bluuebunny/crossref_metadata_2025 huggingface dataset:
‘Mexico City North’: Identity and anti-immigrant sentiment
Authors: Cleaveland Carol
Published: May 2012

This article presents data from a two-year case study using multiple qualitative methods to probe how residents of a suburban area interpreted the question of settlement by undocumented Latino immigrants in their neighborhoods. Though many residents framed their understanding of neighborhood problems via racialized portrayals alluding to ‘inferior’ countries of origin and culture, data here indicate that their hope was to restore both the worth of their properties and what they perceived to be an injured sense of place identity. Findings from this study suggest that non-governmental organizations could assist with mediating conflict and supporting immigrant incorporation into communities by serving as liaisons between newcomers and wary homeowners.
The experiences of Japanese elementary-school children living with ‘developmental disabilities’: Navigating peer relationships
Authors: Kayama Misa , Haight Wendy
Published: May 2012

This article focuses on children’s experiences of the evolving Japanese special education system. Relatively little disability research has focused on non-Western children, which restricts our understanding of the extent to which and how cultures vary in their responses to disability, and the impact of those differences on the developing child. ‘Developmental disabilities’ is a term used by Japanese educators to refer to various neurologically-based conditions which cause ‘milder’ difficulties with school functioning, for example, learning disabilities, Attention Deficit Hyperactivity Disorders (ADHD), and Asperger’s Syndrome. Public schools in Japan recently implemented formal special education services for children with developmental disabilities. Our previous ethnographic research at Greenleaf Elementary School described how educators and parents balanced new requirements to provide formal individualized services with traditional Japanese practices of educating and socializing children within peer groups, in part, through practices that encourage supportive peer relationships. Using a longitudinal, multiple case study design, we describe how three children with developmental disabilities experienced these socialization practices, focusing on their active, individual efforts to connect with peers. Prior to their involvement in special education, all three children struggled with peer relationships. Over time, they used opportunities provided by educators to connect with peers and find their Ibasho, a place where they felt comfortable and accepted, within their peer groups. Children developed relationships with peers through self-regulating contact with them, and through their specialized interests and play. Understanding the experiences and creative responses of children from diverse cultural and subcultural groups provides a unique perspective from which to view our own disability policies and practices.
Civic Passion
Authors: Miegel Fredrik , Olsson Tobias
Published: May 2012

Within media studies the default perspective of “the political” and “the civic” is overly rational. This rational bias can be observed within various research traditions. Two obvious examples are traditional, mainstream research of political communication, and substantial parts of the large body of research drawing on Jürgen Habermas’s theory of the public sphere. Starting from a short review of the rational view of the political/the civic presented within these traditions, Peter Dahlgren’s notion of civic culture is analyzed as a perspective that offers a complementary view. This article elaborates on its intellectual origins by paying special heed to the connection between the civic-culture view of the political and the civic and the perspectives offered by pragmatist philosopher John Dewey. Departing from these insights, the article presents empirical illustration of everyday workings of civic culture, and concludes with reflections concerning what becomes of the media within a civic culture approach.
If They Show Prison Break in the United States on a Wednesday, by Thursday It Is Here
Authors: Pertierra Anna Cristina
Published: May 2012

This article describes practices of informal digital media circulation emerging in urban Cuba between 2005 and 2010, drawing from interviews and ethnographic research in the city of Santiago de Cuba. The Cuban new media landscape is supported by informal networks that blend financial and social exchanges to circulate goods, media, and currency in ways that are often illegal but are largely tolerated. Presenting two case studies of young, educated Cubans who rely on the circulation of film and television content via external hard drives for most of their media consumption, I suggest that the emphasis of much existing literature on the role of state censorship and control in Cuban new media policy overlook the everyday practices through which Cubans are regularly engaged with Latin and U.S. American popular culture. Further, informal economies have been central to everyday life in Cuba both during the height of the Soviet socialist era and in the period since the collapse of the Soviet Union that has seen a juxtaposition of some market reforms alongside centrally planned policies. In the context of nearly two decades of economic crisis, consumer shortages and a dual economy, Cuban people use both informal and state-sanctioned networks to acquire goods ranging from groceries to furnishings and domestic appliances. Understanding the informal media economy of Cuba within this broader context helps to explain how the consumption of commercial American media is largely uncontroversial within Cuban everyday life despite the fraught politics that often dominates discussions of Cuban media policy.
Analysis of environmental impact on mechanical properties of aramid filaments
Authors: Lin Lantian , Shen Yiping , Zhang Qiuping
Published: May 2012

Aramid and aramid copolymer fibres are used in a wide variety of military and civilian applications; however, the effects of environmental exposure on mechanical properties are still not well understood. This paper analyzes the changes of Aramid 1414’s mechanical properties after its exposure to high temperatures, chemical solvents and sunlight, and then compares them with the properties of poly ( p-phenylene benzobisoxazole) as-spun and polysulfonamide fibres. The experimental results suggest that the overall environmental resistant performance of aramid filaments is better than poly ( p-phenylene benzobisoxazole) as-spun and polysulfonamide materials, some conclusions are put forward for the applications of aramid filaments.
A Model for Reduced HIV-1 Viral Load Monitoring in Resource-Limited Settings
Authors: Bryant LeeAnn , Smith Nathaniel , Keiser Philip
Published: May 2012

Background:

Viral load monitoring of antiretroviral therapy in low-income countries is rarely used because of high costs. Reducing the frequency of monitoring may make it financially feasible.

Methods:

We modeled three testing schemes: reduced viral load monitoring (RVLM) with CD4 count at baseline and viral load testing at 6, 36, and 60 months; United States Department of Health and Human Services (US DHHS) Treatment Guidelines; and World Health Organization (WHO) Guidelines using a cohort of 313 HIV-infected patients using Kaplan-Meier analysis.

Results:

Median time to detection of antiretroviral therapy (ART) failure using RVLM was 147 days; using US DHHS, it was 115 days; and using WHO guidelines, it was 1110 days. Median time for the development of first thymidine analog mutation was 594 days. The cost of RVLM was significantly lower than US DHHS.

Conclusions:

RVLM detected failure significantly sooner than CD4 count monitoring alone at a lower cost than US DHHS monitoring. RVLM is a potentially effective method of monitoring ART in resource-limited settings.
A Giant Pancreatic Pseudocyst in a Patient with HIV Infection
Authors: De Socio Giuseppe Vittorio , Vispi Margherita , Fischer Matthias Joachim , Baldelli Franco
Published: May 2012

This article describes the first case of a giant pancreatic pseudocyst in a 48-year-old man with HIV infection under combination antiretroviral therapy. The patient presented with an abdominal mass involving the epigastrium, left hypochondrium, and left flank. An enhanced abdominal computed tomography (CT) scan showed a well-defined cyst of 21 cm in diameter, with a liquid content that dislocated adjacent viscera. Microbiological and cytological tests on fluid were negative, confirming diagnosis of pancreatic pseudocyst. The CT-guided percutaneous drainage was carried out and the patient’s clinical condition gradually improved.
Is More Information Better? How Dismounted Soldiers Use Video Feed From Unmanned Vehicles
Authors: Ophir-Arbelle Ronny , Oron-Gilad Tal , Borowsky Avinoam , Parmet Yisrael
Published: May 2012

Operational tactics in urban areas are often aided by information from unmanned aerial vehicles (UAVs). A major challenge for dismounted soldiers, particularly in urban environments, is to understand the conflict area in general and particularly from the UAV feed. The UAV feed is usually used to enhance soldiers’ situation awareness abilities but less for identifying specific elements. A possible way to further enhance soldiers’ abilities is to provide them with multiple sources of information (e.g., aerial and ground views). This study examined the benefits of presenting video feed from UAVs and unmanned ground vehicles (UGVs) in a combined interface, relative to presenting aerial feed alone. Thirty former infantry soldiers with no experience in operating unmanned vehicles participated. Objective performance, subjective evaluations, and eye-tracking patterns were examined in two scenarios. In Scenario 1, performance scores in both identification and orientation tasks were superior in the combined configuration. In Scenario 2, performance scores in the identification tasks were improved, and the addition of the UGV feed did not harm performance in the orientation task. Eye movement scanning patterns reinforced that both UAV and UGV feeds were used for the mission. The combined configuration generated consistent benefits with regard to the identification tasks, perceived mental demand, and reduction of false reports without having any apparent cost on participants. Ground views may provide additional support to dismounted soldiers.
‘Objective Culture’ and the Development of Nonknowledge: Georg Simmel and the Reverse Side of Knowing
Authors: Gross Matthias
Published: May 2012

Recent debates about the knowledge society have furthered awareness of the limits of knowing and, in turn, have fuelled sociological debates about the persistence and intensification of ignorance. In view of the ubiquity of the notion of ignorance, this paper focuses on Georg Simmel’s insightful observations about Nichtwissen (nonknowledge) as the reverse side of knowledge. The paper seeks to relate the notion of nonknowledge to Simmel’s conceptualization of objective and subjective culture. In Simmel’s view, modern society produces cultural objects in order to satisfy individuals’ inherent drive to become social beings. Ever more nonknowledge can be understood as an outcome of the growing difficulties in absorbing the achievement of objective culture into subjective culture. To illustrate the crucial importance of such a view of the unknown for today’s debates on the knowledge society, the paper uses illustrative examples ranging from the strategic acknowledgement of nonknowledge in personal relationships to public encounters and the right not to know one’s own genetic identity.
Extracellular matrix protein tenascin-C is required in the bone marrow microenvironment primed for hematopoietic regeneration
Authors: Nakamura-Ishizu Ayako , Okuno Yuji , Omatsu Yoshiki , Okabe Keisuke , Morimoto Junko , Uede Toshimitsu , Nagasawa Takashi , Suda Toshio , Kubota Yoshiaki
Published: May 2012

The BM microenvironment is required for the maintenance, proliferation, and mobilization of hematopoietic stem and progenitor cells (HSPCs), both during steady-state conditions and hematopoietic recovery after myeloablation. The ECM meshwork has long been recognized as a major anatomical component of the BM microenvironment; however, the molecular signatures and functions of the ECM to support HSPCs are poorly understood. Of the many ECM proteins, the expression of tenascin-C (TN-C) was found to be dramatically up-regulated during hematopoietic recovery after myeloablation. The TN-C gene was predominantly expressed in stromal cells and endothelial cells, known as BM niche cells, supporting the function of HSPCs. Mice lacking TN-C (TN-C−/−) mice showed normal steady-state hematopoiesis; however, they failed to reconstitute hematopoiesis after BM ablation and showed high lethality. The capacity to support transplanted wild-type hematopoietic cells to regenerate hematopoiesis was reduced in TN-C−/− recipient mice. In vitro culture on a TN-C substratum promoted the proliferation of HSPCs in an integrin α9–dependent manner and up-regulated the expression of the cyclins (cyclinD1 and cyclinE1) and down-regulated the expression of the cyclin-dependent kinase inhibitors (p57Kip2, p21Cip1, p16Ink4a). These results identify TN-C as a critical component of the BM microenvironment that is required for hematopoietic regeneration.
EVI1 is critical for the pathogenesis of a subset of MLL-AF9–rearranged AMLs
Authors: Bindels Eric M. J. , Havermans Marije , Lugthart Sanne , Erpelinck Claudia , Wocjtowicz Elizabeth , Krivtsov Andrei V. , Rombouts Elwin , Armstrong Scott A. , Taskesen Erdogan , Haanstra Jurgen R. , Beverloo H. Berna , Döhner Hartmut , Hudson Wendy A. , Kersey John H. , Delwel Ruud , Kumar Ashish R.
Published: May 2012

The proto-oncogene EVI1 (ecotropic viral integration site-1), located on chromosome band 3q26, is aberrantly expressed in human acute myeloid leukemia (AML) with 3q26 rearrangements. In the current study, we showed, in a large AML cohort carrying 11q23 translocations, that ∼ 43% of all mixed lineage leukemia (MLL)–rearranged leukemias are EVI1pos. High EVI1 expression occurs in AMLs expressing the MLL-AF6, -AF9, -AF10, -ENL, or -ELL fusion genes. In addition, we present evidence that EVI1pos MLL-rearranged AMLs differ molecularly, morphologically, and immunophenotypically from EVI1neg MLL-rearranged leukemias. In mouse bone marrow cells transduced with MLL-AF9, we show that MLL-AF9 fusion protein maintains Evi1 expression on transformation of Evi1pos HSCs. MLL-AF9 does not activate Evi1 expression in MLL-AF9–transformed granulocyte macrophage progenitors (GMPs) that were initially Evi1neg. Moreover, shRNA-mediated knockdown of Evi1 in an Evi1pos MLL-AF9 mouse model inhibits leukemia growth both in vitro and in vivo, suggesting that Evi1 provides a growth-promoting signal. Using the Evi1pos MLL-AF9 mouse leukemia model, we demonstrate increased sensitivity to chemotherapeutic agents on reduction of Evi1 expression. We conclude that EVI1 is a critical player in tumor growth in a subset of MLL-rearranged AMLs.
Loss of heterozygosity in 7q myeloid disorders: clinical associations and genomic pathogenesis
Authors: Jerez Andres , Sugimoto Yuka , Makishima Hideki , Verma Amit , Jankowska Anna M. , Przychodzen Bartlomiej , Visconte Valeria , Tiu Ramon V. , O'Keefe Christine L. , Mohamedali Azim M. , Kulasekararaj Austin G. , Pellagatti Andrea , McGraw Kathy , Muramatsu Hideki , Moliterno Alison R. , Sekeres Mikkael A. , McDevitt Michael A. , Kojima Seiji , List Alan , Boultwood Jacqueline , Mufti Ghulam J. , Maciejewski Jaroslaw P.
Published: May 2012

Loss of heterozygosity affecting chromosome 7q is common in acute myeloid leukemia and myelodysplastic syndromes, pointing toward the essential role of this region in disease phenotype and clonal evolution. The higher resolution offered by recently developed genomic platforms may be used to establish more precise clinical correlations and identify specific target genes. We analyzed a series of patients with myeloid disorders using recent genomic technologies (1458 by single-nucleotide polymorphism arrays [SNP-A], 226 by next-generation sequencing, and 183 by expression microarrays). Using SNP-A, we identified chromosome 7q loss of heterozygosity segments in 161 of 1458 patients (11%); 26% of chronic myelomonocytic leukemia patients harbored 7q uniparental disomy, of which 41% had a homozygous EZH2 mutation. In addition, we describe an SNP-A–isolated deletion 7 hypocellular myelodysplastic syndrome subset, with a high rate of progression. Using direct and parallel sequencing, we found no recurrent mutations in typically large deletion 7q and monosomy 7 patients. In contrast, we detected a markedly decreased expression of genes included in our SNP-A defined minimally deleted regions. Although a 2-hit model is present in most patients with 7q uniparental disomy and a myeloproliferative phenotype, haplodeficient expression of defined regions of 7q may underlie pathogenesis in patients with deletions and predominant dysplastic features.
Use of serial analysis of gene expression to reveal the specific regulation of gene expression profile in asthmatic rats treated by acupuncture
Authors: Yin Lei-Miao , Jiang Gong-Hao , Wang Yu , Wang Yan , Liu Yan-Yan , Jin Wei-Rong , Xu Yu-Dong , Zhang Qing-Hua , Yang Yong-Qing
Published: May 2012

Background

Asthma has become an important public health issue and approximately 300 million people have suffered from the disease worldwide. Nowadays, the use of acupuncture in asthma is increasing. This study intended to systematically analyze and compare the gene expression profiles between the asthmatic and acupuncture-treated asthmatic rat lung, and tried to gain insight into the molecular mechanism underlying the early airway response (EAR) phase of asthma treated by acupuncture.

Methods

Four tag libraries of serial analysis of gene expression (SAGE) were established from lung tissues of control rats (CK), asthmatic rats (AS), asthmatic rats treated by acupuncture (ASAC), and control rats treated by acupuncture (CKAC). Bioinformatic analyses were carried out by using the methods including unsupervised hierarchical clustering, functional annotation tool of the database for annotation, visualization, and integrated discovery (DAVID), gene ontology (GO) tree machine, and Kyoto encyclopedia of genes and genomes (KEGG) pathway analysis.

Results

There were totally 186 differentially expressed tags (P < 0.05, PCK/AS) between the libraries of CK and AS, 130 differentially expressed tags between libraries of AS/ASAC (P < 0.05, PAS/ASAC), and 144 differentially expressed tags between libraries of CK/CKAC (P < 0.05, PCK/CKAC). The gene expression profiles of AS and ASAC were more similar than other libraries via unsupervised SAGE clustering. By comparison of PCK/ASand PAS/ASAC, the DAVID genes functional classification was found to be changed from "immune response" to "response to steroid hormone stimulus", and the GO term "antigen processing and presentation of peptide antigen" disappeared in PAS/ASAC. Totally 3 same KEGG pathways were found among the three groups. Moreover, 21 specific tags of the acupuncture in treating asthma were detected using Venn diagrams.

Conclusion

Our SAGE research indicates that the gene expression profile of the EAR phase of asthma could be effectively and specifically regulated by acupuncture, which suggests that the gene expression of immune response and steroid hormone may play an important role in the treatment.
Distribution of nitrogen fixation and nitrogenase-like sequences amongst microbial genomes
Authors: Dos Santos Patricia C , Fang Zhong , Mason Steven W , Setubal João C , Dixon Ray
Published: May 2012

Background

The metabolic capacity for nitrogen fixation is known to be present in several prokaryotic species scattered across taxonomic groups. Experimental detection of nitrogen fixation in microbes requires species-specific conditions, making it difficult to obtain a comprehensive census of this trait. The recent and rapid increase in the availability of microbial genome sequences affords novel opportunities to re-examine the occurrence and distribution of nitrogen fixation genes. The current practice for computational prediction of nitrogen fixation is to use the presence of the nifH and/or nifD genes.

Results

Based on a careful comparison of the repertoire of nitrogen fixation genes in known diazotroph species we propose a new criterion for computational prediction of nitrogen fixation: the presence of a minimum set of six genes coding for structural and biosynthetic components, namely NifHDK and NifENB. Using this criterion, we conducted a comprehensive search in fully sequenced genomes and identified 149 diazotrophic species, including 82 known diazotrophs and 67 species not known to fix nitrogen. The taxonomic distribution of nitrogen fixation in Archaea was limited to the Euryarchaeota phylum; within the Bacteria domain we predict that nitrogen fixation occurs in 13 different phyla. Of these, seven phyla had not hitherto been known to contain species capable of nitrogen fixation. Our analyses also identified protein sequences that are similar to nitrogenase in organisms that do not meet the minimum-gene-set criteria. The existence of nitrogenase-like proteins lacking conserved co-factor ligands in both diazotrophs and non-diazotrophs suggests their potential for performing other, as yet unidentified, metabolic functions.

Conclusions

Our predictions expand the known phylogenetic diversity of nitrogen fixation, and suggest that this trait may be much more common in nature than it is currently thought. The diverse phylogenetic distribution of nitrogenase-like proteins indicates potential new roles for anciently duplicated and divergent members of this group of enzymes.
Coverage evaluation of universal bacterial primers using the metagenomic datasets
Authors: Mao Dan-Ping , Zhou Quan , Chen Chong-Yu , Quan Zhe-Xue
Published: May 2012

Background

The coverage of universal primers for the bacterial 16S rRNA gene plays a crucial role in the correct understanding of microbial community structure. However, existing studies on primer coverage are limited by the lack of appropriate databases and are restricted to the domain level. Additionally, most studies do not account for the positional effect of single primer-template mismatches. In this study, we used 7 metagenomic datasets as well as the Ribosomal Database Project (RDP) to assess the coverage of 8 widely used bacterial primers.

Results

The coverage rates for bacterial primers were found to be overestimated by previous studies that only investigated the RDP because of PCR amplification bias in the sequence composition of the dataset. In the RDP, the non-coverage rates for all primers except 27F were ≪6%, while in the metagenomic datasets, most were ≫10%. If one considers that a single mismatch near the 3′ end of the primer might greatly reduce PCR efficiency, then some phylum non-coverage rates would change by more than 20%. Primer binding-site sequence variants that could not pair with their corresponding primers are discussed.

Conclusions

Our study revealed the potential bias introduced by the use of universal bacterial primers in the assessment of microbial communities. With the development of high-throughput, next-generation sequencing techniques, it will become feasible to sequence more of the hypervariable regions of the bacterial 16S rRNA gene. This, in turn, will lead to the more frequent use of the primers discussed here.
Comparison of different comorbidity measures for use with administrative data in predicting short- and long-term mortality
Authors: Chu Yu-Tseng , Ng Yee-Yung , Wu Shiao-Chi
Published: May 2012

Background

It is important to find a comorbidity measure with better performance for use with administrative data. The new method proposed by Elixhauser et al. has never been validated and compared to the widely used Charlson method in the Asia region. The objective of this study was to compare the performance of three comorbidity measures using information from different data periods in predicting short- and long-term mortality among patients with acute myocardial infarction (AMI) and chronic obstructive pulmonary disease (COPD).

Methods

We conducted a retrospective cohort study using National Health Insurance claims data (2001-2002) in Taiwan. We constructed the Elixhauser, the Charlson/Deyo, and the Charlson/Romano methods based on the International Classification of Disease, 9th Revision, Clinical Modification codes in the claims data. Two data periods, including the index hospitalization as well as the index and prior 1-year hospitalizations, were used in the analysis. The performances were compared using the c-statistics derived from multiple logistic regression models that included age, gender, race, and whether the patient received surgery or not. The outcomes of interest were in-hospital and 1-year mortality.

Results

The performance was in the same rank order among both populations regardless of the outcome and data period: Elixhauser > Charlson/Romano > Charlson/Deyo. In predicting in-hospital mortality, the Elixhauser models using information from the index hospitalization performed best, even better than the Charlson/Deyo or Charlson/Romano models using information from the index and prior hospitalizations. Nevertheless, in predicting 1-year mortality, the Elixhauser models using information from the index and 1-year prior hospitalizations performed better than using information from the index hospitalization only.

Conclusions

This is so far the first study to validate the Elixhauser method and compare it to other methods in the Asia region, and is the first to report its differences in data periods between short- and long-term outcomes. The comorbidity measurement developed by Elixhauser et al. has relatively good predictive validity, and researchers should consider its use in claims-based studies.
Is integration of healthy lifestyle promotion into primary care feasible? Discussion and consensus sessions between clinicians and researchers
Authors: Grandes Gonzalo , Sanchez Alvaro , Cortada Josep M , Balague Laura , Calderon Carlos , Arrazola Arantza , Vergara Itziar , Millan Eduardo ,   the "Prescribe Vida Saludable" group
Published: May 2012

Background

The adoption of a healthy lifestyle, including physical activity, a healthy diet, moderate alcohol consumption and abstinence from smoking, is associated with a major decrease in the incidence of chronic diseases and mortality. Primary health-care (PHC) services therefore attempt, with rather limited success, to promote such lifestyles in their patients. The objective of the present study is to ascertain the perceptions of clinicians and researchers within the Basque Health System of the factors that hinder or facilitate the integration of healthy lifestyle promotion in routine PHC setting.

Methods

Formative research based on five consensus meetings held by an expert panel of 12 PHC professionals with clinical and research experience in health promotion, supplied with selected bibliographic material. These meetings were recorded, summarized and the provisional findings were returned to participants in order to improve their validity.

Results

The Health Belief Model, the Theory of Planned Action, the Social Learning Theory, "stages of change" models and integrative models were considered the most useful by the expert panel. Effective intervention strategies, such as the "5 A's" strategy (assess, advise, agree, assist and arrange) are also available. However, none of these can be directly implemented or continuously maintained under current PHC conditions. These strategies should therefore be redesigned by adjusting the intervention objectives and contents to the operation of primary care centres and, in turn, altering the organisation of the centres where they are to be implemented.

Conclusion

It is recommended to address optimisation of health promotion in PHC from a research perspective in which PHC professionals, researchers and managers of these services cooperate in designing and evaluating innovative programs. Future strategies should adopt a socio-ecological approach in which the health system plays an essential role but which nevertheless complements other individual, cultural and social factors that condition health. These initiatives require an adequate theoretical and methodological framework for designing and evaluating complex interventions.
Characteristics of patients returning to emergency departments in Naples, Italy
Authors: Di Giuseppe Gabriella , Abbate Rossella , Albano Luciana , Marinelli Paolo , Angelillo Italo F ,   The Collaborative Research Group
Published: May 2012

Background

Crowding in hospital Emergency Departments (EDs) is a problem in several countries. We evaluated the number and characteristics of patients who make repeated visits to the EDs in Naples, Italy.

Methods

All patients (≥ 16 years) who presented to the EDs of three randomly selected non-academic acute care public hospitals, within randomly selected week periods, were studied. The two outcomes of interest were the re-utilization, within 72 hours, of the ED and the number of visits in the previous year.

Results

Of the 1430 sampled patients, 51.9% self-reported multiple visits in the previous year and 10.9% and 1.6% used the ED for 3 and ≥4 times, respectively. The number of visits in the previous year was significantly higher in those who live closer to hospital, with a more severe burden of overall comorbidity, and who were on pharmacological treatment. Overall, 72-hours return visits were found in 215 patients (15.8%). Patients were more likely to re-use within 72 hours the ED if younger, were not on pharmacological treatment, attended the ED more times in the previous year, were referred by a physician, arrived at the ED by car driven by other person, had problems of longer duration prior to arrival at the ED, had a surgical ED discharge diagnosis, and were admitted to the hospital.

Conclusion

The data may assist policymakers in the development and implementation of protocols to track changes in the re-utilization of the ED for the high financial impact and for the benefit of the patients.
Using bacterial inclusion bodies to screen for amyloid aggregation inhibitors
Authors: Villar-Piqué Anna , Espargaró Alba , Sabaté Raimon , de Groot Natalia S , Ventura Salvador
Published: May 2012

Background

The amyloid-β peptide (Aβ42) is the main component of the inter-neuronal amyloid plaques characteristic of Alzheimer's disease (AD). The mechanism by which Aβ42 and other amyloid peptides assemble into insoluble neurotoxic deposits is still not completely understood and multiple factors have been reported to trigger their formation. In particular, the presence of endogenous metal ions has been linked to the pathogenesis of AD and other neurodegenerative disorders.

Results

Here we describe a rapid and high-throughput screening method to identify molecules able to modulate amyloid aggregation. The approach exploits the inclusion bodies (IBs) formed by Aβ42 when expressed in bacteria. We have shown previously that these aggregates retain amyloid structural and functional properties. In the present work, we demonstrate that their in vitro refolding is selectively sensitive to the presence of aggregation-promoting metal ions, allowing the detection of inhibitors of metal-promoted amyloid aggregation with potential therapeutic interest.

Conclusions

Because IBs can be produced at high levels and easily purified, the method overcomes one of the main limitations in screens to detect amyloid modulators: the use of expensive and usually highly insoluble synthetic peptides.
Multiple treatment comparisons in a series of anti-malarial trials with an ordinal primary outcome and repeated treatment evaluations
Authors: Youdom Solange Whegang , Samson Adeline , Basco Leonardo K , Thalabard Jean-Christophe
Published: May 2012

Background

Artemisinin-based combination therapies (ACT) are widely used in African countries, including Cameroon. Between 2005 and 2007, five randomized studies comparing different treatment arms among artesunate-amodiaquine and other ACT were conducted in Cameroonian children aged two to 60 months who had uncomplicatedPlasmodium falciparummalaria. In these studies, the categorical criterion proposed by the World Health Organization (WHO) to assess the relative effectiveness of anti-malarial drugs was repeatedly evaluated on Days 14, 21 and 28 after treatment initiation. The aim of the present study was to compare the effects of different treatments on this repeated ordinal outcome, hence using the fully available information.

Methods

The quantitative synthesis was based on individual patient data. Due to the incomplete block design concerning treatment arms between different trials, a mixed treatment comparison (MTC) meta-analysis approach was adopted. The repeated ordinal outcome was modelled through a latent variable, as a proportional odds mixed model with trial, period and treatment arms as covariates. The model was further complexified to account for the variance heterogeneity, and the individual log-residual variance was modelled as a linear mixed model, as well. The effects of individual covariates at inclusion, such as parasitaemia, fever, gender and weight, were also tested. Model parameters were estimated using a Bayesian approachviathe WinBUGS software. After selecting the best model using Deviance Information Criterion (DIC), mixed treatment comparisons were based on the estimated treatment effects.

Results

Modeling the residual variance improved the model ability to adjust the data. The results showed that, compared to artesunate-amodiaquine (ASAQ), dihydroartemisinin-piperaquine (DHPP) was significantly more efficacious. Artesunate-chlorproguanil-dapsone (ASCD) was less efficacious than artesunate-sulphadoxine-pyrimethamine (ASSP), artemether-lumefantrine (AMLM) and DHPP, the difference with the latter being significant. No difference in efficacy was found between ASAQ and AMLM.

Conclusions

Bayesian mixed treatment comparisons of a network of connected randomized trials with repeated measurements of the primary categorical outcome allowed to take into account both the individual- and between- studies sources of heterogeneity. The results of the present study complete the previous quantitative review based on a binary outcome at a fixed time point, suggesting that DHPP represents an alternative for the treatment of uncomplicatedP. falciparummalaria in Cameroonian children.
House design modifications reduce indoor resting malaria vector densities in rice irrigation scheme area in western Kenya
Authors: Atieli Harrysone , Menya Diana , Githeko Andrew , Scott Thomas
Published: May 2012

Background

Simple modifications of typical rural house design can be an effective and relatively inexpensive method of reducing indoor mosquito vector densities and consequently decreasing malaria transmission. Public health scientists have shown the potential for house design to protect people against malaria, yet this type of intervention remains virtually ignored. A randomized-controlled study was, therefore, undertaken to determine the effects of this method of vector control on the density of indoor resting malaria vectors in a rice irrigation scheme area in lowlands of western Kenya.

Methods

Ten treatment houses were modified with ceilings of papyrus mats and insecticide-treated netting (ITN) and tested against ten control houses without papyrus ceilings. To determine densities of mosquitoes resting in homes, the pyrethrum spray method was used to simultaneously collect indoor resting malaria vectors in intervention and control houses. Each house was sampled a total of eight times over a period of four months, resulting in a total of 80 sampling efforts for each treatment. Community response to such intervention was investigated by discussions with residents.

Results

Papyrus mats ceiling modification reduced house entry by Anopheles gambiae s.l and Anopheles funestus densities by between 78–80% and 86% respectively compared to unmodified houses. Geometric mean density of Anopheles gambiae s.l. and Anopheles funestus in modified houses were significantly lower (t18 = 7.174, P < 0.0001 and t18 = 2.52, P = 0.02, respectively) compared to controls. Unmodified houses were associated with relatively higher densities of malaria vectors. There was a 84% (OR 0.16, 95% CI 0.07–0.39, P < 0.0001) and 87% (OR 0.13, 95% CI 0.03–0.5, P = 0.0004) reduction in the odds of Anopheles gambiae s.l. and Anopheles funestus presence in modified houses, respectively, compared with unmodified houses. Residents responded favourably to this mode of vector control.

Conclusion

House modifications involving insect screen ceilings made from locally available materials and small ITN incorporated in house construction have the potential to reduce human exposure to malaria vectors, and thus parasite infection, in a rice irrigation scheme area of western Kenya. Ceiling modification is likely to be acceptable and is expected to be of greatest benefit when used in combination with other malaria control strategies.
Association between illness severity and timing of initial enteral feeding in critically ill patients: a retrospective observational study
Authors: Huang Hsiu-Hua , Hsu Chien-Wei , Kang Shiu-Ping , Liu Ming-Yi , Chang Sue-Joan
Published: May 2012

Background

Early enteral nutrition is recommended in cases of critical illness. It is unclear whether this recommendation is of most benefit to extremely ill patients. We aim to determine the association between illness severity and commencement of enteral feeding.

Methods

One hundred and eight critically ill patients were grouped as “less severe” and “more severe” for this cross-sectional, retrospective observational study. The cut off value was based on Acute Physiology and Chronic Health Evaluation II score 20. Patients who received enteral feeding within 48 h of medical intensive care unit (ICU) admission were considered early feeding cases otherwise they were assessed as late feeding cases. Feeding complications (gastric retention/vomiting/diarrhea/gastrointestinal bleeding), length of ICU stay, length of hospital stay, ventilator-associated pneumonia, hospital mortality, nutritional intake, serum albumin, serum prealbumin, nitrogen balance (NB), and 24-h urinary urea nitrogen data were collected over 21 days.

Results

There were no differences in measured outcomes between early and late feedings for less severely ill patients. Among more severely ill patients, however, the early feeding group showed improved serum albumin (p = 0.036) and prealbumin (p = 0.014) but worsened NB (p = 0.01), more feeding complications (p = 0.005), and prolonged ICU stays (p = 0.005) compared to their late feeding counterparts.

Conclusions

There is a significant association between severity of illness and timing of enteral feeding initiation. In more severe illness, early feeding was associated with improved nutritional outcomes, while late feeding was associated with reduced feeding complications and length of ICU stay. However, the feeding complications of more severely ill early feeders can be handled without significantly affecting nutritional intake and there is no eventual difference in length of hospital stay or mortality between groups. Consequently, early feeding shows to be a more beneficial nutritional intervention option than late feeding in patients with more severe illness.
Inequalities in health: a comparative study between ethnic Norwegians and Pakistanis in Oslo, Norway
Authors: Syed Hammad Raza , Dalgard Odd Steffen , Hussain Akhtar , Dalen Ingvild , Claussen Bjorgulf , Ahlberg Nora L
Published: May 2012

Background

The objective of the study was to observe the inequality in health from the perspective of socio-economic factors in relation to ethnic Pakistanis and ethnic Norwegians in Oslo, Norway.

Method

Data was collected by using an open and structured questionnaire, as a part of the Oslo Health Study 2000–2001. Accordingly 13581 ethnic Norwegians (45% of the eligible) participated as against 339 ethnic Pakistanis (38% of the eligible).

Results

The ethnic Pakistanis reported a higher prevalence of poor self-rated health 54.7% as opposed to 22.1% (p < 0.001) in ethnic Norwegians, 14% vs. 2.6% (p < 0.001) in diabetes, and 22.0% vs. 9.9% (p < 0.001) in psychological distress. The socio-economic conditions were inversely related to self- rated health, diabetes and distress for the ethnic Norwegians. However, this was surprisingly not the case for the ethnic Pakistanis. Odd ratios did not interfere with the occurrence of diabetes, even after adjusting all the markers of socio-economic status in the multivariate model, while self-reported health and distress showed moderate reduction in the risk estimation.

Conclusion

There is a large diversity of self-rated health, prevalence of diabetes and distress among the ethnic Pakistanis and Norwegians. Socio-economic status may partly explain the observed inequalities in health. Uncontrolled variables like genetics, lifestyle factors and psychosocial factors related to migration such as social support, community participation, discrimination, and integration may have contributed to the observed phenomenon. This may underline the importance of a multidisciplinary approach in future studies.
Communicating serum chemical concentrations to study participants: follow up survey
Authors: Buck Alexandra J , Vena John E , McGuinness Bridget M , Cooney Maureen A , Louis Germaine M
Published: May 2012

Background

A considerable literature now supports the importance of effective communication with study participants, including how best to develop communication plans focusing on the uncertainty of health risks associated with particular environmental exposures. Strategies for communicating individual concentrations of environmental chemicals in human biological samples in the absence of clearly established safe or hazardous levels have been discussed from a conceptual basis and to a lesser extent from an empirical basis. We designed and evaluated an empirically based communication strategy for women of reproductive age who previously participated in a prospective study focusing on persistent environmental chemicals and reproductive outcomes.

Methods

A cohort of women followed from preconception through pregnancy or up to 12 menstrual cycles without pregnancy was given their individual serum concentrations for lead, dichloro-2,2-bisp-chlorophenyl ethylene, and select polychlorinated biphenyl congeners. Two versions of standardized letters were prepared depending upon women's exposure status, which was characterized as low or high. Letters included an introduction, individual concentrations, population reference values and guidance for minimizing future exposures. Participants were actively monitored for any questions or concerns following receipt of letters.

Results

Ninety-eight women were sent letters informing them of their individual concentrations to select study chemicals. None of the 89 (91%) participating women irrespective of exposure status contacted the research team with questions or concerns about communicated exposures despite an invitation to do so.

Conclusions

Our findings suggest that study participants can be informed about their individual serum concentrations without generating unnecessary concern.
Miliary tuberculosis occurred after immunosuppressive drug in PNH patient with completely cured tuberculosis; a case report
Authors: Lee Jihyun , Gong Soojung , Lee Byounghoon , Lee Soyoung , Lee Jungae , Kim Naeyu
Published: May 2012

Paroxysmal nocturnal hemoglobinuria (PNH) is a clonal disorder that presents with hemolytic anemia, marrow failure and thrombophilia. During acute attacks, corticosteroid can alleviate the hemolytic paroxysm, but the prolonged administration induces serious toxicity including immunosuppression. So American thoracic society (ATS) for tuberculosis (TB) recommends prophylactic anti-TB medication in patients with a long-term steroid therapy. However, in the patient who was treated for active TB in the past, there are no guidelines of the test for determining patients who have latent TB infection (LTBI) and no recommendations of TB prophylaxis if there is no evidence of reactivation at present. A 40-year-old male patient presented with fever and aggravated weakness for a week. He was diagnosed with PNH a month ago and took corticosteroid for 3 weeks. In the past, he was diagnosed with pulmonary TB and completely cured after treatment. According to guideline, he was not indicated with TB prophylaxis. However, he caught miliary TB, progressed to acute respiratory distress syndrome. We experience this embarrassing case, and emphasize the need to investigate multicentral TB prevalence and to make the guidelines of anti-TB medication in subgroups of hematologic diseases including PNH.
In Silico analysis of Gastric carcinoma Serial Analysis of Gene Expression libraries reveals different profiles associated with ethnicity
Authors: Ossandon Francisco J , Villarroel Cynthia , Aguayo Francisco , Santibanez Eudocia , Oue Naohide , Yasui Wataru , Corvalan Alejandro H
Published: May 2012

Worldwide gastric carcinoma has marked geographical variations and worse outcome in patients from the West compared to the East. Although these differences has been explained by better diagnostic criteria, improved staging methods and more radical surgery, emerging evidence supports the concept that gene expression differences associated to ethnicity might contribute to this disparate outcome. Here, we collected datasets from 4 normal and 11 gastric carcinoma Serial Gene Expression Analysis (SAGE) libraries from two different ethnicities. All normal SAGE libraries as well as 7 tumor libraries were from the West and 4 tumor libraries were from the East. These datasets we compare by Correspondence Analysis and Support Tree analysis and specific differences in tags expression were identified by Significance Analysis for Microarray. Tags to gene assignments were performed by CGAP-SAGE Genie or TAGmapper. The analysis of global transcriptome shows a clear separation between normal and tumor libraries with 90 tags differentially expressed. A clear separation was also found between the West and the East tumor libraries with 54 tags differentially expressed. Tags to gene assignments identified 15 genes, 5 of them with significant higher expression in the West libraries in comparison to the East libraries. qRT-PCR in cell lines from west and east origin confirmed these differences. Interestingly, two of these genes have been associated to aggressiveness (COL1A1 and KLK10). In conclusion we found that in silico analysis of SAGE libraries from two different ethnicities reveal differences in gene expression profile. These expression differences might contribute to explain the disparate outcome between the West and the East.