bluuebunny/crossref_metadata_2025 huggingface dataset:
Bodily Progression of Motor Responses to Increasing Mechanical Force Stimulation in the Newborn Infant and the Effect of Heel Prick
Authors: Abdulkader Huda M. , Freer Yvonne , Fleetwood-Walker Susan M. , McIntosh Neil
Published: January 2008

Background: The newborn infant’s response to stimulation with von Frey filaments has previously been examined only at the spinal level as the flexion withdrawal response or abdominal reflex. The threshold for the spinal responses has been shown to be lower following skin damage and visceral pathology. Higher forces of mechanical stimulation elicit other body responses, which are likely to arise from higher levels in the nervous system: these have not been investigated before. Objective: To investigate the newborn infants’ responses to increasing forces of mechanical (von Frey filament) stimulation and whether their progression is affected by repeated heel prick. Subjects and Methods: The study was performed in 31 full term and 77 preterm infants. Graded mechanical forces (using von Frey filaments) were applied to the heels and the abdominal skin. The thresholds for the flexion withdrawal reflex or abdominal reflex and other body responses were recorded. Results: The thresholds for the flexion withdrawal reflex and other body movements to graded mechanical force on the heel were significantly lower in preterm infants compared to full term infants. The threshold for the abdominal reflex and other body re- sponses from graded mechanical stimulation of the abdomen was also significantly lower in preterm infants. In all infants thresholds were further reduced following sensitisation from previous heel pricks. The progression of the responses is independent of gestation or prior sensitisation. Conclusion: Both preterm and full term newborn infants respond to graded mechanical stimuli by a series of body responses, which progress in response to increasing force from a simple spinal withdrawal reflex to more complex responses involving higher levels of the central nervous system.
A Novel Protein Encoded by Kaposi’s Sarcoma-Associated Herpesvirus Open Reading Frame 36 Inhibits Cell Spreading and Focal Adhesion Kinase Activation
Authors: Park Junsoo , Lee Myung-Shin , Yoo Seung-Min , Seo Taegun
Published: January 2008

Objective: Kaposi’s sarcoma-associated herpesvirus (KSHV) is a γ-herpesvirus implicated in the development of Kaposi’s sarcoma, primary effusion lymphoma and some forms of multicentric Castleman’s disease. The KSHV open reading frame (ORF) 36 encodes a viral serine/threonine protein kinase. The aim of this study was to characterize the cellular function of the ORF36 protein. Methods: The expression kinetics of the ORF36 protein and its localization were determined. The wild-type ORF36 and its mutant proteins were subjected to in vitro kinase assay. Cell morphology change by ORF36 protein was studied. The focal adhesion kinase (FAK) tyrosine phosphorylation and cleavage were determined when ORF36 was expressed. Results: ORF36 protein expressed in the late phase during the KSHV reactivation. The C-terminal domain of ORF36 protein was important for kinase activity. Moreover, the ORF36 protein altered cell morphology to a round shape, similar to the phenotype of FAK-deficient cells. The kinase activity of ORF36 protein was required for the inhibition of cell spreading. Interestingly, ORF36 protein colocalized with FAK, suppressed its tyrosine phosphorylation and promoted FAK cleavage. Conclusion: Our results collectively demonstrate that the KSHV ORF36 protein is a viral protein kinase that inhibits cell spreading and FAK activation.
Possible Relationship between the COMT Gene Vel158Met Polymorphism and Psychometric IQ in Girls of the Qinba Region in China
Authors: Zhang Kejin , Zheng Zijian , Gao Xiaocai , Li Jing , Zhang Fuchang
Published: January 2008

Objective: Catechol-O-methyltransferase (COMT) gene was hypothesized to have a relationship with human prefrontal cortex (PFC) function and individual cognitive abilities. The object of this study was to investigate the possible impact of genotypes of COMT Val158Met polymorphism on cognitive ability among children living in the Qinba region in China. Method: A total of 305 children were included, 163 girls and 142 boys; both complete IQ evaluation and Val158Met genotyping results were obtained. The quantitative traits of psychometric IQ were calculated by using the Chinese Wechsler Intelligence Scale for Children. All subjects’ genotypes of COMT gene Val158Met polymorphism were identified with the restriction fragment length polymorphism method. Results: The F test showed that the average scores (including the Full Scale IQ, Verbal Scale IQ, Performance Scale IQ and three index scores) did not significantly differ among different groups defined by Val158Met genotypes, neither in boys nor in the total group (p > 0.05). There was a significant difference between the average of Freedom from Distractibility score among different genotypes found in girls (p = 0.033). Conclusion: Our results indicate that COMT gene Val158Met polymorphism may be related to the intelligence of Chinese girls, although the results cannot withstand multiple testing. Consequently, further studies with larger samples and perfect design still need place more emphasis on the gender difference and compensation effect of dopamine activity in PFC.
Influence of Rapid Tryptophan Depletion on Laboratory-Provoked Aggression in Children with ADHD
Authors: Stadler C. , Zepf F.D. , Demisch L. , Schmitt M. , Landgraf M. , Poustka F.
Published: January 2008

Background: The present study investigated the effects of rapid tryptophan depletion (RTD), and the ensuing reduction of central nervous system levels of serotonin (5-HT), upon reactive aggression in patients with attention deficit/hyperactivity disorder (ADHD). Furthermore, it was asked whether the relation between 5-HT function and behavioural aggression in patients is influenced by their age, the intensity of their attention problems or their comorbid symptoms. Methods: The study employed a double-blind, within-subject crossover design. On day 1, 22 male adolescent patients with ADHD were subjected to RTD and the subsequent reduction of central 5-HT levels. On day 2, they received a tryptophan-balanced amino acid mixture (BAL), which acted as a placebo. On both days, 4.5 h after the intake of the RTD/BAL amino acids, reactive aggressive behaviour was provoked using a competitive reaction time game, which consisted of both high and low provocation conditions. Results: The number of aggressive responses was significantly higher after low provocation during acute tryptophan depletion, in comparison to the placebo. Furthermore, this study provides evidence that neither age nor the intensity of attention symptoms in ADHD patients had an impact on the relation between 5-HT and reactive aggression. Conclusion: This study indicates that in children with ADHD, there is an inverse relationship between 5-HT and aggression.
Thyrotropin Serum Concentrations in Healthy Volunteers Are Associated with Depression-Related Personality Traits
Authors: Frey Andreas , Lampert Angelika , Dietz Klaus , Striebich Sarah , Locher Christoph , Fedorenko Olga , Möhle Robert , Gallinat Jürgen , Lang Florian , Lang Undine E.
Published: January 2008

Background: Alterations of the hypothalamic-pituitary-thyroid system at the hypophyseal level have been described in affective disorders. The NEO Five-Factor Inventory is a widely used instrument, which assesses neuroticism, a strong marker for vulnerability to depression. Methods: Endogenous serum concentrations of thyroid-stimulating hormone (TSH), free T3 and free T4 were measured and the NEO Five-Factor Inventory was performed in 121 healthy unrelated volunteers (51 male, 70 female; median age: 23 years, range from 17 to 71). Results: The TSH serum concentrations showed a median of 1.35 mU/l with a range from 0.1 to 4.0. The free T3 serum concentrations were 5.2 ± 0.7 pmol/l (mean ± SD), and the free T4 concentrations 16.5 ± 2.4 pmol/l (mean ± SD). The power of 0.4 of the TSH serum concentration and the logarithm of the depression-related factor neuroticism had a bivariate normal distribution and were negatively correlated (r = –0.337, p = 0.0002). Conclusion: Low TSH levels in healthy humans might be linked to an increased risk to develop depression.
Risk Factors Associated with Metabolic Syndrome in Korean Elderly
Authors: Kim M.H. , Lee H.S. , Park H.J. , Kim W.Y.
Published: January 2008

Objective: The aim of our study was to identify risk factors related to the prevalence of metabolic syndrome (MetS) in the Korean elderly population. Methods: This cross-sectional study was conducted with 404 Korean elderly subjects (118 male, 286 female), aged 60 years or older between 2000 and 2003. The subjects were divided into MetS and control groups based on Adult Treatment Panel III guidelines and by applying the Asia-Pacific waist circumference. Dietary intake, blood profiles, and anthropometric variables were measured. Results: The MetS group had a significantly higher serum triglyceride level (p < 0.001) than the control group. The risk of the MetS was inversely associated with the intake of protein, fat, vitamin A, and vitamin E in women. Plasma levels of interleukin-1RA were higher in the MetS group (p < 0.05); however, interleukin-2 levels were not significantly different. Plasma antioxidant vitamin levels tended to be lower in the MetS group and were negatively associated with the risk factors of MetS. Conclusion: Korean elderly subjects with MetS tended to have an increased inflammatory response and a decreased antioxidant capacity. Furthermore, it was identified that undernutrition (especially a deficiency of antioxidant vitamins), not excess intake of energy, fat, or cholesterol, was associated with risk for MetS.
Mother–Daughter Communication About Sex and Sexual Intercourse Among Middle- to Upper-Class African American Girls
Authors: Usher-Seriki Kimberly K. , Smith Bynum Mia , Callands Tamora A.
Published: January 2008

This study investigated linkages between various dimensions of mother— daughter communication about sex and sexual intercourse in a sample of 274 middle- to upper-income African American adolescent girls, drawn from the National Longitudinal Study of Adolescent Health. Logistic regression analysis revealed that girls who reported closer relationships with their mothers were less likely to have had sexual intercourse. They were more likely to report a history of sexual intercourse when their mothers communicated frequently about sexual topics and when daughters perceived their mothers as being more approving of premarital sex. Daughters were less likely to be sexually active when their mothers reported more discussions related to the negative consequences of premarital sex and to delaying sexual intercourse for moral reasons. The implications of these findings for upwardly mobile African American families are discussed.
Father Influences on Employed Mothers' Work–Family Balance
Authors: Fagan Jay , Press Julie
Published: January 2008

This study employed the ecological systems perspective and gender ideology theory to examine the influence of fathers' paid work–family crossover and family involvement on self-reports of work–family balance by employed mothers with children under the age of 13 ( N = 179). Multiple regression analyses revealed that fathers' crossover factors had a significant influence on mothers' perceptions of successful work–family balance. Mothers reported lower levels of work–family balance when fathers brought more stress from work to home. Mothers with more traditional gender ideologies reported higher levels of work–family balance when the father had a flexible job and when he was more involved in child care.
Doctoral Education and Transformative Consumer Research
Authors: Mari Carlo
Published: January 2008

This article examines why and how transformative consumer research (TCR) can become a relevant perspective in doctoral programs. The article draws selectively from studies published in consumer behavior, marketing, and marketing education that theoretically or empirically address this topic. It discusses the meaning and background of TCR together with reasons for its adoption within doctoral programs. It then briefly outlines current practices in doctoral programs in marketing and their main limitations. Finally, a proposal for integrating TCR in doctoral programs is presented, highlighting specific actions to implement it.
Cartilage Damage Determines Intermediate Outcome in the Late Multiple Ligament and Posterolateral Corner-Reconstructed Knee
Authors: Corten Kristoff , Bellemans Johan
Published: January 2008

Background

Patients with chronic ruptures of 1 or both cruciate ligaments in combination with posterolateral rotatory instability of the knee often have some degree of cartilage damage at the time of surgery.

Hypothesis

Chondrosis at the time of reconstruction does not influence early and intermediate functional outcome of the multiple ligament reconstructed knee.

Study Design

Case series; Level of evidence, 4.

Methods

Twenty-one patients were available from an original 27 treated between 1995 and 2000. All patients were assessed preoperatively and postoperatively by physical examination and by applying 4 different knee rating scores. All patients were assessed at a mean follow-up of 39 months (range, 14–75 months) and 87 months (range, 62–123 months).

Results

At the first follow-up, all knee rating scores had improved significantly ( P < .0003) compared with preoperatively; 84% of the reconstructed knees had normal to nearly normal laxities according to the International Knee Documentation Committee 2000 score. At the second follow-up, the functional scores remained significantly ( P < .0089) better than preoperatively. Patients with chondrosis at the time of surgery did not have significantly different knee rating scores at the first follow-up compared with patients without cartilage damage. Four years later, the results in the chondrosis group were significantly worse ( P < .05) for all knee rating scores compared with the patients without chondrosis. The results in 3 of 4 knee rating scores declined significantly in the chondrosis group over the 48-month interval between follow-up sessions. In the Tegner and Lysholm score, the results deteriorated to the preoperative level. Patients with different cruciate ligament reconstructions did not have significantly different knee rating scores.

Conclusion

The posterolateral sling procedure is a stable and reliable technique for posterolateral corner reconstruction. The presence of chondrosis at the time of surgery is an important prognosticator of functional outcome at intermediate follow-up.
Biomechanical Analysis of Medial Collateral Ligament Reconstruction Grafts of the Elbow
Authors: Prud'homme Joe , Budoff Jeffrey E. , Nguyen Lyndon , Hipp John A.
Published: January 2008

Background

There are no biomechanical studies evaluating different tendon grafts for elbow medial collateral ligament reconstruction.

Hypothesis

Using a larger tendon for the graft will yield greater resistance to valgus load for medial collateral ligament docking technique reconstructions. The type of graft used for a medial collateral ligament docking technique reconstruction will have a significant effect on the resistance to valgus loads.

Study Design

Controlled laboratory study.

Methods

Cadaveric elbows from male donors were cyclically loaded to 3 and 5 mm elongation, both intact and after a docking technique medial collateral ligament reconstruction using palmaris longus, gracilis, semitendinosus, and patellar tendon grafts.

Results

There was no significant difference in load to 3 or 5 mm elongation, number of cycles to failure, or stiffness between any tendon graft studied. Every tendon graft reconstruction tested was significantly weaker and less stiff than was the native medial collateral ligament.

Conclusion

There appears to be no biomechanical advantage to be gained by using a larger tendon graft instead of a palmaris longus graft.

Clinical Relevance

The most readily available graft source with the lowest morbidity (often the palmaris longus tendon) should be used for medial collateral ligament reconstruction.
The External Rotation Recurvatum Test Revisited
Authors: LaPrade Robert F. , Ly Thuan V. , Griffith Chad
Published: January 2008

Background

Posterolateral corner injuries can be difficult to diagnose. The external rotation recurvatum test was one of the first clinical tests described to diagnose these injuries. Since its earliest description, it has been reported that a positive test result occurred with posterior translation of the proximal tibia with respect to the distal femur as the knee went into recurvatum, external rotation, and varus angulation.

Purpose

To document the sagittal plane relationship of the tibiofemoral joint in patients with posterolateral knee instability and a positive external rotation recurvatum test finding, and to determine possible injury patterns associated with this test.

Study Design

Case series; Level of evidence, 4.

Materials and Methods

In a series of 134 consecutive patients with posterolateral knee injuries, all patients demonstrating a Positive external rotation recurvatum test result were identified, and bilateral hyperextension lateral radiographs were subsequently obtained to assist with preoperative planning for surgical reconstruction of their knee injuries.

Results

Of the 134 patients with posterolateral knee injuries, 10 demonstrated a positive external rotation recurvatum test finding. All 10 patients were noted to have a combined anterior cruciate ligament and posterolateral knee injury, with the proximal tibia noted to be subluxated anterior with respect to the distal femur on all hyperextension lateral knee radiographs. The percentage of patients with combined anterior cruciate ligament and posterolateral knee injuries with a positive external rotation recurvatum test result was 30%.

Conclusion

Posterolateral corner knee injuries are often difficult to diagnose, and as a result, correct interpretation of pertinent clinical knee examination findings is essential. Regarding posterolateral knee injuries, the interpretation of a positive external rotation recurvatum test result needs to be redefined to demonstrate that the tibia actually subluxates anterior to the femur, which produces an increase in genu recurvatum clinically. Moreover, the presence of a positive external rotation recurvatum test finding should alert the clinician to the presence of a probable combined posterolateral knee and anterior cruciate ligament injury.
Brain Proton Magnetic Resonance Spectroscopy and Neuromuscular Pathology in a Patient With GM1 Gangliosidosis
Authors: Brunetti-Pierri Nicola , Bhattacharjee Meenakshi B. , Wang Zhiyue J. , Zili Chu  , Wenger David A. , Potocki Lorraine , Hunter Jill , Scaglia Fernando
Published: January 2008

The authors report the clinical, neuroradiologic, and neuromuscular pathological findings in a patient with GM1 gangliosidosis. The proton magnetic resonance spectroscopy, previously reported in a single patient with GM1 gangliosidosis, detected a mild reduction of N-acetylaspartate, consistent with relative paucity of axons and neurons and increased levels of myoinositol suggestive of gliotic white matter changes along with the accumulation of an additional compound that could represent either guanidinoacetate or Gal beta 1-6Gal beta 1-4)GlcNAc, an oligosaccharide previously isolated from the urine of GM1 gangliosidosis patients. Although these findings will have to be further confirmed in more patients with GM1 gangliosidosis, they suggest that proton magnetic resonance spectroscopy may provide useful end points to assess the efficacy of novel treatments that could soon become clinically available. Histologically, no significant alterations were found in axons, but there was evidence of redundant and inappropriately folded myelin, which is a feature attributed to disturbed axon-glial interactions.
Child Health and Parental Stress in School-Age Children With a Preschool Diagnosis of Developmental Delay
Authors: Webster Richard I. , Majnemer Annette , Platt Robert W. , Shevell Michael I.
Published: January 2008

Chronic disorders are known to have a wide-ranging impact on overall health and family dynamics. The objective of this study was to assess child health and well-being and parental stress in a cohort of school-age children diagnosed before school entry with either global developmental delay or developmental language impairment. In total, 65 children with preschool developmental delay were assessed at school age (mean ± SD age: 7.3 ± 0.7 years) with the Child Health Questionnaire and Parenting Stress Index, with a mean interval between assessment of 3.9 years. Almost all children who completed testing (60/62) continued to show developmental impairments across domains. On the Child Health Questionnaire, children showed the greatest impairment on the mental health scale (median z score: —0.9). The median Child Health Questionnaire psychosocial health score (40.7) was almost 1 SD below established normative values ( P < .001). More than 40% of parents had a Parenting Stress Index above the 85th percentile (clinically significant parenting stress). Using multiple linear regression analysis, high levels of parenting stress were best predicted by a child's Child Health Questionnaire psychosocial health score ( r 2 = 0.49, P < .001). Thus, 4 years after a preschool-age diagnosis of developmental delay, poor psychosocial health was a common comorbidity. Almost half the parents showed clinically significant levels of parenting stress. There is a need to both recognize and provide ongoing social and emotional support for young children diagnosed with developmental disability and their families.
Accidental Cerebral Venous Gas Embolism in a Young Patient With Congenital Heart Disease
Authors: Buompadre María Celeste , Arroyo Hugo Antonio
Published: January 2008

This article describes an 11-year-old girl with a diagnosis of Ebstein's anomaly. Glenn and Fontan surgeries were performed successfully. She had a generalized tonic-clonic seizure after peripheral intravenous infusion under pressure. A computed tomography brain scan performed 30 minutes later showed multiple serpiginous hypodensities in the cortical sulci and in the superior longitudinal sinus compatible with cerebral venous gas embolism. At follow-up 1 month later, the girl had severe motor impairment. Cerebral gas embolism should be considered in a patient with risk factors and acute neurological symptoms in order to select the treatment of choice, hyperbaric oxygen, and reduce damage to brain tissues.
High-Frequency Rhythmic Cortical Myoclonus in a Long-Surviving Patient With Nonketotic Hypergylcemia
Authors: Mastrangelo Massimo , Canafoglia Laura , Franceschetti Silvana , Oppezzo Chiara , Mosca Fabio , Menni Francesca , Parini Rossella , Ciano Claudia , Scaioli Vidmer , Panzica Ferruccio
Published: January 2008

An 11-year-old girl with nonketotic hyperglycinemia who typically presented with a picture of early myoclonic encephalopathy in the neonatal period is presented in this article. Treated early with sodium benzoate and dextromethorphan, she became seizure-free, while myoclonus persisted. During examination, multifocal rhythmic myoclonic jerks in gamma frequency enhanced by motor activity were noted. Coherence analysis of the electroencephalography−electromyography relationship indicated a cortical origin of the myoclonic jerks. Observation of this case suggests that rhythmic cortical myoclonus may represent a late evolution of this rare disorder.
Subcutaneous Sumatriptan in an Adolescent With Acute Posttraumatic Headache
Authors: Abend Nicholas S. , Nance Michael L. , Bonnemann Carsten
Published: January 2008

Acute posttraumatic headache is common and can evolve into chronic posttraumatic headache, which is associated with medication overuse and disability. However, there are few studies to guide treatment management of acute posttraumatic headache. We describe an adolescent with acute posttraumatic headache that did not respond to several initial medications but had rapid and sustained improvement in headache and associated migrainous features with subcutaneous sumatriptan.
Clinical and Cranial Magnetic Resonance Imaging (MRI) Findings of 21 Patients With Serious Hyperbilirubinemia
Authors: Katar Selahattin , Akay Hatice Ozturkmen , Taskesen Mustafa , Devecioglu Celal
Published: January 2008

This study aims to compare neurological examination and cranial magnetic resonance imaging (MRI) findings in patients with serious hyperbilirubinemia. Twenty-one serious hyperbiluribinemic term neonates (6 girls, 15 boys) who underwent exchange transfusions were included in the study. Neurological examination findings, body weight, age at admission, blood culture, urine culture, urine analysis, C-reactive protein, thyroxine, thyroid-stimulating hormone, total and indirect bilirubin levels, causes of hyperbilirubinemia (blood group typing, glucose-6-phosphate dehydrogenase, blood smear, tandem mass), treatment and duration of follow-up, auditory test results, and cranial MRI findings were evaluated. All patients were term neonates with an average body weight of 2943 ± 533 g. The mean age at admission was 4.47 ± 2.22 days, and the mean bilirubin level was 35.0 ± 10.8 mg/dL. Exchange transfusion was performed once in all, except 4 patients who needed 2 transfusions. Kernicterus findings were found in 76% of patients on neurological examination, and cranial MRI detected a pathological finding in 71% of patients. In 2 patients, cranial MRI showed kernicterus findings, despite normal neurological examination. In contrast, in 3 patients, despite kernicterus findings in neurological examination, cranial MRI was normal. Although cranial MRI has an important place in the diagnosis of kernicterus, it does not always correlate with clinical findings. We believe that studies with larger series are warranted.
Melatonin for Insomnia in Children With Autism Spectrum Disorders
Authors: Andersen Ivy M. , Kaczmarska JoAnna , McGrew Susan G. , Malow Beth A.
Published: January 2008

We describe our experience in using melatonin to treat insomnia, a common sleep concern, in children with autism spectrum disorders. One hundred seven children (2—18 years of age) with a confirmed diagnosis of autism spectrum disorders who received melatonin were identified by reviewing the electronic medical records of a single pediatrician. All parents were counseled on sleep hygiene techniques. Clinical response to melatonin, based on parental report, was categorized as (1) sleep no longer a concern, (2) improved sleep but continued parental concerns, (3) sleep continues to be a major concern, and (4) worsened sleep. The melatonin dose varied from 0.75 to 6 mg. After initiation of melatonin, parents of 27 children (25%) no longer reported sleep concerns at follow-up visits. Parents of 64 children (60%) reported improved sleep, although continued to have concerns regarding sleep. Parents of 14 children (13%) continued to report sleep problems as a major concern, with only 1 child having worse sleep after starting melatonin (1%), and 1 child having undetermined response (1%). Only 3 children had mild side-effects after starting melatonin, which included morning sleepiness and increased enuresis. There was no reported increase in seizures after starting melatonin in children with pre-existing epilepsy and no new-onset seizures. The majority of children were taking psychotropic medications. Melatonin appears to be a safe and well-tolerated treatment for insomnia in children with autism spectrum disorders. Controlled trials to determine efficacy appear warranted.
Physiological Correlates of HIV-Related Fatigue
Authors: Barroso Julie , Pence Brian Wells , Salahuddin Naima , Harmon James L. , Leserman Jane
Published: January 2008

Our primary aim is to describe the relationship of multiple physiological variables and HIV-related fatigue. We report baseline data collected from 128 human immunodeficiency virus (HIV)-positive individuals. The HIV-Related Fatigue Scale was used to measure several aspects of fatigue. Blood was drawn for the following physiological variables: hepatic function, thyroid function, HIV viral load, immunologic function, gonadal function, hematologic function, serum cortisol, and cellular injury. In bivariable analyses, free testosterone ( p = 0.03) and CD8 ( p = 0.07) were negatively correlated with fatigue intensity, and nonlinear relationships were observed between fatigue intensity and total testosterone ( p = 0.02), thyroxine ( p = 0.01), hematocrit ( p = 0.06), and total bilirubin ( p = 0.06). However, none of these associations persisted in multivariable models. It is possible that fatigue suffered by seropositive people is better predicted by other variables, which must be better understood to develop interventions to successfully ameliorate HIV-related fatigue.
Bed and Toilet Height as Potential Environmental Risk Factors
Authors: Capezuti Elizabeth , Wagner Laura , Brush Barbara L. , Boltz Marie , Renz Susan , Secic Michelle
Published: January 2008

Seat height that is too high (> 120% of lower leg length [LLL]) or too low (< 80% of LLL) can impede safe transfer and result in falls. This study examines the difference between LLL of frail nursing home residents and the height of their toilets and beds in the lowest position, compares the patient or environmental characteristics of those able to transfer from the bed or toilet to those who cannot, and determines the relationship of patient or environmental characteristics to bed-related falls. A retrospective observational design using secondary data from 263 nursing home residents finds that bed height of three fourths of participants was greater than 140% of LLL, whereas toilet height of more than half was 100% to 120% of LLL. Increased fall risk is associated with increased age, shorter length of stay, normal lower extremity range of motion, less cognitive impairment, more behavioral symptoms, and no complaints of pain during exam.
Women's Experience of Spirituality Within End-Stage Renal Disease and Hemodialysis
Authors: Tanyi Ruth A. , Werner Joan Stehle
Published: January 2008

The purpose of this descriptive, phenomenological qualitative study is to describe women's lived experiences of spirituality within end-stage renal disease (ESRD) and hemodialysis. The purposive volunteer sample of 16 women regularly attended two outpatient dialysis centers in a large Midwestern city. Audiotaped, transcribed interviews were analyzed using Colaizzi's method. These women affirmed that spirituality was extremely important in living with their illness and necessary treatment regime. Four major clusters of themes pertaining to the women's spiritual experience within their illness emerged: acceptance, understanding, fortification, and emotion modulation. Findings show that spirituality is of great importance in living with ESRD while receiving hemodialysis and suggest that spirituality may be a significant consideration in nursing and interdisciplinary health care. These findings may be used to improve holistic nursing practice and education in related areas.
Child Versus Parent Reports of Parenting Practices
Authors: Barry Christopher T. , Frick Paul J. , Grafeman Sarah J.
Published: January 2008

This study examined parent and child reports of parenting practices separately to predict child and parent reports of child externalizing and internalizing features, as well as delinquent activity. Participants included 98 children (51 male, 47 female) from a community sample, aged 9-15 at the beginning of the study. Results revealed that child reports of parenting practices were significantly correlated with a greater number of indices of delinquency and conduct problems than were parent reports. Child reports of parenting also showed some association with delinquency at three yearly follow-ups, whereas parent reports did not. Finally, reports of negative parenting from both informants were concurrently related to internalizing characteristics. Implications for child assessment and planning interventions for children and parents are discussed.
Predictors of Nursing Home Hospitalization
Authors: Grabowski David C. , Stewart Kate A. , Broderick Suzanne M. , Coots Laura A.
Published: January 2008

Hospitalization of nursing home residents is costly and potentially exposes residents to iatrogenic disease and psychological harm. This article critically reviews the association between the decision to hospitalize and factors related to the residents' welfare and preferences, the providers' attitudes, and the financial implications of hospitalization. Regarding the resident's welfare, factors associated with hospitalization included sociodemographics, health characteristics, nurse staffing, the presence of ancillary services, and the use of hospices. Patient preferences (e.g., advance directives) and provider attitudes (e.g., overburdening of staff) were also associated with increased hospitalization. Finally, financial variables related to hospitalization included nursing home ownership status and state Medicaid policies, such as nursing home payment rates and bed-hold requirements. Most studies relied on potentially confounded research designs, which leave open the issue of selection bias. Nevertheless, the existing literature asserts that nursing home hospitalizations are frequent, often preventable, and related to facility practices and state Medicaid policies.
The Effect of Care Team Composition on the Quality of HIV Care
Authors: Rodriguez Hector P. , Marsden Peter V. , Landon Bruce E. , Wilson Ira B. , Cleary Paul D.
Published: January 2008

Compared to single-clinician care, care provided by multiple clinicians might result in higher-quality care, especially if some of them have condition-specific expertise and complementary knowledge, skills, and roles. Individual physician continuity, which has been shown to be associated with care quality, necessarily decreases when care is provided by multiple clinicians. This study uses data from the HIV Cost and Services Utilization Study to assess the effect of care team composition on the quality of HIV care. In adjusted analyses, care teams composed of three or more clinicians were associated with more consistent prescribing of pneumocystis carinii pneumonia prophylaxis when medically indicated ( p < .01). Patients with multiple physicians generally reported worse care coordination, however, and had more inappropriate use of emergency services. These findings indicate both advantages and disadvantages to having multiple clinicians. More effort should be devoted to facilitating coordination when multiple clinicians provide care.
Effects of a Goal-Oriented Rehabilitation Program in Mild Cognitive Impairment: A Pilot Study
Authors: Londos E. , Boschian K. , Lindén A. , Persson C. , Minthon L. , Lexell J.
Published: January 2008

Background: Memory disturbance, deficient concentration, and fatigue are symptoms seen in amnestic mild cognitive impairment (MCI) as well as in mild traumatic brain injury (TBI). The aim of this study was to assess if an established rehabilitation program commonly used in TBI can aid MCI patients to develop compensatory memory strategies that can improve their cognition, occupational performance, and quality of life (QoL). Methods: Fifteen patients with MCI participated in the program 2 days per week for 8 weeks. Cognitive function, occupational performance, and self-perceived QoL were assessed at baseline, at the end of the intervention, and at follow-up after 6 months. Results: Significant improvements were seen in cognitive processing speed, occupational performance, and in some of the QoL domains. Conclusion: As this goal-oriented rehabilitation program in MCI resulted in some improvements in cognition, occupational performance, and QoL, further randomized controlled studies are warranted.
NFAT but not NF-κB is critical for transcriptional induction of the prosurvival gene A1 after IgE receptor activation in mast cells
Authors: Ullerås Erik , Karlberg Mats , Möller Westerberg Christine , Alfredsson Jessica , Gerondakis Steve , Strasser Andreas , Nilsson Gunnar
Published: January 2008

FcϵRI-activation–induced survival of mast cells is dependent on the expression and function of the prosurvival protein A1. The expression of A1 in lymphocytes and monocytes has previously been described to be transcriptionally regulated by NF-κB. Here we demonstrate that the expression of A1 in mast cells is not dependent on NF-κB but that NFAT plays a crucial role. FcϵRI-induced A1 expression was not affected in mast cells overexpressing an IκB-α super-repressor or cells lacking NF-κB subunits RelA, c-Rel, or c-Rel plus NF-κB1 p50. In contrast, inhibition of calcineurin and NFAT by cyclosporin A abrogated the expression of A1 in mast cells on FcϵRI-activation but had no effect on lipopolysaccharide-induced expression of A1 in J774A.1 monocytic cells. Cyclosporin A also inhibited luciferase expression in an A1 promoter reporter assay. A putative NFAT binding site in the A1 promoter showed inducible protein binding after FcϵRI crosslinking or treatment with ionomycin as detected in a band shift assay or chromatin immunoprecipitation. The binding protein was identified as NFAT1. Finally, mast cells expressing constitutively active NFAT1 exhibit increased expression of A1 after FcϵRI-stimulation. These results indicate that, in FcϵRI stimulated mast cells, A1 is transcriptionally regulated by NFAT1 but not by NF-κB.
Phagocytosis-independent antimicrobial activity of mast cells by means of extracellular trap formation
Authors: von Köckritz-Blickwede Maren , Goldmann Oliver , Thulin Pontus , Heinemann Katja , Norrby-Teglund Anna , Rohde Manfred , Medina Eva
Published: January 2008

These days it has been increasingly recognized that mast cells (MCs) are critical components of host defense against pathogens. In this study, we have provided the first evidence that MCs can kill bacteria by entrapping them in extracellular structures similar to the extracellular traps described for neutrophils (NETs). We took advantage of the ability of MCs to kill the human pathogen Streptococcus pyogenes by a phagocytosis-independent mechanism in order to characterize the extracellular antimicrobial activity of MCs. Close contact of bacteria and MCs was required for full antimicrobial activity. Immunofluorescence and electron microscopy revealed that S pyogenes was entrapped by extracellular structures produced by MCs (MCETs), which are composed of DNA, histones, tryptase, and the antimicrobial peptide LL-37. Disruption of MCETs significantly reduced the antimicrobial effect of MCs, suggesting that intact extracellular webs are critical for effective inhibition of bacterial growth. Similar to NETs, production of MCETs was mediated by a reactive oxygen species (ROS)–dependent cell death mechanism accompanied by disruption of the nuclear envelope, which can be induced after stimulation of MCs with phorbol-12-myristate-13-acetate (PMA), H2O2, or bacterial pathogens. Our study provides the first experimental evidence of antimicrobial extracellular traps formation by an immune cell population other than neutrophils.
Identification of 31 novel mutations in the F8 gene in Spanish hemophilia A patients: structural analysis of 20 missense mutations suggests new intermolecular binding sites
Authors: Venceslá Adoración , Corral-Rodríguez María Ángeles , Baena Manel , Cornet Mónica , Domènech Montserrat , Baiget Montserrat , Fuentes-Prior Pablo , Tizzano Eduardo F.
Published: January 2008

Hemophilia A (HA) is an X-linked bleeding disorder caused by a wide variety of mutations in the factor 8 (F8) gene, leading to absent or deficient factor VIII (FVIII). We analyzed the F8 gene of 267 unrelated Spanish patients with HA. After excluding patients with the common intron-1 and intron-22 inversions and large deletions, we detected 137 individuals with small mutations, 31 of which had not been reported previously. Eleven of these were nonsense, frameshift, and splicing mutations, whereas 20 were missense changes. We assessed the impact of the 20 substitutions based on currently available information about FV and FVIII structure and function relationship, including previously reported results of replacements at these and topologically equivalent positions. Although most changes are likely to cause gross structural perturbations and concomitant cofactor instability, p.Ala375Ser is predicted to affect cofactor activation. Finally, 3 further mutations (p.Pro64Arg, p.Gly494Val, and p.Asp2267Gly) appear to affect cofactor interactions with its carrier protein, von Willebrand factor, with the scavenger receptor low-density lipoprotein receptor–related protein (LRP), and/or with the substrate of the FVIIIapi•FIXa (Xase) complex, factor X. Characterization of these novel mutations is important for adequate genetic counseling in HA families, but also contributes to a better understanding of FVIII structure-function relationship.
Ezrin is a target for oncogenic Kit mutants in murine erythroleukemia
Authors: Monni Richard , Haddaoui Lamya , Naba Alexandra , Gallais Isabelle , Arpin Monique , Mayeux Patrick , Moreau-Gachelin Françoise
Published: January 2008

The model of erythroleukemia caused by Spi-1/PU.1 transgenesis in mice is a multistage disease. A preleukemic step is characterized by an acute proliferation of proerythroblasts due to the arrest of differentiation provoked by Spi-1/PU.1. Later on, a blastic crisis occurs associated with somatic oncogenic mutations in the stem cell factor (SCF) receptor kit. To gain insights into the mechanisms of the leukemic progression, we performed proteomic profiling analyses of proerythroblasts isolated at the 2 stages of the disease. Our results indicate that the level of ezrin, a membrane cytoskeletal crosslinker, is increased in the leukemic cells. We show that Kit oncogenic forms are responsible for ezrin phosphorylation and that phosphorylation rather than overexpression is essential in the leukemic proerythroblasts. Using expression of dominant-negative forms of ezrin, we show that phosphorylation of ezrin on residue Y353 participates in apoptosis resistance, whereas phosphorylation on residue Y145 promotes proliferation of the leukemic cells in vitro and in vivo. Another recurrent oncogenic form of tyrosine kinases (Flt3) most frequently involved in human myeloid leukemia was also able to phosphorylate ezrin. These findings point to a new role for ezrin as signaling player in the development of leukemia, being a downstream effector of oncogenic tyrosine kinases in leukemic blasts.
Pharmacogenetics of minimal residual disease response in children with B-precursor acute lymphoblastic leukemia: a report from the Children's Oncology Group
Authors: Davies Stella M. , Borowitz Michael J. , Rosner Gary L. , Ritz Kristin , Devidas Meenakshi , Winick Naomi , Martin Paul L. , Bowman Paul , Elliott James , Willman Cheryl , Das Soma , Cook Edwin H. , Relling Mary V.
Published: January 2008

Minimal residual disease (MRD) as a marker of antileukemic drug efficacy is being used to assess risk status and, in some cases, to adjust the intensity of therapy. Within known prognostic categories, the determinants of MRD are not known. We measured MRD by flow cytometry at day 8 (in blood) and at day 28 (in bone marrow) of induction therapy in more than 1000 children enrolled in Pediatric Oncology Group therapy protocols 9904, 9905, and 9906. We classified patients as “best risk” if they had cleared MRD by day 8 of therapy and as “worst risk” if they had MRD remaining in bone marrow at day 28, and tested whether MRD was related to polymorphisms in 16 loci in genes hypothesized to influence response to therapy in acute lymphoblastic leukemia (ALL). After adjusting for known prognostic features such as presence of the TEL-AML1 rearrangement, National Cancer Institute (NCI) risk status, ploidy, and race, the G allele of a common polymorphism in chemokine receptor 5 (CCR5) was associated with more favorable MRD status than the A allele (P = .009, logistic regression), when comparing “best” and “worst” risk groups. These data are consistent with growing evidence that both acquired and host genetics influence response to cancer therapy.
Zebrafish in hematology: sushi or science?
Authors: Carradice Duncan , Lieschke Graham J.
Published: January 2008

After a decade of the “modern era” of zebrafish hematology research, what have been their major contributions to hematology and what challenges does the model face? This review argues that, in hematology, zebrafish have demonstrated their suitability, are proving their utility, have supplied timely and novel discoveries, and are poised for further significant contributions. It presents an overview of the anatomy, physiology, and genetics of zebrafish hematopoiesis underpinning their use in hematology research. Whereas reverse genetic techniques enable functional studies of particular genes of interest, forward genetics remains zebrafish's particular strength. Mutants with diverse and interesting hematopoietic defects are emerging from multiple genetic screens. Some mutants model hereditary blood diseases, occasionally leading to disease genes first; others provide insights into developmental hematology. Models of malignant hematologic disorders provide tools for drug-target and pharmaceutics discovery. Numerous transgenic zebrafish with fluorescently marked blood cells enable live-cell imaging of inflammatory responses and host-pathogen interactions previously inaccessible to direct observation in vivo, revealing unexpected aspects of leukocyte behavior. Zebrafish disease models almost uniquely provide a basis for efficient whole animal chemical library screens for new therapeutics. Despite some limitations and challenges, their successes and discovery potential mean that zebrafish are here to stay in hematology research.
Donor cell–derived osteopoiesis originates from a self-renewing stem cell with a limited regenerative contribution after transplantation
Authors: Dominici Massimo , Marino Roberta , Rasini Valeria , Spano Carlotta , Paolucci Paolo , Conte Pierfranco , Hofmann Ted J. , Horwitz Edwin M.
Published: January 2008

In principle, bone marrow transplantation should offer effective treatment for disorders originating from defects in mesenchymal stem cells. Results with the bone disease osteogenesis imperfecta support this hypothesis, although the rate of clinical improvement seen early after transplantation does not persist long term, raising questions as to the regenerative capacity of the donor-derived mesenchymal progenitors. We therefore studied the kinetics and histologic/anatomic pattern of osteopoietic engraftment after transplantation of GFP-expressing nonadherent marrow cells in mice. Serial tracking of donor-derived GFP+ cells over 52 weeks showed abundant clusters of donor-derived osteoblasts/osteocytes in the epiphysis and metaphysis but not the diaphysis, a distribution that paralleled the sites of initial hematopoietic engraftment. Osteopoietic chimerism decreased from approximately 30% to 10% by 24 weeks after transplantation, declining to negligible levels thereafter. Secondary transplantation studies provided evidence for a self-renewing osteopoietic stem cell in the marrow graft. We conclude that a transplantable, primitive, self-renewing osteopoietic cell within the nonadherent marrow cell population engrafts in an endosteal niche, like hematopoietic stem cells, and regenerates a significant fraction of all bone cells. The lack of durable donor-derived osteopoiesis may reflect an intrinsic genetic program or exogenous environmental signaling that suppresses the differentiation capacity of the donor stem cells.