bluuebunny/crossref_metadata_2025 huggingface dataset:
A systematic review of tools for predicting severe adverse events following patient discharge from intensive care units
Authors: Hosein F Shaun , Bobrovitz Niklas , Berthelot Simon , Zygun David , Ghali William A , Stelfox Henry T
Published: May 2013

Introduction

The discharge of patients from the intensive care unit (ICU) to a hospital ward is a common transition of care that is associated with error and adverse events. Risk stratification tools may help identify high-risk patients for targeted interventions, but it is unclear if proper tools have been developed.

Methods

We searched Ovid EMBASE, Ovid MEDLINE, CINAHL, PUBMED and Cochrane Central Register of Controlled Trials from the earliest available date through March 2013, plus reference lists and citations of all studies included in the systematic review. Cohort studies were selected that described the derivation, validation or clinical impact of tools for predicting medical emergency team activation, ICU readmission or mortality following patient discharge from the ICU. Data were extracted on the study design, setting, population, sample size, tool (components, measurement properties) and outcomes.

Results

The literature search identified 9,926 citations, of which eight studies describing eight tools met the inclusion criteria. Reported outcomes included ICU readmission (n = 4 studies), hospital mortality (n = 3 studies) and both ICU readmission and hospital mortality (n = 1 studies). Seven of the tools were comprised of distinct measurable component variables, while one tool used subjective scoring of patient risk by intensive care physicians. The areas under receiver operator curves were reported for all studies and ranged from 0.66 to 0.92. A single study provided a direct comparative analysis between two tools. We did not find any studies evaluating the impact of risk prediction on processes and outcomes of care.

Conclusions

Eight risk stratification tools for predicting severe adverse events following patient discharge from ICU have been developed, but have undergone limited comparative evaluation. Although risk stratification tools may help clinician decision-making, further evaluation of the existing tools' effects on care is required prior to clinical implementation.
Interactions between the volume effects of hydroxyethyl starch 130/0.4 and Ringer´s acetate
Authors: Hahn Robert G , Bergek Christian , Gebäck Tobias , Zdolsek Joachim
Published: May 2013

Introduction

The turnover of Ringer´s solutions is greatly dependent on the physiological situation, such as the presence of dehydration or anaesthesia. The present study evaluates whether the kinetics is affected by previous infusion of colloid fluid.

Methods

Ten male volunteers with a mean age of 22 years underwent three infusion experiments, on separate days and in random order. The experiments included 10 mL/kg of 6% hydroxyethyl starch 130/0.4 (Voluven™), 20 mL/kg of Ringer's acetate, and a combination of both, where Ringer´s was administered 75 minutes after the starch infusion ended. The kinetics of the volume expansion was analysed by non-linear least- squares regression, based on urinary excretion and serial measurement of blood haemoglobin concentration for up to 420 minutes.

Results

The mean volume of distribution of the starch was 3.12 L which agreed well with the plasma volume (3.14 L) estimated by anthropometry. The volume expansion following the infusion of starch showed monoexponential elimination kinetics with a half-life of two hours. Two interaction effects were found when Ringer´s acetate was infused after the starch. First, there was a higher tendency for Ringer´s acetate to distribute to a peripheral compartment at the expense of the plasma volume expansion. The translocated amount of Ringer´s was 70% higher when HES had been infused earlier. Second, the elimination half-life of Ringer´s acetate was five times longer when administered after the starch (88 versus 497 minutes, P <0.02).

Conclusions

Starch promoted peripheral accumulation of the later infused Ringer´s acetate solution and markedly prolonged the elimination half-life.

Trial registration

ClinicalTrials.gov: NCT01195025
Integrated analysis of recurrent properties of cancer genes to identify novel drivers
Authors: D'Antonio Matteo , Ciccarelli Francesca D
Published: May 2013

The heterogeneity of cancer genomes in terms of acquired mutations complicates the identification of genes whose modification may exert a driver role in tumorigenesis. In this study, we present a novel method that integrates expression profiles, mutation effects, and systemic properties of mutated genes to identify novel cancer drivers. We applied our method to ovarian cancer samples and were able to identify putative drivers in the majority of carcinomas without mutations in known cancer genes, thus suggesting that it can be used as a complementary approach to find rare driver mutations that cannot be detected using frequency-based approaches.
Novel roles of reactive oxygen species in the pathogenesis of acute myeloid leukemia
Authors: Zhou Fuling , Shen Qiang , Claret François X
Published: May 2013

It has become apparent that regulation of ROS is important in cell signaling and homeostasis. Accumulation of ROS triggers oxidative stress in various cell types and contributes to the development, progression, and persistence of cancer. Recent research has demonstrated that redox dysregulation caused by ROS promotes proliferation, differentiation, genomic, and epigenetic alterations; immune evasion; and survival in leukemic cells. ROS act as signaling molecules to regulate redox-sensitive transcriptional factors, enzymes, oncogenes, and other downstream effectors. Thus, a thorough understanding the role of ROS as key mediators in leukemogenesis is likely to provide opportunities for improved pharmacological intervention. In this review, we summarize the recent findings that support a role for ROS in the pathogenesis of AML and outline innovative approaches in the implementation of redox therapies for myeloid malignancies.
Convolutional time-lapse seismic modeling for CO2 sequestration at the Dickman oilfield, Ness County, Kansas
Authors: Li Jintan , Liner Christopher , Geng Po , Zeng Jianjun
Published: May 2013

Time-lapse seismic modeling is routinely used to detect the state of hydrocarbon reservoirs at periodic time intervals. The Dickman field located in the U. S. midcontinent provides two possible [Formula: see text] sequestration targets: a regional deep saline reservoir is the primary objective, and a shallower, mature, depleted oil reservoir is a secondary objective. The goal of this work is to characterize and simulate monitoring of the [Formula: see text] movement before, during, and after its injection into these sequestration targets, including fluid flow paths, reservoir property changes, [Formula: see text] containment, and postinjection stability. Seismic images before, during, and after injection would improve understanding of the carbonate sequestration process and management. Our seismic simulation for time-lapse [Formula: see text] monitoring was based on flow simulator output over a 250-year injection and simulation period. The seismic response was accomplished via convolutional (1D) forward modeling. This work will provide an evaluation for the effectiveness of 4D seismic monitoring in providing assurance of long-term [Formula: see text] containment.
Adjuvant MAGE-A3 Immunotherapy in Resected Non–Small-Cell Lung Cancer: Phase II Randomized Study Results
Authors: Vansteenkiste Johan , Zielinski Marcin , Linder Albert , Dahabreh Jubrail , Gonzalez Emilio E. , Malinowski Wojciech , Lopez-Brea Marta , Vanakesa Tonu , Jassem Jacek , Kalofonos Haralabos , Perdeus Jakub , Bonnet Reiner , Basko Jazeps , Janilionis Richard , Passlick Bernward , Treasure Tom , Gillet Marc , Lehmann Frédéric F. , Brichard Vincent G.
Published: May 2013

Purpose

The MAGE-A3 protein is expressed in approximately 35% of patients with resectable non–small-cell lung cancer (NSCLC). Several immunization approaches against the MAGE-A3 antigen have shown few, but often long-lasting, clinical responses in patients with metastatic melanoma.

Patients and Methods

A double-blind, randomized, placebo-controlled phase II study was performed assessing clinical activity, immunologic response, and safety following immunization with recombinant MAGE-A3 protein combined with an immunostimulant (13 doses over 27 months) in completely resected MAGE-A3–positive stage IB to II NSCLC. The primary end point was disease-free interval (DFI).

Results

Patients were randomly assigned to either MAGE-A3 immunotherapeutic (n = 122) or placebo (n = 60). After a median postresection period of 44 months, recurrence was observed in 35% of patients in the MAGE-A3 arm and 43% in the placebo arm. No statistically significant improvement in DFI (hazard ratio [HR], 0.75, 95% CI, 0.46 to 1.23; two-sided P = .254), disease-free survival (DFS; HR, 0.76; 95% CI, 0.48 to 1.21; P = .248), or overall survival (HR, 0.81; 95% CI, 0.47 to 1.40; P = .454) was observed. Corresponding analysis after a median of 70 months of follow-up revealed a similar trend for DFI and DFS. All patients receiving the active treatment showed a humoral immune response to the MAGE-A3 antigen, although no correlation was observed with outcome. No significant toxicity was observed.

Conclusion

In this early development study with a limited number of patients, postoperative MAGE-A3 immunization proved to be feasible with minimal toxicity. These results are being investigated further in a large phase III study.
BMP-2 Differentially Modulates FGF-2 Isoform Effects in Osteoblasts From Newborn Transgenic Mice
Authors: Sabbieti Maria Giovanna , Agas Dimitrios , Marchetti Luigi , Coffin J. Douglas , Xiao Liping , Hurley Marja M.
Published: May 2013

We previously generated separate lines of transgenic mice that specifically overexpress either the Fibroblast growth factor (FGF)-2 low-molecular-mass isoform (TgLMW) or the high-mass isoforms (TgHMW) in the osteoblast lineage. Vector/control (TgVector) mice were also made. Here we report the use of isolated calvarial osteoblasts (COBs) from those mice to investigate whether the FGF-2 protein isoforms differentially modulate bone formation in vitro. Our hypothesis states that FGF-2 isoforms specifically modulate bone morphogenetic protein 2 (BMP-2) function and subsequently bone differentiation genes and their related signaling pathways. We found a significant increase in alkaline phosphatase-positive colonies in TgLMW COBs compared with TgVector controls. BMP-2 treatment significantly increased mineralized colonies in TgVector and TgLMW COBs. BMP-2 caused a further significant increase in mineralized colonies in TgLMW COBs compared with TgVector COBs but did not increase alkaline phosphatase-positive colonies in TgHMW COBs. Time-course studies showed that BMP-2 caused a sustained increase in phosphorylated mothers against decapentaplegic-1/5/8 (Smad/1/5/8), runt-related transcription factor-2 (Runx-2), and osterix protein in TgLMW COBs. BMP-2 caused a sustained increase in phospho-p38 MAPK in TgVector but only a transient increase in TgLMW and TgHMW COBs. BMP-2 caused a transient increase in phospho-p44/42 MAPK in TgVector COBs and no increase in TgLMW COBs, but a sustained increase was found in TgHMW COBs. Basal expression of FGF receptor 1 protein was significantly increased in TgLMW COBs relative to TgVector COBs, and although BMP-2 caused a transient increase in FGF receptor 1 expression in TgVector COBs and TgHMW COBs, there was no further increase TgLMW COBs. Interestingly, although basal expression of FGF receptor 2 was similar in COBs from all genotypes, BMP-2 treatment caused a sustained increase in TgLMW COBs but decreased FGF receptor 2 in TgVector COBs and TgHMW COBs.
Preweaning Growth Hormone Treatment Ameliorates Adipose Tissue Insulin Resistance and Inflammation in Adult Male Offspring Following Maternal Undernutrition
Authors: Reynolds C. M. , Li M. , Gray C. , Vickers M. H.
Published: May 2013

It is well established that early-life nutritional alterations lead to increased risk of obesity and metabolic disorders in adult life. Although it is clear that obesity gives rise to chronic low-grade inflammation, there is little evidence regarding the role of inflammation in the adipose tissue of undernourished (UN) offspring. GH reduces fat mass and has antiinflammatory properties. The present study examined the effect of maternal UN on adipose inflammation in adult offspring and whether GH treatment during a critical period of developmental plasticity could ameliorate metabolic dysfunction associated with a poor start to life. Sprague Dawley rats were assigned to chow (C) or UN (50% ad libitum; UN) diet throughout gestation. Male C and UN pups received saline (control saline [CS]/UN) or GH (2.5 μg/g/d; control growth hormone [CGH]/undernourished growth hormone [UNGH]) from days 3–21. Postweaning males were further randomized and fed either chow or high-fat diet until day 160. An ex vivo glucose uptake assay demonstrated adipose tissue from UN offspring displayed attenuated insulin-stimulated glucose uptake compared with CS, CGH, and UNGH. This was associated with increased insulin receptor, glucose transporter 4, and insulin receptor substrate 1 gene expression. Furthermore, UN demonstrated enhanced TNFα and IL-1β secretion from adipose explants and stromal vascular fraction cultures accompanied by increased adipose tissue gene expression of several key proinflammatory genes and markers of macrophage infiltration. Overall, UN offspring displayed a more potent immunophenotype, which correlated with decreased insulin sensitivity. Preweaning GH treatment negates these detrimental effects, indicating the potential for reversing metabolic dysfunction in UN adult offspring.
Hematopoiesis
Authors: Jagannathan-Bogdan Madhumita , Zon Leonard I.
Published: May 2013

Hematopoiesis – the process by which blood cells are formed – has been studied intensely for over a century using a variety of model systems. There is conservation of the overall hematopoietic process between vertebrates, although some differences do exist. Over the last decade, the zebrafish has come to the forefront as a new model in hematopoiesis research, as it allows the use of large-scale genetics, chemical screens and transgenics. This comparative approach to understanding hematopoiesis has led to fundamental knowledge about the process and to the development of new therapies for disease. Here, we provide a broad overview of vertebrate hematopoiesis. We also highlight the benefits of using zebrafish as a model.
Specification of chondrocytes and cartilage tissues from embryonic stem cells
Authors: Craft April M. , Ahmed Nazish , Rockel Jason S. , Baht Gurpreet S. , Alman Benjamin A. , Kandel Rita A. , Grigoriadis Agamemnon E. , Keller Gordon M.
Published: May 2013

Osteoarthritis primarily affects the articular cartilage of synovial joints. Cell and/or cartilage replacement is a promising therapy, provided there is access to appropriate tissue and sufficient numbers of articular chondrocytes. Embryonic stem cells (ESCs) represent a potentially unlimited source of chondrocytes and tissues as they can generate a broad spectrum of cell types under appropriate conditions in vitro. Here, we demonstrate that mouse ESC-derived chondrogenic mesoderm arises from a Flk-1−/Pdgfrα+ (F−P+) population that emerges in a defined temporal pattern following the development of an early cardiogenic F−P+ population. Specification of the late-arising F−P+ population with BMP4 generated a highly enriched population of chondrocytes expressing genes associated with growth plate hypertrophic chondrocytes. By contrast, specification with Gdf5, together with inhibition of hedgehog and BMP signaling pathways, generated a population of non-hypertrophic chondrocytes that displayed properties of articular chondrocytes. The two chondrocyte populations retained their hypertrophic and non-hypertrophic properties when induced to generate spatially organized proteoglycan-rich cartilage-like tissue in vitro. Transplantation of either type of chondrocyte, or tissue generated from them, into immunodeficient recipients resulted in the development of cartilage tissue and bone within an 8-week period. Significant ossification was not observed when the tissue was transplanted into osteoblast-depleted mice or into diffusion chambers that prevent vascularization. Thus, through stage-specific manipulation of appropriate signaling pathways it is possible to efficiently and reproducibly derive hypertrophic and non-hypertrophic chondrocyte populations from mouse ESCs that are able to generate distinct cartilage-like tissue in vitro and maintain a cartilage tissue phenotype within an avascular and/or osteoblast-free niche in vivo.
Histone variants in pluripotency and disease
Authors: Skene Peter J. , Henikoff Steven
Published: May 2013

Most histones are assembled into nucleosomes during replication to package genomic DNA. However, several variant histones are deposited independently of replication at particular regions of chromosomes. Such histone variants include cenH3, which forms the nucleosomal foundation for the centromere, and H3.3, which replaces histones that are lost during dynamic processes that disrupt nucleosomes. Furthermore, various H2A variants participate in DNA repair, gene regulation and other processes that are, as yet, not fully understood. Here, we review recent studies that have implicated histone variants in maintaining pluripotency and as causal factors in cancer and other diseases.
Stem cell metabolism in tissue development and aging
Authors: Shyh-Chang Ng , Daley George Q. , Cantley Lewis C.
Published: May 2013

Recent advances in metabolomics and computational analysis have deepened our appreciation for the role of specific metabolic pathways in dictating cell fate. Once thought to be a mere consequence of the state of a cell, metabolism is now known to play a pivotal role in dictating whether a cell proliferates, differentiates or remains quiescent. Here, we review recent studies of metabolism in stem cells that have revealed a shift in the balance between glycolysis, mitochondrial oxidative phosphorylation and oxidative stress during the maturation of adult stem cells, and during the reprogramming of somatic cells to pluripotency. These insights promise to inform strategies for the directed differentiation of stem cells and to offer the potential for novel metabolic or pharmacological therapies to enhance regeneration and the treatment of degenerative disease.
Limits to sustained energy intake. XV. Effects of wheel running on the energy budget during lactation
Authors: Zhao Zhi-Jun , Król Elzbieta , Moille Sophie , Gamo Yuko , Speakman John R.
Published: May 2013

The capacity of animals to dissipate heat may constrain sustained energy intake during lactation. We examined these constraints at peak lactation in MF1 mice that had ad libitum access to food, or that had to run a pre-set target on running wheels to obtain ad libitum access to food. The voluntary distance run decreased sharply during pregnancy and peak lactation. When lactating females were provided with 80% of their estimated food requirements, and had to run pre-set distances of 2, 4 or 6 km before given access to additional ad libitum food, most of them did not complete the running target during late lactation and the mice with the highest targets failed to reach their targets earlier in lactation. There were consequently significant group differences in asymptotic food intake (2 km, 16.97±0.40 g day−1; 4 km, 14.29±0.72 g day−1; and 6 km, 12.65±0.45 g day−1) and weaned litter masses (2 km, 71.11±2.39 g; 4 km, 54.63±4.28 g and 6 km, 47.18±2.46 g). When the females did run sufficiently to gain ad libitum food access, their intake did not differ between the different distance groups or from controls that were not required to run. Thus, despite being physically capable of running the distances, mice could not exercise sufficiently in lactation to gain regular ad libitum access to food, probably because of the risks of hyperthermia when combining heat production from exercise with thermogenesis from lactation.
Titania Surface-assisted Laser Desorption–Ionization Mass Spectrometry of Oligosaccharides
Authors: Fujita Takashi , Shibamoto Kohei
Published: May 2013

We demonstrated surface-assisted laser desorption–ionization mass spectrometry measurement of oligosaccharides on a titania surface. Insource fragmentation which had never been reported was observed. We considered that this fragmentation was caused by surface properties of titania, and this suggestion may lead to new application of SALDI-MS.
DFT Computations to Simulate the IR Spectrum of a Transient Intermediate Generated upon Laser Flash Photolysis of Triarylphosphines
Authors: Yasui Shinro , Badal Md Mizanur Rahman , Kobayashi Shinjiro , Mishima Masaaki
Published: May 2013

The mechanism of photooxidation of triarylphosphines Ar3P under air was explored using a combination of a theoretical technique and an experimental technique. Computations based on density functional theory (DFT) were performed to simulate an IR spectrum of a possible intermediate Ar3P+OO•, the absorption bands of which are in good agreement with the bands on the transient spectrum observed by laser flash photolysis–time-resolved infrared spectroscopy (LFP-TRIR). The radical cation Ar3P•+ generated upon LFP is likely to be trapped by O2.
Wetting Dynamics of Oil-in-water Emulsions on Agar Gel Surfaces
Authors: Oyama Taro , Mayama Hiroyuki , Nonomura Yoshimune
Published: May 2013

We have investigated the spreading process of oil-in-water emulsions containing oleic acid droplets on flat and rough fractal agar gel surfaces. Significant spreading inhibition owing to local condensation of oil droplets is observed on flat agar gel surfaces. On the other hand, such inhibition is not observed on the fractal gel surfaces for any of the emulsions. The rough structure of the gel surfaces is an important factor of spreading dynamics of emulsions on surfaces.
Termination of mid-trimester pregnancies: misoprostol versus concurrent weighted Foley catheter and misoprostol
Authors: Shabana Ayman , Salah Hesham , Kandil Mohamed , Soliman Emad , Morsi Dalia
Published: May 2013

Objective: To investigate whether the use of a weighted trans-cervical fluid-filled Foley’s catheter would improve the effectiveness of 400µg vaginal misoprostol regimen in terminating mid-trimester pregnancies.

Methods: This study was conducted at the department of Obstetrics and Gynecology, Menofyia University Hospital in Egypt. Fifty eligible primigravidae were allocated into 2 groups. Termination was carried out in group I using vaginal misoprostol while in group II, a weighted fluid-filled intra-uterine Foley’s catheter was inserted and a similar misoprostol regimen was followed as in group I.

Results:The combined group showed shorter induction to termination interval (15.6 ± 4.9 versus 21.9 ± 5.4 hours; P<0.05). There was no significant difference in the occurrence of side effects between the groups.

Conclusion: A combination of a weighted Foley’s catheter and 400µg of vaginal misoprostol every 4 hours is more effective than misoprostol alone in terminating mid-trimester gestations.
Venous thromboembolism prophylaxis in patients with traumatic brain injury: a systematic review
Authors: Chelladurai Yohalakshmi , Stevens Kent A , Haut Elliott R , Brotman Daniel J , Sharma Ritu , Shermock Kenneth M , Kebede Sosena , Singh Sonal , Segal Jodi B
Published: May 2013

Objective: There is considerable practice variation and clinical uncertainty about the choice of prophylaxis for preventing venous thromboembolism in patients with traumatic brain injury. We performed a systematic review to assess both the effectiveness and safety of pharmacologic and mechanical prophylaxis, and the optimal time to initiate pharmacologic prophylaxis in hospitalized patients with traumatic brain injury.

Data sources and study selection: MEDLINE®, EMBASE®, SCOPUS, CINAHL, International Pharmaceutical Abstracts, clinicaltrial.gov, and the Cochrane Library were searched in July 2012 to identify randomized controlled trials and observational studies reporting on the effectiveness or safety of venous thromboembolism prevention in traumatic brain injury patients.

Data extraction: Paired reviewers extracted detailed information from included articles on standardized forms and assessed the risk of bias in each article.

Data synthesis: Twelve studies (2 randomized controlled trials and 10 cohort studies) evaluated the effectiveness and safety of venous thromboembolism prophylaxis in patients with traumatic brain injury. Five of the included studies assessed the optimal timing of initiation of pharmacological prophylaxis. Low grade evidence supports the effectiveness of enoxaparin over control in reducing deep vein thrombosis. Low grade evidence also supports the safety of unfractionated heparin over control in reducing mortality in patients with traumatic brain injury. Evidence was insufficient for remaining comparisons and outcomes including the optimal timing of initiation of pharmacoprophylaxis.

Conclusion: There is some evidence that pharmacoprophylaxis improves deep vein thromboses and mortality outcomes in patients hospitalized with traumatic brain injury. Additional studies are required to strengthen this evidence base.
Motivational Differences Across Post-Acceptance Information System Usage Behaviors: An Investigation in the Business Intelligence Systems Context
Authors: Li Xixi , Hsieh J. J. Po-An , Rai Arun
Published: May 2013

We identify two post-acceptance information system (IS) usage behaviors related to how employees leverage implemented systems. Routine use (RTN) refers to employees' using IS in a routine and standardized manner to support their work, and innovative use (INV) describes employees' discovering new ways to use IS to support their work. We use motivation theory as the overarching perspective to explain RTN and INV and appropriate the rich intrinsic motivation (RIM) concept from social psychology to propose a conceptualization of RIM toward IS use, which includes intrinsic motivation toward accomplishment (IMap), intrinsic motivation to know (IMkw), and intrinsic motivation to experience stimulation (IMst). We also consider the influence of perceived usefulness (PU)—a representative surrogate construct of extrinsic motivation toward IS use—on RTN and INV. We theorize the relative impacts of the RIM constructs and PU on RTN and INV and the role of personal innovativeness with IT (PIIT) in moderating the RIM constructs' influences on INV. Based on data from 193 employees using a business intelligence system at one of the largest telecom service companies in China, we found (1) PU had a stronger impact on RTN than the RIM constructs, (2) IMkw and IMst each had a stronger impact on INV than either PU or IMap, and (3) PIIT positively moderated the impact of each RIM construct on INV. Our findings provide insights on managing RTN and INV in the post-acceptance stage.
Supratherapeutic International Normalized Ratio Due to Reduced Vitamin K Intake Secondary to Prolonged Vomiting in a Patient on Warfarin
Authors: Reaves Anne B , Clarke Catherine J , Tillman Emma M
Published: May 2013

OBJECTIVE:

To report a case of prolonged vomiting during warfarin therapy, leading to an elevated international normalized ratio (INR).

CASE SUMMARY:

A 32-year-old female with a history of cyclic vomiting syndrome since early childhood and bilateral pulmonary emboli diagnosed 4 months prior to this acute event presented to the clinic for routine monitoring of warfarin therapy. The warfarin dose had been maintained at 35 mg/wk for 3½ months (INR 2-3.5), but it was increased to 37.5 mg/wk because the INR had trended down to the low goal range over the preceding month. At presentation, the patient reported a 15-day history of vomiting with minimal oral intake that required intravenous fluids to prevent dehydration. The INR was 4.7; warfarin was withheld, and oral vitamin K 5 mg as well as subcutaneous vitamin K 10 mg was administered the following day. The INR then decreased to 1.3. Therapy was transitioned to subcutaneous enoxaparin 1 mg/kg every 12 hours for the duration of the patient's anticoagulation therapy.

DISCUSSION:

Multiple reports have demonstrated malabsorption of warfarin and decreased INR response in the presence of underlying gastrointestinal disease. Despite a prolonged episode of cyclic vomiting syndrome, our patient had an elevated INR. In normal circumstances, warfarin is rapidly absorbed from the gastrointestinal tract and reaches maximum serum concentrations in approximately 90 minutes. Studies have shown that although the presence of food does not affect overall absorption of the medication, it can decrease the rate of absorption. Our patient was vomiting 20-30 minutes after oral dose administration. Because the patient was not consuming food, absorption of warfarin was potentially prompt, thus contributing to the elevated INR. The variability of vitamin K in the diet also can have significant impact on the response to warfarin. Our patient's INR had been stable while she consumed 3 servings each week of foods rich in vitamin K. This consumption was abruptly discontinued with the onset of the cyclic vomiting syndrome. We believe that decreased intake and retention of oral vitamin K–containing foods from the diet due to the prolonged vomiting coupled with the rapid onset of absorption resulted in a notably increased INR and subsequent bruising in our patient.

CONCLUSIONS:

In the presence of prolonged vomiting, warfarin therapy requires more frequent monitoring than usual to detect fluctuations in INR that may increase the risk of adverse events.
Development of a Composite Specimen Interface Cracking (CSIC) Test for Top-Down Cracking
Authors: Chen Yu , Tebaldi Gabriele , Roque Reynaldo , Lopp George
Published: May 2013

Pavement top-down cracking performance not only depends on pavement layer material characteristics, but also on layer interface conditions. Interface conditions involve both the shear resistance along the interface and the cracking resistance across the interface provided by the interface bonding agents. Regarding hot-mix asphalt (HMA), currently available tests are mainly focused on pavement layer material properties. When thick polymer modified asphalt emulsion (PMAE) was applied at the interface between an open-graded friction course (OGFC) and a dense graded structural layer, a bonded interface was formed by the migration of PMAE up into the OGFC air voids. Shear strength tests, which can well characterize the adhesive film effect of interface bonding agents, cannot fully capture the effect of bonded interface on pavement cracking performance. To simulate the crack initiation and propagation process and evaluate the effect of bonded interface conditions on top-down cracking performance, a composite specimen interface cracking (CSIC) test was developed. The developed system involves repeated tensile loading and monitoring of the rate of damage development (reduction in stiffness) on composite specimens specifically designed for this purpose. Number of loading cycles to failure and damage rate results from the proposed test on three different interface conditions clearly indicate that this test method can be used to optimize bonding agents and application rates for enhanced cracking performance. This method may also provide a suitable specification test for evaluation of interface conditions on reflective cracking performance.
An Evaluation of the Non-Isothermal and Isothermal Pyrolysis of Polyether Sulfone in Thermogravimetric Analysis
Authors: Yang Mu-Hoe , Lin Yeuh-Hui
Published: May 2013

The thermal degradation behavior of polyether sulfone was examined using a dynamic heating program thermogravimetry analyzer under nitrogen atmosphere. The kinetic model of thermal degradation for the polyether sulfone was evaluated by using the kinetic parameters from dynamic thermogravimetric data. A discussion of the applicability of the model is presented using the four consecutive reactions analytical method. The model proposed correlates the thermograms obtained at thermogravimetric and differential thermogravimetric data with the same set of kinetic parameters. The degrees of decomposition for various components of polyether sulfone under dynamic conditions were simultaneously predicted via mathematical simulation. Moreover, the isothermal condition and the degree of decomposition were also predicted for various temperature conditions of the thermal degradation of polyether sulfone.
Evaluation of Single Sampling Plans by Attributes Using Mixture of Two Distributions
Authors: Loganathan A. , Krishnan P. Muthu , Vijayaraghavan R. , Saral M.
Published: May 2013

Inspection lots that are formed from the products or materials produced from two or more streams of a manufacturing industry may be heterogeneous with respect to some quality characteristic. In such cases, lot quality may not be of the same kind, rather a mixture of several kinds, and, hence, a mixture of distributions is an appropriate model to study the quality of such heterogeneous lots. This paper presents a study on the evaluation of a single sampling plan by attributes through its operating characteristic function under the conditions of mixture of two binomial and Poisson distributions.
Rheological Characterization of Asphalt Concrete Using a Shear Box
Authors: Said Safwat F. , Hakim Hassan , Eriksson Olle
Published: May 2013

Pavement deformation in bituminous layers is mainly caused by shear deformations. There is a need for a practical shear test for routine use, which can be used to evaluate the shear properties of bituminous materials. Shear properties are related to pavement performance and needed in viscoelastic pavement evaluation models. The main objective of this work is to determine the rheological properties of asphalt concrete materials for use in viscoelastic models and performance evaluation of bituminous pavement layers. This paper describes an asphalt concrete shear box test for determining the shear modulus and phase angle of asphalt mixtures and estimating their viscosity. The sensitivity of the test method was determined by testing cylindrical asphalt concrete specimens of varying mix composition. A procedure is presented for rheological characterization of asphalt concrete materials for use as a performance indicator. It is also concluded that the asphalt concrete shear box is reliable for measuring the shear modulus, phase angle and viscosity of asphalt concrete at different temperatures and frequencies for use in evaluating pavement models and discriminating between asphalt mixes.
Evaluation of Effective Thermal Conductivity for Mineral Cast Structural Materials Using Steady-State and Transient Methods
Authors: Selvakumar A. , Mohanram P. V.
Published: May 2013

Thermal conductivity is a thermophysical property that represents the rate at which heat energy can be transported through the material. For any alternate material chosen for machine tool structures, the study of its thermal characteristics is imminent. Thermal conductivity is one major characteristic to be analysed. Mineral cast structures made of epoxy-granite are found to exhibit good mechanical properties, such as high stiffness and damping ratio. The material also has lesser weight, compared to conventional materials used for machine tool structures. Hence, these materials are emerging as an alternate to conventional cast iron machine tool structures. This study attempts to determine the effective thermal conductivity of epoxy granite material using steady-state and transient plane source (TPS) methods. The results obtained using the experimental methods are compared with geometrical models and the suitability of the methods is evaluated. It is observed that both methods are suitable for measuring effective thermal conductivity of two-phase materials. Compared to TPS method, the steady-state method is a slow and material-consuming technique but provides more accurate results. The effective thermal conductivity of the developed material is compared with some commercial polymer composites and observed that the developed material has greater thermal conductivity.
Determination of Dry Rubber Content in Natural Rubber Latex Based on Wavelet-Domain Fluorescence Image
Authors: Zhang Lin , Zhao Zhimin , Ji Yuyu , Ji Lei
Published: May 2013

A new method for determining the dry rubber content in natural rubber latex based on wavelet-domain fluorescence imaging is explained in this paper. A set of wavelet moment invariants, which are selected automatically based on the discrimination measures defined for the invariant features, are calculated and used to realize the quantitative analysis. Calibration is realized by calculating the standard template vectors of 31 classes of samples. According to the method of minimum distance classification and template matching, the dry rubber content of a tested sample can be determined.
Polyglutamine Disease Toxicity Is Regulated by Nemo-like Kinase in Spinocerebellar Ataxia Type 1
Authors: Ju Hyoungseok , Kokubu Hiroshi , Todd Tiffany W. , Kahle Juliette J. , Kim Soeun , Richman Ronald , Chirala Karthik , Orr Harry T. , Zoghbi Huda Y. , Lim Janghoo
Published: May 2013

Polyglutamine diseases are dominantly inherited neurodegenerative diseases caused by an expansion of a CAG trinucleotide repeat encoding a glutamine tract in the respective disease-causing proteins. Extensive studies have been performed to unravel disease pathogenesis and to develop therapeutics. Here, we report on several lines of evidence demonstrating that Nemo-like kinase (NLK) is a key molecule modulating disease toxicity in spinocerebellar ataxia type 1 (SCA1), a disease caused by a polyglutamine expansion in the protein ATAXIN1 (ATXN1). Specifically, we show that NLK, a serine/threonine kinase that interacts with ATXN1, modulates disease phenotypes of polyglutamine-expanded ATXN1 in aDrosophilamodel of SCA1. Importantly, the effect of NLK on SCA1 pathology is dependent upon NLK's enzymatic activity. Consistent with this, reducedNlkexpression suppresses the behavioral and neuropathological phenotypes in SCA1 knock-in mice. These data clearly indicate that either reducing NLK enzymatic activity or decreasing NLK expression levels can have beneficial effects against the toxicity induced by polyglutamine-expanded ATXN1.
Control of the Gain of Visual–Motor Transmission Occurs in Visual Coordinates for Smooth Pursuit Eye Movements
Authors: Lee Joonyeol , Yang Jin , Lisberger Stephen G.
Published: May 2013

Sensory inputs control motor behavior with a strength, or gain, that can be modulated according to the movement conditions. In smooth pursuit eye movements, the response to a brief perturbation of target motion is larger during pursuit of a moving target than during fixation of a stationary target. As a step toward identifying the locus and mechanism of gain modulation, we test whether it acts on signals that are in visual or motor coordinates. Monkeys tracked targets that moved at 15°/s in one of eight directions, including left, right, up, down, and the four oblique directions. In eight-ninths of the trials, the target underwent a brief perturbation that consisted of a single cycle of a 10 Hz sine wave of amplitude ±5°/s in one of the same eight directions. Even for oblique directions of baseline target motion, the magnitude of the eye velocity response to the perturbation was largest for a perturbation near the axis of target motion and smallest for a perturbation along the orthogonal axis. Computational modeling reveals that our data are reproduced when the strength of visual–motor transmission is modulated in sensory coordinates, and there is a static motor bias that favors horizontal eye movements. A network model shows how the output from the smooth eye movement region of the frontal eye fields (FEFSEM) could implement gain control by shifting the peak of a visual population response along the axes of preferred image speed and direction.
GABAergic Circuits Control Spike-Timing-Dependent Plasticity
Authors: Paille Vincent , Fino Elodie , Du Kai , Morera-Herreras Teresa , Perez Sylvie , Kotaleski Jeanette Hellgren , Venance Laurent
Published: May 2013

The spike-timing-dependent plasticity (STDP), a synaptic learning rule for encoding learning and memory, relies on relative timing of neuronal activity on either side of the synapse. GABAergic signaling has been shown to control neuronal excitability and consequently the spike timing, but whether GABAergic circuits rule the STDP remained unknown. Here we show that GABAergic signaling governs the polarity of STDP, because blockade of GABAAreceptors was able to completely reverse the temporal order of plasticity at corticostriatal synapses in rats and mice. GABA controls the polarity of STDP in both striatopallidal and striatonigral output neurons. Biophysical simulations and experimental investigations suggest that GABA controls STDP polarity through depolarizing effects at distal dendrites of striatal output neurons by modifying the balance of two calcium sources, NMDARs and voltage-sensitive calcium channels. These findings establish a central role for GABAergic circuits in shaping STDP and suggest that GABA could operate as a Hebbian/anti-Hebbian switch.
The Day-After Effect: Long Term, Hebbian-Like Restructuring of Resting-State fMRI Patterns Induced by a Single Epoch of Cortical Activation
Authors: Harmelech Tal , Preminger Son , Wertman Eliahu , Malach Rafael
Published: May 2013

During rest, the cerebral cortex displays rich, coordinated patterns of spontaneous activity. The mechanism that shapes these patterns is largely unknown. Here we demonstrate that a Hebbian-like, sustained process plays a role in focusing these coherent patterns. Human subjects used an fMRI-based neurofeedback (NF) paradigm to intensely activate the dorsal anterior cingulate cortex for a single epoch (30 min). Resting-state correlations between all of the cortical voxels' BOLD time courses (functional connectivity) were mapped before, immediately after, and one day after the NF session. We found that the single epoch of cortical activation induced a lasting restructuring of the functional connections according to a Hebbian-like rule. Therefore, the change (increase and decrease) in functional connectivity strength of cortical voxels during rest reflected the level of their prior coactivation during the NF epoch. Interestingly, the effect was significantly enhanced 1 d after the NF activation epoch. The effect was evident in each subject individually, indicating its potential as a diagnostic window into thepersonalhistory of prior brain activations of both healthy and abnormal individuals.
Adaptive Vorsteuerung für Windenergieanlagen
Authors: Schlipf David , Cheng Po Wen
Published: May 2013

Der Beitrag beschreibt, wie Windmessungen mit LIDAR in einer Vorsteuerung verwendet werden können, um die Drehzahlschwankungen und damit die Belastungen von Windenergieanlagen zu reduzieren. Kernstück dieser Vorsteuerung ist ein Filter, der adaptiv auf die aktuellen Messungen eingestellt werden muss, da sich die Prädiktionszeit und die Korrelation zwischen Vorhersage und Anlagenverhalten kontinuierlich ändern. Die Ergebnisse werden mit Messdaten einer 5 MW Anlage validiert.
Regelung von Windenergieanlagen mit hydrodynamischem Überlagerungsgetriebe
Authors: Schmid Christian , Glasbrenner Michael , Hörmannskirchner Stefan
Published: May 2013

Im vorliegenden Beitrag wird ein alternatives Triebstrangkonzept für Windenergieanlagen betrachtet und hinsichtlich der Regelung auf eine konkrete Ausführungsvariante mit hydrodynamischem Überlagerungsgetriebe vertieft. Hierbei steht ein belastungsoptimiertes Gesamtregelungskonzept der Windturbine im Vordergrund, welches die Leistungs- sowie Drehzahlregelung zur Minimierung der Triebstrang- und Strukturbelastung umfasst. Dazu werden wirkungsvolle Entwurfs- sowie Optimierungsverfahren eingesetzt.
Major Histocompatibility Complex Class I Haplotype Diversity in Chinese Rhesus Macaques
Authors: Karl Julie A , Bohn Patrick S , Wiseman Roger W , Nimityongskul Francesca A , Lank Simon M , Starrett Gabriel J , O’Connor David H
Published: May 2013

The use of Chinese-origin rhesus macaques (Macaca mulatta) for infectious disease immunity research is increasing despite the relative lack of major histocompatibility complex (MHC) class I immunogenetics information available for this population. We determined transcript-based MHC class I haplotypes for 385 Chinese rhesus macaques from five different experimental cohorts, providing a concise representation of the full complement of MHC class I major alleles expressed by each animal. In total, 123 Mamu-A and Mamu-B haplotypes were defined in the full Chinese rhesus macaque cohort. We then performed an analysis of haplotype frequencies across the experimental cohorts of Chinese rhesus macaques, as well as a comparison against a group of 96 Indian rhesus macaques. Notably, 35 of the 51 Mamu-A and Mamu-B haplotypes observed in Indian rhesus macaques were also detected in the Chinese population, with 85% of the 385 Chinese-origin rhesus macaques expressing at least one of these class I haplotypes. This unexpected conservation of Indian rhesus macaque MHC class I haplotypes in the Chinese rhesus macaque population suggests that immunologic insights originally gleaned from studies using Indian rhesus macaques may be more applicable to Chinese rhesus macaques than previously appreciated and may provide an opportunity for studies of CD8+ T-cell responses between populations. It may also be possible to extend these studies across multiple species of macaques, as we found evidence of shared ancestral haplotypes between Chinese rhesus and Mauritian cynomolgus macaques.
Utilização do picro-sirius para corar o Paracoccidioides brasiliensis
Authors: Almeida Hipólito de Oliveira , Brandão Marilda da Costa , Morais Maria das Graças Reis de , Reis Marlene Antonia dos , Silveira Suzana Aperecida
Published: May 2013

A solução do picro-sirius foi usada para corar o Paracoccidioides brasiliensis em tecidos humanos fixados em formol. À luz comum, o fungo mostra uma faixa periférica avermelhada e, à luz polarizada, apresenta um ou mais anéis birrefringentes esverdeados. A imersão prévia em solução de hidróxido de sódio a 1%, por alguns minutos, melhora a coloração, sendo o fungo visualizado com mais nitidez à luz polarizada. Por outro lado, a diferenciação dos cortes corados, com picro-sirius em hidróxido de sódio a 0,5%, elimina a birrefringência do colágeno mais rapidamente que a do Paracoccidioides.
Estudo necroscópico de um caso da forma crônica da doença de Chagas com eletrocardiograma e raio-X de tórax normais: referência especial ao sistema excito-condutor do coração
Authors: Lopes Edison Reis , Rocha Ademir , Adad Sheila J. , Fernandes Edson Luiz , Chapadeiro Edmundo
Published: May 2013

Descrevem-se as alterações anatomopatológicas observadas na necropsia de chagásico crônico, provavelmente, portador da forma indeterminada da doença. O coração mostrou lesões dos três folhetos e do sistema excito-condutor, traduzidas especialmente por pequenos focos inflamatórios. Havia discreta fibrose do miocárdio contrâtil, nódulo átrio-ventricular e origem do ramo esquerdo do feixe de His. Tais alterações, embora de leve intensidade, assemelham-se, qualitativamente, às relatadas nas demais formas crônicas da doença de Chagas e representam lesões ativas, com potencial evolutivo. No esôfago, observou-se entre outros fatos, despopulação neuronal acentuada.