bluuebunny/crossref_metadata_2025 huggingface dataset:
Nursing and medical staff knowledge regarding the monitoring and management of accidental or exposure hypothermia in adult major trauma patients
Authors: Ireland Sharyn , Murdoch Katie , Ormrod Paul , Saliba Emma , Endacott Ruth , Fitzgerald Mark , Cameron Peter
Published: December 2006

Recording a patient’s vital signs is a basic requirement that in part informs clinical decision‐making. Practice suggests that recording a trauma patient’s temperature is occasionally overlooked in the emergency department. A staff survey was undertaken to gain an appreciation of knowledge and understanding of the issues that surround accidental or exposure hypothermia in trauma patients. Results demonstrate that nurses and doctors are unsure of how to define hypothermia and are not conversant with simple ways to prevent heat loss or rewarm patients. Complications from hypothermia such as coagulopathy and metabolic acidosis were seldom identified. Issues that limit staff recording temperature include patient access and acuity, lack of knowledge and confidence and access to temperature‐measuring devices. These results emphasize the need for regular education. Implications for clinical practice were considered; an algorithm to guide staff on ways to improve the monitoring and management of temperature in trauma patients was developed. Opportunities for ongoing and further research were identified.
Psychometric testing of a Norwegian version of the Premature Infant Pain Profile: An acute pain assessment tool. A clinical validation study
Authors: Vederhus Bente Johanne , Eide Geir Egil , Natvig Gerd Karin
Published: December 2006

As neonates are submitted to pain, assessing the pain is crucial in effective pain control. The Premature Infant Pain Profile, an acute measurement tool combining physiological, behavioural and contextual indicators, was translated into Norwegian and tested clinically. The purpose was to establish construct validity, interrater reliability and internal consistency. In addition, the effect of sucrose as pain analgesia was tested in neonates ≥ 36 weeks of gestational age. In a known‐groups comparisons design with repeated measures, 111 consecutive neonates, preterm and term, were all observed at baseline, non‐pain and pain event. Neonates in the neonatal unit received sucrose at pain event. A significant interaction effect of gestational age and events was found in the sucrose neonates. A significant interaction effect was detected from sucrose and event type for neonates from 36 weeks. The internal consistency of the six‐item score was acceptable. A correlation coefficient of 0.89–0.97 was obtained for interrater reliability. The Norwegian version of the Premature Infant Pain Profile seems to be a reliable and valid instrument for pain assessment in neonates.
Sexuality: The challenge to espoused holistic care
Authors: Higgins Agnes , Barker Philip , Begley Cecily M
Published: December 2006

Nurses, by virtue of the close relationship with patients, are in a unique position to promote sexual health and provide sexual health advice to people in their care. Although nurses espoused the ideals of person‐centred and holistic care, evidence from research studies suggested that, for a number of reasons, nurses did not consciously and proactively engage with patients in relation to sexual concerns. In today health‐care environment, where patients are seeking information about the impact of illness and treatments on their sexual function, nurses have a responsibility to proactively engage with patients’ sexual health concerns in an informed and sensitive manner. The aim of this paper is to provide nurses with guidelines on how they might include this aspect of care within their everyday work.
Opinions of ageing workers on relative importance of health promotion
Authors: Naumanen Paula
Published: December 2006

This study describes individual, workplace and occupational health‐promoting factors, and their impacts for worker’s health from the perspective of ageing Finnish workers. The pretested questionnaire was sent to 150 ageing workers, of whom 93 returned the form. Statistical analyses were performed using frequencies, means, Mann–Whitney U‐test and Krushkal–Wallis test. Over 90% of respondents stated that health habits, individual arrangements in the workplace, good workplace atmosphere, access to health checks, counselling and nursing care all represented important factors for health promotion. Better health, work satisfaction and motivation of employees were the main factors impacting on health promotion. Ageing workers stated that health and safety organization and rehabilitation institutes were the most important copartners. Management must take a positive attitude towards ageing workers and make the necessary arrangements to support their well‐being and this should be done in collaboration with occupational health professionals.
Exploring the concept of ‘information need’
Authors: Timmins Fiona
Published: December 2006

Identifying information needs is frequently espoused in textbooks, policy documents and reports of research studies; provision of health‐care is also now described as ‘needs‐based’, rather than ‘service‐based’. Yet, there is little understanding or clear definitions of this construct in the literature on the topic. The purpose of this paper is to explore the concept of information need, using concept analysis, with the aim of providing greater clarity. Rodgers’ evolutionary approach to concept analysis was used to identify common attributes, antecedents and consequences, of the term information need. Information need emerged as a want or desire for information to be shared by professionals using appropriate communication skills. Information‐seeking behaviour manifests in individuals as a response to a stimulus that is perceived as either a challenge or a threat. This attempt to provide a greater clarification of the term was prompted by the ubiquitous use of the term with little consistent definition. It is hoped that this conceptual clarification will guide further study in this area, particularly in relation to the subjective nature of contemporary information needs and its role in coping behaviours of individuals and groups.
Outcome and recurrence in treatment of phimosis using topical betamethasone in children in Hong Kong
Authors: Ku Wai‐Hung , Chiu Becky S‐K , Huen Kwai‐Fun
Published: January 2007

Aim:  To study the efficacy of treating phimosis with topical steroid, and its long‐term outcome and side effects. We also looked into the effect of daily retraction and cleansing of prepuce on preventing recurrence of phimsosis.

Methods:  This prospective study comprised 138 boys who were prescribed 0.05% betamethasone ointment (Diprocel) during 1 August 2001–31 July 2004. Five boys were excluded because of non‐compliance. Of the remaining 133 boys, 108 were followed‐up and assessed. Age ranged from 0.03 to 12.9 years (mean = 3.38, SD = 2.79). The number of treatment course received, short‐term and long‐term outcome, side effects and the effect of daily foreskin retraction were studied.

Results:  The success rate of first treatment course was 81.5%, and 60.2% of boys remained free from phimosis upon latest assessment. The follow‐up period ranged from 0.4 to 4.4 years (mean = 2.45, SD = 0.90). There were no side effects noted. We found a significant and linear relationship between daily foreskin retraction and sustained resolution of phimosis.

Conclusion:  Topical steroid is an effective and safe treatment for phimosis, especially when combined with a good hygiene practice of the foreskin with daily cleansing and retraction. A trial of topical steroid treatment should be offered upon considering circumcision.
Proteomics analysis in lung cancer: Challenges and opportunities
Authors: KIKUCHI Takefumi , CARBONE David P.
Published: December 2006

Abstract:  Recent technological developments in proteomic analysis are bringing us new insights into the molecular classification of tumours. Although proteomic analysis in cancer profiling is still under development both in terms of the instruments used and the data analytical tools, this method has great potential advantages for the analysis of biospecimens of many types. Direct measurement of abnormally expressed or modified proteins in the tumour tissue and/or patient blood may be an effective approach for discovering new biomarkers. Proteomics has the significant advantage of being able to discern not only changes in expression levels but also in post‐translational modifications. Thus, the proteomics approach to protein profiling and biomarker discovery uncovers biomarkers from a different viewpoint than microarray analysis. This review summarizes the range of proteomics technologies employed for cancer profiling, and how they have been used to derive new classification models for human lung cancer.
Genetic analysis of CC16, OGG1 and GCLC polymorphisms and susceptibility to COPD
Authors: LIU Shengming , LI Bing , ZHOU Yumin , ZHONG Nanshan , RAN Pixin
Published: December 2006

Background and objectives:  The importance of genetic susceptibility in COPD has not been determined. The aim of this study was to investigate the association between susceptibility to COPD and polymorphisms in the Clara cell 16 kDa secretory protein (CC16), 8‐hydroxy‐guanine glycosylase (OGG1) and glutamatecysteine ligase catalytic subunit (GCLC) genes in a southern Chinese population of Han nationality.

Methods:  A case‐control study was performed on 166 paired subjects with or without COPD, who were randomly selected from a pool of 310 paired subjects. These subjects were selected from epidemiological survey participants, with matched‐pairs being strictly localized in the Guangzhou urban and Shaoguan rural areas. The following polymorphisms were genotyped by PCR‐single strand conformation polymorphism analysis: 38 A/G in exon 1 of the CC16 gene, 1245C/G in exon 7 of the OGG1 gene and −129C/T in the GCLC gene. Genotype frequencies and allelic frequencies were analysed.

Results:  There were no significant differences in the distribution of genotype frequencies for CC16 38 A/G, OGG1 1245C/G or GCLC −129C/T between the COPD and non‐COPD subjects. The distribution of the allelic frequencies of these three genes also showed no significant difference between the two groups.

Conclusions:  The genetic polymorphisms in CC16 38 A/G, OGG1 1245C/G and GCLC −129C/T are not associated with susceptibility to COPD in a southern Chinese population of Han nationality.
Intronic single‐nucleotide polymorphisms in Bcl‐2 are associated with chronic obstructive pulmonary disease severity
Authors: SATA Makoto , TAKABATAKE Noriaki , INOUE Sumito , SHIBATA Yoko , ABE Shuichi , MACHIYA Jun‐ichi , WADA Toshihiro , JI Guijin , KIDO Takashi , MATSUURA Tadashi , MURAMATSU Masa‐aki , KUBOTA Isao
Published: December 2006

Background and objective:  COPD is a multifactorial disease influenced by genetic and environmental factors, and gene‐by‐environmental interactions. There is considerable variability in the degree of airflow obstruction, moreover only 10–15% of chronic smokers develop COPD. These observations indicate that additional risk factors, possibly genetic, contribute to not only the susceptibility to COPD but also the development and severity of COPD. Recent paradigms highlight the presence and causal role of apoptosis in emphysema. There is a large amount of information on the genes involved in the regulation of apoptosis and one of the most studied is Bcl‐2. The aim of this study was to investigate the genetic association of Bcl‐2 gene with the level of lung function, that is, the severity, of COPD.

Methods:  The genetic association of Bcl‐2 polymorphisms with lung function was investigated in 261 Japanese patients with COPD using 12 single‐nucleotide polymorphisms (SNPs) in Bcl‐2.

Results:  Four SNPs showed a significant association between the high and low lung function groups in a dominant trait comparison. Subsequent linkage‐disequilibrium mapping and analyses of haplotype structure also showed a significant association between the level of lung function and two haplotypes comprised of the associated SNPs in Bcl‐2.

Conclusions:  Although the linkage between Bcl‐2 gene and the susceptibility to COPD remains to be clarified, the findings of the current study indicate that Bcl‐2 might be influencing the level of lung function, that is, the development and severity of COPD.
Oxidative stress and lipid‐derived inflammatory mediators during acute exacerbations of cystic fibrosis
Authors: REID David W. , MISSO Neil , AGGARWAL Shashi , THOMPSON Philip J. , WALTERS E. Haydn
Published: December 2006

Background and objective:  In cystic fibrosis (CF) very few studies have assessed sputum 8‐iso‐PGF2α levels during pulmonary exacerbations as a direct measure of airway oxidative stress. The role of other lipid‐derived inflammatory mediators, such as the cysteinyl leukotrienes (cys‐LTs) and prostaglandin (PG)‐E2, during exacerbations is also poorly defined and the effect of conventional antibiotic therapy on these components of the inflammatory process is unclear.

Methods:  Sputum 8‐iso‐PGF2α, total cys‐LT and PGE2 levels were measured in 17 CF patients experiencing a pulmonary exacerbation and repeated analysis were performed in 15 of these patients after antibiotic treatment. Eight stable CF and nine healthy subjects provided control data.

Results:  Sputum 8‐iso‐PGF2α was significantly elevated in acute, but not stable CF patients versus healthy controls (P < 0.001). Similarly, sputum cys‐LT and PGE2 levels were increased in acute compared with stable CF patients and healthy controls (P ≤ 0.001). Although substantially lower than in acute patients, sputum cys‐LT levels in stable patients were also significantly higher than in normal controls (P = 0.01). There were strong associations between cys‐LT levels and sputum total cell counts, and blood neutrophils in acute patients (r2 = 0.53, P = 0.001 and r2 = 0.33, P < 0.05, respectively). Overall in the CF patients, FEV1%predicted was strongly and negatively correlated with sputum 8‐iso‐PGF2α (r2 = 0.34, P = 0.006), cys‐LT (r2 = 0.40, P = 0.002) and PGE2 (r2 = 0.52, P < 0.001) levels. Antibiotic treatment reduced sputum total cell count (P = 0.03), but did not affect 8‐iso‐PGF2α, cys‐LT or PGE2 levels.

Conclusions:  CF exacerbations are characterized by increased oxidative stress and sputum concentrations of bioactive lipid mediators. Treatment does not modulate these aspects of inflammation and more targeted therapy needs further study.
Lack of association between the microsatellite polymorphism in intron 2 of human Toll‐like receptor 2 gene and bronchiectasis among Koreans
Authors: KIM Hee Joung , LEE Hye Won , LEE Ji Eun , JOH Joon Sung , HAN Sung Koo , SHIM Young‐Soo , YIM Jae‐Joon
Published: December 2006

Background and objective:  The genetic factors for the development of bronchiectasis are not well understood in most patients. The aim of this study was to elucidate the possible association between bronchiectasis and guanine–thymine (GT) repeat polymorphism in intron 2 of the human Toll‐like receptor 2 (TLR2), which has a crucial role in adaptive as well as innate immunity.

Methods:  A total of 194 patients with bronchiectasis and the same number of age‐ and gender‐matched healthy blood donors were prospectively enrolled. The numbers of GT repeats were determined by PCR and gene scans. For further analysis, the alleles were classified into three subclasses: 12–16 GT repeats, short alleles (S allele); 17–22 repeats, medium‐length alleles (M allele); and 23–27 repeats, long alleles (L allele).

Results:  The overall distribution of alleles was not different between patient and control groups (P = 0.71). In addition, the frequencies of genotypes including short alleles were not different between patient and control groups (P = 0.92). Extent of bronchiectasis (P = 0.92) and bacterial colonization (P = 0.48) were not associated with any subclass genotype.

Conclusions:  Alleles and genotype including the shorter GT repeats in intron 2 of the TLR2, were not associated with the development, extent and bacterial colonization of bronchiectasis in Koreans.
DETERMINING NORMAL VALUES FOR INTRA‐ABDOMINAL PRESSURE
Authors: Chionh Joanne J. L. , Wei Benjamin P. C. , Martin Jenepher A. , Opdam Helen I.
Published: December 2006

Background:  Intra‐abdominal pressure (IAP) measurements can be used for the early detection and management of the abdominal compartment syndrome. IAP values are widely thought to be atmospheric or subatmospheric. However, there are no reports that describe normal IAP values using urinary bladder pressure measurements in patients not suspected of having a raised IAP level. This study sought to determine these normal values to aid our interpretation of IAP measurements in post‐surgical patients or patients with suspected increased IAP.

Methods:  Urinary bladder pressure measurements were carried out in 40 men and 18 women awake medical or non‐abdominal surgery inpatients with existing indwelling catheters. Measurements were made in the supine, 30° and 45° sitting positions. Comparisons were carried out to determine the effects on urinary bladder pressure of body position, sex and a suspected diagnosis of benign prostatic hypertrophy.

Results:  Median values for IAP were higher if measured in a more upright position (P < 0.0001). Median values were supine, 9.5 cmH2O (range, 1–18 cmH2O); 30° upright, 11.5 cmH2O (range, 3–19 cmH2O); and at 45° upright, 14.0 cmH2O (range, 4–22 cmH2O). Measurements recorded were neither atmospheric nor subatmospheric. IAP was higher in men compared with women in the supine and 30° positions (P < 0.05) but not in the 45° position (P = 0.083). There was no significant difference between patients with and without suspected benign prostatic hypertrophy.

Conclusions:  Normal IAP using urinary bladder pressure in awake patients are above atmospheric pressure. As a patient is moved from the supine into the upright position, IAP measurements increase.
BREAST SPECIMEN ULTRASOUND AND MAMMOGRAPHY IN THE PREDICTION OF TUMOUR‐FREE MARGINS
Authors: Tan Kok‐Yang , Tan Su‐Ming , Chiang Siew‐Hwa , Tan Andrew , Chong Chee‐Keong , Tay Khoon‐Hean
Published: December 2006

Background:  Adequacy of margins is important for local recurrence control in breast‐conserving surgery for breast cancer. This study aims to compare the accuracy of intraoperative specimen ultrasonography (IOUS) and specimen mammography in the prediction of achieving adequate histologically tumour‐free margins during breast‐conserving surgery.

Methods:  Between March 2003 and September 2004, a prospective study was carried out on 25 patients who underwent breast‐conserving surgery. After wide excision, IOUS and specimen mammography were used to assess adequacy of margins. Further surgery was undertaken when either method showed an inadequate margin. The margins were assessed histologically and correlated with IOUS and mammographic findings.

Results:  Using IOUS alone, higher rates of histologically tumour‐free margins were achieved compared with mammography alone. Combined IOUS and mammography achieved similar or slightly higher rates of histologically tumour‐free margins compared with IOUS alone. If the margin measured on IOUS is twice the desired histological margin, this will result in achieving a histologically tumour‐free rate of >90%. Associated ductal carcinoma in situ was the only significant factor found to decrease the rate of achieving adequate margins.

Conclusion:  Intraoperative specimen ultrasonography is useful in predicting histologically tumour‐free margins during breast conserving surgery for cancer.
SURGICAL INCLINATION AND ANATOMY TEACHING AT THE UNIVERSITY OF AUCKLAND
Authors: Insull Phillip J. , Kejriwal Ritwik , Blyth Phil
Published: December 2006

Background:  Medical graduate interest in surgery has declined and medical students are less capable in anatomy than they once were. Declining interest in surgery is because of factors, including growing number of women entering medical school. There has been less emphasis in teaching anatomy at various medical schools in recent years. The aim of this study is to quantify surgical inclination in Auckland medical students to assess whether gender differences exist in surgical inclination and determine confidence in anatomy knowledge and resources used by Auckland medical students.

Method:  Survey design was cross‐sectional and included 25‐point questionnaire using Likert scale response ranking and tick box replies. Two hundred and eighteen surveys were emailed to functioning addresses of fourth and fifth year students at University of Auckland, School of Medicine, New Zealand.

Results:  Response rate was 71.6%. Twenty per cent of students were found to be surgically inclined (95% confidence interval, 0.15–0.26). The proportion of surgically inclined men was significantly higher than women (P < 0.05). Thirty‐three per cent of all respondents (95% confidence interval, 0.26–0.41) felt their knowledge of anatomy was adequate to practice medicine safely. Textbooks and atlases were most commonly used to learn anatomy (P < 0.05). Radiology was the least commonly used method to learn anatomy (P < 0.05). Eighty‐seven per cent (95% confidence interval, 0.81–0.92) of respondents agreed that revisiting dissection during surgical attachments would be helpful.

Conclusion:  Men are significantly more likely to be surgically inclined than women at the University of Auckland. A significantly greater proportion of students felt that their knowledge of gross anatomy was inadequate for safe medical practice. Students use traditional methods to learn anatomy more commonly than radiological methods. The majority of students surveyed would like to revisit cadaver dissection during clinical attachments in surgery.
EXTRACELLULAR MATRIX AS A BIOACTIVE MATERIAL FOR SOFT TISSUE RECONSTRUCTION
Authors: Hodde Jason
Published: December 2006

The extracellular matrix (ECM) directs all phases of healing following trauma or disease and is therefore a natural source of prosthetic mesh material that can be used strategically to induce the repair and restoration of soft tissues following surgery. Biomaterials such as Surgisis® (Cook Biotech Incorporated, West Lafayette, IN, USA), which are derived from natural ECM, provide the extracellular components necessary to direct the healing response, allow for the proliferation of new, healthy tissue and restore tissue integrity to the damaged site. The 3‐D organization of these extracellular components distinguishes the Surgisis® mesh from synthetic materials and is associated with constructive tissue remodelling instead of scar tissue. Common features of this ECM‐assisted tissue remodelling include angiogenesis, recruitment of circulating progenitor cells and constructive remodelling of damaged tissue structures. The tissue response to this biologic mesh is discussed in the context of recent reports on clinical hernia repair.
COMMENTARY: SCIENCE SCANDAL OR ETHICS SCANDAL? OLIVIERI REDUX
Authors: SCHAFER ARTHUR
Published: January 2007

Dr. Nancy Olivieri has become an icon of research integrity for her insistence on publishing adverse data about a drug she was investigating. She has been celebrated world‐wide as a hero of biomedical ethics for her bravery in disclosing potential dangers to research subjects, in the face of both drug company threats and coercive pressures from her hospital and university. Like so many other ‘whistle‐blowers’ however, she now faces both personal vilification and disturbing accusations of scientific error. The case against Olivieri is assessed and found to be baseless.
Institutions, Inequality and Social Norms: Explaining Variations in Participation
Authors: Lister Michael
Published: January 2007

This article seeks to explain why electoral participation varies over time and space. It develops a hypothesis that one factor is the nature of social citizenship rights, which relates to welfare state provision. The article argues that institutions shape and influence social norms and, in so doing, affect individual behaviour. Rights which are more universal in nature encourage norms of solidarity and participation in ways that more residual systems do not. Therefore, where welfare states are more universalist in nature, we should see higher levels of participation. I use inequality rates as a measure of welfare state outputs to investigate this and find a significant negative relationship between inequality and electoral turnout. This suggests that the nature of welfare state institutions has an effect upon individuals' political behaviour.
Carrier Frequency of a Nonsense Mutation in the Adenosine Deaminase (ADA) Gene Implies a High Incidence of ADA‐deficient Severe Combined Immunodeficiency (SCID) in Somalia and a Single, Common Haplotype Indicates Common Ancestry
Authors: Sanchez Juan J. , Monaghan Gemma , Børsting Claus , Norbury Gail , Morling Niels , Gaspar H. Bobby
Published: December 2006

Inherited adenosine deaminase (ADA) deficiency is a rare metabolic disorder that causes immunodeficiency, varying from severe combined immunodeficiency (SCID) in the majority of cases to a less severe form in a small minority of patients. Five patients of Somali origin from four unrelated families, with severe ADA‐SCID, were registered in the Greater London area. Patients and their parents were investigated for the nonsense mutation Q3X (ADA c7C>T), two missense mutations K80R (ADA c239A>G) and R142Q (ADA c425G>A), and a TAAA repeat located at the 3′ end of an Alu element (AluVpA) positioned 1.1 kb upstream of the ADA transcription start site. All patients were homozygous for the haplotype ADA‐7T/ADA‐239G/ADA‐425G/AluVpA7. Among 207 Somali immigrants to Denmark, the frequency of ADA c7C>T and the maximum likelihood estimate of the frequency of the haplotype ADA‐7T/ADA‐239G/ADA‐425G/AluVpA7 were both 0.012 (carrier frequency 2.4%). Based on the analysis of AluVpA alleles, the ADA c7C/T mutation was estimated to be approximately 7,100 years old. Approximately 1 out of 5 – 10000 Somali children will be born with ADA deficiency due to an ADA c7C/T mutation, although within certain clans the frequency may be significantly higher. ADA‐SCID may be a frequent immunodeficiency disorder in Somalia, but will be underdiagnosed due to the prevailing socioeconomic and nutritional deprivation.
Effects of an antiatherogenic diet during pregnancy on markers of maternal and fetal endothelial activation and inflammation: the CARRDIP study
Authors: Khoury J , Henriksen T , Seljeflot I , Mørkrid L , Frøslie KF , Tonstad S
Published: January 2007

Objective To study the effect of an antiatherogenic diet on maternal and cord blood concentrations of systemic biomarkers of endothelial cell activation, haemostasis and inflammation.

Design Single blinded randomised controlled clinical trial.

Setting Obstetric outpatient clinic and maternity unit of a university hospital in Norway.

Population Nonsmoking pregnant women aged 21–38 years carrying a single fetus and with no previous pregnancy‐related complications.

Methods Subjects (n= 290) were randomised to continue their usual diet or to adopt a diet low in saturated fat and cholesterol from gestational week 17–20 to birth. Soluble forms of cellular adhesion molecules, high‐sensitivity C‐reactive protein (CRP) and haemostatic markers were measured at 17–20 weeks of gestation (baseline) and subsequently up to week 36. All the above, except CRP, were also measured in cord blood.

Main outcome measures Concentrations of maternal and fetal biomarkers and maternal CRP.

Results All biomarkers except CRP levels increased significantly during the study period in both the intervention and control groups. None of the maternal or fetal biomarkers were influenced by the intervention (P> 0.05) except for a tendency to lower concentrations of cord blood tissue plasminogen activator antigen in the intervention group compared with the control group, median (interquartile range) 5.4 ng/ml (3.1–7.7) versus 5.8 ng/ml (3.5–11.8),P= 0.05.

Conclusion An antiatherogenic diet in pregnancy did not significantly influence maternal or fetal blood concentrations of a range of biomarkers for inflammation. Thus, the previously reported effects of a cholesterol‐lowering diet on maternal lipid profile and preterm delivery (<37 complete weeks of gestation) do not seem to involve changes in the systemic inflammatory responses of pregnancy.
Dopaminergic neuron loss and up‐regulation of chaperone protein mRNA induced by targeted over‐expression of alpha‐synuclein in mouse substantia nigra
Authors: St Martin Jessie L. , Klucken Jochen , Outeiro Tiago F. , Nguyen Paul , Keller‐McGandy Christine , Cantuti‐Castelvetri Ippolita , Grammatopoulos Tom N. , Standaert David G. , Hyman Bradley T. , McLean Pamela J.
Published: January 2007

Several transgenic mouse lines with altered α‐synuclein expression have been developed that show a variety of Parkinson’s disease‐like symptoms without specific loss of dopaminergic neurons. Targeted over‐expression of human α‐synuclein using viral‐vector mediated gene delivery into the substantia nigra of rats and non‐human primates leads to dopaminergic cell loss and the formation of α‐synuclein aggregates reminiscent of Lewy bodies. In the context of these recent findings, we used adeno‐associated virus (AAV) to over‐express wild type human α‐synuclein in the substantia nigra of mice. We hypothesized that this over‐expression would recapitulate pathological hallmarks of Parkinson’s disease, creating a mouse model to further characterize the disease pathogenesis. Recombinant AAV expressing α‐synuclein was stereotaxically injected into the substantia nigra of mice, leading to a 25% reduction of dopaminergic neurons after 24 weeks of transduction. Furthermore, examination of mRNA levels of stress‐related proteins using laser capture microdissection and quantitative PCR revealed a positive correlation of Hsp27 expression with the extent of viral transduction at 4 weeks and a positive correlation of Hsp40, Hsp70 and caspase 9 with the extent of viral transduction at 24 weeks. Taken together, our findings suggest that targeted over‐expression of α‐synuclein can induce pathology at the gross anatomical and molecular level in the substantia nigra, providing a mouse model in which upstream changes in Parkinson’s disease pathogenesis can be further elucidated.
BMI and objectively measured body fat and body fat distribution in prepubertal children
Authors: Dencker Magnus , Thorsson Ola , Lindén Christian , Wollmer Per , Andersen Lars B. , Karlsson Magnus K.
Published: December 2006

Background  Body Mass Index (BMI) is often used as a surrogate estimate of body fat in epidemiological studies. This study explores the association between BMI, body fat and body fat distribution assessed by Dual‐Energy X‐Ray Absorptiometry (DXA) in younger children.

Methods  Cross‐sectional study of 246 children (138 boys and 108 girls) aged 8–11 years. DXA was used to quantify abdominal fat mass (AFM), total body fat (TBF) and also total body fat as percentage of total body mass (BF%). Body fat distribution was calculated as AFM/TBF.

Results  We found close correlations between BMI vs. TBF, BF% and AFM (r = 0·94, r = 0·92 and r = 0·93) for boys and (r = 0·95, r = 0·92 and r = 0·95) for girls, respectively (P<0·05 for all r‐values). However, significantly lower correlation (P<0·001 for difference between the r‐values) existed for body fat distribution (r = 0·64 for boys and 0·73 for girls).

Conclusion  Percentage body fat, TBF and AFM were all closely associated with BMI, suggesting that BMI serves as a good surrogate marker for obesity in population studies. However, a significantly lower correlation existed for BMI vs. body fat distribution, which may be a limitation when BMI is used to study cardiovascular risk factors in epidemiological studies.
Myocardial ischaemia in patients with peripheral arterial disease
Authors: Svensson Per , De Faire Ulf , Niklasson U. , Östergren Jan
Published: December 2006

Aim: To study the relation between myocardial ischemia assessed with different techniques in patients with peripheral arterial disease (PAD) in comparison with a matched control group.

Methods: Ninety‐nine male patients with PAD and 94 age‐ and sex‐matched control subjects without PAD or ischaemic heart disease performed a exercise treadmill test, dipyridamole Tc‐99m sestamibi myocardial perfusion SPECT (MPS) (43 controls) and 48‐h ambulatory ECG (AECG)‐monitoring (43 controls).

Results: Thirteen of 99 patients had irreversible and 24 of 99 had reversible perfusion defects in MPS in comparison with 0 of 43 and six of 43 of control subjects respectively (P<0·01). Thirteen of 84 evaluable patients experienced a total of 36 episodes of ST‐depression in AECG in comparison with two episodes in two of 42 control subjects (P = 0·07). Out of 13 patients with ST‐depression episodes only three had reversible ischaemia in MPS.

Conclusion: Most PAD patients with episodes of ST‐segment depression have no reversible ischaemia as assessed with dipyridamole‐stress MPS. Episodes of ST‐segment depression may reflect types of myocardial ischaemia that are different from those detected by MPS.
Effect of fat digestion on superior mesenteric artery blood flow in humans
Authors: Symersky T. , Huisman E. J. , Wasser M. N. J. M. , Masclee A. A. M.
Published: December 2006

Background and aim:  Intraluminal nutrients stimulate superior mesenteric artery (SMA) blood flow. Of the macronutrients, especially fat affects the magnitude of the SMA blood flow response to a meal. Little is known however on the influence of fat hydrolysis on SMA flow.

Methods:  We compared in eight healthy volunteers the SMA flow response (Doppler ultrasonography) to continuous intraduodenal fat perfusion (LCT, 240 kCal h−1) during conditions with normal hydrolysis (placebo, control), increased hydrolysis (pancreatic enzyme supplementation; 50 kU lipase) and impaired hydrolysis (orlistat 240 mg).

Results:  Intraduodenal LCT significantly (P<0·01) increased SMA flow in all experiments over basal. The SMA flow response to fat during pancreatic enzyme supplementation (1·49 ± 0·1 l min−1) was significantly (P<0·05) higher compared with placebo (1·11 ± 0·16 l min−1). Lipase inhibition with orlistat did not significantly affect fat stimulated SMA flow compared with placebo: 0·89 ± 0·08 l min−1 versus 1·11 ± 0·16 l min−1.

Conclusions:  Administration of pancreatic enzymes significantly increases fat stimulated SMA flow. Fat digest products in the intestinal lumen contribute to the regulation of SMA blood flow.
The effect of mandibular advancement appliances on awake upper airway and masticatory muscle activity in patients with obstructive sleep apnoea
Authors: Johal Ama , Gill Gulsharondip , Ferman Anthony , McLaughlin Kieron
Published: December 2006

Background:  There is little understanding of how dental appliances, designed to posture the mandible forwards, act on pharyngeal airway dilatory and masticatory muscles in patients with obstructive sleep apnoea (OSA). This study evaluates, in a prospective cohort design, the effect of mandibular advancement splints (MAS) on awake genioglossus (GG), geniohyoid (GH) and masseter (M) muscle activity.

Methods:  Fifty OSA patients received a custom‐made removable Herbst MAS appliance, adjusted for maximum therapeutic benefit, as judged by subjective improvement. Awake electromyographic (EMG) activity was recorded at baseline and with the MAS in situ, by using bipolar surface electrodes in patients seated upright and in the natural head position. The lower splint was modified to facilitate the placement of the intra‐oral bipolar surface electrodes used to record GG EMG activity.

Results:  Significant increases in GG (P = 0·041), GH (P<0·001) and M (P<0·001) muscle activity accompanied placement of the MAS.

Conclusions:  These findings support the contention of a physiological role, which may act to augment the anatomical action of MAS.
Skin tissue water and laser Doppler blood flow during a menstrual cycle
Authors: Mayrovitz Harvey N. , Brown‐Cross Dawn , Washington Zee
Published: December 2006

Previous work offers conflicting evidence concerning whether basal skin blood flow (SBF) varies with the menstrual cycle. Our goal was to determine the extent of cycle‐dependent changes in forearm SBF parameters and if they are linked to local tissue water content and arm volume changes. Both arms of 10 premenopausal women were evaluated three times during their cycle (days 4, 12 and 22) and 10 postmenopausal women were evaluated once. Each evaluation included laser Doppler blood flow parameters (perfusion, volume and velocity), skin temperature, arm volume and local tissue water determined by a new tissue dielectric constant method. Estradiol and progesterone concentrations were determined at each visit by using saliva samples and analysis showed the expected pattern of variation over the cycle. Main results showed no significant cycle‐dependent variations in any SBF parameter, temperature, tissue water or arm volume. Postmenopausal women had significantly less estradiol levels, but did not differ with respect to premenopausal women in any measured parameter except for a slightly less blood velocity (P<0·01). We hypothesize that that the absence of changes in tissue water and arm volume in our group may account for the constancy of the measured SBF parameters. However, in other populations, hormonally induced tissue changes may occur and contribute to the cycle‐dependent changes in resting blood perfusion that have been reported. This possibility suggests that it may be useful to measure and report a skin tissue water index when serial changes in blood perfusion are being investigated.
THE INEQUITY AND INAPPROPRIATENESS OF APPLYING STATUTES OF LIMITATIONS TO CIVIL ACTIONS ARISING FROM CHILDHOOD SEXUAL ABUSE
Authors: Beattie Beth
Published: January 2007

This research examines the long‐term consequences of childhood sexual abuse, the unique circumstances surrounding such abuse, and how these circumstances lead to victims being unable to expeditiously initiate civil action against their abusers. The unfairness and the inappropriateness of applying traditional time limitation principals to plaintiff victims of childhood sexual abuse are then discussed. Finally, a more equitable test to be applied to cases involving actions by adult victims of childhood sexual abuse against their abusers is proposed.
The potential of non‐pathogenic Gaeumannomyces spp., occurring naturally or introduced into wheat crops or preceding crops, for controlling take‐all in wheat
Authors: Gutteridge R.J. , Jenkyn J.F. , Bateman G.L.
Published: December 2006

Take‐all disease (Gaeumannomyces graminis var. tritici) in wheat crops is known to be suppressed by naturally occurring antagonistic fungi, closely related to the pathogen, that infect grasses and cereals. This form of suppression was re‐investigated because of the changing importance and role of grass weeds and grass covers in arable farming. Natural populations of the competitive fungus Gaeumannomyces cylindrosporus, allowed to develop under rye‐grass, were more effective than artificially introduced populations in suppressing the development of take‐all in following wheat crops. To be effective, the antagonist needs to be present before the start of wheat cropping. Introducing G. cylindrosporus, but not G. graminis var. graminis (a potential antagonist that is faster growing), into a previous crop, or just after the previous crop, sometimes suppressed take‐all, but the effect was small. It is concluded that, for any future attempts at biocontrol by these fungi, they should be introduced into a preceding crop not susceptible to take‐all. Take‐all inoculum in the soil should be at a minimum and effective hosts of the take‐all pathogen must not be present as weeds or volunteers.
A Transient Nucleate Boiling Model Including Microscale Effects and Wall Heat Transfer
Authors: Fuchs Thomas , Kern Jürgen , Stephan Peter
Published: December 2006

A new model is presented to compute nucleate boiling heat and mass transfer. It is based on a previous one (Kern, J., and Stephan, P., 2003, ASME J. Heat Transfer, 125, pp. 1106–1115) for quasi-stationary heat transfer to single vapor bubbles. In contrast to the preceding model, fully transient heat and fluid flow is computed with a free surface of the rising bubble and a periodic calculation of repeated cycles of bubble growth, detachment, and rise, requiring only specification of the waiting time between successive bubbles. Additionally, microscopic effects at the foot of the bubble are considered. The model is verified by comparing computed with measured heat transfer coefficients. Typical results for heat and mass transfer to a single vapor bubble are shown at all time steps of the bubble cycle. By means of the model the transient heat flow through different interfaces, e.g., wall/liquid or liquid/vapor, is computed for the whole bubble cycle. Thus, it was possible to evaluate the influence of transient heat conduction, heat storage, and convection in liquid as well as heat transfer in the wall on overall heat transfer performance.
Cavitation Enhanced Heat Transfer in Microchannels
Authors: Schneider Brandon , Koşar Ali , Kuo Chih-Jung , Mishra Chandan , Cole Gregory S. , Scaringe Robert P. , Peles Yoav
Published: December 2006

Heat transfer has been investigated in the presence of hydrodynamic cavitation instigated by 20-μm wide inlet micro-orifices entrenched inside 227-μm hydraulic diameter microchannels. Average surface temperatures, heat transfer coefficients, and pressure drops have been obtained over effective heat fluxes ranging from 39 to 558W∕cm2 at mass flux of 1814kg∕m2s under noncavitating and three cavitating conditions. Significant heat transfer enhancement has been recorded during supercavitating flow conditions in comparison to noncavitating flows with minimal pressure drop penalty. Once supercavitating conditions were reached, no apparent heat transfer augmentation was detected with the reduction of the cavitation index. Visualization of the flow morphology and the heat transfer coefficient characteristics aided in the evaluation of the dominant heat transfer mechanism under various thermal-hydraulic conditions.
Spreading
Characteristics and Microscale Evaporative Heat Transfer in an Ultrathin Film Containing a Binary
Mixture
Authors: Panchamgam Sashidhar
S. , Plawsky Joel
L. , Wayner Peter
C.
Published: December 2006

Using image-analyzing interferometry, the thickness profile, in the range of δ0 (adsorbed thickness) <δ<3μm, at the leading edge of a moving ultrathin film with phase change, was measured for a mixture of pentane-octane and compared to that of pure pentane. An improved data-analysis procedure was used to enhance the use of the measured thickness profile. There were significant differences between these two systems, demonstrating the presence of large Marangoni interfacial shear stresses with the mixture. A control volume model was developed to evaluate the differences between the pure fluid and the mixture. The disjoining pressure at the leading edge was found to control fluid flow in the evaporating pure system. However, due to Marangoni stresses, the effect of disjoining pressure on the mixture was found to be small at steady state for the fluxes studied. With an upstream bulk mixture of 2% octane and 98% pentane, a shear stress due to the gradient of the liquid-vapor interfacial surface tension resulting from distillation controlled fluid flow in the contact line region. The average curvature of the evaporating pseudo-steady state pure system was significantly larger (smaller length and larger apparent contact angle at δ=0.1μm) than the isothermal value, whereas the reverse occurred for the mixture. Using a continuum model, a comparison of numerically obtained Marangoni stresses and local evaporative heat flux profiles between the two systems was also made.
Evaporation/Boiling in Thin Capillary Wicks (l)—Wick Thickness Effects
Authors: Li Chen , Peterson G. P. , Wang Yaxiong
Published: December 2006

Presented here is the first of a two-part investigation designed to systematically identify and investigate the parameters affecting the evaporation/boiling and critical heat flux (CHF) from thin capillary wicking structures. The evaporation/boiling heat transfer coefficient, characteristics, and CHF were investigated under steady-state conditions for a variety of capillary structures with a range of wick thicknesses, volumetric porosities, and mesh sizes. In Part I of the investigation we describe the wicking fabrication process and experimental test facility and focus on the effects of the capillary wick thickness. In Part II we examine the effects of variations in the volumetric porosity and the mesh size as well as presenting detailed discussions of the evaporation/boiling phenomena from thin capillary wicking structures. An optimal sintering process was developed and employed to fabricate the test articles, which were fabricated using multiple, uniform layers of sintered isotropic copper mesh. This process minimized the interface thermal contact resistance between the heated wall and the capillary wick, as well as enhancing the contact conditions between the layers of copper mesh. Due to the effective reduction in the thermal contact resistance between the wall and capillary wick, both the evaporation/boiling heat transfer coefficient and the critical heat flux (CHF) demonstrated dramatic improvements, with heat transfer coefficients up to 245.5kW∕m2K and CHF values in excess of 367.9W∕cm2, observed. The experimental results indicate that while the evaporation/boiling heat transfer coefficient, which increases with increasing heat flux, is only related to the exposed surface area and is not affected by the capillary wick thickness, the CHF for steady-state operation is strongly dependent on the capillary wick thickness and increases proportionally with increase in the wick thickness. In addition to these observations, the experimental tests and subsequent analysis have resulted in the development of a new evaporation/boiling curve for capillary wicking structures, which provides new physical insights into the unique nature of the evaporation/boiling process in these capillary wicking structures. Sample structures and fabrication processes, as well as the test procedures are described in detail and the experimental results and observations are systematically presented and analyzed.
Thermal Modeling and Control in Production of Intermetallic Coatings From Layered Precursors
Authors: Alaeddine Marios , Ranganathan Rajesh , Ando Teiichi , Doumanidis Charalabos C.
Published: December 2006

Successful fabrication of intermetallic coatings on surfaces of manufacturing interest involves regulation of the temperature/concentration dynamic distributions that develop in the molten layer during the thermal and reaction process. Modeling the spatio-temporal dynamics of this metallurgical process, however, requires partial differential equations that are cumbersome to solve on-line, as part of a real time reference model to the controller. To this end, we present a computationally parallel and meshless model (i.e., decoupled with the capability to be solved numerically in real time) to decipher the dynamics of the thermal coating process and to permit real time monitoring and control of the resulting coating microstructure. The analytical model is based on kinetic growth theories, lumped energy and mass balances, and convolution expressions of distributed temperature and concentration Green’s fields (accounting for the orientation of their gradient and decomposing heat and mass transfer across the coating from substrate conduction). The model is validated with nickel aluminide coatings processed on a robotic plasma arc laboratory station, through in-process infrared thermal sensing and off-line metallographic analysis. A Monte Carlo sample control scheme, that involves on-line parameter identification and model adaptation, is also developed using the model as an in-process observer for successful production of binary metal system coatings that exhibit the desired microstructure geometry and characteristics.