bluuebunny/crossref_metadata_2025 huggingface dataset:
Is Symptomatic Atherosclerotic Cerebrovascular Disease a Risk Factor for Normal-Tension Glaucoma?
Authors: Güngör İnci Ulu , Güngör Levent , Özarslan Yakup , Arıtürk Nurşen , Beden Ümit , Erkan Dilek , Onar Musa Kazım , Öge İhsan
Published: March 2011

Objective: To compare the incidence of glaucomatous optic disk appearance between patients with symptomatic atherosclerotic stroke and healthy individuals with normal intraocular pressures (IOP). Subjects and Methods: 46 patients with ischemic stroke with evident lacunar infarction or large vessel atherosclerosis, and 93 age- and sex-matched healthy individuals, all with normal IOP, were included. Patients and controls were examined for the presence of high cup-to-disk ratios (>0.5). Results: Seven patients (15.22%) in the ischemic cerebrovascular disease (CVD) group and 3 controls (3.23%) had glaucomatous optic disk appearance. All subjects with glaucomatous optic disk appearance in the control group and 3 patients in the study group had visual field defects in concordance with normal-tension glaucoma (NTG). The incidence of glaucomatous optic disk appearance was significantly higher in the group with symptomatic atherosclerotic CVD. Conclusion: Atherosclerotic CVD is a risk factor for having glaucomatous optic disk appearance. Symptomatic atherosclerosis involving the brain vasculature may also affect the eye and lead to NTG. Patients with ischemic strokes due to large artery atherosclerosis or small artery occlusion must be examined and followed for NTG.
Trafficking of Methicillin-Resistant Staphylococci and Co-Colonization with Vancomycin-Resistant Enterococci
Authors: Sharaf Eman J. , Senok Abiola C. , Udo Edet E. , Botta Giuseppe A.
Published: March 2011

Objectives: To determine the trafficking of methicillin-resistant staphylococci between the hospital and community as well as the occurrence of co-colonization with vancomycin-resistant enterococci (VRE). Subjects and Methods: From November 2005 to April 2006, methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus (MRCoNS)-positive patients at the Salmaniya Medical Complex, Bahrain were assessed for VRE co-colonization. Characterization of vancomycin resistance genotype by PCR was carried out. Close family contacts were screened for MRSA and pulsed-field gel electrophoresis (PFGE) analysis of MRSA isolates from patient-family member pairs was conducted. Results: One hundred and eighty-two patients (93 MRSA; 89 MRCoNS) and 356 family members were enrolled. Seven MRSA and 41 MRCoNS strains were isolated from the family members. PFGE analysis revealed the presence of variants of a single MRSA clone among patients and their relatives. A total of 112 patients (62 MRSA; 50 MRCoNS) provided stool for VRE screening. Of these 13 stool specimens (11.6%) were VRE-positive. All the VRE isolates were from MRSA-positive patients, thus positivity rate among MRSA patients was 20.9% (n/N = 13/62). These were predominantly Enterococcus gallinarum with vanC1 genotype and one strain was Enterococcus faecium (vanB genotype). Two E. gallinarum isolates harbored an additional vanB gene. The majority of VRE isolates were from patients in medical and surgical units (n/N = 10/13; 77%). Male gender, prolonged hospitalization and presence of co-morbidities were significantly associated with MRSA/VRE co-colonization (p < 0.05). Conclusion: MRSA/VRE co-colonization with MRSA trafficking between the hospital and community environment is a public health concern occurring in our setting.
Carriage Rate of Group B Streptococci in Pregnant Women in Three Teaching Hospitals in Shiraz, Iran
Authors: Hassanzadeh Parvin , Motamedifar Mohammad , Gharaghani Maral Namdari
Published: March 2011

Objective: The main goal of this study was to assess differences in the vaginal flora of pregnant women and provide a detailed evaluation of vaginal swabs for the presence of group B streptococcus (GBS) and other organisms in three teaching hospitals in Shiraz, southwest of Iran. Subjects and Methods: In a cross-sectional study from April 2006 to March 2007, 310 women with vaginal delivery at three obstetric wards of teaching hospitals in Shiraz were studied. Swab specimens from the vagina and rectum were collected and were examined bacteriologically. All of the newborns were followed up for 3 months. Results: Of 310 pregnant women, 43 (13.8%) were colonized with GBS. There were no differences between GBS carriers and GBS-negative women in risk factors like preterm rupture of membranes (p = 0.77) and preterm labor (p = 0.53). One neonate was hospitalized due to meningitis and GBS was detected in CSF culture and Gram staining. Conclusion: Our data showed that the prevalence of GBS carriage rate in pregnant women in Shiraz, Iran was high. The poor correlation between risk factors and GBS carriage requires further investigation in larger groups.
Presentation of Hospital Outcomes and Different Treatment Methods of Patients with Budd-Chiari Syndrome: A Report from Two Tertiary Hospitals in Iran
Authors: Ebrahimi Mahmoud , Modaghegh Mohammad Hadi , Esmaeilzadeh Abbas
Published: March 2011

Objective: The aim of this study was to report common presentations of Budd-Chiari syndrome (BCS) and the early outcome of different treatment methods in two tertiary hospitals in Iran. Subjects and Methods: This case series study was performed on 21 patients (mean age: 42 ± 13.09 years; 11 male, 52.4%, and 10 female, 47.6%) admitted for treatment of BCS in two tertiary referral centers in Mashhad, Iran, between 2002 and 2008. All required data of signs, underlying etiology, treatment methods and in-hospital mortality were gathered from patients’ medical records. Results: Angiographic and sonographic findings showed that the most frequent isolated location of obstruction was the inferior vena cava (n = 12, 57.1%). No distinct underlying disease was found in 6 (28.6%) patients. Eleven (52.4%) patients had web obstruction and 4 patients had other related underlying diseases. Treatment modalities consisted of medical follow-up in 12 (57.1%), angioplasty in 6 (28.6%), and surgery in 3 (14.3%) patients. Medical follow-up of 3 patients, 1 with angioplasty and 2 who had undergone surgery, disclosed that they had died before discharge from hospital. Conclusion: Higher age at diagnosis may reflect late diagnosis at an advanced stage of disease. We suggest that the early symptoms of this disease should be taken into account more seriously in differential diagnosis. Balloon angioplasty seems to be a more efficient method for treatment of BCS.
Congenital Pelvic Arteriovenous Malformation Presenting with Urinary Retention: A Case Report
Authors: Hammad Fayez T. , Shawish Fahmy , Kazim Essa
Published: March 2011

Objective: To report a case of congenital pelvic arteriovenous malformation (pAVM) with urinary retention. Clinical Presentation and Intervention: A 39-year-old male patient presented with inability to void urine for 8 h. He did not have a history of dysuria or fever, but had increasing urinary frequency and difficulty in voiding over 2 years. Examination revealed a suprapubic mass without external signs of vascular anomaly. A huge, soft, irregular, non-pulsating mass was felt rectally. This mass did not disappear on urinary bladder decompression. Subsequent ultrasound and CT scan revealed pAVMs filling most of the pelvic cavity. Conclusion: To our knowledge, this is the first report of a male patient with congenital pAVM presenting with urinary retention, emphasizing the need for a high index of suspicion for pAVM to avoid potential severe bleeding during suprapubic catheterization for urinary drainage.
Effects of Different Levels of Endotoxin Contamination on Inflammatory Cytokine Production by Peripheral Blood Mononuclear Cells after High-Flux Hemodialysis
Authors: Praditpornsilpa Kearkiat , Tiranathanagul Khajohn , Susantitaphong Paweena , Katavetin Pisut , Trakarnvanich Thananda , Townamchai Natavudh , Kanjanabuch Talerngsak , Avihingsanon Yingyos , Tungsanga Kriang , Eiam-Ong Somchai
Published: March 2011

Background: In Thailand, dialysate endotoxin contamination levels vary from less than 0.001 to 2.0 EU/ml. This difference has prompted an investigation on the production of proinflammatory cytokines and counter-inflammatory mediators of peripheral blood mononuclear cells (PBMCs) after high-flux dialysis. Methods: Patients from four hemodialysis (HD) centers who met the inclusion/exclusion criteria were enrolled into the study. PBMCs were isolated by Ficoll density gradient centrifugation and cultured. Supernatants were tested for interleukin 6 (IL-6), IL-1β and IL-1 receptor antagonist (IL-1Ra) concentration by ELISA. Results: HD centers 1, 2, 3 and 4 had mean dialysate endotoxin contamination levels of 0.001, 0.026, 0.558 and 1.960 EU/ml, respectively. HD center 4 had the highest levels of IL-6 (1,052.3 ± 240.7 pg/106 PBMCs), IL-1β (1,297.1 ± 334.6 pg/106 PBMCs) and IL-1Ra (2,713.4 ± 1,255.3 pg/106 PBMCs). There were no significant differences in cytokine production between HD centers 1 and 2. Conclusion: Our study showed that ultrapure dialysate can minimize the risk of stimulating inflammatory cells. Ultrapure dialysate may prevent or delay endotoxin exposure-related complications.
Dynamic Changes of Edema and Late Gadolinium Enhancement After Acute Myocardial Infarction and Their Relationship to Functional Recovery and Salvage Index
Authors: Dall'Armellina Erica , Karia Nina , Lindsay Alistair C. , Karamitsos Theodoros D. , Ferreira Vanessa , Robson Matthew D. , Kellman Peter , Francis Jane M. , Forfar Colin , Prendergast Bernard D. , Banning Adrian P. , Channon Keith M. , Kharbanda Rajesh K. , Neubauer Stefan , Choudhury Robin P.
Published: March 2011

Background—

Changes in the myocardium in acute ischemia are dynamic and complex, and the characteristics of myocardial tissue on cardiovascular magnetic resonance in the acute setting are not fully defined. We investigated changes in edema and late gadolinium enhancement (LGE) with serial imaging early after acute myocardial infarction, relating these to global and segmental myocardial function at 6 months.

Methods and Results—

Cardiovascular magnetic resonance scans were performed on 30 patients with ST-elevation–myocardial infarction treated by primary percutaneous coronary intervention at each of 4 time points: 12 to 48 hours; 5 to 7 days; 14 to 17 days; and 6 months. All patients showed edema at 24 hours. The mean volume of edema (% left ventricle) was 37±16 at 24 hours and 39±17 at 1 week, with a reduction to 24±13 (
P
<0.01) by 2 weeks. Myocardial segments with edema also had increased signal on LGE at 24 hours (κ=0.77;
P
<0.001). The volume of LGE decreased significantly between 24 hours and 6 months (27±15% versus 22±12%;
P
=0.002). Of segments showing LGE at 24 hours, 50% showed resolution by 6 months. In segments with such a reduction in LGE, 65% also showed improved wall motion (
P
<0.0001). The area of LGE measured at 6 months correlated more strongly with troponin at 48 hours (
r
=0.9;
P
<0.01) than LGE at 24 hours (
r
=0.7). The difference in LGE between 24 hours and 6 months had profound effects on the calculation of salvage index (26±21% at 24 hours versus 42±23% at 6 months;
P
=0.02).

Conclusions—

Myocardial edema is maximal and constant over the first week after myocardial infarction, providing a stable window for the retrospective evaluation of area at risk. By contrast, myocardial areas with high signal intensity in LGE images recede over time with corresponding recovery of function, indicating that acutely detected LGE does not necessarily equate with irreversible injury and may severely underestimate salvaged myocardium.
Integrated regional water management: a study of collaboration or water politics-as-usual in California, USA
Authors: Lubell Mark , Lippert Lucas
Published: March 2011

This article analyzes the effectiveness of Integrated Regional Water Management (IRWM) in the San Francisco Bay Area of California for decreasing fragmentation and increasing collaboration among water management stakeholders. The theory identifies the elements of traditional water management politics that lead to fragmentation and conflict. The water politics-as-usual model is then compared to the collaborative model of integrated water management. The evolution of IRWM in California is briefly described. A survey of Bay Area stakeholders is used to assess whether participation in the Bay Area IRWM achieves the goals of collaboration and integration. The basic results suggest that the Bay Area has made only incremental progress away from the fragmentation and conflict seen in the past.

Points for practitioners

Integrated Regional Water Management is not a panacea for policy fragmentation. Short-term increases in collaboration must be followed by consistent attention to on-the-ground implementation of integrative projects. IRWM is unlikely to cause immediate, drastic changes in policy implementation. Policy change will be incremental and decision-makers must assess whether stronger administrative measures are needed to continue the process of integration and collaboration. Traditionally powerful interests are likely to dominate IRWM decisions unless explicit steps are taken to empower previously excluded groups. The success of IRWM will vary across regions, and more research is needed to identify important contextual variables.
Symposium on water governance. Prologue: water governance as a government’s actions between the reality of fragmentation and the need for integration
Authors: Edelenbos Jurian , Teisman Geert R.
Published: March 2011

This special issue on water governance pays attention to the aspect of fragmentation and integration from an international point of view. We want to give insights into how different countries — the USA, South America and Europe — are dealing with fragmentation in water issues. This first contribution was partly an introduction on the theme of water governance and the fragmentation—integration public administration discussion, and partly gave case illustrations from the Netherlands (two delta areas) in showing how fragmentation and attempts at integration took place. These two cases illustrated that fragmentation is manifest and attempts at integration are alive, but are often not effective. On the one hand (southwestern delta) integration is sought for through centralization (top-down coordination) and creating one overall formal structure (through legislation), on the other hand (IJsseldelta-South) we saw that integration is difficult to manage leading to crowding out and fading out effects (from central, regional integration efforts to local integration efforts).

Points for practitioners

Water resources, especially fresh water, will become one of the scarcest resources for humans, societies and ecosystems. In several areas of the world this is already quite evident. A third of the world’s population lives in water-stressed countries. Water governance is also crucial in terms of water surplus. Almost all the deltas in the world will face flooding problems, and three-quarters of the world’s population live in deltas. The joint starting point for this symposium on Water Governance is the existing fragmentation of responsibilities in this field. Achieving cooperation and integration in such fragmented systems is a core problem in governance.
Peace and War With Endogenous State Capacity
Authors: McBride Michael , Milante Gary , Skaperdas Stergios
Published: March 2011

We explore how peace or war can occur in the presence of commitment problems. These problems can be reduced by institutions of good governance or, alternatively, state capacity which (a) can be considered a collective good and (b) can be improved through investments. We show how the likelihood of a peace agreement depends on the level of state capacity and on investments in state capacity made by adversaries. In accordance with existing evidence but contrary to various theories of conflict, we find that income levels unambiguously increase the chance of peace. Among other issues, we discuss the critical role of external actors in encouraging or discouraging commitment and in developing good governance institutions.
Socialist Summer-home Settlements in Post-socialist Suburbanisation
Authors: Leetmaa Kadri , Brade Isolde , Anniste Kristi , Nuga Mari
Published: March 2011

The construction of new housing has been the most visible of all the spatial changes to have affected the post-socialist suburban landscape. It is argued in this article that former summer-home settlements are a hidden component of contemporary residential suburbanisation in former socialist countries. The building of summer or weekend homes ( dacha settlements in the former Soviet Union) around major cities for urban residents was a specific feature of socialist metropolitan planning. After removing construction restrictions, the stock of vacant dachas started to support the supply side of the suburban housing market. While dachas were a reserve of affordable housing during the recession of the 1990s, they served as a stock of building plots during the construction boom of the mid 2000s. In the Tallinn Metropolitan Area, former second homes are even more important than new post-1991 residential areas in terms of giving access to detached houses to the metropolitan population.
iPhones in China: The Contradictory Stories of Media-ICT Globalization in the Era of Media Convergence and Corporate Synergy
Authors: Yu Shi
Published: March 2011

This study analyzes Mainland China’s official and unofficial reception of the iPhone, a highly popular smartphone made by Apple. Apple, with its synergistic business measures, seeks to shape all aspects of iPhone users’ mobile experiences, whether related to hardware, software, content, or service. As Apple attempts to expand on its U.S. success, the iPhone case in China displays many contradictory stories of Apple’s globalization endeavors. This article analyzes the structural obstacles facing Apple that come from the Chinese bureaucratic capitalist party-state and local wireless carriers and reveals both the creativity of Chinese iPhone users and the limits of their resistant tactics. To make sense of the intricacies of this global-local encounter, we need to combine political economic and critical cultural analyses and interpret resistance in light of the power imbalance intensified by media convergence and corporate synergy on the structural level.
Impact on Decisions to Start or Continue Medicines of Providing Information to Patients about Possible Benefits and/or Harms
Authors: Crockett Rachel A. , Sutton Stephen , Walter Fiona M. , Clinch Megan , Marteau Theresa M. , Benson John
Published: March 2011

Background. The impact of providing information about medicines to patients on decisions about starting or continuing them is unknown. Purpose. To estimate the impact on decisions to start or continue medicines, of providing information to patients about possible benefits and/or harms. Data Sources. Electronic searches from 1980 to October 2010; reference and citation searches of included studies. Study Selection. Two investigators assessed studies' eligibility against inclusion criteria: randomized or pseudorandomized trials; participants older than 16 years and deciding for themselves; one group received information about possible benefits and/or harms of a potentially beneficial medicine, compared with another who did not; d) a measure of decision about starting or continuing a medicine. Data Extraction. One investigator extracted all data, checked by a second. Data Synthesis. Eight studies were included, covering a range of medicines. There was no consistent impact of interventions on decisions about whether to start or continue medicines (pooled odds ratio 1.08; 95% confidence interval [CI], 0.69–1.70; P = 0.74). Among those who received more information, knowledge was increased (pooled mean difference 8.47; 95% CI 2.17–14.77; P = 0.008), and decisional conflict was reduced (pooled mean difference -0.15; 95% CI -0.24 to -0.06; P = .001). Limitations. A small number of studies across different clinical contexts, of uncertain heterogeneity, were included. Conclusions. Providing information to patients about possible benefits and/or harms has no consistent effect on the number who decide to start or continue medicines, although it increases patients' knowledge and reduces their decisional conflict.
Shortage, fuzzy property and other dead ends in the anthropological analysis of (post)socialism
Authors: Thelen Tatjana
Published: March 2011

The article begins with the observation that, despite almost ideal conditions, anthropological research on postsocialism has had little impact on general theoretical debates. One reason for this development, it will be argued, can be found in earlier interpretations of socialism that continue to have an effect on the field by obstructing innovative conceptualizations. The appropriation of ideas derived from neo-institutionalism by anthropologists produced analyses that found both socialism and postsocialism to be deficient. Thereby the ambivalent construction of the socialist ‘other’ allowed the general focus on economics to appear unproblematic. Following the introduction of Western institutions into formerly socialist contexts, the analytical focus shifted from old ‘different’ and ‘inefficient’ institutions to now ‘inefficient’ or at least ‘different’ actors. Taking the example of work relations, the article shows that only by overcoming these normative assumptions about the ‘other’ can anthropologists begin to question implicit knowledge and thereby open the possibility for new theorizing.
Autochthony, ethnicity, indigeneity and nationalism: Time-honouring and state-oriented modes of rooting individual-territory-group triads in a globalizing world
Authors: Zenker Olaf
Published: March 2011

Recently, proliferating discourses on autochthony and indigeneity have been noted as the flip-side of globalization. Against this backdrop, this article synthesizes insights from studies of nationalism and research on autochthony, explaining how identity formations literally ‘take place’ by conceptualizing ‘autochthony’ — the proclaimed ‘original’ link between individual, territory and group — as the root phenomenon. Two causal logics underlying this autochthonous ethnicity are distinguished, which honour time differently: ‘individualized autochthony’ links the individual, territory and group in such a way that shared culture/descent follow from place of birth/residence within the same present, whereas ‘collectivized autochthony’ inverts this causality on the basis of continuously evoking the same past. The article concludes by distinguishing between ‘indigeneity’ and ‘nationalism’ as alternative modes for targeting the state: whereas indigeneity refers to cases of autochthony that demand special entitlements from the state, nationalism denotes such cases that aim for the very entitlement of the state itself.
A new urban type: Gangsters, terrorists, global cities
Authors: Rao Vyjayanthi
Published: March 2011

This article examines the concept of urban charisma as a quality that circulates through urban imaginaries and in the gestures and practices of everyday urban figures. Specifically exploring the figure of the gangster in Bombay cinema in the context of recent events of militant attacks in Mumbai, and tracing the empirical and cinematic transformation of the gangster into terrorist, this article argues that the cultural biographies of these figures, available through cinema, fiction, non-fiction writing and other forms of mass media are instructive as ‘reading principles’ through which chaotic and transitional urban spaces acquire legibility in popular imagination. As the city mutates rapidly, the mythic figure of the gangster and the enigmatic figure of the ordinary citizen-terrorist take on a new significance for understanding urban transformation precisely because these figures are framed by and in turn enframe these shifts most visibly, as these transformations become part of urban soul.
Waste vinegar residue as substrate for phytase production
Authors: Wang Zhi-Hong , Dong Xiao-Fang , Zhang Guo-Qing , Tong Jian-Ming , Zhang Qi , Xu Shang-Zhong
Published: March 2011

Waste vinegar residue, the by-product of vinegar processing, was used as substrate for phytase production from Aspergillus ficuum NTG-23 in solid-state fermentation to investigate the potential for the efficient re-utilization or recycling of waste vinegar residue. Statistical designs were applied in the processing of phytase production. First, a Plackett–Burman (PB) design was used to evaluate eleven parameters: glucose, starch, wheat bran, (NH4)2SO4, NH4NO3, tryptone, soybean meal, MgSO4·7H2O, CaCl2·7H2O, FeSO4·7H2O, incubation time. The PB experiments showed that there were three significant factors: glucose, soybean meal and incubation time. The closest values to the optimum point were then derived by steepest ascent path. Finally, a mathematical model was created and validated to explain the behavioural process after these three significant factors were optimized using response surface methodology (RSM). The best phytase activity was attained using the following conditions: glucose (7.2%), soybean meal (5.1%), and incubation time (271 h). The phytase activity was 7.34-fold higher due to optimization by PB design, steepest ascent path design and RSM. The phytase activity was enhanced 0.26-fold in comparison with the results by the second step of steepest ascent path design. The results indicate that with waste vinegar residue as a substrate higher production of phytase from Aspergillus ficuum NTG-23 could be obtained through an optimization process and that this method might be applied to an integrated system for recycling of the waste vinegar residue.
Electrographic Seizures During Therapeutic Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy
Authors: Wusthoff Courtney J. , Dlugos Dennis J. , Gutierrez-Colina Ana , Wang Anne , Cook Noah , Donnelly Maureen , Clancy Robert , Abend Nicholas S.
Published: March 2011

Electrographic seizures are common in neonates with hypoxic-ischemic encephalopathy, but detailed data are not available regarding seizure incidence during therapeutic hypothermia. The objective of this prospective study was to determine the incidence and timing of electrographic seizures in term neonates undergoing whole-body therapeutic hypothermia for hypoxic-ischemic encephalopathy as detected by conventional full-array electroencephalography for 72 hours of therapeutic hypothermia and 24 hours of normothermia. Clinical and electroencephalography data were collected from 26 consecutive neonates. Electroencephalograms were reviewed by 2 pediatric neurophysiologists. Electrographic seizures occurred in 17 of 26 (65%) patients. Seizures were entirely nonconvulsive in 8 of 17 (47%), status epilepticus occurred in 4 of 17 (23%), and seizure onset was in the first 48 hours in 13 of 17 (76%) patients. Electrographic seizures were common, were often nonconvulsive, and had onset over a broad range of times in the first days of life.
Chemical Stabilization of Oils Rich in Long-Chain Polyunsaturated Fatty Acids During Storage
Authors: Pop F.
Published: March 2011

During the microencapsulation process, the fish oil undergoes multiple changes in its physical properties such as bulkiness and dispersibility in aqueous phase and dry matrix. Autoxidation already occurred in the first stages of the microencapsulation process itself during emulsification and spray-drying. An efficient stabilization was achieved using a ternary combination of lipophilic antioxidants, synergistic compounds and a trace metal chelator, e.g. a combination of tocopherols, rich in the δ-derivative and low in the α-derivative, with ascorbyl palmitate and lecithin. Trace metal chelation by, e.g. Citrem or lecithin in combination with ascorbyl palmitate proved to be of particular importance in the emulsion, but not during the storage of the microencapsulated oil. In the microencapsulated oil, the addition of rosemary extract rich in carnosic acid to ternary blends of tocopherols, ascorbyl palmitate and lecithin or Citrem significantly retarded autoxidation.
Arterial dysfunction and functional performance in patients with peripheral artery disease: A review
Authors: Coutinho Thais , Rooke Thom W , Kullo Iftikhar J
Published: March 2011

Functional performance influences quality of life in individuals with peripheral artery disease (PAD) and is also a powerful prognostic marker in these patients. The pathophysiology of impaired functional performance in patients with PAD is incompletely understood. The severity of atherosclerotic burden, non-invasively assessed by the ankle—brachial index (ABI), does not reliably predict the degree of functional impairment observed in PAD patients. We review associations of measures of arterial function (arterial stiffness and endothelial dysfunction) with functional performance in PAD patients, and also review potential therapies for arterial stiffness and endothelial dysfunction that could improve functional performance in PAD. Recent studies suggest that measures of arterial function, such as arterial stiffness and endothelial function, are associated with exercise performance in the setting of PAD. These studies have provided new insights into (1) the pathophysiology of functional impairment in PAD, (2) mechanisms of strategies known to be effective such as walking programs, and (3) potential new therapeutic interventions for improving functional performance. Thus, therapies aimed at arterial ‘de-stiffening’ and improving endothelial function (such as aerobic exercise, statins and angiotensin-converting enzyme inhibitors) may improve functional performance in patients with PAD; however, further investigations are needed.
Reliability and Safety Assessments of the Satellite Separation Process of a Typical Launch Vehicle
Authors: Singaravelu J , Jeyakumar D , Nageswara Rao B
Published: March 2011

This paper presents in brief the formulation of the rigid body separation dynamics that are useful for the design and analysis of satellite separation systems using the helical compression spring mechanism. In satellite launch vehicle chronology, safe injection of the satellite into the desirable orbit is an important final task. The body rate of the satellite during separation should be within the satellite control capabilities. The Taguchi method is employed in order to understand the influencing parameters in the separation process. Statistical analysis has been carried out to identify the probability distribution function for reliability and safety assessment of the satellite separation of a launch vehicle. Using the response surface method (RSM), an empirical relation is obtained for the body rate of the satellite in terms of the 28 physical parameters. The RSM results are compared with the Taguchi simulation results. Reliability and safety assessments are made on the satellite separation of a typical launch vehicle.
Randomized controlled trial of the application of topical b-FGF-impregnated gelatin microspheres to improve tissue survival in subzone II fingertip amputations
Authors: Kusuhara Hirohisa , Itani Yoshihito , Isogai Noritaka , Tabata Yasuhiko
Published: March 2011

We undertook a randomized controlled trial of subzone II fingertip amputations, comparing standard treatment with topical application of gelatin microspheres prepared with basic fibroblast growth factor (b-FGF) to provide a slow, sustained release of b-FGF with microsphere degradation. Forty-eight digits from 42 patients were randomized into the two study arms. The microspheres were applied as a paste on exposed tissue surfaces, whereas standard treatment was without any topical treatment. Patients were treated either with microsurgical revascularization or by simple composite graft, based on the surgeon’s clinical decision. Tissue survival of the replanted fingertips was measured by a blinded evaluator 3 weeks postoperatively. A modest improvement in survival was seen with b-FGF-microsphere application for both revascularized and composite grafted fingertips, though this did not achieve statistical significance. Whether the slow release of b-FGF through a bioresorbable carrier gives any improvement in outcome in patients with subzone II fingertip amputations is unproven.
Environmental and policy approaches to increasing physical activity
Authors: Howell Shawna L. , Tucker Pattie , Liburd Leandris
Published: March 2011

The Centers for Disease Control and Prevention’s (CDC) Racial and Ethnic Approaches to Community Health (REACH) program funded 40 communities in the United States during 1999—2007. Three of these communities implemented interventions to increase physical activity among African Americans. This case study looks at these interventions and the evidence-based recommendations from the CDC’s Community Guide for Preventive Services. These recommendations address creating or improving access to physical activity and the dissemination of information via media campaigns. Findings suggest that although the evidence could not be applied in every respect, culturallytailored change strategies can meet unique characteristics of African Americans with or at risk for heart disease and may contribute to increased physical activity. (Global Health Promotion, 2011; 18(1): pp. 43—46)
Action in Childcare Settings training programme
Authors: Dagenais Christian , Dutil Julie
Published: March 2011

The intervention is a train-the-trainer programme for childcare practitioners aimed at preventing the maltreatment of young children in Québec. The content of the programme was determined based on systematic reviews of published evidence on the issue. A number of training sessions were subsequently offered to practitioners in the targeted settings and rigorously evaluated. Lessons learned included: the importance of a needs assessment for adequate knowledge transfer to end users; train-the-trainers programmes are effective for transferring evidence to large groups; and training participants’ perception of the value of evidence depends on the confidence inspired by those who transmit it.
Oral health promotion for children with disabilities in the Republic of Ireland
Authors: Owens Janine
Published: March 2011

Children with disabilities are a marginalized group in relation to health in the Republic of Ireland, and oral health is frequently relegated to a position of little or no importance by parents, paid carers, and non-dental professionals. Subsequently, there is often a higher need for treatment and inpatient procedures that could be prevented. Introducing a health promotion intervention which aimed to reduce the need for dental treatment was envisioned as being the way forward. A qualitative evaluation of the context for implementation highlighted barriers in achieving the aims of the plan.
Scientific evidence and policy change: lowering the legal blood alcohol limit for drivers to 0.08% in the USA
Authors: Sleet David A. , Mercer Shawna L. , Hopkins Cole Krista , Shults Ruth A. , Elder Randy W. , Nichols James L.
Published: March 2011

The United States (US) Centers for Disease Control and Prevention (CDC), and key partners conducted a systematic review of the effectiveness of 0.08% blood alcohol concentration (BAC) laws on alcohol-related traffic mortality. Review findings of strong evidence of effectiveness were presented by partners during US Congressional hearings contributing to the passage of a bill requiring states to lower the legal BAC limit to 0.08% (80 mg of alcohol/100 ml of blood) or lose a portion of their federal highway funds. The bill was signed into law, making 0.08 the new national standard. Extensive and targeted dissemination of the evidence and recommendations to key stakeholders and partners built support for policy change at the state level.
Case study of the use of evaluation evidence to inform diabetes prevention programming in two Canadian health regions
Authors: Yates Mary Jane , MacLellan-Wright Mary Frances , Wolbeck Minke Sharlene , Horne Tammy , Davachi Shahnaz , Ortiz Lucenia , Moscardelli Silvana
Published: March 2011

This study compares the use of evidence in two 18-month Canadian projects with a similar goal: improved prevention of type II diabetes in women from ethno-cultural communities with a gestational diabetes diagnosis. Evidence used for both projects included epidemiological data and research literature, needs assessments with the target population, and project evaluations. Contexts for the use of evidence differed between the two projects in terms of the innovation and its level of complexity; organizational context and system readiness for change; and partnership characteristics. This study showed that while evidence played some role in determining project success, it was but one factor in deciding how project activities were (or were not) sustained.
Promoción de la salud basada en la evidencia : un campo emergente
Authors: Juneau Carl-Etienne , Jones Catherine M. , McQueen David V. , Potvin Louise
Published: March 2011

El empleo de la evidencia en la práctica de la promoción de la salud suscita mucha polémica. El presente artículo pretende afinar nuestra comprensión de esta cuestión a partir del estudio y análisis de 26 casos prácticos que integran este número especial. Los casos ponen de manifiesto que los profesionales de la promoción de la salud utilizan una amplia gama de evidencia derivada de la investigación en las intervenciones destinadas a personas de alto riesgo, a poblaciones enteras y a grupos vulnerables, y que lo hacen de conformidad con las cinco estrategias para la acción que establece la Carta de Ottawa para la Promoción de la Salud. En casi todos los casos, los profesionales tuvieron que actuar de mediadores y adaptar los datos de la investigación al caso concreto. Ocho factores clave ayudaron a los profesionales a integrar la evidencia en la práctica : pertinencia local y cultural de la evidencia, capacitación comunitaria, diálogo permanente desde el principio con todas las personas interesadas y afectadas por la intervención, partenariados bien establecidos que cuenten con apoyo académico, comunicación adecuada que responda a las necesidades de las organizaciones y de los decisores políticos en el tiempo oportuno, reconocimiento y toma de conciencia de la brecha existente entre la evidencia y la práctica, actividades de divulgación de nuestros postulados e incidencia pública, y recursos suficientes previamente reservados para cada programa. Estos casos prácticos aportan pruebas de que existe una promoción de la salud basada en la evidencia, de que la base de esta evidencia es amplia y de que los profesionales utilizan diversas estrategias para adaptarla a cada caso concreto. (Global Health Promotion, 2011; 18(1): pp. 157—168)
Essential thrombocythemia versus early primary myelofibrosis: a multicenter study to validate the WHO classification
Authors: Thiele Jürgen , Kvasnicka Hans Michael , Müllauer Leonhard , Buxhofer-Ausch Veronika , Gisslinger Bettina , Gisslinger Heinz
Published: March 2011

Controversy persists regarding the role of histopathology in the distinction between essential thrombocythemia (ET) and early-prefibrotic primary myelofi-brosis (PMF) presenting with thrombocythemia. To investigate the impact and reproducibility of bone marrow (BM) morphology according to the World Health Organization classification, 295 patients with the presumptive clinical diagnosis of either ET or early PMF were studied. Data of this cohort (Vienna group) were compared with 732 corresponding patients (Cologne group). Evaluating blindly (only age and gender known) BM specimens, the 2 groups of pathologists achieved an overall consensus of 78% regarding the total series and 88% concerning the discrimination between ET versus PMF. In 126 ET and 81 early PMF patients without pretreatment and complete documentation, a 90% concordance with the independently established clinical diagnosis was found. In 12 patients, overlapping of histopathology and some clinical findings between ET and polycythemia vera occurred. Contrasting ET, early PMF showed significant differences of presenting hematologic data and an unfavorable prognosis (estimated mean survival, 14 vs 21 years). Comparison of clinical and survival data of the Vienna cohort with the historical Cologne series revealed an overall congruence. This study highlights the impact of BM morphology for the differentiation between true vs false ET.
Constitutive activation of metalloproteinase ADAM10 in mantle cell lymphoma promotes cell growth and activates the TNFα/NFκB pathway
Authors: Armanious Hanan , Gelebart Pascal , Anand Mona , Belch Andrew , Lai Raymond
Published: March 2011

One of the main functions of A Disintegrin and Metalloproteinase 10 (ADAM10) is to regulate the bioavailability of adhesion molecules and ligands to various cellular-signaling receptors. Constitutive activation of ADAM10 has been implicated in the pathogenesis of several types of solid tumors. In this study, we found that mantle cell lymphoma (MCL) cell lines and all 12 patient samples examined expressed the active/mature form of ADAM10. In contrast, PBMCs from healthy donors (n = 5) were negative. Using immunohistochemistry, ADAM10 was readily detectable in 20 of 23 (87%) MCL tumors, but absent in 5 reactive tonsils. Knockdown of ADAM10 using short interfering RNA (siRNA) in MCL cells significantly induced growth inhibition and cell-cycle arrest, and these changes were correlated with down-regulation of cyclin D1, up-regulation of p21waf1, and significant reductions in the TNFα production/transcriptional activity of NFκBp65. The addition of recombinant ADAM10 to MCL cells led to the opposite biologic effects. Lastly, down-regulation of ADAM10 using siRNA enhanced the growth-suppressing effects mediated by the proteasome inhibitors MG132 and bortezomib. We conclude that constitutive activation of ADAM10 contributes to the growth of MCL and therefore inhibition of ADAM10 may be a useful strategy to enhance the response of MCL to other therapeutic agents.
Gene-expression profiling and not immunophenotypic algorithms predicts prognosis in patients with diffuse large B-cell lymphoma treated with immunochemotherapy
Authors: Gutiérrez-García Gonzalo , Cardesa-Salzmann Teresa , Climent Fina , González-Barca Eva , Mercadal Santiago , Mate José L. , Sancho Juan M. , Arenillas Leonor , Serrano Sergi , Escoda Lourdes , Martínez Salomé , Valera Alexandra , Martínez Antonio , Jares Pedro , Pinyol Magdalena , García-Herrera Adriana , Martínez-Trillos Alejandra , Giné Eva , Villamor Neus , Campo Elías , Colomo Luis , López-Guillermo Armando ,   for the Grup per l'Estudi dels Limfomes de Catalunya I Balears (GELCAB)
Published: March 2011

Diffuse large B-cell lymphomas (DLBCLs) can be divided into germinal-center B cell–like (GCB) and activated-B cell–like (ABC) subtypes by gene-expression profiling (GEP), with the latter showing a poorer outcome. Although this classification can be mimicked by different immunostaining algorithms, their reliability is the object of controversy. We constructed tissue microarrays with samples of 157 DLBCL patients homogeneously treated with immunochemotherapy to apply the following algorithms: Colomo (MUM1/IRF4, CD10, and BCL6 antigens), Hans (CD10, BCL6, and MUM1/IRF4), Muris (CD10 and MUM1/IRF4 plus BCL2), Choi (GCET1, MUM1/IRF4, CD10, FOXP1, and BCL6), and Tally (CD10, GCET1, MUM1/IRF4, FOXP1, and LMO2). GEP information was available in 62 cases. The proportion of misclassified cases by immunohistochemistry compared with GEP was higher when defining the GCB subset: 41%, 48%, 30%, 60%, and 40% for Colomo, Hans, Muris, Choi, and Tally, respectively. Whereas the GEP groups showed significantly different 5-year progression-free survival (76% vs 31% for GCB and activated DLBCL) and overall survival (80% vs 45%), none of the immunostaining algorithms was able to retain the prognostic impact of the groups (GCB vs non-GCB). In conclusion, stratification based on immunostaining algorithms should be used with caution in guiding therapy, even in clinical trials.
Cross-protective TH1 immunity against Aspergillus fumigatus and Candida albicans
Authors: Stuehler Claudia , Khanna Nina , Bozza Silvia , Zelante Teresa , Moretti Silvia , Kruhm Michaela , Lurati Sarah , Conrad Barbara , Worschech Eike , Stevanović Stefan , Krappmann Sven , Einsele Hermann , Latgé Jean-Paul , Loeffler Juergen , Romani Luigina , Topp Max S.
Published: March 2011

T cell–mediated heterologous immunity to different pathogens is promising for the development of immunotherapeutic strategies. Aspergillus fumigatus and Candida albicans, the 2 most common fungal pathogens causing severe infections in immunocompromised patients, are controlled by CD4+ type 1 helper T (TH1) cells in humans and mice, making induction of fungus-specific CD4+ TH1 immunity an appealing strategy for antifungal therapy. We identified an immunogenic epitope of the A fumigatus cell wall glucanase Crf1 that can be presented by 3 common major histocompatibility complex class II alleles and that induces memory CD4+ TH1 cells with a diverse T-cell receptor repertoire that is cross-reactive to C albicans. In BALB/c mice, the Crf1 protein also elicits cross-protection against lethal infection with C albicans that is mediated by the same epitope as in humans. These data illustrate the existence of T cell–based cross-protection for the 2 distantly related clinically relevant fungal pathogens that may foster the development of immunotherapeutic strategies.
Lysophosphatidic acid suppresses endothelial cell CD36 expression and promotes angiogenesis via a PKD-1–dependent signaling pathway
Authors: Ren Bin , Hale James , Srikanthan Sowmya , Silverstein Roy L.
Published: March 2011

In pathologic settings including retinal ischemia and malignant tumors, robust angiogenesis occurs despite the presence in the microenvironment of antiangiogenic proteins containing thrombospondin structural homology (TSR) domains. We hypothesized that antiangiogenesis mediated by TSR-containing proteins could be blunted by localized down-regulation of their cognate receptor on microvascular endothelial cells (MVECs), CD36. Through screening a panel of endothelial cell agonists, we found that lysophosphatidic acid (LPA) dramatically down-regulated CD36 surface expression on primary MVECs. LPA is a lipid-signaling mediator known to have proangiogenic activity, but the mechanisms are largely unknown. We observed that LPA caused CD36 down-regulation in a dose- and time-dependent manner and was long lasting. Down-regulation occurred at the transcriptional level via a signaling pathway involving specific LPA receptors and protein kinase D. LPA-induced MVEC CD36 repression significantly attenuated in vitro antiangiogenic responses to thrombospondin-1, including blockade of migration, tube formation, and VEGFR-2 signaling in response to fibroblast growth factor-2. In vivo relevance was demonstrated by showing that LPA abrogated thrombospondin-1–mediated inhibition of neovascularization of Matrigel plugs implanted in mice. Our data thus indicate that the proangiogenic mechanism of LPA may in part be via switching off the antiangiogenic switch mediated by TSR proteins and CD36.