bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic Value of Stress Echocardiography in Patients Presenting with Syncope
Authors: Po Jose Ricardo F. , Chaudhry Farooq A. , Balasundaram Kiruthika , Shami Waseem , Penesetti Sunil , Kommaraju Kiran K. , Mohareb Sameh , Patel Suketukumar , Agarwal Vikram , Argulian Edgar
Published: January 2015

Background

Evaluation for ischemia is appropriate in patients at risk for or with a history of coronary artery disease presenting with syncope. The aim of this study is to determine the prognostic value of stress echocardiography in patients presenting with syncope.

Methods

We examined our database of all patients undergoing stress echocardiography at our institution. Patients referred due to syncope were grouped as high risk based on any of the following: (1) known history of coronary artery disease, (2) left ventricular ejection fraction <50%, (3) moderate or severe mitral or aortic valve regurgitation, and (4) moderate mitral or aortic valve stenosis. The main outcomes were the presence of ischemia on stress imaging and all‐cause mortality using the social security death index.

Results

A total of 225 patients were identified; mean age was 64.3 ± 14.5 years, the mean follow‐up duration was 29.2 ± 13.8 months. There were 163 patients in the low‐risk group and 62 patients in the high‐risk group. On imaging, 7% of the overall cohort had ischemia. The low‐risk group had 5 (3%) patients with ischemia and the high‐risk group had 10 patients (16%) with ischemia (P < 0.01). The mortality rate was significantly higher in the high‐risk group (3.99%/year vs. 1.02%/year; P = 0.02); this difference was not affected by the presence of ischemia.

Conclusions

High‐risk patients with syncope as defined by appropriateness criteria and existing evidence carry a higher risk of ischemia and all‐cause mortality. The presence of ischemia may not be predictive of long‐term outcome in this group.
Early Recognition of Apical Ballooning Syndrome by Global Longitudinal Strain Using Speckle Tracking Imaging—The Evil Eye Pattern, a Case Series
Authors: Sosa Sualy , Banchs Jose
Published: January 2015

We report 4 cases of patients diagnosed with stress‐induced cardiomyopathy and the pattern of typical apical ballooning syndrome (ABS), who presented to our institution with chest pain, mildly elevated cardiac enzymes and ischemic electrocardiographic changes, found to have severe hypokinesis or akinesis of the mid to apical segments with dynamic basal segments on two‐dimensional (2D) echocardiography along with a global longitudinal strain (GLS) pattern markedly different from the typical left anterior descending artery (LAD) myocardial infarction pattern. All of them had a similar GLS pattern on presentation, which was easy to recognize on the polar map the day of the event. Three of the patients underwent left heart catheterization and found to have nonobstructive coronary artery disease (CAD). We discuss the usefulness of early recognition of ABS using GLS images.
Exploring Noninvasive Tricuspid dP/dt as a Marker of Right Ventricular Function
Authors: Singbal Yash , Vollbon William , Huynh Luan Tan , Wang William Y. S. , Ng Arnold C. T. , Wahi Sudhir
Published: January 2015

Background

Right ventricular (RV) function assumes prognostic significance in various disease states, but RV geometry is not amenable to volumetric assessment by two‐dimensional echocardiography. Intra‐ventricular pressure rate of rise (dP/dt) predicts myocardial contractility and adjusting for the maximal regurgitant velocity (Vmax) corrects for preload. We examined the relationship of noninvasive tricuspid dP/dt and dP/dt/Vmax with RV ejection fraction (RVEF) by cardiac magnetic resonance imaging (CMR) as a measure of RV function.

Methods

Fifty CMRs and echocardiograms performed within 30 days were included. Tricuspid regurgitation (TR) spectral Doppler trace was analyzed offline. TR dP/dt was calculated using simplified Bernoulli equation (dP/dt between 1 and 2 m/sec). dP/dt/Vmax was calculated as a ratio of dP/dt and TR Vmax. RV end‐diastolic (EDV) and end‐systolic volumes (ESV) were obtained from contouring of steady‐state‐free precession axial stack CMR images; RVEF was calculated as [(RVEDV − RVESV)/RVEDV] × 100. RVEF >42% was considered normal.

Results

Majority of studies were suitable for analysis. Median age was 48 years (IQR = 36–63); 56.4% were female (n = 22/39). There was correlation between dP/dt and RVEF (r2 = 0.51, P < 0.01) which improved with dP/dt/Vmax (r2 = 0.59, P < 0.01). dP/dt >400 mmHg/sec had a positive predictive value of 91%, sensitivity and specificity of 74% and 84% respectively for normal RVEF. Inter‐observer agreement and repeatability analysis showed no significant difference.

Conclusion

Tricuspid dP/dt correlates well with CMR RVEF. A dP/dt of more than 400 mmHg/sec strongly predicts normal RVEF. Adjusting for preload (dP/dt/Vmax) further improves this correlation.
Restorative effect of hair follicular dermal cells on injured human hair follicles in a mouse model
Authors: Yamao Mikaru , Inamatsu Mutsumi , Okada Taro , Ogawa Yuko , Ishida Yuji , Tateno Chise , Yoshizato Katsutoshi
Published: January 2015

No model is available for examining whether in vivo‐damaged human hair follicles (hu‐HFs) are rescued by transplanting cultured hu‐HF dermal cells (dermal papilla and dermal sheath cells). Such a model might be valuable for examining whether in vivo‐damaged hu‐HFs such as miniaturized hu‐HFs in androgenic alopecia are improvable by auto‐transplanting hu‐HF dermal cells. In this study, we first developed mice with humanized skin composed of hu‐keratinocytes and hu‐dermal fibroblasts. Then, a ‘humanized scalp model mouse’ was generated by transplanting hu‐scalp HFs into the humanized skin. To demonstrate the usability of the model, the lower halves of the hu‐HFs in the model were amputated in situ, and cultured hu‐HF dermal cells were injected around the amputated area. The results demonstrated that the transplanted cells contributed to the restoration of the damaged HFs. This model could be used to explore clinically effective technologies for hair restoration therapy by autologous cell transplantation.
Preclinical evidence implicating corticotropin‐releasing factor signaling in ethanol consumption and neuroadaptation
Authors: Phillips T. J. , Reed C. , Pastor R.
Published: January 2015

The results of many studies support the influence of the corticotropin‐releasing factor (CRF) system on ethanol (EtOH) consumption and EtOH‐induced neuroadaptations that are critical in the addiction process. This review summarizes the preclinical data in this area after first providing an overview of the components of the CRF system. This complex system involves hypothalamic and extra‐hypothalamic mechanisms that play a role in the central and peripheral consequences of stressors, including EtOH and other drugs of abuse. In addition, several endogenous ligands and targets make up this system and show differences in their involvement in EtOH drinking and in the effects of chronic or repeated EtOH treatment. In general, genetic and pharmacological approaches paint a consistent picture of the importance of CRF signaling via type 1 CRF receptors (CRF1) in EtOH‐induced neuroadaptations that result in higher levels of intake, encourage alcohol seeking during abstinence and alter EtOH sensitivity. Furthermore, genetic findings in rodents, non‐human primates and humans have provided some evidence of associations of genetic polymorphisms in CRF‐related genes with EtOH drinking, although additional data are needed. These results suggest that CRF1 antagonists have potential as pharmacotherapeutics for alcohol use disorders. However, given the broad and important role of these receptors in adaptation to environmental and other challenges, full antagonist effects may be too profound and consideration should be given to treatments with modulatory effects.
Help‐seeking amongst women survivors of domestic violence: a qualitative study of pathways towards formal and informal support
Authors: Evans Maggie A. , Feder Gene S.
Published: January 2015

Background

Informal and formal support for women experiencing domestic violence and abuse (DVA) can improve safety and health outcomes. There has been little qualitative work on the role of both pathways to support and women's experiences of disclosing their experience of DVA in different contexts.

Objective and study design

This qualitative study used repeat interviews with women survivors of DVA to explore their pathways to support and their experiences of barriers and facilitators to disclosure and help‐seeking.

Setting and participants

Thirty‐one women seeking help from specialist DVA agencies in the UK were interviewed twice over 5 months.

Results

Women recounted long journeys of ambivalence, often only disclosing abuse after leaving the perpetrator. Access to specialist support rarely came via general practitioners, despite high levels of consulting for anxious and depressed feelings, and was more often facilitated by police or housing agencies following a crisis such as assault. Informal disclosure only led to specialist help if the family member or friend themselves had experience or knowledge of DVA.

Discussion and conclusions

Women experiencing DVA need earlier access to specialized DVA services. Many women needed an ‘enabler’ to facilitate access, but once this contact was made, disclosure to other professionals or to family and friends was legitimized in the eyes of the women. Safely accessible publicity about DVA services and an appropriate response from social and health‐care professionals should be promoted, including support for women disclosing DVA to take action on the information they receive about services.
A reference image‐based method for optimization of clinical immunohistochemistry
Authors: Kap Marcel , Lam King H , Ewing‐Graham Patricia , Riegman Peter
Published: January 2015

Aims

Cold ischaemic and formalin fixation time (CIT and FFT) are considered to be crucial parameters for intralaboratory variation in immunohistochemistry (IHC). Here we describe a new method to optimize IHC, by using control tissue blocks with known pre‐analytical history and comparing the IHC outcome with digitized reference slides.

Methods and results

Tissue specimens (two per tissue type) were divided into eight samples, which were subjected to different CIT and FFT. Immunohistochemistry was performed with 34 routinely used antibodies, following standard operating procedures. Relative staining intensity of four sections per slide was scored. Of the antibodies studied, seven were influenced by CIT, 13 by FFT and five by both parameters. IHC protocols were adapted until most sections on the slide showed the same intensity. Changing the antibody dilution for 10 protocols and the antigen retrieval method for six protocols improved the consistency of the IHC staining. Nine protocols could not be optimized. The optimized staining results were compared to reference slides and were found to be of adequate quality.

Conclusions

It was possible to optimize most IHC protocols by adapting the analytical, rather than the pre‐analytical, phase. If global references can be established, this method could decrease interlaboratory variation, preceding standardization of the pre‐analytical workflow.
Mediating Community Participation: Practice of Support Workers in Initiating, Facilitating or Disrupting Encounters between People with and without Intellectual Disability
Authors: Bigby Christine , Wiesel Ilan
Published: January 2015

Promoting community participation for people with intellectual disability through encounter with strangers is an integral part of the mission of disability support workers. This paper offers detailed micro‐level analysis of the practices of support workers when they accompany a person with intellectual disability outside their home and explores the subtle differences which make some staff practices more effective than others in promoting more convivial encounters with strangers. Based on 160 h of observations of twenty‐six adults with intellectual disability in a variety of public places, and interviews and focus groups with their support workers, the paper points to some of the critical judgements support workers need to make when considering whether, when and how to initiate or intervene in such encounters.
Silent Cerebral Events/Lesions Related to Atrial Fibrillation Ablation: A Clinical Review
Authors: DENEKE THOMAS , JAIS PIERRE , SCAGLIONE MARCO , SCHMITT RAINER , DI BIASE LUIGI , CHRISTOPOULOS GEORGIOS , SCHADE ANJA , MÜGGE ANDREAS , BANSMANN MARTIN , NENTWICH KARIN , MÜLLER PATRICK , KRUG JOACHIM , ROOS MARKUS , HALBFASS PHILLIP , NATALE ANDREA , GAITA FIORENZO , HAINES DAVID
Published: January 2015

Silent Cerebral Events/Lesions Related to AF Ablation

Brain magnetic resonance imaging (MRI) has identified a high incidence of cerebral ischemia in asymptomatic patients after atrial fibrillation (AF) ablation (silent). Detection of cerebral ischemic events on MRI is based on acute hyperintense lesions on diffusion‐weighted imaging. In the literature, the incidence is related to specifications of MRI and depends on the definition applied. In comparative studies, silent cerebral events (SCE, diffusion‐weighted MRI [DWI] positive only) appear to be approximately 3 times more common compared to using a definition of silent cerebral lesions (SCL; without fluid attenuated inverse recovery sequence [FLAIR] positivity). Whereas the FLAIR sequence may turn positive within days after the ischemic event, SCE definition is highly sensitive for early phases of ischemic brain damage. SCE/SCL appear to represent cerebral ischemic infarcts and determine the “embolic fingerprint” of a specific ablation technology and strategy used. The optimum time point for detecting SCE is early after AF ablation (24–72 hours), whereas detection of SCL can only be performed within the first 2–7 days (due to delay of FLAIR positivity). Different technology‐, procedure‐, and patient‐related parameters have been identified to play a role in the multifactorial genesis of SCE/SCL. In recent years, evidence has been gathered that there may be differences of SCE/SCL rates depending upon the ablation technology used, but small patient numbers and a large number of potential confounders hamper all studies. As major findings of recent studies, mode of periprocedural and intraprocedural anticoagulation has been identified as a major predictor for incidences of SCE/SCL. Whereas procedural characteristics related to higher SCE/SCL‐rates may be modified, unchangeable patient‐related factors should be taken into account for future individualized risk assessment. Novel ablation devices introduced into the market should be tested for their potential embolic fingerprint and refinements of ablation procedures to reduce their embolic potential should be prompted. The knowledge of “best practice” in terms of low SCE/SCL rates has prompted changes in work‐flow, which have been implemented into ablation procedures using novel ablation devices. So far, no study has linked SCE/SCL to neuropsychological decline and the low number of AF‐ablation‐associated events needs to be weighted against the multitude of preexisting asymptomatic MRI‐detected brain lesions related to the course of AF itself. Future studies are needed to evaluate if more white matter hyperintensities due to AF may be prevented by AF ablation (producing only a small number of SCE/SCL).
Mood repair via attention refocusing or recall of positive autobiographical memories by adolescents with pediatric‐onset major depression
Authors: Kovacs Maria , Yaroslavsky Ilya , Rottenberg Jonathan , George Charles J. , Baji Ildikó , Benák István , Dochnal Roberta , Halas Kitti , Kiss Enikő , Vetró Ágnes , Kapornai Krisztina
Published: January 2015

Background

Impaired emotion regulation is increasingly recognized as a core feature of depressive disorders. Indeed, currently and previously depressed adults both report greater problems in attenuating sadness (mood repair) in daily life than healthy controls. In contrast, studies of various strategies to attenuate sad affect have mostly found that currently or previously depressed adults and controls were similarly successful at mood repair in the laboratory. But few studies have examined mood repair among depression‐prone youths or the effects of trait characteristics on mood repair outcomes in the laboratory.

Methods

Adolescents, whose first episode of major depressive disorder (MDD) had onset at age 9, on average (probands), and were either in remission or depressed, and control peers, watched a sad film clip. Then, they were instructed to engage in refocusing attention (distraction) or recalling happy memories. Using affect ratings provided by the youths, we tested two developmentally informed hypotheses about whether the subject groups would be similarly able to attenuate sadness via the two mood repair strategies. We also explored if self‐reported habitual (trait) mood repair influenced laboratory performance.

Results

Contrary to expectations, attention refocusing and recall of happy memories led to comparable mood benefits across subjects. Control adolescents reported significantly greater reductions in sadness than did depressed (Cohen's d = .48) or remitted (Cohen's d = .32) probands, regardless of mood repair strategy, while currently depressed probands remained the saddest after mood repair. Habitual mood repair styles moderated the effects of instructed (state) mood repair in the laboratory.

Conclusions

Whether depressed or in remission, adolescents with MDD histories are not as efficient at mood repair in the laboratory as controls. But proband‐control group differences in mood repair outcomes were modest in scope, suggesting that the abilities that subserve affect regulation have been preserved in probands to some degree. Further information about the nature of mood repair problems among youths with depression histories would help to better understand the clinical course of MDD and to design personalized interventions for depression.
Inside and Outside the Pituitary: Comparative Analysis of Gnrhr Expression Provides Insight into the Mechanisms Underlying the Evolution of Gene Expression
Authors: Schang AL
Published: January 2015

DNA cis‐acting elements involved in gene regulation may actively contribute to adaptation processes because they are submitted to lower evolutionary constraints than coding DNA. In this regard, comparisons of the mechanisms underlying basal and regulated Gnrhr expression have revealed some features that promote stable and consistent Gnrhr expression in pituitary gonadotroph cells in different species. The presence of two divergent SF1 (NR5A1) response elements in all analysed mammalian Gnrhr promoters probably comprises one of the features that ensures reliable expression in the pituitary. By contrast, in other tissues, such as the hippocampus and testis, our analyses revealed dissimilar levels of Gnrhr expression among species. Indeed, Gnrhr was consistently expressed after birth in the rat but not the mouse hippocampus. Similar discrepancies were observed in foetal and adult testes. The ability of the rat promoter to drive reporter gene expression in the hippocampus and testis of transgenic mice just as it naturally directs the expression of the endogenous Gnrhr in rats strongly suggests that regulatory DNA sequences contained species‐specific instructions prevailing over other controls. The major conclusion emerging from these studies is that Gnrhr promoter sequences are mainly responsible for directing transcriptional programmes and play a predominant role over the species‐specific cell environment.
Salty or Sweet? Nutritional Quality, Consumption, and Cost of Snacks Served in Afterschool Programs
Authors: Beets Michael W. , Weaver Robert G. , Tilley Falon , Turner‐McGrievy Gabrielle , Huberty Jennifer , Ward Dianne S. , Freedman Darcy A.
Published: January 2015

BACKGROUND

Snacks served in afterschool programs (ASPs, 3‐6 pm) represent an important opportunity to promote healthy eating. ASP policies suggest a fruit/vegetable is served daily, while sugar‐sweetened foods/beverages and artificially flavored snacks are eliminated. Limited information exists on the types of snacks served in ASPs, if snacks meet existing nutrition policies, whether children eat the snacks, and their cost.

METHODS

Direct observation of snacks served and consumed was collected in 20 ASPs serving over 1700 elementary age children. The number of days that snacks were served/week was evaluated for compliance with nutrition policies. Costs of snacks were collected via receipts.

RESULTS

Programs served desserts and artificially flavored salty snacks on 2.7 and 2.1 days/week. Fruits and vegetables were served 0.6 and 0.1 days/week, respectively. Sugar‐sweetened beverages were served 1.8 days/week. Of the children (N = 383) observed, 75% to 100% consumed the snack served, with 95% and 100% of served fruits/vegetables consumed. No ASP served fruit/vegetables daily, 18 served sugar‐sweetened foods, 16 served artificially flavored snacks, and 14 served sugar‐sweetened beverages. Desserts and salty snacks cost $0.27‐$0.32/snack vs $0.38‐$0.40/snack for vegetables/fruits.

CONCLUSIONS

The quality of snacks failed to meet nutrition policies and consists of predominately high‐sugar and artificially flavored options. Strategies to improve snack offerings in ASPs while addressing price barriers are required.
Religion, Religious Diversity and Tourism
Authors: Fourie Johan , Rosselló Jaume , Santana‐Gallego Maria
Published: January 2015

Religious beliefs influence many aspects of daily life. It is therefore plausible to argue that these beliefs affect some of our most central endeavors, such as trade, migration, foreign investment and travel. This paper investigates the role a country's religious affiliation plays in destination choice for international tourism flows. To that end, a gravity model for international tourist arrivals is estimated by using a large dataset of 164 countries for the period 1995–2010. Results provide evidence that religious similarity have significant explanatory power in global tourism flows even after controlling for other measures of cultural affinity. Moreover, the presence of common religious minorities in the country has a positive impact on tourism flows. However, although religious pluralism foster tourism flows between countries, religious similarity has a stronger positive effect.
Autonomy‐Enhancing Paternalism
Authors: Binder Martin , Lades Leonhard K.
Published: January 2015

We present a form of soft paternalism called “autonomy‐enhancing paternalism” that seeks to increase individual well‐being by facilitating the individual ability to make critically reflected, autonomous decisions. The focus of autonomy‐enhancing paternalism is on helping individuals to become better decision‐makers, rather than on helping them by making better decisions for them. Autonomy‐enhancing paternalism acknowledges that behavioral interventions can change the strength of decision‐making anomalies over time, and favors those interventions that improve, rather than reduce, individuals' ability to make good and unbiased decisions. By this it prevents manipulation of the individual by the soft paternalist, accounts for the heterogeneity of individuals, and counteracts slippery slope arguments by decreasing the probability of future paternalistic interventions. Moreover, autonomy‐enhancing paternalism can be defended based on both liberal values and welfare considerations.
Allergen expression in the European house dust mite Dermatophagoides pteronyssinus throughout development and response to environmental conditions
Authors: VIDAL‐QUIST J. C. , ORTEGO F. , LOMBARDERO M. , CASTAÑERA P. , HERNÁNDEZ‐CRESPO P.
Published: January 2015

House dust mites are a major source of allergy worldwide. While diagnosis and treatment based on mite extracts have remarkably advanced, little information exists on the expression of allergens in mites. We have studied gene expression of eight Dermatophagoides pteronyssinus (Trouessart) (Acari: Pyroglyphidae) allergens (Der p 1, 2, 3, 4, 5, 7, 10 and 21). All allergens showed higher transcription in nymphs compared with larvae or adults, with the only exception of Der p 10. The transcription of Der p 4 and Der p 10, together with the transcription and protein ratios Der p 1 to Der p 2, were higher in males than in females. One‐week exposure of mite cultures to 16 or 35 °C (versus 24 °C) or low RH (44% versus 76%) significantly influenced the allergen gene transcription profile. Our results demonstrate that allergen expression is quantitatively and/or qualitatively influenced by mite development and sex, as well as by the environment. We suggest that monitoring allergen gene expression may be a useful tool to assist the optimization of mite cultures in the production of standardized allergenic extracts for clinical use.
Foxhole Faith and Funk Religion: Anglo-American Perspectives from Two World Wars
Authors: Snape Michael
Published: January 2015

The role of combat as a religious stimulant was widely observed and debated during both World Wars. Through a consideration of American opinion in World War II, especially in the light of British opinion a generation earlier, this paper illustrates that, however similar expressions of combatants’ faith may have been across time and space, their perceived value was very much dictated by their wider religious context, and particularly by the existing assumptions and priorities of religious observers and pundits. This meant that, in the American context of World War II, appraisals tended to be much more positive than in the British context of World War I, adding considerable substance and longevity to the claim that ‘there are no atheists in foxholes’.
Normal esophageal pressure topography metrics for data derived from the Sandhill‐Unisensor high‐resolution manometry assembly in supine and sitting positions
Authors: do Carmo G. C. , Jafari J. , Sifrim D. , de Oliveira R. B.
Published: January 2015

Background

Normal values of the esophageal motor function parameters for high‐resolution manometry (HRM‐EPT) adopted by the Chicago classification were established using the proprietary system of Given Imaging. It is conceivable that normal values of a system do not apply to data from others. Most studies using HRM were based on supine swallows, whereas deglutition occurs mostly in the upright position. We wished to establish normal values for HRM‐EPT parameters obtained with the Sandhill's HRM‐EPT system and compare the results in supine and sitting positions.

Methods

Sixty‐nine healthy volunteers, 38 females, median age 27 years, were included in this study. All underwent supine HRM, and 34 of them underwent sitting HRM, with at least 10 single 5‐mL swallows for analysis obtained in each position.

Key Results

The normal range (5–95th percentiles) for the following parameters was calculated: distal contractile integral (DCI), 606–4998 mmHg·s·cm; contractile front velocity (CFV), 2.0–6.5 cm/s; distal latency (DL), 5.1–8.8 s; intrabolus pressure (IBP), 1.9–17.6 mmHg; upper esophageal sphincter (UES) pressure, 45.2–186.9 mmHg; esophagogastric junction (EGJ) length, 1.8–4 cm; EGJ resting pressure, 8.1–61.6 mmHg, and integrated relaxation pressure (IRP) 2.5–23.5 mmHg. Normal values of EGJ resting pressure, IRP, DCI, and IBP but not CFV, DL, and UES resting pressure were significantly lower in the sitting posture.

Conclusions & Inferences

Studies performed with Sandhill's HRM‐EPT system should use its own specific normal data. Normal values should be established for different study
Multiple origins and chromosomal novelty in the allotetraploid Tragopogon castellanus (Asteraceae)
Authors: Mavrodiev Evgeny V. , Chester Michael , Suárez‐Santiago Víctor N. , Visger Clayton J. , Rodriguez Roseana , Susanna Alfonso , Baldini Riccardo M. , Soltis Pamela S. , Soltis Douglas E.
Published: January 2015

Tragopogon includes two classic examples of recently formed allopolyploid species in North America: T. mirus and T. miscellus. Older Tragopogon allotetraploids from Eurasia offer ideal taxa for comparing the longer term outcomes of allopolyploidy.

To help resolve the ancestry of one of these older polyploids, phylogenetic analyses of multiple populations of the allotetraploid T. castellanus (2n = 24) and its putative diploid parents, T. crocifolius and T. lamottei, were conducted using sequences from nuclear (internal transcribed spacer, ITS; and alcohol dehydrogenase 1A, Adh) and plastid (trnT‐trnL spacer, trnL intron, trnL‐trnF spacer and rpl16 intron) loci. Fluorescence in situ hybridization (FISH) and genomic in situ hybridization (GISH) were used to investigate the chromosomal constitution of T. castellanus.

Our data confirm that the widely distributed T. crocifolius and the Iberian endemic, T. lamottei, are the diploid parents of T. castellanus, and that this polyploid formed at least three times.

One group of populations of T. castellanus is distinct in exhibiting two pairs of rearranged chromosomes. These data suggest that some of the chromosomal variants that originate in young polyploids (here, an intergenomic translocation) may become fixed in populations, contributing to novelty in older polyploid lineages. The geographical distributions of the allopolyploids and parents are also complex, with allotetraploid populations being disjunct from one or both of the most closely related diploid parental populations.
Findings of a Naloxone Database and its Utilization to Improve Safety and Education in a Tertiary Care Medical Center
Authors: Rosenfeld David M. , Betcher Jeffrey A. , Shah Ruby A. , Chang Yu‐Hui H. , Cheng Meng‐Ru , Cubillo Efrain I. , Griffin Julia M. , Trentman Terrence L.
Published: January 2015

Introduction

Analyzing hospital naloxone use may assist in identification of areas for quality and safety improvement. Our primary objective is to quantitate the incidence of hospital naloxone use and to assess certain patient populations at risk.

Methods

During the years 2008 to 2011, each clinical scenario where naloxone was administered on an in‐patient care ward was reviewed. The events were assessed to separate situations where naloxone rescue was effective in reversing opioid‐induced intoxication vs. others. Further analysis was conducted to stratify patient populations at greatest risk.

Results

Naloxone was administered for well‐defined opioid‐induced respiratory depression and oversedation 61% of the time, the remainder used for patient deterioration of other etiology. Surgical populations are at risk with an incidence of 3.8/1,000 hospitalized patients, and this is the greatest within 24 hours of surgery. General surgical patients represent the highest surgical patient risk at 5.5/1,000. Medical patients represent lower risk at 2.0/1,000. Patients with patient‐controlled analgesia and epidural opioid infusion are high risk at 12.1 and 13.1/1,000 patients, respectively. Many quality and safety interventions were gradually implemented in response to this data and are summarized. These include nursing and provider education, electronic medical record modification, and more stringent patient monitoring practices.

Conclusion

Examination of naloxone use can assist in the identification and stratification of patients at risk for opioid‐induced respiratory depression and oversedation and can serve as a driver for improvements in hospital patient safety. This information can also guide other institutions interested in similar improvements.
Biomass harvest of invasive Typha promotes plant diversity in a Great Lakes coastal wetland
Authors: Lishawa Shane C. , Lawrence Beth A. , Albert Dennis A. , Tuchman Nancy C.
Published: January 2015

Ecological and financial constraints limit restoration efforts, preventing the achievement of desired ecological outcomes. Harvesting invasive plant biomass for bioenergy has the potential to reduce feedback mechanisms that sustain invasion, while alleviating financial limitations. Typha × glauca is a highly productive invasive wetland plant that reduces plant diversity, alters ecological functioning, its impacts increase with time, and is a suitable feedstock for bioenergy. We sought to determine ecological effects of Typha utilization for bioenergy in a Great Lakes coastal wetland by testing plant community responses to harvest‐restoration treatments in stands of 2 age classes and assessing community resilience through a seed bank study. Belowground harvesting increased light penetration, diversity, and richness and decreased Typha dominance and biomass in both years post‐treatment. Aboveground harvesting increased light and reduced Typha biomass in post‐year 1 and in post‐year 2, increased diversity and richness and decreased Typha dominance. Seed bank analysis revealed that young stands (<20 years) had greater diversity, richness, seedling density, and floristic quality than old stands (>30 years). In the field, stand‐age did not affect diversity or Typha dominance, but old stands had greater Typha biomass and slightly higher richness following harvest. Harvesting Typha achieved at least 2 desirable ecological outcomes: reducing Typha dominance and increasing native plant diversity. Younger stands had greater potential for native recovery, indicated by more diverse seed banks. In similar degraded wetlands, a single harvest of Typha biomass would likely result in significant biodiversity and habitat improvements, with the potential to double plant species richness.
Downstream lightening and upward heavying: Experiments with sediments differing in density
Authors: Viparelli Enrica , Solari Luca , Hill K. M.
Published: January 2015

Sorting and selective transport of particles by material density is important for understanding a wide range of processes, including the formation of mineral placers, deposition of mine tailings and routing of tracers and contaminants. This article describes an experimental study of the transport of mixtures of particles of differing density in a sediment‐feed flume. During the runs, a downstream prograding wedge‐shaped deposit was formed. Results show two sorting processes: (i) longitudinal sorting characterized by preferential deposition of heavy particles in the upstream part of the deposit – downstream lightening; and (ii) vertical sorting with less dense particles preferentially deposited in the lowermost portion of the migrating front – upward heavying. Downstream lightening is the analogue of the well‐known downstream fining observed in the more studied case of mixtures of heterogeneous size with the same density. In both cases, the lighter particles are carried further downstream than the heavier particles. Upward heavying is unexpected when compared with deposits of heterogeneous size and same‐density particles, where the heaviest (i.e. coarsest) particles are deposited in the lowermost part of the front. The physical mechanism underlying this upward heavying might be related to the physics of gravity‐driven granular flows; the front of the deposit acts like a dense granular flow down an inclined plane. In this case, the denser particles settle away from the free surface and at the top of the heap, while the lighter particles flow to the bottom. As the front of the deposit advances, this progressively gives rise to an upward heavying pattern. The application of classical surface‐based fractional bedload transport models suggests that equal mobility is not approached in the case of mixtures of particles with uniform size and different densities. This study hypothesizes that other mechanics related to the physics of the segregation processes in these systems contribute to these results.
A Polynomial Formulation of Inverse Kinematics of Rolling Contact
Authors: Cui Lei , Dai Jian S.
Published: January 2015

Rolling contact has been used by robotic devices to drive between configurations. The degrees of freedom (DOFs) of rolling contact pairs can be one, two, or three, depending on the geometry of the objects. This paper aimed to derive three kinematic inputs required for the moving object to follow a trajectory described by its velocity profile when the moving object has three rotational DOFs and thus can rotate about any axis through the contact point with respect to the fixed object. We obtained three contact equations in the form of a system of three nonlinear algebraic equations by applying the curvature theory in differential geometry and simplified the three nonlinear algebraic equations to a univariate polynomial of degree six. Differing from the existing solution that requires solving a system of nonlinear ordinary differential equations, this polynomial is suitable for fast and accurate numerical root approximations. The contact equations further revealed the two essential parts of the spin velocity: The induced spin velocity governed by the geometry and the compensatory spin velocity provided externally to realize the desired spin velocity.
Prosthesis Loading After Temporomandibular Joint Replacement Surgery: A Musculoskeletal Modeling Study
Authors: Ackland David C. , Moskaljuk Adrian , Hart Chris , Vee Sin Lee Peter , Dimitroulis George
Published: January 2015

One of the most widely reported complications associated with temporomandibular joint (TMJ) prosthetic total joint replacement (TJR) surgery is condylar component screw loosening and instability. The objective of this study was to develop a musculoskeletal model of the human jaw to assess the influence of prosthetic condylar component orientation and screw placement on condylar component loading during mastication. A three-dimensional model of the jaw comprising the maxilla, mandible, masticatory muscles, articular cartilage, and articular disks was developed. Simulations of mastication and a maximum force bite were performed for the natural TMJ and the TMJ after prosthetic TJR surgery, including cases for mastication where the condylar component was rotated anteriorly by 0 deg, 5 deg, 10 deg, and 15 deg. Three clinically significant screw configurations were investigated: a complete, posterior, and minimal-posterior screw (MPS) configuration. Increases in condylar anterior rotation led to an increase in prosthetic condylar component contact stresses and substantial increases in condylar component screw stresses. The use of more screws in condylar fixation reduced screw stress magnitudes and maximum condylar component stresses. Screws placed superiorly experienced higher stresses than those of all other condylar fixation screws. The results of the present study have important implication for the way in which prosthetic components are placed during TMJ prosthetic TJR surgery.
Design of a Dedicated Five Degree-of-Freedom Magnetic Resonance Imaging Compatible Robot for Image Guided Prostate Biopsy
Authors: Chen Longquan , Paetz Torben , Dicken Volker , Krass Scheherazade , Issawi Jumana Al , Ojdanić Darko , Krass Stefan , Tigelaar Gerrit , Sabisch Jan , Poelgeest Auguste van , Schaechtele Jonathan
Published: January 2015

In order to improve the current clinical application of magnetic resonance (MR)-guided prostate biopsies, a new, fully magnetic resonance imaging (MRI)-compatible solution has been developed. This solution consists of a five degree-of-freedom (5DOF) pneumatic robot, a programmable logic controller (PLC), and a software application for visualization and robot control. The robot can be freely positioned on the MR table. For the calibration of the robot and MR coordinate system, the robot’s needle guide (NG) is used. The software application supports the calibration with image segmentation and graphic overlays and guides the user through the interventional planning process. After selecting a target point, the application calculates the needed movements via solving the kinematics of the robot and translating the adjustment into commands for the PLC driving the step motors of the robot. In case further adjustments are required, the software also allows for manual control of the robot, to position the NG according to the acquired MR images.
Wheelchair Models With Integrated Transfer Support Mechanisms and Passive Actuation
Authors: D’Angelo Lorenzo T. , Abdul-Sater Kassim , Pfluegl Florian , Lueth Tim C.
Published: January 2015

The concept presented in this paper describes two new approaches to integrate transfer support functions into wheelchairs. The goal is to relieve caregivers and nurses in their daily task of lifting patients from and to the wheelchair without the need of an additional external lift device, such as commonly used lifting cranes or lifting belts. The contributions of this paper are (i) the design of two different mechanical linkages, which realize two types of transfer motions, (ii) the selection of a passive actuator for weight compensation and simulation of the force induced by it (static design), as well as (iii) the experimental evaluation of the simulation using rapid prototyping functional models of the concepts. The results are two different design concepts, each of which can realize a particular, smooth transfer motion.
A mitral annulus tracking approach for navigation of off‐pump beating heart mitral valve repair
Authors: Li Feng P. , Rajchl Martin , Moore John , Peters Terry M.
Published: January 2015

Purpose:

To develop and validate a real‐time mitral valve annulus (MVA) tracking approach based on biplane transesophageal echocardiogram (TEE) data and magnetic tracking systems (MTS) to be used in minimally invasive off‐pump beating heart mitral valve repair (MVR).

Methods:

The authors’ guidance system consists of three major components: TEE, magnetic tracking system, and an image guidance software platform. TEE provides real‐time intraoperative images to show the cardiac motion and intracardiac surgical tools. The magnetic tracking system tracks the TEE probe and the surgical tools. The software platform integrates the TEE image planes and the virtual model of the tools and the MVA model on the screen. The authors’ MVA tracking approach, which aims to update the MVA model in near real‐time, comprises of three steps: image based gating, predictive reinitialization, and registration based MVA tracking. The image based gating step uses a small patch centered at each MVA point in the TEE images to identify images at optimal cardiac phases for updating the position of the MVA. The predictive reinitialization step uses the position and orientation of the TEE probe provided by the magnetic tracking system to predict the position of the MVA points in the TEE images and uses them for the initialization of the registration component. The registration based MVA tracking step aims to locate the MVA points in the images selected by the image based gating component by performing image based registration.

Results:

The validation of the MVA tracking approach was performed in a phantom study and a retrospective study on porcine data. In the phantom study, controlled translations were applied to the phantom and the tracked MVA was compared to its “true” position estimated based on a magnetic sensor attached to the phantom. The MVA tracking accuracy was 1.29 ± 0.58 mm when the translation distance is about 1 cm, and increased to 2.85 ± 1.19 mm when the translation distance is about 3 cm. In the study on porcine data, the authors compared the tracked MVA to a manually segmented MVA. The overall accuracy is 2.37 ± 1.67 mm for single plane images and 2.35 ± 1.55 mm for biplane images. The interoperator variation in manual segmentation was 2.32 ± 1.24 mm for single plane images and 1.73 ± 1.18 mm for biplane images. The computational efficiency of the algorithm on a desktop computer with an Intel® Xeon® CPU @3.47 GHz and an NVIDIA GeForce 690 graphic card is such that the time required for registering four MVA points was about 60 ms.

Conclusions:

The authors developed a rapid MVA tracking algorithm for use in the guidance of off‐pump beating heart transapical mitral valve repair. This approach uses 2D biplane TEE images and was tested on a dynamic heart phantom and interventional porcine image data. Results regarding the accuracy and efficiency of the authors’ MVA tracking algorithm are promising, and fulfill the requirements for surgical navigation.
Low Physical Activity Levels and Associated Factors in Brazilian Adolescents From Public High Schools
Authors: dos Santos Silva Roberto Jerônimo , Santos Silva Diego Augusto , Oliveira Antônio C.
Published: January 2015

Background:

Several studies have shown that physical activity levels have declined in many countries, even with the regular practice of physical education in schools. The purpose of this study was to identify the prevalence of low physical activity levels and associated factors in adolescents enrolled in public high schools in Northeastern Brazil.

Methods:

The sample was composed of 2259 adolescents (62.3% female) aged 16.26 ± 1.1 years. A questionnaire was applied to collect data on physical activity levels, sociodemographic information, tobacco use and alcohol consumption, nutritional status and sedentary behavior. Descriptive statistics and Poisson regression hierarchized model with Prevalence Rate (PR) and P ≤ .05 were used.

Results:

Higher prevalence of low physical activity level (89.1%) was observed. It was observed that 19.6% of individuals did not attend physical education classes regularly. Association was identified between low physical activity level and older girls (P = .02) and not attending physical education classes (P < .01). In males, the group most likely to have that low physical activity level was those whose parents studied until three years (P = .04).

Conclusions:

Low physical activity level was present in most adolescents, more evident in girls. Lifestyle changes are needed, with substitution of sedentary activities for physical and sport activities in schools.
Physical Activity Matters: Associations Among Body Mass Index, Physical Activity, and Health-Related Quality of Life Trajectories Over 10 Years
Authors: Feeny David , Garner Rochelle , Bernier Julie , Thompson Amanda , McFarland Bentson H. , Huguet Nathalie , Kaplan Mark S. , Ross Nancy A. , Blanchard Chris M.
Published: January 2015

Background:

The objective of this study was to assess the associations among body mass index (BMI), leisure time physical activity (LTPA) and health-related quality of life (HRQL) trajectories among adults.

Methods:

Self-reported data were drawn from the Canadian National Population Health Survey, with respondents being interviewed every 2 years between 1996–97 and 2006–07. Using growth curve modeling, HRQL trajectories for individuals aged 18 and over were associated with measures of BMI and LTPA. Growth models were constructed separately for males and females.

Results:

Findings suggested that, for males, BMI categories had little impact on baseline HRQL, and no impact on the rate of change in HRQL. Among women, higher BMI categories were associated with significantly lower baseline HRQL. However, BMI had no impact on the rate of change of HRQL. Conversely, for both men and women and regardless of BMI category, LTPA had significant impacts on baseline HRQL, as well as the rate of change in HRQL. Individuals who were inactive or sedentary had much steeper declines in HRQL as they aged, as compared with individuals who were active in their leisure time.

Conclusions:

The results underscore the importance of LTPA in shaping trajectories of HRQL.