bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical and radiological differences in posterior reversible encephalopathy syndrome between patients with preeclampsia‐eclampsia and other predisposing diseases
Authors: Liman T. G. , Bohner G. , Heuschmann P. U. , Scheel M. , Endres M. , Siebert E.
Published: January 2012

Background:  Posterior reversible encephalopathy syndrome (PRES) is a serious maternal complication in pregnancy, but data on the clinicoradiological differences to other etiologies of PRES are scarce. In this study, we aimed to investigate the clinical and imaging characteristics of PRES in preeclampsia‐eclampsia patients compared with other predisposing diseases in a large cohort.

Methods:  We retrospectively reviewed the radiological report data bases between January 1999 and August 2010 for patients with PRES. Patients fulfilling the criteria for PRES after detailed investigation of clinical charts and imaging studies were separated into patients with eclampsia‐preeclampsia and other predisposing causes. Various imaging features at onset of symptoms and on follow‐up as well as clinical and paraclinical data were analyzed.

Results:  A total of 24 patients with preeclampsia‐eclampsia associated PRES and 72 patients with PRES of other predisposing causes were included into the study. In preeclampsia‐eclampsia patients, headaches were significantly more frequent as initial PRES‐related symptom (P < 0.001), whereas altered mental state was significantly less frequent (P = 0.001). Thalamus, midbrain, and pons affection was significantly less frequent in preeclampsia‐eclampsia associated PRES (P = 0.01). Preeclampsia‐eclampsia patients had significantly less severe edema, less cytotoxic edema, hemorrhage and contrast enhancement, while more frequent complete resolution of edema and less frequent residual structural lesions were seen on follow‐up imaging.

Conclusion:  In our PRES cohort, we found major clinicoradiological differences between preeclampsia‐eclampsia and other predisposing causes pointing toward a less severe course of disease in preeclampsia‐eclampsia.
Is there a future for neuroprotective agents in acute ischaemic stroke?
Authors: Kaste M.
Published: January 2012

Click here to view the accompanying paper in this issue.
Bank Lending Networks, Experience, Reputation, and Borrowing Costs: Empirical Evidence from the French Syndicated Lending Market
Authors: Godlewski Christophe J. , Sanditov Bulat , Burger‐Helmchen Thierry
Published: January 2012

Abstract:  We investigate the network structure of bank lending markets and evaluate the impact of lenders' network centrality, considered a measure of their experience and reputation, on borrowing costs. We show that the French market for syndicated bank loans is a ‘small world’ characterized by large local density and short social distances between lenders. Such a network structure allows for better information and resources flows between banks thus enhancing their social captial. We then show that lenders' experience and reputation play a significant role in reducing loan spreads and thus increasing borrower's wealth.
Pre‐IPO Acquirers’ Issuance Cost and Long‐Run Performance: Do Their M&A Disclosures Matter?
Authors: Hsu Junming , Young Weiju , Wang Hsin‐Yi
Published: January 2012

Abstract:  This paper investigates whether the activities and disclosures of mergers and acquisitions (M&As) preceding initial public offerings (IPOs) are associated with issuers’ (1) issuance cost and (2) long‐run performance. The results show that pre‐IPO acquirers have higher opportunity costs of issuance (OCI) than their matching companies (without pre‐IPO M&As) but their underpricing does not differ significantly, indicating that they tend to raise more funds by issuing a greater number of shares. This action can be due to issuers’ intention to undertake more M&As or fear of their inability to successfully issue equity in the future. We also find that pre‐IPO acquirers underperform their matching companies in the long run, with those undisclosing M&A information in the prospectus performing worse than those who did. These results reveal that investors’ valuation of disclosing pre‐IPO acquirers is lower, but not low enough, because they underestimate the difficulty of M&A integration. Further, investors overvalue undisclosing acquirers more seriously because they know little about their pre‐IPO M&A activities. These phenomena suggest that information disclosure in the prospectus does affect investors’ valuation.
Saturated long‐chain fatty acids activate inflammatory signaling in astrocytes
Authors: Gupta Sunita , Knight Alecia G. , Gupta Shruti , Keller Jeffrey N. , Bruce‐Keller Annadora J.
Published: January 2012

J. Neurochem. (2012) 120, 1060–1071.

This study describes the effects of long‐chain fatty acids on inflammatory signaling in cultured astrocytes. Data show that the saturated fatty acid palmitic acid, as well as lauric acid and stearic acid, trigger the release of TNFα and IL‐6 from astrocytes. Unsaturated fatty acids were unable to induce cytokine release from cultured astrocytes. Furthermore, the effects of palmitic acid on cytokine release require Toll‐like receptor 4 rather than CD36 or Toll‐like receptor 2, and do not depend on palmitic acid metabolism to palmitoyl‐CoA. Inhibitor studies revealed that pharmacologic inhibition of p38 or p42/44 MAPK pathways prevents the pro‐inflammatory effects of palmitic acid, whereas JNK and PI3K inhibition does not affect cytokine release. Depletion of microglia from primary astrocyte cultures using the lysosomotropic agent l‐leucine methyl ester revealed that the ability of palmitic acid to trigger cytokine release is not dependent on the presence of microglia. Finally, data show that the essential ω‐3 fatty acid docosahexaenoic acid acts in a dose‐dependent manner to prevent the actions of palmitic acid on inflammatory signaling in astrocytes. Collectively, these data demonstrate the ability of saturated fatty acids to induce astrocyte inflammation in vitro. These data thus raise the possibility that high levels of circulating saturated fatty acids could cause reactive gliosis and brain inflammation in vivo, and could potentially participate in the reported adverse neurologic consequences of obesity and metabolic syndrome.
Linkage of cardiac gene expression profiles and ETS2 with lifespan variability in rats
Authors: Sheydina Anna , Volkova Maria , Jiang Liqun , Juhasz Ondrej , Zhang Jing , Tae Hyun‐Jin , Perino Maria G. , Wang Mingyi , Zhu Yi , Lakatta Edward G. , Boheler Kenneth R.
Published: January 2012

Longevity variability is a common feature of aging in mammals, but the mechanisms responsible for this remain largely unknown. Using microarray datasets coupled with prediction analysis of microarrays (PAM), we identified a set of 252 cardiac transcripts predictive of relative lifespan in Wistar and Fisher 344 rats. Prediction analysis of microarrays ‘tests’ of rat heart transcriptomes from a third longer lived Fisher × Norway Brown rat strain validated the predictive value of this gene subset. The expression patterns of these genes were highly conserved, and corresponding promoter regions were employed to identify common cis–elements and trans‐activating factors implicated in their control. Specifically, four transcription factors (Max, Ets2, Erg, and Msx2) present in heart displayed longevity‐dependent, strain‐independent changes in abundance, but only ETS2 had an expression profile that directly correlated with the relative lifespan gene set. In heart, ETS2 was prevalent in cardiomyocytes (CMs) and showed a high degree of myocyte‐to‐myocyte variability predominantly in adult rat hearts prior to the exponential increase in the rate of mortality. Exclusively in this group, elevated ETS2 significantly overlapped with TUNEL staining in heart myocytes. In response to sympathetic stimuli, ETS2 is also up‐regulated, and functionally, adenovirus‐mediated over‐expression of ETS2 promotes apoptosis‐inducing factor‐mediated, caspase‐independent programmed necrosis exclusively in CMs that can be fully inhibited by the PARP‐1 inhibitor DPQ. We conclude that variations in ETS2 abundance in hearts of adult rodents and the associated loss of CMs contribute at least partially, to the longevity variability observed during normal aging of rats through activation of programmed necrosis.
Motivations and barriers in using distributed supply chain simulation
Authors: Mustafee Navonil , Taylor Simon , Katsaliaki Korina , Dwivedi Yogesh , Williams Michael
Published: January 2012

Discrete event simulation (DES) is a technique that is used by analysts to take informed decisions regarding an existing or proposed system of interest.DESmodels typically represent the processes associated with various business units. However, in the case of supply chains more than one business unit may need to be modelled as different organisations may be responsible for various supply chain operations such as manufacturing, transport and logistics, distribution, warehouse operations, etc. Organisations can be protective about their internal processes and can have concerns regarding data/information security and privacy. Thus it could be argued that creating a singleDESsupply chain model representing the various inter‐organisational processes is usually not an option since this will run counter to organisational privacy. Further, issues such as data transfer, model composability and execution speed may also make a single model approach problematic. A potential solution could be to create several distinct and well‐definedDESmodels, each modelling the processes associated with one specific supply chain business unit, linked together over the internet. We refer to this possible distributed approach as Distributed Supply Chain Simulation (DSCS). Although this approach holds great promise, there are technical barriers in usingDSCS. The paper discusses the benefits and barriers of a distributed approach and then, using a healthcareDSCS, the technological feasibility is demonstrated. In conclusion, the paper argues that adopting a standardised approach toDSCSwill remove a major barrier to its use.
Epithelial Na+ channel activity in human airway epithelial cells: the role of serum and glucocorticoid‐inducible kinase 1
Authors: Watt Gordon B , Ismail Noor AS , Caballero Agustin Garcia , Land Stephen C , Wilson Stuart M
Published: January 2012

BACKGROUND AND PURPOSE Glucocorticoids appear to control Na+ absorption in pulmonary epithelial cells via a mechanism dependent upon serum and glucocorticoid‐inducible kinase 1 (SGK1), a kinase that allows control over the surface abundance of epithelial Na+ channel subunits (α‐, β‐ and γ‐ENaC). However, not all data support this model and the present study re‐evaluates this hypothesis in order to clarify the mechanism that allows glucocorticoids to control ENaC activity.

EXPERIMENTAL APPROACH Electrophysiological studies explored the effects of agents that suppress SGK1 activity upon glucocorticoid‐induced ENaC activity in H441 human airway epithelial cells, whilst analyses of extracted proteins explored the associated changes to the activities of endogenous protein kinase substrates and the overall/surface expression of ENaC subunits.

KEY RESULTS Although dexamethasone‐induced (24 h) ENaC activity was dependent upon SGK1, prolonged exposure to this glucocorticoid did not cause sustained activation of this kinase and neither did it induce a coordinated increase in the surface abundance of α‐, β‐ and γ‐ENaC. Brief (3 h) exposure to dexamethasone, on the other hand, did not evoke Na+ current but did activate SGK1 and cause SGK1‐dependent increases in the surface abundance of α‐, β‐ and γ‐ENaC.

CONCLUSIONS AND IMPLICATIONS Although glucocorticoids activated SGK1 and increased the surface abundance of α‐, β‐ and γ‐ENaC, these responses were transient and could not account for the sustained activation of ENaC. The maintenance of ENaC activity did, however, depend upon SGK1 and this protein kinase must therefore play an important but permissive role in glucocorticoid‐induced ENaC activation.
Risky Decision‐Making: An fMRI Study of Youth at High Risk for Alcoholism
Authors: Cservenka Anita , Nagel Bonnie J.
Published: January 2012

Background:  Adolescents with a family history of alcoholism (FHP) are at risk for developing an alcohol use disorder (AUD), and some studies indicate that FHP individuals show deficits in executive functioning. The ability to make adaptive decisions is one aspect of successful executive functioning that is often measured during risk‐taking tasks; however, this behavior has not been examined in FHP youth. As impaired decision‐making could predispose FHP youth to make poor choices related to alcohol use, the current study examined the neural substrates of risk‐taking in FHP adolescents and their family history negative (FHN) peers.

Methods:  Thirty‐one (18 FHP, 13 FHN) youth between 13 and 15 years old were included in this study. All youth had used little to no alcohol prior to study involvement. Functional magnetic resonance imaging was used to examine the neural substrates of risk‐taking during the Wheel of Fortune (WOF) decision‐making task (Ernst et al., 2004) in FHP and FHN youth.

Results:  FHP youth did not differ from FHN youth in risk‐taking behavior, but showed less brain response during risky decision‐making in right dorsolateral prefrontal cortex and right cerebellar regions compared with FHN peers.

Conclusions:  Despite no behavioral differences on the WOF decision‐making task, FHP youth exhibited atypical neural response during risk‐taking compared with FHN peers. Atypical brain activity, in regions implicated in executive functioning could lead to reduced cognitive control, which may result in risky choices regarding alcohol use. This could help explain the higher rates of AUDs seen in FHP adolescents. Further examination of risky behavior and associated brain response over the course of adolescence is necessary to characterize the vulnerabilities of FHP youth in the absence of alcohol abuse.
Cycles in Politics: Wavelet Analysis of Political Time Series
Authors: Aguiar‐Conraria Luís , Magalhães Pedro C. , Soares Maria Joana
Published: January 2012

Spectral analysis and ARMA models have been the most common weapons of choice for the detection of cycles in political time series. Controversies about cycles, however, tend to revolve around an issue that both techniques are badly equipped to address: the possibility of irregular cycles without fixed periodicity throughout the entire time series. This has led to two main consequences. On the one hand, proponents of cyclical theories have often dismissed established statistical techniques. On the other hand, proponents of established techniques have dismissed the possibility of cycles without fixed periodicity. Wavelets allow the detection of transient and coexisting cycles and structural breaks in periodicity. In this article, we present the tools of wavelet analysis and apply them to the study of two lingering puzzles in the political science literature: the existence of cycles in election returns in the United States and in the severity of major power wars.
External Networking and Internal Firm Governance
Authors: FRACASSI CESARE , TATE GEOFFREY
Published: January 2012

We use panel data on S&P 1500 companies to identify external network connections between directors and CEOs. We find that firms with more powerful CEOs are more likely to appoint directors with ties to the CEO. Using changes in board composition due to director death and retirement for identification, we find that CEO‐director ties reduce firm value, particularly in the absence of other governance mechanisms to substitute for board oversight. Moreover, firms with more CEO‐director ties engage in more value‐destroying acquisitions. Overall, our results suggest that network ties with the CEO weaken the intensity of board monitoring.
Political Uncertainty and Corporate Investment Cycles
Authors: JULIO BRANDON , YOOK YOUNGSUK
Published: January 2012

We document cycles in corporate investment corresponding with the timing of national elections around the world. During election years, firms reduce investment expenditures by an average of 4.8% relative to nonelection years, controlling for growth opportunities and economic conditions. The magnitude of the investment cycles varies with different country and election characteristics. We investigate several potential explanations and find evidence supporting the hypothesis that political uncertainty leads firms to reduce investment expenditures until the electoral uncertainty is resolved. These findings suggest that political uncertainty is an important channel through which the political process affects real economic outcomes.
Tiebreaker: Certification and Multiple Credit Ratings
Authors: BONGAERTS DION , CREMERS K. J. MARTIJN , GOETZMANN WILLIAM N.
Published: January 2012

This paper explores the economic role credit rating agencies play in the corporate bond market. We consider three existing theories about multiple ratings: information production, rating shopping, and regulatory certification. Using differences in rating composition, default prediction, and credit spread changes, our evidence only supports regulatory certification. Marginal, additional credit ratings are more likely to occur because of, and seem to matter primarily for, regulatory purposes. They do not seem to provide significant additional information related to credit quality.
The Value of Investment Banking Relationships: Evidence from the Collapse of Lehman Brothers
Authors: FERNANDO CHITRU S. , MAY ANTHONY D. , MEGGINSON WILLIAM L.
Published: January 2012

We examine the long‐standing question of whether firms derive value from investment bank relationships by studying how the Lehman collapse affected industrial firms that received underwriting, advisory, analyst, and market‐making services from Lehman. Equity underwriting clients experienced an abnormal return of around −5%, on average, in the 7 days surrounding Lehman's bankruptcy, amounting to $23 billion in aggregate risk‐adjusted losses. Losses were especially severe for companies that had stronger and broader security underwriting relationships with Lehman or were smaller, younger, and more financially constrained. Other client groups were not adversely affected.
Family‐Controlled Firms and Informed Trading: Evidence from Short Sales
Authors: ANDERSON RONALD C. , REEB DAVID M. , ZHAO WANLI
Published: January 2012

We investigate the relation between organization structure and the information content of short sales, focusing on founder‐ and heir‐controlled firms. Our analysis indicates that family‐controlled firms experience substantially higher abnormal short sales prior to negative earnings shocks than nonfamily firms. Supplementary testing indicates that family control characteristics intensify informed short selling. Further analysis suggests that daily short‐sale interest in family firms contains useful information in forecasting stock returns; however, we find no discernable effect for nonfamily firms. This analysis provides compelling evidence that informed trading via short sales occurs more readily in family firms than in nonfamily firms.
Elevated Temperature Thermal Properties of ZrB2 with Carbon Additions
Authors: Thompson Matthew J. , Fahrenholtz William G. , Hilmas Greg E.
Published: January 2012

The thermal properties of zirconium diboride (ZrB2) ceramics with carbon additions of up to 3 wt% were characterized up to 2000°C. Carbon contents were selected to produce ZrB2 that was nominally pure, contained dissolved carbon, or contained carbon inclusions. The microstructure and density changes that resulted from the carbon additions affected the thermal behavior of ZrB2 at room and elevated temperatures. Thermal diffusivity at 200°C increased from 0.150 cm2/s for nominally pure ZrB2 to 0.175 cm2/s for ZrB2 with 3 wt% carbon. The thermal diffusivity decreased with increasing temperature, reaching a value of 0.143 cm2/s at 2000°C for ZrB2 with 3 wt% carbon. In addition, thermal diffusivity changed irreversibly during the first thermal cycle after densification due to changes in the microstructure that started between 1550°C and 1650°C. Heating resulted in the formation of a new phase, growth of ZrB2 grains, changes in the morphology of carbon inclusions, and migration of W impurities from the ZrB2 matrix into the new phase. Heat capacity, unlike thermal diffusivity, did not change during thermal cycling. Thermal conductivity, which was calculated from thermal diffusivity, heat capacity, and density, was as high as 64.2 W·(m·K)−1 at 2000°C for ZrB2 with 3 wt% carbon. The phonon contribution to thermal conductivity decreased to nearly zero with the addition of 3 wt% carbon due to the presence of elongated carbon inclusions around ZrB2 grains.
Modeling the Influence of Carbon Spheres on the Porosity of SOFC Anode Materials
Authors: Horri Bahman Amini , Selomulya Cordelia , Wang Huanting
Published: January 2012

The influence of fabrication pressure and other ceramic processing variables, including volumetric loading fraction and the particle size ratio of pore‐forming agents, on the porosity of fabricated ceramic anodes, was investigated using an integrated experimental approach with mathematical modeling to differentiate the impacts of each parameter. Despite historic observation of the properties of ceramic bodies, to date, there is a lack of available models to accurately interpret the ceramic properties as a function of the processing variables. Herein, we focus on the open porosity of the solid oxide fuel cell anode prepared from NiO/YSZ (nickel oxide/yttria stabilized zirconia) as the ceramic powder and using CMS (carbon microspheres) as a pore‐forming agent. A range of pore‐former volumetric blend ratios (4.4%–44.6%) and different particle size ratios between NiO/YSZ and CMS (11.27, 4.29, and 0.26) were used, whereas the influence of the applied uni‐axial fabrication pressure on the open porosity of sintered anode was studied in a range of atmospheric pressure up to 40 MPa. A good agreement was observed between the proposed model and the experimental data, implying that the approach could be used to determine the significant processing parameters to fabricate ceramics with desired porosity. The model could also be used to interpret the physical basis of pore formation when using a pore‐forming agent in a fabricated porous ceramic body.
Effects of Crystallization Atmospheres on the Near‐Infrared Absorbtion and Electroconductive Properties of Tungsten Bronze Type MxWO3 (M = Na,K)
Authors: Guo Chongshen , Yin Shu , Sato Tsugio
Published: January 2012

The fine particles of tetragonal KxWO3 and cubic NaxWO3 were successfully synthesized by reducing WO42− with BH4− in aqueous solutions, followed by the crystallization of amorphous precursors by calcination under N2, NH3 and H2 (5 vol%)/N2 atmospheres at 600°C for 1 h, respectively. The products showed excellent electrical conductivity, visible light transparency, and near‐infrared light shielding characteristics, where the samples crystallized in H2 (5 vol%)/N2 mixed gas showed the highest electric conductivity being superior to commercial conductive oxide ITO. Meanwhile, the samples showed strong absorption of near‐infrared light and instantaneous conversion of photo‐energy to local heat. The effects of crystallization atmosphere on the near‐infrared absorbtion and electroconductivity properties of KxWO3 and NaxWO3 are discussed in detail.
Changes to the Triaxial Composition of the Hydrated Phases (CaO/Al2O3/SiO2) in the Metakaolin/Lime System
Authors: García Giménez Rosario , Rodríguez Olga , Vigil de la Villa Raquel , Frías Moisés
Published: January 2012

This study examines the composition of certain hydrates (calcium silicate, aluminum silicate, and related phases) produced by the pozzolanic reaction of waste‐paper sludge that had previously been activated at different temperatures. It summarizes and compares the evolution of the oxide compounds, and records their stability intervals. Changes to their mineralogical composition were analyzed using X‐Ray Diffraction, scanning electron microscopy, and energy dispersive X‐ray spectroscopy. The hydration products from 1 to 360 days of curing time were CSH gels, hydrotalcite‐type compounds (LDH), and stratlingite (C2ASH8). CSH gels were employed as substrates for growing other materials and their morphologies were modified from fibrous to hexagonal layers. The composition of the LDH‐type compounds observed in the carbonate group varied with changes in curing time. Two LDH‐type compound types were identified: (a) with and (b) without magnesium. Stratlingite was the only stable material after long‐curing times.
Mechanisms of Mono‐Vacancy and Oxygen Permeability in Y2SiO5 Orthosilicate Studied by First‐Principles Calculations
Authors: Liu Bin , Wang Jiemin , Li Fangzhi , Wang Jingyang , Zhou Yanchun
Published: January 2012

Understanding the mechanisms of native point defects and oxygen‐vacancy diffusion in Y2SiO5 is important to evaluate its performance as environmental and thermal barrier coating (ETBC). In the present first‐principles calculations, we show that oxygen vacancy is the predominant vacancy species and prefers to form on the oxygen lattice sites inside SiO4 tetrahedra instead of on the interstitial non‐silicon‐bonded oxygen site. The calculated defect formation energy and concentration of mono‐vacancies in Y2SiO5 obviously depend on the chemical potential of each element. The results suggest that it is possible to tailor the vacancy species in Y2SiO5 by controlling the chemical environment in material synthesis. Finally, theoretical simulation revealed that the self‐diffusion of oxygen vacancy has high energy barriers in Y2SiO5, which is comparable to those in SiO2 and Al2O3. The result demonstrates low oxygen permeability in Y2SiO5 and further strengthens its promising applications as ETBC material.
Photoluminescent Properties of Sb‐Doped Phosphate Glass
Authors: Masai Hirokazu , Matsumoto Syuji , Fujiwara Takumi , Tokuda Yomei , Yoko Toshinobu
Published: January 2012

The authors report on the UV‐excited photoluminescence measured in Sb2O3–ZnO–P2O5 glass. Pre‐heat treatment performed before melting effectively prevented the discoloration caused by precipitation of Sb nanoparticles. Although both Sb3+ and Sn2+ belong to the ns2‐type emission center, the Sb3+‐doped 60ZnO–40P2O5 glass showed an emission with a weaker intensity and a broader band than Sn2+‐doped 60ZnO–40P2O5 glass. The emission decay of 1.0SbO3/2–60ZnO–40P2O5 glass was about 2.5 μs, which was shorter than that of 1.0SnO–60ZnO–40P2O5 glass. The obtained results suggest that the emission properties of ns2‐type emission centers depend on several factors, such as element of emission center, chemical composition, and preparation scheme, which are easily and widely tuned in random amorphous materials.
Performance of the Canadian CT Head Rule and the New Orleans Criteria for Predicting Any Traumatic Intracranial Injury on Computed Tomography in a United States Level I Trauma Center
Authors: Papa Linda , Stiell Ian G. , Clement Catherine M. , Pawlowicz Artur , Wolfram Andrew , Braga Carolina , Draviam Sameer , Wells George A.
Published: January 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19:2–10 © 2012 by the Society for Academic Emergency Medicine

Objectives:  This study compared the clinical performance of the Canadian CT Head Rule (CCHR) and the New Orleans Criteria (NOC) for detecting any traumatic intracranial lesion on computed tomography (CT) in patients with a Glasgow Coma Scale (GCS) score of 15. Also assessed were ability to detect patients with “clinically important” brain injury and patients requiring neurosurgical intervention. Additionally, the performance of the CCHR was assessed in a larger cohort of those presenting with GCS of 13 to 15.

Methods:  This prospective cohort study was conducted in a U.S. Level I trauma center and enrolled a consecutive sample of mildly head‐injured adults who presented to the emergency department (ED) with witnessed loss of consciousness, disorientation or amnesia, and GCS 13 to 15. The rules were compared in the group of patients with GCS 15. The primary outcome was prediction of “any traumatic intracranial injury” on CT. Secondary outcomes included “clinically important brain injury” on CT and need for neurosurgical intervention.

Results:  Among the 431 enrolled patients, 314 patients (73%) had a GCS of 15, and 22 of the 314 (7%) had evidence of a traumatic intracranial lesion on CT. There were 11 of 314 (3.5%) who had “clinically important” brain injury, and 3 of 314 (1.0%) required neurosurgical intervention. The NOC and CCHR both had 100% sensitivity (95% confidence interval [CI] = 82% to 100%), but the CCHR was more specific for detecting any traumatic intracranial lesion on CT, with a specificity of 36.3% (95% CI = 31% to 42%) versus 10.2% (95% CI = 7% to 14%) for NOC. For “clinically important” brain lesions, the CCHR and the NOC had similar sensitivity (both 100%; 95% CI = 68% to 100%), but the specificity was 35% (95% CI = 30% to 41%) for CCHR and 9.9% (95% CI = 7% to 14%) for NOC. When the rules were compared for predicting need for neurosurgical intervention, the sensitivity was equivalent at 100% (95% CI = 31% to 100%) but the CCHR had a higher specificity at 80.7% (95% CI = 76% to 85%) versus 9.6% (95% CI = 7% to 14%) for NOC. Among all 431 patients with a GCS score 13 to 15, the CCHR had sensitivities of 100% (95% CI = 84% to 100%) for 27 patients with clinically important brain injury and 100% (95% CI = 46% to 100%) for five patients requiring neurosurgical intervention.

Conclusions:  In a U.S. sample of mildly head‐injured patients, the CCHR and the NOC had equivalently high sensitivities for detecting any traumatic intracranial lesion on CT, clinically important brain injury, and neurosurgical intervention, but the CCHR was more specific. A larger cohort will be needed to validate these findings.
Developing a Diagnosis‐based Severity Classification System for Use in Emergency Medical Services for Children
Authors: Alessandrini Evaline A. , Alpern Elizabeth R. , Chamberlain James M. , Shea Judy A. , Holubkov Richard , Gorelick Marc H. ,   for the Pediatric Emergency Care Applied Research Network
Published: January 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19:70–78 © 2012 by the Society for Academic Emergency Medicine

Objectives:  Lack of adequate risk adjustment methodologies has hindered the progress of emergency medicine health services research. The authors hypothesized that a consensus‐derived, diagnosis‐based severity classification system (SCS) would be significantly associated with actual measures of emergency department (ED) resource use and could ultimately be used to examine severity‐adjusted outcomes across patient populations.

Methods:  A panel of subject matter experts used consensus methods to assign severity scores (1 = lowest severity to 5 = highest severity) to 3,041 ED International Classifications of Diseases (ICD), 9th revision, diagnosis codes. SCS scores were assigned to ED visits using the visit diagnosis code with the highest severity. We tested the association between the SCS scores and measures of ED resource use in three data sets: the Pediatric Emergency Care Applied Research Network Core Data Project (PCDP), the National Hospital Ambulatory Medical Care Survey (NHAMCS), and the Connecticut state ED data set.

Results:  There was a significant association between the five‐level SCS and all six measures of resource use: triage category, disposition, ED resource use, Current Procedural Terminology Evaluation and Management (CPT E&M) codes, ED length of stay, and ED charges within the three ED data sets.

Conclusions:  The SCS demonstrates validity in its strong association with actual ED resource use. The use of readily available ICD‐9 diagnosis codes makes the SCS useful as a risk adjustment tool for health services research.
Root Causes of Errors in a Simulated Prehospital Pediatric Emergency
Authors: Lammers Richard , Byrwa Maria , Fales William
Published: January 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19:37–47 © 2012 by the Society for Academic Emergency Medicine

Objectives:  Systematic evaluation of prehospital provider performance during actual resuscitations is difficult. Although prior studies reported pediatric drug‐dosing mistakes and other types of management errors, the underlying causes of those errors were not investigated. The objective of this study was to identify causes of errors during a simulated, prehospital pediatric emergency.

Methods:  Two‐person emergency medical services (EMS) crews from five geographically diverse agencies participated in a validated simulation of an infant with altered mental status, seizures, and respiratory arrest using their own equipment and drugs. A scoring protocol was used to identify errors. A debriefing conducted by a trained facilitator immediately after the simulated event elicited root causes of active and latent errors, which were analyzed by thematic qualitative assessment methods.

Results:  Forty‐five crews completed the study. Clinically important themes that emerged from the data included oxygen delivery, equipment organization and use, glucose measurement, drug administration, and inappropriate cardiopulmonary resuscitation. Delay in delivery of supplemental oxygen resulted from two different automaticity errors and a 54% failure rate in using an oropharyngeal airway (OPA). Most crews struggled to locate essential pediatric equipment. Three found broken or inoperable bag/valve/masks (BVMs), resulting in delayed ventilation. Some mistrusted their intraosseous (IO) injection gun device; others used it incorrectly. Only 51% of crews measured blood glucose; some discovered that glucometers were not stored in their sealed pediatric bags. The error rate for diazepam dosing was 47%; for midazolam, it was 60%. Underlying causes of dosing errors were found in four domains (cognitive, procedural, affective, and teamwork), and they included incorrect estimates of weight, incorrect use of the Broselow pediatric emergency tape, faulty recollection of doses, difficulty with calculations under stress, mg/kg to mg to mL conversion errors, inaccurate measurement of volumes, use of the wrong end of prefilled syringes, and failure to crosscheck doses with partners.

Conclusions:  Simulation, followed immediately by facilitated debriefing, uncovered underlying causes of active cognitive, procedural, affective, and teamwork errors, latent errors, and error‐producing conditions in EMS pediatric care.
Cardiac differentiation of human pluripotent stem cells
Authors: Jiang Junjie , Han Pengcheng , Zhang Qiangzhe , Zhao Jianmin , Ma Yue
Published: January 2012

Due to the extremely limited proliferative capacity of adult cardiomyocytes, human embryonic (pluripotent) stem cell derived cardiomyocytes (hESC‐CMs) are currently almost the only reliable source of human heart cells which are suited to large‐scale production. These cells have the potential for wide‐scale application in drug discovery, heart disease research and cell‐based heart repair. Embryonic atrial‐, ventricular‐ and nodal‐like cardiomyocytes can be obtained from differentiated human embryonic stem cells (hESCs). In recent years, several highly efficient cardiac differentiation protocols have been developed. Significant progress has also been made on understanding cardiac subtype specification, which is the key to reducing the heterogeneity of hESC‐CMs, a major obstacle to the utilization of these cells in medical research and future cell‐based replacement therapies. Herein we review recent progress in cardiac differentiation of hESCs and cardiac subtype specification, and discuss potential applications in drug screening and cell‐based heart regeneration.
The non‐anticoagulant heparin‐like K5 polysaccharide derivative K5‐N,OSepi attenuates myocardial ischaemia/reperfusion injury
Authors: Collino Massimo , Pini Alessandro , Mastroianni Rosanna , Benetti Elisa , Lanzi Cecilia , Bani Daniele , Chini Jacopo , Manoni Marco , Fantozzi Roberto , Masini Emanuela
Published: January 2012

Heparin and low molecular weight heparins have been demonstrated to reduce myocardial ischaemia/reperfusion (I/R) injury, although their use is hampered by the risk of haemorrhagic and thrombotic complications. Chemical and enzymatic modifications of K5 polysaccharide have shown the possibility of producing heparin‐like compounds with low anticoagulant activity and strong anti‐inflammatory effects. Using a rat model of regional myocardial I/R, we investigated the effects of an epimerized N‐,O‐sulphated K5 polysaccharide derivative, K5‐N,OSepi, on infarct size and histological signs of myocardial injury caused by 30 min. ligature of the left anterior descending coronary artery followed by 1 or 24 h reperfusion. K5‐N,OSepi (0.1–1 mg/kg given i.v. 15 min. before reperfusion) significantly reduced the extent of myocardial damage in a dose‐dependent manner. Furthermore, we investigated the potential mechanism(s) of the cardioprotective effect(s) afforded by K5‐N,OSepi. In left ventricular samples, I/R induced mast cell degranulation and a robust increase in lipid peroxidation, free radical‐induced DNA damage and calcium overload. Markers of neutrophil infiltration and activation were also induced by I/R in rat hearts, specifically myeloperoxidase activity, intercellular‐adhesion‐molecule‐1 expression, prostaglandin‐E2 and tumour‐necrosis‐factor‐α production. The robust increase in oxidative stress and inflammatory markers was blunted by K5‐N,OSepi, in a dose‐dependent manner, with maximum at 1 mg/kg. Furthermore, K5‐N,OSepi administration attenuated the increase in caspase 3 activity, Bid and Bax activation and ameliorated the decrease in expression of Bcl‐2 within the ischaemic myocardium. In conclusion, we demonstrate that the cardioprotective effect of the non‐anticoagulant K5 derivative K5‐N,OSepi is secondary to a combination of anti‐apoptotic and anti‐inflammatory effects.
MAPK and PI3K/AKT mediated YB‐1 activation promotes melanoma cell proliferation which is counteracted by an autoregulatory loop
Authors: Sinnberg Tobias , Sauer Birgit , Holm Per , Spangler Barbara , Kuphal Silke , Bosserhoff Anja , Schittek Birgit
Published: January 2012

Abstract:  Y‐box binding protein 1 (YB‐1) is an oncogenic transcription and translation factor and is overexpressed in several types of cancer. Our previous data showed that YB‐1 is upregulated and translocated to the nucleus during melanoma progression and that YB‐1 is an important transcription factor regulating proliferation, survival, migration, invasion and chemosensitivity of melanoma cells. It has been suggested that YB‐1 is activated and translocated to the nucleus after S102‐phosphorylation in the DNA binding domain. In this study, we show that activation of YB‐1 by S102‐phosphorylation and nuclear translocation is increased during melanoma progression using a human tissue microarray with 100 melanocytic lesions. Furthermore, we analysed the mechanisms governing the expression and activity of YB‐1 in melanoma cells. We show that the PI3K/AKT and p53 signalling, growth factors and chemotherapeutic agents increase YB‐1 promoter activity. This, however, resulted in no or only modest increase in YB‐1 protein expression. We show that the MAPK and PI3K/AKT signalling pathways, both activated in melanoma cells, as well as p53 overexpression increase YB‐1 S102‐phosphorylation, whereas NFκB signalling inhibits phosphorylation. Overexpression of YB‐1 in melanoma cells inhibits translation efficiency and by this proliferation and survival of melanoma cells indicating that there is an autoregulatory loop restricting YB‐1 protein expression. These data suggest that there is a tightly regulated feedback mechanism regulating YB‐1 expression and activation, necessary for proper cell cycle progression of melanoma cells.
Infrequent p53 gene mutation but UV gradient‐like p53 protein positivity in keloids
Authors: Heitzer Ellen , Seidl Hannes , Bambach Isabella , Schmidbauer Ulrike , Cerroni Lorenzo , Wolf Peter
Published: January 2012

Abstract:  Keloids are characterized by extreme fibroblastic overgrowth of unknown pathogenesis after skin injury. Previous studies, mostly in non‐Caucasian populations, suggest that p53 mutations may be involved. To substantiate this, we performed DNA sequence analysis of exons 4–8 of the p53 gene and immunohistochemical staining of p53 protein in archived keloidal tissue samples from 23 Caucasian patients. In contrast to previous reports, we found mutated p53 in keloidal tissue in a minority of cases (2/23; 12%). The G allele frequency and C allele frequency at the p53 polymorphic codon 72 were 0.72 (33/46) and 0.28 (13/46), respectively, in our study, a finding that was similar to the 0.77 (184/240) vs. 0.23 (56/240) (P = 0.4580; chi‐squared test) observed in the Hap Map data of a European population but statistically significantly different from the 0.43 (547/1258) vs. 0.57 (711/1258) (P = 0.0002; chi‐squared test) observed in the 1000 Genome project [Database of Single Nucleotide Polymorphisms (dbSNP). Bethesda (MD): National Center for Biotechnology Information, National Library of Medicine. dbSNP accession:rs1042522, (dbSNP Build ID: 132). Available from: (http://www.ncbi.nlm.nih.gov/SNP/] a difference most likely due to the different genetic background of the populations enrolled. However, one‐third of the keloidal samples showed lesional nuclear p53 staining with a UV penetration gradient‐like positivity (P ≤ 0.0084). Staining with an anti‐cyclobutane pyrimidine dimer antibody revealed the total absence of short‐term photoproducts in the epidermis as well as keloidal tissue. Furthermore, all fibroblasts expressing p53 stained negative for Ki‐67, indicating that these cells were in a quiescent stage and p53 upregulation did not contribute to keloidal proliferation. We conclude that p53 plays no major role in the pathogenesis of keloids in the Caucasian population.
Habitat use of lake trout (Salvelinus namaycush) following species introduction
Authors: Wall Alexander J. , Blanchfield Paul J.
Published: January 2012

Abstract –  Although introductions of prey species have the potential to significantly alter habitat use by top predatory fish, this aspect has rarely been directly quantified. Introduction of yellow perch (Perca flavescens), a littoral–pelagic prey species, to a small boreal lake previously dominated by littoral cyprinids provided a unique opportunity to examine how a change in forage base influenced habitat use by the sole top predator, lake trout (Salvelinus namaycush). We monitored lake trout pelagic and spatial distribution using acoustic telemetry before (2001) and after (2008) the introduction of perch to determine whether habitat use reflected a deeper, offshore prey community. After accounting for differences in water temperature and dissolved oxygen concentrations between years and the inclusion of a control lake, our data suggest that lake trout habitat use changed after the introduction of yellow perch. Lake trout, on average, were 1.4 m deeper (P < 0.01), reduced their use of littoral habitat by 55% (P = 0.03) and experienced a 71% decrease in home range size (P < 0.01), consistent with a greater offshore habitat overlap between predator and prey after the introduction of yellow perch. This study illustrates how introduced prey species may have a significant influence on habitat use by top predatory fish, while also showing the importance of using direct measurements to quantify behavioural changes.
Link between inflammation and aquaporin‐5 distribution in submandibular gland in sjögren’s syndrome?
Authors: Soyfoo MS , Konno A , Bolaky N , Oak JS , Fruman D , Nicaise C , Takiguchi M , Delporte C
Published: January 2012

Oral Diseases (2012) 18, 568–574

Objective:  To determine whether a link exists between inflammation and aquaporin‐5 distribution in submandibular glands from three animal models for Sjögren’s syndrome: IQI/JIC, r1ΔT/r2n and non‐obese diabetic mice.

Methods:  Mice of different ages were used. Inflammatory infiltrates were quantified using the focus score. Acinar aquaporin‐5 subcellular distribution was determined by immunohistochemistry and quantified using labelling indices.

Results:  Minor inflammatory infiltrates were present in r1f/r2n mice. Massive inflammatory infiltrates and acinar destruction were observed in 24‐week‐old non‐obese diabetic mice, 10‐and 13‐month‐old IQI/JIC mice and some r1ΔT/r2n mice. Aquaporin‐5 immunoreactivity was primarily apical in submandibular glands from 8‐ and 24‐week‐old Balb/C mice, 8‐week‐old non‐obese diabetic mice, 2‐, 4‐ and 7‐month‐old IQI/JIC mice and r1f/r2n mice. In contrast, decreased apical aquaporin‐5 labelling index with concomitant increased apical‐basolateral, apical‐cytoplasmic and/or apical‐basolateral‐cytoplasmic aquaporin‐5 labelling indices was observed in 24‐week‐old non‐obese diabetic, 10‐ and 13‐month‐old IQI/JIC and r1ΔT/r2n mice with a focus score ≥ 1.

Conclusions:  Altered aquaporin‐5 distribution in submandibular acinar cells from IQI/JIC, non‐obese diabetic and r1ΔT/r2n mice with a focus score ≥ 1 appears to be concomitant to the presence of inflammatory infiltrates and acinar destruction.
Comparative assessment of validity and reliability of the Oral Impacts on Daily Performance (OIDP) frequency scale: a cross‐sectional survey among adolescents in Davanagere city, Karnataka, India
Authors: Usha GV , Thippeswamy HM , Nagesh L
Published: January 2012

Abstract:  Aim: To evaluate reliability and validity of an abbreviated version of the Oral Impact on Daily Performance (OIDP) questionnaire and to analyse the interrelationship between OIDP scores, socio‐demographic characteristics and oral health status among high school children in Davanagere city, Karnataka, India. Materials and methods: This cross‐sectional survey was conducted with 900 school children aged between 12 and 15. The subjects were randomly selected from six high schools. Selected subjects completed a survey instrument predesigned to measure subjective oral health indicators including the eight‐item OIDP frequency scores. The study participants were clinically examined for dental caries, and they completed a self‐administered questionnaire about demographic information and oral behaviours. Results: 44% of the students reported at least one oral impact in the previous 6 months. The reliability of the instrument was measured in terms of Cronbach’s alpha for the OIDP frequency. It was found to be 0.81. Eating was the most common performance affected (33%) followed by cleaning teeth (22%) and speaking (20%). The severity of impacts was low for relaxing and carrying out works. Conclusion: The OIDP frequency score has acceptable psychometric properties in the context of an oral health survey among high school children of Davanagere city, Karnataka, India.
Growth hormone deficiency: a possible complication of glucose transporter 1 deficiency?
Authors: Nakagama Yu , Isojima Tsuyoshi , Mizuno Yoko , Takahashi Nagahisa , Kitanaka Sachiko , Igarashi Takashi
Published: January 2012

Glucose transporter 1 deficiency syndrome (GLUT1DS) is an autosomal dominant disorder of brain energy metabolism caused by impaired GLUT1‐mediated glucose transport across the blood‐brain barrier. Although the clinical spectrum of this disorder is expanding rapidly, the growth patterns and endocrine status of these patients are not well known. We report the case of a boy aged 12 years and 7 months who has GLUT1DS complicated by growth failure. His failure to grow had progressed since birth, and his body height was 125 cm (−3.6 SDS). Growth hormone stimulation tests showed severe growth hormone deficiency (GHD), and we initiated GH replacement therapy. After 2 years of treatment, the boy’s growth rate recovered from 1.7 cm/year before treatment, to 7.5 cm/year and 4.3 cm/year after treatment with no adverse effects. We speculate that GHD is a possible complication of GLUT1DS and discuss the underlying causative mechanism.

Conclusion:  GHD may be a possible complication of GLUT1DS.