Identification of differences and comparison of fuel characteristics of torrefied agro-byproducts under oxidative conditions

Torrefaction is a pretreatment method for upgrading biomass into solid fuels. This study aimed to investigate the properties of agro-byproducts pretreated under different oxidative conditions at temperatures of 210-290 °C for 1 h to determine optimal operating conditions for upgrading biomass. The mass yields of lignocellulosic and herbaceous biomass were 90.27-42.20% and 92.00-45.50% and 85.71-27.23% and 88.09-41.58% under oxidative and reductive conditions, respectively. The calorific value of lignocellulosic and herbaceous biomass under oxidative conditions increased by approximately 0.14-9.60% and 3.98-20.02%, respectively. Energy yield of lignocellulosic and herbaceous biomass showed 63.78-96.93% and 90.77-44.39% showed 88.09-41.58% and 92.38-27.23% under oxygen-rich and deficit conditions. A decrease in oxygen and an increase in carbon dioxide and carbon monoxide were confirmed through gas measurements. Torrefaction evaluations were conducted using energy-mass co-benefit index (EMCI). Decreases of ΔEMCI were observed under certain conditions. Both oxidative and reductive conditions can be employed for pepper stems, wood pellets, and pruned apple branches. Based on standards, the optimal temperatures for pepper stems, wood pellets, and pruned apple branches in oxidative conditions were 250, 270, and 250 °C, respectively.

Editor’s Choice- Sedation in the coronary intensive care unit: An adapted algorithm for critically ill cardiovascular patient

In the current era, cardiovascular intensive care units care for more complex patients who are far sicker than historical post-myocardial infarction patients, and sedation has become a common intervention in these units. Current sedation best practices derive mainly from non-cardiac units which limits their generalization to the critically ill cardiac patient. Thus, a great variability in sedation protocols, especially the selection of sedative agents, is commonly seen in daily practice across cardiac units. We present an updated review on sedation in cardiovascular critical care medicine with emphasis on the hemodynamic impact. The goal of this review is to generate a general sedation algorithm specific for the cardiac patient.

All-cause mortality risk predictors in a preventive cardiology clinic cohort-examining diabetes and individual metabolic syndrome criteria: a PRECIS database study

AIM

It is unclear if metabolic syndrome (MS) is equal to type 2 diabetes mellitus (DM) in predicting cardiovascular disease (CVD) risk and mortality, and its prognostic value compared to Framingham risk model is controversial. We assessed mortality, CVD risk and prevalence in patients with DM and those without DM who met National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) MS criteria compared to patients without DM or MS. We analysed which component(s) of NCEP MS criteria had greatest predictive value for mortality.

METHODS

Retrospective cohort analysis of 1189 DM, 1241 MS (fasting glucose < 126 mg/dl and > or =3 components NCEP-ATP III criteria) and 3023 non-DM/non-MS patients presented for baseline visit to Preventive Cardiology clinic between 1995 and 2006, whose subsequent vital status was determined for a median of 5.2 years. The association with mortality was determined by Cox proportional hazards models. The incremental predictive value of MS components was performed by concordance indexes.

RESULTS AND CONCLUSION

DM group had highest mortality and CVD prevalence vs. MS and non-DM/non-MS groups respectively (all p < or = 0.001). Patients with MS criteria had increased CVD prevalence and 1.5-fold increased mortality vs. non-DM/non-MS group (all p < 0.02). In NCEP MS criteria, only fasting glucose significantly predicted mortality in MS group (p = 0.05). MS criteria predicted CVD prevalence in a parallel manner to Framingham risk score assessment. In a cohort of patients at high risk for CVD whose risk factors are being treated, presence of diabetes in addition to plasma glucose within NCEP MS criteria strongly predicts all-cause mortality.

Extracardiac vascular disease and effectiveness of sustained clopidogrel treatment

OBJECTIVE

To assess the effectiveness of long term treatment with clopidogrel of patients with extracardiac vascular disease (ECVD) (a history of either peripheral arterial disease or cerebrovascular disease).

DESIGN

Subgroup analysis of a prospective randomised clinical trial.

SETTING

The CREDO (clopidogrel for the reduction of events during observation) trial was a randomised, double blind, placebo controlled trial conducted at 99 centres in North America from June 1999 through April 2001.

PATIENTS

2116 patients who were to undergo elective coronary intervention or were deemed at high likelihood of undergoing percutaneous coronary intervention were enrolled in the CREDO trial. The current study sample consisted of 272 patients with ECVD.

MAIN OUTCOME MEASURE

One year incidence of the composite of death, myocardial infarction, or stroke in the intent to treat population.

RESULTS

Patients with ECVD had a more than twofold greater relative risk reduction with clopidogrel for the primary end point compared with patients without ECVD (47.9%, 95% confidence interval (CI) -4.2% to 73.9%, v 18.2%, 95% CI -10.5 % to 39.5%, respectively).

CONCLUSIONS

Longer term clopidogrel treatment provides added protection against thrombotic events throughout the arterial vasculature, not limited to the coronary arteries, and may be especially effective for patients with more diffuse atherosclerosis such as ECVD.

Single fiber analysis by internal reflection infrared microspectroscopy

Attenuated total reflection (ATR) is a convenient mode for single fiber analysis by infrared microspectroscopy, particularly when transmission spectra are difficult to obtain or when surface preferenced sampling is desirable. Textile finishes such as spin finishes, anti-static finishes, and permanent press finishes are revealed by ATR techniques. Bicomponent fibers may be analyzed by a combination of ATR techniques, transmission techniques, and spectral subtraction.

Effect of smoking status and abciximab use on outcome after percutaneous coronary revascularization: Pooled analysis from EPIC, EPILOG, and EPISTENT

BACKGROUND

Tobacco use has been studied in relation to the development of atherosclerotic heart disease and outcome after acute coronary syndromes, though outcome data after percutaneous coronary intervention (PCI) are limited. Tobacco use has been associated with increased fibrinogen levels, thrombin generation, and increased platelet aggregation, and these factors may cause ischemic events after PCI.

METHODS

We assessed whether smokers undergoing PCI have more ischemic events and if glycoprotein IIb/IIIa receptor blockade is particularly beneficial in preventing ischemic events in this cohort. We examined clinical outcomes for smokers and nonsmokers by using pooled analysis from 3 large, placebo-controlled trials of the glycoprotein IIb/IIIa antagonist abciximab during PCI.

RESULTS

Among 6519 patients, 34% were smokers. The primary end point of death, myocardial infarction, or urgent revascularization within 30 days was reduced by abciximab from 12.3% to 6.4% (relative risk reduction, 48%; P <.001) in smokers and from 11.3% to 5.9% (relative risk reduction, 48%; P <.001) in nonsmokers treated with abciximab. At 6 months, death, myocardial infarction, or urgent revascularization was reduced from 14.4% to 8.5% (relative risk reduction, 41%; P <.001) in smokers and from 14.6% to 8.8% (relative risk reduction, 40%; P <.001) in nonsmokers. Adjusting for baseline differences, smoking was an independent predictor of poor outcome at 30 days (odds ratio, 1.22; 95% confidence interval, 1.02, 1.47; P =.03).

CONCLUSIONS

This pooled analysis demonstrates that after PCI, smokers had worse 30-day outcomes than did nonsmokers. However, both groups had a comparable degree of benefit with platelet inhibition through the use of abciximab.

Echocardiographic assessment of the mechanisms of correction of bileaflet prolapse causing mitral regurgitation with only posterior leaflet repair surgery

Recent data suggest that posterior leaflet repair alone corrects mitral regurgitation in patients with bileaflet prolapse and normal anterior chordae. The purpose of this study was to use echocardiography to define the anatomic differences between posterior and bileaflet prolapse and to determine if posterior leaflet repair alone leads to correction of bileaflet prolapse. We studied patients who underwent quadrangular resection of the posterior mitral valve leaflet to treat bileaflet prolapse (group I, n = 20) or isolated posterior leaflet prolapse (group II, n = 20). Echocardiographic characteristics were compared before and after the procedure. There were no differences in the left ventricular end-diastolic or end-systolic dimensions or function between the 2 groups. However, anterior leaflet length was greater in patients with bileaflet prolapse (3.3 +/- 0.6 cm vs 2.6 +/- 0.4 cm, p = 0.003). In group I, posterior leaflet repair changed anterior leaflet displacement from -0.8 +/- 0.2 to 0.5 +/- 0.4 cm (p <0.001) and posterior leaflet displacement from -0.8 +/- 0.3 cm below to 0.5 +/- 0.4 cm (p <0.001) in front of the mitral annular plane. In group II, anterior leaflet displacement was unchanged from 0.2 +/- 0.1 to 0.3 +/- 0.2 cm (p = 0.22), whereas posterior leaflet displacement changed from -0.7 +/- 0.2 to 0.4 +/- 0.2 cm (p <0.001). Thus, patients with bileaflet prolapse and no ruptured chords have excessive anterior leaflet length. In such patients, posterior leaflet repair alone corrects anterior and posterior leaflet prolapse.

Optimizing percutaneous coronary revascularization in diabetic women: analysis from the EPISTENT trial

Clinical studies have demonstrated that diabetic women have an increased risk of death and nonfatal myocardial infarction (MI) after percutaneous coronary intervention (PCI). However, there have been few data regarding the outcome of diabetic women in the current era of percutaneous coronary revascularization. Using the Evaluation of Platelet IIb/IIIa Inhibitor for Stenting Trial (EPISTENT) database, we determined morbidity and mortality for diabetic women undergoing PCT in the current era using stents and the glycoprotein IIb/IIIa inhibitor, abciximab. There were no mortality differences in the diabetic women treated with stent-placebo, stent-abciximab, or balloon-abciximab at 30 days and 6 months. However, the primary end point of 1-year death, MI, or target vessel revascularization (TVR) was lowered in the diabetic women from 34.5% in the stent-placebo group and 28.9% in the balloon-abciximab group to 13. 3% in the stent-abciximab group (p = 0.02 for stent-stent comparison, and p = 0.09 for stent-abciximab vs. balloon-abciximab comparison). Also, 1-year TVR rates were lowered from 21.1% in the stent-placebo group and 26.7% in the balloon-abciximab group to 4.5% in the stent-abciximab group (p = 0.02 for stent-stent comparison, and p = 0.004 for stent-abciximab vs. balloon-abciximab comparison). The combination of stenting and abciximab therapy among diabetic women resulted in a significant reduction in 1-year rate of death, MI, or TVR compared with stent-placebo or balloon-abciximab therapy.

Effects of endotoxin and tumor necrosis factor alpha on regional brain neurotransmitters in mice

Alterations in regional brain concentration of dopamine (DA), norepinephrine (NE), serotonin (5-HT) and their metabolites were investigated in male BALB/c mice injected intraperitoneally with bacterial lipopolysaccharide (LPS, 2 mg kg(-1)) or recombinant murine tumor necrosis factor alpha (TNFalpha, 0.1 mg kg(-1)) at 2, 6, 12 and 24 h after the injection. At 2 h post-injection the LPS administration resulted in hypothermia, which was not apparent at later time points. No consistent effects were observed by either LPS or TNFalpha on peripheral leukocyte counts or plasma transaminase levels. Both LPS and TNFalpha slightly elevated NE metabolism in the striatum at 2-12 h. Concentrations of DA and its metabolites were significantly elevated only in the hypothalamus following TNFalpha at 24 h. Tumor necrosis factor alpha exerted pronounced effects on 5-HT metabolism in most brain regions at 2 h. Results suggest that the effect of LPS is more complex compared with TNFalpha because of the endogenous production of other cytokines including the TNFalpha.

Clinical benefit of glycoprotein IIb/IIIa blockade with Abciximab is independent of gender: pooled analysis from EPIC, EPILOG and EPISTENT trials. Evaluation of 7E3 for the Prevention of Ischemic Complications. Evaluation in Percutaneous Transluminal Coronary Angioplasty to Improve Long-Term Outcome with Abciximab GP IIb/IIIa blockade. Evaluation of Platelet IIb/IIIa Inhibitor for Stent

OBJECTIVES

We sought to determine the efficacy and safety of platelet glycoprotein IIb/IIIa receptor (GP IIb/IIIa) blockade with abciximab in women undergoing percutaneous coronary intervention.

BACKGROUND

Although gender differences in response to platelet glycoprotein IIb/IIIa receptor blockade have been described, there have been no large clinical studies to assess these differences.

METHODS

Outcomes were determined using meta-analysis technique.

RESULTS

In the pooled analysis, the primary end point of death, myocardial infarction (MI) or urgent revascularization within 30 days was reduced from 11.3% to 5.8% (p<0.001) in men and from 12.7% to 6.5% (p<0.001) in women treated with abciximab. At six months, death, MI or urgent revascularization was reduced from 14.1% to 8.3% (p<0.001) in men and 16.0% to 9.9% (p<0.001) in women receiving abciximab. At one year, mortality was reduced from 2.7% to 1.9% (p = 0.06) in men and 4.0% to 2.5% (p = 0.03) in women treated with abciximab. Major bleeding events occurred in 2.9% versus 3.0% (p = 0.96) of women and 2.7% versus 1.3% (p = 0.003) of men treated with placebo versus abciximab, respectively. Minor bleeding events occurred in 4.7% versus 6.7% (p = 0.01) of women and 2.3% versus 2.2% (p = 0.94) of men treated with placebo versus abciximab, respectively.

CONCLUSIONS

This pooled analysis demonstrated no gender difference in protection from major adverse outcomes with GP IIb/IIIa inhibition with abciximab. Although women had higher rates of both major and minor bleeding events with abciximab compared with men, major bleeding in women was similar with and without abciximab. There was a small increased risk of minor bleeding with abciximab in women.

Use of a neural network to predict stone growth after shock wave lithotripsy

OBJECTIVES

To determine whether a neural network is superior to standard computational methods in predicting stone regrowth after shock wave lithotripsy (SWL) and to determine whether the presence of residual fragments, as an independent variable, increases risk.

METHODS

We reviewed the records of 98 patients with renal or ureteral calculi treated by primary SWL at a single institution and followed up for at least 1 year; residual stone fragment growth or new stone occurrence was determined from abdominal radiographs. A neural network was programmed and trained to predict an increased stone volume over time utilizing input variables, including previous stone events, metabolic abnormality, directed medical therapy, infection, caliectasis, and residual fragments after SWL. Patient data were partitioned into a training set of 65 examples and a test set of 33. The neural network did not encounter the test set until training was complete.

RESULTS

The average follow-up period was 3.5 years (range 1 to 10). Of 98 patients, 47 had residual stone fragments 3 months after SWL; of these 47, 8 had increased stone volume at last follow-up visit. Of 51 patients stone free after SWL, 4 had stone recurrence. Coexisting risk factors were incorporated into a neural computational model to determine which of the risk factors was individually predictive of stone growth. The classification accuracy of the neural model in the test set was 91%, with a sensitivity of 91%, a specificity of 92%, and a receiver operating characteristic curve area of 0.964, results significantly better than those yielded by linear and quadratic discriminant function analysis.

CONCLUSIONS

A computational tool was developed to predict accurately the risk of future stone activity in patients treated by SWL. Use of the neural network demonstrates that none of the risk factors for stone growth, including the presence of residual fragments, is individually predictive of continuing stone formation.

Predictors of general quality of life in patients with benign prostate hyperplasia or prostate cancer

PURPOSE

Studies in disease specific populations have emphasized disease specific quality of life with little study of general quality of life. Furthermore, studies of general quality of life in disease specific populations have mostly examined the importance of disease specific variables, and have generally yielded poor correlations of such variables and general quality of life. We attempted to model the emotional component of general quality of life in patients with prostate disease.

MATERIALS AND METHODS

We integrated prospectively collected disease specific and nonspecific clinical and self-reported patient data. We also applied neural network and more conventional statistical tools to examine the relative use of various available analytical methodologies in modeling general quality of life.

RESULTS

Neural networks created reasonably good models of the emotional component of general quality of life. Logistic regression analysis also created reasonably good models and, given current computational schemes, allowed for identification of significant inputs in the models more readily than did the feed-forward, back propagation neural networks. All models of general quality of life relied primarily on disease nonspecific inputs, including social support, activities of daily living and coping.

CONCLUSIONS

Our observations suggested that efforts to optimize general quality of life in patients with prostate disease must integrate disease nonspecific variables.

Identification of an oncogenic form of the thrombopoietin receptor MPL using retrovirus-mediated gene transfer

Thrombopoietin and its receptor (MPL) are important regulators of megakaryopoiesis. We have identified an activating mutation of MPL using a combination of a retrovirus-mediated gene transfer and polymerase chain reaction-driven random mutagenesis. This point mutation causes a single amino acid substitution from Ser498 to Asn498 in the transmembrane region and abrogates factor-dependency of all interleukin-3-dependent cell lines tested. Murine interleukin-3-dependent Ba/F3 cells expressing the mutated but not the normal form of MPL were tumorigenic when transduced into syngeneic mice. Analysis of intracellular signaling pathways indicated that the mutant MPL protein constitutively activated two distinct signaling pathways, SHC-Raf-MAPK and JAK2-STAT3/STAT5.

Urbanization and economic development policy in Korea

"This paper has firstly discussed the development strategy and urbanization in [the Republic of] Korea for the period 1960-1980. [This is] followed with an intensive review of the past and recent population redistribution policy of Korea. Finally the authors make some general suggestions which are characterized as an expansion of opportunities and services in the underprivileged areas." (summary in CHI)

Subacute sensory neuropathy: a remote effect of carcinoma

Seven patients with subacute sensory neuropathy are described and the findings in 29 previously reported patients are reviewed. The presence of this characteristic neurological disorder strongly suggests an accompanying neoplasm. Five of 7 patients had cancer, and 4 died. Autopsy was performed on 3, and pathological analysis revealed inflammation and degeneration of dorsal root ganglia and degeneration of posterior roots and posterior columns of the spinal cord. The dorsal root ganglion was biopsied in 4 patients and showed similar inflammatory lesions. Electron microscopical studies showed inflammation and neuronal degeneration. No viral particles were seen. Viral cultures of the biopsied ganglia from 4 patients were negative. Antineuronal antibodies were not detected in 2 patients. The cause of this syndrome is unknown, and no treatment has been successful.