bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of diabetic nephropathy with Tripterygium wilfordii Hook F extract: a prospective, randomized, controlled clinical trial
Authors: Ge Yongchun , Xie Honglang , Li Shijun , Jin Bo , Hou Jinhua , Zhang Haitao , Shi Mingjun , Liu Zhihong
Published: May 2013

Background

Diabetic nephropathy (DN) is the most common cause of end-stage renal failure. Although angiotensin II receptor blockers (ARBs) can be used to attenuate proteinuria in DN patients, their efficacy remains limited. This clinical trial aimed to evaluate the efficacy of Tripterygium wilfordii Hook F (TwHF) extract in the treatment of type 2 diabetes mellitus (DM)-induced nephropathy.

Methods

A total of 65 DN patients with proteinuria levels ≥ 2.5 g/24 h and serum creatinine levels < 3 mg/dl were enrolled in this six-month, prospective, randomized, controlled study. The patients were randomized into treatment groups that received either 120 mg of TwHF extract per day for three months, followed by 60 mg per day for three more months, or 160 mg of valsartan daily for six months. The urinary protein and estimated glomerular filtration (eGFR) level were measured at one, three, and six months after the commencement of treatment. The primary measure of treatment efficacy was a reduction in the 24-h urine protein level between baseline and the end of the study, and the secondary measure of treatment efficacy was a reduction in the eGFR value.

Results

At the end of the treatment period, the mean urine protein level in the TwHF group was dramatically decreased (4.99 ± 2.25 g/24 h vs 2.99 ± 1.81 g/24 h, p < 0.01), with decreases at one, three, and six months of 32.9%, 38.8%, and 34.3%, respectively. In contrast, the proteinuria in the valsartan group was not significantly attenuated, and the decreases in urine protein levels at treatment months one, three, and six were 1.05%, 10.1%, and -11.7%, respectively. The mean decrease in eGFR in the valsartan group was greater than that in the TwHF group (26.4% vs. 13.7%, respectively; p =0.067).

Conclusions

TwHF extract can reduce the urine protein level of DN patients and represents a novel, potentially effective, and safe drug for the treatment of DN patients with proteinuria.

Trial registration

ClinicalTrials.gov: NCT00518362
Vitamin D to prevent acute lung injury following oesophagectomy (VINDALOO): study protocol for a randomised placebo controlled trial
Authors: Parekh Dhruv , Dancer Rachel C A , Lax Sian , Cooper Mark S , Martineau Adrian R , Fraser William D , Tucker Olga , Alderson Derek , Perkins Gavin D , Gao-Smith Fang , Thickett David R
Published: May 2013

Background

Acute lung injury occurs in approximately 25% to 30% of subjects undergoing oesophagectomy. Experimental studies suggest that treatment with vitamin D may prevent the development of acute lung injury by decreasing inflammatory cytokine release, enhancing lung epithelial repair and protecting alveolar capillary barrier function.

Methods/Design

The ‘Vitamin D to prevent lung injury following oesophagectomy trial’ is a multi-centre, randomised, double-blind, placebo-controlled trial. The aim of the trial is to determine in patients undergoing elective transthoracic oesophagectomy, if pre-treatment with a single oral dose of vitamin D3 (300,000 IU (7.5 mg) cholecalciferol in oily solution administered seven days pre-operatively) compared to placebo affects biomarkers of early acute lung injury and other clinical outcomes. The primary outcome will be change in extravascular lung water index measured by PiCCO® transpulmonary thermodilution catheter at the end of the oesophagectomy. The trial secondary outcomes are clinical markers indicative of lung injury: PaO2:FiO2 ratio, oxygenation index; development of acute lung injury to day 28; duration of ventilation and organ failure; survival; safety and tolerability of vitamin D supplementation; plasma indices of endothelial and alveolar epithelial function/injury, plasma inflammatory response and plasma vitamin D status. The study aims to recruit 80 patients from three UK centres.

Discussion

This study will ascertain whether vitamin D replacement alters biomarkers of lung damage following oesophagectomy.

Trial registration

Current Controlled Trials ISRCTN27673620
A distinctive colour associated with high iodine content in malignant pleural effusion from metastatic papillary thyroid cancer: a case report
Authors: Rosenstengel Andrew , Lim Ee Mun , Millward Michael , Lee YC Gary
Published: May 2013

Introduction

Pleural effusions are a common clinical problem and affect about one million people in the United States and United Kingdom each year. Over 60 causes of pleural effusion have been identified; establishing the definitive aetiology can be difficult, and often requires invasive procedures. Guidelines state that macroscopic examination of the fluid should be the first step in determining the aetiology of a pleural effusion. Papillary thyroid carcinoma is an uncommon cause of malignant pleural effusion, with only 10 cases reported in the literature, their physical characteristics and composition having been rarely described. We describe for the first time a distinctive brown colour of the malignant effusion (despite centrifugation) from a rare case of metastatic papillary thyroid cancer to the pleura, associated with a high pleural fluid iodine content. Such a characteristic may be useful in expediting diagnosis of a malignant pleural effusion in the appropriate clinical context.

Case presentation

We present the case of a 71-year-old Caucasian man with metastatic papillary thyroid cancer; a large, long-standing, right-sided pleural effusion and a 83-fold higher pleural thyroglobulin level compared to corresponding serum, supporting this malignancy as the cause of the patient’s effusion. The pleural fluid had a distinctive pigmentation similar to iodine-containing antiseptic preparations. Biopsy during medical thoracoscopy confirmed metastatic papillary thyroid carcinoma. Analysis of pleural fluid showed a pleural thyroglobulin level over 80 times that of serum levels (29,000μg/L versus 350ug/L). Pleural fluid iodine content was 23,000ug/L and may account for the fluid’s distinctive pigment, as iodine is an essential component in thyroglobulin and thyroid hormone synthesis.

Conclusions

Pleural fluid pigmentation may aid diagnosis in the appropriate clinical setting. A distinctive iodine-like brown colour of pleural fluid may represent elevated iodine content and should raise consideration of metastatic thyroid cancer as a cause for a pleural effusion.
Rapid detection of haemotropic mycoplasma infection of feline erythrocytes using a novel flow cytometric approach
Authors: Sánchez-Pérez Angeles , Brown Graeme , Malik Richard , Assinder Stephen J , Cantlon Katherine , Gotsis Christine , Dunbar Samantha , Fraser Stuart T
Published: May 2013

Background

The haemotropic mycoplasmas Mycoplasma haemofelis and Candidatus Mycoplasma haemominutum cause feline infectious anaemia with infection rates in feline populations reflecting widespread subclinical infection. Clinically significant infections are much rarer but can be life-threatening. Current diagnosis is dependent upon visualising organisms in stained blood smears, PCR or quantitative PCR (qPCR). These procedures are labour-intensive and time-consuming. Furthermore, PCR-based approaches offer limited insight into the disease burden of the infected animal.

Methods

We have developed a novel and rapid flow cytometric system that permits diagnosis of haemotropic mycoplasma infections and quantitation of the percentage of erythrocytes that are parasitized. The method exploits the fact that mature mammalian erythrocytes, the host cell for haemoplasmas, are enucleated and thus lack nucleic acid. DRAQ5 is a synthetic anthrocycline dye which rapidly crosses cell membranes and binds to nucleic acids. The presence of exogenous bacterial DNA in mammalian erythrocytes can, therefore, be detected by DRAQ5 uptake and flow cytometric detection of DRAQ5 fluorescence.

Results

Here, we show that this system can detect epi-erythrocytic infection of companion felines by haemotropic mycoplasma. Due to their differences in size, and hence the quantity of DNA, the two major feline hemoplasmas M. haemofelis and Candidatus M. haemominutum can be distinguished according to DRAQ5 fluorescence. We have also shown the usefulness of DRAQ5 uptake in monitoring a cat infected with M. haemofelis sequentially during treatment with doxycycline.

Conclusions

The technique described is the first report of a flow cytometric method for detecting haemotropic mycoplasmas in any species and could be applied to widespread screening of animal populations to assess infection by these epi-erythrocytic parasites.
Long non-coding RNA: a new player in cancer
Authors: Zhang Hua , Chen Zhenhua , Wang Xinxin , Huang Zunnan , He Zhiwei , Chen Yueqin
Published: May 2013

Emerging evidence showed that long non-coding RNAs (lncRNAs) play important roles in a wide range of biological processes and dysregulated lncRNAs are involved in many complex human diseases, including cancer. Although a few lncRNAs’ functions in cancer have been characterized, the detailed regulatory mechanisms of majority of lncRNAs in cancer initiation and progression remain largely unknown. In this review, we summarized recent progress on the mechanisms and functions of lncRNAs in cancer, especially focusing on the oncogenic and tumor suppressive roles of the newly identified lncRNAs, and the pathways these novel molecules might be involved in. Their potentials as biomarkers for diagnosis and prognosis in cancer are also discussed in this paper.
HIM-herbal ingredients in-vivo metabolism database
Authors: Kang Hong , Tang Kailin , Liu Qi , Sun Yi , Huang Qi , Zhu Ruixin , Gao Jun , Zhang Duanfeng , Huang Chenggang , Cao Zhiwei
Published: May 2013

Background

Herbal medicine has long been viewed as a valuable asset for potential new drug discovery and herbal ingredients’ metabolites, especially the in vivo metabolites were often found to gain better pharmacological, pharmacokinetic and even better safety profiles compared to their parent compounds. However, these herbal metabolite information is still scattered and waiting to be collected.

Description

HIM database manually collected so far the most comprehensive available in-vivo metabolism information for herbal active ingredients, as well as their corresponding bioactivity, organs and/or tissues distribution, toxicity, ADME and the clinical research profile. Currently HIM contains 361 ingredients and 1104 corresponding in-vivo metabolites from 673 reputable herbs. Tools of structural similarity, substructure search and Lipinski’s Rule of Five are also provided. Various links were made to PubChem, PubMed, TCM-ID (Traditional Chinese Medicine Information database) and HIT (Herbal ingredients’ targets databases).

Conclusions

A curated database HIM is set up for the in vivo metabolites information of the active ingredients for Chinese herbs, together with their corresponding bioactivity, toxicity and ADME profile. HIM is freely accessible to academic researchers at http://www.bioinformatics.org.cn/.
The effects of chronic AMPK activation on hepatic triglyceride accumulation and glycerol 3-phosphate acyltransferase activity with high fat feeding
Authors: Henriksen Bradley S , Curtis Mary E , Fillmore Natasha , Cardon Brandon R , Thomson David M , Hancock Chad R
Published: May 2013

Background

High fat feeding increases hepatic fat accumulation and is associated with hepatic insulin resistance. AMP Activated Protein Kinase (AMPK) is thought to inhibit lipid synthesis by the acute inhibition of glycerol-3-phosphate acyltransferase (GPAT) activity and transcriptional regulation via sterol regulatory element binding protein-1c (SREBP-1c).

Methods

The purpose of this study was to determine if chronic activation of AMPK prevented an increase in GPAT1 activity in rats fed a high fat diet. Rats were fed a control (C), or a high fat (HF) diet (60% fat) for 6 weeks and injected with saline or a daily aminoimidazole carboxamide ribnucleotide (AICAR) dose of 0.5 mg/g body weight.

Results

Chronic AMPK activation by AICAR injections resulted in a significant reduction in hepatic triglyceride accumulation in both the C and HF fed animals (C, 5.5±0.7; C+AICAR, 2.7 ±0.3; HF, 21.8±3.3; and HF+AICAR, 8.0±1.8 mg/g liver). HF feeding caused an increase in total GPAT and GPAT1 activity, which was not affected by chronic AMPK activation (GPAT1 activity vs. C, C+AICAR, 92±19%; HF, 186±43%; HF+AICAR, 234±62%). Markers of oxidative capacity, including citrate synthase activity and cytochrome c abundance, were not affected by chronic AICAR treatment. Interestingly, HF feeding caused a significant increase in long chain acyl-CoA dehydrogenase or LCAD (up 66% from C), a marker of fatty acid oxidation capacity.

Conclusions

These results suggest that chronic AMPK activation limits hepatic triglyceride accumulation independent of a reduction in total GPAT1 activity.
Modeling bioavailability to organs protected by biological barriers
Authors: Quignot Nadia
Published: May 2013

Computational pharmacokinetic (PK) modeling gives access to drug concentration vs. time profiles in target organs and allows better interpretation of clinical observations of therapeutic or toxic effects. Physiologically-based PK (PBPK) models in particular, based on mechanistic descriptions of the body anatomy and physiology, may also help to extrapolate in vitro or animal data to human.

Once in the systemic circulation, a chemical has access to the microvasculature of every organ or tissue. However, its penetration in the brain, retina, thymus, spinal cord, testis, placenta,… may be limited or even fully prevented by dynamic physiological blood-tissue barriers. Those barriers are both physical (involving tight junctions between adjacent cells) and biochemical (involving metabolizing enzymes and transporters).

On those cases, correct mechanistic characterization of the passage (or not) of molecules through the barrier can be crucial for improved PBPK modeling and prediction.

In parallel, attempts to understand and quantitatively characterize the processes involved in drug penetration of physiological barriers have led to the development of several in vitro experimental models. Data from such assays are very useful to calibrate PBPK models.

We review here those in vitro and computational models, highlighting the challenges and perspectives for in vitro and computational models to better assess drug availability to target tissues.
Effects of sprint interval and continuous endurance training on serum levels of inflammatory biomarkers
Authors: Hovanloo Fariborz , Arefirad Tahereh , Ahmadizad Sajad
Published: May 2013

Chronic and inflammatory diseases are major causes of mortality. Although the anti-inflammatory effects of exercise have been confirmed, but the effect of different types of exercise on inflammatory markers is different. The aim of this study is comparing the effects of two types of sprint interval (SIT) and continuous endurance (CET) training on inflammatory markers. Sixteen students who had recreational activities participated in this study and were randomly assigned to one of the two protocols. The SIT protocol consisted of four to six 30-s “all-out” Wingate tests separated by 4 minutes of recovery and The CET protocol included 90–120 minutes of cycling at 65% Vo2max. The two protocols were performed 3 days per week and for two weeks. In each group, two blood samples were collected before and 2 days (24 and 48 hrs) after the training. Results showed that there was no significant difference between the two training protocols on all measured parameters (p>0.05). The results of present study showed that the SIT and CET have identical effects on inflammatory markers.
Turning point economic development of modern Russia
Authors: Басовский  , Basovskiy Leonid , Басовская  , Basovskaya Elena
Published: May 2013

The transition of the Russian economy to grow in 1998 and studied the transition to slower growth in 2008–2009. Based on catastrophe theory shows that in 1998 and in 2008–2009 Russia’s economy was turning point in its development. After passing the turning point of 2008–2009 economy entered a period of sustainable growth retardation. Slower growth rates do not exceed the rate of growth of the world economy. The transition to slower growth generated by the policy, as reflected in federal law enacted in 2005–2011. Built econometric models, reflecting the negative impact of imperfect institution of ownership on the productivity of the economy and corporate profits, found arisen with institutional trap.
Toward an Improved Methodology to Construct and Reconcile Decision Analytic Preference Judgments
Authors: Anderson Richard M. , Clemen Robert
Published: May 2013

Psychologists and behavioral economists have documented a variety of judgmental flaws that people make when they face novel decision situations. Similar flaws arise when decision analysts work with decision makers to assess their preferences and trade-offs, because the methods the analyst uses are often unfamiliar to the decision makers. In this paper we describe a process designed to mitigate the occurrence of such biases; it brings together three steps. In training, the decision maker is first given values to apply in judgment tasks unrelated to the decision at hand, providing an introduction to thinking deliberately and quantitatively about preferences. In practice, the learned tasks are then applied to a familiar decision, with the goal of developing the next incremental level of expertise in using the methods. Finally, in application, the more deliberative style of thinking is used to address the problem of interest. In an environmental resource setting with two oyster habitat managers, we test the procedure by attempting to mitigate the prominence effect that has been reported in the behavioral research literature. The resulting preference weights appear to be free of the prominence effect, providing initial steps toward operationalizing the “building code” for preferences introduced by Payne et al. [Payne JW, Bettman JR, Schkade DA (1999) Measuring constructed preferences: Towards a building code. J. Risk Uncertainty 19(1–3):243–270].
Hypothyroidism in dogs: laboratory findings
Authors: Parry Nicola M. A.
Published: May 2013

Diagnosis of hypothyroidism is typically based on a combination of clinical signs and laboratory findings. The condition is commonly overdiagnosed in dogs, especially because many medical conditions can be associated with reduced circulating concentrations of thyroid hormone. Since available diagnostic tests lack high sensitivity and specificity, its definitive diagnosis can be difficult. In the past 20 years, development of newer diagnostic tests has enhanced the ability to differentiate canine hypothyroidism from other conditions. The most commonly used criteria to diagnose hypothyroidism are decreased total thyroxine (TT4) or free thyroxine (FT4) in combination with increased thyroid-stimulating hormone (TSH) concentration.
Endoscopy: part 1 – an introduction for the veterinary practitioner
Authors: Robertson Elise
Published: May 2013

Endoscopy and minimally invasive surgery are considered ‘standard’ practice in human healthcare. Veterinary practitioners are now starting to appreciate the benefits of these minimally invasive procedures in everyday practice (reduced tissue trauma, minimal postoperative pain and faster recovery times), and the endoscopist benefits from improved magnification, illumination and visualisation of areas that were previously considered difficult or impossible to access, without resorting to traditional surgical interventions.
Head trauma: pathophysiology and assessment
Authors: Lowrie Mark
Published: May 2013

Traumatic brain injury (TBI) is a common presentation in the emergency clinic and can result from falls, crush injuries or road traffic accidents. TBI has two components—–the primary injury, which occurs at the time of impact as a result of direct mechanical damage, and secondary brain injury, which occurs minutes to days following the trauma. It is the secondary brain injury that treatment aims to reduce. The initial diagnosis is usually straightforward, relying on a combination of history and clinical signs. However, the neurological examination, when approached in a structured manner, gives information not only regarding the location and extent of the TBI, but offers clues as to the prognosis and effectiveness of treatment. This article reviews the basic pathophysiology surrounding TBI in veterinary patients and discusses the steps involved in performing an appropriate neurological assessment.
Leishmaniosis: changing times for the travelling dog
Authors: Wright Ian
Published: May 2013

Leishmania remains a significant risk to dogs travelling abroad on The Pet Travel Scheme (PETS). The difficulty in treating canine patients with Leishmaniosis combined with its zoonotic potential and lack of chemical prophylaxis is of particular concern as public awareness of the parasite remains low. It is important that veterinary surgeons and nurses provide up-to-date, accurate advice on protecting dogs against this parasite as well as recognising and treating cases. This article reviews the life cycle and epidemiology of the parasite as well as the available diagnostic tests, treatments and preventative measures.
Hypoglycaemia
Authors: McBrearty Alix , Ramsey Ian
Published: May 2013

Blood glucose is maintained within a narrow range by the balance between intestinal absorption, glucose synthesis and glucose release from glycogen stores. Many diseases can affect this balance and result in hypoglycaemia; this can result in dramatic clinical signs due to neuroglycopenia. This article summarises the physiology of glucose regulation and the clinical signs of hypoglycaemia, its emergency treatment and its causes.
Neonatal calf diarrhoea: a case study
Authors: Tilling Oliver
Published: May 2013

This article describes the investigation of a neonatal calf diarrhoea outbreak in a dedicated tuberculosis isolation unit. Like many calf rearers purchasing young calves, this farmer did not have control over the first 7 days of their lives. Focus therefore was on treatment of sick animals, reducing the risk of spread of pathogens and diagnostic testing to aid management. Longer term an all-in all-out programme followed by disinfection, and a review of purchasing policy to help selection of source farms was established.
Innovation within orthopaedics: the basics of patenting
Authors: McNamara K.
Published: May 2013

According to a report by Millennium Research Group in January 2011, the US orthopaedic extremity device market will generate over $4.6 billion in revenue by 2015. 1 With an ageing demographic and increasing demand for better quality of life into old age, there is clearly a commercial drive for the orthopaedic device community to develop new and innovative solutions to bone and joint problems. Devising such solutions is one thing; protecting them, so that research investment can be rewarded, is another. How is such protection achieved? The judicious use of intellectual property rights plays a key role, and this article aims to provide some information about the use of patents to protect innovation.
Deleted in malignant brain tumor 1 is secreted in the oviduct and involved in the mechanism of fertilization in equine and porcine species
Authors: Ambruosi Barbara , Accogli Gianluca , Douet Cécile , Canepa Sylvie , Pascal Géraldine , Monget Philippe , Moros Carla , Holmskov Uffe , Mollenhauer Jan , Robbe-Masselot Catherine , Vidal Olivier , Desantis Salvatore , Goudet Ghylène
Published: May 2013

Oviductal environment affects preparation of gametes for fertilization, fertilization itself, and subsequent embryonic development. The aim of this study was to evaluate the effect of oviductal fluid and the possible involvement of deleted in malignant brain tumor 1 (DMBT1) on IVF in porcine and equine species that represent divergent IVF models. We first performed IVF after pre-incubation of oocytes with or without oviductal fluid supplemented or not with antibodies directed against DMBT1. We showed that oviductal fluid induces an increase in the monospermic fertilization rate and that this effect is canceled by the addition of antibodies, in both porcine and equine species. Moreover, pre-incubation of oocytes with recombinant DMBT1 induces an increase in the monospermic fertilization rate in the pig, confirming an involvement of DMBT1 in the fertilization process. The presence of DMBT1 in the oviduct at different stages of the estrus cycle was shown by western blot and confirmed by immunohistochemical analysis of ampulla and isthmus regions. The presence of DMBT1 in cumulus–oocyte complexes was shown by western blot analysis, and the localization of DMBT1 in the zona pellucida and cytoplasm of equine and porcine oocytes was observed using immunofluorescence analysis and confocal microscopy. Moreover, we showed an interaction between DMBT1 and porcine spermatozoa using surface plasmon resonance studies. Finally, a bioinformatic and phylogenetic analysis allowed us to identify the DMBT1 protein as well as a DMBT1-like protein in several mammals. Our results strongly suggest an important role of DMBT1 in the process of fertilization.
Role of sulphate in development
Authors: Dawson Paul Anthony
Published: May 2013

Sulphate contributes to numerous processes in mammalian physiology, particularly during development. Sulphotransferases mediate the sulphate conjugation (sulphonation) of numerous compounds, including steroids, glycosaminoglycans, proteins, neurotransmitters and xenobiotics, transforming their biological activities. Importantly, the ratio of sulphonated to unconjugated molecules plays a significant physiological role in many of the molecular events that regulate mammalian growth and development. In humans, the fetus is unable to generate its own sulphate and therefore relies on sulphate being supplied from maternal circulation via the placenta. To meet the gestational needs of the growing fetus, maternal blood sulphate concentrations double from mid-gestation. Maternal hyposulphataemia has been linked to fetal sulphate deficiency and late gestational fetal loss in mice. Disorders of sulphonation have also been linked to a number of developmental disorders in humans, including skeletal dysplasias and premature adrenarche. While recognised as an important nutrient in mammalian physiology, sulphate is largely unappreciated in clinical settings. In part, this may be due to technical challenges in measuring sulphate with standard pathology equipment and hence the limited findings of perturbed sulphate homoeostasis affecting human health. This review article is aimed at highlighting the importance of sulphate in mammalian development, with basic science research being translated through animal models and linkage to human disorders.
Exemplar Pediatric Collaborative Improvement Networks: Achieving Results
Authors: Billett Amy L. , Colletti Richard B. , Mandel Keith E. , Miller Marlene , Muething Stephen E. , Sharek Paul J. , Lannon Carole M.
Published: May 2013

A number of pediatric collaborative improvement networks have demonstrated improved care and outcomes for children. Regionally, Cincinnati Children’s Hospital Medical Center Physician Hospital Organization has sustained key asthma processes, substantially increased the percentage of their asthma population receiving “perfect care,” and implemented an innovative pay-for-performance program with a large commercial payor based on asthma performance measures. The California Perinatal Quality Care Collaborative uses its outcomes database to improve care for infants in California NICUs. It has achieved reductions in central line–associated blood stream infections (CLABSI), increased breast-milk feeding rates at hospital discharge, and is now working to improve delivery room management. Solutions for Patient Safety (SPS) has achieved significant improvements in adverse drug events and surgical site infections across all 8 Ohio children’s hospitals, with 7700 fewer children harmed and >$11.8 million in avoided costs. SPS is now expanding nationally, aiming to eliminate all events of serious harm at children’s hospitals. National collaborative networks include ImproveCareNow, which aims to improve care and outcomes for children with inflammatory bowel disease. Reliable adherence to Model Care Guidelines has produced improved remission rates without using new medications and a significant increase in the proportion of Crohn disease patients not taking prednisone. Data-driven collaboratives of the Children’s Hospital Association Quality Transformation Network initially focused on CLABSI in PICUs. By September 2011, they had prevented an estimated 2964 CLABSI, saving 355 lives and $103 722 423. Subsequent improvement efforts include CLABSI reductions in additional settings and populations.
Physician Professionalism and Accountability: The Role of Collaborative Improvement Networks
Authors: Miles Paul V. , Conway Patrick H. , Pawlson L. Gregory
Published: May 2013

The medical profession is facing an imperative to deliver more patient-centered care, improve quality, and reduce unnecessary costs and waste. With significant unexplained variation in resource use and outcomes, even physicians and health care organizations with “the best” reputations cannot assume they always deliver the best care possible. Going forward, physicians will need to demonstrate professionalism and accountability in a different way: to their peers, to society in general, and to individual patients. The new accountability includes quality and clinical outcomes but also resource utilization, appropriateness and patient-centeredness of recommended care, and the responsibility to help improve systems of care. The pediatric collaborative improvement network model represents an important framework for helping transform health care. For individual physicians, participation in a multisite network offers the opportunity to demonstrate accountability by measuring and improving care as part of an approach that addresses the problems of small sample size, attribution, and unnecessary variation in care by pooling patients from individual practices and requiring standardization of care to participate. For patients and families, the model helps ensure that they are likely to receive the current best evidence-based recommendation. Finally, this model aligns with payers’ goals of purchasing value-based care, rewarding quality and improvement, and reducing unnecessary variation around current best evidenced-based, effective, and efficient care. In addition, within the profession, the American Board of Pediatrics recognizes participation in a multisite quality improvement network as one of the most rigorous and meaningful approaches for a diplomate to meet practice performance maintenance of certification requirements.
Collaborative Networks for Both Improvement and Research
Authors: Clancy Carolyn M. , Margolis Peter A. , Miller Marlene
Published: May 2013

Moving significant therapeutic discoveries beyond early biomedical translation or T1 science and into practice involves: (1) T2 science, identifying “the right treatment for the right patient in the right way at the right time” (eg, patient-centered outcomes research) and tools to implement this knowledge (eg, guidelines, registries); and (2) T3 studies addressing how to achieve health care delivery change. Collaborative improvement networks can serve as large-scale, health system laboratories to engage clinicians, researchers, patients, and parents in testing approaches to translate research into practice. Improvement networks are of particular importance for pediatric T2 and T3 research, as evidence to establish safety and efficacy of therapeutic interventions in children is often lacking. Networks for improvement and research are also consistent with the Institute of Medicine’s Learning Healthcare Systems model in which learning networks provide a system for improving care and outcomes and generate new knowledge in near real-time. Creation of total population registries in collaborative network sites provides large, representative study samples with high-quality data that can be used to generate evidence and to inform clinical decision-making. Networks use collaboration, data, and quality-improvement methods to standardize practice. Therefore, variation in outcomes due to unreliable and unnecessary care delivery is reduced, increasing statistical power, and allowing a consistent baseline from which to test new strategies. In addition, collaborative networks for improvement and research offer the opportunity to not only make improvements but also to study improvements to determine which interventions and combination of strategies work best in what settings.
Atomistic and Coarse-Grained Modeling Strategies for Thin Film Nucleation and Growth on Quasicrystalline Surfaces
Authors: Evans James W. , Thiel Patricia A. , Ünal Bariş
Published: May 2013

Strategies are described for modeling the kinetics of non-equilibrium film growth during deposition of metals on quasicrystalline substrates. We review previous atomistic-level lattice-gas modeling and Kinetic Monte Carlo simulation for pseudomorphic (or commensurate) submonolayer growth based on a “disordered or irregular bond-network” (DBN) of neighboring adsorption sites. We describe extensions to treat strain effects and multilayer growth, and discuss a type of commensurate-incommensurate transition expected around 2-3 layers. We also describe a coarse-grained “step dynamics” modeling which tracks the dynamics of island edges in each layer rather than individual atoms. Step dynamics models can also include key aspects of the physics such as layer-dependent energetics, including quantum size effects, and strain effects.
Thermal transport properties of decagonal quasicrystals and their approximants
Authors: Popčević Petar , Bilušić Ante , Velebit Kristijan , Smontara Ana
Published: May 2013

Transport properties (thermal conductivity, electrical resistivity and thermopower) of decagonal quasicrystald-AlCoNi, and approximant phases Y-AlCoNi, o-Al13Co4, m-Al13Fe4, m-Al13(Fe,Ni)4and T-AlMnFe have been reviewed. Among all presented alloys the stacking direction (periodic for decagonal quasicrystals) is the most conductive one for the charge and heat transport, and the in/out-of-plane anisotropy is much larger than the in-plane anisotropy. There is a strong relationship between periodicity length along stacking direction and anisotropy of transport properties in both quasicrystals and their approximants suggesting a decrease of the anisotropy with increasing number of stacking layers.
3-sensor array for hand held breath diagnostic tool
Authors: Gouma P. , Sood S.
Published: May 2013

Polymorphic transitions in nanocrystalline metal oxides leads to structural transformations resulting in differing properties at varying operating temperatures. Nanocrystalline MoO3 transforms from a metastable monoclinic phase to stable orthorhombic phase when heat treated in the temperature range of 420C to 500C. Gas sensing results have shown that at 420C MoO3 is sensitive to Isoprene, a 450C it shows sensitivity to CO2 and to ammonia at 500C. DSC data has proved that MoO3 changes crystal structure to monoclinic at 420C and to orthorhombic at about485C. This confirms a correlation between structure and gas sensing properties of MoO3. Using this knowledge a hand-held diagnostic tool is developed to monitor specific breath gases which can be biomarkers for diseases. The device consists of three sensors, the read-out gives a real time resistance value for each resistive sensor which is stored in a microprocessor. This is a one of a kind handheld tool for disease detection using ceramic sensors as detectors for gases which are known to be biomarkers for diseases.
Iodine-Rich Biocidal Reactive Materials
Authors: Johnson Curtis E. , Higa Kelvin T.
Published: May 2013

The objectives of this work are to prepare and characterize iodine-rich thermites and reactive materials for potential application in bio-agent defeat. Iodine-rich compositions were prepared using metal iodate oxidizers in combination with aluminum fuel. Higher iodine contents were achieved using iodine-rich additives, tetraiodoethylene and tin tetraiodide. Reactivity during rapid combustion was evaluated for both nanoscale and micron-scale materials. The nanoscale materials were evaluated directly using a spark-initiated pan dent test. The micron-scale materials were mixed with 50% of nano Al/MoO3 and also evaluated with the pan dent test. The results for the mixed material were shown to fit well to a linear combination of the expected dent for each component, based on a rapid reaction. Results of the pan dent test were used to down-select micron thermites for further testing. Bismuth iodate was synthesized by precipitation from nitric acid solutions. The average particle size was controlled by the addition rate, and sizes included 95 nm (amorphous structure), and 330 nm and 3 micron (both crystalline). Additional sizes were produced by ball milling the 3 micron material, giving 1 micron and 350 nm sizes. Fluoropolymers were included in some compositions to provide additional biocidal products, namely HF, that could be produced from reaction of AlF3 product with water.
Role of CSL Boundaries on Displacement Cascades in β-SiC
Authors: Nandi Prithwish K. , Annamareddy V. Ajay , Eapen Jacob
Published: May 2013

Molecular dynamics (MD) simulations are carried out to understand the mechanisms of damage production and recovery near grain boundaries in β-SiC under neutron irradiation. Our investigations show that the damage generated by radiation is reduced by the presence of a ∑9{122}[110] tilt grain boundary. Directional displacements which are averaged over an isoconfigurational ensemble are used to characterize the statistical nature of atomic mobility near the grain boundary.
Atomic Force Microscopy Based Electric Modes in Characterization of Organic Photovoltaics
Authors: Wall Craig , Magonov Sergei , Belikov Sergey , Alexander John
Published: May 2013

Capabilities of Atomic Force Microscopy in different modes including Electric Force Microscopy and Kelvin Force Microscopy are reviewed and illustrated on several samples including organic photovoltaics (P3HT/PCBM, PEDOT:PSS). Compositional mapping of these blends is enhanced with a combined use of the modes, and variations of local electric properties are detected down to the nanometer scale. The revealed morphology will assist in development of comprehensive models accounting for the structure-property relationship in solar cells and related devices.
Discordances in Estrogen Receptor Status, Progesterone Receptor Status, and HER2 Status Between Primary Breast Cancer and Metastasis
Authors: Curtit Elsa , Nerich Virginie , Mansi Laura , Chaigneau Loic , Cals Laurent , Villanueva Cristian , Bazan Fernando , Montcuquet Philippe , Meneveau Nathalie , Perrin Sophie , Algros Marie-Paule , Pivot Xavier
Published: May 2013

Background.

The primary aim of this retrospective study was to investigate intraindividual correlation of estrogen receptor (ER) status, progesterone receptor (PR) status, and HER2 status between primary breast cancer and metastatic breast cancer (mBC). Secondary aims included patients' characteristics, overall survival, feasibility of histopathological evaluation in the metastatic setting, and predictive factors associated with receptors status discordance.

Methods.

Patients with either biopsy of metastatic relapse or surgery of metastasis were identified. Demographics, tumor characteristics, treatment characteristics, and ER, PR, and HER2 statuses were retrospectively obtained in patients' reports. Receptors statuses were assessed by immunohistochemistry with a positivity cutoff of more than 10% for ER and PR. HER2 was considered as positive if overexpression was scored at 3+ in immunohistochemistry or if amplification ratio was >2 in fluorescent in situ hybridization.

Results.

From a cohort of 489 patients with mBC, 269 patients had histopathological samples of metastatic relapse. Histopathological analysis of the specimen confirmed the diagnosis of mBC in 235 patients. Discordance in one or more receptors between primary breast cancer and mBC was found in 99 patients (42%). A switch in receptor status was identified for ER in 17% of tumors (p = 4 × 10−3), PR in 29% of cancers (p < 4 × 10−4), and HER2 in 4% of lesions (p = .16). Exposure to chemotherapy and to anthracycline-based chemotherapy was statistically associated with switches in ER status. Seven (2%) second malignancies and three benign diseases (1%) were diagnosed.

Conclusions.

This study confirms that discordance in ER and PR receptor expression between the primary breast tumor and the corresponding metastatic lesions is high, whereas HER2 status remains relatively constant. Chemotherapy, and specifically anthracycline-based chemotherapy, was associated with switch in ER status. These results were obtained in a selected population of patients; further studies are warranted to confirm these data and to determine the interest of systematic rebiopsy in the metastatic setting.
Centrifuge tests investigating the influence of pile cross-section on pile driving resistance of open-ended piles
Authors: Henke Sascha , Bienen Britta
Published: May 2013

Soil plugging in open-ended piles not only leads to an increase in compressive bearing capacity but also influences pile driving resistance. Numerous factors affect the tendency for soil plugging, for example pile geometry, penetration depth and installation method. In this study, the influence of the cross-sectional geometry of different open-ended piles (tubular, U- and sheet-piles) on the internal and external stress state at the pile toe is investigated. The underlying data were obtained from tests of pile installation (pile jacking) into dry silica sand conducted using a geotechnical beam centrifuge. During pile penetration the internal and external horizontal stresses at the pile toe were recorded to obtain the stress state inside the open-ended piles. The results are discussed with respect to the influence of the pile's geometrical properties (diameter of tubular piles, base width of U-piles and opening angle of sheet-piles) on the plugging tendency or the pile driving resistance. To conclude, a simple analytical approach based on equilibrium analyses is presented to predict the pile's bearing capacity.
Scour and flow around submerged structures
Authors: Sarkar Arindam
Published: May 2013

The results of an experimental investigation on scour of non-cohesive uniform and non-uniform sediment beds and flow around fully submerged structures over a fixed plane bed are discussed. In the study, the submergence factor, Froude number and cylinder Reynolds number for all the experiments were kept in the ranges of 0·25–0·75, 0·23–0·70 and 13 500–58 650 respectively. The free surface profile over the submerged structures consists of distinct upper and lower layers; the lower layer is characterised by continuous mixing with the generated downstream wake whereas the characteristics of the upper layer depend on the submergence factor and the Froude number. Using observed scour depths at different times, the time variation of scour depth is scaled by an exponential law. The non-dimensional time scale decreases following a power-law relationship with an increase in densimetric Froude number. It is evident that there is a considerable reduction in the non-dimensional scour depth with an increase in the submergence ratio, mainly due to the decrease in the intensity of the horseshoe vortex. It is also evident that the normalised equilibrium scour depth decreases with an increase in the ratio of cylinder diameter to sediment size. A significant reduction of 40% of the scour depth in uniform sediment was observed in experiments with non-uniform sediments. The three-dimensional flow fields around the submerged structure over a fixed plane bed were measured with an acoustic Doppler velocimeter. The vertical velocity distributions indicate deceleration of the approaching flow, acceleration around the submerged body and the approach to the original state of open-channel flow downstream of the submerged structure.
Ideal free distribution of fixed dispersal phenotypes in a wing dimorphic beetle in heterogeneous landscapes
Authors: Hendrickx Frederik , Palmer Stephen C. F. , Travis Justin M. J.
Published: May 2013

According to the ideal free distribution (IFD) theory, individuals that are able to perceive the quality of different patches in a landscape and disperse freely are expected to redistribute themselves proportionally to the carrying capacities of heterogeneous patches. Here, we argue that, when dispersal is unconditional and genetically fixed, a coalition of sedentary and dispersing phenotypes can attain an IFD under spatiotemporally uncorrelated variation in fitness. This not only leads to a stable polymorphism of both dispersal phenotypes, but also implies that the number of dispersing individuals should on average be equal among patches and determined by the carrying capacity of the smallest local populations in the landscape. Differences in carrying capacity among patches are thus only reflected by changes in the number of sedentary individuals. Individual‐based simulations show that this mechanism can be generalized over a wide range of spatiotemporal conditions and dispersal strategies. Moreover, these expectations are in strong agreement with empirical data on the density of both dispersal phenotypes of the wing dimorphic ground beetlePterostichus vernaliswithin and among 10 different landscapes. Hence, for the first time, these results demonstrate that this mechanism serves as a plausible alternative to the competition‐colonization model to explain the spatial distribution of fixed dispersal phenotypes in heterogeneous landscapes. Understanding of the frequency distributions of individuals expressing discrete dispersal morphs moreover improves our predictive and management capabilities for a broad range of species, for which we currently typically rely on using mean dispersal rates.
How many founders for a biological invasion? Predicting introduction outcomes from propagule pressure
Authors: Britton John Robert , Gozlan Rodolphe Elie
Published: May 2013

Ecological theory on biological invasions attempts to characterize the predictors of invasion success and the relative importance of the different drivers of population establishment. An outstanding question is how propagule pressure determines the probability of population establishment, where propagule pressure is the number of individuals of a species introduced into a specific location (propagule size) and their frequency of introduction (propagule number). Here, we used large‐scale replicated mesocosm ponds over three reproductive seasons to identify how propagule size and number predict the probability of establishment of one of world's most invasive fish, Pseudorasbora parva, as well as its effect on the somatic growth of individuals during establishment. We demonstrated that, although a threshold of 11 introduced pairs of fish (a pair is 1 male, 1 female) was required for establishment probability to exceed 95%, establishment also occurred at low propagule size (1–5 pairs). Although single introduction events were as effective as multiple events at enabling establishment, the propagule sizes used in the multiple introductions were above the detected threshold for establishment. After three reproductive seasons, population abundance was also a function of propagule size, with rapid increases in abundance only apparent when propagule size exceeded 25 pairs. This was initially assisted by adapted biological traits, including rapid individual somatic growth that helped to overcome demographic bottlenecks.