bluuebunny/crossref_metadata_2025 huggingface dataset:
The effectiveness of a specially designed shoulder chair for closed reduction of acute shoulder dislocation in the emergency department: a randomised control trial
Authors: Chung Josephine Yuen Man , Cheng Chi Hung , Graham Colin A , Rainer Timothy H
Published: October 2012

Study objective

The objective of this study was to demonstrate the effectiveness of a specially designed chair for closed reduction of acute shoulder dislocations.

Method

This was a prospective, non-blinded randomised controlled trial conducted in a university affiliated emergency department (ED). The inclusion criteria were (1) age ≥18 years; (2) anterior or posterior shoulder dislocation without fracture of the surgical neck of the humerus; (3) patient who is able to communicate and cooperate. Participants were randomly assigned using a computer generated random number sequence into one of two groups—either the traditional practice group or Oxford chair group. Administration of intravenous sedation was only permitted in the traditional practice group due to the concerns of sedation use in the sitting position while unsupported on the chair. The primary outcome measure was length of ED stay. The secondary outcome measures were length of time for the procedure, successful reduction rate, levels of pain experienced by patients in different time periods before and after the reduction.

Result

Sixty eligible patients were recruited, 30 in each group. The median lengths of stay in the ED in Oxford chair group (n=30) and traditional method group (n=30) were152 min and 173 min respectively (p=0.183). The median procedure time was 3 min for the Oxford chair group compared to 5 min in the traditional method group (p=0.179). The success rate for the Oxford chair method was 77% (23/30). There were no statistically or clinically significant differences of pain score at any point.

Conclusions

The chair method had a 77% success rate in reducing acute shoulder dislocations without sedation. There was no difference in pain level experienced by patients between the chair method and the traditional method. Patient factors, including patients who have had previous shoulder surgery and patients who have fracture dislocations, contribute to the reduced efficacy of the chair method. It remains possible that the chair method may reduce patient length of stay in the ED in uncomplicated patients.
Sexual activity-related emergency department admissions: eleven years of experience at a Swiss university hospital
Authors: Pfortmueller Carmen Andrea , Koetter Jana Nimia , Zimmermann Heinz , Exadaktylos Aristomenis Konstantinos
Published: October 2012

Principals

Most people enjoy sexual intercourse without complications, but a significant, if small, number need to seek emergency medical help for related health problems. The true incidence of these problems is not known. We therefore assessed all admissions to our emergency department (ED) in direct relation to sexual intercourse.

Methods

All data were collected prospectively and entered into the ED's centralised electronic patient record database (Qualicare, Switzerland) and retrospectively analysed. The database was scanned for the standardised key words: ‘sexual intercourse’ (German ‘Geschlechtsverkehr’) or ‘coitus’ (German ‘Koitus’).

Results

A total of 445 patients were available for further evaluation; 308 (69.0%) were male, 137 (31.0%) were female. The median age was 32 years (range 16–71) for male subjects and 30 years (range 16–70) for female subjects. Two men had cardiovascular emergencies. 46 (10.3%) of our patients suffered from trauma. Neurological emergencies occurred in 55 (12.4%) patients: the most frequent were headaches in 27 (49.0%), followed by subarachnoid haemorrhage (12, 22.0%) and transient global amnesia (11, 20.0%). 154 (97.0%) of the patients presenting with presumed infection actually had infections of the urogenital tract. The most common infection was urethritis (64, 41.0%), followed by cystitis (21, 13.0%) and epididymitis (19, 12.0%). A sexually transmitted disease (STD) was diagnosed in 43 (16.0%) of all patients presenting with a presumed infection. 118 (43.0%) of the patients with a possible infection requested testing for an STD because of unsafe sexual activity without underlying symptoms.

Conclusions

Sexual activity is mechanically dangerous, potentially infectious and stressful for the cardiovascular system. Because information on ED presentation related to sexual intercourse is scarce, more efforts should be undertaken to document all such complications to improve treatment and preventative strategies.
The Einstein–Maxwell-particle system in the York canonical basis of ADM tetrad gravity. Part 3. The post-minkowskian N-body problem, its post-newtonian limit in nonharmonic 3-orthogonal gauges and dark matter as an inertial effect 1This paper is one of three companion papers published in the same issue of Can. J. Phys.
Authors: Alba David , Lusanna Luca
Published: October 2012

We conclude the study of the post-minkowskian (PM) linearization of ADM tetrad gravity in the York canonical basis for asymptotically minkowskian space–times in the family of nonharmonic 3-orthogonal gauges parametrized by the York time 3K(τ, s) (the inertial gauge variable, not existing in Newton gravity, describing the general relativistic remnant of the freedom in clock synchronization in the definition of the shape of the instantaneous 3-spaces as 3-submanifolds of space–time). As matter we consider only N scalar point particles with a Grassmann regularization of the self-energies and with an ultraviolet cutoff making possible the PM linearization and the evaluation of the PM solution for the gravitational field. We study in detail all the properties of these PM space–times emphasizing their dependence on the gauge variable 3K(1) = (1/Δ)3K(1) (the nonlocal York time): Riemann and Weyl tensors, 3-spaces, time-like and null geodesics, red-shift, and luminosity distance. Then we study the post-newtonian (PN) expansion of the PM equations of motion of the particles. We find that in the two-body case at the 0.5PN order there is a damping (or antidamping) term depending only on 3K(1). This opens the possibility of explaining dark matter in Einstein theory as a relativistic inertial effect: the determination of 3K(1) from the masses and rotation curves of galaxies would give information on how to find a PM extension of the existing PN celestial frame used as an observational convention in the 4-dimensional description of stars and galaxies. Dark matter would describe the difference between the inertial and gravitational masses seen in the non-euclidean 3-spaces, without a violation of their equality in the 4-dimensional space–time as required by the equivalence principle.
Individual Roles of Atoms and Ions during Hydrogen Plasma Passivation of Surface Defects on GaN Created by Plasma Etching
Authors: Chen Shang , Ishikawa Kenji , Lu Yi , Kometani Ryosuke , Kondo Hiroki , Tokuda Yutaka , Egawa Takashi , Amano Hiroshi , Sekine Makoto , Hori Masaru
Published: October 2012

In the recovery of photoluminescence intensities for band-edge emissions at around 3.47 eV in the case of gallium nitride (GaN), we have studied the individual roles of hydrogen atoms (H) and hydrogen ions (H
n

+). Surface defects such as nitrogen vacancies created by plasma etching were passivated by H termination. By utilizing hydrogen plasmas, we clarified the recovery efficiency by optical and stoichiometrical improvements with respect to the balance between the fluxes of H and H
n

+. By deflecting H
n

+ by applying an electric field, the efficiency was improved using an identical H dosage, since the simultaneous irradiation of the energetic H
n

+ promoted the desorption of the formed passivated Ga–H bonds.
Study of a-Plane GaN Epitaxial Lateral Overgrowth Using Carbonized Photoresist Mask on r-Plane Sapphire
Authors: Jang Samseok , Lee Dohan , Kwon Jun-hyuck , Kim Sang-il , Yim So young , Lee Jaesang , Park Ji Hun , Byun Dongjin
Published: October 2012

Epitaxial lateral overgrowth (ELO) a-plane GaN samples were successfully grown on masked sapphire (11̄02) substrates using an in-situ carbonized photoresist (PR) mask by a metalorganic chemical vapor deposition (MOCVD) method. The PR masks for the ELO process were prepared using conventional lithography in the form of a stripe with an opening of 4 µm and a period of 12 µm. The stripe-patterned PR was annealed at 1100 °C in a H2 atmosphere. The stripes were aligned parallel to the <11̄00>GaN direction. The ELO process of GaN was strongly dependent on the direction of the stripes. Overall, the PR masks on the r-plane sapphire substrate were carbonized during the heating step before the main growth, so that the carbonized PR mask acted as an ELO mask. The study results confirmed the promising potential of the ELO process using an in-situ carbonized PR mask on r-plane sapphire.
Analyzing and simulating fracture patterns of theran wall paintings
Authors: Shin Hijung , Doumas Christos , Funkhouser Thomas , Rusinkiewicz Szymon , Steiglitz Kenneth , Vlachopoulos Andreas , Weyrich Tim
Published: October 2012

In this article, we analyze the fracture patterns observed in wall paintings excavated at Akrotiri, a Bronze Age Aegean settlement destroyed by a volcano on the Greek island of Thera around 1630 BC. We use interactive programs to trace detailed fragment boundaries in images of manually reconstructed wall paintings. Then, we use geometric analysis algorithms to study the shapes and contacts of those fragment boundaries, producing statistical distributions of lengths, angles, areas, and adjacencies found in assembled paintings. The result is a statistical model that suggests a hierarchical fracture pattern where fragments break into two pieces recursively along cracks nearly orthogonal to previous ones. This model is tested by comparing it with simulation results of a hierarchical fracture process. The model could be useful for predicting fracture patterns of other wall paintings and/or for guiding future computer-assisted reconstruction algorithms.
Short-term complexity indexes of heart period and systolic arterial pressure variabilities provide complementary information
Authors: Porta A. , Castiglioni P. , Rienzo M. Di , Bari V. , Bassani T. , Marchi A. , Takahashi A. C. M. , Tobaldini E. , Montano N. , Catai A. M. , Barbic F. , Furlan R. , Cividjian A. , Quintin L.
Published: October 2012

It is unclear whether the complexity of the variability of the systolic arterial pressure (SAP) provides complementary information to that of the heart period (HP). The complexity of HP and SAP variabilities was assessed from short beat-to-beat recordings (i.e., 256 cardiac beats). The evaluation was made during a pharmacological protocol that induced vagal blockade with atropine or a sympathetic blockade (beta-adrenergic blockade with propranolol or central sympathetic blockade with clonidine) alone or in combination, during a graded head-up tilt, and in patients with Parkinson's disease (PD) without orthostatic hypotension undergoing orthostatic challenge. Complexity was quantified according to the mean square prediction error (MSPE) derived from univariate autoregressive (AR) and multivariate AR (MAR) models. We found that: 1) MSPEMAR did not provide additional information to that of MSPEAR; 2) SAP variability was less complex than that of HP; 3) because HP complexity was reduced by either vagal blockade or vagal withdrawal induced by head-up tilt and was unaffected by beta-adrenergic blockade, HP was under vagal control; 4) because SAP complexity was increased by central sympathetic blockade and was unmodified by either vagal blockade or vagal withdrawal induced by head-up tilt, SAP was under sympathetic control; 5) SAP complexity was increased in patients with PD; and 6) during orthostatic challenge, the complexity of both HP and SAP variabilities in patients with PD remained high, thus indicating both vagal and sympathetic impairments. Complexity indexes derived from short HP and SAP beat-to-beat series provide complementary information and are helpful in detecting early autonomic dysfunction in patients with PD well before circulatory symptoms become noticeable.
TGFβRIIb
Mutations Trigger Aortic Aneurysm Pathogenesis by Altering Transforming Growth Factor β2 Signal Transduction
Authors: Bee Katharine J. , Wilkes David C. , Devereux Richard B. , Basson Craig T. , Hatcher Cathy J.
Published: October 2012

Background—

Thoracic aortic aneurysm (TAA) is a common progressive disorder involving gradual dilation of the ascending and/or descending thoracic aorta that eventually leads to dissection or rupture. Nonsydromic TAA can occur as a genetically triggered, familial disorder that is usually transmitted in a monogenic autosomal dominant fashion and is known as familial TAA. Genetic analyses of families affected with TAA have identified several chromosomal loci, and further mapping of familial TAA genes has highlighted disease-causing mutations in at least 4 genes: myosin heavy chain 11 (
MYH11)
, α-smooth muscle actin (
ACTA2)
, and transforming growth factor β receptors I and II (
TGFβRI
and
TGFβRII
).

Methods and Results—

We evaluated 100 probands to determine the mutation frequency in
MYH11
,
ACTA2
,
TGFβRI
, and
TGFβRII
in an unbiased population of individuals with genetically mediated TAA. In this study, 9% of patients had a mutation in one of the genes analyzed, 3% of patients had mutations in
ACTA2
, 3% in
MYH11
, 1% in
TGFβRII
, and no mutations were found in
TGFβRI.
Additionally, we identified mutations in a 75 base pair alternatively spliced
TGFβRII
exon, exon 1a that produces the TGFβRIIb isoform and accounted for 2% of patients with mutations. Our in vitro analyses indicate that the
TGFβRIIb
activating mutations alter receptor function on TGFβ2 signaling.

Conclusions—

We propose that TGFβRIIb expression is a regulatory mechanism for TGFβ2 signal transduction. Dysregulation of the TGFβ2 signaling pathway, as a consequence of
TGFβRIIb
mutations, results in aortic aneurysm pathogenesis.
Effective Treatment of Edema and Endothelial Barrier Dysfunction With Imatinib
Authors: Aman Jurjan , van Bezu Jan , Damanafshan Amin , Huveneers Stephan , Eringa Etto C. , Vogel Steven M. , Groeneveld A.B. Johan , Vonk Noordegraaf Anton , van Hinsbergh Victor W.M. , van Nieuw Amerongen Geerten P.
Published: October 2012

Background—

Tissue edema and endothelial barrier dysfunction as observed in sepsis and acute lung injury carry high morbidity and mortality, but currently lack specific therapy. In a recent case report, we described fast resolution of pulmonary edema on treatment with the tyrosine kinase inhibitor imatinib through an unknown mechanism. Here, we explored the effect of imatinib on endothelial barrier dysfunction and edema formation.

Methods and Results—

We evaluated the effect of imatinib on endothelial barrier function in vitro and in vivo. In human macro- and microvascular endothelial monolayers, imatinib attenuated endothelial barrier dysfunction induced by thrombin and histamine. Small interfering RNA knock-downs of the imatinib-sensitive kinases revealed that imatinib attenuates endothelial barrier dysfunction via inhibition of Abl-related gene kinase (Arg/Abl2), a previously unknown mediator of endothelial barrier dysfunction. Indeed, Arg was activated by endothelial stimulation with thrombin, histamine, and vascular endothelial growth factor. Imatinib limited Arg-mediated endothelial barrier dysfunction by enhancing Rac1 activity and enforcing adhesion of endothelial cells to the extracellular matrix. Using mouse models of vascular leakage as proof-of-concept, we found that pretreatment with imatinib protected against vascular endothelial growth factor–induced vascular leakage in the skin, and effectively prevented edema formation in the lungs. In a murine model of sepsis, imatinib treatment (6 hours and 18 hours after induction of sepsis) attenuated vascular leakage in the kidneys and the lungs (24 hours after induction of sepsis).

Conclusions—

Thus, imatinib prevents endothelial barrier dysfunction and edema formation via inhibition of Arg. These findings identify imatinib as a promising approach to permeability edema and indicate Arg as novel target for edema treatment.
Barriers to the uptake of eye care services in developing countries: A systematic review of interventions
Authors: Abdullah Khadija Nowaira , Al-Sharqi Omar Zayan , Abdullah Muhammad Tanweer
Published: October 2012

Objective:

This research identifies effective and ineffective interventions for reducing barriers to the uptake of eye care services in developing countries.

Design:

Systematic literature review.

Setting:

Only research studies done in developing countries were included.

Method:

The review is restricted to English-language articles published between 1997 and 2007. It includes studies that reported randomized trials (controlled and uncontrolled) and surveys with some form of outcome measure, with or without process evaluation. The literature search was conducted on six electronic databases. Data were extracted and synthesized using a standard data extraction form. A narrative synthesis was carried out for the purpose of this review. The quality of the included trials was assessed by CRD guidelines and Crombie’s checklist. The applicability of research findings was evaluated by the RE-AIM model.

Results:

One randomized cluster trial and nine surveys were critically appraised. Three multi-faceted interventions were judged effective while another three were found ineffective. Two out of the three effective interventions used service provision and educational input. Two out of the three ineffective interventions also used service provision alongside other methods including screening and counselling. Findings of effective interventions were generalizable.

Conclusion:

The review suggests that eye health education and service provision lessen the barriers to service uptake and increase the uptake of eye care services. The role of counselling and screening services needs further review by large and good-quality studies.
Linking Noncompliant Behaviors and Programmatic Responses
Authors: Guastaferro Wendy P. , Daigle Leah E.
Published: October 2012

Drug courts are charged with positively influencing the behavior of a difficult-to-treat population. Sanctions represent a drug court’s efforts to instill accountability in participants, an important component of behavior modification. This research examined the application of sanctions within a drug court’s proactive supervision model and sanctions matrix. An exploratory analysis of individual-level factors (including risk level, treatment characteristics, and punishment history) that increase the likelihood of receiving a sanction was conducted. Factors related to receiving any type of sanction and a drug sanction, and whether receiving a sanction was related to program retention were examined. Most participants (71%) received a sanction. On average, each participant received 4 sanctions and 259 sanctions were given over a 2-year period. The majority of people (77%) continued to be actively enrolled after receiving a sanction. Practice and policy implications regarding the use of sanctions within the context of offender change are discussed.
Psychometric Properties of a Proposed Short Form of the BASC Teacher Rating Scale–Preschool
Authors: Yanosky Daniel J. , Schwanenflugel Paula J. , Kamphaus Randy W.
Published: October 2012

A 25 item short form of the Behavioral Assessment System for Children (BASC) Teacher Rating Scale–Preschool (TRS-P) was developed by the BASC authors to serve as an emotional/behavioral indicator for an academic intervention study targeting preschool-aged students. The BASC screener is thought to fulfill a need for an abbreviated behavior rating scale for preschool-aged students that teacher’s can complete in a short amount of time. The purpose of the current study is to assess the psychometric properties of the BASC screener. Internal reliability analysis demonstrated remarkably high internal consistency for the screener. Long-term test-retest reliability was found to be acceptable. Furthermore, the construct validity of the screener was investigated using both exploratory and confirmatory factor analysis methods. Results showed that the screener measures three distinct constructs: Social Skills, Attention/Cognition, and Affect. Evidence of convergent/divergent and discriminant validity is provided.
Food Safety for the Solid Organ Transplant Patient
Authors: Obayashi Patricia A. C.
Published: October 2012

Issues regarding food safety are seen increasingly in the news; outbreaks of foodborne illness have been associated with public health concerns ranging from mild illness to death. For the solid organ transplant patient, immunosuppressive and antibacterial drugs, which maintain transplant organ function, can expose the transplant patient to increased risk of foodborne illness from bacteria, viruses, fungi, and parasites. This review article describes the clinical consequences, sources of foodborne illness, and food safety practices needed to minimize risks to the solid organ transplant patient who must take lifelong immunosuppressive drugs. All members of the transplant team share responsibility for education of the solid organ transplant patient in preventing infections. The registered dietitian, as part of the transplant team, is the recognized expert in providing food safety education in the context of medical nutrition therapy to solid organ transplant patients, the patients’ caregivers, and other healthcare providers.
ω-3 Long-Chain Polyunsaturated Fatty Acids and Fatty Acid Desaturase Activity Ratios as Eventual Endophenotypes for ADHD
Authors: Henríquez-Henríquez Marcela , Solari Sandra , Várgas Gisela , Vásquez Luis , Allende Fidel , Castañón S. Carla , Tenorio Marcela , Quiroga Gutiérrez Teresa
Published: October 2012

Objective: Epidemiological studies suggest that long-chain polyunsaturated fatty acids (LC-PUFAs) may be suitable as endophenotypes for ADHD. To be appropriated vulnerability traits, endophenotypes should be altered in unaffected relatives of index cases. Serum profiles of LC-PUFAs in unaffected relatives of ADHD patients remain understudied. The main objective of this study was to compare serum LC-PUFAs in ADHD patients, unaffected relatives of index cases, and general-population unaffected participants. Method: LC-PUFA profiles of 72 participants (27 ADHD patients, 27 unaffected relatives, and 18 general-population participants) were obtained by gas chromatography–mass spectrometry (GC-MS). Groups were compared by parametrical statistics. Results: Unaffected females from the general population presented lower Docosapentaenoic acid (DPA; p = .0012) and a-linolenic acid (ALA; p = .0091) levels compared with ADHD females and unaffected relatives. In addition, docosahexaenoic acid (DHA)/ALA and DHA/DPA ratios, addressing desaturase activity, were significantly lower in ADHD patients and unaffected relatives of ADHD patients in the female-subgroup ( p = .022 and .04, respectively). Conclusion: DHA/ALA, DHA/DPA, serum DPA, and serum ALA may be suitable as endophenotypes for ADHD women.
The ‘when’ of memory: Contemporary memorials to distant and violent pasts
Authors: Bavidge Eleanor
Published: October 2012

In 2006, the Tower of London erected a new memorial to commemorate the victims of the Tower. Previously marketed as a fun-packed revel in the macabre, the memorial sculpture has altered the mood of remembrance at the Tower. The article uses the example of the memorial as an opportunity to explore the ethics and aesthetics that surround contemporary memorializing of violent and distant pasts in relation to tourism.
The Development of a Culturally Relevant, Theoretically Driven HPV Prevention Intervention for Urban Adolescent Females and Their Parents/Guardians
Authors: Brawner Bridgette M. , Baker Jillian L. , Voytek Chelsea D. , Leader Amy , Cashman Rebecca R. , Silverman Randee , Peter Nadja , Buchner Bradley J. , Barnes Christopher A. , Jemmott Loretta S. , Frank Ian
Published: October 2012

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States, accounting for the large majority of cervical cancer and anogenital warts cases. Two HPV vaccines are currently licensed and recommended for women and girls. However, vaccination rates have been suboptimal, with evidence of disparities influencing both uptake and series completion among African American and Hispanic adolescents. There has been a dearth of theory-based, behavioral interventions targeted to prevent HPV infection and increase HPV vaccine uptake among urban adolescents. This article describes the development of two skills-based intervention curricula aimed to increase HPV prevention and vaccination among low-income urban adolescent females 9 to 18 years old. Guided by the theory of planned behavior, elicitation research was conducted to elucidate the social psychological factors that underlie HPV vaccination intentions ( N = 141). The findings were subsequently used to identify theoretical mediators of behavioral change to drive the intervention. Culturally relevant strategies to promote HPV vaccination were translated into the curricula content. Both curricula were designed to motivate and empower participants to reduce risk of being infected with HPV. Targeting theoretical mediators of behavioral change, derived from the voices of the community, may prove to be successful in increasing HPV vaccination and preventing HPV.
Promoting Positive Youth Development and Highlighting Reasons for Living in Northwest Alaska Through Digital Storytelling
Authors: Wexler Lisa , Gubrium Aline , Griffin Megan , DiFulvio Gloria
Published: October 2012

Using a positive youth development framework, this article describes how a 3-year digital storytelling project and the 566 digital stories produced from it in Northwest Alaska promote protective factors in the lives of Alaska Native youth and serve as digital “hope kits,” a suicide prevention approach that emphasizes young people’s reasons for living. Digital stories are short, participant-produced videos that combine photos, music, and voice. We present process data that indicate the ways that digital stories serve as a platform for youth to reflect on and represent their lives, important relationships and achievements. In so doing, youth use the digital storytelling process to identify and highlight encouraging aspects of their lives, and develop more certain and positive identity formations. These processes are correlated with positive youth health outcomes. In addition, the digital stories themselves serve as reminders of the young people’s personal assets—their reasons for living—after the workshop ends. Young people in this project often showed their digital stories to those who were featured positively within as a way to strengthen these interpersonal relationships. Evaluation data from the project show that digital storytelling workshops and outputs are a promising positive youth development approach. The project and the qualitative data demonstrate the need for further studies focusing on outcomes related to suicide prevention.
Sports Specialization in Young Athletes
Authors: Jayanthi Neeru , Pinkham Courtney , Dugas Lara , Patrick Brittany , LaBella Cynthia
Published: October 2012

Context:

Sports specialization is intense training in 1 sport while excluding others. Sports specialization in early to middle childhood has become increasingly common. While most experts agree that some degree of sports specialization is necessary to achieve elite levels, there is some debate as to whether such intense practice time must begin during early childhood and to the exclusion of other sports to maximize potential for success. There is a concern that sports specialization before adolescence may be deleterious to a young athlete.

Evidence Acquisition:

PubMed and OVID were searched for English-language articles from 1990 to 2011 discussing sports specialization, expert athletes, or elite versus novice athletes, including original research articles, consensus opinions, and position statements.

Results:

For most sports, there is no evidence that intense training and specialization before puberty are necessary to achieve elite status. Risks of early sports specialization include higher rates of injury, increased psychological stress, and quitting sports at a young age. Sports specialization occurs along a continuum. Survey tools are being developed to identify where athletes fall along the spectrum of specialization.

Conclusion:

Some degree of sports specialization is necessary to develop elite-level skill development. However, for most sports, such intense training in a single sport to the exclusion of others should be delayed until late adolescence to optimize success while minimizing injury, psychological stress, and burnout.
Resolution of Acute Onset Hemichorea–Hemiballismus After Treatment With Intravenous Tissue Plasminogen Activator
Authors: Mccollum D. , Silvers S. , Dawson S. B. , Barrett K. M.
Published: October 2012

Hyperkinetic movement disorders are uncommon after acute ischemic stroke. Since these movement disorders are rarely the initial manifestation of acute cerebral ischemia, their presence may result in diagnostic uncertainty or it may inappropriately delay intravenous thrombolytic therapy for ischemic stroke. Hemichorea–hemiballism (HC-HB) is one of the more frequently encountered hyperkinetic movement disorders occurring in conjunction with stroke. Although HC-HB may result from a stroke mimic, the acute onset should prompt rapid evaluation and consideration for the presence of stroke along with its time-dependent therapies including recombinant tissue plasminogen activator (rtPA). In this article, we describe a case of a patient with acute cerebral ischemia presenting clinically with HC-HB, who was given intravenous rtPA therapy despite an initially negative, early diffusion-weighted magnetic resonance imaging (MRI). Follow-up brain MRI performed 24 hours after the initiation of thrombolytic therapy confirmed acute infarction in the contralateral striatum. The patient had near-complete resolution of her HC-HB on discharge and had no complications related to the administration of intravenous rtPA.
The hot ductility of Nb/V containing high Al, TWIP steels
Authors: Kang S E , Tuling A , Lau I , Banerjee J R , Mintz B
Published: October 2012

The hot ductility of Nb/V containing high Al, twin induced plasticity (TWIP) steels has been examined over the temperature range 650–1150°C after melting and after ‘solution treatment’. Previous work had shown that the hot ductility is poor for the 1·5 mass-Al, TWIP steel due to precipitation of AlN at the austenite grain boundaries, the depth of the trough being similar to that for an X65 grade pipeline steel but with the trough covering a much wider temperature range. Adding Nb and V made the ductility even worse due to the additional precipitation of NbCN and VN. Very low reduction of area values, 10–20 were obtained in the temperature range 700–900°C. Increasing the cooling rate to the test temperature resulted in even worse ductility. The ductility of these steels after ‘solution treatment’ is similar to that obtained after melting but when the cast was hot rolled followed by ‘solution treatment’ and cooling to the test temperature ductility improved due to grain refinement.
Effects of interface characteristics on mechanical properties of carbon nanotube reinforced polymer composites
Authors: Shojaie M , Golestanian H
Published: October 2012

Carbon nanotubes (CNTs) possess exceptional mechanical properties and are therefore suitable candidates for use as reinforcements in composite materials. To take full advantage of their exceptional properties, load sharing mechanisms needs to be understood in the composite materials. Load transfer in composites is achieved through the fibre/matrix interface. In the present paper, finite element method is used to investigate the effects of interface behaviour on carbon nanotube based composite mechanical properties. The effective nanocomposite mechanical properties are evaluated using a three-dimensional nanoscale representative volume element (RVE). In this RVE approach, a single nanotube and the surrounding polymer matrix are modelled. Two cases of perfect bonding and an elastic interface are considered. In addition, the rule of mixtures relations is used to validate the results of numerical models. The results indicate that mechanical properties of nanocomposite materials are significantly influenced by the interface strength.
Grain interior precipitation and related lamellar forming grain boundary reaction in Ag–Pd–Cu–Au–Zn alloy
Authors: Cho M-H , Kim Y-O , Kwon Y H , Kim H-I , Seol H-J
Published: October 2012

Grain interior precipitation and related lamellar forming grain boundary reaction in an Ag–Pd–Cu–Au–Zn alloy were examined by characterising the hardening behaviour, phase transformations, changes in microstructure and changes in element distribution during aging. The solution treated specimen was composed of the Ag–Au rich α1 matrix and the CuPd β1 particle-like structures of various sizes containing Zn. The α1 phase decomposition into α2 and α3 in the grain interior accompanied the microstructural changes into fine tweed-like structure containing lattice strains in the interphase boundaries, resulting in hardening in the early stage of aging process. The increased lattice strains in the grain interior induced the grain boundary reaction, stimulating the development of coarse lamellar structure composed of the α2 and α3 phases. The increase in volume fraction of the lamellar structure accompanied the decrease in hardness by consuming the dense interphase boundaries of the fine tweed-like structure.
Detection of obstructive sleep apnoea by an electronic nose
Authors: Greulich Timm , Hattesohl Akira , Grabisch Antje , Koepke Janine , Schmid Severin , Noeske Sarah , Nell Christoph , Wencker Marion , Jörres Rudolf A. , Vogelmeier Claus Franz , Köhler Ulrich , Koczulla Andreas Rembert
Published: October 2012

Diagnosis of obstructive sleep apnoea syndrome (OSAS) is technically demanding, cost-intensive and time-consuming. The measurement of volatile organic compounds by an electronic nose is an innovative method that determines distinct molecular patterns of exhaled breath in different patient groups. We addressed the following questions: What is the diagnostic accuracy of an electronic nose in the detection of OSAS and the ability to detect effects of standard therapy in patients with OSAS? Are these results related to changes in distinct markers of airway inflammation and extracellular remodelling?

We included 40 OSAS patients and 20 healthy controls. Exhaled breath of all participants was analysed using the Cyranose 320 electronic nose. Pharyngeal washings were performed to sample the upper airway compartment. For statistical analysis linear discriminant analysis was employed.

We identified a linear discriminant function separating OSAS from control (p<0.0001). The corresponding area under the receiver-operating curve was 0.85 (95% CI 0.75–0.96; sensitivity 0.93 and specificity 0.7). In pharyngeal washing fluids of OSAS patients, we observed higher levels of α1-antitrypsin and markers of extracellular remodelling compared to controls.

The electronic nose can distinguish between OSAS patients and controls with high accuracy.
Noninvasive cardiac output measurements in patients with pulmonary hypertension
Authors: Rich Jonathan D. , Archer Stephen L. , Rich Stuart
Published: October 2012

Pulmonary hypertension (PH) is characterised by a progressive decline in cardiac output (CO) and right heart failure. NICOM® (noninvasive cardiac output monitor) is a bioreactance-based technology that has been broadly validated, but its specific application in right heart failure and PH is unknown.

Cardiac catheterisation was performed in 50 consecutive patients with PH. CO measurements were performed using three different methods (thermodilution, Fick and NICOM) at baseline and after vasodilator challenge. We compared the precision (coefficient of variation) and accuracy of NICOM compared to thermodilution and Fick.

The mean CO (L·min−1) at baseline as measured by the three methods was 4.73±1.15 (NICOM), 5.69±1.74 (thermodilution) and 4.84±1.39 (Fick). CO measured by NICOM was more precise than by thermodilution (3.5±0.3%versus9.6±6.1%, p<0.001). Bland–Altman analyses comparing NICOM to thermodilution and Fick revealed bias and 95% limits of agreement that were comparable to those comparing Fick to thermodilution. All three CO methods detected an increase in CO in response to vasodilator challenge.

CO measuredviaNICOM is precise and reliably measures CO at rest and changes in CO with vasodilator challenge in patients with PH. NICOM may allow for the noninvasive haemodynamic assessment of patients with PH and their response to therapy.
Repeatability and responsiveness of exercise tests in pulmonary arterial hypertension
Authors: Mainguy Vincent , Malenfant Simon , Neyron Anne-Sophie , Bonnet Sébastien , Maltais François , Saey Didier , Provencher Steeve
Published: October 2012

Exercise tolerance in pulmonary arterial hypertension (PAH) is most commonly assessed by the 6-min walk test (6MWT). Whether endurance exercise tests are more responsive than the 6MWT remains unknown.

20 stable PAH patients (mean±sdage 53±15 years and mean pulmonary arterial pressure 44±16 mmHg) already on PAH monotherapy completed the 6MWT, the endurance shuttle walk test (ESWT) and the cycle endurance test (CET) before and after the addition of sildenafil citrate 20 mg three times daily or placebo for 28 days in a randomised double-blind crossover setting. Pre- or post-placebo tests were used to assess repeatability of each exercise test, whereas pre- or post-sildenafil citrate tests were used to assess their responsiveness.

Sildenafil citrate led to placebo-corrected changes in exercise capacity of 18±25 m (p = 0.02), 58±235 s (p = 0.58) and 29±77 s (p = 0.09) for the 6MWT, the ESWT and the CET, respectively. The 6MWT was associated with a lower coefficient of variation between repeated measures (3%versus18%versus13%), resulting in a higher standardised response mean compared with endurance tests (0.72, 0.25 and 0.38 for the 6MWT, the ESWT and the CET, respectively).

The 6MWT had the best ability to capture changes in exercise capacity when sildenafil citrate was combined with patients’ baseline monotherapy, supporting its use as an outcome measure in PAH.
Sleep disordered breathing in patients receiving therapy with buprenorphine/naloxone
Authors: Farney Robert J. , McDonald Amanda M. , Boyle Kathleen M. , Snow Gregory L. , Nuttall R.T. , Coudreaut Michael F. , Wander Theodore J. , Walker James M.
Published: October 2012

Patients using chronic opioids are at risk for exceptionally complex and potentially lethal disorders of breathing during sleep, including central and obstructive apnoeas, hypopnoeas, ataxic breathing and nonapnoeic hypoxaemia. Buprenorphine, a partial μ-opioid agonist with limited respiratory toxicity, is widely used for the treatment of opioid dependency and chronic nonmalignant pain. However, its potential for causing sleep disordered breathing has not been studied.

70 consecutive patients admitted for therapy with buprenorphine/naloxone were routinely evaluated with sleep medicine consultation and attended polysomnography.

The majority of patients were young (mean±sdage 31.8±12.3 years), nonobese (mean±sdbody mass index 24.9±5.9 kg·m−2) and female (60%). Based upon the apnoea/hypopnoea index (AHI), at least mild sleep disordered breathing (AHI ≥5 events·h−1) was present in 63% of the group. Moderate (AHI ≥15– <30 events·h−1) and severe (AHI ≥30 events·h−1) sleep apnoea was present in 16% and 17%, respectively. Hypoxaemia, defined as an arterial oxygen saturation measured by pulse oximetry, of <90% for ≥10% of sleep time, was present in 27 (38.6%) patients.

Despite the putative protective ceiling effect regarding ventilatory suppression observed during wakefulness, buprenorphine may induce significant alterations of breathing during sleep at routine therapeutic doses.
Haemodynamics, exercise capacity and clinical events in pulmonary arterial hypertension
Authors: Savarese Gianluigi , Musella Francesca , D'Amore Carmen , Losco Teresa , Marciano Caterina , Gargiulo Paola , Rengo Giuseppe , Dellegrottaglie Santo , Bossone Eduardo , Leosco Dario , Perrone-Filardi Pasquale
Published: October 2012

The purpose of this study was to clarify whether changes in cardiopulmonary haemodynamics induced by pharmacological therapy correlate with exercise capacity and clinical events in patients with pulmonary arterial hypertension.

16 randomised trials including 2353 patients, followed up for 16.4±10.6 weeks, measuring cardiopulmonary haemodynamics by right heart catheterisation and reporting clinical events were included. Meta-analysis and meta-regression analysis were performed to assess the effects of treatments on clinical events and the relationship between haemodynamic changes (pulmonary artery pressure, pulmonary vascular resistance, cardiac index and right atrial pressure) and clinical events.

Treatments significantly reduced all-cause death (OR 0.5, 95% CI 0.3–0.7; p<0.01), hospitalisation for pulmonary arterial hypertension (OR 0.4, 95% CI 0.2–0.7; p<0.01), initiation of rescue therapy (OR 0.3, 95% CI 0.2–0.6; p<0.01) and the composite outcome (OR 0.3, 95% CI 0.3–0.5; p<0.01). No relationship was found between changes of haemodynamic parameters and clinical events, whereas changes of cardiac index and pulmonary vascular resistance significantly correlated with changes in the 6-min walking distance (r = 0.64, p = 0.03; r = -0.55, p = 0.04, respectively).

In patients with pulmonary arterial hypertension, improvements of cardiopulmonary haemodynamics observed in randomised clinical trials correlate with exercise capacity changes but do not predict clinical events in a short-term follow-up.
A quantitative genetic and epigenetic model of complex traits
Authors: Wang Zhong , Wang Zuoheng , Wang Jianxin , Sui Yihan , Zhang Jian , Liao Duanping , Wu Rongling
Published: October 2012

Background

Despite our increasing recognition of the mechanisms that specify and propagate epigenetic states of gene expression, the pattern of how epigenetic modifications contribute to the overall genetic variation of a phenotypic trait remains largely elusive.

Results

We construct a quantitative model to explore the effect of epigenetic modifications that occur at specific rates on the genome. This model, derived from, but beyond, the traditional quantitative genetic theory that is founded on Mendel’s laws, allows questions concerning the prevalence and importance of epigenetic variation to be incorporated and addressed.

Conclusions

It provides a new avenue for bringing chromatin inheritance into the realm of complex traits, facilitating our understanding of the means by which phenotypic variation is generated.
Genome organization and characteristics of soybean microRNAs
Authors: Turner Marie , Yu Oliver , Subramanian Senthil
Published: October 2012

Background

microRNAs (miRNAs) are key regulators of gene expression and play important roles in many aspects of plant biology. The role(s) of miRNAs in nitrogen-fixing root nodules of leguminous plants such as soybean is not well understood. We examined a library of small RNAs from Bradyrhizobium japonicum-inoculated soybean roots and identified novel miRNAs. In order to enhance our understanding of miRNA evolution, diversification and function, we classified all known soybean miRNAs based on their phylogenetic conservation (conserved, legume- and soybean-specific miRNAs) and examined their genome organization, family characteristics and target diversity. We predicted targets of these miRNAs and experimentally validated several of them. We also examined organ-specific expression of selected miRNAs and their targets.

Results

We identified 120 previously unknown miRNA genes from soybean including 5 novel miRNA families. In the soybean genome, genes encoding miRNAs are primarily intergenic and a small percentage were intragenic or less than 1000 bp from a protein-coding gene, suggesting potential co-regulation between the miRNA and its parent gene. Difference in number and orientation of tandemly duplicated miRNA genes between orthologous genomic loci indicated continuous evolution and diversification. Conserved miRNA families are often larger in size and produce less diverse mature miRNAs than legume- and soybean-specific families. In addition, the majority of conserved and legume-specific miRNA families produce 21 nt long mature miRNAs with distinct nucleotide distribution and regulate a more conserved set of target mRNAs compared to soybean-specific families. A set of nodule-specific target mRNAs and their cognate regulatory miRNAs had inverse expression between root and nodule tissues suggesting that spatial restriction of target gene transcripts by miRNAs might govern nodule-specific gene expression in soybean.

Conclusions

Genome organization of soybean miRNAs suggests that they are actively evolving. Distinct family characteristics of soybean miRNAs suggest continuous diversification of function. Inverse organ-specific expression between selected miRNAs and their targets in the roots and nodules, suggested a potential role for these miRNAs in regulating nodule development.
Reducing confounding and suppression effects in TCGA data: an integrated analysis of chemotherapy response in ovarian cancer
Authors: Hsu Fang-Han , Serpedin Erchin , Hsiao Tzu-Hung , Bishop Alexander JR , Dougherty Edward R , Chen Yidong
Published: October 2012

Background

Despite initial response in adjuvant chemotherapy, ovarian cancer patients treated with the combination of paclitaxel and carboplatin frequently suffer from recurrence after few cycles of treatment, and the underlying mechanisms causing the chemoresistance remain unclear. Recently, The Cancer Genome Atlas (TCGA) research network concluded an ovarian cancer study and released the dataset to the public. The TCGA dataset possesses large sample size, comprehensive molecular profiles, and clinical outcome information; however, because of the unknown molecular subtypes in ovarian cancer and the great diversity of adjuvant treatments TCGA patients went through, studying chemotherapeutic response using the TCGA data is difficult. Additionally, factors such as sample batches, patient ages, and tumor stages further confound or suppress the identification of relevant genes, and thus the biological functions and disease mechanisms.

Results

To address these issues, herein we propose an analysis procedure designed to reduce suppression effect by focusing on a specific chemotherapeutic treatment, and to remove confounding effects such as batch effect, patient's age, and tumor stages. The proposed procedure starts with a batch effect adjustment, followed by a rigorous sample selection process. Then, the gene expression, copy number, and methylation profiles from the TCGA ovarian cancer dataset are analyzed using a semi-supervised clustering method combined with a novel scoring function. As a result, two molecular classifications, one with poor copy number profiles and one with poor methylation profiles, enriched with unfavorable scores are identified. Compared with the samples enriched with favorable scores, these two classifications exhibit poor progression-free survival (PFS) and might be associated with poor chemotherapy response specifically to the combination of paclitaxel and carboplatin. Significant genes and biological processes are detected subsequently using classical statistical approaches and enrichment analysis.

Conclusions

The proposed procedure for the reduction of confounding and suppression effects and the semi-supervised clustering method are essential steps to identify genes associated with the chemotherapeutic response.