bluuebunny/crossref_metadata_2025 huggingface dataset:
The Relationship Between Organizational Culture and Implementation of Clinical Practice Guidelines
Authors: Dodek Peter , Cahill Naomi E. , Heyland Daren K.
Published: November 2010

The context in which critical care providers work has been shown to be associated with adherence to recommendations of clinical practice guidelines (CPGs). Consideration of contextual factors such as organizational culture may therefore be important when implementing guidelines. Organizational culture has been defined simply as “how things are around here” and encompasses leadership, communication, teamwork, conflict resolution, and other domains. This narrative review highlights the results of recent quantitative and qualitative studies, including studies on adherence to nutrition guidelines in the critical care setting, which demonstrate that elements of organizational culture, such as leadership support, interprofessional collaboration, and shared beliefs about the utility of guidelines, influence adherence to guideline recommendations. Outside nutrition therapy, there is emerging evidence that strategies focusing on organizational change (eg, revision of professional roles, interdisciplinary teams, integrated care delivery, computer systems, and continuous quality improvement) can favorably influence professional performance and patient outcomes. Consequently, future interventions aimed at implementing nutrition guidelines should aim to measure and take into account organizational culture, in addition to considering the characteristics of the patient, provider, and guideline. Further high quality, multimethod studies are required to improve our understanding of how culture influences guideline implementation, and which organizational change strategies might be most effective in optimizing nutrition therapy.
Attitudes and Beliefs Related to the Canadian Critical Care Nutrition Practice Guidelines
Authors: Cahill Naomi E. , Narasimhan Sweta , Dhaliwal Rupinder , Heyland Daren K.
Published: November 2010

Background: The objective of this study was to evaluate the attitudes of critical care practitioners toward the Canadian Critical Care Nutrition Clinical Practice Guidelines (CPGs) and compare them with actual practice. Methods: An international Web‐based survey was conducted. Respondents were asked to rate their strength of recommendation for 26 nutrition practices included in the Canadian CPGs. Attitudinal results were compared with actual practice on each recommendation. Results: 514 practitioners from 27 countries completed the survey. The majority (91.4%) considered nutrition therapy to be very important for critically ill patients. There was strong endorsement for the following established practices: enteral nutrition (EN) used in preference to parenteral nutrition (PN), use of polymeric solutions and feeding protocols, and avoiding hyperglycemia. There was also strong endorsement for the following practices that are not routinely done in actual practice: EN initiated within 24 to 48 hours of admission, use of motility agents, head‐of‐bed elevation, use of glutamine and antioxidants, and maximizing EN before starting PN. There was diversity of opinion on the recommendations pertaining to arginine‐supplemented diets, small bowel feeding, use of pharmaconutrients, intensive insulin therapy, and withholding soybean oil lipids in PN solutions and hypocaloric PN. Conclusion: Overall, attitudes toward the Canadian CPGs were positive. However, we identified some areas where there was diversity of opinion, highlighting a need for further research and education. System tools may be a useful strategy to integrate guideline recommendations into practice where there is strong endorsement but the recommendation is not happening in actual practice.
Randomized Trials in Critical Care Nutrition
Authors: Heyland Daren K. , Heyland Jesse , Dhaliwal Rupinder , Madden Sarah , Cook Deborah
Published: November 2010

Background: The purpose of this methodological review is to quantify and qualify critical care nutrition randomized controlled trials (RCTs) that inform our practice, to evaluate their strengths and limitations, and to recommend strategies for improving the design of future trials in this area. Methods: The literature was systematically reviewed to find all RCTs published between 1980 and December 2008 that evaluated nutrition interventions in critical care. Data were abstracted on the nature and quality of included RCTs. Results: A total of 207 RCTs met the inclusion criteria. Of these, 170 (82.1%) were single‐center, and 37 (17.9%) were multicenter. The largest number of trials evaluated intensive insulin therapy (n = 25), arginine‐supplemented diets (n = 22), and supplemental parenteral glutamine (n = 17). The first RCTs were published in 1983 (n = 2), and the mean sample size was 39.0. In 2008, there were 26 RCTs, each enrolling an average of 237.1 patients. Excluding 2 cluster RCTs, 62 of 205 (30.2%) trials had concealed randomization, 125 of 205 (61.0%) reported on intention‐to‐treat analyses, and 69 of 205 (33.7%) had a double‐blinded intervention; 18 of 205 (8.8%) studies reported on all 3 design characteristics. Currently, 60 critical care nutrition RCTs (18 multicenter trials) are registered on clinical trials registries. Conclusions: The future of clinical critical care nutrition research is promising, with more trials of increasing sample size being conducted. Robust trial methodology, transparent reporting, and the development of research networks will help to further advance this important field.
Impact of Enteral Feeding Protocols on Enteral Nutrition Delivery
Authors: Heyland Daren K. , Cahill Naomi E. , Dhaliwal Rupinder , Sun Xiaoqun , Day Andrew G. , McClave Stephen A.
Published: November 2010

Background: To evaluate the effect of enteral feeding protocols on key indicators of enteral nutrition in the critical care setting. Methods: International, prospective, observational, cohort studies conducted in 2007 and 2008 in 269 intensive care units (ICUs) in 28 countries were combined for the purposes of this analysis. The study included 5497 consecutively enrolled, mechanically ventilated, adult patients who stayed in the ICU for at least 3 days. Sites recorded the presence or absence of a feeding protocol operational in their ICU. They provided selected nutritional data on enrolled patients from ICU admission to ICU discharge for a maximum of 12 days. Sites that used a feeding protocol were compared with those that did not. Results: On average, protocolized sites used more enteral nutrition (EN) alone (70.4% of patients vs 63.6%, P = .0036), started EN earlier (41.2 hours from admission to ICU vs 57.1, P = .0003), and used more motility agents in patients with high gastric residual volumes (64.3% of patients vs 49.0%, P = .0028) compared with sites that did not use a feeding protocol. Overall nutritional adequacy (61.2% of patients' caloric requirements vs 51.7%, P = .0003) and adequacy from EN were higher in protocolized sites compared with nonprotocolized sites (45.4% of requirements vs 34.7%, P < .0001). EN adequacy remained significantly higher after adjustment for pertinent patient and ICU level baseline characteristics. Conclusions: The presence of an enteral feeding protocol is associated with significant improvements in nutrition practice compared with sites that do not use such a protocol.
Nutrition Therapy for the Critically Ill Surgical Patient
Authors: Drover John W. , Cahill Naomi E. , Kutsogiannis Jim , Pagliarello Giuseppe , Wischmeyer Paul , Wang Miao , Day Andrew G. , Heyland Daren K.
Published: November 2010

Background: To identify opportunities for quality improvement, the nutrition adequacy of critically ill surgical patients, in contrast to medical patients, is described. Methods: International, prospective, and observational studies conducted in 2007 and 2008 in 269 intensive care units (ICUs) were combined for purposes of this analysis. Sites provided institutional and patient characteristics and nutrition data from ICU admission to ICU discharge for maximum of 12 days. Medical and surgical patients staying in ICU at least 3 days were compared. Results: A total of 5497 mechanically ventilated adult patients were enrolled; 37.7% had surgical ICU admission diagnosis. Surgical patients were less likely to receive enteral nutrition (EN) (54.6% vs 77.8%) and more likely to receive parenteral nutrition (PN) (13.9% vs 4.4%) (P < .0001). Among patients initiating EN in ICU, surgical patients started EN 21.0 hours later on average (57.8 vs 36.8 hours, P < .0001). Consequently, surgical patients received less of their prescribed calories from EN (33.4% vs 49.6%, P < .0001) or from all nutrition sources (45.8% vs 56.1%, P < .0001). These differences remained after adjustment for patient and site characteristics. Patients undergoing cardiovascular and gastrointestinal surgery were more likely to use PN, were less likely to use EN, started EN later, and had lower total nutrition and EN adequacy rates compared with other surgical patients. Use of feeding and/or glycemic control protocols was associated with increased nutrition adequacy. Conclusions: Surgical patients receive less nutrition than medical patients. Cardiovascular and gastrointestinal surgery patients are at highest risk of iatrogenic malnutrition. Strategies to improve nutrition performance, including use of protocols, are needed.
Guidelines, Guidelines, Guidelines
Authors: Dhaliwal Rupinder , Madden Sarah M. , Cahill Naomi , Jeejeebhoy Khursheed , Kutsogiannis Jim , Muscedere John , McClave Steve , Heyland Daren K.
Published: November 2010

Over the past decade, clinical guidelines for nutrition therapy in the critically ill have been developed by different North American societies. To avoid target audience confusion and uncertainty, there is a need to undergo a review of the content of these guidelines. In this review, the authors compared the grading systems, the levels of evidence used, and the content of North American nutrition clinical guidelines. The 3 clinical guidelines that met their search criteria and hence were included in the comparison are the Canadian Clinical Practice Guidelines, the American Dietetics Association's evidence‐based guideline for critical illness, and the Society of Critical Care Medicine and American Society of Parenteral and Enteral Nutrition's joint guideline. Through their comparison, the authors have shown that although there are several topics where there is a similar direction of recommendation across the 3 societies/organizations, there are stark contrasts among many of the recommendations. These major differences can be attributed to the admission of different populations, lower levels of evidence or expert opinion into the guideline production process, lack of clarity in the link between the evidence and the recommendation, and lack of uniformity in the reporting of levels of evidence and grades of recommendation. The authors have identified the need for the North American nutrition organizations to harmonize the development of future nutrition guidelines in a timely way, so that they remain current and up‐to‐date. Furthermore, guideline users need to be aware of the dissimilarities in these guidelines before applying the recommendations to their daily practice.
Fathering and mothering of preschool boys with hyperactivity
Authors: Keown Louise
Published: November 2010

This study examined links between paternal and maternal parenting factors and preschool hyperactivity in a community sample. Forty-one hyperactive and 38 comparison boys (aged 47—62 months) and their fathers and mothers were assessed on a range of interview, parent questionnaire, and observational measures of parenting and child behavior. Results showed that less observed maternal warmth, fathers’ self-reported overreactive and less authoritative parenting practices, and less satisfaction with parenting (fathers and mothers) were all significantly related to child hyperactivity, following statistical adjustment for the effects of child conduct problems and maternal age. Lower rates of observed paternal and maternal sensitivity were not significantly associated with preschool hyperactivity, after controlling for child conduct problems and maternal age. Findings highlight the importance of considering the role of both fathers’ and mothers’ parenting in the development of boys with early onset hyperactive and attentional behavior difficulties.
The impact of political scandals on political support: An experimental test of two theories
Authors: Maier Jürgen
Published: November 2010

One of the most obvious trends in Western democracies, during the past decades, has been the decline of citizens’ political support (that is, the growth of negative attitudes toward political parties, politicians and democracy). One explanation for this trend is that the number of political scandals has increased. However, the impact of political scandals on political support is not clear. Whereas the dysfunctional theory assumes that political scandals in general have an unfavourable impact on the political system, functional theory claims that political scandals can have positive effects. Using data from an experiment, this article analyses which theory is superior. It finds support for the dysfunctional theory: support for politicians and political parties was significantly eroded after exposure to scandal coverage whereas trust in institutions as well as satisfaction with democracy were not affected. The article concludes that political scandals contribute to the decline of political support.
Analysis of Quality of Proxy Questions in Health Surveys by Behavior Coding
Authors: Benítez Isabel , Padilla José Luis , Ongena Yfke
Published: November 2010

The aim of this study is to show how to analyze the quality of questions for proxy informants by means of behavior coding. Proxy questions can undermine survey data quality because of the fact that proxies respond to questions on behalf of other people. Behavior coding can improve questions by analyzing interviewer–respondent interactions. Twenty-nine proxies participated in the pretesting of a disability questionnaire. The questionnaire includes 11 questions related to daily-life limitations as a result of health problems. Interviewer–proxy interactions were coded and analyzed by means of Sequence Viewer program. The percentages, from a methodological perspective, of ideal “question-and-answer” sequences varied from 28% to 76% throughout the 11 questions analyzed. The results obtained pointed out the necessity of reviewing some of the proxy questions analyzed. Behavior coding can improve the quality of proxy questions in health surveys when proxy informants are surveyed.
Histopathologic Features, Immunophenotyping, Clonality, and Eubacterial Fluorescence In Situ Hybridization in Cats With Lymphocytic Cholangitis/Cholangiohepatitis
Authors: Warren A. , Center S. , McDonough S. , Chiotti R. , Goldstein R. , Meseck E. , Jacobsen M. , Rowland P. , Simpson K.
Published: November 2010

Feline lymphocytic cholangitis is a poorly characterized disease complex with respect to histologic lesions, immunophenotype, and etiopathogenesis. Seventy-eight cases of feline lymphocytic cholangitis ( n = 51) and feline hepatic lymphoma ( n = 27) were reviewed using standardized histopathology, immunophenotyping (B cell and T cell), polymerase chain reaction for T-cell receptor (TCR) gene rearrangement, and fluorescence in situ hybridization (FISH) for eubacteria. Five histopathologic features in cases of lymphocytic cholangitis assisted in its differentiation from hepatic lymphoma: bile duct targeting ( n = 32, 62.7%), ductopenia ( n = 9, 17.6%), peribiliary fibrosis ( n = 37, 72.5%), portal B-cell aggregates ( n = 36, 70.6%), and portal lipogranulomas ( n = 38, 74.5%). The majority of lymphocytic cholangitis cases ( n = 35, 68.6%) were T cell predominant; 15 (29.4%) had an equal mix of B cells and T cells, and 1 (1.9%) had a B cell–predominant infiltrate; 66.6% of hepatic lymphoma cases were T-cell lymphomas. TCR clonality results were unexpected, with 17.1% of cases of lymphocytic cholangitis having clonal or oligoclonal populations and with T-cell lymphomas having variable TCR clonality (63.6% clonal or oligoclonal, 36.3% polyclonal). The majority of lymphocytic cholangitis ( n = 32 of 36, 88.8%) and all hepatic lymphoma cases had no detectable eubacteria using FISH. As demonstrated here, bile duct targeting, ductopenia, peribiliary fibrosis, portal B-cell aggregates, and portal lipogranulomas are lymphocytic cholangitis features that, along with polyclonal TCR (83%), help differentiate it from hepatic lymphoma. No strong evidence was found implicating in situ bacterial colonization as an etiopathogenesis of lymphocytic cholangitis.
Osteoporosis Associated With Pulmonary Silicosis in an Equine Bone Fragility Syndrome
Authors: Arens A. M. , Barr B. , Puchalski S. M. , Poppenga R. , Kulin R. M. , Anderson J. , Stover S. M.
Published: November 2010

California horses incur a bone fragility syndrome manifested by pathologic fractures. This study investigated gross, radiographic, and histologic features of the disorder as well as relationships with silicosis and levels of heavy metals and trace minerals through a postmortem study of 9 affected and 3 unaffected horses. Bones and soft tissues were evaluated grossly and histologically. Bones, lymph nodes, and lung tissue were evaluated radiographically. Tissues were evaluated for silicon levels, intracytoplasmic crystals, heavy metals, and trace minerals. All 9 affected horses had osteoporosis and clinical or subclinical pulmonary disease due to silicosis (8/9) or pneumoconiosis (1/9). All affected horses had radiographic findings consistent with osteopenia and histologic evidence of osteoporosis characterized by osteopenia, numerous resorption cavities, cement lines, and a mosaic lamellar pattern indicative of multiple remodeling events. Silicosis was characterized by widespread pulmonary granuloma formation with fibrosis; variable tracheobronchiolar and mediastinal granulomatous lymphadenitis; intracellular crystals within lung and lymph node macrophages; and pronounced lymph node fibrosis, focal necrosis, and dystrophic calcification. Crystals in lung (6/9) and lymph node (8/9) tissues were identified as cytotoxic silica dioxide polymorphs. Lung and liver tissue from affected horses had elevated levels of elemental silicon. Osteoporosis was highly correlated ( r = 0.8, P < .01) with silicosis. No abnormalities in heavy metal or trace minerals were detected. This evaluation indicated that horses with bone fragility disorder have systemic osteoporosis associated with fibrosing pulmonary silicosis. The etiopathogenesis of the bone fragility syndrome is unknown; however, this study provides circumstantial evidence for a silicate associated osteoporosis.
Effects of Lubricant Content on Extrusion Processing and Mechanical Properties of Wood Flour-High-density Polyethylene Composites
Authors: Adhikary K. B. , Park C. B. , Islam M.R. , Rizvi G. M.
Published: November 2010

Wood plastic composite (WPC) development has been facilitated by the economical extrusion of WPC profiles for various applications. The physical and mechanical properties of WPC products can be optimized by regulating extrusion processing conditions and material formulations. Rectangular WPC profiles were produced with varied high-density polyethylene (HDPE), wood fiber (WF), and lubricant contents under different extrusion conditions in a twin-screw extruder extrusion line. Optimal tensile and flexural properties were obtained with 50 wt% WF at 7 and 3 wt% lubricant and maleated polyethylene (MAPE) contents. The apparent shear viscosity of the WPC melts decreased gradually with increased lubricant content. Hence, for practical applications, a combination of HDPE grade, WF, lubricant, and MAPE contents can provide the benefits of lower shear viscosity while maintaining the mechanical properties and surface smoothness of WPC profiles.
Correlation in Morphology and Thermal Behavior of Nanoclay-reinforced Polyetherimide Nanocomposites
Authors: Dwivedi M. , Alam S. , Ghosh A. K.
Published: November 2010

Organoclay (Cloisite 30B)-reinforced polyetherimide (PEI) and pristine nanoclay (K10)-reinforced PEI nanocomposite films were made by solution casting process with 0.5, 1.0, 2.0, and 3.0 wt% values of nanoclay. Scanning electron micrographs showed that Cloisite 30B was uniformly dispersed in PEI/Cloisite 30B nanocomposites. Glass transition temperature (Tg) of PEI/Cloisite 30B nanocomposites was observed to be higher than those of neat PEI and PEI/K10 nanocomposites. Tg remained unchanged for all wt% values of Cloisite 30B, whereas Tg of PEI/K10 kept on reducing with increasing values of the content of K10. Wide angle X-ray diffraction and transmission electron micrographs showed intercalation and exfoliation, of Cloisite 30B, which restricted the diffusion of heat through silicate layers to achieve high thermal stability of PEI/Cloisite 30B nanocomposites over PEI/K10 nanocomposites in thermogravimetric analysis and isothermal aging.
The Tipping Point of Animacy
Authors: Looser Christine E. , Wheatley Thalia
Published: November 2010

Faces capture humans’ attention; yet, beyond aesthetic appreciation, it is presumably not the face itself that interests people but the mind behind it. Minds think, feel, and act in ways that have direct consequences for well-being, but despite their importance, how minds are perceived in faces is not well understood. We investigated this mechanism by presenting participants with morphed images created from animate (human) and inanimate (mannequin) faces. Life and mind were perceived to “appear” at a consistent location on the morph continuum, close to the human endpoint. This location constituted a categorical boundary, as evidenced by increased sensitivity to differences in image pairs that straddled this tipping point. Additionally, the impression of life was gleaned from the eyes more than from other facial features. These results suggest that human beings are highly attuned to specific facial cues, carried largely in the eyes, that gate the categorical perception of life.
For Whom Is Parting With Possessions More Painful?
Authors: Maddux William W. , Yang Haiyang , Falk Carl , Adam Hajo , Adair Wendi , Endo Yumi , Carmon Ziv , Heine Steven J.
Published: November 2010

The endowment effect—the tendency for owners (potential sellers) to value objects more than potential buyers do—is among the most widely studied judgment and decision-making phenomena. However, the current research is the first to explore whether the effect varies across cultures. Given previously demonstrated cultural differences in self-construals and self-enhancement, we predicted a smaller endowment effect for East Asians compared with Westerners. Two studies involving buyers and sellers of a coffee mug (Study 1a) and a box of chocolates (Study 1b) supported this prediction. Study 2 conceptually replicated this cultural difference by experimentally manipulating independent and interdependent self-construals. Finally, Study 3 provided evidence for an underlying self-enhancement mechanism: Cultural differences emerged when self-object associations were made salient, but disappeared when self-object associations were minimized. Thus, the endowment effect may be influenced by the degree to which independence and self-enhancement (vs. interdependence and self-criticism) are culturally valued or normative.
Review: Testosterone Therapy: Treatment of Metabolic Disturbances in Heart Failure
Authors: Naghi Jesse J. , Philip Kiran J. , DiLibero Deanna , Willix Robert , Schwarz Ernst R.
Published: November 2010

Heart failure (HF) is a complex progressive multisystem disease state with significant morbidity and mortality, which is not solely defined by pathology of the cardiovascular system but also is influenced by neurohormonal regulatory adjustments, peripheral cytokines, as well as hormonal and musculoskeletal dysfunction. Recent attention to the catabolic state found in patients with chronic heart failure has sparked interest in new potential targets for medical therapy. In particular, as many as 26% to 37% of men affected with HF have been found to be testosterone deficient. The severity of androgen deficiency has been shown to correlate with symptoms, functional class, and prognosis in patients with heart failure. Testosterone supplementation has been an accepted therapy in hypogonadal men with fatigue, muscle wasting, and sexual dysfunction for some time. Patients with severe HF show a similar constellation of symptoms and hypothetically would benefit from androgen replacement. Recent clinical studies have confirmed that functional, biochemical, and cardiopulmonary status in patients with HF have significant improvements when treated with testosterone supplementation. Symptomatic improvements may be obtainable in hypogonadal patients with HF who receive supplemental testosterone. This review seeks to outline the cardiovascular and peripheral effects of testosterone supplementation in patients with chronic HF.
Clinical Applications of Bivalirudin in the Cardiac Catheterization Laboratory
Authors: Thompson Keith A. , Philip Kiran J. , Schwarz Ernst R.
Published: November 2010

Heparin has been used in the catheterization laboratory to prevent ischemic complications of percutaneous coronary intervention (PCI). Bivalirudin, a direct thrombin inhibitor, is an anticoagulant that has several pharmacologic advantages over heparin, and it has been proposed that bivalirudin is superior to heparin in its ability to prevent bleeding complications of PCI. As such, there have been a variety of large prospective clinical trials comparing bivalirudin and heparin over the past 13 years. The results of these trials have prompted the general acceptance of bivalirudin as a safe alternative to heparin use during PCI, and bivalirudin has been given a class 1 recommendation by the American College of Cardiology/American Heart Association (ACC/AHA) guidelines for a variety of clinical indications. This article will review the data supporting the use of bivalirudin in the cardiac catheterization laboratory and describe several advantages of bivalirudin over traditional heparin use. We also include a discussion of the use of bivalirudin in conjunction with other medications that are frequently used in the catheterization laboratory. We end with an analysis of the economic differences between bivalirudin and heparin and the impact that financial factors may have on the choice of anticoagulant.
Different Forms of Governance: Responses of Two Metropolitan Regions in Turkey to State Restructuring
Authors: Ataöv Anli , Eraydin Ayda
Published: November 2010

Important differences have recently become apparent in the forms of governance being implemented in different metropolitan regions, even among those within the same country. A number of theoretical debates attempt to explain the nature of these differences, emphasizing the importance of structural factors as well as embedded economic and social characteristics. This article aims to show that existing theoretical debates are linked by three issues that act as interfaces among them: institutions, flows in the form of material resources and regulatory power, and governance capacity and coalitions. This article explores the emerging forms of governance within the two largest metropolitan regions of Turkey, Izmir and Antalya, taking into consideration these three issues.
Exploring Seniors’ Casino Gaming Intention
Authors: Phillips WooMi Jo , Jang SooCheong (Shawn)
Published: November 2010

To better understand seniors’ intentions in visiting casinos, this study proposed an extension of the theory of planned behavior (TPB) with casino gaming motivation. The results of this study suggest that among motivations for seniors to visit casinos, winning and enjoyment directly and positively affected behavioral intentions, and all predictable variables of TPB positively affected seniors’ casino visiting intentions. Contrary to our expectations, past casino visits did not have a moderating effect on the relationships between the major TPB variables (attitude, subjective norm, and perceived behavioral control) casino motivation and behavioral intentions. The overall study results suggest that the proposed extended model is a useful tool for explaining seniors’ casino visiting intentions. Some theoretical and practical implications for casino operations are also discussed.
The Role of Genetic Variation in Muscle Strength
Authors: Kostek Matthew , Hubal Monica J. , Pescatello Linda S.
Published: November 2010

Skeletal muscle is an important link to an individual’s health and quality of life. The primary clinical interest in skeletal muscle is muscle strength. Muscle strength is a complex trait, influenced by biological, morphological, psychological, and environmental factors. Muscle strength is highly variable among individuals and has a strong genetic component. Though several genetic variants have been associated with muscle strength, genes comprising this genetic component are generally unknown. Research examining associations between genetic variants and muscle strength suffers from scientific challenges such as lack of replication, population stratification, and complexity of defining muscle phenotypes. Additionally, non-scientific challenges such as privacy and protection of genetic information and the questionable value of direct-to-consumer genetic marketing exist. How these challenges will influence research examining genetics and muscle strength is uncertain. Findings from this research may lead to improved treatment for muscle-related disease as well as improved health and quality of life. This may be realized through the development of genetic profiles that clinicians can implement into personalized treatment plans. This review will summarize the current literature regarding genetic variation and muscle strength. The authors’ focus will be on the muscle strength response to resistance training. Additionally, the authors discuss challenges and implications of this research.
Tailored Health Communication to Change Lifestyle Behaviors
Authors: Noar Seth M. , Grant Harrington Nancy , Van Stee Stephanie K. , Shemanski Aldrich Rosalie
Published: November 2010

Tailored health communication research represents a very promising line of inquiry that has the potential to produce major impacts on lifestyle behaviors. This study defines tailoring and discusses how tailored interventions operate, including comparing/ contrasting different tailoring channels. Next, the authors review the literature on tailored interventions to change lifestyle behaviors, with a focus on smoking cessation, dietary change, and physical activity, as well as interventions that address multiple lifestyle behaviors. Finally, future directions for tailoring research are discussed. To date, a large literature has amassed showing the promise of tailored programs delivered via print, Internet, local computer/kiosk, telephone, and interpersonal channels. Numerous studies demonstrate that these programs are capable of significant impacts on smoking cessation, dietary change, physical activity, and multiple behavior change. It is concluded that the potential of tailoring will be more fully realized as (a) the field builds a more cumulative science of tailoring and (b) greater dissemination of efficacious tailored programs takes place.
Tomato Consumption and Health: Emerging Benefits
Authors: Burton-Freeman Britt , Reimers Kristin
Published: November 2010

Tomatoes and tomato products are one of the most familiar vegetables in the American diet. Quantitatively, they are the most consumed nonstarchy vegetable and are the most significant source of dietary lycopene; a powerful antioxidant that has greater bioavailability after cooking and processing (eg, canning). A large body of research supports an inverse relationship between consuming tomatoes and tomato products and risk of certain cancers, while emerging research is exploring the protective relationship between tomato intake and a host of conditions, including cardiovascular disease, osteoporosis, ultraviolet light—induced skin damage, and cognitive dysfunction. Initial studies of tomato consumption and disease risk reduction focused on lycopene and antioxidant activity. More recent hypotheses recognize the advantages of the whole tomato; and hence, research on the role of tomato products in health and disease risk reduction extends beyond antioxidant function to include other protective mechanisms such as antithrombotic and anti-inflammatory functions. Increasing daily vegetable intake in the American diet offers the potential to yield significant health benefits. In addition to the specific benefits of tomato consumption, encouraging greater tomato and tomato product consumption may help increase overall vegetable intake because of their wide availability, well-established acceptability, cost-effectiveness, and convenience of multiple forms. Leveraging emerging science about tomatoes and tomato products may be one simple and effective strategy to help individuals increase vegetable intake, leading to improved overall eating patterns, and ultimately, better health.
T-cell immune responses to Wilms tumor 1 protein in myelodysplasia responsive to immunosuppressive therapy
Authors: Sloand Elaine M. , Melenhorst J. Joseph , Tucker Zachary C. G. , Pfannes Loretta , Brenchley Jason M. , Yong Agnes , Visconte Valeria , Wu Colin , Gostick Emma , Scheinberg Phillip , Olnes Matthew J. , Douek Daniel C. , Price David A. , Barrett A. John , Young Neal S.
Published: November 2010

Clinical observations and laboratory evidence link bone marrow failure in myelodysplastic syndrome (MDS) to a T cell–mediated immune process that is responsive to immunosuppressive treatment (IST) in some patients. Previously, we showed that trisomy 8 MDS patients had clonally expanded CD8+ T-cell populations that recognized aneuploid hematopoietic progenitor cells (HPC). Furthermore, microarray analyses showed that Wilms tumor 1 (WT1) gene was overexpressed by trisomy 8 hematopoietic progenitor (CD34+) cells compared with CD34+ cells from healthy donors. Here, we show that WT1 mRNA expression is up-regulated in the bone marrow mononuclear cells of MDS patients with trisomy 8 relative to healthy controls and non–trisomy 8 MDS; WT1 protein levels were also significantly elevated. In addition, using a combination of physical and functional assays to detect the presence and reactivity of specific T cells, respectively, we demonstrate that IST-responsive MDS patients exhibit significant CD4+ and CD8+ T-cell responses directed against WT1. Finally, WT1-specific CD8+ T cells were present within expanded T-cell receptor Vβ subfamilies and inhibited hematopoiesis when added to autologous patient bone marrow cells in culture. Thus, our results suggest that WT1 is one of the antigens that triggers T cell–mediated myelosuppression in MDS.
Lunatic Fringe prolongs Delta/Notch-induced self-renewal of committed αβ T-cell progenitors
Authors: Yuan Julie S. , Tan Joanne B. , Visan Ioana , Matei Irina R. , Urbanellis Peter , Xu Keli , Danska Jayne S. , Egan Sean E. , Guidos Cynthia J.
Published: November 2010

Lunatic Fringe (Lfng) enhances Notch1 activation by Delta-like 4 (DL4) to promote Notch1-dependent T-lineage commitment of thymus-seeding progenitors. Subsequently, Notch1 and T-cell receptor-β (TCRβ)–containing pre-TCR complexes signal CD4/CD8 double-negative 3 (DN3) committed T-cell progenitors to survive, proliferate, and differentiate into CD4/CD8 double-positive (DP) αβ T-cell precursors. Few DP thymocytes develop without Notch1 or pre-TCR signals, whereas ectopic Notch1 activation causes T-cell leukemia. However, mechanisms of a Notch-pre-TCR collaboration during this “β-selection” process are poorly understood. We genetically manipulated Lfng to attenuate or enhance Notch1 activation in DN3 thymocytes without inducing leukemogenesis. We show that Lfng temporally sustains DL-induced Notch1 signaling to prolong proliferative self-renewal of pre-DP thymocytes. Pre-TCR signaling greatly augmented Notch trophic functions to promote robust proliferation of pre-DP progenitors. In contrast, in the absence of DL/Notch signaling, pre-TCR-expressing progenitors rapidly atrophied and differentiated into DP thymocytes. Thus, Lfng prolongs Notch1 signaling to promote self-renewal more than differentiation during the early stages of β-selection. Our data provide novel insights into the Notch-pre-TCR collaboration, and suggest that decreasing Lfng expression during the DN3-DP transition minimizes the potent leukemogenic potential of Notch1 signaling.
Towards individualized follow-up in adult acute myeloid leukemia in remission
Authors: Hokland Peter , Ommen Hans Beier
Published: November 2010

An increasing body of data has demonstrated that the traditional concept of morphologic complete remission in acute myeloid leukemia, in which less than 5% myeloblasts is regarded as a sufficient response criterion, is not biologically sound. Fortunately, the quantitative reverse-transcribed polymerase chain reaction (RT-PCR) method seems to be a promising alternative because of its high degree of preclinical standardization and extreme sensitivity on the background of an accurate day-to-day estimate of sample quality. Widespread implementation of this has, however, to some extent been hampered by the lack of knowledge of how and when to measure minimal residual disease levels and, even more importantly, how to react preemptively on a molecular relapse defined by a PCR reversal. Thus, only few prospective studies have been published to date to clinically validate this assay. Here, we discuss outstanding issues in the clinical implementation of RT-PCR for fusion transcripts, mutated and overexpressed genes in acute myeloid leukemia patients in complete remission, and propose a set of guidelines, which can be used when designing prospective trials aimed at validating the use of RT-PCR as well as for following these patients based on mathematical models for disease recurrence recently developed in our laboratory.
Recovery of B-cell homeostasis after rituximab in chronic graft-versus-host disease
Authors: Sarantopoulos Stefanie , Stevenson Kristen E. , Kim Haesook T. , Washel Whitney S. , Bhuiya Nazmim S. , Cutler Corey S. , Alyea Edwin P. , Ho Vincent T. , Soiffer Robert J. , Antin Joseph H. , Ritz Jerome
Published: November 2010

Investigation of the effects of rituximab (anti-CD20) on B-cell-activating factor of the tumor necrosis factor family (BAFF) and B cells would better define the significance of B-cell homeostasis in chronic graft-versus-host disease (cGVHD) pathophysiology. We studied 20 cGVHD patients at a median of 25 months after rituximab treatment when most patients had recovered total B-cell numbers. A total of 55% of patients had stable/improved cGVHD, and total B-cell numbers in these patients were significantly higher compared with rituximab-unresponsive patients. Although total B-cell number did not differ significantly between cGVHD groups before rituximab, there was a proportional increase in B-cell precursors in patients who later had stable/improved cGVHD. After rituximab, BAFF levels increased in all patients. Coincident with B-cell recovery in the stable/improved group, BAFF/B-cell ratios and CD27+ B-cell frequencies decreased significantly. The peripheral B-cell pool in stable/improved cGVHD patients was largely composed of naive IgD+ B cells. By contrast, rituximab-unresponsive cGVHD patients had persistent elevation of BAFF and a predominance of circulating B cells possessing an activated BAFF-RLoCD20Lo cell surface phenotype. Thus, naive B-cell reconstitution and decreased BAFF/B-cell ratios were associated with clinical response after rituximab in cGVHD. Our findings begin to delineate B-cell homeostatic mechanisms important for human immune tolerance.
A non-BRICHOS surfactant protein c mutation disrupts epithelial cell function and intercellular signaling
Authors: Woischnik Markus , Sparr Christiane , Kern Sunčana , Thurm Tobias , Hector Andreas , Hartl Dominik , Liebisch Gerhard , Mulugeta Surafel , Beers Michael F , Schmitz Gerd , Griese Matthias
Published: November 2010

Background

Heterozygous mutations ofSFTPC, the gene encoding surfactant protein C (SP-C), cause sporadic and familial interstitial lung disease (ILD) in children and adults. The most frequentSFTPCmutation in ILD patients leads to a threonine for isoleucine substitution at position 73 (I73T) of the SP-C preprotein (proSP-C), however little is known about the cellular consequences of SP-CI73Texpression.

Results

To address this, we stably expressed SP-CI73Tin cultured MLE-12 alveolar epithelial cells. This resulted in increased intracellular accumulation of proSP-C processing intermediates, which matched proSP-C species recovered in bronchial lavage fluid from patients with this mutation. Exposure of SP-CI73Tcells to drugs currently used empirically in ILD therapy, cyclophosphamide, azathioprine, hydroxychloroquine or methylprednisolone, enhanced expression of the chaperones HSP90, HSP70, calreticulin and calnexin. SP-CI73Tmutants had decreased intracellular phosphatidylcholine level (PC) and increased lyso-PC level without appreciable changes of other phospholipids. Treatment with methylprednisolone or hydroxychloroquine partially restored these lipid alterations. Furthermore, SP-CI73Tcells secreted into the medium soluble factors that modulated surface expression of CCR2 or CXCR1 receptors on CD4+ lymphocytes and neutrophils, suggesting a direct paracrine influence of SP-CI73Ton neighboring cells in the alveolar space.

Conclusion

We show that I73T mutation leads to impaired processing of proSP-C in alveolar type II cells, alters their stress tolerance and surfactant lipid composition, and activates cells of the immune system. In addition, we show that some of the mentioned cellular aspects behind the disease can be modulated by application of pharmaceutical drugs commonly applied in the ILD therapy.
Identification of small RNAs in Francisella tularensis
Authors: Postic Guillaume , Frapy Eric , Dupuis Marion , Dubail Iharilalao , Livny Jonathan , Charbit Alain , Meibom Karin L
Published: November 2010

Background

Regulation of bacterial gene expression by small RNAs (sRNAs) have proved to be important for many biological processes. Francisella tularensis is a highly pathogenic Gram-negative bacterium that causes the disease tularaemia in humans and animals. Relatively little is known about the regulatory networks existing in this organism that allows it to survive in a wide array of environments and no sRNA regulators have been identified so far.

Results

We have used a combination of experimental assays and in silico prediction to identify sRNAs in F. tularensis strain LVS. Using a cDNA cloning and sequencing approach we have shown that F. tularensis expresses homologues of several sRNAs that are well-conserved among diverse bacteria. We have also discovered two abundant putative sRNAs that share no sequence similarity or conserved genomic context with any previously annotated regulatory transcripts. Deletion of either of these two loci led to significant changes in the expression of several mRNAs that likely include the cognate target(s) of these sRNAs. Deletion of these sRNAs did not, however, significantly alter F. tularensis growth under various stress conditions in vitro, its replication in murine cells, or its ability to induce disease in a mouse model of F. tularensis infection. We also conducted a genome-wide in silico search for intergenic loci that suggests F. tularensis encodes several other sRNAs in addition to the sRNAs found in our experimental screen.

Conclusion

Our findings suggest that F. tularensis encodes a significant number of non-coding regulatory RNAs, including members of well conserved families of structural and housekeeping RNAs and other poorly conserved transcripts that may have evolved more recently to help F. tularensis deal with the unique and diverse set of environments with which it must contend.
POLYAR, a new computer program for prediction of poly(A) sites in human sequences
Authors: Akhtar Malik Nadeem , Bukhari Syed Abbas , Fazal Zeeshan , Qamar Raheel , Shahmuradov Ilham A
Published: November 2010

Background

mRNA polyadenylation is an essential step of pre-mRNA processing in eukaryotes. Accurate prediction of the pre-mRNA 3'-end cleavage/polyadenylation sites is important for defining the gene boundaries and understanding gene expression mechanisms.

Results

28761 human mapped poly(A) sites have been classified into three classes containing different known forms of polyadenylation signal (PAS) or none of them (PAS-strong, PAS-weak and PAS-less, respectively) and a new computer program POLYAR for the prediction of poly(A) sites of each class was developed. In comparison with polya_svm (till date the most accurate computer program for prediction of poly(A) sites) while searching for PAS-strong poly(A) sites in human sequences, POLYAR had a significantly higher prediction sensitivity (80.8% versus 65.7%) and specificity (66.4% versus 51.7%) However, when a similar sort of search was conducted for PAS-weak and PAS-less poly(A) sites, both programs had a very low prediction accuracy, which indicates that our knowledge about factors involved in the determination of the poly(A) sites is not sufficient to identify such polyadenylation regions.

Conclusions

We present a new classification of polyadenylation sites into three classes and a novel computer program POLYAR for prediction of poly(A) sites/regions of each of the class. In tests, POLYAR shows high accuracy of prediction of the PAS-strong poly(A) sites, though this program's efficiency in searching for PAS-weak and PAS-less poly(A) sites is not very high but is comparable to other available programs. These findings suggest that additional characteristics of such poly(A) sites remain to be elucidated. POLYAR program with a stand-alone version for downloading is available at http://cub.comsats.edu.pk/polyapredict.htm.
Protein aggregation containing beta-amyloid, alpha-synuclein and hyperphosphorylated tau in cultured cells of hippocampus, substantia nigra and locus coeruleus after rotenone exposure
Authors: Chaves Rodrigo S , Melo Thaiany Q , Martins Stephanie A , Ferrari Merari FR
Published: November 2010

Background

Protein aggregates containing alpha-synuclein, beta-amyloid and hyperphosphorylated tau are commonly found during neurodegenerative processes which is often accompanied by the impairment of mitochondrial complex I respiratory chain and dysfunction of cellular systems of protein degradation. In view of this, we aimed to develop an in vitro model to study protein aggregation associated to neurodegenerative diseases using cultured cells from hippocampus, locus coeruleus and substantia nigra of newborn Lewis rats exposed to 0.5, 1, 10 and 25 nM of rotenone, which is an agricultural pesticide, for 48 hours.

Results

We demonstrated that the proportion of cells in culture is approximately the same as found in the brain nuclei they were extracted from. Rotenone at 0.5 nM was able to induce alpha-synuclein and beta amyloid aggregation, as well as increased hyperphosphorylation of tau, although high concentrations of this pesticide (over 1 nM) lead cells to death before protein aggregation. We also demonstrated that the 14kDa isoform of alpha-synuclein is not present in newborn Lewis rats.

Conclusion

Rotenone exposure may lead to constitutive protein aggregation in vitro, which may be of relevance to study the mechanisms involved in idiopathic neurodegeneration.