bluuebunny/crossref_metadata_2025 huggingface dataset:
Four Decades of Chronic Haemodialysis: Lessons from the Past and Implications for the Future
Authors: Prabhavalkar S.M. , Verghis R. , McNamee P.T. , Courtney A.E.
Published: October 2012

Background: There have been substantial changes in the provision of chronic haemodialysis (HD) therapy over time, yet data regarding the impact of these differences on clinical outcomes are limited. Aim: To identify factors which have significantly changed over the last 40 years in relation to patients receiving maintenance HD therapy. Methods: All 2,647 patients who were established on the chronic HD programme in Northern Ireland between 1970 and 2010 were included. Clinical data and survival outcomes were obtained from a prospectively recorded database. The study period was divided into four decades in order to assess the temporal changes. Results: The total number of patients receiving HD therapy has risen, and the mean age of the HD population has increased significantly (39.0 years in the 1970s vs. 66.8 years in the 2000s, p < 0.001). Diabetic nephropathy has emerged as the commonest aetiology for ESRD (0% in the 1970s to 20.3% in the 2000s, p < 0.001). The median survival of patients on HD has improved significantly over time from 5.2 months (95% CI 2.6–15.5) in the 1970s to 41.7 months (95% CI 38–45.2) in the 2000s (p < 0.0001). Factors that remained significant in determining survival were age, primary renal diagnosis, and decade of commencement of dialysis. Conclusions: Survival on HD has significantly improved despite older patients with multiple co-morbidities being accepted for treatment reflecting both increased dialysis frequency and better management of cardiovascular risk factors. The increasing age of HD patients and their improved survival have implications for future planning and delivery of dialysis.
Diarrhea Is a Positive Outcome Predictor for Sorafenib Treatment of Advanced Hepatocellular Carcinoma
Authors: Koschny Ronald , Gotthardt Daniel , Koehler Christiane , Jaeger Dirk , Stremmel Wolfgang , Ganten Tom M.
Published: October 2012

Objective: This study was performed to identify clinical predictors for better survival in patients with advanced hepatocellular carcinoma (HCC) under sorafenib treatment. Methods: Between December 2007 and January 2010, 46 patients with advanced HCC were treated with sorafenib until significant tumor progression or intolerable toxicity. We prospectively collected clinical baseline data as well as data on the incidence and severity of toxic side effects of sorafenib to be correlated with progression-free survival and overall survival (OS), respectively. Results: Only 26.1% (n = 12) of patients tolerated sorafenib without requiring dose reduction. The most frequent grade 3 toxicities were diarrhea (32.6%), hand-foot skin reaction (13.0%), fatigue (4.3%), and nausea/vomiting (2.2%). Eastern Cooperative Oncology Group performance status (p = 0.034) and portal vein infiltration (p = 0.021) significantly correlated with OS. Furthermore, we found a significant correlation between OS and appearance of grade 2 or 3 diarrhea with a median actuarial survival of 11.8 months (95% CI 6.9–16.6) compared to 4.2 months in patients with grade 0 or 1 diarrhea (95% CI 0.0–9.1; p = 0.009). In contrast, appearance of hand-foot skin reaction did neither correlate with progression-free survival nor with OS. Conclusion: Appearance of grade 2 or 3 diarrhea indicates a better OS of HCC patients undergoing sorafenib treatment.
Cyclosporine A Impairs Norepinephrine-Induced Vascular Contractility
Authors: Bergler Tobias , Resch Markus , Reinhold Stephan W. , Birner Christoph , Jungbauer Carsten G. , Griese Daniel P. , Schmid Peter , Banas Bernhard , Endemann Dierk
Published: October 2012

Usage of cyclosporine A (CsA) after kidney transplantation may be associated with development of nephrotoxicity and vasculopathy, but the mechanisms by which CsA causes vascular dysfunction are still under scrutiny. We established a transplantation model and investigated the effect of CsA on vascular contractility with the aid of a pressurized myograph in comparison with control and unilaterally nephrectomized rats. Results were correlated with mRNA expression studies of α- and β-adrenoreceptors, in mesenteric resistance arteries versus the thoracic aorta. Consequences of everolimus on functional properties as well as adrenoreceptor expression were also studied. CsA significantly downregulated expression of mesenteric adrenoreceptors, whereas no effect on aortic adrenoreceptors was seen. Administration of everolimus had no influence on mRNA adrenoreceptor expression in mesenteric resistance arteries. Furthermore, contractile responses of mesenteric resistance arteries to norepinephrine were markedly reduced after treatment with CsA, while there was no difference in contraction by endothelin. Everolimus did not alter the contractility response at all. In summary, norepinephrine-induced, but not endothelin-induced, contractile responses of mesenteric resistance arteries are blunted in CsA-treated rats. This finding was accompanied by a marked downregulation of adrenoreceptors in mesenteric resistance arteries and was limited to the usage of CsA.
Periodontal Health of Children with Type 1 Diabetes Mellitus in Kuwait: A Case-Control Study
Authors: Al-Khabbaz Areej K. , Al-Shammari Khalaf F. , Hasan Abdulaziz , Abdul-Rasoul Majedah
Published: October 2012

Objective: The aim of this study was to evaluate periodontal health in children diagnosed with type 1 diabetes mellitus. Subjects and Methods: Periodontal health was clinically examined and compared in 95 children diagnosed with type 1 diabetes and 61 healthy control subjects (4–14 years old). Plaque index, gingival index, clinical attachment loss and bleeding on probing were assessed on the 6 Ramfjord index teeth. Diabetes history was recorded based on information provided by the physician from the medical record of each diabetic child. Diabetes history included date of diagnosis, diabetes duration, age at diagnosis, latest reading for glycosylated hemoglobin and any existing diabetes complications. Data were analyzed using the Statistical Package for Social Science software, version 18. ‘Periodontitis’ was defined as at least one site with clinical attachment loss >2 mm on at least 2 teeth. Results: Sixty-two of the diabetic children (65%) had poor compliance with dental care, and 42 of them (44%) had never visited the dentist before. The children with type 1 diabetes mellitus had a significantly higher plaque index and gingival index and more bleeding on probing than control subjects (p < 0.001). In the diabetic group, periodontitis was significantly associated with longer duration of diabetes (odds ratio 2.230, confidence interval 1.308–3.801; p = 0.003) and older age at diagnosis of diabetes (odds ratio 1.838, confidence interval 1.091–3.096; p = 0.022). Conclusions: Periodontal disease in young patients with type 1 diabetes was more evident than in those without diabetes. These data showed that diabetes duration may play a significant role in the progression of periodontal disease in diabetic children.
Acute Bacterial Prostatitis in Humans: Current Microbiological Spectrum, Sensitivity to Antibiotics and Clinical Findings
Authors: Nagy Vincent , Kubej Dušan
Published: October 2012

Objective: To assess the current microbiological profile and sensitivity to antibiotics in patients with acute bacterial prostatitis (ABP). Patients and Methods: In the period 2003–2010, we treated 192 ABP patients, aged from 18 to 85 years (average 56.3 years). We performed a biochemical examination including a microbiological urine examination. After admission, we immediately began the empirical antibacterial treatment. Results: The clinical picture was dominated by pain, prostate enlargement and failure of micturition in 185 (96.4%) patients; 14 (7.3%) patients had acute urinary retention where epicystostomy was necessary. Fever occurred in 177 (92.2%) patients and Escherichia coli was the most frequent etiological agent detected in 103 (53.7%) patients followed by Pseudomonas aeruginosa and Klebsiella species. In 16 (8.3%) patients we found 2 bacteriological strains. Sterile urine was found in 65 (33.8%) patients. Fluoroquinolones, aminoglycosides and cephalosporins were used most frequently. 147 (76.6%) patients were treated according to the microbiological results. Overview of resistance shows an increase in resistance to fluoroquinolones. In 14 (7.3%) patients there was progression to urosepsis. Conclusion: Clinicians should consider local drug-resistance patterns when choosing antibiotics and should adjust the therapy on the basis of bacterial cultures and local sensitivity to antibiotics.
Retrograde Nailing versus Locked Plating of Extra-Articular Distal Femoral Fractures: Comparison of 36 Cases
Authors: Gao Kanda , Gao Wei , Huang Jianhua , Li Haoqing , Li Fan , Tao Jie , Wang Qiugen
Published: October 2012

Objective: The purpose of this study was to retrospectively evaluate the use of locked plating (LP) and retrograde nailing (RN) for treating extra-articular distal femoral fractures. Materials and Methods: From January 2004 to March 2009, 36 patients with extra-articular distal femoral fractures were surgically treated at our Trauma Center. The patients were divided into two groups according to the treatment method, with 19 patients being treated by LP (LP group) and 17 patients via RN (RN group). Results: The demographics of age (p = 0.460) and gender (p = 0.481) in both LP and RN groups were similar. No differences were found with respect to postoperative malreduction, deep infection, hardware failure, operating time, knee pain, HSS score and range of knee movement. The mean intraoperative blood loss was significantly higher in the RN group (298 ± 65.2 ml, range 200–410) than in the LP group (200 ± 48.9 ml, range 130–300) (p < 0.01). However, a higher rate of union disturbance was observed in the LP group (36.8%) compared to the RN group (5.9%) (p = 0.044). Conclusions: The overall union disturbance rate in the LP group was higher than in the RN group. However, further analysis revealed that clinical outcome may largely depend on surgical technique rather than on the choice of implant. Therefore, correct rules (the same for every procedure) should be strictly adhered to, especially in the application of LP.
Effects of Age on Outcome in the SENTIS Trial: Better Outcomes in Elderly Patients
Authors: Leker Ronen R. , Molina Carlos , Cockroft Kevin , Liebeskind David S. , Concha Mauricio , Shuaib Ashfaq , De Deyn Peter Paul , Burgin W. Scott , Gupta Rishi , Dillon William , Diener Hans-Christoph
Published: October 2012

Background: Increasing age is associated with poor outcome after stroke. The Safety and Efficacy of NeuroFlo Technology in Ischemic Stroke (SENTIS) trial explored the augmentation of collateral circulation to the ischemic penumbra as a novel approach to stroke treatment. The aim of this post hoc analysis was to examine the effect of age on outcomes in the SENTIS trial. Methods: Using data from the randomized controlled SENTIS trial, we explored outcomes of cerebral blood flow augmentation using the NeuroFlo™ device in patients categorized by age strata at 70 and 80 years. We evaluated outcomes of overall serious adverse event (SAE) and intracerebral hemorrhage (ICH) rates, freedom from all-cause and stroke-related mortality, and independent functional outcome as defined by the modified Rankin Scale score (mRS ≤2). Results: The SENTIS as-treated cohort included 251 patients ≥70 years and 107 patients ≥80 years. Elderly SENTIS patients included a higher percentage of women and Caucasians than the younger group. Patients in the older group more frequently had vascular risk factors including hypertension, previous stroke, transient ischemic attacks and atrial fibrillation. However, baseline risk-factor profile, stroke severity, and time to randomization did not differ between the treated and nontreated elderly patients. The older patients treated with NeuroFlo had significantly higher chances for survival and for obtaining an independent functional state (mRS ≤2) compared with those who were not treated. Rates of SAEs and ICHs did not differ between the treatment groups. Conclusions: NeuroFlo treatment is safe and results in better outcomes for elderly patients. This may be the result of recruitment and support of already existing collateral systems in these patients.
Midtrimester Fetal Herpes Simplex-2 Diagnosis by Serology, Culture and Quantitative Polymerase Chain Reaction
Authors: Curtin William M. , Menegus Marilyn A. , Patru Maria-Magdalena , Peterson C. Jeanne , Metlay Leon A. , Mooney Robert A. , Stanwood Nancy L. , Scheible Amy L. , Dorgan Angela
Published: October 2012

The acquisition of herpes simplex virus (HSV) in utero comprises a minority of neonatal herpes infections. Prenatal diagnosis is rare. We describe a midtrimester diagnosis of fetal HSV-2 infection. Ultrasound at 20 weeks for elevated maternal serum α-fetoprotein (MSAFP) showed lagging fetal growth, echogenic bowel, echogenic myocardium, and liver with a mottled pattern of echogenicity. Amniocentesis demonstrated normal karyotype, elevated AFP and positive acetylcholinesterase. Culture isolated HSV-2 with an aberrant growth pattern. Maternal serology was positive for HSV-2. Quantitative DNA polymerase chain reaction (PCR) showed 59 million copies/ml. Fetal autopsy demonstrated widespread tissue necrosis but only sparse HSV-2 inclusions. Fetal HSV-2 infection can be suspected when an elevated MSAFP accompanies ultrasound findings suggesting perinatal infection. Maternal HSV serology, amniotic fluid culture and quantitative PCR are recommended for diagnostic certainty and counseling.
Very Early Development of Nucleus Taeniae of the Amygdala
Authors: Ikebuchi Maki , Nanbu Sanae , Okanoya Kazuo , Suzuki Ryoji , Bischof Hans-Joachim
Published: October 2012

The avian nucleus taeniae of the amygdala (TnA) corresponds to part of the mammalian medial amygdala. Like its mammalian counterpart, it has been shown to be involved in the control of social function. According to behavioral observations, such control is already necessary early in the ontogenetic development of a bird. If so, TnA should be one of the earliest differentiating brain structures of the telencephalon. Our anatomical study shows that TnA can already be delineated at posthatching day one. The volume of TnA exhibits a growth spurt between days 1 and 8 posthatch, developing at a faster rate than the entire telencephalon. Our results suggest that between days 1 and 8 the growth of neuropil exceeds the enhancement of neuron number (leading to a decrease of cell density), and an addition at the same pace of new neurons and neuropil thereafter. A plateau is reached at posthatch day 30. The development of TnA precedes that of the song control nuclei and is similar to the early growth of thalamic and telencephalic sensory areas. This adds to the idea that this structure may already be involved in social control at the time of hatching. A proximate cause of the early development of TnA might be the direct afference from the olfactory bulb.
Adult Hepatoblastoma: Systemic Review of the English Literature
Authors: Wang Yun Xiang , Liu Hong
Published: October 2012

Aims: To review all the case reports or case series of patients with adult hepatoblastoma. Methods: A search of all case reports on adult hepatoblastoma in the English literature was performed using the PubMed database. Demographic information, clinical findings, treatment modalities and outcomes were extracted and analyzed. Results: A total of 36 English articles and 40 patients with adult hepatoblastoma were collected. All these cases were confirmed by pathological diagnosis. The median age of the 40 patients was 41.5 years, including 21 males and 19 females. Hepatitis B virus tests were positive in 6 patients, and 15 patients were positive for α-fetoprotein (AFP). Liver cirrhosis was only confirmed in 7 cases. Hepatoblastoma commonly forms a single giant mass within the liver. Twenty-three cases underwent radical liver resection, including 9 cases of comprehensive treatment. The median survival time for 27 patients with available follow-ups was 4 months; 1-year survival was 29.6%. In Cox multivariate analysis, curative liver resection was an independent prognostic factor for prolonged survival (p = 0.003). Conclusions: Curative liver resection can prolong survival. Improvements in outcome will require the development of more effective systemic therapies.
New Insights into the Management of Renal Cell Cancer
Authors: Pécuchet Nicolas , Fournier Laure S. , Oudard Stéphane
Published: October 2012

Kidney cancer is composed of several bio-histological entities. The most frequent type, clear-cell carcinoma, is not homogenous regarding gene mutations or transcriptomic profiles, but the biologic classifications are not yet mature. Therefore, biologically driven strategies of treatment have not yet been developed in the clinical setting. The choice of first-line agent currently depends on the prognostic criteria published by Motzer et al. [J Clin Oncol 1999;17:2530–2540] and recently by Heng et al. [J Clin Oncol 2009;27:5794–5799], with anti-vascular endothelial growth factor (VEGF) therapies for good- or intermediate-prognosis groups and anti-mammalian target of rapamycin (mTOR) for poor-risk patients. In the past years, biological changes leading to resistance to targeted agents have been widely investigated. Discoveries resulted in the development of second-generation VEGF receptor tyrosine kinase inhibitors, characterized by an improved potency and selectivity. Besides, co-inhibition of signalling pathways mediating resistance to anti-VEGF are being developed targeting fibroblast growth factor and c-Met. Dual mTOR/phosphatidylinositol 3-kinase inhibitors have greater efficacy than rapalogs in preclinical models and are being investigated in early clinical trials. In conclusion, the changing landscape in the biology and treatment of kidney cancer offers new opportunities for clinicians to treat patients, but, due to relatively high costs, the use of targeted therapies will likely be strongly controlled by health authorities.
Literature Review of Recombinant Tissue Plasminogen Activator Used for Recent-Onset Submacular Hemorrhage Displacement in Age-Related Macular Degeneration
Authors: van Zeeburg Elsbeth J.T. , van Meurs Jan C.
Published: October 2012

Aims: To review and discuss the literature on recombinant tissue plasminogen activator (rtPA) for the treatment of a recent-onset submacular hemorrhage in patients with age-related macular degeneration. Methods: The administration technique of rtPA, the use of additional gas and vascular endothelial growth factor inhibitors (anti-VEGF), and the displacement rate of submacular hemorrhage and complications were noted from published reports, and a case series from the Rotterdam Eye Hospital (REH). Results: 38 studies with a total of 1,185 patients (1,176 eyes), and 28 patients from the REH were analyzed. Several methods for rtPA administration are available, which can be divided into two groups: submacular rtPA administration with vitrectomy; or intravitreal rtPA administration without vitrectomy. In both groups, the administration of gas and/or anti-VEGF agents could be additional. There appears to be no clear difference in complete displacement or complication rate between the more or the less invasive treatment groups. Conclusion: Although intravitreal injection of rtPA and gas only was reported to be as effective as subretinal rtPA with vitrectomy and gas, recent studies tend to use vitrectomy. These data underscore the need for a randomized controlled trial to choose the most effective and safe method of rtPA administration.
Estradiol and Pubertal Growth in Girls
Authors: Albin Anna-Karin , Niklasson Aimon , Westgren Ulf , Norjavaara Ensio
Published: October 2012

Aim: The objective of this study was to determine estradiol levels and assess their relationship to pubertal growth in girls. Methods: Thirty-seven 24-hour profiles of serum 17β-estradiol were retrospectively analyzed in relation to growth in 27 healthy girls admitted for short/tall stature (n = 20) or recruited as healthy volunteers at Göteborg Pediatric Growth Research Center (GP-GRC). Inclusion Criteria: Birth weight and length above –2 SDS, gestational age 37–42 weeks, prepubertal height and weight within ±3 SDS and normal growth hormone secretion. Serum estradiol was determined by a validated ultrasensitive extraction radioimmunoassay (detection limit 4 pmol/l). A sixth-grade polynomial was fitted to each girl’s growth data. Growth velocity and age at peak height velocity (PHV) was calculated. Results: A dose-response model was used to find the morning 17β-estradiol level at which half of the maximal pubertal growth up to PHV had occurred, EC50, which was 20 pmol/l with a 95% confidence interval of 13–31. When 17β-estradiol exceeds early pubertal levels (Tanner breast stage 2, 10–51 pmol/l), less than 25% of the potential pubertal growth velocity up to PHV remains. Conclusions: Morning 17β-estradiol in the low early pubertal range (13–31 pmol/l) is associated with increasing growth velocity.
The Lay Public’s Understanding and Perception of Dementia in a Developed Asian Nation
Authors: Tan Wai Jia , Hong Song-Iee , Luo Nan , Lo Tong Jen , Yap Philip
Published: October 2012

Background: Early detection of dementia aims to improve treatment outcomes. However, poor perception and understanding of dementia are significant barriers. We aim to investigate the public’s perception of dementia and identify variables associated with the different profiles of public perception. Methods: A custom-designed questionnaire was used to assess laypersons’ knowledge and perception of dementia during a health fair at a public hospital in Singapore, a developed Asian nation. Out of a sample of 370 subjects, 32 declined to participate (response rate = 91.4%). Latent class analysis (LCA) was used to identify meaningful subgroups of subjects from significant associations with multiple indicators of dementia awareness. Multinomial logistic regression was performed exploring variables associated with each of the subgroups derived from LCA. Results: The majority of the study participants were female (66.9%), 65 years or older (71.1%), and ethnic Chinese (88.1%). LCA classified the study participants into 3 subgroups: Class 1 (good knowledge, good attitude), Class 2 (good knowledge, poor attitude), and Class 3 (poor knowledge, poor attitude), in proportions of 14.28, 63.83, and 21.88%, respectively. Compared to other classes, participants with good knowledge and good attitude towards dementia (Class 1) were more likely to know someone with dementia and understand the effects of the disease, be married, live in private housing, receive higher monthly income, and not profess belief in Buddhism, Taoism, or Hinduism. Conclusion: Our results show that the public in Singapore may not be ready for screening initiatives and early dementia diagnosis. Education efforts should be targeted at lower socioeconomic groups, singles, and those of certain oriental religions.
Analysis of Aggregate Impact Factor Inflation in Ophthalmology
Authors: Caramoy Albert , Korwitz Ulrich , Eppelin Anita , Kirchhof Bernd , Fauser Sascha
Published: October 2012

Purpose: To analyze the aggregate impact factor (AIF) in ophthalmology, its inflation rate, and its relation to other subject fields. Methods: A retrospective, database review of all subject fields in the Journal Citation Reports (JCR), Science edition. Citation data, AIF, number of journals and citations from the years 2003–2011 were analyzed. Data were retrieved from JCR. Future trends were calculated using a linear regression method. Results: The AIF varies considerably between subjects. It shows also an inflation rate, which varies annually. The AIF inflation rate in ophthalmology was not as high as the background AIF inflation rate. Conclusions: The AIF inflation rate caused the AIF to increase annually. Not considering these variations in the AIF between years and between fields will make the AIF as a bibliometric tool inappropriate.
Prevalence of Cytomegalovirus DNA in Cord Blood and Voided Urine Obtained from Pregnant Women at the End of Pregnancy
Authors: Al-Awadhi Rana , Al-Harmi Jehad , AlFadhli Suad
Published: October 2012

Objective: This study was undertaken to determine the prevalence of congenital cytomegalovirus (CMV) infection in pregnant women at the end of pregnancy in Kuwait using cord blood and maternal urine. Subjects and Methods: Urine samples were collected prior to childbirth, and cord blood was collected immediately after delivery from 983 women. Anti-CMV IgG and IgM antibodies were determined using ELISA; CMV DNA was detected using nested PCR, and viral load was calculated using real-time PCR. CMV concentration in samples was categorized as low when the viral load ≤103 copies/µl, intermediate when the viral load = 103–104 copies/µl, and high when the viral load >104 copies/µl. The cord blood serology outcome was compared to cord blood PCR, cord blood viral load, maternal urine PCR and viral load analyses. Results: Serology showed that of the 983 cord blood samples, 89 (9%) were positive for anti-CMV IgM antibodies; PCR test showed 44 (4.5%) contained CMV DNA, and there was a high viral load in all. Maternal urine PCR showed that 9 (10.11%) women had CMV DNA, and there was a high viral load in 7 (78%). The kappa test for measures of agreement showed a reasonable agreement (0.45) between cord blood PCR and urine PCR. Conclusion: This study showed that CMV infection in the cord blood sera of pregnant women is common in Kuwait and highlights the need for more clinically based studies to follow up newborns with congenital CMV infection.
Caffeine’s Mechanisms of Action and Its Cosmetic Use
Authors: Herman A. , Herman A.P.
Published: October 2012

Caffeine is being increasingly used in cosmetics due to its high biological activity and ability to penetrate the skin barrier. This alkaloid is frequently used as a hydrophilic model substance in human and animal skin penetration as well as different synthetic membrane using Franz diffusion cell experiments. The commercially available topical formulations of caffeine normally contain 3% caffeine. As for a cosmetic purpose, caffeine is used as an active compound in anti-cellulite products because it prevents excessive accumulation of fat in cells. This alkaloid stimulates the degradation of fats during lipolysis through inhibition of the phosphodiesterase activity. Caffeine has potent antioxidant properties. It helps protect cells against the UV radiation and slows down the process of photoaging of the skin. Moreover, caffeine contained in cosmetics increases the microcirculation of blood in the skin and also stimulates the growth of hair through inhibition of the 5-α-reductase activity.
Insular Ischemic Stroke: Clinical Presentation and Outcome
Authors: Lemieux F. , Lanthier S. , Chevrier M.-C. , Gioia L. , Rouleau I. , Cereda C. , Nguyen D.K.
Published: October 2012

Background: The insula is a small but complex structure located in the depth of the sylvian fissure, covered by the frontal, parietal and temporal operculum. Ischemic strokes limited to the insula are rare and have not been well studied. Our objective is to better define the clinical presentation and outcome of insular ischemic strokes (IIS). Methods: We reviewed the institutional prospective, consecutive stroke database from two centers to identify patients with IIS seen between 2008 and 2010. We also searched the Medline database using the keywords insula(r), infarction and stroke to identify previously published IIS cases confirmed by MRI. Minimal extension to an adjacent operculum or subinsular area was accepted. Clinicoradiological correlation was performed by distinguishing IIS involving the anterior (AIC) or posterior insular cortex (PIC). We collected clinical, demographic and radiological data. The outcome was determined using the modified Rankin Scale (mRS). Results: We identified 7 patients from our institutions and 16 previously published cases of IIS. Infarcts were limited to the AIC (n = 4) or the PIC (n = 12) or affected both (n = 7). The five most frequent symptoms were somatosensory deficits (n = 10), aphasia (n = 10), dysarthria (n = 10), a vestibular-like syndrome (n = 8) and motor deficits (n = 6). A significant correlation was found between involvement of the PIC and somatosensory manifestations (p = 0.04). No other statistically significant associations were found. IIS presentation resembled a partial anterior circulation infarct (n = 9), a lacunar infarct (n = 2) or a posterior circulation infarct (n = 2). However, most cases presented findings that did not fit with these classical patterns (n = 10). At the 6 month follow up, mRS was 0 in 8/23 (35%) patients, 1–2 in 7/23 (30%) and unknown in 8/23 (35%). Conclusions: IIS presentation is variable. Due to the confluence of functions in a restricted region, it results in multimodal deficits. It should be suspected when vestibular-like or motor but especially somatosensory, speech or language disturbances are combined in the same patient. The outcome of IIS is often favorable. Larger prospective studies are needed to better define the clinical presentation and outcome of IIS.
Both BMI and Waist Circumference Are Associated with Coronary Vasoreactivity in Overweight and Obese Men
Authors: Sundell Jan , Raitakari Olli T. , Viikari Jorma , Kantola Ilkka , Nuutila Pirjo , Knuuti Juhani
Published: October 2012

Objective: Guidelines differ about the value of assessment of adiposity measures for cardiovascular disease risk prediction. Reduced coronary vasoreactivity appears to be one of the earliest abnormalities in the development of coronary artery disease. We studied the associations of BMI, waist circumference, waist-to-hip ratio (WHR) and percentage of fat with coronary vasoreactivity. Methods: Myocardial blood flow was quantitated in 14 overweight or obese non-smoking men (age 32 ± 7 years, BMI 32 ± 3 kg/m2, waist circumference 106 ± 9 cm, WHR 0.96 ± 0.04, %fat 27.2 ± 3.7) using positron emission tomography and oxygen-15-labelled water. The measurements were performed basally and during adenosine infusion (140 µg/kg/min) to measure coronary vasoreactivity. Results: Adenosine infusion induced significant increase in myocardial blood flow (from 0.8 ± 0.2 to 3.5 ± 0.9 ml/g/min). After adjustment for LDL-cholesterol, HbA1c, systolic blood pressure and age, hyperaemic myocardial blood flow was inversely associated with BMI (r = –0.87, p = 0.001), waist circumference (r = –0.84, p = 0.003), WHR (r = –0.79, p = 0.007) and %fat (r = –0.65, p = 0.04). Conclusions: Both BMI and waist circumference are associated with coronary vasoreactivity in overweight and obese men.
Effects of Hemodynamics on Global and Regional Lung Perfusion
Authors: Cao Jie J. , Wang Yi , McLaughlin Jeannette , Rhee Peter , Passick Michael , Ngai Nora , Cheng Joshua , Gulotta Ronald J. , Berke Andrew D. , Petrossian George A. , Reichek Nathaniel
Published: October 2012

Background—

Cardiac hemodynamics affect pulmonary vascular pressure and flow, but little is known of the effects of hemodynamics on lung perfusion at the tissue level. We sought to investigate the relationship between hemodynamic abnormalities in patients with left heart failure and global and regional lung perfusion using lung perfusion quantification by magnetic resonance imaging.

Methods and Results—

Lung perfusion was quantified in 10 normal subjects and 28 patients undergoing clinically indicated left and right heart catheterization and same day research cardiac magnetic resonance imaging. A total of 228 lung slices were evaluated. Global lung perfusion, determined as the average of 6 coronal lung slices through the anterior, mid, and posterior left and right lungs, was significantly lower in patients with reduced cardiac index (<2.5 L/min per m
2
): 94±30 mL/100 mL per minute versus 132±40 mL/100 mL per minute in those with preserved cardiac index (≥2.5 L/min per m
2
;
P
=0.003). The gravitational anterior to posterior perfusion gradient was inversely associated with left ventricular end-diastolic pressure (
r
=−0.728;
P
<0.001), resulting in a blunted perfusion gradient in patients with elevated left ventricular end-diastolic pressure, a finding largely attributed to the perfusion reduction in posterior lung regions. In a multivariate regression analysis adjusting for all hemodynamic variables, altered lung perfusion gradient was most closely associated with increased mean pulmonary arterial pressure (
P
=0.016).

Conclusions—

Increased left ventricular filling pressure and the resultant increase in pulmonary arterial pressure are associated with disruption of the normal gravitational lung perfusion gradient. Our findings underscore the complexity of heart-lung interaction in determining pulmonary hemodynamics in left heart failure.
Regional Changes in Wind Energy Potential over Europe Using Regional Climate Model Ensemble Projections
Authors: Hueging Hanna , Haas Rabea , Born Kai , Jacob Daniela , Pinto Joaquim G.
Published: October 2012

The impact of climate change on wind power generation potentials over Europe is investigated by considering ensemble projections from two regional climate models (RCMs) driven by a global climate model (GCM). Wind energy density and its interannual variability are estimated based on hourly near-surface wind speeds. Additionally, the possible impact of climatic changes on the energy output of a sample 2.5-MW turbine is discussed. GCM-driven RCM simulations capture the behavior and variability of current wind energy indices, even though some differences exist when compared with reanalysis-driven RCM simulations. Toward the end of the twenty-first century, projections show significant changes of energy density on annual average across Europe that are substantially stronger in seasonal terms. The emergence time of these changes varies from region to region and season to season, but some long-term trends are already statistically significant in the middle of the twenty-first century. Over northern and central Europe, the wind energy potential is projected to increase, particularly in winter and autumn. In contrast, energy potential over southern Europe may experience a decrease in all seasons except for the Aegean Sea. Changes for wind energy output follow the same patterns but are of smaller magnitude. The GCM/RCM model chains project a significant intensification of both interannual and intra-annual variability of energy density over parts of western and central Europe, thus imposing new challenges to a reliable pan-European energy supply in future decades.
Weakened Interannual Variability in the Tropical Pacific Ocean since 2000
Authors: Hu Zeng-Zhen , Kumar Arun , Ren Hong-Li , Wang Hui , L’Heureux Michelle , Jin Fei-Fei
Published: October 2012

An interdecadal shift in the variability and mean state of the tropical Pacific Ocean is investigated within the context of changes in El Niño–Southern Oscillation (ENSO). Compared with 1979–99, the interannual variability in the tropical Pacific was significantly weaker in 2000–11, and this shift can be seen by coherent changes in both the tropical atmosphere and ocean. For example, the equatorial thermocline tilt became steeper during 2000–11, which was consistent with positive (negative) sea surface temperature anomalies, increased (decreased) precipitation, and enhanced (suppressed) convection in the western (central and eastern) tropical Pacific, which reflected an intensification of the Walker circulation.

The combination of a steeper thermocline slope with stronger surface trade winds is proposed to have hampered the eastward migration of the warm water along the equatorial Pacific. As a consequence, the variability of the warm water volume was reduced and thus ENSO amplitude also decreased. Sensitivity experiments with the Zebiak–Cane model confirm the link between thermocline slope, wind stress, and the amplitude of ENSO.
Comparison of TRMM 2A25 Products, Version 6 and Version 7, with NOAA/NSSL Ground Radar–Based National Mosaic QPE
Authors: Kirstetter Pierre-Emmanuel , Hong Y. , Gourley J. J. , Schwaller M. , Petersen W. , Zhang J.
Published: October 2012

Characterization of the error associated with satellite rainfall estimates is a necessary component of deterministic and probabilistic frameworks involving spaceborne passive and active microwave measurements for applications ranging from water budget studies to forecasting natural hazards related to extreme rainfall events. The authors focus here on the relative error structure of Tropical Rainfall Measurement Mission (TRMM) precipitation radar (PR) quantitative precipitation estimation (QPE) at the ground by comparison of 2A25 products with reference values derived from NOAA/NSSL’s ground radar–based National Mosaic and QPE system (NMQ/Q2). The primary contribution of this study is to compare the new 2A25, version 7 (V7), products that were recently released as a replacement of version 6 (V6). Moreover, the authors supply uncertainty estimates of the rainfall products so that they may be used in a quantitative manner for applications like hydrologic modeling. This new version is considered superior over land areas and will likely be the final version for TRMM PR rainfall estimates. Several aspects of the two versions are compared and quantified, including rainfall rate distributions, systematic biases, and random errors. All analyses indicate that V7 is in closer agreement with the reference rainfall compared to V6.
Convective Bursts, Downdraft Cooling, and Boundary Layer Recovery in a Sheared Tropical Storm
Authors: Molinari John , Frank Jaclyn , Vollaro David
Published: October 2012

Tropical Storm Edouard (2002) experienced episodic outbreaks of convection downshear within the storm core in the presence of 11–15 m s−1 of ambient vertical wind shear. These outbreaks lasted 2–6 h and were followed by long periods with no deep convection. Flights from U.S. Air Force reconnaissance aircraft within the boundary layer were used to investigate the cause of one such oscillation. Low equivalent potential temperature θe air filled the boundary layer as convection ceased, creating a 4–6-K deficit in θe within the convective region. Soundings within 110 km of the center were supportive of convective downdrafts, with midlevel relative humidity below 15% and large downdraft CAPE. Deep convection ceased within 75 km of the center for more than 8 h. Tangential velocity reached hurricane force locally during the convective outbreak, then became nearly symmetric after convection stopped, arguably as a result of axisymmetrization, and the storm weakened. Nevertheless, the corresponding lack of convective downdrafts during this period allowed surface heat and moisture fluxes to produce substantial increases in boundary layer entropy. A new burst of convection followed. Consistent with recent papers it is argued that tropical cyclone intensification and decay can be understood as a competition between surface heat and moisture fluxes (“fuel”) and low-entropy downdrafts into the boundary layer (“antifuel”).
‘I think boys would rather be alpha male’: Being male and sexual health experiences of young men from a deprived area in the UK
Authors: Watkins F , Bristow K , Robertson S , Norman R , Litva A , Stanistreet D
Published: October 2012

Objective:

To explore the experiences of young men aged 16–19, living in an area of high deprivation, when accessing local sexual health services.

Design:

A qualitative design drawing on ethnographic methods.

Setting:

A local college.

Methods:

A multi-method approach was adopted using: one-to-one semi-structured interviews with young men and stakeholders; focus groups with young men; and participant observation in the areas surrounding the college clinics.

Results:

While a number of the young men constructed their masculinity as dominant, promiscuous and deliberately unfeminine, this was not widespread and was often a conscious performance. This was possibly a response to boredom that the young men frequently mentioned but also because they felt it was expected of them. The young men in this study demonstrated the need to take responsibility for their actions, recognized the importance of making good judgements, and to have respect for their partner in relationships. They understood that taking alcohol and drugs could affect their ability to act in a sexually responsible manner. It was also clear that, while targeted sexual health messages remain a beneficial public health strategy, there remained a perception that existing sexual health services were still aimed at women and not suited to the young men.

Conclusion:

The young men in this study demonstrated adherence to aspects of hegemonic masculinity but this was extremely complex and suggests a nuanced approach is needed to understand young men’s attitudes to sexual health services. By taking this approach strategies for enabling men to access services will be more appropriate and potentially more successful.
School nurses and health education: The classroom experience
Authors: Klein Julie , Sendall Marguerite C , Fleming Marylou , Lidstone John , Domocol Michelle
Published: October 2012

Objective:

The aim of the study is to explore school nurses’ experience of health education.

Design:

A qualitative approach, phenomenology was used to answer the question.

Method:

Sixteen participants were recruited through purposeful and snowball sampling. Participants undertook an audio-recorded interview which was transcribed and analysed.

Results:

Five themes represent school nurses’ experience of health education. Within these five themes, three issues were identified by the participants as having a negative impact on their experience of health education. These were: (1) feeling unwanted by the school; (2) not supported by the school hierarchy; and (3) a lack of role definition.

Conclusion:

These three issues provide important insight into school nurses’ experience of health education and have implications for other school nurses and professionals in the school environment.
A new structure-related model to predict the permeability of non-crimp fabric preform
Authors: Dong Shuhua , He Haidong , Jia Yuxi , Wang Chengguo , Jiao Xuejian
Published: October 2012

The permeability of the fabric preform is a critical input parameter for analyzing the liquid composite molding impregnation process. However, the permeability prediction is challenging due to its complex dependence on the fabric structure. In this paper, a novel analytical model is developed to predict the permeability of non-crimp fabric preform based on the relation between the pressure drop and geometric parameters of the microchannel cross section. The model takes into account four structural parameters including the width, the height, the semi-major axis length of the ellipse section of fiber bundle and the distance between fiber bundles. The permeability of the unit cell is calculated by the presented analytical model and the finite element simulation, respectively. The results show that the channels between fiber bundles play an important role in determining the fabric permeability. The structural parameters of the unit cell have important effects on the permeability. The new structure-related permeability model can accurately predict the permeability of the non-crimp fabric preform in a certain range.
Development a simple method to create the superhydrophobic composite coatings
Authors: Jafari Reza , Farzaneh M
Published: October 2012

This article presents an easy and inexpensive method to elaborate superhydrophobic surfaces. A superhydrophobic surface was prepared by spray coating a mixture of calcium carbonate particles, stearic acid and polymer latex suspensions on an aluminum substrate. The Taguchi L18 orthogonal array was used to optimize the fabrication process parameters, namely the percentage of stearic acid, the calcium carbonate particles to copolymer weight ratio, and the spray distance from the substrate. Through the Taguchi method, it was found that the percentage of stearic acid plays the most significant role in affecting the coating’s wettability. The optimal condition proposed by this method has been verified through additional experiments which showed an increase in contact angle up to 158°.
Modification of polylactic acid fabric by two lipolytic enzyme hydrolysis
Authors: Lee So Hee , Song Wha Soon
Published: October 2012

Polylactic acid (PLA) has received considerable attention as a biomass material in the textile industry. To use PLA fiber in the textile industry, suitable post-processing is needed. To establish enzymatic finishing of PLA fibers, we evaluated the hydrolytic activities of two representative lipolytic enzymes; lipase and esterase. In addition, we established the optimal hydrolytic treatment conditions of each enzyme. Results showed that the optimal lipase and esterase treatment conditions are a pH of 8.0, a temperature of 40°C, a concentration of 10% owf, and a calcium chloride concentration of 10 mM. PLA fabrics experienced a weight loss of about 0.7% from enzyme treatment with no loss of tensile strength. Biodeterioration due to enzymatic hydrolysis were observed in scanning electron microscopy images. There was an approximately twofold improvement in moisture regain by enzymatic hydrolysis. Finally, X-ray diffractometry identified a new peak localized at 2θ = 18.5° after enzyme treatment. The degree of crystallinity was increased and the crystallite size was decreased.
A novel method to identify yak fiber in textile
Authors: Lu Weimin , Fei Jing , Yang Juan , Tang Minfeng , Dong Zhenglian , Zhou Zhiping , Ye Jiang , Wu Haizhen
Published: October 2012

Yak down and brown cashmere share a high similarity in morphological appearance, so that either bleached or dyed samples might not be differentiated visually. False declaration and adulteration with relatively cheap yak down is quite common in brown cashmere products due to the lure of high profits. We provide a novel and effective method based on deoxyribonucleic acid analysis technology to identify yak down by designing a set of TaqMan minor groove binder polymerase chain reaction primers and a probe that can react specifically to the yak 12S ribosomal ribonucleic acid gene. The method can be applied directly to identify yak fiber products and to examine the quality of cashmere products.
An angled robotic dual-nozzle electrospinning set-up for preparing PU/PA6 composite fibers
Authors: Park Chan Hee , Kim Chae-Hwa , Pant Hem Raj , Tijing Leonard D , Yu Mi Hwa , Kim Yonjig , Kim Cheol Sang
Published: October 2012

This paper presents the design and development of a robust electrospinning set-up for the processing of polymer composites at the nanoscale. A robotic-controlled movable dual-nozzle (keeping the rotating collector at a fixed position) set-up with two power supplies is presented for nanocomposite electrospinning. We studied the effect of different angles between two nozzles on the physicochemical properties of composite PU/PA6 electrospun mats obtained from this electrospining set-up. Scanning electron microscopy (SEM) images of the mats indicated that the diameter of the nanofibers and their evenness was affected by the angle between the nozzles. The effect of angle (between the nozzles) on the mechanical strength of the composite mats was also evaluated. The hybrid mat obtained from the dual- nozzle system was found to be mechanically stronger than the individual fibrous mat. Furthermore, the mechanical strength of the composite mat could be increased by decreasing the angle between the tips of the nozzles.