bluuebunny/crossref_metadata_2025 huggingface dataset:
Hydrogen-rich saline alleviates early brain injury via reducing oxidative stress and brain edema following experimental subarachnoid hemorrhage in rabbits
Authors: Zhuang Zong , Zhou Meng-liang , You Wan-chun , Zhu Lin , Ma Chi-yuan , Sun Xue-jun , Shi Ji-xin
Published: May 2012

Background

Increasing experimental and clinical data indicate that early brain injury (EBI) after subarachnoid hemorrhage (SAH) largely contributes to unfavorable outcomes, and it has been proved that EBI following SAH is closely associated with oxidative stress and brain edema. The present study aimed to examine the effect of hydrogen, a mild and selective cytotoxic oxygen radical scavenger, on oxidative stress injury, brain edema and neurology outcome following experimental SAH in rabbits.

Results

The level of MDA, caspase-12/3 and brain water content increased significantly at 72 hours after experimental SAH. Correspondingly, obvious brain injury was found in the SAH group by terminal deoxynucleotidyl transferase-mediated uridine 5’-triphosphate-biotin nick end-labeling (TUNEL) and Nissl staining. Similar results were found in the SAH + saline group. In contrast, the upregulated level of MDA, caspase-12/3 and brain edema was attenuated and the brain injury was substantially alleviated in the hydrogen treated rabbits, but the improvement of neurology outcome was not obvious.

Conclusion

The results suggest that treatment with hydrogen in experimental SAH rabbits could alleviate brain injury via decreasing the oxidative stress injury and brain edema. Hence, we conclude that hydrogen possesses the potential to be a novel therapeutic agent for EBI after SAH.
Intraclass reliability for assessing how well Taiwan constrained hospital-provided medical services using statistical process control chart techniques
Authors: Chien Tsair-Wei , Chou Ming-Ting , Wang Wen-Chung , Tsai Li-Shu , Lin Weir-Sen
Published: May 2012

Background

Few studies discuss the indicators used to assess the effect on cost containment in healthcare across hospitals in a single-payer national healthcare system with constrained medical resources. We present the intraclass correlation coefficient (ICC) to assess how well Taiwan constrained hospital-provided medical services in such a system.

Methods

A custom Excel-VBA routine to record the distances of standard deviations (SDs) from the central line (the mean over the previous 12 months) of a control chart was used to construct and scale annual medical expenditures sequentially from 2000 to 2009 for 421 hospitals in Taiwan to generate the ICC. The ICC was then used to evaluate Taiwan’s year-based convergent power to remain unchanged in hospital-provided constrained medical services. A bubble chart ofSDsfor a specific month was generated to present the effects of using control charts in a national healthcare system.

Results

ICCs were generated for Taiwan’s year-based convergent power to constrain its medical services from 2000 to 2009. All hospital groups showed a gradually well-controlled supply of services that decreased from 0.772 to 0.415. The bubble chart identified outlier hospitals that required investigation of possible excessive reimbursements in a specific time period.

Conclusion

We recommend using the ICC to annually assess a nation’s year-based convergent power to constrain medical services across hospitals. Using sequential control charts to regularly monitor hospital reimbursements is required to achieve financial control in a single-payer nationwide healthcare system.
Longitudinal Evaluation of Transition Services (“LETS Study”): Protocol for outcome evaluation
Authors: Tsybina Irina , Kingsnorth Shauna , Maxwell Joanne , Bayley Mark , Lindsay Sally , McKeever Patricia , Colantonio Angela , Hamdani Yani , Healy Helen , Macarthur Colin
Published: May 2012

Background

Because of advances in medical treatment, most children with physical disabilities can expect to achieve near normal life spans. Typically, coordinated teams of health care providers in specialized pediatric settings care for these children. As these children reach adulthood, however, the availability of services and expertise changes because the adult health care system has different processes designed to meet their specialized needs. Gaps in continuity of care during the transition from pediatric to adult services, and associated poor health outcomes are well documented. In response, new models of care are being introduced to address the complex process of health care transition. This paper describes a study protocol of a client-centred, prospective, longitudinal, mixed-method evaluation of linked model of health care across the lifespan (the LIFEspan Model), offered by a pediatric rehabilitation centre and an adult rehabilitation centre.

Method

This project will include a process and an outcome evaluation of the LIFEspan Model. Theprocess evaluationwill detail the specific service delivery that occurs with respect to preparation for transition and transfer of care through chart audits of pediatric medical records and qualitative interviews with LIFEspan staff. Theoutcome evaluationwill measure the effect of the model on: 1) maintaining continuity within the health care system from pediatric to adult care; and 2) secondary outcomes related to health, well-being, social participation, transition readiness, and health care utilization of youth with cerebral palsy and acquired brain injury. Standardized instruments will include Health Utilities Inventory, Assessment of Life Habits, Arc’s Self-Determination, Assessment of Health-Related Quality of Life, Partners in Health Questionnaire, Social Support Questionnaire, and Self-Efficacy for Managing Chronic Disease.

Discussion

The LETS study will be original in its undertaking of a prospective examination of outcomes 1-year post-transition, use of multiple comparison groups, and absence of disability-related exclusion criteria ensuring that the transition experiences of varied populations of young people and their families will be represented.

Trial registration

http://www.clinicaltrials.gov, ID NCT00975338
Fabrication and characterization of WO3/Ag/WO3 multilayer transparent anode with solution-processed WO3 for polymer light-emitting diodes
Authors: Jeon Kangmin , Youn Hongseok , Kim Seongbeom , Shin Seongbeom , Yang Minyang
Published: May 2012

The dielectric/metal/dielectric multilayer is suitable for a transparent electrode because of its high-optical and high-electrical properties; however, it is fabricated by an expensive and inefficient multistep vacuum process. We present a WO3/Ag/WO3 (WAW) multilayer transparent anode with solution-processed WO3 for polymer light-emitting diodes (PLEDs). This WAW multilayer not only has high transmittance and low resistance but also can be easily and rapidly fabricated. We devised a novel method to deposit a thin WO3 layer by a solution process in an air environment. A tungstic acid solution was prepared from an aqueous solution of Na2WO4 and then converted to WO3 nanoparticles (NPs) by a thermal treatment. Thin WO3 NP layers form WAW multilayer with a thermal-evaporated Ag layer, and they improve the transmittance of the WAW multilayer because of its high transmittance and refractive index. Moreover, the surface of the WO3 layer is homogeneous and flat with low roughness because of the WO3 NP generation from the tungstic acid solution without aggregation. We performed optical simulation and experiments, and the optimized WAW multilayer had a high transmittance of 85% with a sheet resistance of 4 Ω/sq. Finally, PLEDs based on the WAW multilayer anode achieved a maximum luminance of 35,550 cd/m2 at 8 V, and this result implies that the solution-processed WAW multilayer is appropriate for use as a transparent anode in PLEDs.
Thoracic hyperextension injury with complete “bony disruption” of the thoracic cage: Case report of a potentially life-threatening injury
Authors: Bailey James , VanderHeiden Todd , Burlew Clay Cothren , Pinski-Sibbel Sarah , Jordan Janeen , Moore Ernest E , Stahel Philip F
Published: May 2012

Background

Severe chest wall injuries are potentially life-threatening injuries which require a standardized multidisciplinary management strategy for prevention of posttraumatic complications and adverse outcome.

Case presentation

We report the successful management of a 55-year old man who sustained a complete “bony disruption” of the thoracic cage secondary to an “all-terrain vehicle” roll-over accident. The injury pattern consisted of a bilateral “flail chest” with serial segmental rib fractures, bilateral hemo-pneumothoraces and pulmonary contusions, bilateral midshaft clavicle fractures, a displaced transverse sternum fracture with significant diastasis, and an unstable T9 hyperextension injury. After initial life-saving procedures, the chest wall injuries were sequentially stabilized by surgical fixation of bilateral clavicle fractures, locked plating of the displaced sternal fracture, and a two-level anterior spine fixation of the T9 hyperextension injury. The patient had an excellent radiological and physiological outcome at 6 months post injury.

Conclusion

Severe chest wall trauma with a complete “bony disruption” of the thoracic cage represents a rare, but detrimental injury pattern. Multidisciplinary management with a staged timing for addressing each of the critical injuries, represents the ideal approach for an excellent long-term outcome.
Inhibition of MMP-9 by a selective gelatinase inhibitor protects neurovasculature from embolic focal cerebral ischemia
Authors: Cui Jiankun , Chen Shanyan , Zhang Chunyang , Meng Fanjun , Wu Wei , Hu Rong , Hadass Or , Lehmidi Tareq , Blair Gregory J , Lee Mijoon , Chang Mayland , Mobashery Shahriar , Sun Grace Y , Gu Zezong
Published: May 2012

Background

Cerebral ischemia has been shown to induce activation of matrix metalloproteinases (MMPs), particularly MMP-9, which is associated with impairment of the neurovasculature, resulting in blood–brain barrier breakdown, hemorrhage and neurodegeneration. We previously reported that the thiirane inhibitor SB-3CT, which is selective for gelatinases (MMP-2 and −9), could antagonize neuronal apoptosis after transient focal cerebral ischemia.

Results

Here, we used a fibrin-rich clot to occlude the middle cerebral artery (MCA) and assessed the effects of SB-3CT on the neurovasculature. Results show that neurobehavioral deficits and infarct volumes induced by embolic ischemia are comparable to those induced by the filament-occluded transient MCA model. Confocal microscopy indicated embolus-blocked brain microvasculature and neuronal cell death. Post-ischemic SB-3CT treatment attenuated infarct volume, ameliorated neurobehavioral outcomes, and antagonized the increases in levels of proform and activated MMP-9. Embolic ischemia caused degradation of the neurovascular matrix component laminin and tight-junction protein ZO-1, contraction of pericytes, and loss of lectin-positive brain microvessels. Despite the presence of the embolus, SB-3CT mitigated these outcomes and reduced hemorrhagic volumes. Interestingly, SB-3CT treatment for seven days protected against neuronal laminin degradation and protected neurons from ischemic cell death.

Conclusion

These results demonstrate considerable promise for the thiirane class of selective gelatinase inhibitors as potential therapeutic agents in stroke therapy.
Tungsten-enhanced growth of Methanosphaera stadtmanae
Authors: Dridi Bédis , Khelaifia Saber , Fardeau Marie-Laure , Ollivier Bernard , Drancourt Michel
Published: May 2012

Background

The methanogenic Archaea Methanosphaera stadtmanae has been detected in the human gut microbiota by both culture and culture-independent methods. Its growth reaches an exponential phase after 5 to 7-day culture in medium 322 (10% vol). Our recent successful isolation of Methanomassiliicoccus luminyensis, a tungstate-selenite-requiring Archaea sharing similar metabolism characteristics with M. stadtmanae prompted us to study the effects of tungsten and selenium on M. stadtmanae growth.

Findings

Addition of 0.2 mg/L sodium tungstate to medium 322 yielded, 48 hours after inoculation, a growth rate equivalent to that obtained after 6 days with control culture as measured by methane monitoring and optical density measurement. Addition of 50 μg/mL sodium selenate had no effect on M. stadtmanae growth. Quantitative real-time PCRs targeting the M. stadtmanae 16S rRNA confirmed these data.

Conclusions

These data provide new information regarding the poorly known nutritional requirements of the human gut colonizing organisms
M. stadtmanae. Adding sodium tungstate to basal medium may facilitate phenotypic characterization of this organism and additionally aid the isolation of new Archaea
from complex host microbiota.
Clinician awareness of tetanus-diphtheria vaccination in trauma patients: a questionnaire study
Authors: Yoon Young-Hoon , Moon Sung-Woo , Choi Sung-Hyuk , Cho Young-Duck , Kim Jung-Youn , Kwak Young Ho
Published: May 2012

Background

Most trauma patients visit the hospital via the emergency department. They are at high risk for tetanus infection because many trauma patients are wounded. Tetanus immunity in the Korean population has been revealed to be decreased in age groups over 20 years old. It is important for emergency physicians to vaccinate patients with the tetanus booster in wound management.

Methods

Questionnaires were sent to the directors of the emergency departments of resident training hospitals certified by the Korean Society of Emergency Medicine.

Results

Two thirds of the emergency department directors surveyed reported applying tetanus prophylaxis guidelines to more than 80% of wounded patients. However, about 45% of clinicians in the emergency departments considered giving less than half of the wounded patient tetanus booster vaccinations, and there were no distinct differences in tetanus booster vaccination rates among different age groups. Most emergency physicians are familiar with tetanus prophylaxis guidelines for wound management. However, more than half of the emergency department directors reported that the major reason for not considering tetanus-diphtheria vaccination was due to assumptions that patients already had tetanus immunity.

Conclusion

Attitude changes should be encouraged among emergency physicians regarding tetanus prophylaxis. As emergency physicians are frequently confronted with patients that are at a high risk for tetanus infection in emergency situations, they need to be more informed regarding tetanus immunity epidemiology and encouraged to administer tetanus booster vaccines.
Noninvasive mechanical ventilation may be useful in treating patients who fail weaning from invasive mechanical ventilation: a randomized clinical trial
Authors: Trevisan Cristiane E , Vieira Silvia R ,   the Research Group in Mechanical Ventilation Weaning
Published: May 2012

Introduction

The use of noninvasive positive-pressure mechanical ventilation (NPPV) has been investigated in several acute respiratory failure situations. Questions remain about its benefits when used in weaning patients from invasive mechanical ventilation (IMV). The objective of this study was to evaluate the use of bi-level NPPV for patients who fail weaning from IMV.

Methods

This experimental randomized clinical trial followed up patients undergoing IMV weaning, under ventilation for more than 48 hours, and who failed a spontaneous breathing T-piece trial. Patients with contraindications to NPPV were excluded. Before T-piece placement, arterial gases, maximal inspiratory pressure, and other parameters of IMV support were measured. During the trial, respiratory rate, tidal volume, minute volume, rapid shallow breathing index, heart rate, arterial blood pressure, and peripheral oxygen saturation were measured at 1 and 30 minutes. After failing a T-piece trial, patients were randomly divided in two groups: (a) those who were extubated and placed on NPPV and (b) those who were returned to IMV. Group results were compared using the Student t test and the chi-square test.

Results

Of 65 patients who failed T-piece trials, 28 were placed on NPPV and 37 were placed on IMV. The ages of patients in the NPPV and IMV groups were 67.6 ± 15.5 and 59.7 ± 17.6 years, respectively. Heart disease, post-surgery respiratory failure, and chronic pulmonary disease aggravation were the most frequent causes of IMV use. In both groups, ventilation time before T-piece trial was 7.3 ± 4.1 days. Heart and respiratory parameters were similar for the two groups at 1 and 30 minutes of T-piece trial. The percentage of complications in the NPPV group was lower (28.6% versus 75.7%), with lower incidences of pneumonia and tracheotomy. Length of stay in the intensive care unit and mortality were not statistically different when comparing the groups.

Conclusion

The results suggest that NPPV is a good alternative for ventilation of patients who fail initial weaning attempts. NPPV reduces the incidence of pneumonia associated with mechanical ventilation and the need for tracheotomy.

Trial registration

CEP HCPA (02–114).
Phase II Trial of Vorinostat With Idarubicin and Cytarabine for Patients With Newly Diagnosed Acute Myelogenous Leukemia or Myelodysplastic Syndrome
Authors: Garcia-Manero Guillermo , Tambaro Francesco Paolo , Bekele Nebiyou B. , Yang Hui , Ravandi Farhad , Jabbour Elias , Borthakur Gautam , Kadia Tapan M. , Konopleva Marina Y. , Faderl Stefan , Cortes Jorge E. , Brandt Mark , Hu Yumin , McCue Deborah , Newsome Willie Mae , Pierce Sherry R. , de Lima Marcos , Kantarjian Hagop M.
Published: May 2012

Purpose

To evaluate the safety and efficacy of the combination of the histone deacetylase inhibitor vorinostat with idarubicin and ara-C (cytarabine) in patients with acute myelogenous leukemia (AML) or myelodysplastic syndrome (MDS).

Patients and Methods

Patients with previously untreated AML or higher-risk MDS age 15 to 65 years with appropriate organ function and no core-binding factor abnormality were candidates. Induction therapy was vorinostat 500 mg orally three times a day (days 1 to 3), idarubin 12 mg/m2intravenously (IV) daily × 3 (days 4 to 6), and cytarabine 1.5 g/m2IV as a continuous infusion daily for 3 or 4 days (days 4 to 7). Patients in remission could be treated with five cycles of consolidation therapy and up to 12 months of maintenance therapy with single-agent vorinostat. The study was designed to stop early if either excess toxicity or low probability of median event-free survival (EFS) of more than 28 weeks was likely.

Results

After a three-patient run-in phase, 75 patients were treated. Median age was 52 years (range, 19 to 65 years), 29 patients (39%) were cytogenetically normal, and 11 (15%) had FLT-3 internal tandem duplication (ITD). No excess vorinostat-related toxicity was observed. Induction mortality was 4%. EFS was 47 weeks (range, 3 to 134 weeks), and overall survival was 82 weeks (range, 3 to 134 weeks). Overall response rate (ORR) was 85%, including 76% complete response (CR) and 9% in CR with incomplete platelet recovery. ORR was 93% in diploid patients and 100% in FLT-3 ITD patients. Levels of NRF2 and CYBB were associated with longer survival.

Conclusion

The combination of vorinostat with idarubicin and cytarabine is safe and active in AML.
Sex Differences in Fertility-Related Information Received by Young Adult Cancer Survivors
Authors: Armuand Gabriela M. , Rodriguez-Wallberg Kenny A. , Wettergren Lena , Ahlgren Johan , Enblad Gunilla , Höglund Martin , Lampic Claudia
Published: May 2012

Purpose

The aim was to investigate male and female cancer survivors' perception of fertility-related information and use of fertility preservation (FP) in connection with cancer treatment during reproductive age.

Methods

The study sample consisted of cancer survivors diagnosed from 2003 to 2007 identified in population-based registers in Sweden. Inclusion criteria included survivors who were age 18 to 45 years at diagnosis and had lymphoma, acute leukemia, testicular cancer, ovarian cancer, or female breast cancer treated with chemotherapy. Of 810 eligible participants, 484 survivors (60% response rate) completed a postal questionnaire.

Results

The majority of male participants reported having received information about treatment impact on fertility (80%) and FP (68%), and more than half of the men banked frozen sperm (54%). Among women, less than half (48%) reported that they received information about treatment impact on fertility, and 14% reported that they received information about FP. Only seven women (2%) underwent FP. Predictors for receiving information about treatment impact on fertility were a pretreatment desire to have children (odds ratio [OR], 3.5), male sex (OR, 3.2), and being ≤ 35 years of age at diagnosis (OR, 2.0). Predictors for receiving information about FP included male sex (OR, 14.4), age ≤ 35 at diagnosis (OR, 5.1), and having no children at diagnosis (OR, 2.5).

Conclusion

Our results show marked sex differences regarding the receipt of fertility-related information and use of FP. There is an urgent need to develop fertility-related information adapted to female patients with cancer to improve their opportunities to participate in informed decisions regarding their treatment and future reproductive ability.
Prospective Study of Falls and Risk Factors for Falls in Adults With Advanced Cancer
Authors: Stone Carol A. , Lawlor Peter G. , Savva George M. , Bennett Kathleen , Kenny Rose Anne
Published: May 2012

Purpose

Retrospective studies of inpatients with cancer suggest that a cancer diagnosis confers a high risk of falls. In adults with advanced cancer, we aimed to prospectively document the incidence of falls, identify the risk factors, and determine if falls in this population occur predominantly in older patients.

Patients and Methods

Patients admitted consecutively to community and inpatient palliative care services with metastatic or locoregionally advanced cancer who were mobile without assistance were recruited. Risk-factor assessment was conducted on initial encounter. Patients underwent follow-up via weekly telephone contact for 6 months or until time of fall or death. Relationship between covariates and time to fall was examined using hazard ratios (HRs) derived from univariate and multivariate Cox proportional hazards models.

Results

Of 185 participants (52.4% men; mean age 68 ± standard deviation of 12.6 years), 50.3% fell; 35 (53%) of 66 participants age < 65 years and 58 (48.7%) of 119 age ≥ 65 years fell; 61.3% of falls occurred in the community; 42% resulted in injury. Median time to fall was 96 days (95% CI, 64.66 to 127.34). Primary brain tumor or brain metastasis (HR 2.5; P = .002), number of falls in the preceding 3 months (HR, 1.27; P = .005), severity of depression (HR, 1.12; P = .012), benzodiazepine dose (HR, 1.05; P = .004), and cancer-related pain (HR, 1.96; P = .024) were independently associated with time to fall in multivariate analysis.

Conclusion

Fifty percent of adults with advanced cancer, regardless of age, will experience a fall associated with high risk of physical injury. There is a compelling need to assess the efficacy of assessment and management of modifiable fall risk factors in patients with advanced cancer.
Differential Gene Expression by Oxyphil and Chief Cells of Human Parathyroid Glands
Authors: Ritter Cynthia S. , Haughey Bruce H. , Miller Brent , Brown Alex J.
Published: May 2012

Context:

Parathyroid oxyphil cells, whose function is unknown, are thought to be derived from chief cells. Oxyphil cells increase in number in parathyroid glands of patients with chronic kidney disease (CKD) and are even more abundant in patients receiving treatment for hyperparathyroidism with calcitriol and/or the calcimimetic cinacalcet.

Objective:

We examined oxyphil and chief cells of parathyroid glands of CKD patients for differential expression of genes important to parathyroid function.

Design/Setting/Participants:

Parathyroid tissue from CKD patients with refractory hyperparathyroidism was immunostained for gene expression studies.

Main Outcome Measure:

Immunostaining for PTH, PTHrP, calcium-sensing receptor, glial cells missing 2, vitamin D receptor, 25-hydroxyvitamin D-1α-hydroxylase, and cytochrome c was quantified and expression reported for oxyphil and chief cells.

Results:

Expression of all proteins analyzed, except for the vitamin D receptor, was higher in oxyphil cells than in chief cells.

Conclusion:

Human parathyroid oxyphil cells express parathyroid-relevant genes found in the chief cells and have the potential to produce additional autocrine/paracrine factors, such as PTHrP and calcitriol. Additional studies are warranted to define the secretory properties of these cells and clarify their role in parathyroid pathophysiology.
From “Impossible” Writing to a Poetics of Intimacy: John Ashbery's Reading of Gertrude Stein
Authors: Setina Emily
Published: May 2012

In 1957, a young John Ashbery reviewed Gertrude Stein's Stanzas in Meditation for Poetry magazine. Titled “The Impossible,” the essay explores difficulty as a means of readerly intimacy and participation. Ashbery's later “G.M.P.” describes the pathos of the writer's impossible desire to be “really understood”; the early essay, which I revisit in its published form and through notes and drafts, makes an argument about difficult writing itself: that it can demand not just intellectual but affective response. Ashbery calls attention to a poetics of intimacy in Stanzas and reads its grand representational goals in relation, rather than opposition, to personality.
C. D. Wright's Deepstep Come Shining: A Wheeling Collage
Authors: Baker Robert
Published: May 2012

This essay presents a close reading of C. D. Wright's Deepstep Come Shining. One of the great book-length poems published in America over the last few decades, this poem gathers the strengths of Wright's earlier books while at the same time inventing the sort of roving collage essential to her recent books of social witness, One Big Self, Rising, Falling, Hovering, and One with Others. Deepstep teaches us to read these more recent books of Wright's. It also teaches us, indirectly, to read again the larger Romantic and modernist traditions that Deepstep and these recent books reinflect. In this way it helps us to see the stakes of a collagist long poem in our time. The essay concludes by suggesting that Deepstep, while embracing the art of disjunction characteristic of contemporary culture, at the same time surpasses this art through an innovative practice of drawing connections.
American Society for Gastrointestinal Endoscopy guidelines for appropriate use of colonoscopy: are they suitable for African patients?
Authors: Mudawi H M Y , Mohammed Ali S E A , Dabora A A , El Tahir M A , Suliman S H , Salim O E F H , Elsiddig H D , Ibrahim S Z
Published: May 2012

This study investigates the appropriateness and diagnostic yield of colonoscopy referrals in an African setting using the American Society of Gastrointestinal Endoscopy guidelines: a prospective, descriptive, cross-sectional hospital-based study. A total of 311 patients were included in the study; 228 referrals (73.3%) were considered appropriate and clinically significant pathology was found in 157 patients, giving an overall diagnostic yield of 50.5%. Diagnostic yield in those with appropriate referrals was 58.8% and 27.7% ( P = 0.004) in those with inappropriate referrals. In our setting these guidelines are useful in improving diagnostic yield and reducing the rate of inappropriate referrals for colonoscopy. However, patients above the age of 50 presenting with lower gastrointestinal symptoms should undergo a colonoscopy even if the indication was inappropriate, especially in countries which are not implementing colorectal cancer screening programmes for average risk patients.
Reverse marsupialization technique of defibulation to restore vulvo-perineal elasticity: a case report and description of technique
Authors: Nkwo Peter O
Published: May 2012

A ‘reverse marsupialization’ technique was used to restore vulval and perineal elasticity in order to improve the reproductive and sexual health of a woman with severely scarred vulva and perineum following infibulations.
Markov Breaks in Regression Models
Authors: Smith Aaron
Published: May 2012

This article develops a new Markov breaks (MB) model for forecasting and making inference in linear regression models with breaks that are stochastic in both timing and magnitude. The MB model permits an arbitrarily large number of abrupt breaks in the regression coefficients and error variance, but it maintains a low-dimensional state space, and therefore it is computationally straightforward. In particular, the likelihood function can be computed analytically using a single iterative pass through the data and thereby avoids Monte Carlo integration. The model generates forecasts and conditional coefficient predictions using a probability weighted average over regressions that include progressively more historical data. I employ the MB model to study the predictive ability of the yield curve for quarterly GDP growth. I show evidence of breaks in the predictive relationship, and the MB model outperforms competing breaks models in an out-of-sample forecasting experiment.
Epistemische Gerechtigkeit. Sozialempirie und Perspektivenpluralismus in der Angewandten Ethik
Authors: Schicktanz Silke
Published: May 2012

To demonstrate the necessity of (certain kinds of) social-empirical research in practical-moral judgment, I will present three interrelated arguments. Firstly, skepticism towards ethical expertise; secondly, the normative meaning of being affected; and thirdly, epistemic justice. Epistemic justice will be at the center of my contribution as it can be regarded to constitute the normative and epistemic basic condition for the other two arguments. Taken together they provide a conclusive argument for the necessity of the inclusion of certain perspectives, namely those of affected persons. Relying on Miranda Frickers concept of epistemic justice and Donna Haraways idea of situated knowledge, I will argue that these perspectives should be granted an ethically exclusive place in practical-moral judgment.
Genetic and Environmental Influences on Infant Sleep
Authors: Fisher Abigail , van Jaarsveld Cornelia H. M. , Llewellyn Clare H. , Wardle Jane
Published: May 2012

BACKGROUND:

Sleep duration is attracting increasing attention in relation to chronic disease risk, but few large-scale studies have investigated the determinants of sleep characteristics in early life. In this study we used data from a large, population-based twin study to examine genetic and environmental influences on sleep duration and sleep difficulties in infancy.

METHODS:

Participants were 1931 pairs of young twins (3862 children) from the Gemini twin birth cohort. Sleep patterns were assessed at 15 months by using a modification of the Brief Infant Sleep Questionnaire completed by parents. Outcomes included nighttime and daytime sleep duration and frequency of night waking.

RESULTS:

Twin analyses showed that nighttime sleep duration was predominantly influenced by the shared environment (66%, confidence interval [CI] 63%–70%) with a modest genetic effect (26%, CI 22%–30%). A similar pattern was observed for daytime nap duration (shared environment: 57%, CI 53%–62%; genetic effect: 37%, CI 33%–41%) and sleep disturbance (shared environment: 55%, 44%–64%) with a genetic effect of 40% (30%–51%). These estimates were similar for boys and girls.

CONCLUSIONS:

These results indicate an important contribution of the shared family environment as well as genes to children’s sleep behavior. There is a need for research to identify specific environmental determinants that could provide targets for interventions to improve sleep quality.
Postsecondary Education and Employment Among Youth With an Autism Spectrum Disorder
Authors: Shattuck Paul T. , Narendorf Sarah Carter , Cooper Benjamin , Sterzing Paul R. , Wagner Mary , Taylor Julie Lounds
Published: May 2012

OBJECTIVES:

We examined the prevalence and correlates of postsecondary education and employment among youth with an autism spectrum disorder (ASD).

METHODS:

Data were from a nationally representative survey of parents, guardians, and young adults with an ASD. Participation in postsecondary employment, college, or vocational education and lack of participation in any of these activities were examined. Rates were compared with those of youth in 3 other eligibility categories: speech/language impairment, learning disability, and mental retardation. Logistic regression was used to examine correlates of each outcome.

RESULTS:

For youth with an ASD, 34.7% had attended college and 55.1% had held paid employment during the first 6 years after high school. More than 50% of youth who had left high school in the past 2 years had no participation in employment or education. Youth with an ASD had the lowest rates of participation in employment and the highest rates of no participation compared with youth in other disability categories. Higher income and higher functional ability were associated with higher adjusted odds of participation in postsecondary employment and education.

CONCLUSIONS:

Youth with an ASD have poor postsecondary employment and education outcomes, especially in the first 2 years after high school. Those from lower-income families and those with greater functional impairments are at heightened risk for poor outcomes. Further research is needed to understand how transition planning before high school exit can facilitate a better connection to productive postsecondary activities.
High ERK Protein Expression Levels Correlate with Shorter Survival in Triple-Negative Breast Cancer Patients
Authors: Bartholomeusz Chandra , Gonzalez-Angulo Ana M. , Liu Ping , Hayashi Naoki , Lluch Ana , Ferrer-Lozano Jaime , Hortobágyi Gabriel N.
Published: May 2012

The mitogen-activated protein kinase (MAPK) signaling pathway is known to be activated in triple-negative breast cancer (TNBC). Extracellular signal–related kinase (ERK), a member of the MAPK pathway, promotes cell proliferation, angiogenesis, cell differentiation, and cell survival. To assess the prognostic impact of ERK in TNBC patients, relative quantities of ERK (ERK-2 and pMAPK) and direct targets of the ERK pathway (MAPK/ERK kinase 1, phospho-enriched protein in astrocytes [PEA]-15, phosphorylated (p)PEA-15, tuberous sclerosis protein 2, p70S6 kinase, and p27) were measured using reverse-phase protein arrays in tumor tissue from patients with TNBC (n = 97) and non-TNBC (n = 223). Protein levels in patients with TNBC were correlated with clinical and tumor characteristics and outcome. The median age of patients with TNBC was 55 years (range, 27–86 years). Disease stage was I in 21%, II in 60%, and III in 20% of the patients. In a multivariate analysis, among patients with TNBC, those with ERK-2–overexpressing tumors had a lower overall survival rate than those with low ERK-2–expressing tumors (hazard ratio [HR], 2.76; 95% confidence interval [CI], 1.19–6.41). However, high pMAPK levels were associated with a significantly higher relapse-free survival rate (HR, 0.66; 95% CI, 0.46–0.95). In conclusion, ERK-2 and pMAPK are valuable prognostic markers in TNBC. Further studies are justified to elucidate ERK's role in TNBC tumorigenicity and metastasis.
High Let-7a MicroRNA Levels in KRAS-Mutated Colorectal Carcinomas May Rescue Anti-EGFR Therapy Effects in Patients with Chemotherapy-Refractory Metastatic Disease
Authors: Ruzzo Annamaria , Graziano Francesco , Vincenzi Bruno , Canestrari Emanuele , Perrone Giuseppe , Galluccio Nadia , Catalano Vincenzo , Loupakis Fotios , Rabitti Carla , Santini Daniele , Tonini Giuseppe , Fiorentini Giammaria , Rossi David , Falcone Alfredo , Magnani Mauro
Published: May 2012

Preclinical and experimental data in vivo indicate that Lethal-7 (Let-7) microRNA downregulates KRAS with antitumor effects in the presence of activating KRAS mutations. We quantified the Let-7a isoform in KRAS-mutated colorectal carcinomas from patients who received salvage cetuximab plus irinotecan. The study population was retrospectively identified among metastatic colorectal cancer patients who underwent third-line therapy with cetuximab plus irinotecan in a period when only epidermal growth factor receptor (EGFR) expression was required for anti-EGFR therapy. In 59 patients harboring KRAS mutations, Let-7a levels were analyzed for association with overall survival (OS) and progression-free survival (PFS) times. An exploratory subgroup analysis was performed using the rs61764370 (LCS6 T>G) polymorphism that experimentally impairs Let-7 binding to KRAS mRNA. In the whole group, higher Let-7a levels were significantly associated with better survival outcomes. For the primary OS endpoint, the multivariate hazard ratio was 0.82 (95% confidence interval, 0.73–0.91; p = .01). The same findings with an accentuated positive effect of high Let-7a levels on both OS and PFS times were observed in an exploratory analysis of the 45 wild-type LCS6 patients (excluding 14 carriers of the LCS6 G allele variant). All survival associations were confirmed after excluding patients with KRAS codon 13 mutations. Among the clinicopathologic features, high Let-7a levels were associated with grade 2–3 skin toxicity (p = .002). In patients with KRAS mutations, Let-7a analysis may serve to identify subgroups of patients who may still benefit from EGFR inhibition and this may open up new perspectives for alternative treatment strategies.
Influence of yielding of flexural reinforcement on shear transfer through cracks
Authors: Vaz Rodrigues Rui
Published: May 2012

In statically indeterminate structures, yielding of flexural reinforcement in one section does not necessarily mean that the structure has reached its ultimate load. Typically this occurs in reinforced concrete slabs, which are elements that mostly do not require any kind of shear reinforcement (an exception is made in the case of punching shear). Therefore, the effect of the yielding strains of the flexural reinforcement (if they exist) should be considered when designing for shear. This effect has been studied previously, when it was shown that in 11 tested beams without shear reinforcement, the shear capacity was strongly reduced after yielding. This result is consistent with model code 2010 provisions for one-way shear without shear reinforcement, because the shear capacity decreases with longitudinal web strains and with the critical shear crack theory (CSCT). In this paper, detailed measurements of the web displacements from the same beams are analysed. These allowed quantification of the stresses and the shear force carried across the critical shear crack by aggregate interlock action for varying levels of the longitudinal reinforcement strains.
Tsunami and wind-driven wave forces in the Mediterranean Sea
Authors: Camilleri Denis H
Published: May 2012

The comparison between the impact forces generated from a tsunami wave and those from a wind-driven wave are presented here. Wind-driven wave forces are derived from established maritime theory going back to the nineteenth century. The understanding of tsunami impact forces is derived from more recent research correlated further by some recent model testing. The maritime theory on wave impact force for breaking and non-breaking waves is very well developed from breakwater/seawall engineering. It commenced with Stephenson and Hiro's nineteenth century rule of thumb equations, which was then followed in the twentieth century by Sainflou's theory (1928) for standing waves in deep water. Minikin's studies in the 1950s yielded results for breaking waves and noted high dynamic localised loads and these was followed in 1985 by Goda's equations applicable for both breaking and non-breaking waves. At Alderney, typical impact pressures of 40 t/m2 (400 kN/m2) for 20 m/s waves were recorded, although a Ciria document published in 1992 notes that the average wave pressure on sea walls varies from 150 kN/m2 down to 50 kN/m2 pressure. Users are cautioned about the extremely high wave forces associated with the Minikin method. In 1984, Blackmore and Hewson developed a method to estimate an average wave pressure from broken wave loads. The present analysis which was undertaken for the bathymetry and climatological data of the Mediterranean Sea then outlines the Malta scenario. It can act as a guide to structural engineers in selecting suitable values for the impact pressures that vertical walls may be subjected to for the cases of wind-driven or tsunami waves.
Integrated multi-agency framework: sustainable water management
Authors: Elmahdi Amgad , McFarlane Don
Published: May 2012

Equitable allocation of groundwater resources is a growing challenge due to increasing demand for water and the competing triple bottom line values placed on its use. Sustainable management of water resources comes with compromises and trade-offs of the other subsystems such as the environment and economic and social dimensions and almost ignores stakeholders' objectives and benefits. The aim of this paper is to evaluate the hypothesis that ‘through a multi-agency approach and management, a comprehensive multi-agency framework (MAF) can promote optimal, sustainable and equitable development and use of water resources for present and future generations'. The framework has been successfully demonstrated in a case study at the Gnangara mound groundwater system in Western Australia and showed what can be achieved with supporting tools such as a decision support system (DSS) to facilitate and support the MAF during trade-off analysis. Without a MAF, the potential for more conflict between agencies' objectives and actions increases. A MAF and DSS allow thorough understanding of the triple bottom line impacts, ease the selection of preferred options and result in better public involvement and investment.
Effect of the grain size on hysteresis of liquid‐crystalline Blue Phase I
Authors: Nayek Prasenjit , Jeong Heon , Kang Shin‐Woong , Lee Seung Hee , Park Heung‐Shik , Lee Hyuck Jin , Kim Hee Seop , Lee Gi‐Dong
Published: May 2012

Abstract— Three different blue‐phase I liquid‐crystal samples with different grain‐size distribution were studied. Polycrystalline platelet grains reflects light in the visible region and have been observed under a polarizing optical microscope. Green and blue grain areas have been measured and then the statistical histogram by the Gaussian distribution function was fitted and the mean grain size was calculated. The effect of hysteresis on grain size has been compared for the three samples. Hysteresis depends explicitly on the grain‐size distribution. Large grain size has revealed less hysteresis, while small grain size depicted pronounced hysteresis.
Polarization‐independent blue‐phase liquid‐crystal gratings driven by vertical electric field
Authors: Zhu Ge , Li Jia‐Nan , Lin Xiao‐Wen , Wang Hai‐Feng , Hu Wei , Zheng Zhi‐Gang , Cui Hong‐Qing , Shen Dong , Lu Yan‐Qing
Published: May 2012

Abstract— A blue‐phase liquid‐crystal grating is proposed by applying a vertical electric field with lateral periodic distribution. Simulation on electric‐field distribution was also carried out, the results of which suggest the alternation of isotropic and ordinary refractive indices in the lateral direction. Through the electrode configuration design, both 1 D and 2D gratings were demonstrated with high transmittance of ca. 85%. The diffraction efficiency of the first order reached up to 38.7% and 1 7.8% for the 1D and 2D cases, respectively. The field‐induced fast phase modulation permits a rapid switching of diffraction orders down to the submillisecond scale.
The basic characteristics of the municipalities of Backa in the Euroregion “The Danube-Drava-Sava”
Authors: Milankovic Jelena , Djukicin Smiljana , Djordjevic Jasmina
Published: May 2012

The Euroregion ?The Danube-Drava-Sava? was brought into being for the purpose
of stimulating the integration of the countries that it comprises into a
unique entity in which mutual interests will be advanced. The aim of the
Euroregion formation is not only the economic, but also the international,
trans-border, political and social cooperation. Since 2002. four Serb
municipalities have been granted the status of observers. Those are the
municipalities of Subotica, Sombor, Apatin and Bac. Owing to this status, the
mentioned municipalities have been offered the opportunity to develop
different aspects of trans-border cooperation starting with agricultural and
economic, leading to cultural and social. This paper is aimed to demonstrate
what progress has been made and how much the municipalities have made use of
their status in the mentioned Euroregion as well as what their perspectives
and intentions for further development are.
Procalcitonin and BISAP score versus c-reactive protein and APACHE II score in early assessment of severity and outcome of acute pancreatitis
Authors: Bezmarevic Mihailo , Kostic Zoran , Jovanovic Miodrag , Mickovic Sasa , Mirkovic Darko , Soldatovic Ivan , Trifunovic Bratislav , Pejovic Janko , Vujanic Svetlana
Published: May 2012

Background/Aim. Early assessment of severity and continuous monitoring of
patients are the key factors for adequate treatment of acute pancreatitis
(AP). The aim of this study was to determine the value of procalcitonin
(PCT) and Bedside Index for Severity in Acute Pancreatitis (BISAP) scoring
system as prognostic markers in early stages of AP with comparison to other
established indicators such as Creactive protein (CRP) and Acute Physiology
and Chronic Health Evaluation (APACHE) II score. Methods. This prospective
study included 51 patients (29 with severe AP). In the first 24 h of
admission in all patients the APACHE II score and BISAP score, CRP and PCT
serum concentrations were determined. The values of PCT serum concentrations
and BISAP score were compared with values of CRP serum concentrations and
APACHE II score, in relation to the severity and outcome of the disease.
Results. Values of PCT, CRP, BISAP score and APACHE II score, measured at 24
h of admission, were significantly elevated in patients with severe form of
the disease. In predicting severity of AP at 24 h of admission, sensitivity
and specificity of the BISAP score were 74% and 59%, respectively, APACHE II
score 89% and 69%, respectively, CRP 75% and 86%, respectively, and PCT 86%
and 63%, respectively. It was found that PCT is highly significant predictor
of the disease outcome (p < 0,001). Conclusion. In early assessment of AP
severity, PCT has better predictive value than CRP, and similar to the
APACHE II score. APACHE II score is a stronger predictor of the disease
severity than BISAP score. PCT is a good predictor of AP outcome.
Biochemical bone markers and biological effects of osteoporosis therapy
Authors: Kovacev-Zavisic Branka , Novakovic-Paro Jovanka , Djuric Nikola , Icin Tijana , Todorovic-Djilas Ljiljana , Kovacev Nemanja
Published: May 2012

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