bluuebunny/crossref_metadata_2025 huggingface dataset:
The Role of Cardiac Rehabilitation in Achieving Optimal Treatment
Authors: Mendes Miguel ,   Head of Cardiology Department, CHLO-Hospital de Santa Cruz, Av. Professor Reynaldo dos Santos, 2794-095 Carnaxide, Portugal. E: miguel.mendes.md@sapo.pt
Published: August 2014

The clinical practice of European cardiologists is directed by the European Society of Cardiology’s guidelines for several clinical entities, in which ‘optimal medical treatment’ (a specific drug regime and lifestyle measures) for each syndrome is defined. The described pharmacotherapy is composed of several drugs, since the clinical research behind the recommendations is conducted using an ‘on top of’ strategy. For example, an asymptomatic patient after an acute coronary syndrome with normal ventricular function and without residual ischaemia has an indication to take at least four types of tablets per day, which is difficult to understand and to follow long term. The cost of the drugs is sometimes beyond the patient’s means, which also contributes to lower compliance. A clinician’s practice is usually very busy, which means it is almost impossible to perform patient education and promote adherence to drug therapy and lifestyle changes. Cardiac rehabilitation, as proved by the Global Secondary Prevention Strategies to Limit Event Recurrence after Myocardial Infarction (GOSPEL) study, may be considered the best available secondary prevention programme, as it educates patients and promotes adherence to the optimal medical treatment to a greater degree than usual care.
Drug-coated Balloons – Potential Coronary Vascular Applications
Authors: Scheller Bruno , Cremers Bodo , Schmitmeier Stephanie , Schnorr Beatrix , Clever Yvonne , Speck Ulrich ,   Clinical and Experimental Interventional Cardiology, University of Saarland, 66421 Homburg/Saar, Germany. E: bruno.scheller@uks.eu; Internal Medicine III, University Hospital of Saarland, Homburg/Saar, Klinische und Experimentelle Interventionelle Kardiologie, Universitêt des Saarlandes, 66421 Homburg/Saar, Germany.
E: bruno.scheller@uks.eu,   Internal Medicine III, University Hospital of Saarland, Homburg/Saar,   Department of Radiology, Experimental Radiology, Charité University Hospital, Berlin,   Department of Radiology, Experimental Radiology, Charité University Hospital, Berlin,   Internal Medicine III, University Hospital of Saarland, Homburg/Saar,   Department of Radiology, Experimental Radiology, Charité University Hospital, Berlin
Published: August 2014

One of the most innovative fields in modern medical research is the percutaneous transluminal treatment of vascular disease. During the last few decades considerable advances have been made in intravascular interventions for the treatment of coronary and peripheral arterial disease. However, long-term outcome remains an area of concern in many applications. Restenosis is still a challenge in endovascular medicine and has thus been referred to as the Achilles’ heel of percutaneous intervention. Therefore, novel strategies have been developed to overcome this problem. These include drug-eluting stents and the more recently introduced non-stent-based local drug delivery systems, in particular the drug-coated balloon. The results of several pre-clinical and clinical studies indicate that short-term exposure of injured arteries to paclitaxel delivered from regular angioplasty balloons may be sufficient to reduce late lumen loss and restenosis rates during the critical period after angioplasty of diseased coronary and peripheral arteries. Although the number of published trials and patients treated is still limited, the available data seem to prove that restenosis inhibition by immediate drug release is feasible. This article reviews the potential applications of the drug-coated balloon in coronary vascular disease.
Management of Acute Stroke by Cardiologists
Authors: Hopkins L Nelson
Published: August 2014

Every year in the US, nearly 800,000 patients experience an acute stroke. Stroke is the number one cause of adult disability in the US and poses a serious financial burden. Current treatments focus on re-establishing blood flow to the ischaemic territory or reperfusion, with intravenous thrombolytics, intra-arterial endovascular thrombolytics or mechanical clot retrievers. Comprehensive stroke centres offer the best opportunity for assessment and treatment of stroke patients. However, the number of well-trained neuroendovascular specialists (including neurosurgeons, radiologists and neurologists) cannot offer 24/7 acute stroke coverage at all of the major centres across the US. One solution that has been proposed and is in fact being utilised at some centres is the use of an interventional cardiologist to treat acute stroke. In this article the background, pitfalls and requirements of cardiologists treating acute stroke are discussed.
A Review of Angiotensin Receptor Blocker-based Therapies at all Levels of Cardiovascular Risk
Authors: Tocci Giuliano , Castello Lorenzo , Volpe Massimo ,   Cardiology Unit, Clinical and Molecular Medicine Department, Sant‗Andrea Hospital, Faculty of Medicine, Sapienza University of Rome; IRCCS Neuromed, Polo Molisano Sapienza University of Rome, Pozzilli,   Cardiology Unit, Clinical and Molecular Medicine Department, Sant‗Andrea Hospital, Faculty of Medicine, Sapienza University of Rome,   Cardiology Unit, Clinical and Molecular Medicine Department, Sant‗Andrea Hospital, Faculty of Medicine, Sapienza University of Rome, Via di Grottarossa 1035–39, 00189 Rome, Italy. E: massimo.volpe@uniroma1.it; IRCCS Neuromed, Polo Molisano Sapienza University of Rome, Pozzilli
Published: August 2014

The renin–angiotensin system (RAS) has a key role in the maintenance of cardiovascular homeostasis, and water and electrolyte metabolism in healthy subjects, as well as in several diseases including hypertension, left ventricular hypertrophy and dysfunction, coronary artery disease, renal disease and congestive heart failure. These conditions are all characterised by abnormal production and activity of angiotensin II, which represents the final effector of the RAS. Over the last few decades, accumulating evidence has demonstrated that antihypertensive therapy based on angiotensin II receptor blockers (ARBs) has a major role in the selective antagonism of the main pathological activities of angiotensin II. Significant efforts have been made to demonstrate that blocking the angiotensin II receptor type 1 (AT1) subtype receptors through ARB-based therapy results in proven benefits in different clinical settings. In this review, we discuss the main benefits of antihypertensive strategies based on ARBs in terms of their efficacy, safety and tolerability.
How Do We Approach Low High-density Lipoprotein Cholesterol in 2011?
Authors: Godfrey Esther , Halcox Julian PJ ,   Department of Cardiology, University Hospital of Wales; Wales Heart Research Institute, Cardiff University School of Medicine,   Department of Cardiology, University Hospital of Wales; Wales Heart Research Institute, Sir Geraint Evans Wales Heart Research Institute, Cardiff University School of Medicine, Heath Park, Cardiff CF14 4XN, UK. E: halcoxjp@cardiff.ac.uk
Published: August 2014

The prevalence of obesity and of the metabolic syndrome is increasing worldwide, and the management of global cardiovascular disease (CVD) risk requires strategies for the treatment of complex, pro-atherogenic dyslipidaemia. Considerable evidence provides a scientific rationale for the role of high-density lipoprotein (HDL) in atheroprotection. Although HDL function can become altered in pathological states, the quantitative evaluation of HDL cholesterol (HDL-C) in addition to total cholesterol (TC) levels improves the accuracy of CVD risk prediction, and is therefore a component of most global CVD risk assessment models. Non-pharmacological lifestyle interventions, such as diet and exercise for weight loss and smoking cessation, are the mainstay of raising HDL in clinical practice. Several HDL-raising medications are available but, beyond statin therapy, evidence of an incremental clinical benefit is limited. Potent novel HDL therapeutics are emerging that not only increase HDL-C levels but may also improve HDL function. Early data have restored some confidence in the potential of new cholesteryl ester transfer protein (CETP) antagonists in clinical practice. It is essential that clinical trials address vascular burden and patient outcomes, and data from large outcome trials are eagerly awaited.
Outpatient Evaluation of Secondary Causes of Resistant Hypertension
Authors: Thomas George , Bravo Emmanuel L ,   Associate Staff Member,   Consultant, Department of Nephrology and Hypertension Q7, Glickman Urological and Kidney Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, US. E: bravoe@ccf.org
Published: August 2014

Primary aldosteronism, pheochromocytoma and renovascular hypertension are hypertensive syndromes often associated with resistant hypertension. Early recognition of these disorders has come as the result of a better understanding of their pathophysiology. Prompt and definitive diagnosis has resulted from the availability of sensitive and accurate diagnostic tools. Finally, safe and effective pharmacotherapeutic agents and innovative surgical techniques have led to excellent and predictable clinical outcomes.
Radiation Safety in Thoracic Imaging – Opinion
Authors: Tack Denis ,   Department of Radiology, Clinique Louis Caty, Hôpital RHMS, Baudour, Clos du Mélèze, 17 1420 Braine-L’Alleud, Belgium. E: denis.tack@skynet.be
Published: August 2014

Guidelines for the reduction of computed tomography (CT) radiation doses were introduced in 1997. However, the process initiated by European regulatory authorities to reduce the excess radiation from CT has not produced the expected results. Reference diagnostic levels (RDLs) from surveys are still twice as high as needed for multidetector CT (MDCT) in most European countries and were not significantly reduced compared with the initial levels. Many factors may at least partially explain the lack of dose reduction. One of them is the complexity of the dose-optimisation process while maintaining image quality at a diagnostically acceptable level. The chest is an anatomical region where the radiation dose could be substantially reduced because of high natural contrasts between structures, such as air in the lungs and fat in the mediastinum. In this article, the concept of CT radiation-dose optimisation and the factors that contribute to maintaining global excess in radiation dose are reviewed, and a brief summary of results from research in the field of chest CT radiation dose is given.
Appropriateness in Echocardiography
Authors: Sicari Rosa , Cortigiani Lauro ,   National Research Council, Institute of Clinical Physiology, Via Giuseppe Moruzzi 1, 56124 Pisa, Italy. E: rosas@ifc.cnr.it,   Campo di Marte Hospital, Lucca
Published: August 2014

Appropriateness is the new imperative of contemporary medicine. In the words of the American College of Cardiology Foundation (ACCF), ‘Appropriate echocardiograms are those that are likely to contribute to improving patients’ clinical outcomes, and importantly, inappropriate use of echocardiography may be potentially harmful to patients and generate unwarranted costs to the healthcare system’. The appropriateness criteria issued by the ACCF stem from a real practical need to reduce costs and avoid the abuse and misuse of non-invasive imaging technologies. Even though very often cited and referred to, these criteria have not yet had a real impact on routine clinical practice. The present article assesses the impact of the ACCF criteria on the basis of the available evidence.
Sleep-disordered Breathing and Heart Failure – Insights from Speckle Tracking Echocardiography
Authors: Takeuchi Masaaki , Haruki Nobuhiko , Otsuji Yutaka ,   Associate Professor, Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555 Japan. E: takeuchi@med.uoeh-u.ac.jp,   Assistant Professor,   Professor, Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu
Published: August 2014

Patients with heart failure frequently have associated sleep-disordered breathing, which has a significant negative impact on cardiac function. Echocardiography is a versatile modality for the management of heart failure. Recent developments in speckle tracking analysis have demonstrated that two-dimensional strain has potential for the quantification of subclinical abnormalities in ventricular function. This article outlines the utility of speckle tracking echocardiography in patients with heart failure and sleep-disordered breathing.
An Atypical Presentation of Acute Coronary Syndrome
Authors: Gardezi Syed Khurram Mushtaq ,   Research Registrar, Department of Cardiovascular Research, Lancashire Cardiac Centre, Blackpool Victoria Hospital, Blackpool, FY3 8NR, UK. E: drskmgardezi@gmail.com
Published: August 2014

A 61-year-old man was admitted to hospital with severe occipital headache and weakness and numbness of the left arm. His electrocardiograms showed changes hinting at acute coronary syndrome (ACS). However, in view of his clinical presentation, he underwent tests for likely subarachnoid haemorrhage, but this was ruled out. The next day, he was referred to cardiology. A transthoracic echocardiogram showed reduced left ventricular systolic function along with regional wall motion abnormalities involving inferoposterior walls. The patient was treated as per the protocol for ACS. A dobutamine stress echocardiogram confirmed inferior myocardial infarction with evidence of myocardial viability in the affected left ventricular segments. Subsequent investigations confirmed three-vessel coronary artery disease and reduced left ventricular systolic function. The patient underwent successful coronary artery bypass grafting.
Gender-related Differences in Clinical Variables Associated with Survival of Patients with Atrial Fibrillation
Authors: Shteinshnaider Miriam , Almoznino-Sarafian Dorit , Berman Sylvia , Tzur Irma , Cohen Natan , Gorelik Oleg ,   Attending Physician, Department of Internal Medicine ‘F’,   Deputy Head, Department of Internal Medicine ‘F’,   Head of Research Laboratory, Research and Development Division and Department of Nephrology,   Attending Physician, Department of Internal Medicine ‘F’,   Clinical Professor, Department of Internal Medicine ‘F’,   Attending Physician, Department of Internal Medicine ‘F’, Assaf Harofeh Medical Center, Affiliated to Sackler School of Medicine, Tel Aviv University, 70300 Zerifin, Israel. E: internal6@asaf.health.gov.il
Published: August 2014

Little is known about gender-related differences in clinical variables affecting the survival in inpatients with atrial fibrillation (AF). We recorded and compared clinical data and long-term mortality between 126 males and 124 females hospitalised with paroxysmal/persistent AF. Women were older and more symptomatic than men. Hypertension and renal dysfunction were more common in females, while dyslipidemia and smoking prevailed in males. Males were more likely to have a decreased left ventricular function and segmental wall motion abnormalities. On a median of a 39-month follow-up, mortality was comparable in males and females (p=0.6). Older age was significantly associated with poor survival in both groups. New-onset AF was significantly associated with shorter survival in males (Odds Ratio [OR] 3.35). In females, diabetes mellitus was significantly associated with increased mortality (OR 2.45), while statin treatment predicted better survival (OR 0.45). Gender-related differences in clinical characteristics were observed in inpatients with AF. Mortality was comparable in men and women. However, several clinical variables, which affect prognosis, were found sex-related.
Pulmonary Vascular Versus Right Ventricular Function Changes During Targeted Therapies of Pulmonary Hypertension – An Argument for Upfront Combination Therapy?
Authors: Jacobs Wouter , Vonk-Noordegraaf Anton ,   Department of Pulmonary Medicine, VU University Medical Centre, Amsterdam, The Netherlands,   Department of Pulmonary Medicine, VU University Medical Centre, P.O. Box 7057, 1007MB Amsterdam, The Netherlands. E: a.vonk@vumc.nl
Published: August 2014

Pulmonary arterial hypertension is a progressive disease of the pulmonary vasculature, ultimately leading to right heart failure and death. Current treatment is aimed at targeting three different pathways: the prostacyclin, endothelin and nitric oxide pathways. These therapies improve functional class, increase exercise capacity and improve haemodynamics. In addition, data from a meta-analysis provide compelling evidence of improved survival. Despite these treatments, the outcome is still grim and the cause of death is inevitable – right ventricular failure. One explanation for this paradox of haemodynamic benefit and still worse outcome is that the right ventricle does not benefit from a modest reduction in pulmonary vascular resistance. This article describes the physiological concepts that might underlie this paradox. Based on these concepts, we argue that not only a significant reduction in pulmonary vascular resistance, but also a significant reduction in pulmonary artery pressure is required to save the right ventricle. Haemodynamic data from clinical trials hold the promise that these haemodynamic requirements might be met if upfront combination therapy is used.
Understanding and Minimising Occupational Radiation in the Catheterisation Laboratory with PISAX and the ACIST CVi® Contrast Delivery System
Authors: Bar Olivier ,   Interventional Cardiologist, Saint Gatien Clinic, Tours, France. E: o.bar@ciic.fr
Published: August 2014

This paper provides an overview of radiation exposure and its associated risks in the cardiac catheterisation laboratory (cath lab), as well as strategies to minimise radiation exposure for operators, cath lab staff and patients. The benefits of using a mobile 2 mm lead equivalent radiation shield (PISAX) and adoption of an automated contrast injection system (the ACIST CVi® Contrast Delivery System) are discussed, and the potential advantages of their combination are reviewed.
Challenges in Complicated Coronary Chronic Total Occlusion Recanalisation
Authors: Reifart Nicolaus ,   Main Taunus Heart Institute, 65812 Bad Soden, Germany. E: n.reifart@reifart-partner.de
Published: August 2014

Percutaneous coronary intervention for chronic total occlusions (CTOs) is still today a challenge even for experienced operators. In the hands of the most experienced the success rate increased from about 60 to 90 % in the past 10 years; paralleled by a long-term patency with drug-eluting stents exceeding 90 %. These results are comparable or even superior to surgical revascularisation. Thanks to Japanese and European CTO club online registries and live courses we are able to rapidly understand and adopt new strategies, techniques and materials to master morphology deemed untreatable 10 years ago. Several of the persistent challenges and solutions unique to CTO interventions are discussed.
Technical Aspects of Provisional Stenting in Percutaneous Treatment of Complex Bifurcation Lesions
Authors: Burzotta Francesco , Trani Carlo ,   Institute of Cardiology, Department of Cardiovascular Sciences, Catholic University of the Sacred Heart, 00168 Rome, Italy. E: f.burzotta@rm.unicatt.it,   Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy
Published: August 2014

Drug-eluting stent (DES) implantation using the ‘provisional’ approach is the gold standard for percutaneous treatment of patients with unselected bifurcated lesions. Nevertheless, many operators still consider the provisional approach unsuitable for coronary patients with complex bifurcation anatomies. Yet, the provisional approach may be so differently carried out that its procedural outcome is often unpredictable. Some technical refinements may help to anticipate or manage procedural difficulties, which may occur during the management of complex patients. We sought to overview the issues related with DES selection as well as some technical points, which may increase the effectiveness of provisional stenting. In particular, the DES characteristics influencing bifurcation interventions and the technical refinements, which may be considered during a provisional stenting procedure are discussed. Indeed, main vessel stent sizing, proximal optimisation, side branch protection modality, side branch rewiring, kissing balloon and side branch rescue techniques are all pivotal to increase the safety and efficacy of the provisional strategy especially in the setting of complex anatomies and patients.
Phenological decoupling of mortality from wave forcing in kelp beds
Authors: de Bettignies Thibaut , Wernberg Thomas , Lavery Paul S. , Vanderklift Mathew A. , Gunson Jim R. , Symonds Graham , Collier Neil
Published: August 2014

Kelps often live in a harsh hydrodynamic environment where wave‐driven dislodgement of individuals can alter the biodiversity and functioning of reef systems, and increase production in coastal ecosystems adjacent to reefs. The current paradigm is that winter storms tear kelps from reefs once hydrodynamic forces exceed attachment or tissue strength—a threshold response that implies a pulsed relationship between wave forces and dislodgement. Here, we challenge this understanding by showing how kelp phenology can decouple susceptibility to dislodgement from seasonal patterns in wave forces. We measured kelp dislodgement rates and hydrodynamic forces at nine subtidal reefs over two years (n = 4320 kelps tagged and monitored). Contrary to expectation, we found relatively low and constant dislodgement rates for all reefs (13% ± 6% [mean per season ± SD]) in spite of a strong temporal pattern in wave action and extreme water velocities (winter peaks up to 3–4 m/s). A biomechanical model, based on the balance between kelp attachment strength and hydrodynamic drag, demonstrated that severe reduction in individual kelp size toward winter (>50% decrease in biomass for all sites) minimized drag and made the kelps less susceptible to high water velocities, allowing individuals to survive storm velocities over 3–4 m/s. We conclude that the timing of reduced susceptibility to disturbance, through the seasonal reduction of individual kelp biomass that coincides with times of highest water velocities is critical to the dynamics of kelp dislodgement and survival. We propose that phenological processes maintain many kelp beds in a higher degree of population stability and equilibrium with hydrodynamic forces than previously believed.
Development of a Frailty Measure for Older Adults: The Frailty Index for Elders
Authors: Tocchi Christine , Dixon Jane , Naylor Mary , Jeon Sangchoon , McCorkle Ruth
Published: August 2014

Background and Purpose: Frailty is a significant challenge for health care. Therefore, it is important to identify frail individuals. Theoretical Framework: The Vulnerability/Risk/Human Response/Care Model. The purpose of this study was to develop and validate a measure to identify frail older adults. Methods: Instrument development encompassed the following: delineation of content domains, item generation, content validity, quantitative content validity analysis, and psychometric analysis. Results: Findings indicated the following: (a) Frailty is a complex concept, (b) the Frailty Index for Elders (FIFE) is composed of 10 items, (c) FIFE was able to predict depression, and (d) FIFE was able to differentiate differences in demographic profiles by social support environment. Conclusions: FIFE is a valid instrument. FIFE can be used to study the relationships among frailty determinants, provide standardized measurement, and develop and measure interventional studies.
The Need-Adapted Approach in Psychosis: The Impact of Psychosis on the Treatment and the Professionals
Authors: Borchers Pekka , Seikkula Jaakko , Arnkil Tom
Published: August 2014

Psychosis is a challenging phenomenon for professionals. In the need-adapted approach (NAA), therapy meetings constitute a deliberate effort to meet the challenges by bringing all the main parties together within a common discussion. The aims of this study are to analyze and evaluate psychiatrists’ experiences of the treatment processes in psychosis. A qualitative multiple case study approach has been used. Between August 2007 and January 2009, co-research interviews (CR-Is) and stimulated-recall interviews (STR-Is) with 10 psychiatrists from 3 different parts of Finland were videoed and transcribed verbatim. The material was analyzed using qualitative content analysis. The difficult emotions of the professionals and the critical views expressed had a prominent role. It was almost impossible to proceed with the treatment until the memories of coercive acts had been addressed. There were fewer harmful effects in outpatient than in inpatient care. If the client-centered principles of NAA were not followed, the CR-Is functioned primarily as critical evaluations of the treatment processes. The STR-Is helped the psychiatrists to find words for difficult experiences. For the sake of both practice and research, the experiences of staff in the treatment of psychosis should be taken into account. For better prediction of failure, routine measures to obtain feedback could be included in NAA.
An Innovator in Lactation Equity: Q & A With Sherry Payne, MSN, RN, CNE, IBCLC, RLC
Authors: Hemming Marie
Published: August 2014

Sherry Payne, MSN, RN, CNE, IBCLC, is the executive director of Uzazi Village, a nonprofit organization devoted to decreasing pregnancy-related health disparities in the urban core of Kansas City. She also facilitated the 2014 Lactation Summit: Addressing Inequities Within the Lactation
Consultant Profession. Ms. Payne speaks frequently around the country to professional audiences on topics related to lactation and birth disparities. One of the many barriers that aspiring International Board Certified Lactation Consultants (IBCLCs) of color face is acquiring clinical hours.
The Uzazi Village Lactation Consultant Mentorship Program is an innovative solution connecting aspiring IBCLCs from the Kansas City community to the Uzazi Village Breastfeeding Clinic, which provides free services to area families.
Prescribed Fire and Timber Harvesting Effects on Soil Carbon and Nitrogen in a Pine Forest
Authors: Roaldson L.M. , Johnson D.W. , Miller W.W. , Murphy J.D. , Walker R.F. , Stein C.M. , Glass D.W. , Blank R.R.
Published: August 2014

Thinning and prescribed fire are common management tools used to eliminate thick fuel loads that could otherwise facilitate and encourage a more severe catastrophic wildfire. The objective of this study was to quantify the lasting effects of prescribed fire on forest floor and soil nutrients approximately 9 yr after a burn occurred near Truckee, CA. The study site includes a prescribed fire following various harvest and understory removal treatments: whole‐tree thinning, cut‐to‐length thinning, and no thinning. Data were collected before, immediately after, and 9 yr later following a prescribed burn. All forest floor and soil samples were analyzed for nutrients (O horizon: total N; mineral soil: total N, total C, mineral N). Fuel reductions were evident 9 yr after the fire in the burned plots. No significant changes in total C or total N in surface (0–20‐cm) mineral soils occurred during the 9‐yr period. Mineral N concentrations in surface soils were greater in unburned than in burned cut‐to‐length thinning treatments after 9 yr. These differences were attributed to N inputs from decomposing slash and to the reduction in the biomass of N2 fixers by burning.
Five years operation of a decentralized membrane bioreactor package plant treating domestic wastewater
Authors: Tai C. S. , Snider-Nevin J. , Dragasevich J. , Kempson J.
Published: August 2014

Membrane bioreactor (MBR) package systems are providing affordable and simple-to-use decentralized wastewater treatment solutions for small to medium sized communities that face the challenge of balancing environmental and regulatory responsibilities with budgetary limitations. With a greater confidence and understanding of MBR technology, there is an increasing incentive in using MBR technology for these types of applications. Furthermore, valued qualities such as compact footprint, quick installation and start-up, process reliability, ease of operation, and superior effluent quality suitable for direct surface discharge and water reclamation have made MBR package system a preferred solution for decentralized wastewater treatment applications. This paper presents a retrofit solution for the Whitehouse Terrace Wastewater Treatment Plant. The existing extended aeration activated sludge package plant was retrofitted with a pre-engineered newterra MicroClearTM MBR package system for a small community along St Lawrence River in Brockville, Ontario. Five years full scale operation data of the MBR package system is presented and it is evident that the MBR package system consistently delivered high quality effluent that is far better than the required limit for direct surface water discharge to the St. Lawrence's river, with average effluent quality of 2.4, 2.6, 0.5, 0.05 mg/L, 1.7 counts/100 mL and 7.4 for biochemical oxygen demand, TSS, TP, TAN, Escherichia coli and pH, respectively.
Advanced control of a water supply system: a case study
Authors: Bakker M. , Rajewicz T. , Kien H. , Vreeburg J. H. G. , Rietveld L. C.
Published: August 2014

Conventional automatic production flow control and pump pressure control of water supply systems are robust and simple: production flow is controlled based on the level in the clear water reservoir and pump pressure is controlled on a static set-point. Recently, more advanced computer-based control methods were developed in which production flow is controlled by using a short-term water demand forecasting model and pressure is controlled by a dynamic pressure control module. To assess the differences between conventional and advanced control, we examined operational data of water treatment plantGruszczyn that supplies drinking water to a part of the city of Poznań, Poland. We compared two periods of three weeks of conventional and advanced control. The comparison showed that with advanced control the variation in the production flow was 83% lower, and the pump pressure of the clear water pumps was 29% lower. The lower pressure resulted in 20% less background leakage and the overall system's energy costs were 11.5% lower.
Gastroprotective Effect of Aqueous Extract of Azadirachta indica (Neem) on Ethanol Induced Gastric Lesion in Rats
Authors: Rahman Rifayet , Khan Ismail , Hoque Mahbubul , Aktar Muqbula Tasrin , Sharmin Zinat Rehana
Published: August 2014

The present study has been undertaken to find out the gastro-protective effect of aqueous extract of Azadirachta indica on ethanol induced gastric lesion in rats. To demonstrate this effect : some parameters of gastric damage -such as number of lesions, lesions length, lesions breadth, lesions area, lesions index and percent inhibition was chosen. In addition, histological features of rat stomach were also examined to confirm gastric damage and to determine the extent. The rats were provided with aqueous extract of Azadirachta indica (300mg /kg body wt) orally by gastric tube. After 12 hrs,1 ml absolute ethanol were orally administered to all groups by gastric tube. After 60 mins of administration, all rats were sacrificed. Rats pretreated with aqueous extract of Azadirachta indica (300mg /kg body wt) showed significant decrease in stomach damage both macroscopically and microscopically as compared to control. It is observed that aqueous extract of Azadirachta indica has gastroprotective effect. Therefore, aqueous extract of Azadirachta indica can be used to prevent gastric ulcer. DOI: http://dx.doi.org/10.3329/bjpp.v28i1-2.20074 Bangladesh J Physiol Pharmacol 2012; 28(1&2):10-14
Effect of lactation on serum total cholesterol & triglyceride
Authors: Begum Khadiza , Begum Rokeya , Akhter Qazi Shamima , Sultana Nusrat , Bari Shamima
Published: August 2014

Background: There is an association between breast feeding & maternal lipid profile. Pregnancy related hyperlipidaemia reverse quickly with lactation. Objective: To observe Serum Total cholesterol & triglyceride in lactating & nonlactating mother. Method: The present cross sectional study was conducted in the Department of Physiology, Dhaka Medical College, Dhaka, during the period of July 2010 to June 2011. A total 300 subjects were included within the age limit from 20 to 40 years of women. Among them100 were normal healthy subjects & had child above 3 years were considered as group A (control). The rest 200 women were selected as study subject (group B) having child between the age 6 weeks to 2 years. Group B is again subdivided into group B1 (100 lactating mother) & group B2 (100 nonlactating mother). The subjects were selected from pediatric ward & OPD of pediatrics, DMCH and BSMMU, Dhaka. Data were collected in data collection sheet after taking informed written consent of the subjects. The study parameters total cholesterol & Triglyceride were done in the Department of Physiology, Dhaka Medical College. The data were analyzed by computer with SPSS programs using unpaired Student ?t test.Results: In group B1 total cholesterol & triglyceride levels were non significantly higher than that of group A but in group B2 these values were significantly higher than that of group A. Within the study groups all these values were significantly higher in nonlactating mother than lactating mother. It was observed that high level of study parameters were more in B2 than that of group B1. Conclusion: From the results of the present study it may be concluded that lactation has effect on lowering serum total cholesterol & triglyceride which may preferably related to health education for the mother. http://dx.doi.org/10.3329/bjpp.v29i1-2.20060Bangladesh J Physiol Pharmacol 2013; 29(1&2) : 1-7
Learning Style Scales: a valid and reliable questionnaire
Authors: Abdollahimohammad Abdolghani , Ja’afar Rogayah
Published: August 2014

Purpose: Learning-style instruments assist students in developing their own learning strategies and outcomes, in eliminating learning barriers, and in acknowledging peer diversity. Only a few psychometrically validated learning-style instruments are available. This study aimed to develop a valid and reliable learning-style instrument for nursing students. Methods: A cross-sectional survey study was conducted in two nursing schools in two countries. A purposive sample of 156 undergraduate nursing students participated in the study. Face and content validity was obtained from an expert panel. The LSS construct was established using principal axis factoring (PAF) with oblimin rotation, a scree plot test, and parallel analysis (PA). The reliability of LSS was tested using Cronbach’s α, corrected item-total correlation, and test-retest. Results: Factor analysis revealed five components, confirmed by PA and a relatively clear curve on the scree plot. Component strength and interpretability were also confirmed. The factors were labeled as perceptive, solitary, analytic, competitive, and imaginative learning styles. Cronbach’s α was > 0.70 for all subscales in both study populations. The corrected item-total correlations were > 0.30 for the items in each component. Conclusion: The LSS is a valid and reliable inventory for evaluating learning style preferences in nursing students in various multicultural environments.
Intervention to Improve Biosecurity System of Poultry Production Clusters (PPCs) in Thailand
Authors: Aengwanich Worapol , Boonsorn Thongchai , Srikot Prayat
Published: August 2014

Widespread outbreaks of avian influenza occurred in 2004–2005. The outbreaks resulted in extensive losses for the poultry sector in East and South East Asia. Thailand suffered a tremendous impact from the disease. Later, in 2006, there was another outbreak of the aforementioned disease in poultry production clusters (PPCs) in Nakhon Phanom province in the northeastern region of Thailand. In this study, we conducted an intervention by working together with the Department of Livestock Development officials to improve the biosecurity level of PPCs in this province. The methods employed in the intervention included meetings to build understanding and hear about various ideas and problems among stakeholders; instructions; having the farmers perform self-evaluations of the level of biosecurity on the farms; and measures for motivating farmers, e.g., farm contests and handing out awards. The results revealed the following information: After intervention, attraction to wild bird of poultry farms in PPCs decreased (p < 0.05), because the farmers cut down trees around farm and poultry housing. Moreover, biosecurity system planning inside farms in PPCs increased (p < 0.05). The scores for biosecurity system planning inside farms that increased following the intervention are a positive sign that farmers will continue to develop better biosecurity systems on their farms.
Commercial Smartphone-Based Devices and Smart Applications for Personalized Healthcare Monitoring and Management
Authors: Vashist Sandeep , Schneider E. , Luong John
Published: August 2014

Smartphone-based devices and applications (SBDAs) with cost effectiveness and remote sensing are the most promising and effective means of delivering mobile healthcare (mHealthcare). Several SBDAs have been commercialized for the personalized monitoring and/or management of basic physiological parameters, such as blood pressure, weight, body analysis, pulse rate, electrocardiograph, blood glucose, blood glucose saturation, sleeping and physical activity. With advances in Bluetooth technology, software, cloud computing and remote sensing, SBDAs provide real-time on-site analysis and telemedicine opportunities in remote areas. This scenario is of utmost importance for developing countries, where the number of smartphone users is about 70% of 6.8 billion cell phone subscribers worldwide with limited access to basic healthcare service. The technology platform facilitates patient-doctor communication and the patients to effectively manage and keep track of their medical conditions. Besides tremendous healthcare cost savings, SBDAs are very critical for the monitoring and effective management of emerging epidemics and food contamination outbreaks. The next decade will witness pioneering advances and increasing applications of SBDAs in this exponentially growing field of mHealthcare. This article provides a critical review of commercial SBDAs that are being widely used for personalized healthcare monitoring and management.
Spatiotemporal Scaling Effect on Rainfall Network Design Using Entropy
Authors: Wei Chiang , Yeh Hui-Chung , Chen Yen-Chang
Published: August 2014

Because of high variation in mountainous areas, rainfall data at different spatiotemporal scales may yield potential uncertainty for network design. However, few studies focus on the scaling effect on both the spatial and the temporal scale. By calculating the maximum joint entropy of hourly typhoon events, monthly, six dry and wet months and annual rainfall between 1992 and 2012 for 1-, 3-, and 5-km grids, the relocated candidate rain gauges in the National Taiwan University Experimental Forest of Central Taiwan are prioritized. The results show: (1) the network exhibits different locations for first prioritized candidate rain gauges for different spatiotemporal scales; (2) the effect of spatial scales is insignificant compared to temporal scales; and (3) a smaller number and a lower percentage of required stations (PRS) reach stable joint entropy for a long duration at finer spatial scale. Prioritized candidate rain gauges provide key reference points for adjusting the network to capture more accurate information and minimize redundancy.
Biodiesel Production from Non-Edible Beauty Leaf (Calophyllum inophyllum) Oil: Process Optimization Using Response Surface Methodology (RSM)
Authors: Jahirul Mohammad , Koh Wenyong , Brown Richard , Senadeera Wijitha , O'Hara Ian , Moghaddam Lalehvash
Published: August 2014

In recent years, the beauty leaf plant (Calophyllum Inophyllum) is being considered as a potential 2nd generation biodiesel source due to high seed oil content, high fruit production rate, simple cultivation and ability to grow in a wide range of climate conditions. However, however, due to the high free fatty acid (FFA) content in this oil, the potential of this biodiesel feedstock is still unrealized, and little research has been undertaken on it. In this study, transesterification of beauty leaf oil to produce biodiesel has been investigated. A two-step biodiesel conversion method consisting of acid catalysed pre-esterification and alkali catalysed transesterification has been utilized. The three main factors that drive the biodiesel (fatty acid methyl ester (FAME)) conversion from vegetable oil (triglycerides) were studied using response surface methodology (RSM) based on a Box-Behnken experimental design. The factors considered in this study were catalyst concentration, methanol to oil molar ratio and reaction temperature. Linear and full quadratic regression models were developed to predict FFA and FAME concentration and to optimize the reaction conditions. The significance of these factors and their interaction in both stages was determined using analysis of variance (ANOVA). The reaction conditions for the largest reduction in FFA concentration for acid catalysed pre-esterification was 30:1 methanol to oil molar ratio, 10% (w/w) sulfuric acid catalyst loading and 75 °C reaction temperature. In the alkali catalysed transesterification process 7.5:1 methanol to oil molar ratio, 1% (w/w) sodium methoxide catalyst loading and 55 °C reaction temperature were found to result in the highest FAME conversion. The good agreement between model outputs and experimental results demonstrated that this methodology may be useful for industrial process optimization for biodiesel production from beauty leaf oil and possibly other industrial processes as well.
In Vitro Selection of a Single-Stranded DNA Molecular Recognition Element against Atrazine
Authors: Williams Ryan , Crihfield Cassandra , Gattu Srikanth , Holland Lisa , Sooter Letha
Published: August 2014

Widespread use of the chlorotriazine herbicide, atrazine, has led to serious environmental and human health consequences. Current methods of detecting atrazine contamination are neither rapid nor cost-effective. In this work, atrazine-specific single-stranded DNA (ssDNA) molecular recognition elements (MRE) were isolated. We utilized a stringent Systematic Evolution of Ligands by Exponential Enrichment (SELEX) methodology that placed the greatest emphasis on what the MRE should not bind to. After twelve rounds of SELEX, an atrazine-specific MRE with high affinity was obtained. The equilibrium dissociation constant (Kd) of the ssDNA sequence is 0.62 ± 0.21 nM. It also has significant selectivity for atrazine over atrazine metabolites and other pesticides found in environmentally similar locations and concentrations. Furthermore, we have detected environmentally relevant atrazine concentrations in river water using this MRE. The strong affinity and selectivity of the selected atrazine-specific ssDNA validated the stringent SELEX methodology and identified a MRE that will be useful for rapid atrazine detection in environmental samples.
Microwave Plasma Synthesis of Materials—From Physics and Chemistry to Nanoparticles: A Materials Scientist’s Viewpoint
Authors: Szabó Dorothée , Schlabach Sabine
Published: August 2014

In this review, microwave plasma gas-phase synthesis of inorganic materials and material groups is discussed from the application-oriented perspective of a materials scientist: why and how microwave plasmas are applied for the synthesis of materials? First, key players in this research field will be identified, and a brief overview on publication history on this topic is given. The fundamental basics, necessary to understand the processes ongoing in particle synthesis—one of the main applications of microwave plasma processes—and the influence of the relevant experimental parameters on the resulting particles and their properties will be addressed. The benefit of using microwave plasma instead of conventional gas phase processes with respect to chemical reactivity and crystallite nucleation will be reviewed. The criteria, how to choose an appropriate precursor to synthesize a specific material with an intended application is discussed. A tabular overview on all type of materials synthesized in microwave plasmas and other plasma methods will be given, including relevant citations. Finally, property examples of three groups of nanomaterials synthesized with microwave plasma methods, bare Fe2O3 nanoparticles, different core/shell ceramic/organic shell nanoparticles, and Sn-based nanocomposites, will be described exemplarily, comprising perspectives of applications.
Structural and Mechanical Characterization of Sustainable Composites Based on Recycled and Stabilized Fly Ash
Authors: Besco Stefano , Bosio Alberto , Brisotto Mariangela , Depero Laura , Lorenzetti Alessandra , Bontempi Elza , Bonora Renato , Modesti Michele
Published: August 2014

This paper reports the results on the use of an innovative inert, based on stabilized fly ash from municipal solid waste incineration as a filler for polypropylene. The starting material, which contains large quantities of leachable Pb and Zn, was stabilized by means of an innovative process using rice husk ash as a waste silica source, together with other fly ashes, such as coal fly ash and flue gas desulfurization residues. The use of all waste materials to obtain a new filler makes the proposed technology extremely sustainable and competitive. The new composites, obtained by using the stabilized material as a filler for polypropylene, were characterized and their mechanical properties were also investigated. A comparison with a traditional polypropylene and calcium carbonate based compound was also done. This research activity was realized in the frame of the COSMOS-RICE project, financed by the EU Commission.
Tackling Air Pollution in China—What do We Learn from the Great Smog of 1950s in LONDON
Authors: Zhang Dongyong , Liu Junjuan , Li Bingjun
Published: August 2014

Since the prolonged, severe smog that blanketed many Chinese cities in first months of 2013, living in smog has become “normal” to most people living in mainland China. This has not only caused serious harm to public health, but also resulted in massive economic losses in many other ways. Tackling the current air pollution has become crucial to China’s long-term economic and social sustainable development. This paper aims to find the causes of the current severe air quality and explore the possible solutions by reviewing the current literature, and by comparing China’s air pollution regulations to that of the post London Killer Smog of 1952, in the United Kingdom (UK). It is hoped that China will learn the lesson from the UK, and decouple its economic growth from the detrimental impact of environment. Policy suggestions are made.
Syntheses of 15N-labeled pre-queuosine nucleobase derivatives
Authors: Levic Jasmin , Micura Ronald
Published: August 2014

Pre-queuosine or queuine (preQ1) is a guanine derivative that is involved in the biosynthetic pathway of the hypermodified tRNA nucleoside queuosine (Que). The core structure of preQ1 is represented by 7-(aminomethyl)-7-deazaguanine (preQ1 base). Here, we report the synthesis of three preQ1 base derivatives with complementary 15N-labeling patterns, utilizing [15N]-KCN, [15N]-phthalimide, and [15N3]-guanidine as cost-affordable 15N sources. Such derivatives are required to explore the binding process of the preQ1 base to RNA targets using advanced NMR spectroscopic methods. PreQ1 base specifically binds to bacterial mRNA domains and thereby regulates genes that are required for queuosine biosynthesis.