bluuebunny/crossref_metadata_2025 huggingface dataset:
Management of Palpable but Radiologically Occult Breast Abnormalities
Authors: Sundara Rajan Sreekumar , White Jonathan , Peckham-Cooper Adam , Lane Sally , Lansdown Mark
Published: April 2012

Objective: To examine the utility of palpation-guided fine-needle aspiration cytology (pgFNAC) in the context of clinically palpable but radiologically occult breast abnormalities in this era of digital mammography and high sensitivity ultrasound. Methods: Women undergoing pgFNAC from January 2005 to December 2007 were identified from the histopathology database and correlated with clinical and radiological findings recorded prospectively in electronic patient records. Results: 142 cases matching our selection criteria were identified with a mean age of 43 (SD ±13.7) years; 83 patients had focal lumps and 59 had non-focal lumpiness. In the latter, pgFNAC showed C1 cytology in 45 (76.3%), C2 in 13 (22%) and C3 in 1 (1.7%) patient. In 83 patients with a focal discrete lump, pgFNAC revealed C1 cytology in 65 (78.3%), C2 in 14 (16.9%), and 2 patients each had C3 and C4 cytology. Core biopsy was undertaken in the latter 4 patients, invasive cancer was found in 1 patient each with C3 and C4 cytology and benign pathology in the rest. To date, none of the patients discharged has developed pre-malignant or malignant lesions in the ipsilateral breast. Conclusion: In patients presenting with clinically palpable but radiologically occult breast abnormality, pgFNAC can identify those who need further investigation or who can be safely discharged.
Comparison of Breast Carcinoma Prognostic/Predictive Biomarkers on Cell Blocks Obtained by Various Methods: Cellient, Formalin and Thrombin
Authors: Gorman Blythe K. , Kosarac Ognjen , Chakraborty Subhendu , Schwartz Mary R. , Mody Dina R.
Published: April 2012

Objective: To compare results of immunohistochemical (IHC) assays for estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) performed on thrombin, formalin and Cellient cell blocks to those performed on tissue. Study Design: Formalin, thrombin and Cellient cell blocks were prepared from cytologic samples obtained from resection specimens of 31 patients with invasive breast carcinoma. ER, PR, HER2 and MIB-1 (Ki-67) IHC stains were performed on all three types of cell blocks and compared to the same stains performed on the patient’s paraffin-embedded biopsy or resection. Cell and tissue blocks with equivocal staining for HER2 were submitted for fluorescence in situ hybridization (FISH). Results: Adequate Cellient blocks were obtained for all 31 cases. Comparison of results of ER IHC assays on all three types of cell blocks showed 100% correlation with tissue. Both Cellient and thrombin blocks showed 100% correlation with tissue for HER2 IHC and FISH results. The only statistically significant difference between cell block methods was found in PR staining, where false-negative results occurred with Cellient and thrombin blocks. Conclusion: Breast biomarker IHC assays performed on Cellient blocks are reliable and correlate with tissue block results, particularly for ER and HER2, the most clinically important markers.
Body Mass Index and Outcome of ASC-H-Interpreted Cervical Smears in Postmenopausal Women
Authors: Ahn Soomin , Lee Yoo-Young , Sung Ji-Youn , Lee Jae Jun , Oh Young Lyun , Sung Chang Ohk , Song Sang Yong
Published: April 2012

Objective: Patient age is one important factor used to evaluate the risk in women with ASC-H (atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion). This finding may be associated with atrophic changes reflecting a hypoestrogenic status and suggests that body mass index (BMI) can affect the outcome of ASC-H smears in postmenopausal women. Study Design: We investigated the outcome of 154 postmenopausal women with an ASC-H smear and assessed relationships with BMI categories and serum estradiol levels. Results: In patients with higher BMI, an underlying squamous intraepithelial lesion (SIL) was more frequent than in patients with lower BMI, and a higher BMI was also associated with increased serum estradiol levels. When samples were classified by preparation method, these findings were more pronounced in liquid-based smears than in conventional smears. Principal component analysis using three factors (BMI, age and human papilloma virus status) revealed two distinct groups: those with a negative cervical smear and those with a smear result indicating SIL+. Conclusion: Hormonal alterations can affect the outcome of ASC-H smears, and BMI is one factor that should be considered when evaluating the risk associated with ASC-H smears in postmenopausal women.
Concomitant Drug- and Infection-Induced Antineutrophil Cytoplasmic Autoantibody (ANCA)-Associated Vasculitis with Multispecific ANCA
Authors: Kontic Milica , Radovanovic Sanja , Nikolic Milos , Bonaci-Nikolic Branka
Published: April 2012

Objective: To report the first case of concomitant drug- and infection-induced antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) in a patient treated with propylthiouracil (PTU) and suffering from tuberculosis. Presentation and Intervention: A 28-year-old woman with PTU-treated hyperthyroidism presented with fever, purpura, pulmonary cavitations and ANCA to myeloperoxidase, bactericidal/permeability-increasing protein (BPI), proteinase-3 and elastase. Skin histopathology confirmed vasculitis. However, sputum examination revealed Mycobacterium tuberculosis. Remission was achieved after PTU withdrawal and treatment with antituberculosis drugs. Conclusion: Our case confirmed that BPI-ANCA are elevated in active tuberculosis. Multispecific ANCA were helpful for the diagnosis of concomitant PTU- and M. tuberculosis-induced AAV.
Downscaled Climate Change Scenarios for Baja California and the North American Monsoon during the Twenty-First Century
Authors: Cavazos Tereza , Arriaga-Ramírez Sarahí
Published: April 2012

Regional climate change scenarios for Baja California/Southern California (BCC) and the North American monsoon (NAM) were produced as part of the Baja California State Climate Change Action Program (PEACC-BC). Bias-corrected and spatially downscaled scenarios (BCSD) from six general circulation models (GCMs) with a total of 12 realizations were analyzed for two scenarios of the Intergovernmental Panel on Climate Change (IPCC) Special Report on Emissions Scenarios (SRES): B1 (low emissions) and A2 (high emissions) during the twenty-first century. A validation of the original GCM realizations and the BCSD scenarios with observed data during 1961–90 show that the ensemble GCM produces too much precipitation during autumn and winter, which could be the cause of the observed delay of the summer monsoon rains; the ensemble BCSD considerably improves the mean annual cycles and spatial distributions of precipitation and temperature in the region. However, both ensembles greatly underestimate the observed interannual variability of precipitation. BCSD scenarios of temperature and precipitation during the twenty-first century were evaluated on the basis of the multimodel median change relative to 1961–90. The scenarios of precipitation change show large interannual variations and larger uncertainties than the scenarios of temperature change. The A2 scenarios show the largest reductions of precipitation in the last 20 yr of the twenty-first century; a decrease of 30% is projected for BCC mainly in winter and spring, while precipitation in the NAM region could be weakened by 20% during winter, spring, and summer. After 2050, a significant reduction of precipitation is expected in northwestern Mexico and the southwestern United States south of 35°N, and temperature changes larger than 2°C warming.
Quantitative Comparison of the Spatial Distribution of Radar and Gauge Rainfall Data
Authors: Yoon Seong-Sim , Phuong Anh Tran , Bae Deg-Hyo
Published: April 2012

The common statement that a rain gauge network usually provides better observation at specific points while weather radar provides more accurate observation of the spatial distribution of rain field over a large area has never been subjected to quantitative evaluation. The aim of this paper is to evaluate the statement by using some statistical criteria. The Monte Carlo simulation experiment, inverse distance weighting (IDW) interpolation method, and cross-validation technique are used to investigate the relation between the accuracy of the interpolated rainfall and the rain gauge density. The radar reflectivity–rainfall intensity (Z–R) relationship is constructed by the least squares fitting method from observation data of radar and rain gauges. The variation in this relationship and the accuracy of the radar rainfall with rain gauge density are evaluated by using the Monte Carlo simulation experiment. Three storm events are selected as the case studies. The obtained results show that the accuracy of interpolated and radar rainfall increases nonlinearly with increasing gauge density. The higher correlation coefficient (γ) value of radar-rainfall estimation, compared to gauge interpolation, especially in the convective storm, proves that radar observation provides a more accurate spatial structure of the rain field than gauge observation does.
Collective Regulation of Wages and Conditions in Aged Care: Beyond Labour Law
Authors: Kaine Sarah
Published: April 2012

This article considers the collective regulation of wages and conditions in the highly feminized residential aged care workforce. It argues that the traditional regulation of wages and conditions through industrial instruments such as awards and collective bargaining agreements has failed to produce adequate or sustainable outcomes. Continuing low pay is exacerbating labour supply issues in a sector set to experience exponential growth in the coming decades. The ability of traditional labour law to deliver optimal outcomes for aged care workers is limited not only by low levels of collective representation, but also by funding constraints within the sector. This article explores regulatory alternatives and suggests that the integration of labour standards and outcomes into the existing accreditation standards and funding mechanisms for residential aged care warrants policymakers’ attention.
A new time-domain method for calculation of basic electric values in public distribution networks
Authors: Petrović Predrag B , Župunski Ivan Ž
Published: April 2012

The paper proposes a practical new algorithm for calculation of electrical active power and root mean square value of current and voltage signals using a windowing technique by reducing the weight of samples at the endpoints of sampling interval. The proposed method offers a significant improvement in computational efficiency with a low numerical error. The calculation of observed values was realized by summation of samples of instantaneous power in a time domain, without the need for synchronization. The suggested algorithm was simulated and experimentally tested. The errors related to the signal processing, and errors bound were investigated and provided. A processing precision of 0.05% was achieved.
Bribes and ballots: The impact of corruption on voter turnout in democracies
Authors: Stockemer Daniel , LaMontagne Bernadette , Scruggs Lyle
Published: April 2012

While officials involved in graft, bribery, extortion, nepotism, or patronage typically like keeping their deeds private, the fact that corruption can have serious effects in democracies is no secret. Numerous scholars have brought to light the impact of corruption on a range of economic and political outcomes. One outcome that has received less attention, however, is voter turnout. Do high levels of corruption push electorates to avoid the polls or to turn out in larger numbers? Though of great consequence to the corruption and voter-turnout literature, few scholars in either area have tackled this question and none has done so in a broad sample of democracies. This article engages in this endeavor through an analysis of the broadest possible sample of democratic states. Through instrumental variable regression we find that as corruption increases the percentage of voters who go to the polls decreases.
Long-Term Follow-Up of Children Treated With the Modified Atkins Diet
Authors: Chen Wendy , Kossoff Eric H.
Published: April 2012

The modified Atkins diet has been studied in mostly short-term clinical trials and case series. No studies have systematically examined the long-term benefits and side effects. The modified Atkins diet was started without prior ketogenic diet use in 87 children at the Johns Hopkins Hospital since 2002, of which 54 continued for more than 6 months. Children who had not been seen within the past 2 years were contacted by phone and email. At their most recent point during the modified Atkins diet (mean 19.9 months), 30 of 54 (55%) children with diet durations of more than 6 months achieved >50% improvement; 19 (35%) were seizure-free. Using an intent-to-treat analysis, at 12 months, 33 of 87 (38%) had >50% seizure reduction; 16 (18%) were seizure-free. These results are similar to published data for short-term modified Atkins diet and long-term ketogenic diet use. Side effects were predominantly elevations in lipid profile and gastrointestinal upset.
Involvement of fatty acid metabolism in the hepatotoxicity induced by divalproex sodium
Authors: Wang W , Lin R , Zhang J , Mao Y , Bu X , Ji Q , Zhai X , Lin Q , Yang L , Zhang K
Published: April 2012

Divalproex sodium is an antiepileptic drug. Hepatotoxicity is one of the most common side effects induced by divalproex sodium. Impaired fatty acid metabolism is considered to play an important role in the drug-induced hepatotoxicity. The sterol regulatory element-binding protein 1c (SREBP-1c) and peroxisome proliferator-activated receptor α (PPARα) are two key transcription factors involved, respectively, in fatty acid synthesis and degradation in liver. In the present study, we investigated the hepatotoxicity induced by divalproex sodium and its potential mechanism. The results indicated that divalproex sodium significantly decreased the cell viability and increased lactate dehydrogenase leakage in hepatocytes. The activities of alanine aminotransferase and aspartate transaminase were increased in hepatocytes treated with divalproex sodium. Furthermore, divalproex sodium activated SREBP-1c and increased the mRNA expressions of acetyl-CoA carboxylase 1, fatty acid synthase and stearoyl-CoA desaturase 1. Divalproex sodium also inhibited PPARα and decreased the messenger RNA expressions of 3-hydroxy-3-methylglutaryl-CoA synthase 2 and carnitine palmitoyltransferase 1A. These results suggest that the hepatotoxicity induced by divalproex sodium may be related with fatty acid synthesis and degradation mediated by SREBP-1c and PPARα in hepatocytes.
The information seeking and use behaviors of retired investors
Authors: O’Connor Lisa G.
Published: April 2012

This exploratory study examines the information seeking and use behaviors of a group of US retired or near-retirement investors from everyday life information seeking and serious leisure perspectives. Although primarily qualitative, it also collects and analyzes quanitative data to describe retired investors’ information preferences and use. Semi-structured interviews and journaling are used to examine the information seeking behaviors of a diverse group of investors and to assess the impact that personal characteristics, such as sex, socio-economic status, and educational attainment have on their behaviors. Findings suggest that the female investors studied were less likely to create information intensive fields and that this tendency is exacerbated by low educational attainment. Furthermore, the male investors studied were more likely to adopt Internet technology for their investing information seeking regardless of their educational attainment. Recommendations are made for improving information services to this important segment of the population.
Tale of Two Citizenships? Citizenship, Migration and Care in the European Union
Authors: Askola Heli
Published: April 2012

This paper examines the normative content of European Union citizenship with the aid of recent feminist research into gendered citizenship, care and migration. Feminist literature shows how long-standing feminist issues around care and domestic work are now made more prominent by the increasing formal employment of European women and the corresponding involvement of female migrant workers, often with precarious legal status, in performing childcare and domestic tasks in Europe. The literature on this phenomenon can be used to bring together two kinds of marginalisation built into Union citizenship – the explicit exclusion of those who are not Union citizens and the more implicit barriers that are based on a gendered division of labour. While optimistic analyses of Union citizenship assume its current limitations can be overcome, feminist research into gendered citizenship, care and migration actually shows they are part and parcel of how Union citizenship is currently conceived, making it difficult to change.
The Role of Recontextualization in the Multivocal, Ambiguous Process of Strategizing
Authors: Aggerholm Helle Kryger , Asmuß Birte , Thomsen Christa
Published: April 2012

This paper shows how ambiguity arises across multiple strategizing activities through the presence of multiple strategic actors within and across different strategizing phases. During the authoring phase, the intentionality of the different management actor voices becomes detached from the meaning expressed in the strategy text, resulting in a decontextualized, monovocal strategy paper. In the translation phase, the study shows how the text still possesses an inherent multivocality making it impossible to talk about strategy text as an atemporal, neutral object. In the phase of interpreting the strategy, three main rhetorical positions are identified among the employees:acceptance, ambiguity and rejection, representing the multivocal interpretations of the employees interviewed. The study contributes to the ongoing discussion about the challenges and potentials of the multivocal, multicontextual nature of strategizing in organizations.
The Purple Toe Syndrome in Female With Factor V Leiden Mutation Successfully Treated With Enoxaparin
Authors: Dulíček Petr , Bártová J. , Beránek M. , Malý J. , Pecka M.
Published: April 2012

Purple toe syndrome is a rare complication of warfarin therapy. It occurs usually after 3 to 8 weeks of therapy and it is caused by cholesterol emboli from atheromatous plaque. Sudden onset of pain in affected area, typically in toes and feet, is the main characteristic of the syndrome. We describe a case of a 65-year-old female with purple toe syndrome after 6 weeks of warfarin. Indication of warfarin was a proximal deep venous thrombosis, which developed after prolonged immobilization. Factor V (FV) Leiden and persistent high FVIII activity were found as additional eliciting factors for venous thromboembolism. After warfarin withdrawal and enoxaparin treatment, symptoms disappeared promptly but a slight discoloration of the toe persists.
The Role of the Police in Evacuations
Authors: Bonkiewicz Luke , Ruback R. Barry
Published: April 2012

Disaster evacuations are stressful events in which citizens and law enforcement frequently interact with each other. Most emergency response plans are based on military strategies that operate independent of the general public, but we argue that the police must be cognizant of several social psychological factors that affect citizens’ behavior during evacuations, including risk perception, social networks, and access to resources. Drawing from social psychological, criminal justice, and disaster research, we propose a model that (a) describes how citizens’ priorities and behaviors change as a disaster evolves and (b) identifies policing strategies that accommodate these changing behaviors and facilitate a successful evacuation. Our model, embedded in how people behave and what police are taught, can increase citizen compliance with law enforcement during disaster evacuations, remove more citizens from harm, save lives, and improve the relationship between communities and the police.
Correlates of Foot Pursuit Injuries in the Los Angeles County Sheriff’s Department
Authors: Kaminski Robert J. , Rojek Jeff , Smith Hayden P. , Alpert Geoffrey P.
Published: April 2012

Police foot pursuits have come under increased scrutiny in recent years because of concerns of officer-involved shootings and fatalities associated with this tactical response. Consequently, there have been calls for police administrators to place strict limits on officer discretion to engage in foot pursuits. Such limits may be premature, however, given limited empirical evidence regarding the hazards of foot pursuits. To help inform this debate, this study analyzed foot-pursuit injuries using data provided by the Los Angeles County Sheriff’s Department. The findings indicate that in the vast majority of pursuits, deputies and suspects were uninjured or sustained only minor injuries. In this regard, they do not appear to be any more hazardous than resistive encounters generally. However, that suspects were injured in 60% of foot pursuits and that the use of conducted energy devices by deputies was associated with an increased odds of suspect injury suggest the dynamics of foot pursuits may be different.
Sleep Stage Assessment Using Power Spectral Indices of Heart Rate Variability With a Simple Algorithm
Authors: Tanida Keiko , Shibata Masashi , Heitkemper Margaret M.
Published: April 2012

Clinical researchers do not typically assess sleep with polysomnography (PSG) but rather with observation. However, methods relying on observation have limited reliability and are not suitable for assessing sleep depth and cycles. The purpose of this methodological study was to compare a sleep analysis method based on power spectral indices of heart rate variability (HRV) data to PSG. PSG and electrocardiography data were collected synchronously from 10 healthy women (ages 20–61 years) over 23 nights in a laboratory setting. HRV was analyzed for each 60-s epoch and calculated at 3 frequency band powers (very low frequency [VLF]-hi: 0.016–0.04 Hz; low frequency [LF]: 0.04–0.15 Hz; and high frequency [HF]: 0.15–0.4 Hz). Using HF/(VLF-hi + LF + HF) value, VLF-hi, and heart rate (HR) as indices, an algorithm to categorize sleep into 3 states (shallow sleep corresponding to Stages 1 & 2, deep sleep corresponding to Stages 3 & 4, and rapid eye movement [REM] sleep) was created. Movement epochs and time of sleep onset and wake-up were determined using VLF-hi and HR. The minute-by-minute agreement rate with the sleep stages as identified by PSG and HRV data ranged from 32 to 72% with an average of 56%. Longer wake after sleep onset (WASO) resulted in lower agreement rates. The mean differences between the 2 methods were 2 min for the time of sleep onset and 6 min for the time of wake-up. These results indicate that distinguishing WASO from shallow sleep segments is difficult using this HRV method. The algorithm's usefulness is thus limited in its current form, and it requires additional modification.
Ports and patches: Digital games as unstable objects
Authors: Newman James
Published: April 2012

The problem for curators and archivists of digital games is that the games are inherently unstable. As a range of commentators have explored, gameplay in digital games often takes quite unexpected, unpredictable and emergent directions as players probe at the boundaries of rules and systems. For those engaged in the archiving, curation and exhibition of digital games, a clear challenge comes from the contingency of playing preferences, and that various ‘playings’ might be differently informed by prefigurative and regulatory materials such as walkthroughs, FAQs and reviews. However, before we get to considerations of the ways it is (re)configured through the performance of play, in fact regardless of whether it is ever played at all, we should recognise that a digital game is a potentially changing, unstable object. In fact, it is typically better thought of as a growing and mutating collection of many objects. This article centres less on ideas of performance or the changing nature of the game at play but rather concentrates on the instability of the fabric of the game to-be-played-with. As media that are routinely ported (transferred and translated) to different operating systems and platforms with differing hardware and software capabilities, and patched (updated to fix bugs or modify gameplay mechanics), digital games simply cannot be conceived of as static objects or texts. To demonstrate the impact of porting and patching on the instability of digital games, this article draws on an analysis of Sega’s Sonic the Hedgehog series.
European travelers’ return likelihood and satisfaction with Mediterranean sun-and-sand destinations: A Chi-square Automatic Identification Detector−based segmentation approach
Authors: Assaker Guy , Hallak Rob
Published: April 2012

Drawing on the literature on visitor satisfaction, return likelihood, and customer segmentation, this study applies a Chi-square Automatic Identification Detector segmentation technique to segment European visitors on their likelihood to revisit selected Mediterranean sun-and-sand destinations. The Chi-square Automatic Identification Detector procedure distinguishes five segments in terms of return likelihood, with different levels of satisfaction according to the respondents’ repeat visit status, occupation, and country of residence. The findings are further discussed in the framework of the literature on return likelihood. Marketing implications and suggestions for Mediterranean sun-and-sand destination managers are also presented.
Intergroup bias toward “Group X”: Evidence of prejudice, dehumanization, avoidance, and discrimination against asexuals
Authors: MacInnis Cara C. , Hodson Gordon
Published: April 2012

Although biases against homosexuals (and bisexuals) are well established, potential biases against a largely unrecognized sexual minority group, asexuals, has remained uninvestigated. In two studies (university student and community samples) we examined the extent to which those not desiring sexual activity are viewed negatively by heterosexuals. We provide the first empirical evidence of intergroup bias against asexuals (the so-called “Group X”), a social target evaluated more negatively, viewed as less human, and less valued as contact partners, relative to heterosexuals and other sexual minorities. Heterosexuals were also willing to discriminate against asexuals (matching discrimination against homosexuals). Potential confounds (e.g., bias against singles or unfamiliar groups) were ruled out as explanations. We suggest that the boundaries of theorizing about sexual minority prejudice be broadened to incorporate this new target group at this critical period, when interest in and recognition of asexuality is scientifically and culturally expanding.
Synergistic and Additive Effects of Modified Citrus Pectin With Two Polybotanical Compounds, in the Suppression of Invasive Behavior of Human Breast and Prostate Cancer Cells
Authors: Jiang Jiahua , Eliaz Isaac , Sliva Daniel
Published: April 2012

Aim. The objective of this study was to evaluate the combined effect of a known galectin-3 inhibitor, PectaSol-C modified citrus pectin (MCP), and 2 novel integrative polybotanical compounds for breast and prostate health, BreastDefend (BD) and ProstaCaid (PC), on invasive behavior in human breast and prostate cancer cells in vitro, respectively. Methods. The effect of MCP and BD and of MCP and PC on invasiveness was assessed by cell adhesion, cell migration, and cell invasion assays. Secretion of urokinase plasminogen activator (uPA) was determined by Western blot analysis. Results. Although low concentrations of MCP (0.25-1.0 mg/mL) do not suppress cell adhesion of breast or prostate cancer cells, the combination of MCP with BD or PC synergistically inhibits adhesion of these cells. Dose-dependent inhibition of breast and prostate cancer cell migration by MCP (0.25-1.0 mg/mL) is synergistically enhanced by BD (20 µg/mL) and PC (10 µg/mL), respectively. BD or PC did not further inhibit the invasion of breast and prostate cancer cells by MCP; however, the combination of MCP with BD or PC suppressed secretion of uPA from breast and prostate cancer cells, respectively. Conclusion. The combination of MCP with BD and of MCP with PC synergistically inhibits the metastatic phenotypes of human breast and prostate cancer cells, respectively. Further studies confirming these observations in animal models of breast and prostate cancer metastasis are warranted.
Perioperative Pain Relief by a COX-2 Inhibitor Affects Ileal Repair and Provides a Model for Anastomotic Leakage in the Intestine
Authors: van der Vijver R. J. , van Laarhoven C. J. H. M. , de Man B. M. , Lomme R. M. L. M. , Hendriks T.
Published: April 2012

The authors examined the potential of the cyclooxygenase 2 (COX-2) inhibitor carprofen to reproducibly induce anastomotic leakage. In experiment 1, an anastomosis was constructed in both ileum and colon of 20 rats, and they were given carprofen (5 mg/kg subcutaneously every 24 hours) or buprenorphine (0.02 mg/kg subcutaneously every 12 hours). In another 20 rats an anastomosis was constructed in either ileum or colon, and all received carprofen (experiment 2). Animals were sacrificed after 3 days. In experiment 1, the ileal dehiscence rate was 60% in the carprofen group and 0% in the buprenorphine group ( P = .0108). Colonic anastomoses in both groups remained patent. In experiment 2, the anastomotic leakage rate was 80% in ileum and 0% in colon. Thus, COX-2 inhibitors can severely interfere with intestinal healing, particularly in the ileum. Perioperative administration of carprofen yields a unique model for anastomotic leakage, which allows translational research on the effectiveness of perisuture line reinforcement.
School Nurses and Athletic Trainers Team Up on Emergency Planning
Authors: Rains Carilyn A. , Robinson Brian
Published: April 2012

The broad topic of emergency planning has fast become an issue of top priority nationally for schools and organizations in both the public and private sectors in all areas related to disaster planning and preparedness. This article focuses on the development and implementation of a district-wide Emergency Action Plan specific to emergency readiness in the school sport setting. The critical, collaborative roles of the school nurse and the certified athletic trainer can determine the ultimate outcome and degree of success when dealing with potentially life-threatening, health-related events. These health emergencies may occur during the school day or during after-school athletic and other activities.
How interpersonal motives explain the influence of organizational culture on organizational productivity, creativity, and adaptation
Authors: Moon Henry , Quigley Narda R. , Marr Jennifer Carson
Published: April 2012

Despite decades of research on organizational culture, the current literature lacks an orienting paradigm by which research findings can be accumulated regarding specific cultural forms’ influence on specific organizational outcomes. This paper introduces an AIM (ambidextrous interpersonal motives) model of organizational culture. First, drawing on literature from both individual psychology and social anthropology, we suggest that organizational culture can be understood through a framework of interpersonal motives (cooperation, competition, and autonomy). Second, we extend research on organizational ambidexterity to describe both pure and hybrid forms of interpersonally based organizational culture. Third, we suggest that pure forms of culture have consequences for individual achievement and citizenship, with unclear implications for higher level outcomes, while combinations of cultural motives (hybrid forms) have positive consequences for higher level outcomes such as organizational productivity, creativity, and adaptation. Fourth, we address the importance of subcultures and temporal considerations in the model with regard to organizational viability and overall performance. Finally, we outline the theoretical and practical implications for future research in organizational culture.
Functional Limitations and Psychological Distress
Authors: Bierman Alex
Published: April 2012

This research examines how marital status modifies the relationship between functional limitations and two aspects of psychological distress—depression and anger. Analyses of a multiwave national probability survey show that marriage weakens the relationship between functional limitations and depression, but this moderation is specific to older men. Functional limitations are not significantly related to anger once time-stable confounds are comprehensively controlled, and this association does not differ by marital status. This research shows that marriage may benefit mental health by preventing the deleterious effects of chronic stressors, but marital status intersects with additional social statuses and a life course context in creating these modifying effects. In addition, research that does not consider both internalizing and externalizing mental health outcomes and comprehensively take time-stable confounds into account may present an incomplete depiction of the mental health consequences of stress and social arrangements.
Juxtaglomerular apparatus hyperplasia under dual angiotensin blockade. A footprint of adequate RAS inhibition or a concern for renal fibrosis?
Authors: Fernandez-Fernandez Beatriz , Ortiz Alberto , Gomez-Guerrero Carmen , Barat Antonio , Martín-Cleary Catalina , Egido Jesús
Published: April 2012

Background

Dual renin-angiotensin system blockade with angiotensin-converting enzyme inhibitors and angiotensin receptor blockers has been advocated to minimize proteinuria. However, recent trials have questioned the renal safety of this approach. Our understanding on the molecular effects of dual blockade in humans is incomplete.

Case presentation

We present a patient with corticoid resistant nephrotic syndrome who developed marked juxtaglomerular apparatus hyperplasia and renin expression in the context of dual angiotensin system blockade.

Conclusions

Although renin may have profibrotic effects mediated by (pro)renin receptor activation, this report raises questions on the potential consequences of local renin activation on chronic kidney disease in patients with dual angiotensin blockade.
Lean oncology: a new model for oncologists
Authors: Montesarchio Vincenzo , Grimaldi Antonio Maria , Fox Bernard A , Rea Antonio , Marincola Francesco M , Ascierto Paolo A
Published: April 2012

The history of the term Lean is relatively recent and originates from the Toyota Production System (TPS). The term "Lean" means "thin", which refers to a mental process, operational, productive, no-frills, quick but not hasty, consequential to the previous event. The Lean process flows seamlessly into the result, eliminates unnecessary complications to the effect, prevents unnecessary equipment processes. The idea is to 'do more with less', like using the (few) available resources in the most productive way possible, through the elimination of all types of waste that inevitably accompanies every stage of a production process. Lean management is primarily a management philosophy, a system of values and behaviors that goes beyond the mere application of the instrument and that, once internalized, will form the nucleus of the corporate culture. "Lean Oncology" is a term coined to identify a methodology of care and treatment to cancer patients, consisting on process simplification, streamlining of the organizational and routes of drug treatment, detection and elimination of waste. Its main objective is the centrality of the patient.
The Economic impact of Non-communicable Diseases on households in India
Authors: Engelgau Michael M , Karan Anup , Mahal Ajay
Published: April 2012

Background

In India, Non Communicable Diseases (NCDs) and injuries account for an estimated 62% of the total age-standardized burden of forgone Disability Adjusted Life Years (DALYs). Public and private financing of clinical services to reduce the NCD burden is a major challenge.

Methods

We used National Sample Survey Organization (NSSO) survey data from 1995-96 and 2004 covering nearly 200 thousand households to assess healthcare utilization patterns and out of pocket health spending by disease category. For this purpose, self-reported diseases and conditions were categorized into NCDs and non-NCDs. Survey data were used to assess how households financed their overall health expenditures and related this pattern to specific health conditions. We measured catastrophic spending on NCD-related hospitalization, defined as occurring when health expenditures exceeded 40% of a household's ability to pay, that is, household consumption spending less combined survival consumption expenditure; and impoverishment when per capita expenditure within the household decreased to below the poverty line once health spending was netted out.

Results

The share of NCDs in out of pocket health expenses incurred by households increased over time, from 31.6 percent in 1995-96 to 47.3 percent in 2004. In both years, own savings and income were the most important source of financing for many health conditions, typically between 40-60 percent of all spending, whereas 30-35 percent was from borrowing. The odds of catastrophic hospitalization expenditures for cancer was nearly 170% greater and for CVD and injuries 22 percent greater than the odds due to communicable diseases. Impoverishment patterns were similar.

Conclusions

Out of pocket expenses for treating NCDs rose sharply over the period from 1995-96 to 2004. When NCDs are present, the financial risks to which Indians households are exposed are significant.
Evolutionary constraints and expression analysis of gene duplications in Rhodobacter sphaeroides 2.4.1
Authors: Peters Anne E , Bavishi Anish , Cho Hyuk , Choudhary Madhusudan
Published: April 2012

Background

Gene duplication is a major force that contributes to the evolution of new metabolic functions in all organisms. Rhodobacter sphaeroides 2.4.1 is a bacterium that displays a wide degree of metabolic versatility and genome complexity and therefore is a fitting model for the study of gene duplications in bacteria. A comprehensive analysis of 234 duplicate gene-pairs in R. sphaeroides was performed using structural constraint and expression analysis.

Results

The results revealed that most gene-pairs in in-paralogs are maintained under negative selection (ω ≤ 0.3), but the strength of selection differed among in-paralog gene-pairs. Although in-paralogs located on different replicons are maintained under purifying selection, the duplicated genes distributed between the primary chromosome (CI) and the second chromosome (CII) are relatively less selectively constrained than the gene-pairs located within each chromosome. The mRNA expression patterns of duplicate gene-pairs were examined through microarray analysis of this organism grown under seven different growth conditions. Results revealed that ~62% of paralogs have similar expression patterns (cosine ≥ 0.90) over all of these growth conditions, while only ~7% of paralogs are very different in their expression patterns (cosine < 0.50).

Conclusions

The overall findings of the study suggest that only a small proportion of paralogs contribute to the metabolic diversity and the evolution of novel metabolic functions in R. sphaeroides. In addition, the lack of relationships between structural constraints and gene-pair expression suggests that patterns of gene-pair expression are likely associated with conservation or divergence of gene-pair promoter regions and other coregulation mechanisms.
Rapid paracellular transmigration of Campylobacter jejuni across polarized epithelial cells without affecting TER: role of proteolytic-active HtrA cleaving E-cadherin but not fibronectin
Authors: Boehm Manja , Hoy Benjamin , Rohde Manfred , Tegtmeyer Nicole , Bæk Kristoffer T , Oyarzabal Omar A , Brøndsted Lone , Wessler Silja , Backert Steffen
Published: April 2012

Background

Campylobacter jejuni is one of the most important bacterial pathogens causing food-borne illness worldwide. Crossing the intestinal epithelial barrier and host cell entry by C. jejuni is considered the primary reason of damage to the intestinal tissue, but the molecular mechanisms as well as major bacterial and host cell factors involved in this process are still widely unclear.

Results

In the present study, we characterized the serine protease HtrA (high-temperature requirement A) of C. jejuni as a secreted virulence factor with important proteolytic functions. Infection studies and in vitro cleavage assays showed that C. jejuni’s HtrA triggers shedding of the extracellular E-cadherin NTF domain (90 kDa) of non-polarised INT-407 and polarized MKN-28 epithelial cells, but fibronectin was not cleaved as seen for H. pylori’s HtrA. Deletion of the htrA gene in C. jejuni or expression of a protease-deficient S197A point mutant did not lead to loss of flagella or reduced bacterial motility, but led to severe defects in E-cadherin cleavage and transmigration of the bacteria across polarized MKN-28 cell layers. Unlike other highly invasive pathogens, transmigration across polarized cells by wild-type C. jejuni is highly efficient and is achieved within a few minutes of infection. Interestingly, E-cadherin cleavage by C. jejuni occurs in a limited fashion and transmigration required the intact flagella as well as HtrA protease activity, but does not reduce transepithelial electrical resistance (TER) as seen with Salmonella, Shigella, Listeria or Neisseria.

Conclusion

These results suggest that HtrA-mediated E-cadherin cleavage is involved in rapid crossing of the epithelial barrier by C. jejuni via a very specific mechanism using the paracellular route to reach basolateral surfaces, but does not cleave the fibronectin receptor which is necessary for cell entry.
Dynamical systems analysis of spike-adding mechanisms in transient bursts
Authors: Nowacki Jakub , Osinga Hinke M , Tsaneva-Atanasova Krasimira
Published: April 2012

Transient bursting behaviour of excitable cells, such as neurons, is a common feature observed experimentally, but theoretically, it is not well understood. We analyse a five-dimensional simplified model of after-depolarisation that exhibits transient bursting behaviour when perturbed with a short current injection. Using one-parameter continuation of the perturbed orbit segment formulated as a well-posed boundary value problem, we show that the spike-adding mechanism is a canard-like transition that has a different character from known mechanisms for periodic burst solutions. The biophysical basis of the model gives a natural time-scale separation, which allows us to explain the spike-adding mechanism using geometric singular perturbation theory, but it does not involve actual bifurcations as for periodic bursts. We show that unstable sheets of the critical manifold, formed by saddle equilibria of the system that only exist in a singular limit, are responsible for the spike-adding transition; the transition is organised by the slow flow on the critical manifold near folds of this manifold. Our analysis shows that the orbit segment during the spike-adding transition includes a fast transition between two unstable sheets of the slow manifold that are of saddle type. We also discuss a different parameter regime where the presence of additional saddle equilibria of the full system alters the spike-adding mechanism.
Notch1 Is Regulated by Chorionic Gonadotropin and Progesterone in Endometrial Stromal Cells and Modulates Decidualization in Primates
Authors: Afshar Yalda , Miele Lucio , Fazleabas Asgerally T.
Published: April 2012

No other tissue in the body undergoes such a vast and extensive growth and remodeling in a relatively short period of time as the primate endometrium. Endometrial integrity is coordinated by ovarian hormones, namely, estrogens, progesterone, and the embryonic hormone chorionic gonadotropin (CG). These regulated events modulate the menstrual cycle and decidualization. The Notch family of transmembrane receptors regulate cellular proliferation, differentiation, and apoptosis, cellular processes required to maintain endometrial integrity. In two primate models, the human and the simulated pregnant baboon model, we demonstrated that Notch1 is increased during the window of uterine receptivity, concomitant with CG. Furthermore, CG combined with estrogens and progesterone up-regulate the level of Notch1, whereas progesterone increases the intracellular transcriptionally competent Notch1, which binds in a complex with progesterone receptor. Inhibition of Notch1 prevented decidualization, and alternatively, when decidualization is biochemically recapitulated in vitro, Notch1 is down-regulated. A focused microarray demonstrated that the Notch inhibitor, Numb, dramatically increased when Notch1 decreased during decidualization. We propose that in the endometrium, Notch has a dual role during the window of uterine receptivity. Initially, Notch1 mediates a survival signal in the uterine endometrium in response to CG from the implanting blastocyst and progesterone, so that menstrual sloughing is averted. Subsequently, Notch1 down-regulation may be critical for the transition of stromal fibroblast to decidual cells, which is essential for the establishment of a successful pregnancy.
The impacts of repeated cold exposure on insects
Authors: Marshall Katie E. , Sinclair Brent J.
Published: April 2012

Insects experience repeated cold exposure (RCE) on multiple time scales in natural environments, yet the majority of studies of the effects of cold on insects involve only a single exposure. Three broad groups of experimental designs have been employed to examine the effects of RCE on insect physiology and fitness, defined by the control treatments: ‘RCE vs cold’, which compares RCE with constant cold conditions; ‘RCE vs warm’, which compares RCE with constant warm conditions; and ‘RCE vs matched cold’ which compares RCE with a prolonged period of cold matched by time to the RCE condition. RCE are generally beneficial to immediate survival, and increase cold hardiness relative to insects receiving a single prolonged cold exposure. However, the effects of RCE depend on the study design, and RCE vs warm studies cannot differentiate between the effects of cold exposure in general vs RCE in particular. Recent studies of gene transcription, immune function, feeding and reproductive output show that the responses of insects to RCE are distinct from the responses to single cold exposures. We suggest that future research should attempt to elucidate the mechanistic link between physiological responses and fitness parameters. We also recommend that future RCE experiments match the time spent at the stressful low temperature in all experimental groups, include age controls where appropriate, incorporate a pilot study to determine time and intensity of exposure, and measure sub-lethal impacts on fitness.