bluuebunny/crossref_metadata_2025 huggingface dataset:
Secrecy-Enhanced Data Dissemination Using Cooperative Relaying in Vehicular Networks
Authors: Sun Li , Du Qinghe , Ren Pinyi
Published: November 2013

Due to the potentials in promoting the driving safety and easing the traffic congestion, vehicular networks, especially vehicle-to-vehicle (V2V) communications, have recently been receiving much attention. The data dissemination protocol for V2V applications should not only provide end-to-end transmissions with low error probability and high throughput but also offer antieavesdropping capabilities. To achieve this goal, we in this paper propose a secrecy-enhanced relaying protocol for vehicular environments. Based on the network topology and the velocity of the moving vehicles, the proposed scheme first generates the relay candidate set, from which a single relay is then selected opportunistically to assist the source. By using the superposition coding strategy, the selected relay jointly sends the source message and the artificial interference to enable secure communications. We derive the tight closed-form expressions for the upper and lower bounds of the secrecy outage probability, based on which we analyze the diversity order of the system. The method to generate the interference signal is introduced, and the choice of superposition weight factor is also given. The analytical and simulation results show that the proposed relay-aided protocol yields a better performance than the competing alternatives in terms of both the secrecy performance and the implementation complexity.
Myomectomy during Caesarean Birth in Fibroid-Endemic, Low-Resource Settings
Authors: Awoleke J. O.
Published: November 2013

If myomectomy during caesarean delivery becomes a widespread practice, it could potentially eliminate multiple surgeries for both indications. However, many surgeons have been reluctant to adopt this policy without conclusive evidence demonstrating its safety. This study reviews the publications on caesarean myomectomy especially from the African Continent with respect to duration of surgery, blood loss, length of hospital stay, and blood transfusions. Judging from the lack of large studies on caesarean myomectomy, the proportion of surgeons who attempt the procedure is largely low because of concerns about its safety. However, most of the authors suggested that the complications and morbidity following caesarean myomectomy do not significantly differ from those occurring during caesarean section alone, while fertility is apparently not compromised by this treatment. With careful patient selection, adequate experience, and efficient haemostatic measures, the procedure does not appear as hazardous as was once thought. This piece of information is relevant for counseling women who request for the simultaneous removal of previously diagnosed fibroids during caesarean section. Staff and facilities for safe management of haemorrhage are a requisite for the procedure. Large randomized trials are needed to guide decisions as to the best clinical practice regarding myomectomy during caesarean delivery.
Notch Signaling and T-Helper Cells in EAE/MS
Authors: Bassil Ribal , Orent William , Elyaman Wassim
Published: November 2013

The Notch signaling pathway preservation across species hints to the indispensable role it plays during evolution. Over the last decade the science community has extensively studied the Notch signaling pathway, with Notch emerging as a key player in embryogenesis, tissue homeostasis, angiogenesis, and immunoregulation. Multiple sclerosis (MS) is an incurable yet treatable autoimmune chronic inflammatory disease of the central nervous system. The aim of this review is to provide a brief description of the Notch signaling pathway, and summarize the current literature implicating Notch in the pathogenesis of MS.
Modeling a Microstretch Thermoelastic Body with Two Temperatures
Authors: Marin M. , Agarwal R. P. , Mahmoud S. R.
Published: November 2013

We consider a theory of thermoelasticity constructed by taking into account the heat conduction in deformable bodies which depends on two temperatures. The first one is the conductive temperature, the second is the thermodynamic temperature, and the difference between them is proportional to the heat supply.
Mitotane-Induced Hyperlipidemia: A Retrospective Cohort Study
Authors: Shawa Hassan , Deniz Ferhat , Bazerbashi Hadil , Hernandez Mike , Vassilopoulou-Sellin Rena , Jimenez Camilo , Habra Mouhammed Amir
Published: November 2013

Limited data are available about mitotane-nduced hyperlipidemia. We retrospectively analyzed lipid data in 38 patients with adrenocortical carcinoma (ACC) who received mitotane therapy with emphasis on HDL cholesterol (HDL-c) and clinical predictors of lipid changes. At baseline, the mean levels of HDL-c, LDL-c, and triglycerides were 53.3 mg/dL, 114.4 mg/dL, and 149 mg/dL, respectively. HDL-c, LDL-c, and triglyceride concentrations significantly increased with mitotane therapy to a mean HDL peak (HDL-P) of 86.3 mg/dL (P<0.001), a mean LDL peak of 160.1 mg/dL (P<0.001), and a mean triglyceride peak (Tg-P) of 216.7 mg/dL (P=0.042). HDL-P positively correlated with mitotane concentration (r=0.52,P<0.001), while LDL-P levels and Tg-P did not. Gender, body mass index, cortisol overproduction, baseline levels of HDL-c, and triglyceride did not predict change in HDL-c. Similar changes were noticed in subgroup analysis after excluding patients who were using lipid-lowering agents. In conclusion, in ACC patients, mitotane caused significant increases in HDL-c that may counteract the deleterious atherosclerotic effects of LDL-c and Tg rise. Understanding the mechanism of HDL change may lead to the discovery of novel HDL-c-elevating drugs.
Drawable Region of the Generalized Log Aesthetic Curves
Authors: Gobithaasan R. U. , Karpagavalli R. , Miura Kenjiro T.
Published: November 2013

The main characteristic of visually pleasing curves used for product design is a monotonic curvature profile. Recently, a planar curve called Generalized Log Aesthetic Curve (GLAC) has been extended from the Log Aesthetic Curve (LAC), and it has an additional shape parameter,ν. This curve preserves the monotonicity of curvature and is said to produce visually pleasing curves. This paper delves on the drawable region of the GLAC segment which indicates the probable solutions of shape parameters from given interpolating points and the direction of travel at those points. The first section reviews the formulation of GLAC and its related bounds. The section describes the algorithm for identifying the drawable region. It is followed by the section describing how small changes ofνwiden the drawable boundaries. The final section discusses the superiority of GLAC compared to LAC for use in industrial product design.
Investigation into the Dynamics and Control of an Underwater Vehicle-Manipulator System
Authors: Santhakumar Mohan
Published: November 2013

This study addresses the detailed modeling and simulation of the dynamic coupling between an underwater vehicle and manipulator system. The dynamic coupling effects due to damping, restoring, and inertial effects of an underwater manipulator mounted on an autonomous underwater vehicle (AUV) are analyzed by considering the actuator and sensor characteristics. A model reference control (MRC) scheme is proposed for the underwater vehicle-manipulator system (UVMS). The effectiveness of the proposed control scheme is demonstrated using numerical simulations along with comparative study between conventional proportional-integral-derivative (PID) control. The robustness of the proposed control scheme is also illustrated in the presence of external disturbances and parameter uncertainties.
A Rank-Two Feasible Direction Algorithm for the Binary Quadratic Programming
Authors: Mu Xuewen , Zhang Yaling
Published: November 2013

Based on the semidefinite programming relaxation of the binary quadratic programming, a rank-two feasible direction algorithm is presented. The proposed algorithm restricts the rank of matrix variable to be two in the semidefinite programming relaxation and yields a quadratic objective function with simple quadratic constraints. A feasible direction algorithm is used to solve the nonlinear programming. The convergent analysis and time complexity of the method is given. Coupled with randomized algorithm, a suboptimal solution is obtained for the binary quadratic programming. At last, we report some numerical examples to compare our algorithm with randomized algorithm based on the interior point method and the feasible direction algorithm on max-cut problem. Simulation results have shown that our method is faster than the other two methods.
Association between Mediators in the Tear Fluid and the Severity of Keratoconus
Authors: Kolozsvári Bence Lajos , Petrovski Goran , Gogolák Péter , Rajnavölgyi Éva , Tóth Flóra , Berta András , Fodor Mariann
Published: November 2013

Purpose: To study the association between different types of mediators in the tear fluid and topographic indices characterizing the severity of keratoconus (KC). Methods: In this study, nonstimulated tear fluid samples were collected from 14 eyes of 11 patients with KC. The following indices were measured by corneal topography: maximum K value, average K value, Klyce/Maeda keratoconus index (KCI), Smolek/Klyce keratoconus severity index, opposite sector index, center/surround index, keratoconus prediction index and standard deviation of corneal power. The concentrations of interleukin (IL)-6, IL-13, CXCL8 (IL-8), chemokine (C-C motif) ligand 5 (CCL5, regulated and normal T cell expressed and secreted), matrix metalloproteinase-9 (MMP-9), MMP-13, tissue inhibitor of metalloproteinase-1, nerve growth factor (NGF) and epidermal growth factor were measured by cytometric bead array technology. Release of mediators was calculated from their concentrations and the volume of tears collected over 2 min. Results: Significant positive associations were found between CCL5, MMP-13 and NGF and several topographic indices. Significant negative correlations were found between IL-6 and KCI. Age-dependent associations were observed between IL-13, CXCL8, CCL5 and MMP-13 and the topographic data. Conclusion: Several correlations were observed between the mediators and the topographic indices, suggesting possible roles in the pathophysiology of KC. Our data indicate that some mediators have different effects on the severity of disease in an age-dependent manner.
Innate and Adaptive Immunity in Inflammatory Bowel Diseases
Authors: Foersch Sebastian , Waldner Maximilian J. , Neurath Markus F.
Published: November 2013

While barrier function and the effects of the intestinal microbiome have only recently moved into the focus of inflammatory bowel disease research, the role of the innate and the adaptive immune system in these gastrointestinal disorders has extensively been studied. Although still not completely understood, the increasing knowledge about the immune system's contribution to the pathophysiology of inflammatory bowel diseases has led to new diagnostic and therapeutic approaches. This review gives a compact overview on this important topic.
What Is Wrong with Granulocytes in Inflammatory Bowel Diseases?
Authors: Levine Adam P. , Segal Anthony W.
Published: November 2013

The neutrophil plays a central role in the acute inflammatory response, a crucial mechanism required for the efficient clearance of invading microorganisms and antigenic material. Patients with primary immunodeficiencies of neutrophil function, particularly chronic granulomatous disease, are predisposed to develop bowel inflammation that is indistinguishable from Crohn's disease (CD) on the basis of clinical, endoscopic and histopathological features. The intrinsic function of the neutrophil is normal in the vast majority of patients with CD; however, there is clear evidence of an impairment of neutrophil recruitment to sites of trauma and bacterial infection. This is associated with an inability to adequately clear bacteria that have penetrated the tissues, resulting in the formation of granulomata, the histological hallmark of the disease, and the subsequent initiation of a chronic adaptive immune response. The reduced secretion of proinflammatory cytokines by macrophages, most notably TNF-α, may account for the attenuated neutrophil recruitment observed in CD. Stimulation of the innate immune system in CD, particularly in patients in remission, may be an alternative therapeutic strategy that could reduce the risk of future disease relapses.
Comparing Guidelines for the Treatment of Inflammatory Bowel Disease
Authors: Hanauer Stephen B. , Kirsner Joseph B.
Published: November 2013

As we enter into the era of ‘personalized medicine', many of the recommendations of ‘evidence-based medicine' require scrutiny and adaptation to optimize individual outcomes. Several examples of these discrepancies are exemplified by the topics of aminosalicylate use in Crohn's disease, early use of biologic agents that target TNF and the role of calcineurin inhibitors versus anti-TNF agents in steroid-refractory ulcerative colitis.
Risks of Inflammatory Bowel Disease Treatment with Glucocorticosteroids and Aminosalicylates
Authors: Curkovic Ivanka , Egbring Marco , Kullak-Ublick Gerd A.
Published: November 2013

Background: Glucocorticosteroids and aminosalicylates, mainly mesalazine (5-ASA), are both standard therapeutics in the treatment of inflammatory bowel disease (IBD) patients. The glucocorticosteroids are highly effective in inducing remission in both ulcerative colitis and Crohn's disease, but their use is limited by the high incidence and the potentially serious nature of adverse events. In an attempt to limit systemic side effects, rapidly metabolized corticosteroids such as budesonide have been introduced. The safety profile of aminosalicylates differs between the formulations. Methods: We summarize the potential risks associated with glucocorticosteroid and aminosalicylate therapy in IBDs. Results: The numerous adverse events of glucocorticosteroids, particularly at high doses and prolonged treatment, include opportunistic infections, diabetes mellitus, hypertension, ocular effects (glaucoma and cataracts), psychiatric complications, hypothalamic-pituitary-adrenal axis suppression and increased fracture risk. Partially, these systemic adverse events occur with budesonide, which only has a low systemic exposure. The safety profile of 5-ASA is comparable to placebo and superior to the old aminosalicylate prodrug sulfasalazine, which had a significantly higher incidence of intolerance reactions including allergic rashes. Only in rare cases has nephrotoxicity such as interstitial nephritis been associated with 5-ASA. Conclusion: Considering the toxicity profile of conventional glucocorticosteroids, one primary goal of treatment in IBD should be corticosteroid-free remission. Therapy with budesonide may result in a better safety profile. 5-ASA treatment is usually well tolerated, but with regard to the rare nephrotoxic events, it is advisable to assess renal function before and during treatment with 5-ASA.
Probiotics
Authors: Kruis Wolfgang
Published: November 2013

Ample research has described multiple biological activities of probiotics in animals and in humans. Probiotics interfere with local and systemic immune reactions and thus exert an influence on the barrier function of the intestinal mucosa. Therefore, attempting inflammatory bowel disease treatment with probiotics seems reasonable. In fact, a growing number of trials have studied the therapeutic effects in ulcerative colitis and Crohn's disease. Promising results have been found and in some, indications such as maintenance of remission of ulcerative colitis and pouchitis guidelines recommend therapy with probiotics already today. However, many open questions still remain and the urgent need for high-quality trials requires much more research in the future.
Defective Antibacterial Barrier in Inflammatory Bowel Disease
Authors: Klag Thomas , Stange Eduard F. , Wehkamp Jan
Published: November 2013

The pathogenesis of inflammatory bowel disease (IBD) is very complex, including a variety of genetic and environmental contributing factors. In this context, over the past few years, a picture of IBD as a primary defect of the innate immune system rather than the adaptive immune system has evolved. The intestinal antimicrobial barrier morphologically consists of a single layer of epithelial cells and the mucus and constitutes the first defense mechanism against the microbial burden of the gut. From a more mechanistic point of view, this barrier additionally depends on a crucial interplay between the mucus and antimicrobial peptides like for instance defensins. Disturbances in this system are in the pathophysiological center stage of IBD genesis and progression. In this article we will give a short overview about some of the key mechanisms in this context with special attention on defensins and the mucus layer.
Combined Therapeutic Effect of Probucol and Cilostazol on Endothelial Function in Patients with Silent Cerebral Lacunar Infarcts and Hypercholesterolemia: A Preliminary Study
Authors: Takase Bonpei , Nagata Masayoshi , Hattori Hidemi , Tanaka Yoshihiro , Ishihara Masayuki
Published: November 2013

Objective: This study evaluated the efficacy of combined therapy with probucol and cilostazol on endothelial function in silent lacunar cerebral infarcts (SLCI) and mild hypercholesterolemia. Subjects and Methods: Flow-mediated vasodilatation (FMD) and nitroglycerin-induced vasodilatation (NMD) were measured before and after 4 weeks of combined therapy with probucol (500 mg/day) and cilostazol (200 mg/day) in 34 patients with a mean age of 72 ± 7 years (range 57-80 years) with SLCI, mild hypercholesterolemia (low-density lipoprotein cholesterol >100 mg/dl) and impaired endothelial function (FMD <6%). Patients were randomly allocated to one of the following two treatment groups: (1) aspirin (100 mg/day) with behavioral modifications, such as diet and/or exercise therapy (A group or control group, n = 17), and (2) probucol and cilostazol treatment (PC group, n = 17), also with behavioral modifications. Results: Although the baseline FMD was not different between the two treatment arms (2.7 ± 1.5 vs. 2.6 ± 1.5%, n.s.), the posttreatment FMD was significantly improved in the PC group (from 2.7 ± 1.5 to 3.5 ± 1.7%, p < 0.05) but not in the A group (from 2.6 ± 1.5 to 2.9 ± 1.4%, n.s.). No differences were observed between baseline and posttreatment NMD in either group. The effects of treatments on lipid profiles were more profound in the PC group. Conclusion: Combined treatment with probucol and cilostazol resulted in subacute improvement in FMD/endothelial function in patients with SLCI with mild hypercholesterolemia. This combination therapy has the potential to reduce the risk of cardiovascular events via improvements in endothelial function and lipid profiles.
Investigating Risk Factors for Internet Gaming Disorder: A Comparison of Patients with Addictive Gaming, Pathological Gamblers and Healthy Controls regarding the Big Five Personality Traits
Authors: Müller K.W. , Beutel M.E. , Egloff B. , Wölfling K.
Published: November 2013

Engaging in online games has become increasingly important as a part of leisure activity in adolescents and adults. While the majority of people use these games in a healthy way, epidemiological studies show that some develop excessive use and symptoms that are related to those of substance-related addictions. Despite increasing research concerning the epidemiology of internet gaming disorder (IGD), predisposing factors have been examined to a lesser extent. Knowing about specific risk factors would help clarify the nosological features of IGD and enhance prevention and intervention. This study aimed to evaluate the relationships between personality traits and IGD. A total of 115 patients meeting the criteria for IGD were compared to 167 control subjects displaying either regular or intense use of online games. Additionally, 115 patients meeting diagnostic criteria for pathological gambling were included. IGD was associated with higher neuroticism, decreased conscientiousness and low extraversion. The comparisons to pathological gamblers indicate that low conscientiousness and low extraversion in particular are characteristic of IGD. An integration of personality variables into an etiopathological model describing presumable mechanisms fostering and maintaining addictive online gaming is proposed. This model could be helpful for the theoretical understanding of addictive gaming, public health campaigns and psychoeducation within therapeutic settings.
Label-Free Quantitative Mass Spectrometry Reveals Novel Pathways Involved in LL-37 Expression
Authors: Cederlund Andreas , Nylén Frank , Miraglia Erica , Bergman Peter , Gudmundsson Gudmundur H. , Agerberth Birgitta
Published: November 2013

Antimicrobial peptides are important for a healthy host-microbe homeostasis. In infections characterized by low levels of the human cathelicidin, LL-37, induction of its expression increases clearance of pathogens. Our aim was to discover signaling pathways and compounds capable of affecting the expression of LL-37. We recently observed a synergistic induction of LL-37 expression by stimulating the colonic epithelial cell-line HT-29 with lactose and phenylbutyrate (PBA). Here, we studied regulatory circuits mediating this synergism in HT-29 cells stimulated with lactose (60 g/l) and PBA (2 mM) for 24 h by using mass spectrometry and pathway analyses. Selected pathways were evaluated for their involvement in LL-37 regulation in a CAMP gene-luciferase reporter system. Three pathways were examined in detail: thyroid hormone receptor and retinoid X receptor (TR/RXR) activation, eicosanoid signaling and steroid biosynthesis. Induced expression of LL-37 was observed upon stimulation with triiodothyronine (T3, 2.5 nM-1 µM for 3-30 h) and thyroxine (T4, 2.5-10 nM for 24 h). Furthermore, the synergism of lactose and PBA was reduced in cells coincubated with inhibitors of phospholipase A2, cyclooxygenase 2 or HMG-CoA reductase. Based on these results, we conclude that proteomics and pathway analyses are valuable tools for dissecting the regulatory networks involved in LL-37 expression.
Cytomegalovirus Disease in Patients with Common Variable Immunodeficiency: Three Case Reports
Authors: Kralickova Pavlina , Mala Eva , Vokurkova Doris , Krcmova Irena , Pliskova Lenka , Stepanova Vlasta , Bartos Vladimir , Koblizek Vladimir , Tacheci Ilja , Bures Jan , Brozik Jan , Litzman Jiri
Published: November 2013

Common variable immunodeficiency (CVID) is the most frequent clinically relevant primary immunodeficiency and shows enormous heterogeneity in clinical presentation. Despite clinical immunodeficiency, opportunistic infections are not a typical manifestation of CVID. A retrospective study of 32 patients followed up for 335 patient-years was performed to determine the frequency of cytomegalovirus (CMV) disease. Symptomatic CMV infection was documented in 3 CVID patients. Patients No. 1 and 2 suffered from CMV pneumonia, with complications due to atypical mycobacteriosis in patient No. 1. Patient No. 3 suffered from CMV enteritis. A history of cancer and chronic hepatitis C infection (patient No. 1), immunosuppressive therapy for interstitial lung disease (patient No. 2) and serious enteropathy complicated with malnutrition (patient No. 3) may have contributed to the complications despite only mild abnormalities in T-cell subpopulations. The direct detection of CMV in bronchoalveolar lavage, stool or tissue samples was the most beneficial diagnostic laboratory method, whereas the detection of CMV DNA in blood did not produce positive results. Adequate treatment of CMV disease led to significant clinical improvement in all 3 patients. The frequency of CMV disease appears to be higher than previously described. In our experience, the probability of opportunistic infections in CVID patients increases with secondary comorbidities and their management.
Visit-To-Visit Variability in Systolic Blood Pressure Is a Novel Risk Factor for the Growth of Intracranial Aneurysms
Authors: Igase Michiya , Igase Keiji , Kohara Katsuhiko , Yamashita Shiro , Fujisawa Mutsuo , Katagi Ryosuke , Miki Tetsuro
Published: November 2013

Background: Although rupture of unruptured intracranial aneurysms (UIAs) is closely associated with UIA growth during follow-up, few studies have investigated how UIAs grow during observation. Hypertension appears to affect the formation of intracranial aneurysms. However, few studies have investigated the association of blood pressure variability with UIA growth. Visit-to-visit variability (VVV) in systolic blood pressure (SBP) is a newly defined concept which appears to be a good predictor of stroke. With this factor in mind, here we conducted a prospective analysis of the results of 2 years of observation of UIAs by magnetic resonance angiography (MRA) and sought to identify risk factors for UIA growth and rupture. Methods: From December 2006 through June 2010, two hundred patients with 212 UIAs were followed for 2 years. Patient ages ranged from 31 to 91 years. Putative risk factors for the growth of UIAs were evaluated. Subjects were divided into two groups: a UIA growth group consisting of patients whose UIAs increased by 1 mm or more in size or who developed subarachnoid hemorrhage (SAH), and an unchanged group. Brachial blood pressure values were recorded at the time of diagnosis and during follow-up in the outpatient clinic. All blood pressure values were then averaged, and the VVV of SBP was defined as the standard deviation (SD) of a minimum of 5 blood pressure measurements at outpatient visits. Results: UIA growth occurred in 20 patients and SAH occurred in 1 patient. Current smoking tended to be more prevalent in the UIA growth group (p < 0.01). Five of the 12 patients with multiple UIAs showed UIA growth within 2 years and multiplicity was a significant risk factor for UIA growth (p < 0.01). The mean baseline size in the UIA growth group was larger than that in the unchanged group (p = 0.01) and 7 of the 18 patients with large UIAs, categorized as having an initial diameter of 7 mm or more, had an increase in UIA size over the 2 years (p < 0.01). On multivariable logistic regression analysis, current smoking, multiplicity, and UIA size ≥7 mm were significant risk factors for UIA growth. Although no significant difference was seen between the UIA growth and unchanged groups in office SBP during the observation period, VVV in SBP was significantly higher in the UIA growth group than in the unchanged group, and it was significantly and independently associated with UIA growth. Conclusions: VVV in SBP is a novel risk factor for the growth of UIAs and may be a key factor for the prevention of UIA rupture. Future research is needed to confirm that SBP stability prevents UIA rupture.
Cell-Free DNA Analysis for Trisomy Risk Assessment in First-Trimester Twin Pregnancies
Authors: Gil M.M. , Quezada Maria Soledad , Bregant Barbara , Syngelaki Argyro , Nicolaides Kypros H.
Published: November 2013

Objective: To examine the clinical implementation of chromosome-selective sequencing of cell-free DNA (cfDNA) in maternal blood and an algorithm that relies on the lower fetal fraction contribution of the 2 fetuses in the assessment of risk for trisomies in twin pregnancies. Methods: Risk for trisomies 21, 18 and 13 by cfDNA testing were estimated in stored plasma samples obtained at 11-13 weeks' gestation from 207 pregnancies with known outcome and prospectively in 68 twin pregnancies undergoing screening at 10-13 weeks. Results: Risk scores for trisomies were provided for 192 (92.8%) of stored plasma and for 63 (92.6%) of the prospective cases. In the retrospective study, 10 of 11 trisomic pregnancies were correctly identified with no false positive results. In the prospective study, 3 trisomic pregnancies were correctly identified with no false positive results. The median of the lower fetal fraction in the prospective study of twins was 7.4% (IQR range 5.9-10.0%), which was lower than in our previous study in singletons (median 10.0%, IQR 7.8-13.0%). Conclusions: cfDNA testing in twins is feasible but the reporting rate of results is lower than in singletons due to a lower fetal fraction.
Randomized, Controlled Trial of Ultrasound-Assisted Catheter-Directed Thrombolysis for Acute Intermediate-Risk Pulmonary Embolism
Authors: Kucher Nils , Boekstegers Peter , Müller Oliver J. , Kupatt Christian , Beyer-Westendorf Jan , Heitzer Thomas , Tebbe Ulrich , Horstkotte Jan , Müller Ralf , Blessing Erwin , Greif Martin , Lange Philipp , Hoffmann Ralf-Thorsten , Werth Sebastian , Barmeyer Achim , Härtel Dirk , Grünwald Henriette , Empen Klaus , Baumgartner Iris
Published: November 2013

Background—

In patients with acute pulmonary embolism, systemic thrombolysis improves right ventricular (RV) dilatation, is associated with major bleeding, and is withheld in many patients at risk. This multicenter randomized, controlled trial investigated whether ultrasound-assisted catheter-directed thrombolysis (USAT) is superior to anticoagulation alone in the reversal of RV dilatation in intermediate-risk patients.

Methods and Results—

Fifty-nine patients (63±14 years) with acute main or lower lobe pulmonary embolism and echocardiographic RV to left ventricular dimension (RV/LV) ratio ≥1.0 were randomized to receive unfractionated heparin and an USAT regimen of 10 to 20 mg recombinant tissue plasminogen activator over 15 hours (n=30; USAT group) or unfractionated heparin alone (n=29; heparin group). Primary outcome was the difference in the RV/LV ratio from baseline to 24 hours. Safety outcomes included death, major and minor bleeding, and recurrent venous thromboembolism at 90 days. In the USAT group, the mean RV/LV ratio was reduced from 1.28±0.19 at baseline to 0.99±0.17 at 24 hours (
P
<0.001); in the heparin group, mean RV/LV ratios were 1.20±0.14 and 1.17±0.20, respectively (
P
=0.31). The mean decrease in RV/LV ratio from baseline to 24 hours was 0.30±0.20 versus 0.03±0.16 (
P
<0.001), respectively. At 90 days, there was 1 death (in the heparin group), no major bleeding, 4 minor bleeding episodes (3 in the USAT group and 1 in the heparin group;
P
=0.61), and no recurrent venous thromboembolism.

Conclusions—

In patients with pulmonary embolism at intermediate risk, a standardized USAT regimen was superior to anticoagulation with heparin alone in reversing RV dilatation at 24 hours, without an increase in bleeding complications.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT01166997.
The Waning of the Little Ice Age: Climate Change in Early Modern Europe
Authors: Kelly Morgan , Ó Gráda Cormac
Published: November 2013

The supposed ramifications of the Little Ice Age, a period of cooling temperatures straddling several centuries in northwestern Europe, reach far beyond meteorology into economic, political, and cultural history. The available annual temperature series from the late Middle Ages to the end of the nineteenth century, however, contain no major breaks, cycles, or trends that could be associated with the existence of a Little Ice Age. Furthermore, the series of resonant images, ranging from frost fairs to contracting glaciers and from dwindling vineyards to disappearing Viking colonies, often adduced as effects of a Little Ice Age, can also be explained without resort to climate change.
Five new eyed species of Sinella (Collembola: Entomobryidae) from China, with a key to the eyed species of the genus
Authors: ZHANG FENG
Published: November 2013

Five new eyed species of Sinella from China, respectively with 3, 3, 2, 1, 1 ommatidia on each side, are described here: S. longisensilla sp. nov., S. yui sp. nov., S. pseudobrowni sp. nov., S. sacellum sp. nov. and S. gracilis sp. nov. Clypeal chaetae and chaetae along cephalic groove exhibit differences among these species and could be used to distinguish species in Sinella and Coecobrya. A key to the eyed species of the genus is given.
On the Role of Planetary-Scale Waves in the Abrupt Seasonal Transition of the Northern Hemisphere General Circulation
Authors: Shaw Tiffany A.
Published: November 2013

The role of planetary-scale waves in the abrupt seasonal transition of the Northern Hemisphere (NH) general circulation is studied. In reanalysis data, the winter-to-summer transition involves the growth of planetary-scale wave latent heat and momentum transports in the region of monsoons and anticyclones that dominate over the zonal-mean transport beginning in midspring. The wave-dominated regime coincides with an abrupt northward expansion of the cross-equatorial circulation and reversal of the trade winds. In the upper troposphere, the transition coincides with the growth of cross-equatorial planetary-scale wave momentum transport and a poleward shift of subplanetary-scale wave transport and jet stream.

The dynamics of the seasonal transition are captured by idealized aquaplanet model simulations with a prescribed subtropical planetary-scale wave sea surface temperature (SST) perturbation. The SST perturbation generates subtropical planetary-scale wave streamfunction variance and transport in the lower and upper troposphere consistent with quasigeostrophic theory. Beyond a threshold SST, a transition of the zonal-mean circulation occurs, which coincides with a localized reversal of absolute vorticity in the NH tropical upper troposphere. The transition is abrupt in the lower troposphere because of the quadratic dependence of the wave transport on the SST perturbation and involves seasonal-time-scale feedbacks between the wave and zonal-mean flow in the upper troposphere, including cross-equatorial wave propagation. The zonal-mean vertical and meridional flows associated with the circulation response are in balance with the planetary-scale wave momentum and latent heat meridional flux divergences. The results highlight the leading-order role of monsoon–anticyclone transport in the seasonal transition, including its impact on the meridional extent of the Hadley and Ferrel cells. They can also be used to explain why the transition is less abrupt in the Southern Hemisphere.
Cirrus, Transport, and Mixing in the Tropical Upper Troposphere
Authors: Dinh Tra , Fueglistaler Stephan
Published: November 2013

The impact of cloud radiative heating on transport time scales from the tropical upper troposphere to the stratosphere is studied in two-dimensional numerical simulations. Clouds are idealized as sources of radiative heating and are stochastically distributed in space and time. A spatial probability function constrains clouds to occur in only part of the domain to depict heterogeneously distributed clouds in the atmosphere.

The transport time from the lower to upper boundaries (age of air) is evaluated with trajectories. The spectra of age of air obtained in the simulations are bimodal, with the first mode composed of trajectories that remain in the cloudy part of the domain during their passages from the lower to upper boundaries, and the second mode composed of the remaining trajectories that visit the cloud-free regions. For the first group of trajectories only, the mean age scales inversely with the time-mean radiative heating in cloudy air, and the one-dimensional advection–diffusion equation provides an adequate model for transport.

However, the exchange between the cloudy and cloud-free regions renders the mean age over all trajectories (including those that visit the cloud-free region) much longer than the time expected if all air parcels remain in cloudy air. In addition, the overall mean age is not inversely proportional to the time-mean heating rate in cloudy air. Sensitivity calculations further show that the sizes, durations, and amplitudes of the individual clouds are also important to the transport time.

The results show that the frequently used decomposition of radiative heating into clear-sky and cloud radiative heating may give incorrect interpretations regarding the time scale of transport into the stratosphere.
Patterns of service utilisation in psychosis: Findings of the 2010 Australian National Survey of Psychosis
Authors: Raudino Alessandra , Carr Vaughan J , Bush Robert , Saw Suzy , Burgess Philip , Morgan Vera A
Published: November 2013

Objective:

This paper reports patterns of health service utilisation in the second Australian national survey of psychosis corresponding with changes in available services of this period.

Method:

Semi-structured interviews were carried out of an age-stratified random sample of adults who screened positive for psychosis. Multivariate logistic regressions were used to identify predictors of service use for a sample of 1825 individuals.

Results:

Use of psychiatric inpatient services was associated with higher symptom levels, suicidal ideation, poor social functioning and younger age. High users of emergency mental health services similarly reported higher symptom levels, poor functioning and younger age, and also reported being married or in a de facto relationship. Recipients of general practitioner services had greater anxiety symptoms and suicidal thoughts, fewer negative symptoms, single marital status and English as their first language. Rehabilitation service use was associated with greater anxiety symptoms, unemployment, younger age of illness onset, living alone and having no dependent children living at home. Last, outpatient/community services were more frequently used by younger people with good premorbid adjustment, hallucinations and a less severe course of illness.

Conclusions:

Service utilisation patterns vary with the clinical and socio-demographic features of those who use them – inpatient and emergency service users being similar in such features and differing from users of other services. Comparison with the first national survey of psychosis revealed a significant decline in acute inpatient service use and a substantial increase in the use of outpatient/community and rehabilitation services over the past 10 years.
From the toe to the head: metastatic endophalmitis following staphylococcal purpura fulminans
Authors: Sharma Alka , Sharma Vishal
Published: November 2013

Staphylococcal infections may present in variable ways. Staphylococcal sepsis can cause significant morbidity and mortality. We report on the case of a 42-year-old man without any co-morbidities who presented with fever and purpura fulminans and later developed metastatic endophthalmitis. He was treated with intravenous and intravitreal vancomycin. The case is reported because of the rare co-occurrence of purpura fulminans and endophthalmitis.
Motilin and Gastrin Secretion and Lipid Profile in Preterm Neonates Following Prebiotics Supplementation
Authors: Dasopoulou Maria , Briana Despina D. , Boutsikou Theodora , Karakasidou Eirini , Roma Eleftheria , Costalos Christos , Malamitsi‐Puchner Ariadne
Published: November 2013

Background: Gut hormones play an important role in the adaptation of the immature neonatal gut, and their secretion may be modulated by prebiotics. Furthermore, prebiotics are well known for their hypolipidemic potentials. We tested the hypothesis that prebiotics could alter motilin and gastrin secretion and reduce lipids in healthy preterms. Methods: A total of 167 newborns were randomized to either a prebiotics enriched formula containing dietary oligosaccharides (short‐chain galacto‐oligo‐saccharides/long‐chain fructo‐oligo‐saccharides [scGOS/lcFOS]), at a concentration of 0.8 g/100 ml, or a common preterm formula. Day 1 and 16 basal motilin, gastrin concentrations, and lipids were evaluated together with growth parameters, gastric residue, bowel habits, and feeding tolerance. Adverse events including necrotizing enterocolitis (NEC) and septicemia were also recorded. Results: Mean motilin increase and day 16 mean values were greater for the intervention, compared with the control group (P = .001, P = .005, respectively), while gastrin remained high in both groups. Mean cholesterol and low density lipoprotein (LDL) increase were significantly greater in the control, compared with the intervention (P = .037, and P = .001) group. Day 16 LDL levels were significantly higher in the control group. Mean weight was increased in the control group, while gastric residue was less and stool frequency was increased in the intervention group. NEC and septicemia were not statistically different between groups. Conclusion: A prebiotics enriched formula resulted in significant surge of motilin relating to reduced gastric residue, compared with a common preterm formula. Mean cholesterol change was lower, while LDL was not increased in the prebiotics group, compared with the control group.
Out on a Limb
Authors: Shockley Robert , Watlington Eliah , Felsher Rivka
Published: November 2013

This article reports the results of a qualitative meta-analysis study of the research and literature on the efficacy of teacher induction on the retention of high-quality secondary school teachers and challenges current assumptions about the efficacy of induction despite the proliferation of induction programs nationwide. A theoretical model for the design of future teacher induction programs that emerged from the research is presented. Recommendations for secondary school leadership, policy, and future research are included.
Lethal mass mimicking myxoma in the heart
Authors: Soo Wern Miin , Pang Yin Huei , Poh Kian-Keong
Published: November 2013

A 70-year-old man presented in advanced heart failure with jaundice. Transthoracic echocardiography revealed a 21 × 24-mm mass in the left atrium attached to the posterior mitral valve leaflet. Surgical excision was attempted, but the tumor had infiltrated the entire left atrial wall and was deemed too extensive to be resectable. Histology confirmed a high-grade pleomorphic sarcoma with malignant fibrous histiocytoma-like features. Liver biopsy revealed a high-grade liver sarcoma.
The ballbot: An omnidirectional balancing mobile robot
Authors: Nagarajan Umashankar , Kantor George , Hollis Ralph
Published: November 2013

The ballbot is a human-sized dynamically stable mobile robot that balances on a single ball. Unlike statically stable mobile robots, the ballbot is tall and narrow with a high center of gravity and a small footprint. Moreover, its dynamic stability enables it to be physically interactive. These characteristics make it better suited to navigate and interact in cluttered human environments. This paper presents the evolved hardware design of the ballbot with a four-wheel inverse mouse-ball drive to actuate the ball, and a yaw drive mechanism that enables unlimited rotation about its vertical axis. The ballbot also has a triad of legs that provide static stability when powered down. This paper presents a detailed description of the ballbot’s control architecture, and it presents several experimental results that demonstrate its balancing and locomotion capabilities. This paper also presents a trajectory planning algorithm that plans for body lean motions, which, when tracked, result in the desired rest-to-rest motions of the robot. Finally, the paper illustrates some interesting human–robot physical interaction behaviors that can be achieved as a result of the ballbot’s dynamic stability.
Governing the liberated child with self-managed family displays
Authors: Haldar Marit , Engebretsen Eivind
Published: November 2013

The 1990s witnessed the replacement of psychological perspectives seeing children as ‘becomings’ to a view of them as ‘beings’. This is challenged by the Foucauldian concept of governmentality understood as technologies of self-making actors capable of monitoring and controlling their own behaviour. This concept is central in the present study of so-called teddy-diaries, which are texts written by first graders and their parents and circulated among other families as part of the Norwegian school curriculum. A key finding of the analyses is that these circulated and displayed texts represent technologies for governing families – especially in reinforcing expectations about how ‘normal’ childhood and family life should be lived.
“What do you mean when you say that you are sexually satisfied?” A mixed methods study
Authors: McClelland Sara I
Published: November 2013

Not enough is understood about the role of gender norms and sexual stigma in shaping individuals’ definitions of sexual satisfaction. The current study aimed to investigate the heterogeneity of definitions of sexual satisfaction in a sample of young adults, ages 18–28 (M = 22.6; SD = 4.78). Forty US participants (50% females; 45% LGBTQ; 53% white) sorted 63 statements about sexual satisfaction using a Q methodology design ( Watts and Stenner, 2005 ), followed by semi-structured interviews. This mixed methods procedure enabled both a systematic and in-depth examination of the dimensions participants prioritized when determining their sexual satisfaction. Analysis of participants’ Q sorts indicated four distinct perspectives on sexual satisfaction: emotional and masculine; relational and feminine; partner focused; and orgasm focused. These four factors were further explored using participants’ interview data. Findings indicated that individuals interpreted sexual satisfaction using several key dimensions not regularly included in survey research. Existing survey items do not regularly attend to the gendered and heteronormative components of sexual satisfaction appraisals and as a result, important interpretive patterns may be overlooked.
Stress concentration factors in the matrix with different imperfect interfaces
Authors: Yao Zhan , Huang Zheng-Ming
Published: November 2013

The Bridging Model is a theory which can be used to predict the strength of a composite only based on its constituent properties. A remaining problem is how to define in-situ properties of the constituents. A previous work by Yao and Huang suggested that an in-situ transverse strength of the matrix can be defined by its monolithic counterpart divided by a stress concentration factor. However, the stress concentration factor therein was obtained based on an interphase model in addition to isotropic assumptions for all the constituent materials. In this paper, different imperfect interfaces and transversely isotropic fibers are employed. The stress concentration factors corresponding to these conditions are derived. Influences of various imperfect interfaces on a stress concentration factor are discussed.
Controlled Flooding in the Grand Canyon
Authors: Rice James
Published: November 2013

Construction of the Glen Canyon Dam in northern Arizona was motivated by the conviction that a river running to the sea is a resource forsaken. Since 1963, it has provided water storage, recreational opportunities, and electricity for millions. It has also generated far-reaching ecological changes, and controlled flooding has been employed since 1996 to restore ecological habitat downriver in the Grand Canyon. The present study situates these high-flow experiments at the Glen Canyon Dam within a neo-Weberian theoretical perspective attuned to a posthumanist critique. The objective of high-flow experiments is to attain greater balance between ecological and instrumental rationalization processes. They are not simply an experiment in habitat renewal but an operational shift signaling a greater resolve to evolve with nature, but they also illustrate the challenges inherent to large-scale ecological restoration. Nonetheless, controlled flooding illustrates important lessons with regard to the need to reflect on, learn from, and adjust socionatural relations in response to ecological degradation and change.