bluuebunny/crossref_metadata_2025 huggingface dataset:
The Development of a Neuropathic Ankle following Successful Correction of Non-Plantigrade Charcot Foot Deformity
Authors: Pinzur Michael S.
Published: September 2012

Background: The treatment of Charcot foot arthropathy has traditionally involved immobilization during the acute phase followed by longitudinal management with accommodative bracing. In response to the perceived poor outcomes associated with nonoperative accommodative treatment, many experts now advise surgical correction of the deformity, especially when the affected foot is not clinically plantigrade. The significant rate of surgical and medical-associated morbidity accompanying this form of treatment has led surgeons to look for improved methods of surgical stabilization, including the use of the circular ring external fixation.

Methods: Over a 7-year period, a single surgeon performed surgical correction of non-plantigrade Charcot foot deformity on 171 feet in 164 patients with a statically applied circular external fixator. Following successful correction, five patients developed a neuropathic deformity of the ipsilateral ankle after removal of the external fixator and subsequent weight bearing total contact cast.

Results: Three of the five patients progressed to successful healing of the neuropathic (Charcot) ankle arthropathy following treatment with a series of weightbearing total contact casts. Two underwent successful ankle fusion with retrograde locked intramedullary nailing.

Discussion: This unusual clinical scenario likely represents either a progression of the disease process in the foot or a complication associated with surgical correction of the original neuropathic foot deformity. A better understanding of this observation will likely become apparent as we acquire more experience with this disorder.

Level of Evidence: IV, Retrospective Case Series
Use of a Geometric Formula to Improve the Radiographic Correction Achieved by the Scarf Osteotomy
Authors: O'Briain David E. , Flavin Robert , Kearns Stephen R.
Published: September 2012

Background: Many procedures for hallux valgus treatment have high recurrence rates, often related to operative considerations such as accuracy of deformity correction, soft tissue balancing and sesamoid alignment. Inadequate distal metatarsal-articular angle (DMAA) correction is common with uni- and bi-planar osteotomies which principally address the inter-metatarsal angle (IMA). The scarf osteotomy is a tri-planar osteotomy which corrects the DMAA and IMA, thereby achieving a more anatomical correction and potentially reducing the recurrence rate. Our hypothesis was that by controlling the length and relative proximal and distal translations of the scarf with a geometric formula, more accurate correction of the IMA and DMAA is possible. Methods: A formula was generated to determine the specific adjustments required to correct the deformity. A prospective trial was performed to assess the accuracy of this formula. Thirty-four adult patients were enrolled in the study. Seventeen patients underwent a standard scarf procedure; 17 were operated on using the corrections prescribed by the formula. Results: Hallux valgus angle (HVA), IMA and DMAA corrections improved with the formula ( p = 0.036, p = 0.049, and p = 0.006, respectively). Patient and procedure selection has changed in our unit as a result of this study, which identified some preoperative deformities as beyond the capabilities of the scarf procedure. Conclusion: The formula allows precise, reproducible, anatomical correction of IMA and DMAA deformities. The degree of correction attainable with the scarf is dependent on the first metatarsal width and the preoperative deformities. The formula highlighted the limitations of the scarf, thereby aiding in appropriate patient and procedure selection.

Level of Evidence: II, Prospective Comparative Series
Medial Distal Tibial Angle: Comparison between Weightbearing Mortise View and Hindfoot Alignment View
Authors: Barg Alexej , Harris Michael D. , Henninger Heath B. , Amendola Richard L. , Saltzman Charles L , Hintermann Beat , Anderson Andrew E
Published: September 2012

Background: The medial distal tibial angle (MDTA) is used to determine ankle alignment. The mortise view is the standard to measure MDTA, but the hindfoot alignment view (HAV) has become popular. The MDTA may vary between views, influencing the choice of surgery. Methods: The MDTA was compared between the mortise and HAV in 146 ankles. MDTA was correlated to age and sagittal tibial tilt for each view. Differences in MDTA by gender and ethnicity were assessed. Diagnostic agreement (varus, valgus, normal) between views was calculated. Clinical assessment of alignment was determined and percent agreement between clinical and radiographic alignment was quantified. Results: The MDTA measured from the mortise view and HAV radiographs was 89.0 (range, 81 to 96 degrees; SD = 2.8) degrees and 86.0 (range, 73 to 95 degrees; SD = 3.5) degrees, respectively. The MDTA was comparable for both genders for mortise ( p = 0.356) and HAV ( p = 0.621). The MDTA was comparable in all ethnic groups for mortise view ( p = 0.616) and HAV ( p = 0.916). Correlation between the measured MDTA and age was not statistically significant for both the mortise ( r = 0.118; p = 0.158) and HAV ( r = 0.148; p = 0.074). In only 47.3% of all ankles was the radiographic diagnosis of alignment the same between views. Agreement between clinical and radiographic classifications was 60.3% for the mortise view and 52.8% for the HAV. Conclusion: Substantial disagreement in primary alignment was found between the mortise and HAV as quantified by the MDTA. Agreement between clinical and radiographic alignment was also poor. Clinical Relevance: Advanced imaging such as CT or MRI may better describe ankle alignment.
Arthroscopic Treatment of Osteochondral Lesions of the Tibial Plafond
Authors: Cuttica Daniel J. , Smith W. Bret , Hyer Christopher F. , Philbin Terrence M. , Berlet Gregory C.
Published: September 2012

Background: Osteochondral lesions of the distal tibial plafond (OLTPs) are an uncommon problem. The purpose of this study was to evaluate clinical outcomes following arthroscopic treatment of OLTPs. Methods: Retrospective chart review was performed on all patients treated arthroscopically for OLTPs. Treatment consisted of generalized synovectomy followed by curettage of the lesion and microfracture. If a cartilage cap was intact, antegrade drilling was performed. Cystic defects were treated with curettage of the cyst and filling of any defect with bone graft. Results: A total of 13 patients were included. Nine patients had isolated lesions, while four had lesions of the distal tibial plafond and talar dome. Average followup was 156 (range, 38 to 402 ± 117.9) weeks and average patient age was 32.9 (range, 14 to 50 ± 11.8) years. Eleven of 13 patients were available for followup modified AOFAS score. The average preoperative score was 35.2 (range, 24 to 49 ± 7.1). The average postoperative modified AOFAS score was 50.4 (range, 33 to 56 ± 7.6). There were four patients (30.8%) with a poor outcome. Conclusion: OLTPs can be challenging to treat. Arthroscopic treatment can lead to improved outcomes. However, the higher incidence of poor outcomes in our series may indicate less predictability in the treatment of OLTPs and that outcomes may not be equivalent to previous reported studies on OLTPs or osteochondral lesions of the talus.

Level of Evidence: IV, Retrospective Case Series
Mechanical Stability of a Locked Step-Plate versus Single Compression Screw Fixation for Medial Displacement Calcaneal Osteotomy
Authors: Konan Sujith , Meswania Jay , Blunn Gordon W. , Madhav Rohit T. , Oddy Michael J.
Published: September 2012

Background: Reconstruction of a flatfoot commonly involves a calcaneal Medial Displacement Osteotomy (MDO) to correct hindfoot valgus in combination with soft tissue procedures. We compared fixation of an MDO using either a single, large cannulated screw versus a locking step-plate in load to failure in a cadaveric model. Methods: Eight matched pairs of cadaveric limbs were loaded using a mechanical testing rig. Two pairs served as non-operated controls. The remaining paired limbs underwent a 10-mm MDO stabilized either with a single 7-mm screw or a step-plate with four locking screws. One pair was used as a pilot study and the remaining five pairs were loaded up to 4500 N to failure. Results: In the five pairs loaded to failure, the median (with 95% CI) maximum force were 1779 N (1099-2312) and 826 N (288-1607) for the plate and screw, respectively ( p = 0.043). With single screw fixation, the tuberosity fragment consistently failed by rotation and angulation into varus. With plate fixation, failure occurred as the screws cut through the internal surfaces of the tuberosity and body with no failure at the screw-plate interface. Conclusion: In this cadaveric model, a locked step-plate supported a significantly higher maximum force than a single large cannulated screw. Clinical Relevance: The magnitude of the load supported by the locking step-plate suggests that allowing early weightbearing post-operation may be safe in clinical practice before union of the osteotomy.
Simian Foot at Skeletal Maturity: Long-Term Case Report Followup
Authors: Groarke Patrick J. , Thomason Katharine , Stephens Michael M.
Published: September 2012

Level of Evidence: V, Expert Opinion
Quality assessment of the essential oils from Nardostachys jatamansi (d. Don) dc and Nardostachys chinensis batal obtained from Kathmandu valley market
Authors: Paudyal Mahesh P , Rajbhandari Meena , Basnet Purushottam , Yahara Shoji , Gewali Mohan B
Published: September 2012

The chemical composition and physicochemical parameters of the essential oils obtained from two species of Nardostachys available in Kathmandu market, N. jatamansi (D. Don) and N. chinensis Batal were determined. GC-MS technique was used for the analysis of the oils. Both oils were characterized by high content of sesquiterpenes. â-gurjunene and jatamansone were the major sesquiterpene components of both oils. Somewhat variation in the amount of chemical components was found in two different species. The physical and chemical parameters such as specific gravity, specific rotation, refractive index and saponification value, acid number, iodine number were very similar for both species. Both oils were, therefore, of comparable quality. Scientific World, Vol. 10, No. 10, July 2012 p13-16 DOI: http://dx.doi.org/10.3126/sw.v10i10.6854
Determination of the average molecular weight of sodium polystyrenesulphonate from viscosity measurement
Authors: Bhattarai Ajaya
Published: September 2012

Precise measurements on the viscosity of aqueous solutions of sodium polystyrenesulphonate and in presence 0.1 N sodium chloride at 308.15 K were reported. The degree of substitution of sodium polystyrenesulphonate used was one. The sodium polystyrenesulphonate (NaPSS) used in these investigations was purchased from Aldrich Chemical Company, Inc. whose  viscosity average molecular weight  was 70,000.  The experimental viscosity average molecular weight of polystyrenesulphonate was found 70,186.15. Scientific World, Vol. 10, No. 10, July 2012 p17-19 DOI: http://dx.doi.org/10.3126/sw.v10i10.6855
Late stages in the biosynthesis of ipecac alkaloids - cephaeline, emetine and psychotrine in Alangium lamarckii Thw. (Alangiaceae)
Authors: Jain Sudha , Chaudhary Paras Nath , Gawade Vishal B
Published: September 2012

The bioconversion of tyrosine, dopamine, N- desacetylisoipecoside (15) and N- desacetylipecoside (16) into cephaeline (2), emetine (1), and psychotrine (3) into Alangium lamarckii Thw. (Alangiaceae) plant has been studied. Stereospecific incorporation of N- desacetylisoipecoside (15) into 1,2 and 3 has been demonstrated. Further it has been shown that reduction of C1’ – C2’ takes place after O-methylation of psychotrine (3). Feeding results further showed that cephaeline was poorly metabolized in the plants to form psychotrine (3) thus demonstrating that dehydrogenation of C1’ – C2’ does not take place. The efficient incorporation of cephaeline into emetine (1) further showed that O- methylation is the terminal step in the biosynthesis of emetine. Emetine (1) was poorly metabolized by the plants to form cephaeline (2) and psychotrine (3). The experiments thus demonstrated that dehydrogenation and O-demethylation of emetine (1) does not occur to give cephaeline (2) and psychotrine (3). Scientific World, Vol. 10, No. 10, July 2012 p24-28 DOI: http://dx.doi.org/10.3126/sw.v10i10.6857
The passivation behavior of sputter-deposited W-xMo alloys on 0.5M NaCl solution
Authors: Bhattarai Jagadeesh
Published: September 2012

The passivation behavior of the sputter-deposited W-xMo alloys was studied in 0.5 M NaCl solution open to air at 25°C using immersion tests and electrochemical measurements. Corrosion rates of the W-xMo alloys containing less than 50 at% molybdenum content are in the range of 1.7-2.0 x10-2 mm/y and are slightly lower than that of tungsten metal whereas the corrosion rates of the alloys containing more than 50 at% molybdenum increased with the addition of molybdenum in the alloys. The W-83Mo alloy showed active-passive transition and transpassive dissolution. The open circuit potential of all the examined W-xMo alloys is shifted to noble direction with the addition of molybdenum content in the alloys. Scientific World, Vol. 10, No. 10, July 2012 p29-32 DOI: http://dx.doi.org/10.3126/sw.v10i10.6858
Histopathological based retrospective study of oral keratotic white lesions in Manipal health systems-hospital
Authors: Gurung P , Sherchan JB , Pai K
Published: September 2012

Oral keratotic white lesions are a common problem that is encountered on routine clinical examination. Clinical appearance of the lesion may belie the true nature of the lesion. So a biopsy followed by histopathological diagnosis is the gold standard in evaluating these lesions for malignant potential or dysplasias. Objective: The aim of the present study is to evaluate the clinicopathologic findings of oral keratotic lesions. Materials and Methods: Oral biopsies of 61 cases of oral keratotic white lesions during the period from January 2006 to July 2009 were studied retrospectively at the Department of Pathology, Kasturba Medical College, Manipal by microscopy. Clinical details and records were obtained from the medical records department. Results: In 61 cases of oral keratotic white lesions the age distribution ranged from 29 to 86 years. 66% were males while 34% were females and most lesions occurred between 31 and 70 years. The buccal mucosa was the most common site of lesion in 35% patients. Only 15 cases had some personal habits and 8/15 cases (53%) showed dysplasia. 12/ 54 cases (22%) of homogenous leukoplakia displayed dysplasia, of which 11 cases (92%) showed mild dysplasia and 1 case (8%) showed moderate dysplasia. Of the 4 cases of speckled leukoplakia, 75% showed dysplasia- mild, moderate and severe. 2/3 cases (66%) of verrucous leukoplakia displayed dysplasia- moderate and severe. There were 41 cases consistent with leukoplakia (67%), of which 22% showed epithelial hyperplasia and hyperkeratosis, 12 cases showed mild dysplasia, 3 cases moderate dysplasia and 2 cases showed severe dysplasia. Benign keratosis formed the largest group (35%) among the 61 cases. Of the 61 cases 17 (27%) showed dysplasia of which 19% was mild dysplasia, 5% was moderate dysplasia and 3% was severe dysplasia. Most frequent histomorphological feature seen in this study was nuclear pleomorphism in 21/ 27 cases (78%). There were 12 cases (71%) of dysplasia in males and 5 cases (28%) of dysplasia in females. There was 1 case of Progressive verrucous leukoplakia   in an 86 year old female patient. There were 3 cases (5%) each of oral lichen planus, lichenoid dysplasia and lichenoid keratosis in the present study. 6 cases (9%) of candidiasis was seen among the 61 biopsies. In the study there was 1 case (2%) each of verrucous  carcinoma, squamous cell carcinoma and micro-invasive squamous cell carcinoma. Conclusions: Oral keratotic white lesions demonstrate a wide spectrum of histopathological features from benign lesions to dysplastic lesions to carcinoma in situ to invasive ones. Scientific World, Vol. 10, No. 10, July 2012 p70-76 DOI: http://dx.doi.org/10.3126/sw.v10i10.6866
Heavy metals in bulk and particle size fractions from street dust of Kathmandu city as the possible basis for risk assessment
Authors: Karmacharya Neena , Shakya Pawan Raj
Published: September 2012

Street dust has been sampled from eight major locations of Kathmandu city. The samples were separated into three particle size fractions (<425, 425-600 and >600 ?m) and analyzed for Pb, Cu, Zn and Fe using Atomic Absorption Spectrophotometric method. Results revealed that the bulk samples as well as all particle size fractions under investigation were found to have the metal abundance order as Fe > Zn > Cu > Pb. However, the trace metal concentrations increased with the decrease of dust particle size in all samples. About 35-68% of heavy metals were associated with the small particle size fraction (<425 ?m) and this particle size accounted for 64-81% of the total mass of street dust from all locations. The smaller particle size fraction has a higher heavy metal content, low density, high mobility in runoff, and thus is a higher risk for the residents of Kathmandu city. From the present study, we conclude that a monitoring plan and a suitable risk assessment are necessary to evaluate the evolution of metal concentration in dust in order to develop the proper measures for reducing the risk of inhalation and ingestion of dust for humans and environment. Scientific World, Vol. 10, No. 10, July 2012 p84-88 DOI: http://dx.doi.org/10.3126/sw.v10i10.6869
Ultrasound-assisted convection-enhanced delivery to the brain in vivo with a novel transducer cannula assembly
Authors: Lewis George K. , Schulz Zachary R. , Pannullo Susan C. , Southard Teresa L. , Olbricht William L.
Published: September 2012

Object

In convection-enhanced delivery (CED), drugs are infused locally into tissue through a cannula inserted into the brain parenchyma to enhance drug penetration over diffusion strategies. The purpose of this study was to demonstrate the feasibility of ultrasound-assisted CED (UCED) in the rodent brain in vivo using a novel, low-profile transducer cannula assembly (TCA) and portable, pocket-sized ultrasound system.

Methods

Forty Sprague-Dawley rats (350–450 g) were divided into 2 equal groups (Groups 1 and 2). Each group was divided again into 4 subgroups (n = 5 in each). The caudate of each rodent brain was infused with 0.25 wt% Evans blue dye (EBD) in phosphate-buffered saline at 2 different infusion rates of 0.25 μl/minute (Group 1), and 0.5 μl/minute (Group 2). The infusion rates were increased slowly over 10 minutes from 0.05 to 0.25 μl/minute (Group 1) and from 0.1 to 0.5 μl/minute (Group 2). The final flow rate was maintained for 20 minutes. Rodents in the 4 control subgroups were infused using the TCA without ultrasound and without and with microbubbles added to the infusate (CED and CED + MB, respectively). Rodents in the 4 UCED subgroups were infused without and with microbubbles added to the infusate (UCED and UCED + MB) using the TCA with continuous-wave 1.34-MHz low-intensity ultrasound at a total acoustic power of 0.11 ± 0.005 W and peak spatial intensity at the cannula tip of 49.7 mW/cm2. An additional 4 Sprague-Dawley rats (350–450 g) received UCED at 4 different and higher ultrasound intensities at the cannula tip ranging from 62.0 to 155.0 mW/cm2 for 30 minutes. The 3D infusion distribution was reconstructed using MATLAB analysis. Tissue damage and morphological changes to the brain were assessed using H & E.

Results

The application of ultrasound during infusion (UCED and UCED + MB) improved the volumetric distribution of EBD in the brain by a factor of 2.24 to 3.25 when there were no microbubbles in the infusate and by a factor of 1.16 to 1.70 when microbubbles were added to the infusate (p < 0.001). On gross and histological examination, no damage to the brain tissue was found for any acoustic exposure applied to the brain.

Conclusions

The TCA and ultrasound device show promise to improve the distribution of infused compounds during CED. The results suggest further studies are required to optimize infusion and acoustic parameters for small compounds and for larger molecular weight compounds that are representative of promising antitumor agents. In addition, safe levels of ultrasound exposure in chronic experiments must be determined for practical clinical evaluation of UCED. Extension of these experiments to larger animal models is warranted to demonstrate efficacy of this technique.
Subcortical surgical anatomy of the lateral frontal region: human white matter dissection and correlations with functional insights provided by intraoperative direct brain stimulation
Authors: De Benedictis Alessandro , Sarubbo Silvio , Duffau Hugues
Published: September 2012

Object

Recent neuroimaging and surgical results support the crucial role of white matter in mediating motor and higher-level processing within the frontal lobe, while suggesting the limited compensatory capacity after damage to subcortical structures. Consequently, an accurate knowledge of the anatomofunctional organization of the pathways running within this region is mandatory for planning safe and effective surgical approaches to different diseases. The aim of this dissection study was to improve the neurosurgeon's awareness of the subcortical anatomofunctional architecture for a lateral approach to the frontal region, to optimize both resection and postoperative outcome.

Methods

Ten human hemispheres (5 left, 5 right) were dissected according to the Klingler technique. Proceeding lateromedially, the main association and projection tracts as well as the deeper basal structures were identified. The authors describe the anatomy and the relationships among the exposed structures in both a systematic and topographical surgical perspective. Structural results were also correlated to the functional responses obtained during resections of infiltrative frontal tumors guided by direct cortico-subcortical electrostimulation with patients in the awake condition.

Results

The eloquent boundaries crucial for a safe frontal lobectomy or an extensive lesionectomy are as follows: 1) the motor cortex; 2) the pyramidal tract and premotor fibers in the posterior and posteromedial part of the surgical field; 3) the inferior frontooccipital fascicle and the superior longitudinal fascicle posterolaterally; and 4) underneath the inferior frontal gyrus, the head of the caudate nucleus, and the tip of the frontal horn of the lateral ventricle in the depth.

Conclusions

Optimization of results following brain surgery, especially within the frontal lobe, requires a perfect knowledge of functional anatomy, not only at the cortical level but also with regard to subcortical white matter connectivity.
Shunting with gravitational valves—can adjustments end the era of revisions for overdrainage-related events?
Authors: Freimann Florian Baptist , Sprung Christian
Published: September 2012

Object

Overdrainage of CSF remains an unsolved problem in shunt therapy. The aim of the present study was to evaluate treatment options on overdrainage-related events enabled by the new generation of adjustable gravity-assisted valves.

Methods

The authors retrospectively studied the clinical course of 250 consecutive adult patients with various etiologies of hydrocephalus after shunt insertion for different signs and symptoms of overdrainage. Primary and secondary overdrainage were differentiated. The authors correlated the incidence of overdrainage with etiology of hydrocephalus, opening valve pressure, and patient parameters such as weight and size. Depending on the severity of overdrainage, they elevated the opening pressure, and follow-up was performed until overdrainage was resolved.

Results

The authors found 39 cases (15.6%) involving overdrainage-related problems—23 primary and 16 secondary overdrainage. The median follow-up period in these 39 patients was 2.1 years. There was no correlation between the incidence of overdrainage and any of the following factors: sex, age, size, or weight of the patients. There was also no statistical significance among the different etiologies of hydrocephalus, with the exception of congenital hydrocephalus. All of the “complications” could be resolved by readjusting the opening pressure of the valve in one or multiple steps, avoiding further operations.

Conclusions

Modern adjustable and gravity-assisted valves enable surgeons to set the opening pressure relatively low to avoid underdrainage without significantly raising the incidence of overdrainage and to treat overdrainage-related clinical and radiological complications without surgical intervention.
Raymond de Vieussens and his contribution to the study of white matter anatomy
Authors: Vergani Francesco , Morris Christopher M. , Mitchell Patrick , Duffau Hugues
Published: September 2012

In recent years, there has been a renewed interest in the study of white matter anatomy, both with the use of postmortem dissections and diffusion tensor imaging tractography. One of the precursors in the study of white matter anatomy was Raymond de Vieussens (1641–1716), a French anatomist born in Le Vigan. He studied medicine at the University of Montpellier in southern France, one of the most ancient and lively schools of medicine in Europe. In 1684 Vieussens published his masterpiece, the Neurographia Universalis, which is still considered one of the most complete and accurate descriptions of the nervous system provided in the 17th century. He described the white matter of the centrum ovale and was the first to demonstrate the continuity of the white matter fibers from the centrum ovale to the brainstem. He also described the dentate nuclei, the pyramids, and the olivary nuclei. According to the theory of Galen, Vieussens considered that the function of the white matter was to convey the “animal spirit” from the centrum ovale to the spinal cord. Although neglected, Vieussens' contribution to the study of white matter is relevant. His pioneering work showed that the white matter is not a homogeneous substance, but rather a complex structure rich in fibers that are interconnected with different parts of the brain. These initial results paved the way to advancements observed in later centuries that eventually led to modern hodology.
Minimally invasive resection of lumbar synovial cysts from a contralateral approach
Authors: Rhee Jay , Anaizi Amjad Nasr , Sandhu Faheem A. , Voyadzis Jean-Marc
Published: September 2012

Synovial cysts of the lumbar spine result from degeneration of the facet capsule and often mimic symptoms commonly seen with herniated intervertebral discs. In symptomatic patients, the prevalence of synovial cysts may be as high as 10%. Although conservative management is possible, the majority of patients will require resection. Traditional procedures for lumbar synovial cyst resection use an ipsilateral approach requiring partial or complete resection of the ipsilateral facet complex, possibly leading to further destabilization. A contralateral technique using minimally invasive tubular retractors for synovial cyst resection avoids facet disruption. The authors report 2 cases of a minimally invasive synovial cyst resection via a contralateral laminotomy. In both cases, complete resection of the cyst was achieved while sparing the facet joint.
Genetic Diversity Characterization of Porcine Reproductive and Respiratory Syndrome Virus Isolates in Romania, Based on Phylogenetic Analysis
Authors: Zaulet Mihaela , Gurau Maria Rodica , Petrovan Vlad , Buburuzan Laura
Published: September 2012

Porcine reproductive and respiratory syndrome (PRRS) is a disease produced by the (PRRS) virus, characterized by endemic evolution in the majority of countries, which remains in actuality being a permanent threat to health and economic free farms, as well as for those infected. The aim of this study was to evaluate the genetic diversity of Romanian PRRSV isolates from the four most important pig farms in Romania by comparing the nucleotide sequences obtained for ORF5 and ORF7 with a wide range of sequences from GenBank belonging to the main types of PRRSV; the type 1. Eighteen different sequences were obtained for ORF5 gene and 10 for ORF7 gene. One Romanian isolate (Rom3) was found in three of the four different investigated farms. The phylogenetic analysis revealed that the Romanian PRRSV nucleotide sequences clustered in three groups within the subtype 1 of the virus. The analysis of amino acid sequences evidenced for GP5 and N-nucleocapsid proteins confirmed that the Romanian virus belonged to type 1.
Association of KIF6 Variant with Lipid Level and Angiographic Coronary Artery Disease Events Risk in the Han Chinese Population
Authors: Wu Ge , Li Gui-Bin , Dai Bin
Published: September 2012

KIF6 is a class of molecular motor from the kinesin superfamily. Recently, multiple large studies consisting mainly of Europeans have shown that KIF6 Trp719Arg SNP may be a new predictive factor for coronary artery disease (CAD) event risk. The allelic frequency distribution of rs20455 is different in various populations, yet studies among the Han population, one of the largest ethnic groups in the World, have not been conducted. This study is aimed to evaluate the association of KIF6 Trp719Arg variant with angiographic CAD and serum lipid levels in the Han population from northern China. In this case-controlled study, peripheral blood samples were collected from 356 patients and 568 controls of Han Chinese origin. Genotyping was performed by a high-resolution melting curve. The impact of rs20455 on CAD and non-fatal MI was evaluated in a dominant genetic model with stepwise multiple regression analysis. There were no significant differences of genotypes and allele frequency between angiographic CAD and control groups (p > 0.05); however, that of MI and non-MI subgroups were significant differences (p < 0.05). After adjusting for significant risk factors, angiographic CAD risk was not significantly increased in 719Arg allele carriers compared with non-carriers. Further analysis revealed that the non-fatal MI risk and triglyceride levels were significantly higher in 719Arg allele carriers than non-carriers. In conclusion, KIF6 719Arg allele was not an independent risk factor for angiographic CAD susceptibility in Han populations from northern China. However, it was associated with a significantly higher TG level, which may indicate an increased myocardial infarction risk in angiographic CAD patients.
Modelling Forest α-Diversity and Floristic Composition — On the Added Value of LiDAR plus Hyperspectral Remote Sensing
Authors: Leutner Benjamin F. , Reineking Björn , Müller Jörg , Bachmann Martin , Beierkuhnlein Carl , Dech Stefan , Wegmann Martin
Published: September 2012

The decline of biodiversity is one of the major current global issues. Still, there is a widespread lack of information about the spatial distribution of individual species and biodiversity as a whole. Remote sensing techniques are increasingly used for biodiversity monitoring and especially the combination of LiDAR and hyperspectral data is expected to deliver valuable information. In this study spatial patterns of vascular plant community composition and α-diversity of a temperate montane forest in Germany were analysed for different forest strata. The predictive power of LiDAR (LiD) and hyperspectral (MNF) datasets alone and combined (MNF+LiD) was compared using random forest regression in a ten-fold cross-validation scheme that included feature selection and model tuning. The final models were used for spatial predictions. Species richness could be predicted with varying accuracy (R2 = 0.26 to 0.55) depending on the forest layer. In contrast, community composition of the different layers, obtained by multivariate ordination, could in part be modelled with high accuracies for the first ordination axis (R2 = 0.39 to 0.78), but poor accuracies for the second axis (R2 ≤ 0.3). LiDAR variables were the best predictors for total species richness across all forest layers (R2 LiD = 0.3, R2 MNF = 0.08, R2 MNF+LiD = 0.2), while for community composition across all forest layers both hyperspectral and LiDAR predictors achieved similar performances (R2 LiD = 0.75, R2 MNF = 0.76, R2 MNF+LiD = 0.78). The improvement in R2 was small (≤0.07)—if any—when using both LiDAR and hyperspectral data as compared to using only the best single predictor set. This study shows the high potential of LiDAR and hyperspectral data for plant biodiversity modelling, but also calls for a critical evaluation of the added value of combining both with respect to acquisition costs.
A Real-Time Cardiac Arrhythmia Classification System with Wearable Sensor Networks
Authors: Hu Sheng , Wei Hongxing , Chen Youdong , Tan Jindong
Published: September 2012

Long term continuous monitoring of electrocardiogram (ECG) in a free living environment provides valuable information for prevention on the heart attack and other high risk diseases. This paper presents the design of a real-time wearable ECG monitoring system with associated cardiac arrhythmia classification algorithms. One of the striking advantages is that ECG analog front-end and on-node digital processing are designed to remove most of the noise and bias. In addition, the wearable sensor node is able to monitor the patient’s ECG and motion signal in an unobstructive way. To realize the real-time medical analysis, the ECG is digitalized and transmitted to a smart phone via Bluetooth. On the smart phone, the ECG waveform is visualized and a novel layered hidden Markov model is seamlessly integrated to classify multiple cardiac arrhythmias in real time. Experimental results demonstrate that the clean and reliable ECG waveform can be captured in multiple stressed conditions and the real-time classification on cardiac arrhythmia is competent to other workbenches.
Potential Vaccines and Post-Exposure Treatments for Filovirus Infections
Authors: Friedrich Brian M. , Trefry John C. , Biggins Julia E. , Hensley Lisa E. , Honko Anna N. , Smith Darci R. , Olinger Gene G.
Published: September 2012

Viruses of the family Filoviridae represent significant health risks as emerging infectious diseases as well as potentially engineered biothreats. While many research efforts have been published offering possibilities toward the mitigation of filoviral infection, there remain no sanctioned therapeutic or vaccine strategies. Current progress in the development of filovirus therapeutics and vaccines is outlined herein with respect to their current level of testing, evaluation, and proximity toward human implementation, specifically with regard to human clinical trials, nonhuman primate studies, small animal studies, and in vitro development. Contemporary methods of supportive care and previous treatment approaches for human patients are also discussed.
Clinical Management of Filovirus-Infected Patients
Authors: Clark Danielle V. , Jahrling Peter B. , Lawler James V.
Published: September 2012

Filovirus infection presents many unique challenges to patient management. Currently no approved treatments are available, and the recommendations for supportive care are not evidence based. The austere clinical settings in which patients often present and the sporadic and at times explosive nature of filovirus outbreaks have effectively limited the information available to evaluate potential management strategies. This review will summarize the management approaches used in filovirus outbreaks and provide recommendations for collecting the information necessary for evaluating and potentially improving patient outcomes in the future.
Persistence of Novel First-Line Antiretroviral Regimes in a Cohort of HIV-Positive Subjects, Coris 2008–2010
Authors: Jarrin Inma , Hernández-Novoa Beatriz , Alejos Belén , Riera Melchor , Navarro Gemma , Bernardino Jose Ignacio , Rivero Maria , del Amo Julia , Moreno Santiago ,   CoRIS
Published: September 2012

Background

The aim of this study was to estimate the persistence of the most commonly used first-line combined antiretroviral regimens (cART) in HIV-infected adults in the CoRIS cohort.

Methods

CoRIS is an open prospective multicentre cohort of HIV-infected adults naive to cART at entry. Patients enrolled between January 2008 and June 2010 were included. The main outcome was treatment persistence, defined as time from cART initiation to first treatment change (TC). Cox models taking into account competing risks to estimate sub-hazard ratios (sHR) were performed.

Results

Of 1,512 patients, 919 (60.8%) initiated cART with the backbone tenofovir disoproxil fumarate (TDF) plus emtricitabine (FTC) plus efavirenz (EFV), 252 (16.7%) plus lopinavir/ritonavir (LPV/r), 129 (8.5%) plus atazanavir/ritonavir (ATV/r), 110 (7.3%) plus darunavir/ritonavir (DRV/r) and 102 (6.7%) plus nevirapine (NVP). Among 414 patients who switched therapy, reason for switching was available for 393. The most frequent reasons were toxicity (40%), simplification (14%) and treatment failure/resistance (13%). In multivariate analyses, there were significant differences in the risk of TC according to initial cART regimen ( P<0.001). Initiating TDF plus FTC with NVP (sHR 1.94, 95% CI 1.38, 2.72) or LPV/r (sHR 1.89, 95% CI 1.45, 2.47) was associated with higher risk of TC than initiating with TDF plus FTC plus EFV. No differences in TC were found between initiating EFV versus ATV/r (sHR 1.29, 95% CI 0.89, 1.86) or DRV/r (sHR 0.98, 95% CI 0.59, 1.65) with TDF plus FTC as backbone.

Conclusions

Switching from initial cART regimens is frequent, toxicity being the main reason for it. The significantly greater persistence of some combinations may be useful for making decisions when initiating cART.
Plasma Microrna Profile as a Predictor of Early Virological Response to Interferon Treatment in Chronic Hepatitis B Patients
Authors: Zhang Xiaonan , Chen Cuncun , Wu Min , Chen Liang , Zhang Jiming , Zhang Xinxin , Zhang Zhanqin , Wu Jingdi , Wang Jiefei , Chen Xiaorong , Huang Tao , Chen Lixiang , Yuan Zhenghong
Published: September 2012

Background

Interferon (IFN) and pegylated interferon (PEG-IFN) treatment of chronic hepatitis B leads to a sustained virological response in a limited proportion of patients and has considerable side effects. To find novel markers associated with prognosis of IFN therapy, we investigated whether a pretreatment plasma microRNA profile could be used to predict early virological response to IFN.

Methods

We performed microRNA microarray analysis of plasma samples from 94 patients with chronic hepatitis B who received IFN therapy. The microRNA profiles from 13 liver biopsy samples were also measured. The OneR feature ranking and incremental feature selection method were used to rank and optimize the number of features in the model. Support vector machine prediction engine and jack-knife cross-validation were used to generate and evaluate the prediction model.

Results

The optimized model consisting of 11 microRNAs yielded a 74.2% overall accuracy in the training group and was independently confirmed in the test group (71.4% accuracy). Univariate and multivariate logistic regression analyses confirmed its independent association with early virological response (OR=7.35; P=2.12x10-5). Combining the microRNA profile with the alanine aminotransferase level improved the overall accuracy from 73.4% to 77.3%. Co-transfection of an HBV replicative construct with microRNA mimics revealed that let-7f, miR-939 and miR-638 were functionally associated with the HBV life cycle.

Conclusions

The 11 microRNA signatures in plasma, together with basic clinical variables, might provide an accurate method to assist in medication decisions and improve the overall sustained response to IFN treatment.
Les acteurs de la contrainte
Authors: Jabko Nicolas
Published: September 2012

Résumé Le discours politique tend à appréhender les contraintes économiques sur un mode incantatoire, comme résultant des « forces du marché » ou encore de la « spéculation ». Cet article s’attache à mieux identifier les agents économiques et les organisations qui imposent des contraintes aux États. Loin de comploter ou de spéculer activement contre ces derniers, la plupart de ces acteurs vivent en symbiose avec eux. Leurs logiques d’action sont différentes, selon leur statut privé ou public. Les acteurs privés s’attachent avant tout à poursuivre leurs intérêts économiques, tandis que les organisations publiques défendent les logiques institutionnelles qui les définissent.
La marge de manœuvre des États. Des démocraties sans souveraineté ?
Authors: Fitoussi Jean-Paul
Published: September 2012

Résumé Les gouvernements ont-ils encore des marges de manœuvre ? Cette question ne peut que comporter une réponse positive. Les gouvernements n’ont-ils pas sauvé les marchés financiers d’une faillite annoncée en 2008 ? C’est donc de l’Europe qu’il s’agit : les pays membres de la zone euro se retrouvent dans la situation d’États fédérés orphelins d’un État fédéral. Il en résulte un déficit de puissance, reflet du déficit démocratique de l’Europe : d’un côté, une légitimité sans instruments, celle des États « fédérés », de l’autre, des instruments dont l’usage est limité par des traités internationaux. C’est donc d’une politique de l’impuissance plutôt que d’une impuissance du politique qu’il s’agit.
The Making of an Education Day in a Canadian Health Care Facility
Authors: Thiele Tracy L. , Kebicz Rodney , Liarakos Monique
Published: September 2012

The benefits of an education day have been documented within a variety of disciplines; however, there is a paucity of up-to-date knowledge on the implementation and planning phases, and these phases are addressed in this article. Having knowledge of what form of delivery education can take can affect employer-provided education throughout health care. This article will benefit staff development educators by addressing issues in staff development and the role that an education day can have in health care facilities.
The Use of Socially Assistive Robots for Dementia Care
Authors: Huschilt Julie , Clune Laurie
Published: September 2012

Innovative solutions for dementia care are required to address the steady rise in adults living with dementia, lack of adequate staffing to provide high-quality dementia care, and the need for family caregivers to provide care for their loved ones in the home. This article provides an overview of the use of socially assistive robots (SARs) to offer support as therapists, companions, and educators for people living with dementia. Social, ethical, and legal challenges associated with the use of robotic technology in patient care and implications for the use of SARs by nurses are discussed. These items considered, the authors conclude that SARs should be considered as a viable way to assist people living with dementia to maintain their highest possible level of independence, enhance their quality of life, and provide support to overburdened family caregivers. Further research is needed to evaluate the merits of this technological approach in the care of adults with dementia.
Statin Drugs: Reducing Cardiovascular Risk in Older Adults
Authors: McLain Kellie , Edlund Barbara J.
Published: September 2012

Dyslipidemia is one of the most modifiable risk factors in preventing heart disease. Evidence demonstrates that the process of atherosclerosis, a result of dyslipidemia, begins in young adults. Initiating statin therapy has been shown to reduce the risk of cardiovascular events and mortality. Determining the right statin medication and dose for an older adult based on national guidelines can be challenging, as multiple factors must be considered in this decision. When initiating statin therapy, clinicians should determine the appropriate percentage of reduction in low-density lipoprotein cholesterol needed to achieve the target goal. Additionally, when changing from one cholesterol-lowering medication to another, knowledge of equivalent dosing is important. Generally, statin drugs are well tolerated with a good safety profile in older adults but are underused in this patient population. Issues such as existing comorbid conditions, polypharmacy with the potential for drug-drug interactions, impaired drug metabolism, and decreased functional status can contribute to adverse events and increase the frequency of myalgias and less frequently, hepatotoxicity. Clinicians prescribing statin therapy for older adults need to remain current on advances in research regarding potential interactions and contraindications within this drug class.
Adolescents, Gangs, and Perceptions of Safety, Parental Engagement, and Peer Pressure
Authors: Kelly Sarah E. , Anderson Debra G.
Published: September 2012

Adolescents are exposed to various forms of gang violence, and such exposure has led them to feel unsafe in their neighborhood and have differing interactions with their parents and peers. This qualitative study explored adolescents’, parents’, and community center employees’ perceptions of adolescents’ interaction with their neighborhood, family, and peers. Three themes emerged from the data: Most adolescents reported that the community center provided a safe environment for them; parental engagement influenced adolescents’ experiences with gangs; and adolescents were subjected to peer pressure in order to belong. Exposure to gang violence can leave an impression on adolescents and affect their mental health, but neighborhood safety and relationships with parents and peers can influence adolescents’ exposure to gang violence. Recommendations regarding the use of health care professionals at community centers are proposed.
Nursing Home Culture Change: What Does It Mean to Nurses?
Authors: Bellot Jennifer
Published: September 2012

The purpose of this study was to explore, from the perspectives of licensed nurses, the organizational culture, work environment, and factors influencing culture change in two nursing homes participating in the Wellspring Program. All licensed nurses ⩾0.25 full-time equivalent from two nursing homes were invited to complete the Organizational Culture Inventory and the Work Environment Scale. A subset of respondents was invited to participate in subsequent interviews. Data indicated unresolved conflict, low employee satisfaction, high work demands, and managerial control in the workplace. Qualitatively, three categories emerged: Confusion over culture change, role, and documentation; Conflict over the integration of traditional care with a resident-centered model; and Commitment to providing quality nursing care to the resident. To ensure the successful implementation of culture change, consideration must be given to clarity of communication, anticipation of role conflict, and building on the underlying strength of job commitment.
Caregiver-Resident Interaction with Barnard’s Feeding Scale
Authors: Beel-Bates Cynthia , Stephenson Paul L. , Nochera Carmen L. , French Rogers Joyce
Published: September 2012

This exploratory study was done first to determine the appropriateness of Barnard’s Feeding Scale (BFS) as a measure of dyadic interaction between caregivers and residents with dementia. Seventy-five of the 76 discrete BFS behaviors were observed during the feedings, thus indicating appropriateness of the BFS. Then, 228 dyadic feedings were observed and scored to achieve the second purpose: to numerically describe caregiver-resident interaction during mealtimes in two nursing homes. Results showed caregivers in both nursing homes demonstrated the highest interaction scores on BFS subscale Response to Distress and the lowest scores on two of the caregiver subscales, Sensitivity to Cues and Social-Emotional Responsiveness. Caregivers’ total mean scores correlated (
r
= 0.523) with those of residents. The third purpose of the study was accomplished using quantitative data to begin exploring the potential influence of participant and other factors during feeding. Clinically, the specific behavioral items of the BFS provide objective assessment of caregiver-resident interaction during feeding.