bluuebunny/crossref_metadata_2025 huggingface dataset:
Does optometrists’ self‐reported practice in glaucoma detection predict actual practice as determined by standardised patients?
Authors: Theodossiades Julia , Myint Joy , Murdoch Ian E , Edgar David F , Lawrenson John G
Published: February 2012

Citation information: Theodossiades J, Myint J, Murdoch IE, Edgar DF & Lawrenson JG. Does optometrists’ self‐reported practice in glaucoma detection predict actual practice as determined by standardised patients? Ophthalmic Physiol Opt 2012, 32, 234–241. doi: 10.1111/j.1475‐1313.2012.00898.x

Purpose:  Questionnaires are commonly used as a proxy measure of clinical practice; however their application in a variety of healthcare settings has found significant self‐reporting bias. The aim of this study is to estimate the validity of self‐reporting as a measure of optometrist case‐finding practice for glaucoma and the appropriate referral of suspects.

Methods:  Two complementary approaches were used: (1) a sample of optometrists (N = 34) on an ophthalmic list in West London were visited incognito by Standardised Patient (SP) volunteers aged over 54 who were trained to identify the components of a standard Sight Test. Optometrists from the same list were then invited to participate in a structured face‐to‐face interview regarding their case finding practice for glaucoma. The findings from the two sources were compared. (2) as part of a national glaucoma survey of optometrists, respondents (N = 1264) were asked in a free text question for the information that they would include in a referral letter for suspect glaucoma. The responses were compared to the content of a sample of glaucoma referral letters (N = 571) obtained from consultant ophthalmologists across the UK. In each case, the degree of correspondence (‘match’) between reported practice and actual practice was assessed by chi‐square analysis.

Results:  For the SP study there was incomplete correspondence between the questionnaire and SP reports in several areas e.g. questions relating to a complete history and symptoms, measurement of intra‐ocular pressure and visual fields. Complete correspondence was found for questions asking about the routine assessment of ocular health and refraction. For the referral study, correspondence between survey findings and referral letters was obtained for IOP only. No correspondence was found for disc assessment, visual fields or family history of glaucoma.

Conclusions:  The overall findings from both studies indicate that self‐reported clinical practice questionnaires overestimate routine tests undertaken by optometrists in practice. Although there was a good correspondence for mandatory tests, correspondence was poor for discretionary tests. These findings should be borne in mind in all questionnaire studies that report current practice in glaucoma case‐finding.
Implications of Epidemiological Data for Identifying Persons with Substance Use and Other Mental Disorders
Authors: Rosenthal Richard N. , Nunes Edward V. , Le Fauve Charlene E.
Published: February 2012

The authors conducted systematic searches in standard databases using key search terms related to epidemiology, prevalence, and co‐occurring substance use and other mental disorders (COD), as well as specific combinations of drug and mental disorders. The authors targeted high‐quality, large sample epidemiological surveys so as to utilize studies of high methodological rigor in the construction of recommendations for clinical identification. Further refined searches to identify these studies revealed common themes and related research gaps. Findings suggest that clinicians should have increased expectation that a patient with a substance use disorder (SUD) has a co‐occurring mental disorder if the SUD is relatively severe, if the patient began using substances (including tobacco) at an early age, is female, is dependent on nicotine, or has a drug use disorder. Patients identified as having at least one SUD and one co‐occurring mental disorder should be assessed to identify other likely CODs, because disorders are not normally distributed and tend to cluster in relatively few individuals. (Am J Addict 2012;21:97–103)
Neovascular potential of adipose‐derived stromal cells (ASCs) from diabetic patients
Authors: Gu Ja Hea , Lee Jae Sun , Kim Deok‐Woo , Yoon Eul‐Sik , Dhong Eun‐Sang
Published: February 2012

We explored the vascular biology of adipose‐derived stromal cells (ASCs) from diabetic patients and applied these cells to a murine ischemic flap model to assess the comparative angiogenic potentials between normal and diabetic human ASCs. ASCs were obtained from diabetic patients (n = 5) and controls (n = 5). Secretion and expression of angiogenic cytokines were measured under normoxic and hypoxic condition in vitro. Conditioned media harvested from ASC cultures were assessed for their ability to stimulate human umbilical vein endothelial cell proliferation and tubulization. The control and diabetic ASCs were injected into the murine ischemic flaps, and the surviving area was measured. Diabetic adipose‐derived stromal cells showed a lower level of vascular endothelial growth factor expression and cell proliferation rates than the control cells (p < 0.05). However, vascular endothelial growth factor, hepatocyte growth factor secretion, tubulogenesis, and cell proliferation in diabetic conditioned media were increased in response to hypoxic stimuli (p < 0.05), and it was similar to those of control cells. In an animal study, diabetic and normal ASCs significantly increased flap survival (p < 0.05); however, the functional difference was not found between the two groups. Diabetic ASCs were impaired in their ability to produce vascular endothelial growth factors and to induce cellular proliferation under hypoxic conditions. However, diabetic ASCs showed similar flap salvaging effect compared with controls. These findings may be important in the context of future study of autologous cell‐based therapy in diabetic patients.
Keratin dressings speed epithelialization of deep partial‐thickness wounds
Authors: Pechter Patricia M. , Gil Joel , Valdes Jose , Tomic‐Canic Marjana , Pastar Irena , Stojadinovic Olivera , Kirsner Robert S. , Davis Stephen C.
Published: February 2012

Keratin gene expression is regarded as a hallmark of epidermal biology. It demarcates the three keratinocyte phenotypes: basal (expressing KRT5 and KRT14), differentiating (expressing KRT1 and KRT10), and activated (wound healing), which is characterized by expression of KRT6, KRT16, and KRT17. Activated keratinocytes are among the first signals of epidermal wound healing. In addition, they are found deregulated in nonhealing chronic wounds. To examine keratins as a potential modality for wound‐healing disorders, we evaluated two different keratin dressings, liquid or solid, and assessed their effects of epithelialization and closure using porcine partial‐thickness wound‐healing model in vivo. We found that both forms of keratin dressings accelerated closure and epithelialization, achieving statistically significant differences on day 5. Evidence suggesting early onset of epithelialization was corroborated further by gene expression analyses revealing induction of KRT6A, KRT16, and KRT17 by day 2 postwounding. The data suggest that keratin dressings may stimulate epithelialization by enhancing the activation of keratinocytes. We conclude that keratin‐containing dressings can accelerate wound healing and closure. Further studies are needed to determine the molecular mechanisms of this activation.
Septic Shock With Multiorgan Failure: From Conventional Apheresis to Adsorption Therapies
Authors: Stegmayr Bernd , Abdel‐Rahman Emaad M. , Balogun Rasheed A.
Published: February 2012

Septic shock is often associated with multiorgan failure, a life threatening clinical condition during which there is an imbalance in the proinflammatory and anti‐inflammatory cytokines, chemokines, antigens, endotoxins, procoagulant, and anticoagulant factors and also resultant effects of therapeutic intervention like volume overload. Various extracorporeal therapies have shown some positive results as adjunctive therapeutic intervention to traditional antimicrobials in an effort to bring the inflammatory mediators to a homeostatic balance and to improve poor organ perfusion caused by hypotension and thrombosis in the microcirculation. This review focuses on current information on the use of therapeutic apheresis procedures as adjunctive therapy in such clinical situations as well as the exciting prospects for the near future. The sometimes disappointing results of early phase clinical studies may, in some cases, be related to the well known barriers to successful clinical trials in critically ill patients rather than to failure of the novel concept of adjunctive extracorporeal treatment of septic shock. It should be noted that some of the specialized apheresis technologies reviewed in this article are not yet available for clinical use in the United States as they are not yet approved for use by the US Food and Drug Administration.
A Transformative Decision‐Making Process for Mammography Screening Among Rural, Low‐Income Women
Authors: Purtzer Mary A.
Published: February 2012

Objective

The study objective was to expand theoretical knowledge of the mammography‐screening decision‐making process. The purpose of this article was to report the decision‐making process of participants who moved from nonscreening to screening.

Design and Sample

Grounded theory methodology was used. Seventeen rural, low‐income women aged 46–64 years were recruited.

Measures

In‐depth, face‐to‐face interviews were conducted. Semi‐structured questions focused on decision making, readiness for change, and health care experiences.

Results

Two phases of decision making were identified. Phase I, A Dormant Period of Nonscreening Behavior, is an inactive screening period characterized by (a) knowledge deficits, (b) unengaged cognition, and (c) misleading perceptions. Phase II, A Transformative Learning Process Resulting in Screening Behavior, is characterized by (a) aroused affective responses, (b) awakened cognitive responses, (c) new knowledge construction, and (d) changed perceptual responses. A catalytic event provides the stimulus to move from Phase I to Phase II. Transformative learning emerged as the central conceptual category underlying the decision to obtain screening. Transformative learning includes a triggering event that facilitates questioning previously held assumptions about mammography.

Conclusion

Participants demonstrated a transformative process resulting in movement from nonscreening to screening. Further study is needed regarding nursing interventions that serve as catalysts for transformation and subsequent screening.
Atypical Granular Cell Tumor Occurring in an Individual with Noonan Syndrome Treated with Growth Hormone
Authors: Moos D. , Droitcourt C. , Rancherevince D. , Marec Berard P. , Skowron F.
Published: February 2012

Abstract: We report a large infiltrating atypical granular cell tumor in a child with Noonan syndrome. Even though granular cell tumors are rare in childhood, five cases have been reported in children with Noonan syndrome. This study compares these different cases and explores the possibility of activation of the granular cell by the Ras pathway.
Complex Limbal Choristoma in Nevus Sebaceous Syndrome
Authors: NEMA NITIN , SINGH KULDEEP , VERMA AMIT
Published: February 2012

Abstract:  Excision of an epibulbar choristoma followed by amniotic membrane grafting was performed on a 3‐month‐old baby who presented with nevus sebaceous syndrome. Upon histopathologic examination, the excised mass was seen to be a complex choristoma, a rare ocular tumor. Amniotic membrane transplantation is currently the most acceptable modality of treatment of limbal choristoma, with good cosmetic outcome.
A Comparative Life Cycle Assessment Study of Polyethylene Based on Sugarcane and Crude Oil
Authors: Liptow Christin , Tillman Anne‐Marie
Published: February 2012

A potential strategy for tackling the negative environmental impact of conventional plastics is to produce them from renewable resources. However, such a strategy needs to be assessed quantitatively, by life cycle assessment (LCA) for example.

This screening LCA is intended to identify key aspects that influence the environmental impact of sugarcane low‐density polyethylene (LDPE) and compare these results against fossil‐based LDPE.

The study showed that the major contributors to the environmental impact of sugarcane LDPE are ethanol production, polymerization, and long‐distance sea transport. The comparison between sugarcane‐ and oil‐based plastics showed that the sugarcane alternative consumes more total energy, although the major share is renewable. Moreover, for their potential impacts on acidification, eutrophication, and photochemical ozone creation, no significant difference between the two materials exists.

However, with regard to global warming potential (GWP), the contribution of land use change (LUC) is decisive. Although the range of LUC emissions is uncertain, in the worst case they more than double the GWP of sugarcane LDPE and make it comparable to that of fossil‐based LDPE. LUC emissions can thus be significant for sugarcane LDPE, although there is need for a consistent LUC assessment method.

In addition, to investigate the influence of methodological choices, this study performed attributional and consequential assessments in parallel. No major differences in key contributors were found for these two assessment perspectives.
Care‐Related Risk Factors for Hospital‐Acquired Pressure Ulcers in Elderly Adults with Hip Fracture
Authors: Baumgarten Mona , Rich Shayna E. , Shardell Michelle D. , Hawkes William G. , Margolis David J. , Langenberg Patricia , Orwig Denise L. , Palmer Mary H. , Jones Patricia S. , Sterling Robert , Kinosian Bruce P. , Magaziner Jay
Published: February 2012

Objectives

To identify care‐related factors associated with hospital‐acquired pressure ulcers (HAPUs).

Design

Prospective cohort study.

Setting

Nine hospitals in Baltimore Hip Studies network.

Participants

Six hundred fifty‐eight individuals aged 65 and older who underwent surgery for hip fracture.

Measurements

Skin examinations at baseline and on alternating days until hospital discharge. Participants were deemed to have a HAPU if they developed one or more new Stage 2 or higher pressure ulcers (PUs) during the hospital stay.

Results

Longer emergency department stays were associated with lower HAPU incidence (>4–6 hours: adjusted incidence rate ratio (aIRR) = 0.68, 95% confidence interval (CI) = 0.48–0.96; >6 hours: aIRR = 0.68, 95% CI = 0.46–0.99, both vs ≤ 4 hours). Participants with 24 hours or longer between admission and surgery had a higher postsurgery HAPU rate than those with less than 24 hours (aIRR = 1.62, 95% CI = 1.24–2.11). Surgery with general anesthesia had a lower postsurgery HAPU rate than surgery with other types of anesthesia (aIRR = 0.66, 95% CI = 0.49–0.88). There was no significant association between HAPU incidence and timing of transport to the hospital, type of transport to the hospital, or surgery duration.

Conclusion

Most of the factors hypothesized to be associated with higher PU incidence were associated with lower incidence or were not significantly associated, suggesting that HAPU development may not be as sensitive to care‐related factors as commonly believed. Rigorous studies of innovative preventive interventions are needed to inform policy and practice.
Parachute Mitral Valve with Severe Mitral Regurgitation in an Adult Patient
Authors: Espinola‐Zavaleta Nilda , Chugh Reema , Ramírez Gabriela Meléndez
Published: February 2012

Parachute mitral valve (PMV) is rarely seen in the adult population, in isolation or in association with other congenital heart defects, since most patients may have had milder lesions previously that were asymptomatic early in life, or were not detected due to lack of a comprehensive examination. We report a case of an 18‐year‐old woman with a history of exertional dyspnea, atypical chest pain, and cough for about 1 year. The echocardiographic examination identified a PMV with severe mitral regurgitation associated with bicuspid aortic valve and coarctation of the aorta. Most patients present with mitral stenosis of varying degree of severity, and rarely present with severe mitral regurgitation as seen in our patient. (Echocardiography 2012;29:E122‐E125)
Myocardial Longitudinal Peak Systolic Acceleration (pSac): Relationship to Ejection Phase, Pressure, and Contractility
Authors: Odland Hans Henrik , Brun Henrik , Sejersted Yngve , Dalen Marit , Edvardsen Thor , Saugstad Ola Didrik , Thaulow Erik
Published: February 2012

Acceleration has been measured both noninvasively and invasively, during both isovolumic contraction and early ejection and has been shown to reflect contractility, especially through correlation with dP/dtmax. In this study timing and amplitude of mitral valve annulus acceleration assessed by tissue Doppler were measured and related to diastolic and systolic events. Invasive load independent measures of contractility, based on pressure–volume relationships, were derived, and pacing was done to modulate and control heart rate. Peak systolic acceleration (pSac) of the mitral valve annulus was shown to occur slightly later but timely related to dP/dtmax (P < 0.05), while peak preejection acceleration (pPac) was related to diastolic events. During inotropy and preload modulation dP/dtmax was found to be the strongest determinant of pSac (β= 0.9 ± 0.1; P < 0.001 and β= 1.3 ± 0.4; P < 0.001, respectively, log‐transformed variables). PSac increased with pacing at a higher rate (β= 0.1 ± 0.0 cm/sec2, P = 0.03). Furthermore, pSac indexed to end‐diastolic volume (EDV) was linearly correlated to load independent contractility parameters (Emax, R = 0.7; ESPVR, R = 0.7; and PRSW, R = 0.5), and proved stable toward changes in preload and afterload. The relation between dP/dtmax/EDV and pSac/EDV was stable throughout the study. In conclusion we found that peak systolic longitudinal acceleration (pSac) of the mitral valve annulus during aortic valve opening is strongly associated with dP/dtmax. Indexed to EDV, pSac may represent a load independent noninvasive contractility parameter. We consider pSac a candidate marker of long‐axis contractility which should be viewed upon as the long‐axis contribution to dP/dtmax. (Echocardiography 2012;29:541‐553)
A Human Vascular Model Based on Microdialysis for the Assessment of the Vasoconstrictive Dose–Response Effects of Norepinephrine and Vasopressin in Skin
Authors: FOLKESSON KIM TCHOU , SAMUELSSON ANDERS , TESSELAAR ERIK , DAHLSTRÖM BENGT , SJÖBERG FOLKE
Published: February 2012

Please cite this paper as: Folkesson KT, Samuelsson A, Tesselaar E, Dahlström B, Sjöberg F. A human vascular model based on microdialysis for the assessment of the vasoconstrictive dose–response effects of norepinephrine and vasopressin in skin. Microcirculation 19: 352–359, 2012.

Objective:  Microdialysis enables drug delivery in the skin and simultaneous measurement of their effects. The present study aimed to evaluate dose‐dependent changes in blood flow and metabolism during microdialysis of norepinephrine and vasopressin.

Methods:  We investigated whether increasing concentrations of norepinephrine (NE, 1.8–59 μmol/L) and vasopressin (VP, 1–100 nmol/L), delivered sequentially in one catheter or simultaneously through four catheters, yield dose‐dependent changes in blood flow (as measured using urea clearance) and metabolism (glucose and lactate).

Results:  We found a significant dose‐dependent vasoconstriction with both drugs. Responses were characterized by a sigmoid dose response model. Urea in the dialysate increased from a baseline of 7.9 ± 1.7 to 10.9 ± 0.9 mmol/L for the highest concentration of NE (p < 0.001) and from 8.1 ± 1.4 to 10.0 ± 1.7 mmol/L for the highest concentration of VP (p  = 0.037). Glucose decreased from 2.3 ± 0.7 to 0.41 ± 0.18 mmol/L for NE (p = 0.001) and from 2.7 ± 0.6 to 1.3 ± 0.5 mmol/L for VP (p < 0.001). Lactate increased from 1.1 ± 0.4 to 2.6 ± 0.5 mmol/L for NE (p = 0.005) and from 1.1 ± 0.4 to 2.6 ± 0.5 mmol/L for VP (p = 0.008). There were no significant differences between responses from a single catheter and from those obtained simultaneously using multiple catheters.

Conclusions:  Microdialysis in the skin, either with a single catheter or using multiple catheters, offers a useful tool for studying dose response effects of vasoactive drugs on local blood flow and metabolism without inducing any systemic effects.
Crystallization Kinetics and Mechanism of Strontium Zinc Silicate Glass
Authors: Tiwari Babita , Dixit Anupam , Pillai C. G. Sivan , Gadkari Sanjay C. , Kothiyal Govind Prasad
Published: February 2012

The non‐isothermal crystallization kinetics of the strontium zinc silicate (SZS) glasses, having composition 51SrO‐9ZnO‐40SiO2 (wt%), was studied using the differential thermal analysis (DTA). Glasses prepared by quenching the melt in air, were subjected to different heat treatments for studying the crystallization behavior. Formation of crystalline phases and microstructure were studied by using powder X‐ray diffraction and scanning electron microscopy. The activation energy and mechanism of crystallization were determined according to Kissinger, Ozawa and Matusita‐Sakka equations. The DTA exotherm observed at around 920°C consists of two overlapping crystallization peaks corresponding to two different crystalline phases. Strontium silicate (Sr3Si3O9) and SZS (Sr2ZnSi2O7) phases crystallize almost simultaneously as major phases. The activation energies for the these crystallization peaks are 700 kJ/mol and 704 kJ/mol. Higher activation energies indicate that the kinetics are more thermally activated making the control of crystallization more difficult. The values of growth morphology parameters n (Avarami parameter) and m (dimensionality of crystal growth) suggest a diffusion controlled bulk crystallization with three‐ and two‐dimensional growth. This is also confirmed by an interconnected growth of stubby granular/prismatic shaped crystals in the glass‐ceramic. The microstructural evolution of the glass upon heating suggests the occurrence of phase separation with an apparently spinodal decomposition mechanism prior to the crystallization.
Gender, Fashion Consumer Groups, and Shopping Orientation
Authors: Workman Jane E. , Cho Siwon
Published: February 2012

This study examined how individual’s demographic and psychographic differences influence consumers’ shopping orientations. The purpose of this study was to compare shopping orientations for clothing between fashion consumer groups and gender. A convenience sample of 276 American college students was recruited. A 2 × 2 between‐subjects multivariate analysis of variance followed by analysis of variance was used to test hypotheses. Findings of this study revealed that women and men differ in convenience, recreational, and fashion‐conscious shopping orientations, but do not differ in impulsive, quality, brand, or price shopping orientations. Fashion change agents tended to be higher than fashion followers in all seven shopping orientations. There was a significant interaction between gender and fashion consumer group on six shopping orientations, but no interaction on brand shopping orientation existed. Findings of the study extend the understanding of today’s young male consumers in clothing shopping showing that they are convenience oriented, impulsive, searching for bargains, and they care about brand names and product quality. Results further indicate that male fashion change agents have higher motivational attitudes in impulsive, quality, convenience, and price shopping orientations than other groups. Findings suggest practical implications for segmenting fashion consumers using their shopping orientations.
Women During Midlife: Is It Transition or Crisis?
Authors: McFadden Joan R. , Rawson Swan Kay T.
Published: February 2012

Increased longevity has expanded the period known as midlife. During midlife, women tend to experience changes in health and family roles that can lead to increased stress and/or depression or alternatively to feelings of well‐being. The purpose of this paper was to review the research on women at midlife. The review of literature revealed several smaller studies and one large comprehensive study, the Melbourne Study, which was a 10‐year longitudinal study conducted in Australia. The authors suggest that there is a need for “life transition” courses for women who are interested in understanding how to improve their health and well‐being.
Assessment of the ‘no eosinophils' rule: are eosinophils truly absent in pityriasis lichenoides, connective tissue disease, and graft‐vs.‐host disease?
Authors: Sharon Victoria R. , Konia Thomas H. , Barr Keira L. , Fung Maxwell A.
Published: February 2012

Eosinophils are often present in the inflammatory infiltrate of an interface dermatitis, but the diagnostic specificity of eosinophils in interface dermatitis has not been formally evaluated. We retrospectively identified 97 examples of interface dermatitis with clinically confirmed diagnoses, including lupus erythematosus (LE), lichen planus, pityriasis lichenoides (PL), graft‐vs.‐host disease (GVHD), dermatomyositis (DM) and drug reaction. Diagnoses were clinically confirmed by at least two dermatologists. Slides were reviewed in a blinded fashion by at least two dermatopathologists. The average eosinophil count per 10 ×200 (×20 objective) fields was lowest for PL (0.2), DM (0.3), GVHD (0.4), and LE (0.5) [defined as Group 1] and was higher for lichen planus, drug reactions, erythema multiforme (major and minor) and viral exanthems [defined as Group 2]. Distinction between Group 1 and Group 2 was maximized using an eosinophil count cutoff of 1.1. In conclusion, eosinophils are usually rare to absent in PL, DM, most forms of LE and GVHD. While final interpretation requires a composite assessment of all features, our results suggest that the presence of even a single eosinophil within nine or ten ×20 fields argues against a diagnosis of PL, DM or LE.

Sharon VR, Konia TH, Barr KL, Fung MA. Assessment of the ‘no eosinophils' rule: are eosinophils truly absent in pityriasis lichenoides, connective tissue disease, and graft‐vs.‐host disease?
Selected variants of the steroid‐5‐alpha‐reductase isoforms SRD5A1 and SRD5A2 and the sex steroid hormone receptors ESR1, ESR2 and PGR: No association with female pattern hair loss identified
Authors: Redler Silke , Tazi‐Ahnini Rachid , Drichel Dmitriy , Birch Mary P. , Brockschmidt Felix F. , Dobson Kathy , Giehl Kathrin A. , Refke Melanie , Kluck Nadine , Kruse Roland , Lutz Gerhard , Wolff Hans , Böhm Markus , Becker Tim , Nöthen Markus M. , Betz Regina C. , Messenger Andrew
Published: February 2012

Abstract:  Female pattern hair loss (FPHL) is a common disorder with a complex mode of inheritance. Although understanding of its etiopathogenesis is incomplete, an interaction between genetic and hormonal factors is assumed to be important. The involvement of an androgen‐dependent pathway and sex steroid hormones is the most likely hypothesis. We therefore selected a total of 21 variants from the steroid‐5‐alpha‐reductase isoforms SRD5A1 and SRD5A2, the sex steroid hormone receptors ESR1, ESR2 (oestrogen receptor) and PGR (progesterone receptor) and genotyped these in a case–control sample of 198 patients (145 UK; 53 German patients) and 329 controls (179 UK; 150 German). None of these variants showed any significant association, either in the overall UK and German samples or in the subgroup analyses. In summary, the present results, while based on a limited selection of gene variants, do not point to the involvement of SRD5A1, SRD5A2, ESR1, ESR2 or PGR in FPHL.
Glycosaminoglycans: key players in cancer cell biology and treatment
Authors: Afratis Nikos , Gialeli Chrisostomi , Nikitovic Dragana , Tsegenidis Theodore , Karousou Evgenia , Theocharis Achilleas D. , Pavão Mauro S. , Tzanakakis George N. , Karamanos Nikos K.
Published: February 2012

Glycosaminoglycans are natural heteropolysaccharides that are present in every mammalian tissue. They are composed of repeating disaccharide units that consist of either sulfated or non‐sulfated monosaccharides. Their molecular size and the sulfation type vary depending on the tissue, and their state either as part of proteoglycan or as free chains. In this regard, glycosami‐noglycans play important roles in physiological and pathological conditions. During recent years, cell biology studies have revealed that glycosaminoglycans are among the key macromolecules that affect cell properties and functions, acting directly on cell receptors or via interactions with growth factors. The accumulated knowledge regarding the altered structure of glycosaminoglycans in several diseases indicates their importance as biomarkers for disease diagnosis and progression, as well as pharmacological targets. This review summarizes how the fine structural characteristics of glycosaminoglycans, and enzymes involved in their biosynthesis and degradation, are involved in cell signaling, cell function and cancer progression. Prospects for glycosaminoglycan‐based therapeutic targeting in cancer are also discussed.
An overview of the fundamentals of the chemistry of silica with relevance to biosilicification and technological advances
Authors: Belton David J. , Deschaume Olivier , Perry Carole C.
Published: February 2012

Biomineral formation is widespread in nature, and occurs in bacteria, single‐celled protists, plants, invertebrates, and vertebrates. Minerals formed in the biological environment often show unusual physical properties (e.g. strength, degree of hydration) and often have structures that exhibit order on many length scales. Biosilica, found in single‐celled organisms through to higher plants and primitive animals (sponges), is formed from an environment that is undersaturated with respect to silicon, and under conditions of approximately neutral pH and relatively low temperatures of 4−40 °C compared to those used industrially. Formation of the mineral may occur intracellularly or extracellularly, and specific biochemical locations for mineral deposition that include lipids, proteins and carbohydrates are known. In most cases, the formation of the mineral phase is linked to cellular processes, an understanding of which could lead to the design of new materials for biomedical, optical and other applications. In this contribution, we describe the aqueous chemistry of silica, from uncondensed monomers through to colloidal particles and 3D structures, that is relevant to the environment from which the biomineral forms. We then describe the chemistry of silica formation from alkoxides such as tetraethoxysilane, as this and other silanes have been used to study the chemistry of silica formation using silicatein, and such precursors are often used in the preparation of silicas for technological applications. The focus of this article is on the methods, experimental and computational, by which the process of silica formation can be studied, with an emphasis on speciation.
Prevalence and characteristics of patients with risky alcohol consumption presenting to emergency departments in rural Australia
Authors: Havard Alys , Shakeshaft Anthony P , Conigrave Katherine M
Published: February 2012

Objective:This study measures the prevalence of problematic alcohol consumption in patients of EDs in rural areas of Australia, relative to the general population in the same rural communities. It also identifies the characteristics associated with risky drinking in rural ED patients.

Methods:Surveys containing the Alcohol Use Disorders Identification Test (AUDIT) and questions corresponding to the 2001 Australian Alcohol Guidelines were completed by 1056 patients presenting to five EDs in rural areas of New South Wales, and 756 residents of the same five communities.

Results:Relative to the general community, ED patients were statistically significantly more likely to engage in risky alcohol consumption according to the AUDIT (39%vs20%), alcohol consumption posing a high risk of short‐term harm (26%vs18%) and alcohol consumption posing a high risk of long‐term harm (7%vs3%). Although being aged under 40 years of age, being unmarried, not completing school and being assigned less urgent triage categories were associated with risky alcohol use among ED patients, rates of risky consumption were high across all patient subgroups.

Conclusions:Risky drinking, across a number of measures, is overrepresented in patients of rural Australian EDs relative to the general community, and this type of consumption is not limited to certain subgroups of patients. There is a need for interventions that address both heavy single occasion drinking and excessive regular consumption in patients of rural Australian EDs, with universal interventions recommended rather than targeted programmes.
A new parenthood paradigm for twenty-first century family law in England and Wales?
Authors: Callus Thérèse
Published: February 2012

There are few other areas in family law where incongruence between the legal and social positions is as evident as that concerning parenthood. Recent cases involving lesbian couples and known sperm donors serve to highlight the increasing tension between the respective roles of biology, intention and functional parenting in the attribution of legal parental status. As both legislative and case-law developments have shown, intention is central in some circumstances, but not in others. The main claim of this paper is that this ad hoc approach leads to incoherent and unsatisfactory law: instead of striving to identify a status, what we are really looking to do is to identify the people who assume responsibility for a child. Drawing upon recent case-law, this paper explores how a conceptual reform of the law could result in a principled framework which would place formally recognised intention at the heart of parental status in order to reconnect legal duty with social reality for as many children and parents as possible. Moreover, it would ensure that parental status would not be dictated by the mode of conception of the child (natural or assisted). The analysis identifies the objectives of reform before proposing a new model which, while recognising the social importance of the biological parentage link, would reserve legal status for functional parenthood.
Cell Survival and Altered Gene Expression Following Photodynamic Inactivation of Paracoccidioides brasiliensis
Authors: Almeida Luciane M. , Zanoelo Fabiana F. , Castro Kelly P. , Borissevitch Iouri E. , Soares Célia M. A. , Gonçalves Pablo J.
Published: February 2012

Paracoccidioidomycosis (PCM) is a systemic mycosis caused by Paracoccidioides brasiliensis. Currently, the treatment approach involves the use of antifungal drugs and requires years of medical therapy, which can induce nephrotoxicity and lead to resistance in yeast strains. Photodynamic inactivation (PDI) is a new therapy capable of killing microorganisms via the combination of a nontoxic dye with visible light to generate toxic reactive oxygen species (ROS). We investigated the phototoxic effect of 5,10,15,20‐tetrakis(1‐methyl‐4‐pyridinio)porphyrin (TMPyP), a cationic porphyrin, on the survival of P. brasiliensis following exposure to light. Phototoxicity was found to depend on both the fluence and concentration of the photosensitizer (PS). Although the biological effects of PDI are known, the molecular mechanisms underlying the resultant damage to cells are poorly defined. Therefore, we evaluated the molecular response to PDI‐induced oxidative stress by gene transcription analysis. We selected genes associated with the high‐osmolarity glycerol (HOG)‐mitogen‐activated protein kinase (MAPK) pathway and antioxidant enzymes. The genes analyzed were all overexpressed after PDI treatment, suggesting that the oxidative stress generated in our experimental conditions induces antioxidant activity. In addition to PDI‐induced gene expression, there was high cell mortality, suggesting that the antioxidant response was not sufficient to avoid fungal mortality.
Analysis of consumption pattern of highway transportation fuel in Nigeria
Authors: Nwachukwu Maxwell Umunna , Mba Harold Chike
Published: February 2012

The scarcity of highway transportation fuel in Nigeria has been partly associated with the inability of the nation's forecast of demand for highway transportation to accurately determine and incorporate the diversity in consumption pattern that is apparent in the country. This has posed enormous challenge for the country. This study is aimed at providing empirical evidence on consumption pattern of highway transportation fuel in Nigeria. It was hypothesised that consumptions of highway transportation fuel do not differ significantly among the various parts of the country. Four major cities, namely Lagos, Kano, Abuja and Enugu, were chosen on representative basis of size, function and location from their respective regions as the sample for this study. Analysis of variance technique was used in testing the research hypothesis. The results of the test suggest that the consumption of highway transportation fuel differ significantly among the four selected cities, with the exception of Abuja and Kano, at 0.01 significant level (F‐cal = 160.3; α‐sign = 0.000). The outcome of this study is capable of enhancing policies towards eliminating fuel scarcity in Nigeria.
Real exchange rate assessment for Nigeria: an evaluation of determinants, strategies for identification and correction of misalignments
Authors: Ozsoz Emre , Akinkunmi Mustapha
Published: February 2012

By using monthly data for the 2004–2010 period and a vector error correction model approach, this paper evaluates the determinants of real exchange rates for the Nigerian Naira. Estimations suggest that oil prices, broad money supply, level of foreign reserves held by the Central Bank and interest rate differentials with trading partners can be used as good predictors of the long run Naira equilibrium real exchange rate. It is shown that the recent increases in the world price of oil have a significant appreciating effect in the real Naira rate, while increases in the money supply have the opposite impact. The study also uses the behavioural equilibrium exchange rate approach to identify the misalignments in the real Naira rate. Findings point out to the undervaluation of the Naira at the end of 2010.
PREGNANCY IN DIABETES AND KIDNEY DISEASE
Authors: Bramham Kate , Rajasingham Daghni
Published: February 2012

With appropriate multi‐disciplinary team care, most women with diabetic nephropathy will have successful pregnancy outcomes; however, pregnancy complications are increased compared to non‐diabetic individuals, particularly in those with poor glycaemic control. Women with more severe renal impairment, especially those with hypertension and proteinuria at are highest risk of worse pregnancy outcomes and deterioration in pre‐existing renal function. Pre‐pregnancy counselling should be offered to all women with diabetes in order to optimise diabetic care, and inform women of potential complications. Pregnancy is an indicator of long‐term health, and may indicate important issues for the future management of women with diabetic nephropathy.
CHANGING TRENDS IN END‐STAGE RENAL DISEASE DUE TO DIABETES IN THE UNITED KINGDOM
Authors: Hill C. J. , Fogarty D. G.
Published: February 2012

Background:In some countries, diabetic kidney disease (DKD) is responsible for half of all new patients requiring renal replacement therapy (RRT). Understanding the relationship between early and later stages of DKD is important as it is a preventable cause of renal failure. This review aims to establish the trends in end‐stage renal disease (ESRD) due to diabetes in the United Kingdom as the first step in this understanding.

Methods:Using annual reports from the UK Renal Registry, we summarise the presentation, incidence, prevalence and survival of ESRD patients with diabetes over the last 10–15 years.

Results:Between 1995 and 2009, initiation of RRT in diabetes patients increased from 12.3 to 27.6 patients per million population (pmp). These rates are approximately five times less than those of Caucasians in the United States suggesting fundamental differences in early DKD management. Survival of diabetic patients on dialysis has improved such that prevalent numbers on RRT increased from 47 to 117 pmp in a 12‐year period. A longer time to prepare patients for RRT is strongly related with better outcomes. In 2002, 23% of all patients with diabetic nephropathy were referred late, within 90 days of RRT start; by 2009, this figure had fallen to 11.2%. Access to renal transplantation, the best form of RRT, has improved with almost 12.5% of new transplants occurring in patients with diabetes compared to 8.3% in 1997.

Conclusions:End Stage DKD is more extensively and better treated now than in the late 1990s and coincides with a time of rapid expansion of UK renal services. More diabetes patients start RRT, patients are referred earlier and survive longer. The prevalence of end‐stage DKD is 2.5 times what it was just over 10 years ago. However, across the United Kingdom, there still exists variation in the incidence and outcomes of end‐stage DKD. That these figures have grown so much but are still dwarfed by other countries’ burden of DKD merits further research. Further prevention of DKD is achievable for the United Kingdom and particularly critical for developing nations who can least afford the expensive ‘option’ of RRT.
DIABETIC FOOT CARE: PREVENTION IS BETTER THAN CURE
Authors: Meaney Beverley
Published: February 2012

Patients receiving renal replacement therapy especially haemodialysis (HD) are at high risk of foot ulcers which can lead to amputation. With the increasing numbers of patients with diabetes now presenting with renal failure, renal nurses are in a pivotal position to educate patients and initiate and oversee good foot care. This paper describes the risk factors for these patients and discusses general care for prevention and treatment of these factors. Factors such as regular screening which can be done easily and effectively in an HD setting where patients attend regularly is the first method towards prevention. Care and treatment of foot wounds based on results from the author's unit are discussed. The creation of a diabetes care programme for the author's HD unit have resulted in a more holistic approach to the care of the patient with diabetes and renal disease with special attention to foot care, which in turn has lead to an improved standard of care and better management of the patients’ diabetes. This paper discusses information from this programme offering a summary of risks and treatments to assist those caring for these patients.
RENAL HEALTH AND TRANSPLANTATION: A FOCUS ON ETHNICITY
Authors: Randhawa Gurch
Published: February 2012

It is widely acknowledged within the United Kingdom that there are significant inequalities in renal health and transplant serv‐ices—in relation to demand for, access to and waiting times for these services—between minority ethnic groups in particular. This phenomenon is not unique to the United Kingdom and affects many other countries that have a strong tradition of immigration. The solutions to reducing these inequalities are multi‐faceted and require both short‐term and long‐term policy and resource‐driven initiatives. In the short term, there is an urgent need to increase the number of organ donors from minority ethnic groups which will positively impact upon improved access to transplantation and contribute to reduced waiting times. The increase in donor registration can only be achieved if there are evidence‐based, concerted and adequately resourced efforts to engage with minority ethnic communities at grass‐roots level. In the long term, public health interventions are required that proactively seek to prevent and manage long‐term conditions among the United Kingdom's multi‐ethnic and multi‐faith population, thereby reducing the demand for transplantation.
Helping Business Managers Discover Their Appetite for Design Thinking
Authors: Liedtka Jeanne , Ogilvie Tim
Published: February 2012

If you were going to write a “cookbook” for business managers who want to learn more about design thinking, which recipes would you include?
Collaboration Above the Fray: Designing Strategic Conversations that Matter
Authors: Ertel Chris , Solomon Lisa Kay
Published: February 2012

How do you develop effective strategies under uncertain conditions while engaging more people with different perspectives—more effectively? The key lies in designing a more useful strategic conversation.
Encouraging Customer Co‐creation Online: Why Money Doesn't Matter
Authors: Gibson Riley
Published: February 2012

The best incentive for enlisting customers as online co‐creators is… human nature.
Conducting Design Research Internationally: A Dutch‐German Approach
Authors: Best Kathryn , Wolf Brigitte , van Wijk Kees
Published: February 2012

A design research collaboration between The Netherlands and Germany results in a toolkit for small and medium‐size enterprises.
Next‐Level Branding: Digital Brand Fit in Video‐Game Design
Authors: Wuts Jasper , Person Oscar , Jan Hultink Erik , Brands Maarten
Published: February 2012

Did you know there are more than 50 video games under the Star Wars brand? Here's a primer on brand extensions in the video gaming industry.
Techniques for the in vivo assessment of cardio‐renal function in zebrafish (Danio rerio) larvae
Authors: Rider Sebastien A. , Tucker Carl S. , del‐Pozo Jorge , Rose Kirsten N. , MacRae Calum A. , Bailey Matthew A. , Mullins John J.
Published: February 2012

Key points 

The anatomical structures and discrete nephric regions of the pronephric zebrafish kidney are similar to those of the mammalian nephron.

Renal blood supply and subsequent renal filtration rate are both key determinants of kidney function.

Our study developed classical functional assays for larval zebrafish that effectively model the effects of the nephrotoxin gentamicin and high salt loading.

The techniques demonstrate the disruption in ion and water balance resulting from reduced cardiovascular flow and renal filtration rate.

The ability to measure cardio‐renal function in zebrafish offers advantages associated with the fish model to gain a wider understanding of kidney physiology.
Selective TRIF-Dependent Signaling by a Synthetic Toll-Like Receptor 4 Agonist
Authors: Bowen William S. , Minns Laurie A. , Johnson David A. , Mitchell Thomas C. , Hutton Melinda M. , Evans Jay T.
Published: February 2012

A single change in a synthetic lipid A mimetic may reduce the toxicity of this vaccine adjuvant.
MNK2 Inhibits eIF4G Activation Through a Pathway Involving Serine-Arginine–Rich Protein Kinase in Skeletal Muscle
Authors: Hu Shou-Ih , Katz Mark , Chin Sherry , Qi Xiaoqing , Cruz Joseph , Ibebunjo Chikwendu , Zhao Shanchuan , Chen Amy , Glass David J.
Published: February 2012

In muscle, the kinase-dependent and -independent functions of MNK2 inhibit the protein translation protein eIF4G under conditions that promote atrophy.
Too Much Tolerance?
Authors: Mueller Kristen L.
Published: February 2012

Maintenance of T cell tolerance is likely regulated by epigenetic mechanisms.