bluuebunny/crossref_metadata_2025 huggingface dataset:
Skin pigmentation in Caucasian babies is high and evenly distributed throughout the body
Authors: Lock‐Andersen J. , Wulf H. C. , Knudstorp N. D.
Published: February 2009

To investigate if Caucasian babies have particular sun sensitive skin and if skin pigmentation before any sun exposure is uniform throughout the body, we measured skin pigmentation objectively by skin reflectance spectroscopy in 10 anatomical sites in 20 healthy Caucasian babies (mean age 5 months, range 1 to 10 months) that had not been sun exposed previously. We found that skin pigmentation at all the measured sites was significantly higher than the constitutive pigmentation in Caucasian adults (P<0.01). Furthermore, the level of skin pigmentation in all the 10 measured sites in the babies was statistically not different (P<0.31) and there was no gender differences in pigmentation for any site.
Commercial sunscreen lotions prevent ultraviolet radiation‐induced depletion of epidermal Langerhans cells in Skh‐1 and C3H mice
Authors: Beasley D. G. , Montgomery M. A. , Moloney S. J. , Edmonds S. , Roberts L. K.
Published: February 2009

There is much controversy regarding the ability of sunscreens to prevent ultraviolet (UV)‐induced immune suppression. Epidermal Langerhans cells (LC) play a key antigen‐presenting role in the afferent limb of the immune system's response to antigens introduced through the skin. It has been suggested that depletion of LC in UV‐exposed skin is a critical step toward the induction of immunosuppression by UV radiation. There are a number of disparate reports with inconsistent results concerning the ability of sunscreens to prevent UV‐induced depletion of LC. The purpose of this study was to systematically evaluate the ability of sunscreens to prevent UV‐induced LC depletion in mice. Epidermal sheets obtained from skin biopsies taken from mice exposed to UV radiation from Kodacel‐filtered FS20 sunlamps, which do not emit UV power at wavelengths <290 nm, were immunoperoxidase stained for LC using a rat monoclonal antibody against mouse Ia (major histocompatibility complex class II antigen). Time course and dose‐response curves for LC depletion were generated for Skh‐1 and C3H mice. Dose‐response curves for acute UV exposure induced depletion of LC in Skh‐1 and C3H mice were similar, but not identical. LC density in the skin of Skh‐1 mice that received chronic UV exposure (3 days/week for 8 weeks) was reduced by 62% after 2 weeks of exposure, but returned to normal levels by 6 weeks. Five commercial sunscreen lotions with labeled sun protection factors (SPF) of 4, 8, 15, 30 and 45 were tested for their capacity to block UV‐induced depletion of LC. LC were depleted ˜75% in the skin of unprotected or placebo lotion treated Skh‐1 mice exposed to UV given on two consecutive days. Conversely, LC depletion was prevented in similarly UV exposed Skh‐1 mice protected with a SPF 30 sunscreen. In C3H mice the levels of protection against LC depletion provided by the five sunscreens were proportional to the level of protection predicted by their labeled SPF. Comparisons of dose‐response curves showed that significantly higher doses of UV were required for LC depletion and induction of skin edema than for the induction of local suppression of contact hypersensitivity. Thus, at UV doses where sunscreens provide complete protection against immunosuppression of contact hypertensitivity, prevention of LC depletion and skin edema would be expected.
Effects of PUVA and UVB treatments on restoration of epidermal barrier function and vascular response after suction blister injury in human skin in vivo
Authors: Koivukangas V. , Oikarinen A.
Published: February 2009

PUVA and UVB phototherapies are used in the treatment of psoriasis and other inflammatory skin diseases. Ultraviolet radiation causes inflammation and modulates cell kinetics in the skin. PUVA also has an inhibitory effect on skin DNA synthesis. In this study, the effects of PUVA and UVB treatments on epidermal wound healing were examined using the suction blister wound model. The healing of the wound was studied indirectly by measuring water evaporation and blood flow in the wound area. On the fourth day, water evaporation was more abundant in PUVA‐treated patients (42±5 g/m2h) than in UVB treated (36±4 g/m2h) or control patients (27±3 g/m2h) (analysis of variance, the least significant difference test at a level of 0.05). The P value for the difference of means between the PUVA and control groups was 0.014. Blood flow was also more abundant during the fourth (PUVA 162±11 arbitrary units, UVB 122±10, controls 115±15) and sixth (PUVA 108±18, UVB 73±17, controls 57±13) day in PUVA treated patients (analysis of variance, the least significant difference test at a level of 0.05). The results suggest that PUVA treatment decreases the restoration of the epidermal barrier function. The PUVA‐treated patients also showed a more intense and prolonged vascular response that may be due to PUVA‐related inflammation.
How effective are UV opaque face shields in UVB phototherapy cabins?
Authors: Hamilton D. , Diffey B. L.
Published: February 2009

A few hours after servicing illuminated lamps inside a whole body ultraviolet radiation B (UVB) phototherapy cabin, a technician developed erythema to the anterior neck with subsequent peeling, despite wearing a UV‐opaque face shield. Measurements using polysulphone film badges attached to various sites on the head and neck of a mannikin were carried out to explore the spatial distribution of UVB exposure. It was found that the lower face and neck can receive sufficient exposure to result in erythema, the reason being that the fluorescent lamps will extend to about 1.5 m inferior to the head of an upright person and so result in irradiation from below. It is important, therefore, that if operators or service personnel need to be in an illuminated UVB cabin for several minutes or more, adequate protection should be provided to the chin and neck, in addition to a UV‐opaque face shield.
Effects of water temperature on photosensitization in bath‐PUVA therapy with 8‐methoxypsoralen
Authors: Gruss C. , Behrens S. , von Kobyletzki G. , Reuther T. , Husebo L. , Altmeyer P. , Kerscher M.
Published: February 2009

The pharmacokinetic aspects of bath‐PUVA are not completely clarified. Therefore, we determined the phototoxic response of human skin following psoralen baths at temperatures ranging from 32°C to 42°C (71.6–107.6°F) and UVA doses ranging from 0.5 to 5.5 J/cm2. The highest therapeutical photosensitization (i.e., lowest minimal phototoxic dose) was assessed at temperatures of 37°C (98.6°F) and above. Photosensitization was significantly decreased at lower temperatures. These data indicate that a bath temperature of 37°C (98.6°F) should be used to gain optimal therapeutic efficiency in a clinical setting. Furthermore, in order to minimize the risk of adverse phototoxic effects in bath‐PUVA, it is important to use a constant temperature during the psoralen bath.
Protection against photodynamic therapy (PDT)‐induced photosensitivity by fabric materials
Authors: Menter J. M. , Hollins T. D. , Sayre R. M. , Etemadi A. A. , Willis I. , Hughes S. N. G.
Published: February 2009

“Special” highly protective fabrics are now available that offer broad‐spectrum protection in preventing sunburn, and possibly other types of photodamage. It is important to know to what extent these fabrics are capable of protecting the wearer against skin cancer, photosensitivity disorders, and inadvertent phototoxic reactions from photodynamic therapy (PDT). We assess the ability of one such special (Solumbra) fabric and one “typical” summer fabric to provide protection against PDT phototoxicity produced in tape‐stripped Sk‐1 hairless mice by topical 5‐aminolevulinic acid (ALA) and (primarily) visible light (360–800 nm). Since ALA‐derived photosensitizers absorb most of the visible spectrum, results from these studies give a good indication of the photoprotective capability of these fabrics throughout this region. Mice were irradiated dorsally with a Kodak slide projector equipped with a 300 W tungsten‐halogen lamp (I0=48.3 mW/cm2). After determining the minimal phototoxic dose (MPD) to be 1.40±0.4 J/cm2, we irradiated the tape‐stripped ALA‐sensitized mice through the stretched test fabrics with appropriate multiples of the MPD. The special fabric provided protection against 25–30 MPD visible light between 360–800 nm in 14/14 mice. The typical fabric failed to provide protection against 2.5 MPD of the same spectrum. No phototoxic or other adverse responses were seen with either the ALA or light control. In conclusion, the Solumbra fabric is much more protective against ALA photosensitization than the typical fabric. Both appear better at blocking UV than visible light.
Correlation of skin phototype with facial wrinkle formation
Authors: Nagashima H. , Hanada K. , Hashimoto I.
Published: February 2009

Facial wrinkle formation is a representative sign of photoaging. Skin can be divided into different skin phototypes (SPTs) depending on its sensitivity to solar radiation. We have determined the relationship between SPTs and deep and fine wrinkle scores on the faces of 230 Japanese subjects. This group was chosen because it is relatively easy to quantify acute and chronic sun damage in Japanese individuals. SPT in the Japanese subjects was classified into one of four groups, SPT‐I to ‐IV according to Fitzpatrick's classification method. The subjects were further classified into indoor or outdoor workers. After photographing the outer canthus, deep and fine wrinkles were discriminated visually and scored from 1–11 and from 1–9, respectively. UV light was used as a photographic light source for clear depiction of the fine wrinkles. Higher scores were recorded for deep wrinkles in individuals with SPT‐I, who are more sensitive to sunlight than those with SPT‐III or IV, who are more tolerant to sunlight. However, the same tendency did not seem to be apparent for fine wrinkle scores. A high incidence of SPT‐IV was seen in outdoor workers. Early detection of SPT‐I in individuals who are sensitive to sunlight, may help to predict and prevent photoaging of deep wrinkles. Sensitivity to sunlight may play a part in determining an individual's choice of working environment.
Influence of UVA pre‐exposure on UVB‐induced erythema: A chromometric study
Authors: Routaboul C. , Marguery M. C. , Garigue J. , Bazex J.
Published: February 2009

We examined the influence of ultraviolet A (UVA) pre‐exposure on UVB minimal erythemal dose in 9 Caucasian subjects. Three zones were tested. One zone received only UVB, the second zone received a low UVA dose + UVB, and the third zone received a high UVA dose + UVB. Each zone was divided into 9 circles receiving increasing doses of UVB in order to obtain 3 different UVA‐exposed series of 9 circles. Visual and chromometric readings were performed 24 h later. Pre‐exposure to UVA caused variations in the slope of the dose‐response curve (colorimetric index as a function of the UVB dose). In relation to UVB erythema, these variations indicated a protective effect for 6/9 subjects and an aggressive effect for 3/9 subjects. No predictive criteria were found for inclusion within a group.
Photo(chemo)therapy in private practice in Belgium, France and The Netherlands
Authors: Faguer K. , Roelandts R. , Dompmartin A. , van der Veen W. , Coster J. , Stoof T. , van der Valk P. , Leroy D.
Published: February 2009

Photo(chemo)therapy is used widely, and ultraviolet (UV) sources, protocols and indications are numerous. A survey was carried out to examine how photo(chemo)therapy is employed in private practice and to determine whether safety guidelines are respected. A questionnaire survey sent to Belgian, French and Dutch dermatologists generated 593 useful responses. UV sources, doses of UV and 8‐methoxypsoralen (8‐MOP), as well as the frequency of the treatment, were all different in the three countries. UV starting doses were rarely chosen according to the minimal phototoxic dose (MPD) or to the minimal erythema dose (MED). Total cumulative UV doses were not always determined. Maintenance PUVA therapy for psoriasis was still performed by 15 to 40% of dermatologists in the respective countries. Another striking fact was that genital protection is not universal. On the other hand, the irradiance of tubes is checked regularly, and contraindications are respected. Despite the availability of guidelines, clinicians seem to be inconstant in their assessment of the carcinogenic risk of UV radiation.
Transmittance spectra and theoretical sun protection factors for a series of sunscreen‐containing sun care products
Authors: Rosenstein B. S. , Weinstock M. A. , Habib R.
Published: February 2009

Sun care products containing sunscreens are widely used, but consumers are generally unaware of the important differences in the ability of these lotions to block exposure to the ultraviolet A (UVA) portion of the solar spectrum. The purpose of this study was to determine the transmittance spectra, with particular emphasis on the UVA portion of the spectrum, for a variety of commercially available sun care products, to determine Commission Internationale d'Eclairage (CIE) erythema effectiveness spectra and to compare these with information in the product label. The transmittance spectra for a sample of sun care products were measured spectrophotometrically. These values were convoluted with the CIE erythema action spectrum and the sunlight spectra determined for solar noon on June 21 at 0° and 50° N latitude to produce CIE effectiveness spectra. The UVA transmitted through the sun care products that claimed UVA protection on the bottle label varied from as little as 6% to as much as 52%. In addition, it was determined from the CIE effectiveness spectra that any erythema induced following application of the tested lotions would be caused by the UVA portion of the solar spectrum for all, but one, of the products examined. The results of this study emphasize the necessity for better guidance to the consumer as to the ability of sun care products to provide protection against UVA exposure.
Extracorporeal photochemotherapy for cutaneous T‐cell lymphoma: a 9.7‐year experience
Authors: Jiang S. B. , Dietz S. B. , Kim M. , Lim H. W.
Published: February 2009

Cutaneous T‐cell lymphoma (CTCL) is an indolent lymphoma usually of CD4+ T lymphocytes in which the aggressive treatment for the advanced stages does not increase survival. Photopheresis has been established as an alternative modality for the therapy of erythrodermic CTCL and reportedly improves survival in patients with advanced stages of the disease. The objective of this study is to review the experience of treating patients with erythrodermic CTCL with extracorporeal photochemotherapy (ECP) at the New York Veteran Affairs Medical Center/NYU Medical Center between September 1987 and April 1997. Forty‐one patients with erythrodermic CTCL (stages III and IV) received photopheresis; 25 of them fulfilled the inclusion criterion, i.e., the completion of greater than or equal to 6 cycles of photopheresis. Skin score was defined as a product of severity and percentage of involved surface area. Complete clinical response was defined as disappearance of measurable disease for at least one month, and partial response was defined as greater than or equal to 50% clearance of measurable disease for at least one month. The profile of the patients was: 20 men, 5 women; average age: 64.2 years; 17 patients had stage III disease, and 8 had stage IV disease. Five of the 25 patients (20%) achieved complete clinical response, another 15 (60%) had partial response, and 5 (20%) had no response. The mean time (±SD) to achieve complete clinical clearance was 12.6± 10 months (range: 4–30 months) and the mean time (±SD) to obtain partial clinical response, including complete response, was 9.7±5.3 months (range: 4–17 months). Remission duration ranged from 9 to 67 months. The median survival time from the time of initiation of photopheresis is estimated at 70 months. The complete responder group had a lower median CD4/CD8 ratio compared to the non‐responders at baseline (3.8 vs 7.2, respectively), although the difference was not statistically significant (P=0.40). At the time of maximal response, the CD4/CD8 ratio of the complete responder group decreased towards normal values (median= 1.2), whereas this ratio increased among the non‐responders (median=11.0; P=0.04). Side effects were minimal. Extracorporeal photochemotherapy is an effective and safe treatment for erythrodermic CTCL. In some of these patients, it can induce a long‐term and complete clinical remission.
Effect of stretch on the ultraviolet spectral transmission of one type of commonly used clothing
Authors: Kimlin M. G. , Parisi A. V. , Meldrum L. R.
Published: February 2009

The spectral ultraviolet (UV) transmission through stockings was measured in field and laboratory based trials using a spectroradiometer. From these spectral UV measurements, the ultraviolet protection factor (UPF) was calculated. The UPF of stockings measured in the field was generally higher than that measured in the laboratory when using a quartz tungsten halogen light as the UV source. The UPF of 50 denier stockings decreased 868% when stretched 30% from their original size. Doctors recommending and patients using high denier stockings for patient photo‐protection should be aware of the dramatic decrease in UPF when the stocking is in a stretched position, such as over a human leg.
Hand and foot PUVA soaks: An audit of the Massachusetts General Hospital's experience from 1994 to 1998
Authors: Taylor C. R. , Baron E. D.
Published: February 2009

Palmoplantar psoriasis and eczema can be chronic recalcitrant dermatoses. Oral psoralen plus ultraviolet A (PUVA) has proven effective for these, but has a number of unwanted side effects. Previous studies have shown that regional PUVA therapy using the 8‐methoxypsoralen (8‐MOP) soak method followed by immediate UVA irradiation is also beneficial and well tolerated. The purpose of this audit was to determine the efficacy of hand and foot PUVA soaks by reviewing the experience of the Massachusetts General Hospital's Phototherapy Unit with this treatment modality Phototherapy records of all patients who underwent hand and foot PUVA soaks from 1994 to 1998 were reviewed. Details regarding the treatment procedure, patient compliance, patient response and incidence of side effects were noted and summarized. Of the 56 patients who underwent at least 20 treatments, 29% had excellent response, 42% had minimal to moderate response, and 29% had poor response. The average number of treatments to induce clearing was 41. The average maximum treatment dose at clearing was 5.85 J/cm2, while the average cumulative dose to achieve clearing was 267.17 J/cm2. 8‐MOP PUVA soak therapy is quite useful for chronic hand and foot dermatoses. Patient compliance must be emphasized to obtain favorable results.
Ultraviolet radiation‐blocking characteristics of contact lenses: relevance to eye protection for psoralen‐sensitised patients
Authors: Anstey A. , Taylor D. , Chalmers I. , Ansari E.
Published: February 2009

Nine brands of contact lens marketed as “UV protective” were tested for ultraviolet (UV) transmission in order to assess potential suitability for psoralen‐sensitised patients. UV‐transmission characteristics of hydrated lenses was tested with a Bentham monochromator spectro‐radiometer system. All lenses showed minimal transmission loss in the visible band. The performance of the nine lenses was uniform for ultraviolet B radiation with negligible transmission, but showed variation in transmission for ultraviolet A radiation. None of the lenses complied with UV‐transmission criteria used previously to assess UV‐blocking spectacles. Only two lenses had UV‐blocking characteristics which came close to the arbitrary criteria used. The performance of ordinary soft and hard lenses was very similar, with negligible blocking of UV radiation. None of the nine contact lenses marketed as “UV protective” excluded sufficient UVA to comply with criteria in current use to assess UV protection in spectacles for psoralensensitised patients. However, the improved UV‐blocking characteristics of contact lenses identified in this paper compared to previous studies suggests that such a contact lens will soon become available. Meanwhile, contact lens‐wearing systemically sensitised PUVA patients should continue to wear approved spectacles for eye protection whilst photosensitised with psoralen.
Role of UVA in the pathogenesis of melanoma and non‐melanoma skin cancer: A short review
Authors: Rünger T. M.
Published: February 2009

It is well established, at least in mice, that not only ultraviolet C (UVC) or ultraviolet B (UVB), but also ultraviolet A (UVA) is able to induce squamous cell carcinomas. Results from animal models, epidemiological studies, and clinical observations suggest that UVA might play an important role in the pathogenesis of malignant melanoma as well. In contrast to UVC or UVB, UVA is hardly able to excite the DNA molecule directly and produces only few pyrimidine dimers. Oxidative DNA base damage, generated indirectly through photosensitizers, might be responsible for the mutagenic and carcinogenic properties of UVA. This is supported by differences in mutation spectra induced by UVA and UVB in mammalian cells and tumors. Avoidance of natural and artificial UVA sources is recommended, especially for melanoma‐prone individuals.
In vitro phototoxicity of new quinolones: production of active oxygen species and photosensitized lipid peroxidation
Authors: Kawada A. , Hatanaka K. , Gomi H. , Matsuo I.
Published: February 2009

To elucidate photosensitization potentials of new quinolone antibacterial agents, production of active oxygen species and peroxidation of squalene after ultraviolet A exposure were investigated. Production of singlet oxygen and/or hydrogen peroxide was estimated by bleaching of p‐nitroso‐N, N‐dimethylaniline. Lomefloxacin showed the greatest ability to produce active oxygen species, and this ability was reduced by the addition of the singlet oxygen quencher sodium azide. Ciprofloxacin and fleroxacin also had strong activity. Photosensitized peroxidation of squalene was evaluated by measurement of thiobarbituric acid‐reactive substances. Lomefloxacin was the strongest sensitizer, followed by fleroxacin and ciprofloxacin. These results suggest that certain new quinolones are involved in phototoxicity via the mechanism of active oxygen species.
Sinus Lift Using a Nanocrystalline Hydroxyapatite Silica Gel in Severely Resorbed Maxillae: Histological Preliminary Study
Authors: Canullo Luigi , Dellavia Claudia
Published: February 2009

Purpose: The aim of this preliminary study was to evaluate histologically a nanocrystalline hydroxyapatite silica gel in maxillary sinus floor grafting in severely resorbed maxillae.

Materials and Methods: A total of 16 consecutive patients scheduled for sinus lift were recruited during this study. Patients were randomly divided in two groups, eight patients each. In both groups, preoperative residual bone level ranged between 1 and 3 mm (mean value of 2.03 mm). No membrane was used to occlude the buccal window.

Second surgery was carried out after a healing period of 3 months in Group 1 and 6 months in Group 2. Using a trephine bur, one bone specimen was harvested from each augmented sinus and underwent histological and histomorphometric analysis.

Results: Histological analysis showed significant new bone formation and remodeling of the grafted material. In the cores obtained at 6 months, regenerated bone, residual NanoBone, and bone marrow occupied respectively 48 ± 4.63%, 28 ± 5.33%, and 24 ± 7.23% of the grafted volume. In the specimens taken 3 months after grafting, mean new bone was 8 ± 3.34%, mean NanoBone was 45 ± 5.10%, and mean bone marrow was 47 ± 6.81% of the bioptical volume.

Conclusions: Within the limits of this preliminary prospective study, it was concluded that grafting of maxillary sinus using nanostructured hydroxyapatite silica gel as only bone filler is a reliable procedure also in critical anatomic conditions and after early healing period.
Cytokinin‐induced structural adaptability of a Lupinus luteus PR‐10 protein
Authors: Fernandes Humberto , Bujacz Anna , Bujacz Grzegorz , Jelen Filip , Jasinski Michal , Kachlicki Piotr , Otlewski Jacek , Sikorski Michal M. , Jaskolski Mariusz
Published: February 2009

Plant pathogenesis‐related (PR) proteins of class 10 are the only group among the 17 PR protein families that are intracellular and cytosolic. Sequence conservation and the wide distribution of PR‐10 proteins throughout the plant kingdom are an indication of an indispensable function in plants, but their true biological role remains obscure. Crystal and solution structures for several homologues have shown a similar overall fold with a vast internal cavity which, together with structural similarities to the steroidogenic acute regulatory protein‐related lipid transfer domain and cytokinin‐specific binding proteins, strongly indicate a ligand‐binding role for the PR‐10 proteins. This article describes the structure of a complex between a classic PR‐10 protein [Lupinus luteus (yellow lupine) PR‐10 protein of subclass 2, LlPR‐10.2B] and N,N′‐diphenylurea, a synthetic cytokinin. Synthetic cytokinins have been shown in various bioassays to exhibit activity similar to that of natural cytokinins. The present 1.95 Å resolution crystallographic model reveals four N,N′‐diphenylurea molecules in the hydrophobic cavity of the protein and a degree of conformational changes accompanying ligand binding. The structural adaptability of LlPR‐10.2B and its ability to bind different cytokinins suggest that this protein, and perhaps other PR‐10 proteins as well, can act as a reservoir of cytokinin molecules in the aqueous environment of a plant cell.
On expectations‐driven business cycles in economies with production externalities
Authors: Eusepi* Stefano
Published: February 2009

Expectations‐driven business cycles are defined as positive co‐movement between consumption, investment and hours that result from a change in expectations, holding constant technology, preferences and government intervention. This note explores the possibility of expectations‐driven business cycles in business cycle models with external effects. It is found that in one‐sector models conditions for expectations‐driven business cycles and conditions for multiple equilibria are tightly connected. In two‐sector models those conditions appear to be mutually exclusive.
Global indeterminacy in locally determinate real business cycle models
Authors: Coury Tarek , Wen Yi
Published: February 2009

We investigate the global dynamics of real business cycle models with production externalities. We confirm that purely local analysis does not tell the full story. With externalities smaller than required for local indeterminacy, local analysis shows the steady state to be a saddle, implying a unique equilibrium. However, global analysis reveals that the steady state is surrounded by stable deterministic cycles. Our analysis suggests that indeterminacy is more pervasive than previously believed, and the results strengthen the view that caution should be exercised when linearized versions of this class of real business cycle models are used in applied work.
Clinical use of physical activity measures
Authors: Reiser Lorraine M , Schlenk Elizabeth A
Published: February 2009

Purpose:  To provide a review of physical activity measures and subjective and objective methods of its measurement. Considerations for the use of these measurements in research and practice will be discussed.

Data sources:  The PubMed, CINAHL, and Health and Psychosocial Instruments databases, and the Centers for Disease Control Web site were searched using the search term “Physical Activity Measurement.”

Conclusions:  Physical activity is a lifestyle factor that is a key focus in chronic disease–related research, prevention, and interventions. Healthy People 2010 set goals of decreasing the prevalence of preventable diseases by encouraging healthier lifestyle patterns. Shifts toward more sedentary lifestyles have resulted in increases in life‐limiting disease states, including obesity, diabetes, heart disease, cancer, and osteoporosis. Physical activity measurements have been used widely in research studies but are less commonly used in primary care. Measuring individuals’ physical activity levels as part of the health assessment will enhance the provider’s ability to engage in health promotion and suggest health protection interventions. The strengths, weaknesses, and potential applications to practice of physical activity measures are summarized in an effort to familiarize nurse practitioners (NPs) with commonly used tools and encourage integration of physical activity assessment into their current practice.

Implications for practice:  NPs are in an ideal position to promote health by encouraging appropriate amounts of physical activity. Screening, health promotion, and disease prevention are part of the core competencies of NP practice established by the National Organization of Nurse Practitioner Faculties. Increased knowledge of physical activity measures will enhance the NP’s ability to evaluate relevant physical activity research for use in evidence‐based practice. Incorporation of simple yet appropriate physical activity measurements into practice will expand the NP’s ability to identify and thus address sedentary lifestyles in their clientele.
Interventions for promoting mobility in community‐dwelling older adults
Authors: Yeom Hye A , Keller Colleen , Fleury Julie
Published: February 2009

Purpose:  The purposes of this review were to provide an updated report of intervention studies designed to enhance mobility in older adults and discuss the strengths and limitations of existing intervention studies and their implications for practice.

Data sources:  Medline, CINAHL, and PsychInfo were searched to identify original research articles reporting interventions for promoting mobility in community‐dwelling older adults.

Conclusion:  Effective interventions for enhancing mobility in older adults include walking, aerobic exercise, and resistance training focusing on strength, balance, and flexibility. Group‐based interventions show significant beneficial effects in increasing mobility. To obtain significant effects of physical activity interventions, the patient should participate in the exercise programs for at least 12 weeks. Strengths of existing clinical trials for promoting mobility in older adults include testing of various types of physical activity and training interventions and the use of an experimental design with a control group. The major challenges of creating mobility enhancement recommendations for older adults include detailing a mobility enhancement program will delay disability, creating a specific program dose for different populations by gender and ethnicity, and developing culturally appropriate mobility enhancement programs to improve adherence over time.

Implications for practice:  Prescribing regular physical activity including aerobic exercise and resistance training in a primary care setting can be a beneficial approach to minimize progression of impaired mobility in older adults. The typical dose of the physical activity prescription is 20–60 min of aerobic activity three times weekly. Adherence to mobility enhancement recommendations by older patients can be followed up by in‐person interview or use of mobility monitoring tools such as exercise diary or log.
Excitation of the M Intermediates of Bacteriorhodopsin†
Authors: Tóth‐Boconádi Rudolf , Dér András , Fábián László , Taneva Stefka Germanova , Keszthelyi Lajos
Published: February 2009

Protein electric response signals (PERS) of the M intermediates of wild‐type bacteriorhodopsin (bR) were recorded. Contrary to earlier findings reporting on a single‐phase response upon excitation of the M intermediates, a kinetic analysis of the signals revealed the existence of three components, the fastest and the slowest ones of negative, while the middle one of positive sign with respect to the normal direction of proton pumping. Based on proton motion indicator experiments and molecular dipole calculations, the components were assigned to proton transfer steps and conformational changes driving the bR molecule back from the M to the ground state upon blue light excitation. The fastest, negative pump component was assigned to the proton transfer from D85 to the Schiff base. The subsequent positive component was attributed to rearrangements in the protein core (in the vicinity of the retinal molecule), triggered by the primary proton transfer process. The slowest component was established to reflect charge rearrangements associated with proton uptake by the protein from the bulk.
Designing Point Mutants to Detect Structural Coupling in a Heterotrimeric G Protein α‐subunit by NMR Spectroscopy†
Authors: Abdulaev Najmoutin G. , Mao Xiang , Ramon Eva , Ngo Tony , Mysliwy Justyna , Marino John P. , Ridge Kevin D.
Published: February 2009

To better understand the mechanism by which the activating signal is transmitted from the receptor‐interacting regions on the G protein α‐subunit (Gα) to the guanine nucleotide‐binding pocket, we generated and characterized mutant forms of Gα with alterations in switch II (Trp‐207→Phe) and the carboxyl‐terminus (Phe‐350→Ala). Previously reported bacterial expression methods for the high‐level production of a uniformly isotope‐labeled Gtα/Gi1α chimera, ChiT, were successfully used to isolate milligram quantities of 15N‐labeled mutant protein. NMR analysis showed that while the GDP/Mg2+‐bound state of both mutants shared an overall conformation similar to that of the GDP/Mg2+‐bound state of ChiT, formation of the “transition/activated” state in the presence of aluminum fluoride (AlF4−) revealed distinct differences between the wild‐type and mutant Gα subunits, particularly in the response of the 1HN, 15N cross‐peak for the Trp‐254 indole in the Trp‐207→Phe mutant and the 1HN, 15N cross‐peak for Ala‐350 in the Phe‐350→Ala mutant. Consistent with the NMR data, the F350→Ala mutant showed an increase in intrinsic fluorescence that was similar to Gtα and ChiT upon formation of the “transition/activated” state in the presence of AlF4−, whereas the intrinsic fluorescence of the Trp‐207→Phe mutant decreased. These results show that the substitution of key amino acid positions in Gα can effect structural changes that may compromise receptor interactions and GDP/GTP exchange.
Mitochondrial Responses of Normal and Injured Human Skin Fibroblasts Following Low Level Laser Irradiation—An In Vitro Study
Authors: Zungu Innocent L. , Hawkins Evans Denise , Abrahamse Heidi
Published: February 2009

Laser irradiation has proved to be very efficient in speeding and improving the quality of healing in pathological conditions of diverse etiologies. However, the mechanisms by which the beneficial effects are attained are not clear. Mitochondria are the primary phototargets during irradiation. The study aimed to establish if laser irradiation had an effect on hypoxic and acidotic cells. The study also aimed to use existing information regarding the possible mechanism of action (established in wounded cells) and apply these principles to acidic and hypoxic irradiated cells to determine whether laser has a stimulatory or inhibitory effect. Cell cultures were modified to simulate conditions of hypoxia (hypoxic gas mixture 95% N2 and 5% O2) and acidosis (pH 6.7) whereas the central scratch model was used to simulate a wound. Cells were irradiated with a helium–neon (632.8 nm, 3 mW cm−2) laser using 5 or 16 J cm−2 on days 1 and 4. Mitochondrial responses were measured 1 or 24 h after laser irradiation by assessing changes in mitochondrial membrane potential (MMP), cyclic AMP, intracellular Ca2+ and adenosine triphosphate (ATP) cell viability. Hypoxia and acidosis significantly reduced MMP when compared with normal nonirradiated control cells. Wounded, hypoxic and acidotic cells irradiated with 5 J cm−2 showed an increase in mitochondrial responses when compared with nonirradiated cells while 16 J cm−2 showed a significant decrease. The study confirmed that laser irradiation with 5 J cm−2 stimulated an increase in intracellular Ca2+ which resulted in an increase in MMP, ATP and cAMP, which ultimately results in photobiomodulation to restore homeostasis of injured cells.
Dissection of Environmental Changes at the Cytoplasmic Surface of Light‐activated Bacteriorhodopsin and Visual Rhodopsin: Sequence of Spectrally Silent Steps†
Authors: Kim Tai‐Yang , Moeller Martina , Winkler Kathrin , Kirchberg Kristina , Alexiev Ulrike
Published: February 2009

The physico‐chemical properties as well as the conformation of the cytoplasmic surface of the 7‐helix retinal proteins bacteriorhodopsin (bR) and visual rhodopsin change upon light activation. A recent study found evidence for a transient softening of bR in its key intermediate M [Pieper et al. (2008) Phys. Rev. Lett. 100, 228103] as a direct proof for the functional significance of protein flexibility. In this report we compare environmental and flexibility changes at the cytoplasmic surface of light‐activated bR and rhodopsin detected by time‐resolved fluorescence spectroscopy. The changes in fluorescence of covalently bound fluorescent probes and protein real‐time dynamics were investigated. We found that in fluorescently labeled bR and rhodopsin the intensity of fluorescein and Atto647 increased upon formation of the key intermediates M and metarhodopsin‐II, respectively, suggesting different surface properties compared to the dark state. Furthermore, time‐resolved fluorescence anisotropy experiments reveal an increase in steric restriction of loop flexibility because of changes in the surrounding protein environment in both the M‐intermediate as well as the active metarhodopsin‐II state. The kinetics of the fluorescence changes at the rhodopsin surface uncover multiple transitions, suggesting metarhodopsin‐II substates with different surface properties. Proton uptake from the aqueous bulk phase correlates with the first transition, while late proton release seems to parallel the second transition. The last transition between states of different surface properties correlates with metarhodopsin‐II decay.
Optical Characteristics of Polymer Films Based on Bacteriorhodopsin for Irreversible Recording of Optical Information†
Authors: Druzhko Anna B.
Published: February 2009

Bacteriorhodopsin (BR)‐containing polymer films have been developed in which photoinduced transformations of BR molecules take place during the process of photoinduced hydroxylaminolysis (PHA). The routine simplified scheme of the phototransformation is B↔M412 in the case of polymer films based on nonmodified BR. In the case of polymer films based on BR modified by hydroxylamine (HA), this scheme is changed to where retinal oxime (RO) is a final product of chemical trapping of retinal by the HA molecule. Under certain conditions, the rate of RO to B regeneration is infinitely low. So, the irreversibility of RO formation allows one to use PHA for the preparation of films for irreversible write once recording. Some optical sensitometric characteristics are compared for polymer‐BR films and polymer‐BR–HA films. It has been shown that the photosensitivity level for polymer‐BR–HA films depends on the time after film preparation. A method is offered to increase the photosensitivity of polymer‐BR–HA films and to avoid the photosensitivity decrease with the time after film preparation.
Systems for accreditation in blood transfusion services
Authors: Hindawi S.
Published: February 2009

Accreditation is a non‐governmental, voluntary process that evaluates institutions, agencies, and educational programs. It is defined as the process whereby an agency or association grants public recognition to Institutes or Blood Banks for having met certain established standards as determined through initial and periodic evaluations that usually involve submitting a self‐evaluation report, site inspection by a team of experts, and evaluation by an independent board or commission. To be accredited Institution and or Blood Transfusion Services should establish and maintain quality systems involving all activities that determine the quality policy objectives & responsibilities taking into account the principles of good manufacturing practice (GMP). There are many Established systems for accreditation which can help any institution to know its strengths, weaknesses and opportunities through an informed review process. Any assessment and subsequent accreditation is made with reference to a set of standards so that the standing of an institution can be compared with that of other similar institutions.

In summery the accreditation is a continuous process for improvement of quality and safety of participating institutes or facilities and we should encourage all health institutes to be involved in one or another system for accreditation. There is a need for a local or regional accreditation system for health institutes especially for blood transfusion services to help in the development and improvement of the quality of their services.
Dendritic cell vaccination and immune monitoring
Authors: Aarntzen E. H. J. G. , Figdor C. G. , Adema G. J. , Punt C. J. A. , De Vries I. J. M.
Published: February 2009

Dendritic cells (DCs) are the professional antigen‐presenting cells of the immune system. Following infection or inflammation, they undergo a complex process of maturation and migrate to lymph nodes where they present antigens to T cells. Their decisive role in inducing immunity formed the rationale for DC immunotherapy: DCs loaded with tumour antigens are injected into cancer patients to stimulate T cells to eradicate tumours. Effective immune responses and favourable clinical outcomes have indeed been observed, but only in a minority of patients. Therefore, it is obvious that current DC‐based protocols need to be improved. For this reason, we study in small proof‐of‐principle trials the fate, interactions and effectiveness of the injected DC. The success of DC‐based immunotherapy to induce cellular immunity against tumours is highly dependent on accurate delivery and trafficking of the DC to T cell‐rich areas of secondary lymphoid tissues.
Quality management in blood establishments
Authors: Vuk T.
Published: February 2009

Transfusion medicine has a specific position relative to other fields of medical science. A series of laboratory and clinical medicine activities and pharmaceutical‐like manufacture, with tight interaction of various professionals are involved in the complex chain of transfusion medicine, from the promotion of blood donation through the utilization of blood products. Maintaining constant high quality and safety of the products and services required by blood donors, patients and public at large are the prime and foremost goals to be pursued in transfusion medicine. These supreme goals can only be achieved through efficient quality management in all segments and with due support from all those involved in this complex system. Recognizing quality as a necessity, transfusion services all over the world have introduced or are just being introducing quality management systems according to particular standards and regulations. In EU countries, quality management in blood establishments is legal obligation defined by the 2005/62/EC Directive. Only a comprehensive and integrated quality management system can guarantee quality in a continuous way. Standard requirements and specifications of such an integrated system based on GMP and ISO 9000 series standards are elaborated in this paper.
Proteomics and blood transfusion
Authors: Liumbruno G. M. , D’Amici G. M. , Zolla L. , Grazzini G.
Published: February 2009

Transfusion medicine is a clinical discipline characterized by one of the most advanced quality management systems, which is structured so as to assure the production of blood components and raw materials, for biopharmaceutical fractionation, that are safe, efficient and effective.

During the production, pathogen inactivation and storage processes there is the risk of changes in the integrity of blood components, especially at the protein level. These changes could be the cause of some of the negative effects of transfusion therapy. It is therefore a major challenge to identify significant alterations of these products, and, in this context, proteomics can play a potentially relevant role in transfusion medicine to assess the protein composition of blood‐derived therapeutics, particularly for identifying modified proteins.

Proteomics can also provide a more detailed understanding of the proteins found in plasma derivatives, with particular regard to peptide and protein changes related to the various procedures used for protein purification and pathogen inactivation during the modern plasma industrial factionation. The latter could cause protein modifications and/or degradation and neoantigen production, with the potential to induce adverse effects in recipients.

At present, blood component quality control is mainly focused on standardized quantitative assessment, providing relatively limited information about products. Proteomics allows a comprehensive study of protein modifications, qualitative and quantitative analysis, and high‐throughput protein identification. Moreover, being the only tool to evaluate structural changes in proteins (or their degradation products) after their manipulation, and having the capacity to identify many new proteins, proteomics seems to be the most promising tool for global quality assessment and possible improvement of the production process of blood components and plasma derivatives. It can also provide comprehensive information about possible contaminants and neoantigens that may influence the immunogenic capacity of blood‐derived therapeutics.
Faint and pre‐faint reactions in whole blood donors: predictive value of pre‐donation measurements
Authors: Tomasulo P. , Custer B. , Wiltbank T. B. , Bravo M. , Giordano G. F. , Kamel H.
Published: February 2009

Background  A small proportion of blood donors have adverse reactions. The purpose of this study was to determine predictors of faint and significant hypotensive reactions that could serve as targets for interventions to reduce reactions, thus improving the blood donation experience for those at higher risk of reactions and reducing the risk of serious adverse events.

Methods  The records of 422,231 allogeneic whole blood donations from a 9‐month period were assessed for adverse reactions. Incidents related to needle insertion, such as hematoma were excluded. Demographic, biometric, and clinical measurements were collected. Reactions were analyzed by multivariate logistic regression analysis comparing donors with any adverse reaction to donors without reactions and by stratified rates according to reaction severity.

Results  The overall reaction prevalence was 1·43%. Of the reactions, 63%, 29% and 8% were classified as mild, moderate and severe, respectively. Markers of reactions were: age, gender, race, blood volume, blood pressure, pulse and body mass index. Compared to donors without reactions, the strongest predictor of a reaction was a donor's blood volume <3500 ml (OR 2·9, 95% CI 2·57–3·23). Age and first time status were also associated with a significantly higher risk of reaction with 17–18 years olds (OR 2·8, 95% CI 2·59–2·98) and 19–24 year olds (OR 2·39, 95% CI 2·23–2·56) at higher risk compared to 25–65 year olds, and first time donors at higher risk compared to repeat donors (OR 2·2, 95% CI 2·07–2·33). Using a lower weight limit of 50 kg does not prevent donors from giving more than 15% of their blood volume.

Conclusion  The results of this study are helpful in identifying donors at risk for adverse reactions and in understanding the contributors to reactions. Donor blood volume was a strong predictor of reaction. Selecting donors using blood volume, not weight, should reduce the frequency of reactions.