bluuebunny/crossref_metadata_2025 huggingface dataset:
A case of coelomic cysts of the mediastinum
Authors: Ujiie Hideki , Okada Daisuke , Nakajima Yuki , Akiyama Hirohiko
Published: July 2013

Coelomic cysts are rare cysts of mesothelial origin. They are generally unilocular and can develop in various sites. We describe a case of a multicystic lesion discovered incidentally in the anterior mediastinum of a 41-year-old man. Immunohistochemistry confirmed multiple coelomic cysts of the mediastinum.
Enlarged coronary artery pseudoaneurysm after drug-eluting stent implantation
Authors: Hori Daijiro , Noguchi Kenichiro , Nomura Yohei , Tanaka Hiroyuki
Published: July 2013

A 73-year-old man with 2-vessel coronary artery disease underwent a staged percutaneous coronary intervention that resulted in rupture of the right coronary artery and pseudoaneurysm formation. Although the pseudoaneurysm regressed over a week, it reexpanded after a year. Resection of the pseudoaneurysm and coronary artery bypass grafting were performed. The drug-eluting stent at the coronary artery injury site may have delayed healing and remodeling of the artery, thus contributing to reexpansion of the pseudoaneurysm.
Post-infarction ventricular septal defect: surgical outcomes in the last decade
Authors: Yam Nicholson , Au Timmy Wing-Kuk , Cheng Lik-Cheung
Published: July 2013

Background:

Post-infarction ventricular septal defects require surgical closure. Only a few studies have been conducted in Asian populations. This study reports the current outcomes and determinants affecting survival.

Methods:

Between January 1995 and January 2012, 40 patients underwent surgery for post-infarction ventricular septal defect. We analyzed demographics, clinical, angiographic, and echocardiographic parameters, operative data, postoperative morbidity, and survival. Mean follow-up was 5.2 ± 5.3 years. Univariate and multivariate analyses were used to determine the factors affecting 30-day mortality and long-term survival.

Results:

There was no intraoperative death. Our 30-day mortality was 20%. Single-vessel disease was found on coronary angiography in 63% of patients. Eight patients had concomitant coronary artery bypass grafting. Overall survival at 1, 5, and 10 years was 68%, 55%, and 42%, respectively. Event-free survival from subsequent angina, myocardial infarction, congestive heart failure, or percutaneous interventions at 1, 5, and 10 years was 66%, 43%, and 25%, respectively. Preoperative oliguria and postoperative sepsis were independent predictors of 30-days mortality on multivariate analysis ( p = 0.02). Preoperative left ventricular function was associated with long-term survival ( p = 0.048).

Conclusion:

We had good results of current postinfarction ventricular septal defect repair. Selected patients had concomitant coronary artery bypass grafting. Preoperative oliguria and postoperative sepsis were independent predictors of 30-day mortality, while left ventricular function was related to long-term survival.
Ventricular tachyarrhythmia after coronary bypass surgery: incidence and outcome
Authors: Sadr-Ameli Mohammad Ali , Alizadeh Abolfath , Ghasemi Valiollah , Heidarali Mona
Published: July 2013

Background

Ventricular tachyarrhythmia after coronary artery bypass graft is common and the occurrence has been described, but the incidence and risk factors are not well defined.

Aim

To evaluate the incidence of arrhythmias and to detect high-risk populations.

Methods

In this prospective study, 856 consecutive patients undergoing coronary artery bypass graft were monitored for new-onset ventricular tachyarrhythmias: non-sustained monomorphic ventricular tachyarrhythmia, sustained monomorphic ventricular tachyarrhythmia, sustained polymorphic ventricular tachyarrhythmia, and ventricular fibrillation. Detailed analyses of the clinical, demographic, echocardiographic, and surgical findings and arrhythmias occurrence was carried out during 6 months of follow-up.

Results

The incidence of ventricular tachyarrhythmia was 26.6% (17.6% non-sustained monomorphic ventricular tachycardia, 5.5% sustained monomorphic ventricular tachycardia, 0.8% sustained polymorphic ventricular tachycardia, and 2.7% ventricular fibrillation). The strongest degrees of statistical significance were for low ejection fraction ( p = 0.01) and ischemic heart disease ( p = 0.02). The incidence of ventricular fibrillation (61%) was greatest in the first 48 h after surgery. Postoperative myocardial infarction ( p = 0.03) and hemodynamic instability ( p = 0.05) were also predictors of arrhythmia occurrence. Recurrence of arrhythmia was highest in the ventricular fibrillation group (52%). The correlations between tachyarrhythmia, age, sex, electrolyte disorders, body mass index, and systemic or pulmonary hypertension were not significant.

Conclusion

In view of the strong relationship between ventricular arrhythmias and low ejection fraction, ischemic heart disease, coronary artery disease severity, postoperative myocardial infection, and hemodynamic impairment, continuous monitoring is necessary, especially in the first 48 h after coronary artery bypass surgery.
Pneumonectomy after response to gefitinib treatment for lung adenocarcinoma
Authors: Funakoshi Yasunobu , Takeuchi Yukiyasu , Maeda Hajime
Published: July 2013

A 69-year-old Japanese woman who had never smoked had lung adenocarcinoma harboring epidermal growth factor receptor mutation. After 8 months of gefitinib treatment, salvage pneumonectomy was performed. Microscopic examination showed that non-responsive adenocarcinoma remained although necrosis was prominent. Postoperatively, the patient developed empyema that was successfully managed. The postoperative empyema after treatment with gefitinib should be noted, as well as the finding that residual viable tumor cells remained even after the dramatic radiographic response.
Successful endovascular treatment of ruptured bronchial artery aneurysm
Authors: Hori Daijiro , Noguchi Kenichiro , Nomura Yohei , Tanaka Hiroyuki
Published: July 2013

Rupture of a bronchial artery aneurysm occurs rarely and may mimic aortic dissection. A 78-year-old-man was admitted with sudden chest pain. Chest radiography showed widening of the mediastinum, suggestive of aortic dissection, but contrast-enhanced computed tomography revealed hemomediastinum and bronchial artery aneurysm. Although open surgery has been the first choice for ruptured bronchial artery aneurysm, this case was successfully treated by an endovascular procedure with the combined use of coils and a gelatin sponge.
Total anomalous systemic with partial anomalous pulmonary venous connections
Authors: Vallath Gopakumar , Gajjar Trushar , Desai Neelam
Published: July 2013

A 9-year-old girl with cyanosis, dyspnea, and grade II clubbing was diagnosed by contrast transthoracic echocardiography and angiocardiography to have an anomalous connection of the venae cavae to the physiologic left atrium with partial anomalous pulmonary venous connection. Successful surgical correction was achieved, and the patient’s recovery was uneventful.
Surgical treatment for right aortic arch with Kommerell’s diverticulum
Authors: Ishikawa Noboru , Oi Masaya , Maruta Kazuto , Iizuka Hirofumi , Kawaura Hiroyuki
Published: July 2013

Kommerell’s diverticulum causes compression of the esophagus between the aberrant origin of the left subclavian artery and ascending aorta, leading to dysphagia or dyspnea. We describe 3 cases of successful surgical treatment of right aortic arch with Kommerell’s diverticulum and aberrant origin of the left subclavian artery, using a right anterolateral partial sternotomy. This allows both resection of the Kommerell’s diverticulum as well as reconstruction of the aberrant origin of the left subclavian artery anatomically.
Descending necrotizing mediastinitis and sternoclavicular joint osteomyelitis
Authors: Dajer-Fadel Walid L , Ibarra-Pérez Carlos , Borrego-Borrego Rafael , Navarro-Reynoso Francisco P , Argüero-Sánchez Rubén
Published: July 2013

Descending necrotizing mediastinitis is usually associated with cervical or odontogenic infections. We describe a patient with blunt trauma to the chest 2 years earlier, and a slowly developing chest wall hematoma 18 months prior to admission, complicated by chronic sternoclavicular joint osteomyelitis, eventually leading to descending mediastinitis. Thoracotomy with drainage of the mediastinal spaces and multiple procedures for the sternoclavicular joint infection were successful. The rarity of this association and undefined optimal management prompted this report.
Left ventricular hemangioma
Authors: Oueida Farouk M , Lui Raphael C , Al-Refae Mustafa A , Al-Omran Hamed M
Published: July 2013

A young Saudi woman presented with symptoms of palpitation, near syncope, anxiety, and fatigue. Transthoracic echocardiography showed a left ventricular mass. Under cardiopulmonary bypass, brief cardioplegic arrest, and the aid of a thoracoscope, the mass was resected. Histologic examination showed a rare benign cardiac tumor: mixed cavernous-capillary hemangioma.
Unusual heart transplantation for iterative disinsertion of mitral prosthesis
Authors: Pozzi Matteo , Barreda Eleodoro , D’Alessandro Cosimo , Nguyen Anthony , Leprince Pascal , Pavie Alain
Published: July 2013

Heart transplantation is the gold standard of care for end-stage heart failure, usually associated with an impairment of left ventricular systolic function. We describe a case of heart transplantation in a 58-year-old man with normal left ventricular systolic function, because of recurrent mitral prosthesis disinsertion after multiple reoperations for infective endocarditis.
CardiaMed mechanical valve: mid-term results of a multicenter clinical trial
Authors: Nazarov Vladimir M , Zheleznev Sergey I , Bogachev-Prokophiev Alexandr V , Afanasyev Alexandr V , Nemchenko Eugene V , Jeltovskiy Yuri V , Lavinyukov Sergey O
Published: July 2013

Background

Prosthesis choice is a major concern in valvular surgery.

Methods

A multicenter clinical trial was performed to assess the efficacy and safety of the CardiaMed prosthetic heart valve. The study enrolled 420 patients who underwent mitral (209) or aortic (211) valve replacement from 2003 to 2004 at 7 institutions in Russia, and who were followed up from 2006 to 2011. The mean age was 52.2 ± 10.2 years (range, 12–78 years), 47.4% were female, and 99.05% completed the study.

Results

The maximum observation term was 7.5 years (2188.5 patient-years); 1081.6 patient-years for aortic and 1106.9 patient-years for mitral valve replacement. The overall 7-year survival rate was 85.1% ± 3.7%; 86.1% ± 4.8% and 84.4% ± 5.4% for aortic and mitral valve replacement, respectively. The 7-year freedom from valve-related death was 93.9% ± 3.7% and 94.5% ± 3.2% for aortic and mitral valve replacement, respectively. When early mortality (<30 days) was excluded, these rates were 94.8% ± 3.1% and 93.8% ± 3.82%, respectively. Linearized valve-dependent complication rates were determined for structural valve failure (0%/patient-year overall), thrombosis (0.63%/patient-year, all for mitral valve replacement), thromboembolic complications including transient neurologic deficits (0.13%/patient-year overall, 0.5%/patient-year for aortic valve replacement, 0.8%/patient-year for mitral valve replacement), hemorrhagic bleeding (0.64%/patient-year overall, 0.55%/patient-year for aortic valve replacement, 0.09%/patient-year for mitral valve replacement), prosthetic endocarditis (0.28%/patient-year overall, 0.28%/patient-year for aortic valve replacement, 0%/patient-year for mitral valve replacement), and hemolysis (0%/patient-year overall).

Conclusion

The CardiaMed mechanical heart valve prostheses meets world standards of safety and efficacy.
Acute renal dysfunction: time from coronary angiography to cardiac surgery
Authors: Baloria Kanwar A , Pillai Biju S , Goel Sanjay , Selot Nandini
Published: July 2013

Background

The incidence of acute renal dysfunction has not changed much over the years, despite improvements in perioperative care. Our objectives were to evaluate the impact of timing of cardiac surgery after coronary angiography on acute renal dysfunction, to identify risk factors associated with development of acute renal dysfunction, and to measure the association between acute renal dysfunction and mortality.

Patients and methods

The patients were divided into 3 groups: group A (cardiac surgery 0–3 days after angiography), group B (surgery 4–6 days after angiography), and group C (surgery > 6 days after angiography). Endpoints were acute renal dysfunction, defined as serum creatinine > 25% of baseline on the 3rd postoperative day, and mortality.

Results

In 749 patients, the incidence of acute renal dysfunction was 15%; 5% required dialysis. Hypertension, congestive heart failure, chronic obstructive pulmonary disease, ejection fraction < 40%, prolonged cardiopulmonary bypass time, intraaortic balloon pump use, and urgent surgery were risk factors for acute renal dysfunction after cardiac surgery. Patients in group C had a lower risk of acute renal dysfunction.

Conclusion

Acute renal dysfunction has a definite relationship with the time period between angiography and cardiac surgery. The causative factors for this condition are multiple and also show a consistent association with mortality.
Evaluation of myocardial fat deposition by multislice computed tomography
Authors: Durmaz Mehmet Sedat , Demirtaş Hakan , Aralaşmak Ayşe , Özkaynak Can
Published: July 2013

Aim

To investigate correlations between myocardial fat deposition of unknown etiology and myocardial infarction, coronary artery stenosis, time after the infarction, aneurysmatic dilatation of arteries, and stenting or bypass operation.

Patients and methods

We evaluated coronary computed tomography angiographies of 266 patients presenting with history of myocardial infarction or having risk factors for coronary artery disease, analyzed the characteristics of myocardial fat, and compared the clinical parameters of patients with and without myocardial fat.

Results

34 of the 266 patients had myocardial fat deposits. Of the 34 with myocardial fat, 47% had a history of myocardial infarction. Myocardial fat occurrence after myocardial infarction was statistically significant. Myocardial fat was more frequently associated with longer time after infarction and fewer coronary arteries involved, but without statistical significance. A bypass operation and myocardial fat deposition correlated with aneurysmatic dilatation of the coronary arteries and myocardial fat deposition within the area supplied by this artery.

Conclusion

Myocardial fat was detected in 34% of patients with myocardial infarction. Myocardial fat was significantly more frequent in patients who underwent a bypass operation and those who had aneurysmatic dilatation of the coronary arteries. The frequency of myocardial fat deposition increased with the involvement of fewer coronary arteries and longer time after infarction.
Bilateral internal thoracic artery grafting in insulin-treated diabetes
Authors: Lev-Ran Oren , Matsa Menachem , Ishay Yaron , Abod Moataz Abo , Vodonos Alina , Sahar Gideon
Published: July 2013

Background

We sought to assess the risk and late outcome of bilateral internal thoracic artery grafting in eligible insulin-treated diabetic subsets.

Methods

147 insulin-treated diabetic patients undergoing arterial revascularization were grouped as: skeletonized bilateral internal thoracic artery ( n = 83) or internal thoracic artery-radial artery ( n = 64). Chronic lung disease or overweight and female constituted exclusion criteria for bilateral internal thoracic artery grafts.

Results

Patients who had bilateral internal thoracic artery grafts were younger and comprised fewer females. Left-sided bilateral internal thoracic artery configurations were predominantly applied. Despite mean hemoglobin A1c of 8.0% ± 1% (range, 7%–13.5%) respective rates of deep sternal infection in bilateral internal thoracic artery and radial artery patients were 1.2% and 0%; superficial wound infection occurred in 3.1% and 3.6%, respectively. One sternoplasty was performed. Bilateral internal thoracic artery grafting did not correlate with sternal complications (odds ratio = 2.24, 95%CI: 0.56–8.95, p = 0.256). Of the radial artery conduits, 98% were adequate, and procurement-site complications occurred in 3.1%. Follow-up was 2–58 months (median, 25 months). Five-year survival was comparable in the 2 groups ( p = 0.360). Bilateral internal thoracic artery grafting did not reduce late major adverse cardiac events ( p = 0.729) or late mortality ( p = 0.384).

Conclusions

Skeletonized bilateral internal thoracic artery grafts can be used with acceptable risk in a substantial portion of insulin-treated diabetic patients, so it should not be automatically denied, but the choice of such grafts is not associated with midterm cardiac benefits.
Low dose tranexamic acid effect on post-coronary artery bypass grafting bleeding
Authors: Esfandiari Bakhtiari Rostam , Bistgani Mohammad Moazeni , Kabiri Majid
Published: July 2013

Objective

This study investigated the effects of low-dose tranexamic acid on post-coronary artery bypass surgery bleeding .

Background

Diffuse microvascular bleeding is still a common problem after cardiac procedures. This study was designed to evaluate the hemostatic effects of low-dose tranexamic acid in on-pump coronary artery bypass graft surgery.

Methods

In this prospective randomized placebo-controlled study, 150 patients who were candidates for coronary artery bypass were enrolled and randomly assigned to 1 of 2 groups (tranexamic acid or placebo). Total drainage volume and the need for transfusion as well as surgical complications were recorded and compared in the 2 groups.

Results

There was significantly less mediastinal chest tube drainage up to 48 h in the tranexamic acid group (432 ± 210 mL) compared to the placebo group (649 ± 235 mL, p = 0.006). In the placebo group, 43 (58%) patients were given allogeneic blood during hospital stay compared to 22 (25%) in the tranexamic acid group ( p < 0.001). No significant difference in postoperative complications was seen.

Conclusion

The use of low-dose tranexamic acid can significantly reduce blood loss and need for transfusion, with no increase in complications.
Symmetrical excessive pectus excavatum in children
Authors: Balci Akin Eraslan , Eren Sevval , Ozyurtkan Mehmet Oguzhan
Published: July 2013

Objectives

The indications for repair of pectus excavatum are controversial. We present our surgical results in children with severe pectus excavatum.

Methods

27 children aged 6–15-years were included in the study. Pulmonary function tests and chest measurements were performed pre- and postoperatively. Deformed cartilages were resected subperichondrially, and a Kirchner wire was used to support the chest cage; it was removed 5 days after the operation. Fourteen children with restricted pulmonary function were considered to have excessive pectus excavatum.

Results

3 patients had asthma-like symptoms that resolved postoperatively. None suffered chest pain postoperatively. Postoperative hospital stay was 7.1 days. Only minor complications occurred postoperatively. The mean pectus severity index was 0.27 ± 0.2 preoperatively and 0.41 ± 0.1 postoperatively ( p < 0.05). For children with restricted pulmonary function, it was 0.17 ± 0.3 preoperatively and 0.38 ± 0.2 postoperatively ( p < 0.05). Mean percentage of predicted forced expiratory volume in 1 s changed significantly from 79.2% ± 17.8% preoperatively to 83.6% ± 12.2% by the 3rd postoperative month. For children with a pectus severity index <0.2, it changed from 68.5% ± 13.2% preoperatively to 82.3% ± 13.4%. Pulmonary restriction correlated with a worse pectus severity index ( r = 0.8). After 6 and 13 months, a minor decrease in pulmonary function was noted. Significant increases in right and left ventricular function occurred in cases of severe deformity.

Conclusions

Surgery is recommended not only for cosmetic reasons but also to increase cardiorespiratory functional capacity and alleviate symptoms. Kirchner wires can be used safely.
Mediastinal bronchogenic cyst compressing left recurrent laryngeal nerve
Authors: Ashraf Hakeem Zubair , Ahangar Abdul Ghani , Lone Ghulam Nabi , Rathore Shyam Singh , Ashai Masrat
Published: July 2013

A 15-year-old boy developed recurrent laryngeal nerve compression by a bronchogenic cyst, causing recurrent choking. Bronchogenic cyst compressing the recurrent laryngeal nerve is unusual. The patient had a normal voice and occasional choking with periods of normalcy in between. A left posterolateral thoracotomy was performed and cyst was excised. Histopathology revealed bronchogenic cyst.
An unusual cause of pulmonary edema
Authors: Chong Adrian , Wahi Sudhir , Harvey Ryan , Finn Chris , Shah Pallav , Gould Paul
Published: July 2013

Primary cardiac tumors are rare malignancies. Patients may present with congestive cardiac failure due to intracavitary obstruction to blood flow, valvular dysfunction, embolic phenomena, local invasion resulting in arrhythmias, pericardial involvement, constitutional symptoms, or paraneoplastic syndromes. We describe the case of a previously fit 79-year-old woman who presented with acute pulmonary edema due to a large left atrial pleomorphic sarcoma causing severe functional mitral stenosis. She underwent palliative debulking surgery with good symptomatic relief.
The influence of infrastructure, training, content and communication on the success of NEPAD’S pilot e-Schools in Kenya
Authors: Nyagowa Hesbon O , Ocholla Dennis N , Mutula Stephen M
Published: July 2013

This study was conducted to evaluate the contribution of four of the seven e-School dimensions to the success of the pilot phase of the New Partnership for Africa’s Development (NEPAD) e-School project in Kenya. The study employed survey research methodology. All six of the NEPAD e-Schools in Kenya were included and the teachers and students in those schools formed the study population. Of the 5,186 students and teachers, a representative sample of 1,508 was selected using probabilistic techniques. Data was collected using observations and a survey questionnaire. It was established that all six of the e-Schools had installed the basic computing facilities required for integrating information and communication technologies (ICT) in teaching and learning; all the e-Schools were observed to have the Very Small Aperture Terminal (VSAT) for Internet access in computer laboratories where a variable number of computers were installed. The ICT infrastructure provided modest communication capabilities. But while teachers received technical (ICT) training, they did not receive training on pedagogies for ICT integration in teaching and learning. We conducted hypothesis testing and confirmed that the four dimensions of E-School Success Model, investigated in the current study, positively contribute towards the success of the e-School. We therefore concluded that ICT infrastructure quality, content and communication quality, training effectiveness and use make considerable contributions to the success of the pilot phase of the NEPAD e-School project in Kenya. We recommend that stakeholders should continue investing in the NEPAD e-School project. Further studies on the impact of the other three dimensions of the e-Schools are recommended.
Planning the information architecture in a local public administration organization
Authors: Rocha Álvaro , Sá Filipe
Published: July 2013

An Information Architecture is the basis for a comprehensive and integrated information system of any organization, capable of providing answers that meet the challenges posed by the contemporary competitive environment. In this paper we analyse a number of representative methodologies used in Information Architecture definitions and, based on a set of pre-defined criteria, we select the Adapted BSP (Business Systems Planning) Methodology to apply in a local public administration organization in Portugal. This methodology proved to be sufficiently flexible and suited to the goals proposed.
Determinants of the use of food product information by female workers in Nigerian state universities
Authors: Babalola Yemisi T , Opeke Rosaline O , Aja Godwin ND
Published: July 2013

This study examined the influence of demographic characteristics, perception of food risks and health information literacy on the use of food product information among 561 female staff in eight State Universities in Nigeria. Descriptive statistics and binary logistic regression were used to analyze the data. The findings revealed that age, perceived risks and health information literacy were the factors that influence the use or non-use of food product information among the respondents. Women who are above 50 years are more likely to use food product information in consumption decisions than younger women. Furthermore, the respondents showed high perception of food risks; however, about half of them have optimistic bias towards the hazards of eating unwholesome packaged foods. The study therefore recommends that the National Agency for Food and Drug Administration and Control (NAFDAC) embark on aggressive awareness campaigns on the health hazards associated with eating unwholesome packaged food, targeting younger female workers in Nigerian State Universities. Public health experts, librarians and other information professionals should also embark on enlightenment programmes for the public and the academic community. This study complements an earlier study which examined the use of various types of food product information in consumption of packaged foods among the same population.
Evidence on the cost and cost-effectiveness of palliative care: A literature review
Authors: Smith Samantha , Brick Aoife , O’Hara Sinéad , Normand Charles
Published: July 2013

Background:

In the context of limited resources, evidence on costs and cost-effectiveness of alternative methods of delivering health-care services is increasingly important to facilitate appropriate resource allocation. Palliative care services have been expanding worldwide with the aim of improving the experience of patients with terminal illness at the end of life through better symptom control, coordination of care and improved communication between professionals and the patient and family.

Aim:

To present results from a comprehensive literature review of available international evidence on the costs and cost-effectiveness of palliative care interventions in any setting (e.g. hospital-based, home-based and hospice care) over the period 2002–2011.

Design:

Key bibliographic and review databases were searched. Quality of retrieved papers was assessed against a set of 31 indicators developed for this review.

Data Sources:

PubMed, EURONHEED, the Applied Social Sciences Index and the Cochrane library of databases.

Results:

A total of 46 papers met the criteria for inclusion in the review, examining the cost and/or utilisation implications of a palliative care intervention with some form of comparator. The main focus of these studies was on direct costs with little focus on informal care or out-of-pocket costs. The overall quality of the studies is mixed, although a number of cohort studies do undertake multivariate regression analysis.

Conclusion:

Despite wide variation in study type, characteristic and study quality, there are consistent patterns in the results. Palliative care is most frequently found to be less costly relative to comparator groups, and in most cases, the difference in cost is statistically significant.
Palliative care for people with non-malignant lung disease: Summary of current evidence and future direction
Authors: Boland Jason , Martin Jonathan , Wells Athol U , Ross Joy R
Published: July 2013

Background:

The physical and psychosocial needs of patients with chronic non-malignant lung disease are comparable to those with lung cancer. This article will focus on chronic obstructive pulmonary disease, interstitial lung disease and cystic fibrosis as examples of life-limiting, non-curable and non-malignant lung diseases.

The need for supportive and palliative care:

Recent national guidance has demanded that palliative care is inclusive of all patients with life-limiting disease, irrespective of diagnosis, and that specialist palliative care teams are involved in the management of patients on a basis of need rather than prognosis.

What is known:

Despite medical therapy, most patients with moderate to severe chronic obstructive pulmonary disease, interstitial lung disease and cystic fibrosis experience pain, fatigue and dyspnoea, with the majority not getting relief from dyspnoea towards the end of life. Furthermore, dyspnoea causes social isolation and difficulty performing activities of daily living and impairs quality of life. There is an increasing evidence base for the assessment of supportive and palliative care needs, symptom interventions, prognostication, models of service delivery and implications of these for clinical practice and research in non-malignant lung diseases.

What is unknown:

Despite advances, much still remains unknown regarding assessment, management and prognostication in individual chronic non-malignant lung diseases. Although different service models are being used in clinical practice, the optimal model(s) of service delivery remain unknown.

Implication for future research, policy and practice:

We describe key areas for further research, which include the need for large, high-quality trials of pharmacological and non-pharmacological interventions and their combinations as well as evaluation of the efficacy and cost-effectiveness of models of care. As access to palliative care is poor for these patients, the barriers to referral need to be understood and reduced, which along with effective working between palliative care teams, with respiratory services backup, should optimise delivery of care in patients with life-limiting non-malignant lung disease.
Meeting Report
Authors: Sasseville V. G. , Mankowski J. L. , Baldessari A. , Harbison C. , Laing S. , Kaliyaperumal S. , Mätz-Rensing K. , Miller A. D. , Schmidt L. D. , Kaplan-Kees J. , Dick E. J. , Reader J. R. , Liu D. , Crawford L. K. , Lane J. H. , Corner S. M. , Pardo I. D. , Evans M. G. , Murnane R. , Terio K. A.
Published: July 2013

A workshop on Emerging Respiratory Viral Infections and Spontaneous Diseases in nonhuman primates was sponsored by the concurrent Annual Meetings of the American College of Veterinary Pathologists and the American Society for Veterinary Clinical Pathology, held December 1–5, 2012, in Seattle, Washington. The session had platform presentations from Drs Karen Terio, Thijs Kuiken, Guy Boivin, and Robert Palermo that focused on naturally occurring influenza, human respiratory syncytial virus, and metapneumovirus in wild and zoo-housed great apes; the molecular biology and pathology of these viral respiratory diseases in nonhuman primate (NHP) models; and the therapeutic and vaccine approaches to prevention and control of these emerging respiratory viral infections. These formal presentations were followed by presentations of 14 unique case studies of rare or newly observed spontaneous lesions in NHPs (see online files for access to digital whole-slide images corresponding to each case report at http://scanscope.com/ACVP%20Slide%20Seminars/2012/Primate%20Pathology/view.apml ). The session was attended by meeting participants that included students, pathology trainees, and experienced pathologists from academia and industry with an interest in respiratory and spontaneous diseases of NHPs.
Neuronal Loss and Decreased GLT-1 Expression Observed in the Spinal Cord of Pembroke Welsh Corgi Dogs With Canine Degenerative Myelopathy
Authors: Ogawa M. , Uchida K. , Yamato O. , Inaba M. , Uddin M. M. , Nakayama H.
Published: July 2013

Canine degenerative myelopathy (DM) is a progressive neurodegenerative disease that is frequently found in Pembroke Welsh Corgi (PWC) dogs. Canine DM is potentially a spontaneous animal model for human amyotrophic lateral sclerosis (ALS) because of similar lesions and the involvement of superoxide dismutase 1 (SOD1) mutation. However, the ventral horn lesion in DM has not been characterized in detail. Glutamate excitotoxicity due to deficiency of the glutamine-glutamate cycle has been implicated in neuron death in ALS. Thus, we examined 5 PWC dogs with an SOD1 mutation that were affected by DM, 5 non-DM PWC dogs, and 5 Beagle dogs without neurologic signs to assess the neuronal changes and the expression levels of 2 glial excitatory amino acid transporters (glutamate transporter 1 [GLT-1] and glutamate/aspartate transporter [GLAST]). The number of neurons in the spinal ventral horns of the DM dogs was significantly decreased, whereas no change was found in the cell size. Chromatolysis, lipofuscin-laden neurons, and marked synapse loss were also observed. GLT-1 expression was strikingly decreased in DM dogs, whereas GLAST expression showed no significant change. The results indicate that excitotoxicity related to the reduced expression of GLT-1, but not GLAST, may be involved in neuron loss in DM, as in human ALS, whereas intraneuronal events may differ between the 2 diseases.
Neurobiological Factors as Predictors of Cognitive–Behavioral Therapy Outcome in Individuals With Antisocial Behavior
Authors: Cornet Liza J. M. , de Kogel Catharina H. , Nijman Henk L. I. , Raine Adrian , van der Laan Peter H.
Published: July 2013

This review focuses on the predictive value of neurobiological factors in relation to cognitive–behavioral therapy outcome among individuals with antisocial behavior. Ten relevant studies were found. Although the literature on this topic is scarce and diverse, it appears that specific neurobiological characteristics, such as physiological arousal levels, can predict treatment outcome. The predictive value of neurobiological factors is important as it could give more insight into the causes of variability in treatment outcome among individuals with antisocial behavior. Furthermore, results can contribute to improvement in current treatment selection procedures and to the development of alternative treatment options.
Comparison of several optimisation strategies for the determination of material constants in the Chaboche visco-plasticity model
Authors: Rouse James P , Hyde Christopher J , Sun Wei , Hyde Thomas H
Published: July 2013

Determining representative material constant sets for models that can accurately predict the complex plasticity and creep behaviour of components undergoing cyclic loading is of great interest to many industries. The Chaboche unified visco-plasticity model is an example of a model that, with the correct modifications, shows much promise for this particular application. Methods to approximate material constant values in the Chaboche model have been well established; however, the need for optimisation of these parameters is vital due to assumptions made in the initial estimation process. Optimisation of a material constant set is conducted by fitting the predicted response to the experimental results of cyclic tests. It is expected that any experimental data set (found using the same values of test parameters such as temperature; the dependency of which is not accounted for in the original Chaboche model) should yield a single set of optimised material parameters for a given material. In practice, this may not be the case. Experimental test programs usually include multiple loading waveforms; therefore, it is often possible to optimise for separate, different sets of material constants for the same material operating under comparable conditions. Several optimisation strategies that utilise multiple sets of experimental data to form the objective functions in optimisation programs have been applied and critiqued. A procedure that evaluates objective functions derived from the multiple experimental data types simultaneously (i.e. in the same optimisation iteration) was found to give the most consistently high-quality fitting. In the present work, this is demonstrated using cyclic experimental data for a P91 steel at 600 °C. Similar strategies may be applied to many constitutive laws that require some form of optimisation to determine material constant values.
The UN at the peacemaking–peacebuilding nexus
Authors: Beardsley Kyle
Published: July 2013

The UN Security Council (UNSC) confronts at least three challenges in translating its actions during armed conflict into more durable peace after conflict. First, heavy-handed interventions such as military deployments and sanctions can impede the ability of the disputants to identify and reach a self-sustaining settlement when there is insufficient follow-through. Second, coordination problems can arise in handing off peacemaking activities from actors in the Secretariat to the UNSC when post-conflict security guarantees and continuous engagement are needed. Third, explicit attempts by the UNSC to produce peace and stability make it susceptible to the problem of cheap talk when it proclaims its concerns. After characterizing these problems in theory and generating observable implications, the paper uses original data on UNSC resolutions to test the hypotheses. The results indicate that the UN can succeed as a short-term peacemaker, particularly when it relies on diplomatic engagement and sanctions. However, when there is not adequate follow-through in the form of peacekeeping, the UN struggles to improve the long-term prospects of peace in part because it tends to promote stop-gap ceasefire resolutions. With peacekeeping, active UN involvement during conflict can promote long-term stability. Half measures such as condemnations have little effect on the stability of peace.
Fear of rejection: The puzzle of unaccepted mediation offers in international conflict
Authors: Melin Molly M. , Gartner Scott Sigmund , Bercovitch Jacob
Published: July 2013

How do factors that influence mediation offers affect belligerent behavior? The circumstances that attract potential mediators are not the same as those that make mediation desirable to belligerents. Third parties offer mediation when the conflict is intense, generation of an agreement is likely and they have ties to the conflict. However, mediation is less acceptable to belligerents in these circumstances. This dynamic creates a dilemma; the characteristics that make third parties more forthcoming with mediation offers simultaneously make disputants more likely to reject mediation proposals. A better understanding of this strategic process can help scholars and policy-makers better determine how to supply mediation where it is needed most.
Classification and Natural History of the Neuronal Ceroid Lipofuscinoses
Authors: Mink Jonathan W. , Augustine Erika F. , Adams Heather R. , Marshall Frederick J. , Kwon Jennifer M.
Published: July 2013

The neuronal ceroid lipofuscinoses represent a group of disorders characterized by neurodegeneration and intracellular accumulation of an auto-fluorescent lipopigment (ceroid lipofuscin). Together, they represent the most prevalent class of childhood neurodegenerative disease. The neuronal ceroid lipofuscinoses encompass several distinct biological entities that vary in age of onset, specific neurologic phenotype, and rate of progression. In this review, we describe 9 major forms and present a classification scheme. Understanding the age of onset, clinical features, and natural history can inform rational diagnostics. Better knowledge of the natural histories of these disorders is necessary to shed light on the underlying pathobiology and to develop new therapeutics.
Mineralized polycaprolactone nanofibrous matrix for odontogenesis of human dental pulp cells
Authors: Kim Jong-Jin , Bae Won-Jung , Kim Joung-Mok , Kim Jung-Ju , Lee Eun-Jung , Kim Hae-Won , Kim Eun-Cheol
Published: July 2013

The aim of the present study was to fabricate mineralized polycaprolactone nanofibrous scaffold and investigate its ability to elicit odontogenic differentiation of human dental pulp cells, compared to the pure polycaprolactone scaffold. Polycaprolactone nanofibrous scaffold was produced by electrospinning, and the surface was mineralized with apatite. Cellular behaviors on the mineralized polycaprolactone scaffold were assessed in terms of cell adhesion, growth, and odontoblastic differentiation. To evaluate the signal transduction of human dental pulp cells, mRNA expression was analyzed and Western blotting was performed. Mineralized polycaprolactone showed improved cell proliferation, mineralized nodule formation, and expression of odontoblastic marker genes including alkaline phosphatase, osteopontin, osteocalcin, dentin sialophosphoprotein (DSPP), and dentin matrix protein-1, as compared with pure polycaprolactone. Although the cell adhesion on the mineralized polycaprolactone was similar to that of the polycaprolactone, the expression level of proteins including collagen type I and the key adhesion receptor (integrin components α1, α2, and β1) was upregulated in mineralized polycaprolactone compared to polycaprolactone. Especially, cells seeded onto mineralized polycaprolactone scaffolds showed significantly increased levels of phosphorylated focal adhesion kinase, a marker of integrin activation, and downstream pathways, such as phosphor (p)-Akt, p-extracellular signal regulated kinase, p-c Jun N-terminal kinase, nuclear factor-kappa B, c-fos, and c-jun, compared with pure polycaprolactone. The mineralized polycaprolactone scaffold is attractive for dentin tissue engineering by promoting growth and odontogenic differentiation of human dental pulp cells through the integrin-mediated signaling pathway.
Comparative studies on the accumulation of strain and recovery ratio of Veriflex®, a shape-memory polymer for a high strain (∊m = 210%)
Authors: Chowdhury A. M. Sarwaruddin , Schmidt Christina , Neuking Klaus , Eggeler Gunther
Published: July 2013

In the present study, the functional fatigue in the commercial SMP Veriflex®, which is associated with repeating up to maximum 40 programming/one-way effect (1WE) cycles, has been examined. The material is characterized by a glass transition temperature ( Tg) of 67°C, above which it looses all its strength. An interesting comparative investigation on thermomechanical cycles, including programming, cooling, unloading, and heating to trigger the 1WE, were carried out for Veriflex at 62°C ( T < Tg, below 5°C but near to Tg) and also at 72°C ( T > Tg, above 5°C but near to Tg) for strains of 140% and for a recovery time of 10 min. Accumulation of strain was estimated during the thermomechanical treatments for using strains of 140% at 62°C ( T < Tg) as well as at 72°C ( T > Tg). Recovery ratios for strains of 140% at 62°C ( T < Tg) as well as at 72°C ( T > Tg) were also estimated. It turns out that programming, cooling, unloading, and heating to trigger the 1WE causes an increase in irreversible strain and is associated with a corresponding decrease in the intensity of the 1WE in particular during the first thermomechanical cycles. Confocal laser scanning microscopic) study shows a very little wavy surface structure evolved during cycling up to strains of 140% at 72°C ( T > Tg). Infrared study features the chemical nature after cycling, processing, and programming of Veriflex.
An assembly tolerance representation model based on spatial relations for generating assembly tolerance types
Authors: Qin Yuchu , Zhong Yanru , Huang Meifa , Liu Fuyun
Published: July 2013

The main advantage of polychromatic sets-based assembly tolerance representation model is that the number of feature types to be processed is larger. However, the number of recommended assembly tolerance types generated by the model is somewhat large for the same feature surfaces. Furthermore, the model cannot be directly applied to further assembly tolerance analysis and synthesis due to the fact that the information of degrees of freedom cannot be processed in polychromatic sets. To further reduce the number of recommended assembly tolerance types and to lay foundation for further assembly tolerance analysis and synthesis, a spatial relation layer is introduced into the polychromatic sets-based model and an assembly tolerance representation model based on spatial relations for generating assembly tolerance types is proposed. The proposed model is hierarchically organized and consists of part layer, assembly feature surface layer, spatial relation layer and assembly tolerance type layer. Each layer is defined with an adjacency matrix, respectively. By the mapping from spatial relations to assembly tolerance types, the number of recommended assembly tolerance types generated by the mapping from feature surfaces to assembly tolerance types is able to be further reduced. In addition, the information of degrees of freedom can be attached in the elements of adjacency matrices when recommended assembly tolerance types are generated by spatial relations so that the proposed model can be directly applied to further assembly tolerance analysis and synthesis. The effectiveness of the proposed model is demonstrated by an approach for generating assembly tolerance types and a practical example.
Effect of the multi-staged clutch damper characteristics on the transmission gear rattle under two engine conditions
Authors: Yoon Jong-Yun , Singh Rajendra
Published: July 2013

The scope of this article is limited to the torsional driveline system of a front-engine front-wheel type of vehicle. A reduced-order model of a manual transmission (with the third gear engaged and the fifth gear unloaded) is developed on the basis of the modal characteristics. A simplified nonlinear mathematical model is then proposed with the focus on the multi-staged clutch damper properties such as the asymmetric transition angles and the pre-loads. The drag torque is estimated under two engine conditions (wide-open throttle and coast) by assuming that the vehicle is in the steady-state condition. Finally, the gear rattle criteria are investigated, and illustrative examples for three real-life clutch dampers are described. In particular, methods for solving the real-life gear rattle phenomenon are suggested.
Automated visual inspection of angle cocks during train operation
Authors: Zhou Fuqiang , Zou Rong , Qiu Yafei , Gao He
Published: July 2013

Fault inspection is a key part of ensuring safe operation of freight trains. The development of machine vision technology has resulted in vision-based fault inspection becoming the principal means of fault inspection. An angle cock is an important component in the brake system, and a fault in it could lead to a serious accident. In this paper, we propose an automated vision method to inspect for missing handles on an angle cock during operation of a freight train. Images of the angle cock are acquired and they are analyzed using a proposed gradient encoding histogram and support vector machine that combine to create a detection system. Experimental results show that we achieved a fault detection rate of 99.8% using the proposed system, which represents a good real-time performance and high detection accuracy.
False-positive prostate cancer markers in a man with symptomatic urethral Chlamydia trachomatis infection
Authors: Smelov V , Novikov A , Brown L J , Eklund C , Strokova L , Ouburg S , Morre S A , Dillner J
Published: July 2013

Summary

Symptomatic male urethral Chlamydia trachomatis infection resulted in inflammation of the prostate, with associated increases in both prostate-specific (PSA) and prostate cancer-specific (PCA3) markers with prostate biopsies showing no evidence of malignancy.