bluuebunny/crossref_metadata_2025 huggingface dataset:
BMP9-Induced Osteogenetic Differentiation and Bone Formation of Muscle-Derived Stem Cells
Authors: Xiang Li , Liang Chen , Zhen-Yong Ke , Liang-Jun Yin , Zhong-Liang Deng
Published: January 2012

Efficient osteogenetic differentiation and bone formation from muscle-derived stem cells (MDSCs) should have potential clinical applications in treating nonunion fracture healing or bone defects. Here, we investigate osteogenetic differentiation ability of MDSCs induced by bone morphogenetic protein 9 (BMP9)in vitroand bone formation ability in rabbit radius defects repairing model. Rabbit's MDSCs were extracted by type I collagenase and trypsin methods, and BMP9 was introduced into MDSCs by infection with recombinant adenovirus. Effects of BMP9-induced osteogenetic differentiation of MDSCs were identified with alkaline phosphatase (ALP) activity and expression of later marker. In stem-cell implantation assay, MDSCs have also shown valuable potential bone formation ability induced by BMP9 in rabbit radius defects repairing test. Taken together, our findings suggest that MDSCs are potentiated osteogenetic stem cells which can be induced by BMP9 to treat large segmental bone defects, nonunion fracture, and/or osteoporotic fracture.
Male Fertility and Reduction in Semen Parameters: A Single Tertiary-Care Center Experience
Authors: Milardi D. , Grande G. , Sacchini D. , Astorri A. L. , Pompa G. , Giampietro A. , De Marinis L. , Pontecorvi A. , Spagnolo A. G. , Marana R.
Published: January 2012

Background. Infertility is both a clinical and a public problem, affecting the life of the couple, the healthcare services, and social environment. Standard semen analysis is the surrogate measure of male fertility in clinical practice.Objective. To provide information about the relationship between semen parameters and spontaneous conception.Methods. We evaluated retrospectively 453 pregnancies that occurred among 2935 infertile couples evaluated at an infertility clinic of a tertiary-care university hospital, between 2004 and 2009.Results. Normal semen analysis was present only in 158 patients; 295 subfertile patients showed alterations in at least one seminal parameter. A reduction in all seminal parameters was observed in 41 patients. Etiological causes of male infertility were identified in 314 patients.Conclusion. Our data highlights the possibility of a spontaneous conception with semen parameters below WHO reference values. Therefore, we support the importance of defining reference values on a population of fertile men. Finally, we analyzed the related ethical issues.
Study on High Performance of MPI-Based Parallel FDTD from WorkStation to Super Computer Platform
Authors: He Z. L. , Huang K. , Zhang Y. , Yan Y. , Liang C. H.
Published: January 2012

Parallel FDTD method is applied to analyze the electromagnetic problems of the electrically large targets on super computer. It is well known that the more the number of processors the less computing time consumed. Nevertheless, with the same number of processors, computing efficiency is affected by the scheme of the MPI virtual topology. Then, the influence of different virtual topology schemes on parallel performance of parallel FDTD is studied in detail. The general rules are presented on how to obtain the highest efficiency of parallel FDTD algorithm by optimizing MPI virtual topology. To show the validity of the presented method, several numerical results are given in the later part. Various comparisons are made and some useful conclusions are summarized.
CZE/PAD and HPLC-UV/PAD Profile of Flavonoids from Maytenus aquifolium and Maytenus ilicifolia “espinheira santa” Leaves Extracts
Authors: Diagone Cristina A. , Colombo Renata , Lanças Fernando M. , Yariwake Janete H.
Published: January 2012

This paper describes the application of HPLC and CZE to analyze flavonoids in the leaves of Maytenus ilicifolia and Maytenus aquifolium, which are species widely used in Brazilian folk medicine. The two species showed different flavonoid profiles, but acidic hydrolysis of the Maytenus extracts confirmed that all these compounds are quercetin or kaempferol derivatives. A comparison of the CZE and HPLC profiles of Maytenus extracts showed numerous flavonoid peaks using HPLC. However, the advantages of CZE such as analysis without requiring clean-up and less generation of chemical waste than with HPLC point to the potential of the CZE technique for the quality control (routine analysis) of “espinheira santa” phytopharmaceuticals.
Relationship between Color and Translucency of Multishaded Dental Composite Resins
Authors: Naeimi Akbar Homan , Moharamzadeh Keyvan , Wood Duncan J. , Van Noort Richard
Published: January 2012

The aim of the present study was to compare the translucency of different shades of two highly aesthetic multilayered restorative composite resins. In total nine shades from Esthet.X and ten shades from Filtek Supreme composite resins were chosen. Discs of each shade were prepared (N=3) and light-cured. Total and diffuse transmittance values for each sample were measured. Statistical analysis showed that the opaque dentine shades of both composites were the least translucent and the enamel shades had the highest translucency. There was a significant decrease in translucency from A2 to C2 of regular body shades and also from A4 to C4 of opaque dentine shades of Esthet.X composite resin. Grey enamel shade had a significantly higher diffuse translucency compared to clear and yellow enamel shades. There was a significant decrease in translucency from A2B to D2B and also in diffuse translucency from A4D to C6D shades of Filtek Supreme composite resin. It can be concluded that the color of the composite resins tested in this study had a significant effect on their translucency. Information on the translucency of different shades of composite resins can be very useful for the clinicians in achieving optimal esthetic restorative outcome.
Further Evidence on the Role of Thyroid Autoimmunity in Women with Recurrent Miscarriage
Authors: Lazzarin Natalia , Moretti Costanzo , De Felice Giovanna , Vaquero Elena , Manfellotto Dario
Published: January 2012

It has been twenty years since the first paper reporting the association between thyroid antibodies (TAIs) and spontaneous miscarriage was published. Following this observation, several studies have clearly demonstrated an increased prevalence of TAI in patients with recurrent miscarriage (RM). However, the exact mechanism underlying this association remains a matter of debate. The aim of the present study was to evaluate the thyroid function, throughout a specific test, in patient with RM and TAI focusing on the hypothesis that TAI should be an indirect sign of a mild thyroid dysfunction. 46 patients with RM and TAI were included in the study. All patients underwent short TRH stimulation test showing an abnormal response in the vast majority of cases (65%). Normal FT4 and FT3 mean values were found whereas TSH values were in the upper normal range (2.64±1.3 mUI/L). Our data support the hypothesis that in patients with RM the presence of TAI is an indirect sign of a subtle thyroid dysfunction detectable by a specific test. This test give the possibility to identify women with RM in which specific therapeutic approaches could effectively improve the possibility for a successful pregnancy.
Good Oral Health and Diet
Authors: Scardina G. A. , Messina P.
Published: January 2012

An unhealthy diet has been implicated as risk factors for several chronic diseases that are known to be associated with oral diseases. Studies investigating the relationship between oral diseases and diet are limited. Therefore, this study was conducted to describe the relationship between healthy eating habits and oral health status. The dentistry has an important role in the diagnosis of oral diseases correlated with diet. Consistent nutrition guidelines are essential to improve health. A poor diet was significantly associated with increased odds of oral disease. Dietary advice for the prevention of oral diseases has to be a part of routine patient education practices. Inconsistencies in dietary advice may be linked to inadequate training of professionals. Literature suggests that the nutrition training of dentists and oral health training of dietitians and nutritionists is limited.
Myasthenia Gravis in Pregnancy: A Case Report
Authors: Berlit Sebastian , Tuschy Benjamin , Spaich Saskia , Sütterlin Marc , Schaffelder Regine
Published: January 2012

Objective. To present a case of maternal myasthenia gravis in pregnancy and give a systematic review of the literature.Case. We report the case of a 38-year-old parturient with a life-threatening complication of immune-mediated myasthenia gravis shortly after an elective cesarean section on patient's request under spinal anesthesia at 35 + 3 weeks of gestation. The newborn was transferred to the pediatric unit for surveillance and did not show any signs of muscular weakness in the course of time. The mother developed a respiratory insufficiency on the second day postpartum. The myasthenic crisis led to a progressive dyspnoea within minutes, which exacerbated in a secondary generalized seizure with cardiac-circulatory arrest. After successful cardiopulmonary resuscitation, the patient was transferred to intensive care. The interdisciplinary therapeutic approach included ventilatory assistance via endotracheal intubation, parenteral pyridostigmine, azathioprine, and steroids. By interdisciplinary measures, a stable state was regained.Conclusion. Myasthenia gravis especially when associated with pregnancy is a high-risk disease. As this disease predominantly occurs in women of reproductive age, it is important to be aware of this condition in obstetrics and its interdisciplinary diagnostic and therapeutic management.
Surgical Treatment of Liver Metastases in Neuroendocrine Neoplasms
Authors: Jagannath Palepu , Chhabra Deepak , Shrikhande Shailesh , Shah Rajiv
Published: January 2012

Neuroendocrine neoplasms (NENs) are a distinctive entity, and nearly 10% of patients already have liver metastases at presentation. The management of neuroendocrine liver metastases (NEN-LM) is complex with differing patterns of metastatic presentation. An aggressive approach should be used to resect the primary tumor, to remove regional lymph nodes, and to resect or treat appropriate distant metastases (including liver tumors). Despite having an indolent course, NENs have a significantly reduced survival when liver metastases are untreated. Though a wide range of therapies are now available with a multimodal approach to the treatment, surgical treatment offers the only chance for a significant survival prolongation and/or improvement of symptoms and quality of life. A review of the existing surgical modalities for NEN-LM is discussed in this paper.
Physicians’ Ability to Predict Hospital Length of Stay for Patients Admitted to the Hospital from the Emergency Department
Authors: Mak Gregory , Grant William D. , McKenzie James C. , McCabe John B.
Published: January 2012

Accurate predictions of patient length of stay (LOS) in the hospital can effectively manage hospital resources and increase efficiency of patient care. A study was done to assess emergency medicine physicians' ability of predicting the LOS of patients who enter the hospital through the ER. Results indicate that EM physicians are relatively accurate with their pediatric patients than any other age groups. In addition, as actual hospital LOS increases, the prediction accuracy decreases. Possible reasons may be due increasing medical complications associated with increasing age and this may lead to overall longer stays. Other variables such as the admitted service of the patient are not statistically significant in predicting LOS in this study. Future studies should be done in order to determine other variables that may affect LOS predictions.
The Existence of Solutions for a Fractional 2m‐Point Boundary Value Problems
Authors: Wang Gang , Liu Wenbin , Yang Jinyun , Zhu Sinian , Zheng Ting
Published: January 2012

By using the coincidence degree theory, we consider the following 2m‐point boundary value problem for fractional differential equation ,
0 < t < 1,
where 2 < α ≤ 3, and are the standard Riemann‐Liouville fractional derivative and fractional integral, respectively. A new result on the existence of solutions for above fractional boundary value problem is obtained.
Transtympanic Electrocochleography for the Diagnosis of Ménière's Disease
Authors: Hornibrook Jeremy , Kalin Catherine , Lin Emily , O'Beirne Greg A. , Gourley John
Published: January 2012

This paper evaluated the diagnostic power of electrocochleography (ECochG) in detecting Ménière's disease (MD) as compared with two subjective assessment methods, including the clinical guidelines provided by the American Academy of Otolaryngology—Head and Neck Surgery Committee on Hearing Equilibrium and the Gibson score. A retrospective study of 250 suspected MD cases was conducted. The agreement between the three assessment methods was found to be relatively high, with a total reliability being higher than 70%. Participants who tested “positive” with ECochG exhibited a higher occurrence rate of asymmetric hearing threshold as well as the four MD symptoms, namely, vertigo, hearing loss, tinnitus, and aural fullness. The “positive” ECochG group also showed a high correlation between the ECochG measures in response to stimuli at adjacent frequency ranges, suggesting that the interfrequency ECochG correspondence may be sensitive to the presence of endolymphatic hydrops and thus may serve as a useful diagnostic marker for MD.
On the Study of Viscoelastic Walters′ B Fluid in Boundary Layer Flows
Authors: Madani Tonekaboni Seyed Ali , Abkar Ramin , Khoeilar Reza
Published: January 2012

Viscoelastic Walters′ B fluid flows for three problems, stagnation‐point flow, Blasius flow, and Sakiadis flow, have been investigated. In each problem, Cauchy equations are changed to a nondimensional differential equations using stream functions and with assumption of boundary layer flow. The fourth‐order predictor‐corrector finite‐difference method for solving these nonlinear differential equations has been employed. The results that have been obtained using this method are compared with the results of the last studies, and it is clarified that this method is more accurate. It is also shown that the results of last study about Sakiadis flow of Walter′s B fluid are not true. In addition, the effects of order of discretization in the boundaries are investigated. Moreover, it has been discussed about the valid region of Weissenberg numbers for the second‐order approximation of viscoelastic fluids in each case of study.
Health Care Seeking Behavior among Caregivers of Sick Children Who Had Cerebral Malaria in Northwestern Nigeria
Authors: Eseigbe Edwin E. , Anyiam Jane O. , Ogunrinde Gboye O. , Wammanda Robinson D. , Zoaka Hassan A.
Published: January 2012

Cerebral malaria is a significant cause of childhood morbidity in our region. The challenges of effective management include time and quality of treatment. The study appraised the health care seeking behavior of caregivers of sick children who developed cerebral malaria, in Zaria, northwestern Nigeria. Caregivers indentified were parents 29 (87.9%) and grandparents 4 (12.1%). Most of them were in the upper social classes. Health care options utilized before presentation at our facility were formal health facility 24 (72.7%), patent medicine seller 12 (36.4%), home treatment 10 (30.3%), and herbal concoction 6 (18.2%) with majority 24 (72.7%) using more than one option. Antimalarial therapy was instituted in 25 (75.6%) of the cases. Mortality was significantly associated with the use of herbal concoction, treatment at a formal health facility and patent medicine seller, multiple convulsions, age less than 5 years, and noninstitution of antimalarial therapy before presentation. The study showed use of inappropriate health care options by caregivers and highlighted the need to pursue an awareness drive among caregivers on the use of health care options.
The Loss of Smell in Persistent Allergic Rhinitis Is Improved by Levocetirizine due to Reduction of Nasal Inflammation but Not Nasal Congestion (the CIRANO Study)
Authors: Guilemany José Maria , García-Piñero Alfons , Alobid Isam , Centellas Silvia , Mariño Franklin Santiago , Valero Antonio , Bernal-Sprekelsen Manuel , Picado César , Mullol Joaquim
Published: January 2012

Background: Persistent allergic rhinitis (PER) has a moderate impact on the sense of smell, but no controlled study has reported the effect of antihistamines on the loss of smell in patients with PER. Methods: Patients with PER and subjective loss of the sense of smell (n = 27) were included in this pilot randomised, double-blind, placebo-controlled study. Nasal symptoms, nasal endoscopy, skin prick test, acoustic rhinometry, peak nasal inspiratory flow, nasal nitric oxide (nNO), and olfactometry (Barcelona Smell Test-24; BAST-24) were performed and evaluated in all PER patients at baseline and after 7 and 30 days of treatment with levocetirizine 5 mg or placebo. Results: The study population was randomized into two homogeneous groups: levocetirizine (n = 14) and placebo groups (n = 13). The evolution of symptoms reflected the therapeutic effect of levocetirizine treatment on rhinorrhea, nasal itching, eye itching, sneezing, and the total symptoms score after 7 and 30 days. Significant improvement in loss of smell by a visual analog scale (VAS) was observed after 7 days of levocetirizine treatment (7.2 ± 4.3; p < 0.05) compared to placebo (–9.4 ± 6.2). Improvement in smell identification by BAST-24 was strongly correlated (r = 0.72; p < 0.05) with smell improvement by VAS after 30 days. After 7 days of treatment with levocetirizine, the nNO values decreased (–494 ± 188) compared to placebo (155 ± 284 ppb; p < 0.05). Conclusions: The CIRANO study suggests that levocetirizine is effective on PER symptoms, including a transient improvement in loss of smell, and that this improvement concurs more with reduction of nasal inflammation than of nasal patency.
Visibility of the Lesser Sphenoid Wing Is an Important Indicator for Detecting the Middle Cerebral Artery on Transcranial Color-Coded Sonography
Authors: Suzuki Rieko , Koga Masatoshi , Mori Mayumi , Endo Kaoru , Toyoda Kazunori , Minematsu Kazuo
Published: January 2012

Background: Failure to detect the sphenoidal segment of the middle cerebral artery (M1) on transcranial color-coded sonography (TCCS) results from either M1 occlusion or an insufficient temporal bone window (TBW). We sought to identify a simple indicator on B mode images for M1 evaluation. Methods: Consecutive acute ischemic stroke patients with an intact M1 segment underwent prospective TCCS evaluation. Visibilities of the contralateral temporal bone (CTB), midbrain (MB) and lesser sphenoid wing (LSW) on B mode images were defined as follows: ‘invisible’, ‘poor’ if the contour was less than 50% visible, ‘fair’ if more than 50% visible and ‘good’ if totally visible. M1 detectability on color Doppler images was defined as follows: ‘INVISIBLE’, ‘POOR’ if the M1 was detected as color dots, ‘FAIR’ if linearly but discontinuously detectable, and ‘GOOD’ if linearly and continuously detectable. The relationship between each structure’s visibility and M1 detectability was assessed. Results: Seventy-six patients with 152 TBWs were evaluated. The CTB was ‘invisible’ in 2%, ‘poor’ in 22%, ‘fair’ in 36% and ‘good’ in 40%. Visibility of the MB was 36, 24, 26 and 14%, respectively. Visibility of the LSW was 16, 22, 29 and 32%, respectively. The M1 was ‘INVISIBLE’ in 51%, ‘POOR’ in 7%, ‘FAIR’ in 7% and ‘GOOD’ in 35%. Spearman’s rank correlation coefficient between each structure’s visibility and M1 detectability was 0.68 for the CTB, 0.66 for the MB and 0.80 for the LSW, respectively (p < 0.001 for all). Conclusion: Visibility of the LSW on B mode appears to be a better indicator than other structures for M1 evaluation.
Intensive Radiographic and Biomarker Surveillance in Stage II and III Colorectal Cancer
Authors: Fora Ahmad , Patta Annie , Attwood Kristopher , Wilding Gregory , Fakih Marwan
Published: January 2012

Objective: The objective of this study was to determine the rate of salvage resections in patients with stage II and III colorectal cancer following intensive surveillance in a comprehensive cancer center. Methods: Patients with stage II and III colorectal cancer with a minimum follow-up of 3 years were included. Carcinoembryonic antigen was obtained every 3 months for 2 years and then every 6 months for years 3–5. CT scans of the chest, abdomen and pelvis were performed every 6 months for 2 years and then yearly for years 3–5. Colonoscopy was performed at year 1 and then every 3 years. Results: One hundred and seventy-seven patients were followed for a median of 60 months; 44 patients were diagnosed with recurrent disease. CT was the first sign of recurrence in 68% of patients. Carcinoembryonic antigen test was normal in 20 patients (45%) at the time of disease recurrence. Twenty-five patients (57%) with recurrent disease underwent curative-intent resection, 12 of whom are still cancer free at a median follow-up of 81 months. Conclusions: In this retrospective study, intensive radiographic screening was associated with a high salvage resection rate, which led to favorable clinical outcomes. Randomized clinical trials are urgently needed to define the optimal duration and schedule of radiographic screening in stage II and III colorectal cancer.
Adiponectin and Cardiovascular Outcomes among Hemodialysis Patients
Authors: Abdallah Emad , Waked Emam , Nabil Malak , El-Bendary Omnia
Published: January 2012

Background: Adiponectin (ADPN) levels are consistently elevated among patients with advanced chronic kidney disease, but its relationship with cardiovascular outcomes in this population remains controversial. The aim of our study was to measure the plasma levels of ADPN in patients with end-stage renal disease on maintenance hemodialysis (HD) and we studied its correlates to cardiovascular outcomes and mortality. Methods: Our study included 133 HD patients (79 male and 54 female patients) with a mean age of 54.6 ± 17.3 years who had been receiving regular HD for at least 6 months in the nephrology units of Theodor Bilharz Research Institute, Cairo, Egypt. The clinical and biochemical correlates of plasma ADPN levels were investigated and the predictive power of ADPN levels with respect to cardiovascular events and mortality was prospectively tested in HD patients, who were monitored for 24 ± 9 months. Plasma ADPN levels were measured by using a sensitive enzyme-linked immunosorbent assay. Results: Plasma ADPN levels were 3 times higher (p < 0.0001) among HD patients (18.1 ± 6.8 µg/ml) than among healthy subjects (6.2 ± 1.8 µg/ml). Plasma ADPN levels were lower (p < 0.007) among patients who experienced new cardiovascular events (13.9 ± 6.4 µg/ml) than among event-free patients (18.6 ± 8.4 µg/ml). The relative risk of cardiovascular events was 1.96 times (95% confidence interval 1.290–2.977, p = 0.0016) higher among patients in group 1 (ADPN <15.1 µg/ml), compared with those in group 2 (ADPN ≥15.1 µg/ml). Plasma ADPN levels were inversely related to BMI, insulin levels, homeostatic model assessment index values, triglyceride and LDL-C, CRP and left ventricular mass index. Furthermore, plasma ADPN levels were directly related to HDL-C. Conclusion: Plasma ADPN is an independent (inverse) predictor of cardiovascular events and mortality among HD patients. The directions of the relationships between ADPN and several metabolic risk factors indicate that ADPN has a protective role in prevention of CVD.
Evolution of Depression Symptoms following Stroke: A Prospective Study Using Computerized Ambulatory Monitoring
Authors: Sibon Igor , Lassalle-Lagadec Saioa , Renou Pauline , Swendsen Joel
Published: January 2012

Background: Despite the high prevalence and impact of post-stroke depression (PSD), questions persist concerning the nature and stability of PSD over time. The current study uses state-of-the-art computerized ambulatory monitoring techniques to assess daily life depression symptoms following stroke and examines the evolution of depression levels over a three-month period. Methods: 48 patients admitted to a university hospital neurology unit for ischemic or hemorrhagic stroke participated in ambulatory monitoring of DSM-IV depression symptoms for a one-week period after hospital discharge. Clinician-administered measures of depression were also obtained at discharge and again three months later. Results: The percentage of the sample with elevated depression scores was the same at discharge and three months later, but consistency in depression profiles was low. Ambulatory monitoring revealed that elevated depression levels at hospital discharge were most strongly associated with anhedonia (t ratio = 4.840, p < 0.001) and fatigue (t ratio = 4.00, p < 0.001), whereas individuals with elevated scores at three months were predicted by daily life negative thoughts (t ratio = 4.051, p < 0.001), anxious mood (t ratio = 3.489, p < 0.01), sad mood (t ratio = 2.621, p < 0.05) and emotional reactivity (t ratio = 2.466, p < 0.05). Conclusions: The prevalence of depression may appear stable during the immediate weeks and months following stroke, but it is likely to be composed of very different symptom profiles. The immediate physical and psychological impact of stroke may induce somatic symptoms that explain elevated depression levels and which may not indicate a risk factor for later depression.
The Proteasome Inhibitor Bortezomib Prevents Lupus Nephritis in the NZB/W F1 Mouse Model by Preservation of Glomerular and Tubulointerstitial Architecture
Authors: Hainz Nadine , Thomas Susanne , Neubert Kirsten , Meister Silke , Benz Kerstin , Rauh Manfred , Daniel Christoph , Wiesener Michael , Voll Reinhard E. , Amann Kerstin
Published: January 2012

Background/Aims: Crucial steps in the initiation of lupus nephritis are the deposition of (auto-)antibodies and consequent complement activation. In spite of aggressive treatment patients may develop terminal renal failure. Therefore, new treatment strategies are needed. In extension to our previously published data we here analyzed the potential renoprotective mechanisms of bortezomib (BZ) in experimental lupus nephritis by focusing on morphological changes. Methods: Female NZB×NZW F1 mice develop lupus-like disease with extensive nephritis that finally leads to lethal renal failure. Treatment with 0.75 mg/kg BZ i.v. or placebo (PBS) twice per week started at 18 or 24 weeks of age. Antibody production was measured with ELISA and kidney damage was determined by quantitative morphological and immunohistochemical methods. Results: BZ treatment completely inhibited antibody production in both BZ-treated groups and prevented the development of nephritis in comparison to PBS-treated animals. Glomerular and tubulointerstitial damage scores, collagen IV expression, mean glomerular volume as well as tubulointerstitial proliferation and apoptosis were significantly lower after BZ treatment. Glomerular ultrastructure and in particular podocyte damage and loss were prevented by BZ treatment. Conclusions: BZ effectively prevents the development of nephritis in the NZB/W F1 mouse model. Specific protection of podocyte ultrastructure may critically contribute to renoprotection by BZ, which may also represent a potential new treatment option in human lupus nephritis.
Rituximab Treatment for Adults with Refractory Nephrotic Syndrome: A Single-Center Experience and Review of the Literature
Authors: Kisner Tuelay , Burst Volker , Teschner Sven , Benzing Thomas , Kurschat Christine E.
Published: January 2012

Background/Aims: Minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS) are common causes of nephrotic syndrome (NS) in adults. However, induction of remission and sustained control of proteinuria is often difficult. Recently, B cell-directed therapy using the anti-CD20 antibody rituximab has been suggested as induction regimen in pediatric FSGS and MCD patients. Data on rituximab use in adults are still limited. Methods: We report on rituximab use in five consecutively treated adult patients (mean age 42.2 ± 9.9 years) with FSGS or relapsing MCD (2 FSGS, 3 MCD) who failed to respond to standard immunosuppressive treatment. Median follow-up was 8 months (3–25). Results: Rituximab induced complete remission in 2 MCD patients and partial remission in 3 patients. Proteinuria was reduced by 86.8% (42.9–95.2) 3 months and by 73.0% (60.1–95.5) 6 months after therapy. In 1 patient with severe FSGS, partial remission was not evident before 6 months after rituximab treatment. Relapses occurred in 2 patients. No severe adverse events related to rituximab were observed. Conclusion: Our findings suggest that B cell-directed therapies are novel treatment options for adults with refractory NS. Response to rituximab varied, with MCD patients exhibiting a faster and more pronounced response compared to FSGS patients.
Changing Profile of Health and Function from Age 70 to 85 Years
Authors: Jacobs Jeremy M. , Maaravi Yoram , Cohen Aaron , Bursztyn Michael , Ein-Mor Eliana , Stessman Jochanan
Published: January 2012

Background: Old age has traditionally been considered to begin at age 65. The improving health and functional status observed among older people may necessitate reevaluation of this cut-off point. Objective: To present the changing prevalence of common geriatric syndromes, functional parameters, common disease status and health care utilization, at ages 70, 78 and 85, in order to help address the question of when does contemporary aging actually begin. Methods: Medical, psychosocial, cognitive, and functional status, and health service utilization at age 70, 78 and 85 were assessed through the Jerusalem Longitudinal Cohort Study (1990–2010), which prospectively followed a representative sample (born 1920–1921), of 1,861 people, all of whom underwent home-based comprehensive assessment. Results: At age 70, the cohort had good health, low comorbidity, preserved cognition, mobility and independence in basic and instrumental activities of daily activities (ADL). Rising comorbidity, declining cognitive status, increasing depression, and difficulty in ADLs were seen at 78. By age 85, compared to age 70, comorbidity had tripled, depression, hearing and visual impairment, falls, dizziness and mobility problems had doubled; 23% of subjects had cognitive impairment, 42.5% suffered urinary incontinence, and dependence in basic and instrumental ADLs was common (37.8 and 51.7%, respectively). Home care was 4.5, 10.1, and 24.6%, and hospitalization in the previous year occurred among 12.3, 18.8 and 27.8% at ages 70, 78 and 85, respectively. Conclusions: At age 70, the overall health profile was favorable, prevalence of geriatric syndromes was low, cognitive and functional status was preserved, and health service utilization was low. The progressive deterioration seen at ages 78 and more profoundly so at age 85, suggest that a cut-off point beyond age 70 years may serve to better define entry into old age.
Differences in Copy Number Variation between Discordant Monozygotic Twins as a Model for Exploring Chromosomal Mosaicism in Congenital Heart Defects
Authors: Breckpot J. , Thienpont B. , Gewillig M. , Allegaert K. , Vermeesch J.R. , Devriendt K.
Published: January 2012

Studies addressing the role of somatic copy number variation (CNV) in the genesis of congenital heart defects (CHDs) are scarce, as cardiac tissue is difficult to obtain, especially in non-affected individuals. We explored the occurrence of copy number differences in monozygotic (MZ) twins discordant for the presence of a CHD, as an illustrative model for chromosomal mosaicism in CHDs. Array comparative genomic hybridization was performed on peripheral blood-derived DNA obtained from 6 discordant MZ twin pairs and on sex-matched reference samples. To identify CNV differences between both twin members as well as potential CNVs in both twins contributing to the phenotype, DNA from each twin was hybridized against its co-twin, and against a normal control. Three copy number differences in 1 out of 6 MZ twin pairs were detected, confirming the occurrence of somatic CNV events in MZ twins. Further investigation by copy number and (epi)genome sequencing analyses in MZ twins, discordant for the presence of CHDs, is required to improve our knowledge on how postzygotic genetic, environmental and stochastic factors can affect human heart development.
The Social and Behavioural Pathway of Dental Caries Experience among Jewish Adults in Jerusalem
Authors: Zini A. , Sgan-Cohen H.D. , Marcenes W.
Published: January 2012

Aims: To report dental caries status, related health behaviours and social determinants among a representative sample of adults residing in Jerusalem. Methods: This cross-sectional study was conducted using a stratified sample of 254 Jewish and married adults aged 35–44 years in Jerusalem. Dental caries status was examined according to DMFT, percentage of caries-free persons and of people maintaining all their natural teeth (no teeth missing due to caries). The results were analysed by the independent variables and interpreted by weighted caries scores for the total Jerusalem population. Results: The mean age was 38.63 years. Weighted DMFT was found to be 10.59; 6.8% of the population were caries-free; 67.1% demonstrated maintenance of all natural teeth. Level of education was the distal factor, associated with number of natural teeth, DMFT and untreated decay. Mediating behavioural determinants included dental attendance, plaque level and sugar consumption. Discussion: The findings of this study demonstrated that caries experience among Jewish married adults in Jerusalem was moderate with low unmet dental caries needs. Additionally, data confirmed that a low level of education was a strong distal social determinant of caries experience, which affected dental health status via a pathway mediated by behavioural factors.
Mortality Associated with Dose Response of Erythropoiesis-Stimulating Agents in Hemodialysis versus Peritoneal Dialysis Patients
Authors: Duong Uyen , Kalantar-Zadeh Kamyar , Molnar Miklos Z. , Zaritsky Joshua J. , Teitelbaum Isaac , Kovesdy Csaba P. , Mehrotra Rajnish
Published: January 2012

Background: Several studies have shown an association between erythropoietin-stimulating agent (ESA) responsiveness and mortality in chronic kidney disease (CKD) patients. In our present study, we examined the association between prescribed ESA dose and mortality in peritoneal dialysis (PD) and hemodialysis (HD) patients. We hypothesized that PD patients received lower ESA dose for the same achieved hemoglobin compared to HD patients and that ESA dose-mortality associations were different between PD and HD patients. Methods: We compared the prescribed doses of ESA between 139,103 HD and 10,527 PD patients treated in DaVita dialysis clinics from 7/2001 through 6/2006 using adjusted Poisson regression and examined mortality-predictability of prescribed ESA dose and ESA responsiveness index (ESA/hemoglobin) in PD and HD with follow-up through 6/2007 using Cox regression models. Results: Poisson adjusted ratio of ESA dose of HD to PD was 3.6 (95% CI 3.5–3.7). In PD patients, adjusted all-cause death hazard ratios (HR) for ESA doses of 3,000–5,999, 6,000–8,999 and ≧9,000 U/week (reference <3,000 U/week) were 0.97 (0.87–1.07), 0.85 (0.76–0.95) and 1.08 (0.98–1.18), respectively; whereas in HD patients across commensurate ESA dose increments of 10,000–19,999, 20,000–29,999 and ≧30,000 U/week (reference <10,000 U/week) were 1.14 (1.11–1.17), 1.54 (1.50–1.58) and 2.15 (2.10–2.21), respectively. In PD and HD patients, the adjusted death HR of the 4th to 1st quartile of ESA responsiveness index were 1.14 (1.04–1.26) and 2.37 (2.31–2.43), respectively. Conclusions: Between 2001 and 2006, most PD patients received substantially lower ESA dose for same achieved hemoglobin levels, and low ESA responsiveness was associated with higher mortality in both HD and PD patients.
Sister Chromatid Exchange Assessment by Chromosome Orientation-Fluorescence in situ Hybridization on the Bovine Sex Chromosomes and Autosomes 16 and 26
Authors: Revay T. , King W.A.
Published: January 2012

Mammalian genome replication and maintenance are intimately coupled with the mechanisms that ensure cohesion between the resultant sister chromatids and the repair of DNA breaks. Although a sister chromatid exchange (SCE) is an error-free swapping of precisely matched and identical DNA strands, repetitive elements adjacent to the break site can act as alternative template sites and an unequal sister chromatid exchange can result, leading to structural variations and copy number change. Here we test the vulnerability for SCEs of the repeat-rich bovine Y chromosome in comparison with X, 16 and 26 chromosomes, using chromosome orientation-fluorescence in situ hybridization. The mean SCE rate of the Y chromosome (0.065 ± 0.029) was similar to that of BTA16 and BTA26 (0.065, 0.055), but was only approximately half of that of the X chromosome (0.142). As the chromosomal length affects the number of SCE events, we adjusted the SCE rates of the Y, 16, and 26 chromosomes to the length of the largest chromosome X resulting in very similar adjusted SCE (SCEadj) rates in all categories. Our results – based on 3 independent bulls – show that, although the cattle Y chromosome is a chest full of repeated elements, their presence and the documented activity of repeats in SCE formation does not manifest in significantly higher SCEadj rates and suggest the importance of the structural organization of the Y chromosome and the role of alternative mitotic DNA repair mechanisms.
The Natural History of Preclinical Diastolic Dysfunction
Authors: Vogel Mark W. , Slusser Joshua P. , Hodge David O. , Chen Horng H.
Published: January 2012

Background—

Preclinical diastolic dysfunction (PDD) has been broadly defined as subjects with left ventricular diastolic dysfunction, without the diagnosis of congestive heart failure (HF) and with normal systolic function. Our objective was to determine the risk factors associated with the progression from PDD (stage B) HF to symptomatic (stage C) HF.

Methods and Results—

Using the resources of the Rochester Epidemiology Project, all residents of Olmsted County, MN, who underwent echocardiography between January 1, 2004, and December 31, 2005, and had grade 2–4 diastolic dysfunction and ejection fraction ≥50% were identified. Patients with a diagnosis of HF before or within 30 days of the echocardiogram were excluded. Patients were also excluded if they had a diagnosis of atrial fibrillation or severe mitral or aortic valve regurgitation at the time of the echocardiogram. A total of 388 patients met the inclusion criteria. The mean age of the cohort was 67±12 years, with a female (57%) predominance. Prevalence of renal insufficiency (estimated glomerular filtration rate <60 mL/min per 1.73 m
2
) was 34%. The 3-year cumulative probabilities of development of (stage C) HF, development of atrial fibrillation, cardiac hospitalization, and mortality were 11.6%, 14.5%, 17.7%, and 10.1% respectively. In multivariable Cox proportional hazard regression analysis, we determined that age, renal dysfunction, and right ventricular systolic pressure were independently associated with the development of HF.

Conclusions—

This population-based study demonstrated that in PDD (stage B) HF, there was a moderate degree of progression to symptomatic (stage C) HF over 3 years, and renal dysfunction was associated with this progression independent of age, sex, hypertension, coronary disease, and ejection fraction.
Atmospheric Entropy. Part I: Climate Dissipation Structure
Authors: Li Jiangnan , Chylek Petr
Published: January 2012

Atmospheric entropy and its association with climate dissipation are investigated. The balance equation for entropy is derived through the mean and transient thermal and moisture equations. The entropy production contains the internal and external parts. The external entropy production, due to small-scale diabatic heating, can be evaluated by the surface entropy flux. Using NCEP data from 1998 to 2007, it is found that the surface entropy flux is much larger in the tropics than in the extratropics. In the December–February (DJF) Northern Hemisphere, there are two strong positive centers of boundary layer supply of entropy: one is in the northwestern Pacific and the other is in the western Atlantic. The external entropy production, due to large-scale eddy flow, can be evaluated by the convergence of eddy entropy flow. It is found that the large-scale eddy entropy flow is divergent in the midlatitudes and convergent in the higher latitudes. The internal entropy production shows the dissipation to the orderly thermal structure. For the internal entropy production due to a large-scale eddy, it is shown that in the Northern Hemisphere during DJF there are three maxima, located in the western Pacific, western Atlantic, and northern polar regions. This illustrates the dissipation of the highly organized thermal structure in such regions. An interesting finding is that the large-scale eddy internal entropy production is negative in the lower stratosphere. It is found that the long-time-averaged global mean of the internal entropy production is 0.037 49 W m−2K−1. By including the entropy sink from radiation, the total entropy production is close to balance.
A Simple Model for Stratocumulus to Shallow Cumulus Cloud Transitions
Authors: Chung D. , Teixeira J.
Published: January 2012

It is shown that essential features of stratocumulus to shallow cumulus cloud transitions can be represented by a simple stochastic model constructed from an ensemble of transitions, each of which depends on the amount of surface latent heat flux relative to initial cloud-top longwave net radiative flux. In its essence the simple model establishes a causal relation between the increase of sea surface temperature (SST) and the decrease in cloud fraction (CF) along the trade winds. The mean and variance of SST are taken from observations. Model predictions are compared with observations of CF along Lagrangian trajectories in four eastern subtropical ocean regions. The model reproduces well the decrease in mean CF and the peak in CF spread.
Evaluation and Intercomparison of Cloud Fraction and Radiative Fluxes in Recent Reanalyses over the Arctic Using BSRN Surface Observations
Authors: Zib Behnjamin J. , Dong Xiquan , Xi Baike , Kennedy Aaron
Published: January 2012

With continual advancements in data assimilation systems, new observing systems, and improvements in model parameterizations, several new atmospheric reanalysis datasets have recently become available. Before using these new reanalyses it is important to assess the strengths and underlying biases contained in each dataset. A study has been performed to evaluate and compare cloud fractions (CFs) and surface radiative fluxes in several of these latest reanalyses over the Arctic using 15 years (1994–2008) of high-quality Baseline Surface Radiation Network (BSRN) observations from Barrow (BAR) and Ny-Alesund (NYA) surface stations. The five reanalyses being evaluated in this study are (i) NASA's Modern-Era Retrospective analysis for Research and Applications (MERRA), (ii) NCEP's Climate Forecast System Reanalysis (CFSR), (iii) NOAA's Twentieth Century Reanalysis Project (20CR), (iv) ECMWF's Interim Reanalysis (ERA-I), and (v) NCEP–Department of Energy (DOE)'s Reanalysis II (R2). All of the reanalyses show considerable bias in reanalyzed CF during the year, especially in winter. The large CF biases have been reflected in the surface radiation fields, as monthly biases in shortwave (SW) and longwave (LW) fluxes are more than 90 (June) and 60 W m−2 (March), respectively, in some reanalyses. ERA-I and CFSR performed the best in reanalyzing surface downwelling fluxes with annual mean biases less than 4.7 (SW) and 3.4 W m−2 (LW) over both Arctic sites. Even when producing the observed CF, radiation flux errors were found to exist in the reanalyses suggesting that they may not always be dependent on CF errors but rather on variations of more complex cloud properties, water vapor content, or aerosol loading within the reanalyses.
A Numerical Investigation of Wet and Dry Onset Modes in the North American Monsoon Core Region. Part I: A Regional Mechanism for Interannual Variability
Authors: Turrent Cuauhtémoc , Cavazos Tereza
Published: January 2012

In this study the results of two regional fifth-generation Pennsylvania State University–NCAR Mesoscale Model (MM5) simulations forced at their boundaries with low-pass-filtered North American Regional Reanalysis (NARR) composite fields from which synoptic-scale variability was removed are presented. The filtered NARR data are also assimilated into the inner domain through the use of field nudging. The purpose of this research is to investigate wet and dry onset modes in the core region of the North American monsoon (NAM). Key features of the NAM that are present in the NARR fields and assimilated into the regional simulations include the position of the midlevel anticyclone, low-level circulation over the Gulf of California, and moisture flux patterns into the core monsoon region, for which the eastern Pacific is the likely primary source of moisture. The model develops a robust diurnal cycle of deep convection over the peaks of the Sierra Madre Occidental (SMO) that results solely from its radiation scheme and internal dynamics, in spite of the field nudging. The wet onset mode is related to a regional land–sea thermal contrast (LSTC) that is ~2°C higher than in the dry mode, and is further characterized by a northward-displaced midlevel anticyclone, a stronger surface pressure gradient along the Gulf of California, larger mean moisture fluxes into the core region from the eastern Pacific, a stronger diurnal cycle of deep convection, and the more northward distribution of precipitation along the axis of the SMO. A proposed regional LSTC mechanism for NAM onset interannual variability is consistent with the differences between both onset modes.
Evaluation of the New CNDV Option of the Community Land Model: Effects of Dynamic Vegetation and Interactive Nitrogen on CLM4 Means and Variability
Authors: Gotangco Castillo C. Kendra , Levis Samuel , Thornton Peter
Published: January 2012

The Community Land Model, version 4 (CLM4) includes the option to run the prognostic carbon–nitrogen (CN) model with dynamic vegetation (CNDV). CNDV, which simulates unmanaged vegetation, modifies the CN framework to implement plant biogeography updates. CNDV simulates a reasonable present-day distribution of plant functional types but underestimates tundra vegetation cover. The CNDV simulation is compared against a CN simulation using a vegetation distribution generated by CNDV and against a carbon-only simulation with prescribed nitrogen limitation (CDV). The comparisons focus on the means and variability of carbon pools and fluxes and biophysical factors, such as albedo, surface radiation, and heat fluxes. The study assesses the relative importance of incorporating interactive nitrogen (CDV to CNDV) versus interactive biogeography (CN to CNDV) in present-day equilibrium simulations. None of the three configurations performs consistently better in simulating carbon or biophysical variables compared to observational estimates. The interactive nitrogen (N) cycle reduces annual means and interannual variability more than dynamic vegetation. Dynamic vegetation reduces seasonal variability in leaf area and, therefore, in moisture fluxes and surface albedo. The interactive N cycle has the opposite effect of enhancing seasonal variability in moisture fluxes and albedo. CNDV contains greater degrees of freedom than CN or CDV by adjusting both through nitrogen–carbon interactions and through vegetation establishment and mortality. Thus, in these equilibrium simulations, CNDV acts as a stronger “regulator” of variability compared to the other configurations. Discussed are plausible explanations for this behavior, which has been shown in past studies to improve climate simulations through better represented climate–vegetation interactions.