bluuebunny/crossref_metadata_2025 huggingface dataset:
Continuing education and clinical research for the training of obstetricians and gynecologists in Europe
Authors: Creatsas George , Mastorakos George
Published: September 2010

The need for doctors to develop in their profession and in science applies to all ages and at all hierarchical levels. This development can be sustained both via education and research. In this brief paper, we examine certain crucial aspects of education and research in obstetrics and gynecology (OB/GYN) as they are actually observed in Europe. The need for uniform development of continuing professional development (CPD) among all European countries is progressively becoming apparent. There is no single approach to CPD. Junior doctors should benefit from the teaching of senior obstetricians and gynecologists, especially those in a hierarchical system of training that must assure their progress. Hospital visiting organized by EBCOG enables OB/GYN departments of teaching hospitals to unify their teaching and learning approaches. Furthermore, improving the ability of trainees and specialists to conduct clinical research is vital, as this will transform the breakthroughs of basic science into clinical practice. A formal training period in research should be available to most competent trainees in OB/GYN in addition to their basic clinical training.
The Coming of an Aged Society in Taiwan: Issues and Policies
Authors: Lin Wan‐I
Published: September 2010

For most advanced industrialized countries, an aging society has been a national issue since the 1970s. However, Taiwan was not aware of this issue until 1993, the year when the old‐age population reached 7.0%. As an aging nation under the definition of the United Nations, the Taiwanese government began to pay more attention to the aging population, and executed several policies in response to this demographic transition. First, this article examines Taiwan’s demographic transition from an aging society to an aged society, and its impacts. Second, it demonstrates the responses of Taiwan to the coming of an aged society and explores crucial issues that Taiwanese society is facing.
Interpretation of complex phenotypes: lessons from the Mitf gene
Authors: Steingrímsson Eiríkur
Published: September 2010

Mutations provide important structure–function relationships by allowing the correlation of phenotypes to the underlying genotypes. Knockout mutations that lead to loss‐of‐function are important and informative in this respect. However, spontaneous and induced mutations sometimes provide surprising phenotypes, which lead to unexpected functional insights and novel biochemical pathways, especially when multiple mutations (alleles) exist at a locus. An excellent example is provided by the microphthalmia (Mitf) locus in the mouse. The multiple Mitf alleles have their own phenotypic properties, most of which have been explained by the underlying mutation. However, one allele, the Mitf Mi‐White (Mitf Mi‐Wh) mutation, exhibits phenotypes that have not yet been fully explained. Here, the molecular, genetic, and phenotypic properties of this mutation are reviewed and an attempt made to explain the underlying biochemical reason for its observed effects.
Precision and accuracy of the ICare tonometer – Peripheral and central IOP measurements by rebound tonometry
Authors: Muttuvelu Danson V. , Baggesen Kirsten , Ehlers Niels
Published: September 2010

Purpose:  The purpose of this study was to evaluate the ICare tonometers precision and accuracy and the extent to which intraocular pressure (IOP) measurements are influenced by measuring position.

Methods:  This was carried out by comparing the central and peripheral ICare‐IOP readings and comparing ICare‐ with the Goldmann applanation tonometer (GAT)‐IOP readings. IOP was measured using the ICare rebound tonometer on the right eye of 40 subjects, straight at the centre of the cornea (CS), straight 2 mm from the nasal and temporal limbus (NS and TS), and in 10 degrees nasally and temporally angled positions measured from the same location as CS (NA and TA). The IOP was also assessed with the GAT.

Results:  Central IOP (CS) was significantly (p < 0.001) greater than peripheral measurements (NS, TS, NA and TA) by approximately 3–4 mmHg. Centre IOP (CS) significantly overestimated by mean 2 mmHg and the peripheral measurements significantly underestimates approximately 1.4–2 mmHg compared with GAT readings.

Conclusion:  The ICare tonometer may be useful in a routine clinical setting for IOP screening, but the ICare measurement is not a substitute for the GAT measurement, when a precise and accurate IOP is desired.
Role of Antiischemic Agents in the Management of Non‐ST Elevation Acute Coronary Syndrome (NSTE‐ACS)
Authors: El‐Kadri Moutaz , Sharaf‐Dabbagh Hala , Ramsdale David
Published: September 2010

Non‐ST elevation acute coronary syndrome (NSTE‐ACS) is the commonest acute presentation of coronary artery disease (CAD). Mortality and morbidity of the condition has improved substantially over the last few decades as a result of the cumulative effect of multiple interventions acting via different mechanisms. Despite a significant increase in the rate of coronary intervention, medical therapy continues to retain a central role in the treatment of NSTE‐ACS particularly in frail patients where revascularization is inappropriate or when it is incomplete. Several antiischemic agents have been used in the treatment of the condition. Beta blockers are often the first‐line choice with calcium channel blockers and nitrates being used as an alternative when beta blockers are contraindicated, or as an addition to achieve optimal symptom control. Newer agents, such as nicorandil, ivabradine, and ranolazine have also been used in refractory cases. Although most of these agents have been extensively studied in large randomized controlled trials in patients with stable CAD or ST elevation acute coronary syndrome (STE‐ACS), the evidence supporting their use in NSTE‐ACS is less clear cut. In this article, we review various drugs available for controlling ischemia and the latest evidence in support of their use in NSTE‐ACS.
Late Cretaceous‐Cenozoic Exhumation History of the Lüliang Mountains, North China Craton: Constraint from Fission‐track Thermochronology
Authors: LI Xiaoming , SONG Yougui
Published: September 2010

The Lüliang Mountains, located in the North China Craton, is a relatively stable block, but it has experienced uplift and denudation since the late Mesozoic. We hence aim to explore its time and rate of the exhumation by the fission‐track method. The results show that, no matter what type rocks are, the pooled ages of zircon and apatite fission‐track range from 60.0 to 93.7 Ma and 28.6 to 43.3 Ma, respectively; all of the apatite fission‐track length distributions are unimodal and yield a mean length of ∼13 μm; and the thermal history modeling results based on apatite fission‐track data indicate that the time‐temperature paths exhibit similar patterns and the cooling has been accelerated for each sample since the Pliocene (c.5 Ma). Therefore, we can conclude that a successive cooling, probably involving two slow (during c.75–35 Ma and 35–5 Ma) and one rapid (during c.5 Ma‐0 Ma) cooling, has occurred through the exhumation of the Lüliang Mountains since the late Cretaceous. The maximum exhumation is more than 5 km under a steady‐state geothermal gradient of 35°C/km. Combined with the tectonic setting, this exhumation may be the resultant effect from the surrounding plate interactions, and it has been accelerated since c.5 Ma predominantly due to the India‐Eurasia collision.
Occurrence and Characterization of Verocytotoxigenic Escherichia coli (VTEC) Strains from Dairy Farms in Trinidad
Authors: Roopnarine R. R. , Ammons D. , Rampersad J. , Adesiyun A. A.
Published: September 2010

A cross‐sectional study was conducted to determine the prevalence and characteristics of verocytotoxigenic Escherichia coli (VTEC) on 25 dairy farms each located in Waller field and Carlsen field farming areas in Trinidad. On each selected farm, faecal samples were collected from milking cows, calves and humans; rectal swabs were obtained from pet farm dogs; bulk milk was sampled as well as effluent from the milking parlour. Escherichia coli was isolated from all sources on selective media using standard methods. Isolates of E. coli were subjected to slide agglutination test using E. coli O157 antiserum, vero cell cytotoxicity assay to detect verocytotoxin (VT) and heat labile toxin (LT) production, the polymerase chain reaction (PCR) to detect VT genes, and the dry spot test to screen for E. coli O157 and non‐O157 strains. In addition, faecal samples from animal and human sources were tested for VT genes using PCR. Of a total of 933 E. coli isolates tested by the slide test, eight (0.9%) were positive for the O157 strain. The vero cell cytotoxicity assay detected VT‐producing strains of E. coli in 16.6%, 14.6%, 3.2% and 7.1% of isolates from cows, calves, farm dogs and humans respectively (P < 0.05; χ2). For LT production, the highest frequency was detected amongst isolates of E. coli from calves (10.8%) and the lowest (0.0%) amongst isolates from humans and bulk milk (P < 0.05; χ2). Of the 61 VT‐producing isolates by vero cell cytotoxicity assay tested by PCR, the VT, LT and eae genes were detected in 62.3%, 4.9% and 1.6% respectively (P < 0.05; χ2). Amongst the 45 E. coli isolates that were VT positive (vero cell) or VT‐gene positive by PCR, 2.2%, 2.2%, 4.4% and 6.7% belonged to non‐O157 strains O91, O111, O103 and O157, respectively, as determined by the Dry spot test. Detection of VTEC strains in milk and dairy animals poses a health risk to consumers of milk originating from these farms. In addition, the demonstration of VTEC strains in humans, VT gene in faecal samples and E. coli isolates as well as non‐O157 VTEC strains of E. coli are being documented for the first time in the country.
Individual Animals of a Cattle Herd Infected with the Same Mycobacterium bovis Genotype Shows Important Variations in Bacteriological, Histopathological and Immune Response Parameters
Authors: Meikle V. , Schneider M. , Azenzo G. , Zumárraga M. , Magnano G. , Cataldi A.
Published: September 2010

Cattle are the host and main reservoir of the etiologic agent of bovine tuberculosis, Mycobacterium bovis; although other mammalian species, including humans, are susceptible. The tuberculin test and/or slaughterhouse surveillance is the diagnostic method used by control programs all around the world to control and eradicate the disease. In order to compare different tuberculosis diagnostic tests and to reach disease confirmation, a study was performed in a group of 14 steers of Friesian breed, reacting positively to tuberculin test. Three ante‐mortem assays were performed according to the type of sample: the gamma interferon (IFN‐γ) test (which quantifies the release of this cytokine by sensitized lymphocytes in whole blood in response to purified protein derivative (PPD) and recombinant ESAT‐6 and CFP10 proteins); PCR and bacteriologic culture from nasal swab and intradermal tuberculin test. These assays were taken at different times to assess the evolution of clinical parameters. Post‐mortem examination showed macroscopic and microscopic tuberculosis lesions with acid‐fast bacillus and positive cultures. By spoligotyping, we observed that all the isolates showed the same pattern. The positive results based on comparison to lesions observed ranged from 58% to 75% for the IFN‐γ assays, to 72% for cultures, and ranged from 50% to 90% for PCR in nasal swabs. In conclusion, in a herd infected by the same strain, ante‐mortem direct and immune‐diagnostic parameters change, suggesting that several tests are needed for a faster control of infection at herd level.
Inactivation of Avian Influenza Viruses by Chemical Agents and Physical Conditions: A Review
Authors: De Benedictis P. , Beato M. S. , Capua I.
Published: September 2010

The recent outbreaks of avian influenza (AI) worldwide have highlighted the difficulties in controlling this disease both in developed and in developing countries. Biosecurity is considered the most important tool to prevent and control AI. In certain areas of the world, AI has become endemic and the recent outbreaks in Europe and Africa show that the epidemiological situation is evolving in an unprecedented way. The consequences of this situation are economic losses to the poultry industry, food security issues in developing countries and a serious threat to human health, due to the direct consequences of AI infection in humans, and more alarmingly due to the risk of the generation of a new pandemic virus from the animal reservoir. In this paper, the physical and chemical methods of inactivating AI viruses are reviewed, with particular emphasis on the practicalities of using such methods in the poultry industry.
Legislation for the Control of Avian Influenza in the European Union
Authors: Pittman M. , Laddomada A.
Published: September 2010

In the light of experience gained with avian influenza (AI) outbreaks in Europe and elsewhere in the world, the European Union (EU) legislation has recently been updated. The strategy to control the introduction and spread of AI relies on rapid disease detection, killing of infected birds, movement restrictions for live birds and their products, cleaning and disinfection and vaccination. Measures are not only to be implemented in case of outbreaks of highly pathogenic AI (HPAI), but are now also directed against occurrence of low pathogenic AI of H5 and H7 (LPAI) subtypes in poultry, albeit in a modified manner proportionate to the risk posed by these pathotypes. Enhanced surveillance in poultry holdings and wild birds, as well as preventive vaccination, has also been introduced. EU Measures are flexible and largely based on risk assessment of the local epidemiological situation. The occurrence of HPAI H5N1 of the Asian lineage in the EU and its unprecedented spread by wild migratory birds necessitated the adoption of additional control measures. Although HPAI H5N1 has affected wild birds and poultry holdings in several EU Member States, EU legislation and its implementation in Member States has so far successfully limited the impact of the disease on animal and human health.
Serogroups, Atypical Biochemical Characters, Colicinogeny and Antibiotic Resistance Pattern of Shiga Toxin‐producingEscherichia coliIsolated from Diarrhoeic Calves in Gujarat, India
Authors: Arya G. , Roy A. , Choudhary V. , Yadav M. M. , Joshi C. G.
Published: September 2010

This study was designed to investigate the antibiotic resistance, colicinogeny, serotyping and atypical biochemical characteristics of 41 Shiga toxin‐producingEscherichia coli(STEC) strains detected using polymerase chain reaction from 90E. colistrains isolated from 46 diarrhoeic calves. The STEC strains belonged to 14 different serogroups. Seventeen per cent of the STEC strains carried theeaeAgene while 14.28% of the 49 non‐STEC strains wereeaeApositive. Twenty eight (68.29%) of the 41 STEC strains were rhamnose non‐fermentors. All the STEC strains revealed resistance to at least three of the antibiotics tested. 100% resistance was found against kanamycin and cephalexin followed by cephaloridine, enrofloxacin, amikacin, ampicillin, tetracycline, ceftiofur, ciprofloxacin, colistin and co‐trimoxazole. Eighteen (44%) of the STEC strains produced colicin and all these colicinogenic strains were resistant to three or more antibiotics. Eleven STEC strains (26.82%) showed urease activity. The results of this study suggest that diarrhoeic calves are an important reservoir of STEC strains that are potentially pathogenic for farm animals and humans. Moreover, rhamnose fermentation, colicinogeny and atypical biochemical behaviour, such as urease activity, may serve as important markers or diagnostic tools for epidemiological surveys to trace the source of infection in disease outbreaks.
Estimation of the Diagnostic Accuracy of theinvA‐gene‐based PCR Technique and a Bacteriological Culture for the Detection ofSalmonellaspp. in Caecal Content from Slaughtered Pigs using Bayesian Analysis
Authors: Mainar‐Jaime R. C. , Atashparvar N. , Chirino‐Trejo M.
Published: September 2010

The goal of this study was to estimate the accuracy of theinvA‐gene‐based polymerase chain reaction (PCR) and a culture technique based on pre‐enrichment with buffered peptone water, three selective enrichment media (selenite, tetrathionate and Rappaport‐Vassiliadis broths) and four selective, solid media (Xylose‐Lysine‐Tergitol‐4,Salmonella/Shigella, Hekton‐Enteric and MacConkey), for the detection ofSalmonellaorganisms from caecal samples from slaughter pigs. For this purpose a latent‐class (Bayesian) approach was used. Two hundred and three slaughtered pigs were used after grouping them into two groups of 96 and 107 animals. Sensitivity (Se) was estimated to be 56% (95% probability interval 40, 76) for culture and 91% (81, 97) for PCR. The specificity (Sp) of the PCR was 88% (80, 95) while the Sp of the culture had been considered 100% in the statistical analysis as all culture‐positive samples were confirmed by serotyping. PCR Se was not affected by theSalmonellaserotypes present in the samples analysed. Accordingly, a minimum of 25.5% of the pigs was estimated to harbourSalmonellaorganisms in their faeces. It was concluded that bacteriology on caecal samples alone was a poor diagnostic method, and that the PCR method could be considered a cost‐effective alternative to culture inSalmonellamonitoring programmes. However, given the moderate Sp of this molecular technique, PCR‐positive samples should be further confirmed through bacteriology.
Meeting Report: Panel on the Potential Utility and Strategies for Design and Implementation of a National Companion Animal Infectious Disease Surveillance System
Authors: Stone A. B. , Hautala J. A.
Published: September 2010

This meeting report summarizes the discussions and recommendations of a Blue Ribbon Panel convened by the Science and Technology Policy Institute at the Institute for Defense Analysis on behalf of the White House Office of Science and Technology Policy (OSTP) on 13 September 2006 to discuss the potential utility and possible strategies for design and implementation of a companion animal health surveillance system. The panel comprised representatives from federal agencies, state agencies, academia, professional societies, and the private sector. The panel concluded that a companion animal surveillance system might prove valuable to efforts to protect public health, but that further study of the relationship between companion animal health and human health were needed to assess the utility and potential applications of a companion animal surveillance system. The findings of this panel may be used, along with other important sources of information, to inform policy discussions focussed on identifying strategies for recognizing and monitoring zoonotic disease threats appearing in companion animals in the USA.
The First Laboratory‐confirmed Rabid Pig in Maryland, 2003
Authors: DuVernoy T. S. , Mitchell K. C. , Myers R. A. , Walinski L. W. , Tinsley M. O.
Published: September 2010

This article is the first to describe the clinical picture and potential human health impact of laboratory‐confirmed rabies infection in a pet Vietnamese pot‐bellied pig in Maryland. Although cases of confirmed rabies infection have been infrequently reported in pet or agricultural during the past 10 years in the United States, exposure to rabies‐positive animals remains a public health concern particularly for veterinarians, pet owners and other animal caretakers. It is important that individuals who are in a high‐risk rabies exposure group remain vigilant to this potential public health threat in all mammal species.
Investigation and Characterization of the Frozen Feeder Rodent Industry in Texas Following a Multi‐StateSalmonellaTyphimurium Outbreak Associated with Frozen Vacuum‐Packed Rodents
Authors: Lee K. M. , McReynolds J. L. , Fuller C. C. , Jones B. , Herrman T. J. , Byrd J. A. , Runyon M.
Published: September 2010

A multi‐state outbreak investigation ofSalmonellaTyphimurim cases associated with pet snakes and the frozen vacuum‐packed rodents used to feed them identified a Texas frozen feeder rodent facility (Supplier A) as the source of theSalmonella‐infected frozen rodents. Texas authorities collected samples directly from Supplier A. SevenSalmonella‐positive samples out of 49 environmental swabs were found and one adult mouse out of 88 frozen feeder rodents wasSalmonella‐positive by culture. NoSalmonellastrains were isolated from rodent feeds. The pulsed‐field gel electrophoresis (PFGE) subtype patterns ofS.Typhimurium isolates from feeder rodent and environment samples were indistinguishable from the outbreak strain isolated from humans. A follow‐up investigation was performed on all additional feeder rodent facilities identified in Texas.Salmonellawas isolated at one of four facilities; seven of 100 rodent samples were positive forSalmonellaat this facility. The serotypeS.I 4,[5],12:i:‐ was isolated from seven feeder rodent samples, and PFGE patterns of the seven isolates were indistinguishable. As observed in the initial outbreak investigation, noSalmonellawere cultured from rodent feeds at any of the facilities. The feeder rodent industry is an insufficiently recognized industry in the United States. Outbreak investigation and testing of additional feeder rodent facilities in Texas indicate that further evaluation of feeder rodent facilities as a source ofSalmonellafor pet snakes and humans is warranted.
Programme to Vaccinate Poultry Workers Against Seasonal Influenza: Options for Delivery in the East of England
Authors: Vivancos R. , Reacher M. , Cosford P. ,   on behalf of the East of England Poultry Workers Seasonal Influenza Vaccination Group
Published: September 2010

Avian influenza A (H5N1) has spread to the UK causing outbreaks in commercial poultry. Vaccination of poultry workers with seasonal influenza has been advised to prevent a viral mutation that could facilitate human‐to‐human transmission, causing a new pandemic strain. This project aimed to determine delivery options and costs of a vaccination programme targeted at poultry workers. Data from the Great Britain Poultry Register were used to understand the distribution of the target population. A stakeholders group in the East of England (EoE) discussed delivery options. An options appraisal is used to prioritize these options. There are over 10 000 poultry workers distributed throughout the EoE. Five delivery options were considered (industry’s occupational health services, via general practitioners as a Directed or Locally Enhanced Services, via other community healthcare providers and a commercial provider). Delivery is likely to cost between £35 414 and £182 899 (or £10.18–£48.93 per person vaccinated) in the EoE, depending on delivery mechanism, target threshold and level of uptake. Delivering through a commercial provider was the preferred option. Whichever way the programme is delivered it should be cost‐neutral to the Primary Care Trust (PCT). Otherwise PCTs may see themselves having to prioritize between vaccinating poultry workers against other pressing programmes.
Serum biotinidase is a sensitive and specific biochemical marker of hepatic dysfunction: A preliminary report
Authors: Faith Minnie , Eapen Chundamannil Eapen , Wilfred Gnanaiah , Ramachandran Jeyamani , Jacob Molly
Published: September 2010

Biotinidase is an enzyme synthesized predominantly by the liver. Serum activity of this enzyme has been shown to be low in chronic liver disease. In this study, we endeavored to assess the diagnostic value of serum biotinidase as a marker of hepatic biosynthetic function in acute and chronic liver dysfunction. Twenty‐three patients with acute liver disease and 46 with chronic liver disease, as diagnosed by clinical examination, laboratory tests, histopathology and tests for viral markers, were inducted into the study. Forty‐six healthy volunteers were selected as controls. Serum biotinidase activity was estimated in all the subjects. Biotinidase activity was found to be significantly lower in the serum of patients with acute (4.59 ± 1.26 IU/L vs 7.56 ± 0.82 IU/L in controls; P≤ 0.001) and chronic (2.98 ± 1.18 IU/L vs 7.56 ± 0.82 IU/L in controls; P≤ 0.001) liver disease. Using receiver–operator characteristic curves, serum biotinidase was found to have high values of sensitivity and specificity when applied as a diagnostic test in both acute and chronic liver disease. These results suggest that serum biotinidase may be a sensitive and specific diagnostic marker of hepatic biosynthetic function in both acute and chronic liver disease.
Changes in mitochondrial membrane potential and reactive oxygen species during wogonin‐induced cell death in human hepatoma cells
Authors: Yu Jian Qing , Liu Hui Bin , Tian Dai Zhi , Liu Yan Wen , Lei Jia Chuan , Zou Guo Lin
Published: September 2010

Flavonoids exist extensively in plants, and several biological effects of them have been demonstrated. Wogonin is an important flavonoid compound. In this study, wogonin showed obvious growth inhibition on Bel‐7402 cells. The major mechanisms of inhibition included cell apoptosis and cytotoxic effects. Wogonin‐induced cell death showed characteristics of apoptosis including DNA fragmentation, chromatin condensation, appearance of apoptotic bodies, and an increase in hypodiploid cells. However, the percentage of necrosis cells also increased with the increase of wogonin concentration. Furthermore, treatment with wogonin caused changes of reactive oxygen species (ROS) and mitochondrial membrane potentials (ΔΨm, MMP), the decrease of the ratio of reduced and oxidized glutathione (GSH/GSSG), cytochrome c release and activation of caspase‐9.
Effect of Solanum trilobatum on hepatic drug metabolising enzymes during diethylnitrosamine‐induced hepatocarcinogenesis promoted by Phenobarbital in rat
Authors: Jahan Moula Shah , Vani Ganapathy , Shyamaladevi Chennam Srinivasulu
Published: September 2010

The present study was aimed to investigate the chemopreventive effects of Solanum trilobatum (ST) extract against diethylnitrosamine (DEN)‐induced hepatocarcinogenesis promoted by Phenobarbital (PB) in Wistar rats. Hepatocarcinogenesis was initiated by a single intraperitoneal injection of DEN (200 mg/kg b.w.) and promoted with PB (0.05%) in basal diet. The experimental study extended for periods of 13 and 26 weeks. Alcoholic extract of ST was orally administered for the entire experimental period after initiation along with commencement of promotion. The chemopreventive effect of ST was assessed from the incidence of nodules, drug metabolizing phase I components such as contents of cytochrome P450, cytochrome b5, activities of NADPH cytochrome c reductase, NADH – cytochrome b5 reductase and phase II components such as levels of glutathione, activities of UDP‐glucuronyl transferase, glutathione S‐transferase and γ‐glutamyl transpeptidase in the liver. Lipid peroxidation at basal and prooxidants‐induced (NADPH + ADP + Fe and Ascorbate + Fe) states was assessed in the microsomes. Animals administered with ST extract evidenced significant inhibition of tumor nodular incidence in DEN + PB + ST animals compared to DEN + PB animals, with favorable alterations in the hepatic drug‐metabolizing phase I and phase II components. Administration of ST inhibited basal and pro‐oxidant‐induced lipid peroxidation. The present result suggests the probable mediation of chemoprevention by ST against DEN‐induced carcinogenesis by the modulation of drug metabolizing components in the liver of treated animals.
Clinical and molecular characterization of Wilson disease in Spanish patients
Authors: Brage Antonio , Tomé Santiago , García Aranzazu , Carracedo Ángel , Salas Antonio
Published: September 2010

Wilson disease (WD) results when specific mutations occur at the ATP7B gene. The presence of mutations in the ATP7B gene was studied in the coding region and the intron–exon boundaries in 15 WD Spanish patients, and their first‐degree relatives when possible. A total of 20 nucleotide sequence changes were detected, 18 missense and two splicing mutations. Six of these variants were classified as disease‐causing mutations, five missense, and one splicing; four of them have been previously described (M645R, A1065P, H1069Q, and 3060 + 5G > T), whereas two were novel (P768L and A990P). No mutation was clearly prevalent, although the H1069Q mutation predominated, nor did a good phenotype–genotype correlation exist. The two new mutations described were manifested as an asymptomatic increase in serum transaminases. The remaining 14 changes were classified as polymorphisms and their potential effects on protein function are discussed. The identification of mutations in the ATP7B gene has allowed a conclusive diagnosis to be made of WD in patients presenting neurological phenotype or neurological of hepatic phenotype, who would otherwise not have been diagnosed using classical criteria. WD patients could start chelating treatment earlier on and possibly modify the natural progression of the disease.
The combination of type I interferon and ribavirin has an inhibitory effect on mouse hepatitis virus infection
Authors: Sone Saburo , Izawa Akiko , Narumi Hideki , Kajita Akemi , Tanabe Junichi , Taguchi Fumihiro
Published: September 2010

Aim:  To determine the differences in efficacy between therapy using IFN‐β and ribavirin, and using IFN‐α and ribavirin.

Methods:  We studied the effect of combination therapy consisting of IFN‐β and ribavirin on mouse hepatitis virus (MHV) infection in mice.

Results:  Combination treatment of ribavirin and IFN‐α was more effective than IFN‐α mono‐treatment in the MHV‐mouse system, and combination treatment with ribavirin and IFN‐β was more effective than IFN‐β mono‐treatment in the MHV‐mouse system. Furthermore, administering IFN‐β once or twice one day before combination treatment using ribavirin and IFN‐α was more effective than administering IFN‐α once or twice one day before the combination treatment using ribavirin and IFN‐α.

Conclusion:  These data indicate that this MHV‐infection system is a good animal model to assess anti‐HCV activity for therapy using IFN and ribavirin, and suggest that administering IFN‐β before the start of combination therapy with ribavirin and IFN‐α promotes the therapeutic effects of combination treatment with ribavirin and IFN‐α ?in chronic hepatitis C patients.
Protective effect of glycyrrhizin and matrine on acute vanishing bile duct syndrome induced by alpha‐naphthylisothiocyanate in rats
Authors: Zhao Ying , Zhai Desheng , Chen Xijing , He Hui , Lu Qin , Yu Qiaoling
Published: September 2010

Aim: To explore the effects of glycyrrhizin (GL) and matrine (MT) on acute vanishing bile duct syndromes (AVBDS) in rats.

Methods: AVBDS in rats were induced by alphanaphthylisothiocyanate (ANIT), and the effects of GL and MT on AVBDS were explored and compared with dexamethasone (DEX) by serology determination, histological assessment of liver damage and bile excretion experiments.

Results: The protection of DEX pre‐treatment was directed toward cholangiocytes rather than hepatocytes. Rats remedially treated with DEX 3 h after ANIT were not resistant to ANIT toxicity. Notably, remedial treatment with DEX 12 h after ANIT enhanced ANIT toxicity. However, GL and MT attenuated both bile duct and hepatocyte damage induced by ANIT in the initial phase of impairment.

Conclusion: The nature products (GL and MT) exhibited better protection against ANIT‐induced AVBDS than DEX. In the initial phase of impairment of AVBDS, the protection of GL and MT may be due partially to modifying the metabolism and excretion of ANIT and to their anti‐inflammatory effects.
A case of acute hepatitis E associated with multidrug hypersensitivity and cytomegalovirus reactivation
Authors: Takikawa Yasuhiro , Yasumi Yuki , Sato Akihiro , Endo Ryujin , Suzuki Kazuyuki , Mori Yasuki , Akasaka Hidetoshi , Miura Yasuhiro , Sawai Takashi , Okamoto Hiroaki
Published: September 2010

A 65‐year‐old Japanese man was hospitalized because of acute hepatitis and severe cholestasis due to hepatitis E virus (HEV) infection combined with a drug reaction to a cold preparation. He died of disseminated intravascular coagulation and severe intestinal bleeding due to systemic cytomegalovirus reactivation following the development of severe eruptions with marked eosinophilia due to drug hypersensitivity to taurine and ursodeoxycholate preparations. The close interaction between viral infection or reactivation and drug hypersensitivity was considered as a pathophysiology in this case, which emphasizes the need for further study of the immunological mechanism of the interaction.
The prevalence of atherosclerosis in cirrhotic patients: assessment of two aspects of atherosis and sclerosis
Authors: Kawakami Manri , Koda Masahiko , Murawaki Yoshikazu
Published: September 2010

Aim:  In general, cirrhotic patients are known to have a low prevalence of cardiovascular disease. Cirrhosis is often accompanied by diabetes mellitus, while blood pressure and serum cholesterol levels are low in liver cirrhosis. We examined the atherosclerosis of patients with chronic liver disease by two phases of atherosis “lipid deposition” and sclerosis “arterial fibrosis.”

Methods:  Atherosis was assessed by carotid intima‐media thickness and the ratio of the systolic blood pressure at the ankle to the average systolic blood pressure at the right arm (ankle brachial pressure index), while sclerosis was evaluated by brachial ankle pulse wave velocity.

Results:  There were no significant differences in intima‐media thickness and ankle brachial index among grades of cirrhosis. Brachial ankle pulse wave velocity decreased closely as the severity of cirrhosis progressed (F = 4.90, P < 0.05). In univariate analysis, brachial ankle pulse wave velocity was correlated with systolic blood pressure, age, total bilirubin, albumin, prothrombin time, retention rate of indocyanine green at 15 min, blood ammonia, branched chain amino acids/tyrosine molar rate and fasting blood sugar. Multiple regression analysis showed that systolic blood pressure and total bilirubin were independent factors for the inhibition of vascular sclerosis progression.

Conclusion:  Although no difference in atherosis between cirrhotic patients and healthy controls was found, vascular sclerosis was decreased with the severity of cirrhosis through hypotension and hyperbilirubinemia.
Persistent infection of hepatitis E virus transmitted by blood transfusion in a patient with T‐cell lymphoma
Authors: Tamura Akinori , Shimizu Yohko K. , Tanaka Torahiko , Kuroda Kazumichi , Arakawa Yasuyuki , Takahashi Kazuaki , Mishiro Shunji , Shimizu Kazufumi , Moriyama Mitsuhiko
Published: September 2010

Aim:  With advent of reverse‐transcription (RT)/polymerase chain reaction (PCR) for detection of the hepatitis E viral genome, we carried out retrospective examinations.

Methods:  Serum samples collected from 68 patients diagnosed as viral hepatitis with unknown etiology were tested for viral markers of hepatitis virus.

Results:  Two of them were found positive for hepatitis E viral RNA. While the clinical course of one patient (patient 1) was typical as acute hepatitis E, another patient (patient 2) was persistently infected with HEV. Patient 2 was infected with the virus via blood transfusion during chemotherapy against T‐cell lymphoma. The entire viral genome from the donor was identical with that from the serum of patient 2 obtained on day 170 after the transfusion of the implicated red blood cell (RBC) product, confirming the transmission of HEV by transfusion. The patient remained negative for anti‐HEV antibodies for the follow‐up period of six months, probably due to immune suppression by lymphoma and chemotherapy.

Conclusion:  We report here an unusual case of long‐term HEV infection in a patient with T‐cell lymphoma. Persistent infection with HEV was probably due to the absence of anti‐HEV antibodies, which was caused by lymphoma and chemotherapy.
Drug-related problems at discharge: results on the Spanish pharmacy discharge programme CONSULTENOS
Authors: López MaÁngeles Pardo , Saliente Ma Teresa Aznar , Company Enrique Soler , Monsalve Ana Garcia , Cueva Marta Aparício , Domingo Elena Arroyo , Hernández Monica Montero , Carrión Carmen Carrión , Martí Monica Climente , Querejeta Nuria Bujaldón , Blasco Joaquín Borrás , Milá Amparo Rocher
Published: September 2010

Objectives

The aim of this study was to describe the most common drug-related problems (DRPs) found after discharge, pharmacist interventions and their results for the patients enrolled on the CONSULTENOS programme.

Methods

An observational, prospective, multicentre study was conducted to evaluate the results of a pharmaceutical care programme at discharge. Patients from 10 hospitals participating in the CONSULTENOS programme were enrolled. Pharmacists conducting this programme were newly graduated and worked under the supervision of a pharmacy staff member; only two pharmacists had previous hospital pharmacy experience. DRPs were identified and classified according to the Iaser methodology. Frequencies, types of DRP, interventions and outcomes were registered prospectively, at discharge and during a follow-up call 7 days after leaving the hospital.

Key findings

A total of 7711 patients were included in the study. DRPs were detected in 23.7% of the patients, with a total of 2120 DRPs (1788 at discharge and 332 in the follow-up). The most common problems identified at discharge were twofold: firstly the need of an additional treatment (34.1%) and secondly an unnecessary treatment (18.1%). In the follow-up phone call the most frequent DRPs were adverse effects (29.2%). Besides the standard educational interventions at discharge, 3313 extra interventions were performed, of which 85% were accepted. The outcomes for the patients were positive in 80% of the cases, although documentation with objective or subjective data was rare.

Conclusions

DRPs occur frequently after patient discharge. A pharmaceutical care programme can identify and solve DRPs in this scenario. The clinical impact of the pharmacists' interventions should be better addressed.
How do patients read, understand and use prescription labels? An exploratory study examining patient and pharmacist perspectives
Authors: Law Anandi V , Zargarzadeh Amir H
Published: September 2010

Objectives

The aim of the study was to investigate ease of reading, understanding and usefulness of prescription labels in a real-world setting from patients’ and pharmacists’ perspectives.

Methods

A prospective, cross-sectional, exploratory study was conducted by interviewing 179 patients and 40 pharmacists in selected community pharmacies.

Key findings

The average age of patients was 55 years, 65% were females, and 56.4% had a high-school education or more. Pharmacists’ mean age was 40.4 years with 12.8 years of experience. Self-reported ease of reading and understanding was rated as very or somewhat easy by 97.8 and 97.2%, respectively. Most of the patients correctly read (91.6%) and interpreted (89.4%) the label. A majority (90.5%) of patients found the label somewhat or very useful. About half of the pharmacist sample believed patients had difficulty reading or understanding the labels.

Conclusions

This study, conducted with a sample that approximated the US population in level of education, found that prescription labels were reported to be useful and easy to read and understand. These results deviated from previous studies that were conducted in specific populations. Current prescription labels are useful and easy to read and understand by those who have college or higher education but improvements may be needed for specific vulnerable populations.
Testing a trigger tool as a method of detecting harm from medication errors in a UK hospital: a pilot study
Authors: Franklin Bryony Dean , Birch Sylvia , Schachter Mike , Barber Nick
Published: September 2010

Objectives

The aim was to adapt a US adverse drug event (ADE) trigger tool for UK use, and to establish its positive predictive value (PPV) and sensitivity in comparison to retrospective health record review for the identification of preventable ADEs, in a pilot study on one hospital ward.

Methods

An established US trigger tool was adapted for UK use. We applied it retrospectively to 207 patients' health records, following up positive triggers to identify any ADEs (both preventable and non-preventable). We compared the preventable ADEs to those identified using full health record review.

Key findings

We identified 168 positive triggers in 127 (61%) of 207 patients. Seven ADEs were identified, representing an ADE in 3.4% of patients or 0.7 ADEs per 100 patient days. Five were non-preventable adverse drug reactions and two were due to preventable errors. The prevalence of preventable ADEs was 1.0% of patients, or 0.2 per 100 patient days. The overall PPV was 0.04 for all ADEs, and 0.01 for preventable ADEs. PPVs for individual triggers varied widely. Five preventable ADEs were identified using health record review. The sensitivity of the trigger tool for identifying preventable ADEs was 0.40, when compared to health record review.

Conclusions

Although we identified some ADEs using the trigger tool, more work is needed to further refine the trigger tool to reduce the false positives and increase sensitivity. To comprehensively identify preventable ADEs, retrospective health record review remains the gold standard and we found no efficiency gain in using the trigger tool.
A NOVEL DESIGN METHODOLOGY FOR REDUCING SIMULTANEOUS SWITCHING NOISE EVALUATED BY A DIFFERENTIAL-IBIS STRUCTURE
Authors: HUANG WEN-TZENG , TAN SUN-YEN , CHANG YUAN-JEN
Published: September 2010

Modern electronic products increasingly require high speed, high density, and low-voltage operation. In such designs, the power-delivery system could be affected by input noise to the point that it becomes unstable. Simultaneous switching noise (SSN) is a major factor that interferes with power integrity. Although decoupling capacitors cannot effectively alleviate the problem of SSN, they have been generally used in the HP Simulation Program with Integrated Circuit Emphasis model for reducing SSN. The differential I/O buffer information specification (D-IBIS) model uses equivalent circuits to describe the behavior of an integrated circuit. In this study, we propose a novel method for effectively reducing SSN evaluated by an enhanced D-IBIS model with decoupling capacitors and a high-frequency low-impendence circuit. We show that this new method reduces noise by about 40–64% compared to traditional design methodologies.
COLOR IMAGES SEGMENTATION ALGORITHMS DURING A SPORTS MEETING: APPLICATION TO SOCCER VIDEO IMAGES
Authors: JLASSI MOURAD MOUSSA , DOUIK ALI , MESSAOUD HASSANI
Published: September 2010

The choice of the best color system representation is an efficient technique in background modeling and a fundamental task in detecting foreground objects on both static and dynamic scenes. In this paper, we present some algorithms consecrated for images color segmentation's issued from a soccer video. This manuscript is prominent for many next computers vision studies. Indeed, in this paper many segmentation techniques using pixel values are developed (statistical, fuzzy tools) and gives a high robustness level even in presence of significant shadows and highlights. The use of RGB color space to represent a pixel is not obvious to lead to valuable results in certain situations, for this reason, we proposed a new approach using color to improve players detection in images by determining the three significant color components on the one hand, and using statistical theory to model the background on the other hand. In fact the use of color is widely employed by many researchers. Also this paper presents experimental results of soccer scenes, which will evaluate the proposed methods in order to extract players and eliminate the effects of shadows, and to keep the best levels.
A FULLY INTEGRATED MULTI-BAND LCVCO BASED ON CMOS TECHNOLOGY
Authors: MA XUEPO , ZHANG WEI , LIU YANG
Published: September 2010

In this paper, a cross-coupled complementary inductance–capacitance voltage controlled oscillator (LCVCO) with low phase noise and wide tuning range is presented. It has a multi-band topology and was fabricated with RF CMOS technology. For the purpose of lowering the K VCO and reducing the nonlinearities of varactors, the sizes of the varactors are set small. Also noise filtering technique is adopted to minimize up-conversion of the low frequency noise as well as down-conversion of the high frequency noise, thus the phase noise performance of the VCO is greatly improved. Simulation and experimental results indicate that the LCVCO displays a phase noise of -126.1 dBc at 900 kHz offset in worst case with a tuning range from 1.76 to 1.96 GHz.
QUANTUM SINGULAR VALUE DECOMPOSITION BASED APPROXIMATION ALGORITHM
Authors: GYONGYOSI LASZLO , IMRE SANDOR
Published: September 2010

Singular Value Decomposition (SVD) is one of the most useful techniques for analyzing data in linear algebra. SVD decomposes a rectangular real or complex matrix into two orthogonal matrices and one diagonal matrix. The proposed Quantum-SVD algorithm interpolates the non-uniform angles in the Fourier domain. The error of the Quantum-SVD approach is some orders lower than the error given by ordinary Quantum Fourier Transformation. Our Quantum-SVD algorithm is a fundamentally novel approach for the computation of the Quantum Fourier Transformation (QFT) of non-uniform states. The presented Quantum-SVD algorithm is based on the singular value decomposition mechanism, and the computation of Quantum Fourier Transformation of non-uniform angles of a quantum system. The Quantum-SVD approach provides advantages in terms of computational structure, being based on QFT and multiplications.
A SYSTEMATIC COMPUTER-AIDED APPROACH TO LOW-NOISE AMPLIFIER DESIGN
Authors: ROY NILADRI , MCCORMICK GARRETT , DEVABHAKTUNI VIJAY , RAUT RABIN
Published: September 2010

Low-noise amplifiers (LNAs) are critical to a wide variety of electronic circuits. In the design phase preceding fabrication, an LNA needs to be designed for a given set of specifications (e.g., gain, noise-figure, power consumption, etc.), which tend to be application-dependent. Typically, LNA design using commercial computer-aided design (CAD) tools can be human-intensive and requires a certain degree of expertise. This paper presents a systematic multi-phase CAD approach for the design of LNAs. In the first phase, a quick pre-analysis of the given LNA specifications is carried out leading to the selection of an appropriate LNA topology. In the second phase, an initial design of the LNA is generated employing an appropriate design procedure. Finally, the initial design is adjusted/fine-tuned so as to meet/exceed the given specifications, where necessary. The advantages of the proposed approach are shown through several practical LNA design examples in 0.18 μm CMOS technology.
ROUTING AWARE PLACEMENT ALGORITHM AND EFFICIENT FREE SPACE MANAGEMENT FOR RECONFIGURABLE SYSTEMS
Authors: ESMAEILDOUST MOHAMMAD , ZAKEROLHOSSEINI ALI
Published: September 2010

In partially reconfigurable devices like FPGA, logic resources and communication channels can be reconfigured without affecting other section of the device. This allows parallel execution of multiple tasks on a FPGA. Due to limited resources on a FPGA, an effective management for efficient execution of tasks is required.

We present a new approach for management of FPGA logic resources and also communication channels in an online task placement. The approach creates communication channels between the tasks and also tasks with I/O elements without requiring extra computation overhead. We present a fast algorithm for searching MERs for management of FPGA space. Then, we present a exact routing algorithm to find distance and create exact path between two set of tasks. A new fitting strategy based on the rate of communication between the tasks is also presented. The results indicate the proposed strategy and also its combination with some other known strategies can improve the quality of placement.