bluuebunny/crossref_metadata_2025 huggingface dataset:
Florida’s Mandated Educational Leadership Program Redesign
Authors: Mountford Meredith , Acker-Hocevar Michele A.
Published: July 2013

In 2007, educational leadership programs in Florida were notified by Florida’s Department of Education of a law requiring all programs to align with new legislation, State Rule 6A-5.081. Previously, most state-approved preparation programs were based on Florida’s Leadership Preparation Standards, a version of the 1996 Interstate School Leadership Licensure Consortium (ISLLC) standards; the new law was based on 132 new skills and competencies that were not clearly linked to ISLLC. This article examines faculty response at one university to the mandate, the processes faculty used to redesign the program, and the composition and structure of the redesigned educational leadership preparation program.
Revisioning a School Administrator Preparation Program
Authors: Phillips Joy C.
Published: July 2013

This article provides a descriptive case study of the process used at one of North Carolina’s public universities to respond to a state-mandated revisioning directive for educational leadership preparation programs. The case provides an overview of the state educational leadership policy context, discussion of state and local support offered, examination of circumstances that facilitated or hindered program redesign and implementation, discussion of the faculty revisioning process, comparison of pre- and post-redesign program features, and the relationship of the redesigned program to recommended educational leadership preparation program guidelines.
Experiencing Educational Leadership Preparation Program Redesign in Alabama
Authors: Kochan Frances , Reames Ellen H.
Published: July 2013

Calls for changing educational leadership preparation have led many state policy makers to initiate program redesign efforts; the governor of Alabama constituted a working group to examine the situation and develop recommendations. This article details the school leadership preparation program redesign process in Alabama from the perspective of faculty at one university. The article presents an overview of the design process, basic program tenets, and manner in which one set of university faculty engaged in this endeavor. It also presents facilitating and hindering factors, compares redesigned program with previous program, and aligns the redesigned program with best practices.
Differences in purchasing behaviour between physical and virtual laboratory stores
Authors: Desmet Pierre , Bordenave Richard , Traynor John
Published: July 2013

In operational terms (cost, implementation), a virtual 3D laboratory store offers an attractive alternative to a physical laboratory store for testing in-store marketing initiatives (packaging, price or other). Comparing controlled samples, this study shows that declared attitudes to the product are the same but observes significant differences for in-store shopping behaviour and attention to price. These differences are moderated when the subject is a regular buyer of the brand.
The coping strategies used by teenagers criticized by their peers for their brand choice
Authors: Benmoyal-Bouzaglo Sarah , Guiot Denis
Published: July 2013

Few academic studies have addressed the question of how teenagers respond in school social contexts to peer criticism about their choice of brand. To better determine the outlines of this societal issue and associated education marketing, these reactions are studied through the concept of coping, deployed with a combined process-style approach. Three successive quantitative surveys ( n1 = 208; n2 = 200; n3 = 446) were used to highlight five specific coping strategies: justification of the purchase circumstances, revenge, denial of the problem, self-reproach, and making the criticizers feel guilty. Gender, perceived controllability of the situation and brand sensitivity are the main determinants of these strategies.
Resistance to a social innovation: An analytic framework for problems of Fair Trade diffusion
Authors: Gurviez Patricia , Sirieix Lucie
Published: July 2013

In this study we propose conceptualizing Fair Trade as a form of social innovation. Our goal is to better understand its failure to gain general acceptance by examining consumer resistance to innovation. Research methods include observation (consumption behavior in a canteen) and face-to-face interviews. Our findings reveal that individual barriers are insufficient to explain resistance to Fair Trade. We discuss the reasons why consumers in our study showed low levels of identification with and appropriation of Fair Trade. We conclude with recommendations for facilitating the adoption of Fair Trade and social innovations.
The impact of telepresence in an online ad on forming attitudes towards the product: The relevance of the traditional experiential approach
Authors: Debbabi Sana , Baile Serge , des Garets Véronique , Roehrich Gilles
Published: July 2013

This study proposes a conceptual model for understanding the impact of telepresence in an online ad on the process of forming attitudes towards the product. The model takes the traditional experiential approach as its frame of reference. It formulates two interdependent attitude formation processes in a telepresence situation: the first cognitive, the second affective. The model is tested by means of a quasi-experiment. The results confirm the hypotheses of direct and indirect causality among the variables comprising the two processes. This causal analysis allows us to carry out a conceptual diagnosis and to make various recommendations.
The relevance of multifactorial gender and its measure in marketing
Authors: Ulrich Isabelle , Tissier-Desbordes Elisabeth
Published: July 2013

This article outlines the relevance of gender, and its measurement, in providing meaningful insights into marketing research. The authors show that gender has evolved towards a multifactorial approach with three main factors: cognitive (with gender identity), affective and behavioral. Gender adds an explanatory dimension to our understanding of consumer behavior beyond biological sex, preferably within a multifactorial approach. The authors also explain when, and how, to apply gender and its measurement, identifying the situations where using gender is relevant, distinguishing between biological, social, cultural and situational contexts.
The Devil Is in the Detail
Authors: Burns Pippa , Jones Sandra C. , Iverson Don , Caputi Peter
Published: July 2013

Introduction: The Internet can support people to self-manage their asthma, while overcoming barriers frequently found in primary care. A user-centred design process was utilised to explore the types of asthma information older adults perceived to be beneficial in helping them manage their asthma and the website features they felt were desirable for an asthma education website. Methods: A survey package was mailed to 9,000 adults aged 55 years and over, whose contact details had been obtained from the Australian Electoral Commission. Four focus groups were also conducted covering: asthma management; asthma Internet information; and website features. The Technology Acceptance Model was used as a framework to structure results. Results: Survey respondents indicated that they wanted information about identifying and avoiding asthma triggers, dealing with asthma attacks and the latest information on asthma management. Whilst focus group participants stated that asthma blogs, Internet forums and control assessment quizzes would not be useful to them. However the use of videos was seen as beneficial. Internet forums were the only feature discussed where older adults expressed concerns with their ability to use them effectively. Discussion: While older adults indicated a desire for basic asthma information the individual nature of asthma needs to be taken into consideration when creating website content. Both survey respondents and focus groups participants showed little interest in the use of blogs or forums on asthma. These results have implications for professionals providing self-management education to older adults with asthma and other chronic diseases.
Allergy Teaching in UK Medical Schools
Authors: Sanghvi Mihir M. , Curtis Michael R. C. , Bansal Rhea A.
Published: July 2013

Aims. The inadequate provision of allergy services in the United Kingdom is attributed, in part, to poor undergraduate teaching of the subject. We ascertained the level of medical student knowledge about allergy, an extremely common disease, and congenital heart disease, an important yet rare condition, to see if the focus of medical student teaching was correctly matched to disease burden within the general population. Methods. An online quiz was designed consisting of 10 questions on common allergy problems and 10 questions on congenital heart disease to be taken by medical students. Results. Two hundred and fourteen respondents took the quiz, the majority (78.5%) of who were clinical medical students. There was a significant difference between the mean scores for the allergy (µ = 28.7%, standard deviation = 15.5) and congenital heart disease (µ = 40.1%, standard deviation = 21.3) sections; t(213) = −6.78, P < .0001. Discussion. Knowledge about basic allergic disease was very poor within a medical student population. Mean percentage scores were significantly reduced when compared to questions concerning the rare and infrequently encountered condition of congenital heart disease. We question the wisdom of undue emphasis on certain rarely encountered conditions against common, equally important conditions in medical school teaching.
Using Electronic Medical Record Data to Characterize the Level of Medication Use by Age-Groups in a Network of Primary Care Clinics
Authors: Freund Jeff , Meiman Jon , Kraus Connie
Published: July 2013

Purpose: Our primary aim was to characterize the level of medication use across age-groups by examining electronic medical record data for a large number of patients receiving care in primary care clinics. A secondary aim was to identify factors associated with higher levels of medication use or polypharmacy. Methods: We conducted a retrospective query of electronic medical record data from a clinical data warehouse, evaluating 114 012 patients seen in primary care clinics at least once in the previous 6 months. Medication use was evaluated in 3 different categories: level 1 (0-4 medications), level 2 (5-9 medications), and level 3 (≥10 medications). Multivariate analysis was used to analyze different patient demographics and comorbidities for association with level of medication use. Results: At ages 18 to 24 years, 15% (male) to 23% (female) of patients were taking greater than 5 medications, a trend that continued to increase with older cohorts. Female patients were more likely to have level 2 (odds ratio [OR] = 1.76) and level 3 (OR = 2.73) use compared with men. Level 2 and level 3 use was associated with other patient characteristics, including number of patient encounters (level 2 OR = 2.99; level 3 OR = 8.08 for >7 encounters) and common chronic conditions such as chronic pain (level 2 OR = 2.56; level 3 OR = 6.40), diabetes (level 2 OR = 2.4; level 3 OR = 4.61), heart disease (level 2 OR = 1.99; level 3 OR = 3.65), hypertension (level 2 OR = 2.27; level 3 OR = 2.87), and dyslipidemia (level 2 OR = 1.82; level 3 OR = 2.12). Conclusion: Electronic medical record data may be an important tool for providing more comprehensive information regarding medication usage. Medication usage assessed by electronic medical records, even among the youngest cohort, appears to be greater than other sources of medication usage indicate. Higher levels of medication use were associated with a number of factors, including gender, body mass index, number of patient encounters, and comorbid conditions.
Alternate virtual populations elucidate the type I interferon signature predictive of the response to rituximab in rheumatoid arthritis
Authors: Schmidt Brian J , Casey Fergal P , Paterson Thomas , Chan Jason R
Published: July 2013

Background

Mechanistic biosimulation can be used in drug development to form testable hypotheses, develop predictions of efficacy before clinical trial results are available, and elucidate clinical response to therapy. However, there is a lack of tools to simultaneously (1) calibrate the prevalence of mechanistically distinct, large sets of virtual patients so their simulated responses statistically match phenotypic variability reported in published clinical trial outcomes, and (2) explore alternate hypotheses of those prevalence weightings to reflect underlying uncertainty in population biology. Here, we report the development of an algorithm, MAPEL (Mechanistic Axes Population Ensemble Linkage), which utilizes a mechanistically-based weighting method to match clinical trial statistics. MAPEL is the first algorithm for developing weighted virtual populations based on biosimulation results that enables the rapid development of an ensemble of alternate virtual population hypotheses, each validated by a composite goodness-of-fit criterion.

Results

Virtual patient cohort mechanistic biosimulation results were successfully calibrated with an acceptable composite goodness-of-fit to clinical populations across multiple therapeutic interventions. The resulting virtual populations were employed to investigate the mechanistic underpinnings of variations in the response to rituximab. A comparison between virtual populations with a strong or weak American College of Rheumatology (ACR) score in response to rituximab suggested that interferon β (IFNβ) was an important mechanistic contributor to the disease state, a signature that has previously been identified though the underlying mechanisms remain unclear. Sensitivity analysis elucidated key anti-inflammatory properties of IFNβ that modulated the pathophysiologic state, consistent with the observed prognostic correlation of baseline type I interferon measurements with clinical response. Specifically, the effects of IFNβ on proliferation of fibroblast-like synoviocytes and interleukin-10 synthesis in macrophages each partially counteract reductions in synovial inflammation imparted by rituximab. A multianalyte biomarker panel predictive for virtual population therapeutic responses suggested population dependencies on B cell-dependent mediators as well as additional markers implicating fibroblast-like synoviocytes.

Conclusions

The results illustrate how the MAPEL algorithm can leverage knowledge of cellular and molecular function through biosimulation to propose clear mechanistic hypotheses for differences in clinical populations. Furthermore, MAPEL facilitates the development of multianalyte biomarkers prognostic of patient responses in silico.
Genetic basis for phenotypic differences between different Toxoplasma gondii type I strains
Authors: Yang Ninghan , Farrell Andrew , Niedelman Wendy , Melo Mariane , Lu Diana , Julien Lindsay , Marth Gabor T , Gubbels Marc-Jan , Saeij Jeroen PJ
Published: July 2013

Background

Toxoplasma gondii has a largely clonal population in North America and Europe, with types I, II and III clonal lineages accounting for the majority of strains isolated from patients. RH, a particular type I strain, is most frequently used to characterize Toxoplasma biology. However, compared to other type I strains, RH has unique characteristics such as faster growth, increased extracellular survival rate and inability to form orally infectious cysts. Thus, to identify candidate genes that could account for these parasite phenotypic differences, we determined genetic differences and differential parasite gene expression between RH and another type I strain, GT1. Moreover, as differences in host cell modulation could affect Toxoplasma replication in the host, we determined differentially modulated host processes among the type I strains through host transcriptional profiling.

Results

Through whole genome sequencing, we identified 1,394 single nucleotide polymorphisms (SNPs) and insertions/deletions (indels) between RH and GT1. These SNPs/indels together with parasite gene expression differences between RH and GT1 were used to identify candidate genes that could account for type I phenotypic differences. A polymorphism in dense granule protein, GRA2, determined RH and GT1 differences in the evasion of the interferon gamma response. In addition, host transcriptional profiling identified that genes regulated by NF-ĸB, such as interleukin (IL)-12p40, were differentially modulated by the different type I strains. We subsequently showed that this difference in NF-ĸB activation was due to polymorphisms in GRA15. Furthermore, we observed that RH, but not other type I strains, recruited phosphorylated IĸBα (a component of the NF-ĸB complex) to the parasitophorous vacuole membrane and this recruitment of p- IĸBα was partially dependent on GRA2.

Conclusions

We identified candidate parasite genes that could be responsible for phenotypic variation among the type I strains through comparative genomics and transcriptomics. We also identified differentially modulated host pathways among the type I strains, and these can serve as a guideline for future studies in examining the phenotypic differences among type I strains.
Contribution of SLC7A1 genetic variant to hypertension, the TAMRISK study
Authors: Määttä Kirsi , Kunnas Tarja , Nikkari Seppo T
Published: July 2013

Background

The rs41318021 polymorphism in the SLC7A1 gene affects endothelial NO production through changes in L-arginine transport. This variation could thus hypothetically cause dysfunction of endothelium and lead to hypertension. The association of rs41318021 with hypertension was therefore studied in a Finnish cohort.

Methods

A total of 412 hypertensive cases and 771 non-hypertensive controls from a Finnish 50-year-old cohort were included in this study. The data was collected from the Tampere adult population cardiovascular risk study (TAMRISK). DNA was extracted from buccal swabs and amplified using PCR. A subpopulation of men and women who had available follow-up data of blood pressure measurements at the age of 35-, 40-, 45- and 50 years was also analyzed.

Results

There was no difference between the variant frequencies of the hypertension group and normotensive group at the age of 50 years (p = 0.209). However, repeated measures analysis from the 15-year follow-up showed that subjects having gene variants CT or TT had slightly higher diastolic blood pressure than subjects having genotype CC (p = 0.047). By post-hoc analysis, this was most pronounced at the age of 35 years (p = 0.044).

Conclusion

The rs41318021 polymorphism in the SLC7A1 gene was not associated with essential hypertension in 50-year-old subjects. However, a borderline effect of this variation upon diastolic blood pressure was seen in these same subjects in a 15-year follow-up from a 35-year-old cohort to 50 years of age.
Antibacterial activities of selected edible plants extracts against multidrug-resistant Gram-negative bacteria
Authors: Djeussi Doriane E , Noumedem Jaurès AK , Seukep Jackson A , Fankam Aimé G , Voukeng Igor K , Tankeo Simplice B , Nkuete Antoine HL , Kuete Victor
Published: July 2013

Background

In response to the propagation of bacteria resistant to many antibiotics also called multi-drug resistant (MDR) bacteria, the discovery of new and more efficient antibacterial agents is primordial. The present study was aimed at evaluating the antibacterial activities of seven Cameroonian dietary plants (Adansonia digitata, Aframomum alboviolaceum, Aframomum polyanthum, Anonidium. mannii, Hibiscus sabdarifa, Ocimum gratissimum and Tamarindus indica).

Methods

The phytochemical screening of the studied extracts was performed using described methods whilst the liquid broth micro dilution was used for all antimicrobial assays against 27 Gram-negative bacteria.

Results

The results of the phytochemical tests indicate that all tested extracts contained phenols and triterpenes, other classes of chemicals being selectively present. The studied extracts displayed various degrees of antibacterial activities. The extracts of A. digitata, H. sabdarifa, A. polyanthum, A. alboviolaceum and O. gratissimum showed the best spectra of activity, their inhibitory effects being recorded against 81.48%, 66.66%, 62.96%, 55.55%, and 55.55% of the 27 tested bacteria respectively. The extract of A. polyanthum was very active against E. aerogenes EA294 with the lowest recorded minimal inhibitory concentration (MIC) of 32 μg/ml.

Conclusion

The results of the present work provide useful baseline information for the potential use of the studied edible plants in the fight against both sensitive and MDR phenotypes.
Associations among total and food additive phosphorus intake and carotid intima-media thickness – a cross-sectional study in a middle-aged population in Southern Finland
Authors: Itkonen Suvi T , Karp Heini J , Kemi Virpi E , Kokkonen Elina M , Saarnio Elisa M , Pekkinen Minna H , Kärkkäinen Merja UM , Laitinen E Kalevi A , Turanlahti Maila I , Lamberg-Allardt Christel JE
Published: July 2013

Background

Dietary phosphorus (P) intake in Western countries is 2- to 3-fold higher than recommended, and phosphate is widely used as a food additive in eg. cola beverages and processed meat products. Elevated serum phosphate concentrations have been associated with cardiovascular disease (CVD) risk factors and CVD itself in several studies in patients with renal dysfunction and in a few studies in the general population. Carotid intima-media thickness (IMT) is a CVD risk factor, thus the aim of the study was to determine if an association between dietary P, especially food additive phosphate (FAP), intake, and IMT exists.

Methods

Associations among total phosphorus (TP) and FAP intake and carotid IMT were investigated in a cross-sectional study of 37- to 47-year-old females (n = 370) and males (n = 176) in Finland. Associations among TP intake, FAP intake, and IMT were tested by analysis of covariance (ANCOVA) in quintiles (TP) and sextiles (FAP) using sex, age, low-density/high-density lipoprotein cholesterol ratio, smoking status, and IMT sonographer as covariates.

Results

No significant associations were present between TP or FAP intake and IMT (p > 0.05, ANCOVA), but in between-group comparisons some differences were found indicating higher IMT among subjects with higher P intake. When testing for a significant linear trend with contrast analysis, a positive trend was observed between energy-adjusted TP intake and IMT among all subjects (p = 0.039), and among females a tendency for a trend existed (p = 0.067). Among all subjects, a significant positive linear trend was also present between FAP intake and IMT (p = 0.022); this trend was also seen in females (p = 0.045). In males, no significant associations or trends were noted between TP or FAP intake and IMT (p > 0.05).

Conclusions

Our results indicate that a significant linear trend exists between energy-adjusted TP intake and FAP intake, and IMT among all subjects. Based on these results, high dietary P intake should be further investigated due to its potential association with adverse cardiovascular health effects in the general population.
Prevalence of physical activity and obesity in US counties, 2001–2011: a road map for action
Authors: Dwyer-Lindgren Laura , Freedman Greg , Engell Rebecca E , Fleming Thomas D , Lim Stephen S , Murray Christopher JL , Mokdad Ali H
Published: July 2013

Background

Obesity and physical inactivity are associated with several chronic conditions, increased medical care costs, and premature death.

Methods

We used the Behavioral Risk Factor Surveillance System (BRFSS), a state-based random-digit telephone survey that covers the majority of United States counties, and the National Health and Nutrition Examination Survey (NHANES), a nationally representative sample of the US civilian noninstitutionalized population. About 3.7 million adults aged 20 years or older participated in the BRFSS from 2000 to 2011, and 30,000 adults aged 20 or older participated in NHANES from 1999 to 2010. We calculated body mass index (BMI) from self-reported weight and height in the BRFSS and adjusted for self-reporting bias using NHANES. We calculated self-reported physical activity—both any physical activity and physical activity meeting recommended levels—from self-reported data in the BRFSS. We used validated small area estimation methods to generate estimates of obesity and physical activity prevalence for each county annually for 2001 to 2011.

Results

Our results showed an increase in the prevalence of sufficient physical activity from 2001 to 2009. Levels were generally higher in men than in women, but increases were greater in women than men. Counties in Kentucky, Florida, Georgia, and California reported the largest gains. This increase in level of activity was matched by an increase in obesity in almost all counties during the same time period. There was a low correlation between level of physical activity and obesity in US counties. From 2001 to 2009, controlling for changes in poverty, unemployment, number of doctors per 100,000 population, percent rural, and baseline levels of obesity, for every 1 percentage point increase in physical activity prevalence, obesity prevalence was 0.11 percentage points lower.

Conclusions

Our study showed that increased physical activity alone has a small impact on obesity prevalence at the county level in the US. Indeed, the rise in physical activity levels will have a positive independent impact on the health of Americans as it will reduce the burden of cardiovascular diseases and diabetes. Other changes such as reduction in caloric intake are likely needed to curb the obesity epidemic and its burden.
Left behind: widening disparities for males and females in US county life expectancy, 1985–2010
Authors: Wang Haidong , Schumacher Austin E , Levitz Carly E , Mokdad Ali H , Murray Christopher JL
Published: July 2013

Background

The United States spends more than any other country on health care. The poor relative performance of the US compared to other high-income countries has attracted attention and raised questions about the performance of the US health system. An important dimension to poor national performance is the large disparities in life expectancy.

Methods

We applied a mixed effects Poisson statistical model and Gaussian Process Regression to estimate age-specific mortality rates for US counties from 1985 to 2010. We generated uncertainty distributions for life expectancy at each age using standard simulation methods.

Results

Female life expectancy in the United States increased from 78.0 years in 1985 to 80.9 years in 2010, while male life expectancy increased from 71.0 years in 1985 to 76.3 years in 2010. The gap between female and male life expectancy in the United States was 7.0 years in 1985, narrowing to 4.6 years in 2010. For males at the county level, the highest life expectancy steadily increased from 75.5 in 1985 to 81.7 in 2010, while the lowest life expectancy remained under 65. For females at the county level, the highest life expectancy increased from 81.1 to 85.0, and the lowest life expectancy remained around 73. For male life expectancy at the county level, there have been three phases in the evolution of inequality: a period of rising inequality from 1985 to 1993, a period of stable inequality from 1993 to 2002, and rising inequality from 2002 to 2010. For females, in contrast, inequality has steadily increased during the 25-year period. Compared to only 154 counties where male life expectancy remained stagnant or declined, 1,405 out of 3,143 counties (45%) have seen no significant change or a significant decline in female life expectancy from 1985 to 2010. In all time periods, the lowest county-level life expectancies are seen in the South, the Mississippi basin, West Virginia, Kentucky, and selected counties with large Native American populations.

Conclusions

The reduction in the number of counties where female life expectancy at birth is declining in the most recent period is welcome news. However, the widening disparities between counties and the slow rate of increase compared to other countries should be viewed as a call for action. An increased focus on factors affecting health outcomes, morbidity, and mortality such as socioeconomic factors, difficulty of access to and poor quality of health care, and behavioral, environmental, and metabolic risk factors is urgently required.
Does high-density lipoprotein influence the development of saphenous vein graft disease after coronary bypass surgery?: exploratory analysis from the CASCADE trial
Authors: Jerzewski Katie , Ruel Marc , Voisine Pierre , Le May Michel R , Kulik Alexander
Published: July 2013

Background

Low levels of high-density lipoprotein (HDL) purportedly increase the risk after coronary bypass surgery. This may relate to the development of saphenous vein graft (SVG) disease early postoperatively, but this premise has never been evaluated in the context of a prospective trial.

Methods

The CASCADE Trial was a multi-center study of 113 patients evaluating the use of postoperative clopidogrel. Patients received standard lipid management after surgery (96% statins). At 12 months, angiography and intravascular ultrasound was performed to assess SVG occlusion and intimal hyperplasia, respectively. In this exploratory analysis, we evaluated the influence of HDL levels on the development of SVG disease at 12 months, using the established cut-off of <40 mg/dL suggesting increased risk.

Results

While HDL levels increased over the time-period of the trial (P < 0.0001), 51.1% of patients had HDL levels <40 mg/dL 12 months after surgery. Slightly more SVG occlusions occurred amongst patients with HDL levels <40 mg/dL (6.8%), compared to patients with HDL levels >40 mg/dL (4.0%, P = 0.5). With multivariate adjustment, HDL level <40 mg/dL was associated with a trend towards more SVG occlusions (odds ratio: 3.2; P = 0.12). Lower HDL level was also associated with more intimal hyperplasia on ultrasound at 12 months (P = 0.10). Patients who had HDL levels >60 mg/dL had the least amount of intimal hyperplasia, significantly less than the remainder of the cohort (P = 0.01).

Conclusions

Within this population, lower HDL levels were associated with trends towards more graft occlusions and more vein intimal hyperplasia. Modulation of postoperative HDL levels may represent a valuable future strategy for the reduction of SVG disease.
Vaccum drainage system application in the management of operation-related non-regional epidural hematoma
Authors: Ma Jun , Li Huan , Cheng Linggang , Lin Song
Published: July 2013

Background

Epidural intracranial hematoma is one of the most common complications of surgeries for intracranial tumors. The non-regional epidural hematoma is related to severe fluctuation of the intracranial pressure during the operation. The traditional management of hematoma evacuation through craniotomy is time-consuming and may aggravate intracranial pressure imbalance, which causes further complications. We designed a method using vaccum epidural drainage system, and tried to evaluate advantage and the disadvantage of this new technique.

Methods

Seven patients of intracranial tumors were selected. All of the patients received tumor resection and intra-operative non-regional epidural hematoma was confirmed through intra-operative ultrasound or CT scan. The vaccum drainage system was applied. Another ten patients who received craniotomy for intra-operative non-regional epidural hematoma evacuation were selected as comparison. Regular tests, like serial CT scan, were performed afterward to evaluate the effectiveness and to help deciding when to remove the drainage system.

Results

The vaccum drainage method was effective in epidual hemotoma clearance and prevented recurrent epidural hemorrhage. The drainage systems were removed within 4 days. All of the patients recovered well. No complications related to the drainage system were observed.

Conclusions

Compared to the traditional craniotomy, the new method of epidural hemoatoma management using vaccum epidural drainage system proved to be as effective in hematoma clearance, and was less-invasive and easier to perform, with less complication, shorter hospitalization, less economic burden, and better prognosis.
Prevalence and risk factors for nasal carriage of Staphylococcus aureus in children attending anganwaries (preschools) in Ujjain, India
Authors: Dey Sapna , Rosales-Klintz Senia , Shouche Shobha , Pathak Jai Prakash Narayan , Pathak Ashish
Published: July 2013

Background

Children with nasal carriage ofS. aureusplay an important role in community spread ofS. aureusand methicillin-resistantS. aureus(MRSA). Screening the nasal carriage isolates ofS. aureusfor antibiotic resistance patterns will provide guidelines for empiric therapy of community-acquired infections. The aim of the present study was to determine the prevalence ofS. aureusand MRSA and it’sin vitroantibiotic susceptibility pattern among children inanganwaries(preschools) of Ujjain city India. This work is an extension to our previous publication in BMC Pediatrics (http://www.biomedcentral.com/1471-2431/10/100).

Methods

A prospective study was done among children aged 1 to 6 years of age attending 100anganwarieschosen purposely for the study to evenly cover the city. From eachanganwari10 children were randomly selected for nasal swabbing. Children having pyoderma were not included. Information on risk factors for nasal colonization was collected using a pre-tested questionnaire. Swabs from anterior nares were plated on 5% sheep blood agar. Antibiotic susceptibility tests were performed using Kirby-Bauer’s disc diffusion method according to performance standards of Clinical and Laboratory Standard Institute guidelines.

Results

A total of 1002 children were included in the study. The prevalence ofS. aureusnasal carriage was 35% (95% confidence interval CI 32.07 to 37.98) and that of MRSA nasal carriage was 29% (95% CI 24.28 to 33.88). The factors that were independently associated with nasal carriage ofS. aureuswere: “age-group” i.e. as the age increased beyond the age of 2 years the OR of nasal carriage decreased, “family size of more than 10 members” OR 2.59 (95% CI 1.53-4.37;P < 0.001), and protein energy malnutrition Grade 3 or 4 (OR 1.40, 95% CI 1.04-1.90;P = 0.026). The resistance pattern ofS. aureusand MRSA showed resistance not only to single antibiotic class but co-resistance and multi-drug resistance was also common.

Conclusions

The high rates of nasal carriage ofS. aureusand MRSA and presence of resistance to commonly used antibiotics are disturbing. Antibiotic stewardship programmes that promote judicious use of antibiotic along with strategies to prevent community spread ofS. aureusare urgently needed.
Reverse transcription quantitative real-time polymerase chain reaction reference genes in the spared nerve injury model of neuropathic pain: validation and literature search
Authors: Piller Nicolas , Decosterd Isabelle , Suter Marc R
Published: July 2013

Background

The reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR) is a widely used, highly sensitive laboratory technique to rapidly and easily detect, identify and quantify gene expression. Reliable RT-qPCR data necessitates accurate normalization with validated control genes (reference genes) whose expression is constant in all studied conditions. This stability has to be demonstrated.

We performed a literature search for studies using quantitative or semi-quantitative PCR in the rat spared nerve injury (SNI) model of neuropathic pain to verify whether any reference genes had previously been validated. We then analyzed the stability over time of 7 commonly used reference genes in the nervous system – specifically in the spinal cord dorsal horn and the dorsal root ganglion (DRG). These were: Actin beta (Actb), Glyceraldehyde-3-phosphate dehydrogenase (GAPDH), ribosomal proteins 18S (18S), L13a (RPL13a) and L29 (RPL29), hypoxanthine phosphoribosyltransferase 1 (HPRT1) and hydroxymethylbilane synthase (HMBS). We compared the candidate genes and established a stability ranking using the geNorm algorithm. Finally, we assessed the number of reference genes necessary for accurate normalization in this neuropathic pain model.

Results

We found GAPDH, HMBS, Actb, HPRT1 and 18S cited as reference genes in literature on studies using the SNI model. Only HPRT1 and 18S had been once previously demonstrated as stable in RT-qPCR arrays. All the genes tested in this study, using the geNorm algorithm, presented gene stability values (M-value) acceptable enough for them to qualify as potential reference genes in both DRG and spinal cord. Using the coefficient of variation, 18S failed the 50% cut-off with a value of 61% in the DRG. The two most stable genes in the dorsal horn were RPL29 and RPL13a; in the DRG they were HPRT1 and Actb. Using a 0.15 cut-off for pairwise variations we found that any pair of stable reference gene was sufficient for the normalization process.

Conclusions

In the rat SNI model, we validated and ranked Actb, RPL29, RPL13a, HMBS, GAPDH, HPRT1 and 18S as good reference genes in the spinal cord. In the DRG, 18S did not fulfill stability criteria. The combination of any two stable reference genes was sufficient to provide an accurate normalization.
Decreased prevalence of sepsis but not mild or severe P. falciparum malaria is associated with pre-existing filarial infection
Authors: Panda Madhumita , Sahoo Prakash K , Mohapatra Alok Das , Dutta Soumya kanti , Thatoi Pravat K , Tripathy Rina , Das Bidyut K , Satpathy Ashok K , Ravindran Balachandran
Published: July 2013

Background

Enhanced inflammatory host responses have been attributed as the cellular basis for development of severe malaria as well as sepsis. In contrast to this, filarial infections have been consistently reported to be associated with an immunological hypo-responsive phenotype. This suggests that successful control of filariasis by employing mass drug administration, could potentially contribute to an increase in incidence of sepsis and cerebral malaria in human communities. A case control study was undertaken to address this critical and urgent issue.

Methods

Eighty-nine patients with sepsis and one hundred and ninety-six patients with P. falciparum malaria all originating from Odisha, were tested for prevalence of circulating filarial antigens - a quantitative marker of active filarial infection. Antibodies to four stage specific malarial recombinant proteins were measured by solid phase immunoassays and circulating CD4+CD25high T-cells were quantified by flow cytometry with an objective to study if pre-existing filarial infections influence antibody responses to malarial antigens or the levels of circulating T-regulatory cells in P. falciparum infected patients.

Results

Prevalence of filarial antigenemia was significantly less in sepsis patients as compared to controls suggesting that pre-existing filariasis could influence development of sepsis. On the other hand, levels of circulating filarial antigen were comparable in severe malaria cases and healthy controls suggesting that development of severe malaria is independent of pre-existing W. bancrofti infections. Plasma TNF-a, RANTES and antibodies to recombinant malarial proteins as well as levels of circulating CD4+ CD25high cells were comparable in malaria patients with or without filarial infections.

Conclusions

These observations imply that successful control of filariasis could have adverse consequences on public health by increasing the incidence of sepsis, while the incidence of severe malaria may not adversely increase as a consequence of elimination of filariasis.
Conflict of interest: use of pyrethroids and amidines against tsetse and ticks in zoonotic sleeping sickness endemic areas of Uganda
Authors: Bardosh Kevin , Waiswa Charles , Welburn Susan C
Published: July 2013

Background

Caused by trypanosomes and transmitted by tsetse flies, Human African Trypanosomiasis and bovine trypanosomiasis remain endemic across much of rural Uganda where the major reservoir of acute human infection is cattle. Following elimination of trypanosomes by mass trypanocidal treatment, it is crucial that farmers regularly apply pyrethroid-based insecticides to cattle to sustain parasite reductions, which also protect against tick-borne diseases. The private veterinary market is divided between products only effective against ticks (amidines) and those effective against both ticks and tsetse (pyrethroids). This study explored insecticide sales, demand and use in four districts of Uganda where mass cattle treatments have been undertaken by the ‘Stamp Out Sleeping Sickness’ programme.

Methods

A mixed-methods study was undertaken in Dokolo, Kaberamaido, Serere and Soroti districts of Uganda between September 2011 and February 2012. This included: focus groups in 40 villages, a livestock keeper survey (n = 495), a veterinary drug shop questionnaire (n = 74), participatory methods in six villages and numerous semi-structured interviews.

Results

Although 70.5% of livestock keepers reportedly used insecticide each month during the rainy season, due to a variety of perceptions and practices nearly half used products only effective against ticks and not tsetse. Between 640 and 740 litres of insecticide were being sold monthly, covering an average of 53.7 cattle/km2. Sales were roughly divided between seven pyrethroid-based products and five products only effective against ticks. In the high-risk HAT district of Kaberamaido, almost double the volume of non-tsetse effective insecticide was being sold. Factors influencing insecticide choice included: disease knowledge, brand recognition, product price, half-life and mode of product action, product availability, and dissemination of information. Stakeholders considered market restriction of non-tsetse effective products the most effective way to increase pyrethroid use.

Conclusions

Conflicts of interest between veterinary business and vector control were found to constrain sleeping sickness control. While a variety of strategies could increase pyrethroid use, regulation of the insecticide market could effectively double the number of treated cattle with little cost to government, donors or farmers. Such regulation is entirely consistent with the role of the state in a privatised veterinary system and should include a mitigation strategy against the potential development of tick resistance.
MicroRNA-200c overexpression inhibits tumorigenicity and metastasis of CD117+CD44+ ovarian cancer stem cells by regulating epithelial-mesenchymal transition
Authors: Chen Dengyu , Zhang Yunxia , Wang Jing , Chen Junsong , Yang Cuiping , Cai Kai , Wang Xiaoying , Shi Fangfang , Dou Jun
Published: July 2013

Background

Cancer stem cells (CSCs) are believed to be ‘seed cell’ in cancer recurrence and metastasis. MicroRNAs (miRNAs) can play an important role in the progression of primary tumor towards metastasis by regulating the epithelial-mesenchymal transition (EMT). The goal of this study was to investigate the effect of miRNA-200c overexpression on the EMT, tumorigenicity and metastasis of epithelial ovarian cancer (EOC) CSCs.

Methods

The EOC CD117+CD44+CSCs were isolated from the human ovarian cancer cell line SKOV3 by using a magnetic-activated cell sorting system, and the lentivirus miR-200c transduced CSCs were then selected for the study. The assays of colony forming, wound healing, cellular migration in vitro and tumor progression in vivo were performed.

Results

The miR-200c expression was reduced in the CD117+CD44+CSCs compared with the non-CD117+CD44+CSCs. However, the stable overexpression of the miR-200c in the CD117+CD44+CSCs resulted in a significant down-regulation of ZEB-1 and the Vimentin expression, an upregulation of the E-cadherin expression as well as a decrease of colony forming, migratory and invasion in vitro. Importantly, the miR-200c overexpression significantly inhibited the CD117+CD44+CSCs xenograft growth and lung metastasis in vivo in nude mice by inhibition of the EMT. In addition, the down-regulation of ZEB-1 showed the same efficacy as the miR-200c overexpression in the CD117+CD44+CSCs.

Conclusion

These findings from this study suggest that the miR-200c overexpression may be considered a critical approach for the EOC CD117+CD44+CSCs in clinical trials.
State of Emergency Medicine in Switzerland: a national profile of emergency departments in 2006
Authors: Sanchez Bienvenido , Hirzel Alexandre H , Bingisser Roland , Ciurea Annette , Exadaktylos Aris , Lehmann Beat , Matter Hans , Meier Kaspar , Osterwalder Joseph , Sieber Robert , Yersin Bertrand , Camargo Jr Carlos A , Hugli Olivier
Published: July 2013

Background

Emergency departments (EDs) are an essential component of any developed health care system. There is, however, no national description of EDs in Switzerland. Our objective was to establish the number and location of EDs, patient visits and flow, medical staff and organization, and capabilities in 2006, as a benchmark before emergency medicine became a subspecialty in Switzerland.

Methods

In 2007, we started to create an inventory of all hospital-based EDs with a preliminary list from the Swiss Society of Emergency and Rescue Medicine that was improved with input from ED physicians nationwide. EDs were eligible if they offered acute care 24 h per day, 7 days per week. Our goal was to have 2006 data from at least 80% of all EDs. The survey was initiated in 2007 and the 80% threshold reached in 2012.

Results

In 2006, Switzerland had a total of 138 hospital-based EDs. The number of ED visits was 1.475 million visits or 20 visits per 100 inhabitants. The median number of visits was 8,806 per year; 25% of EDs admitted 5,000 patients or less, 31% 5,001-10,000 patients, 26% 10,001-20,000 patients, and 17% >20,000 patients per year. Crowding was reported by 84% of EDs with >20,000 visits/year. Residents with limited experience provided care for 77% of visits. Imaging was not immediately available for all patients: standard X-ray within 15 min (70%), non-contrast head CT scan within 15 min (38%), and focused sonography for trauma (70%); 67% of EDs had an intensive care unit within the hospital, and 87% had an operating room always available.

Conclusions

Swiss EDs were significant providers of health care in 2006. Crowding, physicians with limited experience, and the heterogeneity of emergency care capabilities were likely threats to the ubiquitous and consistent delivery of quality emergency care, particularly for time-sensitive conditions. Our survey establishes a benchmark to better understand future improvements in Swiss emergency care.