bluuebunny/crossref_metadata_2025 huggingface dataset:
The Development of Ascending Aortic Aneurysms After Elective Aortic Valve Replacement With St Jude Mechanical Valve Prosthesis in the Bicuspid Patient
Authors: Cohoon Kevin P. , Foley Jillian , Dieter Robert S. , Bakhos Mamdouh , Schwartz Jeffrey
Published: June 2012

The association between bicuspid aortic valve (BAV) and ascending aorta aneurysm is well described. Replacement of the ascending aorta is now being considered at 4.5 cm. We identified patients confirmed with BAV who underwent elective aortic valve replacement (AVR) with a mechanical St Jude Bioprosthesis from 1994 to 2000 who were ≤65 years of age at the time of surgery. Follow-up imaging was obtained by computed tomography (CT) angiography or echocardiography. A total of 225 patients who underwent AVR were identified; 60 patients had a BAV. Of all, 36 (60%) patients with BAV returned for follow-up imaging of their ascending aorta. Eight patients (22%) had diameters classifiable as aneurysmal (>4.5 cm) that developed within 9.6 ± 4.1 years from implant and requiring surgery. Of all, 7 patients (12%) died within 5.9 ± 2.5 years from their implant date. Lifelong serial monitoring of the ascending aorta for patients with BAV should be the standard of care.
Examining the Concept of Choice in Sexual Health Interventions for Young People
Authors: Spencer Grace , Doull Marion , Shoveller Jean A.
Published: June 2012

Concepts of choice are often drawn upon within sexual health promotion discourses to encourage young people to take “responsibility” for and promote their own sexual health and reproductive control. A systematic literature search using predefined inclusion criteria identified peer-reviewed articles focusing on sexual health interventions for young people. Discourse analysis was used to interrogate how concepts of choice were articulated or inferred within the interventions. Of the eligible studies ( n = 30), 16 were based on theories of behavioral change, suggesting a linear pathway between choice and improvements in sexual health. Studies that accounted for contextual factors were a minority ( n = 6). Overall, study reports offered a limited account of the “situatedness” of young people’s opportunities to exercise choice. This reliance had a tendency to position young people as passive recipients of interventions which seemed to undermine the more active notion of “making choices” presented within these frameworks.
Incidental Thyroid Cancer Found during Surgery for Head and Neck Squamous Cell Carcinoma
Authors: Gilbert Mark R. , Kim Seungwon
Published: June 2012

Objective

To quantify the incidence of occult thyroid cancer encountered during neck dissection in patients with head and neck squamous cell carcinoma (HNSCC), to discuss the management of these patients, and to assess the need for further treatment of the incidentally discovered thyroid cancer.

Study Design

Case series with chart review.

Setting

University‐based tertiary care hospital.

Methods

The authors retrospectively reviewed 2538 neck dissections performed at their institution over a 15‐year period. Twenty‐nine patients had an incidental pathologic finding of thyroid cancer at surgery. The authors reviewed demographics, diagnoses, histopathology, initial and subsequent management, and outcome.

Results

Well‐differentiated thyroid cancer (WDC) was found in every case in this cohort. Fifteen patients died during the period of the study (2.4‐year follow‐up), with 14 patients still alive (4.3‐year follow‐up). Seven patients, all of whom are still alive, received further treatment for their thyroid cancer: 2 with completion thyroidectomy, 2 with I‐131 ablation, and 3 with both. There was no clinical evidence of recurrence of thyroid cancer in any of the patients who died, and none died as a result of thyroid cancer. In addition, none of the patients still alive have biopsy‐proven evidence of thyroid cancer recurrence.

Conclusion

None of the patients in this cohort died as a result of their thyroid disease, and none of the patients had evidence of recurrence of their WDC during the follow‐up period. The results suggest that further management of occult WDC discovered in patients receiving neck dissections for HNSCC is not necessary.
The role of self-control in the link between prior and future victimization:
Authors: Averdijk Margit , Loeber Rolf
Published: June 2012

This article investigated the effect of self-control on the link between individuals’ prior and future victimization, using panel data across nine years from the Pittsburgh Youth Study. Results showed that for victims with high self-control, prior theft victimization was related to decreased risk of later theft victimization. However, self-control was not related to repeat violent victimization. Control variables related to opportunity structures and delinquent subcultures played a key role in influencing the effect of self-control on the relationship between prior and later victimization. Implications of the findings are discussed.
Chronic treatment with selective I2-imidazoline receptor ligands decreases the content of pro-apoptotic markers in rat brain
Authors: Garau Celia , Miralles Antonio , García-Sevilla Jesús A
Published: June 2012

Selective I2-imidazoline receptor ligands induce neuroprotection through various molecular mechanisms including blockade of N-methyl-D-aspartate (NMDA) receptors. To investigate new neuroprotective mechanisms associated with I2-imidazoline receptors, the effects of selective (2-styryl-2-imidazoline (LSL 61122), 2-(2-benzofuranyl)-2-imidazoline (2-BFI), 2-(4,5-dihydroimidazol-2-yl) quinoline hydrochloride (BU-224)) and non-selective (idazoxan) I2-drugs on canonical apoptotic pathways were assessed in rat brain cortex. The acute treatment with LSL 61122 (10 mg/kg) reduced the content of mitochondrial (pro-apoptotic) Bax (-33%) and cytochrome c (-31%), which was prevented by idazoxan, an I2-receptor antagonist. The sustained stimulation of I2-imidazoline receptors with selective drugs (10 mg/kg, every 12 h for seven days) was associated with down-regulation of key components of the extrinsic (Fas receptor: -20%; Fas associated protein with death domain (FADD) adaptor: -47–54%) and/or intrinsic (Bax: -20–23%; cytochrome c: -22–28%) apoptotic signalling and/or up-regulation of survival anti-apoptotic factors (p-Ser194 FADD/FADD ratio: +1.6-2.5-fold; and/or Bcl-2/Bax ratio: +1.5-fold), which in the long-term could dampen cell death in the brain. Similar chronic treatments with LSL 60101 (the imidazole analogue of 2-BFI) and idazoxan (a mixed I2/α2-ligand) did not induce significant alterations of pro- or anti-apoptotic proteins. The disclosed anti-apoptotic mechanisms of selective I2-imidazoline drugs may work in concert with other molecular mechanisms of neuroprotection (e.g. blockade of NMDA receptors) that are engaged by I2-ligands.
Prediction on the bending moment transmitted to the forging manipulator owing to press motion using a single degree of freedom model
Authors: Li Gang , Liu Deshi
Published: June 2012

The bending moment exerted to the forging manipulator induced by the press motion during the metal forming process is investigated. The manipulator system, including the manipulator and the workpiece, is modelled as a single degree of freedom system oscillator with displacement excitement. The Winkler foundation is used to simulate the rotational constraint of the forging dies on the workpiece because of the surface contact. The closed solution of the dynamic bending moment in time domain is obtained, a useful design formula is derived that explicitly shows the dependence of the bending moment amplitude on the relative parameters, including the press position, clamp mass and compliance stiffness. The analytical results are compared with the commercial finite element software simulations, and good agreements could be observed. The results indicate that the press position where the forging dies act on the workpiece plays a crucial role to the dynamic bending moment. The maximum bending moment increases with the increase of clamp mass and compliance stiffness.
Product life cycle information management in the electronics supply chain
Authors: Bindel Axel , Rosamond Emma , Conway Paul , West Andrew
Published: June 2012

Information availability and data transparency are key requirements from manufacturers when supporting products throughout the life cycle, for example, when implementing product service systems. The application of embedded wireless technologies into printed circuit boards can help by bridging current knowledge gaps in order to minimise both technical and financial risk through: reduced product downtime, improved quality of tracking, and enhanced end-of-life decision making. The application of an embedded radio frequency identification device into printed circuit boards for life cycle monitoring of electronic products to support product service systems is discussed in this article.
Analytical modeling of combustion of a single iron particle burning in the gaseous oxidizing medium
Authors: Bidabadi Mehdi , Mafi Majid
Published: June 2012

In the present study, a theoretical investigation is accomplished to model the combustion of a single iron particle by virtue of a novel thermophysical approach. It is assumed that a spherical iron particle falls freely in the gaseous medium and preheats and then burns heterogeneously on its external surface in this hot oxidizing environment and oxygen diffuses inward to the particle. A new physical parameter for thermal radiation is introduced. By solving the energy conservation equation for the iron particle, the temperature distribution of the iron particle during the preheating and combustion processes is calculated analytically. Also, by solving the oxygen mass conservation equation, the variation of oxygen concentration within the iron particle during the combustion stage is estimated. In the proposed model, the effect of thermal radiation and dynamic behavior of burning iron particle are considered. Because of high thermal conductivity and micro size of iron particle, the Biot number is negligibly small. The non-homogeneous partial differential equations of energy and mass species resulted from the modeling of combustion are solved by utilizing the method of separation of variables. The assumptions applied in the modeling are such that do not violate the actual combustion phenomenon. Also, the numerical solution of energy equation in the combustion stage is presented and compared with the obtained analytical solution. Also, the burnout time of iron particle is evaluated in this article. This investigation is one of the first performed efforts for analyzing and modeling of single iron particle combustion.
Investigation of electronic flow regulated J-T cooling system for detector cooling applications
Authors: Kumar R , Maheshwari S , Sharma C
Published: June 2012

An improved fixed orifice Joule Thomson cooling system has been obtained to provide a viable alternative to self-regulating Joule Thomson (J-T) coolers. It is based on the fact that Joule Thomson coolers require sufficiently lower gas flow for continued liquid formation. The inherent problem of high gas consumption of the system is solved electronically by reducing the gas flow to a sufficient level. Normally, in a self-regulated Joule Thompson cooling system, the flow reduction is achieved by reducing expansion orifice area through temperature-controlled mechanical bellow mechanism or flow area control mechanisms. In this article, an effort has been made to provide a gas-independent alternative to a self-regulating system which is always fluid specific.
Burrow-centric distance-estimation methods inspired by surveillance behavior of fiddler crabs
Authors: Yu Seung-Eun , Kim DaeEun
Published: June 2012

There are several ways to estimate the distance to an object based on visual information. Many robotic systems compute object distances based on disparity values or motion information. In addition to a disparity cue or image motion, research has shown that animals can possibly estimate the distance using the image size as well as the azimuth and elevation angles in their visual field. In this paper, inspired by the vigilance behavior of fiddler crabs, we suggest distance-estimation methods with several visual cues for engineering applications. A foraging fiddler crab can estimate the distance of an intruder from the burrow entrance. If the intruder is close to the burrow, the crab rushes back home to maintain possession of the burrow. In this study, we investigated burrow-centered distance-estimation methods based on visual information such as the retinal position, that is, the azimuth and elevation angles in an omnidirectional view as well as the image size and retinal speed of a target object. The methods show potential for engineering applications to the surveillance problem.
Seven Rules on Having a Happy Marriage Along With Work
Authors: Määttä Kaarina , Uusiautti Satu
Published: June 2012

In modern society, men and women want to have a successful marriage and a career. However, people are faced with new demands at work and home, and therefore, finding a balance between work and family life is a real challenge. In this article, the data consist of stories written by Finns who have been married for more than 10 years ( N = 342 married couples) and who were able to combine demanding work and family lives. In voluntary statements, the respondents discussed the factors that explain the stability and happiness of their marriages. Stories were analyzed with inductive content analysis and qualitative categorizing. Seven rules of personal behavior as the resolutions of having a good marriage along with work were found as results. The results show that none of the couples had avoided difficulties; instead, the couples had created personal models of interaction that could be seen as the secret of their marital success.
The Professional Will
Authors: Bradley Loretta J. , Hendricks Bret , Kabell Douglas R.
Published: June 2012

Attention is directed to the ethical responsibility for the counselor to develop a professional will. Essentially the professional will is a roadmap for what the counselor directs to happen in the event that the counselor becomes incapacitated due to sudden death or illness. A model of a professional will is provided.
The Jackson Career Explorer
Authors: Schermer Julie Aitken
Published: June 2012

The present report consists of two further validity studies using the Jackson Career Explorer (JCE), a short form and continuous version of the Jackson Vocational Interest Survey, measuring 34 interests. The first study examined the relationships between the JCE and five personality factors, from a sample of 528 individuals. The correlations found typically replicate the pattern of relationships found between vocational interests and personality. The second study examined the JCE in relation to Holland’s Vocational Preference Inventory in a sample of 270 individuals. Convergent correlations were found between the two interest measures. The results further support the use of the JCE as a measure of vocational interests.
China as Chimney of the World
Authors: Malm Andreas
Published: June 2012

What has caused the early 21st-century emissions explosion in China? Driving a global explosion, it appears to stand in some relation to processes of globalization, but these links have mostly remained unexplored. This article revisits some established frameworks for understanding the connection between globalization and environmental degradation and argues that they are insufficient for explaining the Chinese explosion. A new hypothesis is outlined, called “the fossil capital hypothesis.” It proposes that globally mobile capital will tend to relocate production to countries with cheap and disciplined labor, but only through the accelerated consumption of fossil energy. Via three specified “effects,” the inflow of global capital will therefore set off massive increases in CO2 emissions. The hypothesis is applied in a brief analysis of developments in China between 2001 and 2008, and in other Asian countries after the Chinese strike wave in 2010.
Mycoplasma species in cats with lower airway disease: improved detection and species identification using a polymerase chain reaction assay
Authors: Reed Nicki , Simpson Kerry , Ayling Roger , Nicholas Robin , Gunn-Moore Danielle
Published: June 2012

There is some evidence that Mycoplasma species may be associated with lower airway disease in cats. Retrospective and prospective studies were carried out on a total population of 76 cats but failed to identify any cases of Mycoplasma species infection by bacterial culture alone. The overall prevalence of bacterial infection (15.8%) was also lower than that identified in previous studies. When a molecular detection technique, the PCR-DGGE, was employed the prevalence of Mycoplasma species detected was 15.4%, with M felis, M gateae and M feliminutum species identified, although the significance of these Mycoplasma species in feline lower airway disease remains in question. However, the PCR-DGGE technique allowed species identification and indicated the presence of M feliminutum, a species not previously isolated from the lower airways of cats.
The Associations Between OPRM1 and COMT Genotypes and Postoperative Pain, Opioid Use, and Opioid-Induced Sedation
Authors: Henker Richard A. , Lewis Allison , Dai Feng , Lariviere William R. , Meng Li , Gruen Gary S. , Sereika Susan M. , Pape Hans , Tarkin Ivan S. , Gowda Indira , Conley Yvette P.
Published: June 2012

Previous studies have associated mu-opioid receptor ( OPRM1) genotype with pain and analgesia responses in postoperative and patient populations. This study investigates the role of catechol-O-methyltransferase ( COMT) and OPRM1 genotypes in acute postoperative pain scores, opioid use, and opioid-induced sedation after surgical procedures for orthopedic trauma in an otherwise healthy patient population. Verbal pain/sedation scores, opioid use, and physiologic responses in the immediate postoperative period were examined for association with genetic variants in Caucasians genotyped for OPRM1 single nucleotide polymorphisms (SNPs) A118G and C17T and COMT SNPs. The OPRM1 A118G genotype was associated with patients’ postoperative Numerical Pain scale (NPS) ratings at 15 min in the postanesthesia care unit (PACU) ( p = .01) and patients' sedation scores at 15 min in the PACU ( p = .02). COMT genotype (rs4818) was associated with opioid consumption in the first 45 min in the PACU ( p = .04). NPS ratings at 45 min were also higher in the group of patients with A/A genotype of rs4680 than in patients with the other two genotypes at this SNP ( p = .03). Our haplotype trend analysis identified a COMT haplotype “GCGG” significantly associated with NPS at 15 min ( p = .0013), amount of opioids consumed in the first 45 min ( p = .0024), and heart rate at 45 min in the PACU ( p = .017). The results indicate that genetic variations in COMT contribute to the acute postoperative pain and analgesia responses and physiologic responses in this group of otherwise healthy postoperative orthopedic trauma patients.
Statins and beyond: Concurrent strategies for prevention of cardiovascular disease in patients with type 2 diabetes
Authors: Standl Eberhard
Published: June 2012

Diabetes is a significant risk factor for the development of cardiovascular disease (CVD), particularly in the presence of high blood pressure, poor glycaemic control and high total cholesterol. While efforts to control blood pressure or blood glucose beyond levels considered ‘normal’ in patients with diabetes have not produced the expected reduction in CVD, treatment with statins to reduce levels of low-density lipoprotein cholesterol (LDL-C) has been much more successful. However, many patients with diabetes who receive statins (even at high doses) remain at significant residual risk of CVD due to the presence of atherogenic dyslipidaemia. Markers of persisting risk include low levels of high-density lipoprotein cholesterol (HDL-C), high levels of triglycerides (TG) and LDL-C levels above target despite high-dose statin therapy. Combining statins with drugs that target HDL-C and TG, such as fibrates, niacin and omega-3 polyunsaturated fatty acid (PUFA) ethyl esters, may offer further protection from CVD in patients with diabetes.
Game Attendance and Outcome Uncertainty in the National Hockey League
Authors: Coates Dennis , Humphreys Brad R.
Published: June 2012

We analyze the relationship between attendance, outcome uncertainty, and team quality in the National Hockey League (NHL). Based on the results from a reduced form model of attendance at 6,054 regular season NHL games from 2005-2006 to 2009-2010, we find evidence that attendance increases when fans expect the home team to win, but holding this constant, attendance falls for games expected to be close. An asymmetric relationship exists between expected game outcomes and attendance, suggesting the need for an expanded definition of the Uncertainty of Outcome Hypothesis that includes aspects of consumer decision making under uncertainty.
Adapting Parent–Child Interaction Therapy to Treat Severe Conduct Problems With Callous-Unemotional Traits
Authors: Kimonis Eva R. , Armstrong Kathleen
Published: June 2012

Children with conduct problems and callous-unemotional traits (i.e., lack of empathy, guilt, and lack of caring behaviors)(CP + CU) show poor response to empirically supported interventions for treating disruptive behaviors. Children with CP + CU are specifically less responsive to discipline components of parent training, although they respond well to reward-based behavioral strategies. This case study presents the treatment of a 5-year-old boy with severe disruptive behavior (CP, attention-deficit/hyperactivity disorder) and pronounced CU traits using Parent–Child Interaction Therapy, followed by the delivery of an adjunctive token economy system. Interventions that treat children with CP + CU are critically needed and have the potential for significant societal impact given the stability of their traits and severe behavioral outcomes. Findings from this case report (a) document an improvement in CP that was maintained to follow-up and (b) provide preliminary support for adapting parent-training interventions to modify severe CP in young children with CU traits.
Management of patients with difficult autoimmune hepatitis
Authors: Parker Richard , Oo Ye Htun , Adams David H.
Published: June 2012

Autoimmune hepatitis (AIH) is characterized by a T-cell rich infiltrate associated with lobular and interface hepatitis, hypergammaglobulinemia and production of autoantibodies. Genetic risk is linked to the HLA particularly DRB1*0301 and DRB1*0401 alleles in North American and European Caucasian populations. It has recently been suggested that functional deficiencies in CD4+CD25+CD127lowFOXP3+ regulatory T cells contribute to the breakdown of immune tolerance that results in AIH. Most patients respond to immunosuppressive therapy with corticosteroids and can be maintained in remission by low-dose corticosteroid treatment and/or azathioprine. For those who progress to end-stage disease liver transplantation is an effective treatment although it is associated with recurrence. In the future it is likely that biological therapies will allow more targeted therapy designed to switch the balance to immune regulation and thereby restore immune homeostasis. Although treatment for many cases is relatively straightforward and successful problems are encountered in those who fail to respond to standard treatment, are unable to tolerate it or relapse. In such cases alternative therapies should be considered. In addition treatment is complicated in some patients by comorbidity and special care is required during and after pregnancy. We will discuss the current and future therapeutic options for patients with difficult to treat AIH.
Respiratory arrest and oversedation in an adolescent given intramuscular clonazepam for rapid tranquillization
Authors: Channing Jonathan , Hill Simon , Wetherill Marion , White Oliver
Published: June 2012

Many young people in forensic adolescent units require intramuscular medication for rapid tranquillization. The efficacy and safety of the medications used is not well reported in this age group. Here we report a case of a 14-year-old girl experiencing severe oversedation and respiratory compromise on two occasions following intramuscular clonazepam.
The B-cell receptor signaling pathway as a therapeutic target in CLL
Authors: Woyach Jennifer A. , Johnson Amy J. , Byrd John C.
Published: June 2012

Targeted therapy with imatinib and other selective tyrosine kinase inhibitors has transformed the treatment of chronic myeloid leukemia. Unlike chronic myeloid leukemia, chronic lymphocytic leukemia (CLL) lacks a common genetic aberration amenable to therapeutic targeting. However, our understanding of normal B-cell versus CLL biology points to differences in properties of B-cell receptor (BCR) signaling that may be amenable to selective therapeutic targeting. The applica-tion of mouse models has further expanded this understanding and provides information about targets in the BCR signaling pathway that may have other important functions in cell development or long-term health. In addition, overexpression or knockout of selected targets offers the potential to validate targets genetically using new mouse models of CLL. The initial success of BCR-targeted therapies has promoted much excitement in the field of CLL. At the present time, GS-1101, which reversibly inhibits PI3Kδ, and ibrutinib (PCI-32765), an irreversible inhibitor of Bruton tyrosine kinase, have generated the most promising early results in clinical trials including predominately refractory CLL where durable disease control has been observed. This review provides a summary of BCR signaling, tools for studying this pathway relevant to drug development in CLL, and early progress made with therapeutics targeting BCR-related kinases.
Long-term outcomes of 107 patients with myelofibrosis receiving JAK1/JAK2 inhibitor ruxolitinib: survival advantage in comparison to matched historical controls
Authors: Verstovsek Srdan , Kantarjian Hagop M. , Estrov Zeev , Cortes Jorge E. , Thomas Deborah A. , Kadia Tapan , Pierce Sherry , Jabbour Elias , Borthakur Gautham , Rumi Elisa , Pungolino Ester , Morra Enrica , Caramazza Domenica , Cazzola Mario , Passamonti Francesco
Published: June 2012

Ruxolitinib is JAK1/JAK2 inhibitor with established clinical benefit in myelofibrosis (MF). We analyzed long-term outcomes of 107 patients with intermediate-2 or high-risk MF receiving ruxolitinib at MD Anderson Cancer Center (MDACC) on phase 1/2 trial. After a median of 32 months of follow-up, 58 patients (54%) were still receiving ruxolitinib, with overall survival (OS) of 69%. The splenomegaly and symptom reductions achieved with ruxolitinib were sustained with long-term therapy. Therapy was well tolerated; discontinuation rates at 1, 2, and 3 years were 24%, 36%, and 46%, respectively. OS of 107 MDACC patients was significantly better (P = .005) than that of 310 matched (based on trial enrollment criteria) historical control patients, primarily because of highly significant difference in OS in the high-risk subgroup (P = .006). Furthermore, among MDACC patients, those with high-risk MF experienced the same OS as those with intermediate-2 risk. Patients with ≥ 50% reduction in splenomegaly had significantly prolonged survival versus those with < 25% reduction (P < .0001). Comparison of discontinuation rates and reasons for stopping the therapy to those reported for other 51 patients in the phase 1/2 trial, and 155 ruxolitinib-treated patients in phase 3 COMFORT-I study, suggest that continued therapy with ruxolitinib at optimal doses contributes to the benefits seen, including OS benefit.
Generation and characterization of an inducible transgenic model for studying mouse esophageal biology
Authors: Roth Sabrina , Franken Patrick , Monkhorst Kim , Kong a San John , Fodde Riccardo
Published: June 2012

Background

To facilitate the in vivo study of esophageal (stem) cell biology in homeostasis and cancer, novel mouse models are necessary to elicit expression of candidate genes in a tissue-specific and inducible fashion. To this aim, we developed and studied a mouse model to allow labeling of esophageal cells with the histone 2B-GFP (H2B-GFP) fusion protein.

Results

First, we generated a transgenic mouse model expressing the reverse tetracycline transactivator rtTA2-M2 under control of the promoter (ED-L2) of the Epstein-Barr virus (EBV) gene encoding the latent membrane protein-1 (LMP-1). The newly generated ED-L2-rtTA2-M2 (ED-L2-rtTA) mice were then bred with the previously developed tetO-HIST1H2BJ/GFP (tetO-H2B-GFP) model to assess inducibility and tissue-specificity. Expression of the H2B-GFP fusion protein was observed upon doxycycline induction but was restricted to the terminally differentiated cells above the basal cell layer. To achieve expression in the basal compartment of the esophagus, we subsequently employed a different transgenic model expressing the reverse transactivator rtTA2S-M2 under the control of the ubiquitous, methylation-free CpG island of the human hnRNPA2B1-CBX3 gene (hnRNP-rtTA). Upon doxycycline administration to the compound hnRNP-rtTA/tetO-H2B-GFP mice, near-complete labeling of all esophageal cells was achieved. Pulse-chase experiments confirmed that complete turnover of the esophageal epithelium in the adult mouse is achieved within 7–10 days.

Conclusions

We show that the esophagus-specific promoter ED-L2 is expressed only in the differentiated cells above the basal layer. Moreover, we confirmed that esophageal turn-over in the adult mouse does not exceed 7–10 days.
Spatiotemporal analysis of indigenous and imported dengue fever cases in Guangdong province, China
Authors: Li Zhongjie , Yin Wenwu , Clements Archie , Williams Gail , Lai Shengjie , Zhou Hang , Zhao Dan , Guo Yansha , Zhang Yonghui , Wang Jinfeng , Hu Wenbiao , Yang Weizhong
Published: June 2012

Background

Dengue fever has been a major public health concern in China since it re-emerged in Guangdong province in 1978. This study aimed to explore spatiotemporal characteristics of dengue fever cases for both indigenous and imported cases during recent years in Guangdong province, so as to identify high-risk areas of the province and thereby help plan resource allocation for dengue interventions.

Methods

Notifiable cases of dengue fever were collected from all 123 counties of Guangdong province from 2005 to 2010. Descriptive temporal and spatial analysis were conducted, including plotting of seasonal distribution of cases, and creating choropleth maps of cumulative incidence by county. The space-time scan statistic was used to determine space-time clusters of dengue fever cases at the county level, and a geographical information system was used to visualize the location of the clusters. Analysis were stratified by imported and indigenous origin.

Results

1658 dengue fever cases were recorded in Guangdong province during the study period, including 94 imported cases and 1564 indigenous cases. Both imported and indigenous cases occurred more frequently in autumn. The areas affected by the indigenous and imported cases presented a geographically expanding trend over the study period. The results showed that the most likely cluster of imported cases (relative risk = 7.52, p < 0.001) and indigenous cases (relative risk = 153.56, p < 0.001) occurred in the Pearl River Delta Area; while a secondary cluster of indigenous cases occurred in one district of the Chao Shan Area (relative risk = 471.25, p < 0.001).

Conclusions

This study demonstrated that the geographic range of imported and indigenous dengue fever cases has expanded over recent years, and cases were significantly clustered in two heavily urbanised areas of Guangdong province. This provides the foundation for further investigation of risk factors and interventions in these high-risk areas.
Etiology of community-acquired pneumonia in a population-based study: Link between etiology and patients characteristics, process-of-care, clinical evolution and outcomes
Authors: Capelastegui Alberto , España Pedro P , Bilbao Amaia , Gamazo Julio , Medel Federico , Salgado Juan , Gorostiaga Iñaki , Lopez de Goicoechea Maria Jose , Gorordo Inmaculada , Esteban Cristobal , Altube Lander , Quintana Jose M
Published: June 2012

Background

The etiologic profile of community-acquired pneumonia (CAP) for each age group could be similar among inpatients and outpatients. This fact brings up the link between etiology of CAP and its clinical evolution and outcome. Furthermore, the majority of pneumonia etiologic studies are based on hospitalized patients, whereas there have been no recent population-based studies encompassing both inpatients and outpatients.

Methods

To evaluate the etiology of CAP, and the relationship among the different pathogens of CAP to patients characteristics, process-of-care, clinical evolution and outcomes, a prospective population-based study was conducted in Spain from April 1, 2006, to June 30, 2007. Patients (age >18) with CAP were identified through the family physicians and the hospital area.

Results

A total of 700 patients with etiologic evaluation were included: 276 hospitalized and 424 ambulatory patients. We were able to define the aetiology of pneumonia in 55.7% (390/700). The most frequently isolated organism wasS. pneumoniae(170/390, 43.6%), followed byC. burnetti(72/390, 18.5%),M. pneumoniae(62/390, 15.9%), virus as a group (56/390, 14.4%), Chlamydia species (39/390, 106%), andL. pneumophila(17/390, 4.4%). The atypical pathogens and theS. pneumoniaeare present in pneumonias of a wide spectrum of severity and age. Patients infected by conventional bacteria were elderly, had a greater hospitalization rate, and higher mortality within 30 days.

Conclusions

Our study provides information about the etiology of CAP in the general population. The microbiology of CAP remains stable: infections by conventional bacteria result in higher severity, and theS. pneumoniaeremains the most important pathogen. However, atypical pathogens could also infect patients in a wide spectrum of severity and age.
Prediction of melanoma metastasis by the Shields index based on lymphatic vessel density
Authors: Emmett Maxine S , Symonds Kirsty E , Rigby Howard , Cook Martin G , Price Rebecca , Metcalfe Chris , Orlando Antonio , Bates David O
Published: June 2012

Background

Melanoma usually presents as an initial skin lesion without evidence of metastasis. A significant proportion of patients develop subsequent local, regional or distant metastasis, sometimes many years after the initial lesion was removed. The current most effective staging method to identify early regional metastasis is sentinel lymph node biopsy (SLNB), which is invasive, not without morbidity and, while improving staging, may not improve overall survival. Lymphatic density, Breslow's thickness and the presence or absence of lymphatic invasion combined has been proposed to be a prognostic index of metastasis, by Shields et al in a patient group.

Methods

Here we undertook a retrospective analysis of 102 malignant melanomas from patients with more than five years follow-up to evaluate the Shields' index and compare with existing indicators.

Results

The Shields' index accurately predicted outcome in 90% of patients with metastases and 84% without metastases. For these, the Shields index was more predictive than thickness or lymphatic density. Alternate lymphatic measurement (hot spot analysis) was also effective when combined into the Shields index in a cohort of 24 patients.

Conclusions

These results show the Shields index, a non-invasive analysis based on immunohistochemistry of lymphatics surrounding primary lesions that can accurately predict outcome, is a simple, useful prognostic tool in malignant melanoma.
Prediction of axillary lymph node metastasis in primary breast cancer patients using a decision tree-based model
Authors: Takada Masahiro , Sugimoto Masahiro , Naito Yasuhiro , Moon Hyeong-Gon , Han Wonshik , Noh Dong-Young , Kondo Masahide , Kuroi Katsumasa , Sasano Hironobu , Inamoto Takashi , Tomita Masaru , Toi Masakazu
Published: June 2012

Background

The aim of this study was to develop a new data-mining model to predict axillary lymph node (AxLN) metastasis in primary breast cancer. To achieve this, we used a decision tree-based prediction method—the alternating decision tree (ADTree).

Methods

Clinical datasets for primary breast cancer patients who underwent sentinel lymph node biopsy or AxLN dissection without prior treatment were collected from three institutes (institute A, n = 148; institute B, n = 143; institute C, n = 174) and were used for variable selection, model training and external validation, respectively. The models were evaluated using area under the receiver operating characteristics (ROC) curve analysis to discriminate node-positive patients from node-negative patients.

Results

The ADTree model selected 15 of 24 clinicopathological variables in the variable selection dataset. The resulting area under the ROC curve values were 0.770 [95% confidence interval (CI), 0.689–0.850] for the model training dataset and 0.772 (95% CI: 0.689–0.856) for the validation dataset, demonstrating high accuracy and generalization ability of the model. The bootstrap value of the validation dataset was 0.768 (95% CI: 0.763–0.774).

Conclusions

Our prediction model showed high accuracy for predicting nodal metastasis in patients with breast cancer using commonly recorded clinical variables. Therefore, our model might help oncologists in the decision-making process for primary breast cancer patients before starting treatment.
ROCK inhibitor fasudil attenuated high glucose-induced MCP-1 and VCAM-1 expression and monocyte-endothelial cell adhesion
Authors: Li Hailing , Peng Wenhui , Jian Weixia , Li Yuanmin , Li Qi , Li Weiming , Xu Yawei
Published: June 2012

Background

Previous studies suggested that the RhoA/ROCK pathway may contribute to vascular complications in diabetes. The present study was designed to investigate whether ROCK inhibitor fasudil could prevent high glucose-induced monocyte-endothelial cells adhesion, and whether this was related to fasudil effects on vascular endothelial cell expression of chemotactic factors, vascular cell adhesion molecule-1 (VCAM-1) and monocyte chemoattractant protein-1 (MCP-1).

Methods

HUVECs were stimulated with high glucose (HG) or HG + fasudil in different concentration or different time. Monocyte-endothelial cell adhesion was determined using fluorescence-labeled monocytes. The mRNA and protein expression of VCAM-1 and MCP-1 were measured using real-time PCR and western blot. The protein levels of RhoA, ROCKI and p-MYPT were determined using western blot analysis. ELISA was employed to measure the expression of soluble VCAM-1 and MCP-1 in cell supernatants and human serum samples.

Results

Fasudil significantly suppressed HG-induced adhesion of THP-1 to HUVECs. Fasudil reduced Rho/ROCK activity (as indicated by lower p-MYPT/MYPT ratio), and prevented HG induced increases in VCAM-1 and MCP-1 mRNA and protein levels. Fasudil also decreased MCP-1 concentration in HUVEC supernatants, but increased sVCAM-1 shedding into the media. In human diabetic subjects, 2 weeks of fasudil treatment significantly decreased serum MCP-1 level from 27.9 ± 10.6 pg/ml to 13.8 ± 7.0 pg/ml (P < 0.05), while sVCAM-1 increased from 23.2 ± 7.5 ng/ml to 39.7 ± 5.6 ng/ml after fasudil treatment (P < 0.05).

Conclusions

Treatment with the Rho/ROCK pathway inhibitor fasudil attenuated HG-induced monocyte-endothelial cell adhesion, possibly by reducing endothelial expression of VCAM-1 and MCP-1. These results suggest inhibition of Rho/ROCK signaling may have therapeutic potential in preventing diabetes associated vascular inflammation and atherogenesis.
Ex vivo drug sensitivity profiles of Plasmodium falciparum field isolates from Cambodia and Thailand, 2005 to 2010, determined by a histidine-rich protein-2 assay
Authors: Tyner Stuart D , Lon Chanthap , Se Youry , Bethell Delia , Socheat Doung , Noedl Harald , Sea Darapiseth , Satimai Wichai , Schaecher Kurt , Rutvisuttinunt Wiriya , Fukuda Mark M , Chaorattanakawee Suwanna , Yingyuen Kritsanai , Sundrakes Siratchana , Chaichana Panjaporn , Saingam Piyaporn , Buathong Nillawan , Sriwichai Sabaithip , Chann Soklyda , Timmermans Ans , Saunders David L , Walsh Douglas S
Published: June 2012

Background

In vitro drug susceptibility assay of Plasmodium falciparum field isolates processed “immediate ex vivo” (IEV), without culture adaption, and tested using histidine-rich protein-2 (HRP-2) detection as an assay, is an expedient way to track drug resistance.

Methods

From 2005 to 2010, a HRP-2 in vitro assay assessed 451 P. falciparum field isolates obtained from subjects with malaria in western and northern Cambodia, and eastern Thailand, processed IEV, for 50% inhibitory concentrations (IC50) against seven anti-malarial drugs, including artesunate (AS), dihydroartemisinin (DHA), and piperaquine.

Results

In western Cambodia, from 2006 to 2010, geometric mean (GM) IC50 values for chloroquine, mefloquine, quinine, AS, DHA, and lumefantrine increased. In northern Cambodia, from 2009–2010, GM IC50 values for most drugs approximated the highest western Cambodia GM IC50 values in 2009 or 2010.

Conclusions

Western Cambodia is associated with sustained reductions in anti-malarial drug susceptibility, including the artemisinins, with possible emergence, or spread, to northern Cambodia. This potential public health crisis supports continued in vitro drug IC50 monitoring of P. falciparum isolates at key locations in the region.
Automated diagnosis of diabetic retinopathy and glaucoma using fundus and OCT images
Authors: Pachiyappan Arulmozhivarman , Das Undurti N , Murthy Tatavarti VSP , Tatavarti Rao
Published: June 2012

We describe a system for the automated diagnosis of diabetic retinopathy and glaucoma using fundus and optical coherence tomography (OCT) images. Automatic screening will help the doctors to quickly identify the condition of the patient in a more accurate way. The macular abnormalities caused due to diabetic retinopathy can be detected by applying morphological operations, filters and thresholds on the fundus images of the patient. Early detection of glaucoma is done by estimating the Retinal Nerve Fiber Layer (RNFL) thickness from the OCT images of the patient. The RNFL thickness estimation involves the use of active contours based deformable snake algorithm for segmentation of the anterior and posterior boundaries of the retinal nerve fiber layer. The algorithm was tested on a set of 89 fundus images of which 85 were found to have at least mild retinopathy and OCT images of 31 patients out of which 13 were found to be glaucomatous. The accuracy for optical disk detection is found to be 97.75%. The proposed system therefore is accurate, reliable and robust and can be realized.
Endotracheal intubation using the C-MAC® video laryngoscope or the Macintosh laryngoscope: A prospective, comparative study in the ICU
Authors: Noppens Ruediger R , Geimer Stephanie , Eisel Nicole , David Matthias , Piepho Tim
Published: June 2012

Introduction

Endotracheal intubation in the ICU is a challenging procedure and is frequently associated with life-threatening complications. The aim of this study was to investigate the effect of the C-MAC® video laryngoscope on laryngeal view and intubation success compared with direct laryngoscopy.

Methods

In a single-center, prospective, comparative before-after study in an anesthetist-lead surgical ICU of a tertiary university hospital, predictors of potentially difficult tracheal intubation, number of intubation attempts, success rate and glottic view were evaluated during a 2-year study period (first year, Macintosh laryngoscopy (ML); second year, C-MAC®).

Results

A total of 274 critically ill patients requiring endotracheal intubation were included; 113 intubations using ML and 117 intubations using the C-MAC® were assessed. In patients with at least one predictor for difficult intubation, the C-MAC® resulted in more successful intubations on first attempt compared with ML (34/43, 79% vs. 21/38, 55%; P = 0.03). The visualization of the glottis with ML using Cormack and Lehane (C&L) grading was more frequently rated as difficult (20%, C&L grade 3 and 4) compared with the C-MAC® (7%, C&L grade 3 and 4) (P < 0.0001).

Conclusion

Use of the C-MAC® video laryngoscope improved laryngeal imaging and improved the intubating success rate on the first attempt in patients with predictors for difficult intubation in the ICU setting. Video laryngoscopy seems to be a useful tool in the ICU where potentially difficult endotracheal intubations regularly occur.
GnRH Neuron Firing and Response to GABA in Vitro Depend on Acute Brain Slice Thickness and Orientation
Authors: Constantin Stephanie , Piet Richard , Iremonger Karl , Hwa Yeo Shel , Clarkson Jenny , Porteous Robert , Herbison Allan E.
Published: June 2012

The GnRH neurons exhibit long dendrites and project to the median eminence. The aim of the present study was to generate an acute brain slice preparation that enabled recordings to be undertaken from GnRH neurons maintaining the full extent of their dendrites or axons. A thick, horizontal brain slice was developed, in which it was possible to record from the horizontally oriented GnRH neurons located in the anterior hypothalamic area (AHA). In vivo studies showed that the majority of AHA GnRH neurons projected outside the blood-brain barrier and expressed c-Fos at the time of the GnRH surge. On-cell recordings compared AHA GnRH neurons in the horizontal slice (AHAh) with AHA and preoptic area (POA) GnRH neurons in coronal slices [POA coronal (POAc) and AHA coronal (AHAc), respectively]. AHAh GnRH neurons exhibited tighter burst firing compared with other slice orientations. Although α-Amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) excited GnRH neurons in all preparations, γ-aminobutyric acid (GABA) was excitatory in AHAc and POAc but inhibitory in AHAh slices. GABAA receptor postsynaptic currents were the same in AHAh and AHAc slices. Intriguingly, direct activation of GABAA or GABAB receptors respectively stimulated and inhibited GnRH neurons regardless of slice orientation. Subsequent experiments indicated that net GABA effects were determined by differences in the ratio of GABAA and GABAB receptor-mediated effects in “long” and “short” dendrites of GnRH neurons in the different slice orientations. These studies document a new brain slice preparation for recording from GnRH neurons with their extensive dendrites/axons and highlight the importance of GnRH neuron orientation relative to the angle of brain slicing in studying these neurons in vitro.