bluuebunny/crossref_metadata_2025 huggingface dataset:
The benefits of thermal clothing during winter in patients with heart failure: a pilot randomised controlled trial
Authors: Barnett Adrian G , Lucas Margaret , Platts David , Whiting Elizabeth , Fraser John F
Published: May 2013

Objectives

To examine whether providing thermal clothing to heart failure patients improves their health during winter.

Design

A randomised controlled trial with an intervention group and a usual care group.

Setting

Heart failure clinic in a large tertiary referral hospital in Brisbane, Australia.

Participants

Eligible participants were those with known systolic heart failure who were over 50  years of age and lived in Southeast Queensland. Participants were excluded if they lived in a residential aged care facility, had incontinence or were unable to give informed consent. Fifty-five participants were randomised and 50 completed.

Interventions

Participants randomised to the intervention received two thermal hats and tops and a digital thermometer.

Primary and secondary outcome measures

The primary outcome was the mean number of days in hospital. Secondary outcomes were the number of general practitioner (GP) visits and self-rated health.

Results

The mean number of days in hospital per 100 winter days was 2.5 in the intervention group and 1.8 in the usual care group, with a mean difference of 0.7 (95% CI −1.5 to 5.4). The intervention group had 0.2 fewer GP visits on average (95% CI −0.8 to 0.3), and a higher self-rated health, mean improvement –0.3 (95% CI −0.9 to 0.3). The thermal tops were generally well used, but even in cold temperatures the hats were only worn by 30% of the participants.

Conclusions

Thermal clothes are a cheap and simple intervention, but further work needs to be done on increasing compliance and confirming the health and economic benefits of providing thermals to at-risk groups.

Trial registration

The study was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12612000378820)
Determining immunisation status of children from history: a diagnostic accuracy study
Authors: Nohavicka Laura , Ashdown Helen F , Kelly Dominic F
Published: May 2013

Objectives

Children presenting unplanned to healthcare services are routinely asked about previous immunisations as part of their assessment. We aimed to assess the accuracy of screening children for immunisation status by history.

Design

Diagnostic accuracy study. We compared information from patient history by a retrospective review of notes and used a central database of child immunisation records as the reference standard.

Setting

Paediatric emergency department in a tertiary hospital in Oxford, UK.

Participants

Consecutive children aged 6 months to 6 years presenting over a 2-month period.

Outcome measures

Proportion of children with documented immunisation history; sensitivity and specificity of detecting overdue immunisations by history compared to central records.

Results

1166 notes were surveyed. 76.3% children were asked about immunisations. The proportion of children who were fully immunised on central records was 93.1%. History had a sensitivity of 41.3% (95% CI 27% to 56.8%) and a specificity of 98.7% (95% CI 97.5% to 99.4%) for detecting those who were overdue. Negative predictive value was 95.8% (95% CI 93.9% to 97.2%). Only around a third of children with overdue immunisations are detected by the current screening methods, and approximately 1 in 20 children stated as being up to date are in fact overdue.

Conclusions

History had poor sensitivity for identifying overdue immunisation. Strategies to improve detection of children overdue with immunisation should focus on alternative strategies for alerting clinicians, such as linkage of community and hospital electronic records.
Association ofTrichomonas vaginaliswith its symbiontMycoplasma hominissynergistically upregulates the in vitro proinflammatory response of human monocytes
Authors: Fiori Pier Luigi , Diaz Nicia , Cocco Anna Rita , Rappelli Paola , Dessì Daniele
Published: May 2013

Objectives

Trichomonas vaginalisis the causative agent of trichomoniasis, one of the most common sexually transmitted diseases worldwide. In recent years we have described the symbiotic relationship betweenT vaginalisandMycoplasma hominis. How this biological association might affect the pathogenicity of one or both the microorganisms is still unknown. Since local inflammation is thought to play a central role inT vaginalisinfection, we investigated the in vitro response of human macrophages to naturally mycoplasma-freeT vaginalis, as compared to a mycoplasma-infected trichomonad isolate.

Methods

THP-1 cells were stimulated with two isogenicT vaginalisisolates, one naturally mycoplasma-free and one stably associated withM hominis, and secreted cytokines measured by ELISA. Nuclear factor κB (NFκB) involvement in THP-1 response toT vaginalisandM hominiswas evaluated by means of a reporter system based on detection of alkaline phosphatase activity.

Results

We found that the presence ofM hominisupregulates the expression of a panel of proinflammatory cytokines in a synergistic fashion. We also found that the upregulation of the proinflammatory response by THP-1 cells involves the transcription factor NFκB.

Conclusions

These findings suggest that the presence ofM hominisinT vaginalisisolates might play a key role in inflammation during trichomoniasis, thus affecting the severity of the disease. The synergistic upregulation of the macrophage proinflammatory response might also affect some important clinical conditions associated withT vaginalisinfection, such as the increased risk of acquiring cervical cancer or HIV, which are thought to be affected by the inflammatory milieu during trichomoniasis.
Practical Integrated Analysis of Pointers, Dataflow and Control Flow
Authors: Staiger-Stöhr Stefan
Published: May 2013

This article presents a family of static analyses to determine pointer targets, control flow, and dataflow in combination. The integrated solution to these mutually dependent problems approaches the result from the optimistic side. It is a general strategy for static program analysis and does not need any upfront approximation for one of the problems to overcome the mutual dependencies. A degenerated case yields Andersen’s famous pointer analysis; otherwise, the analyses are flow-sensitive and can support direct and indirect strong updates, within the same cubic asymptotic complexity as known for Andersen, albeit with larger constants.

Surprisingly, the ideas behind the integrated analysis are intuitive. The strategy we describe naturally evolves from considering the mutual dependencies between the three problems, or from generalizing Andersen’s analysis to flow sensitivity. Such a flow-sensitive Andersen analysis not only computes pointer targets with higher precision than the original analysis, but it also creates an interprocedural SSA form at the same time.

Our extensive experimental evaluation shows that the integrated solution is practical as it can be applied to reasonably large real-world programs within a few seconds or minutes. This uses some optimizations which together achieve a speedup of more than 100 for several programs. We compare several members of the family of analyses, from flow- and field-insensitive to flow- and field-sensitive with strong updates, both with and without optimizations. This gives some insights into the effects of these dimensions of precision on the results. It also sheds new light on the benefits of flow sensitivity versus the costs associated with it.
A study of pricing for cloud resources
Authors: Xu Hong , Li Baochun
Published: May 2013

We present a study of pricing cloud resources in this position paper. Our objective is to explore and understand the interplay between economics and systems designs proposed by recent research. We develop a general model that captures the resource needs of various applications and usage pricing of cloud computing. We show that a uniform price does not suffer any revenue loss compared to first-order price discrimination. We then consider alternative strategies that a provider can use to improve revenue, including resource throttling and performance guarantees, enabled by recent technical developments. We prove that throttling achieves the maximum revenue at the expense of tenant surplus, while providing performance guarantees with an extra fee is a fairer solution for both parties. We further extend the model to incorporate the cost aspect of the problem, and the possibility of right-sizing capacity. We reveal another interesting insight that in some cases, instead of focusing on right-sizing, the provider should work on the demand and revenue side of the equation, and pricing is a more feasible and simpler solution. Our claims are evaluated through extensive trace-driven simulations with real-world workloads.
Analytical modeling for what-if analysis in complex cloud computing applications
Authors: Singh Rahul , Shenoy Prashant , Natu Maitreya , Sadaphal Vaishali , Vin Harrick
Published: May 2013

Modern cloud applications are complex distributed systems with tens or hundreds of interacting software components. An important management task in cloud computing platforms is to predict the impact of a certain workload or reconfiguration change on the performance of the application. Such predictions require the design of "what-if" models of the application that take as input hypothetical changes in the application's workload or environment and estimate its impact on performance. We present a workload-based what-if analysis system that uses commonly available monitoring information in large scale systems to enable the administrators to ask a variety of workload-based "what-if" queries about the system. We use a network of queues to analytically model the behavior of large distributed cloud applications. Our system automatically generates node-level queueing models and then uses model composition to build system-wide models. We employ a simple what-if query language and an intelligent query execution algorithm that employs on-the-fly model construction and a change propagation algorithm to efficiently answer queries on large scale systems. We have built a prototype and have used traces from two large production cloud bapplications from a financial institution as well as real-world synthetic applications to evaluate its what-if modeling framework. Our experimental evaluation validates the accuracy of our node-level resource usage, latency and workload models and then shows how our system enables what-if analysis in four different cloud applications.
How (not) to build a transport layer for anonymity overlays
Authors: Tschorsch Florian , Scheuermann Björn
Published: May 2013

Internet anonymity systems, like for instance Tor, are in widespread use today. Technically they are realized as overlays, i. e., they add another instance of routing, forwarding, and transport functionality on top of the Internet protocol stack. This has important (and often subtle) implications, as overlay and underlay may interact. Far too often, existing designs neglect this. Consequently, they suffer from performance issues that are hard to track down and fix. The existing body of work in this area often takes a quite narrow view, tweaking the design in order to improve one specific aspect. The behavior of the interacting underlay and overlay transport layers is complex, though, and often causes unexpected-and unexplored-side effects. Therefore, we show that so far considered combinations of overlay and underlay protocols cannot deliver good throughput, latency, and fairness at the same time, and we establish guidelines for a future, better suited transport layer design.
Routing topology inference for wireless sensor networks
Authors: Liang Yao , Liu Rui
Published: May 2013

We consider an important problem of wireless sensor network (WSN) routing topology inference/tomography from indirect measurements observed at the data sink. Previous studies on WSN topology tomography are restricted to static routing tree estimation, which is unrealistic in real-world WSN time-varying routing due to wireless channel dynamics. We study general WSN routing topology inference where routing structure is dynamic. We formulate the problem as a novel compressed sensing problem. We then devise a suite of decoding algorithms to recover the routing path of each aggregated measurement. Our approach is tested and evaluated though simulations with favorable results. WSN routing topology inference capability is essential for routing improvement, topology control, anomaly detection and load balance to enable effective network management and optimized operations of deployed WSNs.
LCD-Net
Authors: Sathiaseelan Arjuna , Crowcroft Jon
Published: May 2013

"The Internet is for everyone" claims Vint Cerf, the father of the Internet via RFC 3271. The Internet Society's recent global Internet survey reveals that the Internet should be considered as a basic human birth right. We strongly agree with these and believe that basic access to the Internet should be made free, at least to access the essential services. However the current Internet access model, which is governed by market economics makes it practically infeasible for enabling universal access especially for those with socio-economic barriers. We see enabling benevolence in the Internet (act of sharing resources) as a potential solution to solve the problem of digital exclusion caused due to socio-economic barriers. In this paper, we propose LCD-Net: Lowest Cost Denominator Networking, a new Internet paradigm that architects multi-layer resource pooling Internet technologies to support benevolence in the Internet. LCD-Net proposes to bring together several existing resource pooling Internet technologies to ensure that users and network operators who share their resources are not affected and at the same time are incentivised for sharing. The paper also emphasizes the need to identify and extend the stakeholder value chain to ensure such benevolent access to the Internet is sustainable.
Rehabilitation with Poststroke Motor Recovery: A Review with a Focus on Neural Plasticity
Authors: Takeuchi Naoyuki , Izumi Shin-Ichi
Published: May 2013

Motor recovery after stroke is related to neural plasticity, which involves developing new neuronal interconnections, acquiring new functions, and compensating for impairment. However, neural plasticity is impaired in the stroke-affected hemisphere. Therefore, it is important that motor recovery therapies facilitate neural plasticity to compensate for functional loss. Stroke rehabilitation programs should include meaningful, repetitive, intensive, and task-specific movement training in an enriched environment to promote neural plasticity and motor recovery. Various novel stroke rehabilitation techniques for motor recovery have been developed based on basic science and clinical studies of neural plasticity. However, the effectiveness of rehabilitative interventions among patients with stroke varies widely because the mechanisms underlying motor recovery are heterogeneous. Neurophysiological and neuroimaging studies have been developed to evaluate the heterogeneity of mechanisms underlying motor recovery for effective rehabilitation interventions after stroke. Here, we review novel stroke rehabilitation techniques associated with neural plasticity and discuss individualized strategies to identify appropriate therapeutic goals, prevent maladaptive plasticity, and maximize functional gain in patients with stroke.
Laparoscopic Treatment of Intrauterine Fallopian Tube Incarceration
Authors: Kondo William , Bruns Rafael Frederico , Nicola Marcelo Chemin , Ribeiro Reitan , Trippia Carlos Henrique , Zomer Monica Tessmann
Published: May 2013

Herniation of the pelvic structures into the uterine cavity (appendix vermiformis, small bowel, omentum, or fallopian tube) may occur after uterine perforation. In this paper, we describe one case of intrauterine fallopian tube incarceration treated by means of laparoscopic surgery.
Preoperative Hematocrit Concentration and the Risk of Stroke in Patients Undergoing Isolated Coronary-Artery Bypass Grafting
Authors: Musallam Khaled M. , Jamali Faek R. , Rosendaal Frits R. , Richards Toby , Spahn Donat R. , Khavandi Kaivan , Barakat Iskandar , Demoss Benjamin , Lotta Luca A. , Peyvandi Flora , Sfeir Pier M.
Published: May 2013

Background. Identification and management of risk factors for stroke following isolated coronary artery bypass grafting (CABG) could potentially lower the risk of such serious morbidity.Methods. We retrieved data for 30-day stroke incidence and perioperative variables for patients undergoing isolated CABG and used multivariate logistic regression to assess the adjusted effect of preoperative hematocrit concentration on stroke incidence.Results. In 2,313 patients (mean age 65.9 years, 73.6% men), 43 (1.9%, 95% CI: 1.4–2.5) developed stroke within 30 days following CABG (74.4% within 6 days). After adjustment for a priori defined potential confounders, each 1% drop in preoperative hematocrit concentration was associated with 1.07 (95% CI: 1.01–1.13) increased odds for stroke (men, OR: 1.08, 95% CI: 1.01–1.16; women, OR: 1.02, 95% CI: 0.91–1.16). The predicted probability of stroke for descending preoperative hematocrit concentration exceeded 2% for values <37% (<37% for men (adjusted OR: 2.39, 95% CI: 1.08–5.26) and <38% for women (adjusted OR: 2.52, 95% CI: 0.53–11.98), with a steeper probability increase noted in men). The association between lower preoperative hematocrit concentration and stroke was evident irrespective of intraoperative transfusion use.Conclusion. Screening and management of patients with low preoperative hematocrit concentration may alter postoperative stroke risk in patients undergoing isolated CABG.
Propagation of Measurement-While-Drilling Mud Pulse during High Temperature Deep Well Drilling Operations
Authors: Li Hongtao , Meng Yingfeng , Li Gao , Wei Na , Liu Jiajie , Ma Xiao , Duan Mubai , Gu Siman , Zhu Kuanliang , Xu Xiaofeng
Published: May 2013

Signal attenuates while Measurement-While-Drilling (MWD) mud pulse is transmited in drill string during high temperature deep well drilling. In this work, an analytical model for the propagation of mud pulse was presented. The model consists of continuity, momentum, and state equations with analytical solutions based on the linear perturbation analysis. The model can predict the wave speed and attenuation coefficient of mud pulse. The calculated results were compared with the experimental data showing a good agreement. Effects of the angular frequency, static velocity, mud viscosity, and mud density behavior on speed and attenuation coefficients were included in this paper. Simulated results indicate that the effects of angular frequency, static velocity, and mud viscosity are important, and lower frequency, viscosity, and static velocity benefit the transmission of mud pulse. Influenced by density behavior, the speed and attenuation coefficients in drill string are seen to have different values with respect to well depth. For different circulation times, the profiles of speed and attenuation coefficients behave distinctly different especially in lower section. In general, the effects of variables above on speed are seen to be small in comparison.
Normal Thymic Size and Low Rate of Infections in Human Donor Milk Fed HIV-Exposed Uninfected Infants from Birth to 18 Months of Age
Authors: Jeppesen Dorthe Lisbeth , Ersbøll Annette Kjær , Hoppe Tine Ursula , Nielsen Susanne Dam , Valerius Niels Henrik
Published: May 2013

Objective. To evaluate the immune function in HIV-exposed uninfected (HIV-EU) infants fed human donor milk.Methods. Ultrasound-obtained thymic index (Ti), T-lymphocyte subsets, and the number of infections were examined from birth to 18 months of age in 18 HIV-EU infants. The infants were compared to a cohort of 47 term, HIV-unexposed breastfed or formula-fed infants.Results. The thymic size at 12 months of age was not significantly different between the HIV-EU group and the control infants (P=0.56). At 4 months of age, the HIV-EU infants had significantly fewer infections than the control infants (P<0.001). Furthermore, in the control group, the infants exclusively breastfed at 4 months of age had significantly fewer infections at 8 months when compared to age-matched formula-fed infants (P=0.001).Conclusion. HIV-EU infants fed human donor milk have normal growth of thymus and contract fewer infections than other healthy infants. This finding along with fewer infections in exclusively breastfed infants compared to formula-fed infants supports the beneficial effect of human milk on the immune system. We suggest, when breastfeeding is not possible, that providing human donor milk to vulnerable groups of infants will be beneficial for their maturing immune system.
Anomalous Microwave Emission from Star Forming Regions
Authors: Scaife Anna M. M.
Published: May 2013

The evidence for microwave emission from spinning dust grains has been strengthened considerably by its detection in a number of discrete astrophysical objects associated with star formation. These detections, in combination with statistical constraints on its presence on large angular scales in the diffuse ISM, have provided strong observational confirmation of an emission mechanism still referred to as anomalous. This emission has a peaked spectrum with a maximum in the microwave band; the present review discusses the continuum radio emission mechanisms which can contribute to this region of the electromagnetic spectrum, collects published results on the prevalence of anomalous microwave emission in a variety of star formation regions, presents the overall conclusions that may be drawn from the detections so far, and discusses the prospects for future research on the anomalous microwave emission attributed to spinning dust within star forming regions.
Facile Preparation of Phosphotungstic Acid-Impregnated Yeast Hybrid Microspheres and Their Photocatalytic Performance for Decolorization of Azo Dye
Authors: Chen Lan , Bai Bo
Published: May 2013

Phosphotungstic acid (HPW)-impregnated yeast hybrid microspheres were prepared by impregnation-adsorption technique through tuning pH of the aqueous yeast suspensions. The obtained products were characterized by field emission scanning electron microscopy (FE-SEM), energy dispersive spectrometry (EDS), X-ray diffraction (XRD), thermogravimetry-differential scanning calorimetry (TG-DSC), and ultraviolet-visible spectrophotometry (UV-Vis), respectively. FE-SEM and EDS ascertain that the HPW has been effectively introduced onto the surface of yeast, and the resulting samples retain ellipsoid shape, with the uniform size (length 4.5 ± 0.2 μm, width 3.0 ± 0.3 μm) and good monodispersion. XRD pattern indicates that the main crystal structure of as-synthesized HPW@yeast microsphere is Keggin structure. TG-DTA states that the HPW in composites has better thermal stability than pure HPW. Fourier transform infrared spectroscopy (FT-IR) elucidates that the functional groups or chemical bonds inherited from the pristine yeast cell were critical to the assembling of the composites. UV-Vis shows that the obtained samples have a good responding to UV light. The settling ability indicates that the hybrid microspheres possess an excellent suspension performance. In the test of catalytic activity, the HPW@yeast microsphere exhibits a high photocatalytic activity for the decoloration of Methylene blue and Congo red dye aqueous solutions, and there are a few activity losses after four cycles of uses.
Sleep, Fatigue, and Functional Health in Psychotic Patients
Authors: Waters Flavie , Naik Neepa , Rock Daniel
Published: May 2013

This study sought to examine the association between sleep, fatigue, and functional health in psychotic patients. Participants included 93 psychotic inpatients (n=67with schizophrenia) who completed the Chalder Fatigue Scale (ChFS), the Fatigue Symptom Inventory (FSI), the Pittsburgh Sleep Quality Index (PSQI), and the SF36 Health Survey. Patients were classified on the basis of their performance on sleep and fatigue measures: 60% reported significant levels of fatigue and 67% significant sleep disturbances. 28.4% reported both, suggesting that fatigue and sleep dysfunctions do not necessarily cooccur. A closer examination of patterns showed that fatigue was only related to qualitative aspects of sleep and not quantifiable aspects of sleep disturbances. The results also showed that functional health was the lowest in patients with high levels of fatigue, compared to patients with sleep problems only or patients with neither symptom. A regression analysis further showed that the size of the contribution of fatigue onto functional health was twice as much as that of sleep dysfunctions. In conclusion, the results show that (i) dissatisfaction with sleep—and not sleep itself—is related to fatigue symptoms and that (ii) fatigue is particularly detrimental to functional health, regardless of the presence of sleep dysfunctions.
Oxidation of Marine Omega-3 Supplements and Human Health
Authors: Albert Benjamin B. , Cameron-Smith David , Hofman Paul L. , Cutfield Wayne S.
Published: May 2013

Marine omega-3 rich oils are used by more than a third of American adults for a wide range of purported benefits including prevention of cardiovascular disease. These oils are highly prone to oxidation to lipid peroxides and other secondary oxidation products. Oxidized oils may have altered biological activity making them ineffective or harmful, though there is also evidence that some beneficial effects of marine oils could be mediated through lipid peroxides. To date, human clinical trials have not reported the oxidative status of the trial oil. This makes it impossible to understand the importance of oxidation to efficacy or harm. However, animal studies show that oxidized lipid products can cause harm. Oxidation of trial oils may be responsible for the conflicting omega-3 trial literature, including the prevention of cardiovascular disease. The oxidative state of an oil can be simply determined by the peroxide value and anisidine value assays. We recommend that all clinical trials investigating omega-3 harms or benefits report the results of these assays; this will enable better understanding of the benefits and harms of omega-3 and the clinical importance of oxidized supplements.
Exploring Outcome Measures for Exercise Intervention in People with Parkinson’s Disease
Authors: King L. A. , Salarian A. , Mancini M. , Priest K. C. , Nutt J. , Serdar A. , Wilhelm J. , Schlimgen J. , Smith M. , Horak F. B.
Published: May 2013

Background. It is widely believed that exercise improves mobility in people with Parkinson’s disease (PD). However, it is difficult to determine whether a specific type of exercise is the most effective. The purpose of this study was to determine which outcome measures were sensitive to exercise intervention and to explore the effects of two different exercise programs for improving mobility in patients with PD.Methods. Participants were randomized into either the Agility Boot Camp (ABC) or treadmill training; 4x/week for 4 weeks. Outcome measures were grouped by the International Classification of Function/Disability (ICF). To determine the responsiveness to exercise, we calculated the standardized response means.t-tests were used to compare the relative benefits of each exercise program.Results. Four of five variables at the structure/function level changed after exercise: turn duration (P=0.03), stride velocity (P=0.001), peak arm speed (P=0.001), and horizontal trunk ROM during gait (P=0.02). Most measures improved similarly for both interventions. The only variable that detected a difference between groups was postural sway in ABC group (F=4.95;P=0.03).Conclusion. Outcome measures at ICF body structure/function level were most effective at detecting change after exercise and revealing differences in improvement between interventions.
A Meta-Analysis of Randomized Controlled Trials on Acupuncture for Amblyopia
Authors: Yan Xingke , Zhu Tiantian , Ma Chongbing , Liu Anguo , Dong Lili , Wang Junyan
Published: May 2013

Objective. To assess the evidence of efficacy and safety of acupuncture for amblyopia and analyze the current situation of its clinical setting.Methods. We systemically searched Wanfang, Chongqing Weipu Database for Chinese Technical Periodicals (VIP), China National Knowledge Infrastructure (CNKI), and PubMed. Published randomized controlled trials (RCT) and controlled clinical trials (CCT) that evaluated the effect of acupuncture for amblyopia compared with conventional treatment were identified. The methodological quality of the included trials was assessed based on the Jadad scale. Data synthesis was facilitated using RevMan 5.1.Results. Fourteen trials involving 2662 participants satisfied the minimum criteria for meta-analysis. The evidence showed that the total effective rate of treatment within the group receiving acupuncture was higher than that in conventional group; there were statistically significant differences between groups (polled random effects model (RR) = 1.17, 95% confidence interval (1.11, 1.24),Z=5.56,P<0.00001).Conclusion. The total effective rate of acupuncture for amblyopia was significantly superior to conventional treatment, indicating that acupuncture was a promising treatment for amblyopia. However, due to the limited number of CCTs and RCTs, especially those of large sample size and multicenter randomized controlled studies that were quantitatively insufficient, we could not reach a completely affirmative conclusion until further studies of high quality are available.
Real-Time Energy Management Control for Hybrid Electric Powertrains
Authors: Zaher Mohamed , Cetinkunt Sabri
Published: May 2013

This paper focuses on embedded control of a hybrid powertrain concepts for mobile vehicle applications. Optimal robust control approach is used to develop a real-time energy management strategy. The main idea is to store the normally wasted mechanical regenerative energy in energy storage devices for later usage. The regenerative energy recovery opportunity exists in any condition where the speed of motion is in the opposite direction to the applied force or torque. This is the case when the vehicle is braking, decelerating, the motion is driven by gravitational force, or load driven. There are three main concepts for energy storing devices in hybrid vehicles: electric, hydraulic, and mechanical (flywheel). The real-time control challenge is to balance the system power demands from the engine and the hybrid storage device, without depleting the energy storage device or stalling the engine in any work cycle. In the worst-case scenario, only the engine is used and the hybrid system is completely disabled. A rule-based control algorithm is developed and is tuned for different work cycles and could be linked to a gain scheduling algorithm. A gain scheduling algorithm identifies the cycle being performed by the work machine and its position via GPS and maps both of them to the gains.
Endocrine Actions of Osteocalcin
Authors: Patti Aurora , Gennari Luigi , Merlotti Daniela , Dotta Francesco , Nuti Ranuccio
Published: May 2013

Osteocalcin is the most abundant noncollagenous protein of bone matrix. Once transcribed, this protein undergoes posttranslational modifications within osteoblastic cells before its secretion, including the carboxylation of three glutamic residues in glutamic acid, which is essential for hydroxyapatite binding and deposition in the extracellular matrix of bone. Recent provocative data from experimental observations in mice showed that the circulating undercarboxylated fraction of osteocalcin increases insulin secretion and sensitivity, lowers blood glucose, and decreases visceral fat in both genders, while it enhances testosterone production by the testes in males. Moreover, both total and undercarboxylated osteocalcins increase following physical activity with potential positive effects on glucose tolerance. Despite that these evidences have been only in part confirmed in humans, further prospective investigations are needed to definitively establish the endocrine role of osteocalcin both in the general population and cohorts of patients with diabetes or other metabolic disorders.
On the Slowly Decreasing Sequences of Fuzzy Numbers
Authors: Talo Özer , Başar Feyzi
Published: May 2013

We introduce the slowly decreasing condition for sequences of fuzzy numbers. We prove that this is a Tauberian condition for the statistical convergence and the Cesáro convergence of a sequence of fuzzy numbers.
On the Weighted Mixed Almost Unbiased Ridge Estimator in Stochastic Restricted Linear Regression
Authors: Liu Chaolin , Yang Hu , Wu Jibo
Published: May 2013

We introduce the weighted mixed almost unbiased ridge estimator (WMAURE) based on the weighted mixed estimator (WME) (Trenkler and Toutenburg 1990) and the almost unbiased ridge estimator (AURE) (Akdeniz and Erol 2003) in linear regression model. We discuss superiorities of the new estimator under the quadratic bias (QB) and the mean square error matrix (MSEM) criteria. Additionally, we give a method about how to obtain the optimal values of parameterskandw. Finally, theoretical results are illustrated by a real data example and a Monte Carlo study.
Esophageal Gastrointestinal Stromal Tumor: Diagnostic Complexity and Management Pitfalls
Authors: Markakis Charalampos G. , Spartalis Eleftherios D. , Liarmakopoulos Emmanouil , Kavoura Evangelia G. , Tomos Periklis
Published: May 2013

Introduction. Gastrointestinal stromal tumors of the esophagus are rare.Case Presentation. This is a case of a 50-year-old male patient who was referred to our department complaining of atypical chest pain. A chest computed tomographic scan and endoscopic ultrasound revealed a submucosal esophageal tumor measuring 5 cm in its largest diameter. Suspecting a leiomyoma, we performed enucleation via right thoracotomy. The pathology report yielded a diagnosis of an esophageal gastrointestinal stromal tumor. The patient has shown no evidence of recurrence one year postoperatively.Conclusions. This report illustrates the complexity and dilemmas inherent in diagnosing and treating esophageal GISTs.
A Perspective on Robotic Assistance for Knee Arthroplasty
Authors: Netravali Nathan A. , Shen Feimo , Park Youngbae , Bargar William L.
Published: May 2013

Knee arthroplasty is used to treat patients with degenerative joint disease of the knee to reduce pain and restore the function of the joint. Although patient outcomes are generally quite good, there are still a number of patients that are dissatisfied with their procedures. Aside from implant design which has largely become standard, surgical technique is one of the main factors that determine clinical results. Therefore, a lot of effort has gone into improving surgical technique including the use of computer-aided surgery. The latest generation of orthopedic surgical tools involves the use of robotics to enhance the surgeons’ abilities to install implants more precisely and consistently. This review presents an evolution of robot-assisted surgical systems for knee replacement with an emphasis on the clinical results available in the literature. Ever since various robotic-assistance systems were developed and used clinically worldwide, studies have demonstrated that these systems are as safe as and more accurate than conventional methods of manual implantation. Robotic surgical assistance will likely result in improved surgical technique and improved clinical results.
Hypoxia Triggers Hedgehog-Mediated Tumor–Stromal Interactions in Pancreatic Cancer
Authors: Spivak-Kroizman Taly R. , Hostetter Galen , Posner Richard , Aziz Meraj , Hu Chengcheng , Demeure Michael J. , Von Hoff Daniel , Hingorani Sunil R. , Palculict Timothy B. , Izzo Julie , Kiriakova Galina M. , Abdelmelek Mena , Bartholomeusz Geoffrey , James Brian P. , Powis Garth
Published: May 2013

Pancreatic cancer is characterized by a desmoplastic reaction that creates a dense fibroinflammatory microenvironment, promoting hypoxia and limiting cancer drug delivery due to decreased blood perfusion. Here, we describe a novel tumor–stroma interaction that may help explain the prevalence of desmoplasia in this cancer. Specifically, we found that activation of hypoxia-inducible factor-1α (HIF-1α) by tumor hypoxia strongly activates secretion of the sonic hedgehog (SHH) ligand by cancer cells, which in turn causes stromal fibroblasts to increase fibrous tissue deposition. In support of this finding, elevated levels of HIF-1α and SHH in pancreatic tumors were determined to be markers of decreased patient survival. Repeated cycles of hypoxia and desmoplasia amplified each other in a feed forward loop that made tumors more aggressive and resistant to therapy. This loop could be blocked by HIF-1α inhibition, which was sufficient to block SHH production and hedgehog signaling. Taken together, our findings suggest that increased HIF-1α produced by hypoxic tumors triggers the desmoplasic reaction in pancreatic cancer, which is then amplified by a feed forward loop involving cycles of decreased blood flow and increased hypoxia. Our findings strengthen the rationale for testing HIF inhibitors and may therefore represent a novel therapeutic option for pancreatic cancer. Cancer Res; 73(11); 3235–47. ©2013 AACR.
Melanoma-Educated CD14+ Cells Acquire a Myeloid-Derived Suppressor Cell Phenotype through COX-2–Dependent Mechanisms
Authors: Mao Yumeng , Poschke Isabel , Wennerberg Erik , Pico de Coaña Yago , Egyhazi Brage Suzanne , Schultz Inkeri , Hansson Johan , Masucci Giuseppe , Lundqvist Andreas , Kiessling Rolf
Published: May 2013

Tumors can suppress the host immune system by employing a variety of cellular immune modulators, such as regulatory T cells, tumor-associated macrophages, and myeloid-derived suppressor cells (MDSC). In the peripheral blood of patients with advanced stage melanoma, there is an accumulation of CD14+HLA-DRlo/− MDSC that suppress autologous T cells ex vivo in a STAT-3–dependent manner. However, a precise mechanistic basis underlying this effect is unclear, particularly with regard to whether the MDSC induction mechanism relies on cell–cell contact of melanoma cells with CD14+ cells. Here, we show that early-passage human melanoma cells induce phenotypic changes in CD14+ monocytes, leading them to resemble MDSCs characterized in patients with advanced stage melanoma. These MDSC-like cells potently suppress autologous T-cell proliferation and IFN-γ production. Notably, induction of myeloid-suppressive functions requires contact or close proximity between monocytes and tumor cells. Further, this induction is largely dependent on production of cyclooxygenase-2 (COX-2) because its inhibition in these MDSC-like cells limits their ability to suppress T-cell function. We confirmed our findings with CD14+ cells isolated from patients with advanced stage melanoma, which inhibited autologous T cells in a manner relying up prostaglandin E2 (PGE2), STAT-3, and superoxide. Indeed, PGE2 was sufficient to confer to monocytes the ability to suppress proliferation and IFN-γ production by autologous T cells ex vivo. In summary, our results reveal how immune suppression by MDSC can be initiated in the tumor microenvironment of human melanoma. Cancer Res; 73(13); 3877–87. ©2013 AACR.
Coevolution of Solid Stress and Interstitial Fluid Pressure in Tumors During Progression: Implications for Vascular Collapse
Authors: Stylianopoulos Triantafyllos , Martin John D. , Snuderl Matija , Mpekris Fotios , Jain Saloni R. , Jain Rakesh K.
Published: May 2013

The stress harbored by the solid phase of tumors is known as solid stress. Solid stress can be either applied externally by the surrounding normal tissue or induced by the tumor itself due to its growth. Fluid pressure is the isotropic stress exerted by the fluid phase. We recently showed that growth-induced solid stress is on the order of 1.3 to 13.0 kPa (10–100 mmHg) – high enough to cause compression of fragile blood vessels, resulting in poor perfusion and hypoxia. However, the evolution of growth-induced stress with tumor progression and its effect on cancer cell proliferation in vivo is not understood. To this end, we developed a mathematical model for tumor growth that takes into account all three types of stresses: growth-induced stress, externally applied stress, and fluid pressure. First, we conducted in vivo experiments and found that growth-induced stress is related to tumor volume through a biexponential relationship. Then, we incorporated this information into our mathematical model and showed that due to the evolution of growth-induced stress, total solid stress levels are higher in the tumor interior and lower in the periphery. Elevated compressive solid stress in the interior of the tumor is sufficient to cause the collapse of blood vessels and results in a lower growth rate of cancer cells compared with the periphery, independently from that caused by the lack of nutrients due to vessel collapse. Furthermore, solid stress in the periphery of the tumor causes blood vessels in the surrounding normal tissue to deform to elliptical shapes. We present histologic sections of human cancers that show such vessel deformations. Finally, we found that fluid pressure increases with tumor growth due to increased vascular permeability and lymphatic impairment, and is governed by the microvascular pressure. Crucially, fluid pressure does not cause vessel compression of tumor vessels. Cancer Res; 73(13); 3833–41. ©2013 AACR.
Growth of Triple-Negative Breast Cancer Cells Relies upon Coordinate Autocrine Expression of the Proinflammatory Cytokines IL-6 and IL-8
Authors: Hartman Zachary C. , Poage Graham M. , den Hollander Petra , Tsimelzon Anna , Hill Jamal , Panupinthu Nattapon , Zhang Yun , Mazumdar Abhijit , Hilsenbeck Susan G. , Mills Gordon B. , Brown Powel H.
Published: May 2013

Triple-negative breast cancers (TNBC) are aggressive with no effective targeted therapies. A combined database analysis identified 32 inflammation-related genes differentially expressed in TNBCs and 10 proved critical for anchorage-independent growth. In TNBC cells, an LPA-LPAR2-EZH2 NF-κB signaling cascade was essential for expression of interleukin (IL)-6, IL-8, and CXCL1. Concurrent inhibition of IL-6 and IL-8 expression dramatically inhibited colony formation and cell survival in vitro and stanched tumor engraftment and growth in vivo. A Cox multivariable analysis of patient specimens revealed that IL-6 and IL-8 expression predicted patient survival times. Together these findings offer a rationale for dual inhibition of IL-6/IL-8 signaling as a therapeutic strategy to improve outcomes for patients with TNBCs. Cancer Res; 73(11); 3470–80. ©2013 AACR.
BMP-6 in Renal Cell Carcinoma Promotes Tumor Proliferation through IL-10–Dependent M2 Polarization of Tumor-Associated Macrophages
Authors: Lee Jae-Ho , Lee Geun Taek , Woo Seung Hyo , Ha Yun-Sok , Kwon Seok Joo , Kim Wun-Jae , Kim Isaac Yi
Published: May 2013

Dysregulated bone morphogenetic proteins (BMP) may contribute to the development and progression of renal cell carcinoma (RCC). Herein, we report that BMP-6 promotes the growth of RCC by interleukin (IL)-10–mediated M2 polarization of tumor-associated macrophages (TAM). BMP-6–mediated IL-10 expression in macrophages required Smad5 and STAT3. In human RCC specimens, the three-marker signature BMP-6/IL-10/CD68 was associated with a poor prognosis. Furthermore, patients with elevated IL-10 serum levels had worse outcome after surgery. Together, our results suggest that BMP-6/macrophage/IL-10 regulates M2 polarization of TAMs in RCC. Cancer Res; 73(12); 3604–14. ©2013 AACR.
Conditional Loss of ErbB3 Delays Mammary Gland Hyperplasia Induced by Mutant PIK3CA without Affecting Mammary Tumor Latency, Gene Expression, or Signaling
Authors: Young Christian D. , Pfefferle Adam D. , Owens Philip , Kuba María G. , Rexer Brent N. , Balko Justin M. , Sánchez Violeta , Cheng Hailing , Perou Charles M. , Zhao Jean J. , Cook Rebecca S. , Arteaga Carlos L.
Published: May 2013

Mutations in PIK3CA, the gene encoding the p110α catalytic subunit of phosphoinositide 3-kinase (PI3K), have been shown to transform mammary epithelial cells (MEC). Studies suggest this transforming activity requires binding of mutant p110α via p85 to phosphorylated YXXM motifs in activated receptor tyrosine kinases (RTK) or adaptors. Using transgenic mice, we examined if ErbB3, a potent activator of PI3K, is required for mutant PIK3CA-mediated transformation of MECs. Conditional loss of ErbB3 in mammary epithelium resulted in a delay of PIK3CAH1047R-dependent mammary gland hyperplasia, but tumor latency, gene expression, and PI3K signaling were unaffected. In ErbB3-deficient tumors, mutant PI3K remained associated with several tyrosyl phosphoproteins, potentially explaining the dispensability of ErbB3 for tumorigenicity and PI3K activity. Similarly, inhibition of ErbB RTKs with lapatinib did not affect PI3K signaling in PIK3CAH1047R-expressing tumors. However, the p110α-specific inhibitor BYL719 in combination with lapatinib impaired mammary tumor growth and PI3K signaling more potently than BYL719 alone. Furthermore, coinhibition of p110α and ErbB3 potently suppressed proliferation and PI3K signaling in human breast cancer cells harboring PIK3CAH1047R. These data suggest that PIK3CAH1047R-driven tumor growth and PI3K signaling can occur independently of ErbB RTKs. However, simultaneous blockade of p110α and ErbB RTKs results in superior inhibition of PI3K and mammary tumor growth, suggesting a rational therapeutic combination against breast cancers harboring PIK3CA activating mutations. Cancer Res; 73(13); 4075–85. ©2013 AACR.
The Increased Risk of Colon Cancer Due to Cigarette Smoking May Be Greater in Women than Men
Authors: Parajuli Ranjan , Bjerkaas Eivind , Tverdal Aage , Selmer Randi , Le Marchand Loïc , Weiderpass Elisabete , Gram Inger T.
Published: May 2013

Background: Smoking is a recently established risk factor for colon cancer. We wanted to explore the hypothesis that women may be more susceptible to smoking-attributed colon cancer than men as one of the possible explanations for the high colon cancer risk of Norwegian women.

Methods: We followed 602,242 participants aged 19 to 67 years at enrollment in 1972–2003, by linkage to national registries through December 2007. We used Cox proportional hazard models to estimate HRs and 95% confidence intervals (CI).

Results: During a mean follow-up of 14 years, altogether 3,998 (46% women) subjects developed colon cancer. Female ever-smokers had a 19% (HR = 1.19, 95% CI = 1.09–1.32) and male ever-smokers an 8% (HR = 1.08, CI = 0.97–1.19) increased risk of colon cancer compared with never smokers. For all the four dose–response variables examined, female ever-smokers in the most exposed category of smoking initiation, (HR = 1.48, 95% CI = 1.21–1.81), of daily cigarette consumption (HR = 1.28, 95% CI = 1.06–1.55), of smoking duration (HR = 1.47, 95% CI = 1.11–1.95), and of pack-years of smoking (HR = 1.33, 95% CI = 1.11–1.57) had a significantly increased risk of more than 20% for colon cancer overall and of more than 40% for proximal colon cancer, compared with never smokers. A test for heterogeneity by gender was statistically significant only for ever smoking and risk of proximal colon cancer (Wald χ2, P = 0.02).

Conclusions: Female smokers may be more susceptible to colon cancer and especially to proximal colon cancer than male smokers.

Impact: Women who smoke are more vulnerable to colon cancer than men. Cancer Epidemiol Biomarkers Prev; 22(5); 862–71. ©2013 AACR.