bluuebunny/crossref_metadata_2025 huggingface dataset:
Adapting a Community of Practice Model to Design an Innovative Ethics Curriculum in Healthcare
Authors: Naidoo Sudeshni , Vernillo Anthony T.
Published: September 2013

The focus of healthcare ethics within the framework of ethical principles and philosophical foundations has always, in recent times, been the community, namely, the healthcare provider, the patient or, in research, the study participant. An initiative is thus described whereby a community of practice (CoP) model was developed around health ethics in health research, education and clinical care. The ethics curriculum was redesigned to include several components that are integrated and all embracing, namely, health research ethics, healthcare ethics, health personnel education in ethics and global and public health ethics. A CoP is a group who share a common interest and a desire to learn from and contribute to the community with their variety of experiences. The CoP is dynamic and organic, generating knowledge that can be translated into effective healthcare delivery and ethical research. It requires the collaboration and social presence of active participants such as community members, healthcare professionals and educators, ethicists and policy makers to benefit the community by developing approaches that adapt to and resonate with the community and its healthcare needs. Philosophical principles constitute the foundation or underpinning of this innovative curriculum. Recommendations are presented that will continue to guide the consolidation and sustainability of the CoP.
Protective Effect of Geranylgeranylacetone against Methamphetamine-Induced Neurotoxicity in Rat Pheochromocytoma Cells
Authors: Lv Tao , Li Ye , Jia Jinjing , Shi Zhizhou , Bai Jie
Published: September 2013

Background: Methamphetamine is a central nervous system stimulant and is one of the agents most commonly abused by illicit drug users which could induce neuron apoptosis when it is used repeatedly and overdosed. Our previous study demonstrated that geranylgeranylacetone (GGA) was an inducer of thioredoxin-1 (Trx-1) and heat shock protein 70 (Hsp70), which played a cytoprotective role against neurotoxicity. Methods: Using the MTT assay, we detected the effect of GGA on cell viability by methamphetamine in rat pheochromocytoma (PC12) cells. Tyrosine hydroxylase, Trx-1, Hsp70, procaspase-9, procaspase-12 and procaspase-3 expression were examined by Western blot analysis. We also detected enzymatic activities of caspase-3 and caspase-9. Results: We found that GGA protected PC12 cells from apoptosis caused by methamphetamine. Furthermore, GGA reversed the decreases in Trx-1 and Hsp70 by methamphetamine, and prevented the methamphetamine-induced decreases in procaspase-9 and procaspase-3. On the other hand, GGA prevented the methamphetamine-induced increases in the enzymatic activity of caspase-9 and caspase-3. Procaspase-12 was not changed by any treatment. Conclusions: These results indicate that GGA protects PC12 cells from methamphetamine-induced toxicity by increasing Trx-1 and Hsp70 and by preventing mitochondria pathway-mediated apoptosis. In summary, GGA may be used as a therapy for neurotoxicity induced by methamphetamine.
Early Violence Exposure and Self-Regulatory Development: A Bioecological Systems Perspective
Authors: McCoy Dana Charles
Published: September 2013

Each year, thousands of American children are exposed to violence in their homes and communities. Although research in multiple fields has shown this violence to have severe and negative consequences for children's self-regulation, this work lacks a unified theoretical orientation that sufficiently captures the complexity of these relationships. Using a bioecological systems framework, the present article presents a multidimensional model of the relationship between children's exposure to violence and their self-regulatory development. Specifically, this model considers: (a) different dimensions of exposure (including chronicity, pervasiveness, and proximity); (b) child- and family-level mediating mechanisms (including biological stress-response systems and parenting); (c) the transactional, multidirectional nature of these relationships; and (d) the ways in which individual and environmental factors may contribute to multifinality. Finally, the present article also proposes a number of methodological and conceptual suggestions for strengthening future research in the area of violence, self-regulation, and psychosocial risk.
Partially Reversible Cardiomyopathy after Renal Transplant Associated with Anti-Troponin I Antibodies
Authors: Nunes José Pedro L. , do Sameiro Faria Maria , Sampaio Susana , Quintas José , Katus Hugo A. , Kaya Ziya
Published: September 2013

Cardiomyopathy associated with dialysis has been shown to be reversible in some cases. A 58-year-old female patient with polycystic renal disease and end-stage renal disease had a renal transplant after 9 years on hemodialysis. Dilated cardiomyopathy with depressed left ventricular ejection fraction markedly improved after transplantation, with normalization of the ejection fraction. High titers for anti-troponin I antibodies were measured: IgG 1:640, IgM 1:80. In our case, the presence of anticardiac (anti-troponin I) antibodies may suggest that the syndrome of reversible cardiomyopathy seen after renal transplantation is associated with immunosuppression therapy acting on immunological mechanisms previously at play.
Platelet Antibodies, Activated Platelets and Serum Leptin in Childhood Immune Thrombocytopenic Purpura
Authors: Badrawy Hosny , Elsayh Khalid I. , Zahran Asmaa M. , EL-Ghazali Mohamad Hamdy
Published: September 2013

Background/Aim: The aim of this study was to evaluate the levels of platelet-associated antibodies (PAIgG and PAIgM), activated platelets and serum leptin in children with acute immune thrombocytopenic purpura (ITP). Methods: The study included 40 patients with ITP and 40 healthy age- and sex-matched controls. PAIgG, PAIgM and activated platelet levels were estimated by flow cytometry, and serum leptin levels were estimated by ELISA. Results: Activated platelets and serum leptin were significantly higher in the ITP patients than in the controls. The percentage and mean florescence intensity of PAIgG and PAIgM staining were significantly higher in the patients than in the controls. Serum leptin and activated platelet levels in patients with thrombocytopenia of brief duration were significantly lower than those in patients with thrombocytopenia of prolonged duration. The levels of activated platelets, serum leptin and PAIgG were positively correlated, and the levels of serum leptin, activated platelets and platelet counts were negatively correlated. Conclusion: The increased levels of activated platelets, serum leptin and platelet-associated antibodies in children with acute ITP suggest that these factors could play a role in ITP pathogenesis. Additionally, activated platelets and serum leptin could have prognostic significance in paediatric acute ITP.
The Combination of a Retinoid, a Phenolic Agent and an Antioxidant Improves Tolerance while Retaining an Optimal Depigmenting Action in Reconstructed Epidermis
Authors: Sorg O. , Kasraee B. , Salomon D. , Saurat J.H.
Published: September 2013

Background: Cutaneous pigmented lesions urge the need to find safe and effective treatments to lighten the skin. Objective: The aim of this study was to combine a retinoid (retinaldehyde), a new phenolic agent (4-(1-phenylethyl)-resorcinol) and a proreducing agent (δ-tocopheryl-β-D-glucopyranoside) to achieve synergistic actions for skin lightening. Methods: The tolerance profile and the depigmenting properties of these agents were assessed in murine keratinocyte and melanocyte cell lines, as well as in a 3-dimensional model of reconstructed epidermis. Results: Retinaldehyde and 4-(1-phenylethyl)-resorcinol induced a significant decrease of tissue viability in reconstructed epidermis, but this cytotoxicity was prevented by the addition of δ-tocopheryl-β-D-glucopyranoside. The combination of the three agents was, however, efficient in decreasing the specific melanin content and the density of active melanocytes. Conclusion: A combination of various chemicals acting via different mechanisms allows a decrease in the toxicity of each compound alone while retaining optimal skin-lightening properties.
Pyoderma gangraenosum, Akne und suppurative Hidradenitis nach Darm-Bypass-Operation
Authors: Marzano Angelo V. , Ishak Rim S. , Colombo Antonella , Caroli Francesco , Crosti Carlo
Published: September 2013

Die klinische Triade von Pyoderma gangraenosum (PG), Akne und suppurativer Hidradenitis (PASH) wurde kürzlich als neue Krankheitsentität innerhalb des Spektrums autoinflammatorischer Syndrome beschrieben. Dabei handelt es sich um eine neue Gruppe entzündlicher Erkrankungen, die sich von allergischen, infektiösen und autoimmunbedingten Krankheiten unterscheiden. Das PASH-Syndrom ähnelt dem PAPA(pyogene Arthritis, Akne und Pyoderma gangraenosum)-Syndrom, unterscheidet sich von diesem jedoch durch die fehlende assoziierte Arthritis und die fehlende genetische Grundlage. Das PAPA-Syndrom wird durch Mutationen in einem Gen verursacht, das an der Regulation der angeborenen Immunreaktion beteiligt ist, das PSTPIP1, wohingegen bei Patienten mit PASH-Syndrom bislang keine Mutationen nachgewiesen wurden. Wir berichten über einen jungen Mann, der nach einer Darm-Bypass-Operation wegen Adipositas gleichzeitig ein disseminiertes PG, eine typische Hidradenitis suppurativa und akneiforme Eruptionen im Gesicht entwickelte. Die kutanen Manifestationen im Zusammenhang mit einem Darm-Bypass-Syndrom gleichen oft einem PG oder anderen neutrophilen Dermatosen, was dafür spricht, dass die Pathogenese dieser Erkrankung mit einer Neutrophilen-vermittelten Entzündung in Zusammenhang steht. Dies ist der erste Bericht über das PASH-Syndrom nach einem bariatrischen Eingriff; wir schlagen vor, solche neutrophilen Dermatosen in die Liste der möglichen Komplikationen nach Darm-Bypass-Operationen aufzunehmen. Umfangreiche genetische Untersuchungen können helfen, die Ätiopathogenese des PASH-Syndroms sowie der autoinflammatorischen Erkrankungen im Allgemeinen zu klären.
Pubertal Growth and Serum Testosterone and Estradiol Levels in Boys
Authors: Albin Anna-Karin , Norjavaara Ensio
Published: September 2013

Background/Aims: To study serum testosterone and estradiol in healthy boys in relation to growth during puberty up to peak height velocity (PHV). Methods: Growth velocity was analyzed through testosterone (n = 41) and 17β-estradiol (n = 37) 24-hour profiles in a dose-response model. Participants were 26 healthy boys admitted for short or tall stature or participating as healthy volunteers at the Queen Silvia Children's Hospital. Other inclusion criteria included the following: gestational age 37-42 weeks, birth weight and length >-2 standard deviation score (SDS) and prepubertal height and weight within ±3 SDS. Testosterone was measured using a modified radioimmunoassay (RIA) with a detection limit of 0.03 nmol/l. Estradiol was determined using an ultrasensitive extraction RIA with a detection limit 4 pmol/l. A sixth-grade polynomial was fitted to each child's growth data, giving growth velocity and age at PHV. Results: Growth velocity increased by 50% from prepubertal growth to PHV at a morning testosterone level of 3.1 nmol/l (95% confidence interval 2.4-4.2), EC50. The corresponding EC50 of 17β-estradiol was 6.5 pmol/l (3.2-13). Boys approaching PHV (<4% remaining) had morning testosterone levels >10 nmol/l and 17β-estradiol >9 pmol/l. Conclusion: Observed early puberty/initial mid puberty morning testosterone levels of 2.4-4.2 nmol/l are associated with a 50% increase in growth velocity from prepubertal growth to PHV in healthy boys.
In silico Analysis and Experimental Validation of Mycobacterium tuberculosis-Specific Proteins and Peptides of Mycobacterium tuberculosis for Immunological Diagnosis and Vaccine Development
Authors: Mustafa Abu Salim
Published: September 2013

Comparative analyses of the Mycobacterium tuberculosis genome with the genomes of other mycobacteria have led to the identification of several genomic regions of difference (RDs) between M. tuberculosis and M. bovis BCG. The identification of immunodominant and HLA-promiscuous antigens and peptides encoded by these RDs could be useful for diagnosis and the development of new vaccines against tuberculosis. The analysis of RD proteins and peptides by in silico methods (using computational programs to predict major and HLA-promiscuous antigenic proteins and peptides) and experimental validations (using peripheral blood mononuclear cells and sera from tuberculosis patients and BCG-vaccinated healthy subjects to assess antigen-specific cellular and humoral immune responses in vitro) identified several major antigens and peptides. To evaluate the in vivo potentials, the genes of immunodominant antigens were cloned and expressed in DNA vaccine vectors. Immunizations of experimental animals with the recombinant constructs induced antigen-specific cellular responses. Further experiments showed that each of these proteins had several T and B cell epitopes scattered throughout their sequence, which confirmed their strong immunogenicity. In conclusion, the bioinformatics-based in silico identification of promiscuous antigens and peptides of M. tuberculosis is a useful approach to identify new candidates important for diagnosis and vaccine applications.
Cutaneous versus Non-Cutaneous Angiosarcoma: Clinicopathologic Features and Treatment Outcomes in 60 Patients at a Single Asian Cancer Centre
Authors: Farid Mohamad , Ong Whee Sze , Lee Marcus Jin Fu , Jeevan Raaj , Ho Zhen Chong , Sairi Alisa Noor Hidayah , Soh Lay Tin , Poon Donald , Teh Jonathan , Chin Francis , Teo Melissa , Quek Richard
Published: September 2013

Background: Angiosarcoma (AS) is an uncommon soft tissue sarcoma with dismal prognosis that presents either cutaneously (C-AS) or non-cutaneously (NC-AS). We compared the clinical features and treatment outcomes between these 2 groups. Methods: A single-centre study evaluating 60 AS patients between 2002 and 2012 was performed. Results: The median age was 70 years. C-AS of the scalp or face comprised 66% of patients. C-AS patients were older than NC-AS (median age 74 vs. 56 years; p < 0.001). Proportionately more C-AS patients presented with non-metastatic disease (86 vs. 50%; p = 0.007). Amongst resected C-AS and NC-AS patients, rates of positive surgical margins (53 vs. 50%; p = 1.00) and adjuvant therapy (25 vs. 43%; p = 0.626) were not significantly different, though proportionately fewer C-AS patients relapsed (36 vs. 78%; p = 0.038). Paclitaxel was the most common agent in first line palliative systemic therapy, achieving an objective response rate of 56%. Median overall survival was 11.2 months, with no significant difference between C-AS and NC-AS (11.3 vs. 9.8 months; p = 0.895). Conclusion: Distinct from AS in the West, our series demonstrates a clear preponderance of scalp AS. Disparities in clinical characteristics between C-AS and NC-AS did not translate into survival differences.
Midline Suboccipital Osteoplastic Craniotomy - ‘Cobra Craniotomy'
Authors: Maiti Tanmoy , Bhat Dhananjaya I. , Devi Bhagavatula Indira , Shukla Dhaval
Published: September 2013

Background: Midline suboccipital craniotomy has been proposed as an alternative to conventional craniectomy for removal of posterior fossa tumors. Method: We describe a modified technique for midline suboccipital osteoplastic craniotomy based on the atlantooccipital membrane for a 17-year-old boy with superior vermian astrocytoma. Osteoplastic craniotomy was performed safely in this patient. Result: The presence of the turned down, attached bone flap did not interfere with surgery. Reattachment of the bone flap was easy and stable. This technique was not associated with additional risks. Conclusion: Midline suboccipital osteoplastic craniotomy is a better option for superiorly placed midline posterior fossa tumor surgery.
Hunger Hormone Profile Monitoring after Gastroplication in an Adolescent
Authors: Calcaterra Valeria , Pelizzo Gloria , Nakib Ghassan , Larizza Daniela , Fonte Maria Luisa , De Amici Mara , Cena Hellas
Published: September 2013

Introduction: Gut and adipose tissue hormones play an important role in energy balance control, particularly through the regulation at either short- or long-term food intake after bariatric surgery. Case: A 15-year-old obese female (BMI 42.2) who was unresponsive to medical treatment underwent gastroplication. Hunger hormone levels (leptin, ghrelin and insulin), weight loss and eating behavior were monitored at 3, 6 and 12 months after surgery. Results: Weight loss was obtained, progressively achieving a loss of 45.6 kg 1 year after surgery. A strong reduction in insulin concentration and insulin resistance was documented. At 3 months after the operation, a surprising leptin level drop was observed. During the following months a progressive increase in leptin levels and leptin/kg of fat mass were documented. Fasting ghrelin levels increased in the first 3 months, then fell over the next 6 months. Up to 6 months after gastroplication, we observed a less marked drop in plasma ghrelin after meal ingestion, while the values after 1 year showed a substantial fall in the postprandial period despite a further fasting ghrelin increased level. Early achievement of satiety was found. Conclusion: Hunger hormones level changes seem to be involved in weight loss and eating behavior after gastroplication in adolescents.
Intravitreal Injections: A Healthcare Failure Modes and Effects Analysis
Authors: Lanzetta Paolo , Holz Frank , Monés Jordi , Querques Giuseppe , Stanga Paulo , Veritti Daniele , Barbone Fabio , Brusaferro Silvio , Isola Miriam
Published: September 2013

Purpose: To perform a risk mitigation review of intravitreal injections. Methods: A pan-European expert team conducted a healthcare failure modes and effects analysis (HFMEA) of intravitreal injection techniques. Possible failures at each stage were identified and potential causes and effects considered. A risk value (1-10) was assigned for each failure's severity, probability of occurrence and likelihood of going undetected, and a risk priority number (RPN) calculated. Results: This HFMEA revealed 91 intravitreal injection failure modes, of which 28, deemed to have an appreciable risk, were explored. Recommendations were proposed to reduce these risks, mostly relating to patient, staff, room and equipment preparation, injection procedure and patient discharge. Conclusions: The HFMEA process produced practical recommendations to improve the risk profile of intravitreal injection.
Recurrent Strokes due to Transient Vasospasms of the Extracranial Internal Carotid Artery
Authors: Wöpking Sigrid , Kastrup Andreas , Lentschig Markus , Brunner Freimuth
Published: September 2013

Vasospasms of the intracranial arteries are a well-known complication of subarachnoid hemorrhage and are also frequently encountered in other disorders such as migraine, cerebral vasculitis or reversible cerebral vasoconstriction syndrome. In contrast, recurrent spontaneous vasospasms of the extracranial circulation appear to be extremely rare and have most often been associated with migraine. We present a patient with recurrent strokes due to spontaneous transient vasospastic occlusions of the internal carotid artery (ICA) without migraine over a time period of at least 13 years. Initially, the patient had presented with a bilateral ICA occlusion and a cerebral infarct on the right side. While the right ICA remained occluded, a reopening of the left ICA could be detected 3 days after this initial event. In subsequent years, both duplex sonography and magnetic resonance angiography revealed recurrent occlusions of the left ICA, which resolved spontaneously within days. This case and other rare previous reports indicate that recurrent non-migrainous vasospasms of the extracranial carotid artery likely reflect a distinct entity which can cause ischemic strokes.
A new species and new records of the genus Hypogastrura Bourlet, 1839 (Collembola, Hypogastruridae) from Iran
Authors: KAHRARIAN MORTEZA , VAFAEI-SHOUSHTARI REZA , SKARŻYŃSKI DARIUSZ , KONIKIEWICZ MARTA , SOLEYMANNEZHADYAN EBRAHIM , MEHR MASOUMEH SHAYAN , SHAMS BAHMAN
Published: September 2013

Hypogastrura persica sp. nov. is described from the Zagros Mountains (Kermanshah Province, Iran). The new species can be distinguished from two nearest congeners, namely H. exigua Gisin, 1958 (Alps) and H. magistri Babenko, 1994 (Siberia), by the body size, the number of sensilla on antennal segment IV, the number of setae on dens and ventral tube as well as chaetotaxy of abdominal terga IV and V. Three species of the genus, viz. H. martiani Skarżyński & Kaprus’, 2009, H. purpurescens (Lubbock, 1867) and H. socialis (Uzel, 1891), have been recorded from Iran for the first time.
100 Years of Presence or Absence?
Authors: Sharma Aakanksha
Published: September 2013

The cinema of India is considered synonymous with Bollywood. This misnomer actually hides in itself myriad hues from the hinterland. While some regions have developed competitive industries, some others are dying a slow death due to state apathy. The situation is particularly bad in regions where Hindi dialects are spoken, namely Uttar Pradesh, Rajasthan, Punjab and Haryana. While Bhojpuri films and Punjabi films have started achieving wide commercial success, the identity of Haryanvi cinema has gotten lost somewhere. If Haryanvi is just another dialect of Hindi, then why has Hindi cinema not been able to fulfil the cultural needs of the Haryanvi speaking audience? Is there scope for investigating the larger socio-economic factors that have reduced Haryanvi cinema to this state? This article is an attempt to investigate the political economy of Haryanvi cinema in relation to the overarching presence of the ubiquitous big brother ‘Bombay cinema’.
Dispensing Nostalgia for a Price
Authors: Uppal Charu
Published: September 2013

Indian culture, dispensed through colorful musicals of Bollywood, remains a common thread of emotional connection for the Indian diaspora spread around the globe in more than 100 countries. Indo-Fijian diaspora, unlike its counterpart in the developed nations where Indians migrated of their own choice, and often hold white collar jobs, is formed of a varied group that almost replicates India in the range of jobs they hold. Despite that similarity, old Indian diaspora remains missing from the Bollywood content that it consumes. This article, through data collected in the Fiji Islands, illustrates the concrete practices that Indo-Fijians engage in to access, and experience Bollywood.
Bhojpuri Cinema
Authors: Shrivastava Madhusri
Published: September 2013

Using Cultural Studies as the framework, this article attempts a content analysis of selected Bhojpuri films to determine how the media help maintain the regional identity of migrants from UP and Bihar residing in Kandivali (east), Mumbai. The Bhojpuri media are closely entwined with the migrants’ everyday realities and social interactions; they reinforce notions of ideal gender roles, alleviate anxieties associated with acculturation, gratify desires vicariously and are instruments of pseudo-empowerment. Familiar images embossed in the media texts ensure continuity with folk traditions, feeding the resurgent pride of the community. The study examines how certain conventions and formulas in Bhojpuri cinema strengthen perceptions of the ‘Bhojpuriya’ identity amongst the migrants, ensuring that the cultural offerings reflect their perspectives on social and cultural issues. Media representations delve into the cultural memory of the migrants, providing them emotional and cultural sustenance in their host city.
Singing Bodies and ‘Movement’ Images in a 1937 Tamil Film
Authors: Gopalan Ravindran
Published: September 2013

Gilles Deleuze’s film philosophy is best known for its discovery of ‘movement images’ and ‘time images’ in the ubiquitous category of filmic images. The advent of Deleuze’s film philosophy has not only pushed the boundaries of filmic images beyond their ‘representational’ territory, but unleashed a very innovative and relevant theoretical framework to examine the narrative locations of films produced in different cultural territories. Early Tamil cinema is best known for its potential to invoke the power of singing bodies through a countless number of songs. The Deleuzian notion of ‘movement images’ provides more than enough pointers to examine early Tamil cinema’s attempts to construct ‘movement images’ through the singing bodies. In examining the singing bodies of the 1937 Tamil film, Chintamani, this article seeks to innovate by deploying Julia Kristeva’s concept of ‘abject’ along with Deleuze’s concept of ‘movement images’. The analytical juxtaposition of these two different concepts reveals itself eminently in uncovering new layers of narrative locations of the singing bodies in Chintamani.
Kannada Cinema
Authors: Rego Richard
Published: September 2013

In 2013 AD, Indian film industry is a hundred years old. For many, the centenarian Indian film industry means Bollywood. But in actuality, Indian cinema consists not only of a relatively small segment of Hindi cinema called Bollywood, but also many more regional cinemas which account for approximately 84 per cent of the films produced in India. Kannada cinema, one of the South Indian language cinemas, produces more than 125 films annually; but has not received sufficient attention from the critics, students and scholars of film studies. Girish Kasaravalli, an internationally renowned Kannada film director, has been making socially conscious films and thus contributing to Indian society and its own self-understanding. Some of the themes which keep recurring in his films are casteism, women and identity, inter-relationships and violence done to elders. In his films—discussed here—Girish Kasaravalli critiques the practice of discrimination based on caste system (also known by its more vicious practice called untouchability) in Indian society. This article employs textual analysis to examine three of his films— Ghatashraddha, Bannada Vesha and Thayi Saheba—to explore the practice of casteism in Indian society as represented by him, and Kasaravalli’s vision of his society and human being vis-à-vis the caste system.
Feline CKD
Authors: Paepe Dominique , Daminet Sylvie
Published: September 2013

Practical relevance:

Feline chronic kidney disease (CKD) is frequently encountered by veterinarians. Timely diagnosis and staging may facilitate the initiation of adequate therapy and improve the prognosis for patients.

Clinical challenges:

Feline CKD is diagnosed based on the presence of compatible clinical signs and renal azotaemia, which implies that urinalysis (particularly urine specific gravity) is mandatory to confirm the diagnosis. Although the diagnosis of advanced feline CKD and associated complications is usually straightforward, based on complete blood and urine examination, all routine blood and urine tests have their limitations in detecting early CKD. Therefore, diagnosing early or non-azotaemic CKD is much more challenging. Although determination of glomerular filtration rate (GFR) would be ideal to identify early kidney dysfunction, practical limitations hamper its routine use in clinical practice.

Patient group:

CKD is typically a disease of aged cats, but may affect cats of all ages. Conclusive breed and sex predispositions for feline CKD are not reported.

Audience:

This review is directed at practising veterinarians and provides an overview of the required diagnostic tests, the classification system established by the International Renal Interest Society, and the importance of and possible techniques for early detection of CKD.

Evidence base:

Staging of cats with CKD is essential as it directs management and provides a prognostic guide. Given that diagnosis at early disease stages is associated with more prolonged survival times, simple, inexpensive and accurate methods for early CKD diagnosis are needed. Techniques currently under investigation include limited sampling strategies to estimate GFR, clearance marker cut-off concentrations to identify cats with low GFR, new indirect GFR markers and urinary biomarkers.
Cooking up a storm: developing an infection prevention training recipe book
Authors: Gardiner Alyson , Nevill Michael , Millward Sue
Published: September 2013

Infection prevention practitioners are required to both provide and deliver infection prevention training but often struggle to resource effective and innovative programmes. The West Midlands branch of the Infection Prevention Society saw the opportunity to develop a training book for its members in the format of ‘recipes’. This book has quick and easy tips for developing and delivering innovative, fun and novel training sessions.
Continuous decontamination of an intensive care isolation room during patient occupancy using 405 nm light technology
Authors: Maclean M , Booth MG , Anderson JG , MacGregor SJ , Woolsey GA , Coia JE , Hamilton K , Gettinby G
Published: September 2013

Environmental contamination within intensive care units (ICU) is recognised as a source of patient infection, and improved cleaning and disinfection methods are continually being sought. Visible light of 405 nm has been shown to have bactericidal properties, and this communication reports on the use of a ceiling-mounted 405 nm light system for continuous environmental disinfection of contact surfaces and air in an occupied ICU isolation room. Levels of bacterial contamination on a range of contact surfaces around the room were assessed before, during and after use of the system. For each study, the lighting units were operated continuously during daylight hours. Results demonstrate that the spatial distribution of bacterial contamination was reduced almost uniformly across all sampled contact surfaces during use of the 405 nm light system. Pooled data showed that significant reductions in overall bacterial contamination around the room were achieved, with bacterial counts reduced by up to 67% ( p=0.0001) over and above that achieved with standard cleaning and infection control procedures alone. Use of 405 nm light significantly reduced environmental contamination across almost all sampled contact surfaces within the ICU isolation room. This has particular benefit in ICU where equipment and other ‘hand-touch’ sites make routine cleaning difficult, thus helping maintain a cleaner environment, and contributing to reducing cross-infection from environmental sources.
Comparative genomics of metabolic capacities of regulons controlled by cis-regulatory RNA motifs in bacteria
Authors: Sun Eric I , Leyn Semen A , Kazanov Marat D , Saier Milton H , Novichkov Pavel S , Rodionov Dmitry A
Published: September 2013

Background

In silico comparative genomics approaches have been efficiently used for functional prediction and reconstruction of metabolic and regulatory networks. Riboswitches are metabolite-sensing structures often found in bacterial mRNA leaders controlling gene expression on transcriptional or translational levels.

An increasing number of riboswitches and other cis-regulatory RNAs have been recently classified into numerous RNA families in the Rfam database. High conservation of these RNA motifs provides a unique advantage for their genomic identification and comparative analysis.

Results

A comparative genomics approach implemented in the RegPredict tool was used for reconstruction and functional annotation of regulons controlled by RNAs from 43 Rfam families in diverse taxonomic groups of Bacteria. The inferred regulons include ~5200 cis-regulatory RNAs and more than 12000 target genes in 255 microbial genomes. All predicted RNA-regulated genes were classified into specific and overall functional categories. Analysis of taxonomic distribution of these categories allowed us to establish major functional preferences for each analyzed cis-regulatory RNA motif family. Overall, most RNA motif regulons showed predictable functional content in accordance with their experimentally established effector ligands. Our results suggest that some RNA motifs (including thiamin pyrophosphate and cobalamin riboswitches that control the cofactor metabolism) are widespread and likely originated from the last common ancestor of all bacteria. However, many more analyzed RNA motifs are restricted to a narrow taxonomic group of bacteria and likely represent more recent evolutionary innovations.

Conclusions

The reconstructed regulatory networks for major known RNA motifs substantially expand the existing knowledge of transcriptional regulation in bacteria. The inferred regulons can be used for genetic experiments, functional annotations of genes, metabolic reconstruction and evolutionary analysis. The obtained genome-wide collection of reference RNA motif regulons is available in the RegPrecise database (http://regprecise.lbl.gov/).
A novel phenoxy thiophene sulphonamide molecule protects against glutamate evoked oxidative injury in a neuronal cell model
Authors: Gliyazova Nailya S , Huh Eun Y , Ibeanu Gordon C
Published: September 2013

Background

Glutamate is one of the major neurotransmitters in the central nervous system. It is a potent neurotoxin capable of neuronal destruction through numerous signal pathways when present in high concentration. Glutamate-evoked excitotoxicity has been implicated in the etiology of many neurodegenerative diseases including Alzheimer’s disease (AD), Parkinson’s disease (PD), and ischemic stroke. Increasing evidence has shown that reactive oxygen species (ROS) provoked by glutamate-linked oxidative stress plays a crucial role in the pathogenesis of these disorders. We previously reported the discovery of an aryl thiophene compound, 4-chloro-N-(naphthalen-1-ylmethyl)-5-(3-(piperazin-1-yl)phenoxy)thiophene-2-sulfonamide (B355252) from a proprietary library of small molecules. We showed that this compound was capable of potentiating nerve growth factor (NGF)-primed neurite outgrowth in neuronal cell models in a low NGF environment. In the present study we investigated the neuroprotective effects and signaling pathways of B355252 on glutamate-evoked excitotoxicity in HT-22, a murine hippocampal neuronal cell line.

Results

Glutamate significantly decreased HT-22 neuronal cell viability in a concentration-dependent manner as measured by the MTT assay. Co-treatment with 2, 4, and 8 μM B355252 protected against cell death caused by glutamate-induced toxicity by 9.1% (p<0.01), 26.0% (p<0.001), and 61.9% (p<0.001) respectively, compared to glutamate-treated control group. B355252 at a concentration of 8 μM fully rescued HT-22 from the neurototoxic effects of glutamate, and by itself increased cell viability by 16% (p<0.001) above untreated control. Glutamate enhanced reduction in glutathione (GSH) synthesis was reversed by 15% (p<0.01) in the presence of B355252. B355252 reduced the expression of apoptosis inducing factor (AIF) by 27%, while the proapoptotic Bcl-2 associated X protein (Bax) was strongly attenuated 3-fold. Glutamate-evoked increase in intracellular calcium (Ca2+) load and subsequent ROS production was inhibited by 71% (p<0.001) and 40% (p<0.001) respectively, to comparable level as untreated control in the presence of B355252. Glutamate significantly upregulated the phosphorylation of extracellular signal regulated kinase Erk1/2 (pERK1/2), while decreasing Erk3. In contrast, B355252 potently attenuated the glutamate-dependent activation of Erk1/2 and robustly increased the level of ERK3 in HT-22.

Conclusions

A novel phenoxy thiophene small molecule, B355252, suppresses glutamate-evoked oxidative stress in HT-22 neurons by blocking Ca2+ and ROS production, and altering the expression or phosphorylation states of Erk kinases. This molecule previously reported to enhance neurite outgrowth in the presence of sub-physiological concentrations of NGF appears to be a promising drug candidate for development as a potential therapeutic and neuroprotective agent for various neurodegenerative disorders.
Additional role of second washing specimen obtained during single bronchoscopy session in diagnosis of pulmonary tuberculosis
Authors: Yoo Hongseok , Song Jae-Uk , Koh Won-Jung , Jeon Kyeongman , Um Sang-Won , Suh Gee Young , Chung Man Pyo , Kim Hojoong , Kwon O Jung , Lee Nam Yong , Woo Sookyoung , Park Hye Yun
Published: September 2013

Background

Flexible bronchoscopy with bronchial washing is a useful procedure for diagnosis of pulmonary tuberculosis (TB), when a patient cannot produce sputum spontaneously or when sputum smears are negative. However, the benefit of gaining serial bronchial washing specimens for diagnosis of TB has not yet been studied. Therefore, we conducted a retrospective study to determine the diagnostic utility of additional bronchial washing specimens for the diagnosis of pulmonary TB in suspected patients.

Methods

A retrospective analysis was performed on 174 patients [sputum smear-negative, n = 95 (55%); lack of sputum specimen, n = 79 (45%)] who received flexible bronchoscopy with two bronchial washing specimens with microbiological confirmation of pulmonary TB in Samsung Medical Center, between January, 2010 and December, 2011.

Results

Pulmonary TB was diagnosed by first bronchial washing specimen in 141 patients (81%) out of 174 enrolled patients, and an additional bronchial washing specimen established diagnosis exclusively in 22 (13%) patients. Smear for acid-fast bacilli (AFB) was positive in 46 patients (26%) for the first bronchial washing specimen. Thirteen patients (7%) were positive only on smear of an additional bronchial washing specimen. Combined smear positivity of the first and second bronchial washing specimens was significantly higher compared to first bronchial washing specimen alone [Total cases: 59 (34%) vs. 46 (26%), p < 0.001; cases for smear negative sputum: 25 (26%) vs. 18 (19%), p = 0.016; cases for poor expectoration: 34 (43%) vs. 28 (35%), p = 0.031]. The diagnostic yield determined by culture was also significantly higher in combination of the first and second bronchial washing specimens compared to the first bronchial washing. [Total cases: 163 (94%) vs. 141 (81%), p < 0.001; cases for smear negative sputum: 86 (91%) vs. 73 (77%), p < 0.001; cases for poor expectoration: 77 (98%) vs. 68 (86%), p = 0.004].

Conclusions

Obtaining an additional bronchial washing specimen could be a beneficial and considerable option for diagnosis of TB in patients with smear-negative sputum or who cannot produce sputum samples.
Comparison of once-daily versus twice-daily combination of Ropinirole prolonged release in Parkinson’s disease
Authors: Yun Ji Young , Kim Han-Joon , Lee Jee-Young , Kim Young Eun , Kim Ji Seon , Kim Jong-Min , Jeon Beom S
Published: September 2013

Background

Ropinirole prolonged release (RPR) is a once-daily formulation. However, there may be individual pharmacokinetic differences so that multiple dosing may be preferred in some individuals. This study compares once-daily and twice-daily RPR in patients with Parkinson’s disease.

Methods

This study was an open-label crossover study. We enrolled Parkinson’s disease patients on dopamine agonist therapy with unsatisfactory control such as motor fluctuation, dyskinesia and sleep-related problems. Agonists were switched into equivalent dose of RPR. Subjects were consecutively enrolled into either once-daily first or twice-daily first groups, and received the same amount of RPR in a single and two divided dosing for 8 weeks respectively in a crossover manner without a washout period.

The primary outcome was a questionnaire of the preference completed by patients in the last visit. The secondary outcome measures included the Unified Parkinson’s Disease Rating Scale part 3 (mUPDRS), Hoehn and Yahr stage (H&Y); sleep questionnaire including overall quality of sleep, nocturnal off symptoms and early morning symptoms; Epworth Sleep Scale (ESS); compliances and patient global impression (PGI).

Results

A total of 82 patients were enrolled and 61 completed the study. 31 patients preferred twice-daily regimen, 17 preferred the once-daily regimen, and 13 had no preference. Their mean mUPDRS, H&Y, ESS, sleep quality, compliance and adverse events were not statistically different in both regimens. PGI-improvement on wearing off defined was better in twice-daily dosing regimen.

Conclusions

RPR is a once-daily formulation, but multiple dosing was preferred in many patients. Multiple dosing of RPR might be a therapeutic option if once-daily dosing is unsatisfactory.

Trial registration

This study is registered with ClinicalTrials.gov, number NCT00986245.
Adherence to Antiretroviral Therapy and associated factors among HIV infected children in Ethiopia: unannounced home-based pill count versus caregivers’ report
Authors: Biressaw Silenat , Abegaz Woldaregay Erku , Abebe Markos , Taye Workeabeba Abebe , Belay Mulugeta
Published: September 2013

Background

The introduction of Antiretroviral Therapy (ART) has brought a remarkable reduction in HIV-related mortality and morbidity both in adults and children living with HIV/AIDS. Adherence to ART is the key to the successful treatment of patients as well as containment of drug resistance. Studies based on caregivers’ report have shown that adherence to ART among children is generally good. However, subjective methods such as caregivers’ report are known to overestimate the level of adherence. This study determined the rate of adherence and its predictors using unannounced home-based pill count and compared the result with caregivers’ report in a tertiary referral hospital in Ethiopia.

Methods

A cross-sectional study was conducted between December 1, 2011 and January 30, 2012. The study participants were 210 children on ART and their caregivers attending pediatric ART clinic of Tikur Anbessa Hospital (TAH), Addis Ababa University. Caregivers were interviewed at the ART clinic using a structured questionnaire. Then, unannounced home-based pill count was done 7 days after the interview.

Results

Caregiver-reported adherence in the past 7 days prior to interview was 93.3%. Estimated adherence using unannounced home-based pill count was found, however, to be 34.8%. On multivariate logistic regression model, children with married [aOR = 7.85 (95% CI: 2.11,29.13)] and widowed/divorced [aOR = 7.14 (95% CI: 2.00,25.46)] caregivers, those who were not aware of their HIV sero-status [aOR = 2.35 (95% CI:1.09, 5.06)], and those with baseline WHO clinical stage III/IV [OR = 3.18 (95% CI: 1.21, 8.40] were more likely to adhere to their ART treatment. On the other hand, children on d4T/3Tc/EFV combination [OR = 0.10 (95% CI: 0.02, 0.53)] were less likely to adhere to their treatment. Caregivers’ forgetfulness and child refusal to take medication were reported as the major reasons for missing doses.

Conclusion

The level of adherence based on unannounced home-based pill count was unacceptably low. Interventions are urgently needed to improve adherence to ART among children at TAH. Besides, a longitudinal study measuring adherence combined with clinical parameters (viral load and CD4 count) is needed to identify a simple and reliable measure of adherence in the study area.
Arsenic immunotoxicity: a review
Authors: Dangleben Nygerma L , Skibola Christine F , Smith Martyn T
Published: September 2013

Exposure to arsenic (As) is a global public health problem because of its association with various cancers and numerous other pathological effects, and millions of people worldwide are exposed to As on a regular basis. Increasing lines of evidence indicate that As may adversely affect the immune system, but its specific effects on immune function are poorly understood. Therefore, we conducted a literature search of non-cancer immune-related effects associated with As exposure and summarized the known immunotoxicological effects of As in humans, animals and in vitro models. Overall, the data show that chronic exposure to As has the potential to impair vital immune responses which could lead to increased risk of infections and chronic diseases, including various cancers. Although animal and in vitro models provide some insight into potential mechanisms of the As-related immunotoxicity observed in human populations, further investigation, particularly in humans, is needed to better understand the relationship between As exposure and the development of disease.
Activated protein C resistance in Behcet’s disease
Authors: Abdel Badaee Hoda , Edrees Amr , Amin Sherif , El Amir Maher , Ragab Gaafar
Published: September 2013

Behcet’s disease is a chronic multi-system disorder of unknown etiology with protean manifestations. Venous thromboembolism is more common than arterial thrombosis, with deep vein thrombosis being the most frequent. Endothelial dysfunction resulting from vascular inflammation is considered to be an important factor of thrombosis, although the endothelial injury itself cannot completely explain the hypercoagulable state of the disease because other vasculitis syndromes do not increase the risk of thrombosis. The aim of this study is to evaluate the prevalence of activated protein C resistance (APC-R) in Egyptian patients with Behcet’s disease. Also, to detect hyperhomocysteinemia in selected cases (with vascular complications) to assess their relationship with thromboembolic complications. The APC resistance ratio mean in the group of patients with vascular involvement was 2.6 ± 0.8 which was less than the group with no vascular involvement 2.8 ± 0.6, with non- significant P-value (0.5). There was more incidence of ocular lesions in the group of patients with high homocysteine level than the group of patients with normal homocytsteine level with significant P-value (0.08).
Protocol for CONSORT-SPI: an extension for social and psychological interventions
Authors: Montgomery Paul , Grant Sean , Hopewell Sally , Macdonald Geraldine , Moher David , Michie Susan , Mayo-Wilson Evan
Published: September 2013

Background

Determining the effectiveness of social and psychological interventions is important for improving individual and population health. Such interventions are complex and, where possible, are best evaluated by randomised controlled trials (RCTs). The use of research findings in policy and practice decision making is hindered by poor reporting of RCTs. Poor reporting limits the ability to replicate interventions, synthesise evidence in systematic reviews, and utilise findings for evidence-based policy and practice. The lack of guidance for reporting the specific methodological features of complex intervention RCTs contributes to poor reporting. We aim to develop an extension of the Consolidated Standards of Reporting Trials Statement for Social and Psychological Interventions (CONSORT-SPI).

Methods/design

This research project will be conducted in five phases. The first phase was the project launch, which consisted of the establishment of a Project Executive and International Advisory Group, and recruitment of journal editors and the CONSORT Group. The second phase involves a Delphi process that will generate a list of possible items to include in the CONSORT Extension. Next, there will be a formal consensus meeting to select the reporting items to add to, or modify for, the CONSORT-SPI Extension. Fourth, guideline documents will be written, including an explanation and elaboration (E&E) document that will provide detailed advice for each item and examples of good reporting. The final phase will comprise guideline dissemination, with simultaneous publication and endorsement of the guideline in multiple journals, endorsement by funding agencies, presentations at conferences and other meetings, and a dedicated website that will facilitate feedback about the guideline.

Conclusion

As demonstrated by previous CONSORT guidelines, the development of an evidence-based reporting guideline for social and psychological intervention RCTs should improve the accuracy, comprehensiveness, and transparency of study reports. This, in turn, promises to improve the critical appraisal of research and its use in policy and practice decision making. We invite readers to participate in the project by visiting our website (http://tinyurl.com/CONSORT-study).