bluuebunny/crossref_metadata_2025 huggingface dataset:
Uncertainty and Sensitivity Studies with TRACE-SUSA and TRACE-DAKOTA by Means of Transient BFBT Data
Authors: Jaeger Wadim , Sánchez Espinoza Victor Hugo , Montero Mayorga Francisco Javier , Queral Cesar
Published: March 2013

In the present paper, an uncertainty and sensitivity study is performed for transient void fraction and pressure drop measurements. Two transients have been selected from the NUPEC BFBT database. The first one is a turbine trip without bypass and the second one is a trip of a recirculation pump. TRACE (version 5.0 patch 2) is used for the thermohydraulic study and SUSA and DAKOTA are used for the quantification of the model uncertainties and the evaluation of the sensitivities. As uncertain parameters geometrical values, hydraulic diameter, and wall roughness are considered while mass flow rate, power, pressure, and inlet subcooling (inlet temperature) are chosen as boundary and input conditions. Since these parameters change with time, it is expected that the importance of them on pressure drop and void fraction will change, too. The results show that the pressure drop is mostly sensitive to geometrical variations like the hydraulic diameter and the form loss coefficient of the spacer grid. For low void fractions, the parameter of the highest importance is the inlet temperature/subcooling while at higher void fraction the power is also of importance.
Biomarkers of Hypochromia: The Contemporary Assessment of Iron Status and Erythropoiesis
Authors: Urrechaga Eloísa , Borque Luís , Escanero Jesús F.
Published: March 2013

Iron status is the result of the balance between the rate of erythropoiesis and the amount of the iron stores. Direct consequence of an imbalance between the erythroid marrow iron requirements and the actual supply is a reduction of red cell hemoglobin content, which causes hypochromic mature red cells and reticulocytes. The diagnosis of iron deficiency is particularly challenging in patients with acute or chronic inflammatory conditions because most of the biochemical markers for iron metabolism (serum ferritin and transferrin ) are affected by acute phase reaction. For these reasons, interest has been generated in the use of erythrocyte and reticulocyte parameters, available on the modern hematology analyzers. Reported during blood analysis routinely performed on the instrument, these parameters can assist in early detection of clinical conditions (iron deficiency, absolute, or functional; ineffective erythropoiesis, including iron restricted or thalassemia), without additional cost. Technological progress has meant that in recent years modern analyzers report new parameters that provide further information from the traditional count. Nevertheless these new parameters are exclusive of each manufacturer, and they are patented. This is an update of these new laboratory test biomarkers of hypochromia reported by different manufactures, their meaning, and clinical utility on daily practice.
Massive Hematometra due to Congenital Cervicovaginal Agenesis in an Adolescent Girl Treated by Hysterectomy: A Case Report
Authors: Gasim Turki , Al Jama Fathia E.
Published: March 2013

A case of massive hematometra with a bicornuate uterus in a 14-year-old mentally handicapped girl complicated by vaginal agenesis and absent cervix is presented. She was managed by abdominal hysterectomy and right salpingo-oophorectomy that included the ovarian cystadenoma. The left ovary was conserved. This treatment was considered appropriate for this patient.
Construction, Expression, and Characterization of Thymosin Alpha 1 Tandem Repeats inEscherichia coli
Authors: Xue Xiao-Chang , Yan Zhen , Li Wei-Na , Li Meng , Qin Xin , Zhang Cun , Hao Qiang , Wang Zeng-Lu , Zhao Ning , Zhang Wei , Zhang Ying-Qi
Published: March 2013

Thymosin alpha 1 (Tα1), which is composed of 28 amino acids, has been commercialized worldwide for its immune-modulatory and antitumor effects. Tα1 can stimulate T cell proliferation and differentiation from bone marrow stem cells, augment cell-mediated immune responses, and regulate homeostasis of immune system. In this study, we developed a novel strategy to produce Tα1 concatemer (Tα1③) inEscherichia coliand compared its activity with chemically synthesized Tα1. Results showed that Tα1③can more effectively stimulate T cell proliferation and significantly upregulate IL-2 receptor expression. We concluded that the expression system for Tα1 concatemer was constructed successfully, which could serve as an efficient tool for the production of large quantities of the active protein.
Pitfalls in Neuroimaging of Headache: A Case Report and Review of the Literature
Authors: Vallamkondu V. , Shakeel M. , Hussain A. , McAteer D.
Published: March 2013

Headache is a common symptom, with a lifetime prevalence of over 90% of the general population in the United Kingdom (UK). It accounts for 4.4% of consultations in primary care and 30% of neurology outpatient consultations. Neuroimaging is indicated in patients with red flag features for secondary headaches. The guidelines recommend CT or MRI scan to identify any intracranial pathology. We present a unique case where the initial noncontrast CT scan failed to identify a potential treatable cause for headache. A middle aged man presented with headache and underwent a CT scan without contrast enhancement. The scan was reported as normal. The headache persisted for years and the patient underwent a staging CT scan to investigate an oropharyngeal cancer. This repeat CT scan utilized contrast enhancement and revealed a meningioma. Along with other symptoms, headache is an established presenting complaint in patients with meningioma. The contrast enhanced CT brain proved superior to a nonenhanced CT scan in identifying the meningioma. In a patient with persistent headache where other causes are excluded and a scan is to be requested, perhaps contrast enhanced CT is a better option than a plain CT scan of brain.
Familial Budd-Chiari Syndrome in China: A Systematic Review of the Literature
Authors: Qi Xingshun , Wang Juan , Ren Weirong , Bai Ming , Yang Man , Han Guohong , Fan Daiming
Published: March 2013

Familial occurrence of Budd-Chiari syndrome (BCS) has been reported in scattered cases, which potentially favors the congenital theory. A review of the literature was conducted to demonstrate this phenomenon in China. PubMed, VIP, and CNKI databases were searched for studies describing at least two Chinese BCS patients from the same one family. In the 18 eligible papers, 30 siblings or first-degree relatives from 14 families were diagnosed with BCS at 9 different centers. Common clinical presentations included varices of abdominal wall and lower limbs, edema of legs, and ascites. Type and location of obstruction were similar among these patients from the same one family. Screening for BCS was conducted in 65 family members from 3 families, demonstrating that 2 asymptomatic siblings from one family were further diagnosed with BCS. Factor V Leiden mutation was found in 3 of 4 patients from one family and in one of 2 patients from another one family. Prothrombin G20210A gene mutation was found in none of the 4 patients from the 2 families. In conclusion, our study showed the possibility of familial aggregation in Chinese BCS patients, but these available data cannot support the previous hypothesis that familial BCS originates from congenital vascular malformation.
Comparing Diagnostic Accuracy of Cognitive Screening Instruments: A Weighted Comparison Approach
Authors: Larner A.J.
Published: March 2013

Background/Aims: There are many cognitive screening instruments available to clinicians when assessing patients' cognitive function, but the best way to compare the diagnostic utility of these tests is uncertain. One method is to undertake a weighted comparison which takes into account the difference in sensitivity and specificity of two tests, the relative clinical misclassification costs of true- and false-positive diagnosis, and also disease prevalence. Methods: Data were examined from four pragmatic diagnostic accuracy studies from one clinic which compared the Mini-Mental State Examination (MMSE) with the Addenbrooke's Cognitive Examination-Revised (ACE-R), the Montreal Cognitive Assessment (MoCA), the Test Your Memory (TYM) test, and the Mini-Mental Parkinson (MMP), respectively. Results: Weighted comparison calculations suggested a net benefit for ACE-R, MoCA, and MMP compared to MMSE, but a net loss for TYM test compared to MMSE. Conclusion: Routine incorporation of weighted comparison or other similar net benefit measures into diagnostic accuracy studies merits consideration to better inform clinicians of the relative value of cognitive screening instruments.
Extension of Future Time Perspective in Motivational Goals of Different Age Groups
Authors: Lens Willy , Gailly Antoine
Published: March 2013

Age related differences in extension of future time perspective in motivational goals are studied at three socio-economic levels in a representative sample of the French speaking adult population in Belgium. The hypothesis of an inverted U-shaped relationship between age and extension of future time perspective is tested statistically. It cannot be maintained when using two indices of future extension that are borrowed from earlier studies in this field: (a) the proportion of number of references to the near future to the number of references to the distant future, and (b) the mean future extension score in number of years. The proportion of the mean future extension score to the statistically calculated expected life time is proposed as a new and better index of future extension for comparing different age groups. With this new index the hypothesis is confirmed at the three socioeconomic levels. The limits of the cross-sectional method that is used and the relative value of the new index of extension of future time perspective are discussed.
Cognitive Socialization During Adolescence
Authors: Oerter Rolf
Published: March 2013

Our knowledge of cognitive development in adolescence is still surprisingly limited, despite all the available data. It is possible that the primary subject-environment relations of adolescents have not been sufficiently considered. This paper seeks to describe the development of cognitive structure as establishing isomorphism between the subject and the environment, with regard to "primary content areas", using an ecological model of cognitive development as the theoretical framework. The primary content area chosen for this analysis was modern work structure. In the analysis clearly definable stages could be discerned along two dimensions.

The first of these was the serial differentiation of the psychological concepts "effort-industry" (E), "aptitude-intelligence" (A) and "pure subject" (S). Once an individual has attained the level of S he can function independently of the work process by being liberated from the relationships between the subject and the environment and is capable of thinking independently. The data presented supports this and confirm the theoretical expectations regarding the development of implicit concepts.

The second dimension is the development of planning in relation to the temporal sequence of tasks. The planning becomes more efficient in this respect and the data confirm the expected developmental sequence in efficiency: (a) reliable execution of tasks, first without and then with consideration of time limits; (b) systematic use of tools and machines; and (c) the delegation of tasks. An investigation of outsolving organisational problems confirmed the expected developmental sequences of planning.
Further Evidence on the Cognitive Abilities of the Japanese: Data from the WPPSI
Authors: Lynn Richard , Hampson Susan
Published: March 2013

The structure of abilities of Japanese children is analysed in terms of the Burt-Vernon hierarchical model of intelligence. The data are derived from the Japanese standardisation of the Wechsler Preschool and Primary Scale for Intelligence. It is found that Japanese children do not differ significantly from white American children on Spearman's g, are significantly inferior on the group verbal factor and superior on the group perceptual factor. On the primary abilities, Japanese children are inferior on verbal comprehension, not significantly different on perceptual speed, and superior on number and spatial ability. It is suggested-that this pattern of Japanese cognitive strengths and weaknesses helps to clarify a number of conflicting findings on Japanese intelligence.
Personal Control over Development: Effects on the Perception and Emotional Evaluation of Personal Development in Adulthood
Authors: Brandtstadter Jochen , Krampen Gunter , Greve Werner
Published: March 2013

Proceeding from an action perspective on development, this article addresses the impact of perceived control over personal development on the perception and emotional evaluation of developmental achievements and prospects in adulthood. Findings from a research project on personal control and emotional experience of development in adulthood reveal that low subjective control over development is related: (1) to a depressive outlook on personal development; (2) to an unfavorable appraisal of personal development in terms of perceived distances from personally valued developmental goals as well as in terms of personal resources for developmental progress. The findings further indicate that unsatisfying prospects of personal development may instigate self-corrective tendencies. The analyses reported (path analysis, analyses of variance) are based on questionnaire data obtained on a sample of over 630 married couples in the age range of 30 to 60 years. The results are specified with regard to different dimensions of personal development as well as to age and sex of respondents.
Incentives as a Treatment Variable for Facilitation Performance of Elderly Adults on Concrete Piagetian Tasks
Authors: Robinson Kenneth , Ross Steven M.
Published: March 2013

Reduced cognitive functioning of older adults is viewed by some researchers as mainly a problem of performance rather than of competence. To further explore this issue, the present study assessed performance of 52 elderly subjects on Piagetian tasks, with or without provision of incentives as a motivating condition. Although the incentive group scored higher than the no-incentive group on all tasks, differences did not reach significance. Contrary to the expected pattern, conservation of volume scores were higher than conservation of surface area scores. One interpretation is that elderly adults might be more influenced than younger age groups by extrinsic properties of conservation task stimuli. Implications of these and other findings for further research with the elderly are discussed.
Rate of Forgetting in Early Childhood
Authors: Merriman William E. , Azmitia Margarita , Perlmutter Marion
Published: March 2013

The relation between age and rate of forgetting was investigated with a task that eliminated differences in level of initial learning. Three-, four-, and six-year-olds were shown 40 pictures, then were tested for their recognition of 20 pictures immediately, followed by a recognition test of all pictures 24 hours later. Rate of forgetting was nearly identical in every age group. The results are discussed in terms of the interference theory of forgetting and hypotheses about the relation of forgetting to neurological maturation.
Mother and Infant Activity and Interaction in Japan and in the United States: II. A Comparative Microanalysis of Naturalistic Exchanges Focused on the Organisation of Infant Attention
Authors: Bornstein Marc H. , Toda Sueko , Azuma Hiroshi , Tamis-LeMonda Catherine , Ogino Misako
Published: March 2013

This study compares and contrasts activities and interactions related to maternal organisation of infant attention toward mother and toward the environment in Japanese and U.S. American mother-infant dyads. Observational data derived from 48 Tokyo and New York City mothers and their 5month-old infants seen at home were submitted to microanalysis. Relations among selected mother and infant activities, notably maternal control of and responsiveness to attentional focus in infants, are evaluated using cooccurrence and lag-sequential analyses. American and Japanese mothers and babies engaged in most activities at similar rates. However, American mothers appear to respond to environmental involvement in their infants by further encouraging infants to attend to properties, objects, or events in the environment, whereas it is during periods of decreased environmental interest and increased social interest that Japanese mothers deploy didactic encouragement. The results reveal activity and interaction patterns which are similar between these two cultures, as well as patterns which are culturespecific.
Parental Attachment and Children's Socio-emotional Development: Some Findings on the Validity of the Adult Attachment Interview in The Netherlands
Authors: van Ijzendoorn Marinus H. , Kranenburg Marian J. , Zwart-Woudstra Hylda A. , van Busschbach Agnes M. , Lambermon Mirjam W.E.
Published: March 2013

In this study, the Adult Attachment Interview (AAI) was applied in The Netherlands, to test certain aspects of its validity, and to provide information about its relation to toddlers' socio-emotional adaptation. In the second year of life, a sample of 80 infants were seen with their father, mother, and professional caregiver in the Strange Situation procedure, and in a free-play situation to assess caregivers' sensitivity. Two years later, 68 children participated in a follow-up study, involving mothers, fathers, and professional caregivers. Parents were interviewed with the AAI, and completed the Parental Bonding Instrument that measures attachment experiences in childhood. Parents also completed the Nijmegen-California Q-sort, to measure their children's ego-resilience and ego-control. Professional caregivers rated children's sociability in pre-school using the Pre-School Behavior Inventory.

As predicted the AAI and the Parental Bonding Instrument were related. Only the AAI, however, yielded classifications that corresponded with the quality of infant-parent attachment. Furthermore, AAI classifications for mothers were related to maternal sensitivity: Secure mothers are more sensitive to their daughters than insecure mothers, but for boys this was not true. In addition, AAI classifications for parents were related to their children's socio-emotional development in the pre-school years. Secure mothers have children with more ego-resilience and less ego-undercontrol. Dismissing fathers have children who are rated as more aggressive, less social, and less timid than secure or preoccupied fathers. The AAI appears to be a promising instrument for measuring parental state of mind with respect to attachment relationships in a variety of natural settings.
Effects of Pinyin and Script Type on Verbal Processing: Comparisons of China, Taiwan, and Hong Kong Experience
Authors: Chen May Jane , Yuen Joseph Chak-Kau
Published: March 2013

Children in the People's Republic of China (PRC) learn to read Chinese using a simplified script by pinyin, an alphabetic system. Taiwanese children learn Chinese using traditional characters and pinyin, Hong Kong children also learn Chinese with traditional characters, but without pinyin. The effects of these experiences were assessed by comparing children's performance on three tasks relevant to verbal processing. This study involved groups of children from each of the three places, China, Taiwan, and Hong Kong. Three tasks were used: pseudohomophone naming, similarity judgement, and lexical decision. The results showed that the PRC children and Taiwanese children performed better than the Hong Kong children in the naming of pseudohomophones. In the similarity judgement task, the children were required to choose between two response words, one of which was similar to the target word in pronunciation and the other in appearance. The PRC children tended to choose the visually similar reponse words more often than did the Taiwanese and Hong Kong children. In the lexical decision task, the PRC children were far less accurate than the other children in rejecting nonwords as real words. These results suggest that pinyin training helps readers pronounce unfamiliar words by facilitating the extraction of phonological information for pronunciation and that the PRC children's experience in learning the simplified Chinese script has made them more responsive to visual information but less precise in word recognition.
Effects of Infant Attachment to Mother and Father on Quality of Adaptation in Preschool: From Dyadic to Individual Organisation of Self
Authors: Suess G. J. , Grossmann K. E. , Sroufe L. Alan
Published: March 2013

A total of 39 children, classified in Ainsworth's Strange Situation at 12 and 18 months of age with their mothers and fathers, were observed in play groups and given a cartoon-based social perception test at 5 years of age. Children with anxious attachment histories (primarily avoidant in this sample) differed from those with secure histories on a number of single variables, and behavioural profiles based on combinations of variables showed strong significant differences in quality of play, conflict resolution, and problem behaviours. Measures of play competence, conflict resolution, and behaviour problems were significantly related to infant-mother attachment for girls, but not for boys. Overall competence, however, was significantly related to attachment to the mother for both boys and girls. Children with anxious attachment histories also showed misperceptions of cartoon stimuli, more often perceiving negative intentions than children with secure histories. Between-group differences were notably stronger using classifications with mothers than classifications with fathers. However, effects based on combined attachment information with both mother and father were more powerful for some variables.
Children's Understanding of Multiple Desires
Authors: Bennett Mark , Galpert Linda
Published: March 2013

Research concerned with children's understanding of multiple emotions (e.g. Harter, 1986) suggests that an understanding of multiple desires may be late appearing. However, evidence from the "theory of mind" tradition argues against this and suggests that such understanding should be in place by 4 or 5 years of age. The present paper addresses the issue directly, looking at understanding of successive and simultaneous desires. Three experiments involving predictions or judgements about story characters' desires are reported. Analysis of the data indicates that in contrast to earlier work on understanding of emotion, an understanding of multiple desires would appear to be present by 5 years of age, perhaps earlier. Possible sources of the discrepancy between understanding of desires and emotions are considered.
The Dynamics of State Fiscal Behavior Over the Business Cycle
Authors: Kwak Sunjoo
Published: March 2013

The purpose of this study is to examine how cyclical fluctuations in tax revenue affect state fiscal policies, using a state panel data set. In particular, the study develops a measure of revenue gap—the cyclical component of tax revenue—by calculating the orthogonal deviations of tax bases from the trend, and then analyzes its effects on the level of spending and taxation—as measured by expenditure gap and overall tax rate—using a dynamic panel-data model. The analyses reveal that revenue gap is positively related to expenditure gap and negatively to overall tax rate. These results clearly show the procyclical patterns of state fiscal policies and further suggest the association between revenue volatility and fiscal instability. Based on the results, the study discusses the spending stabilization rules as a policy solution to the recurring state fiscal crises.
Body Composition in Prepubertal, HIV‐Infected Children
Authors: Palchetti Cecília Zanin , Patin Rose Vega , Machado Daisy Maria , Szejnfeld Vera Lúcia , Succi Regina Célia de Menezes , Oliveira Fernanda Luisa Ceragioli
Published: March 2013

Background: The aim of this study was to compare bioelectrical impedance analysis (BIA) equations developed for healthy pediatric populations and for HIV‐infected children using dual‐energy X‐ray absorptiometry (DXA) as the gold standard. Materials and Methods: A cross‐sectional study was carried out with 40 prepubertal, HIV‐infected children who regularly attended the Pediatric Infectious Disease Clinic at the Universidade Federal de São Paulo, São Paulo, Brazil. The study was conducted from August to November 2008. Demographic data, clinical parameters, immunological status, and use of antiretroviral therapy were obtained from the patients’ medical records. We performed anthropometric parameters and body composition analyses, analyzed body composition by BIA and DXA, and compared the results obtained from BIA through using equations for both healthy and HIV‐infected populations. Results: The mean ± SD age of the study population was 9.8 ± 1.2 years. Half of the population were females, and 82.5% of the children were clinically classified as B and C. Total body fat, by both absolute mass and by percentage, exhibited high homogeneity between the results obtained from BIA and DXA. However, there was no concordance in fat‐free mass. The equation for healthy children showed good sensitivity and specificity when comparing the percentage of total body fat measured by DXA. Conclusion: BIA provides reliable data on total body fat but not fat‐free mass when compared with DXA. The BIA equation developed for healthy pediatric populations can be used to determine total body fat in HIV‐infected children.
Fluid Resuscitation in Septic Shock
Authors: Sadaka Farid , Juarez Mayrol , Naydenov Soophia , O’Brien Jacklyn
Published: March 2013

Purpose:

To determine whether progressively increasing fluid balance after initial fluid resuscitation for septic shock is associated with increased mortality.

Methods:

A retrospective review of the use of intravenous fluids in patients with septic shock in a large university affiliated hospital with 56 medical–surgical intensive care unit beds. We analyzed the data of 350 patients with septic shock who were managed according to the Surviving Sepsis Campaign guidelines. Based on net fluid balance at 24 hours, we examined the results of increase in positive fluid balance on the risk of in-hospital mortality. Patients were divided into 4 groups based on the amount of fluid balance by 24 hours, based on 6-L aliquots.

Results:

At 24 hours, the average fluid balance was +6.5 L. After correcting for age and sequential organ failure assessment score, a more positive fluid balance at 24 hours significantly increased the risk of in-hospital mortality. Using Cox proportional hazard analysis, excess 12-, 18-, and 24-L positive fluid balance had higher risk of mortality than those patients with a neutral to positive 6-L fluid balance (reference group). Adjusted hazard ratios, 1.519 (95% confidence interval [CI], 1.353-1.685), 1.740 (95% CI, 1.467-2.013), and 1.620 (95% CI, 1.197-2.043), respectively, P < .05.

Conclusion:

In patients with septic shock resuscitated according to current guidelines, a more positive fluid balance at 24 hours is associated with an increase in the risk of mortality. Optimal survival occurred at neutral fluid balance and up to 6-L positive fluid balance at 24 hours after the development of septic shock.
Double framing in Lilya 4-Ever: Sex trafficking and postsocialist abjection
Authors: Suchland Jennifer
Published: March 2013

The image of the trafficked woman from a former state socialist country has come to symbolize the global crisis in sex trafficking. The ‘Natasha’ image is also a referent for the failure of state socialism. This article provides an analysis of the film Lilya 4-Ever (dir. Lukas Moodyson, 2002) to show how both sex trafficking and postsocialism are framed in representations of sex trafficking. The film presents the problem of sex trafficking in two covertly problematic ways, narrowing the issue to prostitution and illegal migration. While the film avoids voyeurism of sexual violence, this is replaced by voyeurism of postsocialist abjection. Postsocialist abjection is aesthetically captured as an eternal state of collapse. Thus, the tragedy of sex trafficking is the result of and a symbol for the failure (post-)state socialism.
Communitarian journalism and the common good: Lessons from the Catholic Worker
Authors: Borden Sandra L
Published: March 2013

The US newspaper the Catholic Worker ( CW) is an instructive example for developing a key concept in communitarian journalism theory: the common good. The principal question to be examined in this article is: how can communitarian journalists make constructive use of the inherent tension between particular common good s and the common good? To answer this question, I will refer to the experience of the CW in negotiating two particular tensions: the tensions between spiritual/temporal and between Catholic/American. A secondary question to be explored is: how can communitarian journalism move beyond liberal tolerance in responding to difference in pluralistic societies? To answer this question, I will elaborate on the CW’s practices of hospitality, which have allowed staffers to remain faithful to the paper’s particular conception of the common good while actively engaging with, and learning from, their non-Catholic neighbors.
Factor V Leiden Mutation–Related Chronic Skin Ulcers
Authors: Kayatas Kadir , Cebeci Filiz , Karatoprak Cumali , Benzer Muhammet , Demirtunç Refik , Demirkesen Cuyan
Published: March 2013

Chronic skin ulcers require extensive, systemic differential diagnosis; thus, they are difficult to diagnose and treat. Transient or persistent hypercoagulable states are among the rare causes of skin ulcers. Here, we present the case of a 27-year-old woman patient with recurrent, nonhealing skin ulcers of 8 years’ duration, who had been treated unsuccessfully with various medications under different diagnoses at different clinics. On admission, a skin biopsy demonstrated occlusive vasculopathy, and the search for an inherited hypercoagulable state revealed a heterozygous factor V Leiden mutation. The patient was treated with anticoagulants and hyperbaric oxygen. On treatment, the skin lesions healed and did not recur.
Cool Excimer Laser-Assisted Angioplasty (CELA) and Tibial Balloon Angioplasty (TBA) in Management of Infragenicular Arterial Occlusion in Critical Lower Limb Ischemia (CLI)
Authors: Sultan Sherif , Tawfick Wael , Hynes Niamh
Published: March 2013

We aim to compare cool excimer laser-assisted angioplasty (CELA) versus tibial balloon angioplasty (TBA) in patients with critical limb ischemia (CLI) with tibial artery occlusive disease. The primary end point is sustained clinical improvement (SCI) and amputation-free survival (AFS). The secondary end points are binary restenosis, target extremity revascularization (TER), and cost-effectiveness. From June 2005 to October 2010, 1506 patients were referred with peripheral vascular disease and 572 with CLI. A total of 80 patients underwent 89 endovascular revascularizations (EVRs) for tibial occlusions, 47 using TBA and 42 using CELA. All patients were Rutherford category 4 to 6. Three-year SCI was enhanced with CELA (81%) compared to TBA (63.8%; P = .013). Three-year AFS significantly improved with CELA (95.2%) versus TBA (89.4%; P = .0165). Three-year freedom from TER was significantly improved with CELA (92.9%) versus 78.7% TBA ( P = .026). Three-year freedom from MACE was comparable in both the groups ( P = .455). Patients with CELA had significantly improved quality time without symptoms of disease or toxicity of treatment (Q-TWiST) at 3 years (10.5 months; P = .048) with incremental cost of €2073.19 per quality-adjusted life year gained. Tibial EVR provides exceptional outcome in CLI. The CELA has superior SCI, AFS, and freedom from TER, with improved Q-TWiST and cost-effectiveness.
Management of febrile neutropenia in the era of bacterial resistance
Authors: Alp Sehnaz , Akova Murat
Published: March 2013

Managing cancer patients with fever and neutropenia must be considered as a medical emergency since any delay in initiating appropriate empirical antibacterial therapy may result in high rates of mortality and morbidity. Emerging antibacterial resistance in bacterial pathogens infecting febrile neutropenic patients complicates management, and choosing the type of empirical antimicrobial therapy has become a challenge. To further complicate the decision process, not all neutropenic patients are in same category of susceptibility to develop severe infection. While low-risk patients may be treated with oral antibiotics in the outpatient setting, high-risk patients usually need to be admitted to hospital and receive parenteral broad-spectrum antibiotics until the neutrophil levels recover. These strategies have recently been addressed in two international guidelines from the Infectious Diseases Society of America (IDSA) and the European Conference on Infections in Leukaemia (ECIL). This review gives a brief overview of current antimicrobial resistance problems and their effects in febrile neutropenic cancer patients by summarizing the suggestions from the IDSA and ECIL guidelines.
A mechanistic role for DNA methylation in endothelial cell (EC)-enriched gene expression: relationship with DNA replication timing
Authors: Shirodkar Apurva V. , St. Bernard Rosanne , Gavryushova Anna , Kop Anna , Knight Britta J. , Yan Matthew Shu-Ching , Man Hon-Sum Jeffrey , Sud Maneesh , Hebbel Robert P. , Oettgen Peter , Aird William C. , Marsden Philip A.
Published: March 2013

Key Points

Promoter DNA methylation, an epigenetic process, is functionally relevant for regulating the expression of endothelial cell–enriched genes.
Nonsmall cell lung cancer
Authors: Sculier Jean-Paul
Published: March 2013

The objective of this review is to report the Clinical Year in Review proceedings in the field of nonsmall cell lung cancer that were presented at the 2012 European Respiratory Society Congress in Vienna, Austria. Various topics were reviewed, including epidemiology, screening, diagnosis, treatment, prognosis, and palliative and end of life care.
Targeting a genetic defect: cystic fibrosis transmembrane conductance regulator modulators in cystic fibrosis
Authors: Derichs Nico
Published: March 2013

Cystic fibrosis (CF) is caused by genetic mutations that affect the cystic fibrosis transmembrane conductance regulator (CFTR) protein. These mutations can impact the synthesis and transfer of the CFTR protein to the apical membrane of epithelial cells, as well as influencing the gating or conductance of chloride and bicarbonate ions through the channel. CFTR dysfunction results in ionic imbalance of epithelial secretions in several organ systems, such as the pancreas, gastrointestinal tract, liver and the respiratory system. Since discovery of theCFTRgene in 1989, research has focussed on targeting the underlying genetic defect to identify a disease-modifying treatment for CF. Investigated management strategies have included gene therapy and the development of small molecules that targetCFTRmutations, known as CFTR modulators. CFTR modulators are typically identified by high-throughput screening assays, followed by preclinical validation using cell culture systems. Recently, one such modulator, the CFTR potentiator ivacaftor, was approved as an oral therapy for CF patients with the G551D-CFTRmutation. The clinical development of ivacaftor not only represents a breakthrough in CF care but also serves as a noteworthy example of personalised medicine.
Functional characterization of EZH2β reveals the increased complexity of EZH2 isoforms involved in the regulation of mammalian gene expression
Authors: Grzenda Adrienne , Lomberk Gwen , Svingen Phyllis , Mathison Angela , Calvo Ezequiel , Iovanna Juan , Xiong Yuning , Faubion William , Urrutia Raul
Published: March 2013

Background

Histone methyltransferase enhancer of zeste homologue 2 (EZH2) forms an obligate repressive complex with suppressor of zeste 12 and embryonic ectoderm development, which is thought, along with EZH1, to be primarily responsible for mediating Polycomb-dependent gene silencing. Polycomb-mediated repression influences gene expression across the entire gamut of biological processes, including development, differentiation and cellular proliferation. Deregulation of EZH2 expression is implicated in numerous complex human diseases. To date, most EZH2-mediated function has been primarily ascribed to a single protein product of the EZH2 locus.

Results

We report that the EZH2 locus undergoes alternative splicing to yield at least two structurally and functionally distinct EZH2 methyltransferases. The longest protein encoded by this locus is the conventional enzyme, which we refer to as EZH2α, whereas EZH2β, characterized here, represents a novel isoform. We find that EZH2β localizes to the cell nucleus, complexes with embryonic ectoderm development and suppressor of zeste 12, trimethylates histone 3 at lysine 27, and mediates silencing of target promoters. At the cell biological level, we find that increased EZH2β induces cell proliferation, demonstrating that this protein is functional in the regulation of processes previously attributed to EZH2α. Biochemically, through the use of genome-wide expression profiling, we demonstrate that EZH2β governs a pattern of gene repression that is often ontologically redundant from that of EZH2α, but also divergent for a wide variety of specific target genes.

Conclusions

Combined, these results demonstrate that an expanded repertoire of EZH2 writers can modulate histone code instruction during histone 3 lysine 27-mediated gene silencing. These data support the notion that the regulation of EZH2-mediated gene silencing is more complex than previously anticipated and should guide the design and interpretation of future studies aimed at understanding the biochemical and biological roles of this important family of epigenomic regulators.
Self-aggregating TIAF1 in lung cancer progression
Authors: Hong Qunying , Hsu Li-Jin , Chou Pei-Yi , Chou Ying-Tsen , Lu Chen-Yu , Chen Yu-An , Chang Nan-Shan
Published: March 2013

Recent studies have demonstrated that transforming growth factor beta (TGF-β1)-induced antiapoptotic factor (TIAF1) is able to form aggregates in the hippocampi of middle-aged normal individuals. The aggregating TIAF1 induces generation of amyloid beta (Aβ) for causing neurodegeneration. Intriguingly, TIAF1 aggregates are shown, together with Smad4 and Aβ, in the cancer stroma and peritumor capsules of many solid tumors. During lung cancer progression, for example, TIAF1 and amyloid fibrils are significantly upregulated in the cancer stroma. Aggregates of TIAF1 and Aβ are shown on the interface between metastatic lung cancer cells and the brain tissues. Conceivably, these peritumor materials are needed for cancer cells to survive. In vitro experiments revealed that TIAF1 is a crucial component for tumor suppressors p53 and WWOX-mediated tumor suppression and apoptosis. While metastatic lung cancer cells are frequently devoid of WWOX and p53, we provide new perspectives regarding the role of TIAF1 in the pathogenesis of lung cancer development, and propose a therapeutic approach for targeting TIAF1.
The Quantity Theory of Insanity by Will Self
Authors: Ginn Stephen
Published: March 2013

The Quantity Theory of Insanity is a short story by the English novelist and journalist Will Self. It is one of six stories in a collection of the same name. Its central conceit is that there is ‘only a fixed proportion of sanity available to any given society at any given time’. The story is a broad satire of academia, social science and our treatment and understanding of mental disorder.
Biological psychiatry: time for new paradigms
Authors: Linden David
Published: March 2013

Biological psychiatry has not yet produced clinically viable biomarkers for any of the major psychiatric diseases, and the past 25 years have not brought any fundamentally new biological treatment principles. I discuss reasons for this slow progress and suggest avenues for the development of biomarkers and the discovery of new treatment targets.
Mental health service discrimination against older people
Authors: Anderson David , Connelly Peter , Meier Richard , McCracken Cherie
Published: March 2013

Aims and method

To provide a picture of availability and equality of access to mental health services for older people prior to the Equality Act. In 2010, a questionnaire was sent to health commissioners in England, Scotland and Wales under a Freedom of Information request.

Results

Overall, 132 (76%) replied. Of 11 services, 7 were either unavailable or did not provide equality of access to older people in more than a third of commissioning areas. When provided by specialist older people's mental health, services were more often considered to ensure equality.

Clinical implications

Increasing need resulting from an ageing population is unlikely to be met in the face of current inequality. Inequality on the basis of age is the result of government policy and not the existence of specialist services for older people. Single age-inclusive services may create indirect age discrimination. Availability alone is insufficient to demonstrate equality of access. Monitoring the effects of legislation must take this into account.
Automatic Modernism: D. H. Lawrence, Vitalism, and the Political Body
Authors: Wientzen Timothy
Published: March 2013

This article argues for the centrality of ideas of automatism and habit within the political and aesthetic life of literary modernism. D. H. Lawrence's characteristic interest in the raptures of sexuality and corporality are read in relation to shifts in the nature of political life, in particular the function of material conditioning within the institutions of the nation-state. The rise of such a political technology, this article suggests, was an important precondition for Lawrence's own emphasis on alternative categories of political life, most importantly the “primary cognition” of the body. Lawrence's sense of political embodiment placed him in fundamental accord with the work of the vitalist philosophers Henri Bergson and Georges Sorel. Sorel's notion of political myth in particular informs a reading of Lawrence's late novel The Plumed Serpent (1926), which enacts a vitalist drama of political embodiment. Considered by Lawrence to be his best novel, The Plumed Serpent enables a retrospective reading of Lawrence's formal method, including the value of readerly affect in his attempts to counter the habituating forces of mass modernity.
Politics of Return: Homecoming Stories of the Vietnamese Diaspora
Authors: Wang Chih-ming
Published: February 2013

Intrigued by the question of diasporic return, this article is concerned with the cultural politics of what I call “homecoming stories” of the Vietnamese diaspora. In order not to be confused with the imaginary returns that have been practiced in many Vietnamese-US writings, such as Lan Cao's Monkey Bridge (1997) or Kien Nguyen's The Unwanted (2001), this article focuses instead on Vietnamese-US narratives about the experience of physical returns by looking at Andrew Pham's Catfish and Mandala (1999) and Andrew Lam's Perfume Dreams (2005). Understanding that ethnic memoirs are not to be read only as testimonies of war and personal traumas, this article argues that these two texts represent what critic Rocio G. Davis calls “relational life writing” that aims to intervene in the contested terrains of trans-Pacific memories and geopolitics. It further argues that Pham's and Lam's homecoming stories not only reconfigure the “refugee subjectivity” of Vietnamese diaspora but also recast Asian American studies in diasporic contexts by taking the aspirations and concerns of Vietnam seriously, although their journeys “home” are by no means patriotic returns but only temporary visits. These return narratives are significantly framed in the contentious memories of war and survival and are triangulated in the complex relations between the United States, Vietnam, and Vietnamese America. Via a critical reading of Catfish and Mandala and Perfume Dreams, this article seeks to engage with the ongoing conversations about transnational Asian American studies by working through the issue of Asian-US relations.
A SAP domain-containing protein shuttles between the nucleus and cell membranes and plays a role in adhesion and migration in D. discoideum
Authors: Kelsey Jessica S. , Blumberg Daphne D.
Published: March 2013

The AmpA protein reduces cell adhesion, thereby influencing cell migration in Dictyostelium. To understand how ampA influences cell migration, second site suppressors of an AmpA overexpressing cell line were created by REMI mutagenesis. Mutant candidates were identified by their ability to suppress the large plaques that the AmpA overexpressing cells form on bacterial lawns as a result of their increased rate of migration. One suppressor gene, sma, encodes an uncharacterized protein, which contains a SAP DNA-binding domain and a PTEN-like domain. Using sma gene knockouts and Sma-mRFP expressing cell lines, a role for sma in influencing cell migration was uncovered. Knockouts of the sma gene in a wild-type background enhanced chemotaxis. An additional role for Sma in influencing cell–cell adhesion was also demonstrated. Sma protein transitions between cytosolic and nuclear localizations as a function of cell density. In growing cells migrating to folic acid it is localized to regions of actin polymerization and absent from the nucleus. A role for Sma in influencing ampA mRNA levels is also demonstrated. Sma additionally appears to be involved in ampA pathways regulating cell size, actin polymerization, and cell substrate adhesion. We present insights to the SAP domain-containing group of proteins in Dictyostelium and provide evidence of a role for a SAP domain-containing protein shuttling from the nucleus to sites of actin polymerization during chemotaxis to folic acid and influencing the efficiency of migration.
Prognostic factors for premature growth plate arrest as a complication of the surgical treatment of fractures of the medial malleolus in children
Authors: Petratos D. V. , Kokkinakis M. , Ballas E. G. , Anastasopoulos J. N.
Published: February 2013

McFarland fractures of the medial malleolus in children, also classified as Salter–Harris Type III and IV fractures, are associated with a high incidence of premature growth plate arrest. In order to identify prognostic factors for the development of complications we reviewed 20 children with a McFarland fracture that was treated surgically, at a mean follow-up of 8.9 years (3.5 to 17.4). Seven children (35%) developed premature growth arrest with angular deformity. The mean American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale for all patients was 98.3 (87 to 100) and the mean modified Weber protocol was 1.15 (0 to 5). There was a significant correlation between initial displacement (p = 0.004) and operative delay (p = 0.007) with premature growth arrest. Both risk factors act independently and additively, such that all children with both risk factors developed premature arrest whereas children with no risk factor did not. We recommend that fractures of the medial malleolus in children should be treated by anatomical reduction and screw fixation within one day of injury.

Cite this article: Bone Joint J 2013;95-B:419–23.