bluuebunny/crossref_metadata_2025 huggingface dataset:
Pain monitoring in anesthetized children: first assessment of skin conductance and analgesia‐nociception index at different infusion rates of remifentanil
Authors: Sabourdin Nada , Arnaout Michel , Louvet Nicolas , Guye Marie‐Laurence , Piana Federica , Constant Isabelle
Published: November 2012

Background

Analgesia and nociception can not be specifically monitored during general anesthesia. Movement of the patient or hemodynamic variations are usually considered as symptoms of insufficient analgesia. The measure of skin conductance (SC) allows an assessment of peripheral sympathetic activity. The analgesia‐nociception index (ANI) provides an evaluation of the parasympathetic activity based on heart rate variability. These two non‐invasive monitors might allow a better assessment of perioperative nociception.

Objectives

Describe the profiles of SC and ANI after a standardized nociceptive stimulation, in anesthetized children, at different infusion rates of remifentanil.

Materials/Methods

For this pilot study, 12 children (8.4 ± 5 years) scheduled for middle‐ear surgery were anesthetized with desflurane to maintain a bispectral index at 50. Remifentanil was used for analgesia, at an initial infusion rate of 0.2 μg·kg−1·min−1. Remifentanil infusion rate was then decreased: Five steady‐state periods of 10 min were obtained at 0.2, 0.16, 0.12, 0.08, and 0.04 μg·kg−1·min−1. At the end of each period, a standardized tetanic stimulation was applied to the patient. Variations in heart rate, blood pressure, SC, and ANI were recorded before and after each stimulation.

Results

After the stimulation, ANI was significantly decreased compared with prestimulation values for all remifentanil infusion rates. This decrease was greater at 0.04 μg·kg−1·min−1 than at the other infusion rates. SC, heart rate, and blood pressure were not modified by the stimulations, whatever the dose of remifentanil.

Conclusion

ANI might provide a more sensitive assessment of nociception in anesthetized children than hemodynamic parameters or skin conductance.
The development of continuous positive airway pressure: an interview with Dr. George Gregory
Authors: Mai Christine L. , Yaster Myron , Firth Paul
Published: November 2012

George Gregory, M.D. (1934‐), Professor Emeritus at the University of California, San Francisco, has made numerous contributions to neonatology and pediatric anesthesia through his research efforts and authoritative textbook, Gregory's Pediatric Anesthesia. However he identified his defining moment as the occasion he saved the life of an infant suffering from neonatal respiratory distress syndrome by using continuous positive airway pressure (CPAP) ventilation. The development of CPAP by Gregory revolutionized the treatment of premature infants with respiratory failure. Prior to the creation of this treatment, the mortality rate of neonates with respiratory distress syndrome was >50%. The innovation markedly improved the ventilation of infants with respiratory distress and led to significant improvements in survival rates. Based on an interview with Dr. Gregory, this article describes the discovery of CPAP and reviews his career in advancing pediatric anesthesia and critical care medicine.
The paracetamol concentration‐effect relation in neonates
Authors: Allegaert Karel , Naulaers Gunnar , Vanhaesebrouck Sophie , Anderson Brian J
Published: November 2012

Objectives

We suggested a loading dose (20 mg·kg−1) followed by 10 mg·kg−1 q6h of intravenous (IV) paracetamol to achieve an effect compartment concentration of 11 mg·l−1 in neonates. Since there are no pharmacodynamic data to support such an effect compartment concentration, pain scores collected in neonates treated with an IV paracetamol loading dose (20 mg·kg−1) were used to validate this effect compartment concentration.

Methods

Pain scores (Leuven Neonatal Pain Score, LNPS, 0–14) before and 0.5, 1, 2, 3, 4, 5, and 6 h after IV paracetamol loading dose administration in neonates to whom IV paracetamol was administered as single analgesic (PARANEO, www.clinicaltrials.gov, NCT00969176) were collected. Trends were analyzed using repeated measures anova. An Emax model with a delayed response compartment was fitted to data using population modeling.

Results

Nineteen of 60 neonates included in the PARANEO study received monotherapy with IV paracetamol to treat mild to moderate pain (e.g., alprostadil administration, delivery related trauma). Using repeated measures anova, there was a trend (P = 0.02) for lower pain scores within 30 min after administration, with a slight increase in pain scores from 5 to 6 h. An Emax model had a maximum effect of 4.15 pain units, an EC50 of 2.07 mg·l−1. Equilibration halftime (T1/2keo) was 1.58 h.

Conclusion

Intravenous paracetamol is effective for moderate pain. An effect compartment concentration of 10 mg·l−1 (loading dose of 20 mg·kg−1) is associated with a pain score reduction of 3.4 LNPS units. This analysis suggests a similar paracetamol effect compartment concentration in neonates compared to children.
Development of Zn‐related necrosis in tobacco is enhanced by expressing AtHMA4 and depends on the apoplastic Zn levels
Authors: SIEMIANOWSKI OSKAR , BARABASZ ANNA , WEREMCZUK ALEKSANDRA , RUSZCZYŃSKA ANNA , BULSKA EWA , WILLIAMS LORRAINE ELIZABETH , ANTOSIEWICZ DANUTA MARIA
Published: November 2012

The aim of the ms was to better understand the Zn‐sensitive phenotype obtained as a result of expression of AtHMA4 (coding for a Zn‐export protein) in tobacco. We found that due to AtHMA4 expression the apoplast is overloaded with Zn, and development of necrosis (symptom of Zn toxicity) is related to the Zn concentration in the apoplast, and not to the Zn concentration in leaves. It was hypothesized that the Zn concentration is ‘sensed’ in the apoplast; when apoplastic Zn levels exceed a threshold, a signal is generated which initiates mechanisms leading to loading of Zn excess into a compact groups of cells which eventually die resulting in necrosis. Thus the appearance of necrosis on one hand is a symptom of Zn toxicity, but on the other could be regarded as a defense mechanism initiated when a plant faces high Zn toxicity.
Prevalence of the E318K MITF germline mutation in Italian melanoma patients: associations with histological subtypes and family cancer history
Authors: Ghiorzo P. , Pastorino L. , Queirolo P. , Bruno W. , Tibiletti M. G. , Nasti S. , Andreotti V. ,   Genoa Pancreatic Cancer Study Group, Paillerets B. Bressac‐de , Bianchi Scarrà G.
Published: November 2012

A French and an Australian study have recently identified a rare germline functional variant in the microphthalmia‐associated transcription factor (MITF) (E318K) that predisposes to familial and sporadic melanoma and to renal cell carcinoma (RCC), showing a new link between two tumour types with different risk factors and between deregulated sumoylation and cancer. The aim of this study was to test the prevalence of the MITF E318K mutation in 667 Italian melanoma patients. We observed significant associations between histological subtypes and family cancer history. Carriers exhibited a nearly threefold higher risk of developing melanoma compared with controls. Carriers were also more likely to have developed multiple primary melanomas (6.40‐fold), compared with wt patients. Carriers with a personal and/or family history of pancreatic cancer and kidney cancer had a nearly 31‐ and eightfold higher risk of developing melanoma compared with wt patients. Our findings further support MITF as a medium‐penetrance melanoma susceptibility gene, highlight a potential association with histological subtypes and suggest that MITF may predispose to pancreatic cancer.
Bilateral Acromial Dimples: A Case Report and Review of the Literature
Authors: Debosz Joanna , Haber Richard M.
Published: November 2012

Bilateral acromial dimples are uncommon in pediatric dermatology. They are usually found as a sporadic finding with limited clinical symptoms but may cause concern for parents. They can occur spontaneously or be inherited. Bilateral acromial dimples may occasionally be present as part of more complex syndromes. This article reports an 18‐month‐old girl with congenital bilateral acromial dimples and presents a classification of this unusual entity. A literature review of English and non‐English publications was performed. We report the second case of bilateral acromial dimples seen in the context of maternal cocaine use during pregnancy. Our case is probably sporadic and nonsyndromal. We suggest that bilateral acromial dimples be classified as syndromal or nonsyndromal and that nonsyndromal cases be subdivided into inherited and sporadic. Although bilateral acromial dimples can be seen in 18q deletion syndrome, Apert syndrome, Say syndrome, and a recently described syndrome in Brazil, our review of the literature does not support the association with trisomy 9 syndrome. Dermatologists need to be aware of this unusual cutaneous finding and potential syndromal associations. The significance of the association with fetal exposure to cocaine during pregnancy has yet to be determined. The biological mother was not available for assessment for bilateral acromial dimples.
Extragenital Bullous Lichen Sclerosus in a Pediatric Patient: A Case Report and Literature Review
Authors: Shiver Mallory , Papasakelariou Catherine , Ahmad Brown Jameel , Wirges Marla , Kincannon Jay
Published: November 2012

A 14‐year‐old girl presented with a 1‐year history of a pruritic, bullous lesion on her posterior neck. A biopsy revealed bullous lichen sclerosus. Although unusual, this bullous variant of lichen sclerosus is well recognized in the adult literature, but extragenital bullous and hemorrhagic lesions are rare in children. A review of this case and the literature describes the clinical features, pathophysiology, and treatment options for this extragenital bullous variant in an effort to raise awareness of this rare clinical presentation.
Annual and herbaceous perennial native Australian plant species are symptomless hosts of Phytophthora cinnamomi in the Eucalyptus marginata (jarrah) forest of Western Australia
Authors: Crone M. , McComb J. A. , O'Brien P. A. , Hardy G. E. St J.
Published: November 2012

Resistant annual and herbaceous perennial plant species were identified as key hosts which allow Phytophthora cinnamomi to persist on severely impacted black gravel sites within the Eucalyptus marginata (jarrah) forest of southwest Western Australia. Of the annual and herbaceous perennial plant species present on black gravel sites, 15 out of 19 species were found to be hosts of P. cinnamomi, and 10 of these were symptomless hosts. In particular, the native annual Trachymene pilosa and the two native herbaceous perennials Stylidium diuroides and Chamaescilla corymbosa were commonly found to be hosts of the pathogen. Species from 12 new genera including three from new families (Crassulaceae, Droseraceae and Primulaceae) are reported for the first time to be hosts of P. cinnamomi. The species from which P. cinnamomi was recovered were the native species: Chamaescilla corymbosa, Crassula closiana, Drosera erythrorhiza, Hydrocotyle callicarpa, Levenhookia pusilla, Paracaleana nigrita, Podotheca angustifolia, Pterochaeta paniculata, Rytidosperma caespitosum, Siloxerus multiflorus, Stylidium diuroides and Trachymene pilosa, and the introduced annual weeds Hypochaeris glabra, Lysimachia arvensis and Pentameris airoides.
Melatonin Treatment at Dry‐off Improves Reproductive Performance Postpartum in High‐producing Dairy Cows under Heat Stress Conditions
Authors: Garcia‐Ispierto I , Abdelfatah A , López‐Gatius F
Published: November 2012

Contents

The aim of this study was to determine the effect of melatonin treatment during the early dry‐off period on subsequent reproductive performance and milk production in high‐producing dairy cows under heat stress conditions. In experiment I, addressing the pharmacokinetics of melatonin treatment in lactating dairy cows, doses of untreated, 3, 6, 9 or 12 implants/animal (18‐mg melatonin each implant) were given as subcutaneous implants on gestation day 120–20 multiparous lactating dairy cows (four cows/dose group). Experiment II was performed during the warm season on 25 heifers and 114 high milk‐producing Holstein‐Friesian cows. Animals were randomly assigned to a control (C) or melatonin group (M). Animals in the M group received nine implants (heifers) or 12 (cows) of melatonin on day 220 of gestation. In experiment I, cows in the 12 implants group showed a higher maximum melatonin concentration (Cmax) and area under the concentration curve from treatment day 0 to day 49 (AUC0–49d) than those in the remaining groups, among which there were no significant differences in this variable. In experiment II, the likelihood of repeat breeding syndrome (<3 vs ≥4 AIs per cow) and pregnancy loss (first trimester) were 0.36 and 0.19 times lower in treated than control animals, respectively. Plasma prolactin levels decreased significantly (p = 0.01) after melatonin treatment and recovered during the postpartum compared to control cows. No significant effects on milk production were observed in the subsequent lactation. Significant differences in days open between groups (means 123 ± 71.9 and 103 ± 43, respectively, for C and M; p = 0.02) were registered. In conclusion, melatonin treatment in the early dry‐off period improves the reproductive performance of dairy cattle, reducing the number of days open, repeat breeding syndrome and pregnancy loss.
Cognitive testing in non‐demented Turkish immigrants ‐ comparison of the RUDAS and the MMSE
Authors: NIELSEN T. R. , VOGEL A. , GADE A. , WALDEMAR G.
Published: November 2012

Nielsen, T. R. Vogel, A., Gade, A. & Waldemar, G. (2012). Cognitive testing in healthy Turkish immigrants ‐ comparison of the RUDAS and the MMSE. Scandinavian Journal of Psychology 53, 455–460.

Methods for culturally and linguistically appropriate cognitive testing of elderly minority populations are lacking in Europe. The aim of this study was to compare performance on the Rowland Universal Dementia Assessment Scale (RUDAS) and the Mini Mental State Examination (MMSE) in Turkish immigrants in Denmark and determine the impact of demographic and health‐related variables on test performance. A sample of non‐demented community‐dwelling Turkish immigrants was recruited from the greater Copenhagen area. All participants completed a structured interview regarding demographic, physical and mental health status, as well as measures of depression and acculturation, and cognitive testing with the RUDAS and the MMSE. A total of 76 non‐demented participants aged 50 or more were included in the study. The mean performance on the RUDAS and the MMSE was 26.8 (SD 2.4) and 23.7 (SD 4.3), respectively. In group comparisons, correlation analyses and regression analyses, level of schooling represented a more significant variable for RUDAS and MMSE performance than any other variable. However, the impact of schooling was considerably more pronounced on the MMSE and the test was not found to be a valid measure of general cognitive function in subjects with less than five years of schooling. Although not entirely free of educational bias, the RUDAS can be a valuable supplement to the MMSE for assessment of general cognitive function in Turkish minority populations.
Development of sense of coherence during two group interventions
Authors: KÄHÖNEN KARI , NÄÄTÄNEN PETRI , TOLVANEN ASKO , SALMELA‐ARO KATARIINA
Published: November 2012

Kähönen, K., Näätänen, P., Tolvanen, A. & Salmela‐Aro, K. (2012). Development of sense of coherence during two group interventions. Scandinavian Journal of Psychology 53, 523–527.

Burnout is a serious occupational hazard. This study investigated the possibility to develop an effective salutogenic group intervention among employees suffering from severe burnout symptoms. Participants consisted of employees aged 31 to 59 years working in different public service occupations, such as police officers, tax officers, (and other public service officers), and assigned to three different groups: analytic (N = 25), psychodramatic (N = 24) and controls (N = 28). The intervention comprised 16 separate days over a nine‐month period. Changes in sense of coherence (SOC) were measured four times with the 13‐item Orientation to Life Questionnaire during the intervention and at six‐month follow‐up, and analyzed by general linear model (GLM) and using Cohen’s d to estimate effect sizes. Change in SOC between the three groups was statistically significant (F(4,148) = 2.65, p = 0.036). The psychodrama group showed a higher increase in SOC than the analytic group during the intervention, while the improvement in the analytic group was significant during the six‐month follow‐up. Total effect size from baseline to follow‐up was in the analytic group 0.71, in the psychodrama group 0.47, and in the control group from baseline to end of intervention 0.09. The results show that it is possible to improve SOC by group intervention in the occupational healthcare context. The dialogue‐based analytic method and action‐based psychodramatic method differ in their specific effects.
Social Construction of Community and Immigration Networks in Rural Areas: Towards a Dynamic View of Their Importance to Balkan Immigrants
Authors: Labrianidis Lois , Sykas Theodosis
Published: November 2012

In this study we firstly introduce a source of social capital formation that has not yet been pointed out by the theory of social capital. We do this by historically assessing the social structures in South European rural areas, with a particular focus on the ones prevailing in the Greek countryside. This is the historically embedded sense of community for people living in agricultural communities. Secondly, we introduce immigrants' social networks into the countryside's particular social environment in order to juxtapose their importance for the immigrants' integration. Our conclusion, articulated in four prepositions, is that, the interaction of immigrants with the communal structures and with the characteristics of the social capital, which is based on the sense of community, creates under appropriate conditions a favourable environment for the immigrants' socioeconomic integration.
Under Pressure: Young Farmers In Marriage Markets – A Greek Case Study
Authors: Kaberis Nikos , Koutsouris Alex
Published: November 2012

Gender issues, and masculinity in particular, have increasingly drawn the attention of scholars in the last decade. Nevertheless, given the well‐established phenomenon of young rural women's rejection of framers and exodus from rural areas, scant attention is paid to the issue of rural marriage markets. This article aims to address the topic of young farmers' perceptions and practices in their search for a bride. The target population was young males who joined the ‘Young Farmers’ programme in two tobacco producing communities in Greece. Utilising Bourdieu's oeuvre (especially ‘habitus’), we argue that young male farmers do not seem able to reflect on their current position in the local marriage market and, in general, challenge dominant structures owing to themselves being ‘trapped’ in the tobacco production habitus (including dominant masculinity). While consciousness‐raising and change seem difficult the implications of the current crisis (including social suffering and disorders) are not yet plainly manifested.
In the aftermath of the end‐Permian extinction: the microbialite refuge?
Authors: Forel Marie‐Béatrice , Crasquin Sylvie , Kershaw Steve , Collin Pierre‐Yves
Published: November 2012

We present the first study of micro‐crustaceans (ostracods) associated with microbial crusts in the aftermath of the most devastating extinction, the end‐Permian extinction (EPE). These post‐extinction microbialites dominated shallow shelf marine environments and were traditionally considered as devoid of any associated fauna. We present a micro‐palaeontological analysis of a large record from microbial and non‐microbial settings following the EPE. This dataset documents the proliferation of ostracods strictly associated with microbialites. Based on the diet of extant ostracods and uniformitarianism, we propose that the abundant microbes in the mats served as an unlimited food supply. Photosynthetic cyanobacteria may also have locally provided oxygen under low oxygen conditions interpreted by others for the microbialites. Microbialites provided a specialised environment that may have acted as refuge for ostracods in the immediate aftermath of the EPE. The surviving faunas may have been progenitors for the starting of the latter radiation.
The HOPS Proteins hVps41 and hVps39 Are Required for Homotypic and Heterotypic Late Endosome Fusion
Authors: Pols Maaike S. , ten Brink Corlinda , Gosavi Prajakta , Oorschot Viola , Klumperman Judith
Published: November 2012

The homotypic fusion and protein sorting (HOPS) complex is a multisubunit tethering complex that in yeast regulates membrane fusion events with the vacuole, the yeast lysosome. Mammalian homologs of all HOPS components have been found, but little is known about their function. Here, we studied the role of hVps41 and hVps39, two components of the putative human HOPS complex, in the endo‐lysosomal pathway of human cells. By expressing hemagglutinin (HA)‐tagged constructs, we show by immunoelectron microscopy (immunoEM) that both hVps41 and hVps39 associate with the limiting membrane of late endosomes as well as lysosomes. Small interference RNA (siRNA)‐mediated knockdown of hVps41 or hVps39 resulted in an accumulation of late endosomes, a depletion in the number of lysosomes and a block in the degradation of endocytosed cargo. Lysosomal pH and cathepsin B activity remained unaltered in these conditions. By immunoEM we found that hVps41 or hVps39 knockdown impairs homotypic fusion between late endosomes as well as heterotypic fusion between late endosomes and lysosomes. Thus, our data show that both hVps41 and hVps39 are required for late endosomal–lysosomal fusion events and the delivery of endocytic cargo to lysosomes in human cells.
Adaptor Protein Complexes AP‐4 and AP‐5: New Players in Endosomal Trafficking and Progressive Spastic Paraplegia
Authors: Hirst Jennifer , Irving Carol , Borner Georg H.H.
Published: November 2012

The adaptor proteins (APs) are a family of five heterotetrameric complexes with important functions in vesicle trafficking. While the roles of APs 1–3 are broadly established, comparatively little is known about AP‐4 and AP‐5. Current evidence suggests that AP‐4 mediates TGN to endosome transport of specific cargo proteins, such as the amyloid precursor protein APP, and that it is involved in basolateral sorting in polarized cells. Furthermore, several independent studies have reported human patients with mutations in AP‐4 genes. AP‐4 deficiency causes severe intellectual disability and progressive spastic para‐ or tetraplegia, supporting an important role for AP‐4 in brain function and development. The newly discovered AP‐5 complex appears to be involved in endosomal dynamics; its precise localization and function are still unclear. Intriguingly, AP‐5 deficiency is also associated with progressive spastic paraplegia, suggesting that AP‐5, like AP‐4, plays a fundamental role in neuronal development and homeostasis. The unexpected phenotypic parallels between AP‐4 and AP‐5 patients may in turn suggest a functional relationship of the two APs in vesicle trafficking.
Multiple Sorting Systems for Secretory Granules Ensure the Regulated Secretion of Peptide Hormones
Authors: Sun Meng , Watanabe Tsuyoshi , Bochimoto Hiroki , Sakai Yuko , Torii Seiji , Takeuchi Toshiyuki , Hosaka Masahiro
Published: November 2012

Prior to secretion, regulated peptide hormones are selectively sorted to secretory granules (SGs) at the trans‐Golgi network (TGN) in endocrine cells. Secretogranin III (SgIII) appears to facilitate SG sorting process by tethering of protein aggregates containing chromogranin A (CgA) and peptide hormones to the cholesterol‐rich SG membrane (SGM). Here, we evaluated the role of SgIII in SG sorting in AtT‐20 cells transfected with small interfering RNA targeting SgIII. In the SgIII‐knockdown cells, the intracellular retention of CgA was greatly impaired, and only a trace amount of CgA was localized within the vacuoles formed in the TGN, confirming the significance of SgIII in both the tethering of CgA‐containing aggregates and the establishment of the proper SG morphology. Although the intracellular retention of proopiomelanocortin (POMC) was considerably impaired in SgIII‐knockdown cells, residual adrenocorticotropic hormone (ACTH)/POMC was still localized to some few remaining SGs together with another granin protein, secretogranin II (SgII), and was secreted in a regulated manner. Biochemical analyses indicated that SgII bound directly to the SGM in a cholesterol‐dependent manner and was able to retain the aggregated form of POMC, revealing a latent redundancy in the SG sorting and retention mechanisms, that ensures the regulated secretion of bioactive peptides.
Development of a Quick Dynamic Response Maximum Power Point Tracking Algorithm for Off-Grid System With Adaptive Switching (On–Off) Control of dc/dc Converter
Authors: Averbukh M. , Ben-Galim Y. , Uhananov A.
Published: November 2012

This paper presents a new approach of Adaptive Search Control Method to perform maximum power point tracking (MPPT) in solar panels (SP). The suggested approach adapts the operation point (current I and voltage V) of the solar panel so quickly that it tracks MPP under the harshest environmental conditions by incorporating a flexible switching in a Boost dc/dc converter, which connects the photovoltaic (PV) panel to the load. The usage of a flexible switching control increases the dynamic response of MPPT and the efficiency of tracking. A dedicated simulink (matlab) model was developed for validation of the proposed MPPT method which was verified through multiple simulation conditions. Based on these results, the prototype system for evaluating the suggested method was developed and assembled. This prototype was developed on the base of a photonic integrated circuit (PIC) family microcontroller unit with an external circuit for accurate voltage and current measurements. The technical characteristics of the developed system (efficiency and tracking speed) have been verified experimentally with a 100 W c-Si solar panel under various environmental conditions. The results of measured and estimated MPPT efficiency were represented.
Comparative Analysis of Solar Thermal Cooling and Solar Photovoltaic Cooling Systems
Authors: Fumo N. , Bortone V. , Zambrano J. C.
Published: November 2012

The Energy Information Administration of the United States Department of Energy projects that more than 80% of the energy consumption of the U.S. by 2035 will come from fossil fuels. This projection should be the fuel to promote projects related to renewable energy in order to reduce energy consumption from fossil fuels to avoid their undesirable consequences such as carbon dioxide emissions. Since solar radiation match pretty well building cooling demands, solar cooling systems will be an important factor in the next decades to meet or exceed the green gases reduction that will be demanded by the society and regulations in order to mitigate environmental consequences such as global warming. Solar energy can be used as source of energy to produce cooling through different technologies. Solar thermal energy applies to technology such as absorption chillers and desiccant cooling, while electricity from solar photovoltaic can be used to drive vapor compression electric chillers. This study focuses on the comparison of a solar thermal cooling system that uses an absorption chiller driven by solar thermal energy, and a solar photovoltaic cooling system that uses a vapor compression system (electric chiller) driven by solar electricity (solar photovoltaic system). Both solar cooling systems are compared against a standard air cooled cooling system that uses electricity from the grid. The models used in the simulations to obtain the results are described in the paper along with the parameters (inputs) used. Results are presented in two figures. Each figure has one curve for the solar thermal cooling system and one for the solar photovoltaic cooling system. One figure allows estimation of savings calculated based the present value of discounted energy consumption cost. The other figure allows estimating primary energy consumption reduction and emissions reduction. Both figures presents the result per ton of refrigeration and as a function of area of solar collectors or/and area of photovoltaic modules. This approach to present the result of the simulations of the systems makes these figures quite general. This means that the results can be used to compare both solar cooling systems independently of the cooling demand (capacity of the system), as well as allow the analysis for different sizes of the solar system used to harvest the solar energy (collectors or photovoltaic modules).
An Autoclavable Steerable Cannula Manual Deployment Device: Design and Accuracy Analysis
Authors: Burgner Jessica , Swaney Philip J. , Bruns Trevor L. , Clark Marlena S. , Rucker D. Caleb , Burdette E. Clif , Webster Robert J.
Published: November 2012

Accessing a specific, predefined location identified in medical images is a common interventional task for biopsies and drug or therapy delivery. While conventional surgical needles provide little steerability, concentric tube continuum devices enable steering through curved trajectories. These devices are usually developed as robotic systems. However, manual actuation of concentric tube devices is particularly useful for initial transfer into the clinic since the Food and Drug Administration (FDA) and Institutional Review Board (IRB) approval process of manually operated devices is simple compared to their motorized counterparts. In this paper, we present a manual actuation device for the deployment of steerable cannulas. The design focuses on compactness, modularity, usability, and sterilizability. Further, the kinematic mapping from joint space to Cartesian space is detailed for an example concentric tube device. Assessment of the device’s accuracy was performed in free space, as well as in an image-guided surgery setting, using tracked 2D ultrasound.
Modulation of Vigilance in the Primary Hypersomnias by Endogenous Enhancement of GABA
A
Receptors
Authors: Rye David B. , Bliwise Donald L. , Parker Kathy , Trotti Lynn Marie , Saini Prabhjyot , Fairley Jacqueline , Freeman Amanda , Garcia Paul S. , Owens Michael J. , Ritchie James C. , Jenkins Andrew
Published: November 2012

A component of cerebrospinal fluid in excessively sleepy people activates an inhibitory signaling pathway and mimics the actions of sedative-hypnotics.
Pharmacogenetics at 50: Genomic Personalization Comes of Age
Authors: Urban Thomas J. , Goldstein David B.
Published: November 2012

In the past five decades, genetic studies of drug responses have provided few durable clinically relevant genetic markers, but current genomic technologies promise to increase the pace of such discoveries.
Treating Epilepsy with a Light Potassium Diet
Authors: Bernard Christophe
Published: November 2012

Gene therapy in a rat model of focal epilepsy decreases neuron excitability, preventing epileptogenesis and abrogating epileptic activity.
The Neutrophil: A Work Horse, Not a Trojan Horse
Authors: Yipp Bryan G.
Published: November 2012

Neutrophils go beyond direct pathogen killing by initiating CD8 T cell immunity within the bone marrow.
Riboswitches for Intracellular Study of Genes Involved in
Francisella
Pathogenesis
Authors: Reynoso Colleen M. K. , Miller Mark A. , Bina James E. , Gallivan Justin P. , Weiss David S.
Published: November 2012

The study of many important intracellular bacterial pathogens requires an understanding of how specific virulence factors contribute to pathogenesis during the infection of host cells. This requires tools to dissect gene function, but unfortunately, there is a lack of such tools for research on many difficult-to-study, or understudied, intracellular pathogens. Riboswitches are RNA-based genetic control elements that directly modulate gene expression upon ligand binding. Here we report the application of theophylline-sensitive synthetic riboswitches to induce protein expression in the intracellular pathogen
Francisella
. We show that this system can be used to activate the bacterial expression of the reporter β-galactosidase during growth in rich medium. Furthermore, we applied this system to control the expression of green fluorescent protein during intracellular infection by the addition of theophylline directly to infected macrophages. Importantly, we could control the expression of a novel endogenous protein required for growth under nutrient-limiting conditions and replication in macrophages, FTN_0818. Riboswitch-mediated control of FTN_0818 rescued the growth of an
FTN_0818
mutant in minimal medium and during macrophage infection. This is the first demonstration of the use of a synthetic riboswitch to control an endogenous gene required for a virulence trait in an intracellular bacterium. Since this system can be adapted to diverse bacteria, the ability to use riboswitches to regulate intracellular bacterial gene expression will likely facilitate the in-depth study of the virulence mechanisms of numerous difficult-to-study intracellular pathogens such as
Ehrlichia chaffeensis
,
Anaplasma phagocytophilum
, and
Orientia tsutsugamushi
, as well as future emerging pathogens.

IMPORTANCE
Determining how specific bacterial genes contribute to virulence during the infection of host cells is critical to understanding how pathogens cause disease. This can be especially challenging with many difficult-to-study intracellular pathogens. Riboswitches are RNA-based genetic control elements that can be used to help dissect gene function, especially since they can be used in a broad range of bacteria. We demonstrate the utility of riboswitches, and for the first time show that riboswitches can be used to functionally control a bacterial gene that is critical to the ability of a pathogen to cause disease, during intracellular infection. Since this system can be adapted to diverse bacteria, riboswitches will likely facilitate the in-depth study of the virulence mechanisms of numerous difficult-to-study intracellular pathogens, as well as future emerging pathogens.
Unexpected Diversity of Signal Peptides in Prokaryotes
Authors: Payne Samuel H. , Bonissone Stefano , Wu Si , Brown Roslyn N. , Ivankov Dmitry N. , Frishman Dmitrij , Paša-Tolić Ljiljana , Smith Richard D. , Pevzner Pavel A.
Published: November 2012

Signal peptides are a cornerstone mechanism for cellular protein localization, yet until now experimental determination of signal peptides has come from only a narrow taxonomic sampling. As a result, the dominant view is that Sec-cleaved signal peptides in prokaryotes are defined by a canonical AxA motif. Although other residues are permitted in the motif, alanine is by far the most common. Here we broadly examine proteomics data to reveal the signal peptide sequences for 32 bacterial and archaeal organisms from nine phyla and demonstrate that this alanine preference is not universal. Discoveries include fundamentally distinct signal peptide motifs from
Alphaproteobacteria
,
Spirochaetes
,
Thermotogae
and
Euryarchaeota
. In these novel motifs, alanine is no longer the dominant residue but has been replaced in a different way for each taxon. Surprisingly, divergent motifs correlate with a proteome-wide reduction in alanine. Computational analyses of ~1,500 genomes reveal numerous major evolutionary clades which have replaced the canonical signal peptide sequence with novel motifs.

IMPORTANCE
This article replaces a widely held general model with a more detailed model describing phylogenetically correlated variation in motifs for Sec secretion.
Genomic Characterization of a Newly Discovered Coronavirus Associated with Acute Respiratory Distress Syndrome in Humans
Authors: van Boheemen Sander , de Graaf Miranda , Lauber Chris , Bestebroer Theo M. , Raj V. Stalin , Zaki Ali Moh , Osterhaus Albert D. M. E. , Haagmans Bart L. , Gorbalenya Alexander E. , Snijder Eric J. , Fouchier Ron A. M.
Published: November 2012

A novel human coronavirus (HCoV-EMC/2012) was isolated from a man with acute pneumonia and renal failure in June 2012. This report describes the complete genome sequence, genome organization, and expression strategy of HCoV-EMC/2012 and its relation with known coronaviruses. The genome contains 30,119 nucleotides and contains at least 10 predicted open reading frames, 9 of which are predicted to be expressed from a nested set of seven subgenomic mRNAs. Phylogenetic analysis of the replicase gene of coronaviruses with completely sequenced genomes showed that HCoV-EMC/2012 is most closely related to
Tylonycteris
bat coronavirus HKU4 (BtCoV-HKU4) and
Pipistrellus
bat coronavirus HKU5 (BtCoV-HKU5), which prototype two species in lineage C of the genus
Betacoronavirus
. In accordance with the guidelines of the International Committee on Taxonomy of Viruses, and in view of the 75% and 77% amino acid sequence identity in 7 conserved replicase domains with BtCoV-HKU4 and BtCoV-HKU5, respectively, we propose that HCoV-EMC/2012 prototypes a novel species in the genus
Betacoronavirus
. HCoV-EMC/2012 may be most closely related to a coronavirus detected in
Pipistrellus pipistrellus
in The Netherlands, but because only a short sequence from the most conserved part of the RNA-dependent RNA polymerase-encoding region of the genome was reported for this bat virus, its genetic distance from HCoV-EMC remains uncertain. HCoV-EMC/2012 is the sixth coronavirus known to infect humans and the first human virus within betacoronavirus lineage C.

IMPORTANCE
Coronaviruses are capable of infecting humans and many animal species. Most infections caused by human coronaviruses are relatively mild. However, the outbreak of severe acute respiratory syndrome (SARS) caused by SARS-CoV in 2002 to 2003 and the fatal infection of a human by HCoV-EMC/2012 in 2012 show that coronaviruses are able to cause severe, sometimes fatal disease in humans. We have determined the complete genome of HCoV-EMC/2012 using an unbiased virus discovery approach involving next-generation sequencing techniques, which enabled subsequent state-of-the-art bioinformatics, phylogenetics, and taxonomic analyses. By establishing its complete genome sequence, HCoV-EMC/2012 was characterized as a new genotype which is closely related to bat coronaviruses that are distant from SARS-CoV. We expect that this information will be vital to rapid advancement of both clinical and vital research on this emerging pathogen.
An unusual case of Parinaud's syndrome
Authors: Mallia Maria , Chircop Charmaine , Aquilina Josanne
Published: November 2012

A 25-year-old man presented with blurred vision, headache and dizziness. On questioning, there was also a history of a preceding diarrhoeal illness. Initial investigations were normal. However, after a week, he represented with a Parinaud's syndrome. In view of the preceding diarrhoea, the transient unsteadiness and the areflexia on examination, anti-GQ1b antibodies were requested. The resulting titre was positive confirming the suspected diagnosis of Miller Fisher syndrome. He responded to intravenous immunoglobulins with full resolution of his symptoms and signs. Although various unusual neuro-ophthalmological signs have been reported localising to the brainstem, to our knowledge, this is the first case report of Parinaud's syndrome being the presenting symptom of Miller Fisher syndrome.
Clinical improvement precedes lesion size regression in a severe case of acute disseminated encephalomyelitis
Authors: Stettner Mark , Albrecht Philipp , Derksen Angelika , Hartmann Christian , Turowski Bernd , Neuen-Jacob Eva , Hartung Hans Peter , Kieseier Bernd C , Arendt Gabriele
Published: November 2012

Here, we present a case of a severe acute disseminated encephalomyelitis (ADEM) of a 42-year-old male patient. The diagnosis was established after brain biopsy and due to acutely evolving encephalopathy occurring in the context of atypicalMycoplasma pneumoniae(MP). We analysed the prominent MRI white matter lesions using a three-dimensional algorithm as cutting-edge technique to study morphological abnormalities and correlated them to the clinical condition of the patient. We found a discrepancy between the lesion size and the clinical deficits of the patient, actually the clinical improvement antedated the regression of the white matter lesions.
Accessory mitral valve without subaortic obstruction of left ventricular outflow tract in a middle-aged male
Authors: Golias Christos , Bitsis Theodosis , Krikidis Dimitrios , Charalabopoulos Konstantinos
Published: November 2012

Accessory mitral valve (AMV) is a rare congenital abnormality with a usually early-age clinical onset, being potentially a cause of subvalvular obstruction of the left ventricular outflow tract. This report describes the case of a 60-year-old patient presented with palpitations and chest pain. Primary evaluation revealed a ventricular tachycardia episode while transthoracic echocardiography showed an intracardiac additional structure at the level of the left ventricular outflow tract. After transoesophageal echocardiography and paraclinical investigations this structure was proven to be an AMV tissue which did not provoke left ventricular outflow obstruction. This case presents an unusual late-age clinical onset of AMV without a clinically significant LVOT (left ventricular outflow tract) obstruction and highlights the importance of transthoracic and transoesophageal echocardiography in the diagnosis of this rare cardiological entity.
Jejunal intussusception: a cause of upper gastrointestinal bleeding?
Authors: Akter Farhana , Harilingam Mohanraj
Published: November 2012

Intussusception is an important cause of abdominal pain in the paediatric population and is the most common abdominal emergency in early childhood. Intussusception in adults is, however, rare and can lead to diagnostic challenges for admitting physicians/surgeons. We present a case of a 76-year-old lady with history of a recent myocardial infarction and vasculitis presenting with melaena and bleeding per rectum, with suspicion of haematochezia. She complained of abdominal pain but was not clinically obstructed. Gastroscopy performed was negative. Colonoscopy was attempted; however, it was inconclusive because of active bleeding. A CT angiogram of the abdomen was performed, which showed a jejunal intussusception. There was no evidence of vasculitis or small bowel obstruction. She was not considered fit for surgery and was managed conservatively.
Anticoagulant-induced priapism progressing to penile gangrene: a devastating complication!
Authors: Nagathan Deepak Sharanappa , Pahwa Harvinder Singh , Kumar Awanish , Goel Apul
Published: November 2012

A 35-year-old man developed priapism with the use of low-molecular-weight heparin and warfarin following repair of left brachial artery sustained after gunshot injury. Priapism progressed to penile gangrene despite decompression and distal shunt procedure leading to total penectomy and perineal urethrostomy. We describe the mechanism of anticoagulant (heparin and warfarin)-induced penile gangrene and the possible methods to avert such a devastating complication.
Central venous catheter embolisation
Authors: Harrison Elizabeth , Lal Simon
Published: November 2012

Tunnelled central venous catheters are commonly used for a variety of indications, including home parenteral nutrition, but are rarely associated with fracture and embolisation; the risk of embolisation is reported to be greater with catheters placed via the subclavian vein rather than the internal jugular route. We report the case of a 64-year-old woman with type 3 (chronic and irreversible) intestinal failure who presented with pain and swelling on infusion of parenteral nutrition through her internal jugular catheter. A chest x-ray showed fracture and embolisation of her catheter into the right ventricle. The embolised portion was retrieved and removed via the femoral route, without complication and the catheter replaced. We discuss causes of line embolisation, and highlight the possibility of embolisation occurring with an internal jugular catheter.
Dysplasia epiphysealis hemimelica: a huge articular mass with unpredictable surgical results
Authors: Luevitoonvechkij Sirichai , Khunsree Songsak , Sirirungruangsarn Yuddhasert , Settakorn Jongkolnee
Published: November 2012

Dysplasia epiphysealis hemimelica or Trevor's disease is a rare disorder of localised osteochondral overgrowth affecting the epiphysis of extremities. This paper reports a 12-year-old boy presenting with a large bony mass at the left ankle diagnosed as dysplasia epiphysealis hemimelica. The articular surface of the ankle joint of the patient was evaluated with preoperative and postoperative MRIs. The 2-year postoperative MRI showed early osteoarthritis of the ankle, therefore demonstrating the importance of early excision avoiding more complex resections of intra-articular lesions.
Ruptured aortic dissection presenting with new onset atrial fibrillation
Authors: Chang Rei-Yeuh , Kan Chung-Ben , Yan Yuan-Horng
Published: November 2012

We report this type A aortic dissection in both ascending and descending thoracic aorta presenting with new onset atrial fibrillation. CT images confirmed the final diagnosis. The mechanism may be due to compression of the left atrium by a large haematoma.
Pathological fracture of femur secondary to infected synovial sarcoma
Authors: Murphy Colin G , Treacy Ann , Dudeney Sean , O'Toole Gary C
Published: November 2012

Pathological fracture is not uncommon in musculoskeletal oncological surgical practice. When complicated by infection, it is both limb- threatening and life-threatening problem. Pathological fractures require urgent investigation, not urgent treatment. We present the case of a 75-year-old man who presented with an infected sarcoma causing a pathological fracture of his right femur.
The occult nature of intramedullary spinal cord metastases from renal cell carcinoma
Authors: Zakaria Zaitun , Fenton Eoin , Jansen Michael , O'Brien David
Published: November 2012

Renal cell carcinomas (RCC) are characterised by a tendency to metastasise widely, often while remaining occult. Intramedullary spinal cord metastases (ISCM) from RCC may be the presenting feature of the disease or present at any time in the disease course. This case report discusses an ISCM from RCC which became manifested at the time of resection of the primary tumour. We review the literature published on ISCM from RCC from 1990 to date comparing disease characteristics and presentations.