bluuebunny/crossref_metadata_2025 huggingface dataset:
The Belgian policy of funding antimicrobial stewardship in hospitals and trends of selected quality indicators for antimicrobial use, 1999–2010: a longitudinal study
Authors: Lambert Marie-Laurence , Bruyndonckx Robin , Goossens Herman , Hens Niel , Aerts Marc , Catry Boudewijn , Neely Fiona , Vogelaers Dirk , Hammami Naima
Published: February 2015

Objectives

In order to improve antimicrobial (AM) use, a policy of providing technical and financial support to AM management teams (AMTs) was rolled out in all Belgian hospitals between 2002 and 2008. We aimed to analyse the association of this policy with AM use for the two indications accounting for the largest number of patients receiving AM: prophylaxis for major lower limb orthopaedic surgery and pneumonia.

Design, setting, participants

We used patient-level data routinely collected in all Belgian acute care hospitals between 1999 and 2010. We modelled trends for selected quality indicators (QIs) using the year of AMT implementation in each hospital as the main ‘change point’, with fine-tuned case-mix adjustment. Of all admissions for lower limb orthopaedic surgery, and pneumonia between 1999 and 2010, 90% (325 094) and 95% (327 635), respectively, were found eligible for analyses.

Outcomes

The surgery QI was defined as: cefazolin, dose in the expected range, and no use of other AM. For pneumonia, QIs were: ratio of oral/parenteral defined daily doses (DDD, O/P QI), and mean number of DDD minus penicillin, per 100 days of hospitalisation (DDD QI).

Results

Between 1999 and 2010, the surgery QI improved from 59% to 71%, the O/P QI from 0.72 to 0.97, and the DDD QI from 96 to 64. Heterogeneity between hospitals was high. Overall, no association was found with the year of implementation of the AMT.

Conclusions

Improvements have been observed but could not be related at the national level to the policy under study. However, these results cannot be extrapolated to other QIs for AM use in hospitals. Our findings do not question the need for AMT, nor the need for continuation of AMT funding. Several recommendations can be made in order to make the best of Belgium's unique political and financial commitments in that field.
Smad4 inactivation predicts for worse prognosis and response to fluorouracil-based treatment in colorectal cancer
Authors: Kozak Margaret M , von Eyben Rie , Pai Jonathan , Vossler Stephen R , Limaye Maneesha , Jayachandran Priya , Anderson Eric M , Shaffer Jenny L , Longacre Teri , Pai Reetesh K , Koong Albert C , Chang Daniel T
Published: February 2015

Aims

To determine whether expression of Smad4, a tumour suppressor found to be absent in 10% of colorectal cancer (CRC), is associated with outcomes in patients with CRC.

Methods

Tumour samples from 241 consecutive patients with CRC who underwent upfront colon resection between 2005 and 2009 were obtained. Triplicate tissue cores from resected primary colon tumours and matched normal controls were used to construct the tissue microarrays (TMAs). We examined the expression of Smad4 using immunohistochemistry. Clinicopathological records were obtained for all patients. TMAs were reviewed by two pathologists and scored as either ‘positive’ or ‘negative’ for nuclear staining. In total, 21 of 241 tumours (8.6%) were Smad4 negative.

Results

Loss of Smad4 expression correlated with significantly worse overall survival (OS) (p=0.011) and disease-free survival (DFS) (p=0.024). Patients with loss of Smad4 expression had a median OS of 31 months compared with 89 months positive Smad4 expression. Loss of Smad4 remained significant on multivariate analysis for OS (p=0.0097). In patients with node-positive disease, loss of Smad4 predicts for worse DFS (p=0.012). In patients with metastatic and recurrent disease, Smad4 loss predicts for worse OS (p=0.012). Of the patients that received capecitabine over the course of their treatment, those with Smad4 loss (n=13) had significantly worse DFS (p=0.003) and OS (p=0.0007).

Conclusions

Loss of Smad4 expression is associated with worse DFS and OS in multiple subsets of patients with CRC. Further studies are required to validate our findings and ascertain the role of Smad4 status in the management of this disease.
A multistep cytological approach for patients with jaundice and biliary strictures of indeterminate origin
Authors: Boldorini Renzo , Paganotti Alessia , Andorno Silvano , Orlando Stefania , Mercalli Francesca , Orsello Marco , Ballarè Marco , Magnani Corrado , Sartori Massimo
Published: February 2015

Aims

Fluorescence in situ hybridisation (FISH) increases the sensitivity for detecting pancreatobiliary tract cancer over routine cytology. In this study, diagnostic accuracy and costs of cytology and FISH in detecting cancer in patients with jaundice with biliary strictures were assessed.

Methods

Brushing specimens from 109 patients with jaundice were obtained during endoscopic retrograde cholangiopancreatography and examined by cytology and FISH. The specimens were considered FISH-positive for malignancy if at least five polysomic cells or 10 cells with homozygous or heterozygous 9p21/p16 deletion were detected. Definitive diagnosis of the stricture as benign or malignant relied on surgical pathology (45 cases) or clinical-radiological follow-up >18 months (64 cases). We calculated costs of cytology and FISH based on the reimbursement from the Piedmont region, Italy (respectively, €33 and €750).

Results

Ninety of 109 patients had evidence of malignancy (44 pancreatic carcinomas, 36 cholangiocarcinomas, 5 gallbladder carcinomas, 5 other cancers), while 19 had benign strictures. Routine cytology showed 42% sensitivity, but 100% specificity for the diagnosis of malignancy, while FISH-polysomy showed 70% sensitivity with 100% specificity and FISH-polysomy plus homozygous or heterozygous 9p21/p16 deletion showed 76% sensitivity with 100% specificity. The cost per additional correct diagnosis of cancer obtained by FISH, in comparison with cytology, was €1775 using a sequential cytological approach (ie, performing FISH only in patients with negative or indeterminate cytology).

Conclusions

FISH should be recommended as the second step in detecting cancer in patients with jaundice with pancreatobiliary tract strictures and cytology negative or indeterminate for malignancy.
Longer breastfeeding duration reduces the positive relationships among gestational weight gain, birth weight and childhood anthropometrics
Authors: Zhu Yeyi , Hernandez Ladia M , Dong Yongquan , Himes John H , Hirschfeld Steven , Forman Michele R
Published: February 2015

Background

The relationship between gestational weight gain (GWG) and childhood growth remains controversial. An examination on whether infant feeding practices mediate this relationship may improve our understanding of it.

Methods

We investigated whether the relationships among GWG, birth weight and childhood anthropometrics were mediated through infant feeding practices (breastfeeding duration and age at introduction of solid foods) in a cross-sectional multiethnic study of 1387 mothers and their children aged 0–5.9 years in the USA (2011–2012). Child anthropometrics included age-specific and sex-specific z-scores for weight-for-age (WAZ), height/length-for-age (HAZ), weight-for-height/length (WHZ) and body mass index-for-age (BMIZ); and ulnar length, a marker for limb growth. We used structural equation modelling to calculate standardised path coefficients and total, direct and indirect associations of GWG, birth weight and infant feeding practices with child anthropometrics.

Results

Maternal GWG had a positive indirect association with all anthropometrics mediated via birth weight, whereas longer breastfeeding duration reduced the positive associations of GWG and birth weight with WAZ, WHZ and BMIZ in non-Hispanics (β=−0.077, −0.064 and −0.106, respectively). Longer breastfeeding duration and introducing solid foods at a later age were positively associated with ulnar length (β=0.023 and 0.030, respectively) but not HAZ, suggesting a distinct association, for the first time, with limb growth.

Conclusions

Findings suggest that promoting longer breastfeeding duration among women with excessive GWG who had high birthweight newborns may mitigate the potential for their offspring to develop obesity. In addition, findings reinforce the importance of promoting appropriate GWG and preventing high birth weight, which are positively associated with childhood anthropometrics.
Recurrent miscarriage: causes, evaluation and management
Authors: Garrido-Gimenez Carmen , Alijotas-Reig Jaume
Published: February 2015

Recurrent miscarriage is frustrating for the physician and a heartbreaking experience for the patient. Approximately 5% of couples trying to conceive have two consecutive miscarriages. Despite a thorough study of patients, the aetiology of this common obstetric complication is unknown in 50% of cases. Known causes include abnormal chromosomes, endocrinological disorders and uterine abnormalities. Although antiphospholipid antibodies have been demonstrated in miscarriages, the role played by alloimmune mechanisms remains unclear. New immunological approaches such as natural killer cells, regulatory T cells, tumour necrosis factor α, cell-derived microparticles, leptin, certain glycoproteins and cytokines should be considered. The management of thyroid diseases and immunological disorders is continuously evolving. Several genetic diagnostic procedures such as parental karyotyping and preimplantation genetic screening should probably not be used routinely. Antiphopholipid syndrome and some recurrent miscarriage-related endocrinological disorders can be effectively treated. Finally, new therapeutic approaches and the pleiotropic effects of old ones have led to improved fetal–maternal outcomes.
Permanent deformation characteristics of saturated sand under cyclic loading
Authors: Cai Yuanqiang , Sun Qi , Guo Lin , Juang C. Hsein , Wang Jun
Published: February 2015

The loading path involving principal stress rotation (PSR) during shear is an important phenomenon encountered in many field conditions. Typically for traffic loading, both the magnitude and direction of principal stresses may vary with time due to the motion of vehicles, and the stress path can be mimicked by a heart shape in the deviatoric stress space. Conventional triaxial tests are not suitable to recreate this type of stress path in that no torsional shear stress can be applied on the test samples. To overcome this limitation, a series of tests using a hollow cylinder apparatus were conducted on sand to investigate the permanent deformation characteristics under drained conditions with different levels of confining pressure (σc), cyclic vertical stress ratio (CVSR), and cyclic torsional stress ratio (η). The results clearly show an increase in the permanent deformation with η, indicating that the PSR effect on permanent deformation cannot be ignored. Both σc and CVSR were found to also affect permanent deformation, which was more pronounced when PSR was coupled into the test. A five-parameter formulation that accounted for the effect of confining pressure, deviatoric stress, torsional shear stress, and number of loading cycles was subsequently established to analyze the permanent strain. The formulation coefficients were first determined and then used to explain the effects of stress variables on the permanent deformation. Validation studies were performed to address the adequacy of the formulation to predict permanent deformation.
Three-dimensional numerical analysis of geocell-reinforced soft clay beds by considering the actual geometry of geocell pockets
Authors: Hegde A.M. , Sitharam T.G.
Published: February 2015

Due to its complex honeycomb structure, the numerical modeling of the geocell has always been a big challenge. Generally, the equivalent composite approach is used to model the geocells. In the equivalent composite approach, the geocell–soil composite is treated as the soil layer with improved strength and stiffness values. Though this approach is very simple, it is unrealistic to model the geocells as the soil layer. This paper presents a more realistic approach of modeling the geocells in three-dimensional (3D) framework by considering the actual curvature of the geocell pocket. A square footing resting on geocell reinforced soft clay bed was modeled using the “fast Lagrangian analysis of continua in 3D” (FLAC3D) finite difference package. Three different material models, namely modified Cam-clay, Mohr–Coulomb, and linear elastic were used to simulate the behaviour of foundation soil, infill soil and the geocell, respectively. It was found that the geocells distribute the load laterally to the wider area below the footing as compared to the unreinforced case. More than 50% reduction in the stress was observed in the clay bed in the presence of geocells. In addition to geocells, two other cases, namely, only geogrid and geocell with additional basal geogrid cases were also simulated. The numerical model was systematically validated with the results of the physical model tests. Using the validated numerical model, parametric studies were conducted to evaluate the influence of various geocell properties on the performance of reinforced clay beds.
Quantitative parameter of risk perception: can we measure a geoethic and socio-economic component in disaster vulnerability?
Authors: Kostyuchenko Yuriy V. , Movchan Dmytro
Published: February 2015

This paper is dedicated to the study of risk perception issues. A formal algorithm for the quantitative analysis of social factors of disaster risk is proposed. A modified form of the damage function based on the prospect theory and decision making under uncertainty due to cognitive bias and the handling of risk is proposed. Relationships for analysis of the most probable damage according to age, education and income of the population are proposed. Using multi-source statistics, the interconnected influence of education and long-term experience (education function) on the one hand, and short-term information (risk perception function) on the other hand to develop the damage function as a measure of vulnerability toward disasters has been demonstrated. As the result of the data analysis demonstrates, up to half of the damage function might be caused by social factors: education, long-term experience and responsible behaviour of information agents. It was concluded that public efforts based on ethical principles and directed toward empowering people and developing the human capacity through education can have a positive response in reducing vulnerability and enhancing the adaptive capacity toward the disasters including climate-related threats.
The L'Aquila trial
Authors: Cocco Massimo , Cultrera Giovanna , Amato Alessandro , Braun Thomas , Cerase Andrea , Margheriti Lucia , Bonaccorso Alessandro , Demartin Martina , De Martini Paolo Marco , Galadini Fabrizio , Meletti Carlo , Nostro Concetta , Pacor Francesca , Pantosti Daniela , Pondrelli Silvia , Quareni Francesca , Todesco Micol
Published: February 2015

The first stage of the trial in L'Aquila (Italy) ended with a conviction of seven experts, convened by the head of Civil Protection on 31 March 2009, for multiple manslaughter and serious injuries. They were sentenced to six years in jail, perpetual interdiction from public office and a fine of several million euros to be paid to the victims of the earthquake of 6 April 2009 (moment magnitude 6.3) for having caused, by their negligent conduct, the death of 29 persons and the injury of several others. The verdict had a tremendous impact on the scientific community and on the way scientists deliver their expert opinions to decision makers and society. This paper analyses the scientific argumentations reported in the Verdict Motivations, where scientific data and results were largely debated and misused to demonstrate that they should have been considered as a tool to predict an impending large earthquake. Moreover, we show that the supposed message of reassurance was not generated at the experts’ meeting or by the official Istituto Nazionale di Geofisica e Vulcanologia reports. The media had a key role in conveying information during the seismic swarm, contributing to the risk perception. We stress that prevention actions based on seismic hazard knowledge are the best defence against earthquakes.
A geoethical approach to industrial development of georesources and groundwater use: the Indian experience
Authors: Limaye Shrikant Daji
Published: February 2015

Geoethics is a new branch of geosciences, which is located at the meeting point of geology, philosophy, sociology, economics and ecology. In the past hundred years or so, the human footprints on the natural ecosystems are constantly getting larger and more detrimental. The development of natural resources, such as minerals and water, has certainly contributed to the economic progress of many developed and low-income nations but it has also caused degradation of the ecosystem. The sustainable use of natural resources or the eco-friendly and socio-friendly use of natural resources to ensure a long-term assurance of ecosystem services is a recent thought, which is the foundation of observing geoethics. This paper takes an overview of geoethical principles and discusses their application at the field level while developing groundwater or mineral resources. Although the paper is based on the author's experience in India, the methods are equally applicable in other low-income countries faced with the problem of balancing industrial and agricultural development with environmental protection.
Simple geoethics: an essay on daily Earth science
Authors: Bohle Martin
Published: February 2015

As research into the functioning of Earth, Earth sciences concern many subjects that influence the everyday dealings of the general population. However, these subjects often pass unnoticed and people have little chance to consider how these subjects intersect with their daily lives, thus, limiting their opportunities to develop informed insights regarding humankind's position within Earth's systems. To overcome this limitation, Earth science storylines should be part of the general public discourse, as meteorology experiences have been for some time. As examples can show, many opportunities for ‘telling Earth science storylines’ exist, including the use of social media for outreach activities. Earth science specialists should tell ‘Earth science storylines’ inspired by the founding scientists of geosciences who in their time were often called ‘physical geographers’.
Indispensable role of endothelial nitric oxide synthase in caloric restriction-induced cardioprotection against ischemia-reperfusion injury
Authors: Shinmura Ken , Tamaki Kayoko , Ito Kentaro , Yan Xiaoxiang , Yamamoto Tsunehisa , Katsumata Yoshinori , Matsuhashi Tomohiro , Sano Motoaki , Fukuda Keiichi , Suematsu Makoto , Ishii Isao
Published: February 2015

Caloric restriction (CR) confers cardioprotection against ischemia-reperfusion injury (IRI). We previously found that treatment with NG-nitro-l-arginine methyl ester completely abrogates CR-induced cardioprotection and increases nuclear sirtuin 1 (Sirt1) expression. However, it remains unclear whether endothelial nitric oxide (NO) synthase (eNOS) plays a role in CR-induced cardioprotection and Sirt1 activation. We subjected eNOS-deficient (eNOS−/−) mice to either 3-mo ad libitum (AL) feeding or CR (−40%). Isolated perfused hearts were subjected to 25-min global ischemia followed by 60-min reperfusion. The degree of myocardial IRI in AL-fed eNOS−/− mice was more severe than that in AL-fed wild-type mice. Furthermore, CR did not exert cardioprotection in eNOS−/− mice. eNOS−/− mice exhibited elevated blood pressure and left ventricular hypertrophy compared with wild-type mice, although they underwent CR. Although nuclear Sir1 content was increased, the increases in cardiac Sirt1 activity with CR was absent in eNOS−/− mice. In eNOS−/− mice treated with hydralazine, blood pressure and left ventricular weight became comparable with CR-treated wild-type mice. However, CR-induced cardioprotection was not observed. Resveratrol enhanced cardiac Sirt1 activity but failed to mimic CR-induced cardioprotection in eNOS−/− mice. Finally, combination therapy with resveratrol and hydralazine attenuated myocardial IRI and reduced infarct size in eNOS−/− mice, and their effects were comparable with those observed in CR-treated wild-type mice. These results demonstrate the essential roles of eNOS in the development of CR-induced cardioprotection and Sirt1 activation during CR. The combination of a relatively low dose of resveratrol with an adequate vasodilator therapy might be useful for managing patients with endothelial dysfunction associated with impaired NO bioavailability.
The functional effect of dilated cardiomyopathy mutation (R144W) in mouse cardiac troponin T is differently affected by α- and β-myosin heavy chain isoforms
Authors: Gollapudi Sampath K. , Tardiff Jil C. , Chandra Murali
Published: February 2015

Given the differential impact of α- and β-myosin heavy chain (MHC) isoforms on how troponin T (TnT) modulates contractile dynamics, we hypothesized that the effects of dilated cardiomyopathy (DCM) mutations in TnT would be altered differently by α- and β-MHC. We characterized dynamic contractile features of normal (α-MHC) and transgenic (β-MHC) mouse cardiac muscle fibers reconstituted with a mouse TnT analog (TnTR144W) of the human DCM R141W mutation. TnTR144Wdid not alter maximal tension but attenuated myofilament Ca2+sensitivity ( pCa50) to a similar extent in α- and β-MHC fibers. TnTR144Wattenuated the speed of cross-bridge (XB) distortion dynamics ( c) by 24% and the speed of XB recruitment dynamics ( b) by 17% in α-MHC fibers; however, both b and c remained unaltered in β-MHC fibers. Likewise, TnTR144Wattenuated the rates of XB detachment ( g) and tension redevelopment ( ktr) only in α-MHC fibers. TnTR144Walso decreased the impact of strained XBs on the recruitment of new XBs (γ) by 30% only in α-MHC fibers. Because c, b, g, ktr, and γ are strongly influenced by thin filament-based cooperative mechanisms, we conclude that the TnTR144W- and β-MHC-mediated changes in the thin filament interact to produce a less severe functional phenotype, compared with that brought about by TnTR144Wand α-MHC. These observations provide a basis for lower mortality rates of humans (β-MHC) harboring the TnTR141Wmutant compared with transgenic mouse studies. Our findings strongly suggest that some caution is necessary when extrapolating data from transgenic mouse studies to human hearts.
Adaptive capacity of the right ventricle: why does it fail?
Authors: Poels Ella M. , da Costa Martins Paula A. , van Empel Vanessa P. M.
Published: February 2015

Only in recent years has the right ventricle (RV) function become appreciated to be equally important to the left ventricle (LV) function to maintain cardiac output. Right ventricular failure is, irrespectively of the etiology, associated with impaired exercise tolerance and poor survival. Since the anatomy and physiology of the RV is distinctly different than that of the LV, its adaptive mechanisms and the pathways involved are different as well. RV hypertrophy is an important mechanism of the RV to preserve cardiac output. This review summarizes the current knowledge on the right ventricle and its response to pathologic situations. We will focus on the adaptive capacity of the right ventricle and the molecular pathways involved, and we will discuss potential therapeutic interventions.
Possible involvement of downregulation of the apelin-APJ system in doxorubicin-induced cardiotoxicity
Authors: Hamada Juri , Baasanjav Altansarnai , Ono Natsumi , Murata Kazuya , Kako Koichiro , Ishida Junji , Fukamizu Akiyoshi
Published: February 2015

Apelin peptide is an endogenous ligand of APJ (a putative receptor protein related to the angiotensin II type 1 receptor), which is a member of a G protein-coupled receptor superfamily with seven transmembrane domains. Recent findings have suggested that the apelin-APJ system plays a potential role in cardiac contraction and cardioprotection. In the present study, we show that the apelin-APJ system is disrupted in doxorubicin (Dox)-induced cardiotoxicity. We found downregulation of apelin and APJ mRNA expression in C57Bl/6J mouse hearts on days 1 and 5 after Dox administration (20 mg/kg ip). Plasma apelin levels and cardiac APJ protein expression were significantly decreased on day 5 after Dox injection. Cardiac apelin contents were reduced on day 1 but increased to basal levels on day 5 after Dox injection. We also examined the effects of APJ gene deletion on Dox-induced cardiotoxicity. Compared with wild-type mice, APJ knockout mice showed a significant depression in cardiac contractility on day 5 after Dox (15 mg/kg ip) treatment followed by a decrease in 14-day survival rates. Moreover, Dox-induced myocardial damage, cardiac protein carbonylation, and autophagic dysfunction were accelerated in APJ knockout mice. Rat cardiac H9c2 cells showed Dox-induced decreases in viability, which were prevented by APJ overexpression and the combination with apelin treatment. These results suggest that the suppression of APJ expression after Dox administration can exacerbate Dox-induced cardiotoxicity, which may be responsible for depressed protective function of the endogenous apelin-APJ system. Modulation of the apelin-APJ system may hold promise for the treatment of Dox-induced cardiotoxicity.
Effects of exercise training on neurovascular control and skeletal myopathy in systolic heart failure
Authors: Negrao Carlos E. , Middlekauff Holly R. , Gomes-Santos Igor L. , Antunes-Correa Ligia M.
Published: February 2015

Neurohormonal excitation and dyspnea are the hallmarks of heart failure (HF) and have long been associated with poor prognosis in HF patients. Sympathetic nerve activity (SNA) and ventilatory equivalent of carbon dioxide (VE/VO2) are elevated in moderate HF patients and increased even further in severe HF patients. The increase in SNA in HF patients is present regardless of age, sex, and etiology of systolic dysfunction. Neurohormonal activation is the major mediator of the peripheral vasoconstriction characteristic of HF patients. In addition, reduction in peripheral blood flow increases muscle inflammation, oxidative stress, and protein degradation, which is the essence of the skeletal myopathy and exercise intolerance in HF. Here we discuss the beneficial effects of exercise training on resting SNA in patients with systolic HF and its central and peripheral mechanisms of control. Furthermore, we discuss the exercise-mediated improvement in peripheral vasoconstriction in patients with HF. We will also focus on the effects of exercise training on ventilatory responses. Finally, we review the effects of exercise training on features of the skeletal myopathy in HF. In summary, exercise training plays an important role in HF, working synergistically with pharmacological therapies to ameliorate these abnormalities in clinical practice.
Impact of an endurance training program on exercise-induced cardiac biomarker release
Authors: Legaz-Arrese Alejandro , López-Laval Isaac , George Keith , Puente-Lanzarote Juan José , Mayolas-Pi Carmen , Serrano-Ostáriz Enrique , Revilla-Martí Pablo , Moliner-Urdiales Diego , Reverter-Masià Joaquín
Published: February 2015

We evaluated the influence of a 14-wk endurance running program on the exercise-induced release of high-sensitivity cardiac troponin T (hs-cTnT) and NH2-terminal pro-brain natriuretic peptide (NT-proBNP). Fifty-eight untrained participants were randomized to supervised endurance exercise (14 wk, 3–4 days/wk, 120–240 min/wk, 65–85% of maximum heart rate) or a control group. At baseline and after the training program, hs-cTnT and NT-proBNP were assessed before and 5 min, 1 h, 3 h, 6 h, 12 h, and 24 h after a 60-min maximal running test. Before training, hs-cTnT was significantly elevated in both groups with acute exercise ( P < 0.0001) with no between-group differences. There was considerable heterogeneity in peak hs-cTnT concentration with the upper reference limit exceeded in 71% of the exercise tests. After training, both baseline and postexercise hs-cTnT were significantly higher compared with pretraining and the response of the control group ( P = 0.008). Acute exercise led to a small but significant increase in NT-proBNP, but this was not mediated by training ( P = 0.121). In summary, a controlled endurance training intervention resulted in higher pre- and postexercise values of hs-cTnT with no changes in NT-proBNP.
Surface‐Initiated Atom Transfer Radical Polymerization of Magnetite Nanoparticles with Statistical Poly(tert‐butyl acrylate)‐poly(poly(ethylene glycol) methyl ether methacrylate) Copolymers
Authors: Kanhakeaw Patcharin , Rutnakornpituk Boonjira , Wichai Uthai , Rutnakornpituk Metha
Published: February 2015

This work presented the surface modification of magnetite nanoparticle (MNP) with poly[(t‐butyl acrylate)‐stat‐(poly(ethylene glycol) methyl ether methacrylate)] copolymers (P[(t‐BA)‐stat‐PEGMA]) via a surface‐initiated “grafting from” atom transfer radical polymerization (ATRP). Loading molar ratio of t‐BA to PEGMA was systematically varied (100 : 0, 75 : 25, 50 : 50, and 25 : 75, resp.) such that the degree of hydrophilicity of the copolymers, affecting the particle dispersibility in water, can be fine‐tuned. The reaction progress in each step of the synthesis was monitored via Fourier transform infrared spectroscopy (FTIR). The studies in the reaction kinetics indicated that PEGMA had higher reactivity than that of t‐BA in the copolymerizations. Gel permeation chromatography (GPC) indicated that the molecular weights of the copolymers increased with the increase of the monomer conversion. Transmission electron microscopy (TEM) revealed that the particles were spherical with averaged size of 8.1 nm in diameter. Dispersibility of the particles in water was apparently improved when the copolymers were coated as compared to P(t‐BA) homopolymer coating. The percentages of MNP and the copolymer in the composites were determined via thermogravimetric analysis (TGA) and their magnetic properties were investigated via vibrating sample magnetometry (VSM).
Polymorphisms of GLP-1 Receptor Gene and Response to GLP-1 Analogue in Patients with Poorly Controlled Type 2 Diabetes
Authors: Lin Chia-Hung , Lee Yun-Shien , Huang Yu-Yao , Hsieh Sheng-Hwu , Chen Zih-Syuan , Tsai Chi-Neu
Published: February 2015

Aim. The relationship between genetic polymorphisms of the glucagon-like peptide-1 (GLP-1) receptor (GLP1R) gene and unresponsiveness to GLP-1 analogue treatment in patients with poorly controlled type 2 diabetes mellitus (DM) is unclear.Methods. Thirty-six patients with poorly controlled type 2 DM were enrolled and they received six days of continuous subcutaneous insulin infusion for this study. After the normalization of blood glucose in the first 3 days, the patients then received a combination therapy with injections of the GLP-1 analogue, exenatide, for another 3 days. All 13 exons and intron-exon boundaries of theGLP1Rgene were amplified to investigate the association.Results. The short tandem repeat at 8GA/7GA (rs5875654) had complete linkage disequilibrium (LD, withr2=1) with single nucleotide polymorphism (SNP) rs761386. Quantitative trait loci analysis ofGLP1Rgene variation with clinical response of GLP1 analogue showed the missense rs3765467 and rs761386 significantly associated with changes in the standard deviation of plasma glucose (SDPGbaseline-SDPGtreatment with GLP-1 analogue) (P=0.041and 0.019, resp.). The reportedPvalues became insignificant after multiple testing adjustments.Conclusion. The variable response to the GLP-1 analogue was not statistically correlated with polymorphisms of theGLP1Rgene in patients with poorly controlled type 2 DM.
Cognitive Outcomes following Transcatheter Aortic Valve Implantation: A Systematic Review
Authors: Lai Ka Sing Paris , Herrmann Nathan , Saleem Mahwesh , Lanctôt Krista L.
Published: February 2015

Severe aortic stenosis is the most common valvular heart disease in the elderly in the Western world and contributes to a large proportion of all deaths over the age of 70. Severe aortic stenosis is conventionally treated with surgical aortic valve replacement; however, the less invasive transcatheter aortic valve implantation (TAVI) is suggested for those at high surgical risk. While TAVI has been associated with improved survival and favourable outcomes, there is a higher incidence of cerebral microembolisms in TAVI patients. This finding is of concern given mechanistic links with cognitive decline, a symptom highly prevalent in those with cardiovascular disease. This paper reviews the literature assessing the possible link between TAVI and cognitive changes. Studies to date have shown that global cognition improves or remains unchanged over 3 months following TAVI while individual cognitive domains remain preserved over time. However, the association between TAVI and cognition remains unclear due to methodological limitations. Furthermore, while these studies have largely focused on memory, cognitive impairment in this population may be predominantly of vascular origin. Therefore, cognitive assessment focusing on domains important in vascular cognitive impairment, such as executive dysfunction, may be more helpful in elucidating the association between TAVI and cognition in the long term.
Hybrid Control for Bidirectional Z‐Source Inverter for Locomotives
Authors: Vijayan Vasanthi , Ashok S.
Published: February 2015

Electric traction uses three phase locomotives in main line services. Three phase locomotives consist of voltage source inverters for driving the traction motors. This paper proposes a hybrid algorithm for bidirectional Z‐source inverters in accelerating region of operation of locomotives. The speed control method adopted is same as that in the existing three phase locomotives which is variable voltage variable frequency. Bidirectional Z‐source inverter is designed for getting the same output power as in voltage source inverter fed locomotives. Simulation is done in all regions of traction speed curve, namely, acceleration, free running, and braking by regeneration. The voltage stress across the devices and modulation index are considered while analyzing the proposed control algorithm. It is found that the modulation index remains at a high value over the entire range of frequencies. Due to the higher value of modulation index the harmonics in the inverter output voltage is reduced. Also the voltage stress across devices is limited to a value below the device rating used in the present three phase locomotives. A small scale prototype of the bi‐directional Z‐source inverter fed drive is developed in the laboratory and the hybrid control was verified in the control topology.
Conservative Management for Lingual Thyroid Ectopic
Authors: Sigua-Rodriguez Eder Alberto , Rangel Goulart Douglas , Asprino Luciana , de Moraes Manzano Afonso Celso
Published: February 2015

Lingual thyroid gland is a rare clinical entity. The presence of an ectopic thyroid gland located at the base of the tongue may be presented with symptoms like dysphagia, dysphonia, and upper airway obstruction. We are introducing a case of an 8-year-old girl who had lingual thyroid that presented dysphagia and foreign body sensation in the throat. The diagnostic was reached with clinical examination, thyroid scintigraphy withTc99mand ultrasound. A laryngoscopy was performed which confirmed a spherical mass at base of tongue. Investigation should include thyroid function tests. In this case we observed subclinical hypothyroidism. There are different types of surgical approaches for the treatment of this condition; however, the treatment with Levothyroxine Sodium allowed the stabilization of TSH levels and clinical improvement of symptoms in a follow-up of 2 years.
On Homogeneous Parameter-Dependent Quadratic Lyapunov Function for RobustH∞Filtering Design in Switched Linear Discrete-Time Systems with Polytopic Uncertainties
Authors: Pang Guochen , Zhang Kanjian
Published: February 2015

This paper is concerned with the problem of robustH∞filter design for switched linear discrete-time systems with polytopic uncertainties. The condition of being robustly asymptotically stable for uncertain switched system and less conservativeH∞noise-attenuation level bounds are obtained by homogeneous parameter-dependent quadratic Lyapunov function. Moreover, a more feasible and effective method against the variations of uncertain parameter robust switched linear filter is designed under the given arbitrary switching signal. Lastly, simulation results are used to illustrate the effectiveness of our method.
A Proven Case of CutaneousRhizopusInfection Presenting with Severe Limb Pain Very Soon after Induction Treatment in a Patient with Acute Lymphoblastic Leukemia
Authors: Pepeler Mehmet Sezgin , Acar Kadir , Güzel Tunçcan Özlem , Uluoğlu Ömer , Kalkancı Ayşe , Atalar Hakan , Kılıç Koray , Türköz Sucak Gülsan
Published: February 2015

Objective and Importance. Invasive mucormycosis may complicate the course of patients with hematologic malignancies and has a very high mortality rate. Early diagnosis and aggressive approach combined with surgical and medical treatment have paramount importance for cure.Clinical Presentation. We report here a case of a patient with acute lymphoblastic leukemia presenting with a subcutaneous mass lesion which was sampled by an ultrasound guided needle biopsy. The pathology showed microorganisms with aseptate hyphae with wide, irregular walls and more or less branching with highly vertical angles which suggested a mold infection. The specimen was also cultured whereRhizopusspp. grew.Conclusion. Posaconazole 200 mg QID was commenced. She recovered from neutropenia and pain on day 20 of treatment. After 4 courses of hyper-CVAD chemotherapy, the remaining soft tissue mass was removed surgically and she underwent allogeneic HSCT from a full matched sibling donor under secondary prophylaxis.
Structural Characterization andIn VitroAntioxidant Activity of Kojic Dipalmitate Loaded W/O/W Multiple Emulsions Intended for Skin Disorders
Authors: Gonçalez Maíra Lima , Marcussi Diana Gleide , Calixto Giovana Maria Fioramonti , Corrêa Marcos Antonio , Chorilli Marlus
Published: February 2015

Multiple emulsions (MEs) are intensively being studied for drug delivery due to their ability to load and increase the bioavailability of active lipophilic antioxidant, such as kojic dipalmitate (KDP). The aim of this study was to structurally characterize developed MEs by determining the average droplet size (Dnm) and zeta potential (ZP), performing macroscopic and microscopic analysis and analyzing their rheological behavior andin vitrobioadhesion. Furthermore, thein vitrosafety profile and antioxidant activity of KDP-loaded MEs were evaluated. The developed MEs showed a Dnm of approximately 1 micrometer and a ZP of −13 mV, and no change was observed in Dnm or ZP of the system with the addition of KDP. KDP-unloaded MEs exhibited ‘‘shear thinning’’ flow behavior whereas KDP-loaded MEs exhibited Newtonian behavior, which are both characteristic of antithixotropic materials. MEs have bioadhesion properties that were not influenced by the incorporation of KDP. The results showed that the incorporation of KDP into MEs improved the safety profile of the drug. Thein vitroantioxidant activity assay suggested that MEs presented a higher capacity for maintaining the antioxidant activity of KDP. ME-based systems may be a promising platform for the topical application of KDP in the treatment of skin disorders.
Roles of Osteopontin Gene Polymorphism (rs1126616), Osteopontin Levels in Urine and Serum, and the Risk of Urolithiasis: A Meta-Analysis
Authors: Li Xiao , Liu Kang , Pan Yongsheng , Zhang Jing , Lv Qiang , Hua Lixin , Wang Zengjun , Li Jie , Yin Changjun
Published: February 2015

Objective. Previous studies have investigated the relationships between osteopontin gene polymorphism rs1126616 and OPN levels and urolithiasis, but the results were controversial. Our study aimed to clarify such relationships.Methods. A meta-analysis was performed by searching the databases Pubmed, Embase, and Web of Science for relevant studies. Crude odds ratios (ORs) or standardised mean differences with 95% confidence intervals (CIs) were calculated to evaluate the strength of association. Publication bias was estimated using Begg’s funnel plots and Egger’s regression test.Results. Overall, a significantly increased risk of urolithiasis was associated with OPN gene polymorphism rs1126616 for all the genetic models except recessive model. When stratified by ethnicity, the results were significant only in Turkish populations. For OPN level association, a low OPN level was detected in the urine of urolithiasis patients in large sample size subgroup. Results also indicated that urolithiasis patients have lower OPN level in serum than normal controls.Conclusion. This meta-analysis revealed that the T allele of OPN gene polymorphism increased susceptibility to urolithiasis. Moreover, significantly lower OPN levels were detected in urine and serum of urolithiasis patients than normal controls, thereby indicating that OPN has important functions in the progression of urolithiasis.
Effect of Variable Fluid Properties on Natural Convection of Nanofluids in a Cavity with Linearly Varying Wall Temperature
Authors: Bhuvaneswari M. , Ganesan Poo Balan , Sivasankaran S. , Viswanathan K. K.
Published: February 2015

The present study analyzed convective heat transfer and fluid flow characteristics of nanofluid in a two-dimensional square cavity under different combinations of thermophysical models of nanofluids. The right vertical wall temperature is varying linearly with height and the left wall is maintained at low temperature whereas the horizontal walls are adiabatic. Finite volume method is used to solve the governing equations. Two models are considered to calculate the effective thermal conductivity of the nanofluid and four models are considered to calculate the effective viscosity of the nanofluid. Numerical solutions are carried out for different combinations of effective viscosity and effective thermal conductivity models with different volume fractions of nanoparticles and Rayleigh numbers. It is found that the heat transfer rate increases for Models M1 and M3 on increasing the volume fraction of the nanofluid, whereas heat transfer rate decreases for Model M4 on increasing the volume fraction of the nanoparticle. The difference among the effective dynamic viscosity models of nanofluid plays an important role here such that the average Nusselt number demonstrates an increasing or decreasing trend with the concentration of nanoparticle.
Animal Models of Diabetic Macrovascular Complications: Key Players in the Development of New Therapeutic Approaches
Authors: Heinonen Suvi E. , Genové Guillem , Bengtsson Eva , Hübschle Thomas , Åkesson Lina , Hiss Katrin , Benardeau Agnes , Ylä-Herttuala Seppo , Jönsson-Rylander Ann-Cathrine , Gomez Maria F.
Published: February 2015

Diabetes mellitus is a lifelong, incapacitating metabolic disease associated with chronic macrovascular complications (coronary heart disease, stroke, and peripheral vascular disease) and microvascular disorders leading to damage of the kidneys (nephropathy) and eyes (retinopathy). Based on the current trends, the rising prevalence of diabetes worldwide will lead to increased cardiovascular morbidity and mortality. Therefore, novel means to prevent and treat these complications are needed. Under the auspices of the IMI (Innovative Medicines Initiative), the SUMMIT (SUrrogate markers for Micro- and Macrovascular hard end points for Innovative diabetes Tools) consortium is working on the development of novel animal models that better replicate vascular complications of diabetes and on the characterization of the available models. In the past years, with the high level of genomic information available and more advanced molecular tools, a very large number of models has been created. Selecting the right model for a specific study is not a trivial task and will have an impact on the study results and their interpretation. This review gathers information on the available experimental animal models of diabetic macrovascular complications and evaluates their pros and cons for research purposes as well as for drug development.
Effect of Piperidin-4-ones on the Corrosion Inhibition of Mild Steel in 1 N H2SO4
Authors: Tharial Xavier Glory , Thirumalairaj Brindha , Jaganathan Mallika
Published: February 2015

The corrosion inhibition of mild steel in 1 N sulphuric acid solution by 2,6-diphenylpiperidin-4-ones with various substituents at 3- and 3,5-positions (01–06) has been tested by weight loss, potentiodynamic polarization, electrochemical impedance spectroscopic methods, and FTIR and UV absorption spectra. The surface morphology of the mild steel specimen has been analyzed by SEM. The effect of temperature (300 to 323 ± 1 K) on the corrosion behavior of mild steel in the presence of the inhibitors (01–06) was studied using weight loss techniques. The effect of anions (Cl−, Br−, and I−) on the corrosion behavior of mild steel in the presence of the same inhibitors was also studied by weight loss method and the synergism parameters were calculated. The adsorption characteristics of the inhibitors have been determined from the results.
Prospects of HA-Based Universal Influenza Vaccine
Authors: Hashem Anwar M.
Published: February 2015

Current influenza vaccines afford substantial protection in humans by inducing strain-specific neutralizing antibodies (Abs). Most of these Abs target highly variable immunodominant epitopes in the globular domain of the viral hemagglutinin (HA). Therefore, current vaccines may not be able to induce heterosubtypic immunity against the divergent influenza subtypes. The identification of broadly neutralizing Abs (BnAbs) against influenza HA using recent technological advancements in antibody libraries, hybridoma, and isolation of single Ab-secreting plasma cells has increased the interest in developing a universal influenza vaccine as it could provide life-long protection. While these BnAbs can serve as a source for passive immunotherapy, their identification represents an important step towards the design of such a universal vaccine. This review describes the recent advances and approaches used in the development of universal influenza vaccine based on highly conserved HA regions identified by BnAbs.
Synthesis of Superparamagnetic Iron Oxide Nanoparticles Modified with MPEG‐PEI via Photochemistry as New MRI Contrast Agent
Authors: Zhang Yancong , Zhang Lianying , Song Xinfeng , Gu Xiangling , Sun Hanwen , Fu Chunhua , Meng Fanzong
Published: February 2015

Novel method for synthesis of superparamagnetic iron oxide nanoparticles (SPIONs) coated with polyethylenimine (PEI) and modified with poly(ethylene glycol) methyl ether (MPEG), MPEG‐PEI‐SPIONs, was developed. PEI‐SPIONs were successfully prepared in aqueous system via photochemistry, and their surface was modified with poly(ethylene glycol) methyl ether (MPEG). The so‐obtained MPEG‐PEI‐SPIONs had a uniform hydrodynamic particle size of 34 nm. The successful coating of MPEG‐PEI on the SPIONs was ascertained from FT‐IR analysis, and the PEI and MPEG fractions in MPEG‐PEI‐SPIONs were calculated to account for 31% and 12%, respectively. Magnetic measurement revealed that the saturated magnetization of MPEG‐PEI‐SPIONs reached 46 emu/g and the nanoparticles showed the characteristic of being superparamagnetic. The stability experiment revealed that the MPEG‐PEI modification improved the nanoparticles stability greatly. T2 relaxation measurements showed that MPEG‐PEI‐SPIONs show similar R2 value to the PEI‐SPIONs. The T2‐weighted magnetic resonance imaging (MRI) of MPEG‐PEI‐SPIONs showed that the magnetic resonance signal was enhanced significantly with increasing nanoparticle concentration in water. These results indicated that the MPEG‐PEI‐SPIONs had great potential for application in MRI.