bluuebunny/crossref_metadata_2025 huggingface dataset:
Failure to Eradicate Vancomycin-Resistant Enterococci in a University Hospital and the Cost of Barrier Precautions
Authors: Lai Kwan Kew , Kelley Anita L. , Melvin Zita S. , Belliveau Paul P. , Fontecchio Sally A.
Published: September 2009

Objective:

To describe the effect of infection control interventions on the incidence of vancomycin-resistant enterococci (VRE), the utility of pharyngeal cultures for surveillance for VRE colonization, and the cost of barrier precautions.

Design:

Evaluation of the occurrence of VRE infection or colonization, rates of vancomycin use, results of surveillance cultures before and after interventions, and the cost of increased barrier precautions.

Setting:

University of Massachusetts Medical Center, a 347-bed tertiary-care teaching hospital with eight intensive-care units, one burn unit, and one bone marrow transplant unit.

Participants:

Patients in the intensive-care units and staff who were involved with patients colonized or infected with VRE.

Methods:

Infection control interventions included placement of patients with VRE in private rooms, strict contact isolation, cohorting of patient and nursing staff, prohibiting of equipment sharing, and monitoring of compliance with the vancomycin restriction policy, with hand washing, and of the adequacy of environmental cleaning. Both rectal and pharyngeal cultures were obtained from patients at the beginning of the outbreak, and the utility of pharyngeal cultures was evaluated. The cost of barrier precautions was estimated by comparing the cost of glove and gown use before and after the outbreak began.

Results:

The interventions decreased the number of new cases of VRE, but total eradication of VRE was not achieved. Compliance with the room-cleaning protocol was 91% (141/155 observations). Hand washing following interaction with patients who were not in isolation was 51%, vs 100% for patients in isolation. Overall, handwashing compliance was 71% (319/449): 56% (130/231) for physicians and 86% (187/218) for nurses (P<.0001). The mean number of doses of vancomycin dispensed per 1,000 patient days decreased from 145 to 114 per 1,000 patient days (P<.001). Compliance with vancomycin-use guidelines was 85%. Forty-six (77%) of 60 surveillance rectal swabs yielded enterococci, as compared to only 4 (11%) of 36 pharyngeal cultures (P<.0001). Expenses on glove and gowns alone increased by over $11,000 per year since the epidemic began.

Conclusions:

Implementation of the various infection control measures did not eradicate VRE cases from the hospital. Rectal cultures were more useful than pharyngeal cultures for surveillance of VRE. Controlling VRE epidemics can be costly.
Wound Healing Activity of Rubus sanctus Schreber (Rosaceae): Preclinical Study in Animal Models
Authors: Süntar Ipek , Koca Ufuk , Keleş Hikmet , Akkol Esra Küpeli
Published: September 2009

Young shoots of Rubus species have been used for healing of wounds, infected insect bites and pimples in folk medicine for ages. In order to evaluate the wound healing activity of Rubus sanctus, four different extracts were prepared from the whole aerial parts of the plant by using n‐hexane, chloroform, ethyl acetate and methanol, respectively. Incision wound healing model by using tensiometer on rats and excision model on mice were employed to assess the activity. Remarkable wound healing activity was observed with the ointment formulation of the methanol extract at 1% concentration on the mentioned models. The results of histopathological examination also supported the outcome of both incision and excision wound models. The wound healing effect was comparatively evaluated with a reference ointment Madecassol. The experimental data confirmed the ethnobotanical usage of R. sanctus.
The eastern Baltic cod fishery: a fleet-based management strategy evaluation framework to assess the cod recovery plan of 2008
Authors: Bastardie Francois , Nielsen J. Rasmus , Kraus Gerd
Published: September 2009

Bastardie, F., Nielsen, J. R., and Kraus, G. 2010. The eastern Baltic cod fishery: a fleet-based management strategy evaluation framework to assess the cod recovery plan of 2008. – ICES Journal of Marine Science, 67: 71–86. A management strategy evaluation framework was developed for the international Baltic cod fishery to evaluate the performance and robustness of the 2008 multi-annual management plan for the eastern stock. The spatially explicit management evaluation covered two cod recruitment regimes and various fleet adaptation scenarios. The tested management options included total allowable catch control, direct effort control, and closed areas and seasons. The modelled fleet responded to management by misreporting, improving catching power, adapting capacity, and reallocating fishing effort. The model was calibrated with spatially and temporally disaggregated landings and effort data from five countries covering 83% of the total cod catches. The simulations revealed that the management plan is robust and likely to rebuild the stock in the medium term even under low recruitment. Direct effort reduction limited underreporting of catches, but the overall effect was impaired by the increased catching power or spatio-temporal effort reallocation. Closures had a positive effect, protecting part of the population from being caught, but the effect was impaired if there was seasonal effort reallocation. Over the entire 15-year simulation period, all fleets could realize variable but positive profits under all scenarios tested, owing to stock recovery.
Genomic imprinting: employing and avoiding epigenetic processes
Authors: Bartolomei Marisa S.
Published: September 2009

Genomic imprinting refers to an epigenetic mark that distinguishes parental alleles and results in a monoallelic, parental-specific expression pattern in mammals. Few phenomena in nature depend more on epigenetic mechanisms while at the same time evading them. The alleles of imprinted genes are marked epigenetically at discrete elements termed imprinting control regions (ICRs) with their parental origin in gametes through the use of DNA methylation, at the very least. Imprinted gene expression is subsequently maintained using noncoding RNAs, histone modifications, insulators, and higher-order chromatin structure. Avoidance is manifest when imprinted genes evade the genome-wide reprogramming that occurs after fertilization and remain marked with their parental origin. This review summarizes what is known about the establishment and maintenance of imprinting marks and discusses the mechanisms of imprinting in clusters. Additionally, the evolution of imprinted gene clusters is described. While considerable information regarding epigenetic control of imprinting has been obtained recently, much remains to be learned.
Breaking down bone: new insight into site-specific mechanisms of breast cancer osteolysis mediated by metalloproteinases: Figure 1.
Authors: Guise Theresa A.
Published: September 2009

Bone metastases are the most common skeletal complication of malignancy. Tumor cells disrupt normal bone remodeling to promote bone destruction and its associated morbidity. In the August 15, 2009, issue of Genes & Development, Lu and colleagues (pp. 1882–1894) propose a novel molecular mechanism by which tumor-produced metalloproteinases release epidermal growth factor (EGF) ligands to activate the central osteoclastogenic pathway receptor activator of NF-κB ligand (RANKL) to promote breast cancer osteolysis. This work has important therapeutic applications that may quickly translate to more effective treatment for bone metastases.
Phosphorylation modulates rapid nucleocytoplasmic shuttling and cytoplasmic accumulation of Neurospora clock protein FRQ on a circadian time scale
Authors: Diernfellner Axel C.R. , Querfurth Christina , Salazar Carlos , Höfer Thomas , Brunner Michael
Published: September 2009

The Neurospora clock protein FREQUENCY (FRQ) is an essential regulator of the circadian transcription factor WHITE COLLAR COMPLEX (WCC). In the course of a circadian period, the subcellular distribution of FRQ shifts from mainly nuclear to mainly cytosolic. This shift is crucial for coordinating the negative and positive limbs of the clock. We show that the subcellular redistribution of FRQ on a circadian time scale is governed by rapid, noncircadian cycles of nuclear import and export. The rate of nuclear import of newly synthesized FRQ is progressively reduced in a phosphorylation-dependent manner, leading to an increase in the steady-state level of cytoplasmic FRQ. The long-period frq7 mutant displays reduced kinetics of FRQ7 protein phosphorylation and a prolonged accumulation in the nucleus. We present a mathematical model that describes the cytoplasmic accumulation of wild-type and mutant FRQ on a circadian time scale on the basis of frequency-modulated rapid nucleocytoplasmic shuttling cycles.
Biochemical Characterization of AtRECQ3 Reveals Significant Differences Relative to Other RecQ Helicases
Authors: Kobbe Daniela , Blanck Sandra , Focke Manfred , Puchta Holger
Published: September 2009

Members of the conserved RecQ helicase family are important for the preservation of genomic stability. Multiple RecQ homologs within one organism raise the question of functional specialization. Whereas five different homologs are present in humans, the model plant Arabidopsis (Arabidopsis thaliana) carries seven RecQ homologs in its genome. We performed biochemical analysis of AtRECQ3, expanded upon a previous analysis of AtRECQ2, and compared their properties. Both proteins differ in their domain composition. Our analysis demonstrates that they are 3′ to 5′ helicases with similar activities on partial duplex DNA. However, they promote different outcomes with synthetic DNA structures that mimic Holliday junctions or a replication fork. AtRECQ2 catalyzes Holliday junction branch migration and replication fork regression, while AtRECQ3 cannot act on intact Holliday junctions. The observed reaction of AtRECQ3 on the replication fork is in line with unwinding the lagging strand. On nicked Holliday junctions, which have not been intensively studied with RecQ helicases before, AtRECQ3, but not AtRECQ2, shows a clear preference for one unwinding mechanism. In addition, AtRECQ3 is much more efficient at catalyzing DNA strand annealing. Thus, AtRECQ2 and AtRECQ3 are likely to perform different tasks in the cell, and AtRECQ3 differs in its biochemical properties from all other eukaryotic RECQ helicases characterized so far.
A Single Amino Acid Change in the Enhancer of Zeste Ortholog CURLY LEAF Results in Vernalization-Independent, Rapid Flowering in Arabidopsis
Authors: Doyle Mark R. , Amasino Richard M.
Published: September 2009

Many strains of Arabidopsis (Arabidopsis thaliana) require exposure to prolonged cold for rapid flowering, a process known as vernalization. Vernalization in Arabidopsis results in the suppression of FLOWERING LOCUS C (FLC), a repressor of flowering. In a screen for mutants that no longer require vernalization for rapid flowering, we identified a dominant allele of the Enhancer of Zeste E(z) ortholog CURLY LEAF (CLF), clf-59. CLF is a Polycomb Group gene, and the clf-59 mutant protein contains a proline-to-serine transition in a cysteine-rich region that precedes the SET domain. Mutant plants are early flowering and have reduced FLC expression, but, unlike clf loss-of-function mutants, clf-59 mutants do not display additional pleiotropic phenotypes. clf-59 mutants have elevated levels of trimethylation on lysine 27 of histone H3 (H3K27me3) at FLC. Thus, clf-59 appears to be a gain-of-function allele, and this allele represses FLC without some of the components required for vernalization-mediated repression. In the course of this work, we also identified a marked difference in H3K27me3 levels at FLC between plants that contain and those that lack the FRIGIDA (FRI) gene. Furthermore, FRI appears to affect CLF occupancy at FLC; thus, our work provides insight into the molecular role that FRI plays in delaying the onset of flowering.
[Ru(py)4Cl(NO)](PF6)2·0.5H2O: a model system for structural determination and ab initio calculations of photo-induced linkage NO isomers
Authors: Cormary Benoît , Malfant Isabelle , Buron-Le Cointe Marylize , Toupet Loïc , Delley Bernard , Schaniel Dominik , Mockus Nicholas , Woike Theo , Fejfarová Karla , Petříček Václav , Dušek Michal
Published: September 2009

Structure analysis of ground state (GS) and two light-induced (SI and SII) metastable linkage NO isomers of [Ru(py)4Cl(NO)](PF6)2·0.5H2O is presented. Illumination of the crystal by a laser with λ = 473 nm at T = 80 K transfers around 92% of the NO ligands from Ru—N—O into the isomeric configuration Ru—O—N (SI). A subsequent irradiation with λ = 980 nm generates about 48% of the side-on configuration \rm Ru \lt ^N_O (SII). Heating to temperatures above 200 K or irradiation with light in the red spectral range transfers both metastable isomers reversibly back to the GS. Photodifference maps clearly show the N—O configurations for both isomers and they could be used to find a proper starting model for subsequent refinements. Both metastable isomers have slightly but significantly different cell parameters with respect to GS. The main structural changes besides the Ru—O—N and \rm Ru \lt ^N_O linkage are shortenings of the trans Ru—Cl bonds and the equatorial Ru—N bonds. The experimental results are compared with solid-state calculations based on density functional theory (DFT), which reproduce the observed structures with high accuracy concerning bond lengths and angles. The problem of how the different occupancies of SI and GS could affect refinement results was solved by a simulation procedure using the DFT data as starting values.
High‐resolution wide‐field microscopy with adaptive optics for spherical aberration correction and motionless focusing
Authors: KNER P. , SEDAT J.W. , AGARD D.A. , KAM Z.
Published: September 2009

Live imaging in cell biology requires three‐dimensional data acquisition with the best resolution and signal‐to‐noise ratio possible. Depth aberrations are a major source of image degradation in three‐dimensional microscopy, causing a significant loss of resolution and intensity deep into the sample. These aberrations occur because of the mismatch between the sample refractive index and the immersion medium index. We have built a wide‐field fluorescence microscope that incorporates a large‐throw deformable mirror to simultaneously focus and correct for depth aberration in three‐dimensional imaging. Imaging fluorescent beads in water and glycerol with an oil immersion lens we demonstrate a corrected point spread function and a 2‐fold improvement in signal intensity. We apply this new microscope to imaging biological samples, and show sharper images and improved deconvolution.
Phytoplankton and ecological assessment of brackish and freshwater coastal lagoons in the Algarve, Portugal
Authors: Cartaxana Paulo , Mendes Carlos R. , Brotas Vanda
Published: September 2009

Phytoplankton biomass and composition were monitored for four coastal lagoons of the Algarve, Portugal, from February to November 2006. The phytoplankton community in the freshwater lagoons – Dunas Douradas (FW1) and Garrão (FW2) – as determined by biomarker pigment concentration using high‐performance liquid chromatography and the program chemtax, was dominated by diatoms and chlorophytes. For the brackish lagoons – Salgados (BW1) and Almargem (BW2) – cyanophytes and diatoms were the most important groups respectively. The trophic state indices, based on algal biomass, classify FW1, FW2 and BW1 lagoons as hypertrophic, whereas BW2 is classified as mesotrophic. Signs of eutrophication in the former lagoons include large phytoplankton biomass (chlorophyll‐a) fluctuations, the presence of phytoplankton taxa that usually thrive under nutrient‐enriched conditions and high concentrations of chlorophyll‐a‐degradation products. Chemotaxonomic analyses derived from high‐performance liquid chromatography data might constitute a valuable tool for achieving Water Framework Directive requirements for an evaluation system based on phytoplankton taxonomic composition.
Assessment of the impacts of a new artificial lake mouth on the hydrobiology and fisheries of Chilika Lake, India
Authors: Mohanty Rajeeb K. , Mohapatra Anil , Mohanty S. K.
Published: September 2009

The degraded state of the fragile ecosystem of Chilika Lake, located on the east coast of India, was undergoing restoration through an effective hydrological intervention during the year 2000. Studies on the lake’s hydrobiology and fisheries for the period of 7 years before and 7 years after the hydrological intervention indicated a rapid recovery of the lake fishery immediately after opening of the new lake mouth, with a sixfold increase in the average annual fish landings. During 2000–2001 to 2006–2007, the average fisheries output (11 051.3 t), catch per unit effort (6.2 kg boat−1 day−1), the economic valuation of the average annual catch (637 million rupees) and productivity (11.97 t km−2) exhibited dramatic increases of 498%, 464%, 1177% and 498.5%, respectively, compared with the 7‐year pre‐intervention data. Multivariate statistical analysis inferred that most of the lake’s environmental variables are strongly associated with salinity factor, which seems to have governed the lake ecology. The salinity dynamics of the lake are governed by both freshwater inflows and seawater ingress through the new artificial lake mouth. Correlation analysis indicated that salinity was positively correlated with prawn catch (R2 = 0.542; d.f. = 25; P < 0.01), crab catch (R2 = 0.628; d.f. = 25; P < 0.001) and fish catch (R2 = 0.476; d.f. = 25, P < 0.05). The average increase in the salinity regime (43.8%) for the lake during the post‐hydrological intervention period, compared with the pre‐hydrological intervention period, appears to have positively impacted the fish, prawn and mud crab catches. A gradual decrease in total fisheries output since 2005–2006, however, was attributed mainly to a continuing increase in destructive fishing practices in the absence of any conservation and regulatory measures for fishing, and large‐scale collection of shrimp juveniles from the outer channel for shrimp aquaculture. Thus, carefully planned conservation and regulation measures must be ensured, with active participation of local communities during this early phase of lake restoration. In the absence of such measures, the present scenario of fisheries enhancement might not be sustained over the long term.
Serum trace element levels in COPD patient: The relation between trace element supplementation and period of mechanical ventilation in a randomized controlled trial
Authors: EL‐ATTAR May , SAID Mohamed , EL‐ASSAL Gehan , SABRY Nirmeen A. , OMAR Emad , ASHOUR Laila
Published: September 2009

Background and objective:  Many trace elements play important roles in activating or inhibiting enzymatic reactions, by competing with other elements and metalloproteins for binding sites, by affecting the permeability of cell membranes and by other mechanisms. They play important roles in the oxidant/antioxidant balance. As such, trace elements are thought to be involved directly or indirectly in the pathogenesis of several diseases. The aim of the present study is to investigate the effect trace elements (Se, Mn and Zn) intravenously administered on the period the COPD patients spend on mechanical ventilation.

Methods:  In a randomized double‐blinded controlled trial a set of 120 subjects (40 normal volunteers and 80 COPD) were recruited. Serum concentration levels of Se, Mn and Zn were determined for all enrolled subjects with Inductively Coupled Plasma spectroscopy. COPD patients received intravenous supplementation of the above trace elements and the period the patients spent on mechanical ventilation was determined.

Results:  There was a significant reduction (P = 0.013) in the period the patients with COPD spent on the mechanical ventilation when received intravenous supplementation (9.4 ± 7.3 days) compared with the COPD patients who received placebo (17.8 ± 7.6 days).

Conclusions:  Trace element (Se, Mn and Zn) status is altered in critically ill patients with COPD. The supplementation achieved a reduction in the period those patients spent on the mechanical ventilation. A larger multi‐centre trial is required to confirm this preventive effect and to explore its applicability to other critical care conditions.
Impact of massage therapy on motor outcomes in very low‐birthweight infants: Randomized controlled pilot study
Authors: Ho Yuen‐Bing , Lee Robert S.Y. , Chow Chun‐Bong , Pang Marco Y.C.
Published: September 2009

Background:  The purpose of the present study was to determine the effects of massage therapy on motor development, weight gain, and hospital discharge in preterm very low‐birthweight (VLBW) newborns.

Methods:  Twenty‐four preterm VLBW newborns (<34 weeks and <1500 g) were enrolled in this randomized controlled pilot study. The intervention group (n = 12) received massage therapy starting at 34 weeks post‐conceptional age (15 min daily, 5 days/week for 4 weeks). The infants in the sham treatment group (n = 12) received similar duration of light still touch. Test of Infant Motor Performance (TIMP) score gain, weight gain, and post‐conceptional age at discharge were compared between the two groups after intervention using Mann–Whitney U‐test.

Results:  No significant between‐group difference in TIMP score gain and weight gain was identified when all subjects were analyzed. In subgroup analysis, among those with below‐average pre‐treatment TIMP score (<35), the intervention group (n = 6) achieved significantly higher TIMP score gain (P = 0.043) and earlier hospital discharge (P = 0.045) than the sham treatment group (n = 5). These same infants, however, also had significantly shorter duration of total parenteral nutrition than their counterparts in the sham treatment group (P = 0.044).

Conclusions:  Massage therapy might be a viable intervention to promote motor outcomes in a subgroup of VLBW newborns with poor motor performance. A larger randomized controlled trial is required to further explore the effects of massage therapy in this high‐risk group.
Biorthogonal Wavelets Based on Interpolatory  Subdivision
Authors: Wang H. , Ma W.
Published: September 2009

This article presents an efficient construction of biorthogonal wavelets built upon an interpolatory  subdivision for quadrilateral meshes. The interpolatory subdivision scheme is first turned into a scheme for reversible primitive wavelet synthesis. Some desired properties are then incorporated in the primitive wavelet using the lifting scheme. The analysis and synthesis algorithms of the resulting new wavelet are finally obtained as local and in‐place lifting operations. The wavelet inherits the advantage of  refinement with added levels of resolution. Numerical experiments show that the lifted wavelet built upon interpolatory  subdivision has sufficient stability and better performance in dealing with closed or open semi‐regular quadrilateral meshes compared with other existing wavelets for quadrilateral manifold meshes.
Are the cognitive functions of children with Down syndrome related to their participation?
Authors: RIHTMAN TANYA , TEKUZENER ESTI , PARUSH SHULA , TENENBAUM ALEX , BACHRACH STEVEN J , ORNOY ASHER
Published: September 2009

Aim  There is a lack of investigation into the functional developmental profile of children with Down syndrome. On the basis of current international health paradigms, the purpose of this study was to assess the developmental profile of these children.

Method  Sixty children (33 males, 27 females) with Down syndrome (age range 6–16y; mean age 9y 3mo, SD 28.8mo), who had received standard, holistic, early intervention, were assessed. Of these, 42 (70%) had congenital anomalies, 12 had severe congenital heart defects. Participants were assessed on measures of cognitive function (Beery–Buktenica Developmental Test of Visual–Motor Integration; Stanford–Binet Intelligence Scale) and participation (Vineland Adaptive Behaviour Scales).

Results  No difference was found on any measure on the basis of severity of congenital anomaly. Results showed improvements in age‐related body function and correlations between specific body functions and participation. No decline in IQ was found with age, and significant correlations between IQ and all other measures were noted. Although sex differences were found in the body functions of short‐term memory and motor function, no difference in measures of activity performance and participation was found.

Interpretation  Our findings emphasize the need for paediatric Down syndrome intervention to encourage improved body functions while emphasizing the acquisition of functional skills that enable enhanced participation in age‐appropriate activities.
Intensive speech and language therapy for older children with cerebral palsy: a systems approach
Authors: PENNINGTON LINDSAY , MILLER NICK , ROBSON SHEILA , STEEN NICK
Published: September 2009

Aim To investigate whether speech therapy using a speech systems approach to controlling breath support, phonation, and speech rate can increase the speech intelligibility of children with dysarthria and cerebral palsy (CP).

Method Sixteen children with dysarthria and CP participated in a modified time series design. Group characteristics were as follows: seven males, nine females; age range 12 to 18 years (mean 14y, SD 2); CP type: nine spastic, two dyskinetic, four mixed, one Worster–Drought; Gross Motor Function Classification System levels range I to V (median IV). Children received three 30‐ to 45‐minute sessions of individual therapy per week for 6 weeks. Intelligibility in single words and connected speech was compared across four points: 1 week and 6 weeks before therapy, and 1 week and 6 weeks after its completion. Three familiar listeners and three unfamiliar listeners scored each recording. Mean percentage intelligibility was compared using general linear modelling techniques.

Results After treatment, familiar listeners understood 14.7% more single words and 12.1% more words in connected speech. Unfamiliar listeners understood 15% more single words and 15.9% more words in connected speech after therapy.

Interpretation Therapy was associated with increases in speech intelligibility. Effects of the therapy should be investigated further, in an exploratory trial with younger children and in a randomized controlled trial.
Clinical, functional, and neurophysiologic assessment of dysplastic cortical networks: Implications for cortical functioning and surgical management
Authors: Duchowny Michael
Published: September 2009

Cortical malformations are highly epileptogenic lesions associated with complex, unanticipated, and often aberrant electrophysiologic and functional relationships. These relationships are inextricably linked to widespread cortical networks subserving eloquent functions, particularly language and motor ability. Cytomegalic neurons but not balloon cells in Palmini type 2 dysplastic cortex are intrinsically hyperexcitable and contribute to local epileptogenesis and functional responsiveness. However, there is much evidence that focal cortical dysplasia is rarely a localized or even regional process, and is a functionally, electrophysiologically, and ultimately clinically integrated neural network disorder. Not surprisingly, malformed cortex is implicated in cognitive dysfunction, particularly disturbances of linguistic processing. An understanding of these relationships is critical for successful epilepsy surgery. Gains in surgical prognosis rely on multiple diagnostic modalities to delineate complex anatomic, electrophysiologic, and functional relationships in magnetic resonance imaging (MRI)–negative patients with rates of seizure‐freedom roughly comparable to lesional patients
Expensive blood safety initiatives may offer less benefit than we think
Authors: Kamper‐Jørgensen Mads , Hjalgrim Henrik , Edgren Gustaf , Titlestad Kjell , Ullum Henrik , Shanwell Agneta , Reilly Marie , Melbye Mads , Nyrén Olof , Rostgaard Klaus
Published: September 2009

BACKGROUND: Various blood safety initiatives have ensured a historically low risk of infection transmission through blood transfusion. Although further prevention of infection transmission is possible through, for example, nucleic acid testing and future introduction of pathogen inactivation, such initiatives are very costly in relation to the benefit they offer. Although estimation of the cost‐effectiveness requires detailed information about the survival of transfusion recipients, previous cost‐effectiveness analyses have relied on incorrect survival assumptions.

STUDY DESIGN AND METHODS: Based on empirical data of more than 1 million Scandinavian transfusion recipients followed for up to 20 years, we present two new survival functions. In a fictitious example we assessed the impact of survival assumptions on the estimated costs per quality‐adjusted life‐year (QALY) gained, by using the survival functions of three previous cost‐effectiveness analyses along with the two new survival functions.

CONCLUSIONS: We conclude that despite considerable costs, previous cost‐effectiveness studies may have underestimated the costs per QALY gained by as much as 44%.
Recent Advances in the Recovery and Improvement of Functional Proteins from Fish Processing By‐Products: Use of Protein Glycation as an Alternative Method
Authors: Sanmartín Esther , Arboleya Juan Carlos , Villamiel Mar , Moreno F. Javier
Published: September 2009

ABSTRACT:  The recovery of proteins from fish by‐products for their utilization as food ingredients is becoming of increasing interest in the food industry as they may possess good functional and nutritional properties. This article reviews the main processing methods, such as enzymatic hydrolysis, pH shifting, membrane filtration, and some emerging technologies, used for the recovery of proteins from fish processing by‐products. The impact of these methods on the yield and, especially, on the functionality of the recovered proteins is discussed in detail. Considering that there is a huge amount of fish by‐products destined for nonfood use, one of the current challenges of the food industry is the development of technologies that allow the recovery of ingredients from the fish processing by‐products with potential to provide new and natural sources of high‐value functional ingredients for human consumption. In this sense, this review explores the potential use of the glycation reaction to increase the yield of proteins extracted from fish by‐products, as well as the effect of this reaction on their functional and biological properties.
Palette of Our Palates: A Brief History of Food Coloring and Its Regulation
Authors: Burrows, J.D. Adam
Published: September 2009

ABSTRACT:  Food color additives are vital to how we taste and perceive food, yet they generally remain mysterious to the public. This article examines food color additives from historical and regulatory perspectives. First, it uses recent examples to illustrate the importance of colors to our enjoyment of food. It then recounts the early history of food colors and the emergence of regulation to prevent their unsafe and fraudulent uses. The margarine war of the late 19th and early 20th centuries is described, as well as the 1906 and 1938 Food and Drug Acts. The article then enters the modern era of color additive regulation, beginning with the Color Additive Amendments of 1960. The debate over the Delaney anti‐cancer clause is assessed, as well as other recent safety and regulatory controversies. The article asserts that this string of incidents has gained public notoriety for color additives. The article concludes by discussing the future of food coloring and the move towards more natural dyes.
Bioreactance: A new tool for cardiac output and thoracic fluid content monitoring during hemodialysis
Authors: KOSSARI Niloufar , HUFNAGEL Gilles , SQUARA Pierre
Published: September 2009

Outpatient hemodialysis therapy (HD) can be associated with hemodynamic compromise. Bioreactance® has recently been shown to provide accurate, noninvasive, continuous, measurements of cardiac output (CO) and thoracic impedance (Zo) from which thoracic fluid content (TFC) can be derived assuming TFC=1000/Zo. This study was designed to evaluate the changes in TFC in comparison with the traditional indices of fluid removal (FR) and to understand the trends in CO changes in HD patients. Minute‐by‐minute changes in TFC and CO were prospectively collected using the bioreactance system (NICOM®) in HD patients of a single unit. Changes in body weight (ΔW), hematocrit (ΔHct), and amount of FR were also measured. Twenty‐five patients (age 77 ± 11 years) were included. The TFC decreased in all patients by an average of 5.4 ± 7.9 kΩ−1, weight decreased by 1.48 ± 0.98 kg, and FR averaged 2.07 ± 1.93 L over a 3‐ to 4‐hour HD session. There were good correlations between ΔTFC and ΔW (R=0.80, P<0.0001) and FR (R=0.85, P<0.0001). ΔHct (4.13 ± 3.42%) was poorly correlated with ΔTFC (R=0.35, P=0.12) and FR (R=0.40, P=0.07). The regression line between FR and TFC yielded FR=1.0024−0.1985TFC; thus, a 1 kΩ−1 change of Zo correlates with an ∼200 mL change in total body water. The change in CO (−0.52 ± 0.49 L/min m2) during HD did not correlate with FR (R=0.15, P=NS). Changes in TFC represented the monitored variable most closely related to FR. CO remained fairly constant in this stable patient cohort. Further studies in high‐risk patients are warranted to understand whether TFC and CO monitoring can improve HD session management.
Soft Tissue Decomposition of Submerged, Dismembered Pig Limbs Enclosed in Plastic Bags*
Authors: Pakosh Caitlin M. , Rogers Tracy L.
Published: September 2009

Abstract:  This study examines underwater soft tissue decomposition of dismembered pig limbs deposited in polyethylene plastic bags. The research evaluates the level of influence that disposal method has on underwater decomposition processes and details observations specific to this scenario. To our knowledge, no other study has yet investigated decomposing, dismembered, and enclosed remains in water environments. The total sample size consisted of 120 dismembered pig limbs, divided into a subsample of 30 pig limbs per recovery period (34 and 71 days) for each treatment. The two treatments simulated non‐enclosed and plastic enclosed disposal methods in a water context. The remains were completely submerged in Lake Ontario for 34 and 71 days. In both recovery periods, the non‐enclosed samples lost soft tissue to a significantly greater extent than their plastic enclosed counterparts. Disposal of remains in plastic bags therefore results in preservation, most likely caused by bacterial inhibition and reduced oxygen levels.
Towards a proposal for assessment of blinding success in clinical trials: up‐to‐date review
Authors: Kolahi Jafar , Bang Heejung , Park Jongbae
Published: September 2009

Abstract – 

The CONSORT statement recommended that investigators should clearly report which key trial persons were blinded to treatment allocation and test for the success of blinding. Clinical researchers, however, more often than not overlook the assessment of the success of blinding. The severe under‐reporting on the success of blinding may improve with awareness of existing quantitative methods. The two statistical methods, James’ blinding index (BI) and Bang’s BI, are currently available. Subjects could be asked to guess their treatment assignment, possibly with an option to express the degree of certainty. Assessments of blinding at various points may serve different purposes, i.e. to evaluate comparability between experimental versus control treatments before the trial by the third party; to examine further comparability and credibility of the control treatment and patients’ expectation about treatment received in early stage of the trial, and to summarize the overall maintenance of the blinding success at the end of the trial. In this article, we review BIs and how to use these methods along with discussion of other issues in blinding assessment and reporting. We contend the two BIs that were independently developed but carry complementary properties would characterize blinding behaviours in clinical trials qualitatively as well as quantitatively, and may also shed some lights on the interpretation of the study findings. Finally we urge the Item 11b of the CONSORT statement to be revised to require the assessment/reporting of blinding success for all trials that adopt blinding schemes.
Long‐term efficacy of etanercept in hidradenitis suppurativa: results from an open‐label phase II prospective trial
Authors: Pelekanou Aimilia , Kanni Theodora , Savva Athina , Mouktaroudi Maria , Raftogiannis Maria , Kotsaki Antigone , Giamarellos‐Bourboulis Evangelos J.
Published: September 2009

Please cite this paper as: Long‐term efficacy of etanercept in hidradenitis suppurativa: results from an open‐label phase II prospective trial. Experimental Dermatology 2010; 19: 538–540.

Objective:  To evaluate the long‐term efficacy of etanercept for the management of hidradenitis suppurativa.

Methods:  Analysis was based on the long‐term follow‐up (weeks 24–144) of 10 patients enrolled in a prospective open‐label phase II study; etanercept was initially administered subcutaneously 50 mg once weekly for 12 weeks in 10 patients. Disease recurrence and the need to restart etanercept were recorded.

Results:  Three patients did not report any disease recurrence. A second course of treatment with etanercept was needed in seven patients. Favourable responses were found in five; two patients failed treatment.

Conclusions:  The first treatment course achieved long‐term disease remission in almost one‐third of patients. The remaining needed a second treatment course but even in that case, their disease severity at restart was significantly lower compared with baseline.
CC chemokines as potential immunologic markers correlated with clinical improvement of atopic dermatitis patients by immunotherapy
Authors: Kwon Yeon Sook , Oh Sang Ho , Wu Wen Hao , Bae Byung Gi , Lee Hee Jung , Lee Min‐Geol , Lee Kwang Hoon
Published: September 2009

Please cite this paper as: CC chemokines as potential immunologic markers correlated with clinical improvement of atopic dermatitis patients by immunotherapy. Experimental Dermatology 2010; 19: 246–251.

Abstract:  Although immunotherapy is not accepted as a curative treatment for atopic dermatitis (AD), most studies have shown positive effects of immunotherapy on AD patients. The serum levels of CC chemokine ligand 17 (CCL17), CCL22 and CCL18 have been reported to be highly correlated with disease severity, which suggests important roles for CC chemokines in the pathogenesis of AD.

Objective:  The purpose of this study was to investigate the changes in clinical and immunologic markers before and after immunotherapy and to find which CC chemokines correlate with clinical improvement after immunotherapy with house dust mite (HDM) allergens in AD patients.

Methods and Results:  A total of 20 AD patients who were sensitized to HDM allergens through a skin‐prick test and Pharmacia CAP system were treated with subcutaneous immunotherapy using HDM allergens (treatment duration 12–60 months). Eczema area and severity index scores in 20 patients with AD decreased significantly after immunotherapy (P < 0.001). Serum total immunoglobulin E (IgE) and Dermatophagoides pteronyssinus‐specific IgE levels tended to decrease after treatment although this was not statistically significant, and the D. farinae‐specific IgE level showed no change. Serum CCL17, CCL22 and CCL18 levels decreased significantly from baseline after treatment (P = 0.043, 0.017 and <0.001, respectively). The percentage reductions in serum CCL17 and CCL22 level were significantly correlated with reductions in disease severity (P = 0.007, R2 = 0.301 and P = 0.037, R2 = 0.177, respectively).

Conclusion:  We suggest that CCL17 and CCL22 are good immunological marker candidates that can be used to assess clinical improvement after immunotherapy in AD patients.
Tyrosine kinase 2 and interferon regulatory factor 5 polymorphisms are associated with discoid and subacute cutaneous lupus erythematosus
Authors: Järvinen Tiina M. , Hellquist Anna , Koskenmies Sari , Einarsdottir Elisabet , Koskinen Lotta L. E. , Jeskanen Leila , Berglind Linda , Panelius Jaana , Hasan Taina , Ranki Annamari , Kere Juha , Saarialho‐Kere Ulpu
Published: September 2009

Please cite this paper as: Tyrosine kinase 2 and interferon regulatory factor 5 polymorphisms are associated with discoid and subacute cutaneous lupus erythematosus. Experimental Dermatology 2010; 19: 123–131.

Abstract:  Lupus erythematosus (LE) is a heterogeneous disease ranging from skin‐restricted manifestations to a progressive multisystem disease. The specific skin lesions include chronic cutaneous, subacute cutaneous and acute cutaneous LE. Both genetic and environmental factors are involved in the development of LE. However, reports on the genetic background of cutaneous lupus erythematosus (CLE) forms, namely discoid (DLE) and subacute cutaneous lupus erythematosus (SCLE), are sparse. We investigated whether the known systemic LE (SLE) susceptibility genes also predispose to CLE. Altogether, 219 Finnish patients with DLE or SCLE and 356 healthy controls were recruited. Single nucleotide polymorphisms tagging reported risk genes were genotyped. Tyrosine kinase 2 (TYK2) rs2304256 was associated with increased risk of DLE (P = 0.012, OR = 1.47, 95% CI = 1.01–1.98). Expression of TYK2 was demonstrated by immunohistochemistry in macrophage‐like cells and neutrophils and interferon regulatory factor 5 (IRF5) in macrophage‐ and fibroblast‐like cells of DLE, SCLE and SLE skin. IRF5 rs10954213 showed association with DLE (P = 0.017, OR = 1.40, 95% CI = 1.06–1.86) and SCLE (P = 0.022, OR = 1.87, 95% CI = 1.09–3.21). A haplotype of cytotoxic T‐lymphocyte‐associated protein 4 (CTLA4) showed association with DLE (P = 0.0065, OR = 2.51, 95% CI = 1.25–5.04). Our results show that the TYK2, IRF5 and CTLA4 genes previously associated with SLE also confer risk for DLE and SCLE, suggesting that different LE subphenotypes may share pathogenetic pathways.
Overcoming barriers to physical activity among culturally and linguistically diverse older adults: A randomised controlled trial
Authors: Borschmann Karen , Moore Kirsten , Russell Melissa , Ledgerwood Kay , Renehan Emma , Lin Xiaoping , Brown Colin , Sison Jasmine
Published: September 2009

Aim:  To investigate by randomised trial, health professional facilitated sessions aiming to overcome barriers to physical activity (PA), improve readiness to undertake PA, increase PA participation and improve fitness among older Australian adults from Macedonian and Polish backgrounds.

Method:  One hundred and twenty‐one participants (mean age 70 years, 63% female) were block randomised to the intervention group (three one‐hour group education and goal setting sessions over 7 weeks) or control group (one‐hour health promotion talk) following baseline assessment, with reassessment approximately 9 weeks later.

Results:  No significant differences were found between experimental groups in primary (Stages of Change Questionnaire (SocQ), steps per day and Human Activity Profile) or secondary outcomes.

Conclusion:  This study has highlighted methodological considerations for PA health promotion and research with older adults from culturally and linguistically diverse (CALD) backgrounds in a community setting. Investigation of older CALD adults' perceptions of what are ‘adequate levels of PA’ and methods of increasing PA is warranted.
Burden of Stroke in Brunei Darussalam
Authors: Nainar S. H. , Venketasubramanian N.
Published: September 2009

Brunei Darussalam, located on the north-west coast of Borneo, has a total area of 5765 km2 ( 1 ). Divided into four districts – Brunei-Muara, Belait, Temburong and Tutong with the majority of the population living in the Brunei-Muara District, approximately 74% of the population is urban with an overall population of 390 000, male/female ratio 1·13:1 ( 2 ). The main ethnic group is Malay (66·6%), which comprises the different Brunei indigenous communities of Malay, Belait, Bisaya, Brunei, Dusun, Kedayan, Murut and Tutong. Chinese ethnicity comprises 11% while other undefined ethnicities 22·4%. Approximately, 39·2% are aged below 19 years, 2·8% over 65 years with a median age of 26 years. Brunei's gross national income per capita (PPP international $) is 49 900 ( 3 ).
The Debrecen Stroke Database: Demographic Characteristics, Risk Factors, Stroke Severity and Outcome in 8088 Consecutive Hospitalised Patients with Acute Cerebrovascular Disease
Authors: Bereczki D. , Mihálka L. , Fekete I. , Valikovics A. , Csépány T. , Fülesdi B. , Bajkó Z. , Szekeres C. , Fekete K. , Csiba L.
Published: September 2009

Background

High stroke mortality in central-eastern European countries might be due to higher stroke incidence, more severe strokes or less effective acute care than in countries with lower mortality rate. Hospital databases usually yield more detailed information on risk factors, stroke severity and short-term outcome than population-based registries.

Patients and methods

The Debrecen Stroke Database, data of 8088 consecutively hospitalised patients with acute cerebrovascular disease in a single stroke centre in East Hungary between October 1994 and December 2006, is analysed. Risk factors were recorded and stroke severity on admission was scored by the Mathew stroke scale. The modified Glasgow outcome scale was used to describe patient condition at discharge.

Results

Mean age was 68 ± 13 years, 11·4% had haemorrhagic stroke. The rate of hypertension on admission was 79% in men, and 84% in women, 40·3% of men and 19·8% of women were smokers, and 34% of all patients had a previous cerebrovascular disease in their history. Case fatality was 14·9%, and 43% had some disability at discharge. Outcome at discharge was worse with higher age, higher glucose, higher blood pressure, higher white cell count and erythrocyte sedimentation rate and more severe clinical signs on admission. In multivariate analysis admission blood pressure lost its significance in predicting outcome.

Conclusions

In this large Hungarian stroke unit database hypertension on admission, smoking and previous cerebrovascular disease were more frequent than in most western databases. These findings indicate major opportunities for more efficient stroke prevention in this and probably other eastern European countries.