bluuebunny/crossref_metadata_2025 huggingface dataset:
Severe Unexplained Relative Hypotension and Bradycardia in the Emergency Department
Authors: Kharod Shivam , Norman Candice , Ryan Matthew , Hoelle Robyn M.
Published: March 2014

A precipitous episode of hypotension with concomitant bradycardia is a true medical emergency especially in patients with chronic hypertension and often requires hospitalization for detailed interrogation of the underlying causes. We describe herein a case of a patient with chronic labile hypertension who presented to the ED with a sharp drop in blood pressure and heart rate which was not simply explained by an antihypertensive overdose but more so by an aggregate of the patient’s multiple chronic medical conditions. This report highlights the complexities of treating simultaneous hypotension and bradycardia and the importance of discerning the underpinnings of the causes including past medical issues, patient medications, and the timeline of key events leading to the issue at hand.
Associations between Cognitive, Sociocontextual, and Affective Variables and Unprotected Anal Intercourse among Men Who Have Sex with Men—A Comparative Study Conducted in Two Chinese Cities
Authors: Lau Joseph T. F. , Feng T. J. , Liu X. L. , Gu Jing , Tsui Hi Yi , Hong F. C. , Wang Zixin , Cao Wangnan
Published: March 2014

Few studies compared HIV-related risk behaviors between cities with different sociocultural environments among men who have sex with men (MSM). This study investigated the prevalence of unprotected anal intercourse (UAI) and associated individual and socio-cultural factors among Chinese MSM in Hong Kong and Shenzhen in Mainland China, which were proximal to each other but experienced different socioeconomic developments. Amongst all the 535 participants, 40.2% had had UAI. Significant factors of UAI among Shenzhen MSM included being able to find someone to share one’s sexual orientation, disclosure of sexual orientation to family members, HIV risk perception, and use of alcohol or substances (adjusted OR ranged from 2.37 to 4.91), whilst disclosure of sexual orientation to family members was the only significant factor among Hong Kong MSM (adjusted OR = 1.64). Geographic variations in factors associated with UAI were observed. Future research and interventions need to take this into account.
Energy Flow Chart‐Based Energy Efficiency Analysis of a Range‐Extended Electric Bus
Authors: Wu Xiaogang , Hu Chen , Chen Jingfu
Published: March 2014

This paper puts forward an energy flow chart analysis method for a range‐extended electric bus. This method uses dissipation and cycle energy, recycle efficiency, and fuel‐traction efficiency as evaluation indexes. In powertrain energy efficiency analysis, the range‐extended electric bus is developed by Tsinghua University, the driving cycle based on that of Harbin, a northern Chinese city. The CD‐CS and blended methods are applied in energy management strategies. Analysis results show with average daily range of 200 km, auxiliary power of 10 kW, CD‐CS strategy, recycle ability and fuel‐traction efficiency are higher. The input‐recycled efficiency using the blended strategy is 24.73% higher than CD‐CS strategy, while the output‐recycled efficiency when using the blended strategy is 7.83% lower than CD‐CS strategy.
Mathematical Model of Schistosomiasis under Flood in Anhui Province
Authors: Qi Longxing , Cui Jing-an , Huang Tingting , Ye Fengli , Jiang Longzhi
Published: March 2014

Based on the real observation data in Tongcheng city, this paper established a mathematical model of schistosomiasis transmission under flood in Anhui province. The delay of schistosomiasis outbreak under flood was considered. Analysis of this model shows that the disease free equilibrium is locally asymptotically stable if the basic reproduction number is less than one. The stability of the unique endemic equilibrium may be changed under some conditions even if the basic reproduction number is larger than one. The impact of flood on the stability of the endemic equilibrium is studied and the results imply that flood can destabilize the system and periodic solutions can arise by Hopf bifurcation. Finally, numerical simulations are performed to support these mathematical results and the results are in accord with the observation data from Tongcheng Schistosomiasis Control Station.
Enhanced Performance of Mg0.1Zn0.9O UV Photodetectors Using Photoelectrochemical Treatment and Silica Nanospheres
Authors: Lee Hsin-Ying , Lin Yu-Chang , Lee Meng-Ju , Uen Wu-Yih , Sreenivas Kondepudy
Published: March 2014

The Mg0.1Zn0.9O films were grown using atomic layer deposition (ALD) system and applied to metal‐semiconductor‐metal ultraviolet photodetectors (MSM‐UPDs) as an active layer. To suppress the dangling bonds on the Mg0.1Zn0.9O surface, the photoelectrochemical (PEC) treatment was used to passivate the Mg0.1Zn0.9O surface, which could reduce the dark current of the MSM‐UPDs about one order. Beside, to increase more incident light into the Mg0.1Zn0.9O active layer of the MSM‐UPDs, the 500‐nm‐diameter silica nanospheres were spin‐coated on the Mg0.1Zn0.9O active layer to improve the antireflection capability at the wavelength of 340 nm. The reflectivity of the Mg0.1Zn0.9O films with silica nanospheres antireflection layer decreased about 7.0% in comparison with the Mg0.1Zn0.9O films without silica nanospheres. The photocurrent and UV‐visible ratio of the passivated Mg0.1Zn0.9O MSM‐UPDs with antireflection layer were enhanced to 5.85 μA and 1.44 × 104, respectively, at the bias voltage of 5 V. Moreover, the noise equivalent power and the specific detectivity of the passivated Mg0.1Zn0.9O MSM‐UPDs with antireflection layer were decreased to 2.60 × 10−13 W and increased to 1.21 × 1012 cmHz1/2W−1, respectively, at the bias voltage of 5 V. According to the above mentions, the PEC treatment and silica nanospheres antireflection layer could effectively enhance the performance of Mg0.1Zn0.9O MSM‐UPDs.
Enhancing the Detection of BOLD Signal in fMRI by Reducing the Partial Volume Effect
Authors: Du Yiping P. , Chu Renxin , Tregellas Jason R.
Published: March 2014

Purpose. To investigate the advantages of reducing the partial volume effect (PVE) to enhance the detection of the BOLD signal in fMRI.Methods. A linear phase term was added ink-space to obtain half-voxel shifting of 64 × 64T2*-weighted echo-planar images. Three sets of image data shifted in thex,y, and diagonal direction, respectively, are combined with the original 64 × 64 data to form the 128 × 128 voxel-shifted interpolated data.Results. A simulation of a synthetic fMRI dataset shows that the voxel-shifted interpolation (VSI) can increase thet-score up to 50% in single-voxel activations. An fMRI study (n=7) demonstrates that 20.4% of the interpolated voxels have highert-scores than their nearest neighboring voxels in the original maps. The average increase of thet-score in these interpolated voxels is 13.3%.Conclusion. VSI yields increased sensitivity in detecting voxel-size BOLD activations, improved spatial accuracy of activated regions, and improved detection of the peak BOLD signal of an activated region. VSI can potentially be used as an alternative to the high-resolution fMRI studies in which reduction in SNR and increase in imaging time become prohibitive.
Comparison of Latanoprost/Timolol with Carbonic Anhydrase Inhibitor and Dorzolamide/Timolol with Prostaglandin Analog in the Treatment of Glaucoma
Authors: Inoue Kenji , Soeda Shoichi , Tomita Goji
Published: March 2014

Purpose.We retrospectively reviewed medical records of glaucoma patients to investigate how switching medications may affect intraocular pressure (IOP) management. Three concomitant medications were changed to two medications: one combination drop and one single-action drop. Associated adverse effects were also examined.Subjects and Methods.A total of 112 patients with primary open-angle glaucoma or ocular hypertension were examined. All patients were concomitantly using a prostaglandin (PG) analog, aβ-blocker, and a carbonic anhydrate inhibitor (CAI). Fifty-five patients began using latanoprost (PG analog)/timolol (β-blocker) fixed-combination (LTFC) drops and a CAI (group 1), and 57 patients began using dorzolamide (CAI)/timolol fixed-combination (DTFC) drops and a PG analog (group 2). The IOP was measured every 6 months for 2 years following medication changes. Changes in visual field mean deviation (MD) and medication discontinuations were also examined.Results.There were no significant differences in IOP or MD values before and after medication changes in either group. The proportion of medication discontinuations, uncontrolled IOP, and adverse reactions was similar in both groups.Conclusion.Switching patients from multiple single-action medications to combination medications was not associated with changes in IOP, visual field testing results, or adverse event frequency.
Preparation and Characterization of an Amphipathic Magnetic Nanosphere
Authors: Ji Yongsheng , Lv Ruihong , Xu Zhigang , Zhao Chuande , Zhang Haixia
Published: March 2014

The amphipathic magnetic nanospheres were synthesized using C8and polyethylene glycol as ligands. Their morphology, structure, and composition were characterized by transmission electron microscope, Fourier transform infrared, and elementary analysis. The prepared materials presented uniform sphere with size distribution about 200 nm. The magnetic characteristics of magnetic nanomaterials were measured by vibrating sample magnetometer. The target products had a saturation magnetization value of 50 emu g−1and superparamagnetism. The adsorption capability was also studied by static tests, and the material was applied to enrich benzenesulfonamide from calf serum. The results exhibited that the C8-PEG phase owned better adsorption capability, biocompatible property, and dispersivity in aqueous samples.
Escherichia coliStrains Isolated from the Uteri Horn, Mouth, and Rectum of Bitches Suffering from Pyometra: Virulence Factors, Antimicrobial Susceptibilities, and Clonal Relationships among Strains
Authors: Agostinho Juliana M. A. , de Souza Andressa , Schocken-Iturrino Ruben P. , Beraldo Lívia G. , Borges Clarissa A. , Ávila Fernando A. , Marin José M.
Published: March 2014

Pyometra is recognized as one of the main causes of disease and death in the bitch, andEscherichia coliis the major pathogen associated with this disease. In this study, 70E. coliisolates from the uteri horn, mouth, and rectum of bitches suffering from the disease and 43E. coliisolates from the rectum of clinically healthy bitches were examined for the presence of uropathogenic virulence genes and susceptibility to antimicrobial drugs. DNA profiles of isolates from uteri horn and mouth in bitches with pyometra were compared by REP, ERIC, and BOX-PCR. Virulence gene frequencies detected in isolates from canine pyometra were as follows: 95.7%fim, 27.1%iss, 25.7%hly, 18.5%iuc, and 17.1%usp. Predominant resistance was determined for cephalothin, ampicillin, and nalidixic acid among the isolates from all sites examined. Multidrug resistance was found on∼50% pyometra isolates. Using the genotypic methods some isolates from uteri, pus, and saliva of the same bitch proved to have identical DNA profiles which is a reason for concern due to the close relationship between household pets and humans.
Assessment of Technetium-99m Labeled Macroaggregated Albumin Rhinoscintigraphy for the Measurement of Nasal Mucociliary Transport Rate: Intratest, Interobserver, and Intraobserver Reproducibility
Authors: Dostbil Zeki , Dag Yusuf , Cetinkaya Ozlem , Akdag Mehmet , Tasdemir Bekir
Published: March 2014

Objectives.The measurement of mucociliary transport velocity by rhinoscintigraphy with Tc-99m-macroaggregated albumin (99mTc-MAA) is reliable measure of mucociliary clearance. The aim of this study is to assess the intratest, interobserver, and intraobserver reproducibility of nasal mucociliary transport rate (NMTR) measurement.Materials and Methods.Twenty-two subjects were evaluated to determine intratest reproducibility and a group of 35 subjects was examined to determine inter- and intraobserver reproducibility. Rhinoscintigraphy with99mTc-MAA was used to measure NMTR in all study subjects. Paired NMTR measurements were compared using a range of statistical methodologies. Intraclass correlation coefficients (ICC) and repeatability coefficients and Bland-Altman plots were applied to assess the degree of intratest, interobserver, and intraobserver variation.Results.Statistical analysis of test and retest experiments demonstrated the statistical equivalence of intratest NMTR measurements, interobserver NMTR measurements, and intraobserver NMTR measurements. The intratest ICC, interobserver ICC, and intraobserver ICC were 0.96, 0.83, and 0.91, respectively, indicating that intratest and intraobserver reproducibility are excellent and interobserver reproducibility is good.Conclusions.Rhinoscintigraphy using99mTc-MAA results in highly reproducible measurement of NMTR. The use of radionuclide imaging in measuring NMTR results in excellent intratest and intraobserver reproducibility and good interobserver reliability.
Cardiovascular Complications of Sleep Apnea: Role of Oxidative Stress
Authors: Badran Mohammad , Ayas Najib , Laher Ismail
Published: March 2014

Obstructive sleep apnea (OSA) occurs in 2% of middle-aged women and 4% of middle-aged men with a higher prevalence among obese subjects. This condition is considered as an independent risk factor for cerebrovascular and cardiovascular diseases. One of the major pathophysiological characteristics of OSA is intermittent hypoxia. Hypoxia can lead to oxidative stress and overproduction of reactive oxygen species, which can lead to endothelial dysfunction, a hallmark of atherosclerosis. Many animal models, such as the rodent model of intermittent hypoxia, mimic obstructive sleep apnea in human patients and allow more in-depth investigation of biological and cellular mechanisms of this condition. This review discusses the role of oxidative stress in cardiovascular disease resulting from OSA in humans and animal models.
Response of a Shape Memory Alloy Beam Model under Narrow Band Noise Excitation
Authors: Ge Gen
Published: March 2014

To describe the hysteretic nonlinear characteristic of the strain‐stress relation of shape memory alloy (SMA), a Van‐der‐Pol hysteretic cycle is applied to simulate the hysteretic loops. Then, the model of a simply supported SMA beam subject to transverse narrow band noise excitation with nonlinear damping was proposed. The deterministic and the stochastic responses are studied, respectively, applying the multiple scale method. The stability of the steady state responses is analyzed by Floquet theory and the moment method. The numerical simulation results quite agree with the theoretical analysis.
Expression of Neural Markers by Undifferentiated Mesenchymal-Like Stem Cells from Different Sources
Authors: Foudah Dana , Monfrini Marianna , Donzelli Elisabetta , Niada Stefania , Brini Anna T. , Orciani Monia , Tredici Giovanni , Miloso Mariarosaria
Published: March 2014

The spontaneous expression of neural markers, already demonstrated in bone marrow (BM) mesenchymal stem cells (MSCs), has been considered as evidence of the MSCs’ predisposition to differentiate toward neural lineages, supporting their use in stem cell-based therapy for neural repair. In this study we have evaluated, by immunocytochemistry, immunoblotting, and flow cytometry experiments, the expression of neural markers in undifferentiated MSCs from different sources: human adipose stem cells (hASCs), human skin-derived mesenchymal stem cells (hS-MSCs), human periodontal ligament stem cells (hPDLSCs,) and human dental pulp stem cells (hDPSCs). Our results demonstrate that the neuronal markersβIII-tubulin and NeuN, unlike other evaluated markers, are spontaneously expressed by a very high percentage of undifferentiated hASCs, hS-MSCs, hPDLSCs, and hDPSCs. Conversely, the neural progenitor marker nestin is expressed only by a high percentage of undifferentiated hPDLSCs and hDPSCs. Our results suggest that the expression ofβIII-tubulin and NeuN could be a common feature of stem cells and not exclusive to neuronal cells. This could result in a reassessment of the use ofβIII-tubulin and NeuN as the only evidence proving neuronal differentiation. Further studies will be necessary to elucidate the relevance of the spontaneous expression of these markers in stem cells.
Coffee Intake and Gastric Cancer Risk: The Singapore Chinese Health Study
Authors: Ainslie-Waldman Cheryl E. , Koh Woon-Puay , Jin Aizhen , Yeoh Khay Guan , Zhu Feng , Wang Renwei , Yuan Jian-Min , Butler Lesley M.
Published: March 2014

Background: Despite experimental evidence showing chemopreventive effects of coffee-related compounds on gastric carcinogenesis, epidemiologic studies generally do not support coffee–gastric cancer associations. Observational data are lacking among high-risk populations with sufficient regular coffee consumption.

Methods: We examined the association between caffeinated coffee intake and gastric cancer risk in a population-based cohort that enrolled 63,257 Chinese men and women ages 45 to 74 years between 1993 and 1998 in Singapore. Incident gastric cancer cases (n = 647) were identified after a mean follow-up of 14.7 years. Biomarkers of Helicobacter pylori (H. pylori) infection were measured in a subset of gastric cancer cases with blood collected before cancer diagnosis and their matched controls.

Results: In the total cohort, daily versus nondaily coffee intake was associated with a statistically nonsignificant decrease in gastric cancer risk [HR = 0.85; 95% confidence interval (CI), 0.69–1.04]. In women, the inverse association strengthened and reached statistical significance (HR = 0.63; 95% CI, 0.46–0.87). In analyses restricted to never smokers and nondrinkers of alcohol, inverse associations strengthened in the total cohort (HR = 0.69; 95% CI, 0.52–0.91) and in women (HR = 0.52; 95% CI, 0.37–0.74). There was no coffee–gastric cancer risk association among men, regardless of smoking status or alcohol consumption. Similar results were observed in the nested case–control study after adjustment for H. pylori infection.

Conclusion: Daily coffee consumption may reduce the risk of gastric cancer in high-risk populations, especially among women.

Impact: Research aimed at identifying the compounds in coffee that may protect against gastric carcinogenesis is warranted. Cancer Epidemiol Biomarkers Prev; 23(4); 638–47. ©2014 AACR.
Venous Thromboembolism and Cancer Risk among Elderly Adults in the United States
Authors: Marks Morgan A. , Engels Eric A.
Published: March 2014

Background: Few studies have evaluated cancer risk following venous thromboembolism (VTE). Both VTE and cancer disproportionately affect older adults.

Methods: Using linked Surveillance, Epidemiology, and End Results (SEER)–Medicare data, we evaluated 1.2 million cancer cases and 200,000 controls (66–99 years old, 1992–2005). VTEs occurring before selection were identified using Medicare claims. Logistic regression was used to estimate ORs.

Results: VTE was present in 2.5% of cases and 2.2% of controls. VTE was associated with risk of cancers of the lung [OR = 1.18; 95% confidence interval (CI), 1.12–1.23], stomach (OR = 1.19; 95% CI, 1.09–1.30), small intestine (OR = 1.42; 95% CI, 1.17–1.71), colon (OR = 1.25; 95% CI, 1.18–1.31), gallbladder (OR = 1.39; 95% CI, 1.16–1.67), pancreas (OR = 1.53; 95% CI, 1.43–1.64), soft tissue (OR = 1.43; 95% CI, 1.21–1.68), ovary (OR = 1.35; 95% CI, 1.22–1.50), and kidney/renal pelvis (OR = 1.34; 95% CI, 1.23–1.46), and melanoma (OR = 1.17; 95% CI, 1.08–1.27), non-Hodgkin lymphoma (OR = 1.27; 95% CI, 1.20- 1.35), myeloma (OR = 1.48; 95% CI, 1.35–1.63), and acute myeloid leukemia (OR = 1.35; 95% CI, 1.19–1.54). Strongest risks were observed within 1 year of VTE diagnosis, but risks were elevated more than 6 years after VTE for colon cancer (OR = 1.24; 95% CI, 1.12–1.37), pancreatic cancer (OR = 1.33; 95% CI, 1.15–1.54), and myeloma (OR = 1.35; 95% CI, 1.10–1.66). Few differences in risk were observed by VTE subtype. Cancers of the lung, stomach, and pancreas were more likely to have distant metastases within one year after VTE.

Conclusion: Among elderly adults, cancer risk is elevated following VTE diagnosis.

Impact: Short-term associations with cancer are likely driven by enhanced screening following VTE and reverse causation. While obesity, other comorbidities, and smoking cannot be excluded as explanations, longer-term elevations for select cancers suggest that some VTEs may be caused by cancer precursors. Cancer Epidemiol Biomarkers Prev; 23(5); 774–83. ©2014 AACR.
The Association between Postdiagnosis Dietary Supplement Use and Total Mortality Differs by Diet Quality among Older Female Cancer Survivors
Authors: Inoue-Choi Maki , Greenlee Heather , Oppeneer Sarah J. , Robien Kim
Published: March 2014

Background: Dietary supplements are widely used by cancer survivors. However, health effects among older cancer survivors are unclear.

Methods: We used the Iowa Women's Health Study, a prospective cohort study with 2,118 postmenopausal women with a confirmed cancer diagnosis (1986–2002), to evaluate the association between postdiagnosis dietary supplement use assessed in 2004 and subsequent all-cause mortality. Risk of death was evaluated using multivariable-adjusted Cox proportional hazards regression. We performed stratified analyses by diet quality score, dietary micronutrient intake, and perceived general health.

Results: Through 2010, 608 deaths were identified. Approximately 85% of the cancer survivors used dietary supplements. Overall supplement use and multivitamin use were not associated with mortality. Iron supplement use was associated with 39% higher risk of death [95% confidence interval (CI), 1.09–1.77]. This association was stronger among survivors with deteriorating general health. Folic acid supplement use was associated with higher risk of death, only among survivors reporting low-quality diets (HR, 2.33; 95% CI, 1.33–4.08; Pinteraction = 0.006). Multivitamin use and using a greater number of supplements was associated with a trend towards higher mortality only among those with poor diet quality. Using vitamin E supplements in combination with multivitamin was associated with lower risk of death only among survivors with higher dietary vitamin E intake (HR, 0.61; 95% CI, 0.39–0.94; Pinteraction = 0.02).

Conclusions: Postdiagnosis supplement use was associated with higher mortality among older female cancer survivors with poor general health and/or poor dietary intake.

Impact: The association between postdiagnosis dietary supplement use and mortality may differ by diet quality and health status among older female cancer survivors. Cancer Epidemiol Biomarkers Prev; 23(5); 865–75. ©2014 AACR.
Gonadotropin-Releasing Hormone Neurones Innervate Kisspeptin Neurones in the Female Mouse Brain
Authors: Kalló Imre , Vida Barbara , Bardóczi Zsuzsanna , Szilvásy-Szabó Anett , Rabi Fruzsina , Molnár Tamás , Farkas Imre , Caraty Alain , Mikkelsen Jens , Coen Clive W. , Hrabovszky Erik , Liposits Zsolt
Published: March 2014

Kisspeptin (KP) neurones in the rostral periventricular area of the third ventricle (RP3V) and arcuate nucleus (Arc) are important elements in the neuronal circuitry regulating gonadotropin-releasing hormone (GnRH) secretion. KP and co-synthesised neuropeptides/neurotransmitters act directly on GnRH perikarya and processes. GnRH neurones not only form the final output pathway regulating the reproductive functions of the anterior pituitary gland, but also provide neuronal input to sites within the hypothalamus. The current double-label immunohistochemical studies investigated whether GnRH-immunoreactive (IR) projections to the RP3V and/or Arc establish morphological connections with KP-IR neurones at these sites. To optimise visualisation of KP immunoreactivity in, respectively, the RP3V and Arc, ovariectomised (OVX) oestrogen-treated and OVX oil-treated female mice were studied. Confocal laser microscopic analysis of immunofluorescent specimens revealed GnRH-IR axon varicosities in apposition to approximately 25% of the KP-IR neurones in the RP3V and 50% of the KP-IR neurones in the Arc. At the ultrastructural level, GnRH-IR neurones were seen to establish asymmetric synaptic contacts, which usually reflect excitatory neurotransmission, with KP-IR neurones in both the RP3V and Arc. Together with previous data, these findings indicate reciprocal connectivity between both of the KP cell populations and the GnRH neuronal system. The functional significance of the GnRH-IR input to the two separate KP cell populations requires electrophysiological investigation.
Endoscopic Treatment of Vesicoureteral Reflux with Non-Simultaneous Involuntary Detrusor Contraction in Chronic Spinal Cord Injury Patients with Neurogenic Detrusor Overactivity
Authors: Vírseda Miguel C. , Salinas Jesús C. , Bolufer Eduardo , Esteban Manuel F.
Published: March 2014

Objective: To analyze whether it is correct to use endoscopic treatment via bulking agents of vesicoureteral reflux (VUR) seen on video urodynamics with non-simultaneous involuntary detrusor contraction in chronic spinal cord injury (SCI) patients with neurogenic detrusor overactivity (NDO). Methods: A retrospective study was performed with a cohort of 76 patients (age 48.9 ± 14.4 years) (mean ± standard deviation) of both sexes with chronic SCI who underwent endoscopic treatment of VUR during the years 2008 to 2011. Patients were subjected to clinical examinations and video urodynamic studies preoperatively and 22 ± 11.4 months after the intervention. Results: Resolution of VUR was achieved in 46 cases (61%). Cured patients had a statistically significant younger age and showed stress urinary incontinence more frequently. On the contrary, a greater grade of VUR, presence of bilateral reflux and presence of NDO were positively associated with treatment failure. The variables that independently influenced the cure of the reflux were NDO and reflux grade. Conclusions: The failure rate was high in patients with NDO, even though the reflux was not synchronous with involuntary detrusor contraction, and therefore these patients should have NDO eradicated before doing any anti-reflux procedures.
Giant Adrenal Myelolipoma Masquerading as Heart Failure
Authors: Joy Parijat S. , Marak Creticus P. , Nashed Nadia S. , Guddati Achuta K.
Published: March 2014

Adrenal myelolipomas are rare benign tumors of the adrenal cortex composed of adipose and hematopoietic cells. They have been postulated to arise from repeated stimulation by stress, inflammation and ACTH oversecretion. Myelolipomas are usually detected incidentally on imaging and do not require any active intervention besides regular follow-up by imaging. However, myelolipomas may insidiously grow to large sizes and cause mass effects and hemorrhage. Timely diagnosis and surgical resection are curative and lifesaving.
Comparison of CHADS
2
, R
2
CHADS
2
, and CHA
2
DS
2
-VASc Scores for the Prediction of Rhythm Outcomes After Catheter Ablation of Atrial Fibrillation
Authors: Kornej Jelena , Hindricks Gerhard , Kosiuk Jedrzej , Arya Arash , Sommer Philipp , Husser Daniela , Rolf Sascha , Richter Sergio , Huo Yan , Piorkowski Christopher , Bollmann Andreas
Published: March 2014

Background—

Recurrences of atrial fibrillation (AF) occur in up to 30% within 1 year after catheter ablation. This study evaluated the value of CHADS
2
, R
2
CHADS
2
, and CHA
2
DS
2
-VASc scores for the prediction of rhythm outcomes after AF catheter ablation.

Methods and Results—

Using the Leipzig Heart Center AF Ablation Registry, we documented rhythm outcomes within the first 12 months in 2069 patients (67% men; 60±10 years; 35% persistent AF) undergoing AF catheter ablation. AF recurrences were defined as any atrial arrhythmia occurring within the first week (early recurrences, ERAF) and between 3 and 12 months (late recurrences, LRAF) after ablation. ERAF and LRAF occurred in 36% and 33%, respectively. On multivariable analysis, R
2
CHADS
2
(odds ratio [OR], 1.11; 95% confidence interval [CI], 1.02–1.21;
P
=0.016) and CHA
2
DS
2
-VASc (OR, 1.09; 95% CI, 1.017–1.17;
P
=0.015) scores as well as persistent AF and left atrial diameter were significant predictors for ERAF. Similarly, the same clinical variables remained significant predictors for LRAF even after adjustment for ERAF, which was the strongest predictor for LRAF (HR, 3.12; 95% CI, 2.62–3.71;
P
<0.001). However, using receiver operating characteristic curve analyses, both scores demonstrated relatively low predictive value for ERAF (area under the curve [AUC], 0.536 [0.510–0.563];
P
=0.007; and AUC, 0.547 [0.521–0.573];
P
<0.001 for R
2
CHADS
2
and CHA
2
DS
2
-VASc, respectively) and LRAF (AUC, 0.548 [0.518–0.578];
P
=0.002; and AUC, 0.550 [0.520–0.580];
P
=0.001).

Conclusions—

R
2
CHADS
2
and CHA
2
DS
2
-VASc were associated with rhythm outcomes after catheter ablation. However, AF type, left atrial diameter, and especially ERAF are also significant predictors for LRAF that should be included into new clinical scores for the prediction of rhythm outcomes after catheter ablation.
One-Year Clinical Outcome After Pulmonary Vein Isolation Using the Second-Generation 28-mm Cryoballoon
Authors: Metzner Andreas , Reissmann Bruno , Rausch Peter , Mathew Shibu , Wohlmuth Peter , Tilz Roland , Rillig Andreas , Lemes Christine , Deiss Sebastian , Heeger Christian , Kamioka Masashi , Lin Tina , Ouyang Feifan , Kuck Karl-Heinz , Wissner Erik
Published: March 2014

Background—

The use of second-generation cryoballoon for pulmonary vein isolation in patients with paroxysmal atrial fibrillation has demonstrated encouraging acute and mid-term results. Long-term outcome data are not yet available.

Methods and Results—

Fifty patients (18 women; mean age, 61±11 years; mean left atrial diameter, 43±5 mm) with paroxysmal (36 of 50 patients; 72%) or short-standing (<3-month duration) persistent atrial fibrillation (14 of 50 patients; 28%) underwent cryoballoon-based pulmonary vein isolation. Freeze cycle duration was 240 seconds. After successful pulmonary vein isolation, a bonus freeze was applied. Follow-up was based on outpatient clinic visits at 3, 6, and 12 months including Holter-ECGs and telephonic interviews. Recurrence was defined as a symptomatic or documented arrhythmia episode >30 seconds excluding a 3-month blanking period. A total of 192 pulmonary veins were identified, and 191 of 192 (99%) pulmonary veins were successfully isolated. Phrenic nerve palsy occurred in 1 of 50 (2%) patients. Follow-up was available for 49 of 50 (98%) patients with a mean follow-up duration of 440±39 days. Thirty-nine of 49 (80%) patients remained in stable sinus rhythm. Of 8 of 10 patients with arrhythmia recurrence, a second procedure using radiofrequency ablation demonstrated left atrial to pulmonary vein reconduction.

Conclusions—

The use of second-generation 28-mm cryoballoon for pulmonary vein isolation results in an 80% 1-year success rate.
Evolution of Transcatheter Aortic Valve Replacement
Authors: Bourantas Christos V. , Serruys Patrick W.
Published: March 2014

Transcatheter aortic valve replacement emerged ≈20 years ago and changed the landscape of structural interventional cardiology. The first experiments in animal models provided proofs of the concept and the substrate for the first percutaneous valve implantation in patients. The initial promising results in a clinical setting drew the attention of the industry and of the scientific community, and an effort was made for the past 12 years to address the limitations of the technology, facilitate the procedure, minimize the risk of complications, and broaden the applications of transcatheter aortic valve replacement. This article reviews the evolution of transcatheter aortic valve replacement, presents the first steps in this field, cites the evidence from registries and clinical trials, highlights the limitations of this treatment, and discusses the future perspectives and the developments proposed to address the current pitfalls.
Prospective Relationship of Change in Ideal Cardiovascular Health Status and Arterial Stiffness: The Cardiovascular Risk in Young Finns Study
Authors: Aatola Heikki , Hutri‐Kähönen Nina , Juonala Markus , Laitinen Tomi T. , Pahkala Katja , Mikkilä Vera , Telama Risto , Koivistoinen Teemu , Lehtimäki Terho , Viikari Jorma S. A. , Raitakari Olli T. , Kähönen Mika
Published: March 2014

Background

In 2010, the American Heart Association defined ideal cardiovascular health as the simultaneous presence of 4 favorable health behaviors (nonsmoking, ideal body mass index, physical activity at goal, and dietary pattern that promotes cardiovascular health) and 3 favorable health factors (ideal levels of total cholesterol, blood pressure, and fasting glucose). The association between a change in ideal cardiovascular health status and pulse wave velocity, a surrogate marker of cardiovascular disease, has not been reported.

Methods and Results

The study cohort consisted of 1143 white adults from the Cardiovascular Risk in Young Finns Study who were followed for 21 years since baseline (1986). This cohort was divided in 2 subgroups: 803 participants (aged 9 to 18 years at baseline) to study the health status change from childhood to adulthood and 340 participants (aged 21 to 24 years at baseline) to study health status change from young adulthood to middle age. The change in the ideal cardiovascular health index was inversely associated with
pulse wave velocity
(adjusted for age, sex, and heart rate), every 1‐point increase corresponded to a 0.09‐m/s (
P
<0.001) decrease in
pulse wave velocity
in both groups. This association remained significant in subgroups based on the ideal cardiovascular health index at baseline.

Conclusions

The change in ideal cardiovascular health status, both from childhood to adulthood and from young adulthood to middle age, was an independent predictor of adult
pulse wave velocity
. Our results support the concept of ideal cardiovascular health as a useful tool for primordial prevention of
cardiovascular disease
.
Brazilian View Of Responsibility To Protect
Authors: Almeida Paula Wojcikiewicz
Published: March 2014

Brazil’s foreign policy has traditionally been conducted based on the principle of non-intervention. With the objective of attaining a permanent seat on the Security Council, the country has been demonstrating an effective engagement in peace operations. The principle of non-intervention has given way to that of non-indifference, which represents the first major change in Brazilian diplomacy. A second change stems from Brazil’s proposal of ‘responsibility while protecting’. While this initiative demonstrates the country’s intention to participate actively in the UN, one might ask whether it makes any substantial contribution to the RtoP debate, since several fundamental questions remain unanswered. Is this an attempt to renegotiate and reformulate the concept of RtoP or is it a new a strategy to implement measures based on the RtoP? This article aims to analyse the evolution of the Brazilian view on the RtoP in order to understand its true value.
Heterogeneous computing and grid scheduling with parallel biologically inspired hybrid heuristics
Authors: Wang Jinglian , Gong Bin , Liu Hong , Li Shaohui , Yi Juan
Published: March 2014

This work presents novel parallel biologically inspired hybrid heuristics for task scheduling in distributed heterogeneous computing and grid environments, and NP-hard problems with capital relevance in distributed computing. Firstly, sequential hybrid metaheuristics based on artificial immune systems (AIS) are developed to provide a good scheduler in reduced execution time and improved resource utilization. In the new AIS, affinities of the antibody’s genes are also effectively evaluated and regarded as memes from population real-time evolution; self-organized gene–meme co-evolution is simulated to improve population convergence; and appropriate Lyapunov functions inspired by interactive activation and competition neural networks are constructed to balance exploration and exploitation. Secondly, parallelization of the AIS-based algorithm is hierarchically designed and integrates with the two traditional parallel models (master–slave models and island models). The method has been specifically implemented on the newly developed supercomputer platform of hybrid multi-core CPU+GPU using C-CUDA for solving large-sized realistic instances. Numerical experiments are performed on both well known problem instances and large instances that model medium-sized grid environments. The comparative study shows that the proposed parallel approach is able to achieve high solving efficacy, outperforming previous results reported in the related literature, and also showing good scalability behaviour when facing high-dimension problem instances.
Not All Refinancings Are Created Equal
Authors: Luby Martin J.
Published: March 2014

In this ongoing era of fiscal stress, state and local governments have increasingly turned to financial measures to help balance their budgets. One financial tactic commonly employed is debt refinancing. This article details the common refinancing strategies employed by state and local governments. Based on these strategies, typical refinancing transaction types are constructed and evaluated based on an assessment framework that relies on four debt refinancing principles developed in this article. Based on this assessment framework, the article concludes with a series of general recommendations for state and local governments to consider when refinancing debt.
How height is related to our health and longevity
Authors: Samaras Thomas T
Published: March 2014

Most people believe that being taller and heavier is a sign of higher social status and privilege; however, an objective evaluation of the advantages and disadvantages of increased body size (excluding obesity) indicated that shorter, smaller bodies have numerous advantages in terms of health and longevity. With healthful nutrition and lifestyles, and good medical care, shorter people are less likely to suffer from age-related chronic diseases and more likely to reach advanced ages. A variety of biological factors explain the inherent benefits of smaller bodies. These include reduced cell replication, much lower DNA damage and reduced cancer incidence. Other beneficial factors include higher sex hormone binding globulin, higher insulin-like growth factor binding protein-1, lower insulin and lower insulin-like growth factor-1. We discuss recommendations for how taller people can minimize their risks. Future public health practices should focus on healthful nutrition, without promoting continued secular growth in height and weight.
Experimental study on the wear and damage behavior of different wheel/rail materials
Authors: Wang Wen-jian , Jiang Wen-juan , Wang Heng-yu , Liu Qi-yue , Zhu Min-hao , Jin Xue-song
Published: March 2014

The objective of this study is to investigate the effect of hardness and contact stress on wear and damage behavior of wheel and rail materials using a rolling-sliding simulation facility. Furthermore, the hardness matching and damage mechanism of wheel and rail materials are explored and clarified using several techniques. The wear weight of wheel rollers increases nearly linearly with the hardness ratio of rail and wheel rollers. However, the wear weight of rail rollers linearly decreases at the same conditions. An increase in the hardness of the wheel material results in the damage mechanism of the wheel roller changing from small pitting and adhesion wear to delamination wear. Then the rail roller shows severe shelling damage. Practically, the matching of the hardness of wheel and rail materials shows significant potential for alleviating wear and surface damage. An increase in the contact stress results in the wear of wheel and rail rollers becoming more severe. The damage mechanism changes from small shelling to serious delamination damage and oxidation wear. The main compositions of wear debris are the oxide Fe2O3 and martensite. Accordingly, decreasing the contact stress is an effective measure for alleviating wear and damage of heavy-haul wheel and rail materials.
Altruism and mature care
Authors: Hem Marit Helene , Halvorsen Kristin , Nortvedt Per
Published: March 2014

Introduction:

We discuss Carol Gilligan's original concept of mature care in the light of the altruistic approach to caring and good clinical judgment.

Discussion:

In particular, we highlight how the concept of mature care can capture important challenges in today's nursing. Further, we illuminate how mature care might differ normatively from an altruistic approach to caring and the traditional prudential virtues in nursing. We also discuss similarities between mature care and virtue ethics.

Conclusion:

For nursing and nurses' identity, in today's health care system that is increasingly pressured to ‘produce' health, we believe it is important to both developing further theories on mature care and having normative discussions about care.
Living by numbers: Media representations of sports stars’ careers
Authors: Tulle Emmanuelle
Published: March 2014

This article will address the making and unmaking of elite sporting careers, by focusing on the media reporting of the rise and fall of two elite sport stars, Roger Federer and Lance Armstrong. Sport stars are not simply the raw, unmediated products of innate or mysterious physical ability. Their physical capital is constituted through techniques – physical and discursive – that reflect wider social and cultural values. In this paper I report on the role played by numbers (objective time, chronological age and physiological biomarkers) to construct but also regulate athletic careers. Numbers will be shown to have normative power that reinforces understandings of age and ageing within a narrative of decline. The athletes’ ability to challenge their subjection as old will also be explored.
Oxaliplatin-Induced Renal Tubular Vacuolization
Authors: Yaghobi Joybari Ali , Sarbaz Samaneh , Azadeh Payam , Mirafsharieh S. Abbas , Rahbari Ali , Farasatinasab Maryam , Mokhtari Majid
Published: March 2014

Objective: Chemotherapy with oxaliplatin is used for a wide range of malignancies. Unlike other platinum derivatives, oxaliplatin has less nephrotoxicity. However, in recent years, there have been multiple reports of different forms of renal toxicity related to this agent. Case Summary: A 40-year-old woman with colon adenocarcinoma developed jaundice, hematuria, and oliguria after the 36th cycle of oxaliplatin chemotherapy. Laboratory data revealed severe anemia, thrombocytopenia, increased creatinine, indirect hyperbilirubinemia, and high lactate dehydrogenase. A negative direct antiglobulin test and presence of <1% schistocytes in the peripheral blood smear stood against the diagnosis of immune-mediated hemolytic anemia or hemolytic uremic syndrome/thrombotic thrombocytopenic purpura. Renal biopsy was consistent with interstitial nephritis with tubular vacuolization in favor of drug-induced renal injury. Based on the Naranjo Probability Scale, the likelihood of oxaliplatin-induced renal injury in this case was probable. Discussion: To our knowledge, this is the first case report of renal tubular vacuolization with symptoms mimicking thrombotic microangiopathy in a patient on long-term chemotherapy with oxaliplatin. Conclusions: Oxaliplatin can induce various forms of nephrotoxicity such as renal tubular vacuolization, acute tubular necrosis, renal tubular acidosis, and acute kidney injury secondary to hematological toxicity. Monitoring for renal function abnormalities and hemolysis should be considered during oxaliplatin-based chemotherapy.
Rejecting multiple-period disturbances: active vibration control of a two degree-of-freedom piezoelectric flexible structure system
Authors: Lin Chi-Ying , Chiu Wei-Hsiang , Lin Jonqlan
Published: March 2014

In this study, an active vibration suppression control is presented for use in a two degree-of-freedom piezoelectric flexible structure system containing a rectangular plate driven by dc motors. A mathematical model involving a clamped-free-free-free cantilever flexible plate, piezoelectric transducer, and motor dynamics is derived for modal analysis and control design. To simplify the control design of this multivariable system, a two-stage design strategy is proposed because the plate motion exerts a comparatively small effect on the dc motors. Both the plate vibration and coupling effect in the motors are considered when designing a centralized motor tracking controller. Given a well-designed two-axis motor control system, piezoelectric actuators are used on the plate to perform efficient active vibration suppression control. Hybrid proportional-derivative and repetitive control methods are extended to manage the multiple-period disturbances and resonant excitation. Three sets of simulation experiments were conducted, focusing on suppressing the plate vibration response and demonstrating the effectiveness of the proposed method.
Passiflora edulispeel intake and ulcerative colitis: Approaches for prevention and treatment
Authors: Cazarin Cinthia BB , da Silva Juliana K , Colomeu Talita C , Batista Ângela G , Vilella Conceição A , Ferreira Anderson L , Junior Stanislau Bogusz , Fukuda Karina , Augusto Fabio , de Meirelles Luciana R , Zollner Ricardo de L , Junior Mário R Maróstica
Published: March 2014

Inflammatory bowel disease is a chronic relapsing disease that affects millions of people worldwide; its pathogenesis is influenced by genetic, environmental, microbiological, and immunological factors. The aim of this study was to evaluate the effects of short- and long-term Passiflora edulis peel intake on the antioxidant status, microbiota, and short-chain fatty acids formation in rats with 2,4,6-trinitrobenzenesulphonic acid-induced colitis using two “ in vivo” experiments: chronic (prevention) and acute (treatment). The colitis damage score was determined using macroscopic and microscopic analyses. In addition, the antioxidant activity in serum and other tissues (liver and colon) was evaluated. Bifidobacteria, lactobacilli, aerobic bacteria and enterobacteria, and the amount of short-chain fatty acids (acetic, butyric, and propionic acids) in cecum content were counted. Differences in the colon damage scores were observed; P. edulis peel intake improved serum antioxidant status. In the treatment protocol, decreased colon lipid peroxidation, a decreased number of aerobic bacteria and enterobacteria, and an improvement in acetic and butyric acid levels in the feces were observed. An improvement in the bifidobacteria and lactobacilli was observed in the prevention protocol. These results suggested that P. edulis peel can modulate microbiota and could be used as source of fiber and polyphenols in the prevention of oxidative stress through the improvement of serum and tissue antioxidant status.