bluuebunny/crossref_metadata_2025 huggingface dataset:
Differential expression of SOX17 and SOX2 in germ cells and stem cells has biological and clinical implications
Authors: de Jong J , Stoop H , Gillis AJM , van Gurp RJHLM , van de Geijn G‐JM , Boer M de , Hersmus R , Saunders PTK , Anderson RA , Oosterhuis JW , Looijenga LHJ
Published: February 2008

Combined action of SOX and POU families of transcription factors plays major roles in embryonic development. In embryonic stem cells, the combination of SOX2 and POU5F1 (OCT3/4) is essential for maintaining the undifferentiated state by activating pluripotency‐linked genes, and inhibition of genes involved in differentiation. Besides embryonic stem cells, POU5F1 is also present in early germ cells, primordial germ cells, and gonocytes, where it has a role in suppression of apoptosis. Here we demonstrate that SOX2 is absent in germ cells of human fetal gonads, and as expected carcinoma in situ (CIS), ie the precursor lesion of testicular germ cell tumours of adolescents and adults (TGCTs), and seminoma. Based on genome‐wide expression profiling, SOX17 was found to be present, instead of SOX2, in early germ cells and their malignant counterparts, CIS and seminoma. Immunohistochemistry, western blot analysis, and quantitative RT‐PCR showed that SOX17 is a suitable marker to distinguish seminoma from embryonal carcinoma, confirmed in representative cell lines. Aberrant SOX2 expression can be present in Sertoli cells when associated with CIS, which can be misdiagnosed as embryonal carcinoma. In conclusion, this study demonstrates the absence of SOX2 in human embryonic and malignant germ cells, which express SOX17 in conjunction with POU5F1. This finding has both diagnostic and developmental biological implications. It allows the identification of seminoma‐like cells from embryonal carcinoma based on a positive marker and might be the explanation for the different function of POU5F1 in normal and malignant germ cells versus embryonic stem cells. Copyright © 2008 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
A survey of public transport use by immunocompromised children in the United Kingdom
Authors: Manley Sue , Selwood Karen , Pizer Barry
Published: January 2008

Background

The advice given to immunocompromised children and their families on the use of public transport at our oncology unit has been inconsistent, with a lack of written or evidence based guidelines. We therefore carried out two surveys, one national and one local on this issue, to determine what advice is given to families. We also undertook an extensive literature search on this subject.

Methods

The first survey was completed by the Paediatric Oncology Nurses Forum link member at each of the 22 United Kingdom Childrens' Cancer Study Group (UKCCSG) centres. We asked their current practice for use of public transport for hospital visits, school attendance, regular weekly use and holidays. We looked at recommendations for travel on holiday in the UK and abroad with reference to neutrophil and platelet counts. The second survey was completed by parents of 64 children attending our outpatient clinic over a 2‐week period to ascertain whether the families comply with our verbal recommendations.

Results

There was a 100% response from UKCCSG centres. None of the centres had any written or evidence based guidelines. 55% of centres allowed public transport for hospital visits, 82% for school and 90% for holidays. Sixty‐eight percent of centres allowed UK travel with a neutrophil count of 0.5–1 × 109/L and 18% if neutrophils <0.5 × 109/L. Eighteen percent of centres allowed foreign travel with a neutrophil count of 0.5–1 × 109/L but only 9% if <0.5 × 109/L. The second survey showed 2% used public transport to attend hospital, 5% for school, 17% for regular use and 50% travelled by plane for holidays. A Pubmed literature search revealed a lack of studies on immunocompromised patients.

Conclusion

A certain use of public transport is necessary for patients to engage in as normal a life as possible. There is a need for further studies to produce sensible and consistent advice on this issue. Pediatr Blood Cancer 2008;50:988–991. © 2008 Wiley‐Liss, Inc.
Congenital amegakaryocytic thrombocytopenia: The diagnostic importance of combining pathology with molecular genetics
Authors: Rose Melissa J. , Nicol Kathleen K. , Skeens Micah A. , Gross Thomas G. , Kerlin Bryce A.
Published: January 2008

Congenital Amegakaryocytic Thrombocytopenia (CAMT) is a rare bone marrow failure syndrome that presents with isolated thrombocytopenia within the first year of life. Classic diagnostic bone marrow findings reveal absent or significantly decreased megakaryocytes with otherwise normal marrow cellularity. We present a newborn with thrombocytopenia whose initial bone marrow aspirate showed an appropriate number of megakaryocytes. CAMT was subsequently diagnosed after molecular testing demonstrated a mutation in the thrombopoietin receptor. The presence of a normal number of megakaryocytes on an initial bone marrow aspirate should not exclude CAMT from the differential diagnosis of thrombocytopenia within the first year of life. Pediatr Blood Cancer 2008;50:1263–1265. © 2008 Wiley‐Liss, Inc.
Sevelamer hydrochloride: A novel treatment of hyperphosphatemia associated with tumor lysis syndrome in children
Authors: Abdullah Shaker , Diezi Manuel , Sung Lillian , Dupuis L. Lee , Geary Denis , Abla Oussama
Published: January 2008

Background

Sevelamer is a phosphate‐binder used effectively for the treatment of hyperphosphatemia in patients treated with dialysis.

Objectives

To describe the safety of sevelamer in children with hyperphosphatemia secondary to tumor lysis syndrome and the serum phosphate concentrations observed following its administration.

Procedure

A retrospective chart review of all children with leukemia/lymphoma diagnosed between November 2002 and April 2004 who received sevelamer during their initial admission was conducted. We monitored the effects of sevelamer on serum phosphate concentration, calcium/phosphate product and renal function at hours 24, 48, and 72 from sevelamer initiation.

Results

Thirteen patients received sevelamer during the study period. Their median age was 13 years (range 2.7–17.9) and eight were boys. Nine children had acute lymphoblastic leukemia, one had acute myeloid leukemia and 3 had non‐Hodgkin's lymphoma. The most frequently used dose of sevelamer was 400 mg orally twice daily. The median duration of sevelamer therapy was 2 days (range 1–7). Two children were excluded from the efficacy analysis due to concurrent use of dialysis. Mean serum phosphate levels decreased after sevelamer administration, in eleven patients, from a baseline 2.2 mmol/L ± 0.4 (95% CI, 1.7–3.1) to 1.1 mmol/L ± 0.2 at hour 72 (95%CI, 0.6–1.5). The only toxicity attributed to sevelamer was mild vomiting in three patients.

Conclusions

Sevelamer appears to be effective and tolerable for the treatment of hyperphosphatemia associated with tumor lysis syndrome. Pediatr Blood Cancer 2008;51:59–61. © 2008 Wiley‐Liss, Inc.
Discontinuity and failures of therapy with bisphosphonates: joint assessment of predictors with multi‐state models
Authors: Zambon Antonella , Baio Gianluca , Mazzaglia Giampiero , Merlino Luca , Corrao Giovanni
Published: January 2008

Background

Data from a cohort of women treated with bisphosphonates were used to illustrate that multi‐state models may be the useful tools of analysis where two causes of treatment failure are the ultimate outcome of interest, and the sequence of recurrent episodes of treatment starting and discontinuing is also of concern.

Methods

All the 11 863 women resident in the Italian Region of Lombardy, aged 45 years or over and who received bisphosphonates for the first time during 2003 entered into the study and were followed up until December 2005. Multi‐state models with in‐treatment and treatment‐free periods as transient states, and fractures and gastrointestinal‐related events as competing causes of failure, were fitted to the data. The effect of several covariates on transition rates between states was estimated.

Results

One half of the women was treated with bisphosphonates for less than 27% of the period of observation. Negative prognostic factors for treatment discontinuation were younger age and the use of alendronate at once‐daily dosing, with low refill compliance during follow‐up. The risk of fracture was higher for older women who experienced fracture before entry in the cohort, and for those who switched between drugs, had low refill compliance, experienced episodes of treatment discontinuation and used corticosteroids during follow‐up.

Conclusions

The use of multi‐state models in pharmacoepidemiology provides non‐biased estimates of the effect of covariates in predicting treatment discontinuation, restarting and failures. Our analyses emphasize the importance of maximising compliance in order to reduce the risks of both treatment discontinuation and fracture. Copyright © 2008 John Wiley & Sons, Ltd.
Kinetic and conformational properties of a novel T‐cell antigen receptor transmembrane peptide in model membranes
Authors: Amon Michael A. , ALI Marina , Bender Veronika , Hall Kristopher , Aguilar Marie‐Isabel , Aldrich‐Wright Janice , Manolios Nicholas
Published: January 2008

Core peptide (CP; GLRILLLKV) is a 9‐amino acid peptide derived from the transmembrane sequence of the T‐cell antigen receptor (TCR) α‐subunit. CP inhibits T‐cell activation both in vitro and in vivo by disruption of the TCR at the membrane level. To elucidate CP interactions with lipids, surface plasmon resonance (SPR) and circular dichroism (CD) were used to examine CP binding and secondary structure in the presence of either the anionic dimyristoyl‐L‐α‐phosphatidyl‐DL‐glycerol (DMPG), or the zwitterionic dimyristoyl‐L‐α‐phoshatidyl choline (DMPC).

Using lipid monolayers and bilayers, SPR experiments demonstrated that irreversible peptide–lipid binding required the hydrophobic interior provided by a membrane bilayer. The importance of electrostatic interactions between CP and phospholipids was highlighted on lipid monolayers as CP bound reversibly to anionic DMPG monolayers, with no detectable binding observed on neutral DMPC monolayers.

CD revealed a dose‐dependent conformational change of CP from a dominantly random coil structure to that of β‐structure as the concentration of lipid increased relative to CP. This occurred only in the presence of the anionic DMPG at a lipid : peptide molar ratio of 1.6:1 as no conformational change was observed when the zwitterionic DMPC was tested up to a lipid : peptide ratio of 8.4 : 1. Copyright © 2008 European Peptide Society and John Wiley & Sons, Ltd.
Thermal behavior and flame retardancy of flexible poly(vinyl chloride) treated with zinc hydroxystannate and zinc stannate
Authors: Wu Weihong , Qu Hongqiang , Li Zhi , Yuan Huijie
Published: January 2008

The flame‐retardant and smoke‐suppressant properties of inorganic tin compounds such as zinc hydroxystannate (ZHS) and zinc stannate (ZS) were studied in comparison with those of alumina trihydrate and magnesium hydroxide through the limiting oxygen index test and a smoke density test. The thermal degradation in air of flexible poly(vinyl chloride) (PVC) treated with the above compounds was studied by thermal analysis from ambient temperature to 800°C. The activation energy was calculated by using the Vyazovkin model‐free kinetic method and the Kissinger method. The results showed that tin compounds such as ZHS and ZS could be used as highly effective flame retardants for flexible PVC; these flame retardants enhanced the stability and the activation energy of the oxidation of the char. J. VINYL ADDIT. TECHNOL, 2008. © 2008 Society of Plastics Engineers
Tragal cartilage grafts in rhinoplasty: A viable alternative in the graft‐depleted patient
Authors: Cochran C. Spencer , DeFatta Robert J.
Published: January 2008

OBJECTIVE

To describe a simple technique for harvesting tragal cartilage and describe its use in rhinoplasty.

STUDY DESIGN

Retrospective review.

SUBJECTS AND METHODS

Rhinoplasties performed between January 2005 and June 2007 in which tragal cartilage grafts were utilized by the senior author (CSC) were reviewed to assess type of graft, preservation of tragal contour, and donor‐site morbidity.

RESULTS

Tragal cartilage grafts were used in three primary and three secondary rhinoplasty patients. Postoperative follow‐up ranged from six months to 12 months. Tragal cartilage was used as five alar contour grafts, one lateral crural onlay graft, one dorsal onlay graft, and one infratip lobule graft. Tragal cartilage was used to close the septal perforation of one patient. Tragal contour was preserved in all patients, and there were no complications noted with this procedure.

CONCLUSION

The tragus provides a simple, convenient alternative source of cartilage for rhinoplasty in graft‐depleted patients.
Resource utilization in the management of subglottic stenosis
Authors: Shah Rahul K. , Lander Lina , Choi Sukgi S. , Zalzal George H.
Published: January 2008

OBJECTIVE

The purpose of this study was to determine resource utilization in managing subglottic stenosis.

STUDY DESIGN

The Kids' Inpatient Database (KID) 2003 was analyzed.

SUBJECTS AND METHODS

International Classification of Diseases, Ninth Revision code 478.74 was the inclusion criteria.

RESULTS

Two thousand forty‐six admissions with subglottic stenosis were sampled; there were 10 deaths (0.49%). States with the most admissions were Ohio, California, and Illinois; these did not have the highest spending per admission. Two hundred eighteen (10.7%) underwent a laryngeal graft procedure; states with the most were Ohio (35.8%), Texas, California, and Florida. Indicators of increased resource utilization include length of stay, nonelective admission, race, primary payer, hospital location, and type.

CONCLUSIONS

For subglottic stenosis, three states account for 37% of admissions, and four states account for 56% of laryngeal graft procedures in 2003. The mean total charges were $53,787; 90% of admissions had total charges less than $139,253. Patients who underwent surgical procedures had total charges of $76,409.
Pilot study of an objective structured clinical examination (“the Six Pack”) for evaluating clinical competencies
Authors: Franzese Christine B.
Published: January 2008

OBJECTIVE

The purpose of this study was to evaluate an Objective Structured Clinical Examination (OSCE) designed to examine all six competencies and provide meaningful results to improve resident performance.

STUDY DESIGN

A prospective, observational study.

METHODS

The OSCE consists of 1 hour for examination of a simulated patient, documentation, and feedback, with 30 minutes for an evidence‐based medicine (EBM) test. Eight otolaryngology residents participated. Digital recordings and written documentation were evaluated on all competencies except practice‐based learning. An EBM test was scored to assess practice‐based learning.

RESULTS

Overall, senior residents scored better. Seniors scored better on performing a focused history, whereas juniors scored better for thoroughness. Seniors coded better than juniors, although seniors tended to undercode and juniors tended to over‐code. Two cases of “insurance fraud” were also discovered.

CONCLUSIONS

The “Six Pack” successfully evaluated all competencies while providing valuable information. A clinical practicum was added to improve history and physical examination skills. The discussion of coding and a billing seminar also resulted. Residents believed the OSCE was valuable. Faculty members were impressed with the useful information obtained.
Medial maxillectomy: A comparative study as a surgical procedure
Authors: Parida Pradipta Kumar , Gupta Ashok Kumar
Published: January 2008

OBJECTIVE

The purpose of this study was to compare the long‐term results of endoscopic and conventional medial maxillectomy.

STUDY DESIGN

A prospective study.

SUBJECTS AND METHODS

This study was conducted on 28 patients. No patient had intracranial or intraorbital extension. Thirteen patients (4 with adenocarcinoma, 5 with inverted papilloma, and 4 with malignant melanoma) underwent endoscopic medial maxillectomy, and 15 patients (5 with adenocarcinoma, 5 with inverted papilloma, and 5 with malignant melanoma) underwent conventional medial maxillectomy with a postoperative follow‐up of 12 to 48 months.

RESULTS

In group 1 (the endoscopic group), recurrence was seen in one case (7.6%) with malignant melanoma 3 months after the surgery and was managed by revision endoscopic removal of the disease. The overall success rate in this group was 92.4%. In group 2 (the conventional group), the disease recurred in one (6.6%) patient with malignant melanoma. The overall recurrence rate was 7.2%.

CONCLUSIONS

The precise determination of tumor origin and extent of tumor during the surgery is the key to a successful outcome.
Palatal implants for the treatment of snoring and obstructive sleep apnea/hypopnea syndrome
Authors: Friedman Michael , Schalch Paul , Lin Hsin‐Ching , Kakodkar Kedar A. , Joseph Ninos J. , Mazloom Narges
Published: January 2008

OBJECTIVE

Randomized, double‐blinded, placebo‐controlled, clinical trial to determine the effectiveness of palatal implants for treatment of mild/moderate obstructive sleep apnea/hypopnea syndrome (OSAHS).

STUDY DESIGN AND SETTING

Sixty‐two non‐obese adults with history of snoring, daytime sleepiness, and mild/moderate OSAHS, were randomized to receive palatal implants (n = 31) or placebo procedure (n = 31). Complete follow‐up including quality of life (QOL, SF‐36), snoring visual analog scale (VAS), and Epworth Sleepiness Scale (ESS) data were obtained in 62 patients. Seven patients refused follow‐up polysomnography for a total of 55 patients (29 implant and 26 placebo).

RESULTS

The treatment group (change in score of −7.9 ± 7.7) was significantly improved compared with the placebo group (change in score of 0.9 ± 4.3) for apnea/hypopnea index (AHI) (P < 0.0001), QOL, SF‐36 (P < 0.0001), snoring VAS (P < 0.0001), and ESS (P = 0.0002).

CONCLUSIONS

Palatal implants improve AHI, QOL, snoring intensity, and daytime sleepiness for selected patients with mild/moderate OSAHS.
The coblation tonsillectomy learning curve
Authors: Carney A. Simon , Harris Penelope K. , MacFarlane Patricia L. , Nasser Simon , Esterman Adrian
Published: January 2008

OBJECTIVE

To establish if there is a learning curve for coblation tonsillectomy.

STUDY DESIGN

Regression analysis of data obtained from surgeons identified from the Australian Tonsillectomy Survey.

SUBJECTS AND METHODS

Thirty otolaryngologists were invited to contribute audit data. Data were stratified into groups of 10 procedures and analysed with regression analysis.

RESULTS

Nineteen (70%) surgeons responded. Complete data were obtained for 1700 cases and return to theatre data on 2062 cases. There was a significant learning curve with respect to both primary (P = 0.050) and secondary (P = 0.028) hemorrhage rates. Mean rates were 0.3% (95% CI 0.1% to 0.7%) and 2.1% (95% CI 1.5% to 2.9%) for primary and secondary bleeds, respectively, with return to theatre in 0.2% (95% CI 0.1% to 0.5%) and 1.3% (95% CI 0.9% to 1.9%), respectively.

CONCLUSION

The introduction of coblation tonsillectomy into Australia was associated with a statistically significant learning curve with respect to both primary and secondary hemorrhage rates.
Reduction surgeries for delayed cases with isolated blowout fractures
Authors: Hinohira Yasuyuki , Yumoto Eiji , Hyodo Masamitsu , Shiraishi Atsushi
Published: January 2008

OBJECTIVE

To show the effectiveness of endoscopic reduction surgeries for delayed cases with blowout fractures, and to determine the cause of persisting diplopia based on surgical findings.

DESIGN

Retrospective study.

SETTING

Between 1997 and 2006, 114 patients with isolated blowout fractures underwent surgery. In 6 of 114 patients, there were delayed cases in which over 3 months had elapsed since the initial trauma. For persisting diplopia, surgeries were performed using an endoscopic endonasal approach.

RESULTS

Adhesion between the protruded periorbita and the paranasal sinus mucosa was remarkable in the delayed cases. Dissection of the adhesion and removal of the bone fragments were performed. The ocular motility improvement was confirmed by intraoperative eye traction tests. Postoperatively, diplopia disappeared in five patients.

CONCLUSION

Endoscopic reduction surgeries for delayed cases are available in the treatment of blowout fractures. The main cause of diplopia was determined to be the adhesion.
Advanced access to otolaryngology: Lessons learned
Authors: Baugh Reginald F. , Alpard Craig R. , Colon Elizabeth
Published: January 2008

Reports of experience with implementing advanced access techniques in specialty practices are few in number. In our facility, we were able to demonstrate that patients' access to care improved from >100 days to 72 hours, patient satisfaction increased 22%, and productivity increased 29%. The lessons we learned after the successful implementation of advanced access in an academic otolaryngology practice are presented here.
A reliable surface landmark for localizing supratrochlear artery: Medial canthus
Authors: Ugur Mehmet Birol , Savranlar Ahmet , Uzun Lokman , Küçüker Hüdaverdi , Cinar Fikret
Published: January 2008

OBJECTIVE

To determine the reliability of medial canthus as a surface landmark to locate supratrochlear vascular pedicle.

STUDY DESIGN AND SETTING

The distance from medial canthal line to supratrochlear vascular pedicle was measured in 57 healthy volunteers (Doppler imaging study) and also in 15 fresh cadavers.

RESULTS

In the Doppler study, the pedicle was found at most 3 mm lateral or medial to medial canthus (mean ± SD, 0.8 ± 0.7 mm). SVP mark tended to be medial to the medial canthus mark in females (males, 6; females, 42), whereas it was lateral to it in males (males, 20; females, 5). In the cadaver study, the pedicle was found 0.7 mm away from medial canthus on average.

CONCLUSION

Medial canthus can be used as a reliable landmark for paramedian forehead flaps. When Doppler examination fails, pedicle may be found at most 3 mm away from medial canthus. SVP is more commonly located lateral to medial canthus in males and medial to it in females.
Melkersson‐Rosenthal syndrome
Authors: Kanerva Mervi , Moilanen Kirsi , Virolainen Susanna , Vaheri Antti , Pitkäranta Anne
Published: January 2008

OBJECTIVES

To study characteristics of Melkersson‐Rosenthal syndrome (MRS) patients with facial palsy (FP) and differences in patients treated at the Departments of Otorhinolaryngology and Dermatology.

METHODS

Clinical picture of MRS was studied from patient charts at two departments. Patients with FP received a questionnaire and were examined. Tissue biopsies were searched for non‐necrotizing granulomatous infiltrations typical of MRS and blood DNA for UNC‐93B1 gene mutations predisposing to herpesvirus infection.

RESULTS

At the Department of Otorhinolaryngology, all 18 MRS patients had FP, 9 the triad form. Two patients revealed non‐necrotizing granulomatous infiltrations during acute edema episodes; another two had association with uveitis. Edema was rarely persistent and did not dominate the clinical picture. No UNC‐93B1 mutations were found. At the Department of Dermatology, 2 patients had triad MRS and 15 had monosymptomatic granulomatous cheilitis with persistent edema and typical MRS histology.

CONCLUSION

The clinical picture of MRS with FP differed from the current knowledge of edema‐dominated MRS. More studies focusing on MRS with FP would broaden our understanding of the syndrome.
Striving for growth, bypassing the poor? A critical review of Rwanda's rural sector policies
Authors: Ansoms An
Published: January 2008

Equity is complementary to the pursuit of long-term prosperity. Greater equity is doubly good for poverty reduction. It tends to favour sustained overall development, and it delivers increased opportunities to the poorest groups in a society. (François Bourguignon, speech at the launching of the World Development Report, 2006)

This paper studies the Rwandan case to address some of the challenges and pitfalls in defining pro-poor strategies. The paper first looks at the danger of a purely growth-led development focus (as in Rwanda's first PRSP), and evaluates the extent to which the agricultural sector has been a pro-poor growth engine. It then studies Rwanda's current rural policies, which aim to modernise and ‘professionalise’ the rural sector. There is a high risk that these rural policy measures will be at the expense of the large mass of small-scale peasants. This paper stresses that the real challenge to transform the rural sector into a true pro-poor growth engine will be to value and incorporate the capacity and potential of small-scale ‘non-professional’ peasants into the core strategies for rural development. The lessons drawn from the Rwandan case should inspire policy makers and international donors worldwide to shift their focus away from a purely output-led logic towards distribution-oriented rural development policies. In other words, the challenge is to reconcile efficiency in creating economic growth with equity, and perhaps, to put equity first.
Making sense of violence: voices of soldiers in the Congo (DRC)
Authors: Baaz Maria Eriksson , Stern Maria
Published: January 2008

During the last years the DRC has made itself known in the world for terrible acts of violence committed by armed men – militia and the regular army – against the civilian population. The voices of the soldiers and combatants have so far been absent in the accounts of this violence. This silence is problematic, both because it makes it harder to understand such violence, but also because it reinforces stereotypes of African warriors as primitive and anarchic, driven by innate violence and tribal hatred. Enquiry into the particular discursive as well as material circumstances of the armed conflict in the DRC, which might better redress the complex and interrelated context in which ‘people in uniforms’ commit violence, is consequently impeded. The story we recount here emerges from soldiers within the main perpetrator of violence in the DRC today: the Integrated Armed Forces. The soldiers' interview texts challenge the dominant representation of soldiers and combatants in the DRC. The soldiers made sense of the prevalence of violence (in which they too had participated) in several interrelated ways, none of which reflected any expression of ‘natural’ (if dormant) violent tendencies, hatred or vengefulness for the enemy.
The domestication of the mobile phone: oral society and new ICT in Burkina Faso
Authors: Hahn Hans Peter , Kibora Ludovic
Published: January 2008

This article addresses the topic of the recent boom in mobile phones in Burkina Faso. Mobile phones are placed in the theoretical framework of domestication and, more particularly, of cultural appropriation. They are therefore regarded not only as devices to communicate, but also as material objects which cause economic problems and may affect social relations through the uneven disposition over such objects. As in many other African countries, the growth of mobile phone usage in Burkina Faso is higher than in Western countries, reflecting the particular appreciation of these devices. This development contrasts sharply with the difficult economic situation of many of the users. This context may explain some particular patterns of usage, and is discussed against the background of the communication principles ruling in societies still adequately described as ‘oral societies’. Domestication leads to a partial usage of the devices' technical possibilities. Nevertheless, it transforms mobile phones into socially meaningful means of communication.
Spectral rigidity and discreteness of 2233-groups
Authors: BUSER PETER , FLACH NICOLE , SEMMLER KLAUS-DIETER ,   with an Appendix, MACLACHLAN COLIN , ROSENBERGER GERHARD
Published: January 2008

In this paper we describe methods for dealing with the trace spectrum of a subgroup of PSL(2,$\mathbb{R}$) generated by four elliptic elements α, β, γ, δ of respective orders 2, 2, 3, 3, satisfying αβγδ = 1. We give a parametrization and a fundamental domain in the parameter space of such groups. Furthermore we construct an algorithm that decides whether or not a given group is discrete and which moves the discrete groups into the fundamental domain. Our main result is that any two discrete such groups are isospectral if and only if they are conjugate in (2,$\mathbb{R}$).

In the Appendix we consider pairs of subgroups of (2,$\mathbb{R}$) that arise from non-conjugate maximal orders in a quaternion algebra over a number field. We show that for the isospectrality of such pairs there is a peculiar exception in the case where the groups contain elements of both orders 2 and 3.
Stable solutions of a scalar conservation law for particle-size segregation in dense granular avalanches
Authors: SHEARER M. , GRAY J. M. N. T. , THORNTON A. R.
Published: January 2008

Dense, dry granular avalanches are very efficient at sorting the larger particles towards the free surface of the flow, and finer grains towards the base, through the combined processes of kinetic sieving and squeeze expulsion. This generates an inversely graded particle-size distribution, which is fundamental to a variety of pattern formation mechanisms, as well as subtle size-mobility feedback effects, leading to the formation of coarse-grained lateral levees that create channels in geophysical flows, enhancing their run-out. In this paper we investigate some of the properties of a recent model [Gray, J. M. N. T. & Thornton, A. R. (2005) A theory for particle size segregation in shallow granular free-surface flows. Proc. R. Soc. 461, 1447–1473]; [Thornton, A. R., Gray, J. M. N. T. & Hogg, A. J. (2006) A three-phase mixture theory for particle size segregation in shallow granular free-surface flows. J. Fluid. Mech. 550, 1–25] for the segregation of particles of two sizes but the same density in a shear flow typical of shallow avalanches. The model is a scalar conservation law in space and time, for the volume fraction of smaller particles, with non-constant coefficients depending on depth within the avalanche. It is proved that for steady flow from an inlet, complete segregation occurs beyond a certain finite distance down the slope, no matter what the mixture at the inlet. In time-dependent flow, dynamic shock waves can develop; they are interfaces separating different mixes of particles. Shock waves are shown to be stable if and only if there is a greater concentration of large particles above the interface than below. Constructions with shocks and rarefaction waves are demonstrated on a pair of physically relevant initial boundary value problems, in which a region of all small particles is penetrated from the inlet by either a uniform mixture of particles or by a layer of small particles over a layer of large particles. In both cases, and under a linear shear flow, solutions are constructed for all time and shown to have similar structure for all choices of parameters.
Extending the surgical boundaries in the management of the left ventricular outflow tract obstruction in discordant ventriculo-arterial connections – a surgical and morphological study
Authors: Martins Paula , Tran Vi , Price Gemma , Tsang Victor , Cook Andrew C.
Published: January 2008

When there is obstruction of the left ventricular outflow tract, there are several surgical approaches to the repair of discordant ventriculo-arterial connections in the setting of concordant atrioventricular connections. Choosing the optimal technique demands not only knowledge of the different surgical procedures, but also the understanding of the particular anatomic features present in a specific patient. These requisites are then essential to plan the operation, to foresee some difficult situations, and to avoid post-operative complications. In this review, we assess all these surgical and anatomic aspects, focussing on their relative importance in clinical assessment.
Burnout und Coping in der stationären Altenpflege. Ein regionaler Vergleich an examinierten Pflegekräften
Authors: Jenull Brigitte , Brunner Eva , Mayr Michaela , Mayr Michaela
Published: January 2008

Der berufliche Alltag in der stationären Altenpflege ist mit einer Vielzahl von Belastungsfaktoren sowohl auf physischer als auch psychischer Ebene verbunden. Die vorliegende Studie untersucht Arbeitsbelastungen, Burnout, Gesundheit und Coping bei examinierten Pflegekräften in zwei Bundesländern Österreichs –Wien (n = 78) und Kärnten (n = 59). Der im Durchschnitt älteren Wiener Stichprobe, die sich häufig zum Beruf berufen fühlt, steht eine jüngere Kärntner Kollegenschaft mit einer vorwiegend prosozial und ökonomisch orientierten Berufsmotivation gegenüber. Die Ergebnisse zeigen bei 23% der Studienteilnehmerinnen eine bedenklich hohe Ausprägung der emotionalen Erschöpfung und von 17% werden Aversionen gegen KlientInnen thematisiert. Belastet fühlen sich die Befragten vor allem durch die Arbeitsbedingungen und die Arbeit mit und am alten Menschen. Kärntner Pflegekräfte beurteilten ihren eigenen Gesundheitszustand besser als die Wiener Kolleginnen, die eine geringere Arbeitszufriedenheit angaben. Als wesentliche Strategien im Umgang mit Stress konnten Sport, familiäre Kontakte sowie Lesen identifiziert werden. Die Studie unterstreicht die hohe Burnoutgefährdung der examinierten Pflegekräfte in der stationären Altenpflege.
Bedürfnisse von Brustkrebspatientinnen nach pflegerischer Unterstützung während der stationären Erstbehandlung
Authors: Pinkert Christiane , Holtgräwe Martina , Remmers Hartmut
Published: January 2008

Das Ziel dieser Studie ist die Erkundung von speziell an Pflegende adressierten, subjektiven Betreuungsbedürfnissen von Frauen mit Brustkrebs während der chirurgischen Primärtherapie. Untersuchungen haben gezeigt, dass die psychosoziale Unterstützung der betroffenen Frauen positive Effekte auf die Krankheitsverarbeitung und den Krankheitsverlauf haben kann. Für die Studie sind leitfadengestützte, qualitative Interviews mit 42 betroffenen Frauen durchgeführt worden. Die Datenanalyse erfolgte nach den Kriterien einer zusammenfassenden Inhaltsanalyse. Die Bedürfnisse der interviewten Frauen betreffen drei Ebenen: die Beziehungsebene mit den Aspekten Fürsorglichkeit, emotionale Unterstützung und bedürfnisgerechte Kommunikation, die Problemebene, auf der eine verlässliche und fachlich korrekte Versorgung wichtig ist und die Organisationsebene, die für eine patientenfreundliche Unternehmenskultur steht. Die Erwartungen und Bedürfnisse der Patientinnen an die Pflegenden sind vielfältig. Sie umfassen ein breites Spektrum professioneller Pflege.
Radially anisotropic shear velocity structure of the upper mantle globally and beneath North America
Authors: Nettles Meredith , Dziewoński Adam M.
Published: February 2008

A surface wave dispersion data set of unprecedented size is used to obtain a variable‐resolution model of the radially anisotropic shear wave velocity structure of the upper mantle beneath North America and globally. Love and Rayleigh wave phase velocities for periods in the range 35–150 s constrain a three‐dimensional model of velocity variations on a length scale of a few hundred kilometers within the North American continent and a few thousand kilometers globally. The short‐ and long‐wavelength models are determined simultaneously. Long‐period surface wave phase velocities (200–350 s) are used to help constrain longer‐wavelength and transition zone structure. Laterally varying velocity sensitivity kernels are used to account for the dependence of the velocity sensitivity on lateral variations in crust and mantle velocity structure. The sensitivity kernels are updated in several iterations to avoid nonlinearities associated with the inverse problem for the determination of mantle structure. Variations in isotropic velocity in the uppermost several hundred kilometers of the mantle are found to correlate well with surface tectonic features. Within the North American craton, the locations of strongest radial anisotropy generally correlate with the locations of fastest isotropic velocity. Variations in radial anisotropy show a clear continent‐ocean signature. Strong anisotropy occurs at shallow depths (<100 km) under the continents, with a secondary peak found at a depth of ∼200 km. Maximum anisotropy under the oceans occurs at a depth of ∼125 km, with no secondary maximum. Combined interpretation of isotropic and anisotropic continent‐ocean differences suggests a different role for the low‐velocity zone under continental and oceanic regions.
Toward a mechanistic understanding of how natural bacterial communities respond to changes in temperature in aquatic ecosystems
Authors: Hall Edward K , Neuhauser Claudia , Cotner James B
Published: February 2008

We examine how heterotrophic bacterioplankton communities respond to temperature by mathematically defining two thermally adapted species and showing how changes in environmental temperature affect competitive outcome in a two-resource environment. We did this by adding temperature dependence to both the respiration and uptake terms of a two species, two-resource model rooted in Droop kinetics. We used published literature values and results of our own work with experimental microcosms to parameterize the model and to quantitatively and qualitatively define relationships between temperature and bacterioplankton physiology. Using a graphical resource competition framework, we show how physiological adaptation to temperature can allow organisms to be more, or less, competitive for limiting resources across a thermal gradient (2–34 °C). Our results suggest that the effect of temperature on bacterial community composition, and therefore bacterially mediated biogeochemical processes, depends on the available resource pool in a given system. In addition, our results suggest that the often unclear relationship between temperature and bacterial metabolism, as reported in the literature, can be understood by allowing for changes in the relative contribution of thermally adapted populations to community metabolism.
Characterization of Ghrelin in Pedigreed Baboons: Evidence for Heritability and Pleiotropy
Authors: Voruganti V. Saroja , Tejero M. Elizabeth , Proffitt J. Michael , Cole Shelley A. , Cox Laura A. , Mahaney Michael C. , Rogers Jeffery A. , Freeland‐Graves Jeanne H. , Comuzzie Anthony G.
Published: January 2008

Background: Ghrelin is an orexigenic hormone that is produced primarily in the stomach, and stimulates food intake via its receptors situated in the hypothalamus.

Objective: The purpose of this study was to characterize baboon ghrelin cDNA and investigate the genetic influence on the variation in plasma ghrelin levels in baboons.

Methods and Procedures: The sample consisted of 376 baboons (263 females, 113 males) from a pedigreed colony at the Southwest Foundation for Biomedical Research, San Antonio, Texas. Ghrelin cDNA was cloned by reverse‐transcription polymerase chain reaction (RT‐PCR) and sequenced. Real‐time RT‐PCR was performed to quantify mRNA from the collected tissues. Genetic contribution to plasma ghrelin was estimated using a variance components method implemented in SOLAR.

Results: The baboon coding region and predicted amino acid sequence for ghrelin showed 97 and 96% sequence identity with humans, respectively. Maximum expression of ghrelin mRNA was detected in hypothalamus and stomach. Mean ± s.e. plasma levels of ghrelin were 3,406 ± 99 pg/ml. A significant heritability was observed for plasma ghrelin (h2= 0.25, P < 0.001). A genome‐wide scan revealed the evidence of suggestive linkage for a locus affecting plasma ghrelin on chromosome 9q22 (between markers D9S910 and D9S261, logarithm of the odds (LOD) score = 2.3). Significant genetic correlations (P < 0.001) among ghrelin, body weight, and leptin were observed.

Discussion: These results indicate a significant genetic component in the variation of plasma ghrelin in baboons and reveal a high degree of similarity between baboon and human ghrelin with respect to its cDNA and its correlation with other obesity traits.
Which Obesity Indicators Are Better Predictors of Metabolic Risk?: Healthy Twin Study
Authors: Lee Kayoung , Song Yun‐Mi , Sung Joohon
Published: January 2008

No consensus exists as to the most sensitive and specific obesity indicator associated with metabolic risk factors. We aimed to validate anthropometry as the predictor for obesity‐related metabolic risk factors through comparison with direct body composition measures in Korean adults. A total of 995 Korean women and 577 Korean men who participated in the Healthy Twin study were the subjects. Anthropometric measurements included BMI, waist circumference (WC), waist‐to‐hip ratio (WHR), and waist‐to‐height ratio (WHTR). Direct body composition measures included the percentage of body fat (%BF) measured using dual‐energy X‐ray absorptiometry scanners and bioelectrical impedance analyzer (BIA). The following criteria were used to define abnormal metabolic risk factors: blood pressure ≥ 130/85 mm Hg, fasting glucose (≥ 100 mg/dl), insulin (≥ 25 μU/ml), homeostasis model assessment (HOMA) (≥ 2.61), high‐density lipoprotein (HDL) (<40 mg/dl for men or <50 mg/dl for women), triacylglycerol (≥ 150 mg/dl), uric acid (>7 mg/dl for men or >6 mg/dl for women), high‐sensitivity C‐reactive protein (hs‐CRP) (≥ 2.11 mg/l). In multiple regression analyses (adjusted for age, education, smoking, alcohol, exercise and past/current medical history, and treated families as a random effect), WC, WHTR, and BMI were consistently associated with all metabolic risk factors regardless of the subject's gender. Some of the areas under the receiver‐operating characteristic curves regarding abnormal metabolic risk factors were significantly higher for the three indicators of central obesity than for %BF. Our study validates the usefulness of anthropometry over direct body fat measures to predict metabolic risks.
All‐cause and Cardiovascular Disease Mortality Increased With Metabolic Syndrome in Taiwanese
Authors: Huang Kuo‐Chin , Lee Long‐Teng , Chen Ching‐Yu , Sung Pei‐Kun
Published: January 2008

Objective: This study aimed to investigate the relationship between mortality and metabolic syndrome using the America Heart Association/National Heart Lung Blood Institute (AHA/NHLBI) and International Diabetes Federation (IDF) definitions in a Taiwanese cohort.

Methods and Procedures: A total of 124,513 participants, aged 20–94 years, from four nationwide health centers in Taiwan were recruited from 1998 to 1999. Cox proportional hazard regression analyses were used to estimate the relative risks (RRs) for all‐cause and cardiovascular disease (CVD) mortality for those with metabolic syndrome compared to those without metabolic syndrome over 8 years of follow‐up.

Results: The baseline prevalence of metabolic syndrome was 22.4% by the AHA/NHLBI and 13.9% by the IDF definition. A total of 2,762 deaths (527 CVD) occurred. Using the AHA/NHLBI definition, the RRs (95% confidence intervals) of all‐cause and CVD mortality were 1.21 (1.09–1.34) and 1.77 (1.40–2.24), respectively, in men and 1.30 (1.12–1.49) and 1.69 (1.19–2.42), respectively, in women. The association between metabolic syndrome and mortality was attenuated when using the IDF definition. Excluding subjects with diabetes or CVD at baseline, the RRs for CVD mortality still remained significant using the two definitions.

Discussion: Metabolic syndrome, using either the AHA/NHLBI or IDF definitions, is a common disorder in Taiwanese adults and is similarly associated with an increase in all‐cause and CVD mortality as found in Western populations. Our study suggests that Asians with metabolic syndrome are also at higher risk for death.
Obesity and Self‐reported General Health, Hawaii BRFSS: Are Polynesians at Higher Risk?
Authors: Ochner Margaret H. , Salvail Florentina R. , Ford Earl S. , Ajani Umed
Published: January 2008

Objective: This study compared the relationship between fair/poor general health status among overweight and obese Polynesians with that among other overweight and obese persons in Hawaii.

Methods and Procedures: Data were pooled from the 1998–2003 Hawaii Behavioral Risk Factor Surveillance System (BRFSS) and logistic regression used to examine the predictors of fair/poor health status.

Results: Polynesians were significantly more likely to be obese than non‐Polynesians; overweight Polynesians were more likely than other overweight individuals to report fair/poor health status. After adjusting for confounders, among Polynesians, being obese was no longer associated with fair/poor health. Non‐Polynesians who were obese (odds ratio 1.9; 95% confidence interval: 1.4–2.6), older, less educated, smokers, diabetic, hypertensive, and physically inactive were more likely to report fair/poor health.

Discussion: Although Polynesians were significantly more obese than the rest of the Hawaii population, their weight was not independently associated with their odds for fair/poor health as it was with non‐Polynesians. The difference may be that, for Polynesians, hypertension and diabetes overrode the effect of obesity on general health status or this group maintains different cultural perceptions of body size. Regardless, these findings show a major health risk among Polynesians and suggest the need for culturally specific health interventions.
Atherogenecity of LDL and Unfavorable Adipokine Profile in Metabolically Obese, Normal‐weight Woman
Authors: Hyun Y.J. , Koh S.J. , Chae J.S. , Kim J.Y. , Kim O.Y. , Lim H.H. , Jang Y. , Park S. , Ordovas Jose M. , Lee J.H.
Published: January 2008

Objective: The relationship of visceral adiposity with adipocytokines and low‐density lipoprotein (LDL) particle distribution and oxidation in Asian metabolically obese, normal‐weight (MONW) individuals has not been evaluated. We aimed to investigate the association between visceral adiposity and adipocytokines and cardiovascular disease (CVD) risk factors in MONW Korean women with normal glucose tolerance.

Methods and Procedures: We examined the metabolic characteristics of 135 non‐obese (BMI <25 kg/m2) women aged 25–64 years. Twenty‐five women (BMI <25 kg/m2 and visceral fat adiposity (VFA) ≥100 cm2) were classified as MONW and 25 women (BMI <25 kg/m2 and VFA <100 cm2), pair‐matched for age, weight, height, and menopausal status, as control group. Plasma lipid profiles and adipocytokines were evaluated in these two groups.

Results: MONW subjects had higher systolic (P < 0.05) and diastolic blood pressure (P < 0.005) and higher concentrations of triacylglycerol (TG) (P < 0.005), insulin (P < 0.01), and free fatty acid (FFA) (P < 0.05) than control subjects. There was no significant difference between two groups in LDL‐cholesterol (LDL‐C) concentrations; however, MONW subjects had smaller LDL particles (P < 0.01) and higher concentrations of oxidized LDL (ox‐LDL) (P < 0.05) compared with controls. Moreover, MONW subjects had higher concentrations of tumor necrosis factor‐α (TNF‐α) (P < 0.05), interleukin‐6 (IL‐6) (P < 0.05) and leptin (P < 0.05), and lower plasma adiponectin concentrations (P < 0.05). Higher intake of saturated fat with lower ratio of polyunsaturated fatty acids (PUFAs) to saturated fatty acids (SFA) and lower fiber intake than normal subjects were found in MONW women.

Discussion: We found an unfavorable inflammatory profile and a more atherogenic LDL profile in MONW female subjects even in the absence of a known CVD risk factors. Moreover, MONW consumed more saturated fat and less fiber than the control group.