bluuebunny/crossref_metadata_2025 huggingface dataset:
Physical activity levels and determinants of change in young adults: a longitudinal panel study
Authors: Zimmermann-Sloutskis Dorith , Wanner Miriam , Zimmermann Erwin , Martin Brian W
Published: January 2010

Background

There is growing concern about physical inactivity in adolescents and young adults. Identifying determinants that are associated with low levels of physical activity and with changes in physical activity levels will help to develop specific prevention strategies. The present study describes the prevalence and potential determinants of physical activity behavior and behavior changes of young adults. The study is based on the Swiss Household Panel (SHP), a longitudinal study assessing social changes in a representative sample of Swiss households since 1999.

Methods

Data is collected yearly using computer-assisted telephone interviews. Information is obtained from each household member over 14 years of age. Participants between 14 and 24 years entering the SHP between 1999 and 2006 were included (N = 3,068). "Inactive" was defined as less than 1 day/week of at least 30 minutes of moderate physical activity, "no sport" as exercising less than once a week. Age, gender, nationality, linguistic region, household income, education, membership in a sport club, reading, and Internet use were included as potential determinants of physical activity behavior and behavior change.

Results

In both young men and young women, the prevalence of inactivity, "no sport", and non-membership in a sport club was increasing with age. Women were less active than men of the same age. From one wave to the following, 11.1% of young men and 12.1% of young women became active, and 11.9% of men and 13.7% of women became inactive, respectively (pooled data over all eight waves). Non-membership in a sport club was the strongest predictor for "no sport" (ORmen 6.7 [4.9-8.9]; ORwomen 8.1 [5.7-11.4]), but also for being inactive (OR 4.6 [3.5-6.0]; 4.6 [3.3-6.4]). Leaving a sport club (OR 7.8 [4.4-14.0]; 11.9 [5.9-24.1]) and remaining non-member (OR 7.8 [4.7-12.9]; 12.4 [6.4-24.1]) were the strongest predictors of becoming "no sport". Effects for becoming inactive were similar, though smaller (OR 5.9 [3.4-10.5] and 5.1 [2.7-9.6] for leaving a club, OR 5.1 [3.1-8.4] and 6.9 [4.0-11.8] for remaining non-member).

Conclusions

The most important findings were the strong effects of sport club membership on general physical activity. The correlation between sport club membership and exercise was not surprising in its nature, but in its strength.
Norepinephrine enhances the LPS-induced expression of COX-2 and secretion of PGE2 in primary rat microglia
Authors: Schlachetzki Johannes CM , Fiebich Bernd L , Haake Elisabeth , de Oliveira Antonio CP , Candelario-Jalil Eduardo , Heneka Michael T , Hüll Michael
Published: January 2010

Background

Recent studies suggest an important role for neurotransmitters as modulators of inflammation. Neuroinflammatory mediators such as cytokines and molecules of the arachidonic acid pathway are generated and released by microglia. The monoamine norepinephrine reduces the production of cytokines by activated microgliain vitro. However, little is known about the effects of norepinephrine on prostanoid synthesis. In the present study, we investigate the role of norepinephrine on cyclooxygenase- (COX-)2 expression/synthesis and prostaglandin (PG)E2production in rat primary microglia.

Results

Interestingly, norepinephrine increased COX-2 mRNA, but not protein expression. Norepinephrine strongly enhanced COX-2 expression and PGE2production induced by lipopolysaccharide (LPS). This effect is likely to be mediated by β-adrenoreceptors, since β-, but not α-adrenoreceptor agonists produced similar results. Furthermore, β-adrenoreceptor antagonists blocked the enhancement of COX-2 levels induced by norepinephrine and β-adrenoreceptor agonists.

Conclusions

Considering that PGE2displays different roles in neuroinflammatory and neurodegenerative disorders, norepinephrine may play an important function in the modulation of these processes in pathophysiological conditions.
Regulation of HIV-1 transcription in cells of the monocyte-macrophage lineage
Authors: Kilareski Evelyn M , Shah Sonia , Nonnemacher Michael R , Wigdahl Brian
Published: January 2010

Human immunodeficiency virus type 1 (HIV-1) has been shown to replicate productively in cells of the monocyte-macrophage lineage, although replication occurs to a lesser extent than in infected T cells. As cells of the monocyte-macrophage lineage become differentiated and activated and subsequently travel to a variety of end organs, they become a source of infectious virus and secreted viral proteins and cellular products that likely initiate pathological consequences in a number of organ systems. During this process, alterations in a number of signaling pathways, including the level and functional properties of many cellular transcription factors, alter the course of HIV-1 long terminal repeat (LTR)-directed gene expression. This process ultimately results in events that contribute to the pathogenesis of HIV-1 infection. First, increased transcription leads to the upregulation of infectious virus production, and the increased production of viral proteins (gp120, Tat, Nef, and Vpr), which have additional activities as extracellular proteins. Increased viral production and the presence of toxic proteins lead to enhanced deregulation of cellular functions increasing the production of toxic cellular proteins and metabolites and the resulting organ-specific pathologic consequences such as neuroAIDS. This article reviews the structural and functional features of the cis-acting elements upstream and downstream of the transcriptional start site in the retroviral LTR. It also includes a discussion of the regulation of the retroviral LTR in the monocyte-macrophage lineage during virus infection of the bone marrow, the peripheral blood, the lymphoid tissues, and end organs such as the brain. The impact of genetic variation on LTR-directed transcription during the course of retrovirus disease is also reviewed.
Human interphase chromosomes: a review of available molecular cytogenetic technologies
Authors: Vorsanova Svetlana G , Yurov Yuri B , Iourov Ivan Y
Published: January 2010

Human karyotype is usually studied by classical cytogenetic (banding) techniques. To perform it, one has to obtain metaphase chromosomes of mitotic cells. This leads to the impossibility of analyzing all the cell types, to moderate cell scoring, and to the extrapolation of cytogenetic data retrieved from a couple of tens of mitotic cells to the whole organism, suggesting that all the remaining cells possess these genomes. However, this is far from being the case inasmuch as chromosome abnormalities can occur in any cell along ontogeny. Since somatic cells of eukaryotes are more likely to be in interphase, the solution of the problem concerning studying postmitotic cells and larger cell populations is interphase cytogenetics, which has become more or less applicable for specific biomedical tasks due to achievements in molecular cytogenetics (i.e. developments of fluorescence in situ hybridization -- FISH, and multicolor banding -- MCB). Numerous interphase molecular cytogenetic approaches are restricted to studying specific genomic loci (regions) being, however, useful for identification of chromosome abnormalities (aneuploidy, polyploidy, deletions, inversions, duplications, translocations). Moreover, these techniques are the unique possibility to establish biological role and patterns of nuclear genome organization at suprachromosomal level in a given cell. Here, it is to note that this issue is incompletely worked out due to technical limitations. Nonetheless, a number of state-of-the-art molecular cytogenetic techniques (i.e multicolor interphase FISH or interpahase chromosome-specific MCB) allow visualization of interphase chromosomes in their integrity at molecular resolutions. Thus, regardless numerous difficulties encountered during studying human interphase chromosomes, molecular cytogenetics does provide for high-resolution single-cell analysis of genome organization, structure and behavior at all stages of cell cycle.
Chicken blood provides a suitable meal for the sand fly Lutzomyia longipalpis and does not inhibit Leishmania development in the gut
Authors: Sant'Anna Mauricio RV , Nascimento Alexandre , Alexander Bruce , Dilger Erin , Cavalcante Reginaldo R , Diaz-Albiter Hector M , Bates Paul A , Dillon Rod J
Published: January 2010

Background

The aim of this study was to address the role of chickens as bloodmeal sources for female Lutzomyia longipalpis and to test whether chicken blood is harmful to Leishmania parasite development within the sand flies. Bloodmeal ingestion, excretion of urate, reproduction, fecundity, as well as Leishmania infection and development were compared in sand flies fed on blood from chickens and different mammalian sources.

Results

Large differences in haemoglobin and protein concentrations in whole blood (dog>human>rabbit> chicken) did not correlate with differences in bloodmeal protein concentrations (dog = chicken>human>rabbit). This indicated that Lu. longipalpis were able to concentrate bloodmeals taken from different hosts using prediuresis and this was confirmed by direct observation. Sand flies fed on chickens or dogs produced significantly more eggs than those fed on human blood. Female Lu. longipalpis retained significantly more urate inside their bodies when fed on chicken blood compared to those fed on rabbit blood. However, when the amounts of urate excreted after feeding were measured, sand flies fed on rabbit blood excreted significantly more than those fed on chicken blood. There was no difference in female longevity after feeding on avian or mammalian blood.

Sand flies infected via chicken blood produced Leishmania mexicana infections with a similar developmental pattern but higher overall parasite populations than sand flies infected via rabbit blood.

Conclusions

The results of this study help to define the role that chickens play in the epidemiology of leishmaniasis. The present study using a Lu. longipalpis/L. mexicana model indicates that chickens are suitable hosts to support a Lu. longipalpis population and that chicken blood is likely to support the development of transmissible Leishmania infections in Lu. longipalpis.
Deep wound infection after a trochanteric fracture internal fixation presenting with hip dislocation: a case report
Authors: Tzurbakis Matheus , Morakis Emmanouil , Mouzopoulos Georgios , Lasanianos Nikolaos , Georgilas Ioannis
Published: January 2010

We report a rare case of posterior hip dislocation after a low energy trauma. The patient sustained a trochanteric fracture in the same hip six months ago, which was fixed using a sliding hip screw and had healed. At surgery a deep wound infection was found and a methicillin-resistant Staphylococcus epidermidis (MRSE) was cultured. After thorough debridement, an excisional arthroplasty was decided. The patient received specific intravenous antibiotics and after six weeks a total hip arthroplasty was done. In three years follow-up the patients presented with a fully functional hip without any signs of infection. Hip dislocation after a trochanteric fracture internal fixation is rare complication associated with high morbidity and mortality. Infection eradication and a second stage arthroplasty can be life and limb saving.
Patient presenting with lipoma of the index finger: a case report
Authors: Chronopoulos Efstathios , Ptohis Nikolaos , Karanikas Christos , Kalliakmanis Alkis , Plessas Spyros , Neofytou Ioannis , Laspas Fotios , Tzovara Ioanna , Chalazonitis Athanasios
Published: January 2010

Introduction

Lipomas can be found anywhere in the body with the majority located in the head and neck region as well as in the shoulder and back. They are not very common in the hand and those involving the fingers are very rare. Although, it is not the only case reported, lipoma of the index finger is very uncommon.

Case presentation

A 52-year-old Caucasian man presented with a lipoma of the right index finger. He complained of no pain but he had difficulty in manual movements. Treatment was surgical excision of the lipoma. There has been no recurrence for two years.

Conclusion

Although lipomas of the fingers are rare entities, their awareness is imperative since the differential diagnosis from other soft tissue tumors and from the special lipomatous subtype involved is quite extensive.
Highly active antiretroviral treatment for the prevention of HIV transmission
Authors: Granich Reuben , Crowley Siobhan , Vitoria Marco , Lo Ying‐Ru , Souteyrand Yves , Dye Christopher , Gilks Charlie , Guerma Teguest , De Cock Kevin M , Williams Brian
Published: January 2010

In 2007 an estimated 33 million people were living with HIV; 67% resided in sub‐Saharan Africa, with 35% in eight countries alone. In 2007, there were about 1.4 million HIV‐positive tuberculosis cases. Globally, approximately 4 million people had been given highly active antiretroviral therapy (HAART) by the end of 2008, but in 2007, an estimated 6.7 million were still in need of HAART and 2.7 million more became infected with HIV.

Although there has been unprecedented investment in confronting HIV/AIDS ‐ the Joint United Nations Programme on HIV/AIDS estimates $13.8 billion was spent in 2008 ‐ a key challenge is how to address the HIV/AIDS epidemic given limited and potentially shrinking resources. Economic disparities may further exacerbate human rights issues and widen the increasingly divergent approaches to HIV prevention, care and treatment.

HIV transmission only occurs from people with HIV, and viral load is the single greatest risk factor for all modes of transmission. HAART can lower viral load to nearly undetectable levels. Prevention of mother to child transmission offers proof of the concept of HAART interrupting transmission, and observational studies and previous modelling work support using HAART for prevention. Although knowing one's HIV status is key for prevention efforts, it is not known with certainty when to start HAART.

Building on previous modelling work, we used an HIV/AIDS epidemic of South African intensity to explore the impact of testing all adults annually and starting persons on HAART immediately after they are diagnosed as HIV positive. This theoretical strategy would reduce annual HIV incidence and mortality to less than one case per 1000 people within 10 years and it would reduce the prevalence of HIV to less than 1% within 50 years. To explore HAART as a prevention strategy, we recommend further discussions to explore human rights and ethical considerations, clarify research priorities and review feasibility and acceptability issues.
Substitutions in the Reverse Transcriptase and Protease Genes of HIV‐1 Subtype B in Untreated Individuals and Patients Treated With Antiretroviral Drugs
Authors: Turner Dan , Brenner Bluma , Moisi Daniela , Liang Chen , Wainberg Mark A
Published: January 2010

The nucleotide transition G→A is known as a hypermutation due to its high prevalence in HIV‐1 and other pathogens. However, the contribution of the G→A transition in the generation of drug resistance mutations is unknown. Our objective was to ascertain the rate of nucleotide substitutions in protease (PR) and reverse transcriptase (RT) in both untreated and treated HIV‐1 patients. Genotypic analysis was performed on viruses from both treated and untreated patients with subtype B infections. Nucleotide genomic diversity was compared with a consensus subtype B reference virus. Then, the prevalence of resistance‐associated mutations in different subgroups of treated patients was evaluated in relation to the patterns of nucleotide transitions. In untreated patients (n = 50) G→A was most prevalent, followed by A→G, C→T, and T→C transitions. In treated patients (n = 51), the prevalence of A→G was similar to that of G→A. Among mutations that confer resistance to antiretroviral drugs, M184V was present in 76% of treated patients and K70R in 31% (A→G transitions). Other frequent mutations in RT included T215Y (C→A and A→T substitutions), which was prevalent in 31% of treated patients. In PR, a L90M (T→A substitution) was prevalent in 47% of protease inhibitor (PI)‐treated patients. In conclusion, the G→A transition was most prevalent in RT and PR among untreated patients. In contrast, A→G was the most prevalent transition in patients treated with antiretroviral drugs.
Protective effect of resin adsorption on septic plasma-induced tubular injury
Authors: Cantaluppi Vincenzo , Weber Viktoria , Lauritano Carola , Figliolini Federico , Beltramo Silvia , Biancone Luigi , De Cal Massimo , Cruz Dinna , Ronco Claudio , Segoloni Giuseppe Paolo , Tetta Ciro , Camussi Giovanni
Published: January 2010

Introduction

A pro-apoptotic effect of circulating mediators on renal tubular epithelial cells has been involved in the pathogenesis of sepsis-associated acute kidney injury (AKI). Adsorption techniques have been showed to efficiently remove inflammatory cytokines from plasma. The aim of this study was to evaluate the efficiency of the hydrophobic resin Amberchrom CG161 M to adsorb from septic plasma soluble mediators involved in tubular injury.

Methods

We enrolled in the study 10 critically ill patients with sepsis-associated AKI and we evaluated the effects of their plasma on granulocyte adhesion, apoptosis and functional alterations of cultured human kidney tubular epithelial cells. We established an in vitro model of plasma adsorption and we studied the protective effect of unselective removal of soluble mediators by the Amberchrom CG161 M resin on septic plasma-induced tubular cell injury.

Results

Plasma from septic patients induced granulocyte adhesion, apoptosis and altered polarity in tubular cells. Plasma adsorption significantly decreased these effects and abated the concentrations of several soluble mediators. The inhibition of granulocyte adhesion to tubular cells was associated with the down-regulation of ICAM-1 and CD40. Resin adsorption inhibited tubular cell apoptosis induced by septic plasma by down-regulating the activation of caspase-3, 8, 9 and of Fas/death receptor-mediated signalling pathways. The alteration of cell polarity, morphogenesis, protein reabsorption and the down-regulation of the tight junction molecule ZO-1, of the sodium transporter NHE3, of the glucose transporter GLUT-2 and of the endocytic receptor megalin all induced by septic plasma were significantly reduced by resin adsorption.

Conclusions

Septic plasma induced a direct injury of tubular cells by favouring granulocyte adhesion, by inducing cell apoptosis and by altering cell polarity and function. All these biological effects are related to the presence of circulating inflammatory mediators that can be efficiently removed by resin adsorption with a consequent limitation of tubular cell injury.
Communicating the Results of Randomized Clinical Trials: Do Patients Understand Multidimensional Patient-Reported Outcomes?
Authors: McNair Angus G.K. , Brookes Sara T. , Davis Christopher R. , Argyropoulos Miltiadis , Blazeby Jane M.
Published: January 2010

Purpose

Evidence suggests that patient-reported outcomes (PROs) from randomized trials in oncology may not influence clinical decision making and patient choice. Reasons for this are currently unclear and little is known about patients' interpretation of PROs. This study assessed patients' understanding of multidimensional PROs in a graphical format.

Patients and Methods

Semistructured interviews in which patients interpreted a series of graphs depicting simple, then multiple different hypothetical PROs associated with two treatments with identical chances of survival were audio recorded. The interviewer and a blinded observer (listening to audio recordings) scored patients' understanding of the graphs. Logistic regression examined the associations between patient understanding of the graphs and clinical and sociodemographic details.

Results

One hundred thirty-two patients with esophageal and gastric cancer were interviewed and 115 understood the first two graphs depicting different PROs of two treatments (87%; 95% CI,81 to 93). Simultaneous interpretation of adverse and beneficial treatment effects was achieved by 74 (66%; 95% CI, 57 to 75). Graphs showing complex, longitudinal data were correctly interpreted by 97 (73%; 95% CI, 66 to 81) and 108 (81%; 95% CI, 75 to 88), respectively. Univariable analyses demonstrated associations between patient understanding and patient age, educational level, and cancer site (P ≤ .02 for all); however, in a multivariable model each of these associations was attenuated.

Conclusion

Most patients understand graphical multidimensional PROs, although a smaller majority were able to interpret more complex, or simultaneous, presentations. Additional work is needed to define methods for communicating clinical and PRO data from trials to allow patients to make informed treatment choices.
Prevention of Aromatase Inhibitor–Induced Bone Loss Using Risedronate: The SABRE Trial
Authors: Van Poznak Catherine , Hannon Rosemary A. , Mackey John R. , Campone Mario , Apffelstaedt Justus P. , Clack Glen , Barlow David , Makris Andreas , Eastell Richard
Published: January 2010

Purpose

To investigate the management of bone health in women with early breast cancer (EBC) who were scheduled to receive anastrozole.

Patients and Methods

Postmenopausal women with hormone receptor–positive EBC were assigned to one of three strata by risk of fragility fracture. Patients with the highest risk (H) received anastrozole 1 mg/d plus risedronate 35 mg/wk orally. Patients with moderate-risk (M) were randomly assigned in a double-blind manner to anastrozole and risedronate (A + R) or to anastrozole and placebo (A + P). Patients with lower-risk (L) received anastrozole (A) alone. Calcium and vitamin D were recommended for all patients. Lumbar spine and total hip bone mineral density (BMD) were assessed at baseline, 12 months, and 24 months.

Results

At 24 months, in the M group, treatment with A + R resulted in a significant increase in lumbar spine and total hip BMD compared with A + P treatment (2.2% v −1.8%; treatment ratio, 1.04; P < .0001; and 1.8% v −1.1%; treatment ratio, 1.03; P < .0001, respectively). In the H stratum, lumbar spine and total hip BMD increased significantly (3.0%; P = .0006; and 2.0%; P = .0104, respectively). Patients in the L stratum showed a significant decrease in lumbar spine BMD (−2.1%; P = .0109) and a numerical decrease in total hip BMD (−0.4%; P = .5988). Safety profiles for anastrozole and risedronate were similar to those already established.

Conclusion

In postmenopausal women at risk of fragility fracture who were receiving adjuvant anastrozole for EBC, the addition of risedronate at doses established for preventing and treating osteoporosis resulted in favorable effects in BMD during 24 months.
Fluid balance chart: do we understand it?
Authors: Tang Vincent CY , Lee Elaine WY
Published: January 2010

Introduction

The fluid balance chart is used as a non-invasive tool to assess the surgical patient's hydration status. Surgical trainees prescribe fluids on a daily basis, an essential part of patient fluid management. A good understanding of these charts is important, as inaccurate interpretation can have a detrimental effect on patient outcome. Therefore, we asked the question: can surgical trainees interpret and calculate fluid balance charts correctly?

Method

We prospectively asked 25 surgical trainees including 12 at Specialty Training (ST) level and 13 at Foundation Year (FY) level, to calculate the total input and output of 13 fluid balance charts, and rate how difficult these charts were to interpret.

Results

Clinical experience does not appear to influence the correct calculation of the total input and output values of the fluid balance charts. However, out of the 13 charts, there is a statistically significant difference from the original documented values in eight of the ST group and nine of the FY group for the total input values, and three of the ST group and four of the FY group for the total output values, with some by a large magnitude.

Conclusion

This study shows alarming results with cause for concern where there is a huge variation in surgical trainee calculated and original documented values, as well as variations between trainees irrespective of training grades, which is a potential risk management issue. It highlights that inaccurate interpretation of these charts are not due to lack of clinical experience, but the fundamental problem lies within the lack of education and inconsistent poor documentation of these charts.
Areca Cessation and Dentists in Harrow (North London)
Authors: Nathan Kathryn A
Published: January 2010

Aim

To assess dentists’ awareness and provision of areca cessation counselling to patients in general dental practices in Harrow (North London) in 2007.

Methods

In this cross-sectional study, questionnaires with specific questions and a space for free comments were sent to all 150 general dentists in the Primary Care Trust NHS Harrow area on 1st June 2007. The questionnaires had been piloted and the study was given ethical approval by Harrow Research Ethics Committee. Completed questionnaires were assessed to determine dentists’ provision of areca cessation counselling to dental patients. Free comments were assessed for content and meaning.

Results

A response rate of 57% (83/150 dentists) was obtained. Dentists were nearly twice as likely to neglect to provide patients with areca cessation counselling (32.5%) than to neglect to provide tobacco cessation counselling (16.9%). Dentists’ comments revealed a lack of awareness and the materials and support needed to counsel patients in areca cessation.

Conclusions

The majority of dentists who took part in this study require increased training, support and materials to facilitate awareness of areca nut use in the community and cessation counselling for patients.
Unexplained Toothache: An Evidence-Based Approach to Diagnosis and Management
Authors: Aggarwal Vishal R
Published: January 2010

This ‘in my opinion’ paper uses two case studies to highlight the importance of making an early diagnosis of unexplained orofacial pain. Patients with this condition can present with symptoms that can easily be confused with more common dental pain that is related to an organic pathology. An incorrect diagnosis can lead to invasive and irreversible treatment using advanced surgical or restorative techniques that are not evidence-based. Current evidence supports the use of non-invasive techniques such as behavioural interventions; for example, cognitive behaviour therapy. It is therefore imperative that patients with this condition are recognised early in primary care so that management is appropriate from the outset. This will prevent unnecessary invasive intervention, protecting the patient from harm and the practitioner from litigation.
A Study of Patient Attitudes towards Fasting Prior to Intravenous Sedation for Dental Treatment in a Dental Hospital Department
Authors: McKenna Gerald , Manton Sarah , Neilson Avril
Published: January 2010

Introduction

Intravenous sedation is the most commonly used method of sedation for the provision of adult dental care. However, disparity exists in pre-operative fasting times in use for patients throughout the United Kingdom.

Aims

The aims of the study were to obtain information on the effects of existing extended pre-operative fasting regimens, to canvas patient opinions on the fasting process, and to record their positive and negative experiences associated with it.

Methods

A prospective cross-sectional descriptive study using survey methodology was conducted of adult patients attending a dental hospital for operative treatment under intravenous sedation. Sixty-four questionnaires were distributed over a four-month period, beginning 2nd October 2007.

Results

The surveyed patient pool consisted of 38 females and 14 males with a mean age of 32.4 years. The response rate achieved was 81.2%. Seventy-one per cent of patients indicated that normally they consumed something for breakfast, the most common items being tea and toast. Fifty-one per cent of patients indicated that they would wish to eat the same as normal prior to their appointment and 59% wished to drink as normal. Only 19% of respondents reported that they did not wish to eat anything, with 8% preferring not to drink anything at all. Seventy-nine per cent of the patients reported that they had experienced at least one adverse symptom after fasting and 42% had experienced two or more such symptoms. In general, those patients with more experience of sedation found fasting less unpleasant than those attending for the first time ( P<0.05). In addition, one-quarter of all patients indicated that the fasting process had made them feel more nervous about their sedation appointment.

Conclusions

The extended fasting regimen prior to intravenous sedation appeared to affect patients’ wellbeing, as the majority reported adverse symptoms.
NHS Dentistry: Modern and Dependable?
Authors: Eaton Kenneth A
Published: January 2010

Report of a joint Faculty of General Dental Practice (UK) Lay Advisory Group/Research Seminar held at The Royal College of Surgeons of England on 15th September 2009
Habitat use and spatial organisation of relocated black rhinos in Namibia
Authors: Göttert Thomas , Schöne Joachim , Zinner Dietmar , Hodges John Keith , Böer Michael
Published: January 2010

In this study we systematically examined species-specific exploration behaviour and behavioural acclimatisation of a black rhino Diceros bicornis founder group post-translocation. The study was carried out in a fenced region, approximately 350 km2 in size and directly adjacent to Etosha National Park in Namibia. Rhinos were radio-tracked and movement data were complemented by detailed habitat descriptions at the centres of rhino activity with vegetation plot sampling. Rhinos used both geological formations of the study area: Otavi dolomite and Etosha calcrete substrate. The latter was dominated by Acacia spp. due to former land use for livestock farming. The size of total and seasonal home ranges and core areas, as well as home range establishment patterns and habitat use, are highly variable among individual rhinos. Home ranges of most individuals from our study are among the largest recorded for the species. We found age class specific patterns of home range establishment, typical mating and social behaviour, seasonal changes of home range and core area size, and clear shifts in spatial behaviour over time. The results provide our best estimate to date for the natural exploration behaviour and behavioural acclimatisation of black rhinos in a semi-arid savannah ecosystem.
Interpretation of Resistivity Piezocone Tests in a Contaminated Municipal Solid Waste Disposal Site
Authors: Mondelli Giulliana , Giacheti Heraldo Luiz , Howie John A.
Published: January 2010

A resistivity piezocone (RCPTU–resistivity cone penetration test with pore pressure measurement) and groundwater and soil samplers were used to detect contamination from a landfill for urban solid waste located in the state of São Paulo in southeastern Brazil. Background resistivity values were obtained in the laboratory using undisturbed soil samples. The strong influence of clay minerals common in tropical soils made it difficult to interpret the tests and to differentiate potentially contaminated zones from changes in soil type. A local correlation between fines content and the soil behavior index (Ic) of the various collected soils allowed the RCPTU tests to be interpreted to identify the contaminated regions of the aquifer. These results showed excellent repeatability and allowed for a detailed stratigraphic analysis of the highly heterogeneous profiles. Electrical resistivity measurements have proven to be an interesting resource to help detect contaminated soils, thus improving the quality and efficiency of geoenvironmental site investigations using integrated direct and indirect techniques. The interpretation of resistivity piezocone tests for the study site is not straightforward as it is in sedimentary sands since soil genesis affects soil behavior and soil and water sampling is required to support interpretation.
The Fission Yeast Rad32(Mre11)–Rad50–Nbs1 Complex Acts Both Upstream and Downstream of Checkpoint Signaling in the S-Phase DNA Damage Checkpoint
Authors: Willis Nicholas , Rhind Nicholas
Published: January 2010

The Mre11–Rad50–Nbs1 (MRN) heterotrimer plays various and complex roles in DNA damage repair and checkpoint signaling. Its role in activating Ataxia-Telangiectasia Mutated (ATM), the central checkpoint kinase in the metazoan double-strand break response, has been well studied. However, its function in the checkpoint independent of ATM activation, as well as functions that are completely checkpoint independent, are less well understood. In fission yeast, DNA damage checkpoint signaling requires Rad3, the homolog of the ATR (ATM and Rad3-related) kinase, not Tel1, the ATM homolog, allowing us to dissect MRN's ATM-independent S-phase DNA damage checkpoint roles from its role in ATM activation. We find that MRN is involved in Rad3 (ATR)-dependent checkpoint signaling in S phase, but not G2, suggesting that MRN is involved in ATR activation through its role in replication fork metabolism. In addition, we define a role for MRN in the S-phase DNA damage checkpoint-dependent slowing of replication that is independent of its role in checkpoint signaling. Genetic interactions between MRN and Rhp51, the fission yeast Rad51 homolog, lead us to suggest that MRN participates in checkpoint-dependent replication slowing through negative regulation of recombination.
Convergently Recruited Nuclear Transport Retrogenes Are Male Biased in Expression and Evolving Under Positive Selection in Drosophila
Authors: Tracy Charles , Río Javier , Motiwale Mansi , Christensen Shawn M , Betrán Esther
Published: January 2010

The analyses of gene duplications by retroposition have revealed an excess of male-biased duplicates generated from X chromosome to autosomes in flies and mammals. Investigating these genes is of primary importance in understanding sexual dimorphism and genome evolution. In a particular instance in Drosophila, X-linked nuclear transport genes (Ntf-2 and ran) have given rise to autosomal retroposed copies three independent times (along the lineages leading to Drosophila melanogaster, D. ananassae, and D. grimshawi). Here we explore in further detail the expression and the mode of evolution of these Drosophila Ntf-2- and ran-derived retrogenes. Five of the six retrogenes show male-biased expression. The ran-like gene of D. melanogaster and D. simulans has undergone recurrent positive selection. Similarly, in D. ananassae and D. atripex, the Ntf-2 and ran retrogenes show evidence of past positive selection. The data suggest that strong selection is acting on the origin and evolution of these retrogenes. Avoiding male meiotic X inactivation, increasing level of expression of X-linked genes in male testes, and/or sexual antagonism might explain the recurrent duplication of retrogenes from X to autosomes. Interestingly, the ran-like in D. yakuba has mostly pseudogenized alleles. Disablement of the ran-like gene in D. yakuba indicates turnover of these duplicates. We discuss the possibility that Dntf-2r and ran-like might be involved in genomic conflicts during spermatogenesis.
Patient-to-Nurse Ratios and Outcomes of Moderately Preterm Infants
Authors: Profit Jochen , Petersen Laura A. , McCormick Marie C. , Escobar Gabriel J. , Coleman-Phox Kim , Zheng Zheng , Pietz Kenneth , Zupancic John A. F.
Published: January 2010

OBJECTIVE:

Moderately preterm infants (30–3467 weeks' gestational age) represent the largest population of NICU residents. Whether their clinical outcomes are associated with differences in NICU nurse-staffing arrangements has not been assessed. The objective of this study was to test the influence of patient-to-nurse ratios (PNRs) on outcomes of care provided to moderately preterm infants.

PATIENTS AND METHODS:

Using data from a prospective, multicenter, observational cohort study of 850 moderately preterm infants from 10 NICUs in California and Massachusetts, we tested for associations between PNR and several important clinical outcomes by using multivariate random-effects models. To correct for the influence of NICU size, we dichotomized the sample into those with an average daily census of <20 or ≥20 infants.

RESULTS:

Overall, we found few clinically significant associations between PNR and clinical outcomes of care. Mean PNRs were higher in large compared with small NICUs (2.7 vs 2.1; P < .001). In bivariate analyses, an increase in PNR was associated with a slightly higher daily weight gain (5 g/day), greater gestational age at discharge, any intraventricular hemorrhage, and severe retinopathy of prematurity. After controlling for case mix, NICU size, and site of care, an additional patient per nurse was associated with a decrease in daily weight gain by 24%. Other variables were no longer independently associated with PNR.

CONCLUSIONS:

In this population of moderately preterm infants, the PNR was associated with a decrease in daily weight gain, but was not associated with other measures of quality. In contrast with findings in the adult intensive care literature, measured clinical outcomes were similar across the range of nurse-staffing arrangements among participating NICUs. We conclude that the PNR is not useful for profiling hospitals' quality of care delivery to moderately preterm infants.
Improved Detection of Developmental Delays Among Young Children in Foster Care
Authors: Jee Sandra H. , Szilagyi Moira , Ovenshire Claire , Norton Amy , Conn Anne-Marie , Blumkin Aaron , Szilagyi Peter G.
Published: January 2010

OBJECTIVE:

Our goal was to determine if systematic use of a validated developmental screening instrument is feasible and improves the detection of developmental delay (DD) in a pediatric medical home for children in foster care.

DESIGN AND METHODS:

This study had a pre-post study design, following a practice intervention to screen all children in foster care for DD by using the Ages and Stages Questionnaire (ASQ). The baseline detection rate was determined by medical chart review for all children aged 4 to 61 months who were new to foster care (NFC) during a 2-year period. After implementation of systematic screening, caregivers of young children who were NFC or already in foster care (IFC) completed the ASQ at preventive health care visits. We assessed the feasibility of systematic screening (the percentage of ASQs completed among the NFC and IFC groups). We compared the detection of DD among the baseline NFC group and the screening-NFC group by using bivariate and multivariable logistic regression.

RESULTS:

Of 261 visits that occurred after initiation of screening, 251 (96%) visits had a completed ASQ form in the medical chart, demonstrating high feasibility. Among children who were NFC, the detection of DD was higher in the screening than baseline period for the entire population (58% vs 29%; P < .001), for each age group (infants: 37% vs 14%; toddlers: 89% vs 42%; preschool: 82% vs 44%; all P ≤ .01), and for all developmental domains. On adjusted analyses, the detection of potential DD in toddler and preschool children was higher among the NFC screening group than the NFC baseline group.

CONCLUSION:

Systematic screening for DD using the ASQ was feasible and seemed to double the detection of DDs.
Relative Benefits of Population-Level Interventions Targeting Restraint-Use in Child Car Passengers
Authors: Du Wei , Finch Caroline F. , Hayen Andrew , Bilston Lynne , Brown Julie , Hatfield Julie
Published: January 2010

OBJECTIVES:

Because public health resources for injury prevention are limited, methods for comparing competing strategies are needed. We aimed to estimate potential injury reductions for 4 population-level interventions that target restraint practices for child car passengers aged 0 to 12 years.

METHODS:

Population-attributable risk fraction (PARF) is a population-level estimate of excess risk from exposure to a risk factor. PARFs were calculated for each intervention scenario by using published age-specific mortality/injury relative-risk estimates; restraint practices among injured child car passengers from police-collected data; and observational data for correctness of restraint use in New South Wales, Australia. PARF reductions were estimated for population uptakes of 25%, 50%, and 75%.

RESULTS:

Assuming a 50% population uptake, (1) promoting age-appropriate restraint use could prevent additional fatalities (5.1%, infants; 3.4%, 1- to 6-year-olds) and nonfatal injuries (3.2%, infants; 16.2%, 1- to 6-year-olds) compared with promoting any restraint use; (2) further encouraging correct age-appropriate restraint use could also prevent additional fatalities (9.1%, infants; 14.3%, 1- to 6-year-olds) and nonfatal injuries (9.2%, infants; 10.7%, 1- to 6-year-olds); and (3) for children aged 7 to 12 years, promoting correct use of restraints could prevent an additional 3.4% fatalities and 3.1% nonfatal injuries compared with promoting any restraint use.

CONCLUSIONS:

Interventions that target child passenger-restraint practices offer population-level benefits in terms of reduction in fatalities and injuries. These tangible benefits call for action internationally, not only to promote restraint use but correct age-appropriate restraint use for child car passengers.
Injury-Prevention Practices as Depicted in G- and PG-Rated Movies, 2003–2007
Authors: Tongren Jon Eric , Sites Anne , Zwicker Katharyn , Pelletier Andrew
Published: January 2010

OBJECTIVE:

Our goal was to determine if the depiction of injury-prevention practices in children's movies is different from what was reported from 2 earlier studies, which showed infrequent depiction of characters practicing recommended safety behaviors.

METHODS:

The top-grossing 25 domestic G-rated (general audience) and PG-rated (parental guidance suggested) movies per year for 2003–2007 were included in this study. Movies or scenes were excluded if they were animated, not set in the present day, fantasy, documentary, or not in English. Injury-prevention practices involving motor vehicles, pedestrians, boaters, and bicyclists were recorded for characters with speaking roles.

RESULTS:

Sixty-seven (54%) of 125 movies met the inclusion criteria for this study. A total of 958 person-scenes were examined: 524 (55%) depicted children and 434 (45%) adults. Twenty-two person-scenes involved crashes or falls, resulting in 3 injuries and no deaths. Overall, 311 (56%) of 555 motor-vehicle passengers were belted; 73 (35%) of 211 pedestrians used crosswalks; 60 (75%) of 80 boaters wore personal flotation devices; and 8 (25%) of 32 bicyclists wore helmets. In comparison with previous studies, usage of safety belts, crosswalks, personal flotation devices, and bicycle helmets increased significantly.

CONCLUSIONS:

The entertainment industry has improved the depiction of selected safety practices in G- and PG-rated movies. However, approximately one half of scenes still depict unsafe practices, and the consequences of these behaviors are rarely shown. The industry should continue to improve how it depicts safety practices in children's movies. Parents should highlight the depiction of unsafe behaviors and educate children in following safe practices.
Modeling and Simulation of Ethylene and 1-Butene Copolymerization in Solution with a Ziegler-Natta Catalyst
Authors: Pontes Karen Valverde , Cavalcanti Marcelo , Maciel Filho Rubens , Embiruçu Marcelo
Published: January 2010

A comprehensive mathematical model for the ethylene/1-butene polymerization in solution with Ziegler-Natta catalyst is developed. The process comprises a series of continuously stirred and tubular reactors in which polyethylene resins with different properties may be produced. The mechanistic model considers the moments of the bivariant molecular weight distribution in order to ascertain the average molecular weight and polydispersity. The polymer quality is verified through the melt index, density and stress exponent, which is a measure of the polydispersity. The model developed investigates the stationary and dynamic behavior of the process following step changes in feed conditions. It allows for the prediction of non-linear and inverse responses, encouraging the use of the model for optimization and control purposes.
ATLANTIC DIP: The Impact of Obesity on Pregnancy Outcome in Glucose-Tolerant Women
Authors: Owens Lisa A. , O'Sullivan Eoin P. , Kirwan Breeda , Avalos Gloria , Gaffney Geraldine , Dunne Fidelma ,   for the ATLANTIC DIP Collaborators
Published: January 2010

OBJECTIVE

A prospective study of the impact of obesity on pregnancy outcome in glucose-tolerant women.

RESEARCH DESIGN AND METHODS

The Irish Atlantic Diabetes in Pregnancy network advocates universal screening for gestational diabetes. Women with normoglycemia and a recorded booking BMI were included. Maternal and infant outcomes correlated with booking BMI are reported.

RESULTS

A total of 2,329 women fulfilled the criteria. Caesarean deliveries increased in overweight (OW) (odds ratio 1.57 [95% CI 1.24–1.98]) and obese (OB) (2.65 [2.03–3.46]) women. Hypertensive disorders increased in OW (2.30 [1.55–3.40]) and OB (3.29 [2.14–5.05]) women. Reported miscarriages increased in OB (1.4 [1.11–1.77]) women. Mean birth weight was 3.46 kg in normal BMI (NBMI), 3.54 kg in OW, and 3.62 kg in OB (P < 0.01) mothers. Macrosomia occurred in 15.5, 21.4, and 27.8% of babies of NBMI, OW, and OB mothers, respectively (P < 0.01). Shoulder dystocia occur in 4% (>4 kg) compared with 0.2% (<4 kg) babies (P < 0.01). Congenital malformation risk increased for OB (2.47 [1.09–5.60]) women.

CONCLUSIONS

OW and OB glucose-tolerant women have greater adverse pregnancy outcomes.
Incidence and Outcome of Operatively Treated Achilles Tendon Rupture in the Elderly
Authors: Čretnik Andrej , KošKir Roman , Kosanović Miloš
Published: January 2010

Background: Very little has been published about Achilles tendon rupture in the elderly. Optimal therapy is controversial with conservative treatment generally recommended. The purpose of our study was to find the incidence and outcome of operatively treated Achilles tendon ruptures in the elderly. Materials and Methods: We determined the incidence of a closed complete Achilles tendon rupture in a period from 1991 to 2000 in two centers caring for 572,929 people with 108,668 people over 60 years of age. Results: In a 10-year period there were 434 ruptures, all of which were treated operatively: 146 in an open fashion and 288 percutaneously. The average incidence was 7.6 ruptures per 100,000 people. The average age of patients was 38.7 years, with a male-to-female ratio of 16.7:1. There were 14 ruptures in 13 patients older than 60 years, with the incidence of 1.28 ruptures per 100,000 people. Seven of the ruptures were operated on in an open way under spinal anesthesia and seven percutaneously under local anesthesia. The average age of the patients was 67.9 years, with a male-to-female ratio of 1.6:1 and the mean ASA score 1.64. There were no major complications in either group. One patient in the percutaneous group had transient sural nerve injury and one patient in the open group had a superficial infection. All of the patients returned to their previous activities, four of them with some limitations. The average AOFAS score was 93.1 points. Conclusion: Achilles tendon rupture in the elderly is a rare injury. Operative treatment can yield a successful outcome.

Level of Evidence: III, Retrospective Comparative Study