title stringlengths 0 901 | abstract stringlengths 3 9.89k | PMID int64 22 25.3M | embedding listlengths 768 768 |
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CKM and LILRB5 are associated with serum levels of creatine kinase. | Statins (HMG-CoA reductase inhibitors) are the most prescribed class of lipid-lowering drugs for the treatment and prevention of cardiovascular disease. Creatine kinase (CK) is a commonly used biomarker to assist in the diagnosis of statin-induced myotoxicity but the normal range of CK concentrations is wide, which limits its use as a diagnostic biomarker. We conducted a genome-wide association study of serum CK levels in 3412 statin users. Patients were recruited in Quebec, Canada, and genotyped on Illumina Human610-Quad and an iSelect panel enriched for lipid homeostasis, hypertension, and drug metabolism genes. We found a strong association signal between serum levels of CK and the muscle CK (CKM) gene (rs11559024: P=3.69×10(-16); R(2)=0.02) and with the leukocyte immunoglobulin-like receptor subfamily B member 5 (LILRB5) gene (rs2361797: P=1.96×10(-10); R(2)=0.01). Genetic variants in those 2 genes were independently associated with CK levels in statin users. Results were successfully replicated in 5330 participants from the Montreal Heart Institute Biobank in statin users for CKM (rs11559024: P=4.32×10(-16); R(2)=0.02) and LILRB5 (rs12975366 P=4.45×10(-10); R(2)=0.01) and statin nonusers (P=4.08×10(-7), R(2)=0.01; P=3.17×10(-9), R(2)=0.02, respectively). This is the first genome-wide study to report on the underlying genetic determinants of CK variation in a population of statin users. We found statistically significant association for variants in the CKM and LILRB5 genes. | 25,214,527 | [
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Loss of nNOS inhibits compensatory muscle hypertrophy and exacerbates inflammation and eccentric contraction-induced damage in mdx mice. | Approaches targeting nitric oxide (NO) signaling show promise as therapies for Duchenne and Becker muscular dystrophies. However, the mechanisms by which NO benefits dystrophin-deficient muscle remain unclear, but may involve nNOSβ, a newly discovered enzymatic source of NO in skeletal muscle. Here we investigate the impact of dystrophin deficiency on nNOSβ and use mdx mice engineered to lack nNOSμ and nNOSβ to discern how the loss of nNOS impacts dystrophic skeletal muscle pathology. In mdx muscle, nNOSβ was mislocalized and its association with the Golgi complex was reduced. nNOS depletion from mdx mice prevented compensatory skeletal muscle cell hypertrophy, decreased myofiber central nucleation and increased focal macrophage cell infiltration, indicating exacerbated dystrophic muscle damage. Reductions in muscle integrity in nNOS-null mdx mice were accompanied by decreases in specific force and increased susceptibility to eccentric contraction-induced muscle damage compared with mdx controls. Unexpectedly, muscle fatigue was unaffected by nNOS depletion, revealing a novel latent compensatory mechanism for the loss of nNOS in mdx mice. Together with previous studies, these data suggest that localization of both nNOSμ and nNOSβ is disrupted by dystrophin deficiency. They also indicate that nNOS has a more complex role as a modifier of dystrophic pathology and broader therapeutic potential than previously recognized. Importantly, these findings also suggest nNOSβ as a new drug target and provide a new conceptual framework for understanding nNOS signaling and the benefits of NO therapies in dystrophinopathies. | 25,214,536 | [
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Quantum molecular resonance-assisted phonomicrosurgery: preliminary experience. | The objective of this study was to evaluate the use of quantum molecular resonance (QMR) energy in phonomicrosurgery. Quantum molecular resonance energy (QMRE) is an innovative technology that provides low temperature cutting and coagulation of tissues and causes minimal tissue damage during the procedure. Because of these features, this technology may offer new possibilities in phonomicrosurgery. Twelve patients with vocal fold polyps underwent QMR-assisted phonomicrosurgery. The patients were evaluated before and after surgery at 1 and 3 months postoperatively by using the voice handicap index, laryngeal stroboscopy rating, acoustic voice analysis, and perceptual voice evaluation. The subjects were also evaluated by a patient self-assessment questionnaire at 3 months postoperatively. All parameters significantly improved after QMR-assisted phonomicrosurgery (P < .05). All of the patients also subjectively improved by self-rating. These results suggest that QMRE is a safe and potentially promising treatment in phonomicrosurgery. Yet, further studies should be conducted to confirm these results. | 25,214,549 | [
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Modeling ovarian follicle growth in commercial and heritage Single Comb White Leghorn hens. | Approximately 84% of the energy in chicken eggs resides in the yolk. A robust model of ovarian follicle development is therefore valuable for estimating energy requirements of laying hens. The current experiment was designed to model the growth of ovarian follicles in 32-wk-old modern commercial line (CL) and unselected heritage line (HL) Single Comb White Leghorn hens. The volume of yolk deposited daily during the rapid growth phase (RGP) was estimated using a double dye technique. For 21 d, 8 CL and 8 HL hens were fed capsules (no. 1) containing Sudan IV (red) and Sudan Black dyes on alternate days. An additional 8 control CL hens were fed empty capsules. Eggs were collected, and the daily volume of yolk deposited was estimated. Significant differences are reported where P < 0.05. Dye had no significant effect on BW, ME intake, or egg weight. Maintenance ME requirements were 192 and 177 kcal/kg(0.67) for CL and HL hens, respectively. Duration of the RGP was shorter (7.35 d) in the CL hens compared with the HL hens (7.95 d). A nonlinear Lomolino model described follicular weight, which varied between strains over d 2 to 9 of follicle development; at each day during development, follicle weights were higher where RGP were shorter. The volume of yolk deposited for the 8 d preceding oviposition in CL was 0.17, 0.28, 0.43, 0.99, 1.84, 2.47, 2.82, 2.86, and 2.51 cm(3); and in HL was 0.17, 0.33, 0.72, 1.40, 2.15, 2.46, 2.48, 2.32, and 1.93 cm(3). The HL had a higher rate of yolk deposition 7 to 5 d before oviposition, and CL had a higher rate of yolk deposition 3 to 1 d before oviposition with no significant difference between lines on d 4 before oviposition. Although growth patterns differed, there were no differences among lines in final follicle weights (14.1 g) or retained energy (42.4 kcal). | 25,214,554 | [
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Strong, lightweight, and recoverable three-dimensional ceramic nanolattices. | Ceramics have some of the highest strength- and stiffness-to-weight ratios of any material but are suboptimal for use as structural materials because of their brittleness and sensitivity to flaws. We demonstrate the creation of structural metamaterials composed of nanoscale ceramics that are simultaneously ultralight, strong, and energy-absorbing and can recover their original shape after compressions in excess of 50% strain. Hollow-tube alumina nanolattices were fabricated using two-photon lithography, atomic layer deposition, and oxygen plasma etching. Structures were made with wall thicknesses of 5 to 60 nanometers and densities of 6.3 to 258 kilograms per cubic meter. Compression experiments revealed that optimizing the wall thickness-to-radius ratio of the tubes can suppress brittle fracture in the constituent solid in favor of elastic shell buckling, resulting in ductile-like deformation and recoverability. | 25,214,624 | [
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Airway-related symptoms and surgeries in patients with mucopolysaccharidosis I. | Mucopolysaccharidosis I (MPS I) is a progressive, debilitating, and life-threatening genetic disease, which, owing to the nonspecific nature of the early symptoms, is often unrecognized and associated with significant diagnostic delays. To improve early recognition leading to early diagnosis and initiation of treatment, we characterized the extent of airway-related symptoms and surgeries among patients with MPS I. Analysis of the frequency of airway-related symptoms and surgeries from 1041 patients enrolled in the MPS I Registry and correlation with other systemic manifestations of MPS I. Airway-related symptoms (macroglossia, enlarged tonsils, reactive airway disease/asthma, or sleep disturbances) were reported for as many as 85% of Hurler, 83% of Hurler-Scheie, and 65% of Scheie patients-very often before the diagnosis of MPS I was established. Surgeries for an airway indication were reported in 39% of patients and many had at least 1 airway-related surgery before the diagnosis of MPS I was confirmed. The mean percentage of patients with airway-related symptoms for whom hernias and/or dysostosis multiplex were also reported was 84% and 54%, respectively. Airway-related symptoms and surgeries are common and often the earliest presenting feature in MPS I. Improved recognition of early MPS I disease manifestations may lead to earlier diagnosis and treatment. | 25,214,650 | [
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Implementing Interdisciplinary Teams Does Not Necessarily Improve Primary Care Practice Climate. | The complexity of successfully implementing interdisciplinary care team approaches in primary care has challenged many delivery system stakeholders. One-year changes in clinicians' and staff experiences of practice climate among 5 practices implementing interdisciplinary primary care teams and 28 other practices were compared. In adjusted analyses, practices implementing care teams reported improved team structure (78.0 in 2011 vs 79.3 in 2012), team functioning (75.7 vs 77.7), readiness for change (77.6 vs 77.7), and perceptions of skills and knowledge (48.0 vs 53.6) over time. However, the improvements were not significantly different from changes experienced by other practices. Achieving improvements in practice climate through care team redesign is challenging, even with structured learning opportunities for team members. Practice climate did not deteriorate over time, indicating that implementing a complex team redesign does not harm working relationships of frontline clinicians and staff. | 25,214,648 | [
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Tribal vs. Public Schools: Perceived Discrimination and School Adjustment among Indigenous Children from Early to Mid-Adolescence. | The purpose of this study is to assess the differential effects of perceived discrimination by type of school on positive school adjustment among Indigenous children during late elementary and early middle school years. The analysis utilizes a sample of 654 Indigenous children from four reservations in the Northern Midwest and four Canadian First Nation reserves. Multiple group linear growth modeling within a structural equation framework is employed to investigate the moderating effects of school type on the relationship between discrimination and positive school adjustment. Results show that students in all school types score relatively high on positive school adjustment at time one (ages 10-12). However, in contrast to students in tribal schools for whom positive school adjustment remains stable, those attending public schools and those moving between school types show a decline in school adjustment over time. Furthermore, the negative effects of discrimination on positive school adjustment are greater for those attending public schools and those moving between schools. Possible reasons for this finding and potential explanations for why tribal schools may provide protection from the negative effects of discrimination are discussed. | 25,214,671 | [
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Medication Adherence in Older Adults: A Qualitative Study. | To effectively address medication adherence and improve cardiovascular health among older adults, a deeper understanding is needed of the barriers that this age group faces and approaches that would be most effective and feasible for improving adherence. We conducted a focus group study (n=25) in a diverse population of older adults with hypertension recruited from the Cohort Study of Medication Adherence in Older Adults (CoSMO). A structured guide was used to collect feedback on barriers to adherence and acceptability and feasibility of intervention strategies. The final coding framework outlines factors at the individual, relationship, health care system, and environmental or policy level which affect adherence in older adults, including memory, knowledge, attitudes and beliefs, side effects, social support, interaction with health care providers, and cost and convenience of medication filling. Patient responses highlighted the varied nature of barriers and the need for interventions which are both multi-faceted and tailored. | 25,214,707 | [
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Age-related macular degeneration in the aspect of chronic low-grade inflammation (pathophysiological parainflammation). | The products of oxidative stress trigger chronic low-grade inflammation (pathophysiological parainflammation) process in AMD patients. In early AMD, soft drusen contain many mediators of chronic low-grade inflammation such as C-reactive protein, adducts of the carboxyethylpyrrole protein, immunoglobulins, and acute phase molecules, as well as the complement-related proteins C3a, C5a, C5, C5b-9, CFH, CD35, and CD46. The complement system, mainly alternative pathway, mediates chronic autologous pathophysiological parainflammation in dry and exudative AMD, especially in the Y402H gene polymorphism, which causes hypofunction/lack of the protective complement factor H (CFH) and facilitates chronic inflammation mediated by C-reactive protein (CRP). Microglial activation induces photoreceptor cells injury and leads to the development of dry AMD. Many autoantibodies (antibodies against alpha beta crystallin, alpha-actinin, amyloid, C1q, chondroitin, collagen I, collagen III, collagen IV, elastin, fibronectin, heparan sulfate, histone H2A, histone H2B, hyaluronic acid, laminin, proteoglycan, vimentin, vitronectin, and aldolase C and pyruvate kinase M2) and overexpression of Fcc receptors play role in immune-mediated inflammation in AMD patients and in animal model. Macrophages infiltration of retinal/choroidal interface acts as protective factor in early AMD (M2 phenotype macrophages); however it acts as proinflammatory and proangiogenic factor in advanced AMD (M1 and M2 phenotype macrophages). | 25,214,719 | [
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Tecidual reaction of calcium hydroxide front chronic stress histological study in rats. | The Calcium Hydroxide has been widely used as an intracanal dressing and in combination with restorative and endodontic materials and its main goal is the tissue reparation. However, when the patient has chronic stress, the immunological response and tissue repair decreases in both the epithelial and connective tissue. Therefore, the aim was to analyze the effect of chronic stress on the tissue response in rats exposed to calcium hydroxide (CH). A total of 60 wistar rats were anesthetized, and a polyethylene tube containing CH was inserted under the skin. After 24 h, they were divided into two groups: Calcium hydroxide + stress (CHSG) n = 30 and calcium hydroxide (CHG) n = 30. They were stressed by physical restraint, for 12 h each day for periods of 7, 15 and 30 days when 10 animals from each group were euthanized. The tissues surrounding the polyethylene tubes were removed, and slides were prepared and stained with hematoxylin and eosin. The analysis was performed with an optical microscope with magnification of 4-400 times by a blinded senior examiner. The sample slides were classified according to the following scores 0 - absent/1 - present/2 - infiltrate to: Inflammatory infiltrate containing fibrous condensation, lymphocytes, plasmacytes, macrophages, neutrophils, and eosinophils. The data were statistically analyzed using the Student's t-test (P < 0.05) for paired samples. The exposure time of 7 days elicited no statistical difference between groups (P > 0.05). The 15 days exposure group had higher averages for CHG to eosinophils and inflammatory infiltrate (P < 0.05). In 30 days, CHG showed higher averages to inflammatory infiltrate and lower averages to FC (P < 0.05). Some modified patterns of responses in the CHSG were observed at 15 days and 30 days. | 25,214,724 | [
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Reducing the burden of regular indwelling urinary catheter changes in the catheter clinics: the opinion of patients and relatives on the practice of self-catheterization. | Clean intermittent self-catheterization is accepted worldwide as a standard of care for patients with long-standing need for urinary bladder decompression. Evidence of its routine practice in our low-resource setting is lacking, leading to increasing number of patients with a long-standing indwelling urinary catheter. To seek the opinion of patients already using indwelling catheters regarding the practice of self-catheterization. Over a 4-month period, the opinion of every patient and patient's relative that attended the regular urinary catheter clinic was sought using an intern-administered questionnaire. The data was analyzed using SPSS version 20. A total of 108 patients completed the questionnaire. Age range was 16-100 years with a mean of 62.2±15.5 years. Only 30.5% of the patients had formal education beyond the primary level. The median cost for change of the indwelling catheter was 1,325 naira ($8.28 US) with a range of 500-4,000 naira ($3.13-$25 USD). Analysis showed that: 70.8% of patients aged under 60 years/60.6% of those with formal education beyond primary level/61.9% of those wearing catheters for <3 months would give consent for training in self-catheterization. Higher cost of catheter change did not influence the decision to consider self-catheterization. Of the 59 patient relatives who completed the questionnaire, 63% of those younger than 50 years old and 69.2% of those with tertiary education would be willing to undertake training to administer self-catheterization. A select group of patients and accompanying relatives in our low-resource setting are willing to learn and practice self-catheterization. | 25,214,771 | [
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Aging of vestibular function evaluated using correlational vestibular autorotation test. | Imbalance from degeneration of vestibular end organs is a common problem in the elderly. However, the decline of vestibular function with aging was revealed in few vestibular function tests such as vestibular autorotation test (VAT). In the current VAT, there are drawbacks of poor test-retest reliability, slippage of the sensor at high-speed rotations, and limited data about the effect of aging. We developed a correlational-VAT (cVAT) system that included a small, light sensor (less than 20 g) with wireless data transmission technique to evaluate the aging of vestibular function. We enrolled 53 healthy participants aged between 25 and 75 years and divided them into five age groups. The test conditions were vertical and horizontal head autorotations of frequencies from 0 to 3 Hz with closed eyes or open eyes. The cross-correlation coefficient (CCC) between eye velocity and head velocity was obtained for the head autorotations between 1 Hz and 3 Hz. The mean of the CCCs was used to represent the vestibular function. Age was significantly and negatively correlated with the mean CCC for all test conditions, including horizontal or vertical autorotations with open eyes or closed eyes (P<0.05). The mean CCC with open eyes declined significantly at 55-65 years old and the mean CCC with closed eyes declined significantly at 65-75 years old. Vestibular function evaluated using mean CCC revealed a decline with age, and the function of visual-vestibulo-ocular reflex declined 10 years earlier than the function of vestibulo-ocular reflex. | 25,214,774 | [
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Once-daily indacaterol 75 μg in moderate- to-severe COPD: results of a Phase IV study assessing time until patients' perceived onset of effect. | Indacaterol 75 μg once daily is a long-acting β2 agonist approved for maintenance bronchodilator treatment in patients with chronic obstructive pulmonary disease (COPD). The purpose of this study was to evaluate patients' perception of onset of effect with a single dose. In this double-blind, crossover, Phase IV study, 40 patients were randomized to receive a single dose of indacaterol 75 μg or placebo via a dry powder inhaler device. The primary variable was time until patient's perception of onset of effect, using a simple self-administered (nonvalidated) questionnaire that patients answered at nine protocol-specified time points. Exploratory variables included change in forced expiratory volume in 1 second (FEV1) and change in percent predicted FEV1 from predose to postdose (determined 60-75 minutes postdose). The least-squares mean time to patient's perception of onset of effect was 25.4 minutes and 23.9 minutes for indacaterol and placebo, respectively. There was no significant effect for treatment, period, or sequence on the time to patient's perception. In addition, no statistically significant differences between treatments were observed for patient's global satisfaction with onset of effect and global expectation of treatment adherence. For the exploratory variable change in FEV1 from predose to postdose, indacaterol showed superiority over placebo with a clinically relevant least-squares mean treatment difference of 0.12 L (P<0.0001). There was little or no association between patient's perception of time to onset of effect and change in FEV1, or change in percent predicted FEV1. Both treatments were well tolerated. A single dose of indacaterol 75 μg did not separate from placebo in terms of patient perception of onset, although there was an improvement in FEV1 for indacaterol compared with placebo. Development and use of a validated questionnaire may be needed to address the inconsistency in evaluating this patient-related outcome. | 25,214,778 | [
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An individual drug-therapy and genetic testing report of temporal bone verrucous carcinoma. | To investigate the pathology and pathogenesis of and treatment methods for temporal bone verrucous carcinoma. A single-patient report of verrucous carcinoma on the left external auditory canal is presented and analyzed along with all cases of temporal bone verrucous carcinoma that have been documented in the English literature. Most of the patients with verrucous carcinoma of the temporal bone have histories of surgery, trauma, or infection, and verrucous carcinomas are sensitive to antimicrotubule chemotherapeutic medicines. Adjuvant radiation therapy is not effective, but surgical treatment might be relatively more effective. Temporal bone verrucous carcinoma has a poor prognosis; therefore, the preferred treatment is surgical resection facilitated with antimicrotubule chemotherapeutic treatment. Adjuvant radiation therapy is not a preferred treatment for temporal bone verrucous carcinoma. | 25,214,794 | [
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Advancing adolescent health and health services in Saudi Arabia: exploring health-care providers' training, interest, and perceptions of the health-care needs of young people. | Adolescent health is regarded as central to global health goals. Investments made in adolescent health and health services protect the improvements witnessed in child health. Though Saudi Arabia has a large adolescent population, adolescent health-care only began to emerge in recent years, yet widespread uptake has been very limited. Health-care providers are key in addressing and providing the necessary health-care services for adolescents, and so this study was conducted with the aim of identifying opportunities for the advancement of knowledge transfer for adolescent health services in Saudi Arabia. This Web-based, cross-sectional study was carried out at four hospitals in Saudi Arabia. Physicians and nurses were invited to participate in an online survey addressing their contact with adolescent patients, and training, knowledge, and attitudes towards adolescent health-care. A total of 232 professionals participated. The majority (82.3%) reported sometimes or always coming into contact with adolescent patients. Less than half (44%), however, had received any sort of training on adolescent health during their undergraduate or postgraduate education, and only 53.9% reported having adequate knowledge about the health-care needs of adolescents. Nurses perceived themselves as having more knowledge in the health-care needs of adolescents and reported feeling more comfortable in communicating with adolescents as compared with physicians. The majority of participants were interested in gaining further skills and knowledge in adolescent health-care and agreed or strongly agreed that adolescents have specific health-care needs that are different than children or adults (82.3% and 84.0%, respectively). With respect to health services, the majority (85.8%) believed that adolescents should be hospitalized in adolescent-specific wards. Only 26.7% of health-care providers believed that patients should be transferred from child to adult health-care services at 12-13 years of age, as is currently practiced in the country. A gap exists between the training, knowledge and skills of health-care providers, and the needs to address health-care issues of adolescents in Saudi Arabia. This coupled with the fact that health-care providers are interested in gaining more knowledge and skills and are supportive of changes in the health-care system provides an opportunity for building local capacity and instituting medical and nursing education and health-care reform that can better serve the needs of the country's young population. | 25,214,805 | [
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Preparing for ICD-10-CM/PCS implementation: impact on productivity and quality. | Coding productivity is expected to drop significantly during the lead-up to and in the initial stages of ICD-10-CM/PCS implementation, now expected to be delayed until October 1, 2015. This study examined the differences in coding productivity between ICD-9-CM and ICD-10-CM/PCS for hospital inpatient cases matched for complexity and severity. Additionally, interrater reliability was calculated to determine the quality of the coding. On average, coding of an inpatient record took 17.71 minutes (69 percent) longer with ICD-10-CM/PCS than with ICD-9-CM. A two-tailed T-test for statistical validity for independent samples was significant (p = .001). No coder characteristics such as years of experience or educational level were found to be a significant factor in coder productivity. Coders who had received more extensive training were faster than coders who had received only basic training. Though this difference was not statistically significant, it provides a strong indication of significant return on investment for staff training time. Coder interrater reliability was substantial for ICD-9-CM but only moderate for ICD-10-CM/PCS, though some ICD-10-CM/PCS cases had complete interrater (coder) agreement. Time spent coding a case was negatively correlated with interrater reliability (-0.425 for ICD-10-CM and -0.349 for ICD-10-PCS). This finding signals that increased time per case does not necessarily translate to higher quality. Adequate training for coders, as well as guidance regarding time invested per record, is important. Additionally, these findings indicate that previous estimates of initial coder productivity loss with ICD-10-CM/PCS may have been understated. | 25,214,823 | [
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The effects of 5-hydroxytryptophan in combination with different Fatty acids on gastrointestinal functions: a pilot experiment. | Background. Fat affects gastric emptying (GE). 5-Hydroxythryptophan (5-HTP) is involved in central and peripheral satiety mechanisms. Influence of 5-HTP in addition to saturated or monounsaturated fatty acids (FA) on GE and hormone release was investigated. Subjects/Methods. 24 healthy individuals (12f : 12m, 22-29 years, BMI 19-25.7 kg/m²) were tested on 4 days with either 5-HTP + short-chain saturated FA (butter), placebo + butter, 5-HTP + monounsaturated FA (olive oil), or placebo + olive oil in double-blinded randomized order. Two hours after FA/5-HTP or placebo intake, a (13)C octanoid acid test was conducted. Cortisol, serotonin, cholecystokinin (CCK), and ghrelin were measured, as were mood and GE. Results. GE was delayed with butter and was normal with olive (P < 0.05) but not affected by 5-HTP. 5-HTP supplementation did not affect serotonin levels. Food intake increased plasma CCK (F = 6.136; P < 0.05) irrespective of the FA. Ghrelin levels significantly decreased with oil/5-HTP (F = 9.166; P < 0.001). The diurnal cortisol profile was unaffected by FA or 5-HTP, as were ratings of mood, hunger, and stool urgency. Conclusion. Diverse FAs have different effects on GE and secretion of orexigenic and anorexigenic hormones. Supplementation of 5-HTP had no effect on plasma serotonin and central functions. Further studies are needed to explain the complex interplay. | 25,214,830 | [
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Religion, acculturation, and incarceration: determinants of substance use among Hispanic adults in the United States. | The influence of religion, acculturation, and incarceration on substance abuse has been studied, though predominantly among adolescents. Little research exists on how such factors influence substance use among Hispanic adults. The objective of this study was to assess key determinants of substance use among Hispanic adults. Public access 2012 National Survey on Drug Use and Health was utilized. Univariate and multivariable logistic regression analyses were conducted while accounting for complex survey design to obtain population-weighted estimates. Receiver operator curve analysis was used to evaluate the relative contribution of each variable. Importance of religious influence in life and Spanish language interview were associated with lower odds of substance use, while history of incarceration increased the likelihood of substance use among Hispanic adults. Other factors associated with lower odds were increasing age, being female, and currently married. Other factors associated with increased odds were high school graduate and some college in addition to living above the 200% federal poverty level. Results from this study add to the limited body of the literature on determinants of substance use among Hispanic adults. Health education measures should target acculturated Hispanic adults and those with incarceration history to reduce substance use. | 25,214,855 | [
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The clinicopathological significance of epithelial mesenchymal transition associated protein expression in head and neck squamous cell carcinoma. | Epithelial mesenchymal transition (EMT) has an important role in invasion and metastasis of tumor cells. The purpose of this study was to evaluate the roles of EMT-associated proteins on progression and metastasis as a prognostic/predictive factor in curatively-resected (R0) head and neck squamous cell carcinoma (HNSCC). A total of 118 patients who received curative surgery for HNSCC at Inha University Hospital between January 1996 and December 2011 were included. We used protein immunohistochemistry to evaluate the expression of E-cadherin, vimentin, and EZH2 on tissue microarrays. Also, we reviewed all medical records and analyzed the relationship between the expression of EMT-associated proteins and prognosis. The E-cadherin-negative group showed more moderate/poor differentiation of cancer cell type than the higher E-cadherin-expressing group (p=.016) and high EZH2 expression was significantly correlated with nodal metastasis (p=.012). Our results demonstrate a significant association between high expression of EZH2 and vimentin and presence of distant progression (p=.026). However, expression of E-cadherin, vimentin, and EZH2 was not significantly associated with overall survival. These findings suggest that an EMT-associated protein expression profile is correlated with aggressiveness of disease and prognosis, and could be a useful marker for determination of additional treatment in curatively-resected HNSCC patients. | 25,214,857 | [
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Differential Features of Microsatellite-Unstable Colorectal Carcinomas Depending on EPCAM Expression Status. | Recent studies have revealed that a small subset of Lynch syndrome-associated colorectal carcinomas (CRCs) is caused by a germline EPCAM deletion-induced MSH2 epimutation. Based on the finding of this genetic alteration, we investigated the implications of EPCAM expression changes in microsatellite instability-high (MSI-H) CRCs. Expression of EPCAM and DNA mismatch repair proteins was assessed by immunohistochemistry in 168 MSI-H CRCs. Using DNA samples of these tumors, MLH1 promoter methylation status was also determined by methylation-specific real-time polymerase chain reaction method (MethyLight). Among 168 MSI-H CRCs, complete loss (CL) and focal loss (FL) of EPCAM expression was observed in two (1.2%) and 22 (13.1%) cases, respectively. Both of the EPCAM-CL cases were found in MSH2-negative tumors without MLH1 promoter methylation. However, only nine of the 22 EPCAM-FL tumors had MSH2 deficiency. Of the 22 EPCAM-FL tumors, 13 showed MLH1 loss, and among them, nine cases were determined to have MLH1 methylation. EPCAM-FL was significantly associated with advanced stage (p=.043), distant metastasis (p=.003), poor differentiation (p=.001), and signet ring cell component (p=.004). Loss of EPCAM expression is differentially associated with clinicopathological and molecular features, depending on the completeness of the loss, in MSI-H CRCs. | 25,214,859 | [
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Synergistic effect of fermented rice extracts on the probiotic and laxative properties of yoghurt in rats with loperamide-induced constipation. | Aim. The objective was to evaluate the synergistic effects of fermented rice extracts (FRe) on the laxative and probiotic properties of yoghurt in rats with loperamide-induced constipation. Methods. After constipation induction, yoghurt containing FRe (BFRe; 0.05%, 0.1%, or 1%) was administered orally once per day for 6 days. Results. Loperamide treatment caused marked decreases in fecal pellet numbers and water content discharged, as well as in the surface mucosal thickness of the colonic lumen, intestinal charcoal transit ratio, thickness, and number of mucous-producing goblet cells in the colonic mucosa, whereas it increased the remnant fecal pellet number and the mean diameter of the colonic lumen. However, this loperamide-induced constipation was ameliorated by treatment with FRe, yoghurt single formula, or 0.05%, 0.1%, or 1% BFRe (10 mL/kg). Additionally, the viable numbers of Lactobacillus in the cecal contents and feces were markedly higher than those in constipated rats. Moreover, greater probiotic and laxative effects were detected in BFRe-treated rats than in rats treated with equivalent doses of yoghurt or FRe single formula. Conclusion. The results suggest that addition of FRe to liquid yoghurt will enhance the probiotic and beneficial laxative effects of yoghurt in the digestive tract, without causing side effects. | 25,214,876 | [
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Evolution of acuteness in pathogen metapopulations: conflicts between "classical" and invasion-persistence trade-offs. | Classical life-history theory predicts that acute, immunizing pathogens should maximize between-host transmission. When such pathogens induce violent epidemic outbreaks, however, a pathogen's short-term advantage at invasion may come at the expense of its ability to persist in the population over the long term. Here, we seek to understand how the classical and invasion-persistence trade-offs interact to shape pathogen life-history evolution as a function of the size and structure of the host population. We develop an individual-based infection model at three distinct levels of organization: within an individual host, among hosts within a local population, and among local populations within a metapopulation. We find a continuum of evolutionarily stable pathogen strategies. At one end of the spectrum-in large well-mixed populations-pathogens evolve to greater acuteness to maximize between-host transmission: the classical trade-off theory applies in this regime. At the other end of the spectrum-when the host population is broken into many small patches-selection favors less acute pathogens, which persist longer within a patch and thereby achieve enhanced between-patch transmission: the invasion-persistence tradeoff dominates in this regime. Between these extremes, we explore the effects of the size and structure of the host population in determining pathogen strategy. In general, pathogen strategies respond to evolutionary pressures arising at both scales. | 25,214,895 | [
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Evaluation of anti-tuberculosis induced adverse reactions in hospitalized patients. | Tuberculosis has been one of the common diseases of human communities. Besides of disease-related complications, there are serious adverse reactions due to Anti-tuberculosis (Anti-TB) drug therapy. To assess the rate of Adverse Drug Reactions (ADRs) induced by Anti-TB drugs in the infectious disease department for a period of one year. To detect serious and preventable recognized ADRs. All patients admitted to the infectious disease department at Imam tertiary teaching hospital in Iran who received Anti-TB drugs from July 2001 to July 2002 entered the study. These patients were monitored for ADRs during hospital stay. The ADRs were then classified based on patients and reactions factors. The causality and severity of the reactions were determined using Naranjo algorithm and Hartwig questionnaire, respectively. During the study period, 83 patients received Anti-TB drugs; of them 44 developed at least one ADR. Total number of 81 ADRs was detected in this study. ADRs were recognized as the major cause of hospital admission in 11 (13.3%) patients. The most frequent system-organ class affected by ADRs was Liver and biliary system (37%). Hepatitis was observed in 21 (25.3%) patients leading to death in two patients. Anti-TB drugs could cause significant adverse effects both in quantity and severity leading to hospitalization, prolonged hospital stay and even death. More attention is needed to prevent these reactions. | 25,214,900 | [
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Changes in knowledge after attending a community pharmacists' asthma workshop. | Pharmacists can play an important role in both the detection of asthma and its monitoring in patients with asthma. To assess the change in asthma knowledge, and associated variables, of pharmacists attending the "Pharmacotherapy follow- up of Adult Bronchial Asthma" workshops run by the Pharmaceutical Care Center of Stada Laboratories. All participants in the "Pharmacotherapy follow-up of Adult Bronchial Asthma" workshops completed a pre-test and a post-test. Those who left the workshop and those who did not complete the tests were not included in the analysis. Tests were scored from 0 to 10, and the change in scores was analyzed. Of the 90 participating pharmacists, 79 fulfilled the inclusion criteria. 81% (64) were female, and their average age was 38.8 years [CI95%= 36.65-40.81]. The average pre-test score was 3.65 [CI95%=3.29-4.01]; 72.2% of the pharmacists scored less than 5 points. The average post-test score was 7.33 [CI95%=7.01-7.65]. The average change in scores was 3.68 [CI95%=3.29-4.07]. No statistical significance was found between this change in scores and other variables analyzed (age, gender, previous training, or position in the pharmacy). CAF Stada "Adult Bronchial Asthma" workshops increased pharmacists' general knowledge. | 25,214,901 | [
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Lessons from gefitinib-induced interstitial lung disease in Japan: Problems in approval, pharmacovigilance, and regulatory decision-making procedures. | The objective of this study was to identify problems in the approval, pharmacovigilance, and post-approval regulatory decision-making procedures involving gefitinib and to propose countermeasures to prevent further drug-induced suffering in Japan in the future. We comprehensively reviewed reports regarding gefitinib published during the period from 2000 to 2006 by regulatory agencies, the manufacturer of the gefitinib-containing drug, cancer clinical study groups, and a scientific society. We identified the following major problems in the approval, pharmacovigilance, and regulatory decision-making procedures: 1) the results of animal experiments and pre-marketing clinical trials, and reports of adverse drug reactions from other countries were not properly reflected in the label; 2) indications for the drug were expanded without strict evaluation of the external validity of pre-marketing clinical trials; and 3) despite many serious cases of interstitial lung disease (ILD) being spontaneously reported, well-designed post-marketing surveillance was not immediately performed. We propose a mandatory total registry of all drug users and surveillance (i.e. a prospective outcome study) as one of the rational solutions for preventing further drug-induced suffering in Japan. | 25,214,906 | [
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Assessment of the decreased productivity of patients with diabetes type 2 in the Clinical Endocrinological Center Sofia, Bulgaria. | This study aims to assess the influence of type 2 diabetes on the patients' productivity and quality of life. The WHO's methodology - HLQ (Health and Labor Questionnaire) is applied. Subjects were 38 patients with type 2 diabetes, diagnosed and treated at the Clinical center on endocrinology at the MU- Specialized hospital center for active treatment- Sofia. Control consisted of 100 patients without diabetes. The results from the study proofs the fact that the patients with type 2 diabetes manage with their day- to-day activities like their colleagues and even better, but they absent from work because of: their illness, experiencing fatigue and insomnia, pain in hands, legs, joints and muscles. They receive hospital treatment because of the insufficient control on their treatment and the advanced diabetes complications. The application of the Osterhaus method establishes that type 2 diabetes is connected with the excess illness-related work loss and with more often "medically related absences". These do not lead to significant indirect productivity costs because these patients are with lower income. The cumulative costs from the sporadic work loss during their whole life are even greater, because of the increased spread of the disease, suboptimum treatment, and many complications and prolonged life duration thanks to the contemporary medicine. | 25,214,910 | [
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Identification by observation of clinical pharmacists' activities in a hospital inpatient setting. | The aim of the study was to quantify clinical pharmacists' workload in Australia. Specific objectives were to perform a direct observation of the pattern of clinical activities in two acute hospitals and compare that with previously documented self-reported patterns. We were also interested in identifying what records kept by pharmacists would capture all the activities they perform. An observer recorded the activities of clinical pharmacists on six separate days in the medical and surgical wards of two Melbourne metropolitan hospitals. We examined resultant data to determine suitable records by which clinical pharmacists could capture all the activities they perform. To compare the observed pattern of clinical activities with those earlier self-reported by pharmacists, we categorised our data using the Pharmacy Activity Codes present in the penultimate version of the ICD-10-AM classification system. The observer recorded the performance of 807 workload 'events', representing 28 separate types of activities. When compressed into the Pharmacy Activity Codes formerly used in the ICD-10-AM classification system, the pattern of activities identified by direct observation matched that which had previously been self-reported by pharmacists. The majority of the activities performed could be captured by completion of a Pharmaceutical Care Plan and by recording pharmacists' interventions to a database. The remaining activities may be recorded for departmental workload purposes in a simple template format. The pattern of clinical pharmacist activity at the two hospitals was confirmed by direct observation as similar to that previously reported in other Australian hospitals. A Pharmaceutical Care Plan, a database for intervention recording and a simple workload template provide the means to record all activities that clinical pharmacists perform. | 25,214,912 | [
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Documentation of pharmacotherapeutic interventions of pharmacy students. | During patient care rounds with the medical team, pharmacy students have made positive contributions for the benefit of the patient. However, very little has been documented regarding the impact these future healthcare professionals are making while on clinical rotations. The objective of this study was to assess the impact that clinical interventions made by 6th year pharmacy students had on overall patient outcome. Using a special program for a personal digital assistant (PDA), the students daily recorded the pharmacotherapeutic interventions they made. The interventions ranged from dosage adjustments to providing drug information. Data was collected over a 12-week period from various hospitals and clinics in the Jacksonville, Florida area. In total, there were 89 pharmaceutical interventions performed and recorded by the students. Fifty interventions involved drug modification and fifty-four interventions were in regards to drug information and consulting. Of the drug information and consulting interventions, 15 were drug modification. This study shows the impact pharmacy students make in identifying, recommending, and documenting clinical pharmacotherapeutic interventions. Similar to pharmacists, pharmacy students can also have a positive contribution towards patient care. | 25,214,925 | [
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Evaluation of thiazide diuretic use as preferred therapy in uncomplicated essential hypertension patients. | Thiazide diuretics are effective antihypertensive medications shown to reduce the risk of cardiovascular events and stroke. Despite being the preferred choice for uncomplicated essential hypertension, thiazide diuretics continue to be underutilized. Uncomplicated essential hypertension patients taking a single antihypertensive medication were evaluated upon enrollment, diagnosis after enrollment or initiation of therapy in treatment naïve patients. Clinician prescribing habits were determined for both pre-existing and newly diagnosed hypertensive patients. For the cost savings analysis, hydrochlorothiazide (HCTZ) 25mg daily was selected as the preferred conversion medication. Four hundred seventy-eight patients were included. ACE inhibitors were the most prescribed at 35.4% (n=169), followed by dihydropyridine calcium channel blockers (DHP CCB) and thiazide diuretics, both at 20.3% (n=97). Only 12.9% (n=33) of patients with hypertension that were taking an antihypertensive medication upon enrollment were either continued or started on thiazide diuretic therapy. Newly diagnosed or treatment naïve patients were prescribed a thiazide diuretic 28.8% (n=64) of the time. DHP CCB accounted for 58.8% of the total medication cost per month with thiazide diuretics responsible for 0.8% of the cost. If all patients had been prescribed HCTZ 25mg daily, 95.8% of the total medication cost per month could have been saved. Thiazide diuretics were underutilized as preferred therapy in patients with pre-existing or newly diagnosed uncomplicated essential hypertension. While cost of therapy should not be the sole reason for medication selection, thiazide diuretics are an attractive option and should be considered as a preferred therapy in this patient population. | 25,214,929 | [
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Acute traumatic coagulopathy: Incidence, risk stratification and therapeutic options. | Uncontrolled hemorrhage is responsible for over 50% of all trauma-related deaths within the first 48 hours after admission. Clinical observations together with recent research resulted in an appreciation of the central role of coagulopathy in acute trauma care. A synopsis is presented of different retrospective analyses based upon datasets from severe multiply injured patients derived from the TR-DGU database (Trauma Registry of the Deutsche Gesellschaft fur Unfallchirurgie (DGU)/ German Society of Trauma Surgery) with respect to frequency, risk stratification and therapeutic options of acute traumatic coagulopathy (ATC). The synopsis of different analyses based upon the datasets from severe multiply injured patients derived from the TR-DGU database and development/validation of a scoring system (TASH-score = Trauma Associated Severe Hemorrhage) that allows an early and reliable estimation for the probability of massive transfusion as a surrogate for life-threatening hemorrhage after severe multiple injuries. The high frequency of ATC upon emergency room admission is associated with significant morbidity and mortality in multiply injured patients. The TASH-score is recognized as an easy-to-calculate and valid scoring system to predict the individual's probability for massive transfusion and thus ongoing life-threatening hemorrhage at a very early stage after severe multiple injuries. An early aggressive management of ATC including a more balanced administration of blood products to improve outcome is advocated. | 25,214,935 | [
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Expression of triggering receptor-1 in myeloid cells of mice with acute lung injury. | Myeloid cell (TREM-1) is an important mediator of the signal transduction pathway in inflammatory response. In this study, a mouse model of acute lung injury (ALI) by intraperitoneal injection of lipopolysaccharide (LPS) was established to observe the expression pattern of TREM-1 in lung tissue and the role of TREM-1 in pulmonary inflammatory response to ALI. Thirty BALB/C mice were randomly divided into a normal control group (n=6) and an ALI group (n=24). The model of ALI was made by intraperitonal injection of LPS in dose of 10 mg/kg. Specimens from peripheral blood and lung tissue were collected 6, 12, 24 and 48 hours after LPS injection. RT-PCR was used to detect TREM-1 mRNA, and ELISA was employed for detection of TREM-1 protein and TNF-a protein, and HE staining was performed for the pathological Smith lung scoring under a light microscope. The expressions of TREM-1 mRNA in lung tissue and blood of the ALI group 6, 12, 24, and 48 hours after injection of LPS were higher than those in the control group. The levels of TREM-1 protein and the levels of TNF-a protein in lung tissue of the ALI group 6, 12, 24, and 48 hours after LPS injection were higher than those of the control group; the level of TREM-1 protein peaked 12 hours after LPS injection, but it was not significantly correlated with the expression of TREM-1 mRNA (P=0.14); the TNF-a concentration was positively correlated with TREM-1 levels in lung tissue and with Smith pathological score (r=0.795, P=0.001:r=0.499, P=0.034), but not with the expression of TREM-1 mRNA (P=0.176). The expression of TREM-1 mRNA in lung tissue of mice with ALI is elevated, and the expression of TREM-1 mRNA is related to the level of TNF-a and the severity of inflammatory response to ALI. The expressions of the TREM-1 gene are not consistent with the levels of TREM-1 protein, suggesting a new functional protein involved in immune regulation. | 25,214,958 | [
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Emergency department in hospitals, a window of the world: A preliminary comparison between Australia and China. | This study aimed to make a preliminary comparison of emergency department (ED) presentations between Australia and China. The comparison could provide insights into the health systems and burden of diseases and potentially stimulate discussion about the development of acute health system in China. An observational study was performed to compare Australian ED presentations using data obtained from a single adult tertiary-referral teaching hospital in metropolitan Brisbane against Chinese ED presentations using public domain information published in existing Chinese and international medical journals. There are major differences in ED presentations between Australia and China. In 2008, 1) 35.4% of patients arrived at a tertiary teaching hospital ED in Brisbane, Australia by ambulance; 2) 1.7% were treated for poisoning; 3) 1.4% for cerebral vascular disease; 4) 1.7% for cardiac disease; and 5) 42.6% for trauma. The top events diagnosed were mental health problems including general psychiatric examination, psychiatric review, alcohol abuse, and counselling for alcohol abuse, which accounted for 5.5% of all ED presentations. Among ED patients in China, 6.7% arrived at a tertiary teaching hospital by ambulance in Shenyang in 1997; 3.7% were treated for poisoning in Shanxi Zhouzhi County People's Hospital ED in 2006; 14.9% for cerebral vascular diseases at Qinghai People's Hospital ED in 1993-1995; 1.7% for cardiac diseases at the Second People's Hospital ED, Shenzhen Longgang in 1993; and 44.3% for trauma at Shanxi Zhouzhi County People's Hospital ED in 2006. The top events were trauma and poisoning among the young and cerebral infarction in the older population. Compared with Australian, Chinese ED patients had 1) lower ambulance usage; 2) higher proportion of poisoning; 3) higher proportion of cerebral vascular diseases; 4) similar proportion of cardiac disease; 5) similar proportion of trauma; and 6) little reported mental health problems. Possible explanations for these differences in China include a pay for service pre-hospital care system, lack of public awareness about poisons, inadequate hypertension management, and lack of recognition of mental health problems. | 25,214,964 | [
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Prognostic indicators of patients with acute kidney injury in intensive care unit. | Acute kidney injury (AKI) is associated with a high mortality. This study was undertaken to detect the factors associated with the prognosis of AKI. We retrospectively reviewed 98 patients with AKI treated from March 2008 to August 2009 at this hospital. In these patients, 60 were male and 38 female. Their age ranged from 19 to 89 years (mean 52.4±16.1 years). The excluded patients were those who died within 24 hours after admission to ICU or those who had a history of chronic kidney disease or incomplete data. After 60 days of treatment, the patients were divided into a survival group and a death group. Clinical data including gender, age, history of chronic diseases, the worst laboratory values within 24 hours after diagnosis (values of routine blood tests, blood gas analysis, liver and renal function, levels of serum cystatin C, and blood electrolytes) were analyzed. Acute physiology, chronic health evaluation (APACHE) II scores and 60-day mortality were calculated. Univariate analysis was performed to find variables relevant to prognosis, odds ratio (OR) and 95% confidence interval (CI). Multiple-factor analysis with logistic regression analysis was made to analyze the correlation between risk factors and mortality. The 60-day mortality was 34.7% (34/98). The APACHE II score of the death group was higher than that of the survival group (17.4±4.3 vs. 14.2±4.8, P<0.05). The mortality of the patients with a high level of cystatin C>1.3 mg/L was higher than that of the patients with a low level of cystatin C (<1.3 mg/L) (50% vs. 20%, P<0.05). The univariate analysis indicated that organ failures≥2, oliguria, APACHE II>15 scores, cystatin C>1.3 mg/L, cystatin C>1.3 mg/L+APACHE II>15 scores were the risk factors of AKI. Logistic regression analysis, however, showed that organ failures≥2, oliguria, cystatin C>1.3 mg/L +APACHE II>15 scores were the independent risk factors of AKI. Cystatin C>1.3 mg/L+APACHE II>15 scores is useful in predicting adverse clinical outcomes in patients with AKI. | 25,214,970 | [
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Expression patterns of plasma von Willebrand factor and serum interleukin-8 in patients with early-stage severe pulmonary contusion. | von Willebrand factor (vWF) is only released from endothelial cells and platelets and is an in vivo and in vitro marker of endothelial injury in septic patients with acute lung injury (ALI). Interleukin-8 (IL-8), as a proinflammatory mediator causing recruitment of inflammatory cells, induces an increase in oxidant stress mediators and makes it as a key parameter for localized inflammation. However, it has not been well established whether the level of serum IL-8 is associated with the severity of lung injury and whether it is a prognosis marker for severe lung contusion. This study was to investigate the expression of plasma vWF and IL-8 and their association with the severity and outcomes of severe pulmonary contusion. A total of 63 patients were divided into a severe pulmonary contusion with acute respiratory distress syndrome (ARDS) group and a non-ARDS group, or a survivor group and a non-survivor group, or an injury severity score (ISS) <20 group and an ISS ≥20 group. Another 20 healthy volunteers served as controls. The levels of plasma vWF and serum IL-8 were measured by enzyme-linked immunosorbent assay (ELISA) at 1, 3, 5 and 7 days after injury. The expression patterns of the plasma vWF and serum IL-8 were compared between different groups. The concentrations of plasma vWF and serum IL-8 were significantly increased in all severe pulmonary contusion patients at all time points in comparison with the control group. The concentrations of plasma vWF in patients with ARDS increased during the whole study period, but vWF in patients with non-ARDS increased gradually until day 5 and then decreased at day 7. The concentration of serum IL-8 showed a similar expression pattern in both groups, but the expression increased more significantly in the ARDS group than in the non-ARDS group. Interestingly, both plasma vWF and serum IL-8 levels steadily increased in the non-survivor group. Furthermore, the level of plasma vWF was higher in the ISS≥20 group than in the ISS<20 group. The level of serum IL-8 in the ISS≥20 group was consistently high, while that in the ISS<20 group peaked at day 3 and decreased at day 5. In addition, the level of plasma vWF was positively correlated with platelet count, but negatively correlated with oxygen index. The level of serum IL-8 was positively correlated with white blood cell count and ISS score, and inversely correlated with oxygen index. The elevated levels of plasma vWF and serum IL-8 in severe pulmonary contusion patients reflect the severity of pulmonary injury and patients outcomes, suggesting that the plasma vWF and serum IL-8 are sensitive markers for clinical evaluation of the severity of pulmonary injury and predication of patient prognosis. | 25,214,996 | [
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Demand for hospital emergency departments: a conceptual understanding. | Emergency departments (EDs) are critical to the management of acute illness and injury, and the provision of health system access. However, EDs have become increasingly congested due to increased demand, increased complexity of care and blocked access to ongoing care (access block). Congestion has clinical and organisational implications. This paper aims to describe the factors that appear to influence demand for ED services, and their interrelationships as the basis for further research into the role of private hospital EDs. Multiple databases (PubMed, ProQuest, Academic Search Elite and Science Direct) and relevant journals were searched using terms related to EDs and emergency health needs. Literature pertaining to emergency department utilisation worldwide was identified, and articles selected for further examination on the basis of their relevance and significance to ED demand. Factors influencing ED demand can be categorized into those describing the health needs of the patients, those predisposing a patient to seeking help, and those relating to policy factors such as provision of services and insurance status. This paper describes the factors influencing ED presentations, and proposes a novel conceptual map of their interrelationship. This review has explored the factors contributing to the growing demand for ED care, the influence these factors have on ED demand, and their interrelationships depicted in the conceptual model. | 25,215,019 | [
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Application of fiberoptic bronchscopy in patients with acute exacerbations of chronic obstructive pulmonary disease during sequential weaning of invasive-noninvasive mechanical ventilation. | Early withdrawal of invasive mechanical ventilation (IMV) followed by noninvasive MV (NIMV) is a new strategy for changing modes of treatment in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) with acute respiratory failure (ARF). Using pulmonary infection control window (PIC window) as the switch point for transferring from invasive to noninvasive MV, the time for early extubation can be more accurately judged, and therapy efficacy can be improved. This study aimed to prospectively investigate the clinical effectiveness of fiberoptic bronchscopy (FOB) in patients with AECOPD during sequential weaning of invasive-noninvasive MV. Since July 2006 to January 2011, 106 AECOPD patients with ARF were treated with comprehensive medication and IMV after hospitalization. Patients were randomly divided into two groups according to whether fiberoptic bronchoscope is used (group A, n=54) or not (group B, n=52) during sequential weaning from invasive to noninvasive MV. In group A, for sputum suction and bronchoalveolar lavage (BAL), a fiberoptic bronchoscope was put into the airway from the outside of an endotracheal tube, which was accompanied with uninterrupted use of a ventilator. After achieving PIC window, patients of both groups changed to NIMV mode, and weaned from ventilation. The following listed indices were used to compare between the groups after treatment: 1) the occurrence time of PIC, the duration of MV, the length of ICU stay, the success rate of weaning from MV for the first time, the rate of reventilation and the occurrence rate of ventilator-associated pneumonia (VAP); 2) the convenience and safety of FOB manipulation. The results were compared using Student's t test and the Chi-square test. The occurrence time of PIC was (5.01±1.49) d, (5.87±1.87) d in groups A and B, respectively (P<0.05); the duration of MV was (6.98±1.84) d, (8.69±2.41) d in groups A and B, respectively (P<0.01); the length of ICU stay was (9.25±1.84) d, (11.10±2.63) d in groups A and B, respectively (P<0.01); the success rate of weaning for the first time was 96.30%, 76.92% in groups A and B, respectively (P<0.01); the rate of reventilation was 5.56%, 19.23% in groups A and B, respectively (P<0.05); and the occurrence rate of VAP was 3.70%, 23.07% in groups A and B, respectively (P<0.01). Moreover, it was easy and safe to manipulate FOB, and no side effect was observed. The application of FOB in patients with AECOPD during sequential weaning of invasive-noninvasive MV is effective in ICU. It can decrease the duration of MV and the length of ICU stay, increase the success rate from weaning MV for the first time, reduce the rate of reventilation and the occurrence rate of VAP. In addition, such a method is convenient and safe in patients of this kind. | 25,215,035 | [
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Edaravone attenuates paraquat-induced lung injury by inhibiting oxidative stress in human type II alveolar epithelial cells. | Edaravone (3-methyl-1-penyl-2-pyrazolin-5-one) is a potent free-radical scavenger and has the antioxidant ability to inhibit lipid peroxidation. The study aimed to examine the effect of edaravone on protecting the acute injury of human type II alveolar epithelial cells (A549 cells) induced by paraquat (PQ) and the change of production of reactive oxygen species (ROS), malondialdehyde (MDA), superoxide dismutase (SOD). A549 cells were cultured and divided into PQ group (group P), edaravone-treated group (group E) and normal control group (group C). The cells in group P were exposed to paraquat (600 μmol/L), and the cells in group E were treated with edaravone (100 μmol/L) additionally, and no drug intervention was given to the cells in group C. Real-time monitoring by LSCM was used to detect the cell response and the intracellular dynamic change of ROS level in A549 cells after administration of PQ and edaravone. And the levels of SOD and MDA were detected respectively by biochemistry colorimetry. Data were expressed as mean ± standard error of the mean. Statistical analysis was carried out with the soft SPSS 16.0. The concentration of intracellular ROS significantly increased when PQ was given to A549 cells. But after administration of edaravone, the concentration of intracellular ROS was decreased. Compared to the PQ group, the levels of SOD in the edaravone group were significantly increased while the levels of MDA were markedly decreased. Paraquat can increase the oxidative stress, and induce the lipid peroxidation of A549 cells. Edaravone has the effect to scavenge reactive oxygen species, and to protect against the PQ-induced lung toxicity. | 25,215,040 | [
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Protective effect of exogenous IGF-I on the intestinalmucosal barrier in rats with severe acute pancreatitis. | Severe acute pancreatitis (SAP) can result in intestinal mucosal barrier (IMB) dysfunction. This study was undertaken to demonstrate the effect of IGF-I on the intestinal mucosal barrier in rats with SAP and its possible mechanisms. Seventy-two male Wistar rats were randomly divided into three groups: a sham operation (SO group, n=24), a SAP group not treated with IGF-I (SAP group, n=24), and a SAP group treated with IGF-I (IGF-I group, n=24). SAP was induced in the rats by injecting 5.0% sodium taurocholate into the biliary-pancreatic duct. The SO rats were given an infusion of normal saline instead. The rats in the IGF-I group underwent the SAP procedure and were given a subcutaneous injection of IGF-I at 30 minutes before the operation and at 3 hours after the operation. Eight rats in each group were sacrificed at 6, 12 and 24 hours after operation. Apoptosis of mucosal cells in the small intestine was determined by TUNEL. The levels of endotoxin and DAO and serum amylase were also measured. Pathologic changes in the small intestine were monitored. Changes of bax and bcl-2 mRNA expression in the small intestine were determined by reverse transcription polymerase chain reaction (RT-PCR). The levels of serum amylase were lower in the IGF-I group than in the SAP group at all three time points (P<0.05). The levels of endotoxin in the IGF-I group were higher than those in the SAP group at 6 hours, but lower in the IGF-I group than in the SAP group at 12 and 24 hours (P<0.05). The levels of diamine oxidase were higher in the IGF-I group at 6 hours but lower than those in the SAP group at 12 and 24 hours. The pathological score of the small intestine was lower in the IGF-I group than in the SAP group, and the difference was statistically significant at 12 and 24 hours. The pathologic changes observed under electron microscopy were better in the IGF-I group than those in the SAP group. The apoptosis index of intestinal epithelial cells was significantly decreased in the IGF-I group compared with the SAP group. Compared with the SO group, the mRNA expression levels of bax were increased at each time point in the SAP group, and were significantly decreased in the IGF-I group as compared with the SAP group at each time point (P<0.05). The expression levels of bcl-2 were weak and not different between the SO group and the SAP group (P>0.05). They were significantly increased in the IGF-I group versus the SO and SAP groups (P<0.05). The ratio of bax and bcl-2 mRNA expression levels at each time point in the SAP group were significantly higher than those in the SO group, but they were obviously decreased in the IGF-I group. Exogenous IGF-I seems to protect mucosal cells in the small intestine against SAP-induced apoptosis and could alleviate SAP-induced injury of the intestinal mucosa. The underlying mechanisms include enhanced mRNA expression of bcl-2 and inhibition of bax mRNA expression. | 25,215,066 | [
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Undergraduate paramedic students cannot do drug calculations. | Previous investigation of drug calculation skills of qualified paramedics has highlighted poor mathematical ability with no published studies having been undertaken on undergraduate paramedics. There are three major error classifications. Conceptual errors involve an inability to formulate an equation from information given, arithmetical errors involve an inability to operate a given equation, and finally computation errors are simple errors of addition, subtraction, division and multiplication. The objective of this study was to determine if undergraduate paramedics at a large Australia university could accurately perform common drug calculations and basic mathematical equations normally required in the workplace. A cross-sectional study methodology using a paper-based questionnaire was administered to undergraduate paramedic students to collect demographical data, student attitudes regarding their drug calculation performance, and answers to a series of basic mathematical and drug calculation questions. Ethics approval was granted. The mean score of correct answers was 39.5% with one student scoring 100%, 3.3% of students (n=3) scoring greater than 90%, and 63% (n=58) scoring 50% or less, despite 62% (n=57) of the students stating they 'did not have any drug calculations issues'. On average those who completed a minimum of year 12 Specialist Maths achieved scores over 50%. Conceptual errors made up 48.5%, arithmetical 31.1% and computational 17.4%. This study suggests undergraduate paramedics have deficiencies in performing accurate calculations, with conceptual errors indicating a fundamental lack of mathematical understanding. The results suggest an unacceptable level of mathematical competence to practice safely in the unpredictable prehospital environment. | 25,215,067 | [
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Overview of the shenzhen emergency medical service call pattern. | In Shenzhen, the Emergency Medical Service (EMS) system has been in service since 1997. This study aims to examine the operation of Shenzhen 120 EMS center and to identify the reasons of calling EMS. In this retrospective quantitative descriptive study, the data from the Shenzhen 120 EMS registry in 2011 were analyzed. Shenzhen 120 EMS center is a communication command center. When the number of 120 are dialed, it is forwarded to the closest appropriate hospital for ambulance dispatch. In 2011, the Shenzhen 120 EMS center received 153 160 ambulance calls, with an average of 420 calls per day. Calling emergency services was mainly due to traffic accidents. Trauma and other acute diseases constituted a majority of ambulance transports. The adult patients aged 15-60 years are the principal users of EMS. There are no recognized 'paramedic' doctors and nurses. The pre-hospital emergency service is under the operation of emergency departments of hospitals. Shenzhen at present does not have specialized pre-hospital training for doctors and nurses in post-trauma management. Moreover, specialized pre-hospital training, financial support, and public health education on proper use of EMS should be emphasized. The Shenzhen 120 EMS center has its own epidemiology characteristics. Traumatic injury and traffic accident are the main reasons for calling ambulance service. In-depth study emphasizing the distribution and characteristics of trauma patients is crucial to the future development of EMS. | 25,215,072 | [
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General characteristics of patients with electrolyte imbalance admitted to emergency department. | Fluid and electrolyte balance is a key concept to understand for maintaining homeostasis, and for a successful treatment of many metabolic disorders. There are various regulating mechanisms for the equilibrium of electrolytes in organisms. Disorders of these mechanisms result in electrolyte imbalances that may be life-threatening clinical conditions. In this study we defined the electrolyte imbalance characteristics of patients admitted to our emergency department. This study was conducted in the Emergency Department (ED) of Uludag University Faculty of Medicine, and included 996 patients over 18 years of age. All patients had electrolyte imbalance, with various etiologies other than traumatic origin. Demographic and clinical parameters were collected after obtaining informed consent from the patients. The ethical committee of the university approved this study. The mean age of the patients was 59.28±16.79, and 55% of the patients were male. The common symptoms of the patients were dyspnea (14.7%), fever (13.7%), and systemic deterioration (11.9%); but the most and least frequent electrolyte imbalances were hyponatremia and hypermagnesemia, respectively. Most frequent findings in physical examination were confusion (14%), edema (10%) and rales (9%); and most frequent pathological findings in ECG were tachycardia in 24%, and atrial fibrillation in 7% of the patients. Most frequent comorbidity was malignancy (39%). Most frequent diagnoses in the patients were sepsis (11%), pneumonia (9%), and acute renal failure (7%). Electrolyte imbalances are of particular importance in the treatment of ED patients. Therefore, ED physicians must be acknowledged of their fluid-electrolyte balance dynamics and general characteristics. | 25,215,103 | [
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Therapeutic benefits of mild hypothermia in patients successfully resuscitated from cardiac arrest: A meta-analysis. | Good neurological outcome after cardiac arrest (CA) is hard to achieve for clinicians. Experimental and clinical evidence suggests that therapeutic mild hypothermia is beneficial. This study aimed to assess the effectiveness and safety of therapeutic mild hypothermia in patients successfully resuscitated from CA using a meta-analysis. We searched the MEDLINE (1966 to April 2012), OVID (1980 to April 2012), EMBASE (1980 to April 2012), Chinese bio-medical literature & retrieval system (CBM) (1978 to April 2012), Chinese medical current contents (CMCC) (1995 to April 2012), and Chinese medical academic conference (CMAC) (1994 to April 2012). Studies were included if 1) the study design was a randomized controlled trial (RCT); 2) the study population included patients successfully resuscitated from CA, and received either standard post-resuscitation care with normothermia or mild hypothermia; 3) the study provided data on good neurologic outcome and survival to hospital discharge. Relative risk (RR) and 95% confidence interval (CI) were used to pool the effect. The study included four RCTs with a total of 417 patients successfully resuscitated from CA. Compared to standard post-resuscitation care with normothermia, patients in the hypothermia group were more likely to have good neurologic outcome (RR=1.43, 95% CI 1.14-1.80, P=0.002) and were more likely to survive to hospital discharge (RR=1.32, 95% CI 1.08-1.63, P=0.008). There was no significant difference in adverse events between the normothermia and hypothermia groups (P>0.05), nor heterogeneity and publication bias. Therapeutic mild hypothermia improves neurologic outcome and survival in patients successfully resuscitated from CA. | 25,215,129 | [
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Techniques of rapid sequence induction and intubation at a university teaching hospital. | Rapid sequence induction and intubation (RSII) is a medical procedure involving a prompt induction of general anesthesia by using cricoid pressure that prevents regurgitation of gastric contents. The factors affecting RSII are prophylaxis for aspiration, preoxygenation, drug and equipment preparation for RSII, ventilation after induction till intubation and patient condition. We sometimes saw difficulties with the practice of this technique in our hospital operation theatres. The aim of this study was to assess the techniques of rapid sequence induction and intubation. Hospital based observational study was conducted with a standardized checklist. All patients who were operated upon under general anesthesia during the study period were included. The techniques of RSII were observed during the induction of anesthesia by trained anesthetists. Altogether 140 patients were included in this study with a response rate of 95.2%. Prophylaxis was not given to 130 patients (92.2%), and appropriate drugs were not used for RSII in 73 patients (52.1%), equipments for difficult intubation in 21 (15%), suction machines with catheter not connected and turned on in 122 (87.1%), ventilation for patients after induction and before intubation in 41 (29.3%), cricoid pressure released before cuff inflation in 12 (12.1%), and difficult intubation in 8 (5.7%), respectively. RSII with cricoid pressure was applied appropriately in 94 (67.1%) patients, but cricoid pressure was not used in 46 (32.9%) patients. The techniques of rapid sequence induction and intubation was low. Training should be given for anesthetists about the techniques of RSII. | 25,215,158 | [
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An Investigation on Mitochondrial DNA Deletions and Telomere Shortening during Multiple Passages of Adult Stem Cells. | Limited resources for adult stem cells necessitate their in vitro culture prior to clinical use. Investigating mitochondrial DNA (mtDNA) and telomere shortening has proved to be important indications of stem cell validity. This study was designed to investigate these indicators in multiple passages of three adult stem cell lines which were produced in our stem cell laboratory. In this study, Dental Pulp Stem Cells (DPSCs), Periapical Follicle Stem Cells (PAFSCs) and Human Foreskin Fibroblast (HFF) cell lines were expanded for 20 passages. After 1, 5, 10, 15 and 20 passages, expanded cells were harvested and DNA was extracted for further studies. Common mtDNA mutation was detected by multiplex PCR and telomere shortening was tested by Southern blot analysis. The common deletion was not detected in any of the stem cells or cell lines after several passages. In addition, Southern blot analysis indicated that the mean difference of telomere length between first and last passage was 0.25 kb in DPSC, 0.1 kb in PAFSC and 0.32 kb in HFF which indicates that the mean telomere length in various passages of the samples showed insignificant changes. Absence of mtDNA mutations in adult stem cell lines indicates good mitochondrial function even after 20 passages. In addition, absence of telomere shortening indicates stem cells validity after multiple passages. It is hoped this information could pave the way for using in vitro expansion of adult stem cells for future clinical applications. | 25,215,179 | [
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Genetic Profile Variation in Vaccine Strains and Clinical Isolates of Bordetella pertussis Recovered from Iranian Patients. | Re-emergence of pertussis has been reported in Iran despite a high rate of vaccination coverage. Low efficacy of the vaccine might be due to the genetic divergence between clinical versus vaccine strains. In the current study, the genetic profiles of clinical isolates and vaccine strains of Bordetella pertussis (B. pertussis) were assessed by using Pulsed Field Gel Electrophoresis (PFGE). Following phenotypic and molecular identification of isolates, XbaI-digested genomic DNA of 5 clinical isolates, 2 vaccine strains and a Tohama I strain were analyzed by PFGE along with B. parapertussis as a control. Seven distinct PFGE profiles were found among all examined isolates/strains. In 5 clinical isolates, 4 profiles were identified whereas the vaccine strains displayed 2 distinct profiles. The reference strain, Tohama I had a distinct profile. Vaccine and clinical profiles had low similarity, with relatedness of approximately 40%. The genetic profiles of B. pertussis were different between circulating isolates and vaccine strains used in the national vaccination programs. Since new genetic profiles of B. pertussis can be disseminated periodically, the profiles of isolates circulating in the population should be monitored over the course of the re-emergence. | 25,215,182 | [
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Biodegradability of oily wastewater using rotating biological contactor combined with an external membrane. | A novel implementation of a hybrid membrane bioreactor (HMBR) has been studied in this paper. It is utilized as combination of rotating biological contractor (RBC) and an external membrane, as a new biological system for oily wastewater treatment. Chemical oxygen demand (COD) and total petroleum hydrocarbon (TPH) as factors of Biodegradability has been evaluated. They are both compared together for different hydraulic retention times (HRTs) and petroleum pollution concentrations in RBC and HMBR. The ratio of TPH to COD of Molasses has been varied between 0.2 to 0.8 at two HRTs of 18 and 24 hours while the temperature, pH and dissolved oxygen were kept in the range of 20-25°C, 6.5-7.5, and 2-3.5 mg/l, respectively. The best TPH removal efficiency (99%) was observed in TPH/COD = 0.6 and HRT = 24 hr in HMBR and Removal efficiency was decreased in the ratios above 0.6 in both bioreactors. The experimental results showed that HMBR had higher treatment efficiency than RBC at all ratios and HRTs. | 25,215,189 | [
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The overlap between binge eating disorder and substance use disorders: Diagnosis and neurobiology. | Binge eating disorder (BED) is a relatively common condition, especially in young adult females, and is characterized by chronic over-consumption of food resulting in embarrassment, distress, and potential health problems. It is formally included as a disorder in DSM-5 for the first time, an acknowledgement to its debilitating nature. This article explores the overlap between binge eating disorder and substance use disorders (SUD). The bibliographic search was a computerized screen of PubMed databases from January 1990 to the present. Binge eating disorder, substance use disorder, binging, obesity, food addiction, comorbidity, dopamine, opioid, serotonin, glutamate, and pharmacological treatment were the keywords used in searching. BED shares similar phenomenology to SUD, including significant urges to engage in binging episodes, resulting in distress and impairment. Similar neurobiological pathways are found in both BED and SUD and medications based on similar neurobiology have been examined for both disorders. A subset of individuals with BED may have a "food addiction", but there is no clinical agreement on the meaning of "food addiction". Exploring the relationship between BED and obesity may also shed light on the extent to which BED can be viewed as an addiction. Overall, nascent research regarding BED and SUD suggests an overlap between these disorders, but there are discrepancies between these two disorders that need further exploration. | 25,215,200 | [
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A preliminary investigation into the prevalence and prediction of problematic cell phone use. | Likening mobile phone use dependency to the classification of excessive behaviors may be necessarily equivalent in seriousness to previously established addictions such as problematic computing or excessive gambling. The aim of the study explores into the behavior of excessive use of mobile phones as a pathological behavior. Two studies investigated criteria for problematic mobile phone usage by examining student (Study 1, N = 301) and nonstudent (Study 2, N = 362) responses to a set of adapted mobile phone addiction inventories. Study 1 investigated cell phone addiction inventories as constructs designed to measure problematic cell phone use. Additionally, Study 2 sought to predict age, depression, extraversion, emotional stability, impulse control, and self-esteem as independent variables that augment respondents' perceptions of problematic use. The results from Study 1 and Study 2 indicate that 10 to 25% of the participants tested exhibited problematic cell phone usage. Additionally, age, depression, extraversion, and low impulse control are the most suitable predictors for problematic use. The results of the two studies indicate that problematic mobile phone use does occur and ought to be taken seriously by the psychological community. Presently, there is limited data providing conclusive evidence for a comprehensible categorization of cell phone addiction, as well as a unified explanatory model specific to problematic mobile phone use. Studies such as this one may contribute substantial findings, adding scientific significance, and offering a valuable submission for the ongoing progress of creating intervention frameworks relative to "virtual addictions". | 25,215,213 | [
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The influence of advertising on compulsive buying - The role of persuasion knowledge. | The growing concern over compulsive buying (CB) among consumers has led to vast amount of research examining the antecedents of this maladaptive behaviour. The focus of previous research was, however, mainly on examining the internal, psychological factors contributing to CB. The current research, on the other hand, sheds light on one of the external triggers which can possibly stimulate CB, namely advertising. An online survey has been conducted to identify the attitudes and scepticism towards advertising as well as ad avoidance and persuasion knowledge among a sample of 582 Belgian consumers. Furthermore, all participants were screened with regard to compulsive buying tendencies. This research provides evidence that positive attitudes towards advertising can lead to CB. An important factor in this relation is persuasion knowledge. The study results lead to the conclusion that people higher in persuasion knowledge dispose less positive attitudes towards advertising which can subsequently prevent them from engaging in CB. Moreover high scores on scepticism towards advertising and ad avoidance among Belgian consumers in our sample point to a need for advertisers to modify their practices in order to gain more trust from consumers. This study also shows that advertising in particular attracts and seems to affect an already disadvantaged group of people - namely compulsive buyers. | 25,215,215 | [
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An exploratory examination of marijuana use, problem-gambling severity, and health correlates among adolescents. | Gambling is common in adolescents and at-risk and problem/pathological gambling (ARPG) is associated with adverse measures of health and functioning in this population. Although ARPG commonly co-occurs with marijuana use, little is known how marijuana use influences the relationship between problem-gambling severity and health- and gambling-related measures. Survey data from 2,252 Connecticut high school students were analyzed using chi-square and logistic regression analyses. ARPG was found more frequently in adolescents with lifetime marijuana use than in adolescents denying marijuana use. Marijuana use was associated with more severe and a higher frequency of gambling-related behaviors and different motivations for gambling. Multiple health/functioning impairments were differentially associated with problem-gambling severity amongst adolescents with and without marijuana use. Significant marijuana-use-by-problem-gambling-severity-group interactions were observed for low-average grades (OR = 0.39, 95% CI = [0.20, 0.77]), cigarette smoking (OR = 0.38, 95% CI = [0.17, 0.83]), current alcohol use (OR = 0.36, 95% CI = [0.14, 0.91]), and gambling with friends (OR = 0.47, 95% CI = [0.28, 0.77]). In all cases, weaker associations between problem-gambling severity and health/functioning correlates were observed in the marijuana-use group as compared to the marijuana-non-use group. Some academic, substance use, and social factors related to problem-gambling severity may be partially accounted for by a relationship with marijuana use. Identifying specific factors that underlie the relationships between specific attitudes and behaviors with gambling problems and marijuana use may help improve intervention strategies. | 25,215,219 | [
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Proliferation in the Alzheimer hippocampus is due to microglia, not astroglia, and occurs at sites of amyloid deposition. | Microglia and astrocytes contribute to Alzheimer's disease (AD) etiology and may mediate early neuroinflammatory responses. Despite their possible role in disease progression and despite the fact that they can respond to amyloid deposition in model systems, little is known about whether astro- or microglia can undergo proliferation in AD and whether this is related to the clinical symptoms or to local neuropathological changes. Previously, proliferation was found to be increased in glia-rich regions of the presenile hippocampus. Since their phenotype was unknown, we here used two novel triple-immunohistochemical protocols to study proliferation in astro- or microglia in relation to amyloid pathology. We selected different age-matched cohorts to study whether proliferative changes relate to clinical severity or to neuropathological changes. Proliferating cells were found across the hippocampus but never in mature neurons or astrocytes. Almost all proliferating cells were co-labeled with Iba1+, indicating that particularly microglia contribute to proliferation in AD. Proliferating Iba1+ cells was specifically seen within the borders of amyloid plaques, indicative of an active involvement in, or response to, plaque accumulation. Thus, consistent with animal studies, proliferation in the AD hippocampus is due to microglia, occurs in close proximity of plaque pathology, and may contribute to the neuroinflammation common in AD. | 25,215,243 | [
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Nicardipine-induced acute pulmonary edema: a rare but severe complication of tocolysis. | We report four cases of acute pulmonary edema that occurred during treatment by intravenous tocolysis using nicardipine in pregnancy patients with no previous heart problems. Clinical severity justified hospitalization in intensive care unit (ICU) each time. Acute dyspnea has begun at an average of 63 hours after initiation of treatment. For all patients, the first diagnosis suspected was pulmonary embolism. The patients' condition improved rapidly with appropriate diuretic treatment and by modifying the tocolysis. The use of intravenous nicardipine is widely used for tocolysis in France even if its prescription does not have a marketing authorization. The pathophysiological mechanisms of this complication remain unclear. The main reported risk factors are spontaneous preterm labor, multiple pregnancy, concomitant obstetrical disease, association with beta-agonists, and fetal lung maturation corticotherapy. A better knowledge of this rare but serious adverse event should improve the management of patients. Nifedipine or atosiban, the efficiency of which tocolysis was also studied, could be an alternative. | 25,215,245 | [
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A Case of Chronic Ethylene Glycol Intoxication Presenting without Classic Metabolic Derangements. | Acute ethylene glycol ingestion classically presents with high anion gap acidosis, elevated osmolar gap, altered mental status, and acute renal failure. However, chronic ingestion of ethylene glycol is a challenging diagnosis that can present as acute kidney injury with subtle physical findings and without the classic metabolic derangements. We present a case of chronic ethylene glycol ingestion in a patient who presented with acute kidney injury and repeated denials of an exposure history. Kidney biopsy was critical to the elucidation of the cause of his worsening renal function. | 25,215,251 | [
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Anti-Inflammatory Effect of Emblica officinalis in Rodent Models of Acute and Chronic Inflammation: Involvement of Possible Mechanisms. | Emblica officinalis, commonly known as amla in Ayurveda, is unarguably the most important medicinal plant for prevention and treatment of various ailments. The present study investigated the anti-inflammatory activity of hydroalcoholic extract of Emblica officinalis (HAEEO). Acute inflammation in rats was induced by the subplantar injection of carrageenan, histamine, serotonin, and prostaglandin E2 and chronic inflammation was induced by the cotton pellet granuloma. Intraperitoneal (i.p.) administration of HAEEO at all the tested doses (300, 500, and 700 mg/kg) significantly (P < 0.001) inhibited rat paw edema against all phlogistic agents and also reduced granuloma formation. However, at the dose of 700 mg/kg, HAEEO exhibited maximum anti-inflammatory activity in all experimental models, and the effects were comparable to that of the standard anti-inflammatory drugs. Additionally, in paw tissue the antioxidant activity of HAEEO was also measured and it was found that HAEEO significantly (P < 0.001) increased glutathione, superoxide dismutase, and catalase activity and subsequently reduced lipid peroxidation evidenced by reduced malondialdehyde. Taken all together, the results indicated that HAEEO possessed potent anti-inflammatory activity and it may hold therapeutic promise in the management of acute and chronic inflammatory conditions. | 25,215,258 | [
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Animal Models of Psychosis: Current State and Future Directions. | Psychosis is an abnormal mental state characterized by disorganization, delusions and hallucinations. Animal models have become an increasingly important research tool in the effort to understand both the underlying pathophysiology and treatment of psychosis. There are multiple animal models for psychosis, with each formed by the coupling of a manipulation and a measurement. In this manuscript we do not address the diseases of which psychosis is a prominent comorbidity. Instead, we summarize the current state of affairs and future directions for animal models of psychosis. To accomplish this, our manuscript will first discuss relevant behavioral and electrophysiological measurements. We then provide an overview of the different manipulations that are combined with these measurements to produce animal models. The strengths and limitations of each model will be addressed in order to evaluate its cross-species comparability. | 25,215,267 | [
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Diabetic kidney disease: from epidemiology to clinical perspectives. | With worldwide epidemic of diabetes mellitus, diabetic nephropathy which is one of the major causes of microvascular complication has become a serious concern in Korea as well as the rest of the world. In view of its significance, there is an urgent and paramount need for proper managements that could either deter or slow the progression of diabetic nephropathy. Despite advances in care, ever increasing number of patients suffering from diabetic kidney disease and from end-stage renal disease implies that the current management is not adequate in many aspects. The reasons for these inadequacies compromise lack of early diagnosis, failure to intervene with timely and aggressive manner, and lack of understanding on the kind of interventions required. Another issue equally important for the adequate care of patients with diabetic nephropathy is an understanding of past, present and future epidemiology of diabetic nephropathy which serves, especially in Korea, as a material determining standard diagnosis and treatment and a national health-policy decision. | 25,215,271 | [
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The presence of biomarker enzymes of selected Scleractinian corals of Palk Bay, southeast coast of India. | The health and existence of coral reefs are in danger by an increasing range of environmental and anthropogenic impacts. The causes of coral reef decline include worldwide climate change, shoreline development, habitat destruction, pollution, sedimentation and overexploitation. These disasters have contributed to an estimated loss of 27% of the reefs. If the current pressure continues unabated, the estimated loss of coral reef will be about 60% by the year 2030. Therefore, the present study was aimed to analyze the enzymes involved in stress induced by coral pathogen and its resistance. We focused on the enzymes involved in melanin synthesis pathway (phenoloxidase (PO) and peroxidases (POD)) and free radical scavenging enzymes (super oxide dismutase (SOD), catalase (CAT)) and glutathione peroxidase (Gpx) in selected scleractinian corals such as Acropora formosa, Echinopora lamellosa, Favia favus, Favites halicora, Porites sp., and Anacropora forbesi. Overall, PO activity of coral was significantly lower than that of zooxanthellae except for Favia favus. Coral colonies with lower PO and POD activities are prone to disease. Maximum antioxidant defensive enzymes were observed in Favia favus followed by Echinopora lamellose. It is concluded that assay of these enzymes can be used as biomarkers for identifying the susceptibility of corals towards coral bleaching induced by pathogen. | 25,215,288 | [
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Clinical features and genetic analysis of 20 Chinese patients with X-linked hyper-IgM syndrome. | X-linked hyper-IgM syndrome (XHIGM) is one type of primary immunodeficiency diseases, resulting from defects in the CD40 ligand/CD40 signaling pathways. We retrospectively analyzed the clinical and molecular features of 20 Chinese patients diagnosed and followed up in hospitals affiliated to Shanghai Jiao Tong University School of Medicine from 1999 to 2013. The median onset age of these patients was 8.5 months (range: 20 days-21 months). Half of them had positive family histories, with a shorter diagnosis lag. The most common symptoms were recurrent sinopulmonary infections (18 patients, 90%), neutropenia (14 patients, 70%), oral ulcer (13 patients, 65%), and protracted diarrhea (13 patients, 65%). Six patients had BCGitis. Six patients received hematopoietic stem cell transplantations and four of them had immune reconstructions and clinical remissions. Eighteen unique mutations in CD40L gene were identified in these 20 patients from 19 unrelated families, with 12 novel mutations. We compared with reported mutation results and used bioinformatics software to predict the effects of mutations on the target protein. These mutations reflected the heterogeneity of CD40L gene and expanded our understanding of XHIGM. | 25,215,306 | [
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Multiple object tracking using the shortest path faster association algorithm. | To solve the persistently multiple object tracking in cluttered environments, this paper presents a novel tracking association approach based on the shortest path faster algorithm. First, the multiple object tracking is formulated as an integer programming problem of the flow network. Then we relax the integer programming to a standard linear programming problem. Therefore, the global optimum can be quickly obtained using the shortest path faster algorithm. The proposed method avoids the difficulties of integer programming, and it has a lower worst-case complexity than competing methods but better robustness and tracking accuracy in complex environments. Simulation results show that the proposed algorithm takes less time than other state-of-the-art methods and can operate in real time. | 25,215,322 | [
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Numerical study on tsunami hazard mitigation using a submerged breakwater. | Most coastal structures have been built in surf zones to protect coastal areas. In general, the transformation of waves in the surf zone is quite complicated and numerous hazards to coastal communities may be associated with such phenomena. Therefore, the behavior of waves in the surf zone should be carefully analyzed and predicted. Furthermore, an accurate analysis of deformed waves around coastal structures is directly related to the construction of economically sound and safe coastal structures because wave height plays an important role in determining the weight and shape of a levee body or armoring material. In this study, a numerical model using a large eddy simulation is employed to predict the runup heights of nonlinear waves that passed a submerged structure in the surf zone. Reduced runup heights are also predicted, and their characteristics in terms of wave reflection, transmission, and dissipation coefficients are investigated. | 25,215,334 | [
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Advances in dental materials. | The dental market is replete with new resorative materials marketed on the basis of novel technological advances in materials chemistry, bonding capability or reduced operator time and/or technique sensitivity. This paper aims to consider advances in current materials, with an emphasis on their role in supporting contemporary clinical practice. | 25,215,343 | [
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[Good local control by supracricoid partial laryngectomy (SCPL)]. | The suprachoroidale partial laryngectomy (SCPL) can provide organ-preserving alternative to total laryngectomy in selected endolaryngeal malignancies. In a large case series Sperry et al. retrospectively analyzed the surgical and oncological outcome. | 25,215,385 | [
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Long-term outcomes of bilateral pallidal stimulation for primary generalised dystonia. | Bilateral pallidal stimulation is an established surgical management for patients with primary generalised dystonia (PGD). The aim of this study was to present our long-term experience of bilateral pallidal stimulation in patients with PGD. The study population is composed of 12 patients diagnosed with of PGD (six patients with DYT-1 positive PGD and six patients with DYT-1 negative PGD). The patients were operated under general anaesthesia with no intraoperative target refinement by means of microrecording. The stereotactic technique was based on a combination of the indirect targeting technique relative to the midcommisural point coordinates and direct image-guided MRI target refinement. The formal objective assessment included the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS). The BFMDRS assessment was performed before and after it annually up to five years when bilateral pallidal stimulation was switched on and compared to baseline scores. Baseline BFMDRS scores and subsequent follow-up BFMDRS scores were compared with the use of a Wilcoxon signed-rank test for matched pairs. A two-tailed probability level of 5% (p<0.05) was considered significant. At the last follow-up visit, in patients with DYT-1 positive PGD the mean preoperative functional and motor scores of the BFMDRS decreased from 14.0 and 63.75 to postoperative scores of 5.75 (p=0.068) and 22.0 (p=0.066), respectively. In patients with DYT-1 negative PGD the mean preoperative functional and motor scores of the BFMDRS decreased from 13.0 and 46.5 to postoperative scores of 5.25 (p=0.066) and 22.75 (p=0.068), respectively. The hardware-related complications affected seven patients. Our results indicate that bilateral pallidal stimulation is an effective treatment for patients with DYT-1 positive and DYT-1 negative PGD. The most common hardware-related complication (DBS lead breakage) in our series was associated with the slippage of the connector to the cervical area. To prevent this complication after changing the surgical technique (suturing and placing the connector in parietal region) we did not observe these complications. Unilateral IPG failure resulted in the development of severe status dystonicus. | 25,215,446 | [
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Contribution of groundwater discharge to the coastal dissolved nutrients and trace metal concentrations in Majorca Island: karstic vs detrital systems. | Submarine groundwater discharge (SGD) and derived nutrient (NO2(-), NO3(-), NH4(+), PO4(3-), and SiO2) and trace element (Cd, Co, Cu, Fe, Mo, Ni, Pb, V and Zn) loadings to the coastal sea were systematically assessed along the coast of Majorca Island, Spain, in a general survey around the island and in three representative coves during 2010. We estimated that brackish water discharges through the shoreline are important contributors to the DIN, SiO2, Fe, and Zn budgets of the nearshore waters. Furthermore, our results showed that SGD-derived elements are conditioned by the hydrogeological formations of the aquifer and discharge type. Thus, while rapid discharges through karstic conduits are enriched in SiO2 and Zn, the large detrital aquifers of the island typically present enhanced concentrations of Fe. The estimated total annual inputs of chemicals constituents discharged by SGD to the coastal waters were as follows: DIN: 610 × 10(3) kg yr(-1), SiO2: 1400 × 10(3) kg yr(-1), Fe: 3.2 × 10(3) kg yr(-1), and Zn: 2.0 × 10(3) kg yr(-1). Our results provide evidence that SGD is a major contributor to the dissolved pool of inorganic nutrients and trace metals in the nearshore waters of Majorca. | 25,215,451 | [
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Health risk assessment of Chinese consumers to nickel via dietary intake of foodstuffs. | A quantitative risk assessment was carried out to characterise the health risk from nickel (Ni) via dietary exposure for Chinese consumers. Ni contamination in foods was investigated by conducting a survey and a literature review. The daily diet of the public was categorised into nine food groups and the consumption data for each group were obtained from a nationwide survey. Deterministic and probabilistic methods were applied to calculate the target hazard quotients (THQs) by comparing the estimated dietary Ni intake with respect to the tolerable daily intake (TDI). The average estimated daily Ni intake (μg kg(-1) bw day(-1)) for men, women, 2-3-year-old children and 4-17-year-old children were 7.2, 7.3, 17.1 and 10.0, respectively. The consumption of cereals, beans, vegetables and marine products contributed significantly to the total daily intake of Ni. The mean THQ values (95% confidence interval) and the probability of dietary Ni exposure higher than the TDI were 0.60 (0.58-0.62) and 8.2% for men, 0.61 (0.59-0.63) and 8.4% for women, 1.35 (1.32-1.39) and 72.0% for 2-3-year-old children, and 0.87 (0.82-0.91) and 28.5% for 4-17-year-old children, respectively. This study showed a potential health risk from Ni via dietary exposure for Chinese consumers, especially among children. | 25,215,469 | [
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Inflammatory response in Parkinson's disease (Review). | Parkinson's disease (PD) is one of the most common age‑related neurodegenerative diseases, which results from a number of environmental and inherited factors. PD is characterized by the slow progressive degeneration of dopaminergic (DA) neurons in the substantia nigra. The nigrostriatal DA neurons are particularly vulnerable to inflammatory attack. Neuroinflammation is an important contributor to the pathogenesis of age‑related neurodegenerative disorders, such as PD, and as such anti‑inflammatory agents are becoming a novel therapeutic focus. This review will discuss the current knowledge regarding inflammation and review the roles of intracellular inflammatory signaling pathways, which are specific inflammatory mediators in PD. Finally, possible therapeutic strategies are proposed, which may downregulate inflammatory processes and inhibit the progression of PD. | 25,215,472 | [
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Replication of the 4p16 susceptibility locus in congenital heart disease in Han Chinese populations. | Congenital heart disease (CHD) is the most common form of congenital human birth anomalies and a leading cause of perinatal and infant mortality. Some studies including our published genome-wide association study (GWAS) of CHD have indicated that genetic variants may contribute to the risk of CHD. Recently, Cordell et al. published a GWAS of multiple CHD phenotypes in European Caucasians and identified 3 susceptibility loci (rs870142, rs16835979 and rs6824295) for ostium secundum atrial septal defect (ASD) at chromosome 4p16. However, whether these loci at 4p16 confer the predisposition to CHD in Chinese population is unclear. In the current study, we first analyzed the associations between these 3 single nucleotide polymorphisms (SNPs) at 4p16 and CHD risk by using our existing genome-wide scan data and found all of the 3 SNPs showed significant associations with ASD in the same direction as that observed in Cordell's study, but not with other subtypes- ventricular septal defect (VSD) and ASD combined VSD. As these 3 SNPs were in high linkage disequilibrium (LD) in Chinese population, we selected one SNP with the lowest P value in our GWAS scan (rs16835979) to perform a replication study with additional 1,709 CHD cases with multiple phenotypes and 1,962 controls. The significant association was also observed only within the ASD subgroup, which was heterogeneous from other disease groups. In combined GWAS and replication samples, the minor allele of rs16835979 remained significant association with the risk of ASD (OR = 1.22, 95% CI = 1.08-1.38, P = 0.001). Our findings suggest that susceptibility loci of ASD identified from Cordell's European GWAS are generalizable to Chinese population, and such investigation may provide new insights into the roles of genetic variants in the etiology of different CHD phenotypes. | 25,215,500 | [
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Experimental validation of the role of trifluoroethanol as a nanocrowder. | Trifluoroethanol (TFE) is commonly used to induce protein secondary structure, especially α-helix formation. Due to its amphiphilic nature, however, TFE can also self-associate to form micellelike, nanometer-sized clusters. Herein, we hypothesize that such clusters can act as nanocrowders to increase protein folding rates via the excluded volume effect. To test this hypothesis, we measure the conformational relaxation kinetics of an intrinsically disordered protein, the phosphorylated kinase inducible domain (pKID), which forms a helix-turn-helix in TFE solutions. We find that the conformational relaxation rate of pKID displays a rather complex dependence on TFE percentage (v/v): while it first decreases between 0 and 5%, between 5 and 15% the rate increases and then remains relatively unchanged between 15 and 30% and finally decreases again at higher percentages (i.e., 50%). This trend coincides with the fact that TFE clustering is maximized in the range of 15-30%, thus providing validation of our hypothesis. Another line of supporting evidence comes from the observation that the relaxation rate of a monomeric helical peptide, which due to its predominantly local interactions in the folded state is less affected by crowding, does not show a similar TFE dependence. | 25,215,518 | [
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Acid reflux directly causes sleep disturbances in rat with chronic esophagitis. | Gastroesophageal reflux disease (GERD) is strongly associated with sleep disturbances. Proton pump inhibitor (PPI) therapy improves subjective but not objective sleep parameters in patients with GERD. This study aimed to investigate the association between GERD and sleep, and the effect of PPI on sleep by using a rat model of chronic acid reflux esophagitis. Acid reflux esophagitis was induced by ligating the transitional region between the forestomach and the glandular portion and then wrapping the duodenum near the pylorus. Rats underwent surgery for implantation of electrodes for electroencephalogram and electromyogram recordings, and they were transferred to a soundproof recording chamber. Polygraphic recordings were scored by using 10-s epochs for wake, rapid eye movement sleep, and non-rapid eye movement (NREM) sleep. To examine the role of acid reflux, rats were subcutaneously administered a PPI, omeprazole, at a dose of 20 mg/kg once daily. Rats with reflux esophagitis presented with several erosions, ulcers, and mucosal thickening with basal hyperplasia and marked inflammatory infiltration. The reflux esophagitis group showed a 34.0% increase in wake (232.2±11.4 min and 173.3±7.4 min in the reflux esophagitis and control groups, respectively; p<0.01) accompanied by a reduction in NREM sleep during light period, an increase in sleep fragmentation, and more frequent stage transitions. The use of omeprazole significantly improved sleep disturbances caused by reflux esophagitis, and this effect was not observed when the PPI was withdrawn. Acid reflux directly causes sleep disturbances in rats with chronic esophagitis. | 25,215,524 | [
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PP4 is essential for germinal center formation and class switch recombination in mice. | PP4 is a serine/threonine phosphatase required for immunoglobulin (Ig) VDJ recombination and pro-B/pre-B cell development in mice. To elucidate the role of PP4 in mature B cells, we ablated the catalytic subunit of murine PP4 in vivo utilizing the CD23 promoter and cre-loxP recombination and generated CD23(cre)PP4(F/F) mice. The development of follicular and marginal zone B cells was unaffected in these mutants, but the proliferation of mature PP4-deficient B cells stimulated by in vitro treatment with either anti-IgM antibody (Ab) or LPS was partially impaired. Interestingly, the induction of CD80 and CD86 expression on these stimulated B cells was normal. Basal levels of serum Igs of all isotypes were strongly reduced in CD23(cre)PP4(F/F) mice, and their B cells showed a reduced efficiency of class switch recombination (CSR) in vitro upon stimulation by LPS or LPS plus IL-4. When CD23(cre)PP4(F/F) mice were challenged with either the T cell-dependent antigen TNP-KLH or the T cell-independent antigen TNP-Ficoll, or by H1N1 virus infection, the mutant animals failed to form germinal centers (GCs) in the spleen and the draining mediastinal lymph nodes, and did not efficiently mount antigen-specific humoral responses. In the resting state, PP4-deficient B cells exhibited pre-existing DNA fragmentation. Upon stimulation by DNA-damaging drug etoposide in vitro, mutant B cells showed increased cleavage of caspase 3. In addition, the mutant B cells displayed impaired CD40-mediated MAPK activation, abnormal IgM-mediated NF-κB activation, and reduced S phase entry upon IgM/CD40-stimulation. Taken together, our results establish a novel role for PP4 in CSR, and reveal crucial functions for PP4 in the maintenance of genomic stability, GC formation, and B cell-mediated immune responses. | 25,215,539 | [
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Is 18F-fluorocholine-positron emission tomography/computerized tomography a new imaging tool for detecting hyperfunctioning parathyroid glands in primary or secondary hyperparathyroidism? | Preoperative ultrasonography and scintigraphy using (99m)Tc-sestamibi are commonly used to localize abnormal parathyroid glands. In cases of discrepant results between scintigraphy and ultrasonography, it is important to rely on another diagnostic imaging modality. (18)F-fluorodeoxyglucose (FDG) and (11)C-methionine positron emission tomography (PET) have been studied, but are imperfect to detect abnormal parathyroid glands. Recently, first cases of abnormal parathyroid glands taking-up radiolabelled choline were discovered incidentally in men referred to (11)C-choline or (18)F-fluorocholine (FCH)-PET/CT for prostate cancer. We checked if FCH uptake was a general feature of adenomatous or hyperplastic parathyroid glands. FCH-PET/CT was performed in 12 patients with primary (n = 8) or secondary hyperparathyroidism (1 dialyzed, 3 grafted) and with discordant or equivocal results on preoperative ultrasonography (US) and/or (123)I/(99m)Tc-sestamibi dual-phase scintigraphy. The results of the FCH-PET/CT were evaluated, with surgical exploration and histopathologic examination as the standard of truth. On a per-patient level, the detection rate of FCH-PET/CT (at least one FCH focus corresponding to an abnormal parathyroid gland in a given patient) was 11/12 = 92%. FCH-PET/CT detected 18 foci interpreted as parathyroid glands and correctly localized 17 abnormal parathyroid glands (7 adenomas and 10 hyperplasias). On a per-lesion level, FCH-PET/CT results were 17 TP, 2 false negative ie, a lesion-based sensitivity of 89%, and 1 false positive. As the main result of this pilot study, we show that in patients with hyperparathyroidism and with discordant or equivocal results on scintigraphy or on ultrasonography, adenomatous or hyperplastic parathyroid glands can be localized by FCH-PET/CT with good accuracy. Furthermore, FCH-PET/CT can solve discrepant results between preoperative ultrasonography and scintigraphy and has thus a potential as a functional imaging modality in the detection of abnormal parathyroid glands. Our preliminary results are encouraging and prompt us to further evaluate FCH-PET/CT as a functional imaging agent in patients with biochemical hyperparathyroidism. | 25,215,560 | [
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Resistivity peaks and magnetic properties of an annealed graphene. | We report on the transport and magnetic properties of graphene annealed at 800 °C under an Ar atmosphere. Temperature dependence of resistivity of the annealed graphene shows that the ferromagnetic Curie temperature can be observed from the magnetoimpurity model. The Curie temperature is 220 K for the annealed graphene. | 25,215,565 | [
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Mechanism of action of peptidoglycan O-acetyltransferase B involves a Ser-His-Asp catalytic triad. | The O-acetylation of the essential cell wall polymer peptidoglycan is essential in many bacteria for their integrity and survival, and it is catalyzed by peptidoglycan O-acetlytransferase B (PatB). Using PatB from Neisseria gonorrhoeae as the model, we have shown previously that the enzyme has specificity for polymeric muropeptides that possess tri- and tetrapeptide stems and that rates of reaction increase with increasing degrees of polymerization. Here, we present the catalytic mechanism of action of PatB, the first to be described for an O-acetyltransferase of any bacterial exopolysaccharide. The influence of pH on PatB activity was investigated, and pKa values of 6.4-6.45 and 6.25-6.35 for the enzyme-substrate complex (kcat vs pH) and the free enzyme (kcat·KM(-1) vs pH), respectively, were determined for the respective cosubstrates. The enzyme is partially inactivated by sulfonyl fluorides but not by EDTA, suggesting the participation of a serine residue in its catalytic mechanism. Alignment of the known and hypothetical PatB amino acid sequences identified Ser133, Asp302, and His305 as three invariant amino acid residues that could potentially serve as a catalytic triad. Replacement of Asp302 with Ala resulted in an enzyme with less than 20% residual activity, whereas activity was barely detectable with (His305 → Ala)PatB and (Ser133 → Ala)PatB was totally inactive. The reaction intermediate of the transferase reaction involving acetyl- and propionyl-acyl donors was trapped on both the wild-type and (Asp302 → Ala) enzymes and LC-MS/MS analysis of tryptic peptides identified Ser133 as the catalytic nucleophile. A transacetylase mechanism is proposed based on the mechanism of action of serine esterases. | 25,215,566 | [
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Biatrial tachycardia following linear anterior wall ablation for the perimitral reentry: incidence and electrophysiological evaluations. | A left atrial (LA) anterior ablation line (AnL), connecting the mitral annulus and right pulmonary veins or a roof line, has been suggested as an alternative to mitral isthmus (MI) ablation for perimitral flutter (PMF). Theoretically, the AnL can exclude the LA septal wall from the reentrant circle, and lead to involvement of the right atrium (RA) in a tachycardia (AT) mechanism. Among 807 patients undergoing atrial fibrillation ablation, PMF was diagnosed in 28 subjects, and AnL was performed in 13, and MI ablation in 15 cases. In 4 (31%) patients, AnL resulted in abrupt AT cycle length prolongation, which was associated with the development of a clockwise biatrial tachycardia (bi-AT). The bi-AT propagated along the lateral and posterior mitral annulus, entered the RA via the coronary sinus, and after activating the RA septum reentered the LA over the Bachmann's bundle. The bi-AT was terminated by ablation in Bachmann's bundle insertion areas in the RA or LA. No bi-AT was documented in the MI group. One patient in the AnL group died of stroke in 10 days following the procedure. Anatomic evaluation showed that at the level of the AnL the RA anteroseptal area was separated from the LA by the aortic root, and was free from ablation damage. A bi-AT can develop when an AnL is created for PMF termination. Biatrial entrainment mapping facilitates diagnosis. Termination of the bi-AT is feasible when ablated from either RA or LA. | 25,215,599 | [
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Listenmee and Listenmee smartphone application: synchronizing walking to rhythmic auditory cues to improve gait in Parkinson's disease. | Evidence supports the use of rhythmic external auditory signals to improve gait in PD patients (Arias & Cudeiro, 2008; Kenyon & Thaut, 2000; McIntosh, Rice & Thaut, 1994; McIntosh et al., 1997; Morris, Iansek, & Matyas, 1994; Thaut, McIntosh, & Rice, 1997; Suteerawattananon, Morris, Etnyre, Jankovic, & Protas , 2004; Willems, Nieuwboer, Chavert, & Desloovere, 2006). However, few prototypes are available for daily use, and to our knowledge, none utilize a smartphone application allowing individualized sounds and cadence. Therefore, we analyzed the effects on gait of Listenmee®, an intelligent glasses system with a portable auditory device, and present its smartphone application, the Listenmee app®, offering over 100 different sounds and an adjustable metronome to individualize the cueing rate as well as its smartwatch with accelerometer to detect magnitude and direction of the proper acceleration, track calorie count, sleep patterns, steps count and daily distances. The present study included patients with idiopathic PD presented gait disturbances including freezing. Auditory rhythmic cues were delivered through Listenmee®. Performance was analyzed in a motion and gait analysis laboratory. The results revealed significant improvements in gait performance over three major dependent variables: walking speed in 38.1%, cadence in 28.1% and stride length in 44.5%. Our findings suggest that auditory cueing through Listenmee® may significantly enhance gait performance. Further studies are needed to elucidate the potential role and maximize the benefits of these portable devices. | 25,215,623 | [
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CO oxidation catalyzed by single gold atoms supported on aluminum oxide clusters. | The single gold atom doped aluminum oxide clusters AuAl3O3(+), AuAl3O4(+), and AuAl3O5(+) have been prepared and mass-selected to react with CO, O2, and mixtures of CO and O2 in an ion trap reactor under thermal collision conditions. The reactions have been characterized by mass spectrometry with isotopic substitution ((16)O2 → (18)O2) and density functional theory calculations. The AuAl3O5(+) cluster can oxidize two CO molecules consecutively to form AuAl3O4(+) and then AuAl3O3(+), the latter of which can react with one O2 molecule to regenerate AuAl3O5(+). The AuAl3(16)O3(+) ions interact with a mixture of C(16)O and (18)O2 to produce the fully substituted (18)O species AuAl3(18)O3-5(+), which firmly identifies a catalytic cycle for CO oxidation by O2. The oxidation catalysis is driven by electron cycling primarily through making and breaking a gold-aluminum chemical bond. To the best of our knowledge, this is the first identification of catalytic CO oxidation by O2 mediated with gas-phase cluster catalysts with single-noble-metal atoms, which serves as an important step to understand single-atom catalysis at strictly a molecular level. | 25,215,631 | [
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Phenethyl isothiocyanate suppresses cervical carcinoma metastasis potential and its molecular mechanism. | Tumor metastasis is a prominent cause of treatment failure in cervical carcinoma. Phenethyl isothiocyanate (PEITC) is an active component extracted from cruciferous plants that has exhibited anticancer activity in various types of human cancer; however, its effect on the inhibition of metastasis remains unclear. The current study aimed to explore the effect of PEITC on the suppression of metastasis in HeLa cervical carcinoma cells. Multiple variables were assessed with different methods as follows: Cell viability, with a Vi‑CELL analyzer; cell adhesion, by MTS assay; cell invasion, by Transwell assay; cell cycle, by flow cytometry assay; cytokine concentration, by ELISA assay; metastasis‑related gene and protein expression, by quantitative polymerase chain reaction and western blotting; and transcription factor activity, by gene reporter assay. The results indicated that PEITC exhibited an inhibitory effect on the adhesion and invasion of HeLa cells by induction of G2/M phase arrest, it reduced the expression of CDK1, MMP‑2/9, CD44, ICAM‑1, increased the production of TGF‑β, IL‑6 and IL‑8, and increased the phosphorylation of Smad2. These results suggest that PEITC may be a potential antitumor compound, acting through the TGF‑β/Smad2 pathway; and it has the potential for future use as a therapy for cervical carcinoma subsequent to further studies. | 25,215,638 | [
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Home health agency work environments and hospitalizations. | An important goal of home health care is to assist patients to remain in community living arrangements. Yet home care often fails to prevent hospitalizations and to facilitate discharges to community living, thus putting patients at risk of additional health challenges and increasing care costs. To determine the relationship between home health agency work environments and agency-level rates of acute hospitalization and discharges to community living. Analysis of linked Center for Medicare and Medicaid Services Home Health Compare data and nurse survey data from 118 home health agencies. Robust regression models were used to estimate the effect of work environment ratings on between-agency variation in rates of acute hospitalization and community discharge. Home health agencies with good work environments had lower rates of acute hospitalizations and higher rates of patient discharges to community living arrangements compared with home health agencies with poor work environments. Improved work environments in home health agencies hold promise for optimizing patient outcomes and reducing use of expensive hospital and institutional care. | 25,215,647 | [
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Sterhirsutins A and B, two new heterodimeric sesquiterpenes with a new skeleton from the culture of Stereum hirsutum collected in Tibet Plateau. | Two new heterodimeric sesquiterpenes, sterhirsutins A (1) and B (2), and two new sesquiterpenes, hirsutic acids D-E (3 and 4), were identified from the culture of Stereum hirsutum. The absolute configurations in 1 and 2 were confirmed by single-crystal X-ray diffraction experiments and electronic circular dichroism (ECD) calculations. Compounds 1 and 2 are likely biosynthesized from a hirsutane-type sesquiterpene and α-humulene by a hetero-Diels-Alder cycloaddition. Compounds 1-4 showed cytotoxicity against K562 and HCT116 cell lines. | 25,215,649 | [
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Measuring the heat exchange of a quantum process. | Very recently, interferometric methods have been proposed to measure the full statistics of work performed on a driven quantum system [Dorner et al., Phys. Rev. Lett. 110, 230601 (2013) and Mazzola et al., Phys. Rev. Lett. 110, 230602 (2013)]. The advantage of such schemes is that they replace the necessity to make projective measurements by performing phase estimation on an appropriately coupled ancilla qubit. These proposals are one possible route to the tangible experimental exploration of quantum thermodynamics, a subject which is the center of much current attention due to the current control of mesoscopic quantum systems. In this Rapid Communication we demonstrate that a modification of the phase estimation protocols can be used in order to measure the heat distribution of a quantum process. In addition, we demonstrate how our scheme maybe implemented using ion trap technology. Our scheme should pave the way for experimental explorations of the Landauer principle and hence the intricate energy to information conversion in mesoscopic quantum systems. | 25,215,667 | [
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Universal expression for adiabatic pumping in terms of nonequilibrium steady states. | We develop a unified treatment of pumping and nonequilibrium thermodynamics. We show that the pumping current generated through an adiabatic mechanical operation in equilibrium can be expressed in terms of the stationary distribution of the corresponding driven nonequilibrium system. We also show that the total transfer in pumping can be evaluated from the work imported to the driven counterpart. These findings lead us to a unified viewpoint for pumping and nonequilibrium thermodynamics. | 25,215,690 | [
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Canonical versus noncanonical equilibration dynamics of open quantum systems. | In statistical mechanics, any quantum system in equilibrium with its weakly coupled reservoir is described by a canonical state at the same temperature as the reservoir. Here, by studying the equilibration dynamics of a harmonic oscillator interacting with a reservoir, we evaluate microscopically the condition under which the equilibration to a canonical state is valid. It is revealed that the non-Markovian effect and the availability of a stationary state of the total system play a profound role in the equilibration. In the Markovian limit, the conventional canonical state can be recovered. In the non-Markovian regime, when the stationary state is absent, the system equilibrates to a generalized canonical state at an effective temperature; whenever the stationary state is present, the equilibrium state of the system cannot be described by any canonical state anymore. Our finding of the physical condition on such noncanonical equilibration might have significant impact on statistical physics. A physical scheme based on circuit QED is proposed to test our results. | 25,215,704 | [
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Imaging critical fluctuations of pure fluids and binary mixtures. | We use optical microscopy techniques to directly visualize the structures that emerge in binary mixtures and pure fluids near their respective critical points. We attempt to understand these structures by studying the image formation using both a phase contrast and a dark field filter to our microscope. We found that images of critical fluctuations for both liquid-liquid and liquid-gas critical systems have gray level intensity histograms with Gaussian shape. For all fluids investigated, the temperature-dependent standard deviation of the Gaussian histogram follows a power law with the same exponent. Since the image intensity fluctuations are determined by order parameter fluctuations, this direct imaging method allowed us to estimate the critical exponent of compressibility with very good accuracy. | 25,215,709 | [
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Theory of diffusion of active particles that move at constant speed in two dimensions. | Starting from a Langevin description of active particles that move with constant speed in infinite two-dimensional space and its corresponding Fokker-Planck equation, we develop a systematic method that allows us to obtain the coarse-grained probability density of finding a particle at a given location and at a given time in arbitrary short-time regimes. By going beyond the diffusive limit, we derive a generalization of the telegrapher equation. Such generalization preserves the hyperbolic structure of the equation and incorporates memory effects in the diffusive term. While no difference is observed for the mean-square displacement computed from the two-dimensional telegrapher equation and from our generalization, the kurtosis results in a sensible parameter that discriminates between both approximations. We carry out a comparative analysis in Fourier space that sheds light on why the standard telegrapher equation is not an appropriate model to describe the propagation of particles with constant speed in dispersive media. | 25,215,711 | [
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Weiss mean-field approximation for multicomponent stochastic spatially extended systems. | We develop a mean-field approach for multicomponent stochastic spatially extended systems and use it to obtain a multivariate nonlinear self-consistent Fokker-Planck equation defining the probability density of the state of the system, which describes a well-known model of autocatalytic chemical reaction (brusselator) with spatially correlated multiplicative noise, and to study the evolution of probability density and statistical characteristics of the system in the process of spatial pattern formation. We propose the finite-difference method for the numerical solving of a general class of multivariate nonlinear self-consistent time-dependent Fokker-Planck equations. We illustrate the accuracy and reliability of the method by applying it to an exactly solvable nonlinear Fokker-Planck equation (NFPE) for the Shimizu-Yamada model [Prog. Theor. Phys. 47, 350 (1972)] and nonlinear Fokker-Planck equation [Desai and Zwanzig, J. Stat. Phys. 19, 1 (1978)] obtained for a nonlinear stochastic mean-field model introduced by Kometani and Shimizu [J. Stat. Phys. 13, 473 (1975)]. Taking the problems indicated above as an example, the accuracy of the method is compared with the accuracy of Hermite distributed approximating functional method [Zhang et al., Phys. Rev. E 56, 1197 (1997)]. Numerical study of the NFPE solutions for a stochastic brusselator shows that in the region of Turing bifurcation several types of solutions exist if noise intensity increases: unimodal solution, transient bimodality, and an interesting solution which involves multiple "repumping" of probability density through bimodality. Additionally, we study the behavior of the order parameter of the system under consideration and show that the second type of solution arises in the supercritical region if noise intensity values are close to the values appropriate for the transition from bimodal stationary probability density for the order parameter to the unimodal one. | 25,215,716 | [
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Solution of the explosive percolation quest: scaling functions and critical exponents. | Percolation refers to the emergence of a giant connected cluster in a disordered system when the number of connections between nodes exceeds a critical value. The percolation phase transitions were believed to be continuous until recently when, in a new so-called "explosive percolation" problem for a competition-driven process, a discontinuous phase transition was reported. The analysis of evolution equations for this process showed, however, that this transition is actually continuous, though with surprisingly tiny critical exponents. For a wide class of representative models, we develop a strict scaling theory of this exotic transition which provides the full set of scaling functions and critical exponents. This theory indicates the relevant order parameter and susceptibility for the problem and explains the continuous nature of this transition and its unusual properties. | 25,215,726 | [
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Shear modulus of glasses: results from the full replica-symmetry-breaking solution. | We compute the shear modulus of amorphous hard and soft spheres, using the exact solution in infinite spatial dimensions that has been developed recently. We characterize the behavior of this observable in the whole phase diagram, and in particular around the glass and jamming transitions. Our results are consistent with other theoretical approaches, which are unified within this general picture, and they are also consistent with numerical and experimental results. Furthermore, we discuss some properties of the out-of-equilibrium dynamics after a deep quench close to the jamming transition, and we show that a combined measure of the shear modulus and of the mean square displacement allows one to probe experimentally the complex structure of phase space predicted by the full replica-symmetry-breaking solution. | 25,215,733 | [
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Effects of local pH on the formation and regulation of cristae morphologies. | Cristae, folded subcompartments of the inner mitochondrial membrane (IMM), have complex and dynamic morphologies. Since cristae are the major site of adenosine triphosphate synthesis, morphological changes of cristae have been studied in relation to functional states of mitochondria. In this sense, investigating the functional and structural significance of cristae may be critical for understanding progressive mitochondrial dysfunction. However, the detailed mechanisms of the formation and regulation of these cristae structures have not been fully elucidated. Among the hypotheses concerning the regulation of cristae morphologies, we exclusively investigate the effects of the local pH gradient on the cristae morphologies by using a numerical model. An area-difference induced curvature of the membrane is modeled as a function of local pH. This curvature is then applied to the finite element model of a closed lipid bilayer in order to find the energetically favorable membrane configuration. From this study, we substantiate the hypothesis that a tubular crista structure can be formed and regulated by the local pH gradient. Through the simulations with various initial conditions, we further demonstrate that the diameter of a crista is mainly determined by the local pH gradient, and the energetically favorable direction of crista growth is perpendicular to the longitudinal axis of a mitochondrion. Finally, the simulation results at the mitochondrial scale suggest that the cristae membrane may have a lower local pH value and/or a higher cardiolipin composition than the other parts of the IMM. | 25,215,753 | [
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Conformational change in cytochrome P450 reductase adsorbed at a Au(110)-phosphate buffer interface induced by interaction with nicotinamide adenine dinucleotide phosphate. | Changes observed in the reflection anisotropy spectroscopy (RAS) profiles of monolayers of cytochrome P450 reductase adsorbed at Au(110)-electrolyte interfaces at 0.056 V following the addition of nicotinamide adenine dinucleotide phosphate (NADP(+)) are explained in terms of a simple model as arising from changes in the orientation of an isoalloxazine ring located in the flavin mononucleotide binding domain of the protein. The model also accounts for the changes observed in the RAS as the potential applied to the Au(110) surface is varied and suggests that differences in the dependence of the RAS profile of the adsorbed protein on the potential applied to the electrode in the absence and presence of NADP(+) are explicable as arising from a competition between the applied potential acting to reduce the protein and the NADP(+) to oxidize it. | 25,215,759 | [
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Scale-free and economical features of functional connectivity in neuronal networks. | A form of activity that is highly studied in cultured cortical networks is the neuronal avalanche, characterized by bursts whose distribution follows a power law. While the statistics of neuronal avalanches are well characterized, much less is known about the neuronal interactions from which they arise. We examined statistical dependencies between pairs of cells in spontaneously active cultures of cortical neurons using an information measure of transfer entropy. We show that the distribution of transfer entropy follows a power law with a slope near 3/2. Using graph-theoretic approaches of weighted networks, we demonstrate that this power law maximizes a measure of global economy that accounts for both the efficiency of neuronal interactions as well as the overall traffic in the network. Finally, we describe a pairwise Poisson model that captures the statistics of information transfer in a population of spiking neurons. Using this model, we show that avalanches can occur in systems with weak pairwise interactions, and that strong pairwise interactions can arise without avalanches, suggesting that these two measures capture distinct properties of brain dynamics. | 25,215,772 | [
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Dynamical immunization strategy for seasonal epidemics. | The topic of finding an effective strategy to halt virus in a complex network is of current interest. We propose an immunization strategy for seasonal epidemics that occur periodically. Based on the local information of the infection status from the previous epidemic season, the selection of vaccinated nodes is optimized gradually. The evolution of vaccinated nodes during iterations demonstrates that the immunization tends to locate in both global hubs and local hubs. We analyze the epidemic prevalence using a heterogeneous mean-field method, and we present numerical simulations of our model. This immunization performs better than some other previously known strategies. Our work highlights an alternative direction in immunization for seasonal epidemics. | 25,215,782 | [
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0.1353589,
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Heterogeneous mean field for neural networks with short-term plasticity. | We report about the main dynamical features of a model of leaky integrate-and-fire excitatory neurons with short-term plasticity defined on random massive networks. We investigate the dynamics by use of a heterogeneous mean-field formulation of the model that is able to reproduce dynamical phases characterized by the presence of quasisynchronous events. This formulation allows one to solve also the inverse problem of reconstructing the in-degree distribution for different network topologies from the knowledge of the global activity field. We study the robustness of this inversion procedure by providing numerical evidence that the in-degree distribution can be recovered also in the presence of noise and disorder in the external currents. Finally, we discuss the validity of the heterogeneous mean-field approach for sparse networks with a sufficiently large average in-degree. | 25,215,785 | [
-0.1443954,
0.04729531,
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0.2263226,
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0.1528376,
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-0.2431451,
0.1584821,
-0.1251614,
0.07768335,
0.02320229,
0.07608327,
0.0138839... |
Temporal stability of network partitions. | We present a method to find the best temporal partition at any time scale and rank the relevance of partitions found at different time scales. This method is based on random walkers coevolving with the network and as such constitutes a generalization of partition stability to the case of temporal networks. We show that, when applied to a toy model and real data sets, temporal stability uncovers structures that are persistent over meaningful time scales as well as important isolated events, making it an effective tool to study both abrupt changes and gradual evolution of a network mesoscopic structures. | 25,215,787 | [
0.07798557,
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0.01215956,
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-0.3948868,
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0.07304341,
0.1698162,
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0.04056498,
0.08318311,
-0.1751708,
0.2626483,
0.1161809,
-0.0005559946,
-0.1... |
Disorder-enhanced exciton delocalization in an extended dendrimer. | The exciton dynamics in a disordered extended dendrimer is investigated numerically. Because a homogeneous dendrimer exhibits few highly degenerate energy levels, a dynamical localization arises when the exciton is initially located on the periphery. However, it is shown that the disorder lifts the degeneracy and favors a delocalization-relocalization transition. Weak disorder enhances the delocalized nature of the exciton and improves any quantum communication, whereas strong disorder prevents the exciton from propagating in accordance with the well-known Anderson theory. | 25,215,792 | [
-0.1503576,
0.02756682,
0.05327909,
0.09741204,
0.1653004,
-0.2080677,
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0.03574866,
0.02459139,
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0.1552462,
0.3030302,
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-0.713853,
0.1236219,
0.1526414,
-0.3154501,
0.1073544,
-0.01042066,
-0.03149923... |
Generalized dark-bright vector soliton solution to the mixed coupled nonlinear Schrödinger equations. | We have constructed a dark-bright N-soliton solution with 4N+3 real parameters for the physically interesting system of mixed coupled nonlinear Schrödinger equations. Using this as well as an asymptotic analysis we have investigated the interaction between dark-bright vector solitons. Each colliding dark-bright one-soliton at the asymptotic limits includes more coupling parameters not only in the polarization vector but also in the amplitude part. Our present solution generalizes the dark-bright soliton in the literature with parametric constraints. By exploiting the role of such coupling parameters we are able to control certain interaction effects, namely beating, breathing, bouncing, attraction, jumping, etc., without affecting other soliton parameters. Particularly, the results of the interactions between the bound state dark-bright vector solitons reveal oscillations in their amplitudes under certain parametric choices. A similar kind of effect was also observed experimentally in the BECs. We have also characterized the solutions with complicated structure and nonobvious wrinkle to define polarization vector, envelope speed, envelope width, envelope amplitude, grayness, and complex modulation. It is interesting to identify that the polarization vector of the dark-bright one-soliton evolves on a spherical surface instead of a hyperboloid surface as in the bright-bright case of the mixed coupled nonlinear Schrödinger equations. | 25,215,794 | [
-0.05369642,
0.09016282,
-0.2679012,
-0.1198001,
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-0.3211036,
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0.2259092,
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0.2717823,
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0.006958882,
0.02220785,
-0.1619287,
0.3212786,
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-0.18... |
Achieving modulated oscillations by feedback control. | In this paper, we develop an approach to achieve either frequency or amplitude modulation of an oscillator merely through feedback control. We present and implement a unified theory of our approach for any finite-dimensional continuous dynamical system that exhibits oscillatory behavior. The approach is illustrated not only for the normal forms of dynamical systems but also for representative biological models, such as the isolated and coupled FitzHugh-Nagumo model. We demonstrate the potential usefulness of our approach to uncover the mechanisms of frequency and amplitude modulations experimentally observed in a wide range of real systems. | 25,215,801 | [
-0.1571038,
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-0.4052679,
-0.02108494,
0.09307167,
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-0.3726239,
0.09581897,
0.02031442,
-0.1038991,
-0.15... |
Unpinning of scroll waves under the influence of a thermal gradient. | Three-dimensional scroll waves of electrical activity are among the mechanisms believed to be responsible for the rapid, unsynchronized contraction of cardiac ventricles, thereby reducing the heart's ability to pump blood. Scroll waves can attach themselves to unexcitable obstacles, and this sometimes highly elongates their life span. Hence, the unpinning and annihilation of these vortices has attracted much attention in recent decades. In this work, we study the influence of a thermal gradient on scroll waves pinned to inert obstacles, in the Belousov-Zhabotinsky reaction. Under a temperature gradient, scroll rings were seen to unpin from these obstacles, thus strikingly reducing their lifetimes. These results were also reproduced by numerical simulations using the Barkley model. | 25,215,808 | [
0.02825531,
0.04855559,
-0.3568559,
0.490754,
0.2871491,
-0.1074541,
-0.3229171,
0.1197583,
0.3795623,
0.1824361,
0.164247,
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0.1686738,
-0.08561097,
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0.0688605,
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-0.1622826,
0.01657871,
0.173529,
-0.06818717,
-0.1888565,
-0.03... |
Non-Darcy behavior of two-phase channel flow. | We study the macroscopic behavior of two-phase flow in porous media from a phase-field model. A dissipation law is first derived from the phase-field model by homogenization. For simple channel geometry in pore scale, the scaling relation of the averaged dissipation rate with the velocity of the two-phase flow can be explicitly obtained from the model which then gives the force-velocity relation. It is shown that, for the homogeneous channel surface, Dacry's law is still valid with a significantly modified permeability including the contribution from the contact line slip. For the chemically patterned surfaces, the dissipation rate has a non-Darcy linear scaling with the velocity, which is related to a depinning force for the patterned surface. Our result offers a theoretical understanding on the prior observation of non-Darcy behavior for the multiphase flow in either simulations or experiments. | 25,215,823 | [
-0.1565429,
0.04388535,
0.0001283159,
0.3166367,
0.2291235,
-0.2661514,
-0.2634572,
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0.1209174,
0.2352279,
-0.08667861,
-0.3580251,
-0.05504061,
0.1504044,
-0.2725486,
-0.1132876,
-0.2530859,
0.007085341,
-0.1650693,
-0.3031629,
0.3911959,
-0.1381635,
-0.0005145... |
Statistical scaling of pore-scale Lagrangian velocities in natural porous media. | We investigate the scaling behavior of sample statistics of pore-scale Lagrangian velocities in two different rock samples, Bentheimer sandstone and Estaillades limestone. The samples are imaged using x-ray computer tomography with micron-scale resolution. The scaling analysis relies on the study of the way qth-order sample structure functions (statistical moments of order q of absolute increments) of Lagrangian velocities depend on separation distances, or lags, traveled along the mean flow direction. In the sandstone block, sample structure functions of all orders exhibit a power-law scaling within a clearly identifiable intermediate range of lags. Sample structure functions associated with the limestone block display two diverse power-law regimes, which we infer to be related to two overlapping spatially correlated structures. In both rocks and for all orders q, we observe linear relationships between logarithmic structure functions of successive orders at all lags (a phenomenon that is typically known as extended power scaling, or extended self-similarity). The scaling behavior of Lagrangian velocities is compared with the one exhibited by porosity and specific surface area, which constitute two key pore-scale geometric observables. The statistical scaling of the local velocity field reflects the behavior of these geometric observables, with the occurrence of power-law-scaling regimes within the same range of lags for sample structure functions of Lagrangian velocity, porosity, and specific surface area. | 25,215,826 | [
0.002285531,
0.05413393,
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0.1963042,
0.03196887,
-0.261537,
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0.0924615,
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0.05929926,
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0.1786959,
0.01599728,
0.1786918,
0.7731629,
0.1310439,
-0.1028377,
... |
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