bluuebunny/crossref_metadata_2025 huggingface dataset:
Belonging and Doing: Important Factors for Satisfaction With Sexual Relations as Perceived By People With Persistent Mental Illness
Authors: Eklund Mona , Östman Margareta
Published: July 2009

Background: It is increasingly acknowledged that satisfaction with sexual relations forms an important aspect of people’s lives, but little is known of factors associated with this phenomenon among people with mental illness.

Aim: This study aimed to investigate how demographic, social, clinical, and health-related factors were related to satisfaction with sexual relations.

Methods: Patients with persistent mental illness (N = 103), recruited from an outpatient unit, were assessed regarding the target variables.

Results: No clinical variable, and only one demographic factor, namely being a cohabitant, was found to be important to satisfaction with sexual relations. Several social factors, pertaining to how everyday occupations were valued and how the social network was perceived, were shown to be of importance. General quality of life, but not self-rated health or interviewer-assessed psychopathology, was also important for satisfaction with sexual relations. A multivariate analysis showed that the most signifi cant factor for satisfaction with sexual relations was how everyday activities were valued, and being a cohabitant explained some additional variation.

Conclusion: Previous research indicates that the mental health care services largely neglect sexual problems among people with mental illness, and the fi ndings may provide additional knowledge that may be used in the support of this target group.
Towards Integration of Biological, Psychological and Social Aspects in Agent-Based Simulation of Violent Offenders
Authors: Bosse Tibor , Gerritsen Charlotte , Treur Jan
Published: July 2009

In the analysis of criminal behavior, a combination of biological, psychological and social aspects may be taken into account. Dynamical modeling methods developed in recent years often address biological, psychological or social dynamical systems separately. This paper makes the first step in the development of an agent-based modeling approach for criminal behavior in which these aspects are integrated in one dynamical system. It is shown how within a certain (multi-agent) social context, biological factors, such as certain brain deviations, testosterone levels and serotonin levels, affect cognitive and emotional functioning in such a way that a crime is committed when the perceived opportunity is there. This paper presents one generic model for the behavior of violent offenders with parameters that can be set to obtain simulation traces for three known types of offenders.
Exploring Multi-Paradigm Modeling Techniques
Authors: Hardebolle Cécile , Boulanger Frédéric
Published: July 2009

Multi-Paradigm Modeling (MPM) addresses the necessity of using multiple modeling paradigms when designing complex systems. Because of its multidisciplinary nature, the MPM field involves research teams with technical backgrounds as different as control science, model checking, modeling language engineering or system-on-chip development. In this paper, we propose to explore the MPM domain through a survey of existing techniques from different horizons. Since the heterogeneity of models is at the heart of MPM, we first identify the sources of this heterogeneity and introduce the problems it raises. Then we show how the different existing techniques address these problems.
Composable Cellular Automata
Authors: Mayer Gary R. , Sarjoughian Hessam S.
Published: July 2009

Cellular automata (CA) provide a convenient approach to modeling a system comprised of homogeneous entities that, generally, have a spatial relationship with one another. CA are used to model systems that can be appropriately represented as a collection of interconnected automata. These networked automata may act as either a model representation of the entire system, or used to model a sub-system within a hybrid system. As the sub-systems within a hybrid system are disparate, so too can the models representing them be disparate using a multi-model approach. However, to take advantage of multi-modeling, CA and other models used to represent the sub-systems must be founded on system-theoretical principles. Furthermore, each model’s formalism must account for input and output data exchange with other modeling formalisms. Therefore, to support modular synthesis of distinct CA models with non-CA models, a composable cellular automata (CCA) formalism is proposed. This formalism is provided as a domain-neutral, mathematical specification. The CCA is then exemplified as part of a multi-model, and the GRASS development environment is used to describe one possible implementation approach.
Using Load Transformations for the Specification of Arrival Processes in Simulation and Analysis
Authors: Heckmüller Stephan , Wolfinger Bernd E.
Published: July 2009

In this paper the innovative approach of load transformation is used to derive valid load models for secondary loads in computer networks, as they can be observed at lower-layer interfaces of protocol stacks. We apply the technique of load transformation onto a load represented by batch Markovian arrival process (BMAP) models and choose as concrete load transformation the practically relevant token bucket mechanism, which is widely used in current networks. We are able to determine closed-form analytical solutions to describe the transformed load. Investigations by means of simulations of the quality of our analytical models reflecting token-bucket-based load transformations underline the high level of accuracy and validity of the predicted secondary load. We also present a tool implementing different transformation functionalities which can be used for the specification of arrival processes for simulative and analytic performance evaluation.
Independent Verification and Validation of an Industrial Simulation Model
Authors: Robinson Stewart , Brooks Roger J.
Published: July 2009

The independent verification and validation (IV&V) of simulation models is largely restricted to applications in the military and public policy domains. There is little evidence of IV&V for industrial simulation models. This is largely because industrial simulations are normally of a much smaller scale and do not warrant a full IV&V. A procedure for IV&V of industrial simulation models is described that provides a viable alternative where the cost and time of IV&V must be contained. The procedure consists of the following activities: structured walkthrough, review of model assumptions, code examination, review of verification procedures, replications analysis, review of static analysis, review of output reporting, and investigation of results and experimentation. The IV&V of a Sellafield Limited supply chain model is described.
A Novel Discriminative Approach Based on Hidden Markov Models and Wavelet Transform to Transformer Protection
Authors: Jazebi Saeed , Vahidi Behrooz , Seyed Hossein Hosseinian
Published: July 2009

In this paper we present a combinatorial scheme based on hidden Markov models (HMM) and wavelet transform (WT) to discriminate between magnetizing inrush currents and internal faults in power transformers. HMMs are powerful tools for transient classification which compute the maximum likelihood probability between training and testing data signals for identification. The WT is employed to extract certain features which reduce the computation burden of HMMs and enhance detection accuracy. The newly extracted feature efficiently discriminates between faults by different trends. The k-means clustering technique is applied to reduce the training procedure time investment. Since the discrimination method is based on the probabilistic characteristics of the signals without application of any deterministic index, more reliable and accurate classification is achieved. This method is independent of the selection thresholds. Based on the proposed algorithm a highspeed relay response (a quarter of a cycle) can be achieved. The suitable performance of this method is demonstrated by simulation of different faults and switching conditions on a power transformer using PSCAD/EMTDC software.
Media Use and Global Warming Perceptions
Authors: Zhao Xiaoquan
Published: July 2009

This study used the reinforcing spirals model to investigate the mutual influence between individuals’ media use and their global warming perceptions. Data from the science module of the 2006 General Social Survey were analyzed using structural equation modeling. Results offered support for the reinforcing spirals model’s predictions. Media use mediated the effects of age, race, and education on perceived knowledge about global warming. Perceived knowledge and concern over global warming also predicted future information seeking about the polar regions.
Science TV News Exposure Predicts Science Beliefs
Authors: Hwang Yoori , Southwell Brian G.
Published: July 2009

The authors attempt here to address a dilemma faced in recent investigation of science and health communication effects: the difficulty of assessing exposure impact in situations beyond the laboratory. Based on social representation theory, we posit that TV news exposure, especially for stories framed as relevant to the everyday lives of individual audience members, can affect people’s beliefs about science and that such exposure also should interact with interpersonal conversation to jointly predict beliefs. To assess these relationships in a real world setting, we integrated market-level and individual-level data from a science TV news project funded by the National Science Foundation and employed multilevel modeling to predict beliefs about science. This move allowed us to combine information about TV Designated Market Areas with responses from a national Internet-based survey and permitted a model that included both market-level and individual-level variables. Results indicate both main effects and interaction effects. Presence of relevant science stories in a TV market, for example, positively predicted subsequent beliefs about the general accessibility of science among audience members in that market even after controlling for individual-level variables.
A new enhancement to the R-tree node splitting
Authors: Al-Badarneh Amer F. , Yaseen Qussai , Hmeidi Ismail
Published: July 2009

The performance of spatial queries depends mainly on the underlying index structure used to handle them. R-tree, a well-known spatial index structure, suffers largely from high overlap and high coverage resulting mainly from splitting the overflowed nodes. Assigning the remaining entries to the underflow node in order to meet the R-tree minimum fill constraint ( Remaining Entries problem) may induce high overlap or high coverage. This is done without considering the geometric features of the remaining entries and this may cause a very non-optimized expansion of that particular node. This paper presents a solution to the above problem. The proposed solution to this problem distributes rectangles as follows: (1) assign m entries to the first node, which are nearest to the first seed; (2) assign other m entries to the second node, which are nearest to the second seed; (3) assign the remaining entries one by one to the nearest seed. Several experiments on real data, as well as synthetic data, show that the proposed splitting algorithm outperforms the efficient version of the original R-tree in terms of query performance.
Factor Structure of the Denyes Self Care Practice Instrument (DSCPI-90©)
Authors: Andrews Diane Randall , Richard David , Aroian Karen
Published: July 2009

This study evaluates the factor structure and concurrent validity of a measure of self-care, the Denyes Self Care Practice Instrument (DSCPI-90©), when used with adults. Three hundred eight participants complete the 18-item DSCPI-90© and a measure of general health status. Data are examined using descriptive statistics, exploratory factor analysis, and correlation. An efficient 12-item, two-factor model is identified. Reducing the number of items from 18 to 12 does not have an untoward effect on either scale reliability or the amount of variance explained. Correlations with a measure of health status are modest, lending validity to the construct of self-care as being distinct from, yet related to, health status. It is concluded that the 12-item version of the DSCPI© is reliable and valid when used with adults.
Posterior Cerebral Artery Occlusion After Mycoplasma pnuemoniae Infection Associated With Genetic Defect of MTHFR C677T
Authors: Ju Seok Ryu  , Ha Jung Kim  , In Young Sung  , Tae Sung Ko
Published: July 2009

Cerebral artery occlusion in childhood, particularly in the posterior circulation, is a rare neurological complication of Mycoplasma pneumoniae infection. A genetic defect in the methylenetetrahydrofolate reductase gene could result in hyperhomocysteinemia and increased risk of stroke. We report a patient with posterior cerebral artery occlusion after Mycoplasma pneumoniae infection associated with a homozygous, methylenetetrahydrofolate reductase gene mutant type.
Intractable Chronic Motor Tics Dramatically Respond to Clerodendrum inerme (L) Gaertn
Authors: Fan Pi-Chuan , Huang Wei-Jan , Chiou Lih-Chu
Published: July 2009

Tics are characterized by involuntary, sudden, rapid, repetitive, nonrhythmic, stereotyped movements or phonic productions. Those who suffer from either motor or phonic tics, but not both, for more than 1 year are diagnosed with chronic tic disorder. Several pharmacological interventions have been proposed for the treatment of tic disorder. Dopamine D2 receptor blockers and dopamine depletors are thought to be the most effective ones clinically. However, such treatments are suboptimal in terms of effectiveness and side effects, such as body weight gain and extrapyramidal symptoms. We report on a 13-year-old girl, with chronic motor tic disorder refractory to multiple anti-tic therapies, who showed dramatic improvement and remission after taking the crude leaf extract of Clerodendrum inerme (L) Gaertn. No side effects were observed during a follow-up of more than 2 years. To the best of our knowledge, this is the first report on the anti-tic effect of Clerodendrum inerme.
Angelman Syndrome Scientific Symposium on the Structure and Function of UBE3A/E6AP
Authors: Williams Charles
Published: July 2009

In 1997, the genetic basis for the Angelman syndrome was identified as disruption of the UBE3A/E6-AP gene, an important protein component is the ubiquitin degradation pathway. During the last decade, increasing attention has been focused on this gene and how it functions within neurons, especially how it regulates protein homeostasis associated with synaptic function. The symposium enabled neuroscientists and other researchers to present and discuss studies targeted toward better understanding of UBE3A and its role in the Angelman syndrome.
The Use of Carbapenems in the Treatment of Serious Infections
Authors: Baughman Robert P.
Published: July 2009

Inadequate initial antimicrobial treatment in serious infections leads to increased mortality. Achieving adequate treatment is increasingly difficult because of the increasing prevalence of multidrug-resistant (MDR) pathogens. The carbapenems are potent, broad-spectrum antibiotics that have been shown to be safe and efficacious therapies in the treatment of serious infections. This review is intended to compare the 4 major members of the carbapenem class, which include imipenem, meropenem, ertapenem, and doripenem, with other widely used antimicrobial agents in the intensive care unit (ICU). The carbapenems are potent, broad-spectrum antibiotics that have been shown to be safe and efficacious therapies in the treatment of serious infections. They provide better gram-negative coverage than other β-lactams and are stable against extended-spectrum β-lactamases and AmpC β-lactamases, making them effective in the treatment of many MDR bacteria. The newly approved carbapenem, doripenem, may help preserve the utility of the carbapenem class.
Analytic Reviews: High-Frequency Oscillatory Ventilation (HFOV) and Airway Pressure Release Ventilation (APRV): A Practical Guide
Authors: Stawicki S.P. , Goyal Munish , Sarani Babak
Published: July 2009

Despite advances in ventilator management, 31% to 38% of patients with adult respiratory distress syndrome (ARDS) will die, some from progressive respiratory failure. Inability to adequately oxygenate patients with severe ARDS has prompted extensive efforts to identify what are now known as alternative modes of ventilation including high-frequency oscillatory ventilation and airway pressure release ventilation. Both modalities are based on the principles of the open-lung concept and aim to improve oxygenation by keeping the lung uniformly inflated for an extended period of time. Although a mortality benefit has not been proven, some patients may benefit from these alternative modes of ventilation as rescue measures while the underlying process resolves. The purpose of this article is to review the evidence and mechanisms underlying each modality and to describe the fundamental steps in initiating, adjusting, and terminating these modes of ventilation.
A Comparison of Infusion Volumes in the Measurement of Intra-Abdominal Pressure
Authors: Kimball Edward J. , Baraghoshi Gabriele K. , Mone Mary C. , Hansen Heidi J. , Adams Danielle M. , Alder Stephen C. , Jackson Peter , Cannon Philip , Horn Jeffrey , Wolfe Timothy R.
Published: July 2009

Bladder pressure measurement through a foley catheter is the current standard in monitoring for intraabdominal hypertension (IAH) and abdominal compartment syndrome (ACS). Accurate pressure transduction requires a continuous fluid column with a small volume of transducing medium at the tip of the catheter. Infusing excessive fluid volume can falsely elevate the measured intra-abdominal pressure (IAP) due to bladder overdistention and can lead to intrinsic muscular contraction. This effect can be seen with volumes as low as 60 mL. Recent expert consensus has recommended 25 mL as the maximal infusion volume; however, 50 mL is the most commonly cited volume of infusion in the literature. The purpose of this analysis was to determine the variance between IAP values using a range of volume infusions between 10 and 60 mL. Eighteen adult, surgical intensive care unit (SICU) patients who were undergoing IAP measurement for IAH or clinically indicated monitoring were enrolled in a prospective, nontreatment study. Intra-abdominal pressure measurements were obtained with stepwise increases of injectate volume from 10 to 60 mL (in 10 mL increments). Bland-Altman analyses and receiver operating characteristic (ROC) curves were used for analysis. After analysis accounting for data correlation within patients, means and standard deviations were generated for differences between 50 mL and 10, 20, 30, 40, and 60 mL bladder infusion volumes. Bland-Altman analyses showed good agreement between measurements and no significant difference in variance (mean ≤1.35 mm Hg) between volume comparisons. The ROC curve generated for each test volume using a diagnostic pressure value for IAH (!12 mm Hg) showed that a value between 11 and 12 mm Hg gave the best combination of sensitivity and specificity for all test volumes. In SICU patients, with a clinical indication for IAP monitoring, bladder infusion volumes between 10 mL and 60 mL provide consistent IAP measurements.
Intraoperative Diagnosis of Unsuspected Methemoglobinemia Due to Low Pulse Oximetry Values
Authors: Tobias Joseph D. , Ramachandran Venkataraman
Published: July 2009

Methemoglobinemia results from the oxidation of the iron in the hemoglobin molecule from the ferrous to the ferric state. Methemoglobinemia may result from congenital deficiencies of enzymes that normally convert methemoglobin (metHb) to hemoglobin, alterations in the hemoglobin molecule itself or, most commonly, from medications or toxins. As metHb cannot carry oxygen, clinical sequelae result when the concentration of metHb is high enough to compromise oxygen delivery to the tissues. With low levels, the patient may be asymptomatic or only symptomatic during periods of increased tissue oxygen demands such as exercise. With higher levels, symptoms may occur at rest. We describe an adolescent with acute leukemia who presented to the operating room for placement of a Broviac catheter for permanent central venous access. Given a persistently low oxygen saturation as measured by pulse oximetry (92% to 94%) with no response to changes in the inspired oxygen concentration and the lack of physical findings on auscultation to explain the low oxygen saturation, the diagnosis of metHb was entertained and confirmed by laboratory analysis.
Adoption Benefits: A Smart Addition to the Work—Life Package
Authors: Boerio Carrie
Published: July 2009

Employers can add adoption benefits that are inexpensive, easy to administer and attractive to employees.
The Medial Prefrontal Cortex and Integration in Autism
Authors: Shalom Dorit Ben
Published: July 2009

This article offers a unifying theoretical interpretation of known abnormalities in people with autism spectrum disorders (ASDs) in four psychological domains, namely emotion, memory, sensation-perception, and motor skills. It proposes that in all four domains three levels of processing can be identified: a basic level, an integrative level, and a “logical” or higher-order level. It also notes that in typically developing people, there is evidence that the integrative level is subserved by subregions of the medial prefrontal cortex. The major argument of the article is to propose and argue that the integrative level in all four domains is responsible for common atypicalities in people with ASDs.
Statins Reduce Appropriate Cardioverter-Defibrillator Shocks and Mortality in Patients With Heart Failure and Combined Cardiac Resynchronization and Implantable Cardioverter-Defibrillator Therapy
Authors: Desai Harit , Aronow Wilbert S. , Tsai Fausan S. , Ahn Chul , Lai Hoang M. , Amin Harshad , Gandhi Kaushang , Frishman William H. , Cohen Martin , Sorbera Carmine
Published: July 2009

Of 209 patients with heart failure treated with combined cardiac resynchronization therapy and implantable cardioverter-defibrillator therapy, appropriate cardioverter-defibrillator shocks occurred at 34-month follow-up in 22 of 121 patients (18%) on statins and in 30 of 88 patients (34%) not on statins (P = .009). Deaths occurred in 3 of 121 patients (2%) on statins and in 9 of 88 patients (10%) not on statins (P = .017). Stepwise Cox regression analysis showed that significant independent prognostic factors for appropriate shocks were use of statins (risk ratio = 0.46), smoking (risk ratio = 3.5), and diabetes (risk ratio = 0.34). Significant independent prognostic factors for the time to mortality were use of statins (risk ratio = 0.05), use of digoxin (risk ratio = 4.2), systemic hypertension (risk ratio = 14.2), diabetes (risk ratio = 4.3), and left ventricular ejection fraction (risk ratio = 1.1).
Factor V Leiden in an Urartian, Dating Back to 1000 BC
Authors: Alakoç Yeşim Doğan , Aka P. Sema , Eğin Yonca , Akar Nejat
Published: July 2009

Factor V Leiden (FVL) is the most common monogenic disorder that causes activated protein C (APC) resistance, creating hyper-coagulation. The mutation shows an uneven geographic distribution, significantly high in European populations. The mutation is believed to have originated approximately 20 000 years ago probably from a geographic region close to Anatolia. This fact makes it noteworthy to search for the mutation in ancient populations that once lived in this area. One of these civilizations, Urartu was centered around Van Lake in Eastern Turkey. The archeological remains from the excavations of the region are dated back to 1000 BC. Teeth, taken from the excavations of Van Yoncatepe fortress, were taken into DNA analysis considering all the precautions for ancient DNA analysis. Multiplex STR (Short Tandem Repeats) analysis were performed both to determine the gender of the samples and to conclude that the samples are preserved from modern DNA contamination. After getting an 80% amplification success for amelogenin, a melting curve analysis using lightcycler was performed to determine the FVL genotype of each sample. Of the 60 samples, 1 gave a positive amplification result for FV gene and was found to be heterozygous. To date, the age of this mutation was estimated based on statistical calculations using haplotype frequencies; here for the first time, we report FVL in an ancient population of 3000 years.
Hemifacial paralysis in a child treated for leukemia: unusual side effect of omeprazole?
Authors: Bauters Tiene GM , Verlooy Joris , Mondelaers Veerle , Robays Hugo , Laureys Geneviève
Published: July 2009

We report a hemifacial paralysis as an adverse drug reaction possibly related to the use of omeprazole in a patient with acute lymphoblastic leukemia. We believe that this case, although very rare, is clinically significant and worth mentioning, owing to the frequent use of omeprazole in the oncology setting. J Oncol Pharm Practice (2010) 16: 129—132.
Suction, Salvage, Sutures, and Potions: Blood Management Post-Aprotinin
Authors: Baker Robert A.
Published: July 2009

Hemostasis management of the cardiac surgical patient has changed following the withdrawal of aprotinin for use in cardiac surgical patients. The challenge to minimize blood loss and reduce exposure of cardiac surgical patients to blood products continues to grow with patients presenting being older and sicker and more complex procedures being performed. The cardiac surgery team has many options available for it to consider; although current recommendations strongly support the use of cell salvage as one process to assist in this challenge, other options need to be equally critically evaluated.
Optimal Versus Suboptimal Perfusion During Cardiopulmonary Bypass and the Inflammatory Response
Authors: De Somer F.
Published: July 2009

Despite major improvements in perfusion techniques over the past 50 years, it is still not possible to formulate a clear definition of what is meant by optimal perfusion. In part this is due to the lack of sufficient evidence-based data and in part because of the complex pathophysiology that takes place during cardiac surgery with cardiopulmonary bypass. To find an answer we need to understand the exact mechanism of the inflammatory reaction triggered by the cardiopulmonary bypass. However, it is clear that further improvement of the cardiopulmonary bypass components alone will be sufficient. Only a combined strategy can further improve cardiopulmonary bypass—related morbidity and mortality. Such a combined strategy will embrace perfusion techniques as well as a pharmacological approach. It will also require a continuous monitoring of the microcirculation. The latter will not only allow to rapidly sense changes in the quality of perfusion but, even more important, also make it possible to intervene at the moment of deterioration. Recent research shows that such an approach has positive an impact on cardiopulmonary bypass—related morbidity postoperatively.
Immediate Postoperative Care of the Heart Transplant Recipient: Perils and Triumphs
Authors: Novick Richard J.
Published: July 2009

The early postoperative care of a heart transplant recipient remains challenging, even in experienced centers with a long tradition of excellence. Approximately 10% to 20% of heart transplant recipients experience potentially life-threatening right ventricular dysfunction intraoperatively and early postoperatively due to an elevated pulmonary vascular resistance. In addition, heart transplant recipients experience a high risk of perioperative hemorrhage, as well as opportunistic infection and rejection. The authors describe a case of severe right ventricular dysfunction in a 46-year-old male several hours after heart transplantation for a dilated cardiomyopathy. This patient was salvaged by judicious multimodality therapy including the use of adrenergic agents, phosphodiesterase inhibitors, inhaled nitric oxide, and extracorporeal membrane oxygenation. The risk factors for the development of early graft failure after heart transplantation are reviewed, along with the principles of appropriate management of this complication.
What Was Hot and What Was Not in 2007?: A Literature Review
Authors: Bainbridge Daniel
Published: July 2009

While the number of publications each year in cardiac anesthesia is enormous there are a select group of interesting articles highlighting controversies in current practice or new techniques, medications, procedures which may change practice down the road. The purpose of this article is to review some of these articles. While by no means a systematic review, this article highlights some of the more interesting papers from the cardiac anesthesia and surgical literature from 2007. The articles focus on areas such as: methods to reduce both cerebral dysfunction and renal dysfunction, myocardial protection inhaled volatile anesthetic agents, and methods to reduce atrial fibrillation.
Autonomic Nervous System and Cardiovascular Disease
Authors: Deschamps Alain , Denault André
Published: July 2009

Because anesthesia affects the integrity of the autonomic nervous system, anesthesiologists use vital signs to maintain respiratory and circulatory homeostasis. However, patients with genetic predispositions or with autonomic dysfunctions are at risk of severe complications from anesthesia. For these patients, the monitoring of vital signs may not give sufficient warning to avoid complications. The development of methods to measure autonomic tone could be of interest to anesthesiologists because they could warn of changes in autonomic tone before vital signs are affected. New noninvasive methods are being developed to obtain measurements of parasympathetic and sympathetic output allowing for the monitoring of perioperative autonomic tone. These measurements are based on analysis of heart rate and blood pressure variability. In this report, the principals of the analysis of heart rate and blood pressure variability will be explained and the usefulness of these methods to anesthesiologists will be discussed.
Comparison of Commonly Used Placement Sites for Activity Monitoring
Authors: Pat Rapp Mary , Nelson Francine , Oliver Melinda , Bergstrom Nancy , Cron Stanley G.
Published: July 2009

Background: No accepted standard exists to evaluate nonsleep-related activity in nursing facility residents where monitors are variously placed at the ankle, waist, wrist, thigh, or embedded in sheeting and set to record activity frequency. Objectives: To determine optimal placement of activity monitors by site—at the ankle, waist, or wrist for nursing facility residents. Methods: Nursing facility residents (N = 16) wore accelerometers at three sites: the nondominant ankle, waist, and wrist, while recording activity in three modes: frequency, duration, and intensity. Results: The natural log activity mean for each mode by site and time revealed no significant differences between the three sites for activity intensity, F(2, 62.78) = .15, p = .86; activity duration, F(2, 69.84) = .50, p = .61; and activity frequency, F(2, 70.04) = 1.25, p = .29. There were no significant site—time interactions. The natural log activity by site and mode indicated no significant differences by site for the 24-hr mean, F(2, 107.64) = .20, p = .82; activity median, F(2, 100.42) = .47, p = .63; and activity standard deviation, F(2, 108.69) = 1.5, p = .23. A significant difference was seen by site for the acceleration index, F(2, 106.32) = 9.57, p < .001. No significant site—mode interactions were found. Conclusions: Similarity between ankle, waist, or wrist sites when measuring activity by various modes, frequency, duration, or intensity, suggests the monitors measure nonsleep-related activity equally well at any of the sites.
Angiotensin II does not influence expression of sarcoplasmic reticulum Ca2 + ATPase in atrial myocytes
Authors: Wu Cho-Kai , Tseng Chuen-Den , Huang Yin-Tsen , Hsieh Chia-Shan , Tsai Wei-Shan , Lin Jiunn-Lee , Chiang Fu-Tien , Tsai Chia-Ti
Published: July 2009

Introduction. The sarcoplasmic reticulum Ca2+ ATPase (SERCA) is essential for the regulation of the intracellular calcium level in cardiomyocytes. Previous studies have found that angiotensin II (Ang II) decreased SERCA2 gene expression in ventricular myocytes. Alteration of SERCA activity is important in the mechanism of atrial fibrillation. The present study was undertaken to examine Ang II effects on atrial myocytes.

Materials and methods. An ~1.75-kb promoter region of SERCA2 gene was cloned with the pGL3 luciferase vector. The direct effects of Ang II on SERCA2 gene expression in HL-1 atrial myocytes were examined by promoter activity assay, followed by Western blot analysis for protein levels and quantitative real-time reverse transcription polymerase chain reaction for mRNA amounts.

Results. Ang II did not increase the promoter activity of the 1,754-bp promoter-receptor construct of the SERCA2 gene. The levels of SERCA2 protein and mRNA were also unchanged at different time points after Ang II treatment.

Conclusions. Although Ang II had prominent effects on SERCA2 in ventricular myocytes, it did not alter SERCA2 gene expression and protein levels in atrial myocytes. We provide a model for further investigation of the regulation of SERCA2 gene expression in atrial myocytes.
Atrial fibrillation in primary aldosteronism
Authors: Watson Timothy , Karthikeyan Vellore J , Lip Gregory YH , Beevers D. Gareth
Published: July 2009

Introduction. Primary aldosteronism (PA) is caused by autonomous hypersecretion of aldosterone from the adrenal cortex, classically from an adenoma, resulting in sodium and water retention, hypokalaemia and raised blood pressure. The sodium and water retention causes suppression of renin release. The possible cardiac sequelae of aldosterone excess are encountered primarily in patients with secondary hyperaldosteronism due to heart failure, where plasma renin, angiotensin and aldosterone levels are all raised. However, there is also evidence that primary aldosterone excess, in the presence of low renin levels, may also be cardiotoxic.

Patients. In this report, we describe five patients with PA, who developed atrial fibrillation (AF) in the absence of structural cardiac lesions and in one case despite good control of blood pressure and electrolytes.

Conclusion. In patients with hypertension and AF, who have no evidence of coronary disease or any other underlying cause of AF with preserved systolic function, a diagnosis of PA should be considered.
HRD's Role in Identifying, Measuring, and Managing Knowledge Assets in the Intangible Economy
Authors: Muyia Nafukho Fredrick
Published: July 2009

The problem and the solution. HRD's role in identifying, measuring, and managing knowledge assets in organizations is critical. Knowledge management refers to the ability of an organization to generate data, refine the data into information, and strategically use the information to make decisions.This article reviews relevant literature and demonstrates the role of HRD in identifying, measuring, and managing intangible knowledge assets in organizations. The article argues that in the 21st century, organizations are faced with tremendous challenges including financial meltdown, uncertain economy, cut-throat competition, globalized markets, economic marginalization, privatization and outsourcing of services, mergers, takeovers, rapidly advancing technology, rapid change, and generation of new knowledge.This article defines knowledge assets and examines the various forms of intellectual capital. The relevance of knowledge ratios to identifying, measuring, and managing knowledge assets in organizations is discussed.The success of tomorrow's organizations will lie in their capacity to learn, generate new knowledge, and successfully manage knowledge assets using new tools such as the balanced scorecard and the human resource scorecard.The article concludes by showing that knowledge is a new intangible asset most critical to the survival and thriving of both profit and nonprofit organizations.
Ayurvedic Management of Unilateral Loss of Vision Following a Blunt Injury to Eye: A Case Report
Authors: Rastogi Sanjeev , Chawla Shobhit , Singh R.P.
Published: July 2009

A 45-year-old previously healthy male suffered a major visual setback following a blunt injury to his left eye. The vision in the affected eye was lost immediately and did not return after the resolution of initial inflammation. His retinal examination revealed a subretinal hemorrhage with an area of chorioretinal atrophy in the left macula. A 3-month trial of conventional therapy, consisting of hemostatics, antioxidants, steroids, and vitamin A, was of no avail except for the return of vision to finger-counting ability. An optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) conducted at 3 months revealed hyper-reflectivity and irregularity at retinal pigment epithelium (RPE) Bruch’s membrane complex and decreased retinal thickness. Ayurvedic therapy was started at this time. At a 3-month treatment follow-up (6 months following the injury), there was a remarkable improvement in vision in the left eye, which was observed as 6/18 on the Snellen chart. After a total of 6 months of Ayurvedic therapy followed by 6 months of withdrawal, a subsequent follow-up found the vision in the patient’s left eye to be 6/12. OCT and an FFA done at this time was marked by substantial improvements in the RPE Bruch’s membrane complex. Ayurvedic therapy seems to have contributed substantially to the improved vision, which had been lost completely following a blunt injury to the left eye.
Efficacy of tiotropium in the prevention of exacerbations of COPD
Authors: Anzueto Antonio , Miravitlles Marc
Published: July 2009

Exacerbations are the most frequent cause of medical visits, hospital admissions and death among patients with chronic obstructive pulmonary disease (COPD). Tiotropium bromide is a long-acting bronchodilator that has demonstrated clinical efficacy in significantly improving the FEV1 and health-related quality of life (HRQL) in patients with COPD. The prolonged and persistent bronchodilation achieved with tiotropium may reduce the exacerbation and COPD-related hospitalisation rates. The effect of tiotropium treatment on the incidence of exacerbations has been determined (as a secondary outcome) in registration trials. There are studies designed specifically to demonstrate the effect of tiotropium on the reduction in the frequency of exacerbations. Two of these studies of 6-month and 1-year duration demonstrated an additional significant benefit in the reduction of exacerbations and hospitalisations. The recent UPLIFT trial included 5993 patients followed for 4 years and, compared with control, tiotropium significantly delayed time-to-first exacerbation (16.7 versus 12.5 months) and time-to-first hospitalisation for exacerbations (lower risk of hospitalisation; HR, 0.86 [95% CI = 0.78-0.95]; p = 0.002). Tiotropium also reduced the mean number of exacerbations by 14% (rate per patient-year, 0.73 versus 0.85; HR, 0.86 [95% CI = 0.81-0.91]; p < 0.001). It is important to highlight that the control group in the UPLIFT trial consisted of patients with usual treatment for COPD, which included inhaled corticosteroids and/or long-acting beta-2 agonists in up to 62% of cases at baseline and up to 73% of cases at any time during follow-up. The new clinical trials have demonstrated a significant reduction in exacerbations and hospitalisations, even in patients treated with other drugs that can potentially prevent exacerbations.
Sneeze reflex: facts and fiction
Authors: Songu Murat , Cingi Cemal
Published: July 2009

Sneezing is a protective reflex, and is sometimes a sign of various medical conditions. Sneezing has been a remarkable sign throughout the history. In Asia and Europe, superstitions regarding sneezing extend through a wide range of races and countries, and it has an ominous significance. Although sneezing is a protective reflex response, little else is known about it. A sneeze (or sternutation) is expulsion of air from the lungs through the nose and mouth, most commonly caused by the irritation of the nasal mucosa. Sneezing can further be triggered through sudden exposure to bright light, a particularly full stomach and physical stimulants of the trigeminal nerve, as a result of central nervous system pathologies such as epilepsy, posterior inferior cerebellar artery syndrome or as a symptom of psychogenic pathologies. In this first comprehensive review of the sneeze reflex in the English literature, we aim to review the pathophysiology, etiology, diagnosis, treatment and complications of sneezing.
How I treat Waldenström macroglobulinemia
Authors: Treon Steven P.
Published: July 2009

Waldenström macroglobulinemia (WM) is a distinct B-cell disorder resulting from the accumulation, predominantly in the bone marrow, of clonally related IgM-secreting lymphoplasmacytic cells. Genetic factors play an important role, with 20% of patients demonstrating a familial predisposition. Asymptomatic patients should be observed. Patients with a disease-related hemoglobin level less than 10 g/L, platelet count less than 100 × 109/L, bulky adenopathy or organomegaly, symptomatic hyperviscosity, peripheral neuropathy, amyloidosis, cryoglobulinemia, cold-agglutinin disease, or evidence of disease transformation should be considered for therapy. Plasmapheresis should be considered for symptomatic hyperviscosity and for prophylaxis in patients in whom rituximab therapy is contemplated. The use of rituximab as monotherapy or in combination with cyclophosphamide, nucleoside analog, bortezomib, or thalidomide-based regimens can be considered for the first-line therapy of WM and should take into account specific treatment goals, future autologous stem cell transplantation eligibility, and long-term risks of secondary malignancies. In the salvage setting, the reuse or use of an alternative frontline regimen can be considered as well as bortezomib, alemtuzumab, and stem cell transplantation. Newer agents, such as bendamustine and everolimus, can also be considered in the treatment of WM.
Coagulation factors IX through XIII and the risk of future venous thrombosis: the Longitudinal Investigation of Thromboembolism Etiology
Authors: Cushman Mary , O'Meara Ellen S. , Folsom Aaron R. , Heckbert Susan R.
Published: July 2009

Higher levels of procoagulant factors and factor XII deficiency may be risk factors for first venous thromboembolism (VTE). We studied associations of coagulation factors IX through XIII with risk of future VTE in 2 general population samples. Using a nested case-control study combining the 21 860 participants of the Atherosclerosis Risk in Communities study and the Cardiovascular Health Study, we determined antigenic levels of these coagulation factors in primarily pre-event blood samples from 462 participants who subsequently developed VTE and 1047 participants who remained free of VTE. Only elevated levels of factors IX and XI were associated with increased risk of VTE after adjustment for age, sex, race, and study. For factor IX, the odds ratio (OR) was 1.4 (95% confidence interval [CI], 1.0-2.0) comparing the top to bottom quintile. The OR for factor XI was higher: 2.0 (95% CI, 1.4-2.9). With further adjustment for body mass index and diabetes, only elevated factor XI remained associated with VTE risk: OR 1.8 (95% CI, 1.3-2.7). Associations were similar by study and whether the thrombosis was idiopathic or secondary. Factor XII deficiency was not related to VTE risk. Among these procoagulant factors, only elevated factor XI was a risk factor for VTE.
The CD8+ memory T-cell state of readiness is actively maintained and reversible
Authors: Allam Atef , Conze Dietrich B. , Giardino Torchia Maria Letizia , Munitic Ivana , Yagita Hideo , Sowell Ryan T. , Marzo Amanda L. , Ashwell Jonathan D.
Published: July 2009

The ability of the adaptive immune system to respond rapidly and robustly upon repeated antigen exposure is known as immunologic memory, and it is thought that acquisition of memory T-cell function is an irreversible differentiation event. In this study, we report that many phenotypic and functional characteristics of antigen-specific CD8 memory T cells are lost when they are deprived of contact with dendritic cells. Under these circumstances, memory T cells reverted from G1 to the G0 cell-cycle state and responded to stimulation like naive T cells, as assessed by proliferation, dependence upon costimulation, and interferon-γ production, without losing cell surface markers associated with memory. The memory state was maintained by signaling via members of the tumor necrosis factor receptor superfamily, CD27 and 4-1BB. Foxo1, a transcription factor involved in T-cell quiescence, was reduced in memory cells, and stimulation of naive CD8 cells via CD27 caused Foxo1 to be phosphorylated and emigrate from the nucleus in a phosphatidylinositol-3 kinase–dependent manner. Consistent with these results, maintenance of G1 in vivo was compromised in antigen-specific memory T cells in vesicular stomatitis virus-infected CD27-deficient mice. Therefore, sustaining the functional phenotype of T memory cells requires active signaling and maintenance.
Mechanical strain induces involution-associated events in mammary epithelial cells
Authors: Quaglino Ana , Salierno Marcelo , Pellegrotti Jesica , Rubinstein Natalia , Kordon Edith C
Published: July 2009

Background

Shortly after weaning, a complex multi-step process that leads to massive epithelial apoptosis is triggered by tissue local factors in the mouse mammary gland. Several reports have demonstrated the relevance of mechanical stress to induce adaptive responses in different cell types. Interestingly, these signaling pathways also participate in mammary gland involution. Then, it has been suggested that cell stretching caused by milk accumulation after weaning might be the first stimulus that initiates the complete remodeling of the mammary gland. However, no previous report has demonstrated the impact of mechanical stress on mammary cell physiology. To address this issue, we have designed a new practical device that allowed us to evaluate the effects of radial stretching on mammary epithelial cells in culture.

Results

We have designed and built a new device to analyze the biological consequences of applying mechanical stress to cells cultured on flexible silicone membranes. Subsequently, a geometrical model that predicted the percentage of radial strain applied to the elastic substrate was developed. By microscopic image analysis, the adjustment of these calculations to the actual strain exerted on the attached cells was verified. The studies described herein were all performed in the HC11 non-tumorigenic mammary epithelial cell line, which was originated from a pregnant BALB/c mouse. In these cells, as previously observed in other tissue types, mechanical stress induced ERK1/2 phosphorylation and c-Fos mRNA and protein expression. In addition, we found that mammary cell stretching triggered involution associated cellular events as Leukemia Inhibitory Factor (LIF) expression induction, STAT3 activation and AKT phosphorylation inhibition.

Conclusion

Here, we show for the first time, that mechanical strain is able to induce weaning-associated events in cultured mammary epithelial cells. These results were obtained using a new practical and affordable device specifically designed for such a purpose. We believe that our results indicate the relevance of mechanical stress among the early post-lactation events that lead to mammary gland involution.