bluuebunny/crossref_metadata_2025 huggingface dataset:
Phase 2 trial of induction and concurrent chemoradiotherapy with weekly irinotecan and cisplatin followed by surgery for esophageal cancer
Authors: Ilson David H. , Minsky Bruce D. , Ku Geoffrey Y. , Rusch Valerie , Rizk Nabil , Shah Manish , Kelsen David P. , Capanu Marinela , Tang Laura , Campbell Jenny , Bains Manjit
Published: October 2011

BACKGROUND:

Preoperative chemoradiation improves survival in esophageal and gastroesophageal junction (GEJ) cancer. We evaluated irinotecan and cisplatin as induction chemotherapy followed by concurrent chemoradiation in esophageal cancer.

METHODS:

Patients with uT1N1M0 or uT2‐4NanyM0 resectable squamous cancer or adenocarcinoma of the esophagus or GEJ received irinotecan 65 mg/m2 and cisplatin 30 mg/m2 for 4 treatments in weeks 1 through 5, followed by 4 treatments in weeks 7 through 11 with 50.4 Gy in daily fractions, followed by surgery. The primary endpoint was pathologic complete response (pCR). Positron emission tomography (PET) scan was performed prior to chemotherapy and as restaging prior to radiotherapy.

RESULTS:

Fifty‐five patients were evaluable, 75% of whom had adenocarcinoma and 65% of whom had uT3N1 disease. Thirty‐eight patients underwent R0 resection (69%). The incidence of pCR was 16% (95% confidence interval, 8%‐29%). Median overall survival was 31.7 months. An exploratory analysis of PET response to induction chemotherapy indicated a correlation with pCR (32% vs 4%), R0 resection (84% vs 57%), progression‐free survival (24.1 vs 7.7 months), and overall survival (40.2 vs 25.5 months).

CONCLUSIONS:

Weekly treatment with irinotecan, cisplatin, and radiation achieved results no better and potentially inferior to other phase 2 chemoradiotherapy trials with a low rate of pCR. The use of PET scan after induction chemotherapy to direct chemotherapy during subsequent radiotherapy merits further study. Cancer 2011. © 2011 American Cancer Society.
Performance analysis of multicast routing and wavelength assignment protocol with dynamic traffic grooming in WDM networks
Authors: Kaliammal N. , Gurusamy G.
Published: October 2011

The need for on‐demand provisioning of wavelength‐routed channels with service‐differentiated offerings within the transport layer has become more essential because of the recent emergence of high bit rate Internet protocol (IP) network applications. Diverse optical transport network architectures have been proposed to achieve the above requirements. This approach is determined by fundamental advances in wavelength division multiplexing (WDM) technologies. Because of the availability of ultra long‐reach transport and all‐optical switching, the deployment of all‐optical networks has been made possible. The concurrent transmission of multiple streams of data with the assistance of special properties of fiber optics is called WDM. The WDM network provides the capability of transferring huge amounts of data at high speeds by the users over large distances. There are several network applications that require the support of QoS multicast, such as multimedia conferencing systems, video‐on‐demand systems, real‐time control systems, etc. In a WDM network, the route decision and wavelength assignment of lightpath connections are based mainly on the routing and wavelength assignment (RWA). The multicast RWA's task is to maximize the number of multicast groups admitted or minimize the call‐blocking probability. The dynamic traffic‐grooming problem in wavelength‐routed networks is generally a two‐layered routing problem in which traffic connections are routed over lightpaths in the virtual topology layer and lightpaths are routed over physical links in the physical topology layer. In this paper, a multicast RWA protocol for capacity improvement in WDM networks is designed. In the wavelength assignment technique, paths from the source node to each of the destination nodes and the potential paths are divided into fragments by the junction nodes and these junction nodes have the wavelength conversion capability. By using the concept of fragmentation and grouping, the proposed scheme can be generally applied for the wavelength assignment of multicast in WDM networks. An optimized dynamic traffic grooming algorithm is also developed to address the traffic grooming problem in mesh networks in the multicast scenario for maximizing the resource utilization and minimizing the blocking probability. Copyright © 2011 John Wiley & Sons, Ltd.
T‐cell prolymphocytic leukemia (T‐PLL) with overlapping cytomorphological features with T‐CLL and T‐ALL: A Case Initially Diagnosed by Fine‐Needle Aspiration Cytology and Immunocytochemistry
Authors: Das Dilip K. , Pathan Shahed K. , Joneja Munish , Al‐Musawi Fatma A. , John Bency , Mirza Kamran R.
Published: October 2011

T‐cell prolymphocytic leukemia (T‐PLL) is a very unusual form of chronic lymphoproliferative disorder, which has rarely been diagnosed by fine needle aspiration (FNA) cytology. We report one such case with some overlapping cytomorphological features with chronic lymphocytic leukemia and acute lymphoblastic leukemia. A 91‐year‐old man presented with generalized lymphadenopathy, pleural effusion, ascites, and an ulcerated growth in rectum. FNA smears from the left cervical lymph node showed a monotonous population of small lymphoid cells having small but distinct nucleoli that was initially diagnosed as chronic lymphocytic leukemia (CLL). Smears from the left axillary lymph node contained both small and medium‐sized lymphoid cells with frequent hand‐mirror cell appearance, which has been described in acute lymphoblatic leukemia (ALL). Immunocyto/histochemical stainings on smears and cell block preparations of the aspirate showed the following immunophenotype: CD3+, CD4+, CD5+, CD7+, CD8‐, CD20‐, CD23‐, and Tdt‐. Total peripheral blood leukocyte count was 26.4 × 109/L and total lymphocyte count, 8.3 × 109/L with predominance of small lymphocytes. T‐cell nature of the neoplasm was confirmed by biopsies from the cervical lymph node (T‐cell lymphoma), bone marrow (T‐cell lymphoid neoplasm/chronic lymphocytic leukemia), and the ulcerated rectal lesion (atypical T‐cell lymphoproliferative disorder). The patient developed deep vein thrombosis, heparin‐induced thrombocytopenia and bleeding from duodenal ulcer. By the time the reports of all the investigations were ready, the patient succumbed to bronchopneumonia. To the best of our knowledge, this T‐CLL/T‐PLL which was diagnosed initially by FNA cytology with immunocytochemical support is first of its kind to be reported. Diagn. Cytopathol. 2013;41:360–365. © 2011 Wiley Periodicals, Inc.
Stocks of carbon and nitrogen and partitioning between above‐ and belowground pools in the Brazilian coastal Atlantic Forest elevation range
Authors: Vieira Simone A. , Alves Luciana F. , Duarte‐Neto Paulo J. , Martins Susian C. , Veiga Larissa G. , Scaranello Marcos A. , Picollo Marisa C. , Camargo Plinio B. , do Carmo Janaina B. , Neto Eráclito Sousa , Santos Flavio A. M. , Joly Carlos A. , Martinelli Luiz A.
Published: October 2011

We estimated carbon and nitrogen stocks in aboveground biomass (AGB) and belowground biomass (BGB) along an elevation range in forest sites located on the steep slopes of the Serra do Mar on the north coast of the State of São Paulo, southeast Brazil. In elevations of 100 m (lowland), 400 m (submontane), and 1000 m (montane) four 1‐ha plots were established, and above‐ (live and dead) and belowground (live and dead) biomass were determined. Carbon and nitrogen concentrations in each compartment were determined and used to convert biomass into carbon and nitrogen stocks. The carbon aboveground stock (CAGB) varied along the elevation range from approximately 110 to 150 Mg·ha−1, and nitrogen aboveground stock (NAGB), varied from approximately 1.0 to 1.9 Mg·ha−1. The carbon belowground stock (CBGB) and the nitrogen belowground stock (NBGB) were significantly higher than the AGB and varied along the elevation range from approximately 200–300 Mg·ha−1, and from 14 to 20 Mg·ha−1, respectively. Finally, the total carbon stock (CTOTAL) varied from approximately 320 to 460 Mg·ha−1, and the nitrogen total stock (NTOTAL) from approximately 15 to 22 Mg·ha−1. Most of the carbon and nitrogen stocks were found belowground and not aboveground as normally found in lowland tropical forests. The above‐ and belowground stocks, and consequently, the total stocks of carbon and nitrogen increased significantly with elevation. As the soil and air temperature also decreased significantly with elevation, we found a significantly inverse relationship between carbon and nitrogen stocks and temperature. Using this inverse relationship, we made a first approach estimate that an increase of 1°C in soil temperature would decrease the carbon and nitrogen stocks in approximately 17 Mg·ha−1and 1 Mg·ha−1of carbon and nitrogen, respectively.
A Facile Approach for the Synthesis of Ag‐Coated Fe3O4@TiO2 Core/Shell Microspheres as Highly Efficient and Recyclable Photocatalysts
Authors: Zhang Yongxing , Yu Xinyao , Jia Yong , Jin Zhen , Liu Jinhuai , Huang Xingjiu
Published: October 2011

A facile, green, and efficient approach for the fabrication of Ag‐coated Fe3O4@TiO2 microspheres with a good core/shell structure has been demonstrated. The protocol employed involves the coating of successive layers of TiO2 nanoparticles on to a magnetic core using a vapor–thermal method at low temperature followed by the deposition of silver nanoparticles on the surface of the Fe3O4@TiO2 microspheres through a photochemical route. The Ag‐coated Fe3O4@TiO2 microspheres show excellent magnetic properties at room temperature. The photocatalytic properties of the products were investigated for the degradation of organic dyes. The loading of Ag nanoparticles coated on to the surface of the Fe3O4@TiO2 microspheres was controlled by changing the UV photoreduction time. The photocatalytic degradation rates were found to increase with the Ag nanoparticle loading until a maximum photodegradation rate was reached, further increasing the Ag loading led to a decrease in the photodegration rate. Furthermore, compared with that of Degussa P25 titania and uncoated Fe3O4@TiO2 microspheres, the products have better photocatalytic activity. The renewable photocatalytic activity of the microspheres was also examined. The results indicate that the catalytic activity was still present after recycling the photocatalysts five times. Thus, the Ag‐coated Fe3O4@TiO2 core/shell microspheres can serve as effective and conveniently recyclable photocatalysts.
Synthesis and characterization of mono‐acylglycerols through the glycerolysis of methyl esters obtained from linseed oil
Authors: Schulz Gracélie A. S. , da Silveira Kelly C. , Libardi Daniela B. , Peralba Maria do Carmo R. , Samios Dimitrios
Published: October 2011

Here we investigate the production and characterization of mono‐acylglycerols through the glycerolysis of biodiesel, a methyl ester mixture, obtained from linseed oil. The biodiesel employed was derived from linseed oil through transesterification according to transesterification double step process 1. The efficiency of H2SO4, CaO, and NaOH as catalysts was evaluated for the production of mono‐acylglycerols. The glycerolysis reactions were performed by varying the molar ratio of the reagents (biodiesel:glycerol), the type and amount of catalyst, reaction time and temperature. Systematic evaluation of reaction yield is shown as a function of these parameters. Reaction products were characterized through IR spectroscopy, hydrogen NMR, and the GC techniques. The study of three different catalysts indicated that the most efficient was 5% NaOH in a 1:5 biodiesel–glycerol molar ratio with 10 h reaction time. The reaction reached a maximum of 85% biodiesel conversion with a mono‐acylglycerol yield of 72% at 130°C.
Analysis and antioxidant capacity of the phenolic compounds from argan fruit (Argania spinosa (L.) Skeels)
Authors: El Monfalouti Hanae , Charrouf Zoubida , Belviso Simona , Ghirardello Daniela , Scursatone Bernardo , Guillaume Dominique , Denhez Clément , Zeppa Giuseppe
Published: October 2011

Polyphenol composition of the shell, pulp, and roasted and unroasted kernels of the argan fruit was qualitatively and quantitatively determined by HPLC coupled with electrospray negative ionization ion trap MS (HPLC‐ESI‐MS). Eleven phenolic compounds were identified. Unroasted kernels and shell contained various polyphenols but the pulp was characterized by a very high amount of total polyphenols (75.78 mg of gallic acid equivalent/g). The radical scavenging (DPPH. method) and antioxidant activity (ABTS method) of each fruit part was also determined. Argan fruit pulp showed the highest radical scavenging activity (0.17 ± 0.005 µM Trolox equivalent (TE)/mg) and antioxidant activity (0.375 ± 0.07 µM TE/mg). Therefore, argan fruit polyphenols are good candidates to be exploited as health supplements and nutraceuticals.
An upwinded state approximate Riemann solver
Authors: Srinivasan B. , Jameson A. , Krishnamoorthy S.
Published: October 2011

Stability is achieved in most approximate Riemann solvers through ‘flux upwinding’, where the flux at the interface is arrived at by adding a dissipative term to the average of the left and right flux. Motivated by the existence of a collapsed interface state in the gas‐kinetic Bhatnagar–Gross–Krook (BGK) method, an alternative approach to upwinding is attempted here; an interface state is arrived at by taking an upwinded average of left and right states, and then the flux is calculated as a function of this ‘collapsed’ interface state. This so called ‘state‐upwinding’ approach gives rise to a new scheme called the linearized Riemann solver for the Euler and Navier–Stokes equations. The scheme is shown to be closely associated with the Roe scheme. It is, however, computationally less expensive and gives qualitatively comparable results over a wide range of problems. Most importantly, this scheme is found to preserve stationary contacts while not exhibiting the carbuncle phenomenon which plagues the Roe and other contact‐preserving schemes. The scheme is therefore motivated as a new starting point to analyze the origin of the carbuncle phenomenon. Copyright © 2011 John Wiley & Sons, Ltd.
A correlative approach at characterizing nanoparticle mobility and interactions after cellular uptake
Authors: Schumann Christian , Schübbe Sabrina , Cavelius Christian , Kraegeloh Annette
Published: October 2011

The interactions of nanoparticles with human cells are of large interest in the context of nanomaterial safety. Here, we use live cell imaging and image‐based fluorescence correlation methods to determine colocalization of 88 nm and 32 nm silica nanoparticles with endocytotic vesicles derived from the cytoplasmic membrane and lysosomes, as well as to quantify intracellular mobility of internalized particles, in contrast to particle number quantification by counting techniques. In our study, A549 cells are used as a model for human type II alveolar epithelial cells. We present data supporting endocytotic uptake of the particles and subsequent active transport to the perinuclear region. The presence of particles in lamellar bodies is proposed as a potential exocytosis route. (© 2012 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Hyperspectral imaging microscopy for identification and quantitative analysis of fluorescently‐labeled cells in highly autofluorescent tissue
Authors: Leavesley Silas J. , Annamdevula Naga , Boni John , Stocker Samantha , Grant Kristin , Troyanovsky Boris , Rich Thomas C. , Alvarez Diego F.
Published: October 2011

Standard fluorescence microscopy approaches rely on measurements at single excitation and emission bands to identify specific fluorophores and the setting of thresholds to quantify fluorophore intensity. This is often insufficient to reliably resolve and quantify fluorescent labels in tissues due to high autofluorescence. Here we describe the use of hyperspectral analysis techniques to resolve and quantify fluorescently labeled cells in highly autofluorescent lung tissue. This approach allowed accurate detection of green fluorescent protein (GFP) emission spectra, even when GFP intensity was as little as 15% of the autofluorescence intensity. GFP‐expressing cells were readily quantified with zero false positives detected. In contrast, when the same images were analyzed using standard (single‐band) thresholding approaches, either few GFP cells (high thresholds) or substantial false positives (intermediate and low thresholds) were detected. These results demonstrate that hyperspectral analysis approaches uniquely offer accurate and precise detection and quantification of fluorescence signals in highly autofluorescent tissues. (© 2012 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Disadvantaged neighborhood influences on depression and anxiety in youth with perinatally acquired human immunodeficiency virus: how life stressors matter
Authors: Kang Ezer , Mellins Claude A. , Dolezal Curtis , Elkington Katherine S. , Abrams Elaine J.
Published: October 2011

Children living with perinatal HIV illness (PHIV+) disproportionately reside in disadvantaged neighborhoods and contend with persistent mental health challenges. This study examined the influences of disadvantaged residential neighborhood on anxiety and depression, and potential resources that buffer against internalizing problems when youths were exposed to neighborhood stressors. Multilevel analysis of 196 PHIV+ and 129 perinatally HIV‐exposed but uninfected youth (PHIV−) in New York City found that higher exposure to neighborhood disorder was associated with higher levels of depression and anxiety for PHIV+ and PHIV− youths. Stressful events unrelated to residential neighborhoods significantly mediated the relationship between neighborhood disorder and anxiety and depression. Social problem solving and religiosity did not moderate the relationship between neighborhood disorder and internalizing problems. Our findings highlighted that interventions that attenuate the negative effects of stressful life events were equally critical in addressing the broader impact of disadvantaged neighborhoods on the mental health of youth affected by HIV. © 2011 Wiley Periodicals, Inc.
Pathophysiology of stroke and stroke‐induced retinal ischemia: Emerging role of stem cells
Authors: Muthaian Rupadevi , Minhas Gillipsie , Anand Akshay
Published: October 2011

The current review focuses on pathophysiology, animal models and molecular analysis of stroke and retinal ischemia, and the role of stem cells in recovery of these disease conditions. Research findings associated with ischemic stroke and retinal ischemia have been discussed, and efforts towards prevention and limiting the recurrence of ischemic diseases, as well as emerging treatment possibilities with endothelial progenitor cells (EPCs) in ischemic diseases, are presented. Although most neurological diseases are still not completely understood and reliable treatment is lacking, animal models provide a major step in validating novel therapies. Stem cell approaches constitute an emerging form of cell‐based therapy to treat ischemic diseases since it is an attractive source for regenerative therapy in the ischemic diseases. In this review, we highlight the advantages and limitations of this approach with a focus on key observations from preclinical animal studies and clinical trials. Further research, especially on treatment with EPCs is warranted. J. Cell. Physiol. 227: 1269–1279, 2012. © 2011 Wiley Periodicals, Inc.
Dibenzo[d,f][1,3] dioxepine derivatives: A review
Authors: Zhang Hai‐Quan , Zhang Cheng‐Bo
Published: October 2011

This review presents a survey of synthetic methods and reaction mechanism of the dibenzo[d,f][1,3] dioxepine derivatives. Furthermore, the influence of the substituent groups in 6,6′‐position of dibenzo[d,f][1,3] dioxepine on their conformation is explored. The functional dibenzo[d,f][1,3] dioxepine synthetically versatiles substrate, as they can be used for synthesis of a large variety of π‐conjugated oligomer and polymer containing heterocyclic compounds, such as dibromination dibenzo[d,f][1,3] dioxepine derivative as a raw material of synthesis for organic semiconductor polymers. The synthetic and fluorescent property of π‐conjugated polymers basic on dibenzo[d,f][1,3] dioxepine also is explored. J. Heterocyclic Chem., (2012).
Trends in inpatient continuity of care for a cohort of Medicare patients 1996–2006
Authors: Fletcher Kathlyn E. , Sharma Gulshan , Zhang Dong , Kuo Yong‐Fang , Goodwin James S.
Published: October 2011

BACKGROUND:

Little is known about how changes in health care delivery, such as the use of hospitalists, have impacted inpatient continuity.

OBJECTIVE:

To examine the extent of inpatient discontinuity (ie, being seen by more than one generalist physician) during hospitalization for selected patients.

DESIGN:

Retrospective cohort.

SETTING:

4,859 US hospitals.

PATIENTS:

Medicare fee‐for‐service beneficiaries hospitalized for chronic obstructive pulmonary disease (COPD), pneumonia, and congestive heart failure (CHF) from 1996 through 2006.

MEASUREMENTS:

We analyzed the proportion of Medicare beneficiaries who received care from 1, 2, or 3 or more generalist physicians during hospitalization. We also examined the factors associated with continuity during the hospitalization.

RESULTS:

Between 1996 and 2006, 64.3% of patients received care from 1, 26.9% from 2 and 8.8% from 3 or more generalist physicians during hospitalization. The percentage of patients who received care from one generalist physician declined from 70.7% in 1996 to 59.4% in 2006 (P < 0.001). In a multivariable analysis, continuity with one generalist physician decreased by 5.5% (95% CI, 5.3%–5.6%) per year between 1996 and 2006. Patients receiving all care from hospitalists saw fewer generalist physicians compared to those who received all care from a non‐hospitalist or both. Older patients, females, non‐Hispanic whites, those with higher socioeconomic status, and those with more comorbidities were more likely to receive care from multiple generalist physicians.

LIMITATIONS:

The results may not be generalizable to non‐Medicare populations.

CONCLUSIONS:

Hospitalized patients are experiencing less continuity than 10 years ago. The hospitalist model of care does not appear to play a role in this discontinuity. Journal of Hospital Medicine 2011;6:441–447. © 2011 Society of Hospital Medicine.
Fast dixon whole‐body MRI for detecting distant cancer metastasis: a preliminary clinical study
Authors: Costelloe Colleen M. , Kundra Vikas , Ma Jingfei , Chasen Beth A. , Rohren Eric M. , Bassett Roland L. , Madewell John E.
Published: October 2011

Purpose:

To evaluate the feasibility of fast Dixon whole‐body (WB) magnetic resonance imaging (MRI) for detecting bone and liver metastasis in clinical patients and to compare its performance with skeletal scintigraphy (SS) for detecting bone metastases using reference imaging with >1 year follow‐up as the gold standard.

Materials and Methods:

Twenty‐nine patients with bone metastases prospectively underwent WB MRI and SS. WB MRI included coronal T2, axial T1 with and without intravenous gadolinium (including triphasic liver sequences), and axial diffusion‐weighted imaging, plus spinal sagittal postcontrast T1‐weighted images. The skeleton was divided into 16 segments. Reviewers blinded to other images identified up to five lesions per segment and rated them using a five‐point confidence scale for metastatic disease. Sensitivities and specificities were compared using the McNemar test.

Results:

The sensitivity of WB MRI and SS in detecting bone metastases was 70.8% and 59.6% (P = 0.003), respectively; specificity was 89.1% and 98.7% (P < 0.0001). WB MRI detected all livers with metastases (n = 8). One focal nodular hyperplasia was classified as a metastasis on WB MRI.

Conclusion:

Fast Dixon WB MRI is feasible in clinical patients, highly specific, and more sensitive than SS in detecting bone metastases, and can detect metastases of the liver. J. Magn. Reson. Imaging 2012;399‐408. © 2011 Wiley Periodicals, Inc.
Disruption of the AKT pathway inhibits metastasis in an orthotopic model of head and neck squamous cell carcinoma
Authors: Knowles Joseph A. , Golden Blake , Yan Li , Carroll William R. , Helman Emily E. , Rosenthal Eben L.
Published: October 2011

Objectives/Hypothesis:

MK‐2206 is an orally active, allosteric inhibitor of AKT, a component of the phosphatidylinositol‐3 kinase (PI3K) pathway. The PI3K‐AKT pathway is a downstream signaling pathway that has recently been found to play an important role in head and neck squamous cell carcinoma (HNSCC). The objective of this study is to examine the role AKT inhibition may play in treatment of HNSCC.

Study Design:

In vivo and in vitro study.

Methods:

Cell migration after 24‐hour treatment with subtherapeutic doses of MK‐2206 was assessed using an enzyme‐linked immunosorbent assay in four HNSCC cell lines: CAL27, FaDu, SCC‐1, and SCC‐5. In vitro effect of MK‐2206 on cell migration was assessed by making linear scratches in culture plates after cell lines were grown to confluency. Images were taken at 8, 16, and 24 hours. In vivo analysis was performed on nude mice with human SCC1‐orthotopic tongue tumors. After tumors were allowed to grow for 7 days, mice were treated with oral dosing of 120 mg/kg of MK‐2206 every other day for 2 weeks. Tumor size was assessed after each treatment using a pair of digital calipers. At the end of the treatment period, mice were sacrificed and cervical lymph nodes were assessed for metastasis using fluorescent imaging of tumor cell markers.

Results:

Subtherapeutic doses of MK‐2206 were sufficient to significantly reduce cell migration in FaDu, SCC‐1, and SCC‐5 cell lines (P < .001) but not in Cal27 (P = .09). In vitro scratch test results in SCC‐1 cells yielded significant reduction in cell movement at 8, 16, and 14 hours (P < .001). In vivo orthotopic model yielded significant reduction in primary tumor size (P = .04) and reduction in positive cervical lymph nodes (P = .01) between treatment and control mice. In addition we found 100% survival of MK‐2206 treated mice after 2 weeks of treatment compared with 70% survival in our control group (P = .03).

Conclusions:

Treatment with MK‐2206 is sufficient to inhibit HNSCC chemotaxis and migration in vitro. In an orthotopic model, treatment with MK‐2206 reduces primary tumor size and cervical metastasis while improving survival. MK‐2206 currently is being used in phase II clinical trials for combination treatment of metastatic solid tumors and may be useful for treating HNSCC as well. Laryngoscope, 121:2359‐2365, 2011
Status epilepticus as a main manifestation of posterior reversible encephalopathy syndrome after pediatric hematopoietic stem cell transplantation
Authors: Cordelli Duccio Maria , Masetti Riccardo , Bernardi Bruno , Barcia Giulia , Gentile Valentina , Biagi Carlotta , Prete Arcangelo , Pession Andrea , Franzoni Emilio
Published: October 2011

Background

Posterior reversible encephalopathy syndrome (PRES) is a severe neurological complication after pediatric allogeneic hematopoietic stem cell transplantation (allo‐HSCT). Seizures are a common manifestation of PRES. Status epilepticus (SE) is a potentially life‐threatening event rarely described in this condition. The aim of this study was to describe the clinical and electroencephalographic features of SE as a manifestation of PRES in children after allo‐HSCT.

Procedure

We retrospectively identified episodes of SE as a consequence of PRES out of 211 children who received allo‐HSCT in the period January 2000 to June 2008.

Results

PRES was diagnosed in 11 patients. We identified 12 episodes of SE associated to PRES in 10 patients. Nonconvulsive SE (NCSE) involving posterior regions of the brain (confirmed by EEG monitoring) was observed in four cases; convulsive SE (CSE) was observed in eight cases. Gaze deviation, oculoclonic movements, nystagmus, and altered mental status were the main clinical signs during NCSE and preceded CSE in 5/8 cases. Most patients needed intensive care management. A complete normalization of neurological examination and EEG pattern was observed in all patients after SE and withdrawal of causative agent. Follow‐up MRI showed complete resolution of brain edema in all patients.

Conclusions

Our experience shows that SE is more frequent than previously reported and is often the main manifestation of PRES after pediatric allo‐HSCT. Looking for suggestive clinical signs as well as routine use of EEG monitoring may allow prompt recognition of SE and therapy of both SE and PRES. Pediatr Blood Cancer 2012; 58: 785–790. © 2011 Wiley Periodicals, Inc.
Mechanical Properties of Individual Layers in a‐SiC:H Multilayer Film
Authors: Cech Vladimir , Trivedi Rutul , Skoda David
Published: October 2011

Hydrogenated amorphous carbon‐silicon (a‐SiC:H) multilayer film consisting of five soft bilayers (layer A: E = 15.4 GPa, H = 1.69 GPa; layer B: E = 9.63 GPa, H = 0.94 GPa) was deposited from tetravinylsilane monomer at two RF powers (10, 0.1 W) on silicon wafer by plasma‐enhanced chemical vapor deposition. The multilayer comprising ten layers of 0.13‐µm thickness was sectioned at a shallow angle of 4° by ultramicrotomy to reveal the individual layers. The layers in the multilayer film were distinguished by the surface topography mode of semicontact atomic force microscopy utilizing the step character in height corresponding to the stiffness of the individual layers and by atomic force acoustic microscopy (AFAM) utilizing the distribution of resonant frequencies corresponding to elastic anisotropy. The sectioned individual layers were sufficiently smooth (roughness: 0.001 µm) to make nanoindentation measurements for each layer. The Young's modulus E and hardness H were determined for individual layers, enabling us to distinguish a stiffer layer A from a more pliant layer B. An influence of the surrounding layers and substrate on the determined mechanical constants was discussed as well.

magnified image
Overview of recommended management of acute stroke
Authors: Ankolekar Sandeep , Bath Philip
Published: October 2011

The authors present a guide to current recommendations for the acute management of ischaemic and haemorrhagic stroke and describe the GP's role before admission and after discharge. Copyright © 2011 Wiley Interface Ltd
Commissioning cost‐effective delivery of intravenous iron
Authors: Ali Omar
Published: October 2011

In our Navigator series Omar Ali looks at some of the commissioning and medicines management issues facing primary and secondary care and provides guidance and solutions. Copyright © 2011 Wiley Interface Ltd
Retigabine: first‐in‐class AED for partial‐onset seizures
Authors: Chaplin Steve , Neligan Aidan
Published: October 2011

Retigabine (Trobalt) is a new antiepileptic drug with a novel mode of action and licensed as adjunctive treatment for partial‐onset seizures. In our New products review Steve Chaplin presents the clinical data relating to its efficacy and adverse events and Dr Aidan Neligan discusses its place in the treatment of epilepsy. Copyright © 2011 Wiley Interface Ltd
Diagnosis and recommended treatment of helminth infections
Authors: Abbas Allifia , Newsholme William
Published: October 2011

A number of worm infections are seen in the UK and, apart from threadworm, are mostly seen in migrants from tropical countries. Our Drug review discusses currently recommended treatments, followed by sources of further information. Copyright © 2011 Wiley Interface Ltd
Prescribing antidiabetic drugs for patients with renal dysfunction
Authors: Wilding John , Kirby Mike , Evans Marc
Published: October 2011

In this Expert Panel Discussion the participants discuss the options available for treating diabetes patients who have some degree of renal impairment. Copyright © 2011 Wiley Interface Ltd
Co‐prescription of a nitrate or nicorandil with a PDE‐5 inhibitor
Authors: Spencer Rachel , Serumaga Brian
Published: October 2011

In this series we present a number of prescribing safety indicators developed as part of an RCGP project.1 The evidence base behind each of the indicators is given along with information to illustrate their clinical significance. We provide a ‘real‐life’ audit based on the indicator to show how practices could begin to analyse their own prescribing data. Copyright © 2011 Wiley Interface Ltd
Evaluation of the Antiosteoporotic Potential of Cimicifuga heracleifolia in Female Mice
Authors: Ahn Byung‐Su , Yang Miyoung , Jang Hyosun , Lee Hae June , Moon Changjong , Kim Jong‐Choon , Jung Uhee , Jo Sung Kee , Jang Jong‐Sik , Kim Sung‐Ho
Published: October 2011

Cimicifugae rhizoma might be protective against osteoporosis. This study investigated the effects of Cimicifuga heracleifolia (CH), an Asian species of Cimicifugae rhizome, on bone loss in ovariectomized (OVX) mice. The C3H/HeN mice were divided into sham and OVX groups. The OVX mice were treated with vehicle, 17β‐estradiol (E2) or CH for 6 weeks. Serum calcium, phosphorus, E2 concentration and serum alkaline phosphatase (ALP) activity were measured. Tibiae and femora were analysed using microcomputed tomography. The biomechanical property and osteoclast surface level were measured. Treatment with CH (i.p., 50 mg/kg of body weight, every other day) prevented the OVX‐induced increase in body weight but did not alter the uterus weight of the OVX mice. Serum ALP levels and osteoclast surface levels in the OVX mice were reduced by treatment with CH. The CH significantly preserved trabecular bone mass, bone volume, trabecular number, trabecular thickness, structure model index and bone mineral density of proximal tibia metaphysis or distal femur metaphysis. However, grip strength, mechanical property and cortical bone architecture did not differ among the experimental groups. The results indicate that the supply of CH can prevent OVX‐induced bone loss in mice. Copyright © 2011 John Wiley & Sons, Ltd.
The performance of the modified Φ(ϱz) approach as compared to the love and scott, ruste and standard ZAF correction procedures in quantitative electron probe microanalysis
Authors: Bastin G. F. , Heijligers H. J. M. , van Loo F. J. J.
Published: October 2011

The recently introduced modified Gaussian φ(ϱz) approach is compared with three other correction procedures for quantitative electronprobe microanalysis. On the basis of results obtained for 441 published microanalysis data it is concluded that the modified Φ(ϱz) approach and the Love‐Scott correction model perform equally well and are both superior to the Ruste and ZAF correction models. Special attention has been paid to the new atomic number correction proposed by Love et al. It was found to be only marginally better than that of the Φ(ϱz) approach.
Detectable resistance in electron beam testing of wiring networks
Authors: Brunner M.
Published: October 2011

Electron beam testing of wiring and packaging modules allows detection of high resistance shorts between networks up to resistances which may be well above 1 GΩ. The detection of low resistance defects is limited by electron beam currents, network capacitance, and testing time. The dependence of the smallest detectable resistance on technical parameters is discussed for three proposed test techniques employing one or two electron beams. The detection limit is estimated for a realistic case to be between 5MΩ and 10 MΩ.
Pesticide induced alterations in marrow physiology and depletion of stem and stromal progenitor population: An experimental model to study the toxic effects of pesticide
Authors: Chatterjee Sumanta , Basak Pratima , Chaklader Malay , Das Prosun , Pereira Jacintha Archana , Chaudhuri Samaresh , Law Sujata
Published: October 2011

Long‐term exposure of agriculturally used organochloride and organophosphate pesticides have been shown to cause long‐lasting hematotoxicity and increased incidence of aplastic anemia in humans. The mechanisms involved in pesticide induced hematotoxicity and the features of toxicity that may play a major role in bone marrow suppression are not known. The aim of the present study was to investigate the hematological consequences of pesticide exposure in swiss albino mice exposed to aqueous mixture of common agriculturally used pesticides for 6 h/day, 5 days/week for 13 weeks. After the end of last exposure, without a recovery period, the strong hematotoxic effect of pesticide was assessed in mice with long‐term bone marrow explant culture (LTBMC‐Ex) system and cell colony forming assays. Bone marrow explant culture from the pesticide exposed group of mice failed to generate a supportive stromal matrix and did not produce adequate number of hematopoietic cells and found to contain largely the adipogenic precursors. The decreased cell colony numbers in the pesticide exposed group indicated defective maturational and functional status of different marrow cell lineages. As a whole, exposure of mice to the mixture of pesticides reduced the total number of bone marrow cells (granulocytes are the major targets of pesticide toxicity), hematopoietic, and non‐hematopoietic progenitor cells and most of the hematological parameters. Replication of primitive stem/progenitor cells in the marrow was decreased following pesticide exposure with G0/G1‐phase arrest of most of the cells. The progenitor cells showed decreased percentage of cells in S/G2/M‐phase. The increased apoptosis profile of the marrow progenitors (Increased CD95 expression) and primitive stem cells (High Annexin‐V positivity on Sca1+ cells) with an elevated intracellular cleaved caspase‐3 level on the Sca1+ bone marrow cells provided the base necessary for explaining the deranged bone marrow microenvironmental structure which was evident from scanning electron micrographs. These results clearly indicate a strong, long lasting toxic effect of pesticides on the bone marrow microenvironment and different microenvironmental components which ultimately leads to the formation of a degenerative disease like aplastic anemia. © 2011 Wiley Periodicals, Inc. Environ Toxicol 29: 84–97, 2014.
Elective Global Surgery Rotations for Residents: A Call for Cooperation and Consortium
Authors: Mitchell Katrina B. , Tarpley Margaret J. , Tarpley John L. , Casey Kathleen M.
Published: October 2011

Background

International elective experiences are becoming an increasingly important component of American general surgery education. In 2011, the Residency Review Committee (RRC) approved these electives for credit toward graduation requirements. Previous surveys of general surgery program directors have established strong interest in these electives but have not assessed the feasibility of creating a national and international database aimed at educational standardization. The present study was designed to gain in‐depth information from program directors about features of existing international electives at their institution and to ascertain interest in national collaboration.

Methods

This cross‐sectional study of 253 United States general surgery program directors was conducted using a web‐based questionnaire program.

Results

Of the program directors who responded to the survey, twelve percent had a formal international elective in place at their institution, though 80% of these did not have a formal associated curriculum for the rotation. Sixty percent of respondents reported that informal international electives existed for their residents. The location, length, and characteristics of these electives varied widely. Sixty‐eight percent of program directors would like to participate in a national and international database designed to facilitate standardization of electives and educational exchange.

Conclusions

In a world of increasing globalization, international electives are more important than ever to the education of surgery residents. However, a need for standardization of these electives exists. The creation of an educational consortium and database of international electives could improve the academic value of these electives, as well as provide increased opportunities for twinning and bidirectional exchange.
Contrast Dispersal Patterns as a Predictor of Clinical Outcome With Transforaminal Epidural Steroid Injection for Lumbar Radiculopathy
Authors: Paidin Mark , Hansen Pamela , McFadden Molly , Kendall Richard
Published: October 2011

Objective

To assess the relationship between epidural contrast dispersal patterns from lumbar transforaminal epidural steroid injections (TFESIs) and both immediate‐ and short‐term pain reduction. We also investigated the effect of the grade of nerve root compression on contrast dispersal pattern and pain reduction.

Design

Retrospective review of data from a previous prospective study of outcomes after TFESI.

Setting

Academic spine and musculoskeletal clinic.

Patient Sample

Thirty‐eight subjects who underwent single‐level lumbar TFESI for unilateral lumbar radicular pain.

Methods

A retrospective assessment of a digital database of TFESIs for unilateral lumbar radicular pain. Type of contrast pattern was analyzed by 2 physiatrists as type I (tubular appearance); type II (nerve root visible as a filling defect); or type III (cloudlike appearance). Grade of nerve root compression on magnetic resonance also was analyzed by 2 physiatrists as grade I abutment, grade II displacement, or grade III entrapment.

Outcome Measures

Effect of type of contrast pattern and grade of nerve root compression on change in Numeric Pain Rating Scale (NPRS) at time of injection (T1), 2 weeks after (T2), and 2 months after (T3).

Results

Mean decrease in NPRS at all time points was statistically significant with both types I and III contrast dispersal patterns. Groups with grades II and III nerve root compression had statistically significant reductions in NPRS at all time points.

Conclusions

In this retrospective review we found that TFESIs can have an immediate beneficial effect on pain regardless of contrast pattern type or grade of nerve root compression. Subjects with higher grades of nerve root compression and a type I or III contrast pattern have significantly greater reductions in pain at 15 minutes, 2 weeks, and 2 months. Our findings are limited by methodological restrictions, and further confirmation with a prospective trial to review other possible associated factors is recommended.
Analysis of the melt phase of a rotating polymer disc supporting a diffusion flame
Authors: Nayagam Vedha , Williams F. A.
Published: October 2011

When a laminar diffusion flame is established over a spinning, thermoplastic, polymer fuel disc in a quiescent, oxidizing environment, the polymer melts and flows radially outwards, causing some fuel to be lost and not transported to the diffusion flame. The viscosity of the liquid in the melt layer retards the radial flow, thereby determining the amount of fuel lost. The melt layer is analysed here for two limiting cases, namely one in which the liquid viscosity depends strongly on temperature, leading to an asymptotic analysis involving two zones in the liquid, and one in which the liquid viscosity is constant, independent of temperature, so that there is only one zone in the liquid. The utility of these two limits is assessed by comparing their predictions with those of full numerical integrations for poly(methyl methacrylate) (PMMA) discs burning in air at atmospheric pressure.
Maternal undernutrition during critical windows of development results in differential and sex-specific effects on postnatal adiposity and related metabolic profiles in adult rat offspring
Authors: Howie G. J. , Sloboda D. M. , Vickers M. H.
Published: October 2011

It is well established that altered maternal nutrition may induce long-term metabolic consequences in offspring. However, the effects of maternal undernutrition during different developmental windows on sex-specific growth and metabolism in offspring are not well defined. We investigated the effect of moderate maternal undernutrition during pregnancy and/or lactation on postnatal growth and metabolic outcomes in offspring. Wistar rats were randomly assigned to one of four groups: (1) control (CONT) dams fed a standard diet throughout pregnancy and lactation; (2) dams undernourished to 50 % of CONT during pregnancy (UNP); (3) dams fed at 50 % of CONT throughout lactation (UNL); (4) dams fed at 50 % of CONT throughout pregnancy and lactation (UNPL). UNP and UNPL offspring were lighter at birth compared to CONT and UNL. UNL and UNPL offspring were growth restricted at weaning and remained smaller into adulthood. UNP males and females developed increased adiposity and hyperleptinaemia in adulthood compared to all other groups. Adiposity in UNL and UNPL males was similar to CONT offspring. In UNL and UNPL females, adiposity was lower than for CONT females. Markers of bone mass, lipid metabolism and hepatic function were altered in UNP offspring but were similar in UNL and UNPL offspring compared to CONT. Lack of catch-up growth during lactation in offspring of undernourished mothers prevented development of adiposity and related metabolic disorders in later life. These data highlight that the timing and duration of undernutrition during critical windows of development exert differential effects on postnatal outcomes in a sex-specific manner.
EFFECT OF REDUCED TILLAGE AND MINERAL FERTILIZER APPLICATION ON MAIZE AND SOYBEAN PRODUCTIVITY
Authors: KIHARA J. , BATIONO A. , WASWA B. , KIMETU J. M. , VANLAUWE B. , OKEYO J. , MUKALAMA J. , MARTIUS C.
Published: October 2011

Reduced tillage is said to be one of the potential ways to reverse land degradation and ultimately increase the productivity of degrading soils of Africa. We hypothesised that crop yield following a modest application of 2 t ha−1 of crop residue in a reduced tillage system is similar to the yield obtained from a conventional tillage system, and that incorporation of legumes in a cropping system leads to greater economic benefits as opposed to a cropping system involving continuous maize. Three cropping systems (continuous maize monocropping, legume/maize intercropping and rotation) under different tillage and residue management systems were tested in sub-humid western Kenya over 10 seasons. While soybean performed equally well in both tillage systems throughout, maize yield was lower in reduced than conventional tillage during the first five seasons but no significant differences were observed after season 6. Likewise, with crop residue application, yields in conventional and reduced tillage systems are comparable after season 6. Nitrogen and phosphorus increased yield by up to 100% compared with control. Gross margins were not significantly different among the cropping systems being only 6 to 39% more in the legume–cereal systems relative to similar treatments in continuous cereal monocropping system. After 10 seasons of reduced tillage production, the economic benefits for our cropping systems are still not attractive for a switch from the conventional to reduced tillage.