bluuebunny/crossref_metadata_2025 huggingface dataset:
Smoking and periodontal disease
Authors: Zee K‐Y
Published: September 2009

Periodontal disease is considered to be an opportunistic infection as a result of interactions between the causative agents (dental plaque) and the host responses which may be modulated by genetic, environmental and acquired risk factors. Besides being a well‐confirmed risk factor in a number of systemic diseases, tobacco smoking has also been associated with periodontal disease. Over the past 10–15 years, more and more scientific data on the impact of smoking on various aspects of periodontal disease and the underlying mechanisms has been published. The purpose of this review was to provide an overview of the available data in order to give practitioners a better understanding of the relationship between smoking and periodontal disease. Subsequently, they can use some of the information in treatment decisions and give advice to patients who are smokers suffering from periodontal disease.
Periodontal maintenance
Authors: Tan AES
Published: September 2009

The main goal of periodontal therapy is to establish an oral environment compatible with periodontal health by the physical disruption of the plaque biofilm and adjunctive chemical means if required. Implicit in this objective is the ongoing requirement of detection and interception of new and recurrent disease, which continues at selected intervals for the life of the dentition after the initial (“active”) phase of periodontal treatment. This concept of ongoing periodontal maintenance therapy has been embraced as the mandatory requirement for favourable periodontal outcomes based on institutional clinical trials and in practice‐based studies in various parts of the world. This review examines the ramifications of periodontal maintenance therapy based upon a multi‐level assessment of logistic issues and risk factors at three levels: (1) The patient level – treatment time; patient attendance compliance; and homecare measures, antiseptics/antibiotics and smoking. (2) The level of the individual tooth – tooth loss; and evaluation of success versus survival. (3) The level of each tooth surface (“site”) – probing depth, loss of attachment and bleeding on probing; and changes in clinical attachment levels. In spite of the diversity of studies conducted, there is agreement on the efficacy of periodontal maintenance therapy when compared with studies on untreated populations and in treated cases that were not maintained.
Spanning Citizenship Spaces Through Transnational Coalitions: The Case of the Global Campaign for Education
Authors: Gaventa John , Mayo Marjorie
Published: September 2009

How do changing patterns of power and governance affect how and where citizens mobilise collectively to claim their rights? This paper presents a case study of the Global Campaign for Education (GCE), a civil society coalition that came together in 1999 to mobilise people across the world in a campaign for the right to quality, free education for all. The paper interrogates the experience of the GCE to better understand how advocacy movements meet the inherent difficulties of mobilising across different levels of governance to achieve globally recognised rights. The GCE is widely perceived as a successful example of a campaign coalition. Its deep, pre‐existing roots in collective organisation in the global South were the foundation for this success. Inclusive and representative formal structures, collective framing of campaign issues and careful recognition of the different roles played by actors in different locations were key factors in building the campaign coalition. The case study discussed the way that involvement in a global campaign affects the citizenship identities of those involved. A sense of global citizenship amongst activists added to rather than replacing a sense of local and national citizenship; as governance is multiscaled, so citizenship can therefore be multidimensional. The challenge is how to continue to build and sustain inclusive and democratic coalitions which span multiple sites and spaces of citizenship.
‘Show me the Evidence’: Mobilisation, Citizenship and Risk in Indian Asbestos Issues
Authors: Waldman Linda
Published: September 2009

This paper examines asbestos issues, mobilisation and citizenship in India. It shows how asbestos has been considered as a tool for Indian economic growth and modernisation and explores the scientific debates around its ‘safe’ use. In seeking to locate experiences of citizenship within a globalised context, this research has focused on anti‐asbestos mobilisation and protest in cosmopolitan cities as well as more decentralised contexts. It argues that the state's narrow definition of asbestos diseases enables it to officially document the lack of asbestos diseases experienced by Indian workers. This process, which defines sufferers as politically invisible and inconsequential, accompanied by the 30 year delay between exposure and the onset of disease, hinders anti‐asbestos organisations as there is no constituency to be mobilised. Parallel (and partially interrelated) grassroots asbestos movements which are more worker‐orientated are, however, marginalised from the transnational protests. The paper argues that mobilisation around identity issues thus creates different contexts in India, in which activists are simultaneously both intimately connected and enormously distant to different aspects of the mobilisation process. In addition, while geographic and political differences are compressed through transnational mobilisation; class, regional and educational differences are expanded.
Morphological and Functional Characteristics of Three-Dimensional Engineered Bone-Ligament-Bone Constructs Following Implantation
Authors: Ma Jinjin , Goble Kristen , Smietana Michael , Kostrominova Tatiana , Larkin Lisa , Arruda Ellen M.
Published: September 2009

The incidence of ligament injury has recently been estimated at 400,000/year. The preferred treatment is reconstruction using an allograft, but outcomes are limited by donor availability, biomechanical incompatibility, and immune rejection. The creation of an engineered ligament in vitro solely from patient bone marrow stromal cells (has the potential to greatly enhance outcomes in knee reconstructions. Our laboratory has developed a scaffoldless method to engineer three-dimensional (3D) ligament and bone constructs from rat bone marrow stem cells in vitro. Coculture of these two engineered constructs results in a 3D bone-ligament-bone (BLB) construct with viable entheses, which was successfully used for medial collateral ligament (MCL) replacement in a rat model. 1 month and 2 month implantations were applied to the engineered BLBs. Implantation of 3D BLBs in a MCL replacement application demonstrated that our in vitro engineered tissues grew and remodeled quickly in vivo to an advanced phenotype and partially restored function of the knee. The explanted 3D BLB ligament region stained positively for type I collagen and elastin and was well vascularized after 1 and 2 months in vivo. Tangent moduli of the ligament portion of the 3D BLB 1 month explants increased by a factor of 2.4 over in vitro controls, to a value equivalent to those observed in 14-day-old neonatal rat MCLs. The 3D BLB 1 month explants also exhibited a functionally graded response that closely matched native MCL inhomogeneity, indicating the constructs functionally adapted in vivo.
A Method for Automatically Optimizing Medical Devices for Treating Heart Failure: Designing Polymeric Injection Patterns
Authors: Wenk Jonathan F. , Wall Samuel T. , Peterson Robert C. , Helgerson Sam L. , Sabbah Hani N. , Burger Mike , Stander Nielen , Ratcliffe Mark B. , Guccione Julius M.
Published: September 2009

Heart failure continues to present a significant medical and economic burden throughout the developed world. Novel treatments involving the injection of polymeric materials into the myocardium of the failing left ventricle (LV) are currently being developed, which may reduce elevated myofiber stresses during the cardiac cycle and act to retard the progression of heart failure. A finite element (FE) simulation-based method was developed in this study that can automatically optimize the injection pattern of the polymeric “inclusions” according to a specific objective function, using commercially available software tools. The FE preprocessor TRUEGRID® was used to create a parametric axisymmetric LV mesh matched to experimentally measured end-diastole and end-systole metrics from dogs with coronary microembolization-induced heart failure. Passive and active myocardial material properties were defined by a pseudo-elastic-strain energy function and a time-varying elastance model of active contraction, respectively, that were implemented in the FE software LS-DYNA. The companion optimization software LS-OPT was used to communicate directly with TRUEGRID® to determine FE model parameters, such as defining the injection pattern and inclusion characteristics. The optimization resulted in an intuitive optimal injection pattern (i.e., the one with the greatest number of inclusions) when the objective function was weighted to minimize mean end-diastolic and end-systolic myofiber stress and ignore LV stroke volume. In contrast, the optimization resulted in a nonintuitive optimal pattern (i.e., 3 inclusions longitudinally×6 inclusions circumferentially) when both myofiber stress and stroke volume were incorporated into the objective function with different weights.
A Study on Construction Three-Dimensional Nonlinear Finite Element Model and Stress Distribution Analysis of Anterior Cruciate Ligament
Authors: Xie Feng , Yang Liu , Guo Lin , Wang Zhi-jun , Dai Gang
Published: September 2009

To establish a finite element model that reflects the geometric characteristics of the normal anterior cruciate ligament (ACL), explore the approaches to model knee joint ligaments and analyze the mechanics of the model. A healthy knee joint specimen was subjected to three-dimensional laser scanning, and then a three-dimensional finite element model for the normal ACL was established using three-dimensional finite element software. Based on the model, the loads of the ACL were simulated to analyze the stress-strain relationship and stress distribution of the ACL. Using the ABAQUS software, a three-dimensional finite element model was established. The whole model contained 22,125 nodes and 46,411 units. In terms of geometric similarity and mesh precision, this model was superior to previous finite element models for the ACL. Through the introduction of material properties, boundary conditions, and loads, finite elements were analyzed and computed successfully. The relationship between overall nodal forces and the displacement of the ACL under anterior loads of the tibia was determined. In addition, the nephogram of the ACL stress spatial distribution was obtained. A vivid, three-dimensional model of the knee joint was established rapidly by using reverse engineering technology and laser scanning. The three-dimensional finite element method can be used for the ACL biomechanics research. The method accurately simulated the ACL stress distribution with the tibia under anterior loads, and the computational results were of clinical significance.
Differences in Aortic Arch Geometry, Hemodynamics, and Plaque Patterns Between C57BL/6 and 129/SvEv Mice
Authors: Zhu Hui , Zhang Ji , Shih Jessica , Lopez-Bertoni Federico , Hagaman John R. , Maeda Nobuyo , Friedman Morton H.
Published: September 2009

Atherosclerotic plaques are distributed differently in the aortic arches of C57BL/6 (B6) and 129/SvEv (129) apolipoprotein E (apoE)-deficient mice. It is now recognized that hemodynamic wall shear stress (WSS) plays an important role in the localization of atherosclerotic development. Since the blood flow field in the vessel is modulated by the vascular geometry, we quantitatively examined the difference in the aortic arch geometry and hemodynamic WSS between the two corresponding wild-type mouse strains. The three-dimensional (3D) geometry of 14 murine aortic arches, seven from each strain, was characterized using casts and stereo microscopic imaging. Based on the geometry of each cast, an average 3D geometry of the aortic arch for each mouse strain was obtained, and computational fluid dynamic calculations were performed in the two average aortic arches. Many geometric features, including aortic arch shape, vessel diameter, and branch locations, were significantly different at p<0.05 between the two mouse strains. Lower shear stress was found at the inner curvature of the aortic arch in the 129 strain, corresponding to greater involvement in the corresponding apoE-deficient mice relative to the B6 strain. These results support the notion that heritable features of arterial geometry can contribute to individual differences in local susceptibility to arterial disease.
Opening Angles and Material Properties of the Early Embryonic Chick Brain
Authors: Xu Gang , Kemp Philip S. , Hwu Joyce A. , Beagley Adam M. , Bayly Philip V. , Taber Larry A.
Published: September 2009

Mechanical forces play an important role during brain development. In the early embryo, the anterior end of the neural tube enlarges and differentiates into the major brain subdivisions, including three expanding vesicles (forebrain, midbrain, and hindbrain) separated by two constrictions. Once the anterior neuropore and the spinal neurocoel occlude, the brain tube undergoes further regional growth and expansion in response to increasing cerebrospinal fluid pressure. Although this is known to be a response to mechanical loads, the mechanical properties of the developing brain remain largely unknown. In this work, we measured regional opening angles (due to residual stress) and stiffness of the embryonic chick brain during Hamburger–Hamilton stages 11–13 (approximately 42–51 h incubation). Opening angles resulting from a radial cut on transverse brain slices were about 40–110 deg (depending on region and stage) and served as an indicator of circumferential residual stress. In addition, using a custom-made microindentation device and finite-element models, we determined regional indentation stiffness and material properties. The results indicate that the modulus is relatively independent of position and stage of development with the average shear modulus being about 220 Pa for stages 11–13 chick brains. Information on the regional material properties of the early embryonic brain will help illuminate the process of early brain morphogenesis.
Distinguishing hypertrophic cardiomyopathy from athlete’s heart physiological remodelling: clinical significance, diagnostic strategies and implications for preparticipation screening
Authors: Maron B J
Published: September 2009

Sudden cardiac death in young competitive athletes is an important public health problem, although a relatively low-event-rate phenomenon. The single most common cardiovascular cause of these unexpected catastrophes is hypertrophic cardiomyopathy (HCM), accounting for about one-third of cases. Since the phenotypic expression of HCM is variable, and not uncommonly includes patients with mild and localised left ventricular hypertrophy, the differential diagnosis with physiological remodelling of athlete’s heart not uncommonly arises. This review discusses those non-invasive strategies that are useful in distinguishing the benign consequences of systematic athletic training from pathological left ventricular hypertrophy with the potential for sudden cardiac death. Preparticipation screening in healthy general athlete populations may raise the suspicion of HCM, and ultimately lead to definitive diagnosis. However, recently controversy has arisen regarding the most effective and practical strategy for the screening of athletes. European investigators have promoted routine 12-lead ECGs as part of a national mandatory programme distinct from the customary practice in the US which is limited to history and physical examinations. Consensus criteria and recommendations for eligibility and disqualification of athletes with HCM (and other cardiovascular abnormalities) have proved useful to the practising community.
Advances in cardiac imaging: the role of magnetic resonance imaging and computed tomography in identifying athletes at risk
Authors: Prakken N H , Velthuis B K , Cramer M J , Mosterd A
Published: September 2009

Advanced cardiac imaging, using cardiac magnetic resonance imaging (MRI) and multidetector computed tomography (CT), is increasingly used in the work-up of athletes with suspected abnormalities on screening. Both imaging modalities produce highly accurate and reproducible structural and functional cardiac information. Cardiac MRI has the advantage of imaging without radiation exposure or the use of iodine-containing contrast agents, but is sometimes not possible due to claustrophobia or other contraindications. Although cardiac MRI can rule out coronary artery anomalies, multidetector CT is superior to cardiac MRI for visualising the full extent of the coronary arteries and atherosclerotic coronary artery disease. For patients less than 35 years of age, cardiac MRI is the first option after initial echocardiography for further assessment of cardiomyopathies, myocarditis and coronary anomalies, which are major causes of sudden cardiac death in young athletes. For athletes over 35 years of age the most common cause of sudden cardiac death is coronary artery disease, whereby cardiovascular screening requires further diagnostic modalities and may include multidetector CT.
Return to play? Practical considerations for young athletes with cardiovascular disease
Authors: Anderson B R , Vetter V L
Published: September 2009

Sports activities are an important part of the daily life of young persons. For a small proportion of those with cardiac conditions, sports participation can result in sudden cardiac arrest. Children and adolescents often participate in both organised and spontaneous play, for which activity guidelines are needed when a condition known to cause sudden cardiac death is identified. This article examines the current guidelines that provide recommendations for sports participation by young persons with cardiovascular disease and reviews the current information on risks of physical activity for those with specific cardiac conditions. The goal of the practitioner is to balance the risks of restriction from physical activity with the benefits of participation. Some practical recommendations are offered for consideration, along with potential alternatives to absolute restriction.
The ageing athlete: screening prior to vigorous exertion in asymptomatic adults without known cardiovascular disease
Authors: Freeman J , Froelicher V , Ashley E
Published: September 2009

The exercise electrocardiogram (ECG) is widely considered the best available test for screening asymptomatic adults without known cardiovascular (CV) disease prior to initiating a vigorous exercise programme due to its prognostic value, widespread availability and low cost. Observational studies have demonstrated an increased relative risk of CV events with positive screening exercise ECG tests in men with diabetes, advanced age, or multiple cardiac risk factors. Recent observational studies have not demonstrated similar prognostic value for exercise ECG testing in asymptomatic healthy women. Despite the predictive ability of exercise ECG testing in several groups, there have been no studies demonstrating a significant impact of screening on morbidity and mortality in completely asymptomatic patients, leading to significant discordance in consensus guidelines on screening. One prospective observational study is ongoing in Italy that may for the first time demonstrate the ability to decrease incident CV events using preparticipation screening exercise ECG testing in adult athletes with targeted exclusion from athletics. Until more conclusive data is available the authors currently recommend screening exercise ECG testing in asymptomatic men with diabetes and asymptomatic men over age 45 with two or more CV risk factors prior to initiating a vigorous exercise programme. Consideration should also be given to screening asymptomatic patients younger than 45 with particularly strong risk factor exposure or elderly patients with fewer than two risk factors.
Prevention of sudden cardiac death: return to sport considerations in athletes with identified cardiovascular abnormalities
Authors: Link M S
Published: September 2009

Sudden cardiac death in the athlete is uncommon but extremely visible. In athletes under age 30, genetic heart disease, including hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, and ion channel disorders account for the majority of the deaths. Commotio cordis, involving blunt trauma to the chest leading to ventricular fibrillation, is also a leading cause of sudden cardiac death in young athletes. As the athlete ages, coronary atherosclerosis contributes to an increasing incidence of sudden death during sporting activities. For athletes with aborted sudden death or arrhythmia-related syncope, an implantable cardioverter defibrillator is generally indicated, and they should be restricted from most competitive sports. Participation in competitive athletics for athletes with heart disease should generally follow the recently published 36th Bethesda Conference Eligibility Recommendations for Competitive Athletes with Cardiovascular Abnormalities.
Preparing for sudden cardiac arrest—the essential role of automated external defibrillators in athletic medicine: a critical review
Authors: Drezner J A
Published: September 2009

Sudden cardiac arrest (SCA) is the leading cause of death in exercising young athletes. Three factors—prompt recognition of SCA, the presence of a trained rescuer to initiate cardiopulmonary resuscitation (CPR) and access to early defibrillation through on-site automated external defibrillators (AEDs)—are critical to improving survival. Schools, clubs and organisations sponsoring athletic events should have an established emergency response plan for SCA. Essential elements of an emergency response plan include an effective communication system to alert first responders and retrieve the AED, training of anticipated responders in CPR and AED use, access to an AED for early defibrillation, integration of on-site AED programmes with the local emergency medical services system, and practice and review of the response plan. Timely access to AEDs at training and sporting competitions permits effective management of SCA and the prevention of sudden cardiac death in athletes. SCA should be suspected in any collapsed and unresponsive athlete and an AED applied as soon as possible for rhythm analysis and defibrillation if indicated. This article reviews emergency response planning for SCA and highlights recent data that provide a compelling case for the essential role of AEDs in the athletic setting.
Research involving storage and use of human tissue: how did the Human Tissue Act 2004 affect decisions by research ethics committees?
Authors: Angell E , Tarrant C , Dixon-Woods M
Published: September 2009

Background:

Little is known about the types of issues research ethics committees (RECs) raise in their letters about research involving the storage and use of human tissue.

Aims:

To classify the issues that appear to trouble RECs and to identify how the implementation of the Human Tissue (HT) Act in September 2006 might have affected REC decisions.

Methods:

100 letters relating to applications about research use of human tissue were randomly selected from the National Research Ethics Service database, of which half were issued before the implementation of the HT Act and half post-implementation. Ethical issues raised by RECs were classified with a coding scheme developed using ethnographic content analysis.

Results:

Many letters raised issues about informed consent, including specific concerns about the information to be provided to participants about the taking, using and storing of their tissue samples. However, RECs appeared to be less likely to raise concerns about informed consent to use or store tissue after the HT Act, and there was some evidence that RECs were more comfortable allowing archived tissue samples to be used without additional patient consent after the HT Act than before.

Conclusions:

In the wake of the HT Act, RECs do not appear to be more cautious about approving research to use or store tissue without consent when responding to applications for ethical approval. The HT Act has provided clarity and authority to RECs and may indeed facilitate the process of gaining ethical approval for tissue-based research.
Comparison of reflective and reflex testing for hypomagnesaemia in severe hypokalaemia
Authors: Jones B J , Twomey P J
Published: September 2009

Aim:

To compare the impact and effectiveness of introducing reflective and reflex testing of magnesium in severe hypokalaemia.

Methods:

All specimens with [K] ⩽2.5 mmol/l were retrospectively identified in three 6-month periods: baseline, with reflective testing, and with reflex testing. For each episode of hypokalaemia it was noted whether [Mg] was measured.

Results:

Measurement of [Mg] increased from 7.7% to 63.9% (p<0.001) after introducing reflective testing, and then to 98.7% (p<0.001) with reflex testing. Diagnosis of hypomagnesaemia increased from 7.7% to 43.1% (p<0.001) and 69.3% (p<0.01) with reflective and reflex testing, respectively. For severe hypomagnesaemia ([Mg] <0.50 mmol/l) the increase was from 1.9% to 8.3% (p = 0.127 relative to baseline) with reflective testing and then to 12.0% with reflex testing (p<0.05 relative to baseline and p = 0.463 relative to reflective testing). The number of tests needed to diagnose was similar for reflective and reflex testing: 1.48 and 1.42 for hypomagnesaemia, respectively; and 7.67 and 8.22 for severe hypomagnesaemia, respectively. 42 and 70 extra magnesium assays compared to baseline were requested due to reflective and reflex testing, respectively.

Conclusion:

Reflex testing was the most time-efficient and consistent method of diagnosing hypomagnesaemia in severe hypokalaemia. This was mainly due to the increased number of magnesium assays performed. However, as the absolute increase in test numbers was small (28 in a 6-month period) and the test is inexpensive, selective reflex testing can improve quality in a cost-efficient manner.
Cyclin D1 positive follicular lymphoma
Authors: Olsen B , Srkalovic G , Hall M , McPhail E
Published: September 2009

This report describes an unusual case of cyclin D1 expression by an otherwise typical follicular lymphoma, of low histological grade. BCL2–IGH and CCND1–IGH fusions were identified by interphase fluorescence in situ hybridisation.
MicroRNAs in clinical oncology: at the crossroads between promises and problems
Authors: Metias S M , Lianidou E , Yousef G M
Published: September 2009

MicroRNAs (miRNAs) are small RNAs that do not code for proteins, but function by controlling protein expression of other genes. miRNAs have been shown to control cell growth, differentiation and apoptosis. Shortly after their discovery, miRNAs have been found to be associated with cancer. Earlier reports have shown that human cancers frequently show a distorted expression profile of miRNAs. In this review, the biogenesis of miRNAs and potential mechanisms of their dysregulation and involvement in cancer pathogenesis are discussed. The current literature on potential applications of miRNAs in the field of clinical oncology from diagnostic to prognostic and predictive applications at the tissue, and more recently, serum levels, is reviewed. The potential therapeutic applications of miRNAs and RNAi in the field of cancer are summarised. Finally, some of the potential challenges that face the transition of miRNAs from a research setting into a clinical application are highlighted, with a future prospective of the incorporation of miRNAs in cancer patient management.
JAK2V617Factivating mutation is associated with the myeloproliferative type of chronic myelomonocytic leukaemia
Authors: Pich A , Riera L , Sismondi F , Godio L , Bonino L Davico , Marmont F , di Celle P Francia
Published: September 2009

Background:

Chronic myelomonocytic leukaemia (CMML) is a haematopoietic malignancy with heterogeneous clinical and morphological features. It is classified in the World Health Organization myeloproliferative-myelodysplastic overlap category. JAK2V617Fmutation can be found in a large percentage of patients with myeloproliferative neoplasms.

Aims:

To investigate the association between JAK2V617Fmutation and clinical, haematological and bone marrow histological features in CMML and to verify whether the mutation is associated with the myeloproliferative type of the disease.

Methods:

78 consecutive patients with newly diagnosed CMML from 2004 to 2008 were included in the study. JAK2V617Fmutation was assessed using direct sequencing of exon 14 or by allele-specific PCR from total peripheral blood or bone marrow samples.

Results:

JAK2V617Fmutation was identified in eight cases (10.2%). All patients with the mutation presented with splenomegaly and had a significantly higher haemoglobin level and neutrophil count than patients without the mutation. All bone marrow biopsies of JAK2V617F-mutated CMML showed increased erythropoiesis, a marked myeloid and megakaryocytic hyperplasia with occasionally clustered megakaryocytes, and a mild or moderate (grade 1 or 2) fibrosis; six cases showed an increased number of dilated sinusoids and reactive lymphoid nodules.

Conclusions:

The results indicate that JAK2V617Fmutation is associated with clinical and morphological features of the myeloproliferative type of CMML. Therefore, JAK2 mutation analysis together with bone marrow morphology could help in a more appropriate classification of the disease.
The number of multinucleated trophoblastic giant cells in the basal decidua is decreased in retained placenta
Authors: van Beekhuizen H J , Joosten I , de Groot A N J A , Lotgering F K , van der Laak J , Bulten J
Published: September 2009

Aims:

Retained placenta (RP) is a major cause of obstetric haemorrhage. The aim of the study was to obtain a better understanding of the mechanisms that cause some placentas to become retained, while most are not.

Methods:

23 RPs clinically diagnosed as placenta adhesiva and 10 control placentas (CPs) were examined for differences in trophoblast fusion into multinucleated trophoblastic giant cells (MTGCs), defects in the basal decidua, and decidual attachment of myometrial fibres.

Results:

The number of MTGCs in the basal decidua was significantly smaller in RPs (0.23 MTGC/standard length) than in CPs (1.11 MTGC/standard length) (p<0.001). Defects in the decidua were observed in 4% of the RPs and in 0% of the CPs. Myometrial fibres were attached to the decidua in 78% of the RPs and in 0% of the CPs (p<0.001).

Conclusions:

In placenta adhesiva compared with CPs, significantly less MTGCs were present in the basal decidua, the basal decidua was intact, and myometrial fibres were more frequently attached to the basal decidua. It is speculated that these findings may indicate that defective fusion of trophoblastic cells into MTGCs plays a causative role in placenta adhesiva.
Multiple squamous hyperplastic-fibrous inflammatory polyps of the oesophagus: a new feature of eosinophilic oesophagitis?
Authors: Mulder D J , Gander S , Hurlbut D J , Soboleski D A , Smith R G , Justinich C J
Published: September 2009

This report describes the unusual case of a 12-year-old boy with multiple polyps in the oesophagus and concurrent eosinophilic oesophagitis (EoE). Polyps were of a fibrous-inflammatory composition featuring eosinophils, mast cells, hyperplastic epithelium and fibrosis, which are all features described with EoE. EoE is an increasingly recognised clinicopathological disorder characterised by large numbers of eosinophils infiltrating the oesophageal mucosa. Polyps in the oesophagus are rare, have not previously been associated with EoE, and may represent a new feature of the disease.
KITD816V+systemic mastocytosis associated with KITD816V+acute erythroid leukaemia: first case report with molecular evidence for same progenitor cell derivation
Authors: McClintock-Treep S A , Horny H-P , Sotlar K , Foucar M K , Reichard K K
Published: September 2009

A case of systemic mastocytosis associated with a clonal haematological non-mast cell lineage disease (SM-AHNMD), where the associated disease is acute erythroid leukaemia (erythroid/myeloid type), is reported. Interestingly, molecular studies showed the KITD816V+mutation not only in the mast cells, but also in the myeloid blast population and the leukaemic erythroid cells. As is the case with most erythroid leukaemias, the patient had a very aggressive clinical course and died shortly after diagnosis. It is believed that this is the first reported case of systemic mastocytosis with erythroid leukaemia where the KITD816V+mutation was detected in all three cell types. Molecular findings provide evidence for derivation of these seemingly morphologically distinct lesions from the same clonal precursor cell. From a practice standpoint, this case illustrates the importance of definitively diagnosing the associated non-mast cell lineage disease due to its prognostic implications.
Bulls and bears: the stock market and clinical pathology research
Authors: Khong T Y
Published: September 2009

Aims:

To analyse the level of funded research in clinical pathology in a recent bear and bull market to act as a predictor for future funding during the current global financial crisis.

Methods:

The level of funding for research published in three clinical pathology journals in 2005 and 2008 to coincide with the bear market of March 2000 to October 2002 and with the subsequent bull market to October 2007 was determined using a Medline query. Other parameters examined were the type of article, affiliation of the first author and the pathology subspecialty.

Results:

Approximately 30% of publications were funded and did not differ between the 2 years studied. Original research papers were more likely to be funded than case reports or reviews. Research from university departments of pathology was more likely to be funded than from hospital pathology departments but there were more publications from hospital pathology departments. The proportion of research in the different subspecialties that was funded did not differ significantly between each other and between 2005 and 2008.

Conclusions:

Based on data from the previous bear market, which was the longest and deepest of the post 1950 era, and the subsequent bull market, which led to the all-time high in the Dow Jones Industrial Index, funding for clinical pathology research does not seem to be affected by bull or bear markets.
Social networking sites: a novel portal for communication
Authors: Farmer A D , Bruckner Holt C E M , Cook M J , Hearing S D
Published: September 2009

Background

The internet has transformed many spheres of society. Most notably the advent of social networking websites, such as MySpace, Bebo and Facebook, have attracted many millions of users worldwide. There are over 350 such sites in operation across the internet. There is a paucity of data in the adult literature examining the medical usage of this interesting facet of modern life.

Aims

To ascertain whether Facebook has user groups that are connected with common medical conditions, and to classify the user groups that were identified as well as enumerating the number of individual users contained therein.

Methods

We conducted a search of the entire Facebook website between December 2007 and January 2009. We used medical and lay nomenclature for the most prevalent non-communicable diseases as identified from the World Health Organisation Burden of Disease publication to identify whether they were represented among individual Facebook users and user groups.

Results

We identified 290 962 individual users who were part of 757 groups. Patient groups accounted for 47.4%, patient/carer support groups 28.1%, fund raising groups 18.6%, and others 5.8%. Notably, there were other groups containing representations from the scientific research community in addition to educational resources. The groups with the most individual members pertained to malignant neoplasms and cardiovascular disease (141 458 users) consistent with their worldwide prevalence.

Conclusions

Facebook is providing a readily accessible portal for patients, carers and healthcare professionals to share their experiences of investigation, diagnosis and management of disease. Furthermore, this technology is being used for research, education and fundraising. Further research is warranted to explore the further potential of this new technology.
Consultation activities of clinical ethics committees in the United Kingdom: an empirical study and wake-up call
Authors: Whitehead J M , Sokol D K , Bowman D , Sedgwick P
Published: September 2009

Objective

To identify the consultation activities of clinical ethics committees (CECs) in the UK and the views of CEC chairpersons regarding such activities.

Methods

An anonymous, password-protected online questionnaire was sent by e-mail to 70 CEC chairpersons. The questionnaire contained 14 items.

Results

Of the 70 CECs contacted, 30 responded (a response rate of 43%). There has been an almost fourfold increase in the number of CECs in the past 7 years. Over half of the CECs that responded had considered three or fewer active cases and three or fewer retrospective cases in the preceding year. Eighty percent of chairpersons felt that the number of active cases considered by their committee was too low. Seventy percent of CECs had rapid response teams. Aside from low consultation caseloads, chairpersons identified a number of concerns, including education and training of members, composition of CECs, low profile and lack of funding and support. Although most respondents believed there is a need for clinical ethics support in the NHS, many noted the limited use of the services, even after efforts to increase the visibility of their CEC.

Conclusion

Despite a sharp increase in the absolute numbers of CECs across the UK, the number of cases considered by the majority of CECs is low. The findings presented here suggest we must reflect on the reasons for such low caseloads and pause to consider whether the committee model is most appropriate for the UK context.
Venous thromoboembolic disease and pregnancy
Authors: Martineau M , Nelson-Piercy C
Published: September 2009

Although venous thromboembolism is a preventable and treatable condition, it remains the most common cause of direct maternal death in the UK, with a four-fold increased incidence compared to that of the non-pregnant population. The risk of VTE is apparent from early pregnancy and maximal immediately postpartum. Increasing rates of obesity and maternal age over 35 years are in part responsible for this escalation and are likely to continue to rise exponentially over the next decade. Targeted prophylaxis in those considered at increased risk should be offered antenatally with regular reassessment of individual risk throughout pregnancy. Many of the symptoms attributable to VTE are common in normal pregnancy; therefore a high index of suspicion and a low threshold for objective investigation are important. Unfounded fears concerning the potential adverse effects of ionising radiation on fetal wellbeing often serve to delay investigation and treatment. This article provides an overview of the pathophysiology, diagnosis, treatment and prevention of VTE in pregnancy and refers the reader to recent evidence based guidelines.
Sm-Nd data for granitoids across the Namaqua sector of the Namaqua-Natal Province, South Africa
Authors: Pettersson Åsa , Cornell David H. , Yuhara Masaki , Hirahara Yuka
Published: September 2009

Sm–Nd data for rocks of granitic composition in an east–west traverse across the Namaqua Sector of the Mesoproterozoic
c
. 1.2 Ga Namaqua–Natal Province of southern Africa provide new evidence about the timing of crustal extraction from the mantle. Recent ion probe zircon dating has shown that, contrary to previous indications that pre-Namaqua basement had been preserved in parts of the Namaqua Sector, the majority of the magmatic rocks were emplaced during the 1.4–1.0 Ga Namaqua tectogenesis and very little U–Pb evidence of older precursors remains. Sm–Nd model ages show that Mesoproterozoic crustal extraction did occur, but was also strong in the Palaeoproterozoic, with local evidence for the existence of Archaean crust. The distribution of model ages generally corresponds with the established terranes, subdivided using lithostratigraphic and structural criteria. The northern part of the Bushmanland Terrane shows early Palaeoproterozoic to Archaean model ages and is clearly different from the southern part, which has Mesoproterozoic model ages. This supports the previously published results of a north–south traverse and justifies the separation of the Garies Terrane from the Bushmanland Terrane, though further subdivisions are not supported. The continuation of the Richtersveld Province east of Pofadder is supported by one sample, and the terrane boundary between the Bushmanland and Kakamas terranes is marked by an abrupt change from Palaeoproterozoic to Mesoproterozoic model ages. Model ages for the Kakamas and Areachap terranes do not distinguish them well. They suggest a Mesoproterozoic to late Palaeoproterozoic origin for both terranes, neither of which has a purely juvenile character. The influence of Palaeoproterozoic crust-forming events is clear in the Kaaien Terrane to the east, possibly reflecting reworking of the Kaapvaal Craton. The Namaqua Sector of the Province thus has a history of crustal extraction and evolution which reaches back locally to the Archaean, with major Palaeoproterozoic and Mesoproterozoic crust-forming events. This differs from the Natal Sector, which has a largely juvenile character related to a Mesoproterozoic Wilson cycle. Attempts to reconstruct the Mesoproterozoic Supercontinent Rodinia will have to take into account the extensive Nd-isotopic evidence for older crustal events in the Namaqua sector.
Evidence for 2.35 to 2.30 Ga juvenile crustal growth in the northwest Borborema Province, NE Brazil
Authors: dos Santos Ticiano J. S. , Fetter Allen H. , Van Schmus W. Randall , Hackspacher Peter C.
Published: September 2009

The
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. 600 Ma Brasiliano Borborema Province of NE Brazil comprises a complex collage of Precambrian crustal blocks cut by a series of continental-scale shear zones. The predominant basement rocks in the province are 2.1–2.0 Ga Transamazonian gneisses of both juvenile and reworked nature. U–Pb zircon and Sm–Nd whole-rock studies of tonalite-trondhjemite-granodiorite basement gneisses in the NW Ceará or Médio Coreaú domain in the northwestern part of the Borborema Province indicate that this represents a continental fragment formed by 2.35–2.30 Ga juvenile crust. This block has no apparent genetic affinity with any other basement gneisses in the Borborema Province, and it does not represent the tectonized margin of the
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. 2.1–2.0 Ga São Luis Craton to the NW. The petrological and geochemical characteristics, as well as the Nd-isotopic signatures of these gneisses, are consistent with their genesis in an island arc setting. This finding documents a period of crustal growth during a period of the Earth's history which is known for its tectonic quiescence and paucity of crust formation.
The IGCP 509 database system: design and application of a tool to capture and illustrate litho- and chrono-stratigraphic information for Palaeoproterozoic tectonic domains, large igneous provinces and ore deposits; with examples from southern Africa
Authors: Eglington Bruce M. , Reddy Steven M. , Evans David A. D.
Published: September 2009

The IGCP 509 project is collating global information for the Palaeoproterozoic era through the activities of numerous international collaborators. A database system (StratDB) and web interface has been designed to facilitate this process with links to an existing geochronology database (DateView). As a result, all information captured will remain available in a digital format for future researchers. The philosophy and design of the database and some of the outputs available from it are described. One of the principal features of the system is that it facilitates the construction of time–space correlation charts using an innovative application of GIS technology to non-geographic information, which permits users to query a variety of attribute information associated with lithostratigraphic units, metamorphic and deformation episodes associated with user-selected tectonic domains, large igneous provinces and major ore deposits. In the process, much of the manual labour normally associated with the construction of such charts in standard graphical or drafting packages is avoided. Associations between units, deformation, metamorphism, large igneous provinces and ore deposits may become more apparent once linked information is available for querying and investigation. Geochronological information from the DateView database may also be linked to entities stored in StratDB. GIS maps may be linked to the attribute information in StratDB and DateView to construct a variety of time-slice maps or palaeogeographic reconstructions with the same symbology as is used in the time–space correlation charts. This database system will facilitate the dissemination of lithostratigraphic information for many countries to a broader community and will help non-specialists to easily view information for various Palaeoproterozoic tectonic domains. The system is illustrated using a preliminary compilation of information for the Palaeoproterozoic of southern Africa. The correlation charts and time-slice maps provide insights to the geological evolution of this region which emphasize some aspects and correlations which have not previously been extensively considered; for instance, possible correlation of units in the central and western zones of the Limpopo Belt (South Africa, Zimbabwe and Botswana) with the Magondi Belt of Zimbabwe and its extension into northern Botswana.