bluuebunny/crossref_metadata_2025 huggingface dataset:
A history of an internet exchange point
Authors: Cardona Restrepo Juan Camilo , Stanojevic Rade
Published: April 2012

In spite of the tremendous amount of measurement efforts on understanding the Internet as a global system, little is known about the 'local' Internet (among ISPs inside a region or a country) due to limitations of the existing measurement tools and scarce data. In this paper, empirical in nature, we characterize the evolution of one such ecosystem of local ISPs by studying the interactions between ISPs happening at the Slovak Internet eXchange (SIX). By crawling the web archive waybackmachine.org we collect 158 snapshots (spanning 14 years) of the SIX website, with the relevant data that allows us to study the dynamics of the Slovak ISPs in terms of: the local ISP peering, the traffic distribution, the port capacity/utilization and the local AS-level traffic matrix. Examining our data revealed a number of invariant and dynamic properties of the studied ecosystem that we report in detail.
The top ten similarities between playing hockey and building a better internet
Authors: Arlitt Martin
Published: April 2012

Time tends to pass more quickly than we would like. Sometimes it is helpful to reflect on what you have accomplished, and to derive what you have learned from the experiences. These "lessons learned" may then be leveraged by yourself or others in the future. Occasionally, an external event will motivate this self reflection. For me, it was the 50th anniversary reunion of the St. Walburg Eagles, held in July 2011. The Eagles are a full-contact (ice) hockey team I played with between 1988 and 1996 (the Eagles ceased operations twice during this period, which limited me to four seasons playing with them), while attending university. What would I tell my friends and former teammates that I had been doing for the past 15 years? After some thought, I realized that my time as an Eagle had prepared me for a research career, in ways I would never have imagined. This article (an extended version with color photos is available in [1]) shares some of these similarities, to motivate others to reflect on their own careers and achievements, and perhaps make proactive changes as a result.
The essential elements of successful innovation
Authors: Kalmanek Charles
Published: April 2012

It has become a truism that innovation in the information and communications technology (ICT) fields is occurring faster than ever before. This paper posits that successful innovation requires three essential elements: a need, know-how or knowledge, and favorable economics. The paper examines this proposition by considering three technical areas in which there has been significant innovation in recent years: server virtualization and the cloud, mobile application optimization, and mobile speech services. An understanding of the elements that contribute to successful innovation is valuable to anyone that does either fundamental or applied research in fields of information and communication technology.
Atrial septostomy benefits severe pulmonary hypertension patients by increase of left ventricular preload reserve
Authors: Koeken Yvette , Kuijpers Nico H. L. , Lumens Joost , Arts Theo , Delhaas Tammo
Published: April 2012

At present, it is unknown why patients suffering from severe pulmonary hypertension (PH) benefit from atrial septostomy (AS). Suggested mechanisms include enhanced filling of the left ventricle, reduction of right ventricular preload, increased oxygen availability in the peripheral tissue, or a combination. A multiscale computational model of the cardiovascular system was used to assess the effects of AS in PH. Our model simulates beat-to-beat dynamics of the four cardiac chambers with valves and the systemic and pulmonary circulations, including an atrial septal defect (ASD). Oxygen saturation was computed for each model compartment. The acute effect of AS on systemic flow and oxygen delivery in PH was assessed by a series of simulations with combinations of different ASD diameters, pulmonary flows, and degrees of PH. In addition, blood pressures at rest and during exercise were compared between circulations with PH before and after AS. If PH did not result in a right atrial pressure exceeding the left one, AS caused a left-to-right shunt flow that resulted in decreased oxygenation and a further increase of right ventricular pump load. Only in the case of severe PH a right-to-left shunt flow occurred during exercise, which improved left ventricular preload reserve and maintained blood pressure but did not improve oxygenation. AS only improves symptoms of right heart failure in patients with severe PH if net right-to-left shunt flow occurs during exercise. This flow enhances left ventricular filling, allows blood pressure maintenance, but does not increase oxygen availability in the peripheral tissue.
Cardiac resynchronization therapy modulation of exercise left ventricular function and pulmonary O2 uptake in heart failure
Authors: Tomczak Corey R. , Paterson Ian , Haykowsky Mark J. , Lawrance Richard , Martellotto Andres , Pantano Alfredo , Gulamhusein Sajad , Haennel Robert G.
Published: April 2012

To better understand the mechanisms contributing to improved exercise capacity with cardiac resynchronization therapy (CRT), we studied the effects of 6 mo of CRT on pulmonary O2 uptake (V̇o2) kinetics, exercise left ventricular (LV) function, and peak V̇o2 in 12 subjects (age: 56 ± 15 yr, peak V̇o2: 12.9 ± 3.2 ml·kg−1·min−1, ejection fraction: 18 ± 3%) with heart failure. We hypothesized that CRT would speed V̇o2 kinetics due to an increase in stroke volume secondary to a reduction in LV end-systolic volume (ESV) and that the increase in peak V̇o2 would be related to an increase in cardiac output reserve. We found that V̇o2 kinetics were faster during the transition to moderate-intensity exercise after CRT (pre-CRT: 69 ± 21 s vs. post-CRT: 54 ± 17 s, P < 0.05). During moderate-intensity exercise, LV ESV reserve (exercise − resting) increased 9 ± 7 ml (vs. a 3 ± 9-ml decrease pre-CRT, P < 0.05), and steady-state stroke volume increased (pre-CRT: 42 ± 8 ml vs. post-CRT: 61 ± 12 ml, P < 0.05). LV end-diastolic volume did not change from rest to steady-state exercise post-CRT ( P > 0.05). CRT improved heart rate, measured as a lower resting and steady-state exercise heart rate and as faster heart rate kinetics after CRT (pre-CRT: 89 ± 12 s vs. post-CRT: 69 ± 21 s, P < 0.05). For peak exercise, cardiac output reserve increased significantly post-CRT and was 22% higher at peak exercise post-CRT (both P < 0.05). The increase in cardiac output was due to both a significant increase in peak and reserve stroke volume and to a nonsignificant increase in heart rate reserve. Similar patterns in LV volumes as moderate-intensity exercise were observed at peak exercise. Cardiac output reserve was related to peak V̇o2 ( r = 0.48, P < 0.05). These findings demonstrate the chronic CRT-mediated cardiac factors that contribute, in part, to the speeding in V̇o2 kinetics and increase in peak V̇o2 in clinically stable heart failure patients.
Socioeconomic Conditions and Risk of Mental Depression: An Empirical Analysis for Brazilian Citizens
Authors: Santos Marcelo Justus dos , Kawamura Henrique Coelho , Kassouf Ana Lúcia
Published: April 2012

The aim of this study is to investigate whether there is any relationship between socioeconomic factors and mental depression, specifically in connection with family income and education. Our empirical model was estimated using the database of three National Household Sampling Surveys (1998, 2003, and 2008) and their special supplements on the health status of the Brazilian population. Analyses for men and women were conducted separately. Family income proved to be a protective factor against depression for both men and women. With regard to the effects of education, the estimates indicate that the maximum risk of depression occurs when women have approximately four years of schooling and men have about eight. Above these levels, the risk decreases as schooling years increase.
Pancreatic Pseudocyst: Therapeutic Dilemma
Authors: Khanna A. K. , Tiwary Satyendra K. , Kumar Puneet
Published: April 2012

Pancreatic pseudocyst develops in both acute and chronic pancreatitis. It is an entity likely to either remain asymptomatic or develop devastating complications. Despite being diagnosed easily, treatment exercise is still at crossroads whether in the form of internal or external drainage or endoscopic, laparoscopic, or open intervention with a good radiological guidance. The therapeutic dilemma whether to treat a patient with a pancreatic pseudocyst, as well as when and with what technique, is a difficult one. This paper is intended to get information about diagnostic and therapeutic exercises most appropriate for acute and chronic pancreatic pseudocyst.
Symptomatic Squamous Papilloma of the Uvula: Report of a Case and Review of the Literature
Authors: Goodstein Lindsay A. , Khan Andleeb , Pinczewski Joel , Young VyVy N.
Published: April 2012

Background. Oral squamous papillomas are benign pedunculated masses that grow most commonly on the palate. These benign lesions rarely cause symptoms.Methods. Here we present the case of a large, elongated squamous papilloma of the uvula causing dysphagia. We also review pertinent literature related to these lesions.Results. This patient underwent surgical excision of her atypically symptomatic oral lesion, with complete resolution of symptoms.Conclusion. Oral squamous papillomas are benign lesions which are usually asymptomatic. Dysphagia due to a squamous papilloma of the uvula has only been reported once in the literature previously. The development of symptoms such as dysphagia due to squamous papilloma of the uvula is uncommon; however this may be more likely in the presence of particularly large lesions.
A Mathematical Model for the Dynamics of a Fish Algae Consumption Model with Impulsive Control Strategy
Authors: Yang Jin , Zhao Min
Published: April 2012

A dynamic mathematical model of fish algae consumption with an impulsive control strategy is proposed and analyzed in detail. It is shown that the system has a globally asymptotically stable algae‐eradication periodic solution which can be obtained using the Floquet theory of impulsive differential equations and small‐amplitude perturbation techniques. The conditions for the permanence of the system can also be determined. Numerical results for impulsive perturbations show the rich dynamic behavior of the system. All these results may be useful in controlling eutrophication.
Cypermethrin-Induced Toxic Effect on Glycogen Metabolism in Estuarine Clam,Marcia Opima(Gmelin, 1791) of Ratnagiri Coast, Maharashtra
Authors: Tendulkar Medha , Kulkarni Arvind
Published: April 2012

Cypermethrin is a synthetic pyrethroid class of insecticide. Toxic effects of cypermethrin were studied by selectingMarcia opimaas an animal model. Cypermethrins effect on the total glycogen content of mantle, gill, foot, hepatopancreas, male gonad and a female gonad of an estuarine clam,Marcia opimawas examined. The clams were exposed to 1.58 ppm cypermethrin for acute and1/th of that concentration for chronic treatment. It was found that there was a decrease in glycogen content in various tissues as compared to control. In LC0and LC50groups, glycogen was decreased in all tissues except in hepatopancreas compared to control. This decrease is greater in mantle, gill, and foot in LC50group than the decrease in those tissues of LC0group. In chronic exposure it was found that glycogen was decreased in mantle, foot, male gonad, and female gonad when compared to the control group except in gill and hepatopancreas. Decrease in glycogen content indicates greater utilization of glycogen for metabolic purposes and too combat with cypermethrin stress. The significant increase in glycogen content in gill and hepatopancreas may be a reaction to the increase in energy demand.
An Unusual Case of a Tonsillolith
Authors: Chan John , Rashid Mamun , Karagama Yakubu
Published: April 2012

Tonsilloliths are rare calcified concretions that develop in tonsillar crypts within the substance of the tonsil or around it. Large tonsilloliths can mimic many conditions including abscesses or neoplasms. Given the wide range of differentials, it is difficult to diagnose tonsilloliths unless there is a considered emphasis on thorough history taking, careful inspection and a detailed characterisation of the lesion through digital palpation. This may be further supplemented with investigations such as plain radiography and computer tomography. Here, we illustrate a case with risk factors of oropharyngeal cancer and a history of fish bone impaction in the throat that was initially diagnosed as a “tonsillar foreign body” which turned out eventually to be a large tonsillolith.
Elastic Modes of an Anisotropic Ridge Waveguide
Authors: Galinde Ameya , Koochakzadeh Masoud , Abbaspour-Tamijani Abbas
Published: April 2012

A semi-analytical method for finding the elastic modes propagating along the edge of an anisotropic semi-infinite plate is presented. Solutions are constructed as linear combinations of a finite number of the corresponding infinite plate modes with the constraint that they decay in the direction perpendicular to the edge and collectively satisfy the free boundary condition over the edge surface. Such modes that are confined to the edge can be used to approximate solutions of acoustic ridge waveguides whose supporting structures are sufficiently far away from the free edge. The semi-infinite plate or ridge is allowed to be oriented arbitrarily in the anisotropic crystal. Modifications to the theory to find symmetric and antisymmetric solutions for special crystal orientations are also presented. Accuracy of the solutions can be improved by including more plate modes in the series. Numerical techniques to find modal dispersion relations and orientation dependent modal behavior, are discussed. Results for ridges etched in single crystal Silicon are found to be in good agreement with Finite Element simulations. It is found that variations in modal phase velocity with respect to crystal orientation are not significant, suggesting that anisotropy may not be a critical issue while designing ridge waveguides in Silicon.
The Gross‐Pitaevskii Model of Spinor BEC
Authors: Yan Dongming , Ma Tian
Published: April 2012

The Gross‐Pitaevskii model of spinor Bose‐Einstein condensates
is studied. Using the abstract results obtained for infinite‐dimensional
Hamilton system, we establish the mathematical theory for the model of
spinor BEC. Furthermore, three conservative quantities of spinor BEC, that is, the energy, total particle number, and magnetization intensity, are also proved.
Stability and Hopf Bifurcation in a Computer Virus Model with Multistate Antivirus
Authors: Dong Tao , Liao Xiaofeng , Li Huaqing
Published: April 2012

By considering that people may immunize their computers with countermeasures in susceptible state, exposed state and using anti‐virus software may take a period of time, a computer virus model with time delay based on an SEIR model is proposed. We regard time delay as bifurcating parameter to study the dynamical behaviors which include local asymptotical stability and local Hopf bifurcation. By analyzing the associated characteristic equation, Hopf bifurcation occurs when time delay passes through a sequence of critical value. The linerized model and stability of the bifurcating periodic solutions are also derived by applying the normal form theory and the center manifold theorem. Finally, an illustrative example is also given to support the theoretical results.
Enhanced Hydrogen Production over C-Doped CdO Photocatalyst in NaS/NaSO Solution under Visible Light Irradiation
Authors: Gu Quan , Zhuang Huaqiang , Long Jinlin , An Xiaohan , Lin Huan , Lin Huaxiang , Wang Xuxu
Published: April 2012

The C-doped CdO photocatalysts were simply prepared by high-temperature solid-state process. The as-prepared photocatalysts were characterized by X-ray powder diffraction (XRD), diffuse reflectance spectroscopy (UV-Vis DRS), scanning electron microscopy (SEM) and X-ray photoelectron spectroscopy (XPS). The results demonstrated that the carbon was doped into CdO, resulting in the red-shift of the optical absorption of CdO. The photocatalytic behavior of CdO and C-doped CdO was evaluated under the visible light irradiation by using the photocatalytic hydrogen evolution as a model reaction. The C-doped CdO photocatalysts had higher photocatalytic activity over parent CdO under visible light irradiation. The results indicated that the H2production was due to the existence of CdS and the enhancement of visible light photocatalytic activity of H2production was originated from the doping of carbon into the CdO lattice. The probably reaction mechanism was also discussed and proposed.
Short Communication: Is Ethanol-Based Hand Sanitizer Involved in Acute Pancreatitis after Excessive Disinfection?—An Evaluation with the Use of PBPK Model
Authors: Huynh-Delerme Céline , Artigou Catherine , Bodin Laurent , Tardif Robert , Charest-Tardif Ginette , Verdier Cécile , Sater Nessryne , Ould-Elhkim Mostafa , Desmares Catherine
Published: April 2012

An occupational physician reported to the French Health Products Safety Agency (Afssaps) a case of adverse effect of acute pancreatitis (AP) in a teaching nurse, after multiple demonstrations with ethanol-based hand sanitizers (EBHSs) used in a classroom with defective mechanical ventilation. It was suggested by the occupational physician that the exposure to ethanol may have produced a significant blood ethanol concentration and subsequently the AP. In order to verify if the confinement situation due to defective mechanical ventilation could increase the systemic exposure to ethanolviainhalation route, a physiologically based pharmacokinetic (PBPK) modeling was used to predict ethanol blood levels. Under the worst case scenario, the simulation by PBPK modeling showed that the maximum blood ethanol concentration which can be predicted of 5.9 mg/l is of the same order of magnitude to endogenous ethanol concentration (mean = 1.1 mg/L; median = 0.4 mg/L; range = 0–35 mg/L) in nondrinker humans (Al-Awadhi et al., 2004). The present study does not support the likelihood that EBHS leads to an increase in systemic ethanol concentration high enough to provoke an acute pancreatitis.
TGF-β1 Induces Endothelial Cell Apoptosis by Shifting VEGF Activation of p38MAPK from the Prosurvival p38β to Proapoptotic p38α
Authors: Ferrari Giovanni , Terushkin Vitaly , Wolff Martin J. , Zhang Xiaodong , Valacca Cristina , Poggio Paolo , Pintucci Giuseppe , Mignatti Paolo
Published: April 2012

TGF-β1 and VEGF, both angiogenesis inducers, have opposing effects on vascular endothelial cells. TGF-β1 induces apoptosis; VEGF induces survival. We have previously shown that TGF-β1 induces endothelial cell expression of VEGF, which mediates TGF-β1 induction of apoptosis through activation of p38 mitogen-activated protein kinase (MAPK). Because VEGF activates p38MAPK but protects the cells from apoptosis, this finding suggested that TGF-β1 converts p38MAPK signaling from prosurvival to proapoptotic. Four isoforms of p38MAPK —α, β, γ, and δ—have been identified. Therefore, we hypothesized that different p38MAPK isoforms control endothelial cell apoptosis or survival, and that TGF-β1 directs VEGF activation of p38MAPK from a prosurvival to a proapoptotic isoform. Here, we report that cultured endothelial cells express p38α, β, and γ. VEGF activates p38β, whereas TGF-β1 activates p38α. TGF-β1 treatment rapidly induces p38α activation and apoptosis. Subsequently, p38α activation is downregulated, p38β is activated, and the surviving cells become refractory to TGF-β1 induction of apoptosis and proliferate. Gene silencing of p38α blocks TGF-β1 induction of apoptosis, whereas downregulation of p38β or p38γ expression results in massive apoptosis. Thus, in endothelial cells p38α mediates apoptotic signaling, whereas p38β and p38γ transduce survival signaling. TGF-β1 activation of p38α is mediated by VEGF, which in the absence of TGF-β1 activates p38β. Therefore, these results show that TGF-β1 induces endothelial cell apoptosis by shifting VEGF signaling from the prosurvival p38β to the proapoptotic p38α. Mol Cancer Res; 10(5); 605–14. ©2012 AACR.
Hospital-Diagnosed Late Sequelae after Female Chlamydia trachomatis Infections in 1990–2006 in Turku, Finland
Authors: Kortekangas-Savolainen Outi , Mäkinen Juha , Koivusalo Katariina , Mattila Katariina
Published: April 2012

Background: Rather little is known about the late sequelae of previously detected female Chlamydia infections. Methods: The late sequelae of previous female Chlamydia infections detected during a 15-year period in a south-western Finnish university hospital were surveyed. Hospital records of women with positive laboratory diagnoses of Chlamydia trachomatis as a sign of genital infection were collected from the years 1990–2006 and subsequently linked to known or suspected in-hospital-treated late Chlamydia complications. Results: The annual number of late complications has increased in proportion to the increasing trend of detected Chlamydia cases. 239 late complications of the total of 4,920 previously detected Chlamydia-positive infections were observed. The most frequent in-hospital-treated complications were disturbances in early pregnancy (n = 72) and low abdominal pain (n = 67). The others were 45 genital tract or pelvic infections, 34 cases of tubal or unknown infertility and 21 complications of late pregnancy and delivery. Conclusion: The late sequelae of Chlamydia infections need increasing attention in hospitals.
Successful Treatment of Two Patients with Postpartum Disseminated Intravascular Coagulation Complicated by Abdominal Compartment Syndrome
Authors: Na Quan , Liu Cai-xia , Cui Hong , Chen Jing , Liu Si-shi , Li Qiu-ling
Published: April 2012

Disseminated intravascular coagulation (DIC) and abdominal compartment syndrome (ACS) are rare complications of pregnancy, and even more rare are cases with both complications occurring concomitantly. Obstetricians are relatively unfamiliar with these types of cases, the majority of which are fatal. We describe here a primigravida with acute fatty liver of pregnancy and a multipara with placental abruption who each developed uterine inertia complicated by postpartum DIC that required total hysterectomy. They developed ACS postoperatively and required decompressive laparotomy to alleviate increased intra-abdominal pressure and end-organ dysfunction. After timely decompressive laparotomy, both patients recovered without any additional complications and were discharged within 4 weeks of their initial admission. These 2 cases serve to remind obstetricians to consider the possibility of ACS whenever there is a fresh wound in the abdominal cavity of a patient with postpartum DIC. However, even when there is severe deterioration in the condition of a patient with ACS, immediate decompressive laparotomy may not be appropriate; the timing of the procedure is very important.
Surgical Management and Clinical Prognosis of Adrenocortical Carcinoma
Authors: Dong Dexin , Li Hanzhong , Yan Weigang , Ji Zhigang , Mao Quanzong
Published: April 2012

Objective: To study the relationship between surgical management and prognosis of adrenocortical carcinoma (ACC) in order to guide the surgical management of ACC. Methods: Clinical data of 45 cases of ACC treated in our hospital were retrospectively analyzed. The 45 cases included 3 cases in stage I, 12 cases in stage II, 7 cases in stage III, and 23 cases in stage IV. 17 cases underwent complete excision, 14 cases underwent palliative excision, 8 cases had non-operative treatment and 6 cases gave up treatment. All patients were followed up from 2 to 141 months. Results: The average survival time of 31 patients with surgery was 32.46 months, and the average survival time of 14 patients without surgery was 4.75 months. There were statistically significant differences between the two groups (p < 0.01). There were no statistically significant differences between the two groups in survival time in stage III and stage IV (p > 0.05). Conclusions: Surgery is considered to be the only method to cure ACC. For ACC in stage I and II, tumor resection is the most effective treatment, and second surgical operation is recommended for local recurrence. For ACC in stage III, extensive surgical operation is recommended, and for ACC in stage IV, surgical operation has no effect on the prognosis.
Assessment of Biophysical Skin Properties at Different Body Sites in Hospitalized Old Patients: Results of a Pilot Study
Authors: Fiedler M. , Gerhardt L.-C. , Derler S. , Bischofberger G. , Hürny C. , Münzer T.
Published: April 2012

Background: Skin aging is a risk factor for a decubitus and biophysical skin properties could help to identify persons at risk. Whether such biophysical properties of aged human skin differ between areas is undetermined. Objective: To investigate whether viscoelasticity, hydration or friction differ between important areas for decubitus risk. Methods: Pilot study in 32 (18 female, 14 male) acute and subacute old patients aged 81.9 ± 5.9 years (±SD), without active skin disease after an average of 10 days of stay. Assessment of skin resilience/viscoelasticity (E) and hydration (H) at the volar forearm (VF), trochanter (TR) and the sacrum (SA), nutrition by a Mini Nutritional Assessment (MNA), total body water (TBW), lean body mass (LBM), % body fat (%F) by bioimpedance and routine laboratory parameters (hemoglobin, hematocrit, leukocytes, C-reactive protein, serum proteins and creatinine). Results: Mean body mass index (27 ± 4.2), MNA (22.5 ± 2.9), Braden score (20 ± 2.5), E (68.5 ± 6.0%) and H (38.3 ± 6.7) at any site and laboratory parameters did not differ by sex. Men had more TBW (+12 ± 1.5 liters), LBM (+9 ± 2 kg), less %F (–8.8 ± 2.1%), increased H-TR (+7.11 ± 2.8) and H-SA (+5.68 ± 2.5). Overall E-VF correlated significantly with E-TR (r2 = 0.40, p < 0.0001) and E-SA (r2 = 0.40, p < 0.0001). In contrast, skin hydration was not correlated. Conclusion: Results of forearm elasticity experiments can be used as a model for other body sites at risk for the development of pressure ulcers.
Clinical Features, DYT1 Mutation Screening and Genotype-Phenotype Correlation in Patients with Dystonia from Iran
Authors: Akbari Mohammad Taghi , Zand Zahra , Shahidi Gholam Ali , Hamid Mohammad
Published: April 2012

Objective: To test Iranian patients with primary torsion dystonia to determine the frequency of 904–906 del GAG mutation in the DYT1 (TOR1A) gene and to investigate the genotype-phenotype association for this disease. Subjects and Methods: Sixty-three patients with primary dystonia were investigated. DNA was extracted from peripheral blood and these samples were subjected to PCR-sequencing for exon 5 of the DYT1 gene. Results: Of the 63 patients, 10 (15.9%) carried the triplet GAG deletion mutation; this is a high DYT1-positive rate in comparison with other populations and the type of dystonia in this positive group was generalized in all except 1. In our patients, limbs were the most severely involved site at the time of onset and in most cases it developed to generalized form. The majority of DYT1-positive cases showed higher leg onset (5 patients, 62.5%) in comparison with higher arm onset in negative patients (20 patients, 50%). Also, the progression to generalized dystonia in DYT1-positive patients was significantly higher than in DYT1-negative patients. The mean age at onset was 8.6 ± 1.6 years (7–12 years) in DYT1-positive patients, while mean age at onset in patients with no GAG deletion mutation was higher (15.7 ± 11.5 years). Conclusions: The DYT1 904–906 del GAG mutation is responsible for some of Iranian dystonia patients, and screening for the DYT1 deletion is significant in cases with the generalized type of primary dystonia. Also, patients with leg or arm onset at a younger age are more likely to be DYT1-positive among primary torsion dystonia cases.
A Lower Prevalence of Self-Reported Fear of Falling Is Associated with Memory Decline among Older Adults
Authors: Uemura Kazuki , Shimada Hiroyuki , Makizako Hyuma , Yoshida Daisuke , Doi Takehiko , Tsutsumimoto Kota , Suzuki Takao
Published: April 2012

Background: In spite of a number of reports about various factors associated with the fear of falling (FoF) among older adults (such as age and physical function), the relationship between FoF and cognitive decline remains unclear. Objective: To determine which cognitive function is related with the prevalence of FoF in older adults. Methods: Participants were 101 older adults (mean age 75.1 years; 48.5% males). Of these, 54 older adults (53.4%) were classified as the fear group on the basis of the presence of FoF. Age, gender, the Timed Up and Go test (TUG), fall history, the Alzheimer’s Disease Assessment Scale, the Wechsler Memory Scale-Revised-Logical Memory I (WMS-LM I), the delayed memory test, digit symbol coding, digit span and verbal fluency were measured as potential relevant factors. Results: Logistic regression analysis revealed that TUG [odds ratio (OR) 1.43, 95% confidence interval (CI) 1.12–1.83; p = 0.004], WMS-LM I (OR 1.20, 95% CI 1.07–1.35; p = 0.002) and fall history (OR 4.38, 95% CI 1.53–12.51; p = 0.006) were independently associated with FoF. Conclusions: The results suggest that a lower prevalence of self-reported FoF is associated with memory decline among older adults. Insensitivity to FoF may be one of the characteristics of psychological change with memory decline.
Spectral-Domain Optical Coherence Tomography in Uveitic Macular Edema: Morphological Features and Prognostic Factors
Authors: Iannetti Ludovico , Spinucci Giovanni , Abbouda Alessandro , De Geronimo Daniele , Tortorella Paolo , Accorinti Massimo
Published: April 2012

Aim: To assess the morphological characteristics of uveitic macular edema studied with Spectralis optical coherence tomography (OCT) and to investigate the correlation between the tomographic features and visual acuity. Methods: 71 eyes of 55 patients underwent examination with Spectralis OCT (Heidelberg Engineering, Germany). Data was correlated with logMAR best-corrected visual acuity (BCVA). Results: Two morphological patterns were observed: cystoid macular edema (CME) in 69% and diffuse macular edema in 31% of eyes. BCVA was 0.2 in CME, 0.1 in diffuse edema (p = 0.008). Foveal thickness was 413.4 ± 212 µm in CME, 311.27 ± 53 µm in diffuse edema (p = 0.03). BVCA was 0.3 in eyes with serous retinal detachment (SRD), 0.2 in eyes without SRD (p = 0.02). BCVA was 0.4 in eyes with inner segment/outer segment (IS/OS) disruption, 0.1 in eyes with integrity of the IS/OS junction (p = 0.01). Conclusions: BCVA is negatively correlated with cystoid pattern, foveal thickening and SRD. Disruption of the IS/OS junction is associated with poor vision in uveitic macular edema.
Two-Year Course of Subfoveal Pigment Epithelial Detachment in Eyes with Age-Related Macular Degeneration and Visual Acuity Better than 20/40
Authors: Baba Takayuki , Kitahashi Masayasu , Kubota-Taniai Mariko , Oshitari Toshiyuki , Yamamoto Shuichi
Published: April 2012

Purpose: To investigate the course of subfoveal pigment epithelial detachments (PEDs) in eyes with age-related macular degeneration (AMD) and best-corrected visual acuity (BCVA) ≥20/40. Methods: Thirty-seven eyes of 35 patients with a subfoveal PED were divided into an avascular PED group (n = 11), a vascularized PED group due to polypoidal choroidal vasculopathy (PCV, n = 14) and an occult choroidal neovascularization (CNV) group (n = 12). Intravitreal bevacizumab or ranibizumab was given as needed. The BCVA, central foveal thickness, PED thickness, and lesion size were measured at baseline and at 2 years after the initial examination. Results: The BCVA did not change significantly in the avascular group, decreased from 0.06 ± 0.11 to 0.23 ± 0.15 logMAR units in the PCV group and from 0.12 ± 0.12 to 0.71 ± 0.70 logMAR units in the CNV group. At 2 years, the central foveal and PED thicknesses were not significantly different among the 3 groups, and the lesion was significantly larger in the PCV and CNV groups than in the avascular group. Conclusions: The vascularized PED cases had a poorer visual outcome than avascular PEDs with anti-VEGF drugs at the 2-year follow-up.
Radiation Dose Features and Solid Cancer Induction in Pediatric Computed Tomography
Authors: Pauwels Ernest K.J. , Bourguignon Michel H.
Published: April 2012

Over the past two decades technical advances and improvements have made computed tomography (CT) a valuable and essential tool in the array of diagnostic imaging modalities. CT uses ionizing radiation (X-rays) which may damage DNA and increase the risk of carcinogenesis. This is especially pertinent in pediatric CT as children are more radiosensitive and have a longer life expectancy than adults. The purpose of this paper is to review and elucidate the potential harmful effects of ionizing radiation in terms of solid cancer induction from pediatric CT scanning. In the light of scientific and technical developments, we will also discuss the possible strategies and ongoing efforts to reduce CT radiation exposure in pediatric patients. In this context, we will not ignore the fact that a well-justified CT scan may exceed its risk and have a favorable impact.
Dermoscopy of Merkel Cell Carcinoma
Authors: Dalle Stéphane , Parmentier Laurent , Moscarella Elvira , Phan Alice , Argenziano Giuseppe , Thomas Luc
Published: April 2012

Introduction: Merkel cell carcinoma (MCC) is an aggressive cutaneous tumor whose clinical presentation, usually a pink nodule, is not specific. We aimed in this study to determine the dermoscopic criteria encountered in MCC. Methods: From our image database we selected the patients diagnosed with MCC and scored the dermoscopic criteria shown by these tumors. Results: Ten patients coming from three different academic hospitals were studied. Vascular structures were the more relevant dermoscopic features. In 8 out of 10 (80%) patients a polymorphic vascular pattern was seen, composed of milky-red clods/areas in association with one or more additional vascular structures. Conclusion: Although an overlap existed between the dermoscopic features observed in MCC and amelanotic melanoma, the presence of a polymorphous vascular pattern may constitute an additional clinical clue to accurately diagnose this rare tumor.
Alternative Procedure to Allow Continuation of Dapsone Therapy despite Serious Adverse Reaction in a Case of Dapsone-Sensitive Erythema Elevatum Diutinum
Authors: Seneschal Julien , Guillet Stéphanie , Ezzedine Khaled , Taïeb Alain , Milpied Brigitte
Published: April 2012

Dapsone has potent anti-inflammatory effects and remains an effective therapy in a variety of skin disorders: cutaneous vasculitis, neutrophilic dermatoses and blistering disorders. However it may cause a severe idiosyncratic reaction compatible with drug-induced DRESS (drug reaction with eosinophilia and systemic symptoms) leading to the discontinuation of the treatment despite its effectiveness. We report a 68-year-old woman who was successfully treated with dapsone for erythema elevatum diutinum. However she developed a hypersensitivity syndrome compatible with DRESS with fever, skin rash and acute hepatitis confirmed in vitro by the presence of circulating dapsone-specific T cells. Dapsone therapy was suspended, leading to a relapse of erythema elevatum diutinum. While alternative therapies were totally ineffective in our patient to improve her skin condition, we proposed a tolerance induction protocol to dapsone with excellent results.
Tetrasomy 9p Mosaicism Associated with a Normal Phenotype in Two Cases
Authors: Papoulidis I. , Kontodiou M. , Tzimina M. , Saitis I. , Hamid A.B. , Klein E. , Kosyakova N. , Kordaß U. , Kunz J. , Siomou E. , Nicolaides P. , Orru S. , Thomaidis L. , Liehr T. , Petersen M.B. , Manolakos E.
Published: April 2012

Tetrasomy 9p is a rare chromosomal syndrome and about 30% of known cases exhibit mosaicism. Approximately 50 of the reported cases with tetrasomy 9p mosaicism show a characteristic facial appearance, growth failure, and developmental delay. However, 3 patients with mosaicism for isochromosome 9p and a normal phenotype have also been reported. We report 2 additional cases of clinically normal young females with tetrasomy 9p mosaicism, one of whom also exhibited X chromosome aneuploidy mosaicism leading to an overall of 6 different cell lines. STR analysis performed on this complex mosaic case indicated that the extra isochromosome was of maternal origin while the X chromosome aneuploidy was of paternal origin, indicating a postzygotic event.
Frozen Section-Guided Wide Local Excision in the Treatment of Recurrent Scrotal Extramammary Paget’s Disease
Authors: Li Bingkun , Li Liping , Wang Xiang , Xu Ke , Fang Zujun , Ding Qiang
Published: April 2012

Background: A wide excision is generally accepted to be the standard modality of treatment for scrotal extramammary Paget’s disease (EMPD). The disease has a recurrence rate of about 10% and a second wide excision is still the chief treatment. We investigated the therapeutic methods for recurrent scrotal EMPD. Methods: We retrospectively studied the therapeutic methods and prognosis of 26 cases of recurrent EMPD. Seventy-two cases of primary scrotal EMPD served as controls. All of the cases were treated with frozen section-guided wide local excision. Results: There was no significant difference in the follow-up period of the recurrent cases before recurrence (p = 0.3228), local recurrence rate (p = 0.449), and total recurrence rate (p = 0.100) between the two groups, respectively. There is a favorable trend of worse mortality rate in the recurrence group (p = 0.056). The rate of inguinal lymph node metastasis was higher in the group with recurrent disease than in the control group (p = 0.017). Conclusion: Wide excision of the lesion still appears to be the most effective modality of treatment for recurrent scrotal Paget’s disease. Inguinal lymphadenectomy or sentinel lymph node biopsy should be offered to patients with primary lesions.
The Value of BP230 Enzyme-Linked Immunosorbent Assay in the Diagnosis and Immunological Follow-Up of Bullous Pemphigoid
Authors: Le Saché-de Peufeilhoux L. , Ingen-Housz-Oro S. , Hue S. , Sbidian E. , Valeyrie-Allanore L. , Ortonne N. , Roujeau J.C. , Wolkenstein P. , Chosidow O. , André C.
Published: April 2012

Background: The value of 230-kDa bullous pemphigoid antibody (BP230) enzyme-linked immunosorbent assay (ELISA) for the diagnosis of bullous pemphigoid (BP) was investigated, but in the immunological follow-up of the disease remains unknown. Objective: Evaluation of BP230 ELISA for diagnosis, follow-up and prediction of relapse in BP. Methods: Monocenter retrospective and prospective study. Patients with typical BP. Detection of autoantibodies by indirect immunofluorescence (IIF), BP180 and BP230 ELISA tests at diagnosis, during the treatment (disease control or failure) and at treatment stop (relapse or not 3 months after). Results: 74 patients were included. At diagnosis, BP230 ELISA sensitivity was lower than IIF and BP180 ELISA. Combining both ELISA added a weak gain of sensitivity. Both tests paralleled the clinical evolution, especially in case of disease control. At the end of the treatment, BP230 ELISA was not different in patients with or without relapse. Conclusion: In routine practice, BP230 ELISA does not seem to be a useful additional test in typical BP.
Psychological Burden in Adult Neurofibromatosis Type 1 Patients: Impact of Disease Visibility on Body Image
Authors: Granström Sofia , Langenbruch Anna , Augustin Matthias , Mautner Victor-Felix
Published: April 2012

Aim: To evaluate the impact of disease visibility on psychological stress factors in neurofibromatosis type 1 (NF1) and to explore the body image of NF1 patients. Methods: 228 adult NF1 patients participated in this cross-sectional survey. The questionnaire assessed perceived disease visibility and patients’ body image. Outcome parameters were depression, distress and quality of life. Mediation models were performed to test if body experience mediated the effect of disease visibility on outcome parameters. Results: Adult NF1 patients had a negative body image, expressed by bodily insecurity/uneasiness and fewer feelings of attractiveness and self-confidence. Compared to the body image of patients with other disfiguring diseases, patients with NF1 felt less attractive, displayed less self-confidence (women: p < 0.001; men: p < 0.001) and were more insecure/uneasy and sexually dissatisfied with their bodies (men: p < 0.001; women: p ≤ 0.12, d = 0.28). The found effect of disease visibility on psychological stress was completely mediated by how patients experienced their bodies. Conclusions: Our study shed light on the importance of how NF1 patients experience and appraise their own bodies. We revealed that body image is an important link between disease visibility and psychological well-being. The body image of patients can be improved with psychotherapeutic interventions.
Giant Mongolian Macules with Bilateral Ocular Involvement: Case Report and Review
Authors: Köse Osman , Huseynov Şikar , Demiriz Murat
Published: April 2012

Dermal melanocytosis is characterized by the presence of spindle-shaped melanocytes in the dermis. The most common form is Mongolian spots. A 15-month-old girl from Azerbaijan had a systematized dark blue-gray hyperpigmentation on her shoulder, back and extremities. The hyperpigmentation was also found on both sclera and choroidal areas, without any other facial involvement. On histopathological examination, dense melanocytes were found on the intermediate and deep dermis. Her physical and mental development was normal. This association of blue macules and involvement of both sclerae does not represent a distinct entity and cannot be categorized as an example of nevus of Ota.
Strictly Positive-Definite Spike Train Kernels for Point-Process Divergences
Authors: Park Il Memming , Seth Sohan , Rao Murali , Príncipe José C.
Published: April 2012

Exploratory tools that are sensitive to arbitrary statistical variations in spike train observations open up the possibility of novel neuroscientific discoveries. Developing such tools, however, is difficult due to the lack of Euclidean structure of the spike train space, and an experimenter usually prefers simpler tools that capture only limited statistical features of the spike train, such as mean spike count or mean firing rate. We explore strictly positive-definite kernels on the space of spike trains to offer both a structural representation of this space and a platform for developing statistical measures that explore features beyond count or rate. We apply these kernels to construct measures of divergence between two point processes and use them for hypothesis testing, that is, to observe if two sets of spike trains originate from the same underlying probability law. Although there exist positive-definite spike train kernels in the literature, we establish that these kernels are not strictly definite and thus do not induce measures of divergence. We discuss the properties of both of these existing nonstrict kernels and the novel strict kernels in terms of their computational complexity, choice of free parameters, and performance on both synthetic and real data through kernel principal component analysis and hypothesis testing.
A Pacific Centennial Oscillation Predicted by Coupled GCMs*
Authors: Karnauskas Kristopher B. , Smerdon Jason E. , Seager Richard , González-Rouco Jesús Fidel
Published: April 2012

Internal climate variability at the centennial time scale is investigated using long control integrations from three state-of-the-art global coupled general circulation models. In the absence of external forcing, all three models produce centennial variability in the mean zonal sea surface temperature (SST) and sea level pressure (SLP) gradients in the equatorial Pacific with counterparts in the extratropics. The centennial pattern in the tropical Pacific is dissimilar to that of the interannual El Niño–Southern Oscillation (ENSO), in that the most prominent expression in temperature is found beneath the surface of the western Pacific warm pool. Some global repercussions nevertheless are analogous, such as a hemispherically symmetric atmospheric wave pattern of alternating highs and lows. Centennial variability in western equatorial Pacific SST is a result of the strong asymmetry of interannual ocean heat content anomalies, while the eastern equatorial Pacific exhibits a lagged, Bjerknes-like response to temperature and convection in the west. The extratropical counterpart is shown to be a flux-driven response to the hemispherically symmetric circulation anomalies emanating from the tropical Pacific.

Significant centennial-length trends in the zonal SST and SLP gradients rivaling those estimated from observations and model simulations forced with increasing CO2 appear to be inherent features of the internal climate dynamics simulated by all three models. Unforced variability and trends on the centennial time scale therefore need to be addressed in estimated uncertainties, beyond more traditional signal-to-noise estimates that do not account for natural variability on the centennial time scale.
Influence of the Tropics on the Southern Annular Mode
Authors: Ding Qinghua , Steig Eric J. , Battisti David S. , Wallace John M.
Published: April 2012

Perturbations in the southern annular mode (SAM) are shown to be significantly correlated with SST anomalies in the central tropical Pacific during austral winter and SST anomalies in the eastern tropical Pacific during austral summer. The SAM signature in the Pacific sector resembles a tropically forced Rossby wave train, the so-called Pacific–South American pattern, while the signature in the Indian Ocean sector is a zonally elongated meridional dipole. Thus, the SAM contains strong zonally asymmetric variability and tends to behave differently in the Eastern and Western Hemispheres, with internal dynamics prevailing in the Indian Ocean sector and the forced response to tropical SST anomalies exerting a strong influence in the Pacific sector. The tropically forced component of the SAM in the Pacific sector is related to a geographically fixed active Rossby wave source to the east of Australia within the core of the subtropical jet. In addition to the well-documented positive trend in summer, the SAM also exhibits a negative wintertime trend since 1979, characterized by prominent geopotential height increases over the high latitudes. In both seasons, SAM trends are closely linked to long-term trends in tropical Pacific SST that are independent of the canonical eastern Pacific ENSO variability. Although the SAM is an intrinsic pattern of high-latitude variability, the SAM index reflects the superposition of both high-latitude and tropically forced variability.