bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnostic Accuracy of 256-Detector Row Computed Tomography in Detection and Characterization of Incidental Pancreatic Cystic Lesions
Authors: Ippolito D. , Allegranza P. , Bonaffini P. A. , Talei Franzesi C. , Leone F. , Sironi S.
Published: June 2015

Purpose. To assess the diagnostic value of 256-detector row MDCT in the characterization of incidentally detected pancreatic cystic lesions (PCLs).Materials and Methods. We retrospectively reviewed 6389 studies performed on a 256-row detector scanner, wherein ≥1 PCLs were incidentally detected. Images from a total of 192 patients (99 females; age range 31–90 years) were analysed referring to morphologic predictive signs of malignancy, including multifocality, inner septa, wall thickening, and mural enhancing nodules.Results. We evaluated 292 PCLs in 192 patients (solitary in 145 and ≥2 in 47; incidence 2.05%). Size ranged from 3 to 145 mm (mean 15 mm); body was the most common location (87/292; 29.8%). Intralesional septa were detected in 52/292 lesions (17.8%), wall thickening >2 mm in 13 (4.5%), enhancing wall and mural nodules in 15 (5.1%) and 12 (4.1%), respectively. Communication with ductal system was evident in 45 cases. The most common diagnoses, established by histology or imaging analysis, were IPMNs (about 86%), while serous cystic neoplasia (3.7%) and metastases (0.5%) were the less common.Conclusion. MDCT provides detailed features for characterization of PCLs, which are incidentally discovered with increased frequency due to the widespread use of cross-sectional imaging.
Knocking DownSnrnp200Initiates Demorphogenesis of Rod Photoreceptors in Zebrafish
Authors: Liu Yuan , Chen Xue , Qin Bing , Zhao Kanxing , Zhao Qingshun , Staley Jonathan P. , Zhao Chen
Published: June 2015

Purpose. The small nuclear ribonucleoprotein 200 kDa (SNRNP200) gene is a fundamental component for precursor message RNA (pre-mRNA) splicing and has been implicated in the etiology of autosomal dominant retinitis pigmentosa (adRP). This study aims to determine the consequences of knocking downSnrnp200in zebrafish.Methods. Expression of theSnrnp200transcript in zebrafish was determined via whole mountin situhybridization. Morpholino oligonucleotide (MO) aiming to knock down the expression ofSnrnp200was injected into zebrafish embryos, followed by analyses of aberrant splicing and expression of the U4/U6-U5 tri-small nuclear ribonucleoproteins (snRNPs) components and retina-specific transcripts. Systemic changes and retinal phenotypes were further characterized by histological study and immunofluorescence staining.Results.Snrnp200was ubiquitously expressed in zebrafish. Knocking downSnrnp200in zebrafish triggered aberrant splicing of thecbln1gene, upregulation of other U4/U6-U5 tri-snRNP components, and downregulation of a panel of retina-specific transcripts. Systemic defects were found correlated with knockdown ofSnrnp200in zebrafish. Only demorphogenesis of rod photoreceptors was detected in the initial stage, mimicking the disease characteristics of RP.Conclusions. We conclude that knocking downSnrnp200in zebrafish could alter regular splicing and expression of a panel of genes, which may eventually trigger rod defects.
High Risk Infants Follow-Up: A Case Study in Iran
Authors: Heidarzadeh Mohammad , Jodeiry Behzad , Hosseini Mohammad Baqer , Mirnia Kayvan , Akrami Forouzan , Habbibollahi Abbas , Moazzen Sara , Dastgiri Saeed
Published: June 2015

Background. A follow-up program for high risk infants was initiated in Alzahra Maternity Hospital in Tabriz city, Iran, in 2013. The aim of this paper is to give a brief report of the program.Material and Methods. Two groups of high risk neonates were studied. The first group comprising 509 infants received services in Alzahra Maternity Hospital implemented by the follow-up program. This included a full package for family to look after high risk infant and periodic clinical evaluation at two and four weeks after birth and then two, three, four, five, and six months later again. The second group including 131 infants in Taleqani Maternity Hospital received routine services after birth with no specific follow-up care.Results. Some anthropometric indices showed a significant improvement in the intervention hospital compared to control group. These included the following: head circumference at first and second months; weight in the first, fourth, fifth, and sixth months; and height in sixth month only. Clinical evaluation of infants showed an improvement for some of the medical conditions.Conclusion. Follow-up care program for a minimum of six months after discharge from maternity hospitals may help to avoid adverse and life threatening consequences in high risk infants.
An Autopsy of Nanofiltration Membrane Used for Landfill Leachate Treatment
Authors: Demir Ibrahim , Koyuncu Ismail , Guclu Serkan , Yildiz Senol , Balahorli Vahit , Caglar Suphi , Turken Turker , Pasaoglu Mehmet E. , Kaya Recep , Sengur-Tasdemir Reyhan
Published: June 2015

Komurcuoda leachate treatment plant, Istanbul, which consists of membrane bioreactor (MBR) and nanofiltration (NF) system, faced rapid flux decline in membranes after 3‐year successful operation. To compensate rapid flux decline in membranes, the fouled membranes were renewed but replacement of the membranes did not solve the problem. To find the reasons and make a comprehensive analysis, membrane autopsy was performed. Visual and physical inspection of the modules and some instrumental analysis were conducted for membrane autopsy. Membranes were found severely fouled with organic and inorganic foulants. Main foulant was iron which was deposited on surface. The main reason was found to be the changing of aerator type of MBR. When surface aerators were exchanged with bottom diffusers which led to increasing of dissolved oxygen (DO) level of the basin, iron particles were oxidized and they converted into particulate insoluble form. It was thought that probably this insoluble form of the iron particles was the main cause of decreased membrane performance. After the diagnosis, a new pretreatment alternative including a new iron antiscalant was suggested and system performance has been recovered.
Enhanced Dynamic Model of Pneumatic Muscle Actuator with Elman Neural Network
Authors: Hošovský Alexander , Piteľ Ján , Židek Kamil
Published: June 2015

To make effective use of model-based control system design techniques, one needs a good model which captures system’s dynamic properties in the range of interest. Here an analytical model of pneumatic muscle actuator with two pneumatic artificial muscles driving a rotational joint is developed. Use of analytical model makes it possible to retain the physical interpretation of the model and the model is validated using open-loop responses. Since it was considered important to design a robust controller based on this model, the effect of changed moment of inertia (as a representation of uncertain parameter) was taken into account and compared with nominal case. To improve the accuracy of the model, these effects are treated as a disturbance modeled using the recurrent (Elman) neural network. Recurrent neural network was preferred over feedforward type due to its better long-term prediction capabilities well suited for simulation use of the model. The results confirm that this method improves the model performance (tested for five of the measured variables: joint angle, muscle pressures, and muscle forces) while retaining its physical interpretation.
Capturing Uncertainty Information and Categorical Characteristics for Network Payload Grouping in Protocol Reverse Engineering
Authors: Luo Jian-Zhen , Yu Shun-Zheng , Cai Jun
Published: June 2015

As a promising tool to recover the specifications of unknown protocols, protocol reverse engineering has drawn more and more attention in research over the last decade. It is a critical task of protocol reverse engineering to extract the protocol keywords from network trace. Since the messages of different types have different sets of protocol keywords, it is an effective method to improve the accuracy of protocol keyword extraction by clustering the network payload of unknown traffic into clusters and analyzing each clusters to extract the protocol keywords. Although the classic algorithms such asK-means and EM can be used for network payload clustering, the quality of resultant traffic clusters was far from satisfactory when these algorithms are applied to cluster application layer traffic with categorical attributes. In this paper, we propose a novel method to improve the accuracy of protocol reverse engineering by applying a rough set-based technique for clustering the application layer traffic. This technique analyze multidimension uncertain information in multiple categorical attributes based on rough sets theory to cluster network payload, and apply the Minimum Description Length criteria to determine the optimal number of clusters. The experiments show that our method outperforms the existing algorithms and improves the results of protocol keyword extraction.
Serum miR-21, miR-29a, and miR-125b Are Promising Biomarkers for the Early Detection of Colorectal Neoplasia
Authors: Yamada Atsushi , Horimatsu Takahiro , Okugawa Yoshinaga , Nishida Naoshi , Honjo Hajime , Ida Hiroshi , Kou Tadayuki , Kusaka Toshihiro , Sasaki Yu , Yagi Makato , Higurashi Takuma , Yukawa Norio , Amanuma Yusuke , Kikuchi Osamu , Muto Manabu , Ueno Yoshiyuki , Nakajima Atsushi , Chiba Tsutomu , Boland C. Richard , Goel Ajay
Published: June 2015

Purpose: Circulating microRNAs (miRNA) are emerging as promising diagnostic biomarkers for colorectal cancer, but their usefulness for detecting early colorectal neoplasms remains unclear. This study aimed to identify serum miRNA biomarkers for the identification of patients with early colorectal neoplasms.

Experimental Design: A cohort of 237 serum samples from 160 patients with early colorectal neoplasms (148 precancerous lesions and 12 cancers) and 77 healthy subjects was analyzed in a three-step approach that included a comprehensive literature review for published biomarkers, a screening phase, and a validation phase. RNA was extracted from sera, and levels of miRNAs were examined by real-time RT-PCR.

Results: Nine miRNAs (miR-18a, miR-19a, miR-19b, miR-20a, miR-21, miR-24, miR-29a, miR-92, and miR-125b) were selected as candidate biomarkers for initial analysis. In the screening phase, serum levels of miR-21, miR-29a, and miR-125b were significantly higher in patients with early colorectal neoplasm than in healthy controls. Elevated levels of miR-21, miR-29a, and miR-125b were confirmed in the validation phase using an independent set of subjects. Area under the curve (AUC) values for serum miR-21, miR-29a, miR-125b, and their combined score in discriminating patients with early colorectal neoplasm from healthy controls were 0.706, 0.741, 0.806, and 0.827, respectively. Serum levels of miR-29a and miR-125b were significantly higher in patients who had only small colorectal neoplasms (≤5 mm) than in healthy subjects.

Conclusions: Because serum levels of miR-21, miR-29a, and miR-125b discriminated patients with early colorectal neoplasm from healthy controls, our data highlight the potential clinical use of these molecular signatures for noninvasive screening of patients with colorectal neoplasia. Clin Cancer Res; 21(18); 4234–42. ©2015 AACR.
Activation of the Mitochondrial Apoptotic Pathway Produces Reactive Oxygen Species and Oxidative Damage in Hepatocytes That Contribute to Liver Tumorigenesis
Authors: Hikita Hayato , Kodama Takahiro , Tanaka Satoshi , Saito Yoshinobu , Nozaki Yasutoshi , Nakabori Tasuku , Shimizu Satoshi , Hayashi Yoshito , Li Wei , Shigekawa Minoru , Sakamori Ryotaro , Miyagi Takuya , Hiramatsu Naoki , Tatsumi Tomohide , Takehara Tetsuo
Published: June 2015

Chronic hepatitis, including viral hepatitis and steatihepatitis, is a well-known high-risk condition for hepatocellular carcinoma. We previously reported that continuous hepatocyte apoptosis drives liver tumors in hepatocyte-specific Bcl-xL or Mcl-1 knockout mice. In this study, we further examine the underlying cellular mechanisms of generating tumors in apoptosis-prone liver. In cultured hepatocytes, the administration of ABT-737, a Bcl-xL/-2/-w inhibitor, led to production of reactive oxygen species (ROS) as well as activation of caspases. Mitochondria isolated from murine liver, upon administration of truncated-Bid, a proapoptotic Bcl-2 family protein, released cytochrome c and produced ROS, which was dependent on mitochondrial respiration. Hepatic apoptosis, regeneration, accumulation of oxidative damages, and tumorigenesis observed in hepatocyte-specific Mcl-1 knockout mice were substantially attenuated by further deficiency of Bax or Bid, suggesting that a balance of mitochondrial Bcl-2 family proteins governs generation of oxidative stress and other pathologies. Whole-exome sequencing clarified that C>A/G>T transversion, which is often caused by oxidative DNA damage in proliferating cells, was a frequently observed mutation pattern in liver tumors of Mcl-1 knockout mice. The administration of antioxidant L-N-acetylcysteine did not affect apoptosis, compensatory regeneration, or fibrotic responses but significantly reduced oxidative DNA damage and incidence and multiplicity of live tumors in Mcl-1 knockout mice. In conclusion, activation of the mitochondrial apoptotic pathway in hepatocytes accumulates intracellular oxidative damages, leading to liver tumorigenesis, independently of liver regeneration or fibrosis. This study supports a concept that antioxidant therapy may be useful for suppressing liver carcinogenesis in patients with chronic liver disease. Cancer Prev Res; 8(8); 693–701. ©2015 AACR.
Plasmakinetic Vapor Enucleation of the Prostate with Button Electrode versus Plasmakinetic Resection of the Prostate for Benign Prostatic Enlargement >90 ml: Perioperative and 3-Month Follow-Up Results of a Prospective, Randomized Clinical Trial
Authors: Zhang Keqin , Sun Dingqi , Zhang Hui , Cao Qingwei , Fu Qiang
Published: June 2015

Objective: To evaluate plasmakinetic vapor enucleation of the prostate (PVEP) with button electrode and plasmakinetic resection of the prostate (PKRP) in patients with urinary symptoms due to benign prostatic enlargement (BPE) >90 ml. Methods: A total of 112 patients with symptomatic BPE were randomly assigned to either PKRP or PVEP prospectively from August 2012 to May 2014 in our department. Perioperative and postoperative data were investigated during a 3-month follow-up. Results: PVEP was significantly superior to PKRP in terms of operation time (63.9 ± 7.7 vs. 78.1 ± 13.6 min, p < 0.001), hemoglobin loss (1.18 ± 0.30 vs. 1.63 ± 0.38 g/dl, p < 0.001), serum sodium decrease (2.9 ± 0.7 vs. 4.3 ± 0.8 mmol/l, p < 0.001), catheterization duration (49.3 ± 12.2 vs. 78.1 ± 14.8 h, p < 0.001) and hospital stay (100.2 ± 28.3 vs. 116.0 ± 29.2 h, p = 0.004). There were no statistical differences in blood transfusion between the two groups. In addition, there were no statistical differences in maximum urinary flow rate, International Prostate Symptom Score, postvoid residual urine volume, quality-of-life score, transient incontinence, and urethral stricture at 3 months postoperatively. Conclusions: PVEP with button electrode is an equally effective technique for treatment of large BPE with PKRP, with more safety and faster recovery. It may become the superior alternative to PKRP for patients with large BPE.
Efficacy and Safety of Long-Term Imatinib Therapy for Pulmonary Arterial Hypertension
Authors: Speich Rudolf , Ulrich Silvia , Domenighetti Guido , Huber Lars C. , Fischler Manuel , Treder Ursula , Breitenstein Alexander
Published: June 2015

Background: Antiproliferative strategies have emerged as a potential therapeutic option for pulmonary arterial hypertension (PAH). Objective: To evaluate the long-term efficacy and safety of imatinib. Methods: This is an observational study of 15 patients with idiopathic PAH (n = 13) or PAH associated with connective tissue disease (n = 2) treated off-label with imatinib 400 mg daily. Pulmonary hypertension-specific therapy was established in all patients (triple therapy in 10, dual therapy in 3, and monotherapy in 2 patients). Results: After 6 months, improvement in hemodynamics (p < 0.01), functional class (p = 0.035), and quality of life (p = 0.005) was observed. After a median follow-up of 37 months, there was a sustained improvement in functional class (p = 0.032), quality of life (p = 0.019), and echocardiographic parameters of right ventricular function (p < 0.05). Three patients (20%) presented with completely normal echocardiography, absent tricuspid regurgitation, and normal pro-brain natriuretic peptide levels, indicative of ‘hemodynamic remission'. Of note, however, only 1 case was assessed by invasive hemodynamics. The overall 1- and 3-year survival was 100 and 90%, respectively. Two patients experienced a subdural hematoma (SDH), which in both cases resolved without sequelae. After careful consultation of the potential risks and benefits, all patients as well as a safety cohort of 9 subsequent cases decided to continue the imatinib therapy. After adjusting the target international normalized ratio (INR) to around 2.0, no further cases of SDH occurred during 50 patient-years. Conclusions: Long-term treatment with imatinib may improve the functional class and quality of life. Single cases might even attain hemodynamic remission. The occurrence of 5% SDH per patient-years is concerning. However, adjusting the INR to around 2.0 might obviate this complication.
Pulmonary Hemodynamic Response to Exercise in Chronic Thromboembolic Pulmonary Hypertension before and after Pulmonary Endarterectomy
Authors: Richter Manuel Jonas , Sommer Natascha , Gall Henning , Voswinckel Robert , Seeger Werner , Mayer Eckhard , Wiedenroth Christoph B. , Rieth Andreas , Grimminger Friedrich , Guth Stefan , Ghofrani Hossein A.
Published: June 2015

Background: Pulmonary endarterectomy (PEA) is the treatment of choice in surgically accessible chronic thromboembolic pulmonary hypertension (CTEPH). An important predictor of outcome is postsurgical residual pulmonary hypertension. Objective: We aimed to use the hemodynamic response during exercise before PEA as a measurement for the hemodynamic outcome 1 year after PEA. Methods: Between January 2011 and December 2013, 299 patients underwent PEA in our center. A total of 16 patients who were assessed by means of invasive hemodynamic measurements during exercise both at baseline and 1 year after PEA were retrospectively analyzed. Results: Pre-PEA mean pulmonary arterial pressure (mPAP) increased during exercise from 35.8 ± 7.6 to 53.8 ± 5.1 mm Hg, diastolic pulmonary arterial pressure (dPAP) from 21.5 ± 5.6 to 30.3 ± 9.6 mm Hg, cardiac output (CO) from 4.4 ± 0.8 to 6.5 ± 1.9 l/min and diastolic pulmonary gradient (DPG) from 14.6 ± 4.9 to 20.7 ± 12.7 mm Hg. Post-PEA mPAP increased from 23.7 ± 6.6 at rest to 43.2 ± 7.1 mm Hg, while CO increased to a higher extent from 5.1 ± 0.9 to 8.4 ± 1.9 l/min. There were significant correlations between pre-PEA DPG/CO and dPAP/CO slopes with the pulmonary vascular resistance (Spearman r = 0.578, p = 0.019, and r = 0.547, p = 0.028) and mPAP at rest after PEA (Spearman r = 0.581, p = 0.018, and r = 0.546, p = 0.028). Conclusions: In CTEPH, the presurgical dynamic DPG/CO and dPAP/CO slopes during submaximal exercise are associated with the hemodynamic outcome 1 year after PEA.
Successful Rituximab Therapy in Steroid-Resistant, Cryptogenic Organizing Pneumonia: A Case Series
Authors: Shitenberg Dorit , Fruchter Oren , Fridel Ludmila , Kramer Mordechai R.
Published: June 2015

Cryptogenic organizing pneumonia (COP) is an interstitial lung disease that is usually responsive to corticosteroid treatment. The treatment of COP has not been studied in randomized controlled trials; thus, treatment decisions are based on practice guidelines. We herein present, for the first time, 4 cases of patients with biopsy-proven COP who did not respond to corticosteroids but benefited from rituximab therapy. This report consists of a retrospective case series of patients who experienced steroid-resistant, biopsy-proven COP. Patients included in this case series suffered from acute or chronic COP and did not respond to corticosteroid treatment for a few weeks to months but later responded to rituximab. In a series of 4 patients, 1 patient had a complete radiological and clinical response after rituximab therapy, and the steroids could be gradually tapered. Three patients had a chronic course but had been able to lower steroid dosage or even discontinue the drug after being treated with rituximab. Since 40% of the patients with COP do not respond to or stay dependent on steroids, we think that even the ability to lower the steroid dosage by using rituximab as a steroid-sparing agent with a good safety profile is worth the effort. However, further studies are warranted.
Uniparental Disomy in Somatic Mosaicism 45,X/46,XY/46,XX Associated with Ambiguous Genitalia
Authors: Serra Alexandre , Denzer Friederike , Hiort Olaf , Barth Thomas F. , Henne-Bruns Doris , Barbi Gotthold , Rettenberger Günther , Wabitsch Martin , Just Walter , Leriche Clothilde
Published: June 2015

Disorders of sex development (DSD) affect the development of chromosomal, gonadal and/or anatomical sex. We analyzed a patient with ambiguous genitalia aiming to correlate the genetic findings with the phenotype. Blood and tissue samples from a male patient with penoscrotal hypospadias were analyzed by immunohistochemistry, karyotyping and FISH. DNA was sequenced for the AR, SRY and DHH genes, and further 26 loci in different sex chromosomes were analyzed by MLPA. The gonosomal origin was evaluated by simple tandem repeat (STR) analysis and SNP array. Histopathology revealed a streak gonad, a fallopian tube and a rudimentary uterus, positive for placental alkaline phosphatase, cytokeratin-7 and c-kit, and negative for estrogen, androgen and progesterone receptors, alpha-inhibin, alpha-1-fetoprotein, β-hCG, and oct-4. Karyotyping showed a 45,X/46,XY mosaicism, yet FISH showed both 46,XX/46,XY mosaicism (gonad and urethral plate), 46,XX (uterus and tube) and 46,XY karyotypes (rudimentary testicular tissue). DNA sequencing revealed intact sequences in SOX9, WNT4, NR0B1, NR5A1, CYP21A2, SRY, AR, and DHH. STR analysis showed only one maternal allele for all X chromosome markers (uniparental isodisomy, UPD), with a weaker SRY signal and a 4:1 ratio in the X:Y signal. Our findings suggest that the observed complex DSD phenotype is the result of somatic gonosomal mosaicism and UPD despite a normal blood karyotype. The presence of UPD warrants adequate genetic counseling for the family and frequent, lifelong, preventive follow-up controls in the patient.
The Heated Condensation Framework. Part II: Climatological Behavior of Convective Initiation and Land–Atmosphere Coupling over the Conterminous United States
Authors: Tawfik Ahmed B. , Dirmeyer Paul A. , Santanello Joseph A.
Published: June 2015

This is Part II of a two-part study introducing the heated condensation framework (HCF), which quantifies the potential convective state of the atmosphere in terms of land–atmosphere interactions. Part I introduced the full suite of HCF variables and applied them to case studies with observations and models over a single location in the southern Great Plains. It was shown in Part I that the HCF was capable of identifying locally initiated convection and quantifying energetically favorable pathways for initiation. Here, the HCF is applied to the entire conterminous United States and the climatology of convective initiation (CI) in relation to local land–atmosphere coupling (LoCo) is explored for 34 summers (June–August) using the North American Regional Reanalysis (NARR) and observations. NARR is found to be capable of capturing the convective threshold (buoyant mixing potential temperature θBM) and energy advantage transition (energy advantage potential temperature θadv) for most of the United States. However, there are compensating biases in the components of moisture qmix and temperature q*, resulting in low θBM biases for the wrong reason. The HCF has been used to show that local CI occurred over the Rocky Mountains and the southern Great Plains 35%–65% of the time. Finally, the LoCo process chain has been recast in light of the HCF. Both positive and negative soil moisture–convective feedbacks are possible, with negative feedbacks producing a stronger response in CI likelihood under weak convective inhibition. Positive feedbacks are present but weaker.
Analog Probabilistic Precipitation Forecasts Using GEFS Reforecasts and Climatology-Calibrated Precipitation Analyses*
Authors: Hamill Thomas M. , Scheuerer Michael , Bates Gary T.
Published: June 2015

Analog postprocessing methods have previously been applied using precipitation reforecasts and analyses to improve probabilistic forecast skill and reliability. A modification to a previously documented analog procedure is described here that produces highly skillful, statistically reliable precipitation forecast guidance at ° grid spacing. These experimental probabilistic forecast products are available via the web in near–real time.

The main changes to the previously documented analog algorithm were as follows: (i) use of a shorter duration (2002–13), but smaller grid spacing, higher-quality time series of precipitation analyses for training and forecast verification (i.e., the Climatology-Calibrated Precipitation Analysis); (ii) increased training sample size using data from 19 supplemental locations, chosen for their similar precipitation analysis climatologies and terrain characteristics; (iii) selection of analog dates for a particular grid point based on the similarity of forecast characteristics at that grid point rather than similarity in a neighborhood around that grid point; (iv) using an analog rather than a rank-analog approach; (v) varying the number of analogs used to estimate probabilities from a smaller number (50) for shorter-lead forecasts to a larger number (200) for longer-lead events; and (vi) spatial Savitzky–Golay smoothing of the probability fields. Special procedures were also applied near coasts and country boundaries to deal with data unavailability outside of the United States while smoothing.

The resulting forecasts are much more skillful and reliable than raw ensemble guidance across a range of event thresholds. The forecasts are not nearly as sharp, however. The use of the supplemental locations is shown to especially improve the skill of short-term forecasts during the winter.
Cerebrospinal fluid lactate: measurement of an adult reference interval
Authors: Slack Sally D , Turley Paul , Allgar Victoria , Holbrook Ian B
Published: June 2015

Background

Differentiating bacterial meningitis from viral meningitis is a diagnostic challenge. Cerebrospinal fluid lactate has been proposed as a valuable test to differentiate disease states; however, its use in adults is limited by a lack of robust reference interval data.

Methods

Cerebrospinal fluid samples with no cells or organisms detected, no culture growth after 48 h, and no increase in cerebrospinal fluid bilirubin were used to derive reference interval data for cerebrospinal fluid lactate in adults ( n = 120).

Results

A cerebrospinal fluid lactate reference interval of 1.0 (90% CI 0.9–1.1) – 2.2 mmol/L (90% CI 2.0–2.6) was defined.

Conclusions

Cerebrospinal fluid lactate results are rapidly available to the clinician. When interpreted against the adult reference interval derived in this study, results can help to triage patients presenting with symptoms of meningitis.
Barriers encountered by doctoral nursing students during their research studies and their strategies for overcoming them: A qualitative study
Authors: Hjelm Markus
Published: June 2015

The aim of this study was to explore the barriers experienced by doctoral nursing students during their research studies. An additional aim was to explore the strategies used to overcome these barriers. It can be a very challenging endeavour for doctoral nursing students to complete their research studies. During their research studies, doctoral students encounter various barriers that impede the progress of their studies. The study design was qualitative, and data were collected through individual interviews with seven doctoral nursing students at one university in Sweden between September and the end of November 2014. The data revealed seven themes illustrating barriers and strategies used by the doctoral nursing students to overcome these barriers: 1) difficulties in defining concepts, 2) intellectual struggles with qualitative analysis, 3) lack of control during the recruitment process, 4) missing a more research-oriented environment, 5) interruption to study focus when combining research and work, 6) lack of motivation, and 7) feeling powerless during supervision. In conclusion, this study illustrates the importance of facilitating good relationships between doctoral nursing students, their supervisors and faculty as a possible way of reducing barriers during research studies. These findings could be of help in the development of better learning environments for doctoral nursing students.
Carotid Artery Sacrifice and Reconstruction in the Setting of Advanced Head and Neck Cancer
Authors: Mourad Moustafa , Saman Masoud , Stroman David , Lee Thomas , Ducic Yadranko
Published: June 2015

Objective

To determine oncological and neuromorbidity outcomes in patients with advanced head and neck cancer (stage IVB) requiring sacrifice and reconstruction of the carotid artery.

Study Design

Case series with chart review.

Setting

Tertiary care referral center.

Subjects and Methods

Overall, 51 patients underwent carotid artery sacrifice during surgical treatment of the neck, in both the primary and salvage setting. All patients underwent autogenous in‐line carotid artery bypass grafting with either saphenous vein or the deep femoral vein in conjunction with vascular surgery. In all, the study included 39 males and 12 female subjects, with age ranging from 39 to 82 (mean, 62.7).

Results

Two patients (3.9%) had a cerebral vascular accident in the immediate postoperative period. The remaining 49 patients (96%) had no neurologic sequela. Serial ultrasonic evaluation revealed 4 patients with intra‐luminal thrombus within the site of reconstruction. Perioperative mortality occurred in a single patient. Disease‐related mortality occurred in 9.8% (5) of patients, with an overall 2‐year survival of 82%.

Conclusions

We presently report the largest series of surgical treatment for advanced head and neck cancer with carotid artery involvement. We document an overall 2‐year survival of 82% in the setting of low perioperative neuromorbidity and mortality rates. We therefore consider carotid artery sacrifice and autogenous vein graft reconstruction in the absence of distant metastatic disease as a viable treatment option for what was once thought to be a palliative procedure.
Effects of whole body vibration on pulmonary function, functional exercise capacity and quality of life in people with chronic obstructive pulmonary disease: a systematic review
Authors: Yang Xiaotian , Zhou Yujing , Wang Pu , He Chengqi , He Hongchen
Published: June 2015

Objective:

To examine the effect of whole-body vibration in enhancing pulmonary function, functional exercise capacity and quality of life in people with chronic obstructive pulmonary disease and examine its safety.

Method:

Randomized controlled trials examining the effects of whole body vibration among people with chronic obstructive pulmonary disease were identified by two independent researchers. Articles were excluded if they were studies on people with other primary diagnosis, abstracts published in the conferences or books. PEDro scale was used to assess the methodological quality of the selected studies. We evaluated the level of evidence by using the GRADE approach. The results were extracted by two researchers and confirmed by the third researcher if disagreement existed.

Data source:

Sources included Cochrane Central Register of Controlled Trials, PubMed, CINAHL, EMBASE, PEDro, AMED, PsycINFO, ClinicalTrials.gov, Current Controlled Trials and reference lists of all relevant articles.

Result:

Four studies involving 206 participants were included in this systematic review. Methodological quality was rated as good for two studies. No great benefits on pulmonary function were found in whole body vibration treatment group. Two studies showed that quality of life was improved in people with chronic obstructive pulmonary disease. Whole body vibration led to significant improvements in functional exercise capacity measured with six minutes walking test. Nearly no adverse events were observed.

Conclusion:

Whole body vibration may improve functional exercise capacity and quality of life in people with chronic obstructive pulmonary disease. There was insufficient evidence to prove the effects of whole body vibration on pulmonary function.
Experimental modeling of strain-dependent cyclic plasticity for prediction of hysteresis curve
Authors: Khademi Ehsan , Majzoobi Gholam Hossein , Bonora Nicola , Gentile Domenico
Published: June 2015

Although attempts have been devoted to consider the strain range effect in the material models, identification of material constants for accurate modeling the material response under cyclic loading within a wide range of strain amplitude is still a challenge. The experiments show that the cyclic stress–strain curves are severely dependent on the strain range for ductile metals. In most of the cyclic material models, only the stabilized cycle is considered to compute the constants of the models. Considering this strategy in the simulation of ductile metals subjected to cyclic loading may lead to erroneous results particularly for the initial cycles of the loading. In this study, strain-controlled tests were conducted to study the cyclic behavior of oxygen-free high thermal conductivity pure copper at different strain ranges. Each cycle of the hysteresis curve was divided into a tensile and a compressive half cycle. The yield stress and the constants of the four-rule Chaboche kinematic hardening model were computed for each half cycle using an automated program developed based on the genetic algorithm optimization. The results indicated that the constants of Chaboche model were dependent on the strain range and the accumulated plastic strain. Therefore, new strain range–dependent relations for isotropic and kinematic hardening conditions were proposed and the constants of the relations were computed. The proposed model could accurately simulate the stress–strain curve of the hysteresis loop from monotonic loading to the stabilized cycle.
Fbxl11 Is a Novel Negative Element of the Mammalian Circadian Clock
Authors: Reischl Silke , Kramer Achim
Published: June 2015

In mammals, molecular circadian rhythms are generated by autoregulatory transcriptional-translational feedback loops with PERIOD/CRYPTOCHROME containing complexes inhibiting the transcription of their own genes. Although the major circadian oscillator components seem to be identified, an increasing number of additional factors modulating core clock component functions are being discovered. In a systematic screen using short hairpin RNA in human clock reporter cells, we identified FBXL11 (also known as KDM2A), a histone-demethylase, whose gene dosage is crucial for a correct circadian period. Knockdown of FBXL11 leads to period shortening and overexpression to period lengthening. In addition, altering FBXL11 gene dosage modulates clock gene transcript levels, most prominently that of Nr1d1. FBXL11 exercises its role in the mammalian circadian clock by acting as a negative element on CLOCK/BMAL1 and RORα-induced transcription. It binds directly to the promoter regions of CLOCK/BMAL1-regulated genes via a CXXC-type zinc finger motif in a circadian phase-dependent manner; however, the histone-demethylase activity of FBXL11 is not required for transcriptional repression. Therefore, we propose FBXL11 as a novel component of the circadian clock that regulates the circadian gene expression by a so far unknown mechanism.
Entrapment of Victims of Spousal Abuse in Ghana
Authors: Adjei Stephen Baffour
Published: June 2015

Drawing on discursive psychology and positioning theory, this study explores the influence of cultural and familial value orientations on battered women’s identity, agency, and decision to leave or stay in abusive conjugal relationship in Ghana. Two semi-structured focus group discussions and four in-depth personal interviews were conducted with 16 victims of husband-to-wife abuse from rural and urban Ghana. The findings indicate that entrapment of victims of spousal abuse in Ghana reflects their social embeddedness and that battered women’s identities and agency are expressed in the context of familial and cultural value orientations. The primacy of family identity and victims’ apparent implicit moral obligation to preserve the social image of their extended family influence their entrapment. Participants’ discursive accounts further suggest that stay or leave decisions of battered women in Ghana reflect a joint product of negotiated agency between victims and their extended family. It is thus argued that the agency of battered women in Ghana is not constituted by individual psychological states or motives, but instead, viewed as a property of victims who exercise it in a given relational context, and partly constituted by familial relationships and identities. The study suggests that intervention initiatives in Ghana should focus on the phenomenon of conjugal violence beyond immediate victims to include families and the larger communities in which victims are embedded.
Exploring Another’s Subjective Life-World
Authors: Eberle Thomas S.
Published: June 2015

Regarding the relationship between phenomenology and the social sciences, significantly different traditions exist between German-speaking countries and the Anglo-Saxon world, which create many misunderstandings. Phenomenology is not just a research method; in its origin, it is a philosophy and has epistemological and methodological implications for empirical research. This essay pursues several goals: First, some basic tenets of Husserl’s phenomenology and Schutz’s mundane life-world analysis are restated. Second, an approach of “phenomenological hermeneutics” is presented that complies with the postulate of adequacy and aspires to understand other people’s life-worlds more profoundly than the widely accepted research practice of treating interview transcripts as data. The methodical procedure is illustrated using selected pieces from a case study of a patient who suffered a cerebral hemorrhage and became severely disoriented. Third, some crucial implications of such an approach are discussed in regard to a phenomenology-based ethnography.
Materials for food packaging applications based on bio-based polymer nanocomposites
Authors: Attaran Seyed Ahmad , Hassan Azman , Wahit Mat Uzir
Published: June 2015

Concerns about environmental waste problems caused by non-biodegradable petrochemical-based plastic packaging materials as well as consumer demand for high-quality food products have led to increased interest in the development of biodegradable packaging materials using annually renewable natural biopolymers. Inherent shortcomings of natural polymer-based packaging materials such as low mechanical properties and low barrier properties can be recovered by applying nanocomposite technology. Polymer nanocomposites, especially natural biopolymer-layered silicate nanocomposites, exhibit markedly improved packaging properties due to large nanoparticle surface area and their significant aspect ratios. Additionally, natural biopolymer is susceptible to microorganisms, resulting in good biodegradability, which is one of the most promising aspects of its incorporation in packaging materials and industries. The present review article explains the various categories of nanoclay and bio-based polymer-based composites with particular regard to their application as packaging materials. It also gives an overview of the most recent advances and emerging new aspects of nanotechnology for development of composites for environmentally compatible food packaging materials.
Improved Organizational Outcomes Associated With Incorporation of Early Clinical Experiences for Second-Year Student Pharmacists at an Academic Medical Center
Authors: Pinelli Nicole R. , McLaughlin Jacqueline E. , Chen Sheh-Li , Luter David N. , Arnall Justin , Smith Shayna , Roth Mary T. , Rodgers Philip T. , Williams Dennis M. , Amerine Lindsey B.
Published: June 2015

Purpose:

To assess the feasibility of engaging second professional year student pharmacists in the medication reconciliation process on hospital and health system pharmacy practice outcomes.

Methods:

Student pharmacists in their second professional year in the Doctor of Pharmacy degree program at our institution were randomly selected from volunteers to participate. Each participant completed training prior to completing three 5-hour evening shifts. Organizational metrics, student pharmacist perception regarding quality of interactions with health care professionals, and pharmacist perceptions were collected.

Results:

A total of 83 medication histories were performed on complex medical patients (57.0 ± 19.2 years, 51% female, 65% Caucasian, 12 ± 6 medications); of those, 93% were completed within 24 hours of hospital admission. Second professional student pharmacists completed on average 1.9 ± 0.6 medication histories per shift (range 1-3). Student pharmacists identified 0.9 medication-related problems per patient in collaboration with a pharmacist preceptor. Student pharmacists believed the quality of their interactions with health care professionals in the Student Medication and Reconciliation Team (SMART) program was good or excellent. The program has been well received by clinical pharmacists involved in its design and implementation.

Conclusion:

This study provides evidence that second professional year student pharmacists can assist pharmacy departments in the care of medically complex patients upon hospital admission.
Genetic Variation in CYP2R1 and GC Genes Associated With Vitamin D Deficiency Status
Authors: Slater Nicole A. , Rager Michelle L. , Havrda Dawn E. , Harralson Arthur F.
Published: June 2015

This cross-sectional study enrolled 180 patients at a private family practice in Virginia. Total serum vitamin D concentrations were obtained weekly from January 30, 2013, through March 30, 2013, in consecutive patients regularly scheduled for laboratory work at the practice. Patients were categorized into 2 groups and analyzed for variant alleles in vitamin D receptor ( VDR; rs2228570), cytochrome P450 2R1 ( CYP2R1; rs10741657), 7-dehydrocholesterol reductase ( DHCR7; rs12785878), and group-specific component ( GC; rs2282679) to determine whether variants of those alleles influenced total serum 25(OH)D concentrations. One-hundred and eighty patients were enrolled, with 40 (22%) being sufficient, 25-hydroxy vitamin D level 25(OH)D ≥ 30 ng/mL, and 140 (78%) being insufficient, 25(OH)D < 30 ng/mL. Of the 4 genes, 2 genes, CYP2R1 (rs10741657) and GC (rs2282679), demonstrated a significant association related to vitamin D status. Subjects with 1 or more variant alleles at rs10741657 were almost 3.7 (odds ratio [OR] 3.67; 95% confidence interval [CI]: 1.35-9.99) times more likely be insufficient in vitamin D and subjects with 1 or more variant alleles at rs2282679 were about half (OR 0.42; 95% CI: 0.18-0.93) as likely to be insufficient in vitamin D. Allelic variations in CYP2R1 (rs10741657) and GC (rs2282679) affect vitamin D levels, but variant alleles on VDR (rs2228570) and DHCR7 (rs12785878) were not correlated with vitamin D deficiency, 25(OH)D < 30 ng/mL.
Demand-based manufacturing service capability estimation of a manufacturing system in a social manufacturing environment
Authors: Cao Wei , Jiang Pingyu , Jiang Kaiyong
Published: June 2015

The exponential growth of cross-enterprise collaboration in recent years has facilitated the emergency of a new manufacturing mode called social manufacturing, wherein order winning hinges mostly on their customer and demand-oriented manufacturing service capability rather than the traditional factors such as relationships and distances. Therefore, a manufacturing service capability estimation model is proposed in this article, which comprises two sub-models, that is, a machining service capability (M-capability) model and a production service capability (P-capability) model. The former explains what kinds of manufacturing service a manufacturing system can provide, while the latter estimates how much manufacturing service the manufacturing system can produce in a certain time period. Besides, each of the two sub-models is considered from both single-socialized manufacturing resources and multi-socialized manufacturing resources’ manufacturing system perspectives. First, an ontology and Semantic Web–based model is established for estimating the M-capability of a single-socialized manufacturing resource manufacturing system and further extended to multiple socialized manufacturing resources manufacturing systems. Then, P-capability evaluation model based on rough set–based propagation neural network is proposed for a single-socialized manufacturing resource manufacturing system. Afterward, the results of rough set–based propagation neural network are further utilized as the inputs of the latter particle swarm optimization–based P-capability estimation model for multiple socialized manufacturing resources manufacturing systems. Finally, a typical case is fully studied to illustrate the feasibility of the proposed models.
On-line detection and measurements of tool wear for precision boring of titanium components
Authors: Liu Tien-I , Jolley Bob , Yang Che-Hua
Published: June 2015

On-line detection and measurements of tool wear is important to assure manufacturing accuracy, enhance manufacturing efficiency, and reduce manufacturing costs. In this research, adaptive neuro-fuzzy inference systems are utilized in conjunction with features extracted from three-axis cutting force data for the on-line detection and measurements of tool wear for precision boring of titanium components. Cutting force data were measured for carbide tools during the boring of titanium parts. At the end of every boring process, the average flank wear width was measured to determine the cutting tool conditions. Measurements were accomplished with the aid of a toolmaker’s microscope. In total, 14 features were obtained from the cutting force data. Euclidean distance measure was utilized to determine which features showed the best indication of cutting tool conditions. This approach can reduce the number of features for on-line detection and measurements of tool wear for precision boring of titanium parts. The selected two most prominent features were kurtosis of longitudinal force and average of the ratio between tangential force and radial force. On-line detection of boring tool wear obtained excellent results, using a 2×2 adaptive neuro-fuzzy inference systems, of being able to predict tool conditions on-line with 100% reliability. On-line measurements of boring tool wear also produced exceedingly successful results with a minimum error for a 1×10 adaptive neuro-fuzzy inference systems of 0.87%.