bluuebunny/crossref_metadata_2025 huggingface dataset:
Interspecific Visual Adaptations among Wobbegong Sharks (Orectolobidae)
Authors: Theiss Susan M. , Collin Shaun P. , Hart Nathan S.
Published: January 2011

Several visual traits have previously been assessed in elasmobranchs; however, few studies have examined and compared multiple visual attributes within a particular genus. The primary advantage of studying closely related species is that any differences between them are more likely to reflect functional ecological adaptations rather than the effects of phylogenetic separation. In this study, the visual capabilities of 4 wobbegong shark species, which vary in life-history and/or habitat, were examined: the western wobbegong (Orectolobus hutchinsi), the spotted wobbegong (O. maculatus), the ornate wobbegong (O. ornatus) and the dwarf spotted wobbegong (O. parvimaculatus). The retinae of all 4 wobbegong species are duplex; rod and cone photoreceptors can be distinguished easily on the basis of morphology. Some variation in relative eye size exists, with O. parvimaculatus possessing the largest eyes. The topographic distribution of cells within the ganglion cell layer of O. hutchinsi reveals a weakly elongated central visual streak of increased cell density, mediating a higher spatial resolving power of 2.06 cycles deg–1 in the frontal visual field. Retinal topography of O. maculatus and O. parvimaculatus is similar, with both possessing a dorsal horizontal streak facilitating an increased spatial resolving power of 3.51 cycles deg–1 and 3.91 cycles deg–1, respectively, in the lower visual field. O. parvimaculatus also possesses an area of increased cell density in the naso-ventral region of the retina, mediating acute vision in the upper caudal region of the visual field. While all 4 species have visual systems optimised for increased visual sensitivity, O. maculatus and O. parvimaculatus appear to be particularly well suited to activity under low light conditions.
Quantitative Assessment of Brain Volumes in Fish: Comparison of Methodologies
Authors: Ullmann Jeremy F.P. , Cowin Gary , Collin Shaun P.
Published: January 2011

When correlating brain areas with behavioral and environmental characteristics, a variety of techniques are employed. In fishes (elasmobranchs and teleosts), 2 methods, histology and the idealized ellipsoid and/or half-ellipsoid technique, are primarily used to calculate the volume of a brain area and therefore its relationship to social or ecological complexity. In this study on a perciform teleost, we have quantitatively compared brain volumes obtained using the conventional techniques of histology and approximating brain volume to an idealized ellipsoid (or half ellipsoid) and magnetic resonance imaging, an established clinical tool typically used for assessing brain volume in other vertebrates. Our results indicate that, when compared to brain volumes measured using magnetic resonance imaging of brain regions in situ, variations in brain shape and histological artifacts can lead to significant differences in brain volume, especially in the telencephalon and optic tecta. Consequently, in comparative studies of brain volumes, we advise caution when using the histological and/or ellipsoid methods to make correlations between brain area size and environmental, behavioral and social characteristics and, when possible, we propose the use of magnetic resonance imaging.
Characterization of the Dopamine System in the Brain of the Túngara Frog, Physalaemus pustulosus
Authors: O’Connell Lauren A. , Matthews Bryan J. , Ryan Michael J. , Hofmann Hans A.
Published: January 2011

Dopamine is an evolutionarily ancient neurotransmitter that plays an essential role in mediating behavior. In vertebrates, dopamine is central to the mesolimbic reward system, a neural network concerned with the valuation of stimulus salience, and to the nigrostriatal motor system and hypothalamic nuclei involved in the regulation of locomotion and social behavior. In amphibians, dopaminergic neurons have been mapped out in several species, yet the distribution of dopaminoreceptive cells is unknown. The túngara frog, Physalaemus pustulosus, is an excellent model system for the study of neural mechanisms by which valuations of stimuli salience and social decisions are made, especially in the context of mate choice. In order to better understand where dopamine acts to regulate social decisions in this species, we have determined the distribution of putative dopaminergic cells (using tyrosine hydroxylase immunohistochemistry) and cells receptive to dopaminergic signaling (using DARPP-32 immunohistochemistry) throughout the brain of P. pustulosus. The distribution of dopaminergic cells was comparable to other anurans. DARPP-32 immunoreactivity was identified in key brain regions known to modulate social behavior in other vertebrates including the proposed anuran homologues of the mammalian amygdalar complex, nucleus accumbens, hippocampus, striatum, preoptic area, anterior hypothalamus, ventromedial hypothalamus, and ventral tegmental area/substantia nigra pars compacta. Due to its widespread distribution, DARPP-32 likely also plays many roles in non-limbic brain regions that mediate non-social information processing. These results significantly extend our understanding of the distribution of the dopaminergic system in the anuran brain and beyond.
Standardized Antipyretic Treatment in Stroke: A Pilot Study
Authors: Kallmünzer Bernd , Krause Christiane , Pauli Elisabeth , Beck Alexander , Breuer Lorenz , Köhrmann Martin , Kollmar Rainer
Published: January 2011

Background: Fever after acute cerebral injury is associated with unfavorable functional outcome and increased mortality, but there is controversy about the optimal antipyretic treatment. This study investigated an institutional standard operating procedure (SOP) for fever treatment in stroke patients including a sequence of pharmacologic and physical interventions. Methods: A 4-step antipyretic SOP was established for patients with acute cerebral ischemia or hemorrhage and a body temperature ≧37.5°C within the first 6 days after admission. Data on the course of body temperature, duration of fever and achievement of normothermia were recorded. Results were compared to a historic control group that underwent conventional treatment. Results: A total of 77 patients (mean age 70.4 ± 14.2 yeas) received 331 antipyretic interventions. Sequential administration of paracetamol (n = 219), metamizole (n = 71) and calf packing (n = 24) resulted in a significant drop in body temperature after 60 min in each instance. In 5 of 9 cases which were refractory to previous attempts, normothermia followed the infusion of ice-cooled saline. In more than 90% of cases treated per protocol, normothermia was achieved within 120 min. Compared to conventional treatment, fever burden was significantly lower within the first 4 days after admission (p < 0.001). Conclusion: This SOP may help to optimize antipyretic treatment for stroke patients.
Colonoscopic Findings and Pathologic Characteristics of Strongyloides Colitis: A Case Series
Authors: Minematsu Hideki , Hokama Akira , Makishi Tomoko , Arakaki Kyoko , Kinjo Fukunori , Fujita Jiro
Published: January 2011

Background/Aims: Strongyloidiasis, which is caused by Strongyloides stercoralis, is one of the prevalent infections in the tropical and subtropical regions worldwide. The larvae mainly infect the small intestine and cause serious disseminated strongyloidiasis. Although upper gastrointestinal features in strongyloidiasis are well known, colonoscopic evaluation has not been established yet. The aim of this study is to clarify the characteristic findings on colonic lesions in strongyloidiasis. Method: From January 2005 to December 2009, 10 cases with strongyloidiasis underwent colonoscopy at a single center on an endemic island of Japan. The clinical and colonoscopic findings were analyzed retrospectively. Results: Six (60%) cases had an immunocompromised condition, including human T lymphotropic virus type 1 infection, corticosteroids, and chemotherapy. Hyperinfection or disseminated strongyloidiasis was not presented. Endoscopic features included yellowish-white nodules, erythema, and loss of vascular pattern, which were mainly observed in the right colon. Pathological examination revealed the filariform Strongyloides larvae and the eosinophilic infiltration of the lamina propria. Conclusion: This study demonstrates that colonoscopic observation and biopsies are very useful to diagnose strongyloidiasis. Asymptomatic cases with strongyloidiasis can have colonic involvement. Yellowish-white nodules may be a characteristic finding of colonic lesions in strongyloidiasis and can be a cautious marker to prevent fatal disseminated strongyloidiasis in endemic regions.
Clinical Features of Gastrointestinal Follicular Lymphoma: Comparison with Nodal Follicular Lymphoma and Gastrointestinal MALT Lymphoma
Authors: Tari Akira , Asaoku Hideki , Kunihiro Masaki , Tanaka Shinji , Fujihara Megumu , Yoshino Tadashi
Published: January 2011

We retrospectively compared the clinicopathological features of primary intestinal follicular lymphomas (FL-GIs), nodal follicular lymphomas (FL-LNs) and gastrointestinal MALT lymphomas (MALT-GIs), and investigated the distribution and the endoscopic appearances of FL-GI to evaluate the effectiveness of treatment modality. The subjects were 28 FL-GI patients, 135 FL-LN patients and 70 MALT-GI patients. In FL-LNs the clinical stage III–IV was 83%, while in FL-GIs clinical stage I–II was 68%. In MALT-GIs clinical stage I–II was 87%. The overall survival was significantly better in MALT-GI patients than in FL-LN patients. All FL-GI patients were alive at the time of evaluation. Regarding the histological grade (WHO), grade 1 was 81% in FL-GI, whereas in FL-LN grade 2 was 28% and grade 3 was 11%. The Follicular Lymphoma International Prognostic Index was low in 61% of FL-GIs, while in FL-LNs it was equally distributed to low, intermediate and high, suggesting that the prognosis is better in FL-GIs than in FL-LNs. The clinicopathological studies revealed the FL-GI has intermediate characteristics between FL-LN and MALT-GI. We recommend a ‘watch-and-wait’ policy or chemotherapy with rituximab for the therapy of FL-GIs because the lesions are often located in broader areas from the lower duodenum to the small intestine.
Spinocerebellar Projections from the Cervical and Lumbosacral Enlargements in the Chicken Spinal Cord
Authors: Furue Masato , Uchida Shinsuke , Shinozaki Aya , Imagawa Tomohiro , Hosaka Yoshinao Z. , Uehara Masato
Published: January 2011

In birds, spinocerebellar (SC) projections to the cerebellar cortex have not been understood well. We examined SC fiber terminal fields originating from the cervical and lumbosacral enlargements (CE and LSE, respectively) in the chicken. SC fiber terminals show parasagittal bands in the granular layer. Labeled terminals from the CE were distributed primarily in folia II–V and IX. Parasagittal bands of labeled terminals from the CE were not clearly separated in folia II and III but were clearly separated in folia IV and V. In folium IX, labeled terminals were diffusely distributed in all subfolia with no evidence of banding. The numbers of bands were 5 in folium II, 12 in folium III and 7 in folia IV and V at maximum. Labeled terminals from the LSE were distributed primarily in folia II–VI and IX. Labeled terminals from the LSE were arranged in 4 bands in folium II and in 8 bands in folium III at maximum. Parasagittal bands from the LSE in folia IV and V were not clearly separated. In folium VI, the numbers of parasagittal bands was 6 at maximum. In folium IX, labeled terminals were mainly found in subfolium IXc forming 6–8 parasagittal bands. There were more parasagittal bands of labeled terminals from the CE than from the LSE. The topography of SC fiber terminals from the CE was different from that of SC fiber terminals from the LSE.
Distribution of Two Isozymes of 5α-Reductase in the Brains of Adult Male and Female Green Anole Lizards
Authors: Cohen Rachel E. , Wade Juli
Published: January 2011

The 5α-reductase (5αR) enzyme converts testosterone to 5α-dihydrotestosterone. This local metabolism within the brain is important for the full expression of male sexual behavior in many species, including green anole lizards. Two isozymes of 5αR exist and little is known about their specific distributions. We conducted in situ hybridization for both isozymes in intact male and female green anole brains during the breeding (BS) and non-breeding (NBS) seasons. 5αR1 mRNA was only detected in the brainstem, while 5αR2 was expressed in specific areas throughout the brain. As our primary interest was evaluating the potential role of 5αR in forebrain regulation of reproductive behavior, we quantified 5αR2 expression in the preoptic area, amygdala (AMY), and ventromedial hypothalamus (VMH). More 5αR2 cells were detected during the NBS than BS in the AMY, and the density of these cells was greater in females than males. In the VMH, the right side contained more 5αR2 cells than the left, an effect driven by a lateralized increase in the NBS. These data expand understanding of the distribution and potential roles of both isozymes in the adult brain, and differences in expression patterns between mammals and birds suggest that they may have been co-opted for different functions later in evolution.
Development of Tectal Connectivity across Metamorphosis in the Bullfrog (Rana catesbeiana)
Authors: Horowitz Seth S. , Simmons Andrea Megela
Published: January 2011

In the bullfrog (Rana catesbeiana), the process of metamorphosis culminates in the appearance of new visual and visuomotor behaviors reflective of the emergence of binocular vision and visually-guided prey capture behaviors as the animal transitions to life on land. Using several different neuroanatomical tracers, we examined the substrates that may underlie these behavioral changes by tracing the afferent and efferent connectivity of the midbrain optic tectum across metamorphic development. Intratectal, tectotoral, tectotegmental, tectobulbar, and tecto-thalamic tracts exhibit similar trajectories of neurobiotin fiber label across the developmental span from early larval tadpoles to adults. Developmental variability was apparent primarily in intensity and distribution of cell and puncta label in target nuclei. Combined injections of cholera toxin subunit β and Phaseolus vulgaris leucoagglutinin consistently label cell bodies, puncta, or fiber segments bilaterally in midbrain targets including the pretectal gray, laminar nucleus of the torus semicircularis, and the nucleus of the medial longitudinal fasciculus. Developmentally stable label was observed bilaterally in medullary targets including the medial vestibular nucleus, lateral vestibular nucleus, and reticular gray, and in forebrain targets including the posterior and ventromedial nuclei of the thalamus. The nucleus isthmi, cerebellum, lateral line nuclei, medial septum, ventral striatum, and medial pallium show more developmentally variable patterns of connectivity. Our results suggest that even during larval development, the optic tectum contains substrates for integration of visual with auditory, vestibular, and somatosensory cues, as well as for guidance of motivated behaviors.
Ustekinumab and Herpes Zoster
Authors: Failla V. , Nikkels A.F.
Published: January 2011

Background: TNF-α antagonists may increase the risk of herpes zoster (HZ), as well as the duration and severity. Recently, the monoclonal antibody ustekinumab, blocking the p40 subunit of IL-12 and IL-23, has been introduced for treating moderate to severe plaque psoriasis. There are no PubMed reports of HZ occurring in people receiving ustekinumab treatment. Common HZ was reported in clinical trials. Observation: Two patients with severe psoriasis treated with ustekinumab developed severe contiguous multidermatomal HZ 1 and 9 months after treatment initiation. Discussion: The occurrence of HZ after the instauration of ustekinumab suggests a causal relationship. Indeed, the inhibition of the p40 subunit of IL-12 shifts the immune response towards a Th1 profile with diminished IFN-γ and TNF-α expression, decreasing the antiviral immune response. Conclusion: Ustekinumab is probably a risk factor for developing HZ. Anti-HZ vaccination prior to ustekinumab treatment should be considered.
The Memory Function of Noradrenergic Activity in Non-REM Sleep
Authors: Gais Steffen , Rasch Björn , Dahmen Johannes C. , Sara Susan , Born Jan
Published: January 2011

There is a long-standing assumption that low noradrenergic activity during sleep reflects mainly the low arousal during this brain state. Nevertheless, recent research has demonstrated that the locus coeruleus, which is the main source of cortical noradrenaline, displays discrete periods of intense firing during non-REM sleep, without any signs of awakening. This transient locus coeruleus activation during sleep seems to occur in response to preceding learning-related episodes. In the present study, we manipulate noradrenergic activity during sleep in humans with either the α2-autoreceptor agonist clonidine or the noradrenaline reuptake inhibitor reboxetine. We show that reducing noradrenergic activity during sleep, but not during wakefulness, impairs subsequent memory performance in an odor recognition task. Increasing noradrenergic availability during sleep, in contrast, enhances memory retention. We conclude that noradrenergic activity during non-REM sleep interacts with other sleep-related mechanisms to functionally contribute to off-line memory consolidation.
Forecasting Post-Extratropical Transition Outcomes for Tropical Cyclones Using Support Vector Machine Classifiers
Authors: Felker Steven R. , LaCasse Brian , Tyo J. Scott , Ritchie Elizabeth A.
Published: January 2011

Intensity changes following the multistage process of extratropical transition have proven to be especially difficult to forecast because of the extremely similar storm evolutions prior to and during the first stages of the transformation from a warm-cored axisymmetric tropical storm to a cold-cored asymmetrical extratropical low pressure system. In this study, differences in surrounding synoptic environments between dissipating and reintensifying extratropical transitioning tropical cyclones are used to develop a predictive technique for extratropical transition intensity change that can be used to enhance the standard numerical guidance. Using a set of all historical transitioning storms between 2000 and 2008 in the western North Pacific, common differences between 850-hPa potential temperature fields surrounding extratropical transition intensifiers and extratropical transition dissipaters, respectively, were identified. These features were then used as inputs into a support vector machine classification system in the hopes of creating a robust prediction system. Once the system was trained on a random subset of the data (80%), performance was tested on the remaining test set (20%). Overall, it was found that the prediction system was able to correctly predict extratropical transition intensity outcome in >75% of the test cases at 72 h prior to extratropical transition. This paper discusses the feature selection and classification system used, as well as the performance results, in detail.
Response of the Antarctic Stratosphere to Two Types of El Niño Events
Authors: Hurwitz M. M. , Newman P. A. , Oman L. D. , Molod A. M.
Published: January 2011

This study is the first to identify a robust El Niño–Southern Oscillation (ENSO) signal in the Antarctic stratosphere. El Niño events between 1979 and 2009 are classified as either conventional “cold tongue” events (positive SST anomalies in the Niño-3 region) or “warm pool” events (positive SST anomalies in the Niño-4 region). The 40-yr ECMWF Re-Analysis (ERA-40), NCEP, and Modern Era Retrospective–Analysis for Research and Applications (MERRA) meteorological reanalyses are used to show that the Southern Hemisphere stratosphere responds differently to these two types of El Niño events. Consistent with previous studies, cold tongue events do not impact temperatures in the Antarctic stratosphere. During warm pool El Niño events, the poleward extension and increased strength of the South Pacific convergence zone favor an enhancement of planetary wave activity during September–November. On average, these conditions lead to higher polar stratospheric temperatures and a weakening of the Antarctic polar jet in November and December, as compared with neutral ENSO years. The phase of the quasi-biennial oscillation (QBO) modulates the stratospheric response to warm pool El Niño events; the strongest planetary wave driving events are coincident with the easterly phase of the QBO.
Revisiting Vacillations in Shallow-Water Models of the Stratosphere Using Potential-Vorticity-Based Numerical Algorithms
Authors: MirRokni Seyed Majid , Mohebalhojeh Ali R. , Dritschel David G.
Published: January 2011

Polar vortex vacillations are investigated using long-term simulations of potential-vorticity (PV)-based shallow-water (SW) models for the stratosphere. In the models examined, mechanical forcing is applied through a time-independent topography mimicking tropospheric excitation of the stratosphere. Thermal forcing is applied through a linear relaxation of the mass field to a time-independent equilibrium state mimicking the radiative relaxation taking place in the stratosphere. The SW equations in the PV, velocity divergence, and acceleration divergence representation are solved for a range of resolutions using the “diabatic contour-advective semi-Lagrangian” (DCASL) algorithm and a standard pure semi-Lagrangian (SL) algorithm. Using very different numerical algorithms enables the determination of the degree of numerical sensitivity and the properties of the vacillations with much greater accuracy than in previous related studies.

The focus here is on the Lagrangian or material evolution of the polar vortex. The authors examine quasi-Lagrangian diagnostics based on equivalent latitude, the mass enclosed by PV contours, and the terms involved in its time evolution. The PV field forms the basis for calculating quasi-Lagrangian diagnostics. Variations in the mass enclosed by a PV contour are associated with nonconservative processes such as diabatic heating, friction, and irreversible small-scale mixing. Generally, the mass of the polar vortex increases under the action of diabatic mass fluxes, whereas it decreases under the action of dissipative mass fluxes.

The results herein differ from previous results reported at T42 resolution by Rong and Waugh in which a spectral transform algorithm is used to solve the SW equations in a vorticity–divergence–mass representation, and in which dissipation is provided by explicitly damping vorticity using hyperdiffusion. Except for the first large-amplitude oscillation, there is little sign of a clear, systematic phase shift between the dissipative and diabatic mass fluxes across the edge of the polar vortex, as proposed by Rong and Waugh as the main mechanism responsible for the vacillations. Concomitant with the absence of a phase shift, the vacillations tend to decay and occur intermittently. Rather than a phase shift, inherent fluctuations in both the diabatic and mass fluxes across the edge of the polar vortex appear to be responsible for the vacillations.
The Effect of Satellite Rainfall Error Modeling on Soil Moisture Prediction Uncertainty
Authors: Maggioni Viviana , Reichle Rolf H. , Anagnostou Emmanouil N.
Published: January 2011

This study assesses the impact of satellite rainfall error structure on soil moisture simulations with the NASA Catchment land surface model. Specifically, the study contrasts a complex satellite rainfall error model (SREM2D) with the standard rainfall error model used to generate ensembles of rainfall fields as part of the Land Data Assimilation System (LDAS) developed at the NASA Global Modeling and Assimilation Office. The study is conducted in the Oklahoma region, which offers good coverage by weather radars and in situ meteorological and soil moisture measurement stations. The authors used high-resolution (25 km, 3-hourly) satellite rainfall fields derived from the NOAA/Climate Prediction Center morphing (CMORPH) global satellite product and rain gauge–calibrated radar rainfall fields (considered as the reference rainfall). The LDAS simulations are evaluated in terms of rainfall and soil moisture error. Comparisons of rainfall ensembles generated by SREM2D and LDAS against reference rainfall show that both rainfall error models preserve the satellite rainfall error characteristics across a range of spatial scales. The error structure in SREM2D is shown to generate rainfall replicates with higher variability that better envelop the reference rainfall than those generated by the LDAS error model. Likewise, the SREM2D-generated soil moisture ensemble shows slightly higher spread than the LDAS-generated ensemble and thus better encapsulates the reference soil moisture. Soil moisture errors, however, are less sensitive than precipitation errors to the complexity of the precipitation error modeling approach because soil moisture dynamics are dissipative and nonlinear.
Processing Turbulence Data Collected on board the Helicopter Observation Platform (HOP) with the Empirical Mode Decomposition (EMD) Method
Authors: Holder Heidi E. , Bolch M. Adam , Avissar Roni
Published: January 2011

The Duke University Helicopter Observation Platform (HOP) has previously been shown to be a useful instrument for the measurement of turbulent atmospheric fluxes. As with all such measurements, especially those made from moving platforms, spurious signals, such as instrument noise and mesoscale atmospheric motions, are superposed on the desired signal. Empirical mode decomposition (EMD) is applied in a novel way to identify and separate out different signals represented by intrinsic mode functions (IMFs) in the HOP data and is shown to be an effective tool for the task. The method produces a basis that is adaptive, unique, and orthogonal, all of which are required for this type of data processing, and none of which are present in more traditional techniques. The results of applying EMD are shown to be nonlinear, and occasionally the removal of the correct number of IMFs increases the observed value of energy and fluxes calculated with the eddy correlation technique.
Reconstruction of Aircraft Trajectories from AMDAR Weather Reports
Authors: Drüe Clemens
Published: January 2011

It is well known that aircraft-based meteorological measurements exhibit systematic errors depending on various flight dynamic parameters. It is also widely assumed that operational Aircraft Meteorological Data Relay (AMDAR) weather reports by commercial aircraft are affected in a similar way. However, so far, it is not possible to study such systematic errors, because datasets that contain both AMDAR reports and flight dynamic variables are not available. To overcome this deficiency, a method was developed to reconstruct the flight trajectories of aircraft using just the aircraft type and operational AMDAR reports. Because AMDAR reports do not contain information on the flight plan, origin, destination, or the motion vector of the airplane, it is not possible to employ a trajectory solver as used by air traffic control. Instead, the method uses groups of trajectory templates that are fitted to AMDAR data taken during approach or departure. This algorithm allows estimation of the heading, true airspeed, aircraft mass, roll state, pitch angle, and angle of attack of the reporting aircraft for each AMDAR report. For verification, the algorithm was applied to navigation data gathered from two Airbus-manufactured aircraft, of which one is in commercial service and one is used for aviation research. From a total of 48 profiles, a very good agreement of reconstructed and measured values was found.
Microwave-assisted foaming of expandable polystyrene beads
Authors: Sen Indraneel , Dadush Eric , Penumadu Dayakar
Published: January 2011

A novel method for obtaining polystyrene foam, which uses microwave as the source of energy for expansion process, is developed. In this article, a method to disperse target expansion agent using two-stage bulk polymerization and free radical suspension polymerization of styrene is described. Current and proposed research uses environmentally friendly and potentially recyclable expansion agents and highly efficient volumetric heating systems. Spherical polystyrene beads containing 2-propanol as expansion agent are successfully prepared which are then expanded using microwave energy. Microwave processing conditions developed by trial experiments are reported. A brief discussion on the theory of microwave heating in the context of current research is presented for direct reference and convenience to the reader.
CURB-65, PSI, and APACHE II to Assess Mortality Risk in Patients With Severe Sepsis and Community Acquired Pneumonia in PROWESS
Authors: Richards Guy , Levy Howard , Laterre Pierre-Francois , Feldman Charles , Woodward Brad , Bates Becky M. , Qualy Rebecca L.
Published: January 2011

Background: Patients with community-acquired pneumonia (CAP) comprised 35.6% of the overall phase 3 Recombinant Human Activated Protein C Worldwide Evaluation in Severe Sepsis (PROWESS) study and 33.1% of the placebo arm. We investigated the use of CURB-65, the Pneumonia Severity Index (PSI), and Acute Physiology and Chronic Health Evaluation II (APACHE II) prediction scores to identify the CAP population from the PROWESS placebo arm at the greatest mortality risk. Methods: Patients were classified as having CAP if the lung was the primary infection site and the patient originated from home. The abilities of CURB-65, PSI, and APACHE II scores to determine the 28-day and in-hospital mortality were compared using receiver operator characteristic (ROC) curves and the associated areas under the curve. Results: PROWESS enrolled 278 patients with CAP in the placebo arm. The areas under the ROC curves for PSI = 5, CURB-65 ≥3, and APACHE II ≥25 for predicting 28-day (c = 0.65, 0.66, and 0.64, respectively) and in-hospital mortality (c = 0.65, 0.65, and 0.64, respectively) were not statistically different from each other. The 28-day mortality of patients with a PSI score of 5, CURB-65 ≥3, and APACHE II ≥25 was 41.6%, 37.9%, and 43.5%, respectively. Conclusions: Despite early diagnosis and appropriate antibiotic therapy, conventionally treated CAP with PSI = 5, CURB-65 ≥3, or APACHE II ≥25 has an unacceptably high mortality. In this study, PSI, CURB-65, and APACHE II scoring systems perform similarly in predicting the 28-day and in-hospital mortality; however, differences in the categorization of severe CAP were observed and there was a significant mortality in patients with a CURB-65 <3 and PSI <5.
A Positive Response to a Recruitment Maneuver With PEEP Titration in Patients With ARDS, Regardless of Transient Oxygen Desaturation During the Maneuver
Authors: Hodgson Carol L. , Tuxen David V. , Bailey Michael J. , Holland Anne E. , Keating Jenny L. , Pilcher David , Thomson Kenneth R. , Varma Dinesh
Published: January 2011

Recruitment maneuvers (RMs) can expand collapsed alveoli in ventilated patients. The optimal method for delivering RMs is unknown. Purpose: To evaluate the safety and the respiratory and hemodynamic effects of a staircase recruitment maneuver (SRM) with decremental positive end expiratory pressure (PEEP) titration and the consequences of desaturation during the SRM in patients with early acute lung injury (ALI). Methods: In total, 20 consecutive patients with early ALI were enrolled and received an SRM. Patients were given 15 ± 3 cm H2O pressure-controlled ventilation. Positive end expiratory pressure was increased from baseline (range 10-18) to 20, 30, and 40 cm H2O every 2 minutes to achieve maximum alveolar pressure of 55 ± 3 cm H2O, then decreased at 3-minute intervals to 25, 22.5, 20, 17.5, and 15 cm H2O until a decrease of 1% to 2% oxygen saturation from maximum was detected. Positive end expiratory pressure was left at the level where the fall in oxygen saturation occurred. Standard respiratory and circulatory variables, arterial and central venous gases were measured before, during, and after the SRM. Results: There were significant improvements in shunt fraction (36.3% ± 10% to 26.4% ± 14%, P < .001), oxygen saturation (93.4% ± 2% to 96.8% ± 3%, P = .007), partial pressure of oxygen, arterial (PaO2)/fraction of inspired oxygen ([FIO2]; 150 ± 42 to 227 ± 100, P = .004), lung compliance (33.9 ± 9.1 to 40.1 ± 11.4 mL/cm H2O, P < .01), and chest x-ray (CXR) after the SRM. Briefly, 80% of the patients responded and the response was maintained at 1 hour. In total, 8 patients desaturated 6.1% ± 2.8% in SaO2 during the SRM but 5 of those improved SaO2 relative to baseline by the end of the SRM. Conclusions: In all, 80% of the patients with early ALI responded to the SRM with decremental PEEP titration. Desaturation during the SRM did not indicate a failed response 1 hour later.
Review of A Large Clinical Series: Predicting Death for Patients With Abdominal Septic Shock
Authors: Hanisch Ernst , Brause Rüdiger , Paetz Jürgen , Arlt Björn
Published: January 2011

This paper reports the result of the MEDAN project that analyzes a multicenter septic shock patient data collection. The mortality prognosis based on 4 scores that are often used is compared with the prognosis of a trained neural network. We built an alarm system using the network classification results. Method. We analyzed the data of 382 patients with abdominal septic shock who were admitted to the intensive care unit (ICU) from 1998 to 2002. The analysis includes the calculation of daily sepsis-related organ failure assessment (SOFA), Acute Physiological and Chronic Health Evaluation (APACHE) II, simplified acute physiology score (SAPS) II, multiple-organ dysfunction score (MODS) scores for each patient and the training and testing of an appropriate neural network. Results. For our patients with abdominal septic shock, the analysis shows that it is not possible to predict their individual fate correctly on the day of admission to the ICU on the basis of any current score. However, when the trained network computes a score value below the threshold during the ICU stay, there is a high probability that the patient will die within 3 days. The trained neural network obtains the same outcome prediction performance as the best score, the SOFA score, using narrower confidence intervals and considering three variables only: systolic blood pressure, diastolic blood pressure and the number of thrombocytes. We conclude that the currently best available score for abdominal septic shock may be replaced by the output of a trained neural network with only 3 input variables.
A Review of the Fundamental Principles and Evidence Base in the Use of Extracorporeal Membrane Oxygenation (ECMO) in Critically Ill Adult Patients
Authors: Allen Steve , Holena Daniel , McCunn Maureen , Kohl Benjamin , Sarani Babak
Published: January 2011

Extracorporeal membrane oxygenation (ECMO) comprises a commonly used method of extracorporeal life support. It has proven efficacy and is an accepted modality of care for isolated respiratory or cardiopulmonary failure in neonatal and pediatric populations. In adults, there are conflicting studies regarding its benefit, but it is possible that ECMO may be beneficial in certain adult populations beyond postcardiotomy heart failure. As such, all intensivists should be familiar with the evidence-base and principles of ECMO in adult population. The purpose of this article is to review the evidence and to describe the fundamental steps in initiating, adjusting, troubleshooting, and terminating ECMO so as to familiarize the intensivist with this modality.
Enacting the right to have rights: Jacques Rancière’s critique of Hannah Arendt
Authors: Schaap Andrew
Published: January 2011

In her influential discussion of the plight of stateless people, Hannah Arendt invokes the ‘right to have rights’ as the one true human right. In doing so she establishes an aporia. If statelessness corresponds not only to a situation of rightlessness but also to a life deprived of public appearance, how could those excluded from politics possibly claim the right to have rights? In this article I examine Jacques Rancière’s response to Arendt’s aporetic account of human rights, situating this in relation to his wider criticism of Arendt’s conception of the political. According to Rancière, Arendt depoliticizes human rights in identifying the human with mere life (zoë) and the citizen with the good life (bios politikos). For, in doing so, she takes the distinction between zoë and the bios politikos to be ontologically given whereas politics is typically about contesting how that distinction is drawn. For Rancière ‘the human’ in human rights does not refer to a life deprived of politics. Rather, the human is a litigious name that politicizes the distinction between those who are qualified to participate in politics and those who are not. In contrast to Arendt, Rancière’s approach enables us to recognize contests over human rights, such as that of the sans papiers, as part and parcel of social struggles that are the core of political life.
Justice as a secondary moral ideal: The British idealists and the personal ethics perspective in understanding social justice
Authors: Dimova-Cookson Maria
Published: January 2011

This paper aims to show the advantages of the personal ethics perspective employed by the British idealists in the analysis of justice. In the context of Green’s and Bosanquet’s political theory, justice is a secondary moral ideal. Yet, it is argued here, their moral philosophy leads us, through a longer path, to the philosophical grounds we already occupy today: those of thinking about human rights as fundamental, not derivative, i.e. thinking about justice as a primary, not secondary moral ideal. There are three related yet distinct philosophical claims here. First, the British idealists saw clearly the stand-off between justice and virtue. Second, the personal ethics of Green and Bosanquet, with some reconstruction offered here, outlines the way in which this stand-off can be resolved without undermining its significance. Third, the personal ethics perspective is beneficial for resolving some of the difficulties surrounding the institutional approach of implementing of social justice.
Cicero on decorum and the morality of rhetoric
Authors: Kapust Daniel
Published: January 2011

This paper explores an important problem in political theory and a central issue in the study of Cicero’s thought: the tension between philosophy and rhetoric. Through an exploration of the virtue of decorum in Cicero’s rhetorical thought ( chiefly On the Ideal Orator and Orator) and in his moral philosophy ( On Duties), I argue that the virtue of decorum provides an external check on both speech and action rooted in humans’ rational nature. Given the roots of decorum in humans’ rational nature and the natural law, the desire to meet our audience’s approval does not involve Cicero in a sophistic approach to rhetoric. Rather, the desire to observe decorum provides the orator and his audience with standards of judgement that transcend mere taste and reflect underlying moral knowledge.
Oxidative stress, antioxidant status and lipid profile in the saliva of type 2 diabetics
Authors: Al-Rawi Natheer H
Published: January 2011

Background: The aim of this study was to assess the salivary content of lipid peroxidation and antioxidants in patients with type 2 diabetes.

Method: We studied 25 patients with type 2 diabetes and other 25 age- and sex-matched health control. To evaluate the oxidative status we measured the levels of malondialdehyde (MDA) in the saliva and serum of all participants. Lipid profile was also estimated through measuring total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and very low-density lipoprotein cholesterol (VLDL-C) levels. Antioxidant levels were also assessed through measuring the salivary and serum concentration of uric acid, superoxide dismutase and reduced glutathione (GSH).

Results: The high concentration of lipid fractions in saliva usually follows that recorded in serum. Salivary MDA levels, a product of lipid peroxidation, were significantly increased among diabetics together with uric acid. However, GSH levels were similar to those of the control group.

Conclusion: Lipid peroxidation and antioxidant parameters assessed in saliva of diabetic patients may be of great importance in evaluating the disease activity and severity. The increase in lipid peroxidation and the tendency of antioxidants to rise in diabetes is probably due to an adaptive response to the pro-oxidant status of diabetes.
Correlates of acute insulin resistance in the early phase of non-diabetic ST-elevation myocardial infarction
Authors: Lazzeri Chiara , Valente Serafina , Chiostri Marco , Picariello Claudio , Gensini Gian Franco
Published: January 2011

The relationship between insulin secretion and acute insulin resistance (as assessed by Homeostatic Model Assessment [HOMA] index) and clinical and biochemical parameters in the early phase of non-diabetic ST-elevation myocardial infarction (STEMI) is so far unexplored. We aimed at assessing this relation in 286 consecutive STEMI patients without previously known diabetes submitted to primary percutaneous coronary intervention (PCI). Insulin resistance (as indicated by HOMA) was detectable in 67.1%. Non-parametric correlation showed that HOMA index was significantly correlated with BMI ( r = 0.242; p < 0.0001) and HbA1c ( r = 0.189; p < 0.001). At multivariable backward linear regression analysis, glycaemia was directly related to leukocyte count ( p = 0.0003), age ( p = 0.0001), creatine kinase isoform MB (CK-MB) ( p = 0.00278) and lactate ( p < 0.0001). Insulin was directly and significantly related to glycaemia ( p = 0.0006), body mass index (BMI) ( p = 0.00028) and lactate ( p = 0.0096) In the early phase of STEMI without previously known diabetes the acute glucose dysmetabolism is quite complex, comprising increased glucose values and the development of acute insulin resistance. While insulin secretion is strictly related to BMI, apart from glucose levels, increased glucose values can be mainly related to the acute inflammatory response (as indicated to leukocyte count and C-RP), to age and to the degree of myocardial damage (as inferred by CK-MB)
Comparative analysis of risk factors for acute graft-versus-host disease and for chronic graft-versus-host disease according to National Institutes of Health consensus criteria
Authors: Flowers Mary E. D. , Inamoto Yoshihiro , Carpenter Paul A. , Lee Stephanie J. , Kiem Hans-Peter , Petersdorf Effie W. , Pereira Shalini E. , Nash Richard A. , Mielcarek Marco , Fero Matthew L. , Warren Edus H. , Sanders Jean E. , Storb Rainer F. , Appelbaum Frederick R. , Storer Barry E. , Martin Paul J.
Published: January 2011

Risk factors for grades 2-4 acute graft-versus-host disease (GVHD) and for chronic GVHD as defined by National Institutes of Health consensus criteria were evaluated and compared in 2941 recipients of first allogeneic hematopoietic cell transplantation at our center. In multivariate analyses, the profiles of risk factors for acute and chronic GVHD were similar, with some notable differences. Recipient human leukocyte antigen (HLA) mismatching and the use of unrelated donors had a greater effect on the risk of acute GVHD than on chronic GVHD, whereas the use of female donors for male recipients had a greater effect on the risk of chronic GVHD than on acute GVHD. Total body irradiation was strongly associated with acute GVHD, but had no statistically significant association with chronic GVHD, whereas grafting with mobilized blood cells was strongly associated with chronic GVHD but not with acute GVHD. Older patient age was associated with chronic GVHD, but had no effect on acute GVHD. For all risk factors associated with chronic GVHD, point estimates and confidence intervals were not significantly changed after adjustment for prior acute GVHD. These results suggest that the mechanisms involved in acute and chronic GVHD are not entirely congruent and that chronic GVHD is not simply the end stage of acute GVHD.
Enhanced Near-Infrared Luminescence of Yb(III) Complexes with Phosphine Oxide and Hexafluoroacetylacetonate Ligands
Authors: Kishimoto Shin-ichiro , Nakagawa Tetsuya , Kawai Tsuyoshi , Hasegawa Yasuchika
Published: January 2011

Near-infrared (NIR) luminescent Yb(III) complexes composed of low-vibrational frequency (LVF) fluorinated acetylacetonate and phosphine oxide ligands are reported. Their structures are determined using X-ray single-crystal analyses and categorized as eight-coordinated square antiprism. The radiative rate constants (kr), the nonradiative rate constants (knr), and the 4f–4f emission quantum efficiency (ΦEm) are estimated using their absorption spectra of magnetic dipole transition in Yb(III) complexes (2F5/2 → 2F7/2) and the observed emission lifetimes. Characteristic NIR luminescence properties of Yb(III) complexes with LVF phosphine oxide and fluorinated acetylacetonate ligands are elucidated in terms of the radiative and nonradiative rate constants.
Design of Functional Nucleic Acid Systems for Biomolecular Analysis
Authors: Sando Shinsuke
Published: January 2011

With the aim of realizing an in situ nucleic acid analysis, we have developed functional nucleic acid probes that can autonomously detect and analyze nucleic acid sequences of interest. Fluorophore-labeled artificial oligonucleotide probes with target-dependent self-ligation or self-digestion functionalities can be used to sense nucleic acids in solution, on solid supports, or even in cells. In addition, we have successfully established a new sensing system using nonmodified nucleic acids as a probe. These probes and sensors are all composed of nonmodified natural-type nucleic acids, and thus can be transcribed directly from dsDNA, giving a high potency for in situ or in-cell application.
Expert witnesses criticised
Authors: Notley Richard G
Published: January 2011

The Court invariably needs and invariably depends upon the help it receives from experts. The expert advises, but the judge decides – on the evidence. If there is nothing before the Court which throws doubt upon the expert evidence then the court must accept it. However, the Court relies upon the medical expert witness to be up to date, to be honest and to be familiar with the relevant medical literature. It has need to be on guard against the over-dogmatic expert, the expert who feels that his or her reputation or amour propre is at stake, or the expert who has developed a scientific prejudice. Agreeing to act as a medical expert witness is not a decision to be taken lightly, wantonly or ill-advisedly. Not only does it involve a lot of hard work, but may expose the expert's shortcomings in an all too public way, as two experienced medical expert witnesses, have discovered.
The interaction of reasonableness and best interests
Authors: Lambert Harry
Published: January 2011

This article examines whether the Mental Capacity Act 2005 has or should change the approach of the courts in assessing damages for protected parties in clinical negligence/catastrophic personal injury claims.