bluuebunny/crossref_metadata_2025 huggingface dataset:
In VivoEffect of Arsenic Trioxide on Keap1-p62-Nrf2 Signaling Pathway in Mouse Liver: Expression of Antioxidant Responsive Element-Driven Genes Related to Glutathione Metabolism
Authors: Srivastava Ritu , Sengupta Archya , Mukherjee Sandip , Chatterjee Sarmishtha , Sudarshan Muthammal , Chakraborty Anindita , Bhattacharya Shelley , Chattopadhyay Ansuman
Published: July 2013

Arsenic is a Group I human carcinogen, and chronic arsenic exposure through drinking water is a major threat to human population. Liver is one of the major organs for the detoxification of arsenic. The present study was carried out in micein vivoafter arsenic treatment through drinking water at different doses and time of exposure. Arsenic toxicity is found to be mediated by reactive oxygen species. Nuclear factor (erythroid-2 related) factor 2 (Nrf2)/Keap1 (Kelch-like ECH-associated protein 1)/ARE (antioxidant response element)—driven target gene system protects cells against oxidative stress and maintains cellular oxidative homeostasis. Our result showed 0.4 ppm, 2 ppm, and 4 ppm arsenic trioxide treatment through drinking water for 30 days and 90 days induced damages in the liver of Swiss albino mice as evidenced by histopathology, disturbances in liver function, induction of heat shock protein 70, modulation of trace elements, alteration in reduced glutathione level, glutathione-s-transferase and catalase activity, malondialdehyde production, and induction of apoptosis. Cellular Nrf2 protein level and mRNA level increased in all treatment groups. Keap1 protein as well as mRNA level decreased concomitantly in arsenic treated mice. Our study clearly indicates the important role of Nrf2 in activating ARE driven genes related to GSH metabolic pathway and also the adaptive response mechanisms in arsenic induced hepatotoxicity.
Emphysematous Cystitis Occurred in the Case Treated with Steroid for Autoimmune Hepatitis
Authors: Yoshino Tateki , Ohara Shinya , Moriyama Hiroyuki
Published: July 2013

Emphysematous cystitis is a rare clinically entity, more commonly seen in diabetic, immunocompromised patients, which was characterized by air within the bladder wall and lumen. A 83-year-old woman was introduced to our department with fever elevation and abnormal findings of computed tomography (CT). She took orally prednisolone for autoimmune hepatitis. Pelvic CT revealed diffuse air throughout the bladder wall. Urinalysis showed combined hematuria and pyuria.Escherichia coliwas detected in blood culture. Abnormal findings of complete blood count and laboratory examination included an elevated WBC count (12,200/L), C-reactive protein (11.7 mg/dL), and creatinine (1.07 mg/dL). Cystoscopy confirmed diffuse submucosal emphysema throughout. On the basis of diagnosis with emphysematous cystitis, she was treated with antibiotics based on the results of blood culture and indwelling Foley catheter. After treatment, the improvement of inflammatory findings and submucosal emphysema on cystoscopy and CT were achieved.
Neonatal Host Defense against Staphylococcal Infections
Authors: Power Coombs Melanie R. , Kronforst Kenny , Levy Ofer
Published: July 2013

Preterm infants are especially susceptible to late-onset sepsis that is often due to Gram-positive bacterial infections resulting in substantial morbidity and mortality. Herein, we will describe neonatal innate immunity toStaphylococcusspp. comparing differences between preterm and full-term newborns with adults. Newborn innate immunity is distinct demonstrating diminished skin integrity, impaired Th1-polarizing responses, low complement levels, and diminished expression of plasma antimicrobial proteins and peptides, especially in preterm newborns. Characterization of distinct aspects of the neonatal immune response is defining novel approaches to enhance host defense to prevent and/or treat staphylococcal infection in this vulnerable population.
New Hosts ofSimplicimonas similisandTrichomitus batrachorumIdentified by 18S Ribosomal RNA Gene Sequences
Authors: Dimasuay Kris Genelyn B. , Lavilla Orlie John Y. , Rivera Windell L.
Published: July 2013

Trichomonads are obligate anaerobes generally found in the digestive and genitourinary tract of domestic animals. In this study, four trichomonad isolates were obtained from carabao, dog, and pig hosts using rectal swab. Genomic DNA was extracted using Chelex method and the 18S rRNA gene was successfully amplified through novel sets of primers and undergone DNA sequencing. Aligned isolate sequences together with retrieved 18S rRNA gene sequences of known trichomonads were utilized to generate phylogenetic trees using maximum likelihood and neighbor-joining analyses. Two isolates from carabao were identified asSimplicimonas similiswhile each isolate from dog and pig was identified asPentatrichomonas hominisandTrichomitus batrachorum, respectively. This is the first report ofS. similisin carabao and the identification ofT. batrachorumin pig using 18S rRNA gene sequence analysis. The generated phylogenetic tree yielded three distinct groups mostly with relatively moderate to high bootstrap support and in agreement with the most recent classification. Pathogenic potential of the trichomonads in these hosts still needs further investigation.
Biosorption of Cr(III) and Pb(II) by Schoenoplectus californicus and Insights into the Binding Mechanism
Authors: Rearte Tomás Agustín , Bozzano Patricia Beatriz , Andrade Maria Luisa , Fabrizio de Iorio Alicia
Published: July 2013

Biosorption and desorption of chromium and lead on shoots biomass of Schoenoplectus californicus were investigated by performing batch sorption tests in different conditions of pH, biosorbent dose, and initial concentration in simple and binary solutions. Langmuir, Freundlich, Temkin, and Dubinin-Radushkevich isotherm models were employed to describe sorption equilibrium. Filters and biomass were characterized before and after treatments by environmental scanning electron microscopy and X-ray energy-dispersive spectrometry. The optimal conditions for biosorption were found to be pH 5 for both metals. The contact time to reach pseudoequilibrium changed as a function of pH and the metal studied. The highest optimisation of biosorbent dose was 5 g L−1 at pH 7 and 15 g L−1 at pH 5 for both metals. The most effective extracting agents for lead and chromium proved to be HNO3 and NaOH, respectively. The recovery of lead was greater than of chromium because the Cr(III) sorption mechanisms involve a stronger binding energy than the mechanisms for Pb(II), such as in intern sphere complexes. Both metals accounted for a high % removal (>90%) under the best sorption conditions. The use of Schoenoplectus californicus proved to be an efficient and economical alternative for the treatment of effluents contaminated with lead and chromium.
FatalStrongyloidesHyperinfection Complicating a Gram-Negative Sepsis after Allogeneic Stem Cell Transplantation: A Case Report and Review of the Literature
Authors: Izquierdo Isabel , Briones Javier , Lluch Rafael , Arqueros Cristina , Martino Rodrigo
Published: July 2013

Strongyloides stercoralisis an intestinal nematode that causes strongyloidiasis, which affects 30 to 100 million people worldwide. Risk factors for hyperinfection and disseminated disease include immunosuppressive drug therapy, human T-lymphotropic virus-1 (HTLV-1) infection, solid organ and bone marrow transplantation, hematologic malignant diseases, hypogammaglobulinemia, and severe malnutrition and associated conditions. The diagnosis can be difficult because a single stool examination fails to detect larvae in up to 70% of the cases, and the symptoms are nonspecific. Although eosinophilia is a common finding in patients with chronicStrongyloidesinfection, it is an unreliable predictor of hyperinfection. Furthermore, the lack of eosinophilia while receiving immunosuppressive therapy cannot reliably exclude the underlying chronicStrongyloidesinfection. We report here a fatalStrongyloideshyperinfection in a patient receiving allogeneic stem cell transplantation; risk factors and outcome in this clinical setting are discussed.
Iterative Nearest Neighborhood Oversampling in Semisupervised Learning from Imbalanced Data
Authors: Li Fengqi , Yu Chuang , Yang Nanhai , Xia Feng , Li Guangming , Kaveh-Yazdy Fatemeh
Published: July 2013

Transductive graph‐based semisupervised learning methods usually build an undirected graph utilizing both labeled and unlabeled samples as vertices. Those methods propagate label information of labeled samples to neighbors through their edges in order to get the predicted labels of unlabeled samples. Most popular semi‐supervised learning approaches are sensitive to initial label distribution which happened in imbalanced labeled datasets. The class boundary will be severely skewed by the majority classes in an imbalanced classification. In this paper, we proposed a simple and effective approach to alleviate the unfavorable influence of imbalance problem by iteratively selecting a few unlabeled samples and adding them into the minority classes to form a balanced labeled dataset for the learning methods afterwards. The experiments on UCI datasets and MNIST handwritten digits dataset showed that the proposed approach outperforms other existing state‐of‐art methods.
Almost Periodic Solutions for Neutral-Type BAM Neural Networks with Delays on Time Scales
Authors: Li Yongkun , Yang Li
Published: July 2013

Using the existence of the exponential dichotomy of linear dynamic equations on time scales, a fixed point theorem and the theory of calculus on time scales, we obtain some sufficient conditions for the existence and exponential stability of almost periodic solutions for a class of neutral-type BAM neural networks with delays on time scales. Finally, a numerical example illustrates the feasibility of our results and also shows that the continuous-time neural network and its discrete-time analogue have the same dynamical behaviors. The results of this paper are completely new even if the time scale𝕋=ℝorℤand complementary to the previously known results.
Research on the Horizontal Displacement Coefficient of Soil Surrounding Pile in Layered Foundations by Considering the Soil Mass’s Longitudinal Continuity
Authors: Wen-Juan Yao , Hua-Cong Zhou
Published: July 2013

When utilizing thep-ycurve to simulate the nonlinear characteristics of soil surrounding pile in layered foundations, due to having not taken into account the soil mass’s longitudinal continuity, the calculation deviation of horizontal displacement increases with the growth of a load. This paper adopted the layered elasticity system theory to consider the soil mass’s longitudinal continuity, as well as utilizing the research method for layered isotropic bodies, assuming that the horizontal resistance is evenly distributed around the perimeter of the pile's cross-section. Then an appropriate transfer matrix method of horizontal displacement coefficient for the soil surrounding pile in layered foundations was established. According to the calculation principle of finite element equivalent load, the horizontal displacement coefficient matrix was deduced as well as providing a corrected formula for the horizontal displacement of soil surrounding pile through thep-ycurve method when the external load was increased. Following the established model, a program was created which was used for calculating and analyzing the horizontal displacement coefficient matrix of three-layered soil in order to verify this method’s validity and rationale. Where there is a relatively large discrepancy in the soil layers’ properties, this paper’s method is able to reflect the influence on the layered soil’s actual distributional difference as well as the nearby soil layers’ interaction.
Efficacy and Safety of a Chinese Herbal Formula (Invigorating Kidney and Strengthening Spleen) in Chronic Hepatitis B Virus Carrier: Results from a Multicenter, Randomized, Double-Blind, and Placebo-Controlled Trial
Authors: He Jinsong , Zhou Daqiao , Tong Guangdong , Xing Yufeng , Chen Yingjie , Zhang Xiaohui , Zhan Bolin , Gao Hui , Zhou Xiaozhou , Xiong Yiqun , Liu Xinliang , Peng Lisheng , Qiu Mei , Zheng Yingjun
Published: July 2013

A Chinese Herbal Formula (CHF) has acquired a certain therapeutic effect on chronic HBV infection. To assess the efficacy and safety of CHF on HBV replication in chronic HBV carriers, we performed a randomized, double-blind, and placebo-controlled trial involving patients from 16 centers. A total of 300 confirmed chronic HBV carriers were randomized at baseline in a ratio of 2 : 1 to receive either CHF or placebo for 52 weeks. The results showed that a greater proportion of CHF than placebo treated patients achieved virological response at week 52; the mean decline of serum HBsAg levels in the CHF group dropped more obviously than that in the control group at all stages of the treatment; however, the rates of HBeAg loss and seroconversion had no difference between the two groups. Meanwhile, were presented significant increases in IFN-γ; IL-2 levels and reductions in IL-4 and IL-10 levels in the treatment group compared to the control group at week 52. There were no drug-related serious adverse events. In conclusion, the treatment with 52-week CHF is safe and effective in inhibiting HBV replication in chronic HBV carriers. The ability of the compound to modulate host immune function probably contributed to this effect.
Mesenchymal CD44 Expression Contributes to the Acquisition of an Activated Fibroblast Phenotype via TWIST Activation in the Tumor Microenvironment
Authors: Spaeth Erika L. , Labaff Adam M. , Toole Bryan P. , Klopp Ann , Andreeff Michael , Marini Frank C.
Published: July 2013

Tumor–stroma interactions play a crucial role in cancer progression by eliciting factors that promote proliferative, angiogenic, and invasive supports to the tumor microenvironment. Mesenchymal stromal/stem cells (MSC) contribute to stroma in part as cancer-associated fibroblasts (CAF), but a complete understanding of how MSC contribute to the tumor stroma is lacking. In this study, we show how CAF phenotypes rely upon MSC expression of the multifunctional cell surface glycoprotein CD44, a putative stem cell marker. Through bone marrow transplantation experiments in a transgenic mouse model of cancer, we determined that CD44 deficiency leads to a relative reduction in the contribution of bone marrow–derived cells to tumor stroma. CD44 attenuation in MSC limited their expression of CAF markers induced by tumor conditioning, and these MSC migrated poorly and provided weak angiogenic support compared with wild-type MSC. These defects were linked to deficiencies in the ability of CD44-attenuated MSC to transcriptionally upregulate Twist expression. Together, our results establish that CD44 expression contributes to critical functions in the tumor stroma. Cancer Res; 73(17); 5347–59. ©2013 AACR.
Generation of Tumor Antigen-Specific T Cell Lines from Pediatric Patients with Acute Lymphoblastic Leukemia—Implications for Immunotherapy
Authors: Weber Gerrit , Caruana Ignazio , Rouce Rayne H. , Barrett A. John , Gerdemann Ulrike , Leen Ann M. , Rabin Karen R. , Bollard Catherine M.
Published: July 2013

Purpose: Although modern cure rates for childhood acute lymphoblastic leukemia (ALL) exceed 80%, the outlook remains poor in patients with high-risk disease and those who relapse, especially when allogeneic hematopoietic stem cell transplantation is not feasible. Strategies to improve outcome and prevent relapse are therefore required. Immunotherapy with antigen-specific T cells can have antileukemic activity without the toxicities seen with intensive chemotherapy, and therefore represents an attractive strategy to improve the outcome of high-risk patients with ALL. We explored the feasibility of generating tumor antigen-specific T cells ex vivo from the peripheral blood of 50 patients with ALL [26 National Cancer Institute (NCI) high-risk and 24 standard-risk] receiving maintenance therapy.

Experimental Design: Peripheral blood mononuclear cells were stimulated with autologous dendritic cells pulsed with complete peptide libraries of WT1, Survivin, MAGE-A3, and PRAME, antigens frequently expressed on ALL blasts.

Results: T-cell lines were successfully expanded from all patients, despite low lymphocyte counts and irrespective of NCI risk group. Antigen-specificity was observed in more than 50% of patients after the initial stimulation and increased to more than 90% after three stimulations as assessed in IFN-γ-enzyme-linked immunospot (ELISpot) and 51Cr-release assays. Moreover, tumor-specific responses were observed by reduction of autologous leukemia blasts in short- and long-term coculture experiments.

Conclusion: This study supports the use of immunotherapy with adoptively transferred autologous tumor antigen-specific T cells to prevent relapse and improve the prognosis of patients with high-risk ALL. Clin Cancer Res; 19(18); 5079–91. ©2013 AACR.
Chk1/2 Inhibition Overcomes the Cisplatin Resistance of Head and Neck Cancer Cells Secondary to the Loss of Functional p53
Authors: Gadhikar Mayur A. , Sciuto Maria Rita , Alves Marcus Vinicius Ortega , Pickering Curtis R. , Osman Abdullah A. , Neskey David M. , Zhao Mei , Fitzgerald Alison L. , Myers Jeffrey N. , Frederick Mitchell J.
Published: July 2013

Despite the use of multimodality therapy using cisplatin to treat patients with advanced stage squamous cell carcinoma of the head and neck (HNSCC), there is an unacceptably high rate of treatment failure. TP53 is the most commonly mutated gene in HNSCC, and the impact of p53 mutation on response to cisplatin treatment is poorly understood. Here, we show unambiguously that wild-type TP53 (wtp53) is associated with sensitivity of HNSCC cells to cisplatin treatment, whereas mutation or loss of TP53 is associated with cisplatin resistance. We also show that senescence is the major cellular response to cisplatin in wtp53 HNSCC cells and that cisplatin resistance in p53-null or -mutant TP53 cells is due to their lack of senescence. Given the dependence on checkpoint kinase (Chk)1/2 kinases to mediate the DNA damage response in p53-deficient cells, there is potential to exploit this to therapeutic advantage through targeted inhibition of the Chk1/2 kinases. Treatment of p53-deficient HNSCC cells with the Chk inhibitor AZD7762 sensitizes them to cisplatin through induction of mitotic cell death. This is the first report showing the ability of a Chk kinase inhibitor to sensitize TP53-deficient HNSCC to cisplatin in a synthetic lethal manner, which has significance given the frequency of TP53 mutations in this disease and because cisplatin has become part of standard therapy for aggressive HNSCC tumors. These preclinical data provide evidence that a personalized approach to the treatment of HNSCC based on Chk inhibition in p53-mutant tumors may be feasible. Mol Cancer Ther; 12(9); 1860–73. ©2013 AACR.
An Unusual Cause of Urinary Retention in a Young Female: A Case Report
Authors: Regmi Subodh Kumar , Walia Ritika , Kumar Rajeev
Published: July 2013

Inflammatory myofibroblastic tumors are commonly seen in young adults and adolescents and commonly present with painless hematuria. We report a case of a 38-year-old woman who presented to us with urinary retention due to a prolapsing tumor mass from the urethra, which was discovered to be an inflammatory myofibroblastic tumor arising from the bladder base and involving the bladder neck. The patient underwent a successful transurethral resection of the tumor and at 6-month follow-up was continent and symptom-free.
Doppler Ultrasound and X-Ray-Guided Percutaneous Nephrolithotomy with One-Step Balloon Dilation for Complex Renal Stones
Authors: Wang Yanbo , Jiang Fengming , Hou Yuchuan , Wang Yan , Chen Qihui , Zhang Haifeng , Xu Ning , Lu Zhihua , Hu Jinghai , Wang Xiaoqing , Lu Ji , Hao Yuanyuan , Wang Chunxi
Published: July 2013

Objectives: To assess the safety and efficacy of combining Doppler ultrasound with X-ray-guided percutaneous nephrolithotomy (PCNL) with one-step balloon dilation for management of complex renal stones. Material and Methods: We retrospectively analyzed 85 renal stone patients who underwent 89 PCNLs from January 2011 to May 2012. Doppler ultrasound with X-ray-guided PCNL with one-step balloon dilation was finished on the Fluoroscopic Table (Siemens, Berlin, Germany) with the patient under general anesthesia. Results: The study included 85 patients (49 male and 36 female) with a mean age of 42.5 ± 16.4 years. All patients underwent 89 PCNLs (4 patients had bilateral stones). The mean operative time was 72.8 min (range: 35-140). The average fluoroscopic screening time was 5.55 ± 1.81 s (range: 4-12). Successful access to the collecting system was 98.9% (88/89). Although most of the cases (85/89) were managed satisfactorily by a single tract, a second tract was used in 4 cases. No severe complications occurred. The stone-free rate of PCNL monotherapy was 77.5% (69/89). At 3 months, the stone-free rate increased to 89.9% (80/89) after shock wave lithotripsy. Conclusions: PCNL with one-step balloon dilation for the management of complex renal stones under the guidance of combining Doppler ultrasound with X-ray is safe and effective because of its high stone-free rate and low operative time.
Erlotinib and Radiation Therapy for Elderly Patients with Esophageal Cancer - Clinical and Correlative Results from a Prospective Multicenter Phase 2 Trial
Authors: Iyer Renuka , Chhatrala Ravi , Shefter Tracey , Yang Gary , Malhotra Usha , Tan Wei , LeVea Charles , Robins Melissa , Khushalani Nikhil
Published: July 2013

Purpose: Elderly patients with esophageal cancer who are not candidates for chemoradiation may benefit from targeted agents; hence erlotinib combined with radiotherapy was evaluated in this trial. Materials and Methods: Patients >65 years with carcinoma of the thoracic esophagus or gastroesophageal junction who were not eligible for platinum-based treatment received erlotinib daily for 1 year starting on day 1 of radiotherapy [50.4 Gy days 1-28 (Mon-Fri) at 1.8 Gy per fraction]. Response was assessed by endoscopy and computed tomography. The primary endpoint was overall survival (OS), and secondary endpoints were complete response, progression-free survival (PFS) and toxicity. Results: The ECOG performance status in the 17 study patients was 0,1 and 2 in 2, 12 and 3 patients, respectively; 1, 5, 7 and 4 patients were in stage I, II, III and IV, respectively; adenocarcinoma was noted in 16 patients and squamous cell carcinoma in 1; there were 3 current, 12 past and 2 never smokers. Median OS was 7.3 months (95% confidence interval, CI: 3.8-22.3) with 14 deaths. There were 2 mucosal complete responses, 1 residual carcinoma in situ and 3 partial endoscopic responses in 9 patients who had endoscopy after radiotherapy. Estimated PFS was 4.5 months (95% CI: 2.4-7.3). Progression was distant (n = 3), locoregional (n = 6), unknown (n = 5) and too early (n = 3). Estimated 1-year survival was 29% (95% CI: 11-51%), 5 patients lived >12 months. Treatment-related toxicities of grade 3-4 occurred in 5 patients. Patients with epidermal growth factor receptor amplification and never smokers had the longest OS (22.3 and 16.6 months, respectively). Conclusions: Erlotinib with radiotherapy is tolerable and warrants further biomarker-driven evaluation in this population.
Companion Diagnostics in Oncology - Current Status and Future Aspects
Authors: Jørgensen Jan Trøst
Published: July 2013

A large number of targeted anticancer drugs are currently under development and most of them will have a companion diagnostic linked to their use. If a diagnostic assay is developed in conjunction with a targeted anticancer drug, such an assay will later end up determining the conditions for the use of the drug after its approval. The assay then becomes a kind of ‘gatekeeper' in relation to which patients should be treated with the drug in question. This ‘gatekeeper' role implies that companion diagnostic assays must live up to the same regulatory standards and requirements known from drug development. The assays must have proven to be analytically robust and reliable and to have demonstrated clinical utility before they are routinely used in the clinic. In the drug-diagnostic codevelopment model, several ‘traditional' study designs have been used to demonstrate clinical utility. However, if we are to benefit from the increasing knowledge provided by molecular oncology, new ways should be developed to demonstrate the clinical utility of drug-diagnostic combinations. The development of such an approach will require a rethinking at different levels and is likely to include a number of ethical, regulatory and practical challenges.
Comparative Tolerability and Harms of Individual Statins
Authors: Naci Huseyin , Brugts Jasper , Ades Tony
Published: July 2013

Background—

Our objective was to estimate the comparative harms of individual statins using both placebo-controlled and active-comparator trials.

Methods and Results—

We systematically reviewed randomized trials evaluating different statins in participants with and without cardiovascular disease. We performed random-effects pairwise and network meta-analyses to quantify the relative harms of individual statins. We included 55 two-armed placebo-controlled and 80 two- or multiarmed active-comparator trials including 246 955 individuals. According to pairwise meta-analyses, individual statins were not different than control in terms of myalgia, creatine kinase elevation, cancer, and discontinuations because of adverse events. Statins as a class resulted in significantly higher odds of diabetes mellitus (odds ratio, 1.09; 95% confidence interval, 1.02–1.16) and transaminase elevations (odds ratio, 1.51; 95% confidence interval, 1.24–1.84) compared with control. When individual statins were compared in network meta-analyses, there were numerous statistically detectable differences, favoring simvastatin and pravastatin. According to dose-level comparisons, individual statins resulted in higher odds of discontinuations with higher doses of atorvastatin and rosuvastatin. Similarly, higher doses of atorvasatin, fluvastatin, lovastatin, and simvastatin were associated with higher odds of transaminase elevations. Simvastatin at its highest doses was associated with creatine kinase elevations (odds ratio, 4.14; 95% credible interval, 1.08–16.24). Meta-regression analyses adjusting for study-level age at baseline, low-density lipoprotein cholesterol level, and publication year did not explain heterogeneity. There was no detectable inconsistency in the network.

Conclusions—

As a class, adverse events associated with statin therapy are not common. Statins are not associated with cancer risk but do result in a higher odds of diabetes mellitus. Among individual statins, simvastatin and pravastatin seem safer and more tolerable than other statins.
Transcatheter Aortic Valve Replacement in Nonsurgical Candidates With Severe, Symptomatic Aortic Stenosis
Authors: Simons Cyrena T. , Cipriano Lauren E. , Shah Rashmee U. , Garber Alan M. , Owens Douglas K. , Hlatky Mark A.
Published: July 2013

Background—

Transcatheter aortic valve replacement (TAVR) seems to improve the survival and quality of life of patients with aortic stenosis ineligible for surgical aortic valve replacement.

Methods and Results—

We used a decision analytic Markov model to estimate lifetime costs and benefits in a hypothetical cohort of patients with severe, symptomatic aortic stenosis who were ineligible for surgical aortic valve replacement. The model compared transfemoral TAVR with medical management and was calibrated to the Placement of Aortic Transcatheter Valves (PARTNER) trial. TAVR increased life expectancy from 2.08 to 2.93 years and quality-adjusted life expectancy from 1.19 to 1.93 years. TAVR also reduced subsequent hospitalizations by 1.40 but increased complications, particularly stroke (from 1% to 11% lifetime risk), and also increased lifetime costs from $83 600 to $1 69 100. The incremental cost-effectiveness of TAVR was $1 16 500 per quality-adjusted life-year gained ($99 900 per life-year gained). Results were robust to reasonable changes in individual variables but were sensitive to the level of annual healthcare costs caused by noncardiac diseases and to the projected life expectancy of medically treated patients.

Conclusions—

TAVR seems to be an effective but somewhat expensive alternative to medical management among patients with symptomatic aortic stenosis ineligible for surgery. TAVR is more cost-effective for patients with a lower burden of noncardiac disease.
Toll-Like Receptor 4 Antagonist Attenuates Intracerebral Hemorrhage–Induced Brain Injury
Authors: Wang Yan-Chun , Wang Peng-Fei , Fang Huang , Chen Jing , Xiong Xiao-Yi , Yang Qing-Wu
Published: July 2013

Background and Purpose—

Accumulating evidence indicates that inflammatory responses cause secondary injury after intracerebral hemorrhage (ICH). We recently demonstrated the involvement of toll-like receptor 4 (TLR4) signaling in these processes. The purpose of the current study was to investigate the protective effect and mechanism of TAK-242 (Ethyl (6R)-6-[N-(2-chloro-4-fluorophenyl) sulfamoyl] cyclohex-1-ene-1 -carboxylate, Takeda), a TLR4 antagonist, in an ICH mouse model.

Methods—

TAK-242 was intraperitoneally injected 6 hours after ICH once daily for 5 successive days. We assessed neurological deficit scores; changes in brain water content; and levels of inflammatory factors, DNA damage, and neuronal degeneration in perihematomal region 1, 3, and 5 days after ICH. Peripheral inflammatory cell infiltration was determined using flow cytometry; and the expression of TLR4 downstream signaling molecules was assessed by Western blot.

Results—

TAK-242 significantly reduced brain water content, neurological deficit scores, and levels of inflammatory factors. The levels of DNA damage and neuronal degeneration were also significantly decreased, as was peripheral inflammatory cell infiltration. The expression of TLR4 downstream signaling molecules, including myeloid differentiation primary response gene 88, toll/IR-1(TIR)-domain-containing adaptor protein inducing interferon-beta IκBα, nuclear factor-κBp65, and phosphorylated nuclear factor-κBp65, was significantly downregulated.

Conclusions—

The results suggest that TLR4 antagonist reduced inflammatory injury and neurological deficits in a mouse model of ICH. The mechanism may involve decreased expression of signaling molecules downstream of TLR4.
Twenty-Four-Year Trends in the Incidence of Ischemic Stroke in Sweden From 1987 to 2010
Authors: Rosengren Annika , Giang Kok Wai , Lappas Georgios , Jern Christina , Torén Kjell , Björck Lena
Published: July 2013

Background and Purpose—

The incidence of stroke in Sweden increased between 1989 and 2000 among people aged ≤65 years, but more recent data on those aged >65 years are lacking.

Methods—

Through the Swedish Hospital Discharge and Cause of Death registries, we identified all cases of nonfatal and fatal ischemic stroke (IS) among people aged 18 to 84 years during 1987–2010 in Sweden.

Results—

Of the 391 081 stroke cases identified, 1.6% were 18 to 44 years, 16.7% were 45 to 64 years, and 81.7% were 65 to 84 years. Among people aged 18 to 44 years, there was a continuous increase in the incidence of stroke of 1.3% (95% confidence interval, 0.8%–1.8%) per year for men and 1.6% (1.0%–2.3%) per year for women. Among men and women aged 45 to 64 years, slightly declining rates were observed from the late 1990s, with a mean annual decrease of 0.4% (0.1%–0.7%) among men and 0.6% (0.2%–1.0%) among women. Among men aged 65 to 84 years, a decrease of 3.7% in IS (3.4%–4.0%) per year was observed from the late 1990s. This was more marked in women, where an initial decrease of 2.5% (2.1%–2.9%) per year was followed by an accelerated decrease of 5.1% (4.4%–5.8%) after 2005. Mortality from IS decreased markedly in all age groups.

Conclusions—

The incidence of IS in elderly people in Sweden is now decreasing, whereas the decline in IS incidence in the middle-aged people is much less steep. The increasing incidence of stroke in the young, particularly if carried forward to an older age, is concerning.
Timeliness of Intravenous Thrombolysis via Telestroke in Georgia
Authors: Bruno Askiel , Lanning Katherine M. , Gross Hartmut , Hess David C. , Nichols Fenwick T. , Switzer Jeffrey A.
Published: July 2013

Background and Purpose—

Through 2-way live video and audio communication, telestroke enhances urgent treatment of patients with acute stroke in emergency departments (EDs) without immediate access to on-site specialists. To assess for opportunities to shorten the door to thrombolysis time, we measured multiple time intervals in a telestroke system.

Methods—

We retrospectively analyzed 115 records of consecutive acute stroke patients treated with intravenous thrombolysis during a 20-month period via a statewide telestroke system in 17 EDs in Georgia. On the basis of times documented in the telestroke system, we calculated the time elapsed between the following events: ED arrival, telestroke patient registration, start of specialist consultation, head computed tomography, thrombolysis recommendation, and thrombolysis initiation.

Results—

The most conspicuous delay was from ED arrival to telestroke patient registration (median, 39 minutes; interquartile range, 21–56). Median time from ED arrival to thrombolysis initiation was 88 minutes, interquartile range 75 to 105. Thrombolysis was initiated within 60 minutes from ED arrival in 13% of patients.

Conclusions—

The greatest opportunity to expedite acute thrombolysis via telestroke is by shortening the time from ED arrival to telestroke patient registration.
The Permanence of Inconsistency: Libya, the Security Council, and the Responsibility to Protect
Authors: Hehir Aidan
Published: July 2013

Many observers heralded the Security Council—sanctioned intervention in Libya in March 2011 as evidence of the efficacy of the responsibility to protect (R2P). Although there is no doubt that the intervention was significant, the implications of Resolution 1973 are not as profound as some have claimed. The intervention certainly coheres with the spirit of R2P, but it is possible to situate it in the context of a trajectory of Security Council responses to large-scale intrastate crises that predate the emergence of R2P. This trajectory is a function of the decisionmaking of the five permanent members of the Security Council (P5), a group guided by politics and pragmatism rather than principles. As a consequence, the Security Council's record in dealing with intrastate crises is characterized by a preponderance of inertia punctuated by aberrant flashes of resolve and timely action impelled by the occasional coincidence of interests and humanitarian need, rather than an adherence to either law or norms. The underlying factors that contributed to this record of inconsistency—primarily the P5's veto power—remain post-Libya, and thus the international response to intrastate crises likely will continue to be inconsistent.
Hybrid Basketry: Interweaving Digital Practice within Contemporary Craft
Authors: Zoran Amit
Published: July 2013

Contemporary 3D printing and traditional craft rarely meet in the same creation. They tend to live in different worlds. In this paper, the author argues for merging these two distinct traditions. To that end, he developed hybrid basketry, a medium where 3D-printed structures are shaped to allow the growth and development of hand-woven patterns. While the 3D-printed plastic elements contribute the aesthetics of the digital curvatures and manifolds, the hand-woven reed, jute, and canvas fibers infuse the baskets with a unique organic appeal. The author discusses his motivation, describes the making process, and presents four hybrid baskets, integrating a deeper discussion on the place of craft and tradition within our contemporary approach to design and fabrication.
Redescriptions of poorly known species of jumping spiders (Araneae: Salticidae) from South Africa and Namibia
Authors: AZARKINA GALINA N. , FOORD STEFAN H.
Published: July 2013

The following seven species of southern African Salticidae, known only from type specimens or one sex, and last described in the early 20th century, are redescribed: Baryphas ahenus Simon, 1902, Brancus muticus Simon, 1902, Euophrys quadrispinosa Lawrence, 1927, Evarcha natalica Simon, 1902, Mogrus macrocephalus Lawrence, 1927, Thyene damarensis Lawrence, 1927 and Thyene bilineata Lawrence, 1927. Two new synonyms are proposed, Thyene damarensis Lawrence, 1927 syn. n. with Hyllus dotatus (Peckham et Peckham, 1903) and Thyene bilineata striatipes Lawrence, 1927 syn. n. with T. bilineata Lawrence, 1927. One new combination is proposed, Thyenula natalica comb. n. (ex Evarcha). Lectotypes for Baryphas ahenus Simon, 1902 and Thyene bilineata Lawrence, 1927 are designated. The female of Brancus muticus Simon, 1902 is described for the first time.
Taxonomic reappraisal of the sphagesaurid crocodyliform Sphagesaurus montealtensis from the Late Cretaceous Adamantina Formation of São Paulo State, Brazil
Authors: Iori Fabiano Vidoi , Marinho Thiago da Silva , Carvalho Ismar de Souza , Campos Antonio Celso de Arruda
Published: July 2013

Sphagesaurus montealtensis is a sphagesaurid whose original description was based on a comparison with Sphagesaurus huenei, the only species of the clade described to that date. Better preparation of the holotype and the discovery of a new specimen have allowed the review of some characteristics and the identification of several synapomorphies of S. montealtensis with the genus Caipirasuchus: presence of antorbital fenestra; external nares bordered only by the premaxillae; premaxilla with four teeth and one diastema (between the 3rd–4th teeth); one diastema between the 4th premaxillary tooth and the 1st maxillary tooth; dentary with ten teeth and two diastemata (between the 4th–5th and 5th – 6th teeth); nasal with a groove parallel to the suture with the frontal bone; nasal long, with an acute anterior margin touching anterolaterally the premaxilla, jugal is a straight bar in the lateral view; frontal is longer than wide; a dorsoventrally expanded and vertically oriented quadrate with a groove separating the medial and lateral condyles; the frontal has a discrete sagittal crest; dentary with six posterior sphagesauriform teeth and four anterior conical teeth, the first three are the smallest of the series and the fourth is slightly laterally compressed. The referral of S. montealtensis to the genus Caipirasuchus, as Caipirasuchus montealtensis comb. nov. is proposed here, based on the new taxonomic observations and the results of a phylogenetic analysis.
Spatial Averaging of HF Radar Data for Wave Measurement Applications
Authors: Wyatt Lucy R. , Jaffrés Jasmine B. D. , Heron Mal L.
Published: July 2013

HF radar data are often collected for time periods that are optimized for current measurement applications where, in many cases, very high temporal resolution is needed. Previous work has demonstrated that this does not provide sufficient averaging for robust wave measurements to be made. It was shown that improvements could be made by averaging the radar data for longer time periods. HF radar provides measurements over space as well as in time, so there is also the possibility to average in space. However, the radar data are correlated in space because of the range and azimuth processing. The implications of this are discussed and estimates of the impact on the reduction in variance in the radar Doppler spectral estimates are obtained. Spatial inhomogeneities and temporal nonstationarity in the ocean wave field itself also need to be taken into account. It is suggested that temporal averaging over periods of up to one hour and spatial averaging over 9–25 nearest neighbors may be suitable, and these will be explored in later work.
A Diabatic Lagrangian Technique for the Analysis of Convective Storms. Part II: Application to a Radar-Observed Storm
Authors: Ziegler Conrad L.
Published: July 2013

A new diabatic Lagrangian analysis (DLA) technique that derives predicted fields of potential temperature, water vapor and cloud water mixing ratios, and virtual buoyancy from three-dimensional, time-dependent wind and reflectivity fields (see Part I) is applied to the radar-observed 9 June 2009 supercell storm during the Second Verification of the Origins of Rotation in Tornadoes Experiment (VORTEX2). The DLA diagnoses fields of rain and graupel content from radar reflectivity and predicts the evolution of analysis variables following radar-inferred air trajectories in the evolving storm with application of the diagnosed precipitation fields to calculate Lagrangian-frame microphysical processes. Simple damping and surface flux terms and initialization of trajectories from heterogeneous, parametric mesoscale analysis fields are also included in the predictive Lagrangian calculations. The DLA output compares favorably with observations of surface in situ temperature and water vapor mixing ratio and accumulated rainfall from a catchment rain gauge in the 9 June 2009 storm.
Negotiating Site-Based Management and Expanded Teacher Decision Making
Authors: Mayer Anysia Peni , Donaldson Morgaen L. , LeChasseur Kimberly , Welton Anjalé D. , Cobb Casey D.
Published: July 2013

Purpose:

This article presents findings from a study of six schools in the Together Initiative (TI), which facilitates increased school autonomy from districts and expands teacher decision-making authority. This study aims to understand how TI’s theory of action changed structures, cultures, and agency as the concepts of site-based management and expanded teacher decision making were interpreted and implemented by district and school leaders and teachers.

Research Design:

Data were collected over the first 2 years of the initiative using a concurrent mixed-methods design. Field notes from more than 200 hours of observations and transcripts of 231 semistructured interviews with stakeholders were coded using the constant-comparative method. Findings from qualitative data were triangulated with annual teacher survey findings.

Findings:

Implementation of TI varied across the six schools and depended greatly on school staffs’ existing relationships the district, principal support for decision-making structures, and the extent to which school cultures reflected trust and teachers were able to enact greater agency. Only two schools experienced moderate increases in site-based management and expanded teacher decision making; those that did not were missing at least one of these structural or cultural supports.

Conclusions:

At a time when charter schools are touted as an effective reform model, this article informs policy and practice on the original charter concept—autonomous, innovative district schools. Our findings suggest that creating contexts where site-based management can flourish is far more complicated than changing structures or establishing supportive school cultures.
Principals as Bricoleurs
Authors: Koyama Jill
Published: July 2013

Purpose: The study investigates the ways in which principals engage with, and attend to, the data-driven accountability measures of No Child Left Behind (NCLB) and local mandates. Theoretical framework: The study is framed with the notion of assemblage, a term often associated with actor-network theory (ANT)—a theory that focuses analytic attention on how disparate actors, material, and discursive practices come together to form dynamic associations. Within the assemblage, principals are situated as bricoleurs.Research methods and data: Data for analysis come from interviews conducted with 45 New York City principals between June 2005 and October 2008 as part of a larger ethnographic study examining NCLB, and a series of interviews with 12 of the 45 principals, conducted annually through March 2012. District surveys, various documents, and field notes of participant observation also inform the study. Findings: Principals play active policy roles in negotiating federal regulations and local initiatives, as well as selectively performing assessment and accountability mandates. Principals, who have often been cast in the media as either dupes of the state or as active resistors, negotiate and appropriate external accountability in innovative, sometimes savvy, ways. Implications for practice and research: Principals need to consider institutional circumstances and external accountability not as boundaries or constraints, but rather as available material with which to respond. Future research should aim to examine the ways in which principals engage with data and accountability demands via reflexive interactions with different types of knowledge, mediating artifacts, and methods.
Social Stratification
Authors: Johnson Lee A.
Published: July 2013

Every society has an organizational structure that reflects what is valued by that society. Those members of the society that are deemed more valuable or that contribute more to society are rewarded with a larger share of the goods and services. The ancient Mediterranean world functioned within a rigid hierarchical structure, in which the most valued members were openly designated—in the family, the city, the empire, and the cosmos. The virtues of the social stratification system were made apparent through the patronage/clientage system as the means of distribution of goods, the cultural battle for honor and the aversion to shame, and the patriarchal structure of the family, to name a few instances. Recognition of the prevailing hierarchical structure in the ancient Mediterranean world sheds light upon biblical writings, some of which affirm, and others of which challenge the cultural customs arising from the hyper-stratification of the societies from which they emerged.
Age-related differences in evaluating developmental stability
Authors: Mustafić Maida , Freund Alexandra M.
Published: July 2013

Two studies examined the hypothesis that the evaluation of developmental stability changes across adulthood. Results of Study 1 ( N = 119) supported the expectation that older adults ( Mage = 65.29 years)—compared to younger ( Mage = 23.38 years) and middle-aged adults ( Mage = 38.68 years)—evaluate developmental stability more positively and losses less negatively across all life domains included in this study (subjective well-being, social relationships, cognition, physical functioning). Replicating and extending these findings, Study 2 ( N = 182, age-range: 18–86 years) demonstrated that these age-related differences exist only for stability on an explicit and implicit level of evaluation. Moreover, Study 2 shows that the positive evaluation of stability increases after resource investments into maintaining stability were made salient. We discuss the results in relation to motivational orientation and psychological adjustment to developmental change.
Intra-union politics and wage-setting coordination in Eurozone countries
Authors: Park Sung Ho
Published: July 2013

This article revisits one of the established hypotheses in the literature on European industrial relations. Focusing on the context in which wages are set via central coordination, the hypothesis explores why the wage-setting system often collapses and is replaced with sectoral or company-level bargaining. The answer revolves around the issue of wage costs, with the main claim being that the change (that is, de-coordination) occurs when employers are not satisfied with the performance of cost control. This article asserts that the hypothesis has only limited applicability. In particular, it holds only if central coordination remains a potential source of high wage costs. If the system turns to a reliable mechanism for wage moderation, which is true in the Eurozone countries, the hypothesis does not hold. Under this circumstance, employers will no longer consider de-coordination as a means of cost control. Instead, de-coordination can occur as a consequence of intra-union politics, as diverse union actors interact with each other in their response to the wage issue. The article will examine this new hypothesis of de-coordination in the context of three Eurozone countries in the 1990s and 2000s: Finland, Ireland, and Belgium.