bluuebunny/crossref_metadata_2025 huggingface dataset:
Using factor analysis to create complementary and alternative medicine domains: An examination of patterns of use
Authors: Ayers Stephanie L. , Kronenfeld Jennie J.
Published: April 2010

Previous research on complementary and alternative medicine (CAM) in the United States has relied heavily on the National Center for Complementary and Alternative Medicine’s (NCCAM) domains of CAM but with noted limitations. We conducted a multifaceted examination of previous CAM domains and tested if they represent actual patterns of CAM use. The data come from the 2002 United States’ National Health Interview Survey and include 30,923 adults. Outcome measures included 20 types of CAM used in the last 12 months. Both exploratory and confirmatory factor analysis were used to test how CAM modalities should be categorized. Results indicate that prayer should be created as a new domain apart from Mind—Body Medicine. Herbs and vitamins fit best with Alternative Medical Systems while acupuncture best fits with chiropractic and massage. These findings suggest that how types of CAM have been previously categorized in earlier research is inconsistent with actual patterns of CAM utilization.These findings provided a framework for conducting and analyzing future CAM research, both in the USA and in other countries, and should be used in future research to try to explain and understand the variation and predictors of CAM utilization.
Nutritional health, subjectivity and resistance: Women’s accounts of dietary practices
Authors: Madden Helen , Chamberlain Kerry
Published: April 2010

Food is related to health, both directly and symbolically, in complex ways. Also, social practices around food are highly gendered, and, in the context of family life, fall largely to mothers. This study examines mothers’ talk about nutritional health, and food, health and dietary practices in the context of everyday life, using a discursive analysis of the talk from focus group discussions. Findings show that discourses surrounding nutritional health offer women a variety of conflictual subjectivities. If they do not engage in ‘correct’ dietary practices, women are positioned as immoral, both as individuals and as mothers. Further, their ability to determine which foods are ‘healthy’ or ‘unhealthy’ is undermined through a distrust of ‘facts’ and scientific evidence, and they are rendered susceptible to exploitation through claims made for food as health promoting. Together, these areas of conflict perpetuate subjectivities of anxiety around dietary practices.The women seek to re-position themselves and overcome these contradictions by offering a variety of legitimations for their dietary practices. In doing so, they resist nutritional health messages and reveal how such messages can have unintended effects.
The phenomenology of time: Lived experiences of people with HIV/AIDS in China
Authors: Zhou Yanqiu Rachel
Published: April 2010

Based on a qualitative study of lived experiences of people living with HIV/AIDS in China, this article explores the role of time — in particular, time as lived (or, perceptual time) — in these individuals’ construction and reconstruction of the meanings of their illness experiences. Although their HIV infection interrupted the linear flow of time, the end of which is death, they had reconstructed the meanings of time according to their priorities in the process of living with this disease. Making sense of time beyond a linear time framework benefited these individuals by enabling them to restore their control over their lives and transform a process of deteriorating and dying into a process of living and growing. It is concluded that time, as a distinct form of illness experience, merits further examination in future AIDS research as well as in health research.
Mental distress: Strategies of sense-making
Authors: Cardano Mario
Published: April 2010

The irruption of severe mental distress into the life of an individual determines a deep biographical disruption. To cope with this crisis, individuals are involved in a laborious sense-making activity, through the composition of narratives intended to create a new link between past, present and future. This essay analyses the sense-making strategies that follow this dramatic experience through the comparison of four illness narratives composed by Italian participants. The narratives are selected from a broader textual corpus in a way that authorizes their connotation as ‘flesh and blood’ ideal types. These narratives illustrate three kinds of explanation for the outset of mental distress: the biomedical adopted by Vito; the spiritual-religious adopted by Marta; and the psycho-social adopted by Giacomo. Vito, Marta and Giacomo are still inside the story they are telling, and compose the events by observing them through the eyes of a patient, qualifying their diversity as a stigma. The fourth narrative is different, composed by Serena, a ‘voices hearer’ who comes to terms with her voices not by silencing them with drugs, but by accepting them as a charisma that has transformed her into a medium and, on final analysis, a balanced woman.
Public justification and the limits of state action
Authors: Lister Andrew
Published: April 2010

One objection to the principle of public reason is that since there is room for reasonable disagreement about distributive justice as well as about human flourishing, the requirement of reasonable acceptability rules out redistribution as well as perfectionism. In response, some justificatory liberals have invoked the argument from higher-order unanimity, or nested inclusiveness. If it is not reasonable to reject having some system of property rights, and if redistribution is just the enforcement of a different set of property rights, redistribution is legitimate if chosen democratically. This article explores two problems with this response. First, there are different ways to describe the set of possible policies, and so different ways to specify the noncoercive default that obtains in the absence of conclusive justification. Second, if the coercive exercise of political power must be conclusively justified, policies that are more coercive ought to require conclusive justification as against policies that are less coercive. These problems about the baseline with respect to which we require public justification raise the question of how we measure coercion, and whether or in what sense there is a presumption against coercion. The article distinguishes and argues against three such presumptions.
The Competencies Used by Effective Managers to Build Teams: An Empirical Study
Authors: Gilley Ann , Gilley Jerry W. , McConnell C. William , Veliquette Abigail
Published: April 2010

Despite the abundance of research on teams and their benefits to organizations, little attention has been paid to management’s role in building effective teams. This study investigated the relationship between specific managerial competencies and building teams, and identified the primary predictors of a manager’s success in facilitating teams to be able to involve employees in decision making, coach others, and communicate effectively.
Interference Between Cognition, Double-Limb Support, and Swing During Gait in Community-Dwelling Individuals Poststroke
Authors: Plummer-D'Amato Prudence , Altmann Lori J. P. , Behrman Andrea L. , Marsiske Michael
Published: April 2010

Background. Dual tasking can interfere with activity after stroke. Objective. The authors examined the interactions between 3 different cognitive tasks and the swing and double-limb support (DLS) components of the gait cycle in community-dwelling individuals poststroke. Methods. Acquisition of cognitive and gait data were synchronized to study the cognitive—motor interference effects during the different phases of the gait cycle. Participants performed 3 different cognitive tasks in isolation and in combination with walking as well as a single walking task. Tasks were performed continuously for 3 minutes, generating 131 ± 39 gait cycles per person for analysis for each walking trial. Data were analyzed for 8 participants 7.6 ± 4.2 months poststroke. Results. A significant increase was found in the proportion of the gait cycle spent in DLS in dual-task walking because of an increased duration of the DLS phase associated with paretic weight acceptance. There was a significant dual-task effect on nonparetic swing duration: participants reduced the amount of time in paretic single-limb stance in the 3 dual-task conditions. Temporal asymmetry of gait did not increase significantly under dual-task conditions. Reaction times were not affected by whether the stimuli were present during the swing or DLS phase of the gait cycle. Conclusions. The findings from this pilot study provide evidence that cognitive—motor interference during gait may be influenced by the phase of the gait cycle, especially DLS involving paretic weight acceptance, which may affect community ambulators with hemiparetic stroke.
Effectiveness of Modified Constraint-Induced Movement Therapy in Children With Unilateral Spastic Cerebral Palsy: A Randomized Controlled Trial
Authors: Aarts Pauline B. , Jongerius Peter H. , Geerdink Yvonne A. , van Limbeek Jacques , Geurts Alexander C.
Published: April 2010

Background. In children with unilateral spastic cerebral palsy (CP), there is only limited evidence for the effectiveness of modified constraint-induced movement therapy (mCIMT). Objective. To investigate whether 6 weeks of mCIMT followed by 2 weeks of bimanual task-specific training (mCIMT-BiT) in children with unilateral spastic CP improves the spontaneous use of the affected limb in both qualitative and quantitative terms more than usual care (UC) of the same duration. Methods. Children with unilateral spastic CP with Manual Ability Classification System (MACS) scores I, II, or III and aged 2.5 to 8 years were recruited and randomly allocated to either the mCIMT-BiT group (three 3-hour sessions per week: 6 weeks of mCIMT, followed by 2 weeks of task-specific training in goal-directed bimanual play and self-care activities) or to 1.5 hours of more general physical or occupational weekly plus encouragement to use the affected hand for the UC group. Primary outcome measures were the Assisting Hand Assessment and the ABILHAND-Kids. Secondary outcomes were the Melbourne Assessment of Unilateral Upper Limb Function, the Canadian Occupational Performance Measure, and the Goal Attainment Scale. Results. Twenty-eight children were allocated to mCIMT-BiT and 24 to UC. Except for the Melbourne, all primary and secondary outcome measures demonstrated significant improvements in the mCIMT-BiT group. Conclusion. mCIMT followed by task-specific training of goal-directed bimanual play and self-care activities is an effective intervention to improve the spontaneous use of the more affected upper limb in children with relatively good baseline upper extremity function.
Translating Animal Doses of Task-Specific Training to People With Chronic Stroke in 1-Hour Therapy Sessions: A Proof-of-Concept Study
Authors: Birkenmeier Rebecca L. , Prager Eliza M. , Lang Catherine E.
Published: April 2010

Objective. The purposes of this study were to (1) examine the feasibility of translating high-repetition doses of upper-extremity (UE) task-specific training to people with stroke within the confines of the current outpatient delivery system of 1-hour therapy sessions and (2) to gather preliminary data regarding the potential benefit of this intensity of training. Methods. A total of 15 patients with chronic (>6 months) UE paresis caused by stroke underwent 3 weeks of baseline assessments followed by 6 weeks of the high-repetition intervention (3 sessions/wk for 6 weeks). During each 1-hour session, participants were challenged to complete 300 or more repetitions of UE functional task training (3 tasks × 100 repetitions). Assessments during and after the intervention were used to measure feasibility and potential benefit. Results. For the 13 participants completing the intervention, the average number of repetitions per session was 322. The percentage of sessions attended was 97%. Participant ratings of pain and fatigue were low. Action Research Arm test scores improved an average of 8 points during the intervention and were maintained at the 1-month follow-up. Secondary measures of activity and participation increased, but the measure of impairment did not. Conclusions. It is feasible to deliver hundreds of repetitions of task-specific training to people with stroke in 1-hour therapy sessions. Preliminary outcome data suggest that this intervention may be beneficial for some people with stroke.
Leucine With Resistance Training for the Treatment of Sarcopenia
Authors: Lenz Thomas L.
Published: April 2010

Aging is associated with a progressive loss of muscle leading to increasing frailty, weakness, and loss of functional independence. Sarcopenia is a specific muscle-wasting disorder commonly described as an age-related loss in lean muscle tissue. It is estimated that 25% to 50% of men and women 65 years of age and older are sarcopenic. Resistance training is the most effective exercise for slowing the rate of loss of muscle mass and maintaining or improving muscle strength. Several studies have indicated that branched-chain amino acids, especially leucine, regulate skeletal muscle protein synthesis. The purpose of this article is to present the available research on the effectiveness of leucine and it metabolite beta-hydroxy-beta-methylbutyrate on muscle protein synthesis in addition to resistance training for the treatment of sarcopenia.
Resistance Training During Weight Loss in Overweight and Obese Older Adults: What Are the Benefits?
Authors: Delmonico Matthew J. , Lofgren Ingrid E.
Published: April 2010

Obesity and sarcopenia are important public health challenges that affect the healthy aging trajectory of older adults. Although weight loss is recommended for overweight and obese older adults to prevent chronic disease, exercise is an important additional weight management strategy to maximize fat mass loss while retaining lean mass and improving function. Resistance training (RT) is a well-known exercise modality to improve muscle function and lean mass and has been investigated in several recent studies as a potentially powerful strategy to employ along with weight loss in overweight and obese older adults. RT is an important exercise training strategy as outlined in the Physical Activity Guidelines for Americans and is recommended by the American College of Sports Medicine for older adults who are able to safely participate. This brief review will highlight some of the age-related consequences of sarcopenia and obesity and will summarize some of the published research findings of combined RT and weight loss in overweight and obese older adults.
The Role of Endothelial Dysfunction on Development and Progression of Atherosclerosis and Methods to Assess Vascular Function and Structure
Authors: Dengel Donald R. , Bronas Ulf G.
Published: April 2010

The endothelium was originally thought to be just a semipermeable barrier between the vessel wall and the bloodstream, but today we now realize that it is actually a highly active autocrine, paracrine, and endocrine organ. Researchers have also begun to realize that the endothelium plays a key role in the development of atherosclerosis as well as other diseases. This increased recognition has resulted in considerable effort by both researchers and clinicians to develop accurate and reliable methods to measure and track changes in both vascular structure and function. In addition, research interest has focused on various cardiovascular risk factors (eg, age, gender, obesity, physical inactivity) and the effect they have on vascular structure and function. In this review, the authors discuss different research and clinical methods to assess vascular structure and function as well as the effect of various cardiovascular risk factors on the endothelium and the vascular system. They also discuss the ability to modify vascular structure and function through various lifestyle modifications such as weight loss and exercise.
Treatment of obesity with extension of sleep duration: a randomized, prospective, controlled trial
Authors: Cizza Giovanni , Marincola Paula , Mattingly Megan , Williams Lyda , Mitler Merrill , Skarulis Monica , Csako Gyorgy
Published: April 2010

Background The prevalence of chronic sleep deprivation is increasing in modern societies with negative health consequences. Recently, an association between short sleep and obesity has been reported.

Purpose Primary objectives: To assess the feasibility of increasing sleep duration to a healthy length (approximately 7½ h) and to determine the effect of sleep extension on body weight. Secondary objectives: To examine the long-term effects of sleep extension on endocrine (leptin and ghrelin) and immune (cytokines) parameters, the prevalence of metabolic syndrome, body composition, psychomotor vigilance, mood, and quality of life.

Methods One hundred-fifty obese participants who usually sleep less than 6½ h, are being randomized at a 2:1 ratio to either an Intervention or to a Comparison Group. They are stratified by age (above and below 35) and the presence or absence of metabolic syndrome. During the first 12 months (Efficacy Phase) of the study, participants are evaluated at bi-monthly intervals: the Intervention Group is coached to increase sleep by at least 30—60 min/night, while the Comparison Group maintains baseline sleep duration. In the second (Effectiveness) phase, participants converge into the same group and are asked to increase (Comparison Group) or maintain (Intervention Group) sleep duration and are evaluated at 6-month intervals for an additional 3 years. Non-pharmacological and behavior-based interventions are being utilized to increase sleep duration. Endocrine, metabolic, and psychological effects are monitored. The sleep, energy expenditure, and caloric intake are assessed by activity monitors and food recall questionnaires. At yearly intervals, body composition, abdominal fat, and basal metabolic rate are measured by dual energy X-ray absorptiometry (DXA), computerized tomography (CT), and indirect calorimetry, respectively.

Results As of January 2010, 109 participants had been randomized, 64 to the Intervention Group and 45 to the Comparison Group (76% women, 62% minorities, average age: 40.8 years; BMI: 38.5 kg/m2). Average sleep duration at screening was less than 6 h/night, 40.3 h/week. A total of 28 Intervention and 22 Comparison participants had completed the Efficacy Phase.

Limitations The study is not blinded and the sample size is relatively small. Conclusions This proof-of-concept study on a randomized sample will assess whether sleep extension is feasible and whether it influences BMI. Clinical Trials 2010; 7: 274—285. http://ctj.sagepub.com
A general inefficacy interim monitoring rule for randomized clinical trials
Authors: Freidlin Boris , Korn Edward L , Gray Robert
Published: April 2010

Background The ultimate goal of a phase III randomized clinical trial designed to demonstrate superiority of a new versus standard therapy is to provide sufficiently compelling evidence to affect clinical practice. To balance patient interests against the need for acquiring evidence it is desirable to stop a study for inefficacy as soon as convincing evidence that the new therapy is not beneficial becomes available.

Purpose To discuss potential deficiencies in some commonly used inefficacy monitoring rules and to propose a comprehensive inefficacy monitoring procedure.

Methods The proposed approach is developed using clinical, logistical, and statistical considerations. The new approach is compared to the commonly used inefficacy rules in a simulation study.

Results Some of the commonly used inefficacy rules are suboptimal with respect to the strength of evidence required for stopping throughout the trial: too conservative in the middle and/or too aggressive at the end. Our approach allows timely stopping (a) if the new therapy is harmful, and (b) if the interim data provides convincing evidence that the new therapy has no tangible benefit. Relative to common inefficacy rules, our procedure is shown to result in potentially fewer treated patients and shorter study duration under the null hypothesis with only a minor loss of power under the alternative hypothesis.

Limitations The proposed procedure is applicable to superiority designs with well-defined clinical objectives.

Conclusions The proposed inefficacy approach is attractive from statistical, clinical, and logistical standpoints. By decreasing average stopping times relative to the commonly used boundaries, our rule lessens patient exposure to inactive treatments, improves resource utilization, and accelerates dissemination of important clinical information. At the same time, the proposed rule provides a clear benchmark for providing compelling evidence that the new therapy is not beneficial. Clinical Trials 2010; 7: 197—208. http://ctj.sagepub.com
A flexible futility monitoring method with time-varying conditional power boundary
Authors: Ying Zhang  , Clarke William R
Published: April 2010

Background In an ongoing multi-center randomized control clinical trial, the Carotid Occlusion Surgery Study (COSS), the study protocol specifies multiple interim analyses whose results will be reviewed by an independent DSMB to determine if the trial needs to be stopped early due to either efficacy or futility. Conditional power is used as the decision rule for the DSMB to recommend stopping the trial for futility. An aggressive rule for futility stopping sets a relatively high threshold for the conditional power which may result in significant loss of overall power of the study. A conservative rule using a lower threshold may not be able to stop the trial early when there is indeed no treatment efficacy.

Purpose The goal of this article is to develop a flexible futility monitoring plan with a time-varying conditional power boundary that maintains the overall power of the study well, but has a better chance to stop the trial earlier for futility compared to a futility stopping rule with a fixed value for the minimum conditional power to continue.

Methods The conditional power boundary for futility is developed using the β-spending function method for sequential test statistics and assuming no interim analysis for efficacy. It is then modified to account for the repeated interim analyses for efficacy.

Results Simulation studies that mirror the design of the COSS trial show that the proposed method with sample size calculated without considering interim analyses will maintain the designed size and power well when the designed effect size holds, but will have a better chance to exit the trial earlier if the true effect size is smaller than the designed size such that it is not clinically meaningful to conduct the trial.

Limitations The method is valid for sequential test statistics that constitute of a stochastic process which approximates the Brownian motion. It is not applicable to the monitored process that behaves quire differently from the Brownian motion. Conclusions The proposed conditional power method facilitates a flexible futility monitoring plan that can be easily implemented in long-term clinical trials where multiple interim analyses are required. It provides the DSMB an objective guideline to use in considering early stopping for futility. Clinical Trials 2010; 7: 209. http:// ctj.sagepub.com
Chylomicrons combined with endotoxin moderate microvascular permeability
Authors: Spitzer Austin L. , Chuang Kelley I. , Victorino Gregory P. , Kasravi Behzad , Curran Brian , Lee Diana , Harris Hobart W.
Published: April 2010

Triglyceride-rich lipoprotein-bound endotoxin (CM-LPS) inhibits the host innate immune response to sepsis by attenuating the hepatocellular response to pro-inflammatory cytokine stimulation. This ‘cytokine tolerance’ in hepatocytes is a transient, receptor-dependent process that correlates with internalization of CM-LPS via low density lipoprotein (LDL) receptors. Since endothelial cells are integral to the immune response and similarly express LDL receptors, we hypothesized that CM-LPS could be internalized and ultimately attenuate the deleterious effects of pro-inflammatory molecules like tumor necrosis factor-α (TNF-α) and platelet activating factor (PAF) on endothelial permeability. Here, we show that CM-LPS complexes induce cytokine tolerance in endothelial cells. In rats, TNF-α increased hydraulic conductivity 2.5-fold over baseline and PAF increased it 5-fold; but, pretreatment with CM-LPS or an attenuated analog (CM-LPS*) inhibited these changes. Nuclear/cytoplasmic levels of p65 were reduced after TNF-α-stimulation in endothelial cell monolayers pretreated with CM-LPS, a finding consistent with inhibition of nuclear factor (NF)-κB translocation. Also consistent with inhibition was stabilized intercellular adhesion, as illustrated with antibody to VE-cadherin using confocal microscopy. These results provide additional support for the integral role of lipoproteins in the innate immune response to infection and lend further credence to developing lipid-based therapy for Gram-negative sepsis.
The Human Dimension
Authors: Kusluvan Salih , Kusluvan Zeynep , Ilhan Ibrahim , Buyruk Lutfi
Published: April 2010

Human resources are often seen as one of the most important assets of tourism and hospitality organizations. Numerous studies have examined how employee performance can be managed to contribute to the organizational bottom line. This article is a structured review of the literature regarding key human resources management (HRM) issues in the tourism and hospitality industry. Based on this review, the authors offer an assessment of emerging trends in HRM and a summary of what has been advocated in the literature for managing employee performance.
What Matters Most? The Perceived Importance of Ability and Personality for Hiring Decisions
Authors: Tews Michael J. , Stafford Kathryn , Tracey J. Bruce
Published: April 2010

This study examined the emphasis hiring managers placed on general mental ability (GMA) and personality—agreeableness, conscientiousness, emotional stability, and extraversion—when evaluating applicant profiles for servers for a national restaurant chain. GMA was framed as either “intelligence” or the “ability to learn and solve problems.” Under both conditions, GMA was valued, but less than agreeableness, conscientiousness, and emotional stability, even though GMA has been demonstrated to be the strongest predictor of employee performance. Framed as the “ability to learn and solve problems,” GMA was more highly valued, but still less than personality.
What Matters More?
Authors: Way Sean A. , Sturman Michael C. , Raab Carola
Published: April 2010

Research has provided little empirical support for the concept that employee job satisfaction is a causal driver of employee job performance, customer satisfaction, and company performance. This concept is an enduring one, however, and it has been codified as the starting point in the widely espoused service profit chain. Using a sample of eighty-four food and beverage (F&B) manager groups from forty Asian hotel properties owned and managed by a single multinational hotel chain, we examine the effect of job satisfaction, and contrast this effect with that of group service climate, on supervisor ratings of group job performance behaviors (group task performance and organizational citizenship behaviors). The findings underscore the weak connection between job satisfaction and job performance. However, group service climate was found to have a positive effect on supervisor ratings of group job performance behaviors. Consistent with prior research, this study’s findings indicate that managers may improve their employees’ job performance (and job satisfaction) by ensuring that employees understand what is expected of them and how their performance will be appraised and rewarded by the organization.
Is Energy Expenditure of Infants Predictable After Surgery?
Authors: Bechard Lori J. , Ziegler Jane , Duggan Christopher
Published: April 2010

Infants undergoing surgery have unique metabolic demands. The stress of an operation and recovery combined with expectations for growth and development imply elevations in energy expenditure beyond that of healthy, free-living infants. In contrast, surgery may trigger a diversion of energy utilization from tissue accumulation and growth toward the catabolic stress response and cytokine production. Predictive equations are commonly used in clinical settings to estimate basal or resting energy expenditure because measurement techniques such as indirect calorimetry may not be feasible or available. Investigations of measured energy expenditure in surgical infants have portrayed mixed results, however, and estimation equations may not consistently lead to accurate assessment of actual energy needs. Studies are limited in number and quality and often involve a heterogeneous, small population. Grouped outcomes may conceal the wide variability frequently observed in these studies. Measurement of energy expenditure is therefore preferable to the use of predictive equations to customize nutrition intervention for individual infants undergoing surgery.
Macrophage-specific gene functions in Spi1-directed innate immunity
Authors: Zakrzewska Anna , Cui Chao , Stockhammer Oliver W. , Benard Erica L. , Spaink Herman P. , Meijer Annemarie H.
Published: April 2010

The Spi1/Pu.1 transcription factor plays a crucial role in myeloid cell development in vertebrates. Despite extensive studies of Spi1, the controlled gene group remains largely unknown. To identify genes dependent on Spi1, we used a microarray strategy using a knockdown approach in zebrafish embryos combined with fluorescence-activated cell sorting of myeloid cells from transgenic embryos. This approach of using knockdowns with specific green fluorescent protein-marked cell types was highly successful in identifying macrophage-specific genes in Spi1-directed innate immunity. We found a gene group down-regulated on spi1 knockdown, which is also enriched in fluorescence-activated cell-sorted embryonic myeloid cells of a spi1:GFP transgenic line. This gene group, representing putative myeloid-specific Spi1 target genes, contained all 5 previously identified Spi1-dependent zebrafish genes as well as a large set of novel immune-related genes. Colocalization studies with neutrophil and macrophage markers revealed that genes cxcr3.2, mpeg1, ptpn6, and mfap4 were expressed specifically in early embryonic macrophages. In a functional approach, we demonstrated that gene cxcr3.2, coding for chemokine receptor 3.2, is involved in macrophage migration to the site of bacterial infection. Therefore, based on our combined transcriptome analyses, we discovered novel early macrophage-specific marker genes, including a signal transducer pivotal for macrophage migration in the innate immune response.
Complement anaphylatoxin C5a contributes to hemodialysis-associated thrombosis
Authors: Kourtzelis Ioannis , Markiewski Maciej M. , Doumas Michael , Rafail Stavros , Kambas Konstantinos , Mitroulis Ioannis , Panagoutsos Stelios , Passadakis Ploumis , Vargemezis Vasilios , Magotti Paola , Qu Hongchang , Mollnes Tom Eirik , Ritis Konstantinos , Lambris John D.
Published: April 2010

Thrombosis is a common complication of end-stage renal disease, particularly in patients on hemodialysis. Although substantial progress has been made in preventing thrombotic complications in various other groups of patients, the mechanisms of thrombosis during hemodialysis require clarification. In this report, we demonstrate that complement activation triggered by hemodialysis biomaterials, and the subsequent generation of the complement anaphylatoxin C5a, results in the expression of functionally active tissue factor (TF) in peripheral blood neutrophils. Because TF is a key initiator of coagulation in vivo, we postulate that the recurring complement activation that occurs during long-term hemodialysis contributes to thrombosis in dialyzed end-stage renal disease patients. Furthermore, we found that complement contributed to the induction of granulocyte colony-stimulating factor, which has been implicated in the pathogenesis of thrombosis in patients treated with the recombinant form of this molecule. Importantly, the inhibition of complement activation attenuated the TF expression and granulocyte colony-stimulating factor induction in blood passing through a hemodialysis circuit, suggesting that the complement system could become a new therapeutic target for preventing thrombosis in patients with chronic renal failure who are maintained on hemodialysis.
Different effects of the probe summarization algorithms PLIER and RMA on high-level analysis of Affymetrix exon arrays
Authors: Qu Yi , He Fei , Chen Yuchen
Published: April 2010

Background

Alternative splicing is an important mechanism that increases protein diversity and functionality in higher eukaryotes. Affymetrix exon arrays are a commercialized platform used to detect alternative splicing on a genome-wide scale. Two probe summarization algorithms, PLIER (Probe Logarithmic Intensity Error) and RMA (Robust Multichip Average), are commonly used to compute gene-level and exon-level expression values. However, a systematic comparison of these two algorithms on their effects on high-level analysis of the arrays has not yet been reported.

Results

In this study, we showed that PLIER summarization led to over-estimation of gene-level expression changes, relative to exon-level expression changes, in two-group comparisons. Consequently, it led to detection of substantially more skipped exons on up-regulated genes, as well as substantially more included (i.e., non-skipped) exons on down-regulated genes. In contrast, this bias was not observed for RMA-summarized data. By using a published human tissue dataset, we compared the tissue-specific expression and splicing detected by Affymetrix exon arrays with those detected based on expressed sequence databases. We found the tendency of PLIER was not supported by the expressed sequence data.

Conclusion

We showed that the tendency of PLIER in detection of alternative splicing is likely caused by a technical bias in the approach, rather than a biological bias. Moreover, we observed abnormal summarization results when using the PLIER algorithm, indicating that mathematical problems, such as numerical instability, may affect PLIER performance.
EST analysis reveals putative genes involved in glycyrrhizin biosynthesis
Authors: Li Ying , Luo Hong-Mei , Sun Chao , Song Jing-Yuan , Sun Yong-Zhen , Wu Qiong , Wang Ning , Yao Hui , Steinmetz André , Chen Shi-Lin
Published: April 2010

Background

Glycyrrhiza uralensis is one of the most popular medicinal plants in the world and is also widely used in the flavoring of food and tobacco. Due to limited genomic and transcriptomic data, the biosynthetic pathway of glycyrrhizin, the major bioactive compound in G. uralensis, is currently unclear. Identification of candidate genes involved in the glycyrrhizin biosynthetic pathway will significantly contribute to the understanding of the biosynthetic and medicinal chemistry of this compound.

Results

We used the 454 GS FLX platform and Titanium regents to produce a substantial expressed sequence tag (EST) dataset from the vegetative organs of G. uralensis. A total of 59,219 ESTs with an average read length of 409 bp were generated. 454 ESTs were combined with the 50,666 G. uralensis ESTs in GenBank. The combined ESTs were assembled into 27,229 unique sequences (11,694 contigs and 15,535 singletons). A total of 20,437 unique gene elements representing approximately 10,000 independent transcripts were annotated using BLAST searches (e-value ≤ 1e-5) against the SwissProt, KEGG, TAIR, Nr and Nt databases. The assembled sequences were annotated with gene names and Gene Ontology (GO) terms. With respect to the genes related to glycyrrhizin metabolism, genes encoding 16 enzymes of the 18 total steps of the glycyrrhizin skeleton synthesis pathway were found. To identify novel genes that encode cytochrome P450 enzymes and glycosyltransferases, which are related to glycyrrhizin metabolism, a total of 125 and 172 unigenes were found to be homologous to cytochrome P450s and glycosyltransferases, respectively. The cytochrome P450 candidate genes were classified into 32 CYP families, while the glycosyltransferase candidate genes were classified into 45 categories by GO analysis. Finally, 3 cytochrome P450 enzymes and 6 glycosyltransferases were selected as the candidates most likely to be involved in glycyrrhizin biosynthesis through an organ-specific expression pattern analysis based on real-time PCR.

Conclusions

Using the 454 GS FLX platform and Titanium reagents, our study provides a high-quality EST database for G. uralensis. Based on the EST analysis, novel candidate genes related to the secondary metabolite pathway of glycyrrhizin, including novel genes encoding cytochrome P450s and glycosyltransferases, were found. With the assistance of organ-specific expression pattern analysis, 3 unigenes encoding cytochrome P450s and 6 unigenes encoding glycosyltransferases were selected as the candidates most likely to be involved in glycyrrhizin biosynthesis.
Normal and malignant epithelial cells with stem-like properties have an extended G2 cell cycle phase that is associated with apoptotic resistance
Authors: Harper Lisa J , Costea Daniela Elena , Gammon Luke , Fazil Bilal , Biddle Adrian , Mackenzie Ian C
Published: April 2010

Background

Subsets of cells with stem-like properties have been previously isolated from human epithelial cancers and their resistance to apoptosis-inducing stimuli has been related to carcinoma recurrence and treatment failure. The aim of this study was to investigate the mechanisms of resistance to apoptosis-inducing agents of cells with stem-like properties in both normal and malignant human epithelia.

Methods

Cells isolated from fresh human head and neck carcinomas (n = 11), cell lines derived from head and neck, prostate and breast human carcinomas (n = 7), and from normal human oral mucosa (n = 5), were exposed to various apoptosis-inducing stimuli (UV, Tumour Necrosis Factor, Cisplatin, Etoposide, and Neocarzinostatin). Flow cytometry for CD44 and epithelial-specific antigen (ESA) expression, colony morphology, tumour sphere formation and rapid adherence assays were used to identify the subset of cells with stem-like properties. Apoptosis, cell cycle and expression of various cell cycle checkpoint proteins were assessed (Western Blot, qPCR). The role of G2-checkpoint regulators Chk1 and Chk2 was investigated by use of debromohymenialdisine (DBH) and siRNA.

Results

In both cancer biopsies and carcinoma cell lines a subset of CD44high cells showed increased clonogenicity, a significantly lower rate of apoptosis, and a significantly higher proportion of cells in the G2-phase of the cell cycle. An inverse correlation between the percentage of cells in G2-phase and the rate of apoptosis was found. Pulse-chase with iododeoxyuridine (IdU) demonstrated that CD44high carcinoma cells spent longer time in G2, even in un-treated controls. These cells expressed higher levels of G2 checkpoint proteins, and their release from G2 with BDH or Chk1 siRNA increased their rate of apoptosis. Low passage cultures of normal keratinocytes were also found to contain a subset of CD44high cells showing increased clonogenicity, and a similar pattern of G2-block associated with apoptotic resistance.

Conclusions

These data indicate that both normal and malignant human epithelial cells with stem-like properties show greater resistance to apoptosis associated with extended G2 cell cycle phase, and that this property is not a consequence of neoplastic transformation. Targeting G2 checkpoint proteins releases these cells from the G2-block and makes them more prone to apoptosis, implying an opportunity for improved therapeutic approaches.
The association between problematic cellular phone use and risky behaviors and low self-esteem among Taiwanese adolescents
Authors: Yang Yuan-Sheng , Yen Ju-Yu , Ko Chih-Hung , Cheng Chung-Ping , Yen Cheng-Fang
Published: April 2010

Background

Cellular phone use (CPU) is an important part of life for many adolescents. However, problematic CPU may complicate physiological and psychological problems. The aim of our study was to examine the associations between problematic CPU and a series of risky behaviors and low self-esteem in Taiwanese adolescents.

Methods

A total of 11,111 adolescent students in Southern Taiwan were randomly selected into this study. We used the Problematic Cellular Phone Use Questionnaire to identify the adolescents with problematic CPU. Meanwhile, a series of risky behaviors and self-esteem were evaluated. Multilevel logistic regression analyses were employed to examine the associations between problematic CPU and risky behaviors and low self-esteem regarding gender and age.

Results

The results indicated that positive associations were found between problematic CPU and aggression, insomnia, smoking cigarettes, suicidal tendencies, and low self-esteem in all groups with different sexes and ages. However, gender and age differences existed in the associations between problematic CPU and suspension from school, criminal records, tattooing, short nocturnal sleep duration, unprotected sex, illicit drugs use, drinking alcohol and chewing betel nuts.

Conclusions

There were positive associations between problematic CPU and a series of risky behaviors and low self-esteem in Taiwanese adolescents. It is worthy for parents and mental health professionals to pay attention to adolescents' problematic CPU.
A rare case of low-grade myofibroblastic sarcoma of the femur in a 38-year-old woman: a case report
Authors: Arora Raman , Gupta Ruchika , Sharma Alok , Dinda Amit K
Published: April 2010

Introduction

Primary myofibroblastic sarcoma of the bone is a rare spindle cell tumour with, to the best of our knowledge, only eight cases reported in the available English language literature. The disease's rarity and its low-grade features make an accurate diagnosis difficult in most cases. The differential diagnoses of this unusual tumour include various benign entities as well as other sarcomas. Due to the difference in prognosis, a precise pathologic diagnosis is essential, which requires a combination of thorough morphologic examination, immunohistochemistry and electron microscopy wherever available.

Case presentation

We report the case of a 38-year-old Indian woman with a lytic lesion in her left femur. The tumour was associated with cortical destruction and soft tissue extension. A biopsy from the soft tissue component showed features suggestive of a low-grade malignant mesenchymal tumour. Excision of the tumour was performed and histopathological examination showed a low-grade spindle cell sarcoma with collagenous stroma. Expressions of vimentin and smooth muscle actin were also noted. Ultrastructural examination confirmed its myofibroblastic nature. A final diagnosis of low-grade myofibroblastic sarcoma of the left femur was thus rendered.

Conclusion

Low-grade myofibroblastic sarcoma is one of the rarer osseous spindle cell sarcomas depicting a favourable prognosis in the cases reported so far. Its diagnosis requires ancillary techniques like immunohistochemistry and electron microscopy. To the best of our knowledge, we report the ninth case in the literature and the first case from our subcontinent.
Dihydrotachysterol intoxication treated with pamidronate: a case report
Authors: Jensterle Mojca , Pfeifer Marija , Sever Matjaz , Kocjan Tomaz
Published: April 2010

Introduction

Hypoparathyroidism is a chronic condition which requires a lifelong substitution with vitamin D analogues and careful monitoring. This is especially true for older patients and older compounds as dihydrotachysterol with longer half-life that might lead to long-lasting hypercalcemic episodes.

Case presentation

A 74-year old male patient with postsurgical hypoparathyroidism who has been successfully supplemented with dihydrotachysterol (1.7 ml/day) for over 50 years presented with neuropsychiatric disturbances, constipation, renal insufficiency and polyuria. Laboratory investigation demonstrated serum calcium 3.7 mmol/L, serum creatinine 180 micromol/L, urine calcium excretion 1.1 mmol/mmol of the creatinine, normal 25 OH vitamin D3 and low parathormone and 1,25 di OH vitamin D3. Careful history revealed that he has been erroneously taking 2.5 ml of dihydrotachysterol per day for at least 6 to 8 weeks that caused vitamin D intoxication and symptomatic hypercalcemia. He was treated with intravenous saline infusion, prednisolone and 60 mg of intravenous sodium pamidronate. On the fourth day after admission serum calcium dropped rapidly within the reference range. The treatment for hypoparathyroidism had to be reinstituted 10 days after dihydrotachysterol had been discontinued when the patient was switched to shorter acting calcitriol.

Conclusions

Here we reported that the immediate use of pamidronate in addition to classic treatment of dihydrotachysterol intoxication with intravenous saline, diuretics and glucocorticoids is an effective treatment choice that leads to rapid resolution of hypercalcemia.
Insulin like growth factor-I in acute subarachnoid hemorrhage: a prospective cohort study
Authors: Bendel Stepani , Koivisto Timo , Ryynänen Olli-Pekka , Ruokonen Esko , Romppanen Jarkko , Kiviniemi Vesa , Uusaro Ari
Published: April 2010

Introduction

Neuroendocrine deficiencies may affect recovery after aneurysmal subarachnoid hemorrhage (aSAH). Insulin like growth factor-I (IGF-I) regulates neuronal growth and apoptosis in ischemic stroke. Our study was designed to a) characterize the behavior of serum IGF-I and growth hormone (GH) in the acute and late phases after aSAH reflecting possible pituitary gland function and b) evaluate the association between IGF-I and morbidity assessed by Glasgow outcome scale (GOS) and health related quality of life (HRQoL) in patients with aSAH.

Methods

In this prospective cohort study, patients with aSAH (n = 30) were compared to patients who underwent elective aneurysm surgery (n = 16). Serum GH and IGF-I concentrations were measured daily for five (controls) or seven (aSAH) days and at three months. GOS and 15d HRQoL was measured at three months. A mixed models method was used for testing between the groups. For factors possibly affecting HRQoL in aSAH patients, we constructed a Bayesian predicting model using a P-course Bayesian classifier.

Results

The mean IGF-I concentrations for days one to five were 8.1 ± 3.5 nmol/l in patients with aSAH and 11.2 ± 3.1 in the control group (P = 0.01). No corresponding difference was found at three months. Serum GH concentrations were similar in both patient groups. Severity of the aSAH did not affect serum IGF-I concentrations. Patients with GOS ≤ 4 had lower IGF-I concentrations and lower HRQoL than patients with GOS 5 (P = 0.02 and 0.003 respectively). The 15d HRQoL was 0.81 ± 0.16 in patients with aSAH and 0.86 ± 0.09 in control patients (P = 0.24). In the Bayesian model, the use of statins prior to aSAH, hyponatremia, high maximal sequential organ specific score (SOFAmax), and low cumulative IGF-I concentrations on days one to seven were associated with poor HRQoL (accuracy 89%, sensitivity 86%, and specificity 93%).

Conclusions

IGF-I concentrations are low during acute aSAH, which may have an impact on morbidity.

Trial registration

ClinicalTrials.gov Identifier NCT00614887