bluuebunny/crossref_metadata_2025 huggingface dataset:
Early activation of the coagulation system during lower body negative pressure
Authors: Zaar M. , Johansson P. I. , Nielsen L. B. , Crandall C. G. , Shibasaki M. , Hilsted L. , Secher N. H.
Published: July 2009

We considered that a moderate reduction of the central blood volume (CBV) may activate the coagulation system. Lower body negative pressure (LBNP) is a non‐invasive means of reducing CBV and, thereby, simulates haemorrhage. We tested the hypothesis that coagulation markers would increase following moderate hypovolemia by exposing 10 healthy male volunteers to 10 min of 30 mmHg LBNP. Thoracic electrical impedance increased during LBNP (by 2·6 ± 0·7 Ω, mean ± SD; P < 0·001), signifying a reduced CBV. Heart rate was unchanged during LBNP, while mean arterial pressure decreased (84 ± 5 to 80 ± 6 mmHg; P < 0·001) along with stroke volume (114 ± 22 to 96 ± 19 ml min−1; P < 0·001) and cardiac output (6·4 ± 2·0 to 5·5 ± 1·7 l min−1; P < 0·01). Plasma thrombin–antithrombin III complexes increased (TAT, 5 ± 6 to 19 ± 20 μg l−1; P < 0·05), indicating that LBNP activated the thrombin generating part of the coagulation system, while plasma D‐dimer was unchanged, signifying that the increased thrombin generation did not cause further intravascular clot formation. The plasma pancreatic polypeptide level decreased (13 ± 11 to 6 ± 8 pmol l−1; P < 0·05), reflecting reduced vagal activity. In conclusion, thrombin generation was activated by a modest decrease in CBV by LBNP in healthy humans independent of the vagal activity.
Quiet Resting is Not Necessary Prior to Routine Antenatal Blood Pressure Measurement
Authors: Duggan P.M.
Published: July 2009

Summary: A premeasurement period of 5 minutes quiet resting is recommended prior to measuring blood pressure. The aim of this study was to determine the effect of this period of rest on the level of blood pressure in pregnant women. One hundred pregnant women had their blood pressure measured on a single visit using a QuietTrak ambulatory blood pressure monitor, used to remove human observer bias. Group 1 (n = 50) had blood pressure measured as soon as possible on entering the clinic room and again after 5 minutes rest. Group 2 were rested for 5 minutes on entry to the clinic room prior to the first blood pressure measurement and had the second measurement taken after a further 5 minutes rest. Results were compared in the 2 groups using ANOVA. In Group 1, the initial, mean systolic blood pressure was 116.6 versus 115.5 mmHg taken after 5 minutes quiet rest (p = 0.66). The corresponding diastolic values were 66.2 versus 64.1 (p = 0.40). In Group 2, the initial mean systolic blood pressure was 116.2 versus 115.6 taken after 5 minutes quiet rest (p = 0.85). The corresponding diastolic values were 68.5 versus 65.6 (p = 0.34). Blood pressure was as likely to rise as to fall after a period of quiet rest. It is not necessary to have pregnant women quietly resting during routine visits before having blood pressure measured.
Cost Consequences of Implementation of an Early Obstetrical Discharge Programme in a Military Teaching Hospital*
Authors: LTC Byron C. Calhoun , Capt Delores Gries , Maj Wanda Barfield , Capt Christine Kovac , Col Roderick Hume
Published: July 2009

Summary: We evaluate the cost consequence of a voluntary early obstetrical discharge programme in a military teaching hospital. The study involved a control group of routine obstetrical discharge patients with uncomplicated vaginal delivery from March 1 to August 31, 1994 and the study group of early obstetrical discharge (24–48 hours) patients with uncomplicated vaginal delivery from March 1 to August 31, 1996. There were 1,042 total control patients with routine vaginal delivery totalling 2,668 hospital days with a mean number of hospital days of 2.56 per patient. The study group of early obstetrical discharge patients with uncomplicated vaginal delivery encompassed 1,050 patients with 1,965 hospital days with mean hospital days of 1.87 per patient (p <0.05) without an increase in postpartum clinic or emergency room visits. The total cost of admissions (cost calculation of $1,221 per hospital day) fell from $3,257, 628 in the routine discharge group to $2,399,625 in the early discharge cohort showing a total cost savings of $858,003 over the 6‐months study period. The average cost per obstetrical admission for routine vaginal delivery fell from $3,126 per day to $2,285 per day without an increase in the postpartum paediatric adverse outcomes. Maternal postpartum readmission rates were statistically significantly increased (p <0.05) in the study group at 0.6% with an OR[2.32(2.17, 6.92)] but all readmissions fell outside the 48‐hour early discharge window. This programme showed significant cost savings without concomitant increase in paediatric or maternal adverse outcomes.
Decrease in Incidence of Gestational Diabetes Mellitus in Far North Queensland Between 1992 and 1996
Authors: Kim Stephano , Humphrey Michael D.
Published: July 2009

Summary: The pregnant population in Far North Queensland is at high risk of medical complications, such as diabetes, compared to the general Australian population (1,2). This retrospective observational study shows a true decline in the incidence of gestational diabetes mellitus (GDM) in this region over a 5‐year period (1992–1996), contradicting the current belief that the incidence of GDM is increasing in non‐Caucasian Australians. Although this change may be due to an improvement in medical and/or dietary intervention in this region, the real cause for the decline is yet to be recognized.
Female Genital Mutilation ‐ Experience of The Royal Women's Hospital, Melbourne
Authors: Knight Rachael , Hotchin Ann , Bayly Chris , Grover Sonia
Published: July 2009

Summary: This study was performed to improve our knowledge and understanding of the needs of women affected by female genital mutilation. We looked at the types of complications of these practices which present to a large metropolitan women's hospital in order to determine how we can appropriately treat and support affected women. This was an observational study of women from countries with a high prevalence of female genital mutilation who presented to the Royal Women's Hospital between October, 1995 and January, 1997. Fifty one patients with a past history of female genital mutilation who were attending the hospital for antenatal or gynaecological care consented to participate in the study. We found that 77.6% of women identified as having had female genital mutilation had undergone infibulation. More than 85% of the women in our study reported a complication of the procedure. The major complications were dyspareunia, apareunia and urinary tract infections; 29.4% of these women required surgery to facilitate intercourse. In our study group there was no difference in Caesarean section rates between the women who had previously delivered in Australia compared with those who had delivered in Africa. Women who have had a female genital mutilation procedure have specific needs for their care which present challenges to both their general practitioners and obstetrician/gynaecologists. These women have significant complications related to their procedure including social and psychosexual problems which require sympathetic management.
Contribution of the Assisted Reproductive Technologies to Fertility in Males Suffering Spinal Cord Injury
Authors: Taylor Zoe , Molloy David , Hill Vernon , Harrison Keith
Published: July 2009

Summary: This study reviews 19 couples referred between 1990 and 1997 for fertility treatment for anejaculatory infertility in the male partner following spinal injury. Using sperm obtained by assisted ejaculation procedures, 14 of the 19 patients (74%) achieved at least 1 pregnancy. Pregnancy rates per treatment cycle were 12.0% for timed intrauterine insemination, 38.9% for gamete intra‐Fallopian transfer and 19.2% for intracytoplasmic sperm injection followed by uterine embryo transfer. Choice of the appropriate assisted reproduction treatment to match the available semen quality results in a high level of success in such patients.
Management of Uterine Leiomyosarcoma in Australia
Authors: Card Gregory B. , Mulvany Nicholas J. , Quinn Michael A.
Published: July 2009

Summary: Uterine leiomyosarcoma is an uncommon malignancy for which the management varies widely between individual gynaecologists and gynaecological oncology units. We have performed a retrospective review of patients treated at both the Royal Women's Hospital in Melbourne (1970–1997) and King George V Hospital in Sydney (1987–1993). In addition we have performed a survey of Certified Gynaecological Oncologists (CGO's) to assess the current management of uterine leiomyosarcomas in Australia. The results show varied management practices exist in Australia, many of which are not supported by evidence in the current literature. Oophorectomy in the premenopausal patient appears unnecessary unless the ovaries are macroscopically involved. The role of pelvic lymphadenectomy is debatable. This practice was recommended by many CGO's, yet these nodes are rarely positive unless obvious extrauterine disease is present. Adjuvant chemotherapy appears not to have a role at present unless in a trial setting. Adjuvant radiotherapy does appear to have a potential palliative role as it prevents locoregional relapse, although survival is not prolonged. Until suitable phase 3 trials are available, gynaecological oncology units should be meticulous in prospectively recording the clinical course of their patients and critically analyzing their current management strategies.
ULTRASTRUCTURAL CHARACTERIZATION OF THE LYTIC CYCLE OF AN INTRANUCLEAR VIRUS INFECTING THE DIATOM CHAETOCEROS CF. WIGHAMII(BACILLARIOPHYCEAE) FROM CHESAPEAKE BAY, USA1
Authors: Eissler Yoanna , Wang Kui , Chen Feng , Eric Wommack K. , Wayne Coats D.
Published: July 2009

Numerous microalgal species are infected by viruses that have the potential to control phytoplankton dynamics by reducing host populations, preventing bloom formation, or causing the collapse of blooms. Here we describe a virus infecting the diatom Chaetoceros cf. wighamii Brightw. from the Chesapeake Bay. To characterize the morphology and lytic cycle of this virus, we conducted a time‐course experiment, sampling every 4 h over 72 h following viral inoculation. In vivo fluorescence began to decline 16 h after inoculation and was reduced to <19% of control cultures by the end of experiment. TEM confirmed infection within the first 8 h of inoculation, as indicated by the presence of virus‐like particles (VLP) in the nuclei. VLP were present in two different arrangements: rod‐like structures that appeared in cross‐section as paracrystalline arrays of hexagonal‐shaped profiles measuring 12 ± 2 nm in diameter and uniformly electron‐dense hexagonal‐shaped particles measuring ∼ 22–28 nm in diameter. Nuclei containing paracrystalline arrays were most prevalent early in the infection cycle, while cells containing VLP increased and then declined toward the end of the cycle. The proportion of nuclei containing both paracrystalline arrays and VLP remained relatively constant. This pattern suggests that rod‐like paracrystalline arrays fragmented to produce icosahedral VLP. C. cf. wighamii nuclear inclusion virus (CwNIV) is characterized by a high burst size (averaged 26,400 viruses per infected cell) and fast generation time that could have ecological implications on C. cf. wighamii population control.
PHOTOSYNTHETIC INORGANIC CARBON ACQUISITION IN AN ACID‐TOLERANT, FREE‐LIVING SPECIES OF COCCOMYXA (CHLOROPHYTA)1
Authors: Verma Vidhu , Bhatti Shabana , Huss Volker A. R. , Colman Brian
Published: July 2009

The processes of CO2 acquisition were characterized for the acid‐tolerant, free‐living chlorophyte alga, CPCC 508. rDNA data indicate an affiliation to the genus Coccomyxa, but distinct from other known members of the genus. The alga grows over a wide range of pH from 3.0 to 9.0. External carbonic anhydrase (CA) was detected in cells grown above pH 5, with the activity increasing marginally from pH 7 to 9, but most of the CA activity was internal. The capacity for HCO3− uptake of cells treated with the CA inhibitor acetazolamide (AZA), was investigated by comparing the calculated rate of uncatalyzed CO2 formation with the rate of photosynthesis. Active bicarbonate transport occurred in cells grown in media above pH 7.0. Monitoring CO2 uptake and O2 evolution by membrane‐inlet mass spectrometry demonstrated that air‐grown cells reduced the CO2 concentration in the medium to an equilibrium concentration of 15 μM, but AZA‐treated cells caused a drop in extracellular CO2 concentration to a compensation concentration of 27 μM at pH 8.0. CO2‐pulsing experiments with cells in the light indicated that the cells do not actively take up CO2. An internal pool of unfixed inorganic carbon was not detected at the CO2 compensation concentration, probably because of the lack of active CO2 uptake, but was detectable at times before compensation point was reached. These results indicate that this free‐living Coccomyxa possesses a CO2‐concentrating mechanism (CCM) due to an active bicarbonate‐uptake system, unlike the Coccomyxa sp. occurring in symbiotic association with lichens.
Securitization, Insurance, and Reinsurance
Authors: Cummins J. David , Trainar Philippe
Published: July 2009

Abstract

This article considers strengths and weaknesses of reinsurance and securitization in managing insurable risks. Traditional reinsurance operates efficiently in managing relatively small, uncorrelated risks and in facilitating efficient information sharing between cedants and reinsurers. However, when the magnitude of potential losses and the correlation of risks increase, the efficiency of the reinsurance model breaks down, and the cost of capital may become uneconomical. At this juncture, securitization has a role to play by passing the risks along to broader capital markets. Securitization also serves as a complement for reinsurance in other ways such as facilitating regulatory arbitrage and collateralizing low‐frequency risks.
Incremental Pacing for the Diagnosis of Complete Cavotricuspid Isthmus Block During Radiofrequency Ablation of Atrial Flutter
Authors: BAZAN VICTOR , MARTÍ‐ALMOR JULIO , PEREZ‐RODON JORDI , BRUGUERA JORDI , GERSTENFELD EDWARD P. , CALLANS DAVID J. , MARCHLINSKI FRANCIS E.
Published: July 2009

Incremental Pacing for the Diagnosis of Cavotricuspid Isthmus Block. Background: Complete conduction block of the cavotricuspid isthmus (CTI) reduces atrial flutter recurrences after ablation. Incremental rapid pacing may distinguish slow conduction from complete CTI conduction block.

Methods and Results: Fifty‐two patients (67 ± 9 years) undergoing 55 CTI ablation procedures were included. With ablation, double potentials (DPs) separated by an isoelectric line of ≥30 ms were obtained. Incremental atrial pacing (600–250 ms) was performed from coronary sinus (CS) and low lateral right atrium (LLRA). A <20 ms increase in the DPs distance during incremental pacing was indexed as complete CTI block. In 8 patients, an initial <20 ms DPs distance increase was noted; direct complete isthmus block was suggested and no additional ablation performed. In the remaining, the CTI line was remapped for conduction gaps and additional radiofrequency energy pulses applied. Complete block, as indexed by incremental pacing, occurred in 46 of 55 procedures, with one flutter recurrence (follow‐up 8 ± 2 months): DPs interval variation of 116 ± 20 to 123 ± 20 ms (CS), P = 0.21; and 122 ± 25 to 135 ± 35 ms (LLRA), P = 0.17. The remaining 9 patients (persistent rate‐dependent DPs increase) presented 3 flutter recurrences, P = 0.01: DP distance from 127 ± 15 to 161 ± 18 ms (CS), P < 0.001; and 114 ± 24 to 142 ± 10 ms (LLRA), P = 0.007.

Conclusion: Incremental pacing distinguishes complete CTI block from persistent conduction. Such identification, accompanied by additional ablation to achieve block, should minimize flutter recurrences after ablative therapy. (J Cardiovasc Electrophysiol, Vol. 21, pp. 33–39, January 2010)
Early Detection of Pulmonary Vein Reconnection After Isolation in Patients With Paroxysmal Atrial Fibrillation: A Comparison of ATP‐Induction and Reassessment at 30 Minutes Postisolation
Authors: JIANG CHEN‐YANG , JIANG RU‐HONG , MATSUO SEIICHIRO , LIU QIANG , FAN YOU‐QI , ZHANG ZHU‐WEN , FU GUO‐SHENG
Published: July 2009

Introduction: Catheter ablation for paroxysmal AF (PAF) is limited by an unacceptable recurrence rate, mainly due to pulmonary vein (PV) reconnection. Strategies to minimize reconnection include adenosine infusion and also a waiting period of 30 minutes after PV isolation. The aim of the present study was to assess whether these two strategies revealed the same conduction gap.

Methods and Results: In total, 88 consecutive patients (54 males, mean age of 60 years) with drug refractory PAF underwent circumferential PV isolation (CPVI). After isolation of ipsilateral PVs, with entry and exit block checked using a circular mapping catheter, 20 mg ATP was injected during isoproterenol infusion to reveal dormant conduction gap(s). Unless the reconnection revealed by ATP persisted, PVs were further remapped with the circular mapping catheter at 30 minutes postisolation. Totally, PV reconnection was observed in 56 (64%) patients. 24.3% veins (80/329) were found reconnected. Reassessment at 30 minutes postablation was more efficient as compared to ATP induction (19.8% vs 14.6% for ATP). The agreement between these 2 methods is moderate (kappa value = 0.50). In veins that transiently reconnected after ATP administration and later observed at 30 minutes postablation, 94% (17 of 19) of them were found being reconnected with the same gap.

Conclusion: Acute PV reconnection is common, occurring in 64% of patients, as detected by adenosine infusion and waiting time. Each shows a unique quality as compared to one another. The combined use of these 2 methods may reduce the AF recurrence rate after CPVI.
Subgroup Hypotheses: Clinician’s Friend or Researcher’s Fiction?
Authors: Wyer Peter C.
Published: July 2009

Researchers and clinicians may be tempted to consider apparent differences in effects of interventions in subgroups of study populations for the purposes of individualizing care or directing subsequent focused research efforts. Such “subgroup hypotheses” have a high propensity of being artifacts of chance and are rarely supported when stringent criteria are applied. Subgroup hypotheses emerging from single trials should rarely if ever be considered for application. This article describes published criteria for evaluating the believability of a subgroup hypothesis and presents a conceptual framework for understanding the principles underlying those criteria. Examples of both failed and validated subgroup hypotheses drawn from emergency medicine research are given.
Climate Change and Emergency Medicine: Impacts and Opportunities
Authors: Hess Jeremy J. , Heilpern Katherine L. , Davis Timothy E. , Frumkin Howard
Published: July 2009

There is scientific consensus that the climate is changing, that human activity plays a major role, and that the changes will continue through this century. Expert consensus holds that significant health effects are very likely. Public health and health care systems must understand these impacts to properly pursue preparedness and prevention activities. All of medicine will very likely be affected, and certain medical specialties are likely to be more significantly burdened based on their clinical activity, ease of public access, public health roles, and energy use profiles. These specialties have been called on to consider the likely impacts on their patients and practice and to prepare their practitioners. Emergency medicine (EM), with its focus on urgent and emergent ambulatory care, role as a safety‐net provider, urban concentration, and broad‐based clinical mission, will very likely experience a significant rise in demand for its services over and above current annual increases. Clinically, EM will see amplification of weather‐related disease patterns and shifts in disease distribution. In EM’s prehospital care and disaster response activities, both emergency medical services (EMS) activity and disaster medical assistance team (DMAT) deployment activities will likely increase. EM’s public health roles, including disaster preparedness, emergency department (ED)‐based surveillance, and safety‐net care, are likely to face increasing demands, along with pressures to improve fuel efficiency and reduce greenhouse gas emissions. Finally, EM’s roles in ED and hospital management, particularly related to building and purchasing, are likely to be impacted by efforts to reduce greenhouse gas emissions and enhance energy efficiency. Climate change thus presents multiple clinical and public health challenges to EM, but also creates numerous opportunities for research, education, and leadership on an emerging health issue of global scope.
Children's Moral Evaluations of Ecological Damage: The Effect of Biocentric and Anthropocentric Intentions1
Authors: Kortenkamp Katherine V. , Moore Colleen F.
Published: July 2009

Moral evaluations of ecologically damaging events were studied in 5th, 8th, and 11thgraders and college students (N = 246). Participants made 4 kinds of judgments about 2 scenarios: decision rightness, damage rightness, blame of the decision maker, and blame of the agents causing the damage. In both scenarios, the decision maker's intentions varied (biocentric vs. anthropocentric) as did the damage severity. Overall, participants' judgments were less harsh when the decision maker had biocentric intentions and when the damage was less severe. However, there were age differences in use of intentions to judge decision rightness. The proposition that judgments of blame of the decision maker should be a joint function of decision and damage rightness was also supported.
Optimism and College Retention: Mediation by Motivation, Performance, and Adjustment1
Authors: Solberg Nes Lise , Evans Daniel R. , Segerstrom Suzanne C.
Published: July 2009

Although higher education has been linked to better income, longer life expectancy, and better health, about 25–45% of incoming college freshmen never graduate. The current study examined whether optimistic expectancies are associated with college retention. Participants (N = 2,189) were given surveys when entering college, and academic records were attained after freshman year completion. Dispositional and academic optimism were associated with less chance of dropping out of college, as well as better motivation and adjustment. Academic optimism was also associated with higher grade point average (GPA). Structural equation models revealed that dispositional optimism predicted retention through motivation and adjustment, which in turn predicted retention. Academic optimism, on the other hand, predicted retention through its effect on GPA, motivation, and adjustment.
The Effects of a Humanities Reading Program on Economically and Educationally Disadvantaged Individuals
Authors: Katzev Richard , Allen Jennifer , Peters Cheryl L.
Published: July 2009

The effects of a 2‐semester college‐level humanities course were examined in a group of economically and educationally disadvantaged individuals in Portland, OR, and a group of incarcerated males at a medium‐security prison in Pendleton, OR. Student responses on a pre‐ and post‐course survey were compared. Within‐group comparisons indicated that Portland students displayed significant improvement in participation in volunteer organizations, enrollment in college classes, life satisfaction, verbal ability, and analysis of the major course themes. Inmates improved on desire to participate in community organizations, vote in elections, critical thinking, life satisfaction, and applying major course themes. These results demonstrate that the power of literary classics brings about a wide range of positive changes in individuals from low‐income communities and prison settings.
Crosstalk between the NF‐κB activating IKK‐complex and the CSN signalosome
Authors: Orel Lukas , Neumeier Hannah , Hochrainer Karin , Binder Bernd R. , Schmid Johannes A.
Published: July 2009

A great variety of signalling pathways regulating inflammation, cell development and cell survival require NF‐κB transcription factors, which are normally inactive due to binding to inhibitors, such as IκBα. The canonical activation pathway of NF‐κB is initiated by phosphorylation of the inhibitor by an IκB kinase (IKK) complex triggering ubiquitination of IκB molecules by SCF‐type E3‐ligase complexes and rapid degradation by 26S‐proteasomes. The ubiquitination machinery is regulated by the COP9 signalosome (CSN). We show that IκB kinases interact with the CSN‐complex, as well as the SCF‐ubiquitination machinery, providing an explanation for the rapid signalling‐induced ubiquitination and degradation of IκBα. Furthermore, we reveal that IKK’s phosphorylate not only IκBα, but also the CSN‐subunit Csn5/JAB1 (c‐Jun activation domain binding protein‐1) and that IKK2 influences ubiquitination of Csn5/JAB1. Our observations imply that the CSN complex acts as an inhibitor of constitutive NF‐κB activity in non‐activated cells. Knock‐down of Csn5/JAB1 clearly enhanced basal NF‐κB activity and improved cell survival under stress. The inhibitory effect of Csn5/JAB1 requires a functional MPN+ metalloprotease domain, which is responsible for cleaving ubiquitin‐like Nedd8‐modifications. Upon activation of cells with tumour necrosis factor‐α, the CSN complex dissociates from IKK’s allowing full and rapid activation of the NF‐κB pathway by the concerted action of interacting protein complexes.
Differential regulation of oestrogen receptor β isoforms by 5′ untranslated regions in cancer
Authors: Smith Laura , Brannan Rebecca A. , Hanby Andrew M. , Shaaban Abeer M. , Verghese Eldo T. , Peter Mark B. , Pollock Steven , Satheesha Sampoorna , Szynkiewicz Marcin , Speirs Valerie , Hughes Thomas A.
Published: July 2009

Oestrogen receptors (ERs) are critical regulators of the behaviour of many cancers. Despite this, the roles and regulation of one of the two known ERs – ERβ– are poorly understood. This is partly because analyses have been confused by discrepancies between ERβ expression at mRNA and proteins levels, and because ERβ is expressed as several functionally distinct isoforms. We investigated human ERβ 5′ untranslated regions (UTRs) and their influences on ERβ expression and function. We demonstrate that two alternative ERβ 5′UTRs have potent and differential influences on expression acting at the level of translation. We show that their influences are modulated by cellular context and in carcinogenesis, and demonstrate the contributions of both upstream open reading frames and RNA secondary structure. These regulatory mechanisms offer explanations for the non‐concordance of ERβ mRNA and protein. Importantly, we also demonstrate that 5′UTRs allow the first reported mechanisms for differential regulation of the expression of the ERβ isoforms 1, 2 and 5, and thereby have critical influences on ERβ function.
Podosome‐like structures of non‐invasive carcinoma cells are replaced in epithelial‐mesenchymal transition by actin comet‐embedded invadopodia
Authors: Takkunen Minna , Hukkanen Mika , Liljeström Mikko , Grenman Reidar , Virtanen Ismo
Published: July 2009

Podosomes and invadopodia are actin‐based structures at the ventral cell membrane, which have a role in cell adhesion, migration and invasion. Little is known about the differences and dynamics underlying these structures. We studied podosome‐like structures of oral squamous carcinoma cells and invadopodia of their invasive variant that has undergone a spontaneous epithelial‐mesenchymal transition (EMT). In 3D imaging, podosomes were relatively large structures that enlarged in time, whereas invadopodia of invasive cells remained small, but were more numerous, degraded more extracellular matrix (ECM) and were morphologically strikingly different from podosomes. In live‐cell imaging, highly dynamic, invadopodia‐embedded actin tails were frequently released and rocketed through the cytoplasm. Resembling invadopodia, we found new club‐ended cell extensions in EMT‐experienced cells, which contained actin, cortactin, vinculin and MT1‐matrix metalloproteinase. These dynamic cell extensions degraded ECM and, in field emission scanning electron microscopy, protruded from the dorsal cell membrane. Plectin, αII‐spectrin, talin and focal adhesion kinase immunoreactivities were detected in podosome rings, whereas they were absent from invadopodia. Tensin potentially replaced talin in invadopodia. Integrin α3β1 surrounded both podosomes and invadopodia, whereas integrin αvβ5 localized only to invadopodia heads. Pacsin 2, in conjunction with filamin A, was detected early in podosomes, whereas pacsin 2 was not found in invadopodia and filamin A showed delayed accumulation. Fluorescence recovery after photobleaching indicated faster reorganization of actin, cortactin and filamin A in podosomes compared to invadopodia. In conclusion, EMT affects the invasion machinery of oral squamous carcinoma cells. Non‐invasive squamous carcinoma cells constitutively organize podosomes, whereas invasive cells form invadopodia. The club‐ended cell extensions, or externalized invadopodia, are involved in ECM degradation and maintenance of contact to adhesion substrate and surrounding cells during invasion.
Lichen planus sialadenitis: a mucosal analog of lichen planopilaris and lichen planoporitis
Authors: Lourenço Silvia Vanessa , Resende Ana Cristina Brandão , Bologna Sheyla Batista , Nico Marcello Menta Simonsen
Published: July 2009

Lichen planus (LP) is the most prevalent dermatological disorder with oral manifestation. Oral lesions comprise a broad spectrum of clinical presentations. We report the case of a 56‐year‐old woman who presented erosive LP on the buccal and lower lip mucosae. Besides typical erosions, small white keratotic papules on an erythematosus background on the lower lip mucosa were observed. Biopsy of lower lip lesions showed an unusual histopathological presentation consisting of a lichenoid inflammation targeted to salivary gland ducts. This is probably a salivary gland analog of lichen planopilaris and lichen planoporitis.

Lourenço SV, de Resende ACB, Bologna SB, Simonsen Nico MM. Lichen planus sialadenitis: a mucosal analog of lichen planopilaris and lichen planoporitis.
Comparison of Pharmacokinetics of Vardenafil Administered Using an Ultrasonic Nebulizer for Inhalation vs a Single 10-mg Oral Tablet
Authors: Berry Brooke , Altman Phillip , Rowe James , Vaisman Jack
Published: July 2009

Introduction

Delivery of vardenafil (for improvement of erectile function) via the inhaled route of administration may be advantageous in that this avoids extensive first pass metabolism and may therefore increase the bioavailability (hence the reliability of absorption) and shorten the time of pharmacological onset of activity. A unique nebulizer design has been developed by the sponsor (Advanced Medical Institute Pty Ltd) that is capable of delivering relatively large volumes of drug.

Aim

The primary objective of the Phase 1 study was to assess and compare the pharmacokinetics of a single dose of vardenafil 10-mg tablet and a single dose of vardenafil solution administered via inhalation using an ultrasonic nebulizer device. Secondary objective was to assess the safety of vardenafil administered via inhalation using an ultrasonic nebuliser device.

Methods

Two-part study in healthy volunteers. Dose-ranging study was performed in two subjects to determine the appropriate inhalational dose, followed by an open, randomized, crossover, single dose pharmacokinetic study in 12 subjects, which compared a single 10-mg oral dose to the inhalation dose.

Main Outcome Measures

Cmax, Cmax/Dose, Tmax, ke, t1/2, AUC0–t, AUCt–∞, AUC0–∞, AUC0–∞, AUC0–∞/Dose, and % area extrapolated.

Results

The two treatments are not bioequivalent, with vardenafil absorbed and eliminated faster and with less variability using the nebulizer for drug delivery. Administration via the inhalational route was not associated with any clinically significant changes in blood pressure or heart rate, and no serious adverse events were recorded, demonstrating an acceptable safety profile.

Conclusion

To our knowledge, this is the first report of the administration of vardenafil HCl via the pulmonary route of administration. This trial demonstrates that vardenafil HCl may be administered using the ultrasonic nebulizer to reach blood levels comparable with those produced by a vardenafil 10-mg oral tablet, faster and using less drug. This new route of administration may potentially improve the onset of action, reliability, and safety for this class of drug.
Acceptance of and Discontinuation Rate from Paroxetine Treatment in Patients with Lifelong Premature Ejaculation
Authors: Salonia Andrea , Rocchini Lorenzo , Sacca’ Antonino , Pellucchi Federico , Ferrari Matteo , Carro Ubaldo Del , Ribotto Paolo , Gallina Andrea , Zanni Giuseppe , Deho’ Federico , Rigatti Patrizio , Montorsi Francesco
Published: July 2009

Introduction

Selective serotonin reuptake inhibitors are the most widely used agents for delaying ejaculation in patients with premature ejaculation (PE).

Aim

The aim of this study was to assess the acceptance of and the discontinuation rate from paroxetine treatment in patients with lifelong PE.

Methods

We analyzed the acceptance of and discontinuation rates of 93 consecutive potent patients (mean age, 37.6 years) seeking medical treatment for lifelong PE. The patients were assessed with detailed medical and sexual history, self-reported intravaginal ejaculatory latency time, self-administered International Index of Erectile Function, complete physical examination, and the Meares–Stamey test. The patients received a paroxetine prescription (10 mg daily for 21 days and then 20 mg as needed) for the first 3 months. Thereafter, the patients could either stay with the same on-demand treatment or take paroxetine 10 mg daily for 3 months. The patients were evaluated at 3 and 6 months, and requested to complete multiple-choice global assessment questions regarding specific reasons for eventual therapy discontinuation.

Main Outcome Measures

The primary end point was acceptance and discontinuation rates for paroxetine treatment in patients seeking medical treatment for lifelong PE. The secondary end point was the reasons for nonacceptance of treatment or discontinuation.

Results

Twenty-eight (30.10%) patients decided not to start paroxetine. Fear of using an “antidepressant drug” was the main reason (42.9%) for treatment nonacceptance. Twenty (30.8%) patients who initiated therapy eventually discontinued it. Treatment effect below expectations was the main reason of treatment dropout (75%) during the first 3 months, followed by temporary loss of interest in sex because of relationship issues (15%) and side effects (10%). Of the patients who continued treatment, 77.8% preferred daily paroxetine, while 22.2% continued as-needed therapy.

Conclusions

Thirty percent of lifelong PE patients seeking medical treatment for complaints of early ejaculation freely decided not to start any paroxetine treatment, and roughly 30% of patients who started therapy eventually discontinued it.
Neural Activations of the Acquisition of Conditioned Sexual Arousal: Effects of Contingency Awareness and Sex
Authors: Klucken Tim , Schweckendiek Jan , Merz Christian J. , Tabbert Katharina , Walter Bertram , Kagerer Sabine , Vaitl Dieter , Stark Rudolf
Published: July 2009

Introduction

Learning processes like classical conditioning are involved in mediating sexual behavior. Yet, the neural bases underlying these processes have not been investigated so far.

Aim

The aim of this study was to explore neural activations of classical conditioning of sexual arousal with respect to sex differences and contingency awareness.

Methods

In the acquisition phase, a geometric figure (CS+) was presented for 8 seconds and was followed by highly sexual arousing pictures (UCS), whereas another figure (CS−) predicted neutral pictures. Ratings and contingency awareness were assessed after the entire conditioning procedure. Forty subjects (20 females) were classified into one of four groups according to their sex and the development of contingency awareness (aware females, aware males, unaware females, and unaware males).

Main Outcome Measures

Blood oxygen level dependent (BOLD) responses measured by functional magnetic resonance imaging (fMRI), skin conductance responses (SCRs), and subjective ratings.

Results

fMRI analysis showed two effects (awareness and sex) when comparing CS+ with CS−: (i) aware compared to unaware subjects showed enhanced differentiation (e.g., ventral striatum, orbitofrontal cortex, occipital cortex); and (ii) men showed increased activity compared to women in the amygdala, thalamus, and brainstem. CS+ and CS− ratings differed in aware subjects only. However, no conditioned SCRs occurred in any group.

Conclusion

The increased activity in men is in line with theories postulating that men are generally more prone to conditioning of sexual arousal. Further, contingency awareness seems to be an important factor in appetitive learning processes, which facilitates conditioning processes.
GLASS TRANSITION OF RAINBOW TROUT AND EFFECT OF CRYOPROTECTANTS ON SOME CHANGES
Authors: AKTAŞ NESİMİ , AKKÖSE AHMET
Published: July 2009

Sucrose (2%), sorbitol (2%), mannitol (2%), gum arabic (0.15%), carrageenan (0.15%) 8 and meat stabilizer (0.5%) were blended with ground rainbow trout and stored for 6 months separately at −9, −13C (glass transition temperature [Tg] of rainbow trout determined by differential scanning calorimetry) and −18C. Total volatile basic nitrogen (TVB‐N) and thiobarbituric acid‐reactive substances (TBARS) were determined at first, third and sixth months of storage periods. Sodium dodecyl sulfate‐polyacrylamide gel electrophoresis (SDS‐PAGE) was conducted on isolated myofibrillar proteins for first, third and sixth months. Biopolymers and storage period had a significant effect (P < 0.05) on the TVB‐N and TBARS values. Tg (−13C) and −18C showed the same effects on TVB‐N and TBARS values, but −9C had statistically different effect on them. SDS‐PAGE characteristics of myofibrillar proteins revealed that the samples with gum arabic, sucrose and sorbitol were different from the other samples.

PRACTICAL APPLICATIONS

Glass transition is a second‐order time–temperature dependent on phase transition. It assists in identifying food stability during storage, as well as selecting suitable conditions of temperature for processing. In the present study, total volatile basic nitrogen and thiobarbituric acid‐reactive substance values of the samples stored at Tg (−13C) and −18C were determined as statistically the same. Both from the economical and quality retention point of view, this situation is important to practical applications.
THERMODYNAMIC APPROACH TO EQUILIBRIUM ISOTHERMS IN SALTED STRUCTURED FOOD
Authors: FITO PEDRO , FITO PEDRO J. , BETORET NOELIA , ARGÜELLES ÁNGEL , CHENOLL CREU
Published: July 2009

Some foods are preserved by salting in NaCl saturation conditions (fish, meat and some vegetables).

It is known that the polyphasic and multicomponent character of foods plays a basic role in defining equilibrium conditions; therefore, it is essential for a correct modeling of food behavior. However, in most cases, only one homogeneous phase is considered for process modeling.

In this paper, the polyphasic and multicomponent character of foods was applied for thermodynamic description of salted foods in order to have a better analysis of their water sorption isotherms. A simplified model of the food in terms of four phases (aqueous solution of salt and native soluble solids, solid matrix and fat) is proposed.

The water sharing out between phases was analyzed, and the water content and relationships for each phase were proposed. This model was applied to salted meat isotherms, obtaining a good fitting between experimental and predicted data.

PRACTICAL APPLICATIONS

The final quality of salted meat products depends on the complex cellular structure, salt and water relations and transformations. A new isotherm model for salted products, with structural and thermodynamic considerations, is proposed as a tool to control the production of salted foods.

This model describes the structure of food as an insoluble solid matrix with salt and water interactions, liquid phase (water and salt solution) and solid salt, and explains the water and salt distribution during adsorption and desorption of water.

Thus, this new model is an excellent tool to predict salt and water interactions in the complex food structure in order to improve some quality parameters of salted products such as content of salt crystals, distribution of salt or protein degradation.
RHEOLOGICAL AND SEM STUDIES ON THE INTERACTION BETWEEN SPENT BREWER'S YEAST β‐GLUCANS AND κ‐CARRAGEENAN
Authors: XU XUEMING , PU QINGLIN , HE LIU , NA YANG , WU FENGFENG , JIN ZHENGYU
Published: July 2009

The microstructure of gel network produced byκ‐carrageenan (KC), and spent brewer's yeastβ‐glucans (BYG) and the two polymers' mixture were analyzed through rheological and scanning electron microscopy (SEM) experiments. Small amplitude oscillatory tests in the linear domain of viscoelasticity were applied to study the rheological properties of the two polymers in different mixing ratios. The mechanical spectra measurements gave neat evidence that although KC played the dominant role in forming the gel network, BYG contributed to the gel system, especially in the mixtures with low concentration (0.05 and 0.1 wt%) KC. BYG strengthened the gel network attributing to its entanglement with KC molecules, instead of inhibiting the KC to form ordered structure. It indicated that the two polymers were compatible with possible interactions that might be due to the intermolecular force and hydrogen bond between the two polymers. The microstructure's shape of the two polymers in SEM images demonstrated support explanation for the rheological properties.

PRACTICAL APPLICATIONS

The fine particulate β‐glucans filled the cavity of the κ‐carrageenan network which enhances the mixed system gel strength. The results of this research might be useful for products development in food industry.
Best‐practice intervention for care of clients who self‐mutilate
Authors: Hicks K. Madalyn , Hinck Susan M.
Published: July 2009

Purpose: To describe the development of a best practice intervention to guide nurse practitioners (NPs) who care for individuals who self‐mutilate.

Data sources: The evidence on which the guideline was based includes six descriptive studies and expert clinical opinion articles. The framework for development of the guideline is a systematic process to obtain and analyze the best available evidence, develop a theory‐driven intervention, and propose a system for ongoing evaluation of the effectiveness of the intervention.

Conclusions: The guideline is an information sheet, containing the definition of self‐mutilation, background of the problem, target population affected, and intervention. The three components of the intervention are (a) the NP's self‐evaluation of values, beliefs, and assumptions about individuals who self‐mutilate; (b) a focused, in‐depth assessment of the client; and (c) therapeutic strategies to address the emotional, social, and biological dimensions of self‐mutilation.

Implications for practice: This Best‐Practice Intervention for Care of Clients Who Self‐Mutilate guideline provides direction for NPs to address a preventable, self‐injury behavior effectively. Further study is needed to examine the effectiveness of the use of the guideline and the intervention.
Anal Pap smears: Should we be doing them?
Authors: Lindsey Kimberley , DeCristofaro Claire , James Janet
Published: July 2009

Purpose: To identify the need to perform anal Papanicolau (Pap) smears for diagnosing histologic changes associated with human papilloma virus (HPV) infection in order to provide early intervention for the prevention of anal cancer. To offer the primary care provider information, based on evidence‐based research, about identifying the high‐risk patient using risk factors, instructions on performing the anal Pap smear, interpreting the results, and initiating treatment interventions and/or referrals for care. Additionally, the possibility of an HPV vaccine for men will be discussed.

Data Sources: Evidence‐based literature, theoretical framework, and peer‐reviewed articles.

Conclusions: Performing anal Pap smears is a valuable tool to detect cytologic changes associated with some strains of HPV infection. For persons participating in receptive anal intercourse, this diagnostic procedure provides the opportunity for early detection to guide appropriate follow‐up and interventions.

Implications for practice: Appropriate screening can be incorporated easily into a primary care practice. High‐risk groups that would benefit from this screening include men who have sex with men, HIV‐infected men and women, immunocompromised men and women, women with a history of cervical or vulvar cancer (or high‐grade cervical lesions), and women participating in receptive anal intercourse.
Prooxidant Activity of Oxidized α‐Tocopherol in Vegetable Oils
Authors: Chapman Timothy M. , Kim Hyun Jung , Min David B.
Published: July 2009

ABSTRACT:  The effect of oxidized α‐tocopherol on the oxidative stabilities of soybean, corn, safflower, and olive oils and the oxidation of oleic, linoleic, and linolenic acids were studied. The 0, 650, 1300, and 2600 ppm oxidized α‐tocopherol were added to soybean, corn, safflower, and olive oils and 10000 ppm oxidized α‐tocopherol to the mixture of oleic, linoleic, and linolenic acids. Samples in the gas‐tight vials were stored in the dark for 6 or 35 d at 55 °C. The oxidative stabilities of oils were determined by headspace oxygen with GC and peroxide value. Fatty acids were determined by GC. As the concentration of oxidized α‐tocopherol in soybean, corn, safflower, and olive oils increased, the depletion of headspace oxygen and the peroxide values of oils increased during storage. The prooxidant effects of oxidized α‐tocopherol on soybean and corn oils with about 55% linoleic acid were greater than those on safflower and olive oils with about 12% linoleic acid, respectively (P < 0.05). The changes of fatty acids during storage showed that the oxidation ratios of oleic, linoleic, and linolenic acids were 1 : 2 : 3, 1 : 12 : 26, and 1 : 8 : 16 after 5, 30, and 35 d of storage, respectively. The oxidation of α‐tocopherol in oil should be prevented and the oxidized α‐tocopherol should be removed to improve the oxidative stability of oils.