bluuebunny/crossref_metadata_2025 huggingface dataset:
The temperature sensitivity of fiber bragg gratings embedded in an Al 6061 matrix by ultrasonic welding
Authors: Zhu Zhengqiang , Chen Yanjun , Zhang Yifu
Published: November 2011

The low temperatures and low pressure employed in ultrasonic welding make it suitable for embedding optical fiber gratings (fiber Bragg gratings (FBGs)) in the fabrication of 3D smart composites. However, FBG sensors embedded in metal matrices are easily damaged and broken. A method is therefore presented for the metallization of FBG by the combination of electroless nickel plating and electro nickel plating, followed by embedding the coated FBG in an aluminum alloy 6061 matrix in order to fabricate smart metal structures. Experimental results show that nickel plating can protect the FBG and provide benefits in the fabrication of aluminum alloy smart structures using ultrasonic welding. The temperature-sensing properties of smart metal structures fabricated in this way are analyzed, and the results show that the temperature sensitivity has been improved twofold. Also, the temperature sensing shows good linearity, and the temperature cross-sensitivity has been effectively controlled; the temperature resolution has also been improved, making the measurements more accurate.
The Promise of Standardized Data Collection
Authors: Johnson Kathleen H. , Bergren Martha Dewey , Westbrook Linda Oakes
Published: November 2011

A gap in data prevents measurement of the needs of school-age children and the influence of school nursing interventions on student health and education outcomes. Its remedy is in the data collected in school health rooms. A national clinical database describing school health will allow education and health leaders to build evidence-based programs for children. Several states collect school health data describing student needs and school nursing practice. This study identified, collated, described, and evaluated the variables compiled from state school health reporting documents to identify commonalities and form the foundation of a standardized school health reporting system. A comprehensive content analysis of variables in the instruments yielded a framework within which school health data can be organized and described. It consists of five broad categories describing staffing; risk management; health promotion; episodic care; and care coordination. The result provides a nationally standardized coding set to describe school health.
Temozolomide plus radiotherapy for glioblastoma in a Canadian province: Efficacy versus effectiveness and the impact of O6-methylguanine-DNA-methyltransferase promoter methylation
Authors: Lam Nadine , Chambers Carole R
Published: November 2011

Background: Radiotherapy with concomitant and adjuvant temozolomide has been the standard of care for newly diagnosed glioblastoma in adults since the pivotal trial by Roger Stupp and colleagues. The effectiveness of this regimen has not been evaluated in Canada. Additionally, the impact of O6-methylguanine-DNA-methyltransferase (MGMT) promoter methylation on patient survival has not been confirmed. Hence, survival outcomes and MGMT predictive value were compared for the patients in Alberta versus the Stupp trial population.

Methods: Retrospective chart review of 215 adult glioblastoma patients who started radiotherapy and temozolomide between January 2007 and December 2010 at the Cross Cancer Institute (Edmonton, Alberta) or the Tom Baker Cancer Centre (Calgary, Alberta).

Results: In the Alberta population, median overall survival was 14.3 months (vs. 14.6 months in trial, p = NS) and median progression-free survival was 5.8 months (vs. 6.9 months in trial, p = NS). However, unlike the trial, the Alberta MGMT subgroup analysis for overall survival was not statistically significant, despite a hazard ratio of 0.65 in favor of the methylated group. More Alberta patients received corticosteroids ( p < 0.0001) and fewer underwent complete resection ( p = 0.0001) or a postprogression second surgery ( p = 0.01) than the Stupp population, but characteristics were otherwise similar.

Conclusion: Current practice in Alberta enables patients to achieve overall and progression-free survival similar to the clinical trial. Further follow-up is required to confirm the predictive value of the MGMT assay. Until that is clarified or better treatments are developed, it is reasonable to continue offering this treatment regimen to patients regardless of MGMT methylation status.
The Unemployment Puzzle of Corporate Taxation
Authors: Feldmann Horst
Published: November 2011

Using annual data on nineteen industrial countries for the period 1979–2005 and a large number of controls, this article is the first to empirically study the impact of corporate taxes on the unemployment rate. In contrast to previous empirical research on the labor demand, investment and growth effects of corporate taxation, which consistently finds adverse effects, the regression results suggest that higher corporate taxes may have a favorable impact, lowering the unemployment rate. The magnitude of the estimated effect is substantial. The results of this study are robust to both endogeneity and numerous variations in specification.
Gender in audiovisual translation: Naturalizing feminine voices in the French Sex and the City
Authors: Feral Anne-Lise
Published: November 2011

This article explores how certain feminine voices are adapted or ‘naturalized’ in audiovisual translation in order to conform to the intended audience’s assumed gender beliefs and values. Using purposefully selected examples from the American series Sex and the City, the author analyses elements pertaining to American feminism and how they are rendered in the French dubbing and subtitles. While the subtitles retain most references, the dubbing reveals a marked tendency to delete, weaken and transform allusions to American feminist culture as well as female achievements in the public sphere and feminist ideology. These findings are discussed in relation to the history, place and representation of women and feminism in France. The case study suggests that integrating a feminist approach in audiovisual translation research could help women’s studies detect the unspoken gender values of the cultures for which audiovisual translation is produced.
A randomized clinical trial of autologous T-cell therapy in multiple sclerosis: subset analysis and implications for trial design
Authors: Fox Edward , Wynn Daniel , Cohan Stanley , Rill Donna , McGuire Dawn , Markowitz Clyde
Published: November 2011

Background: Tovaxin is an autologous T-cell immunotherapy under investigation for the treatment of MS. The product consists of in vitro expanded myelin-reactive T-cells manufactured against up to six immunodominant peptides derived from three myelin antigens.

Methods: A Phase 2b placebo controlled study (TERMS) was conducted in 150 subjects to gather safety and efficacy data in relapsing-remitting MS and clinically isolated syndrome subjects.

Results: Tovaxin had a favorable safety profile. Although no statistically significant clinical or radiological benefit of Tovaxin immunotherapy was identified in the modified intent-to-treat population, a prospective analysis of subjects with more active disease favored Tovaxin in terms of annualized relapse rate (ARR) and disability progression. An analysis also found a possible legacy effect of prior disease-modifying treatment (DMT) which may have contributed to a lowered ARR in the placebo group. DMT-naïve subjects treated with Tovaxin had a lower ARR compared to the placebo group, particularly in those with active baseline disease (ARR≥1, ARR>1). However, clinical benefit was not was accompanied by a treatment-dependent improvement in MRI measures.

Conclusions: Previous DMT exposure may reduce effect size and study power. Limiting subject selection to DMT-treatment-naïve individuals may be a reasonable approach to phase 2 or proof-of-concept studies of limited duration.
Artificial neural network prediction of the wear rate of powder metallurgy Al/Al2O3 metal matrix composites
Authors: Mahmoud T S
Published: November 2011

In this study, the artificial neural network (ANN) approach is used to predict the wear rate of Al/Al2O3 metal matrix composites (MMCs). The Al/Al2O3 MMCs were fabricated using the conventional powder metallurgy route. Different ANN structures were used to develop models for prediction and optimization of the wear rates of the Al/Al2O3 composites under dry sliding conditions. The effects of the volume fraction of Al2O3 particulates, density, and hardness of the Al/Al2O3 composites, as well as the applied pressure, sliding speed, and test temperature on the wear rates were evaluated using the ANN models. The results showed that the developed multilayer perceptron ANN model can be effectively used to predict the wear rates of Al/Al2O3 MMCs. The generalized radial basis function showed lower prediction performance.
Influence of fuel injection parameters on combustion-induced noise in a small diesel engine
Authors: Bhat C S , Meckl P H , Bolton J S , Abraham J
Published: November 2011

In this paper, the effects of fuel injection parameters on combustion-induced noise in a small single-cylinder direct-injection diesel engine used in a generator set are described. A range of fuel injection parameters, including injection timing and injection quantity, was explored to understand their influence on combustion-induced noise by studying their effect on in-cylinder pressure development. Fourier analysis was performed to understand the effects of changing combustion characteristics on in-cylinder pressure levels in different frequency ranges. In addition, time–frequency analysis was used to understand the changes in the combustion chamber resonance effects under different injection settings. Finally, overall engine noise levels were measured to confirm the changes as predicted by the in-cylinder pressure analysis. Results suggest that retarding main injection has the largest impact on reducing noise. When using split injection, earlier preinjection and larger preinjection quantities tend to result in lower noise.
Vascular endothelial growth factor polymorphisms are involved in the late vascular complications in Type II diabetic patients
Authors: Bleda Silvia , De Haro Joaquin , Varela Cesar , Esparza Leticia , Ferruelo Antonio , Acin Francisco
Published: November 2011

Aim: To determine the potential genotype differences in the vascular endothelial growth factor (VEGF) gene in diabetic patients, which might explain the difference in terms of the development of clinical vascular complications: great vessels atherosclerosis vs. retinopathy.

Methods: Genotyping of the VEFG gene insertion/deletion −2549, the C−2578A and the G+405C polymorphisms was done in 40 diabetic patients (26 with peripheral artery disease (PAD) and 14 with diabetic retinopathy (DR)).

Results: There was a significant increase in the frequency of the VEGF −2549 DD genotype in PAD patients compared with the DR group (34.6 vs. 0; p = 0.016), as well as in the distribution of the VEGF −2549 ID genotype in DR compared with PAD patients (85.7 vs. 38.4; p = 0.005). There was a significant increase in the frequency of the VEGF −2578 CC genotype in the PAD group compared with DR (34.6 vs. 0; p = 0.016), as well as in the VEGF −2578 CA genotype in DR patients compared with PAD (85.7 vs. 34.6; p = 0.002). The VEGF +405 genotype was not associated with diabetic vascular complications.

Conclusion: This study provides preliminary evidence that VEGF polymorphisms are associated with a differential presentation of diabetic vascular complications.
Desired Attributes and Skills of Program Managers in Translation of Evidence-Based Interventions
Authors: Williams Rhonda , Woodell Carol , McCarville Erin , Damitz Maureen , Banks Tinesha , Montoya Jorge , Lesch Julie Kennedy , Peretz Patricia , Lara Marielena
Published: November 2011

Successful chronic disease project management, especially of multiyear initiatives using evidence-based interventions (EBIs), is of great importance to funders, health care decision makers, and researchers, particularly in light of limited funding. However, a gap in knowledge may exist regarding which attributes and skills are most desirable in a program manager to help him or her ensure successful implementation of EBIs. Although some literature examines the dynamics contributing to the success of community coalitions, public health leadership, and community health education, there is minimal literature exploring the significance of a program manager’s role in the conceptualization, implementation, and sustainability of initiatives to improve patient and community health. The authors present their experiences as participants in a large-scale asthma initiative implemented in priority communities, as well as results of a survey distributed among all personnel of the program sites. The survey aimed to assess the key skills and attributes, in addition to contextual factors, that contribute to the strength of a program manager overseeing EBIs in asthma initiatives. The results suggest that certain attributes and skills are desirable in recruiting and hiring of a program manager, especially when augmented by ongoing skill-building training, and can help ensure program and research success.
Supporting Tobacco Control
Authors: Buller David B. , Bettinghaus Erwin P. , Helme Donald , Young Walter F. , Borland Ron , Maloy Julie A. , Cutter Gary R. , Andersen Peter A. , Walther Joseph B.
Published: November 2011

A large and growing literature confirms that well-designed web-based programs can be effective in preventing or treating several chronic diseases. This study examined how the Internet can deliver information and train community activists and specifically tested the effects of web-based technical assistance on local tobacco control coalitions’ efforts to use media advocacy to advance their agendas. The authors compared a highly interactive, Enhanced website (intervention) to a noninteractive, Basic text-based website (comparison) in Colorado communities. A total of 24 tobacco control coalitions led by local county health departments and nursing services were enrolled in the project and randomly assigned to use either the intervention or comparison website. A total of 73 local daily and weekly newspapers were identified in the service areas of 23 of the 24 coalitions. A posttest assessment of newspaper coverage was conducted to locate all newspaper articles with tobacco control information published between January 1 and April 9, 2004, the last 3 months of the intervention. Although there was no evidence of a treatment effect on the frequency of newspaper articles on tobacco-related issues, there was, however, evidence that newspapers in counties where the coalition had access to the Enhanced website printed more stories focused on local/regional issues and more anti-tobacco local/regional stories than in the counties where coalitions had access to the Basic website. Coalitions can improve their influence on local media for community tobacco control when high-quality online technical assistance, training, and resources are available to them.
Technical Assistance and Tobacco Control
Authors: Pokhrel Kabi , Caine Julie
Published: November 2011

Ursula Bauer, PhD, MPH, currently directs the National Center for Chronic Disease Prevention and Health Promotion at the Centers for Disease Control and Prevention. She has also worked in the New York Department of Health as Director of the Division of Chronic Disease and Injury Prevention and as Director of the Tobacco Control Program. In this interview, she shares her perspectives on the importance of technical assistance in tobacco control.
Getting Universal Primary Tobacco Use Prevention Into Priority Area Schools
Authors: Bier Melinda C. , Zwarun Lara , Fehrmann Warren Victoria
Published: November 2011

The impact of any prevention intervention depends on its ability to influence health risks and behavior change and the extent to which the target audience has access to and participates in the program. In this article, the authors make the case that media literacy–based tobacco prevention education can be integrated into the middle school curriculum in a way that delivers on both counts. They describe Missouri’s successful development and dissemination of the Youth Empowerment in Action! Tobacco Education, Advocacy, and Media curriculum to schools serving populations that are most vulnerable to tobacco-related health disparities. They make three recommendations to support health program developers’ efforts to motivate and prepare teachers to implement and sustain universal tobacco prevention education in areas of highest need.
Balancing “Fidelity” and Community Context in the Adaptation of Asthma Evidence-Based Interventions in the “Real World”
Authors: Lara Marielena , Bryant-Stephens Tyra , Damitz Maureen , Findley Sally , González Gavillán Jesús , Mitchell Herman , Ohadike Yvonne U. , Persky Victoria W. , Ramos Valencia Gilberto , Rojas Smith Lucia , Rosenthal Michael , Thyne Shannon , Uyeda Kimberly , Viswanathan Meera , Woodell Carol
Published: November 2011

The Merck Childhood Asthma Network (MCAN) initiative selected five sites (New York City, Puerto Rico, Chicago, Los Angeles, and Philadelphia) to engage in translational research to adapt evidence-based interventions (EBIs) to improve childhood asthma outcomes. The authors summarize the sites’ experience by describing criteria defining the fidelity of translation, community contextual factors serving as barriers or enablers to fidelity, types of adaptation conducted, and strategies used to balance contextual factors and fidelity in developing a “best fit” for EBIs in the community. A conceptual model captures important structural and process-related factors and helps frame lessons learned. Site implementers and intervention developers reached consensus on qualitative rankings of the levels of fidelity of implementation for each of the EBI core components: low fidelity, adaptation (major vs. minor), or high fidelity. MCAN sites were successful in adapting core EBI components based on their understanding of structural and other contextual barriers and enhancers in their communities. Although the sites varied regarding both the EBI components they implemented and their respective levels of fidelity, all sites observed improvement in asthma outcomes. Our collective experiences of adapting and implementing asthma EBIs highlight many of the factors affecting translation of evidenced-based approaches to chronic disease management in real community settings.
Characteristics of Generalized Anxiety Disorder in Patients With Dementia
Authors: Calleo Jessica S. , Kunik Mark E. , Reid Dana , Kraus-Schuman Cynthia , Paukert Amber , Regev Tziona , Wilson Nancy , Petersen Nancy J. , Snow A. Lynn , Stanley Melinda
Published: November 2011

Background: Overlap of cognitive and anxiety symptoms (i.e., difficulty concentrating, fatigue, restlessness) contributes to inconsistent, complicated assessment of generalized anxiety disorder (GAD) in persons with dementia. Methods: Anxious dementia patients completed a psychiatric interview, the Penn State Worry Questionnaire-Abbreviated, and the Rating for Anxiety in Dementia scale. Analyses to describe the 43 patients with and without GAD included the Wilcoxon Mann-Whitney two-sample test, Fisher’s exact test. Predictors of GAD diagnosis were identified using logistic regression. Results: Those with GAD were more likely to be male, have less severe dementia and endorsed more worry, and anxiety compared to patients without GAD. Gender, muscle tension and fatigue differentiated those with GAD from those without GAD. Conclusions: Although this study is limited by a small sample, it describes clinical characteristics of GAD in dementia, highlighting the importance of muscle tension and fatigue in recognizing GAD in persons with dementia.
The Interaction Between Neighborhood Disadvantage and Genetic Factors in the Prediction of Antisocial Outcomes
Authors: Beaver Kevin M. , Gibson Chris L. , DeLisi Matt , Vaughn Michael G. , Wright John Paul
Published: November 2011

Objective. There is growing recognition that antisocial behaviors are produced by a combination of environmental and genetic factors. Research has revealed that environmental and genetic factors work interactively and often moderate the effects of the other. Method. We test for gene–environment interactions in the current study by examining whether neighborhood disadvantage interacts with two dopamine receptor genes ( DRD2 and DRD4) to predict three different antisocial measures: adolescent victimization, contact with delinquent peers, and involvement in violent delinquency. Results. Analysis of male respondents drawn from the National Longitudinal Study of Adolescent Health revealed that the association between the two dopamine genes and the measures of antisocial outcomes tended to be stronger in disadvantaged neighborhoods. Conclusions. Antisocial outcomes appear to be affected by gene–environment interactions between dopaminergic genes and neighborhood disadvantage.
The Effects of Neighborhood Context on Youth Violence and Delinquency
Authors: Fagan Abigail A. , Wright Emily M.
Published: November 2011

This study examined the effects of neighborhood structural and social characteristics on offending among girls and boys aged 8–17 residing in 80 Chicago neighborhoods. The results demonstrated gender differences in contextual effects, although not in ways predicted by social disorganization theory. Collective efficacy and concentrated disadvantage were not significantly associated with self-reported offending among males. Among females, collective efficacy was related to higher rates of general delinquency and violence, while disadvantage reduced the likelihood of self-reported violence. These outcomes suggest that neighborhoods may impact individual offending in complex ways and highlight the importance of considering gender when researching contextual effects on youth offending.
The potential for central monitoring techniques to replace on-site monitoring: findings from an international multi-centre clinical trial
Authors: Bakobaki Julie M , Rauchenberger Mary , Joffe Nicola , McCormack Sheena , Stenning Sally , Meredith Sarah
Published: November 2011

Background Compliance with Good Clinical Practice (GCP) guidelines should ensure the safety of trial participants and the reliability of trial results. Over the last decade, increasing emphasis has been placed on the role of costly on-site monitoring and source data verification as processes to demonstrate that GCP is being followed, despite a lack of empirical evidence that these are effective.

Purpose To assess whether findings from on-site monitoring of a recent international multi-centre clinical trial could have been identified using central data review and other centralised monitoring techniques.

Methods Findings documented in a sample of site monitoring reports, and Programme Management Board Executive (PMBe) reports, from the Microbicides Development Programme (MDP) 301 trial – a randomised placebo-controlled trial of a microbicide gel to prevent vaginally acquired HIV infection conducted in four countries in East and Southern Africa – were extracted and individually assessed to determine whether they could have been detected in the trial database or through other central means.

Results Four site visit reports contained 268 monitoring findings from a review of 104 participant files covering 324 study visits. Of the 268 findings, 76 (28.4%) were also identified in the study database. Central checks, had these been in place (such as central receipt and review of back-translated documents, enrolment and testing logs, informed consent, and more complex database queries), could have identified a further 179 (66.8%); 13 (4.9%) other findings (all minor) could have been identified through a review of the participant folder at site. The four PMBe reports reviewed included six major and three critical findings from a review of over 1000 participant files: only two of these (both major) were assessed as unlikely to be identified using central monitoring techniques.

Limitations The study data used were not collected with this retrospective review in mind. It suggests that prospective work is needed to compare monitoring practices in real time.

Conclusions While there may be some categories of findings that it is not possible to identify centrally, the very large majority of findings reviewed in this analysis could be identified using central monitoring strategies. These data suggest that with better central and targeted on-site monitoring, it should be possible to identify and address most protocol and procedural compliance issues without performing intensive and costly routine on-site data monitoring.
Efficacy and safety of telaprevir in patients with genotype 1 hepatitis C infection
Authors: Cunningham Morven , Foster Graham R.
Published: November 2011

Chronic hepatitis C infection represents a significant and growing health problem worldwide. Patients with genotype 1 hepatitis C respond poorly to the current standard of care, pegylated interferon and ribavirin, which is frequently associated with unpleasant side effects. Consequently new agents with improved efficacy and tolerability are needed. The efficacy and safety of the direct-acting antiviral agent telaprevir in the treatment of genotype 1 hepatitis C infection have been demonstrated in a number of clinical trials. The addition of telaprevir to standard therapy considerably improves response rates and allows response-guided shortening of treatment duration in a substantial number of treatment-naïve patients. Side effects associated with telaprevir therapy include rash, anaemia, gastrointestinal disturbance and anorectal discomfort. Telaprevir-resistant variants have been identified in patients who have failed telaprevir-containing therapy, and whether selection of these variants will compromise future therapeutic options is currently unknown. The efficacy and safety of telaprevir in the treatment of the most challenging patients, including those with recurrent hepatitis C following liver transplantation and those co-infected with HIV, remains to be established.
Implementing Quality Improvement Intervention of Pediatric Asthma in Primary Health Care—Al Ain, United Arab Emirates
Authors: Revel Anthony D. , Baynouna Latifa Mohammad
Published: November 2011

Background and Objectives. Asthma is a common childhood condition that has an impact on the affected children, their parents, and the community. Poor management of this condition is evident. This study evaluated a structured process for quality improvement of asthma care in children. Settings and Design. Intervention strategies included the following: ( a) the dissemination of clinical practice guidelines for the care of asthma in pediatrics, ( b) flow sheets in the patient chart, ( c) audit feedback, and ( d) academic detailing. The outcome performance measures were in the areas of history, physical assessment, documentation, clinical outcome, quality of life, prescribing, knowledge, and use of health care services. Methods. A randomized controlled study of 7 centers: 3 in the intervention group and 4 in the control group. Results. The effectiveness of academic detailing was apparent in improved patient education and patients’ knowledge of trigger factors. There was a lack of any improvement in all other performance measures that were comprehensively assessed in this study. Conclusions. Academic detailing and targeted patient education were shown to be effective. Strategies that did not demonstrate effectiveness in this setting were the single session of audit and feedback, distribution of guidelines, and distribution of chart flow sheets. A future recommendation would be to strengthen self-management and structured care.
Defects in Glanzmann thrombasthenia and LAD-III (LAD-1/v) syndrome: the role of integrin β1 and β3 in platelet adhesion to collagen
Authors: van de Vijver Edith , De Cuyper Iris M. , Gerrits Anja J. , Verhoeven Arthur J. , Seeger Karl , Gutiérrez Laura , van den Berg Timo K. , Kuijpers Taco W.
Published: November 2011

Patients with Glanzmann thrombasthenia or Leukocyte Adhesion Deficiency-III syndrome (LAD-III or LAD-1/variant) present with increased bleeding tendency because of the lack or dysfunction of the fibrinogen receptor GPIIb/IIIa (integrin αIIbβ3), respectively. Although the bleeding disorder is more severe in LAD-III patients, classic aggregometry or perfusion of Glanzmann or LAD-III platelets over collagen-coated slides under physiologic shear rate does not discriminate between these 2 conditions. However, in a novel flow cytometry-based aggregation assay, Glanzmann platelets were still capable of forming small aggregates upon collagen stimulation, whereas LAD-III platelets were not. These aggregates required functional GPIa/IIa (integrin α2β1) instead of integrin αIIbβ3, thus explaining the clinically more severe bleeding manifestations in LAD-III patients, in which all platelet integrins are functionally defective. These findings provide genetic evidence for the differential requirements of platelet integrins in thrombus formation and demonstrate that correct integrin function assessment can be achieved with a combination of diagnostic methods.
Activated MCTC mast cells infiltrate diseased lung areas in cystic fibrosis and idiopathic pulmonary fibrosis
Authors: Andersson Cecilia K , Andersson-Sjöland Annika , Mori Michiko , Hallgren Oskar , Pardo Annie , Eriksson Leif , Bjermer Leif , Löfdahl Claes-Göran , Selman Moises , Westergren-Thorsson Gunilla , Erjefält Jonas S
Published: November 2011

Background

Although mast cells are regarded as important regulators of inflammation and tissue remodelling, their role in cystic fibrosis (CF) and idiopathic pulmonary fibrosis (IPF) has remained less studied. This study investigates the densities and phenotypes of mast cell populations in multiple lung compartments from patients with CF, IPF and never smoking controls.

Methods

Small airways, pulmonary vessels, and lung parenchyma were subjected to detailed immunohistochemical analyses using lungs from patients with CF (20 lung regions; 5 patients), IPF (21 regions; 7 patients) and controls (16 regions; 8 subjects). In each compartment the densities and distribution of MCTand MCTCmast cell populations were studied as well as the mast cell expression of IL-6 and TGF-β.

Results

In the alveolar parenchyma in lungs from patients with CF, MCTCnumbers increased in areas showing cellular inflammation or fibrosis compared to controls. Apart from an altered balance between MCTCand MCTcells, mast cell in CF lungs showed elevated expression of IL-6. In CF, a decrease in total mast cell numbers was observed in small airways and pulmonary vessels. In patients with IPF, a significantly elevated MCTCdensity was present in fibrotic areas of the alveolar parenchyma with increased mast cell expression of TGF-β. The total mast cell density was unchanged in small airways and decreased in pulmonary vessels in IPF. Both the density, as well as the percentage, of MCTCcorrelated positively with the degree of fibrosis. The increased density of MCTC, as well as MCTCexpression of TGF-β, correlated negatively with patient lung function.

Conclusions

The present study reveals that altered mast cell populations, with increased numbers of MCTCin diseased alveolar parenchyma, represents a significant component of the histopathology in CF and IPF. The mast cell alterations correlated to the degree of tissue remodelling and to lung function parameters. Further investigations of mast cells in these diseases may open for new therapeutic strategies.
Exogenous interleukin-6, interleukin-13, and interferon-gamma provoke pulmonary abnormality with mild edema in enterovirus 71-infected mice
Authors: Huang Szu-Wei , Lee Yi-Ping , Hung Yu-Ting , Lin Chun-Hung , Chuang Jih-Ing , Lei Huan-Yao , Su Ih-Jen , Yu Chun-Keung
Published: November 2011

Background

Neonatal mice developed neurological disease and pulmonary dysfunction after an infection with a mouse-adapted human Enterovirus 71 (EV71) strain MP4. However, the hallmark of severe human EV71 infection, pulmonary edema (PE), was not evident.

Methods

To test whether EV71-induced PE required a proinflammatory cytokine response, exogenous pro-inflammatory cytokines were administered to EV71-infected mice during the late stage of infection.

Results

After intracranial infection of EV71/MP4, 7-day-old mice developed hind-limb paralysis, pulmonary dysfunction, and emphysema. A transient increase was observed in serum IL-6, IL-10, IL-13, and IFN-γ, but not noradrenaline. At day 3 post infection, treatment with IL-6, IL-13, and IFN-γ provoked mild PE and severe emphysema that were accompanied by pulmonary dysfunction in EV71-infected, but not herpes simplex virus-1 (HSV-1)-infected control mice. Adult mice did not develop PE after an intracerebral microinjection of EV71 into the nucleus tractus solitarii (NTS). While viral antigen accumulated in the ventral medulla and the NTS of intracerebrally injected mice, neuronal loss was observed in the ventral medulla only.

Conclusions

Exogenous IL-6, IL-13, and IFN-γ treatment could induce mild PE and exacerbate pulmonary abnormality of EV71-infected mice. However, other factors such as over-activation of the sympathetic nervous system may also be required for the development of classic PE symptoms.
Characterization of RNase MRP RNA and novel snoRNAs from Giardia intestinalis and Trichomonas vaginalis
Authors: Chen Xiaowei S , Penny David , Collins Lesley J
Published: November 2011

Background

Eukaryotic cells possess a complex network of RNA machineries which function in RNA-processing and cellular regulation which includes transcription, translation, silencing, editing and epigenetic control. Studies of model organisms have shown that many ncRNAs of the RNA-infrastructure are highly conserved, but little is known from non-model protists. In this study we have conducted a genome-scale survey of medium-length ncRNAs from the protozoan parasites Giardia intestinalis and Trichomonas vaginalis.

Results

We have identified the previously 'missing' Giardia RNase MRP RNA, which is a key ribozyme involved in pre-rRNA processing. We have also uncovered 18 new H/ACA box snoRNAs, expanding our knowledge of the H/ACA family of snoRNAs.

Conclusions

Results indicate that Giardia intestinalis and Trichomonas vaginalis, like their distant multicellular relatives, contain a rich infrastructure of RNA-based processing. From here we can investigate the evolution of RNA processing networks in eukaryotes.
Mycobacterium genavense as a cause of subacute pneumonia in patients with severe cellular immunodeficiency
Authors: Rammaert Blandine , Couderc Louis-Jean , Rivaud Elisabeth , Honderlick Patrick , Zucman David , Mamzer Marie-France , Cahen Pierre , Bille Emmanuel , Lecuit Marc , Lortholary Olivier , Catherinot Emilie
Published: November 2011

Background

Mycobacterium genavense is a rare nontuberculous mycobacteria (NTM). Human infections are mostly disseminated in the setting of the AIDS epidemic or the use of aggressive immunosuppressive treatments. M. genavense culture is fastidious, requiring supplemented media. Pulmonary involvement rarely occurs as a primary localization.

Cases presentation

We report here two patients with pneumonia as the predominant manifestation of M. genavense infection: one kidney transplanted patient and one HIV-infected patient. Both patients were initially treated with anti-tuberculous drugs before the identification of M. genavense on sputum or broncho-alveolar lavage fluid culture. A four-drug regimen including clarithromycin and rifabutin was started. Gamma interferon has been helpful in addition to antimycobacterial treatment for one patient.

Conclusion

Clinicians should be aware that M. genavense could be the etiologic agent of sub-acute pneumonia mimicking tuberculosis in patients with cellular immunodeficiency status.
Chemotherapeutic errors in hospitalised cancer patients: attributable damage and extra costs
Authors: Ranchon Florence , Salles Gilles , Späth Hans-Martin , Schwiertz Vérane , Vantard Nicolas , Parat Stéphanie , Broussais Florence , You Benoît , Tartas Sophie , Souquet Pierre Jean , Dussart Claude , Falandry Claire , Henin Emilie , Freyer Gilles , Rioufol Catherine
Published: November 2011

Background

In spite of increasing efforts to enhance patient safety, medication errors in hospitalised patients are still relatively common, but with potentially severe consequences. This study aimed to assess antineoplastic medication errors in both affected patients and intercepted cases in terms of frequency, severity for patients, and costs.

Methods

A 1-year prospective study was conducted in order to identify the medication errors that occurred during chemotherapy treatment of cancer patients at a French university hospital. The severity and potential consequences of intercepted errors were independently assessed by two physicians. A cost analysis was performed using a simulation of potential hospital stays, with estimations based on the costs of diagnosis-related groups.

Results

Among the 6, 607 antineoplastic prescriptions, 341 (5.2%) contained at least one error, corresponding to a total of 449 medication errors. However, most errors (n = 436) were intercepted before medication was administered to the patients. Prescription errors represented 91% of errors, followed by pharmaceutical (8%) and administration errors (1%). According to an independent estimation, 13.4% of avoided errors would have resulted in temporary injury and 2.6% in permanent damage, while 2.6% would have compromised the vital prognosis of the patient, with four to eight deaths thus being avoided. Overall, 13 medication errors reached the patient without causing damage, although two patients required enhanced monitoring. If the intercepted errors had not been discovered, they would have resulted in 216 additional days of hospitalisation and cost an estimated annual total of 92, 907€, comprising 69, 248€ (74%) in hospital stays and 23, 658€ (26%) in additional drugs.

Conclusion

Our findings point to the very small number of chemotherapy errors that actually reach patients, although problems in the chemotherapy ordering process are frequent, with the potential for being dangerous and costly.
Determinants of rapid weight gain during infancy: baseline results from the NOURISH randomised controlled trial
Authors: Mihrshahi Seema , Battistutta Diana , Magarey Anthea , Daniels Lynne A
Published: November 2011

Background

Rapid weight gain in infancy is an important predictor of obesity in later childhood. Our aim was to determine which modifiable variables are associated with rapid weight gain in early life.

Methods

Subjects were healthy infants enrolled in NOURISH, a randomised, controlled trial evaluating an intervention to promote positive early feeding practices. This analysis used the birth and baseline data for NOURISH. Birthweight was collected from hospital records and infants were also weighed at baseline assessment when they were aged 4-7 months and before randomisation. Infant feeding practices and demographic variables were collected from the mother using a self administered questionnaire. Rapid weight gain was defined as an increase in weight-for-age Z-score (using WHO standards) above 0.67 SD from birth to baseline assessment, which is interpreted clinically as crossing centile lines on a growth chart. Variables associated with rapid weight gain were evaluated using a multivariable logistic regression model.

Results

Complete data were available for 612 infants (88% of the total sample recruited) with a mean (SD) age of 4.3 (1.0) months at baseline assessment. After adjusting for mother's age, smoking in pregnancy, BMI, and education and infant birthweight, age, gender and introduction of solid foods, the only two modifiable factors associated with rapid weight gain to attain statistical significance were formula feeding [OR = 1.72 (95%CI 1.01-2.94), P = 0.047] and feeding on schedule [OR = 2.29 (95%CI 1.14-4.61), P = 0.020]. Male gender and lower birthweight were non-modifiable factors associated with rapid weight gain.

Conclusions

This analysis supports the contention that there is an association between formula feeding, feeding to schedule and weight gain in the first months of life. Mechanisms may include the actual content of formula milk (e.g. higher protein intake) or differences in feeding styles, such as feeding to schedule, which increase the risk of overfeeding.

Trial Registration

Australian Clinical Trials RegistryACTRN12608000056392
Statistical learning methods as a preprocessing step for survival analysis: evaluation of concept using lung cancer data
Authors: Behera Madhusmita , Fowler Erin E , Owonikoko Taofeek K , Land Walker H , Mayfield William , Chen Zhengjia , Khuri Fadlo R , Ramalingam Suresh S , Heine John J
Published: November 2011

Background

Statistical learning (SL) techniques can address non-linear relationships and small datasets but do not provide an output that has an epidemiologic interpretation.

Methods

A small set of clinical variables (CVs) for stage-1 non-small cell lung cancer patients was used to evaluate an approach for using SL methods as a preprocessing step for survival analysis. A stochastic method of training a probabilistic neural network (PNN) was used with differential evolution (DE) optimization. Survival scores were derived stochastically by combining CVs with the PNN. Patients (n = 151) were dichotomized into favorable (n = 92) and unfavorable (n = 59) survival outcome groups. These PNN derived scores were used with logistic regression (LR) modeling to predict favorable survival outcome and were integrated into the survival analysis (i.e. Kaplan-Meier analysis and Cox regression). The hybrid modeling was compared with the respective modeling using raw CVs. The area under the receiver operating characteristic curve (Az) was used to compare model predictive capability. Odds ratios (ORs) and hazard ratios (HRs) were used to compare disease associations with 95% confidence intervals (CIs).

Results

The LR model with the best predictive capability gave Az = 0.703. While controlling for gender and tumor grade, the OR = 0.63 (CI: 0.43, 0.91) per standard deviation (SD) increase in age indicates increasing age confers unfavorable outcome. The hybrid LR model gave Az = 0.778 by combining age and tumor grade with the PNN and controlling for gender. The PNN score and age translate inversely with respect to risk. The OR = 0.27 (CI: 0.14, 0.53) per SD increase in PNN score indicates those patients with decreased score confer unfavorable outcome. The tumor grade adjusted hazard for patients above the median age compared with those below the median was HR = 1.78 (CI: 1.06, 3.02), whereas the hazard for those patients below the median PNN score compared to those above the median was HR = 4.0 (CI: 2.13, 7.14).

Conclusion

We have provided preliminary evidence showing that the SL preprocessing may provide benefits in comparison with accepted approaches. The work will require further evaluation with varying datasets to confirm these findings.
Challenges to mapping the health risk of hepatitis A virus infection
Authors: Mohd Hanafiah Khayriyyah , Jacobsen Kathryn H , Wiersma Steven T
Published: November 2011

Background

World maps are among the most effective ways to convey public health messages such as recommended vaccinations, but creating a useful and valid map requires careful deliberation. The changing epidemiology of hepatitis A virus (HAV) in many world regions heightens the need for up-to-date risk maps. HAV infection is usually asymptomatic in children, so low-income areas with high incidence rates usually have a low burden of disease. In higher-income areas, many adults remain susceptible to the virus and, if infected, often experience severe disease.

Results

Several challenges associated with presenting hepatitis A risk using maps were identified, including the need to decide whether prior infection or continued susceptibility more aptly indicates risk, whether to display incidence or prevalence, how to distinguish between different levels of risk, how to display changes in risk over time, how to present complex information to target audiences, and how to handle missing or obsolete data.

Conclusion

For future maps to be comparable across place and time, we propose the use of the age at midpoint of population susceptibility as a standard indicator for the level of hepatitis A endemicity within a world region. We also call for the creation of an accessible active database for population-based age-specific HAV seroprevalence and incidence studies. Health risk maps for other conditions with rapidly changing epidemiology would benefit from similar strategies.
Retinoic acid pathway activity in wilms tumors and characterization of biological responses in vitro
Authors: Wegert Jenny , Bausenwein Sabrina , Kneitz Susanne , Roth Sabine , Graf Norbert , Geissinger Eva , Gessler Manfred
Published: November 2011

Background

Wilms tumor (WT) is one of the most common malignancies in childhood. With current therapy protocols up to 90% of patients can be cured, but there is still a need to improve therapy for patients with aggressive WT and to reduce treatment intensity where possible. Prior data suggested a deregulation of the retinoic acid (RA) signaling pathway in high-risk WT, but its mode of action remained unclear.

Results

The association of retinoid signaling and clinical parameters could be validated in a large independent tumor set, but its relevance in primary nephrectomy tumors from very young children may be different. Reduced RA pathway activity and MYCN overexpression were found in high risk tumors as opposed to tumors with low/intermediate risk, suggesting a beneficial impact of RA especially on advanced WT. To search for possible modes of action of retinoids as novel therapeutic options, primary tumor cell cultures were treated in vitro with all-trans-RA (ATRA), 9cis- RA, fenretinide and combinations of retinoids and a histone deacetylase (HDAC) inhibitor. Genes deregulated in high risk tumors showed opposite changes upon treatment suggesting a positive effect of retinoids. 6/7 primary cultures tested reduced proliferation, irrespective of prior RA signaling levels. The only variant culture was derived from mesoblastic nephroma, a distinct childhood kidney neoplasm. Retinoid/HDAC inhibitor combinations provided no synergistic effect. ATRA and 9cis- RA induced morphological changes suggestive of differentiation, while fenretinide induced apoptosis in several cultures tested. Microarray analysis of ATRA treated WT cells revealed differential expression of many genes involved in extracellular matrix formation and osteogenic, neuronal or muscle differentiation. The effects documented appear to be reversible upon drug withdrawal, however.

Conclusions

Altered retinoic acid signaling has been validated especially in high risk Wilms tumors. In vitro testing of primary tumor cultures provided clear evidence of a potential utility of retinoids in Wilms tumor treatment based on the analysis of gene expression, proliferation, differentiation and apoptosis.
Mobile multimedia sensor networks: architecture and routing
Authors: Chen Min , Lai Chin-Feng , Wang Honggang
Published: November 2011

Recent advances in the fields of wireless technology and multimedia systems have exhibited a strong potential and tendency on improving human life by enabling smart services in ubiquitous computing environments. This paper investigates a mobile multimedia system through combining various technologies, such as wireless sensor networks, embedded multimedia system and node mobility. In particular, we will employ some powerful sensor node with both mobility and multimedia functionalities, which can be controlled by contextual information collected by other systems to enable interactive multimedia services. The new architecture is called mobile multimedia sensor network (MMSN) in this paper. A routing scheme named mobile multimedia geographic routing (MGR) is specially designed to minimize energy consumption and satisfy constraints on the average end-to-end delay of specific applications in MMSNs. Simulations verify the MGR's performance to satisfy QoS requirement while saving energy for MMSNs.