bluuebunny/crossref_metadata_2025 huggingface dataset:
Measuring outcome in child and adolescent mental health services: Consumers’ views of measures
Authors: Stasiak Karolina , Parkin Andrew , Seymour Fred , Lambie Ian , Crengle Sue , Pasene-Mizziebo Ettie , Merry Sally
Published: October 2012

Background:

Outcome measurement in child and adolescent mental health services in New Zealand became mandatory in 2005 and little is known about how this is perceived by service users.

Aims:

This study aimed to ascertain what service users think about routine outcome measurement in child and adolescent mental health services.

Method:

Nine semi-structured focus groups of child and adolescent service users ( n=34) and family members ( n=21) were held in different sites in New Zealand to determine their views on outcome measures.

Results:

Consumers supported outcome assessment with some provisos that have important implications for clinical services: the method of collecting information is critical to acceptance; assessment should be done in the context of an established relationship with the clinician; care is needed over the timing and context of assessment, access to information and feedback of results; and measures should be brief and holistic and their limitations recognised.

Conclusion:

Service users support outcome measures but their implementation requires care and consultation.
A confusion of tenses: Health screening and time
Authors: Stronge Paul
Published: October 2012

The article seeks to contribute to a re-evaluation of the role played by the contemporary health screen by exploring its relation to tense and time. Mobilizing data around operational aspects of screening for type 2 diabetes (T2D) alongside more general historical and conceptual perspectives, it challenges implicit assumptions that the screen represents either a momentary ‘cut’ in a longer process or a singular event with its own durational integrity. In contrast, the article argues, two distinct kinds of temporally related processes merge within any given screening episode. On one hand a rich heterogeneity of durations – physiological, technical, social, experiential – is involved. Yet this multiplicity is afforded unity and coherence insofar as the screen becomes a ‘thick’ site of intersection or fusion between the three major tenses. Drawing on aspects of the thought of Bergson and Deleuze as well as Mol’s notion of ‘ontological politics’, the article reconceptualizes the screen as a ‘leaky receptacle’ for temporal complexity and teases out pragmatic implications of such a re-envisioning.
Leading from the middle: Constrained realities of clinical leadership in healthcare organizations
Authors: Martin Graham P , Waring Justin
Published: October 2012

In many developed-world countries, there have been efforts to increase the ‘leadership capacity’ of healthcare professionals, particularly lower-status staff without formal managerial power. Creating frontline ‘leaders’ is seen as a means of improving the quality of healthcare, but such efforts face considerable challenges in practice. This article reports on a qualitative, interview-based study of 23 staff in two UK operating theatre departments, mostly nurses by professional background, who were given formal leadership responsibilities by their hospitals and redesignated as ‘team leaders’ and ‘theatre co-ordinators’. While participants were familiar with leadership theory and could offer clear accounts of good leadership in practice, they were often limited in their ability to enact their leadership roles. Professional and managerial hierarchies constrained participants’ leadership capacity, and consequently the exercise of leadership rested on alignment with managerial relationships and mandates. The findings highlight difficulties with accounts of leadership as something to be distributed across organizations; in healthcare organizations, established institutional structures and norms render this approach problematic. Rather, if fostering leadership capacity is to have the transformational effect that policymakers desire, it may need to be accompanied by other, wider changes that attend to institutional, organizational and professional context.
Regression Analysis of the Relationship between Urban Heat Island Effect and Urban Canopy Characteristics in a Mountainous City, Chongqing
Authors: Lu Jun , Li Chundie , Yu Chuck , Jin Ming , Dong Shaowei
Published: October 2012

In order to guide the urban planning of thermal environment in a mountainous city, this paper reports a study which investigated the impact of four canopy characteristics: impermeable rate (IR), building density (BD), water body percentage (WBP) and planting rate (PR), on the average ambient air temperature (AAT) within seven built-up areas in the metropolitan city of Chongqing. A rural area was also monitored as a control for the investigation. Oziexplorer was used to measure the IR, BD, WP and PR within a radius of 100 m to 500 m of the locations investigated. Univariate linear regression was used to determine the correlation degree (CD) between each canopy characteristics and AAT. Different trends were observed and this correlated with the increasing radius of different sites. The maximum correlation coefficient between IR and AAT was observed within a 100-m radius of the investigated site. It was found that with an increase of radius, the influence of IR on AAT became weaker. The influence of BD on AAT became more significant and reached a maximum within 250 m radius. The multivariate linear regression analysis has illustrated the order of importance of canopy characteristics as: IR > WBP > PR > BD on daily mean air temperature within a 100-m radius of the locations investigated in Shapingba, Chongqing.
Characterization of Indoor Air Bioaerosols in an Electrical Headquarter Building
Authors: Rocha C. A. , Silva R. J. , Monzón A. E. , Alfonzo J.
Published: October 2012

Bioaerosols may produce poor indoor air quality and affect the health of the building occupants. We identified bacteria and fungi from bioaerosols and determined the microbial density values by the impaction method on solid surface in 104 locations distributed in 26 floors from an electrical headquarter building. Indoor contamination was interpreted as follow: >500 CFU m−3, indoor microbial density higher than the outdoor microbial density and pathogenic isolate. Results showed bacterial density values from 28 CFU m−3 to 522 CFU m−3 from which 18 theatres exceeded the non-contaminated density range, overcame the outdoor average density value (198 CFU m−3) or depicted the presence of the pathogenic bacteria Staphylococcus aureus and/or Staphylococcus saprophyticus. Other bacterial opportunistic pathogens were isolated. Airborne fungal detection depicted density values from 2 CFU m−3 to 800 CFU m−3. Fungal density values exceeding the non-contamination range were detected in 12 theatres distributed in 7 floors. No pathogenic fungi were detected. However, opportunistic pathogen or sick building syndrome (SBS)-associated fungal isolates, particularly Penicillum and Aspergillus, were widely distributed in almost all floors. Even though we did not associate our findings with SBS and building-related illness (BRI), we showed that this culture-based analysis proved to be an adequate way to determine the microbiological indoor air quality.
Integrating requirements for the delivery of information relating to construction–product compositions
Authors: Azuma Kenichi , Funaki Rika , Hasegawa Ayumi , Shinohara Naohide , Yamaguchi Makoto , Fujita Kiyo-Omi , Kikuchi Yusuke , Tanabe Shin-Ichi
Published: October 2012

Information on the compositions of construction products is useful to construction designers, builders and occupants to help establish good indoor air quality and building environment. Existing measures to deliver this information, such as labelling or material safety data sheets, have not been adequate for construction products. The study aims to evaluate the status of the current information-delivery system and clarify requirements for a future system. A questionnaire survey on the current status and requirements of an information-delivery system for construction-product compositions was conducted in Japan. In total, 203 manufacturers, including two associations, and 35 users responded. Responses relating to 439 and 226 products from manufacturers and users, respectively, were obtained. Majority of the manufacturers and users responded that a standardized scheme is needed. Large discrepancies were noted between the delivery levels required by users and the actual levels from manufacturers in terms of the information-delivery range and display elements. The limitations of information delivery for manufacturers differed between composite products or equipment and products in which the compositions played an important role in quality and performance. Concerns included the cost and manpower required to examine the compositions for new information-delivery system and the importance of maintaining consistency with existing systems.
Production, circulation and deconstruction of gender norms in LGBTQ speech practices
Authors: Greco Luca
Published: October 2012

This paper investigates interdiscursivity in talk about gender norms in the Lesbian, Gay, Bisexual, Trans, Queer (LGBTQ) community. Drawing from field work conducted among gay and lesbian parents, transgender people, and the Drag King community, I show how accounts like les hommes sont comme ça (‘Men are like that’) or les femmes sont comme ça (‘Women act that way’) emerging in discourse about pregnancy reveal gender-based norms and their relationship to social conditions. Adopting a linguistic anthropology perspective, while paying particular attention to agency, categorization, circulation, and recontextualization processes, I show how gender norms are constructed and deconstructed through interactional, semantic, and morphosyntactic patterns found in a variety of multisemiotic mediums (e.g. texts, multiparty conversations and forum exchanges, images) and in a diversity of contexts. In addition to its contribution to the study of gender and language, this article takes new steps in the ongoing development of membership categorization analysis and queer linguistics.
Linguistic and embodied formats for making (concrete) offers
Authors: Kärkkäinen Elise , Keisanen Tiina
Published: October 2012

The article examines how discourse participants use language, the body and the local interactional and material context in the construction of offers. The data consist of eight hours of video recordings of everyday interactions in English and Finnish, and conversation analysis is used as the method. We focus on offers that make available to the recipient some concrete referent or material object or artifact in the current situation, that is, ‘concrete offers’. The article shows that such offers can be conceptualized as consisting of two interlinked actions, one identifying the referent and the other explicating the offer. The article further argues that the frequent accomplishment over time of such complex actions may contribute to the emergence of a set of social action formats for offers. This action combination is explored by discussing offers that range from fully linguistically articulated ones, to types where embodied actions take an increasingly central role.
Patient initiated presentations of additional concerns
Authors: Nielsen Søren Beck
Published: October 2012

Patients sometimes visit their general practitioners with more than one concern. This article investigates when and how patients initiate presentations of such additional concerns. The study is conversation analytic in its approach and scope. It is based upon video-recordings of naturally occurring general practice consultations in Denmark. Data suggest that Danish patients relatively frequently initiate presentations of additional concerns and defer such initiations until moments when the parties would otherwise engage in closing down the consultations. Additional concerns are introduced in response to the doctor’s possible pre-closing remarks. The parties, thereafter, employ a set of transitional elements: confirmation, preliminary announcement and ratification. This transition enables the parties to recycle the activities of the visit, to discuss and examine yet another concern. Thus, additional concerns are not presented completely unexpectedly or randomly as commonsense understanding sometimes has it; they are introduced at orderly moments and by means of recognizable methods.
Effect of iron on wear behavior of as-cast and heat-treated hypereutectic Al–18Si–4Cu–0.5Mg alloy: A Taguchi approach
Authors: Dhiman Mohit , Dwivedi Dheerendra K , Sehgal Rakesh , Bhat IK
Published: October 2012

This study describes the influence of Fe (wt%) on the microstructure, hardness, and wear behavior of Al–18Si–4Cu–0.5Mg– XFe ( X = Fe, at 0.4, 2.0, and 5.0 wt%) hypereutectic Al–Si alloy. The range of alloys was selected on the basis of literature study. The literature revealed that most of the studies on the effect of iron have been focused on either hypo-eutectic Al–Si alloys or lower levels of iron in the alloy. As Fe-rich intermetallic compounds are high melting point compounds, it is expected that they should improve the high temperature strength of the Al–Si alloys. The higher iron contents were specifically selected to obtain the advantage of high temperature stability leading to high wear resistance. Microstructure has been characterized using optical microscopy, scanning electron micrography, and image analysis studies. Maximum hardness of the alloy was obtained when solutionized (at 500 ℃) for 4 h followed by artificial aging (at 190 ℃) for 6 h. Heat-treated samples with only maximum hardness were further tested for wear behavior. The wear behavior of alloy in the as-cast and heat-treated conditions has been analyzed using Taguchi approach and analysis of variance analysis to find out the factors that affect wear significantly.
Dynamic fault detection and isolation for automotive engine air path by independent neural network model
Authors: Yu Ding Li , Hamad Adnan , Gomm J Barry , Sangha Mahavir S
Published: October 2012

Fault detection and isolation have become one of the most important aspects of automobile design. A new fault detection and isolation scheme is developed for automotive engines in this paper. The method uses an independent radial basis function neural network model to model engine dynamics, and the modelling errors are used to form the basis for residual generation. Furthermore, another radial basis function network is used as a fault classifier to isolate occurred fault from other possible faults in the system by classifying fault characteristics embedded in the modelling errors. The performance of the developed scheme is assessed using an engine benchmark, the mean value engine model with Matlab/Simulink. Five faults have been simulated on the mean value engine model, including three sensor faults, one component fault and one actuator fault. The three sensor faults considered are 10–20% changes superimposed on the measured outputs of manifold pressure, manifold temperature and crankshaft speed sensors; the component fault considered is air leakage in the intake manifold; the actuator fault considered is the malfunction of fuel injector. The simulation results show that all the simulated faults can be clearly detected and isolated in dynamic conditions throughout the engine operating range.
A meta-analysis of the association between angiotensin-converting enzyme insertion/deletion gene polymorphism and end-stage renal disease risk in IgA nephropathy patients
Authors: Zhou Tian-Biao , Yin Sheng-Sheng , Liang Rong
Published: October 2012

Background and objective:

The association between angiotensin-converting enzyme (ACE) insertion/deletion (I/D) gene polymorphism and end-stage renal disease (ESRD) risk in IgA nephropathy (IgAN) patients is still controversial. A meta-analysis was performed to evaluate the association between ACE I/D gene polymorphism and ESRD susceptibility in IgAN patients.

Method:

A predefined literature search and selection of eligible relevant studies were performed to collect data from electronic databases.

Results:

Thirteen articles were identified for the analysis of the association between ACE I/D gene polymorphism and ESRD risk in IgAN patients. D allele and DD genotype were associated with ESRD susceptibility in IgAN patients for overall populations ( p=0.01 and 0.003, respectively). In Asians, there was a markedly positive association between DD genotype and ESRD susceptibility ( p=0.03). Furthermore, D allele and DD genotype were associated with ESRD susceptibility in Caucasians ( p=0.02 and 0.03, respectively). However, II genotype might not play a protective role against ESRD onset for overall populations, Asians and Caucasians.

Conclusion:

DD homozygote is a significant genetic molecular marker for the onset of ESRD in IgAN patients.
Aliskiren alleviates doxorubicin-induced nephrotoxicity by inhibiting oxidative stress and podocyte injury
Authors: Rashikh Azhar , Pillai Krishna K , Ahmad Shibli J , Akhtar Mohammad , Najmi Abul K
Published: October 2012

Introduction:

Doxorubicin (DXR) is one of the most effective and widely used anthracycline antibiotics. However, its clinical application is hampered by toxic effects in many organs. Nephrotoxicity is one of the major side effects of anthracycline antibiotics. This study was designed to investigate the possible protective effects of aliskiren (a direct renin inhibitor) in DXR-induced nephrotoxicity in rats.

Materials and methods:

Wistar albino rats were intraperitoneally (ip) injected with DXR and renin activity, albumin, total protein, urea, creatinine levels in plasma and ultrastructural changes in podocytes were assessed.

Results:

Rats subjected to DXR administration had significant ( p<0.01) increases in systolic blood pressure, plasma renin activity, plasma concentration of urea, creatinine and tissue malondialdehyde and significant ( p<0.01) reductions in plasma concentrations of albumin, total protein and antioxidant defense (reduced glutathione (GSH), superoxide dismutase (SOD) and catalase (CAT)) in renal tissues. Furthermore, DXR-induced nephrotoxicity has also been characterized by broadening of podocyte foot processes, enlargement of glomerular basement membrane width and reduction in slit pore diameter. The above effects of DXR were significantly ( p<0.01) prevented by aliskiren treatment.

Conclusions:

These findings revealed that the blockade of renin activity by aliskiren is a promising approach in the treatment of DXR-induced nephrotoxicity.
Molecular changes in the early phase of renin-dependent cardiac hypertrophy in hypertensive cyp1a1ren-2 transgenic rats
Authors: Kunert-Keil Christiane , Landsberger Martin , Jantzen Franziska , Niessner Felix , Kroemer Heyo K , Felix Stephan B , Brinkmeier Heinrich , Peters Jörg
Published: October 2012

An early response to high arterial pressure is the development of cardiac hypertrophy. Functional and transcriptional regulation of ion channels and Ca2+ handling proteins are involved in this process but the relative contribution of each is unclear. In this study, we investigated the expression of genes involved in action potential generation and Ca2+ homeostasis of cardiomyocytes in hypertensive cyp1a1 ren-2 transgenic rats. In this model, the transgene prorenin was induced by indole-3-carbinol for 2 weeks allowing the induction of hypertension. Electrophysiological recordings from cardiomyocytes of hypertensive rats revealed a slight increase in membrane capacitance consistent with cellular hypertrophy. L-type calcium current density was reduced by 30%. Left ventricles of hypertensive rats showed a significant increase in transcript and protein levels of the cation channel TRPC6 and FK506-binding protein, whereas levels of SERCA2 and voltage-dependent potassium channels Kv4.2 and Kv4.3 were found to be decreased. Further, a marked nuclear localization of the transcription factors GATA4 and NFATC4 was observed in cardiac tissue of hypertensive rats. The cyp1a1 ren-2 transgenic rat thus appears to be a valid model to investigate early changes in cardiac hypertrophy. This study points to roles for TRPC6, FK506BP, SERCA2, Kv4.2, and Kv4.3 in the development of cardiac hypertrophy.
Balloon-Occlusion Catheter Rupture During Balloon-Occluded Retrograde Transvenous Obliteration of Gastric Varices Utilizing Sodium Tetradecyl Sulfate
Authors: Saad Wael E. A. , Nicholson David , Lippert Allison , Wagner Cynthia (Cindy) , Turba Cenk U. , Sabri Saher S. , Davies Mark G. , Matsumoto Alan H. , Angle John (Fritz)
Published: October 2012

Balloon-occluded retrograde transvenous obliteration (BRTO) is an established procedure for the management of bleeding gastric varices in Asia. Invariably, the sclerosant utilized in Asia is ethanolamine oleate and the inventory used (vascular sheaths, balloon-occlusion catheters, and microcatheters) is not available outside Asia. A total of 41 BRTO procedures were performed with a technical and obliterative (gastric varix obliteration) success rate of 95% (n = 39 of 41) and 85% (n = 35 of 41), respectively. Complications were 4.9% (n = 2/41). A total of 6 balloon ruptures occurred (14.6%, n = 6 of 41). One rupture (16.7%, n = 1 of 6 of ruptures) lead to a technical failure and 2 ruptures (33.3%, n = 2 of 6 of ruptures) lead to an obliterative failure. Balloon rupture contributed to 50% of technical failures (n = 1/2, P = .274) and 33% of obliteration failures (n = 2/6, P = .148). In conclusion, the incidence of balloon-occlusion catheter rupture utilizing 3% sodium tetradecyl sulfate (STS) and inventory unique to the United States is significantly higher than in Asia (<8% rupture rate). However, these ruptures have no significant technical or clinical consequences.
Patients on Hemodialysis Are Better Served by a Proximal Arteriovenous Fistula for Long-Term Venous Access
Authors: Sultan Sherif , Hynes Niamh , Hamada Nader , Tawfick Wael
Published: October 2012

Patients with end-stage renal disease should have arteriovenous fistula (AVF) formation 3 to 6 months prior to commencing hemodialysis (HD). However, this is not always possible with strained health care resources. We aim to compare autologous proximal AVF (PAVF) with distal AVF (DAVF) in patients already on HD. Primary end point is 4-year functional primary. Secondary end point is freedom from major adverse clinical events (MACEs). From January 2003 to June 2009, out of 495 AVF formations, 179 (36%) patients were already on HD. These patients had 200 AVF formations (49 DAVF vs 151 PAVF) in arms in which no previous fistula had been formed. No synthetic graft was used. Four-year primary functional patency significantly improved with PAVF (68.9% ± SD 8.8%) compared to DAVF (7.3% ± SD 4.9%; P < .0001). Five-year freedom from MACE was 85% with PAVF compared to 40% with DAVF ( P < .005). Proximal AVF bestows long-term functional access with fewer complications compared to DAVF for patients already on HD.
Fine Tilt Tuning of a Laparoscopic Camera by Local Magnetic Actuation
Authors: Simi Massimiliano , Pickens Ryan , Menciassi Arianna , Herrell S. Duke , Valdastri Pietro
Published: October 2012

Background. The magnetic surgical camera is an emerging technology having the potential to improve visualization without taking up port site space. However, tilting the point of view downward/upward can be done only by constantly applying a pressure on the abdomen. This study aims to test the hypothesis that the novel concept of local magnetic actuation (LMA) is able to increase the tilt range available for a magnetic camera without the need for deforming the abdominal wall. The hypothesis that 2-port laparoscopic nephrectomy in fresh tissue human cadavers could be performed by using the LMA camera is also tested. Methods. First, the 2 cameras were separately inserted, anchored, and moved inside the inflated abdomen. Tilting angles were quantified by image analysis while intra-abdominal pressure changes were monitored. Then, 5 two-port nephrectomies were performed by using the LMA camera while collecting quantitative outcomes. Results. The magnetic camera required a constant pressure on the magnetic handle to achieve an average ±20° tilt from the horizontal position, with an average of 7 mm Hg loss of intra-abdominal pressure. The LMA camera allowed for 75° of tilt from the horizontal position with a resolution of ±1°, without any need to deform the abdomen. All the nephrectomies were completed successfully within an average time of 11 minutes. Conclusion. LMA is an effective strategy to provide magnetic cameras with wide-range and high-resolution vertical motion without the need to deform the abdominal wall.
A Novel Adaptor Converts a Laparoscope Into a High-Definition Rigid Sigmoidoscope
Authors: Sherwinter Danny A.
Published: October 2012

The rigid sigmoidoscope is an important tool in a surgeon’s armamentarium, yet it has remained essentially unchanged despite poor imaging and the inability to project or record the images. Herein we report our initial experience with a novel introducer built from readily available operating room supplies and designed to convert any standard laparoscope into a high-definition rigid sigmoidoscope.
Parasympathomimetic Effect of Shilajit Accounts for Relaxation of Rat Corpus Cavernosum
Authors: Kaur Sarabjeet , Kumar Pravin , Kumar Deo , Kharya M. D. , Singh Nityanand
Published: October 2012

Previous studies have reported an enhancement of central cholinergic signal cascade by shilajit. For the present study, it was hypothesized that parasympathomimetic effect of shilajit accounting for relaxation of rat corpus cavernosum may be one of the major mechanisms attributing to its traditional role as an aphrodisiac. To test this hypothesis, the acute peripheral effect of standard acetylcholine (ACh), shilajit, and their combination was evaluated on cardiorespiratory parameters such as mean arterial blood pressure (MABP), heart rate (HR), respiratory rate (RR), and neuromuscular transmission (NMT). Furthermore, in vitro effect of standard ACh, shilajit, and their combination was tested on the rat corpus cavernosum. Six groups were used for the in vivo study ( N = 5): Group I (control-saline), Group II (ACh), Group III (Sh), Group IV (Sh followed by ACh), Group V (Atropine followed by ACh), and Group VI (Atropine followed by Sh). The in vitro study included four groups: Group I (control-saline), Group II (ACh), Group III (Sh), and Group IV (Sh followed by ACh). The results of the in vivo study confirmed the peripheral parasympathomimetic effect of shilajit (400 µg/mL). The in vitro results revealed that shilajit (400 and 800 µg/mL) relaxed cavernous strips’ concentration dependently and enhanced ACh-mediated relaxations. The peripheral parasympathomimetic effects of shilajit were confirmed by blockade of shilajit-induced relaxations (in vitro) and shilajit-induced lowering of MABP and HR (in vivo) by atropine.
Multicultural Food Perspectives
Authors: Colby Sarah E.
Published: October 2012

Dietary patterns are strongly influenced by cultural background and perspectives. Levels of dietary acculturation need to be considered when talking with immigrants about healthy eating. Lower levels of dietary acculturation are associated with positive health outcomes. Encouraging healthy traditional foods is a positive approach to use with individuals who are at lower levels of dietary acculturation. Questions about languages spoken in different settings and foods most often consumed can help health care practitioners assess levels of dietary acculturation. General intake recommendations of lower saturated fat, more whole grains, more fruits, more vegetables, leaner proteins, and smaller portion sizes (for caloric balance) are general recommendations that can be applied within most cultural food patterns to optimize health outcomes.
Pregnancy Denied, Pregnancy Rejected in Stephanie Daley
Authors: Ayres Susan , Manjunath Prema
Published: October 2012

This article offers a reading of Hilary Brougher’s film Stephanie Daley (2006), in which a teen is accused of murdering her newborn (neonaticide). Brougher depicts a “phenomenology of unwanted pregnancy” and an example of therapeutic jurisprudence. Part One examines Brougher’s treatment of the “shadow side of pregnancy,” and highlights barriers to the empathetic treatment of neonaticide. Part Two emphasizes the process of therapeutic jurisprudence as experienced by the two main characters. Brougher’s film provides a social narrative and phenomenology that may influence laws and legal responses and enlarge social understanding of unwanted pregnancy.
The Time of Engagement, Zaman al-ishtibak
Authors: Esmeir Samera
Published: October 2012

This commentary examines two relationships between law and revolutions. In the first, international law collapses revolutions into military warfare, and in the second, state law endows itself with revolutionary powers. What are the meanings of revolution these two relationships articulate and the other meanings they foreclose? Both relationships fail to capture revolution as struggle; instead, they subject revolutions to the measures of violence and change. Against revolutionary struggles, contemporary modern law claims revolutionary capacities for itself. But revolutionary struggles persist precisely because the law knows how to relate to revolutions only through the measures of violence and change, thereby failing to appreciate the peculiar practice of struggle – that of clashing engagement.
The Substance of Self-Government
Authors: Fleming James E
Published: October 2012

In Democratic Rights: The Substance of Self-Government, Corey Brettschneider develops an attractive and powerful conception of self-government – the value theory of democracy – that encompasses both substantive rights like privacy and procedural rights. Although he argues, following Habermas and Rawls, that substantive rights and procedural rights are “co-original,” the structure of his theory may lead him to reduce the former into the latter and not fully to account for personal self-government in his conception of democratic self-government. The wages of his democratic justifications for substantive rights may be a surprising anxiety or unwarranted tension concerning judicial review protecting such rights.
Assessment of volar angulation and shortening in 5th metacarpal neck fractures: an inter- and intra-observer validity and reliability study
Authors: Sletten I. N. , Nordsletten L. , Hjorthaug G. A. , Hellund J. C. , Holme I. , Kvernmo H. D.
Published: October 2012

Four methods for measuring volar angulation in 5th metacarpal neck fractures were tested for validity and reliability. Mid-medullary canal measurement in the lateral view (method MC-90) has previously been proven valid in a cadaveric study, hence used as a reference to test validity of the latter three. These three yielded a significant different mean fracture angle compared with MC-90, with only minor enhancement in reliability. Therefore, none of these three methods is recommended as a better standard method than the MC-90, where reliability was found to be substantial (intraclass correlation coefficient 0.53–0.81). Two methods for measuring shortening in 5th metacarpal neck fractures were compared, and stipulation of shortening by drawing a line through the most distal point of the heads of the neighbouring 3rd and 4th metacarpals (method SH-Stip) is a simple method with excellent reliability (intraclass correlation coefficient 0.81–0.96) for estimating shortening, requiring only radiological examination of the injured hand.
The effect of metacarpal shortening on digital flexion force
Authors: Wills B. P. D. , Crum J. A. , McCabe R. P. , Vanderby R. , Ablove R. H.
Published: October 2012

Metacarpal shaft fractures are common injuries that frequently unite with some shortening of the metacarpal. The aim of this study was to determine the effect of metacarpal shortening on digital flexion force. The index metacarpal of six cadaveric upper limbs was incrementally shortened. The flexion force produced at the end of the finger was recorded using a small load cell. At full extension, there was no significant change in flexion force produced regardless of the amount of shortening. However, at 50% aggregate flexion the loss of force became statistically significant at a shortening of 7.5 mm or more. At full digital flexion, the loss of force became statistically significant at shortening of 5 mm or more. At increasing amounts of finger flexion, progressive metacarpal shortening produces proportionally greater loss of fingertip flexion force. From this study it appears that metacarpal shortening of up to 5 mm should give minimal loss of finger flexion force.
Retinoic acid inducible gene-I (RIG-I) signaling of hepatic stellate cells inhibits hepatitis C virus replication in hepatocytes
Authors: Wang Yizhong , Ye Li , Wang Xu , Li Jieliang , Song Li , Ho Wenzhe
Published: October 2012

Retinoic acid inducible gene-I (RIG-I) is critical in the activation of the type I IFN-dependent antiviral innate immune response to hepatitis C virus (HCV) infection. We examined whether hepatic stellate cells (HSC; LX-2) possess a functional RIG-I signaling pathway and produce antiviral factors that can inhibit HCV. We showed that LX-2 cells treated with the RIG-I ligand (5′ppp-dsRNA) expressed significantly higher levels of IFN-β and IFN-λ than the control cells. The RIG-I activation in LX-2 cells also induced the expression of Toll-like receptor 3 (TLR3) and IFN regulatory factor-7 (IRF-7), the key regulators of the IFN signaling pathway. When HCV Japanese fulminant hepatitis (JFH)-1-infected hepatocytes were co-cultured with LX-2 cells stimulated with 5′ppp-dsRNA or incubated in media conditioned with supernatant (SN) from 5′ppp-dsRNA-stimulated LX-2 cells, HCV replication in hepatocytes was suppressed significantly. This LX-2 cell action on HCV replication was mediated through both IFN-β and IFN-λ, as Abs to IFN-α/β or IFN-λ receptors could neutralize the LX-2 SN-mediated anti-HCV effect. The role of IFNs in LX-2 cell-mediated anti-HCV activity is further supported by the observation that LX-2 SN treatment induced the expression of IFN stimulated genes, 2′-5′-oligoadenylate synthase-1 (OAS-1) and myxovirus resistance A (MxA), in HCV-infected Huh7 cells. These observations highlight the importance of HSC in liver innate immunity against HCV infection via a RIG-I-mediated signaling pathway.
Differential microRNA (miRNA) expression could explain microbial tolerance in a novel chronic peritonitis model
Authors: Kanaan Ziad , Barnett Rebecca , Gardner Sarah , Keskey Bobby , Druen Devin , Billeter Adrian , Cheadle William G
Published: October 2012

We observed persistent peritoneal bacteria despite a transient early innate immune response to intraperitoneal (IP) Klebsiella pneumoniae. Pretreatment with LPS prior to peritonitis induced a tolerant pattern of pro-inflammatory cytokine protein production over 72 h, but not at the mRNA level. MicroRNAs (miRNAs) regulate inflammatory cytokines and may explain this paradox. After pretreatment with IP LPS or saline, C57BL/6 mice were given 103 CFU of K. pneumoniae IP. Total RNA was isolated from peritoneal exudate cells (4 h, 24 h and 48 h following infection). mRNA and miRNA expression levels were detected and bioinformatics pathway analysis was performed, followed by measuring TNF-α, IL-1β, IL-6 and High-mobility Group Box 1 (HMBG1) protein levels. Of 88 miRNAs studied, 30 were significantly dysregulated at all time points in the LPS-pretreated group, including MiR-155, -146a, -142-3p, -299, and - 200c -132 and -21. TNF-α, regulated by miR-155 and miR-146a, was decreased in the LPS-pretreated group at all time points ( P < 0.05), as were HMGB1, a key alarmin regulated by miR-146, -142-3p, -299 and - 200c ( P < 0.05), and IL-1β and IL-6, both regulated by miR-132and miR-21 respectively ( P < 0.05). Specific dysregulation of miR-155, -146a, -142-3p, -299, and - 200c -132 and -21 with their corresponding effects on the TLR and NF-κB signaling pathways during inflammation, suggests a plausible mechanism for tolerance in this novel chronic model with persistent peritoneal infection.
Immunotherapy updates in pancreatic cancer: are we there yet?
Authors: Gunturu Krishna Soujanya , Rossi Gabriela R. , Wasif Muhammad Saif
Published: October 2012

Pancreatic cancer is a lethal disease and remains one of the most resistant cancers to traditional therapies. Historically, chemotherapy or radiotherapy did not provide meaningful survival benefit in advanced pancreatic cancer. Gemcitabine and recently FOLFIRINOX (5-flourouracil, leucovorin, oxaliplatin and irinotecan) have provided some limited survival advantage in advanced pancreatic cancer. Targeted agents in combination with gemcitabine had not shown significant improvement in the survival. Current therapies for pancreatic cancer have their limitations; thus, we are in dire need of newer treatment options. Immunotherapy in pancreatic cancer works by recruiting and activating T cells that recognize tumor-specific antigens which is a different mechanism compared with chemotherapy and radiotherapy. Preclinical models have shown that immunotherapy and targeted therapies like vascular endothelial growth factor and epidermal growth factor inhibitors work synergistically. Hence, new immunotherapy and targeted therapies represent a viable option for pancreatic cancer. In this article, we review the vaccine therapy for pancreatic cancer.
The Impact of Knee Surface Alignment on Ankle Sprain Occurrence
Authors: Armenis Elias , Pefanis Nikolaos , Tsiganos Georgios , Karagounis Panagiotis , Tokatlidou Christin , Baltopoulos Panagiotis
Published: October 2012

Background. Knee position provides useful information for the anatomical alignment of the lower extremity. Analyzing the geometric components of this alignment should yield useful information about how these factors affect the occurrence of an ankle sprain. The aim of this study is to investigate the correlation among these anthropometric characteristics and the possible future occurrence of ankle sprain injuries. Material and methods. A total of 60 elite athletes (25.2 ± 3.2 years) participated in the current study. The data used for measuring knee surface alignment were the following: anatomical alignment angle (AA), condylar hip angle (CH), tibial plateau angle (PA), and joint surface (condylar plateau) angle (CP). Standardized radiography was used in all measurements. All knee alignment measurements were made on digital radiographs. The study lasted for 18 months. A logistic regression (probit) was used for the statistical analysis of the outcomes. A significance level of P = .05 was considered. Results. The knee angle factors (AA, CH, PA, and CP) proved to be statistically nonsignificant (P > .05). Conclusions. The geometric knee surface alignment factors do not seem to be a decisive factor that would increase the probability of spraining an ankle.

Levels of Evidence: Prognostic Level IV: Case Series
New findings in osteoarthritis pathogenesis: therapeutic implications
Authors: Pulsatelli Lia , Addimanda Olga , Brusi Veronica , Pavloska Branka , Meliconi Riccardo
Published: October 2012

This review focuses on the new perspectives which can provide insight into the crucial pathways that drive cartilage-bone physiopathology. In particular, we discuss the critical signaling and effector molecules that can activate cellular and molecular processes in both cartilage and bone cells and which may be relevant in cross talk among joint compartments: growth factors (bone morphogenetic proteins and transforming growth factor), hypoxia-related factors, cell–matrix interactions [discoidin domain receptor 2 (DDR2) and syndecan 4], signaling molecules [WNT, Hedgehog (Hh)]. With the continuous progression of our knowledge on the molecular pathways involved in cartilage and bone changes in osteoarthritis (OA), an increasing number of potentially effective candidates for OA therapy are already under scrutiny in clinical trials to ascertain their possible safe use in an attempt to identify molecules active in slowing or halting OA progression and reducing joint pain. We then review the principal molecules currently under clinical investigation.
Spi-B is critical for plasmacytoid dendritic cell function and development
Authors: Sasaki Izumi , Hoshino Katsuaki , Sugiyama Takahiro , Yamazaki Chihiro , Yano Takahiro , Iizuka Akihiko , Hemmi Hiroaki , Tanaka Takashi , Saito Masuyoshi , Sugiyama Masanaka , Fukuda Yuri , Ohta Tomokazu , Sato Katsuaki , Ainai Akira , Suzuki Tadaki , Hasegawa Hideki , Toyama-Sorimachi Noriko , Kohara Hiroshi , Nagasawa Takashi , Kaisho Tsuneyasu
Published: October 2012

Plasmacytoid dendritic cells (pDCs), originating from hematopoietic progenitor cells in the BM, are a unique dendritic cell subset that can produce large amounts of type I IFNs by signaling through the nucleic acid–sensing TLR7 and TLR9 (TLR7/9). The molecular mechanisms for pDC function and development remain largely unknown. In the present study, we focused on an Ets family transcription factor, Spi-B, that is highly expressed in pDCs. Spi-B could transactivate the type I IFN promoters in synergy with IFN regulatory factor 7 (IRF-7), which is an essential transcription factor for TLR7/9-induced type I IFN production in pDCs. Spi-B–deficient pDCs and mice showed defects in TLR7/9-induced type I IFN production. Furthermore, in Spi-B–deficient mice, BM pDCs were decreased and showed attenuated expression of a set of pDC-specific genes whereas peripheral pDCs were increased; this uneven distribution was likely because of defective retainment of mature nondividing pDCs in the BM. The expression pattern of cell-surface molecules in Spi-B–deficient mice indicated the involvement of Spi-B in pDC development. The developmental defects of pDCs in Spi-B–deficient mice were more prominent in the BM than in the peripheral lymphoid organs and were intrinsic to pDCs. We conclude that Spi-B plays critical roles in pDC function and development.
Galectin-3 binds to CD45 on diffuse large B-cell lymphoma cells to regulate susceptibility to cell death
Authors: Clark Mary C. , Pang Mabel , Hsu Daniel K. , Liu Fu-Tong , de Vos Sven , Gascoyne Randy D. , Said Jonathan , Baum Linda G.
Published: October 2012

Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma and an aggressive malignancy. Galectin-3 (gal-3), the only antiapoptotic member of the galectin family, is overexpressed in DLBCL. While gal-3 can localize to intracellular sites, gal-3 is secreted by DLBCL cells and binds back to the cell surface in a carbohydrate-dependent manner. The major counterreceptor for gal-3 on DLBCL cells was identified as the transmembrane tyrosine phosphatase CD45. Removal of cell-surface gal-3 from CD45 with the polyvalent glycan inhibitor GCS-100 rendered DLBCL cells susceptible to chemotherapeutic agents. Binding of gal-3 to CD45 modulated tyrosine phosphatase activity; removal of endogenous cell-surface gal-3 from CD45 with GCS-100 increased phosphatase activity, while addition of exogenous gal-3 reduced phosphatase activity. Moreover, the increased susceptibility of DLBCL cells to chemotherapeutic agents after removal of gal-3 by GCS-100 required CD45 phosphatase activity. Gal-3 binding to a subset of highly glycosylated CD45 glycoforms was regulated by the C2GnT-1 glycosyltransferase, indicating that specific glycosylation of CD45 is important for regulation of gal-3–mediated signaling. These data identify a novel role for cell-surface gal-3 and CD45 in DLBCL survival and suggest novel therapeutic targets to sensitize DLBCL cells to death.
Potential implication of new torque teno mini viruses in parapneumonic empyema in children
Authors: Galmès Johanna , Li Yongjun , Rajoharison Alain , Ren Lili , Dollet Sandra , Richard Nathalie , Vernet Guy , Javouhey Etienne , Wang Jianwei , Telles Jean-Noël , Paranhos-Baccalà Gláucia
Published: October 2012

An unexplained increase in the incidence of parapneumonic empyema (PPE) in pneumonia cases has been reported in recent years. The present study investigated the genetic and biological specifications of new isolates of torque teno mini virus (TTMV) detected in pleural effusion samples from children hospitalised for severe pneumonia with PPE.

A pathogen discovery protocol was applied in undiagnosed pleural effusion samples and led to the identification of three new isolates of TTMV (TTMV-LY). Isolated TTMV-LY genomes were transfected into A549 and human embryonic kidney 293T cells and viral replication was assessed by quantitative real-time PCR and full-length genome amplification. A549 cells were further infected with released TTMV-LY virions and the induced-innate immune response was measured by multiplex immunoassays.

Genetic analyses of the three TTMV-LY genomes revealed a classic genomic organisation but a weak identity (<64%) with known sequences. We demonstrated thein vitroreplication of TTMV-LY in alveolar epithelial cells and the effective release of infectious viral particles. We also showed a selective production of inflammatory mediators in response to TTMV infection.

This study reports the description of replicative TTMV-LY isolated from parapneumonic effusions of children hospitalised with PPE, suggesting a potential role of the virus in the pathogenesis of pneumonia.
Treatment of COPD by clinical phenotypes: putting old evidence into clinical practice
Authors: Miravitlles Marc , Soler-Cataluña Juan José , Calle Myriam , Soriano Joan B.
Published: October 2012

The new Global Initiative for Chronic Obstructive Lung Disease update has moved the principles of treatment of stable chronic obstructive pulmonary disease (COPD) forward by including the concepts of symptoms and risks into the decision of therapy. However, no mention of the concept of clinical phenotypes is included. It is recognised that COPD is a very heterogeneous disease and not all patients respond to all drugs available for treatment. The identification of responders to therapies is crucial in chronic diseases to provide the most appropriate treatment and avoid unnecessary medications. The classically defined phenotypes of chronic bronchitis and emphysema, together with the newly described phenotypes of overlap COPD-asthma and frequent exacerbator, allow a simple classification of patients that share clinical characteristics and outcomes and, more importantly, similar responses to existing treatments.

These clinical phenotypes can help clinicians identify patients that respond to specific pharmacological interventions. For example, frequent exacerbators are the only subjects with an indication for anti-inflammatory treatment in COPD. Among them, those with chronic bronchitis are the only candidates to receive phosphodiesterase-4 inhibitors. Patients with overlap COPD-asthma phenotype show an enhanced response to inhaled corticosteroids and infrequent exacerbators should only receive bronchodilators. These well-defined clinical phenotypes could potentially be incorporated into treatment guidelines.