bluuebunny/crossref_metadata_2025 huggingface dataset:
Antimicrobial activity of endophytic fungi associated with Orchidaceae in Brazil
Authors: Vaz Aline B.M. , Mota Rubens C. , Bomfim Maria Rosa Q. , Vieira Mariana L.A. , Zani Carlos L. , Rosa Carlos A. , Rosa Luiz H.
Published: December 2009

The purpose of this study was to examine antimicrobial activity of endophytic fungi isolated from the leaves, stems, and roots of 54 species of Orchidaceae collected in a Brazilian tropical ecosystem. In total, 382 filamentous fungi and 13 yeast isolates were obtained and cultured to examine the production of crude extracts. Thirty-three percent of the isolates displayed antimicrobial activity against at least one target microorganism. The multivariate statistical analyses conducted indicate that the extracts of endophytic fungi isolated from leaves of terrestrial orchids in semideciduous forest were more active against Escherichia coli , whereas extracts of endophytic fungi from roots of rupicolous orchids collected in rock fields were more active against Candida krusei and Candida albicans . Among the fungi that were screened in the study, 22 isolates held their antimicrobial activities after replication and were therefore selected for assessment of the minimum inhibitory concentration (MIC), which ranged from 62.5 to 250 µg/mL and 7.8 to 250 µg/mL against bacteria and fungi, respectively. One isolate of Alternaria sp. and one isolate of Fusarium oxysporum presented the strongest antibacterial activity. Three Fusarium isolates, Epicoccum nigrum , and Sclerostagonospora opuntiae showed the greatest MIC values against the pathogenic yeasts. This study is the first survey investigating the bioactive potential of endophytic fungi associated with tropical Orchidaceae species present in Brazilian ecosystems.
M-BRANE BOUND STATES AND THE SUPERSYMMETRY OF BPS SOLUTIONS IN THE BAGGER–LAMBERT THEORY
Authors: JEON IMTAK , KIM JONGWOOK , LEE BUM-HOON , PARK JEONG-HYUCK , KIM NAKWOO
Published: December 2009

We continue our study of BPS equations and supersymmetric configurations in the Bagger–Lambert (BL) theory. The superalgebra allows three different types of central extensions which correspond to compounds of various M-theory objects: M2-branes, M5-branes, gravity waves and Kaluza–Klein monopoles which intersect or have overlaps with the M2-branes whose dynamics is given by the BL action. As elementary objects they are all 1/2-BPS, and multiple intersections of n-branes generically break the supersymmetry into 1/2n, as it is well known. But a particular composite of M-branes can preserve from 1/16 up to 3/4 of the original [Formula: see text] supersymmetries as previously discovered. In this paper we provide the M-theory interpretation for various BPS equations, and also present explicit solutions to some 1/2-BPS equations.
ESTIMATE OF THE MAGNETIC FIELD STRENGTH IN HEAVY-ION COLLISIONS
Authors: SKOKOV V. V. , ILLARIONOV A. YU. , TONEEV V. D.
Published: December 2009

Magnetic fields created in the noncentral heavy-ion collision are studied within a microscopic transport model, namely the Ultrarelativistic Quantum Molecular Dynamics model (UrQMD). Simulations were carried out for different impact parameters within the SPS energy range (E lab = 10-158A GeV ) and for highest energies accessible for RHIC. We show that the magnetic field emerging in heavy-ion collisions has the magnitude of the order of [Formula: see text] for the SPS energy range and [Formula: see text] for the RHIC energies. The estimated value of the magnetic field strength for the LHC energy amounts to [Formula: see text].
GH Therapy in Noonan Syndrome: Review of Final Height Data
Authors: Dahlgren Jovanna
Published: December 2009

Background and Aims: Several studies, despite using small cohorts, have shown a short-term improvement in the height velocity of short children with Noonan syndrome (NS) when treated with recombinant growth hormone (GH). However, the question is whether or not this improvement is sustained until adult height is reached. This paper reviews the few studies reporting final height data of GH treatment in individuals with NS. Methods: Review of published papers from 4 main and several small studies with final height data after GH treatment in NS. Results: The range of height gain to adult age varies between 0.6 and 2.0 SDS, depending on genotype, age at start of treatment, duration of treatment and which growth charts are used. The younger the age at which treatment is started, the better the result. There seems to be a correlation between growth response and genotype, with a diminished growth response when the PTPN11 mutation is present. Conclusion: Data on the benefits of GH treatment during childhood and adolescence upon the final height are encouraging in individuals with NS. There is a substantial height gain during prepubertal years, which continues during the pubertal period, reaching a final height within the normal population in the majority of previously short individuals with NS.
Prognostic Modeling of Individual Patient Risk and Mortality Impact of Ischemic and Hemorrhagic Complications
Authors: Pocock Stuart J. , Mehran Roxana , Clayton Tim C. , Nikolsky Eugenia , Parise Helen , Fahy Martin , Lansky Alexandra J. , Bertrand Michel E. , Lincoff A. Michael , Moses Jeffrey W. , Ohman E. Magnus , White Harvey D. , Stone Gregg W.
Published: December 2009

Background—

Both ischemic and hemorrhagic complications increase mortality rate in acute coronary syndromes. Their frequency and relative importance vary according to individual patient risk profiles. We sought to develop prognostic models for the risk of myocardial infarction (MI) and major bleeding to assess their impact on risk of death and to examine the manner in which alternative antithrombotic regimens affect these risks in individual patients.

Methods and Results—

The Acute Catheterization and Urgent Intervention Triage Strategy (ACUITY) trial randomized 13 819 patients with acute coronary syndrome to heparin plus a glycoprotein IIb/IIIa inhibitor, bivalirudin plus a glycoprotein IIb/IIIa inhibitor, or bivalirudin alone. By logistic regression, there were 5 independent predictors of MI within 30 days (n=705; 5.1%) and 8 independent predictors of major bleeding (n=645; 4.7%), only 2 of which were common to both event types. In a covariate-adjusted, time-updated Cox regression model, both MI and major bleeding significantly affected subsequent mortality rate (hazard ratios, 2.7 and 2.9, respectively; both
P
<0.001). Treatment with bivalirudin versus heparin plus a glycoprotein IIb/IIIa inhibitor was associated with a nonsignificant 8% increase in MI and a highly significant 50% decrease in major bleeding. Given the individual patient risk profiles and the fact that bivalirudin prevented ≈6 major bleeds for each MI that might occur from its use, the estimated reduction in bleeding was greater than the estimated increase in MI by bivalirudin alone rather than heparin plus a glycoprotein IIb/IIIa inhibitor for nearly all patients.

Conclusions—

Consideration of the individual patient risk profile for MI and major bleeding and the relative treatment effects of alternative pharmacotherapies permits personalized decision making to optimize therapy of patients with acute coronary syndrome.

Clinical Trial Registration—

clinicaltrials.gov Identifier: NCT00093158.
A Model of Indispensability of a Large Glial Layer in Cerebrovascular Circulation
Authors: Gandrakota Rohit , Chakravarthy V. S. , Pradhan Ranjan K.
Published: December 2009

We formulate the problem of oxygen delivery to neural tissue as a problem of association. Input to a pool of neurons in one brain area must be matched in space and time with metabolic inputs from the vascular network via the glial network. We thus have a model in which neural, glial, and vascular layers are connected bidirectionally, in that order. Connections between neuro-glial and glial-vascular stages are trained by an unsupervised learning mechanism such that input to the neural layer is sustained by the precisely patterned delivery of metabolic inputs from the vascular layer via the glial layer. Simulations show that the capacity of such a system to sustain patterns is weak when the glial layer is absent. Capacity is higher when a glial layer is present and increases with the layer size. The proposed formulation of neurovascular interactions raises many intriguing questions about the role of glial cells in cerebral circulation.
Optimal Decision Making on the Basis of Evidence Represented in Spike Trains
Authors: Zhang Jiaxiang , Bogacz Rafal
Published: December 2009

Experimental data indicate that perceptual decision making involves integration of sensory evidence in certain cortical areas. Theoretical studies have proposed that the computation in neural decision circuits approximates statistically optimal decision procedures (e.g., sequential probability ratio test) that maximize the reward rate in sequential choice tasks. However, these previous studies assumed that the sensory evidence was represented by continuous values from gaussian distributions with the same variance across alternatives. In this article, we make a more realistic assumption that sensory evidence is represented in spike trains described by the Poisson processes, which naturally satisfy the mean-variance relationship observed in sensory neurons. We show that for such a representation, the neural circuits involving cortical integrators and basal ganglia can approximate the optimal decision procedures for two and multiple alternative choice tasks.
Terrorism and Policy: Introduction
Authors: Sandler Todd
Published: December 2009

This article sets the stage for the special issue by indicating the current focus in the literature on applying analytical tools to enlighten policy makers in the practice of counterterrorism in the post-9/11 era. In particular, the article briefly indicates the main areas of recent work. The article also introduces some key concepts. Next, the article highlights the methodology and main contributions of each of the seven articles of the special issue. The novelty and policy insights of each article are emphasized.
Le satanisme ou le “religieusement incorrect”
Authors: Bobineau Olivier
Published: December 2009

Le satanisme est l’objet de fantasmes en France pour au moins deux raisons principales. D’une part, ce phénomène social, reposant sur une doctrine dont nous verrons les grandes lignes, n’est jamais défini précisément. Cette absence de définition conduit les pouvoirs publics et l’opinion à multiplier les amalgames et à considérer tant des courants musicaux que des actes illégaux comme relevant du satanisme, dont on grossit les effectifs et l’impact social. D’autre part, le satanisme est considéré comme une religion menaçante, largement diffusée au sein de la jeunesse, en proie à une “perte des valeurs”. C’est pourquoi il convient tout d’abord de définir rigoureusement le satanisme à partir de recherches entamées depuis 1995 avant de voir en quoi le satanisme, loin d’être une religion, relève d’un fait religieux et constitue “le religieusement incorrect” ultraminoritaire.
Entre metanoïa et paranoïa: Approches sociologique et médiatique du satanisme en France
Authors: Mombelet Alexis
Published: December 2009

En dressant le portrait de trois satanistes français, il s’agit tout d’abord de lever le voile sur le regard qu’ils portent sur Satan et sur les pratiques auxquelles ils s’adonnent dans le cadre de leurs croyances. L’auteur montre ainsi dans quelle mesure le satanisme est symptomatique des grandes tendances qui touchent la religiosité contemporaine. Ensuite, à travers la délicate question du nombre de satanistes que le territoire français abrite, l’auteur se montre attentif au fossé existant entre les pouvoirs publics, dont les travaux sont relayés par les médias, et l’expérience vécue des satanistes, mais également des métalleux et des gothics, tous pointés du doigt dans un même mouvement. Enfin, cette mise en perspective le conduit à opérer une distinction entre le satanisme et l’imaginaire satanique, d’un côté, et le satanisme et les exactions dites “sataniques”, de l’autre.
Invisible Religion in a “Non-believing” Country: The Case of the Czech Republic
Authors: Hamplová Dana , Nešpor Zdeněk R.
Published: December 2009

The authors analyse contemporary ir/religiosity and spirituality in the Czech Republic using data from national censuses, international surveys and a specialized national survey on the de-traditionalization and individualization of religion from 2006. The authors conclude that the influence of socio-demographic characteristics on a respondent’s religiosity, both traditional and alternative, is weak; a more important factor in the determination of a person’s world-view was found to be his/her religious socialization or the absence thereof. The effectiveness of religious socialization differs significantly between the various churches; the least effective being the Catholic Church and Czechoslovak Hussite Church. For historical reasons, attitudes towards Catholicism also influence the Czech mind-set on religion in general. The out-of-church movement became established very early in the country’s history and was subsequently strengthened by Communist anticlericalism resulting in today’s prevalence of “non-believers”, the highest proportion in Europe.
Girls, gangs and violence: Assessing the evidence
Authors: Batchelor Susan
Published: December 2009

Current evidence on girls and gangs in the UK is considerably hampered by a set of methodological issues. The first of these stems from the difficulties associated with defining what constitutes a ‘gang’ or being a ‘gang member.’ A second set of issues arise from the fact that much of the qualitative research in this area is conducted by male adult researchers utilizing male gang members and adult practitioners as their source of information about females. The findings of such studies are challenged by research with girls and young women, which demonstrates that group involvement can be both rewarding and destructive for girls.
The public face of binge drinking: British and Danish young women, recent trends in alcohol consumption and the European binge drinking debate
Authors: Measham Fiona , Østergaard Jeanette
Published: December 2009

International and national data sets are utilized to compare changes in young women’s alcohol consumption between the UK and Denmark, two European countries renowned for their alcohol-related problems. Explanations for young women’s increased sessional drinking have previously focused on the public spectacle of the binge drinker and the notion of a ‘convergence’ between women’s and men’s consumption patterns, incomes and broader lifestyles. An apparent decline in young women’s binge drinking and weekly drinking in both countries since 2000 is counterbalanced by more frequent drinking, home drinking and wine drinking into middle age, associated with professional occupations. In the face of an enduring polarization of the public excesses of youth with supposedly civilized moderation within the home, the article argues for a more nuanced understanding of the relationship between alcohol, women’s changing lives and northern European drinking cultures.
Therapy to improve gestural expression in aphasia: a controlled clinical trial
Authors: Daumüller Maike , Goldenberg Georg
Published: December 2009

Objectives: To assess whether production of communicative gestures can be ameliorated by therapy, to explore factors that might influence individual variability of therapeutic success and to find out whether therapy effects generalize to unpractised gestures.

Setting: Hospital department specializing in rehabilitation of patients with neuropsychological disorders.

Subjects: Twenty-three consecutive severely aphasic patients received therapy; ten were tested repeatedly without interpolated therapy.

Design: Twenty-four communicative gestures were divided into three sets of eight gestures. In the therapy group one set was practised during each of three consecutive periods and after that period changes in proficiency were assessed for all three sets. Comparisons were made between changes of practised and unpractised gestures during each therapy period within the therapy group, and between changes of unpractised gestures in the therapy group, and the changes brought forward by repeated testing in the control group.

Interventions: Therapy was centred on familiarizing patients with the communicative functions of gestures and on improving the spatial precision of their gestures.

Main measure: Scoring of gestures considered their accuracy and the necessity of assistance.

Results: Therapy led to substantial improvement of practised gestures. There was also improvement of unpractised gestures which was significantly smaller than that of practised gestures but greater than the improvement induced by repeated testing in the control group.

Conclusions: In view of the limited generalization, gesture therapy should concentrate on gestures that are relevant for communication in daily living of the individual patients.
Exercise on a treadmill or walking outdoors? A randomized controlled trial comparing effectiveness of two walking exercise programmes late after stroke
Authors: Langhammer Birgitta , Stanghelle Johan K
Published: December 2009

Objective: To evaluate spatial and temporal gait characteristics and endurance late after stroke in people who had received two different walking exercises. A secondary aim was to compare the outcomes in relation to length of time exercising and number of exercise occasions between the two.

Design: A randomized controlled trial.

Setting: A private rehabilitation centre.

Subjects: Thirty-nine people with stroke entered the study, and five dropped out.

Interventions: Treadmill training versus walking outdoors.

Main measures: Six-Minute Walk Test, a 10-metre walk test and pulse rates at rest and in activity.

Results: There were significant differences in favour of the treadmill group in Six-Minute Walk Test distance (P = 0.04), Six-Minute Walk Test speed (P = 0.03), 10-m walking speed (P = 0.03), bilateral stride length (right leg; P =0.009, left leg; P =0.003) and step width (P = 0.01), indicating more symmetrical use of the legs in the treadmill group (1.02—1.10 m versus 0.97—0.92 m). There were no significant differences between groups in cadence (P = 0.78). All participants complied 100% with their respective programmes. Exercise frequency did not differ between the groups but significantly less time was spent exercising on the treadmill compared with walking exercise outdoors (107 versus 316 minutes, P =0.002). There were no differences in use of assistive aids between the groups on arrival at the clinic or at departure.

Conclusion: The results indicate that treadmill walking improves spatial and temporal gait characteristics more effectively than walking outdoors.
An integrated programme after pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: effect on emotional and functional dimensions of quality of life
Authors: Moullec G. , Ninot G.
Published: December 2009

Objective: To assess whether a maintenance integrated health care programme is effective in improving functional and emotional dimensions of quality of life in patients with chronic obstructive pulmonary disease (COPD) after a first pulmonary rehabilitation.

Design: Prospective controlled trial.

Setting: Three rehabilitation centres and three patient self-help associations within a health care network in France.

Subjects: Forty patients with moderate to severe COPD.

Interventions: After a first four-week inpatient pulmonary rehabilitation programme, patients took part in a maintenance integrated health care programme or usual care for 12 months.

Main measures: The primary outcomes were the change in functional and emotional dimensions of quality of life measured by the St George’s Respiratory Questionnaire (SGRQ), the brief World Health Organization Quality of Life questionnaire (Brief-WHOQOL) and six specific questions using a 10-cm visual analogue scale. Secondary outcomes were change in exercise tolerance measured by six-minute walking test and cycle exercise.

Results: At one year, the maintenance intervention (n = 11) produced improvements in functional and emotional dimensions scores of quality of life and exercise tolerance. Patients in the usual aftercare group (n = 16) exhibited maintenance of functional dimension scores of quality of life, but a clinically relevant decline in emotional scores of quality of life and in six-minute walking distance one year after the pulmonary rehabilitation.

Conclusion: Patient self-help association seems to be an innovative and efficient organizational structure to support patients with COPD after pulmonary rehabilitation in real-life settings. A distinction between emotional and functional dimensions of quality of life may improve the design and evaluation of integrated health care programmes in patients with COPD.
The Problem with Pluto
Authors: Messeri Lisa R.
Published: December 2009

In 2006, for the first time in its history, the International Astronomical Union defined the characteristics of a ‘planet’ in our Solar System and consequently demoted Pluto from ‘planet’ to ‘dwarf planet’. Scientific and popular discussion leading up to and following the formal definition of planet demonstrated that astronomers, amateurs, educators, and school children had been employing Pluto in different ways to construct multiple scientific and cultural cosmologies. Formalizing the definition brought these cosmologies into direct collision, necessarily privileging some cosmologies over others. The story of Pluto, from discovery to demotion, illustrates the discursive disruption that stemmed from forced consensus. Before ‘planet’ received a formal definition, it was a tacitly understood term that encompassed several meanings and acted as part of the contact language in a trading zone, as described by Peter Galison. Social groups were able to clearly communicate using the word ‘planet’ despite differing cosmologies. This paper takes a closer look at Pluto’s history, highlighting three moments when Pluto’s planetary status was challenged. Each moment — a controversial exhibit opening that excluded Pluto from the planetary display, the discovery of objects in the Solar System larger than Pluto, and the International Astronomical Union conference at which astronomers crafted the definition of planet — spurred discourse that accentuated conflicting cosmologies. Actors involved in these incidents directed the discussion in order to maintain clear communication or to make sure their cosmologies remained relevant. Only with the formal definition of planet, which excluded several popular and scientific cosmologies and shifted discussion about classification in our Solar System from a prototypical to an Aristotelian language, was Pluto demoted.
Ranitidine as an alcohol dehydrogenase inhibitor in acute methanol toxicity in rats
Authors: El-Bakary Amal A , El-Dakrory Sahar A , Attalla Sohayla M , Hasanein Nawal A , Malek Hala A
Published: December 2009

Methanol poisoning is a hazardous intoxication characterized by visual impairment and formic acidemia. The therapy for methanol poisoning is alcohol dehydrogenase (ADH) inhibitors to prevent formate accumulation. Ranitidine has been considered to be an inhibitor of both gastric alcohol and hepatic aldehyde dehydrogenase enzymes. This study aimed at testing ranitidine as an antidote for methanol acute toxicity and comparing it with ethanol and 4-methyl pyrazole (4-MP). This study was conducted on 48 Sprague-Dawley rats, divided into 6 groups, with 8 rats in each group (one negative control group [C1], two positive control groups [C2, C3] and three test groups [1, 2 and 3]). C2, C3 and all test groups were exposed to nitrous oxide by inhalation, then, C3 group was given methanol (3 g/kg orally). The three test groups 1, 2 and 3 were given ethanol (0.5 g/kg orally), 4-MP (15 mg/kg intraperitoneally) and ranitidine (30 mg/kg intraperitoneally), respectively, 4 hours after giving methanol. Rats were sacrificed and heparinized, cardiac blood samples were collected for blood pH and bicarbonate. Non-heparinized blood samples were collected for formate levels by high performance liquid chromatography. Eye balls were enucleated for histological examination of the retina. Ranitidine corrected metabolic acidosis (p = .025), decreased formate levels (p = .014) and improved the histological findings in the retina induced by acute methanol toxicity.
Systemic lupus erythematosus and strongyloidiasis: a multifaceted connection
Authors: Caramaschi P. , Marocco S. , Gobbo M. , La Verde V. , Volpe A. , Bambara LM , Biasi D.
Published: December 2009

We describe a case of systemic lupus erythematosus complicated by strongyloidiasis. The parasitic infection appeared with diarrhoea, weight loss and peripheral eosinophilia in association with recurrence of polyarthritis, probably due to a flare of systemic lupus erythematosus. The literature about the coexistence of systemic lupus erythematosus and strongyloidiasis has been reviewed.
Identification of autoantigens specific for systemic lupus erythematosus with central nervous system involvement
Authors: Iizuka N. , Okamoto K. , Matsushita R. , Kimura M. , Nagai K. , Arito M. , Kurokawa MS , Masuko K. , Suematsu N. , Hirohata S. , Kato T.
Published: December 2009

Using proteomic analysis, we identified candidate autoantigens specific for central nervous system (CNS) involvement in systemic lupus erythematosus (SLE). Proteins, extracted from cultured human neuroblastoma cells, were separated both by SDS-PAGE (1-DE) and two-dimensional electrophoresis (2-DE), and transferred to membranes. Western blot analysis was performed using serum samples from 30 SLE patients with CNS involvement (CNS-Lupus) and from 30 SLE patients without CNS involvement (non-CNS-SLE). The detected autoantigens were identified using MALDI-TOF/TOF MS. On the 1-DE Western blot, we detected 32 antigenic bands in the serum samples from the CNS-Lupus patients. Among them, four bands were detected significantly more frequently in the CNS-Lupus patients than in the non-CNS-SLE patients. Three bands were detected in four or more of the CNS-Lupus patients but in only one or none of the non-CNS-SLE patients. We thus selected these seven bands for the next investigations. Next, we detected protein spots corresponding to the selected seven bands by 2-DE Western blot and identified four proteins. They are peroxiredoxin-4, ubiquitin carboxyl-terminal hydrolase isozyme L1, splicing factor arginine/serine-rich 3, and histone H2A type 1. These four candidate autoantigens for the anti-neuronal cell antibodies would be a useful marker for CNS-Lupus.
Study Guides to the Rescue
Authors: Conderman Greg , Bresnahan Val
Published: December 2009

As general education classrooms become more diverse, teachers continue to explore ways to support students’ learning. Study guides support students in learning their material, focus their attention on important topics, and help them review for quizzes or tests. This article provides successful classroom-tested ideas for developing and using study guides in diverse inclusive settings. Names in vignette passages are pseudonyms.
Letter Writing as an Intervention in Family Therapy With Adolescents who Engage in Nonsuicidal Self-Injury
Authors: Hoffman Rachel , Gimenez Hinkle Michelle , White Kress Victoria
Published: December 2009

Family therapy can be an important component of a comprehensive treatment plan when counseling adolescents who engage in nonsuicidal self-injury. The authors provide a rationale for the use of letter writing as a therapeutic intervention when counseling families in which an adolescent engages in nonsuicidal self-injury. Descriptions of types of therapeutic letters are provided and illustrated in a case example.
Rational Use and Rationale for Use: Psychiatric Medication at an Argentine Institution for Intellectual Disability
Authors: de Menil Victoria , Cohen Alex
Published: December 2009

This article describes obstacles to the rational use of psychiatric drugs in a 1000-bed institution for people with intellectual disability employing the WHO framework for rationality. Quantitative data were collected from 98 charts and qualitative data from 14 individuals in this case study. Eight-three percent of patients were taking psychiatric medications, even though 67% of these had no psychiatric diagnosis. Antipsychotics were the first-order treatment; antidepressants were rarely prescribed. These prescribing patterns are influenced by institutional culture, including an emic construct of retardation as a form of psychosis. Low staff-to-patient ratios, a lack of non-medical treatments, and the hospitalization of patients for social reasons also contribute to medication misuse.
Transitions of Elders Between Long-Term Care and Hospitals
Authors: Naylor Mary D. , Kurtzman Ellen T. , Pauly Mark V.
Published: December 2009

Elderly long-term care recipients who require acute hospitalizations must navigate a fragmented system with poor “handoffs,” often resulting in negative outcomes. This article makes the case that reducing preventable hospitalizations and improving transitions to and from hospitals will enhance health care quality and outcomes among these elders. Immediate action targeting diffusion of evidence-based care is recommended to decrease avoidable rehospitalizations and achieve cost savings. Policy changes are needed to address barriers to high-quality transitional care, including deficits in health professionals’ and caregivers’ knowledge and resources, regulatory obstacles, and inadequate financial incentives and clinical information systems.
Choosing health, constrained choices
Authors: Chee Khoon Chan
Published: December 2009

In parallel with the neo-liberal retrenchment of the welfarist state, an increasing emphasis on the responsibility of individuals in managing their own affairs and their well-being has been evident. In the health arena for instance, this was a major theme permeating the UK government’s White Paper Choosing Health: Making Healthy Choices Easier (2004), which appealed to an ethos of autonomy and self-actualization through activity and consumption which merited esteem. As a counterpoint to this growing trend of informed responsibilization, constrained choices (constrained agency) provides a useful framework for a judicious balance and sense of proportion between an individual behavioural focus and a focus on societal, systemic, and structural determinants of health and well-being. Constrained choices is also a conceptual bridge between responsibilization and population health which could be further developed within an integrative biosocial perspective one might refer to as the social ecology of health and disease. (Global Health Promotion, 2009; 16 (4): pp. 54—57)
TLK1B promotes repair of DSBs via its interaction with Rad9 and Asf1
Authors: Canfield Caroline , Rains Justin , De Benedetti Arrigo
Published: December 2009

Background

The Tousled-like kinases are involved in chromatin assembly, DNA repair, transcription, and chromosome segregation. Previous evidence indicated that TLK1B can promote repair of plasmids with cohesive ends in vitro, but it was inferred that the mechanism was indirect and via chromatin assembly, mediated by its interaction with the chromatin assembly factor Asf1. We recently identified Rad9 as a substrate of TLK1B, and we presented evidence that the TLK1B-Rad9 interaction plays some role in DSB repair. Hence the relative contribution of Asf1 and Rad9 to the protective effect of TLK1B in DSBs repair is not known. Using an adeno-HO-mediated cleavage system in MM3MG cells, we previously showed that overexpression of either TLK1B or a kinase-dead protein (KD) promoted repair and the assembly of Rad9 in proximity of the DSB at early time points post-infection. This established that it is a chaperone activity of TLK1B and not directly the kinase activity that promotes recruitment of 9-1-1 to the DSB. However, the phosphorylation of Rad9(S328) by TLK1B appeared important for mediating a cell cycle checkpoint, and thus, this phosphorylation of Rad9 may have other effects on 9-1-1 functionality.

Results

Here we present direct evidence that TLK1B can promote repair of linearized plasmids with incompatible ends that require processing prior to ligation. Immunodepletion of Rad9 indicated that Rad9 was important for processing the ends preceding ligation, suggesting that the interaction of TLK1B with Rad9 is a key mediator for this type of repair. Ligation of incompatible ends also required DNA-PK, as addition of wortmannin or immunodepletion of Ku70 abrogated ligation. Depletion of Ku70 prevented the ligation of the plasmid but did not affect stimulation of the fill-in of the ends by added TLK1B, which was attributed to Rad9. From experiments with the HO-cleavage system, we now show that Rad17, a subunit of the "clamp loader", associates normally with the DSB in KD-overexpressing cells. However, the subsequent release of Rad17 and Rad9 upon repair of the DSB was significantly slower in these cells compared to controls or cells expressing wt-TLK1B.

Conclusions

TLKs play important roles in DNA repair, not only by modulation of chromatin assembly via Asf1, but also by a more direct function in processing the ends of a DSB via interaction with Rad9. Inhibition of Rad9 phosphorylation in KD-overexpressing cells may have consequences in signaling completion of the repair and cell cycle re-entry, and could explain a loss of viability from DSBs in these cells.
Decreased mitochondrial DNA content in blood samples of patients with stage I breast cancer
Authors: Xia Peng , An Han-Xiang , Dang Cheng-Xue , Radpour Ramin , Kohler Corina , Fokas Emmanouil , Engenhart-Cabillic Rita , Holzgreve Wolfgang , Zhong Xiao Yan
Published: December 2009

Background

Alterations of mitochondrial DNA (mtDNA) have been implicated in carcinogenesis. We developed an accurate multiplex quantitative real-time PCR for synchronized determination of mtDNA and nuclear DNA (nDNA). We sought to investigate whether mtDNA content in the peripheral blood of breast cancer patients is associated with clinical and pathological parameters.

Methods

Peripheral blood samples were collected from 60 patients with breast cancer and 51 age-matched healthy individuals as control. DNA was extracted from peripheral blood for the quantification of mtDNA and nDNA, using a one-step multiplex real-time PCR. A FAM labeled MGB probe and primers were used to amplify the mtDNA sequence of the ATP 8 gene, and a VIC labeled MGB probe and primers were employed to amplify the glyceraldehyde-3-phosphate-dehydrogenase gene. mtDNA content was correlated with tumor stage, menstruation status, and age of patients as well as lymph node status and the expression of estrogen receptor (ER), progesterone receptor (PR) and Her-2/neu protein.

Results

The content of mtDNA in stage I breast cancer patients was significantly lower than in other stages (overall P = 0.023). Reduced mtDNA was found often in post menopausal cancer group (P = 0.024). No difference in mtDNA content, in regards to age (p = 0.564), lymph node involvement (p = 0.673), ER (p = 0.877), PR (p = 0.763), and Her-2/neu expression (p = 0.335), was observed.

Conclusion

Early detection of breast cancer has proved difficult and current detection methods are inadequate. In the present study, decreased mtDNA content in the peripheral blood of patients with breast cancer was strongly associated with stage I. The use of mtDNA may have diagnostic value and further studies are required to validate it as a potential biomarker for early detection of breast cancer.
Early detection of influenza outbreaks using the DC Department of Health's syndromic surveillance system
Authors: Griffin Beth Ann , Jain Arvind K , Davies-Cole John , Glymph Chevelle , Lum Garret , Washington Samuel C , Stoto Michael A
Published: December 2009

Background

Since 2001, the District of Columbia Department of Health has been using an emergency room syndromic surveillance system to identify possible disease outbreaks. Data are received from a number of local hospital emergency rooms and analyzed daily using a variety of statistical detection algorithms. The aims of this paper are to characterize the performance of these statistical detection algorithms in rigorous yet practical terms in order to identify the optimal parameters for each and to compare the ability of two syndrome definition criteria and data from a children's hospital versus vs. other hospitals to determine the onset of seasonal influenza.

Methods

We first used a fine-tuning approach to improve the sensitivity of each algorithm to detecting simulated outbreaks and to identifying previously known outbreaks. Subsequently, using the fine-tuned algorithms, we examined (i) the ability of unspecified infection and respiratory syndrome categories to detect the start of the flu season and (ii) how well data from Children's National Medical Center (CNMC) did versus all the other hospitals when using unspecified infection, respiratory, and both categories together.

Results

Simulation studies using the data showed that over a range of situations, the multivariate CUSUM algorithm performed more effectively than the other algorithms tested. In addition, the parameters that yielded optimal performance varied for each algorithm, especially with the number of cases in the data stream. In terms of detecting the onset of seasonal influenza, only "unspecified infection," especially the counts from CNMC, clearly delineated influenza outbreaks out of the eight available syndromic classifications. In three of five years, CNMC consistently flags earlier (from 2 days up to 2 weeks earlier) than a multivariate analysis of all other DC hospitals.

Conclusions

When practitioners apply statistical detection algorithms to their own data, fine tuning of parameters is necessary to improve overall sensitivity. With fined tuned algorithms, our results suggest that emergency room based syndromic surveillance focusing on unspecified infection cases in children is an effective way to determine the beginning of the influenza outbreak and could serve as a trigger for more intensive surveillance efforts and initiate infection control measures in the community.
Assessing exposure, uptake and toxicity of silver and cerium dioxide nanoparticles from contaminated environments
Authors: Gaiser Birgit K , Fernandes Teresa F , Jepson Mark , Lead Jamie R , Tyler Charles R , Stone Vicki
Published: December 2009

The aim of this project was to compare cerium oxide and silver particles of different sizes for their potential for uptake by aquatic species, human exposure via ingestion of contaminated food sources and to assess their resultant toxicity. The results demonstrate the potential for uptake of nano and larger particles by fish via the gastrointestinal tract, and by human intestinal epithelial cells, therefore suggesting that ingestion is a viable route of uptake into different organism types. A consistency was also shown in the sensitivity of aquatic, fish cell and human cell models to Ag and CeO2 particles of different sizes; with the observed sensitivity sequence from highest to lowest as: nano-Ag > micro Ag > nano CeO2 = micro CeO2. Such consistency suggests that further studies might allow extrapolation of results between different models and species.
Knowledge, use and ecology of golden thistle (Scolymus hispanicus L.) in Central Spain
Authors: Polo Sandra , Tardío Javier , Vélez-del-Burgo Ainhoa , Molina María , Pardo-de-Santayana Manuel
Published: December 2009

Background

This paper assesses the current ethnobotanical knowledge, use and management of Scolymus hispanicus L. in two localities of Central Spain and the relation with its natural abundance. It also addresses the influence of sociodemographic factors such as age, gender and time living in the village in the variation of knowledge and practice levels.

Methods

During 2007 and 2008, 99 semi-structured interviews and a questionnaire were made to a random stratified sample by sex and age, asking them about their traditional knowledge and practices (use and gathering) of Scolymus hispanicus. A knowledge and practice (KP) index was created based on the answers to the questionnaire.

Results and Discussion

Scolymus hispanicus is still gathered and consumed by 20% and 35% of the informants, respectively. According to the KP index, the knowledge and practice level is similar in both villages. Age and time living in the village are the factors that better explain the variability in the KP level. People living for more than ten years in the village and those older than 60 years have the highest knowledge level, whereas the younger than 19 the lowest.

Conclusions

Our data suggests that the prevalence of ethnobotanical knowledge and uses depends more on the cultural importance of the plant and the transmission of such popular knowledge than on the resource's abundance.
Late treatment with imatinib mesylate ameliorates radiation-induced lung fibrosis in a mouse model
Authors: Li Minglun , Abdollahi Amir , Gröne Hermann-Josef , Lipson Kenneth E , Belka Claus , Huber Peter E
Published: December 2009

Background

We have previously shown that small molecule PDGF receptor tyrosine kinase inhibitors (RTKI) can drastically attenuate radiation-induced pulmonary fibrosis if the drug administration starts at the time of radiation during acute inflammation with present but limited effects against acute inflammation. To rule out interactions of the drug with acute inflammation, we investigated here in an interventive trial if a later drug administration start at a time when the acute inflammation has subsided - has also beneficial antifibrotic effects.

Methods

Whole thoraces of C57BL/6 mice were irradiated with 20 Gy and treated with the RTKI imatinib starting either 3 days after radiation (during acute inflammation) or two weeks after radiation (after the acute inflammation has subsided as demonstrated by leucocyte count). Lungs were monitored and analyzed by clinical, histological and in vivo non-invasive computed tomography as a quantitative measure for lung density and lung fibrosis.

Results

Irradiation induced severe lung fibrosis resulting in markedly reduced mouse survival vs. non-irradiated controls. Both early start of imatinib treatment during inflammation and late imatinib start markedly attenuated the development of pulmonary fibrosis as demonstrated by clinical, histological and qualitative and quantitative computed tomography results such as reduced lung density. Both administration schedules resulted in prolonged lifespans. The earlier drug treatment start resulted in slightly stronger beneficial antifibrotic effects along all measured endpoints than the later start.

Conclusions

Our findings show that imatinib, even when administered after the acute inflammation has subsided, attenuates radiation-induced lung fibrosis in mice. Our data also indicate that the fibrotic fate is not only determined by the early inflammatory events but rather a complex process in which secondary events at later time points are important. Because of the clinical availability of imatinib or similar compounds, a meaningful attenuation of radiation-induced lung fibrosis in patients seems possible.
Long-Term Follow-Up of Cisplatin Combination Chemotherapy in Patients With Disseminated Nonseminomatous Germ Cell Tumors: Is a Postchemotherapy Retroperitoneal Lymph Node Dissection Needed After Complete Remission?
Authors: Ehrlich Yaron , Brames Mary J. , Beck Stephen D.W. , Foster Richard S. , Einhorn Lawrence H.
Published: December 2009

Purpose

Controversy arises regarding the optimal management of patients with nonseminomatous germ cell tumor (NSGCT) who achieve a serologic and radiographic complete remission (CR) to systemic chemotherapy. Some authors recommend postchemotherapy retroperitoneal lymph node dissection (PC-RPLND), whereas others omit surgery and observe these patients. In an attempt to address this question, we report the long-term follow-up of patients treated at Indiana University who were observed without PC-RPLND.

Patients and Methods

This is a retrospective analysis of patients with NSGCT who achieved a CR to first-line chemotherapy and were monitored without further therapy. CR was defined as normalization of serum tumor markers and resolution of radiographic disease (residual mass < 1 cm).

Results

One hundred forty-one patients were identified. Five patients (4%) had less than 2 years of follow-up. After a median follow-up of 15.5 years, 12 patients (9%) experienced relapse. Of these 12 patients, eight patients currently have no evidence of disease (NED), and four patients died of disease. The estimated 15-year recurrence-free survival (RFS) and cancer-specific survival rates were 90% and 97%, respectively. The estimated 15-year RFS for good-risk patients (n = 109) versus intermediate- or poor-risk patients (n = 32) was 95% and 73% (P = .001), respectively. Six patients (4%) experienced recurrence in the retroperitoneum, of whom two patients died of disease. Five patients had late relapse (range, 3 to 13 years), including two patients in the retroperitoneum. All five patients currently have NED.

Conclusion

Patients obtaining a CR after first-line chemotherapy can be safely observed without PC-RPLND. Relapses are rare and potentially curable with further treatment.
Multicenter, Phase II Study of Decitabine for the First-Line Treatment of Older Patients With Acute Myeloid Leukemia
Authors: Cashen Amanda F. , Schiller Gary J. , O'Donnell Margaret R. , DiPersio John F.
Published: December 2009

Purpose

Older patients with acute myeloid leukemia (AML) have limited treatment options because of the lack of effectiveness and the toxicity of available therapies. We investigated the efficacy and toxicity of the hypomethylating agent decitabine as initial therapy in older patients with AML.

Patients and Methods

In this multicenter, phase II study, patients older than 60 years who had AML (ie, > 20% bone marrow blasts) and no prior therapy for AML were treated with decitabine 20 mg/m2 intravenously for 5 consecutive days of a 4-week cycle. Response was assessed by weekly CBC and bone marrow biopsy after cycle 2 and after each subsequent cycle. Patients continued to receive decitabine until disease progression or an unacceptable adverse event occurred.

Results

Fifty-five patients (mean age, 74 years) were enrolled and were treated with a median of three cycles (range, one to 25 cycles) of decitabine. The expert-reviewed overall response rate was 25% (complete response rate, 24%). The response rate was consistent across subgroups, including in patients with poor-risk cytogenetics and in those with a history of myelodysplastic syndrome. The overall median survival was 7.7 months, and the 30-day mortality rate was 7%. The most common toxicities were myelosuppression, febrile neutropenia, and fatigue.

Conclusion

Decitabine given in a low-dose, 5-day regimen has activity as upfront therapy in older patients with AML, and it has acceptable toxicity and 30-day mortality.