bluuebunny/crossref_metadata_2025 huggingface dataset:
Fluorescein-Aided Confocal Laser Endomicroscopy of the Lung
Authors: Fuchs Florian S. , Zirlik Sabine , Hildner Kai , Frieser Markus , Ganslmayer Marion , Schwarz Stephan , Uder Michael , Neurath Markus F.
Published: August 2010

Background: There are only few reports about confocal laser endomicroscopy (CLE) for pulmonary imaging. In these studies, in contrast to gastrointestinal endoscopy, CLE was performed without fluorescein. Objectives: The aim of the present study was to evaluate the value of fluorescein usage for CLE of the lung. Methods: Fluorescein-aided CLE was performed in 15 consecutively recruited patients and in 4 young healthy volunteers with a miniprobe during flexible bronchoscopy. Before and after intravenous administration of fluorescein, central airways and alveolar structures were evaluated. Results: Fluorescein administration did not permit imaging of epithelial cells in the central airways. In the lung periphery, alveolar walls and partially macrophages could be seen in native imaging, as expected. After administration of fluorescein, alveoli were almost filled with foam in areas with normal lung tissue. The origin of this foam was shown to be artificial. Furthermore, in patients with pathologies of the lung parenchyma, dark neoplastic and inflammatory cells adjacent to the alveolar walls were identified. No relevant side effects of fluorescein administration could be observed. Conclusions: Fluorescein-aided CLE of the lung appeared to be safe and well tolerated. While the lack of staining of cells in the central airways was a major limitation, it permitted analysis of the lung interstitium and alveolar space and thus emerges as a new approach for the in vivo analysis of interstitial lung diseases.
Survival After Cardiac Transplantation in Patients With Hypertrophic Cardiomyopathy
Authors: Maron Martin S. , Kalsmith Benjamin M. , Udelson James E. , Li Wenjun , DeNofrio David
Published: August 2010

Background—

Heart transplant is a treatment option for selected patients with hypertrophic cardiomyopathy (HCM). However, the prevalence, clinical profile, and outcome of this subgroup of HCM patients are uncertain. Therefore, we sought to determine the occurrence, clinical characteristics, and prognosis of HCM patients who underwent cardiac transplantation in the United States during a 15-year period.

Methods and Results—

Demographic, clinical, and survival outcomes of 26 706 adult (age ≥18 years), heart-only transplant recipients between January 1990 and December 2004 were acquired from the United Network of Organ Sharing Registry. Pretransplant diagnoses were classified as follows: HCM (n=303, 1%) and non-HCM (26 403, 99%), comprising 3 patient subgroups: (1) ischemic cardiomyopathy (n=14 308, 54%), (2) dilated cardiomyopathy (n=11 760, 44%), and (3) restrictive cardiomyopathy (n=335, 1%). Study follow-up began at the time of heart transplant and was 76±44 months (mean±SD) among survivors. The 1-, 5-, and 10-year overall transplant survival for HCM patients was 85%, 75%, and 61%, respectively, with a trend toward greater survival compared with that of non-HCM transplant patients (82%, 70%, and 49%, respectively; log-rank test,
P
=0.05). However, propensity-matched, covariate-adjusted, Cox regression model analysis showed better survival over time (
P
<0.01) among the HCM patients. When HCM posttransplant survival was compared with that in each of the non-HCM patient subgroups, HCM patients had more favorable survival than did those transplanted for ischemic cardiomyopathy (
P
=0.02). In contrast, HCM posttransplant survival did not differ from that of patients transplanted for restrictive (
P
=0.08) or dilated (
P
=0.25) cardiomyopathy.

Conclusions—

HCM patients compose a small subset (1%) of the overall population of patients who undergo heart transplantation in the United States. Nonetheless, survival after transplant among HCM patients is comparable to that of patients transplanted for non-HCM cardiovascular diseases, with possible enhanced survival over time.
Polymer Injection Therapy to Reverse Remodel the Papillary Muscles
Authors: Solis Jorge , Levine Robert A. , Johnson Benjamin , Guerrero J. Luis , Handschumacher Mark D. , Sullivan Suzanne , Lam Kaitlyn , Berlin Jason , Braithwaite Gavin J.C. , Muratoglu Orhun K. , Vlahakes Gus J. , Hung Judy
Published: August 2010

Background—

Ischemic mitral regurgitation (MR) results from displacement of the papillary muscles caused by ischemic ventricular distortion. Progressive left ventricular (LV) remodeling has challenged therapy. Our hypothesis is that repositioning of the papillary muscles can be achieved by injection of polyvinyl-alcohol (PVA) hydrogel polymer into the myocardium in chronic MR despite advanced LV remodeling.

Methods and Results—

Ten sheep underwent ligation of the circumflex branches to produce chronic ischemic MR over 8 weeks. PVA was injected into the myocardium underlying the infarcted papillary muscle. Two-dimensional and 3D echocardiograms and hemodynamic data were obtained before infarct (baseline), before PVA (chronic MR), and after PVA. PVA injection significantly decreased MR from moderate to severe to trace (MR vena contracta, 5.8±1.2 to1.8±1.3 mm; chronic MR to post-PVA stage;
P
=0.0003). This was associated with a decrease in infarcted papillary muscle–to–mitral annulus tethering distance (30.3±5.7 to 25.9±4.6 mm,
P
=0.02), tenting volume (1.8±0.7 to 1.4±0.5 mL,
P
=0.01), and leaflet closure area (8.8±1.3 cm
2
to 7.6±1.3 cm
2
,
P
=0.004) from chronic MR to post-PVA stages. PVA was not associated with significant decreases in LV ejection fraction (41±3% versus 40±3%,
P
=NS), end-systolic elastance, τ (82±36 ms to 72±26,
P
=NS), or LV stiffness coefficient (0.05±0.04 to 0.03±0.01).

Conclusions—

PVA hydrogel injections improve coaptation and reduce remodeling in chronic MR without impairing LV systolic and diastolic function. This new approach offers a potential alternative for relieving tethering and ischemic MR by correcting papillary muscle position.
Relationship Between Arterial and Fibrous Cap Remodeling
Authors: Yamada Ryotaro , Okura Hiroyuki , Kume Teruyoshi , Saito Ken , Miyamoto Yoshinori , Imai Koichiro , Tsuchiya Tetsuo , Maehama Tomoko , Okahashi Noriko , Obase Kikuko , Hayashida Akihiro , Neishi Yoji , Kawamoto Takahiro , Yoshida Kiyoshi
Published: August 2010

Background—

Positive arterial remodeling and thin fibrous cap are characteristics of rupture-prone or vulnerable plaque. The natural course of the fibrous cap thickness and the relationship between serial arterial remodeling and changes in fibrous cap thickness are unknown. Therefore, the purpose of this study was to evaluate the relationship between changes in fibrous cap thickness and arterial remodeling by using optical coherence tomography (OCT) and intravascular ultrasound (IVUS) during 6-month follow-up.

Methods and Results—

Both IVUS and OCT examinations were performed on 108 vessels from 36 patients with ischemic heart disease who underwent percutaneous coronary intervention. Fifty-eight fibroatheromas were selected from 82 nonsignificant, nonculprit lesions (angiographic diameter stenosis, 25% to 75%; plaque burden, >40% by IVUS). Fibroatheroma was defined by OCT as lipid-rich plaque in >1 quadrant that has lipid. Thickness of the fibrous cap was measured by OCT. IVUS and OCT examinations were repeated at 6-month follow-up. Serial changes and relationships between IVUS indices and fibrous cap thickness were investigated. Overall, fibrous cap thickness (98.1±38.9 to 96.9±44.5 μm) as well as IVUS indices did not change significantly within 6 months. The percent changes in fibrous cap thickness correlated negatively and significantly (
r
=−0.54;
P
<0.0001; generalized estimating equation adjusted,
r
=−0.42;
P
=0.001) with the percent changes in external elastic membrane cross-sectional area.

Conclusions—

Arterial remodeling is related to changes in fibrous cap thickness. Positive arterial remodeling is not only an adaptive process, but also related to thinning of the fibrous cap.
Rosuvastatin for Primary Prevention Among Individuals With Elevated High-Sensitivity C-Reactive Protein and 5% to 10% and 10% to 20% 10-Year Risk
Authors: Ridker Paul M , MacFadyen Jean G. , Nordestgaard Børge G. , Koenig Wolfgang , Kastelein John J.P. , Genest Jacques , Glynn Robert J.
Published: August 2010

Background—

Recent primary prevention guidelines issued in Canada endorse the use of statin therapy among individuals at “intermediate risk” who have elevated levels of high-sensitivity C-reactive protein (hsCRP). However, trial data directly addressing whether this recommendation defines a patient population in which statin therapy is effective have not previously been published.

Methods and Results—

In the Justification for Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin (JUPITER) trial, which demonstrated a 44% reduction in first vascular events when rosuvastatin 20 mg was compared with placebo among 17 802 primary prevention patients with LDL cholesterol <130 mg/dL and hsCRP ≥2 mg/L, 6091 participants (2525 women, 3566 men) had baseline estimated 10-year Framingham risks of 5% to 10% and 7340 participants (1404 women, 5936 men) had baseline estimated Framingham risk of 11% to 20%. In these 2 “intermediate risk” subgroups, relative risk reductions consistent with the overall trial treatment effect were observed (hazard ratio, 0.55; 95% confidence interval, 0.36 to 0.84; 5-year number needed to treat=40,
P
=0.005 for those with 5% to 10% risk; hazard ratio, 0.51; 95% confidence interval, 0.39 to 0.68, 5-year number needed to treat=18,
P
<0.0001 for those with 11% to 20% risk). Use of the Reynolds Risk Score to stratify the study population gave similar results but reclassified large numbers of individuals into lower- or higher-risk groups. The majority of women with elevated hsCRP who benefited from rosuvastatin were at 5% to 10% 10-year risk at study entry using either global risk scoring system.

Conclusions—

Consistent with recent evidence-based Canadian Cardiovascular Society guidelines for primary prevention, the JUPITER trial demonstrates that rosuvastatin 20 mg significantly reduces major cardiovascular events among men and women with elevated hsCRP and “intermediate risk” defined either as 5% to 10% or 10% to 20% 10-year risk.

Clinical Trial Registration—

URL:
http://clinicaltrials.gov
. Unique identifier: NCT00239681.
National Patterns of Risk-Standardized Mortality and Readmission for Acute Myocardial Infarction and Heart Failure
Authors: Bernheim Susannah M. , Grady Jacqueline N. , Lin Zhenqiu , Wang Yun , Wang Yongfei , Savage Shantal V. , Bhat Kanchana R. , Ross Joseph S. , Desai Mayur M. , Merrill Angela R. , Han Lein F. , Rapp Michael T. , Drye Elizabeth E. , Normand Sharon-Lise T. , Krumholz Harlan M.
Published: August 2010

Background—

Patient outcomes provide a critical perspective on quality of care. The Centers for Medicare and Medicaid Services (CMS) is publicly reporting hospital 30-day risk-standardized mortality rates (RSMRs) and risk-standardized readmission rates (RSRRs) for patients hospitalized with acute myocardial infarction (AMI) and heart failure (HF). We provide a national perspective on hospital performance for the 2010 release of these measures.

Methods and Results—

The hospital RSMRs and RSRRs are calculated from Medicare claims data for fee-for-service Medicare beneficiaries, 65 years or older, hospitalized with AMI or HF between July 1, 2006, and June 30, 2009. The rates are calculated using hierarchical logistic modeling to account for patient clustering, and are risk-adjusted for age, sex, and patient comorbidities. The median RSMR for AMI was 16.0% and for HF was 10.8%. Both measures had a wide range of hospital performance with an absolute 5.2% difference between hospitals in the 5th versus 95th percentile for AMI and 5.0% for HF. The median RSRR for AMI was 19.9% and for HF was 24.5% (3.9% range for 5th to 95th percentile for AMI, 6.7% for HF). Distinct regional patterns were evident for both measures and both conditions.

Conclusions—

High RSRRs persist for AMI and HF and clinically meaningful variation exists for RSMRs and RSRRs for both conditions. Our results suggest continued opportunities for improvement in patient outcomes for HF and AMI.
Blind Mouth Singing
Authors: Cortiñas Jorge Ignacio , Fusco Coco
Published: August 2010

Reinaldo Arenas's novels are still unavailable in Cuba, but 20 years after the exiled writer's suicide a Cuban-American playwright, Jorge Ignacio Cortiñas, has written an homage to Arenas that will be produced in Havana, where hyphenated Cubans are rarely acknowledged. This is the full script of Blind Mouth Singing in the original English-language version.
Of Tent Shows and Liturgies: One breath left: Dies Iræ
Authors: Nascimento Cláudia Tatinge
Published: August 2010

The Workcenter of Jerzy Grotowski and Thomas Richards claims that their Project The Bridge: Developing Theatre Arts, open to the paying public, hosts the emergence of “performance/non-performance” structures. Performed solely in Istanbul in 2003, One breath left: Dies Iræ was a pivotal moment in the Project's development.
Meeting to Find a Way to Let Me Down Easy
Authors: Joice Candace M.
Published: August 2010

Let Me Down Easy is the latest installment in Anna Deavere Smith's docudrama series, On the Road: A Search for the American Character. Opening on Broadway during the height of the 2009 town hall meetings centered on health care reform, Let Me Down Easy affirms the need for cultural events that transform the average citizen's private voice into public discourse.
Transient Moisture Distribution and Hygrothermal Stress Analysis of Composite Laminates Using Equivalent Diffusion Methods
Authors: Sarae Wataru , Seong Jong Kim  , Jae Hyuk Kim  , Sung Kyu Ha
Published: August 2010

It often takes several decades to reach moisture equilibrium state in composite laminates. Therefore, hourly varying fluctuating boundary moisture and temperature conditions require several millions of time steps to reach a state of equilibrium. A new transient analysis method is proposed to efficiently solve moisture distribution of composite laminates with rapidly fluctuating moisture and temperature boundary conditions. First, effective constant diffusivity and maximum moisture content were obtained by averaging transient temperature-dependent moisture diffusivity. In this way, a simple analytic solution can be effectively used to determine the transient moisture distribution under hourly fluctuating boundary conditions. Its efficiencies are demonstrated in three different conditions by comparing this method with a conventional finite difference method. Hygrothermal stress and material degradation were consequently discussed to demonstrate that we must avoid a simple knock-down factor or 40% devastating penalty and use more rational simulation and supporting data.
Numerical simulation of quasi-stationary ring spinning process linear elastic yarn
Authors: Rong Yin  , Gu Hong-bo
Published: August 2010

This article reports a theoretical investigation on the ring spinning balloon in the textile industry. Theoretical equations incorporating yarn elasticity are obtained, which has been ignored by most previous models. This model differs from the earlier ones in that their choice of yarn was perfectly flexible and inextensible; those used here we presume to be more realistic. Discussions in this paper deal with the significance of various yarn elasticity parameters on varying yarn tension and balloon shape. Some results are given, from which the model seems to be very efficient and reliable in the simulation of the ring spinning process. Restrictions on the applicability of the theory are also pointed out.
Optimization of oligourethane methacrylate based UV paints composition for printing on cotton fabrics
Authors: Solina Elena V , Safonov Valentin V , Ivanov Victor B
Published: August 2010

The effect of structure and content of the main components of UV paints (disperse dyes and pigments, photoinitiators, oligomers, cross-linking agents) and some auxiliary substances on photosensitivity of paints and color fastness are studied. Optimization of the composition of UV paints containing disperse dyes offers smaller color variation in UV drying and provides high color fastness to wetting and rubbing. A disadvantage of UV paints based on disperse dyes, is the relatively low fastness to light, which may be overcome by substituting the latter by organic pigments. For more optimal correspondence to other modern technologies of pigment printing, the use of emulsion UV paints is suggested. Such paints provide materials with good hygroscopic properties, improved physicomechanical characteristics and high color fastness.
Evaluation of the wear label description in carpets by using local binary pattern techniques
Authors: Orjuela Sergio , Vansteenkiste Ewout , Rooms Filip , De Meulemeester Simon , Keyser Robin , Philips Wilfried
Published: August 2010

Carpet manufacturers certify their products for end-use applications by evaluating the wear behavior of their carpets in mechanical experiments. Currently, this process is performed by visual inspection, suffering from subjective gathers that limit reliability. To automate this process, we propose the use of image processing techniques, specifically of local binary pattern (LBP) statistics. Such statistics are tolerant against illumination changes, can be easily implemented, and perform well when combined with a symmetrized adaptation of the Kullback—Leibler divergence. As a main innovation, we extend the existing rotationally invariant LBPs by including ‘mirror’ and ‘complement’ invariants. We show an accurately improved and more reliable estimation of the degree of wear in worn carpets. The evaluation is performed on four digital reference scales, each containing eight pairs of images comparing transitional degrees of wear to the original appearance. Additionally, the texture changes due to distortions of the pile yarn tufts are enhanced by choosing a suitable scale factor per reference. We validate the findings using six physical reference scales, each containing four pairs of images. In both references, linear correlations of over 0.89 are demonstrated between the degrees of wear and extracted features from the images. These findings justify the use of the proposed LBP extensions in a first approach towards an automated low-cost inspection system for carpet wear at low computation cost.
Wrinkle-resistant finishing of cotton fabric with BTCA - the effect of co-catalyst
Authors: Lam YL , Kan CW , Yuen CWM
Published: August 2010

Fabrics treated with dimethyloldihydroxylethyleneurea (DMDHEU) are susceptible to formaldehyde release. High concentrations of formaldehyde have been reported to cause cancer in animal studies. Due to the toxicity of DMDHEU, the polycarboxylic acid class of non-formaldehyde crosslinking agents used for wrinkle-resistant treatment has been introduced. Among various researches, 1,2,3,4-butanetetracarboxylic acid (BTCA) is a desirable reactant when catalysed with sodium hypophosphite (SHP). The characteristics of TiO 2 or nano-TiO2, acting as a co-catalyst in a BTCA wrinkle-resistant finishing system are examined in this study. Surface morphology and molecular structure of cotton specimens together with the wrinkle-resistant, UV protection, yellowing, tensile and tearing properties of the treated specimens are also evaluated.
Should blood flow during cardiopulmonary bypass be individualized more than to body surface area?
Authors: Thomassen SA , Larsson A. , Andreasen JJ , Bundgaard W. , Boegsted M. , Rasmussen BS
Published: August 2010

Blood flow during cardiopulmonary bypass (CPB) is calculated on body surface area (BSA). Increasing comorbidity, age and weight of today’s cardiac patients question this calculation as it may not reflect individual metabolic requirement. The hypothesis was that a measured cardiac index (CI) prior to normothermic CPB is a better estimate. A cross-over study, with random allocation to CPB blood flow for 20 minutes based on either a calculation (2.4 L/min/m2) or on CI, with a switch to the opposite flow for another 20 minutes, was performed. Twenty-two elective cardiac surgery patients with normal ventricular function were included. Effect parameters were cerebral oxygenation, mixed venous saturation and arterial lactate. CI varied from 1.9 to 3.1 L/min/m2 (median 2.4 L/min/m2). No differences in effect parameters were seen. In conclusion, a CPB blood flow based on an individual estimate did not improve cerebral and systemic oxygenation compared to a blood flow based on BSA.
Health Learning and Adult Education: In Search of a Theory of Practice
Authors: Schecter Sandra R. , Lynch Jacqueline
Published: August 2010

Fifty-five percent of Canadians aged 16 to 64 years lack the skills necessary to read and appropriately interpret health information in textual format. This critical review of research explores issues related to adults’ health and health literacy learning in an effort to illuminate why this unacceptable condition persists. The authors also explore avenues that show promise in leading to more success-producing strategies for health promotion among adults. Given the cyclical relationship of health with other social conditions, the problem has proved stubbornly resistant to educational intervention. A community of practice model is proposed as a means of addressing some of the weaknesses in previous adult education programs.
Financialization, Shareholder Value, and the Transformation of Timberland Ownership in the US
Authors: Gunnoe Andrew , Gellert Paul K.
Published: August 2010

In the last two decades, significant portions of US timberlands previously held by vertically integrated corporations have been sold off to institutional investors (known as TIMOs and REITs). This article explains the causes as well as the social and ecological implications of this transformation through a multi-level analysis that combines macrostructural theories of financialization with the shareholder value conception of control in corporate governance. Bringing this integrated perspective to bear on the industrial timber sector and its landownership practices illuminates both how financialization is built through specific institutional practices and how such practices are equally shaped by the broader structural pressures of financialization. By focusing on the so-called ‘real’ effects of financialization through shareholder value in a particular natural resource sector, we begin to outline the construction of an ecological political economy of financialization. We argue that an ecological political economy would address the broader effects of financialization on socio-ecological transformations.
Centennial- to decadal-scale monsoon precipitation variability in the semi-humid region, northern China during the last 1860 years: Records from stalagmites in Huangye Cave
Authors: Liangcheng Tan  , Yanjun Cai  , Zhisheng An  , Edwards R. Lawrence , Hai Cheng  , Shen Chuan-Chou , Haiwei Zhang
Published: August 2010

We developed a composite oxygen isotopic record of cave calcite for the last 1860 years based on three stalagmites from the Huangye Cave in eastern Gansu Province, northern China. The δ18O values reflect monsoon precipitation changes, with lower δ18O values representing higher precipitation and vice versa. Three intervals of high precipitation were identified at AD 138—450, AD 730—1200, and AD 1860—1960. Two intervals of low precipitation occurred at AD 1320—1410 and AD 1530—1860. The reconstructed monsoon precipitation variations correlate well with other records further east in the eastern Yellow River Basin, suggesting synchronous precipitation changes during the late Holocene in the semi-humid region of northern China on decadal to centennial scales. Peak periods of warfare in dynastic transition times, such as at AD 391—420, AD 601—630, AD 1111—1140, AD 1351—1380, and AD 1621—1650, correspond to sharp declines in precipitation or temperature in semi-humid northern China, indicating a strong connection between climatic and societal changes. Our study suggests that climatic deterioration in semi-humid northern China has played an important role in Chinese societal evolution.
A thousand years of human impact in the northern Scandinavian mountain range: Long-lasting effects on forest lines and vegetation
Authors: Staland Hanna , Salmonsson Jonas , Hörnberg Greger
Published: August 2010

The vegetation history has been examined by pollen, microscopic and macroscopic charcoal analyses in the vicinity of two alpine Stállo settlement sites and one forested ‘Reference area’ with no settlement remains in northwestern Sweden in the northern part of the Scandinavian mountain range. The acquired data provide indications of the effects of human activities on local vegetation during the settlement phase, and on ecological processes in both long- and short-term perspectives. The results show that one settlement site, Gieddeålge, was established just above the forest line in the Betula treeline zone, and the other, Varenodjukke, in the Betula forest. At Gieddeålge an increase in herbs and graminoids appears to have occurred c. 700 cal. BP (during the thirteenth century) suggesting that the vegetation was altered by nutrient addition, most likely related to human activities associated with the settlement. At Varenodjukke, the Betula trees around the settlement were cut down and the site developed into an alpine heath dominated by Betula nana, which still characterizes the site today. In the Reference area evidence of changes to the vegetation probably caused by human impact was also found from c. 3500 to 700 cal. BP. In conclusion, the vegetation currently present at Gieddeålge and Varenodjukke has been strongly influenced by previous human activities, which have clearly had profound effects, both short and long term, on the composition of the vegetation and the properties of the ecosystems in these areas. Further, when studying processes, such as anticipated global warming that will influence future patterns of vegetation in these forest-line areas, legacies of land use must be taken into consideration.
Mobility Adaptations of Older Adults: A Secondary Analysis
Authors: Rush Kathy L. , Watts Wilda E. , Stanbury Janice
Published: August 2010

The purpose of this secondary study was to describe the mobility adaptations of community—living older adults. The primary study, designed to understand weakness and aging from the perspective of older adults, revealed that older adults viewed weakness as a progression from inability to an end point of ‘giving up,’ which prompted the use of adaptation strategies to preserve mobility and to counter a self-identity of being weak. A qualitative descriptive design guided the primary study of 15 community—living older adults, who participated in in-depth interviews. A systematic secondary analysis using Baltes and Baltes’ theory of Selective Optimization with Compensation (SOC) showed that older adults used selection, optimization, and compensation adaptations across a range of mobility behaviors. The SOC model offered a framework for profiling older adults’ agency and motivations in meeting mobility challenges as they age and provided the basis for targeted interventions to maximize mobility with aging.
Update on the diagnosis and treatment of Pneumocystis pneumonia
Authors: Carmona Eva M. , Limper Andrew H.
Published: August 2010

Pneumocystis is an opportunistic fungal pathogen that causes an often-lethal pneumonia in immunocompromised hosts. Although the organism was discovered in the early 1900s, the first cases of Pneumocystis pneumonia in humans were initially recognized in Central Europe after the Second World War in premature and malnourished infants. This unusual lung infection was known as plasma cellular interstitial pneumonitis of the newborn, and was characterized by severe respiratory distress and cyanosis with little or no fever and no pathognomic physical signs. At that time, only anecdotal cases were reported in adults and usually these patients had a baseline malignancy that led to a malnourished state. In the 1960–1970s additional cases were described in adults and children with hematological malignancies, but Pneumocystis pneumonia was still considered a rare disease. However, in the 1980s, with the onset of the HIV epidemic, Pneumocystis prevalence increased dramatically and became widely recognized as an opportunistic infection that caused potentially life-treating pneumonia in patients with impaired immunity. During this time period, prophylaxis against this organism was more generally instituted in high-risk patients. In the 1990s, with widespread use of prophylaxis and the initiation of highly active antiretroviral therapy (HAART) in the treatment of HIV-infected patients, the number of cases in this specific population decreased. However, Pneumocystis pneumonia still remains an important cause of severe pneumonia in patients with HIV infection and is still considered a principal AIDS-defining illness. Despite the decreased number of cases among HIV-infected patients over the past decade, Pneumocystis pneumonia continues to be a serious problem in immunodeficient patients with other immunosuppressive conditions. This is mostly due to increased use of immunosuppressive medications to treat patients with autoimmune diseases, following bone marrow and solid organ transplantation, and in patients with hematological and solid malignancies. Patients with hematologic disorders and solid organ and hematopoietic stem cell transplantation are currently the most vulnerable groups at risk for developing this infection. However, any patient with an impaired immunity, such as those receiving moderate doses of oral steroids for greater than 4 weeks or those receiving other immunosuppressive medications are at also at significant risk.
Biomechanical Considerations in the Competitive Swimmer’s Shoulder
Authors: Heinlein Scott A. , Cosgarea Andrew J.
Published: August 2010

Context:

Competitive swimming has become an increasingly popular sport in the United States. In 2007, more than 250 000 competitive swimmers were registered with USA Swimming, the national governing body. The average competitive swimmer swims approximately 60 000 to 80 000 m per week. With a typical count of 8 to 10 strokes per 25-m lap, each shoulder performs 30 000 rotations each week. This places tremendous stress on the shoulder girdle musculature and glenohumeral joint, and it is why shoulder pain is the most frequent musculoskeletal complaint among competitive swimmers.

Evidence Acquisition:

Articles were obtained through a variety of medical search sources, including Medline, Google Scholar, and review articles from 1980 through January 2010.

Results:

The most common cause of shoulder pain in swimmers is supraspinatus tendinopathy. Glenohumeral instability and labral tears have also been reported, but a paucity of information remains regarding prevalence and treatment in swimmers.

Conclusion:

Because of the great number of stroke repetitions and force generated through the upper extremity, the shoulder is uniquely vulnerable to injury in the competitive swimmer. Comprehensive evaluation should include the entire kinetic chain, including trunk strength and core stability.
Defect of plasmacytoid dendritic cells in warts, hypogammaglobulinemia, infections, myelokathexis (WHIM) syndrome patients
Authors: Tassone Laura , Moratto Daniele , Vermi William , De Francesco Maria , Notarangelo Lucia D. , Porta Fulvio , Lougaris Vassilios , Facchetti Fabio , Plebani Alessandro , Badolato Raffaele
Published: August 2010

Warts, hypogammaglobulinemia, infections, myelokathexis (WHIM) syndrome is a genetic disease that is caused by heterozygous mutations of the CXCR4 gene. These mutations confer an increased leukocyte response to the CXCR4-ligand CXCL12, resulting in abnormal homeostasis of many leukocyte types, including neutrophils and lymphocytes. Analysis of the myeloid and plasmacytoid dendritic cell blood counts in WHIM patients revealed a striking defect in the number of plasmacytoid dendritic cells as well as a partial reduction of the number of myeloid dendritic cells, compared with healthy subjects. Moreover, the production of interferon-α by mononuclear cells in response to herpes simplex infection, or after stimulation with the Toll-like receptor 9 ligand CpG, was undetectable in WHIM patients. Because plasmacytoid dendritic cells play a key role in the defense against viruses and their generation and motility are in part dependent on CXCR4, we hypothesized that the susceptibility of WHIM patients to warts is related to the abnormal homeostasis of plasmacytoid dendritic cells.
Prognosis of Binet stage A chronic lymphocytic leukemia patients: the strength of routine parameters
Authors: Letestu Rémi , Lévy Vincent , Eclache Virginie , Baran-Marszak Fanny , Vaur Dominique , Naguib Dina , Schischmanoff Olivier , Katsahian Sandrine , Nguyen-Khac Florence , Davi Frédéric , Merle-Béral Hélène , Troussard Xavier , Ajchenbaum-Cymbalista Florence
Published: August 2010

Recent developments in the management of chronic lymphocytic leukemia (CLL) patients have made necessary the availability of dependable prognostic factors. We have developed a prognostic index derived from the multivariate analysis of 339 stage A patients at diagnosis, exhaustively studied for classical and recent predictive markers. Only 4 biologic parameters were found to be independent predictors of progression-free survival (PFS): serum thymidine kinase (sTK), lymphocytosis, β2-microglobulin, and CD38 expression. Two groups were distinguishable: cases with no or 1 risk factor (among whom 85% did not progress after 7 years), and cases with 2 or more factors showing a median PFS of 20 months. Finally, we propose an easy, fast, cost-effective strategy for a trustworthy prognostication in stage A patients, who currently represent more than 80% of the CLL population, allowing physicians to adapt follow-up individually.
HMGA1 down-regulation is crucial for chromatin composition and a gene expression profile permitting myogenic differentiation
Authors: Brocher Jan , Vogel Benjamin , Hock Robert
Published: August 2010

Background

High mobility group A (HMGA) proteins regulate gene transcription through architectural modulation of chromatin and the formation of multi-protein complexes on promoter/enhancer regions. Differential expression of HMGA variants has been found to be important for distinct differentiation processes and deregulated expression was linked to several disorders. Here we used mouse C2C12 myoblasts and C2C12 cells stably over-expressing HMGA1a-eGFP to study the impact of deregulated HMGA1 expression levels on cellular differentiation.

Results

We found that induction of the myogenic or osteogenic program of C2C12 cells caused an immediate down-regulation of HMGA1. In contrast to wild type C2C12 cells, an engineered cell line with stable over-expression of HMGA1a-eGFP failed to differentiate into myotubes. Immunolocalization studies demonstrated that sustained HMGA1a-eGFP expression prevented myotube formation and chromatin reorganization that normally accompanies differentiation. Western Blot analyses showed that elevated HMGA1a-eGFP levels affected chromatin composition through either down-regulation of histone H1 or premature expression of MeCP2. RT-PCR analyses further revealed that sustained HMGA1a expression also affected myogenic gene expression and caused either down-regulation of genes such as MyoD, myogenin, Igf1, Igf2, Igfbp1-3 or up-regulation of the transcriptional repressor Msx1. Interestingly, siRNA experiments demonstrated that knock-down of HMGA1a was required and sufficient to reactivate the myogenic program in induced HMGA1a over-expressing cells.

Conclusions

Our data demonstrate that HMGA1 down-regulation after induction is required to initiate the myogenic program in C2C12 cells. Sustained HMGA1a expression after induction prevents expression of key myogenic factors. This may be due to specific gene regulation and/or global effects on chromatin. Our data further corroborate that altered HMGA1 levels influence the expression of other chromatin proteins. Thus, HMGA1 is able to establish a specific chromatin composition. This work contributes to the understanding of how differential HMGA1 expression is involved in chromatin organization during cellular differentiation processes and it may help to comprehend effects of HMGA1 over-expression occurring in malign or benign tumours.
Reticulate evolution in stick insects: the case of Clonopsis (Insecta Phasmida)
Authors: Milani Liliana , Ghiselli Fabrizio , Pellecchia Marco , Scali Valerio , Passamonti Marco
Published: August 2010

Background

Phasmids show noteworthy abilities to overcome species-specific reproductive isolation mechanisms, including hybridization, polyploidy, parthenogenesis, hybridogenesis and androgenesis. From an evolutionary standpoint, such tangled reproductive interactions lead to the complex phyletic relationships known as "reticulate evolution". Moroccan stick insects of the genus Clonopsis include one bisexual (C. felicitatis) and two closely related parthenogenetic forms (C. gallica, C. soumiae), which represent a polyploid series in chromosome number, but with apparent diploid karyotypes. Moreover, two Clonopsis strains of ameiotic males have been described, C. androgenes-35 and C. androgenes-53. As a consequence, Clonopsis stick insects may have experienced complex micro-evolutionary events, which we try to disentangle in this study.

Results

Mitochondrial cox2 analysis supports a recent divergence of Clonopsis, while AFLPs evidence genetic differentiation not linked to karyotypes, so that parthenogenetic C. gallica and C. soumiae appear to be a mix of strains of polyphyletic origin rather than single parthenogenetic species. Moreover, an admixed hybrid origin seems to be confirmed for C. androgenes.

Conclusion

On the whole, Clonopsis is an intriguing case of reticulate evolution. Actually, complex cladogenetic events should be taken into account to explain the observed genetic structure, including diploidization of polyploid karyotypes, possibly coupled with hybridization and androgenesis. We also proposed a "working hypothesis" to account for the observed data, which deserves further studies, but fits the observed data very well.
Immune regulation of a chronic bacteria infection and consequences for pathogen transmission
Authors: Pathak Ashutosh K , Creppage Kathleen E , Werner Jacob R , Cattadori Isabella M
Published: August 2010

Background

The role of host immunity has been recognized as not only playing a fundamental role in the interaction between the host and pathogen but also in influencing host infectiousness and the ability to shed pathogens. Despite the interest in this area of study, and the development of theoretical work on the immuno-epidemiology of infections, little is known about the immunological processes that influence pathogen shedding patterns.

Results

We used the respiratory bacterium Bordetella bronchiseptica and its common natural host, the rabbit, to examine the intensity and duration of oro-nasal bacteria shedding in relation to changes in the level of serum antibodies, blood cells, cytokine expression and number of bacteria colonies in the respiratory tract. Findings show that infected rabbits shed B. bronchiseptica by contact up to 4.5 months post infection. Shedding was positively affected by number of bacteria in the nasal cavity (CFU/g) but negatively influenced by serum IgG, which also contributed to the initial reduction of bacteria in the nasal cavity. Three main patterns of shedding were identified: i- bacteria were shed intermittently (46% of individuals), ii- bacteria shedding fell with the progression of the infection (31%) and iii- individuals never shed bacteria despite being infected (23%). Differences in the initial number of bacteria shed between the first two groups were associated with differences in the level of serum antibodies and white blood cells. These results suggest that the immunological conditions at the early stage of the infection may play a role in modulating the long term dynamics of B. bronchiseptica shedding.

Conclusions

We propose that IgG influences the threshold of bacteria in the oro-nasal cavity which then affects the intensity and duration of individual shedding. In addition, we suggest that a threshold level of infection is required for shedding, below this value individuals never shed bacteria despite being infected. The mechanisms regulating these interactions are still obscure and more studies are needed to understand the persistence of bacteria in the upper respiratory tract and the processes controlling the intensity and duration of shedding.
Upregulation of synaptotagmin IV inhibits transmitter release in PC12 cells with targeted synaptotagmin I knockdown
Authors: Moore-Dotson Johnnie M , Papke Jason B , Harkins Amy B
Published: August 2010

Background

The function of synaptotagmins (syt) in Ca2+-dependent transmitter release has been attributed primarily to Ca2+-dependent isoforms such as syt I. Recently, syt IV, an inducible Ca2+-independent isoform has been implicated in transmitter release. We postulated that the effects of syt IV on transmitter release are dependent on the expression of syt I.

Results

To test this, we increased syt IV expression in PC12 cells by either upregulation with forskolin treatment or overexpression with transfection. Two separately generated stable PC12 cell lines with syt I expression abolished by RNAi targeting were used and compared to control cells. We measured catecholamine release from single vesicles by amperometry and neuropeptide Y release from populations of cells by an immunoassay. In syt I targeted cells with forskolin-induced syt IV upregulation, amperometry measurements showed a reduction in the number of release events and the total amount of transmitter molecules released per cell. In cells with syt IV overexpressed, similar amperometry results were obtained, except that the rate of expansion for full fusion was slowed. Neuropeptide Y (NPY) release from syt I knockdown cells was decreased, and overexpression of syt IV did not rescue this effect.

Conclusions

These data support an inhibitory effect of syt IV on release of vesicles and their transmitter content. The effect became more pronounced when syt I expression was abolished.
Salvianolic acid B functioned as a competitive inhibitor of matrix metalloproteinase-9 and efficiently prevented cardiac remodeling
Authors: Jiang Baohong , Chen Jing , Xu Lingling , Gao Zhenting , Deng Yanping , Wang Yanhui , Xu Feng , Shen Xu , Guo De-an
Published: August 2010

Background

Infarct-induced left ventricular (LV) remodeling is a deleterious consequence after acute myocardial infarction (MI) which may further advance to congestive heart failure. Therefore, new therapeutic strategies to attenuate the effects of LV remodeling are urgently needed. Salvianolic acid B (SalB) from Salviae mitiorrhizae, which has been widely used in China for the treatment of cardiovascular diseases, is a potential candidate for therapeutic intervention of LV remodeling targeting matrix metalloproteinase-9 (MMP-9).

Results

Molecular modeling and LIGPLOT analysis revealed in silico docking of SalB at the catalytic site of MMP-9. Following this lead, we expressed truncated MMP-9 which contains only the catalytic domain, and used this active protein for in-gel gelatin zymography, enzymatic analysis, and SalB binding by Biacore. Data generated from these assays indicated that SalB functioned as a competitive inhibitor of MMP-9. In our rat model for cardiac remodeling, western blot, echocardiography, hemodynamic measurement and histopathological detection were used to detect the effects and mechanism of SalB on cardio-protection. Our results showed that in MI rat, SalB selectively inhibited MMP-9 activities without affecting MMP-9 expression while no effect of SalB was seen on MMP-2. Moreover, SalB treatment in MI rat could efficiently increase left ventricle wall thickness, improve heart contractility, and decrease heart fibrosis.

Conclusions

As a competitive inhibitor of MMP-9, SalB presents significant effects on preventing LV structural damage and preserving cardiac function. Further studies to develop SalB and its analogues for their potential for cardioprotection in clinic are warranted.
SLC2A10 genetic polymorphism predicts development of peripheral arterial disease in patients with type 2 diabetes. SLC2A10and PAD in type 2 diabetes
Authors: Jiang Yi-Der , Chang Yi-Cheng , Chiu Yen-Feng , Chang Tien-Jyun , Li Hung-Yuan , Lin Wen-Hsing , Yuan Hsiang-Yu , Chen Yuan-Tsong , Chuang Lee-Ming
Published: August 2010

Background

Recent data indicate that loss-of-function mutation in the gene encoding the facilitative glucose transporter GLUT10 (SLC2A10) causes arterial tortuosity syndrome via upregulation of the TGF-β pathway in the arterial wall, a mechanism possibly causing vascular changes in diabetes.

Methods

We genotyped 10 single nucleotide polymorphisms and one microsatellite spanning 34 kb across the SLC2A10 gene in a prospective cohort of 372 diabetic patients. Their association with the development of peripheral arterial disease (PAD) in type 2 diabetic patients was analyzed.

Results

At baseline, several common SNPs of SLC2A10 gene were associated with PAD in type 2 diabetic patients. A common haplotype was associated with higher risk of PAD in type 2 diabetic patients (haplotype frequency: 6.3%, P = 0.03; odds ratio [OR]: 14.5; 95% confidence interval [CI]: 1.3- 160.7) at baseline. Over an average follow-up period of 5.7 years, carriers with the risk-conferring haplotype were more likely to develop PAD (P = 0.007; hazard ratio: 6.78; 95% CI: 1.66- 27.6) than were non-carriers. These associations remained significant after adjustment for other risk factors of PAD.

Conclusion

Our data demonstrate that genetic polymorphism of the SLC2A10 gene is an independent risk factor for PAD in type 2 diabetes.
Three versions of Perceived Stress Scale: validation in a sample of Chinese cardiac patients who smoke
Authors: Leung Doris YP , Lam Tai-hing , Chan Sophia SC
Published: August 2010

Background

Smoking causes heart disease, the major cause of death in China and Hong Kong. Stress is one major trigger of smoking and relapse, and understanding stress among smoking cardiac patients can therefore help in designing effective interventions to motivate them to quit. The objective of this study was to examine the psychometric properties of the Perceived Stress Scale (PSS), and to compare the appropriateness of the three versions of the scale (PSS-14, PSS-10, and PSS-4) among Chinese cardiac patients who were also smokers.

Methods

From March 2002 to December 2004, 1860 cardiac patients who smoked were recruited at the cardiac outpatient clinics of ten acute hospitals in Hong Kong, and 1800 questionnaires were analysed. Participants completed a questionnaire including the PSS, nicotine dependence and certain demographic variables. The psychometric properties of the PSS were investigated: construct validity using confirmatory factor analysis, reliability using Cronbach's alpha and concurrent validity by examining the relationship with smoking- and health-related variables.

Results

For all the three versions of the PSS, confirmatory factor analyses corroborated the 2-factor structure of the scale, with the positive and negative factors correlating significantly and negatively to a moderate extent (r < -0.5), and high Cronbach's alpha values for the two subscales (alpha > 0.5). All the correlations of the two subscales and the smoking- and health-related variables were statistically significant and in the expected directions although of small magnitudes, except daily cigarette consumption.

Conclusions

The findings confirmed the satisfactory psychometric properties of all three Chinese versions of PSS. We recommend the use of PSS-10 for research which focuses on the two components of perceived stress, as it shows a higher reliability; and the use of PSS-4 if such partition is not essential and space for multiple measures is limited.