bluuebunny/crossref_metadata_2025 huggingface dataset:
A New Approach to Control of Anemia in “At Risk” Infants and Children Around the World 2004 Ryley-Jeffs Memorial Lecture
Authors: Zlotkin Stanley
Published: May 2007

An estimated 60-80% of the world's population is affected by iron deficiency. It is the most common preventable nutritional deficiency in the world, despite global goals for its reduction. Young children are the highest risk group, particularly during their rapid period of growth. Anemia in infants and young children is known to have a negative impact on motor and socioemotional development and cognitive function. A new intervention, microencapsulated ferrous fumarate Sprinkles, has been developed to treat iron deficiency. The development process took the intervention from the idea stage to the research stage to the implementation stage. Multiple micronutrient Sprinkles are a breakthrough in meeting the global challenge to reduce childhood anemia due to iron and other micronutrient deficiencies. The goal of the Sprinkles project is to reduce the global burden of childhood anemia by promoting healthy weaning practices, by advocating home-fortification strategies to increase the micronutrient content of weaning foods, and by making Sprinkles widely available, particularly in developing countries.
Processed Tomato Products as a Source of Dietary Lycopene:Bioavailability and Antioxidant Properties
Authors: Rao A. Venket
Published: May 2007

Oxidative stress is one of the major contributors to increased risk of chronic diseases. A diet rich in tomatoes and tomato products containing lycopene, a carotenoid antioxidant, has been found to protect against these chronic diseases by mitigating oxidative damage. The study aim was to evaluate the effects of a long-term tomato-rich diet, consisting of various processed tomato products, on bioavailability and antioxidant properties of lycopene. Seventeen healthy human subjects (ten men, seven non-pregnant women) participated in the study. Following a two-week washout period during which subjects avoided foods containing lycopene, all subjects consumed test tomato products including tomato juice, tomato sauce, tomato paste, ketchup, spaghetti sauce, and ready-to-serve tomato soup providing 30 mg of lycopene a day for four weeks. At the end of treatment, serum lycopene level increased significantly (p <0.05), from 181.79 ± 31.25 to 684.7 ± 113.91 nmol/L. Similarly, total antioxidant potential increased significantly (p <0.05), from 2.26 ± 0.015 to 2.38 ± 0.17 mmol/L Trolox equivalent. Lipid and protein oxidation was reduced significantly (p <0.05). The results suggest that a tomato-rich diet containing different sources of lycopene can increase serum lycopene levels and reduce oxidative stress effectively.
Media Literacy:A Critical Role for Dietetic Practice
Authors: Wadsworth Laurie A. , Thompson Angela M.
Published: May 2007

The mass media, including broadcast, electronic, and print media, have become entrenched in Canadians’ daily lives. Spending the majority of their leisure time with mass media puts Canadians at increased health risk. Our review of the research literature shows that television (TV) viewing and content are linked to potential consumer health risks due to developed health attitudes, beliefs, and behaviours. The associated health risks of children and youth are of particular concern. Excessive TV viewing has been associated with obesity development, increased energy consumption, reduced energy expenditure, negative body image development, and reduced concern with the concept of self-care. Media literacy, the ability to view critically and understand mediated messages, is a possible technique to mitigate these adverse effects. The enhanced inclusion of media literacy concepts in health education activities of dietetic practice is advocated. Dietitians could increase their understanding of research findings on the health-related effects of mass media use and the implications of including media literacy in daily practice. Such awareness would further augment available health promotion strategies.
Distance Delivery of Nutrition Education
Authors: Mazurak Vera C. , Whybrow Ellen , Varnhagen Stanley , Field Catherine J.
Published: May 2007

Questions often arise about the quality of an educational experience in a distance format. Debate exists as to whether the relatively new format of on-line education can offer an equivalent learning experience for students, and the perception remains that virtual learning is impersonal. We examined students’ experience in an introductory undergraduate nutrition course that had been remodelled as an asynchronous, active-learning, student-centred model. The investigation used the framework of instructional message design, a concept based on cognitive science principles, to highlight themes in student survey and focus group data. Results indicate that a motivating and accessible quality educational experience is possible in an on-line format through a student-centred model. Such a model provides a means to offer education to a diverse and larger audience. Further investigation is needed to determine faculty professional development needs and cost-effective ways to expand the model. Such a model provides alternatives to expand delivery to encourage interest in the field, and to provide continuing education for allied professionals and the general public.
Collective Kitchens in Canada: A Review of the Literature
Authors: Engler-Stringer Rachel , Berenbaum Shawna
Published: May 2007

Purpose: Collective kitchens are community-based cooking programs in which small groups of people cook large quantities of food. They have developed over the past 20 years, and hundreds of groups have been formed across the country. However, collective kitchens described in the literature vary considerably in structure, purpose, and format. The purpose of this review is to synthesize research on this topic.

Methods: Articles and theses were collected through searches of major databases, and synthesized to improve understanding of current information, and of continuing gaps in the knowledge of collective kitchens in Canada.

Results: The limited published research on collective kitchens suggests that social and learning benefits are associated with participation. Some indication exists that participants also find the food cooked to be high quality, culturally acceptable, and acquired in a manner that maintains personal dignity. Whether collective kitchens have an impact on food resources as a whole is unclear, as research has been limited in scale.

Conclusions: The role of collective kitchens in community building and empowering participants often is noted, and bears further investigation. Dietitians and nutritionists have a unique opportunity to facilitate the health promotion and food security benefits of collective kitchens.
Nutrition in Primary Health Care: Using a Delphi Process To Design New Interdisciplinary Services
Authors: Brauer Paula , Dietrich Linda , Davidson Bridget ,   Steering Committee
Published: May 2007

Purpose: A modified Delphi process was used to identify key features of interdisciplinary nutrition services, including provider roles and responsibilities for Ontario Family Health Networks (FHNs), a family physician-based type of primary care.

Methods: Twenty-three representatives from interested professional organizations, including three FHN demonstration sites, completed a modified Delphi process. Participants reviewed evidence from a systematic literature review, a patient survey, a costing analysis, and key informant interview results before undertaking the Delphi process. Statements describing various options for services were developed at an in-person meeting, which was followed by two rounds of e-mail questionnaires. Teleconference discussions were held between rounds.

Results: An interdisciplinary model with differing and complementary roles for health care providers emerged from the process. Additional key features addressing screening for nutrition problems, health promotion and disease prevention, team collaboration, planning and evaluation, administrative support, access to care, and medical directives/delegated acts were identified. Under the proposed model, the registered dietitian is the team member responsible for managing all aspects of nutrition services, from needs assessment to program delivery, as well as for supporting all providers’ nutrition services.

Conclusions: The proposed interdisciplinary nutrition services model merits evaluation of cost, effectiveness, applicability, and sustainability in team-based primary care service settings.
Building a Vision of Dietitian Services In Primary Health Care
Authors: Cantwell Barbara , Clarke Carol , Bellman Jane
Published: May 2007

Purpose: Primary health care (PHC) reform, especially efforts to implement interdisciplinary teams, has implications for dietetic practice. A consistent, clear vision of the registered dietitian’s (RD’s) role in PHC is needed to develop a successful advocacy agenda.

Methods: The Dietitians of Canada (DC) Central and Southern Ontario Primary Health Care Action Group organized a four-step process to engage dietitians in developing an advocacy agenda for RD PHC services in Ontario. Two facilitated workshops brought together dietitian opinion leaders to enhance the understanding of current roles, find common ground, and develop a shared vision. All DC members were invited to review the draft vision, and feedback was integrated into a revised vision.

Results: Registered dietitians saw PHC reform through many lenses, and were uncertain about how reforms would affect their practices. In a national review, the majority of reviewers (approximately 85% of 270) supported the draft vision; additional clarity was needed on resources and the breadth of services that RDs would provide.

Conclusion: Development of a PHC vision for RDs should be helpful in advocating for dietitian services in PHC.
Definitions of Healthy Eating Among University Students
Authors: House Jennifer , Su Jenny , Levy-Milne Ryna
Published: May 2007

Purpose: To identify definitions of healthy eating in terms of food characteristics, eating behaviours, barriers, and benefits in university students.

Methods: Four focus groups were conducted; verbatim transcripts were analyzed and coded using qualitative methods. Participants were nine students of dietetics and six students of other subjects. All were females in their third or fourth year at the University of British Columbia (UBC).

Results: Participants often described healthy eating as consuming all food groups of Canada’s Food Guide to Healthy Eating, with the associated notions of moderation and balance. Benefits of healthy eating were cited as a healthy weight, good physical appearance, feeling better, preventing disease, and achieving personal satisfaction. Barriers to healthy eating included lack of time, choice, taste preferences, and finances. There was some discrepancy between what the dietetics students perceived as barriers for clients (e.g., lack of information), and barriers the potential clients (other students) perceived for themselves.

Conclusions: As dietitians, we must try to understand our clients’ definitions of healthy eating and their barriers to achieving it, which likely differ from our own.
Canadian Dietitians’ Use and PerceptionsOf Glycemic Index in Diabetes Management
Authors: Kalergis Maria , Pytka Evelyne , Yale Jean-François , Mayo Nancy , Strychar Irene
Published: May 2007

Purpose: Several health organizations, including the Canadian Diabetes Association, advocate use of the glycemic index (GI) in the nutritional management of diabetes. However, the clinical utility and applications of the GI remain controversial. Our goal was to determine, via a postal survey, whether dietitians were using the GI and barriers to its use if they were not.

Methods: This cross-sectional study was conducted in 2003. Members of Dietitians of Canada and the Ordre professionnel des diététistes du Québec (n=6,060) were first contacted by mail to identify those working with individuals with diabetes. Among respondents (n=2,857), 1,805 worked with individuals with diabetes and were sent a questionnaire. Using Chi-square analyses, users and nonusers were compared for their professional characteristics, perceived benefits, barriers, general knowledge about the concept, and confidence in teaching the GI.

Results: Among questionnaire respondents (n=1,057), 39% (n=415) used the GI and 61% (n=642) did not. Overall, users were more likely to have a greater diabetes patient caseload, perceived greater benefits and had greater confidence in teaching the concept. Nonusers cited lack of teaching tools and lack of knowledge on how to teach the concept as major barriers.

Conclusions: Further research is required to identify the clinical reasoning that triggers dietitians to apply the concept in their practice.
Empowerment Evaluation in Redesigning A Public Health Unit Nutrition Program
Authors: Dwyer John J. M. , Vavaroutsos Denise , Lutterman Ann , Hier Michelle , Hughes May , Makarchuk Mary-Jo
Published: May 2007

This article illustrates how empowerment evaluation was used in Toronto Public Health’s (TPH) nutrition programming redesign to consult with staff about how roles, responsibilities, and organisational structure could be changed to improve how nutrition programs are delivered. One of three moderators facilitated the ten two-hour focus group sessions in TPH. TPH staff, namely 71 front-line staff and 13 managers who were responsible for providing community nutrition services, participated in the study. Focus group participants included Public Health Dietitians, Public Health Nutritionists, Public Health Nurses (PHNs), and paraprofessionals (i.e., community nutrition assistants). Participants’ preferred roles, responsibilities, and organisational structure in TPH, which they believe would improve nutrition service delivery in the community, were examined. A constant comparison approach was used to develop themes inductively. It was found that participants wanted Dietitians and Nutritionists to provide current nutrition-related information to them. They felt that nutrition programs should be promoted better and made more accessible to the public. They suggested that Dietitians and Nutritionists and other staff should share information with each other better. They suggested that Dietitians and Nutritionists should provide nutrition services directly to the public and provide support to other staff, mainly PHNs, who deliver nutrition programs. In conclusion, this empowerment evaluation produced results that were used to assist in decision making about nutrition programming.
Food Insecurity in University Students Receiving Financial Aid
Authors: Meldrum Liesel A. , Willows Noreen D.
Published: May 2007

Purpose: To evaluate the adequacy of loans funding and the risk for food insecurity in students living away from home and receiving loans at the University of Alberta.

Methods: A nutritious seven-day menu was developed. The menu was priced for skilled and unskilled shoppers at a grocery store near to campus and a discount-style grocery store further away.

Results: The menu was more costly for males, unskilled shoppers and those students who shopped near to campus. The menu cost was as high as $296/month and often exceeded the $196 allocated by the Canada Student Loans Program for food each month.

Conclusions: Based on the findings from this study, students reliant on financial assistance likely have insufficient money for a nutritionally adequate diet and are at risk for food insecurity. Shopping skills and budgeting, while important, would be insufficient to alleviate food insecurity for many students who require financial aid. Increased funding for food in student loans is necessary.
Primary Food Sources of NutrientsIn the Diet of Canadian Adults
Authors: Johnson-Down Louise , Ritter Heidi , Starkey Linda Jacobs , Gray-Donald Katherine
Published: May 2007

Purpose: Food sources of nutrients in the Canadian diet were explored. Knowledge of these sources is important to public health professionals and to those in clinical practice.

Methods: Using data from the Food Habits of Canadians study, we investigated nutrient sources from detailed food groupings in a sample of 1,543 adults (971 women, 572 men) from across Canada. Subjects were interviewed by trained dietitians. At the time of the interview, a sociodemographic questionnaire and a 24-hour dietary recall were completed.

Results: The response rate was 30%. Subjects aged 18 to 34 reported eating more prepared and convenience foods than did those aged 35 to 65. Energy was contributed mainly by breads, pasta, rice, grains, and fluid milk. Protein intake was primarily derived from meat and dairy products; legumes, nuts, seeds, and eggs were not high contributors. For men aged 35 to 65 and women aged 18 to 65, butter, margarine, and oil were the primary fat sources; they were the second most common source for men aged 18 to 34. Fibre was provided by foods that are not usually considered good sources, but because of the large total consumption of these foods, they are important in Canadians’ diet. The main source of calcium was dairy products, and iron came mainly from non-heme sources.

Conclusions: We must understand the contributions of foods to nutrients, and distinguish “important” sources of nutrients (those consumed by many in substantial amounts) from “good” sources (foods rich in particular nutrients, whether eaten or not).
Nutritional Quality and Price Of University Food Bank Hampers
Authors: Willows Noreen D. , Au Vivian
Published: May 2007

Purpose: Food insecurity appears to be a growing problem for post-secondary students, but little study has been made of the 51 campus-based food banks that exist. In 2003-04, the University of Alberta Campus Food Bank (CFB) distributed hampers intended to supply four days of food to 630 unique clients, of whom 207 (32.8%) were children. The nutritional adequacy of food hampers and cost saving to students were evaluated in the current study.

Methods: Hampers prepared for one adult, and for one adult with one child, were nutritionally evaluated and scored for number of servings according to Canada’s Food Guide to Healthy Eating. Two types of hampers were evaluated: those containing only non-perishable items, and those containing non-perishable and perishable items. Hamper contents were priced to establish the cost saving to students.

Results: The study revealed that a student with one child would receive up to $58.02 worth of food in a hamper that contained perishable items. All hampers met the recommended minimum servings for each food group, but were very low in fat and protein from animal sources.

Conclusions: Because students can obtain hampers only twice each month, the CFB is not the solution to food insecurity on campus. Awareness of the issue of post-secondary student food insecurity needs to be raised.
Eat Smart! Workplace Cafeteria Program Evaluation of the Nutrition Component
Authors: Dawson Jody , Dwyer John J. M. , Evers Susan , Sheeshka Judy
Published: May 2007

Purpose: The nutrition component of the Eat Smart! Workplace Cafeteria Program (ESWCP) in a hospital was evaluated. We assessed staff’s frequency of visits to and purchases in the hospital cafeteria, attitudes about the program, short-term eating behaviour change, and suggestions to improve the ESWCP.

Methods: Questionnaires were sent to hospital staff members who were not on leave (n=504). Dillman’s Tailored Design Method was used to design and implement the survey. Four mail-outs were used and yielded a 51% response rate.

Results: Eighty-seven percent of respondents visited the hospital cafeteria at least once a week in an average seven-day week, and 69% purchased one to five meals or snacks there each week. Eighty-six percent of respondents said that they were aware of the hospital’s program. Notices on cafeteria tables were the primary method of learning about the program (67%). Reported program benefits included increased knowledge about healthy eating, convenience of having healthy foods in the cafeteria, and increased energy.

Conclusion: Many respondents were aware of the program, provided positive comments about it, and reported positive changes in eating habits. However, future observational research is warranted to note foods served and sold before and after program implementation, as well as to examine whether results can be generalized to other settings.
Beverage Caffeine Intakes in Young ChildrenIn Canada and the US
Authors: Knight Carol A. , Knight Ian , Mitchell Diane C.
Published: May 2007

Purpose: Throughout childhood there is a shift from predominantly milk-based beverage consumption to other types of beverages, including those containing caffeine. Although a variety of health effects in children and adults have been attributed to caffeine, few data exist on caffeine intake in children aged one to five years.

Methods: Because beverages provide about 80% of total caffeine consumed in children of this age group, beverage consumption patterns and caffeine intakes were evaluated from two beverage marketing surveys: the 2001 Canadian Facts study and the 1999 United States Share of Intake Panel study.

Results: Considerably fewer Canadian children than American children consume caffeinated beverages (36% versus 56%); Canadian children consume approximately half the amount of caffeine (7 versus 14 mg/day in American children). Differences were largely because of higher intakes of carbonated soft drinks in the US.

Conclusions: Caffeine intakes from caffeinated beverages remain well within safe levels for consumption by young children.
The Iron Status of Canadian Adolescents and Adults:Current Knowledge and Practical Implications
Authors: Cooper Marcia J. , Cockell Kevin A. , L’abbé Mary R.
Published: May 2007

Overview: Iron is an essential nutrient, playing a central role in oxygen transport and cellular energy metabolism. The importance of ensuring adequate bioavailable dietary iron stems from the severe consequences associated with iron deficiency (ID) and anemia, including reduced immune function and resistance to infection, developmental delays and irreversible cognitive deficits in young children, impaired physical work performance, and adverse pregnancy outcomes.

Specific populations: Poor dietary iron intake and ID exist in Canada, particularly in women of reproductive age. Data from the provincial nutrition surveys suggest that the prevalence of inadequate iron intakes (and low intakes of absorbable iron) among women under 50 years of age is over 10%, which may reflect poor iron status. Teenage girls are at risk for low iron stores because of the adolescent growth spurt and the onset of menstruation; those who are vegetarian are at even greater risk.

Conclusions: The Canadian diet has changed so that grain products are now the main source of dietary iron for all age groups. The public must be educated to ensure the consumption of adequate quantities of bioavailable iron and enhancing factors such as vitamin C. Industry, government, and health professionals must work together to promote healthy eating patterns and the selection of appropriate foods.
A Nutrition Odyssey: Knowledge Discovery, Translation, and Outreach 2006 Ryley-Jeffs Memorial Lecture
Authors: Atkinson Stephanie A.
Published: May 2007

Background: The 21st-century model of health research is founded on a broad base of multidisciplinary research that is expeditiously and effectively translated into evidence-based practice, education, policy, and advocacy. The key objective is to improve the health of populations.

Dietitians’ roles: Dietitians, whether they are working in clinical or public health nutrition or food science, have a vital role to play in this paradigm of health research. As dietitians’ roles have evolved beyond the traditional ones into subspecialties including epidemiology, nutrigenomics, functional foods, nutraceuticals, toxicology, natural health products, and multidisciplinary research, the need for advanced training in subspecialty fields has become essential.

Opportunities: A dietetics background is an excellent foundation upon which to develop a research career in one of these new areas of nutrition. Opportunities for personnel awards and research funding targeted at nutrition clinician-scientists and other nutrition subspecialists have grown tremendously in recent years.

Conclusion: The information in this paper is intended to inspire dietitians seeking advanced academic training in one of the new exciting avenues for a career in nutrition. These avenues will permit dietitians to contribute to knowledge discovery, translation, and outreach to improve the nutritional status and health of populations in Canada and globally.
Performance Issues of Dietetic Interns:A Dietetic Educator's Perspective
Authors: Lordly Daphne
Published: May 2007

Purpose: Dietetic internships provide practical experience leading, in most cases, to the attainment of entry-level dietetic competence. Problematic intern performance issues were examined, as were how educators resolve these issues and the supports they require to manage them.

Methods: A survey was electronically distributed to all Dietitians of Canada internship/university course directors (n=57). The response rate was 40% (n=23).

Results: Annually, 61% of internships involve challenging performance issues related to intern knowledge, skills, attitude, and behaviour. These issues manifest themselves individually or in combination as an intern's inability to apply/demonstrate appropriate knowledge/skill, a view/approach to the profession that is not in keeping with the organizational view, an attitude that is in conflict with program values, a negative response to feedback, an inability to relate to others, work habits that are in conflict with program values, and personal attributes that detract from the ability to meet program expectations. Educators respond to these issues by modifying their communications, the learning environment, and the program.

Conclusions: Educators’ strategies could be enhanced through consultation with other educators, mentor training, and the development of formal procedures.
Cover Picture: Encapsulation of Water‐Immiscible Solvents in Polyglutamate/ Polyelectrolyte Nanocontainers (Adv. Funct. Mater. 8/2007)
Authors: Teng X. , Shchukin D. G. , Möhwald H.
Published: May 2007

A novel approach for encapsulation of hydrophobic materials into hydrophilic multifunctional shells is based on combining ultrasonic techniques and layer‐by‐layer protocols. Polyglutamate/polyelectrolyte nanocontainers of 600 nm size loaded with hydrophobic tetraphenylporphin are fabricated in work reported by Dmitri Shchukin and co‐workers on p. 1273. The hydrophobic core of the nanocontainers can encapsulate a huge variety of water‐insoluble drugs and the outer hydrophilic polyelectrolyte shell has controlled permeability and multifunctionality.

A novel approach for encapsulation of hydrophobic materials into a hydrophilic multifunctional shell is presented, based on combining an ultrasonic technique and a layer‐by‐layer protocol. Polyglutamate/polyethyleneimine (PEI)/polyacrylic acid (PAA) and polyglutamate/PEI/PAA/silver nanocontainers loaded with a hydrophobic dye, 5,10,15,20‐tetraphenylporphin, dissolved in toluene, are fabricated. Uniform, stable, and monodisperse polyglutamate/PEI/PAA nanocontainers of about 600 nm are obtained. The hydrophobic core of the nanocontainers might contain a huge variety of water‐insoluble drugs and the outer polyelectrolyte shell may provide controlled permeability and desired multifunctionality. Confocal fluorescence microscopy and scanning electron microscopy are employed for the characterization of the resulting nanocontainers. Using sodium dodecyl sulfate as surfactant, the amount of nanocontainers, their monodispersity, and stability can be increased dramatically.
Hydroxyurea therapy for management of secondary erythrocytosis in cyanotic congenital heart disease
Authors: Reiss Ulrike M. , Bensimhon Pamela , Zimmerman Sherri A. , Ware Russell E.
Published: May 2007

Secondary erythrocytosis in cyanotic congenital heart disease (CCHD) causes substantial morbidity because of complications of hyperviscosity, including stroke and chronic end organ damage. Phlebotomy provides temporary improvement but leads to iron deficiency and can actually increase blood viscosity. We describe the successful use of hydroxyurea (hydroxycarbamide) in four patients with uncorrected CCHD and symptomatic secondary erythrocytosis. In all patients, hydroxyurea improved symptoms of hyperviscosity. Substantial decreases in the red blood cell (RBC) count were observed, along with increases in the mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH), leading to only modest declines in the circulating hemoglobin concentration. Two patients experienced transient mild myelosuppression, which promptly resolved with dose reduction of hydroxyurea. Hydroyxurea provides a novel and useful therapeutic approach to reduce hyperviscosity from secondary erythrocytosis in patients with CCHD, while preserving oxygen carrying capacity and avoiding iron depletion by phlebotomy. Am. J. Hematol., 2007. © 2007 Wiley‐Liss, Inc.
Normal hematopoietic function and multiple bone marrow clonal abnormalities in a patient with acute myeloid leukemia after two mismatched stem‐cell transplants with graft failure and autologous reconstitution
Authors: Ostronoff Fabiana , Bueso‐Ramos Carlos , Cortes Jorge , Giralt Sergio
Published: May 2007

A 13‐year‐old male with primary refractory acute myelogenous leukemia (AML‐M0), underwent two mismatched stem cell transplantations (SCT) and experienced graft failure after both procedures. Of interest, his peripheral blood cell counts are normal 7 years after his first SCT, his bone marrow is morphologically normal, however, cytogenetic analysis reveals multiple recurring cytogenetic abnormalities. This is the third case of chromosomal instability with morphological normal marrow and peripheral blood to be reported, these rare cases suggest that hematopoietic stem cells must have compensating mechanisms that allow normal function despite extensive chromosomal damage, supporting the notion that normal marrow function is possible even with extensive chromosomal damage. Am. J. Hematol., 2007. © 2007 Wiley‐Liss, Inc.
The role of autoantibody‐producing plasma cells in immune thrombocytopenic purpura refractory to rituximab
Authors: Kuwana M. , Iki S. , Urabe A.
Published: May 2007

Rituximab is becoming popular as a treatment for immune thrombocytopenic purpura (ITP). We report here a patient with ITP, who initially responded to rituximab, but later became refractory. In this patient, the appearance of plasma cells producing anti‐platelet autoantibodies is likely to be one of the mechanisms for rituximab resistance. Am. J. Hematol., 2007. © 2007 Wiley‐Liss, Inc.
Treatment of acquired severe aplastic anemia with antilymphocyte globulin, cyclosporin A, methyprednisolone, and granulocyte colony‐stimulating factor
Authors: Dinçol Günçağ , Aktan Melih , Diz‐Küçükkaya Reyhan , Yavuz Selim , Nalçacı Meliha , Öztürk Şükrü , Palanduz Şükrü , Doğan Öner , Ağan Mehmet
Published: May 2007

Fifty‐six adult patients with newly diagnosed acquired severe aplastic anemia (SAA) received horse antilymphocyte globulin (ALG), cyclosporin A (CyA), methylprednisolone (Mpred), granulocyte colony‐stimulating factor (G‐CSF) as first‐line therapy. The median age was 34 (range, 17–72) and median neutrophil count 0.280 × 109/L. Trilineage hematologic recovery (at a median interval of 105 days from treatment) was seen in 46 patients (37 complete, 9 partial) after one (n = 38) or two (n = 8) courses of ALG. Cytogenetic abnormalities were observed in three unresponders, clonal hematologic disease in three complete responders, and relapse of marrow aplasia in four complete responders. Median follow up for surviving patients was 1,668 days (range, 237–4,012). The actuarial survival at 5 years was 82%, falling to 77.1% at 7 years and was stationary at 7 and 8 years. Survival was not influenced by the neutrophil count (72% vs. 87%, for neutrophils less than vs. greater than 0.2 × 109/L; P = 0.54). Immunosuppressive treatment of SAA with the 4‐drug combination appears to be effective. The significant prognostic effect of an enduring increase of the white blood cell (WBC) count during G‐CSF treatment may suggest complete and partial response to therapy. In nonresponders, the WBC count either did not change or elevated values gradually returned to nearly their initial levels while the patients were still under G‐CSF treatment. In patients not responsive to treatment but living under CyA and G‐CSF, the possibility of developing cytogenetic abnormalities does not seem to be low, despite the absence of findings attributable to manifest myelodysplastic syndrome. Am. J. Hematol., 2007. © 2007 Wiley‐Liss, Inc.
Hepatic veno‐occlusive disease after tranexamic acid administration in patients undergoing allogeneic hematopoietic stem cell transplantation
Authors: Mori Takehiko , Aisa Yoshinobu , Shimizu Takayuki , Yamazaki Rie , Mihara Ai , Yajima Tomoharu , Hibi Toshifumi , Ikeda Yasuo , Okamoto Shinichiro
Published: May 2007

Tranexamic acid is one of the widely used antifibrinolytic agents. In spite of its effective inhibitory activity against plasminogen, thromboembolic adverse events caused by tranexamic acid are rare. We encountered three recipients of allogeneic hematopoietic stem cell transplantation (HSCT) who developed hepatic veno‐occlusive disease (VOD) shortly after the administration of tranexamic acid. Hepatic VOD was resolved completely in all patients with the discontinuation of the drug, and with supportive measures with or without intravenous tissue plasminogen activator administration. These findings suggest that administration of tranexamic acid could be one of the possible risk factors for developing hepatic VOD in HSCT recipients. Am. J. Hematol., 2007. © 2007 Wiley‐Liss, Inc.
Colobomatous macrophthalmia with microcornea syndrome maps to the 2p23‐p16 region
Authors: Elcioglu Nursel H. , Akin Burcu , Toker Ebru , Elcioglu Mustafa , Kaya Ali , Tuncali Timur , Wollnik Bernd , Hornby Stella , Akarsu Nurten A.
Published: May 2007

Colobomatous macrophthalmia with microcornea syndrome (OMIM 602499) is a rare, autosomal dominant malformation characterized by microcornea, uveal coloboma, axial enlargement of the globe, and myopia. Using what is currently the largest described pedigree and candidate localization approach, we first excluded the candidate genes PAX2, PAX3, PAX6, and PAX9. Subsequently, the chromosome 14q24 region containing the CHX10, SIX1, and SIX4 genes were also excluded. Positive LOD scores were obtained with the DNA markers selected from the 2p23‐p16 region. A maximum pairwise LOD score of 3.61 (Θ = 0) was noted with the DNA marker D2S1788. Haplotype analysis positioned the locus between DNA markers D2S2263 and D2S1352 within a 22 Mb physical interval. This region contains major candidate genes, such as SIX2, SIX3, and CYP1B1; however, mutation analysis did not identify a causative mutation in these genes. Macrophthalmia, colobomatous, with microcornea (MACOM) is proposed as the gene symbol for this malformation linked to 2p23‐p16. © 2007 Wiley‐Liss, Inc.
Detection of a de novo interstitial 2q microdeletion by CGH microarray analysis in a patient with limb malformations, microcephaly and mental retardation
Authors: Svensson Annika M. , Curry Cynthia J. , South Sarah T. , Whitby Heidi , Maxwell Teresa M. , Aston Emily , Fisher Jamie , Carmack C.E. , Scheffer Alicia , Abu‐Shamsieh Aimee , Brothman Arthur R.
Published: May 2007

We describe the cytogenetic diagnosis using BAC‐ and oligonucleotide microarrays of a 16‐year‐old Laotian‐American female, who first presented at 2½ years of age with microcephaly, developmental retardation, and skeletal abnormalities of the upper limb including mild syndactyly of the second and third and the third and fourth fingers, short middle phalanges and clinodactyly of the fifth digit at the distal interphalangel joint on both hands, and symphalangism of the metacarpal‐phalangeal joints of the second and fifth digits bilaterally. Her lower limbs displayed symphalangism of the metatarsal‐phalangeal joint of the second, third, and fourth digits on both feet, with fusion of the middle and distal phalanges of the second and fifth digits and hallux valgus bilaterally. G‐banded chromosomal study at age 4 was normal. However, comparative genomic hybridization at age 15 with the Spectral Genomics 1 Mb Hu BAC array platform indicated a microdeletion involving two BAC clones, RP11‐451F14 → RP11‐12N7 at 2q31.1. The maximal deletion on initial analysis comprised the HOXD cluster, which is implicated in limb development. Florescence in situ hybridization (FISH) using the RP11‐451F14 probe confirmed the deletion. Both parents were negative for the deletion. Additional FISH using BAC RP11‐387A1, covering the HOXD cluster, limited the maximal deletion to approximately 2.518 Mb, and excluded involvement of the HOXD cluster. The Agilent 44K and 244K platforms demonstrated a deletion of approximately 2,011,000 bp, which did not include the HOXD cluster. The malformations in our patient may be caused by deletion of a regulatory element far upstream of the HOXD cluster. © 2007 Wiley‐Liss, Inc.
A newly recognized craniosynostosis syndrome with features of Aarskog–Scott and Teebi syndromes
Authors: Hoffman Jodi D. , Irons Mira , Schwartz Charles E. , Medne Livija , Zackai Elaine H.
Published: May 2007

We present two unrelated boys with craniosynostosis and similar facial features including hypertelorism, down‐slanted palpebral fissures, ptosis, broad mouth with a thin upper lip, and preauricular pits. Both patients had short, broad first digits as well as short, broad hands. Both also had respiratory difficulties and umbilical abnormalities. Although, many of these features are seen in Aarskog–Scott and in Teebi hypertelorism syndromes, both children had craniosynostosis, which has not been previously reported in either syndrome. We propose that these children may have a previously unreported syndrome consistent with X‐linked inheritance, although an autosomal dominant mode of transmission cannot be excluded. © 2007 Wiley‐Liss, Inc.
Interstitial deletion of 6q without phenotypic effect
Authors: Hansson Kerstin , Szuhai Karoly , Knijnenburg Jeroen , van Haeringen Arie , de Pater Joke
Published: May 2007

Cytogenetically detectable euchromatic deletions without phenotypic consequences are rarely encountered. We report on a 34‐year‐old woman with normal intelligence referred for karyotyping because of recurrent abortions. With the exception of a bicuspid aortic valve without hemodynamic consequences, which is a common minor anomaly in the general population, no dysmorphic features were found on physical examination. Conventional chromosome analysis (GTG‐banding) revealed an interstitial deletion in the long arm of chromosome 6. With array comparative genomic hybridization (array‐CGH) the size of the deletion was estimated to be between 9.9 and 11.6 Mb and the refined karyotype was 46,XX,del(6)(q22.31q23.1). © 2007 Wiley‐Liss, Inc.
Report of a child with a complete de novo 17p duplication localized to the terminal region of the long arm of chromosome 17
Authors: Paskulin Giorgio A. , Zen Paulo R.G. , Rosa Rafael F.M. , Manique Rosana C. , Cotter Philip D.
Published: May 2007

We report the second case of a child with trisomy of the entire short arm of chromosome 17 secondary to a de novo duplication. Trisomy 17p in this patient resulted from a duplication, localized to the distal region of the long arm of the same chromosome, an abnormality not previously described. This cytogenetic abnormality was confirmed using whole chromosome paint, subtelomeric and Smith‐Magenis probes by fluorescence in situ hybridization (FISH) analysis. The child presented with phenotypic features previously described in trisomy 17p, including some specific facial dysmorphia, microcephaly, growth retardation, hypotonia, short webbed neck, congenital heart defect, minor abnormalities of the hands, agenesis of the corpus callosum and abnormalities of the iris. Iris alterations and defects involving the left side of heart and the aorta also may represent truly clinical hallmarks of this cytogenetic abnormality. In conclusion, this cytogenetic anomaly seems to represent a severe malformation entity with a poor prognosis and a recognizable clinical pattern that justifies the use of the term “17p trisomy syndrome” suggested previously by other authors. © 2007 Wiley‐Liss, Inc.
Influence of the copolymer architecture and composition on the response and mechanical properties of pH‐sensitive fibers
Authors: Sahoo Anasuya , Jassal Manjeet , Agrawal Ashwini K.
Published: May 2007

A series of copolymers based on acrylonitrile (AN) and acrylic acid (AA) with varying architecture and composition were synthesized using free radical polymerization. The distribution of monomers in the copolymer chains could be successfully controlled by regulating the addition of more reactive monomer (AA). Copolymers having nearly random distribution of comonomer moieties to block type distribution with different composition (10–50 mol % AA) were synthesized to investigate the effect of polymer architecture and composition on pH response and mechanical properties of resultant structures. These copolymers were solution spun from dimethylformamide‐water system, drawn in coagulation bath, and annealed at 120°C for 2 h to make pH‐sensitive fibers which were structurally stable without the need of chemical crosslinking. The fibers from block copolymers showed significantly better tensile strength (34.3 MPa), higher retractive forces (0.26 MPa), and enhanced pH response (swelling 3890%) in comparison with fibers from random copolymer (13.55 MPa, 0.058 MPa, and 1723%, respectively). The tensile strength and retractive forces could be further improved to a value of 72 MPa and 0.36 MPa, respectively, by changing the composition of the block copolymer while retaining the swelling percentage similar to the random copolymer mentioned above. It is proposed that on processing to fibers, the block copolymers could form a segregated domain structure with separate domains of AA and AN, where AN domains were responsible for high structural integrity by providing connectivity among polymer chains, while AA domains showed improved response to changing pH of the environment. © 2007 Wiley Periodicals, Inc. J Appl Polym Sci 2007
Synthesis of tri(hydroxyphenyl)methane using polyaniline‐p‐toluenesulfonic acid salt
Authors: Palaniappan S. , Sudhakar P.
Published: May 2007

Synthesis of tri(hydroxyphenyl)methane and tri(hydroxyphenyl)butane were achieved using polyaniline‐p‐toluenesulfonic acid salt as polymeric solid acid catalyst. This method provides several advantages such as easy preparation of the catalyst, its stability, recovery and easy work‐up procedure. © 2007 Wiley Periodicals, Inc. J Appl Polym Sci 2007
Which is the compromise option? Information format and task format as determinants
Authors: Chang Chung‐Chau , Liu Hsin‐Hsien
Published: May 2007

When consumers must make a decision but are uncertain of their preferences, they often select a compromise choice. Early studies emphasized the relational properties of choice alternatives and indicated that the middle option, whose attribute values fall between the values of other alternatives, is always the compromise option. More recent studies have suggested that when consumers rate two attributes with the same metrics, the attribute–balance choice whose two attributes have equal ratings, might represent the compromise choice. We propose that the different characteristics of the middle and attribute–balance options—which may be compatible with certain determinants such as information and task formats—might be more salient and affect the relative attractiveness of each option. The results of three experiments confirmed this prediction: the middle option was more attractive in list‐by‐attributes and rejecting conditions, whereas the attribute–balance option was more attractive in list‐by‐alternatives and choosing conditions. Copyright © 2007 John Wiley & Sons, Ltd.
Cooperation of plants and microorganisms: Getting closer to the genetic construction of sustainable agro‐systems
Authors: Tikhonovich Igor A. , Provorov Nikolai A.
Published: May 2007

The molecular research into two types of beneficial plant‐microbe symbioses is reviewed: nutritional (with N2‐fixing bacteria or mycorrhizal fungi) and defensive (with endo‐ and epiphytic microbes suppressing pathogens and phytophagans). These symbioses are based on the signaling interactions that result in the development of novel tissue/cellular structures and of extended metabolic capacities in the partners, which greatly improve the adaptive potential of plants due to a decrease in their sensitivity to biotic and abiotic stresses. The molecular, genetic and ecological knowledge on plant‐microbe interactions provides a strategy for the organization of sustainable crop production based on substituting the agrochemicals (mineral fertilizers, pesticides) by microbial inoculants. An improvement of plant‐microbe symbioses should involve the coordinated modifications in the partners' genotypes resulting in highly complementary combinations. These modifications should be based on the broad utilization of genetic resources from natural symbiotic systems aimed at: (i) increased competitiveness of the introduced (effective) with respect to local (ineffective) microbial strains, and (ii) overcoming the limiting steps in the metabolic machineries of the symbiotic systems.
Gray, black, and blue: the state of research and intervention for intimate partner abuse among elders
Authors: Desmarais Sarah L , Reeves Kim A
Published: May 2007

Though not as common as in younger populations, intimate partner abuse (IPA) among elders is a significant and often overlooked problem. In this article, we focus on problems for research and intervention. We begin with a brief review of the phenomena of elder abuse and IPA, highlighting problems resulting from definitional issues and inconsistencies in research methodology. The balance of the paper comprises a discussion of problems for intervention. Drawing from the IPA and elder abuse literatures, risk factors unique to IPA among elders are presented, and limitations of existing screening and risk assessment instruments for use within this context are identified. The focus then shifts to legal considerations when working with elders who have experienced or perpetrated IPA. Our goals are to synthesize the elder abuse and IPA literatures, identify limitations within both, and to reflect upon the state of knowledge regarding IPA among elders. Copyright © 2007 John Wiley & Sons, Ltd.
Decision‐making capacity in elderly, terminally ill patients with cancer
Authors: Sorger Brooke Myers , Rosenfeld Barry , Pessin Hayley , Timm Anne Kosinski , Cimino James
Published: May 2007

Despite the importance and complexity of evaluating decision‐making capacity at the end of life, little research has focused on terminally ill patients' decision‐making ability. The purpose of this study was to explore the decision‐making capacity of elderly, terminally ill patients and the psychological and physical factors that affect decision making. Decision‐making capacity and cognitive abilities were assessed using four measures: the Hopkins Competency Assessment Kit, the Bechara Gambling Task, the Concept Assessment Kit, and the Mini Mental Status Exam. In addition, symptoms of depression, level of physical functioning, and extent of physical symptoms were evaluated in order to identify correlates of decision‐making ability. Two samples were compared: elderly, terminally ill patients with cancer (n = 43) and elderly, physically healthy adults living in supportive community residence (n = 35). Results revealed significantly poorer decision‐making abilities among the terminal ill sample compared with healthy comparisons, but no association between demographic variables (e.g., age, race, or education) or clinical variables (depression or physical symptoms) and decision making. Implications for evaluating decision‐making capacity are addressed. Copyright © 2007 John Wiley & Sons, Ltd.