bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and Validation of a New Generation of Flexible Endoscope for NOTES
Authors: Swanström Lee , Swain Paul , Denk Peter
Published: May 2009

Background. The concept of intraperitoneal flexible endoscopy has created much interest and investigation. Both gastroenterologists with a surgical leaning and surgeons with advanced endoscopy interests are researching the feasibility of this new approach. Current flexible scopes and instruments are extremely limited for use in natural orifice transluminal endoscopic surgery (NOTES). We describe the development of an endoscopic system specifically designed for endoluminal and NOTES procedures and demonstrates benefits and efficacy in benchtop and cadaver models. Technique. In conjunction with industry, an 18-mm 4-channel rigidizing access device was designed. Measurements of the strength (torsional and lifting) of standard endoscopes and the new scope were made. The new device and instruments are used in 8 cadavers to document its feasibility in a variety of specific tasks: endoluminal plication, upper abdomen and lower abdomen visualization, bowel manipulation, solid organ retraction, cholecystectomy, and enterotomy closure. Results. Benchtop comparison between a standard scope and the new scope showed equal maneuverability but the newer scope had greater force delivery at the tip (0.042 vs 1.96 lb, P < .001) and greater instrument application force (0.09 vs 0.23 lb, P < .002). Introduction of the scope was possible in all cadavers but difficult in cadavers <60 kg. Intragastric manipulation was feasible and exiting the stomach was possible although it required a 2-cm gastrotomy. The scope system was maneuverable in both lower quadrants without difficulty. The upper abdomen was viewable, with variable success in steering the scope between left and right quadrants. The entire gastrointestinal tract was able to be visualized in most cadavers. The scope generated sufficient force to lift and manipulate intraabdominal structures. Cholecystectomy was successful in 5 of 5 attempts. Conclusion. A new flexible access endoscope with 4 large access channels showed utility in a cadaver model—satisfying some of the requirements for performance of NOTES procedures.
Recombinant and plasma-derived factor VIII products induce distinct splenic cytokine microenvironments in hemophilia A mice
Authors: Qadura Mohammad , Waters Braden , Burnett Erin , Chegeni Rouzbeh , Bradshaw Scott , Hough Christine , Othman Maha , Lillicrap David
Published: May 2009

The use of plasma-derived factor VIII (pdFVIII) concentrates in hemophilia A has been reported to result in reduced anti-FVIII antibody formation. In this study, we have investigated whether the cytokine microenvironment induced by pdFVIII has an influence on reducing anti-FVIII antibody titers in hemophilic mice. Microarray and confirmatory quantitative reverse transcription polymerase chain reaction (RT-PCR) experiments show that pdFVIII infusion causes a different transcriptional profile in dendritic cells than recombinant FVIII (rFVIII). Both treatments caused up-regulation of proinflammatory gene expression, but rFVIII and pdFVIII treatments promote expression of genes that induce Th1 and Th2 responses, respectively. Moreover, administration of rFVIII or pdFVIII concentrates resulted in distinct T-cell splenic cytokine microenvironments. rFVIII induced the release of Th1 cytokines and IL-10, whereas pdFVIII induced the release of Th2 cytokines and transforming growth factor-β. We have also observed high titers of anti–human von Willebrand factor (VWF) antibodies in the pdFVIII-treated mice and propose that this results from antigenic competition. We further investigated the role of this phenomenon using infusions of FVIII and increasing concentrations of recombinant human factor IX (FIX). These studies show an inverse relationship between increasing concentrations of FIX and the production of anti-FVIII antibodies. In summary, these studies report new mechanisms that contribute to reduced anti-FVIII antibody development in hemophilia A after pdFVIII infusions.
GATA-1 associates with and inhibits p53
Authors: Trainor Cecelia D. , Mas Caroline , Archambault Patrick , Di Lello Paola , Omichinski James G.
Published: May 2009

In addition to orchestrating the expression of all erythroid-specific genes, GATA-1 controls the growth, differentiation, and survival of the erythroid lineage through the regulation of genes that manipulate the cell cycle and apoptosis. The stages of mammalian erythropoiesis include global gene inactivation, nuclear condensation, and enucleation to yield circulating erythrocytes, and some of the genes whose expression are altered by GATA-1 during this process are members of the p53 pathway. In this study, we demonstrate a specific in vitro interaction between the transactivation domain of p53 (p53TAD) and a segment of the GATA-1 DNA-binding domain that includes the carboxyl-terminal zinc-finger domain. We also show by immunoprecipitation that the native GATA-1 and p53 interact in erythroid cells and that activation of p53-responsive promoters in an erythroid cell line can be inhibited by the overexpression of GATA-1. Mutational analysis reveals that GATA-1 inhibition of p53 minimally requires the segment of the GATA-1 DNA-binding domain that interacts with p53TAD. This inhibition is reciprocal, as the activation of a GATA-1–responsive promoter can be inhibited by p53. Based on these findings, we conclude that inhibition of the p53 pathway by GATA-1 may be essential for erythroid cell development and survival.
Red cell genotyping and the future of pretransfusion testing
Authors: Anstee David J.
Published: May 2009

Over the past 20 years the molecular bases of almost all the major blood group antigens have been determined. This research has enabled development of DNA-based methods for determining blood group genotype. The most notable application of these DNA-based methods has been for determining fetal blood group in pregnancies when the fetus is at risk for hemolytic disease of the fetus and newborn. The replacement of all conventional serologic methods for pretransfusion testing by molecular methods is not straightforward. For the majority of transfusion recipients matching beyond ABO and D type is unnecessary, and the minority of untransfused patients at risk of alloimmunization who would benefit from more extensively blood group–matched blood cannot be identified reliably. Even if a method to identify persons most likely to make alloantibodies were available, this would not of itself guarantee the provision of extensively phenotype-matched blood for these patients because this is determined by the size and racial composition of blood donations available for transfusion. However, routine use of DNA-based extended phenotyping to provide optimally matched donations for patients with preexisting antibodies or patients with a known predisposition to alloimmunization, such as those with sickle cell disease, is widely used.
EphrinB reverse signaling contributes to endothelial and mural cell assembly into vascular structures
Authors: Salvucci Ombretta , Maric Dragan , Economopoulou Matina , Sakakibara Shuhei , Merlin Simone , Follenzi Antonia , Tosato Giovanna
Published: May 2009

EphrinB transmembrane ligands and their cognate EphB receptor tyrosine kinases regulate vascular development through bidirectional cell-to-cell signaling, but little is known about the role of EphrinB during postnatal vascular remodeling. We report that EphrinB is a critical mediator of postnatal pericyte-to-endothelial cell assembly into vascular structures. This function is dependent upon extracellular matrix-supported cell-to-cell contact, engagement of EphrinB by EphB receptors expressed on another cell, and Src-dependent phosphorylation of the intracytoplasmic domain of EphrinB. Phosphorylated EphrinB marks angiogenic blood vessels in the developing and hypoxic retina, the wounded skin, and tumor tissue, and is detected at contact points between endothelial cells and pericytes. Furthermore, inhibition ofEphrinB activity prevents proper assembly of pericytes and endothelial cells into vascular structures. These results reveal a role for EphrinB signaling in orchestrating pericyte/endothelial cell assembly, and suggest that therapeutic targeting of EphrinB may prove useful for disrupting angiogenesis when it contributes to disease.
Regulation of Th17 cell differentiation and EAE induction by MAP3K NIK
Authors: Jin Wei , Zhou Xiao-Fei , Yu Jiayi , Cheng Xuhong , Sun Shao-Cong
Published: May 2009

Th17 cells play an important role in mediating autoimmune diseases, but the molecular mechanism underlying Th17 differentiation is incompletely understood. We show here that NF-κB–inducing kinase (NIK), which is known to regulate B-cell maturation and lymphoid organogenesis, is important for the induction of Th17 cells. NIK-deficient naive CD4 T cells are attenuated in the differentiation to Th17 cells, although they are competent in committing to the other effector lineages. Consistently, NIK knockout mice are resistant to experimental autoimmune encephalomyelitis, a disease model that involves the function of Th17 cells. This phenotype was also detected in Rag2 knockout mice reconstituted with NIK-deficient T cells, confirming a T-cell intrinsic defect. We further show that NIK mediates synergistic activation of STAT3 by T-cell receptor and IL-6 receptor signals. NIK deficiency attenuates activation of STAT3 and induction of STAT3 target genes involved in Th17-commitment program. These findings establish NIK as an important signaling factor that regulates Th17 differentiation and experimental autoimmune encephalitis induction.
Phase 2 study of the efficacy and safety of the combination of arsenic trioxide, interferon alpha, and zidovudine in newly diagnosed chronic adult T-cell leukemia/lymphoma (ATL)
Authors: Kchour Ghada , Tarhini Mahdi , Kooshyar Mohamad-Mehdi , El Hajj Hiba , Wattel Eric , Mahmoudi Mahmoud , Hatoum Hassan , Rahimi Hossein , Maleki Masoud , Rafatpanah Houshang , Rezaee S. A. Rahim , Yazdi Mojtaba Tabatabaei , Shirdel Abbas , de Thé Hugues , Hermine Olivier , Farid Reza , Bazarbachi Ali
Published: May 2009

Adult T-cell leukemia/lymphoma (ATL) is resistant to chemotherapy and carries a dismal prognosis particularly for the acute and lymphoma subtypes. Promising results were obtained with the combination of zidovudine and interferon-alpha. Chronic ATL has a relatively better outcome, but poor long-term survival is noted when patients are managed with a watchful-waiting policy or with chemotherapy. In ATL cell lines, arsenic trioxide shuts off constitutive NF-κB activation and potentiates interferon-alpha apoptotic effects through proteasomal degradation of Tax. Clinically, arsenic/interferon therapy exhibits some efficacy in refractory aggressive ATL patients. These results prompted us to investigate the efficacy and safety of the combination of arsenic, interferon-alpha, and zidovudine in 10 newly diagnosed chronic ATL patients. An impressive 100% response rate was observed including 7 complete remissions, 2 complete remissions but with more than 5% circulating atypical lymphocytes, and 1 partial response. Responses were rapid and no relapse was noted. Side effects were moderate and mostly hematologic. In conclusion, treatment of chronic ATL with arsenic, interferon-alpha, and zidovudine is feasible and exhibits an impressive response rate with moderate toxicity. Long-term follow up will clarify whether this will translate to disease cure. Overall, these clinical results strengthen the concept of oncogene-targeted cancer therapy.
ESTPiper – a web-based analysis pipeline for expressed sequence tags
Authors: Tang Zuojian , Choi Jeong-Hyeon , Hemmerich Chris , Sarangi Ankita , Colbourne John K , Dong Qunfeng
Published: May 2009

Background

EST sequencing projects are increasing in scale and scope as the genome sequencing technologies migrate from core sequencing centers to individual research laboratories. Effectively, generating EST data is no longer a bottleneck for investigators. However, processing large amounts of EST data remains a non-trivial challenge for many. Web-based EST analysis tools are proving to be the most convenient option for biologists when performing their analysis, so these tools must continuously improve on their utility to keep in step with the growing needs of research communities. We have developed a web-based EST analysis pipeline called ESTPiper, which streamlines typical large-scale EST analysis components.

Results

The intuitive web interface guides users through each step of base calling, data cleaning, assembly, genome alignment, annotation, analysis of gene ontology (GO), and microarray oligonucleotide probe design. Each step is modularized. Therefore, a user can execute them separately or together in batch mode. In addition, the user has control over the parameters used by the underlying programs. Extensive documentation of ESTPiper's functionality is embedded throughout the web site to facilitate understanding of the required input and interpretation of the computational results. The user can also download intermediate results and port files to separate programs for further analysis. In addition, our server provides a time-stamped description of the run history for reproducibility. The pipeline can also be installed locally, allowing researchers to modify ESTPiper to suit their own needs.

Conclusion

ESTPiper streamlines the typical process of EST analysis. The pipeline was initially designed in part to support theDaphnia pulexcDNA sequencing project. A web server hosting ESTPiper is provided athttp://estpiper.cgb.indiana.edu/to now support projects of all size. The software is also freely available from the authors for local installations.
Different atrophy-hypertrophy transcription pathways in muscles affected by severe and mild spinal muscular atrophy
Authors: Millino Caterina , Fanin Marina , Vettori Andrea , Laveder Paolo , Mostacciuolo Maria Luisa , Angelini Corrado , Lanfranchi Gerolamo
Published: May 2009

Background

Spinal muscular atrophy (SMA) is a neurodegenerative disorder associated with mutations of the survival motor neuron gene SMN and is characterized by muscle weakness and atrophy caused by degeneration of spinal motor neurons. SMN has a role in neurons but its deficiency may have a direct effect on muscle tissue.

Methods

We applied microarray and quantitative real-time PCR to study at transcriptional level the effects of a defective SMN gene in skeletal muscles affected by the two forms of SMA: the most severe type I and the mild type III.

Results

The two forms of SMA generated distinct expression signatures: the SMA III muscle transcriptome is close to that found under normal conditions, whereas in SMA I there is strong alteration of gene expression. Genes implicated in signal transduction were up-regulated in SMA III whereas those of energy metabolism and muscle contraction were consistently down-regulated in SMA I. The expression pattern of gene networks involved in atrophy signaling was completed by qRT-PCR, showing that specific pathways are involved, namely IGF/PI3K/Akt, TNF-α/p38 MAPK and Ras/ERK pathways.

Conclusion

Our study suggests a different picture of atrophy pathways in each of the two forms of SMA. In particular, p38 may be the regulator of protein synthesis in SMA I. The SMA III profile appears as the result of the concurrent presence of atrophic and hypertrophic fibers. This more favorable condition might be due to the over-expression of MTOR that, given its role in the activation of protein synthesis, could lead to compensatory hypertrophy in SMA III muscle fibers.
Are social norms associated with smoking in French university students? A survey report on smoking correlates
Authors: Riou França Lionel , Dautzenberg Bertrand , Falissard Bruno , Reynaud Michel
Published: May 2009

Background

Knowledge of the correlates of smoking is a first step to successful prevention interventions. The social norms theory hypothesises that students' smoking behaviour is linked to their perception of norms for use of tobacco. This study was designed to test the theory that smoking is associated with perceived norms, controlling for other correlates of smoking.

Methods

In a pencil-and-paper questionnaire, 721 second-year students in sociology, medicine, foreign language or nursing studies estimated the number of cigarettes usually smoked in a month. 31 additional covariates were included as potential predictors of tobacco use. Multiple imputation was used to deal with missing values among covariates. The strength of the association of each variable with tobacco use was quantified by the inclusion frequencies of the variable in 1000 bootstrap sample backward selections. Being a smoker and the number of cigarettes smoked by smokers were modelled separately.

Results

We retain 8 variables to predict the risk of smoking and 6 to predict the quantities smoked by smokers. The risk of being a smoker is increased by cannabis use, binge drinking, being unsupportive of smoke-free universities, perceived friends' approval of regular smoking, positive perceptions about tobacco, a high perceived prevalence of smoking among friends, reporting not being disturbed by people smoking in the university, and being female. The quantity of cigarettes smoked by smokers is greater for smokers reporting never being disturbed by smoke in the university, unsupportive of smoke-free universities, perceiving that their friends approve of regular smoking, having more negative beliefs about the tobacco industry, being sociology students and being among the older students.

Conclusion

Other substance use, injunctive norms (friends' approval) and descriptive norms (friends' smoking prevalence) are associated with tobacco use.

University-based prevention campaigns should take multiple substance use into account and focus on the norms most likely to have an impact on student smoking.
Correlation of histopathological diagnosis with habits and clinical findings in oral submucous fibrosis
Authors: Pandya Shruti , Chaudhary Ajay Kumar , Singh Mamta , Singh Mangal , Mehrotra Ravi
Published: May 2009

Background

Oral submucous fibrosis is a common oral health problem in India. This study was conducted to correlate the histopathological diagnosis with habits and clinical findings in patients suffering from oral submucous fibrosis (OSF).

Methods

Patients suffering from oral submucous fibrosis from the Departments of Otorhinolayngology and Pathology, Moti Lal Nehru Medical College, Allahabad, India were studied from 2004–2008. Detailed information was gathered in a pretested proforma. Emphasis was given to the various addictions, clinical findings and histological examination was done.

Results

Two hundred and thirty nine patients were studied, yielding a male to female ratio of 6.8:1. Maximum patients were in the 21–30 years age group with a marked male predominance. Of these, 197 (82.4%) patients chewed areca nut/dohra, 14 (5.8%) were smokers and 2 (0.8%) patients were habituated to alcohol. 89(37.2%) patients reported difficulty in opening of the mouth (trismus). 51 (57.4%) patients were found to have stage II (2–3 cm) trismus while rest had stage I and III. The buccal mucosa was found to be the most commonly involved site. On the basis of histopathological examination, 52(21.7%) were classified as OSF grade I, 75(31.3%) patients as grade II and 112(46.8%) had grade III disease.

Conclusion

The widespread habit of chewing dohra/paan masala is a major risk factor of OSF, especially in the younger age group. In this study, an increase in histopathological grading was found with severity and duration of addiction habit. However no significant correlation was found between clinical staging and histopathological grading.
Reflections on the structural dynamics of floating beams and ship hulls in waves
Authors: Taylor R Eatock
Published: May 2009

The paper aims to shed light on links between the classical modal superposition analysis of ship hydroelasticity and the alternative formulation, more recently developed, in which equations for structural deflection and hydrodynamic pressure are coupled explicitly. The analysis is focused on a simple two-dimensional model of a uniform beam in small-amplitude waves. A new numerical representation is presented (based on a series of Legendre functions). Matrix equations are developed which provide links between the two formulations, and illustrative results are discussed. The influence of the beam flexibility on deflections and bending moments is shown, and the contributions of added mass and added damping effects are considered. The elastic wavelength in the floating beam is shown to be an important parameter.
An Audit of Urology Two-Week Wait Referrals in a Large Teaching Hospital in England
Authors: Mathew Anup , Desai KM
Published: May 2009

INTRODUCTION

Two week wait referral guidelines have been published by the UK Department of Health for suspected urological cancers. Concordance to these guidelines is variable. Our objectives were to assess the incidence of urological malignancy and the proportion of inappropriate referrals in the two-week wait pathway.

PATIENTS AND METHODS

Retrospective audit of all two-week wait referrals to the urology department over 6 months. Inappropriate referrals were those not satisfying the referral criteria, but referred under the two-week wait system. Detection rates were calculated for each referral criterion based on diagnosis obtained from histology, imaging reports and clinic letters.

RESULTS

Incidence of cancer was 90 of 400 two-week wait referrals (23%). The cancer-detection rate based on reasons for referral ranged from 50 of 122 (41%) for elevated prostate-specific antigen levels to 2 of 56 (4%) for scrotal lumps; 42 (11%) referrals were inappropriate.

CONCLUSIONS

The overall cancer-detection rate is acceptable. Most inappropriate referrals were for long-standing symptoms and non-specific testicular/scrotal symptoms. The testicular cancer detection rate raises questions about the two-week wait guidelines. Providing general practitioners with fast-track scrotal ultrasound and revising the guideline may reduce the disproportionately high number of patients referred with suspected testicular cancer. Other inappropriate referrals are a cause for concern as they add to the workload of the ‘urgent-referral’ pathway. Urological cancers (those involving the prostate, testis, penis, urethra, bladder, ureters and kidneys) accounted for 15.4% of all new cancers in England, 1 and 12.1% of deaths from cancer, 2 in England and Wales, in 2004. The two-week wait referral guidelines published by the UK Department of Health for suspected urological cancers 3 are summarised in Table 1 . NHS trusts and SHAs are encouraged to carry out clinical audits of suspected cancer referrals to generate further information. 4 There is wide variation among various centres and regions in the concordance of general practitioner (GP) referrals based on these guidelines, and also the rate of cancers detected based on the two-week wait system. [Table: see text] The objectives of this audit were to calculate: (i) the rate of detection of cancers among the two-week wait referrals; (ii) the rate of detection of cancers based on the reason for referral; and (iii) the proportion of inappropriate referrals.
Assessing the Feasibility of a One-Stop Approach to Diagnosis for Urological Patients
Authors: Coull Nadine , Rottenberg Giles , Rankin Sheila , Pardos-Martinez Maria , Coker Bola , Jenkins Elaine , O'Brien Tim
Published: May 2009

INTRODUCTION

Conventional publicly funded out-patient services in many specialties are characterised by delays, fragmented diagnostic processes, and overloaded clinics. This is bad for patients as it is clinically dangerous; bad for managers who spend hours managing the failure; bad for doctors who respond by overloading clinics; and bad for purchasers who have to fund the multiple out-patient visits needed. Sound clinical and financial reasons exist for introducing more efficient diagnostic processes.

PATIENTS AND METHODS

A total of 330 consecutive patients referred to the urology department of Guy' and St Thomas' NHS Foundation Trust were invited to attend one of nine one-stop clinics staffed by consultant urologists with specialist registrars, nurses, and clerical staff. Pre-clinic blood and urine tests were ordered based on the referral letter. Clinics had facilities to perform cystoscopy, ultrasound, and urinary flow studies. Correspondence was generated in real time, and a copy given to the patient.

RESULTS

Overall, 257 patients attended the clinics. Twenty-three patients cancelled appointments and 50 patients did not attend. Pre-clinic tests were requested in 133 patients and were completed by 86% of the patients who attended. Of patients, 42% were diagnosed and discharged; 28% were listed for surgery, extracorporeal shock wave lithotripsy (ESWL), or referred to another specialty. About 30% of patients needed further out-patient review; in approximately two-thirds to complete a diagnosis and one-third to review the results of therapy initiated. An estimated 350 appointments and 550 patient visits to hospital were saved.

CONCLUSIONS

A one-stop method of consultation is efficient across a range of urological presenting complaints, and dramatically reduces the need for follow–up consultations. It has potential to: (i) reduce delays to being seen in out-patients; (ii) lead to more cost-effective care; and (iii) increase safety and patient satisfaction. It should become the standard of care in urology, and is probably applicable in many other disciplines.
A Survey of the Peri-Operative Management of Urological Patients on Clopidogrel
Authors: Mukerji Gaurav , Munasinghe Indumina , Raza Asif
Published: May 2009

INTRODUCTION

Peri-operative management of patients receiving platelet inhibitors, such as clopidogrel presents a dilemma to surgeons in every surgical specialty including urology. The risk of procedure-related bleeding while continuing clopidogrel needs to be weighed against the risk of thrombo-embolism after discontinuing it. The objective of the survey was to determine current UK practice regarding clopidogrel use/cessation in patients undergoing elective urological procedures.

SUBJECTS AND METHODS

A 10-part questionnaire relating to pre- and postoperative clopidogrel use was mailed to all UK urology consultants listed in the British Association of Urological Surgeons' directory.

RESULTS

A total of 570 questionnaires were sent and 297 (52%) were returned. The majority of respondents stop clopidogrel prior to TUR surgery (96.6%), major urological surgery (91.7%), TRUS biopsy (90.6%), ESWL (81.8%) and cystoscopy and biopsy (70.1%). The time clopidogrel was stopped pre-operatively and restarted postoperatively was very variable and dependent on local guidelines or urologist preference. Almost half (49.5%) of the respondents would stop clopidogrel irrespective of its indication and 40.7% never consulted a cardiologist/haematologist before stopping clopidogrel. Less than half (43.4%) had a protocol/guideline in place concerning stopping clopidogrel before surgery. Of respondents, 43% do not routinely prescribe bridging therapy after discontinuing clopidogrel. Over half (55%) reported bleeding complications in patients who continued their clopidogrel during urological procedures and 22 (7.4%) of respondents reported an adverse thrombo-embolic event after stopping clopidogrel. The vast majority of respondents (92.8%) felt evidence-based guidelines on clopidogrel use during the peri-operative period would be useful.

CONCLUSIONS

This survey has highlighted a significant variation in practice with regards to pre- and postoperative management of clopidogrel in patients undergoing urological procedures. The results of this survey highlight the need for evidence-based guidelines for the peri-operative management of patients on clopidogrel.
Complications of Bariatric Surgery: Presentation and Emergency Management – a Review
Authors: Monkhouse SJW , Morgan JDT , Norton SA
Published: May 2009

INTRODUCTION

The prevalence of obesity surgery is increasing rapidly in the UK as demand rises. Consequently, general surgeons on-call may be faced with the complications of such surgery and need to have an understanding about how to manage them, at least initially. Obesity surgery is mainly offered in tertiary centres but patients may present with problems to their local district hospital. This review summarises the main complications that may be encountered.

MATERIALS AND METHODS

A full literature search was carried out looking at articles published in the last 10 years. Keywords for search purposes included bariatric, surgery, complications, emergency and management.

CONCLUSIONS

Complications of bariatric surgery have been extensively written about but never in a format that is designed to aid the on-call surgeon. The intricate details and rare complications have been excluded to concentrate on those symptoms and signs that are likely to be encountered by the emergency team.
Rereading the History and Historiography of Epistemic Domination and Resistance in Africa
Authors: Ogot Bethwell A.
Published: May 2009

The process of narrating and interpreting the African past has long been an intellectual struggle against European assumptions and prejudices about the nature of time and history in Africa. As the historian David William Cohen states, “The major issue in the reconstruction of the African past is the question of how far voices exterior to Africa shape the presentation of Africa's past and present” (1985:198). Many historians, especially those without any background or training in African historiography, have assumed, incorrectly, that prior to European contact with Africa, indigenous “traditions” were ancient, permanent, and reproduced from generation to generation without change. This is the false image of cultural isolation and temporal stagnation that has been assiduously disseminated in many parts of the world.
The Environmental and Social History of African Sacred Groves: A Tanzanian Case Study
Authors: Sheridan Michael J.
Published: May 2009

Sacred groves figure prominently in efforts to create community-based conservation in Africa. Although they are often conceptualized in functionalist terms as relics of climax forest and peak cultural florescence, attention to the intersections of ecological and social dynamics offers a framework for understanding African sacred groves that avoids assumptions of steady states of habitat and culture. This article, based on a case study from the North Pare Mountains of northeastern Tanzania, demonstrates that the sacredness of these groves is embedded in social institutions, and that the deeply contested nature of these meanings produces African landscapes. It concludes that sacred groves, as examples of cultural and ecological co-evolution, require research based on hybrid social and natural scientific methods. The implication for conservation policy is that sacred groves are not simply local forms of conservation, and that their management demands cooperation among local, national, and global institutions.
Rethinking Patrimonialism and Neopatrimonialism in Africa
Authors: Pitcher Anne , Moran Mary H. , Johnston Michael
Published: May 2009

Current usages of the termspatrimonialandneopatrimonialin the context of Africa are conceptually problematical and amount to a serious misreading of Weber. His use of the termpatrimonialdelineated a legitimate type of authority, not a type of regime, and included notions of reciprocity and voluntary compliance between rulers and the ruled. Those reciprocities enabled subjects to check the actions of rulers, which most analyses of (neo) patrimonialism overlook. We apply these insights to a case study of Botswana and suggest that scholars reconsider the application of Weber's concepts to African states.
El Gran Combo, Cortijo, and the Musical Geography of Cangrejos/Santurce, Puerto Rico
Authors: Berríos-Miranda Marisol , Dudley Shannon
Published: May 2009

Cet article s'appuie sur des récits, des exemples musicaux, des articles de journaux et des écrits scientifiques pour établir des liens entre le public transnational du Gran Combo de Porto Rico et l'historie transnationale de Cangrejos, appelé aujourd'hui Santurce. L' orchestre qui a donné naissance au Gran Combo, Cortijo y su Combo (dont la plupart des membres viennent du quartier dit de l'arrrêt de bus nº 21 à Santurce), a aidé à créer des connections diasporiques entre plusieurs communautés noires de la Caraïbe et d'Amérique Latine dans les années 1950. Pendant cinq décennies El Gran Combo a poursuivi dans cette voie et l'a étendue en restant fidèle à une éthique communautaire forte. Pour nous la portée transnationale de ces musiciens résulte en partie, premièrement des siècles d'immigration vers Porto Rico en provenance des autres îles ce qui a donné naissance à Cangrejos à une culture musicale hybride et inclusive, et deuxièmement des développements économiques du XXe siècle qui ont placé Santurce au carrefour des divertissements internationaux, des media, et des migrations de travailleurs. Ces flux de personnes et de musique forment une "geógraphie musicale" qui relie les quartiers de Santurce et leurs musiciens aux réseaux transnationaux et qui place Porto Rico à la fois en Amérique Latine et aux États-Unis. La dernière section de notre papier examine la façon dont la culture transnationale de Santurce a contribué à conférer une portée internationale à la salsa dans les années 1960 et 70. Nous concluons par quelques observations sur le rôle de la musique dans la construction de communautés qui s'étendent pardelà les frontières nationales.
La colección John Alden Mason: una documentación sonora para la historia de Puerto Rico
Authors: Vargas Hugo Viera
Published: May 2009

Ces notes attestent de l'importance de la collection de musique populaire John Alden Mason, qui a été dressée à Puerto Rico entre 1914 et 1915. Actuellement, la collection se trouve dans les Archives de la Musique Traditionnelle à Indiana University, Bloomington. En general, ces notes soutiennent la valeur potentielle de cette collection pour ceux qui étudient la culture portoricaine du début du vingtième siècle. En examinant les bombas qui ont été enregistrées dans la ville montagneuse d'Utuado comme un index de la héterogénéité de la musique et culture portoricaine, je soutines que ces bombas enregistrées brisent les espaces sociaux, raciaux, et géographiques dans lesquels ce genre de musique a été délimité. Ainsi, je souligne les avantages d'employer les paroles des chansons comme sources primaires pour les études historiques. A ce titre, je soutiens que ces "documents sonores" permettent aux rechercheurs d'étudier les expériences personnelles de beaucoup de Portoricains qui n'ont pas eu la possibilité de s'exprimer à l'écrit. Comme exemple, je termine mes notes avec une analyse brève de chansons qui concernent les relations entre les hommes et les femmes.
Haul and Pull Up: History, Mento and the eBay Age
Authors: Neely Daniel Tannehill
Published: May 2009

Avec l'apparition de eBay en 1997, le marché international des disques anciens de la Jamaïque a connu un succès fulgurant en facilitant l'acquisition du nombre de matériels qui étaient préalablement inaccessibles. Cet article s'interroge sur une éventuelle fragmentation de l'histoire de la Jamaïque avec du support sonore et comment ce développement influence l'étude des musiques de la Caraïbe. Les donnés historiques et historiographiques jouent un rôle crucial dans certains travaux de recherches ethnographiques. Tandis qu'un grand nombre d'institutions de recherche ne disposent d'aucune trace de matériels de musique traditionnelle, eBay s'est imposé comme une référence de qualité pour des chercheurs en quête d'importants matériels d'archives. De nos jours, le nombre d'entrepeneurs intéressé à la vente de ces matériels sur eBay va grandissant, ce qui entre autres fortifie le marché informel du pays. D'un coté, la vente de ces disques supporte la musique jamaïcaine traditionnelle; mais, de l'autre, elle peut être considérée comme un processus de dè-contextualisation. En étudiant le commerce de la musique mento jamaïcaine, cet article s'est proposé d'aborder comment le collectionnisme entre frontières, le processus par lequel les matériels culturels vont au delà des limites nationales et intègrent des institutions de collection privées, peut être une source d'ouverture.
The Weapons of Our Warfare: Music, Positionality, and Transcendence Among Haitian Pentecostals
Authors: Butler Melvin L.
Published: May 2009

Durant la première décennie du XXIe siècle, les congrégations chrétiennes pentecôtistes représentent une importante force culturelle en Haïti et dans sa diaspora. Ceux qui s'identifient comme «Pannkotis» (pentecôtistes) comprennent une variété remarquable d'églises allant des «armées célestes» jusqu'à celles construites sur la base des congrégations américaines traditionnelles. Tandis qu'ils sont en proie à des difficultés socio-économiques, les croyants pentecôtistes louent et adorent Dieu avec exubérance, disposent d'un arsenal «d'armes» musicales pour assurer leur survie, défendre leur espace spirituel, et articuler leur identité et espérance religieuse. Considérant l'interaction de leur position et leur foi, je crois que la pratique musicale dont il est question ici représente pour les deux groupes distincts une épée à double tranchant. Elle pénètre les obstacles spirituels nuisibles et attaque un ennemi commun satanique, mais crée également des murs sociaux et religieux séparant les deux groupes. C'est justement ce côté paradoxal de la musique pentecôtiste – son habileté à unir spirituellement et à diviser socialement – qui est l'objet de ma réflexion.
Banishment, Jurisdiction, and Identity in Seventeenth-Century New England: The Case of Roger Williams
Authors: Goodman Nan
Published: May 2009

This essay rereads the works of Roger Williams that pertain to his banishment from the Massachusetts Bay Colony in an effort to uncover not their much-examined religious perspective but their previously unnoticed common-law framework. In their rise to prominence in the early to mid-seventeenth century, certain principles of the common law—including the use of precedent and the law’s responsiveness to changing human needs—Shelped alter many aspects of the law, including the law of jurisdiction, which was of particular relevance to banishment. Indeed, as a result of a proliferation of jurisdictions and a growing uncertainty about the legal boundaries between them, banishment, the essay argues, in the form of a previously unrecognized kind of narrative—what I will call the banishment narrative—came to prominence as an entirely new way of figuring who the early modern, and in particular the white English, colonist really was.
The Political Threat of a Female Christ: Ann Lee, Morality, and Religious Freedom in the United States, 1780–1819
Authors: Jortner Adam
Published: May 2009

The claims of Ann Lee and the Shakers that Christ had returned as a female bred both opposition and obedience in the early American republic. From 1780 onward, new converts accepted the claims of incarnation and took their places in the hierarchical church of the Shakers while opponents derided the Shakers as dangerous and possibly subversive. The return of Christ as a female, therefore, raised more questions about the public order of masculine self-government than about universal salvation. Ultimately, Shakers defended themselves not by diluting their radical religion, but by portraying themselves as a loyal, apolitical, and feminine organization. An examination of the published attacks on and defenses of Shakerism between 1780 and 1819 suggests that the struggle over Shakerism centered more on loyalty than on theology.
The Political Other in Nineteenth-Century British North America: The Satire of Thomas Chandler Haliburton
Authors: Godeanu-Kenworthy Oana
Published: May 2009

In the first half of the nineteenth century, British North America was trying to find its way within the Empire and in North America. The American democratic and republican experiment offered the Canadian colonies an alternative that seemed both appealing and threatening. The Nova Scotian politician, historian, and satirist T. C. Haliburton articulated the fears of his time in a series of humorous sketches targeting a general audience and designed to spur a collective debate on the advantages and disadvantages of democracy. This article explores Haliburton’s political satire in parallel with the classic interpretation of democracy in America offered by Alexis de Tocqueville. Both authors wrote about American democracy at about the same time and related to the American model from without, being aware of the profound effect the new form of government could have on their own communities.
Are State Medicaid Application Enrollment Forms Readable?
Authors: Wilson Jocelyn M. , Wallace Lorraine S. , DeVoe Jennifer E.
Published: May 2009

We sought to assess readability and layout characteristics of state-issued Medicaid enrollment applications. We attempted to locate Internet-based Medicaid enrollment applications from each of the 50 states and the District of Columbia. Readability of each Medicaid enrollment application “Signature” page was calculated using McLaughlin’s Simplified Measure of Gobbledygoop formula, while layout characteristics were assessed utilizing criteria included in the User-Friendliness Tool. Readability of Medicaid enrollment application Signature pages ranged from 11th to 18th grade level (M±SD=15.5±1.5). Most (66%) applications did not use a recommended font size (≥12 point). None of the applications required little work to make them comply with good formatting standards according to the User-Friendliness Tool. Medicaid enrollment applications overall exhibit text font sizes below 12 point, crowded formatting, and excessively high reading demands. State health departments should revise their Medicaid enrollment applications to adhere to established low-literacy guidelines to improve understanding and comprehension by potential enrollees.
Developing a Disaster Preparedness Campaign Targeting Low-Income Latino Immigrants: Focus Group Results for Project PREP
Authors: Eisenman David P. , Glik Deborah , Maranon Richard , Gonzales Lupe , Asch Steven
Published: May 2009

Low-income immigrant Latinos are particularly vulnerable to disasters because they are both ill-prepared and disproportionately affected. Disaster preparedness programs that are culturally appropriate must be developed and tested. To develop such a program, we conducted 12 focus groups with low-income immigrant Latinos to understand their perceptions and understanding of disaster preparedness, and facilitators and obstacles to it. Participants were concerned about remaining calm during an earthquake. Obstacles to storage of disaster supplies in a kit and developing a family communication plan were mentioned frequently. Misunderstandings were voiced about the proper quantity of water to store and about communication plans. Several focus groups spontaneously suggested small group discussions ( platicas ) as a way to learn about disaster preparedness. They wanted specific help with building their family communication plans. They rated promotoras de salud highly as potential teachers. Results will guide the development of a disaster preparedness program tailored to the needs of low-income Latino immigrants.
Physical and Mental Health Status of Hurricane Katrina Evacuees in Houston in 2005 and 2006
Authors: Mortensen Karoline , Wilson Rick K. , Ho Vivian
Published: May 2009

Objectives . Hurricane Katrina necessitated the evacuation of over 200,000 individuals into Houston. This study compared characteristics of three samples of evacuees with those of the U.S. population and examined how evacuees’ experiences have changed over time.
Methods . Sub-populations of evacuees in Houston were surveyed immediately following the hurricane, two months afterwards, and one year later. Demographic characteristics, socioeconomic status, physical and mental health status, and access to care of the most disadvantaged evacuees in Houston were analyzed.
Results . Predominantly, evacuees surveyed were Black, low-income, unemployed, and facing challenges accessing health care. Twenty-eight percent felt their health was worse than it was before Katrina. Almost 60% of evacuees reported nervousness, restlessness, worthlessness, hopelessness, and spells of terror or panic at least a few times a week.
Conclusions . The evacuees displaced by the storm experienced loss of full-time employment, income, and deteriorating health, as well as struggles accessing necessary physical and mental health care.
Early Collaboration for Adaptation: Addressing Depression in Low-Income New Mothers
Authors: Pfefferle Susan G. , Cooper Ben , Layton Debbie , Rohrbach Sharon
Published: May 2009

This paper describes the development and implementation of a collaborative research project between a community agency and university-based researcher. The goal of the project was to address depression in low-income new mothers who would not ordinarily have access to mental health services.
Preventive Dental Service Utilization for Medicaid-Enrolled Children in New Hampshire: A Comparison of Care Provided by Pediatric Dentists and General Dentists
Authors: Chi Donald , Milgrom Peter
Published: May 2009

In this study, we compared preventive dental utilization through visits to a pediatric dentist (PD) vs. visits to a general dentist (GD) among Medicaid-enrolled children in New Hampshire (n = 12,964). Dental claims were analyzed using conditional logistic regression models. After adjusting for covariates, children seen by a PD were 51% more likely to have received fluoride treatment, 26% more likely to have had at least two dental examinations, and 19% more likely to have received a sealant than children seen by a GD. Overall, our results suggest that children seen by a PD were more likely to have received preventive services than those seen by a GD. Because Medicaid-enrolled children are at increased risk for poor oral health, policies should be enacted to ensure that high-risk children receive appropriate and regular prevention-oriented dental care.
Health Needs in Brooklyn’s Chinatown: A Pilot Assessment Using Rapid Participatory Appraisal
Authors: Thein Khin , Zaw Kyaw Thuya , Teng Rui-Er , Liang Celia , Julliard Kell
Published: May 2009

Background . The relatively new Chinatown of Brooklyn is medically underserved. A pilot assessment of the health needs of this community was conducted using Rapid Participatory Appraisal.
Methods . In-depth interviews with health professionals and community members plus searches of national, state, and local electronic health databases were conducted taking into account multiple determinants of health.
Results . Community organization, sociological factors, services, and policy were all partly responsible for unmet health needs, including the lack of an overall community structure related to health. Health concerns of all kinds were exacerbated by poverty, language barriers, immigration status, culture, and the need for acculturation. Significant health assets were present but were not adequate to address needs.
Discussion . While each health concern had its own unique identifiable causes, the interaction of these concerns and the limitations of assets at all levels make solutions difficult.