bluuebunny/crossref_metadata_2025 huggingface dataset:
What drives hospital performance? The impact of comparative outcome evaluation of patients admitted for hip fracture in two Italian regions
Authors: Pinnarelli Luigi , Nuti Sabina , Sorge Chiara , Davoli Marina , Fusco Danilo , Agabiti Nera , Vainieri Milena , Perucci Carlo A
Published: October 2011

Background

From 2006 to 2007 Lazio and Tuscany, two Italian regions, released data about hospital performance and implemented strategic programmes aimed at improving the quality of hospital care. Furthermore, different pay-for-performance systems were introduced: the hospital's performance determined the DRG (Diagnosis-Related Group) reimbursement rate for Lazio providers while in Tuscany the chief executive officer's compensation was linked to the hospital's performance. The authors evaluated the impact of the Lazio and Tuscany programmes on quality of healthcare for orthopaedic patients compared with other Italian regions.

Methods

The proportion of older patients admitted with hip fractures who had surgery within 48 h and the median waiting time for surgical treatment of fractures of the tibia or fibula were estimated separately for Lazio, Tuscany and other Italian regions for two periods: 2006–2007 and 2008–2009. Risk-adjusted proportions were obtained using the direct standardisation method and a multivariate logistic regression was performed taking into account age, gender and comorbidity status.

Results

The proportion of hip operations performed within 48 h was increased by 34% for Lazio (p<0.001) and 46% for Tuscany (p<0.001) and reduced by 3% in other Italian regions (p<0.001). To assess for possible adverse consequences, such as increased waiting times for other orthopaedic procedures, the authors monitored time to surgery for tibia or fibula fractures. There were no significant differences in the median time to surgery for tibia or fibula fractures between the two periods.

Conclusions

The Lazio and Tuscany programmes appeared to have a positive impact on quality of care for older patients admitted with hip fracture without having a negative impact on other orthopaedic interventions. The results highlight the need for continuous quality improvement by repeating the evaluation process and by combining the performance system with a management strategy.
Predictive factors of bacteraemia in low-risk patients with febrile neutropenia
Authors: Ahn Shin , Lee Yoon-Seon , Chun Yeon Hee , Lim Kyung Soo , Kim Won , Lee Jae-Lyun
Published: October 2011

Purpose

The authors intended to determine the predictive factors of bacteraemia in low-risk febrile neutropenia (FN) classified by the Multinational Association for Supportive Care in Cancer Risk Index score.

Methods

FN episodes managed in an emergency department from June 2009 to May 2010 were included. Clinical and laboratory features including procalcitonin (PCT) and C reactive protein (CRP) were retrospectively analysed.

Results

Of the total 285 episodes, 243 (85.3%) were classified as low risk. In this group, 19 (7.8%) had bacteraemia. There was a significant difference (p<0.05) in age, respiration rate ≥24 (36.8% vs 7.6%), Eastern Cooperative Oncology Group performance status (PS) ≥2 (42.1% vs 11.6%), platelet counts (107.0±42.4 vs 131.8±73.7 ×103/mm3), serum aspartate aminotransferase (42.3±30.7 vs 28.7±17.4 IU/litre) and blood urea nitrogen (19.6±9.8 vs 11.6± 8.6 mg/dl) between episodes with and without bacteraemia. PCT ≥0.5 ng/ml and CRP ≥10 mg/dl had higher rates of bacteraemia than PCT <0.5 ng/ml (28.2% vs 3.9%, p<0.001) and CRP <10 mg/dl (13.9% vs 5.3%, p=0.022) did. On multivariate analysis, PCT ≥0.5 ng/ml (OR 4.7, 95% CI 1.38 to 16.29), respiration rate ≥24 (OR 4.1, 95% CI 1.20 to 13.63) and Eastern Cooperative Oncology Group PS ≥2 (OR 3.2, 95% CI 1.02 to 10.10) were predictive of bacteraemia in the low-risk group.

Conclusion

PCT, tachypnoea and PS were predictive of bacteraemia in the low-risk patients with FN. If the patient has high probability of bacteraemia, the patient could benefit from parenteral antibiotic treatment while awaiting the blood culture results.
Causes of pulmonary granulomas: a retrospective study of 500 cases from seven countries
Authors: Mukhopadhyay Sanjay , Farver Carol F , Vaszar Laszlo T , Dempsey Owen J , Popper Helmut H , Mani Haresh , Capelozzi Vera L , Fukuoka Junya , Kerr Keith M , Zeren E Handan , Iyer Venkateswaran K , Tanaka Tomonori , Narde Ivy , Nomikos Angheliki , Gumurdulu Derya , Arava Sudheer , Zander Dani S , Tazelaar Henry D
Published: October 2011

Background

The frequencies of various causes of pulmonary granulomas in pathological material are unknown, as is the influence of geographical location on aetiology. The aim of this study was to identify the causes of pulmonary granulomas in pathological specimens, to define their frequencies, and to determine whether these causes vary by geographical location.

Methods

500 lung biopsies and resections containing granulomas were reviewed retrospectively by expert pulmonary pathologists from 10 institutions in seven countries. Fifty consecutive cases from each location were assigned a diagnosis based on histological features and available clinical/microbiological data.

Results

A specific cause was identified in 58% of cases (290/500), most commonly sarcoidosis (136, 27%) and mycobacterial or fungal infections (125, 25%). Mycobacteria were identified in 19% of cases outside the USA versus 8% within the USA. In contrast, fungi accounted for 19% cases in the USA versus 4% in other locations. Fungi were mostly detected by histology, whereas most mycobacteria were identified in cultures. In 42% of cases (210/500) an aetiology could not be determined.

Conclusions

Across several geographical settings, sarcoidosis and infections are the most common causes of pulmonary granulomas diagnosed in pathological specimens. Fungi are more commonly identified than mycobacteria in the USA, whereas the reverse is true in other countries. A definite aetiology cannot be demonstrated in more than a third of all cases of pulmonary granulomas, even after histological examination. These findings highlight the need to submit material for histology as well as cultures in all cases in which granulomatous disease enters the differential diagnosis.
Clinicopathological and molecular study of penile melanoma
Authors: Oxley J D , Corbishley C , Down L , Watkin N , Dickerson D , Wong N A C S
Published: October 2011

Aims

To examine the clinicopathological features of a series of penile melanomas and screen for mutations in theBRAFandKITgenes, which are seen in melanomas from other sites.

Methods and results

12 patients with penile melanoma were identified over a 10-year period in two supra-regional networks in the UK. The 2- and 5-year survival was 61% and 20%, respectively. Half the patients had lymph node involvement at presentation; this was a poor prognostic indicator.KITexons 11, 13, 17 and 18, andBRAFcodons 600 and 601 were analysed for mutations by Sanger sequencing and pyrosequencing, respectively. None of the tumours showed eitherKITmutations or theBRAFV600E mutation.

Conclusion

Penile melanomas are extremely rare and have a similar prognosis to melanomas elsewhere, but they often present late, leading to a poor outcome. The mutations seen in melanomas from other sites appear to be rarely present in these tumours.
Income inequality and health: the role of population size, inequality threshold, period effects and lag effects
Authors: Kondo Naoki , van Dam Rob M , Sembajwe Grace , Subramanian S V , Kawachi Ichiro , Yamagata Zentaro
Published: October 2011

Background

Income inequality has been associated with worse health outcomes in several but not all studies. The heterogeneity across studies may be explained by the variations in the size of area or population over which income inequality was evaluated. Moreover, the studies above a certain inequality threshold, conducted more recently, and incorporating a time lag may have stronger associations between income inequality and health. The authors investigated if the strength of the association between income inequality and health was altered by these factors.

Methods

The authors conducted a multivariate meta-regression analysis using nine multilevel cohort studies on income inequality and mortality and 14 multilevel cross-sectional studies on income inequality and self-rated health.

Results

Among cross-sectional studies, studies evaluating country-level inequality (average population>24 million) were more likely to show a stronger association between income inequality and poor health compared with those evaluating income inequality within small average populations (<820 000). There were no significant differences in the effect size of inequality–health association relating to the differences in the population size within a country across which income inequality was evaluated in both cross-sectional and cohort studies. The authors found that the threshold effects, period effects and lag effects were independent of the population size.

Conclusions

Income inequality at the country level may have stronger adverse contextual effects on health than inequality in smaller areas, perhaps by best reflecting social stratification in a society. Furthermore, we found that threshold, period and lag effects were independent of area unit for evaluating inequality, which may have important policy implications.
Improved insulin sensitivity with calorie restriction does not require reduced JNK1/2, p38, or ERK1/2 phosphorylation in skeletal muscle of 9-month-old rats
Authors: Sharma Naveen , Bhat Abhijit D. , Kassa Anketse D. , Xiao Yuanyuan , Arias Edward B. , Cartee Gregory D.
Published: October 2011

Calorie restriction [CR; ∼40% below ad libitum (AL) intake] improves the health of many species, including rats, by mechanisms that may be partly related to enhanced insulin sensitivity for glucose disposal by skeletal muscle. Excessive activation of several mitogen-activated protein kinases (MAPKs), including JNK1/2, p38, and ERK1/2 has been linked to insulin resistance. Although insulin can activate ERK1/2, this effect is not required for insulin-mediated glucose uptake. We hypothesized that skeletal muscle from male 9-mo-old Fischer 344/Brown Norway rats CR (35–40% beginning at 3 mo old) versus AL rats would have 1) attenuated activation of JNK1/2, p38, and ERK1/2 under basal conditions; and 2) no difference for insulin-induced ERK1/2 activation. In contrast to our hypothesis, there were significant CR-related increases in the phosphorylation of p38 (epitrochlearis, soleus, and gastrocnemius), JNK1 (epitrochlearis and soleus), and JNK2 (gastrocnemius). Consistent with our hypothesis, CR did not alter insulin-mediated ERK1/2 activation. The greater JNK1/2 and p38 phosphorylation with CR was not attributable to diet effects on muscle oxidative stress (assessed by protein carbonyls and 4-hydroxynonenal protein conjugates). In muscles from the same rats used for the present study, we previously reported a CR-related increase in insulin-mediated glucose uptake by the epitrochlearis and the soleus (Sharma N, Arias EB, Bhat AD, Sequea DA, Ho S, Croff KK, Sajan MP, Farese RV, Cartee GD. Am J Physiol Endocrinol Metab 300: E966–E978, 2011). The present results indicate that the improved insulin sensitivity with CR is not attributable to attenuated MAPK phosphorylation in skeletal muscle.
Third ventricular coinjection of subthreshold doses of NPY and AgRP stimulate food hoarding and intake and neural activation
Authors: Teubner Brett J. W. , Keen-Rhinehart Erin , Bartness Timothy J.
Published: October 2011

We previously demonstrated that 3rd ventricular (3V) neuropeptide Y (NPY) or agouti-related protein (AgRP) injection potently stimulates food foraging/hoarding/intake in Siberian hamsters. Because NPY and AgRP are highly colocalized in arcuate nucleus neurons in this and other species, we tested whether subthreshold doses of NPY and AgRP coinjected into the 3V stimulates food foraging, hoarding, and intake, and/or neural activation [c-Fos immunoreactivity (c-Fos-ir)] in hamsters housed in a foraging/hoarding apparatus. In the behavioral experiment, each hamster received four 3V treatments by using subthreshold doses of NPY and AgRP for all behaviors: 1) NPY, 2) AgRP, 3) NPY+AgRP, and 4) saline with a 7-day washout period between treatments. Food foraging, intake, and hoarding were measured 1, 2, 4, and 24 h and 2 and 3 days postinjection. Only when NPY and AgRP were coinjected was food intake and hoarding increased. After identical treatment in separate animals, c-Fos-ir was assessed at 90 min and 14 h postinjection, times when food intake (0–1 h) and hoarding (4–24 h) were uniquely stimulated. c-Fos-ir was increased in several hypothalamic nuclei previously shown to be involved in ingestive behaviors and the central nucleus of the amygdala (CeA), but only in NPY+AgRP-treated animals (90 min and 14 h: magno- and parvocellular regions of the hypothalamic paraventricular nucleus and perifornical area; 14 h only: CeA and sub-zona incerta). These results suggest that NPY and AgRP interact to stimulate food hoarding and intake at distinct times, perhaps released as a cocktail naturally with food deprivation to stimulate these behaviors.
Regulation of epithelial Na+channels by adrenal steroids: mineralocorticoid and glucocorticoid effects
Authors: Frindt Gustavo , Palmer Lawrence G.
Published: October 2011

Epithelial Na+channels (ENaC) can be regulated by both mineralocorticoid and glucocorticoid hormones. In the mammalian kidney, effects of mineralocorticoids have been extensively studied, but those of glucocorticoids are complicated by metabolism of the hormones and cross-occupancy of mineralocorticoid receptors. Here, we report effects of dexamethasone, a synthetic glucocorticoid, on ENaC in the rat kidney. Infusion of dexamethasone (24 μg/day) for 1 wk increased the abundance of αENaC 2.26 ± 0.04-fold. This was not accompanied by an induction of Na+currents ( INa) measured in isolated split-open collecting ducts. In addition, hormone treatment did not increase the abundance of the cleaved forms of either αENaC or γENaC or the expression of βENaC or γENaC protein at the cell surface. The absence of hypokalemia also indicated the lack of ENaC activation in vivo. Dexamethasone increased the abundance of the Na+transporters Na+/H+exchanger 3 (NHE3; 1.36 ± 0.07-fold), Na+-K+-2Cl−cotransporter 2 (NKCC2; 1.49 ± 0.07-fold), and Na-Cl cotransporter (NCC; 1.72 ± 0.08-fold). Surface expression of NHE3 and NCC also increased with dexamethasone treatment. To examine whether glucocorticoids could either augment or inhibit the effects of mineralocorticoids, we infused dexamethasone (60 μg/day) together with aldosterone (12 μg/day). Dexamethasone further increased the abundance of αENaC in the presence of aldosterone, suggesting independent effects of the two hormones on this subunit. However, INawas similar in animals treated with dexamethasone+aldosterone and with aldosterone alone. We conclude that dexamethasone can occupy glucocorticoid receptors in cortical collecting duct and induce the synthesis of αENaC. However, this induction is not sufficient to produce an increase in functional Na+channels in the apical membrane, implying that the abundance of αENaC is not rate limiting for channel formation in the kidney.
Preferential reductions in intermuscular and visceral adipose tissue with exercise-induced weight loss compared with calorie restriction
Authors: Murphy Joan C. , McDaniel Jennifer L. , Mora Katherine , Villareal Dennis T. , Fontana Luigi , Weiss Edward P.
Published: October 2011

Intermuscular adipose tissue (IMAT) and visceral adipose tissue (VAT) are associated with insulin resistance. We sought to determine whether exercise-induced weight loss (EX) results in greater reductions in IMAT and VAT compared with similar weight loss induced by calorie restriction (CR) and whether these changes are associated with improvements in glucoregulation. Sedentary men and women (50–60 yr; body mass index of 23.5–29.9 kg/m2) were randomized to 1 yr of CR ( n = 17), EX ( n = 16), or a control group (CON; n = 6). Bilateral thigh IMAT and VAT volumes were quantified using multi-slice magnetic resonance imaging. Insulin sensitivity index (ISI) was determined from oral glucose tolerance test glucose and insulin levels. Weight loss was comparable ( P = 0.25) in the CR (−10.8 ± 1.4%) and EX groups (−8.3 ± 1.5%) and greater than in the control group (−2.0 ± 2.4%; P < 0.05). IMAT and VAT reductions were larger in the CR and EX groups than in the CON group ( P ≤ 0.05). After controlling for differences in total fat mass change between the CR and EX groups, IMAT and VAT reductions were nearly twofold greater ( P ≤ 0.05) in the EX group than in the CR group (IMAT: −45 ±5 vs. −25 ± 5 ml; VAT: −490 ± 64 vs. −267 ± 61 ml). In the EX group, the reductions in IMAT were correlated with increases in ISI ( r = −0.71; P = 0.003), whereas in the CR group, VAT reductions were correlated with increases in ISI ( r = −0.64; P = 0.006). In conclusion, calorie restriction and exercise-induced weight loss both decrease IMAT and VAT volumes. However, exercise appears to result in preferential reductions in these fat depots.
Linearizability of Systems of Ordinary Differential Equations Obtained by Complex Symmetry Analysis
Authors: Safdar M. , Qadir Asghar , Ali S.
Published: October 2011

Five equivalence classes had been found for systems of two second‐order ordinary differential equations, transformable to linear equations (linearizable systems) by a change of variables. An “optimal (or simplest) canonical form” of linear systems had been established to obtain the symmetry structure, namely, with 5‐, 6‐, 7‐, 8‐, and 15‐dimensional Lie algebras. For those systems that arise from a scalar complex second‐order ordinary differential equation, treated as a pair of real ordinary differential equations, we provide a “reduced optimal canonical form.” This form yields three of the five equivalence classes of linearizable systems of two dimensions. We show that there exist 6‐, 7‐, and 15‐dimensional algebras for these systems and illustrate our results with examples.
Elizabethkingia meningosepticum(Chryseobacterium meningosepticum) Infections in Children
Authors: Ceyhan Mehmet , Celik Melda
Published: October 2011

Chryseobacterium meningosepticumis a ubiquitous Gram-negative bacillus historically associated primarily with meningitis in neonates and a wide variety of infections in immunocompromised patients. Neonatal infections often occur as outbreaks with environmental contamination being the source.C. meningosepticuminfections are not common but are clinically important because the organism is naturally resistant to multiple antibiotics. In this paper, we have reviewed the nosocomial outbreaks ofC. meningosepticumin newborns and infants reported so far in the literature and overviewed the infection control interventions, treatment modalities, and prevention measures.
Trace Element Concentration and Speciation in Selected Mining-Contaminated Soils and Water in Willow Creek Floodplain, Colorado
Authors: Burt R. , Weber T. , Park S. , Yochum S. , Ferguson R.
Published: October 2011

Long-term mining activities in the mountains around Creede, Colorado have resulted in significant contamination in soils and water in the Willow Creek floodplain. Total major and trace were determined for soils and water and sequential chemical extraction for soils. Objectives were to determine concentrations and potential reactivity of trace elements and investigate their relationship with other soil and water properties. Water trace elements showed significant variability among sites, ranging from 347 to 12108 μg/L. Relative trend showed (Zn > Sr > Ba) > (Mn > W > Cd) > (Sn > V≈Ni≈Cu > Co) > (Ag). Soil trace elements showed significant short-range spatial variability, ranging from 2819 to 19274 mg/kg. Relative trend showed (Pb≈Zn > Mn > Ba > P) > (As > Cu > Sr > V > Cd > Sb≈Ag) > (Co≈Cr > Mo≈Sn≈Ni) > (Be≈W > Se≈Hg). Predominant fractions were oxide, specifically-sorbed/carbonate bound, and residual. Water soluble and exchangeable fractions showed (Zn≈Cd) > Pb and Cd > Zn > Pb, respectively. Mobility factors for highly contaminated soils showed Cd≈Zn > Pb > Cu > As.
Characterization and Photocatalytic Activity of Enhanced Copper-Silica-Loaded Titania Prepared via Hydrothermal Method
Authors: Poliah Ramarao , Sreekantan Srimala
Published: October 2011

TiO2nanopowder, loaded with SiO2and Cu-SiO2, was prepared under both acidic and basic environments via the hydrothermal method. The morphology and structure of TiO2were studied by XRD, TEM, and FT-IR. The photocatalytic activity of samples was studied by monitoring the degradation of methyl orange, using a UV-visible spectrophotometer. The effect of Ti/Si ratio, pH, and Cu2+addition on the formation of TiO2and its photocatalytic activity was investigated in detail. The results show that a large surface area and a high surface acidity were important factors to achieve good TiO2performance. The presence of Ti-O-Si bonding enhanced surface acidity, which improved its ability to adsorb more hydroxyl radicals and increased its surface area. The addition of 0.1 mol% concentration of Cu2+and 25 mol% SiO2in TiO2induced the formation of new states close to the conduction band, which narrowed the band gap energy and enhanced the photodegradation efficiency.
Pharmacogenetics and Age-Related Macular Degeneration
Authors: Schwartz Stephen G. , Brantley Milam A.
Published: October 2011

Pharmacogenetics seeks to explain interpatient variability in response to medications by investigating genotype-phenotype correlations. There is a small but growing body of data regarding the pharmacogenetics of both nonexudative and exudative age-related macular degeneration. Most reported data concern polymorphisms in thecomplement factor Handage-related maculopathy susceptibility 2genes. At this time, the data are not consistent and no definite conclusions may be drawn. As clinical trials data continue to accumulate, these relationships may become more apparent.
Biochemical Frequency Control by Synchronisation of Coupled Repressilators: AnIn SilicoStudy of Modules for Circadian Clock Systems
Authors: Hinze Thomas , Schumann Mathias , Bodenstein Christian , Heiland Ines , Schuster Stefan
Published: October 2011

Exploration of chronobiological systems emerges as a growing research field within bioinformatics focusing on various applications in medicine, agriculture, and material sciences. From a systems biological perspective, the question arises whether biological control systems for regulation of oscillatory signals and their technical counterparts utilise similar mechanisms. If so, modelling approaches and parameterisation adopted from building blocks can help to identify general components for frequency control in circadian clocks along with gaining insight into mechanisms of clock synchronisation to external stimuli like the daily rhythm of sunlight and darkness. Phase-locked loops could be an interesting candidate in this context. Both, biology and engineering, can benefit from a unified view resulting from systems modularisation. In a first experimental study, we analyse a model of coupled repressilators. We demonstrate its ability to synchronise clock signals in a monofrequential manner. Several oscillators initially deviate in phase difference and frequency with respect to explicit reaction and diffusion rates. Accordingly, the duration of the synchronisation process depends on dedicated reaction and diffusion parameters whose settings still lack to be sufficiently captured analytically.
Troop Takeover and Reproductive Success of Wild Male Japanese Macaques on Yakushima Island (Macaca fuscata yakui)
Authors: Hayakawa Sachiko , Soltis Joseph
Published: October 2011

Troop takeover is common in one-male primate groups, but there are few reports in multimale groups. Japanese macaques (Macaca fuscata) form multimale groups and males commonly join troops at the bottom rank. On Yakushima island, however, where group size is relatively small, entrance into groups at the alpha position is also observed. This paper reports on the general features of troop takeover, on the predictors of takeover events, and on the reproductive success of takeover males. Troop takeovers occurred only in the mating season; nontroop males (NTMs) did not cooperate with each other; former alpha males were rarely expelled from the troop; new alpha males did not commit infanticide; new alpha male tenure in the group was usually less than two years. Logistic regression analysis showed that the number of NTMs associating with a troop predicted the occurrence of troop takeover. Paternity discrimination revealed that 33.3% (3/9) of takeover males succeeded in siring offspring. Contrary to this low success rate, binary logistic regression analysis revealed that the takeover males can expect higher reproductive success compared to troop males. Entering a troop and out-competing the alpha male is one of many available strategies to attain reproductive success in male Japanese macaques.
Canonical Quantization of Higher‐Order Lagrangians
Authors: Nawafleh Khaled I.
Published: October 2011

After reducing a system of higher‐order regular Lagrangian into first‐order singular Lagrangian using constrained auxiliary description, the Hamilton‐Jacobi function is constructed. Besides, the quantization of the system is investigated using the canonical path integral approximation.
Fluorescence Detection 400–480 nm Using Microfluidic System Integrated GaP Photodiodes
Authors: McIntosh Dion , Zhou Qiugui , Lara Francisco J. , Landers James , Campbell Joe C.
Published: October 2011

Ciprofloxacin is a commonly used antibiotic and the active ingredient in a veterinary antibiotic. Detecting its presence allows us to understand its absorption process in blood as well as tissue. A portable microfluidic system has been fabricated. It operates at low bias voltage and shows a linear relationship between concentration levels and system response. Detection of concentrations down to 1 ppb of ciprofloxacin in microliters of solution was achieved.
Fuzzy Stability of a Quadratic‐Additive Functional Equation
Authors: Jin Sun Sook , Lee Yang Hi
Published: October 2011

We investigate a fuzzy version of stability for the functional equation f(x + y + z + w) +2f(x) + 2f(y) + 2f(z) + 2f(w)−f(x + y) − f(x + z) − f(x + w)−f(y + z) − f(y + w) − f(z + w) = 0.
Converting Maturing Nuclear Sites to Integrated Power Production Islands
Authors: Solbrig Charles W.
Published: October 2011

Nuclear islands, which are integrated power production sites, could effectively sequester and safeguard the US stockpile of
plutonium. A nuclear island, an evolution of the integral fast reactor, utilizes all the Transuranics (Pu plus minor actinides) produced in power production, and it eliminates all spent fuel shipments to and from the site. This latter attribute requires that fuel reprocessing occur on each site and that fast reactors be built on‐site to utilize the TRU. All commercial spent fuel shipments could be eliminated by converting all LWR nuclear power sites to nuclear islands. Existing LWR sites have the added advantage of already possessing a license to produce nuclear power. Each could contribute to an increase in the nuclear power production by adding one or more fast reactors. Both the TRU and the depleted uranium obtained in reprocessing would be used on‐site for fast fuel manufacture. Only fission products would be shipped to a repository for storage. The nuclear island concept could be used to alleviate the strain of LWR plant sites currently approaching or exceeding their spent fuel pool storage capacity. Fast reactor breeding ratio could be designed to convert existing sites to all fast reactors, or keep the majority thermal.
A Human Head and Neck Squamous Cell Carcinoma Cell Line with Acquiredcis-Diamminedichloroplatinum-Resistance Shows Remarkable Upregulation of BRCA1 and Hypersensitivity to Taxane
Authors: Saiki Yuriko , Ogawa Takenori , Shiga Kiyoto , Sunamura Makoto , Kobayashi Toshimitsu , Horii Akira
Published: October 2011

Recently, an inverse relationship between resistance to platinum-based chemotherapeutic agents and taxanes has been implicated in breast and ovarian cancers, and a possible pivotal role for BRCA1 has also been suggested. Becausecis-diamminedichloroplatinum (CDDP) and taxanes are the most active antitumor agents against head and neck squamous cell carcinoma (HNSCC), we analyzed the sensitivity of nine HNSCC cell lines and their previously established derived CDDP-resistant cell lines to two representative taxanes: docetaxel and paclitaxel. None of the nine original cell lines showed any cross resistance between CDDP and taxanes, but one of the CDDP-resistant cell lines, RPMI2650CR, demonstrated hypersensitivity to both taxanes when compared to the parental cell line, RPMI2650. Furthermore, RPMI2650CR exhibited increased expression of BRCA1. These data suggest that (i) taxanes are a good candidate for a second-line therapeutic drug for HNSCC patients with acquired CDDP resistance and (ii) BRCA1 can be a candidate marker for predicting an inverse CDDP/taxane sensitivity phenotype in HNSCC.
Granulocytic Sarcoma of the Stomach Presenting as Dysphagia during Pregnancy
Authors: Sekaran Anuradha , Darisetty Santosh , Lakhtakia Sandeep , Ramchandani Mohan , Reddy Duvuru Nageshwar
Published: October 2011

Granulocytic sarcoma also known as extramedullary myeloid sarcoma or chloroma is an uncommon manifestation of leukemia and presents as a deposit of leukemic cells outside the bone marrow. We report a case of a twenty-five-year-old pregnant woman who presented with progressive dysphagia and recurrent postprandial vomiting. Upper GI endoscopy had shown large flat laterally spread nodular lesions in the cardia and proximal body of stomach. Biopsies from the gastric lesion showed granulocytic sarcoma of the stomach. Concurrent peripheral and bone marrow picture was suggestive of acute myeloid leukemia (AML–M4). There is limited reported literature on granulocytic sarcoma of the stomach. Concurrent gastric granulocytic sarcoma involving cardia and AML in pregnancy has not been reported till date.
BacillusStrains Most Closely Related toBacillus nealsoniiAre Not Effectively Circumscribed within the Taxonomic Species Definition
Authors: Peak K. Kealy , Duncan Kathleen E. , Luna Vicki A. , King Debra S. , McCarthy Peter J. , Cannons Andrew C.
Published: October 2011

Bacillusstrains with >99.7% 16S rRNA gene sequence similarity were characterized with DNA:DNA hybridization, cellular fatty acid (CFA) analysis, and testing of 100 phenotypic traits. When paired with the most closely related type strain, percent DNA:DNA similarities (%S) for sixBacillusstrains were all far below the recommended 70% threshold value for species circumscription withBacillus nealsonii. An apparent genomic group of fourBacillusstrain pairings with 94%–70%Swas contradicted by the failure of the strains to cluster in CFA- and phenotype-based dendrograms as well as by their differentiation with 9–13 species level discriminators such as nitrate reduction, temperature range, and acid production from carbohydrates. The novelBacillusstrains were monophyletic and very closely related based on 16S rRNA gene sequence. Coherent genomic groups were not however supported by similarly organized phenotypic clusters. Therefore, the strains were not effectively circumscribed within the taxonomic species definition.
Three-Phase Characterization of Uniaxially Stretched Linear Low-Density Polyethylene
Authors: Kolgjini Blerina , Schoukens Gustaaf , Kiekens Paul
Published: October 2011

This study comprises a detailed morphological study of cold-drawn polyethylene monofilaments by Raman spectroscopy, differential scanning calorimetry (DSC) and X-ray measurements. The structure of the three-phase morphology of the linear low-density polyethylene monofilaments was investigated by combining these measurements. It was found that the most important structure variation was found in the intermediate or rigid amorphous phase, whereby the amounts of crystalline and amorphous phases were nearly constant and almost independent of the cold-draw ratio. The intermediate third phase contains gauche and transmolecules, and the amount of transmolecules was increased with the cold-draw ratio and was directly related to this cold-draw ratio. It was found that the two peaks in the Raman spectra, respectively, at 1303 and 1295 cm-1, can be correlated to the amount of gauche and transmolecules in the polyethylene monofilaments. A good and new insight into the three-phase morphology was obtained by combining the DSC and X-ray measurements with the amounts of trans- and gauche molecules from the Raman spectra analysis.
Comparative Evaluation of the Safety and Efficacy of Long-Term Use of Imidafenacin and Solifenacin in Patients with Overactive Bladder: A Prospective, Open, Randomized, Parallel-Group Trial (the LIST Study)
Authors: Zaitsu Masayoshi , Mikami Koji , Ishida Noriko , Takeuchi Takumi
Published: October 2011

Objectives. Overactive bladder (OAB) is a chronic disease, but comparative trials of anticholinergics, which are commonly used for treatment of OAB, have generally been performed for up to 12 weeks only. There is no comparative study of a long-term intervention.Methods. We conducted a 52-week prospective randomized comparative study to evaluate the efficacy and tolerability of two anticholinergics.Results. Forty-one Japanese patients with untreated OAB were randomly assigned to imidafenacin and solifenacin groups. There was no difference in OABSS and KHQ scores between the two groups, but the severity and incidence of adverse events caused by the anticholinergics showed increased differences between the groups with time. The severity of dry mouth and the incidence of constipation were significantly lower in the imidafenacin group ( and , resp.).Conclusions. This study is the first long-term trial to show differences in the properties of anticholinergics that were not detected in short-term studies. Since OAB is a chronic disease, we conclude that imidafenacin is preferable to solifenacin from a perspective of safety.
Identities on the Weighted q‐Bernoulli Numbers of Higher Order
Authors: Kim T. , Dolgy D. V. , Lee B. , Rim S.-H.
Published: October 2011

We give a new construction of the weighted q‐Bernoulli
numbers and polynomials of higher order by using multivariate p‐adic
q‐integral on ℤp.
PI3K Functions in Cancer Progression, Anticancer Immunity and Immune Evasion by Tumors
Authors: Dituri Francesco , Mazzocca Antonio , Giannelli Gianluigi , Antonaci Salvatore
Published: October 2011

The immunological surveillance of tumors relies on a specific recognition of cancer cells and their associate antigens by leucocytes of innate and adaptive immune responses. However, a dysregulated cytokine release can lead to, or be associated with, a failure in cell-cell recognition, thus, allowing cancer cells to evade the killing system. The phosphatidylinositol 3-kinase (PI3K) pathway regulates multiple cellular processes which underlie immune responses against pathogens or malignant cells. Conversely, there is accumulating evidence that the PI3K pathway is involved in the development of several malignant traits of cancer cells as well as their escape from immunity. Herein, we review the counteracting roles of PI3K not only in antitumor immune response but also in the mechanisms that cancer cells use to avoid leukocyte attack. In addition, we discuss, from antitumor immunological point of view, the potential benefits and disadvantages arising from use of anticancer pharmacological agents targeting the PI3K pathway.
Male Infertility and Its Causes in Human
Authors: Miyamoto Toshinobu , Tsujimura Akira , Miyagawa Yasushi , Koh Eitetsu , Namiki Mikio , Sengoku Kazuo
Published: October 2011

Infertility is one of the most serious social problems facing advanced nations. In general, approximate half of all cases of infertility are caused by factors related to the male partner. To date, various treatments have been developed for male infertility and are steadily producing results. However, there is no effective treatment for patients with nonobstructive azoospermia, in which there is an absence of mature sperm in the testes. Although evidence suggests that many patients with male infertility have a genetic predisposition to the condition, the cause has not been elucidated in the vast majority of cases. This paper discusses the environmental factors considered likely to be involved in male infertility and the genes that have been clearly shown to be involved in male infertility in humans, including our recent findings.
Systematic Review on the Efficacy and Safety of Herbal Medicines for Vascular Dementia
Authors: Man Sui Cheung , Chan Kam Wa , Lu Jia-Hong , Durairajan Siva Sundara Kumar , Liu Liang-Feng , Li Min
Published: October 2011

We present a systematic review of existing research that aims to assess the efficacy and safety of herbal medications (HM), as either monotherapy or adjunct to orthodox medications (OM), mainly comprised of cholinesterase inhibitors, for vascular dementia (VaD). We included 47 studies conducted in mainland China, each testing different HM. Of 43 HM monotherapy studies, 37 reported HM to be significantly better than OM or placebo; six reported similar efficacy between HM and OM. All four HM adjuvant studies reported significant efficacy. No major adverse events for HM were reported. Heterogeneity in diagnostic criteria, interventions and outcome measures hindered comprehensive data analysis. Studies suggested that HM can be a safe and effective treatment for VaD, either alone or in conjunction with OM. However, methodological flaws in the design of the studies limited the extent to which the results could be interpreted. Thirty most commonly used herbal constituents, including Rhizoma Chuanxiong (Chuanxiong in Chinese), Radix Polygoni Multiflori (Heshouwu in Chinese) and Radix Astragali (Huangqi in Chinese). were ranked. Further multi-center trials with large sample sizes, high methodological quality and standardized HM ingredients are necessary for clinical recommendations to be made.
Inhalative IL-10 Attenuates Pulmonary Inflammation following Hemorrhagic Shock without Major Alterations of the Systemic Inflammatory Response
Authors: Kobbe Philipp , Lichte Philipp , Schreiber Helen , Reiss Lucy Kathleen , Uhlig Stefan , Pape Hans-Christoph , Pfeifer Roman
Published: October 2011

Several studies report immunomodulatory effects of endogenous IL-10 after trauma. The present study investigates the effect of inhalative IL-10 administration on systemic and pulmonary inflammation in hemorrhagic shock. Male C57/BL6 mice (8 animals per group) were subjected to pressure-controlled hemorrhagic shock for 1.5 hrs followed by resuscitation and inhalative administration of either 50 μL PBS (Shock group) or 50 μg/kg recombinant mouse IL-10 dissolved in 50 μL PBS (Shock + IL-10 group). Animals were sacrificed after 4.5 hrs of recovery and serum IL-6, IL-10, KC, and MCP-1 concentrations were measured with ELISA kits. Acute pulmonary inflammation was assessed by pulmonary myeloperoxidase (MPO) activity and pulmonary H&E histopathology. Inhalative IL-10 administration decreased pulmonary inflammation without altering the systemic concentrations of IL-6, IL-10, and KC. Serum MCP-1 levels were significantly reduced following inhalative IL-10 administration. These findings suggest that inhalative IL-10 administration may modulate the pulmonary microenvironment without major alterations of the systemic inflammatory response, thus minimizing the potential susceptibility to infection and sepsis.
Self‐Calibrated Energy‐Efficient and Reliable Channels for On‐Chip Interconnection Networks
Authors: Huang Po-Tsang , Hwang Wei
Published: October 2011

Energy‐efficient and reliable channels are provided for on‐chip interconnection networks (OCINs) using a self‐calibrated voltage scaling technique with self‐corrected green (SCG) coding scheme. This self‐calibrated low‐power coding and voltage scaling technique increases reliability and reduces energy consumption simultaneously. The SCG coding is a joint bus and error correction coding scheme that provides a reliable mechanism for channels. In addition, it achieves a significant reduction in energy consumption via a joint triplication bus power model for crosstalk avoidance. Based on SCG coding scheme, the proposed self‐calibrated voltage scaling technique adjusts voltage swing for energy reduction. Furthermore, this technique tolerates timing variations. Based on UMC 65 nm CMOS technology, the proposed channels reduces energy consumption by nearly 28.3% compared with that for uncoded channels at the lowest voltage. This approach makes the channels of OCINs tolerant of transient malfunctions and realizes energy efficiency.
Operative Outcomes for Cervical Myelopathy and Radiculopathy
Authors: Galbraith J. G. , Butler J. S. , Dolan A. M. , O'Byrne J. M.
Published: October 2011

Cervical spondylotic myelopathy and radiculopathy are common disorders which can lead to significant clinical morbidity. Conservative management, such as physical therapy, cervical immobilisation, or anti-inflammatory medications, is the preferred and often only required intervention. Surgical intervention is reserved for those patients who have intractable pain or progressive neurological symptoms. The goals of surgical treatment are decompression of the spinal cord and nerve roots and deformity prevention by maintaining or supplementing spinal stability and alleviating pain. Numerous surgical techniques exist to alleviate symptoms, which are achieved through anterior, posterior, or circumferential approaches. Under most circumstances, one approach will produce optimal results. It is important that the surgical plan is tailored to address each individual's unique clinical circumstance. The objective of this paper is to analyse the major surgical treatment options for cervical myelopathy and radiculopathy focusing on outcomes and complications.
Selective Antibody Response to Streptococcus gallolyticus Pilus Proteins in Colorectal Cancer Patients
Authors: Boleij Annemarie , Roelofs Rian , Danne Camille , Bellais Samuel , Dramsi Shaynoor , Kato Ikuko , Tjalsma Harold
Published: October 2011

Streptococcus gallolyticus subsp. gallolyticus (previously called Streptococcus bovis biotype I) infections have long been associated with colorectal cancer (CRC). This work aimed to investigate the CRC-associated humoral immune response to four pilus proteins of this bacterium by newly developed ELISAs. Pilus proteins are interesting diagnostic targets as they are the building blocks of pilin-like structures that mediate bacterial virulence and are readily exposed to the host immune system upon infection. The presence of serum antibodies against these pilus proteins was evaluated in Dutch and American populations. These analyses showed that an immune response to these antigens was specific for clinical S. gallolyticus subsp. gallolyticus infections, but that increased serum antibody titers to multiple pilus proteins in single individuals were rarely observed. However, a multiplex approach based on antibody titers against any of these four antigens resulted in assay sensitivities between 16% and 43% for the detection of early-stage CRC. Together these findings underscore the potential of a multi-antigen approach to complement diagnosis of S. gallolyticus subsp. gallolyticus–associated CRC. Cancer Prev Res; 5(2); 260–5. ©2011 AACR.
Interactions of Lymphocytes, Thyrocytes and Fibroblasts in Hashimoto’s Thyroiditis: An Immunohistochemical and Ultrastructural Study
Authors: Ben-Skowronek Iwona , Szewczyk Leszek , Ciechanek Roman , Korobowicz Elzbieta
Published: October 2011

Background: The mechanism of autoimmune reaction, a diffuse process consisting of a combination of epithelial cell destruction, lymphoid cellular infiltration, and fibrosis in Hashimoto’s thyroiditis, is not well known. The aim of this study was to analyse the cell subsets in thyroid tissue of patients with Hashimoto’s thyroiditis. Methods: We studied paraffin-embedded thyroid specimens obtained from children with Hashimoto’s thyroiditis and children without an autoimmune thyroid disease. Mononuclear T cells were detected by means of CD3+, CD4+, CD8+ antibodies, B cells by CD79 alpha+ antibodies, and antigen-presenting cells by CD1a+ antibodies, and they were counted in every 1,000 cells. The specimens from each patient were routinely estimated and investigated under the electron microscope. Results: In Hashimoto’s thyroiditis, we observed a statistically significant increase in T suppressor/cytotoxic cells CD8+ (20.54 ± 0.68%) in comparison to the control group (0.65 ± 0.30%), simple goitre (4.01 ± 5.54%) and nodular goitre (8.53 ± 2.37%), and a statistically significant increase in plasma CD79 alpha+ cells (31.65 ± 9.11%) in comparison to the control group (4.11 ± 1.94%), simple goitre (1.83 ± 0.64%) and nodular goitre (5.22 ± 1.63%). Simultaneously, we observed a low number of CD4+ T helper cells in the thyroid gland (0.93 ± 0.99%) in Hashimoto’s thyroiditis (0.19 ± 0.05% in the control group, 1.05 ± 2.71% in simple goitre, 2.03 ± 1.06% in nodular goitre). The ultrastructural investigations showed interactions between T cells, plasmocytes, fibrocytes and thyrocytes leading to apoptosis of thyrocytes. An immunological synapse between T cells, plasmocytes and thyrocytes in the thyroid gland was noticed. Conclusions: In Hashimoto’s thyroiditis, autoantigen presentation in combination with a low number of CD4+ T helper cells and a high number of CD8+ cells and plasmocytes caused the development of a cytotoxic reaction against thyrocytes, leading to apoptosis of the thyrocytes.
Assessment of Tumor Thickness in Melanocytic Skin Lesions: Comparison of Optical Coherence Tomography, 20-MHz Ultrasound and Histopathology
Authors: Hinz Torsten , Ehler Lin-Kristin , Voth Harald , Fortmeier Ines , Hoeller Tobias , Hornung Thorsten , Schmid-Wendtner Monika-Hildegard
Published: October 2011

Background: Accurate assessment of vertical tumor size is important for surgical treatment planning of melanocytic skin lesions. High-frequency ultrasound (HFUS) is frequently used for this purpose, but overestimation of tumor thickness is known as a problem especially in thin melanocytic lesions. Optical coherence tomography (OCT) as a new imaging technique might be a promising alternative. Objective: To evaluate the ability of OCT to accurately determine the vertical tumor thickness of melanocytic skin lesions and to compare it with HFUS and histopathology in order to improve surgical planning. Methods: In this single-center study, 26 melanocytic lesions were imaged by OCT and HFUS. Vertical lesion dimensions of both methods were compared with histopathological measurements. Results: Bland-Altman plots for OCT and histopathology as well as for HFUS and histopathology revealed better agreement for OCT and histopathology concerning tumor thickness measurements. Tumor thickness values for the melanocytic lesions measured by OCT presented a median tumor thickness of 0.31 mm (range 0.10–0.77) compared to a median tumor thickness of 0.25 mm (range 0.06–1.5) measured by histopathology. The median tumor thickness of HFUS was 0.44 mm (range 0.23–1.1). A Spearman correlation procedure including the correlation coefficient (r) showed a stronger relationship between OCT and histopathology (r = 0.734) compared to HFUS and histopathology (r = 0.390). Conclusions: On the basis of this smaller study cohort, OCT seems to be more exact than HFUS as far as thickness determination of thin melanocytic skin lesions is concerned.