bluuebunny/crossref_metadata_2025 huggingface dataset:
TIMP2 Deficiency Accelerates Adverse Post–Myocardial Infarction Remodeling Because of Enhanced MT1-MMP Activity Despite Lack of MMP2 Activation
Authors: Kandalam Vijay , Basu Ratnadeep , Abraham Thomas , Wang Xiuhua , Soloway Paul D. , Jaworski Diane M. , Oudit Gavin Y. , Kassiri Zamaneh
Published: January 2010

Rationale
:

Myocardial infarction (MI) results in remodeling of the myocardium and the extracellular matrix (ECM). Tissue inhibitors of metalloproteinases (TIMPs) are critical regulators of ECM integrity via inhibiting matrix metalloproteinases (MMPs). TIMP2 is highly expressed in the heart and is the only TIMP that, in addition to inhibiting MMPs, is required for cell surface activation of pro-MMP2. Hence, it is difficult to predict the function of TIMP2 as protective (MMP-inhibiting) or harmful (MMP-activating) in heart disease.

Objective
:

We examined the role of TIMP2 in the cardiac response to MI.

Methods and Results
:

MI was induced in 11- to 12-week-old male TIMP2
−/−
and age-matched wild-type mice. Cardiac function was monitored by echocardiography at 1 and 4 weeks post-MI. ECM fibrillar structure was visualized using second harmonic generation and multiphoton imaging of unfixed/unstained hearts. Molecular analyses were performed at 3 days and 1 week post-MI on flash-frozen infarct, periinfarct, and noninfarct tissue. Membrane type 1 (MT1)-MMP levels and activity were measured in membrane protein fractions. TIMP2
−/−
-MI mice exhibited a 25% greater infarct expansion, markedly exacerbated left ventricular dilation (by 12%) and dysfunction (by 30%), and more severe inflammation compared to wild-type MI mice. Adverse ECM remodeling was detected by reduced density and enhanced disarray of fibrillar collagen in TIMP2
−/−
-MI compared to wild-type MI hearts. TIMP2 deficiency completely abrogated MMP2 activation but markedly increased collagenase activity, particularly MT1-MMP activity post-MI.

Conclusions
:

The MMP-inhibitory function of TIMP2 is a key determinant of post-MI myocardial remodeling primarily because of its inhibitory action on MT1-MMP. TIMP2 replenishment in diseased myocardium could provide a potential therapy in reducing or preventing disease progression.
Reduced Sox9 Function Promotes Heart Valve Calcification Phenotypes In Vivo
Authors: Peacock Jacqueline D. , Levay Agata K. , Gillaspie Devin B. , Tao Ge , Lincoln Joy
Published: January 2010

Rationale
:

Calcification of heart valve structures is the most common form of valvular disease and is characterized by the appearance of bone-like phenotypes within affected structures. Despite the clinical significance, the underlying etiology of disease onset and progression is largely unknown and valve replacement remains the most effective treatment. The SRY-related transcription factor
Sox9
is expressed in developing and mature heart valves, and its function is required for expression of cartilage-associated proteins, similar to its role in chondrogenesis. In addition to cartilage-associated defects, mice with reduced sox9 function develop skeletal bone prematurely; however, the ability of sox9 deficiency to promote ectopic osteogenic phenotypes in heart valves has not been examined.

Objective
:

This study aims to determine the role of
Sox9
in maintaining connective tissue homeostasis in mature heart valves using in vivo and in vitro approaches.

Methods and Results
:

Using histological and molecular analyses, we report that, from 3 months of age,
Sox9

fl
/+

;Col2a1-cre
mice develop calcific lesions in heart valve leaflets associated with increased expression of bone-related genes and activation of inflammation and matrix remodeling processes. Consistently, ectopic calcification is also observed following direct knockdown of
Sox9
in heart valves in vitro. Furthermore, we show that retinoic acid treatment in mature heart valves is sufficient to promote calcific processes in vitro, which can be attenuated by
Sox9
overexpression.

Conclusions
:

This study provides insight into the molecular mechanisms of heart valve calcification and identifies reduced
Sox9
function as a potential genetic basis for calcific valvular disease.
Safety of Intravenous Thrombolysis for Acute Ischemic Stroke in Patients Receiving Antiplatelet Therapy at Stroke Onset
Authors: Diedler Jennifer , Ahmed Niaz , Sykora Marek , Uyttenboogaart Maarten , Overgaard Karsten , Luijckx Gert-Jan , Soinne Lauri , Ford Gary A. , Lees Kennedy R. , Wahlgren Nils , Ringleb Peter
Published: January 2010

Background and Purpose—

Antiplatelets (APs) may increase the risk of symptomatic intracerebral hemorrhage (ICH) following intravenous thrombolysis after ischemic stroke.

Methods—

We assessed the safety of thrombolysis under APs in 11 865 patients compliant with the European license criteria and recorded between 2002 and 2007 in the Safe Implementation of Treatments in Stroke (SITS) International Stroke Thrombolysis Register (SITS-ISTR). Outcome measures of univariable and multivariable analyses included symptomatic ICH (SICH) per SITS Monitoring Study (SITS-MOST [deterioration in National Institutes of Health Stroke Scale ≥4 plus ICH type 2 within 24 hours]), per European Cooperative Acute Stroke Study II (ECASS II [deterioration in National Institutes of Health Stroke Scale ≥4 plus any ICH]), functional outcome at 3 months and mortality.

Results—

A total of 3782 (31.9%) patients had received 1 or 2 AP drugs at baseline: 3016 (25.4%) acetylsalicylic acid (ASA), 243 (2.0%) clopidogrel, 175 (1.5%) ASA and dipyridamole, 151 (1.3%) ASA and clopidogrel, and 197 (1.7%) others. Patients receiving APs were 5 years older and had more risk factors than AP naïve patients. Incidences of SICH per SITS-MOST (ECASS II respectively) were as follows: 1.1% (4.1%) AP naïve, 2.5% (6.2%) any AP, 2.5% (5.9%) ASA, 1.7% (4.2%) clopidogrel, 2.3% (5.9%) ASA and dipyridamole, and 4.1% (13.4%) ASA and clopidogrel. In multivariable analyses, the combination of ASA and clopidogrel was associated with increased risk for SICH per ECASS II (odds ratio, 2.11; 95% CI, 1.29 to 3.45;
P
=0.003). However, we found no significant increase in the risk for mortality or poor functional outcome, irrespective of the AP subgroup or SICH definition.

Conclusion—

The absolute excess of SICH of 1.4% (2.1%) in the pooled AP group is small compared with the benefit of thrombolysis seen in randomized trials. Although caution is warranted in patients receiving the combination of ASA and clopidogrel, AP treatment should not be considered a contraindication to thrombolysis.
Prediction of Recurrent Stroke and Vascular Death in Patients With Transient Ischemic Attack or Nondisabling Stroke
Authors: Weimar Christian , Benemann Jens , Michalski Dominik , Müller Martin , Luckner Konrad , Katsarava Zaza , Weber Ralph , Diener Hans-Christoph
Published: January 2010

Background and Purpose—

Several predictive scores have been developed and validated for stratifying cerebrovascular patients based on the risk of future (cerebro)vascular events. We aimed to prospectively compare the predictive accuracy of the Essen Stroke Risk Score, Stroke Prognostic Instrument, Hankey score, and the Life Long After Cerebral ischemia score.

Methods—

Between August 2005 and December 2006, we included 2381 patients from 10 German stroke centers with an acute nondisabling ischemic stroke or transient ischemic attack and with prospective assessment of clinical variables for calculation of the predictive scores. A total of 1897 patients (79.7%) could be followed up for a median of 1 year. To evaluate the performance of each model, we calculated the area under the curve by receiver operating characteristic. In addition, we used the recommended cutoff values for calculation of sensitivity and specificity for stroke or the combined outcome of stroke or cardiovascular death.

Results—

The Kaplan–Meier estimate for the overall annual stroke risk was 4.8% and for recurrent stroke or cardiovascular death 6.6%. We could confirm the predictive value of all 4 previously developed scores with a marginally superior performance of the SPI-II.

Conclusions—

In patients with acute nondisabling ischemic stroke or transient ischemic attack, all 4 scores are able to stratify the risk of recurrent stroke or the combined outcome. Simple point scores (Essen Stroke Risk Score, Stroke Prognostic Instrument) may help to raise awareness for medical prevention in clinical routine and increase compliance with risk factor modification.
A Telestroke Network Enhances Recruitment into Acute Stroke Clinical Trials
Authors: Switzer Jeffrey A. , Hall Christiana E. , Close Brian , Nichols Fenwick T. , Gross Hartmut , Bruno Askiel , Hess David C.
Published: January 2010

Background and Purpose—

Acute stroke clinical trials are conducted primarily at academic medical centers. As a result, patients living in rural areas are excluded from participation, results may not be generalizable to nonacademic settings, and studies may be slow to recruit subjects. Telemedicine can provide rural patients with emergency neurovascular consultation. We sought to determine whether telemedicine facilitates enrollment into acute stroke trials.

Methods—

We have an established rural “hub and spoke” telestroke network. From 2005 to 2009, we participated in 2 time-sensitive acute stroke trials: Factor Seven for Acute Hemorrhagic Stroke and Minocycline to Improve Neurological Outcome. Candidates for the 2 trials could be identified at either the hub or at the spokes, with patients presenting to the latter transferred to the hub for enrollment. We analyzed the times from symptom onset to consultation via telemedicine, arrival at the hub, and to initiation of a study drug to determine the impact of telemedicine on study enrollment.

Results—

Nineteen of 28 subjects enrolled in the 2 trials were identified initially at an outside facility via a telemedicine link. An additional 9 candidates identified by telemedicine could not be enrolled because of transportation time. Arrival at the hub was 127 minutes later (median, 207 [95% CI, 145 to 255] versus 80 [95% CI, 55 to 142];
P
=0.0002), and study drug was started 74 minutes later (median, 298 [95% CI, 218 to 352] versus 225 [95% CI, 147 to 330];
P
=0.05) for subjects who were identified via telemedicine and required transport to the hub compared with local subjects who presented directly to the hub.

Conclusions—

Telemedicine can enhance enrollment into time-sensitive acute stroke trials. However, transfer of subjects to the hub results in delays in study initiation for some and precludes enrollment for others similar to the weaknesses of “ship and drip” thrombolytic strategies. To save time, efforts are needed to enroll clinical trial subjects and begin the research drug at the remote site under telemedicine guidance.
Sinking Skin Flap Syndrome and Paradoxical Herniation After Hemicraniectomy for Malignant Hemispheric Infarction
Authors: Sarov Mariana , Guichard Jean-Pierre , Chibarro Salvatore , Guettard Emilie , Godin Ophelia , Yelnik Alain , George Bernard , Bousser Marie-Germaine , Vahedi Katayoun ,   the DECIMAL investigators
Published: January 2010

Background and Purpose—

“Sinking skin flap” (SSF) syndrome is a rare complication after large craniectomy that may progress to “paradoxical” herniation as a consequence of atmospheric pressure exceeding intracranial pressure. The prevalence and characteristics of SSF syndrome after hemicraniectomy for malignant infarction of the middle cerebral artery are not well known.

Methods—

We analyzed a prospective cohort of 27 patients who underwent hemicraniectomy for malignant middle cerebral artery infarction. All had a clinical and brain imaging follow-up at 3 months and were followed until cranioplasty.

Results—

Three of 27 patients (11%) had, at 3 to 5 months posthemicraniectomy, SSF syndrome with severe orthostatic headache as the main symptom. In addition, 4 patients (15%) had radiological SSF syndrome but no clinical symptoms except partial seizures in one. Patients with SSF syndrome had a smaller surface of craniectomy (76.2 cm
2
versus 88.7 cm
2
,
P
=0.05) and a tendency toward larger infarct volume, an older age, and a longer delay to cranioplasty than those without this syndrome.

Conclusions—

SSF syndrome either clinically symptomatic or asymptomatic affects one fourth of patients 3 to 5 months after hemicraniectomy for malignant middle cerebral artery infarction. It should be diagnosed as early as possible to avoid progression to a paradoxical herniation.
The Relationship Between Waist Circumference and the Risk of Stroke and Myocardial Infarction in a Japanese Urban Cohort
Authors: Furukawa Yoko , Kokubo Yoshihiro , Okamura Tomonori , Watanabe Makoto , Higashiyama Aya , Ono Yuu , Kawanishi Katsuyuki , Okayama Akira , Date Chigusa
Published: January 2010

Background and Purpose—

Body mass index is most commonly used as the obesity index. Recently, waist circumference (WC) has been shown to be associated with the risk of cardiovascular disease (CVD). However, no studies have observed an association between WC and CVD in Japan. We examined the relationships of WC and body mass index with CVD in a Japanese urban population.

Methods—

We studied 5474 Japanese individuals (aged 30 to 79 years without CVD at baseline) who completed a baseline survey and received follow-up through December 2005. WC was measured at the umbilical level of participants in the standing position to the nearest 1 cm. The Cox proportional hazard ratios for CVD according to the quartiles of WC were calculated after adjustment for age, smoking, and drinking status.

Results—

During a mean follow-up of 11.7 years, 207 strokes and 133 myocardial infarctions were documented. In women, compared with the lowest quartile (WC <70 cm), the hazard ratio (95% CIs) after adjusting for age, smoking, and drinking in the highest quartile (WC ≥84 cm) were 1.85 (1.03 to 3.31) for CVD and 2.64 (1.16 to 6.03) for stroke. However, no such relationships of WC with CVD or stroke risk were observed in men. After further adjustment of hypertension, diabetes, and hypercholesterolemia, all of the mentioned relationships were not statistically significant. No associations of body mass index with CVD or strokes were observed.

Conclusions—

WC may be a better predictor for CVD or stroke in Japanese women.
Social conflicts and policy-making in Korea: interpretation of policy failures through a public discourse perspective
Authors: Ha Yeonseob , Joo Jaehyun , Kang Minah , Lah T.J. , Jang Jiho
Published: January 2010

In recent times, public policy-making in Korea has increasingly led to serious social conflicts. Competing and conflicting interests become publicly exposed in various, usually angry, ways such as wild picketing and disruptive demonstrations. In any society, public policy-making is usually associated with social conflicts, but the level and magnitude of social conflicts and, as a result, disarray in the policy-making process in Korea, have been unprecedented. This article argues that the Korean government’s inattention to public discourse and policy-making strategies is largely responsible for the difficulties it has experienced in recent years. Korean society still lacks an effective decision-making system that could allow effective communication between policy stakeholders and coordinate their legitimate demands. By utilizing a public discourse perspective, this article provides detailed analyses of policy-making difficulties in Korea and proposes alternative ways to reach a social consensus for conflict-ridden social issues.

Points for practitioners

This article analyzes three cases of policy-making difficulties the Korean government has recently experienced. The three cases are the Radio Waste Disposal Facility siting decision, the introduction of the National Education Information System, and the Korea—US FTA Agreement. The three cases show how the lack of coordinating processes and inattention to policy-making strategies, such as issue framing in the communicative stage, could make public policies adrift. Our analysis shows that, to cope with policy-making problems in Korea, it is necessary to develop institutional mechanisms to incorporate various social interests at the stage of coordinative discourse. Furthermore, Korea needs to develop a more elaborate stage of communicative discourse.
Public financial reporting in true and fair terms — discussion on shortfalls in Germany and recommendations for the reform agenda
Authors: Papenfuß Ulf , Schaefer Christina
Published: January 2010

International public financial management reform is mainly influenced by private sector accountancy concepts and characterized by a detailed discussion of technicalities. In the case of Germany, a critical assessment of the status quo shows that the public accounting and reporting system cannot meet its primary aims in an appropriate manner despite considerable reform steps. The article recalls the primary aims of financial accounting and categorizes prevailing shortfalls. It examines criteria for the consolidation basis and reporting requirements with regard to public sector specifics by considering risk structures and the strategic relevance of certain assets. In a wider context, it should also help to shift the reform debate back to its core objective: the effective, efficient and sustainable provision of public services.

Points for practitioners

In order to comprehend the significance of financial accounting, it may be helpful to recall its original, primary aims, thus enabling a steering and information system for government as well as public administration to be regained. Governments fulfil public services which should be provided effectively and efficiently. Public financial management plays a major role in meeting these requirements. Eliminating ‘escape from the budget’, preventing ‘quests for niches in the budget’ and enhancing the information value of the financial statement with regard to public sector specifics are the principal guidelines for any reforms. The article conveys the basic requirements of a financial accounting system and gives critical insight into developments and shortfalls of Germany together with concrete proposals. This provides an opportunity to draw conclusions and avoid similar shortfalls at earlier stages of the reform process.
Goal ambiguity and informal discretion in the implementation of public policies: the case of Spanish immigration policy
Authors: Bastien Joëlle
Published: January 2010

Policy formation does not come to an end when a bill becomes a law. Street-level bureaucrats also play a role in shaping public policies through their daily use of discretion. Through a comparative analysis of the work done by street-level bureaucrats in two different organizations in charge of implementing the Spanish immigration policy, we examined the relation between goal ambiguity and the use of informal discretion using a qualitative method relying on Lipsky’s theoretical framework. Based on the data obtained through five in-depth interviews with street-level bureaucrats in each of the two selected organizations, we confirm the link between goal ambiguity and the use of informal discretion. Besides, our observations also tend to associate a low level of informal discretion to a high level of engagement toward public service values such as impartiality and fairness.

Points for practitioners

This article offers a practical methodology to identify goal ambiguity and informal discretion in an organization. It provides tools for assessing their level and monitoring their evolution within an organization, which often constitute mandatory steps when working on initiatives related to the reinforcement of common goals in an organization (e.g. service improvement in terms of fairness and impartiality, achieving consistency in the implementation stage of a policy, managing a ‘change agenda’, etc.). It will be of particular interest to practitioners who are in charge of monitoring difficult-to-measure outputs linked to the quality of the process at the implementation stage.
Modernization routes and relations between political and administrative spheres in Switzerland
Authors: Giauque David , Resenterra Fabien , Siggen Michaël
Published: January 2010

On the basis of three case studies, the authors attempt to identify changes in relationships between politicians and senior civil servants. Reforms inspired by ‘New Public Management’ (NPM) have been implemented with the aim of creating a clearer separation between strategic activities entrusted to politicians, and the operational or managerial tasks generally under the remit of senior civil servants. By analysing the reforms implemented in three Swiss cantons, the article tests the hypothesis of strategic contingency of political-administrative relations, in particular in view of the different modernization routes selected in each of the three cantons. Obtained using both quantitative and qualitative survey techniques, the empirical results allow us to cast strong doubt on the emergence of greater distance between politicians and the civil service. While our results indicate elements of strategic contingency, no empirical factor allows us to identify greater separation between political and administrative spheres as a result of the reforms. In contrast, politicians and senior civil servants still freely admit their very high level of interdependence in designing, deciding and implementing public policies. Other explanations must therefore be put forward to explain this lack of distinction in the results, in particular institutional aspects.

Points for practitioners

This article shows that senior civil servants must be regarded as key players in the definition and implementation of public policies. Admittedly, administrative reform strategies influence relations between political and administrative spheres and contribute towards the development of new dynamics. However, the results of the research presented in this article clearly show that, from a public management point of view, it is hardly reasonable to attempt at all costs to separate these two spheres which are in fact complementary.
Technical cooperation within the context of foreign aid: trends for the CEE countries in transition (1991—2004)
Authors: Sobis Iwona , de Vries Michiel S.
Published: January 2010

This article investigates technical assistance (TA) to CEE countries in relation to development aid in general. There is plenty of literature examining the foreign aid, but specific components of aid, like technical assistance, remain largely unexplored. One debate about development aid focuses on whether aid is primarily given to improve the situation in the recipient countries or if this improvement is simply a side-effect from aid based on political-military factors. This article argues that development aid, unlike technical assistance, is often provided based on political-military factors with the accompanying side-effect of improving the situation. To investigate aid money to CEE countries during their transition (1990—2004), we used data from OECD DAC that distinguishes technical assistance as a component of foreign aid. The analysis shows that the foreign aid to CEE countries in general seems to have been largely determined by political factors while the money provided for TA is shown to be especially determined by the recipient countries’ needs. The technical assistance has proved to be much more sustainable. The article concludes that empirical research should analyze the components of aid separately.

Points for practitioners

The volume of technical assistance to CEE countries cannot be explained by political and military developments in recipient countries. Instead, such assistance is intended to contribute to the adaptation and development of the recipient countries to their new situation. This analysis shows that the main motivation for TA is to improve the situation in the recipient country. This underlines the importance of such technical assistance as well as efforts to improve the way in which such the technical assistance is planned, provided and evaluated.
The Delegation of War to Rebel Organizations
Authors: Salehyan Idean
Published: January 2010

States in an international dispute sometimes choose to attack their enemies with their own military forces but other times choose to empower domestic insurgent groups. What explains the decision to act through rebel proxies rather than directly engage a rival? Theories and empirical analyses of international conflict have adopted a state-centric bias, ignoring the substitution between direct uses of force and indirect action through rebel organizations. This note examines the decision to delegate conflict to rebels through the lens of principal—agent theory. While states support rebel groups to forgo some of the costs of conflict, they also lose a degree of foreign policy autonomy. Preliminary evidence of conflict delegation is presented, along with a number of empirically testable propositions. Finally, the consequences of delegation from the rebels’ perspective are explored. This framework serves as a starting point for future research on rebel—patron interactions.
Isolationism and Domestic Politics
Authors: Urbatsch R.
Published: January 2010

Isolationism has long been seen as a reaction against domestic economic conditions or a threatening international environment, but domestic politics could equally spur such a reaction. Disagreement with current foreign policy or opposition to political parties directing foreign policy may provoke negative feelings on the general prospect of international engagement. Some of what appears to be isolationism, then, is not a universal rejection of international intervention but is instead contingent on partisan control of the executive. Data from the American National Election Studies confirms this: copartisans of the president are substantially less likely to agree with isolationist statements or simultaneously to support isolationism and specific interventionist policies. In addition to further illuminating the sources of public opinion about foreign policy, these findings suggest that some common measures of isolationism may not measure what they intend to measure.
An Exploratory Examination of the Consequences of Burnout in Terms of Life Satisfaction, Turnover Intent, and Absenteeism Among Private Correctional Staff
Authors: Lambert Eric G. , Hogan Nancy L. , Altheimer Irshad
Published: January 2010

Burnout, a syndrome caused by excessive strain and psychological exhaustion, comprises the dimensions of emotional exhaustion, depersonalization, and feelings of being ineffective. Survey results from 160 correctional staff at a maximum security private prison in the Midwest were used to compute ordinary least squares regression equations in order to reveal the effects of burnout on the outcomes of life satisfaction, turnover intent, and absenteeism. Ineffectiveness was linked with none of the three outcomes. Depersonalization was linked with increased turnover intent and more frequent absenteeism, and emotional exhaustion was linked with all three outcomes. The results differed somewhat between female and male staff and between correctional and noncorrectional officers.
The Humanism is in the Details: An Insider’s Account of Humanistic Modifications to a Cognitive-Behavioral Treatment Program in a Maximum-Security Prison
Authors: Dahlen Kathryn , Johnson Robert
Published: January 2010

The cognitive-behavioral and humanistic approaches to treatment are often considered to be inherently at odds with one another, because cognitive-behavioral programs often follow a rigid format whereas humanistic programs explicitly accommodate the individuality of offenders. Drawing on observations from an in-depth, on-site immersion in a prison treatment program, the authors demonstrate that these seemingly disparate approaches can be merged in practice with positive results, particularly when used in conjunction with an emphasis on mature coping skills.
Testing the Cycle of Violence Hypothesis: Child Abuse and Adolescent Dating Violence as Predictors of Intimate Partner Violence in Young Adulthood
Authors: Manchikanti Gómez Anu
Published: January 2010

Child abuse is an important determinant of future violence perpetration and victimization. Past research examining linkages between child abuse and adult intimate partner violence (IPV) has predominantly focused on married individuals and not considered adolescent dating violence. In the present study, data from three waves of the National Longitudinal Study of Adolescent Health are used to examine the impact of child abuse and adolescent dating violence on the likelihood of IPV victimization and perpetration in young adulthood. Child abuse and adolescent dating violence are common in this study population and are highly predictive of IPV. In regression models stratified by gender, child abuse and adolescent dating violence are significant predictors of IPV victimization and perpetration for both men and women, but the magnitude of these associations differs by gender. Although gender differences exist, it appears that experiencing violence during childhood and/ or adolescence is highly predictive of IPV in young adulthood.
Antipsychotic Polypharmacy in Outpatients at Birch Hill Hospital: Incidence and Adherence to Guidelines
Authors: Ranceva Nadezda , Ashraf Wasim , Odelola Deji
Published: January 2010

The purpose of this article is to determine prescribing rates and adherence to guidelines with regard to antipsychotic polypharmacy, high‐dose prescribing, and sedative use in an outpatient population. A prospective case‐note audit involving 250 consecutive attendees of an outpatient clinic was carried out. Data were analyzed using descriptive statistical methods. Differences between the groups were estimated using t test and Λ2 where applicable. Results showed that the rate of polypharmacy was 17.4%. Reasons for polypharmacy were documented in 53% of cases. High‐dose antipsychotics were used in 2.5% of the monotherapy group and in 38% of the polypharmacy group. An ECG was done in 35% of patients on high‐dose antipsychotic therapy. In the monotherapy group, 6.2% versus 26.5% in the polypharmacy group of patients were on at least 1 sedative or hypnotic (odds ratio [OR], 5.47; 95% confidence interval [CI], 2.02–14.82; P < .001). Forty‐two percent of patients prescribed sedatives had schizophrenia spectrum disorders, and none of the patients were diagnosed with anxiety disorders. The current study confirms that despite repeated recommendations against the practice, polypharmacy rates remain consistent at the 20% level. Thorough documentation, calculating the total antipsychotic dose, and obtaining an ECG would constitute good practice.
Rereading the Story of Abraham, Isaac, and ‘Us’ in Romans 4
Authors: Jipp Joshua W.
Published: January 2010

Interpretations of Rom. 4 have often been subordinated to a single theme from Rom. 3.21-31, such as justification by faith, the inclusion of the Gentiles, or Paul’s demonstration that his gospel is in continuity with the Torah. While there is undeniable merit in these contentions, this article argues that Paul invokes Abraham for multiple purposes in order to answer his interlocutor’s charges against his gospel (Rom. 3.27—4.1). Paul’s argument is multifaceted and cannot be reduced to a single overarching theme. The second half of the article provides an exegesis of the oft-neglected 4.16-25 and argues that Paul crafts a reading of the Abraham story, a reading which is indebted to his prior Christological commitments, which answers the interlocutor’s question from 4.1 as to how Abraham can be the forefather of both Jews and Gentiles.
A CD36 synthetic peptide inhibits silica-induced lung fibrosis in the mice
Authors: Xin Wang  , Lina Lv  , Ying Chen  , Jie Chen
Published: January 2010

Silicosis is a kind of pneumoconiosis caused by inhalation of silica dust, which is characterized by lung fibrosis. The biologically active form of transforming growth factor-β1 (TGF-β1) plays a key role in the development of lung fibrosis. CD36 is involved in the transformation of latent TGF-β1 (L-TGF-β1) to active TGF-β1. The antagonistic effect of the synthetic peptide was analyzed by the administration of CD36 (93-110) synthetic peptide to the silicosis model of mice. The hydroxyproline content of the silica + CD36 (93-110) synthetic peptide group was significantly lower than that of the other experimental groups [silica and silica + CD36 (208-225) synthetic peptide groups] (p < .05). Inflammation, fibrotic degree and distribution of collagen fibers in silicotic nodules of the silica + CD36 (93-110) synthetic peptide group were less than those of the other experimental groups. The expressions of collagen I and III of the silica + CD36 (93-110) synthetic peptide group were significantly lower than those of the other experimental groups (p < .05). CD36 (93-110) synthetic peptide reduced the tissue fibrotic pathologies and collagen accumulation in the silicosis model of mice, resulting in the decreased severity of silica-induced lung fibrosis.
Beryllium contamination and exposure monitoring in an inhalation laboratory setting
Authors: Muller Caroline , Audusseau Séverine , Salehi Fariba , Truchon Ginette , Chevalier Gaston , Mazer Bruce , Kennedy Greg , Zayed Joseph
Published: January 2010

Beryllium (Be) is used in several forms: pure metal, beryllium oxide, and as an alloy with copper, aluminum, or nickel. Beryllium oxide, beryllium metal, and beryllium alloys are the main forms present in the workplace, with inhalation being the primary route of exposure. Cases of workers with sensitization or chronic beryllium disease challenge the scientific community for a better understanding of Be toxicity. Therefore, a toxicological inhalation study using a murine model was performed in our laboratory in order to identify the toxic effects related to different particle sizes and chemical forms of Be. This article attempts to provide information regarding the relative effectiveness of the environmental monitoring and exposure protection program that was enacted to protect staff (students and researchers) in this controlled animal beryllium inhalation exposure experiment. This includes specific attention to particle migration control through intensive housekeeping and systematic airborne and surface monitoring. Results show that the protective measures applied during this research have been effective. The highest airborne Be concentration in the laboratory was less than one-tenth of the Quebec OEL (occupational exposure limit) of 0.15 μg/m3. Considering the protection factor of 103 of the powered air-purifying respirator used in this research, the average exposure level would be 0.03 × 10— 4 μg/m3, which is extremely low. Moreover, with the exception of one value, all average Be concentrations on surfaces were below the Quebec Standard guideline level of 3 μg/100 cm2 for Be contamination. Finally, all beryllium lymphocyte proliferation tests for the staff were not higher than controls.
The Roles of Victim and Offender Substance Use in Sexual Assault Outcomes
Authors: Brecklin Leanne R. , Ullman Sarah E.
Published: January 2010

The impact of victim and offender preassault substance use on the outcomes of sexual assault incidents was analyzed. Nine hundred and seventy female sexual assault victims were identified from the first wave of a longitudinal study based on a convenience sampling strategy. Multivariate models showed that victim injury was more likely in assaults involving offender substance use (regardless of whether or not the victim was also using substances). Offender use of physical force and verbal threats were also related to greater odds of completed rape and injury, and force was associated with medical attention seeking. Based on this study, rape prevention programs should target men and focus on the role of substance use in sexual assault. These prevention programs should incorporate information on the roles of offender and victim substance use, offender aggression, and other situational factors in sexual assault outcomes. Study limitations and suggestions for future research on the role of victim and offender substance use in rape incidents are presented.
Commentary on ‘‘Toxicity Testing in the 21st Century: A vision and a Strategy’’
Authors: Waddell William J
Published: January 2010

The report of the National Academy of Sciences entitled ‘Toxicity Testing in the 21st Century: A Vision and a Strategy,’ hereinafter referred to as ‘The Report,’ is more of a vision than of a strategy. The present article addresses three observations made on The Report; namely, dose response, PBPK modeling, and in vitro testing. An additional observation this author has of the document is that a role for a scientist who can analyze the big picture is missing from the document. Science today is necessarily composed of specialists in many areas because science today encompasses many diverse, specific fields. Each specialist is in a world of his or her own and unable to integrate all the facts. Must we wait for another Newton or Einstein?
Commentary on ‘‘Toxicity Testing in the 21st Century: A vision and a Strategy’’: Stem Cells and Cell-Cell Communication as Fundamental Targets in Assessing the Potential Toxicity of Chemicals
Authors: Trosko James E
Published: January 2010

Faced with the reality of our current methods of drug discovery and toxicity assessment of all chemicals is less than perfect, the Report, ‘‘Toxicity Testing in the 21 st Century: A Vision and a Strategy’’, posed a reality check on all scientific efforts to find new conceptual and technical approaches for being better predictors of potential human health effects. This Commentary is a challenge to both the current paradigms and techniques to test chemicals for their potential toxicities. While, clearly, our scientific understanding of the mechanisms of chemical-induced toxicity and of the pathogeneses of all human diseases are not complete, the state of scientific understanding seems not only sufficient to know what we are now doing is not sufficient, but that it is adequate enough to make a new paradigm and technological change. Basically, the challenge includes the opinion that human exposure to chemicals, that are associated with one or more health endpoints (birth defects, cardiovascular diseases, cancer, reproductive and neurological dysfunctions), is the result of epigenetic , not mutagenic or genotoxic, mechanisms. In addition, it is postulated that the adult human stem cell should be considered the ‘‘target’’ cell for the important chemical-induced health effects. To test this hypothesis that altering the quantity and quality of adult stem cells by chemical exposures during in utero, neonatal, adolescent, adult and geriatric phases of life can lead to health consequences, it is recommended that 3-D in vitro cultures be used on male and female human adult stem cells from a few major organs (e.g., heart, brain, liver, lung, kidney, breast, prostate ). Altered stem cell biology (e.g., increase or decrease in the stem cell numbers in specific organs; altered apoptotic and differentiation frequencies), as well as measured cell-cell communication, should be seriously considered as toxicity endpoints.
Taurine reduces FK506-induced generation of ROS and activation of JNK and Bax in Madin Darby canine kidney cells
Authors: Jeon Seol-Hee , Park Hye-Min , Kim Shang-Jin , Lee Mun-Young , Kim Gi-Beum , Mizanur Rahman Md. , Woo Jeong-Nam , Kim In-Shik , Kim Jin-Shang , Kang Hyung-Sub
Published: January 2010

The immunosuppressive compound FK506 has been successfully used in kidney and liver transplant recipients. However, the compound can induce significant side effects on kidney function. Taurine is a potent free radical scavenger that attenuates a variety of renal diseases that are the consequence of excessive oxygen free radical damage. The purpose of this study was to investigate FK506-mediated death of Madin Darby canine kidney (MDCK) cells, in relation to reactive oxygen species (ROS) production. We determined the calcium (Ca2+) and magnesium (Mg2+) concentration in cultured MDCK cells by microfluorescence techniques and the level of activation of c-Jun-N-terminal kinase (JNK), extracellular signal regulated kinases (ERK), Bcl-2 and Bax proteins by Western blot. Treatment with 10 μM FK506 induced apoptosis in MDCK cells by increasing the level of intracellular ROS and Ca2+ and by decreaseing the level of intracellular Mg2+. This increase in intracellular ROS promoted JNK and Bax activation, which increased FK506-induced MDCK cell death. Taurine reduced the FK506-induced generation of ROS and activation of JNK and Bax. The results indicate that taurine can prevent FK506-induced kidney toxicity.
Shrines, Cultivators, and Muslim ‘Conversion’ in Punjab and Bengal, 1300–1700
Authors: Eaton Richard M.
Published: January 2010

This article discusses the growth of predominantly Muslim populations in two regions of South Asia—western Punjab and eastern Bengal. No evidence supports conventional understandings that Islamisation in these areas resulted from a desire for social liberation on the part of the lower orders of the Hindu caste system. Nor should Islamisation in these regions be characterised as instances of ‘conversion’, a term embedded in the nineteenth century Protestant missionary movement and thus, inappropriate for reconstructing religious processes in medieval Bengal and Punjab. Rather, transformations of religious identity in these two regions appear to have been gradual and unselfconscious in nature. They also appear to have been part of larger socio-political and economic changes that were occurring in the regions, in particular the diffusion of settled peasant agriculture.
Conversion to Christianity in African History before Colonial Modernity
Authors: Rüther Kirsten
Published: January 2010

This article examines different paradigms of conversions to Christianity in regions of Africa prior to the advent of colonial modernity. Religious change, in general, connected converts and various intermediaries to resources and power within specific settings. Even though African cultures were oral, conversions generated the production of texts which became important print media and were at least partly responsible for prompting conversions elsewhere in the world. The first case study explains how mission initiatives along the so-called West African slave coast almost always resulted in failure between 1450 and 1850, but how these failed efforts figure as important halfway options which reveal fundamental mechanisms of conversion. The dynamics of interaction were different in the African Kingdom of Kongo, where conversions became intimately entwined in the consolidation of political power and where, subsequent to the adoption of Christianity, new understandings of power evolved. Last but not least, in South Africa, again, another paradigm of conversion developed within the nexus of conflict and settler violence. Contested narratives of Christianity and conversion emerged as settlers tried to keep Christianity as a religious resource to be shared among whites only.
Fatima Hatun née Beatrice Michiel
Authors: Dursteler Eric
Published: January 2010

During the last decades of the sixteenth century, Beatrice Michiel fled an unhappy marriage in Venice for Constantinople. She converted to Islam, taking the name of Fatima, remarried, and because of her access to the imperial harem, played a significant role in Veneto-Ottoman relations in this troubled period. Beatrice/Fatima’s experience provides a suggestive window into the often ignored experience of renegade women on the Mediterranean frontier. While women’s religiosity is usually viewed as more unwavering than men’s, this case study suggests that while their motivations may have differed from those of men, women too might convert without compulsion. This story also provides a window onto ways in which women were able to subordinate societal and cultural mentalities and structures through utilising the political, religious and cultural frontiers of the Mediterranean as a means to prise themselves free from familial and economic circumstances in which they normally had limited power to act.
The Materiality of Difference
Authors: Scheller Benjamin
Published: January 2010

The article seeks to retrace the processes by which Jewish converts and their descendants in the late medieval Kingdom of Naples were included into and/or excluded from Christian society. It focuses on a case study of the Apulian seaport of Trani. Following a systems theoretical perspective, it conceives exclusion as a multidimensional process of (re-)production of differences in social practices that affect the position and action of an individual in different fields of society. It then attempts to explain the success and failure of the inclusion of converted Jews and their descendants into Christian society by analysing the reproduction of difference as an interplay of cultural and material factors.
Who Plans (Not) to Study Abroad? An Examination of U.S. Student Intent
Authors: Stroud April H.
Published: January 2010

With the number of American students studying abroad increasing each year and the expected passage of a federal law that would increase and diversify study abroad participation and locations, U.S. colleges and universities likely will have to make changes related to curriculum, faculty involvement, institutional leadership, programming, and resources (both financial and human) to meet the mandate. Therefore, it is imperative that colleges and universities understand how the characteristics and backgrounds of their students influence intent to study abroad. This study examined factors that may affect U.S. student participation in study abroad, including parental income and education, gender, race, intended major, attitudes about other cultures, and distance of college from home. Data were collected from a large, public northeastern university in the United States that participated in the 2007 Cooperative Institutional Research Program (CIRP) survey, which provides information about incoming students’ backgrounds, academic and career expectations, personal goals, and opinions on a wide range of political and social issues. The results indicate that being female, attending school more than 100 miles from home, and expressing an interest in improving one’s understanding of other cultures and countries have a positive influence on American students’ intent to study abroad. Planning to pursue a master’s degree or higher, living with family while attending school and majoring in engineering and professional areas such as architecture and medicine negatively affect U.S. student intent to study abroad.
Resistive Impedance Matching Circuit for Piezoelectric Energy Harvesting
Authors: Kong Na , Ha Dong Sam , Erturk Alper , Inman Daniel J.
Published: January 2010

A two-stage power conditioning circuit consisting of an AC-DC converter followed by a DC-DC converter is proposed for a vibration-based energy harvesting system. The power conditioning circuit intends to maximize the amount of power extracted from a piezoelectric energy harvester by matching the source impedance with the circuit by adaptively adjusting the duty cycle. An equivalent electrical circuit representation derived from a distributed-parameter piezoelectric energy harvester model is adapted to enable the impedance matching method proposed here. For a given piezoelectric energy harvester, there is a theoretical maximum power output that is determined by the mechanical damping, base acceleration, and the effective mass of the harvester structure under base excitation. Experimental results are given to validate the effectiveness of the proposed resistive impedance matching circuit around the first resonance frequency of a cantilevered piezoelectric energy harvester.