by carrying out experimental tests on submicron sintered high-speed steel micro-pins. Micro-tools with a diameter 335 µm and an aspect ratio as high as 90:1 can be manufactured using this novel technique with a surface finish below Ra 0.7 µm and thickness of recast layer below 3 µm.