bluuebunny/crossref_metadata_2025 huggingface dataset:
Mechanical and Electrical Properties of Styrene‐Isoprene‐Styrene Copolymer Doped with Expanded Graphite Nanoplatelets
Authors: Špitalský Zdenko , Kratochvíla Ján , Csomorová Katarína , Krupa Igor , Graça Manuel P. F. , Costa Luis C.
Published: August 2015

The molecular dynamics of a triblock copolymer and of expanded graphite nanoplatelets were investigated. Composites were prepared using the solution technique. The effects of filler addition and of filler‐matrix interactions were investigated using dielectric relaxation spectroscopy (DRS) and dynamic mechanical analysis (DMA). Only one relaxation was observed by DRS, which was associated with the relaxation of the main polymer chain. Both DRS and DMA demonstrated that the addition of the filler does not cause a significant change in either the temperature of the relaxation or its activation energy, which suggests the presence of weak interactions between the filler and matrix. The storage modulus of the composites increased with increasing filler content. The composite containing 8% filler exhibited a storage modulus increase of approximately 394% in the rubber area. Using the DC electrical conductivity measurements, the electrical percolation threshold was determined to be approximately 5%. The dielectric permittivity and conductivity in the microwave region were determined, confirming that percolating behavior and the critical threshold concentration.
From Inpatient Notes to Outpatient Followup: Enhancing the Rhinology Service in a Tertiary Centre through Student Led Projects
Authors: Sayma M. , Hyne R. , Sharma M. , Kyle L. , Abo Khatwa M. , MacKay-Davies I. , Poulios A. , Khalil H. S.
Published: August 2015

Introduction. Medical students can use systems to help improve the quality of care in a unit. Following the review of care within the ENT department at a tertiary centre a number of quality improvement projects were put in place.Methods. The following interventions were established: (1) creation of an outpatient telephone enquiry clinic, (2) development of a rhinology database, (3) introduction of operative note templates, and (4) construction of electronic discharge summary templates (eDSTs).Discussion and Outcomes. (1) Consultant telephone inquiry clinics were successfully organised and showed high levels of patient satisfaction. (2) A database to collect patient reported outcome measures was piloted within rhinology outpatients; the results suggest that such a database would be simple to introduce and yield benefits for patients and the department. (3) Operative note templates for FESS procedures were implemented with a view to improving the continuity of care onto the ward; these have become well established and further steps to integrate these into routine care are being taken. (4) eDSTs specific to FESS and septorhinoplasty procedures were introduced with a view to increasing completion speed of templates and adherence to Royal College of Physician Guidance.
Synthesis and Crystal Structure ofN-Dichloroacetyl-3,4-dihydro-3-methyl-6-chloro-2H-1,4-benzoxazine
Authors: Gao Shuang , Qu Hai-Tao , Ye Fei , Fu Ying
Published: August 2015

A new compound,N-dichloroacetyl-3,4-dihydro-3-methyl-6-chloro-2H-1,4-benzoxazine, was synthesized and characterized. The crystal structure of the title compound (C11H10Cl3NO2,Mr=294.55) has been determined by single-crystal X-ray diffraction. The crystal belongs to monoclinic, space groupP21/c, witha=6.7619(14),b=24.866(5),c=9.737(3) Å,α=90.00,β=130.982(18),γ=90.00°,V=1235.9(5) Å3,Z=4,Dx=1.583 Mg/cm3,λ(Mo  Ka)=0.71073 Å,F(000)=600,μ=0.729 mm−1,R=0.0476, andwR=0.1274for 2217 reflections withI>2σ(I).
A Randomized Controlled Trial for the Effectiveness of Progressive Muscle Relaxation and Guided Imagery as Anxiety Reducing Interventions in Breast and Prostate Cancer Patients Undergoing Chemotherapy
Authors: Charalambous Andreas , Giannakopoulou Margarita , Bozas Evangelos , Paikousis Lefkios
Published: August 2015

Objective. To test the effectiveness of guided imagery (GI) and progressive muscle relaxation (PMR) as stress reducing interventions in patients with prostate and breast cancer who undergo chemotherapy.Methods. Patients were randomly assigned to either the control group or the intervention group (PMR and GI). Patients were observed for a total duration of 3 weeks and assessed with the SAS and BECK-II questionnaires for anxiety and depression, respectively, in addiotion to two biological markers (saliva cortisol and saliva amylase) (trial registration number:NCT01275872).Results. 256 patients were registered and 236 were randomly assigned. In total 104 were randomised to the control group and 104 to the intervention group. Intervention’s mean anxiety score and depression score changes were significantly different compared to the control’s (b=-29.4,p<0.001;b=-29.4,p<0.001, resp.). Intervention group’s cortisol levels before the intervention (0.30±0.25) gradually decreased up to week 3 (0.16±0.18), whilst the control group’s cortisol levels before the intervention (0.21±0.22) gradually increased up to week 3 (0.44±0.35). The same interaction appears for the Amylase levels (p<0.001).Conclusions. The findings showed that patients with prostate and breast cancer undergoing chemotherapy treatment can benefit from PMR and GI sessions to reduce their anxiety and depression.
Roles of Commensal Microbiota in Pancreas Homeostasis and Pancreatic Pathologies
Authors: Leal-Lopes Camila , Velloso Fernando J. , Campopiano Julia C. , Sogayar Mari C. , Correa Ricardo G.
Published: August 2015

The pancreas plays a central role in metabolism, allowing ingested food to be converted and used as fuel by the cells throughout the body. On the other hand, the pancreas may be affected by devastating diseases, such as pancreatitis, pancreatic adenocarcinoma (PAC), and diabetes mellitus (DM), which generally results in a wide metabolic imbalance. The causes for the development and progression of these diseases are still controversial; therefore it is essential to better understand the underlying mechanisms which compromise the pancreatic homeostasis. The interest in the study of the commensal microbiome increased extensively in recent years, when many discoveries have illustrated its central role in both human physiology and maintenance of homeostasis. Further understanding of the involvement of the microbiome during the development of pathological conditions is critical for the improvement of new diagnostic and therapeutic approaches. In the present review, we discuss recent findings on the behavior and functions played by the microbiota in major pancreatic diseases and provide further insights into its potential roles in the maintenance of pancreatic steady-state activities.
Investigation of Optimum Polymerization Conditions for Synthesis of Cross-Linked Polyacrylamide-Amphoteric Surfmer Nanocomposites for Polymer Flooding in Sandstone Reservoirs
Authors: El-hoshoudy A. N. , Desouky S. E. M. , Elkady M. Y. , Alsabagh A. M. , Betiha M. A. , Mahmoud S.
Published: August 2015

Currently enhanced oil recovery (EOR) technology is getting more attention by many countries since energy crises are getting worse and frightening. Polymer flooding by hydrophobically associated polyacrylamides (HAPAM) and its modified silica nanocomposite are a widely implemented technique through enhanced oil recovery (EOR) technology. This polymers class can be synthesized by copolymerization of acrylamide (AM), reactive surfmer, functionalized silica nanoparticles, and a hydrophobic cross-linker moiety in the presence of water soluble initiator via heterogeneous emulsion polymerization technique, to form latexes that can be applied during polymer flooding. Chemical structure of the prepared copolymers was proven through different techniques such as Fourier transform infrared spectroscopy (FTIR), and nuclear magnetic spectroscopy (1H&13C-NMR), and molecular weight was measured by gel permeation chromatography. Study of the effects of monomer, surfmer, cross-linker, silica, and initiator concentrations as well as reaction temperature was investigated to determine optimum polymerization conditions through single factor and orthogonal experiments. Evaluation of the prepared copolymers for enhancing recovered oil amount was evaluated by carrying out flooding experiments on one-dimensional sandstone model to determine recovery factor.
The State of Nutrition Education at US Medical Schools
Authors: Adams Kelly M. , Butsch W. Scott , Kohlmeier Martin
Published: August 2015

Purpose. To assess the state of nutrition education at US medical schools and compare it with recommended instructional targets. Method. We surveyed all 133 US medical schools with a four-year curriculum about the extent and type of required nutrition education during the 2012/13 academic year. Results. Responses came from 121 institutions (91% response rate). Most US medical schools (86/121, 71%) fail to provide the recommended minimum 25 hours of nutrition education; 43 (36%) provide less than half that much. Nutrition instruction is still largely confined to preclinical courses, with an average of 14.3 hours occurring in this context. Less than half of all schools report teaching any nutrition in clinical practice; practice accounts for an average of only 4.7 hours overall. Seven of the 8 schools reporting at least 40 hours of nutrition instruction provided integrated courses together with clinical practice sessions. Conclusions. Many US medical schools still fail to prepare future physicians for everyday nutrition challenges in clinical practice. It cannot be a realistic expectation for physicians to effectively address obesity, diabetes, metabolic syndrome, hospital malnutrition, and many other conditions as long as they are not taught during medical school and residency training how to recognize and treat the nutritional root causes.
Frozen Mummies from Andean Mountaintop Shrines: Bioarchaeology and Ethnohistory of Inca Human Sacrifice
Authors: Ceruti Maria Constanza
Published: August 2015

This study will focus on frozen mummies of sacrificial victims from mounts Llullaillaco (6739 m), Quehuar (6130 m), El Toro (6160 m), and the Aconcagua massif. These finds provide bioarchaeological data from mountaintop sites that has been recovered in scientifically controlled excavations in the northwest of Argentina, which was once part of the southern province of the Inca Empire. Numerous interdisciplinary studies have been conducted on the Llullaillaco mummies, including radiological evaluations by conventional X-rays and CT scans, which provided information about condition and pathology of the bones and internal organ, as well as dental studies oriented to the estimation of the ages of the three children at the time of death. Ancient DNA studies and hair analysis were also performed in cooperation with the George Mason University, the University of Bradford, and the Laboratory of Biological Anthropology at the University of Copenhagen. Ethnohistorical sources reveal interesting aspects related to the commemorative, expiatory, propitiatory, and dedicatory aspects of human sacrifice performed under Inca rule. The selection of the victims along with the procedures followed during the performance of thecapacochaceremony will be discussed, based on the bioarchaeological evidences from frozen mummies and the accounts recorded by the Spanish chroniclers.
Working with Individuals Who Provide Nursing Care to Educate Older Adults about Foodborne Illness Prevention: The Food Safety Because You Care! Intervention
Authors: Wohlgenant Kelly C. , Godwin Sandria L. , Cates Sheryl C. , Stone Richard
Published: August 2015

Older adults are more susceptible to foodborne infections than younger adults and many older adults do not follow recommended food safety practices. This study implemented the Food Safety Because You Care! program with 88 individuals in the United States who provide nursing care to older adult patients and subsequently surveyed them. The majority of respondents had favorable opinions of the program. Following program exposure, many of the respondents advised their older adult patients about food safety. The findings from this study suggest that the program is a useful tool that can assist those who provide nursing care as they interact with their older patients and lead them to positively influence older adults’ food safety practices. However, more research is needed to examine changes in providers’ behaviors as a result of program exposure and the accompanying effect on older adults’ food safety practices.
A Fetus with Iniencephaly Delivered at the Third Trimester
Authors: Tanriverdi Esra Cinar , Delibas Ilhan Bahri , Kamalak Zeynep , Kadioglu Berrin Goktug , Bender Rukiye Ada
Published: August 2015

Iniencephaly is an uncommon neural tube defect, having retroflexion of the head without a neck and severe distortion of the spine. Iniencephaly is classified into two groups, iniencephaly apertus (with encephalocele) and iniencephaly clausus (without encephalocele). Incidence ranges from 0.1 to 10 in 10.000 pregnancies and it is seen more frequently in girls. Most of the fetuses with this defect die before birth or soon after birth, while those with the milder forms may live through childhood. Recurrence risk is around 1–5%. Family should be offered termination to reduce maternal risks and counseled for folic acid supplementation before the next planned pregnancy. Here we present a rare case of iniencephaly clausus which was diagnosed at 18th week of gestation by ultrasonography and delivered in the third trimester of pregnancy due to rejection of termination.
Nonlinear Stability of Periodic Traveling Wave Solutions for(n +1)-Dimensional Coupled Nonlinear Klein-Gordon Equations
Authors: Sun Cong , Jiang Bo
Published: August 2015

We study the existence and orbital stability of smooth periodic traveling waves solutions of the(n +1)-dimensional coupled nonlinear Klein-Gordon equations. Such a system occurs in quantum mechanics, fluid mechanics, and optical fiber communication. Inspired by Angulo Pava’s results (2007), and by applying the stability theory established by Grillakis et al. (1987), we prove the existence of periodic traveling waves solutions and obtain the orbital stability of the solutions to this system.
Modeling Metabolism and Disease in Bioarcheology
Authors: Qualls Clifford , Appenzeller Otto
Published: August 2015

We examine two important measures that can be made in bioarcheology on the remains of human and vertebrate animals. These remains consist of bone, teeth, or hair; each shows growth increments and each can be assayed for isotope ratios and other chemicals in equal intervals along the direction of growth. In each case, the central data is a time series of measurements. The first important measures are spectral estimates in spectral analyses and linear system analyses; we emphasize calculation of periodicities and growth rates as well as the comparison of power in bands. A low frequency band relates to the autonomic nervous system (ANS) control of metabolism and thus provides information about the life history of the individual of archeological interest. Turning to nonlinear system analysis, we discuss the calculation of SM Pinus’ approximate entropy (ApEn) for short or moderate length time series. Like the concept that regular heart R-R interval data may indicate lack of health, low values of ApEn may indicate disrupted metabolism in individuals of archeological interest and even that a tipping point in deteriorating metabolism may have been reached just before death. This adds to the list of causes of death that can be determined from minimal data.
Deciphering Asthma Biomarkers with Protein Profiling Technology
Authors: Kuang Zhizhou , Wilson Jarad J. , Luo Shuhong , Zhu Si-Wei , Huang Ruo-Pan
Published: August 2015

Asthma is a chronic inflammatory disease of the airways, resulting in bronchial hyperresponsiveness with every allergen exposure. It is now clear that asthma is not a single disease, but rather a multifaceted syndrome that results from a variety of biologic mechanisms. Asthma is further problematic given that the disease consists of many variants, each with its own etiologic and pathophysiologic factors, including different cellular responses and inflammatory phenotypes. These facets make the rapid and accurate diagnosis (not to mention treatments) of asthma extremely difficult. Protein biomarkers can serve as powerful detection tools in both clinical and basic research applications. Recent endeavors from biomedical researchers have developed technical platforms, such as cytokine antibody arrays, that have been employed and used to further the global analysis of asthma biomarker studies. In this review, we discuss potential asthma biomarkers involved in the pathophysiologic process and eventual pathogenesis of asthma, how these biomarkers are being utilized, and how further testing methods might help improve the diagnosis and treatment strain that current asthma patients suffer.
A Systematic Approach to the Application of Soft Tissue Histopathology in Paleopathology
Authors: Grove Christina , Peschel Oliver , Nerlich Andreas G.
Published: August 2015

The application of histology to soft tissue remains offers an important technique to obtain diagnostically important information on various physiological and pathological conditions in paleopathology. In a series of 29 cases with mummified tissue ranging between 16 months and c. 5.200 years of postmortem time interval, we systematically investigated paleohistology and the preservation of various tissues. We established a reproducible histological ranking system for the evaluation of mummified tissue preservation. The application of this scheme to the series showed good tissue preservation of tissues with high connective tissue content but also fat tissue and connective tissue rich organs, such as lung tissue, while most other internal organs were less well preserved despite highly different postmortem time intervals. There are some organs with only poor conservation even in short term periods such as the kidneys and CNS. Artificial mummification does not provide better conservation than naturally mummified tissues; “cold” mummies may be much better conserved than those from desert areas. The identification of specific pathologies underlines the potential power of paleohistology.
Upper Ocean Thermal Responses to Sea Spray Mediated Turbulent Fluxes during Typhoon Passage
Authors: Zhang Lianxin , Guan Changlong , Sun Chunjian , Gao Siyu , Yu Shaomei
Published: August 2015

A one-dimensional turbulent model is used to investigate the effect of sea spray mediated turbulent fluxes on upper ocean temperature during the passage of typhoon Yagi over the Kuroshio Extension area in 2006. Both a macroscopical sea spray momentum flux algorithm and a microphysical heat and moisture flux algorithm are included in this turbulent model. Numerical results show that the model can well reproduce the upper ocean temperature, which is consistent with the data from the Kuroshio Extension Observatory. Besides, the sea surface temperature is decreased by about 0.5°C during the typhoon passage, which also agrees with the sea surface temperature dataset derived from Advanced Microwave Scanning Radiometer for the Earth Observing and Reynolds. Diagnostic analysis indicates that sea spray acts as an additional source of the air-sea turbulent fluxes and plays a key role in increasing the turbulent kinetic energy in the upper ocean, which enhances the temperature diffusion there. Therefore, sea spray is also an important factor in determining the upper mixed layer depth during the typhoon passage.
Identification and Characterization of Bioactive Compounds Targeting UropathogenicEscherichia colifrom Sanjin Tablets
Authors: Meng Jie , Zou Zhun , Lu Chen , Li Tingting , Wang Cui , Wang Zheng , Zhai Donggai , Liu Wei , Zou Jieming , Li Rongxiu
Published: August 2015

Sanjin Tablets are completely natural preparation with significant efficacy in treating urinary tract infection. To identify the bioactive compounds from Sanjin Tablets, we separated components capable of binding to the soluble proteins of uropathogenicEscherichia coli(UPEC) by affinity binding and characterized their identities using liquid chromatography-mass spectrometry (LC-MS) analysis. Our study discovered eight compounds withE. coliprotein-binding capabilities, and all these compounds were tracked back to the original natural ingredients of Sanjin Tablets. These compounds presented essentially no antibacteria activity, indicating that they affect UPEC by means other than directly killing the cells. Further molecular modeling analysis predicted molecular targets for these compounds and mapped the residues potentially involved in compound-target interactions. All the predicted targets turned out to be critical proteins regulating the metabolisms ofE. coli, suggesting that these compounds may affect metabolic pathways in UPEC and inhibit pathogenesis. These data will benefit future design of drugs with higher efficacy and specificity on targeting pathogenic bacteria.
In SilicoIdentification of Highly Conserved Epitopes of Influenza A H1N1, H2N2, H3N2, and H5N1 with Diagnostic and Vaccination Potential
Authors: Muñoz-Medina José Esteban , Sánchez-Vallejo Carlos Javier , Méndez-Tenorio Alfonso , Monroy-Muñoz Irma Eloísa , Angeles-Martínez Javier , Santos Coy-Arechavaleta Andrea , Santacruz-Tinoco Clara Esperanza , González-Ibarra Joaquín , Anguiano-Hernández Yu-Mei , González-Bonilla César Raúl , Ramón-Gallegos Eva , Díaz-Quiñonez José Alberto
Published: August 2015

The unpredictable, evolutionary nature of the influenza A virus (IAV) is the primary problem when generating a vaccine and when designing diagnostic strategies; thus, it is necessary to determine the constant regions in viral proteins. In this study, we completed anin silicoanalysis of the reported epitopes of the 4 IAV proteins that are antigenically most significant (HA, NA, NP, and M2) in the 3 strains with the greatest world circulation in the last century (H1N1, H2N2, and H3N2) and in one of the main aviary subtypes responsible for zoonosis (H5N1). For this purpose, the HMMER program was used to align 3,016 epitopes reported in the Immune Epitope Database and Analysis Resource (IEDB) and distributed in 34,294 stored sequences in the Pfam database. Eighteen epitopes were identified: 8 in HA, 5 in NA, 3 in NP, and 2 in M2. These epitopes have remained constant since they were first identified (~91 years) and are present in strains that have circulated on 5 continents. These sites could be targets for vaccination design strategies based on epitopes and/or as markers in the implementation of diagnostic techniques.
Unsteady Vibration Aerodynamic Modeling and Evaluation of Dynamic Derivatives Using Computational Fluid Dynamics
Authors: Liu Xu , Liu Wei , Zhao Yunfei
Published: August 2015

Unsteady aerodynamic system modeling is widely used to solve the dynamic stability problems encountering aircraft design. In this paper, single degree-of-freedom (SDF) vibration model and forced simple harmonic motion (SHM) model for dynamic derivative prediction are developed on the basis of modified Etkin model. In the light of the characteristics of SDF time domain solution, the free vibration identification methods for dynamic stability parameters are extended and applied to the time domain numerical simulation of blunted cone calibration model examples. The dynamic stability parameters by numerical identification are no more than 0.15% deviated from those by experimental simulation, confirming the correctness of SDF vibration model. The acceleration derivatives, rotary derivatives, and combination derivatives of Army-Navy Spinner Rocket are numerically identified by using unsteady N-S equation and solving different SHV patterns. Comparison with the experimental result of Army Ballistic Research Laboratories confirmed the correctness of the SHV model and dynamic derivative identification. The calculation result of forced SHM is better than that by the slender body theory of engineering approximation. SDF vibration model and SHM model for dynamic stability parameters provide a solution to the dynamic stability problem encountering aircraft design.
Initialized Decadal Predictions by LASG/IAP Climate System Model FGOALS-s2: Evaluations of Strengths and Weaknesses
Authors: Wu Bo , Chen Xiaolong , Song Fengfei , Sun Yong , Zhou Tianjun
Published: August 2015

Decadal prediction experiments are conducted by using the coupled global climate model FGOALS-s2, following the CMIP 5 protocol. The paper documents the initialization procedures for the decadal prediction experiments and summarizes the predictive skills of the experiments, which are assessed through indicators adopted by the IPCC AR5. The observational anomalies of surface and subsurface ocean temperature and salinity are assimilated through a modified incremental analysis update (IAU) scheme. Three sets of 10-year-long hindcast and forecast runs were started every five years in the period of 1960–2005, with the initial conditions taken from the assimilation runs. The decadal prediction experiment by FGOALS-s2 shows significant high predictive skills in the Indian Ocean, tropical western Pacific, and Atlantic, similar to the results of the CMIP5 multimodel ensemble. The predictive skills in the Indian Ocean and tropical western Pacific are primarily attributed to the model response to the external radiative forcing associated with the change of atmospheric compositions. In contrast, the high skills in the Atlantic are attributed, at least partly, to the improvements in the prediction of the Atlantic multidecadal variability coming from the initialization.
Statistical Prediction of the South China Sea Surface Height Anomaly
Authors: Shao Caixia , Zhang Weimin , Sun Chunjian , Chai Xinmin , Wang Zhimin
Published: August 2015

Based on the simple ocean data assimilation (SODA) data, this study analyzes and forecasts the monthly sea surface height anomaly (SSHA) averaged over South China Sea (SCS). The approach to perform the analysis is a time series decomposition method, which decomposes monthly SSHAs in SCS to the following three parts: interannual, seasonal, and residual terms. Analysis results demonstrate that the SODA SSHA time series are significantly correlated to the AVISO SSHA time series in SCS. To investigate the predictability of SCS SSHA, an exponential smoothing approach and an autoregressive integrated moving average approach are first used to fit the interannual and residual terms of SCS SSHA while keeping the seasonal part invariant. Then, an array of forecast experiments with the start time spanning from June 1977 to June 2007 is performed based on the prediction model which integrates the above two models and the time-independent seasonal term. Results indicate that the valid forecast time of SCS SSHA of the statistical model is about 7 months, and the predictability of SCS SSHA in Spring and Autumn is stronger than that in Summer and Winter. In addition, the prediction skill of SCS SSHA has remarkable decadal variability, with better phase forecast in 1997–2007.
An Assessment of Data from the Advanced Technology Microwave Sounder at the Met Office
Authors: Doherty Amy , Atkinson Nigel , Bell William , Smith Andrew
Published: August 2015

An appraisal of the Advanced Technology Microwave Sounder (ATMS) for use in numerical weather prediction (NWP) is presented, including an assessment of the data quality, the impact on Met Office global forecasts in preoperational trials, and a summary of performance over a period of 17 months operational use. After remapping, the noise performance (NEΔT) of the tropospheric temperature sounding channels is evaluated to be approximately 0.1 K, comparing favourably with AMSU-A. However, the noise is not random, differences between observations and simulations based on short-range forecast fields show a spurious striping effect, due to 1/f noise in the receiver. The amplitude of this signal is several tenths of a Kelvin, potentially a concern for NWP applications. In preoperational tests, adding ATMS data to a full Met Office system already exploiting data from four microwave sounders improves southern hemisphere mean sea level pressure forecasts in the 2- to 5-day range by 1-2%. In operational use, where data from five other microwave sounders is assimilated, forecast impact is typically between −0.05 and −0.1 J/kg (3.4% of total mean impact per day over the period 1 April to 31 July 2013). This suggests benefits beyond redundancy, associated with reducing already small analysis errors.
Effects of CO2 Pneumoperitoneum on the Cognitive Function of Patients Undergoing Gynecologic Laparoscopy
Authors: Liu Lu-Lu , Bao Ning , Lu Huang-Wei
Published: August 2015

Aim: To evaluate the effects of CO2 pneumoperitoneum during gynecologic laparoscopy on patients' postoperative cognitive function. Methods: This prospective clinical study included 225 adult female patients with American Society of Anesthesiologists physical status I or II. Patients underwent conventional open surgery (group I, n = 115) or gynecologic laparoscopy using abdominal insufflation with CO2 to an intra-abdominal pressure of 15 mm Hg (group II, n = 110). Serum S100β and neuron-specific enolase (NSE) concentrations were measured, both immediately before surgery and before the patient awoke after surgery. The Mini-Mental State Examination (MMSE) was administered 1 day before surgery as well as 1, 6, 12, 24 and 72 h after surgery and before discharge. Results: MMSE scores were significantly lower relative to baseline at 1, 6 and 12 h post surgery, but returned to baseline by 48 h (group I) or 72 h (group II) post surgery. One hour after surgery, S100β serum levels were higher in group II than in group I (p < 0.05). NSE levels did not differ between the groups. In group II, the MMSE score significantly correlated with serum S100β or NSE concentrations. Conclusion: CO2 pneumoperitoneum influences postoperative cognitive function in patients undergoing gynecologic laparoscopy.
Macrophage Phenotype in Kidney Injury and Repair
Authors: Meng Xiao-Ming , Tang Patrick Ming-Kuen , Li Jun , Lan Hui Yao
Published: August 2015

Background: Glomerular and interstitial macrophage infiltration is a feature for both the acute and chronic kidney diseases. Macrophages have been shown to play a diverse role in kidney injury and repair. Thus, macrophages may be a key cell type in acute and chronic kidney injury and repair. Summary and Key Messages: During renal inflammation, circulating monocytes are recruited and then become activated and polarized. By adapting to the local microenvironment, macrophages can differentiate into different phenotypes and function as a double-bladed sword in different stages of kidney disease. In general, M1 macrophages play a pathogenic role in boosting inflammatory renal injury, whereas M2 macrophages exert an anti-inflammatory and wound healing (or profibrotic) role during renal repair. In this review, we highlight the phenotypic polarization of macrophages in renal diseases and dissect their distinct functions in renal injury and repair processes, respectively. Moreover, the current understanding of regulatory mechanisms on the phenotypic switch and macrophage-related therapy are also intensively discussed.
Maternal Nicotine Exposure Induces Epithelial-Mesenchymal Transition in Rat Offspring Lungs
Authors: Chen Chung-Ming , Chou Hsiu-Chu , Huang Liang-Ti
Published: August 2015

Background: Maternal nicotine exposure induces lung injuries and fibrosis in rat offspring. Epithelial-mesenchymal transition (EMT) following lung injury is a process in which epithelial cells mediate tissue repair. Objective: To determine the effects of maternal nicotine exposure on EMT in neonatal rat lungs. Methods: Nicotine was administered to pregnant Sprague-Dawley rats using a subcutaneous osmotic minipump that delivered a dose of 6 mg/kg/day on gestational days 7-21 or from gestational day 7 to postnatal day 14. A control group received an equal volume of saline. Results: The percentage of 8-hydroxy-2'-deoxyguanosine-positive cells in nuclear staining was significantly higher, the E-cadherin protein expression was significantly lower, and the N-cadherin protein expression was significantly higher in rats born to prenatal and postnatal nicotine-treated dams than in those born to prenatal saline- and nicotine-treated dams on postnatal day 7. These characteristics of EMT were associated with a significant increase in α-smooth muscle actin (SMA) expression on postnatal day 21. Rats born to prenatal and postnatal nicotine-treated dams showed significantly higher α-SMA expression and total collagen than those born to prenatal saline- and nicotine-treated dams on postnatal day 21. The number of cells expressing fibroblast-specific protein 1 and vimentin was higher in rats born to prenatal and postnatal nicotine-treated dams than in those born to prenatal saline- and nicotine-treated dams on postnatal days 7 and 21. Conclusions: Maternal nicotine exposure during gestation and lactation induces EMT and contributes to lung fibrosis in rat offspring.
Protein A-Based Immunoadsorption Is More Efficient Than Conventional Plasma Exchange to Remove Circulating Anti-HLA Antibodies
Authors: Maillard Nicolas , Absi Lena , Claisse Guillaume , Masson Ingrid , Alamartine Eric , Mariat Christophe
Published: August 2015

We retrospectively evaluated the ability of protein-A immunoadsorption (IA) as compared to that of conventional plasma exchanges (PE) in reducing the mean fluorescence intensity (MFI) of anti-HLA antibodies assessed by the single antigen assay in sensitized renal transplant recipients. Change in MFI of 441 anti-HLA antibodies was measured after 1 single session of IA or after 3 consecutive daily PE sessions. While both strategies were able to significantly lower the amount of anti-HLA antibodies, the relative reduction in MFI was higher after IA as compared to PE (-69 vs. -58%, respectively, p = 0.003). This better efficacy of IA was observed despite a lower total volume of treated plasma (105 ± 6 vs. 160 ± 16 ml/kg after IA and after PE, respectively). Our data suggest a higher efficiency of IA over conventional PE sessions to remove anti-HLA antibodies and call for a larger evaluation of IA to confirm its potential added value in desensitization protocols.
Xenopus in Space and Time: Fossils, Node Calibrations, Tip-Dating, and Paleobiogeography
Authors: Cannatella David
Published: August 2015

Published data from DNA sequences, morphology of 11 extant and 15 extinct frog taxa, and stratigraphic ranges of fossils were integrated to open a window into the deep-time evolution of Xenopus. The ages and morphological characters of fossils were used as independent datasets to calibrate a chronogram. We found that DNA sequences, either alone or in combination with morphological data and fossils, tended to support a close relationship between Xenopus and Hymenochirus, although in some analyses this topology was not significantly better than the Pipa + Hymenochirus topology. Analyses that excluded DNA data found strong support for the Pipa + Hymenochirus tree. The criterion for selecting the maximum age of the calibration prior influenced the age estimates, and our age estimates of early divergences in the tree of frogs are substantially younger than those of published studies. Node-dating and tip-dating calibrations, either alone or in combination, yielded older dates for nodes than did a root calibration alone. Our estimates of divergence times indicate that overwater dispersal, rather than vicariance due to the splitting of Africa and South America, may explain the presence of Xenopus in Africa and its closest fossil relatives in South America.
A complementary role for tetraspanin superfamily member CD151 and ADP purinergic P2Y12 receptor in platelets
Authors: Makkawi Mohammed , Moheimani Fatemeh , Alserihi Raed , Howells David , Wright Mark , Ashman Leonie , Jackson Denise E.
Published: August 2015

P2Y12 receptor is required for sustained activation of integrin αllbβ3, irreversible platelet aggregation and thrombus stabilisation. Tetraspanin superfamily member CD151 associates with integrin aNbp3 and plays critical roles in regulation of thrombus growth and stability in vivo. The possible functional relationship between P2Y12 and CD151 in a molecular cluster in platelets may affect thrombus formation. Hence our aim was to investigate the physical and functional requirements for this association in platelets. Our investigations reveal a specific and constitutive association between CD151 and P2Y12 receptor in human platelets shown by immunoprecipitation/western blot studies and by flow cytometry. Specifically, the prominent association involves CD151 with P2Y12 oligomers, and to a lesser extent P2Y12 monomers. This association is not altered by platelet aggregation induced by different agonists. There is also a distinct complex of tetraspanin CD151 with ADP purinergic receptor P2Y12 but not P2Y1. P2Y12 oligomer interaction with CD151 is selective as compared to other tetraspanins. To investigate the functional relationship between these receptors in platelets we used wild-type or CD151 knockout (KO) mice treated with either PBS or 50 mg/kg clopidogrel. CD151 KO mice treated with clopidogrel exhibited synergy in delayed kinetics of clot retraction, in PAR-4 and collagen-mediated platelet aggregation, platelet spreading on fibrinogen and without restricting cAMP inhibition. Clopidogrel treated CD151 KO arterioles showed smaller and less stable thrombi with increased tendency to embolise ex vivo and in vivo. These studies demonstrate a complementary role between CD151 and P2Y12 receptor in platelets in regulating thrombus growth and stability.
Aspirin for primary prevention in diabetes mellitus: from the calculation of cardiovascular risk and risk/benefit profile to personalised treatment
Authors: Santilli Francesca , Pignatelli Pasquale , Violi Francesco , Davì Giovanni
Published: August 2015

Type 2 diabetes mellitus is characterised by persistent thromboxane (TX)-dependent platelet activation, regardless of disease duration. Low-dose aspirin, that induces a permanent inactivation of platelet cyclooxygenase (COX)-1, thus inhibiting TXA2 biosynthesis, should be theoretically considered the drug of choice. The most up-to-date meta-analysis of aspirin prophylaxis in this setting, which includes three trials conducted in patients with diabetes and six other trials in which such patients represent a subgroup within a broader population, reported that aspirin is associated with a non-significant decrease in the risk of vascular events, although the limited amount of available data precludes a precise estimate of the effect size. An increasing body of evidence supports the concept that less-than-expected response to aspirin may underlie mechanisms related to residual platelet hyper-reactivity despite anti-platelet treatment, at least in a fraction of patients. Among the proposed mechanisms, the variable turnover rate of the drug target (platelet COX-1) appears to represent the most convincing determinant of the inter-individual variability in aspirin response. This review intends to develop the idea that the understanding of the determinants of less-than-adequate response to aspirin in certain individuals, although not changing the paradigm of the indication to low-dose aspirin prescription in primary prevention, may help identifying, in terms of easily detectable clinical or biochemical characteristics, individuals who would attain inadequate protection from aspirin, and for whom different strategies should be challenged.
Therapy persistence in newly diagnosed non-valvular atrial fibrillation treated with warfarin or NOAC
Authors: Katholing Anja , Wallenhorst Christopher , Freedman Saul Benedict , Martinez Carlos
Published: August 2015

Efforts to reduce stroke in atrial fibrillation (AF) have focused on increasing physician adherence to oral anticoagulant (OAC) guidelines, but high early vitamin K antagonist (VKA) discontinuation is a limitation. We compared persistence of non-VKA OAC (NOAC) with VKA treatment in the first year after OAC inception for incident AF in real-world practice. We studied 27,514 anticoagulant-naïve patients with incident non-valvular AF between January 2011 and May 2014 in the UK primary care Clinical Practice Research Datalink, with full medication use linkage: mean age 74.2 ± 12.4, 45.7 % female, mean follow-up 1.9 ± 1.1 years. After treatment initiation and follow-up until 1/2015, the proportion remaining on OAC at one year (persistence) was estimated using competing risk survival analyses. OAC was commenced ≤90 days after incident AF in 13,221 patients (48.1 %): 12,307 VKA and 914 NOAC (apixaban, dabigatran, rivaroxaban). Amongst those treated with OAC, the proportion commencing NOAC increased from zero in 1/2011 to 27.0 % in 5/2014, and OAC prescriptions for CHA2DS2VASc score ≥2 (guideline adherence) increased from 41.2 % to 65.5 %. Persistence with OAC declined over 12 months to 63.6 % for VKA and 79.2 % for NOAC (p< 0.0001). Persistence for those with CHA2DS2VASc ≥2 was significantly greater for NOAC (83.0 %) than VKA (65.3 %, p< 0.0001) at one year and all earlier time points. Comparison of VKA and NOAC cohorts matched on individual CHA2DS2VASc components showed consistent results. In conclusion, persistence was significantly higher with NOAC than VKA, and could alone lead to fewer cardioembolic strokes. Increased guideline adherence following NOAC introduction could further decrease AF stroke burden.

Supplementary Material to this article is available online at www.thrombosis-online.com.
Mechanistic Insights into Sympathetic Neuronal Regeneration
Authors: Bravo Paco E. , Lautamäki Riikka , Carter Debra , Holt Daniel P. , Nekolla Stephan G. , Dannals Robert F. , Russell Stuart D. , Bengel Frank M.
Published: August 2015

Background—

Post-transplant reinnervation is a unique model to study sympathetic neuronal regeneration in vivo. The differential role of subcellular mechanisms of catecholamine handling in nerve terminals has not been investigated.

Methods and Results—

Three different carbon-11–labeled catecholamines were used for positron emission tomography of transport (C-11 m-hydroxyephedrine, HED), vesicular storage (C-11 epinephrine, EPI), and metabolic degradation (C-11 phenylephrine). A 2-day protocol was used, including quantification of myocardial blood flow by N-13 ammonia. Resting myocardial blood flow and EPI, HED and phenylephrine retention were homogeneous in healthy volunteers (n=7). Washout was only observed for phenylephrine (
T
1/2
49±6 min). In nonrejecting, otherwise healthy heart transplant recipients (>1 year after surgery, n=10), resting myocardial blood flow was also homogenous. Regional catecholamine uptake of varying degrees was observed in the anterior left ventricular wall and septum. Overall, 24±19% of left ventricle showed HED uptake levels comparable with healthy volunteers, whereas it was only 8±7% for EPI (
P
=0.004 versus HED). Phenylephrine washout was not different from healthy volunteers in the area with restored EPI and HED retention (
T
1/2
41±7 min;
P
>0.05), but was significantly enhanced in the EPI/HED mismatch area (
T
1/2
36±8 min;
P
=0.008), consistent with inefficient vesicular storage and enhanced metabolic degradation.

Conclusions—

Regeneration of subcellular components of sympathetic nerve terminal function does not occur simultaneously. In the reinnervating transplanted heart, a region with normal catecholamine transport and vesicular storage is surrounded by a borderzone, where transport is already restored but vesicular storage remains inefficient, suggesting that vesicular storage is a more delicate mechanism. This observation may have implications for other pathologies involving cardiac autonomic innervation.
Clinical Effectiveness of Statin Therapy After Ischemic Stroke: Primary Results From the Statin Therapeutic Area of the Patient-Centered Research Into Outcomes Stroke Patients Prefer and Effectiveness Research (PROSPER) Study
Authors: O’Brien Emily C. , Greiner Melissa A. , Xian Ying , Fonarow Gregg C. , Olson DaiWai M. , Schwamm Lee H. , Bhatt Deepak L. , Smith Eric E. , Maisch Lesley , Hannah Deidre , Lindholm Brianna , Peterson Eric D. , Pencina Michael J. , Hernandez Adrian F.
Published: August 2015

Background—

In patients with ischemic stroke, data on the real-world effectiveness of statin therapy for clinical and patient-centered outcomes are needed to better inform shared decision making.

Methods and Results—

Patient-Centered Research Into Outcomes Stroke Patients Prefer and Effectiveness Research (PROSPER) is a Patient-Centered Outcomes Research Institute–funded research program designed with stroke survivors to evaluate the effectiveness of poststroke therapies. We linked data on patients
≥
65 years of age enrolled in the Get With The Guidelines–Stroke Registry to Medicare claims. Two-year to postdischarge outcomes of those discharged on a statin versus not on a statin were adjusted through inverse probability weighting. Our coprimary outcomes were major adverse cardiovascular events and home time (days alive and out of a hospital or skilled nursing facility). Secondary outcomes included all-cause mortality, all-cause readmission, cardiovascular readmission, and hemorrhagic stroke. From 2007 to 2011, 77 468 patients who were not taking statins at the time of admission were hospitalized with ischemic stroke; of these, 71% were discharged on statin therapy. After adjustment, statin therapy at discharge was associated with a lower hazard of major adverse cardiovascular events (hazard ratio, 0.91; 95% confidence interval, 0.87–0.94), 28 more home-time days after discharge (
P
<0.001), and lower all-cause mortality and readmission. Statin therapy at discharge was not associated with increased risk of hemorrhagic stroke (hazard ratio, 0.94; 95% confidence interval, 0.72–1.23). Among statin-treated patients, 31% received a high-intensity dose; after risk adjustment, these patients had outcomes similar to those of recipients of moderate-intensity statin.

Conclusion—

In older ischemic stroke patients who were not taking statins at the time of admission, discharge statin therapy was associated with lower risk of major adverse cardiovascular events and nearly 1 month more home time during the 2-year period after hospitalization.
One More Look at the Negation of the Infinitive Construct in Second Temple Hebrew
Authors: Mor Uri
Published: August 2015

Second Temple Hebrew (Late Biblical Hebrew, Ben Sira, and Qumranic Hebrew) makes predicative use of two seemingly similar constructions: לא + infinitive and אין + infinitive. A syntactic examination of the two from a historical perspective, in light of morphosyntactic changes in the verbal system of Second Temple Hebrew and its sentence patterns, reveals that in spite of the similarities between them in form and in function, these are two seperate constructions that evolved independently. The former, initially a verbal phrase, is the negative counterpart of the affirmative predicative infinitive, and the latter, which constitutes a complete predication, is an offshoot of the existential pattern יש/אין + nominal phrase. In the Hebrew style of the Second Temple period the difference between them narrowed, so that they were occasionally interchangeable.
Ézéchiel 18 et les défis que comporte l’analyse de l’exégèse intra-biblique
Authors: Maurais Jean
Published: August 2015

The relationship between Ezekiel 18:1-4 and Exodus 20:5-6 is sometimes interpreted in a way that highlights three difficulties encountered by modern exegetes when assessing the motivations underlying inner-biblical exegesis. From these three difficulties emerges another explanation of Ezekiel’s intention which illustrates some principles that could help refine the analysis of inner-biblical exegesis.