bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of Nonfatal Hospitalization for Heart Failure on Subsequent Mortality in Patients With Chronic Heart Failure
Authors: Solomon Scott D. , Dobson Joanna , Pocock Stuart , Skali Hicham , McMurray John J.V. , Granger Christopher B. , Yusuf Salim , Swedberg Karl , Young James B. , Michelson Eric L. , Pfeffer Marc A.
Published: August 2007

Background—

Patients with chronic heart failure (HF) are at increased risk of both fatal and nonfatal major adverse cardiovascular events. We used data from the Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM) trials to assess the influence of nonfatal hospitalizations for HF on subsequent mortality rates in a broad spectrum of HF patients.

Methods and Results—

In the present study, 7599 patients with New York Heart Association class II to IV HF and reduced or preserved left ventricular ejection fraction were randomized to placebo or candesartan. We assessed the risk of death after discharge from a first hospitalization for HF using time-updated Cox proportional-hazards models on 7572 patients for whom discharge data were available. Of 7572 patients, 1455 (19%) had at least 1 HF hospitalization, and 586 of 1819 deaths occurred after discharge from an HF hospitalization. The mortality rate was increased after HF hospitalizations, even after adjustment for baseline predictors of death (hazard ratio, 3.15; 95% confidence interval, 2.83 to 3.50). Longer duration of HF hospitalization enhanced the risk of dying, as did repeat HF hospitalizations. Moreover, risk of death was highest within a month of discharge and then declined progressively over time, particularly for death resulting from HF progression and for sudden cardiac death. We observed a similar pattern of risk associated with all-cause hospitalization, although the magnitude was less than that with HF hospitalization.

Conclusions—

In patients with chronic HF, the risk of death is greatest in the early period after discharge after a hospitalization for HF and is directly related to the duration and frequency of HF hospitalizations. These findings suggest a role for increased surveillance in the early postdischarge period of greatest vulnerability after an HF admission.
Disseminating Cardiopulmonary Resuscitation Training by Distributing 35 000 Personal Manikins Among School Children
Authors: Isbye Dan L. , Rasmussen Lars S. , Ringsted Charlotte , Lippert Freddy K.
Published: August 2007

Background—

Because most cardiac arrests occur at home, widespread training is needed to increase the incidence of cardiopulmonary resuscitation (CPR) by lay persons. The aim of this study was to evaluate the effect of mass distribution of CPR instructional materials among schoolchildren.

Methods and Results—

We distributed 35 002 resuscitation manikins to pupils (12 to 14 years of age) at 806 primary schools. Using the enclosed 24-minute instructional DVD, they trained in CPR and subsequently used the kit to train family and friends (second tier). They completed a questionnaire on who had trained in CPR using the kit. Teachers also were asked to evaluate the project. The incidence of bystander CPR in out-of-hospital cardiac arrest in the months following the project was compared with the previous year. In total, 6947 questionnaires (19.8%) were returned. The 6947 kits had been used to train 17 140 from the second tier (mean, 2.5 persons per pupil; 95% confidence interval, 2.4 to 2.5). The teachers had used a mean of 64 minutes (95% confidence interval, 60 to 68) for preparation and a mean of 13 minutes (95% confidence interval, 11 to 15) to tidy up. Incidence of bystander CPR in the months after the project did not increase significantly compared with the previous year (25.0% versus 27.9%;
P
=0.16).

Conclusions—

CPR training can be disseminated in a population by distributing personal resuscitation manikins among children in primary schools. The teachers felt able to easily facilitate CPR training. The incidence of bystander CPR did not increase significantly in the months following the project.
Estrogen Protects Against Increased Blood Pressure in Postpubertal Female Growth Restricted Offspring
Authors: Ojeda Norma B. , Grigore Daniela , Robertson Elliott B. , Alexander Barbara T.
Published: August 2007

Placental insufficiency in the rat results in intrauterine growth restriction and development of hypertension in prepubertal male and female growth-restricted offspring. However, after puberty, only male growth-restricted offspring remain hypertensive, whereas female growth-restricted offspring stabilize their blood pressure to levels comparable to adult female controls. Because female rats reach their maximum levels of estrogen at puberty, we hypothesize that estrogen may be a factor involved in the stabilization of blood pressure in adult female growth-restricted offspring. At 10 weeks of age, female control and growth-restricted offspring underwent ovariectomy or sham surgery and insertion of a telemetry probe. Mean arterial pressure was similar at 16 weeks of age between control (123±4 mm Hg) and growth-restricted offspring (122±2 mm Hg); however, ovariectomy led to a significant increase in blood pressure in growth-restricted offspring (140±2 mm Hg;
P
<0.05 versus intact counterpart) with no significant effect in controls (124±1 mm Hg). Estrogen replacement by subcutaneous minipellet initiated at 14 weeks of age in a subset of ovariectomized control and growth-restricted offspring reversed the effect of ovariectomy on blood pressure in growth-restricted offspring at 16 weeks of age (111±3 mm Hg;
P
<0.05 versus ovariectomized counterpart); renin angiotensin system blockade also abolished ovariectomy-induced hypertension in female growth-restricted offspring (106±2 mm Hg;
P
<0.05 versus ovariectomized counterpart). Therefore, sex differences are observed in this model of fetal programmed hypertension, and results from this study suggest that estrogen contributes to normalization of blood pressure in adult female growth-restricted offspring.
Carbon Monoxide Stimulates the Ca2+–Activated Big Conductance K Channels in Cultured Human Endothelial Cells
Authors: Dong De-Li , Zhang Yan , Lin Dao-Hong , Chen Jun , Patschan Susann , Goligorsky Michael S. , Nasjletti Alberto , Yang Bao-Feng , Wang Wen-Hui
Published: August 2007

We used the whole-cell patch-clamp technique to study K channels in the human umbilical vein endothelial cells and identified a 201 pS K channel, which was blocked by tetraethylammonium and iberiotoxin but not by TRAM34 and apamin. This suggests that the Ca2+-activated big-conductance K channel (BK) is expressed in endothelial cells. Application of carbon monoxide (CO) or tricarbonylchloro(glycinato)ruthenium(II), a water soluble CO donor, stimulated the BK channels. Moreover, application of hemin, a substrate of heme oxygenase, mimicked the effect of CO and increased the BK channel activity. The stimulatory effect of hemin was significantly diminished by tin mesoporphyrin, an inhibitor of heme oxygenase. To determine whether the stimulatory effect of CO on the BK channel was mediated by NO and the cGMP-dependent pathway, we examined the effect of CO on BK channels in cells treated with,NG-nitro-l-arginine methyl ester, 1H(1,2,4)oxadiazolo(4,3-a)quinoxalin-1-one, an inhibitor of soluble guanylate cyclase, or KT5823, an inhibitor of protein kinase G. Addition of either diethylamine NONOate or sodium nitroprusside significantly increased BK channel activity. Inhibition of endogenous NO synthesis withNG-nitro-l-arginine methyl ester, blocking soluble guanylate cyclase or protein kinase G, delayed but did not prevent the CO-induced activation of BK channels. Finally, application of an antioxidant agent, ebselen, had no effect on CO-mediated stimulation of BK channels in human umbilical vein endothelial cells. We conclude that BK channels are expressed in human umbilical vein endothelial cells and that they are activated by both CO and NO. CO activates BK channels directly, as well as via a mechanism involving NO or the cGMP-dependent pathway.
Scalable Implementations of Ensemble Filter Algorithms for Data Assimilation
Authors: Anderson Jeffrey L. , Collins Nancy
Published: August 2007

A variant of a least squares ensemble (Kalman) filter that is suitable for implementation on parallel architectures is presented. This parallel ensemble filter produces results that are identical to those from sequential algorithms already described in the literature when forward observation operators that relate the model state vector to the expected value of observations are linear (although actual results may differ due to floating point arithmetic round-off error). For nonlinear forward observation operators, the sequential and parallel algorithms solve different linear approximations to the full problem but produce qualitatively similar results. The parallel algorithm can be implemented to produce identical answers with the state variable prior ensembles arbitrarily partitioned onto a set of processors for the assimilation step (no caveat on round-off is needed for this result).

Example implementations of the parallel algorithm are described for environments with low (high) communication latency and cost. Hybrids of these implementations and the traditional sequential ensemble filter can be designed to optimize performance for a variety of parallel computing environments. For large models on machines with good communications, it is possible to implement the parallel algorithm to scale efficiently to thousands of processors while bit-wise reproducing the results from a single processor implementation. Timing results on several Linux clusters are presented from an implementation appropriate for machines with low-latency communication.

Most ensemble Kalman filter variants that have appeared in the literature differ only in the details of how a prior ensemble estimate of a scalar observation is updated given an observed value and the observational error distribution. These details do not impact other parts of either the sequential or parallel filter algorithms here, so a variety of ensemble filters including ensemble square root and perturbed observations filters can be used with all the implementations described.
Autocorrelation and Cross-Correlation Estimators of Polarimetric Variables
Authors: Melnikov Valery M. , Zrnić Dusan S.
Published: August 2007

Herein are proposed novel estimators of differential reflectivity ZDR and correlation coefficient ρhv between horizontally and vertically polarized echoes. The estimators use autocorrelations and cross correlations of the returned signals to avoid bias by omnipresent but varying white noise. These estimators are considered for implementation on the future polarimetric Weather Surveillance Radar-1988 Doppler (WSR-88D) network. On the current network the reflectivity factor is measured at signal-to-noise ratios (SNRs) as low as 2 dB and the same threshold is expected to hold for the polarimetric variables. At such low SNR and all the way up to SNR = 15 dB, the conventional estimators of differential reflectivity and the copolar correlation coefficient are prone to errors due to uncertainties in noise levels caused by instability of radar devices, thermal radiations of precipitation and the ground, and wideband radiation of electrically active clouds. Noise variations at SNR less than 15 dB can bias the estimates beyond apparatus accuracy. For brevity the authors refer to the estimators of ZDR and ρhv free from noise bias as the “1-lag estimators” because these are derived from 1-lag correlations. The estimators are quite robust and the only weak assumption for validity is that spectral widths of signals from vertically and horizontally polarized returns are equal. This assumption is verified on radar data. Radar observations demonstrate the validity of these estimator and lower sensitivity to interference signals than the conventional algorithms.
Comparisons of Raman Lidar Measurements of Tropospheric Water Vapor Profiles with Radiosondes, Hygrometers on the Meteorological Observation Tower, and GPS at Tsukuba, Japan
Authors: Sakai Tetsu , Nagai Tomohiro , Nakazato Masahisa , Matsumura Takatsugu , Orikasa Narihiro , Shoji Yoshinori
Published: August 2007

The vertical distribution profiles of the water vapor mixing ratio (w) were measured by Raman lidar at the Meteorological Research Institute, Japan, during the period from 2000 to 2004. The measured values were compared with those obtained with radiosondes, hygrometers on a meteorological observation tower, and global positioning system (GPS) antennas near the lidar site. The values of w obtained with the lidar were lower than those obtained with the corrected Meisei RS2-91 radiosonde by 1.2% on average and higher than those obtained with the corrected Vaisala RS80-A radiosonde by 17% for w ≥ 0.5 g kg−1. The lidar data were higher than those radiosondes’ data by 19% or 33% for w < 0.5 g kg−1. The vertical variations of w obtained with the lidar differed from those obtained with the Meisei RS-01G radiosonde and Meteolabor Snow White radiosonde by 5% on average for w ≥ 0.5 g kg−1. The lidar data were lower than those radiosondes’ data by 37% or 39% for w < 0.5 g kg−1. The temporal variations of w obtained with the lidar and the hygrometers on the meteorological tower agreed to within 0.4% at a height of 213 m, although the absolute values differed systematically by 9%–14% due to the incomplete overlap of the laser beam and the receiver’s field of view at heights between 50 and 150 m. The precipitable water vapor obtained with the lidar indicated a mean positive bias of 2 mm (9%–11%) relative to those obtained with GPS. The lidar water vapor calibration coefficient that was calculated using RS2-91 radiosonde data varied by 11% during an 18-month period. Therefore, it is necessary to develop an accurate, yet convenient, method for determining the calibration coefficient for the use of the lidar.
Design of the AmeriFlux Portable Eddy Covariance System and Uncertainty Analysis of Carbon Measurements
Authors: Ocheltree T. W. , Loescher H. W.
Published: August 2007

The AmeriFlux network continues to improve the understanding of carbon, water, and energy fluxes across temporal and spatial scales. The network includes ∼120 research sites that contribute to the understanding of processes within and among ecosystems. To improve the networks ability and confidence to synthesize data across multiple sites, the AmeriFlux quality assurance and quality control laboratory was established to reduce the within- and among-site uncertainties. This paper outlines the design of the portable eddy covariance system (PECS) and subsequent data processing procedures used for site comparisons. Because the PECS makes precision measurements of atmospheric CO2, the authors also present the results of uncertainty analyses in determining the polynomials for an infrared gas analyzer, estimating the CO2 in secondary standards, and estimating ambient CO2 in field measurements. Under field conditions, drift in the measurement of CO2 increased the uncertainty in flux measurements across 7 days by 5% and was not dependent on the magnitude or direction of the flux. The maximum relative flux measurement error for unstable conditions was 10.03 μmol CO2 m−2 s−1.
Targeted Dropwindsondes in Complex Terrain
Authors: Poulos Gregory S. , Wang Junhong , Lauritsen Dean K. , Cole Harold L.
Published: August 2007

The dropwindsonde (or dropsonde) is a frequently utilized tool in geophysical research and its use over ocean and flat terrain is a reliable and well-established practice. Its use in complex terrain, however, is complicated by signal acquisition challenges that can be directly related to the ground target location, local relief, and line of sight to flight tracks relevant to the observation sought. This note describes a straightforward technique to calculate the theoretical altitude above ground to which a ground-targeted dropsonde will provide data for a given airborne platform. It is found that this height HCq can be calculated from expected airborne platform horizontal velocity Uag, mean dropwindsonde vertical velocity Ws, the relevant barrier maximum HB, and the horizontal distance from the target area to the barrier maximum DB. Here, HCq is found to be weakly dependent on release altitude through Ws. An example from the Terrain-induced Rotor Experiment (T-REX) is used to show that for modern aircraft platforms and dropwindsondes signal loss can occur 1–2 km above ground if mitigation is not pursued. Practical mitigation techniques are described for those complex terrain cases where signal propagation problems would create a significant negative scientific impact.
Brazilian Foreign Policy in the Cardoso Era
Authors: Vigevani Tullo , Fernandes de Oliveira Marcelo
Published: August 2007

The Fernando Henrique Cardoso administration attempted to replace a reactive foreign policy agenda dominated by a logic of autonomy through distance with a proactive international agenda guided by a logic of autonomy through integration . In adopting this agenda, the administration maintained that Brazil would be able to confront its problems and secure more control over its future if it actively contributed to elaborating the norms and guidelines of the administration of the global order. Because of structural weaknesses, however, this policy of integration, adherence, and participation was not adequately accompanied by positions entailing practical responsibilities—responsibilities that would have prepared both government and civil society for a higher profile in the post—cold-war era. In the end, the gains achieved during Cardoso's tenure failed to alter Brazil's international standing in any significant way.
Justice-Sector and Human Rights Reform under the Cardoso Government
Authors: Macaulay Fiona
Published: August 2007

The federal government under Cardoso was not ideologically committed to the adoption of specific “neoliberal” policies in the field of crime control and criminal justice through the reform of the courts, the police, and the prison system. Its failure to curtail institutionally driven human rights violations resulted from a more diffuse “environmental” effect of neoliberalism whereby fiscal management concerns monopolized the government's economic and political capital and from structural constraints on domestic political and governance configurations such as federalism and the character of the Ministry of Justice. Penal policy in Brazil, as elsewhere, was incoherent and volatile because of the confluence of two distinct political ideologies, economic neoliberalism and social neoconservatism, with the federal government pursuing strategies of delegation and denial. Policy transfer and norm convergence were affected positively by the international human rights regime and its domestic allies and negatively by local moral conservatives and producer groups acting as policy blockers rather than entrepreneurs.
Brazilian Regional Power in the Development of Mercosul
Authors: Genna Gaspare M. , Hiroi Taeko
Published: August 2007

President Fernando Henrique Cardoso's government presided over three critical junctures in the development of the Common Market of the South (Mercosul): the attempted military coup in Paraguay in 1996, the devaluation of the Brazilian real in 1999, and the Argentine economic crisis in 2002. Its responses to these events were critical to the development of Mercosul because of Brazil's unique position as the largest country in the bloc. Many theories of free trade and regional integration hold that economic integration requires a regionally preponderant power that acts as a core provider of collective goods for member states. When such a power provides benefits, satisfaction among the member states increases and the likelihood of integration is increased. An examination of the Cardoso government's policies during the three critical junctures suggests that regional integration declined when Argentina incurred costs during the Brazilian currency crisis and increased when Cardoso's government provided aid during the Argentine economic crisis and helped defeat the attempted coup in Paraguay.
From Interdependence to Neo-mercantilism
Authors: Abu-El-Haj Jawdat
Published: August 2007

The Cardoso era was more paradoxical than globalization scholars have been willing to acknowledge. Whereas the literature anticipated denationalization, the opposite was observed in Brazil. The assumption of leadership by the local bourgeoisie was linked with a general increase in the international competitiveness of Brazilian capitalism. This was the outcome of three government policies: the attraction of international capital to renewed investment in basic infrastructure, the reorganization of the boundaries between domestic capital and multinationals to increase productivity, and the transformation of the internal market into the main source of capital accumulation. The transition was, however, incomplete. In the last two years of Cardoso's second administration, faced by political pressure and external crises, Brazilian elites opted to return to a neo-mercantilist approach to development.
Class Relations in Brazil's New Neoliberal Phase
Authors: Boito Armando
Published: August 2007

While maintaining the neoliberal capitalist model, the Lula administration has ushered it into a new phase. With respect to the bloc in power, national and international financial capital today shares its hegemony with the important domestic industrial and agrarian bourgeoisie. However, with respect to the working class, there have been two changes. First, the new unionist elite that has been moving toward a micro-corporativism since the mid-1990s has established an alliance with the domestic bourgeoisie against financial capital. Second, the poor and unorganized laborers, who have been serving as a support class for neoliberal politics since the Collor and Cardoso administrations, today are more linked to the government and are a passive base for the rise of “Lulismo,” a political phenomenon separate from the Partido dos Trabalhadores.
Celso Furtado and the Resumption of Construction in Brazil
Authors: Rocha Geisa Maria
Published: August 2007

An analysis of Lula's economic and social policy during his first term (2003—2006) shows the degree to which Celso Furtado's predictions about the outcome of market fundamentalism in Latin America and the direction of the Lula government in Brazil have materialized. Faced with the daunting task of administering Cardoso's legacy of massive indebtedness, Lula's priority was to ensure debt-service payments and gain international credibility by strictly following the prescriptions of the old and the new or revised Washington Consensus, thus breaking his promise of a social transformation with a new development model. The central question now is whether a second Lula administration (2007—2010) will represent a transition to a national strategy capable of producing economic growth with social inclusion. Furtado's structuralist insights provide the basis for the elaboration and implementation of an alternative development project for the country and the region at large.
Effects of Ignoring Item Interaction on Item Parameter Estimation and Detection of Interacting Items
Authors: Chen Cheng-Te , Wang Wen-Chung
Published: August 2007

This study explores the effects of ignoring item interaction on item parameter estimation and the efficiency of using the local dependence index Q3 and the SAS NLMIXED procedure to detect item interaction under the three-parameter logistic model and the generalized partial credit model. Through simulations, it was found that ignoring positive item interaction led to overestimation for the discrimination parameters, underestimation for the difficulty parameters, and a Q3 much smaller than zero. As the guessing parameters approached zero, the overestimation for the discrimination parameters became more serious. In contrast, ignoring negative item interaction led to underestimation for the discrimination parameters, overestimation for the difficulty parameters, and a Q3 much larger than zero. As the guessing parameters approached zero, the underestimation for the discrimination parameters became less serious. A modification of posterior predictive p value for Q3 was proposed to detect item interaction and was found to work very well. Direct modeling of item interaction using NLMIXED was demonstrated.
Computerized Adaptive Testing for Polytomous Motivation Items: Administration Mode Effects and a Comparison With Short Forms
Authors: Hol A. Michiel , Vorst Harrie C. M. , Mellenbergh Gideon J.
Published: August 2007

In a randomized experiment (n = 515), a computerized and a computerized adaptive test (CAT) are compared. The item pool consists of 24 polytomous motivation items. Although items are carefully selected, calibration data show that Samejima's graded response model did not fit the data optimally. A simulation study is done to assess possible consequences of model misfit. CAT efficiency was studied by a systematic comparison of the CAT with two types of conventional fixed length short forms, which are created to be good CAT competitors. Results showed no essential administration mode effects. Efficiency analyses show that CAT outperformed the short forms in almost all aspects when results are aggregated along the latent trait scale. The real and the simulated data results are very similar, which indicate that the real data results are not affected by model misfit.
High-Stiffness Distal Fixation Restores Anterior Laxity and Stiffness as Well as Joint Line Fixation with an Interference Screw
Authors: Liu-Barba David , Howell Stephen M. , Hull Maury L.
Published: August 2007

Background

Fixation of an anterior cruciate ligament graft at the joint line with an interference screw restores anterior laxity better than low-stiffness distal fixation with double staples and sutures tied to a post at implantation in porcine bone.

Hypothesis

Fixation of an anterior cruciate ligament graft with a high-stiffness distal fixation device restores anterior laxity and knee stiffness as well as joint line fixation with an interference screw in human bone.

Study Design

Controlled laboratory study.

Methods

Eleven cadaveric knees with foam reinforcement of the bone were reconstructed with a double-looped tendon graft and fixed with an interference screw and 3 high-stiffness methods of fixation (tandem washer, WasherLoc, and WasherLoc with bone dowel). Anterior laxity at 225 and 110 N of anterior load and knee stiffness were measured at 0°, 30°, 60°, 90°, and 120° of flexion with a 6 degrees of freedom load application system.

Results

The increase in anterior laxity and knee stiffness with the interference screw was not significantly different from that with the high-stiffness distal methods.

Conclusion

In the human knee, the use of high-stiffness fixation devices placed distal to the joint line restored anterior laxity and knee stiffness as well as joint line fixation with an interference screw at implantation.

Clinical Relevance

The stiffness provided by each method of fixation should be considered along with the length of the graft when determining anterior laxity and knee stiffness.
Donor Site Evaluation after Autologous Osteochondral Mosaicplasty for Cartilaginous Lesions of the Elbow Joint
Authors: Iwasaki Norimasa , Kato Hiroyuki , Kamishima Tamotsu , Suenaga Naoki , Minami Akio
Published: August 2007

Background

One significant disadvantage of autologous osteochondral mosaicplasty (mosaicplasty) is the harvesting of osteochondral grafts from the normal articular area of the knee joint. However, the effect of harvesting grafts on knee function remains unclear.

Purpose

To clarify the functional effects on the donor knee of harvesting osteochondral grafts and to perform magnetic resonance imaging evaluation of donor site repair after mosaicplasty for capitellar osteochondritis dissecans in young athletes.

Study Design

Case series; Level of evidence, 4.

Methods

Eleven male competitive athletes with advanced lesions of capitellar osteochondritis dissecans underwent mosaicplasties. The surgical technique involves obtaining small-sized cylindrical osteochondral grafts from the lateral periphery of the femoral condyle at the level of the patellofemoral joint and transplanting them to osteochondral defects in the capitellum. Assessment at a mean follow-up of 26 months included local findings of the donor knees, a Lysholm knee scoring scale, International Knee Documentation Committee standard evaluation form, and magnetic resonance imaging evaluation.

Results

All patients returned to a competitive level of their previous sports without any donor site disturbances. Based on the Lysholm knee score and International Knee Documentation Committee evaluation form, all knees were graded as excellent and normal, respectively. The magnetic resonance imaging showed 50% to 100% defect fill in 6 of 9 patients and normal or nearly normal signals in 4 patients at the donor sites.

Conclusion

No adverse effects of osteochondral graft harvest on donor knee function were found after mosaicplasty for capitellar osteochondritis dissecans in young athletes. However, magnetic resonance imaging indicates that the donor site is resurfaced with fibrous tissue.
The Effect of Faith or Spirituality in Pregnancy
Authors: Jesse D. Elizabeth , Schoneboom Chantel , Blanchard Amy
Published: August 2007

This study used a qualitative descriptive research design to discover the relevance and meaning of spirituality in the lives of 130 urban low-income pregnant women by asking the open-ended question, “How does your faith or spirituality affect your pregnancy if at all?” Forty-seven percent of the women in this study described how spirituality affected their pregnancy positively, 45% described that spirituality did not affect them, and 5.4% were unsure. A content analysis of those who answered positively revealed six themes from the data describing the meaning of faith or spirituality in pregnancy: (a) guidance and support; (b) protection, blessing, or reward; (c) communication with God; (d) strength and confidence; (e) help with difficult moral choices; and (f) a generalized positive effect. These findings point to the importance of attending to spirituality as a resource in pregnancy for those who value it and further exploring the meaning of spirituality in pregnancy.
Self-Care Activities Captured Through Discussion Among Community-Dwelling Older Adults
Authors: Dunn Karen S. , Riley-Doucet Cheryl K.
Published: August 2007

Four separate focus group sessions were conducted in the Detroit metropolitan area to invite vital elders to speak freely about their health, health problems, health practices, and how they maintain their bio-psycho-social and spiritual well-being. Twenty-eight participants were interviewed. The majority were African American, female, widowed, Protestant, and had achieved a high school or greater educational level. Field notes and taped interviews were transcribed for data analysis. Together, two raters completed data reduction and coding for theme identification and categorization. A holistic nursing model was used to guide the content analysis. Five themes were revealed that described the context of well-being for community-dwelling elders: faith ways, positive energy, support systems, wellness activities, and affirmative self-appraisal. Well-being depended on an awareness of how lifestyle impacted the physical, psychological, social, and spiritual health of each individual. This study lends credence to interventions aimed at promoting holistic health care for community-dwelling elders.
Toward Easing Suffering Through Reflection
Authors: Johns Christopher
Published: August 2007

This article is a partially constructed reflective narrative on my practice as a complementary therapist working with Indigo, a dying patient at the hospice, and her family that offers insights into practice and narrative construction. The reflective effort is to appreciate and work toward easing Indigo's suffering. However, this emerges as problematic and invites the reader to dialogue with the text in terms of the readers' own experiences.
Influences on work/ non-work conflict
Authors: Allan Cameron , Loudoun Rebecca , Peetz David
Published: August 2007

Work/non-work conflict is important because it tells us about the well-being of individuals and more generally of a particular workplace or organization. Important progress has been made in research literature on the importance of structural policies designed to assist workers to meet competing demands to be at work and at home. More information is needed into organizational influences on the emotional aspects of work/non-work conflict. Based on a survey of over 900 employees, we use factor, correlation and multiple regression analyses to find that exacerbation in work/non-work conflict is a result of high workload pressure, long working hours, unsupportive management and weak employee control, especially control over workload and when employees can take time off.
`More paper than physical'
Authors: Hobbs Mitchell
Published: August 2007

When Rupert Murdoch announced in April 2004 that he intended to see his company, News Corporation, reincorporated in the United States, two competing representations of the `media mogul' came to dominate the press's interpretation of this event. The first of these `Murdoch representations' was the most common, and painted an image of a successful entrepreneur, a `celebrity CEO'. Yet, the second `Murdoch representation' painted a different image, a more detailed portrait, with critical attention paid to the modus operandi of the world's most notorious media proprietor. This article deconstructs these representations of Murdoch, a mythic fracturing of image resulting from the political economy of the Australian press. In essence, the article explores issues of media diversity, myth and ideology, and the propensity of the press for critical, impartial, journalism. The empirical data are drawn from an analysis of two of Australia's pre-eminent newspapers: The Australian and the Sydney Morning Herald.
The Baha'i faith and Caodaism
Authors: Possamai Adam , Possamai-Inesedy Alphia
Published: August 2007

In Australia, new immigrant and ethnic communities constitute the largest segment of the phenomenon of increasing religious diversity and change. These groups celebrate and maintain a way of life and a religious culture from elsewhere, but they are also working in Australian society: not just resisting pressures for assimilation, but helping members to translate the norms and values of their land of origin into the new Australian context. In this process, a de-secularization of the world at both local and global levels occurs; indeed, while offering support to migrants, these groups offer a site of `cultural security' to them and simultaneously promote and diffuse their religion in Australia's public sphere. This article focuses on the Baha'i faith and Caodaism; two groups with an ever-increasing growth in the Western world, and an involvement at local, national and international levels. The research shows that these two groups have had different measures of success in Australia, highlighting the fact that the de-secularization process does not have the same intensity among these groups. This article aims at finding the reason behind this difference of intensity.
Perforin-dependent apoptosis functionally compensates Fas deficiency in activation-induced cell death of human T lymphocytes
Authors: Mateo Véronique , Ménager Michael , de Saint-Basile Geneviève , Stolzenberg Marie-Claude , Roquelaure Bertrand , André Nicolas , Florkin Benoit , le Deist Françoise , Picard Capucine , Fischer Alain , Rieux-Laucat Frédéric
Published: August 2007

Activation-induced cell death (AICD) is involved in peripheral tolerance by controlling the expansion of repeatedly stimulated T cells via an apoptotic Fas (CD95; APO-1)–dependent pathway. The TNFRSF-6 gene encoding Fas is mutated in children suffering from autoimmune lymphoproliferative syndrome (ALPS), which is characterized by lymphoproliferation and autoimmunity. We examined AICD in Fas-deficient T cells from ALPS patients. We showed that primary activated Fas-deficient T cells die by apoptosis after repeated T cell antigen receptor (TCR) stimulation despite resistance to Fas-mediated cell death. This Fas-independent AICD was found to be mediated through a cytotoxic granules-dependent pathway. Cytotoxic granules-mediated AICD was also detected in normal T lymphocytes though to a lesser extent. As expected, the cytotoxic granules-dependent AICD was abolished in T cells from Rab27a- or perforin-deficient patients who exhibited defective granules-dependent cytotoxicity. Supporting an in vivo relevance of the cytotoxic granules-dependent AICD in ALPS patients, we detected an increased number of circulating T lymphocytes expressing granzymes A and B. Altogether, these data indicated that the cytotoxic granules-dependent cell death in ALPS may compensate for Fas deficiency in T lymphocytes. Furthermore, they identified a novel AICD pathway as a unique alternative to Fas apoptosis in human peripheral T lymphocytes.
Blunted hepcidin response to oral iron challenge in HFE-related hemochromatosis
Authors: Piperno Alberto , Girelli Domenico , Nemeth Elizabeta , Trombini Paola , Bozzini Claudia , Poggiali Erika , Phung Yen , Ganz Tomas , Camaschella Clara
Published: August 2007

Inadequate hepcidin synthesis leads to iron overload in HFE-related hemochromatosis. We explored the regulation of hepcidin by iron in 88 hemochromatosis patients (61 C282Y/C282Y, 27 C282Y/H63D) and 23 healthy controls by analyzing urinary hepcidin before and 24 hours after a 65-mg oral iron dose. Thirty-four patients were studied at diagnosis and had iron overload, and 54 patients were iron depleted. At diagnosis, hepcidin values in C282Y homozygotes were similar to controls, whereas values in C282Y/H63D heterozygotes were higher (P = .02). However, the hepcidin/ferritin ratio was decreased in both homozygotes (P < .001) and heterozygotes (P = .017), confirming the inadequate hepcidin production for the iron load with both genotypes. In iron-depleted patients of both genotypes studied at a time remote from phlebotomy, basal hepcidin was still lower than in controls (P < .001 for C282Y/C282Y and P = .002 for heterozygotes). After an iron challenge, mean urinary hepcidin excretion increased in controls (P = .001) but not patients, irrespective of genotype and iron status. Significant hepcidin increase ( ≥ 10 ng/mg creatinine) was observed in 74% of controls, 15% of homozygotes, and 32% of heterozygotes. The hepcidin response to oral iron is blunted in HFE-related hemochromatosis and not improved after iron depletion. The findings support the involvement of HFE in iron sensing and subsequent regulation of hepcidin.
Short-term oleoyl-estrone treatment affects capacity to manage lipids in rat adipose tissue
Authors: Salas Anna , Noé Véronique , Ciudad Carlos J , Romero M Mar , Remesar Xavier , Esteve Montserrat
Published: August 2007

Background

Short-term OE (oleoyl-estrone) treatment causes significant decreases in rat weight mainly due to adipose tissue loss. The aim of this work was to determine if OE treatment affects the expression of genes that regulate lipid metabolism in white adipose tissue.

Results

Gene expression in adipose tissue from female treated rats (48 hours) was analysed by hybridization to cDNA arrays and levels of specific mRNAs were determined by real-time PCR. Treatment with OE decreased the expression of 232 genes and up-regulated 75 other genes in mesenteric white adipose tissue. The use of real-time PCR validate that, in mesenteric white adipose tissue, mRNA levels for Lipoprotein Lipase (LPL) were decreased by 52%, those of Fatty Acid Synthase (FAS) by 95%, those of Hormone Sensible Lipase (HSL) by 32%, those of Acetyl CoA Carboxylase (ACC) by 92%, those of Carnitine Palmitoyltransferase 1b (CPT1b) by 45%, and those of Fatty Acid Transport Protein 1 (FATP1) and Adipocyte Fatty Acid Binding Protein (FABP4) by 52% and 49%, respectively. Conversely, Tumour Necrosis Factor (TNFα) values showed overexpression (198%).

Conclusion

Short-term treatment with OE affects adipose tissue capacity to extract fatty acids from lipoproteins and to deal with fatty acid transport and metabolism.
Regions of Diversity 8, 9 and 13 contribute to Streptococcus pneumoniae virulence
Authors: Embry Addie , Hinojosa Ernesto , Orihuela Carlos J
Published: August 2007

Background

Streptococcus pneumoniae is the leading cause of community-acquired pneumonia. Previously, using comparative genomic analyses, 13 regions of genomic plasticity have been identified in the S. pneumoniae genome. These "Regions of Diversity" (RDs) accounted for half the genomic variation observed amongst all pneumococci tested, moreover, were determined to encode a variety of putative virulence factors. To date, genes within 5 RDs have been unequivocally demonstrated to contribute to S. pneumoniae virulence. It is unknown if the remaining RDs also contribute to virulence.

Results

Using allelic exchange, we created S. pneumoniae mutants that were deficient in RD2, 5, 7, 8, 9, 12 and 13. Mutants deficient in RD8, 9 and 13 were attenuated in a mouse model of disease. RD8 is 40,358 nucleotides in length and encodes 37 genes. Using a panel of isogenic mutants, we determined that RD8b3 is the operon within RD8 that is responsible for virulence. Mice infected with mutants deficient in RD8, RD8b3, RD9 and RD13 had significantly less bacteria in the blood two days after intranasal challenge and improved survival over time versus mice infected with wild type. In all instances mutants colonized the nasopharynx at levels equivalent to wild type.

Conclusion

Genes within RD1, 3, 4, 6, and 10 have previously been shown to contribute to virulence. This study demonstrates that genes within RD8, 9 and 13 also contribute to virulence. The ability of mutants deficient in RD2, 5, 7, 8, 9, 12, and 13 to colonize the nasopharynx indicates that genes within these RDs are not required for asymptomatic carriage. Nonetheless, the observation that mutants deficient in RD8b3, 9 and 13 are attenuated indicates that genes within these loci are necessary for spread of the bacteria beyond the nasopharynx to normally sterile sites.
Decrease in oxidative phosphorylation yield in presence of butyrate in perfused liver isolated from fed rats
Authors: Gallis Jean-Louis , Tissier Pierre , Gin Henri , Beauvieux Marie-Christine
Published: August 2007

Background

Butyrate is the main nutrient for the colonocytes but the effect of the fraction reaching the liver is not totally known. A decrease in tissue ATP content and increase in respiration was previously demonstrated when livers were perfused with short-chain fatty acids (SCFA) such as butyrate, or octanoate.

In fed rats the oxidative phosphorylation yield was determined on the whole isolated liver perfused with butyrate in comparison with acetate and octoanoate (3 mmol/L). The rate of ATP synthesis was determined in the steady state by monitoring the rate of ATP loss after inhibition of (i) cytochrome oxidase (oxidative phosphorylation) with KCN (2.5 mmol/L) and (ii) glyceraldehyde 3-phosphate dehydrogenase (glycolysis) with IAA (0.5 mmol/L). The ATP flux, estimated by 31P Nuclear Magnetic Resonance, and the measured liver respiration allowed the ATP/O ratio to be determined.

Results

ATP turnover was significantly lower in the presence of butyrate (0.40 ± 0.10 μmoles/min.g, p = 0.001, n = 7) and octanoate (0.56 ± 0.10 μmoles/min.g, p = 0.01, n = 5) than in control (1.09 ± 0.13 μmoles/min.g, n = 7), whereas perfusion with acetate induced no significant decrease (0.76 ± 0.10 μmoles/min.g, n = 7). Mitochondrial oxygen consumption was unchanged in the presence of acetate (1.92 ± 0.16 vs 1.86 ± 0.16 for control) and significantly increased in the presence of butyrate (p = 0.02) and octanoate (p = 0.0004) (2.54 ± 0.18 and 3.04 ± 0.15 μmoles/min.g, respectively). The oxidative phosphorylation yield (ATP/O ratio) calculated in the whole liver was significantly lower with butyrate (0.07 ± 0.02, p = 0.0006) and octanoate (0.09 ± 0.02, p = 0.005) than in control (0.30 ± 0.05), whereas there was no significant change with acetate (0.20 ± 0.02).

Conclusion

Butyrate or octanoate decrease rather than increase the rate of ATP synthesis, resulting in a decrease in the apparent ATP/O ratio. Butyrate as a nutrient has the same effect as longer chain FA. An effect on the hepatic metabolism should be taken into account when large quantities of SCFA are directly used or obtained during therapeutic or nutritional strategies.
Aspirin and Simvastatin Combination for Cardiovascular Events Prevention Trial in Diabetes (ACCEPT-D): design of a randomized study of the efficacy of low-dose aspirin in the prevention of cardiovascular events in subjects with diabetes mellitus treated with statins
Authors: De Berardis Giorgia , Sacco Michele , Evangelista Virgilio , Filippi Alessandro , Giorda Carlo B , Tognoni Gianni , Valentini Umberto , Nicolucci Antonio ,   ACCEPT-D Study Group
Published: August 2007

Background

Despite the high cardiovascular risk, evidence of efficacy of preventive strategies in individuals with diabetes is scant. In particular, recommendations on the use of aspirin in patients with diabetes mostly reflect an extrapolation from data deriving from other high risk populations. Furthermore, the putative additive effects of aspirin and statins in diabetes remain to be investigated. This aspect is of particular interest in the light of the existing debate regarding the need of multiple interventions to reduce total cardiovascular risk, which has also led to the proposal of a polypill. Aim of the study is to evaluate the efficacy of aspirin in the primary prevention of major cardiovascular events in diabetic patients candidate for treatment with statins. These preventive strategies will be evaluated on the top of the other strategies aimed at optimizing the care of diabetic patients in terms of metabolic control and control of the other cardiovascular risk factors.

Methods/Design

The ACCEPT-D is an open-label trial assessing whether 100 mg/daily of aspirin prevent cardiovascular events in patients without clinically manifest vascular disease and treated with simvastatin (starting dose 20 mg/die). Eligible patients will be randomly assigned to receive aspirin + simvastatin or simvastatin alone. Eligibility criteria: male and female individuals aged >=50 years with diagnosis of type 1 or type 2 diabetes, already on treatment with statins or candidate to start the treatment (LDL-cholesterol >=100 mg/dL persisting after 3 months of dietary advise). The primary combined end-point will include cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, and hospital admission for cardiovascular causes (acute coronary syndrome, transient ischemic attack, not planned revascularization procedures, peripheral vascular disease). A total of 515 first events are needed to detect a reduction in the risk of major cardiovascular events of 25% (alpha = 0.05; 1-beta = 0.90). Overall, 5170 patients will be enrolled. The study will be conducted by diabetes specialists and general practitioners.

Discussion

The study will provide important information regarding the preventive role of aspirin in diabetes when used on the top of the other strategies aimed to control cardiovascular risk factors.

Trial registration

Current Controlled Trials ISRCTN48110081.