bluuebunny/crossref_metadata_2025 huggingface dataset:
α‐Adrenoceptor agonists for the treatment of vasovagal syncope: a meta‐analysis of worldwide published data
Authors: Liao Ying , Li Xueying , Zhang Yanwu , Chen Stella , Tang Chaoshu , Du Junbao
Published: April 2009

Aim:  The present study was aimed at evaluating present randomized controlled trials (RCTs) regarding the effect of α‐adrenoceptor agonists on vasovagal syncope (VVS).

Methods:  According to inclusion and exclusion criteria, articles were selected from medical electronic databases. RCTs were then assessed based on the Juni assessment, and meta‐analysis was completed using the Review Manager 4.2 software. Indication to further evaluate effects was the recurrence of syncope during follow‐up treatment or a response in the head‐up tilt test (HUT) after treatment. The results were stated as odd ratio (OR), with a 95% confidence interval (CI) and a  p <  0.05 significant level.

Results:  In total, six RCTs were selected. Funnel plot analysis showed possible publication bias. Meta‐analysis of the six RCTs, including all 165 patients in the treatment group and 164 patients in the control group, indicated that α‐adrenoceptor agonists were more effective than placebos in treating VVS (OR = 0.21, 95% CI: 0.06–0.77, p = 0.02). The further, weighted independent t‐test disclosed that the weighted mean percentage of responders for midodrine (76.3%± 7.7%) was significantly higher than that for etilefrine (65.5%± 15.4%) (t = 5.863, p  <  0.001).

Conclusion:  The currently published RCTs support that α‐adrenoceptor agonists might be effective for VVS. Midodrine can be regarded as a better choice compared with etilefrine.
Natural evolution of regurgitation in healthy infants
Authors: Hegar Badriul , Dewanti Nita R , Kadim Muzal , Alatas Safira , Firmansyah Agus , Vandenplas Yvan
Published: April 2009

Objectives:  To determine the natural history of infant regurgitation during the first year of life.

Methods: Parents recorded prospectively the frequency of regurgitation for 1 week before consultation during the first year of life. A sub‐group analysis according to the method of feeding was planned.

Results:  A total of 130 infants of an original sample of 163 (80%) newborns were followed up for 1 year. Daily spilling was highest during the first month of life (73%) and decreased gradually to 50% during the fifth month of life. During the first 2 months of life, 20% of the infants regurgitated more than four times per day. After the age of 12 months, only 4% of the infants had daily regurgitations. Exclusively breastfed infants did regurgitate less than partially breastfed infants. Weight gain was influenced by the frequency of regurgitation, especially in partially breastfed infants.

Conclusion: Regurgitation in infancy is common, decreasing from birth, and tends to disappear by 12 months of age. Weight gain during the first 4 months of life is decreased in infants who regurgitate more than four times a day. Our data suggest that exclusively breastfed infants regurgitate less than partially breastfed babies.
Mineral solubility of Panicum maximum with four herbaceous forage legume mixtures incubated in the rumen of N' Dama steers
Authors: AJAYI Festus T. , BABAYEMI Olaniyi Jacob , TAIWO Abiodun A.
Published: April 2009

This study was designed to determine the mineral concentration and bioavailability of iron (Fe), phosphorus (P), calcium (Ca) and sodium (Na) of mixtures of Panicum maximum (Panicum) with Lablab purpureus (Lablab), Centrosema pubescens (Centro), Stylosanthes guianensis (Stylo), and Aeschynomene histrix (Histrix) in a fistulated N'Dama steer. The solubility of minerals was determined by an in sacco method by incubating ground samples of these forages in the rumen at 0, 6, 12, 24, 48 and 72 h. The mineral solubility characteristics of the forages were evaluated using the equation PD = a + b (1 − e−ct). The result showed that Panicum intercropped with legumes had better crude protein (CP) (av. 9.22% DM) and ash content (av. 2.22% DM) than sole Panicum which gave 7.63% DM and 1.84% DM for CP and ash contents respectively. The highest value of CP of 23.29% DM and ash content (3.96% DM) was obtained for Lablab. The mineral content values of the intercrop were higher than the sole Panicum. Higher mineral content values were obtained in the sole legumes. Iron solubility values of b and potential degradation (PD) which were 58.71% and 87.92% respectively were for Panicum/Histrix mixtures. Calcium solubility values ranged from 30.0% in Panicum to 46.0% in Panicum/Lablab mixture for b fraction. P solubility ranged from 28.0% and 46.0% for b and PD fractions in Panicum to 43.0% and 71.0% in Panicum/Centro mixture respectively. The solubility of the legumes was higher in Na for b fraction (av. 42.0%) and PD fraction (av. 60.0%). Higher values of b (av. 38.0%) and PD (av. 52.0%) were obtained for the mixtures than for sole Panicum. This study revealed that intercropping Panicum with either of the herbaceous forage legumes used for this experiment would increase the Ca, P, Na and Fe contents of the grass.
Death losses due to stillbirth, neonatal death and diseases in cloned cattle derived from somatic cell nuclear transfer and their progeny: a result of nationwide survey in Japan
Authors: WATANABE Shinya , NAGAI Takashi
Published: April 2009

To obtain the data concerning death losses due to stillbirth, neonatal death and diseases in cloned cattle derived from somatic cell nuclear transfer (SCNT) and their progeny produced by Japanese institutions, a nationwide survey was carried out in July‐August, 2006. As a result, lifetime data concerning 482 SCNT cattle (97.5% of cattle produced in the country at that time) and 202 progeny of SCNT cattle were accumulated and the death loss of these cattle was analyzed. Although 1/3 of delivered SCNT calves died during the perinatal period due to stillbirth and neonatal death, incidence of death loss due to diseases in SCNT cattle surviving more than 200 days after birth seems to be the same as these in conventionally bred cattle. In contrast, progeny of SCNT cattle showed the same level in death loss as observed in conventionally bred cattle throughout their lifetime. These results suggest that robust health would be expected in SCNT cattle surviving to adulthood and their progeny.
Using a complex non‐TDN based model (the DVE/OEB system) to predict microbial protein synthesis, endogenous protein, degradation balance, and total truly absorbed protein supply of different varieties of cereal oats for ruminants
Authors: YU Peiqiang , NIU Zhiyuan
Published: April 2009

Recently a new super‐genotype of oat has been developed in the Crop Development Center called CDC SO‐I (‘SuperOat’: low lignin and high fat). In a previous study, we evaluated total metabolizable protein using a TDN‐based model‐NRC‐2001 which is popular in North America. However, the TDN‐based NRC model is not accepted universally. The objectives of this study were to use a complex non‐TDN based model, the DVE/OEB system, to evaluate potential nutrient supply to ruminants from the SuperOat in comparison with two normal varieties of oats (CDC Dancer and Derby) in western Canada. The quantitative predictions were made in terms of: (i) truly absorbed rumen synthesized microbial proteins in the small intestine; (ii) truly absorbed rumen undegraded feed protein in the small intestine; (iii) endogenous protein in the digestive tract; (iv) total truly absorbed protein in the small intestine; and (v) protein degraded balance. Results showed that using the DVE/OEB system to predict the potential nutrient supply, it was found that the SuperOat had similar truly absorbed rumen synthesized microbial protein levels (61, 63, 59 g/kg DM, P > 0.05, for SuperOat, CDC Dancer and Derby, respectively), higher truly absorbed rumen undegraded feed protein than CDC Dancer (22 vs. 17 g/kg DM P < 0.05, for SuperOat, CDC Dancer, respectively), but similar to Derby (22 vs. 21 g/kg DM; P > 0.05), and similar endogenous protein (16, 16, 18 g/kg DM; P > 0.05). Total truly absorbed protein in the small intestine is only numerically higher in the SuperOat (67 vs. 65, 62 g/kg DM, P > 0.05, for CDC Dancer and Derby, respectively). However, the protein degraded balance was significantly different (P < 0.05) with a positive value for the SuperOat (7.0 g/kg DM) and negative values for two normal varieties (−1.5, −6.8 g/kg DM for CDC Dancer and Derby, respectively). In conclusion, the model predicted significantly different protein degradation balance. The SuperOat had positive degradation balance but other two normal varieties had negative protein degraded balance However, the SuperOat had similar total absorbed protein value to the two normal varieties of oats.
Influence of orally administered bovine lactoferrin on lipid metabolism in lipopolysaccharide‐injected preruminant calves
Authors: KUSHIBIKI Shiro , SHINGU Hiroyuki , KOMATSU Tokushi , ITOH Fumiaki , MORIYA Naoko , TOUNO Eiko , OSHIBE Akinori , HODATE Koichi
Published: April 2009

The aim of this study was to investigate the influence of oral lactoferrin (LF) administration on lipid metabolism changes in calves given lipopolysaccharide (LPS). Twenty‐one 4‐day‐old Holstein calves were divided into three groups, with each group receiving one of three oral doses of LF (0, 1, 3 g/day) for 10 consecutive days (day −10 to day −1). All calves were intravenously injected with LPS (50 ng/kg BW) on day 0, the day after LF treatment ended. Plasma triglyceride concentrations were lower (P < 0.05) in the LF‐treated calves than in the control calves given 0 g/day of LF at 12 and 24 h after LPS injection. Plasma NEFA concentrations were elevated between 6 and 24 h after LPS treatment. At 12 h, the concentration of plasma NEFA was lower (P < 0.05) in the calves given LF 3 g/day than in the control calves. On day 0, plasma total cholesterol and phospholipid concentrations tended to be lower in the LF groups administered 1 and 3 g of LF/day than in the control group, but did not differ significantly among the groups. The plasma very‐low‐density and low‐density lipoprotein concentrations were lower (P < 0.05) at 12, 24, and 72 h in the LF groups than in the control calves. The concentrations of plasma high‐density lipoprotein tended to be lower in the LF groups than in the control group between day 0 and 96 h, though there were no significant group differences. The concentration of plasma interleukin‐1β was lower (P < 0.05) in the calves fed LF 3 g/day than in the control calves at 2 and 12–48 h after LPS injection. These data suggest that LF inhibits LPS‐induced alterations in lipid metabolism in preruminant calves.
Application of cycling index and input‐output environs for interpretation of nutrient flows in mixed rice‐beef production systems in Japan
Authors: TABATA Yusuke , OISHI Kazato , KUMAGAI Hajime , HIROOKA Hiroyuki
Published: April 2009

The objective of the present study was to apply two methods developed in ecology, the cycling index and input‐output environs, to interpret nutrient flows in mixed rice‐beef production systems. The cycling index (CI) was a quantitative measure of nutrient cycling. It was defined as the proportion of cycled nutrients to the total amount of nutrient flows. On the other hand, the input‐output environs provide a quantitative distribution on a particular input or output. In this study, these methods were applied to the nutrient flows in the mixed rice‐beef production systems in Japan. The results of CI provided information on the effects of nutrient cycling on the efficient conversion of nutrient imports to nutrient export. The results of input‐output environs indicated that the indices represent indirect effects provided by the interaction between rice and beef production. In conclusion, these methods indicated new findings on nutrient utilization in the systems. The results of this study implied the further applicability of these two methods to the study of nutrient flows in mixed crop‐animal production systems.
INTEROBSERVER AGREEMENT ON THE ASSESSABILITY OF STANDARD VENTRODORSAL HIP‐EXTENDED RADIOGRAPHS AND ITS EFFECT ON AGREEMENT IN THE DIAGNOSIS OF CANINE HIP DYSPLASIA AND ON ROUTINE FCI SCORING
Authors: VERHOEVEN GEERT E. C. , COOPMAN FRANK , DUCHATEAU LUC , BOSMANS TIM , VAN RYSSEN BERNADETTE , VAN BREE HENRI
Published: April 2009

Insufficient agreement on scoring hip quality might be caused by differences in the assessability of a radiograph (exposure, contrast, positioning, and diagnostic quality). We studied the agreement in assessability of standard ventrodorsal hip‐extended radiographs by experienced (nine) and inexperienced (21) observers, using the standard subjective method of quality control, currently applied in screening programs. The effect of assessability on the agreement of scoring hip quality [dysplastic vs. nondysplastic and the final Federation Cinologique International (FCI) score] was also investigated. There was a significant difference (P<0.0001) in agreement on assessability between the experienced and inexperienced observers. In 68% of evaluations, experienced observers stated that the radiograph was assessable. Inexperienced observers evaluated the radiographs as being assessable in only 46.5% of evaluations. Increased interobserver agreement on assessability of a radiograph did not increase the overall interobserver agreement in the diagnosis of hip dysplasia, nor did it result in consistent scoring of the hip status from that radiograph, despite a significant (P<0.05) increase in agreement of FCI scoring with an increasing agreement on assessability at a one to five ratio in the experienced group. The inconsistent evaluation of radiographic quality, as well as the inconsistent evaluation of the hip quality, caused differences in diagnosing hip dysplasia and FCI scoring in the same dog ranging from excellent hips to moderate hip dysplasia. Therefore, the credibility of the FCI screening method for canine hip dysplasia, using the standard hip‐extended radiographic view, as currently applied in most European countries, is questionable.
IMAGING FEATURES OF ATLANTO‐OCCIPITAL OVERLAPPING IN DOGS
Authors: CERDA‐GONZALEZ SOFIA , DEWEY CURTIS W. , SCRIVANI PETER V. , KLINE KAREN L.
Published: April 2009

The imaging features of four dogs with atlanto‐occipital overlapping are described. This malformation appeared to play a role in the development of neck pain, ataxia, variable cerebellar involvement, medullary kinking, and possibly syringomyelia. Using cervical radiographs, three of the four dogs were initially diagnosed with an atlanto‐axial malformation. Because this disorder could not account for all clinical signs, magnetic resonance and computed tomography images were also acquired. These provided a more complete evaluation of the craniocervical junction, allowing detection of atlanto‐occipital overlapping, medullary kinking, occipital dysplasia, abnormalities of the dens, and syringomyelia in these dogs. Head position during imaging affected the degree of atlanto‐occipital overlap. These findings emphasize the need to modify the currently accepted imaging recommendations for dogs with head and neck pain and/or cranial cervical myelopathy. We suggest that the entire craniocervical junction be evaluated, even if atlanto‐axial subluxation has already been detected. Moreover, we propose that atlanto‐occipital overlapping is a perhaps underrecognized disorder that can influence the clinical signs and therapeutic outcome of dogs with anomalies of the craniocervical junction.
CEREBROSPINAL FLUID SIGNAL‐VOID SIGN IN DOGS
Authors: SCRIVANI PETER V. , FREER SEAN R. , DEWEY CURTIS W. , CERDA‐GONZALEZ SOFIA
Published: April 2009

The cerebrospinal fluid signal‐void sign is an observable signal loss from cerebrospinal fluid (CSF), especially on T2‐weighted magnetic resonance (MR) images. In people, this sign is attributed to rapid CSF flow or turbulence from arterial pulsations and occurs more frequently with reduced intracranial compliance. The purposes of this study were to describe the CSF signal‐void sign, document whether a similar sign occurs in dogs and investigate associations between it and other conditions. The sample population consisted of 327 dogs admitted for neurocranium evaluation using a 0.2 T system. Review of the medical records and MR images was performed to characterize the presence and location of a CSF signal‐void sign, ventricular size, syringomyelia, and other lesions. A CSF signal‐void sign was detected in at least the mesencephalic aqueduct in 59/327 (18.0%) dogs, including some with no morphologic brain abnormality. The majority of these dogs (45/59% or 76%) weighed <15 kg. In two other dogs, a CSF signal‐void sign was detected only in a cervical syrinx. In dogs weighing >15 kg, a CSF signal‐void sign was seen with various conditions. In 137/327 (41.9%) dogs weighing <15 kg, the presence of a CSF signal‐void sign in the aqueduct (45 dogs) was associated with syringomyelia (P=0.0468) and increased ventricular size (P=0.0054): syringomyelia also was associated with increased ventricular size (P=0.0009). In conclusion, a CSF signal‐void sign was seen in dogs with various conditions. In small‐breed dogs, a CSF signal‐void sign in the aqueduct was associated with ventricular enlargement and syringomyelia.
COMPARISON OF SINGLE‐SLICE COMPUTED TOMOGRAPHY PROTOCOLS FOR DETECTION OF PULMONARY NODULES IN DOGS
Authors: JOLY HUGO , D'ANJOU MARC‐ANDRÉ , ALEXANDER KATE , BEAUCHAMP GUY
Published: April 2009

Two dogs (4 and 38 kg) with radiographic evidence of pulmonary nodules were evaluated using single‐slice, helical computed tomography (CT). Each thorax was scanned using 12 combinations of examination parameters that included slice collimation width (3 and 5 mm for the small dog and 5 and 7 mm for the large dog), pitch (1, 1.5, and 2), and reconstruction interval (0.5 and 1). Sensitivity, specificity, and accuracy for nodule detection were evaluated for each protocol by three different observers, their results being compared with a consensus evaluation of images acquired with the protocol providing the best theoretic resolution (narrow collimation, pitch of 1, reconstruction interval of 0.5). For all observers, sensitivity and accuracy were significantly increased when using a protocol with narrow collimation (P<0.0001–0.005 and P=0.0003–0.005, respectively). Pitch and reconstruction interval did not significantly influence the accuracy, sensitivity, or specificity for at least two of the observers. Additionally, nodule size (<3 mm vs. ≥3 mm) did not significantly affect nodule detection. Interobserver repeatability was variable among protocols (κ=0.32–0.78), highlighting the fact that nodule detection may be more dependent on the observer than on the choice of the CT protocol. For single‐slice CT, the results of this study suggest that narrow collimation (3–5 mm, depending on the animal's size), a pitch of 2 and a reconstruction interval of 1 should be used in dogs for the detection of pulmonary nodules.
USE OF CONTRAST‐ENHANCED COMPUTED TOMOGRAPHY TO ASSESS ANGIOGENESIS IN DEEP DIGITAL FLEXOR TENDONOPATHY IN A HORSE
Authors: PUCHALSKI SARAH M. , GALUPPO LARRY D. , DREW CLIFTON P. , WISNER ERIK R.
Published: April 2009

We compared contrast‐enhanced computed tomography (CT) and high field magnetic resonance (MR) imaging in a horse with deep digital flexor tendonopathy. Lesions in the distal extremity were documented grossly and histopathologically. In contrast‐enhanced CT, the deep digital flexor tendon lesions were markedly contrast enhancing with evidence of angiogenesis in the core and dorsal border lesions. The lesion morphology was clearly delineated on MR imaging, but without contrast media angiogenesis cannot be identified. Gross examination, histopathologic examination, and CD31 immunohistochemistry confirmed the tendonopathy and an increased presence of small blood vessels. In this horse, deep digital flexor tendon lesions appeared similarly on contrast‐enhanced CT and MR imaging. Contrast‐enhanced CT may be an alternative to MR imaging for assessing tendon and ligament injury in the digit of the horse.
PROTON SPOT SCANNING RADIOTHERAPY OF SPONTANEOUS CANINE TUMORS
Authors: MAYER‐STANKEOVÁ SIMONA , FIDEL JANEAN , WERGIN MELANIE C. , HAUSER BEAT , SUMOVÁ ANDREA , GOITEIN GUDRUN , PEDRONI EROS , LOMAX ANTHONY J. , SCHNEIDER UWE , BLATTMANN HANS , KASER‐HOTZ BARBARA
Published: April 2009

Thirty dogs with spontaneous tumors were irradiated with proton therapy using a novel spot scanning technique to evaluate the safety and efficacy of the system, and to study the acute and late radiation reactions. Nasal tumors, soft tissue sarcomas, and miscellaneous tumors of the head were treated with a median total dose of 52.5 Gy given in 3.5 Gy fractions. Acute effects, late effects, tumor response, and outcome were analyzed. No unexpected radiation reactions were seen, however two dogs did develop in‐field osteosarcoma, and one dog developed in‐field bone necrosis. Complete response to therapy was seen in 40% (12/30), partial response in 47% (14/30), and no response in 13% (4/30). Median survival for all dogs was 385 days (range of 14–4583 days). Dogs with nasal cavity tumors had a median survival of 385 days (range of 131–1851 days) and dogs with soft tissue sarcomas had a median survival time of 612 days (range of 65–4588 days). Treatment outcome was similar to historical controls. This new proton spot scanning technique proved to be safe and reliable.
PROGNOSTIC SIGNIFICANCE OF TUMOR HISTOLOGY AND COMPUTED TOMOGRAPHIC STAGING FOR RADIATION TREATMENT RESPONSE OF CANINE NASAL TUMORS
Authors: ADAMS WILLIAM M. , KLEITER MIRIAM M. , THRALL DONALD E. , KLAUER JULIA M. , FORREST LISA J. , LA DUE TRACY A. , HAVIGHURST THOMAS C.
Published: April 2009

Prognostic significance of tumor histology and four computed tomography (CT) staging methods was tested retrospectively in dogs from three treatment centers that underwent intent‐to‐cure‐radiotherapy for intranasal neoplasia. Disease‐free and overall survival times were available for 94 dogs. A grouping of anaplastic, squamous cell, and undifferentiated carcinomas had a significantly shorter median disease‐free survival (4.4 mo) than a grouping of all sarcomas (10.6 months). Disease‐free survivals were not significantly different, when all carcinomas were compared with all sarcomas. The published original and modified WHO staging methods did not significantly relate to either survival endpoint. A modified human maxillary tumor staging system previously applied to canine nasal tumors was prognostically significant for both survival endpoints; a further modified version of that CT‐based staging system resulted in improved significance for both survival endpoints. Dogs with unilateral intranasal involvement without bone destruction beyond the turbinates on CT, had longest median survival (23.4 months); CT evidence of cribriform plate involvement was associated with shortest median survival (6.7 months). Combining CT and histology statistically improved prognostic significance for both survival endpoints over the proposed CT staging method alone. Significance was lost when CT stages were collapsed to <four categories or histopathology groupings were collapsed to <three categories.
Restricted localization of proline‐rich membrane anchor (PRiMA) of globular form acetylcholinesterase at the neuromuscular junctions – contribution and expression from motor neurons
Authors: Leung K. Wing , Xie Heidi Q. , Chen Vicky P. , Mok Mokka K. W. , Chu Glanice K. Y. , Choi Roy C. Y. , Tsim Karl W. K.
Published: April 2009

The expression and localization of the proline‐rich membrane anchor (PRiMA), an anchoring protein of tetrameric globular form acetylcholinesterase (G4 AChE), were studied at vertebrate neuromuscular junctions. Both muscle and motor neuron contributed to this synaptic expression pattern. During the development of rat muscles, the expression of PRiMA and AChET and the enzymatic activity increased dramatically; however, the proportion of G4 AChE decreased. G4 AChE in muscle was recognized specifically by a PRiMA antibody, indicating the association of this enzyme with PRiMA. Using western blot and ELISA, both PRiMA protein and PRiMA‐linked G4 AChE were found to be present in large amounts in fast‐twitch muscle (e.g. tibialis), but in relatively low abundance in slow‐twitch muscle (e.g. soleus). These results indicate that the expression level of PRiMA‐linked G4 AChE depends on muscle fiber type. In parallel, the expression of PRiMA, AChET and G4 AChE also increased in the spinal cord during development. Such expression in motor neurons contributed to the synaptic localization of G4 AChE. After denervation, the expression of PRiMA, AChET and G4 AChE decreased markedly in the spinal cord, and in fast‐ and slow‐twitch muscles.
Squamous cell carcinoma arising from perineal lesion in a familial case of Hidradenitis suppurativa
Authors: Chandramohan K , Mathews Anitha , Kurian Anu , Thomas Shaji , Ramachandran K
Published: April 2009

Hidradenitis suppurativa (HS) is a chronic dermatologic disorder characterised by multiple vesiculopustular cutaneous lesions in skin. It sometimes express autosomal dominant mode of inheritance. In some patients, it can give rise to squamous cell carcinoma of skin. Unlike the usual marjolin's ulcer which develops in chronic scars, this disease carries a grave prognosis with high recurrence rate and mortality.

Here we are reporting the case of a 40‐year‐old gentle man with hidradenitis suppurativa, who presented with squamous cell carcinoma in the perianal region, and had multiple family members affected with HS. A short history and review of literature are discussed. Squamous cell carcinoma arising from HS is a major therapeutic challenge. This malignancy carries very high rates of recurrence and mortality. Careful surveillance of the lesions of HS, especially occurring in perineal region is very important to diagnose secondary malignancies. Similarly, meticulous surgical excision with careful resection of all sinus tracks and frozen section examination of margins are very important to eradicate the disease.
The use of plasma rich in growth factors on wound healing in the skin: experimental study in rabbits
Authors: Molina‐Miñano Francesco , López‐Jornet Péa , Camacho‐Alonso Fabio , Vicente‐Ortega Vicente
Published: April 2009

The objective of this study was to use autologous plasma rich in growth factors (PRGF) on wound healing in the skin in New Zealand albino rabbits and to study reepithelialisation and inflammation at 7 and 28 days. A prospective study carried out on 20 adult rabbits. Two wounds were made on the in the skin on the back of each animal; one control, and the other in which PRGF was applied. The PRGF preparation was obtained from 10 ml of whole blood. The reepithelialisation and inflammation of wounds were measured at 7 and 28 days. Reepithelialisation improved in skin at 7 days (P = 0·007), with resolution of the inflammatory process (P = 0·005), having significant differences with respect to the control. Therefore, PRGF accelerates reepithelialisation and reduces inflammation at 7 days in skin.
The efficacy and safety of epidermal growth factor in treatment of diabetic foot ulcers: the preliminary results
Authors: Tuyet Hoa Le , Nguyen Quynh Tram Tran , Vo Hoang Minh Hien , Thi Bich Dao Nguyen , Do Dinh Thang , Le Tan Duc , Van Hoang Lam , Le Huy Truong , Doan Huu Hau , Tran Trong Tri Nguyen
Published: April 2009

Objective: To evaluate the efficacy and safety of recombinant human epidermal growth factor (rh‐EGF) in healing foot ulcers in diabetic patients.

Methods: A total of 28 subjects with foot ulcers were recruited into the pilot study. Patients who had obvious peripheral arterial disease, trans‐tibial amputation, plastic surgery or skin flap, and skin graft were excluded. The properly debrided wounds and the non closure wounds after toe amputation were included. When the wounds became clean or uninfected, they received twice‐a‐day treatment with 0·005% Easyef and hydrocolloid dressing. The size and severity of the wounds were evaluated. Others such as blood sugar, renal and hepatic function, serum albumin, vascular condition, foot infection or osteomyelitis were assessed.

Results: All of 28 patients had positive response of granulation (100%). Complete healing was noted in 13 out of 23 subjects and finished 8‐week follow‐up (56·5%). The rates of wound closure were 43·3%, 59·9%, 68·7%, and 84·8% in week 2, 4, 6 and 8, respectively, regardless of the severity. Being dropped out, three patients needed further interventions. No skin allergic reaction. Over‐granulation was observed in one female patient (3·7%), but as minor.

Conclusions: Easyef has positive effects on healing of moderate‐to‐severe foot ulcers and demonstrated being safe to diabetic patients. The drug had high tolerability and compliance.
Use of a Nanoflex powder dressing for wound management following debridement for necrotising fasciitis in the diabetic foot
Authors: Fitzgerald Ryan H , Bharara Manish , Mills Joseph L , Armstrong David G
Published: April 2009

This paper discusses the application of Nanoflex powder dressing for management of complex soft tissue wounds. A case report is presented detailing the management of a 43‐year‐old Native American woman with diabetes mellitus who required serial debridements for necrotising fasciitis. Following debridement, the patient was left with a large dorsal foot wound and was transitioned through multiple advanced wound healing modalities. Negative pressure wound therapy (NPWT) was initially utilised in the early postoperative setting to control drainage and to promote granulation tissue; the patient was subsequently transitioned to a Nanoflex powder dressing on postoperative day 4. She reported a decrease in pain associated with dressing changes when transitioned from NPWT to the use of Nanoflex powder dressing. We hypothesise that this pain reduction is the result of a light cooling effect of the exudate‐controlling dressing and subsequent reduction in inflammation as well as the total contact nature of the dressing. Nanoflex powder dressings are a recently developed advanced wound healing modality with promise in the management of complex soft tissue wounds, both as a primary wound dressing as well as a delivery platform for analgesics, antimicrobials and pro‐angiogenic compounds.
Perceived need for emergency medicine training in Pakistan: A survey of medical education leadership
Authors: Razzak Junaid A , Ahmed Adnan , Saleem Ali Faisal , Nasrullah Muazzam
Published: April 2009

Objective:  To assess the perception of leaders of the academic medical institutions regarding the need for specialty training in emergency medicine.

Methods:  A cross‐sectional survey was conducted in all medical colleges of Pakistan in September 2005. Our sample included all academic leaders of recognized medical colleges in Pakistan. A questionnaire was designed and sent (mailed and faxed) to vice chancellors, deans, principals or medical directors of the institutions. Reminders were sent through faxes and emails wherever available, followed by phone calls if responses were not available after several attempts.

Results:  At the time of study, there were 39 medical colleges recognized by Pakistan Medical and Dental Council. Of these, responses were received from 26 teaching institutions in the country. A majority of the respondents (85%) were not satisfied with the care provided in the ED of their primary teaching hospital, and three‐fourth (74%) thought that doctors specialized in other disciplines, like internal medicine and family medicine, cannot adequately manage all emergencies. When asked if Pakistan should have a separate residency training programme in emergency medicine, 96% responded in affirmative, and many (85%) thought that they will start a residency programme in emergency medicine if it was approved as a separate specialty.

Conclusion:  This survey shows significant support for a separate local training programme for emergency medicine in the country.
Laryngoscope illumination grade does not influence time to successful manikin intubation
Authors: Moore Simone , Dwyer Donovan , Arendts Glenn
Published: April 2009

Objectives:  Endotracheal intubation is an important, time‐critical, life‐saving emergency medicine procedure. Laryngoscope characteristics might influence time to successful intubation. The objective of the present study was to determine whether laryngoscope light of variable intensity would influence the length of time required to achieve successful endotracheal intubation.

Methods:  An in vivo single‐blind prospective randomized cross‐over trial was conducted using a variable light source laryngoscope and three clinically plausible intensities of light – high (600 lux), medium (200 lux) and low (50 lux). Thirty‐six volunteer senior emergency medical staff repeatedly intubated two manikins three times each, based on one of six randomly assigned permutations of light intensity. The primary end‐point was time to successful intubation.

Results:  There was no statistically significant difference in time to intubation versus light intensity for either manikin.

Conclusion:  The intensity of laryngoscope light across a clinically plausible range does not affect time to intubation.
Periodic Therapeutic Plasma Exchange in Patients With Moderate to Severe Chronic Myasthenia Gravis Non‐Responsive to Immunosuppressive Agents: An Eight Year Follow‐Up
Authors: Triantafyllou Nik I , Grapsa Eirini Ioannis , Kararizou Evangelia , Psimenou Erasmia , Lagguranis Antonios , Dimopoulos Athanasios
Published: April 2009

Few patients with moderate or severe myasthenia gravis (MG) do not respond to immunosuppressive treatment. We present our experience with periodic therapeutic plasma exchange (TPE), in 11 patients with MG resistant to intravenous immunoglobulin (IVIg) therapy, who had frequent relapses even whilst on high doses of immunosuppressive drugs, over a period of 8 years. All patients underwent TPE until control of their symptoms was achieved, and afterwards TPE sessions were continued periodically in an attempt to achieve remission of the disease, without immunosuppressant therapy. Two of the patients were progressively weaned off immunosuppressive agents, as well as TPE, and they are now symptom free. The other nine patients are still under a periodic TPE regime. Seven of them were weaned off all medications and required an average of 3.7 TPE sessions per year during the last 5 years. In the other two patients, those with the most severe form of the disease, the immunosuppressant dosage has been decreased and a TPE session every 2–3 weeks is required in order to control their symptoms. Through all these years TPE has been well tolerated and only minor side‐effects were observed in two patients. Finally, during this 8 year follow‐up period, nine of the patients treated with periodic TPE have been in good control of their symptoms over the last 5 years, and the other two patients live a normal life without any treatment in the last 3 years. Our results suggest that periodic TPE is safe and effective in the control of symptoms in patients with moderate to severe MG who do not respond to immunosuppressive therapies.
A Case Report of Efficiency of Double Filtration Plasmapheresis in Treatment of Goodpasture's Syndrome
Authors: Hajime Nagasu , Michiko Abe , Atsunori Kuwabara , Tatsuo Kawai , Yuko Nishi , Naoki Okuda , Katsuhiko Sakaguchi
Published: April 2009

Goodpasture's syndrome is characterized by pulmonary hemorrhage, rapid progressive glomerulonephritis and the presence of anti‐glomerular basement membrane (anti‐GBM) antibodies. Here, we report a case of Goodpasture's syndrome that we treated with double filtration plasmapheresis (DFPP) combined with immunosuppression therapy. The patient was a 32‐year‐old man with the main complaints of low‐grade fever, general fatigue and dyspnea. The clinical diagnosis was renal‐pulmonary syndrome based on pulmonary hemorrhage on chest X‐ray, rapid progressive renal insufficiency, and elevated C‐reactive protein (CRP). Goodpasture's syndrome was diagnosed because the patient was negative for MPO‐ANCA and PR3‐ANCA, and positive for anti‐GBM antibodies. Renal biopsy showed crescentic glomerulonephritis. Hemodialysis, immunosuppression therapy (methylprednisolone and cyclophosphamide) and DFPP were performed. Anti‐GBM antibodies were followed pre‐ and post‐DFPP, and removal efficiency, cost performance and complications were evaluated. The antibody levels were 121 and 84 EU/mL before and after the first DFPP procedure, respectively, giving a removal efficiency of 24%. Subsequently, the removal efficiencies were 52%, 55% and 60% after the second, third and fourth DFPP procedures. For comparison, the immunoglobulin G (IgG) removal efficiencies were 53%, 57%, 60% and 55% after the four respective DFPP procedures; therefore, the removal efficiencies were similar for anti‐GBM antibodies and IgG in all except the first DFPP procedure. The serum anti‐GBM antibody and IgG concentrations decreased from pre‐ to post‐DFPP, indicating that DFPP may be an effective therapeutic approach in Goodpasture's syndrome.
The active galactic nuclei/starburst content in high-redshift ultraluminous infrared galaxies
Authors: Watabe Y. , Risaliti G. , Salvati M. , Nardini E. , Sani E. , Marconi A.
Published: April 2009

We apply a simple model, tested on local ultraluminous infrared galaxies (ULIRGs), to disentangle the active galactic nuclei (AGN) and starburst contributions in submillimetre and 24 εm-selected ULIRGs observed with the Spitzer–Infrared Spectrograph spectrometer. We quantitatively estimate the average AGN contribution to the stacked 6–8εm rest-frame spectra of these sources in different luminosity and redshift ranges and, under the assumption of similar infrared-to-bolometric ratios as in local ULIRGs, the relative AGN/starburst contributions to the total infrared luminosity. Though the starburst component is always dominant in submillimetre-selected ULIRGs, we find a significant increase of the AGN contribution at redshift z > 2.3 with respect to lower z objects. Finally, we quantitatively confirm that the mid-infrared emission of 24 εm-selected ULIRGs is dominated by the AGN component, but the starburst component contributes significantly to the bolometric luminosity.
A new luminous variable in M33
Authors: Valeev A. F. , Sholukhova O. , Fabrika S.
Published: April 2009

We present a new luminous star in M33 located in the nuclear region. The star shows strong Feii and [Feii] forest, hydrogen emissions in the spectrum, as well as nebular lines. Tiii and Siii lines were detected in absorption, their radial velocity shifted by ≈−30kms−1 relative to emission lines. The star is variable over 7 yr with 0.5 mag variations over a year. We studied its spectral energy distribution together with five confirmed luminous blue variables (LBVs) and VarA in M33 using homogeneous data and methods. We found the star's bolometric luminosity to be logL/L⊙≈ 6.27, a surface temperature of T∼ 16000K and blackbody temperatures of two dust components of T∼ 900 and 420K. The new star has properties intermediate between the LBVs and VarA (probable cool hypergiant). At the same time, it has a hot photosphere, LBV-like luminosity and an extensive circumstellar material (strong [Caii] lines). In these seven luminous variables in M33, we find the total range of the hot component luminosities is 1.0 dex, but that of the dust components is 2.0 dex. We conclude that the dust phenomenon in the luminous variables is temporary and variable, and that the dust activity may follow strong eruptions.
The impact of thermally pulsing asymptotic giant branch stars on hierarchical galaxy formation models
Authors: Tonini Chiara , Maraston Claudia , Devriendt Julien , Thomas Daniel , Silk Joseph
Published: April 2009

The spectro-photometric properties of galaxies in galaxy formation models are obtained by combining the predicted history of star formation and mass accretion with the physics of stellar evolution through stellar population models. In the recent literature, significant differences have emerged regarding the implementation of the thermally pulsing asymptotic giant branch phase of stellar evolution. The emission in the TP-AGB phase dominates the bolometric and near-IR spectrum of intermediate-age (∼1Gyr) stellar populations, hence it is crucial for the correct modelling of the galaxy luminosities and colours. In this paper, for the first time, we incorporate a full prescription of the TP-AGB phase in a semi-analytic model of galaxy formation. We find that the inclusion of the TP-AGB in the model spectra dramatically alters the predicted colour–magnitude relation and its evolution with redshift. When the TP-AGB phase is active, the rest-frame V−K galaxy colours are redder by almost 2 mag in the redshift range z∼ 2–3 and by 1 mag at z∼ 1. Very red colours are produced in disc galaxies, so that the V−K colour distributions of disc and spheroids are virtually undistinguishable at low redshifts. We also find that the galaxy K-band emission is more than 1 mag higher in the range z∼ 1–3. This may alleviate the difficulties met by the hierarchical clustering scenario in predicting the red galaxy population at high redshifts. The comparison between simulations and observations has to be revisited in the light of our results.
Photoheating and supernova feedback amplify each other's effect on the cosmic star formation rate
Authors: Pawlik Andreas H. , Schaye Joop
Published: April 2009

Photoheating associated with reionization and kinetic feedback from core-collapse supernovae have previously been shown to suppress the high-redshift cosmic star formation rate. Here, we investigate the interplay between photoheating and supernova feedback using a set of cosmological, smoothed particle hydrodynamics simulations. We show that photoheating and supernova feedback mutually amplify each other's ability to suppress the star formation rate. Our results demonstrate the importance of the simultaneous, non-independent inclusion of these two processes in models of galaxy formation to estimate the strength of the total negative feedback they exert. They may therefore be of particular relevance to semi-analytic models in which the effects of photoheating and supernova feedback are implicitly assumed to act independently of each other.
On the origin of long gamma-ray bursts
Authors: Van Putten Maurice H. P. M.
Published: April 2009

The HETE II and Swift discoveries of long gamma-ray bursts (GRBs) with and without supernovae reveal a diversity in their astronomical origin with otherwise a common inner engine. The durations, spectral-energy correlations and light curves in gamma-rays are in remarkable agreement with viscous spin-down of stellar mass black holes against surrounding high-density matter, as may ensue in core collapse of massive stars and by tidal break-up of neutron stars in mergers with a companion black hole or another neutron star. While mergers produce a preceding positive chirp in gravitational-wave emissions, black hole spin-down produces a negative chirp in relaxation to a nearly Schwarzschild black hole, followed by quasi-normal mode ringing of the event horizon. Chirps hereby provide unambiguous identification of the origin of long GRBs.
Globalisation, Gentrification and Spatial Hierarchies in and beyond New South Wales: the Local/Global Nexus
Authors: ROFE MATTHEW W.
Published: April 2009

Popular visions of globalisation envisage the collapse of physical space as a significant determinant in social relations. The rapid speed at which movements of capital and information occur are touted as evidence that the constraints of physical space are eroding. The emergence of a global network of persons referred to as the transnational elite further supports these popular perceptions. Characterised as highly educated professionals employed in globally aligned industries, the transnational elite seemingly construct their individual and group identities beyond the scale of the local. However, research undertaken in Newcastle and Sydney with gentrifiers actively constructing their ‘global personas’ problematise popular discourses of globalisation as contributing to the decline of space as fundamental to identity construction. As an emergent élite global community, the gentrifiers create complex cognitive maps of spatial desirability reinforcing the significance of specific places. Through this process, places are ranked according to their global significance forming complex spatial hierarchies. Consequently, some places are cast as global and hence desirable, while others are stigmatised as undesirable non‐global spaces.
Using Orthogonal Array Sampling to Cope with Uncertainty in Ground Water Problems
Authors: Baalousha Husam
Published: April 2009

Uncertainty in ground water hydrology originates from different sources. Neglecting uncertainty in ground water problems can lead to incorrect results and misleading output. Several approaches have been developed to cope with uncertainty in ground water problems. The most widely used methods in uncertainty analysis are Monte Carlo simulation (MCS) and Latin hypercube sampling (LHS), developed from MCS. Despite the simplicity of MCS, many runs are required to achieve a reliable result. This paper presents orthogonal array (OA) sampling as a means to cope with uncertainty in ground water problems. The method was applied to an analytical stream depletion problem. To examine the convergence rate of the OA sampling, the results were compared to MCS and LHS. This study shows that OA can be applied to ground water problems. Results reveal that the convergence rate of the OA sampling is faster than MCS and LHS, with a smaller error of estimate when applied to a stream depletion problem.
Influences of Aquifer Properties on Flow Dimensions in Dolomites
Authors: Verbovšek Timotej
Published: April 2009

The paper focuses on analyses and correlations of flow dimensions in different dolomite aquifers in Slovenia. Flow dimensions are obtained through the reinterpretation of 72 pumping tests with the generalized radial flow model, based on the fractional flow dimension. The average value of flow dimensions is 2.16 for all dolomites. A study of flow dimensions in individual aquifers categorized according to their lithological properties shows that higher dimensions occur in massive late‐diagenetic Cordevolian and Anisian dolomites compared with bedded Main, Bača, and especially Lower Triassic dolomites, which contain a greater proportion of noncarbonate minerals. Partially penetrating wells have higher flow dimensions than fully penetrating wells. Flow dimensions are poorly correlated with hydraulic conductivities of fractures. When comparing the quantities of major dissolved minerals, obtained by hydrogeochemical inverse modeling, with the values of flow dimensions, the Cordevolian and Anisian dolomites are found to exhibit the highest values of both dissolved dolomite and flow dimensions, indicating that greater dissolution occurs at higher flow dimensions. For other aquifers, data points are more scattered and the correlation is mostly poor. When compared with three‐dimensional fractal dimensions of fracture networks, there is no correlation with flow dimensions. However, almost all the values of flow dimensions are lower than the corresponding fractal dimensions in dolomites (average D= 2.77), possibly indicating the channeling of flow within the available space of the fracture networks, consequently reducing the flow dimensions.