bluuebunny/crossref_metadata_2025 huggingface dataset:
Femoral compartment syndrome due to haemangiosarcoma in the semimembranosus muscle in a dog
Authors: Bar‐Am Y. , Anug A. Maria , Shahar R.
Published: April 2006

A five‐year‐old, entire male German shepherd dog was presented to the Veterinary Teaching Hospital—Koret School of Veterinary Medicine because of an acute, painful swelling of the right thigh and severe lameness of two‐weeks duration. On physical examination, a firm and painful mass was detected in the hamstring region. Radiography and ultrasonography revealed a soft tissue mass, with a 250 cc fluid accumulation craniomedial to it. Intracompartmental pressure measurement with a Wick catheter demonstrated significantly elevated pressure within the right caudal femoral compartment (25 to 28 mmHg compared with 5 to 7 mmHg in the unaffected leg). Surgical exploration of the area was undertaken, fasciotomy and mass excision were performed, and resolution of the clinical signs was achieved. The mass was identified by histopathology results as haemangiosarcoma. Two and a half months after surgery, which was followed by adjunct chemotherapy (doxorubicin), the dog was readmitted with a subcutaneous mass in the same area, although he was not lame at this time. Radiographs of the thoracic cavity demonstrated widely disseminated metastases in the lungs. At that point, the owner elected to have the dog euthanased.
Experimental Characterization and Detailed Performance Prediction of a Vacuum Glazing System Fabricated With a Low Temperature Metal Edge Seal, Using a Validated Computer Model
Authors: Griffiths Philip W. , Eames Philip C. , Hyde Trevor J. , Fang Yueping , Norton Brian
Published: April 2006

Current multi-pane windows have a very low heat loss but their solar transmittance is low resulting in a loss of daylight and solar gains. Multi-pane windows also require framing arrangements that are difficult to retrofit to existing apertures in many existing buildings. A contiguously sealed evacuated double-glazing with low long-wave radiative emittance coatings on its internal surfaces, no heavier than conventional double-glazing, with good visual transmittance suitable for retrofitting to existing buildings, has been analyzed experimentally. Measured heat transfer coefficients and visual transmittances of laboratory fabricated evacuated glazing samples, along with theoretical predictions of center of glazing thermal conductance are presented.
Bayesian Parameter Estimation of Convective Heat Transfer Coefficients of a Roof-Mounted Radiant Barrier System
Authors: Lauret Philippe , Miranville Frédéric , Boyer Harry , Garde François , Adelard Laetitia
Published: April 2006

This paper deals with the application of Bayesian methods to the estimation of two convective heat-transfer coefficients of a roof-mounted radiant barrier system. As part of an empirical validation of the thermal model of the roofing complex, a parametric sensitivity analysis highlighted the importance of convective coefficients in the thermal behavior of a roofing complex. A parameter estimation method is then used in order to find the values of the coefficients that lead to an improvement of the thermal model. However, instead of using a classical parameter estimation method, we used a Bayesian inference approach to parameter estimation. The aim of the paper is to introduce the basic concepts of this powerful method in this simple two-parameter case. We show that Bayesian methods introduce an explicit treatment of uncertainty in modeling and a corresponding measure of reliability for the conclusions reached.
General Sun Tracking Formula for Heliostats With Arbitrarily Oriented Axes
Authors: Chen Y. T. , Lim B. H. , Lim C. S.
Published: April 2006

The most general form of solar tracking formulae of an arbitrarily oriented heliostat toward an arbitrarily located target on the Earth is presented. With this complete solution, the used azimuth-elevation, spinning-elevation tracking formula, etc., are the special cases of it. Therefore, more application may be sought out for many individual cases in solar engineering. The new form of tracking solution could bring changes in the geometry and structure of the design of heliostat to meet various requirements.
A HYPERBOLIC PARAMETRIZATION OF LEPTON MIXING FOR SMALL Ue3
Authors: BRAHMACHARI BISWAJOY
Published: April 2006

We use hyperbolic functions to parametrize lepton mixing matrix using only one input parameter ϕ. This matrix has three mixing angles as outputs therefore giving two predictions. In particular, it predicts Ue3 = 0 besides predicting correct solar and atmospheric mixing. We confine ourselves to real ϕ. For complex ϕ mixing matrix is no longer unitary. Next we accentuate this unitary mixing matrix with an additional small parameter δ while keeping unitarity of the matrix exact. When this second parameter is included, with this framework, one can handle small but nonzero Ue3. In the second case from two input parameters one obtains three mixing angles thus one prediction.
GENERALIZATION AND INSTANTIATION FOR COMPONENT REUSE
Authors: SADAOUI SAMIRA , YIN PENGZHOU
Published: April 2006

There is an increasing need for high-quality software components. Reusable components and formal specifications are two complementary and promising approaches to achieve this goal. One method for enhancing the reusability of existing components is generalization that creates generic components by parameterizing specific ones. Generalization and instantiation are two methods related respectively to the development for reuse and development with reuse. Generalization, that is the abstraction of existing components, identifies commonalities across a class of entities, while instantiation customizes the general properties under different circumstances. In this paper, we present several generalization and instantiation algorithms for algebraic specifications. A major difficulty during the generalization process is determining the appropriate level of generality. Highly specific components have little chance of being reused. Meanwhile, if a component is too general, its reuse might also be hard. Therefore, we introduce a novel method based on the categorized constructors to control the level of abstraction in generic components with the goal of producing effective reusable components. Through a medium-scale example, the generalization and instantiation operations are illustrated in detail.
OPTIMAL WAVELET CHOICE IN ELECTROCHEMICAL EXPERIMENTS
Authors: DAROWICKI K. , ZIELIŃSKI A.
Published: April 2006

In the recent years we witness great interest in merging electrochemical experiments with modern digital signal processing techniques. Wavelet analysis seems to be one of the most promising approaches. In the case of wavelets there are various families of analyzing functions which can be selected to suit given experiment demands. In the paper the authors present comparison of results of utilization of different wavelets in electrochemical noise analysis.
N-Acetylglucosaminyltransferase V and β1-6 Branching N-Linked Oligosaccharides Are Associated with Good Prognosis of Patients with Bladder Cancer
Authors: Ishimura Hirofumi , Takahashi Toshiko , Nakagawa Hiroaki , Nishimura Shin-Ichiro , Arai Yoichi , Horikawa Yohei , Habuchi Tomonori , Miyoshi Eiji , Kyan Atsushi , Hagisawa Shigeru , Ohyama Chikara
Published: April 2006

Purpose: N-acetylglucosaminyltransferase V (GnT-V) is an enzyme that catalyzes β1-6 branching of N-acetylglucosamine on asparagine (N)-linked oligosaccharides (N-glycan) of cell proteins. We examined the relationship between GnT-V expression and clinicopathologic features of the patients with bladder cancer.

Experimental Design: We immunohistochemically examined GnT-V expression in paraffin-embedded bladder cancer specimen using anti-GnT-V monoclonal antibody. We compared GnT-V expression with cause-specific survival of the patients with bladder cancer treated by radical cystectomy. Kaplan-Meier survival curves were generated to show the cause-specific survival. Univariate and multivariate analyses were carried out to compare GnT-V expression with other clinical and pathologic variables. We also evaluated mRNA expression of GnT-V and N-linked oligosaccharide structure in bladder cancer specimens.

Results: Immunohistochemistry revealed that GnT-V expression inversely correlated with tumor grade and stage. The incidence of positive GnT-V expression in bladder cancer was significantly higher in low-grade/superficial cancer than in high-grade/invasive cancer. The patients whose tumor was positive for GnT-V survived significantly longer than those whose tumor was negative for GnT-V. Univariate and multivariate analyses revealed that GnT-V expression was an independent predictor of prognosis of the patient. The expression of GnT-V mRNA determined by reverse transcription-PCR was consistent with the results with immunohistochemistry for tumor samples. Carbohydrate structural analysis revealed that superficial bladder cancer is rich in branched N-linked oligosaccharides, for which biosynthesis GnT-V is responsible.

Conclusions: GnT-V and its resultant β1-6 branching N-linked oligosaccharides are closely related to low malignant potential and good prognosis of the patients with bladder cancer.
Bcl-2 Is a Prognostic Marker in Breast Cancer Independently of the Nottingham Prognostic Index
Authors: Callagy Grace M. , Pharoah Paul D. , Pinder Sarah E. , Hsu Forrest D. , Nielsen Torsten O. , Ragaz Joseph , Ellis Ian O. , Huntsman David , Caldas Carlos
Published: April 2006

Purpose: Prognostication of breast cancer using clinicopathologic variables, although useful, remains imperfect. Many reports suggest that gene expression profiling can refine the current approach. Alternatively, it has been shown that panels of proteins assessed by immunohistochemistry might also be useful in this regard. We evaluate the prognostic potential of a panel of markers by immunohistochemistry in a large case series to establish if either a single marker or a panel could improve the prognostic power of the Nottingham Prognostic Index (NPI). We validated the results in an independent series.

Experimental Design and Results: The expression of 13 biomarkers was evaluated in 930 breast cancers on a tissue microarray. Eight markers [estrogen receptor (ER), progesterone receptor (PR), Bcl-2, cyclin E, p53, MIB-1, cytokeratin 5/6, and HER2] showed a significant association with survival at 10 years on univariate analysis. On multivariate analysis that included these eight markers and the NPI, only the NPI [hazard ratio (HR), 1.35; 95% confidence interval (95% CI), 1.16-1.56; P = 0.0005], ER (HR, 0.59; 95% CI, 0.39-0.88; P = 0.011), and Bcl-2 (HR, 0.68; 95% CI, 0.46-0.99; P = 0.055) were significant. In a subsequent multivariate analysis that included the NPI, ER, and Bcl-2, only Bcl-2 (HR, 0.62; 95% CI, 0.44-0.87; P = 0.006) remained independent of NPI (HR, 1.50; 95% CI, 1.16-1.56; P = 0.004). In addition, Bcl-2, used as a single marker, was more powerful than the use of a panel of markers. Based on these results, an independent series was used to validate the prognostic significance of Bcl-2. ER and PR were also evaluated in this validation series. Bcl-2 (HR, 0.83; 95% CI, 0.71-0.96; P = 0.018) retained prognostic significance independent of the NPI (HR, 2.04; 95% CI, 1.67-2.51; P < 0.001) with an effect that was maximal in the first 5 years.

Conclusion: Bcl-2 is an independent predictor of breast cancer outcome and seems to be useful as a prognostic adjunct to the NPI, particularly in the first 5 years after diagnosis.
Association Study With 33 Single-Nucleotide Polymorphisms in 11 Candidate Genes for Hypertension in Chinese
Authors: Gu Dongfeng , Su Shaoyong , Ge Dongliang , Chen Shufeng , Huang Jianfeng , Li Biao , Chen Runsheng , Qiang Boqin
Published: April 2006

Essential hypertension is considered to be a typical complex disease with multifactorial etiology, which leads to inconsistent findings in genetic studies. One possibility of failure to replicate some single-locus results is that the underlying genetics of hypertension are not only based on multiple genes with minor effects but also on gene–gene interactions. To test this hypothesis, a case–control study was constructed in Chinese subjects, detecting both single locus and multilocus effects. Eleven candidate genes were selected from biochemical pathways that have been implicated in the development and progression of hypertension, and 33 polymorphisms were evaluated in 503 hypertension patients and 490 age- and gender-matched controls. Single-locus associations, using traditional logistic regression analyses, and multilocus associations, using classification and regression trees and multivariate adaptive regression splines, were both explored in this study. Final models were selected using either Bonferroni correction or cross-validation. Three polymorphisms,
TH
*rs2070762,
ADRB2
*Q27E, and
GRK4
*A486V, were found to be independently associated with essential hypertension in Chinese subjects. In addition to these individual predictors, a potential interaction of
CYP11B2
-
AGTR1
is also involved in the etiology of hypertension. These findings support the multigenic nature of the etiology of essential hypertension and propose a potential gene–gene interactive model for future studies.
CD73/Ecto-5′-Nucleotidase Protects Against Vascular Inflammation and Neointima Formation
Authors: Zernecke Alma , Bidzhekov Kiril , Özüyaman Burcin , Fraemohs Line , Liehn Elisa A. , Lüscher-Firzlaff Juliane M. , Lüscher Bernhard , Schrader Jürgen , Weber Christian
Published: April 2006

Background—Although CD73/ecto-5′-nucleotidase has been implicated in maintaining vasoprotection, its role in regulating endothelial adhesion molecule or inflammatory monocyte recruitment (eg, in the context of vascular injury) remains to be defined.

Methods and Results—Compared with wild-type mice, CD73-deficient (CD73−/−) mice exhibit increased luminal staining and protein and transcript expression for vascular cell adhesion molecule (VCAM)-1 in carotid arteries. In vitro, aortic endothelial cells (ECs) from CD73−/−mice display an upregulation of mRNA and protein expression of VCAM-1, associated with increased nuclear factor (NF)-κB activity, as determined by chromatin cross-linking and immunoprecipitation or quantitative p65 binding assays. CD73−/−ECs and carotid arteries perfused ex vivo supported increased monocyte arrest under flow conditions, which was mediated by α4β1integrin. After wire injury of carotid arteries, CD73 expression and activity were upregulated in wild-type mice, whereas neointimal plaque formation and macrophage content were increased in CD73−/−mice versus wild-type mice, concomitant with elevated NF-κB activation, luminal VCAM-1 expression, and soluble VCAM-1 concentrations. In contrast, reconstitution of wild-type mice with CD73−/−versus CD73+/+BM did not significantly exacerbate neointima formation. Treatment with the specific A2Areceptor agonist ATL-146e reversed the increased VCAM-1 transcript and protein expression in CD73−/−ECs and inhibited monocyte arrest on CD73−/−ECs. Continuous infusion of ATL-146e prevented neointima formation in CD73−/−mice.

Conclusions—Our data epitomize the importance of vascular CD73 in limiting endothelial activation and monocyte recruitment via generation of adenosine acting through the A2Areceptor, providing a molecular basis for therapeutic protection against vascular inflammation and neointimal hyperplasia.
Father Involvement, Nurturant Fathering, and Young Adult Psychosocial Functioning
Authors: Schwartz Seth J. , Finley Gordon E.
Published: April 2006

The present study was conducted to investigate differences in nurturant fathering, father involvement, and young adult psychosocial functioning among small samples of three nontraditional family forms. A total of 168 young-adult university students from three family forms (27 adoptive, 22 adoptive stepfather, 119 nonadoptive stepfather) completed retrospective measures of nurturant fathering and father involvement and measures of current psychosocial functioning. Results indicated that adoptive fathers were rated as the most nurturant and involved and that nonadoptive stepfathers were rated as the least nurturant and involved. In adoptive families, young adults’ ratings of paternal nurturance and involvement were strongly and positively correlated with their reports of current psychosocial functioning. The relationships of family form to reports of fathering appeared to be moderated by the child's age at father entry and the number of years of involvement in the child's life.
Transitional Phase or a New Balance?
Authors: van Wel Frits , Knijn Trudie
Published: April 2006

In recent years in the Netherlands, mothers’ labor participation has increased sharply. This article examines which factors influence mothers’ employment rates and the division of household and caring responsibilities between parents. From research among 1,285 women with young children, it appears that cultural factors rather than economic motives or institutional obstacles offer the most important explanation for whether they work or not. A culture of care dominates more among women with lower than higher education levels, which clarifies the more limited labor participation of lower educated mothers. A comparison is also drawn between the various earner types of family. It appears that the one-and-a-half earner type of family with the man working full-time and the woman part-time is particularly popular among women with lesser education levels. However, for women with higher educations, the ideal is for both parents to work part-time, but for the time being, they have not yet been able to realize this.
Who Should Care for Our Children?
Authors: Hickman Lisa N.
Published: April 2006

The issue of child care is still widely debated, with some scholars arguing that children fare best in parental care, whereas others suggest center care may enhance children's development. Using the Early Childhood Longitudinal Study—Kindergarten Cohort of 1998 to 1999, the author demonstrates how the use of cross-sectional versus longitudinal analysis results in different conclusions regarding types of care. Cross-sectional analysis indicates that children who had been in center care the year prior to kindergarten exhibited advanced math and reading skills over their parental care counterparts but poorer peer-related social skills net of background controls. However, employing longitudinal analysis that controls for fall test scores of kindergartners and first graders shows that the cognitive effects of center care do not persist and that some social skills actually deteriorate. Longitudinal analyses more successfully isolate the effect of child care than do cross-sectional analyses, and models employing longitudinal methods suggest that children benefit less from the center care experience than previously thought.
Androgenic-Anabolic Steroids Associated with Mechanical Loading Inhibit Matrix Metallopeptidase Activity and Affect the Remodeling of the Achilles Tendon in Rats
Authors: Marqueti Rita C. , Parizotto Nivaldo A. , Chriguer Rosangela S. , Perez Sergio E. A. , Selistre-de-Araujo Heloisa S.
Published: April 2006

Background

The indiscriminate use of anabolic-androgenic steroids has been shown to induce pathologic changes in the Achilles tendon in several situations.

Purpose

To study tendon remodeling in rats treated with anabolic-androgenic steroids combined with an exercise program.

Study Design

Controlled laboratory study.

Methods

Wistar rats were grouped as follows: sedentary (group I), injected with anabolic-androgenic steroids only (group II), trained only (group III), and trained and injected with anabolic-androgenic steroids (group IV). The trained groups performed jumps in water: 4 series of 10 jumps each, with an overload of 50% to 70% of the animal's body weight and a 30-second rest interval between series, for 6 weeks. Anabolic-androgenic steroids (5 mg/kg) were injected subcutaneously. Activity of matrix metallopeptidases, a marker for tendon remodeling, was analyzed in tissue extracts by zymography on gelatin–sodium dodecyl sulfate–polyacrylamide gel electrophoresis.

Results

Morphological analyses of tendons showed that in group II, the most external layer that covers the tendon was thicker with aggregation of the collagen fibers, suggesting an increase in collagen synthesis. In group IV, an inflammatory infiltrate and fibrosis in tendons as well as a pronounced increase of the serum corticosterone level were observed. This training protocol upregulated matrix metallopeptidase activity, whereas anabolic-androgenic steroid treatment strongly inhibited this activity. The appearance of lytic bands with molecular masses of approximately 62 and 58 kDa suggests the activation of matrix metallopeptidase–2.

Conclusion

Anabolic-androgenic steroid treatment can impair tissue remodeling in the tendons of animals undergoing physical exercise by downregulating matrix metallopeptidase activity, thus increasing the potential for tendon injury.

Clinical Relevance

Since the AAS abuse is so widespread, a better comprehension of the pathological effects induced by these drugs may be helpful for the development of new forms of therapy of AAS-induced lesions.
Short-term Effectiveness of Hyperthermia for Supraspinatus Tendinopathy in Athletes
Authors: Giombini Arrigo , Di Cesare Annalisa , Safran Marc R. , Ciatti Riccardo , Maffulli Nicola
Published: April 2006

Background

Hyperthermia has been introduced as a physical therapy modality for soft tissue injuries.

Hypothesis

The authors tested the null hypothesis that there are no short-term differences after the use of hyperthermia, ultra-sound, and exercises for tendinopathy of the supraspinatus tendon.

Study Design

Randomized controlled trial; Level of evidence, 1.

Methods

The authors studied 37 athletes (29 men, 8 women; mean age, 26.7 ± 5.8 years; range, 19-43 years) with supraspinatus tendinopathy who had had symptoms between 3 and 6 months. Subjects were randomly assigned to 3 groups. Group A (n = 14) received hyperthermia at 434 MHz. Group B (n = 12) received continuous ultrasound at 1 MHz at an intensity of 2.0 w/cm23 times a week. Group C (n = 11) undertook exercises, consisting of pendular swinging and stretching exercises 5 minutes twice a day every day. All interventions were undertaken for 4 weeks. Subjects were evaluated at baseline, immediately on completion of treatment, and at 6 weeks after the end of the intervention using mean pain score for pain at night, during movement, and at rest on a visual analog scale; pain on resisted movement and painful arc on active abduction between 40° and 120° on a 4-point scale; and Constant score.

Results

Patients who received hyperthermia experienced significantly better pain relief than did patients receiving ultrasound or exercises: group A, 5.96 to 1.2 (P = .03); group B, 6.3 to 5.15 (P = .10); group C, 6.1 to 4.9 (P = .09).

Conclusion

Hyperthermia at 434 MHz appears safe and effective in the short term for the management of supraspinatus tendinopathy.
Family Members' Perceptions of the Quality of Long-Term Care
Authors: Voutilainen Päivi , Backman Kaisa , Isola Arja , Laukkala Helena
Published: April 2006

The aim of the study is to assess family members' perceptions of the quality of nursing care of older people and its relationships between demographic factors and family involvement. Data were gathered from family members of four residential homes ( N= 474) using structured questionnaires. Data were analyzed using descriptive statistics, correlation, and predictive analyses. The results imply that family members' perceptions of quality were fairly positive. Age, educational background, and the frequency of visits on the ward were related with the quality perception. The association between quality perceptions and family involvement in care proved to be strong. The information and support from the staff and possibilities to participate in decision making were associated with high-quality ratings. The results demonstrate the need for formulating ward policies and training the nursing staff to allow increased family involvement and to support it in an appropriate way.
Mechanisms of Action in the Process of Change: Helping Eating Disorder Clients Make Meaningful Shifts in Their Lives
Authors: Geller Josie
Published: April 2006

This article describes a model for change that draws upon motivational and cognitive-behavioural theories. It is suggested that maladaptive beliefs hold individuals captive in destructive self-perpetuating cycles dominated by the illness. In the context of a trusting therapeutic relationship, inquiry and experimentation can lead to the reformulation of maladaptive beliefs, and to the development, reprioritization and/or strengthening of higher values. A clear cohesive system of higher values allows individuals to make autonomous life decisions, which reduces the need for maladaptive coping strategies.
Something Happens: Elements of Therapeutic Change
Authors: Kraemer Sebastian
Published: April 2006

To make a difference therapists need a theory with which to understand the patient.1 They choose theories that suit them, and need technique to maintain the therapeutic setting. Psychotherapy developed from healing and medicine, and from our ethological heritage of care for dependants. It happens in a special setting which makes new experiences possible. In this article I list a number of ingredients that are necessary in any effective psychotherapy.
Music Therapy with Sexually Abused Children
Authors: Robarts Jacqueline
Published: April 2006

Music is part of everyday life, and is generally regarded as therapeutic. There is increasing interdisciplinary interest in innate human musicality and the link between music and the emotions. Innate musicality is evident in the dynamic forms of emotional expression that both regulate and cultivate the foundations of meaning in human communication (intersubjectivity). This article discusses music therapy, drawing from interdisciplinary perspectives, and illustrated by case material of individual music therapy with a sexually abused child. Where the growth of mind and meaning is devastated at its core by early relational trauma, music, when used with clinical perception, may reach and work constructively with damaged children in an evolving, musically mediated therapeutic relationship.
An Eastern Perspective on Change
Authors: Dwivedi Kedar Nath
Published: April 2006

In Eastern, particularly Buddhist, thinking the process of change and impermanence is an integral part of existence. All suffering in life is the result of ignorance of this basic reality. A deeper awareness and appreciation of this fact leads to enlightenment and real happiness. It is the rapidity of change that is responsible for the illusory processes that create the sense of solidity, continuity, permanence, entity, agency, self or ego. Thus, the mind is able to mix the real with the unreal. In reality, there are merely processes. However, mere intellectual understanding of this is not enough. It requires experiential understanding through the expansion of consciousness and attention to these processes. It also requires experiential training, appropriate attitudes (such as kindness, compassion, joy and equanimity) and development which is often gradual. Thus, learning to appreciate and delight in the existential process of change is at the heart of the Buddhist approach. It is beneficial not only in the long run (i.e., leading to enlightenment and freedom from the cycle of birth and rebirth, the ultimate purpose of life) but also in the short term (i.e., by making living and dying enjoyable).
Arts in health: the value of evaluation
Authors: Staricoff Rosalia Lelchuk
Published: April 2006

This article aims to discuss a number of different approaches to the evaluation of the value of implementing arts projects and arts programmes, presenting the evidence of their impact when implemented either in community settings or within a healthcare environment. It focuses on the evidence provided by quantitative research and also discusses the merits of applying qualitative research, outlining their different approach of collecting, interpreting and analysing the data. A brief consideration is also given to the arguments underpinning the introduction of humanities and arts in medical and nursing education and training, an approach that promotes personal development and, most importantly, encourages the health practitioner to become more humane, understanding and sympathetic in their everyday practice. It also renders them more amenable to the introduction of art in the healthcare environment. The article concludes that the value of evaluating the effect of the arts in healthcare resides in providing to all involved in designing, implementation and funding, the knowledge of what, when and how to introduce different art forms to achieve the most effective results. Evaluations produce evidence of the impact of different art forms in encouraging beneficial clinical outcomes in patients, in enhancing the quality of healthcare services and in improving working conditions and job satisfaction.
Effects of creative and social activity on the health and well-being of socially isolated older people: outcomes from a multi-method observational study
Authors: Greaves Colin J , Farbus Lou
Published: April 2006

Depression and social isolation affect one in seven people over 65 and there is increasing recognition that social isolation adversely affects long-term health. Research indicates that interventions, which promote active social contact, which encourage creativity, and which use mentoring, are more likely to positively affect health and well-being. The purpose of this study was to evaluate a complex intervention for addressing social isolation in older people, embodying these principles: The Upstream Healthy Living Centre. Mentors delivered a series of individually-tailored activities, with support tailing off over time. Two hundred and twentynine participants were offered the Geriatric Depression Scale, SF12 Health Quality of Life, and Medical Outcomes Social Support scale at baseline, then 6 months and 12 months post intervention. Semi-structured interviews were conducted with 26 participants, five carers and four referring health professionals to provide a deeper understanding of outcomes. Data were available for 172 (75%) participants at baseline, 72 (53% of those eligible) at 6 months and 51 (55%) at 12 months. Baseline scores indicated social isolation and high morbidity for mental and physical health. The intervention was successful in engaging this population (80% of referrals were engaged in some form of activity). At 6 months, there were significant improvements in SF12 mental component, and depression scores, but not in perceived physical health or social support. At 12 months, there were significant improvements in depression and social support and a marginally significant improvement in SF12 physical component ( p= 0.06), but the SF12 mental component change was not maintained. The qualitative data showed that the intervention was well-received by participants. The data indicated a wide range of responses (both physical and emotional), including increased alertness, social activity, self-worth, optimism about life, and positive changes in health behaviour. Stronger, ‘transformational’ changes were reported by some participants. Individual tailoring seemed to be a key mediator of outcomes, as was overcoming barriers relating to transport and venues. Key processes underlying outcomes were the development of a positive group identity, and building of confidence/self-efficacy. The Upstream model provides a practical way of engaging socially isolated elderly people and generating social networks. The data suggest a range of psychosocial and physical health benefits. Although there are limitations in attributing causality in uncontrolled studies, the data seem to indicate a reversal of the expected downward trends in some aspects of participants’ health, and suggest that this approach is worth further investigation.
Global transcriptional profiling of the toxic dinoflagellate Alexandrium fundyense using Massively Parallel Signature Sequencing
Authors: Erdner Deana L , Anderson Donald M
Published: April 2006

Background

Dinoflagellates are one of the most important classes of marine and freshwater algae, notable both for their functional diversity and ecological significance. They occur naturally as free-living cells, as endosymbionts of marine invertebrates and are well known for their involvement in "red tides". Dinoflagellates are also notable for their unusual genome content and structure, which suggests that the organization and regulation of dinoflagellate genes may be very different from that of most eukaryotes. To investigate the content and regulation of the dinoflagellate genome, we performed a global analysis of the transcriptome of the toxic dinoflagellate Alexandrium fundyense under nitrate- and phosphate-limited conditions using Massively Parallel Signature Sequencing (MPSS).

Results

Data from the two MPSS libraries showed that the number of unique signatures found in A. fundyense cells is similar to that of humans and Arabidopsis thaliana, two eukaryotes that have been extensively analyzed using this method. The general distribution, abundance and expression patterns of the A. fundyense signatures were also quite similar to other eukaryotes, and at least 10% of the A. fundyense signatures were differentially expressed between the two conditions. RACE amplification and sequencing of a subset of signatures showed that multiple signatures arose from sequence variants of a single gene. Single signatures also mapped to different sequence variants of the same gene.

Conclusion

The MPSS data presented here provide a quantitative view of the transcriptome and its regulation in these unusual single-celled eukaryotes. The observed signature abundance and distribution in Alexandrium is similar to that of other eukaryotes that have been analyzed using MPSS. Results of signature mapping via RACE indicate that many signatures result from sequence variants of individual genes. These data add to the growing body of evidence for widespread gene duplication in dinoflagellates, which would contribute to the transcriptional complexity of these organisms. The MPSS data also demonstrate that a significant number of dinoflagellate mRNAs are transcriptionally regulated, indicating that dinoflagellates commonly employ transcriptional gene regulation along with the post-transcriptional regulation that has been well documented in these organisms.
Three-dimensional drip infusion CT cholangiography in patients with suspected obstructive biliary disease: a retrospective analysis of feasibility and adverse reaction to contrast material.
Authors: Persson A , Dahlström N , Smedby Ö , Brismar TB
Published: April 2006

Background

Computed Tomography Cholangiography (CTC) is a fast and widely available alternative technique to visualise hepatobiliary disease in patients with an inconclusive ultrasound when MRI cannot be performed. The method has previously been relatively unknown and sparsely used, due to concerns about adverse reactions and about image quality in patients with impaired hepatic function and thus reduced contrast excretion. In this retrospective study, the feasibility and the frequency of adverse reactions of CTC when using a drip infusion scheme based on bilirubin levels were evaluated.

Methods

The medical records of patients who had undergone upper abdominal spiral CT with subsequent three-dimensional rendering of the biliary tract by means of CTC during seven years were retrospectively reviewed regarding serum bilirubin concentration, adverse reaction and presence of visible contrast media in the bile ducts at CT examination. In total, 153 consecutive examinations in 142 patients were reviewed.

Results

Contrast media was observed in the bile ducts at 144 examinations. In 110 examinations, the infusion time had been recorded in the medical records. Among these, 42 examinations had an elevated bilirubin value (>19 umol/L). There were nine patients without contrast excretion; 3 of which had a normal bilirubin value and 6 had an elevated value (25–133 umol/L). Two of the 153 examinations were inconclusive. One subject (0.7%) experienced a minor adverse reaction – a pricking sensation in the face. No other adverse effects were noted.

Conclusion

We conclude that drip infusion CTC with an infusion rate of the biliary contrast agent iotroxate governed by the serum bilirubin value is a feasible and safe alternative to MRC in patients with and without impaired biliary excretion.

In this retrospective study the feasibility and the frequency of adverse reactions when using a drip infusion scheme based on bilirubin levels has been evaluated.
On systems and control approaches to therapeutic gain
Authors: Radivoyevitch Tomas , Loparo Kenneth A , Jackson Robert C , Sedwick W David
Published: April 2006

Background

Mathematical models of cancer relevant processes are being developed at an increasing rate. Conceptual frameworks are needed to support new treatment designs based on such models.

Methods

A modern control perspective is used to formulate two therapeutic gain strategies.

Results

Two conceptually distinct therapeutic gain strategies are provided. The first is direct in that its goal is to kill cancer cells more so than normal cells, the second is indirect in that its goal is to achieve implicit therapeutic gains by transferring states of cancer cells of non-curable cases to a target state defined by the cancer cells of curable cases. The direct strategy requires models that connect anti-cancer agents to an endpoint that is modulated by the cause of the cancer and that correlates with cell death. It is an abstraction of a strategy for treating mismatch repair (MMR) deficient cancers with iodinated uridine (IUdR); IU-DNA correlates with radiation induced cell killing and MMR modulates the relationship between IUdR and IU-DNA because loss of MMR decreases the removal of IU from the DNA. The second strategy is indirect. It assumes that non-curable patient outcomes will improve if the states of their malignant cells are first transferred toward a state that is similar to that of a curable patient. This strategy is difficult to employ because it requires a model that relates drugs to determinants of differences in patient survival times. It is an abstraction of a strategy for treating BCR-ABL pro-B cell childhood leukemia patients using curable cases as the guides.

Conclusion

Cancer therapeutic gain problem formulations define the purpose, and thus the scope, of cancer process modeling. Their abstractions facilitate considerations of alternative treatment strategies and support syntheses of learning experiences across different cancers.
Evaluating the quality of interaction between medical students and nurses in a large teaching hospital
Authors: Nadolski Gregory J , Bell Mary A , Brewer Barbara B , Frankel Richard M , Cushing Herbert E , Brokaw James J
Published: April 2006

Background

Effective health care depends on multidisciplinary collaboration and teamwork, yet little is known about how well medical students and nurses interact in the hospital environment, where physicians-in-training acquire their first experiences as members of the health care team. The objective of this study was to evaluate the quality of interaction between third-year medical students and nurses during clinical rotations.

Methods

We surveyed 268 Indiana University medical students and 175 nurses who worked at Indiana University Hospital, the School's chief clinical training site. The students had just completed their third year of training. The survey instrument consisted of 7 items that measured "relational coordination" among members of the health care team, and 9 items that measured psychological distress.

Results

Sixty-eight medical students (25.4%) and 99 nurses (56.6%) completed the survey. The relational coordination score (ranked 1 to 5, low to high), which provides an overall measure of interaction quality, showed that medical students interacted with residents the best (4.16) and with nurses the worst (2.98; p < 0.01). Conversely, nurses interacted with other nurses the best (4.36) and with medical students the worst (2.68; p < 0.01). Regarding measures of psychological distress (ranked 0 to 4, low to high), the interpersonal sensitivity score of medical students (1.56) was significantly greater than that of nurses (1.03; p < 0.01), whereas the hostility score of nurses (0.59) was significantly greater than that of medical students (0.39; p < 0.01).

Conclusion

The quality of interaction between medical students and nurses during third-year clinical rotations is poor, which suggests that medical students are not receiving the sorts of educational experiences that promote optimal physician-nurse collaboration. Medical students and nurses experience different levels of psychological distress, which may adversely impact the quality of their interaction.
Stress analysis in a layered aortic arch model under pulsatile blood flow
Authors: Gao Feng , Watanabe Masahiro , Matsuzawa Teruo
Published: April 2006

Background

Many cardiovascular diseases, such as aortic dissection, frequently occur on the aortic arch and fluid-structure interactions play an important role in the cardiovascular system. Mechanical stress is crucial in the functioning of the cardiovascular system; therefore, stress analysis is a useful tool for understanding vascular pathophysiology. The present study is concerned with the stress distribution in a layered aortic arch model with interaction between pulsatile flow and the wall of the blood vessel.

Methods

A three-dimensional (3D) layered aortic arch model was constructed based on the aortic wall structure and arch shape. The complex mechanical interaction between pulsatile blood flow and wall dynamics in the aortic arch model was simulated by means of computational loose coupling fluid-structure interaction analyses.

Results

The results showed the variations of mechanical stress along the outer wall of the arch during the cardiac cycle. Variations of circumferential stress are very similar to variations of pressure. Composite stress in the aortic wall plane is high at the ascending portion of the arch and along the top of the arch, and is higher in the media than in the intima and adventitia across the wall thickness.

Conclusion

Our analysis indicates that circumferential stress in the aortic wall is directly associated with blood pressure, supporting the clinical importance of blood pressure control. High stress in the aortic wall could be a risk factor in aortic dissections. Our numerical layered aortic model may prove useful for biomechanical analyses and for studying the pathogeneses of aortic dissection.
Diabetes and urbanization in the Omani population: an analysis of national survey data
Authors: Al-Moosa Siba , Allin Sara , Jemiai Nadia , Al-Lawati Jawad , Mossialos Elias
Published: April 2006

Background

The prevalence of type 2 diabetes in Oman is high and appears to be rising. Rising rates of diabetes and associated risk factors have been observed in populations undergoing epidemiological transition and urbanization. A previous study in Oman indicated that urban-dwellers were not significantly more likely to have diabetes. This study was undertaken to determine if a more accurate urban and rural categorization would reveal different findings.

Methods

This study included 7179 individuals aged 20 years or above who participated in a cross-sectional interviewer-administered survey in Oman including blood and anthropomorphic tests. Multiple logistic regression analyses were conducted to analyze the factors associated with diabetes, first in the whole population and then stratified according to region.

Results

The prevalence of diabetes (fasting blood glucose ≥ 7 mmol/l) in the capital region of Muscat was 17.7% compared to 10.5% in rural areas. The prevalence of self-reported diabetes was 4.3%. Urban residence was significantly associated with diabetes (adjusted odds ratio (OR) = 1.7, 95% confidence interval (CI): 1.4–2.1), as was age (OR = 1.2, 95% CI: 1.1- 1.2), obesity (abnormal waist circumference) (OR = 1.8, 95% CI: 1.5–2.1), and systolic blood pressure (SBP) 120–139 (OR = 1.4, 95% CI:1.04–1.8), SBP 140–159 (OR = 1.9, 95% CI: 1.4–2.6), SBP ≥ 160 (OR = 1.7, 95% CI: 1.2–2.5). Stratified analyses revealed higher education was associated with reduced likelihood of diabetes in rural areas (OR = 0.6, 95% CI: 0.4–0.9).

Conclusion

A high prevalence of diabetes, obesity, hypertension and high cholesterol exist in the Omani population, particularly among urban-dwellers and older individuals. It is vital to continue monitoring chronic disease in Oman and to direct public health policy towards preventing an epidemic.
A Randomized, Controlled Trial of Sucrose Analgesia in Infants Younger Than 90 Days of Age Who Require Bladder Catheterization in the Pediatric Emergency Department
Authors: Rogers Alexander J. , Greenwald Michael H. , DeGuzman Michael A. , Kelley Mary E. , Simon Harold K.
Published: April 2006

Objectives:
To determine whether an oral sucrose solution improves pain response for infants undergoing bladder catheterization in an emergency department (ED) population.

Methods:
A randomized, double‐blinded study comparing the analgesic effects of a sucrose solution to placebo for infants ≤90 days of age and requiring bladder catheterization. Infants with prior bladder catheterization, previous painful procedures that day, or neurological or genital abnormalities were excluded. Infants were assigned baseline pain scores and then given 2 mL of sucrose or water 2 minutes before catheterization. Trained pediatric ED nurses rated the infants for pain, presence of cry, and time to return to baseline.

Results:
Eighty‐three patients were enrolled; 40 were randomized to sucrose, and 40, to placebo. Baseline pain scores were similar within each age group. Overall, sucrose did not produce a significant analgesic effect. In subgroup analysis, infants 1–30 days of age receiving sucrose showed a smaller change in pain scores (2.9 vs. 5.3, p = 0.035), were less likely to cry with catheterization (29% vs. 72%, p = 0.008), and returned to baseline more rapidly after catheter removal (10 seconds vs. 37 seconds, p = 0.04) compared with infants who received placebo. Infants older than 30 days of age who received sucrose did not show statistically significant differences in pain scores, crying, or time to return to baseline behavior.

Conclusions:
There was no overall treatment effect when using an oral sucrose solution before bladder catheterization in infants younger than 90 days of age. However, infants younger than or equal to 30 days of age who received sucrose had smaller increases in pain scores, less crying, and returned to baseline more rapidly than infants receiving placebo. Older infants did not show an improved pain response with oral sucrose.