bluuebunny/crossref_metadata_2025 huggingface dataset:
Power output characterization assessment of thermoelectric generation in machine spindles for wireless sensor driving
Authors: Li Sheng , Yao Xinhua , Fu Jianzhong
Published: March 2014

Purpose

– For using wireless sensors to monitor spindle units without opening the spindle shell to replace the battery, harvesting the waste heat from spindle units of machine tools for thermoelectric generation to drive wireless sensors is studied in this paper. The paper aims to discuss these issues.

Design/methodology/approach

– In this paper, the thermal network method and the analogies between electrical and thermal domains are used in the simulation of power output performance of thermoelectric generation on a rotating spindle. After that, experiments are done to obtain the real power output performance of the generation and evaluate the feasibility to drive wireless sensors.

Findings

– The paper provides that the output voltage of the thermoelectric generations was nearly linear with the rotating speed of the spindle, the output voltage was sensitive to the fixed position of the generations, and the thermoelectric system could drive the wireless sensor well most of the time during continuous operation of the spindle.

Research limitations/implications

– It is found that the thermoelectric generation could not provide enough power in the early start-up stage of the spindle rotation, so a high-efficiency power manage system, which will be studied in the future research, is needed to handle this problem.

Practical implications

– The paper includes implications for the development of self-powered wireless sensors in the spindle unit for machine tool monitoring.

Originality/value

– The paper develops a model of the power output performance of thermoelectric generation on a rotating spindle and tests the feasibility to drive wireless sensors with this power.
The relevance of ecological status to ecosystem functions and services in a large boreal lake
Authors: Tolonen Kimmo T. , Hämäläinen Heikki , Lensu Anssi , Meriläinen Jarmo J. , Palomäki Arja , Karjalainen Juha
Published: March 2014

Environmental conventions aim to protect ecosystem structures and functions to provide goods and services for mankind. The degree of aquatic ecosystem naturalness, or ecological status as it is defined in the Water Framework Directive (WFD) of the European Union, is notionally linked to supplies of ecosystem services. In practice, these links have rarely been documented or even investigated, and to justify conservation and management objectives based on the status indicators, it is essential to demonstrate their relationships to ecosystem functions and services.

The WFD requires member states to classify their surface waters aiming to achieve good ecological status of water bodies. However, an implicit assumption of the WFD, that the ecosystem functions and services targeted to be protected and maintained are related to the measured status, remains uncertain.

Using a time‐series data set covering almost 50 years, we examined the development of ecological status of eight sub‐basins of a large boreal lake in response to improved wastewater management and decreasing pollution. We particularly evaluated whether the observed descriptors of biodiversity, ecosystem functions and services were associated with the judgements of ecological status, and hence whether the ecological status is a relevant proxy for ecosystem values to be protected.

The ecological status of the polluted sub‐basins responded consistently to the decreased nutrient and organic loading. Temporal trends in the biological quality elements and water quality were mostly parallel and showed good status roughly simultaneously. Combined ecological status also appeared to predict some features of taxon diversity (profundal macroinvertebrate and phytoplankton richness), ecosystem functions (primary and bacterial production) and ecosystem services (fish catch and reproductive potential of coregonids).

Synthesis and applications. We observed that some ecosystem service supplies and taxon diversity increased with increasing ecological status of the lake. Therefore, our results suggest that ecological status estimates based on simple structural characters are relevant to the ultimate management goals of maintaining biodiversity, ecosystem functions and services and hence might suffice for extensive assessment and monitoring of lake ecosystems.
Variation in Surgical Quality Measure Adherence within Hospital Referral Regions: Do Publicly Reported Surgical Quality Measures Distinguish among Hospitals That Patients Are Likely to Compare?
Authors: Safavi Kyan C. , Dai Feng , Gilbertsen Todd A. , Schonberger Robert B.
Published: March 2014

Objective

To determine whether surgical quality measures that Medicare publicly reports provide a basis for patients to choose a hospital from within their geographic region.

Data Source

The Department of Health and Human Services' public reporting website, http://www.medicare.gov/hospitalcompare.

Study Design

We identified hospitals (n = 2,953) reporting adherence rates to the quality measures intended to reduce surgical site infections (Surgical Care Improvement Project, 1–3) in 2012. We defined regions within which patients were likely to compare hospitals using the hospital referral regions (HRRs) from the Dartmouth Atlas of Health Care Project. We described distributions of reported SCIP adherence within each HRR, including medians, interquartile ranges (IQRs), skewness, and outliers.

Principal Findings

Ninety‐seven percent of HRRs had median SCIP‐1 scores ≥95 percent. In 93 percent of HRRs, half of the hospitals in the HRR were within 5 percent of the median hospital's score. In 62 percent of HRRs, hospitals were skewed toward the higher rates (negative skewness). Seven percent of HRRs demonstrated positive skewness. Only 1 percent had a positive outlier. SCIP‐2 and SCIP‐3 demonstrated similar distributions.

Conclusions

Publicly reported quality measures for surgical site infection prevention do not distinguish the majority of hospitals that patients are likely to choose from when selecting a surgical provider. More studies are needed to improve public reporting's ability to positively impact patient decision making.
The Association between Long‐Term Care Setting and Potentially Preventable Hospitalizations among Older Dual Eligibles
Authors: Wysocki Andrea , Kane Robert L. , Golberstein Ezra , Dowd Bryan , Lum Terry , Shippee Tetyana
Published: March 2014

Objective

To compare the probability of experiencing a potentially preventable hospitalization (PPH) between older dual eligible Medicaid home and community‐based service (HCBS) users and nursing home residents.

Data Sources

Three years of Medicaid and Medicare claims data (2003–2005) from seven states, linked to area characteristics from the Area Resource File.

Study Design

A primary diagnosis of an ambulatory care sensitive condition on the inpatient hospital claim was used to identify PPHs. We used inverse probability of treatment weighting to mitigate the potential selection of HCBS versus nursing home use.

Principal Findings

The most frequent conditions accounting for PPHs were the same among the HCBS users and nursing home residents and included congestive heart failure, pneumonia, chronic obstructive pulmonary disease, urinary tract infection, and dehydration. Compared to nursing home residents, elderly HCBS users had an increased probability of experiencing both a PPH and a non‐PPH.

Conclusions

HCBS users’ increased probability for potentially and non‐PPHs suggests a need for more proactive integration of medical and long‐term care.
Computer Simulations to Investigate the Consequence of Blunt Head Impact
Authors: Baumgartner Laura , Schmitt Kai‐Uwe
Published: March 2014

Blunt head impact as sustained in falls or punches against the head can result in rupture of bridging veins. Computer simulations were performed to simulate three different types of falls and punches against the head. The relative brain‐skull motion was recorded. The falls resulted in impact on the backside of the head, whereas the punches struck the face. The maximum resultant translational and rotational acceleration, the Head Injury Criterion (HIC), and the characteristics of the relative brain‐skull motion, as well as the coup and contre‐coup regions were determined. The maximum resultant translational acceleration was found to be between 2982 and 3541 m/s² for falls and between 814 and 942 m/s² for punches. The maximum resultant rotational acceleration reached 632–1000 rad/s² for falls and 252–620 rad/s² for punches. The HIC for falls was found to be at least 1357 and at most 130 for punches. The major brain‐skull displacement calculated for falls and punches was 6.6 and 4.2 mm, respectively. The results of this study suggest that falls are associated with a higher risk for bridging vein ruptures than punches and that cerebral contusions at the contre‐coup side are more serious.
Identification of putative orthologous genes for the phylogenetic reconstruction of temperate woody bamboos (Poaceae: Bambusoideae)
Authors: Zhang Li‐Na , Zhang Xian‐Zhi , Zhang Yu‐Xiao , Zeng Chun‐Xia , Ma Peng‐Fei , Zhao Lei , Guo Zhen‐Hua , Li De‐Zhu
Published: March 2014

The temperate woody bamboos (Arundinarieae) are highly diverse in morphology but lack a substantial amount of genetic variation. The taxonomy of this lineage is intractable, and the relationships within the tribe have not been well resolved. Recent studies indicated that this tribe could have a complex evolutionary history. Although phylogenetic studies of the tribe have been carried out, most of these phylogenetic reconstructions were based on plastid data, which provide lower phylogenetic resolution compared with nuclear data. In this study, we intended to identify a set of desirable nuclear genes for resolving the phylogeny of the temperate woody bamboos. Using two different methodologies, we identified 209 and 916 genes, respectively, as putative single copy orthologous genes. A total of 112 genes was successfully amplified and sequenced by next‐generation sequencing technologies in five species sampled from the tribe. As most of the genes exhibited intra‐individual allele heterozygotes, we investigated phylogenetic utility by reconstructing the phylogeny based on individual genes. Discordance among gene trees was observed and, to resolve the conflict, we performed a range of analyses using BUCKy and HybTree. While caution should be taken when inferring a phylogeny from multiple conflicting genes, our analysis indicated that 74 of the 112 investigated genes are potential markers for resolving the phylogeny of the temperate woody bamboos.
Primary pulmonary collision tumor with three components in the underlying interstitial lung disease
Authors: Suzuki Shigeki , Ohtsuka Takashi , Hato Tai , Kamiyama Ikuo , Goto Taichiro , Kohno Mitsutomo , Emoto Katsura , Hayashi Yuichiro
Published: March 2014

A collision tumor of the lung is relatively rare. We report a case of a 72‐year‐old man with a collision tumor consisting of three neoplastic components in the underlying interstitial lung disease. Computed tomography showed a parenchymal lesion with an air bronchogram. Transthoracic needle lung biopsy showed chronic inflammation, however, a malignant pulmonary tumor was clinically suspected. The patient underwent a right lower lobectomy with mediastinal lymph node dissection. The histological features of the surgical specimen showed lung cancer with three neoplastic components, which were squamous cell carcinoma, invasive mucinous adenocarcinoma, and invasive non‐mucinous adenocarcinoma. To the best of our knowledge, this is the first documentation of a collision lung tumor with three components.
New orthotopic implantation model of human esophageal squamous cell carcinoma in athymic nude mice
Authors: Song Shuai , Chang Dong , Cui Yong , Hu Jian , Gong Min , Ma Kai , Ding Fang , Liu Zhi‐Hua , Wang Tian‐You
Published: March 2014

Background

Subcutaneous xenograft is a common method to establish animal models of human esophageal squamous cell carcinoma (ESCC). However, the growth microenvironment of transplanted tumors is different from primary tumors. Orthotopic implantation models can provide more biologically relevant context in which to study the disease. So far, an orthotopic implantation model of ESCC has rarely been reported.

Methods

The human ESCC cell line KYSE30 was transfected with pLVX‐Luciferase plasmids. KYSE30‐Luciferase cells were isolated and injected into the flanks of nude mice to develop a subcutaneous tumor. An orthotopic implantation model was established using the fragments derived from the subcutaneous tumor. Fluorescence imaging was used to observe the development of the orthotopic implanted tumor. Hematoxylin and eosin staining was performed to evaluate the invasion and metastasis of the tumor.

Results

KYSE30 cells were successfully transfected with pLVX‐Luciferase plasmids. A primary tumor was developed in all mice. The mice experienced body weight loss. The implanted tumor infiltrated into the esophageal muscularis propria. However, neither distant organ nor lymph node metastasis was found. The progression of the primary tumor was monitored by in vivo fluorescence imaging.

Conclusion

The orthotopic implantation model can be established by sewing the fragments of human ESCC to the abdominal esophagus of a nude mouse. The progression of an orthotopic implantation tumor can be monitored in real time by in vivo fluorescence imaging.
A new frontier in biodiversity inventory: a proposal for estimators of phylogenetic and functional diversity
Authors: Cardoso Pedro , Rigal François , Borges Paulo A. V. , Carvalho José C.
Published: March 2014

Complete sampling of all dimensions of biodiversity is a formidable task, even for small areas. Undersampling is the norm, and the underquantification of diversity is a common outcome. Estimators of taxon diversity (TD) are widely used to correct for undersampling. Yet, no similar strategy has been developed for phylogenetic (PD) or functional (FD) diversity.

We propose three ways of estimating PD and FD, building on estimators originally developed for TD: (i) correcting PD and FD values based on the completeness of TD; (ii) fitting asymptotic functions to accumulation curves of PD and FD; and (iii) adapting nonparametric estimators to PD and FD data.

Using trees as a common framework for the estimation of PD and FD, we tested the approach with European mammal and Azores Islands arthropod data. We demonstrated that different methods were able to considerably reduce the undersampling bias and often correctly estimated true diversity using a fraction of the samples necessary to reach complete sampling.

Besides the utility of knowing the true diversity of an assemblage from incomplete samples, the use of estimators may present further advantages. For instance, comparisons between sites or time periods are possible only if either sampling is complete or sampling effort is equivalent and sufficient to allow sensible comparisons. Also, as PD and FD asymptote faster than TD, comparisons between these different dimensions may require unbiased values. The framework now proposed combines taxon, phylogenetic and functional diversity into a single framework, offering a tool for future developments involving these different facets of biological diversity.
A new statistical framework for the quantification of covariate associations with species distributions
Authors: Beale Colin M. , Brewer Mark J. , Lennon Jack J.
Published: March 2014

Identifying processes that shape species geographical ranges is a prerequisite for understanding environmental change. Currently, species distribution modelling methods do not offer credible statistical tests of the relative influence of climate factors and typically ignore other processes (e.g. biotic interactions and dispersal limitation).

We use a hierarchical model fitted with Markov Chain Monte Carlo to combine ecologically plausible niche structures using regression splines to describe unimodal but potentially skewed response terms. We apply spatially explicit error terms that account for (and may help identify) missing variables.

Using three example distributions ofEuropean bird species, we map model results to show sensitivity to change in each covariate. We show that the overall strength of climatic association differs between species and that each species has considerable spatial variation in both the strength of the climatic association and the sensitivity to climate change.

Our methods are widely applicable to many species distribution modelling problems and enable accurate assessment of the statistical importance of biotic and abiotic influences on distributions.
Studying phenology by flexible modelling of seasonal detectability peaks
Authors: Strebel Nicolas , Kéry Marc , Schaub Michael , Schmid Hans
Published: March 2014

Many animals and plant species have advanced spring phenology in response to climate warming. The majority of avian phenological studies are based on arrival dates. Consequently, knowledge on bird phenology is mainly based on migratory species. In addition, arrival dates of migratory birds may be substantially affected by en route climate conditions, thus failing to provide good indicators for spring phenology on the breeding grounds. Correlating arrival dates with other phenological data or with environmental covariates may be meaningless in these cases.

We propose the date of highest singing activity, quantified by detection probability, as a powerful proxy for breeding phenology that is applicable to migratory and sedentary bird species alike. In contrast to arrival dates, breeding phenology is mainly (non‐migrants) or at least partially (migrants) influenced by conditions experienced within the breeding area.

We developed a new method for flexible estimation of peak detectability date in spring by combining multiseason site occupancy with semi‐parametric regression modelling (thin‐plate splines). We applied our approach to opportunistic observations of 27 bird species (mostly passerines) in Switzerland.

We found substantial differences among species in the date of spring peak detectability: late February to mid‐April in sedentary and short‐distance migratory species and mid‐April to late May in long‐distance migrants. Among 10 species with data for >9 years, five showed a trend in detectability peaks towards an earlier spring phenology by nine to 17 days within 10 years. The mean shift over all species was c. 3·5 days per 10 years.

Our approach is widely applicable, especially for temporally and spatially large‐scale data from monitoring or citizen‐science programmes. Besides using the detectability peak as measure of phenology, the estimated seasonal pattern in detectability can help designing monitoring programmes for improved efficiency. Our approach may be applied to any species with pronounced acoustic displays or other behavioural traits strongly influencing detectability during the breeding period. We believe that it can contribute substantially to unravelling how species and communities respond to environmental change.
Non‐Markovian maximum likelihood estimation of autocorrelated movement processes
Authors: Fleming Christen H. , Calabrese Justin M. , Mueller Thomas , Olson Kirk A. , Leimgruber Peter , Fagan William F.
Published: March 2014

By viewing animal movement paths as realizations of a continuous stochastic process, we introduce a rigorous likelihood method for estimating the statistical parameters of movement processes. This method makes no assumption of a hidden Markov property, places no special emphasis on the sampling rate, is insensitive to irregular sampling and data gaps, can produce reasonable estimates with limited sample sizes and can be used to assignAICvalues to a vast array of qualitatively different models of animal movement at the individual and population levels.

To develop our approach, we consider the likelihood of the first two cumulants of stochastic processes, the mean and autocorrelation functions. Together, these measures provide a considerable degree of information regarding searching, foraging, migration and other aspects of animal movement. As a specific example, we develop the likelihood analyses necessary to contrast performance of animal movement models based on Brownian motion, the Ornstein–Uhlenbeck process and a generalization of the Ornstein–Uhlenbeck process that includes ballistic bouts.

We then show how our framework also provides a new and more accurate approach to home‐range estimation when compared to estimators that neglect autocorrelation in the movement path.

We apply our methods to a data set on Mongolian gazelles (Procapra gutturosa) to identify the movement behaviours and their associated time and length scales that characterize the movement of each individual. Additionally, we show that gazelle annual ranges are vastly larger than those of other non‐migratory ungulates.
Arboreal camera trapping: taking a proven method to new heights
Authors: Gregory Tremaine , Carrasco Rueda Farah , Deichmann Jessica , Kolowski Joseph , Alonso Alfonso
Published: March 2014

Although camera trapping has been shown to be a highly effective non‐invasive tool for wildlife monitoring, the technique has not yet been widely applied to studies of arboreal species. Despite the unique challenges that camera trapping in the canopy poses, its versatility and relatively non‐invasive nature, combined with recent technological improvements on the cameras themselves, make camera trapping a highly useful tool for arboreal research.

We present data on the methodology and effectiveness of arboreal camera trapping during the first 6 months of a year‐long study in the Lower Urubamba Region of Peru investigating animal use of natural crossing points (i.e. branches) over a natural gas pipeline clearing. We placed ReconyxPC800 Hyperfire cameras in 25 crossing points of 13 distinct natural canopy ‘bridges’ at a mean height of 26·8 m.

After 6 months of data collection, we logged 1522 photoevents, recording 20 mammal, 23 bird and four reptile species. An analysis of animal passing events in front of the cameras over time did not suggest any negative response to camera presence. While we found that cameras in the canopy are triggered more frequently by non‐target stimuli (e.g. leaves) than cameras on the ground, we demonstrated significantly reduced false triggering following leaf removal within 1·5 m of the camera.

Our results suggest that arboreal camera trapping can provide robust documentation of a diversity of vertebrate species engaged in a variety of activities, and we provide recommendations for other researchers interested in using in this method. This is the most extensive arboreal camera trapping study to date in terms of the length of the study period, the number of cameras being used and the height of the cameras in the trees. Therefore, lessons provided from this experience can be used to improve the design of future arboreal camera trap studies.
Conflict Prevention, Conflict Mitigation, and Manifestations of Conflict During Emergency Department Consultations
Authors: Chan Teresa , Bakewell Francis , Orlich Donika , Sherbino Jonathan
Published: March 2014

Objectives

The objective was to determine the causes of and mitigating factors for conflict between emergency physicians and other colleagues during consultations.

Methods

From March to September 2010, a total of 61 physicians (31 residents and 30 attendings from emergency medicine [EM], internal medicine, and general surgery) were interviewed about how junior learners should be taught about emergency department (ED) consultations. During these interviews, they were asked if and how conflict manifests during the ED consultation process. Two investigators reviewed the transcripts independently to generate themes related to conflict until saturation was reached. Disagreements were resolved by consensus. The trustworthiness of the analysis was ensured by generating an audit trail, which was subsequently audited by an investigator not involved with the initial analysis. This analysis was compared to previously proposed models of trust and conflict from the sociology and business literature.

Results

All participants recalled some manifestation of conflict. There were 12 negative conflict‐producing themes and 10 protective conflict‐mitigating themes. When comparing these themes to a previously developed model of the domains of trust, each theme mapped to domains of the model.

Conclusions

Conflict affects the ED consultation process. Areas that lead to conflict are identified that map to previous models of trust and conflict. This work extends the current understanding about intradisciplinary conflict in the clinical realm. These new findings may improve the understanding of the nature of conflicts that occur and form the foundation for interventions that may decrease conflict during ED consultations.
Developing differential height, weight and body mass index references for girls that reflect the impact of the menarche
Authors: Mumm R , Scheffler C , Hermanussen M
Published: March 2014

Aim

Growth is both a matter of amplitude and tempo. We aimed to develop references for body height, body weight and body mass index (BMI) with respect to tempo of maturity.

Methods

Data obtained from the German KiGGS study (2003–2006) on body height, body weight and presence or absence of the menarche were re‐analysed in 3776 girls, aged 10–17 years. We developed smoothed centiles for BMI‐, body‐height‐ and body‐weight‐for‐age using the LMS method for premenarcheal and postmenarcheal girls.

Results

Body height, body weight and BMI differed significantly between premenarcheal and postmenarcheal girls. On average, postmenarcheal girls aged 11–17 years were 5.3 cm taller and 9.7 kg heavier, and their BMI was 2.9 kg/m² higher than in premenarcheal girls of the same calendar age.

Conclusion

Adolescent BMI rises with calendar age and biological age. New reference charts for adolescent girls aged 10–18 years were generated to be inserted into the currently used references to avoid misclassifying underweight and overweight pubertal girls.
Ademographic and career profile of municipalCAOsinCanada: Implications for local governance
Authors: O'Flynn Patrick Eamon , Mau Tim A.
Published: March 2014

Little has been written about the Canadian municipal chief administrative officer (CAO). Given the growing importance of municipalities, it is an important gap in the literature. This article depictsCAOsas a group of older white men, highly educated and very experienced. Given the impending retirement of a significant number ofCAOs, municipalities have an opportunity to achieve a greater degree of representativeness. The authors identify a number of research trajectories to enhance our knowledge and understanding of this critical administrative position.

Sommaire

Il existe peu de documents sur les chefs des services municipaux auCanada. Étant donné l'importance croissante des municipalités, cela représente une grave lacune dans la documentation. Cet article décrit les chefs des services municipaux comme un groupe d'hommes blancs d'un certain âge, ayant un haut niveau d'études et une grande expérience. Comme un grand nombre d'entre eux vont prendre leur retraite d'ici peu, les municipalités ont une occasion de parvenir à un plus grand degré de représentativité. Les auteurs identifient un certain nombre de pistes de recherche pour améliorer nos connaissances et notre compréhension de cette fonction administrative cruciale.
Curcumin ameliorates autoimmune diabetes. Evidence in accelerated murine models of type 1 diabetes
Authors: Castro C N , Barcala Tabarrozzi A E , Winnewisser J , Gimeno M L , Antunica Noguerol M , Liberman A C , Paz D A , Dewey R A , Perone M J
Published: March 2014

Type 1 diabetes (T1DM) is a T cell-mediated autoimmune disease that selectively destroys pancreatic β cells. The only possible cure for T1DM is to control autoimmunity against β cell-specific antigens. We explored whether the natural compound curcumin, with anti-oxidant and anti-inflammatory activities, might down-regulate the T cell response that destroys pancreatic β cells to improve disease outcome in autoimmune diabetes. We employed two accelerated autoimmune diabetes models: (i) cyclophosphamide (CYP) administration to non-obese diabetic (NOD) mice and (ii) adoptive transfer of diabetogenic splenocytes into NODscid mice. Curcumin treatment led to significant delay of disease onset, and in some instances prevented autoimmune diabetes by inhibiting pancreatic leucocyte infiltration and preserving insulin-expressing cells. To investigate the mechanisms of protection we studied the effect of curcumin on key immune cell populations involved in the pathogenesis of the disease. Curcumin modulates the T lymphocyte response impairing proliferation and interferon (IFN)-γ production through modulation of T-box expressed in T cells (T-bet), a key transcription factor for proinflammatory T helper type 1 (Th1) lymphocyte differentiation, both at the transcriptional and translational levels. Also, curcumin reduces nuclear factor (NF)-κB activation in T cell receptor (TCR)-stimulated NOD lymphocytes. In addition, curcumin impairs the T cell stimulatory function of dendritic cells with reduced secretion of proinflammatory cytokines and nitric oxide (NO) and low surface expression of co-stimulatory molecules, leading to an overall diminished antigen-presenting cell activity. These in-vitro effects correlated with ex-vivo analysis of cells obtained from curcumin-treated mice during the course of autoimmune diabetes. These findings reveal an effective therapeutic effect of curcumin in autoimmune diabetes by its actions on key immune cells responsible for β cell death.
A systematic review of local excision combined with chemoradiotherapy for early rectal cancer
Authors: Ung L. , Chua T. C. , Engel A. F.
Published: March 2014

Aim

Local excision of early rectal cancer is a less morbid alternative to major abdominal surgery. This review evaluates the role of local excision with neoadjuvant or adjuvant chemoradiotherapy to identify a select group of patients where local excision is appropriate without significantly compromising the oncological outcome.

Method

MEDLINE, PubMed and the Cochrane Central Register of Controlled Trials databases were searched to identify relevant articles investigating the role of local excision with adjuvant or neoadjuvant chemoradiotherapy in patients with T1/T2N0M0 disease. Eleven studies comprising 455 patients were selected. Oncological end‐points included overall survival, disease‐free and disease‐specific survival, recurrence rates as well as perioperative morbidity and mortality.

Results

At a range of 30.5–115.2 months, median overall survival, disease‐specific and disease‐free survival were 75% (66–80.6%), 89% (75–93.3%) and 74% (64–85.2%), respectively. Median local, distant and overall recurrence rates were 10% (4.8–25%), 4.7% (4–11.8%) and 13.1% (10.7–23.5%), respectively. Mortality was 0% in all studies except one (2.9%). Most reported complications were minor and were treated conservatively.

Conclusion

This systematic review provides data suggesting that selected patients with T1/T2N0M0 rectal cancer may undergo local excision without compromising the oncological outcome otherwise conferred by total mesorectal excision. It may be a particularly useful option in patients in whom radical surgery is contraindicated. Randomized trials comparing both management strategies to consolidate this finding may lead to a paradigm change in the management of early rectal cancer.
ATTITUDES TOWARD RISK AND SOCIOECONOMIC FACTORS RELATED TO EDUCATIONAL LOANS
Authors: ORTIZ‐NUÑEZ AURORA
Published: March 2014

We explore the relationship between willingness to take financial risk and the probability of taking out a loan for educational purposes as well as the influence of risk attitudes on the size of the loan using data drawn from the U.S. Survey of Consumer Finances. The findings suggest a positive relationship between individuals' willingness to take financial risk and the probability of taking out a loan for educational purposes. Similarly, individuals' willingness to take financial risk appears to have an important relationship with the size of the educational loan. The findings suggest that non‐white individuals and females are less likely to finance education through loans which could potentially increase inequalities in education and income if such individuals are deterred from investing in human capital. (JEL I22, I23)
Vitamin D deficiency, parathyroid hormone levels, and bone disease among patients with end‐stage liver disease and normal serum creatinine awaiting liver transplantation
Authors: Corey Rebecca L. , Whitaker Michael D. , Crowell Michael D. , Keddis Mira T. , Aqel Bashar , Balan Vijayan , Byrne Thomas , Carey Elizabeth , Douglas David D. , Harrison M. Edwyn , Vargas Hugo E. , Rakela Jorge
Published: March 2014

Vitamin D deficiency is common among patients with end‐stage liver disease (ESLD). The primary aim of our study was to assess the prevalence of vitamin D deficiency, secondary hyperparathyroidism, and bone disease in patients with ESLD awaiting LT.

Methods

We retrospectively studied 190 patients at our center. Serum total 25‐hydroxyvitamin D (25‐OH D), parathyroid hormone (PTH), calcium, and bone mineral analysis (BMA) were recorded. Standard World Health Organization (WHO) criteria were used to diagnose osteopenia/osteoporosis. Only patients with normal serum creatinine were analyzed.

Results

Thirty‐two of 190 patients were excluded from the final analysis (missing serum total 25‐OH D levels in three patients and elevated serum creatinine, 29 patients). 105 of 158 (66.4%) evaluable patients had 25‐OH D levels <25 ng/mL. Patients included in the analysis (n = 158) were divided according to serum total 25‐OH D levels: 0–10 ng/mL (n = 23), 11–20 ng/mL (n = 64), and >20 ng/mL (n = 71). There were no significant differences in mean serum PTH and corrected calcium levels among the three subgroups. Only three patients had elevated serum PTH. Patients with total 25‐OH D ≤ 10 ng/mL had higher model for end‐stage liver disease (MELD) scores vs. those with 25‐OH D > 20 ng/mL (13.3 ± 3, range 8–21, vs. 11.9 ± 3.4, range 6–29, p = 0.004). Irrespective of vitamin D status, bone disease was present in 64.6% of patients.

Conclusion

Low vitamin D levels and bone disease are common among patients with ESLD awaiting LT. Despite a high prevalence of low serum total 25‐OH D, our cohort maintained normal corrected calcium levels and did not develop secondary hyperparathyroidism. We propose that free serum 25‐OH D and vitamin D‐binding protein may be necessary to accurately establish the diagnosis of vitamin D deficiency in the setting of ESLD. Additional studies are needed to further define mechanisms of bone disease in patients with ESLD.
Stenotrophomonas maltophilia infection during allogeneic hematopoietic stem cell transplantation: a single‐center experience
Authors: Shiratori Souichi , Wakasa Kentaro , Okada Kohei , Sugita Junichi , Akizawa Koji , Shigematsu Akio , Hashimoto Daigo , Fujimoto Katsuya , Endo Tomoyuki , Kondo Takeshi , Shimizu Chikara , Hashino Satoshi , Teshima Takanori
Published: March 2014

To examine risk factors for Stenotrophomonas maltophilia (S. maltophilia) infection during allogeneic hematopoietic stem cell transplantation (allo‐HSCT), we retrospectively analyzed 259 patients who underwent allo‐HSCT. Not only S. maltophilia infection but also S. maltophilia colonization was associated with mortality during allo‐HSCT. Among 52 episodes in 39 patients in whom S. maltophilia was detected, documented infection developed in 33 episodes (25 patients). The onset of S. maltophilia infection in the period from the conditioning regimen to engraftment was associated with a high mortality rate. Breakthrough S. maltophilia infection developed in 24% of the patients during prophylactic administration of fluoroquinolones, to which S. maltophilia is sensitive. Reinsertion of a central venous catheter (CVC) immediately after removal was suggested to be a risk for persistent S. maltophilia infection in the period of neutropenia. Our results indicated that (i) onset of S. maltophilia infection in the period from the conditioning therapy to engraftment and (ii) removal and immediate reinsertion of a CVC as treatment after the onset of S. maltophilia infection are possible risk factors for S. maltophilia‐related mortality during allo‐HSCT.
Topography matters in neonatal periventricular haemorrhagic infarction
Authors: Vollmer Brigitte
Published: March 2014

This commentary is on the original article by Soltirovska Salamon et al. on pages 547–555 of this issue.
Cervical spondylosis deformans in two Quarter Horses
Authors: Draper A. C. E. , Finno C. J.
Published: March 2014

This case report describes 2 Quarter Horses diagnosed with severe bridging spondylosis deformans of the cervical spine. Clinical signs in both horses included severe neck stiffness, reduced mobility and issues with grazing normally. Both were diagnosed with cervical radiographs. Ataxia was noted in one horse. One horse has shown progressively worsening signs over 4 years. Where severe neck stiffness and reduced mobility are noted in a horse, cervical spondylosis deformans should be considered as a differential diagnosis.
More than just a filler – the role of hyaluronan for skin homeostasis
Authors: Anderegg Ulf , Simon Jan C. , Averbeck Marco
Published: March 2014

In recent years, hyaluronan (HA) has become an increasingly attractive substance as a non‐immunogenic filler and scaffolding material in cosmetic dermatology. Despite its wide use for skin augmentation and rejuvenation, relatively little is known about the molecular structures and interacting proteins of HA in normal and diseased skin. However, a comprehensive understanding of cutaneous HA homeostasis is required for future the development of HA‐based applications for skin regeneration. This review provides an update on HA‐based structures, expression, metabolism and its regulation, function and pharmacological targeting of HA in skin.
The derivation of log‐transformed abundance data for the quantitative analysis of macroinvertebrate traits – an addendum to ‘A macroecological perspective of trait patterns in stream communities’ by Heino et al. ()
Authors: Monaghan Kieran A. , Soares Amadeu M. V. M.
Published: March 2014

Heino et al. () identified the weak explanatory power of abundance data as an important limitation of macroinvertebrate trait analysis. This limitation may be an artefact of analytical design.

The widespread practice of combining logarithmically transformed abundance data with trait frequencies, log(x + 1)*(trait frequency), represents a nonlinear abundance weighting of trait frequencies, as opposed to an expression of trait abundances per se. Because the addition of logarithmic data is equivalent to multiplication on an arithmetic scale, summing these abundance‐weighted frequencies provides an inconsistent scaling of trait abundance that may confound quantitative comparison.

We provide examples of the options for estimating trait abundance from data on macroinvertebrate abundance and trait frequencies and discuss the meaning of numerical data in the context of analytical objectives.

In the light of the contrasting methods that have been employed to analyse trait data for benthic macroinvertebrates, the conclusion that the explanatory power of trait abundance is inferior to that of taxonomic abundance may be premature.
Renal Dysfunction in Stroke Patients: A Hospital-Based Cohort Study and Systematic Review
Authors: Rowat Anne , Graham Catriona , Dennis Martin
Published: March 2014

Background and purpose

Renal dysfunction (i.e. a reduced estimated glomerular filtration rate, eGFR) is commonly found in hospitalized stroke patients but its associations with Patients' characteristics and outcome require further investigation.

Methods

We linked clinical data from stroke patients enrolled between 2005 and 2008 into two prospective hospital registers with routine laboratory eGFR data. The eGFR was calculated using the Modification of Diet in Renal Disease method and renal dysfunction was defined as <60 ml/min/1·73 m2. In addition we systematically reviewed studies investigating the association between eGFR and outcome after stroke.

Results

Of 2520 patients who had an eGFR measured on admission hospital, 805 (32%) had renal dysfunction. On multivariate analysis, renal dysfunction was significantly less likely in those with a predicted good outcome (OR 0·27, 95% CI 0·21, 0·36) based on the well-validated six simple variable model. After adjustment for other predictive factors, stroke patients with renal dysfunction were more likely to die in hospital compared with those without (odds ratio 1·59, 95% confidence intervals 1·26, 2·00). Of the 31 studies involving 41 896 participants included in the systematic review, 18 studies found that low eGFR was an independent predictor of death and 6 reported a significant association with death and disability.

Conclusion

Our findings suggest that renal dysfunction on admission is common and associated with poor outcomes over the first year. Further work is required to establish to what extent these associations are causal and whether treating impaired renal function improves outcomes.
Use of biological treatments in patients with hidradenitis suppurativa
Authors: Martin‐Ezquerra G. , Masferrer E. , Masferrer‐Niubò M. , Ferran M. , Sánchez‐Regaña M. , Collgros H. , Bordas X. , Notario J. , Alsina M. , Gil I. , Izquierdo N. , Aparicio G. , Mollet J. , Garcia‐Patos V. , Pujol R.M.
Published: March 2014

Introduction

Hidradenitis suppurativa (HS) is a chronic skin disease which causes a great impact in the quality of life. Multiple therapeutic options have been proposed, and recently the potential use of biological drugs in severe cases has been postulated.

Material and Methods

A retrospective study from seven tertiary Spanish centers reviewing the charts of patients with HS treated with biological drugs was performed. Retrieved information included epidemiological data, clinical features, pain intensity, Hurley stage, laboratory data and therapeutic outcomes.

Results

Nineteen patients were included in the study; 10 men (52.6%) and 9 women. Eight patients (42%) showed a Hurley severity stage II and 11 a stage III (57.8%). Adalimumab was prescribed as the first biological treatment in nine out of 19 cases (47.3%), whereas infliximab was prescribed in seven cases (36.8%), ustekinumab in two cases (10.5%) and etanercept in one (5.2%). A complete response was observed in three patients (two cases with infliximab and one case with ustekinumab), a partial improvement in 10 patients and in six patients no clinical improvement was noted. One patient referred worsening of the skin symptoms. In 6 cases, a second biological treatment was prescribed. In three of such cases, a partial improvement was noted, whereas in three cases no clinical improvement was observed. In two cases a switch to a third biological drug was indicated, with a partial improvement in one case.

Discussion and Conclusions

Biological drugs could be a potential and effective therapeutic option for patients with severe HS. Complete and persistent clinical responses are rarely obtained (15%) and partial responses are achieved in approximately 50% of patients. No specific markers for a therapeutic response have been identified. No definitive conclusions regarding the most effective biological drug for HS could be drawn. Higher dosage schedules seem to be associated with higher response rates. The lack of response of one particular drug does not preclude a potential efficacy to another biological treatment.
LEARNING BANKS' EXPOSURE TO SYSTEMATIC RISK: EVIDENCE FROM THE FINANCIAL CRISIS OF 2008
Authors: Viale Ariel M. , Madura Jeff
Published: March 2014

Using a two‐state Markov regime‐switching intertemporal capital asset pricing model, we find that the exposure to systematic risk of bank stocks varies with size and the state of the economy. Across large banks, those with higher net interest margins and lower capital ratios are the most exposed to unexpected shifts in the term structure of interest rates. Small banks with higher net interest rate margins and that rely less on noninterest income are the most exposed to unexpected shifts in the stance of monetary policy. We apply the asset pricing model out of sample to assess its ability to detect troubled banks during a financial crisis.
Mechanical stimulation evokes rapid increases in extracellular adenosine concentration in the prefrontal cortex
Authors: Ross Ashley E. , Nguyen Michael D. , Privman Eve , Venton B. Jill
Published: March 2014

Mechanical perturbations can release ATP, which is broken down to adenosine. In this work, we used carbon‐fiber microelectrodes and fast‐scan cyclic voltammetry to measure mechanically stimulated adenosine in the brain by lowering the electrode 50 μm. Mechanical stimulation evoked adenosine in vivo (average: 3.3 ± 0.6 μM) and in brain slices (average: 0.8 ± 0.1 μM) in the prefrontal cortex. The release was transient, lasting 18 ± 2 s. Lowering a 15‐μm‐diameter glass pipette near the carbon‐fiber microelectrode produced similar results as lowering the actual microelectrode. However, applying a small puff of artificial cerebral spinal fluid was not sufficient to evoke adenosine. Multiple stimulations within a 50‐μm region of a slice did not significantly change over time or damage cells. Chelating calcium with EDTA or blocking sodium channels with tetrodotoxin significantly decreased mechanically evoked adenosine, signifying that the release is activity dependent. An alpha‐amino‐3‐hydroxy‐5‐methylisoxazole‐4‐propionate receptor antagonist, 6‐cyano‐7‐nitroquinoxaline‐2,3‐dione, did not affect mechanically stimulated adenosine; however, the nucleoside triphosphate diphosphohydrolase 1,2 and 3 (NTDPase) inhibitor POM‐1 significantly reduced adenosine so a portion of adenosine is dependent on extracellular ATP metabolism. Thus, mechanical perturbations from inserting a probe in the brain cause rapid, transient adenosine signaling which might be neuroprotective.

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We have discovered immediate changes in adenosine concentration in the prefrontal cortex following mechanical stimulation. The adenosine increase lasts only about 20 s. Mechanically stimulated adenosine was activity dependent and mostly because of extracellular ATP metabolism. This rapid, transient increase in adenosine may help protect tissue and would occur during implantation of any electrode, such as during deep brain stimulation.