bluuebunny/crossref_metadata_2025 huggingface dataset:
Hearing Assistive Technology Considerations for Older Individuals With Dual Sensory Loss
Authors: Kricos Patricia B.
Published: February 2008

This article focuses on the current state of the science related to audiologic rehabilitation of individuals with dual sensory impairment, with an emphasis on considerations for provision of appropriate hearing assistive technology for this population. A substantial increase in the number of older adults is predicted in the coming years, many of whom will have significant age-related impairments in hearing and vision. Thus, hearing care professionals will be called on increasingly to attend to the special needs of people with dual sensory impairment to ensure maximal quality of life and independence for these individuals. Access to sound is critical for individuals who live with compromises in both vision and hearing. Hearing assistive technology may improve not only their speech perception but also their connection and orientation to the environment, as well as enable greater mobility. Thus, the audiologist's provision of appropriate and carefully selected hearing assistive technology may contribute dramatically to the quality of life of the individual with dual sensory loss. Prefitting, fitting, and postfitting considerations in providing hearing aids and other assistive technology to individuals with dual sensory impairment are reviewed.
Men between Worlds
Authors: Aboim Sofia
Published: February 2008

In 2003 Mozambique’s parliament approved a new legal code that proposes a “Western” view of family and gender roles. These changes question the social organization and the symbolic views of gender in Mozambique. We show how men are reconstructing their identities when caught between tradition and male dominance and the Westernized values of the modern equalitarian family. We analyze change at the levels of individual practices and identities and of societal symbolic models to show how entanglements are produced at both levels. At the macro-level the law legitimates Western values and deals with hybrid realities. At the micro-level, men live entangled trajectories in which they mix different references and social times when relating themselves to hegemonic masculinity(ies). The analysis draws on data collected in urban Maputo both through a survey applied to Eduardo Mondlane University students and in-depth interviews with men from several generations and contexts.
THE EFFECT OF ELBOW POSITION ON THE RANGE OF SUPINATION AND PRONATION OF THE FOREARM
Authors: SHAABAN H. , PEREIRA C. , WILLIAMS R. , LEES V. C.
Published: February 2008

A kinematic study was performed to examine the influence of elbow position on the range of supination and pronation of the forearm. The ranges of supination and pronation were measured in 50 volunteers (25 men and 25 women) using a custom-designed jig which constrained unwanted and confounding movements of the limb. Measurements were taken with the elbow in full extension, 45° flexion, 90° flexion and full flexion. The data showed a reciprocal relationship between the range of supination and the range of pronation of the forearm which depended on the degree of elbow flexion. As the elbow is flexed, the maximum angle of supination increases while the maximum angle of pronation decreases ( p<0.001). The converse is true as the elbow is extended ( p<0.001).
TWO TO FIVE YEAR FOLLOW-UP OF THE LPM CERAMIC COATED PROXIMAL INTERPHALANGEAL JOINT ARTHROPLASTY
Authors: FIELD J.
Published: February 2008

This paper presents a retrospective series of 20 LPM semi-constrained ceramic coated cobalt chrome proximal interphalangeal joint arthroplasties performed consecutively in 12 patients for arthritis of the proximal interphalangeal joint by a single surgeon between 2000 and 2004. Eleven were performed for osteoarthritis, four for post-traumatic arthritis and five for rheumatoid arthritis. Although 12 joints had an improvement in pain and an increased functional arc of movement, six joints required revision surgery for implant failure at an average of 19 months, with clinical signs of increasing pain, deteriorating motion and radiological signs of implant loosening and subsidence. This rate of revision is higher than in published series for other PIP joint implants and, therefore, close surveillance of all patients with this prosthesis currently in situ is recommended. Use of the prosthesis has ceased in this unit.
OPEN REDUCTION AND INTERFRAGMENTARY SCREW FIXATION FOR SYMPTOMATIC NONUNION OF DISTAL PHALANGEAL FRACTURES
Authors: CHIM H. , TEOH L. C. , YONG F. C.
Published: February 2008

Although most distal phalangeal fractures can be treated conservatively, there exists a subset of patients who are liable to develop symptomatic non-union, manifesting as pain and/or instability, and who may benefit from early fracture fixation. This group of patients includes those with displaced or comminuted fractures of the shaft or neck and those with oblique fractures prone to displacement. This paper reviews the use of a cortical miniscrew for fixation of fracture non-union in these patients and shows that this is an effective treatment modality with minimal morbidity. Fourteen patients with fractures of the shaft or neck of the distal phalanx complicated by symptomatic non-union were treated by open reduction and interfragmentary screw fixation. All of the fractures united at a mean of 4.2 months and all patients regained normal function of the finger.
THE CLINICAL FEATURES OF ULNAR POLYDACTYLY IN A MIDDLE EASTERN POPULATION
Authors: AL-QATTAN M. M. , AL-SHANAWANI B. , AL-THUNAYAN A. , AL-NAMLA A.
Published: February 2008

Two clinical forms of ulnar polydactyly are recognised in the literature, viz the African and the Caucasian forms. The current study investigated the clinical and radiological features of ulnar polydactyly in 94 Saudi patients. The incidence of ulnar polydactyly was one in 1000 live births. There were 41 males and 53 females. Positive family history, syndromal cases, associated hand anomalies, polydactyly of the little toe and systemic abnormalities were seen in 11%, 6%, 5%, 29% and 23% of cases, respectively. There were 50 unilateral (53%) and 44 bilateral cases (47%). In unilateral cases, the left hand was more commonly affected. Using a modified Rayan–Frey classification, the majority of cases were classified as Type II (pedunculated polydactyly, 52 (55%) cases) and Type III (a functioning and articulating extra digit without complete duplication of the metacarpal, 29 (31%) cases). It was concluded that the Saudi clinical presentation of ulnar polydactyly is somewhat different epidemiologically and lies between the African and Caucasian forms.
LONG TERM FOLLOW-UP AFTER FINGER REPLANTATION
Authors: WALASZEK I. , ZYLUK A.
Published: February 2008

The aim of this retrospective study was to assess objective and subjective aspects of the long-term results of finger replantations and revascularisations. Forty patients with 59 successfully replanted or revascularised fingers, who had a mean age of 38 years, were followed-up over an average of 3.5 years. The assessment included: the profile of the blood flow in the digital arteries of replanted fingers with Doppler ultrasound, active range of motion, total grip strength, pinch grip, static two-point discrimination test and Semmes–Weinstein monofilament testing. The dexterity of the hand was evaluated subjectively with the Carlsson’s questionnaire and cold intolerance with a modified McCabe’s questionnaire. Statistical analysis was performed and a statistically significant correlation was found between the Carlsson’s functional score, active range of motion and total grip strength. In 28 fingers (74%), blood flow in the digital arteries showed an undisturbed profile, while ten fingers showed mild stenosis or impaired microcirculation.
A STUDY OF FUNCTIONAL OUTCOMES FOLLOWING IMPLANTATION OF A TOTAL DISTAL RADIOULNAR JOINT PROSTHESIS
Authors: LAURENTIN-PÉREZ L. A. , GOODWIN A. N. , BABB B. A. , SCHEKER L. R.
Published: February 2008

This paper reports a long-term follow-up measuring pain, range of motion and weight-bearing ability, following implantation of a total distal radioulnar joint prosthesis. This prosthesis differs from excision arthroplasties and ulnar head replacements by replacing all three components of the distal radioulnar joint, viz. the sigmoid notch, the ulnar head and the triangular fibrocartilage. The design allows longitudinal migration of the radius throughout pronation and supination, as well as load bearing of the wrist. Thirty-one patients receiving the prosthesis returned or were interviewed by telephone at a mean of 5.9 (range 4–9) years. Pronation increased from a mean of 65.5° (range 5–90°) to 74° (range 20–90°) and supination from 53° (range 5–90°) to 70° (range 20–90°) while greatly diminishing and/or eliminating pain. Grip increased from a mean of 10 kg (22 lbs) to 24 kg (52 lbs). Weight bearing was restored or increased in 29 of 31 patients.
KELOID FORMATION RESULTING IN ACQUIRED SYNDACTYLY OF AN INITIALLY NORMAL WEB SPACE FOLLOWING SYNDACTYLY RELEASE OF AN ADJACENT WEB SPACE
Authors: TONKIN M. A. , WILLIS K. R. , LAWSON R. D.
Published: February 2008

We present a case of acquired syndactyly secondary to keloid formation in a previously normal web space following release of syndactyly in the adjacent web space.
Ultrasound Examination of the Knee: an Illustrated Guide
Authors: Descamps Marjanne JL , Lim Adrian KP , Mitchell Adam WM
Published: February 2008

Ultrasound (US) is increasingly used for the assessment of periarticular structures of the knee and is frequently used in conjunction with magnetic resonance imaging and plain radiography. This pictorial essay describes a step-by-step approach for the ultrasonic examination of the knee and illustrates the normal anatomical structures which can be demonstrated with US.
Sonographer Role Extension and Career Development; a Review of the Evidence
Authors: Hart Alex , Dixon Anne-Marie
Published: February 2008

Role development for imaging allied health professionals has progressed significantly over the last three decades with many major developments pioneered in the field of ultrasound. This paper reviews the developing role of the radiographer in ultrasound and some of the clinical, professional and educational implications of such development. As the published evidence base underpinning the latest developments is scarce, several contemporary case study examples, which have been presented verbally at study days attended by the authors, have been included. In conclusion, sonographer role development is considered within the professional contexts of extended role, advanced and consultant practice.
The Impact of Primary Ultrasound and ICT on Eradicating Disease and Poverty
Authors: Conlon Rosie M
Published: February 2008

In July 2007, the author attended a meeting of the United Nations Economic and Social High Level Segment held during the world leaders' summit (G8 summit). The primary aim of attendance was to explain to the Information and Computer Technology (ICT) Segment how ultrasound can help achieve the health-related Millennium Development Goals. This article reviews the aims of the Millennium Development Goals, the progress that has already been made towards achieving the health-related ones and explains the potential impact of ultrasound and ICT in remote and resource poor environments. Finally the article highlights the personal and professional contributions that UK healthcare workers can make to the United Nations Development Programme.
Ultrasound in Anaesthesia; the Best Kept Secret
Authors: Donovan Andrew D , Nicholls Barry J
Published: February 2008

The modern practice of anaesthesia and critical care includes performing a number of invasive procedures. These historically have been performed using surface anatomical landmarks to guide needle placement. As a result of this, both success and complication rates have varied considerably. Although radiologists have for many years used two-dimensional ultrasound to guide needle insertion in practical procedures, anaesthetists have not until recently had the resources or training to use such equipment. Developments in ultrasound technology like the introduction of cheap portable high-resolution ultrasound have changed the way anaesthetists perform clinical assessments and practical procedures in theatres and in the critical care setting. We present an overview of the use of ultrasound in anaesthesia illustrated with simple clinical scenarios that give the reader a feel for the impact that the introduction of ultrasound has had on the daily practice of anaesthesia.
Ultrasound for Inflammatory Bowel Disease in Gastroenterology; an Introduction to Basic Technique and Image Interpretation
Authors: Dixon Andrew , Rodgers Peter
Published: February 2008

Bowel ultrasound is often considered as a relatively specialist technique and a lot of sonographers shy away from it, perhaps fearing ridicule from experts in the field. However, as ultrasound becomes more available, and as a wider range of practitioners (like myself) achieve competence, the taboos of specialist ultrasound techniques are being broken down. This paper is a guide to the technique and application of bowel ultrasound for the new or novice practitioner which aims to provide a solid understanding of the technique upon which to build with further experience.

Background: Dr Dixon is a medical gastroenterologist (non-radiologist) who has undertaken training and achieved a postgraduate certificate in medical ultrasound. He sees the role of ultrasound for the gastroenterologist, as a direct extension of clinical history taking and a medical examination. With inflammatory bowel disease a common presentation to gastroenterology clinics, he feels that the ability to use ultrasound to scan patients in a safe and reliable way is invaluable. Dr Dixon uses bowel ultrasound as an extended examination and challenges all, with a bit of practice, to embrace the technique and advance their skills. He believes if he can do it… so can everyone else.
Prenatal Diagnosis of Velamentous Cord Insertion and Vasa Praevia using Ultrasound and Magnetic Resonance Imaging - A Case Report
Authors: Shamas Ambrinbi Gull , Kambhapati Lithabi , Abu-Ghazza Osamabi , Dabbagh Zaidbi , Abdul-kadirbi Rezanbi
Published: February 2008

Velamentous insertion of the cord is defined as insertion of the umbilical cord into membranes before it enters the placenta. It occurs in 1% of singleton pregnancies. Vasa praevia occurs when the amniotic membrane with the velamentous vessels covers the cervical os. Its incidence is 1/2000 to 1/3000 but when it happens prenatal mortality is between 30%-100% from rupture of vessels and fetal exsanguination. Prenatal diagnosis and early delivery by Caesarean section at 36 weeks improve fetal outcome.
Vasa Praevia; a Preventable Tragedy
Authors: Daly-Jones Elizabeth , John Ann , Leahy Alison , Mckenna Ciara , Sepulveda Waldo
Published: February 2008

Vasa praevia can have the catastrophic consequences of a fetal or neonatal death. There are few antenatal diagnoses whereby ultrasound can have such a direct impact on outcome and dramatically increase the chances of survival in pregnancies affected by this condition. The exclusion of vasa praevia can take under a minute and its inclusion within the routine anomaly scan should be prioritised. Until this occurs, healthy babies will continue to die due to this condition.
Rabbit ATG but not horse ATG promotes expansion of functional CD4+CD25highFOXP3+ regulatory T cells in vitro
Authors: Feng Xingmin , Kajigaya Sachiko , Solomou Elena E. , Keyvanfar Keyvan , Xu Xiuli , Raghavachari Nalini , Munson Peter J. , Herndon Thomas M. , Chen Jichun , Young Neal S.
Published: February 2008

Regulatory T cells (Treg) play important roles in suppressing immune responses and maintaining tolerance. Rabbit antithymocyte globulin (rATG) and horse ATG (hATG) are widely used in the treatment of immune-mediated syndromes, but their effects on Treg are unknown. We show here that in vitro culture of normal human peripheral blood mononuclear cells (PBMCs) with a low-dose rATG resulted in marked expansion of functional Treg by converting CD4+CD25− T cells to CD4+CD25+ T cells. hATG did not expand but rather decreased Treg. Immuno-blot showed increased expression of FOXP3 and NFAT1 in CD4+CD25− and CD4+CD25+ T cells exposed to rATG. PBMCs treated with rATG displayed increased interleukin-10 in culture supernatants than those treated with hATG. Furthermore, rATG and hATG showed differences in their potential to stimulate CD4+ T cells as examined using different activation markers. Microarray revealed that rATG induced markedly different gene-expression patterns in PBMCs, compared with hATG-treated or untreated PBMCs. Our findings indicate that rATG expanded Treg, probably through transcriptional regulation by enhanced NFAT1 expression, in turn conferring CD4+CD25− T cell FOXP3 expression and regulatory activity. The therapeutic effects of rATG may occur not only because of lymphocyte depletion but also enhanced Treg cell number and function.
From speciation to introgressive hybridization: the phylogeographic structure of an island subspecies of termite, Reticulitermes lucifugus corsicus
Authors: Lefebvre Thomas , Châline Nicolas , Limousin Denis , Dupont Simon , Bagnères Anne-Geneviève
Published: February 2008

Background

Although much research has been carried out into EuropeanReticulitermestaxonomy in recent years, there is still much discussion about phylogenetic relationships. This study investigated the evolution from intra- to interspecific phylogeny in the island subspeciesReticulitermes lucifugus corsicusand threw new light on this phenomenon. An integrative approach based on microsatellites and mitochondrial and nuclear DNA sequences was used to analyze samples taken from a wide area around the Tyrrhenian sea and showed how the subspecies evolved from its origins to its most recent form on continental coasts.

Results

According to mitochondrial phylogeny and molecular clock calculations, island and continental taxa diverged significantly by vicariance in the Pleistocene glacial period. However, more recently, numerous migrations, certainly human-mediated, affected the structure of the populations. This study provided evidence of direct hybridization and multiple introgressions which occurred in several hybrid areas. Analysis using STRUCTURE based on microsatellite data identified a population in Provence (France) which differed considerably (Fst = 0.477) from populations on the island of Corsica and in Tuscany in the Italian peninsula. This new population, principally distributed in urban areas, is highly heterogeneous especially within the ITS2 regions where homogenization by concerted evolution does not appear to have been completed.

Conclusion

This study provides an unusual picture of genetic interaction between termite populations in the Tyrrhenian area and suggests that more attention should be paid to the role of introgression and human impact on the recent evolution of European termites.
Prevalence of common disease-associated variants in Asian Indians
Authors: Pemberton Trevor J , Mehta Niyati U , Witonsky David , Di Rienzo Anna , Allayee Hooman , Conti David V , Patel Pragna I
Published: February 2008

Background

Asian Indians display a high prevalence of diseases linked to changes in diet and environment that have arisen as their lifestyle has become more westernized. Using 1200 genome-wide polymorphisms in 432 individuals from 15 Indian language groups, we have recently shown that: (i) Indians constitute a distinct population-genetic cluster, and (ii) despite the geographic and linguistic diversity of the groups they exhibit a relatively low level of genetic heterogeneity.

Results

We investigated the prevalence of common polymorphisms that have been associated with diseases, such as atherosclerosis (ALOX5), hypertension (CYP3A5,AGT,GNB3), diabetes (CAPN10,TCF7L2,PTPN22), prostate cancer (DG8S737, rs1447295), Hirschsprung disease (RET), and age-related macular degeneration (CFH,LOC387715). In addition, we examined polymorphisms associated with skin pigmentation (SLC24A5) and with the ability to taste phenylthiocarbamide (TAS2R38). All polymorphisms were studied in a cohort of 576 India-born Asian Indians sampled in the United States. This sample consisted of individuals whose mother tongue is one of 14 of the 22 "official" languages recognized in India as well as individuals whose mother tongue is Parsi, a cultural group that has resided in India for over 1000 years. Analysis of the data revealed that allele frequency differences between the different Indian language groups were small, and interestingly the variant alleles ofALOX5g.8322G>A and g.50778G>A, andPTPN22g.36677C>T were present only in a subset of the Indian language groups. Furthermore, a latitudinal cline was identified both for the allele frequencies of the SNPs associated with hypertension (CYP3A5,AGT,GNB3), as well as for those associated with the ability to taste phenylthiocarbamide (TAS2R38).

Conclusion

Although caution is warranted due to the fact that this US-sampled Indian cohort may not represent a random sample from India, our results will hopefully assist in the design of future studies that investigate the genetic causes of these diseases in India. Our results also support the inclusion of the Indian population in disease-related genetic studies, as it exhibits unique genotype as well as phenotype characteristics that may yield new insights into the underlying causes of common diseases that are not available in other populations.
Analysis of genetic variation in Ashkenazi Jews by high density SNP genotyping
Authors: Olshen Adam B , Gold Bert , Lohmueller Kirk E , Struewing Jeffery P , Satagopan Jaya , Stefanov Stefan A , Eskin Eleazar , Kirchhoff Tomas , Lautenberger James A , Klein Robert J , Friedman Eitan , Norton Larry , Ellis Nathan A , Viale Agnes , Lee Catherine S , Borgen Patrick I , Clark Andrew G , Offit Kenneth , Boyd Jeff
Published: February 2008

Background

Genetic isolates such as the Ashkenazi Jews (AJ) potentially offer advantages in mapping novel loci in whole genome disease association studies. To analyze patterns of genetic variation in AJ, genotypes of 101 healthy individuals were determined using the Affymetrix EAv3 500 K SNP array and compared to 60 CEPH-derived HapMap (CEU) individuals. 435,632 SNPs overlapped and met annotation criteria in the two groups.

Results

A small but significant global difference in allele frequencies between AJ and CEU was demonstrated by a mean F

ST
of 0.009 (P < 0.001); large regions that differed were found on chromosomes 2 and 6. Haplotype blocks inferred from pairwise linkage disequilibrium (LD) statistics (Haploview) as well as by expectation-maximization haplotype phase inference (HAP) showed a greater number of haplotype blocks in AJ compared to CEU by Haploview (50,397 vs. 44,169) or by HAP (59,269 vs. 54,457). Average haplotype blocks were smaller in AJ compared to CEU (e.g., 36.8 kb vs. 40.5 kb HAP). Analysis of global patterns of local LD decay for closely-spaced SNPs in CEU demonstrated more LD, while for SNPs further apart, LD was slightly greater in the AJ. A likelihood ratio approach showed that runs of homozygous SNPs were approximately 20% longer in AJ. A principal components analysis was sufficient to completely resolve the CEU from the AJ.

Conclusion

LD in the AJ versus was lower than expected by some measures and higher by others. Any putative advantage in whole genome association mapping using the AJ population will be highly dependent on regional LD structure.
AphanoDB: a genomic resource for Aphanomyces pathogens
Authors: Madoui Mohammed-Amine , Gaulin Elodie , Mathé Catherine , San Clemente Hélène , Couloux Arnaud , Wincker Patrick , Dumas Bernard
Published: February 2008

Background

The Oomycete genusAphanomycescomprises devastating plant and animal pathogens. However, little is known about the molecular mechanisms underlying pathogenicity ofAphanomycesspecies. In this study, we report on the development of a public database called AphanoDB which is dedicated toAphanomycesgenomic data. As a first step, a large collection of Expressed Sequence Tags was obtained from the legume pathogenA. euteiches, which was then processed and collected into AphanoDB.

Description

Two cDNA libraries ofA. euteicheswere created: one from mycelium growing on synthetic medium and one from mycelium grown in contact to root tissues of the model legumeMedicago truncatula. From these libraries, 18,684 expressed sequence tags were obtained and assembled into 7,977 unigenes which were compared to public databases for annotation. Queries on AphanoDB allow the users to retrieve information for each unigene including similarity to known protein sequences, protein domains and Gene Ontology classification. Statistical analysis of EST frequency from the two different growth conditions was also added to the database.

Conclusion

AphanoDB is a public database with a user-friendly web interface. The sequence report pages are the main web interface which provides all annotation details for each unigene. These interactive sequence report pages are easily available through text, BLAST, Gene Ontology and expression profile search utilities. AphanoDB is available from URL:http://www.polebio.scsv.ups-tlse.fr/aphano/.
All and only CpG containing sequences are enriched in promoters abundantly bound by RNA polymerase II in multiple tissues
Authors: Rozenberg Julian M , Shlyakhtenko Andrey , Glass Kimberly , Rishi Vikas , Myakishev Maxim V , FitzGerald Peter C , Vinson Charles
Published: February 2008

Background

The promoters of housekeeping genes are well-bound by RNA polymerase II (RNAP) in different tissues. Although the promoters of these genes are known to contain CpG islands, the specific DNA sequences that are associated with high RNAP binding to housekeeping promoters has not been described.

Results

ChIP-chip experiments from three mouse tissues, liver, heart ventricles, and primary keratinocytes, indicate that 94% of promoters have similar RNAP binding, ranging from well-bound to poorly-bound in all tissues. Using all 8-base pair long sequences as a test set, we have identified the DNA sequences that are enriched in promoters of housekeeping genes, focusing on those DNA sequences which are preferentially localized in the proximal promoter. We observe a bimodal distribution. Virtually all sequences enriched in promoters with high RNAP binding values contain a CpG dinucleotide. These results suggest that only transcription factor binding sites (TFBS) that contain the CpG dinucleotide are involved in RNAP binding to housekeeping promoters while TFBS that do not contain a CpG are involved in regulated promoter activity. Abundant 8-mers that are preferentially localized in the proximal promoters and exhibit the best enrichment in RNAP bound promoters are all variants of six known CpG-containing TFBS: ETS, NRF-1, BoxA, SP1, CRE, and E-Box. The frequency of these six DNA motifs can predict housekeeping promoters as accurately as the presence of a CpG island, suggesting that they are the structural elements critical for CpG island function. Experimental EMSA results demonstrate that methylation of the CpG in the ETS, NRF-1, and SP1 motifs prevent DNA binding in nuclear extracts in both keratinocytes and liver.

Conclusion

In general, TFBS that do not contain a CpG are involved in regulated gene expression while TFBS that contain a CpG are involved in constitutive gene expression with some CpG containing sequences also involved in inducible and tissue specific gene regulation. These TFBS are not bound when the CpG is methylated. Unmethylated CpG dinucleotides in the TFBS in CpG islands allow the transcription factors to find their binding sites which occur only in promoters, in turn localizing RNAP to promoters.
Geographical variations in the benefit of applying a prioritization system for cataract surgery in different regions of Spain
Authors: Román Rubén , Comas Mercè , Mar Javier , Bernal Enrique , Jiménez-Puente Alberto , Gutiérrez-Moreno Santiago , Castells Xavier ,   the IRYSS Network Modelling Group
Published: February 2008

Background

In Spain, there are substantial variations in the utilization of health resources among regions. Because the need for surgery differs in patients with appropriate surgical indication, introducing a prioritization system might be beneficial. Our objective was to assess geographical variations in the impact of applying a prioritization system in patients on the waiting list for cataract surgery in different regions of Spain by using a discrete-event simulation model.

Methods

A discrete-event simulation model to evaluate demand and waiting time for cataract surgery was constructed. The model was reproduced and validated in five regions of Spain and was fed administrative data (population census, surgery rates, waiting list information) and data from research studies (incidence of cataract). The benefit of introducing a prioritization system was contrasted with the usual first-in, first-out (FIFO) discipline. The prioritization system included clinical, functional and social criteria. Priority scores ranged between 0 and 100, with greater values indicating higher priority. The measure of results was the waiting time weighted by the priority score of each patient who had passed through the waiting list. Benefit was calculated as the difference in time weighted by priority score between operating according to waiting time or to priority.

Results

The mean waiting time for patients undergoing surgery according to the FIFO discipline varied from 1.97 months (95% CI 1.85; 2.09) in the Basque Country to 10.02 months (95% CI 9.91; 10.12) in the Canary Islands. When the prioritization system was applied, the mean waiting time was reduced to a minimum of 0.73 months weighted by priority score (95% CI 0.68; 0.78) in the Basque Country and a maximum of 5.63 months (95% CI 5.57; 5.69) in the Canary Islands. The waiting time weighted by priority score saved by the prioritization system varied from 1.12 months (95% CI 1.07; 1.16) in Andalusia to 2.73 months (95% CI 2.67; 2.80) in Aragon.

Conclusion

The prioritization system reduced the impact of the variations found among the regions studied, thus improving equity. Prioritization allocates the available resources within each region more efficiently and reduces the waiting time of patients with greater need. Prioritization was more beneficial than allocating surgery by waiting time alone.
Diacylglycerol kinase ζ inhibits myocardial atrophy and restores cardiac dysfunction in streptozotocin-induced diabetes mellitus
Authors: Bilim Olga , Takeishi Yasuchika , Kitahara Tatsuro , Arimoto Takanori , Niizeki Takeshi , Sasaki Toshiki , Goto Kaoru , Kubota Isao
Published: February 2008

Background

Activation of the diacylglycerol (DAG)-protein kinase C (PKC) pathway has been implicated in the pathogenesis of a number of diabetic complications. Diacylglycerol kinase (DGK) converts DAG to phosphatidic acid and acts as an endogenous regulator of PKC activity. Akt/PKB is associated with a downstream insulin signaling, and PKCβ attenuates insulin-stimulated Akt phosphorylation.

Methods and Results

We examined transgenic mice with cardiac-specific overexpression of DGKζ (DGKζ-TG) compared to wild type (WT) mice in streptozotocin-induced (STZ, 150 mg/kg) diabetic and nondiabetic conditions. After 8 weeks, decreases in heart weight and heart weight/body weight ratio in diabetic WT mice were inhibited in DGKζ-TG mice. Echocardiography at 8 weeks after STZ-injection demonstrated that decreases in left ventricular end-diastolic diameter and fractional shortening observed in WT mice were attenuated in DGKζ-TG mice. Thinning of the interventricular septum and the posterior wall in diabetic WT hearts were blocked in DGKζ-TG mice. Reduction of transverse diameter of cardiomyocytes isolated from the left ventricle in diabetic WT mice was attenuated in DGKζ-TG mice. Cardiac fibrosis was much less in diabetic DGKζ-TG than in diabetic WT mice. Western blots showed translocation of PKCβ and δ isoforms to membrane fraction and decreased Akt/PKB phosphorylation in diabetic WT mouse hearts. However in diabetic DGKζ-TG mice, neither translocation of PKC nor changes Akt/PKB phosphorylation was observed.

Conclusion

DGKζ modulates intracellular signaling and improves the course of diabetic cardiomyopathy. These data may suggest that DGKζ is a new therapeutic target to prevent or reverse diabetic cardiomyopathy.
Research to action to address inequities: the experience of the Cape Town Equity Gauge
Authors: Scott Vera , Stern Ruth , Sanders David , Reagon Gavin , Mathews Verona
Published: February 2008

Background

While the importance of promoting equity to achieve health is now recognised, the health gap continues to increase globally between and within countries. The description that follows looks at how the Cape Town Equity Gauge initiative, part of the Global Equity Gauge Alliance (GEGA) is endeavouring to tackle this problem.

We give an overview of the first phase of our research in which we did an initial assessment of health status and the socio-economic determinants of health across the subdistrict health structures of Cape Town. We then describe two projects from the second phase of our research in which we move from research to action. The first project, the Equity Tools for Managers Project, engages with health managers to develop two tools to address inequity: an Equity Measurement Tool which quantifies inequity in health service provision in financial terms, and a Equity Resource Allocation Tool which advocates for and guides action to rectify inequity in health service provision. The second project, the Water and Sanitation Project, engages with community structures and other sectors to address the problem of diarrhoea in one of the poorest areas in Cape Town through the establishment of a community forum and a pilot study into the acceptability of dry sanitation toilets.

Methods

A participatory approach was adopted. Both quantitative and qualitative methods were used. The first phase, the collection of measurements across the health subdistricts of Cape Town, used quantitative secondary data to demonstrate the inequities. In the Equity Tools for Managers Project further quantitative work was done, supplemented by qualitative policy analysis to study the constraints to implementing equity. The Water and Sanitation Project was primarily qualitative, using in-depth interviews and focus group discussions. These were used to gain an understanding of the impact of the inequities, in this instance, inadequate sanitation provision.

Results

The studies both demonstrate the value of adopting the GEGA approach of research to action, adopting three pillars of assessment and monitoring; advocacy; and community empowerment. In the Equity Tools for Managers Project study, the participation of managers meant that their support for implementation was increased, although the failure to include nurses and communities in the study was noted as a limitation. The development of a community Water and Sanitation Forum to support the Project had some notable successes, but also experienced some difficulties due to lack of capacity in both the community and the municipality.

Conclusion

The two very different, but connected projects, demonstrate the value of adopting the GEGA approach, and the importance of involvement of all stakeholders at all stages. The studies also illustrate the potential of a research institution as informed 'outsiders', in influencing policy and practice.
Monomorphic post-transplant lymphoproliferative disorder of the tongue: case report and review of literature
Authors: Gonzalez-Cuyar Luis F , Tavora Fabio , Burke Allen P , Gocke Christopher D , Zimrin Ann , Sauk John J , Zhao Xiafeng F
Published: February 2008

Background

Post-transplant lymphoproliferative disorder (PTLD) is a spectrum of hematological diseases arising in context of immunosuppression after organ transplantation. PTLD can involve any organ; however, it is extremely rare in oral cavity.

Methods

Using morphologic and immunophenotypic approaches we have studied a case of monomorphic PTLD of the tongue that developed in a patient following unilateral kidney and pancreas transplantation on immunosuppressive therapy. Additionally, cases of PTLD in the oral cavity were reviewed in the English literature.

Results

The neoplasm showed large cell morphology and B-cell phenotype. In situ hybridization for Epstein-Barr virus was positive. Complete remission was obtained after decreasing immunosuppressive therapy. The patient remained in remission at 790 days' follow up.

Conclusion

This rare case increased our awareness of PTLD in the oral cavity of patients following solid organ transplantation and immunosuppressive therapy.
Genetic analysis of the spindle checkpoint genes san-1, mdf-2, bub-3 and the CENP-F homologues hcp-1 and hcp-2 in Caenorhabditis elegans
Authors: Hajeri Vinita A , Stewart Anil M , Moore Landon L , Padilla Pamela A
Published: February 2008

Background

The spindle checkpoint delays the onset of anaphase until all sister chromatids are aligned properly at the metaphase plate. To investigate the role san-1, the MAD3 homologue, has in Caenorhabditis elegans embryos we used RNA interference (RNAi) to identify genes synthetic lethal with the viable san-1(ok1580) deletion mutant.

Results

The san-1(ok1580) animal has low penetrating phenotypes including an increased incidence of males, larvae arrest, slow growth, protruding vulva, and defects in vulva morphogenesis. We found that the viability of san-1(ok1580) embryos is significantly reduced when HCP-1 (CENP-F homologue), MDF-1 (MAD-1 homologue), MDF-2 (MAD-2 homologue) or BUB-3 (predicted BUB-3 homologue) are reduced by RNAi. Interestingly, the viability of san-1(ok1580) embryos is not significantly reduced when the paralog of HCP-1, HCP-2, is reduced. The phenotype of san-1(ok1580);hcp-1(RNAi) embryos includes embryonic and larval lethality, abnormal organ development, and an increase in abnormal chromosome segregation (aberrant mitotic nuclei, anaphase bridging). Several of the san-1(ok1580);hcp-1(RNAi) animals displayed abnormal kinetochore (detected by MPM-2) and microtubule structure. The survival of mdf-2(RNAi);hcp-1(RNAi) embryos but not bub-3(RNAi);hcp-1(RNAi) embryos was also compromised. Finally, we found that san-1(ok1580) and bub-3(RNAi), but not hcp-1(RNAi) embryos, were sensitive to anoxia, suggesting that like SAN-1, BUB-3 has a functional role as a spindle checkpoint protein.

Conclusion

Together, these data suggest that in the C. elegans embryo, HCP-1 interacts with a subset of the spindle checkpoint pathway. Furthermore, the fact that san-1(ok1580);hcp-1(RNAi) animals had a severe viability defect whereas in the san-1(ok1580);hcp-2(RNAi) and san-1(ok1580);hcp-2(ok1757) animals the viability defect was not as severe suggesting that hcp-1 and hcp-2 are not completely redundant.
The E3 ubiquitin ligase skp2 regulates neural differentiation independent from the cell cycle
Authors: Boix-Perales Hector , Horan Ian , Wise Helen , Lin Horng-Ru , Chuang Li-Chiou , Yew P Renee , Philpott Anna
Published: February 2008

Background

The SCFskp2 complex is an E3 ubiquitin ligase that is known to target a number of cell cycle regulators, including cyclin-dependent kinase inhibitors, for proteolysis. While its role in regulation of cell division has been well documented, additional functions in differentiation, including in the nervous system, have not been investigated.

Results

Using Xenopus as a model system, here we demonstrate that skp2 has an additional role in regulation of differentiation of primary neurons, the first neurons to differentiate in the neural plate. Xenopus skp2 shows a dynamic expression pattern in early embryonic neural tissue and depletion of skp2 results in generation of extra primary neurons. In contrast, over-expression of skp2 inhibits neurogenesis in a manner dependent on its ability to act as part of the SCFskp2 complex. Moreover, inhibition of neurogenesis by skp2 occurs upstream of the proneural gene encoding NeuroD and prior to cell cycle exit. We have previously demonstrated that the Xenopus cyclin dependent kinase inhibitor Xic1 is essential for primary neurogenesis at an early stage, and before these cells exit the cell cycle. We show that SCFskp2 degrades Xic1 in embryos and this contributes to the ability of skp2 to regulate neurogenesis.

Conclusion

We conclude that the SCFskp2 complex has functions in the control of neuronal differentiation additional to its role in cell cycle regulation. Thus, it is well placed to be a co-ordinating factor regulating both cell proliferation and cell differentiation directly.
Role of vasopressin in the treatment of anaphylactic shock in a child undergoing surgery for congenital heart disease: a case report
Authors: Di Chiara Luca , Stazi Giulia V , Ricci Zaccaria , Polito Angelo , Morelli Stefano , Giorni Chiara , La Salvia Ondina , Vitale Vincenzo , Rossi Eugenio , Picardo Sergio
Published: February 2008

Introduction

The incidence of anaphylactic reactions during anesthesia is between 1:5000 and 1:25000 and it is one of the few causes of mortality directly related to general anesthesia. The most important requirements in the treatment of this clinical condition are early diagnosis and maintenance of vital organ perfusion. Epinephrine administration is generally considered as the first line treatment of anaphylactic reactions. However, recently, new pharmacological approaches have been described in the treatment of different forms of vasoplegic shock.

Case presentation

We describe the case of a child who was undergoing surgery for ventricular septal defect, with an anaphylactic reaction to heparin that was refractory to epinephrine infusion and was effectively treated by low dose vasopressin infusion.

Conclusion

In case of anaphylactic shock, continuous infusion of low-dose vasopressin might be considered after inadequate response to epinephrine, fluid resuscitation and corticosteroid administration.
Correction of technical bias in clinical microarray data improves concordance with known biological information
Authors: Eklund Aron C , Szallasi Zoltan
Published: February 2008

The performance of gene expression microarrays has been well characterized using controlled reference samples, but the performance on clinical samples remains less clear. We identified sources of technical bias affecting many genes in concert, thus causing spurious correlations in clinical data sets and false associations between genes and clinical variables. We developed a method to correct for technical bias in clinical microarray data, which increased concordance with known biological relationships in multiple data sets.
Electrodic voltages in the presence of dissolved sulfide: Implications for monitoring natural microbial activity
Authors: Slater Lee , Ntarlagiannis Dimitrios , Yee Nathan , O’Brien Michael , Zhang Chi , Williams Kenneth H.
Published: February 2008

There is growing interest in the development of new monitoring strategies for obtaining spatially extensive data diagnostic of microbial processes occurring in the earth. Open-circuit potentials arising from variable redox conditions in the fluid local-to-electrode surfaces (electrodic potentials) were recorded for a pair of silver-silver chloride electrodes in a column experiment, whereby a natural wetland soil containing a known community of sulfate reducers was continuously fed with a sulfate-rich nutrient medium. Measurements were made between five electrodes equally spaced along the column and a reference electrode placed on the column inflow. The presence of a sulfate reducing microbial population, coupled with observations of decreasing sulfate levels, formation of black precipitate (likely iron sulfide),elevated solid phase sulfide, and a characteristic sulfurous smell, suggest microbial-driven sulfate reduction (sulfide generation) in our column. Based on the known sensitivity of a silver electrode to dissolved sulfide concentration, we interpret the electrodic potentials approaching [Formula: see text] recorded in this experiment as an indicator of the bisulfide [Formula: see text] concentration gradients in the column. The measurement of the spatial and temporal variation in these electrodic potentials provides a simple and rapid method for monitoring patterns of relative [Formula: see text] concentration that are indicative of the activity of sulfate-reducing bacteria. Our measurements have implications both for the autonomous monitoring of anaerobic microbial processes in the subsurface and the performance of self-potential electrodes, where it is critical to isolate, and perhaps quantify, electrochemical interfaces contributing to observed potentials.
Absolute Risk Reductions for Local Recurrence After Postoperative Radiotherapy After Sector Resection for Ductal Carcinoma In Situ of the Breast
Authors: Holmberg Lars , Garmo Hans , Granstrand Bengt , Ringberg Anita , Arnesson Lars-Gunnar , Sandelin Kerstin , Karlsson Per , Anderson Harald , Emdin Stefan
Published: February 2008

Purpose

Evaluate the effects of radiotherapy after sector resection for ductal carcinoma in situ of the breast (DCIS) in patient groups as defined by age, size of the lesion, focality, completeness of excision and mode of detection.

Patients and Methods

A total of 1,067 women in Sweden were randomly assigned to either postoperative radiotherapy (RT) or control from 1987 to 1999, and 1,046 were followed for a mean of 8 years. The main outcome was new ipsilateral breast cancer events and distant metastasis–free survival analyzed according to intention to treat.

Results

There were 64 ipsilateral events in the RT arm and 141 in the control group corresponding to a risk reduction of 16.0 percentage points at 10 years (95% CI, 10.3% to 21.6%) and a relative risk of 0.40 (95% CI, 0.30 to 0.54). There was no statistically significant difference in distant metastasis–free survival. There was an effect modification by age, yielding a low effect of RT in women younger than 50, but substantial protection in women older than 60 years. The age effect was not confounded by focality, lesion size, completeness of excision, or detection mode. There was no group as defined by our stratification variables that had a low risk without radiotherapy.

Conclusion

Our results indicate that younger women have a low protective effect of conventional RT after sector resection. Older women benefit substantially. We caution that the age effect was seen in a subgroup analysis. Further search with conventional clinical variables for a low risk group that does not need RT does not seem fruitful.