bluuebunny/crossref_metadata_2025 huggingface dataset:
Administration of Bone Marrow Derived Mesenchymal Stem Cells into the Liver: Potential to Rescue Pseudoxanthoma Elasticum in a Mouse Model (Abcc6−/−)
Authors: Jiang Qiujie , Takahagi Shunsuke , Uitto Jouni
Published: November 2012

Pseudoxanthoma elasticum (PXE) is a heritable ectopic mineralization disorder caused by loss-of-function mutations in theABCC6gene which is primarily expressed in the liver. There is currently no effective treatment for PXE. In this study, we characterized bone marrow derived mesenchymal stem cells (MSCs) and evaluated their ability to contribute to liver regeneration, with the aim to rescue PXE phenotype. The MSCs, isolated from GFP-transgenic mice by magnetic cell sorting, were shown to have high potential for hepatic differentiation, with expression ofAbcc6, in culture. These cells were transplanted into the livers of 4-week-old immunodeficientAbcc6−/−mice by intrasplenic injection one day after partial hepatectomy, when peak expression of the stromal cell derived factor-1 (SDF-1) in the liver was observed. Fluorescent bioimaging analyses indicated that transplanted MSCs homed into liver between day 1 and 7, and significant numbers of GFP-positive cells were confirmed in the liver by immunofluorescence. Moreover, enhanced engraftment efficiency was observed with MSCs with high expression levels of the chemokine receptor Cxcr4, a receptor for SDF-1. These data suggest that purified MSCs have the capability of differentiating into hepatic lineages relevant to PXE pathogenesis and may contribute to partial correction of the PXE phenotype.
Gemcitabine-Induced Extensive Skin Necrosis
Authors: D'epiro Sara , Salvi Monica , Mattozzi Carlo , Giancristoforo Simona , Campoli Marco , Zanniello Ramona , Luci Cecilia , Macaluso Laura , Giovannoni Sara , Iacovelli Roberto , Calvieri Stefano , Richetta Antonio Giovanni
Published: November 2012

An 82-year-old woman presented with oedema and extensive necrotic ulcerative lesions on the back side of her lower limbs, emerging after the second cycle of chemotherapy consisting of Gemcitabine for metastatic pancreatic cancer. The absence of any convincing argument in favor of cardiovascular or autoimmune disease led us to attribute the onset of skin necrosis to chemotherapy administration. Although skin ischemia has also been described as a paraneoplastic syndrome, in this case we could observe a temporal and causal relationship to Gemcitabine infusion. Recently, this drug has been associated with important vascular side effects; its vascular toxicity is in fact higher than previously estimated. To our knowledge, careful attention should be reserved to neoplastic patients candidated to Gemcitabine administration, especially if previously affected by arterial vascular disease, venous thromboembolism, or collagenoses.
Moving Bed Gasification of Low Rank Alaska Coal
Authors: Kulkarni Mandar , Ganguli Rajive
Published: November 2012

This paper presents process simulation of moving bed gasifier using low rank, subbituminous Usibelli coal from Alaska. All the processes occurring in a moving bed gasifier, drying, devolatilization, gasification, and combustion, are included in this model. The model, developed in Aspen Plus, is used to predict the effect of various operating parameters including pressure, oxygen to coal, and steam to coal ratio on the product gas composition. The results obtained from the simulation were compared with experimental data in the literature. The predicted composition of the product gas was in general agreement with the established results. Carbon conversion increased with increasing oxygen-coal ratio and decreased with increasing steam-coal ratio. Steam to coal ratio and oxygen to coal ratios impacted produced syngas composition, while pressure did not have a large impact on the product syngas composition. A nonslagging moving bed gasifier would have to be limited to an oxygen-coal ratio of 0.26 to operate below the ash softening temperature. Slagging moving bed gasifiers, not limited by operating temperature, could achieve carbon conversion efficiency of 99.5% at oxygen-coal ratio of 0.33. The model is useful for predicting performance of the Usibelli coal in a moving bed gasifier using different operating parameters.
Tai-Chi for Residential Patients with Schizophrenia on Movement Coordination, Negative Symptoms, and Functioning: A Pilot Randomized Controlled Trial
Authors: Ho Rainbow T. H. , Au Yeung Friendly S. W. , Lo Phyllis H. Y. , Law Kit Ying , Wong Kelvin O. K. , Cheung Irene K. M. , Ng Siu Man
Published: November 2012

Objective. Patients with schizophrenia residing at institutions often suffer from negative symptoms, motor, and functional impairments more severe than their noninstitutionalized counterparts. Tai-chi emphasizes body relaxation, alertness, and movement coordination with benefits to balance, focus, and stress relief. This pilot study explored the efficacy of Tai-chi on movement coordination, negative symptoms, and functioning disabilities towards schizophrenia.Methods. A randomized waitlist control design was adopted, where participants were randomized to receive either the 6-week Tai-chi program and standard residential care or only the latter. 30 Chinese patients with schizophrenia were recruited from a rehabilitation residency. All were assessed on movement coordination, negative symptoms, and functional disabilities at baseline, following intervention and 6 weeks after intervention.Results. Tai-chi buffered from deteriorations in movement coordination and interpersonal functioning, the latter with sustained effectiveness 6 weeks after the class was ended. Controls showed marked deteriorations in those areas. The Tai-chi group also experienced fewer disruptions to life activities at the 6-week maintenance. There was no significant improvement in negative symptoms after Tai-chi.Conclusions. This study demonstrated encouraging benefits of Tai-chi in preventing deteriorations in movement coordination and interpersonal functioning for residential patients with schizophrenia. The ease of implementation facilitates promotion at institutional psychiatric services.
Bioconversion of Sugarcane Biomass into Ethanol: An Overview about Composition, Pretreatment Methods, Detoxification of Hydrolysates, Enzymatic Saccharification, and Ethanol Fermentation
Authors: Canilha Larissa , Chandel Anuj Kumar , Suzane dos Santos Milessi Thais , Antunes Felipe Antônio Fernandes , Luiz da Costa Freitas Wagner , das Graças Almeida Felipe Maria , da Silva Silvio Silvério
Published: November 2012

Depleted supplies of fossil fuel, regular price hikes of gasoline, and environmental damage have necessitated the search for economic and eco-benign alternative of gasoline. Ethanol is produced from food/feed-based substrates (grains, sugars, and molasses), and its application as an energy source does not seem fit for long term due to the increasing fuel, food, feed, and other needs. These concerns have enforced to explore the alternative means of cost competitive and sustainable supply of biofuel. Sugarcane residues, sugarcane bagasse (SB), and straw (SS) could be the ideal feedstock for the second-generation (2G) ethanol production. These raw materials are rich in carbohydrates and renewable and do not compete with food/feed demands. However, the efficient bioconversion of SB/SS (efficient pretreatment technology, depolymerization of cellulose, and fermentation of released sugars) remains challenging to commercialize the cellulosic ethanol. Among the technological challenges, robust pretreatment and development of efficient bioconversion process (implicating suitable ethanol producing strains converting pentose and hexose sugars) have a key role to play. This paper aims to review the compositional profile of SB and SS, pretreatment methods of cane biomass, detoxification methods for the purification of hydrolysates, enzymatic hydrolysis, and the fermentation of released sugars for ethanol production.
Thyroid Transcription Factor 1 and Napsin A Double Stain: Utilizing Different Vendor Antibodies for Diagnosing Lung Adenocarcinoma
Authors: Johnson Hunter , Cohen Cynthia , Fatima Nazneen , Duncan David , Siddiqui Momin T.
Published: November 2012

Objective: A combined thyroid transcription factor 1 (TTF-1) and Napsin A double stain has been shown to be useful in the diagnosis of adenocarcinoma (ADC). This study compares differences in double staining patterns among vendor antibodies (Leica, Dako, and Biocare). Study Design: The cohorts included 35 FNA cell blocks of lung ADC and 24 cell blocks of lung squamous cell carcinoma (SqCCA). Double-staining immunohistochemistry was performed with TTF-1 as a brown nuclear stain and Napsin A as a red cytoplasmic stain, using three sets of double stains. Additionally, FISH expression was performed on SqCCAs with aberrant TTF-1 expression. Results: The sensitivity for the double stains ranged from 40 to 74%, while the specificity ranged from 88 to 96%. Two Leica TTF-1-positive SqCCAs also showed low-level amplification by FISH assay not seen in the TTF-1-negative control SqCCAs. Conclusion: The use of Dako TTF-1 antibody paired with Leica Napsin A antibody as a double stain yielded the best results for diagnosing ADC; additionally, the Leica Napsin A-only staining results had the highest positive predictive value at 97%. Both Dako and Biocare antibodies expressed less staining of SqCCAs than Leica staining.
Noninvasive Screening Tests for Colorectal Cancer
Authors: Imperiale Thomas F.
Published: November 2012

Background: Identifying an accurate, reliable, affordable, and acceptable noninvasive screening test for colorectal cancer (CRC) would greatly facilitate population screening. Methods: Published literature from 2000 through February 2012 on noninvasive CRC screening tests was identified, reviewed, and summarized. Results: The highest quality evidence for noninvasive screening exists for guaiac-based fecal occult blood tests (gFOBTs), for which the CRC-specific incidence and mortality reductions are modest. Fecal immunochemical tests (FITs) offer better sensitivity and comparable specificity. Cross-sectional studies comparing gFOBTs and FITs suggest that FITs provide higher detection of advanced neoplasia. Modeling studies favor FITs over gFOBTs with respect to effectiveness and cost-effectiveness. A myriad of studies report the performance of fecal-based and blood-based genetic and protein-based biomarkers; the studies differ in patient population assembled, marker selection, and assay methods. Several markers and panels of markers are promising, although nearly all studies focus on new markers and/or assay methods on small sets of referred patients rather than validating markers using optimal assays in a screening setting. Conclusion: In the absence of long-term randomized trials, adoption of the noninvasive tests will require cross-sectional data on test characteristics obtained from the screening setting, where CRC prevalence is low and the full spectrum of colorectal findings exists, along with estimates of cumulative risks, benefits, and cost-effectiveness. Test adoption will ultimately depend on test characteristics, availability, affordability, and user appeal. There is no noninvasive substitute for the currently recommended screening tests. FITs should replace gFOBTs wherever gFOBTs are used for screening.
Biomarkers in Early-Stage Colorectal Cancer: Ready for Prime Time?
Authors: Church David , Midgley Rachel , Kerr David
Published: November 2012

Background/Aims: During the last two decades, hundreds of reports have detailed putative prognostic and predictive biomarkers for colorectal cancer (CRC). However, the majority of these studies have been small and retrospective, reporting results that are highly likely to represent false positives. Consequently, their relevance to clinical practice requires definition. Methods: Review of published literature on CRC biomarkers, focusing on early-stage disease. Results: Although most putative biomarkers have failed to be validated in subsequent studies, level I evidence now indicates that tumour microsatellite instability can be used to identify a cohort of patients with stage IIA disease at low risk of relapse who can be spared adjuvant chemotherapy. Emerging data suggest that gene expression arrays may have a role in selecting patients with stage IIA disease and mismatch repair-proficient tumours for chemotherapy following tumour resection. Conclusion: Despite the profusion of biomarker literature, only mismatch repair status can be recommended as routine in current clinical practice. High-quality, adequately powered studies are essential to accurately define the utility of existing and putative biomarkers, and to support their rational application in the clinic.
Lynch Syndrome: History, Causes, Diagnosis, Treatment and Prevention (CAPP2 Trial)
Authors: Burn John , Mathers John , Bishop D. Tim
Published: November 2012

Hereditary cancer due to pathological mutations in the mismatch repair gene family is now known as Lynch syndrome and affects at least 1 in 1,000 people, resulting in a 30–50% cancer risk most often involving the colorectum and endometrium. Annual or biennial colonoscopy reduces cancer deaths and many offer gynaecological surveillance, but most other associated cancers are not amenable to early detection. As microsatellite instability testing and tumour immunohistochemistry become routine, case finding will improve. Our recent demonstration that 600 mg aspirin per day for at least 2 years reduces the cancer burden by 63% after a 3-year lag period reinforces the need to identify gene carriers and introduce them to chemoprevention. CaPP3 will test different doses of aspirin in at least 3,000 gene carriers to determine whether low-dose aspirin is as effective.
Inflammatory Bowel Disease Cancer Risk, Detection and Surveillance
Authors: Rogler Gerhard
Published: November 2012

Ulcerative colitis (UC) is a chronic and relapsing inflammation of the colonic mucosa with variable extension from the rectum towards the cecum. The aim of medical treatment is to induce and maintain clinical remission. If no remission can be achieved, continuous inflammation may repeatedly destroy the epithelial cells. This has to be compensated by epithelial increased proliferation which finally can lead to inflammation-associated colorectal cancer (CRC). The risk of colitis-associated CRC is increased after a long disease duration, especially in patients with chronic active disease. This risk may be lower if long-lasting mucosal healing can be achieved. To detect the development of dysplasia/intraepithelial neoplasia and colitis-associated CRC early, surveillance programs have been installed. However, the evidence of success for those surveillance programs is limited. This is partially due to problems of detecting precancerous lesions in the colonic mucosa during those surveillance programs. The specific problems of surveillance programs for the prevention of CRC and specific aspects of patient care in UC are reviewed in this article.
Combined Endoscopic-Laparoscopic Resection of Colon Polyps
Authors: Hahnloser Dieter
Published: November 2012

Aims: To analyze the current literature on combined endoscopic-laparoscopic resection of colon polyps and to compare this new approach to standard laparoscopic colonic resection for polyps not suitable for endoscopic resection. Results: Several studies demonstrated that with a combined endoscopic-laparoscopic approach, polyps were successfully resected in 82–91% with a low morbidity of 3–10% and a short hospital stay of 1–2 days. Segmental laparoscopic resection was necessary in only 9–12%, but had a conversion rate to open surgery of 15% with an average hospital stay of 6–11 days. A cancerous polyp was found in 6–13% after a combined approach, with lymph node metastasis in 6%. Recurrent polyps after a combined endoscopic-laparoscopic resection seem to be rare, but follow-up of most studies is short and incomplete. Conclusion: Combined endoscopic-laparoscopic resection of colon polyps is feasible, safe, and has a high success rate. Malignant lesions can be treated laparoscopically during the same operation, avoiding the need for a second procedure, and with good long-term oncologic outcome.
Multivisceral Resection for T4 or Recurrent Colorectal Cancer
Authors: Larkin J.O. , O’Connell P.R.
Published: November 2012

Background: Approximately 10% of patients with colorectal cancer have locally advanced disease with peritoneal involvement (T4a) or invasion of adjacent organs (T4b) at the time of diagnosis. Of patients who undergo resection with curative intent, between 7 and 33% develop isolated locoregional recurrences. R0 surgical excision is potentially curative. Methods: We reviewed the literature relating to multivisceral resection for T4 or recurrent colorectal cancer. Results: Comprehensive staging to identify the local and systemic extent of disease is essential to determine resectability and patient suitability for a curative approach. PET scans and pelvic MRI (rectal) staging and a coordinated multispecialty input to neoadjuvant treatment, multivisceral surgical resection, reconstruction and adjuvant chemotherapy are essential. Intraoperative radiotherapy and hyperthermic intraperitoneal chemotherapy may have a role in selected patients. R0 resection can achieve 5-year local control rates for primary locally advanced and recurrent colorectal cancer of up to 89 and 38%, respectively, and overall 5-year survival up to 66 and 25%, respectively. Conclusion: An aggressive surgical strategy as part of a multimodal strategy in the treatment of locally advanced or recurrent colorectal cancer in the absence of incurable metastatic disease affords the best prospect for long-term survival in selected patients.
Oncological Management of Unresectable Liver Metastases
Authors: Prenen Hans , Van Cutsem Eric
Published: November 2012

Surgical resection of liver metastases of colorectal cancer can improve clinical outcome and even cure some patients with metastatic disease. For patients with unresectable liver metastases, the ultimate treatment goal is to let them become eligible for resection. In recent years, considerable attention has been paid to molecular targeted therapies to improve the efficacy of the available chemotherapeutic regimens in order to increase the downsizing rate of liver metastases and increase resectability. This overview will focus on the oncological management and chemotherapeutic options of patients with unresectable liver metastases.
Surgical Results after Downstaging of Initially Marginal or Non-Resectable Liver Metastases
Authors: Cauchy F. , Faivre S. , Belghiti J.
Published: November 2012

Surgery remains the best curative treatment for resectable patients with colorectal liver metastases. In patients initially considered unresectable, both refinements in surgical technique using portal vein occlusion or two-step resections and increased efficiency of chemotherapy regimen with the adjunction of antiangiogenics now allow secondary resection. Recent evidence suggests almost identical long-term survival in case of secondary downstaged lesions advocating an aggressive approach. However, these data lie on disparate and nonconsensual criteria for unresectability, which often do not gather technical and oncologic components together. Furthermore, both impaired general status and damaged underlying parenchyma as a consequence of prolonged chemotherapy to achieve resectability as well as the technical challenge required to perform adequate carcinologic resection could increase the operative risk in such patients. In our experience, a subgroup of slow chemo-responding initially unresectable patients who required preoperative liver volume modulation after ≥12 cycles of chemotherapy to achieve sufficient response experienced dramatically high operative risk which jeopardized postoperative chemotherapy and subsequently put these patients at increased risk of recurrence. Whether all patients preoperatively amenable to surgery using intensive chemotherapy and complex surgical strategy actually benefit from such an aggressive approach is a matter of ongoing debate, which needs a reappraisal.
Can Early B-Type Natriuretic Peptide Assays Predict Symptomatic Patent Ductus Arteriosus in Extremely Low Birth Weight Infants?
Authors: Lee Jang Hoon , Shin Jeong Hee , Park Kyu Hee , Rhie Young Jun , Park Moon Sung , Choi Byung Min
Published: November 2012

Background: Earlier and more accurate identification of a high-risk group of preterm infants that are likely to develop a hemodynamically significant patent ductus arteriosus (hsPDA) would allow specific targeting of early treatment and thus possibly minimize the morbidity and mortality associated with a PDA in extremely low birth weight (ELBW) infants. Objective: To investigate the predictability of B-type natriuretic peptide (BNP) for early targeted treatment of hsPDA in ELBW infants. Methods: 73 ELBW infants that underwent echocardiographic evaluation and plasma BNP measurement after birth were enrolled. 31 infants developed hsPDA (HsPDA group) and 42 infants did not develop hsPDA (nPDA group). Results: BNP levels of the HsPDA group were significantly higher than those of the nPDA group at 24 h of age (921 [318–2,133] vs. 152 [91–450] pg/ml) but not different at 12 h of age. BNP levels at 24 h of age were significantly correlated with the magnitudes of the ductal shunt but not at 12 h of age. The area under the receiver operator characteristic curve of BNP levels for prediction of hsPDA at 24 h of age was 0.830. At the cutoff BNP levels of 200 and 900 pg/ml at 24 h of age, sensitivity was 83.9 and 54.8% and specificity was 61.9 and 95.2%, respectively. Conclusions: BNP levels at 24 h of age can be used as a guide for early targeted treatment of hsPDA and avoid the unnecessary use of cyclooxygenase inhibitors in ELBW infants.
The Longitudinal Growth of the Neuromeres and the Resulting Brain in the Human Embryo
Authors: O’Rahilly Ronan , Müller Fabiola
Published: November 2012

The growth of the human brain during the embryonic period was assessed in terms of longitudinal measurements in staged embryos. Precise graphic reconstructions prepared by the onerous point-plotting method were considered to be the most reliable, and 23 were examined in detail. A distinction is necessary between measurements of the brain (cerebral diameters) and those of the skull (osseous diameters), and also between those of the folded brain in situ, studied here, and the later relatively straightened brain. Longitudinal measurements were made of individual neuromeres and their successors in steps (neuromeric lengths). The sum of the neuromeric measurements at any given stage provides the total neuromeric length (TNL) of the folded brain in situ at that stage and it increases in keeping with the greatest length (GL) of the embryo. At stages 16–19, however, the neuromeric length of the brain may exceed the GL. From stage 20 onwards the body length increases more rapidly compared with the length of the brain. The most cephalic neuromere is the telencephalon medium, abbreviated T1 here. The cerebral hemispheres are derived from it, although they are not neuromeres. The hemispheres soon extend rostrally beyond the limit of T1 by an amount that is here designated T2, and that indicates the growth of the telencephalon rostral to the commissural plate, which is the site of the future corpus callosum. Further laterally, the hemispheric length (future fronto-occipital diameter) increases rapidly, as does also the bitemporal (biparietal) diameter. At the end of the embryonic period these diameters are one fourth to one fifth of the head circumference. Additional neuromeric information becomes manifest when the measurements are calculated as percentages of the total length of the brain. The rhombencephalon decreases considerably, diencephalon 2 increases greatly, whereas diencephalon 1 diminishes, and the cerebral hemispheres enlarge massively. In addition, specific neuromeres or subdivisions come to occupy relatively more or relatively less of the total. Three periods were found during which individual neuromeres acquire their maximal or minimal lengths: the maximal absolute lengths were in period 3, whereas the maximal and minimal percentage lengths were in periods 1 and 3. The various neuromeric changes are considered to be related to alterations in functional development. Finally, in furtherance of establishing continuity in prenatal data, comparisons were effected between embryonic and fetal measurements.
EGFR Gene Mutation Study in Cytology Specimens
Authors: Ma Edmond S.K. , Ng Wai-Kuen , Wong Chris L.P.
Published: November 2012

Activating mutations of the epidermal growth factor receptor (EGFR) gene in non-small cell lung cancer predicts a significantly higher clinical response rate to tyrosine kinase inhibitors targeting EGFR, and it is currently recommended that patients under consideration for EGFR TKI as first-line therapy be tested for such mutations to determine the appropriateness of treatment. For lung cancer patients who present with advanced stage disease where surgical treatment is not indicated, cytology specimens obtained through bronchoscopy, drainage of body fluid, or fine-needle aspiration are the only means to obtain tumor cells for tissue diagnosis and EGFR gene mutation testing. We reviewed the experience of 1,410 consecutive EGFR mutation testing requests at a single institution in Hong Kong that comprised 269 cytology specimens and 1,141 surgical specimens. The material inadequacy issue in cytology specimens may be overcome by tumor cell enrichment strategies and employment of mutation detection techniques with increased analytical sensitivity. The use of cytology specimens to test for predictive molecular cancer biomarkers is without a doubt expected to increase, and cytopathologists should be closely engaged with the clinicians in the therapeutic process and become acquainted with new technology in order to directly participate in personalized oncology care.
Obesity and the Cardiorenal Metabolic Syndrome: Therapeutic Modalities and Their Efficacy in Improving Cardiovascular and Renal Risk Factors
Authors: Jindal Ankur , Brietzke Stephen , Sowers James R.
Published: November 2012

The prevalence of obesity has increased rapidly in the United States. Obesity affects about one third of the adult population and, even though it is attributed to excess calorie intake and inadequate physical activity, its etiopathogenesis is much more complex and is an area of active study. Lifestyle modifications (with a focus on increased activity and decreased calorie intake) have modest efficacy in the treatment of obesity. There is a dearth of safe and effective therapeutic modalities to treat obesity. In this review, we discuss the role of different treatment options in the management of obesity and its comorbidities, with a focus on recently approved drugs and the emerging role of bariatric surgery.
Efficacy of a Tyrothricin-Containing Wound Gel in an Abrasive Wound Model for Superficial Wounds
Authors: Wigger-Alberti W. , Stauss-Grabo M. , Grigo K. , Atiye S. , Williams R. , Korting H.C.
Published: November 2012

Background: Topical preparations are a common treatment for superficial acute wounds, which at the least do not interfere with healing and ideally result in enhanced wound healing irrespective of microbial colonization. Objective: To examine the effects of a topical antimicrobial gel and its vehicle on the wound healing of standardized, superficial abrasions. Methods: Thirty-three healthy volunteers were enrolled in a double-blinded, randomized, intraindividual comparison study. Three standardized, superficial abrasions were induced on their forearms. A tyrothricin 0.1% gel (Tyrosur® gel; Engelhard Arzneimittel GmbH & Co. KG, Niederdorfelden, Germany) and its vehicle were randomly applied to two of the test areas, and one lesion remained untreated. Results: A significant improvement of wound healing was seen with both tyrothricin 0.1% gel and its corresponding vehicle in the clinical assessment. The mean area under the curve (AUC) of wound healing scores was the same for both preparations and the mean reepithelization scores were comparable at all test points over the entire 12 days. A lower mean AUC representing less reepithelization was found for the untreated test fields. Conclusion: The use of tyrothricin 0.1% gel and its corresponding vehicle resulted in statistically significant improved wound healing with an earlier onset of healing in particular. Based on these results obtained using an abrasive wound model, it can be concluded that the addition of tyrothricin 0.1% to the gel vehicle did not interfere with the improved wound healing seen with the vehicle alone.
Potential net clinical benefit of population-wide implementation of apixaban and dabigatran among European patients with atrial fibrillation
Authors: Pisters Ron , Nieuwlaat Robby , Lane Deirdre , Crijns Harry , Lip Gregory
Published: November 2012

Vitamin K antagonists (e.g. warfarin) are commonly underutilised, due to limitations such as the need for monitoring, in high-risk atrial fibrillation (AF) patients. We therefore aimed to model the potential impact on clinical outcomes in patients with AF with the use of the novel oral anticoagulant (OAC) drugs, apixaban and dabigatran. We identified all high-risk (CHA2DS2-VASc score ≥2) patients with non-valvular AF and known one-year follow-up from the EuroHeart Survey on AF (EHS-AF). We modelled the expected numbers of clinical events on the novel OACs using published hazard ratios from their respective phase 3 clinical trials and calculated the numbers needed to treat and the mathematical net clinical benefit. Our analysis included 3,400 patients [39% females; mean (SD) age 67 (12) years; CHA2DS2-VASc score 3.0 (1.8)] of which 330 were excluded from the modelling analysis due to concomitant use of OAC and antiplatelet drugs. During one-year follow- up, 108 (3.2%) patients experienced thromboembolism, 51 (1.5%) major bleeds and 146 (4.3%) died. Compared to current treatments (i.e. warfarin, aspirin or nothing) the use of apixaban in highrisk patients would have potentially prevented an additional 17 deaths, 27 strokes and eight major bleeds within this cohort. With use of dabigatran 150 mg BID, 34 strokes could have been prevented and for dabigatran110 mg BID, 16 strokes and six major bleeds would be avoided. Extrapolation of the data from the EHS-AF to the whole of Europe would translate into the prevention of an additional 64,573 major cardiovascular events and deaths each year among patients with a CHA2DS2-VASc ≥2, by the use of apixaban, 43,235 with the use of dabigatran 150 mg bid and 27,272 with the use of dabigatran 110 mg bid. In conclusion, based on this modelling exercise, the utilisation of apixaban and dabigatran for thromboprophylaxis could provide a profound annual mathematical net clinical benefit on stroke and major bleeds, in European AF patients.

Note: The editorial process for this paper was fully handled by Prof. C. Weber, Editor in Chief.
Is the Juice Worth the Squeeze? A Benefit/Cost Analysis of the District of Columbia Opportunity Scholarship Program
Authors: Wolf Patrick J. , McShane Michael
Published: November 2012

School voucher programs have become a prominent aspect of the education policy landscape in the United States. The DC Opportunity Scholarship Program is the only federally funded voucher program in the United States. Since 2004 it has offered publicly funded private school vouchers to nearly four thousand students to attend any of seventy-three different private schools in Washington, DC. An official experimental evaluation of the program, sponsored by the federal government's Institute of Education Sciences, found that the students who were awarded Opportunity Scholarships graduated from high school at a rate 12 percentage points higher than the students in the randomized control group. This article estimates the benefit/cost ratio of the DC Opportunity Scholarship Program, primarily by considering the increased graduation rate that it induced and the estimated positive economic returns to increased educational attainment. We find a benefit to cost ratio of 2.62, or $2.62 in benefits for every dollar spent on the program.
Informing Decisions with a Climate Synthesis Product: Implications for Regional Climate Services
Authors: Guido Zack , Hill Dawn , Crimmins Michael , Ferguson Daniel
Published: November 2012

The demand for regional climate information is increasing and spurring efforts to provide a broad slate of climate services that inform policy and resource management and elevate general knowledge. Routine syntheses of existing climate-related information may be an effective strategy for connecting climate information to decision making, but few studies have formally assessed their contribution to informing decisions. During the 2010–11 winter, drought conditions expanded and intensified in Arizona and New Mexico, creating an opportunity to develop and evaluate a monthly regional climate communication product—La Niña Drought Tracker—that synthesized and interpreted drought and climate information. Six issues were published and subsequently evaluated through an online survey. On average, 417 people consulted the publication each month. Many of the survey respondents indicated that they made at least one drought-related decision, and the product at least moderately influenced the majority of those decisions, some of which helped mitigate economic losses. More than 90% of the respondents also indicated that the product improved their understanding of climate and drought, and that it helped the majority of them better prepare for drought. The results demonstrate that routine interpretation and synthesis of existing climate information can help enhance access to and understanding and use of climate information in decision making, fulfilling the main goals for the provision of climate services.
Explaining Rising Nonresponse Rates in Cross-Sectional Surveys
Authors: Brick J. Michael , Williams Douglas
Published: November 2012

This review of nonresponse in cross-sectional household surveys in the United States shows trends in nonresponse rates, the main reasons for nonresponse, and changes in the components of nonresponse. It shows that nonresponse is increasing but that existing methods for modeling response mechanisms do not adequately explain these changes.
Paradata for Nonresponse Adjustment
Authors: Olson Kristen
Published: November 2012

Survey researchers and practitioners use nonresponse adjustment weights to mitigate the effects of survey nonresponse on sample estimates. One challenge in creating these weights is finding useful auxiliary data that predict both the probability of participating in the survey and the survey variables of interest. This article reviews the use of paradata for nonresponse adjustment. Five different types of paradata are considered: neighborhood observations, observations of the sampled housing unit, observations of persons in the sampled housing unit, call records, and observations about the interviewer-householder interaction. Empirical evidence about the predictive value of these paradata for predicting both participation and survey variables is examined. Challenges of using these paradata are also identified, along with outstanding issues and opportunities related to the use of paradata for nonresponse adjustment.
“We Live in a Technological Era, Whether You Like It or Not”
Authors: Hetling Andrea , Watson Stevie , Horgan Meghan
Published: November 2012

A growing number of state welfare agencies are using the Internet to communicate with potential and current clients. Although public management benefits are clear, little is known about client perspectives. This mixed-methods research project examines the topics of application security, reliability, appropriateness, and ease of use, and personal experiences of potential users to understand opinions of online welfare applications. Focus group findings highlight direct benefits, such as speed and ease of use, and indirect benefits, such as holding caseworkers accountable and avoiding unpleasant office conditions. Study participants also identified exceptions like emergencies and applicants with special needs. Despite mixed feelings, many participants preferred online applications to in-person, worker-led eligibility interviews.
The effects of autonomy support versus psychological control and work engagement versus academic burnout on adolescents’ use of avoidance strategies
Authors: Shih Shu-Shen
Published: November 2012

This study examines the relationships among Taiwanese ninth graders’ perceptions of autonomy support versus psychological control in the classroom context, work engagement versus academic burnout, and their avoidance of help seeking as well as self-handicapping behaviors. Four hundred and thirty-five ninth-grade Taiwanese students completed a self-reported survey assessing these variables. Results of hierarchical regressions indicated that in terms of environmental predictors, teachers’ autonomy support negatively predicted both help avoidance and self-handicapping, whereas teachers’ psychological control positively predicted self-handicapping only. As for the predicting effects of individual factors, students’ dedication negatively predicted both avoidance of help seeking and self-handicapping. By contrast, the lack of efficacy positively predicted help avoidance, whereas cynicism positively predicted self-handicapping. Further, results of MANCOVA revealed that even after controlling for the effects of teachers’ autonomy support and psychological control, burnout students were significantly more likely to avoid seeking academic help and self-handicap than were engaged students.
Works councils and the management of human resources: Evidence from German establishment data
Authors: Pfeifer Christian
Published: November 2012

This empirical research note focuses on the question of whether German works councils are sand or grease in the management of human resources and if the effects differ between three different works council–management relationship types. For this purpose, the author uses survey data from more than 11,000 German firms. The main result is that the effects of works councils on expected HRM (human resource management) problems in German firms are heterogeneous with respect to different aspects of HRM and to differences in works council–management relations. The findings are consistent with rent-protection, rent-sharing and voice functions of works councils.
The Roles of Regional Organizations for Interlocal Resource Exchange
Authors: Kwon Sung-Wook , Feiock Richard C. , Bae Jungah
Published: November 2012

This article investigates competing visions of how regional organizations influence cooperation among individual local governments within a metropolitan area. As network brokers among local governments, regional organizations can reduce the transaction costs of self-governing solutions to regional problems through bargaining and contracting among local units, but their centralized activities might also crowd out interlocal exchanges. Florida Regional Planning Councils are examined to test competing hypotheses based on these two visions, identifying the influence of regional organizations’ governance and activities on interlocal revenue transfers among municipal governments. Evidence that regional organizations can complement as well as substitute for interlocal cooperation is reported. In conclusion we discuss these findings in the context of vertical and horizontal federalism and theories of institutional collective action.
Activated carbon treatment of municipal solid waste incineration flue gas
Authors: Lu Shengyong , Ji Ya , Buekens Alfons , Ma Zengyi , Jin Yuqi , Li Xiaodong , Yan Jianhua
Published: November 2012

Activated carbon injection is widely used to control dioxins and mercury emissions. Surprisingly little attention has been paid to its modelling. This paper proposes an expansion of the classical Everaerts–Baeyens model, introducing the expression of fraction of free adsorption sites, fs, and asserting the significant contribution of fly ash to dioxins removal. Moreover, the model monitors dioxins partitioning between vapour and particulate phase, as well as removal efficiency for each congener separately. The effects of the principal parameters affecting adsorption are analysed according to a semi-analytical, semi-empirical model. These parameters include temperature, contact time during entrained-flow, characteristics (grain-size, pore structure, specific surface area) and dosage of activated carbon, lignite cokes or mineral adsorbent, fly ash characteristics and concentration, and type of incinerator plant.
Solid recovered fuel production from biodegradable waste in grain processing industry
Authors: Kliopova Irina , Staniškis Jurgis Kazimieras , Petraškienė Violeta
Published: November 2012

Management of biodegradable waste is one of the most important environmental problems in the grain-processing industry since this waste cannot be dumped anymore due to legal requirements. Biodegradable waste is generated in each stage of grain processing, including the waste-water and air emissions treatment processes. Their management causes some environmental and financial problems. The majority of Lithuanian grain-processing enterprises own and operate composting sites, but in Lithuania the demand for compost is not given. This study focused on the analysis of the possibility of using biodegradable waste for the production of solid recovered fuel, as a local renewable fuel with the purpose of increasing environmental performance and decreasing the direct costs of grain processing. Experimental research with regard to a pilot grain-processing plant has proven that alternative fuel production will lead to minimizing of the volume of biodegradable waste by 75% and the volume of natural gas for heat energy production by 62%. Environmental indicators of grain processing, laboratory analysis of the chemical and physical characteristics of biodegradable waste, mass and energy balances of the solid recovered fuel production, environmental and economical benefits of the project are presented and discussed herein.
Economic feasibility of ethanol production from biomass and waste resources via catalytic reaction
Authors: Yeon Sun-Hwa , Shin Dae-Hyun , Nho Nam-Sun , Shin Kyoung-Hee , Jin Chang-Soo
Published: November 2012

An economic evaluation of ethanol (EtOH) production from a thermo-chemical process derived from biomass/waste feedstocks was conducted. The influence of feed amounts, catalytic conversions, and EtOH selling prices was examined as these are the major variables for the economic evaluation of biomass/wastes conversion to EtOH. Among the three feedstock systems of biomass, high-moisture municipal solid waste (MSW), and plastic waste, the plastic waste has far better economic feasibility, with a payback period of 2–5 years at maximum CO conversion (40%) from syngas to ethanol, due to its higher heating value in comparison with biomass and high-moisture MSW. The heating value of the feedstock is a key factor in determining the overall economic efficiency in a thermo-chemical EtOH production system. Furthermore, enhancement of the CO conversion (related to catalytic activity) from syngas to EtOH using a low cost catalyst is necessary to retain economic efficiency because the CO conversion and cost consideration of catalyst are crucial factors to reduce the payback period.
Potential Impact of Pharmacist Interventions to Reduce Cost for Medicare Part D Beneficiaries
Authors: Thatcher Erin E. , VanWert Elizabeth M. , Erickson Steven R.
Published: November 2012

The objective was to determine the impact of simulated pharmacist interventions on out-of-pocket cost, time to coverage gap, and cost per patient to the Medicare Part D program using actual patient cases from an adult general medicine clinic. Medication profiles of 100 randomly selected Medicare-eligible patients from a university-affiliated general internal medicine clinic were reviewed by a pharmacist to identify opportunities to cost-maximize the patients’ therapies based on the plan. An online Part-D calculator, Aetna Medicare Rx Essentials, was used as the standard plan to determine medication cost and time to gap. The primary analysis was comparison of the patients’ pre-review and post-review out-of-pocket cost, time to coverage gap, and cost to Medicare. A total of 65 patients had at least 1 simulated pharmacist cost intervention. The most common intervention was substituting for a less costly generic, followed by substituting a generic for a brand name. Projected patient cost savings was $476 per year. The average time to coverage gap was increased by 0.7 ±1.2 months. This study illustrates that the pharmacists may be able to reduce cost to some patients as well as to the Medicare Part D program.
Integrity of surfaces finished with ultrasonic burnishing
Authors: Huuki Juha , Laakso Sampsa VA
Published: November 2012

Ultrasonic burnishing is a relatively new method used for finishing workpieces to produce good surface quality. Ultrasonic burnishing does not involve material removal from the surface of the workpiece. However, the method has a significant deforming effect on the material, especially close to the surface, which is why it is vital to know the effect of the method to residual stresses in the material. This study looks at the residual stresses produced in two 34CrNiMo6-M tempering steel qualities of different hardness. The magnitude of stresses is examined using the hole drilling method. The hardness and surface quality of the finished workpiece are measured. The results show that the ultrasonic burnishing not only treats material on the surface efficiently but also deforms the material deeper, producing compressive residual stresses in the workpiece. The hardness increases after finishing and surface quality improves significantly. The roundness of the workpiece is improved and dimensional changes are minor.
Microcantilever chaotic motion suppression in tapping mode atomic force microscope
Authors: Balthazar José Manoel , Tusset Angelo Marcelo , de Souza Silvio Luiz Thomaz , Bueno Atila Madureira
Published: November 2012

The tapping mode is one of the mostly employed techniques in atomic force microscopy due to its accurate imaging quality for a wide variety of surfaces. However, chaotic microcantilever motion impairs the obtention of accurate images from the sample surfaces. In order to investigate the problem the tapping mode atomic force microscope is modeled and chaotic motion is identified for a wide range of the parameter's values. Additionally, attempting to prevent the chaotic motion, two control techniques are implemented: the optimal linear feedback control and the time-delayed feedback control. The simulation results show the feasibility of the techniques for chaos control in the atomic force microscopy.
Practical use of work analysis to support rail electrical control rooms: A case of alarm handling
Authors: Dadashi Nastaran , Wilson John R , Golightly David , Sharples Sarah , Clarke Theresa
Published: November 2012

Renewals and especially enhancements of rail signalling and control systems are increasingly including a strong programme of human factors integration. One contribution to the human factors work that is required is work analysis – the understanding of what tasks and functions exist in current work systems, the artefacts (controls and displays used) and the strategies employed by skilled operators. One increasingly common approach to such work systems analysis is cognitive work analysis (CWA), used to develop understanding of a work domain and tasks in a structured fashion and as a basis for new design recommendations. The purpose of this paper is to explain, for an engineering and systems developer audience, the basis for and use of CWA. This is done in the context of rail electrical control rooms and especially the use made of various information display elements including alarms.