bluuebunny/crossref_metadata_2025 huggingface dataset:
Reading the Sermon on the Mount in an Age of Ecological Catastrophe
Authors: Bauckham Richard
Published: December 2008

This article offers a reading of Matthew 6:25—34 in its first-century context and a reflection on how it can address our contemporary context of ecological catastrophe. Jesus takes the birds and the wild flowers as examples of God's generous provision for all his creatures. His hearers or readers can learn to trust God for basic needs, but only by seeing the world as God's creation and themselves as fellow-creatures with non-human creatures in the community of creation. For readers today this should free them from modern Western society's addiction to excess and enable them to live within created limits.
An Extensible Product Structure Model for Product Lifecycle Management in the Make-to-Order Environment
Authors: Ni Q.F. , Lu W.F. , Yarlagadda Prasad K. D. V.
Published: December 2008

This article presents a product structure model for developing product lifecycle management systems that is flexible for make-to-order environment. In the make-to-order business context, each product could have a number of variants with slightly different constitutions to fulfill different customer requirements. All the variants of a family have common characteristics and each variant has its specific features. A master-variant pattern is proposed for building the product structure model to explicitly represent common characteristics and specific features of individual variants. The model is capable of enforcing the consistency of a family structure and its variant structure, supporting multiple product views, and facilitating the business processes. A prototype as a proof-of-concept system is presented to illustrate the capability of the proposed extensible product structure model.
The Role of Race/Ethnicity and Race Relations on Public Opinion Related to the Treatment of Blacks by the Police
Authors: Gabbidon Shaun L. , Higgins George E.
Published: December 2008

Previous research has identified strong effects of race on the evaluations of police performance. This research expands on past research by investigating public opinion related to Black treatment by the police. Recent Gallup poll data were examined to determine whether race and ethnicity influenced citizens' views on the treatment of Blacks in comparison to Whites by the police. In addition, the authors examined whether race relations affected citizens' views on the treatment of Blacks by the police. On both fronts, support was found for the influence of these factors. Demographic variables such as age, gender, education, employment status, region, and political ideology were also significantly related to public opinion regarding the perceived treatment of Blacks by the police. After contextualizing these results, the authors discuss the implication of the findings.
Ethical and Cultural Considerations in Delivering Psychiatric Diagnosis: Reconciling the Gap Using MDD Diagnosis Delivery in Less-Acculturated Chinese Patients
Authors: Yeung Albert , Kam Raymond
Published: December 2008

Talking to patients from diverse cultural backgrounds about their psychiatric disorders requires knowledge of one's own culture, the patients' cultures, and the ways in which they might interact, both in positive and unexpectedly negative ways. In this paper, we discuss the issues raised by discussing psychiatric diagnoses with Chinese-Americans who hold traditional illness beliefs and are not familiar with Western conceptions of psychiatric disorders. We explore how cultural values influence this aspect of medical practice, and suggest practical approaches to communicating the diagnosis of major depressive disorder in a culturally sensitive manner. Our clinical approach is to develop co-constructed illness narratives with patients, and to aid this process by reframing different elements of the clinical process into more culturally resonant forms. The following steps are suggested: 1) elicit patient's illness beliefs; 2) understand and acknowledge multiple explanatory models; 3) contextualize depressive symptoms into patient's physical health and social system; 4) introduce Western psychiatric theories in ways that reflect assumptions shared by Traditional Chinese Medicine (TCM); 5) involve patients' families whenever possible; and 6) use terminology that avoids unintended stigma.
When Providers and Patients Come from Different Backgrounds: Perceived Value of Additional Training on Ethical Care Practices
Authors: Roberts Laura Weiss , Johnson Mark E. , Brems Christiane , Warner Teddy D.
Published: December 2008

Fostering the therapeutic alliance, safeguarding confidentiality, gaining informed consent, and enhancing treatment adherence are critical aspects of patient care. We examined whether multidisciplinary health care providers perceive additional training on these areas as helpful in their work with patients from different ethnic backgrounds than the provider. Data are drawn from a National Institute on Drug Abuse-funded survey of 1555 providers in 8 disciplines in New Mexico and Alaska. Clinicians viewed additional training as moderately helpful for ensuring treatment adherence, establishing the therapeutic alliance, safeguarding confidentiality, and engaging in informed consent processes, in that order. Women were more receptive than men to additional training. Modest differences were detected between behavioral and physical health providers and between minority and majority providers. Implications of providers' only modest interest in such training are discussed.
Adapting the SRQ for Ethiopian Populations: A Culturally-Sensitive Psychiatric Screening Instrument
Authors: Youngmann Rafael , Zilber Nelly , Workneh Fikre , Giel Robert
Published: December 2008

The objective of the study was to develop a culturally sensitive psychiatric screening instrument valid for Ethiopians in Ethiopia and Israel. The study sample was composed of 356 Amharic-speaking Ethiopians from Ethiopia and Israel, aged 18—55, divided into three groups: i) general population; ii) people in non-psychiatric treatment; iii) people in psychiatric treatment. They were interviewed with the Self-Reporting Questionnaire (SRQ), modified to include 10 culturally specific items, and the Brief Psychiatric Research Scale (BPRS) as a criterion of psychopathology. Physicians also completed an encounter form about the presence of mental health symptoms in participants. To make the questions more culturespecific, the translation of 12 items on the SRQ was changed. The content, construct, and criterion validity of each question were also examined, leading to the deletion of five items. The validity of the revised instrument (SRQ-F) was superior to that of the original instrument (SRQ). This study demonstrates the need for psychiatric screening instruments to be adapted to different cultures by incorporating meaningful translations and adding culturally specific items.
Daily Stressors, War Experiences, and Mental Health in Afghanistan
Authors: Miller Kenneth E. , Omidian Patricia , Rasmussen Andrew , Yaqubi Aziz , Daudzai Haqmal
Published: December 2008

Working in Afghanistan's capital city of Kabul, the authors assessed the relative contribution of daily stressors and war-related experiences of violence and loss to levels of depression, PTSD, impaired functioning, and a culturally specific measure of general psychological distress. For women, daily stressors were a better predictor than war experiences of all mental health outcomes except for PTSD; for men, daily stressors were a better predictor of depression and functional impairment, while war experiences and daily stressors were similarly predictive of general distress. For men, daily stressors moderated the relationship between war experiences and PTSD, which was significant only under conditions of low daily stress. The study's implications for research and intervention in conflict and post-conflict settings are considered.
Cultural Factors in the Diagnosis and Treatment of Traumatised Migrant Patients from Turkey
Authors: Schouler-Ocak Meryam , Reiske Sophie-Luise , Rapp Michael A. , Heinz Andreas
Published: December 2008

The process of migration may be associated not only with great hope, but also with distressing experiences that can lead to trauma and posttraumatic stress disorders. Although some of the symptoms induced by trauma are common across cultures, the strategies used to deal with them are often culture-specific. In the following paper, we consider the unique aspects of trauma-focused psychotherapy in patients with a history of migration. We discuss a variety of culture-specific factors with the help of two case histories.
Arab Culture and Mental Health Care
Authors: Fakhr El-Islam M.
Published: December 2008

This selective review describes recent literature and the author's experience with mental illness and mental health care, and the impact of cultural transformation on mental health in some Arab Islamic cultures, particularly in Egypt, Qatar and Kuwait. Traditional extended Arab families provide a structure for their members that may sometimes prevent and or compensate for the effects of parental loss and mental disability. The role of traditional families in the care of members and in medical decision-making is discussed. The impact of cultural change on Arab culture is also examined, as is the effect of intergenerational conflict in traditional families.
Ramadan Fasting Triggering Koro-like Symptoms during Acute Alcohol Withdrawal: A Case Report from Oman
Authors: Al-Sinawi Hamed , Al-Adawi Samir , Al-Guenedi Amr
Published: December 2008

This article describes a case of koro-like symptoms from Oman associated with alcohol withdrawal and illustrates how the socio-cultural practices of Ramadan-fasting affected the patterning and timing of presentation of severe alcohol withdrawal symptoms. The patient was severely distressed by the delusion that his penis had been amputated. The acute anxiety involving this delusion appears to be conceptually and phenomenologically similar to koro.
Hybrid Endovascular Repair of an Aneurysmal Chronic Type B Dissection in a Patient with Marfan Syndrome With an Aberrant Right Subclavian Artery
Authors: Cooper David G. , Markur Shiraz , Walsh Stewart R. , Cousins Claire , Hayes Paul D. , Boyle Jonathan R.
Published: December 2008

Abnormal aortic arch anatomy is relatively uncommon but most frequently involves an aberrant right subclavian artery. Rarely, it is associated with aneurysmal dilatation of a chronic type B dissection. Under such circumstances, the abnormal anatomy may complicate therapeutics options. Furthermore, controversy exists regarding the use of surgical or endovascular techniques in patients with aortic aneurysms and underlying arteriopathies. The current literature is limited with regard to reporting of the latter. We present a hybrid approach to repair such an aneurysm in a patient with Marfan syndrome. In a 2-stage procedure, involving initial supra-aortic bypass to all aortic arch branches, followed by endovascular stent graft deployment, the aneurysm was successfully excluded. There were no immediate complications and no evidence of endoleak at 3 months postoperatively, with thrombosis of the false lumen in the chest. By adapting hybrid open and endovascular techniques, complex thoracic aneurysms may be successfully treated in the short term in the presence of an underlying arteriopathy.
Surgical Versus Endovascular Reconstruction for Chronic Mesenteric Ischemia: A Contemporary UK Series
Authors: Davies Robert S. M. , Wall Michael L. , Silverman Stanley H. , Simms Malcolm H. , Vohra Rajiv K. , Bradbury Andrew W. , Adam Donald J.
Published: December 2008

Objective: To assess the outcome of surgical (SR) and endovascular (ER) reconstruction for chronic mesenteric ischemia (CMI). Methods: Retrospective review of consecutive patients who underwent SR or ER for CMI in 3 UK vascular surgery units between 1996 and 2006. Early (<30 days; technical success, morbidity, mortality, length of hospital stay) and late (>30 days) outcomes (symptom recurrence, vessel/graft patency, reintervention, mortality) were assessed. Results: A total of 27 patients underwent 32 reconstructions (SR = 17, ER = 15). A total of 44 of 56 (79%) diseased arteries underwent SR (n = 26; bypass = 24, reimplantation = 2; occlusion = 16, stenosis = 10) or ER (n = 18; stenosis = 16, occlusion = 2). Perioperative mortality for SR and ER was 6% and 0%, respectively (P ≥ .99). Hospital stay was shorter following ER (mean, 4.3 vs. 14.2 days, P = .0003). Mean (range) follow-up for SR and ER was 34 (1-94) and 34 (0-135) months, respectively. At 2 years, SR demonstrated superior secondary patency (100% vs. 65%) and clinical patency (100% vs. 73%). Conclusions: Surgical mesenteric reconstruction is associated with significantly longer hospital stay, but superior long-term outcome compared to endovascular reconstruction.
Effects of an Aerobic Exercise Program on Aerobic Capacity, Spatiotemporal Gait Parameters, and Functional Capacity in Subacute Stroke
Authors: Tang Ada , Sibley Kathryn M. , Thomas Scott G. , Bayley Mark T. , Richardson Denyse , McIlroy William E. , Brooks Dina
Published: December 2008

Background and objective. In spite of the challenges, engaging in exercise programs very early after stroke may positively influence aerobic capacity and stroke-related outcomes, including walking ability. The objective of this study was to evaluate the feasibility of adding aerobic cycle ergometer training to conventional rehabilitation early after stroke and to determine effects on aerobic capacity, walking ability, and health-related quality of life. Methods. A prospective matched control design was used. All participants performed a graded maximal exercise test on a semi-recumbent cycle ergometer, spatiotemporal gait assessments, 6-Minute Walk Test, and Stroke Impact Scale. The Exercise group added 30 minutes of aerobic cycle ergometry to conventional inpatient rehabilitation 3 days/week until discharge; the Control group received conventional rehabilitation only. Results. All Exercise participants (n = 23) completed the training without adverse effects. In the 18 matched pairs, both groups demonstrated improvements over time with a trend toward greater aerobic benefit in the Exercise group with 13% and 23% increases in peak VO2 and work rate respectively, compared to 8% and 16% in the Control group (group-time interaction P = .71 and .62). A similar trend toward improved 6-Minute Walk Test distance (Exercise 53% vs Controls 23%, P = .23) was observed. Conclusion. Early aerobic training can be safely implemented without deleterious effects on stroke rehabilitation. A trend toward greater improvement in aerobic capacity and walking capacity suggests that such training may have an early beneficial effect and should be considered for inclusion in rehabilitation programs.
`Recovery' and current mental health policy
Authors: Pilgrim David
Published: December 2008

This article examines a central plank of current mental health policy — `recovery'. The latter is being used increasingly as a harbinger of progress, when discussing improvements in service quality and social inclusion. Mainly using Britain as a case study, different usages of the term are considered on the part of three main interest groups: traditional biomedical psychiatrists; social psychiatrists emphasizing social skills training; and dissenting service users. These different usages suggest that `recovery' is a polyvalent concept, which creates an uneasy consensus point to define the management philosophies of local services enacting mental health policy. It has also emerged during a time when government health policy is seeking to support people with chronic conditions in community settings on the one hand and minimize the risks they might pose on the other. This tension is particularly relevant for those with mental health problems.
The expert patients programme online, a 1-year study of an Internet-based self-management programme for people with long-term conditions
Authors: Lorig Kate R. , Ritter Philip L. , Dost Ayesha , Plant Kathryn , Laurent Diana D. , Mcneil Ian
Published: December 2008

Objectives: Evaluate the effectiveness of an online self-management programme (EPP Online) for England residents with long-term conditions.

Methods: A prospective longitudinal study. Data were collected online at baseline, 6 and 12 months. The intervention was an asynchronous 6-week chronic-disease self-management programme offered online. We measured seven health status measures (health distress, self-rated health, illness intrusiveness, disability, fatigue, pain and shortness of breath), four behaviours (aerobic exercise, stretching exercise, stress management and communications with physician), and five utilization measures (GP visits, pharmacy visits, PT/OT visits, emergency visits and hospitalizations). We also measured self-efficacy and satisfaction with the health care system.

Results: A total of 568 completed baseline data: 546 (81%) completed 6 months and 443 (78%) completed 1 year. Significant improvements (p<0.01) were found at 6 months for all variables except self-rated health, disability, stretching, hospitalizations and nights in hospital. At 12 months only decrease in disability, nights in hospital and hospitalizations were not significant with reduction in visits to emergency departments being marginally significant (p = 0.012). Both self-efficacy and satisfaction with the health care system improved significantly.

Discussion: The peer-led online programme conditions appears to decrease symptoms, improve health behaviours, self-efficacy and satisfaction with the health care system and reducing health care utilization up to 1 year.
Crack analysis near vacuum brazing interface of Cu/Al dissimilar materials using Al–Si brazing alloy
Authors: Xia C. Z. , Li Y. J. , Puchkov U. A. , Gerasimov S. A. , Wang J.
Published: December 2008

The present paper concentrates on the factors inducing cracking near the Cu/Al vacuum brazing interface using Al–Si brazing alloy. Various analysis and test methods were adopted to analyse the cause of the cracking. Experiment results indicated that two intermetallic compounds layers – δ phase and θ phase – were formed near the interface of Cu and brazing seam region. The microhardness of both the two intermetallic compounds phases reached 720 and 510 HM respectively. The brazing seam region consisted mainly of θ phase and α-Al (Cu) solid solution. Si presence had led to obvious zone liquation in the brazing seam region. Stress concentration appeared on the margin and edge region of the joint. The crack initiated on the θ phase layer, and then extended towards the brazing seam region and δ phase layer. The separation in the θ phase had an obviously brittle fracture surface.
Through thickness residual stresses in large rolls and sleeves for metal working industry
Authors: Hosseinzadeh F. , Smith D. J. , Truman C. E.
Published: December 2008

There is little experimental knowledge about the initial state of through thickness residual stresses in rolls and sleeves for the steel rolling industry. This is surprising bearing in mind the impact that residual stress has on the performance of the roll and sleeve materials in the highly aggressive loading environments of the metal working industry. Previous work has been confined to measurement of very near surface residual stresses and numerical predictions of residual stress distributions. In the present paper through thickness residual stress measurements were carried out using a deep hole drilling technique on a series of rolls and sleeves representative of those used in the rolling industry. Different features of the manufacturing processes used in their production are shown to influence the magnitude and distribution of the residual stresses. It is also shown that the measurements can be used, together with a finite element analysis, to determine the volumetric distribution of the residual stresses.
Rac GTPases play critical roles in early T-cell development
Authors: Dumont Celine , Corsoni-Tadrzak Agnieszka , Ruf Sandra , de Boer Jasper , Williams Adam , Turner Martin , Kioussis Dimitris , Tybulewicz Victor L. J.
Published: December 2008

The Rac1 and Rac2 GTPases play important roles in many processes including cytoskeletal reorganization, proliferation, and survival, and are required for B-cell development. Previous studies had shown that deficiency in Rac2 did not affect T-cell development, whereas the function of Rac1 in this process has not been investigated. We now show that simultaneous absence of both GTPases resulted in a very strong developmental block at the pre-TCR checkpoint and in defective positive selection. Unexpectedly, deficiency of Rac1 and Rac2 also resulted in the aberrant survival of thymocytes lacking expression of TCRβ, showing hallmarks of hyperactive Notch signaling. Furthermore, we found a similar novel phenotype in the absence of Vav1, Vav2, and Vav3, which function as guanine nucleotide exchange factors for Rac1 and Rac2. These results show that a pathway containing Vav and Rac proteins may negatively regulate Notch signaling during early thymic development.
Comparative and phylogenomic studies on the mitochondrial genomes of Pentatomomorpha (Insecta: Hemiptera: Heteroptera)
Authors: Hua Jimeng , Li Ming , Dong Pengzhi , Cui Ying , Xie Qiang , Bu Wenjun
Published: December 2008

Background

Nucleotide sequences and the gene arrangements of mitochondrial genomes are effective tools for resolving phylogenetic problems. Hemipteroid insects are known to possess highly reorganized mitochondrial genomes, but in the suborder Heteroptera (Insecta: Hemiptera), there was only one complete mitochondrial genome sequenced without gene rearrangement and the phylogeny of infraorder Pentatomomorpha in Heteroptera was still uncertain.

Results

Fifteen mitochondrial genomes of the suborder Heteroptera were sequenced. Gene rearrangements were found as follows: 1)tRNA-IandtRNA-Qswitched positions in Aradidae, 2)tRNA-TandtRNA-Pswitched positions in Largidae and Pyrrhocoridae. Two recombination events were found in Alydidae and Malcidae. The other mt-genomes were organized in the same way as observed inDrosophila yakuba. The phylogenetic analyses of infraorder Pentatomomorpha based on the nucleotide sequence raised the hypothesis of (Aradoidea + (Pentatomoidea + (Pyrrhocoroidea + (Lygaeoidea + Coreoidea)))). The rearrangement oftRNA-TandtRNA-Palso linked Largidae and Pyrrhocoridae together. Furthermore, the conserved sequence block in the unusual intergenic spacers betweentRNA-HandND4favored the monophyly of Lygaeoidea. Tetranucleotide ATCA was inferred to be the initiation codon ofND2in Cydnidae. No correlation was found between the rates of nucleotide substitution and gene rearrangement. CG content was significantly correlated with the nucleotide substitution rate of each gene. For ND1, there was a positive correlation (P< 0.01) between amino acids variations and hydrophobicity, but a negative correlation (P< 0.01) for ND6. No conserved sequence was found among the control regions and these regions were not always the most AT-rich region of the mt-genome.

Conclusion

Heteropteran insects are extremely complex groups worthy of further study because of the unusual tetranucleotide initiation codon and their great mt-genomic diversity, including gene rearrangements and recombinations. The mt-genome is a powerful molecular marker for resolving phylogeny at the level of the superfamily and family. Gene rearrangements were not correlated with nucleotide substitution rates. CG content variation caused the different evolutionary patterns among genes. For ND1, in many polar or nonpolar regions the specific identity of the amino acid residues might be more important than maintaining the polarity of these regions, while the opposite is true for ND6. Most sequences of the control regions did not appear to be important for regulatory functions. Finally, we suggest that the term "AT-rich regions" should not be used.
Transcriptome profiling of the feeding-to-fasting transition in chicken liver
Authors: Désert Colette , Duclos Michel J , Blavy Pierre , Lecerf Frédéric , Moreews François , Klopp Christophe , Aubry Marc , Herault Frédéric , Le Roy Pascale , Berri Cécile , Douaire Madeleine , Diot Christian , Lagarrigue Sandrine
Published: December 2008

Background

Starvation triggers a complex array of adaptative metabolic responses including energy-metabolic responses, a process which must imply tissue specific alterations in gene expression and in which the liver plays a central role. The present study aimed to describe the evolution of global gene expression profiles in liver of 4-week-old male chickens during a 48 h fasting period using a chicken 20 K oligoarray.

Results

A large number of genes were modulated by fasting (3532 genes with a pvalue corrected by Benjamini-Hochberg < 0.01); 2062 showed an amplitude of variation higher than +/- 40% among those, 1162 presented an human ortholog, allowing to collect functional information. Notably more genes were down-regulated than up-regulated, whatever the duration of fasting (16 h or 48 h). The number of genes differentially expressed after 48 h of fasting was 3.5-fold higher than after 16 h of fasting. Four clusters of co-expressed genes were identified by a hierarchical cluster analysis. Gene Ontology, KEGG and Ingenuity databases were then used to identify the metabolic processes associated to each cluster. After 16 h of fasting, genes involved in ketogenesis, gluconeogenesis and mitochondrial or peroxisomal fatty acid beta-oxidation, were up-regulated (cluster-1) whereas genes involved in fatty acid and cholesterol synthesis were down-regulated (cluster-2). For all genes tested, the microarray data was confirmed by quantitative RT-PCR. Most genes were altered by fasting as already reported in mammals. A notable exception was theHMG-CoA synthase 1gene, which was up-regulated following 16 and 48 h of fasting while the other genes involved in cholesterol metabolism were down-regulated as reported in mammalian studies. We further focused on genes not represented on the microarray and candidates for the regulation of the target genes belonging to cluster-1 and -2 and involved in lipid metabolism. Data are provided concerning PPARa, SREBP1, SREBP2, NR1H3 transcription factors and two desaturases (FADS1, FADS2).

Conclusion

This study evidences numerous genes altered by starvation in chickens and suggests a global repression of cellular activity in response to this stressor. The central role of lipid and acetyl-CoA metabolisms and its regulation at transcriptional level are confirmed in chicken liver in response to short-term fasting. Interesting expression modulations were observed forNR1H3, FADS1andFADS2genes. Further studies are needed to precise their role in the complex regulatory network controlling lipid metabolism.
Eventration of diaphragm with gastric volvulus: a case report
Authors: Shah Naveed Nazir , Mohsin Mir , Khursheed Syed Quibtiya , Farooq Syed Suraiya Arjumand , Buchh Arshad Altaf , Quraishi Abdul Quadir
Published: December 2008

Background

Eventration of diaphragm associated with gastric volvulus is an uncommon condition.

Case presentation

We are reporting a case of a 60-year-old male having left sided total diaphragmatic eventration associated with chronic intermittent organo-axial gastric volvulus. The patient presented with progressive dyspnea and intermittent gastrointestinal symptoms. Plication of left hemidiaphragm with anterior gastropexy was performed through an abdominal approach. Postoperatively the patient's symptoms improved.

Conclusion

Symptomatic gastric volvulus associated with diaphragmatic eventration is a surgical emergency and always requires surgical repair.
Phosphodiesterase 4 inhibition but not beta-adrenergic stimulation suppresses tumor necrosis factor-alpha release in peripheral blood mononuclear cells in septic shock
Authors: Link Andreas , Selejan Simina , Maack Christoph , Lenz Monika , Böhm Michael
Published: December 2008

Introduction

Stimulation of beta2-adrenergic receptors (β2-ARs) inhibits tumor necrosis factor-alpha (TNF-α) release in monocytes. In septic shock, endogenous catecholamines induce β2-AR downregulation, leading to an increased TNF-α release. The aims of this study were to analyze the molecular mechanisms of β-adrenergic downregulation and to explore therapeutic interventions with maintained anti-inflammatory efficacy in septic shock using the inhibition of phosphodiesterase 4 (PDE4).

Methods

We conducted in vitro stimulation of peripheral blood mononuclear cells of healthy volunteers (n = 20) and patients with septic shock (n = 20) with lipopolysaccharide (LPS) or Staphylococcus aureus enterotoxin B (SEB) without or with isoprenaline, forskolin (an activator of adenylate cyclase), or ropipram (an inhibitor of PDE4). We also conducted flow cytometric analysis of Toll-like receptor (TLR) 4 and TLR2 surface expression and intracellular TNF-α production of untreated and stimulated CD14+ monocytes. Protein expression of β-ARs, of G proteins, of adenylate cyclase, and of TLRs was measured by Western blotting.

Results

Investigations were done by LPS (100 ng/mL) or SEB (10 ng/mL) when TLR4 and TLR2 were maximally expressed. LPS- or SEB-treated CD14+ monocytes of healthy volunteers were able to produce TNF-α. This effect was attenuated by isoprenaline, forskolin, or rolipram in a concentration-dependent manner. In CD14+ monocytes of patients with septic shock, the anti-inflammatory effect of isoprenaline was completely blunted whereas efficacy of forskolin and rolipram was maintained. CD14+ monocytes of healthy volunteers were compared with patients with septic shock: protein expression of β2-ARs was reduced and inhibitory G protein was increased, whereas no changes in adenylate cyclase and stimulatory G protein were found.

Conclusions

In septic shock, the anti-inflammatory effects of catecholamines are blunted by downregulation of β2-ARs and upregulation of the inhibitory G protein in CD14+ monocytes. Beta-adrenergic downregulation is overcome by inhibitors of PDE4. These results provide a mechanistic rationale for the therapeutic use of selective PDE4 inhibitors in the treatment of septic shock.
Dermatan sulfate proteoglycan biglycan as a potential selectin L/CD44 ligand involved in selective recruitment of peripheral blood CD16(−) natural killer cells into human endometrium
Authors: Kitaya Kotaro , Yasuo Tadahiro
Published: December 2008

Unique CD16(−) NK cells acutely increase in the human uterine endometrium after ovulation. The origin of these NK cells remains unknown, but they may be recruited selectively from the circulation. Proteoglycans and their glycosaminoglycan side-chains expressed on endometrial microvascular endothelial cells play a key role in lymphocyte tethering/rolling, the initial step of lymphocyte extravasation. In this study, we sought for the potential proteoglycans involved in tethering/rolling of peripheral blood CD16(−) NK cells on endometrial microvascular endothelial cells. As compared with CD16(+) NK cells and non-NK cells, enriched peripheral blood CD16(−) NK cells bound preferably to immobilized glycosaminoglycans except for keratan sulfate. CD16(−) NK cells bound maximally to dermatan sulfate (DS), which was diminished by enzymatic pretreatment with dermatanase and chondroitinase ABC, but not with chondroitinase ACII. The binding capacity of CD16(−) NK cells to DS was attenuated by blocking antibodies against selectin L and CD44 or pretreatment of CD16(−) NK cells with IL-15. Of three known DS proteoglycans, biglycan and decorin but not epiphycan were expressed in the human cycling endometrium. In the endometrial microvessels, the immunoreactivity for biglycan was greater in the secretory phase than in the proliferative phase, and there was little, if any, immunoreactivity for decorin throughout the menstrual cycle. The ovarian steroid progesterone enhanced biglycan expression in cultured human uterine microvascular endothelial cells. These findings demonstrated that DS proteoglycan biglycan is a potential selectin L/CD44 ligand involved in tethering/rolling of peripheral blood CD16(−) NK cells on endometrial microvascular endothelial cells.
Hypoglycemia with Intensive Insulin Therapy: A Systematic Review and Meta-Analyses of Randomized Trials of Continuous Subcutaneous Insulin Infusion Versus Multiple Daily Injections
Authors: Fatourechi Mitra M. , Kudva Yogish C. , Murad M. Hassan , Elamin Mohamed B. , Tabini Claudia C. , Montori Victor M.
Published: December 2008

Context: Hypoglycemia limits the efficacy of intensive insulin therapy. The extent to which continuous insulin infusion (CSII) overcomes this limitation is unclear.

Objective: The aim was to summarize evidence on the effect of CSII and multiple daily injections (MDIs) on glycemic control and hypoglycemia.

Data Sources: We searched electronic databases between 2002 and March 2008.

Study Selection: We selected published randomized trials of CSII vs. MDI.

Data Extraction: Reviewers working in duplicate and independently extracted study characteristics and quality and differences in glycosylated hemoglobin (HbA1c) and hypoglycemic events.

Data Synthesis: We found 15 eligible randomized trials of moderate quality, with elevated baseline and end-of-study HbA1c levels. Patients with type 1 diabetes using CSII had slightly lower HbA1c [random-effects weighted mean difference, −0.2%; 95% confidence interval (CI), −0.3, −0.1, compared with MDI], with no significant difference in severe (pooled odds ratio, 0.48; 95% CI, 0.23, 1.00) or nocturnal hypoglycemia (pooled odds ratio 0.82, 95% CI 0.33, 2.03). Adolescents and adults with type 1 diabetes enrolled in crossover trials had nonsignificantly fewer minor hypoglycemia episodes per patient per week (−0.08; 95% CI, −0.21, 0.06) with CSII than MDI; children enrolled in parallel trials had significantly more episodes (0.68; 95% CI, 0.16, 1.20; Pinteraction = 0.03). Outcomes were not different in patients with type 2 diabetes.

Conclusions: Contemporary evidence indicates that compared to MDI, CSII slightly reduced HbA1c in adults with type 1 diabetes, with unclear impact on hypoglycemia. In type 2 diabetes, CSII and MDI had similar outcomes. The effect in patients with hypoglycemia unawareness or recurrent severe hypoglycemia remains unclear because of lack of data.
Aromatase and 5α-Reductase Inhibition during an Exogenous Testosterone Clamp Unveils Selective Sex Steroid Modulation of Somatostatin and Growth Hormone Secretagogue Actions in Healthy Older Men
Authors: Veldhuis Johannes D. , Mielke Kristi L. , Cosma Mihaela , Soares-Welch Cacia , Paulo Remberto , Miles John M. , Bowers Cyril Y.
Published: December 2008

Background: How endogenous testosterone (Te), 5α-dihydrotestosterone (DHT), and estradiol (E2) regulate pulsatile GH secretion is not understood.

Hypothesis: Conversion of Te to androgenic (Te→DHT) or estrogenic (Te→E2) products directs GH secretion.

Subjects and Location: Healthy older men (N = 42, ages 50–79 yr) participated at an academic medical center.

Methods: We inhibited 5α-reduction with dutasteride and aromatization with anastrozole during a pharmacological Te clamp and infused somatostatin (SS), GHRH, GH-releasing peptide-2 (GHRP-2), and l-arginine/GHRH/GHRP-2 (triple stimulus) to modulate GH secretion.

Endpoints: Deconvolution-estimated basal and pulsatile GH secretion was assessed.

Results: Administration of Te/placebo elevated Te by 2.8-fold, DHT by 2.6-fold, and E2 concentrations by 1.9-fold above placebo/placebo. Te/dutasteride and Te/anastrozole reduced stimulated DHT and E2 by 89 and 86%, respectively. Stepwise forward-selection regression analysis revealed that 1) Te positively determines mean (P = 0.017) and peak (P < 0.001) GH concentrations, basal GH secretion (P = 0.015), and pulsatile GH secretion stimulated by GHRP-2 (P < 0.001); 2) Te and E2 jointly predict GH responses to the triple stimulus (positively for Te, P = 0.006, and negatively for E2, P = 0.031); and 3) DHT correlates positively with pulsatile GH secretion during SS infusion (P = 0.011). These effects persisted when abdominal visceral fat was included in the regression.

Conclusion: The present outcomes suggest a tetrapartite model of GH regulation in men, in which systemic concentrations of Te, DHT, and E2 along with abdominal visceral fat determine the selective actions of GH secretagogues and SS.
Analysis of residual strain and stress states due to heat treatment and thermal processing
Authors: Vorster W J J , Korsunsky A M
Published: December 2008

This paper dwells on the nature of the highly non-linear interactions occurring during heat treatments with the aim of developing an improved understanding of the process and of the residual strains and stresses formed in heat-treated components during processing. As an example, two industrial quench processes are analysed. A general analytical strategy is presented to study not only these processes, but is formulated in such a way that it may also be extended to other thermomechanical processes. This strategy may therefore serve as a roadmap for industrial designers to analyse thermomechanical processes for optimization. Results in the broad framework of thermomechanical processing indicate that careful characterization and correct representation of the heat transfer conditions leads to significant improvements in accuracy over the current quench modelling techniques. In addition to this, the nature of the thermomechanics involved in spray and bath quench processes is analysed. Neutron diffraction experiments and finite element analyses indicate that the use of water sprays reduces the depth of permanent deformation in quenched components compared to those treated in a water bath. It is shown that this is a direct consequence of the rewetting condition. Understanding the processes involved enables the processing engineer to perform optimization studies of the thermomechanical process, before processing. This ultimately allows production of engineering components with superior mechanical properties, reduced distortion and well-controlled beneficial residual stress states.
Eigenstrain-based model for prediction of laser peening residual stresses in arbitrary three-dimensional bodies Part 2: Model verification
Authors: DeWald A T , Hill M R
Published: December 2008

This paper presents the results from a set of experiments designed to quantify the accuracy of the laser peening residual stress prediction model presented in Part 1. Firstly, a set of specimens containing common geometric features (e.g. corner radii and corner fillets) were machined from annealed 316L stainless steel plate. The regions around the geometric features were treated with laser peening and the resulting residual stress was measured using the contour method. Secondly, the laser peening residual stress prediction model was used to predict the residual stress produced by laser peening for the same set of specimens. A detailed comparison between the measurements and predictions is given in the form of contour plots and line plots of the measured and predicted residual stress. The results show that the model has a fair amount of agreement with the measurements over the range of geometry studied. Both the modelling and experimental results show that a decrease in the radius size for the corner fillet geometry results in an increase in the depth of compressive residual stress and a decrease in the magnitude of the surface residual stress. Both sets of results for the corner radius geometry show that a decrease in the radius size gives a decrease in the magnitude of the compressive surface residual stress. There is disagreement between the measurements and the predictions with respect to the relation between radius size and depth of compressive residual stress for the corner radius geometry.
Eigenstrain analysis of residual strains and stresses
Authors: Korsunsky A M
Published: December 2008

Experimental stress evaluation procedures often rely on the measurement of some component(s) of elastic strain followed by point-wise calculation of stress based on continuum elasticity assumptions. Such point-wise assessments are, however, incomplete and not entirely satisfactory, as calculations conducted for different points can easily give rise to values that may not satisfy requirements of global force balance. The real purpose of experimental data interpretation is in fact to obtain a reasonably internally consistent description of the state of stress everywhere in the object to the greatest possible level of detail. What is usually being sought is a residual-stress-admissible (RS-admissible) field, i.e. such that would satisfy boundary conditions imposed both in terms of tractions and displacements, and would correspond to a divergence-free stress field (i.e. such that satisfies stress equilibrium conditions everywhere). Note, however, that elastic strains are no longer required to be compatible. The lack of compatibility of elastic strains arises from the presence of incompatible plastic strains, acting as the origin of residual stresses throughout the object.

The present study considers the practical challenge of finding the most probable RS-admissible stress–strain field that corresponds to a set of experimental measurements of residual elastic strains at a number of experimental points. A simple optimization formulation is introduced, and the procedure for finding the unknown underlying distribution of eigenstrains is described. It is then illustrated using examples of one- and two-dimensional residual stress profiles. The implications of this approach are discussed for the analysis of residual stress effects on the durability of engineering structures and assemblies.
Can clinicians benefit from patient satisfaction surveys? Evaluating the NSF for Older People, 2005–2006
Authors: lliffe Steve , Wilcock Jane , Manthorpe Jill , Moriarty Jo , Cornes Michelle , Clough Roger , Bright Les ,   Older People Researching Social Issues (OPRSI)
Published: December 2008

Summary

Background

A transformation of healthcare is underway, from a sellers' market to a consumers' market, where the satisfaction of the patient's needs is part of the definition of quality. Patient satisfaction surveys are widely used to judge service quality, but clinicians are sceptical about them because they are too often poorly designed measures that do not lead to improvements in the quality of care.

Aim

To explore the use of patient satisfaction survey data in identifying problems with the provision of inpatient care for older people.

Methods

A case study using secondary analysis of postal survey data about older people's experiences of health and social care services, obtained during the evaluation of the National Service Framework for Older People in 2005–2006. The survey asked about experiences of inpatient care and of discharge from hospital, and sought perceptions of the avoidability of the admission.

Settings and participants

A total of 4170 people aged 50 years and over returned a postal questionnaire in six local authority areas of England. Responses from 584 who had experienced a recent overnight stay in hospital are reported and discussed.

Findings

The response rate was 35%, ranging from 26% to 44% in the six areas surveyed. The great majority of those who had recent direct experience of inpatient care reported that they had been engaged in decision-making, that staff promoted their independence and maintained their dignity. There were widespread examples, however, of the opposite experiences. Discharge from hospital was problematic for about one-third of survey respondents with this experience, and there were different accounts of poorly managed discharges from all areas.

Conclusions

Case studies using local survey data can be used as formative assessments of services. The response rate to the survey and the likelihood of responder bias mean that patient satisfaction survey data of this sort cannot be used to judge or compare services in a summative way, but can highlight areas where remedial action is needed. Small-scale local surveys may seem to lack the robustness of larger studies, but do identify similar areas of concern. Commissioners and clinicians could use the findings of such surveys to inform dialogues about the quality of hospital care for older people.
Jacques-Louis David’s tumour: an opportunity to study the natural history of a pleomorphic adenoma of the parotid gland
Authors: Wine Humphrey , Baum Michael
Published: December 2008

Summary

The great artist and one-time revolutionary, Jacques-Louis David died in 1825. The cause of his death has been open to speculation. An extraordinary sequence of portraits of the artist describes his transition from handsome middle age to a deformed old man. During this phase a swelling appears at the angle of his left jaw and over a period of 20 years a facial palsy can be diagnosed. We submit that this evidence suggests that malignant transformation of a pleomorphic adenoma of the parotid gland was the proximal cause of his death.
From Peer Production to Productization: A Study of Socially Enabled Business Exchanges in Open Source Service Networks
Authors: Feller Joseph , Finnegan Patrick , Fitzgerald Brian , Hayes Jeremy
Published: December 2008

Peer production phenomena such as open source software (OSS) have been posited as a viable alternative to traditional production models. However, community-based development often falls short of creating software “products” in the sense that consumers understand. Our research identifies an emerging business network archetype in the OSS sector, the open source service network (OSSN), which seeks to address the “productization” challenge. To do so, OSSNs must overcome the problems associated with exchanging resources between firms. We demonstrate that OSSNs overcome exchange problems by primarily relying on social, rather than legal, mechanisms; similar to the OSS communities from which they emerged. This is made possible because OSSNs use IT infrastructures that provide high visibility for primary value-creating activities. The research utilizes a multimethod theory-building approach, deriving a model from extant research, refining the model through qualitative case study analysis, and further refining the model through quantitative analysis of survey data. The paper reveals the manifestation of social mechanisms in OSSNs and how these are used for coordinating and safeguarding exchanges between firms. Specifically, we illustrate the primary importance of a shared macroculture (goals and norms) and collective sanctions for punishing firms who violate these goals/norms. Furthermore, our research highlights the interplay between digital and social networks within OSSNs, demonstrating that the use of social mechanisms is inherently dependent upon the underlying IT infrastructure.
Editorial Notes
Authors: Sambamurthy Vallabh
Published: December 2008

The performance of the journal is reviewed and metrics for 2008 are presented. In addition, key editorial transitions are highlighted.
Subsidence of the stem after impaction bone grafting for revision hip replacement using irradiated bone
Authors: Hassaballa M. , Mehendale S. , Poniatowski S. , Kalantzis G. , Smith E. , Learmonth I. D.
Published: December 2008

Loss of bone stock is a major problem in revision surgery of the hip. Impaction bone grafting of the femur is frequently used when dealing with deficient bone stock. In this retrospective study a consecutive series of 68 patients (69 hips) who had revision of a hip replacement with femoral impaction grafting were reviewed. Irradiated bone allograft was used in all hips. Radiological measurement of subsidence of the stem, incorporation of the graft and remodelling was carried out and showed incorporation of the graft in 26 of 69 hips (38%). However, there was no evidence of trabecular remodelling. Moderate subsidence of 5 mm to 10 mm occurred in ten hips (14.5%), and massive subsidence of > 10 mm in five (7.2%).

The results of this study are less favourable than those of others describing studies of revision of the femoral stem using impaction bone grafting. The absence of the characteristic changes of graft remodelling noted in other series raises the question as to whether irradiated bone graft may be a significant factor influencing the post-operative outcome.