bluuebunny/crossref_metadata_2025 huggingface dataset:
Fatigue failure in random vibration and accelerated testing
Authors: Pothula Ashwini , Gupta Abhijit , Kathawate Guru R
Published: September 2011

Accelerated testing involves testing a product at a level higher than the normal usage level. This is important because test time and expenditure for testing can be greatly reduced by accelerated testing. This study involves aluminum beams (bare as well as coated with sprayable damping material) subjected to random vibration. Since most materials fail in fatigue and because accelerated testing is becoming more important due to economic considerations, this paper addresses applicability of various theories for estimation of time failure in normal usage and accelerated condition. Another issue addressed was whether application of damping material makes any difference because many automotive and aerospace applications involve damped materials. Experimentally observed failure time in random vibration for both bare and damped beams under random vibration are compared with various fatigue failure theories. Next the exponent for accelerated testing isobtained for bare and damped beams. This exponent has been studied in terms of both G2/Hz and Grms. Even though different failure theories predicted different failure times, the exponent correlated with all theories for undamped beams and in general with Dirlik theory for damped beams.
A fundamental limitation on the control of end-point force in a very flexible single-link arm
Authors: Bazaei A , Moallem M
Published: September 2011

In this paper, a phenomenon is presented that severely restricts control of end-point force via actuation at the other end in a constrained very flexible single-link arm. This limitation is different from and can be more severe than its known non-minimum-phase characteristic. The link flexibility, contact compliance, and stick–slip friction forces at the hub and end-point areas are incorporated into a unique dynamic model and individual effects of friction forces at the hub and the tip on the control performance are investigated. Experimental results are presented to verify the phenomenon and evaluate the validity of the proposed model.
I Just Like Guys (Girls)
Authors: Teman Eric D.
Published: September 2011

As part of an educational ethnography of a queer cultural center at a western United States university, I explored the center’s cultural importance on the college campus and in its surrounding community. During the course of this study, I used semistructured interviews to inquire about the coming out experiences of four of my participants. Research poetry was used to capture the emotional and poignant words of my gay and lesbian participants.
The Effect of an Inpatient Transition Intervention on Attendance at the First Appointment Postdischarge From a Psychiatric Hospitalization
Authors: Batscha Catherine , McDevitt Judith , Weiden Peter , Dancy Barbara
Published: September 2011

Background: Only 42% of initial appointments following psychiatric hospitalization are kept nationally. Missed appointments increase the likelihood of rehospitalization and increase costs of outpatient care. Objective: This study explored the feasibility, outcomes, and cost of a transition intervention on attendance at the first postdischarge appointment. Design: A pilot study using a one-group prospective design interviewed 15 patients hospitalized with psychosis to address potential barriers to attendance at the first postdischarge appointment. Patients also identified an agenda for this appointment and received a reminder letter. Results: Twelve (92%) of 13 patients attended the postdischarge appointment compared with the previous rate of 44%. Two additional patients were unable to attend because they had been rehospitalized before the scheduled time of the first appointment. Discussion: Contact with a clinician who can bridge the gap between discharge and the first postdischarge appointment is feasible and may be helpful in increasing attendance rates.
Adolescents Who Have Sexually Offended
Authors: Rice Marnie E. , Harris Grant T. , Lang Carol , Chaplin Terry C.
Published: September 2011

It is unclear whether deviant sexual preferences distinguish adolescents who commit sex offenses in the same way that such deviance characterizes adult sex offenders. We compared male adolescents (mean age = 15 at the time of a referral sex offense), matched adult sex offenders, and normal men (adult nonoffenders or nonsex offenders). We hypothesized the following: phallometric responses of the adolescents would be similar to those of adult sex offenders and would differ from normals; adolescents with male child victims would exhibit greater evidence of sexual deviance than those whose only victims were female children; among adolescents who had molested children, those with a history of sexual abuse would exhibit more evidence of sexual deviance than those with no such history; and phallometric measures would predict recidivism. With some notable exceptions or qualifications, results confirmed the hypotheses. Phallometry has valid clinical and research uses with adolescent males who commit serious sex offenses.
Diagnostic profiles determined by the C.A.R.T procedure: IBD patients and fatigue
Authors: Banovic Ingrid , Gilibert Daniel , Jebrane Ahmed , Cosnes Jacques
Published: September 2011

Fatigue is common in IBD. It remains a complex phenomenon with primary factors related to the disease and secondary factors (depression, anxiety, sleep disturbances, pain) whose respective importance and organization are difficult to determine. By using the C.A.R.T. procedure, the diagnostic variables of 108 IBD-related fatigue patients were determined globally, according to their sex and the clinical activity of their disease. Results underline the diversity of diagnostic profiles in which psychological variables have significant influence. It is important to consider fatigue according to profiles that best illustrate its complexity and allow for identifying better potentially remediable factors.
Promoting positive motherhood among nulliparous pregnant women with an intense fear of childbirth: RCT intervention
Authors: Salmela-Aro Katariina , Read Sanna , Rouhe Hanna , Halmesmäki Erja , Toivanen Riikka Maria , Tokola Maiju Ilona , Saisto Terhi
Published: September 2011

This RCT intervention among nulliparous pregnant women with an intense fear of childbirth sought to promote preparedness for childbirth and to enhance positive parenting. Pregnant women (n = 8,611) filled in a ‘fear of childbirth’ questionnaire. Nulliparous women with severe fear of childbirth (n = 355) were randomized into intervention (n = 131; 41 refused) and control (n = 224) groups. They rated themselves on a preparedness scale in middle and late pregnancy, and on a motherhood scale three months after childbirth. The intervention included six psycho-education group sessions during pregnancy and one after childbirth. This intervention increased the mothers’ preparedness for childbirth, which predicted an increase in positive motherhood.
Health, sleep, and professional career in female white-collar workers back to work after long-term sick-listing due to minor mental disorders
Authors: Sandmark Hélène
Published: September 2011

Aims: This study is a 3-year follow up of female white-collar workers, who were on long-term sick leave in 2004 due to stress-related and minor mental disorders. The aim is to show what promotes return-to-work (RTW) and the impact of a long period of sickness absence on professional career. Methods: The study includes a cohort of 233 women who were currently on medically certified sick leave lasting ≥90 days in 2004. A postal questionnaire was sent out after 34 months, regarding self-rated health, quality of sleep, sick-listing status, occupational status, etc. Results: After 34 months, 69% of the women had fully returned to working life. One of the most salient findings is that almost half of those had changed jobs and more than a third were in a new profession. Those who were back in working life rated less negative consequences of the long-term sick-listing on their professional career and their quality of sleep was better (OR 2.90, 95% CI 1.50–5.60 “sleeping all night”). Self-rated health did not show significant association with RTW (OR 2.83, 95% CI 0.91–8.77). Those who had returned to working life reported more control over their lives (OR 1.98, 95% CI 1.01–3.88). Conclusions: The findings imply that, in work health promotion and rehabilitation and efforts to prevent sickness absence due to stress-related disorders, important factors to be considered are job mobility, changes in present work, improved sleep, and control over one's own life.
A Lifecycle Health Performance Tree for Sustainable Healthy Buildings
Authors: Lee Donghoon , Lee Sungho , Kim Jeong Tai , Kim Sunkuk
Published: September 2011

A residential environment configured under inappropriate architectural planning could have a harmful influence on the health of users. Such an issue has led to requirements to improve and to evaluate the health performance of buildings. A proper health performance evaluation would aid tenants or purchasers to make a suitable decision, while also providing building owners and house sellers with useful information regarding the health performance of the buildings. The overall health performance of a building should not merely be a total evaluation score of factors, but a framework that reflects the characteristics and importance of each health-affecting factor. In addition, the overall health performance should include a concept that would enable the use of the tool to estimate and improve the health performance not only at the actual operational stage after completion of a building but over the entire lifecycle including planning, design and construction. To this end, a lifecycle health performance tree (LHT) for sustainable healthy buildings has been developed by this study. Unlike the existing method, which measures the indoor air quality, light and noise factors of a completed space, LHT provides an overall evaluation of the health performance of a space during planning.
First Permanent Implant of Nerve Stimulation Leads Activated by Surface Electrodes, Enabling Hand Grasp and Release
Authors: Gan Liu Shi , Ravid Einat , Kowalczewski Jan Andrzej , Olson Jaret Lawrence , Morhart Michael , Prochazka Arthur
Published: September 2011

Background. More than 150 000 neuroprostheses (NPs) have been implanted in people to restore bodily function in a variety of neural disorders. The authors developed a novel NP, the Stimulus Router System (SRS), in which only passive leads are implanted. Each lead picks up a portion of the current delivered through the skin by an external stimulator. Objective. The authors report on the first human implant of an SRS. Methods. The recipient was a tetraplegic man with bilateral hand paralysis. Three SRS leads were implanted in his right forearm to activate the finger extensors, finger flexors, and thumb flexor. A wristlet containing a surface stimulator and electrodes was used to pass trains of electrical pulses through the skin to each lead. Hand opening and grasp were controlled via a wireless earpiece that sensed small tooth-clicks and transmitted signals to the wristlet. Results. The current required to activate the muscles was less than half that required prior to implantation and below perceptual threshold. Maximal grip force and hand opening aperture were both larger using the SRS. The implanted leads have remained functional for 3 years. The recipient reported various tasks of daily life that improved during SRS usage. An electronic counter revealed mean monthly usage of 18.5 hours, equivalent to 55 hours of continuous manual activity. Conclusions. This first implant of the SRS indicates that it can be effective and reliable and has potential to provide an alternative to existing NPs.
Fatigue and Work Safety Behavior in Men During Early Fatherhood
Authors: Mellor Gary , St. John Winsome
Published: September 2011

This study investigated the relationship between fatigue and work safety behavior of fathers with new babies. A total of 241 fathers completed a questionnaire at 6 and 12 weeks postpartum with items on fatigue and safety behavior at work. Results revealed that fathers worked long hours, reported a moderate-to-high physical intensity of work, and experienced interrupted sleep averaging less than 6 hours. Fathers also reported moderate fatigue at both 6 and 12 weeks postbirth, which was inversely related to safety behavior. Both fatigue and sleep history made a small but statistically significant contribution to safety behavior results at 6 and 12 weeks postbirth. Findings suggest that working fathers with babies experience fatigue during early fatherhood and are unable to recover due to interrupted and poor sleep patterns. Managers should consider the potential for fatigue to compromise work safety and develop risk management strategies that target new fathers.
Nurses’ work patterns: perceived organizational support and psychological contracts
Authors: Mallette Claire
Published: September 2011

With unfolding human resource challenges in health care, little is known of the impact of changing work patterns and employment relationships on the organization and the nursing profession. Social Exchange Theory (perceived organizational support (POS) and psychological contracts) was used to gain understanding of the influence of nurse's employment patterns on employment relationships and individual, organizational and professional outcomes. The sample consisted of 650 randomly selected nurses employed in full-time, part-time, and casual positions across healthcare settings in Ontario, Canada. A cross-sectional survey design explored demographics, volition, POS, psychological contract, job satisfaction, career commitment, and job and career withdrawal. Work patterns and employment relationships are complex and cannot be examined in isolation of other variables such as volition and work congruence. Full-time nurses were found to have more of a relational psychological contract than part-time or casual nurses. The hypothesis was supported that the psychological contract has a direct effect on nurses’ job satisfaction, job withdrawal, career commitment, and career withdrawal. Nurses want to work different work patterns depending on their age and work-life demands. The importance of fostering strong employment relationships and relational psychological contracts to address such issues as an ageing workforce, nursing shortages, and economic demands is highlighted.
Effectiveness and feasibility of using a physical barrier device in reducing rates of microbial contamination of sphygmomanometer cuffs
Authors: Bhanot Nitin , Rao Sriharsha , Sharma Shobha , Malka Edmond S , Ghitan Monica , Gupta Purba , Sahud Andrew G , McCaughey Betsy , Chapnick Edward K
Published: September 2011

phygmomanometers are frequently contaminated with bacteria and are implicated in the transmission of microbes. A pilot study was conducted to determine the effectiveness and feasibility of using a physical barrier device in reducing rates of microbial contamination of sphygmomanometer cuffs. Blood pressure recordings were made with and without a disposable plastic device on healthy individuals to ensure that it did not interfere with the accuracy of readings. Baseline rates of microbial colonisation of sphygmomanometer cuffs were obtained over a six week period. For six weeks the device was applied to patients’ arms before measuring blood pressure, and sphygmomanometer cuffs were recultured during the intervention period. No difference was found in blood pressure recordings with and without the device. No difference in rates of bacterial contamination was observed during the intervention phase of the study. A disposable plastic device acting as a physical barrier may not reduce surface contamination of sphygmomanometer cuffs.
MicroRNA profiles of t(14;18)–negative follicular lymphoma support a late germinal center B-cell phenotype
Authors: Leich Ellen , Zamo Alberto , Horn Heike , Haralambieva Eugenia , Puppe Bernhard , Gascoyne Randy D. , Chan Wing-Chung , Braziel Rita M. , Rimsza Lisa M. , Weisenburger Dennis D. , Delabie Jan , Jaffe Elaine S. , Fitzgibbon Jude , Staudt Louis M. , Mueller-Hermelink Hans-Konrad , Calaminici Mariarita , Campo Elias , Ott German , Hernández Luis , Rosenwald Andreas
Published: September 2011

A total of 90% of follicular lymphomas (FLs) harbor the translocation t(14;18) leading to deregulated BCL2 expression. Conversely, 10% of FLs lack the t(14;18), and the majority of these FLs do not express BCL2. The molecular features of t(14;18)–negative FLs remain largely unknown. We performed microRNA expression analysis in 32 FL grades 1 to 3A, including 17 t(14;18)–positive FLs, 9 t(14;18)–negative FLs without BCL2 expression, and 6 t(14;18)–negative FLs with BCL2 expression. MicroRNA profiles were correlated with corresponding mRNA expression patterns, and potential targets were investigated by quantitative PCR and immunohistochemistry in an independent validation series of 83 FLs. Statistical analysis identified 17 microRNAs that were differentially expressed between t(14;18)–positive FLs and t(14;18)–negative FLs. The down-regulation of miR-16, miR-26a, miR-101, miR-29c, and miR138 in the t(14;18)-negative FL subset was associated with profound mRNA expression changes of potential target genes involving cell cycle control, apoptosis, and B-cell differentiation. miR-16 target CHEK1 showed increased expression in t(14;18)-negative FLs, whereas TCL1A expression was reduced, in line with a partial loss of the germinal center B-cell phenotype in this FL subset. In conclusion, t(14;18)–negative FL have distinct microRNA profiles that are associated with an increased proliferative capacity and a “late” germinal center B-cell phenotype.
Developmental origins and impact of BCR-ABL1 fusion and IKZF1 deletions in monozygotic twins with Ph+ acute lymphoblastic leukemia
Authors: Cazzaniga Giovanni , van Delft Frederik W. , Lo Nigro Luca , Ford Anthony M. , Score Joannah , Iacobucci Ilaria , Mirabile Elena , Taj Mary , Colman Susan M. , Biondi Andrea , Greaves Mel
Published: September 2011

The timing and developmental sequence of events for BCR-ABL1+ acute lymphoblastic leukemia (ALL), usually associated with IKAROS (IKZF1) deletions, are unknown. We assessed the status of BCR-ABL1 and IKZF1 genes in 2 pairs of monozygotic twins, one pair concordant, the other discordant for Philadelphia chromosome positive (Ph+) ALL. The twin pair concordant for ALL shared identical BCR-ABL1 genomic sequence indicative of monoclonal, in utero origin. One twin had IKZF1 deletion and died after transplantation. The other twin had hyperdiploidy, no IKZF1 deletion, and is still in remission 8 years after transplantation. In the twin pair discordant for ALL, neonatal blood spots from both twins harbored the same clonotypic BCR-ABL1 sequence. Low level BCR-ABL1+ cells were present in the healthy co-twin but lacked the IKZF1 deletion present in the other twin's leukemic cells. The twin with ALL relapsed and died after transplantation. The co-twin remains healthy and leukemia free. These data show that in childhood Ph+ ALL, BCR-ABL1 gene fusion can be a prenatal and possibly initiating genetic event. In the absence of additional, secondary changes, the leukemic clone remains clinically silent. IKZF1 is a secondary and probable postnatal mutation in these cases, and as a recurrent but alternative copy number change is associated with poor prognosis.
Increased incidence of nonfatal cardiovascular events in stroke patients with sleep apnoea: effect of CPAP treatment
Authors: Martínez-García M-A. , Campos-Rodríguez F. , Soler-Cataluña J-J. , Catalán-Serra P. , Román-Sánchez P. , Montserrat J-M.
Published: September 2011

Obstructive sleep apnoea (OSA) is a risk factor for stroke, but little is known about the effect of OSA and continuous positive airway pressure (CPAP) on the incidence of long-term, nonfatal cardiovascular events (CVE) in stroke patients.

A prospective observational study was made in 223 patients consecutively admitted for stroke. A sleep study was performed on 166 of them. 31 had an apnoea/hypopnoea index (AHI) <10 events·h−1; 39 had an AHI between 10 and 19 events·h−1and 96 had an AHI ≥20 events·h−1. CPAP treatment was offered when AHI was ≥20 events·h−1. Patients were followed up for 7 yrs and incident CVE data were recorded.

The mean±sdage of the subjects was 73.3±11 yrs; mean AHI was 26±16.7 events·h−1. Patients with moderate-to-severe OSA who could not tolerate CPAP (AHI ≥20 events·h−1; n=68) showed an increased adjusted incidence of nonfatal CVE, especially new ischaemic strokes (hazard ratio 2.87, 95% CI 1.11–7.71; p=0.03), compared with patients with moderate-to-severe OSA who tolerated CPAP (n=28), patients with mild disease (AHI 10–19 events·h−1; n=36) and patients without OSA (AHI <10 events·h−1; n=31).

Our results suggest that the presence of moderate-to-severe OSA is associated with an increased long-term incidence of nonfatal CVE in stroke patients and that CPAP reduces the excess of incidence seen in these patients.
Pulmonary embolism: CT signs and cardiac biomarkers for predicting right ventricular dysfunction
Authors: Henzler T. , Roeger S. , Meyer M. , Schoepf U.J. , Nance J.W. , Haghi D. , Kaminski W.E. , Neumaier M. , Schoenberg S.O. , Fink C.
Published: September 2011

The aim of this study was to prospectively evaluate the accuracy of quantitative cardiac computed tomography (CT) parameters and two cardiac biomarkers (N-terminal-pro-brain natriuretic peptide (NT-pro-BNP) and troponin I), alone and in combination, for predicting right ventricular dysfunction (RVD) in patients with acute pulmonary embolism.

557 consecutive patients with suspected pulmonary embolism underwent pulmonary CT angiography. Patients with pulmonary embolism also underwent echocardiography and NT-pro-BNP/troponin I serum level measurements. Three different CT measurements were obtained (right ventricular (RV)/left ventricular (LV)axial, RV/LV4-CHand RV/LVvolume). CT measurements and NT-pro-BNP/troponin I serum levels were correlated with RVD at echocardiography.

77 patients with RVD showed significantly higher RV/LV ratios and NT-pro-BNP/troponin I levels compared to those without RVD (RV/LVaxial1.68±0.84versus1.00±0.21; RV/LV4-CH1.52±0.45versus1.01±0.21; RV/LVvolume1.97±0.53versus1.07±0.52; serum NT-pro-BNP 6,372±2,319versus1,032±1,559 ng·L−1; troponin I 0.18±0.41versus0.06±0.18 g·L−1). The area under the curve for the detection of RVD of RV/LVaxial, RV/LV4-CH, RV/LVvolume, NT-pro-BNP and troponin I were 0.84, 0.87, 0.93, 0.83 and 0.70 respectively. The combination of biomarkers and RV/LVvolumeincreased the AUC to 0.95 (RV/LVvolumewith NT-pro-BNP) and 0.93 (RV/LVvolumewith troponin I).

RV/LVvolumeis the most accurate CT parameter for identifying patients with RVD. A combination of RV/LVvolumewith NT-pro-BNP or troponin I measurements improves the diagnostic accuracy of either test alone.
Loss of polymeric immunoglobulin receptor expression is associated with lung tumourigenesis
Authors: Ocak Sebahat , Pedchenko Tetyana V. , Chen Heidi , Harris Frederick T. , Qian Jun , Polosukhin Vasiliy , Pilette Charles , Sibille Yves , Gonzalez Adriana L. , Massion Pierre P.
Published: September 2011

Polymeric immunoglobulin receptor (pIgR) expression is downregulated in lung cancer, but its implications in lung tumourigenesis remain unknown. We hypothesised that loss of pIgR expression occurs early, and is associated with cell proliferation and poor prognosis.

pIgR expression was evaluated by immunohistochemistry in airways of patients with normal mucosa, pre-invasive lesions and invasive lesions, and correlated with clinical outcomes. 16-HBE and A549 cells stably transfected with pIgR were tested for proliferation, apoptosis and cell cycle progression.

Immunostaining was strong in normal epithelium, but severely reduced in pre-invasive lesions and most lung cancers. Persistent expression was associated with younger age and adenocarcinoma subtype but not survival. pIgR overexpression significantly reduced A549 and 16-HBE proliferation. Growth inhibition was not due to cell cycle arrest, increased apoptosis or endoplasmic reticulum stress, but we observed altered expression of genes encoding for membrane proteins, including NOTCH3. Interestingly, NOTCH3 expression was inversely correlated with pIgR expression in cell lines and tissues.

pIgR expression was lost in most lung cancers and pre-invasive bronchial lesions, suggesting that pIgR downregulation is an early event in lung tumourigenesis. pIgR overexpression in A549 and 16-HBE cells inhibited proliferation. Future investigations are required to determine the mechanisms by which pIgR contributes to cell proliferation.
Sex in the PAC: A hidden affair in dark septate endophytes?
Authors: Zaffarano Pascal L , Queloz Valentin , Duò Angelo , Grünig Christoph R
Published: September 2011

Background

Fungi are asexually and sexually reproducing organisms that can combine the evolutionary advantages of the two reproductive modes. However, for many fungi the sexual cycle has never been observed in the field or in vitro and it remains unclear whether sexual reproduction is absent or cryptic. Nevertheless, there are indirect approaches to assess the occurrence of sex in a species, such as population studies, expression analysis of genes involved in mating processes and analysis of their selective constraints. The members of the Phialocephala fortinii s. l. - Acephala applanata species complex (PAC) are ascomycetes and the predominant dark septate endophytes that colonize woody plant roots. Despite their abundance in many ecosystems of the northern hemisphere, no sexual state has been identified to date and little is known about their reproductive biology, and how it shaped their evolutionary history and contributes to their ecological role in forest ecosystems. We therefore aimed at assessing the importance of sexual reproduction by indirect approaches that included molecular analyses of the mating type (MAT) genes involved in reproductive processes.

Results

The study included 19 PAC species and > 3, 000 strains that represented populations from different hosts, continents and ecosystems. Whereas A. applanata had a homothallic (self-fertile) MAT locus structure, all other species were structurally heterothallic (self-sterile). Compatible mating types were observed to co-occur more frequently than expected by chance. Moreover, in > 80% of the populations a 1:1 mating type ratio and gametic equilibrium were found. MAT genes were shown to evolve under strong purifying selection.

Conclusions

The signature of sex was found in worldwide populations of PAC species and functionality of MAT genes is likely preserved by purifying selection. We hypothesize that cryptic sex regularely occurs in the PAC and that further field studies and in vitro crosses will lead to the discovery of the sexual state. Although structurally heterothallic species prevail, it cannot be excluded that homothallism represents the ancestral breeding system in the PAC.
Deciphering c-MYC-regulated genes in two distinct tissues
Authors: Robson Samuel C , Ward Lesley , Brown Helen , Turner Heather , Hunter Ewan , Pelengaris Stella , Khan Michael
Published: September 2011

Background

The transcription factor MYC is a critical regulator of diverse cellular processes, including both replication and apoptosis. Differences in MYC-regulated gene expression responsible for such opposing outcomesin vivoremain obscure. To address this we have examined time-dependent changes in global gene expression in two transgenic mouse models in which MYC activation, in either skin suprabasal keratinocytes or pancreatic islet β-cells, promotes tissue expansion or involution, respectively.

Results

Consistent with observed phenotypes, expression of cell cycle genes is increased in both models (albeit enriched in β-cells), as are those involved in cell growth and metabolism, while expression of genes involved in cell differentiation is down-regulated. However, in β-cells, which unlike suprabasal keratinocytes undergo prominent apoptosis from 24 hours, there is up-regulation of genes associated with DNA-damage response and intrinsic apoptotic pathways, includingAtr,Arf,BaxandCycs. In striking contrast, this is not the case for suprabasal keratinocytes, where pro-apoptotic genes such asNoxaare down-regulated and key anti-apoptotic pathways (such as Igf1-Akt) and those promoting angiogenesis are up-regulated. Moreover, dramatic up-regulation of steroid hormone-regulated Kallikrein serine protease family members in suprabasal keratinocytes alone could further enhance local Igf1 actions, such as through proteolysis of Igf1 binding proteins.

Conclusions

Activation of MYC causes cell growth, loss of differentiation and cell cycle entry in both β-cells and suprabasal keratinocytesin vivo. Apoptosis, which is confined to β-cells, may involve a combination of a DNA-damage response and downstream activation of pro-apoptotic signalling pathways, including Cdc2a and p19Arf/p53, and downstream targets. Conversely, avoidance of apoptosis in suprabasal keratinocytes may result primarily from the activation of key anti-apoptotic signalling pathways, particularly Igf1-Akt, and induction of an angiogenic response, though intrinsic resistance to induction of p19Arfby MYC in suprabasal keratinocytes may contribute.
Breakpoint characterization of a novel large intragenic deletion of MUTYH detected in a MAP patient: Case report
Authors: Torrezan Giovana T , da Silva Felipe CC , Krepischi Ana CV , Santos Érika MM , de O Ferreira Fábio , Rossi Benedito M , Carraro Dirce M
Published: September 2011

Background

MUTYH-associated polyposis (MAP) is a recessive, hereditary, colorectal cancer-predisposing syndrome caused by biallelic mutations in the MUTYH gene. Most MUTYH pathogenic variants are missense mutations, and until recently no gross genomic deletions had been described.

Case Presentation

We have identified a large deletion in the MUTYH gene: a > 4.2 kb deletion encompassing exons 4-16. This is the second description of this rearrangement, which has been recently described as the first large deletion in this gene. The clinically suspected MAP patient was homozygous for this mutation and presented with no amplification products for 14 exons of MUTYH on initial screening. Deletion breakpoints were refined to base pair level through array comparative genomic hybridization (aCGH) analysis followed by sequencing. The identified breakpoints were located within intron 3 and 146 bp downstream of the 3' end of the gene, with the presence of an AluJr element adjacent to the distal breakpoint. The presence of a 2 bp insertion at the junction suggests the involvement of the non-homologous end joining (NHEJ) repair mechanism, possibly facilitated by rearrangement-promoting elements. Examination of the MUTYH locus revealed a high Alu density that may make this region prone to rearrangements.

Conclusion

Large deletions are a possible mechanism for loss of function of the MUTYH gene, and investigation of such mutations may be important in identifying causative mutations in MAP patients.
Gender-dependence of substituted judgment on quality of life in patients with dementia
Authors: Schiffczyk Claudia , Jonas Christina , Lahmeyer Constanze , Müller Friedemann , Riepe Matthias W
Published: September 2011

Background

Substituted judgment asks the proxy to decide what the patient would have decided, had he or she been competent. It is unclear whether substituted judgment of the patient's quality of life can serve as a surrogate measure in patients with dementia.

Methods

212 patients with dementia and their proxies were interviewed in their homes. Dementia syndrome was characterized with cognitive, non-cognitive and functional scales. Quality of life (QoL) was assessed with the QoL-AD.

Results

Substituted judgment of the patient's QoL was unrelated to dementia severity but also correlated with the proxie's own QoL (r = 0.356; p < 0.001). Gender-specific analysis reveals that for male proxies the most important variable is severity of patient's depression (r = -0.895; p = 0.001) while for female proxies it is the proxie's own QoL (r = 0.371; p < 0.001). Subjective burden correlates with the proxie's QoL in females (r = -0.282; p = 0.001) but not in males (r = -0.163, p = 0.161).

Conclusion

Substituted judgment of the patient's QoL does not correlate with dementia severity. Substituted judgment is subject to proxy-related variables in a gender-dependent fashion and therefore not suited to serve as an appropriate surrogate of the patients' quality of life.
Scoliotic posture as the initial symptom in adolescents with lumbar disc herniation: its curve pattern and natural history after lumbar discectomy
Authors: Zhu Zezhang , Zhao Qinghua , Wang Bin , Yu Yang , Qian Bangping , Ding Yitao , Qiu Yong
Published: September 2011

Background

There have been few studies focusing on the curve pattern of scoliosis caused by lumbar disc herniation (LDH) in adolescents and the natural history of scoliosis after discectomy. The current study was carried out to identify the curve pattern of scoliosis and investigate the effect of posterior discectomy on the curve improvement in adolescents with LDH.

Methods

This review focused on a group of 26 adolescents with LDH who initially presented to our clinic for evaluation of scoliosis, followed by posterior discectomy between 2000 and 2009. Radiographic measurements included curve pattern, specific curve features, trunk shift, and sagittal profile. The correlation between the side of disc herniation and the direction of lumbosacral curve and the trunk shift was evaluated.

Results

A typical curve pattern was initially identified in all of the patients as a short lumbosacral curve accompanied with a long thoracic or thoracolumbar curve toward the opposite side. 23 of 26 patients (88.5%) had a trunk shift more than 2.0 cm away from the midline, showing a poor coronal balance. A relatively straight sagittal profile was noted in all the patients. 84.6% (22/26) patients had a disc herniation at the convex side of lumbosacral curve. Similarly, 73.1% (19/26) patients showed a trunk shift toward the opposite side of disc herniation. All of the patients had an marked curve improvement immediately after discectomy. In the 17 patients with a more than 2-year follow-up, only two had a residual lumbosacral curve greater than or equal to 20 degrees. The mean ODI improved from 21.4% before surgery to 7.3% at the final follow-up.

Conclusions

A short lumbosacral curve accompanied with a long thoracic or thoracolumbar curve toward the opposite side, and a relatively straight sagittal profile have been noted in all the patients. The direction of lumbosacral curve and trunk shift was related to the side of disc herniation. A majority of patients have a small curve size while assosiated with a significant coronal imbalance. Earlier decompression can provide a greater opportunity for spontaneous correction of scoliosis.
Stages of change: A qualitative study on the implementation of a perinatal audit programme in South Africa
Authors: Belizán María , Bergh Anne-Marie , Cilliers Carolé , Pattinson Robert C , Voce Anna ,   the Synergy Group
Published: September 2011

Background

Audit and feedback is an established strategy for improving maternal, neonatal and child health. The Perinatal Problem Identification Programme (PPIP), implemented in South African public hospitals in the late 1990s, measures perinatal mortality rates and identifies avoidable factors associated with each death. The aim of this study was to elucidate the processes involved in the implementation and sustainability of this programme.

Methods

Clinicians' experiences of the implementation and maintenance of PPIP were explored qualitatively in two workshop sessions. An analytical framework comprising six stages of change, divided into three phases, was used: pre-implementation (create awareness, commit to implementation); implementation (prepare to implement, implement) and institutionalisation (integrate into routine practice, sustain new practices).

Results

Four essential factors emerged as important for the successful implementation and sustainability of an audit system throughout the different stages of change: 1) drivers (agents of change) and team work, 2) clinical outreach visits and supervisory activities, 3) institutional perinatal review and feedback meetings, and 4) communication and networking between health system levels, health care facilities and different role-players.

During the pre-implementation phase high perinatal mortality rates highlighted the problem and indicated the need to implement an audit programme (stage 1). Commitment to implementing the programme was achieved by obtaining buy-in from management, administration and health care practitioners (stage 2).

Preparations in the implementation phase included the procurement and installation of software and training in its use (stage 3). Implementation began with the collection of data, followed by feedback at perinatal review meetings (stage 4).

The institutionalisation phase was reached when the results of the audit were integrated into routine practice (stage 5) and when data collection had been sustained for a longer period (stage 6).

Conclusion

Insights into the factors necessary for the successful implementation and maintenance of an audit programme and the process of change involved may also be transferable to similar low- and middle-income public health settings where the reduction of the neonatal mortality rate is a key objective in reaching Millennium Development Goal 4. A tool for reflecting on the implementation and maintenance of an audit programme is also proposed.
Joint redundant motion vector and intra macroblock refreshment for video transmission
Authors: Xiao Jimin , Tillo Tammam , Lin Chunyu , Zhao Yao
Published: September 2011

This paper proposes a scheme for error-resilient transmission of videos which jointly uses intra macroblock refreshment and redundant motion vector. The selection of using intra refreshment or redundant motion vector is determined by the rate-distortion optimization procedure. The end-to-end distortion is used for the rate-distortion optimization, which can be easily calculated with the recursive optimal per-pixel estimate (ROPE) method. Simulation results show that the proposed method outperforms both the intra refreshment approach and redundant motion vector approach significantly, when the two approaches are deployed separately. Specifically, for the Foreman sequence, the average PSNR of the proposed approach can be 1.12 dB higher than that of the intra refreshment approach and 5 dB higher than that of the redundant motion vector approach.
Sales of antidepressants, suicides and hospital admissions for depression in Veneto Region, Italy, from 2000 to 2005: an ecological study
Authors: Guaiana Giuseppe , Andretta Margherita , Griez Eric , Biancosino Bruno , Grassi Luigi
Published: September 2011

Background

Increased prescription of antidepressants has been consistently associated with a decrease in suicide rates in several countries. The aim of this study is to explore antidepressant consumption, suicide rates and admission for depression in the Veneto Region, Italy, in order to see whether the same pattern could be detected.

Methods

Data from the Italian Ministry of Health (admissions for depression), the Pharmacy Service of a Local Health Unit (antidepressant prescribing) and from the Epidemiological System of the Veneto region (suicide rates) were collected from 2000 to 2005 for the Veneto region.

Results

Suicide rates did not show any marked increase but were stable in males and females. Antidepressant prescribing increased exponentially over the period examined, whilst admissions for depression markedly decreased. The trend for an exponential increase in antidepressant prescribing in the Veneto region is shared with other countries and locales.

Conclusions

It is possible that the increase in antidepressant prescribing might be associated with earlier treatment of depression, thus decreasing the likelihood of aggravation of depression.
Computerized texture analysis of atypical immature myeloid precursors in patients with myelodysplastic syndromes: an entity between blasts and promyelocytes
Authors: Vido Joyce R , Adam Randall L , Lorand-Metze Irene GH , Metze Konradin
Published: September 2011

Background

Bone marrow (BM) blast count is an essential parameter for classification and prognosis of myelodysplastic syndromes (MDS). However, a high degree of cell atypias in bone marrow hemopoietic cells may be found in this group of clonal disorders, making it difficult to quantify precisely myeloblasts, and to distinguish them from promyelocytes and atypical immature myeloid precursors. Our aim was to investigate whether computerized image analysis of routine cytology would help to characterize these cells.

Methods

In May-Grünwald-Giemsa stained BM smears of 30 newly diagnosed MDS patients and 19 cases of normal BM, nuclei of blasts and promyelocytes were digitalized and interactively segmented. The morphological classification of the cells was done by consensus of two observers. Immature granulocytic precursors, which could not be clearly classified either as blasts or promyelocytes, were called "atypic myeloid precursors". Nuclear morphometry and texture features derived from the co-occurrence matrix and fractal dimension (FD) were calculated.

Results

In normal BM, when compared to myeloblasts, nuclei of promyelocytes showed significant increase in perimeter and local texture homogeneity and a decrease in form factor, chromatin gray levels, Haralick's entropy, inertia, energy, contrast, diagonal moment, cluster prominence, the fractal dimension according to Minkowski and its goodness-of-fit. Compared to normal myeloblast nuclei, the chromatin texture of MDS myeloblasts revealed higher local homogeneity and goodness-of-fit of the FD, but lower values of entropy, contrast, diagonal moment, and fractal dimension. The same differences were found between nuclei of normal promyelocytes and those of MDS. Nuclei of atypical myeloid precursors showed intermediate characteristics between those of blasts and promyelocytes according to the quantitative features (perimeter, form factor, gray level and its standard deviation), but were similar to promyelocytes according to the texture variables inertia, energy, contrast, diagonal moment, cluster prominence, and Minkowski's fractal dimension.

Conclusion

BM atypical immature myeloid precursors are difficult to be correctly classified in routine cytology. Although their cytoplasm is more similar to that of myeloblasts, computerized texture analysis indicates a nuclear chromatin remodeling more close to the promyelocyte, thus indicating an asynchronous intermediate maturation stage between blast and promyelocyte.
A highly efficient rice green tissue protoplast system for transient gene expression and studying light/chloroplast-related processes
Authors: Zhang Yang , Su Jianbin , Duan Shan , Ao Ying , Dai Jinran , Liu Jun , Wang Peng , Li Yuge , Liu Bing , Feng Dongru , Wang Jinfa , Wang Hongbin
Published: September 2011

Background

Plant protoplasts, a proven physiological and versatile cell system, are widely used in high-throughput analysis and functional characterization of genes. Green protoplasts have been successfully used in investigations of plant signal transduction pathways related to hormones, metabolites and environmental challenges. In rice, protoplasts are commonly prepared from suspension cultured cells or etiolated seedlings, but only a few studies have explored the use of protoplasts from rice green tissue.

Results

Here, we report a simplified method for isolating protoplasts from normally cultivated young rice green tissue without the need for unnecessary chemicals and a vacuum device. Transfections of the generated protoplasts with plasmids of a wide range of sizes (4.5-13 kb) and co-transfections with multiple plasmids achieved impressively high efficiencies and allowed evaluations by 1) protein immunoblotting analysis, 2) subcellular localization assays, and 3) protein-protein interaction analysis by bimolecular fluorescence complementation (BiFC) and firefly luciferase complementation (FLC). Importantly, the rice green tissue protoplasts were photosynthetically active and sensitive to the retrograde plastid signaling inducer norflurazon (NF). Transient expression of the GFP-tagged light-related transcription factor OsGLK1 markedly upregulated transcript levels of the endogeneous photosynthetic genes OsLhcb1, OsLhcp, GADPH and RbcS, which were reduced to some extent by NF treatment in the rice green tissue protoplasts.

Conclusions

We show here a simplified and highly efficient transient gene expression system using photosynthetically active rice green tissue protoplasts and its broad applications in protein immunoblot, localization and protein-protein interaction assays. These rice green tissue protoplasts will be particularly useful in studies of light/chloroplast-related processes.
No psychiatry without psychopharmacology
Authors: Harrison Paul J. , Baldwin David S. , Barnes Thomas R. E. , Burns Tom , Ebmeier Klaus P. , Ferrier I. Nicol , Nutt David J.
Published: September 2011

The use of psychotropic medication is an important part of most psychiatrists' clinical practice. We propose here that psychiatry needs to give more prominence to psychopharmacology in order to ensure that psychiatric drugs are used effectively and safely. The issue has several ramifications, including the future of psychiatry as a medical discipline.
Stigmatised attitudes towards the ‘stressed’ or ‘ill’ models of mental illness
Authors: Luty Jason , Easow Joby Maducolil , Mendes Vania
Published: September 2011

Aims and method

Tackling discrimination, stigma and inequalities in mental health is a major objective of the UK government. The project aimed to determine the effect of presenting a person with a mental illness as having either a biological illness or a disorder that arose from psychosocial stress to a randomised representative panel of members of the general public. The 20-point Attitude to Mental Illness Questionnaire (AMIQ) was used to assess stigmatised attitudes.

Results

Overall, 187 individuals returned their questionnaires (74% response rate). The mean AMIQ stigma score for the ‘ill’ group was 1.4 (s.e. = 0.3; n = 94). The mean AMIQ score for the ‘stress’ group was 0.5 (s.e. = 0.3; median n = 106; P = 0.0837, median difference = 1; power (for 5% significance) 81%).

Clinical implications

There was no difference in the stigmatised attitudes towards a person with mental illness regardless of whether they were presented as biologically ill or as having an illness that was a response to psychosocial stress.
Use of anti-dementia drugs and delayed care home placement: an observational study
Authors: Salib Emad , Thompson Jessica
Published: September 2011

Aims and method

To examine the association between the use of cholinesterase inhibitors (ChEIs) and time to care home placement. We compared patients who were prescribed ChEIs in 2006 with those who were not with respect to their placement in care homes over a 4-year period, using survival analysis.

Results

During the first 30 months of follow-up there was a delay in care home placement by a median of 12 months in those who took ChEIs compared with those who did not. However, at the end of the follow-up there was no significant reduction in the probability of being in a care home setting between those who had taken ChEIs compared with those who had not (hazard ratio 0.75, 95% CI 0.25–6, P = 0.1).

Clinical implications

The study provides some evidence to suggest that prescribing ChEIs may be associated with a delay in the timing of care home placement as observed in the first 2.5 years of treatment. However, based on purely observational data, no conclusion can be made as to whether such association is causal.