bluuebunny/crossref_metadata_2025 huggingface dataset:
`Listen to me, tell me': a qualitative study of partnership in care for people with non-specific chronic low back pain
Authors: Slade Susan Carolyn , Molloy Elizabeth , Keating Jennifer Lyn
Published: February 2009

Objective: To investigate and summarize participant experience of exercise programmes for non-specific chronic low back pain and the effects of these experiences on exercise participation and engagement.

Subjects: Three groups of six adults (>18 years) who speak, read and understand English and who had participated in an exercise programme for non-specific chronic low back pain.

Method: Qualitative research methods were used and three focus groups were conducted by an experienced facilitator. Each group was guided with a set of pre-determined questions and participants were encouraged to give personal opinions. Transcribed data were read independently by two researchers and analysed thematically according to Grounded Theory.

Results: Preference for partnership in care emerged as a significant theme from all focus group transcripts. The following subthemes emerged: (1) engagement with the health care process; (2) `listen to me; I know my own body'; (3) `tell me: explain it to me'. People with non-specific chronic low back pain want an active role in their rehabilitation. They expressed anger and frustration at not being listened to, not being provided with adequate explanations and education and not being given credit for knowing their own bodies. Tension existed between patients' wanting a genuine voice in the partnership and them wanting a care-provider to give explicit diagnosis and best management instruction.

Conclusion: A gap exists between care-seeker experiences of, and preferences for, exercise programmes for back pain. Care-seekers consider that care-providers should adopt a willingness to listen and consider care-seeker's experiences when designing exercise programmes.
Implications of the Family and Medical Leave Act for Local Governments
Authors: French P. Edward
Published: February 2009

The Family and Medical Leave Act (FMLA) was enacted in 1993 to help full-time employees balance the conflicting demands of their work and personal lives. Private employers with 50 or more employees (at a single work site) and all federal, state, and local government employers are required to comply with the act. Since its inception, many local governments have been sued for violations of its guidelines. This research provides case examples from across the United States to illustrate why many local governments have faced litigation under this act. Several cases filed against cities and counties over the past 7 years are discussed. The intent of this analysis is to highlight many of the legal rights and protections that the FMLA affords to local government employees, to provide a practical understanding and guide for compliance with the requirements of this employment legislation.
Accuracy of Breastfeeding Data on the Massachusetts Birth Certificate
Authors: Navidi Tina , Chaudhuri Jana , Merewood Anne
Published: February 2009

In 2003, the question, “Is the infant being breastfed at discharge?” was added to the US standard certificate of live birth. In Massachusetts, this was adapted to, “Are you breastfeeding or do you intend to?” In 2004-5, we compared the mother's answer to the birth certificate question in 2 hospitals, with her infant's feeding record. At Hospital A, 94.8% (290/306) of birth certificate responses matched the record. At (Baby-Friendly) Hospital B, 79.8% (185/232) matched. At the Baby-Friendly hospital, 17.2% (40/232) of women stated intent to formula feed on the birth certificate but breastfed postpartum. No significant sociodemographic differences existed between women whose answers matched or did not match. Although breastfeeding is a desirable health behavior, mothers did not overstate intent. The assumption that a prenatal feeding decision is an independent predictor of breastfeeding practice may be flawed. In the Baby-Friendly hospital, many women apparently made the decision postpartum. J Hum Lact. 25(2):151-156.
Successful Reemployment Through Resiliency Development
Authors: Fleig-Palmer Michelle M. , Luthans Kyle W. , Mandernach B. Jean
Published: February 2009

The proposed model in this article seeks to extend the job search literature by considering resiliency as a predictor of job search behavior and reemployment outcomes. In addition, because past research in this area has not expressly considered job search skills, they are included in this model as an additional predictor along with their interaction with resiliency. The importance of resiliency for job seekers is discussed with particular emphasis on young adults, minorities, and relocating spouses/partners. Because resiliency is a state-like variable, suggestions are offered to promote the development of resiliency in job seekers. It is hoped that the theoretical framework proposed in this article and the specific recommendations for resiliency development can positively affect job seekers pursuing reemployment.
Editorial
Authors: Goulding Anne
Published: February 2009

Reviews a range of reports, features and web-based resources focusing on the credit crunch and the likely impact on libraries. Suggests that for public libraries, the majority of commentators indicate that the global financial crisis may be a mixed blessing, leading to new and increased use on the one hand but raising the threat of cuts to services on the other. Notes that there are few reports on the potential impact of the economic situation on academic libraries although, again, universities in general may benefit as people seek to retrain or update their skills to make themselves more marketable in the careers marketplace. Concludes with a discussion of how the core principles of librarianship should be maintained and emphasized during these hard times.
Information literacy assessment
Authors: Walsh Andrew
Published: February 2009

Interest in developing ways to assess information literacy has been growing for several years. Many librarians have developed their own tools to assess aspects of information literacy and have written articles to share their experiences. This article reviews the literature and offers readers a flavour of the methods being used for assessment: those which are popular within the field and also illustrative examples from some of the case studies found, particularly where they show how the reliability and validity of the methods have been considered. It does not aim to be an exhaustive list of case studies or methods, but a representative sample to act as a `jumping off point' for librarians considering introducing assessment of information literacy into their own institutions.
Preparing Today for a Sustainable Future
Authors: Peoples Robert
Published: February 2009

Business leaders and their academic trainers must embrace the concept of sustainability to prepare future leaders with the understanding and tools necessary to make key decisions based on more than “just the numbers.” The economic competitiveness of this country and the survival of our species require a deeper understanding of nature if we are to meet the demands of an expanding population and their expectation for improved quality of life. Competition for finite raw materials and resources will continue to expand despite the momentary speed bumps of the current economic slowdown. A model for enhanced decision making is presented that is based in the simple notion of effective communications. A personal example of strategic decision making translates into lessons learned.
Revisiting the Bicutan Siege
Authors: Reyes Napoleon C. , Vaughn Michael S.
Published: February 2009

Special Action Forces of the Philippine National Police stormed an attempted jailbreak in a maximum security detention center in Bicutan, Taguig City, Philippines, on March 15, 2005. This article reviews the results of separate investigations conducted by the Commission on Human Rights and the Philippine Alliance of Human Rights Advocates, news coverage, and the official statements of government officials involved. Three possible justifications emerge to explain the death of 23 detainees and a member of the national police: (1) incompetence of prison and police personnel; (2) a breakdown of administrative control over the police assault team; and (3) a premeditated and concerted effort to eliminate identified enemies of the state. The article concludes that the third option is the most credible, which is bolstered by the government's meager response to explain the massacre, and by failing to adopt measures proposed by the Philippine Commission on Human Rights.
Transducing Neuronal Activity into Dendritic Spine Morphology: New Roles for p38 MAP Kinase and N-cadherin
Authors: Sugiura Hiroko , Tanaka Hidekazu , Yasuda Shin , Takemiya Takako , Yamagata Kanato
Published: February 2009

Synaptic plasticity depends on the generation, modification and disconnection of synapses. An excitatory synapse is connected to a specialized dendritic compartment called a spine, which undergoes activity-induced remodeling. Here, we discuss a signaling pathway that transduces neuronal activity into the remodeling of spine through p38 mitogen-activated protein kinase (MAPK) and N-cadherin. Dendritic spines change their morphology and density in response to neuronal activity. In the early phase, posttranslational modifications of synaptic molecules regulate spine morphology, whereas activity-induced gene products reduce spine density in the late phase. One of the targets of these mechanisms is N-cadherin. An activity-induced protocadherin, arcadlin, stimulates thousand and one 2β (TAO2β) kinase, which in turn activates p38 MAPK through MAPK kinase 3 (MEK3), resulting in the endocytosis of N-cadherin and the decrease in spine number. This pathway also underlies the mechanism of the spine decrease in neuronal disorders, such as Alzheimer's disease and epilepsy. Development of new p38 MAPK inhibitors brings a ray of hope with respect to the development of more effective therapies for these patients.
From Neurotransmitters to Neurotrophic Factors to Neurogenesis
Authors: Hagg Theo
Published: February 2009

New neurons continue to be produced in adult mammals, including humans, predominantly in the anterior subventricular zone of the lateral ventricle and the subgranular zone of the dentate gyrus. This update focuses on the emerging concept that adult CNS neurogenesis can be regulated by targeting neurotransmitter receptors, which, in turn, drive expression of crucial neurotrophic and growth factors. Such an approach might enable the development of pharmacological treatments that harness the endogenous potential of the CNS to replace lost cells in neurological disorders such as stroke and Alzheimer's and Huntington's diseases. This review samples in vivo studies in adult mammals from 2006 to mid-2008. It also provides some considerations for navigating toward translation to human disorders. Among them are the formidable problems of scaling up production of new neurons within the two “niches” of the brain and delivering sufficient numbers to distant degenerating regions for cell replacement. However, an expedition can only succeed if started.
Ocular Dominance Columns: Enigmas and Challenges
Authors: Adams Daniel L. , Horton Jonathan C.
Published: February 2009

In some mammalian species, geniculocortical afferents serving each eye are segregated in layer 4C of striate cortex into stripes called ocular dominance columns. Having described the complete pattern of ocular dominance columns in the human brain, the authors enumerate here the principal enigmas that confront future investigators. Probably the overarching challenge is to explain the function, if any, of ocular dominance columns and why they are present in some species and not others. A satisfactory solution must account for the enormous natural variation, even within the same species, among individuals in column expression, pattern, periodicity, and alignment with other components of the functional architecture. Another major priority is to explain the development of ocular dominance columns. It has been established clearly that they form without visual experience, but the innate signals that guide their segregation and maturation are unknown. Experiments addressing the role of spontaneous retinal activity have yielded contradictory data. These studies must be reconciled, to pave the way for new insights into how columnar structure is generated in the cerebral cortex.
Assessing the Implicit Beliefs of Sexual Offenders Using the Implicit Relational Assessment Procedure
Authors: Dawson David L. , Barnes-Holmes Dermot , Gresswell David M. , Hart Aidan J. , Gore Nick J.
Published: February 2009

Researchers have proposed that the cognitive distortions of sexual offenders are underpinned by a number of implicit cognitive processes termed implicit theories. Until recently, however, the implicit theory hypothesis has received little empirical support due to broader limitations with standard forensic assessment procedures. The current research aimed to determine whether a new assessment methodology, the Implicit Relational Assessment Procedure (IRAP), could provide further evidence for Ward and Keenan's (1999) children as sexual beings implicit theory. The results indicated that the IRAP was significantly more effective at identifying core implicit differences between sexual offenders against children and nonoffenders than a cognitive distortion questionnaire. Furthermore, although both groups demonstrated an overall response bias towards adults as sexual and children as nonsexual, this bias was significantly impaired in the sexual offender group. The findings are discussed in relation to previous implicit theory research and recommendations for the development of implicit methodologies are made.
Facial and Prosodic Affect Recognition Among Pedophilic and Nonpedophilic Criminal Child Molesters
Authors: Suchy Yana , Whittaker Wilson J. , Strassberg Donald S. , Eastvold Angela
Published: February 2009

The present study compared facial and prosodic affect recognition abilities among pedophilic and nonpedophilic child molesters and community-dwelling controls. Pedophilic child molesters are characterized by primary sexual interest in prepubescent children, whereas nonpedophilic child molesters are characterized by offending against children despite being primarily sexually attracted to adults. The results showed that nonpedophilic child molesters made more errors in recognizing both facial and prosodic affect, performing more poorly than both controls and pedophilic child molesters. These findings are consistent with greater psychopathic tendencies among nonpedophilic molesters as well as with prior findings of smaller amygdala volume among child molesters.
Individual Differences in the Propensity for Partner Sexual Coercion
Authors: Camilleri Joseph A. , Quinsey Vernon L.
Published: February 2009

Lalumière, Harris, Quinsey, and Rice (2005) proposed a three-path model (psychopathy, young male syndrome, and competitive disadvantage) of the development of sexually coercive behavior, but none of these individual difference characteristics have been tested among partner rapists. Using a community sample in Study 1, the authors find that psychopathy is the only significant predictor of self-reported propensity for partner sexual coercion. This model is tested in Study 2 by comparing convicted partner rapists, nonsexual partner assaulters, and heterosexual child molesters. One third of partner rapists are psychopaths, and their psychopathy scores are no different from those found in correctional samples. Partner rapists have an average IQ, providing further evidence that competitive disadvantage is less characteristic of partner rapists. There is some indication that partner rapists desist with age. The authors discuss these findings in light of recent findings that implicate cuckoldry risk in partner sexual assault.
Long-Term Effectiveness and Safety of Dexmethylphenidate Extended-Release Capsules in Adult ADHD
Authors: Adler Lenard A. , Spencer Thomas , McGough James J. , Hai Jiang  , Muniz Rafael
Published: February 2009

Objective: This study evaluates dexmethylphenidate extended release (d-MPH-ER) in adults with ADHD. Method: Following a 5-week, randomized, controlled, fixed-dose study of d-MPH-ER 20 to 40 mg/d, 170 adults entered a 6-month open-label extension (OLE) to assess long-term safety, with flexible dosing of 20 to 40 mg/d. Exploratory effectiveness outcomes included change from Week 5 on ADHD Rating Scale (ADHD-RS) and proportion of responders on Clinical Global Impressions—Improvement (CGI-I) scale. Results: 103 patients completed OLE, and effectiveness was evaluable in 102 patients. d-MPH-ER was well tolerated; the most common adverse events (>15%) were headache, insomnia, and decreased appetite. Mean improvements in ADHD-RS score were −10.2 for patients switched from placebo to d-MPH-ER ( n = 20) and −8.4 for those maintained on d-MPH-ER ( n = 82). Respective CGI-I responder rates were 95.0% and 95.1%. Conclusion: Once-daily d-MPH-ER 20 to 40 mg is safe and effective for long-term treatment of adult ADHD. (J. of Att. Dis. 2009; 12(5) 449-459)
Comparative Study of Children With ADHD Only, Autism Spectrum Disorder + ADHD, and Chronic Multiple Tic Disorder + ADHD
Authors: Gadow Kenneth D. , DeVincent Carla J. , Schneider Jayne
Published: February 2009

Objective: Identification of differences among children with ADHD only, autism spectrum disorder (ASD)+ADHD, and chronic multiple tic disorder (CMTD)+ADHD may lead to better understanding of clinical phenotypes. Method: Children were evaluated using the parent- and teacher-completed questionnaires. Results: All three groups were highly similar in severity of oppositional defiant disorder and conduct disorder symptoms; however, the ASD+ADHD group generally exhibited the most severe anxiety, although the CMTD+ADHD group had the most severe generalized anxiety. The two comorbid groups had the most involved medical histories and the greatest likelihood of a family history of psychopathology. Conclusion: Groups differed in clinically meaningful ways, and the apparent association between tics and anxiety may explain in part the elevated levels of anxiety in both comorbid groups. Collectively, results suggest that ADHD may be better conceptualized as a family of interrelated syndromes defined in part by comorbid conditions and that continued research is clearly warranted. (J. of Att. Dis. 2009; 12(5) 474-485)
Reflections on the Narrative Approach: Dilemmas of Power, Emotions and Social Location While Constructing Life-Stories
Authors: Essers Caroline
Published: February 2009

This paper reflects on the use of life-stories as a way to get a better understanding of the multiple identity constructions of Female Entrepreneurs of Moroccan and Turkish Origin. Since life-stories are co-constructions of the researcher and researched, the paper argues that the relationship between these two parties and their different social locations should be explicated in the analysis and writing of the material, as these might reproduce certain power structures. Accounting for such social implications requires a thorough analysis of partiality, issues of inequality, as well as emotions that may direct researchers' interpretations.
Taylorism in the Socialism that Really Existed
Authors: Peci Alketa
Published: February 2009

The principal objective of the present paper is to analyse the introduction of Taylorism, understood as a capitalist way of managing production and labour, in the former Soviet Union. The application of this capitalist model of production and management had strongly influenced the course of Socialism in the former Soviet Union. The study concentrates on the changes which occurred within the period 1917—1929, trying to highlight the factors that influenced the introduction of Taylorism in the former Soviet Union, specially the economic conditions of the country, the characteristics of the proletariat (ruling social class) and the peasantry (dominant social class), the limitations of the ruling role of the Bolshevik party, the macroeconomic and industrialization policies. Such trajectory has to be understood as strongly related to the modernist values struggling for predominance in the first socialist countries.
Usability and acceptability of a website that provides tailored advice on falls prevention activities for older people
Authors: Nyman Samuel R. , Yardley Lucy
Published: February 2009

This article presents the usability and acceptability of a website that provides older people with tailored advice to help motivate them to undertake physical activities that prevent falls. Views on the website from interviews with 16 older people and 26 sheltered housing wardens were analysed thematically. The website was well received with only one usability difficulty with the action plan calendar. The older people selected balance training activities out of interest or enjoyment, and appeared to carefully add them into their current routine. The wardens were motivated to promote the website to their residents, particularly those who owned a computer, had balance problems, or were physically active. However, the participants noted that currently a minority of older people use the Internet. Also, some older people underestimated how much activity was enough to improve balance, and others perceived themselves as too old for the activities.
A means to an end: a web-based client management system in palliative care
Authors: O'Connor Margaret , Erwin Trudy , Dawson Linda
Published: February 2009

Home-based palliative care (hospice) services require comprehensive and fully integrated information systems to develop and manage the various aspects of their business, incorporating client data and management information. These systems assist in maintaining the quality of client care as well as improved management efficiencies. This article reports on a large not-for-profit home-based palliative care service in Australia, which embarked on a project to develop an electronic data management system specifically designed to meet the needs of the palliative care sector. This web-based client information management system represents a joint venture between the organization and a commercial company and has been a very successful project.
Prescription for nursing informatics in pre-registration nurse education
Authors: Bond Carol S. , Procter Paula M.
Published: February 2009

Nurses need to be able to use information and communications technology not only to support their own practice, but also to help their patients make best use of it. This article argues that nurses are not currently adequately prepared to work with information and technology through their pre-registration education. Reflecting the lack of nursing informatics expertise, it is recommended that all pre-registration nursing programmes should have access to a nursing informatics specialist. A prescription to meet the informatics needs of the newly qualified nurse is proposed. This places the areas that need to be included in pre-registration education into broad groups that both articulate the competencies that nurses need to develop, and indicate why they are needed, rather than providing context-free checklists of skills. This is presented as a binary scatter chart with two axes, skill to knowledge and technology to information.
The obstetrician and gynaecologist and the European Computer Driving Licence
Authors: Desai Kiran , Dharmadhikari Deepali , Bhargava Seema , Desai Aditi
Published: February 2009

The European Computer Driving Licence (ECDL) has been adopted as the reference standard for all NHS staff for basic IT skills. The objective of the study was to determine awareness of the ECDL amongst members of the Royal College of Obstetricians and Gynaecologists. An anonymous postal survey was conducted with members and fellows of the College in three UK regions. A total of 720 questionnaires were posted, and the response rate was 47.9 per cent. A fifth of all respondents were not aware of the ECDL at all, and only 10 per cent were trained in the ECDL. However, more than third had some other formal training in IT skills. Half the respondents suggested that the questionnaire had prompted them to train for the ECDL. Much needs to be done to increase awareness of the ECDL and offer incentives for its takeup.
Defining and characterising the progression of type 2 diabetes
Authors: Fonseca Vivian A
Published: February 2009

Type 2 diabetes is a progressive disease characterised by worsening of multiple abnormalities and loss of glycaemic control over time. An increasing need for glucose-lowering treatments is emphasised by the almost inevitable failure of monotherapy and occurrence of weight gain. Longer survival times and development of type 2 diabetes at a younger age also increase the risk of developing microvascular and macrovascular complications. A hallmark of type 2 diabetes mellitus is declining pancreatic β -cell function, which begins years before diagnosis and continues throughout the disease process. This deterioration continues despite initiation of numerous therapies, as these interventions lower glucose but do not directly slow β -cell decline and dysfunction. Defects in α-cell function are also important contributors to disease progression. New therapies that can counter these abnormalities without causing weight gain or hypoglycaemia continue to be assessed.Br J Diabetes Vasc Dis, 2008;8 (suppl 2): S3—S9
Liraglutide, a once-daily human GLP-1 analogue
Authors: Nauck Michael A
Published: February 2009

Glucagon-like peptide-1 (GLP-1) is an incretin hormone physiologically playing a role in glucose homeostasis, together with the partner incretin, glucose dependent insulinotropic peptide (GIP). Active concentrations of this hormone are not maintained for long because of its very rapid degradation and elimination. The effects of the hormone are of potential therapeutic value in type 2 diabetes; therefore, analogues of GLP-1 have been developed that are characterised by a prolonged circulating half-life relative to the naturally occurring hormone. One such long-acting analogue is liraglutide. The effects of liraglutide are maintained over 24 h, allowing once-daily dosing. Liraglutide provides all of the beneficial actions of endogenous GLP-1: glucose-dependent stimulation of insulin secretion, glucagon suppression, deceleration of gastric emptying, appetite suppression/weight loss and, in animal models, inhibition of β-cell apoptosis and promotion of β-cell regeneration. Because liraglutide stimulates insulin secretion and suppresses glucagon secretion only when blood glucose levels are elevated, the risk of treatment-associated hypoglycaemia is low. In clinical studies, liraglutide substantially lowered fasting and postprandial glucose concentrations, with an overall reduction in haemoglobin A1c of up to 1-2%. In some studies, liraglutide has decreased several biomarkers of cardiovascular risk and lowered triglyceride levels significantly. Side effects most commonly are gastrointestinal symptoms; they are usually mild to moderate and resolve over time. Long-term clinical trials are needed to assess whether the effects of liraglutide on the β cell translate into a durable improvement in β-cell function and mass in patients with type 2 diabetes and, if so, whether this will slow or halt disease progression and help prevent complications.Br J Diabetes Vasc Dis, 2008; 8 (Suppl 2): S26—S33
Distributed Leadership in Higher Education
Authors: Bolden Richard , Petrov Georgy , Gosling Jonathan
Published: February 2009

In this article we present findings from research in 12 UK universities that sought to capture a range of perspectives on `distributed leadership' and reveal common and competing experiences within and between institutions. From analysis of findings we identified two principle approaches to the distribution of leadership: `devolved', associated with top-down influence, and `emergent', associated with bottom-up and horizontal influence. We argue that while literature on distributed leadership largely promotes the latter, the former is equally (if not more) significant in terms of how leadership is actually enacted and perceived within universities. We conclude, therefore, that as a description of leadership practice, the concept of `distributed leadership' offers little more clarity than `leadership' alone. As an analytic framework it is a more promising concept drawing attention to the broader contextual, temporal and social dimensions of leadership. Fundamentally, though, we argue that distributed leadership is most influential through its rhetorical value whereby it can be used to shape perceptions of identity, participation and influence but can equally shroud the underlying dynamics of power within universities.
Impact of post-deposition annealing on surface, bulk and interface properties of RF sputtered AlN films
Authors: Kar J. P. , Mukherjee S. , Bose G. , Tuli S. , Myoung J. M.
Published: February 2009

C axis oriented AlN films were deposited on silicon substrate by radio frequency reactive magnetron sputtering. Subsequently the films were annealed in a horizontal furnace at temperatures ranging from 400 to 800°C for 30 min in nitrogen ambient. The change in the morphological properties with annealing temperatures was investigated using X-ray diffraction, Fourier transform infrared spectroscopy, scanning electron microscopy and atomic force microscopy techniques. Morphological studies revealed that the annealing increased surface roughness and grain size. In addition, Al–N bond density along with the crystallinity of the deposited films was improved with annealing. The electrical properties, namely the insulator charge density ( Qin) and the interface electronic state density ( Dit), were estimated by the capacitance–voltage (C–V) measurements. It was found that the Qin increased, but the Dit decreased with annealing temperature. Lower leakage current with improved resistivity and dielectric behaviour was also observed with annealing.
Fabrication of transparent Nd:YAG ceramics by vacuum sintering with CaF2 and tetraethoxysilane additives
Authors: Meng Q. X. , Liang B. Y. , Li H. Y. , Su C. H. , Jin S. Z.
Published: February 2009

Nd:YAG ceramics with CaF2 and tetraethoxysilane (TEOS) as sintering additives were fabricated by vacuum sintering at 1750°C for 5 h and the microstructures were characterised using X-ray diffraction and scanning electron microscopy. Scanning electron microscopy result shows that the sintered bulk doped with TEOS contains many pores in the grains. The bulk doped with CaF2 displays uniform microstructure. The average size of the grains is 10 mm and few pores can be detected in this sintered bulk. The maximum transmittance of the sintered Nd:YAG ceramics were 44% doped with CaF2 and 14% doped with TEOS.
Modification of coupled model of microstructure evolution and flow stress: Experimental validation
Authors: Svyetlichnyy D. S.
Published: February 2009

A mathematical model for prediction of flow stress and microstructure evolution during and after deformation processes was developed in the project. In the present paper, a modified model is shortly presented. The main differences between the previous and current version of the model are stressed and explained. The model consists of two almost independent parts: development of dislocations and microstructure evolution. The main changes are introduced in the calculations of the recrystallised volume. Volume applicable for nucleation is considered in another way as well. An identification of the model parameters is carried out with constrains. The paper presents results of the identification and the model validation at constant and varying deformation conditions. The results that represent grains size effect are also shown.
Host natural killer T cells induce an interleukin-4–dependent expansion of donor CD4+CD25+Foxp3+ T regulatory cells that protects against graft-versus-host disease
Authors: Pillai Asha B. , George Tracy I. , Dutt Suparna , Strober Samuel
Published: February 2009

Although CD4+CD25+ T cells (T regulatory cells [Tregs]) and natural killer T cells (NKT cells) each protect against graft-versus-host disease (GVHD), interactions between these 2 regulatory cell populations after allogeneic bone marrow transplantation (BMT) have not been studied. We show that host NKT cells can induce an in vivo expansion of donor Tregs that prevents lethal GVHD in mice after conditioning with fractionated lymphoid irradiation (TLI) and anti–T-cell antibodies, a regimen that models human GVHD-protective nonmyeloablative protocols using TLI and antithymocyte globulin (ATG), followed by allogeneic hematopoietic cell transplantation (HCT). GVHD protection was lost in NKT-cell–deficient Jα18−/− hosts and interleukin-4 (IL-4)−/− hosts, or when the donor transplant was Treg depleted. Add-back of donor Tregs or wild-type host NKT cells restored GVHD protection. Donor Treg proliferation was lost in IL-4−/− hosts or when IL-4−/− mice were used as the source of NKT cells for adoptive transfer, indicating that host NKT cell augmentation of donor Treg proliferation after TLI/antithymocyte serum is IL-4 dependent. Our results demonstrate that host NKT cells and donor Tregs can act synergistically after BMT, and provide a mechanism by which strategies designed to preserve host regulatory cells can augment in vivo donor Treg expansion to regulate GVHD after allogeneic HCT.
Human and murine amniotic fluid c-Kit+Lin− cells display hematopoietic activity
Authors: Ditadi Andrea , de Coppi Paolo , Picone Olivier , Gautreau Laetitia , Smati Rim , Six Emmanuelle , Bonhomme Delphine , Ezine Sophie , Frydman René , Cavazzana-Calvo Marina , André-Schmutz Isabelle
Published: February 2009

We have isolated c-Kit+Lin− cells from both human and murine amniotic fluid (AF) and investigated their hematopoietic potential. In vitro, the c-Kit+Lin− population in both species displayed a multilineage hematopoietic potential, as demonstrated by the generation of erythroid, myeloid, and lymphoid cells. In vivo, cells belonging to all 3 hematopoietic lineages were found after primary and secondary transplantation of murine c-Kit+Lin− cells into immunocompromised hosts, thus demonstrating the ability of these cells to self-renew. Gene expression analysis of c-Kit+ cells isolated from murine AF confirmed these results. The presence of cells with similar characteristics in the surrounding amnion indicates the possible origin of AF c-Kit+Lin− cells. This is the first report showing that cells isolated from the AF do have hematopoietic potential; our results support the idea that AF may be a new source of stem cells for therapeutic applications.
Prognostic impact of WT1 mutations in cytogenetically normal acute myeloid leukemia: a study of the German-Austrian AML Study Group
Authors: Gaidzik Verena Ingeborg , Schlenk Richard Friedrich , Moschny Simone , Becker Annegret , Bullinger Lars , Corbacioglu Andrea , Krauter Jürgen , Schlegelberger Brigitte , Ganser Arnold , Döhner Hartmut , Döhner Konstanze
Published: February 2009

To evaluate the incidence and clinical impact of WT1 gene mutations in younger adult patients with cytogenetically normal acute myeloid leukemia (CN-AML), sequencing of the complete coding region was performed in diagnostic samples from 617 patients who were treated on 3 German-Austrian AML Study Group protocols. WT1 mutations were identified in 78 (12.6%) of the 617 patients; mutations clustered in exon 7 (54 of 78) and exon 9 (13 of 78), but also occurred in exons 1, 2, 3, and 8. WT1 mutations were significantly associated with younger age, higher serum lactate dehydrogenase levels, higher blood blast counts, and the additional presence of FLT3-ITD (P < .001) and CEBPA mutations (P = .004). There was no difference in relapse-free survival and overall survival between patients with (WT1mut) or without WT1 mutations. Subset analysis showed that patients with the genotype WT1mut/FLT3-ITDpos had a lower complete remission rate (P = .003) and an inferior relapse-free survival (P = .006) and overall survival (P < .001) compared with those with the genotype WT1mut/FLT3-ITDneg. In conclusion, in our large cohort of younger adults with CN-AML, WT1 mutation as a single molecular marker did not impact on outcome. However, our data suggest a negative impact of the genotype WT1mut/FLT3-ITDpos.
Muscarinic receptor subtypes in cilia-driven transport and airway epithelial development
Authors: Klein M. K. , Haberberger R. V. , Hartmann P. , Faulhammer P. , Lips K. S. , Krain B. , Wess J. , Kummer W. , König P.
Published: February 2009

Ciliary beating of airway epithelial cells drives the removal of mucus and particles from the airways. Mucociliary transport and possibly airway epithelial development are governed by muscarinic acetylcholine receptors but the precise roles of the subtypes involved are unknown.

This issue was addressed by determining cilia-driven particle transport, ciliary beat frequency, and the composition and ultrastructural morphology of the tracheal epithelium in M1–M5 muscarinic receptor gene-deficient mice.

Knockout of M3 muscarinic receptors prevented an increase in particle transport speed and ciliary beat frequency in response to muscarine. Furthermore, the ATP response after application of muscarine was blunted. Pretreatment with atropine before application of muscarine restored the response to ATP. Additional knockout of the M2 receptor in these mice partially restored the muscarine effect, most likely through the M1 receptor, and normalised the ATP response. M1, M4 and M5 receptor-deficient mice exhibited normal responses to muscarine. None of the investigated mutant mouse strains had any impairment of epithelial cellular structure or composition.

In conclusion, M3 receptors stimulate whereas M2 receptors inhibit cilia-driven particle transport. The M1 receptor increases cilia-driven particle transport if the M3 and M2 receptors are missing. None of the receptors is necessary for epithelial development.
Association between C-reactive protein and unrecognised sleep-disordered breathing in the elderly
Authors: Roche F. , Gaspoz J-M. , Pichot V. , Picard-Kossovsky M. , Maudoux D. , Garcin A. , Celle S. , Sforza E. , Barthélémy J. C.
Published: February 2009

Elevated levels of C-reactive protein (CRP) have been reported in patients with sleep-disordered breathing (SDB) and may represent an inflammatory marker of cardiovascular risk. However, the association of CRP with SBD in presumed healthy elderly subjects is unknown.

In total, 851 (58.5% females) 68-yr-old subjects, who were free of any known cardiac or sleep disorders, were prospectively examined. Subjects underwent unattended polygraphy, and the apnoea/hypopnoea index (AHI) and oxyhaemoglobin desaturation index (ODI) were assessed. Elevated levels of CRP were found on the morning after the sleep study in patients with more severe SDB. A significant correlation was found between CRP levels, time spent at night with arterial oxygen saturation <90% and ODI. No association was found between CRP levels and AHI. After adjustments for body mass index, smoking status, hypertension, diabetes and dyslipidaemia, a significant association remained between CRP levels and ODI >10 events·h−1.

CRP levels were frequently increased in a large sample of elderly subjects free of major cardiovascular disease. CRP levels were not correlated with the AHI and the indices of sleep fragmentation; the ODI >10 events·h−1was the strongest predictor of raised CRP level.

The present results suggest that, in the elderly, intermittent hypoxaemia may underlie inflammatory processes leading to cardiovascular morbidity.
Humanin vivofluorescence microimaging of the alveolar ducts and sacs during bronchoscopy
Authors: Thiberville L. , Salaün M. , Lachkar S. , Dominique S. , Moreno-Swirc S. , Vever-Bizet C. , Bourg-Heckly G.
Published: February 2009

The aim of the present study was to assess fibred confocal fluorescence microscopy (FCFM) as a tool for imaging the alveolar respiratory systemin vivoduring bronchoscopy.

A 488-nm excitation wavelength FCFM device was used in 41 healthy subjects including 17 active smokers. After topical anaesthesia, the 1.4-mm miniprobe was introduced into the bronchoscope working channel and advanced distally to the alveoli. Morphometric and cellular analyses were performed on selected frames harbouring a minimal compression effect.

In vivoacinar microimaging was obtained from each lung segment except for the apical and posterior segments of both upper lobes. Reproducible patterns, corresponding to the elastic framework of the axial and peripheral interstitial systems, were recorded from 192 separate acini. The mean±sdthickness of the acinar elastic fibres was 10±2.7 μm. Alveolar mouth diameters (mean±sd278±53 μm) were normally distributed but appeared smaller in the right upper lobe and right medial basal segment. Lobular microvessels (median diameter 90 μm) were equally distributed throughout the lungs. Alveolar macrophages were not detectable in nonsmokers, whereas a specific tobacco-tar-induced fluorescence was observed in smoking subjects, providing fine details of the alveolar walls and macrophages. A strong correlation was found between the number of cigarettes smoked per day and the amount of large and mobile macrophages observedin vivo, as well as with the intensity of the macrophage alveolitis.

Fibred confocal fluorescence microscopy enables accurate exploration of the peripheral lungin vivoin both smokers and nonsmokers.
Repeated exposure to organic material alters inflammatory and physiological airway responses
Authors: Sundblad B-M. , von Scheele I. , Palmberg L. , Olsson M. , Larsson K.
Published: February 2009

Farmers and smokers are repeatedly exposed to airborne organic material. We hypothesised that farmers and smokers show altered airway responses to inhaled organic, pro-inflammatory agents.

A total of 11 farmers, 12 smokers and 12 controls underwent lipopolysaccharide (LPS) bronchial challenge and spent 3 h in a pig barn. Lung function, exhaled nitric oxide and bronchial responsiveness were assessed and nasal lavage fluid and induced sputum were also collected. Symptoms and body temperature were recorded before and after exposures.

Following exposure to the pig barn, bronchial responsiveness, exhaled nitric oxide, sputum interleukin (IL)-6, nasal lavage cell count and IL-8 were increased to a greater extent in controls compared to farmers. The sputum IL-6 response was also attenuated in farmers after LPS challenge. The response shown by smokers following exposure to the pig barn was similar to that of controls regarding measurements of exhaled nitric oxide, IL-8 in nasal lavage and IL-6 in sputum, but more similar to farmers concerning bronchial responsiveness and the cell numbers present in nasal lavage. Sputum IL-8 showed a greater increase in smokers than in the other groups following LPS challenge.

We conclude that individuals who are repeatedly exposed to organic material develop an adaptation to the effects of acute exposure to inhaled organic material.
Prognostic relevance of angiogenesis in stage III NSCLC receiving multimodality treatment
Authors: Kreuter M. , Kropff M. , Fischaleck A. , Junker K. , Gerss J. , Heinecke A. , Lindermann M. , Reinmuth N. , Berdel W. E. , Mesters R. M. , Thomas M.
Published: February 2009

Compelling evidence indicates that microvessel density (MVD) is a prognostic marker in early nonsmall cell lung cancer (NSCLC). However, its role in lymph node metastases in stage III NSCLC receiving multimodality treatment is unknown.

Lymph nodes of 142 patients with stage III NSCLC, treated in a trial of the German Lung Cancer Cooperative group, were evaluated for MVD. Median follow-up was 7.39 yrs. MVD was correlated with demographic and tumour-related variables and survival.

MVD (median 33.9) did not correlate with survival. However, in multimodality-treated stage IIIA patients receiving tumour resection with negative margins (R0), those with a high MVD had significantly prolonged overall survival with a median of 4.96 yrs compared with 1.99 yrs for those with low MVD (p = 0.041). Cox regression analysis revealed that MVD was a prognostic factor in R0-resected stage IIIA (hazard ratio 0.417). Furthermore, a significant correlation of MVD to stage was observed, with significantly lower MVD in stage IIIA than IIIB (p = 0.0062), and a significant correlation of MVD to histological subtype was observed, with adenocarcinoma revealing the highest scores (p = 0.0001).

Increased angiogenesis within lymph node metastases is a prognostic indicator for better survival in NSCLC patients. Thus, measurement of MVD might be useful in selecting patients for future neoadjuvant treatment decisions.
Obstructive sleep apnoea and its association with gestational hypertension
Authors: Champagne K. , Schwartzman K. , Opatrny L. , Barriga P. , Morin L. , Mallozzi A. , Benjamin A. , Kimoff R. J.
Published: February 2009

Hypertension develops in 10% of pregnancies. Snoring, a marker of obstructive sleep apnoea, is a newly identified risk factor for gestational hypertension. Moreover, obstructive sleep apnoea is an independent risk factor for incident hypertension in the non-pregnant population. The aim of the present study was to test the hypothesis that obstructive sleep apnoea is associated with new onset of hypertension among pregnant females.

A case–control study was performed involving 17 pregnant females with gestational hypertension and 33 pregnant females without hypertension. Subjects were frequency-matched for gestational age and recruited in a tertiary obstetrical centre. Obstructive sleep apnoea was ascertained by polysomnography and defined by an apnoea/hypopnoea index (AHI) of ≥15 events·h−1, without requirement for desaturation.

The mean±sdAHI for normotensive pregnant females was 18.2±12.2 events·h−1compared with 38.6±36.7 events·h−1for females with hypertensive pregnancies. The crude odds ratio for the presence of obstructive sleep apnoea given the presence of gestational hypertension was 5.6. The odds ratio was 7.5 (95% confidence interval 3.5–16.2), based on a logistic regression model with adjustment for maternal age, gestational age, pre-pregnancy body mass index, prior pregnancies, and previous live births.

In conclusion, gestational hypertension appears to be strongly associated with the presence of obstructive sleep apnoea.
Diagnostic yield and safety of ultrasound-assisted biopsies in superior vena cava syndrome
Authors: Koegelenberg C. F. N. , Bolliger C. T. , Plekker D. , Wright C. A. , Brundyn K. , Louw M. , Schubert P. , van den Heuvel M. M. , Diacon A. H.
Published: February 2009

The yield and safety of ultrasound (US)-assisted transthoracic fine needle aspirations (TTFNA) and cutting needle biopsies (CNB) in the setting of superior vena cava (SVC) syndrome are unknown. The aims of the present prospective study were to asses the diagnostic yield and safety of US-assisted TTFNA and CNB in SVC syndrome with an associated mass lesion abutting the chest wall.

Over a 3-yr period, the present authors screened 59 patients with SVC syndrome, and enrolled 25 patients who had an associated mass lesion that extended to the chest wall. US-assisted TTFNA with rapid on-site evaluation (ROSE) was performed in all cases. CNBs were performed where a provisional diagnosis of bronchogenic carcinoma could not be established, and in 57.1% of patients with bronchogenic carcinoma (limited due to safety constraints).

ROSE of US-assisted TTFNA confirmed diagnostically useful material in 24 patients, and cytological diagnoses were ultimately made in all of these cases (diagnostic yield 96%). US-assisted CNB had a diagnostic yield of 87.5%. Minor haemorrhage occurred in one out of 25 TTFNA and three out of 16 CNB. Neither procedure resulted in major haemorrhage nor pneumothoraces.

US-assisted TTFNA and CNB have a high diagnostic yield and are safe in the setting of SVC syndrome with an associated mass lesion abutting the chest wall.