bluuebunny/crossref_metadata_2025 huggingface dataset:
Probiotic Potential and Safety Properties ofLactobacillus plantarumfrom Slovak Bryndza Cheese
Authors: Belicová Anna , Mikulášová Mária , Dušinský Roman
Published: September 2013

One hundred and twenty-five acid-resistant presumptive lactobacilli were isolated from Slovak Bryndza cheese and screened for their antimicrobial activity against eight bacterial pathogens using spot agar assay. Out of twenty-sixLactobacillusstrains with strong inhibition activity, twenty were identified asLactobacillus plantarumand six asLactobacillus fermentum. The most active elevenL. plantarumisolates were further characterizedin vitrofor some probiotic and safety properties. Only three isolates K10, K21, and ZS07 showed the ability to grow over 50% in the presence of 0.3% bile. Strong deconjugation efficiency was determined for CK06 and K21. The highestβ-galactosidase activity was shown in isolates ZS11, B01, CK06, and ZS07. Only three of the strains had the ability to produce tyramine: CK06, LM1, and ZS11. Strains K09, K21, ZS11, and ZS15 were susceptible to all tested antibiotics. Analysis of the results confirmed theL. plantarumisolates ZS07 and K21 as the most suitable for probiotic use, due to their desirable probiotic and safety characteristics.
Intraperitoneal Urinary Bladder Perforation Observed in a Patient with an Indwelling Urethral Catheter
Authors: Ogawa Soichiro , Date Tomonori , Muraki Osamu
Published: September 2013

This report describes a rare case of an 86-year-old man with an indwelling urethral catheter who developed severe abdominal pain and was diagnosed with intraperitoneal urinary bladder perforation. A home-visiting nurse suspected catheter obstruction and performed a catheter exchange. However, bladder irrigation could not subsequently be performed. Computed tomography of the abdomen and pelvis after transurethral perfusion of contrast medium demonstrated extravasation of the contrast material into the peritoneal cavity. Furthermore, the Foley catheter balloon was positioned in the peritoneal cavity through the bladder. The patient was diagnosed with peritonitis due to spontaneous intraperitoneal perforation of the urinary bladder, and exploratory laparotomy was performed. During exploration, a perforated tear at the top of the bladder was discovered where the Foley catheter had penetrated the bladder. The Foley catheter balloon was floating freely in the peritoneal cavity. There was no evidence of pathologic lesions, such as cancer or inflammatory mass at the site of the injured peritoneum. Successful closure of the damaged peritoneum and bladder was performed. Since the proportion of elderly individuals continues to increase in the general Japanese population, the incidence of the chronic Foley catheterization is expected to increase. Therefore, clinicians should be aware of this potential complication.
A Rare Case of Congenital Simple Cystic Ranula in a Neonate
Authors: Singh Gautam Bir , Rai Anil K. , Arora Rubeena , Garg Sunil , Abbey Pooja , Shukla Shailaja
Published: September 2013

Congenital ranula in a neonate is an uncommon occurrence. We present one such case of the said lesion where the clinical presentation and management were found to be interesting, hitherto unreported in the medical literature. This clinical record also reviews the scant medical literature on congenital ranula in neonates.
Measuring Problematic Mobile Phone Use: Development and Preliminary Psychometric Properties of the PUMP Scale
Authors: Merlo Lisa J. , Stone Amanda M. , Bibbey Alex
Published: September 2013

This study aimed to develop and assess the psychometric properties of an English language measure of problematic mobile phone use. Participants were recruited from a university campus, health science center, and other public locations. The sample included 244 individuals (68.4% female) aged 18–75. Results supported a unidimensional factor structure for the 20-item self-report Problematic Use of Mobile Phones (PUMP) Scale. Internal consistency was excellent (α=0.94). Strong correlations (r=.76,P<.001) were found between the PUMP Scale and an existing scale of cellular phone dependency that was validated in Asia, as well as items assessing frequency and intensity of mobile phone use. Results provide preliminary support for the use of the PUMP Scale to measure problematic use of mobile phones.
Paclitaxel Release from Polyether-Anhydrides Prepared with UV-Curing Process
Authors: Dong Anxin , Zhang Tao
Published: September 2013

Polyanhydrides have been used as drug delivery systems to achieve a long-term delivery due to its hydrophobicity and surface erosion degradation behavior. In order to develop a simple, economical, and rapid approach to synthesize polyanhydrides, we prepared a series of polyether-anhydride membranes composed of different mass fractions of sebacic acid, polyethylene glycol dimethacrylate, and poly(tetramethylene oxide) dimethacrylate by ultraviolet curing process. The chemical structure and thermal properties of target polyanhydrides were characterized, while the paclitaxel releases from the polymer matrix were evaluated by HPLC. The results demonstrated that the UV-curing process is a good method to synthesize the target polymers in a short time, and the paclitaxel release procedure can be controlled by changing the component in the copolymers.
Photocatalytic Decolourization of Direct Yellow 9 on Titanium and Zinc Oxides
Authors: Regulska Elżbieta , Małgorzata Bruś Diana , Karpińska Joanna
Published: September 2013

The photodecolourization of Direct Yellow 9, a member of the group of azo dyes which are commonly used in the various branches of the industry, was investigated. The photostability of this dye was not previously examined. Photocatalytic degradation method was evaluated. Solar simulated light (E=500 W/m2), titanium dioxide, and zinc oxide were used as irradiation source and photocatalysts, respectively. Kinetic studies were performed on a basis of a spectrophotometric method. Degradation efficiency was assessed by applying high performance liquid chromatography. Disappearance of a dye from titanium dioxide and zinc oxide surfaces after degradation was confirmed by thermogravimetry and Raman microscopy. Direct Yellow 9 was found to undergo the photodegradation with approximately two times higher efficiency when zinc oxide was applied in comparison with titanium dioxide. A simple and promising way to apply the photocatalytic removal of Direct Yellow 9 in titanium dioxide and zinc oxide suspensions was presented.
A Highly Potent and Specific MET Therapeutic Protein Antagonist with Both Ligand-Dependent and Ligand-Independent Activity
Authors: Olwill Shane A. , Joffroy Christian , Gille Hendrik , Vigna Elisa , Matschiner Gabriele , Allersdorfer Andrea , Lunde Bradley M. , Jaworski Jakub , Burrows James F. , Chiriaco Cristina , Christian Hans Jürgen , Hülsmeyer Martin , Trentmann Stefan , Jensen Kristian , Hohlbaum Andreas M. , Audoly Laurent
Published: September 2013

Activation of the MET oncogenic pathway has been implicated in the development of aggressive cancers that are difficult to treat with current chemotherapies. This has led to an increased interest in developing novel therapies that target the MET pathway. However, most existing drug modalities are confounded by their inability to specifically target and/or antagonize this pathway. Anticalins, a novel class of monovalent small biologics, are hypothesized to be “fit for purpose” for developing highly specific and potent antagonists of cancer pathways. Here, we describe a monovalent full MET antagonist, PRS-110, displaying efficacy in both ligand-dependent and ligand-independent cancer models. PRS-110 specifically binds to MET with high affinity and blocks hepatocyte growth factor (HGF) interaction. Phosphorylation assays show that PRS-110 efficiently inhibits HGF-mediated signaling of MET receptor and has no agonistic activity. Confocal microscopy shows that PRS-110 results in the trafficking of MET to late endosomal/lysosomal compartments in the absence of HGF. In vivo administration of PRS-110 resulted in significant, dose-dependent tumor growth inhibition in ligand-dependent (U87-MG) and ligand-independent (Caki-1) xenograft models. Analysis of MET protein levels on xenograft biopsy samples show a significant reduction in total MET following therapy with PRS-110 supporting its ligand-independent mechanism of action. Taken together, these data indicate that the MET inhibitor PRS-110 has potentially broad anticancer activity that warrants evaluation in patients. Mol Cancer Ther; 12(11); 2459–71. ©2013 AACR.
Cultivated Sea Lettuce is a Multiorgan Protector from Oxidative and Inflammatory Stress by Enhancing the Endogenous Antioxidant Defense System
Authors: Ratnayake Ranjala , Liu Yanxia , Paul Valerie J. , Luesch Hendrik
Published: September 2013

The health-promoting effects of seaweeds have been linked to antioxidant activity that may counteract cancer-causing oxidative stress-induced damage and inflammation. Although antioxidant activity is commonly associated with direct radical scavenging activity, an alternative way to increase the antioxidant status of a cell is to enhance the endogenous (phase II) defense system consisting of cytoprotective antioxidant enzymes, including NAD(P)H:quinone oxidoreductase 1 (NQO1). These enzymes are transcriptionally regulated by the antioxidant response element (ARE) via the transcription factor Nrf2. Extracts derived from cultivated Ulva sp., a green alga regarded as a marine vegetable (sea lettuce), potently activated the Nrf2-ARE pathway in IMR-32 neuroblastoma and LNCaP prostate cancer cells. RNA interference studies showed that Nrf2 and phosphoinositide 3-kinase (PI3K) are essential for the phase II response in IMR-32 cells. Activity-enriched fractions induced Nrf2 nuclear translocation and target gene transcription, and boosted the cellular glutathione level and therefore antioxidant status. A single-dose gavage feeding of Ulva-derived fractions increased Nqo1 transcript levels in various organs. Nqo1 induction spiked in different tissues, depending on the specific chemical composition of each administered fraction. We purified and characterized four ARE inducers in this extract, including loliolide (1), isololiolide (2), a megastigmen (3), and a novel chlorinated unsaturated aldehyde (4). The ARE-active fractions attenuated lipopolysaccharide-induced iNOS and Cox2 gene expression in macrophagic RAW264.7 cells, decreasing nitric oxide (NO) and prostaglandin E2 (PGE2) production, respectively. Nqo1 activity and NO production were abrogated in nrf2−/− mouse embryonic fibroblasts, providing a direct link between the induction of phase II response and anti-inflammatory activity. Cancer Prev Res; 6(9); 989–99. ©2013 AACR.
An Existential Understanding of Psychotherapy and Psychiatric Practice
Authors: Schlimme Jann E.
Published: September 2013

In this paper Karl Jaspers' writings on psychotherapy and the psychiatric practice will be profoundly investigated and a meticulous reconstruction of the development of his understandings in the course of his oeuvre will be presented. This reconstruction allows for arguing that Jaspers displays a methodologically critical attitude towards medicine as a ‘science of actions' and that he did refrain from developing an existential psychotherapy for methodological and existential reasons. Nonetheless and aside from Jaspers' abstention, some of his concepts from existential philosophy, like ‘Grenzsituation' (border-situation, limit-situation) or ‘Gehäuse' (shell, housings), can be extraordinarily fruitful in psychotherapy and in the psychiatric practice because it requires a change of attitude in order to bring these concepts into play. This different attitude could be called the attitude of the fellow sufferer, or, more neutral, the attitude of the fellow human being.
Jaspers' Critique of Essentialist Theories of Schizophrenia and the Phenomenological Response
Authors: Mishara Aaron L. , Schwartz Michael A.
Published: September 2013

This contribution reviews the fin de siècle and immediately following efforts (Berze, Gross, Jung, Stransky, Weygandt, and others) to find a fundamental psychological disturbance (psychologische Grundstörung) underlying the symptoms of dementia praecox, later renamed schizophrenia by Bleuler (1908, 1911). In his General Psychopathology (1913), Jaspers brings order into the field by bringing to psychopathology a scientific basis coupled with phenomenological rigor. He was critical of theories that proposed an essence of schizophrenia, which is merely asserted verbally. This imperative is reiterated by other members of the Heidelberg School (Gruhle, Mayer-Gross, and K. Schneider). Gruhle (1929) contended that the primary symptoms of schizophrenia, indicating an underlying but still unknown neurobiological disease process, are independent from one another. They cannot be brought under a single, current theoretical model. That is, schizophrenia cannot be explained in terms of a ‘catchword', which is only thought but not empirically studied. Sobered but also inspired by Jaspers' rigor, phenomenological psychiatrists (Binswanger, Blankenburg, Conrad, Ey, and others) proposed more tempered models, which could be studied empirically or tested scientifically. This historical progression may be viewed as a dialectical process: First, bold, merely verbal assertions without method were made, then Jaspers followed with a sobering critique, and finally, the existential-phenomenological clinicians/researchers responded by producing fine-grained, rigorous phenomenological models, tempered by humility and self-critique, which led to hypotheses that could be tested in current clinical neuroscience.
FTO and INSIG2 Genotyping Combined with Metabolic and Anthropometric Phenotyping of Morbidly Obese Patients
Authors: Burgdörfer E. , Korenkov M. , Jonas D. , Weise D. , Haaf T. , Zechner U. , Bartsch O.
Published: September 2013

Obesity is a major health problem worldwide. Associations of obesity with common variants of the fat mass- and obesity-associated gene (FTO) and insulin-induced gene 2 (INSIG2) have been reported in various studies. We aimed to further investigate the association of 2 single nucleotide polymorphisms (SNPs), rs9939609 in FTO and rs7566605 in INSIG2, with body mass index (BMI) and other anthropometric and metabolic parameters in subjects with morbid obesity (BMI ≥40). SNPs rs9939609 and rs7566605 were genotyped in 124 unrelated morbidly obese patients (mean BMI = 50, range 40.1-77.1) from Mainz, Germany, and in 253 normal controls without a history of morbid obesity. Metabolic and anthropometric parameters were analyzed in 109 of the 124 patients, and associations with the genotype data were examined. The high-risk AA genotype for FTO rs9939609 was observed in 32.3% of patients versus 15.8% of controls (p = 0.0004) and was associated with an increased obesity risk [odds ratio (OR) = 2.54, 95% confidence interval (CI) = 1.53-4.21]. The intermediate-risk AT genotype was found in patients and controls at similar frequencies (48.4 vs. 48.6%, OR = 0.99). The low-risk TT genotype for rs9939609 was found in 19.4% of patients (35.5% of controls; p = 0.0013) and was associated with a decreased risk for morbid obesity (OR = 0.43, CI = 0.26-0.73). In contrast, INSIG2 rs7566605 showed no association with obesity in our patients. Evaluation of metabolic data indicated associations between the high-risk FTO genotype (rs9939609_AA) and increased levels of serum glutamic oxaloacetic transaminase (GOT) and between the high-risk INSIG2 genotype (rs7566605_CC) and lower waist-to-hip ratio and lower hemoglobin A1c (HbA1c) levels. Our results confirm an association of the FTO SNP with extreme obesity. However, we found no association of the potential obesity risk allele of INSIG2 in our sample and thus cannot confirm an association of the INSIG2 CC genotype with obesity. We identified an association between the high-risk FTO genotype (rs9939609_AA) and higher GOT levels, which could possibly reflect the increased frequency of nonalcoholic steatohepatitis with obesity. We also detected associations of the high-risk INSIG2 genotype (rs7566605_CC) with lower waist-to-hip ratios and lower HbA1c levels, which may indicate amelioration of impaired glucose tolerance and type 2 diabetes for patients with this genotype after bariatric surgery.
A Multicenter, Randomized, Open-Label, Controlled Study Comparing the Efficacy, Safety and Cost-Effectiveness of a Sequential Therapy with RV4104A Ointment, Ciclopiroxolamine Cream and Ciclopirox Film-Forming Solution with Amorolfine Nail Lacquer Alone in Dermatophytic Onychomycosis
Authors: Paul C. , Coustou D. , Lahfa M. , Bulai-Livideanu C. , Doss N. , Mokthar I. , Turki H. , Nouira R. , Fazaa B. , Ben Osman A. , Zourabichvili O. , Cazeau C. , Coubetergues H. , Picot S. , Bienvenu A.L. , Voisard J.J.
Published: September 2013

Background: The efficacy of topical antifungals is controversial. Objective: To compare the efficacy and safety of a sequential (SEQ) treatment with chemical nail avulsion and topical antifungals to amorolfine nail lacquer in dermatophytic onychomycosis. Methods: This was a randomized, parallel-group, controlled study comparing a 36-week SEQ treatment with chemical nail avulsion with RV4104A ointment (class I medical device containing 40% urea) followed by ciclopirox cream for 8 weeks and ciclopirox nail lacquer for 25 weeks (SEQ group) to amorolfine nail lacquer for 36 weeks (AMO group). Patients had to have a big toenail onychomycosis, sparing the matrix. The primary efficacy criterion was complete cure at week 48. A cost-effectiveness analysis was performed. Results: A total of 142 patients were randomized. The complete cure rate at week 48 was significantly higher in the SEQ group than in the AMO group (36.6 vs. 12.7%, p = 0.001). Clinical cure at week 48 was observed in 53.5% of patients in the SEQ group versus 17% in the AMO group (p < 0.01). The cost of cure per patient was 50% lower with SEQ treatment (EUR 33) compared with amorolfine (EUR 76). Conclusion: A treatment of onychomycosis comprising chemical avulsion of the pathological nail, ciclopirox cream and nail lacquer is significantly more effective than amorolfine nail lacquer.
Cognitive Deficit, Learning Difficulties, Severe Behavioral Abnormalities and Healed Cleft Lip in a Patient with a 1.2-Mb Distal Microduplication at 22q11.2
Authors: Ribeiro-Bicudo L.A. , de Campos Legnaro C. , Gamba B.F. , Candido Sandri R.M. , Richieri-Costa A.
Published: September 2013

The 22q11.2 duplication syndrome has been recently characterized as a new entity with features overlapping the 22q11.2 deletion syndrome. Most 22q11.2 duplications represent reciprocal events of the typical 3-Mb deletions extending between low copy repeat (LCR) 22-A and LCR22-D. It has been suggested that the clinical manifestations observed in patients with 22q11.2 microduplications may range from milder phenotypes to multiple severe defects, and this variability could be responsible for many undetected cases. Here, we report on a patient with a 1.2-Mb microduplication at 22q11.2 spanning LCR22-F and LCR22-H which harbor the SMARCB1 and SNRPD3 genes. The patient presented healed cleft lip, mild facial dysmorphism, cognitive deficit, and delayed language development associated with severe behavioral problems including learning difficulties and aggressive behavior.
Cytoskeletal Protection: Acting on Notch to Prevent Neuronal Dysfunction
Authors: Bonini Sara Anna , Ferrari-Toninelli Giulia , Maccarinelli Giuseppina , Bettinsoli Paola , Montinaro Mery , Memo Maurizio
Published: September 2013

Functional and structural plasticity is a fundamental property of the brain involving chemical, electrical, molecular and cellular responses and leading to reorganization of connections within a brain region and/or between brain regions. The Notch pathway has been recognized as one of the main contributors in regulating neural development and has been proposed as a key mediator in neuroplasticity. We supported this concept, demonstrating that Notch plays a role in determining the only possible ‘cell fate' decisions in post-mitotic mature neurons: synaptic remodelling or neurite extension/retraction. We demonstrated that Notch pathway activation causes a decrease in neurite branching and a loss of varicosities, with consequent reduction in the release of neurotransmitters. Furthermore, in dysfunctional neurons that present Notch pathway hyper-activation, neuronal morphology was reverted by Notch-inhibiting agents. Potentially, a better understanding of the molecular events participating in neuroplasticity may provide relevant information for innovative therapeutic approaches in a variety of neurological disorders. Hence, we propose a Notch-signalling fine-tuned manipulation as a novel approach to modulate neuronal cytoskeleton plasticity in order to prevent dysfunctional structural plasticity in neurodegenerative diseases.
ADAM10 in Synaptic Physiology and Pathology
Authors: Musardo Stefano , Marcello Elena , Gardoni Fabrizio , Di Luca Monica
Published: September 2013

Background: Generation of amyloid-β peptide is at the beginning of a cascade that leads to Alzheimer's disease. Amyloid precursor protein (APP) as well as β- and γ-secretases are the principal players involved in amyloid-β (Aβ) production, while α-secretase cleavage on APP prevents Aβ deposition. A disintegrin and metalloproteinase 10 (ADAM10) has been demonstrated to act as α-secretase in neurons. Objective: Although localization of ADAM10 in the synaptic membrane is the key for its shedding activity, currently, very little is known about the mechanisms that control the synaptic abundance of ADAM10. Results: Two established forms of long-term activity-dependent plasticity, i.e. long-term potentiation and long-term depression (LTD), differentially regulate the synaptic availability and activity of ADAM10. Long-term potentiation decreases ADAM10 surface levels and activity by promoting its endocytosis. This process is mediated by activity-regulated association of ADAM10 with the clathrin adaptor protein 2 (AP2) complex. Conversely, LTD fosters ADAM10 insertion in the membrane and stimulates its activity. Furthermore, ADAM10 interaction with synapse-associated protein 97 (SAP97) is necessary for LTD-induced ADAM10 trafficking and required for LTD maintenance and LTD-induced spine morphology changes. Conclusions: Regulated interaction of ADAM10 with SAP97 and AP2 discloses a novel physiological mechanism of ADAM10 activity regulation at the synapses. This phenomenon produces a situation whereby synaptically regulated ADAM10 activity is positioned to modulate synaptic functioning.
Functional Interaction between Amyloid-β Precursor Protein and Peripherin Neurofilaments: A Shared Pathway Leading to Alzheimer's Disease and Amyotrophic Lateral Sclerosis?
Authors: Muresan Virgil , Villegas Christine , Ladescu Muresan Zoia
Published: September 2013

Background and Objective: The pathology of amyotrophic lateral sclerosis (ALS), a neurodegenerative disorder affecting motor neurons, comprises aberrant accumulations of neurofilaments; mutations in the peripherin subunit of neurofilaments have been identified in some forms of ALS. Recently, the amyloid-β precursor protein (APP), a key element for the pathology of Alzheimer's disease (AD), was linked to ALS. Here, we provide evidence that the generation of the N-terminal fragment of APP, sAPP, relies on peripherin neurofilaments. This finding could relate to a novel molecular mechanism dysregulated in ALS and/or AD. Methods and Results: The production and the fate of sAPP were studied with the brainstem-derived, neuronal cell line, CAD, which expresses endogenous peripherin. We show that sAPP and C-terminal fragments (CTF) are generated to a large extent in the neuronal soma. We find that sAPP, but not CTF, associates with filamentous structures that delineate the nuclear lamina, extend to the cell periphery and immunostain for peripherin. The depletion of peripherin with siRNA eliminates the filamentous immunostaining of sAPP. Conclusion: Our results indicate that a fraction of APP is cleaved by β-secretase in the soma and that the generated sAPP becomes associated with perinuclear peripherin neurofilaments. These findings link the metabolism of APP - which is dysregulated in AD - to the organization of neurofilaments - which is abnormal in ALS - and suggest a possible crosstalk/overlap between the molecular mechanisms of these diseases.
Pharmacology of Cannabinoid Receptor Agonists and a Cyclooxygenase-2 Inhibitor in Rat Bone Tumor Pain
Authors: Cui Jin Hua , Ju Jin , Yoon Myung Ha
Published: September 2013

We evaluated the pharmacology of spinal selective cannabinoid (CB) receptor agonists and a cyclooxygenase-2 (COX-2) inhibitor on bone tumor pain. MRMT-1 tumor cells were injected into the tibia of female Sprague-Dawley rats. MRMT-1 tumor cells produced a bone tumor confirmed by radiologic and histological findings. Intrathecal CB1 (ACEA) and CB2 receptor (AM 1241) agonists and a COX-2 inhibitor (DuP 697) dose-dependently increased the withdrawal threshold. The calculated ED50 (nmol/l) values for ACEA, AM 1241 and DuP 697 were 0.007, 2.3 and 76.1, respectively. Reverse transcriptase polymerase chain reaction and Western blot showed that COX-2 mRNA and protein, but not CB1 or CB2 receptor, were increased in the spinal cords of rats with bone tumors. Spinal CB1 receptor and CB2 receptor agonists and COX-2 inhibitor may be useful in the management of bone tumor pain. Furthermore, CB2 receptor agonist may be more potent than CB1 receptor agonist and COX-2 inhibitor.
Renal Failure after Single Fetal Demise in Monochorionic Twins: Incidence and Description of a Case
Authors: Genova L. , Sueters M. , van Steenis A. , Oepkes D. , Steggerda S.J. , Lopriore E.
Published: September 2013

Single intrauterine fetal demise in monochorionic (MC) twins may result in acute exsanguination from the surviving twin into the low-pressure circulation of the demised co-twin through the vascular anastomoses. This may lead to severe hypoxic-ischemic injury in the surviving twin due to hypovolemia, hypotension and anemia, resulting in multiorgan damage. Most studies in single fetal demise in MC twin pregnancies have reported on the risk of cerebral injury. The aim of our study was to explore the incidence and severity of renal damage in surviving MC twins after intrauterine co-twin death. We reviewed all cases of MC twins with single fetal demise presented over a 10-year period at our center. One of the 44 (2.3%) surviving co-twins was diagnosed with severe renal damage. We describe this case in detail, as it provides valuable insights into the pathogenesis of renal and other organ failure after MC co-twin death.
Ovulation Detection in Saliva, Is It Possible
Authors: Salmassi A. , Schmutzler A.G. , Püngel F. , Schubert M. , Alkatout I. , Mettler L.
Published: September 2013

Background/Aims: The new mini-microscope Geratherm® ovu control was evaluated for its recognition of saliva ferning in a collective of 47 patients taking part in an artificial reproductive technology program on the day of follicular puncture. Methods: The ferning phenomenon was evaluated by patients and laboratory staff according to the criteria: no ferning, slight ferning and good ferning. Results: Geratherm® ovu control showed a specificity of 78% and a sensitivity of 80% in relation to rising E2 levels under follicle-stimulating hormone/human chorionic gonadotrophin. A comparison of the evaluations of the saliva test carried out by patients and by laboratory staff resulted in a high and substantial agreement of 89.4% (κ). Conclusion: Evaluations performed by ovu control were similar to those achieved with a highly sophisticated inverted microscope.
Cardiac Resynchronization Therapy Device Implantation Using a New Sensor-Based Navigation System
Authors: Richter Sergio , Döring Michael , Gaspar Thomas , John Silke , Rolf Sascha , Sommer Philipp , Hindricks Gerhard , Piorkowski Christopher
Published: September 2013

Background—

Cardiac resynchronization therapy (CRT) device implantation can be challenging, time consuming, and fluoroscopy intense. To facilitate left ventricular lead placement, a novel sensor-based electromagnetic tracking system (MediGuide Technology [MGT], St. Jude Medical) has been developed. We report the results of the First Human Use study evaluating the feasibility, safety, and performance of a novel CRT implantation approach using electromagnetic trackable operation equipment.

Methods and Results—

Fifteen consecutive patients (66±8 years, 53% male) with an established indication for CRT were implanted using the new tracking technology. Demographics, anatomical information, detailed fluoroscopy need, procedure time, and adverse events were collected. Patients were followed up for 4 weeks after implantation. The CRT system was successfully implanted with a lateral or posterolateral left ventricular lead position in all patients. The total procedure time was 116±43 minutes, the median total fluoroscopy time (skin to skin) was 5.2 (Q1–Q3, 3.0–8.4) minutes, and the median fluoroscopy time for left ventricular lead deployment (coronary sinus [CS] cannulation to withdrawal of CS sheath) measured 2.6 (Q1–Q3, 1.6–5.6) minutes. There were no severe complications that required an acute intervention or reoperation during the perioperative and postoperative periods.

Conclusions—

Use of the MGT tracking technology allows for safe and successful CRT implantation with the potential for reduced fluoroscopy time. Future randomized studies are needed to validate these data.

Clinical Trial Registration—

URL
http://www.clinicaltrials.gov
. Unique identifier: NCT01519739.
Prediction of Poststroke Hemorrhagic Transformation Using Computed Tomography Perfusion
Authors: Yassi Nawaf , Parsons Mark W. , Christensen Søren , Sharma Gagan , Bivard Andrew , Donnan Geoffrey A. , Levi Christopher R. , Desmond Patricia M. , Davis Stephen M. , Campbell Bruce C.V.
Published: September 2013

Background and Purpose—

Intracerebral hemorrhage is a serious potential complication of stroke thrombolysis. We investigated the optimal computed tomography perfusion (CTP) parameter to predict cerebral parenchymal hematoma (PH) in acute ischemic stroke.

Methods—

Patients with hyperacute ischemic stroke had whole-brain CTP and follow-up computed tomography/MRI to identify hemorrhagic transformation. The association of the 3 parameters relative cerebral blood flow, relative cerebral blood volume, and time to maximum (
T
max
) with PH was examined using receiver operating characteristic analysis and multivariate logistic regression.

Results—

Of 132 patients, 70 were treated with thrombolysis, and 14 (10.6%) developed PH on follow-up imaging. Baseline National Institutes of Health Stroke Scale score (
P
=0.033) and thrombolysis (
P
=0.003) were both predictive of PH. Receiver operating characteristic analysis revealed that
T
max
>14 s (area under the curve=0.748;
P
=0.002) and relative cerebral blood flow <30% of contralateral mean (area under the curve=0.689,
P
=0.021) were the optimal thresholds, and the Bayesian information criterion (+2.6) indicated that
T
max
was more strongly associated with PH than relative cerebral blood flow.
T
max
>14 s volumes of >5 mL allowed prediction of PH with sensitivity of 79%, specificity of 68%, and negative likelihood ratio of 3.16.
T
max
>14 s volume and thrombolysis were both independently predictive of PH in a multivariate logistic regression model (
P
<0.05).

Conclusions—

T
max
>14 s was the CTP parameter most strongly associated with PH. This outperformed relative cerebral blood flow <30%, which closely equates to CTP estimates of ischemic core volume. Although ischemic core volume on CTP is useful in the pretreatment prediction of PH, severe hypoperfusion on
T
max
is more strongly associated and may allow better prediction of the likely anatomic location of hemorrhage.
Impact of Both Ends of the Hemoglobin Range on Clinical Outcomes in Acute Ischemic Stroke
Authors: Park Young Ho , Kim Beom Joon , Kim Jun-Soon , Yang Mi Hwa , Jang Myung Suk , Kim Nayoung , Han Moon-Ku , Lee Ji Sung , Lee Juneyoung , Kim SangYun , Bae Hee-Joon
Published: September 2013

Background and Purpose—

Although both ends of the hemoglobin range may negatively influence clinical outcomes in acute ischemic stroke, most studies have examined the linear relationship or focused on the lower end of the range. Furthermore, it is unclear whether hemoglobin concentrations at different time points during hospitalization correlate with clinical outcomes in the same manner.

Methods—

We identified 2681 consecutive patients with acute ischemic stroke from a prospective stroke registry database and grouped them into hemoglobin concentration quintiles using the following 5 indices: initial, nadir, time-averaged, discharge hemoglobin, and hemoglobin drop. To examine the effect of both ends of hemoglobin range, the third quintile was selected as a reference category except for hemoglobin drop, for which the first quintile was used. As outcome variables, 3-month modified Rankin Scale as an ordinal scale and 3-month mortality were used.

Results—

With respect to higher modified Rankin Scale scores, the adjusted odds ratios and 95% confidence intervals of the first quintiles of initial, nadir, time-averaged, and discharge hemoglobin were 1.74 (1.31−2.31), 2.64 (2.09−3.33), 1.81 (1.42−2.30), and 1.65 (1.29−2.13), respectively. The opposite ends of these hemoglobin indices were not significantly associated. The adjusted odds ratio of the fifth quintile of hemoglobin drop (greatest hemoglobin drop) was 2.09 (1.51−2.89). The mortality analysis showed similar results except for initial hemoglobin.

Conclusions—

In acute ischemic stroke, poor outcome was related to the lower but not the higher end of the hemoglobin range, regardless of when and how hemoglobin concentrations were measured.
Severe Renal Impairment Is Associated With Symptomatic Intracerebral Hemorrhage After Thrombolysis for Ischemic Stroke
Authors: Tütüncü Serdar , Ziegler Annerose M. , Scheitz Jan F. , Slowinski Torsten , Rocco Andrea , Endres Matthias , Nolte Christian H.
Published: September 2013

Background and Purpose—

Patients with renal impairment (RI) have an increased risk of both thrombotic and hemorrhagic events. We aimed to clarify whether RI increases the risk of intracerebral hemorrhage (ICH) after intravenous thrombolysis with recombinant tissue plasminogen activator.

Methods—

Patients who received intravenous thrombolysis with recombinant tissue plasminogen activator within 4.5 hours of symptom onset were retrospectively analyzed. Creatinine levels on admission served to calculate glomerular filtration rate (GFR) to estimate RI according to
International Classification of Diseases
criteria. Effect of RI on symptomatic ICH (sICH) was assessed using dichotomized (GFR <90 and <30 mL/min) and continuous GFR (centered data to test for linear and centered and squared data to test for curvilinear association).

Results—

Of the 740 patients included, 83% had any RI (GFR <90 mL/min) and 5% had severe RI (GFR <30 mL/mL); 4.6% experienced sICH. Univariate comparisons revealed higher prevalence of sICH in patients with severe RI (
P
<0.01) but not with any RI. GFR as a continuous variable (centered and squared) was also associated with sICH (
P
=0.02), but GFR on its own was not. Severe RI and GFR (centered and squared) remained independently associated with sICH in multiple regression analyses.

Conclusions—

Severe RI (GFR <30 mL/min) is associated with sICH after intravenous thrombolysis with recombinant tissue plasminogen activator. The association is curvilinear. Severe RI must be taken into account when balancing the risk–benefit ratio of intravenous thrombolysis with recombinant tissue plasminogen activator.
Substrate dependent talitrid amphipods from fragmented beaches on the north coast of Crete (Crustacea, Amphipoda, Talitridae), including a redefinition of the genus Orchestia and descriptions of Orchestia xylino sp. nov. and Cryptorchestia gen. nov.
Authors: LOWRY J. K. , FANINI LUCIA
Published: September 2013

Four species of talitrid amphipods (Orchestia montagui Audouin, 1826, Orchestia stephenseni Cecchini, 1928, Orchestia xylino sp. nov. and Talitrus saltator (Montagu, 1808)) are reported from a set of fragmented pocket beaches to the east of Heraklion on the north coast of Crete. Aside from a previous record of O. stephenseni these are the first records of talitrid amphipods from the island of Crete. 2) Along a coastal segment of only 4.36 km, characterised by habitat fragmentation and substrate patchiness, a clear correlation between talitrid species and beach type is indicated. Talitrus saltator occurs only on sandy beaches. Orchestia montagui and O. xylino occur on banquette beaches and O. montagui, O. stephenseni and O. xylino occur on mixed sand/gravel and cobble beaches. 3) The genus Orchestia is redefined and confined to 15 marine supralittoral species from eastern North America, islands in the North-eastern Atlantic, and western-Europe, including the Baltic and the Mediterranean Seas plus a perplexing group in New Zealand. 4) The new genus Cryptorchestia is described, based on nine terrestrial species previously included in the genus Orchestia and occurring in western Europe, the Mediterranean Sea and the Azores and Canary islands in the North-eastern Atlantic. 5) The new species Orchestia xylino sp. nov. is described. 6) An extensive bibliography for the species in this study is provided.
Two new species of feather mites (Acarina: Analgoidea) from the Moustached Warbler, Acrocephalus melanopogon (Passeriformes, Acrocephalidae), in Romania
Authors: CONSTANTINESCU IOANA CRISTINA , CHIȘAMERA GABRIEL , POCORA VIOREL , STANCIU CĂTĂLIN , ADAM COSTICĂ
Published: September 2013

Two new species of feather mites Ingrassiella melanopogoni Constantinescu sp. nov. (Xolalgidae) and Trouessartia mironovi Constantinescu sp. nov. (Trouessartiidae) are described from Acrocephalus melanopogon (Passeriformes: Acrocephalidae) from the South-East of Romania. Ingrassiella melanopogoni differs from all species of the genus by having extensions of the posterolateral angles of the prodorsal shield shorter than in other species and not extending to the hysteronotal shield. Trouessartia mironovi is readily distinguished by having an unique combination of characters within the genus: epimerites I are fused in both sexes and epimerites IVa are highly developed in male (coxal fields IV are almost closed).
Influence of Soil Moisture on Urban Microclimate and Surface-Layer Meteorology in Oklahoma City
Authors: Husain Syed Zahid , Bélair Stéphane , Leroyer Sylvie
Published: September 2013

The influence of soil moisture on the surface-layer atmosphere is examined in this paper by analyzing the outputs of model simulations for different initial soil moisture configurations, with particular emphasis on urban microclimate. In addition to a control case, four different soil moisture distributions within the urban and surrounding rural areas are considered in this study. Outputs from the Global Environmental Multiscale atmospheric model simulations are compared with observations from the Joint Urban 2003 experiment held in Oklahoma City, Oklahoma, and the relevant conclusions drawn in this paper are therefore valid for similar medium-size cities. In general, high soil moisture is found to be associated with colder near-surface temperature and lower near-surface wind speed, whereas drier soil resulted in warmer temperatures and enhanced low-level wind. Relative to urban soil moisture content, rural soil conditions are predicted to have larger impacts on both rural and urban surface-layer meteorological conditions. Dry rural and wet urban soil configurations are shown to have a strong influence on the urban–rural temperature contrast and resulted in city-induced secondary circulations that considerably affect the near-surface wind speed. Dry rural soil in particular is found to intensify the nocturnal low-level jet and significantly affect the thermal stability of nocturnal near-neutral urban surface layer by altering both thermal and mechanical generation of turbulence.
North Atlantic SSTs as a Link between the Wintertime NAO and the Following Spring Climate
Authors: Herceg-Bulić Ivana , Kucharski Fred
Published: September 2013

In this paper a potential seasonally lagged impact of the wintertime North Atlantic Oscillation (NAO) on the subsequent spring climate over the European region is explored. Supported by the observational indication of the wintertime NAO–spring climate connection, a modeling approach is used that employs the International Centre for Theoretical Physics (ICTP) atmospheric general circulation model (AGCM) as a stand-alone model and that is also coupled with a mixed layer ocean in the North Atlantic. Both observational and modeled data indicate a pattern of sea surface temperatures (SSTs) in North Atlantic as a possible link between wintertime NAO and climate anomalies in the following spring. The SST pattern is associated with wintertime NAO and persists through the following spring. It is argued that these SST anomalies can affect the springtime atmospheric circulation and surface conditions over Europe. The atmospheric response is recognized in observed as well as in modeled data (mean sea level pressure, temperature, and precipitation). Additionally, an impact on springtime storm activity is found as well.

It is demonstrated that the SST anomalies associated with wintertime NAO persist into the subsequent spring. These SST anomalies enable atmosphere–ocean interaction over the North Atlantic and consequently affect the climate variability over Europe. Although it has a relatively weak impact, the described mechanism provides a temporal teleconnection between the wintertime NAO and subsequent spring climate anomalies.
Impact of Agulhas Leakage on the Atlantic Overturning Circulation in the CCSM4
Authors: Weijer Wilbert , van Sebille Erik
Published: September 2013

The impact of Agulhas leakage variability on the strength of the Atlantic meridional overturning circulation (AMOC) in the Community Climate System Model, version 4 (CCSM4) is investigated. In this model an advective connection exists that transports salinity anomalies from the Agulhas region into the North Atlantic on decadal (30–40 yr) time scales. However, there is no identifiable impact of Agulhas leakage on the strength of the AMOC, suggesting that the salinity variations are too weak to significantly modify the stratification in the North Atlantic. It is argued that this study is inconclusive with respect to an impact of Agulhas leakage on the AMOC. Salinity biases leave the South Atlantic and Indian Oceans too homogeneous, in particular erasing the observed salinity front in the Agulhas retroflection region. Consequently, salinity variability in the southeastern South Atlantic is found to be much weaker than observed.
Estimation of a Ramsay-Curve Item Response Theory Model by the Metropolis–Hastings Robbins–Monro Algorithm
Authors: Monroe Scott , Cai Li
Published: September 2013

In Ramsay curve item response theory (RC-IRT) modeling, the shape of the latent trait distribution is estimated simultaneously with the item parameters. In its original implementation, RC-IRT is estimated via Bock and Aitkin’s EM algorithm, which yields maximum marginal likelihood estimates. This method, however, does not produce the parameter covariance matrix as an automatic byproduct on convergence. In turn, researchers are limited in when they can employ RC-IRT, as the covariance matrix is needed for many statistical inference procedures. The present research remedies this problem by estimating the RC-IRT model parameters by the Metropolis–Hastings Robbins–Monro (MH-RM) algorithm. An attractive feature of MH-RM is that the structure of the algorithm makes estimation of the covariance matrix convenient. Additionally, MH-RM is ideally suited for multidimensional IRT, whereas EM is limited by the “curse of dimensionality.” Based on the current research, when RC-IRT or similar IRT models are eventually generalized to include multiple latent dimensions, MH-RM would appear to be the logical choice for estimation.
Lethal pulmonary thromboembolism: An autopsy-based study on a rare but legally relevant event
Authors: Mobilia Francesca , Casali Michelangelo B , Gallieni Maurizio , Genovese Umberto R
Published: September 2013

Context:

Pulmonary thromboembolism (PTE) is the severe end stage of many different diseases producing prolonged patient immobilization or a hypercoagulative state. Lethal PTE is also one of the most frequent topics for suspected medical malpractice, especially when dealing with patients originally affected by non-critical illnesses and suddenly killed by a non-prevented embolic event. The crucial forensic question about a lethal PTE is the following one: was this lethal PTE an unpreventable complication or was it a consequence of real medical malpractice?

Materials and methods:

The authors analyzed the 1999–2009 autopsy archive of the Institute of Forensic Medicine of Milan University and selected all the cases where PTE was the cause of death. For every selected case, the authors also collected all the available demographic and clinical data. Statistical analysis was performed using SPSS V.16.00.

Results:

In the period 1999–2009, 129 (1.25%) cases out of a total of 10,288 autopsies were diagnosed as having suffered lethal PTE. The male to female ratio was 1:2 (34.1% versus 65.9%). The mean age at death was 67 ± 18 years. In 41% of cases the death occurred outside of the hospital and in the absence of any medical support; in 36.5% of cases it occurred during the territorial paramedical support or during the very first evaluation in the emergency; and in the remaining 22.5% of cases it occurred during a period of hospitalization. In 33.4% of the selected cases, a typical preliminary event was positively identified: a pure major trauma (18.6%); a trauma followed by a major surgery (7%); a major non post-traumatic surgery (7%); and a non-surgical delivery. Symptoms suggesting PTE were detected in 46 cases (35.7%). Nine cases underwent a judicial autopsy in the same original hypothesis of a medical malpractice for incorrect prophylaxis in acutely bed-restricted patients.

Conclusions:

Post-surgical PTE cannot be automatically labeled a consequence of medical malpractice. The combination of correct prophylaxis, careful diagnostic monitoring of the high-risk patient and the correct therapy surely reduces the occurrence of lethal PTE, but it does not completely erase such an insidious pathology. In the hypothesis of a causative medical malpractice, only careful analysis by an experienced forensic pathologist can make a reliable distinction between an unpreventable complication and real medical malpractice.
Kitchen knives and homicide: A systematic study of people charged with murder in the Lothian and Borders region of Scotland
Authors: Kidd SH , Hughes NS , Crichton JHM
Published: September 2013

A recent English study demonstrated high rates of kitchen knife use in homicides by mentally disordered offenders subject to independent inquiries. Everyone accused of homicide in Scotland undergoes psychiatric examination; all such evaluations in a Scottish region between 2006 and 2011 were systematically analysed to identify homicide characteristics. It was hypothesised that kitchen knives would be the commonest sharp instruments used, and would be associated with unplanned domestic homicide against known victims, with no independent association with mental disorder. Kitchen knives were used in 32 of 55 homicides: 94% of 34 sharp object homicides ( p < 0.05). No independent association was found between kitchen knife use and planning, location, relationship, intoxication or mental disorder. Kitchen knife use in homicide appears to be a significant public health issue, and not only in the mentally disordered population. Research is recommended into kitchen knife use in non-fatal violence, and weapon control in populations at increased risk of knife violence.