bluuebunny/crossref_metadata_2025 huggingface dataset:
An Ensemble Adjustment Kalman Filter for the CCSM4 Ocean Component
Authors: Karspeck Alicia R. , Yeager Steve , Danabasoglu Gokhan , Hoar Tim , Collins Nancy , Raeder Kevin , Anderson Jeffrey , Tribbia Joseph
Published: May 2013

The authors report on the implementation and evaluation of a 48-member ensemble adjustment Kalman filter (EAKF) for the ocean component of the Community Climate System Model, version 4 (CCSM4). The ocean assimilation system described was developed to support the eventual generation of historical ocean-state estimates and ocean-initialized climate predictions with the CCSM4 and its next generation, the Community Earth System Model (CESM). In this initial configuration of the system, daily subsurface temperature and salinity data from the 2009 World Ocean Database are assimilated into the ocean model from 1 January 1998 to 31 December 2005. Each ensemble member of the ocean is forced by a member of an independently generated CCSM4 atmospheric EAKF analysis, making this a loosely coupled framework. Over most of the globe, the time-mean temperature and salinity fields are improved relative to an identically forced ocean model simulation without assimilation. This improvement is especially notable in strong frontal regions such as the western and eastern boundary currents. The assimilation system is most effective in the upper 1000 m of the ocean, where the vast majority of in situ observations are located. Because of the shortness of this experiment, ocean variability is not discussed. Challenges that arise from using an ocean model with strong regional biases, coarse resolution, and low internal variability to assimilate real observations are discussed, and areas of ongoing improvement for the assimilation system are outlined.
Evaluating Surface Water Cycle Simulated by the Australian Community Land Surface Model (CABLE) across Different Spatial and Temporal Domains
Authors: Zhang Huqiang , Pak Bernard , Wang Ying Ping , Zhou Xinyao , Zhang Yongqiang , Zhang Liang
Published: May 2013

The terrestrial water cycle in the Australian Community Atmosphere Biosphere Land Exchange (CABLE) model has been evaluated across a range of temporal and spatial domains. A series of offline experiments were conducted using the forcing data from the second Global Soil Wetness Project (GSWP-2) for the period of 1986–95, but with its default parameter settings. Results were compared against GSWP-2 multimodel ensembles and a range of observationally driven datasets. CABLE-simulated global mean evapotranspiration (ET) and runoff agreed well with the GSWP-2 multimodel climatology and observations, and the spatial variations of ET and runoff across 150 large catchments were well captured. Nevertheless, at regional scales it underestimated ET in the tropics and had some significant runoff errors. The model sensitivity to a number of selected parameters is further examined. Results showed some significant model uncertainty caused by its sensitivity to soil wilting point as well as to the root water uptaking efficiency and canopy water storage parameters. The sensitivity was large in tropical rain forest and midlatitude forest regions, where the uncertainty caused by the model parameters was comparable to a large part of its difference against the GSWP-2 multimodel mean. Furthermore, the discrepancy among the CABLE perturbation experiments caused by its sensitivity to model parameters was equivalent to about 20%–40% of the intermodel difference among the GSWP-2 models, which was primarily caused by different model structure/processes. Although such results are model dependent, they suggest that soil/vegetation parameters could be another source of uncertainty in estimating global surface energy and water budgets.
Seasonal Variability of the Tyrrhenian Sea Surface Geostrophic Circulation as Assessed by Altimeter Data
Authors: Iacono R. , Napolitano E. , Marullo S. , Artale V. , Vetrano A.
Published: May 2013

New insights into the structure and variability of the Tyrrhenian Sea's surface circulation are obtained through the analysis of a very long series of altimetric observations (1993–2010). In late winter and part of spring, a consistent mean flow is individuated in the eastern Tyrrhenian Sea, formed by a stream of Atlantic water that meanders around four anticyclonic structures located along the Italian coast, which have smaller cyclonic companions offshore. The signatures of these vortices are also found in images of chlorophyll and sea surface temperature, as well as in modeling results, both from a high-resolution operational model of the Tyrrhenian Sea's circulation and from a dedicated numerical simulation. Analysis of the energy exchange between eddies and mean flow, together with numerical evidence, suggests that this winter–spring circulation pattern may result from basin-scale instability of the Atlantic stream. In summer, the dynamic is dominated by a well-known dipole located to the east of the Bonifacio Strait. However, in the eastern part of the basin, an anticyclonic cell is also found, probably driven by the negative wind stress curl present in summer in this region. The cell encompasses two anticyclonic vortices located in the areas of the Vavilov and Marsili Seamounts. A multichannel singular spectral analysis of the altimetric time series reveals that, besides the expected, dominant seasonal mode, a significant low-frequency mode of variability is also present. This mode has a period of about six years and is mostly localized in the western part of the basin.
Axis Ratios and Flutter Angles of Cloud Ice Particles: Retrievals from Radar Data
Authors: Melnikov Valery , Straka Jerry M.
Published: May 2013

A novel method of retrieving the mean axis ratio (width/length) and standard deviation of orientation angles (σθ, which is called herein the intensity of fluttering) of ice cloud particles from polarimetric radar data is described. The method is based on measurements of differential reflectivity ZDR and the copolar correlation coefficient in cloud areas with ZDR > 4 dB. In three analyzed cases, the values of the retrieved axis ratio were in an interval from 0.15 to 0.4 and σθ found in an interval from 2° to 20°. The latter values indicate that the particles experienced light to moderate fluttering. Ambiguities in the retrievals because of uncertainties in the bulk ice density of the particles and possible presence of columnar crystals are considered. The retrieval method is applicable for centimeter-wavelength radars; the analyzed data were collected with the dual-polarization S-band Weather Surveillance Radar-1988 Doppler (WSR-88D).
Evaluation of Cold-Season Precipitation Forecasts Generated by the Hourly Updating High-Resolution Rapid Refresh Model
Authors: Ikeda Kyoko , Steiner Matthias , Pinto James , Alexander Curtis
Published: May 2013

The hourly updating High-Resolution Rapid Refresh (HRRR) model is evaluated with regard to its ability to predict the areal extent of cold-season precipitation and accurately depict the timing and location of regions of snow, rain, and mixed-phase precipitation on the ground. Validation of the HRRR forecasts is performed using observations collected by the Automated Surface Observing System (ASOS) stations across the eastern two-thirds of the United States during the 2010–11 cold season. The results show that the HRRR is able to reliably forecast precipitation extent during the cold season. In particular, the location and areal extent of both snow and rain are very well predicted. Depiction of rain-to-snow transitions and freezing rain is reasonably good; however, the associated evaluation scores are significantly lower than for either snow or rain. The analyses suggest the skill in accurately depicting precipitation extent and phase (i.e., rain, snow, and mixed phase) depends on the size and organization of a weather system. Typically, larger synoptically forced weather systems are better predicted than smaller weather systems, including the associated rain-to-snow transition or freezing-rain areas. Offsets in space or time (i.e., causing misses and false alarms) have a larger effect on the model performance for smaller weather systems.
Engineering and analysis of gripping fabrics for improved ballistic performance
Authors: Sun Danmei , Chen Xiaogang , Wells Garry
Published: May 2013

Previous studies show that fabric construction is one of the key factors affecting the performance of ballistic fabrics. In order to investigate the effect of yarn gripping in fabrics, plain woven narrow fabrics with different widths have been designed and studied. In terms of narrow fabrics, it was found that narrower fabric demonstrates better performance than wider ones under low impact energy due to the better weft yarn gripping effect of the selvages. In the case of higher impact energy, wider narrow fabric shows better ballistic performance in having sufficient material to dissipate the impact energy. Different ballistic panels were made for ballistic testing, with each panel only formed from the same fabric. Performance of narrow fabric panels is disappointing compared to the broad fabric panel due to the discontinuity of the fabric material. A novel broad fabric has been engineered providing both enhanced yarn gripping and material continuity. Tests showed that panels made from such fabrics have improved performance against both back face deformation and projectile penetration.
A Multilevel Dyadic Study of the Impact of Retirement on Self-Rated Health
Authors: Curl Angela L. , Townsend Aloen L.
Published: May 2013

Objectives:

This study examined the effects of retirement on self-rated health for married couples, using interdependence and social stratification theoretical frameworks.

Method:

Dyadic multilevel modeling of data ( N = 2,213 non-Hispanic couples) from 1992 to 2010 of the Health and Retirement Survey.

Results:

Retirement was associated with worse self-ratings of health (SRH) short term (ST) for both husbands and wives during the first couple of years of retirement. In addition, the longer the husbands (but not wives) were retired, the worse was their SRH. Cross-spouse effects varied by gender: When wives retired, their husbands’ SRH improved ST, but when husbands retired their wives’ SRH improved long term. Spouse education moderated the relationship between years since spouse’s retirement and SRH for wives.

Discussion:

Practitioners can use this information to help married couples through retirement planning and transitions. Results suggest that models of retirement in couples should pay greater attention to gender and other social stratification factors, spousal interdependence, and length of time since retirement.
The Impact of Social Resources on Depressive Symptoms in Racially and Ethnically Diverse Older Adults
Authors: Park Nan Sook , Jang Yuri , Lee Beom S. , Ko Jung Eun , Chiriboga David A.
Published: May 2013

The objectives of this study were (1) to develop an empirical typology of physical health risks in racially and ethnically diverse older adults and (2) to examine whether the impact of social resources on depressive symptoms differs across the identified health risk groups (low, moderate, and high risks). The data source was the Survey of Older Floridians, a statewide survey of older adults aged 65 and older ( n = 1,432). Latent profile analysis with multiple indicators of physical health (chronic conditions, functional disability, and self-rated health) was used to identify three health risk groups (low, moderate, and high risks). The direct and interactive effects of the health risk group membership and social resources (social support and religious service attendance) on depressive symptoms were found. Of particular interest was that the positive impact of social support was most pronounced in the moderate health risk group.
Comparison of survival analysis and palliative care involvement in patients aged over 70 years choosing conservative management or renal replacement therapy in advanced chronic kidney disease
Authors: Hussain Jamilla A , Mooney Andrew , Russon Lynne
Published: May 2013

Background:

There are limited data on the outcomes of elderly patients with chronic kidney disease undergoing renal replacement therapy or conservative management.

Aims:

We aimed to compare survival, hospital admissions and palliative care access of patients aged over 70 years with chronic kidney disease stage 5 according to whether they chose renal replacement therapy or conservative management.

Design:

Retrospective observational study.

Setting/participants:

Patients aged over 70 years attending pre-dialysis clinic.

Results:

In total, 172 patients chose conservative management and 269 chose renal replacement therapy. The renal replacement therapy group survived for longer when survival was taken from the time estimated glomerular filtration rate <20 mL/min ( p < 0.0001), <15 mL/min ( p < 0.0001) and <12 mL/min ( p = 0.002). When factors influencing survival were stratified for both groups independently, renal replacement therapy failed to show a survival advantage over conservative management, in patients older than 80 years or with a World Health Organization performance score of 3 or more. There was also a significant reduction in the effect of renal replacement therapy on survival in patients with high Charlson’s Comorbidity Index scores. The relative risk of an acute hospital admission (renal replacement therapy vs conservative management) was 1.6 ( p < 0.05; 95% confidence interval = 1.14–2.13). A total of 47% of conservative management patients died in hospital, compared to 69% undergoing renal replacement therapy (Renal Registry data). Seventy-six percent of the conservative management group accessed community palliative care services compared to 0% of renal replacement therapy patients.

Conclusions:

For patients aged over 80 years, with a poor performance status or high co-morbidity scores, the survival advantage of renal replacement therapy over conservative management was lost at all levels of disease severity. Those accessing a conservative management pathway had greater access to palliative care services and were less likely to be admitted to or die in hospital.
The Liverpool Care Pathway for cancer patients dying in hospital medical wards: A before–after cluster phase II trial of outcomes reported by family members
Authors: Costantini Massimo , Pellegrini Fabio , Di Leo Silvia , Beccaro Monica , Rossi Carla , Flego Guia , Romoli Vittoria , Giannotti Michela , Morone Paola , Ivaldi Giovanni P , Cavallo Laura , Fusco Flavio , Higginson Irene J
Published: May 2013

Background:

Hospital is the most common place of cancer death but concerns regarding the quality of end-of-life care remain.

Aim:

Preliminary assessment of the effectiveness of the Liverpool Care Pathway on the quality of end-of-life care provided to adult cancer patients during their last week of life in hospital.

Design:

Uncontrolled before–after intervention cluster trial.

Settings/participants:

The trial was performed within four hospital wards participating in the pilot implementation of the Italian version of the Liverpool Care Pathway programme. All cancer patients who died in the hospital wards 2–4 months before and after the implementation of the Italian version of Liverpool Care Pathway were identified. A total of 2 months after the patient’s death, bereaved family members were interviewed using the Toolkit After-Death Family Interview (seven 0–100 scales assessing the quality of end-of-life care) and the Italian version of the Views of Informal Carers - Evaluation of Services (VOICES) (three items assessing pain, breathlessness and nausea-vomiting).

Results:

An interview was obtained for 79 family members, 46 (73.0%) before and 33 (68.8%) after implementation of the Italian version of Liverpool Care Pathway. Following Italian version of Liverpool Care Pathway implementation, there was a significant improvement in the mean scores of four Toolkit scales: respect, kindness and dignity (+16.8; 95% confidence interval = 3.6–30.0; p = 0.015); family emotional support (+20.9; 95% confidence interval = 9.6–32.3; p < 0.001); family self-efficacy (+14.3; 95% confidence interval = 0.3–28.2; p = 0.049) and coordination of care (+14.3; 95% confidence interval = 4.2–24.3; p = 0.007). No significant improvement in symptom’ control was observed.

Conclusions:

These results provide the first robust data collected from family members of a preliminary clinically significant improvement, in some aspects, of quality of care after the implementation of the Italian version of Liverpool Care Pathway programme. The poor effect for symptom control suggests areas for further innovation and development.
Alveolar adenoma combined with multifocal cysts: Case report and literature review
Authors: Wang Xiang , Li Wei-Qing , Yan Hong-Zhu , Li Yi-Ming , He Jin , Liu Hui-Min , Yu Hong-Yu
Published: May 2013

Alveolar adenoma is an extremely rare and benign pulmonary neoplasm; it is always asymptomatic and is usually detected incidentally on routine chest X-radiography. Typically on imaging examinations, alveolar adenoma exhibits as a peripheral, solitary, cystic nodule in the lung, which may easily imitate other lung lesions, consequently leading to difficulties in the differential diagnosis of this condition. Surgical resection is the primary treatment option. The diagnosis of alveolar adenoma is mainly based on postoperative histopathology, with features of proliferative type 2 alveolar epithelial cells and septal mesenchyme. The present case was a 60-year-old woman with alveolar adenoma, combined with systemic mutifocal cystic lesions. She underwent surgery following the obvious enlargement of this mass and a cystic nodule 7 cm in maximum diameter was resected. Postoperative histopathology confirmed a diagnosis of alveolar adenoma; her prognosis was favourable. In addition to reporting a rare case of alveolar adenoma coexisting with multifocal cysts, the English-language literature was reviewed for similar cases of alveolar adenoma.
Impact of type 1 diabetes mellitus on academic performance
Authors: Meo Sultan Ayoub , Alkahlan Mohammad Abdulaziz , Al-mubarak Mohammed Abdulrahman , Al-obayli Mohammed Saad , Melaibary Bader Abdullah , Dous Abdullah Nasser Bin , Alhassoun Asim Ibrahim
Published: May 2013

Objective

To examine the effect of type 1 diabetes on academic performance.

Methods

Ethnically Saudi students with type 1 diabetes, and age, sex, ethnicity and socio-economic status-matched nondiabetic control students were recruited from eight schools. Overall academic grades were recorded, based on the scores obtained in written examinations in English, mathematics, physics, chemistry, biology and humanities.

Results

Students with type 1 diabetes ( n = 36) obtained significantly lower academic grades compared with their nondiabetic control classmates ( n = 36) (86.58 ± 1.48 vs 90.62 ± 1.36).

Conclusions

Overall academic performance is significantly lower in students with type 1 diabetes compared with their nondiabetic classmates. This decline in academic performance may be explained by an association between diabetes and cognitive function.
Single-port access compared with three-port laparoscopic adnexal surgery in a randomized controlled trial
Authors: Yoo Eun-Hee , Shim Eunjung
Published: May 2013

Objective

Scar-related cosmetic outcomes were compared prospectively between conventional three-port and single-port access laparoscopic adnexal gynaecological surgery.

Methods

Enrolled patients were randomly assigned to a single- or three-port surgery group. Scar-related outcomes were evaluated at 1 month, 6 months and 1 year. Scars were assessed by an independent observer using the modified Vancouver Scar Scale (mVSS). All patients were asked about pain related to the scar and scar satisfaction; results were recorded using a numerical rating scale.

Results

Seventy-three patients were enrolled between June 2010 and June 2011. Demographic and surgical outcomes did not differ between the groups. mVSS results were similar in the two groups at each follow-up point. The scar satisfaction profile measured at 1 month showed no significant difference between the groups, but the single-port access group had better results than the conventional group at all other follow-up timepoints.

Conclusion

Cosmetic outcome was better for single-port than for three-port adnexal gynaecological surgery at 6-month and 1-year follow-up.
Place and presence within Salvadoran deportees’ narratives of removal
Authors: Coutin Susan Bibler
Published: May 2013

Based on life history interviews conducted with 1.5 generation Salvadorans who were raised in the United States and then deported to El Salvador, this article examines the displaced subjectivities being produced through intensified deportation regimes. Current theorizations of deportation are extended by examining the transition to illegality experienced by youth who may have thought their place in the United States was secure. Youths’ narratives of removal construct alternative measures of belonging and suggest that the inscription of places within persons cannot be undone merely by removing a person from a particular territory.
Foraging for Thought
Authors: Johnson Matthew R. , Higgins Julie A. , Norman Kenneth A. , Sederberg Per B. , Smith Troy A. , Johnson Marcia K.
Published: May 2013

Perceptual processing of a target stimulus may be inhibited if its location has just been cued, a phenomenon of spatial attention known as inhibition of return (IOR). In the research reported here, we demonstrated a striking effect, wherein items that have just been the focus of reflective attention (internal attention to an active representation) also are inhibited. Participants saw two items, followed by a cue to think back to (i.e., refresh, or direct reflective attention toward) one item, and then had to identify either the refreshed item, the unrefreshed item, or a novel item. Responses were significantly slower for refreshed items than for unrefreshed items, although refreshed items were better remembered on a later memory test. Control experiments in which we replaced the refresh event with a second presentation of one of the words did not show similar effects. These results suggest that reflective attention can produce an inhibition effect for attended items that may be analogous to IOR effects in perceptual attention.
High prevalence of sickness absence and disability pension among multiple sclerosis patients: a nationwide population-based study
Authors: Tinghög Petter , Hillert Jan , Kjeldgård Linnea , Wiberg Michael , Glaser Anna , Alexanderson Kristina
Published: May 2013

Introduction:

Although multiple sclerosis (MS) often implies substantial disability, there is little knowledge about sick leave and disability pension among MS patients.

Objectives:

The purpose of this study was to estimate the prevalence rates of sick leave and disability pension among MS patients and to explore how socio-demographics are associated with such rates.

Methods:

The register data of all people who lived in Sweden in 2005 and were 16–64 years old was used to identify 9721 MS patients and matched controls. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated and effect modifications were evaluated with Wald X2 tests.

Results:

In 2005, 61.7% of the MS patients were on partial or full disability pension compared to 14.2% among the controls. Of the others, 36.8% had ≥1 sick-leave spell for >14 days during that year. Socio-demographics were similarly associated with sick leave and disability pension among MS patients and controls, with the noteworthy exceptions that female gender and immigration status were less potent risk factors in the MS population ( p<0.05).

Conclusion:

In spite of widespread access to modern health care including disease-modifying drugs, the majority of MS patients of working ages were on a disability pension. Strategies enabling MS patients to retain their footing in the labour market are needed.
Assessing the validity of a computer-generated cognitive screening instrument for patients with multiple sclerosis
Authors: Lapshin Helen , Lanctôt Krista L , O’Connor Paul , Feinstein Anthony
Published: May 2013

Background:

Neuropsychological testing requires considerable time, expense, and expertise to administer. These factors can limit patient access. Computerized cognitive testing has been proposed as an alternative.

Objectives:

The objective of this paper is to validate a brief, simple-to-use computer-generated cognitive assessment screening battery for multiple sclerosis (MS) patients that has minimal motor involvement.

Methods:

A sample of 96 MS patients and 98 healthy controls completed a computer-generated battery that included the Stroop, Symbol Digit Modalities Test (C-SDMT), a two- and four-second visual analog of the Paced Auditory Serial Addition Test (PVSAT-2, PVSAT-4), and simple and choice reaction time tests. The Minimal Assessment of Cognitive Function in MS was used to define cognitive impairment in the MS sample.

Results:

Each newly developed test successfully distinguished between cognitively impaired patients and healthy controls as well as cognitively intact patients. A combination of three computerized tests (C-SDMT, PVSAT-2, PVSAT-4) with a mean administration time of 10 minutes had a sensitivity of 82.5% and specificity of 87.5% in detecting cognitive impairment. Good test-retest reliability was obtained for each measure.

Conclusions:

Good sensitivity and specificity, brevity, ease of administration, and a limited motor component highlight the feasibility of introducing this computer-generated cognitive screening instrument in a busy MS clinic.
On the emergence of descriptive norms
Authors: Muldoon Ryan , Lisciandra Chiara , Bicchieri Cristina , Hartmann Stephan , Sprenger Jan
Published: May 2013

A descriptive norm is a behavioral rule that individuals follow when their empirical expectations of others following the same rule are met. We aim to provide an account of the emergence of descriptive norms by first looking at a simple case, that of the standing ovation. We examine the structure of a standing ovation, and show it can be generalized to describe the emergence of a wide range of descriptive norms.
Participatory action research as a tool in solving desert vernacular architecture problems in the Western Desert of Egypt
Authors: Dabaieh Marwa
Published: May 2013

Vernacular architecture is suffering all over the world and Egypt is one of the countries where the desert vernacular is facing a great risk of disappearance. The aim of the research is to introduce a methodological approach applying participatory action research (PAR) as a tool to help save the future of the currently deteriorating desert vernacular architecture. The aim was to help prevent further loss of desert vernacular architecture knowledge and to encourage vernacular know-how in becoming a living part of future building practices. To benefit from local know-how, a desert vernacular model house was constructed using PAR methods that engaged the local community throughout the design and building phases. The model house was constructed based on an understanding of desert vernacular architecture as well as of the urban fabric and building technology. The town of Balat in the Western Desert of Egypt was chosen as a location for this research work application. As this is an international problem the research developed several techniques within PAR, applied in a flexible way, giving the opportunity for further application in similar vernacular settlements suffering from similar problems.
Building entity models through observational learning
Authors: Garcia Richard D , Kania Robert , Fields MaryAnne , Barnes Laura
Published: May 2013

To support the missions and tasks of mixed robotic/human teams, future robotic systems will need to adapt to the dynamic behavior of both teammates and opponents. One of the basic elements of this adaptation is the ability to exploit both long- and short-term temporal data. This adaptation allows robotic systems to predict/anticipate, as well as influence, future behavior for both opponents and teammates and will afford the system the ability to adjust its own behavior in order to optimize its ability to achieve the mission goals. This work is a preliminary step in the effort to develop online entity behavior models through a combination of learning techniques and observations. As knowledge is extracted from the system through sensor and temporal feedback, agents within the multi-agent system attempt to develop and exploit a basic movement model of an opponent. For the purpose of this work, extraction and exploitation is performed through the use of a discretized two-dimensional game. The game consists of a predetermined number of sentries attempting to keep an unknown intruder agent from penetrating their territory. The sentries utilize temporal data coupled with past opponent observations to hypothesize the probable locations of the opponent and thus optimize their guarding locations.
Socialization of Dissonance Processes
Authors: Ellithorpe Morgan E. , Ewoldsen David R. , Fazio Russell H.
Published: May 2013

Based on portrayals of dissonance as a learned drive state, it was hypothesized that there may be a role for parenting style and related variables in the development of dissonance reactions. This experiment found that both reports of having parents with authoritarian parenting styles and learning the link between responsibility and consequences moderated the effect of an induced compliance dissonance manipulation on attitudes. Reports of having experienced authoritarian parenting and responsibility emphasis both bolstered the effect of the dissonance manipulation, accentuating the difference between the dissonance and control conditions as authoritarian parenting and responsibility increased. These findings help shed some light on the processes by which dissonance reactions might be learned.
Clinical outcomes using a faecal immunochemical test for haemoglobin as a first‐line test in a national programme constrained by colonoscopy capacity
Authors: Steele Robert JC , McDonald Paula J , Digby Jayne , Brownlee Linda , Strachan Judith A , Libby Gillian , McClements Paula L , Birrell Janice , Carey Francis A , Diament Robert H , Balsitis Margaret , Fraser Callum G
Published: May 2013

Introduction

Because of their many advantages, faecal immunochemical tests (FIT) are superseding traditional guaiac‐based faecal occult blood tests in bowel screening programmes.

Methods

A quantitative FIT was adopted for use in two evaluation National Health Service (NHS) Boards in Scotland using a cut‐off faecal haemoglobin concentration chosen to give a positivity rate equivalent to that achieved in the Scottish Bowel Screening Programme. Uptake and clinical outcomes were compared with results obtained contemporaneously in two other similar NHS Boards and before and after the evaluation in the two evaluation NHS Boards.

Results

During the evaluation, uptake was 58.5%. This was higher than in the same NHS Boards both before and after the evaluation, higher than in the other two NHS Boards and higher than the 53.7% achieved overall in Scotland. The overall positivity rate was higher in men than in women and increased with age in both genders. Positive predictive values for cancer (4.8%), high‐risk adenoma (23.3%), all adenoma (38.2%) and all neoplasia (43.0%) in the two test NHS Boards were similar in all groups.

Conclusions

In summary, this evaluation of the FIT supports the introduction of FIT as a first‐line test, even when colonoscopy capacity is limited.
On effect of hydrogen on very high cycle fatigue behaviours of high strength steels
Authors: Shi J-B , Li Y D , Guo W M , Xu N , Wu X F , Zhao M , Ma H
Published: May 2013

In order to analyse the effect of hydrogen on very high cycle fatigue properties, hydrogen was precharged into two high strength steels. The applied stress intensity factor range at the periphery of inclusions before and after being precharged is approximately proportional to the cubic root of inclusion size. In addition, the applied stress intensity factor range at the periphery of inclusions after being precharged was lower compared with uncharged specimens. The additional stress intensity factor range generated by hydrogen Δ KH is raised after the hydrogen was precharged. A simple prediction equation of S– N curve was proposed by introducing the hydrogen influence factor. The proposed prediction equation can reasonably describe the S– N curves for precharged specimens.
Non-linear ultrasonic response of plastically deformed aluminium alloy AA 7009
Authors: Zhang J F , Xuan F-Z , Xiang Y X , Yang F Q
Published: May 2013

Using non-linear longitudinal wave and non-linear surface wave, the effect of plastic deformation on the non-linear ultrasonic parameter of aluminium alloy AA 7009 was studied. The results reveal that the second-order non-linear coefficient ([Formula: see text] ) increased with increasing the plastic strain for both types of non-linear waves. A simple power–law relation was developed between the ratio of [Formula: see text] and the plastic strain. The stress exponent index was found to be ∼2·35 and 1 for the non-linear longitudinal wave and the non-linear surface wave respectively. The difference of the non-linear ultrasonic responses was likely due to the microstructural difference between the near surface material and the material far away from the surface.
Dynamic mechanical properties and microstructure of Ti–6Al–7Nb biomedical alloy as function of strain rate
Authors: Lee W-S , Chen C-W
Published: May 2013

The deformation behaviour and microstructural evolution of Ti–6Al–7Nb biomedical alloy under high strain rate conditions are investigated using a compressive split Hopkinson pressure bar. Dynamic compression tests are performed at room temperature under strain rates ranging from 103 to 3×103 s−1. Experimental results show that the flow stress, workhardening coefficient and strain rate sensitivity of the Ti–6Al–7Nb alloy all increase with increasing strain rate. However, the activation volume decreases with increasing strain and strain rate. Moreover, it is shown that the high strain rate deformation behaviour of the Ti–6Al–7Nb alloy can be adequately described using the combined Johnson–Cook and Zerilli–Armstrong constitutive equation. The undeformed and deformed microstructures of the Ti–6Al–7Nb samples are found to consist of equiaxed primary α phase and transformed β phase. The size and volume fraction of the α phase increase with increasing strain rate. Moreover, the dislocation density also increases with increasing strain rate, thereby resulting in a significant strengthening effect.
How I treat NK/T-cell lymphomas
Authors: Tse Eric , Kwong Yok-Lam
Published: May 2013

Natural killer (NK)/T-cell lymphomas and NK-cell leukemias are aggressive malignancies. Occurring worldwide, they show a predilection for Asian and South American populations. Neoplastic cells are surface CD3−, cytoplasmic CD3ε+, CD56+, cytotoxic-molecule positive, Epstein-Barr virus (EBV) positive, with germline T-cell receptor gene. Lymphomas occur commonly in the nasal and upper aerodigestive region. Occasional cases present in the skin, salivary gland, testis, and gastrointestinal tract. Rare cases are disseminated with lymphadenopathy, hepatosplenomegaly, and a leukemic phase. Positron emission tomography computed tomography is useful in staging, as lymphomas are 18-fluorodeoxyglucose avid. Quantification of circulating EBV DNA is an accurate biomarker of tumor load. Nasal NK/T-cell lymphomas present mostly with stage I/II disease. Concomitant/sequential chemotherapy and radiotherapy is standard treatment. Radiotherapy alone is inadequate because of high systemic failure rate. For stage III/IV nasal, nonnasal, and disseminated lymphomas, systemic chemotherapy is indicated. Regimens containing l-asparaginase and drugs unaffected by P-glycoprotein are most effective. Hematopoietic stem cell transplantation (HSCT) is not indicated for early-stage nasal lymphomas. HSCT for lymphomas not in remission has poor results. In advanced-stage nasal, nonnasal, disseminated, or relapsed lymphomas, HSCT may be considered when remission is achieved. Prognostic modeling and EBV DNA monitoring may be useful in risk stratification for HSCT.
Dual effect of Lutzomyia longipalpis saliva on Leishmania braziliensis infection is mediated by distinct saliva-induced cellular recruitment into BALB/c mice ear
Authors: Carregaro Vanessa , Costa Diego Luis , Brodskyn Claudia , Barral Aldina Maria , Barral-Netto Manuel , Cunha Fernando Q , Silva João Santana
Published: May 2013

Background

Leishmaniaparasites are transmitted to their vertebrate hosts by infected Phlebotomine sand flies during the blood meal of the flies. Sand fly saliva is known to enhanceLeishmaniaspp. infection, while pre-exposure to saliva protects mice against parasitic infections. In this study, we investigated the initial inflammatory leucocyte composition induced by one or three inocula of salivary gland extract (SGE) fromLutzomyia longipalpisin the presence or absence ofLeishmania braziliensis.

Results

We demonstrated that inoculating SGE once (SGE-1X) or three times (SGE-3X), which represented a co-inoculation or a pre-exposure to saliva, respectively, resulted in different cellular infiltrate profiles. Whereas SGE-1X led to the recruitment of all leucocytes subtypes including CD4+T cells, CD4+CD25+T cells, dendritic cells, macrophages and neutrophils, the immune cell profile in the SGE-3X group differed dramatically, as CD4+T cells, CD4+CD25+T cells, dendritic cells, macrophages and neutrophils were decreased and CD8+T cells were increased. The SGE-1X group did not show differences in the ear lesion size; however, the SGE-1X group harbored a higher number of parasites. On the other hand, the SGE-3X group demonstrated a protective effect against parasitic disease, as the parasite burden was lower even in the earlier stages of the infection, a period in which the SGE-1X group presented with larger and more severe lesions. These effects were also reflected in the cytokine profiles of both groups. Whereas the SGE-1X group presented with a substantial increase in IL-10 production, the SGE-3X group showed an increase in IFN-γ production in the draining lymph nodes. Analysis of the inflammatory cell populations present within the ear lesions, the SGE-1X group showed an increase in CD4+FOXP3+cells, whereas the CD4+FOXP3+population was reduced in the SGE-3X group. Moreover, CD4+T cells and CD8+T cells producing IFN-γ were highly detected in the ears of the SGE-3X mice prior to infection. In addition, upon treatment of SGE-3X mice with anti-IFN-γ monoclonal antibody, we observed a decrease in the protective effect of SGE-3X againstL. braziliensisinfection.

Conclusions

These results indicate that different inocula ofLutzomyia longipalpissalivary gland extract can markedly modify the cellular immune response, which is reflected in the pattern of susceptibility or resistance toLeishmania braziliensisinfection.
Behavioural and medical predictors of bacterial vaginosis recurrence among female sex workers: longitudinal analysis from a randomized controlled trial
Authors: Guédou Fernand A , Van Damme Lut , Deese Jennifer , Crucitti Tania , Becker Marissa , Mirembe Florence , Solomon Suniti , Alary Michel
Published: May 2013

Background

Data on risk factors of recurrent bacterial vaginosis (RBV) are still scarce. We used data from female sex workers (FSW) participating in a randomized controlled microbicide trial to examine predictors of BV recurrence.

Methods

Trial’s participants with at least an episode of BV which was treated and/or followed by a negative BV result and at least one subsequent visit offering BV testing were included in the analysis. Behavioural and medical data were collected monthly while laboratory testing for STI and genital tract infections were performed quarterly. The Andersen-Gill proportional hazards model was used to determine predictors of BV recurrence both in bivariate and multivariate analyses.

Results

440 women were included and the incidence rate for RBV was 20.8 recurrences/100 person-months (95% confidence interval (CI) =18.1–23.4). In the multivariate analysis controlling for the study site, recent vaginal cleansing as reported at baseline with adjusted hazard-ratio (aHR)=1.30, 95% CI = 1.02-1.64 increased the risk of BV recurrence, whereas consistent condom use (CCU) with the primary partner (aHR=0.68, 95% CI=0.49-0.93) and vaginal candidiasis (aHR=0.70, 95% CI=0.53-0.93), both treated as time-dependent variables, were associated with decreased risk of RBV.

Conclusion

This study confirms the importance of counselling high-risk women with RBV about the adverse effects of vaginal cleansing and the protective effects of condom use with all types of partners for the prevention of sexually transmitted infections, including BV. More prospective studies on risk factors of BV recurrence are warranted.

Trial registration

Trial registration: NCT00153777
The natural history of secondary muscle-invasive bladder cancer
Authors: Hidas Guy , Pode Dov , Shapiro Amos , Katz Ran , Appelbaum Liat , Pizov Galina , Zorn Kevin C , Landau Ezekiel H , Duvdevani Mordechai , Gofrit Ofer N
Published: May 2013

Background

The management of patients with high-grade non muscle invasive bladder cancer (NMIBC) brings diagnostic and therapeutic challenges. In the current study, we sought to study the natural history of progression to "secondary" muscle-invasive bladder cancer (MIBC)-cancer that developed during follow up of patients presenting with non-muscle invasive bladder cancer (NMIBC).

Methods

Between 1998 and 2008, 760 patients were treated for bladder cancer. Primary MIBC (>=T2) tumors (present upon presentation) were diagnosed in 114 patients. All patients with high-grade NMIBC were treated with intravesical BCG. Mean follow-up was 44 months.

Results

Forty patients (6.1%) developed secondary MIBC after a mean period of 21 months from initial diagnosis of bladder cancer. The 2- and 5-year disease-specific survival rates were better for patients with secondary MIBC (90% and 56% compared to 69% and 42% for patients with primary disease, p=0.03). The Kaplan-Meier curves of the two groups were parallel but displaced by approximately 2 years.

Conclusion

In the current series, MIBC progression occurred among initially presenting patients with NMIBC in 6.1%. In most patients, the initial diagnosis of NMIBC is correct and muscle invasion occurs after a mean period of about 2 years. This supports a non-radical approach in patients with high-grade T1, Ta or Tis. Meticulous follow-up with liberal biopsy of any suspicious lesion may provide early diagnosis of invasive disease.
Factors affecting center of pressure in older adults: the Framingham Foot Study
Authors: Hagedorn Thomas J , Dufour Alyssa B , Golightly Yvonne M , Riskowski Jody L , Hillstrom Howard J , Casey Virginia A , Hannan Marian T
Published: May 2013

Background

Although aberrant foot movement during gait has been associated with adverse outcomes in the lower extremities in clinical patients, few studies have analyzed population differences in foot function. The purpose of this study was to assess demographic differences in foot function in a large population‐based study of community‐dwelling adults.

Methods

Participants in this study were from the Framingham Foot Study. Walking data were collected from both feet using a Tekscan Matscan pressure mat. Foot function was characterized using the center of pressure excursion index (CPEI). T‐tests were used to assess differences between population subsets based on sex, and in men and women separately, age, body mass index (BMI), physical activity and in women, past high heel use.

Results

There were 2111 participants included in this analysis. Significant differences in CPEI were noted by sex (p< 0.0001), by age in women (p = 0.04), and by past high heel use in women (p = 0.04).

Conclusions

Foot function during gait was affected by sex, as well as by age and shoe‐wear in women, but not by BMI or physical activity. Future work will evaluate possible relations between CPEI and outcomes such as falls, sarcopenia, and lower extremity function.
Bacteremia and resistant gram-negative pathogens among under-fives in Tanzania
Authors: Christopher Alexandra , Mshana Stephen E , Kidenya Benson R , Hokororo Aldofineh , Morona Domenica
Published: May 2013

Background

Antibiotic resistance is one of the most serious public health concerns worldwide and is increasing at an alarming rate, making daily treatment decisions more challenging. This study is aimed at identifying local bacterial isolates and their antimicrobial susceptibility patterns to avoid irrational antibiotic use, especially in settings where unguided management occurs and febrile illnesses are predominant.

Material and methods

A hospital-based prospective cross-sectional study was conducted from September 2011 to February 2012. Febrile children were serially recruited and demographic and clinical data were collected using a standardized data collection tool. A blood culture was performed and identification of the isolates was undertaken using in-house biochemical tests. Susceptibility to common antibiotics was investigated using the disc diffusion methods.

Results

Of the 1081 children admitted during the study period, 317 (29.3%) met the inclusion criteria and were recruited, of whom 195 (61.5%) and 122 (38.5%) were male and female respectively. The median age was 18 months with an interquartile range of 9 to 36 months. Of the 317 children, 251 (79.2%) were below or equal to 36 months of age. The prevalence of bacteremia was 6.6%. A higher prevalence of bacteraemia was observed in children below 36 months than in those ≥ 36 months (7.5% vs. 3.0%, p = 0.001). Predictors of bacteraemia were an axillary temperature of >38.5 °C (OR =7, 95% CI = 2.2 - 14.8, p-value = 0.0001), a positive malaria slide (OR =5, 95% CI = 3.0 - 21.2, p-value = 0.0001) and a high neutrophils’ count (OR =21 95% CI = 5.6 - 84, p-value = 0.0001). Escherichia coli and Klebsiella pneumoniae accounted for 7 (33.3%) and 6 (28.6%) of all the isolates respectively. Others gram-negatives bacteria were Citrobacter spp 2 (9.5%), Enterobacter spp 1 (4.25%), Pseudomonas spp 2 (9.5%), Proteus spp 1 (4.25%) and Salmonella spp 1 (4.25%). These isolates were highly resistant to ampicillin (95%), co-trimoxazole (90%), tetracycline (90%), gentamicin (80%), augmentin (80%), chloramphenicol (65%), ceftriaxone (35%), cefotaxime (35%) ciprofloxacin (30%), amikacin (30%), ceftazidime (25%) and norfloxacine (10%).

Conclusion

Multi-resistant gram-negative bacteria are the commonest cause of bacteremia in under-fives attending the Bugando Medical Centre, Mwanza, Tanzania. A high body temperature, a positive malaria slide and a high absolute neutrophils’ count were all independent risk factors found to predict bacteremia. A higher mortality rate was observed in children with bacteraemia. Continuous epidemiological surveillance should be conducted so that a proper and effective antibiotics management can be instituted, especially in children with a high grade fever, a positive malaria slide and a high neutrophils’ count.