bluuebunny/crossref_metadata_2025 huggingface dataset:
Milan Criteria and UCSF Criteria: A Preliminary Comparative Study of Liver Transplantation Outcomes in the United States
Authors: Patel Supriya S. , Arrington Amanda K. , McKenzie Shaun , Mailey Brian , Ding Michelle , Lee Wendy , Artinyan Avo , Nissen Nicholas , Colquhoun Steven D. , Kim Joseph
Published: August 2012

The application of orthotopic liver transplantation (OLT) for patients with hepatocellular cancer (HCC) necessitates highly selective criteria to maximize survival and to optimize allocation of a scarce resource. The objective of this study was to compare the outcomes of OLT for HCC in patients transplanted under Milan and UCSF criteria. The United Network of Organ Sharing (UNOS) database was queried for patients who had undergone OLT for HCC from 2002 to 2007, and 1,972 patients (Milan criteria,n=1,913; UCSF criteria,n=59) were identified. Patients were stratified by pretransplant criteria (Milan versus UCSF), and clinical and pathologic factors and overall survival were compared. There were no differences in age, gender, diabetes mellitus, body mass index, and hepatitis B, or C status between the two groups. Overall survival was similar between the Milan and UCSF cohorts (1-, 2-, 3-, and 4-year survival rates: 88%, 81%, 76%, and 72% versus 91%, 80%, 68% and 51%, respectively,P=0.21). Although the number of patients within UCSF criteria was small, our results nevertheless suggest that patients with HCC may have equivalent survival when transplanted under Milan and UCSF criteria. Long-term followup may better determine whether UCSF criteria should be widely adopted.
Political Failures and Intergovernmental Competition
Authors: Hindriks Jean
Published: August 2012

In normative public economics, intergovernmental competition is usually viewed as harmful. Although empirical support for this position does not abound, market integration has intensified competition among developed countries. In this paper we argue that when assessing welfare effects of intergovernmental competition for various forms of political failures (the public choice critique), the outcome is ambiguous and competition can be welfare improving.
Modelling of Spacecraft Dynamics at Deployment of Large Elastic Structure
Authors: Khoroshilov V. S. , Zakrzhevskii A. E.
Published: August 2012

In this paper, a new approach to the modelling of the deployment dynamics of a flexible multi-body system with the time dependent configurations is demonstrated in the frame of the study the dynamics of a spacecraft with the gyro-gravitational system of stabilization. Primarily the gravitational stabilizer that is made as a pantograph structure is in a compact form. The deployment of a flexible pantograph structure is performed after placing the spacecraft into orbit and completion of the preliminary damping by a special jet-propelled system, and after uncaging the gyros. After its deployment, the pantograph turns into an elongated structure that serves as a gravitational stabilizer and carrier of solar batteries. The objective of the study is the creation of the generalized mathematical model and the conducting of the computational modelling of the spacecraft dynamics. The equations of motion are derived with the use of the Eulerian-LaGrangian formalism and symbolic computing. Numerical simulations of the typical operational mode of the system are conducted taking into account various control profiles for the deployment. Numerical results indicate that the system used for attitude stabilization ensures the shape of the deployed design and prescribed accuracy of the orientation.
Necrotizing Sialometaplasia of Palate: A Case Report
Authors: Garcia N. G. , Oliveira D. T. , Faustino S. E. S. , Azevedo A. L. R.
Published: August 2012

Background. Necrotizing sialometaplasia (NS) is an uncommon benign reactive necrotizing inflammatory process involving minor salivary gland that often mimics malignancy both clinically and histopathologically.Case Report. We report the case of a healthy 26-year-old man with a painless swelling in the hard palate near the middle raphe, asymptomatic, well limited, and raised edges. The patient was submitted to incisional biopsy and histopathological examination. The histological diagnosis was necrotizing sialometaplasia.Discussion. The clinical and histological similarity between this entity and a malignant lesion implies a risk of unnecessary or mistreatment. Therefore, clinicians and pathologists should be aware of this lesion as to avoid errors in the diagnosis and treatment of this benign pathologic condition.
A Mysterious Gram-Positive Rods
Authors: Natsag Javzandulam , Min Zaw , Hamad Yasir , Alkhalil Bassel , Rahman Atiq , Williams Richard
Published: August 2012

We encountered a patient with a history of intravenous drug use presenting with fever, malaise and nausea who was found to have cavitary lung lesions. Unexpectedly, gram positive rods grew out on day five on multiple blood cultures, which were later identified asMycobacterium fortuitum. The patient underwent transesophageal echocardiogram, which showed aortic and tricuspid valve vegetations. Liver biopsy demonstrated granulomatous hepatitis. Interestingly, serum alkaline phosphatase level fell with antibiotic treatment.Mycobacterium fortuitumis ubiquitous worldwide, being found in tap water, and soil.M. fortuitumis usually considered as a contaminant. Disseminated infection caused by this bacterium in an immunocompetent host is extremely rare. Most of the disseminated infections have been reported in immune-deficient patients. In immunocompetent people,M. fortuitumcauses human infection primarily by direct inoculation, including localized post-traumatic and surgical wound infections, and catheter-related sepsis. Our patient, an HIV-negative intravenous drug user, hadMycobacterium fortuitumsepsis associated with infective endocarditis, septic pulmonary emboli, and granulomatous hepatitis. Interestingly, the patient admitted using tap water occasionally for mixing heroin when her sterile water ran out, which we thought was the likely source ofM. fortuitum.
Balancing Treatment Allocation over Continuous Covariates: A New Imbalance Measure for Minimization
Authors: Hu Yanqing , Hu Feifang
Published: August 2012

In many clinical trials, it is important to balance treatment allocation over covariates. Although a great many papers have been published on balancing over discrete covariates, the procedures for continuous covariates have been less well studied. Traditionally, a continuous covariate usually needs to be transformed to a discrete one by splitting its range into several categories. Such practice may lead to loss of information and is susceptible to misspecification of covariate distribution. The more recent papers seek to define an imbalance measure that preserves the nature of continuous covariates and set the allocation rule in order to minimize that measure. We propose a new design, which defines the imbalance measure by the maximum assignment difference when all possible divisions of the covariate range are considered. This measure depends only on ranks of the covariate values and is therefore free of covariate distribution. In addition, we developed an efficient algorithm to implement the new procedure. By simulation studies we show that the new procedure is able to keep good balance properties in comparison with other popular designs.
Effects of Electroacupuncture at Head Points on the Function of Cerebral Motor Areas in Stroke Patients: A PET Study
Authors: Fang Zuo , Ning Jia , Xiong Chang , Shulin Yao
Published: August 2012

Positron emission tomography (PET) is used to observe the cerebral function widely and is a good method to explore the mechanism of acupuncture treatment on the central nervous system. By using this method, we observed the cerebral function of 6 patients suffering from ischemic stroke after receiving EA treatment at Baihui(GV20) and right Qubin(GB7). The results were: (1) the glucose metabolism changed significantly on primary motor area (M1), premotor cortex (PMC), and superior parietal louble (LPs) bilaterally, as well as the Supplementary Motor Area (SMA) on the unaffected hemisphere right after the first EA treatment. (2) The glucose metabolism on bilateral M1 and LPs changed significantly after three weeks of daily EA treatments. (3) The glucose metabolism on other areas such as insula, putamen, and cerebellum changed significantly. It demonstrated that EA at Qubin and Baihui couldactivate the cerebral structures related to motor function on the bilateral hemispheres.We concluded that EA was very helpful for the cerebral motor plasticity after the ischemic stroke. Also based on this study we assumed that the brain plasticity should be a network and that acupuncture participated in some sections of this course.
Early Pathologic Findings of Bronchiolitis Obliterans after Allogeneic Hematopoietic Stem Cell Transplantation: A Proposal from a Case
Authors: Nakamoto-Matsubara Rie , Nishikii Hidekazu , Yamada Kenji , Ito Masafumi , Hasegawa Yuichi , Kurita Naoki , Obara Naoshi , Okoshi Yasushi , Suzukawa Kazumi , Yokoyama Yasuhisa , Sakata-Yanagimoto Mamiko , Noguchi Masayuki , Chiba Shigeru
Published: August 2012

Bronchiolitis obliterans (BO) is one of the serious, noninfectious pulmonary complications after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Early diagnosis of BO is usually difficult because patients are often asymptomatic at an initial stage of the disease and pathologic findings are available mostly at the late stages. Therefore, the diagnosis of the disease is based on the pulmonary function test using the National Institute of Health consensus criteria. Here, we report a case of slowly progressive BO. A biopsy specimen at an early stage demonstrated alveolar destruction with lymphocyte infiltration in bronchial walls and mild narrowing of bronchioles without fibrosis, those were strongly indicative of initial pathologic changes of BO. Definitive BO followed, which was proven by both clinical course and autopsy. While alloreactive lymphocytes associated with chronic graft-versus-host disease are believed to initiate BO, we present a rare case that directly implies such a scenario.
Authentication of Algorithm to Detect Metastases in Men with Prostate Cancer Using ICD-9 Codes
Authors: Dolan Matthew T. , Kim Sung , Shao Yu-Hsuan , Lu-Yao Grace L.
Published: August 2012

Background. Metastasis is a crucial endpoint for patients with prostate cancer (PCa), but currently lacks a validated claims-based algorithm for detection. Objective. To develop an algorithm using ICD-9 codes to facilitate accurate reporting of PCa metastases. Methods. Medical records from 300 men hospitalized at Robert Wood Johnson University Hospital for PCa were reviewed. Using the presence of metastatic PCa on chart review as the gold standard, two algorithms to detect metastases were compared. Algorithm A used ICD-9 codes 198.5 (bone metastases), 197.0 (lung metastases), 197.7 (liver metastases), or 198.3 (brain and spinal cord metastases) to detect metastases, while algorithm B used only 198.5. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for the two algorithms were determined. Kappa statistics were used to measure agreement rates between claim data and chart review. Results. Algorithm A demonstrated a sensitivity, specificity, PPV, and NPV of 95%, 100%, 100%, and 98.7%, respectively. Corresponding numbers for algorithm B were 90%, 100%, 100%, and 97.5%, respectively. The agreement rate is 96.8% for algorithm A and 93.5% for algorithm B. Conclusions. Using ICD-9 codes 198.5, 197.0, 197.7, or 198.3 in detecting the presence of PCa metastases offers a high sensitivity, specificity, PPV, and NPV value.
Role of Plasminogen Activator Inhibitor-1 in Urokinase's Paradoxical In Vivo Tumor Suppressing or Promoting Effects
Authors: Jing Yuqi , Kovacs Krisztina , Kurisetty Vittal , Jiang Zhijie , Tsinoremas Nick , Merchan Jaime R.
Published: August 2012

Tumor proteases and inhibitors have been associated with paradoxical effects on tumor progression in preclinical and clinical settings. We previously reported that urokinase (uPA) overexpression delays tumor progression in mammary cancer. This study aimed to determine the role of plasminogen activator inhibitor-1 (PAI-1) on uPA's paradoxical in vivo effects. Using syngeneic murine models, we found that stable uPA overexpression promoted in vivo growth of colon tumors (MC-38) naturally expressing high PAI-1, whereas growth inhibition was observed in renal tumors (RENCA) expressing lower PAI-1 levels. In murine mammary carcinoma (4T1), uPA overexpression shifted the uPA/PAI-1 balance in favor of the protease, resulting in significantly reduced tumor growth and metastases in vivo. Conversely, increased tumor progression was observed in stable PAI-1 overexpressing 4T1 tumors as compared with uPA-overexpressing and control tumors. These effects were associated with downregulation of metastases promoting genes in uPA-overexpressing tumors, such as metalloproteinases, CXCL-1, c-Fos, integrin α-5, VEGF-A, PDGF-α, and IL-1β. In PAI-1–overexpressing tumors, many of the above genes were upregulated. PAI-1 overexpressing tumors had increased total and new tumor microvessels, and increased tumor cell proliferation, whereas the opposite effects were found in uPA-overexpressing tumors. Finally, PAI-1 downregulation led to significant inhibition of 4T1 tumor growth and metastases in vivo. In conclusion, uPA's dual effects on tumor progression occur in the context of its interactions with endogenous PAI-1 expression. Our studies uncover novel mechanisms of in vivo tumor control by modulation of the balance between tumor proteases and inhibitors, which may be exploited therapeutically. Mol Cancer Res; 10(10); 1271–81. ©2012 AACR.
A Novel Function of YWHAZ/β-Catenin Axis in Promoting Epithelial–Mesenchymal Transition and Lung Cancer Metastasis
Authors: Chen Ching-Hsien , Chuang Show-Mei , Yang Meng-Fang , Liao Jiunn-Wang , Yu Sung-Liang , Chen Jeremy J.W.
Published: August 2012

YWHAZ, also known as 14-3-3zeta, has been reportedly elevated in many human tumors, including non–small cell lung carcinoma (NSCLC) but little is known about its specific contribution to lung cancer malignancy. Through a combined array-based comparative genomic hybridization and expression microarray analysis, we identified YWHAZ as a potential metastasis enhancer in lung cancer. Ectopic expression of YWHAZ on low invasive cancer cells showed enhanced cell invasion, migration in vitro, and both the tumorigenic and metastatic potentials in vivo. Gene array analysis has indicated these changes associated with an elevation of pathways relevant to epithelial–mesenchymal transition (EMT), with an increase of cell protrusions and branchings. Conversely, knockdown of YWHAZ levels with siRNA or short hairpin RNA (shRNA) in invasive cancer cells led to a reversal of EMT. We observed that high levels of YWHAZ protein are capable of activating β-catenin–mediated transcription by facilitating the accumulation of β-catenin in cytosol and nucleus. Coimmunoprecipitation assays showed a decrease of ubiquitinated β-catenin in presence of the interaction between YWHAZ and β-catenin. This interaction resulted in disassociating β-catenin from the binding of β-TrCP leading to increase β-catenin stability. Using enforced expression of dominant-negative and -positive β-catenin mutants, we confirmed that S552 phosphorylation of β-catenin increases the β-catenin/YWHAZ complex formation, which is important in promoting cell invasiveness and the suppression of ubiquitnated β-catenin. This is the first demonstration showing YWHAZ through its complex with β-catenin in mediating lung cancer malignancy and β-catenin protein stability. Mol Cancer Res; 10(10); 1319–31. ©2012 AACR.
Diagnosis of Adjustment Disorder: Reliability of Its Clinical Use and Long-Term Stability
Authors: Jäger Markus , Burger Daniel , Becker Thomas , Frasch Karel
Published: August 2012

Background: Adjustment disorder is a common diagnosis in mental health services. However, the diagnostic reliability and stability of this nosological construct are unclear. Sampling and Methods: Clinical chart records of patients who had been discharged with a clinical diagnosis of adjustment disorder were re-evaluated by two independent raters using ICD-10 criteria. On the basis of the chart material, the frequency of readmissions and diagnostic changes were recorded. Results: Of 142 patients with a clinical diagnosis of adjustment disorder, only 91 (64.1%) retrospectively met ICD-10 criteria for this diagnosis. Eighteen of these 91 patients (19.8%) were readmitted to a mental health hospital within a 5-year period and 9 (9.9%) showed a diagnostic change at readmission, 5 of them to substance use disorders (5.5%). Conclusions: The dramatic divergence between the clinical diagnosis and ICD-10 criteria challenges the validity and usefulness of the current nosological concept of adjustment disorder.
Soul Darkness? Dimensions of Religious/ Spiritual Well-Being among Mood-Disordered Inpatients Compared to Healthy Controls
Authors: Unterrainer H.F. , Schoeggl H. , Fink A. , Neuper C. , Kapfhammer H.P.
Published: August 2012

Background: Religiosity and spirituality have been found to be substantially associated with a variety of mental health and illness parameters. However, relevant empirical evidence is sparse, and more research is needed in order to further understand what role religiosity/spirituality plays in the development, progression and healing process of a psychiatric disease. Thus, the purpose of this study was to find out more information about the religious/spiritual needs of anxious/depressive inpatients. Sampling and Methods: A total sample of 200 well-characterized anxious/depressive inpatients was investigated. Results were compared to those from an adjusted group of healthy individuals (n = 200). A newly developed Multidimensional Inventory for Religious/Spiritual Well-Being was applied to both groups, together with established psychiatric measures (e.g. Beck Depression Inventory). Results: Of the dimensions measured, Hope and Forgiveness turned out to be the strongest negative correlates of anxious/depressive symptoms (p < 0.001). Moreover, a lower degree of Hope (p < 0.001) and Experiences of Sense and Meaning (p < 0.01) was found in the patient group compared to healthy controls. In accordance with the literature, religiosity was confirmed to be a substantial suicidal buffer (p < 0.01). Conclusions: Our results account for a more comprehensive psychiatric evaluation, emphasizing in particular the role that religiosity/spirituality plays in overall well-being. Furthermore, religious/spiritual well-being might be considered an important resource to explore, in particular for affective mentally disordered patients.
Exposure to Obstetric Complications in Relation to Subsequent Psychiatric Disorders of Adolescent Inpatients: Specific Focus on Gender Differences
Authors: Lukkari Sari , Hakko Helinä , Herva Anne , Pouta Anneli , Riala Kaisa , Räsänen Pirkko
Published: August 2012

Background: Exposure to obstetric complications is known to be associated with subsequent development of psychiatric disorders. However, earlier findings are mainly based on adult populations having a long follow-up time for onset of psychiatric illness. We examined whether the association of obstetric complications with severe mental disorders is already seen in a population of underage adolescents admitted to psychiatric inpatient care. Method: The study population was a clinical sample of adolescents (n = 508) aged 12–17 years admitted to psychiatric hospital. DSM-IV diagnoses of the psychiatric disorders of the adolescents as well as information on obstetric (i.e., pregnancy, delivery and perinatal) complications and substance use during pregnancy reported by the mothers of the adolescents were based on the semi-structured Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime. Results: A total of 96 (19%) adolescents had been exposed to obstetric complications. The prevalence of pregnancy, delivery or perinatal complications reported by the mothers of the offspring was 55 (57%), 57 (59%) and 13 (14%), respectively. Among adolescents with conduct disorder, exposure to delivery complications was more common among males compared to females (16 vs. 5%, p = 0.006); this was particularly true for section delivery (7 vs. 1%, p = 0.023). A trend towards a significant gender difference was also found among adolescents with anxiety disorder (21 vs. 8%, p = 0.085). Conclusions: Boys seem to be more vulnerable to the exposure of delivery complications than girls. Exposure to obstetric complication may be associated with development of subsequent psychiatric disorder; particularly conduct disorder of adolescent boys.
Attention Deficit Hyperactivity Disorder and Obsessive-Compulsive Disorder among Former Heroin Addicts Currently in Methadone Maintenance Treatment
Authors: Peles Einat , Schreiber Shaul , Sutzman Agata , Adelson Miriam
Published: August 2012

Background: The aim of this study was to evaluate the prevalence of childhood and adulthood attention deficit hyperactivity disorder (ADHD) and clinical obsessive-compulsive disorder (OCD) among adult patients in methadone maintenance treatment (MMT) and to characterize possible risk factors. Sampling andMethods: A random sample of 154 current MMT patients was studied for childhood ADHD (Wender Utah Rating Scale), current clinical OCD (Yale-Brown Obsessive Compulsive Scale), lifetime trauma history and modified Addiction Severity Index for demographics, as well as any lifetime DSM-IV-TR psychiatric diagnosis. Results: Fifty-one patients (33.1%) had childhood ADHD, and more of this group currently had clinical OCD compared to patients who did not have childhood ADHD (55.3 vs. 30.1%). The two groups did not differ with regard to gender and age of admission to MMT. Logistic regression found that the childhood ADHD group had a higher risk of having OCD [odds ratio (OR) 3.8, 95% confidence interval (CI) 1.6–8.8], more severe nicotine smoking (OR 1.4, 95% CI 1.1–1.7) and fewer years of education (OR 0.8, 95% CI 0.6–1) and were more likely to have a DSM-IV-TR axis II disorder (OR 4.3, 95% CI 1.4–13.4) and a history of falls (OR 4.3, 95% CI 1.4–12.9). Conclusions: Although ADHD is more prevalent among males in the general population, the rates in our MMT population were similar in each gender. One third of our sample had suffered from ADHD during childhood, which may have led them to self-medicate with drugs and thus to addiction. Childhood ADHD was associated with current OCD, and both conditions were highly prevalent among our MMT patients. The reason for a history of repeated falls warrants further study.
Evaluating Depressive Symptoms in Schizophrenia: A Psychometric Comparison of the Calgary Depression Scale for Schizophrenia and the Hamilton Depression Rating Scale
Authors: Schennach Rebecca , Obermeier Michael , Seemüller Florian , Jäger Markus , Schmauss Max , Laux Gerd , Pfeiffer Herbert , Naber Dieter , Schmidt Lutz G. , Gaebel Wolfgang , Klosterkötter Joachim , Heuser Isabella , Maier Wolfgang , Lemke Matthias R. , Rüther Eckart , Klingberg Stefan , Gastpar Markus , Riedel Michael , Möller Hans-Jürgen
Published: August 2012

Background: The aim of this study was to compare two measures of depression in patients with schizophrenia and schizophrenia spectrum disorder, including patients with delusional and schizoaffective disorder, to conclude implications for their application. Sampling and Methods: A total of 278 patients were assessed using the Calgary Depression Scale for Schizophrenia (CDSS) and the Hamilton Depression Rating Scale (HAMD-17). The Positive and Negative Syndrome Scale (PANSS) was also applied. At admission and discharge, a principal component analysis was performed with each depression scale. The two depression rating scales were furthermore compared using correlation and regression analyses. Results: Three factors were revealed for the CDSS and HAMD-17 factor component analysis. A very similar item loading was found for the CDSS at admission and discharge, whereas results of the loadings of the HAMD-17 items were less stable. The first two factors of the CDSS revealed correlations with positive, negative and general psychopathology. In contrast, multiple significant correlations were found for the HAMD-17 factors and the PANSS subscores. Multiple regression analyses demonstrated that the HAMD-17 accounted more for the positive and negative symptom domains than the CDSS. Conclusions: The present results suggest that compared to the HAMD-17, the CDSS is a more specific instrument to measure depressive symptoms in schizophrenia and schizophrenia spectrum disorder, especially in acutely ill patients.
The Effect of American Society of Anesthesiology Scores on Percutaneous Nephrolithotomy Outcomes
Authors: Toksoz Serdar , Dirim Ayhan , Kizilkan Yalcin , Ozkardes Hakan
Published: August 2012

Introduction: To evaluate the effect of American Society of Anesthesiology (ASA) scores on percutaneous nephrolithotomy (PNL) outcomes. Materials and Methods: The records of 186 consecutive patients undergoing PNL procedures from 2006 to 2011 at a single institution were evaluated. Patients were divided into a low-risk group with a preoperative ASA of I or II and a high-risk group with ASA of III or IV. Postoperative complications were classified according to the modified Clavien classification system. Results and Conclusions: There were 140 cases in the low-risk and 46 cases in the high-risk groups. The mean operative time was 72 min (40–120 min) and 86 min (55–125 min) and the complication rates were 17.8 and 19.5% for the low- and high-risk groups, respectively. The average duration of nephrostomy tube drainage was 3.3 ± 1 and 4.2 ± 1.5 days for the low- and high-risk groups, respectively. Stone-free rates were 85 and 82% for the low- and high-risk groups, respectively. PNL can be safely performed in the ASA high-risk patient population.
Decline of Health Status Sub-Domains by Exacerbations of Chronic Obstructive Pulmonary Disease: A Prospective Survey
Authors: Verhage Tewe , Boer Lonneke , Molema Johan , Heijdra Yvonne , Dekhuijzen Richard , Vercoulen Jan H.
Published: August 2012

Background: Exacerbations of chronic obstructive pulmonary disease (COPD) are held responsible for a decline in health status (HS). This may not apply equally to all exacerbations, because different definitions are required for quite different illnesses. Selection of definitions and the sensitivity of the HS instrument may affect results regarding the impact of exacerbations. Sensitivity of a new HS instrument, which covers different and more aspects, has not yet been tested, with respect to exacerbations. Objectives: Confirmation of the negative HS effect of exacerbations by using a highly differentiated instrument, and to evaluate which aspects of HS are affected most. Methods: One hundred and sixty-eight ambulatory patients with COPD were evaluated prospectively with regard to a wide range of HS aspects, at the beginning and end of a 1-year follow-up. Recording of symptom changes and treatment on monthly diary cards resulted in the identification of event-based exacerbations. HS was assessed via a newly validated instrument integrating both physiological and non-physiological sub-domains. Parametric correlations were calculated between exacerbation frequency and HS scores at the end of the study. Partial corre-lations were then explored using HS scores at baseline to correct for prior HS levels. Results: Correlations between -exacerbation frequency and HS sub-domains were found to be frequent, predominantly in non-physiological sub--domains. After correction for HS scores at baseline, only 2 sub-domains (belonging to the main domain ‘Complaints') remained significantly but weakly correlated. Conclusion: Exacerbation frequency and HS show weak correlations after a year, but most of these disappear after correction for prior HS levels. In such exacerbations, aggravated HS probably takes much longer to manifest itself.
Perioperative Stroke Risk in Nonvascular Surgery
Authors: Macellari Federica , Paciaroni Maurizio , Agnelli Giancarlo , Caso Valeria
Published: August 2012

Background: Perioperative stroke is an ischemic or hemorrhagic cerebrovascular accident that can arise intraoperatively or from 3 to 30 days after surgery. This relatively rare complication deserves attention because of its high mortality and serious disability, the latter of which can lead to prolonged hospital stay as well as disswcharge to long-term care facilities. The aim of this article was to review the literature on perioperative stroke in general surgery, excluding carotid and cardiac surgeries because these have already been thoroughly investigated in previous papers. Methods: A search strategy was designed to identify all relevant studies on perioperative stroke in the English language. This search was restricted to papers published up to December 5, 2011. Studies were initially identified from the Medline/PubMed database, EMBASE and the Cochrane Database using the search terms ‘surgery’, ‘perioperative stroke’, ‘risk factors’, ‘anticoagulation treatment’ and ‘antiplatelet treatment’. Results: The incidence of perioperative stroke among patients who undergo nonvascular surgery is reported to be about 0.08–0.7%. This depends on the type and complexity of the surgical procedure along with patient risk factors. The reported perioperative mortality is 18–26%. One of the main issues is the management of patients taking anticoagulant or antiplatelet drugs, as the risk of bleeding has to be counterbalanced with the risk of arterial thrombosis due to discontinuation. Additionally, the presence of symptomatic carotid stenosis should be taken into account in the risk evaluation. Conclusions: To date, current guidelines are incomplete regarding the management of patients with vascular disease undergoing nonvascular surgery. It is recommended to stop oral anticoagulation approximately 5 days before major surgery to adequately allow the INR to normalize, and at the same time subcutaneous low-molecular-weight heparin or intravenous unfractionated heparin should be started. Regarding new anticoagulants, dabigatran does not need to be withheld for minor procedures. Currently, there are no clear recommendations on the use of rivaroxaban and apixaban. Data concerning the management of patients undergoing antiplatelet therapy are lacking. To date, neurologists discourage the perioperative withdrawal of aspirin (acetylsalicylic acid, ASA) especially in patients in secondary prevention. The ‘Antiplatelet Agents in the Perioperative Management of Patients Trial’ is ongoing to assess the safety and determine the optimal use of ASA in the perioperative management of patients undergoing general and abdominal surgery. In the meantime an individualized, accurate, multidisciplinary (surgical, neurological, cardiological and anesthesiological) risk/benefit assessment remains the best basis for treatment decision.
Chromosomal Localization of Ribosomal and Telomeric DNA Provides New Insights on the Evolution of Gomphocerinae Grasshoppers
Authors: Jetybayev I.E. , Bugrov A.G. , Karamysheva T.V. , Camacho J.P.M. , Rubtsov N.B.
Published: August 2012

Chromosome location of ribosomal DNA (rDNA) and telomeric repeats was analysed in mitotic chromosomes of 15 species of Gomphocerinae grasshoppers belonging to the tribes Arcypterini, Gomphocerini, Stenobothrini, and Chrysochraontini. Two types of rDNA distribution were found in the Gomphocerini tribe. Type 1, found in 9 species, was characterized by the presence of rDNA in the short arm of the long biarmed chromosomes 2 and 3 and, in some species, also in the X chromosome. Type 2 was found only in Aeropus sibiricus and Stauroderus scalaris and consisted in the presence of pericentromeric rDNA blocks in all chromosomes. A comparison of rDNA distribution in Gomphocerini species with 2n♂ = 23, 2n♂ = 21, and 2n♂ = 17 suggested the possible involvement of chromosome 6 in the ancestral karyotype (2n♂ = 23) in 1 of the 3 centric fusions that decreased the chromosome number in these species. In the tribe Stenobothrini, Stenobothrus eurasius carried a single rDNA cluster in the X chromosome, likewise 2 Spanish species previously analysed, but Omocestus viridulus unusually showed a single rDNA cluster in the longest autosome. Telomeric repeats were located primarily on the ends of chromosome arms. In 2 species, however, we observed the presence of interstitial clusters outside telomeric regions. The first one, Aeropus sibiricus, exhibited a polymorphic interstitial site of telomeric repeats in chromosome 6 as a consequence of a paracentric inversion. Most remarkably, Chorthippus jacobsoni showed the presence of telomeric repeats in the pericentric regions of the 3 biarmed chromosome pairs originated by centric fusion, thus suggesting that these rearrangements were not of the Robertsonian type but true centric fusion with a probable generation of dicentric chromosomes.
Comparison of Spectral-Domain Optical Coherence Tomography and Heidelberg Retina Tomograph III Optic Nerve Head Parameters in Glaucoma
Authors: Seymenoğlu Göktuğ , Başer Esin , Öztürk Bilge
Published: August 2012

Background: To evaluate the agreement between the optic nerve head (ONH) measurements obtained by spectral-domain optical coherence tomography/scanning laser ophthalmoscope (SD-OCT/SLO) and the Heidelberg retinal tomograph III (HRT-III), and to compare the ONH measurements of both devices in different glaucoma types. Methods: In a prospective study, 30 patients with primary open-angle glaucoma (POAG) and 30 patients with pseudoexfoliation glaucoma (PXG) were enrolled. All patients underwent SD-OCT/SLO and HRT-III evaluation of the ONH during the same visit. Agreement between measurements of SD-OCT/SLO and HRT-III were evaluated by determination of intraclass correlation coeficients. In addition, mean ONH measurements obtained with both devices were compared between POAG and PXG patient groups. Results: Mean SD-OCT/SLO measurements were greater than those of HRT-III, except for mean and maximum cup depth. Intraclass correlation coefficient values for disc area, rim area, cup area, cup/disc area ratio, mean cup depth and maximum cup depth were 0.367, 0.213, 0.632, 0.681, 0.775 and 0.661, respectively. No significant differences were found between ONH parameters of POAG and PXG patients as measured with both devices (p > 0.01). Conclusion: ONH measurements with SD-OCT/SLO and HRT-III did not show clinically acceptable agreement in glaucoma patients. This precludes interchangeable use of these measurements in clinical practice. PXG and POAG patient groups displayed similar ONH measurements with both devices.
Heat Shock Protein 70 Gene Polymorphisms in Sudden Sensorineural Hearing Loss
Authors: Chien Chen-Yu , Chang Ning-Chia , Tai Shu-Yu , Wang Ling-Feng , Wu Ming-Tsang , Ho Kuen-Yao
Published: August 2012

Background: Heat shock proteins protect cells and tissues against different types of damage. Previous studies have revealed that the serum level of heat shock protein 70 (HSP70) increases in sudden sensorineural hearing loss (SSNHL) patients. We hypothesized that genetic variants of the HSP70 gene are associated with susceptibility to SSNHL. Methods: We conducted a case-control study with 160 SSNHL cases and 178 controls. Three tagging single nucleotide polymorphisms (SNPs) were selected. The genotypes were determined using TaqMan technology. Hardy-Weinberg equilibrium was tested for each SNP, and genetic effects were evaluated according to three inheritance modes. A haplotype analysis was also performed. Results: All three SNPs were in Hardy-Weinberg equilibrium. The CT genotype of rs2075800 exhibited an adjusted odds ratio of 0.59 (95% confidence interval 0.37–0.94; p = 0.027). The T allele of SNP rs2075800 was associated with SSNHL under the dominant model (p = 0.019; odds ratio 0.59). Haplotype analysis of the three SNPs demonstrated that the haplotype TGC (rs2075800/rs1043618/rs2763979) was statistically significant (p = 0.0137). Conclusions: These results suggest that HSP70 gene polymorphisms influence the susceptibility to the development of SSNHL in the Taiwanese population.
Testing, Implementation, and Evolution of Seeding Concepts—A Review
Authors: Cotton William R.
Published: August 2012

In this paper, testing, implementation, and evolution of both static and dynamic seeding concepts are reviewed. A brief review of both waterspray and hygroscopic seeding is first presented. This is followed by reviews of static seeding of stable orographic clouds and supercooled cumuli. We conclude with a review of dynamic seeding concepts with particular focus on the Florida studies.

It is concluded that it is encouraging that our testing procedures have evolved from single-response-variable “blackbox” experiments to randomized experiments that attempt to test a number of components in the hypothesized chain of physical responses to seeding. It is cautioned, however, that changes in the seeding strategy to optimize detection of a physical response (in any of the intermediate links in the hypothesized chain of responses) can have an adverse effect upon rainfall on the ground.
An Engineer's View on the Implementation and Testing of Seeding Concepts
Authors: Smith Paul L.
Published: August 2012

Comments are made on opportunity recognition, treatment, and evaluation aspects of the implementation and testing of seeding concepts. The main topics include experimental design, experimental units, delivery and dispersion of seeding agents, and statistical evaluation procedures.
Aggregates as Embryos in Seeded Clouds
Authors: Heymsfield Andrew J.
Published: August 2012

The growth of ice particles through aggregation is investigated for seeded clouds using currently available field data and a numerical particle-growth model. Observations indicate that the aggregation process is fairly common, even when moderate liquid water contents, ~0.5 g m–3, are available for particle growth through accretion. The modeling study suggests that certain temperature ranges are especially conducive to aggregate formation.
Evaluation of “Static” and “Dynamic” Seeding Concepts through Analyses of Israeli II and FACE-2 Experiments
Authors: Gagin Abraham
Published: August 2012

In static-mode seeding two assumptions are usually made: a deficiency in concentrations of natural ice crystals is the reason for delay, or even failure, of precipitation formation in certain cloud conditions; and, moderate increases in ice crystal concentrations, obtained by glaciogenic seeding of such clouds, will result in rainfall enhancement either by making the already existing process of rain formation more effective or by inducing precipitation formation in clouds that otherwise would not have precipitated naturally.

The basic assumption behind seeding for dynamic effects is that increased cloud buoyancy, achieved through conversion of supercooled water to ice by seeding, will cause an increase in cloud depth, which in turn will result in stronger rainfall intensities, areas and durations.

These basic assumptions are examined in terms of physical and statistical analyses of data from Israeli II (a static-mode seeding project) and FACE-2 (a dynamic-mode seeding project).
Static Mode Seeding of Summer Cumuli—A Review
Authors: Silverman Bernard A.
Published: August 2012

A review of the state of knowledge of the physics of the static mode seeding hypothesis for convective clouds is presented. The central thesis of the review is that the results of past experimental work are diverse but valid and that credibility of the science depends on understanding the physical reasons for the diverse results. Areas of uncertainty and conflicts in evidence associated with the statement of physical hypothesis, the concept of seedability, the seeding operation, and the chain of physical events following seeding are highlighted to identify what issues need to be resolved to further progress in precipitation enhancement research and application.

It is concluded that the only aspect of static seeding that meets scientific standards of cause-and-effect relationships and repeatability is that glaciogenic seeding agents can produce distinct “seeding signatures” in clouds. However, the reviewer argues that a body of inferential physical evidence has been amassed that provides a better understanding of which clouds are seedable (susceptible to precipitation enhancement by artificial seeding) and which are not, even though the tools for recognizing and properly treating them are imperfect. In particular, the inferred evidence appears to support the claims of physical plausibility for the positive statistical results of the Israeli experiments.

It is suggested that future work continue to be designed for physical understanding and evaluation through comprehensive field studies and numerical modeling. Duplicating the Israeli experiments in another location should receive high priority but, in general, future experiments should move upscale from cumulus congestus to convective complexes. In doing so, a new, more complex physical hypothesis that accounts for cloud–environment and microphysical–dynamical interactions and their response to seeding will have to be developed.
Mesoscale Modeling of the Atmosphere
Authors: Pielke Roger A. , Pearce Robert P.
Published: August 2012

No Abstract available.
Changes in Observed Daily Precipitation over the United States between 1950–79 and 1980–2009
Authors: Higgins R. W. , Kousky V. E.
Published: August 2012

Changes in observed daily precipitation over the conterminous United States between two 30-yr periods (1950–79 and 1980–2009) are examined using a 60-yr daily precipitation analysis obtained from the Climate Prediction Center (CPC) Unified Raingauge Database. Several simple measures are used to characterize the changes, including mean, frequency, intensity, and return period. Seasonality is accounted for by examining each measure for four nonoverlapping seasons. The possible role of the El Niño–Southern Oscillation (ENSO) cycle as an explanation for differences between the two periods is also examined. There have been more light (1 mm ≤ P < 10 mm), moderate (10 mm ≤ P < 25 mm), and heavy (P ≥ 25 mm) daily precipitation events (P) in many regions of the country during the more recent 30-yr period with some of the largest and most spatially coherent increases over the Great Plains and lower Mississippi Valley during autumn and winter. Some regions, such as portions of the Southeast and the Pacific Northwest, have seen decreases, especially during the winter. Increases in multiday heavy precipitation events have been observed in the more recent period, especially over portions of the Great Plains, Great Lakes, and Northeast. These changes are associated with changes in the mean and frequency of daily precipitation during the more recent 30-yr period. Difference patterns are strongly related to the ENSO cycle and are consistent with the stronger El Niño events during the more recent 30-yr period. Return periods for both heavy and light daily precipitation events during 1950–79 are shorter during 1980–2009 at most locations, with some notable regional exceptions.
Convective Initiation in an Idealized Cloud Model Using an Updraft Nudging Technique
Authors: Naylor Jason , Gilmore Matthew S.
Published: August 2012

Previous cloud modeling studies have noted difficulty in producing strong, sustained deep convection in environments with convective inhibition and/or midlevel dryness when the thermal bubble technique is used to initiate convection. This difficulty is also demonstrated herein, using 113 supercell proximity soundings—most of which contain capping inversions and some amount of convective inhibition. Instead, by using an updraft nudging initiation technique, substantially more supercells result and for a longer period. Additionally, the number of supercell-producing cases is maximized when updraft nudging is applied for only the first 15 min of cloud time near the top of the boundary layer instead of longer/shorter periods or when nudging is applied near the surface.
Simulated Vortex Detection Using a Four-Face Phased-Array Doppler Radar
Authors: Brown Rodger A. , Wood Vincent T.
Published: August 2012

The National Weather Radar Testbed was established in Norman, Oklahoma, in 2002 to evaluate, in part, the feasibility of eventually replacing mechanically scanned parabolic antennas with electronically scanned phased-array antennas on weather surveillance radars. If a phased-array antenna system is to replace the current antenna, among the important decisions that must be made are the design (flat faces, cylinder, etc.) that will be needed to cover 360° in azimuth and the choice of an acceptable beamwidth. Investigating the flat-face option, four faces seem to be a reasonable choice for providing adequate coverage. To help with the beamwidth decision-making process, the influence of beamwidth on the resolution of various-sized simulated vortices is investigated. It is found that the half-power beamwidth across the antenna should be no more than 1.0° (equating to a broadside beamwidth of 0.75°) in order to provide National Weather Service forecasters with at least the same quality of data resolution that is currently available for making tornado and severe storm warnings.
Vertebral artery dissection associated with viral meningitis
Authors: Pan Xudong , Ma Aijun , Wang Kun , Nie Shumin , Wu Mei
Published: August 2012

Background

Vertebral artery dissection (VAD) is often associated with trauma or occurs spontaneously, inevitably causing some neurological deficits. Even though acute infection can be related to the development of spontaneous VAD (sVAD), VAD associated with viral meningitis has never been reported in the literature.

Case presentation

A 42-year-old man with fever, sore throat, and runny nose developed sudden onset of occipital headache, vertigo, transient confusion, diplopia, and ataxia. Brain stem encephalitis was diagnosed initially because the cerebrospinal fluid (CSF) study showed inflammatory changes. However, subsequent diffusion-weighted (DWI) magnetic resonance imaging of his brain demonstrated left lateral medullary infarction, and the digital subtraction angiography (DSA) confirmed VAD involving left V4 segment of the artery. Consequently, the patient was diagnosed as VAD accompanied by viral meningitis.

Conclusion

This case suggests that viral meningitis might lead to inflammatory injury of the vertebral arterial wall, even sVAD with multiple neurological symptoms.