bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical profile and treatment of infantile spasms using vigabatrin and ACTH - a developing country perspective
Authors: Ibrahim Shahnaz , Gulab Shamshad , Ishaque Sidra , Saleem Taimur
Published: January 2010

Background

Infantile spasms represent a serious epileptic syndrome that occurs in the early infantile age. ACTH and Vigabatrin are actively investigated drugs in its treatment. This study describes the comparison of their efficacy in a large series of patients with infantile spasms from Pakistan.

Methods

All patients with infantile spasms who presented to Aga Khan University Hospital, Karachi, Pakistan from January, 2006 to April, 2008 were included in this study. Inclusion criteria were clinical symptoms of infantile spasms, hypsarrythmia or modified hyparrythmia on electroencephalography, at least six months of follow-up period and receipt of any of the two drugs mentioned above. The type of drug distribution was random according to the availability, cost and ease of administration.

Results

Fifty six cases fulfilled the inclusion criteria. 62.5% were males. Mean age at onset of seizures was 5 ± 1.4 months. Fifty two (92.8%) patients demonstrated hypsarrythmia on electroencephalography. 64.3% cases were identified as symptomatic while 19.6% were cryptogenic and 16.1% were idiopathic. Eighteen patients received ACTH while 38 patients received Vigabatrin as first line therapy. Initial response to first line therapy was similar (50% for ACTH and 55.3% for Vigabatrin). Overall, the symptomatic and idiopathic groups responded better to Vigabatrin. The relapse rate was higher for ACTH as compared to Vigabatrin (55.5% vs. 33.3%) when considering the first line therapy. Four patients evolved to Lennox-Gastaut variant; all of these patients had initially received Vigabatrin and then ACTH.

Conclusion

Vigabatrin and ACTH showed no significant difference in the initial treatment of infantile spasms. However, patients receiving ACTH were 1.2 times more likely to relapse as compared to the patients receiving Vigabatrin when considering monotherapy. We suggest that Vigabatrin should be the initial drug of choice in patients presenting with infantile spasms. However, larger studies from developing countries are required to validate the therapeutic trends observed in this study.
The relationship between safety net activities and hospital financial performance
Authors: Zwanziger Jack , Khan Nasreen , Bamezai Anil
Published: January 2010

Background

During the 1990's hospitals in the U.S were faced with cost containment charges, which may have disproportionately impacted hospitals that serve poor patients. The purposes of this paper are to study the impact of safety net activities on total profit margins and operating expenditures, and to trace these relationships over the 1990s for all U.S urban hospitals, controlling for hospital and market characteristics.

Methods

The primary data source used for this analysis is the Annual Survey of Hospitals from the American Hospital Association and Medicare Hospital Cost Reports for years 1990-1999. Ordinary least square, hospital fixed effects, and two-stage least square analyses were performed for years 1990-1999. Logged total profit margin and operating expenditure were the dependent variables. The safety net activities are the socioeconomic status of the population in the hospital serving area, and Medicaid intensity. In some specifications, we also included uncompensated care burden.

Results

We found little evidence of negative effects of safety net activities on total margin. However, hospitals serving a low socioeconomic population had lower expenditure raising concerns for the quality of the services provided.

Conclusions

Despite potentially negative policy and market changes during the 1990s, safety net activities do not appear to have imperiled the survival of hospitals. There may, however, be concerns about the long-term quality of the services for hospitals serving low socioeconomic population.
Improved methods for magnetic purification of malaria parasites and haemozoin
Authors: Kim Charles C , Wilson Emily B , DeRisi Joseph L
Published: January 2010

Background

Malaria parasites generate free haem upon catabolism of host haemoglobin during their intraerythrocytic growth cycle. In order to minimize oxidative toxicity of the ferric iron, the free haem molecules are polymerized into the biomineral beta-haematin (commonly referred to as haemozoin). Haemozoin crystals are paramagnetic, and this property can be exploited for the purification of late stage parasites as they contain larger haemozoin crystals than early stage parasites and uninfected cells. Commercially available magnets that were originally developed for the purpose of antibody-mediated cell purification are widely used for this purpose. As these methods are not necessarily optimized for parasite purification, the relationship between magnetic field strength and the quantity and quality of yield during parasite purification was explored.

Methods

Inexpensive rare-earth neodymium magnets with commercially available disposable columns were employed to explore the relationship between magnetic field strength and recovery of free haemozoin and infected erythrocytes (iRBCs).

Results

Yields of free haemozoin increased nearly linearly with increasing magnetic field strength to the strongest fields tested (8,500 Gauss). Stronger magnetic fields also improved the recovery of iRBCs with no detrimental effects on parasite viability. An in-house constructed magnetic stand, built for $75 in materials, produced superior results when compared with much more expensive commercial products.

Conclusions

Existing protocols for the magnetic purification of free haemozoin and iRBCs result in sub-optimal yields. Inexpensive high-strength neodymium magnets offer a better option, resulting in higher yields with no detrimental effects on parasite viability.
Responses to Comments of Weis
Authors: Guo Na , Marra Carlo A , Marra Fawziah
Published: January 2010

A response to Weis and Pasipanodya 'Measuring health-related quality of life in tuberculosis: a systemic review - Response'.
GnRH I and II up-regulate MMP-26 expression through the JNK pathway in human cytotrophoblasts
Authors: Liu Jing , Cao Bin , Li Yu-xia , Wu Xiao-qiu , Wang Yan-ling
Published: January 2010

Background

Matrix metalloproteinase-26 (MMP-26), one of the main mediators of extracellular matrix (ECM) degradation, has been shown to exist in trophoblasts of human placenta and to play a role in trophoblast cell invasion. However, little is known about the regulation of MMP-26 expression in human trophoblasts. Recently, gonadotropin-releasing hormone I (GnRH I) and GnRH II have been shown to regulate the expression of MMP-2, MMP-9/tissue inhibitor of metalloproteinases 1 (TIMP-1), and urokinase plasminogen activator (uPA)/plasminogen activator inhibitor (PAI) in human trophoblasts, suggesting that these two hormones may work as paracrine and/or autocrine regulators in modulating the activities of various protease systems at the feto-maternal interface. In this study, we determined the regulatory effects of GnRH I and GnRH II on the expression of MMP-26 in human immortalized cytotrophoblast-like cell line, B6Tert-1.

Methods

Real-time PCR was used to quantify mRNA levels of MMP-26 in human trophoblast-like cell line, B6Tert-1 and primary cultured cytotrophoblasts. Western blotting was used to characterize the expression of MMP-26 and the phosphorylation of c-Jun NH2-terminal kinase (JNK) and extracellular signal-regulated kinase 1/2 (ERK1/2) in B6Tert-1 cells after treatment with GnRH I and GnRH II.

Results

We found that GnRH I increased MMP-26 expression in B6Tert-1 cells after 12 h of treatment at both the mRNA and protein level, while GnRH II increased MMP-26 expression beginning at 3 h of treatment. Treatment of GnRH I at 1 nM resulted in maximal increase of MMP-26 mRNA and protein levels, whereas GnRH II treatment at a concentration of 100 nM was required to induce maximal increase in MMP-26 expression. In addition, we demonstrated that the activation of JNK, but not ERK1/2, was required for GnRH I and II-stimulated MMP-26 production in B6Tert-1 cells and primary cytotrophoblasts.

Conclusions

These novel findings indicated that GnRH I and II could up-regulate MMP-26 expression through the JNK signaling pathway in human trophoblast-like/trophoblast cells.
Human Coronavirus NL63 Open Reading Frame 3 encodes a virion-incorporated N-glycosylated membrane protein
Authors: Müller Marcel A , van der Hoek Lia , Voss Daniel , Bader Oliver , Lehmann Dörte , Schulz Axel R , Kallies Stephan , Suliman Tasnim , Fielding Burtram C , Drosten Christian , Niedrig Matthias
Published: January 2010

Background

Human pathogenic coronavirus NL63 (hCoV-NL63) is a group 1 (alpha) coronavirus commonly associated with respiratory tract infections. In addition to known non-structural and structural proteins all coronaviruses have one or more accessory proteins whose functions are mostly unknown. Our study focuses on hCoV-NL63 open reading frame 3 (ORF 3) which is a highly conserved accessory protein among coronaviruses.

Results

In-silico analysis of the 225 amino acid sequence of hCoV-NL63 ORF 3 predicted a triple membrane-spanning protein. Expression in infected CaCo-2 and LLC-MK2 cells was confirmed by immunofluorescence and Western blot analysis. The protein was detected within the endoplasmatic reticulum/Golgi intermediate compartment (ERGIC) where coronavirus assembly and budding takes place. Subcellular localization studies using recombinant ORF 3 protein transfected in Huh-7 cells revealed occurrence in ERGIC, Golgi- and lysosomal compartments. By fluorescence microscopy of differently tagged envelope (E), membrane (M) and nucleocapsid (N) proteins it was shown that ORF 3 protein colocalizes extensively with E and M within the ERGIC. Using N-terminally FLAG-tagged ORF 3 protein and an antiserum specific to the C-terminus we verified the proposed topology of an extracellular N-terminus and a cytosolic C-terminus. By in-vitro translation analysis and subsequent endoglycosidase H digestion we showed that ORF 3 protein is N-glycosylated at the N-terminus. Analysis of purified viral particles revealed that ORF 3 protein is incorporated into virions and is therefore an additional structural protein.

Conclusions

This study is the first extensive expression analysis of a group 1 hCoV-ORF 3 protein. We give evidence that ORF 3 protein is a structural N-glycosylated and virion-incorporated protein.
Furfural induces reactive oxygen species accumulation and cellular damage in Saccharomyces cerevisiae
Authors: Allen Sandra A , Clark William , McCaffery J Michael , Cai Zhen , Lanctot Alison , Slininger Patricia J , Liu Z Lewis , Gorsich Steven W
Published: January 2010

Background

Biofuels offer a viable alternative to petroleum-based fuel. However, current methods are not sufficient and the technology required in order to use lignocellulosic biomass as a fermentation substrate faces several challenges. One challenge is the need for a robust fermentative microorganism that can tolerate the inhibitors present during lignocellulosic fermentation. These inhibitors include the furan aldehyde, furfural, which is released as a byproduct of pentose dehydration during the weak acid pretreatment of lignocellulose. In order to survive in the presence of furfural, yeast cells need not only to reduce furfural to the less toxic furan methanol, but also to protect themselves and repair any damage caused by the furfural. Since furfural tolerance in yeast requires a functional pentose phosphate pathway (PPP), and the PPP is associated with reactive oxygen species (ROS) tolerance, we decided to investigate whether or not furfural induces ROS and its related cellular damage in yeast.

Results

We demonstrated that furfural induces the accumulation of ROS in Saccharomyces cerevisiae. In addition, furfural was shown to cause cellular damage that is consistent with ROS accumulation in cells which includes damage to mitochondria and vacuole membranes, the actin cytoskeleton and nuclear chromatin. The furfural-induced damage is less severe when yeast are grown in a furfural concentration (25 mM) that allows for eventual growth after an extended lag compared to a concentration of furfural (50 mM) that prevents growth.

Conclusion

These data suggest that when yeast cells encounter the inhibitor furfural, they not only need to reduce furfural into furan methanol but also to protect themselves from the cellular effects of furfural and repair any damage caused. The reduced cellular damage seen at 25 mM furfural compared to 50 mM furfural may be linked to the observation that at 25 mM furfural yeast were able to exit the furfural-induced lag phase and resume growth. Understanding the cellular effects of furfural will help direct future strain development to engineer strains capable of tolerating or remediating ROS and the effects of ROS.
Could pre-diabetes be considered a clinical condition? opinions from an endocrinologist and a cardiologist
Authors: Magalhães Maria Eliane C , Cavalcanti Breno A , Cavalcanti Saulo
Published: January 2010

The prevalence of pre-diabetes is increasing worldwide and may start 7 to 10 years before the clinical diagnosis of diabetes. In this stage the presence and accumulation of risk factors is common and already implies an increase in cardiovascular risk. Likewise, the onset of cardiovascular diseases (CVD), mainly coronary artery disease (CAD), peripheral vascular disease and cerebrovascular disease can also take place, all of which account for high rates of morbidity and mortality worldwide. Considering pre-diabetes as a clinical entity, non-pharmacological and pharmacological treatments are indicated with drugs which have shown clinical benefits related to reduction in morbidity and mortality. However, there is still need for new long-term studies to assess the real benefits of several new therapeutical approaches, as well as its cost-effectiveness.
Gene expression profiling of peripheral blood cells for early detection of breast cancer
Authors: Aarøe Jørgen , Lindahl Torbjørn , Dumeaux Vanessa , Sæbø Solve , Tobin Derek , Hagen Nina , Skaane Per , Lönneborg Anders , Sharma Praveen , Børresen-Dale Anne-Lise
Published: January 2010

Introduction

Early detection of breast cancer is key to successful treatment and patient survival. We have previously reported the potential use of gene expression profiling of peripheral blood cells for early detection of breast cancer. The aim of the present study was to refine these findings using a larger sample size and a commercially available microarray platform.

Methods

Blood samples were collected from 121 females referred for diagnostic mammography following an initial suspicious screening mammogram. Diagnostic work-up revealed that 67 of these women had breast cancer while 54 had no malignant disease. Additionally, nine samples from six healthy female controls were included. Gene expression analyses were conducted using high density oligonucleotide microarrays. Partial Least Squares Regression (PLSR) was used for model building while a leave-one-out (LOO) double cross validation approach was used to identify predictors and estimate their prediction efficiency.

Results

A set of 738 probes that discriminated breast cancer and non-breast cancer samples was identified. By cross validation we achieved an estimated prediction accuracy of 79.5% with a sensitivity of 80.6% and a specificity of 78.3%. The genes deregulated in blood of breast cancer patients are related to functional processes such as defense response, translation, and various metabolic processes, such as lipid- and steroid metabolism.

Conclusions

We have identified a gene signature in whole blood that classifies breast cancer patients and healthy women with good accuracy supporting our previous findings.
Structures and Proton Conductivity of One-Dimensional M(dhbq)·nH2O (M = Mg, Mn, Co, Ni, and Zn, H2(dhbq) = 2,5-Dihydroxy-1,4-benzoquinone) Promoted by Connected Hydrogen-Bond Networks with Absorbed Water
Authors: Yamada Teppei , Morikawa Shota , Kitagawa Hiroshi
Published: January 2010

One-dimensional (1D) coordination polymers, M(dhbq)·nH2O (M = Mg, Mn, Co, Ni, and Zn, H2(dhbq) = 2,5-dihydroxy-1,4-benzoquinone, n = 2, 2.5, or 3), were synthesized and their structures were investigated using the Rietveld refinement method. They have 1D structure and were isostructural. From water uptake measurements, thermogravimetry, and elemental analysis, new 2.5 hydrate states were discovered. The proton conductivity of M(dhbq) was found to depend on the metal species and the quantity of absorbed water.
Synthesis and Properties of Secondary Thiocarbamoylsilanes
Authors: Murai Toshiaki , Hori Rumi
Published: January 2010

Secondary thioformamides were reacted with excess LDA and Me3SiCl at −78 °C. The silyl group was selectively introduced to the thiocarbonyl carbon atom to give secondary thiocarbamoylsilanes. The use of Me2PhSiCl and t-BuMe2SiCl gave similar products in reduced yields. While a variety of N-arylmethylthioformamides participated in the silylation reaction, the yields of the products were influenced by the substituents on the aromatic ring: electron-withdrawing groups decreased the yield. No reaction occurred with thioformamides having secondary alkyl groups on the nitrogen atom, whereas the reaction of those with primary alkyl groups proceeded smoothly to form the corresponding thiocarbamoylsilanes. Initially, deprotonation takes place at the nitrogen atom to generate lithium thioimidates, which are then silylated with chlorosilanes to form silyl thioimidates. Excess LDA deprotonates silyl thioimidates at the imidate carbon atom to generate lithium silyl thioimidates, which undergo reverse Brook rearrangement to form lithium thioimidates bearing a silyl group at the imide carbon atom. Hydrolysis of the intermediates may lead to the formation of secondary thiocarbamoylsilanes. In UV–visible spectra of thiocarbamoylsilanes, the absorptions ascribed to n–π* transitions were shifted to longer wavelengths by ca. 40–50 nm compared to those of thioformates. Finally, the structures of thioformamide and silylated product and their oxygen counterparts were elucidated by DFT calculations. Elongation of the C=O and C=S bonds in carbamoyl- and thiocarbamoylsilanes is discussed in relation to secondary orbital interactions.
Pyogenic psoas abscess: case series and literature review
Authors: Alvi Abdul Rehman , Rehman Zia Ur , G Nabi Zia Ur Rehman
Published: January 2010

From 1998 to 2008, six patients with pyogenic psoas abscesses were managed. Pain and fever were the most common presentations. Two patients had primary pyogenic abscesses and four had secondary pyogenic abscesses. The diagnoses were made either by computed tomography scans (50%) or magnetic resonance imaging and pus culture were obtained. The associated conditions included: perinepheric abscess (1); lumbar discitis (2); and infected thrombosed abdominal aortic aneurysm (1). Five patients underwent radiologically-guided percutaneous drainage and one required open surgical drainage of the abscess cavity. Optimal results were achieved in all cases except one who died of acute myocardial infarction.
Cryptococcal meningitis in immunocompetent Papua New Guinean children
Authors: Laman M , Hwaihwanje I , Davis T M E , Manning L
Published: January 2010

We report three cases of meningo-encephalitis caused by Cryptococcous neoformans var. gattii in apparently immunocompetent children presenting to a provincial hospital in Papua New Guinea (PNG) over a nine-month period. After a postmortem diagnosis was made in the first case, a further two were identified quickly using Indian ink staining of cerebrospinal fluid (CSF). The second case had a complicated course and recovered after relapse. The third made a full recovery with appropriate antifungal therapy. Despite the fact that an environmental reservoir has not been established, cryptococcal meningo-encephalitis occurs regularly in PNG. In developing countries such as PNG, a lack of laboratory resources and limited therapeutic options can complicate the management of severe infections such as cryptococcosis. Nevertheless, with inexpensive diagnostic tests (such as Indian ink staining of CSF), a high index of suspicion and a pragmatic approach to antifungal therapy, good therapeutic outcomes can be achieved.
Capture and sequence analysis of RNAs with terminal 2′,3′-cyclic phosphates
Authors: Schutz Kevin , Hesselberth Jay R. , Fields Stanley
Published: January 2010

The combination of ligation-based RNA capture methods and high-throughput sequencing has facilitated the characterization of transcriptomes and the identification of novel noncoding RNAs. However, current ligation-based RNA capture methods require RNA substrates with terminal 3′-hydroxyl groups, limiting their utility for identifying RNAs with modified termini like 2′,3′-cyclic phosphates. Cyclic phosphate-terminated RNAs are generated by endonucleolytic cleavages and self-cleaving ribozymes and are found as stable modifications on cellular RNAs such as the U6 spliceosomal RNA. We developed a method that uses the Arabidopsis thaliana tRNA ligase to add an adaptor oligonucleotide to RNAs that terminate in 2′,3′-cyclic phosphates. The adaptor allows specific priming by reverse transcriptase, which is followed by additional steps for PCR amplification and high-throughput DNA sequencing. Applying the method to total human RNA, we found 2836 sequencing reads corresponding to the 3′ terminus of U6 snRNA, validating the method. In addition to a large background of reads that map throughout abundantly transcribed RNAs, we also found 42,324 reads of specific fragments from several tRNA isoacceptor families, suggesting that this method may identify processing events previously undetected by other RNA cloning techniques.
Towards improved understanding of PEG-impregnated waterlogged archaeological wood: A model study on recent oak
Authors: Bjurhager Ingela , Ljungdahl Jonas , Wallström Lennart , Gamstedt E. Kristofer , Berglund Lars A.
Published: January 2010

To prevent deformation and cracking of waterlogged archaeological wood, polyethylene glycol (PEG) as a bulk impregnation agent is commonly applied. PEG maintains the wood in a swollen state during drying. However, swelling of wood can reduce its mechanical properties. In this study, the cellular structure of oak and cell wall swelling was characterized by scanning electron microscopy (SEM) of transverse cross-sections, and the microfibril angle of oak fibers was determined by wide angle X-ray scattering (WAXS). Samples of recent European oak (Quercus robur L) impregnated with PEG (molecular weight of 600) were tested in axial tension and radial compression. Mechanical tests showed that axial tensile modulus and strength were only slightly affected by PEG, whereas radial compressive modulus and yield strength were reduced by up to 50%. This behavior can be explained by the microstructure and deformation mechanisms of the material. Microfibril angles in tensile test samples were close to zero. This implies tensile loading of cellulose microfibrils within the fiber cell walls without almost any shear in the adjacent amorphous matrix. These results are important because they can help separate the impact of PEG on mechanical properties from that of chemical degradation in archaeological artifacts, which display only small to moderate biological degradation.
Quantitative Relationship between Degree of Center Segregation and Large Carbide Size in Continuously Cast Bloom of High Carbon Chromium Bearing Steel
Authors: Kim Kwanho , Oh Kyungshik , Lee Joodong , Lee Duklak
Published: January 2010

One of the disadvantages of the continuous casting process, compared to ingot casting, is the center segregation, which causes the formation of large carbides in blooms of high carbon chromium bearing steel. Many activities have been performed to minimize the center segregation by steel manufacturers, and until now, the soft reduction is chosen as the best way to control it. Large carbides formed during casting, detrimental to the rolling contact fatigue life of bearing components, can just be eliminated by holding blooms at high temperatures for a long time before hot rolling, which is called the soaking process. Therefore it is necessary to examine the relationship between the degree of center segregation and large carbide size in continuously cast blooms for a more efficient soaking process. The aim of this research is to describe the relationship quantitatively. Continuously cast blooms of high carbon chromium bearing steel, AISI 52100, were investigated, and the degree of center segregation was not defined as the ratio of carbon concentration in the segregated region to that of nominal composition (C/C0), as it is defined conventionally, but evaluated with a discrete index by comparing the macrograph of a bloom with the standard one settled arbitrarily for the study. The higher was the degree of center segregation, the bigger was the large carbide, and the quantitative relationship between the degree of center segregation and the maximum size of the large carbide was well fitted linearly with a reliability of 95.9 %. In order to apply soft reduction adequately during casting for the study, an in situ equipment to measure the real thickness of a solidifying bloom was installed in front of the soft reduction zone, and both the degree of center segregation and the large carbide size were improved.
Dynamics of a Newly Developed Hydraulic Step Wave Generator
Authors: Wang S. H. , Tsung T. T.
Published: January 2010

This study presents a hydraulic step wave generator using a spool valve that is used to evaluate the dynamic characteristics of hydraulic components at low frequencies. The hydraulic step wave generator generated a hydraulic step wave with short rise time by suddenly opening a wide passage between the high- and low-pressure chambers. The pressure transient of the fluid of the low-pressure chamber in the generator was effectively restricted by its extremely small volume. Additionally, the reference pressure transducer was installed next to an input port of a test hydraulic component so that the reference transducer and the test component simultaneously received the same signals. Generator performance was evaluated at different pressures and volumes of the high-pressure chamber in the time domain. The experimental results show that the minimum rise time of the pressure transient is about 0.1 ms, which is shorter than that of current hydraulic wave generators. Hence, the generator could function as excitation for testing the dynamic characteristics of hydraulic components.
The Prehistory of The History of Mary Prince: Thomas Pringle's "The Bechuana Boy"
Authors: Shum Matthew
Published: January 2010

Thomas Pringle, a Scottish journalist and poet, is best known to Anglo-American scholarship for his role as editor of the first black female slave narrative to be published in Britain, The History of Mary Prince (1834). Pringle had lived in the Cape Colony from 1820 to 1826, however, and produced an important body of work that is not well known outside South Africa. The central argument of this essay is that the poem "The Bechuana Boy" (first published in 1830) has not yet been recognized as a significant precursor text of the History, even though it helps us locate the narrative as informed by a structure of thought already present in Pringle's work. I examine in particular the way in which the poem engages the notion of sympathy, especially as this derives from Adam Smith's conceptualization in The Theory of Moral Sentiments. Such metropolitan notions meet their limits in the colonized subject, who may only access the circuits of sympathy by divesting himself of indigenous selfhood. In comparing "The Bechuana Boy" and The History of Mary Prince, I draw attention to shared structural and thematic features and elaborate on the affinities between these works despite their generic and other differences. The essay concludes by offering a further brief comparison between the History and Olaudah Equiano's Interesting Narrative (1789). Working with Gayatri Spivak's notion of the "native informant," I argue that the works under examination display similarities in their understanding of the protocols governing the admission of the native informant to mainstream public discourse.
"The Purloined Letter" in the Gift Book: Reading Poe in a Contemporary Context
Authors: Urakova Alexandra
Published: January 2010

The essay returns Edgar Allan Poe's "The Purloined Letter" to The Gift: A Christmas, New Year, and Birthday Present, 1845, the gift book in which it was originally published, in order to explore its relationship to its apparently arbitrary frame. Correspondences among Poe's tale and the ones that surround it in The Gift invite us to read "The Purloined Letter" in relation to the social economy of the gift book and against the background of what could be called its generic plot. While the mainstream stories reemphasize commercial strategy based on commodified seduction, I contend that "The Purloined Letter" provides us with a more complex model that both fulfills the reader's expectations and critiques the underlying ideology of "The Gift." I therefore show how Poe "purloins" the gift book's typical gender economy and how the homosocial eroticism of his tale bears on its famous twentieth-century readings.
"My name was Isabella Linton": Coverture, Domestic Violence, and Mrs. Heathcliff's Narrative in Wuthering Heights
Authors: Pike Judith E.
Published: January 2010

While critics have scrutinized Emily Brontë's use of the framed narrative in Wuthering Heights (1847), raising questions about the reliability of the central narrators, Lockwood and Nelly Dean, scant attention has been paid to Isabella Heathcliff as the third narrator. Though readers have overlooked the importance of Isabella's narrative, Brontë highlights her narrative by including it as the only intact letter in the entire novel and devotes almost an entire chapter to her narrative. Isabella's narrative surfaces in a letter to Nelly Dean, offering a highly unorthodox portrait for the mid-Victorian period of the domestic abuse of a young bride from the gentry class. Isabella's letter, which comprises most of chapter 13, also becomes a critical tool to ferret out the reliability of Heathcliff's account in chapter 14 of their marriage. By analyzing the conflicting accounts of their marriage, this essay demonstrates that Heathcliff 's argument acts as a carefully crafted legal rationale, based upon the laws of coverture, to defend and sanction the domestic confinement of his wife. While the laws of coverture deprived women of a legal and economic voice, Brontë endows Isabella with a complex and at times ironic voice. Brontë paints a powerful portrait of the radical transformation of Isabella from the pampered and infantile Miss Linton to the hardened Mrs. Heathcliff, ending with her as the intrepid, fugitive wife, Isabella Heathcliff. Brontë demonstrates through Isabella's story that as long as the laws of coverture are intact, companionate marriage is at risk of being exploited and compromised.
Religion and the “New Terrorism”
Authors: Butko Thomas J
Published: January 2010

There has been an increase in the number of scholars who proclaim the growth of the “new terrorism,” whose core characteristics include: the central role of religion, its increasingly lethal and indiscriminate nature, and the potential use of weapons of mass destruction (WMDs). As opposed to older terrorist organizations that sought tangible, political goals, the “new terrorism” paradigm claims that Political Islamic groups such as Al-Qaeda are primarily nihilistic and, thus, seek the physical destruction and total elimination of their opponents. Conversely, this article maintains that modern religiously-inspired terrorist movements are similar to older terrorist groups in terms of their objectives, tactics, and strategies, as the role of violence remains primarily communicative, and not destructive. In addition, since the views of the “new terrorism,” especially regarding the appropriate counter-terrorism strategies, resonate with American foreign policy goals and geo-political interests, this conception permits U.S. officials to both delegitimize the aims of current terrorist organizations while, in the process, absolving the West of any responsibility in creating the current conditions responsible for their growth.
Christian Zionism and Its Impact on U.S. Foreign Policy
Authors: Friedman Daniel
Published: January 2010

Christian Zionism remains a powerful religious and political force in American politics and continues to greatly impact U.S. foreign policy and geo strategic interests in the Middle East. Despite the fact that many Americans believe that U.S. policy in the region and its unwavering support for Israel accentuates anti-American sentiment in the area, most continue to overwhelmingly support Israel and steadfastly maintain that the benefits of their alliance with Israel significantly outweigh the potential costs. Thus, in the case of Christian Zionism, as both a religious movement and political ideology, it serves to reinforce and solidify the close historical ties between these two allies more than 60 years after the original founding of the state of Israel.
Understanding the Mental Capacity Act 2005: a guide for clinicians
Authors: Nicholas Nick , Nicholas Sotiris
Published: January 2010

Patients who have legal capacity have an unconditional right to accept or refuse life‐threatening treatment.

The Act allows for advance decisions to be made by someone about future treatment.

The Act recognises a Lasting Power of Attorney, which allows a person to make decisions about another person's welfare when the donor lacks capacity.

Learning objectives:

To understand the test for mental capacity.

To be able to determine ‘best interests’.

To be aware of advance decisions and how they are created.

To understand the legal role of the family for patients who lack capacity.

To be aware of Lasting Powers of Attorney and their limitations.

Ethical issues:

A patient's autonomy could lead them to make an unwise decision.

There may be disagreements between doctors and someone who has Lasting Power of Attorney.

Advance decisions could lead to the potential illegality of passive euthanasia and refusal of life‐sustaining treatment.

Please cite this article as: Nicholas N, Nicholas S. Understanding the Mental Capacity Act 2005: a guide for clinicians. The Obstetrician & Gynaecologist 2010;12:29–34.
DNA methylation: a form of epigenetic control of gene expression
Authors: Lim Derek H K , Maher Eamonn R
Published: January 2010

Epigenetic factors such as DNA methylation play an important role in regulating gene expression.

Aberrant DNA methylation is a feature of a number of important human diseases.

Epigenetic changes are common in human cancer cells.

Learning objectives:

To appreciate the role of DNA methylation as a regulator of gene expression.

To understand the role of DNA methylation in normal gene function.

To illustrate how DNA methylation is implicated in the regulation of genomic imprinting.

To draw attention to how altered DNA methylation can result in human diseases such as imprinting disorders and cancer.

Ethical issues:

What are the implications for assisted reproductive technologies?

There are possible difficulties in interpreting the clinical significance of alterations in DNA methylation.

Please cite this article as: Lim DHK, Maher ER. DNA methylation: a form of epigenetic control of gene expression. The Obstetrician & Gynaecologist 2010;12:37–42.
Fighting cervical cancer in under‐resourced countries
Authors: McGregor David , Olaitan Adeola
Published: January 2010

Cervical cancer is a major health issue in under‐resourced countries.

Simple screening methods can greatly reduce mortality.

Human papillomavirus vaccines can supplement screening programmes.

Cost and low awareness among women are major stumbling blocks.

Learning objectives:

Understanding the impact of cervical cancer in under‐resourced countries.

Outlining the strengths and weaknesses of new prevention tools.

Understanding the central role of education and financing mechanisms in preventing cervical cancer.

Ethical issues:

How can a preventable form of cancer still continue to claim the lives of hundreds of thousands of women every year?

Please cite this article as: McGregor D, Olaitan A. Fighting cervical cancer in under‐resourced countries. The Obstetrician & Gynaecologist 2010;12:49–52.
Figuring Out the Human Dimensions of Fisheries: Illuminating Models
Authors: Hall-Arber Madeleine , Pomeroy Caroline , Conway Flaxen
Published: January 2010

Both natural scientists and economists commonly use quantitative data to create models of the systems that interest them and then use these models to inform fisheries management. Other social scientists rely on lengthier, descriptive texts based primarily on qualitative data to assess the human dimensions. To their dismay, fisheries social scientists find that much of their rich narrative with keen insights ends up filling pages that are neither read nor meaningfully integrated into decision-making in fisheries management. Nevertheless, what all scientists, practitioners, and managers want and need is information that will lead to a better understanding of the ecosystem (comprised of interdependent ecological and human systems) and therefore to fisheries management that benefits the whole system. Based on the belief that only a combination of high-quality quantitative and qualitative data will provide both the numbers and the context needed for success in ecosystem-based management, we discuss efforts to present social and cultural information in forms that are more familiar to those who rely on models for a representation of reality in the fisheries context. We point out how the designers of these models (or how we) think the models might be applied to fisheries management, noting how each model attempts to incorporate qualitative data to depict context essential for grounding the more commonly used biological and economic models. We also assess the benefits and limitations of these models, including the constraints on their development and use.
Caries Experience in Individuals with Cleft Lip and/or Palate in China
Authors: Zhu Wan Chun , Xiao Jin , Liu Yuan , Wu Jun , Li JiYao
Published: January 2010

Objective

To determine the levels of dental caries in subjects with cleft lip and/or palate in China in comparison with controls.

Design

A total of 380 subjects with cleft lip and/or palate and 339 noncleft control subjects were examined for dental caries using the decayed-missing-filled-teeth (DMFT/dmft) and decayed-missing-filled-surfaces (DMFS/dmfs) index. A questionnaire was used to acquire subjects' living habits and family socioeconomic status.

Setting

West China Stomatology Hospital, Sichuan University.

Subjects

Individuals between 3 and 25 years of age.

Results

Caries prevalence and scores for dmft/DMFT and dmfs/DMFS were significantly higher in subjects with cleft palates when compared with the noncleft control group ( p < .05), except 3- to 5-year-old children ( p > .05). However, in the 3- to 5-year-old group, children with cleft lip and/or palate had significantly more caries than children of the same age with only a cleft lip with or without alveolus ( p < .05). Children whose clefts had been surgically repaired had a lower dmft and dmfs than those whose clefts had not been surgically repaired ( p < .05).

Conclusion

Individuals with oral cleft are at an increased risk for dental caries. The types of cleft and the surgical repair are two important factors for dental caries.
Prenatal Ultrasound Diagnosis in 51 Cases of Holoprosencephaly: Craniofacial Anatomy, Associated Malformations, and Genetics
Authors: Wenghoefer M. , Anke M. Ettema , Sina F. , Geipel A. , Kuijpers-Jagtman A.M. , Hansmann H. , Borstlap W.A. , Bergé S.
Published: January 2010

Objective

To analyze the prenatal ultrasound findings of the craniofacial and extracephalic anatomy, the postnatal pathological findings, and the genetic anomalies in 51 cases of holoprosencephaly (HPE).

Materials and Methods

Between 1990 and 2005, a collective of 51 fetuses with tentative ultrasound diagnosis of HPE was recruited at two tertiary referral centers for prenatal ultrasound diagnostics via the Pia Fetal Database (GE Medical Systems, Webling, Germany). Cephalic as well as extracephalic anomalies were investigated, and all cases were subdivided into the subgroups lobar, alobar, and semilobar HPE. In addition to the ultrasound investigation, 45 fetuses were analyzed for genetic anomalies and 21 fetuses underwent an autopsy.

Results

The average age at diagnosis was 21.9 weeks of gestation. There was a greater number of female fetuses, with an overall ratio of 2.67:1. In 61% of all cases, there was a reduction of growth in comparison with healthy fetuses of the same age. Within the second trimenon, the cephalic anomalies became evident when investigating the diameter of the fetal head (second trimenon: 71% below the fifth percentile; third trimenon: 92% below the fifth percentile). In 82% of the cases, extracephalic anomalies were diagnosed additionally. In 63%, the diagnosis of holoprosencephaly led to a termination of pregnancy. Ten percent of the fetuses were born alive. In 81% of the cases, the diagnosis of HPE was confirmed postnatally. The remaining 19% showed other severe cephalic and extracephalic anomalies. Chromosomal anomalies were detected in 79% of the fetuses, most frequently trisomy 13 (59%).

Discussion

Because of recent advances in the development and improvement of high-resolution ultrasound, early diagnosis of congenital anomalies such as HPE is now possible. In this study, which represents the largest collection of prenatally diagnosed HPE reported in the literature to date, the average age at diagnosis was earlier than in other studies. The ultrasound devices of today provide excellent images of the fetus that allow an exact diagnosis of craniomaxillofacial anomalies as well as extracephalic anomalies. Apart from a very few cases, the diagnosis of HPE is incompatible with life.
The Parental Dentocraniofacial Phenotype—An Orofacial Clefting Microform
Authors: Mossey Peter A. , Batra Puneet , McIntyre Grant T.
Published: January 2010

Objective

Using the systematic review method, (1) to identify the investigations of the parental dentocraniofacial phenotype in orofacial clefting, (2) synthesize the data to derive a model of the phenotypic features that will assist in the identification of cleft morphogenes, and (3) make recommendations for the future global strategy for researching the parental craniofacial phenotype in orofacial clefting.

Search Strategy

The Cochrane, Medline (via PubMed and OVID platforms [1966 to December 2006]), Embase, CINAHL, and ASKSAM Orthodontic Reference Database (1950–1997) databases were searched using a combination of the following keywords: microform, parent, craniofacial, dental, and cleft. All published articles were reviewed. There were no exclusions of non-English reports. Of the 36 studies identified using this strategy, 26 met the inclusion criteria.

Data Abstraction/Synthesis

The statistically significant data were abstracted using a pro forma, and the methodological quality of the selected studies was evaluated using a checklist. There was considerable heterogeneity among the studies, and therefore it was not possible to synthesize the data. We were, however, able to collate the data.

Results/Conclusions

(1) The craniofacial phenotype possessed by parents of children with orofacial clefting is distinctive when compared with that of the noncleft population. (2) There is insufficient evidence to produce a model of the phenotypic features to assist in the search for orofacial clefting morphogenes. (3) The pattern of expression of the phenotypic features identified to date supports the contention that there are differences in the inheritance of cleft lip with or without cleft palate and isolated cleft palate. Progress in this field is affected by extreme heterogeneity in etiology of cleft lip with or without cleft palate, as well as heterogeneity in study design. (4) Subphenotyping using features such as microforms should be employed to reduce the heterogeneity and to improve the power of future genetic investigations and will also assist in clinical management and genetic counseling for families.
The Use of Facial Anthropometrics in Aesthetic Assessment
Authors: Edler R. , Rahim M. Abd , Wertheim D. , Greenhill D.
Published: January 2010

Objective

To identify a valid method for scoring facial aesthetics, correlating clinicians' assessments with measurements taken from 3D facial photographs.

Design

Album assessment of facial images, using a visual analog scale of attractiveness and the scores ranked. Facial ratios, obtained following digitization of the images compared with control group mean data, obtained from the Farkas growth study and the differences from the matched mean calculated. Ranked scores compared according to the inclusion of surface as well as caliper (shortest distance) measurements and whether the ranked scores, representing difference to the mean, were weighted.

Patients, Participants

Eleven facial images were presented. Seven clinicians provided clinical judgment.

Main Outcome Measures

Correlation coefficients between mean attractiveness rankings and summed differences between patients' facial proportions and matched control data from the Farkas growth study.

Results

The highest correlation was obtained with the use of the difference accommodating the mean of the Farkas proportion index ( r  =  −.76, p  =  .006), followed by standard deviation ( r  =  −.65, p  =  .032), using data in which the difference is weighted according to the magnitude of the linear measurement involved. Repeatability of the clinicians' assessments and operator digitization were validated.

Conclusions

There appears to be potential in the use of the mean as aesthetic ideal as a principle in aesthetic assessment and perhaps as an objective means of outcome assessment after facial surgery. The most appropriate scoring method would seem to include use of both surface and caliper measurements and incorporate weighting.
Allelic variant at −79 (C>T) in CDKN1B (p27Kip1) confers an increased risk of thyroid cancer and alters mRNA levels
Authors: Landa Iñigo , Montero-Conde Cristina , Malanga Donatella , De Gisi Silvia , Pita Guillermo , Leandro-García Luis-Javier , Inglada-Pérez Lucía , Letón Rocío , De Marco Carmela , Rodríguez-Antona Cristina , Viglietto Giuseppe , Robledo Mercedes
Published: January 2010

The aim of this study is to assess if common genetic variants located in the CDKN1B locus, coding for the cell cycle inhibitor p27Kip1, are involved in thyroid cancer susceptibility. Based on the literature and functional predictions, we selected three polymorphisms within the CDKN1B gene (rs2066827 (T326G, V109G), rs34330 (−79C>T) and rs36228499 (−838C>A)) to perform the first case–control study in thyroid cancer involving this locus. We had 649 Spanish patients with sporadic thyroid cancer and 385 healthy representative controls available. Luciferase reporter gene assays, real-time quantitative reverse transcription-PCR and immunoblot experiments were carried out to demonstrate the putative effect of the associated variant. The polymorphism rs34330 (−79C>T) was identified as a risk factor for developing the follicular variant of papillary thyroid carcinoma (FVPTC), fitting a recessive model (odds ratio=2.12; 95% confidence interval=1.09–4.15; P value=0.023). The risk allele (T) of this single nucleotide polymorphism led to a lower transcription rate in cells transfected with a luciferase reporter driven by the polymorphic p27Kip1 promoter (P value <0.001). This effect was observed in −79TT genotype control carriers, who showed a tendency towards lower CDKN1B mRNA levels in lymphocytes, as well as at the protein level. This is the first study that identifies CDKN1B as a low-penetrance gene in thyroid cancer, and specifically in FVPTC subtype. We propose a reduced CDKN1B gene transcription depending on the genotype of the −79C>T (rs34330) variant as a novel mechanism underlying p27Kip1 downregulation.