bluuebunny/crossref_metadata_2025 huggingface dataset:
Combined Effects of Wind-Driven Upwelling and Internal Tide on the Continental Shelf
Authors: Kurapov A. L. , Allen J. S. , Egbert G. D.
Published: November 2009

Internal tides on the continental shelf can be intermittent as a result of changing hydrographic conditions associated with wind-driven upwelling. In turn, the internal tide can affect transports associated with upwelling. To study these processes, simulations in an idealized, alongshore uniform setup are performed utilizing the hydrostatic Regional Ocean Modeling System (ROMS) with conditions corresponding, as closely as possible, to the central Oregon shelf. “Wind only” (WO), “tide only” (TO), and “tide and wind” (TW) solutions are compared, utilizing cases with constant upwelling-favorable wind stress as well as with time-variable observed stress. The tide is forced by applying cross-shore barotropic flow at the offshore boundary with intensity sufficient to generate an internal tide with horizontal velocity amplitudes near 0.15 m s−1, corresponding to observed levels. The internal tide affects the subinertial circulation, mostly through the changes in the bottom boundary layer variability, resulting in a larger bottom stress and a weaker depth-averaged alongshore current in the TW case compared to WO. The spatial variability of the cross-shore and vertical volume transport is also affected. Divergence in the Reynolds stress associated with the baroclinic tidal flow contributes to the tidally averaged cross-shore momentum balance. Internal waves cause high-frequency variability in the turbulent kinetic energy in both the bottom and surface boundary layers, causing periodic restratification of the inner shelf in the area of the upwelling front. Increased vertical shear in the horizontal velocity resulting from the superposition of the upwelling jet and the internal tide results in intermittent patches of intensified turbulence in the mid–water column. Variability in stratification associated with upwelling can affect not only the propagation of the internal tide on the shelf, but also the barotropic-to-baroclinic energy conversion on the continental slope, in this case changing the classification of the slope from nearly critical to supercritical such that less barotropic tidal energy is converted to baroclinic and a larger fraction of the baroclinic energy is radiated into the open ocean.
The Study of Criminology in China, Part II
Authors: Wong Kam C.
Published: November 2009

As a scholarly discipline, criminology in China is growing in stature, maturity and utility. In the short thirty years since 1979, China has successfully established criminology as a scientific field of study with well-defined subjects, recognised scholars and copious research/publications. To date, there are very few systematic and comprehensive studies of criminology (in English language) as an emerging and important field of academic discipline in China. As a result, we know very little about its focus and scope; direction and trend; theories and findings; and problems and issues. This is a first attempt to do so. The article (in two parts, published separately) investigates into: ‘Literature on law, crime and punishment in China’, ‘The idea of crime (Fanzui)’, ‘Traditional thinking of crime and punishment in imperial China’, ‘Nature, structure and development of criminology’, ‘Contemporary theories on crime and punishment’ and ‘Fundamental issues and challenges’ facing criminological research in China.
Same or Different? Clarifying the Relationship of Need for Cognition to Personality and Intelligence
Authors: Fleischhauer Monika , Enge Sören , Brocke Burkhard , Ullrich Johannes , Strobel Alexander , Strobel Anja
Published: November 2009

Need for cognition (NFC) refers to an individual’s tendency to engage in and enjoy effortful cognitive processing. So far, little attention has been paid to a systematic evaluation of the distinctiveness of NFC from traits with similar conceptualization and from intelligence. The present research contributes to filling this gap by examining the relation of NFC to well-established personality concepts (Study 1) and to a comprehensive measure of intelligence in a sample with broad educational backgrounds (Study 2). We observed NFC to be positively correlated with openness, emotional stability, and traits indicating goal orientation. Using confirmatory factor analysis and event-related potentials, incremental validity of NFC and openness to ideas was demonstrated, showing that NFC is more predictive of drive-related and goal-oriented behavior and attentional resource allocation. Regarding intelligence, NFC was more associated with fluid than with crystallized aspects of intelligence. Altogether, the results provide strong support for the conceptual autonomy of NFC.
An Approach for Addressing the Multiple Testing Problem in Social Policy Impact Evaluations
Authors: Schochet Peter Z.
Published: November 2009

In social policy evaluations, the multiple testing problem occurs due to the many hypothesis tests that are typically conducted across multiple outcomes and subgroups, which can lead to spurious impact findings. This article discusses a framework for addressing this problem that balances Types I and II errors. The framework involves specifying confirmatory and exploratory analyses in study protocols, delineating confirmatory outcome domains, conducting t tests on composite domain outcomes, and applying multiplicity corrections to composites across domains to obtain summative impact evidence. The article presents statistical background and discusses multiplicity issues for subgroup analyses, designs with multiple treatments, and reporting.
Connecting Youth to High-Resource Adults: Lessons From Effective Youth Programs
Authors: Sullivan Patrick J. , Larson Reed W.
Published: November 2009

Adolescents benefit from contact with high-resource community adults, but intergenerational obstacles make these interactions difficult, fragile, and rare. This qualitative research investigated the success of seven, primarily urban, leadership, and arts programs that attempted to facilitate these interactions within their programming. Program advisors and 71 ethnically diverse program youth (mean age = 16.5) were interviewed biweekly over 3 to 4 months. Analyses indicated that programs were effective in facilitating these interactions through organizing activities that entailed structured, meaningful youth-adult role relationships. Substantial brokering efforts appeared to be required of advisors. Although these contacts involved one-time interactions or, at best, longer-term superficial relationships, youth described obtaining valuable information, skills, and access to adult worlds. The findings illuminate the challenges, limits, and benefits of attempts to bridge youth and adult worlds.
Morphology, X-ray Diffraction and Mechanical Properties of Resol-montmorillonite Clay Composites
Authors: Kaushik Anupama , Singh Paramjit , Verma Gaurav , Rekha
Published: November 2009

Layered silicate composites having phenolic matrix were prepared by melt intercalation. The resole resin was synthesized and was characterized by FTIR spectroscopy. Method for making composites consisted of mechanically mixing the modified montmorillonite clay with phenol formaldehyde resin and curing the polymer to form a composite material, via intercalation of polymer in between the clay galleries. The objective was to investigate the effect of clay percentage on the behavior of composites samples. Composite samples with different clay percentages (0—4%) were compared with pristine resin sample. The morphology of the composites was examined by using scanning electron microscope (SEM) and interesting observation was made from tensile fractured sample because of formation of dendrites at 0.8 wt% clay. The crystalline and amorphous behavior was investigated by using X-ray diffraction method. The XRD pattern showed that there was a decrease in amorphous behavior with increasing filler content. Although exfoliation cannot be claimed, but improvement in mechanical properties confirm intercalation. Tensile and flexural modulus increased up to 84 and 46%, respectively, of the initial value with increase in filler content up to 0.8%, after which there was a downward trend due to possible agglomeration of clay particles.
Squamous cell carcinoma arising in a recent plaque of discoid lupus erythematous, in a sun-protected area
Authors: Parikh N. , Choi J. , Li M. , Sharma R. , Fernandez-Peñas P.
Published: November 2009

Squamous cell carcinoma is a known complication reported to occur in chronic discoid lupus erythematosus in sun-exposed areas. We report a patient with systemic lupus erythematosus who developed a squamous cell carcinoma in a recent plaque of discoid lupus erythematosus in a sun-protected area. This article emphasizes the need for a very high index of suspicion for squamous cell carcinoma and repeated biopsies when discoid lupus erythematosus fails to respond to conventional therapy or there is unexplained exacerbation. Lupus (2010) 19, 210—212.
Bilateral retinal vasculitis in a patient with systemic lupus erythematosus and its remission with rituximab therapy
Authors: Hickman RA , Denniston AK , Yee C-S. , Toescu V. , Murray PI , Gordon C.
Published: November 2009

Severe retinal vasculitis is a rare, but potentially blinding, complication of patients with systemic lupus erythematosus (SLE). We describe here the first reported case of treating severe bilateral SLE-associated retinal vasculitis with the anti-CD20 monoclonal antibody rituximab, a drug which has established its role in rheumatoid arthritis and has shown promise in case series for the treatment of severe SLE that is unresponsive to other therapies. This case suggests that rituximab-induced B-cell depletion may provide an important new therapeutic option for refractory cases of this devastating ocular complication.
C3aR inhibition reduces neurodegeneration in experimental lupus
Authors: Jacob A. , Bao L. , Brorson J. , Quigg RJ , Alexander JJ
Published: November 2009

Complement activation is an important aspect of systemic lupus erythematosus. In this study we investigated the role of C3a/C3a receptor (R) signaling in brains of the lupus model, MRL/lpr mice, by treating the mice with C3aR antagonist (a) from 13 to 19 weeks of age. C3aR mRNA (0.2 ± 0.027 versus 0.56 ± 0.19) and protein (0.16 ± 0.09 versus 0.63 ± 0.19) expression was increased in MRL/lpr brains compared with MRL+/+ controls. Apoptosis, a key feature in lupus brain, was significantly reduced by C3aRa treatment, as assessed by DNA laddering, TUNEL staining and caspase3 activity (48% of MRL/lpr mice). mRNA expression of proinflammatory molecules that cause apoptosis, TNFα (0.33 ± 0.07 versus 0.15 ± 0.1), MIP2 (3.8 ± 1.3 versus 1.7 ± 0.6), and INFγ (4.8 ± 1.0 versus 2.07 ± 1.28) are reduced in MRL/lpr brains with C3aRa treatment. In line with these results, Western blotting demonstrates the significant increase in phosphorylation of survival molecules Akt and Erk, decrease in PTEN and reduced iNOS expression. INFγ receptor (R) and AMPA-GluR1 co-localized, and concomitant with reduced INFγR expression, AMPAGluR1 expression was also decreased by C3aR antagonist. All of these variables that modulate neuronal excitability and regulate synaptic plasticity are C3aR dependent in the MRL/lpr brains and suggest a potential therapeutic role for C3aR inhibition in CNS lupus. Lupus (2010) 19, 73—82.
The Philosophy and Practice of Interpretivist Research in Entrepreneurship
Authors: Leitch Claire M. , Hill Frances M. , Harrison Richard T.
Published: November 2009

Knowledge production in entrepreneurship requires inclusivity as well as diversity and pluralism in research perspectives and approaches. In this article, the authors address concerns about interpretivist research regarding validity, reliability, objectivity, generalizability, and communicability of results that militate against its more widespread acceptance. Following the nonfoundationalist argument that all observation is theory-laden, context specific, and that there are no external criteria against which to assess research design and execution and the data produced, the authors propose that quality must be internalized within the underlying research philosophy rather than something to be tested upon completion. This requires a shift from the notion of validity as an outcome to validation as a process. To elucidate this, they provide a guiding framework and present a case illustration that will assist an interpretivist entrepreneurship researcher to establish and demonstrate the quality of their work.
Applied Research Consultants (ARC)
Authors: Nadler Joel T. , Cundiff Nicole L.
Published: November 2009

The demand for highly trained evaluation consultants is increasing. Furthermore, the gap between job seekers’ evaluation competencies and job recruiters’ expectations suggests a need for providing practical training experiences. A model using a vertical practicum (advanced students assisting in the training of newer students) is suggested as an ideal training solution. Applied Research Consultants (ARC) is a 2-year vertical practicum conceptually built around a student-run consulting firm. ARC provides opportunities for graduate students to apply what they have learned in the classroom to real-world situations, thereby gaining invaluable experience. ARC’s history, structure, and successes are discussed in the context of suggested goals in teaching, training, and hiring competent evaluation consultants. Additional methods of providing practical training in evaluation and consultation including class projects, mentored projects, internships, and practicum programs are discussed. The resources, institutional commitment, and possible limitations of a vertical practicum training model are also discussed.
Giorgio Agamben and the End of History: Inoperative Praxis and the Interruption of the Dialectic
Authors: Prozorov Sergei
Published: November 2009

The article presents a conception of the end of history, developed on the basis of Giorgio Agamben’s critical engagement with Alexandre Kojève’s reading of Hegel. Departing from Agamben’s concept of inoperosity as an originary feature of the human condition, we argue that the proper or ‘second’ end of history consists not in the fulfilment of its dialectical process but rather in the radical interruption of the dialectic that terminates the teleological dimension of social praxis. Introducing the figure of the ‘workless slave’ into the scenario of the Master—Slave dialectic, the article demonstrates how the dialectic of history may be ended in a non-dialectical fashion through inoperative praxis that subtracts itself from the struggle for recognition. In the conclusion, the implication of this reading of the end of history for the understanding of Agamben’s ‘coming politics’ is addressed.
Alcohol, drugs and trauma: consequences, screening and intervention in 2009
Authors: Charbonney Emmanuel , McFarlan Amanda , Haas Barbara , Gentilello Larry , Ahmed Najma
Published: November 2009

Alcohol use is a preventable cause of injury as it doubles the risk of re-injury and increases mortality. For this reason, the American College of Surgeons, Committee on Trauma had mandated a screening and subsequent intervention strategy for all Level I centres, and there is good evidence to support the efficacy of such programmes. Clinicians can play a key role in reducing injury related to alcohol use through their participation in these programmes. Although validated screening tools and evidence to support brief interventions for alcohol use exist, the benefit of these experiences for other recreational drugs awaits further research in this area. In the meantime, the implementation of alcohol screening and brief intervention programmes across all trauma programmes and emergency departments should become a global healthcare priority.
Equal recognition, consolidation or familiarization?
Authors: Mantouvalou Katerina
Published: November 2009

A number of theorists have tried to determine how liberal states should respond to the language recognition claims made by minority groups. Liberal multiculturalists defend the ‘equal recognition’ of minority and majority languages, liberal neutralists advance the ‘consolidation’ of a single unified language, and democratic liberals argue for ‘familiarization’ of the majority and the minority population as the fairest response to the groups’ claim. In this article, I illustrate and test these responses with the case of the Muslim minority of Western Thrace, a group that has resided in Greece since Ottoman times and has been the subject of competitive Greek and Turkish relations. Contextual analysis in this article will show that when minority groups are part of antagonistic interstate relations, a priori individual and collective rights approaches cannot ensure that their members are treated fairly. I argue that familiarization of linguistically diverse group members provides the fairest response to the claims of linguistic minorities. This is grounded on the democratic ideal of participation in common institutions under conditions of non-domination.
‘Because tumi Bangali’
Authors: Blackledge Adrian , Creese Angela
Published: November 2009

In this article, we present an analysis of some of the voices we heard as we conducted linguistic ethnographic research in eight complementary (also known as ‘community language’, ‘supplementary’, ‘heritage language’) schools in four British cities. These were the voices of people engaged in teaching and learning languages, including Bengali, Cantonese, Gujarati, Mandarin and Turkish. The content of the language classes frequently reflected the schools’ rationale of teaching students the ‘nationalism of the homeland’ as well as teaching the heritage language. They did this through rehearsing historical events in the collective memory of the country of origin, retelling myths and folk stories associated with the homeland, discussing national symbols, and making explicit links between learning the standard language of the home country and national identity. The students, almost all of whom were born and raised in the UK, at times accepted their teachers’ positioning of them as (e.g.) ‘Chinese’ or ‘Turkish’, but at other times contested the notion of national belonging and affiliation to the country of origin.
Contested spaces
Authors: Hoffstaedter Gerhard
Published: November 2009

The arts community in Malaysia has been affected in many ways by the state’s desire to homogenize and essentialize ethnicity internally, whilst displaying pluralist ideals externally. There are two levels to the debate, one which is orientated towards the global, where the state employs a multicultural tourism imagery, whilst the other is a localized debate mainly informed by reactionary conservatism and state institutions. Concurrently, the arts community employs, uses and deploys global institutions and regional activism to counteract, validate or co-opt state mechanisms of control. Art forms such as mak yong have been pulled into a political tussle over ownership and power to demarcate what is or should be Islamic, Malay or Malaysian. As a result, practitioners and activists collide with the state’s apparatus and its agents.
Are we talking the walk of community-based research?
Authors: Stoecker Randy
Published: November 2009

When we present ourselves as doing research that is participatory and action oriented, are we meeting either of those goals? An analysis of 232 concept applications sent to the Sociological Initiatives Foundation community-based research funding pool shows that most proposed research emphasized neither participation nor action. Grassroots community members, or organizations controlled by them, were rarely involved at the crucial decision stages of research, and instead limited to participation in collecting data. In addition, most research was proposed to produce papers, presentations or websites, rather than directly support action. The article provides a theoretical analysis of why participation and action are crucial and a set of reommendations for how to move toward research that is more participatory and integrally connected to action.
Barriers and Challenges of Implementing Tobacco Control Policies in Hospitals: Applying the Institutional Analysis and Development Framework to the Catalan Network of Smoke-Free Hospitals
Authors: Martinez Cristina
Published: November 2009

This article analyzes tobacco control policies in hospitals based on the experience of the Catalan Network of Smoke-Free Hospitals, Spain. The objective is to understand through this case study how tobacco policies are designed and implemented in health care organizations. Because tobacco control is a public health issue, governmental, institutional, and professional involvement is necessary. This article identifies and examines the structure and relationships among the different actors involved in the tobacco control policies in health care organizations using Ostrom’s Institutional Analysis and Development framework.This theory helps one understand the policy failures and rethink the future challenges. Critical issues should be reviewed to enhance implementation of smoke-free hospitals—such as assuring the compliance of nonsmoking areas and introducing compulsory tobacco cessation activities that are promoted and monitored by the public administration. The author suggests that relying primarily on an organization’s interpretation of rules leads to irregular implementation.
Congenic interval of CD45/Ly-5 congenic mice contains multiple genes that may influence hematopoietic stem cell engraftment
Authors: Waterstrat Amanda , Liang Ying , Swiderski Carol F. , Shelton Brent J. , Van Zant Gary
Published: November 2009

The B6.SJL-Ptprc(d)Pep3(b)/BoyJ (B6.SJL) congenic mouse strain, a valuable and widely used tool in murine bone marrow transplantation studies, has long been considered equivalent to the parental C57B/L6 (B6) strain with the exception of a small congenic interval on chromosome 1 harboring an alternative CD45/Ly-5 alloantigen (Ly-5.1). In this study we compared functional properties of stem and stromal cells between the strains, and delineated the boundary of the B6.SJL congenic interval. We identified a 25% reduction in homing efficiency, 3.8-fold reduction in transplantable long-term hematopoietic stem cells (LT-HSCs), a 5-fold reduction in LT-HSCs capable of 24-hour homing, and a cell-intrinsic engraftment defect of 30% to 50% in B6.SJL-derived bone marrow cells relative to B6-derived cells. These functional differences were independent of stem cell number, cycling, or apoptosis. Genotypic analysis revealed a 42.1-mbp congenic interval in B6.SJL including 306 genes, and at least 124 genetic polymorphisms. Moreover, expression profiling revealed 288 genes differentially expressed between nonhematopoietic stromal cells of the 2 strains. These results indicate that polymorphisms between the B6 and SJL genotype within the B6.SJL congenic interval influence HSC engraftment and result in transcriptional variation within bone marrow stroma.
The architectural pattern of FOXP3-positive T cells in follicular lymphoma is an independent predictor of survival and histologic transformation
Authors: Farinha Pedro , Al-Tourah Abdulwahab , Gill Karamjit , Klasa Richard , Connors Joseph M. , Gascoyne Randy D.
Published: November 2009

Previous studies of follicular lymphoma (FL) patients treated heterogeneously have suggested that decreased numbers of regulatory T cells correlates with improved survival. We studied advanced-stage FL patients from a single institution phase 2 trial. All patients were treated uniformly with multiagent chemotherapy and radiation. Tissue microarrays were constructed using diagnostic biopsies available in 105 patients and stained with CD4, CD8, CD25, and forkhead/winged helix transcription factor 3 (FOXP3) antibodies. Both cell content and cell distribution were evaluated. For all antibodies, there were cases with a predominant intrafollicular or perifollicular localization of cells (follicular pattern) while others displayed a diffuse pattern. The median follow-up of living patients was 17.1 years. The International Prognostic Index score predicted overall survival (OS; P = .004) but not risk of transformation (RT). Cell content did not impact survival, while immunoarchitectural patterns of CD4/CD8 were significant for progression-free survival (PFS; P = .056), CD25 for both PFS and OS (P = .002 and P = .024, respectively), and FOXP3+ predicted PFS, OS, and RT (P = .001, P < .001 and p = .002, respectively). A Cox multivariate model showed both International Prognostic Index score and FOXP3+ pattern were independent predictors of OS (P = .008 and P < .001, respectively), while only FOXP3+ pattern predicted RT (P = .004). We conclude that FOXP3+ cell distribution significantly predicts survival and RT in FL.
International Prognostic Scoring System–independent cytogenetic risk categorization in primary myelofibrosis
Authors: Hussein Kebede , Pardanani Animesh D. , Van Dyke Daniel L. , Hanson Curtis A. , Tefferi Ayalew
Published: November 2009

Among 200 patients with primary myelofibrosis, karyotype at diagnosis was abnormal in 83 (42%). To assess their individual prognostic impact, specific cytogenetic abnormalities with more than or equal to 5 informative cases were identified and the rest grouped separately as “other abnormalities.” Median survival in patients with sole +9 (n = 6), sole 20q− (n = 21), sole 13q− (n = 8), normal karyotype (n = 117), “other abnormalities” (n = 28), complex karyotype (n = 13), and sole +8 (n = 7) were “not reached,” 112, 105, 80, 46, 34, and 28 months, respectively (P = .01). Accordingly, 4 cytogenetic risk groups were considered: (1) favorable (sole +9, 20q−, or 13q−), (2) normal, (3) unfavorable (complex karyotype or sole +8), and (4) “other abnormalities.” Multivariable analysis confirmed the International Prognostic Scoring System (IPSS)–independent prognostic value of both 4-way and 2-way (ie, favorable/normal vs unfavorable/other abnormalities; IPSS-adjusted hazard ratio = 0.37; 95% confidence interval, 0.24-0.58) cytogenetic risk categorization (P < .01). The ability to prognostically dissect a specific IPSS category has major therapeutic implications.
DNA barcode analysis: a comparison of phylogenetic and statistical classification methods
Authors: Austerlitz Frederic , David Olivier , Schaeffer Brigitte , Bleakley Kevin , Olteanu Madalina , Leblois Raphael , Veuille Michel , Laredo Catherine
Published: November 2009

Background

DNA barcoding aims to assign individuals to given species according to their sequence at a small locus, generally part of the CO1 mitochondrial gene. Amongst other issues, this raises the question of how to deal with within-species genetic variability and potential transpecific polymorphism. In this context, we examine several assignation methods belonging to two main categories: (i) phylogenetic methods (neighbour-joining and PhyML) that attempt to account for the genealogical framework of DNA evolution and (ii) supervised classification methods (k-nearest neighbour, CART, random forest and kernel methods). These methods range from basic to elaborate. We investigated the ability of each method to correctly classify query sequences drawn from samples of related species using both simulated and real data. Simulated data sets were generated using coalescent simulations in which we varied the genealogical history, mutation parameter, sample size and number of species.

Results

No method was found to be the best in all cases. The simplest method of all, "one nearest neighbour", was found to be the most reliable with respect to changes in the parameters of the data sets. The parameter most influencing the performance of the various methods was molecular diversity of the data. Addition of genetically independent loci - nuclear genes - improved the predictive performance of most methods.

Conclusion

The study implies that taxonomists can influence the quality of their analyses either by choosing a method best-adapted to the configuration of their sample, or, given a certain method, increasing the sample size or altering the amount of molecular diversity. This can be achieved either by sequencing more mtDNA or by sequencing additional nuclear genes. In the latter case, they may also have to modify their data analysis method.
Endogenous control genes in complex vascular tissue samples
Authors: Folkersen Lasse , Kurtovic Sanela , Razuvaev Anton , Agardh Hanna E , Gabrielsen Anders , Paulsson-Berne Gabrielle
Published: November 2009

Background

Gene expression microarrays and real-time PCR are common methods used to measure mRNA levels. Each method has a fundamentally different approach of normalization between samples. Relative quantification of gene expression using real-time PCR is often done using the 2^(-ΔΔCt) method, in which the normalization is performed using one or more endogenous control genes. The choice of endogenous control gene is often arbitrary or bound by tradition. We here present an analysis of the differences in expression results obtained with microarray and real-time PCR, dependent on different choices of endogenous control genes.

Results

In complex tissue, microarray data and real-time PCR data show the best correlation when endogenous control genes are omitted and the normalization is done relative to total RNA mass, as measured before reverse transcription.

Conclusion

We have found that for real-time PCR in heterogeneous tissue samples, it may be a better choice to normalize real-time PCR Ct values to the carefully measured mass of total RNA than to use endogenous control genes. We base this conclusion on the fact that total RNA mass normalization of real-time PCR data shows better correlation to microarray data. Because microarray data use a different normalization approach based on a larger part of the transcriptome, we conclude that omitting endogenous control genes will give measurements more in accordance with actual concentrations.
Evaluation of routinely reported surgical site infections against microbiological culture results: a tool to identify patient groups where diagnosis and treatment may be improved
Authors: Krukerink Marco , Kievit Job , Marang-van de Mheen Perla J
Published: November 2009

Background

Surgeons may improve their decision making by assessing the extent to which their initial clinical diagnosis of a surgical site infection (SSI) was supported by culture results. Aim of the present study was to evaluate routinely reported SSI by surgeons against microbiological culture results, to identify patient groups with lower agreement where decision making may be improved.

Methods

701 admissions with SSI were reported by surgeons in a university medical centre in the period 1997-2005, which were retrospectively checked for microbiological culture results. Reporting a SSI was conditional on treatment being given (e.g. antibiotics) and was classified by severity. To identify specific patient groups, patients were classified according to the surgery group of the first operation during admission (e.g. trauma).

Results

Of all reported SSI, 523 (74.6%) had a positive culture result, 102 (14.6%) a negative culture result and 76 (10.8%) were classified as unknown culture result (due to no culture taken). Given a known culture result, reported SSI with positive culture results less often concerned trauma patients (16% versus 26%, X2 = 4.99 p = 0.03) and less severe SSI (49% versus 85%, X2 = 10.11 p < 0.01) suggesting that a more conservative approach may be warranted in these patients. The trauma surgeons themselves perceived to have become too liberal in administering antibiotics (and reporting SSI).

Conclusion

Routine reporting of SSI was mostly supported by culture results. However, this support was less often found in trauma patients and less severe SSI, thereby giving surgeons feedback that diagnosis and treatment may be improved in these cases.
Patterns of analgesic use, pain and self-efficacy: a cross-sectional study of patients attending a hospital rheumatology clinic
Authors: Blamey Ruth , Jolly Kate , Greenfield Sheila , Jobanputra Paresh
Published: November 2009

Background

Many people attending rheumatology clinics use analgesics and non-steroidal anti-inflammatories for persistent musculoskeletal pain. Guidelines for pain management recommend regular and pre-emptive use of analgesics to reduce the impact of pain. Clinical experience indicates that analgesics are often not used in this way. Studies exploring use of analgesics in arthritis have historically measured adherence to such medication. Here we examine patterns of analgesic use and their relationships to pain, self-efficacy and demographic factors.

Methods

Consecutive patients were approached in a hospital rheumatology out-patient clinic. Pattern of analgesic use was assessed by response to statements such as 'I always take my tablets every day.' Pain and self-efficacy (SE) were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Arthritis Self-Efficacy Scale (ASES). Influence of factors on pain level and regularity of analgesic use were investigated using linear regression. Differences in pain between those agreeing and disagreeing with statements regarding analgesic use were assessed using t-tests.

Results

218 patients (85% of attendees) completed the study. Six (2.8%) patients reported no current pain, 26 (12.3%) slight, 100 (47.4%) moderate, 62 (29.4%) severe and 17 (8.1%) extreme pain. In multiple linear regression self efficacy and regularity of analgesic use were significant (p < 0.01) with lower self efficacy and more regular use of analgesics associated with more pain.

Low SE was associated with greater pain: 40 (41.7%) people with low SE reported severe pain versus 22 (18.3%) people with high SE, p < 0.001. Patients in greater pain were significantly more likely to take analgesics regularly; 13 (77%) of those in extreme pain reported always taking their analgesics every day, versus 9 (35%) in slight pain. Many patients, including 46% of those in severe pain, adjusted analgesic use to current pain level. In simple linear regression, pain was the only variable significantly associated with regularity of analgesic use: higher levels of pain corresponded to more regular analgesic use (p = 0.003).

Conclusion

Our study confirms that there is a strong inverse relationship between self-efficacy and pain severity. Analgesics are often used irregularly by people with arthritis, including some reporting severe pain.
PTEN inhibits BMI1 function independently of its phosphatase activity
Authors: Fan Catherine , He Lizhi , Kapoor Anil , Rybak Adrian P , De Melo Jason , Cutz Jean-Claude , Tang Damu
Published: November 2009

Background

PTEN is the second most mutated tumor suppressor gene other than p53. It suppresses tumorigenesis by dephosphorylating phosphatidylinositol (3,4,5)-triphosphate (PIP3) to phosphatidylinositol (4,5)-biphosphate (PIP2), thereby directly inhibiting phosphatidylinositol 3 kinase (PI3K)-mediated tumorigenic activities. Consistent with this model of action, cytosolic PTEN is recruited to the plasma membrane to dephosphorylate PIP3. While nuclear PTEN has been shown to suppress tumorigenesis by governing genome integrity, additional mechanisms may also contribute to nuclear PTEN-mediated tumor suppression. The nuclear protein BMI1 promotes stem cell self-renewal and tumorigenesis and PTEN inhibits these events, suggesting that PTEN may suppress BMI1 function.

Results

We investigated whether PTEN inhibits BMI1 function during prostate tumorigenesis. PTEN binds to BMI1 exclusively in the nucleus. This interaction does not require PTEN's phosphatase activity, as phosphatase-deficient PTEN mutants, PTEN/C124S (CS), PTEN/G129E (GE), and a C-terminal PTEN fragment (C-PTEN) excluding the catalytic domain, all associate with BMI1. Furthermore, the residues 186-286 of C-PTEN are sufficient for binding to BMI1. This interaction reduces BMI1's function. BMI1 enhances hTERT activity and reduces p16INK4A and p14ARF expression. These effects were attenuated by PTEN, PTEN(CS), PTEN(GE), and C-PTEN. Furthermore, knockdown of PTEN in DU145 cells increased hTERT promoter activity, which was reversed when BMI1 was concomitantly knocked-down, indicating that PTEN reduces hTERT promoter activity via inhibiting BMI1 function. Conversely, BMI1 reduces PTEN's ability to inhibit AKT activation, which can be attributed to its interaction with PTEN in the nucleus, making PTEN unavailable to dephosphorylate membrane-bound PIP3. Furthermore, BMI1 appears to co-localize with PTEN more frequently in clinical prostate tissue samples from patients diagnosed with PIN (prostatic intraepithelial neoplasia) and carcinoma compared to normal prostate epithelium. While PTEN co-localized with BMI1 in 2.4% of normal prostate epithelial cells, co-localization was observed in 37.6% and 18.5% of cells in PIN and carcinoma, respectively. Collectively, we demonstrate that PTEN inhibits BMI1 function via binding to BMI1 in a phosphatase independent manner.

Conclusion

We demonstrate that nuclear PTEN reduces BMI1 function independently of its phosphatase activity. It was recently observed that nuclear PTEN also suppresses tumorigenesis. Our results, therefore, provide a plausible mechanism by which nuclear PTEN prevents tumorigenesis.
Altered peptide ligands inhibit arthritis induced by glucose-6-phosphate isomerase peptide
Authors: Iwanami Keiichi , Matsumoto Isao , Yoshiga Yohei , Inoue Asuka , Kondo Yuya , Yamamoto Kayo , Tanaka Yoko , Minami Reiko , Hayashi Taichi , Goto Daisuke , Ito Satoshi , Nishimura Yasuharu , Sumida Takayuki
Published: November 2009

Introduction

Immunosuppressants, including anti-TNFα antibodies, have remarkable effects in rheumatoid arthritis; however, they increase infectious events. The present study was designed to examine the effects and immunological change of action of altered peptide ligands (APLs) on glucose-6-phosphate isomerase (GPI) peptide-induced arthritis.

Methods

DBA/1 mice were immunized with hGPI325-339, and cells of draining lymph node (DLN) were stimulated with hGPI325-339 to investigate the T-cell receptor (TCR) repertoire of antigen-specific CD4+ T cells by flow cytometry. Twenty types of APLs with one amino acid substitution at a TCR contact site of hGPI325-339 were synthesized. CD4+ T cells primed with human GPI and antigen-presenting cells were co-cultured with each APL and cytokine production was measured by ELISA to identify antagonistic APLs. Antagonistic APLs were co-immunized with hGPI325-339 to investigate whether arthritis could be antigen-specifically inhibited by APL. After co-immunization, DLN cells were stimulated with hGPI325-339 or APL to investigate Th17 and regulatory T-cell population by flow cytometry, and anti-mouse GPI antibodies were measured by ELISA.

Results

Human GPI325-339-specific Th17 cells showed predominant usage of TCRVβ8.1 8.2. Among the 20 synthesized APLs, four (APL 6; N329S, APL 7; N329T, APL 12; G332A, APL 13; G332V) significantly reduced IL-17 production by CD4+ T cells in the presence of hGPI325-339. Co-immunization with each antagonistic APL markedly prevented the development of arthritis, especially APL 13 (G332V). Although co-immunization with APL did not affect the population of Th17 and regulatory T cells, the titers of anti-mouse GPI antibodies in mice co-immunized with APL were significantly lower than in those without APL.

Conclusions

We prepared antagonistic APLs that antigen-specifically inhibited the development of experimental arthritis. Understanding the inhibitory mechanisms of APLs may pave the way for the development of novel therapies for arthritis induced by autoimmune responses to ubiquitous antigens.
Assessing the usefulness of a novel MRI-based breast density estimation algorithm in a cohort of women at high genetic risk of breast cancer: the UK MARIBS study
Authors: Thompson Deborah J , Leach Martin O , Kwan-Lim Gek , Gayther Simon A , Ramus Susan J , Warsi Iqbal , Lennard Fiona , Khazen Michael , Bryant Emilie , Reed Sadie , Boggis Caroline RM , Evans D Gareth , Eeles Rosalind A , Easton Douglas F , Warren Ruth ML ,   The UK study of MRI screening for breast cancer in women at high risk (MARIBS)
Published: November 2009

Introduction

Mammographic breast density is one of the strongest known risk factors for breast cancer. We present a novel technique for estimating breast density based on 3D T1-weighted Magnetic Resonance Imaging (MRI) and evaluate its performance, including for breast cancer risk prediction, relative to two standard mammographic density-estimation methods.

Methods

The analyses were based on MRI (n = 655) and mammography (n = 607) images obtained in the course of the UK multicentre magnetic resonance imaging breast screening (MARIBS) study of asymptomatic women aged 31 to 49 years who were at high genetic risk of breast cancer. The MRI percent and absolute dense volumes were estimated using our novel algorithm (MRIBview) while mammographic percent and absolute dense area were estimated using the Cumulus thresholding algorithm and also using a 21-point Visual Assessment scale for one medio-lateral oblique image per woman. We assessed the relationships of the MRI and mammographic measures to one another, to standard anthropometric and hormonal factors, to BRCA1/2 genetic status, and to breast cancer risk (60 cases) using linear and Poisson regression.

Results

MRI percent dense volume is well correlated with mammographic percent dense area (R = 0.76) but overall gives estimates 8.1 percentage points lower (P < 0.0001). Both show strong associations with established anthropometric and hormonal factors. Mammographic percent dense area, and to a lesser extent MRI percent dense volume were lower in BRCA1 carriers (P = 0.001, P = 0.010 respectively) but there was no association with BRCA2 carrier status. The study was underpowered to detect expected associations between percent density and breast cancer, but women with absolute MRI dense volume in the upper half of the distribution had double the risk of those in the lower half (P = 0.009).

Conclusions

The MRIBview estimates of volumetric breast density are highly correlated with mammographic dense area but are not equivalent measures; the MRI absolute dense volume shows potential as a predictor of breast cancer risk that merits further investigation.
Variations in arterial blood pressure are associated with parallel changes in FlowTrac/Vigileo®-derived cardiac output measurements: a prospective comparison study
Authors: Eleftheriadis Savvas , Galatoudis Zisis , Didilis Vasilios , Bougioukas Ioannis , Schön Julika , Heinze Hermann , Berger Klaus-Ulrich , Heringlake Matthias
Published: November 2009

Introduction

The reliability of autocalibrated pressure waveform analysis by the FloTrac-Vigileo® (FTV) system for the determination of cardiac output in comparison with intermittent pulmonary arterial thermodilution (IPATD) is controversial. The present prospective comparison study was designed to determine the effects of variations in arterial blood pressure on the reliability of the FTV system in patients undergoing coronary artery bypass grafting (CABG).

Methods

Comparative measurements of cardiac output by FTV (derived from a femoral arterial line; software version 1.14) and IPATD were performed in 16 patients undergoing elective CABG in the period before institution of cardiopulmonary bypass. Measurements were performed after induction of anesthesia, after sternotomy, and during five time points during graft preparation. During graft preparation, arterial blood pressure was increased stepwise in intervals of 10 to 15 minutes by infusion of noradrenaline and lowered thereafter to baseline levels.

Results

Mean arterial blood pressure was varied between 85 mmHg and 115 mmHg. IPATD cardiac output did not show significant changes during periods with increased arterial pressure either during sternotomy or after pharmacological manipulation. In contrast, FTV cardiac output paralleled changes in arterial blood pressure; i.e. increased significantly if blood pressure was raised and decreased upon return to baseline levels. Mean arterial blood pressure (MAP) and FTV cardiac output were closely correlated (r = 0.63 (95% confidence interval [CI]: 0.49 - 0.74), P < 0.0001) while no correlation between MAP and IPATD cardiac output was observed. Bland-Altman analyses for FTV versus IPATD cardiac output measurements revealed a bias of 0.4 l/min (8.5%) and limits of agreement from 2.1 to -1.3 l/min (42.2 to -25.3%).

Conclusions

Acute variations in arterial blood pressure alter the reliability of the FlowTrac/Vigileo® device with the second-generation software. This finding may help to explain the variable results of studies comparing the FTV system with other cardiac output monitoring techniques, questions the usefulness of this device for hemodynamic monitoring of patients undergoing rapid changes in arterial blood pressure, and should be kept in mind when using vasopressors during FTV-guided hemodynamic optimization.
High resolution discovery and confirmation of copy number variants in 90 Yoruba Nigerians
Authors: Matsuzaki Hajime , Wang Pei-Hua , Hu Jing , Rava Rich , Fu Glenn K
Published: November 2009

Background

Copy number variants (CNVs) account for a large proportion of genetic variation in the genome. The initial discoveries of long (> 100 kb) CNVs in normal healthy individuals were made on BAC arrays and low resolution oligonucleotide arrays. Subsequent studies that used higher resolution microarrays and SNP genotyping arrays detected the presence of large numbers of CNVs that are < 100 kb, with median lengths of approximately 10 kb. More recently, whole genome sequencing of individuals has revealed an abundance of shorter CNVs with lengths < 1 kb.

Results

We used custom high density oligonucleotide arrays in whole-genome scans at approximately 200-bp resolution, and followed up with a localized CNV typing array at resolutions as close as 10 bp, to confirm regions from the initial genome scans, and to detect the occurrence of sample-level events at shorter CNV regions identified in recent whole-genome sequencing studies. We surveyed 90 Yoruba Nigerians from the HapMap Project, and uncovered approximately 2,700 potentially novel CNVs not previously reported in the literature having a median length of approximately 3 kb. We generated sample-level event calls in the 90 Yoruba at nearly 9,000 regions, including approximately 2,500 regions having a median length of just approximately 200 bp that represent the union of CNVs independently discovered through whole-genome sequencing of two individuals of Western European descent. Event frequencies were noticeably higher at shorter regions < 1 kb compared to longer CNVs (> 1 kb).

Conclusions

As new shorter CNVs are discovered through whole-genome sequencing, high resolution microarrays offer a cost-effective means to detect the occurrence of events at these regions in large numbers of individuals in order to gain biological insights beyond the initial discovery.