bluuebunny/crossref_metadata_2025 huggingface dataset:
Long Non-Coding RNAs as Master Regulators in Cardiovascular Diseases
Authors: Archer Krystal , Broskova Zuzana , Bayoumi Ahmed , Teoh Jian-peng , Davila Alec , Tang Yaoliang , Su Huabo , Kim Il-man
Published: October 2015

Cardiovascular disease is the leading cause of death in the United States, accounting for nearly one in every seven deaths. Over the last decade, various targeted therapeutics have been introduced, but there has been no corresponding improvement in patient survival. Since the mortality rate of cardiovascular disease has not been significantly decreased, efforts have been made to understand the link between heart disease and novel therapeutic targets such as non-coding RNAs. Among multiple non-coding RNAs, long non-coding RNA (lncRNA) has emerged as a novel therapeutic in cardiovascular medicine. LncRNAs are endogenous RNAs that contain over 200 nucleotides and regulate gene expression. Recent studies suggest critical roles of lncRNAs in modulating the initiation and progression of cardiovascular diseases. For example, aberrant lncRNA expression has been associated with the pathogenesis of ischemic heart failure. In this article, we present a synopsis of recent discoveries that link the roles and molecular interactions of lncRNAs to cardiovascular diseases. Moreover, we describe the prevalence of circulating lncRNAs and assess their potential utilities as biomarkers for diagnosis and prognosis of heart disease.
Ultrafast Laser Engraving Method to Fabricate Gravure Plate for Printed Metal-Mesh Touch Panel
Authors: Chen Weiyuan , Lai Wenlang , Wang Yuming , Wang Kaijun , Lin Shengyu , Yen Yuli , Hocheng Hong , Chou Tahsin
Published: October 2015

In order to engrave gravure plate with fine lines structures, conventional art used lithography with dry/wet etching. Lithography with dry/wet etching method allows to engrave lines with smooth concave shape, but its disadvantages include difficulty in controlling aspect ratio, high and uniform in large size process, substrate material limitation due to etching solution availability, and process complexity. We developed ultra-fast laser technology to directly engrave a stainless plate, a gravure plate, to be used for fabricating 23 in. metal-mesh touch panel by gravure offset printing process. The technology employs high energy pulse to ablate materials from a substrate. Because the ultra-fast laser pulse duration is shorter than the energy dissipation time between material lattices, there is no heating issue during the ablation process. Therefore, no volcano-type protrusion on the engraved line edges occurs, leading to good printing quality. After laser engraving, we then reduce surface roughness of the gravure plate using electro-polishing process. Diamond like carbon (DLC) coating layer is then added onto the surface to increase scratch resistance. We show that this procedure can fabricate gravure plate for gravure offset printing process with minimum printing linewidth 10.7 μm. A 23 in. metal-mesh pattern was printed using such gravure plate and fully functional touch panel was demonstrated in this work.
Effects of Asiatic Acid on Spatial Working Memory and Cell Proliferation in the Adult Rat Hippocampus
Authors: Sirichoat Apiwat , Chaijaroonkhanarak Wunnee , Prachaney Parichat , Pannangrong Wanassanan , Leksomboon Ratana , Chaichun Amnart , Wigmore Peter , Welbat Jariya
Published: October 2015

Asiatic acid is a pentacyclic triterpene from Centella asiatica. Previous studies have reported that asiatic acid exhibits antioxidant and neuroprotective activities in cell culture. It also prevents memory deficits in animal models. The objective of this study was to investigate the relationship between spatial working memory and changes in cell proliferation within the hippocampus after administration of asiatic acid to male Spraque-Dawley rats. Control rats received vehicle (propylene glycol) while treated rats received asiatic acid (30 mg/kg) orally for 14 or 28 days. Spatial memory was determined using the novel object location (NOL) test. In animals administered asiatic acid for both 14 and 28 days, the number of Ki-67 positive cells in the subgranular zone of the dentate gyrus was significantly higher than in control animals. This was associated with a significant increase in their ability to discriminate between novel and familiar object locations in a novel object discrimination task, a hippocampus-dependent spatial memory test. Administration of asiatic acid also significantly increased doublecortin (DCX) and Notch1 protein levels in the hippocampus. These findings demonstrate that asiatic acid treatment may be a potent cognitive enhancer which improves hippocampal-dependent spatial memory, likely by increasing hippocampal neurogenesis.
Restoration of Simulated EnMAP Data through Sparse Spectral Unmixing
Authors: Cerra Daniele , Bieniarz Jakub , Müller Rupert , Storch Tobias , Reinartz Peter
Published: October 2015

This paper proposes the use of spectral unmixing and sparse reconstruction methods to restore a simulated dataset for the Environmental Mapping and Analysis Program (EnMAP), the forthcoming German spaceborne hyperspectral mission. The described method independently decomposes each image element into a set of representative spectra, which come directly from the image and have previously undergone a low-pass filtering in noisy bands. The residual vector from the unmixing process is considered as mostly composed of noise and ignored in the reconstruction process. The first assessment of the results is encouraging, as the original bands taken into account are reconstructed with a high signal-to-noise ratio and low overall distortions. Furthermore, the same method could be applied for the inpainting of dead pixels, which could affect EnMAP data, especially at the end of the satellite’s life cycle.
Population Aging: An Emerging Research Agenda for Sustainable Development
Authors: Kudo Shogo , Mutisya Emmanuel , Nagao Masafumi
Published: October 2015

In recent years, population aging has been recognized as an emerging challenge in many parts of the world. Earlier studies discussed its impacts on the sustainability of social security systems and national economic growth; however, they tended to focus on the issues at the national level and were limited to developed countries. With the knowledge that population aging will be a predominant trend in both developed and developing countries, this paper aims to: (i) describe the global population aging trend and its regional demography; (ii) provide a structural review of population aging challenges at the national, communal and individual levels; and (iii) elaborate future research topics on population aging with a particular emphasis on developing countries. Several indicators suggest rapid population aging in the coming decades, especially in Asia, Latin America and Africa. The structural review presents the diverse challenges that affect both young and older population groups. Finally, the need for linking population aging with the sustainable development concept and the possible rural decline caused by rapid urbanization are suggested as future research topics. Further studies to establish a body of knowledge on population aging in developing countries are required to place population aging on the agenda of future sustainable development discussions.
Preparation of conjugated dienoates with Bestmann ylide: Towards the synthesis of zampanolide and dactylolide using a facile linchpin approach
Authors: Wang Jingjing , Ting Samuel Z Y , Harvey Joanne E
Published: October 2015

Bestmann ylide [(triphenylphosphoranylidene)ketene] acts as a chemical linchpin that links nucleophilic entities, such as alcohols or amines, with carbonyl moieties to produce unsaturated esters and amides, respectively. In this work, the formation of α,β,γ,δ-unsaturated esters (dienoates) is achieved through the coupling of Bestmann ylide, an alcohol and an α,β-unsaturated aldehyde. Primary and secondary alcohols, including allylic alcohols, are suitable substrates; the newly formed alkene has an E-geometry. Strategically, this represents a highly efficient route to unsaturated polyketide derivatives. A linchpin approach to the synthesis of a major fragment of the natural products zampanolide and dactylolide is investigated using Bestmann ylide to link the C16–C20 alcohol with the C3–C8 aldehyde fragment.
Security System: Optimalization, or New Conception?
Authors: Krulik Vladimir , Rašek Antonin
Published: October 2015

The article deals with the development of the security system since the November 1989 events. Special attention is paid to the situation near the year 2005, when the last opportunity to update a comprehensive concept of security system occurred. The text deals with the comprehensive management of the security system issue. The authors of the article present key events and strategic documents forming the current shape of the Czech security system. In the final part of article, you can find the proposal of the strategic document management system within the security development system. Article results in the knowledge that the modern security system concept is still challenge for us.
The Kurdish Diaspora in Central Europe its Response to Actual Development in Syria and Iraq and Predictions of Further Development
Authors: Murad Michael , Kraus Josef
Published: October 2015

Following article deals with the Kurdish diaspora in Middle-Europe at the background of current conflict with so called Islamic State. Kurds are one of the main actors of this strong regional conflict and their diaspora in Germany and Austria are forced to react to such a situation. The text is focused not only on actual situation in Syria and Iraq, but mainly on Kurdish reaction towards it. Not only for Czech reader there is interesting part dealing with Kurdish community in Czech Republic, although this diaspora is not as numerous and strong as in Germany or Austria. One of the important outcomes of the article is an attempt to predict future scenarios of Kurds situation development. But it is necessary to mention the high dynamics of conflict with Islamic State complicates any such an attempt of prediction.
Utilizing online resources for taxonomy: a cybercatalog of Afrotropical apiocerid flies (Insecta: Diptera: Apioceridae)
Authors: Dikow Torsten , Agosti Donat
Published: October 2015

A cybercatalog to the Apioceridae (apiocerid flies) of the Afrotropical Region is provided. Each taxon entry includes links to open-access, online repositories such as ZooBank, BHL/BioStor/BLR, Plazi, GBIF, Morphbank, EoL, and a research web-site to access taxonomic information, digitized literature, morphological descriptions, specimen occurrence data, and images. Cybercatalogs as the one presented here will need to become the future of taxonomic catalogs taking advantage of the growing number of online repositories, linked data, and be easily updatable. Comments on the deposition of the holotype of Apiocera braunsi Melander, 1907 are made.
A new species of Neossos Malloch (Diptera: Heleomyzidae) from the Yukon Territory, Canada, and a revised key to the Nearctic species
Authors: Solecki Anna , Wheeler Terry
Published: October 2015

The rarely collected genus Neossos Malloch contains three Nearctic and one western European species. Most known specimens have been collected from bird nests. Two specimens of an undescribed species of Neossos were collected by sweeping in subarctic tundra and a mesic meadow in the Yukon Territory, Canada. This represents a significant northward extension of the known Nearctic range of the genus.

Neossos tombstonensissp. n. is described from the Yukon Territory. This represents the fourth described Nearctic species of Neossos. Although the type specimens were collected by sweeping, the species is predicted to be associated with bird nests, based on habits of other members of the genus. A revised key to the Nearctic species of Neossos is provided.
Calorimetric study of the early stages of the nanosilica - tricalcium silicate hydration. Effect of temperature
Authors: Sáez del Bosque I. F. , Martínez-Ramírez S. , Blanco-Varela M. T.
Published: October 2015

The pozzolanic reaction of nanosilica in contact with C3S was monitored via isothermal conduction calorimetry. Since that reaction is affected by heat, its variations with curing temperature (25, 40 and 65 °C) were also analysed. The findings showed that while C3S hydration was accelerated by both nSA and higher curing temperature, the former impacted the reaction more intensely. Moreover, the presence of nSA was observed to shorten the acceleration stage during C3S hydration, inducing earlier precipitation of portlandite and earlier C-S-H precipitation and nucleation.
Extracción líquido-líquido de cadmio(II) mediante el líquido iónico ClTIOA (cloruro de tri-iso-octyl amonio) y su aplicación en un sistema de nanotubos de carbono impregnados con ClTIOA
Authors: Alguacil Francisco J. , García-Díaz Irene , López Félix A. , Rodríguez Olga
Published: October 2015

Se ha estudiado la extracción de cadmio(II), de disoluciones en medio HCl, por el líquido iónico (R3NH+Cl-) (R: tri-iso-octyl) disuelto en Exxsol D100. La reacción de extracción tiene un carácter exotérmico. El análisis numérico de la distribución del metal sugiere la formación de las especies R3NH+CdCl3− y (R3NH+)2CdCl42− en la fase orgánica. Estos resultados se han implementado en un sistema que utiliza nanotubos de carbono de pared múltiple impregnados con este líquido iónico. Se han investigado diversas variables experimentales: velocidad de agitación de la disolución acuosa (250–2000 min−1), adición del adsorbente (0,05–0,2 g) y temperatura (20–60 °C).
Sulfur and Nitrogen Chemical Speciation in Crude Oils and Related Carbonaceous Materials
Authors: Mitra-Kirtley Sudipa , Mullins Oliver C. , Pomerantz Andrew E.
Published: October 2015

This chapter gives an overview of sulfur x-ray absorption near edge spectroscopy (XANES) studies performed on some carbonaceous materials, viz. crude oil and related materials (asphaltenes, kerogens, bitumens, and resins), and coals. Thiophene, sulfide, sulfoxide, sulfone, pyrite, and sulfate are found in varying amounts in these materials. In source rock bitumens, sulfoxide is more abundant than in the kerogens, while within the kerogens, the less aromatic Type I samples show a smaller ratio of thiophenic/sulfidic sulfur than in Type II samples. Petroleum asphaltenes have a similar sulfur chemistry, regardless of the source or the burial depth. Resins and oil fractions retain the polar sulfoxide species of the parent oil similar to the more polar asphaltenes fractions. More aromatic sulfur species also dominate in the more matured coals than in the younger coals. Studies of nitrogen XANES also reveal that aromatic forms of nitrogen prevail in samples with increased aromatic carbon.
Cleaner Energy Fuels
Authors: Sareen Neha , Bhattacharya Subrato
Published: October 2015

Today, SO2 pollution has become a glaring problem especially in India and China. Thus, desulfurization of fossil fuels has become an essential area of research. Advances in experimental sciences to explain the desulfurization mechanism will be beneficial to the rational designing of more effective HDS catalysts. Several reaction pathways involving desulfurization of thiophene have been compiled. Also, a repertoire of the desulfurization pathways encountered in the author's laboratory has been provided. The results will not only throw light on some unusual mechanisms of desulfurization process but also break the popular belief that desulfurization is limited to C-S bond cleavage only. The reactions may also serve as a basis for engineering optimal catalysts for future applications.
Advances in Nanotechnology Transition Metal Catalysts in Oxidative Desulfurization (ODS) Processes
Authors: Saladino Raffaele , Botta Giorgia , Crucianelli Marcello
Published: October 2015

Organosulfur compounds show a negative environmental impact because of SOx emissions by combustion of fuel oils. As a consequence, removal of sulfur is becoming a worldwide challenge. The hydrodesulfurization (HDS) process achieves limited performances in the case of refractory S-containing aromatic compounds, such as thiophene and substituted benzothiophenes (BTs), which require highly energy-demanding conditions (high temperature and pressure conditions). Oxidative desulfurization (ODS) is considered the most promising alternative to HDS. During ODS treatment, the organosulfur compounds are oxidized to corresponding sulfoxides and sulfones, which can be successively removed by extraction with polar solvents. Different stoichiometric oxidants have been used in the ODS processes with a different degree of efficacy and environmental impact. The design and development of catalytic procedures can increase the ODS energy efficiency as well as make it more economical and environmentally acceptable. Here we describe the advances in nanostructured organometallic catalysis and biotechology applied to ODS treatment.
Ni/ZnO Nano Sorbent for Reactive Adsorption Desulfurization of Refinery Oil Streams
Authors: Ge Hui , Tang Mingxing , Wen Xiao-Dong
Published: October 2015

The aim of this chapter is to present the Ni/ZnO nano-sorbent for reactive adsorption desulfurization (RADS) of refinery oil steams. The preparation and modification of nano-sorbent are reviewed. Various characterizations involving in the relation of properties with components, structures and dynamic phase change during RADS, are extensively provided. The mechanisms of desulfurization, sulfur transfer and sulfur adsorption are proposed. The contradictories in literature about active structures and reaction mechanism are discussed and the solutions are suggested. This chapter unfolds the impressive application of RADS of Ni/ZnO nano-sorbent to produce a cleaner gasoline. It also delves into the inadequately engineer areas which require further attention so as to make the RADS process more economic and more efficient. The perspective applications other than gasoline desulfurization are also presented.
Trimetallic Sulfide Catalysts for Hydrodesulfurization
Authors: Huirache-Acuña Rafael , Alonso-Nuñez Gabriel , Rivera-Muñoz Eric M. , Gutierrez Omar , Pawelec Barbara
Published: October 2015

The more stringent environmental regulations enacted throughout the world have increased the need of more active hydrotreating (HDT) catalysts, in the petroleum refining industry. Usually, the catalysts used for diesel oil hydrotreatment are ?-Al2O3 supported molybdenum or tungsten sulfides promoted with cobalt or nickel. Current strategies for the design of novel HDS catalysts often include variations in the support formulation, catalyst preparation method and active phase formulation. In this sense, the new generations of catalysts, such as NEBULA®, are based on a totally different concept of bulk-like. In this chapter, we present recent research related to the synthesis, characterization and performance of trimetallic sulfide nanocatalysts for hydrodesulfurization. The present chapter analyses the state of art of the ternary sulfide hydrotreating catalysts.
Polymolybdate Supported Nano Catalyst for Desulfurization of Diesel
Authors: Abu Bakar Wan Azelee Wan , Abdullah Wan Nazwanie Wan , Ali Rusmidah , Mokhtar Wan Nur Aini Wan
Published: October 2015

The Catalytic oxidative desulfurization (Cat-ODS) comprises of molybdenum based catalyst, tert-butyl hydroperoxide (TBHP) as oxidant and dimethylformamide (DMF) as solvent for extraction. A series of polymolybdates supported alumina were prepared using the wet impregnation method. This potential catalyst was characterized by FTIR, FESEM-EDX and XPS for its physical properties. From catalytic testing, Fe/MoO3-Al2O3 calcined at 500°C was revealed as the most potential catalyst which gave the highest sulfur removal under mild condition .The sulfur content in commercial diesel was successfully reduced from 440 ppmw to 88 ppmw under mild condition followed by solvent extraction. Response surface methodology involving Box-Behnken was employed to evaluate and optimize Fe/MoO3/Al2O3 preparation parameters (calcination temperature, catalyst loading, and Fe loading) and their optimum values were found to be 550 ºC, 10 g/L, and 10%. of calcination temperature, catalyst loading, and Fe loading. Based on these results, the reaction mechanisms of peroxy oxygen were proposed.
Molecularly Imprinted Polymer Nanofibers for Adsorptive Desulfurization
Authors: Ogunlaja Adeniyi S. , Tshentu Zenixole R.
Published: October 2015

Desulfurization of fuel oils is an essential process employed in petroleum refineries to reduce the sulfur concentration in fossil fuels in order to meet the mandated environmental protection limit of 10 ppm sulfur. The hydrodesulfurization (HDS) process, which is currently being employed for desulfurization, is limited in treating refractory organosulfur compounds as it only reduces sulfur content in fuels to a range of 200-500 ppm sulfur. Oxidative desulfurization (ODS) is considered a new technology for desulfurization of fuel oils as the process is capable of desulfurizing fuels to reach the ultra-low sulfur levels and can serve as a complementary step to HDS. The chapter discusses, briefly, the oxidation of refractory sulfur compounds found in fuels using vanadium as a catalyst to form organosulfones, a first step in ODS process. The chapter also discusses, in detail, the chemistry involved in molecular imprinting of organosulfones on functional polymers, and the electrospinning of the polymeric matrix to produce molecularly imprinted nanofibers employed for selective adsorption of organosulfones from the oxidized mildly hydrotreated fuels, a second step in the ODS process. Chemical interactions, apart from the imprinting effect, that can be exploited in molecularly imprinted polymers for selective extraction of organosulfones, such as hydrogen bonding, p-p interactions, van der Waals forces and electrostatic interactions, were discussed by employing density functional theory calculations. The possibilities of electrospinning on a large scale as well as prospects for future industrial applications of functional molecularly imprinted nanofibers in desulfurization are also discussed.
Nanotechnology Applied to the Biodesulfurization of Fossil Fuels and Spent Caustic Streams
Authors: Montalvan-Sorrosa Danai , de los Cobos-Vasconcelos Daniel , Gonzalez-Sanchez Armando
Published: October 2015

The use of nanostructured materials in combination with desulfurizing microorganisms is a promising technique that would improve the desulfurization processes of gaseous fuels, oil, and some wastewater. Nanoparticles are highly versatile and tunable depending on the necessities of each particular contaminated media. The chapter shows the current technological options for the biodesulfurization of natural gas, oil and wastewater produced from the petroleum refining, where the application of nano-sized materials combined with desulfurizing microorganisms would improve the desulfurization capacities. In addition, advantages, disadvantages and opportunities of this hybrid technology are presented.
Advances in the Reduction of the Costs Inherent to Fossil Fuels' Biodesulfurization towards Its Potential Industrial Application
Authors: Paixão Susana M. , Silva Tiago P. , Arez Bruno F. , Alves Luís
Published: October 2015

Biodesulfurization (BDS) process consists on the use of microorganisms for the removal of sulfur from fossil fuels. Through BDS it is possible to treat most of the organosulfur compounds recalcitrant to the conventional hydrodesulfurization (HDS), the petroleum industry's solution, at mild operating conditions, without the need for molecular hydrogen or metal catalysts. This technique results in lower emissions, smaller residue production and less energy consumption, which makes BDS an eco-friendly process that can complement HDS making it more efficient. BDS has been extensively studied and much is already known about the process. Clearly, BDS presents advantages as a complementary technique to HDS; however its commercial use has been delayed by several limitations both upstream and downstream the process. This study will comprehensively review and discuss key issues, like reduction of the BDS costs, advances and/or challenges for a competitive BDS towards its potential industrial application aiming ultra low sulfur fuels.
Mapping the Workspace of a Globally Distributed “Agile” Team
Authors: Lauren Benjamin S.
Published: October 2015

Collaborative activities have become an important consideration of contemporary workspace design, and this is especially in software development companies as teams work to innovate products and customer experiences. Meanwhile, globally distributed virtual teams have also grown more common, but collaborating across time zones presents a new set of challenge to navigate. To address some of these challenges, many organizations are also implementing more agile information design strategies. Architecting user-friendly work environments that support collaboration for globally distributed virtual teams practicing agile methodologies is not a simple task, however. This article reports results from a workplace study of a distributed team of information experience designers at a multinational software company as the team worked through reorganization of their internal processes and workflow. The case study illustrates which environmental design features caused disruptions and contradictions for the team as they participated in project work.
From autoimmune hepatitis to Q fever
Authors: Tizzani Davide , Totaro Silvia , Crudo Valentina Laura , Viola Andrea , Gallo Vittorio , Veglio Franco
Published: October 2015

Q fever is an infectious disease caused by Coxiella burnetii. Its clinical presentation is often nonspecific and the serological diagnosis difficult to make, especially in the absence of specific and suspected medical history. This article presents a case of fever of unknown origin (FUO), interpreted as an autoimmune hepatitis, later proven by the liver biopsy to be a granulomatous hepatitis caused by C. burnetii. The approach to FUO, the features of granulomatous hepatitis and Q fever are presented and discussed.
Asymptomatic superior mesenteric vein thrombosis as unusual complication of acute cytomegalovirus infection: a case report
Authors: Bertoni Michele , Risaliti Filippo , Giani Alessandra , Calabrese Emanuele , Di Natale Massimo Edoardo
Published: October 2015

We describe a 39-year-old male who presented with a fever of unknown origin the diagnostic work-up of which disclosed an acute CMV infection complicated by a partial superior mesenteric vein (SMV) thrombosis. Further investigations revealed the presence of factor V Leiden mutation. Oral anticoagulant treatment with warfarin lead to a complete recanalization of SMV two months after. A literature review on the association between CMV infection and portal system (PS) thrombosis in immunocompetent patients was performed. We found that, in agreement with our case, in a minority of case reports patients did not complain of abdominal pain, but presented with a mononucleosic-like syndrome with malaise and prolonged fever and displayed a variable elevation of aminotransferase levels. Interestingly, most of them exhibited a limited extension of portal thrombosis. On the whole, these data suggest that PS thrombosis during acute CMV infection may be an underestimated complication.
Management of Metastatic Apocrine Hidradenocarcinoma with Chemotherapy and Radiation
Authors: Miller Daniel H. , Peterson Jennifer L. , Buskirk Steven J. , Vallow Laura A. , Ta Randy , Joseph Richard , Krishna Murli , Ko Stephen J. , Tzou Katherine S.
Published: October 2015

Hidradenocarcinoma is a rare aggressive form of cutaneous adnexal skin carcinoma originating from the sweat gland. Due to its low incidence, prognostic and treatment strategies are still being explored both for primary and advanced disease. This tumor most often presents as either solid or cystic appearing subcutaneous nodules, which may be associated with pruritus or ulceration. To date the mainstay of treatment for local disease has been surgical excision; however, the paucity of historical data available has shown that these tumors often behave aggressively with high rates of local recurrence, metastasis, and poor overall outcomes. There are few case reports describing the utility of radiation therapy in the treatment of hidradenocarcinoma. Herein, we present a case of metastatic apocrine hidradenocarcinoma in a 32-year-old Caucasian male. The patient initially underwent excisional biopsy which confirmed the diagnosis of poorly differentiated, highly infiltrative, apocrine hidradenocarcinoma. He received systemic chemotherapy for metastatic disease, followed by radiation therapy to areas of grossly palpable adenopathy. Prior to radiation therapy the patient had an enlarged hypermetabolic conglomerate of lymph nodes in the right axilla, and borderline enlarged low activity nodes within the left axilla. He received 3 cycles of chemotherapy followed by tamoxifen and radiation therapy (50.4 Gy in 28 fractions) to areas of progressive disease in the bilateral axilla, lower neck, and axillary skin. Following treatment, the patient had complete resolution of skin nodules and improvement of his pruritus. While the role of radiation therapy in the treatment of hidradenocarcinoma has not been well established, this case report demonstrated the potential benefit of external beam radiotherapy in the management of this rare disease.
PIRO concept
Authors: Rathour S , Kumar S , Hadda V , Bhalla A , Sharma N , Varma S
Published: October 2015

Introduction:

Sepsis is common presenting illness to the emergency services and one of the leading causes of hospital mortality. Researchers and clinicians have realized that the systemic inflammatory response syndrome concept for defining sepsis is less useful and lacks specificity. The predisposition, infection (or insult), response and organ dysfunction (PIRO) staging of sepsis similar to malignant diseases (TNM staging) might give better information.

Materials and Methods:

A prospective observational study was conducted in emergency medical services attached to medicine department of a tertiary care hospital in Northern India. Patients with age 18 years or more with proven sepsis were included in the first 24 hours of the diagnosis. Two hundred patients were recruited. Multivariate logistic regression analysis was done to assess the factors that predicted in-hospital mortality.

Results:

Two hundred patients with proven sepsis, admitted to the emergency medical services were analysed. Male preponderance was noted (M: F ratio = 1.6:1). Mean age of study cohort was 50.50 ± 16.30 years. Out of 200 patients, 116 (58%) had in-hospital mortality. In multivariate logistic regression analysis, the factors independently associated with in-hospital mortality for predisposition component of PIRO staging were age >70 years, chronic obstructive pulmonary disease, chronic liver disease, cancer and presence of foley's catheter; for infection/ insult were pneumonia, urinary tract infection and meningitis/encephalitis; for response variable were tachypnea (respiratory rate >20/minute) and bandemia (band >5%). Organ dysfunction variables associated with hospital mortality were systolic blood pressure <90mm Hg, prolonged activated partial thromboplastin time, raised serum creatinine, partial pressure of oxygen in arterial blood/ fraction of inspired oxygen (PaO2 /FiO2) ratio <300, decreased urine output in first two hours of emergency presentation and Glasgow coma scale ≤9. Each of the components of PIRO had good predictive capability for in-hospital mortality but the total score was more accurate than the individual score and increasing PIRO score was associated with higher in-hospital mortality. The area under receiver operating characteristic curve for cumulative PIRO staging system as a predictor of in-hospital mortality was 0.94.

Conclusion:

This study finds PIRO staging as an important tool to stratify and prognosticate hospitalised patients with sepsis at a tertiary care center. The simplicity of score makes it more practical to be used in busy emergencies as it is based on four easily assessable components.
Incidence and factors associated with medication nonadherence in patients with mental illness
Authors: Lucca JM , Ramesh M , Parthasarathi G , Ram D
Published: October 2015

Background:

In spite of the progress made in the treatment of psychiatric disorders during the last few decades, nonadherence continues to be a frequent phenomenon, often associated with potentially severe clinical consequences and increased health-care costs. There are numerous factors associated with medication nonadherence in patients with mental illness. The aim of the study was to determine the incidence and factors associated with medication nonadherence among psychiatric outpatients.

Materials and Methods:

A cross-sectional study was carried out in the outpatient psychiatric department of an Indian tertiary care private hospital over a period of 1 year. Patients aged 18 years and above who presented with mental illness as diagnosed by the International Classification of Diseases (ICD)-10 and who were receiving at least one psychotropic medication for at least 1 month were included in the study. Medication adherence was assessed using the Medication Adherence Rating Scale (MARS).

Results:

Of the 400 patients, 172 (43%) were nonadherent to their prescribed medications. There is a statistically significant association between the education (P = 0.001), number of drugs (P = 0.002), family income (P = 0.013), and nonadherence. Among the 172 patients, 33.5 % were nonadherent to their therapy due to patient-related factors followed by drug-related factors (32%) and disease-related factors (31%).

Conclusion:

The overall incidence of medication nonadherence in patients with mental illness was 43%. Numerous factors contributed to medication nonadherence. Strategies need to be developed and implemented to enhance medication adherence, and thereby achieve a better therapeutic outcome in patients with mental illness.
An audit of consent refusals in clinical research at a tertiary care center in India
Authors: Thaker SJ , Figer BH , Gogtay NJ , Thatte UM
Published: October 2015

Background and Rationale:

Ensuring research participants’ autonomy is one of the core ethical obligations of researchers. This fundamental principle confers on every participant the right to refuse to take part in clinical research, and the measure of the number of consent refusals could be an important metric to evaluate the quality of the informed consent process. This audit examined consent refusals among Indian participants in clinical studies done at our center.

Materials and Methods:

The number of consent refusals and their reasons in 10 studies done at our center over a 5-year period were assessed. The studies were classified by the authors according to the type of participant (healthy vs patients), type of sponsor (investigator-initiated vs pharmaceutical industry), type of study (observational vs interventional), level of risk [based on the Indian Council of Medical Research (ICMR) "Ethical Guidelines for Biomedical Research on Human Participants"], available knowledge of the intervention being studied, and each patient's disease condition.

Results:

The overall consent refusal rate was 21%. This rate was higher among patient participants [23.8% vs. healthy people (14.9%); P = 0.002], in interventional studies [33.6% vs observational studies (7.5%); P < 0.0001], in pharmaceutical industry-sponsored studies [34.7% vs investigator-initiated studies (7.2%); P < 0.0001], and in studies with greater risk (P < 0.0001). The most common reasons for consent refusals were multiple blood collections (28%), inability to comply with the study protocol (20%), and the risks involved (20%).

Conclusion:

Our audit suggests the adequacy and reasonable quality of the informed consent process using consent refusals as a metric.
Fish gall bladder consumption presenting as acute renal failure
Authors: Gupta A , Karnik ND , Gupta VA , Hase NK
Published: October 2015

A forty two year old male was admitted with history of anuria and breathlessness following consumption of raw rohu fish gall bladder. He had azotemia and required hemodialysis. His renal failure improved over a period of about four weeks. Incidences have been reported from South East Asian countries associating consumption of raw rohu fish gall bladder with acute renal failure.
Свойство $K(\pi,1)$ для неособых отмеченных кривых над конечными полями
Authors: Lebacque Philippe , Schmidt Alexander
Published: October 2015

В случае неособых отмеченных кривых $(X,T)$ над конечными полями характеристики $p$ изучается свойство $K(\pi,1)$ для простого $p$. Доказано, что $(X,T)$ обладает свойством $K(\pi,1),$ если $X$ - аффинная
кривая. Если $X$ - собственная кривая, приведены примеры, показывающие, что свойство может быть как выполнено, так и не выполнено. Рассмотрен случай неотмеченных собственных кривых над конечным полем характеристики, отличной от $p$.
Библиография: 6 наименований.
Критические показатели мгновенного разрушения или локальной разрешимости нелинейных уравнений соболевского типа
Authors: Korpusov Maxim Olegovich
Published: October 2015

Рассматриваются задачи Коши для класса нелинейных уравнений соболевского типа. Показывается, что для таких задач существует критический показатель, зависящий от размерности пространства $\mathbb{R}^N$, в зависимости от которого локальное слабое решение либо существует и единственно, либо не существует.
Библиография: 21 наименование.
Об одном классе случайных возмущений иерархического лапласиана
Authors: Bendikov Alexander Davidovich , Grigor'yan Alexander Asaturovich , Molchanov Stanislav Alekseevich , Samorodnitsky Gennady Pinkhosovich
Published: October 2015

Пусть $(X,d)$ - локально компактное сепарабельное ультраметрическое пространство. Каждой мере $m$ на $X$ и каждой функции $C(B)$, определенной на множестве всех неодноточечных шаров $B$ пространства $X$, соответствует иерархический лапласиан $L=L_{C}$. Оператор $L$ действует на $L^{2}(X,m)$, существенно самосопряжен и имеет чисто точечный спектр. Выбор семейства $\{\varepsilon (B)\}$ независимых одинаково распределенных случайных величин определяет возмущенную функцию $C(B,\omega)$ и возмущенный иерархический лапласиан $L^{\omega }=L_{C(\omega)}$. Изучаются арифметические средние
$\bar{\lambda }(\omega)$ собственных значений оператора $L^{\omega }$. При некоторых слабых предположениях показано, что нормированные арифметические средние $( \bar{\lambda }-\mathbb{E}\bar{\lambda })/\sigma [\bar{\lambda }] $ сходятся к $N(0,1)$ по распределению. Приведены также примеры, когда сходимости к нормальному распределению нет. Доказано существование интегральной плотности состояний. Вводится эмпирический точечный процесс $N^{\omega }$ для собственных значений оператора $L^{\omega }$, и в предположении, что плотность состояний существует и непрерывна, доказывается, что конечномерные распределения процесса $N^{\omega }$ сходятся к конечномерным распределениям пуассоновского точечного
процесса. В качестве примера рассмотрены случайные возмущения оператора Владимирова, действующего на $L^{2}(X,m)$, где $X=\mathbb{Q}_{p}$ - кольцо $p$-адических чисел, а $m$ - мера Хаара.
Библиография: 34 наименования.
Неравенства для гармонических мер относительно неналегающих областей
Authors: Dubinin Vladimir Nikolaevich
Published: October 2015

Пусть области $B_{1}$ и $B_{2}$ являются компонентами дополнения замкнутой жордановой кривой $\Gamma\subset \overline{\mathbb{C}}$, и пусть $E(r)=z\colon |z-z_{0}|\leqslant r\}$, где $z_{0}\in \Gamma$. Известное неравенство для гармонических мер множества $\Gamma\cap E(r)$ относительно областей $B_{1}$, $B_{2}$ распространяется на случай произвольного числа попарно неналегающих областей $B_{k}$, $k=1,…, n$. Доказываются аналогичные неравенства для гармонических мер множеств, сосредоточенных в нескольких кругах либо континуумах $E_{l}(r)$, $l=1,…,m$, заданной логарифмической емкости. Кроме того, для указанных мер устанавливаются неравенства, включающие производные Шварца функций, отображающих конформно области $B_{k}$ на единичный круг.
Библиография: 12 наименований.
Дуализирующие накрытия плоскости
Authors: Kulikov Victor Stepanovich
Published: October 2015

В статье исследованы свойства дуализирующих накрытий плоскости, ассоциированных с плоскими кривыми, и полностью описано множество кривых, для которых галуивизации дуализирующих накрытий имеют в качестве своих особых точек только факторособенности.
Библиография: 14 наименований.
Числа независимости и хроматические числа случайных подграфов некоторых дистанционных графов
Authors: Bogolubsky Lev Igorevich , Gusev Anton Sergeevich , Pyaderkin Mikhail Mikhailovich , Raigorodskii Andrei Mikhailovich
Published: October 2015

Работа связана с классической задачей Нелсона-Хадвигера о поиске хроматического числа
дистанционных графов в $\mathbb R^n$. В основном мы рассматриваем класс графов $G(n, r,s)=(V(n, r), E(n,r,s))$, определeнных так:
\begin{gather*}
V(n, r)=\{\mathbf{x}=(x_1,…,x_n) : x_i\in\{0, 1\}, x_1+…+x_n=r\},

E(n,r,s)=\{\{\mathbf{x}, \mathbf{y}: (\mathbf{x}, \mathbf{y})=s\}\},
\end{gather*}
где $(\mathbf{x}, \mathbf{y})$ - евклидово скалярное произведение. В частности, хроматическое число $G(n,3,1)$ недавно было найдено Й. Балогом, А. В. Косточкой, А. М. Райгородским. Мы изучаем случайные подграфы $\mathscr{G}(G(n,r,s), p)$, ребра в которых выбираются независимо из множества $E(n,r,s)$ каждое с вероятностью $p$. Найдены нетривиальные нижние и верхние оценки числа независимости и хроматического числа таких графов. В случае, когда $r-s$ есть степень простого числа и $r\leq 2s+1$, удалось установить порядок $\alpha(\mathscr{G}(G(n,r,s), p))$ и $\chi(\mathscr{G}(G(n,r,s), p))$.
Библиография: 51 название.
A Tool to Assess Family Medicine Residents' Patient Encounters Using Secure Messaging
Authors: Kim Jung G. , Morris Carl G. , Heidrich Fred E.
Published: October 2015

Background

Secure messages exchanged between patients and family medicine residents via an electronic health record (EHR) could be used to assess residents' clinical and communication skills, but the mechanism is not well understood.

Objective

To design and test a secure messaging competency assessment for family medicine residents in a patient-centered medical home (PCMH).

Methods

Using the existing literature and evidence-based guidelines, we designed an assessment tool to evaluate secure messaging competency for family medicine residents training in a PCMH. Core faculty performed 2-stage validity and reliability testing (n = 2 and n = 9, respectively). A series of randomly selected EHR secure messages (n = 45) were assessed from a sample of 10 residents across all years of training.

Results

The secure message assessment tool provided data on a set of competencies and a framework for resident feedback. Assessment showed 10% (n = 2) of residents at the novice level, 50% (n = 10) as progressing, and 40% (n = 8) as proficient. The most common deficiencies for residents' secure messages related to communication rather than clinical competencies (n = 37 [90%] versus n = 4 [10%]). Interrater reliability testing ranged from 60% to 78% agreement and 20% to 44% disagreement. Disagreement centered on interpersonal communication factors. After 2 stages of testing, the assessment using residents' secure messages was incorporated into our existing evaluation process.

Conclusions

Assessing family medicine residents' secure messaging for patient encounters closed an evaluation gap in our family medicine program, and offered residents feedback on their clinical and communication skills in a PCMH.
Multisite Study to Examine the Amount of Inpatient Physician Continuity Experienced by Hospitalized Patients
Authors: Fletcher Kathlyn E. , Singh Siddhartha , Whittle Jeff , Ratkalkar Vishal , Visotcky Alexis M. , Laud Purushottam , Kordus Andrew , Schapira Marilyn M.
Published: October 2015

Background

Continuity for inpatient medicine has been widely discussed, but methods for measuring it have been lacking.

Objective

To measure the continuity of care experienced by hospitalized patients and to identify predictors of continuity.

Methods

This was a multisite prospective cohort study and retrospective chart review that took place at 3 hospitals: an academic tertiary care center, a Veterans Affairs medical center, and a community teaching hospital. Subjects were general medicine patients and internal medicine residents. We measured continuity of care using 3 metrics: (1) the percentage of hospital time covered by the primary intern; (2) the amount of time between admission and the first handoff of care; and (3) admission-discharge continuity. We conducted univariate analyses to identify patient and hospital factors that may be associated with each type of continuity of care.

Results

Our sample included 869 patients with a mean age of 62.6 years (SD = 17.2) and 34% female patients. The mean percentage of hospital time covered by the primary intern was 39.2% (SD = 16.3%). The mean time between admission and the first handoff of care was 13.3 hours (SD = 7.1). Forty percent of patients experienced admission-discharge continuity. In univariate and multivariable modeling, the site was significantly associated with each type of continuity.

Conclusions

The amount of continuity varied greatly and was influenced by the site and other factors. No site maximized every aspect of continuity. Programs and institutions should decide which aspects of continuity are most important locally and design schedules accordingly.
Residency as a Social Network: Burnout, Loneliness, and Social Network Centrality
Authors: Shapiro Jordan , Zhang Bin , Warm Eric J.
Published: October 2015

Background

Burnout is typically viewed as an individual condition, and no link has been identified between burnout and loneliness.

Objective

To investigate the association of burnout with loneliness and social network degree and centrality.

Methods

A survey containing the Maslach Burnout Inventory (MBI), a 3-question loneliness scale, and a social connectivity component was sent to residents in a large urban academic medical center internal medicine residency program.

Results

The response rate was 77% (95 of 124 residents). We defined significant burnout as MBI subscores of ≥ 27 for emotional exhaustion (EE), ≥ 10 for depersonalization (DP), or both. This was met by 43 (45%), 47 (49%), and 31 (33%) out of 95 respondents, respectively. Those with significant burnout had higher loneliness scores: 5.6 versus 4.5 for EE (P = .002; OR = 1.50; 95% CI 1.15–1.95); 5.4 versus 4.6 for DP (P = .024; OR = 1.33; 95% CI 1.03–1.71); and 5.8 versus 4.6 for both EE and DP (P = .001; OR = 1.54; 95% CI 1.17–2.02). Rating a larger number of coresidents as closer connections on a 5-point Likert scale was not associated with lower burnout scores. No measures of centrality were associated with burnout scores for EE and/or DP. High personal accomplishment subscores on the MBI did correlate significantly with several measures of centrality.

Conclusions

Burnout was associated with loneliness in a dose-dependent fashion. Greater sense of personal accomplishment was associated with greater network centrality.