bluuebunny/crossref_metadata_2025 huggingface dataset:
‘Fullness of the Spirit’ and ‘Fullness of Catholicity’ in Ecclesial Communion
Authors: KUEHN EVAN F.
Published: June 2009

In this article I will consider two terms central to post‐conciliar ecclesiology, both of which express different aspects of the ‘fullness’ of the church. The ‘fullness of the Spirit’ is a biblical concept describing the pouring out of the Spirit at Pentecost and in the historical sacrament of confirmation, while the ‘fullness of catholicity’ is a more recent term employed in conciliar and post‐conciliar discourse to clarify the status of churches and ecclesial communities within the church of Christ. After analyzing the origin and development of each form of fullness, constructive interaction between the two will allow for a critique of post‐conciliar ecclesiological and ecumenical statements.
The Spirit in the Church: The Universal Christ, Particular Spirit and Christian Unity
Authors: WEEDMAN MARK
Published: June 2009

Modern theology has had difficulty in producing an ecclesiology that makes the full visible unity of the church an essential aspect of the church's nature. One reason for this is that important modern ecclesiologies are built on a trinitarian model that either subordinates the Spirit to the Son, or reduces the Spirit to a vague, invisible ‘domain of resonance’, with the result that the church itself is either subordinated or rendered invisible. A new trinitarian model is needed, one that shows how the Spirit cooperates with the Son to produce a visibly united church.
Fluorescence remission spectroscopy of psoriatic lesions and the effect of topical anthralin therapy
Authors: Wollina U , Schmidt W‐D , Koch A , Scheibe A , Erfurth F , Fassler D
Published: June 2009

Background  Psoriatic lesions are characterized by induration, scaling and erythema. Erythema is a result of inflammation and increased microvascular blood flow. Anthralin is the strongest topical antipsoriatic drug that causes clearing of psoriatic lesions and temporary remission.

Objective  The objective evaluation of skin perfusion might be a suitable way to gain a better insight in the pathophysiological process of this disease and to evaluate the response to antipsoriatic anthralin therapy.

Methods  We evaluated 21 psoriatic lesions (plaques, patches and pinpoint lesions) including 4 lesions in remission with anthralin induced erythema and 4 controls of healthy, uninvolved skin. We performed the measurements with a combined fluorescence and remission imaging (FRIS). The FRIS sensor is coupled with a touch screen industrial computer. The equipment consists of a white‐light halogen lamp (20 W), two VIS‐spectrometer modules (Zeiss) for remission detection and references. Imaging is realized by CCD‐colour camera module and white light ring‐lighting. Fluorescence emission was realized using an ultraviolet LED with a wavelength of 370 nm. The fluorescence detector is a highly sensitive MCS CCD (Zeiss) with an integration time of 2.5 sec.

Results  Spectral remission of psoriatic skin is characterized by a pronounced decrease (60–80%) of the haemoglobin double‐peak compared to uninvolved skin. The NADH‐fluorescence is diminished in lesional psoriatic skin including anthralin‐treated areas with clinical remission.

Conclusions  Vascular perfusion is increased in psoriatic lesions as demonstrated by remission spectroscopy. NADH‐fluorescence is reduced in lesional psoriatic skin and in anthralin‐induced erythema. FRIS is a suitable tool for objective evaluation of the cutaneous response to antipsoriatic treatment.
Epidemiology of firesetting in adolescents: mental health and substance use correlates
Authors: MacKay Sherri , Paglia‐Boak Angela , Henderson Joanna , Marton Peter , Adlaf Edward
Published: June 2009

Objective:  Despite high rates of firesetting among community adolescents, little is known about its correlates. This study identifies the mental health and substance use correlates of four firesetting levels in an epidemiological sample of adolescents.

Methods:  Three thousand, nine hundred and sixty‐five (3,965) students in grades 7 to 12 were surveyed. Multinomial analyses were used to compare non‐firesetters; desisters (lifetime, but no past‐year firesetting); low frequency firesetters (once or twice in the past 12 months); and high frequency firesetters (3 + times) on measures of mental health and substance use.

Results:  Twenty‐seven percent of youth reported firesetting during the past year. Of these, 13.7% reported one or two episodes, and 13.5% reported 3 or more episodes. Firesetting was more prevalent among males and among those in high school. Youth who began firesetting before age 10 were more likely to report frequent firesetting during the past year. Compared to non‐firesetters, the firesetting groups had elevated risk profiles. Desisters and low frequency firesetters were more likely to report psychological distress, binge drinking, frequent cannabis use, and sensation seeking. Low frequency firesetters also reported higher rates of delinquent behavior, suicidal intent, and low parental monitoring than non‐firesetters. High frequency firesetters reported elevated risk ratios for all of these risk indicators plus other illicit drug use. The cumulative number of risk indicators was positively associated with firesetting severity.

Conclusions:  Firesetting is associated with psychopathology and substance use during adolescence. Findings highlight the need for programs to address the mental health and substance use problems that co‐occur with firesetting.
Motor function in 5‐year‐old children with cerebral palsy in the South Australian population
Authors: RICE JAMES , RUSSO REMO , HALBERT JULIE , VAN ESSEN PHILLIPA , HAAN ERIC
Published: June 2009

The aim of this study was to describe the motor function of a population of children at age 5 years enrolled on the South Australian Cerebral Palsy Register. Among children born between 1993 and 1998, there were 333 with confirmed cerebral palsy (prevalence rate 2.2 per 1000 live births), in whom 247 assessments (56.7% males, 43.3% females) were completed. The distribution by Gross Motor Function Classification System (GMFCS) level was: level I, 50.6%; level II, 18.2%; level III, 9.3%; level IV, 9.7%; level V, 12.1%. The most common topographical classification was spastic diplegia (38.5%), followed by spastic hemiplegia (34.8%) and spastic quadriplegia (14.6%). Abnormal movements occurred at rest or with intention in 19.4% of children. A high proportion of the population with relatively mild gross motor impairments have difficulty with everyday bimanual tasks, reinforcing the need to assess upper limb function independently of gross motor function. The use of ankle–foot orthoses was common, particularly across GMFCS levels II to IV. Further refinement is indicated for this population’s motor dataset, to include more recently described classification measures as well as future novel measures to better describe the presence of both spasticity and dystonia.
Scanning Electron Microscopic Evaluation of the Surfaces of Artificial Hearts
Authors: Coleman Dennis , Lawson John , Kolff Willem J.
Published: June 2009

This Report summarizes the surface changes seen in artificial hearts implanted in calves for periods up to four months. Fabrication defects as well as degradation resulting from wear are identified. SEM evaluation of the blood contacting surface as well as the surface of the diaphragm associated with the drive mechanism has revealed potential problems with current heart designs and methods of fabrication. Materials evaluation of implanted hearts is crucial for a clinically useful system to evolve.
Use of the Bovine with an Artificial Heart as an Experimental Pharmacologic Model Peripheral Vascular and Direct Cardiac Effects of a Large Dose of Dopamine
Authors: Stanley Theodore H. , English John B. , Lunn Judd K. , Olseny Donald B. , Kolff Willem J.
Published: June 2009

Peripheral vascular and direct cardiac effects of a single intravenous injection of a large dose of dopamine (50μg/Kg) were determined in ten unanesthetized calves before and after replacement of their natural hearts (NH) with pneumatically driven artificial hearts (AH). Data were recorded before and three minutes after injection of dopamine, when alpha adrenergic effects were maximal. Dopamine markedly increased systemic vascular resistance (from 919 to 1490 dyne ˙ sec/cm5in NH calves and 896 to 1420 dyne ˙ sec/cm5in AH calves), mean aortic pressure (from 105 to 144 torr in NH calves and 109 to 129 torr in AH calves), mean pulmonary artery pressure (from 20 to 25 torr in NH calves and 18 to 30 torr in AH calves), and mean right atrial pressure (from 5 to 8 torr in NH calves and 6 to 10 torr in AH calves). Dopamine significantly decreased stroke volume (from 100 to 90 ml in NH calves and 101 to 74 ml in AH calves) and cardiac output (from 8.7 to 7.3 L/min in NH calves and 9.2 to 6.7 L/min in AH calves). Heart rate was significantly reduced by dopamine in NH calves (from 87 to 81 beats/min) but was fixed (91 beats/min) in AH animals. Changes in stroke volume, cardiac output and mean pulmonary artery pressure were significantly greater in AH calves while mean aortic pressure was increased significantly more in NH calves. Increases in right atrial pressure and systemic vascular resistance after dopamine were similar in both groups of animals.

Dopamine also produced marked changes in respiratory dynamics. The compound significantly decreased tidal volume (from 612 to 344 ml in NH calves and 582 to 236 ml in AH calves), minute volume (from 19.6 to 10.3 L/min in NH calves and 20.4 to 6.6 L/min in AH calves) and minute oxygen uptake (from 488 to 430 ml in NH calves and 507 to 355 ml in AH calves). Dopamine also reduced respiratory rate, but only in AH calves (from 35 to 28 breaths/min). Changes in respiratory rate, minute ventilation and oxygen uptake were significantly greater in AH than NH animals. These data demonstrate that large bolus injections of dopamine can produce significant decreases in cardiac output and respiratory dynamics. They also indicate that an animal with an artificial heart, or at least an artificial heart which is unable to respond to the positive inotropic effect of dopamine, will experience a more marked reduction in cardiac output and minute ventilation than an animal with its natural heart.
Albumin‐Coated Amberlite XAD‐7 Resin for Hemoperfusion in Acute Liver Failure: Part I: Adsorption Studies
Authors: Ton Hsueh Yen , Hughes Robin D. , Silk David B. A. , Williams Roger
Published: June 2009

Platelets adhere to most foreign surfaces. As a result, polymers and albumin have been suggested as possible coatings to improve the blood compatibility of such surfaces. Amberlite XAD‐7 has a high affinity for human serum albumin (HSA) and several protein‐bound toxic metabolites.

In the present study it is shown that HSA can be tightly bound to Amberlite XAD‐7 without. the use of chemical coupling agents. Optimal binding was achieved at pH 5.0 and the adsorption conforms to Langmuir's isotherm. Theoretical analysis of data and absence of a residual surface coating visible with scanning electron microscopy suggest a monolayer of albumin. The amount of HSA eluted from the resin under severe flow conditions was negligible (˜1%). Furthermore, in stirred batch studies with human plasma, the HSA coating did not decrease the adsorptive capacity of XAD‐7 for bile acids and bilirubin.
Communicating About Xenotransplantation: Models and Scenarios
Authors: De Bruin Wändi Bruine , Güvenç Ümit , Fischhoff Baruch , Armstrong Christopher M. , Caruso Denise
Published: June 2009

Xenotransplantation entails using organs from genetically modified animals as a way to solve the shortage of human organs for transplantation. As with other novel technologies, if xenotransplantation is to be judged fairly, proponents must explain its complex, uncertain, and unfamiliar risks and benefits. Xenotransplantation's risks include the possibility of a recombinant virus infecting human transplant recipients, potentially causing an epidemic of an unfamiliar disease. Using materials vetted by scientific experts, we communicated the variables and relationships determining this risk in three formally equivalent formats: (a) a graphic model, (b) scenarios structured by the graphic model, and (c) both the model and the scenarios. Participants were randomly assigned to receiving one set of materials. They rated them as equally clear and studied them equally long, suggesting similar ease of cognitive processing. Compared to participants receiving the scenarios, those who received the graphic model better identified causes and effects of the risk, and saw less risk of xenotransplantation. Participants who received both the model and the scenarios generally showed intermediate responses. The study demonstrates a general procedure for developing and evaluating formally equivalent graphic and scenario communications regarding highly uncertain risks. In this application to xenotransplantation, presenting a graphic representation improved people's understanding of the risk.
Why People Do What They Do to Protect Against Earthquake Risk: Perceptions of Hazard Adjustment Attributes
Authors: Lindell Michael K. , Arlikatti Sudha , Prater Carla S.
Published: June 2009

This study examined respondents' self‐reported adoption of 16 hazard adjustments (preimpact actions to reduce danger to persons and property), their perceptions of those adjustments' attributes, and the correlations of those perceived attributes with respondents' demographic characteristics. The sample comprised 561 randomly selected residents from three cities in Southern California prone to high seismic risk and three cities from Western Washington prone to moderate seismic risks. The results show that the hazard adjustment perceptions were defined by hazard‐related attributes and resource‐related attributes. More significantly, the respondents had a significant degree of consensus in their ratings of those attributes and used them to differentiate among the hazard adjustments, as indicated by statistically significant differences among the hazard adjustment profiles. Finally, there were many significant correlations between respondents' demographic characteristics and the perceived characteristics of hazard adjustments, but there were few consistent patterns among these correlations.
Pustular porokeratosis
Authors: Miller Daniel D. , Ruben Beth S.
Published: June 2009

We report a case of disseminated superficial actinic porokeratosis (DSAP) with neutrophilic pustules within cornoid lamellae on histopathologic examination, corresponding to pustules along the elevated rim clinically as well. A review of the literature identified only one other case in which pustules have been associated with porokeratosis. Our case represents an unusual variant of DSAP, which may make an ordinarily straightforward clinical diagnosis more challenging.
Correlations of Wave Characteristics for a Liquid Film Falling Down Along a Vertical Wall
Authors: Koizumi Yasuo , Enari Ryou , Ohtake Hiroyasu
Published: June 2009

The behavior of a liquid film that flows down countercurrently along the inner surface of a circular pipe was examined. In the experiments of the present study, silicone oils of 500 cS, 1000 cS, and 3000 cS, as well as water, were used as the liquid phase. The gas phase was air. The vertically oriented test section was a circular pipe of 30 mm in inner diameter and 5.4 m in length. The substrate thickness of the silicone films, the film Reynolds numbers of which were quite low, was close to the mean film thickness, while the water film substrate was much thinner than the mean film thickness. Waves were observed on the substrate. Waves of a certain amplitude were confirmed to exist, even on the silicone films near the flooding occurrence, where the film Reynolds number was quite low. The mean film thicknesses of the silicone films, as well as that of the water film, were well expressed by applying the universal velocity profile to the film flow. When the film Reynolds number was lower than 600, the wave velocity was well predicted as the velocity of small perturbation waves on a laminar film. As the film Reynolds number became large, the wave velocity became slower than the small perturbation wave velocity. The correlation for the wavelength was developed based on the present experimental results. Combining this correlation with the Nosoko correlations and modifying the constants and exponents of the parameters in the equations, new correlations for the wave velocity and maximum film thickness were proposed. These new correlations were used to predict the wave velocity and the maximum film thickness to an accuracy of within 15%.
Effect of Wick Characteristics on the Thermal Performance of the Miniature Loop Heat Pipe
Authors: Singh Randeep , Akbarzadeh Aliakbar , Mochizuki Masataka
Published: June 2009

Two phase heat transfer devices based on the miniature version of loop heat pipe (LHP) can provide very promising cooling solutions for the compact electronic devices due to their high heat flux management capability and long distance heat transfer with minimal temperature losses. This paper discusses the effect of the wick properties on the heat transfer characteristics of the miniature LHP. The miniature model of the LHP with disk-shaped evaporator, 10 mm thick and 30 mm disk diameter, was designed using copper containment vessel and water as the working fluid, which is the most acceptable combination in electronic cooling applications. In the investigation, wick structures with different physical properties including thermal conductivity, pore radius, porosity, and permeability and with different structural topology including monoporous or biporous evaporating face were used. It was experimentally observed that copper wicks are able to provide superior thermal performance than nickel wicks, particularly for low to moderate heat loads due to their low heat conducting resistance. With monoporous copper wick, maximum evaporator heat transfer coefficient (hev) of 26,270 W/m2 K and evaporator thermal resistance (Rev) of 0.06–0.10°C/W were achieved. For monoporous nickel wick, the corresponding values were 20,700 W/m2 K for hev and 0.08–0.21°C/W for Rev. Capillary structure with smaller pore size, high porosity, and high permeability showed better heat transfer characteristics due to sufficient capillary pumping capability, low heat leaks from evaporator to compensation chamber and larger surface area to volume ratio for heat exchange. In addition to this, biporous copper wick structure showed much higher heat transfer coefficient of 83,787 W/m2 K than monoporous copper wick due to improved evaporative heat transfer at wick wall interface and separated liquid and vapor flow pores. The present work was able to classify the importance of the wick properties in the improvement of the thermal characteristics for miniature loop heat pipes.
Role of the hypoglossal nerve in equine nasopharyngeal stability
Authors: Cheetham Jonathan , Pigott John H. , Hermanson John W. , Campoy Luis , Soderholm Leo V. , Thorson Lisa M. , Ducharme Norm G.
Published: June 2009

The equine upper airway is highly adapted to provide the extremely high oxygen demand associated with strenuous aerobic exercise in this species. The tongue musculature, innervated by the hypoglossal nerve, plays an important role in airway stability in humans who also have a highly adapted upper airway to allow speech. The role of the hypoglossal nerve in stabilizing the equine upper airway has not been established. Isolated tongues from eight mature horses were dissected to determine the distal anatomy and branching of the equine hypoglossal nerve. Using this information, a peripheral nerve location technique was used to perform bilateral block of the common trunk of the hypoglossal nerve in 10 horses. Each horse was subjected to two trials with bilateral hypoglossal nerve block and two control trials (unblocked). Upper airway stability at exercise was determined using videoendoscopy and measurement of tracheal and pharyngeal pressure. Three main nerve branches were identified, medial and lateral branches and a discrete branch that innervated the geniohyoid muscle alone. Bilateral hypoglossal block induced nasopharyngeal instability in 10/19 trials, and none of the control trials (0/18) resulted in instability ( P < 0.001). Mean treadmill speed (± SD) at the onset of instability was 10.8 ± 2.5 m/s. Following its onset, nasopharyngeal instability persisted until the end of the treadmill test. This instability, induced by hypoglossal nerve block, produced an expiratory obstruction similar to that seen in a naturally occurring equine disease (dorsal displacement of the soft palate, DDSP) with reduced inspiratory and expiratory pharyngeal pressure and increased expiratory tracheal pressure. These data suggest that stability of the equine upper airway at exercise may be mediated through the hypoglossal nerve. Naturally occurring DDSP in the horse shares a number of anatomic similarities with obstructive sleep apnea. Study of species with extreme respiratory adaptation, such as the horse, may provide insight into respiratory functioning in humans.
Dominant von Willebrand Disease Type 2A Groups I and II due to Missense Mutations in the A2 Domain of the von Willebrand Factor Gene: Diagnosis and Management
Authors: Michiels Jan Jacques , van Vliet Huub H.D.M.
Published: June 2009

Pertinent findings in patients with von Willebrand disease (VWD) type 2A include prolonged bleeding time (BT), consistently low von Willebrand factor (VWF):ristocetin cofactor activity (RCo)/antigen concentration (Ag) and VWF:collagen binding (CB)/Ag ratios, absence of high, and (depending on severity) intermediate and large VWF multimers, the presence of pronounced triplet structure of individual bands and increased VWF degradation products due to increased proteolysis caused by mutations in the A2 domain of VWF. Two categories of VWD type 2A can be distinguished: group I with severe and group II with mild VWD. A minority of VWD type 2A have mild VWD characterized by near normal to prolonged BT, normal factor VIII coagulant activity and VWF:Ag, low VWF:RCo and VWF:CB, a normal ristocetin-induced platelet aggregation and complete but transient correction of BT and functional VWF parameters to normal levels for only a few hours due to short half-lives for VWF:RCo and CWF:CB. Such transient complete responses to desmopressin (DDAVP) lasting only a few hours may facilitate treatment and prophylaxis of minor bleedings, but may not be able to prevent bleeding during minor and major surgery. Most VWD type 2A patients have pronounced VWD with very low VWF:RCo, prolonged BT, PFA-100 closure times >250 s, and response to DDAVP is only transient, minor, poor or absent, with no correction of the BT despite some increase in VWF:RCo, thus being candidates for factor VIII-VWF concentrate substitution for the acute and prophylactic treatment of bleeding symptoms.
Umbilical Cord Cysts of Allantoic and Omphalomesenteric Remnants with Progressive Umbilical Cord Edema: A Case Report
Authors: Kita Mariko , Kikuchi Akihiko , Miyashita Susumu , Yoshizawa Katsumi , Takagi Kimiyo , Ogiso Yoshifumi
Published: June 2009

We present a unique case of umbilical cord cysts of allantoic and omphalomesenteric remnants with progressive cord edema during pregnancy. Enlargement of the umbilical cord was observed initially at 28 weeks’ gestation; the cord cysts were first recognized at 17 weeks. At 37 weeks, a cesarean section was performed and a male infant weighing 2,300 g was delivered. The entire length of the umbilical cord was 80 cm; the 50-cm proximal portion was strikingly edematous and was 7 cm in diameter. On the 1st day of life, operative exploration was undertaken via an infraumbilical incision. It was evident that a patent urachus protruded from the bladder. The lesion was excised and the bladder was closed in a two-layer anastomosis. Histologically, the intestinal epithelium was connected to the transitional epithelium at the top of the urachus, indicating allantoic remnants fused with omphalomesenteric remnants. Such a case has not been reported previously. It was considered that the overflow of urine from allantoic remnants to omphalomesenteric remnants caused the extraordinary edema of the umbilical matrix. Based on our experience, finding progressive umbilical cord edema may indicate a patent urachus co-existing with allantoic and omphalomesenteric remnants.
Cerebral Ischemic Events Associated With ‘Bubble Study’ for Identification of Right to Left Shunts
Authors: Romero José R. , Frey James L. , Schwamm Lee H. , Demaerschalk Bart M. , Chaliki Hari P. , Parikh Gunjan , Burke Robert F. , Babikian Viken L.
Published: June 2009

Background and Purpose—

Detection of an intracardiac shunt is frequently sought during the evaluation of patients with cryptogenic ischemic stroke and agitated saline intravenous injection, or “bubble study” (BS), is performed in most cases. We present the first attempt to identify the clinical features in patients who had cerebral ischemic events with BS.

Methods—

Using a list serve established by the American Academy of Neurology, a member posted a question regarding the safety of BS in patients with patent foramen ovale. A standardized questionnaire was used to gather data about patients with cerebral ischemic events, details of each case were reviewed, and the findings pooled.

Results—

Five patients with ischemic complications of BS (all female, aged 42 to 90 years) were identified from 4 institutions, 3 ischemic strokes and 2 transient ischemic attacks. Events occurred either during or within 5 minutes of BS. Early brain MRIs confirmed acute infarction in 3, including one who had transient symptoms. MRI infarct volumes were small, and deficits were mild in those who developed stroke. Diagnostic evaluation revealed a patent foramen ovale alone in one case, a pulmonary arteriovenous malformation in one case, and a patent foramen ovale and/or pulmonary shunt in 3 cases.

Conclusions—

Ischemic cerebrovascular complications can occur in patients who undergo BS and are associated with the presence of cardiac or pulmonary shunts. The true incidence and degree of disability remains unknown, and further study is indicated to assess the impact of technical differences in BS methodology. Novel methods to promote physician communication such as the use of electronic list serves may reduce barriers to reporting of drug, technique, or device complications and should be explored to identify rare complications that otherwise will likely go unappreciated.
Temporal Trends in Public Awareness of Stroke
Authors: Kleindorfer Dawn , Khoury Jane , Broderick Joseph P. , Rademacher Eric , Woo Daniel , Flaherty Matthew L. , Alwell Kathleen , Moomaw Charles J. , Schneider Alex , Pancioli Arthur , Miller Rosie , Kissela Brett M.
Published: June 2009

Background and Purpose—

Delay in seeking medical attention after stroke symptom onset is the most important reason for low rates of thrombolytic use for ischemic stroke (IS) in the United States. This may be related to poor recognition of stroke symptoms, or to lack of awareness of time-sensitive stroke treatments. We describe public knowledge of t-PA as a treatment for IS, as well as changes over time in knowledge of stroke warning signs (WS) and risk factors (RF).

Methods—

Survey respondents were drawn from our biracial population of 1.3 million using random-digit dialing in 1995, 2000, and 2005 to reflect the age, race, and gender distribution of stroke patients, based on an ongoing stroke incidence study in the same region. They were asked open-ended questions regarding stroke WS, RF, and, in 2005, specific questions regarding t-PA. Comparisons over time were made using χ
2
analysis, and were corrected for multiple comparisons.

Results—

Over the 10-year study period, 6209 surveys were completed. Knowledge of WS and RF improved between 1995 and 2000. Between 2000 and 2005, knowledge did not improve significantly; however, there was a significant improvement in knowledge of 3 warning signs (12% in 1995 vs 16% in 2005,
P
=0.0004). In 2005, only 3.6% of those surveyed were able to independently name t-PA or “clot buster” when asked: “Suppose you were having a stroke. Do you know of any medication your doctor could give you into the vein to increase your chance of recovering from a stroke?”–although 19% claimed to have heard of t-PA once it was mentioned to them.

Conclusion—

Despite numerous national stroke public awareness campaigns, public knowledge of stroke WS and RF has not improved over the last 5 years. In addition, knowledge of t-PA as a treatment for IS is extremely poor. Public awareness messages in the future should focus on the possibility of urgent treatments, in addition to stroke WS and RF, so the public can translate their knowledge into action and present to medical attention more quickly. This may be the highest yield approach to increasing rates of treatment of IS with t-PA.
The Influence of Treatment Effect Size on Willingness to Adopt a Therapy
Authors: Aberegg Scott K. , O'Brien James M. , Khoury Paneez , Patel Roocha , Arkes Hal R.
Published: June 2009

Background. Physicians are slow to adopt novel therapies, and the reasons for this are poorly understood. The authors sought to determine if the size of the treatment effect of a novel therapy influences willingness to adopt it. Methods. We developed 2 experimental vignette pairs describing a trial of a therapy for a hypothetical disease that showed a statistically significant mortality benefit. The size of the mortality effect was varied in vignettes of a pair (3% v. 10%). The 2 experimental vignette pairs differed in whether study enrollment was reported. Vignettes were mailed to a random sample of physicians using an intersubject design. The main study outcome was respondents’ willingness to adopt the hypothetical therapy, based on the results of the hypothetical trial. Results. There were 124 and 89 respondents to vignette pairs 1 and 2, respectively. In vignette pair 1, 91% versus 71% of respondents adopted the therapy when it reduced mortality by 10% and 3%, respectively (P = 0.0058). For vignette pair 2, 88% versus 51% of respondents adopted the therapy when it reduced mortality by 10% and 3%, respectively (P = 0.0002). In both vignette pairs, nonadopters were more likely than adopters to report side effects of the therapy as a principal reason for their decision. Conclusions. In this study, respondents were less likely to adopt a lifesaving therapy if its associated mortality reduction was 3% compared to 10%. Because most therapies for major medical conditions reduce mortality within or below this range, and because there were no opportunity costs associated with the adoption of the therapy, we believe that this effect represents a bias. Further investigation will be required to determine its prevalence and mechanism.
Optimal Placement of Piezoelectric Actuators and Sensors for Detecting Damage in Plate Structures
Authors: Flynn Eric B. , Todd Michael D.
Published: June 2009

We propose a novel approach for optimal actuator and sensor placement for active sensing-based structural health monitoring. Of particular interest is the optimization of actuator—sensor arrays making use of ultrasonic wave propagation for detecting damage in thin plate-like structures. Using a detection theory framework, we establish the optimum configuration as the one that minimizes Bayes risk. The detector incorporates a statistical model of the active sensing process that accounts for both reflection and attenuation features, implements pulse-echo and pitch-catch actuation schemes, and takes into account line-of-site. The optimization space was searched using a genetic algorithm with a time-varying mutation rate. For verification, we densely instrumented a concave-shaped plate and applied artificial, reversible damage to a large number of randomly generated locations, acquiring active sensing data for each location. We then used the algorithm to predict optimal subsets of the dense array. The predicted optimal arrangements proved to be among the top performers when compared to large sets of randomly generated arrangements.
Strongyloides stercoralis Hyperinfection in a Patient With AIDS
Authors: Bava Amadeo Javier , Troncoso Alcides R.
Published: June 2009

Strongyloides stercoralis is a prevalent cause of severe infection and death in many areas of the world where fecal contamination of soil or water is common. The nematode is endemic in tropical and subtropical regions of the world, including northeastern Argentina, where infection rates may exceed 30% of the population. Strongyloides infections are often light and associated with few or no signs and symptoms, particularly during initial migration through the body. However, certain persons are at risk of severe, clinically significant disease developing. The manifestations of hyperinfection syndrome are divided, based on the system of origin, into intestinal and extraintestinal disease mainly involving the respiratory tract. Unfortunately, S stercoralis hyperinfection is seldom diagnosed until late in the course of the disease, which contributes to a high death rate. In patients with the hyperinfection syndrome and massive Strongyloides infection, adult respiratory distress syndrome with pulmonary insufficiency that requires intubation and mechanical ventilation may also develop. We report a case of S stercoralis hyperinfection in an HIV-infected patient, which resulted in death.
Review: Therapeutic implications of hepatitis C virus resistance to antiviral drugs
Authors: Pawlotsky Jean-Michel
Published: June 2009

Treatment of chronic hepatitis C is currently based on a combination of pegylated interferon-α and ribavirin. Neither drug exerts direct selective pressure on viral functions, meaning that interferon-α/ribavirin treatment failure is not due to selection of interferon-α- or ribavirin-resistant viral variants. Several novel antiviral approaches are currently in preclinical or clinical development, and most target viral enzymes and functions, such as hepatitis C virus protease and polymerase. These new drugs all potentially select resistant viral variants both in vitro and in vivo, and resistance is therefore likely to become an important issue in clinical practice.
Inequalities in maternity care and newborn outcomes: one-year surveillance of births in vulnerable slum communities in Mumbai
Authors: More Neena Shah , Bapat Ujwala , Das Sushmita , Barnett Sarah , Costello Anthony , Fernandez Armida , Osrin David
Published: June 2009

Background

Aggregate urban health statistics mask inequalities. We described maternity care in vulnerable slum communities in Mumbai, and examined differences in care and outcomes between more and less deprived groups.

Methods

We collected information through a birth surveillance system covering a population of over 280 000 in 48 vulnerable slum localities. Resident women identified births in their own localities and mothers and families were interviewed at 6 weeks after delivery. We analysed data on 5687 births over one year to September 2006. Socioeconomic status was classified using quartiles of standardized asset scores.

Results

Women in higher socioeconomic quartile groups were less likely to have married and conceived in their teens (Odds ratio 0.74, 95% confidence interval 0.69–0.79, and 0.82, 0.78–0.87, respectively). There was a socioeconomic gradient away from public sector maternity care with increasing socioeconomic status (0.75, 0.70–0.79 for antenatal care and 0.66, 0.61–0.71 for institutional delivery). Women in the least poor group were five times less likely to deliver at home (0.17, 0.10–0.27) as women in the poorest group and about four times less likely to deliver in the public sector (0.27, 0.21–0.35). Rising socioeconomic status was associated with a lower prevalence of low birth weight (0.91, 0.85–0.97). Stillbirth rates did not vary, but neonatal mortality rates fell non-significantly as socioeconomic status increased (0.88, 0.71–1.08).

Conclusion

Analyses of this type have usually been applied across the population spectrum from richest to poorest, and we were struck by the regularly stepped picture of inequalities within the urban poor, a group that might inadvertently be considered relatively homogeneous. The poorest slum residents are more dependent upon public sector health care, but the regular progression towards the private sector raises questions about its quality and regulation. It also underlines the need for healthcare provision strategies to take account of both sectors.
Identification and characterisation of a novel anti-viral peptide against avian influenza virus H9N2
Authors: Rajik Mohamed , Jahanshiri Fatemeh , Omar Abdul Rahman , Ideris Aini , Hassan Sharifah Syed , Yusoff Khatijah
Published: June 2009

Background

Avian influenza viruses (AIV) cause high morbidity and mortality among the poultry worldwide. Their highly mutative nature often results in the emergence of drug resistant strains, which have the potential of causing a pandemic. The virus has two immunologically important glycoproteins, hemagglutinin (HA), neuraminidase (NA), and one ion channel protein M2 which are the most important targets for drug discovery, on its surface. In order to identify a peptide-based virus inhibitor against any of these surface proteins, a disulfide constrained heptapeptide phage display library was biopanned against purified AIV sub-type H9N2 virus particles.

Results

After four rounds of panning, four different fusion phages were identified. Among the four, the phage displaying the peptide NDFRSKT possessed good anti-viral properties in vitro and in ovo. Further, this peptide inhibited the hemagglutination activity of the viruses but showed very little and no effect on neuraminidase and hemolytic activities respectively. The phage-antibody competition assay proved that the peptide competed with anti-influenza H9N2 antibodies for the binding sites. Based on yeast two-hybrid assay, we observed that the peptide inhibited the viral replication by interacting with the HA protein and this observation was further confirmed by co-immunoprecipitation.

Conclusion

Our findings show that we have successfully identified a novel antiviral peptide against avian influenza virus H9N2 which act by binding with the hemagglutination protein of the virus. The broad spectrum activity of the peptide molecule against various subtypes of the avian and human influenza viruses and its comparative efficiency against currently available anti-influenza drugs are yet to be explored.
Up-Regulation of α5-Integrin by E-Cadherin Loss in Hypoxia and Its Key Role in the Migration of Extravillous Trophoblast Cells during Early Implantation
Authors: Arimoto-Ishida Emi , Sakata Masahiro , Sawada Kenjiro , Nakayama Masahiro , Nishimoto Fumihito , Mabuchi Seiji , Takeda Takashi , Yamamoto Toshiya , Isobe Aki , Okamoto Yoko , Lengyel Ernst , Suehara Noriyuki , Morishige Ken-ichirou , Kimura Tadashi
Published: June 2009

During early pregnancy, cytotrophoblast cells differentiate into extravillous trophoblast (EVT) cells and invade the uterine spiral arteries. This physiological process is essential for the development of maternal-fetal circulation. Because EVT cells are exposed to a low-oxygen environment during this process, we investigated the role of hypoxia in the mechanism that regulates the invasive behavior of EVT cells. Real-time PCR and immunofluorescent analysis were performed to investigate how hypoxia influences the expression of E-cadherin in villous explants cultures and in trophoblast-derived BeWo cells. We determined that hypoxia induced E-cadherin down-regulation through Snail up-regulation in villous explant cultures. The influence of E-cadherin loss was examined by analyzing the expression of α5-integrin and phosphorylated focal adhesion kinase (FAK) by Western blot and evaluating trophoblast invasion using a matrigel invasion assay. E-cadherin loss induced the up-regulation of α5-integrin, which leads to the tyrosine phosphorylation of FAK, resulting in an increase in the invasive activity of EVT cells. An α5-integrin neutralizing antibody inhibited the invasion of EVT cells by attenuating FAK tyrosine phosphorylation. Immunohistochemical analysis using clinical placental bed biopsies revealed that α5-integrin was up-regulated and FAK tyrosine phosphorylated (Try861) as EVT cells invade the uterine myometrium, whereas E-cadherin expression was down-regulated. These results suggest that α5-integrin up-regulation induced by E-cadherin loss under hypoxia has a crucial role in regulating the migration of EVT cells. This finding should help us reach a better understanding of the pathogenesis of critical gestational diseases, such as preeclampsia.
The Effect of Angiotensin-Converting Enzyme Inhibition Using Captopril on Energy Balance and Glucose Homeostasis
Authors: de Kloet Annette D. , Krause Eric G. , Kim Dong-Hoon , Sakai Randall R. , Seeley Randy J. , Woods Stephen C.
Published: June 2009

Increasing evidence suggests that the renin-angiotensin-system contributes to the etiology of obesity. To evaluate the role of the renin-angiotensin-system in energy and glucose homeostasis, we examined body weight and composition, food intake, and glucose tolerance in rats given the angiotensin-converting enzyme inhibitor, captopril (∼40 mg/kg · d). Rats given captopril weighed less than controls when fed a high-fat diet (369.3 ± 8.0 vs. 441.7 ± 8.5 g after 35 d; P < 0.001) or low-fat chow (320.1 ± 4.9 vs. 339.8 ± 5.1 g after 21 d; P < 0.0001). This difference was attributable to reductions in adipose mass gained on high-fat (23.8 ± 2.0 vs. 65.12 ± 8.4 g after 35 d; P < 0.0001) and low-fat diets (12.2 ± 0.7 vs. 17.3 ± 1.3 g after 21 d; P < 0.001). Rats given captopril ate significantly less [3110.3 ± 57.8 vs. 3592.4 ± 88.8 kcal (cumulative 35 d high fat diet intake); P < 0.001] despite increased in neuropeptide-Y mRNA expression in the arcuate nucleus of the hypothalamus and had improved glucose tolerance compared with free-fed controls. Comparisons with pair-fed controls indicated that decreases in diet-induced weight gain and adiposity and improved glucose tolerance were due, primarily, to decreased food intake. To determine whether captopril caused animals to defend a lower body weight, animals in both groups were fasted for 24 h and subsequently restricted to 20% of their intake for 2 d. When free food was returned, captopril and control rats returned to their respective body weights and elicited comparable hyperphagic responses. These results suggest that angiotensin-converting enzyme inhibition protects against the development of diet-induced obesity and glucose intolerance.
Orthologs ofArabidopsis thalianastomatal bHLH genes and regulation of stomatal development in grasses
Authors: Liu Tie , Ohashi-Ito Kyoko , Bergmann Dominique C.
Published: June 2009

Stomata are adjustable pores in the plant epidermis that regulate gas exchange between the plant and atmosphere; they are present on the aerial portions of most higher plants. Genetic pathways controlling stomatal development and distribution have been described in some detail for one dicot species, Arabidopsis, in which three paralogous bHLH transcription factors, FAMA, MUTE and SPCH, control discrete sequential stages in stomatal development. Orthologs of FAMA, MUTE and SPCH are present in other flowering plants. This observation is of particular interest when considering the grasses, because both the morphology of guard cells and their tissue distributions differ substantially between Arabidopsis and this group. By examining gene expression patterns, insertional mutants and cross-species complementation studies, we find evidence that FAMA function is conserved between monocots and dicots, despite their different stomatal morphologies, whereas the roles of MUTE and two SPCH paralogs are somewhat divergent.
Retinal horizontal cells: challenging paradigms of neural development and cancer biology
Authors: Poché Ross A. , Reese Benjamin E.
Published: June 2009

A group of retinal interneurons known as horizontal cells has recently been shown to exhibit a variety of unique biological properties, as compared with other nerve cells, that challenge many long-standing assumptions in the fields of neural development and cancer biology. These features include their unusual migratory behavior, their unique morphological plasticity, and their propensity to divide at a relatively late stage during development. Here, we review these novel features, discuss their relevance for other cell types,outline open questions in our understanding of horizontal cell development and consider their implications.
Extraction of Actinides and Fission Products by the New Ligand, N,N,N′,N′-Tetraoctyl-3,6-dioxaoctanediamide
Authors: Sasaki Yuji , Morita Yasuji , Kitatsuji Yoshihiro , Kimura Takaumi
Published: June 2009

New reagent, N,N,N′,N′-tetraoctyl-3,6-dioxaoctanediamide (DOODA-C8), was synthesized and examined for the actinide and fission product extractions. Extraction from nitric acid to n-dodecane was studied and it was found that DOODA-C8 can extract UVI, PuIV, AmIII, lanthanides (Ln)III, and TcVII. The D values of FeIII, PdII, and ZrIV indicate weak complexation with DOODA-C8. The aqueous conditions for the partitioning process can be prepared in the absence of masking agents.
Effects of transdermal testosterone or oral dydrogesterone on hypoactive sexual desire disorder in transsexual women: results of a pilot study
Authors: Kronawitter Desiree , Gooren Louis J , Zollver Hendryk , Oppelt Patricia G , Beckmann Matthias W , Dittrich Ralf , Mueller Andreas
Published: June 2009

Objective

It has been reported that hypoactive sexual desire disorder (HSDD) affects one-third of transsexual women (defined as postoperative male-to-female transsexuals) receiving estrogen replacement whose bioavailable androgen levels are lower than in ovulating women and comparable with those in surgically postmenopausal women. The aim of this study was to evaluate the efficacy of transdermal testosterone treatment and of oral dydrogesterone in transsexual women with HSDD receiving estrogens.

Methods

Seven transsexual women with HSDD were treated with a testosterone patch and nine transsexual women with HSDD were treated with oral dydrogesterone over 24 weeks. The primary end point was the change in the brief profile of female sexual function (B-PFSF) score. Secondary end points were changes in hormonal parameters and side effect assessments.

Results

A significant increase in total testosterone and free testosterone levels was observed in the group receiving transdermal testosterone. At 24 weeks, there was a significant improvement in the B-PFSF score showing an improvement in sexual desire among transsexual women treated with the testosterone patch, whereas no change in the B-PFSF score was observed in transsexual women treated with oral dydrogesterone. No side effects were reported.

Conclusions

In this pilot study, sexual desire in transsexual women improved significantly after treatment with the testosterone patch, without noticeable side effects.
Glassy cell carcinoma of the endometrium: case report and review of the literature
Authors: Nagy Péter Sámuel , Sipos József
Published: June 2009

A szerzők 68 éves FIGO IB stádiumú méhnyálkahártyából kiinduló tejüvegsejtes carcinomás nőbeteg esetét ismertetik, akinél hysterectomia és kétoldali salpingo-oophorectomia, majd sugárkezelés történt. A beteg kétéves utánkövetése alatt daganatmentes volt. Az endometrium tejüvegsejtes carcinomája ritka tumorféleség, eddig 13 esetet közöltek a világon. Mint az adenosquamosus carcinoma rosszul differenciált változata valódi természetének megismerése ma is vita tárgyát képezi. A prognózisának és klinikai jelentőségének tisztázásához újabb közölt esetek és kritikai analízisük szükséges.