bluuebunny/crossref_metadata_2025 huggingface dataset:
Feline eosinophilic dermatoses: a retrospective immunohistochemical and ultrastructural study of extracellular matrix remodelling
Authors: Porcellato Ilaria , Giontella Andrea , Mechelli Luca , Del Rossi Emilia , Brachelente Chiara
Published: March 2014

Background

Feline eosinophilic dermatoses (FEDs) are common diseases of cats with an unknown pathogenesis. They are histologically characterized by an eosinophilic infiltration and often by the presence of flame figures (FFs) and/or areas of loss of tissue architecture, here termed necrotic foci (NF). It has been postulated that an alteration in the degradation of the extracellular matrix could be responsible for these histological features. Matrix metalloproteinases (MMPs) are a group of proteases that are fundamental in extracellular matrix remodelling.

Hypothesis/Objectives

The aim of the study was to investigate retrospectively the expression of a subgroup of MMPs, in particular MMP‐2 and MMP‐9 gelatinases, in FEDs. The expression of one of their inhibitors, TIMP‐2, was also investigated in order to establish the role of these molecules in the pathogenesis of FEDs. The ultrastructural characteristics of extracellular matrix in FFs and NF were subsequently assessed.

Methods

Fifty‐one formalin‐fixed, paraffin‐embedded specimens from cutaneous and mucosal biopsies diagnosed as FEDs were investigated immunohistochemically. Two selected samples were processed for electron microscopy.

Results

This study revealed an increased expression of MMP‐2 in NF and a decreased expression of this gelatinase in FFs. An imbalance between MMP‐2 and TIMP‐2 was evident using immunohistochemistry. No significative results were observed for MMP‐9 expression. Electron microscopy confirmed the lack of normal collagen fibres in NF, whereas in FFs only occasional, amorphous material was observed among normal collagen fibres.

Conclusions and clinical importance

Our study suggests that an imbalance in the expression of matrix metalloproteinases could be responsible for different morphological findings in FEDs. Further studies are needed to assess the role of matrix metalloproteinases in the pathogenesis of FEDs.
Germination response of local Southern European populations of Datura stramonium at a range of constant temperatures
Authors: Loddo D , Sousa E , Masin R , Calha I M , Zanin G , Fernández‐Quintanilla C , Dorado J
Published: March 2014

Studies on weed germination are required to develop efficient integrated weed management strategies that should be transferable at wide scale and accurate at local level. To study interpopulation variability, which may hamper this process, three local populations of Datura stramonium were collected in Italy, Portugal and Spain and then cultivated simultaneously in three common gardens under different environmental conditions. Hence, nine seed lots were included in the germination tests performed at a range of constant incubating temperatures. Significant effects of population of origin, cultivation site, incubating temperature and their interaction were detected on mean germination percentage and germination t50. Mean germination percentage varied from 0.0 to 89.7% ± 2.10 SE at 8 and 20°C respectively. Mean germination t50 ranged from 636.1 ± 24.86 SE to 267.0 ± 16.06 SE hours at 12 and 20°C respectively. Seed lots deriving from the Portuguese population presented the lowest germination percentages and highest germination t50 at low incubating temperatures, regardless of the cultivation site. This behaviour could be related to an adaptive process of the Portuguese population to the local environmental conditions, produced by the combination of climate and agronomic management. The presence of high interpopulation variability for D. stramonium could hinder the development of transferable IWM strategies. However, management plans could be proposed at regional scale according to the approach of modifying the patterns of agronomic disturbances to which the local populations have adapted.
On Constrained and Energy Efficient Balance Control of a Standing Biped: Experimentation and Stability Analysis
Authors: Sun Yuming , Alghooneh Mansoor , Sun Yun-Hsiang , Qiong Wu Christine
Published: March 2014

Balancing control is important for biped standing. In spite of large efforts, it is very difficult to design balancing control strategies satisfying three requirements simultaneously: maintaining postural stability, improving energy efficiency, and satisfying the constraints between the biped feet and the ground. To implement such a control, inclusion of the actuators' dynamics is necessary, which complicates the overall system, obstructs the control design, and makes stability analysis more difficult. In this paper, a constrained balancing control meeting all three requirements is designed for a standing bipedal robot. The dynamics of the selected actuators has been considered for developing the motion equations of the overall control system, which has usually been neglected in simulations. In addition, stability analysis of such a complex biped control system has been provided using the concept of Lyapunov exponents (LEs), which shows the significance of actuators' dynamics on the stability region. The paper contributes to balancing standing biped in both the theoretical and the practical sense.
A Thermovisco-Hyperelastic Constitutive Model of NEPE Propellant Over a Large Range of Strain Rates
Authors: Zhang Junfa , Zheng Jian , Chen Xiong , Sun Chaoxiang , Xu Jinsheng
Published: March 2014

The uniaxial compressive mechanical curves of nitrate ester plasticized polyether (NEPE) propellant under different temperatures and strain rates have been obtained with a universal testing machine and modified split Hopkinson pressure bar (SHPB). The experimental results show that the mechanical properties of NEPE propellant are both rate dependent and temperature dependent. With decreasing temperature or increasing strain rate, the modulus and rigidity obviously increase. Based on the previous models proposed by Yang and Pouriayevali, we propose a modified viscohyperelastic constitutive model which can describe the mechanical response over a large range of strain rates. Then we add a rate-dependent temperature item into the modified model to make a thermovisco-hyperelastic constitutive model. By comparing the experimental results with the model, we find that the thermovisco-hyperelastic constitutive model can correctly describe the uniaxial compressive mechanical properties of NEPE propellant at different temperatures and over a large range of strain rates from the static state to 4500 s−1.
A Data-Driven Mode Identification Algorithm for Riser Fatigue Damage Assessment
Authors: Shi C. , Park J. , Manuel L. , Tognarelli M. A.
Published: March 2014

A well-established empirical procedure, which we refer to as weighted waveform analysis (WWA), is employed to reconstruct a model riser's response over its entire length using a limited number of strain measurements. The quality of the response reconstruction is controlled largely by identification of the participating riser response modes (waveforms); hence, mode selection is vital in WWA application. Instead of selecting a set of consecutive riser vibratory modes, we propose a procedure that automatically identifies a set of nonconsecutive riser modes that can thus account for higher harmonics in the riser response (at multiplies of the Strouhal frequency). Using temporal data analysis of the discrete time-stamped samples, significant response frequencies are identified on the basis of power spectrum peaks; similarly, using the spatial data analysis of the sparse nonuniformly sampled data, significant wavenumbers are identified using Lomb–Scargle periodograms. Knowing the riser length, the most important wavenumber is related to a specific mode number; this dominant mode is, in turn, related to the dominant peak in power spectra based on the temporal data analysis. The riser's fundamental frequency is estimated as the ratio of the empirically estimated dominant spectral frequency to the dominant mode number. Additional mode numbers are also identified as spectral peak frequencies divided by the fundamental frequency. This mode selection technique is an improvement over similar WWA procedures that rely on a priori knowledge of the riser's fundamental frequency or on the knowledge of the physical properties and assumptions on added mass contributions. At selected target locations, we compare fatigue damage rates, estimated based on the riser response reconstructed using the WWA method with the proposed automated mode selection technique (we refer to this as the “improved” WWA) and those based on the “original” WWA method (that relies on a theoretically computed fundamental natural frequency of the riser). In both cases, predicted fatigue damage rates based on the empirical methods and data at various locations (other than the target) are cross-validated against damage rates based directly on measurements at the target location. The results show that the improved WWA method, which empirically estimates the riser's fundamental natural frequency and automatically selects significant modes of vibration, may be employed to estimate fatigue damage rates quite well from limited strain measurements.
The Effects of Anisotropic Surface Topography and Relative Motion on Hydrodynamic Lubrication
Authors: Yang Yang , Brenner Gunther
Published: March 2014

According to the extended Reynolds theory, surface roughness contributes to the pressure buildup as well as shear stress and transport in the film flow. The effect is usually quantified using pressure and shear flow factors. The influence of the pattern directionality relative to the sliding motion may be considered using an anisotropic model of flow factors. The goal of the present study is to quantify these effects based on a precise numerical solution of the Navier–Stokes equations. For the computation the open source finite volume code OpenFOAM is used. The computational setup allows consideration of the lubrication film between two rough surfaces in relative motion. The roughness of the surfaces is simplified and parameterized using trigonometric functions.
Finite Element Based Nonlinear Normalization of Human Lumbar Intervertebral Disc Stiffness to Account for Its Morphology
Authors: Maquer Ghislain , Laurent Marc , Brandejsky Vaclav , Pretterklieber Michael L. , Zysset Philippe K.
Published: March 2014

Disc degeneration, usually associated with low back pain and changes of intervertebral stiffness, represents a major health issue. As the intervertebral disc (IVD) morphology influences its stiffness, the link between mechanical properties and degenerative grade is partially lost without an efficient normalization of the stiffness with respect to the morphology. Moreover, although the behavior of soft tissues is highly nonlinear, only linear normalization protocols have been defined so far for the disc stiffness. Thus, the aim of this work is to propose a nonlinear normalization based on finite elements (FE) simulations and evaluate its impact on the stiffness of human anatomical specimens of lumbar IVD. First, a parameter study involving simulations of biomechanical tests (compression, flexion/extension, bilateral torsion and bending) on 20 FE models of IVDs with various dimensions was carried out to evaluate the effect of the disc's geometry on its compliance and establish stiffness/morphology relations necessary to the nonlinear normalization. The computed stiffness was then normalized by height (H), cross-sectional area (CSA), polar moment of inertia (J) or moments of inertia (Ixx, Iyy) to quantify the effect of both linear and nonlinear normalizations. In the second part of the study, T1-weighted MRI images were acquired to determine H, CSA, J, Ixx and Iyy of 14 human lumbar IVDs. Based on the measured morphology and pre-established relation with stiffness, linear and nonlinear normalization routines were then applied to the compliance of the specimens for each quasi-static biomechanical test. The variability of the stiffness prior to and after normalization was assessed via coefficient of variation (CV). The FE study confirmed that larger and thinner IVDs were stiffer while the normalization strongly attenuated the effect of the disc geometry on its stiffness. Yet, notwithstanding the results of the FE study, the experimental stiffness showed consistently higher CV after normalization. Assuming that geometry and material properties affect the mechanical response, they can also compensate for one another. Therefore, the larger CV after normalization can be interpreted as a strong variability of the material properties, previously hidden by the geometry's own influence. In conclusion, a new normalization protocol for the intervertebral disc stiffness in compression, flexion, extension, bilateral torsion and bending was proposed, with the possible use of MRI and FE to acquire the discs' anatomy and determine the nonlinear relations between stiffness and morphology. Such protocol may be useful to relate the disc's mechanical properties to its degree of degeneration.
Changes in Vertebral Strain Energy Correlate With Increased Presence of Schmorl's Nodes in Multi-Level Lumbar Disk Degeneration
Authors: Von Forell Gregory A. , Nelson Todd G. , Samartzis Dino , Bowden Anton E.
Published: March 2014

Patients with skipped-level disk degeneration (SLDD) were recently reported as having a higher prevalence of Schmorl's nodes than patients with contiguous multi-level disk degeneration (CMDD). Fourteen versions of a nonlinear finite element model of a lumbar spine, representing different patterns of single and multi-level disk degeneration, were simulated under physiological loading. Results show that vertebral strain energy is a possible predictor in the development of Schmorl's nodes. The analysis also shows evidence that the development of Schmorl's nodes may be highly dependent on the location of the degeneration disk, with a higher prevalence at superior levels of the lumbar spine.
Low sheet resistance titanium nitride films by low-temperature plasma-enhanced atomic layer deposition using design of experiments methodology
Authors: Burke Micheal , Blake Alan , Povey Ian M. , Schmidt Michael , Petkov Nikolay , Carolan Patrick , Quinn Aidan J.
Published: March 2014

A design of experiments methodology was used to optimize the sheet resistance of titanium nitride (TiN) films produced by plasma-enhanced atomic layer deposition (PE-ALD) using a tetrakis(dimethylamino)titanium precursor in a N2/H2 plasma at low temperature (250 °C). At fixed chamber pressure (300 mTorr) and plasma power (300 W), the plasma duration and N2 flow rate were the most significant factors. The lowest sheet resistance values (163 Ω/sq. for a 20 nm TiN film) were obtained using plasma durations ∼40 s, N2 flow rates >60 standard cubic centimeters per minute, and purge times ∼60 s. Time of flight secondary ion mass spectroscopy data revealed reduced levels of carbon contaminants in the TiN films with lowest sheet resistance (163 Ω/sq.), compared to films with higher sheet resistance (400–600 Ω/sq.) while transmission electron microscopy data showed a higher density of nanocrystallites in the low-resistance films. Further significant reductions in sheet resistance, from 163 Ω/sq. to 70 Ω/sq. for a 20 nm TiN film (corresponding resistivity ∼145 μΩ·cm), were achieved by addition of a postcycle Ar/N2 plasma step in the PE-ALD process.
Monte Carlo Calculations in Nuclear Medicine, Second Edition: Applications in Diagnostic Imaging.
Authors: Schuemann Jan
Published: March 2014

Monte Carlo Calculations in Nuclear Medicine, Second Edition: Applications in Diagnostic Imaging. Ljungberg M., Strand S.‐E., King M., CRC Press, Taylor and Francis Group, Boca Raton, FL, 2013. (Hardcover) 354 pp. Price: $135.95. ISBN: 9781439841099.
The pilot-wave perspective on spin
Authors: Norsen Travis
Published: March 2014

The alternative pilot-wave theory of quantum phenomena—associated especially with Louis de Broglie, David Bohm, and John Bell—reproduces the statistical predictions of ordinary quantum mechanics but without recourse to special ad hoc axioms pertaining to measurement. That (and how) it does so is relatively straightforward to understand in the case of position measurements and, more generally, measurements, whose outcome is ultimately registered by the position of a pointer. Despite a widespread belief to the contrary among physicists, the theory can also account successfully for phenomena involving spin. The main goal of this paper is to explain how the pilot-wave theory's account of spin works. Along the way, we provide illuminating comparisons between the orthodox and pilot-wave accounts of spin and address some puzzles about how the pilot-wave theory relates to the important theorems of Kochen and Specker and Bell.
Circular orbits on a warped spandex fabric
Authors: Middleton Chad A. , Langston Michael
Published: March 2014

We present a theoretical and experimental analysis of circular-like orbits made by a marble rolling on a warped spandex fabric. We show that the mass of the fabric interior to the orbital path influences the motion of the marble in a nontrivial way and can even dominate the orbital characteristics. We also compare a Kepler-like expression for such orbits to similar expressions for orbits about a spherically symmetric massive object in the presence of a constant vacuum energy, as described by general relativity.
Comparing measured and calculated frequencies of a demonstration trumpet
Authors: LoPresto Michael C.
Published: March 2014

The effects of the bell and mouthpiece on the playing frequencies of a trumpet can be demonstrated by measuring the playing frequencies of a cylindrical tube of the same length as the trumpet, measuring the playing frequencies with portions of the tube replaced first by a flaring bell section and then by a mouthpiece section, and finally measuring the frequencies with both sections. The frequencies at each step of this demonstration can also be calculated, using expressions for the frequencies of a horn with a flaring bell section and the effective length of the mouthpiece.
Magnet traveling through a conducting pipe: A variation on the analytical approach
Authors: Irvine Benjamin , Kemnetz Matthew , Gangopadhyaya Asim , Ruubel Thomas
Published: March 2014

We present an analytical study of magnetic damping. In particular, we investigate the dynamics of a cylindrical neodymium magnet as it moves through a conducting tube. Owing to the very high degree of uniformity of the magnetization for neodymium magnets, we are able to provide completely analytical results for the electromotive force generated in the pipe and the consequent retarding force. Our analytical expressions are shown to have excellent agreement with experimental observations.
The ellipse in parabolic motion: An undergraduate experiment
Authors: Carrillo-Bernal M. A. , Mancera-Piña P. E. , Cerecedo-Núñez H. H. , Padilla-Sosa P. , Núñez-Yépez H. N. , Salas-Brito A. L.
Published: March 2014

We present a simple method of experimentally studying the elliptic shape of the joined apices of parabolic projectile trajectories in the undergraduate laboratory. The experimental data agrees well with theoretical results, and we find that this experiment provides an interesting twist to the venerable undergraduate experiment on projectile motion.
Measuring the Moon's orbit using a hand-held camera
Authors: Oostra Benjamin
Published: March 2014

This paper describes a way to measure the Moon's distance and orbital eccentricity using a digital camera. The method consists of taking photographs of the Moon and measuring the size of the lunar disk in each picture. On a series of images taken on the same night, the effect of the Earth's size is evident and thus the distance to the Moon can be computed. A larger series of images, covering several weeks, demonstrates that the Moon's orbit is not perfectly circular.
Lower Extremity Mechanics During Marching at Three Different Cadences for 60 Minutes
Authors: Seay Joseph F. , Frykman Peter N. , Sauer Shane G. , Gutekunst David J.
Published: March 2014

During group marches, soldiers must walk in step with one another at the same imposed cadence. The literature suggests that shorter trainees may be more susceptible to injury due to overstriding that can occur when taller recruits dictate marching cadence. This study assessed the effects of fixed cadence simulated marching at cadences above and below preferred step rate (PSR) on lower extremity joint mechanics in individuals who were unaccustomed to marching. During three separate visits, 13 volunteers walked with a 20 kg load on a force-sensing treadmill at self-selected PSR, PSR+15% (shorter strides), and PSR–15% (longer strides) at 1.3 m/s for 60 min. Two-way RM ANOVAs (cadence by time) were performed during the stance phase. Ranges of motion and anteroposterior ground reaction force increased significantly as cadence decreased (P < .03). Knee extension moment increased slightly when step rate decreased from PSR+15% (shortest strides, 0.85 ± 0.2 N m/kg) to PSR (0.87 ± 0.3 N m/kg, 3% increase); however, this increase was substantially greater (20% increase) when cadence was decreased from PSR to PSR–15% (longest strides, 1.09 ± 0.3 N m/kg). Our results indicate that overstriding during fixed-cadence marching is a factor that can substantially increase mechanical stress on lower extremity joints.
Association Between Contraction-Induced Increases in Elbow Flexor Muscle Thickness and Distal Biceps Brachii Tendon Moment Arm Depends on the Muscle Thickness Measurement Site
Authors: Akagi Ryota , Iwanuma Soichiro , Hashizume Satoru , Kanehisa Hiroaki , Yanai Toshimasa , Kawakami Yasuo
Published: March 2014

The purpose of this study was to investigate how the contraction-induced increase in distal biceps brachii tendon moment arm is related to that in elbow flexor muscle thickness, with a specific emphasis on the influence of the site-related differences in muscle thickness. The moment arm and muscle thickness were determined from sagittal and cross-sectional images, respectively, of the right arm obtained by magnetic resonance imaging of nine young men. The muscle thickness was measured at levels from the reference site (60% of the upper arm length from the acromial process of the scapula to the lateral epicondyle of the humerus) to 60 mm distal to it (every 10 mm; 7 measurement sites). At 80° of elbow flexion, the moment arm and muscle thickness were determined at rest and during 60% of maximal voluntary contraction (60%MVC) of isometric elbow flexion. Only the relative change from rest to 60%MVC in muscle thickness at the level 60 mm distal to the reference site correlated significantly with that of the moment arm. This result indicates that the contraction-induced increase in distal biceps brachii tendon moment arm is related to that in elbow flexor muscle thickness near the corresponding muscle-tendon junction.
Kinetics of Badminton Lunges in Four Directions
Authors: Hong Youlian , Wang Shao Jun , Lam Wing Kai , Cheung Jason Tak-Man
Published: March 2014

The lunge is the most fundamental skill in badminton competitions. Fifteen university-level male badminton players performed lunge maneuvers in four directions, namely, right-forward, left-forward, right-backward, and left-backward, while wearing two different brands of badminton shoes. The test compared the kinetics of badminton shoes in performing typical lunge maneuvers. A force plate and an insole measurement system measured the ground reaction forces and plantar pressures. These measurements were compared across all lunge maneuvers. The left-forward lunge generated significantly higher first vertical impact force (2.34 ± 0.52 BW) than that of the right-backward (2.06 ± 0.60 BW) and left-backward lunges (1.78 ± 0.44 BW); higher second vertical impact force (2.44 ± 0.51 BW) than that of the left-backward lunge (2.07 ± 0.38 BW); and higher maximum anterior-posterior shear force (1.48 ± 0.36 BW) than that of the left-backward lunge (1.18 ± 0.38 BW). Compared with other lunge directions, the left-forward lunge showed higher mean maximum vertical impact anterior-posterior shear forces and their respective maximum loading rates, and the plantar pressure at the total foot and heel regions. Therefore, the left-forward lunge is a critical maneuver for badminton biomechanics and related footwear research because of the high loading magnitude generated during heel impact.
Three-Dimensional Kinematics of the Talocrural and Subtalar Joints During Drop Landing
Authors: Fukano Mako , Kuroyanagi Yuji , Fukubayashi Toru , Banks Scott
Published: March 2014

The bones and soft tissues of the foot act as a shock attenuator and the relative bony motions of the talocrural and subtalar joints are the subject of research interest for their roles in lower extremity pathology. Despite this interest, little information exists on the precise in vivo talocrural and subtalar joint kinematics during dynamic activities. Therefore, the purpose of this study was to quantify the three-dimensional kinematics of the talocrural and subtalar joints during landing by using single-plane fluoroscopic imaging and shape matching techniques. Three-dimensional bone positions for 6 subjects during landing from a 10 cm height were determined by using 3D-2D model-image registration techniques. The primary talocrural joint motion after toe contact was dorsiflexion with rotation ranges averaging 12° ± 7° dorsiflexion, 2° ± 2° eversion, and 3° ± 2° internal rotation. The subtalar joint exhibited similar patterns of increased dorsiflexion, eversion, and external rotation up to 150 ms after landing. The angular changes were 5° ± 3° dorsiflexion, 7° ± 3° eversion, and 6° ± 2° external rotation. This study contributes to the quantitative understanding of the function of the normal talocrural and subtalar joints and can be used for comparison with data obtained from injured feet.
The Spatial Dependency of Shoulder Muscle Demands for Seated Lateral Hand Force Exertions
Authors: McDonald Alison C. , Brenneman Elora C. , Cudlip Alan C. , Dickerson Clark R.
Published: March 2014

As the modern workplace is dominated by submaximal repetitive tasks, knowledge of the effect of task location is important to ensure workers are unexposed to potentially injurious demands imposed by repetitive work in awkward or sustained postures. The purpose of this investigation was to develop a three-dimensional spatial map of the muscle activity for the right upper extremity during laterally directed submaximal force exertions. Electromyographic (EMG) activity was recorded from fourteen muscles surrounding the shoulder complex as the participants exerted 40N of force in two directions (leftward, rightward) at 70 defined locations. Hand position in both push directions strongly influenced total and certain individual muscle demands as identified by repeated measures analysis of variance (P < .001). During rightward exertions individual muscle activation varied from 1 to 21% MVE and during leftward exertions it varied from 1 to 27% MVE with hand location. Continuous prediction equations for muscular demands based on three-dimensional spatial parameters were created with explained variance ranging from 25 to 73%. The study provides novel information for evaluating existing and proactive workplace designs, and may help identify preferred geometric placements of lateral exertions in occupational settings to lower muscular demands, potentially mitigating fatigue and associated musculoskeletal risks.
The Influence of Different Force and Pressure Measuring Transducers on Lower Extremity Kinematics Measured During Running
Authors: Sinclair Jonathan , Hobbs Sarah J. , Taylor Paul J. , Currigan Graham , Greenhalgh Andrew
Published: March 2014

In running analyses where both kinetic and kinematic information is recorded, participants are required to make foot contact with a force and/or pressure measuring transducer. Problems arise if participants modify their gait patterns to ensure contact with the device. There is currently a paucity of research investigating the influence of different underfoot kinetic measuring devices on 3-dimensional kinematics of running. Fifteen participants ran at 4.0 m/s in four different conditions: over a floor embedded force plate, Footscan, Matscan, and with no device. Three-dimensional angular kinematic parameters were collected using an eight camera motion analysis system. Hip, knee, and ankle joint kinematics were contrasted using repeated-measures ANOVAs. Participants also rated their subjective comfort in striking each of the three force measuring devices. Significant differences from the uninhibited condition were observed using the Footscan and Matscan in all three planes of rotation, whereas participants subjectively rated the force plate significantly more comfortable than either the Footscan/Matscan devices. The findings of the current investigation therefore suggest that the disguised floor embedded force plate offers the most natural running condition. It is recommended that analyses using devices such as the Footscan/Matscan mats overlying the laboratory surface during running should be interpreted with caution.
Frontal Plane Knee and Hip Kinematics During Sit-to-Stand and Proximal Lower Extremity Strength in Persons With Patellofemoral Osteoarthritis: A Pilot Study
Authors: Hoglund Lisa T. , Hillstrom Howard J. , Barr-Gillespie Ann E. , Lockard Margery A. , Barbe Mary F. , Song Jinsup
Published: March 2014

Increased joint stress and malalignment are etiologic factors in osteoarthritis. Static tibiofemoral frontal plane malalignment is associated with patellofemoral osteoarthritis (PFOA). Patellofemoral joint stress is increased by activities such as sit-to-stand (STS); this stress may be even greater if dynamic frontal plane tibiofemoral malalignment occurs. If hip muscle or quadriceps weakness is present in persons with PFOA, aberrant tibiofemoral frontal plane movement may occur, with increased patellofemoral stress. No studies have investigated frontal plane tibiofemoral and hip kinematics during STS in persons with PFOA or the relationship of hip muscle and quadriceps strength to these motions. Eight PFOA and seven control subjects performed STS from a stool during three-dimensional motion capture. Hip muscle and quadriceps strength were measured as peak isometric force. The PFOA group demonstrated increased peak tibial abduction angles during STS, and decreased hip abductor, hip extensor, and quadriceps peak force versus controls. A moderate inverse relationship between peak tibial abduction angle and peak hip abductor force was present. No difference between groups was found for peak hip adduction angle or peak hip external rotator force. Dynamic tibiofemoral malalignment and proximal lower extremity weakness may cause increased patellofemoral stress and may contribute to PFOA incidence or progression.
Dance Recognition System Using Lower Body Movement
Authors: Simpson Travis T. , Wiesner Susan L. , Bennett Bradford C.
Published: March 2014

The current means of locating specific movements in film necessitate hours of viewing, making the task of conducting research into movement characteristics and patterns tedious and difficult. This is particularly problematic for the research and analysis of complex movement systems such as sports and dance. While some systems have been developed to manually annotate film, to date no automated way of identifying complex, full body movement exists. With pattern recognition technology and knowledge of joint locations, automatically describing filmed movement using computer software is possible. This study used various forms of lower body kinematic analysis to identify codified dance movements. We created an algorithm that compares an unknown move with a specified start and stop against known dance moves. Our recognition method consists of classification and template correlation using a database of model moves. This system was optimized to include nearly 90 dance and Tai Chi Chuan movements, producing accurate name identification in over 97% of trials. In addition, the program had the capability to provide a kinematic description of either matched or unmatched moves obtained from classification recognition
Cytotoxicity of Paclitaxel in Breast Cancer Is due to Chromosome Missegregation on Multipolar Spindles
Authors: Zasadil Lauren M. , Andersen Kristen A. , Yeum Dabin , Rocque Gabrielle B. , Wilke Lee G. , Tevaarwerk Amye J. , Raines Ronald T. , Burkard Mark E. , Weaver Beth A.
Published: March 2014

The chemotherapy drug paclitaxel causes tumor regression and cell death by inducing high rates of chromosome missegregation on multipolar spindles.
Getting to the Heart of Consciousness
Authors: Drum Chester L.
Published: March 2014

Neocortical brain responses to individual heartbeats predict a subject’s ability to cognitively identify a visual stimulus.
Spotlight on Cancer
Authors: Spiller Kara L.
Published: March 2014

Activatable immunoconjugates targeting cancer cells can be used to image and treat disseminated micrometastases.
Fabrication of a hollow bulb prosthesis for the rehabilitation of an acquired total maxillectomy defect
Authors: Vamsi Krishna C H , Babu Jaya Krishna , Fathima Tanveer , Reddy G V K
Published: March 2014

The prosthodontic rehabilitation of maxillary defects is a challenging and demanding task which requires careful pre-surgical and post-surgical planning. Maxillary defects can be congenital or acquired. Acquired defects include those following trauma or surgical treatment of benign or malignant neoplasms. A prosthodontist encounters problems such as absence of support, poor retention, and lack of prosthesis stability in treating these patients. The present case report describes a procedure to fabricate a definitive hollow bulb obturator prosthesis for the rehabilitation of a total maxillectomy defect.
High-altitude cerebral oedema mimicking stroke
Authors: Yanamandra Uday , Gupta Amul , Patyal Sagarika , Varma Prem Prakash
Published: March 2014

High-altitude cerebral oedema (HACO) is the most fatal high-altitude illness seen by rural physicians practising in high-altitude areas. HACO presents clinically with cerebellar ataxia, features of raised intracranial pressure (ICP) and coma. Early identification is important as delay in diagnosis can be fatal. We present two cases of HACO presenting with focal deficits mimicking stroke. The first patient presented with left-sided hemiplegia associated with the rapid deterioration in the sensorium. Neuroimaging revealed features suggestive of vasogenic oedema. The second patient presented with monoplegia of the lower limb. Neuroimaging revealed perfusion deficit in anterior cerebral artery territory. Both patients were managed with dexamethasone and they improved dramatically. Clinical picture and neuroimaging closely resembled acute ischaemic stroke in both cases. Thrombolysis in these patients would have been disastrous. Recent travel to high altitude, young age, absence of atherosclerotic risk factors and features of raised ICP concomitantly directed the diagnosis to HACO.
Spontaneous hymeneal endometriosis: a rare cause of dyspareunia
Authors: Canlorbe Geoffroy , Laas Enora , Cortez Annie , Daraï Emile
Published: March 2014

Vulvar endometriosis can occur after surgery or trauma and cause dyspareunia. A 30-year-old woman presented with orificial dyspareunia lasting for 5 months. Her history was marked by a vaginal birth without perineal injury and the removal of a cyst from the left Bartholin’s gland. On examination, we observed a selectively painful, superficial and retractile lesion, 5 mm in diameter at the junction of the hymen at some distance from the bartholinitis scar. Endometriosis was suspected due to the exacerbation of pain during menses. The surgery consisted of excision of the hymenal area of the painful lesion. Pathological examination confirmed the presence of endometrial tissue. The painful symptoms resolved and no additional treatment was administered. Any vulvar lesion, regardless of its appearance and location, can be related to endometriosis. Surgical resection is recommended to relieve the symptoms and provide histological proof.
Smartphone and tablet apps for concussion road warriors (team clinicians): a systematic review for practical users
Authors: Lee Hopin , Sullivan S John , Schneiders Anthony G , Ahmed Osman Hassan , Balasundaram Arun Prasad , Williams David , Meeuwisse Willem H , McCrory Paul
Published: March 2014

Background

Mobile technologies are steadily replacing traditional assessment approaches for the recognition and assessment of a sports concussion. Their ease of access, while facilitating the early identification of a concussion, also raises issues regarding the content of the applications (apps) and their suitability for different user groups.

Aim

To locate and review apps that assist in the recognition and assessment of a sports concussion and to assess their content with respect to that of internationally accepted best-practice instruments.

Methods

A search of international app stores and of the web using key terms such as ‘concussion’, ‘sports concussion’ and variants was conducted. For those apps meeting the inclusion criteria, data were extracted on the platform, intended users and price. The content of each app was benchmarked to the Sport Concussion Assessment Tool 2 (SCAT2) and Pocket SCAT2 using a custom scoring scheme to generate a percentage compliance statistic.

Results

18 of the 155 apps identified met the inclusion criteria. Almost all (16/18) were available on an iOS platform and only five required a payment to purchase. The apps were marketed for a wide range of intended users from medical professionals to the general public. The content of the apps varied from 0% to 100% compliance with the selected standard, and ‘symptom evaluation’ components demonstrated the highest level of compliance.

Conclusions

The surge in availability of apps in an unregulated market raises concerns as to the appropriateness of their content for different groups of end users. The consolidation of best-practice concussion instruments now provides a framework to inform the development of future apps.
Does a GLP-1 receptor agonist change glucose tolerance in patients treated with antipsychotic medications? Design of a randomised, double-blinded, placebo-controlled clinical trial
Authors: Larsen Julie Rask , Vedtofte Louise , Holst Jens Juul , Oturai Peter , Kjær Andreas , Corell Christoph U , Vilsbøll Tina , Fink-Jensen Anders
Published: March 2014

Background

Metabolic disturbances, obesity and life-shortening cardiovascular morbidity are major clinical problems among patients with antipsychotic treatment. Especially two of the most efficacious antipsychotics, clozapine and olanzapine, cause weight gain and metabolic disturbances. Additionally, patients with schizophrenia-spectrum disorders not infrequently consume alcohol. Glucagon-like peptide-1 (GLP-1) has shown to improve glycaemic control and reduce alcohol intake among patients with type 2 diabetes.

Objectives

To investigate whether the beneficial effects of GLP-1 analogues on glycaemic control and alcohol intake, in patients with type 2 diabetes, can be extended to a population of pre-diabetic psychiatric patients receiving antipsychotic treatment.

Methods and analysis

Trial design, intervention and participants:The study is a 16-week, double-blinded, randomised, parallel-group, placebo-controlled clinical trial, designed to evaluate the effects of the GLP-1 analogue liraglutide on glycaemic control and alcohol intake compared to placebo in patients who are prediabetic, overweight (body mass index ≥27 kg/m2), diagnosed with a schizophrenia-spectrum disorder and on stable treatment with either clozapine or olanzapine.Outcomes: The primary endpointis the change in glucose tolerance from baseline (measured by area under the curve for the plasma glucose excursion following a 4 h 75 g oral glucose tolerance test) to follow-up at week 16.The secondary endpointsinclude changes of dysglycaemia, body weight, waist circumference, blood pressure, secretion of incretin hormones, insulin sensitivity and β cell function, dual-energy X-ray absorption scan (body composition), lipid profile, liver function and measures of quality of life, daily functioning, severity of the psychiatric disease and alcohol consumption from baseline to follow-up at week 16.Status:Currently recruiting patients.

Ethics and dissemination

Ethical approval has been obtained. Before screening, all patients will be provided oral and written information about the trial. The study will be disseminated by peer-review publications and conference presentations.

Trial registration number

ClinicalTrials.gov:NCT01845259, EudraCT: 2013-000121-31.
Is adequate pain relief and time to analgesia associated with emergency department length of stay? A retrospective study
Authors: Sokoloff Catalina , Daoust Raoul , Paquet Jean , Chauny Jean-Marc
Published: March 2014

Objectives

Evaluate the association of adequate analgesia and time to analgesia with emergency department (ED) length of stay (LOS).

Setting and Design

Post hoc analysis of real-time archived data.

Participants

We included all consecutive ED patients ≥18 years with pain intensity >6 (verbal numerical scale from 0 to 10), assigned to an ED bed, and whose pain was re-evaluated less than 1 h after receiving analgesic treatment.

Outcome measures

The main outcome was ED-LOS in patients who had adequate pain relief (AR=↓50% pain intensity) compared with those who did not have such relief (NR).

Results

A total of 2033 patients (mean age 49.5 years; 51% men) met our inclusion criteria; 58.3% were discharged, and 41.7% were admitted. Among patients discharged or admitted, there was no significant difference in ED-LOS between those with AR (median (25th–75th centile): 9.6 h (6.3–14.8) and 18.2 h (11.6–25.7), respectively) and NR (median (25th–75th centile): 9.6 h (6.6–16.0) and 17.4 h (11.3–26.5), respectively). After controlling for confounding factors, rapid time to analgesia (not AR) was associated with shorter ED-LOS of discharged and admitted patients (p<0.001 and <0.05, respectively). When adjusting for confounding variables, ED-LOS is shortened by 2 h (95% CI 1.1 to 2.8) when delay to receive analgesic is <90 min compared with >90 min for discharged and by 2.3 h (95% CI 0.17 to 4.4) for admitted patients.

Conclusions

In our study, AR was not linked with short ED-LOS. However, rapid administration of analgesia was associated with short ED-LOS.
The Champions League - Improving the quality of in-patient antibiotic prescription in Trauma and Orthopaedics
Authors: Evans Jonathan , Saxby Clair , Armstrong Alexander
Published: March 2014

A Trust level audit demonstrated that the trauma and orthopaedic department did not reach its own standards in adhering to Trust antibiotic prescribing guidelines. Junior doctors are the main prescribers of antibiotics during inpatient stays. Local policy states that for all inpatients on antibiotics, the start date, duration, and indication for antibiotics must be documented on the drug card.

Each patient drug card was reviewed by the department pharmacist and it was recorded whether the documentation was in line with Trust policy. A monthly league table, coined 'The Champions League', was created. It was published monthly and displayed in the doctors' office and other clinical areas to highlight which doctors had or had not adhered to the prescribing guidelines.

In August 2012 the monthly audit for the trauma and orthopaedic department included 74 patients. The total number of antibiotic courses prescribed was 28; of these courses only 15 (53.5%) had an indication documented and 15 (53.5%) had a review/stop date documented.

In December 2012, after two published league tables, 61 patients were reviewed. A total of 19 antibiotic courses were prescribed; 18 (94.7%) had the indication documented and 16 (84.2%) had the review/stop date documented.

The standards of prescribing improved within the department and good prescribing practice became ingrained into each doctor's practice. The league table proved to be a novel tool that helped to raise the profile of antibiotic prescribing and change doctor prescribing habits. It created a competitive spirit within the department which improved morale. Doctors responded positively to feedback if they were not achieving the desirable standards, and enjoyed the challenge of improving the standard of prescribing.
Classifying emergency 30-day readmissions in England using routine hospital data 2004–2010: what is the scope for reduction?
Authors: Blunt Ian , Bardsley Martin , Grove Amy , Clarke Aileen
Published: March 2014

Background

Many health systems across the globe have introduced arrangements to deny payment for patients readmitted to hospital as an emergency. The purpose of this study was to develop an exploratory categorisation based on likely causes of readmission, and then to assess the prevalence of these different types.

Methods

Retrospective analysis of 82 million routinely collected National Health Service hospital records in England (2004–2010) was undertaken using anonymised linkage of records at person-level. Numbers of 30-day readmissions were calculated. Exploratory categorisation of readmissions was applied using simple rules relating to International Classification of Diseases (ICD) diagnostic codes for both admission and readmission.

Results

There were 5 804 472 emergency 30-day readmissions over a 6-year period, equivalent to 7.0% of hospital discharges. Readmissions were grouped into hierarchically exclusive categories: potentially preventable readmission (1 739 519 (30.0% of readmissions)); anticipated but unpredictable readmission (patients with chronic disease or likely to need long-term care; 1 141 987 (19.7%)); preference-related readmission (53 718 (0.9%)); artefact of data collection (16 062 (0.3%)); readmission as a result of accident, coincidence or related to a different body system (1 101 818 (19.0%)); broadly related readmission (readmission related to the same body system (1 751 368 (30.2%)).

Conclusions

In this exploratory categorisation, a large minority of emergency readmissions (eg, those that are potentially preventable or due to data artefacts) fell into groups potentially amenable to immediate reduction. For other categories, a hospital's ability to reduce emergency readmission is less clear. Reduction strategies and payment incentives must be carefully tailored to achieve stated aims.
Pure white cell aplasia: report of first case associated with autoimmune hepatitis
Authors: Keast Thomas , Weeraman Deshan , Mayhead Phil , Grace Richard , Mathe Stamford
Published: March 2014

Pure white cell aplasia (PWCA) is a rare, immune-mediated condition that causes a profound inhibition of myelopoiesis. It has been seen in association with other autoimmune conditions, thymomas, chronic lymphocytic leukaemia and as an adverse drug reaction. We report what we believe to be the first case of PWCA associated with autoimmune hepatitis. An 18-year-old woman presented with jaundice and was found to be suffering from acute hepatitis. Later she became neutropenic and lymphopenic. Liver biopsy was indicative of autoimmune hepatitis. This was later confirmed by autoantibody results. Bone marrow aspirate found an absence of all myeloid progenitor cells, highly suggestive of PWCA. The low white cell count only improved after immunosuppression with corticosteroids. Her condition remains stable 1 year later with azathioprine therapy.