bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficient coupling of nanosecond laser pulses with the cluster medium: Generation of hydrogen‐like [C]5+ atomic ions
Authors: Sharma Pramod , Das Soumitra , Vatsa Rajesh K.
Published: December 2014

RATIONALE

Clusters exhibit diverse photochemical behavior as a function of laser parameters, i.e. wavelength, pulse duration and intensity. One such aspect of cluster photochemistry is the generation of energetic multiply charged atomic ions, upon efficient interaction of clusters with intense laser pulses. In the present work, mass spectrometric investigations have been carried out on clusters of tetrahydrofuran (THF, C4H8O) – a saturated cyclic ether – subjected to nanosecond laser pulse (spanning from UV to IR wavelength range) with the aim of shedding light on the complex mechanism of laser‐cluster interactions, which is still ambiguous.

METHODS

THF clusters, generated via supersonic expansion of room‐temperature THF vapours seeded in argon, were subjected to gigawatt intensity laser pulses (355, 532 and 1064 nm) obtained from a nanosecond Nd:YAG laser. The ions generated upon laser‐cluster interaction were characterized using a time‐of‐flight mass spectrometer.

RESULTS

At 355 nm, THF clusters exhibit the usual multiphoton dissociation/ionization behavior while, at 532 nm, observation of multiply charged atomic ions of carbon (up to [C]4+) and oxygen (up to [O]3+) was ascribed to Coulomb explosion of THF clusters. For studies carried out at 1064 nm, multiply charged atomic ions of carbon up to [C]5+ having an ionization energy of ~392 eV were observed, at a laser intensity of 1010 W/cm2.

CONCLUSIONS

The observation of [C]5+ atomic ions signifies efficient coupling of the laser energy with the cluster medium, using a nanosecond laser pulse. The results have been rationalized on the basis of a three‐stage cluster ionization mechanism, suggesting the crucial role of the threshold laser intensity for initiating ionization within the cluster and generation of optimum charge centers for efficient extraction of energy from the laser pulse. Copyright © 2014 John Wiley & Sons, Ltd.
Comparison of peak‐picking workflows for untargeted liquid chromatography/high‐resolution mass spectrometry metabolomics data analysis
Authors: Rafiei Atefeh , Sleno Lekha
Published: December 2014

RATIONALE

Data analysis is a key step in mass spectrometry based untargeted metabolomics, starting with the generation of generic peak lists from raw liquid chromatography/mass spectrometry (LC/MS) data. Due to the use of various algorithms by different workflows, the results of different peak‐picking strategies often differ widely.

METHODS

Raw LC/HRMS data from two types of biological samples (bile and urine), as well as a standard mixture of 84 metabolites, were processed with four peak‐picking softwares: Peakview®, Markerview™, MetabolitePilot™ and XCMS Online. The overlaps between the results of each peak‐generating method were then investigated. To gauge the relevance of peak lists, a database search using the METLIN online database was performed to determine which features had accurate masses matching known metabolites as well as a secondary filtering based on MS/MS spectral matching.

RESULTS

In this study, only a small proportion of all peaks (less than 10%) were common to all four software programs. Comparison of database searching results showed peaks found uniquely by one workflow have less chance of being found in the METLIN metabolomics database and are even less likely to be confirmed by MS/MS.

CONCLUSIONS

It was shown that the performance of peak‐generating workflows has a direct impact on untargeted metabolomics results. As it was demonstrated that the peaks found in more than one peak detection workflow have higher potential to be identified by accurate mass as well as MS/MS spectrum matching, it is suggested to use the overlap of different peak‐picking workflows as preliminary peak lists for more rugged statistical analysis in global metabolomics investigations. Copyright © 2014 John Wiley & Sons, Ltd.
Is It Worth Continuing Sexual Rehabilitation after Radical Prostatectomy with Intracavernous Injection of Alprostadil for More than 1 Year?
Authors: Yiou René , Bütow Zentia , Parisot Juliette , Binhas Michele , Lingombet Odile , Augustin Deborah , de la Taille Alexandre , Audureau Etienne
Published: December 2014

Introduction

Intracavernous alprostadil injection (IAI) is a widely used treatment for sexual rehabilitation (SR) after radical prostatectomy (RP). It is unknown whether the continuation of IAI beyond 1 year continues to improve erectile function.

Aims

To assess evolution of sexual function in patients using IAI who are nonresponsive to phosphodiesterase type 5 inhibitors (PDE5i) between 12 (M12) and 24 (M24) months after RP.

Methods

We retrospectively studied 75 men with a nerve-sparing laparoscopic RP, who had normal preoperative erectile function, and who regularly used IAI for SR for at least 24 months. At M12, no patients had responded to PDE5i.

Main Outcome Measures

At 12 and 24 months, sexual function was assessed with the UCLA Prostate Cancer Index (UCLA-PCI), International Index of Erectile Function (IIEF)-15, and erection hardness score (EHS) with and without IAI. We also assessed the satisfaction rate with IAI, injection-related penile pain, and satisfaction of treatment. Statistical analysis was performed by using t-tests for paired data and Spearman's rho correlation coefficients to assess the relationships between scores at M12 and M24.

Results

Improvement of nocturnal erection was noted (UCLA-PCI, question 25); however, no significant difference was found for IIEF-erectile function with (19.60 ± 9.80 vs. 18.07 ± 10.44) and without IAI (4.63 ± 2.93 vs. 4.92 ± 4.15), UCLA-PCI-sexual bother (37.14 ± 21.45 vs. 37.54 ± 19.67), nor the EHS score with (2.97 ± 1.30 vs. 2.57 ± 1.30) and without IAI (0.67 ± 1.11 vs. 0.76 ± 0.10). The rate of satisfaction with treatment decreased over time (66.6% vs. 46.7%, P = 0.013). Improved response to IAI at M12 was not correlated to improvement in spontaneous erections at M24.

Conclusion

The response to IAI remained stable after 2 years of treatment, and no significant improvement of spontaneous erections during intercourse attempts was found between M12 and M24. Patients should be informed of the limited effect of IAI on natural erections after 1 year.
Expanding Stakeholder Participation in Upfront System Engineering through Storytelling in Virtual Worlds
Authors: Madni* Azad M.
Published: December 2014

Over the last decade, systems engineers have successfully created system modeling languages to communicate with other systems engineers. However, the ability to communicate an evolving system concept and design with stakeholders who are nonengineers remains an elusive goal. In large part, this inability stems from the latter having to understand complex diagrams and equations, and learn new notations employed by systems modeling languages. The problem is further exacerbated by the fact that systems today have to frequently adapt to changing operational and regulatory requirements. Thus, to effectively communicate concepts of operation (CONOPS) and evolving system design to those outside the engineering discipline requires a different approach. This paper presents an innovative approach that employs technical storytelling methods to contextualize and map systems engineering (SE) artifacts represented in SysML to virtual worlds within which various storylines can play out. This capability is intended to improve comprehensibility and transparency of CONOPS and system designs when it comes to communicating with the broader stakeholder community. At the heart of this approach is a virtual world enabled by a 3D game engine, and a mapping capability that allows translation of SE artifacts and interdependencies to virtual world entities and interactions. The key idea behind this integrated capability is to allow the broader stakeholder community to collaborate effectively on key decisions during upfront SE. The benefits of this approach are greater stakeholder satisfaction, avoidance of rework, and more responsive system design.
Attractive holographic c-functions
Authors: Bhattacharyya Arpan , Haque S. Shajidul , Jejjala Vishnu , Nampuri Suresh , Véliz-Osorio Álvaro
Published: December 2014

Abstract

Using the attractor mechanism for extremal solutions in

$$ \mathcal{N}=2 $$

N
=
2

gauged supergravity, we construct a c-function that interpolates between the central charges of theories at ultraviolet and infrared conformal fixed points corresponding to anti-de Sitter geometries. The c-function we obtain is couched purely in terms of bulk quantities and connects two different dimensional CFTs at the stable conformal fixed points under the RG flow.
Displaced vertices from X-ray lines
Authors: Falkowski Adam , Hochberg Yonit , Ruderman Joshua T.
Published: December 2014

Abstract

We present a simple model of weak-scale thermal dark matter that gives rise to X-ray lines. Dark matter consists of two nearly degenerate states near the weak scale, which are populated thermally in the early universe via co-annihilation with slightly heavier states that are charged under the Standard Model. The X-ray line arises from the decay of the heavier dark matter component into the lighter one via a radiative dipole transition, at a rate that is slow compared to the age of the universe. The model predicts observable signatures at the LHC in the form of exotic events with missing energy and displaced leptons and jets. As an application, we show how this model can explain the recently observed 3.55 keV X-ray line.
Operative Procedures in the Elderly in Low‐Resource Settings: A Review of Médecins Sans Frontières Facilities
Authors: Wong Evan G. , Trelles Miguel , Dominguez Lynette , Mupenda Mwania Jerome , Kasonga Tshibangu Cheride , Haq Saqeb Sanaul , Hazrati Khalil U. R. , Gupta Shailvi , Burnham Gilbert , Kushner Adam L.
Published: December 2014

Background

As the demographic transition occurs across developing countries, an increasing number of elderly individuals are affected by disasters and conflicts. This study aimed to evaluate the elderly population that underwent an operative procedure at MSF facilities.

Methods

A retrospective review of prospectively collected operative cases performed at MSF‐Operational Centre Brussels (MSF‐OCB) facilities between June 2008 and December 2012 was completed. Baseline demographic data, American Society of Anesthesiologists (ASA) physical status and surgical indications were collected for each patient. For each procedure, the degree of urgency, anesthesia type, and intra‐operative mortality were noted. All patients aged 50 and over at the time of the procedure were considered elderly, as proposed by the World Health Organization (WHO). Comparisons were made with the 18–49 age group in order to elucidate differences between older and younger individuals.

Results

We reviewed a total of 93,385 procedures performed on 83,911 patients in 21 different countries. Patients aged 50 and over comprised 11.5 % (9,628/83,911) of all patients. While most procedures (57.6 %) in the comparison group were urgent, this proportion decreased substantially in the elderly. Intra‐operative mortality was considerably lower in the 50–59 group (0.12 %) but increased with each age stratum. The most commonly performed surgical procedures in the elderly included herniorrhaphies, simple and extensive wound debridements, abscess incision and drainages, minor tumorectomies, and urological procedures.

Conclusions

In light of the increasing elderly population in developing countries, efforts should be made to better quantify and address their surgical needs.
Emphysematous Gastritis and Gastric Emphysema: Similar Radiographic Findings, Distinct Clinical Entities
Authors: Matsushima Kazuhide , Won Eugene J. , Tangel Matthew R. , Enomoto Laura M. , Avella Diego M. , Soybel David I.
Published: December 2014

Introduction

Despite similar appearances on imaging studies, emphysematous gastritis (EG) and gastric emphysema (GE) are rare clinical entities encountered in surgical practices. The purpose of this review is to clarify the presentation, natural history, and optimal treatment strategies for these two disorders.

Methods

We conducted a comprehensive literature review for reported adult cases of EG and GE in MEDLINE. Two cases from our institution were also included. Patient with demographics, diagnostic and therapeutic data, and outcomes were compared between patients with EG and GE.

Results

A total of 75 cases were included for our review. The finding of intramural air in the stomach was often associated with portal vein gas, pneumatosis intestinalis, or pneumoperitoneum in both groups. Surgical removal of the stomach was performed in 23.1 % of EG patients, but only one patient in the GE group. In the EG group, overall mortality (55 %) appeared to be driven by sepsis and its complications, whereas in the GE group, mortality (29 %) was attributable to comorbid conditions and the underlying illness.

Conclusions

Prompt surgical intervention is more commonly indicated for severe EG and is directed at removal of the septic organ, while the primary indication for surgical intervention in GE is the uncertainty of the diagnosis.
Positron Emission Tomography–Computed Tomography in Oesophageal Cancer Staging: A Tailored Approach
Authors: Bunting David M. , Lai Wesley W. , Berrisford Richard G. , Wheatley Tim J. , Drake Brent , Sanders Grant
Published: December 2014

Background

Positron emission tomography–computed tomography (PET–CT) scanning is used routinely in the staging of oesophageal cancer to identify occult metastases not apparent on CT and changes the management in typically 3–18 % patients. The authors aim to re‐evaluate its role in the management of oesophageal cancer, investigating whether it is possible to identify a group of patients that will not benefit and can safely be spared from this investigation.

Methods

Consecutive patients with oesophageal cancer undergoing PET–CT staging between 2010 and 2013 were identified from a specialist modern multidisciplinary team database. Without knowledge of the PET–CT result, patients were stratified into low‐risk or high‐risk groups according to the likelihood of identifying metastatic disease on PET–CT based on specified criteria routinely available from endoscopy and CT reports. Clinical outcomes in the two groups were investigated.

Results

In 383 undergoing PET–CT, metastatic disease was identified in 52 (13.6 %) patients. Eighty‐three patients were stratified as low risk and 300 as high risk. None of the low‐risk patients went on to have metastatic disease identified on PET–CT. Of the high‐risk patients, 17 % had metastatic disease identified on PET–CT.

Conclusions

In one of the largest studies to date investigating the influence of staging PET–CT on management of patients with oesophageal cancer, the authors report a classification based on endoscopy/CT criteria is able to accurately stratify patients according to the risk of having metastatic disease. This could be used to avoid unnecessary PET–CT 22 % of patients, saving cost, inconvenience and reducing potential delay to definitive treatment in this group.
Radiofrequency Ablation of Benign Symptomatic Thyroid Nodules: Prospective Safety and Efficacy Study
Authors: Ugurlu M. Umit , Uprak Kivilcim , Akpinar Ihsan N. , Attaallah Wafi , Yegen Cumhur , Gulluoglu Bahadir M.
Published: December 2014

Background

Radiofrequency ablation (RFA) is a relatively novel procedure in the management of benign nodular goiter. This study was conducted to evaluate the safety and efficacy of ultrasound (US)‐guided percutaneous RFA for benign symptomatic thyroid nodules as an alternative to surgery.

Methods

The study involved patients for whom a fine needle aspiration biopsy had proved a diagnosis of benign nodular goiter and had nodule‐related symptoms such as dysphagia, cosmetic problems, sensation of foreign body in the neck, hyperthyroidism due to autonomous nodules or fear of malignancy. Percutaneous RFA was performed as an outpatient procedure under local anesthesia. The primary outcome was an evaluation of the changes in symptom scores (0–10) for pain, dysphagia and foreign body sensation at the 1st, 3rd, and 6th months after the RFA procedure. Secondary outcomes were assessing volume changes in nodules, complication rates, and changes in thyroid function status.

Results

A total of 33 patients (24 % female, 76 % male) and a total of 65 nodules were included into the study. More than one nodule was treated in 63.6 % of the patients. We found a statistically significant improvement from baseline to values at the 1st, 3rd, and 6th months, respectively, as follows: pain scores (2.9 ± 2.7, 2.3 ± 2.01, 1.8 ± 1.7, and 1.5 ± 1.2, p 0.005), dysphagia scores (3.9 ± 2.7, 2.6 ± 1.9; 1.7 ± 1.6, and 1.1 ± 0.3, p 0.032), and foreign body sensation scores 3.6 ± 3, 2.5 ± 2.2; 1.6 ± 1.5, and 1.1 ± 0.4, p 0.002).The mean pre‐treatment nodule volume was 7.3 ± 8.3 mL. There was a statistically significant size reduction in the nodules at the 1st, 3rd, and 6th months after RFA (3.5 ± 3.8, 2.7 ± 3.4, and 1.2 ± 1.7 mL, p 0.002). The volume reduction was found to be 74 % at 6th months following the RFA (p 0.005). 8 patients had autonomously functioning nodules in the pre‐treatment period, 50 % (n: 4) became euthyroid at the 6th month after RFA. There were no complaints other than pain (12 %).

Conclusion

RFA can be an alternative treatment modality in the management of benign symptomatic thyroid nodules. The results showed that it is a safe and effective procedure.
A Randomized Controlled Trial Comparing Post‐operative Pain in Single‐Incision Laparoscopic Cholecystectomy Versus Conventional Laparoscopic Cholecystectomy
Authors: Chang Stephen Kin Yong , Wang Yi Liang , Shen Liang , Iyer Shridhar Ganpathi , Madhavan Krishnakumar
Published: December 2014

Introduction

An increasing body of evidence is being published about single‐incision laparoscopic cholecystectomy (SILC), but there are no well‐powered trials with an adequate evaluation of post‐operative pain. This randomized trial compares SILC against four‐port laparoscopic cholecystectomy (LC) with post‐operative pain as the primary endpoint.

Methods

Hundred patients were randomized to either SILC (n = 50) or LC (n = 50). Exclusion criteria were (1) Acute cholecystitis; (2) ASA 3 or above; (3) Bleeding disorders; and (4) Previous open upper abdominal surgery. Patients and post‐operative assessors were blinded to the procedure performed. The site and severity of pain were compared at 4 h, 24 h, 14 days and 6 months post‐procedure using the visual analog scale; non‐inferiority was assumed when the lower boundary of the 95 % confidence interval of the difference was above −1 and superiority when p ≤ 0.05.

Results

The study arms were demographically similar. At 24 h post‐procedure, SILC was associated with less pain at extra‐umbilical sites (rest: p = 0.004; movement: p = 0.008). Pain data were inconclusive at 24 h at the umbilical site on movement; SILC was otherwise non‐inferior for pain at all other points. Operating duration was longer in SILC (79.46 vs 58.88 min, p = 0.003). 8 % of patients in each arm suffered complications (p = 1.000). Re‐intervention rates, analgesic use, return to function, and patient satisfaction did not differ significantly.

Conclusions

SILC has improved short‐term pain outcomes compared to LC and is not inferior in both short‐term and long‐term pain outcomes. The operating time is longer, but remains feasible in routine surgical practice.
Conditional discrimination in Octopus vulgaris
Authors: Tokuda Koji , Masuda Reiji , Yamashita Yoh
Published: December 2014

Conditional discrimination in the octopus (Octopus vulgaris) was studied using successive discrimination training. The experimental animals were divided into two groups, and a barrel-shaped white object (stimulus) was presented to each group. One of the groups was rewarded with food for responding to the stimulus, but only when the tank was aerated, whereas the other group was rewarded with food for responding to the stimulus when the aeration was switched off. The number of trials in which octopuses responded to the stimulus, and the latency of the responses, were significantly different between trials with the aeration on and trials with the aeration off, in both groups. Therefore, the octopuses learned to conditionally discriminate.
Constructing a recombinant hyaluronic acid biosynthesis operon and producing food-grade hyaluronic acid in Lactococcus lactis
Authors: Sheng Juzheng , Ling Peixue , Wang Fengshan
Published: December 2014

Hyaluronic acid (HA), a natural high molecular weight polysaccharide, is produced by Streptococcus zooepidemicus. However, Streptococcus has several drawbacks including its potential to produce exotoxins, so there is demand for an alternative HA source. Here, a recombinant HA biosynthesis operon, as well as the HA biosynthesis operon of S. zooepidemicus were introduced into L. lactis using the nisin-controlled expression system, respectively. HA was successfully synthesized by recombinant L. lactis. Furthermore, overexpression of the endogenous enzymes directing the synthesis of precursor sugars was effective at increasing HA production, and increasing the supply of UDP-activated monosaccharide donors aided synthesis of monodisperse HA polysaccharides. Besides GRAS host strain (L. lactis) and NICE system, the selecting marker (lacF gene) of the recombinant strain is also food grade. Therefore, HA produced by recombinant L. lactis overcomes the problems associated with Streptococcus and provides a source of food-grading HA appropriate for widespread biotechnological applications.
Nichtinvasive Pränataldiagnostik
Authors: Eiben Bernd , Glaubitz Ralf , Kagan Karl Oliver
Published: December 2014

Das Ersttrimesterscreening zur Risikobestimmung für die Trisomien 21, 18 und 13 hat sich in den letzten 15 Jahren in Deutschland etabliert. Die optimale Durchführung setzt die Einhaltung bestimmter Messkriterien beim Ultraschall und bei der biochemischen Analyse voraus sowie die Benutzung evaluierter Risikoberechnungsprogramme wie dem Berechnungsprogramm PRC der Fetal Medicine Foundation Deutschland (FMF-D). Durch die neue Version des Berechnungsprogramms PRC konnten die Trisomie-21-, -18- und -13-Detektionsraten erhöht werden bei gleichzeitiger Senkung der Falsch-positiv-Raten, was einen großen Fortschritt verglichen mit der mütterlichen Altersindikation darstellt.

Durch die Analyse der zellfreien fetalen DNA aus dem mütterlichen Plasma können seit 2 Jahren aber wesentlich bessere Screeningvorhersagen getroffen werden. Über 99 % aller Trisomie-21-Schwangerschaften können mit dieser Methodik als Risikogruppe beschrieben werden. Die Falsch-positiv-Rate liegt unter 1 %. Durch diese Methode ist ein Paradigmenwechsel in der Pränataldiagnostik zu erwarten.
Preventive treatments for breast cancer: recent developments
Authors: Alés-Martínez J. E. , Ruiz A. , Chacón J. I. , Lluch Hernández A. , Ramos M. , Córdoba O. , Aguirre E. , Barnadas A. , Jara C. , González S. , Plazaola A. , Florián J. , Andrés R. , Sánchez Rovira P. , Frau A.
Published: December 2014

Breast cancer is a burden for western societies, and an increasing one in emerging economies, because of its high incidence and enormous psychological, social, sanitary and economic costs. However, breast cancer is a preventable disease in a significant proportion. Recent developments in the armamentarium of effective drugs for breast cancer prevention (namely exemestane and anastrozole), the new recommendation from the National Institute for Health and Care Excellence to use preventative drugs in women at high risk as well as updated Guidelines from the US Preventive Services Task Force and the American Society of Clinical Oncology should give renewed momentum to the pharmacological prevention of breast cancer. In this article we review recent major developments in the field and examine their ongoing repercussion for breast cancer prevention. As a practical example, the potential impact of preventive measures in Spain is evaluated and a course of practical actions is delineated.
China's re-emergence as a global economic power: How should Europe respond?
Authors: Barth Benjamin
Published: December 2014

This article provides an overview of the challenges that the EU is facing due to China's re-emergence as a global economic power. For this purpose, the negotiations for a financial investment agreement provide a backdrop for a discussion of the benefits and disadvantages of closer cooperation with China. The article discusses the contents of the negotiations, the parties involved and the dialogue formats. Moreover, it identifies obstacles to reaching a successful agreement. Based on the analysis, three policy measures are defined that would lay the foundations for a coherent and successful European response to the challenge of a rising China.
Subjektivität und Kausalität in der Migration(sforschung) – Annäherungen an Rationalisierungen von Migrationsentscheidungen in schrumpfenden Regionen
Authors: Meyer Frank , Miggelbrink Judith
Published: December 2014

Based on qualitative research on livescapes in peripheralized regions, claims have surfaced within the recently rejuvenated debate on peripheralization to not only focus on socio-structural aspects of spatial disparities, but also to consider the effects of discursive ascriptions. Using early findings from the research project “Discourse and practices in shrinking regions. An analysis of the subjective relevance of shrinkage discourses using the example of the municipality of Altenburger Land”, we demonstrate how different professionals conceptualize alleged causal relations between financial subsidies for “culture” or “infrastructure” and migration-related decisions. Furthermore, we illuminate their rationalizations of these decisions and take also the subjective aspects of migrations that may contradict their views into consideration. We conclude our chapter with a summary of the important uncertainties in the research of migration as well as regarding the political practice of dealing with migration-related decisions.
Forced Resettlement, Ethnicity, and the (Un)Making of the Ndebele Identity in Buhera District, Zimbabwe
Authors: Musoni Francis
Published: December 2014

This study examines the historical development of hostility between the Shona-speaking inhabitants of Buhera district in south-central Zimbabwe and Ndebele speakers who settled in the area after being forcibly removed from various parts of Matabeleland and Midlands provinces between the 1920s and 1950s. It shows how competition for productive farmlands, which became visible beginning in the 1940s, produced and sustained the Ndebele–Shona hostility in Buhera. While other scholars view this hostility primarily from an ethnic perspective, this article argues that ethnicity was just one of many factors that shaped relations between these people.
The role of endoglin in kidney fibrosis
Authors: Muñoz-Felix Jose M. , Oujo Barbara , Lopez-Novoa Jose M.
Published: December 2014

Tubulointerstitial fibrosis and glomerulosclerosis, are a major feature of end stage chronic kidney disease (CKD), characterised by an excessive accumulation of extracellular matrix (ECM) proteins. Transforming growth factor beta-1 (TGF-β1) is a cytokine with an important role in many steps of renal fibrosis such as myofibroblast activation and proliferation, ECM protein synthesis and inflammatory cell infiltration. Endoglin is a TGF-β co-receptor that modulates TGF-β responses in different cell types. In numerous cells types, such as mesangial cells or myoblasts, endoglin regulates negatively TGF-β-induced ECM protein expression. However, recently it has been demonstrated that ‘in vivo’ endoglin promotes fibrotic responses. Furthermore, several studies have demonstrated an increase of endoglin expression in experimental models of renal fibrosis in the kidney and other tissues. Nevertheless, the role of endoglin in renal fibrosis development is unclear and a question arises: Does endoglin protect against renal fibrosis or promotes its development? The purpose of this review is to critically analyse the recent knowledge relating to endoglin and renal fibrosis. Knowledge of endoglin role in this pathology is necessary to consider endoglin as a possible therapeutic target against renal fibrosis.
Submesoscale baroclinic instability in the balance equations
Authors: Grooms Ian
Published: December 2014

Ocean submesoscale baroclinic instability is studied in the framework of the balance equations. These equations are an intermediate model that includes balanced ageostrophic effects with higher accuracy than the quasigeostrophic approximation, but rules out unbalanced wave motions. As such, the balance equations are particularly suited to the study of baroclinic instability in submesoscale ocean dynamics. The linear baroclinic instability problem is developed in generality and then specialized to the case of constant vertical shear. It is found that non-quasigeostrophic effects appear only for perturbations with cross-front variation, and that perturbation energy can be generated through both baroclinic production and shear production. The Eady problem is solved analytically in the balance equation framework. Ageostrophic effects are shown to increase the range of unstable modes and the growth rate of the instability for perturbations with cross-front variation. The increased level of instability is attributed to both ageostrophic baroclinic production and shear production of perturbation energy; these results are verified in the primitive equations. Finally, submesoscale baroclinic instability is examined in a case where the buoyancy frequency increases rapidly near the bottom boundary, mimicking the increase of stratification at the base of the oceanic mixed layer. The qualitative results of the Eady problem are repeated in this case, with increased growth rates attributed to the production of perturbation energy by the ageostrophic velocity. The results show that submesoscale baroclinic instability acts to reduce lateral buoyancy gradients and their associated geostrophic shear simultaneously through lateral buoyancy fluxes and vertical momentum fluxes.
DATA PROTECTION AND THE RIGHT TO REPUTATION: FILLING THE “GAPS” AFTER THE DEFAMATION ACT 2013
Authors: Erdos David
Published: December 2014

Defamation law has historically occupied a position of overwhelming dominance in the vindication of the traditional right to reputation. Nevertheless, liberalisation of this legal framework including through the Defamation Act 2013 has led to a concern that, when analysed from a fundamental rights perspective, “gaps” in the protection provided for natural persons may have emerged. In this new context, there has been a renewed focus on whether data protection may fill the potential lacunae. Data protection law contains a number of important limitations and exceptions and its jurisprudence has been both limited and sometimes confused. Nevertheless, this article argues that its broad purpose and complex structure ensure it will play a significantly augmented role in the future, especially in actions against website operators facilitating the dissemination of information posted by a third party, the publication of opinion, or where either injunctive relief or the correction of inaccurate information is sought (in particular in cases of continuing online disclosure).
THE GHOST OF THE RULE IN HOLLINGTON v HEWTHORN: EXORCIST REQUIRED
Authors: Spencer J.R.
Published: December 2014

AT an airfield in Dorset, a vintage aircraft took to the air and then – as too often seems to happen – fell out of it. The fatal consequences led to Rogers v Hoyle [2014] EWCA Civ 257, [2014] 3 W.L.R. 145 – proceedings brought on behalf of the dependants of the deceased passenger, Orlando Rogers, against the pilot, Scott Hoyle, whose negligence they claimed had caused the crash. As required by law, the accident had been officially investigated by the Department of Transport's Air Accident Investigation Department (the AAID). Its report contained findings about the cause of the accident which were helpful to the claimants' case, so they sought to adduce it as evidence. To this the defendant objected and sought to persuade the courts to exclude it. That he failed in his attempt is unsurprising because, as Leggatt J. put it at first instance, “If any non lawyer was told that the law does not permit a court to have regard to the AAIB report when deciding how the accident was caused, I am sure that he or she would express astonishment at the suggestion”. But if the sensible outcome was so obvious, why were lengthy judgments at two levels, with over 70 authorities cited and discussed, needed to produce it?
PRESCRIPTIVE ACQUISITION OF RIGHTS OVER PUBLIC AUTHORITY LAND
Authors: Taylor Aaron
Published: December 2014

THE “tripartite” test for the prescriptive acquisition of rights over land, derived from the Roman law of servitudes, has long been a source of confusion. The crucial distinction that underlies it is between use of land that is “as [if] of right” – nec vi, nec clam, nec precario (without force, stealth, or licence) – and use that is “by right” – that is, with a licence. This distinction has been affirmed by the Supreme Court in R. (Barkas) v North Yorkshire County Council & Another [2014] UKSC 31. The court held that use of land pursuant to a statutory entitlement is necessarily use “by right”, and so was not “as of right”.
THE UNCHANGING “DEBENTURE”
Authors: Tjio Hans
Published: December 2014

THE English Court of Appeal in Fons Hf v Corporal Ltd. [2014] EWCA Civ 304 has recently confirmed that the phrase “debenture” when used in a charge agreement should be given its ordinary wide meaning. Some caution should be attached to this holding. Although the word “debenture” commonly appears in legislation or in private contractual documents, the precise meaning that should be ascribed to the word varies with the context. But, if the decision in Fons can be taken as laying down a general definition of “debenture”, then it seems that any contract or legislative drafter seeking to give it a narrower meaning would have to provide specifically for that.
ENGLAND'S UNIQUE APPROACH TO THE SELF-REGULATION OF THIRD PARTY FUNDING: A CRITICAL ANALYSIS OF RECENT DEVELOPMENTS
Authors: Mulheron Rachael
Published: December 2014

Third Party Funding is governed by a unique and unparalleled legal framework in English law. That framework consists of: the recent 2014 Code of Conduct for Litigation Funders, its supervision by the Association of Litigation Funders, and sporadic judicial oversight of Litigation Funding Agreements – and with some unenacted legislation in the background for good measure. The purpose of this article is to analyse and critique this unique regulatory regime in several key respects. These include: the capital adequacy required of Funders; the key anti-champerty factors either judicially stipulated or contained within the 2014 Code; the efficacy and fairness of the so-called “Arkin cap”; the grounds upon which a Funder may legitimately withdraw funding; and the impact of recent contingency fee reforms. Overall, Third Party Funding represents an evolving and controversial landscape, both legally and politically.
Disability and Survival of Multiple Sclerosis in Saskatoon, Saskatchewan
Authors: Hader Walter J.
Published: December 2014

Background:

A population-based prevalent group of 150 clinical definite patients ascertained on 1 January 1977, in Saskatoon, Saskatchewan, was followed for 30 years.

Objectives:

To outline the clinical characteristics, determine the levels of disability at 15, 25, 35, 40, and 45 years after onset, to estimate the survival after onset and life expectancy.

Methods:

Clinical records were maintained, and the cohort reviewed each decade for 30 years. The disability levels according to the Kurtzke Extended Disability Status Scale were recorded and survival times were estimated. SPSS and Kaplan-Meier methods were used for analysis.

Results:

On prevalence day, 1 January 1977, there were 48(32%) men and 102(68%) women, with an average age of onset of 32.2±10 years and 28.4±8.6 years. The average duration of disease was 15.7 years. On 1 January 2007, 39(26%) patients were living, 105(70%) deceased, and 6(4%) were missing The disability levels recorded in 1977 and 2007, at 15 and 45 years after onset, were mild (EDSS≤2.5), 33.3% and 8.0%; moderate (EDSS3-5.5), 17.3% and 2.7%; severe (EDSS6-7.5), 6.6% and 4.7%; maximum (EDSS8-9.5), 22.7% and 10.7%. The median survival time after onset was 33 (95% CI: 27.3-38.6) years for men and 38 (95% CI: 34.1-41.9) years for women. The median duration of life was 68.9 years for men and 69.5 years for women, and a decreased life expectancy of 7.7 and 12.8 years.

Conclusions:

Multiple sclerosis is a progressive neurological disorder and long-term survival is associated with moderate to severe disability and decreased life expectancy.
External Ventricular Drains and Mortality in Patients with Severe Traumatic Brain Injury
Authors: Griesdale Donald E. G. , McEwen Jonathan , Kurth Tobias , Chittock Dean R.
Published: December 2014

Purpose:

To determine our institutional adherence to the Brain Trauma Foundation guidelines with respect to intracranial pressure (ICP) monitoring, and examine the relationship between external ventricular drain (EVD) use and mortality.

Materials & Methods:

Retrospective cohort study of 171 patients with severe traumatic brain injury (TBI). Propensity score adjusted logistic regression was used to model the association between EVD use and mortality.

Results:

EVDs were inserted in 98 of 171 patients. Of the 73 patients without an EVD, 63 (86%) would have qualified for ICP monitoring under the current guidelines. EVDs werein situfor a median of 8 days (SD 6). In adjusted analyses, EVD use was associated with hospital mortality (OR 2.8, 95% CI: 1.1 - 7.1, p=0.04) and 28-day mortality (OR 2.1, 95% CI: 0.80 - 5.6, p=0.13). We observed significant modification of the association between EVD and 28-day mortality by GCS within 12 hours (p-interaction = 0.04), indicating strong association only among those patients with GCS score of at least 6 (OR 5.0, 95% CI: 1.5 - 16.7, p<0.01).

Conclusions:

The association of EVD with 28-day mortality was only apparent among patients with GCS score of ≥ 6. Further research is warranted to further refine which patients may benefit from ICP monitoring.
Prevalence of Mental Disorders in a Canadian Household Population with Dementia
Authors: Nabalamba Alice , Patten Scott B.
Published: December 2014

Background:

Medical and mental health comorbidity in Alzheimer's disease and other dementias presents difficult challenges for health service delivery. However, existing studies have been conducted in clinical samples and may not be informative for planning community services. The Canadian Community Health Survey (CCHS) provides an opportunity to characterize associations between dementias and mental and physical comorbidity in a household population aged 55 and over.

Methods:

Data were obtained from the 2005 CCHS-cycle 3.1. Weighted estimates for mood and anxiety disorders and other characteristics in Canadian population with dementia were calculated and were compared to those in people without the condition.

Results:

According to the CCHS, the prevalence of Alzheimer's disease and other dementia increases with age, more or less doubling every decade. The increase among women is monotonic, whereas among men in the household population the rate of dementia peaks at age 85-89 and falls thereafter. Mood and anxiety disorders were found to be substantially more frequent among people with Alzheimer's disease and other forms of dementia compared to those without the disease (mood disorders: 19.5% vs. 5.3% and anxiety disorders: 16.3% vs. 4.0%). Heart disease, stroke and obesity were associated with dementia as was a lower level of education. Furthermore, people with dementia were more likely than those without the disease to report activity restrictions.

Conclusions:

The high prevalence of mood and anxiety disorders in household population with Alzheimer's disease and other dementia demonstrates the burden of disease that is likely to worsen quality of life over time.
Neuropathology in Canada: Overview of Development and Current Status
Authors: Del Bigio Marc R. , Johnson Edward S.
Published: December 2014

Background:

The expansion of neurosurgery and neurology in Montreal and Toronto in the early 20th century was the stimulus for the development of neuropathology in Canada. Rooted in the disciplines of the neurosciences and laboratory medicine, neuropathology evolved into an independent discipline with the founding of the Canadian Association of Neuropathologists in 1960, and the recognition as a specialty by the Royal College of Physicians and Surgeons in Canada in 1965, fostering the development of several successful training programs. Nonetheless, a paucity of data remains concerning the background of training, scopes of practice, and career paths.

Method:

We conducted a survey of all physicians in Canada who have either practiced neuropathology or undergone relevant training.

Results:

In 2009, 53 physicians were engaged in the practice of neuropathology, either exclusively or a substantial proportion of their time. Most work in tertiary hospitals, but a few service non-academic medical centers. Three routes of training were identified: direct from medical school (often with relevant research training), indirect from another clinical neuroscience specialty, and following or in conjunction with certification in one of the other pathology specialties. Practice profiles differ slightly, and some of the neuropathologists entering from pathology have mixed anatomical pathology/neuropathology responsibilities. Many of those with prior exposure in the neurosciences are more productive with regard to research and publications.

Conclusions:

Existing multiple options for neuropathology training have facilitated recruitment and allowed development of a mosaic of specialists able to fulfill the diversity of needs in Canadian medical and scientific communities.
Intra-Arterial vs Intra-Venous Thrombolysis for Anterior Cerebral Occlusion
Authors: Zhang Bin , Sun Xiaojiang , Li Minghua , Wang Feng , Xu Dan , Duan Hao , Fang Chun
Published: December 2014

Background:

The safety and effectiveness of intra-arterial thrombolysis (IAT) in comparison to intravenous thrombolysis (IVT) for the treatment of ischemic stroke is uncertain. Our study aims to assess and compare IAT to IVT for clinically relevant outcomes in patients with occlusion of the anterior cerebral circulation.

Methods:

Patients with acute ischemic stroke were enrolled for either treatment; those whose symptoms occurred within 4.5 hrs after stroke were treated with IVT, whereas those who presented <4.5 hrs but had contraindications to IVT or presented between 4.5 and 6 hrs were treated with IAT. Evaluated endpoints included: disability at 90 days as measured by the modified Rankin Scale (mRS), incidence of mortality, and incidence of symptomatic intracranial haemorrhage.

Results:

78 patients with anterior cerebral circulation occlusion were included in the study (55 in IVT, 23 in IAT). After 90 days, 82.6% patients treated with IAT reached independence in comparison to 56.4% in the IVT group (P=0.028, RR=2.66, 95% CI: 1.10-7.04). The incidence of all intracranial haemorrhages in the IAT and IVT groups respectively were 30.4% and 12.7% (P=0.103, RR=2.391, 95% CI: 0.946-6.047); symptomatic intracranial haemorrhage occurred in 8.7% and 9.1% of patients (P=1.00, RR= 0.957, 95% CI: 0.200-4.579), and mortality in 8.7% and 16.4% (P=0.492, RR=1.882, 95% CI: 0.440-8.045).

Conclusion:

Results suggest that IAT is more effective than IVT in allowing patients to achieve independence. While inconclusive, the safety of IAT within 6 hrs is comparable to IVT within 4.5 hrs.
Risk of Multiple Sclerosis after Idiopathic Optic Neuritis in a Pakistani Population
Authors: Kazim Syed Faraz , Islam Muhammad , Khan Mustafa , Hameed Bilal , Shafqat Saad
Published: December 2014

Background and objective:

Optic neuritis (ON) is associated with a 38% ten-year risk of developing multiple sclerosis (MS) in Western populations, but the corresponding risk in non-Western populations is unclear. We conducted this study to estimate the risk of progression to MS after an episode of ON in a South Asian population.

Methods:

Two hundred and fifty-three patients with idiopathic ON were identified by reviewing records of visual evoked potentials and chart notes from a single academic center spanning the years 1990-2007. A structured telephone interview was then conducted to identify patients who had subsequently received a diagnosis of MS. The diagnosis was corroborated from chart notes, where possible. Cumulative probability of conversion to MS was calculated using Kaplan-Meier survival analysis.

Results:

The five-year risk of developing MS was 14.6% and the ten-year risk was 24%. Patients (N=218) who had one or more typical demyelinating lesions on baseline brain magnetic resonance imaging (MRI) had a 68% 10-year risk; those with no lesions or non-typical lesions had a 14% risk (p<0.001). Female gender, recurrent ON, and occurrence of ON in winter months were also associated with increased risk (p≤ 0.001). Severity of ON and likelihood of detecting cerebrospinal fluid (CSF) oligoclonal bands were higher in patients who developed MS.

Conclusion:

Idiopathic ON in Pakistan carries a lower risk of progression to MS compared with Western data. As in Western populations, however, presence of abnormal baseline brain MRI and CSF oligoclonal bands correlate with increased MS risk.
Microembolic Signals in Patients with Systemic Lupus Erythematosus
Authors: Azarpazhooh Mahmoud Reza , Mokhber Naghmeh , Orouji Elias , Chambers Brian R. , Hatef Mohammad Reza , Rezaieyazdi Zahra , Sedighi Sima , Foroghipoor Mohsen , Velayati Arash , Gharavi Morteza Modares
Published: December 2014

Introduction:

Central nervous system (CNS) involvement is a common and less understood aspect of systemic lupus erythematosus (SLE). Microembolic signals (MES) have been reported in SLE. We conducted a prospective study to evaluate the frequency of MES among patients with CNS involvement and those without. The main aim of the study is to clarify the pathophysiology of the CNS involvement in SLE.

Methods and Materials:

Sixty eight patients with a diagnosis of SLE (60 females, 8 males) participated in the study. Both middle cerebral arteries were monitored using transcranial Doppler for 60 min to detect MES. All cases underwent neurology and psychiatry assessments.

Results:

MES were detected in 7/68 patients (10.3%) with the mean number of 3.5 per hour. MES were significantly higher in patients with CNS involvement (6/24, 25%) than those without (1/44, 2.2%) (P=0.006). SLE disease activity index, duration of disease, plaque formation, intima-media thickness, and antiphospholipid antibodies were not associated with MES. MES were more frequent in patients receiving Aspirin and/or Warfarin (p=0.02).

Conclusions:

MES may be a predictor for CNS involvement in SLE patients at risk for neuropsychiatric syndromes. Cerebral embolism may be implicated in the pathophysiology of neuropsychiatric SLE.