bluuebunny/crossref_metadata_2025 huggingface dataset:
An unusual presentation of acquired hypothyroidism: the Van Wyk–Grumbach syndrome
Authors: Baranowski E , Högler W
Published: December 2011

The association in young females of long-standing primary hypothyroidism, isosexual precocious pseudopuberty and multicystic enlarged ovaries was first described in 1960 by Van Wyk and Grumbach. Since then, sporadic case reports have contributed to clarifying the key features of this syndrome. The unique elements that lead to this diagnosis are FSH-dominated sexual precocity combined with a delayed bone age in the presence of hypothyroidism. It is important to recognise this syndrome because initiating simple thyroid hormone replacement completely resolves symptoms and hormone abnormalities, avoiding unnecessary investigations for malignancies or surgical intervention. We describe an 8-year-old girl with autoimmune thyroiditis and severe long-standing hypothyroidism presenting with the clinical features of Van Wyk–Grumbach syndrome, a secondary TSH-secreting adenoma and hyperprolactinaemia. In addition, this girl presented with microcytic anaemia, elevated erythrocyte sedimentation rate (ESR) and two unusual features – a newly developed streaky hyperpigmented skin lesion and parathyroid hormone suppression despite vitamin D deficiency. Thyroxine replacement normalised all hormone abnormalities and shrunk the pituitary adenoma within 9 months, but the new skin lesion persisted. We review the literature and explore the pathophysiology of known and new features that give rise to speculation indicating stimulation of the FSH G protein-coupled receptor by excessive TSH, but LH suppression by hyperprolactinaemia.
Post-receptor IGF1 insensitivity restricted to the MAPK pathway in a Silver–Russell syndrome patient with hypomethylation at the imprinting control region on chromosome 11
Authors: Montenegro Luciana R , Leal Andrea C , Coutinho Debora C , Valassi Helena P L , Nishi Mirian Y , Arnhold Ivo J P , Mendonca Berenice B , Jorge Alexander A L
Published: December 2011

Background

Hypomethylation of the paternal imprinting center region 1 (ICR1) is the most frequent molecular cause of Silver–Russell syndrome (SRS). Clinical evidence suggests that patients with this epimutation have mild IGF1 insensitivity.

Objective

To assess in vitro IGF1 action in fibroblast culture from a patient with SRS and IGF1 insensitivity.

Methods

Fibroblast cultures from one patient with SRS due to ICR1 demethylation and controls were established. The SRS patient has severe growth failure, elevated IGF1 level, and poor growth rate during human recombinant GH treatment. IGF1 action was assessed by cell proliferation, AKT, and p42/44-MAPK phosphorylation. Gene expression was determined by real-time PCR.

Results

Despite normal IGF1R sequence and expression, fibroblast proliferation induced by IGF1 was 50% lower in SRS fibroblasts in comparison with controls. IGF1 and insulin promoted a p42/44-MAPK activation in SRS fibroblasts 40 and 36%, respectively, lower than that in control fibroblasts. On the other hand, p42/44-MAPK activation induced by EGF stimulation was only slightly reduced (75% in SRS fibroblasts in comparison with control), suggesting a general impairment in MAPK pathway with a greater impairment of the stimulation induced by insulin and IGF1 than by EGF. A PCR array analysis disclosed a defect in MAPK pathway characterized by an increase in DUSP4 and MEF2C gene expressions in patient fibroblasts.

Conclusion

A post-receptor IGF1 insensitivity was characterized in one patient with SRS and ICR1 hypomethylation. Although based on one unique severely affected patient, these results raise an intriguing mechanism to explain the postnatal growth impairment observed in SRS patients that needs confirmation in larger cohorts.
Target of Rapamycin (TOR) in Nutrient Signaling and Growth Control
Authors: Loewith Robbie , Hall Michael N
Published: December 2011

TOR (Target Of Rapamycin) is a highly conserved protein kinase that is important in both fundamental and clinical biology. In fundamental biology, TOR is a nutrient-sensitive, central controller of cell growth and aging. In clinical biology, TOR is implicated in many diseases and is the target of the drug rapamycin used in three different therapeutic areas. The yeast Saccharomyces cerevisiae has played a prominent role in both the discovery of TOR and the elucidation of its function. Here we review the TOR signaling network in S. cerevisiae.
Treatment of diffuse coronary artery disease with long lengths (≥30 mm) of intracoronary stents
Authors: Jeong Hong , Luu Jane T. , Minisi Anthony J.
Published: December 2011

The interventional treatment of diffuse coronary artery disease often requires the placement of long lengths of intracoronary stents. We have anecdotally observed that target vessel failure rates seem high in these patients. Therefore, we examined long-term angiographic and clinical outcomes in patients treated with long lengths of intracoronary stent. A total of 312 consecutive patients who received ≥30 mm of stent(s) in a single coronary vessel were identified. Bare metal stents (BMS) were placed in 118 of these patients and drug eluting stents (DES) were used in 175 patients. Nineteen patients who received both BMS and DES were excluded from comparative analysis. The mean number of stents placed was 2.4±0.92 and the mean stent length was 45.7±18.2 mm. For the entire cohort, the restenosis rate was 20.8%. Restenosis rates were significantly higher in the BMS group compared to the DES group (34.7% vs. 11.4%;p<0.0001). The rates of major adverse cardiac events were significantly lower in the DES group compared to the BMS group. In conclusion, the treatment of diffuse coronary artery disease by placement of long lengths of intracoronary stent is a durable therapeutic option when DES are utilized.
The use of intravascular ultrasound (IVUS) for direct portosystemic shunt (DIPS) evaluation
Authors: Krokidis Miltiadis , Hatzidakis Adam
Published: December 2011

A 32-year-old male with Budd-Chiari syndrome secondary to paroxysmal nocturnal haemoglobinuria (PNH) underwent direct portosystemic shunt (DIPS). The procedure was difficult, and after initial attempts without success via the internal jugular vein, a stent was placed with ultrasound (US) guidance via femoral approach. Unfortunately, following these two prolonged DIPS procedures, two weeks apart, the patient developed contrast-induced nephropathy, precluding further use of conventional contrast media and necessitating an alternative imaging modality to assess stent function. Transabdominal US was unable to clearly visualize the stent, so intravascular ultrasound (IVUS) was utilized. Good quality images were obtained and the stent's patency was accurately evaluated, identifying the presence of thrombus and leading to balloon angioplasty and improved flows. IVUS may be useful for DIPS stent evaluation.
Ízstimulációval kiváltott agyi tevékenység funkcionális MR-vizsgálata elhízásban
Authors: Vereczkei András , Szalay Csaba , Aradi Mihály , Schwarcz Attila , Orsi Gergely , Perlaki Gábor , Karádi Zoltán , Németh Lívia , Hanna Sophia , Takács Gábor , Szabó István , Bajnok László , Mohos Elemér , Lénárd László , Dóczi Tamás , Janszky József , Komoly Sámuel , Horváth Örs Péter
Published: December 2011

Absztrakt

Bevezetés: Az elhízásban számos tényező játszik szerepet, ezek között az agy megváltozott működésének is jelentőséget tulajdonítanak. A kutatások egyik fontos területe a táplálkozás és anyagcsere központi szabályozásának vizsgálata, mivel a kapcsolódó betegségek – elhízás, kóros soványság, diabetes mellitus, metabolikus szindróma – a modern társadalmak egészségügyi ellátására egyre növekvő terhet rónak. Az e megbetegedések hátterében álló patofiziológiai elváltozások, de ma még az egészséges szervezet centrális regulációs mechanizmusai sem ismertek kellő mértékben. E működések jobb megértését szolgálják a manapság egyre szélesebb körben alkalmazott funkcionális MR- (fMRI) vizsgálatok. Jelen kísérleteinkben kövér betegek és egészséges kontrollszemélyek ízingerlés kiváltotta agyi fMRI-aktivitásváltozásait tanulmányoztuk. Módszerek: A vizsgálatban 10 elhízott és 10 egészséges, hasonló kor- és nemi megoszlású önkéntes alany vett részt. Az ízingerek a következők voltak: 0,1 M nádcukor (kellemes), 0,5 mM koncentrációjú kinin-hidroklorid (kellemetlen) és vaníliaízesítésű folyékony tápszer (Nutridrink; magas kalóriatartalmú komplex íz). Az ízoldatokat PVC-csövön, 5–5 ml térfogatban juttattuk az alanyok szájüregébe. Öblítésként és semleges ingerként desztillált víz szolgált. A képalkotás során, 3T térerőn, standard Echo Planar Imaging (EPI) szekvenciát alkalmaztunk. Az adatok utófeldolgozása az FMRIB Software Library (FSL) programcsomaggal történt. Eredmények: Az ízingerlés kiváltotta agyi aktiváció jellemzően különbözött a két csoportban. A kövér betegek több kérgi és kéreg alatti struktúrában mutatkozó nagy jelintenzitásával összehasonlítva a kontrollokban kevesebb agyterület mérsékeltebb aktivációját tapasztaltuk. Következtetés: Jelen fMRI-vizsgálataink a kellemes és kellemetlen ízingerek hatására kövérek és egészségesek számos agyterületén létrejövő eltérő aktivációra világítottak rá. Eredményeink alapján a módszer segíthet az elhízás központi idegrendszeri tényezőinek pontosabb megismerésében, és hosszú távon hozzájárulhat hatékonyabb testsúlycsökkentő terápiák kifejlesztéséhez is.
A pancreatopleuralis fistula sikeres konzervatív kezelése
Authors: Sahin-Tóth Gábor , Farkas Gyula , Takács Tamás , Leindler László , Lázár György
Published: December 2011

Absztrakt

A szerzők konzervatív módon sikeresen kezelt esetük kapcsán a pancreatopleuralis fistula (PPF) terápiás stratégiájának lehetőségeit foglalják össze. A PPF ritka szövődménye a krónikus pancreatitisnek. Többnyire alkoholos etiológiára visszavezethető, relapsusban levő pancreatitis talaján jön létre, és dominálóan dyspnoés tüneteket produkál. Diagnózishoz fizikális vizsgálat mellett a mellkasi folyadék laboratóriumi vizsgálatával, illetve képalkotó eljárások segítségével juthatunk. Az ERCP a legfontosabb lépés a PPF diagnózisának felállításában. Gyógyítása során a somatostatin analóg gyógyszeres, az endoscopos kezelés során végzett EST, illetve a ductus Wirsungianus stentelése és a folyamatos enteralis (jejunalis) táplálás együttes hatása vezethet eredményre. E komplex terápia melletti sikertelenség esetén a PPF műtéti megoldása javasolt.
Developing the Plan for Growth to go 'beyond carbon'
Authors: Harman Sir John , Dickie Ian , Raingold Andrew
Published: December 2011

Growing demands on the world’s finite resources will mean that resource efficiency will be one of the key determinants of economic success in the twenty-first century. While markets respond to short-term supply restrictions, they are less effective at anticipating constraints in natural resource stocks. As a result, prudent economic policy would promote low resource consumption as a vital part of securing future competitive advantage. However, what policies are required to enable the transition to a resource-efficient economy? This paper summarises the outcomes of three roundtables with high-level practitioners that examined the challenges faced in three sectors (water, food and materials) to make general conclusions. It argues that as resource efficiency and related innovation increasingly become primary benchmarks of a successful economy, it is clear that the UK needs an industrial strategy to address critical resource challenges and one that goes beyond reducing carbon dioxide emissions.
Assessing aboveground tropical forest biomass using Google Earth canopy images
Authors: Ploton Pierre , Pélissier Raphaël , Proisy Christophe , Flavenot Théo , Barbier Nicolas , Rai S. N. , Couteron Pierre
Published: December 2011

Reducing Emissions from Deforestation and Forest Degradation (REDD) in efforts to combat climate change requires participating countries to periodically assess their forest resources on a national scale. Such a process is particularly challenging in the tropics because of technical difficulties related to large aboveground forest biomass stocks, restricted availability of affordable, appropriate remote‐sensing images, and a lack of accurate forest inventory data. In this paper, we apply the Fourier‐based FOTO method of canopy texture analysis to Google Earth's very‐high‐resolution images of the wet evergreen forests in the Western Ghats of India in order to (1) assess the predictive power of the method on aboveground biomass of tropical forests, (2) test the merits of free Google Earth images relative to their native commercial IKONOS counterparts and (3) highlight further research needs for affordable, accurate regional aboveground biomass estimations. We used the FOTO method to ordinate Fourier spectra of 1436 square canopy images (125 × 125 m) with respect to a canopy grain texture gradient (i.e., a combination of size distribution and spatial pattern of tree crowns), benchmarked against virtual canopy scenes simulated from a set of known forest structure parameters and a 3‐D light interception model. We then used 15 1‐ha ground plots to demonstrate that both texture gradients provided by Google Earth and IKONOS images strongly correlated with field‐observed stand structure parameters such as the density of large trees, total basal area, and aboveground biomass estimated from a regional allometric model. Our results highlight the great potential of the FOTO method applied to Google Earth data for biomass retrieval because the texture–biomass relationship is only subject to 15% relative error, on average, and does not show obvious saturation trends at large biomass values. We also provide the first reliable map of tropical forest aboveground biomass predicted from free Google Earth images.
Can fuel‐reduction treatments really increase forest carbon storage in the western US by reducing future fire emissions?
Authors: Campbell John L , Harmon Mark E , Mitchell Stephen R
Published: December 2011

It has been suggested that thinning trees and other fuel‐reduction practices aimed at reducing the probability of high‐severity forest fire are consistent with efforts to keep carbon (C) sequestered in terrestrial pools, and that such practices should therefore be rewarded rather than penalized in C‐accounting schemes. By evaluating how fuel treatments, wildfire, and their interactions affect forest C stocks across a wide range of spatial and temporal scales, we conclude that this is extremely unlikely. Our review reveals high C losses associated with fuel treatment, only modest differences in the combustive losses associated with high‐severity fire and the low‐severity fire that fuel treatment is meant to encourage, and a low likelihood that treated forests will be exposed to fire. Although fuel‐reduction treatments may be necessary to restore historical functionality to fire‐suppressed ecosystems, we found little credible evidence that such efforts have the added benefit of increasing terrestrial C stocks.
Adult Health Behaviors Over the Life Course by Sexual Orientation
Authors: Boehmer Ulrike , Miao Xiaopeng , Linkletter Crystal , Clark Melissa A.
Published: December 2011

Objectives. We estimated differences in health behaviors among adults by sexual orientation.

Methods. We pooled 4 years of data (2001, 2003, 2005, and 2007) from the California Health Interview Survey. We estimated the frequency of smoking, alcohol use, healthy dietary behaviors, physical activity, and health care utilization, and we used logistic regression modeling to determine the odds of each behavior with increasing age and for 2 age groups: younger than 50 years and 50 years old or older.

Results. At any adult age, lesbians had greater odds of smoking and binge drinking than did heterosexual women, and gay and bisexual men had greater health care utilization than did heterosexual men. Other risk behaviors differed with age.

Conclusions. Some behavioral change interventions should target lesbians, gays, and bisexuals at all ages, whereas other interventions should specifically target individuals at younger ages.
Policy Instruments Used by States Seeking to Improve School Food Environments
Authors: Shroff Monal R. , Jones Sonya J. , Frongillo Edward A. , Howlett Michael
Published: December 2011

US legislatures and program administrators have sought to control the sale of foods offered outside of federally funded meal programs in schools, but little is known about which policies, if any, will prevent obesity in children.

We used a theoretical policy science typology to understand the types of policy instruments used by US state governments from 2001 to 2006. We coded 126 enacted bills and observed several types of instruments prescribed by state legislatures to influence the foods sold in schools and improve the school food environment.

Our study helps to better understand the various instruments used by policymakers and sets the stage to examine the effectiveness of the policy instruments used to prevent obesity.
Outcomes of a Latino Community-Based Intervention for the Prevention of Diabetes: The Lawrence Latino Diabetes Prevention Project
Authors: Ockene Ira S. , Tellez Trinidad L. , Rosal Milagros C. , Reed George W. , Mordes John , Merriam Philip A. , Olendzki Barbara C. , Handelman Garry , Nicolosi Robert , Ma Yunsheng
Published: December 2011

Objectives. We tested the effectiveness of a community-based, literacy-sensitive, and culturally tailored lifestyle intervention on weight loss and diabetes risk reduction among low-income, Spanish-speaking Latinos at increased diabetes risk.

Methods. Three hundred twelve participants from Lawrence, Massachusetts, were randomly assigned to lifestyle intervention care (IC) or usual care (UC) between 2004 and 2007. The intervention was implemented by trained Spanish-speaking individuals from the community. Each participant was followed for 1 year.

Results. The participants’ mean age was 52 years; 59% had less than a high school education. The 1-year retention rate was 94%. Compared with the UC group, the IC group had a modest but significant weight reduction (−2.5 vs 0.63 lb; P = .04) and a clinically meaningful reduction in hemoglobin A1c (−0.10% vs −0.04%; P = .009). Likewise, insulin resistance improved significantly in the IC compared with the UC group. The IC group also had greater reductions in percentage of calories from total and saturated fat.

Conclusions. We developed an inexpensive, culturally sensitive diabetes prevention program that resulted in weight loss, improved HbA1c, and improved insulin resistance in a high-risk Latino population.
Public Health Department Accreditation Implementation: Transforming Public Health Department Performance
Authors: Riley William J. , Bender Kaye , Lownik Elizabeth
Published: December 2011

In response to a call for improved quality and consistency in public health departments, the Public Health Accreditation Board (PHAB) is leading a voluntary public health accreditation initiative in the United States.

The public health department accreditation system will implement a comprehensive set of standards that set uniform performance expectations for health departments to provide the services necessary to keep communities healthy. Continuous quality improvement is a major component of PHAB accreditation, demonstrating a commitment to empower and encourage public health departments to continuously improve their performance.

The accreditation process was tested in 30 health departments around the country in 2009 and 2010, and was launched on a national level in September 2011 at the National Press Club in Washington, DC.
Appealing to Vanity: Could Potential Appearance Improvement Motivate Fruit and Vegetable Consumption?
Authors: Whitehead Ross D. , Ozakinci Gozde , Stephen Ian D. , Perrett David I.
Published: December 2011

Fruit and vegetable consumption is inadequate among adults in the United States; this contributes to preventable morbidity and mortality. More effective dietary intervention strategies are needed.

Recently, interventions that advertise the consequences of behavior for appearance have been successful in modifying sun-exposure habits and tobacco use. Such an approach might also facilitate dietary improvement.

Consumption of carotenoid-rich fruit and vegetables positively affects skin color, which influences perceptions of health and attractiveness, and promoting such an effect may motivate target audiences to increase consumption of this important food group. This approach represents a novel direction for the field and is potentially suitable for cost-effective, population-level dissemination through the visual media.
A Curriculum for the New Dental Practitioner: Preparing Dentists for a Prospective Oral Health Care Environment
Authors: Polverini Peter J.
Published: December 2011

The emerging concept of prospective health care would shift the focus of health care from disease management to disease prevention and health management.

Dentistry has a unique opportunity to embrace this model of prospective and collaborative care and focus on the management of oral health.

Academic dentistry must better prepare future dentists to succeed in this new health care environment by providing them with the scientific and technical knowledge required to understand and assess risk and practice disease prevention. Dental schools must consider creating career pathways for enabling future graduates to assume important leadership roles that will advance a prospective oral health care system.
The possible reduction pathways of 2,4,6-trinitrotoluene (TNT) by sulfide under simulated anaerobic conditions
Authors: Qiao Hua , Feng Hua-jun , Liu Shao-ying , Wang Chao-jun , Zhang Yuan , Gao Yan-ni , Li Wen-bing , Yao Jun , Wang Mei-zhen , Shen Dong-sheng
Published: December 2011

To predict the final fate of 2,4,6-trinitrotoluene (TNT) and its intermediates in an anaerobic fermentative solution containing reduced sulfur species and to provide a basis for the adoption of remediation methods, we investigated the pathways of TNT (TNT0 = 50 mg/L) reduction by Na2S at 30 ± 1 °C in an acetic acid–sodium bicarbonate buffer. Liquid chromatography/mass spectrometry (LC/MS) was used to identify TNT metabolites at different reaction times. The law of growth and decline of TNT and its metabolites was determined with time. The LC/MS result, combined with the physicochemical characteristics of related products and information from the literature, indicated possible TNT conversion pathways. Sulfide can initiate both nitroreduction and denitration of TNT simultaneously. Nitroreduction led to the accumulation of primary intermediates 4-hydroxylaminodinitrotoluene and 4-aminodinitrotoluene, whereas denitration resulted in the production of unidentified substances with molecular weight less than that of TNT. Also, polyreaction between the above intermediates formed many unidentified substances. Humification was concluded to be the best choice for remediation of TNT-contaminated soil and water due to the formation of intermediates with stable, intact aromatic systems. However, the denitration pathway of TNT offered the possibility of mineralization.
Working towards sustainable urban water management: the vulnerability blind spot
Authors: Werbeloff L. , Brown R.
Published: December 2011

The unprecedented water scarcity in Australia coincides with the adoption of a new urban water rhetoric. The ‘Security through Diversity’ strategy has been adopted in a number of Australian cities as a new and innovative approach to urban water management. Although this strategy offers a more holistic approach to urban water management, in practice, the Security through Diversity strategy is largely being interpreted and implemented in a way that maintains the historical dependence on large scale, centralised water infrastructure and therefore perpetuates existing urban water vulnerabilities. This research explores the implementation of Security through Diversity as the new water scarcity response strategy in the cities of Perth and Melbourne. Through a qualitative study with over sixty-five urban water practitioners, the results reveal that the practitioners have absorbed the new Security through Diversity language whilst maintaining the existing problem and solution framework for urban water management. This can be explained in terms of an entrenched technological path dependency and cognitive lock-in that is preventing practitioners from more comprehensively engaging with the complexities of the Security through Diversity strategy, which is ultimately perpetuating the existing vulnerability of our cities. This paper suggests that greater engagement with the underlying purpose of the security though diversity strategy is a necessary first step to overcome the constraints of the traditional technological paradigm and more effectively reduce the continued vulnerability of Australian cities.
Domestic wastewater treatment by a constructed wetland system planted with rice
Authors: Kantawanichkul Suwasa , Duangjaisak Wanida
Published: December 2011

The experiments were conducted in four concrete laboratory scale free water surface constructed wetland units 1 m wide, 1.5 m long and 0.8 m deep. Paddy field soil was added to a depth of 0.4 m and rice seedlings (Oryza sativa L.) were transplanted into the units at a density of 25 plants/m2. Domestic wastewater collected from Chiang Mai University was applied into each unit via two different modes to evaluate suitable conditions for wastewater treatment and rice yield. In the first experiment, the wastewater was fed intermittently (7 h/day) with a hydraulic loading rate of 2, 4, 6 and 8 cm/day. The maximum removal efficiencies for chemical oxygen demand, biological oxygen demand, total kjedahl nitrogen and suspended solids were only 49.1, 58.7, 64.0 and 59.4%, respectively, due to the short hydraulic retention time for the biodegradation of organic substances. In the second experiment, the wastewater in each unit was inundated to a depth of 15 cm for 10, 15, 20 and 25 days in each unit and then drained and re-flooded. Removal efficiencies of chemical oxygen demand, biological oxygen demand, total kjedahl nitrogen and suspended solids were greater than in the first experiment especially at the 25 day retention time and except for suspended solids met the Thai national effluent standard. The study revealed that apart from wastewater treatment, wastewater can replace natural water to grow rice in the dry season or throughout the year. Moreover, nutrients in wastewater can be a substitute for chemical fertilizers. Rice grain production was 4,700 kg/ha and only 6% less than the production from the conventional paddy field.
A two steps solution approach to solving large nonlinear models: application to a problem of conjunctive use
Authors: Vieira J. , Cunha M. C.
Published: December 2011

This article describes a solution method of solving large nonlinear problems in two steps. The two steps solution approach takes advantage of handling smaller and simpler models and having better starting points to improve solution efficiency. The set of nonlinear constraints (named as complicating constraints) which makes the solution of the model rather complex and time consuming is eliminated from step one. The complicating constraints are added only in the second step so that a solution of the complete model is then found. The solution method is applied to a large-scale problem of conjunctive use of surface water and groundwater resources. The results obtained are compared with solutions determined with the direct solve of the complete model in one single step. In all examples the two steps solution approach allowed a significant reduction of the computation time. This potential gain of efficiency of the two steps solution approach can be extremely important for work in progress and it can be particularly useful for cases where the computation time would be a critical factor for having an optimized solution in due time.
Calculation of energy recovery and greenhouse gas emission reduction from palm oil mill effluent treatment by an anaerobic granular-sludge process
Authors: Show K. Y. , Ng C. A. , Faiza A. R. , Wong L. P. , Wong L. Y.
Published: December 2011

Conventional aerobic and low-rate anaerobic processes such as pond and open-tank systems have been widely used in wastewater treatment. In order to improve treatment efficacy and to avoid greenhouse gas emissions, conventional treatment can be upgraded to a high performance anaerobic granular-sludge system. The anaerobic granular-sludge systems are designed to capture the biogas produced, rendering a potential for claims of carbon credits under the Kyoto Protocol for reducing emissions of greenhouse gases. Certified Emission Reductions (CERs) would be issued, which can be exchanged between businesses or bought and sold in international markets at the prevailing market prices. As the advanced anaerobic granular systems are capable of handling high organic loadings concomitant with high strength wastewater and short hydraulic retention time, they render more carbon credits than other conventional anaerobic systems. In addition to efficient waste degradation, the carbon credits can be used to generate revenue and to finance the project. This paper presents a scenario on emission avoidance based on a methane recovery and utilization project. An example analysis on emission reduction and an overview of the global emission market are also outlined.
Degradation of Reactive Brilliant Red X-3B by zero-valent iron/activated carbon system in the presence of microwave irradiation
Authors: Pan Fei , Luo Yin , Zhang Li-Rong , Fu Jie
Published: December 2011

Reactive Brilliant Red X-3B in aqueous solution could be degraded rapidly by zero-valent iron/activated carbon in the presence of microwave irradiation (ZVI/AC/MW). From the analysis of ultraviolet–visible adsorption, chemical oxygen demand, total organic carbon, infrared spectra and capillary electrophoresis, we found the degradation was complete and no intermediates remained in the final solution treated for 2 min. Considering the many advantages including high degradation ratios, short reaction time, low costs, no intermediates and no secondary pollution, this method might be fit for dealing with various azo dye wastewaters on a large scale.
Struvite crystallization versus amorphous magnesium and calcium phosphate precipitation during the treatment of a saline industrial wastewater
Authors: Crutchik D. , Garrido J. M.
Published: December 2011

Struvite crystallization (MgNH4PO4·6H2O, MAP) could be an alternative for the sustainable and economical recovery of phosphorus from concentrated wastewater streams. Struvite precipitation is recommended for those wastewaters which have high orthophosphate concentration. However the presence of a cheap magnesium source is required in order to make the process feasible. For those wastewater treatment plants (WWTP) located near the seashore magnesium could be economically obtained using seawater. However seawater contains calcium ions that could interfere in the process, by promoting the precipitation of amorphous magnesium and calcium phosphates. Precipitates composition was affected by the NH4+/PO43− molar ratio used. Struvite or magnesium and calcium phosphates were obtained when NH4+/PO43− was fixed at 4.7 or 1.0, respectively. This study demonstrates that by manipulating the NH4+/PO43− it is possible to obtain pure struvite crystals, instead of precipitates of amorphous magnesium and calcium phosphates. This was easily performed by using either raw or secondary treated wastewater with different ammonium concentrations.
Beyaz®: An Oral Contraceptive Fortified with Folate
Authors: Fruzzetti Franca
Published: December 2011

Beyaz® (Bayer Healthcare Pharmaceuticals, Berlin, Germany) consists of 28 film-coated tablets: 24 tablets each containing 3 mg drospirenone plus 20 µg ethinylestradiol (EE) and 451 µg levomefolate calcium followed by four tablets, each containing 451 µg levomefolate calcium. It has the same indications of the parent compound 20 µg EE/3 mg drospirenone in a 24/4-day regimen (i.e., contraception, moderate acne, premenstrual dysforic disorder). In addition, the 24-day regimen with 20 µg EE/3 mg drospirenone/levomefolate calcium assure significant increases in red blood cell and plasma folate levels reaching values indicated to be protective in reducing the risk of neural tube defects. A progressive decrease in folate levels has been observed in women taking a 30 µg EE pill fortified with the same dose of levomefolate calcium upon discontinuation. At 4 and 8 weeks following cessation of the oral contraceptive, red blood cell folate levels >906 nmol/l were measured in 85 and 60% of women respectively. Because of this, the folate-containing pill may aid in reducing the risk of neural tube defects in a pregnancy conceived during use or shortly after the discontinuation of the product.
17-α Hydroxyprogesterone Caproate for the Prevention of Preterm Birth
Authors: Gupta Simi , Roman Ashley S
Published: December 2011

17-α hydroxyprogesterone caproate is a synthetic form of the natural progestin 17-α hydroxyprogesterone that is US FDA approved for the prevention of recurrent spontaneous preterm birth in women with a history of a prior singleton preterm birth. For women with a history of a prior spontaneous preterm birth between 20 weeks and 36 weeks and 6 days of gestation, the use of 17-α hydroxyprogesterone caproate has been shown to reduce the risk of recurrent preterm birth by more than 30%. This medication is the only Drug currently FDA approved for the prevention of preterm birth, and it is the first Drug the FDA has approved for use exclusively during pregnancy in approximately 15 years.
Intraoperative Radiotherapy during Breast-Conserving Surgery Using a Miniature X-Ray Generator (Intrabeam®): Theoretical and Experimental Background and Clinical Experience
Authors: Wenz Frederik , Blank Elena , Welzel Grit , Hofmann Frank , Astor Daniela , Neumaier Christian , Herskind Carsten , Gerhardt Axel , Suetterlin Marc , Kraus-Tiefenbacher Uta
Published: December 2011

Breast cancer is currently the most frequent indication for intraoperative radiotherapy with increasing numbers worldwide. Intraoperative radiotherapy can be used as a tumor bed boost followed by whole breast radiotherapy, or as a distinct form of accelerated partial breast irradiation in selected patients. This article summarizes the theoretical background including pattern of recurrence and distribution of tumor cell foci in the breast and discusses the rationale for intraoperative radiotherapy, especially using a miniature x-ray generator (Intrabeam®). The concepts of how to avoid geographic and temporal miss by giving radiotherapy during surgery to the open wound cavity are described. Experimental and clinical experience is presented based on in vitro experiments and more than 300 treated patients in a single department with mature follow-up.
Depression and Stroke Risk
Authors: Caso Valeria , Santalucia Paola , Pezzella Francesca Romana
Published: December 2011

Evaluation of: Pan A, Okereke OI, Sun Q et al. Depression and incident stroke in women. Stroke 42(10), 2770–2775 (2011). In the Nurses' Health Study, 80,574 women aged between 54 and 79 years, without a history of stroke, were followed-up from 2000 to 2006. In this cohort, depressive symptoms were assessed at multiple time points utilizing the Mental Health Index score (1992, 1996 and 2000), and clinically significant depressive symptoms were defined as a score ≤52. A survey was carried out regarding antidepressant medication use biennially beginning in 1996, and physician-diagnosed depression was reported biennially from 2000. During this 6-year follow-up, 1033 incident strokes were documented. Having a history of depression was associated with an increased risk for total stroke, as well as the use of antidepressant medications with or without history of depression.
Accelerated Partial Breast Irradiation in Early Breast Cancer: Focus on Intraoperative Treatment with Electrons (ELIOT)
Authors: Zurrida Stefano , Leonardi Maria Cristina , Del Castillo Andrés , Lazzari Roberta , Arnone Paolo , Caldarella Piero
Published: December 2011

Wide tumor resection plus postoperative whole breast irradiation is standard treatment for early breast cancer. Irradiation decreases recurrence rates, but may cause poor cosmesis, breast pain, and cardiac and lung toxicity. Accelerated partial breast irradiation is increasingly used in the hope of increasing convenience, decreasing sequelae and maintaining cure rates. Intraoperative radiotherapy with electrons is an attractive accelerated partial breast irradiation technique because collimator placement is under the direct control of the surgeon who removes the tumor, the skin is spared, shielding protects the chest wall and complete irradiation can be given in a single intraoperative session (avoiding 5–7 weeks of whole breast irradiation). Intraoperative radiotherapy with electrons seems as safe as whole breast irradiation; however, long-term results on local control and survival are not available yet.
Evaluation of an educational campaign to increase hand hygiene at a small animal veterinary teaching hospital
Authors: Shea Annie , Shaw Scott
Published: December 2011

Objective—To establish baseline data on rates of hand hygiene behavior, evaluate the effectiveness of an educational intervention aimed at improving hand hygiene, and determine whether methods similar to those applied in human hospitals to improve hand hygiene can be successfully applied in a small animal veterinary hospital.

Design—Prospective observational study.

Sample—568 and 187 observations of interactions between small animal patients and veterinary health-care providers before and after, respectively, educational intervention.

Procedures—Proper hand hygiene practices were defined as use of antibacterial foam or hand washing before or after physical interactions between health-care providers (veterinary medical faculty members, residents, interns, students, and technicians) and patients or proper use of gloves. Data were collected by anonymous direct observation. After an initial observation period, a multimodal educational campaign promoted proper hand hygiene with specific attention to increasing use of antibacterial foam. Two months later, data on proper hand hygiene practices after intervention were collected.

Results—At baseline, 117 of 568 (20.6%) interactions met criteria for proper hand hygiene practices; after intervention, a significantly greater proportion (78/187 [41.7%]) of interactions met criteria for proper hand hygiene practices. Use of antibacterial foam significantly increased from 34 of 568 (6.0%) to 67 of 187 (35.8%) interactions. Health-care providers were 4.1 times as likely to wash their hands with soap and water or to use antibacterial foam on their hands after the intervention than before the intervention.

Conclusions and Clinical Relevance—Initial low rates of proper hand hygiene practices at baseline were improved substantially 2 months after implementing a low-cost multimodal educational campaign.
Effects of Griseofulvin in the Treatment of Lichen Planus -A Study in BSMMU
Authors: Sen KG , Hira RM , Islam AZMM , Sarker SK , Sarker MN , Biswas AK
Published: December 2011

Lichen Planus (LP) is an inflammatory disorder of skin, mucous membranes, nails and hair. There are various modalities of treatment but none is curative. This prospective therapeutic trial was done among patients with lichen planus at the outpatient department of Dermatology & Venereology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka between November 2001 and April 2002. Total 20 patients were taken of them 12 were male and 8 were female with male to female ratio 3:2. Age of the patients was between 10 to 50 years. Patients were diagnosed clinically & confirmed histologically. They were treated with griseofulvin 500 mg daily for 6 months. Out of 20 patients, 8 had only oral lesions, of them 2 (25%) showed complete response, 3(37.5%) showed moderate improvement and 4 (37.5%) showed no response. Other 12 patients had lichen planus involving skin without oral mucosa, of them 4 (33.3%) showed moderate improvement, 4 (33.3%) showed no response and 4 (33.3%) patients worsens with treatment. So, success in patients with cutaneous lichen planus is less likely; however, griseofulvin may afford relief in selected patients with oral lesion. This study indicates that further prospective placebo controlled studies are needed to clarify the efficacy of griseofulvin in lichen planus. Key words: Lichen planus; Griseofulvin DOI: http://dx.doi.org/10.3329/fmcj.v6i2.9207 FMCJ 2011; 6(2): 86-88
Improper Inhalation Technique-A Barrier to Good Asthma Control
Authors: Barman RC , Islam MMSU , Saha R , Alam T , Ali SY , Ali MY
Published: December 2011

Bronchial Asthma (BA) is a chronic airway disorder with significant morbidity and mortality but due to recent advances in the field of medicine most patients with BA can have complete symptom control and live a normal life. There are various routs of drug delivery for asthma control but among them aerosol inhalation is considered the optimal route. A number of pressured Metered Dose Inhalers (MDI) & Dry Powder Inhalers (DPI) are available for this purpose. However inhalation of therapeutic aerosols is not without difficulty, it requires precise instructions on the inhaler maneuvers, which is different from spontaneous normal breathing. Also, the characteristics of the inhaler device have to be suitable for the user. Available data indicate that, lack of knowledge demonstrated by health professionals & patients on the inhalation maneuvers & handling of inhalers resulting in a reduction of therapeutic benefit. The paper reviews the literature concerning the fundamental aspects of inhaler devices, inhalation maneuvers & device selection, in an attempt to increase the knowledge of and to optimize the clinical use of therapeutic inhalers. As a result of which Asthmatics can be kept under good control. Key words: Bronchial Asthma; MDI; DPI; Inhalation technique; Rotahaler; Cozyhaler. DOI: http://dx.doi.org/10.3329/fmcj.v6i2.9212 FMCJ 2011; 6(2): 104-106
A Case Report on Unilateral Double Testicles
Authors: Paul AC , Hassan MK , Alam MJ , Biswas SK , Saha AK , Mridha NI
Published: December 2011

A unilateral double testicle is a rare anomaly characterized by migration of one testicle towards the opposite inguinal canal. The commonest erratic development is the more or less incomplete descent of the testicle along the normal route of descent, which is known as cryptorchidism. In ectopia of the testicles, as opposed to cryptorchidism, the displaced testicle does not descend along the usual route but as it migrates downwards it moves into an entirely abnormal position. Usually the migrating testicle remains on its own side of the body but may end up in an unusual position e.g. in the superficial tissue of the inguinal region above the external ring, in the area of the base of the penis, in the upper part of the thigh, in the region of perineum or in the pelvic cavity. In this case, the right and left testicles were found to descend together on the right side, whereas the left side of the scrotum was entirely empty. The case was treated with 'Bilateral Transeptal Subdartos Orchidopexy'. The case reported here is evidently one of extreme rarity as there are about 148 reported cases since the first described by Von Lenhossek in1886. Key words: Cryptorchidism; Testicle; Ectopia; Orchidopexy; CTE. DOI: http://dx.doi.org/10.3329/fmcj.v6i2.9214 FMCJ 2011; 6(2): 110-112
Analysis of a Single-Phase Z-Source Inverter for Battery Discharging in Vehicle to Grid Applications
Authors: Yu Yifan , Zhang Qianfan , Liang Bin , Liu Xiaofei , Cui Shumei
Published: December 2011

Vehicle to Grid technology allows the batteries of electric vehicles to operate as energy storage elements for renewable energy power systems. The Z-Source inverter is a new and attractive topology for the power electronics interface. In this paper, the equivalent DC-link voltage ripple of a single-phase Z-Source inverter for Vehicle to Grid applications is analyzed in this paper before deriving a general design approach for the Z-Source network. These theoretical findings, and design rule for a Z-Source network have been confirmed by computer simulations and a laboratory-implemented prototype.
Tetrodotoxin as a Tool to Elucidate Sensory Transduction Mechanisms: The Case for the Arterial Chemoreceptors of the Carotid Body
Authors: Rocher Asuncion , Caceres Ana Isabel , Obeso Ana , Gonzalez Constancio
Published: December 2011

Carotid bodies (CBs) are secondary sensory receptors in which the sensing elements, chemoreceptor cells, are activated by decreases in arterial PO2 (hypoxic hypoxia). Upon activation, chemoreceptor cells (also known as Type I and glomus cells) increase their rate of release of neurotransmitters that drive the sensory activity in the carotid sinus nerve (CSN) which ends in the brain stem where reflex responses are coordinated. When challenged with hypoxic hypoxia, the physiopathologically most relevant stimulus to the CBs, they are activated and initiate ventilatory and cardiocirculatory reflexes. Reflex increase in minute volume ventilation promotes CO2 removal from alveoli and a decrease in alveolar PCO2 ensues. Reduced alveolar PCO2 makes possible alveolar and arterial PO2 to increase minimizing the intensity of hypoxia. The ventilatory effect, in conjunction the cardiocirculatory components of the CB chemoreflex, tend to maintain an adequate supply of oxygen to the tissues. The CB has been the focus of attention since the discovery of its nature as a sensory organ by de Castro (1928) and the discovery of its function as the origin of ventilatory reflexes by Heymans group (1930). A great deal of effort has been focused on the study of the mechanisms involved in O2 detection. This review is devoted to this topic, mechanisms of oxygen sensing. Starting from a summary of the main theories evolving through the years, we will emphasize the nature and significance of the findings obtained with veratridine and tetrodotoxin (TTX) in the genesis of current models of O2-sensing.
Role of Cereal Secondary Metabolites Involved in Mediating the Outcome of Plant-Pathogen Interactions
Authors: Du Fall Lauren A. , Solomon Peter S.
Published: December 2011

Cereal crops such as wheat, rice and barley underpin the staple diet for human consumption globally. A multitude of threats to stable and secure yields of these crops exist including from losses caused by pathogens, particularly fungal. Plants have evolved complex mechanisms to resist pathogens including programmed cell death responses, the release of pathogenicity-related proteins and oxidative bursts. Another such mechanism is the synthesis and release of secondary metabolites toxic to potential pathogens. Several classes of these compounds have been identified and their anti-fungal properties demonstrated. However the lack of suitable analytical techniques has hampered the progress of identifying and exploiting more of these novel metabolites. In this review, we summarise the role of the secondary metabolites in cereal crop diseases and briefly touch on the analytical techniques that hold the key to unlocking their potential in reducing yield losses.
Convenient Synthesis and Biological Evaluation of Modafinil Derivatives: Benzhydrylsulfanyl and Benzhydrylsulfinyl [1,2,3]triazol-4-yl-methyl Esters
Authors: Jung Jae-Chul , Lee Yeonju , Son Jee-Young , Lim Eunyoung , Jung Mankil , Oh Seikwan
Published: December 2011

Simple synthesis and biological activities of modafinil derivatives are described. The key reactions include condensation of acid and propargyl alcohol, subsequent 1,3-dipolar cycloaddition reaction of alkynes and (3-azido-propyl)cyclohexane or (4-azido-butyl)benzene in the presence of sodium ascorbate and CuSO4·5H2O in excellent yield. They were then evaluated for the suppression of LPS-induced NO generation in vitro. It was found that all compounds showed moderate effects for suppression of LPS-induced NO generation.