bluuebunny/crossref_metadata_2025 huggingface dataset:
High‐Rate Pacing Reduces Variability of Repolarization and Prevents Repolarization‐Dependent Arrhythmias in Dogs With Chronic AV Block
Authors: OOSTERHOFF PETER , THOMSEN MORTEN B. , MAAS JOEP N. , ATTEVELD NICO J.M. , BEEKMAN JET D.M. , VAN RIJEN HAROLD V.M. , VAN DER HEYDEN MARCEL A.G. , VOS MARC A.
Published: June 2010

High‐Rate Pacing Prevents Drug‐Induced Arrhythmias. Introduction: High‐rate pacing may have an inhibitory effect on the initiation of Torsade de Pointes arrhythmias (TdP). However, permanent pacing is only indicated in high‐risk patients. We performed a proof of concept study into automatic overdrive pacing for prevention of drug‐induced TdP, using short‐term variability of repolarization (STV) as a feedback parameter of arrhythmic risk.

Methods and Results: The minimal signal sampling frequency required for measuring STV was determined through computer simulation. Arrhythmogenic response to dofetilide (25 μg/kg/5minutes) was tested at two different paced heart rates (60–65 bpm vs 100–110 bpm) in 7 dogs with chronic atrioventricular block, while recording right and left ventricular (LV) monophasic action potential (MAP) and LV electrogram (EGM). Simulations showed a sampling frequency of 500 Hz is sufficient to capture relevant STV values. High‐rate pacing prevented dofetilide‐induced TdP seen at the low rate (low: 6/7 vs high: 1/7). At the low rate, STV from LV MAP duration increased before occurrence of spontaneous, ectopic activity and TdP (1.7 ± 0.6–3.0 ± 1.8 ms, P < 0.05), but at the high‐rate STV did not change significantly (0.9 ± 0.2–1.5 ± 1.4 ms, NS). Regression analysis showed a close relation between STV calculated from LV MAP and from LV EGM (R2= 0.71).

Conclusions: High‐rate pacing increases repolarization reserve in dogs with chronic atrioventricular block, preventing dofetilide‐induced TdP. Changes in repolarization reserve are reflected in values of STV. (J Cardiovasc Electrophysiol, Vol. 21, pp. 1384‐1391, December 2010)
Teratogen screening using transcriptome profiling of differentiating human embryonic stem cells
Authors: Mayshar Yoav , Yanuka Ofra , Benvenisty Nissim
Published: June 2010

Teratogens are substances that may cause defects in normal embryonic development while not necessarily being toxic in adults. Identification of possible teratogenic compounds has been historically beset by the species‐specific nature of the teratogen response. To examine teratogenic effects on early human development we performed non‐biased expression profiling of differentiating human embryonic and induced pluripotent stem cells treated with several drugs – ethanol, lithium, retinoic acid (RA), caffeine and thalidomide, which is known to be highly species specific. Our results point to the potency of specific teratogens and their affected tissues and pathways. Specifically, we could show that ethanol caused dramatic increase in endodermal differentiation, RA caused misregulation of neural development and thalidomide affected both these processes. We thus propose this method as a valuable addition to currently available animal screening approaches.
Association of Peroxisome Proliferator‐Activated Receptor‐Gamma 2 Pro12Ala Polymorphism with Advanced‐Stage Endometriosis
Authors: Hwang Kyu Ri , Choi Young Min , Kim Jong Mee , Lee Gyoung Hoon , Kim Jin Ju , Chae Soo Jin , Moon Shin Yong
Published: June 2010

Citation Hwang KR, Choi YM, Kim JM, Lee GH, Kim JJ, Chae SJ, Moon SY. Association of peroxisome proliferator‐activated receptor‐gamma 2 Pro12Ala polymorphism with advanced‐stage endometriosis. Am J Reprod Immunol 2010

Problem

To investigate whether the peroxisome proliferator‐activated receptor (PPAR)‐γ2 Pro12Ala polymorphism is associated with a risk of advanced‐stage endometriosis in a Korean population.

Methods of study  Case–control study in a collective of 446 patients and 427 controls. The Pro12Ala polymorphism of PPAR‐γ2 gene was genotyped using polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) analysis.

Results  The distribution of the PPAR‐γ2 Pro12Ala polymorphism was different between the advanced‐stage endometriosis group and the control group (non‐CC rates were 5.2% for patients with advanced endometriosis and 10.1% for the control group, respectively, P = 0.006). The frequency for the Ala‐12 allele variant was significantly lower in patients with advanced stage of endometriosis (2.7%) than in the control group (5.3%) (P = 0.006).

Conclusion  These findings suggest that the PPAR‐γ2 Pro12Ala polymorphism is associated with advanced‐stage endometriosis in the Korean population. Unlike results from other studies reported so far, the Ala‐12 allele may have protective effects against advanced‐stage endometriosis in the Korean population.
Incidence of infectious diseases in infants fed follow‐on formula containing synbiotics: an observational study
Authors: Picaud Jean‐Charles , Chapalain Véronique , Paineau Damien , Zourabichvili Othar , Bornet Francis RJ , Duhamel Jean‐François
Published: June 2010

Aim:  Infectious diseases in infants are a major public health issue. Synbiotic‐enriched formulas (EF) are intended to mimic the beneficial effects of human milk on infectious diseases. We performed an observational study in infants switching to follow‐on formula to determine the effects of synbiotic‐enriched formula compared to standard formula (SF).

Methods:  We recorded family characteristics, medical history and growth data, as well as the symptoms, severity and treatment of infectious diseases. Main outcome measures were compared after adjustments for baseline characteristics.

Results:  Between January and June 2007, 771 healthy infants were included in the study; 35.4% experienced at least one infectious disease during the 3‐month study period. The most common were upper respiratory tract (24.1%), otitis (6.6%) and gastrointestinal infectious diseases (5.0%). Infants fed synbiotic‐enriched formula had fewer infectious diseases overall (EF: 31.0%; SF: 40.6%; p = 0.005) and significantly fewer gastrointestinal infectious diseases (EF: 3.5%; SF: 6.8%; p = 0.03). During follow‐up, weight gain was significantly higher (p = 0.0467) in infants fed synbiotic‐enriched formula (18.3 ± 8.7 g/day) versus SF (16.9 ± 7.5 g/day).

Conclusions:  Supplementation with synbiotics may have beneficial effects on the incidence of infectious disease and growth in infants. Further studies are needed determine optimal doses and composition of synbiotics in infant formula.
Coronary Phenotypes in Patients with Erectile Dysfunction and Silent Ischemic Heart Disease: A Pilot Study
Authors: Chang Shih-Tai , Chu Chi-Ming , Hsiao Ju-Feng , Chung Chang-Min , Shee Jia-Jen , Chen Chih-Shou , Hsu Jen-Te
Published: June 2010

Introduction

Accumulated evidence shows that erectile dysfunction (ED) may be a precursor of coronary artery disease (CAD).

Aims

The purpose of this study was to explore the differences in coronary phenotypes between patients with ED and patients with angina pectoris.

Methods

The study enrolled 30 ED patients (study group) and 120 age-matched angina patients who had no ED (control group). All patients had angiographically documented CAD.

Main Outcome Measures

The differences in demographic characteristics, biochemical profiles and coronary characteristics between the study and control groups were compared.

Results

Diabetes mellitus (DM) and obesity defined by body mass index were more common in the study group than in the control group. The mean number of lesions and mean number of vessels with evidence of CAD were significantly different between the study and control groups (2.3 ± 0.1 vs. 2.2 ± 0.1, P <0.001; 2.0 ± 0.2 vs. 1.8 ± 0.1, P <0.001). The distribution of vessel involvement was similar between the groups, except for more common involvement of the ramus in the study group. There were no differences in distribution of lesion sites between the two groups. The control group had a higher percentage of type A stenotic lesions than the study group (16.3% vs. 2.9%, P = 0.004). Significant differences were also observed in type C lesions (52.9% in study group vs. 38.0% in control group, P = 0.026). Fewer calcified, irregular, and bifurcated lesions were present in the study group compared to control.

Conclusions

This study documented coronary phenotypes in ED patients without symptomatic CAD. Although the artery size hypothesis and ED had well been thought to be a precursor of CAD, the severity of coronary lesions in these patients was not more benign than that observed in angina pectoris patients who have no ED.
Sexual Function after Sacrocolpopexy
Authors: Kuhn Annette , Häusermann Aline , Brandner Sonja , Herrmann Gudrun , Schmid Corina , Mueller Michael D.
Published: June 2010

Introduction

Pelvic organ prolapse affects approximately 50% of parous women over 50 years of age and has a lifetime risk of 30–50%. Vault descent or prolapse occurs in about 20% after hysterectomy and can have a negative effect on sexual function.

Sacrocolpopexy is the gold standard of surgical treatment for apical prolapse in fit, sexually active patients. Few data exist which determine sexual function after sacrocolpopexy.

Aim

The aim of this study was to determine sexual function in sexually active patients before and after sacrocolpopexy for the treatment of vault prolapse or descent.

Main Outcome Measures

Main outcome measures were the International Continence Society (ICS) Pelvic Organ Prolapse (ICS POP) Staging and the Female Sexual Function Index, which were filled in before the intervention and at follow-up.

Methods

Between December 2000 and December 2009, we asked sexually active female patients who were to undergo sacrocolpopexy for vault descent or prolapse to participate in this study. The patients were gynecologically examined before and after surgery and prolapse staging was performed using the ICS POP Staging.

Results

Sixty-two patients were included in the study and follow-up was 24 months.

The domains sexual desire, arousal, lubrication, satisfaction, and pain improved significantly postoperatively but orgasm remained unchanged.

There was no vaginal shortening postoperatively, and no serious intra- or postoperative complications occurred.

Conclusion

Sacrocolpopexy is a valuable option for sexually active patients with vault descent or prolapse with an amelioration of most aspects of sexual function but not all.

Other factors as hormonal treatment, concomitant surgery, physiological, and psychological factors have to be taken into consideration.
In Vitro Assessment of Antimicrobial Properties of Rifampin-Coated Titan® Coloplast Penile Implants and Comparison with Inhibizone®
Authors: Dhabuwala Chirpriya
Published: June 2010

Introduction

It is a common practice to soak Titan® Coloplast penile implants in antibiotic solution prior to implantation.

Aim

The aim of this study is to identify an ideal solution for soaking the Titan® Coloplast penile implants prior to implantation.

Methods

Titan® strips were soaked in a different combination of antibiotics and the zone of inhibition was studied against Staphylococcus epidermidis and Escherichia coli. This zone of inhibition was compared against zone of inhibition produced by Inhibizone®-coated silicone strips. Zones of inhibitions were also compared for different components of Inhibizone® implant such as cylinder, tubing, connector, rear tip extender, and reservoir, and compared with similar components of Titan® Coloplast penile implants.

Main Outcome Measures

The zone of inhibition against S. epidermidis and E. coli for Titan strips dipped in Rifampin and Gentamicin was compared against other antibiotics. The clinical significance of dipping Titan®-coated Coloplast implant in Rifampin and Gentamicin solution was determined.

Results

Rifampin 10 mg/mL+gentamicin 1 mg/mL (R10/G1) and rifampin 1 mg/mL+gentamicin 1 mg/mL (R1/G1) had excellent coverage against S. epidermidis and E. coli. The zone of inhibition (utilizing the Titan® coating) produced by both these solutions exceeds that produced by Inhibizone® by 40% to 56% for S. epidermidis and 33% for E. coli. Components of the American Medical System implant (tubing connectors and rear tip extenders) are not coated with antibiotics and had no zone of inhibition.

Conclusion

Soaking Titan®-coated Coloplast implants in R10/G1 solution produces a zone of inhibition greater than that produced by Inhibizone®-coated penile implants. The clinical significance of this increased zone of inhibition can only be determined by a separate clinical study. Dhabuwala C. In vitro assessment of antimicrobial properties of rifampin coated Titan®coloplast penile implants and comparison with Inhibizone®.
Modest Impact of a Brief Curricular Intervention on Poor Documentation of Sexual History in University-Based Resident Internal Medicine Clinics
Authors: Loeb Danielle F. , Aagaard Eva M. , Cali Steve R. , Lee Rita S.
Published: June 2010

Introduction

Providers need an accurate sexual history for appropriate screening and counseling. While curricula on sexual history taking have been described, the impact of such interventions on resident physician performance of the sexual history remains unknown.

Aims

Our aims were to assess the rates of documentation of sexual histories, the rates of documentation of specific components of the sexual history, and the impact of a teaching intervention on this documentation by Internal Medicine residents.

Methods

The study design was a teaching intervention with a pre- and postintervention chart review. Participants included postgraduate years two (PGY-2) and three (PGY-3) Internal Medicine residents (N=25) at two university-based outpatient continuity clinics. Residents received an educational intervention consisting of three 30-minute, case-based sessions in the fall of 2007.

Main Outcome Measures

We reviewed charts from health-care maintenance visits pre- and postintervention. We analyzed within resident pre- and postrates of sexual history taking and the number of sexual history components documented using paired t-tests.

Results

In total, we reviewed 369 pre- and 260 postintervention charts. The mean number of charts per resident was 14.8 (range 8–29) pre-intervention and 10.4 (range 3–25) postintervention. The mean documentation rate per resident for one or more components of sexual history pre- and postintervention were 22.5% (standard deviation [SD]=18.1%) and 31.7% (SD=20.4%), respectively, P <0.01. The most frequently documented components of sexual history were current sexual activity, number of current sexual partners, and gender of current sexual partner. The least documented components were history of specific sexually transmitted infections, gender of sexual partners over lifetime, and sexual behaviors.

Conclusion

An educational intervention modestly improved documentation of sexual histories by Internal Medicine residents. Future studies should examine the effects of more comprehensive educational interventions and the impact of such interventions on physician behavior or patient care outcomes.
Carbon budget alteration due to landcover–landuse change in wetlands: the case of afforestation in the Lower Delta of the Paraná River marshes (Argentina)
Authors: Vicari Ricardo , Kandus Patricia , Pratolongo Paula , Burghi Mariana
Published: June 2010

The objective of this work was to analyse the effects on carbon budget caused by the replacement of freshwater marshes by salicaceae plantations at ecosystem and regional scales, in the Lower Delta of the Paraná River in Argentina. Biomass and net aboveground primary productivity were estimated for one of the main species planted in the delta, Salix babylonica var. sacramenta, and for the dominant species of the marshes that are most widespread in the study area, Scirpus giganteus and Schoenoplectus californicus. Soil organic carbon was also estimated. Afforestation and marshes were mapped based on the digital classification of Landsat imagery. Aboveground biomass stored by afforestation is higher than by marshes (113.4 Mg/ha vs. around 10 Mg/ha). Nevertheless, soil organic matter accumulation is 10‐fold higher in the marshes. A huge amount of carbon is released into the atmosphere when marshes are converted to forest due to change from a wetland to a terrestrial condition.
A statistical and geographical information system analysis for groundwater intrinsic vulnerability: a validated case study from Sfax–Agareb, Tunisia
Authors: Hentati Imen , Zaïri Moncef , Ben Dhia Hamed
Published: June 2010

The groundwater vulnerability to the pollution assessment was considered as an efficient tool to limit and to control its quantitative and qualitative degradation risks. The DRASTIC high, moderate and low groundwater vulnerability zones of the Sfax–Agareb basin (Tunisia) cover about 10, 29 and 61% of the study area, respectively. The validation of the DRASTIC vulnerability map was undertaken through comparison of areas of high nitrate concentration and their relative vulnerability index. The DRASTIC vulnerability map illustrates a good rate of coincidence between the nitrate concentration ranges and the various vulnerability classes as recognized by statistical analysis. The reliability of the final vulnerability map has been tested, showing a general positive trend relating the mean nitrate concentration in the wells to their relative vulnerability classes (R2=0.88). When correlating the 214 available groundwater nitrate concentrations to the DRASTIC index in these wells location, a significant positive correlation with Cor=0.55 was found.
Purinergic regulation of duodenal surface pH and ATP concentration: implications for mucosal defence, lipid uptake and cystic fibrosis
Authors: Kaunitz J. D. , Akiba Y.
Published: June 2010

The duodenum secretes HCO3− as part of a multi‐layered series of defence mechanisms against damage from luminal acid. In the 1980s, an alkaline surface layer was measured over the mucosa which correlated with the rate of HCO3− secretion. As all biological processes are regulated, we investigated how the alkaline pH of the surface layer was maintained. As the ecto‐phosphorylase alkaline phosphatase (AP) is highly expressed in the duodenal brush border, we hypothesized that its extreme alkaline pH optimum (∼pH 8–9) combined with its ability to hydrolyse regulatory purines such as ATP was part of an ecto‐purinergic signalling system, consisting also of brush border P2Y receptors and cystic fibrosis transmembrane regulator‐mediated HCO3− secretion. Extracellular ATP increases the rate of HCO3− secretion through this purinergic system. At high surface pH (pHs), AP activity is increased, which then increases the rate of ATP hydrolysis, decreasing surface ATP concentration ([ATP]s), with a resultant decrease in the rate of HCO3− secretion, which subsequently decreases pHs. This feedback loop is thus hypothesized to regulate pHs over the duodenal mucosa, and in several other HCO3− secretory organs. As AP activity is directly related to pHs, and as AP hydrolyses ATP, [ATP]s and pHs are co‐regulated. As many essential tissue functions such as ciliary motility and lipid uptake are dependent on [ATP]s, dysregulation of pHs and [ATP]s may help explain the tissue dysfunction characteristic of diseases such as cystic fibrosis.
Optimal timing and dosing of platelet transfusions
Authors: Heddle N. M.
Published: June 2010

Background  Over the past 20 years there have been more than 20 randomized controlled trials (RCTs) that have investigated various aspects of platelet transfusion therapy in haematology/oncology patients. These studies have focused on the best platelet product, the importance of ABO compatibility, pathogen inactivation of platelets, platelet triggers and the optimal platelet dose.

Aims  This article summarizes current evidence to support the timing and dosing of platelet transfusions and to explore some ideas of where clinical research in this area may be heading.

Materials and Methods  The articles reviewed in this presentation were identified through a search of PubMed using the term, platelet transfusion and setting limits to identify clinical studies, human studies and manuscripts in English.

Results and Discussion  Three RCTs have informed practices around platelet transfusion trigger with the largest study by Rebulla et al., being the primary study that has changed practices worldwide, with a move towards a lower prophylactic platelet transfusion trigger of 10 × 109/l. Two groups (Germany and Oxford, UK) are currently investigating whether we can push the boundaries of prophylactic platelet transfusions even further by eliminating this form of therapy. Preliminary results from these studies have been published but we will await the final results to determine whether this research will indeed change practice. Over the past year there has also been two major studies (one by the BEST Collaborative, and the second by the US Transfusion Medicine/Hemostasis Network), that provide new information to guide platelet dosing. The Study by the BEST Collaborative (SToP) compared low dose platelets to standard dose platelets with WHO bleeding greater than or equal to Grade 2 as the primary outcome. The US study (PLADO) compared three doses (low, medium and high) and measured the same outcome (WHO bleeding ≥ Grade 2).

Conclusions  Although all of these studies further our knowledge to prescribe platelet transfusions, they also raise some interesting questions about the clinical relevance of the outcomes that we are currently using for these studies. The trend over the past decade has been to use bleeding as the primary outcome; however, bleeding is a complex composite outcome (Grades 2, 3 and 4) comprised of some surrogate components (Grades 2 and 3). It is also an outcome that may be difficult to measure and grade in a consistent and reliable manner. The clinical relevance of this outcome is also complex and may vary depending on the perspective from which it is viewed.
Management of preoperative anaemia in patients undergoing elective surgery
Authors: Goodnough L. T. , Manaitis A. , Earnshaw P. ,   the NATA Consensus Development Working Group
Published: June 2010

Previously undiagnosed anaemia is commonly identified during preadmission testing in patients undergoing elective surgery. Anaemia in these patients and related perioperative therapy have been associated with increased morbidity (including increased rates of perioperative infection) and mortality. Clinical care pathways for patients in these settings have been developed by the Society for Blood Management (SABM) and the Network for the Advancement of Transfusion Alternatives (NATA). These consensus recommendations emphasize the following: (1) preadmission testing, including complete blood counts (CBC) that should occur as close as possible to 30 days before the scheduled surgery date; (2) any anaemia identified should be evaluated and managed before surgery; (3) evaluations and laboratory testing should be performed to rule out nutritional causes (particularly iron deficiency), chronic kidney disease and/or anaemia of inflammation and (4) management of anaemia should include consideration of IV iron therapy and/or therapy with erythropoiesis‐stimulating agents (ESA).
Identification of therapeutically relevant mHags and strategies for mHag‐based immunotherapy after allogeneic HSCT: where do we stand?
Authors: Eiz‐Vesper B. , Blasczyk R.
Published: June 2010

Minor histocompatibility antigens (mHags) play a major role in graft‐versus‐host disease (GvHD) and graft‐versus‐leukaemia (GvL) effect following human leucocyte antigen (HLA)‐matched hematopoietic stem cell transplantation (HSCT). These antigens are defined as immunogenic peptides derived from polymorphic proteins and can be recognized by allogeneic cytotoxic T cells (CTLs) in the context of HLA molecules. The tissue distribution of mHags and HLA molecules influences the clinical outcome of T‐cell responses to these antigens. Differential T‐cell recognition of mHags specifically expressed in hematopoietic cells, including malignant cells from the recipient, may result in a beneficial GvL effect without detrimental GvHD. Furthermore, T‐cell responses against proteins solely expressed in hematopoietic cell lineages from which the malignancy is derived may be appropriate mediators of GvL reactivity without GvHD induction. mHags with hematopoiesis‐restricted expression may therefore serve as primary targets of the T‐cell‐mediated GvL/graft‐versus‐tumour (GvT) effect following HLA‐identical HSCT. This paper reviews the recent findings on methods for identification of mHags specifically functioning as GvL/GvT targets and outlines perspectives for the development of novel strategies for mHag‐based immunotherapy.
Risk modelling in blood safety – review of methods, strengths and limitations
Authors: Custer B.
Published: June 2010

Risk modelling studies in blood safety play an important but occasionally misunderstood role. These studies are intended to quantify and contrast risks and benefits. This information is critical for policy development and intervention decision‐making. The limitations of risk modelling should be considered alongside the results obtained.

The goal of this manuscript and presentation is to review current risk modelling techniques used in blood safety and to discuss the pros and cons of using this information in the decision‐making process. The types of questions that can be answered include the extent of a risk or threat; implications of action or inaction; identification of effective strategies for risk management; or whether to adopt specific interventions. These analyses can be focused on a risk alone but are often combined with economic information to gain an understanding of feasible risk interventions given budgetary or other monetary considerations. Thus, analyses that include risk modelling provide insights along multiple lines. As important, the analyses also provide information on what is not known or uncertain about a potential hazard and how much that uncertainty may influence the decision‐making process.

Specific examples of the range of risk analyses in which the author has participated will be reviewed and will include ongoing process improvement in testing laboratories such as error identification/eradication, estimation of the risk of malaria exposure based on the specific locations of travel, evaluation of blood supply and demand during an influenza pandemic, cost‐utility analyses of screening interventions for infectious diseases in countries with different human development indices, and insurance against emerging pathogen risk. Each of these analyses has a different purpose and seeks to answer different questions, but all rely on similar methods.

The tool kit for risk analysis is broad and varied but does have limitations. The chief limitation of risk modelling is that risk analyses are not scientific experiments or otherwise controlled studies. Consequently, the analyses are more apt to be influenced by assumptions. These assumptions may be necessary to structure a problem in a way that will allow the question of interest to be answered or may result from incomplete or missing information. Another potential limitation is that commissioners of such studies, those who undertake them, and the intended audience, such as regulatory agencies, may have distinct and differing interpretations of the results.

Risk modelling is a set of techniques that can be used to inform and support decision‐making at all levels in transfusion medicine. Advances in risk modelling techniques allow for continued expansion in the scope of possible questions that can be analysed. Expanded use also improves the acceptance of the utility of these studies in blood safety and transfusion medicine.
How do we treat? Clinical haemotherapy: platelet transfusion
Authors: Schrezenmeier H. , Höchsmann B. , Wiesneth M.
Published: June 2010

Platelet transfusions play an important role in prevention or treatment of bleeding in patients with thrombocytopenia or severely impaired platelet function. In clinical haemotherapy a number of decisions are necessary, including choice of the type of platelet concentrate, transfusion trigger for prophylactic platelet transfusions and the dose of platelet transfusion.

Usage of apheresis platelet concentrates and pooled whole blood‐derived platelet concentrates varies greatly between countries and individual institutions. A clear advantage of apheresis concentrates can only be demonstrated in allosensitized patients with HLA‐ or HPA‐antibodies who receive antigen‐compatible apheresis platelet concentrates. We follow the recommendation to base the product choice mainly on availability and medical indication.

Recent data on therapeutic instead of prophylactic transfusions require a new position‐fixing on when platelet transfusions should be given. Given the attempt to optimize patient safety and to avoid life‐threatening bleeding complications the available data still suggest using a prophylactic approach in routine settings outside of clinical trials for treatment of thrombocytopenia in the context of chemotherapy and impaired platelet production.

Various studies addressed the effect of platelet dose in prophylactic transfusions in patients with hypoproliferative thrombocytopenia. We will review these studies and discuss implications for clinical practice.

Some patients fail to achieve the appropriate platelet count increase after transfusion. This is still a challenging situation for clinicians and transfusion services. Approaches to identify the cause of platelet refractoriness as well as therapeutic algorithms will be proposed.
Occult B hepatitis – still a risk for transfusions?
Authors: Velati C.
Published: June 2010

NAT screening for HBV has been introduced when multiplex technology was available only in countries where the endemic of HBV was on medium/high level and where the screening with other serological tests, like anti‐HBc, was impossible without impair self‐sufficiency in blood procurement. The first goal of NAT testing introduction in blood screening was to increase the sensibility of screening tests in order to impair transfusion of blood units from subjects in initial acute phase of infection with no other serological markers (window period shortage). But after HBV NAT implementation the great majority of NAT HBV positive/HBsAg negative subjects are represented by repeat donors with other serological markers of previous contact with HBV (anti‐HBc and anti‐HBs), with low viral load and totally silent from the clinical point of view. In the 2001–2008 period 7,436,996 blood units were tested, in Italy, for HBV DNA and 383 resulted positive: 20 of them (1:372.000) were subjects in acute phase of the infection and seroconverted, 363 (1:20.000) were OBI. Similar pictures are observed in other Mediterranean and East Europe Countries. These data could induce all mathematical models, finalized to calculate the residual risk, to consider HBV as the main infectious risk in transfusion field. But we can observe, where HBV DNA blood screening is in progress since some years, a downward trend of OBI blood donors: in Italy 61.9×106 subjects have been observed in 2005 and 42.2×106 in 2008 (p < 0.05). On the contrary, acute cases are stable. In addition, there are some doubts about the actual capacity of OBI subjects to infect the recipient: some experiences showed that HBV DNA of OBI subjects is less efficient in transmitting the infection than DNA of acute phase subjects.Nevertheless, HBV transfusion transmitted infections from blood donors with low viral load are still reported. In conclusion blood screening with both HBsAg and HBV DNA test is, at the moment, the best way for HBV safe transfusion; in the meantime it limits donors deferral only to those who are really at risk of transmitting a HBV infection. In the future the occurrence of blood donors with OBI will decrease due to progressive deferral of these subjects and to the vaccination campaigns against HBV in progress in countries at medium/high level of HBV endemic.
The Hull floods of 2007: implications for the governance and management of urban drainage systems
Authors: Coulthard T.J. , Frostick L.E.
Published: June 2010

On 25 June, the City of Hull suffered from extensive pluvial flooding, causing damage to over 8600 homes and 1300 businesses. Over 100 mm of rain fell over a 24‐h period, rapidly overwhelming the city's drainage system. Hull is especially vulnerable to flooding as it is largely below sea level and relies on a pumped drainage system with no natural ways of drainage. The causes of the flooding can be locally attributed to blocked roadside gulleys but in the main were due to issues with the conveyance of drained water in sewers and the performance of the three pumping stations. In particular, an extensive redesign of the system in 2001 increased flood storage and reduced the pumping capacity. In 2004, remodelling of the 2001 system indicated that it may be underpredicting flood volumes by 100% and decommissioned pumping stations were re‐activated to rectify matters. Subsequent modelling showed that the performance of the drainage system in 2007 was slightly worse than its 2001 configuration. The floods also revealed a series of key weaknesses in how urban drainage systems are managed. There is no system of warning from surface water flooding in the United Kingdom, despite there being an extensive warning system for coastal and fluvial flooding. Urban drainage is largely designed to accommodate 1 in 30‐year events, but this level is not appropriate in all areas, especially low‐lying regions with little or no natural drainage such as Hull. Finally, the structure of the UK water industry postprivatisation, with Local Authority, the Environment Agency and the Water Utility all having control over separate parts of the system, left no single agency with lead control or responsibility for urban surface water flooding.
Development of a Novel Process Chain Based on Atomic Force Microscopy Scratching for Small and Medium Series Production of Polymer Nanostructured Components
Authors: Brousseau E. B. , Krohs F. , Caillaud E. , Dimov S. , Gibaru O. , Fatikow S.
Published: June 2010

The continuing trend for producing novel micro- and nanostructured devices and components in a broad range of materials is a major motivating factor driving the research in the micro- and nanomanufacturing sector toward developing innovative process chains. Some of such chains enable the serial production of micro- and nanostructured parts in polymer material by combining innovatively and optimizing simultaneously master making and replication technologies. For producing features at the nanoscale, the master making processes that are currently commonly employed rely on complex lithography-based pattern transfers and/or on beam-based direct write processes. Unfortunately, the required equipment to perform these techniques are often capital intensive and necessitate particular operating temperatures or vacuum conditions. At the same time, during the development phase of new or improved nanotechnology-enabled products, it is beneficial to produce rapidly polymer prototypes to test the functionality of components with nanoscale features. Thus, the technologies currently available for nanostructuring replication masters do not comply with the low cost requirements typically associated with the production of small batches of components for prototyping purposes. As a result, this could restrict the successful development of products with functional features at the nanoscale. In this research, a new process chain is presented for the fabrication of nanostructured components in polymer that relies on a simple and cost-effective master making technology. In particular, atomic force microscopy scratching is employed as an alternative technique for nanostructuring replication masters for microinjection molding. The conducted experimental study demonstrated the potential of this approach for small and medium series production of nanostructured devices in thermoplastic materials. In addition, the effects of different scratching parameters on the achievable surface roughness and depth of the patterned structures were analyzed by employing the design of experiments approach.
Micromachined Ultrasonic Print-Head for Deposition of High-Viscosity Materials
Authors: Meacham J. Mark , O’Rourke Amanda , Yang Yong , Fedorov Andrei G. , Degertekin F. Levent , Rosen David W.
Published: June 2010

The recent application of inkjet printing to fabrication of three-dimensional, multilayer and multimaterial parts has tested the limits of conventional printing-based additive manufacturing techniques. The novel method presented here, termed as additive manufacturing via microarray deposition (AMMD), expands the allowable range of physical properties of printed fluids to include important, high-viscosity production materials (e.g., polyurethane resins). AMMD relies on a piezoelectrically driven ultrasonic print-head that generates continuous streams of droplets from 45 μm orifices while operating in the 0.5–3.0 MHz frequency range. The device is composed of a bulk ceramic piezoelectric transducer for ultrasound generation, a reservoir for the material to be printed, and a silicon micromachined array of liquid horn structures, which make up the ejection nozzles. Unique to this new printing technique are the high frequency of operation, use of fluid cavity resonances to assist ejection, and acoustic wave focusing to generate the pressure gradient required to form and eject droplets. We present the initial characterization of a micromachined print-head for deposition of fluids that cannot be used with conventional printing-based rapid prototyping techniques. Glycerol-water mixtures with a range of properties (surface tensions of ∼58–73 mN/m and viscosities of 0.7–380 mN s/m2) were used as representative printing fluids for most investigations. Sustained ejection was observed in all cases. In addition, successful ejection of a urethane-based photopolymer resin (surface tension of ∼25–30 mN/m and viscosity of 900–3000 mN s/m2) was achieved in short duration bursts. Peaks in the ejection quality were found to correspond to predicted device resonances. Based on these results, we have demonstrated the printing of fluids that fall well outside of the accepted range for the previously introduced printing indicator. The micromachined ultrasonic print-head achieves sustained printing of fluids up to 380 mN s/m2, far above the typical printable range.
A Quasi-Static Mechanics Analysis of Three-Dimensional Nanoscale Surface Polishing
Authors: Xu H. , Komvopoulos K.
Published: June 2010

A quasi-static mechanics analysis of nanoscale surface polishing that provides insight into the surface topography evolution and the removal of material at the asperity level is presented. The analysis is based on a three-dimensional stochastic model that accounts for multiscale (fractal) surface roughness and elastic, elastic-plastic, and fully plastic asperity deformation by hard abrasive nanoparticles embedded in the soft surface layer of a rigid polishing plate. Numerical results of the steady-state roughness of the polished surface, material removal rate, and wear coefficient are presented in terms of the apparent contact pressure, polishing speed, original topography and mechanical properties of the polished surface, average size and density of nanoparticles, and surface roughness of the polishing plate. Simulation trends are associated with elastic-plastic and fully plastic asperity contacts, responsible for irreversible topography changes (roughening effect) and material removal (smoothening effect), respectively. Analytical trends and predictions of the steady-state roughness of the polished surface and material removal rate are shown to be in good agreement with experimental results of nanoscale surface polishing (lapping) of magnetic recording ceramic heads.
Assessment of Microbial Biofilm Growth on Nanocrystalline Diamond in
a Continuous Perfusion Environment
Authors: Lewis J. S. , Gittard S. D. , Narayan R. J. , Berry C. J. , Brigmon R. L. , Ramamurti R. , Singh R. N.
Published: June 2010

A major concern with medical and dental biomaterials is colonization of these materials with microbial biofilms. One material processed using chemical vapor deposition and other conventional top-down nanomanufacturing technologies that has recently been considered for use in preventing growth of microorganisms is the nanocrystalline diamond. Nanocrystalline diamond coatings have been evaluated for use as coatings on medical implants (e.g., hip prostheses) and surgical tools due to their low coefficient of friction, high corrosion resistance, high hardness, and high wear resistance. In this study, the microstructural properties and microorganism interaction behavior of nanocrystalline diamond coatings were examined. A device for examining microbial biofilms known as a CDC biofilm reactor was used to examine the interaction between a fluorescent microorganism, Pseudomonas fluorescens, and nanocrystalline diamond coatings in a continuous perfusion environment. Biofilm formation was evident on the nanocrystalline diamond surface after 24 h. No correlation between grain size or morphology and cell density was observed; large variations in P. fluorescens growth on the coatings were observed, even for the samples with similar grain sizes and morphologies. The results of this study suggest that nanocrystalline diamond coatings do not prevent Pseudomonas fluorescens biofilm development in a continuous perfusion environment. Additional treatment of the nanocrystalline diamond coatings with antimicrobial and/or antifouling agents would be necessary to prevent formation of microbial biofilms. The development of novel continuous flow technologies for evaluating the growth of microbial biofilms on biomaterials will provide a better understanding of biomaterial-microorganism interaction and will enable the creation of enhanced antimicrobial biomaterials.
Probe-Tip Induced Damage in Compliant Substrates
Authors: Chandross Michael , Lorenz Christian D. , Stevens Mark J. , Grest Gary S.
Published: June 2010

Nanofabrication using arrays of modified atomic force microscopy (AFM) tips can drastically reduce feature sizes and increase data storage densities. Additionally, AFM experiments are valuable tools for characterizing the tribological properties of surfaces. In order to maximize the potential of nanofabrication techniques, it is necessary to understand fully the interactions between AFM tips and substrates, particularly when the latter is compliant and more damage-prone. To address this issue, we have carried out extensive molecular dynamics simulations of the nanotribological properties of self-assembled alkylsilane monolayers (SAMs) on amorphous silica with a realistic model of an AFM tip. Our simulations demonstrate that for fully physisorbed SAMs, even low load contacts can damage the SAM and cause material transfer to the probe tip. This effect, which is commonly ignored, can have a strong effect on the interpretation of experimental measurements. Partial chemisorption of the SAM lowers, but does not remove the possibility of damage.
Unusual Applications of Machining: Controlled Nanostructuring of
Materials and Surfaces
Authors: Saldana C. , Swaminathan S. , Brown T. L. , Moscoso W. , Mann J. B. , Compton W. D. , Chandrasekar S.
Published: June 2010

A class of deformation processing applications based on the severe plastic deformation (SPD) inherent to chip formation in machining is described. The SPD can be controlled, in situ, to access a range of strains, strain rates, and temperatures. These parameters are tuned to engineer nanoscale microstructures (e.g., nanocrystalline, nanotwinned, and bimodal) by in situ control of the deformation rate. By constraining the chip formation, bulk forms (e.g., foil, sheet, and rod) with nanocrystalline and ultrafine grained microstructures are produced. Scaling down of the chip formation in the presence of a superimposed modulation enables production of nanostructured particulate with controlled particle shapes, including fiber, equiaxed, and platelet types. The SPD conditions also determine the deformation history of the machined surface, enabling microstructural engineering of surfaces. Application of the machining-based SPD to obtain deformation-microstructure maps is illustrated for a model material system—99.999% pure copper. Seemingly diverse, these unusual applications of machining are united by their common origins in the SPD phenomena prevailing in the deformation zone. Implications for large-scale manufacturing of nanostructured materials and optimization of SPD microstructures are briefly discussed.
Tip Based Nanomanipulation Through Successive Directional Push
Authors: Zhao Wei , Xu Kangmin , Qian Xiaoping , Wang Rong
Published: June 2010

Nanomanipulation refers to the process of transporting nanoscale components. It has found applications in nanodevice prototyping and biomolecular and cellular investigation. In this paper, we present an atomic force microscope (AFM) based approach for automated manipulation of nanoparticles to form designed patterns. The automated manipulation is based on a novel method, successive directional push. This method keeps pushing along a fixed forward direction until the particle reaches the baseline of the target position, and it then repeats the pushing process along the baseline direction. This process is iterated until the particle reaches its target position. By examining the topography of several local parallel scan lines, this method can determine the lateral coordinate of the particle. The novelty of this method lies in the fact that further pushing along the same pushing direction can be conducted without precise information about the forward position. The successive directional push method has been successfully implemented into an AFM system. We demonstrate that complex designed patterns including over 100 latex particles of 50 nm diameter can be fabricated with this method.
Integrated Sustainability Analysis of Atomic Layer Deposition for Microelectronics Manufacturing
Authors: Yuan Chris Y. , Dornfeld David A.
Published: June 2010

Atomic layer deposition (ALD) is a promising nanotechnology for wide applications in microelectronics manufacturing due to its ability to control layer growth at atomic scale. Sustainability of ALD technology needs to be quantitatively investigated in this early development stage to improve its economic and environmental performance. In this paper, we present an integrated sustainability analysis of ALD technology through material and energy flow analyses. The study is performed on the ALD of Al2O3 high-κ dielectric film through trimethylaluminum and water binary reactions. The precursor utilizations, methane emissions, and nanowaste generations from the ALD process are all quantitatively studied. Energy flow analysis demonstrates that the ALD process energy consumption is mainly determined by the ALD cycle time rather than the process temperature. Scale-up performance of the ALD technology is also studied for both emission generations and energy consumptions. Strategies and methods for improving the sustainability performance of the ALD technology are suggested based on the analysis.