bluuebunny/crossref_metadata_2025 huggingface dataset:
A hybrid model for diffusion through sagep D barrier films with multiple coatings
Authors: Thorsell Thomas I
Published: November 2010

The amount of gas that penetrates the barrier of a vacuum insulation panels is directly linked to the service life of that panel. Therefore, to model and predict vacuum insulation panel service life, it is necessary to model the diffusion through its barriers. Best barriers on the market today are composites of multiple polymer layers with two or more inorganic coatings. It is accepted that the main part of diffusion, in such films, takes place through defects in the coating layers, but there are only a limited number of numerical models for this geometry with more than one coating. In this article, a hybrid model is presented that models gas permeation through film geometry with two coatings on a polymer substrate. Numerical calculations are combined with analytical ones to create a model that does take individual defect sizes as well as actual defect positions into account. Resulting oxygen transmission values calculated with this model have been compared to available manufacturer data with good agreement.
Ron receptor deficient alveolar myeloid cells exacerbate LPS-induced acute lung injury in the murine lung
Authors: Nikolaidis Nikolaos M , Kulkarni Rishikesh M , Gray Jerilyn K , Collins Margaret H , Waltz Susan E
Published: November 2010

Previous studies have shown that the Ron receptor tyrosine kinase is an important regulator of the acute lung inflammatory response induced by intranasal administration of bacterial LPS. Compared to wild-type mice, complete loss of the Ron receptor in all cell types in vivo was associated with increased lung damage as determined by histological analyses and several markers of lung injury including increases in pro-inflammatory cytokines such as TNF-α. Tumor-necrosis factor-α is a multifunctional cytokine secreted by macrophages, which plays a major role in inflammation and is a central mediator of several disease states including rheumatoid arthritis and sepsis. Based on increased TNF-α production observed in the Ron-deficient mice, we hypothesized that Ron receptor function in the inflammatory cell compartment is essential for the regulating lung injury in vivo. To test this hypothesis, we generated myeloid lineage-specific Ron-deficient mice. In this study, we report that loss of Ron signaling selectively in myeloid cells results in increased lung injury following intranasal administration of LPS as measured by increases in TNF-α production, ensuing neutrophil accumulation and increased lung histopathology. These findings corroborate the role of Ron receptor tyrosine kinase as a negative regulator of inflammation and further demonstrate the in vivo significance of Ron signaling selectively in myeloid cells as a major regulator of this response in vivo. These data authenticate Ron as a potential target in innate immunity and TNF-α-mediated pathologies.
Neisseria meningitidis lipid A mutant LPSs function as LPS antagonists in humans by inhibiting TLR 4-dependent cytokine production
Authors: Sprong Tom , Ley Peter van der , Abdollahi-Roodsaz Shahla , Joosten Leo , Meer Jos van der , Netea Mihai , Deuren Marcel van
Published: November 2010

Lipopolysaccharide is a major constituent of the outer membrane of Gram-negative bacteria and important in the induction of pro-inflammatory responses. Recently, novel LPS species derived from Neisseria meningitidis H44/76 by insertional inactivation of the lpxL1 and lpxL2 genes have been created with a lipid A portion consisting of five (penta-acylated lpxL1) or four (tetra-acylated lpxL2) fatty acids connected to the glucosamine backbone instead of six fatty acids in the wild-type LPS. We show that these mutant LPS-types are poor inducers of cytokines (tumor-necrosis factor-α, IL-1β, IL-10, IL-RA) in human mononuclear cells. Both penta- and tetra-acylated meningococcal LPSs were able to inhibit cytokine production by wild-type Escherichia coli or meningococcal LPS. Binding of FITC-labelled E. coli LPS TLR4 transfected Chinese hamster ovary (CHO) cells was inhibited by both mutant LPS-types. Experiments with CHO fibroblasts transfected with human CD14 and TLR4 showed that the antagonizing effect was dependent on the expression of human TLR4. In contrast to the situation in humans, lpxL1 LPS has agonistic activity for cytokine production in peritoneal macrophages of DBA mice, and exacerbated arthritis in murine collagen induced arthritis model. N. meningitidis lipid A mutant LPSs lpxL1 and lpxL2 function as LPS antagonists in humans by inhibiting TLR4-dependent cytokine production but have agonistic activity in mice.
Both inflammatory and classical lipolytic pathways are involved in lipopolysaccharide-induced lipolysis in human adipocytes
Authors: Grisouard Jean , Bouillet Elisa , Timper Katharina , Radimerski Tanja , Dembinski Kaethi , Frey Daniel M , Peterli Ralph , Zulewski Henryk , Keller Ulrich , Müller Beat , Christ-Crain Mirjam
Published: November 2010

High fat diet-induced endotoxaemia triggers low-grade inflammation and lipid release from adipose tissue. This study aims to unravel the cellular mechanisms leading to the lipopolysaccharide (LPS) effects in human adipocytes. Subcutaneous pre-adipocytes surgically isolated from patients were differentiated into mature adipocytes in vitro. Lipolysis was assessed by measurement of glycerol release and mRNA expression of pro-inflammatory cytokines were evaluated by real-time PCR. Treatment with LPS for 24 h induced a dose-dependent increase in interleukin (IL)-6 and IL-8 mRNA expression. At 1 µg/ml LPS, IL-6 and IL-8 were induced to 19.5 ± 1.8-fold and 662.7 ± 91.5-fold ( P < 0.01 vs basal), respectively. From 100 ng/ml to 1 µg/ml, LPS-induced lipolysis increased to a plateau of 3.1-fold above basal level ( P < 0.001 vs basal). Co-treatment with inhibitors of inhibitory kappa B kinase kinase beta (IKKβ) or NF-κB inhibited LPS-induced glycerol release. Co-treatment with the protein kinase A (PKA) inhibitor H-89, the lipase inhibitor orlistat or the hormone-sensitive lipase (HSL) inhibitor CAY10499 abolished the lipolytic effects of LPS. Co-treatment with the MAPK inhibitor, U0126 also reduced LPS-induced glycerol release. Inhibition of lipolysis by orlistat or CAY10499 reduced LPS-induced IL-6 and IL-8 mRNA expression. Induction of lipolysis by the synthetic catecholamine isoproterenol or the phosphodiesterase type III inhibitor milrinone did not alter basal IL-6 and IL-8 mRNA expression after 24 treatments whereas these compounds enhanced LPS-induced IL-6 and IL-8 mRNA expression. Both the inflammatory IKKβ/NF-κB pathway and the lipolytic PKA/HSL pathways mediate LPS-induced lipolysis. In turn, LPS-induced lipolysis reinforces the expression of pro-inflammatory cytokines and, thereby, triggers its own lipolytic activity.
CXC chemokine ligand 4 (CXCL4) down-regulates CC chemokine receptor expression on human monocytes
Authors: Schwartzkopff Franziska , Petersen Frank , Grimm Tobias Alexander , Brandt Ernst
Published: November 2010

During acute inflammation, monocytes are essential in abolishing invading micro-organisms and encouraging wound healing. Recruitment by CC chemokines is an important step in targeting monocytes to the inflamed tissue. However, cell surface expression of the corresponding chemokine receptors is subject to regulation by various endogenous stimuli which so far have not been comprehensively identified. We report that the platelet-derived CXC chemokine ligand 4 (CXCL4), a known activator of human monocytes, induces down-regulation of CC chemokine receptors (CCR) 1, −2, and −5, resulting in drastic impairment of monocyte chemotactic migration towards cognate CC chemokine ligands (CCL) for these receptors. Interestingly, CXCL4-mediated down-regulation of CCR1, CCR2 and CCR5 was strongly dependent on the chemokine’s ability to stimulate autocrine/paracrine release of TNF-α. In turn, TNF-α induced the secretion CCL3 and CCL4, two chemokines selective for CCR1 and CCR5, while the secretion of CCR2-ligand CCL2 was TNF-α-independent. Culture supernatants of CXCL4-stimulated monocytes as well as chemokine-enriched preparations thereof reproduced CXCL4-induced CCR down-regulation. In conclusion, CXCL4 may act as a selective regulator of monocyte migration by stimulating the release of autocrine, receptor-desensitizing chemokine ligands. Our results stress a co-ordinating role for CXCL4 in the cross-talk between platelets and monocytes during early inflammation.
Now Tweet This: How News Organizations Use Twitter
Authors: Armstrong Cory L. , Fangfang Gao
Published: November 2010

This content analysis examined how Twitter is used as a content dissemination tool within the news industry. Using Gans’ conception of news values as a theoretical framework, this study looked at tweets of nine news organizations during a 4-month period to determine how individuals, links, news headlines and subject areas were employed within the 140-character limits. Results indicated that regional media tended to differ in Twitter usage from both local and national media and that broadcast news agencies were more likely to tweet multimedia packages than were print-based organizations. Crime and public affairs were the most tweeted topics. Implications of results were discussed.
PRT-060318, a novel Syk inhibitor, prevents heparin-induced thrombocytopenia and thrombosis in a transgenic mouse model
Authors: Reilly Michael P. , Sinha Uma , André Pierrette , Taylor Scott M. , Pak Yvonne , DeGuzman Francis R. , Nanda Nisha , Pandey Anjali , Stolla Moritz , Bergmeier Wolfgang , McKenzie Steven E.
Published: November 2010

Heparin-induced thrombocytopenia (HIT) is a major cause of morbidity and mortality resulting from the associated thrombosis. Extensive studies using our transgenic mouse model of HIT have shown that antibodies reactive with heparin-platelet factor 4 complexes lead to FcγRIIA-mediated platelet activation in vitro as well as thrombocytopenia and thrombosis in vivo. We tested PRT-060318 (PRT318), a novel selective inhibitor of the tyrosine kinase Syk, as an approach to HIT treatment. PRT318 completely inhibited HIT immune complex-induced aggregation of both human and transgenic HIT mouse platelets. Transgenic HIT model mice were treated with KKO, a mouse monoclonal HIT-like antibody, and heparin. The experimental group received orally dosed PRT318, whereas the control group received vehicle. Nadir platelet counts of PRT318-treated mice were significantly higher than those of control mice. When examined with a novel thrombosis visualization technique, mice treated with PRT318 had significantly reduced thrombosis. The Syk inhibitor PRT318 thus prevented both HIT immune complex-induced thrombocytopenia and thrombosis in vivo, demonstrating its activity in HIT.
Lymphomas differ in their dependence on Epstein-Barr virus
Authors: Vereide David T. , Sugden Bill
Published: November 2010

Epstein-Barr virus (EBV) encodes oncogenic information and, oftentimes concomitant with host immunosuppression, gives rise to malignancies in all major categories of lymphoma defined by the World Health Organization.1 Here, we conditionally evicted the viral extrachromosomal genome from tumor cells in vitro to examine the role of EBV in different lymphomas, including Burkitt lymphoma (BL) and posttransplant lymphoproliferative disorder. Cells derived from 2 canonical BLs were found to have the least dependence on the virus; some required EBV to prevent the inefficient induction of apoptosis. In contrast, cells derived from a subset of BL, Wp-restricted BL, required EBV to block a robust apoptotic program that involves the up-regulation of the proapoptotic protein Bim. Wp-restricted BL cells also relied on the virus to promote efficient proliferation, a distinction that highlights the multiple contributions EBV makes to affect proliferation of its host cells. Like Wp-BL cells, posttransplant lymphoproliferative disorder cells depended on the virus to inhibit apoptosis. They furthermore required the virus to drive them out of G1/G0. Together, these results reveal a graded dependence on EBV among tumor cells that directly correlates with the number of viral genes expressed in the tumor cell.
B cells lacking the tumor suppressor TNFAIP3/A20 display impaired differentiation and hyperactivation and cause inflammation and autoimmunity in aged mice
Authors: Chu Yuanyuan , Vahl J. Christoph , Kumar Dilip , Heger Klaus , Bertossi Arianna , Wójtowicz Edyta , Soberon Valeria , Schenten Dominik , Mack Brigitte , Reutelshöfer Miriam , Beyaert Rudi , Amann Kerstin , van Loo Geert , Schmidt-Supprian Marc
Published: November 2010

The ubiquitin-editing enzyme A20/TNFAIP3 is essential for controlling signals inducing the activation of nuclear factor-κB transcription factors. Polymorphisms and mutations in the TNFAIP3 gene are linked to various human autoimmune conditions, and inactivation of A20 is a frequent event in human B-cell lymphomas characterized by constitutive nuclear factor-κB activity. Through B cell-specific ablation in the mouse, we show here that A20 is required for the normal differentiation of the marginal zone B and B1 cell subsets. However, loss of A20 in B cells lowers their activation threshold and enhances proliferation and survival in a gene-dose–dependent fashion. Through the expression of proinflammatory cytokines, most notably interleukin-6, A20-deficient B cells trigger a progressive inflammatory reaction in naive mice characterized by the expansion of myeloid cells, effector-type T cells, and regulatory T cells. This culminates in old mice in an autoimmune syndrome characterized by splenomegaly, plasma cell hyperplasia, and the presence of class-switched, tissue-specific autoantibodies.
Development of Loop-Mediated Isothermal Amplification (LAMP) Assays for Rapid Detection of Ehrlichia ruminantium
Authors: Nakao Ryo , Stromdahl Ellen Y , Magona Joseph W , Faburay Bonto , Namangala Boniface , Malele Imna , Inoue Noboru , Geysen Dirk , Kajino Kiichi , Jongejan Frans , Sugimoto Chihiro
Published: November 2010

Background

The rickettsial bacterium Ehrlichia ruminantium is the causative agent of heartwater, a potential zoonotic disease of ruminants transmitted by ticks of the genus Amblyomma. The disease is distributed in nearly all of sub-Saharan Africa and some islands of the Caribbean, from where it threatens the American mainland. This report describes the development of two different loop-mediated isothermal amplification (LAMP) assays for sensitive and specific detection of E. ruminantium.

Results

Two sets of LAMP primers were designed from the pCS20 and sodB genes. The detection limits for each assay were 10 copies for pCS20 and 5 copies for sodB, which is at least 10 times higher than that of the conventional pCS20 PCR assay. DNA amplification was completed within 60 min. The assays detected 16 different isolates of E. ruminantium from geographically distinct countries as well as two attenuated vaccine isolates. No cross-reaction was observed with genetically related Rickettsiales, including zoonotic Ehrlichia species from the USA. LAMP detected more positive samples than conventional PCR but less than real-time PCR, when tested with field samples collected in sub-Saharan countries.

Conclusions

Due to its simplicity and specificity, LAMP has the potential for use in resource-poor settings and also for active screening of E. ruminantium in both heartwater-endemic areas and regions that are at risk of contracting the disease.
Diffuse small bowel thickening in aids patient - a case report
Authors: Singla Rohit , Hari Samriti , Sharma Surendra K
Published: November 2010

Background

Diarrhea is common in HIV/AIDS patients, caused by both classic enteric pathogens and different opportunistic agents.Infection with these different pathogens may lead to similar radiological findings, thus causing diagnostic confusion.

Case presentation

A 30-yr-old female with AIDS presented with chronic diarrhea of 4 months duration. She had diffuse small bowel thickening present on CT scan of her abdomen, with stool examination showing no parasites. She was erroneously diagnosed as abdominal tuberculosis and given antituberculosis drugs with which she showed no improvement. Repeat stool examination later at a specialized laboratory revealedCryptosporidium parvuminfection.

The patient was given an extended course of nitazoxanide treatment, as her stool examination was positive forCryptosporidium parvumeven after 2 weeks of drug consumption. Parasite clearance was documented after 10 weeks of treatment. Interestingly, the bowel thickening reversed with parasitological clearance.

Conclusions

Cryptosporidium parvummay lead to small bowel thickening in AIDS patients. This small bowel thickening may reverse following parasitological clearance.
Cell-free miRNAs may indicate diagnosis and docetaxel sensitivity of tumor cells in malignant effusions
Authors: Xie Li , Chen Xi , Wang Lifeng , Qian Xiaoping , Wang Tingting , Wei Jia , Yu Lixia , Ding Yitao , Zhang Chenyu , Liu Baorui
Published: November 2010

Background

Circulating cell-free microRNAs have been identified as potential cancer biomarkers. However, the existence and the potential application of cell-free miRNAs in effusion samples are still uncertain. In order to explore the potential role of cell-free miRNA in malignant effusions, we selected 22 miRNAs differentially expressed in the serum of lung cancer patients and studied their expression levels in body cavity effusion samples.

Methods

We measured the expression of 22 miRNAs using qRT-PCR in two samples, which were pooled with 18 malignant and 12 benign effusions, respectively. After discarding 9 lowly expressed miRNAs, a panel of 13 miRNAs were measured in 29 samples (benign n = 11, malignant n = 18). We also carried out a WST-8 test to evaluate the docetaxel sensitivity of tumor cells directly isolated from 15 malignant effusions.

Results

We compared the miRNA expression levels between benign and malignant effusions using a Mann-Whitney U test and found miR-24, miR-26a and miR-30d were expressed differently between the two groups (P = 0.006, 0.021 and 0.011, respectively). Cells isolated from effusions rich in cell-free miR-152 were more sensitive to docetaxel (r = 0.60, P = 0.016).

Conclusions

Collectively, our study demonstrated that cell-free miRNAs in the supernatant of effusions may aid in the diagnosis of malignancy and predict chemosensitivity to docetaxel.
Functional diversity in the color vision of cichlid fishes
Authors: Sabbah Shai , Laria Raico Lamela , Gray Suzanne M , Hawryshyn Craig W
Published: November 2010

Background

Color vision plays a critical role in visual behavior. An animal's capacity for color vision rests on the presence of differentially sensitive cone photoreceptors. Spectral sensitivity is a measure of the visual responsiveness of these cones at different light wavelengths. Four classes of cone pigments have been identified in vertebrates, but in teleost fishes, opsin genes have undergone gene duplication events and thus can produce a larger number of spectrally distinct cone pigments. In this study, we examine the question of large-scale variation in color vision with respect to individual, sex and species that may result from differential expression of cone pigments. Cichlid fishes are an excellent model system for examining variation in spectral sensitivity because they have seven distinct cone opsin genes that are differentially expressed.

Results

To examine the variation in the number of cones that participate in cichlid spectral sensitivity, we used whole organism electrophysiology, opsin gene expression and empirical modeling. Examination of over 100 spectral sensitivity curves from 34 individuals of three species revealed that (1) spectral sensitivity of individual cichlids was based on different subsets of four or five cone pigments, (2) spectral sensitivity was shaped by multiple cone interactions and (3) spectral sensitivity differed between species and correlated with foraging mode and the spectral reflectance of conspecifics. Our data also suggest that there may be significant differences in opsin gene expression between the sexes.

Conclusions

Our study describes complex opponent and nonopponent cone interactions that represent the requisite neural processing for color vision. We present the first comprehensive evidence for pentachromatic color vision in vertebrates, which offers the potential for extraordinary spectral discrimination capabilities. We show that opsin gene expression in cichlids, and possibly also spectral sensitivity, may be sex-dependent. We argue that females and males sample their visual environment differently, providing a neural basis for sexually dimorphic visual behaviour. The diversification of spectral sensitivity likely contributes to sensory adaptations that enhance the contrast of transparent prey and the detection of optical signals from conspecifics, suggesting a role for both natural and sexual selection in tuning color vision.
Comparison of the collagen haemostat Sangustop® versus a carrier-bound fibrin sealant during liver resection; ESSCALIVER-Study
Authors: Moench Christian , Bechstein Wolf O , Hermanutz Valentin , Hoexter Godehard , Knaebel Hanns-Peter
Published: November 2010

Background

Haemostasis in liver surgery remains a challenge despite improved resection techniques. Oozing from blood vessels too small to be ligated necessitate a treatment with haemostats in order to prevent complications attributed to bleeding. There is good evidence from randomised trials for the efficacy of fibrin sealants, on their own or in combination with a carrier material. A new haemostatic device is Sangustop®. It is a collagen based material without any coagulation factors. Pre-clinical data for Sangustop® showed superior haemostatic effect. This present study aims to show that in the clinical situation Sangustop® is not inferior to a carrier-bound fibrin sealant (Tachosil®) as a haemostatic treatment in hepatic resection.

Methods/Design

This is a multi-centre, patient-blinded, intra-operatively randomised controlled trial. A total of 126 patients planned for an elective liver resection will be enrolled in eight surgical centres. The primary objective of this study is to show the non-inferiority of Sangustop® versus a carrier-bound fibrin sealant (Tachosil®) in achieving haemostasis after hepatic resection. The surgical intervention is standardised with regard to devices and techniques used for resection and primary haemostasis. Patients will be followed-up for three months for complications and adverse events.

Discussion

This randomised controlled trial (ESSCALIVER) aims to compare the new collagen haemostat Sangustop® with a carrier-bound fibrin sealant which can be seen as a "gold standard" in hepatic and other visceral organ surgery. If non-inferiority is shown other criteria than the haemostatic efficacy (e.g. costs, adverse events rate) may be considered for the choice of the most appropriate treatment.

Trial Registration

NCT00918619
Efficacy of postural techniques assessed by videofluoroscopy for myasthenia gravis with dysphagia as the presenting symptom: a case report
Authors: Juan Hui-Chun , Tou Isabel , Lo Shu-Chen , Wu I-Hsien
Published: November 2010

Introduction

Oropharyngeal weakness leading to dysphagia is rarely the presenting symptom of myasthenia gravis, but it can be a significant source of morbidity and mortality. The earliest possible diagnosis of myasthenia gravis should be made for better management of this cause of treatable dysphagia. A detailed evaluation of swallowing by videofluoroscopy can assist in making an accurate diagnosis and in individualizing appropriate diet compensatory techniques.

Case presentation

We present the case of a 57-year-old Taiwanese man with dysphagia as the presenting symptom of myasthenia gravis, and evaluate the pathological findings of swallowing and effectiveness of compensatory postural techniques for dysphagia using videofluoroscopy.

Conclusions

Videofluoroscopy is a valuable technique for evaluating myasthenia gravis dysphagia, because it allows swallowing interventions to be precisely individualized in accordance with the results obtained.
"Bong lung" in cystic fibrosis: a case report
Authors: Gao Zoe , Wood-Baker Richard , Harle Robin , Muller Kon , Hauser Jenny , Reid David W
Published: November 2010

Introduction

Marijuana or "bong" lung has been recently described. Subjects typically develop large peripheral paraseptal lung bullae and are predisposed to spontaneous pneumothoraces. The underlying mechanism for bullae formation is uncertain, but probably relates to direct lung toxicity and repeated barotrauma as the smoker performs frequent valsalva manoeuvres in an attempt to derive a greater drug effect.

Case presentation

We describe a case of probable "bong lung" occurring in a 23-year-old Caucasian man with cystic fibrosis who had a history of recurrent pneumothoraces and unusual findings on sputum cytology.

Conclusion

Our case highlights the importance of questioning young adult cystic fibrosis patients about illicit drug use and the utility of sputum cytology and computed tomography scanning when patients present with pneumothoraces and deteriorations in clinical status.
Heme and blood-feeding parasites: friends or foes?
Authors: Toh Shu Qin , Glanfield Amber , Gobert Geoffrey N , Jones Malcolm K
Published: November 2010

Hemoparasites, like malaria and schistosomes, are constantly faced with the challenges of storing and detoxifying large quantities of heme, released from their catabolism of host erythrocytes. Heme is an essential prosthetic group that forms the reactive core of numerous hemoproteins with diverse biological functions. However, due to its reactive nature, it is also a potentially toxic molecule. Thus, the acquisition and detoxification of heme is likely to be paramount for the survival and establishment of parasitism. Understanding the underlying mechanism involved in this interaction could possibly provide potential novel targets for drug and vaccine development, and disease treatment. However, there remains a wide gap in our understanding of these mechanisms. This review summarizes the biological importance of heme for hemoparasite, and the adaptations utilized in its sequestration and detoxification.
Map of low-frequency stick–slip of a creep groan
Authors: Fuadi Z , Maegawa S , Nakano K , Adachi K
Published: November 2010

A map that shows the necessary condition for avoiding the generation of low-frequency stick–slip of a creep groan is introduced. The map is obtained as a result of comprehensive investigation employing a novel caliper–slider experimental model. According to the map, creep groan generation is controlled by two dimensionless parameters, designated as stiffness ratio, Sr, and low-frequency stick–slip index, Ls. Stiffness ratio, Sr, is the ratio of structure stiffness to the stiffness at contact interface and Ls is an index formed by various parameters such as normal force, sliding velocity, and difference between static and kinetic coefficients of friction. On the experimental model, creep groan generation can be avoided if one or both of the following conditions is fulfilled: (a) stiffness ratio, Sr, larger than 40 (Sr>40) and/or (b) low-frequency stick–slip, Ls, index larger than 400 (Ls index>400). It is expected that the map can be used as a useful guideline for avoiding the generation of similar phenomenon on a real brake system.
Strategic plan modelling by hospital senior administration to integrate diversity management
Authors: Newhouse John J
Published: November 2010

Limited research suggests that some hospital senior administrators and chief executive officers (CEOs) have employed a strategic planning function to achieve diversity management practices. As the hospital industry struggles with how to integrate diversity practices to improve patient satisfaction, increase the quality of care and enhance clinical outcomes for minority populations, understanding the planning process involved in this endeavour becomes significant for senior hospital administrators. What is not well understood is what this strategic planning process represents and how it is applied to integrate diversity management. Scant research exists about the type of strategic models that hospital CEOs employ when they wish to reposition their organizations through diversity management. This study examines the strategic planning models used by senior administrators to integrate diversity management for an institutional-wide agenda. A qualitative survey process was used for CEOs in the states of New York, Pennsylvania, New Jersey and Delaware. The key research questions dealt with what type of strategic plan approach senior administrators used for integrating diversity management and what rationale they used to pursue this. Significant differences were reported between three types of strategic plan modelling used by CEOs. Also, when comparing past and current practices over time, such differences existed. The need to integrate diversity management is underscored by this study. How senior hospital administrators apply strategic plan models and what impact these approaches have represent the major implications that this study offers.
Increased access rate to a primary health-care centre by introducing a structured patient sorting system developed to make the most efficient use of the personnel: a pilot study
Authors: Thorn Jörgen , Maun Andy , Bornhöft Lena , Kornbakk Malena , Wedham Sofia , Zaffar Mona , Thanner Cathrine
Published: November 2010

The primary health-care centre (PHCC) participating in the study has had financial problems for several years and it has been particularly difficult to recruit general practitioners (GPs). As a result, the access rate to the PHCC was low. The purpose of this study was to increase the access rate to the PHCC and to make the most efficient use of the staff by introducing a structured patient sorting system.

All personnel were involved in the implementation process and participated regularly in interdisciplinary work-groups. A variety of Drop-in receptions were created and a manual for sorting patients by condition was introduced.

The main finding was that the total access rate to the PHCC increased by 27% and that each staff member increased their personal access rate by an average of 13%. Eighty-three percent of the patients who were initially treated by the rehabilitation team were treated solely by the team and did not need to see a GP. No medical backlashes were reported.

These findings indicate a more efficient use of the personnel. Furthermore, both personnel and patients indicated an improvement in the possibility to book patient appointments after the introduction of the structured patient sorting system.
The empowerment and quality health value propositions of e-health
Authors: Asoh Derek A , Rivers Patrick A
Published: November 2010

E-health, as well as its value and benefits, has been characterized as a concept defined in various ways depending on intended audience and use. Attempts to define, characterize and appreciate e-health inadvertently portray it as something out of main stream academia; thus, undermining the relevance and importance of the transformation capabilities of e-health on the practice of health care from the individual and organizational perspectives. In order to contribute towards an understanding and appreciation of e-health as a main stream concept, we propose the use of existing models, theories and principles in support of e-health. Specifically, the empowerment theory and the principles of quality health will be used to discuss the value proposition of e-health. An understanding of the e-health value proposition is important, because it helps organizations to develop a shared vision and context, which in turn keeps organizations focused and realistic as they expend resources and adopt e-health. It also helps e-health consumers understand what is possible and impossible, and how they can best participate in e-health for the betterment of their health and health care.
The effect of work environment on intent to leave the nursing profession: a case study of bedside registered nurses in rural Florida
Authors: Cortelyou-Ward Kendall H , Unruh Lynn , Fottler Myron D
Published: November 2010

The purpose of this research was to explore the effect work environment has on the intent to leave the profession for rural hospital bedside registered nurses (RNs). Subscales of autonomy, control over the practice setting, nurse–physician relationship and organizational support were incorporated into the analysis to determine which aspects of work environment directly affect the intent to leave the profession.

An explanatory cross-sectional survey was distributed to 259 direct care bedside RNs employed at a rural system-affiliated hospital in Central Florida between February 2007 and June 2007. Anonymity was assured. A questionnaire containing demographic questions, the Nursing Work Index-Revised and Blau's intent to leave scale was distributed to all direct care nurses. A 32.8% response rate was achieved for a total of 85 complete and usable surveys.

Data analysis shows that the work environment in general is negatively related to intent to leave. In addition, each of the four subscales was also negatively related to the intent to leave the profession. The results of this study support several recommendations for practice and education, including the promotion of professional practice environments, fostering inter-departmental relationships, and increasing the managerial training of RN managers.
Sensitivity and specificity of herpes simplex virus-2 serological assays among HIV-infected and uninfected urban Ugandans
Authors: Lingappa J , Nakku-Joloba E , Magaret A , Friedrich D , Dragavon J , Kambugu F , Joloba M , Whalen C , Coombs R , Celum C , Morrow R Ashley
Published: November 2010

Herpes simplex virus type 2 (HSV-2) is a risk factor for HIV-1 infection. We characterized HSV-2 serology assay performance in HIV-positive and HIV-negative Africans. Serostatus for HSV-2 and HIV-1 was determined in 493 serum specimens stored from a community HSV-2 prevalence survey in Kampala, Uganda. HSV-2 serology by Focus HerpeSelect ELISA, Biokit HSV-2 rapid assay and Kalon HSV-2 was compared with HSV-2 Western blot (WB) according to HIV-1 serostatus. Sensitivity/specificity was: 99.5%/70.2% for Focus, 97.0%/86.4% for Biokit and 97.5%/96.2% for Kalon. Focus with Biokit confirmation improved sensitivity/specificity (99.4%/96.8%, respectively). Use of a higher Focus index value cut-off of 2.2 instead of 1.1 increased specificity from 70.2% to 92.4%. Kalon had higher specificity than Focus ( P < 0.001). Of commercially available HSV-2 serological assays, Kalon alone, or Focus ELISA followed by Biokit confirmation perform best. Improved HSV-2 assays are needed for HSV-2 and HIV-1 public health activities in Africa.
High prevalence of HIV-1, HIV-2 and other sexually transmitted infections among women attending two sexual health clinics in Bissau, Guinea-Bissau, West Africa
Authors: Månsson F , Camara C , Biai A , Monteiro M , da Silva Z J , Dias F , Alves A , Andersson S , Fenyö E M , Norrgren H , Unemo M
Published: November 2010

The objective was to examine the prevalence of HIV-1, HIV-2 and 10 other sexually transmitted infections (STIs), and to explore the relationship between HIV and those STIs in women attending two sexual health clinics in Bissau, Guinea-Bissau. In all, 711 women with urogenital problems were included. Clinical examination was performed and HIV-1, HIV-2, human T-cell lymphotropic virus (HTLV)-1, HTLV-2 and syphilis were diagnosed by serology. Trichomonas vaginalis was examined using wet mount microscopy. Cervical samples (and swabs from visible ulcers, if present) were used for polymerase chain reaction (PCR) diagnosis of Chlamydia trachomatis, Mycoplasma genitalium, Haemophilus ducreyi, herpes simplex virus (HSV)-1 and HSV-2, and culture diagnosis of Neisseria gonorrhoeae. The prevalence of HIV-1, HIV-2, and HIV-1 and HIV-2 (dual infection) was 9.5%, 1.8% and 1.1%, respectively. The prevalence of HTLV-1 was 2.8%, HTLV-2 0%, HSV-1 1.4%, HSV-2 7.7%, T. vaginalis 20.4%, syphilis 1.0%, N. gonorrhoeae 1.3%, H. ducreyi 2.7%, M. genitalium 7.7% and C. trachomatis 12.6%. HIV-1 and/or HIV-2 infection was significantly associated with active HSV-2 and HIV-1 was significantly associated with M. genitalium infection. In conclusion, HIV-1 and HIV-2 prevalence was higher compared with previous studies of pregnant women in Guinea-Bissau. The prevalence of co-infection of HIV and other STIs is high. National evidence-based guidelines for the management of STIs in Guinea-Bissau are essential.
Completion of a British Association for Sexual Health and HIV regional audit loop: HIV testing in genitourinary medicine clinics in Scotland in 2004 and 2008
Authors: MacDonald R , Goodall L , Nair V , Baguley S , Clutterbuck D
Published: November 2010

In 2004, the British Association for Sexual Health and HIV Scottish Branch audited HIV testing in new attendees diagnosed with a sexually transmitted infection at genitourinary medicine clinics in Scotland. In 2008 the audit loop was completed. Large increases were seen in rates of test offer and uptake, particularly in health boards with low baseline levels of testing. Overall rates of testing remain below those recommended and wide variability between boards persists.
A cured patient who came back for consultation: neuropathic scrotal pruritus relieved after ipsilateral inguinal hernia repair
Authors: Koh W L , Liu T T
Published: November 2010

When no demonstrable cause is uncovered after excluding inflammatory dermatosis, infectious disease or a manifestation of anorectal disease, anogenital pruritus is often described as ‘idiopathic’. Lumbosacral radiculopathy was described by Cohen et al. as one of the possible causes of ‘idiopathic’ anogenital pruritus. We report a case of a patient with chronic pruritus of the right scrotum that was relieved immediately post-ipsilateral inguinal hernia repair. This is, to the best of our knowledge, the first case of neuropathic scrotal pruritus secondary to direct nerve compression by an inguinal hernia. We propose that a proper examination for the presence of inguinal hernia be performed in the work-up for scrotal pruritus.
Distribution and characteristics of sexual health service provision in primary and community care in England
Authors: Yung M , Denholm R , Peake J , Hughes G
Published: November 2010

The objective of this paper was to identify and describe enhanced sexual health services (ESHSs) commissioned for testing, diagnosis and management of sexually transmitted infections (STIs) in primary and community care settings in England. ESHSs commissioned by Primary Care Trusts (PCTs) in England were determined by telephone survey. Further information on service provision was collected by a follow-up email survey. By April 2009, 464 ESHSs had been commissioned to offer testing, diagnosis and treatment of STIs. Most providers were enhanced general practices (56%). Two in five PCTs did not offer any ESHSs and five PCTs had neither genitourinary medicine services nor ESHSs. Among 52 ESHSs that responded, screening and partner notification strategies varied. The distribution and characteristics of ESHS provision in England are heterogeneous emphasizing the need to establish clear clinical care pathways between services. Routine reporting and analysis of service activity could help ensure provision meets local needs.
European guideline for the management of donovanosis, 2010
Authors: O'Farrell N , Moi H
Published: November 2010

Donovanosis is a rare sexually transmitted infection now mainly seen in sporadic cases in Papua New Guinea, South Africa, India, Brazil and Australia. The causative organism is Calymmatobacterium granulomatis though a proposal has been put forward that the organism be reclassified as Klebsiella granulomatis comb. nov. The incubation period is approximately 50 days with genital papules developing into ulcers that increase in size. Four types of lesions are described – ulcerogranulomatous, hypertrophic, necrotic and sclerotic. The diagnosis is usually confirmed by microscopic identification of characteristic Donovan bodies on stained tissue smears. More recently, polymerase chain reaction (PCR) methods have been developed. The recommended treatment is azithromycin 1 g weekly until complete healing is achieved.
BCG-itis in two antiretroviral-treated HIV-infected infants
Authors: de Souza Campos Fernandes R C , Medina-Acosta E
Published: November 2010

Although vaccination with Bacille Calmette-Guérin (BCG) is considered safe, adverse regional ( BCG-itis) and disseminated ( BCG-osis) diseases preferentially occur in the immunocompromised host. The infection with human immunodeficiency virus (HIV) by mother-to-child transmission leads to impaired cellular immune responses, a situation that poses a great challenge regarding the universal use of BCG vaccine. World Health Organization recommends that children who are known to be HIV-infected, even if asymptomatic, should no longer be immunized with BCG. Many of the complications of BCG vaccination occur in severely immunosuppressed HIV-infected children and are related to late institution of antiretroviral and antimycobacterial therapy. We report two cases of BCG-itis in HIV-infected infants, who fulfilled clinical criteria of immune reconstitution inflammatory syndrome: axillary adenitis, one with suppuration, and both temporally associated with precocious restoration of immunity elicited by the use of antiretroviral therapy. Isoniazid (10 mg/kg/day) was offered until regression of adenopathies, and lesions were not handled.
Venous gas embolism during foam sclerotherapy of saphenous veins despite recommended treatment modifications
Authors: Parsi K
Published: November 2010

Objective

To investigate the effectiveness of methods proposed to prevent venous gas embolism during foam sclerotherapy.

Methods

Transthoracic echocardiography was performed concurrent with ultrasound-guided sclerotherapy (UGS) of great or small saphenous veins. A volume of 2.5 mL of 3% sodium tetradecyl sulphate foam was prepared following the Tessari method and injected slowly 5–10 cm away from saphenous junctions. The procedure was repeated with modifications including using a 5 µm filter to generate microfoam, carbon dioxide as the foaming gas, leg elevation before or after the injection and immobility post-treatment.

Results

Bubbles entered the right heart in less than 60 seconds and continued for up to 50 minutes despite all treatment modifications. None of the patients had a patent foramen ovale and none developed any neurological or cardiac symptoms.

Conclusion

Bubble emboli entered the heart during foam UGS of saphenous veins despite all treatment modifications and low volumes of foam used.
Five-minute Giemsa stain for rapid detection of malaria parasites in blood smears
Authors: Jager M M , Murk J L , Piqué R D , Hekker T A M , Vandenbroucke-Grauls C M J E
Published: November 2010

The Giemsa stain is used as the gold standard for the diagnosis of malaria on blood smears. The classical staining procedure requires between 30 and 45 min. We modified the Giemsa stain and reduced the staining time to 5 min without any loss of quality.
Chromium(VI) Ion Removal from Aqueous Solutions Using a Zn–Al-Type Layered Double Hydroxide
Authors: Cocheci Laura , Barvinschi Paul , Pode Rodica , Seftel Elena-Mihaela , Popovici Eveline
Published: November 2010

This paper deals with the structural and adsorptive characterisation of a Zn–Al-type layered double hydroxide to be used for the retention of chromate ions from aqueous media. Structural characterisation by X-ray diffraction and FT-IR spectroscopy showed that the material was a layered double hydroxide with carbonate in the interlayer; however, certain impurities were also identified. Thermogravimetric analysis allowed appropriate calcination temperatures to be chosen for the sorption studies. The equilibrium adsorption of the Cr(VI) ion was best described by the Langmuir–Freundlich equation. Calcining the material at 500 °C led to a product containing mostly stable zinc oxide with low adsorptive properties. The kinetics of Cr(VI) ion retention on the uncalcined layered double hydroxide obeyed the pseudo-first-order model as described by the Lagergren equation. Structural analysis of the product obtained after Cr(VI) ion sorption onto Zn–Al–CO3 showed that the carbonate anion was not replaced in the interlayer and that the Cr(VI) ion was adsorbed within cavities formed by three adjacent metal hydroxide octahedra situated at the edge of the brucite-like layer.
Multi-Component Adsorption Studies on LiLSX and CMS for Helium Separation
Authors: Das Nisith Kr. , Kumar Pradeep , Mallik C. , Bhandari Rakesh K.
Published: November 2010

An experimental study is reported on the purification of helium gas from a ternary mixture of helium (30 mol%), nitrogen (60 mol%) and oxygen (10 mol%) employing a single-column Pressure Swing Adsorption (PSA) process. Appropriate adsorbents were selected for effecting this separation by exploiting adsorption equilibrium isotherm and breakthrough measurements in order to choose the optimum operating conditions for the PSA process. The adsorption and breakthrough characteristics for the pure gas as well as for the mixed gases were also examined. The pure gas adsorption isotherms were obtained employing a static method, while mixed gas adsorption studies were undertaken using a volumetric chromatography technique. Computer simulations, along with breakthrough experiments, were performed to study the adsorption dynamics and thereby identify suitable operating parameters as well as vessel dimensions. Based on these data, a single-column PSA system has been developed for the separation of helium gas. The selection of adsorbent, effect of feed pressure, flow rate and cycle time related to the process performance has been established. It was noted that employing an adsorbent such as LiLSX at a flow rate of 2 ℓ/min, a working pressure of 500 kPa and a feed time of 180 s appears to be appropriate for obtaining 98.3% pure He with 65% recovery for the column dimensions chosen.
Non-nearest-neighbor dependence of the stability for RNA group II single-nucleotide bulge loops
Authors: McCann Michael D. , Lim Geoffery F.S. , Manni Michelle L. , Estes Julie , Klapec Kelly A. , Frattini Gregory D. , Knarr Robert J. , Gratton Jessica L. , Serra Martin J.
Published: November 2010

Thirty-one RNA duplexes containing single-nucleotide bulge loops were optically melted in 1 M NaCl, and the thermodynamic parameters ΔH°, ΔS°, ΔG°37, and TM for each sequence were determined. The bulge loops were of the group II variety, where the bulged nucleotide is identical to one of its nearest neighbors, leading to ambiguity as to the exact position of the bulge. The data were used to develop a model to predict the free energy of an RNA duplex containing a single-nucleotide bulge. The destabilization of the duplex by the bulge was primarily related to the stability of the stems adjacent to the bulge. Specifically, there was a direct correlation between the destabilization of the duplex and the stability of the less stable duplex stem. Since there is an ambiguity of the bulge position for group II bulges, several different stem combinations are possible. The destabilization of group II bulge loops is similar to the destabilization of group I bulge loops, if the second least stable stem is used to predict the influence of the group II bulge. In-line structure probing of the group II bulge loop embedded in a hairpin indicates that the bulged nucleotide is the one positioned farther from the hairpin loop.