bluuebunny/crossref_metadata_2025 huggingface dataset:
HIV and pulmonary arterial hypertension: a systematic review
Authors: Janda S , Quon BS , Swiston J
Published: April 2010

Objectives

HIV‐related pulmonary arterial hypertension (PAH) is a rare entity but is associated with significant morbidity and mortality. The literature describing the outcomes of therapy for this disease is limited to case series and cohort studies. The objective of this study was to systematically review and synthesize the literature on HIV‐related PAH.

Methods

MEDLINE, EMBASE, PapersFirst, the Cochrane collaboration and the Cochrane Register of controlled trials were searched with pre‐defined search terms. Randomized controlled trials, observational cohort studies, case–control studies and case reports were considered for inclusion in the qualitative analysis.

Results

A total of 180 case reports of PAH in HIV‐infected patients were identified. Twenty‐six were excluded and thus 154 case reports were included in the qualitative analysis. Thirteen cohort, one case series and two case–control studies were also identified and included in the review. The average baseline CD4 count at the time of diagnosis of PAH was 352 ± 304 cells/μL. The average time from diagnosis of HIV infection to diagnosis of PAH was 4.3 ± 4.0 years. Predominant chest X‐ray findings included cardiomegaly (80%) and pulmonary arterial enlargement (75%). Highly active antiretroviral therapy, bosentan, and prostaglandin therapy have all been reported to be beneficial in improving haemodynamic and functional status in HIV‐related PAH.

Conclusion

HIV‐related PAH is a rare entity with clinical, laboratory, imaging and pathological manifestations similar to those of idiopathic PAH. The evidence for various treatments is limited to cohort, case series and case–control studies. Randomized controlled trials are needed to properly assess the utility of these therapies in the treatment of HIV‐related PAH.
Repetitive transcranial magnetic stimulation at 1Hz and 5Hz produces sustained improvement in motor function and disability after ischaemic stroke
Authors: Emara T. H. , Moustafa R. R. , ElNahas N. M. , ElGanzoury A. M. , Abdo T. A. , Mohamed S. A. , ElEtribi M. A.
Published: April 2010

Background:  Repetitive transcranial magnetic stimulation (rTMS) is a simple and non‐invasive method of augmenting motor recovery after stroke, probably mediated by restoring inter‐hemispheric activation balance. This placebo‐controlled pilot study examined the possible benefit of stimulating the lesioned hemisphere (5‐Hz rTMS) or inhibiting the contra‐lesional hemisphere (1‐Hz rTMS) on clinical recovery of motor function in patients with ischaemic stroke and assessed the sustainability of the response.

Methods:  Sixty patients with ischaemic stroke (>1 month from onset) with mild‐to‐moderate hemiparesis were randomized to receive 10 daily sessions of either sham rTMS, 5‐Hz ipsi‐lesional rTMS or 1‐Hz contra‐lesional rTMS, in addition to a standard physical therapy protocol. Serial assessments were made over a period of 12 weeks by the thumb‐index finger tapping test (FT), Activity Index (AI) score and the modified Rankin Scale (mRS).

Results:  In contrast to control patients, those receiving active rTMS as ipsi‐lesional 5‐Hz stimulation or 1‐Hz contra‐lesional stimulation showed statistically significant improvement on the FT test, AI scores and mRS score at 2 weeks, and the effect was sustained over the 12‐week observation period. No significant adverse events were observed during treatment in either group.

Conclusions:  Repetitive TMS has beneficial effects on motor recovery that can be translated to clinically meaningful improvement in disability in patients with post‐stroke hemiparesis, with a well‐sustained effect. The similarity of inhibitory and stimulatory rTMS in producing these effects supports the inter‐hemispheric balance hypothesis and encourages further research into their use in long‐term neurorehabilitation programmes of patients with stroke.
Evaluation of admission characteristics, hospital length of stay and costs for cerebral infarction in a medium‐sized city in China
Authors: Ma Y. , Liu Y. , Fu H. ‐M. , Wang X. ‐M. , Wu B. ‐H. , Wang S. ‐X. , Peng G. ‐G.
Published: April 2010

Background and purpose:  Stroke is a heavy economic and health burden for the patients and society. This study aimed to evaluate hospital length of stay (LOS) by admission characteristics and costs correlated with medical insurance status for cerebral infarction in a medium‐sized city in China.

Methods:  A total of 557 consecutive patients with principal diagnosis of cerebral infarction were enrolled. Admission characteristics, LOS, and costs were retrospectively analyzed.

Results:  The mean LOS was 18.5 days (median, 16 days). Our analysis demonstrated that medical insurance status, stroke severity (National Institutes of Health Stroke Scale score, Functional Independence Measure cognitive and motor score, Glasgow coma scale), Oxfordshire Community Stroke Project (OCSP) classification, some comorbidities (coronary heart disease, chronic obstructive pulmonary disease, and hyperlipemia), and raised leukocytes were the main explanatory factors for LOS by stepwise multiple regression model. The mean per patient costs were US$ 983.0, and mean daily costs US$ 67.0. Drugs were the most expensive cost subtype, all subtypes costs except non‐medical care were significantly higher in patients with state medicine than in those with new cooperative medical scheme (NCMS) (P < 0.001).

Conclusion:  Stroke severity, OCSP classification, raised leukocytes on admission, some comorbidities, and medical insurance status may help to predict LOS for patients with cerebral infarction. Healthcare expenditures were heavy burdens to inhabitants. State medicine patients could shorten unnecessary LOS to improve the resources allocation and cost‐efficiency.
The potential power of social policy programmes: income redistribution, economic resources and health
Authors: Lundberg Olle , Fritzell Johan , Åberg Yngwe Monica , Kölegård Maria L.
Published: April 2010

Lundberg O, Fritzell J, Åberg Yngwe M, Kölegård ML. The potential power of social policy programmes: income redistribution, economic resources and health

Int J Soc Welfare 2010: ••: ••–••© 2010 The Author(s), Journal compilation © 2010 Blackwell Publishing Ltd and International Journal of Social Welfare.

This Supplement includes a number of articles dealing with the role of social policy schemes for public health across the life course. As a key social determinant of health, poverty and its consequences have historically been at the forefront of the public health discussion. But also in rich countries today, economic resources are likely to be important for health and survival, both on an individual and an aggregate level. This introductory article serves as a background for the more specific analyses that follow. The focus is on why income and income inequality could have an effect on individual and population health. We discuss relationships between the individual and population levels and between income and health, and some of the possible mechanisms involved. We also present arguments for why welfare state institutions may matter.
Societal shifts and changed patterns of poverty
Authors: Fritzell Johan , Ritakallio Veli‐Matti
Published: April 2010

Fritzell J, Ritakallio VM. Societal shifts and changed patterns of poverty

Int J Soc Welfare 2010: ••: ••–••© 2010 The Author(s), Journal compilation © 2010 Blackwell Publishing Ltd and International Journal of Social Welfare.

This article uses data from the Luxembourg Income Study to analyse cross‐national and cross‐temporal poverty risks in 11 Western countries. We show that poverty risks have tended to increase from the early 1980s to 2000. In line with what we would expect based on the welfare state literature, the Nordic countries tend to have the lowest poverty rates. However, the proportion of the national population with a market income below the poverty threshold has increased in all countries and the cross‐national variation in market income poverty is not apparently related to the type of welfare state regime. We perform a simulation analysis to test whether structural factors, that is, compositional differences in age, family and labour market behaviour, could account for the cross‐national variation found. Our results demonstrate the increasing importance of household labour market attachment for alleviating poverty risks, as well as for explaining the cross‐national variation in these risks.
Social policy and health: transition countries in a comparative perspective
Authors: Ferrarini Tommy , Sjöberg Ola
Published: April 2010

T. Ferrarini, O. Sjöberg. Social policy and health: transition countries in a comparative perspective

Int J Soc Welfare 2010: ••: ••–••© 2010 The Author(s), Journal compilation © 2010 Blackwell Publishing Ltd and International Journal of Social Welfare.

This article analyses the development and design of unemployment insurance and family policy benefits and their links to health outcomes in Estonia, Poland, the Slovak Republic, Slovenia, the Czech Republic and Hungary from the mid‐1990s. Comparing these six transition countries with long‐standing welfare democracies reveals important similarities and differences in policy and health. Unemployment benefit schemes resemble corporatist schemes in important respects, however, with lower coverage and average benefits. Subjective wellbeing is also comparatively low among both employed and unemployed in the transition countries. Several transition countries have mixed family policy strategies that simultaneously support dual‐earner families and traditional gender roles. One clear exception is Slovenia, which has a highly developed dual‐earner support. Family policy generosity is related to lower rates of poverty, infant mortality and child injuries. The article demonstrates the fruitfulness of institutional analyses of the link between social policy and population health in a broader welfare state context.
Influence of high dose tumescent local anaesthesia with prilocaine on systemic interleukin (IL)‐6, IL‐8 and tumour necrosis factor‐α
Authors: Schmittner MD , Faulhaber J , Kemler B , Koenen W , Thumfart JO , Weiss C , Neumaier M , Beck GC
Published: April 2010

Background and objective  Tumescent local anaesthesia (TLA) with high prilocaine doses leads to formation of methemoglobin (MHb) which is known to be a potent activator of pro‐inflammatory endothelial cell response in vitro. As TLA is widely used for large dermatological resections, the aim of this study was to investigate the effects of high prilocaine doses on the systemic inflammatory response in vivo and its clinical relevance.

Methods  This prospective study examines the influence of MHb on serum interleukin (IL)‐6, IL‐8 and tumour necrosis tumour necrosis (TNF)‐α levels up to 72 h after application of TLA with prilocaine in doses higher than 600 mg.

Results  A total of 30 patients received prilocaine in a median dose of 1500 mg (range: 880–4160 mg) for large resections. Peak prilocaine serum concentration was reached 4 h (0.72 ± 0.07 μg/mL), the maximum concentration of MHb (7.43 ± 0.87%) and IL‐6 (28.4 ± 4.1 U/L) 12 h after TLA application. TNF‐α and IL‐8 release were not found significantly increased. Three patients developed MHb concentrations >15%.

Conclusions  This clinical study shows for the first time that a high prilocaine serum concentration leads in vivo to elevated systemic levels of IL‐6 but not of IL‐8 and TNF‐α because of initial high MHb levels. Because of possible and unpredictable high MHb concentrations, TLA should only be performed with prilocaine in doses of 2.5 mg/kg. In general, new solutions of TLA are necessary to achieve adequate anaesthesia for large dermatological resections to decrease the risk of methemoglobinaemia.
Incidence and factors associated with recurrence after incomplete excision of basal cell carcinomas: a study of 90 cases
Authors: Santiago F , Serra D , Vieira R , Figueiredo A
Published: April 2010

Background  Management of incompletely excised basal cell carcinomas (BCC) remains controversial.

Objective  The aim of this study was to assess the rate and the factors associated with the recurrence of incompletely excised BCC.

Methods  In this retrospective monocentric study, data from all surgically excised BCC during 4 years (2000 to 2003) were analysed.

Results  A total of 947 BCC were excised. Of these, 90 were incompletely excised (9.5%). This group was kept under clinical follow‐up for a median period of 62.5 months (range 12–84). Recurrence was confirmed in 29 patients (32.2%). The median interval to recurrence was 12 months (range 1–57). Recurrence of incompletely excised BCC was significantly higher (P < 0.05) in younger patients, in aggressive histological types and in localizations like postauricular and nasogenian folds.

Conclusion  Observation might be an acceptable option in many situations, but for patients with aggressive types of BCC, or with tumours localized in risk areas of the face, immediate re‐excision appears to be the treatment of choice. A careful follow‐up is indicated for at least 3 years; however, long lasted recurrence should not be underestimated.
Genital psoriasis: a questionnaire‐based survey on a concealed skin disease in the Netherlands
Authors: Meeuwis KAP , De Hullu JA , De Jager MEA , Massuger LFAG , Van De Kerkhof PCM , Van Rossum MM
Published: April 2010

Background  Psoriatic lesions may involve nearly all sites of the body. Involvement of the genital skin is frequently classified as part of intertriginous psoriasis without special awareness and treatment for this presentation of the disease. Gaining knowledge about the frequency of the involvement of genital skin in these patients will improve the overall care for patients with psoriasis.

Objectives  We studied the prevalence of genital psoriasis in the Netherlands and epidemiological characteristics of this specific presentation of the disease. Furthermore, we studied the relation between flexural and genital psoriasis.

Patients/Methods  A self‐administered questionnaire was sent to all 5300 members of the Dutch Psoriasis Society. Sociodemographic patient characteristics and disease‐related data (such as localization of psoriatic lesions, involvement of the genitalia, age at onset of genital psoriasis and severity of genital psoriatic lesions) were collected and analysed.

Results  A response rate of 37% was achieved. Almost 46% of the responding patients with psoriasis, that is 16.5% of all potential responders (n = 5300), report genital involvement at some time during the course of their disease. The genitalia can become affected at any age. Many patients with current genital involvement (38%) do not have the flexural skin affected.

Conclusions  A large part of patients with psoriasis suffer from genital psoriasis, which was not associated with flexural involvement in at least one third of them. More attention to the genital region is required in the current standard treatment of both male and female psoriatic patients at any age.
In vitro antifungal susceptibility of dermatophyte strains causing tinea pedis and onychomycosis in patients with non‐insulin‐dependent diabetes mellitus: a case‐control study
Authors: Özcan D , Seçkin D , Demirbilek M
Published: April 2010

Background  The efficacy of antifungal treatment may be reduced and/or delayed in diabetic patients. To date, no study has investigated the in vitro antifungal susceptibility of dermatophytes in this patient group.

Objective  We aimed to determine the dermatophyte species causing tinea pedis and onychomycosis, and in vitro susceptibility of these dermatophytes to terbinafine, itraconazole, and fluconazole in patients with non‐insulin‐dependent diabetes mellitus. We compared the findings in diabetic patients with those in non‐diabetic individuals.

Materials and methods  One hundred patients with non‐insulin‐dependent diabetes mellitus and 100 otherwise healthy controls clinically suspected with tinea pedis and/or onychomycosis were included. Skin scrapings and/or nail clippings were taken and cultured on Sabouraud dextrose agar, mycobiotic agar, and dermatophyte test medium. In vitro antifungal susceptibility tests were carried out according to the Clinical and Laboratory Standards Institute (CLSI) M‐38P protocol with some modifications.

Results  Fifty‐seven samples of 54 diabetics and 50 samples of 50 controls grew dermatophytes. In both groups, Trichophyton rubrum was the most common isolate. Mean MIC values of terbinafine, itraconazole, and fluconazole for all of the isolated dermatophyte strains were similar in two groups (P > 0.05). The difference in mean MIC values of three antifungals for T. rubrum and T. mentagrophytes between two groups was not statistically significant (P > 0.05).

Conclusions  Dermatophyte types causing tinea pedis and onychomycosis, their frequency patterns, and in vitro activity of three antifungals against dermatophytes in diabetics are similar to the non‐diabetics. Terbinafine is the most active agent in vitro in both groups.
Gender aspects in skin diseases
Authors: Chen W , Mempel M , Traidl‐Hofmann C , Al Khusaei S , Ring J
Published: April 2010

Gender differences in medicine have been recognized in anatomy, physiology, as well as in epidemiology and manifestations of various diseases. With respect to skin disorders, males are generally more commonly afflicted with infectious diseases while women are more susceptible to psychosomatic problems, pigmentary disorders, certain hair diseases, and particularly autoimmune as well as allergic diseases. Significantly, more female sex‐associated dermatoses can be identified than the male sex‐associated dermatoses. Dermatoses in the genital area differ between men and women. Gender differences also exist in the occurrence and prognosis of certain skin malignancies. The mechanisms underlying gender differences in skin diseases remain largely unknown. Differences in the skin structure and physiology, effect of sex hormones, ethnic background, sociocultural behaviour and environmental factors may interact to exert the influences. A better understanding of gender differences in human health and diseases will allow the development of novel concepts for prevention, diagnosis and therapy of skin diseases.
We Are Originarios …‘We Just Aren't from Here’: Coca leaf and Identity Politics in the Chapare, Bolivia
Authors: GRISAFFI THOMAS
Published: April 2010

This article first examines the ways in which coca leaf acquired an important symbolic value in forging a counter‐hegemonic discourse that wove together various strands of class and cultural identity struggles in the Chapare province, Bolivia. The second line of enquiry that runs through this article deals with the conflicts that arose when the coca union mutated into a governing political party. Now that the coca growers' leader, Evo Morales, is President of the Republic he is obliged by the international community to reduce the amount of land under coca cultivation. To do this President Morales has had to rhetorically pull coca leaf apart from Andean tradition. This presents a challenge to the integrity of indigenous‐peasant based movements in the Chapare because it brings attention to their constructed nature and thus questions the authenticity of the originario identity.
Subsurface characterization of methane production and oxidation from a New Hampshire wetland
Authors: SHOEMAKER J. K. , SCHRAG D. P.
Published: April 2010

We measured the carbon isotopic composition of pore water carbon dioxide from Sallie’s Fen, a New Hampshire poor fen. The isotope profiles are used in combination with a one‐dimensional diffusion–reaction model to calculate rates of methane production, oxidation and transport over an annual cycle. We show how the rates vary with depth over a seasonal cycle, with methane produced deeper during the winter months and at progressively shallower depths into the summer season. The rates of methane production, constrained by the measured δ13Cdic profiles, cannot explain high methane emission during the summer. We suggest that much of the methane produced during this time comes either from the unsaturated peat, or from the top 1–3 cm of saturated peat where episodic exchange with the atmosphere makes it invisible to our method.
Analysis of requests for information and data from a national soil data centre in France
Authors: De Forges A. C. Richer , Arrouays D.
Published: April 2010

We studied a database that recorded all requests to the French National Soil Data Centre between April 2008 and November 2009 when a total of 440 requests were made. Our hypothesis is that an analysis of such requests can provide an insight into awareness of soil issues and data needs. These requests covered a wide range of topics. The most important threats were contamination, erosion and soil organic carbon decline. Soil acidification appeared to be no longer a priority concern. We found a lack of awareness of topics such as soil sealing and soil compaction. Gaps in data coverage are stressed and we highlight some data that were inadequate for some users’ needs.
Idiopathic Ophthalmodynia and Idiopathic Rhinalgia: Two Topographic Facial Pain Syndromes
Authors: Pareja Juan A. , Cuadrado María L. , Porta‐Etessam Jesús , Fernández‐de‐las‐Peñas César , Gili Pablo , Caminero Ana B. , Cebrián José L.
Published: April 2010

(Headache 2010;50:1286‐1295)

Objective.— To describe 2 topographic facial pain conditions with the pain clearly localized in the eye (idiopathic ophthalmodynia) or in the nose (idiopathic rhinalgia), and to propose their distinction from persistent idiopathic facial pain.

Background.— Persistent idiopathic facial pain, burning mouth syndrome, atypical odontalgia, and facial arthromyalgia are idiopathic facial pain syndromes that have been separated according to topographical criteria. Still, some other facial pain syndromes might have been veiled under the broad term of persistent idiopathic facial pain.

Methods.— Through a 10‐year period we have studied all patients referred to our neurological clinic because of facial pain of unknown etiology that might deviate from all well‐characterized facial pain syndromes.

Results.— In a group of patients we have identified 2 consistent clinical pictures with pain precisely located either in the eye (n = 11) or in the nose (n = 7). Clinical features resembled those of other localized idiopathic facial syndromes, the key differences relying on the topographic distribution of the pain.

Conclusions.— Both idiopathic ophthalmodynia and idiopathic rhinalgia seem specific pain syndromes with a distinctive location, and may deserve a nosologic status just as other focal pain syndromes of the face. Whether all such focal syndromes are topographic variants of persistent idiopathic facial pain or independent disorders remains a controversial issue.
Bilateral intracranial electroencephalographic monitoring immediately following corpus callosotomy
Authors: Silverberg Alyson , Parker‐Menzer Kimberly , Devinsky Orrin , Doyle Werner , Carlson Chad
Published: April 2010

Although many patients with medically refractory focal epilepsy are candidates for resective surgery, patients with multifocal epilepsy and symptomatic generalized epilepsy remain difficult to treat medically and surgically. Corpus callosotomy has been utilized since 1940 for the treatment of seizures, with reports of efficacy in multiple seizure types. Previous studies have demonstrated subsequent lateralization of bilateral/bisynchronous epileptiform activity following callosotomy. To investigate the efficacy of bilateral intracranial electroencephalographic studies immediately following corpus callosotomy, we retrospectively identified 26 patients who underwent corpus callosotomy at our center, 18 of whom had intracranial monitoring following corpus callosotomy. Five of the 18 had focal resections following intracranial electroencephalography (EEG). No patients were seizure free following callosotomy or resection. No differences in postoperative outcomes were seen between patients with intracranial EEG versus those without.
Alteration of dopamine D2/D3 receptor binding in patients with juvenile myoclonic epilepsy
Authors: Landvogt Christian , Buchholz Hans‐Georg , Bernedo Viviane , Schreckenberger Mathias , Werhahn Konrad J.
Published: April 2010

Purpose: To quantify extrastriatal and striatal D2/D3 receptor binding in patients with juvenile myoclonic epilepsy (JME) using the high‐affinity dopamine D2/D3 receptor positron emission tomography (PET) ligand18F‐Fallypride ([18F]FP).

Methods: Twelve patients with JME and 21 age‐matched control subjects were studied. Dynamic images (180 min) were acquired after injection of [18F]FP. Patients had been seizure‐free of all seizure types for at least 10 days before scanning. Parametric images of binding potential (BP) were created using the simplified reference tissue model. The images were stereotactically normalized using a ligand‐specific template. We performed a voxel‐based analysis with statistical parametric mapping (SPM2). Region of interest (ROI) analysis was done comparing the BP of the thalamus, caudate nucleus, anterior (ventral) and posterior (dorsal) putamen, ventral striatum, and temporal lobe.

Results: Compared to controls, patients with JME showed a significant decrease in [18F]FP BP (SPM analysis corr. p < 0.001 at cluster level) restricted to the bilateral posterior putamen. There was no significant alteration of [18F]FP binding in other brains regions. ROI analysis revealed a significant (p < 0.05) decrease of [18F]FP BP in the left (mean −14.8%) and right (mean −16.9%) posterior putamen, but not in the anterior putamen, caudate, ventral striatum, thalamus, or temporal lobe.

Discussion: Patients with JME showed a reduction in D2/3 receptor binding restricted to the bilateral posterior putamen, suggesting a specific alteration of the dopaminergic system. Whether these changes can be regarded as merely functional or whether they relate to the pathophysiology of juvenile myoclonic epilepsy still remains unclear.
Distribution and proliferation of bone marrow cells in the brain after pilocarpine‐induced status epilepticus in mice
Authors: Longo Beatriz , Romariz Simone , Blanco Miriam Marcela , Vasconcelos Juliana Fraga , Bahia Luciana , Soares Milena Botelho Pereira , Mello Luiz E. , Ribeiro‐dos‐Santos Ricardo
Published: April 2010

The distribution of bone marrow cells in brain areas during the acute period after pilocarpine‐induced status epilepticus (SE) was investigated here. To achieve this, we generated chimeric mice by engrafting bone marrow cells from enhanced green fluorescent protein (eGFP) transgenic mice. GFP+ bone marrow–derived cells were found throughout the brain, predominantly in the hippocampus. As expected, these cells exhibited the characteristics of microglia. The pattern of distribution, proliferation, and differentiation of GFP+ cells changes as a function of intensity and time following SE. This pattern is also a consequence of the inflammatory response, which is followed by the progressive neuronal damage that is characteristic of the pilocarpine model.
The Effects of Presenting Imprecise Probabilities in Intelligence Forecasts
Authors: Dieckmann Nathan F. , Mauro Robert , Slovic Paul
Published: April 2010

How to assess and present analytic uncertainty to policymakers has emerged as an important topic in risk and policy analysis. Due to the complexity and deep uncertainty present in many forecasting domains, these reports are often fraught with analytic uncertainty. In three studies, we explore the effect of presenting probability assessments and analytic uncertainty through probability ranges. Participants were presented with mock intelligence forecasts that include narrative evidence as well as numerical probability assessments. Participants were sensitive to the ambiguity communicated through the confidence range. The narrative appeared to have a smaller effect on judgments when accompanied by a probability range as opposed to a point assessment. In one study, participants also thought that the probability range was more useful for decision making at a higher probability whereas the point estimate was more useful at a lower probability. When evaluating a forecast in hindsight, decisionmakers tended to report lower levels of blame and higher levels of source credibility for forecasts that reported ranges as compared to point assessments. These findings suggest that decisionmakers are not necessarily “ambiguity averse” in the forecasting context. Presenting ranges of probability may have distinct advantages as a way to communicate probability and analytic confidence to decisionmakers.
Ecological Information Needs for Environmental Justice
Authors: Burger Joanna , Harris Stuart , Harper Barbara , Gochfeld Michael
Published: April 2010

The concept that all peoples should have their voices heard on matters that affect their well‐being is at the core of environmental justice (EJ). The inability of some people of small towns, rural areas, minority, and low‐income communities, to become involved in environmental decisions is sometimes due to a lack of information. We provide a template for the ecological information that is essential to examine environmental risks to EJ populations within average communities, using case studies from South Carolina (Savannah River, a DOE site with minority impacts), Washington (Hanford, a DOE site with Native American impacts), and New Jersey (nonpoint, urbanized community pollution). While the basic ecological and public health information needs for risk evaluations and assessments are well described, less attention has been focused on standardizing information about EJ communities or EJ populations within larger communities. We suggest that information needed about EJ communities and populations includes demographics, consumptive and nonconsumptive uses of their regional environment (for example, maintenance and cosmetic, medicinal/religious/cultural uses), eco‐dependency webs, and eco‐cultural attributes. A purely demographics approach might not even identify EJ populations or neighborhoods, much less their spatial relation to the impact source or to each other. Using information from three case studies, we illustrate that some information is readily available (e.g., consumption rates for standard items such as fish), but there is less information about medicinal, cultural, religious, eco‐cultural dependency webs, and eco‐cultural attributes, all of which depend in some way on intact, functioning, and healthy ecosystems.
The Declining Talent Pool of Government
Authors: Dewan Torun , Myatt David P.
Published: April 2010

We consider a government for which success requires high performance by talented ministers. A leader provides incentives to her ministers by firing those who fail. However, the consequent turnover drains a finite talent pool of potential appointees. The severity of the optimal firing rule and ministerial performances decline over time: the lifetime of an effective government is limited. We relate this lifetime to various factors, including external shocks, the replenishment of the talent pool, and the leader's reputation. Some results are surprising: an increase in the stability of government and the exogenous imposition of stricter performance standards can both shorten the era of effective government, and an increase in the replenishment of the talent pool can reduce incumbent ministers' performance.
Lobectomy for Pulmonary Vein Occlusion Secondary to Radiofrequency Ablation
Authors: STELIGA MATTHEW A. , GHOURI MAAZ , MASSUMI ALI , REUL ROSS M.
Published: April 2010

Pulmonary Vein Occlusion After RF Ablation.  Pulmonary vein stenosis, a recognized complication of transcatheter radiofrequency ablation in the left atrium, is often asymptomatic. Significant stenosis is commonly treated with percutaneous balloon dilation with or without stenting. We encountered a case of complete pulmonary vein occlusion that caused lobar thrombosis, pleuritic pain, and persistent cough. Imaging studies revealed virtually no perfusion to the affected lobe. A lobectomy was performed, resolving the persistent cough and pain. Pulmonary vein occlusion should be suspected in patients who present with pulmonary symptoms after having undergone ablative procedures for atrial fibrillation. This condition may necessitate surgical intervention if interventions such as balloon dilation or stenting are not possible or are ineffective. (J Cardiovasc Electrophysiol, Vol. 21, pp. 1055‐1058, September 2010)
A Bayesian Approach to Age Estimation in Modern Americans from the Clavicle*
Authors: Langley‐Shirley Natalie , Jantz Richard L.
Published: April 2010

Abstract:  Clavicles from 1289 individuals from cohorts spanning the 20th century were scored with two scoring systems. Transition analysis and Bayesian statistics were used to obtain robust age ranges that are less sensitive to the effects of age mimicry and developmental outliers than age ranges obtained using a percentile approach. Observer error tests showed that a simple three‐phase scoring system proved the least subjective, while retaining accuracy levels. Additionally, significant sexual dimorphism was detected in the onset of fusion, with women commencing fusion at least a year earlier than men (women transition to fusion at approximately 15 years of age and men at 16 years). Significant secular trends were apparent in the onset of skeletal maturation, with modern Americans transitioning to fusion approximately 4 years earlier than early 20th century Americans and 3.5 years earlier than Korean War era Americans. These results underscore the importance of using modern standards to estimate age in modern individuals.
Molecular Assay for Screening and Quantifying DNA in Biological Evidence: The Modified Q‐TAT Assay*
Authors: Wilson Jon , Fuller Valerie , Benson Gifty , Juroske Denise , Duvall Eric , Fu Jun , Pritchard Jane , Allen Robert W.
Published: April 2010

Abstract:  A method is described for the quantitation of total human and male DNA. Q‐TAT utilizes end‐point, multiplex polymerase chain reaction (PCR) amplification of the amelogenin and SRY loci to quantify DNA and incorporates a cloned nonhuman template to detect PCR inhibition. Standard curves of fluorescence from amelogenin or SRY amplicons were generated from amplification of known amounts of NIST traceable SRM‐female or SRM‐male DNA. Curves showed good linearity up to 500 pg of SRM‐template (R2 > 0.99) and reliably estimated total and male DNA content in casework samples. The nonhuman pRLnull template included in each PCR was a sensitive indicator of known PCR inhibitors including EDTA, hemin, blue denim dye, and humic acid. Finally, the SRY amplicon was a sensitive indicator of male DNA and, in mixtures, could reliably estimate male DNA present in an excess of female DNA. The Q‐TAT multiplex is a reliable quantitation method for forensic DNA typing.
A Geometric Morphometric Approach to Sex Determination of the Human Adult Os Coxa
Authors: Bytheway Joan A. , Ross Ann H.
Published: April 2010

Abstract: Sex determination of the human skeleton is best assessed from the os coxa. The present study explored the possibility of using three‐dimensional landmark coordinate data collected from various landmarks located over the entire bone to determine whether there were significant sex differences local to the landmarks. Thirty‐six landmarks were digitized on 200 African American and European American male and female adult human os coxae. MANCOVA results show that sex and size have a significant effect on shape for both European Americans (Sex,F = 17.50, d.f. = 36, 63,p > F = 0.0001; Size,F = 2.56, d.f. = 36, 63,p > F = 0.0022) and African Americans (Sex,F = 21.18, d.f. = 36, 63,p > F = 0.0001; Size,F = 2.59, d.f. = 36, 63,p > F = 0.0005). The discriminant analysis shows that sexing accuracy for European Americans is 98% for both males and females, 98% for African American females, and 100% for African American males.
Arsenic Poisoning Caused by Intentional Contamination of Coffee at a Church Gathering—An Epidemiological Approach to a Forensic Investigation
Authors: Gensheimer Kathleen F. , Rea Vicki , Mills Dora Anne , Montagna Christopher P. , Simone Karen
Published: April 2010

Abstract:  An outbreak of apparent food‐borne illness following a church gathering was promptly reported to the Maine Bureau of Health. Gastrointestinal symptoms among church attendees were initially attributed to consumption of leftover sandwiches that had been served the previous day. However, a rapid epidemiological and laboratory assessment revealed the etiology of illness, including the death of an elderly gentleman, was not food‐borne in origin. A criminal investigation determined that deliberate arsenic contamination of the brewed coffee by one of the church members was the source of the outbreak. Public health officials and criminal investigators must be aware that intentional biologic aggression can initially present as typical unintentional disease outbreaks. Practitioners must also consider the need to properly maintain and preserve potential forensic evidence. This case demonstrates the key role public health practitioners may play in criminal investigations.
Traumatic Death in Ankylosing Spondylitis
Authors: Thomsen Asser H. , Jurik Anne Grethe , Uhrenholt Lars , Vesterby Annie
Published: April 2010

Abstract:  Ankylosing spondylitis (AS) is a chronic rheumatic disease that causes spinal rigidity with an increased risk of spinal fractures. We present a case report where a middle‐aged man, in apparent good health, died following a fall from his bike. Postmortem computed tomography (CT) showed several fractures in the cervical and thoracic spine, with displacement into the spinal canal as well as spinal changes consistent with AS. The cause of death was determined to be upper spinal cord injury caused by cervical spinal fractures that were facilitated by spinal rigidity from AS. Further investigation into the medical records revealed that the decedent had previously been treated for AS. This case report illustrates the importance of obtaining a detailed medical history when investigating deaths, including nonfatal conditions, such as AS. Furthermore, it shows the value of CT in the evaluation of the mechanism and manner of death.
Validation of Ultrastructural Analysis of Mitochondrial Deposits in Cardiomyocytes as a Method of Detecting Early Acute Myocardial Infarction in Humans*
Authors: Begieneman Mark P. V. , Van De Goot Frank R. W. , Fritz Jan , Rozendaal Rence , Krijnen Paul A. J. , Niessen Hans W. M.
Published: April 2010

Abstract:  In the present study, ultrastructural analysis of mitochondrial deposits (black dots within mitochondria) as a method for the detection of early acute myocardial infarction (AMI) was evaluated. In 24 patients with AMI and six controls, analysis was performed in the heart of infarcted patients and noninfarcted controls. In the infarction area in lactate dehydrogenase (LDH)‐diagnosed AMI, the percentage of positive mitochondria was significantly higher compared to corresponding heart tissue in control patients and compared to noninfarcted areas within these patients. Also in patients with a clinically diagnosed AMI but no LDH decoloration, a significant higher percentage of positive mitochondria was found in the left ventricle compared to controls and noninfarcted areas. In patients with AMI, an increase in mitochondria with deposits was found in the infarction area compared to controls and noninfarcted tissue within the same patient, suggesting that electron microscopical changes in mitochondria can be used for the diagnosis of AMI less than 3 h old.
Macroscopic, Microscopic, and Chemical Assessment of Gunshot Lesions on Decomposed Pig Skin
Authors: Gibelli Daniele , Brandone Alberto , Andreola Salvatore , Porta Davide , Giudici Elena , Grandi Marco Aurelio , Cattaneo Cristina
Published: April 2010

Abstract: Very little literature exists on gunshot wounds on decomposed material. In this study, seven pig heads underwent a shooting test. Entrance wounds from the first head underwent neutron activation analysis (NAA) and histological testing immediately after the firing test; the other six heads were exposed to two different environments (open air and soil) and analyzed by radiochemical and histological tests every 15 days. Gunshot wounds in air maintained their morphological characteristics, and those in soil showed severe alteration after 5 weeks. Microscopic testing verified positive results for lead in all gunshot wounds in open air, whereas in most of those in soil lead could not be detected. Radiochemical analysis performed by NAA yielded for all gunshot wounds but one antimony quantities in the range of 0.07–13.89 μg. In conclusion, it may be possible to detect residues of antimony even in degraded tissues.
Variation in the Measurement of Cranial Volume and Surface Area Using 3D Laser Scanning Technology
Authors: Sholts Sabrina B. , Wärmländer Sebastian K.T.S. , Flores Louise M. , Miller Kevin W.P. , Walker Phillip L.
Published: April 2010

Abstract:  Three‐dimensional (3D) laser scanner models of human crania can be used for forensic facial reconstruction, and for obtaining craniometric data useful for estimating age, sex, and population affinity of unidentified human remains. However, the use of computer‐generated measurements in a casework setting requires the measurement precision to be known. Here, we assess the repeatability and precision of cranial volume and surface area measurements using 3D laser scanner models created by different operators using different protocols for collecting and processing data. We report intraobserver measurement errors of 0.2% and interobserver errors of 2% of the total area and volume values, suggesting that observer‐related errors do not pose major obstacles for sharing, combining, or comparing such measurements. Nevertheless, as no standardized procedure exists for area or volume measurements from 3D models, it is imperative to report the scanning and postscanning protocols employed when such measurements are conducted in a forensic setting.
Arthropods of Forensic Importance on Pig Carrion in the Coahuilan Semidesert, Mexico
Authors: Valdes‐Perezgasga Ma. Teresa , Sanchez‐Ramos Francisco Javier , Garcia‐Martinez Oswaldo , Anderson Gail S.
Published: April 2010

Abstract:  This is the first report of an ongoing research to establish a sarcosaprophagous arthropod database in the Coahuilan semidesert. Seven pigs (Sus scrofa L.) were used as human models to determine succession in an open urban area during the 2007 winter–spring period. Arthropods were collected manually and from pitfall traps. Carcass biomass loss, as well as arthropod colonization, was recorded during 71 days postmortem. Five decomposition stages were identified during which most abundant orders were found to be Diptera, Coleoptera, and Hymenoptera. Lucilia sericata (Meigen), Chrysomya rufifacies (Macquart), Necrobia rufipes (DeGeer), Dermestes maculatus (DeGeer), Pheidole hyatti Emery, and Pogonomyrmex rugosus Emery stood out as dominant species.
Improvement in Latent Fingerprint Detection on Thermal Paper Using a One‐Step Ninhydrin Treatment with Polyvinylpyrrolidones (PVP)
Authors: Schwarz Lothar , Klenke Inga
Published: April 2010

Abstract:  Most thermosensitive surfaces of thermal paper turn black when they come into contact with polar organic solvents such as are used in ninhydrin petroleum benzin solution. This dark staining reduces the contrast between the developed fingerprint and the background to such an extent that the identification process becomes very difficult. Integrating polyvinylpyrrolidones (PVP) into a ninhydrin solution prevents the black staining, and the developed fingerprints appear in clear contrast to the background. The new ninhydrin solution containing PVP is successful compared to the two‐step ninhydrin–acetone washing method for thermal paper which is popular in Germany.
Molecular Identification of Three Indian Snake Species Using Simple PCR–RFLP Method*
Authors: Dubey Bhawna , Meganathan P. R. , Haque Ikramul
Published: April 2010

Abstract:  Three endangered Indian snake species, Python molurus, Naja naja, and Xenochrophis piscator are known to be significantly involved in illegal trade. Effective authentication of species is required to curb this illegal trade. In the absence of morphological features, molecular identification techniques hold promise to address the issue of species identification. We present an effective PCR–restriction fragment length polymorphism method for easy identification of the three endangered snake species, Python molurus, Naja naja, and Xenochrophis piscator. A 431‐bp amplicon from cytochrome b gene was amplified using novel snake‐specific primers following restriction digestion with enzymes Mbo II and Fok I. The species‐specific reference fragment patterns were obtained for the target species, which enabled successful identification of even highly degraded shed skin sample confirming the utility of the technique in case of poor‐quality DNA. The assay could be effectively used for forensic authentication of three Indian snake species and would help strengthen conservation efforts.
Comparative Toxicology of Intentional and Accidental Heroin Overdose*
Authors: Darke Shane , Duflou Johan , Torok Michelle
Published: April 2010

Abstract:  The demographic and toxicological characteristics of deliberate (SUI, n = 50) and accidental (ACC, n = 927) fatal heroin overdose cases were examined. SUI cases were more likely to be female, had lower body mass indices, were more likely to be enrolled in treatment and less likely to have hepatic pathology. The median blood morphine concentration of SUI cases was significantly higher than that of ACC cases (0.70 vs. 0.40 mg/L, p < 0.001). Blood morphine concentrations of >1 mg/L were seen among 38.0% of SUI cases compared to 13.9% of ACC cases. Being a member of the SUI group remained a significant independent predictor of higher morphine concentrations after controlling for the effects of potential confounders (p < 0.001), other significant predictors being the absence of alcohol (p < 0.001), the presence of methadone (p < 0.05), and the presence of cocaine (p < 0.05). The current data are consistent with the view that suicide forms a small, but distinct, category of heroin overdose cases, rather than overdose being a parasuicidal phenomenon per se.
The Effects of Different Maceration Techniques on Nuclear DNA Amplification Using Human Bone
Authors: Lee Esther J. , Luedtke Jennifer G. , Allison Jamie L. , Arber Carolyn E. , Merriwether D. Andrew , Steadman Dawnie Wolfe
Published: April 2010

Abstract:  Forensic anthropologists routinely macerate human bone for the purposes of identity and trauma analysis, but the heat and chemical treatments used can destroy genetic evidence. As a follow‐up to a previous study on nuclear DNA recovery that used pig ribs, this study utilizes human skeletal remains treated with various bone maceration techniques for nuclear DNA amplification using the standard Combined DNA Index System (CODIS) markers. DNA was extracted from 18 samples of human lower leg bones subjected to nine chemical and heat maceration techniques. Genotyping was carried out using the AmpFℓSTR® COfiler® and AmpFℓSTR® Profiler Plus® ID kits. Results showed that heat treatments via microwave or Biz/Na2CO3 in sub‐boiling water efficiently macerate bone and produce amplifiable nuclear DNA for genetic analysis. Long‐term use of chemicals such as hydrogen peroxide is discouraged as it results in poor bone quality and has deleterious effects on DNA amplification.