bluuebunny/crossref_metadata_2025 huggingface dataset:
The “Let's Get Alarmed!” initiative: a smoke alarm giveaway programme
Authors: DiGuiseppi Carolyn , Slater Suzanne , Roberts Ian , Adams Lucy , Sculpher Mark , Wade Angela , McCarthy Mark
Published: December 2008

Objectives—To reduce fires and fire related injuries by increasing the prevalence of functioning smoke alarms in high risk households.

Setting—The programme was delivered in an inner London area with above average material deprivation and below average smoke alarm ownership. The target population included low income and rental households and households with elderly persons or young children.

Methods—Forty wards, averaging 4000 households each, were randomised to intervention or control status. Free smoke alarms and fire safety information were distributed in intervention wards by community groups and workers as part of routine activities and by paid workers who visited target neighbourhoods. Recipients provided data on household age distribution and housing tenure. Programme costs were documented from a societal perspective. Data are being collected on smoke alarm ownership and function, and on fires and related injuries and their costs.

Results—Community and paid workers distributed 20 050 smoke alarms, potentially sufficient to increase smoke alarm ownership by 50% in intervention wards. Compared with the total study population, recipients included greater proportions of low income and rental households and households including children under 5 years or adults aged 65 and older. Total programme costs were £145 087.

Conclusions—It is possible to implement a large scale smoke alarm giveaway programme targeted to high risk households in a densely populated, multicultural, materially deprived community. The programme's effects on the prevalence of installed and functioning alarms and the incidence of fires and fire related injuries, and its cost effectiveness, are being evaluated as a randomised controlled trial.
Descriptive study of sledding injuries in Canadian children
Authors: Lee Francis , Osmond Martin H , Vaidyanathan Chandra P , Sutcliffe Teresa , Klassen Terry P
Published: December 2008

Objectives—(1) To describe the characteristics of sledding injuries presenting to a pediatric emergency department and (2) To describe the sledding environment that leads to childhood sledding injuries.

Setting—A pediatric hospital emergency department in Ottawa, Canada and identified sledding sites in the region.

Methods—All patients less than 18 years with sled related injuries were included. Questionnaires were completed gathering information on the sled operator, the sled, the sledding site, and the injury. Site visits were made to designated and non-designated sledding hills in the Ottawa region to record data regarding sled operators, sleds, and the sledding environment.

Results—Ninety five patients were identified with sledding injuries and 81 (85%) completed the questionnaire. The mean age was 9.9 years (range 8 months to 17 years). The majority were male (63%). Most injuries occurred on non-designated sledding hills in the community (70%). Mild to moderate injuries were most common, however nine patients (11%) were admitted to hospital. Fifty one per cent had adult supervision at the time of injury compared with 86% observed at the site visits. Common mechanisms of injuries were collisions with objects (33%), falls in icy conditions (28%), and going off jumps (16%). Most serious injuries occurred with contact with motor vehicles. There was no relationship between the type of sled used and the likelihood of injury.

Conclusions—Sledding hills which have obstacles, icy conditions, jumps, or proximity to roads may result in more childhood injuries. Children with no adult supervision are likely at higher risk of injury.
The spectrum of prevention: developing a comprehensive approach to injury prevention: Figure 1
Authors: Cohen Larry , Swift Susan
Published: December 2008

Objective—The purpose of this paper is to describe the “spectrum of prevention”, a framework for developing multifaceted approaches to injury prevention. The value of the tool is that it can help practitioners develop and structure comprehensive initiatives.

Methods—The spectrum is comprised of six inter-related action levels: (1) strengthening individual knowledge and skills, (2) promoting community education, (3) educating providers, (4) fostering coalitions and networks, (5) changing organizational practices, and (6) influencing policy and legislation. Activities at each of these levels have the potential to support each other and promote overall community health and safety.

Conclusions—The spectrum of prevention is a tool which can help practitioners and policy leaders move beyond a primarily educational approach to achieve broad community goals through injury prevention strategies that include policy development. This framework has been endorsed and applied in a variety of disciplines, however it has not been formally evaluated, a process that could clarify the scope of its effectiveness.
Sensitivity and representativeness of a childhood injury surveillance system: Table 1
Authors: Macarthur Colin , Pless Ivan Barry
Published: December 2008

Objective—To determine the sensitivity and representativeness of the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP).

Setting—The study was conducted in the Ottawa-Carleton region of Ontario, Canada (June through August, 1992).

Methods—Surveillance system sensitivity was estimated by dividing the number of injured children attending the Children's Hospital of Eastern Ontario (the only CHIRPP center in Ottawa-Carleton) by the total number of emergency department attended childhood injuries in the region. CHIRPP representativeness was assessed by comparing the injuries missed by the system with those captured on social, demographic, and clinical factors.

Results—Sensitivity was 65% (1552/2386). Missed and captured injuries were similar on sex, day, time of presentation, injury intent, and delay before presentation. Children older than 14 years, however, were more likely to be missed by the system; adjusted odds ratio 3.52 (95% confidence interval (CI) 2.87 to 4.32). Conversely, children admitted to hospital were less likely to be missed; adjusted odds ratio 0.43 (95% CI 0.23 to 0.80).

Conclusion—Given the systematic errors in capture, CHIRPP data should be used cautiously in studies of etiology.
House fire injury prevention update. Part II. A review of the effectiveness of preventive interventions
Authors: Warda Lynne , Tenenbein Milton , Moffatt Michael E K
Published: December 2008

Objective—To evaluate and summarize the house fire injury prevention literature.

Methods—MEDLINE (1983 to March 1997) was searched by keyword: fire, burn, etiology, cause, prevention, epidemiology, and smoke detector/alarm. ERIC (1966 to March 1997) and PSYCLIT (1974 to June 1997) were searched by keyword: as above, and safety, skills, education, and training. Other sources included references of retrieved publications, review articles, and books;Injury Preventionhand search; government documents; and internet sources. Sources relevant to residential fire injury prevention were selected, evaluated, and summarized.

Results—Forty three publications were selected for review, including seven randomized controlled trials, nine quasiexperiments, two natural experiments, 21 prospective cohort studies, two cross sectional surveys, one case report, and one program evaluation. These studies examined the following types of interventions: school (9), preschool (1), and community based educational programs (5); fire response training programs for children (7), blind adolescents (2), and mentally retarded adults (5) and children (1); office based counseling (4); home inspection programs (3); smoke detector giveaway campaigns (5); and smoke detector legislation (1).

Conclusions—This review of house fire prevention interventions underscores the importance of program evaluation. There is a need for more rigorous evaluation of educational programs, particularly those targeted at schools. An evidence based, coordinated approach to house fire injury prevention is critical, given current financial constraints and the potential for program overload for communities and schools.
Effects of Maryland's law banning Saturday night special handguns on crime guns
Authors: Vernick Jon S , Webster Daniel W , Hepburn Lisa M
Published: December 2008

Objectives—To determine the effects of a 1988 Maryland law that banned “Saturday night special” handguns on the types of guns used in crime. To determine if controls on the lawful market for handguns affect the illegal market as well.

Setting—Baltimore, Maryland, and 15 other US cities participating in a crime gun tracing project.

Methods—Cross sectional comparison of the proportion of crime guns that are banned by the Maryland law, comparing Baltimore, MD with 15 other cities outside of Maryland. Multivariate linear regression analysis to determine if observed differences between Baltimore and 15 other cities are explained by demographic or regional differences among the cities rather than Maryland's law.

Results—Among crime guns, a gun banned by Maryland's law is more than twice as likely (relative risk (RR) 2.3, 95% confidence interval (CI) 2.0 to 2.5) to be the subject of a crime gun trace request in 15 other cities combined, than in Baltimore. Among homicide guns, a crime especially relevant for public safety, a comparable difference (RR 2.1, 95% CI 1.1 to 4.2) was observed. The proportion of Baltimore's crime guns that are banned is 12 percentage points lower than would be expected based on its demographic and regional characteristics alone. Among crime guns purchased after 1990, a much smaller proportion in Baltimore are banned models than in 15 other cities.

Conclusions—Maryland's law has reduced the use of banned Saturday night specials by criminals in Baltimore. Contrary to the claims of some opponents of gun control laws, regulation of the lawful market for firearms can also affect criminals.
Role of commercial drivers in motor vehicle related injuries in Ghana: Table 1
Authors: Mock Charles , Amegashie Justice , Darteh Kwame
Published: December 2008

Introduction—In many low income countries, commercial vehicles are the major source of motorized transport. Drivers of such vehicles may be an important focus for road safety efforts.

Aims—An estimation of the percentage of motor vehicle related injuries that involved commercial vehicles in Ghana was sought. The knowledge, attitude, and practices of commercial drivers with regards to road safety was then evaluated.

Methods—A community based survey was carried out, involving 21 105 persons. As well, focus group discussions were held with 30 commercial drivers.

Results—In the survey, 122 motor vehicle related injuries were reported for the preceding year. The majority (81%) of these involved commercial vehicles, principally buses (40%) and taxis (24%). The involvement of commercial vehicles was the same for both motor vehicle crashes (81%) and pedestrian injuries (82%). However, motor vehicle related injuries in children were especially likely to involve commercial vehicles (95%), in comparison with adults (79%). The focus groups indicated that commercial drivers had a good general attitude towards road safety. Most believed that actions could be taken that would lower the risk of crashes and injuries, including vision examinations, using seat belts, and avoiding alcohol. However, this knowledge was not fully implemented. For example, few drivers had ever had their vision checked and most used seat belts only for long journeys.

Conclusions—In Ghana, commercial drivers are an important group to target in road safety programs. They are also a potentially useful group to include in building coalitions to implement such road safety measures.
Infant injury deaths with unknown intent: what else do we know?: Table 1
Authors: Overpeck Mary D , Brenner Ruth A , Trumble Ann C , Smith Gordon S , MacDorman Marian F , Berendes Heinz W
Published: December 2008

Objectives—Strong evidence based on case record reviews indicates that the incidence of child homicide reported from death certificates is under ascertained. The characteristics of infant injury fatalities with undetermined, but suspicious, intent were compared for the probability that they should be considered homicides.

Methods—Using linked birth and death certificates for all birth cohorts in the US from 1983–91, 2345 injury fatalities reported as intentional, 7594 as unintentional, and 431 as undetermined intent were identified. Maternal and infant variables potentially predictive of injury fatalities were selected based on increased bivariate associations. Relative risks of injury death by intentional, unintentional, and undetermined intent were assessed for maternal and infant characteristics.

Results—Relative risks were consistently higher across all intent categories for infants of mothers with the least education, no prenatal care, young maternal age, and single marital status, as well as for infants who are second or later born, preterm, black, or American Indian. Fatalities with undetermined intent have larger relative risks in the highest risk categories than either intentional or unintentional injuries. Deaths with undetermined intent have risk profiles that more closely resemble profiles for intentional deaths than unintentional.

Conclusions—Injury homicide rates would be almost 20% greater than official classifications indicate if deaths with undetermined intent were included. In analyses of infant homicide, excluding deaths of undetermined intent may lead to an underestimation of the magnitude of the public health problem of intentional injuries among infants. Other studies based on record reviews from multiple sources indicate that misclassification and under ascertainment of homicides may be even greater.
Effect of the mandatory helmet law in Taiwan: Table 1
Authors: Tsai Ming-Che , Hemenway David
Published: December 2008

Objective—To estimate the impact of a mandatory motorcycle helmet law in Taiwan.

Methods—Taiwan passed a mandatory helmet law in June 1997. Data were collected retrospectively from police reports, which include hospital data, to compare six months pre-law (June to November 1996) with the same six months post-law (June to November 1997).

Results—Motorcycle fatalities decreased 14% after the introduction of the helmet law. Head injury fatalities fell 22% while fatalities from injuries to other bodily areas rose 20%. Non-fatal motorcycle injuries fell 31%. Non-fatal head injuries fell 44%; non-fatal injuries to other body parts fell 23%.

Conclusion—This study indicates that large, immediate public health benefits resulted from the mandatory motorcycle helmet law in Taiwan.
Preventative pathology and childhood injury
Authors: Byard Roger W
Published: December 2008

Objective—To delineate a role for pathologists in coordinating the study of childhood deaths due to injury and in developing public safety recommendations.

Methods—Ongoing evaluation of cases of death due to injury occurring in children under 16 years, with formal review of all cases of fatal pediatric injuries recorded in the Department of Histopathology, Women's and Children's Hospital, over the past 35 years, has been undertaken as a part of the “Keeping Your Baby and Child Safe” programme.

Results—Information obtained from these cases has been used to formulate a number of safety recommendations dealing with unsafe sleeping environments, unsafe eating practices, scalding, and dangerous farm environments. Some products have been withdrawn from sale and other products modified.

Conclusions—Pathologists often have extensive knowledge of childhood injuries, which can contribute significantly to health promotion initiatives and community education programmes.
Increasing paintball related eye trauma reported to a state eye injury registry: Figure 1
Authors: Kitchens John W , Danis Ronald P
Published: December 2008

Objectives—To evaluate an apparent increase in documented trauma from paintball related eye injuries reported to the Eye Injury Registry of Indiana.

Methods—A retrospective review of cases reported to the database is reported, with representative case histories.

Results—No injuries from paintball were reported during the period June 1992 to June 1996. Over the next two years 11 injuries were reported, representing 4% of all ocular trauma reports over this period. Visual outcome is poor in many of these eyes and more than one half present with posterior segment ocular injury.

Conclusions—Severe ocular trauma results from impacts from paintball pellets, and the occurrence of injuries appears to be increasing due to growth in popularity of this war game. Diligent use of eye protection by all participants is necessary to prevent a continuing rise in ocular trauma prevalence from this activity.
GAUGE SYMMETRY BREAKING IN A THROAT GEOMETRY
Authors: PAWEŁCZYK JACEK
Published: December 2008

We analyze behavior of D3-branes in BGMPZ throat geometry. We show that although single brane has some of the moduli stabilized multi-brane system tends to expand and form a bound state. Such a system loses non-Abelian gauge symmetry. The described mechanism is an example of gauge symmetry breaking triggered by SUSY breaking.
Noninvasive assessment of pancreatic β-cell function in vivo with manganese-enhanced magnetic resonance imaging
Authors: Antkowiak Patrick F. , Tersey Sarah A. , Carter Jeffrey D. , Vandsburger Moriel H. , Nadler Jerry L. , Epstein Frederick H. , Mirmira Raghavendra G.
Published: December 2008

Loss of β-cell function in type 1 and type 2 diabetes leads to metabolic dysregulation and inability to maintain normoglycemia. Noninvasive imaging of β-cell function in vivo would therefore provide a valuable diagnostic and research tool for quantifying progression to diabetes and response to therapeutic intervention. Because manganese (Mn2+) is a longitudinal relaxation time (T1)-shortening magnetic resonance imaging (MRI) contrast agent that enters cells such as pancreatic β-cells through voltage-gated calcium channels, we hypothesized that Mn2+-enhanced MRI of the pancreas after glucose infusion would allow for noninvasive detection of β-cell function in vivo. To test this hypothesis, we administered glucose and saline challenges intravenously to normal mice and mice given high or low doses of streptozotocin (STZ) to induce diabetes. Serial inversion recovery MRI was subsequently performed after Mn2+ injection to probe Mn2+ accumulation in the pancreas. Time-intensity curves of the pancreas (normalized to the liver) fit to a sigmoid function showed a 51% increase in signal plateau height after glucose stimulation relative to saline ( P < 0.01) in normal mice. In diabetic mice given a high dose of STZ, only a 9% increase in plateau signal intensity was observed after glucose challenge ( P = not significant); in mice given a low dose of STZ, a 20% increase in plateau signal intensity was seen after glucose challenge ( P = 0.02). Consistent with these imaging findings, the pancreatic insulin content of high- and low-dose STZ diabetic mice was reduced about 20-fold and 10-fold, respectively, compared with normal mice. We conclude that Mn2+-enhanced MRI demonstrates excellent potential as a means for noninvasively monitoring β-cell function in vivo and may have the sensitivity to detect progressive decreases in function that occur in the diabetic disease process.
3,5-Diiodo-l-thyronine rapidly enhances mitochondrial fatty acid oxidation rate and thermogenesis in rat skeletal muscle: AMP-activated protein kinase involvement
Authors: Lombardi A. , de Lange P. , Silvestri E. , Busiello R. A. , Lanni A. , Goglia F. , Moreno M.
Published: December 2008

Triiodothyronine regulates energy metabolism and thermogenesis. Among triiodothyronine derivatives, 3,5-diiodo-l-thyronine (T2) has been shown to exert marked effects on energy metabolism by acting mainly at the mitochondrial level. Here we investigated the capacity of T2to affect both skeletal muscle mitochondrial substrate oxidation and thermogenesis within 1 h after its injection into hypothyroid rats. Administration of T2induced an increase in mitochondrial oxidation when palmitoyl-CoA (+104%), palmitoylcarnitine (+80%), or succinate (+30%) was used as substrate, but it had no effect when pyruvate was used. T2was able to 1) activate the AMPK-ACC-malonyl-CoA metabolic signaling pathway known to direct lipid partitioning toward oxidation and 2) increase the importing of fatty acids into the mitochondrion. These results suggest that T2stimulates mitochondrial fatty acid oxidation by activating several metabolic pathways, such as the fatty acid import/β-oxidation cycle/FADH2-linked respiratory pathways, where fatty acids are imported. T2also enhanced skeletal muscle mitochondrial thermogenesis by activating pathways involved in the dissipation of the proton-motive force not associated with ATP synthesis (“proton leak”), the effect being dependent on the presence of free fatty acids inside mitochondria. We conclude that skeletal muscle is a target for T2, and we propose that, by activating processes able to enhance mitochondrial fatty acid oxidation and thermogenesis, T2could play a role in protecting skeletal muscle against excessive intramyocellular lipid storage, possibly allowing it to avoid functional disorders.
Benefits and limitations of reducing glucagon action for the treatment of type 2 diabetes
Authors: Ali Safina , Drucker Daniel J.
Published: December 2008

Glucagon is secreted from the α-cells of the pancreatic islets and regulates glucose homeostasis through modulation of hepatic glucose production. As elevated glucagon levels contribute to the pathophysiology of hyperglycemia in subjects with type 2 diabetes, reduction of glucagon receptor gene (Gcgr) activity represents a potential target for the treatment of T2DM. Herein, we review current concepts of glucagon action in hepatic and extrahepatic tissues and evaluate the therapeutic potential, mechanisms of action, and safety of reducing Gcgr signaling for the treatment of T2DM.
Role of central nervous system aldosterone synthase and mineralocorticoid receptors in salt-induced hypertension in Dahl salt-sensitive rats
Authors: Huang Bing S. , White Roselyn A. , Jeng Arco Y. , Leenen Frans H. H.
Published: December 2008

In Dahl salt-sensitive (S) rats, high salt intake increases cerebrospinal fluid (CSF) Na+ concentration ([Na+]) and blood pressure (BP). Intracerebroventricular (ICV) infusion of a mineralocorticoid receptor (MR) blocker prevents the hypertension. To assess the role of aldosterone locally produced in the brain, we evaluated the effects of chronic central blockade with the aldosterone synthase inhibitor FAD286 and the MR blocker spironolactone on changes in aldosterone and corticosterone content in the hypothalamus and the increase in CSF [Na+] and hypertension induced by high salt intake in Dahl S rats. After 4 wk of high salt intake, plasma aldosterone and corticosterone were not changed, but hypothalamic aldosterone increased by ∼35% and corticosterone tended to increase in Dahl S rats, whereas both steroids decreased by ∼65% in Dahl salt-resistant rats. In Dahl S rats fed the high-salt diet, ICV infusion of FAD286 or spironolactone did not affect the increase in CSF [Na+]. ICV infusion of FAD286 prevented the increase in hypothalamic aldosterone and 30 mmHg of the 50-mmHg BP increase induced by high salt intake. ICV infusion of spironolactone fully prevented the salt-induced hypertension. These results suggest that, in Dahl S rats, high salt intake increases aldosterone synthesis in the hypothalamus and aldosterone acts as the main MR agonist activating central pathways contributing to salt-induced hypertension.
Hemin therapy attenuates kidney injury in deoxycorticosterone acetate-salt hypertensive rats
Authors: Jadhav Ashok , Torlakovic Emina , Ndisang Joseph Fomusi
Published: December 2008

Upregulating the heme oxygenase (HO) system removes the prooxidant heme, and thus is cytoprotective. Additionally, the products from the HO pathway including, carbon monoxide, bilirubin, and biliverdin, scavenge reactive oxygen species, inhibit lipid peroxidation, and suppress tissue inflammation, while the iron formed enhances the synthesis of the antioxidant ferritin. Deoxycorticosterone acetate (DOCA)-salt hypertension, a model of human primary aldosteronism, causes oxidative stress and impairs renal function by stimulating inflammatory/oxidative transcription factors such as NF-κB and activating protein (AP-1). The effect of the HO system in end-organ damage in mineralocorticoid-induced hypertension has not been fully characterized. In this study, the administration of the HO inducer hemin lowered blood pressure (191 vs. 135 mmHg; n = 22, P < 0.01), increased creatinine clearance, and reduced kidney hypertrophy proteinuria, albuminuria, and histopathological lesions, including glomerular hypertrophy, glomerulosclerosis, tubular dilation, tubular cast formation, and interstitial mononuclear cell infiltration in nephrectomy/DOCA-high-salt-hypertension. The renoprotection was accompanied by reduced levels of NF-κB, AP-1, fibronectin, transforming growth factor (TGF)-β, and 8-isoprostane, a marker of oxidative stress. Correspondingly, a robust increase in total antioxidant capacity, HO activity, cGMP, and an antioxidant like ferritin was observed in hemin-treated animals. Our findings suggest that suppression of oxidative/inflammatory insults alongside the corresponding decline of fibronectin and TGF-β, an activator of extracellular matrix proteins, may account for the attenuation of renal histopathological lesions and the antihypertrophic effects of hemin. The multifaceted interaction among the HO system, TGF-β, fibronectin, AP-1, and NF-κB may be explored to design new drugs against end-stage-organ damage.
Ultrasonic evaluations of Achilles tendon mechanical properties poststroke
Authors: Zhao Heng , Ren Yupeng , Wu Yi-Ning , Liu Shu Q. , Zhang Li-Qun
Published: December 2008

Spasticity, contracture, and muscle weakness are commonly observed poststroke in muscles crossing the ankle. However, it is not clear how biomechanical properties of the Achilles tendon change poststroke, which may affect functions of the impaired muscles directly. Biomechanical properties of the Achilles tendon, including the length and cross-sectional area, in the impaired and unimpaired sides of 10 hemiparetic stroke survivors were evaluated using ultrasonography. Elongation of the Achilles tendon during controlled isometric ramp-and-hold and ramping up then down contractions was determined using a block-matching method. Biomechanical changes in stiffness, Young's modulus, and hysteresis of the Achilles tendon poststroke were investigated by comparing the impaired and unimpaired sides of the 10 patients. The impaired side showed increased tendon length (6%; P = 0.04), decreased stiffness (43%; P < 0.001), decreased Young's modulus (38%; P = 0.005), and increased mechanical hysteresis (1.9 times higher; P < 0.001) compared with the unimpaired side, suggesting Achilles tendon adaptations to muscle spasticity, contracture, and/or disuse poststroke. In vivo quantitative characterizations of the tendon biomechanical properties may help us better understand changes of the calf muscle-tendon unit as a whole and facilitate development of more effective treatments.
An Energy‐Efficient Multiwire Error Control Scheme for Reliable On‐Chip Interconnects Using Hamming Product Codes
Authors: Fu Bo , Ampadu Paul
Published: December 2008

We propose an energy‐efficient error control scheme for on‐chip interconnects capable of correcting a combination of multiple random and burst errors. The iterative decoding method, interleaver, using two‐dimensional Hamming product codes and a simplified type‐II hybrid ARQ, achieves several orders of magnitude improvement in residual flit‐error rate for multiwire errors and up to 45% improvement in throughput in high noise environments. For a given system reliability requirement, the proposed error control scheme yields up to 50% energy improvement over other error correction schemes. The low overhead of our approach makes it suitable for implementation in on‐chip interconnect switches.
Interlaced Costas Arrays Do Not Exist
Authors: Drakakis Konstantinos , Gow Rod , Rickard Scott
Published: December 2008

We prove that the only Costas arrays that can be constructed
by interlacing 2 Costas arrays of smaller orders (either equal or differing by 1) are those of order 2, and
that, consequently, no non‐trivial Costas arrays result from this method.
Postpartum Invasive Group A Streptococcal Disease in the Modern Era
Authors: Aronoff David M. , Mulla Zuber D.
Published: December 2008

To describe the clinical features of individuals hospitalized for postpartum invasive group AStreptococcus(GAS) infection, a retrospective, population-based study of hospitalized patients in the state of Florida was conducted. Cases of postpartum invasive GAS infection (occurring within 42 days of delivery) were compared to women with other manifestations of invasive GAS disease with respect to their age at the time of admission. Four cases of postpartum invasive GAS infection were detected in this population, yielding a prevalence of 1.6% (4/257) of postpartum disease in this invasive GAS infection database. Patients presented a median of 4 days (mean of 9 days) after delivery with signs and symptoms of infection. Three cases were complicated by bacteremia and one patient had streptococcal toxic shock syndrome. Each patient received multiple antibiotics and survived. No patients received intravenous immunoglobulin. For comparison, a secondary retrospective investigation of a large hospital discharge dataset obtained from the Florida Agency for Health Care Administration was assessed for patients with puerperal GAS infections. This method yielded an additional three cases, whose clinical and demographic characteristics were summarized. These data highlight that postpartum invasive GAS infection continues to complicate pregnancy, though the frequency has decreased markedly over the past century.
High-Intensity Focused Ultrasound in Small Renal Masses
Authors: Rubio Briones Jose , Collado Serra Argimiro , Gómez-Ferrer Lozano Alvaro , Casanova Ramón-Borja Juan , Iborra Juan Inmaculada , Solsona Narbón Eduardo
Published: December 2008

High-intensity focused ultrasound (HIFU) competes with radiofrequency and cryotherapy for the treatment of small renal masses as a third option among ablative approaches. As an emerging technique, its possible percutaneous or laparoscopic application, low discomfort to the patient and the absence of complications make this technology attractive for the management of small renal masses. This manuscript will focus on the principles, basic research and clinical applications of HIFU in small renal masses, reviewing the present literature. Therapeutic results are controversial and from an clinical view, HIFU must be considered a technique under investigation at present time. Further research is needed to settle its real indications in the management of small renal masses; maybe technical improvements will certainly facilitate its use in the management of small renal masses in the near future.
Security Framework for Pervasive Healthcare Architectures Utilizing MPEG-21 IPMP Components
Authors: Fragopoulos Anastasios , Gialelis John , Serpanos Dimitrios
Published: December 2008

Nowadays in modern and ubiquitous computing environments, it is imperative more than ever the necessity for deployment of pervasive healthcare architectures into which the patient is the central point surrounded by different types of embedded and small computing devices, which measure sensitive physical indications, interacting with hospitals databases, allowing thus urgent medical response in occurrences of critical situations. Such environments must be developed satisfying the basic security requirements for real-time secure data communication, and protection of sensitive medical data and measurements, data integrity and confidentiality, and protection of the monitored patient's privacy. In this work, we argue that the MPEG-21 Intellectual Property Management and Protection (IPMP) components can be used in order to achieve protection of transmitted medical information and enhance patient's privacy, since there is selective and controlled access to medical data that sent toward the hospital's servers.
Sex Cord-Gonadal Stromal Tumor of the Rete Testis
Authors: Sajadi Kamran P. , Dalton Rory R. , Brown James A.
Published: December 2008

A 34-year-old tetraplegic patient with suppurative epididymitis was found on follow-up examination and ultrasonography to have a testicular mass. The radical orchiectomy specimen contained an undifferentiated spindled sex cord-stromal tumor arising in the rete testis. Testicular sex cord-stromal tumors are far less common than germ cell neoplasms and are usually benign. The close relationship between sex cords and ductules of the rete testis during development provides the opportunity for these uncommon tumors to arise anatomically within the rete tesis. This undifferentiated sex cord-stromal tumor, occurring in a previously unreported location, is an example of an unusual lesion mimicking an intratesticular malignant neoplasm.
The Natural Convective Heat Transfer in a Partially Divided Enclosure: A Study on the Influence of the Source Position
Authors: Corvaro Francesco , Paroncini Massimo
Published: December 2008

The aim of this paper is to analyse the natural convective heat transfer generated by a source with a height of ζ located in two different positions inside a square enclosure of side H. In the first case, δ is 0.5 of H while in the second case it is 0.4. The comparison is based both on the evaluation of the local and average Nusselt numbers at different Rayleigh numbers and on the study of the velocity fields at the same Rayleigh numbers in the two different configurations. The experimental analysis was carried out through a holographic interferometry, to study the heat transfer, and through a 2D‐PIV system, to analyse the dynamic behaviour of the phenomenon. Finally, for δ = 0.5 we compared the experimental results with those obtained through the volume finite software Fluent 6.3.26. In the analysis, it is possible to see that the position of the source influences both the average Nusselt numbers on the hot surfaces and the development of a small bubble on the upper surface.
Inhibition of DNA Methyltransferase Activates Tumor Necrosis Factor α–Induced Monocytic Differentiation in Acute Myeloid Leukemia Cells
Authors: Laurenzana Anna , Petruccelli Luca A. , Pettersson Filippa , Figueroa Maria Eugenia , Melnick Ari , Baldwin Albert S. , Paoletti Francesco , Miller Wilson H.
Published: December 2008

Transcriptional silencing via promoter methylation of genes important for cell growth and differentiation plays a key role in myeloid leukemogenesis. We find that clinically achievable levels of 5-aza-2′-deoxycytidine (5-AZA-dC), a potent inhibitor of DNA methylation, can modify chromatin and restore the ability of tumor necrosis factor α (TNFα) to induce monocytic differentiation of the acute myeloid leukemia cells NB4 and U937. Although 5-AZA-dC cannot fully induce differentiation, we show that 5-AZA-dC acts directly on TNFα-responsive promoters to facilitate TNFα-induced transcriptional pathways leading to differentiation. 5-AZA-dC regulates the expression of Dif-2, a TNFα target gene, by deacetylating chromatin domains in a methylation-dependent manner. Chromatin immunoprecipitation analyses of the Dif-2 promoter show histone hyperacetylation and a recruitment of the nuclear factor-κB transcription factor in response to 5-AZA-dC. Furthermore, 5-AZA-dC plus TNFα enhances the level of phosphorylated RNA Pol II at the Dif-2 promoter via synergistic recruitment of TFIIH. We conclude that nonspecific changes in chromatin can allow a specific transcriptional inducer to overcome blocks in leukemic cell differentiation. Our results support the concept of low doses of 5-AZA-dC acting in combination with other agents to target epigenetic changes that drive malignant growth in leukemic cells. [Cancer Res 2009;69(1):55–64]
Aberrant Activation of Androgen Receptor in a New Neuropeptide-Autocrine Model of Androgen-Insensitive Prostate Cancer
Authors: Yang Joy C. , Ok Joon-ha , Busby J. Erik , Borowsky Alexander D. , Kung Hsing-Jien , Evans Christopher P.
Published: December 2008

Treatment of advanced prostate cancer with androgen deprivation therapy inevitably renders the tumors castration-resistant and incurable. Under these conditions, neuroendocrine differentiation of prostate cancer (CaP) cells is often detected and neuropeptides released by these cells may facilitate the development of androgen independence. Exemplified by gastrin-releasing peptide (GRP), these neuropeptides transmit their signals through G protein–coupled receptors, which are often overexpressed in prostate cancer, and aberrantly activate androgen receptor (AR) in the absence of androgen. We developed an autocrine neuropeptide model by overexpressing GRP in LNCaP cells and the resultant cell line, LNCaP-GRP, exhibited androgen-independent growth with enhanced motility in vitro. When orthotopically implanted in castrated nude mice, LNCaP-GRP produced aggressive tumors, which express GRP, prostate-specific antigen, and nuclear-localized AR. Chromatin immunoprecipitation studies of LNCaP-GRP clones suggest that GRP activates and recruits AR to the cognate promoter in the absence of androgen. A Src family kinase (SFK) inhibitor, AZD0530, inhibits androgen-independent growth and migration of the GRP-expressing cell lines, and blocks the nuclear translocation of AR, indicating the involvement of SFK in the aberrant activation of AR and demonstrating the potential use of SFK inhibitor in the treatment of castration-resistant CaP. In vivo studies have shown that AZD0530 profoundly inhibits tumor metastasis in severe combined immunodeficient mice implanted with GRP-autocrine LNCaP cells. This xenograft model shows autocrine, neuropeptide- and Src kinase–mediated progression of androgen-independent CaP postcastration, and is potentially useful for testing novel therapeutic agents. [Cancer Res 2009;69(1):151–60]
Functional Interaction between BubR1 and Securin in an Anaphase-Promoting Complex/CyclosomeCdc20–Independent Manner
Authors: Kim Hyun-Soo , Jeon Yoon-Kyung , Ha Geun-Hyoung , Park Hye-Young , Kim Yu-Jin , Shin Hyun-Jin , Lee Chang Geun , Chung Doo-Hyun , Lee Chang-Woo
Published: December 2008

Activation of the mitotic checkpoint requires the precise timing and spatial organization of mitotic regulatory events, and ensures accurate chromosome segregation. Mitotic checkpoint proteins such as BubR1 and Mad2 bind to Cdc20, and inhibit anaphase-promoting complex/cyclosomeCdc20–mediated securin degradation and the onset of anaphase. BubR1 mediates the proper attachment of microtubules to kinetochores, and links the regulation of chromosome-spindle attachment to mitotic checkpoint signaling. Therefore, disruption of BubR1 activity results in a loss of the checkpoint control, chromosome instability, and/or early onset of malignancy. In this study, we show that BubR1 directly interacts with securin in vitro and in vivo. In addition, the BubR1 interaction contributes to the stability of securin, and there is a significant positive correlation between BubR1 and securin expressions in human cancer. Importantly, BubR1 competes with Cdc20 for binding to securin, and thereby the interaction between BubR1 and securin is greatly increased by the depletion of Cdc20. Our findings may identify a novel regulation of BubR1 that can generate an additional anaphase-inhibitory signal through the Cdc20-independent interaction of BubR1 with securin. [Cancer Res 2009;69(1):27–36]
The Mechanisms of Differential Sensitivity to an Insulin-like Growth Factor-1 Receptor Inhibitor (BMS-536924) and Rationale for Combining with EGFR/HER2 Inhibitors
Authors: Huang Fei , Greer Ann , Hurlburt Warren , Han Xia , Hafezi Rameh , Wittenberg Gayle M. , Reeves Karen , Chen Jiwen , Robinson Douglas , Li Aixin , Lee Francis Y. , Gottardis Marco M. , Clark Edwin , Helman Lee , Attar Ricardo M. , Dongre Ashok , Carboni Joan M.
Published: December 2008

Overexpression and enhanced activity of insulin-like growth factor-I receptor (IGF-IR) in diverse tumor types make it an attractive target for cancer therapy. BMS-536924 is a potent small molecule inhibitor of IGF-IR, which shows antitumor activity in multiple tumor models, including sarcoma. To facilitate the development of IGF-IR inhibitors as cancer therapy, identification of biomarkers for selecting patients most likely to derive clinical benefit is needed. To do so, 28 sarcoma and neuroblastoma cell lines were screened for in vitro response to BMS-536924 to identify sensitive and resistant cell lines. Notably, Ewing's sarcoma, rhabdomyosarcoma, and neuroblastoma are more responsive to BMS-536924, suggesting these specific subtypes may represent potential targeted patient subpopulations for the IGF-IR inhibitor. Gene expression and protein profiling were performed on these cell lines, and candidate biomarkers correlating with intrinsic and/or acquired resistance to BMS-536924 were identified. IGF-I, IGF-II, and IGF-IR were highly expressed in sensitive cell lines, whereas IGFBP-3 and IGFBP-6 were highly expressed in resistant lines. Overexpression of epidermal growth factor receptor (EGFR) and its ligands in resistant cell lines may represent one possible resistance mechanism by the adaptation of IGF-IR–independent growth using alternative signaling pathways. Based on cross-talk between IGF-IR and EGFR pathways, combination studies to target both pathways were performed, and enhanced inhibitory activities were observed. These results provide a strategy for testing combinations of IGF-IR inhibitors with other targeted therapies in clinical studies to achieve improved patient outcomes. Further exploration of mechanisms for intrinsic and acquired drug resistance by these preclinical studies may lead to more rationally designed drugs that target multiple pathways for enhanced antitumor efficacy. [Cancer Res 2009;69(1):161–70]
Silencing PinX1 Compromises Telomere Length Maintenance As Well As Tumorigenicity in Telomerase-Positive Human Cancer Cells
Authors: Zhang Bin , Bai Yun Xiu , Ma Hang Hang , Feng Feng , Jin Rui , Wang Zhi Long , Lin Jian , Sun Shi Peng , Yang Pingxun , Wang Xiao Xiong , Huang Pei Tang , Huang Cui Fen , Peng Ying , Chen Yang Chao , Kung Hsiang-fu , Huang Jun Jian
Published: December 2008

The nucleolar protein PinX1 has been proposed to be a putative tumor suppressor due to its binding to and inhibition of the catalytic activity of telomerase, an enzyme that is highly expressed in most human cancers in which it counteracts telomere shortening–induced senescence to confer cancer cell immortalization. However, the role of PinX1 in telomere regulation, as well as in cancer, is still poorly understood. In this study, we showed that the PinX1 protein is constitutively expressed in various human cells regardless of their telomerase activity and malignant status. Most interestingly, we found that silencing PinX1 expression by a potent short hairpin RNA construct led to a robust telomere length shortening and growth inhibition in telomerase-positive but not in telomerase-negative human cancer cells. We further showed that silencing PinX1 significantly reduced the endogenous association of telomerase with the Pot1-containing telomeric protein complex, and therefore, could account for the phenotypic telomere shortening in the affected telomerase-positive cancer cells. Our results thus reveal a novel positive role for PinX1 in telomerase/telomere regulations and suggest that the constitutive expression of PinX1 attributes to telomere maintenance by telomerase and tumorigenicity in cancer cells. [Cancer Res 2009;69(1):75–83]
Low Levels of Tumor Necrosis Factor α Increase Tumor Growth by Inducing an Endothelial Phenotype of Monocytes Recruited to the Tumor Site
Authors: Li Bin , Vincent Alicia , Cates Justin , Brantley-Sieders Dana M. , Polk D. Brent , Young Pampee P.
Published: December 2008

Microenvironmental cues instruct infiltrating tumor-associated myeloid cells to drive malignant progression. A subpopulation of tumor-associated myeloid cells coexpressing endothelial and myeloid markers, although rare in peripheral blood, are primarily associated with tumors where they enhance tumor growth and angiogenesis. These biphenotypic vascular leukocytes result from the endothelial differentiation of myeloid progenitors, a process regulated by tumor necrosis factor (TNF)α in vitro. An in vivo increase in tumor-derived TNFα expression promoted tumor growth and vascularity of mouse melanoma, lung cancer, and mammary tumors. Notably, tumor growth was accompanied by a significant increase in myeloid/endothelial biphenotypic populations. TNFα-associated tumor growth, vascularity, and generation of tumor vascular leukocytes in mouse melanoma tumors were dependent on intact host TNFα receptors. Importantly, TNFα-expressing tumors did not exhibit increased inflammation over control tumors, suggesting a unique action related to myeloid to endothelial differentiation. Our studies suggest that TNFα constitutes a tumor microenvironment signal that biases recruited monocytes toward a proangiogenic/provasculogenic myeloid/endothelial phenotype. [Cancer Res 2009;69(1):338–48]
Regulation of Estrogen-Dependent Transcription by the LIM Cofactors CLIM and RLIM in Breast Cancer
Authors: Johnsen Steven A. , Güngör Cenap , Prenzel Tanja , Riethdorf Sabine , Riethdorf Lutz , Taniguchi-Ishigaki Naoko , Rau Thomas , Tursun Baris , Furlow J. David , Sauter Guido , Scheffner Martin , Pantel Klaus , Gannon Frank , Bach Ingolf
Published: December 2008

Mammary oncogenesis is profoundly influenced by signaling pathways controlled by estrogen receptor α (ERα). Although it is known that ERα exerts its oncogenic effect by stimulating the proliferation of many human breast cancers through the activation of target genes, our knowledge of the underlying transcriptional mechanisms remains limited. Our published work has shown that the in vivo activity of LIM homeodomain transcription factors (LIM-HD) is critically regulated by cofactors of LIM-HD proteins (CLIM) and the ubiquitin ligase RING finger LIM domain-interacting protein (RLIM). Here, we identify CLIM and RLIM as novel ERα cofactors that colocalize and interact with ERα in primary human breast tumors. We show that both cofactors associate with estrogen-responsive promoters and regulate the expression of endogenous ERα target genes in breast cancer cells. Surprisingly, our results indicate opposing functions of LIM cofactors for ERα and LIM-HDs: whereas CLIM enhances transcriptional activity of LIM-HDs, it inhibits transcriptional activation mediated by ERα on most target genes in vivo. In turn, the ubiquitin ligase RLIM inhibits transcriptional activity of LIM-HDs but enhances transcriptional activation of endogenous ERα target genes. Results from a human breast cancer tissue microarray of 1,335 patients revealed a highly significant correlation of elevated CLIM levels to ER/progesterone receptor positivity and poor differentiation of tumors. Combined, these results indicate that LIM cofactors CLIM and RLIM regulate the biological activity of ERα during the development of human breast cancer. [Cancer Res 2009;69(1):128–36]