bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of competence level in the self‐efficacy–skills relationship: an empirical examination of the skill acquisition process and its implications for information technology training
Authors: Downey James P. , Zeltmann Steven
Published: May 2009

The role of computer training has long been critical in organizations as reliance on technology for strategic advantage increases in importance. How to most effectively conduct such training has clear implications for organizations. This study examines one area of training which is not well understood: the role that competence level plays in the self‐efficacy–competence relationship (if indeed it plays a role at all) during skill acquisition. Two opposing conceptual positions are presented from the literature, one that suggests the relationship between self‐efficacy and competence will be stronger early in the skill acquisition process (when competence is minimal), the other suggesting the strength of the relationship will be stronger at mastery. Using a sample of over 600 and structural equation modeling, the relationship between self‐efficacy and competence for six different computing application domains is tested by dividing respondents in each domain in half, according to competence level. Results empirically demonstrate that level of competence makes a significant difference in the domains, that those higher in ability typically have a stronger relationship with self‐efficacy. Results also show that the relationship is weaker for those new to the application and those who have mastered the application. The important implications for training are discussed.
Predicting autonomous and controlled motivation to transfer training
Authors: Gegenfurtner Andreas , Festner Dagmar , Gallenberger Wolfgang , Lehtinen Erno , Gruber Hans
Published: May 2009

In spite of a broad consensus on the importance of motivation for the transfer of learning from training to the job in work organizations, studies investigating motivation to transfer are limited. This study combines the self‐determination theory, the expectancy theory and the theory of planned behaviour to provide a theoretical framework for investigating attitudes towards training content, relatedness and instructional satisfaction as predictors of two dimensions of transfer motivation: autonomous motivation to transfer and controlled motivation to transfer. A total of 444 subjects, trained in 23 occupational health and safety training courses, completed multi‐item questionnaires immediately following training. Structural equation modelling procedures indicate that controlled motivation to transfer was affected by attitudes towards training content and that autonomous motivation to transfer was affected by attitudes, relatedness and instructional satisfaction. The results are discussed in terms of theoretical and practical implications for training effectiveness associated with the interplay of motivation and transfer in professional training.
What happens to translocated game birds that ‘disappear’?
Authors: Dickens M. J. , Delehanty D. J. , Reed J. M. , Romero L. M.
Published: May 2009

The ultimate goal of most translocation efforts is to create a self‐sustaining wild population of a species deliberately moved from one part of their range to another. As follow‐up of a translocation attempt is often difficult, causes for failure are relatively unknown. Dispersal away from the release site is one potential source of failure because it decreases the likelihood of the released population establishing itself post‐translocation. In this study, we used chukar Alectoris chukar as a surrogate for translocated game birds in order to conduct a large‐scale experimental study. We observed that these desert‐adapted birds demonstrate a strong fidelity for specific water sources. We also report the propensity for the translocated individuals to either disperse and return to their original water source site or remain at the release site. During two field seasons, we observed opposing behaviors such that the proportion of individuals returning to the capture site, versus those remaining at the release site, shifted between years. We analyzed this change between the years as well as within the years to assess the potential underlying causes such as translocated distance, differences in rainfall between seasons and water source type. We concluded that homing behavior was strong in this non‐migratory bird species and that strength of this homing behavior varied, potentially due to conditions surrounding the limiting resource, water availability. The large‐scale, original data presented here may help to explain why some releases result in a successfully established population while other releases result in widely dispersed individuals.
Insulin and the IGF system in the human placenta of normal and diabetic pregnancies
Authors: Hiden Ursula , Glitzner Elisabeth , Hartmann Michaele , Desoye Gernot
Published: May 2009

The insulin/insulin‐like growth factor (IGF) system regulates fetal and placental growth and development. In maternal diabetes, components of this system including insulin, IGF1, IGF2 and various IGF‐binding proteins are deregulated in the maternal or fetal circulation, or in the placenta. The placenta expresses considerable amounts of insulin and IGF1 receptors at distinct locations on both placental surfaces. This makes the insulin and the IGF1 receptor accessible to fetal and/or maternal insulin, IGF1 and IGF2. Unlike the receptor for IGF1, the insulin receptor undergoes a gestational change in expression site from the trophoblast at the beginning of pregnancy to the endothelium at term. Insulin and IGFs are implicated in the receptor‐mediated regulation of placental growth and transport, trophoblast invasion and placental angiogenesis. The dysregulation of the growth factors and their receptors may be involved in placental and fetal changes observed in diabetes, i.e. enhanced placental and fetal growth, placental hypervascularization and higher levels of fetal plasma amino acids.
Multiple sclerosis and acute disseminated encephalomyelitis diagnosed in children after long‐term follow‐up: comparison of presenting features
Authors: ALPER GULAY , HEYMAN ROCK , WANG LI
Published: May 2009

The aim of this study was to compare the characteristics of the first demyelinating event between acute disseminated encephalomyelitis (ADEM) and multiple sclerosis (MS). Children with acute demyelinating disease of the central nervous system and an abnormal brain magnetic resonance image (MRI) were studied. Patients were assigned a final diagnosis after long‐term follow‐up. Comparisons were made between the MS and ADEM groups. Proposed definitions by the Pediatric MS Study Group were applied to our cohort in retrospect and are discussed. Fifty‐two children and adolescents with a documented abnormal brain MRI were identified (24 females, 28 males; mean age 10y 11mo [SD 5y 4mo] range 1y 10mo–19y 7mo). To date, 26 children have been diagnosed with MS, and 24 with ADEM. One child has relapsing neuromyelitis optica and one child has clinically isolated optic neuritis. Follow‐up duration was 6 years 8 months in monophasic patients, and 5 years 6 months in relapsing patients. None of the patients with MS had encephalopathy while encephalopathy was present in 42% of patients with ADEM. Cerebrospinal fluid oligoclonal bands, an elevated immunoglobulin and the periventricular perpendicular ovoid lesions correlated with MS outcome. Several clinical characteristics differ between ADEM and MS at first presentation; encephalopathy, when present, strongly suggests the diagnosis of ADEM.
Increases in muscle volume after plantarflexor strength training in children with spastic cerebral palsy
Authors: MCNEE ANNE E , GOUGH MARTIN , MORRISSEY MATT C , SHORTLAND ADAM P
Published: May 2009

Children with spastic cerebral palsy (CP) have small, weak muscles. However, change in muscle size due to resistance training in this group is unknown. We investigated the effect of plantarflexor strengthening on muscle volume, gait, and function in 13 ambulant children with spastic CP (seven males, six females; mean age 10y 11mo, SD 3y 0mo, range 6y 11mo–16y 11mo; eight with diplegia, five with hemiplegia; Gross Motor Function Classification System level I, six; level II, five; level III, two). Assessments were performed before training, 5 and 10 weeks into training, and at a 3‐month follow‐up. Medial and lateral gastrocnemius volumes were computed from three‐dimensional ultrasound images. The number of unilateral heel raises able to be achieved on each side was assessed. Function was measured using three‐dimensional gait analysis, the ‘timed up and go’ test, the Gillette Functional Assessment Questionnaire, and the Functional Mobility Scale. Training involved heel raises or Thera‐Band resistance, 4 times a week for 10 weeks. Medial and lateral gastrocnemius volumes increased by 17 and 14% at week 5 (p=0.03, p=0.028). This increase was maintained at week 10 and follow‐up (medial gastrocnemius p=0.001, p<0.001; lateral gastrocnemius p=0.006, p=0.007). Heel raises (mean number) increased by week 5 (p=0.002). This was maintained at week 10 and follow‐up (p<0.001; p<0.001). No significant change in measured function was observed. Muscle volume increased in response to training in children with spastic CP. The role of progressive strength training in maintaining long‐term function is discussed.
Neurological manifestations of the Mendelian‐inherited autoinflammatory syndromes
Authors: SANCHEZ GINA A MONTEALEGRE , HASHKES PHILIP J
Published: May 2009

Autoinflammatory syndromes include an expanding list of conditions characterized by unprovoked recurrent attacks of systemic inflammation with lack of auto‐antibodies or autoreactive T cells. Many of these syndromes are genetic diseases with a Mendelian inheritance. Neurological manifestations may be one of the major clinical features and, in some cases, the presenting symptom of these syndromes. The purpose of this review is to increase the recognition among neurologists of the Mendelian‐inherited autoinflammatory syndromes by highlighting the neurological manifestations in the context of other symptoms that should lead physicians to suspect these syndromes. Most important for neurologists are the cryopyrin‐associated periodic syndromes that include familial cold autoinflammatory syndrome, Muckle–Wells syndrome and neonatal‐onset multisystem inflammatory disease (called chronic infantile neurological cutaneous and articular syndrome in Europe). We also review other syndromes with less common neurological involvement, including familial Mediterranean fever, tumor necrosis factor receptor‐associated periodic syndrome, and hyperimmunoglobulinemia D syndrome. Because these syndromes are often treatable and irreversible damage is prevented if they are treated early, it is important to recognize the features that may result in these syndromes presenting to a neurologist, especially in early childhood.
Hypoxia inducible factor (HIF)‐2α is required for the development of the catecholaminergic phenotype of sympathoadrenal cells
Authors: Brown Stephen T. , Kelly Kevin F. , Daniel Juliet M. , Nurse Colin A.
Published: May 2009

The basic helix‐loop‐helix transcription factor, hypoxia inducible factor (HIF)‐2α has been implicated in the development of the catecholaminergic phenotype in cells of the sympathoadrenal (SA) lineage; however, the underlying mechanisms and HIF‐2α targets remain unclear. Using an immortalized rat adrenomedullary chromaffin cell line (MAH cells) derived from a fetal SA progenitor, we examined the role of HIF‐2α in catecholamine biosynthesis. Chronic hypoxia (2% O2, 24 h) induced HIF‐2α in MAH cells but expression of the rate‐limiting enzyme, tyrosine hydroxylase (TH) and catecholamine levels were unaltered. Interestingly, HIF‐2α depleted MAH cells showed dramatically lower (5–12 times) levels of dopamine and noradrenaline compared with wild‐type and scrambled controls, even in normoxia (21% O2). This was correlated with a marked reduction in the expression of DOPA decarboxylase (DDC) and dopamine β hydroxylase (DβH) but not TH. Chromatin immunoprecipitation assays revealed that HIF‐2α was bound to the DDC gene promoter which contains two putative hypoxia response elements. These data suggest that a basal level of HIF‐2α function is required for the normal developmental expression of DDC and DβH in SA progenitor cells, and that loss of this function leads to impaired catecholamine biosynthesis.
Inhibition of EGF‐induced ERK/MAP kinase‐mediated astrocyte proliferation by μ opioids: integration of G protein and β‐arrestin 2‐dependent pathways
Authors: Miyatake Mayumi , Rubinstein Tal J. , McLennan Gregory P. , Belcheva Mariana M. , Coscia Carmine J.
Published: May 2009

Although μ, κ, and δ opioids activate extracellular signal‐regulated kinase (ERK)/mitogen‐activated protein (MAP) kinase, the mechanisms involved in their signaling pathways and the cellular responses that ensue differ. Here we focused on the mechanisms by which μ opioids rapidly (min) activate ERK and their slower (h) actions to inhibit epidermal growth factor (EGF)‐induced ERK‐mediated astrocyte proliferation. The μ‐opioid agonists ([d‐ala2, mephe4, gly‐ol5] enkephalin and morphine) promoted the phosphorylation of ERK/MAP kinase within 5 min via Gi/o protein, calmodulin (CaM), and β‐arrestin2‐dependent signaling pathways in immortalized and primary astrocytes. This was based on the attenuation of the μ‐opioid activation of ERK by pertussis toxin (PTX), the CaM antagonist, W‐7, and siRNA silencing of β‐arrestin2. All three pathways were shown to activate ERK via an EGF receptor transactivation‐mediated mechanism. This was disclosed by abolishment of μ‐opioid‐induced ERK phosphorylation with the EGF receptor‐specific tyrosine phosphorylation inhibitor, AG1478, and μ‐opioid‐induced reduction of EGF receptor tyrosine phosphorylation by PTX, and β‐arrestin2 targeting siRNA in the present studies and formerly by CaM antisense. Long‐term (h) treatment of primary astrocytes with [d‐ala2,mephe4,gly‐ol5] enkephalin or morphine, attenuated EGF‐induced ERK phosphorylation and proliferation (as measured by 5′‐bromo‐2′‐deoxy‐uridine labeling). PTX and β‐arrestin2 siRNA but not W‐7 reversed the μ‐opioid inhibition. Unexpectedly, β‐arrestin‐2 siRNA diminished both EGF‐induced ERK activation and primary astrocyte proliferation suggesting that this adaptor protein plays a novel role in EGF signaling as well as in the opioid receptor phase of this pathway. The results lend insight into the integration of the different μ‐opioid signaling pathways to ERK and their cellular responses.
Spacing Palestine through the home
Authors: Harker Christopher
Published: May 2009

This paper explores connections that can be made between houses, homes and violence in Palestine, and representational consequences of making such connections. Drawing on ethnographic field research in Birzeit, I put recent work on critical geographies of home into conversation with geographies and geopolitics of Palestine. I criticise the tendency to represent Palestinian geographies almost entirely through the lens of the Israeli Occupation. While such studies have a great deal of value both academically and politically, this paper augments such work by developing a different focus and a different representational approach. I use detailed ethnographic vignettes and interviews to engage with the domestic practices that make particular Birzeiti homes. These intimate domestic encounters underpin my argument that there is a need for more work that apprehends Palestinian geographies as complexities that bear a relation to, but are not fully determined by, the Israeli Occupation.
The timing of eclogite facies metamorphism and migmatization in the Orlica–Śnieżnik complex, Bohemian Massif: constraints from a multimethod geochronological study
Authors: BRÖCKER M. , KLEMD R. , COSCA M. , BROCK W. , LARIONOV A. N. , RODIONOV N.
Published: May 2009

The Orlica–Śnieżnik complex (OSC) is a key geological element of the eastern Variscides and mainly consists of amphibolite facies orthogneisses and metasedimentary rocks. Sporadic occurrences of eclogites and granulites record high‐pressure (HP) to ultrahigh‐pressure (UHP) metamorphic conditions. A multimethod geochronological approach (40Ar–39Ar, Rb–Sr, Sm–Nd, U–Pb) has been used to gain further insights into the polymetamorphic evolution of eclogites and associated country rocks. Special attention was given to the unresolved significance of a 370‐ to 360 Ma age group that was repeatedly described in previous studies. Efforts to verify the accuracy ofc.370 Ma K–Ar phengite and biotite dates reported for an eclogite and associated country‐rock gneiss from the location Nowa Wieś suggest that these dates are meaningless, due to contamination with extraneous Ar. Extraneous Ar is also considered to be responsible for a significantly older40Ar–39Ar phengite date ofc.455 Ma for an eclogite from the location Wojtowka. Attempts to further substantiate the importance of 370–360 Ma zircon dates as an indicator for a melt‐forming high‐temperature (HT) episode did not provide evidence in support of anatectic processes at this time. Instead, SHRIMP U–Pb zircon dating of leucosomes and leucocratic veins within both orthogneisses and (U)HP granulites revealed two age populations (490–450 and 345–330 Ma respectively) that correspond to protolith ages of the magmatic precursors and late Variscan anatexis. The results of this study further underline the importance of Late Carboniferous metamorphic processes for the evolution of the OSC that comprise the waning stages of HP metamorphism and lower pressure HT overprinting with partial melting. Eclogites and their country rocks provided no chronometric evidence for an UHP and ultrahigh‐temperature episode at 387–360 Ma, as recently suggested for granulites from the OSC, based on Lu–Hf garnet ages (Anczkiewiczet al., 2007).
The Impact of Diabetes Mellitus on Two‐Year Mortality Following Contemporary Percutaneous Coronary Intervention: Implications for Revascularization Practice
Authors: ANDRON M. , PERRY R. A. , EGRED M. , ALAHMAR A. E. , GRAYSON A. D. , SHAW M. , ROBERTS E. , PALMER N. D. , STABLES R. H.
Published: May 2009

Objective:

To assess the impact of diabetes on 2‐year mortality in current PCI practice.

Background:

In patients with coronary artery disease undergoing revascularization, diabetes mellitus is associated with higher mortality.

Methods:

A retrospective analysis was done of all patients undergoing PCI at our tertiary center between January 2000 and December 2004. There were 6,160 PCI procedures performed in 5,759 patients who received at least one stent. Of these patients, 801 (13.9%) were diabetic and 4,958 (86.1%) were nondiabetic. The primary outcome measure of the study was all‐cause mortality. All patients were followed up for a period of 2 years. Multivariate logistic regression analysis was used to test for a potential independent association between diabetic status and follow‐up mortality.

Results:

Before adjustment, a trend toward higher mortality was observed in diabetic patients compared to non‐diabetics at 1 year (3.2% vs 2.4%) and 2 years (5.1% vs 3.8%), P = 0.12. Independent predictors for mortality were increasing age, renal dysfunction, peripheral vascular disease, NYHA class >2, urgent PCI, treating left main stem lesions, vessel diameter ≤ 2.5 mm, and 3‐vessel disease. The use of drug‐eluting stent was associated with a reduction in mortality. Diabetes was found to have no independent impact on mortality following PCI (odds ratio = 1.08; 95% confidence intervals = 0.73–1.60; P = 0.71).

Conclusion:

The presence of diabetes was not an independent predictor of mortality following PCI. A diabetic patient that does not require insulin treatment and has no evidence of macro‐ or microvascular diabetic disease could enjoy a PCI outcome similar to nondiabetic subjects.
Functional Generalized Linear Models with Images as Predictors
Authors: Reiss Philip T. , Ogden R. Todd
Published: May 2009

Summary Functional principal component regression (FPCR) is a promising new method for regressing scalar outcomes on functional predictors. In this article, we present a theoretical justification for the use of principal components in functional regression. FPCR is then extended in two directions: from linear to the generalized linear modeling, and from univariate signal predictors to high‐resolution image predictors. We show how to implement the method efficiently by adapting generalized additive model technology to the functional regression context. A technique is proposed for estimating simultaneous confidence bands for the coefficient function; in the neuroimaging setting, this yields a novel means to identify brain regions that are associated with a clinical outcome. A new application of likelihood ratio testing is described for assessing the null hypothesis of a constant coefficient function. The performance of the methodology is illustrated via simulations and real data analyses with positron emission tomography images as predictors.
Synthesis and Application in the CO Oxidation Conversion Reaction of Hexagonal Boron Nitride with High Surface Area
Authors: Lin Liangxu , Li Zhaohui , Zheng Ying , Wei Kemei
Published: May 2009

Hexagonal boron nitride (h‐BN) with high surface area has been synthesized via a simple method. Pt/h‐BN catalyst has been prepared from the as‐prepared h‐BN for the CO conversion reaction. Experimental results indicate that the as‐prepared h‐BN particles have a surface area of 125 m2/g, a mesoporous volume of 0.29 cm3/g, and a pore diameter of 4.2 nm. The supported Pt/h‐BN catalyst showed high catalystic performance on the CO conversion reaction.
Effect of Loading Rate and Surface Conditions on the Flexural Strength of Borosilicate Glass
Authors: Nie Xu , Chen Weinong W. , Wereszczak Andrew A. , Templeton Douglas W.
Published: May 2009

This study evaluates the loading rate and surface condition dependence of the flexural strength of a borosilicate glass. The glass specimens are subjected to three different surface treatments before four‐point bending tests to study the effect of surface flaws. Quasistatic (Material Test System 810) and dynamic (Kolsky bar) experiments are performed at loading rates ranging from 0.7 to 4 × 106MPa/s. The results show that the flexural strength of the borosilicate glass has a strong dependence on the loading rate. A chemically etched surface produces an enhanced flexural strength by about an order of magnitude. Scanning electron microscopy images on fracture surfaces indicate that the failure is governed by different types of flaws under different surface treatment conditions. Edge failure is also identified for samples possessing high flexural strength.
Double Hysteresis Loop and Aging Effect in K0.5Na0.5NbO3–K5.4Cu1.3Ta10O9 Lead‐Free Ceramics
Authors: Lin Dunmin , Kwok Kin Wing , Wong Lai‐wa Chan Helen
Published: May 2009

In this work, the double‐loop‐like characteristics of K0.5Na0.5NbO3+x mol% K5.4Cu1.3Ta10O9 ceramic and its relationships with the transition temperature, aging, and switching have been investigated. Our results reveal that the phase transition temperature is an important parameter determining the aging requirement for the ceramics to exhibit the double‐loop‐like characteristics. For a ceramic with a high transition temperature, e.g. the ceramic with x=0.75 (tetragonal–orthorhombic phase temperature ∼206°C), the vacancies can migrate during the crystal transformation and settle in a distribution with the same symmetry as the crystal after the transformation. As a result, defect dipoles along the polarization direction are formed and provide restoring forces to reverse the switched polarizations, and thus producing a double polarization hysteresis (P–E) loop. On the other hand, aging is required for a ceramic with a low transition temperature, e.g. aging at 80°C for 30 days is required for the ceramic with x=1.5 (transition temperature ∼175°C). Our results also reveal that the defect dipoles can be switched under a slow‐switching electric field (<1 Hz) or at high temperatures (>100°C), thus leading to an opening of the double P–E loop.
The Role of Li2CO3 and PbO in the Low‐Temperature Sintering of Sr, K, Nb (SKN)‐Doped PZT
Authors: Donnelly Niall J. , Shrout Thomas R. , Randall Clive A.
Published: May 2009

It is demonstrated that the use of ∼0.9 mol% Li2CO3 (LC) as a sintering aid for Sr, K, Nb modified Pb(Zr1−x,Tix)O3 (PZT) ceramics is effective only in the presence of excess PbO (∼2 mol%). It is shown that LC and PbO react to form the compound, Li2PbO3 (LPO) which has a melting temperature of ∼836°C. Using dilatometry, we were able to correlate shrinkage during heating of a green ceramic to the melting of the LPO. Consequently, complete densification and sizeable grain growth are achieved by solution‐precipitation of the ceramic through the liquid phase. Importantly, sintering is not particularly effective with such small additions of either LC or PbO alone. In confirmation of this model, the LPO compound was presynthesized and used as the only sintering aid in the same PZT composition. The densification behavior of this mixture compared well with the case of separate additions.
Spark‐Plasma‐Sintering Condition Optimization for Producing Transparent MgAl2O4 Spinel Polycrystal
Authors: Morita Koji , Kim Byung‐Nam , Yoshida Hidehiro , Hiraga Keijiro
Published: May 2009

By controlling the heating rate at <10°C/min during spark‐plasma‐sintering (SPS) processing, transparent polycrystalline spinel with an in‐line transmission of 50% and 70% in the visible‐ and infrared‐wavelengths, respectively, can be successfully fabricated for only a 20‐min soak at 1300°C. The high transmission can be attained by reducing the residual porosity and pore size, which was achieved by the low‐heating rate. At high heating rates, many closed pores are formed due to the high densification rate during the heating process and remain as large pores around grain junctions. At temperatures >1300°C, the coalescence of the residual pores and the precipitation of second phases, which are caused by rapid grain growth, degrade the transparency. The present study demonstrates that although the high heating rates have been regarded as a primary advantage for the SPS processing, the low heating rate is highly effective in attaining a high transparency in the spinel even at low temperatures and for short sintering times.
Outcomes After Intravenous Opioids in Emergency Patients: A Prospective Cohort Analysis
Authors: O’Connor Alec B. , Zwemer Frank L. , Hays Daniel P. , Feng Changyong
Published: May 2009

Objectives:  Pain management continues to be suboptimal in emergency departments (EDs). Several studies have documented failures in the processes of care, such as whether opioid analgesics were given. The objectives of this study were to measure the outcomes following administration of intravenous (IV) opioids and to identify clinical factors that may predict poor analgesic outcomes in these patients.

Methods:  In this prospective cohort study, emergency patients were enrolled if they were prescribed IV morphine or hydromorphone (the most commonly used IV opioids in the study hospital) as their initial analgesic. Patients were surveyed at the time of opioid administration and 1 to 2 hours after the initial opioid dosage. They scored their pain using a verbal 0–10 pain scale. The following binary analgesic variables were primarily used to identify patients with poor analgesic outcomes: 1) a pain score reduction of less than 50%, 2) a postanalgesic pain score of 7 or greater (using the 0–10 numeric rating scale), and 3) the development of opioid‐related side effects. Logistic regression analyses were used to study the effects of demographic, clinical, and treatment covariates on the outcome variables.

Results:  A total of 2,414 were approached for enrollment, of whom 1,312 were ineligible (658 were identified more than 2 hours after IV opioid was administered and 341 received another analgesic before or with the IV opioid) and 369 declined to consent. A total of 691 patients with a median baseline pain score of 9 were included in the final analyses. Following treatment, 57% of the cohort failed to achieve a 50% pain score reduction, 36% had a pain score of 7 or greater, 48% wanted additional analgesics, and 23% developed opioid‐related side effects. In the logistic regression analyses, the factors associated with poor analgesia (both <50% pain score reduction and postanalgesic pain score of ≥7) were the use of long‐acting opioids at home, administration of additional analgesics, provider concern for drug‐seeking behavior, and older age. An initial pain score of 10 was also strongly associated with a postanalgesic pain score of ≥7. African American patients who were not taking opioids at home were less likely to achieve a 50% pain score reduction than other patients, despite receiving similar initial and total equianalgesic dosages. None of the variables we assessed were significantly associated with the development of opioid‐related side effects.

Conclusions:  Poor analgesic outcomes were common in this cohort of ED patients prescribed IV opioids. Patients taking long‐acting opioids, those thought to be drug‐seeking, older patients, those with an initial pain score of 10, and possibly African American patients are at especially high risk of poor analgesia following IV opioid administration.
Frequency of Acute Coronary Syndrome in Patients with Normal Electrocardiogram Performed during Presence or Absence of Chest Pain
Authors: Turnipseed Samuel D. , Trythall William S. , Diercks Deborah B. , Laurin Erik G. , Kirk J. Douglas , Smith David S. , Main David N. , Amsterdam Ezra A.
Published: May 2009

Objectives:  The authors hypothesized that patients with active chest pain at the time of a normal electrocardiogram (ECG) have a lower frequency of acute coronary syndrome (ACS) than patients being evaluated for chest pain but with no active chest pain at the time of a normal ECG. The study objective was to describe the association between chest pain in patients with a normal ECG and the diagnosis of ACS.

Methods:  This was a prospective observational study of emergency department (ED) patients with a chief complaint of chest pain and an initial normal ECG admitted to the hospital for chest pain evaluation over a 1‐year period. Two groups were identified: patients with chest pain during the ECG and patients without chest pain during the ECG. Normal ECG criteria were as follow: 1) normal sinus rhythm with heart rate of 55–105 beats/min, 2) normal QRS interval and ST segment, and 3) normal T‐wave morphology or T‐wave flattening. “Normal” excludes pathologic Q waves, left ventricular hypertrophy, nonspecific ST‐T wave abnormalities, any ST depression, and discrepancies in the axis between the T wave and the QRS. Patients’ initial ED ECGs were interpreted as normal or abnormal by two emergency physicians (EPs); differences in interpretation were resolved by a cardiologist. ACS was defined as follows: 1) elevation and characteristic evolution of troponin I level, 2) coronary angiography demonstrating >70% stenosis in a major coronary artery, or 3) positive noninvasive cardiac stress test. Chi‐square analysis was performed and odds ratios (ORs) are presented.

Results:  A total of 1,741 patients were admitted with cardiopulmonary symptoms; 387 met study criteria. The study group comprised 199 males (51%) and 188 females (49%), mean age was 56 years (range, 25–90 years), and 106 (27%) had known coronary artery disease (CAD). A total of 261 (67%) patients experienced chest pain during ECG; 126 (33%) patients experienced no chest pain during ECG. There was no difference between the two groups in age, sex, cardiac risk factors, or known CAD. The frequency of ACS for the total study group was 17% (67/387). There was no difference in prevalence of ACS based on the presence or absence of chest pain (16% or 42/261 vs. 20% or 25/126; OR = 0.77, 95% confidence interval = 0.45 to 1.33, p = 0.4).

Conclusions:  Contrary to our hypothesis concerning patients who presented to the ED with a chief complaint of chest pain, our study demonstrated no difference in the frequency of acute coronary syndrome between patients with chest pain at the time of acquisition of a normal electrocardiogram and those without chest pain during acquisition of a normal electrocardiogram.
Cyclin D1 expression in typical chronic lymphocytic leukaemia
Authors: Abboudi Zaid , Patel Ketan , Naresh Kikkeri N.
Published: May 2009

Demonstration of cyclin D1 expression by immunohistochemistry in a CD5‐positive small B‐cell proliferation is extremely helpful in the diagnosis of mantle cell lymphoma in tissue samples, including bone marrow trephine biopsies (BMTB) and in differentiating them from chronic lymphocytic leukaemia (CLL). Following the identification of cyclin D1 expression in one case of CLL on BMTB, 64 additional cases, which included 25 lymph nodes, one tonsillar lesion, one skin lesion and 37 BMTBs were systematically reviewed for presence of cyclin D1 overexpression. Overall, in seven of 65 samples (∼10%) of CLL, a minority of the leukaemic cells in the proliferation centres expressed cyclin D1. Cytogenetic analysis had been performed in three of seven cases and there was no evidence of translocation involving CCND1 locus. Our findings suggest that a small subset of CLL overexpresses cyclin D1 in amounts that can be demonstrated by immunohistochemistry. Our observation has impact on the diagnosis of small B‐cell lymphomas in BMTB and other tissue samples.
All‐trans retinoic acid can intensify the growth inhibition and differentiation induction effect of rosiglitazone on multiple myeloma cells
Authors: Huang Haiwen , Wu Depei , Fu Jinxiang , Chen Guanghua , Chang Weirong , Chow Howard C. H. , Leung Anskar Y. H. , Liang Raymond
Published: May 2009

Objective:  Activation of PPARγ by its ligands has shown potential anti‐neoplastic effects in solid tumors. In this study, we investigate the effects of rosiglitazone (RGZ) alone as well as in combination with all trans‐retinoic acid (ATRA) on human myeloma cell lines and try to address its potential mechanism.

Methods:  U266, RPMI‐8226 and primary myeloma cells from patients were treated with different concentrations of RGZ in the presence or absence of ATRA and various biological responses were studied by the methods of [3H] thymidine incorporation, MTT, cell cycle analysis, Annexin V‐PI staining, Wright‐Giemsa staining, CD49e expression assay, light chain protein detection, RT‐PCR and caspase‐3 activity assay.

Results:  We report that exposure to RGZ induced proliferation inhibition and viability reduction in a dose‐dependent manner in both U266 and RPMI‐8226 cells. A similar exposure to RGZ also induced cell cycle arrest and cell apoptosis of myeloma cells. A combination of RGZ with ATRA enhanced the effects of RGZ and induced cell cycle arrest and apoptosis more profoundly in both cell lines. RGZ treated cells displayed morphological characteristics of cell differentiation, and more evident signs of differentiation were observed when combined with ATRA. These changes were confirmed by the detection of CD49e expression and light chain protein secretion. Similar cell apoptosis and differentiation were observed when primary CD138+ myeloma cells were treated with RGZ and ATRA. The mRNA expressions of FLIP, XIAP and survivin were detected in both cell lines and the levels decreased significantly after culture with RGZ. The addition of ATRA in culture medium made these changes more apparently. Caspase‐3 activity was increased upon exposure to RGZ in both U266 and RPMI‐8226 cells while combination of RGZ and ATRA brought out more effective activation of caspase‐3. Similar apoptosis and cell differentiation induced by RGZ and ATRA can also be observed in primary CD138+ cells from myeloma patients.

Conclusion:  Concomitant RXRα activation by ATRA enhanced the inhibitory effects of RGZ on myeloma cell proliferation, cell cycle, apoptosis and differentiation. Combination of RGZ and ATRA may be a useful therapy for human multiple myeloma.
Identification of a Cytoplasmic Signal for Apical Transcytosis
Authors: Luton Frédéric , Hexham Mark J. , Zhang Min , Mostov Keith E.
Published: May 2009

Polarized epithelial cells contain apical and basolateral surfaces with distinct protein compositions. To establish and maintain this asymmetry, newly made plasma membrane proteins are sorted in the trans Golgi network for delivery to apical or basolateral surfaces. Signals for basolateral sorting are generally located in the cytoplasmic domain of the protein, whereas signals for apical sorting can be in any part of the protein and can depend on N‐linked glycosylation of the protein. Signals for constitutive transcytosis to the apical surface have not been reported. In this study, we used the polymeric immunoglobulin receptor (pIgR), which is biosynthetically delivered to the basolateral surface. There the pIgR can bind a ligand and, with or without bound ligand, the pIgR can then be transcytosed to the apical surface. We found that the glycosylation of the pIgR did not affect the biosynthetic transport of the pIgR. However, glycosylation had an effect on pIgR apical transcytosis. Importantly, analysis of the cytoplasmic tail of the pIgR suggested that a short peptide segment was sufficient to transcytose the pIgR or a neutral reporter from the basolateral to the apical surface. This apical transcytosis sorting signal was not involved in polarized biosynthetic traffic of the pIgR.
The Drosophila TRPA channel, Painless, regulates sexual receptivity in virgin females
Authors: Sakai T. , Kasuya J. , Kitamoto T. , Aigaki T.
Published: May 2009

Transient receptor potential (TRP) channels play crucial roles in sensory perception. Expression of the Drosophila painless (pain) gene, a homolog of the mammalian TRPA1/ANKTM1 gene, in the peripheral nervous system is required for avoidance behavior of noxious heat or wasabi. In this study, we report a novel role of the Pain TRP channel expressed in the nervous system in the sexual receptivity in Drosophila virgin females. Compared with wild‐type females, pain mutant females copulated with wild‐type males significantly earlier. Wild‐type males showed comparable courtship latency and courtship index toward wild‐type and pain mutant females. Therefore, the early copulation observed in wild‐type male and pain mutant female pairs is the result of enhanced sexual receptivity in pain mutant females. Involvement of pain in enhanced female sexual receptivity was confirmed by rescue experiments in which expression of a pain transgene in a pain mutant background restored the female sexual receptivity to the wild‐type level. Targeted expression of pain RNA interference (RNAi) in putative cholinergic or GABAergic neurons phenocopied the mutant phenotype of pain females. However, target expression of pain RNAi in dopaminergic neurons did not affect female sexual receptivity. In addition, conditional suppression of neurotransmission in putative GABAergic neurons resulted in a similar enhanced sexual receptivity. Our results suggest that Pain TRP channels expressed in cholinergic and/or GABAergic neurons are involved in female sexual receptivity.
Chronic fatigue in adolescence—autonomic dysregulation and mental health: an exploratory study
Authors: Gjone Helene , Wyller Vegard Bruun
Published: May 2009

Aim:  The present study investigates associations between autonomic cardiovascular dysregulation, psychosocial load and mental health in adolescents presenting with chronic fatigue.

Method:  Twenty‐two adolescents, mean age 15.7 years (12.7–19.1), underwent a clinical mental health examination as part of a broad medical investigation which included autonomic tests. Adolescents and their parents were also interviewed with regard to psychosocial stress factors, family health and previous illnesses. A count of psychosocial load was made for each adolescent based on the interview.

Results:  Of 22 fatigued adolescents in the present sample, 14 had psychiatric diagnoses. There was no significant difference in psychosocial load for the fatigued adolescents classified with normal autonomic regulation compared to those with deviant or borderline autonomic regulation. The present psychiatric diagnosis did not differ between the two groups. In a subsample, there was a significant negative association between depressive symptoms and abnormal blood pressure responses during orthostatic challenge.

Conclusion:  No significant psychiatric or psychosocial differences between fatigued adolescents with or without autonomic dysregulation were found in this study. The trends towards higher psychosocial load and greater burden of depressive symptoms in fatigued adolescents with normal autonomic regulation warrant further studies.
The acoustic hood: a patient‐independent device improving acoustic noise protection during neonatal magnetic resonance imaging
Authors: Nordell Anders , Lundh Marcus , Horsch Sandra , Hallberg Boubou , Åden Ulrika , Nordell Bo , Blennow Mats
Published: May 2009

Background:  Magnetic resonance imaging (MRI) is today the imaging modality of choice to investigate the neonatal brain. However, the acoustic noise during scanning is very loud, often exceeding 100 dBA.

Aim:  To reduce the acoustic noise during MRI for neonatal patients. If effective, this would create a safer environment and also result in fewer aborted examinations due to poor image quality from patient motion.

Methods:  A passive acoustic noise protector, the acoustic hood, was built out of dampening material. Sound pressure measurements with and without the acoustic hood were performed using our clinical neonatal scan protocol, consisting of eight imaging sequences. The acoustic hood is placed over the newborn inside the MR scanner tunnel during the examination to absorb acoustic noise.

Results:  The acoustic noise level was substantially reduced using the acoustic hood. Peak sound pressure was reduced 16.18–22.21 dBA depending on the pulse sequence. For the entire frequency spectra, reduction were between 4–13.59 dBA again varying with the pulse sequence.

Conclusion:  Acoustic noise can be reduced further than before by using the patient‐independent acoustic hood in addition to other noise protection. We recommend the use of three passive hearing protections during neonatal MRI: (1) dental putty, (2) paediatric ear muffs, and (3) the acoustic hood.
Polysaccharide binding sites in hyaluronate lyase – crystal structures of native phage–encoded hyaluronate lyase and its complexes with ascorbic acid and lactose
Authors: Mishra Parul , Prem Kumar R. , Ethayathulla Abdul S. , Singh Nagendra , Sharma Sujata , Perbandt Markus , Betzel Christian , Kaur Punit , Srinivasan Alagiri , Bhakuni Vinod , Singh Tej P.
Published: May 2009

Hyaluronate lyases are a class of endoglycosaminidase enzymes with a high level of complexity and heterogeneity. The main function of the Streptococcus pyogenes bacteriophage protein hyaluronate lyase, HylP2, is to degrade hyaluronan into unsaturated disaccharide units. HylP2 was cloned, over‐expressed and purified to homogeneity. The recombinant HylP2 exists as a homotrimer with a molecular mass of approximately 110 kDa under physiological conditions. The HylP2 was crystallized and the crystals were soaked in two separate reservoir solutions containing ascorbic acid and lactose, respectively. The crystal structures of native HylP2 and its two complexes with ascorbic acid and lactose have been determined. HylP2 folds into four distinct domains with a central core consisting of 16 antiparallel β‐strands forming an irregular triangular tube designated as triple‐stranded β‐helix. The structures of complexes show that three molecules each of ascorbic acid and lactose bind to protein at the sugar binding groove in the triple‐stranded β‐helix domain. Both ascorbic acid and lactose molecules occupy almost identical subsites in the long saccharide binding groove. Both ligands are involved in several hydrogen bonded interactions at each subsite. The binding characteristics and stereochemical properties indicate that Tyr264 may be involved in the catalytic activity of HylP2. The mutation of Tyr264 to Phe264 supports this observation.
Glycogen content regulates insulin‐ but not contraction‐mediated glycogen synthase activation in the rat slow‐twitch soleus muscles
Authors: Lai Y.‐C. , Lin F.‐C. , Jensen J.
Published: May 2009

Aim:  The aim of this study was to investigate the effect of glycogen content on glycogen synthase (GS) activation and phosphorylation in the slow‐twitch soleus muscles after contraction, during insulin stimulation and when these two stimuli were combined.

Methods:  Glycogen content was manipulated in vivo with 24 h fasting and fasting followed by 24 h refeeding. Soleus strips were electrically stimulated for 30 min in vitro, and GS activation and phosphorylation were investigated after an additional 30 min incubation with or without insulin.

Results:  Fasting reduced glycogen content in soleus muscle by 40% and refeeding enhanced by 40%, compared to rats with free access to chow. Insulin‐stimulated GS fractional activity was inversely correlated with glycogen content (R = −0.95, P < 0.001, n = 24) and rate of glycogen synthesis was also inversely correlated with glycogen content (R = −0.70, P < 0.001, n = 36). After contraction, GS fractional activity was increased to similar levels in muscles with low, normal and high glycogen content; rate of glycogen synthesis after contraction was also similar. After contraction, insulin additively increased GS activation at all glycogen contents. Group means of GS fractional activity was inversely correlated with GS Ser641 (R = −0.93, P < 0.001) and Ser645,649,653,657 (R = −0.85, P < 0.001) phosphorylation, but not with Ser7 phosphorylation.

Conclusion:  Glycogen content regulates insulin‐ but not contraction‐stimulated GS activation and glycogen synthesis in soleus muscles. Furthermore, phosphorylation of GS Ser641 and Ser645,649,653,657 seems to regulate GS activity in soleus.
Stem Cell Platforms for Regenerative Medicine
Authors: Nelson Timothy J. , Behfar Atta , Yamada Satsuki , Martinez‐Fernandez Almudena , Terzic Andre
Published: May 2009

The pandemic of chronic degenerative diseases associated with aging demographics mandates development of effective approaches for tissue repair. As diverse stem cells directly contribute to innate healing, the capacity for de novo tissue reconstruction harbors a promising role for regenerative medicine. Indeed, a spectrum of natural stem cell sources ranging from embryonic to adult progenitors has been recently identified with unique characteristics for regeneration. The accessibility and applicability of the regenerative armamentarium has been further expanded with stem cells engineered by nuclear reprogramming. Through strategies of replacement to implant functional tissues, regeneration to transplant progenitor cells or rejuvenation to activate endogenous self‐repair mechanisms, the overarching goal of regenerative medicine is to translate stem cell platforms into practice and achieve cures for diseases limited to palliative interventions. Harnessing the full potential of each platform will optimize matching stem cell‐based biologics with the disease‐specific niche environment of individual patients to maximize the quality of long‐term management, while minimizing the needs for adjunctive therapy. Emerging discovery science with feedback from clinical translation is therefore poised to transform medicine offering safe and effective stem cell biotherapeutics to enable personalized solutions for incurable diseases.