bluuebunny/crossref_metadata_2025 huggingface dataset:
Direct reprogramming of mouse fibroblasts to neural progenitors
Authors: Kim Janghwan , Efe Jem A. , Zhu Saiyong , Talantova Maria , Yuan Xu , Wang Shufen , Lipton Stuart A. , Zhang Kang , Ding Sheng
Published: April 2011

The simple yet powerful technique of induced pluripotency may eventually supply a wide range of differentiated cells for cell therapy and drug development. However, making the appropriate cells via induced pluripotent stem cells (iPSCs) requires reprogramming of somatic cells and subsequent redifferentiation. Given how arduous and lengthy this process can be, we sought to determine whether it might be possible to convert somatic cells into lineage-specific stem/progenitor cells of another germ layer in one step, bypassing the intermediate pluripotent stage. Here we show that transient induction of the four reprogramming factors (Oct4, Sox2, Klf4, and c-Myc) can efficiently transdifferentiate fibroblasts into functional neural stem/progenitor cells (NPCs) with appropriate signaling inputs. Compared with induced neurons (or iN cells, which are directly converted from fibroblasts), transdifferentiated NPCs have the distinct advantage of being expandable in vitro and retaining the ability to give rise to multiple neuronal subtypes and glial cells. Our results provide a unique paradigm for iPSC-factor–based reprogramming by demonstrating that it can be readily modified to serve as a general platform for transdifferentiation.
Transverse vibration of single-layer graphene sheets
Authors: Chowdhury R , Adhikari S , Scarpa F , Friswell M I
Published: April 2011

We investigate the vibrational properties of zigzag and armchair single-layer graphene sheets (SLGSs) using the molecular mechanics (MM) approach. The natural frequencies of vibration and their associated intrinsic vibration modes are obtained. Vibrational analysis is performed with different chirality and boundary conditions. The simulations are carried out for three types of zigzag and armchair SLGS. The universal force field potential is used for the MM approach. The first four natural frequencies are obtained for increasing lengths. The results indicate that the natural frequencies decrease as the length increases. The results follow similar trends with results of previous studies for SLGS using a continuum structural mechanics approach. These results have shown the applicability of SLGSs as electromechanical resonators.
A Weyl module filtration for the vertex algebra of differential operators
Authors: Zhu Minxian
Published: April 2011

The aim of this paper is to give a proof of a conjecture stated in a previous paper by the author. We prove the existence of certain filtrations, in the case of rational central charges, for the vertex algebras of differential operators on a Lie group.
First-aid measures
Authors: Sylla Patricia
Published: April 2011

• General principles 56

• Local anaesthesia—general considerations 58

• Complications of local anaesthesia 60

Very often patients require some kind of first aid while they wait for further assessment or definitive treatment. Some of these measures are covered elsewhere in the relevant sections, but consider the following options....
Injuries to the face, nose, and ears
Authors: Sylla Patricia
Published: April 2011

General points in facial trauma 212

Maxillofacial (trauma) emergencies 214

Facial trauma—general considerations 218

Useful clinical signs and their significance 220

Mandibular fractures 230

Dislocated condyle 242

Alveolar fractures 244

Dental trauma 246

Zygomatic and orbital fractures—applied anatomy 248

Zygomatic (malar) fractures 250

Orbital fractures (isolated) ...
Burns
Authors: Sylla Patricia
Published: April 2011

• Introduction 412

• Initial management checklist 416

• Initial management 418

• Assessing the burn patient 422

• Stabilizing the burn patient 426

• Surgical management of burns 428

Burns are systemic injuries, which result in significant morbidity and mortality. They present a major challenge, not only during the resuscitation phase, but also with later reconstruction. With burns of the face, a ...
Miscellaneous conditions
Authors: Sylla Patricia
Published: April 2011

Airway obstruction 432

Foreign bodies (FBs) 434

Stridor 438

Epistaxis (non-traumatic) 439

Urticaria and angioedema 440

Dizzyness/'vertigo' 441

Sore throat 442

Drugs and dressings commonly used in head and neck surgery 444

The upper airway is at risk when the following findings are present:

•...
Respiratory emergencies
Authors: Ramrakha Punit S. , Moore Kevin P. , Sam Amir
Published: April 2011

Acute pneumonia: assessment 166

Acute pneumonia: investigations 168

Acute pneumonia: management 170

Acute pneumonia: specific situations 172

Acute pneumonia: complications 173

Mycoplasma pneumonia 174

Legionella pneumonia 174

Viral pneumonia 175

Chlamydia pneumonia 175

Psittacosis 175

Miscellaneous conditions 176

Acute asthma: assessment 178

Acute severe asthma: immediate therapy ...
Neurological emergencies
Authors: Ramrakha Punit S. , Moore Kevin P. , Sam Amir
Published: April 2011

Coma: assessment 332

Coma: immediate management 334

Coma: clues from examination 336

Coma: management 338

Limb weakness: assessment 340

Limb weakness: localizing the lesion 342

Acute dizziness: assessment 344

Acute dizziness: management 346

Acute loss of vision 348

Approach to acute/sub-acute visual loss 350

Painful red eye: assessment ...
Endocrine emergencies
Authors: Ramrakha Punit S. , Moore Kevin P. , Sam Amir
Published: April 2011

Diabetic ketoacidosis (DKA): assessment 516

DKA: management 1 518

DKA: management 2 520

DKA: complications 522

Hyperosmolar non-ketotic coma (HONK) 1 524

HONK 2 526

Hypoglycaemic coma: assessment 528

Hypoglycaemic coma: management 530

Urgent surgery in patients with diabetes 532

Hyponatraemia: assessment 534

Hyponatraemia: causes ...
Differential diagnosis of common presentations
Authors: Ramrakha Punit S. , Moore Kevin P. , Sam Amir
Published: April 2011

Introduction 814

Systemic enquiry 815

Abdominal pain 1 816

Abdominal pain 2 818

Abdominal pain (referred) 819

Abdominal distension 819

Back pain 820

Blackouts 820

Breathlessness/dyspnoea 821

Chest pain 822

Chest pain (pleuritic) 822

Collapse 822

Confusion 823

Constipation 823

Cough 823

Cutaneous manifestations of internal malignancy ...
Antibiotics in palliative care
Authors: Watson Max , Lucas Caroline , Hoy Andrew , Wells Jo
Published: April 2011

This chapter covers antibiotics in palliative care, including the aim of antibiotic guidance, generic severity considerations, cultures, and other important considerations.
Oncology and palliative care
Authors: Watson Max , Lucas Caroline , Hoy Andrew , Wells Jo
Published: April 2011

This chapter covers organization of cancer care, clinical trials, oncological surgery, chemotherapy, cytotoxic drugs, radiotherapy, types of radiation therapy, managing the side effects of radiotherapy, new developments, common cancers, including patients with lung cancer, colorectal cancer, breast cancer, prostate cancer, gynaecological cancer, upper gastrointestinal tract cancer, cancer of the bladder and ureter, and tumours of the central nervous system, chronic leukaemia and myeloma, palliative care of patients with carcinomatosis of unknown primary site, and investigations.
Cachexia, anorexia and fatigue
Authors: Watson Max , Lucas Caroline , Hoy Andrew , Wells Jo
Published: April 2011

This chapter covers cachexia, anorexia and fatigue, including background, definitions, prevalence, aetiology, metabolic effects, and management.
Skin problems in palliative care
Authors: Watson Max , Lucas Caroline , Hoy Andrew , Wells Jo
Published: April 2011

This chapter focuses on wound care in cancer, pruritis (itch), and lymphoedema.
Paediatric palliative care
Authors: Watson Max , Lucas Caroline , Hoy Andrew , Wells Jo
Published: April 2011

This chapter on paediatric palliative care covers who needs paediatric palliative care, the differences between paediatric and adult palliative care, ethical issues, psychosocial needs in paediatric palliative care, supporting the sick child, supporting parents, parents’ needs and the role of the health professional, sibling needs, community-based care, bereavement, strategies for self-care, and the Association for Children with Life Threatening or Terminal Conditions and their Families (ACT) Charter. The second half of the chapter is divided into the common symptoms experienced by very ill children and outlines a management system for each. There is also an emergency drugs summary.
Palliation in the care of the elderly1
Authors: Watson Max , Lucas Caroline , Hoy Andrew , Wells Jo
Published: April 2011

This chapter discusses palliation in the care of the elderly, including common issues, common sources of suffering and discomfort, and care of the carer.
Spiritual care
Authors: Watson Max , Lucas Caroline , Hoy Andrew , Wells Jo
Published: April 2011

This chapter on spiritual care covers definitions, spirituality and religion, faith practices, spiritual pain, spiritual assessment, and the skills needed in spiritual care.
Rehabilitation
Authors: Watson Max , Lucas Caroline , Hoy Andrew , Wells Jo
Published: April 2011

This chapter provides a brief introduction to rehabilitation, including assessment of potential for successful palliative rehabilitation, and information on the rehabilitation team.
Speech and language therapy
Authors: Watson Max , Lucas Caroline , Hoy Andrew , Wells Jo
Published: April 2011

This chapter provides a brief introduction to speech and language therapy, including the aims and principles of SLT intervention, communication difficulties, and swallowing difficulties.
Social work
Authors: Watson Max , Lucas Caroline , Hoy Andrew , Wells Jo
Published: April 2011

This chapter provides a brief introduction to social work, including financial and practical help in the UK.
Chaplaincy
Authors: Watson Max , Lucas Caroline , Hoy Andrew , Wells Jo
Published: April 2011

This chapter provides a brief introduction to chaplaincy, including chaplains as professional colleagues, and awareness of religious diversity.
Pharmacy
Authors: Watson Max , Lucas Caroline , Hoy Andrew , Wells Jo
Published: April 2011

This chapter provides a brief introduction to pharmacy, including the provision of clinical service, helping patients to accept and understand their medication, liaison with community pharmacy services, teaching and training, and participation in service development, research and audit.
Music therapy
Authors: Watson Max , Lucas Caroline , Hoy Andrew , Wells Jo
Published: April 2011

This chapter provides a very brief introduction to music therapy.
Palliative care for people with learning disabilities
Authors: Watson Max , Lucas Caroline , Hoy Andrew , Wells Jo
Published: April 2011

This chapter on palliative care for people with learning disabilities covers communication, consent, pain and symptom assessment, and loss, grief, and bereavement.
Emergencies in palliative care
Authors: Watson Max , Lucas Caroline , Hoy Andrew , Wells Jo
Published: April 2011

This chapter covers emergencies in palliative care, including sepsis in the neutropenic patient, spinal cord compression, superior vena cava obstruction, haemorrhage, and hypocalcaemia.
Bereavement
Authors: Watson Max , Lucas Caroline , Hoy Andrew , Wells Jo
Published: April 2011

This chapter covers normal manifestations of grief, bereavement support, and complicated grief.
Self-care for health professionals
Authors: Watson Max , Lucas Caroline , Hoy Andrew , Wells Jo
Published: April 2011

This chapter covers self-care for health professionals, and focuses on the impact of caring for dying people, including sources of stress, warning signs of prolonged stress, and strategies for dealing with stress.
Laboratory reference values
Authors: Watson Max , Lucas Caroline , Hoy Andrew , Wells Jo
Published: April 2011

This chapter contains laboratory reference values for haematology and biochemistry.
Sleep-disordered breathing
Authors: Corbridge Rogan , Steventon Nicholas
Published: April 2011

Sleep physiology 286

Assessment of sleep-disordered breathing 288

Sleep studies 290

Sleep-disordered breathing spectrum 291

Medical treatment 292

CPAP therapy 293

Surgery for sleep-disordered breathing 294

Friedman Classification System 295

—20% of sleep time (rapid eye movements seen under closed lids during sleep)

—80% of sleep time. Subdivided into stages by EEG activity:...
Common drugs used in ENT
Authors: Corbridge Rogan , Steventon Nicholas
Published: April 2011

Drugs used in the ear 348

Drugs used in the nose 349

Drugs used in the treatment of acid reflux 350

This group of drugs is widely used for the treatment of otitis externa.

Otitis externa

2 drops tds for 10 days

Presence of grommet or tympanic membrane perforation due to aminoglycoside ototoxicity in the inner ear. Risk thought to be low in the presence of active infection where the middle-ear mucosa is swollen and the antibiotic is unlikely to reach the inner ear via the round window...
Carnitine Deficiency Increases Susceptibility to Bupivacaine-induced Cardiotoxicity in Rats
Authors: Wong Gail K. , Crawford Mark W.
Published: April 2011

Background

Anecdotal reports suggest that carnitine deficiency increases susceptibility to bupivacaine-induced cardiotoxicity. Bupivacaine inhibits lipid-based respiration in myocardial mitochondria via inhibition of acylcarnitine exchange in rats. The authors hypothesized that carnitine deficiency increases susceptibility to bupivacaine-induced asystole in rats and that acute repletion with L-carnitine reverses this effect.

Methods

Thirty male Sprague-Dawley rats were assigned to three groups. Rats assigned to the L-carnitine-deficient and L-carnitine-replete groups received subcutaneous D-carnitine on the 10 d before the experiment to induce L-carnitine deficiency. Control rats received an equal volume of subcutaneous normal saline. The rats were anesthetized and mechanically ventilated. Bupivacaine was infused intravenously at a rate of 2.0 mg · kg⁻¹ · min⁻¹ until asystole occurred. The L-carnitine-replete group received intravenous L-carnitine 100 mg · kg⁻¹ immediately before bupivacaine infusion. At asystole, blood was sampled to measure bupivacaine concentration. The primary outcome was time to asystole.

Results

L-carnitine deficiency significantly decreased survival duration (P < 0.0001). Time to bupivacaine-induced asystole decreased by 22% (P < 0.05) in the L-carnitine-deficient group (847 s [787-898]) (median [interquartile range]) compared with controls (1,082 s [969-1,427]). Intravenous administration of L-carnitine completely reversed the reduction in time to asystole. At asystole, the median plasma bupivacaine concentration in the L-carnitine-deficient group was 38% (P < 0.05) less than that in control animals. Plasma bupivacaine concentration was similar in L-carnitine-replete and control animals.

Conclusions

Carnitine deficiency increased sensitivity to bupivacaine-induced asystole, an effect that was reversed completely by L-carnitine repletion. This study suggests that carnitine deficiency may predispose to bupivacaine-induced cardiotoxicity. L-carnitine may have a protective role against bupivacaine cardiotoxicity.
Propofol Enhances Memory Formation via an Interaction with the Endocannabinoid System
Authors: Hauer Daniela , Ratano Patrizia , Morena Maria , Scaccianoce Sergio , Briegel Isabel , Palmery Maura , Cuomo Vincenzo , Roozendaal Benno , Schelling Gustav , Campolongo Patrizia
Published: April 2011

Background

Propofol is associated with postoperative mood alterations and induces a higher incidence of dreaming compared with other general anesthetics. These effects might be mediated by propofol's inhibitory action on fatty acid amide hydrolase, the enzyme that degrades the endocannabinoid anandamide. Because propofol is also associated with a higher incidence of traumatic memories from perioperative awareness and intensive care unit treatment and the endocannabinoid system is involved in regulating memory consolidation of emotional experiences, the authors investigated whether propofol, at anesthetic doses, modulates memory consolidation via an activation of the endocannabinoid system.

Methods

Male Sprague-Dawley rats were trained on an inhibitory avoidance task in which they received an inescapable foot shock upon entering the dark compartment of the apparatus. Drugs were administered intraperitoneally immediately or 30, 90, or 180 min after training. On the retention test 48 h later, the latency to reenter the dark compartment was recorded and taken as a measure of memory retention.

Results

The anesthetic doses of propofol administered after training significantly increased latencies of 48-h inhibitory avoidance performance (483.4 ± 181.3, 432.89 ± 214.06, 300 and 350 mg/kg, respectively; mean ± SD) compared with the corresponding vehicle group (325.33 ± 221.22, mean ± SD), which is indicative of stronger memory consolidation in propofol treated rats. Administration of a nonimpairing dose of the cannabinoid receptor antagonist rimonabant blocked the memory enhancement induced by propofol (123.39 ± 133.10, mean ± SD). Delayed administration of propofol 90 and 180 min after training or immediate posttraining administration of the benzodiazepine midazolam or the barbiturate pentobarbital did not significantly alter retention.

Conclusions

These findings indicate that propofol, in contrast to other commonly used sedatives, enhances emotional memory consolidation when administered immediately after a stressful event by enhancing endocannabinoid signaling.
Chemical kin label in seabirds
Authors: Célérier Aurélie , Bon Cécile , Malapert Aurore , Palmas Pauline , Bonadonna Francesco
Published: April 2011

Chemical signals yield critical socio-ecological information in many animals, such as species, identity, social status or sex, but have been poorly investigated in birds. Recent results showed that chemical signals are used to recognize their nest and partner by some petrel seabirds whose olfactory anatomy is well developed and which possess a life-history propitious to olfactory-mediated behaviours. Here, we investigate whether blue petrels (
Halobaena caerulea
) produce some chemical labels potentially involved in kin recognition and inbreeding avoidance. To overcome methodological constraints of chemical analysis and field behavioural experiments, we used an indirect behavioural approach, based on mice olfactory abilities in discriminating odours. We showed that mice (i) can detect odour differences between individual petrels, (ii) perceive a high odour similarity between a chick and its parents, and (iii) perceive this similarity only before fledging but not during the nestling developmental stage. Our results confirm the existence of an individual olfactory signature in blue petrels and show for the first time, to our knowledge, that birds may exhibit an olfactory kin label, which may have strong implications for inbreeding avoidance.
Cointegration: a novel approach for the removal of environmental trends in structural health monitoring data
Authors: Cross Elizabeth J. , Worden Keith , Chen Qian
Published: April 2011

Before structural health monitoring (SHM) technologies can be reliably implemented on structures outside laboratory conditions, the problem of environmental variability in monitored features must be first addressed. Structures that are subjected to changing environmental or operational conditions will often exhibit inherently non-stationary dynamic and quasi-static responses, which can mask any changes caused by the occurrence of damage. The current work introduces the concept ofcointegration, a tool for the analysis of non-stationary time series, as a promising new approach for dealing with the problem of environmental variation in monitored features. If two or more monitored variables from an SHM system are cointegrated, then some linear combination of them will be a stationary residual purged of the common trends in the original dataset. The stationary residual created from the cointegration procedure can be used as a damage-sensitive feature that is independent of the normal environmental and operational conditions.
The determination of amino acids composition of the traditional food Potentilla anserina L. root by high‐performance liquid chromatography via fluorescent detection and mass spectrometry
Authors: Xia Lian , You Jinmao
Published: April 2011

In this study, we developed a method of liquid chromatography with fluoresce detector (LC‐FLD) and on‐line mass spectrometry identification (MSI) using 2‐[2‐(7H‐dibenzo [a, g] carbazol‐7‐yl)‐ethoxy] ethyl chloroformate (DBCEC‐Cl) as pre‐column derivatisation reagent for determination of the amino acids (AAs) in Potentilla anserina L. Separation of the derivatised AA exhibited a good baseline resolution in combination with a gradient elution. All AA derivatives give excellent linear responses with correlation coefficients of >0.9992. The detection limits of each AA were 2.60–24.3 fmol. Eighteen AAs, involving seven essential AAs, were detected in Potentilla anserina L. Quantitative recoveries of the AAs from the Potentilla anserina L. were 84–107%, and the relative standard deviation values were <1.45%. The established method in this study was sensitive and precision enough to separate and quantify AA composition of Potentilla anserina L. Good compositional data were obtained from the analysis of the AAs obtained from Potentilla anserina L. root.
Production of structured lipids containing conjugated linolenic acid: optimisation by response surface methodology
Authors: Elibal Begum , Suzen H. Funda , Aksoy H. Ayse , Ustun Guldem , Tuter Melek
Published: April 2011

Structured lipids containing conjugated linolenic acid (CLNA) were produced separately by enzymatic acidolysis reaction of corn and canola oils (CAO) with bitter gourd (Momordica charantia L) seed oil fatty acids [bitter gourd seed oil fatty acids (BGFA)]. Reactions were conducted using a commercial immobilised sn‐1,3‐specific lipase from Thermomyces lanuginosa (Lipozyme TL IM) in hexane. The effects of reaction time, substrate molar ratio, temperature and enzyme amount on incorporation yield of CLNA were investigated and optimised by response surface methodology with three‐level, two‐factor face‐centred cube design. When reactions were conducted using 10% enzyme for 3 h, the optimum reaction conditions were found for corn oil (CO) as 53.5 °C and 5.9:1 BGFA/CO molar ratio. At these conditions, the incorporation of CLNA into CO was determined as 41.4%. However, CLNA incorporation into CAO was resulted as 37% at optimum conditions which were 54.2 °C and 6.8:1 BGFA/CAO molar ratio.
Establishing new nursing roles: a case study of the English community matron initiative
Authors: Drennan Vari , Goodman Claire , Manthorpe Jill , Davies Sue , Scott Cherill , Gage Heather , Iliffe Steve
Published: April 2011

Aim and objective.  To examine the factors affecting the extent to which English policy on the introduction of community matrons for people with chronic conditions was implemented.

Background.  Improving health services for people with chronic diseases (long‐term conditions) is an international priority. In England, the new post of community matron, a case management role, was introduced. A target was set for 3000 community matrons to be in post by 2008, but this was not achieved.

Design.  A realist, pragmatic evaluation of the introduction of community matron posts.

Method.  The study used mixed methods at multiple levels: an analysis of national and local strategy and planning documents, a national survey and a stakeholder analysis using semi‐structured interviews in three primary care organisation case study sites.

Results.  National policy established targets for the introduction of community matron posts, but there was local variation in implementation. Pragmatic decisions reflected the history of local service configurations, available finance, opportunities or challenges created by other service redesigns and scepticism about the value of the community matron role. There was resistance to ‘bolt on’ nursing roles in primary care.

Conclusions.  The implementation of the community matron role is an example of how a policy imperative that valued the clinical skills and expertise of nurses was reinterpreted to fit with local patterns of service delivery. Before new nursing roles are introduced through national policies, a more nuanced understanding is required of the local factors that resist or support such changes.

Relevance to clinical practice.  There is a need for consultation and understanding of local conditions before the implementation of workforce initiatives. For clinicians, it is important to understand how the context of care shapes priorities and definitions of new nursing roles and how their expertise is recognised and used.
Enhancing health literacy and behavioural change within a tele‐care education and support intervention for people with type 2 diabetes
Authors: Long Andrew F. , Gambling Tina
Published: April 2011

Background  Behavioural change interventions for persons with chronic illness draw on a variety of theoretical approaches including motivational interviewing and shared decision making. Health literacy provides an additional, potentially powerful explanatory framework to guide research and practice.

Objective  To examine the changes in the depth and detail of diabetes‐related knowledge and confidence for persons with type 2 diabetes.

Design  Two‐year, prospective, observational study, using questionnaire data at two time points (baseline and 2 years later) and in‐depth interviews with a theoretically selected subsample.

Setting and participants  A total of 319 patients initially recruited from a deprived urban area in north‐west England

Intervention  Dedicated tele‐carer education and support, tailored to the individual circumstances of the patient.

Main outcome measures  Perceptions of confidence, levels of empowerment, learning for self‐care and most helpful aspects of the intervention.

Results  Over 90% expressed confidence in keeping their blood sugar controlled, and high levels of perceived empowerment (mean = 4.25; 95% CI, 4.17–4.33) were found. Changes in the depth and detail of diabetes‐related knowledge and confidence, from the specific to the more general, were observed and enhanced competence in translating knowledge into practice.

Discussion and conclusions  The intervention, built within a developed working partnership between tele‐carer and patient, operated at two levels: health literacy, enhancing knowledge, developing personal skills and enabling self‐control; and socio‐psychological behavioural change, tailored to individuals within their socio‐economic environments, enabling increased motivation and supportive problem‐solving. Both approaches find reflection in the findings and provide powerful explanatory lenses to interrogate the data.
Outcome of renal transplantation in children: A multi‐center national report from Iran
Authors: Otukesh Hasan , Hoseini Rozita , Rahimzadeh Nahid , Fereshtehnejad Seyed‐Mohammad , Simfroosh Naser , Basiri Abbas , Sharifian Mostafa , Hashemi Ghamar Hoseini , Falahzadeh Hosein , Derakhshan Ali , Fazel Mojtaba , Reiesee Darioush , Sayedzadeh Abdolhasan , Vazirian Shams , Nikibakhsh Ahmad Ali , Moghadam Ali Ghafari , Mohamadzadeh Hashem , Naderi Ali , Isfahani Taher , Larijani Faezeh , Shorkhi Hadi , Pasha Abazar Akbarzadeh , Shahbazian Heshmatollah , Valavi Ehsan , Mortazavi Fakhrolsadat , Gheisari Allaleh
Published: April 2011

Otukesh H, Hoseini R, Rahimzadeh N, Fereshtehnejad S‐M, Simfroosh N, Basiri A, Sharifian M, Hashemi GH, Falahzadeh H, Derakhshan A, Fazel M, Reiesee D, Sayedzadeh A, Vazirian S, Nikibakhsh AA, Moghadam AG, Mohamadzadeh H, Naderi A, Isfahani T, Larijani F, Shorkhi H, Pasha AA, Shahbazian H, Valavi E, Mortazavi F, Gheisari A. Outcome of renal transplantation in children: A multi‐center national report from Iran.  Pediatr Transplantation 2011: 15: 533–538. © 2011 John Wiley & Sons A/S.

Abstract:  The outcome of pediatric renal transplantation was previously reported by a single‐center study at the year 2006. Therefore, we aimed to evaluate and report the characteristics and outcome of renal pediatric renal transplantation in a multi‐center nationwide study. In this nationwide report, medical records of 907 children (≤18 yr) with renal transplantation in eight major pediatric transplant centers of Iran were recorded. These 907 patients received a total of 922 transplants. All children who failed to follow‐up were excluded. Rather than baseline characteristics, graft and patient outcomes were considered for survival analysis. For further analysis, they were divided into two groups: patients who had graft survival time more than 10 yr (n = 91) and the ones with graft survival time of equal or less than 10 yr (n = 831). Of 922 recipients, 515 (55.8%) were boys and 407 (44.2%) were girls with the mean age of 13.10 (s.d. = 3.54) yr. DGF and AR were occurred in 10% and 39.5% of the transplanted children, respectively. Transplantation year, dialyzing status before transplantation, DGF, and AR were significant enough to predict graft survival in cox regression model (overall model: p < 0.001). Nowadays, there is a successful live donor pediatric renal transplantation in Iran. Graft survival has improved in our recipients and now the graft survival rates are near to international standards.
Scavenger receptor A index and coronary thrombus in patients with acute ST elevation myocardial infarction
Authors: Emura Iwao , Usuda Hiroyuki , Fujita Toshio , Ebe Katsuya , Nagai Tsuneo
Published: April 2011

To examine the relationship between the scavenger receptor A (SRA) index (the number of SRA+ cells observed in 10 high power fields of peripheral blood (PB) smear samples; normal upper limit <30) and coronary thrombus, 389 thrombi obtained from 393 patients with acute ST elevation myocardial infarction were examined. Thrombi were classified into platelets (PT), mixed (MT), fibrin‐rich (FT) and organizing thrombi (OT); 387, 269, 57 and 29 cases were detected, respectively. Patients were divided into group A (PT only, 89 cases), B (containing MT and PT but not FT, 243 cases), and C (containing FT, 57 cases). SRA+ cells had infiltrated into all FT cases and 147 of the 269 MT, but no PT. At hospitalization, the SRA index exceeded 30 in 276 patients. PT was observed in 274 cases, and MT and FT (residual mural thrombus; RMT) observed in 230. Infarct‐related coronary artery was thought to be totally and rapidly occluded by PT that had formed as a result of severe stenosis due to extrusion of plaque content or growth of RMT. An abnormal increase of SRA+ cells is considered to be a useful finding to detecting the presence of PT and, probably, RMT.
Corneal invasion by hemangiosarcoma in a horse
Authors: Pinn Toby L. , Cushing Tim , Valentino Lorie Moore , Koch Seth A.
Published: April 2011

A 15‐year‐old gray Arabian gelding presented for evaluation of a lateral limbal mass extending across approximately 30% of the cornea. Grossly, the raised mass appeared nonpigmented, smooth, and irregular in shape, with an area of central necrosis and serosanguinous discharge. The mass was removed via lamellar keratectomy and histopathologic evaluation revealed features characteristic of hemangiosarcoma (HSA), including irregular vascular channels lined by a plump spindle cell population. Immunohistochemistry results showed that the neoplastic cells lining the vascular channels present diffuse and strong cytoplasmic reaction with von Willebrand Factor and the perivascular spindle cells exhibit moderate cytoplasmic reaction for smooth muscle actin. A lack of cytokeratin staining definitively excluded a diagnosis of atypical squamous cell carcinoma. Smooth muscle actin staining of the perivascular cells adjacent to the neoplastic endothelial cells is not a feature commonly described in HSA and has not been reported in previous cases of equine HSA. The horse remained in good health 21 months postkeratectomy and has exceeded the survival time of previously documented equine ocular HSA cases where more extreme surgical excision was performed.
Superficial corneal squamous cell carcinoma occurring in dogs with chronic keratitis
Authors: Dreyfus Jennifer , Schobert Charles S. , Dubielzig Richard R.
Published: April 2011

Objective Canine corneal squamous cell carcinoma (SCC) is a rare tumor, with only eight cases previously published in the veterinary literature. The Comparative Ocular Pathology Lab of Wisconsin (COPLOW) has diagnosed 26 spontaneously occurring cases, 23 in the past 4 years. This retrospective study describes age and breed prevalence, concurrent therapy, biologic behavior, tumor size and character, and 6‐month survival rates after diagnosis.

Results A search of the COPLOW database identified 26 corneal SCC cases diagnosed from 1978 to 2008. There is a strong breed predilection (77%) in brachycephalic breeds, particularly those prone to keratoconjunctivitis sicca. The mean age was 9.6 years (range 6–14.5 years). Follow‐up information >6 months was available for 15 of 26 cases. Recurrence occurred in the same eye in nine cases, seven of which were incompletely excised at the time of first keratectomy. No cases were known to have tumor growth in the contralateral eye and no cases of distant metastases are known. Where drug history is known, 16 of 21 dogs had a history of treatment with topical immunosuppressive therapy (cyclosporine or tacrolimus) at the time of diagnosis.

Conclusion Chronic inflammatory conditions of the cornea and topical immunosuppressive therapy may be risk factors for developing primary corneal SCC in dogs. SCC should be considered in any differential diagnosis of corneal proliferative lesions. Superficial keratectomy with complete excision is recommended, and the metastatic potential appears to be low.
Changing diet and physical activity to reduce gestational weight gain: a meta‐analysis
Authors: Gardner B. , Wardle J. , Poston L. , Croker H.
Published: April 2011

Excessive pregnancy weight gain is associated with adverse maternal and child health outcomes. Intervention developers have assumed that adopting a healthier diet and increasing physical activity in pregnancy can limit weight gain, but evaluations of such interventions have yielded mixed results. Recent reviews of this literature have not identified defining characteristics of effective interventions. We systematically reviewed 10 published controlled trials of interventions that aimed to reduce gestational weight gain through changes in diet or physical activity. Characteristics of the sample, intervention content and delivery, and methodology were categorized. Meta‐analysis showed that, overall, diet and physical activity change was effective in reducing gestational weight gain, but there was considerable heterogeneity in outcomes. Our analysis points to sample characteristics and aspects of intervention design, content, delivery and evaluation which differ between studies and may explain variation in effectiveness. Failure to evaluate changes in behaviour or its psychological determinants, and under‐reporting of intervention content, may obscure identification of the processes by which weight change is effected. This limits our ability to discern active intervention ingredients. We suggest that behaviour‐based gestational weight gain reduction interventions be more systematically designed, evaluated and reported to build on insights from behavioural science.
A Method for Assessing Reactions of Water Vapor with Materials in High‐Speed, High‐Temperature Flow
Authors: dos Santos e Lucato Sergio L. , Sudre Olivier H. , Marshall David B.
Published: April 2011

A simple method is described for measuring material erosion by reaction with water vapor under high‐speed flow conditions, with H2O partial pressures, velocities, temperatures, and erosion rates representative of those experienced in gas turbine engines. A water vapor jet is formed by the feeding water at a controlled rate into a capillary inside a tube furnace, where the large expansion of vaporization within the confines of the capillary accelerates the jet. With modest flow rates of liquid water, steam jets with temperatures up to ∼1400°C and velocities in the range 100–300 m/s have been achieved. The partial pressure of water vapor in the 100% steam jet is the same as in an industrial turbine operating at 10 atm total pressure with 10% water vapor. In preliminary experiments with SiC, erosion rates of the order of 1 μm/h have been observed.
Effects of Sintering and Annealing Temperature on Fabrication of Transparent Lu2Ti2O7 by Spark Plasma Sintering
Authors: An Liqiong , Ito Akihiko , Goto Takashi
Published: April 2011

Transparent lutetium titanate (Lu2Ti2O7) was fabricated by reactive spark plasma sintering. Effects of sintering and annealing temperature on the microstructure, optical and mechanical properties of Lu2Ti2O7 bodies were investigated. Pyrochlore Lu2Ti2O7 was obtained at above 1273 K and a full dense specimen was obtained above 1373 K. The average grain size increased from 0.22 to 10.85 μm up to 1773 K and abnormal grain growth occurred at 1823 K. The Lu2Ti2O7 body obtained at 1723 K for 2.7 ks for sintering and 1023 K for 21.6 ks for annealing shows the maximum transmittance with a thickness of 1 mm of 74% at a wavelength of 2000 nm. The hardness was dependent on the relative density and the grain size, while the fracture toughness slightly decreased with increasing annealing and sintering temperatures.
The association between 5‐min Apgar score and mortality disappears after 24 h at the borderline of viability
Authors: Lagatta Joanne , Yan Ke , Hoffmann Raymond
Published: April 2011

Aim:  To quantify the relationship between 5‐min Apgar scores and infant mortality for infants at the borderline of viability.

Methods:  Cohort study of 7008 infants 23–25 weeks’ gestation using 2002 US National Center for Health Statistics data. Using Cox proportional‐hazards models, we quantified the relationship between Apgar score and infant mortality for all infants, and then infants surviving their first 24 h. Models were adjusted for gestational age, birth weight, gender, delivery method, plurality, maternal race, marital status and education.

Results:  Within one year, 46% of infants died. Of the non‐survivors, deaths within 24 h were more common among infants with Apgar scores 0–3 (83%) than among infants with Apgar scores 7–10 (13%). When including all infants and adjusting for potential confounders, each 1‐point increase in Apgar score decreased the hazard of mortality by 0.82. However, after excluding infants who died within 24 h, the hazard ratio increased to 0.95; although statistically significant, the practical impact was negated.

Conclusions: For 23–25 week gestation infants surviving the first 24 h, the Apgar score loses clinical significance. Clinicians should be aware of the limitations of clinical assessments in the delivery room.
Treatment of Herpes Labialis: Comparison of Two OTC Drugs and Untreated Controls
Authors: MCCARTHY JAMES P. , BROWNING WILLIAM D. , TEERLINK CRAIG , VEIT GEORGE
Published: April 2011

Statement of the Problem:  Rapid resolution of active herpes labialis lesions is of great benefit to the patient not only in terms of controlling pain and disfigurement, but in disruption of needed dental treatment.

Purpose of the Study:  Using three groups, this retrospective study investigated the time required to complete healing and the loss of discomfort.

Methods and Materials:  Based on 180 completed surveys, responses were divided into three groups: One group used Abreva (GlaxoSmithKline, Parsippany, NJ, USA). The second used Viroxyn (Quadex Pharmaceuticals, West Jordan, UT, USA). The third group, the Control group, consisted of untreated lesions. All three groups were asked about past experiences with lesions treated using Abreva and/or Viroxyn, and lesions which were left untreated. In addition, 58 participants who had used Viroxyn only responded. Participants were provided standardized responses from which to choose.

Results:  For both the time to healing and time to loss of discomfort, participants in both the Abreva and Viroxyn groups experienced significant improvements. Relative to the Abreva, Viroxyn provided significant improvement in both outcomes (all t‐tests; all p < 0.001). Relative to the Control group, Viroxyn and Abreva offered an 8.0 and 4.0 day reduction in time to healing, respectively. Loss of discomfort occurred within 3.0 days and 1 hour for Abreva and Viroxyn, respectively.

Conclusion:  Relative to the untreated controls, both Abreva and Viroxyn offered a significant reduction in both the time to healing and time to loss of discomfort. Furthermore, Viroxyn offered a significant reduction relative to Abreva.

CLINICAL SIGNIFICANCE

Providing care to patients with active lesions greatly increases the risk of spread of infection from one site to another and to members of the dental team. Precautions include the use of special personal protective equipment and limiting treatment during active outbreaks to urgent care only. Accordingly, any treatment that shortens healing time for active lesions would contribute significantly to the health and well‐being of the patient and the dental team.

(J Esthet Restor Dent 24:103–111, 2012)
Ionizing radiation absorption of surgeons and endoscopy nurses during endoscopic retrograde cholangiopancreatography
Authors: Lo Irene , Lau Stephanie H.Y. , Kwok Kam‐Hung , Kao Sau‐San , Cheung Moon‐Tong
Published: April 2011

Objective:  Exposure of surgeons and nurses to radiation during endoscopic retrograde cholangiopancreatography (ERCP) has not been studied in our locality. Recently, data suggest that cataracts can occur at doses far lower than the permissible occupational limits. The present study is to determine the amount of radiation absorbed by surgeons and nurses while carrying out ERCP.

Methods:  We prospectively recorded the radiation absorption of three surgeons and two nurses during all ERCP procedures for 6 months. Radiation absorption was measured by wearing thermoluminescent dosimeters specifically for measuring eye lens, finger and whole‐body dose. Results were compared with standards set by the International Commission on Radiation Protection. The difference in absorbed radiation to different parts of the body among each individual was evaluated. The number of ERCP procedures a surgeon can tolerate before reaching the occupational limit was determined. Ways to minimise radiation exposure are discussed.

Results:  Three surgeons carried out a total of 134 ERCP, while two nurses assisted in 255 ERCP over a period of 6 months. The mean yearly whole‐body, eyes and fingers‐absorbed dose for surgeons were 0.19 mSv, 0.25 mSv and 0.62 mSv, respectively; whereas those for nurses were 0.1 mSv, 0.84 mSv and 1.07 mSv, respectively. They were all well below the international occupational limit. Among the whole‐body dose, eye lens dose and fingers dose, eye lens dose was the first factor that reached the occupational limit.

Conclusion:  The current radiation safety practice in our endoscopy suite is satisfactory. Human eyes are more vulnerable to radiation damage when compared with the rest of the body. Wearing lead‐eyeglasses during ERCP is mandatory.
Reviewing the standard of care in pancreatic adenocarcinoma: A critical appraisal
Authors: Basu Somprakas , Srivastava Vivek , Shukla Vijay Kumar
Published: April 2011

Treatment of pancreatic adenocarcinoma is still a great challenge to the surgeon. Although recent investigation and treatment protocols have redefined the limits of resectability and adjuvant care, survival outcome still remains dismally low. Because surgical resection of localized disease remains the only hope for curing pancreatic adenocarcinoma, all advances in diagnostic imaging and perioperative care have been aimed at improving the surgical outcome. In the present article, we discuss new developments and the existing controversies in the diagnosis, staging, determination of resectability, and the progress in surgical technique, palliation and, importantly, adjuvant and neoadjuvant therapy, and highlight the latest standard of care wherever possible. Where consensus is lacking, available literature is discussed to narrow the debate and provide a working formula for the readers at large. It is finally understood that for the best outcome, treatment should be tailored to the patient. Although surgical outcome improves in expert hands, the overall survival remains poor irrespective of centres.
Endovascular stenting of descending aorta for retrograde type A dissection
Authors: Chan Howard H.Y. , Wan Innes Y.P. , Shum Chung‐Nin , Wan Song , Underwood Malcolm J.
Published: April 2011

Surgical interposition graft replacement of the ascending aorta, irrespective of antegrade or retrograde type, has traditionally been the standard treatment of all type A aortic dissection. However, open aortic repair carries high surgical risks and mortality. Recent studies showed that endovascular stenting for retrograde type of aortic dissection might have a high success rate and is considered to be less invasive. We report a case of type A aortic dissection, who was diagnosed to be retrograde type according to a 3‐D reconstruction computed tomography scan and was managed successfully with endovascular stenting in the proximal descending aorta. Complete resolution of the false lumen in the ascending and descending aorta was achieved 2 years after the stenting.
High‐Temperature Oxidation of Y2O3‐Doped Al2O3 Matrix Composites Dispersed with Nano‐Ni Particles
Authors: Nanko Makoto , Maruoka Daisuke , Sato Yoku
Published: April 2011

The oxidation kinetics of Y2O3‐doped Al2O3‐based composites dispersed with 5 vol% nano‐Ni particles was investigated at temperatures ranging from 1200° to 1350°C in air. The oxidized zone consisted of Al2O3 matrix and NiAl2O4, which was an oxidation product and a thin surface NiAl2O4 layer. The growth of the oxidized zone followed a parabolic manner, which means that mass transport in the oxidized zone was the rate‐controlling process. Doping of Y2O3 into Al2O3 matrix decreases growth rate of the oxidized zone. The value of the apparent activation energy was 681 kJ/mol, which was larger than that of nondoped Ni/Al2O3 composites.
A New Highly Bioactive Composite for Bone Tissue Repair
Authors: Bellucci Devis , Cannillo Valeria , Sola Antonella
Published: April 2011

In the last few years several attempts have been made to combine hydroxyapatite (HA) with bioactive glasses of different composition, with the aim to obtain composite materials with improved bioactivity or mechanical properties for hard tissue surgery applications. However, high‐temperature treatments are usually required in order to sinter HA‐based composites, causing the bioactive glass to crystallize into a glass–ceramic, with possible negative effects on its bioactivity. Recently, a new glass composition, named BioK and inspired by the 45S5 Bioglass®, has been formulated by substituting the sodium oxide with the potassium oxide. The potassium oxide is expected to reduce the tendency to crystallize of the parent glass. In this work, for the first time the BioK is applied to realize HA‐based composites. The novel samples can be sintered at a relative low temperature (750°C) compared with the widely studied HA/45S5 Bioglass® composites. The new glass formulation and the relatively low sintering temperature of the BioK‐based composites greatly help to preserve the amorphous nature of the glass. According to in vitro tests, this has excellent effects in terms of bioactivity. Moreover Vickers microindentation measurements show that the BioK‐containing composites preserve their local mechanical properties during immersion in body fluids.