bluuebunny/crossref_metadata_2025 huggingface dataset:
Standard and extended lymphadenectomy for adenocarcinoma of the pancreatic head: A meta‐analysis and systematic review
Authors: Ke Kun , Chen Wen , Chen Yanling
Published: October 2013

Background and Aim

Although some retrospective studies have recommended that pancreaticoduodenectomy with extended lymphadenectomy might improve the survival of patients with adenocarcinoma of the head of the pancreas, the procedure remains controversial.

Methods

Using PubMed, EMBASE, and The Cochrane Library databases, a systematic literature review was performed to identify randomized, controlled trials comparing standard and extended lymphadenectomy in pancreaticoduodenectomy for adenocarcinoma of the head of the pancreas.

Results

Four trials including 423 patients satisfied the inclusion criteria. Extended lymphadenectomy failed to improve the overall survival of patients with adenocarcinoma of the head of the pancreas (hazard ratio 1.09; 95% confidence interval 0.84–1.41; P = 0.51). Additionally, postoperative mortality and morbidity were comparable between the standard and extended groups, while extended lymphadenectomy was associated with poor quality of life within 1 year after the operation.

Conclusions

Extended lymphadenectomy do not benefit overall survival. Considering the poor quality of life associated with extended lymphadenectomy, pancreaticoduodenectomy with standard lymphadenectomy is suitable for patients with adenocarcinoma of the head of the pancreas.
Objectively Measured Physical Activity and Progressive Loss of Lean Tissue in Older Japanese Adults: Longitudinal Data from the Nakanojo Study
Authors: Shephard Roy J. , Park Hyuntae , Park Sungjin , Aoyagi Yukitoshi
Published: October 2013

Objectives

To relate 5‐year lean tissue loss to habitual physical activity of elderly adults.

Design

Longitudinal.

Setting

Community of Nakanojo.

Participants

Community‐living Japanese aged 65 to 84 (200 men, 268 women).

Measurements

Daily 24‐hour pedometer/accelerometer data, collected continuously for 5 years, were categorized into activity quartiles. Bioelectrical impedance measurements of lean body mass were taken annually. A sarcopenia threshold was defined arbitrarily as an appendicular lean mass/height2 of more than 1 standard deviation below the mean for healthy young Japanese.

Results

Subjects with greater habitual physical activity retained a greater lean mass over the 5 years of observation. Controlling for baseline lean mass and age, final lean mass was greater for the third activity quartile (men and women with respective mean counts of 7,800 and 7,700 steps per day or mean duration of exercise at >3 metabolic equivalents (METs) of 20 and 17 minutes per day) than for the first and second quartiles. A multivariate‐adjusted proportional hazards model predicted that, over the 5 years, men and women in the two lowest activity quartiles (<6,700 and <6,800 steps per day) were 2.3 (95% confidence interval (CI) = 1.4–4.5) and 3.0 (95% CI = 1.9–3.4) times as likely, respectively, to be sarcopenic as those in the highest activity quartile (>9,000 and >8,400 steps per day). Likewise, men and women with less than 16 and less than 14 minutes per day, respectively, of activity of more than 3 METs were 3.0 (95% CI = 2.0–6.0) and 3.5 (95% CI = 2.1–6.3) times as likely to develop sarcopenia as those with more than 28 and more than 22 minutes per day.

Conclusion

After adjustment for potential confounders, the risk of developing sarcopenia was substantially lower in elderly people taking at least 7,000 to 8,000 steps per day or exercising for at least 15 to 20 minutes per day at an intensity greater than 3 METs. Clinicians should encourage seniors to get at least this volume of regular daily exercise.
Differential effects of ethanol on regional glutamatergic and GABAergic neurotransmitter pathways in mouse brain
Authors: Tiwari Vivek , Veeraiah Pandichelvam , Subramaniam Vaidyanathan , Patel Anant Bahadur
Published: October 2013

This study investigates the effects of ethanol on neuronal and astroglial metabolism using 1H‐[13C]‐NMR spectroscopy in conjunction with infusion of [1,6‐13C2]/[1‐13C]glucose or [2‐13C]acetate, respectively. A three‐compartment metabolic model was fitted to the 13C turnover of GluC3, GluC4, GABAC2, GABAC3, AspC3, and GlnC4 from [1,6‐13C2]glucose to determine the rates of tricarboxylic acid (TCA) and neurotransmitter cycle associated with glutamatergic and GABAergic neurons. The ratio of neurotransmitter cycle to TCA cycle fluxes for glutamatergic and GABAegic neurons was obtained from the steady‐state [2‐13C]acetate experiment and used as constraints during the metabolic model fitting. 1H MRS measurement suggests that depletion of ethanol from cerebral cortex follows zero order kinetics with rate 0.18 ± 0.04 μmol/g/min. Acute exposure of ethanol reduces the level of glutamate and aspartate in cortical region. GlnC4 labeling was found to be unchanged from a 15 min infusion of [2‐13C]acetate suggesting that acute ethanol exposure does not affect astroglial metabolism in naive mice. Rates of TCA and neurotransmitter cycle associated with glutamatergic and GABAergic neurons were found to be significantly reduced in cortical and subcortical regions. Acute exposure of ethanol perturbs the level of neurometabolites and decreases the excitatory and inhibitory activity differentially across the regions of brain.

image

Depletion of ethanol and its effect on brain functions were measured using 1H and 1H‐[13C]‐NMR spectroscopy in conjunction with infusion of 13C‐labeled substrates. Ethanol depletion from brain follows zero order kinetics. Ethanol perturbs level of glutamate, and the excitatory and inhibitory activity in mice brain.
Reconsidering the Specified Tetrad Test
Authors: Garcia Karen , Ennis John M. , Prinyawiwatkul Witoon
Published: October 2013

Additional noise from additional stimuli has been shown to result in a loss of operational power in sensory difference tests. Because the Specified Tetrad test requires the evaluation of four stimuli and has only a slight theoretical power advantage over the two‐alternative forced choice (2‐AFC), Ennis and Jesionka have argued that the Specified Tetrad test should not be used. But this theoretical assertion had not been confirmed experimentally. In this article, we refute this argument using results from a large‐scale comparison of the 2‐AFC with the Specified Tetrad test. Using Thurstonian analysis, we quantified the sensory effect size as measured by both tests and found that the Specified Tetrad test is significantly more sensitive than the 2‐AFC in this setting. In fact, if the sample values from our experiment could be taken as population values, the results of this experiment predict that the Specified Tetrad test is operationally more powerful than a double‐replicated 2‐AFC. While further investigation of the Specified Tetrad test is needed before such a strong statement can be confirmed, these results indicate that the Specified Tetrad test is worthy of such investigation.

Practical Applications

Among the many tools in the sensory scientist's tool box are the specified difference testing methods. These methods can be used when the attribute that defines the difference between the samples is known. Historically, the 2‐AFC has been considered the operationally most powerful method of specified testing, but the 2‐AFC has never been compared with the Specified Tetrad test. In this article, we provide such a comparison, and show that the Specified Tetrad test deserves attention as a specified testing method.
Positive influence of l‐carnitine on the different muscle fibres types of racing pigeons
Authors: Chang M. H. , Tsai F. H. , Chou S. J. , Wang J. H. , Lo D. Y. , Zheng Z. Z. , Chan K. W. , Lai J. M.
Published: October 2013

Succinate dehydrogenase (SDH), Ca2+ ATPase, Lactate dehydrogenase (LDH), are involved in energy metabolism. These enzymes can be used as indicators of the energy capacity of aerobic cells. The study investigated the effects of l‐carnitine supplementation on M. pectoralis superficialis, M. pectoralis profundus, M. extensor carpi radialis muscle and M. flexor carpi ulnaris. Twenty‐eight racing pigeons hatched at the same time were divided randomly into three groups. Eight pigeons, which were used as the control group, were sacrificed at 92‐day old. The remaining twenty pigeons continued training until they reached 157‐day old, with half the pigeons getting 25 mg/head/day of l‐carnitine, while the other half given the same amount of water. The pigeons were assessed by histochemical methods and reverse transcription polymerase chain reaction (RT‐PCR). To assess influence of l‐carnitine on muscle fibre composition and the performance of three genes' mRNA, this study applied SDH localization, SDH, Ca2+ ATPase and LDH mRNA expression to examine the results after oral administration of l‐carnitine in vivo in racing pigeons. The results showed that l‐carnitine significantly elevated the amount of white muscle fibre type IIa (p < 0.05). The mRNA expression quantities of SDH and LDH gene was higher via RT‐PCR method. However, the expression of Ca2+ ATPase remains similar. In conclusion, appropriate oral administration of l‐carnitine of 25 mg/pigeon/day will result in an improvement of muscles related to flying.
Revisiting Chinese‐speaking children's understanding of argument structure
Authors: Jiang Lu , Haryu Etsuko
Published: October 2013

A causative verb is likely to appear in a sentence with two noun arguments, whereas a noncausative verb tends to appear in a sentence with a single argument. The present research investigates from what point children learning Chinese begin to show this knowledge of argument structure. Two‐, 3‐, 4‐, and 5‐year‐old children were tested using a forced‐choice pointing task. The results showed that Chinese‐speaking children aged 2 years could associate a transitive construction with a causative event, whereas they were not able to map an intransitive construction to a noncausative event even after reaching 5 years of age. The reason why Chinese children have such difficulty in learning knowledge of intransitive construction is discussed, focusing on (a) the semantic properties of certain intransitive verbs, which have been found not only in Chinese but also in other languages, and (b) the ellipsis of arguments, which is characteristic of Chinese.
Detection and identification of mycobacteria in fixed stained smears and formalin‐fixed paraffin‐embedded tissues using PCR
Authors: Reppas G. , Fyfe J. , Foster S. , Smits B. , Martin P. , Jardine J. , Lam A. , O'Brien C. , Malik R.
Published: October 2013

Objective

To determine the feasibility of using polymerase chain reaction to amplify DNA from methanol‐fixed, Romanowsky‐stained and Ziehl‐Neelsen‐stained smears to confirm the presence of mycobacteria.

Materials and Methods

Tissue was obtained from 10 archival slides and 27 slides from a prospective series of consecutive cases. Phosphate buffered saline (500 μL) was pipetted onto a stained smear (on a glass slide) using a disposable filtered pipette tip. The material adherent to the slide was scraped from its surface and drawn up into the saline. Routine DNA extraction and purification was carried out before nested polymerase chain reaction testing targeting the 16S‐23S internal transcribed spacer region or a TaqMan real‐time polymerase chain reaction. The real‐time polymerase chain reaction was also used on thick sections cut from formalin‐fixed paraffin‐embedded tissue blocks from 24 canine leproid granulomas.

Results

Mycobacterial DNA was detected in 34 of 37 slides. Polymerase chain reaction products could not be amplified from three archived smears stained using the Ziehl‐Neelsen acid‐fast method, probably because its harsher fixation damaged the DNA. With the nested polymerase chain reaction, species identification using internal transcribed spacer sequence analysis was achieved in all instances, diagnosing a wide range of mycobacteria. The real‐time polymerase chain reaction detected Mycobacterium sp. CLG DNA within all 24 formalin‐fixed paraffin‐embedded specimens tested.

Clinical Significance

This technique should provide a non‐invasive and cost‐effective means of diagnosing mycobacterial infections.
Effects of Different Steps in Gender Reassignment Therapy on Psychopathology: A Prospective Study of Persons with a Gender Identity Disorder
Authors: Heylens Gunter , Verroken Charlotte , De Cock Sanne , T'Sjoen Guy , De Cuypere Griet
Published: October 2013

Introduction

At the start of gender reassignment therapy, persons with a gender identity disorder (GID) may deal with various forms of psychopathology. Until now, a limited number of publications focus on the effect of the different phases of treatment on this comorbidity and other psychosocial factors.

Aims

The aim of this study was to investigate how gender reassignment therapy affects psychopathology and other psychosocial factors.

Methods

This is a prospective study that assessed 57 individuals with GID by using the Symptom Checklist-90 (SCL-90) at three different points of time: at presentation, after the start of hormonal treatment, and after sex reassignment surgery (SRS). Questionnaires on psychosocial variables were used to evaluate the evolution between the presentation and the postoperative period. The data were statistically analyzed by using SPSS 19.0, with significance levels set at P < 0.05.

Main Outcome Measures

The psychopathological parameters include overall psychoneurotic distress, anxiety, agoraphobia, depression, somatization, paranoid ideation/psychoticism, interpersonal sensitivity, hostility, and sleeping problems. The psychosocial parameters consist of relationship, living situation, employment, sexual contacts, social contacts, substance abuse, and suicide attempt.

Results

A difference in SCL-90 overall psychoneurotic distress was observed at the different points of assessments (P = 0.003), with the most prominent decrease occurring after the initiation of hormone therapy (P < 0.001). Significant decreases were found in the subscales such as anxiety, depression, interpersonal sensitivity, and hostility. Furthermore, the SCL-90 scores resembled those of a general population after hormone therapy was initiated. Analysis of the psychosocial variables showed no significant differences between pre- and postoperative assessments.

Conclusions

A marked reduction in psychopathology occurs during the process of sex reassignment therapy, especially after the initiation of hormone therapy.
Urinary Incontinence in Premenopausal Women: Prevalence, Risk Factors and Impact on Quality of Life
Authors: ÜNLÜ Mehmet , ÜSTÜNER Işık , GÜVEN Emine Seda G. , ŞENTÜRK Şenol , ŞAHIN Figen K.
Published: October 2013

Objectives

To determine the prevalence and risk factors of urinary incontinence (UI), and assess its impact on the quality of life (QOL) in premenopausal women.

Methods

In this cross‐sectional study, 690 women aged from 18 to 53 were interviewed using a demographic questionnaire and the International Consultation on Incontinence Questionnaire Short Form.

Results

The overall prevalence of any UI was 27.2%. Of the 188 women reporting UI the types were: stress 36.7%, urgency 32.4% and mixed 30.9%. The mean value of the age and body mass index (BMI) of the cases with UI was statistically significantly higher than the group without UI (P < 0.01). In the premenopausal women of similar age and BMI the incontinence rate was significantly higher in those who had a normal vaginal delivery than those who had a Cesarean section (P < 0.01). In the logistic regression analysis it was determined that the effect on the occurrence of incontinence was as follows in terms of age, education and number of pregnancies; age > 35 years had an odds ratio of 1.896 (95% confidence interval [CI]:1.29–2.80); the effect of the status of not attending a school or only attending primary school had an odds ratio 1.839 (95% CI: 1.23–2.75) and the number of pregnancies > 2 had an odds ratio 1.495 (95% CI:1.00–2.26).

Conclusion

Being older than 35, having a low educational level and a gravida greater than two are the independent risk factors in terms of the occurrence of UI in premenopausal women.
Prospective Randomized Study of MiniArc and Ajust Single Incision Sling Procedures
Authors: MARTAN Alois , KRHUT Jan , MAŠATA Jaromír , ŠVABÍK Kamil , HALAŠKA Michael , HORČIČKA Lukáš , ZACHOVAL Roman
Published: October 2013

Objectives

The aim of this study was to evaluate the efficacy of the Ajust and MiniArc system mini‐sling anti‐incontinence procedures for female stress urinary incontinence, at a minimum of 24 months after surgery.

Methods

This prospective, randomized, multicenter study included 66 women with previously untreated stress urinary incontinence, and 63 patients completed the study. These women were randomly divided into two groups; the first group of patients underwent operations using the Ajust (n = 33) technique, while the second group were treated with the MiniArc (n = 33) technique. The efficacy of the Ajust and MiniArc procedures (n = 31/32) was evaluated at an average of 28/29 months (minimum24 months) after the procedures. Subjective assessment of the cure rate and the leakage of urine was based on the International Consultation on Incontinence Questionnaire ‐ Short Form (ICIQ‐UI SF) and five‐point Likert scale. Objective assessment of leakage of urine was assessed by the cough test.

Results

Subjective assessment by the ICIQ‐UI SF questionnaire showed that 93.5–96.9% of patients were dry or improved 28/29 months after the Ajust/MiniArc operations. Based on evaluation by means of the Likert scale, 83.9/81.3% of patients in the Ajust/MiniArc group were dry or improved. Objective assessment by cough test showed that 93.5/81.3% of patients had negative results for this test 28/29 months after the Ajust/MiniArc procedures.

Conclusions

The cure rates of the Ajust and MiniArc procedures are very good with the follow‐up of 24 months.
Association between Chronic Periodontal Disease and Lower Urinary Tract Symptoms in Both Sexes
Authors: MATSUMOTO Seiji , MATSUDA Mitsuyoshi , TAKEKAWA Masanori , OKADA Masuhiko , HASHIZUME Kazumi , WADA Naoki , HORI Jun‐ichi , KITA Masafumi , IWATA Tatsuya , KAKIZAKI Hidehiro
Published: October 2013

Objective

To investigate the relationship between chronic periodontal disease (CPD) and lower urinary tract symptoms (LUTS) in both sexes.

Methods

The interview sheet of the CPD self‐checklist and LUTS was distributed to 600 adult men and women (300 each) who visited the first dental examination at dental clinics. The International Prostate Symptom Score (IPSS) questionnaire/Quality Of Life (IPSS/QOL) and Overactive Bladder Symptom Score (OABSS) were used to assess LUTS. The relationship between the CPD score and LUTS or OAB was examined.

Results

The interview sheet was collected from 88 men (50.9 ± 16.6 years old) and 97 women (51.1 ± 15.5 years old). There was no statistically significant correlation between the CPD score and age, or between the CPD score and the presence of LUTS in either men or women. However, urgency and weak stream score of IPSS were significantly correlated with the severity of CPD in both sexes. Significant correlation between the severity of CPD and the presence of OAB was only noted in men but not in women.

Conclusions

The present study demonstrated for the first time that some storage and voiding symptoms were significantly associated with CPD in both sexes. Thus, although CPD and LUTS seem to have common pathophysiological factors, the interrelationship between CPD and LUTS is slightly different between men and women.
Genetic evidence for landscape effects on dispersal in the army ant Eciton burchellii
Authors: Soare Thomas W. , Kumar Anjali , Naish Kerry A. , O'Donnell Sean
Published: October 2013

Inhibited dispersal, leading to reduced gene flow, threatens populations with inbreeding depression and local extinction. Fragmentation may be especially detrimental to social insects because inhibited gene flow has important consequences for cooperation and competition within and among colonies. Army ants have winged males and permanently wingless queens; these traits imply male‐biased dispersal. However, army ant colonies are obligately nomadic and have the potential to traverse landscapes. Eciton burchellii, the most regularly nomadic army ant, is a forest interior species: colony raiding activities are limited in the absence of forest cover. To examine whether nomadism and landscape (forest clearing and elevation) affect population genetic structure in a montane E. burchellii population, we reconstructed queen and male genotypes from 25 colonies at seven polymorphic microsatellite loci. Pairwise genetic distances among individuals were compared to pairwise geographical and resistance distances using regressions with permutations, partial Mantel tests and random forests analyses. Although there was no significant spatial genetic structure in queens or males in montane forest, dispersal may be male‐biased. We found significant isolation by landscape resistance for queens based on land cover (forest clearing), but not on elevation. Summed colony emigrations over the lifetime of the queen may contribute to gene flow in this species and forest clearing impedes these movements and subsequent gene dispersal. Further forest cover removal may increasingly inhibit Eciton burchellii colony dispersal. We recommend maintaining habitat connectivity in tropical forests to promote population persistence for this keystone species.
DEMOCRATIC GOVERNANCE AND POLITICAL RATIONALITIES IN THE IMPLEMENTATION OF THE WATER FRAMEWORK DIRECTIVE IN THE NETHERLANDS
Authors: BEHAGEL JELLE HENDRIK , ARTS BAS
Published: October 2013

Multi‐level governance, network governance, and, more recently, experimentalist governance are important analytical frameworks through which to understand democratic governance in the EU. However, these analytical frameworks carry normative assumptions that build on functionalist roots and undervalue political dynamics. This can result in a lack of understanding of the challenges that democratic governance faces in practice. This article proposes the analysis of democratic governance from the perspective of multiple political rationalities to correct such assumptions. It analyses the implementation of the Water Framework Directive in the Netherlands as a paradigmatic case study by showing how governmental, instrumental, and deliberative rationalities are at work in each of the governance elements that it introduces. The article concludes by discussing the implications of a perspective of multiple political rationalities for the understanding and promotion of democratic governance in practice.
Acetaminophen (Paracetamol) Oral Absorption and Clinical Influences
Authors: Raffa Robert B. , Pergolizzi Joseph V. , Taylor Robert , Decker John F. , Patrick Jeffrey T.
Published: October 2013

Acetaminophen (paracetamol) is a widely used nonopioid, non‐NSAIDanalgesic that is effective against a variety of pain types, but the consequences of overdose can be severe. Because acetaminophen is so widely available as a single agent and is increasingly being formulated in fixed‐ratio combination analgesic products for the potential additive or synergistic analgesic effect and/or reduced adverse effects, accidental cumulative overdose is an emergent concern. This has rekindled interest in the sites, processes, and pharmacokinetics of acetaminophen oral absorption and the clinical factors that can influence these. The absorption of oral acetaminophen occurs primarily along the small intestine by passive diffusion. Therefore, the rate‐limiting step is the rate of gastric emptying into the intestines. Several clinical factors can affect absorptionper seor the rate of gastric emptying, such as diet, concomitant medication, surgery, pregnancy, and others. Although acetaminophen does not have the abuse potential of opioids or the gastrointestinal bleeding or organ adverse effects ofNSAIDs, excess amounts can produce serious hepatic injury. Thus, an understanding of the sites and features of acetaminophen absorption—and how they might be influenced by factors encountered in clinical practice—is important for pain management using this agent. It can also provide insight for design of formulations that would be less susceptible to clinical variables.
Delirious behavior or mild reduction of consciousness mimicking influenza‐associated encephalopathy
Authors: Azumagawa Kohji , Kashiwagi Mitsuru , Shimakawa Shuichi , Tanabe Takuya , Tamai Hiroshi
Published: October 2013

Background

During the A/H1N1 pandemic, patients suffered from impaired consciousness. They were suspected of or diagnosed as having influenza‐associated encephalopathy (IAE) in an emergency situation. Their symptoms resembled those of a recently described ‘unique clinical group’, which were reported to have a favorable prognosis.

Methods

We retrospectively examined 46 patients and divided them into two groups. Group IC contained the 26 patients with persisting impaired consciousness. The remainder of the patients were categorized into group R, consisting of patients with only neurological symptoms without impaired consciousness.

Results

Male predominance (22 male/four female) was noted in group IC. Patient age ranged from 5 to 12 years old (mean ± SD, 7.7 ± 2.3 years). Impaired consciousness such as delirious behavior or mild reduction of consciousness lasted continuously or intermittently from 5 min to 2.5 days. On electroencephalogram, semi‐rhythmic high‐voltage slow waves in the parieto‐occipital regions and diffuse high‐voltage slow waves were observed in eight and in two patients, respectively. In group R, there was no gender predominance. Patient age ranged from 1 to 9 years old (mean ± SD, 4.1 ± 2.5 years). All group R patients were clinically diagnosed with febrile seizure.

Conclusions

Some of the characteristics in group IC resembled those of the unique clinical group, and are part of a continuous clinical spectrum. Some patients may have favorable outcome without specific treatment.
Buying time: The use of extracorporeal membrane oxygenation as a bridge to lung transplantation in pediatric patients
Authors: Casswell Georgina K. , Pilcher David V. , Martin Rani S. , Pellegrino Vincent A. , Marasco Silvana F. , Robertson Colin , Butt Warwick , Buckland Mark , Gooi Julian , Snell Gregory I. , Westall Glen P.
Published: October 2013

To describe our experience to date of four children with end‐stage lung disease who have been bridged with ECMO to successful lung transplantation in our institution. Between March 2006 and June 2012, a total of 21 pediatric patients successfully underwent lung transplantation within The Alfred's lung transplantation program. This included four children who were bridged on ECMO prior to transplantation according to the “ECMO bridge to transplant” protocol and whose clinical notes and outcomes were reviewed. Lung transplantation is an established life‐saving treatment for patients with severe lung disease, but remains limited due to scarcity of suitable donor organs. This is a particular issue in the pediatric setting, where the smaller child waits disproportionately longer compared with adult patients for size‐matched donor lungs. As ECMO has become more widely accepted, its use as a bridge to lung transplantation in pediatric patients with severe acute lung injury or end‐stage chronic lung disease has been considered. The medical notes from the four pediatric patients were retrospectively reviewed. Our report describes excellent short‐ and medium‐term outcomes in a small number of children who have been bridged to transplant on ECMO.
Intra‐operative extracorporeal membrane oxygenation use in pediatric lung transplantation – The Zurich experience
Authors: Zuercher Alice J. , Inci Ilhan , Benden Christian , Fretz Gregory , Béchir Markus , Boehler Annette , Weder Walter
Published: October 2013

There is a lack of data regarding use of ECMO in children undergoing lung transplantation. We evaluated our experience of ECMO in pediatric lung transplant recipients. All patients (<18 yr) who underwent lung transplants between 1997 and 2011 were included (17 children; nine males; median age 16 yr), and the use of intra‐operative ECMO evaluated. Transplant procedures were carried out with intra‐operative ECMO in seven children (all bilateral lung transplants). Demographics of ECMO and non‐ECMO patients were comparable. One child was already on ECMO pre‐operative. Lung graft size reduction was undertaken in five ECMO and four non‐ECMO cases, respectively. Five patients were taken off ECMO intra‐operatively; the other patients were weaned off ECMO within 48 h post‐operatively. Three‐months survival was 100%. By 12 months post‐transplantation, one patient each died in the ECMO and in the non‐ECMO group. At the end of the study, six of seven ECMO cases were still alive (median survival 48.5 months); one patient required a retransplant at 53 months. Our small case series suggests that lung transplant procedures can be safely carried out in selected children on intra‐operative ECMO support; however, our pediatric experience regarding this scenario is very limited but probably almost unique.
Peripheral blood biomarkers for the characterization of alloimmune reactivity after pediatric liver transplantation
Authors: Briem‐Richter Andrea , Leuschner Alexander , Krieger Thorsten , Grabhorn Enke , Fischer Lutz , Nashan Bjoern , Haag Friedrich , Ganschow Rainer
Published: October 2013

Individualization of immunosuppressive medications is an important objective in transplantation medicine. Reliable biomarkers to distinguish between patients dependent from intensive immunosuppressive therapy and those where therapy can be minimized among pediatric transplant recipients receiving immunosuppressive medications are still not established. We evaluated the potential of cross‐sectional quantification of regulatory T cells, lymphocyte subsets, and cytokine concentrations as biomarkers in 60 pediatric liver transplant recipients with AR, CR, or normal graft function and in 11 non‐transplanted patients. Transplant recipients presenting with AR had significantly higher CD8+ T‐cell counts, significantly higher concentrations of IL‐2, and increased levels of IFN‐γ compared with asymptomatic patients or controls. Regulatory T‐cell numbers did not differ between children with rejection and children with good graft function. A tendency toward increased concentrations of IL‐4 and TGF‐β was detected in transplant recipients with good graft function. Cross‐sectional parameters of peripheral regulatory T cells in pediatric liver transplant recipients do not seem to be valuable biomarkers for individualizing immunosuppressive therapy prior to the weaning process. Lymphocyte subsets, IL‐2, IFN‐γ, IL‐4, and TGF‐β serum concentrations may be helpful to identify children in whom immunosuppression can be reduced or discontinued.
Post‐transplant lymphoproliferative disorder: No relationship to recombinant human growth hormone use in Australian and New Zealand pediatric kidney transplant recipients
Authors: Longmore Danielle K. , Conwell Louise S. , Burke John R. , McDonald Stephen P. , McTaggart Steven J.
Published: October 2013

PTLD is a potentially life‐limiting complication of pediatric transplantation. Previous registry‐based studies in renal transplantation have suggested a link between rhGH use and PTLD. In this study, demographic and transplant data on those aged <18 yr and transplanted between 1991 and 2008 were collected from the ANZDATA Registry. Associations between gender, age at time of transplant, recipient CMV and EBV status, use of monoclonal antibody therapy, and use of rhGH were studied as potential predictors of PTLD. Among 650 transplants, there were 20 cases (3.1%) of PTLD, with half presenting within two yr post‐transplant. Eight patients exposed to rhGH at any time developed PTLD, and this association was not statistically significant (RR = 1.5[0.6–3.4], p = 0.36). On multivariate analysis, there were no significant predictors for PTLD. In this study, previously identified potential risk factors were not identified as significant predictors for the development of PTLD. Although limited sample size may affect our ability to infer safety, this large retrospective cohort study does not suggest an increased risk of PTLD in pediatric kidney transplant recipients who received rhGH treatment.
Chimerism of allogeneic mesenchymal cells in bone marrow, liver, and spleen after mesenchymal stem cells infusion
Authors: Meleshko Alexander , Prakharenia Irina , Kletski Semen , Isaikina Yanina
Published: October 2013

Although an infusion of culture‐expanded MSCs is applied in clinic to improve results of HSCs transplantation and for a treatment of musculoskeletal disorders, homing, and engraftment potential of culture‐expanded MSC in humans is still obscure. We report two female patients who received allogeneic BM transplantation as a treatment of hematological diseases and a transplantation of MSCs from third‐party male donors. Both patients died within one yr of infectious complications. Specimens of paraffin‐embedded blocks of tissues from transplanted patients were taken. The aim of the study was to estimate possible homing and engraftment of allogeneic BM‐derived MSCs in some tissues/organs of recipient. Sensitive real‐time quantitative PCR analysis was applied with SRY gene as a target. MSC chimerism was found in BM, liver, and spleen of both patients. We conclude that sensitive RQ‐PCR analysis is acceptable for low‐level chimerism evaluation even in paraffin‐embedded tissue specimens.
Prospective Relations Between Adolescents' Social‐emotional Competencies and Their Friendships
Authors: von Salisch Maria , Zeman Janice , Luepschen Nadine , Kanevski Rimma
Published: October 2013

Little is known about what factors predict the formation of reciprocal same‐sex friendships during early adolescence. To examine whether social‐emotional competencies aid in establishing and maintaining these friendships at the beginning and end of seventh grade, 380 German youth (mean age = 12.6 years; 49 percent boys; 100 percent White) reported on their peer support networks and on three broad categories of social‐emotional competencies (i.e., non‐constructive anger regulation, constructive anger regulation, emotional awareness, and expression disclosure). Regression analyses indicated the number of reciprocal friendships at Time 2 (T2) was predicted by adolescents' constructive anger regulation through redirection of attention, and social support when angry at the friend, even after controlling for Time 1 number of friends and peer acceptance. Among girls, willingness to self‐disclose marginally predicted their number of reciprocal friends at T2. Results are discussed in terms of the specific social‐emotional competencies that facilitate involvement in reciprocal friendships.
Where Am I? Investigating Map Matching During Self‐Localization With Mobile Eye Tracking in an Urban Environment
Authors: Kiefer Peter , Giannopoulos Ioannis , Raubal Martin
Published: October 2013

Self‐localization is the process of identifying one's current position on a map, and it is a crucial part of any wayfinding process. During self‐localization the wayfinder matches visually perceptible features of the environment, such as landmarks, with map symbols to constrain potential locations on the map. The success of this visual matching process constitutes an important factor for the success of self‐localization. In this research we aim at observing the visual matching process between environment and map during self‐localization with real‐world mobile eye tracking. We report on one orientation and one self‐localization experiment, both in an outdoor urban environment. The gaze data collected during the experiments show that successful participants put significantly more visual attention to those symbols on the map that were helpful in the given situation than unsuccessful participants. A sequence analysis revealed that they also had significantly more switches of visual attention between map symbols and their corresponding landmarks in the environment, which suggests they were following a more effective self‐localization strategy.
Expression of TWISTED DWARF1 lacking its in‐plane membrane anchor leads to increased cell elongation and hypermorphic growth
Authors: Bailly Aurélien , Wang Bangjun , Zwiewka Marta , Pollmann Stephan , Schenck Daniel , Lüthen Hartwig , Schulz Alexander , Friml Jiri , Geisler Markus
Published: October 2013

Plant growth is achieved predominantly by cellular elongation, which is thought to be controlled on several levels by apoplastic auxin. Auxin export into the apoplast is achieved by plasma membrane efflux catalysts of the PIN‐FORMED (PIN) and ATP‐binding cassette protein subfamily B/phosphor‐glycoprotein (ABCB/PGP) classes; the latter were shown to depend on interaction with the FKBP42, TWISTED DWARF1 (TWD1). Here by using a transgenic approach in combination with phenotypical, biochemical and cell biological analyses we demonstrate the importance of a putative C‐terminal in‐plane membrane anchor of TWD1 in the regulation of ABCB‐mediated auxin transport. In contrast with dwarfed twd1 loss‐of‐function alleles, TWD1 gain‐of‐function lines that lack a putative in‐plane membrane anchor (HA–TWD1‐Ct) show hypermorphic plant architecture, characterized by enhanced stem length and leaf surface but reduced shoot branching. Greater hypocotyl length is the result of enhanced cell elongation that correlates with reduced polar auxin transport capacity for HA–TWD1‐Ct. As a consequence, HA–TWD1‐Ct displays higher hypocotyl auxin accumulation, which is shown to result in elevated auxin‐induced cell elongation rates. Our data highlight the importance of C‐terminal membrane anchoring for TWD1 action, which is required for specific regulation of ABCB‐mediated auxin transport. These data support a model in which TWD1 controls lateral ABCB1‐mediated export into the apoplast, which is required for auxin‐mediated cell elongation.
Neonatal blood transfusion as transmission route in chronic hepatitis C
Authors: Einberg Afrodite Psaros , Lindh Gudrun , Hökeberg Ingegerd , Papadogiannakis Nikos , Fischler Björn
Published: October 2013

Background

The aim of this study was to investigate if neonatal transfusions could underlie chronic hepatitis C in adults for whom the disease transmission route was previously unknown.

Study Design and Methods

Questionnaires were sent to 255 patients with chronic hepatitis C born in Sweden in 1960 to 1975. The medical records of 230 of the patients, of whom 98 (43%) had unknown transmission route, were studied regarding the occurrence of neonatal blood transfusions. The clinical, virologic, and histopathologic characteristics of those found to have received transfusions as neonates were also studied.

Results

Four of 230 (1.7%; 95% confidence interval, 0.5%‐4.4%) patients with hepatitis C had received blood products as neonates. Three of them had reported unknown transmission route. One had cirrhosis, while two had mild histopathologic findings on liver biopsy. Three out of four patients in the transfused group, including the patient with liver cirrhosis, had undergone treatment for hepatitis C, all of them with a sustained viral response.

Conclusion

Previously unidentified neonatal blood transfusions explain only a small fraction of chronic hepatitis C cases with unknown transmission route. Individual patients infected early in life can develop progressive liver damage as young adults and may benefit from antiviral treatment. The finding suggests that efforts are needed to actively trace and test adults who have been subjected to neonatal blood product transfusion before 1992.
Putative paraneoplastic pemphigus and myasthenia gravis in a cat with a lymphocytic thymoma
Authors: Hill Peter B. , Brain Phil , Collins David , Fearnside Steve , Olivry Thierry
Published: October 2013

Background

Paraneoplastic pemphigus (PNP) is a rare and severe autoimmune blistering skin disease of humans. It is associated mainly with haematopoietic neoplasia and a unique autoantibody profile. At this time and in animals,PNPhas only been reported in dogs.

Objectives

To report clinical, histological and immunological findings in a cat with suspected thymoma‐associatedPNP.

Animal

An 8‐year‐old female spayedHimalayan cat.

Results

The cat presented with a thoracic mass diagnosed as a lymphocytic thymoma. Two weeks postremoval, the cat developed myasthenia gravis, which was controlled with prednisolone and pyridostigmine. The myasthenia gravis resolved, but the cat developed severe cutaneous erosions and ulcers primarily affecting the caudal ventral abdomen and perineum, but also the ventral chest, axillae and medial pinnae. Histopathological analysis revealed changes consistent with pemphigus vulgaris and erythema multiforme, a combination of lesions highly suggestive ofPNP. Direct immunofluorescence revealed intercellular epidermal IgG deposition in the lower epidermis, especially in areas of suprabasal clefts. Indirect immunofluorescence revealed antikeratinocyte IgG to basal keratinocytes and bladder epithelial cells. Immunological results supported a diagnosis ofPNP. Skin lesions were treated with prednisolone and chlorambucil and, after clinical remission was obtained, the drugs were tapered and eventually discontinued without further recurrence of skin lesions.

Conclusions and clinical importance

In this cat, clinical, microscopic and immunological findings were consistent with a diagnosis ofPNP, with thymoma being the suspected cause.
Tailoring Strongly Nonlinear Negative Stiffness
Authors: Liu F. , Theodossiades S. , McFarland D. M. , Vakakis A. F. , Bergman L. A.
Published: October 2013

Negative, nonlinear stiffness elements have been recently designed as configurations of pairs or groups of linear springs. We propose a new design of such a system by using a single linear spring with its moving end rolling on a path described by an equation of varying complexity. We examine the effect that the selection of the path has on the size of the deflection regime where negative stiffness is achieved. The stability properties of the equilibrium positions of the system are also investigated, highlighting the influence that the complexity of the path equation brings. The latter naturally affects the characteristics of the forcing functions around these positions. It is demonstrated that the properties of the system can be tailored according to the nature of the equation used and we show how essentially nonlinear negative stiffness elements, (i.e., with no linear parts) can be designed. These results provide a useful standpoint for designers of such systems, who wish to achieve the desired properties in reduced space, which is a common requirement in modern applications.
Set Adaptive Observers for Linear Parameter-Varying Systems: Application to Fault Detection
Authors: Efimov Denis , Raïssi Tarek , Zolghadri Ali
Published: October 2013

This paper deals with the problem of joint state and parameter estimation based on a set adaptive observer design. The problem is formulated and solved for an LPV (linear parameter-varying) system. The resolution methodology avoids the exponential complexity obstruction usually encountered in the set-membership parameter estimation. A simulation example is presented to illustrate the efficiency of the proposed approach.
Experimental Comparison of Three Floating Wind Turbine Concepts
Authors: Goupee Andrew J. , Koo Bonjun J. , Kimball Richard W. , Lambrakos Kostas F. , Dagher Habib J.
Published: October 2013

Beyond many of Earth's coasts exists a vast deepwater wind resource that can be tapped to provide substantial amounts of clean, renewable energy. However, much of this resource resides in waters deeper than 60 m where current fixed bottom wind turbine technology is no longer economically viable. As a result, many are looking to floating wind turbines as a means of harnessing this deepwater offshore wind resource. The preferred floating platform technology for this application, however, is currently up for debate. To begin the process of assessing the unique behavior of various platform concepts for floating wind turbines, 1/50th scale model tests in a wind/wave basin were performed at the Maritime Research Institute Netherlands (MARIN) of three floating wind turbine concepts. The Froude scaled tests simulated the response of the 126 m rotor diameter National Renewable Energy Lab (NREL) 5 MW, horizontal axis Reference Wind Turbine attached via a flexible tower in turn to three distinct platforms, these being a tension leg-platform, a spar-buoy, and a semisubmersible. A large number of tests were performed ranging from simple free-decay tests to complex operating conditions with irregular sea states and dynamic winds. The high-quality wind environments, unique to these tests, were realized in the offshore basin via a novel wind machine, which exhibited low swirl and turbulence intensity in the flow field. Recorded data from the floating wind turbine models include rotor torque and position, tower top and base forces and moments, mooring line tensions, six-axis platform motions, and accelerations at key locations on the nacelle, tower, and platform. A comprehensive overview of the test program, including basic system identification results, is covered in previously published works. In this paper, the results of a comprehensive data analysis are presented, which illuminate the unique coupled system behavior of the three floating wind turbines subjected to combined wind and wave environments. The relative performance of each of the three systems is discussed with an emphasis placed on global motions, flexible tower dynamics, and mooring system response. The results demonstrate the unique advantages and disadvantages of each floating wind turbine platform.
Ablation Dynamics of Silicon by Femtosecond Laser and the Role of Early Plasma
Authors: Zhao X. , Shin Y. C.
Published: October 2013

In this paper, the femtosecond laser ablation of silicon is investigated by a two-dimensional hydrodynamic model. The ablation depth of the silicon wafer ablated in air at different laser intensities is calculated, and the corresponding experimental measurements are carried out for validation. Two different ablation regimes have been identified by varying the laser fluence. While two-photon absorption dominates in the low fluence regime (<2 J/cm2), electron heat diffusion is a major energy transport mechanism at higher laser fluences (>2 J/cm2). The ablation efficiency first increases with the laser fluence, and reaches the peak value at the laser fluence around 8 J/cm2. It starts to drop when the laser fluence further increases, because of the early plasma absorption of the laser beam energy.
Manufacturing Assembly Time Estimation Using Structural Complexity Metric Trained Artificial Neural Networks
Authors: Miller Michael G. , Summers Joshua D. , Mathieson James L. , Mocko Gregory M.
Published: October 2013

Assembly time estimation is traditionally a time-intensive manual process that requires detailed geometric and process information, which is often subjective and qualitative in nature. As a result, assembly time estimation is rarely applied during early design iterations. In this paper, the authors explore the possibility of automating the assembly time estimation process while reducing the level of design detail required. In this approach, they train artificial neural networks (ANNs) to estimate the assembly times of vehicle subassemblies using either assembly connectivity or liaison graph properties, respectively, as input data. The effectiveness of estimation is evaluated based on the distribution of estimates provided by a population of ANNs trained on the same input data using varying initial conditions. Results indicate that this method can provide time estimates of an assembly process with ±15% error while relying exclusively on the geometric part information rather than process instructions.