bluuebunny/crossref_metadata_2025 huggingface dataset:
Sustained Benzodiazepine Use in a Community Sample of Older Adults
Authors: Stowell Keith R. , Chang Chung‐Chou H. , Bilt JoniVander , Stoehr Gary P. , Ganguli Mary
Published: October 2008

OBJECTIVES: To identify factors associated with sustained benzodiazepine use in older adults.

DESIGN: Twelve‐year cohort study.

SETTING: Community‐based epidemiological survey.

PARTICIPANTS: One thousand three hundred forty‐two individuals aged 65 and older.

MEASUREMENTS: Demographics, medication use, depressive symptoms, sleep complaints, alcohol use, and smoking assessed at 2‐year intervals; descriptive analysis to characterize benzodiazepine users and identify factors associated with sustained benzodiazepine use (use at two consecutive waves); and longitudinal lag‐time analysis to determine characteristics that predicted sustained use.

RESULTS: Initially, 5.5% of men and 9.8% of women were using benzodiazepines. Users were significantly more likely than nonusers to be female and less educated, report more depressive and anxiety symptoms, use more prescription medications, have lower self‐rated health, have difficulty maintaining sleep, and be less likely to consume alcohol. Approximately 50%, 44%, and 25% of these users aged 65 to 74, 75 to 84, and 85 and older, respectively, were sustained users at follow‐up. Being female, using two or more nonbenzodiazepine prescription medications, and smoking were independently associated with subsequent sustained benzodiazepine use.

CONCLUSION: At the population level, women, smokers, and users of at least two prescription drugs have higher probabilities of sustaining benzodiazepine use once started. This information can facilitate risk assessment and counseling of older adults before prescribing benzodiazepines.
Minority Talent Loss and the Texas Top 10 Percent Law*
Authors: Niu Sunny Xinchun , Sullivan Teresa , Tienda Marta
Published: October 2008

Objective.This article examines how knowledge about the Texas top 10 percent law influences college enrollment decisions of high achieving minority and nonminority students.

Methods.Using a representative survey of graduates from Texas public high schools in 2002, we compare self‐reported and transcript‐verified class rank and estimate probit models to assess the likelihood that top‐ranked minority students know about the law.

Results.Family socioeconomic status largely explains why highly ranked black and Hispanic students know less about the top 10 percent law than comparable whites, but parents' lack of fluency in English is a significant information barrier for college‐bound, top 10 percent Hispanic students from predominantly minority high schools. Nearly one‐fifth of college‐oriented black and Hispanic top 10 percent seniors who did not know about the law failed to enroll anywhere.

Conclusion.Inadequate information about the top 10 percent law undermines enrollment of talented minorities in higher education.
Class Composition: Socioeconomic Characteristics of Coursemates and College Enrollment*
Authors: Choi Kate H. , Kelly Raley R. , Muller Chandra , Riegle‐Crumb Catherine
Published: October 2008

Objective. We investigate how a student's social climate in school, specifically the percentage of coursemates whose parents are college educated, influences the likelihood of enrolling in a four‐year college.

Methods. Using Add Health and AHAA data, we employ hierarchical logistic regression models to analyze how the socioeconomic characteristics of coursemates influence four‐year college enrollment.

Results. We find evidence that taking courses with children of college‐educated parents increases the likelihood of four‐year college enrollment even after controlling for family background, achievement, and placement.

Conclusion. We argue that the family background characteristics of coursemates may influence college enrollment because coursemates provide access to educational resources, such as information about college, and encourage students to apply to college by serving as a reference group. The favorable educational attainment of students with college‐educated parents is partially due to the greater likelihood that they will take courses with other children of college‐educated parents.
Sex and the Statehouse: The Effects of Gender on Legislative Roll‐Call Voting*
Authors: Hogan Robert E.
Published: October 2008

Objective. This analysis examines whether differences exist between women and men state legislators in their roll‐call voting behavior involving matters of economic and regulatory policy.

Methods. Using interest group rating scores, I examine the voting behavior of representatives in the lower houses of 28 states in legislative sessions from 1995 to 2000. By controlling for a host of variables related to legislators (political party, years of service, etc.) and their districts (average income, level of education, urbanization, etc.), I am able to isolate the independent effect of gender on roll‐call voting.

Results. The findings demonstrate that among Democratic legislators women are less conservative than men, but among Republican lawmakers women are slightly more conservative than men. Additional analyses show that many factors that influence legislative voting by women and men are similar; however, political party has a more prominent effect among women.

Conclusion. Although factors such as political party and some constituency characteristics exert a much stronger influence than gender, women and men legislators differ in their roll‐call voting even when controls for a wide assortment of individual‐ and district‐level conditions are taken into account.
Opening of microglial KATP channels inhibits rotenone‐induced neuroinflammation
Authors: Zhou Fang , Yao Hong‐Hong , Wu Jia‐Yong , Ding Jian‐Hua , Sun Tao , Hu Gang
Published: October 2008

As activated microglia (MG) is an early sign that often precedes and triggers neuronal death, inhibition of microglial activation and reduction of subsequent neurotoxicity may offer therapeutic benefit. The present study demonstrates that rat primary cultured MG expressed Kir6.1 and SUR2 subunits of KATP channel, which was identical to that expressed in BV‐2 microglial cell line. The classic KATP channel opener pinacidil and selective mitochondrial KATP (mito‐KATP) channel opener diazoxide prevented rotenone‐induc microglial activation and production of pro‐inflammatory factors (tumour necrosis factor[TNF]‐α and prostaglandin E2[PGE2]). And the effects of pinacidil and diazoxide were reversed by mito‐KATP blocker 5‐hydroxydecanoate (5‐HD), indicating that mito‐KATP channels participate in the regulation of microglial activation. Moreover, the underlying mechanisms involved the stabilization of mitocho drial membrane potential and inhibition of p38/c‐Jun‐N‐terminal kinase (JNK) activation in microglia. Furthermore, the in vivo study confirmed that diazoxide exhibited neuroprotective effects against rotenone along with the inhibition of microglial activation and neuroinflammation. Thus, microglial mito‐KATP channel might be a novel prospective target for the treatment of neuroinflammation‐related degenerative disorders such as Parkinson's disease.
Insights into post‐translational processing of β‐galactosidase in an animal model resembling late infantile human GM1‐gangliosidosis
Authors: Kreutzer R. , Kreutzer M. , Pröpsting M. J. , Sewell A. C. , Leeb T. , Naim H. Y. , Baumgärtner W.
Published: October 2008

GM1‐gangliosidosis is a lysosomal storage disorder caused by a deficiency of ß‐galactosidase activity. Human GM1‐gangliosidosis has been classified into three forms according to the age of clinical onset and specific biochemical parameters. In the present study, a canine model for type II late infantile human GM1‐gangliosidosis was investigated ‘in vitro’ in detail. For a better understanding of the molecular pathogenesis underlying GM1‐gangliosidosis the study focused on the analysis of the molecular events and subsequent intracellular protein trafficking of β‐galactosidase. In the canine model the genetic defect results in exclusion or inclusion of exon 15 in the mRNA transcripts and to translation of two mutant precursor proteins. Intracellular localization, processing and enzymatic activity of these mutant proteins were investigated. The obtained results suggested that the β‐galactosidase C‐terminus encoded by exons 15 and 16 is necessary for correct C‐terminal proteolytic processing and enzyme activity but does not affect the correct routing to the lysosomes. Both mutant protein precursors are enzymatically inactive, but are transported to the lysosomes clearly indicating that the amino acid sequences encoded by exons 15 and 16 are necessary for correct folding and association with protective protein/cathepsin A, whereas the routing to the lysosomes is not influenced. Thus, the investigated canine model is an appropriate animal model for the human late infantile form and represents a versatile system to test gene therapeutic approaches for human and canine GM1‐gangliosidosis.
Retroperitoneal lymphangioleiomyomatosis associated with endosalpingiosis
Authors: FUKUNAGA MASAHARU , MISTUDA AKI , SHIBUYA KAZUHIRO , HONDA YOSHIKO , SHIMADA NAGATO , KOIKE JUNICHI , SUGIMOTO MOTONOBU
Published: October 2008

A case of retroperitoneal lymphangioleiomyomatosis (LAM) arising from endosalpingiosis is described. A 25‐year‐old woman with no history of tuberous sclerosis or hormonal therapy presented with a painless, palpable abdominal mass. Computed tomographic and magnetic resonance imaging studies of the abdomen demonstrated a 4 cm cystic mass in the retroperitoneum. Macroscopically, the excised retroperitoneal cyst was multilocular and measured 4.0×3.5×3.5 cm. Histologically, the lesion demonstrated three components. The first comprised multiple cysts or glands lined by columnar epithelial cells with cilia. The second component was a condensation of small stromal cells immediately subjacent to the cystic epithelium or glands. The third component was a thick exterior wall composed of plump spindle cells with clear to palely eosinophilic cytoplasm in a fascicular pattern, and slit‐like vascular spaces, resembling LAM. Immunohistochemically, the epithelium and glands were positive for cytokeratin 7. The stromal cells were positive for vimentin and CD10. The cells of the LMA‐like component showed positive staining for HMB45, alpha‐smooth muscle actin, muscle actin and h‐caldesmon. The lesion, LAM arising from endosalpingiosis, represents a distinctive pathologic entity that should be recognized and studied further. This type of lesion should be included in the differential diagnosis of retroperitoneal cystic lesions.
Primary cutaneous CD5+ marginal zone B‐cell lymphoma resembling the plasma cell variant of Castleman's disease
Authors: TSUKAMOTO NORIFUMI , KOJIMA MASARU , UCHIYAMA TOSHIMASA , TAKEUCHI TOKIO , KARASAWA MASAMITSU , MURAKAMI HIROKAZU , SATO SADAO
Published: October 2008

Marginal zone B‐cell lymphoma (MZBL) is occasionally associated with prominent plasma cell differentiation. However, MZBL rarely exhibits histological features that resemble plasmacytoma arising from a localized plasma cell variant of Castleman's disease (PCCD). We here report a histologically similar case that was associated with primary cutaneous tumor. The patient was a 57‐year‐old woman with a 5‐year history of cutaneous nodules. Histologically, a prominent proliferation of plasma cells occupied the interfollicular area of the central portion of the cutaneous tumor, whereas various numbers of CD5+ centrocyte‐like (CCL) cells, which were arranged in a marginal zone distribution pattern, occupied the peripheral region of the tumor. The majority of the lymphoid follicles had atrophic or regressive germinal centers resembling hyaline‐vascular Castleman's disease. CCL cells were observed to have colonized a few of the lymphoid follicles. Immunohistochemistry revealed that these cells had a monotypic intracytoplasmic kappa chain. Without treatment, the patient was quiescent, but 2 years later, there was a transformation to the large cell type. These observations suggest that MZBL needs to be distinguished from PCCD, and that untreated cutaneous MZBL may undergo a high‐grade blastic transformation similar to other indolent lymphoproliferative disorders.
Expression of beclin‐1, an autophagy‐related protein, in gastric and colorectal cancers
Authors: AHN CHANG HYEOK , JEONG EUN GOO , LEE JONG WOO , KIM MIN SUNG , KIM SUNG HEE , KIM SUNG SOO , YOO NAM JIN , LEE SUG HYUNG
Published: October 2008

Autophagy plays important roles in both cell death and cell survival. Beclin‐1, a key regulator of autophagy formation, has been considered as a haploinsufficient tumor suppressor. Loss of expression or point mutation could serve as a mechanism of loss of beclin‐1 tumor suppressor function in cancers. However, our recent study revealed that point mutation of the beclin‐1 gene is a rare event in common human cancers. In this study we investigated beclin‐1 protein expression in 103 colorectal and 60 gastric carcinoma tissues by immunohistochemistry using a tissue microarray approach. In the cancers, expression of beclin‐1 was detected in 95% of the colorectal carcinomas and 83% of the gastric carcinomas. In contrast, normal mucosal cells of both stomach and colon showed no or very weak expression of beclin‐1. There was no significant association of beclin‐1 expression with clinocopathologic characteristics, including invasion, metastasis and stage. The beclin‐1 expression of colorectal and gastric cancers in the present study is quite in contrast to that of the breast cancers in the previous study, which showed a decreased beclin‐1 expression in breast cancer cells compared to normal breast cells. Our data indicate that beclin‐1 inactivation by loss of expression may not occur in colorectal and gastric cancers. Rather, increased expression of beclin‐1 in the malignant colorectal and gastric epithelial cells compared to their normal mucosal epithelial cells suggests that neo‐expression of beclin‐1 may play a role in both colorectal and gastric tumorigenesis.
Ehlers‐Danlos syndrome – vascular type (ecchymotic variant): cutaneous and dermatopathologic features
Authors: Sharma Nand L. , Mahajan Vikram K. , Gupta Neelam , Ranjan Nitin , Lath Anju
Published: October 2008

Ehlers‐Danlos syndrome – vascular type, the only lethal form, is rarely reported in dermatology literature. It is characterized by translucent, atrophic skin, easy bruising, arterial, intestinal and/or uterine fragility manifesting as varicose veins, aneurysms and vascular/visceral/uterine rupture. As its dermatopathologic features are not well elucidated, diagnosis is often made after a catastrophic complication or at autopsy. This 36 year‐old non‐consanguineous male had brown‐black plaques with atrophy and frequent ulceration over legs and dorsal feet and tortuous varicose veins around ankles for the past 15 years. Perivenous skin was translucent and hypopigmented. He had multiple and ecchymotic keloids and small atrophic, pityriasis versicolor‐like lesions over trunk. He did not have hypermobile/hyperextensible skin and joints and showed no systemic or investigative abnormality. Histopathologic features of atrophic lesion included blood extravasation in atrophic epidermis/dermis, focal clustering and dilatation of blood vessels, malformed vessel walls, abundant hemosiderin in the dermis and homogenously stained/whorled patterned collagen especially around blood vessels. Pathology of keloidal lesion showed new collagen and vascular fragility. These histopathologic features appear of diagnostic value especially in patients who have compatible clinical findings but cannot afford confirmation by biochemical testing for abnormal synthesis of type III procollagen or identification of mutations in the COL3A1 gene.
Expression of seven gastric cancer‐associated genes and its relevance for Wnt, NF‐κB and Stat3 signaling
Authors: HAN JING‐CHUN , ZHANG KAI‐LI , CHEN XIAO‐YAN , JIANG HAI‐FENG , KONG QING‐YOU , SUN YUAN , WU MO‐LI , HUANG LEI , LI HONG , LIU JIA
Published: October 2008

The aim of the current study was to profile c‐Myc, standard CD44 (CD44s), CD44v6, cyclin D1, survivin, MMP‐7 and VEGF expression patterns in different gastric samples and to elucidate their relevance for Wnt, NF‐κB and/or Stat3 activation using multiple experimental approaches. The results revealed that 87.1% (27/31) of gastric cancers and 8.7% (2/23) of noncancerous lesions (chronic gastritis and intestinal metaplasia) showed Wnt activation (Wnt+) that was closely related to the expression of the seven genes. Some Wnt− noncancerous lesions also expressed the above‐mentioned genes, higher frequencies of survivin (7/8), VEGF (7/8), cyclin D1 (6/8) and c‐Myc (5/8) but not CD44s (2/8), CD44v6 (3/8) and MMP‐7 (2/8) being detected in the NF‐κB+ samples. Stat3 was activated in 37/54 gastric tissues, and in 3/4 VEGF, 4/6 c‐Myc, 4/8 survivin, 2/4 MMP‐7, 1/2 CD44v6, and 4/9 cyclin D1+ but Wnt−/NF‐κB− samples. These findings showed a close correlation in GCs between Wnt, NF‐κB and Stat3 signaling and expression of the seven genes, the importance of NF‐κB and Stat3 activation in regulating c‐Myc, survivin, cyclin D1 and VEGF in noncancerous lesions, and the potential coordinative effects of these three signalings on GC formation presumably by promoting the transcription of their common target genes.
Ethical and Human Rights Perspectives on Providers' Obligation to Ensure Adolescents' Rights to Privacy
Authors: Ringheim Karin
Published: October 2008

The rights of adolescents to privacy and confidentiality as stipulated in international human rights conventions are poorly protected in reproductive health‐care settings. Fear that their private information will become known, particularly to a parent, has been shown to be a major factor in adolescents’failure to seek the services they need. The tension between parental interests in guiding the development of children and public interest in maintaining a healthy population is considered in light of the ethical principles that bear upon these decisions. In practice, health‐care workers are the intermediaries who must ensure that the privacy rights of adolescent clients are protected. They are bound through obligations engendered in human rights conventions as well as by ethical principles, especially that of nonmaleficence, to provide the young with information and confidential services, skills that must be acquired through training. Enhancing the survival of adolescents promotes the greater social good.
Harm Reduction or Women's Rights? Debating Access to Emergency Contraceptive Pills in Canada and the United States
Authors: Wynn L.L. , Erdman Joanna N. , Foster Angel M. , Trussell James
Published: October 2008

This article compares the ethical pivot points in debates over nonprescription access to emergency contraceptive pills in Canada and the United States. These include women's right to be informed about the contraceptive method and its mechanism of action, pharmacists’conscientious objection concerning the dispensing of emergency contraceptive pills, and rights and equality of access to the method, especially for poor women and minorities. In both countries, arguments in support of expanding access to the pills were shaped by two competing orientations toward health and sexuality. The first, “harm reduction,” promotes emergency contraception as attenuating the public health risks entailed in sex. The second orientation regards access to pills as a question of women's right to engage in nonprocreative sex and to choose from among all reproductive health‐care options. The authors contend that arguments for expanding access to emergency contraceptive pills that frame issues in terms of health and science are insufficient bases for drug regulation; ultimately, women's health is also a matter of women's rights.
Reproductive Health in Iran: Pragmatic Achievements, Unmet Needs, and Ethical Challenges in a Theocratic System
Authors: Mehryar Amir H. , Ahmad‐Nia Shirin , Kazemipour Shahla
Published: October 2008

Since its revival in 1989, the reproductive health and family planning program of Iran has made great strides in raising the contraceptive prevalence rate and reducing fertility. The majority of couples are using modern methods promoted and provided by the national program, although a sizable proportion of couples continue to depend on the traditional method of withdrawal. The longstanding urban–rural gap in contraceptive prevalence rates has been reduced to about 10 percent, which is mainly the result of better‐educated urban couples' continued practice of withdrawal. Despite its enormous success in meeting the needs of married couples, in narrowing the urban–rural gap in access to and use of modern contraceptives, and in reducing fertility, the Iranian family planning program is open to criticism for confining its target audience to married couples and failing to address the issue of abortion. The restrictive aspects of the program are often justified on the grounds of religious values and fear of encouraging sexual promiscuity. Because of the theocratic nature of the political system and the immense power enjoyed by Shiite ulama (religious leaders), no step can be taken to address these restrictions without their implicit support and approval. This study describes some of the ethical issues facing the reproductive health program of Iran and indicates how pragmatic approaches adopted by the ruling Shiite ulama to solve some of the social and medical challenges of a rapidly modernizing society may be extended to overcome ethical hurdles faced by the reproductive health program.
A decade of Cdc14 – a personal perspective Delivered on 9 July 2007 at the 32nd FEBS Congress in Vienna, Austria
Authors: Amon Angelika
Published: October 2008

In budding yeast, the protein phosphatase Cdc14 is a key regulator of late mitotic events. Research over the last decade has revealed many of its functions and today we know that this protein phosphatase orchestrates several aspects of chromosome segregation and is the key trigger of exit from mitosis. Elucidation of the mechanisms controlling Cdc14 activity through nucleolar sequestration now serves as a paradigm for how regulation of the subcellular localization of proteins regulates protein function. Here I review these findings focusing on how discoveries in my laboratory helped elucidate the function and regulation of Cdc14.
Expression of squamous cell carcinoma antigen‐1 in liver enhances the uptake of hepatitis B virus envelope‐derived bio‐nanocapsules in transgenic rats
Authors: Kasuya Takeshi , Nomura Shintaro , Matsuzaki Takashi , Jung Joohee , Yamada Tadanori , Tatematsu Kenji , Okajima Toshihide , Tanizawa Katsuyuki , Kuroda Shun’ichi
Published: October 2008

We previously developed the bio‐nanocapsule, which consists of hepatitis B virus envelope L proteins. The bio‐nanocapsule can be used to deliver genes and drugs specifically to the human liver‐derived tissues in xenograft models, presumably by utilizing the human liver‐specific mechanism of hepatitis B virus infection. The hepatitis B virus tropism is highly restricted to humans and higher primates. Thus, to evaluate the in vivo therapeutic effects of forthcoming bio‐nanocapsule‐based medicines, it will be crucial to develop an animal model whose liver is susceptible to both bio‐nanocapsule and hepatitis B virus. In the present study, we aimed to establish a bio‐nanocapsule‐susceptible animal model using transgenic rats expressing squamous cell carcinoma antigen‐1 (SCCA1), which has been proposed to be a receptor for hepatitis B virus, interacting with the hepatitis B virus envelope protein and enhancing the cellular uptake of hepatitis B virus. We show that the recombinant SCCA1 protein interacts directly with bio‐nanocapsule and inhibits its attachment to the cultured human liver‐derived cells. Furthermore, we have established a transgenic rat that specifically expresses SCCA1 in the liver and also demonstrate that the amount of bio‐nanocapsule accumulated in the liver is significantly increased by the SCCA1 expression. Histological analysis suggests that bio‐nanocapsule is preferentially incorporated into the SCCA1‐expressing hepatocytes but not into macrophages, such as Küppfer cells, nor into endothelial cells. Therefore, this animal model is expected to be useful for the development of bio‐nanocapsule‐based medicines.
Paediatric short stay unit in a community hospital: Effective, efficient and popular
Authors: Hopper Sandy M , Archer Peter , Breene Richard , Bolt Penny , Sammartino Luke
Published: October 2008

Objectives:  Short stay medicine is a cost‐effective and efficient way to manage patients with suitable conditions. Paediatric acute illness and injury are amenable to short stay medicine. Before January 2004, when Maroondah Hospital recommenced inpatient care for children, 700 children were transferred annually to other hospitals. We describe the implementation and performance of the first paediatric short stay unit (SSU) in Victoria, which was designed to remedy this situation.

Methods:  Set in a 291‐bed metropolitan hospital, we audited paediatric emergency attendances, admissions, transfers and discharges. We present quality and consumer satisfaction data.

Results:  The environment was designed for the physical, developmental and social needs of children. We implemented education, a system of exclusion criteria and pathways to enhance safety. Over 12 months, of 9097 paediatric attendances, 1101 required inpatient care. Among them, 862 patients were admitted to the SSU and 239 were transferred. Accordingly, 78% of admitted patients were cared for in‐house. Median length of stay was 20 h. Of the 708 reviewed cases, there were 19 (3%) unexpected transfers from the SSU, 59 (8%) long stays (>48 h) and no deaths. Via a telephone survey, there were 30/355 (8%) unplanned representations and satisfaction data were overwhelmingly positive. We suggest that this model is suitable for centres with limited paediatric cover. In‐house senior emergency physician cover might be preferable to an after‐hours junior staff‐only model.

Conclusion:  A co‐located paediatric SSU within an ED is an efficient, popular and viable alternative for paediatric services to be delivered in a suburban setting.
Review article: Lack of effect of opiates in the treatment of acute cardiogenic pulmonary oedema
Authors: Sosnowski Marcin A
Published: October 2008

Opiates have traditionally been used as one of the main treatments of acute heart failure and are still recognized as such. Most current textbooks and official guidelines advise the use of morphine as one of the first‐line treatments for patients in acute cardiogenic pulmonary oedema and a majority of physicians accept it to be the case. The author performed an extensive literature search in order to validate the evidence for the use of opiates in this condition. A total of seven papers, six in English and one in Polish, were found that directly investigated or reported the clinically important outcomes of treatment of acute pulmonary oedema. Only five of these dealt specifically with the effects of administration of opiates in acute cardiogenic pulmonary oedema. None of the above publications suggested a clinically significant improvement in outcomes of patients treated with morphine, although early research did suggest reduced anxiety, blood pressure and pulse rate as well as a reduction in arterial oxygen contents. The more recent studies suggest a strong association between increased mortality and morbidity (e.g. intensive care unit admissions or intubation rates), although causality is difficult to establish because of research methodologies. The current evidence does not support the routine use of opiates in the treatment of acute pulmonary oedema.
Review article: Amphetamines and related drugs of abuse
Authors: Greene Shaun L , Kerr Fergus , Braitberg George
Published: October 2008

Acute amphetamine toxicity is a relatively common clinical scenario facing the Australasian emergency medicine physician. Rates of use in Australasia are amongst the highest in the world. Clinical effects are a consequence of peripheral and central adrenergic stimulation producing a sympathomimetic toxidrome and a spectrum of central nervous system effects. Assessment aims to detect the myriad of possible complications related to acute amphetamine exposure and to institute interventions to limit associated morbidity and mortality. Meticulous supportive care aided by judicial use of benzodiazepines forms the cornerstone of management. Beta blockers are contraindicated in managing cardiovascular complications. Agitation and hyperthermia must be treated aggressively. Discharge of non‐admitted patients from the emergency department should only occur once physiological parameters and mental state have returned to normal. All patients should receive education regarding the dangers of amphetamine use.
Difficult diagnosis in the emergency department: Hyperemesis in early trimester pregnancy because of incarcerated maternal diaphragmatic hernia
Authors: Ting Joseph Yuk Sang
Published: October 2008

Hyperemesis gravidarum is a frequent presentation to the ED, which usually resolves with fluid rehydration and antiemetics. Early incarcerated maternal diaphragmatic hernia might be misdiagnosed as relatively benign hyperemesis gravidarum in the first two trimesters of pregnancy. Diagnosis is missed because of non‐specific presentation with abdominal pain, nausea and vomiting. Hernias rarely become symptomatic even in latter stages of pregnancy, as the uterus increases in size with each trimester and with raised intra‐abdominal pressure from uterine contraction during labour. Symptoms progress with incarceration and strangulation of abdominal contents within the thoracic cavity, compression of the lung and disruption of caval venous return. A woman at 19‐week gestation presented with delayed diagnosis of strangulated diaphragmatic hernia, representing the earliest gestation in the published literature when this has occurred. She had repeatedly been misdiagnosed with hyperemesis gravidarum. It is worthwhile considering incarcerated maternal diaphragmatic hernia as an unusual cause of refractory vomiting in pregnancy, when associated with clinically significant upper abdominal pain and progressive respiratory embarrassment. This might occur as early as the mid‐second trimester, and without uterine contraction.
Cardiac arrhythmia during propofol sedation
Authors: Douglas Robert J , Cadogan Mike
Published: October 2008

Recent articles have described the increasing frequency of use of propofol as a sedating agent in the ED, and praise the safety profile of propofol when used in this manner. We describe a patient who developed torsade de pointes followed by ventricular fibrillation while undergoing propofol sedation for closed reduction of a mid‐shaft fracture of the tibia and fibula. Possible reasons for the event are discussed, and suggestions are made for areas of further research.
Micronuclei Induced by Imipramine and Desipramine in Mice: A Subchronic Study
Authors: Madrigal‐Bujaidar Eduardo , Madrigal‐Santillán Eduardo Osiris , Alvarez‐Gonzalez Isela , Baez Rocio , Marquez Pilar
Published: October 2008

Abstract:  Depression is a common disease that may cause severe damage to human health. Imipramine (IMI) and desipramine (DES) are medicaments used for treatment, yet studies on their genotoxic potential have given controversial results. Therefore, we designed the present assay to determine their effect as inducers of micronucleated polychromatic erythrocytes (MNPE) and micronucleated normochromatic erythrocytes (MNNE) in mice. The study was carried out in animals administered daily with the compounds for 4 weeks, and the determination of micronuclei was done each week. We also evaluated the bone marrow cytotoxicity induced by the chemicals. Besides, the same determinations were carried out in the following 4 consecutive weeks, but in this period the animals were not treated with the tested compounds. Our results showed a significant increase in both MNPE and MNNE induced by both compounds from the first week of administration. At the fourth week, IMI increased three times the control level, while the effect of DES was about seven times such level. In the second, 4‐week phase, we observed a reduction in the rate of micronuclei approaching the control level. We also detected a bone marrow‐mitotic division decrease by the evaluated chemicals. Our results point to the need for cautiousness in the clinical use of the compounds as well as for testing the effect in patients under treatment.
Supermassive black holes in galactic bulges
Authors: Lou Yu-Qing , Jiang Yan-Fei
Published: October 2008

Growing evidence indicate supermassive black holes (SMBHs) in a mass range of MBH∼ 106–1010 M⊙ lurking in central stellar bulges of galaxies. Extensive observations reveal fairly tight power laws of MBH versus the mean stellar velocity dispersion σ of the host stellar bulge. Together with evidence for correlations between MBH and other properties of host bulges, the dynamic evolution of a bulge and the formation of a central SMBH should be linked. In this Letter, we reproduce the empirical MBH–σ power laws based on our recent theoretical analyses (Lou & Wang; Wang & Lou; Lou, Jiang & Jin) for a self-similar general polytropic quasi-static dynamic evolution of bulges with self-gravity and spherical symmetry, and present a sensible criterion of forming a central SMBH. The key result is , where 2/3 < n < 1 and is a proportional coefficient characteristic of different classes of host bulges. By fitting and comparing several empirical MBH–σ power laws, we conclude that SMBHs and galactic bulges grow and evolve in a coeval manner and most likely there exist several classes of galactic bulge systems in quasi-static self-similar evolution and that to mix them together can lead to an unrealistic fitting. Based on our bulge-SMBH model, we provide explanations for intrinsic scatter in the relation and a unified scenario for the formation and evolution of SMBHs in different classes of host bulges.
Trends in Sexual Risk Behavior and Unprotected Sex Among High School Students, 1991‐2005: The Role of Substance Use
Authors: Anderson John E. , Mueller Trisha E.
Published: October 2008

Objectives:  To determine the trends in sexual activity and unprotected sex among substance‐using youth, we examined data from the 1991‐2005 Youth Risk Behavior Surveys on drug and alcohol use and sexual risk behaviors.

Method:  We examined the association of alcohol and illicit drug use with recent sexual activity and unprotected sex. We assessed linear trends in behaviors and assessed logistic regression models to examine the relationship of alcohol and illicit drug use on trends in the behavioral outcomes.

Results:  Strong associations exist between recent sexual activity and alcohol and illicit drug use from 1991 to 2005. In the multivariate model, the odds ratio of having sex in the past 3 months for lifetime illicit drug users compared with nonusers was 3.84 (CI = 3.48‐4.23). Among past‐month alcohol users compared to nonusers, the odds ratio was 3.23 (CI = 2.93‐3.58). Overall, the trend in sexual activity was downward but not for users of alcohol and illicit drugs. Among the sexually active, unprotected sex was not associated with alcohol use over this time period but was associated with illicit drug use.

Conclusions:  Illicit drug and alcohol use have a strong association with being recently sexually active. Trends in reported sexual activity declined during 1991‐2005, but the trends among alcohol and drug users have not. Many youth remain at dual risk from both substance use and sexual behaviors.
The Metabolic Syndrome and Cardiovascular Disease: Part 2
Authors: Jiamsripong Panupong , Mookadam Martina , Alharthi Mohsen S. , Khandheria Bijoy K. , Mookadam Farouk
Published: October 2008

In part 1 of this overview, the authors reviewed the epidemiology, definitions, pathophysiology, and interaction of inflammatory markers that are elaborated from the very active paracrine adipocyte. In part 2, they focus on the management of the metabolic syndrome. Management of this syndrome includes identification of individuals in the early stages of the syndrome and emphasizes the risk of developing diabetes mellitus and the progression to cardiovascular disease. This can be accomplished by simple physical examination and an assessment of routine laboratory findings, which should include measurement of fasting glucose, a lipid profile, and body morphometrics. A 10‐year risk assessment is needed in patients who have a diagnosis of the metabolic syndrome. The most important therapeutic intervention in the metabolic syndrome is lifestyle change, with a focus on weight reduction and regular leisure time physical activity.
Now or Never: Optimal Antihypertensive Therapy in the Elderly
Authors: Prisant L. Michael
Published: October 2008

Hypertension control rates in the elderly, particularly for systolic hypertension, are poor and lower than control rates in other age groups. Older patients often require treatment with specific antihypertensive drugs because of concomitant conditions and usually need ≥2 drugs to control blood pressure. Combining drugs with complementary mechanisms of action may improve both blood pressure control and the tolerability of individual drugs. A number of fixed‐dose combinations have shown efficacy in older patients and in stage 2 hypertension, including various combinations involving diuretics and angiotensin‐converting enzyme inhibitors or angiotensin II receptor blockers.
Outlook for benefits of sediment microbial fuel cells with two bio‐electrodes
Authors: De Schamphelaire Liesje , Rabaey Korneel , Boeckx Pascal , Boon Nico , Verstraete Willy
Published: October 2008

The benefits of sediment microbial fuel cells (SMFCs) go beyond energy generation for low‐power applications. Aside from producing electrical energy, SMFCs can enhance the oxidation of reduced compounds at the anode, thus bringing about the removal of excessive or unwanted reducing equivalents from submerged soils. Moreover, an SMFC could be applied to control redox‐dependent processes in sediment layers. Several cathodic reactions that may drive these sediment oxidation reactions are examined. Special attention is given to two biologically mediated cathodic reactions, respectively employing an oxygen reduction and a manganese cycle. Both reactions imply a low cost and a high electrode potential and are of interest for reactor‐type MFCs as well as for SMFCs.
Positively regulated bacterial expression systems
Authors: Brautaset Trygve , Lale Rahmi , Valla Svein
Published: October 2008

Regulated promoters are useful tools for many aspects related to recombinant gene expression in bacteria, including for high‐level expression of heterologous proteins and for expression at physiological levels in metabolic engineering applications. In general, it is common to express the genes of interest from an inducible promoter controlled either by a positive regulator or by a repressor protein. In this review, we discuss established and potentially useful positively regulated bacterial promoter systems, with a particular emphasis on those that are controlled by the AraC‐XylS family of transcriptional activators. The systems function in a wide range of microorganisms, including enterobacteria, soil bacteria, lactic bacteria and streptomycetes. The available systems that have been applied to express heterologous genes are regulated either by sugars (l‐arabinose, l‐rhamnose, xylose and sucrose), substituted benzenes, cyclohexanone‐related compounds, ε‐caprolactam, propionate, thiostrepton, alkanes or peptides. It is of applied interest that some of the inducers require the presence of transport systems, some are more prone than others to become metabolized by the host and some have been applied mainly in one or a limited number of species. Based on bioinformatics analyses, the AraC‐XylS family of regulators contains a large number of different members (currently over 300), but only a small fraction of these, the XylS/Pm, AraC/PBAD, RhaR‐RhaS/rhaBAD, NitR/PnitA and ChnR/Pb regulator/promoter systems, have so far been explored for biotechnological applications.
Decreasing Enterobacter sakazakii (Cronobacter spp.) food contamination level with bacteriophages: prospects and problems
Authors: Zuber Sophie , Boissin‐Delaporte Catherine , Michot Lise , Iversen Carol , Diep Benjamin , Brüssow Harald , Breeuwer Pieter
Published: October 2008

Enterobacter sakazakii (Cronobacter spp.) is an opportunistic pathogen, which can cause rare, but life‐threatening infections in neonates and infants through feeding of a contaminated milk formula. We isolated 67 phages from environmental samples and tested their lytic host range on a representative collection of 40 E. sakazakii strains. A cocktail of five phages prevented the outgrowth of 35 out of 40 test strains in artificially contaminated infant formula. Two E. sakazakii phages represented prolate head Myoviridae. Molecular tests identified them as close relatives of Escherichia coli phage T4. The remaining three phages represented isometric head Myoviridae with large genome size of 140 and 200 kb, respectively, which belonged to two different DNA hybridization groups. A high dose of 108 pfu ml−1 of phage could effectively sterilize a broth contaminated with both high and low pathogen counts (106 and 102 cfu ml−1). In contrast, broth inoculated with 104 phage and 102 bacteria per ml first showed normal bacterial growth until reaching a cell titre of 105 cfu ml−1. Only when crossing this threshold, phage replication started, but it could not reduce the contamination level below 100 cfu ml−1. Phages could be produced with titres of 1010 pfu ml−1 in broth culture, but they were not stable upon freeze‐drying. Addition of trehalose or milk formula stabilized the phage preparation, which then showed excellent storage stability even at elevated temperature.
Effects of lyophilization on human amniotic membrane
Authors: Rodríguez‐Ares M. Teresa , López‐Valladares María J. , Touriño Rosario , Vieites Begoña , Gude Francisco , Silva María T. , Couceiro José
Published: October 2008

Purpose:  This study aimed to evaluate the effects of lyophilization and cryopreservation on human amniotic membrane (HAM) in terms of histological characteristics and growth factor levels.

Methods:  Non‐preserved, lyophilized and cryopreserved HAM samples from 13 placentas were investigated. The morphological characteristics of HAM were evaluated using light and electron microscopy. Immunohistochemical methods were also applied to assess the distribution of collagen IV in the basement membrane. Total protein amounts were measured in extracts of intact amniotic membrane from non‐preserved, lyophilized and cryopreserved samples. An enzyme‐linked immunosorbent assay (ELISA) was used to assay growth factor protein levels for epidermal growth factor, fibroblast growth factor basic, hepatocyte growth factor, keratinocyte growth factor, transforming growth factor‐β1 and nerve growth factor.

Results:  Histological examination of lyophilized and cryopreserved human amniotic membrane showed similar results. Immunohistochemistry showed presence of collagen IV throughout the basement membrane, both in cryopreserved and lyophilized samples. Total protein amount was higher in cryopreserved samples, without statistical significance. Growth factors ELISA did not show statistically significant differences except for fibroblast growth factor basic, with higher levels in cryopreserved amniotic membrane.

Conclusions:  Lyophilization maintains the histological structure of HAM, but seems to cause greater reductions in total protein amount and growth factor concentration than cryopreservation.
Simulation of Liquid Jet Breakup Using a Combination of Particle and Grid Methods
Authors: Ishii Eiji , Ishikawa Toru , Tanabe Yoshiyuki
Published: October 2008

Fine atomization of the liquid jet from a fuel injector in an automobile engine lowers engine emissions and improves fuel efficiency. The breakup length of liquid films and the lengths of ligaments near the injector outlet after the breakup of liquid films are important parameters for predicting the atomization. These parameters have been predicted mainly using the Eulerian-grid method. (We refer to this as the ‘grid method’.) However, the grid method causes a loss of the liquid film with numerical diffusion, and it requires a large amount of computation time in practical engineering aspect because fine meshes smaller than the ligaments must be used. On the other hand, the particle method, an alternative (particle-based) method for representing the continuum Navier-Stokes equation which can simulate a ligament using a group of particles, does not cause numerical diffusion. However, a large number of particles are needed to simulate the entire computational domain within the injectors. In this study, we have focused on the flow field only near the injector outlet, and have tried to simulate the breakup of liquid films by using groups of particles in the particle method. In the simulation, the particle method was applied only to the liquid film and the grid method was used in other regions to shorten the computation time. Furthermore, we tried to integrate Brackbill’s surface-tension model, which is widely used in the grid method, into the particle method. To evaluate this approach, we compared the breakup lengths obtained for a cylindrical liquid jet in a uniform air stream with measurements done by Arai and Hashimoto; the breakup lengths agreed well with their measurements. We then simulated the breakup of a liquid film near the outlet of a fuel injector used for automobile engine, and found that our hybrid method could simulate the breakup of the liquid film into ligaments.
Turbulence Simulation and Experimental Study on New 3D Wicket Gate of Francis Turbine
Authors: Zhang Liang , Liu Shuhong , Wu Yulin , Yang Jianming
Published: October 2008

In this investigation, two new 3D wicket gates are designed for improving Francis turbine’s stability under high water head and low discharge condition. Numerical simulation and experiment are applied for studying influence of wicket gate type. The model Francis-turbine with 3D wicket gate is computed on three dimensional turbulence method. Base on standard k-ε turbulence model and SIMPLEC algorithm, the whole water-passage from inlet of case to outlet of draft is computed together, then distribution of velocity and pressure can be obtained. Based on experiment and computation result, comparison of performance and vorticity character between different wicket gates is made.