bluuebunny/crossref_metadata_2025 huggingface dataset:
Just who is at risk? The ethics of environmental regulation
Authors: Simon Ted
Published: July 2010

The willingness to view risk as part of daily life has vanished. A risk-averse mindset among environmental regulators engenders confusion between the ethics of intention and the ethics of consequence, leading to the elevation of the precautionary principle with unintended and often unfortunate outcomes. Environmental risk assessment is conservative, but the actual level of conservatism cannot be determined. High-end exposure assumptions and current toxicity criteria from the USEPA, based on linear extrapolation for carcinogens and default uncertainty factors for systemic toxicants, obscure the degree of conservatism in risk assessments. Ideally, one could choose a percentile of the target population to include within environmental standards, but this choice is complicated by the food, pharmaceutical and advertising industries, whose activities, inadvertent or not, often promote maladaptive and unhealthy lifestyle choices. There has lately been much discussion about background exposures and disease processes and their potential to increase the risk from environmental chemicals. Should these background exposures or disease processes, especially those associated with maladaptive individual choices, be included as part of a regulatory risk evaluation? A significant ethical question is whether environmental regulation should protect those pursuing a self-destructive lifestyle that may add to or synergize with otherwise innocuous environmental exposures. Choosing a target percentile of protection would provide an increased level of transparency and the flexibility to choose a higher or lower percentile if such a choice is warranted. Transparency and flexibility will lead to more responsive environmental regulation that balances protection of public health and the stewardship of societal resources.
I am Many: The Reconstruction of Self Following Acquired Brain Injury
Authors: Gelech Jan M. , Desjardins Michel
Published: July 2010

In this article we examine the construction of self following acquired brain injury from an experience-centered perspective. Life history and semistructured interview transcripts collected from four brain injury survivors were analyzed using thematic, syntactic, and deep structure analysis. Though notions of the “lost” or “shattered” self have dominated discussions of personhood in the acquired brain injury literature, we argue that this perspective is a crude representation of the postinjury experience of self, and that aspects of stability, recovery, transcendence, and moral growth are also involved in this process. We highlight the intersubjective nature of the self, and present the processes of delegitimation, invalidation, negotiation, and resistance as crucial aspects of the postinjury construction of personhood. We explore the implications of this complex process of construction of self for grief and bereavement theories, clinical practice, and professional discourse in the area of acquired brain injury.
Learning Formative Skills of Nursing Practice in an Accelerated Program
Authors: McNiesh Susan , Benner Patricia , Chesla Catherine
Published: July 2010

The purpose of this qualitative research study was to describe how students in an accelerated master’s degree entry program experientially learned the practice of nursing. One research question examined in this study was: What formative experiences did students identify as helping them develop and differentiate their clinical practice? Data from clinical observations and a combination of small group and individual interviews were collected and analyzed using interpretive phenomenological methods. Students identified formative skills learned through the independent care of a patient as pivotal in their identity and agency development. By experiencing the responsibility and action from within the body and from within concrete situations, students developed a new understanding that changed their embodied ways of perceiving and orienting to the situation, as well as their skills and sense of agency.
Masculinities in Motion Latino Men and Violence in Kentucky
Authors: Alcalde M. Cristina
Published: July 2010

Interviews with Latino men in Kentucky underscore multiple ways in which men negotiate being a man in a setting in which they find increased work opportunities yet experience heightened feelings of vulnerability. This article examines how men construct masculinity in response to three interrelated factors: migration, women’s behaviors, and peer pressure. These factors do not determine men’s use of violence, yet situating them within men’s lives allows us to better understand men’s on-the-ground experiences as well as possible connections between men and violence. Findings contribute to an emerging group of studies that examine the destabilization of masculinity and its connections to men’s use of violence against women. I suggest that the violence some Latino men use is symptomatic of men’s perception that they are losing power within broader, sometimes unfamiliar systems of oppression outside the home at the same time as women are gaining power.
Coalition agreement and party mandate: How coalition agreements constrain the ministers
Authors: Moury Catherine
Published: July 2010

In coalition government, the relationship between parties and ministers is one of double delegation: from the party to the minister and from the coalition of parties to the individual minister. On the basis of principal—agent theory, I argue that a coalition agreement is a tool used by coalition parties to reduce agency loss when delegating to ministers. In six governments in Belgium, Italy and The Netherlands, I show that: a majority of the pledges were transferred into cabinet decisions, a majority of cabinet decisions were effectively constrained by the coalition agreement and that one-third of cabinet decisions had been precisely defined beforehand in the document. Interestingly, the length of the coalition agreement, the entry of party leaders to government and the number of ministers participating in the negotiations do not seem to have had a significant influence on the above two measurements.
Mean voter representation and partisan constituency representation: Do parties respond to the mean voter position or to their supporters?
Authors: Ezrow Lawrence , De Vries Catherine , Steenbergen Marco , Edwards Erica
Published: July 2010

Do political parties respond to shifts in the preferences of their supporters, which we label the partisan constituency model, or to shifts in the mean voter position (the general electorate model)? Cross-national analyses — based on observations from Eurobarometer surveys and parties’ policy programmes in 15 countries from 1973 to 2002 — suggest that the general electorate model characterizes the policy shifts of mainstream parties. Alternatively, when we analyse the policy shifts of Communist, Green and extreme Nationalist parties (i.e. ‘niche’ parties), we find that these parties respond to shifts in the mean position of their supporters. The findings have implications for spatial theories and political representation.
Measuring party organization: The vertical dimension of the multi-level organization of state-wide parties in Spain and the UK
Authors: Fabre Elodie
Published: July 2010

Over the past few years, attention to the role of state-wide political parties in multi-level polities has increased in recognition of their linkage function between levels of government, as these parties compete in both state-wide and regional elections across their countries. This article presents a coding scheme designed to describe the relationship between central and regional levels of state-wide parties. It evaluates the involvement of the regional branches in central decision-making and their degree of autonomy in the management of regional party affairs. This coding scheme is applied to state-wide parties in Spain (the socialist PSOE and the conservative Partido Popular) and in the UK (Labour, the Conservatives and the Liberal Democrats). It is an additional tool with which to analyse party organization and it facilitates the comparison of parties across regions and in different countries.
Memory and the self in autism
Authors: Lind Sophie E.
Published: July 2010

This article reviews research on (a) autobiographical episodic and semantic memory, (b) the self-reference effect, (c) memory for the actions of self versus other (the self-enactment effect), and (d) non-autobiographical episodic memory in autism spectrum disorder (ASD), and provides a theoretical framework to account for the bidirectional relationship between memory and the self in ASD. It is argued that individuals with ASD have diminished psychological self-knowledge (as a consequence of diagnostic social and communication impairments), alongside intact physical self-knowledge, resulting in an under-elaborated self-concept. Consequently, individuals with ASD show impaired autobiographical episodic memory and a reduced self-reference effect (which may each rely on psychological aspects of the self-concept) but do not show specific impairments in memory for their own rather than others’ actions (which may rely on physical aspects of the self-concept). However, it is also argued that memory impairments in ASD (e.g., in non-autobiographical episodic memory) may not be entirely accounted for in terms of self-related processes. Other factors, such as deficits in memory binding, may also play a role. Finally, it is argued that deficits in autobiographical episodic memory and future thinking may result in a diminished temporally extended self-concept in ASD.
Total Thyroidectomy Performed With the Starion Vessel Sealing System Versus the Conventional Technique: A Prospective Randomized Trial
Authors: Scerrino Gregorio , Paladino Nunzia Cinzia , Di Paola Valentina , Morfino Giuditta , Matranga Domenica , Gulotta Gaspare , Bonventre Sebastiano
Published: July 2010

Meticulous dissection and accurate hemostasis are required in thyroid surgery. The authors recently performed a number of thyroidectomies using a new device that combines heat and pressure for sealing and cutting tissue. A prospective randomized trial was conducted on 98 patients subjected to total thyroidectomy for benign disease: 49 patients (group A) with the Starion tissue welding system and 49 (group B) with the clamp-and-tie technique. The 2 groups were comparable in mean age, gender, thyroidal volume (20-60 mL), incision length (<35 mm), and pathology. The authors evaluated operative time, postoperative serum calcemia, dosage and length of postoperative calcium and vitamin D treatment, drainage volume, hospital stay, and complications. Student’s t test was used for quantitative variables; for categorical variables, the χ 2 test or Fisher’s exact test, as appropriate, was used. The mean operative time was 53.8 ± 6.1 minutes in group A and 63.2 ± 8 minutes in group B ( P < .0001). The difference in terms of postoperative calcemia was significant (group A: 8.35 ± 0.39 mg/dL; group B: 8.08 ± 0.39 mg/dL; P < .001). The duration of postoperative treatment with calcium and vitamin D was significantly different (group A: 4 days; group B: 5 days; P < .039). No significant difference in terms of postoperative complications was found. The new system reduced operative time and the duration of postoperative hypocalcemia, and there was minimal tissue necrosis and thermal spread. The reduction in duration of postoperative calcium and vitamin D treatment is also an indication of improvement in quality of the treatment.
Total Parenteral Nutrition in the ICU
Authors: Neuman Tzvi , Kohli-Seth Roopa , Wilson Sara , Bassily-Marcus Adel
Published: July 2010

Malnutrition is seen commonly in critically ill patients and may contribute to overall morbidity and mortality. Total parenteral nutrition (TPN) is a specialized form of intravenous nutrition provided to patients with a nonfunctioning gut, malabsorption syndrome, or other indications that prevent enteral feeding. When used appropriately, TPN improves patient outcomes; however, inappropriate use can lead to infectious and metabolic complications. Dedicated multidisciplinary nutrition support teams (NSTs) improve patient safety and quality of care and can lead to tangible cost savings. This article describes indications for appropriate TPN use as developed by the Nutrition Care Committee of the Medical Board at Mount Sinai Hospital. The authors explain how to calculate goals for providing patient-specific nutrition, macronutrient and micronutrient compounding of the TPN formula, follow-up care, and the roles of indirect calorimetry and nitrogen balance. A sample TPN prescription and electronic nursing order set are provided.
Outcomes of pediatric bone marrow transplantation for leukemia and myelodysplasia using matched sibling, mismatched related, or matched unrelated donors
Authors: Shaw Peter J. , Kan Fangyu , Woo Ahn Kwang , Spellman Stephen R. , Aljurf Mahmoud , Ayas Mouhab , Burke Michael , Cairo Mitchell S. , Chen Allen R. , Davies Stella M. , Frangoul Haydar , Gajewski James , Gale Robert Peter , Godder Kamar , Hale Gregory A. , Heemskerk Martin B.A. , Horan John , Kamani Naynesh , Kasow Kimberly A. , Chan Ka Wah , Lee Stephanie J. , Leung Wing H. , Lewis Victor A. , Miklos David , Oudshoorn Machteld , Petersdorf Effie W. , Ringdén Olle , Sanders Jean , Schultz Kirk R. , Seber Adriana , Setterholm Michelle , Wall Donna A. , Yu Lolie , Pulsipher Michael A.
Published: July 2010

Although some trials have allowed matched or single human leukocyte antigen (HLA)–mismatched related donors (mmRDs) along with HLA-matched sibling donors (MSDs) for pediatric bone marrow transplantation in early-stage hematologic malignancies, whether mmRD grafts lead to similar outcomes is not known. We compared patients < 18 years old reported to the Center for International Blood and Marrow Transplant Research with acute myeloid leukemia, acute lymphoblastic leukemia, chronic myeloid leukemia, and myelodysplastic syndrome undergoing allogeneic T-replete, myeloablative bone marrow transplantation between 1993 and 2006. In total, patients receiving bone marrow from 1208 MSDs, 266 8/8 allelic-matched unrelated donors (URDs), and 151 0-1 HLA-antigen mmRDs were studied. Multivariate analysis showed that recipients of MSD transplants had less transplantation-related mortality, acute graft-versus-host disease (GVHD), and chronic GVHD, along with better disease-free and overall survival than the URD and mmRD groups. No differences were observed in transplant-related mortality, acute and chronic GVHD, relapse, disease-free survival, or overall survival between the mmRD and URD groups. These data show that mmRD and 8/8 URD outcomes are similar, whereas MSD outcomes are superior to the other 2 sources. Whether allele level typing could identify mmRD recipients with better outcomes will not be known unless centers alter practice and type mmRD at the allele level.
Human NK cells of mice with reconstituted human immune system components require preactivation to acquire functional competence
Authors: Strowig Till , Chijioke Obinna , Carrega Paolo , Arrey Frida , Meixlsperger Sonja , Rämer Patrick C. , Ferlazzo Guido , Münz Christian
Published: July 2010

To investigate human natural killer (NK)–cell reactivity in vivo we have reconstituted human immune system components by transplantation of human hematopoietic progenitor cells into NOD-scid IL2Rγnull mice. We demonstrate here that this model allows the development of all NK-cell subsets that are also found in human adult peripheral and cord blood, including NKp46+CD56− NK cells. Similar to human cord blood, NK cells from these reconstituted mice require preactivation by interleukin-15 to reach the functional competence of human adult NK cells. Mainly the terminally differentiated CD16+ NK cells demonstrate lower reactivity without this stimulation. After preactivation, both CD16+ and CD16− NK cells efficiently produce interferon-γ and degranulate in response to stimulation with NK cell–susceptible targets, including K562 erythroleukemia cells. NK-cell lines, established from reconstituted mice, demonstrate cytotoxicity against this tumor cell line. Importantly, preactivation can as well be achieved by bystander cell maturation via poly I:C stimulation in vitro and injection of this maturation stimulus in vivo. Preactivation in vivo enhances killing of human leukocyte antigen class I negative tumor cells after their adoptive transfer. These data suggest that a functional, but resting, NK-cell compartment can be established in immune-compromised mice after human hematopoietic progenitor cell transfer.
Targeting of survivin by nanoliposomal ceramide induces complete remission in a rat model of NK-LGL leukemia
Authors: Liu Xin , Ryland Lindsay , Yang Jun , Liao Aijun , Aliaga Cesar , Watts Rebecca , Tan Su-Fern , Kaiser James , Shanmugavelandy Sriram S. , Rogers Andrew , Loughran Kathleen , Petersen Bailey , Yuen Jonathan , Meng Fanxue , Baab Kendall Thomas , Jarbadan Nancy Ruth , Broeg Kathleen , Zhang Ranran , Liao Jason , Sayers Thomas Joseph , Kester Mark , Loughran Thomas P.
Published: July 2010

The natural killer (NK) type of aggressive large granular lymphocytic (LGL) leukemia is a fatal illness that pursues a rapid clinical course. There are no effective therapies for this illness, and pathogenetic mechanisms remain undefined. Here we report that the survivin was highly expressed in both aggressive and chronic leukemic NK cells but not in normal NK cells. In vitro treatment of human and rat NK-LGL leukemia cells with cell-permeable, short-chain C6-ceramide (C6) in nanoliposomal formulation led to caspase-dependent apoptosis and diminished survivin protein expression, in a time- and dose-dependent manner. Importantly, systemic intravenous delivery of nanoliposomal ceramide induced complete remission in the syngeneic Fischer F344 rat model of aggressive NK-LGL leukemia. Therapeutic efficacy was associated with decreased expression of survivin in vivo. These data suggest that in vivo targeting of survivin through delivery of nanoliposomal C6-ceramide may be a promising therapeutic approach for a fatal leukemia.
A novel latent membrane 2 transcript expressed in Epstein-Barr virus–positive NK- and T-cell lymphoproliferative disease encodes a target for cellular immunotherapy
Authors: Fox Christopher P. , Haigh Tracey A. , Taylor Graham S. , Long Heather M. , Lee Steven P. , Shannon-Lowe Claire , O'Connor Simon , Bollard Catherine M. , Iqbal Javeed , Chan Wing C. , Rickinson Alan B. , Bell Andrew I. , Rowe Martin
Published: July 2010

Therapeutic targeting of virus-encoded proteins using cellular immunotherapy has proved successful for Epstein-Barr virus (EBV)–associated posttransplant lymphoproliferative disease. However, the more limited repertoire and immunogenicity of EBV-encoded proteins in other malignancies such as Hodgkin lymphoma and extranodal natural killer (NK)/T lymphoma has been more challenging to target. The immunosubdominant latent membrane protein 2 (LMP2) is considered the optimal target in such Latency II tumors, although data relating to its expression in T/NK malignancies are limited. In addressing the validity of LMP2 as an immunotherapeutic target we found that LMP2-specific effector CD8+ T cells recognized and killed EBV-positive NK- and T-cell tumor lines, despite an apparent absence of LMP2A protein and barely detectable levels of LMP2 transcripts from the conventional LMP2A and LMP2B promoters. We resolved this paradox by identifying in these lines a novel LMP2 mRNA, initiated from within the EBV terminal repeats and containing downstream, epitope-encoding exons. This same mRNA was also highly expressed in primary (extra-nodal) NK/T lymphoma tissue, with virtually undetectable levels of conventional LMP2A/B transcripts. Expression of this novel transcript in T/NK-cell lymphoproliferative diseases validates LMP2 as an attractive target for cellular immunotherapy and implicates this truncated LMP2 protein in NK- and T-cell lymphomagenesis. This study is registered at clinicaltrials.gov as NCT00062868.
Protein structure modelling and evaluation based on a 4-distance description of side-chain interactions
Authors: Potapov Vladimir , Cohen Mati , Inbar Yuval , Schreiber Gideon
Published: July 2010

Background

Accurate evaluation and modelling of residue-residue interactions within and between proteins is a key aspect of computational structure prediction including homology modelling, protein-protein docking, refinement of low-resolution structures, and computational protein design.

Results

Here we introduce a method for accurate protein structure modelling and evaluation based on a novel 4-distance description of residue-residue interaction geometry. Statistical 4-distance preferences were extracted from high-resolution protein structures and were used as a basis for a knowledge-based potential, called Hunter. We demonstrate that 4-distance description of side chain interactions can be used reliably to discriminate the native structure from a set of decoys. Hunter ranked the native structure as the top one in 217 out of 220 high-resolution decoy sets, in 25 out of 28 "Decoys 'R' Us" decoy sets and in 24 out of 27 high-resolution CASP7/8 decoy sets. The same concept was applied to side chain modelling in protein structures. On a set of very high-resolution protein structures the average RMSD was 1.47 Å for all residues and 0.73 Å for buried residues, which is in the range of attainable accuracy for a model. Finally, we show that Hunter performs as good or better than other top methods in homology modelling based on results from the CASP7 experiment. The supporting web site http://bioinfo.weizmann.ac.il/hunter/ was developed to enable the use of Hunter and for visualization and interactive exploration of 4-distance distributions.

Conclusions

Our results suggest that Hunter can be used as a tool for evaluation and for accurate modelling of residue-residue interactions in protein structures. The same methodology is applicable to other areas involving high-resolution modelling of biomolecules.
MS4 - Multi-Scale Selector of Sequence Signatures: An alignment-free method for classification of biological sequences
Authors: Corel Eduardo , Pitschi Florian , Laprevotte Ivan , Grasseau Gilles , Didier Gilles , Devauchelle Claudine
Published: July 2010

Background

While multiple alignment is the first step of usual classification schemes for biological sequences, alignment-free methods are being increasingly used as alternatives when multiple alignments fail. Subword-based combinatorial methods are popular for their low algorithmic complexity (suffix trees ...) or exhaustivity (motif search), in general with fixed length word and/or number of mismatches. We developed previously a method to detect local similarities (the N-local decoding) based on the occurrences of repeated subwords of fixed length, which does not impose a fixed number of mismatches. The resulting similarities are, for some "good" values of N, sufficiently relevant to form the basis of a reliable alignment-free classification. The aim of this paper is to develop a method that uses the similarities detected by N-local decoding while not imposing a fixed value of N. We present a procedure that selects for every position in the sequences an adaptive value of N, and we implement it as the MS4 classification tool.

Results

Among the equivalence classes produced by the N-local decodings for all N, we select a (relatively) small number of "relevant" classes corresponding to variable length subwords that carry enough information to perform the classification. The parameter N, for which correct values are data-dependent and thus hard to guess, is here replaced by the average repetitivity κ of the sequences. We show that our approach yields classifications of several sets of HIV/SIV sequences that agree with the accepted taxonomy, even on usually discarded repetitive regions (like the non-coding part of LTR).

Conclusions

The method MS4 satisfactorily classifies a set of sequences that are notoriously hard to align. This suggests that our approach forms the basis of a reliable alignment-free classification tool. The only parameter κ of MS4 seems to give reasonable results even for its default value, which can be a great advantage for sequence sets for which little information is available.
Pleistocene glacial cycle effects on the phylogeography of the Chinese endemic bat species, Myotis davidii
Authors: You Yuyan , Sun Keping , Xu Lijie , Wang Lei , Jiang Tinglei , Liu Sen , Lu Guanjun , Berquist Sean W , Feng Jiang
Published: July 2010

Background

Global climatic oscillations, glaciation cycles and the unique geographic topology of China have profoundly influenced species population distributions. In most species, contemporary distributions of populations cannot be fully understood, except in a historical context. Complex patterns of Pleistocene glaciations, as well as other physiographic changes have influenced the distribution of bat species in China. Until this study, there had been no phylogeographical research on Myotis davidii, an endemic Chinese bat. We used a combination of nuclear and mitochondrial DNA markers to investigate genetic diversity, population structure, and the demographic history of M. davidii. In particular, we compared patterns of genetic variation to glacial oscillations, topography, and environmental variation during the Pleistocene in an effort to explain current distributions in light of these historical processes.

Results

M. davidii comprises three lineages (MEP, SWP and SH) based on the results of molecular variance analysis (AMOVA) and phylogenetic analyses. The results of a STRUCTURE analysis reveal multi-hierarchical population structure in M. davidii. Nuclear and mitochondrial genetic markers reveal different levels of gene flow among populations. In the case of mtDNA, populations adhere to an isolation-by-distance model, whereas the individual assignment test reveals considerable gene flow between populations. MDIV analysis indicate that the split of the MEP and SWP/SH lineages, and from the SWP and SH lineages were at 201 ka BP and 158 ka BP, respectively. The results of a mismatch distribution analysis and neutrality tests indicate a population expansion event at 79.17 ka BP and 69.12 ka BP in MEP and SWP, respectively.

Conclusions

The complex demographic history, discontinuous extant distribution of haplotypes, and multiple-hierarchy population structure of M. davidii appear associated with climatic oscillations, topography and eco-environmental variation of China. Additionally, the three regions are genetically differentiated from one another in the entire sample set. The degree of genetic differentiation, based on the analysis of mtDNA and nDNA, suggests a male-mediated gene flow among populations. Refuges were in the MEP, SH and the lower elevations of SWP regions. This study also provides insights for conservation management units (MEP, SWP and SH).
Constraints to virus infection in Nicotiana benthamiana plants transformed with a potyvirus amplicon
Authors: Calvo María , Dujovny Gabriela , Lucini Cristina , Ortuño Jesús , Alamillo Josefa M , Simón-Mateo Carmen , López-Moya Juan José , García Juan Antonio
Published: July 2010

Background

Plant genomes have been transformed with full-length cDNA copies of viral genomes, giving rise to what has been called 'amplicon' systems, trying to combine the genetic stability of transgenic plants with the elevated replication rate of plant viruses. However, amplicons' performance has been very variable regardless of the virus on which they are based. This has boosted further interest in understanding the underlying mechanisms that cause this behavior differences, and in developing strategies to control amplicon expression.

Results

Nicotiana benthamiana plants were transformed with an amplicon consisting of a full-length cDNA of the potyvirus Plum pox virus (PPV) genome modified to include a GFP reporter gene. Amplicon expression exhibited a great variability among different transgenic lines and even among different plants of the same line. Plants of the line 10.6 initially developed without signs of amplicon expression, but at different times some of them started to display sporadic infection foci in leaves approaching maturity. The infection progressed systemically, but at later times the infected plants recovered and returned to an amplicon-inactive state. The failure to detect virus-specific siRNAs in 10.6 plants before amplicon induction and after recovery suggested that a strong amplicon-specific RNA silencing is not established in these plants. However, the coexpression of extra viral silencing suppressors caused some amplicon activation, suggesting that a low level of RNA silencing could be contributing to maintain amplicon repression in the 10.6 plants. The resistance mechanisms that prevent amplicon-derived virus infection were also active against exogenous PPV introduced by mechanical inoculation or grafting, but did not affect other viruses. Amplicon-derived PPV was able to spread into wild type scions grafted in 10.6 rootstocks that did not display signs of amplicon expression, suggesting that resistance has little effect on virus movement.

Conclusions

Our results suggest that amplicon-derived virus infection is limited in this particular transgenic line by a combination of factors, including the presumed low efficiency of the conversion from the transgene transcript to replicable viral RNA, and also by the activation of RNA silencing and other defensive responses of the plant, which are not completely neutralized by viral suppressors.
Granulocytic sarcoma of the pancreas: A case report and review of the literatures
Authors: Rong Yefei , Wang Dansong , Lou Wenhui , Kuang Tiantao , Jin Dayong
Published: July 2010

Background

Granulocytic sarcoma (GS) is a form of acute myeloid leukemia (AML), also known as extramedullary myeloid tumor or chloroma. It forms a solid malignant tumor consisting of myelocytes or granulocytes and is typically located in bone while occurrence in other parts of the body is rare.

Case presentation

We reported a 40-year-old male patient who had jaundice, highly elevated bilirubin, and a mass highly suspicious of pancreatic head carcinoma. We performed surgery and the pathology and immunohistochemistry suggested GS; however the blood test and the bone marrow infiltration showed no evidence of AML. In our review of the published reports of GS, we only found six reports of the GS in the pancreas, and we suggested that immunohistochemical staining should be used to accurately differentiate GS from other pancreatic cancer and other types of leukemia.

Conclusions

The accurate diagnosis of GS is necessary for determining prognosis and deciding appropriate therapy.
Risk factors for multi-drug resistant Acinetobacter baumanniibacteremia in patients with colonization in the intensive care unit
Authors: Jung Ji Ye , Park Moo Suk , Kim Song Ee , Park Byung Hoon , Son Ji Young , Kim Eun Young , Lim Joo Eun , Lee Sang Kook , Lee Sang Hoon , Lee Kyung Jong , Kang Young Ae , Kim Se Kyu , Chang Joon , Kim Young Sam
Published: July 2010

Background

Epidemic outbreaks of multi-drug resistant (MDR) Acinetobacter baumannii (AB) in intensive care units (ICUs) are increasing. The incidence of MDR AB bacteremia, which develops as a result of colonization, is increasing through widespread dissemination of the pathogen, and further colonization. We sought to determine risk factors for MDR AB bacteremia in patients colonized with MDR AB in the ICU.

Methods

We conducted a retrospective, observational study of 200 patients colonized with MDR AB in the ICU at Severance Hospital, South Korea during the outbreak period between January 2008 and December 2009.

Results

Of the 200 patients colonized with MDR AB, 108 developed MDR AB bacteremia, and 92 did not. APACHE II scores were higher in bacteremic than non-bacteremic patients at the time of ICU admission and colonization (24.0 vs. 21.6; P = 0.035, 22.9 vs. 16.8; P < 0.001, respectively). There was no difference between the two groups in the duration of time from ICU admission to colonization (7.1 vs. 7.2 days; P = 0.923), but the duration of time at risk was shorter in bacteremic patients (12.1 vs. 6.0 days; P = 0.016). A recent invasive procedure was a significant risk factor for development of bacteremia (odds ratio = 3.85; 95% CI 1.45-10.24; P = 0.007). Multivariate analysis indicated infection and respiratory failure at the time of ICU admission, maintenance of mechanical ventilation, maintenance of endotracheal tube instead of switching to a tracheostomy, recent central venous catheter insertion, bacteremia caused by other microorganism after colonization by MDR AB, and prior antimicrobial therapy, were significant risk factors for MDR AB bacteremia.

Conclusions

Patients in the ICU, colonized with MDR AB, should be considered for minimizing invasive procedures and early removal of the invasive devices to prevent development of MDR AB bacteremia.
Adjuvant radiotherapy and chemotherapy in breast cancer: 30 year follow-up of survival
Authors: McArdle Colin S , McMillan Donald C , Greenlaw Nicola , Morrison David S
Published: July 2010

Background

The long term outcome (more than 15 years) of adjuvant treatment in patients with primary operable breast cancer has rarely been examined.

Methods

A randomised clinical trial of radiotherapy, chemotherapy (28 day cycles of cyclophosphamide, methotrexate and 5-fluorouracil) or both on women with primary operable breast cancer (n = 322) was followed-up for a median of 27 years.

Results

260 (81%) patients died, 204 (78%) from breast cancer. Cancer specific survival (SE) at 10 years, 20 years and 30 years was 41 (3)%, 34 (3)% and 33 (3)% respectively. Presence of more than 3 involved lymph nodes increased cancer-specific mortality (HR 1.88, 95% CI 1.34-2.63) after adjustment for age, socio-economic deprivation and adjuvant treatment. Both age (HR 1.63, 95% CI 1.19-2.22) and involved lymph nodes (HR 1.59, 95% CI 1.17-2.14) were significant predictors of all-cause mortality after adjustment for other factors. There was no significant difference in all-cause or cancer-specific survival between patients in each of the 3 treatment arms.

Conclusions

The present study highlights the long term impact of node positive disease but does not indicate that any regimen was associated with significantly better long-term survival.
Increasing late diagnosis in HIV infection in South Korea: 2000-2007
Authors: Lee Jin-Hee , Kim Gab Jung , Choi Byeong-Sun , Hong Kee-Jong , Heo Mi-Kyung , Kim Sung Soon , Kee Mee-Kyung
Published: July 2010

Background

The number of Koreans diagnosed with human immunodeficiency virus (HIV) infections is increasing annually; however, CD4+ T-cell counts at diagnosis have decreased. The purpose of the present study was to identify clinical and epidemiologic associations with low CD4+ T-cell counts at the time of HIV diagnosis in a Korean population.

Methods

Data from 2,299 HIV-infected individuals with initial CD4+ T-cell counts measured within 6 months of HIV diagnosis and reason for HIV testing were recorded and measured from 2000 to 2007. Data were selected from the database of the Korea Centers for Disease Control and Prevention. Late diagnosis was defined by CD4+ T-cell counts <200 cells/mm3. Reasons for HIV testing were analyzed using logistic regression including epidemiologic variables.

Results

A total of 858 individuals (37.3%) were included in the late diagnosis group. Individuals with a late diagnosis were older, exposed through heterosexual contact, and demonstrated clinical manifestations of acquired immunodeficiency syndrome (AIDS). The primary reason for HIV testing was a routine health check-up (41%) followed by clinical manifestations (31%) of AIDS. The proportion of individuals with a late diagnosis was higher in individuals tested due to clinical symptoms in public health centers (adjusted odds ratio [AOR], 17.3; 95% CI, 1.7-175) and hospitals (AOR, 4.9; 95% CI, 3.4-7.2) compared to general health check-up. Late diagnosis annually increased in individuals diagnosed by voluntary testing both in public health centers (PHCs, P = 0.017) and in hospitals (P = 0.063). Routine testing due to risky behaviors resulted in earlier detection than testing secondary to health check-ups, although this difference was not statistically significant (AOR, 0.7; P = 0.187). Individuals identified as part of hospital health check-ups more frequently had a late diagnosis (P = 0.001)

Conclusions

HIV infection was primarily detected by voluntary testing with identification in PHCs and by testing due to clinical symptoms in hospitals. However, early detection was not influenced by either voluntary testing or general health check-up. It is important to encourage voluntary testing for early detection to decrease the prevalence of HIV infection and AIDS progression.
EDUCORE project: a clinical trial, randomised by clusters, to assess the effect of a visual learning method on blood pressure control in the primary healthcare setting
Authors: Rodríguez-Salceda Isidro , Escortell-Mayor Esperanza , Rico-Blázquez Milagros , Riesgo-Fuertes Rosario , Asúnsolo-del Barco Angel , Valdivia-Pérez Antonio , del Cura-González Isabel , García-Cañón Ana B , Ortiz-Jiménez María F , Cabello-Ballesteros Luisa , Garrido-Elustondo Sofia , Chamorro-González Laura , Rodríguez-Barrientos Ricardo ,   the EDUCORE Group
Published: July 2010

Background

High blood pressure (HBP) is a major risk factor for cardiovascular disease (CVD). European hypertension and cardiology societies as well as expert committees on CVD prevention recommend stratifying cardiovascular risk using the SCORE method, the modification of lifestyles to prevent CVD, and achieving good control over risk factors. The EDUCORE (Education and Coronary Risk Evaluation) project aims to determine whether the use of a cardiovascular risk visual learning method - the EDUCORE method - is more effective than normal clinical practice in improving the control of blood pressure within one year in patients with poorly controlled hypertension but no background of CVD;

Methods/Design

This work describes a protocol for a clinical trial, randomised by clusters and involving 22 primary healthcare clinics, to test the effectiveness of the EDUCORE method. The number of patients required was 736, all between 40 and 65 years of age (n = 368 in the EDUCORE and control groups), all of whom had been diagnosed with HBP at least one year ago, and all of whom had poorly controlled hypertension (systolic blood pressure ≥ 140 mmHg and/or diastolic ≥ 90 mmHg). All personnel taking part were explained the trial and trained in its methodology. The EDUCORE method contemplates the visualisation of low risk SCORE scores using images embodying different stages of a high risk action, plus the receipt of a pamphlet explaining how to better maintain cardiac health. The main outcome variable was the control of blood pressure; secondary outcome variables included the SCORE score, therapeutic compliance, quality of life, and total cholesterol level. All outcome variables were measured at the beginning of the experimental period and again at 6 and 12 months. Information on sex, age, educational level, physical activity, body mass index, consumption of medications, change of treatment and blood analysis results was also recorded;

Discussion

The EDUCORE method could provide a simple, inexpensive means of improving blood pressure control, and perhaps other health problems, in the primary healthcare setting;

Trial registration

The trial was registered with ClinicalTrials.gov, number NCT01155973 [http://ClinicalTrials.gov].
Global expression studies in baker's yeast reveal target genes for the improvement of industrially-relevant traits: the cases of CAF16 and ORC2
Authors: Pérez-Torrado Roberto , Panadero Joaquín , Hernández-López María José , Prieto José Antonio , Randez-Gil Francisca
Published: July 2010

Background

Recent years have seen a huge growth in the market of industrial yeasts with the need for strains affording better performance or to be used in new applications. Stress tolerance of commercial Saccharomyces cerevisiae yeasts is, without doubt, a trait that needs improving. Such trait is, however, complex, and therefore only in-depth knowledge of their biochemical, physiological and genetic principles can help us to define improvement strategies and to identify the key factors for strain selection.

Results

We have determined the transcriptional response of commercial baker's yeast cells to both high-sucrose and lean dough by using DNA macroarrays and liquid dough (LD) model system. Cells from compressed yeast blocks display a reciprocal transcription program to that commonly reported for laboratory strains exposed to osmotic stress. This discrepancy likely reflects differences in strain background and/or experimental design. Quite remarkably, we also found that the transcriptional response of starved baker's yeast cells was qualitatively similar in the presence or absence of sucrose in the LD. Nevertheless, there was a set of differentially regulated genes, which might be relevant for cells to adapt to high osmolarity. Consistent with this, overexpression of CAF16 or ORC2, two transcriptional factor-encoding genes included in this group, had positive effects on leavening activity of baker's yeast. Moreover, these effects were more pronounced during freezing and frozen storage of high-sucrose LD.

Conclusions

Engineering of differentially regulated genes opens the possibility to improve the physiological behavior of baker's yeast cells under stress conditions like those encountered in downstream applications.
Prevalence and characterization of plasmids carrying sulfonamide resistance genes among Escherichia coli from pigs, pig carcasses and human
Authors: Wu Shuyu , Dalsgaard Anders , Hammerum Anette M , Porsbo Lone J , Jensen Lars B
Published: July 2010

Background

Sulfonamide resistance is very common in Escherichia coli. The aim of this study was to characterize plasmids carrying sulfonamide resistance genes (sul1, sul2 and sul3) in E. coli isolated from pigs and humans with a specific objective to assess the genetic diversity of plasmids involved in the mobility of sul genes.

Methods

A total of 501 E. coli isolates from pig feces, pig carcasses and human stools were tested for their susceptibility to selected antimicrobial. Multiplex PCR was conducted to detect the presence of three sul genes among the sulfonamide-resistant E. coli isolates. Fifty-seven sulfonamide-resistant E. coli were selected based on presence of sul resistance genes and subjected to conjugation and/or transformation experiments. S1 nuclease digestion followed by pulsed-field gel electrophoresis was used to visualize and determine the size of plasmids. Plasmids carrying sul genes were characterized by PCR-based replicon typing to allow a comparison of the types of sul genes, the reservoir and plasmid present.

Results

A total of 109/501 isolates exhibited sulfonamide resistance. The relative prevalences of sul genes from the three reservoirs (pigs, pig carcasses and humans) were 65%, 45% and 12% for sul2, sul1, and sul3, respectively. Transfer of resistance through conjugation was observed in 42/57 isolates. Resistances to streptomycin, ampicillin and trimethoprim were co-transferred in most strains. Class 1 integrons were present in 80% of sul1-carrying plasmids and 100% of sul3-carrying plasmids, but only in 5% of sul2-carrying plasmids. The sul plasmids ranged from 33 to 160-kb in size and belonged to nine different incompatibility (Inc) groups: FII, FIB, I1, FIA, B/O, FIC, N, HI1 and X1. IncFII was the dominant type in sul2-carrying plasmids (52%), while IncI1 was the most common type in sul1 and sul3-carrying plasmids (33% and 45%, respectively). Multireplicons were found associated with all three sul genes.

Conclusions

Sul genes were distributed widely in E. coli isolated from pigs and humans with sul2 being most prevalent. Sul-carrying plasmids belonged to diverse replicon types, but most of detected plasmids were conjugative enabling horizontal transfer. IncFII seems to be the dominant replicon type in sul2-carrying plasmids from all three sources.
Comparison between mechanical power requirements of flight estimated using an aerodynamic model andin vitromuscle performance in the cockatiel (Nymphicus hollandicus)
Authors: Morris Charlotte R. , Askew Graham N.
Published: July 2010

There have been few comparisons between the relationship between the mechanical power requirements of flight and flight speed obtained using different approaches. It is unclear whether differences in the power–speed relationships reported in the literature are due to the use of different techniques for determining flight power or due to inter-specific differences. Here we compare the power–speed relationships in cockatiels (Nymphicus hollandicus) determined using both an aerodynamic model and measurements of in vitro performance of bundles of pectoralis muscle fibres under simulated in vivo strain and activity patterns. Aerodynamic power was calculated using different ranges of values for the coefficients in the equations: induced power factor (k 1.0–1.4), the profile (CD,pro 0.01–0.03) and parasite drag (CD,par 0.05–0.195) coefficients. We found that the aerodynamic power-speed relationship was highly sensitive to the values assumed for these coefficients and best fit the power calculated from in vitro muscle performance when k=1.2, CD,pro=0.02 and CD,par=0.13.
The metabolic power requirements of flight and estimations of flight muscle efficiency in the cockatiel (Nymphicus hollandicus)
Authors: Morris Charlotte R. , Nelson Frank E. , Askew Graham N.
Published: July 2010

Little is known about how in vivo muscle efficiency, that is the ratio of mechanical and metabolic power, is affected by changes in locomotory tasks. One of the main problems with determining in vivo muscle efficiency is the large number of muscles generally used to produce mechanical power. Animal flight provides a unique model for determining muscle efficiency because only one muscle, the pectoralis muscle, produces nearly all of the mechanical power required for flight. In order to estimate in vivo flight muscle efficiency, we measured the metabolic cost of flight across a range of flight speeds (6–13 m s−1) using masked respirometry in the cockatiel (Nymphicus hollandicus) and compared it with measurements of mechanical power determined in the same wind tunnel. Similar to measurements of the mechanical power–speed relationship, the metabolic power–speed relationship had a U-shape, with a minimum at 10 m s−1. Although the mechanical and metabolic power–speed relationships had similar minimum power speeds, the metabolic power requirements are not a simple multiple of the mechanical power requirements across a range of flight speeds. The pectoralis muscle efficiency (estimated from mechanical and metabolic power, basal metabolism and an assumed value for the ‘postural costs’ of flight) increased with flight speed and ranged from 6.9% to 11.2%. However, it is probable that previous estimates of the postural costs of flight have been too low and that the pectoralis muscle efficiency is higher.