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Laurent Portel,1 Caroline Fabry-Vendrand,2 Nathalie Texier,3 Déborah Schwartz,3 Audrey Capdepon,2 Gabriel Thabut,2 Didier Debieuvre4 1Service de Pneumologie, Centre Hospitalier Robert Boulin, Libourne, France; 2Astra Zeneca, Courbevoie, France; 3Kappa Santé, Paris, France; 4Service de Pneumologie, Hôpital Émile Muller, Groupe Hospitalier de la Région Mulhouse Sud-Alsace (GHRMSA), Mulhouse, FranceCorrespondence: Laurent Portel, Service de Pneumologie, Centre Hospitalier Robert Boulin, 112 Avenue de la Marne, BP 199, Libourne, 33505, France, Tel +33 557 553 560, Fax +33 557 553 431, Email laurent.portel@ch-libourne.frPurpose: Data on severe non-eosinophilic asthma are scarce. Moreover, as compared with eosinophilic asthma, non-eosinophilic asthma less frequently benefits from the latest therapeutic advances. This study aimed to highlight differences between non-eosinophilic and eosinophilic asthma as they may help the development of new therapeutic agents.Patients and Methods: Data from 1075 adult patients with severe asthma (GINA treatment: 4/5) collected during the cross-sectional non-interventional FASE-CPHG study were analyzed. Two groups of patients (EOS-/EOS+) were constituted based on blood eosinophil counts (cutoff value: 300 G/l). Characteristics of EOS- (N = 500) and EOS+ (N = 575) patients were described; EOS- patients were also described according to their allergic profile based on skin allergy or allergen-specific immunoglobulin E (IgE) assays (cutoff value: 150 IU/mL).Results: Percentages of patients with obesity (29%), allergen sensitization (57%), or ≥ 2 annual exacerbations in the last 12 months (68%) were similar in both groups. As compared with EOS+ patients, EOS- patients less frequently reported chronic rhinitis (41.1% vs 50.5%, p < 0.01) or nasal polyposis (13.6% vs 27.5%, p < 0.01), and more frequently reported GERD (45.2% vs 37.1%, p < 0.01), anxiety (45.5% vs 38.1%, p = 0.01), or depression (18.3% vs 13.3%, p = 0.02). EOS- patients had lower serum total IgE levels (median: 158 vs 319 IU/mL, p < 0.01) and were less frequently treated with long-term oral corticosteroid therapy (16.0% vs 23.7%; p < 0.01). Their asthma was more frequently uncontrolled (48% vs 40%, p < 0.01). Similar results were found with a cutoff value for blood eosinophil counts at 150 G/l. EOS- patients with allergic profile less frequently reported high serum IgE levels (35.6% vs 57.9%, p < 0.01). EOS- and EOS+ patients treated with long-term oral corticosteroids had similar profiles.Conclusion: In our patients with severe asthma, EOS- asthma was approximately as frequent as EOS+ asthma; EOS- asthma was frequently poorly controlled or uncontrolled, confirming the need for a better management. Allergy did not appear to worsen clinical profile.Keywords: asthma, eosinophils, France, hospital, observational study

Julie Anne Ting,1 Susanna A McRae,1,2 Daniel Schwartz,1 Sean J Barbour,1 Maziar Riazy1,2 1Division of Nephrology, University of British Columbia, Vancouver, BC, V5Z 1M9, Canada; 2Department of Pathology, University of British Columbia, Vancouver, BC, V6Z 1Y6, CanadaCorrespondence: Maziar Riazy, Department of Pathology, St. Paul’s Hospital, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada, Tel +1 604-682-2344, extension 62228 or 62225, Fax +1 604-806-8701, Email mriazy1@providencehealth.bc.caAbstract: Lipoprotein glomerulopathy (LPG) is caused by a mutation in the apolipoprotein E gene (APOE) gene and is characterized by lipoprotein thrombi in glomerular capillaries. Here, we describe a case of LPG, the first to be reported from Canada and the first case of LPG in North America to be associated with the APOE Tokyo/Maebashi mutation (p.Leu162_Lys164del, traditional nomenclature 142_144del). A 49-year-old man of Chinese descent with a previous diagnosis of dyslipidemia and a new diagnosis of hypertension was found to have proteinuria on routine urinalysis. Renal biopsy showed markedly dilated glomerular capillaries filled with pale staining mesh-like material that stained positive for Oil-Red-O, consistent with lipoprotein thrombi. APOE gene sequencing confirmed the diagnosis of LPG. The patient was treated with fenofibrate and perindopril. His lipid profile normalized and proteinuria dropped to minimal levels. Repeat renal biopsy 2 years after the first showed resolution of lipoprotein thrombi but with rare residual granular densities by electron microscopy consistent with lipoprotein in the subendothelial space, supporting the hypothesis that this subendothelial material contains precursors to lipoprotein thrombi.Keywords: apolipoprotein E, apoE Tokyo/Maebashi, proteinuria, dyslipidemia, fibrate, lipoprotein glomerulopathy

BackgroundSerum amyloid A (SAA) is a major acute phase protein in horses. A new point-of-care (POC) test for SAA (Stablelab) is available, but studies evaluating its analytical accuracy are lacking.ObjectivesTo evaluate the analytical performance of the SAA POC test by 1) determining linearity and precision, 2) comparing results in whole blood with those in serum or plasma, and 3) comparing POC results with those obtained using a previously validated turbidimetric immunoassay (TIA).Study designAssay validation.MethodsAnalytical validation of the POC test was done in accordance with American Society of Veterinary Clinical Pathology guidelines using residual equine serum/plasma and whole blood samples from the Clinical Pathology Laboratory at the University of California-Davis. A TIA was used as the reference method. We also evaluated the effect of haematocrit (HCT).ResultsThe POC test was linear for SAA concentrations of up to at least 1000 μg/mL (r = 0.991). Intra-assay CVs were 13, 18 and 15% at high (782 μg/mL), intermediate (116 μg/mL) and low (64 μg/mL) concentrations. Inter-assay (inter-batch) CVs were 45, 14 and 15% at high (1372 μg/mL), intermediate (140 μg/mL) and low (56 μg/mL) concentrations. SAA results in whole blood were significantly lower than those in serum/plasma (P = 0.0002), but were positively correlated (r = 0.908) and not affected by HCT (P = 0.261); proportional negative bias was observed in samples with SAA>500 μg/mL. The difference between methods exceeded the 95% confidence interval of the combined imprecision of both methods (15%).Main limitationsAnalytical validation could not be performed in whole blood, the sample most likely to be used stall side.ConclusionThe POC test has acceptable accuracy and precision in equine serum/plasma with SAA concentrations of up to at least 1000 μg/mL. Low inter-batch precision at high concentrations may affect serial measurements, and the use of the same test batch and sample type (serum/plasma or whole blood) is recommended. Comparison of results between the POC test and the TIA is not recommended.

Axisymmetric microelectromechanical (MEM) vibratory rate gyroscopes are designed so the central post which attaches the resonator to the sensor case is a nodal point of the two Coriolis-coupled modes that are exploited for angular rate sensing. This configuration eliminates any coupling of linear acceleration to these modes. When the gyro resonators are fabricated, however, small mass and stiffness asymmetries cause coupling of these modes to linear acceleration of the sensor case. In a resonator postfabrication step, this coupling can be reduced by altering the mass distribution on the resonator so that its center of mass is stationary while the operational modes vibrate. In this paper, a scale model of the disk resonator gyroscope (DRG) is used to develop and test methods that significantly reduce linear acceleration coupling. © 2012 American Society of Mechanical Engineers.

Mira Y Friedman,1,2 Maya Leventer-Roberts,3 Joseph Rosenblum,4 Nir Zigman,4 Iris Goren,4 Vered Mourad,4 Natan Lederman,5 Nurit Cohen,5 Eran Matz,6 Doron Z Dushnitzky,6 Nirit Borovsky,6 Moshe B Hoshen,3 Gili Focht,1 Malka Avitzour,1 Yael Shachar,1 Yehuda Chowers,7 Rami Eliakim,8 Shomron Ben-Horin,8 Shmuel Odes,9 Doron Schwartz,9 Iris Dotan,10 Eran Israeli,11 Zohar Levi,10 Eric I Benchimol,12–14 Ran D Balicer,3 Dan Turner1 On behalf of the Israeli IBD Research Nucleus (IIRN) 1The Juliet Keidan Institute of Pediatric Gastroenterology and Nutrition, Shaare Zedek Medical Center, The Hebrew University of Jerusalem, Jerusalem, Israel; 2Braun School of Public and Community Medicine, The Hebrew University – Hadassah Medical Center, Jerusalem, Israel; 3Clalit Research Institute, Chief’s Office, Clalit Health Services, Tel Aviv, Israel; 4Maccabi Healthcare Services, Tel Aviv, Israel; 5Meuhedet Health Services, Tel Aviv, Israel; 6Leumit Health Services, Tel Aviv, Israel; 7Department of Gastroenterology, Rambam Health Care Campus, Bruce Rappaport School of Medicine, Technion Israel Institute of Technology, Haifa, Israel; 8Department of Gastroenterology, Chaim Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; 9Department of Gastroenterology and Hepatology, Soroka Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel; 10Division of Gastroenterology, Rabin Medical Center, Petah Tikva, Israel; 11Institute of Gastroenterology and Liver Diseases, Hadassah Medical Center, Hebrew University, Jerusalem, Israel; 12CHEO Inflammatory Bowel Disease Centre, Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada; 13Department of Pediatrics and School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada; 14Institute for Clinical Evaluative Sciences, Ottawa, ON, Canada Background: Before embarking on administrative research, validated case ascertainment algorithms must be developed. We aimed at developing algorithms for identifying inflammatory bowel disease (IBD) patients, date of disease onset, and IBD type (Crohn’s disease [CD] vs ulcerative colitis [UC]) in the databases of the four Israeli Health Maintenance Organizations (HMOs) covering 98% of the population. Methods: Algorithms were developed on 5,131 IBD patients and 2,072 controls, following independent chart review (60% CD and 39% UC). We reviewed 942 different combinations of clinical parameters aided by mathematical modeling. The algorithms were validated on an independent cohort of 160,000 random subjects. Results: The combination of the following variables achieved the highest diagnostic accuracy: IBD-related codes, alone if more than five to six codes or combined with purchases of IBD-related medications (at least three purchases or ≥3 months from the first to last purchase) (sensitivity 89%, specificity 99%, positive predictive value [PPV] 92%, negative predictive value [NPV] 99%). A look-back period of 2–5 years (depending on the HMO) without IBD-related codes or medications best determined the date of diagnosis (sensitivity 83%, specificity 68%, PPV 82%, NPV 70%). IBD type was determined by the majority of CD/UC codes of the three recent contacts or the most recent when less than three contacts were recorded (sensitivity 92%, specificity 97%, PPV 97%, NPV 92%). Applying these algorithms, a total of 38,291 IBD patients were residing in Israel, corresponding to a prevalence rate of 459/100,000 (0.46%). Conclusion: The application of the validated algorithms to Israel’s administrative databases will now create a large and accurate ongoing population-based cohort of IBD patients for future administrative studies. Keywords: inflammatory bowel diseases, Crohn’s disease, ulcerative colitis, search algorithms, validation, case ascertainment, Israel, administrative database research

Electrostatic tuning of the resonant modes in microelectromechanical vibratory gyroscopes is often suggested as a means for compensating manufacturing aberrations that produce detuned resonances. In high performance sensors, however, this approach places very stringent requirements on the stability of the bias voltages used for tuning. Furthermore, the bias voltage stability must be maintained over the operating environment, especially with regard to temperature variations. An alternative solution to this problem is to use mass perturbations of the sensor's resonant structure for resonant mode tuning. This paper presents a new mass perturbation technique that only relies on the sensor's integrated actuators and pick-offs to guide the mass perturbation process. The algorithm is amenable to automation and eliminates the requirement that the modal nodes of the resonator be identified by direct measurement. Copyright © 2009 by ASME.

We present the first X-ray observation at sub-arcsecond resolution of the high-redshift (z  = 6.18) radio-loud quasar CFHQS J142952 + 544717 (J1429). The ∼100 net-count 0.3–7 keV spectrum obtained from ∼30 ks Chandra exposure is best fit by a single power-law model with a photon index Γ = 2.0 ± 0.2 and no indication of an intrinsic absorber, implying a 3.6–72 keV rest-frame luminosity |$L_{\rm X}=(2.3^{+0.6}_{-0.5})\times 10^{46}$|  erg s−1. We identify a second X-ray source at 30″ distance from J1429 position, with a soft (Γ ≃ 2.8) and absorbed (equivalent hydrogen column density N H < 13.4 × 1020 cm−2) spectrum, which likely contaminated J1429 spectra obtained in lower angular resolution observations. Based on the analysis of the Chandra image, the bulk of the X-ray luminosity is produced within the central ∼3 kpc region, either by the disc/corona system, or by a moderately aligned jet. In this context, we discuss the source properties in comparison with samples of low- and high-redshift quasars. We find indication of a possible excess of counts over the expectations for a point-like source in a 0.5″–1.5″ (∼3−8 kpc) annular region. The corresponding X-ray luminosity at J1429 redshift is 4 × 1045 erg s−1. If confirmed, this emission could be related to either a large-scale X-ray jet, or a separate X-ray source. [ABSTRACT FROM AUTHOR]

This study examined the social-cognitive and behavioral attributes of children who are concurrently aggressive and victimized by their peers. The characteristics of these ''aggressive victims'' were examined in comparison to bullies, passive victims, and normative comparison children. The sample included 240 urban Los Angeles elementary school children (mean age = 9.5 years), who completed a series of self-report inventories, a social-cognitive interview, and a peer nomination inventory. Ratings of behavioral adjustment were obtained from teachers and academic functioning was obtained through a review of school records. Subgroup comparisons indicated that aggressive victims were characterized by impairments in self-regulation as well as difficulties across domains of functioning. In contrast, bullies tended to exhibit aggression-related biases in social-cognitive processing, but did not suffer from other adjustment problems, and passive victims were characterized by nonassertive behaviors and low levels of social skills. Taken together, our findings highlight the distinctiveness and theoretical importance of the aggressive victim subgroup.

Ziv Harel1,2, Ron Wald1,3, Jeff Perl1,3, Daniel Schwartz4, Chaim Bell2,31Division of Nephrology, St Michael's Hospital, University of Toronto, Toronto, Ontario, 2Department of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, 3Department of Medicine and Keenan Research Centre in the Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, 4Division of Nephrology, University of British Columbia, Vancouver, British Columbia, CanadaBackground: Deficits in the transfer of information between inpatient and outpatient physicians are common and pose a patient safety risk. This is particularly the case for vulnerable populations such as patients with end-stage renal disease requiring dialysis. These patients have unique and complex health care needs that may not be effectively communicated on standard discharge summaries, which may result in potential medical errors and adverse events.Objective: To evaluate Canadian dialysis center directors' perceptions of deficiencies in the content and quality of hospital discharge summaries for dialysis patients.Methods: A web-based, cross-sectional survey of Canadian dialysis center directors was performed between September and November 2010. The survey consisted of three parts. The first part was designed to assess dialysis center directors' attitudes on the quality of discharge summaries they receive. The second part was designed to elicit respondents' preferences for discharge summary content, and the third part consisted of questions regarding demographic and practice information.Results: Of 79 dialysis center directors, 21 (27%) completed the survey. Sixty-two percent felt that current discharge summaries inadequately communicate dialysis-specific information. Receipt of antibiotics for line sepsis or peritonitis, modifications to vascular access, and changes in target weight/dialysis prescription were rated as essential dialysis-specific information to include in discharge summaries by respondents.Conclusion: Over three quarters of dialysis center directors find the current practice of transferring discharge information for hospitalized dialysis patients grossly inadequate. The inclusion of dialysis-specific information may improve the quality of discharge summaries for dialysis patients.Keywords: information transfer, dialysis patients, discharge information