bluuebunny/crossref_metadata_2025 huggingface dataset:
International casemix and funding models: lessons for rehabilitation
Authors: Turner-Stokes Lynne , Sutch Stephen , Dredge Robert , Eagar Kathy
Published: November 2011

This series of articles for rehabilitation in practice aims to cover a knowledge element of the rehabilitation medicine curriculum. Nevertheless they are intended to be of interest to a multidisciplinary audience. The competency addressed in this article is ‘An understanding of the different international models for funding of health care services and casemix systems, as exemplified by those in the US, Australia and the UK.’

Background: Payment for treatment in healthcare systems around the world is increasingly based on fixed tariff models to drive up efficiency and contain costs. Casemix classifications, however, must account adequately for the resource implications of varying case complexity. Rehabilitation poses some particular challenges for casemix development.

Objective: The objectives of this educational narrative review are (a) to provide an overview of the development of casemix in rehabilitation, (b) to describe key characteristics of some well-established casemix and payment models in operation around the world and (c) to explore opportunities for future development arising from the lessons learned.

Results: Diagnosis alone does not adequately describe cost variation in rehabilitation. Functional dependency is considered a better cost indicator, and casemix classifications for inpatient rehabilitation in the United States and Australia rely on the Functional Independence Measure (FIM). Fixed episode-based prospective payment systems are shown to contain costs, but at the expense of poorer functional outcomes. More sophisticated models incorporating a mixture of episode and weighted per diem rates may offer greater flexibility to optimize outcome, while still providing incentive for throughput.

Conclusion: The development of casemix in rehabilitation poses similar challenges for healthcare systems all around the world. Well-established casemix systems in the United States and Australia have afforded valuable lessons for other countries to learn from, but have not provided all the answers. A range of casemix and payment models is required to cater for different healthcare cultures, and casemix tools must capture all the key cost-determinants of treatment for patients with complex needs.
Effectiveness of constraint-induced movement therapy on activity and participation after stroke: a systematic review and meta-analysis of randomized controlled trials
Authors: Peurala Sinikka H , Kantanen Mari P , Sjögren Tuulikki , Paltamaa Jaana , Karhula Maarit , Heinonen Ari
Published: November 2011

Objective: To examine the effect of constraint-induced movement therapy and modified constraint-induced movement therapy on activity and participation of patients with stroke (i.e. the effect of different treatment durations and frequency) by reviewing the results of randomized controlled trials.

Data sources: A systematic literature search was conducted in MEDLINE, CINAHL, EMBASE, PEDro, OTSeeker, CENTRAL and by manual search.

Review methods: Randomized controlled trials for patients over 18 years old with stroke and published in Finnish, Swedish, English or German were included. Studies were collected up to the first week in May 2011. The evidence was high, moderate, low or no evidence according to the quality of randomized controlled trial and the results of meta-analyses.

Results: Search resulted in 30 papers reporting constraint-induced movement therapy, including 27 randomized controlled trials published between 2001 and 2011. Constraint-induced movement therapy practice for 60–72 hours over two weeks produced better mobility (i.e. ability to carry, move and handle objects) with high evidence compared to control treatment. Constraint-induced movement therapy for 20–56 hours over two weeks, 30 hours over three weeks and 15–30 hours over 10 weeks improved mobility of the affected upper extremity. However, with self-care as an outcome measure, only 30 hours of constraint-induced movement therapy practice over three weeks demonstrated an improvement.

Conclusion: Constraint-induced movement therapy and modified constraint-induced movement therapy proved to be effective on affected hand mobility and to some extent self-care on the World Health Organization’s International Classification of Functioning, Disability and Health activity and participation component, but further studies are needed to find out the optimal treatment protocols for constraint-induced movement therapy.
Difficulties in defining hate crime victimization
Authors: Garland Jon
Published: November 2011

This article analyses the issues involved with deciding which identity groups are categorized as specific hate crime victim groups and which are not. It assesses whether theories of hate crime based around hierarchical notions of group dominance and subordination are helpful in determining which groups should be included under the hate crime ‘umbrella’. Through a discussion of the victimization of disabled people, the elderly and the homeless, the article outlines key concepts – relating to community, risk, harm and vulnerability – that are central to comprehending the nature of the abuse that they suffer. It also notes the common misreading of ‘low-level’ targeted harassment as anti-social behaviour, and assesses the impact this has upon the development of a more in-depth understanding of the circumstances of victims. The article also highlights the problems with using collective terms like ‘communities’ or ‘groups’ in this context, as such entities can be very diverse – indeed ‘separate’ groups often intersect with each other. As an alternative, it is suggested that moving the debate away from collective terminology towards an understanding of the risk of targeted victimization that individuals face would be helpful when trying to assess the circumstances of disabled people, the elderly and the homeless, who currently are still at the margins of the hate debate.
Naming the ‘R’ word in racial victimization: Violence against Indian students in Australia
Authors: Mason Gail
Published: November 2011

In 2009, thousands of international students, led by the Federation of Indian Students in Australia, staged a public protest in the central business district of Melbourne in Australia. One focus of the demonstration was the claim that Indian students living in Australia were being deliberately targeted for racist violence and crime.  In the months following the demonstrations, many deep-seated problems in the international education industry were revealed, generating multiple and ongoing reviews of the education, migration, housing, transport and criminal justice sectors. This article focuses on the ways in which police services and political leaders have responded to the claim that racism is behind the victimization of Indian students studying and living in Australia. It will argue that, with one or two exceptions, both have responded with a range of discursive strategies that, ultimately, amount to a form of denial. Significantly, this is not a denial of the problem of violence itself but, rather, a denial of the racial character of that violence. Such denial raises the question: can racist victimization, or any form of hate crime, truly be acknowledged if the prejudiced or biased nature of that victimization is not accorded public recognition and condemnation?
Responsive Interaction Interventions for Children With or at Risk for Developmental Delays
Authors: Kong Na Young , Carta Judith J.
Published: November 2011

The purpose of this article is to synthesize the available studies regarding responsive interaction intervention (RII) for children with or at risk for developmental delays with a focus on six dimensions: (a) the characteristics of participants, (b) the features of RII, (c) the measurement of treatment fidelity, (d) the overall effectiveness of RII as reflected by the percentage of studies reporting significant changes in adult or child outcomes, (e) the measurement of maintenance and generalization of RII effects, and (f) the social validity or level of acceptability. Through a search of articles from 1990 to 2010, the authors identified 26 studies (31 articles) employing group experimental or quasiexperimental designs incorporating these dimensions. Overall, the results of the reviewed studies indicated that implementation of RII resulted in significant positive changes in adults’ responsive behaviors and children’s emotional and social-communicative outcomes. Although the most frequently reported child outcomes were in the social-communication domain, the most consistently significant positive outcomes for parent and child outcomes were in the emotional domain. The authors identify several gaps in this literature and suggest areas where research is needed.
Thermoplastic natural rubber composites reinforced with OMMT, MWNTs, and hybrid OMMT–MWNTs
Authors: Tarawneh Mou'ad A. , Ahmad Sahrim H. , Noum Se Yong Eh , Ahmad Ku Zarina Ku
Published: November 2011

This article discusses the inclusion of MWNTs, nanoclay (OMMT), and hybrid nanofillers (MWNTs–OMMT) as reinforcing agents to improve the mechanical properties of TPNR. TPNR is a blend of PP, LNR as a compatibilizer, and NR at the percentage of volume ratio 70:10:20, respectively. The total reinforcement content is fixed at 4 wt%. The TPNR with 4 wt% OMMT, 4 wt% MWNTs, and hybrid 2 wt% OMMT2 wt% MWNTs was compounded using the internal mixer. The results show that the properties of the composite were improved by using the hybrid nanofillers. The tensile strength and Young's modulus for TPNR −2 wt% MWNTs −2 wt% OMMT hybrid nanofillers are the highest compared with TPNR/4 wt% MWNTs, TPNR/4 wt% OMMT, and TPNR. However, the elongation at break considerably decreased with the hybrid nanofiller. The effect of MWNTs, OMMT, and hybrid MWNTs–OMMT was also confirmed by DMA. This showed that the storage modulus E′, loss modulus E″, and glass transition temperature ( Tg) also increased for all samples reinforced with nanofillers . TEM micrographs revealed the interfacial adhesion between the fillers and the matrix, which contributed significantly to the improvement of the properties.
RhoA/ROCK may involve in cardiac hypertrophy induced by experimental hyperthyroidism
Authors: Na Wang , Peng Guan , Jianping Zhang , Yanzhong Chang , Shengjiang Guan , Li Chu
Published: November 2011

In this study, the role of the RhoA/Rho-kinase (RhoA/ROCK)-signaling pathway in cardiovascular dysfunction associated with hyperthyroidism was examined with the use of fasudil, a Rho-kinase inhibitor. Male Spraque-Dawley rats were treated with l-thyroxine (T4) alone, T4 + low-dose fasudil (2 mg/kg/day) or T4 + high-dose fasudil (10 mg/kg/day) and compared with control animals. Rats in the T4 group showed an increase in the ratio of heart weight to body weight, which was ameliorated by fasudil at both low and high doses. Morphometric and hemodynamic parameters were also evaluated and confirmed that fasudil attenuated the cardiac hypertrophy induced by T4. The extent of phosphorylation of the myosin phosphatase targeting subunit was quantified by Western blotting to evaluate the activity of Rho-kinase in the heart tissue. Both Western blotting and reverse transcriptase–polymerase chain reaction analyses revealed enhancement of Rho-kinase and activator protein 1 activity and reduction of c-FLIPL expression in the T4 group, and this response was inhibited by f asudil in a dose-dependent manner. Furthermore, f asudil inhibited apoptosis induced by T4 as evidenced by the detection of terminal deoxynucleotidyl transferase dUTP nick end labeling–positive cells and the expressions of bax and bcl-2. These results suggested that the RhoA/ROCK pathway is involved in the cardiac hypertrophy induced by experimental hyperthyroidism. The antagonism of this pathway may thus be useful as an alternative target in the treatment of hyperthyroid heart disease.
Effect of ionic products of dicalcium silicate coating on osteoblast differentiation and collagen production via TGF-β1 pathway
Authors: Li Jianyou , Wei Li , Sun Junying , Guan Guohua
Published: November 2011

In this work, the medium containing ionic products of dicalcium silicates (Ca2SiO4) for culturing MG63 cells was prepared by immersing a titanium alloy plate with the plasma sprayed Ca2SiO4 coatings in DMEM solution. The effect of the ionic products on cellular differentiation, collagen production, and local growth factors (prostaglandin E2 [PGE2] and transforming growth factor-β [TGF-β1]) of osteoblast-like MG63 cells were investigated. The normal DMEM was also used to culture MG63 cells as the control group. Differentiation of cell was evaluated by detecting alkaline phosphatase (ALP) activity and osteocalcin (OC) synthesis as well as their gene expression. Collagen production was analyzed by Sircol assay. The levels of PGE2 and TGF-β1 in culture medium were measured using enzyme-linked immunosorbent assay (ELISA). The gene expressions of TGF-β receptors (TGF-β RI and TGF-β RII) were also measured by real-time PCR technology. MG63 cells cultured in DMEM containing ionic products of Ca2SiO4 coating showed enhanced differentiation and increased collagen production. The results obtained from ELISA showed that the levels of PGE2 and TGF-β1 in experimental group were higher than that in control. The gene expression of TGF-β receptors was upregulated, indicating that more TGF-β1 bonded to their receptors which produce more effects on the osteoblastic activity, leading to enhanced differentiation and synthetic activity of osteoblast. It is concluded that ionic products of Ca2SiO4 coating may enhance cellular differentiation and collagen production by influencing TGF-β1 pathway.
Cystatin C is associated with inflammation but not atherosclerosis in systemic lupus erythematosus
Authors: Lertnawapan R , Bian A , Rho YH , Raggi P , Oeser A , Solus JF , Gebretsadik T , Shintani A , Stein CM
Published: November 2011

Background: Even mild renal impairment is associated with increased atherosclerosis and cardiovascular mortality. Cystatin C, a novel measure of renal function, is more sensitive than conventional creatinine-based measures for the detection of subtle renal impairment. Increased cystatin concentrations are also associated with cardiovascular risk, independently of conventional measures of renal function. This study examined the hypothesis that cystatin C is elevated in systemic lupus erythematosus (SLE) and is associated with coronary atherosclerosis.

Methods: Serum cystatin C, creatinine, tumor necrosis factor (TNF)-α, interleukin (IL)-6, coronary artery calcium score (CACS), Framingham risk score (FRS), Modified Diet in Renal Disease estimated glomerular filtration rate (MDRD-eGFR), and other clinical parameters were measured in 118 patients with SLE and 83 control subjects. The independent association between concentrations of cystatin C and SLE was evaluated using multivariable linear regression models, and the relationship between renal measures and coronary calcium was assessed with multivariable proportional odds logistic regression models.

Results: Cystatin C, but not other measures of renal function, was significantly higher in patients with SLE than in controls (1.09 [interquartile range, IQR: 0.85–1.28] mg/l vs. 0.89 [IQR: 0.76–0.99] mg/l; p < 0.001 after adjustment for age, race, sex and MDRD-eGFR). Cystatin C was significantly associated with SLICC ( p = 0.04), erythrocyte sedimentation rate (ESR) ( p = 0.02), TNF-α ( p = 0.008) and IL-6 ( p = 0.01) after adjustment for age, race, and sex. Cystatin C was not significantly correlated with coronary calcium score in SLE (rho=0.096, p = 0.31) and the association remained non-significant after adjustment for age, race, sex, and Framingham risk score ( p = 0.99).

Conclusions: Cystatin C was higher in patients with SLE than in control subjects even after adjustment for conventional measures of renal function. Cystatin C was significantly correlated with several markers of inflammation in SLE but was not associated with coronary atherosclerosis. Subtle renal dysfunction does not appear to be directly associated with accelerated atherosclerosis in SLE.
Sustainable Global Enterprise
Authors: Sharma Aarti , Lee Min-Dong Paul
Published: November 2011

This article explores the role of multinational enterprises (MNEs) in sustainable development by drawing on the perspectives of four distinguished management scholars—Stuart Hart, Ans Kolk, Sanjay Sharma, and Sandra Waddock—as well as the extant literature on sustainability, corporate social responsibility, and international management. The discussions are centered around “Sustainable Global Enterprise” (SGE)—a new concept coined by Hart. Hart labels those MNEs that can generate competitive strategies that simultaneously deliver economic, social, and environmental benefits for the entire world as SGEs. Through deliberations with the above leading thinkers, this article offers insights into how MNEs can imbue the sustainability principles into their strategic framework and simultaneously contribute to sustainable development. The article also sheds light on the enormous new research opportunities yet to be tapped by international management and sustainability scholars.
Combined Aldosterone and Cortisol Secretion by Adrenal Incidentaloma
Authors: Vicennati Valentina , Repaci Andrea , di Dalmazi Guido , Rinaldi Eleonora , Golfieri Rita , Giampalma Emanuela , Minni Francesco , Marrano Nicola , Santini Donatella , Pasquali Renato
Published: November 2011

A 70-year-old woman was referred to the authors’ unit following hospitalization for cardiac failure, high urinary free cortisol concentrations and severe hypokaliemia. A computed tomography scan of the abdomen showed an adrenal adenoma. The 24-hour urinary free cortisol values were high and plasma cortisol levels failed to suppress following 1 mg dexamethasone test. Aldosterone to plasma renin activity ratio was also pathologic, confirmed by saline load. She showed no symptoms of glucocorticoid excess. She was diagnosed with combined primary hyperaldosteronism and Cushing’s syndrome. Cases of adrenal incidentalomas co-secreting cortisol and aldosterone are rare; they should be addressed in patients undergoing adrenal surgery for Conn’s syndrome to avoid adrenal insufficiency after removal of the tumor.
Institutional Perceptions of Opportunities and Challenges of REDD+ in the Congo Basin
Authors: Brown H.Carolyn Peach , Smit Barry , Sonwa Denis J. , Somorin Olufunso A. , Nkem Johnson
Published: November 2011

Tropical forests have a central role to play in a new mechanism designed to mitigate climate change, known as REDD+ (Reduced Emissions From Deforestation and Forest Degradation). Through semistructured interviews and content analysis of relevant documents, the perceptions of the opportunities and challenges of REDD+ of institutions, who may be directly implicated in or affected by its implementation are investigated. Research takes place in three Central African countries, Cameroon, Central African Republic, and Democratic Republic of Congo, which contain the Congo Basin forest. Perception of opportunities include economic development and poverty reduction, biodiversity conservation, network building, and governance reform. Challenges identified include REDD+’s complexity, lack of technical capacity for implementation, opportunities for participation, benefit sharing, and the traditional system of shifting cultivation. Those involved in designing REDD+ internationally need to understand developing-country perspectives, and institutions at all levels need to work together to develop concrete strategies to improve overall outcomes.
Occurrence, Characteristics, and Impact of Chronic Pain in Formerly Abused Women
Authors: Humphreys Janice , Cooper Bruce A. , Miaskowski Christine
Published: November 2011

The purposes of this study were to describe the occurrence of chronic pain and to evaluate for differences in pain characteristics and intimate partner violence between women who reported mild compared with moderate to severe chronic pain. A convenience sample of community-based women ( N = 84) was recruited. The 77% of women who reported chronic pain were dichotomized into two groups. Women with moderate to severe pain ( n = 49) were significantly more likely to be unemployed, to be in the abusive relationship longer, to report more minor injuries and threats of violence, and to report pain in multiple locations that significantly interfered with every aspect of their lives.
The Post-Interstate Era
Authors: Mohl Raymond A. , Rose Mark H.
Published: November 2011

This essay highlights key themes of the five essays that comprise this special issue of the Journal of Planning History on the post-Interstate Era. It outlines in broad strokes the role of highway engineers and politicians in planning and financing the Interstate Highway System. The Interstates had a positive impact on economic growth and automobility, yet citizens groups in many cities challenged route decisions that destroyed neighborhoods and damaged sensitive environments. By the early 1970s, when the Interstate System was mostly completed, Congress opened up the Highway Trust Fund for mass transit alternatives. However, our authors emphasize the persistence of conflict over transportation planning and policy. Construction of late-developing Interstate segments in cities such as St. Paul, Minnesota and Huntsville, Alabama revived the freeway revolt, but unsuccessfully. Highway planners and policy experts developed controversial new strategies for moving traffic, as in Boston’s “Big Dig,” or for creative transportation financing, as with the Chicago Skyway and the Pennsylvania Turnpike. By the end of the twentieth century, planners and politicians in some cities sought to reverse poor route decisions of an earlier era by tearing down elevated freeway segments most judged ugly, onerous, and unnecessary. In the twenty-first century, the engineers, planners, and politicians who control the Interstate Highway System face new challenges as the aging highway infrastructure requires rebuilding and retrofitting in an era of economic decline and political cost cutting.
The Expressway Teardown Movement in American Cities
Authors: Mohl Raymond A.
Published: November 2011

At least two dozen American cities have discussed or planned removals or teardowns of inner-city elevated expressways, and a few cities have already done so. In the 1970s, Boston, New York City, and Portland, Oregon initiated such teardowns, each with a different replacement: Boston began replacing its elevated Central Artery with a system of tunnels, later known as the Big Dig; New York replaced its West Side Highway with a street-level boulevard; and Portland bulldozed its Harbor Drive to make way for a waterfront park. Now, many cities are re-evaluating past highway policy that pushed elevated interstate highways through central cities, with consequent severe damage to housing, businesses, and neighborhoods. The teardown movement is high on the agenda of the Congress for the New Urbanism, now headed by John Norquist. A former Mayor of Milwaukee, Norquist pioneered the twenty-first century expressway teardown in an effort to eliminate an unneeded eyesore and spur downtown economic development. This article surveys the debate over teardown policy in several cities. It also analyzes the movement generally, suggesting that the main thrust is to compensate for past decisions that damaged central cities, but that the movement poses no threat to the heavily used urban expressways that millions of drivers rely on every day. Many teardown advocates have also promoted greater investment in mass transit and light rail.
Gender Differences in Cancer Screening Beliefs, Behaviors, and Willingness to Participate
Authors: Davis Jenna L. , Buchanan Kyrel L. , Katz Ralph V. , Green B. Lee
Published: November 2011

Men have higher cancer mortality rates for all sites combined compared with women. Cancer screening (CS) participation is important for the early detection of cancer. This study explores gender differences in CS beliefs, behaviors, and willingness to participate. The data were collected from a stratified, random-digit dial survey of adults living in New York, Maryland, and Puerto Rico. Chi-square tests and logistic regressions were computed to analyze gender associations among CS beliefs, behaviors, and willingness variables. Men and women believed that CSs were effective, though a higher percentage of men had never had a past CS. Men were less willing to participate in a CS at the present time and in a skin cancer exam; however, when given descriptions of screening conditions, men indicated more willingness to participate. These gender differences highlight the need for health professionals to examine their efforts in providing enhanced CS promotion and education among men.
Sunitinib in advanced pancreatic neuroendocrine tumors: latest evidence and clinical potential
Authors: Delbaldo Catherine , Faivre Sandrine , Dreyer Chantal , Raymond Eric
Published: November 2011

Based on preclinical data available in the RIP1-Tag2 transgenic mouse model, sunitinib is an inhibitor of angiogenesis in pancreatic neuroendocrine tumors blocking vascular endothelial growth factor receptors and platelet-derived growth factor receptors in endothelial cells and pericytes, respectively. Evidence of objective response in phase I trials justified the initiation of a large phase II/III program using sunitinib in patients with advanced/metastatic well-differentiated pancreatic neuroendocrine tumors. In the phase II study, sunitinib showed potent antitumor activity and a safe toxicity profile. In a recent double-blind placebo-controlled randomized phase III trial, sunitinib doubled the progression-free survival of patients, induced objective responses, and reduced the risk of death of patients with advanced/metastatic well-differentiated tumors. These data allowed the approval of sunitinib in several countries including Europe and the United States of America. These recent data provide hope for patients with well-differentiated pancreatic neuroendocrine tumors and will change standards of care in this disease.
Rehabilitation after Articular Cartilage Repair of the Knee in the Football (Soccer) Player
Authors: Hambly Karen , Silvers Holly Jacinda , Steinwachs Matthias
Published: November 2011

Background: Participation in football can put both male and female players at an increased risk for knee osteoarthritis. There is a higher prevalence of focal chondral defects in the knee of athletes compared to nonathletes. The management of chondral defects in the football player is complex and multifactorial. Objective: The aim of this study is to provide an overview of the current strategies for rehabilitation after articular cartilage repair of the knee in the football player. Design: A review of current literature and the scientific evidence for rehabilitation after articular cartilage repair of the knee. Conclusions: Articular cartilage repair has been shown to allow return to sport but rehabilitation timescales are lengthy. Successful rehabilitation for a return to football after articular cartilage repair of the knee requires the player to be able to accept the load of the sport. This necessitates a multidisciplinary approach to rehabilitation, especially in the transition from therapy to performance care. It should be recognized that not all players will return to football after articular cartilage repair. The evidence base for rehabilitative practice after articular cartilage repair is increasing but remains sparse in areas.
Osteochondral and Meniscal Allograft Transplantation in the Football (Soccer) Player
Authors: Görtz Simon , Williams Riley J. , Gersoff Wayne K. , Bugbee William D.
Published: November 2011

Knee injuries are common in football, frequently involving damage to the meniscus and articular cartilage. These injuries can cause significant disability, result in loss of playing time, and predispose players to osteoarthritis. Osteochondral allografting is an increasingly popular treatment option for osteoarticular lesions in athletes. Osteochondral allografts provide mature, orthotopic hyaline cartilage on an osseous scaffold that serves as an attachment vehicle, which is rapidly replaced via creeping substitution, leading to reliable graft integration that allows for simplified rehabilitation and accelerated return to sport. The indications for meniscal replacement in football players are currently still evolving. Meniscus allografts offer potential functional, analgesic, and chondroprotective benefits in the meniscectomized knee. In the player at the end of his or her professional/competitive career, meniscal allografts can play a role in averting progression of chondropenia and facilitating knee function and an active lifestyle. This article is intended to present a concise overview of the limited published results for osteochondral and meniscal allografting in the athletic population and to provide a practical treatment algorithm that is of relevance to the clinician as well as the patient/football player, based on current consensus of opinion.
Microfracture in Football (Soccer) Players
Authors: Mithoefer Kai , Steadman Richard J.
Published: November 2011

Background: Little information is available on the results of microfracture in competitive football (soccer) players. We aimed to evaluate the efficacy of this technique to restore joint function to a level that allows return to this popular high-impact sport. Methods: This article provides an overview of the basic science and the current published scientific evidence for articular cartilage repair using the microfracture technique in elite football (soccer) athletes. In addition, the senior author documents his results in a case series of professional football (soccer) players treated with microfracture. Results: Twenty-one professional male soccer players underwent microfracture for knee articular cartilage defects. Nineteen players had isolated cartilage injuries, and 2 players had simultaneous anterior cruciate ligament injuries. Average age of the player was 27 years (range, 18-32 years). Twelve players (57%) had single defects, and 9 (43%) had multiple defects. All players complied with the postoperative rehabilitation program. Twenty players (95%) returned to professional soccer the season following microfracture surgery and continued to play for an average of 5 years (range, 1-13 years). Years of continued play inversely correlated with player age at the time of microfracture (r = -0.41). Conclusion: Articular cartilage repair with the microfracture technique followed by appropriate rehabilitation provides restoration of knee joint function in professional football (soccer) players with a high rate of return to football (soccer) and continued participation under the significant demands of professional football (soccer). Thorough understanding of the technical aspects, rehabilitation, and literature can help to optimize the results of microfracture in the athletic population.
Mutations of NOTCH1 are an independent predictor of survival in chronic lymphocytic leukemia
Authors: Rossi Davide , Rasi Silvia , Fabbri Giulia , Spina Valeria , Fangazio Marco , Forconi Francesco , Marasca Roberto , Laurenti Luca , Bruscaggin Alessio , Cerri Michaela , Monti Sara , Cresta Stefania , Famà Rosella , De Paoli Lorenzo , Bulian Pietro , Gattei Valter , Guarini Anna , Deaglio Silvia , Capello Daniela , Rabadan Raul , Pasqualucci Laura , Dalla-Favera Riccardo , Foà Robin , Gaidano Gianluca
Published: November 2011

Analysis of the chronic lymphocytic leukemia (CLL) coding genome has recently disclosed that the NOTCH1 proto-oncogene is recurrently mutated at CLL presentation. Here, we assessed the prognostic role of NOTCH1 mutations in CLL. Two series of newly diagnosed CLL were used as training (n = 309) and validation (n = 230) cohorts. NOTCH1 mutations occurred in 11.0% and 11.3% CLL of the training and validation series, respectively. In the training series, NOTCH1 mutations led to a 3.77-fold increase in the hazard of death and to shorter overall survival (OS; P < .001). Multivariate analysis selected NOTCH1 mutations as an independent predictor of OS after controlling for confounding clinical and biologic variables. The independent prognostic value of NOTCH1 mutations was externally confirmed in the validation series. The poor prognosis conferred by NOTCH1 mutations was attributable, at least in part, to shorter treatment-free survival and higher risk of Richter transformation. Although NOTCH1 mutated patients were devoid of TP53 disruption in more than 90% cases in both training and validation series, the OS predicted by NOTCH1 mutations was similar to that of TP53 mutated/deleted CLL. NOTCH1 mutations are an independent predictor of CLL OS, tend to be mutually exclusive with TP53 abnormalities, and identify cases with a dismal prognosis.
Increased Activation of the PI3K/AKT Pathway Compromises Decidualization of Stromal Cells from Endometriosis
Authors: Yin Xunqin , Pavone Mary Ellen , Lu Zhenxiao , Wei JianJun , Kim J. Julie
Published: November 2011

Context:

Endometriosis affects approximately 10% of women in the United States and causes pain and infertility. Decidualization of endometrial stromal cells from women with endometriosis is aberrant.

Objective:

The objective of this study was to investigate a potential mechanism for the inadequate decidual response in stromal cells from ovarian endometriomas.

Design:

Stromal cells of the endometrium from women without endometriosis (HSC) or from ovarian endometriomas (OsisSC) were grown in culture and treated with 10 μm LY294002 or 250 nm MK2206, 100 nm medroxyprogesterone acetate (M), and 0.5 mm dibutyryl cAMP (A) or infection with 100 multiplicity of infection adenoviral constructs containing wild-type Forkhead box O1 or triple-mutant FOXO1. Real-time PCR was used to measure the expression of FOXO1, IGF binding protein-1 (IGFBP1), and prolactin (PRL) mRNA, and Western blot and immunohistochemical staining were used to detect the levels of progesterone receptor (PR), FOXO1, AKT, and p(Ser473)-AKT protein in vitro or in vivo.

Results:

Expression of the decidua-specific genes, IGFBP1 and PRL, were significantly lower in OsisSC compared with normal HSC in response to M+A treatment. Basal expression levels of PRA, PRB, and FOXO1 proteins were dramatically lower in OsisSC. Overexpression of triple-mutant FOXO1 increased mRNA levels of IGFBP1 and PRL in OsisSC in the presence of M+A, whereas the overexpression of wild-type FOXO1 had no effect. AKT was highly phosphorylated in OsisSC compared with HSC and inhibition of phosphatidylinositol 3-kinase, with LY294002, increased levels of FOXO1 protein as well as IGFBP1 mRNA in the presence of M+A. Moreover, inhibition of AKT with MK2206, an allosteric AKT inhibitor, dramatically increased the accumulation of nuclear FOXO1 as well as expression of IGFBP1. Finally, immunohistochemical staining demonstrated higher p(Ser473)-AKT and lower FOXO1 levels in endometriosis tissues, compared with normal endometrial tissues.

Conclusions:

In endometriotic stromal cells, overactivation of the phosphatidylinositol 3-kinase/AKT signaling pathway contributes to the reduced expression of the decidua-specific gene, IGFBP1, potentially through reduced levels of nuclear FOXO1.
Pioglitazone-Mediated Changes in Lipoprotein Particle Composition Are Predicted by Changes in Adiponectin Level in Type 2 Diabetes
Authors: Sam Susan , Haffner Steven , Davidson Michael H. , D'Agostino Ralph , Perez Alfonso , Mazzone Theodore
Published: November 2011

Context:

In animal and observational studies, adiponectin is associated with lipoprotein risk factors for cardiovascular disease.

Objective:

We analyzed data from a randomized clinical trial to evaluate the relationship between changes in adiponectin to changes in lipoprotein risk factors after an intervention that alters adiponectin levels.

Design and Setting:

Adiponectin levels were measured at baseline and follow-up, as were lipoprotein risk factors for cardiovascular disease, at academic medical centers and ambulatory care centers.

Patients and Other Participants:

Participants included 361 men and women with type 2 diabetes.

Intervention:

Intervention included randomization to treatment with glimepiride or pioglitazone for 72 wk.

Main Outcome Measure:

The relationship of treatment-related differences in adiponectin level to treatment-related differences in lipoprotein cardiovascular risk factors at 72 wk was evaluated.

Results:

Pioglitazone led to an increase in adiponectin compared with glimepiride. Compared with baseline, pioglitazone treatment at 72 wk led to an increase in low-density lipoprotein (LDL) and high-density lipoprotein (HDL) particle size and a decrease in very-low-density lipoprotein (VLDL) particle size and LDL particle number. Glimepiride treatment more modestly decreased LDL particle number and increased LDL particle size. At 72 wk, there were significant treatment group differences for HDL, LDL, and VLDL particle size, and triglyceride and HDL cholesterol level. The increase in adiponectin predicted treatment-related improvement for triglyceride and HDL cholesterol level and LDL and HDL particle size.

Conclusion:

Increased adiponectin contributed to treatment-related benefit in lipoprotein cardiovascular disease risk factors in obese diabetic subjects treated with pioglitazone. These results provide support for a model that mechanistically links changes in adiponectin level to changes in lipoprotein composition in humans.
The Fate of Christian Communism
Authors: Boer Roland
Published: November 2011

Why has Christian communism always remained a peripheral if persistent feature of Christianity? This study explores the origins of the idea in the biblical book of Acts of the Apostles, the foregrounding of such communism in the work of Friedrich Engels, Rosa Luxemburg, and Karl Kautsky, and how their work influenced, often in polemical response, biblical scholarship on early Christianity. In particular, this tradition of Christian communism has taken two forms, one concerned with communal living and “having all things in common” and the other with the revolutionary origins of Christianity. While Engels argued for the latter, Luxemburg and Kautsky argued for the former. Some of the basic assumptions of these arguments persist in biblical scholarship: the appeal of Christianity to the lower classes, the ground-shaking nature of the movement, but also the betrayal involved in becoming a religion of the state. But did Christian communism actually exist in earliest, first-, or even second-century Christianity? The evidence is exceedingly slender if not nonexistent. And so I take a dialectical line, arguing that the probable nonexistence of early Christian communism is precisely the basis for the political myth of Christian communism. Later this myth would gain historical traction through those who sought to emulate the myth. One question remains: why did this political myth not become central to Christianity? I argue that it was a regressive myth, attempting to hold on to a fading economic form rather than (like Paul) offering a mediation that enabled a transition to the newer, slave-based mode of production of the Hellenistic world.
The peripheral nervous system supports blood cell homing and survival in theDrosophilalarva
Authors: Makhijani Kalpana , Alexander Brandy , Tanaka Tsubasa , Rulifson Eric , Brückner Katja
Published: November 2011

Interactions of hematopoietic cells with their microenvironment control blood cell colonization, homing and hematopoiesis. Here, we introduce larval hematopoiesis as the first Drosophila model for hematopoietic colonization and the role of the peripheral nervous system (PNS) as a microenvironment in hematopoiesis. The Drosophila larval hematopoietic system is founded by differentiated hemocytes of the embryo, which colonize segmentally repeated epidermal-muscular pockets and proliferate in these locations. Importantly, we show that these resident hemocytes tightly colocalize with peripheral neurons and we demonstrate that larval hemocytes depend on the PNS as an attractive and trophic microenvironment. atonal (ato) mutant or genetically ablated larvae, which are deficient for subsets of peripheral neurons, show a progressive apoptotic decline in hemocytes and an incomplete resident hemocyte pattern, whereas supernumerary peripheral neurons induced by ectopic expression of the proneural gene scute (sc) misdirect hemocytes to these ectopic locations. This PNS-hematopoietic connection in Drosophila parallels the emerging role of the PNS in hematopoiesis and immune functions in vertebrates, and provides the basis for the systematic genetic dissection of the PNS-hematopoietic axis in the future.
Six3 is required for ependymal cell maturation
Authors: Lavado Alfonso , Oliver Guillermo
Published: November 2011

Ependymal cells are part of the neurogenic niche in the adult subventricular zone of the lateral ventricles, where they regulate neurogenesis and neuroblast migration. Ependymal cells are generated from radial glia cells during embryonic brain development and acquire their final characteristics postnatally. The homeobox gene Six3 is expressed in ependymal cells during the formation of the lateral wall of the lateral ventricles in the brain. Here, we show that Six3 is necessary for ependymal cell maturation during postnatal stages of brain development. In its absence, ependymal cells fail to suppress radial glia characteristics, resulting in a defective lateral wall, abnormal neuroblast migration and differentiation, and hydrocephaly.
Eph/ephrin interactions modulate muscle satellite cell motility and patterning
Authors: Stark Danny A. , Karvas Rowan M. , Siegel Ashley L. , Cornelison D. D. W.
Published: November 2011

During development and regeneration, directed migration of cells, including neural crest cells, endothelial cells, axonal growth cones and many types of adult stem cells, to specific areas distant from their origin is necessary for their function. We have recently shown that adult skeletal muscle stem cells (satellite cells), once activated by isolation or injury, are a highly motile population with the potential to respond to multiple guidance cues, based on their expression of classical guidance receptors. We show here that, in vivo, differentiated and regenerating myofibers dynamically express a subset of ephrin guidance ligands, as well as Eph receptors. This expression has previously only been examined in the context of muscle-nerve interactions; however, we propose that it might also play a role in satellite cell-mediated muscle repair. Therefore, we investigated whether Eph-ephrin signaling would produce changes in satellite cell directional motility. Using a classical ephrin ‘stripe’ assay, we found that satellite cells respond to a subset of ephrins with repulsive behavior in vitro; patterning of differentiating myotubes is also parallel to ephrin stripes. This behavior can be replicated in a heterologous in vivo system, the hindbrain of the developing quail, in which neural crest cells are directed in streams to the branchial arches and to the forelimb of the developing quail, where presumptive limb myoblasts emigrate from the somite. We hypothesize that guidance signaling might impact multiple steps in muscle regeneration, including escape from the niche, directed migration to sites of injury, cell-cell interactions among satellite cell progeny, and differentiation and patterning of regenerated muscle.
Are the currently used reference intervals for creatine kinase (CK) reflecting the general population? The Tromsø Study
Authors: Lilleng Hallvard , Johnsen Stein Harald , Wilsgaard Tom , Bekkelund Svein Ivar
Published: November 2011

Laboratory reference intervals are not necessarily reflecting the range in the background population. This study compared creatine kinase (CK) reference intervals calculated from a large sample from a Norwegian population with those elaborated by the Nordic Reference Interval Project (NORIP). It also assessed the pattern of CK-normalization after standardized control analyses.

New upper reference limits (URL) CK values were calculated after exclusion of individuals with risk of hyperCKemia and including individuals with incidentally detected hyperCKemia after they had completed a standardized control analysis. After exclusion of 5924 individuals with possible causes of hyperCKemia, CK samples were analyzed in 6904 individuals participating in the 6th survey of The Tromsø Study. URL was defined as the 97.5 percentile.

New URL in women was 207 U/L. In men <50 years it was 395 U/L and in men ≥50 years 340 U/L. In individuals with elevated CK, normalization grade after control analysis was inversely correlated to the CK level (p<0.04).

URL CK values in women and in men <50 years of age were in accordance with URL CK values given by the NORIP. In men ≥50 years, a higher URL was found and the findings suggest an upward adjustment of URL in this age group.
The impacts of nanotechnology on catalysis by precious metal nanoparticles
Authors: Jin Rongchao
Published: November 2011

This review article focuses on the impacts of recent advances in solution phase precious metal nanoparticles on heterogeneous catalysis. Conventional nanometal catalysts suffer from size polydispersity. The advent of nanotechnology has significantly advanced the techniques for preparing uniform nanoparticles, especially in solution phase synthesis of precious metal nanoparticles with excellent control over size, shape, composition and morphology, which have opened up new opportunities for catalysis. This review summarizes some recent catalytic research by using well-defined nanoparticles, including shape-controlled nanoparticles, high index-faceted polyhedral nanocrystals, nanostructures of different morphology (e.g., core-shell, hollow, etc.), bi- and multi-metallic nanoparticles, as well as atomically precise nanoclusters. Such well-defined nanocatalysts provide many exciting opportunities, such as identifying the types of active surface atoms (e.g., corner and edge atoms) in catalysis, the effect of surface facets on catalytic performance, and obtaining insight into the effects of size-induced electron energy quantization in ultra-small metal nanoparticles on catalysis. With well-defined metal nanocatalysts, many fundamentally important issues are expected to be understood much deeper in future research, such as the nature of the catalytic active sites, the metal-support interactions, the effect of surface atom arrangement, and the atomic origins of the structure-activity and the structure-selectivity relationships.
Prediction and prevention of type 1 diabetes mellitus: initial results and recent prospects
Authors: Madácsy László
Published: November 2011

Epidemiological studies indicate that the incidence and prevalence of type 1 diabetes mellitus is rising worldwide. The increase in incidence has been most prominent in the youngest age group of childhood. Prediction of type 1a autoimmune diabetes can be established by a positive family history or by genetic, immunological or metabolic markers. Prevention of type 1 diabetes can be implemented at three different levels of pathogenesis: primary prevention in individuals without any sign of beta-cell damage, secondary prevention in individuals with signs of beta-cell destruction and tertiary prevention in patients with newly diagnosed type 1 diabetes. In the recent years our knowledge of the disease pathogenesis has grown quickly and worldwide several new prevention trials have been started. Probably immune intervention of type 1 diabetes will prove to be the most effective. Orv. Hetil., 2011, 152, 1916–1921.