bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimizing treatment outcomes with phosphodiesterase type 5 inhibitors for erectile dysfunction: Opening windows to enhanced sexual function and overall health
Authors: Sadovsky Richard , Brock Gerald B. , Gray Mikel , Jensen Penny Kaye , Gutkin Stephen W. , Sorsaburu Sebastian
Published: January 2011

Purpose: Phosphodiesterase type 5 (PDE5) inhibitors have proved to be efficacious, safe, and well tolerated, in clinical trials and practice, for men with erectile dysfunction (ED). However, many patients are not satisfied with treatment and discontinue it prematurely. This review discusses evidence‐based strategies that nurse practitioners (NPs) can use to improve diagnosis of ED, optimize patient outcomes, and identify opportunities to detect other potentially serious comorbid conditions.

Data sources: This article was based on a previously published review, which involved a PubMed–MEDLINE search of the clinical literature from January 1, 1998 (year of sildenafil's approval in many markets), through August 30, 2008 (date of search).

Conclusions: Strategies to optimize responses to PDE5 therapy are summarized by the mnemonic “EPOCH”: Evaluating and educating to ensure realistic expectations of therapy; Prescribing a treatment individualized to the couple's needs and preferences; Optimizing drug dose/regimen and revisiting key educational messages at follow‐up visits; Controlling comorbidities via lifestyle counseling, medications, and/or referrals; and Helping patients and their partners to seek other forms of therapy if they have decided not to use a PDE5 inhibitor.

Implications for practice: The “EPOCH” mnemonic may remind NPs of steps to optimize treatment outcomes with PDE5 inhibitors.
In search of legitimacy: restorative youth conferencing in Northern Ireland
Authors: Doak Jonathan , O'Mahony David
Published: January 2011

Restorative justice principles often feature prominently in peace agreements and initiatives to foster reconciliation and peace-building. As part of its own transitional process, Northern Ireland has undertaken a wide-ranging programme of criminal justice reform, whereby restorative practices have become a central response to juvenile offending. Drawing on a major evaluation of the Northern Ireland Youth Conferencing Scheme, this paper suggests that restorative conferencing holds the potential not only to promote reconciliation between victims and offenders, but it may even bolster the legitimacy deficit suffered by criminal justice institutions. Whilst is vital that such schemes continue to foster their engagement with civil society and the wider community, the broader potential of restorative processes to contribute to post-conflict peace-building is considerable, especially in relation to fostering a sense of legitimacy necessary for the operation of society and the institutions of the state.
New insights into basophil biology: initiators, regulators, and effectors of type 2 inflammation
Authors: Siracusa Mark C. , Comeau Michael R. , Artis David
Published: January 2011

Recent studies indicate that basophils perform essential functions in multiple models of Th2 cytokine‐dependent immunity and inflammation. In addition to their role as late phase effector cells, basophil populations can express MHC class II and costimulatory molecules, migrate into draining lymph nodes, present antigen to naive CD4+ T cells, and promote Th2 cell differentiation. In this context, basophils have been shown to contribute to the induction and propagation of Th2 cytokine responses following exposure to some helminth parasites or allergens. In this review, we discuss recent studies that provide new insights into basophil development, regulation, and effector function. In addition, we discuss the ability of basophils to act both independently and cooperatively with dendritic cells to support Th2 cytokine‐mediated inflammation.
The role of the PD‐1 pathway in autoimmunity and peripheral tolerance
Authors: Fife Brian T. , Pauken Kristen E.
Published: January 2011

Programmed death‐1 (PD‐1) is a surface receptor critical for the regulation of T cell function during immunity and tolerance. PD‐1 interactions with its ligands PD‐L1 and PD‐L2 inhibit T cell effector functions in an antigen‐specific manner. This paper examines the role of PD‐1 in limiting autoreactivity and establishing self‐tolerance and discusses the hypothesis that PD‐1 ligand (PD‐L) expression both spatially and temporally dictates the fate of self‐reactive T cells during the breakdown of peripheral tolerance and development of autoimmunity. We focus our discussion on the role of PD‐1/PD‐L interactions during peripheral tolerance, the differential role for PD‐L1 and PD‐L2 in response to environmental or self‐antigens, and the impact of PD‐1 signaling on dynamic T cell motility and the T cell receptor (TCR) stop signal. Finally, we discuss the potential to selectively target the PD‐1 pathway therapeutically to alter T cell function during autoimmunity.
Effects of UV‐B on Secondary Metabolites of St. John’s Wort (Hypericum perforatum L.) Grown in Controlled Environments
Authors: Brechner Melissa L. , Albright Louis D. , Weston Leslie A.
Published: January 2011

The medicinal plant industry is under increasing scrutiny due to wide variance in active ingredient (AI) concentration from values claimed on labels. Reasons for this disparity include environmental and genotypic variation which influence AI concentration. St. John’s wort (Hypericum perforatum) is a popular herbal remedy which also exhibits marked variance in AI concentration among products. This study evaluated concentration changes of three biologically active metabolites of H. perforatum after exposure to UV light while plants were still vegetative. Treatments were performed with 55‐day‐old plants grown under 400 μmol m−2 s−1 PAR for 16 h a day. Three UV light treatments were evaluated: a single dose, a daily dose and an increasing daily dose. Concentrations of hyperforin, pseudohypericin and hypericin were monitored for 7 days after each treatment. A daily dose and an increasing daily dose did not produce significantly greater increases in secondary metabolites compared to single dose treatments. These results suggest the small but significant transient metabolite concentration increases in H. perforatum can be induced by UV light exposure. Information from this study can be useful in optimizing total biomass and metabolite production in controlled environments.
RNA‐oligonucleotide quantification technique (ROQT) for the enumeration of uncultivated bacterial species in subgingival biofilms
Authors: Teles F.R.F. , Teles R.P. , Siegelin Y. , Paster B. , Haffajee A.D. , Socransky S.S.
Published: January 2011

Approximately 35% of the species present in subgingival biofilms are as yet uncultivated, so their role in periodontal pathogenesis is unknown. The aim of the present study was to develop a high throughput method to quantify a wide range of cultivated and uncultivated taxa in subgingival biofilm samples associated with periodontal disease or health. Oligonucleotides targeting the 16S ribosomal DNA gene were designed, synthesized and labeled with digoxigenin. These probes were hybridized with the total nucleic acids of pure cultures or subgingival biofilm samples. Target species included cultivated taxa associated with periodontal health and disease, as well as uncultivated species, such as TM7 sp. OT 346, Mitsuokella sp. OT 131 and Desulfobulbus sp. OT 041. Sensitivity and specificity of the probes were determined. A Universal probe was used to assess total bacterial load. Sequences complementary to the probes were used as standards for quantification. Chemiluminescent signals were visualized after film exposure or using a CCD camera. In a pilot clinical study, 266 subgingival plaque samples from eight periodontally healthy people and 11 patients with periodontitis were examined. Probes were specific and sensitivity reached 104 cells. Fusobacterium nucleatum ss. polymorphum and Actinomyces gerencseriae were the most abundant cultivated taxa in clinical samples. Among uncultivated/unrecognized species, Mitsuokella sp. OT 131 and Prevotella sp. OT 306 were the most numerous. Porphyromonas gingivalis and Desulfobulbus sp. OT 041 were only detected in patients with periodontitis. Direct hybridization of total nucleic acids using oligonucleotide probes permitted the quantification of multiple cultivated and uncultivated taxa in mixed species biofilm samples.
An interview study investigating experiences of psychological change without psychotherapy
Authors: Gianakis Mary , Carey Timothy A.
Published: January 2011

Objectives. Given that most people who experience psychological distress resolve this distress without the assistance of psychotherapy, the study sought to increase our understanding of naturally occurring change including the facilitators of this change.

Design. The study sought to replicate and extend earlier work in this area. The design involved recruiting participants who had experienced some form of psychological distress and had resolved this distress without accessing psychotherapy services.

Methods. Qualitative methods were used for this study because the lived experience of the participants was of interest. Semi‐structured interviews were used following a pro forma developed in earlier work. Interpretive Phenomenological Analysis was the analytical method adopted for this study to identify themes and patterns in the transcripts of the interviews of the participants.

Results. Data analysis identified the themes of identity, connection, threshold, desire to change, change as a sudden and gradual process, and thinking process. An unexpected finding was the subjectivity associated with deciding whether or not a problem had actually resolved.

Conclusions. The results are discussed in terms of their implications for clinical practice including the apparent importance of people reaching an emotional threshold prior to change. A sense of identity also appears to be important in change experiences.
Exergy Analysis and Sustainability Assessment of a Solar-Ground Based Heat Pump With Thermal Energy Storage
Authors: Caliskan Hakan , Hepbasli Arif , Dincer Ibrahim
Published: January 2011

In this study, both energy and exergy analyses and sustainability assessment of a thermal energy storage system with a solar-ground coupled heat pump installed in a 120 m2 house are performed. The actual operating data taken from the literature are utilized for model validation. The system considered here mainly consists of a solar collection system, an underground thermal storage system, an indoor air conditioning system, and a data collection system. First, energy analysis is employed to the system and its components, and the rates of energy input (solar radiation), energy storage, collector heat loss, and other heat loss are found to be 4.083 kW, 1.753 kW, 1.29 kW, and 1.04 kW for a 5 h working time, respectively, while the energy efficiency of the system is calculated to be 42.94%. Exergy analysis of the entire system is then conducted for various reference temperatures varying from 0°C to 25°C with a temperature interval of 5°C. As a result of this analysis, the rates of the maximum exergy input, exergy storage, and exergy losses are determined for a reference temperature of 0°C to be 0.585 kW, 0.24 kW, and 0.345 kW, respectively. Finally, the maximum exergy efficiency of the system is obtained to be 40.99% and the maximum sustainable development using sustainability index, which is a function of exergy efficiency, is calculated to be 1.6946 for a reference temperature of 0°C. Furthermore, the energy and exergy results are illustrated through Sankey (energy flow) and Grassmann (exergy loss and flow) diagrams.
Prediction of Status Patterns of Wind Turbines: A Data-Mining Approach
Authors: Kusiak Andrew , Verma Anoop
Published: January 2011

This paper presents the application of data-mining techniques for identification and prediction of status patterns in wind turbines. Early prediction of status patterns benefits turbine maintenance by indicating the deterioration of components. An association rule mining algorithm is used to identify frequent status patterns of turbine components and systems that are in turn predicted using historical wind turbine data. The status patterns are predicted at six time periods spaced at 10 min intervals. The prediction models are generated by five data-mining algorithms. The random forest algorithm has produced the best prediction results. The prediction results are used to develop a component performance monitoring scheme.
Status of Enhanced Heat Transfer in Systems With Natural Refrigerants
Authors: Ayub Zahid
Published: January 2011

Global environmental and energy concerns have prompted the heating, ventilating, air-conditioning, and refrigeration industry to revisit the use of natural refrigerants. Nearly all natural refrigerants have superior transport properties as compared with synthetic refrigerants; however, the drawback with natural refrigerants has been their toxicity and flammability with an exception of carbon dioxide. In order to overcome this hurdle, it is essential that enhanced surface methods be developed and introduced to reduce the refrigerant charge in a system. Halocarbon industry has expended enormous amount of time and money in developing the ultrahigh efficiency heat exchangers. This experience and knowledge is available and could be applied in developing the efficient exchangers for natural refrigerant applications. This paper presents an overview of the status of natural refrigerants and the trends in the development of compact and low-charge systems.
Pressure Drop Analysis for Liquid-Liquid Downflow Through Vertical Pipe
Authors: Ghosh S. , Das G. , Das P. K.
Published: January 2011

In the present paper, the pressure drop characteristics and flow patterns during downward vertical flow of lube oil-water as well as kerosene-water through a circular glass conduit have been studied. Core-annular flow has been observed to be the dominant flow pattern and it gives rise to slug flow with increase of water and/or decrease of oil velocity. However, there are subtle differences in the flow distribution observed for high viscosity and low viscosity oils. The two-phase frictional pressure drop for separated flow patterns of both the liquid pairs is predicted using two-fluid model. Since the model predictions have a large mismatch with experimental data, an empirical correlation is also proposed for improved predictions. The homogeneous and drift flux models are used for slug and dispersed flow patterns.
Unsteady Numerical Simulation of Cavitating Turbulent Flow Around a Highly Skewed Model Marine Propeller
Authors: Ji Bin , Luo Xianwu , Wang Xin , Peng Xiaoxing , Wu Yulin , Xu Hongyuan
Published: January 2011

The cavitating flows around a highly skewed model marine propeller in both uniform flow and wake flow have been simulated by applying a mass transfer cavitation model based on Rayleigh–Plesset equation and k-ω shear stress transport (SST) turbulence model. From comparison of numerical results with the experiment, it is seen that the thrust and torque coefficients of the propeller are predicted satisfactory. It is also clarified from unsteady simulation of cavitating flow around the propeller in wake flow that the whole process of cavitating-flow evolution can be reasonably reproduced including sheet cavitation and tip vortex cavitation observed in the experiments. Furthermore, to study the effect of pressure fluctuation on the surrounding, pressure fluctuations induced by the cavitation as well as the propeller rotation are predicted at three reference positions above the propeller for comparison with the experimental data: The amplitudes of the dominant components corresponding to the first, second, and third blade passing frequencies were satisfactorily predicted. It is noted that the maximum difference of pressure fluctuation between the calculation and experiment reached 20%, which might be acceptable by usual engineering applications.
Localized dry-etch substrate thinning for dislocation reduction in heteroepitaxial CdTe/Si(211)
Authors: Jacobs R. N. , Markunas J. K. , Nozaki C. , Jaime-Vasquez M. , Smith P. J. , Benson J. D. , Pellegrino J.
Published: January 2011

Threading dislocations are a significant problem for heteroepitaxial growth of thin films on large lattice-mismatched substrates. In the case of HgCdTe thin films on Si, Ge, or GaAs, the molecular beam epitaxy (MBE) of 10–15-μm-thick CdTe buffer layers has historically played a crucial role in reducing threading dislocation densities to current state-of-the-art levels. In this work, the authors investigate a localized substrate thinning approach and its overall effect on further reducing dislocation densities in the CdTe/Si heteroepitaxial system. In using substrates with regions thinned to thicknesses on the order of the CdTe buffer, the attempt is to reduce the dislocation image force acting from the interface toward the epilayer surface. The authors employ both wet- and dry-etching techniques to create locally back-thinned regions of Si(211) wafers. Localized rather than whole wafer thinning was necessary to maintain sufficient substrate thickness for handling. The opposite sides of the wafers were cleaned using standard techniques prior to CdTe MBE. Scanning electron microscopy and Fourier transform infrared spectroscopy were used to measure epilayer and substrate thicknesses. Using CdTe defect-decoration techniques, a decrease in threading dislocation density by up to 60% has been observed in regions for which the underlying Si substrate was thinned to 2 μm. Results obtained for wet-etch and dry-etch back-thinning approaches suggest that the dislocation-reduction mechanism is not solely based on substrate-thickness induced image forces.
The burden of childhood injuries and evidence based strategies developed using the injury surveillance system in Pasto, Colombia
Authors: Espitia-Hardeman Victoria , Borse Nagesh N , Dellinger Ann M , Betancourt Carmen Elena , Villareal Alba Nelly , Caicedo Luz Diana , Portillo Carlos
Published: January 2011

Objective

This article characterises the burden of childhood injuries and provides examples of evidence–based injury prevention strategies developed using a citywide injury surveillance system in Pasto, Colombia.

Methods

Fatal (2003-2007) and non-fatal (2006-2007) childhood injury data were analysed by age, sex, cause, intent, place of occurrence, and disposition.

Results

Boys accounted for 71.5% of fatal and 64.9% of non-fatal injuries. The overall fatality rate for all injuries was 170.8 per 100,000 and the non-fatal injury rate was 4,053 per 100,000. Unintentional injuries were the leading causes of fatal injuries for all age groups, except for those 15-19 years whose top four leading causes were violence-related. Among non-fatal injuries, falls was the leading mechanism in the group 0-14 years. Interpersonal violence with a sharp object was the most important cause for boys aged 15-19 years. Home was the most frequent place of occurrence for both fatal and non-fatal injuries for young children 0-4 years old. Home, school and public places became an important place for injuries for boys in the age group 5-15 years. The highest case-fatality rate was for self-inflicted injuries (8.9%).

Conclusions

Although some interventions have been implemented in Pasto to reduce injuries, it is necessary to further explore risk factors to better focus prevention strategies and their evaluation. We discuss three evidence-based strategies developed to prevent firework-related injuries during festival, self-inflicted injuries, and road traffic-related injuries, designed and implemented based on the injury surveillance data.
Injury prevention in child death review: child pedestrian fatalities
Authors: Desapriya Ediriweera , Sones Meridith , Ramanzin Tansey , Weinstein Sara , Scime Giulia , Pike Ian
Published: January 2011

Objective

This article describes the epidemiology of child pedestrian fatalities in British Columbia using data generated by the province's Child Death Review Unit, to demonstrate the unique capacity of child death review to provide an ecological understanding of child mortality and catalyse evidence based, multi-level prevention strategies.

Methods

All child pedestrian fatalities in British Columbia from 1 January 1 2003 to 31 December 2008 were reviewed. Data on demographics, circumstance of injury, and risk factors related to the child, driver, vehicle, and physical environment were extracted. Frequency of sociodemographic variables and modifiable risk factors were calculated, followed by statistical comparisons against the general population for Aboriginal ancestry, gender, ethnicity, income assistance and driver violations using z and t tests.

Results

Analysis of child pedestrian fatalities (n=33) found a significant overrepresentation of Aboriginal children (p=0.06), males (p<0.01), and children within low income families (p<0.01). The majority of incidents occurred in residential areas (51.5%), with a speed limit of 50 kph or higher (85.7%). Risky pedestrian behaviour was a factor in 56.7% of cases, and 33% of children under 10 years of age were not under active supervision. Drivers had significantly more driving violations than the comparison population (p<0.01).

Conclusion

Child pedestrian fatalities are highly preventable through the modification of behavioural, social, and environmental risk factors. This paper illustrates the ability of child death review to generate an ecological understanding of injury epidemiology not otherwise available and advance policy and programme interventions designed to reduce preventable child mortality.
Use of child death review to inform sudden unexplained infant deaths occurring in a large urban setting
Authors: Brixey Suzanne N , Kopp Brianna C , Schlotthauer Amy E , Collier Abigael , Corden Timothy E
Published: January 2011

Objective

To illustrate the benefits and utility of the child death review (CDR) reporting system when examining risk factors associated with infant death occurring within two subgroups of sudden unexpected infant deaths (SUID)—unintentional suffocation and sudden infant death syndrome (SIDS)—in a large urban county in Wisconsin.

Design

Retrospective CDR data were analysed, 2007–2008, for Milwaukee County, Wisconsin.

Patients or subjects

Unintentional suffocation and SIDS infant deaths under 1 year of age in Milwaukee County, Wisconsin, 2007–2008, with a CDR record indicating a death in a sleep environment.

Main outcome measure

Study examined demographic characteristics, bed-sharing, incident sleep location, position of child when put to sleep, position of child when found, child's usual sleep place, crib in home, and other objects found in sleep environment.

Results

Unintentional suffocation (n=11) and SIDS (n=40) classified deaths with CDR data made up 18% (51/283) of all infant deaths in Milwaukee County from 2007 to 2008. The majority of infants who died of unintentional suffocation (n=9, 81.8%) or SIDS (n=26, 65.0%) were black and under the age of 3 months. Bed-sharing was involved in most of the unintentional suffocation deaths (n=10, 90.9%) and the SIDS deaths (n=28, 70.0%). All unintentional suffocation deaths (n=11, 100%) and the majority of SIDS deaths (n=31, 77.5%) took place in a non-crib sleeping environment.

Conclusions

The study demonstrates how CDR provides enhanced documentation of risk factors to help steer prevention efforts regarding SUID deaths in a community and reaffirms infants in an unsafe sleep environment have an increased risk of death.
Social inequalities in residential exposure to road traffic noise: An environmental justice analysis based on the RECORD Cohort Study
Authors: Havard Sabrina , Reich Brian J , Bean Kathy , Chaix Basile
Published: January 2011

Objectives

To explore social inequalities in residential exposure to road traffic noise in an urban area.

Methods

Environmental injustice in road traffic noise exposure was investigated in Paris, France, using the RECORD Cohort Study (n=2130) and modelled noise data. Associations were assessed by estimating noise exposure within the local area around participants' residence, considering various socioeconomic variables defined at both individual and neighbourhood level, and comparing different regression models attempting or not to control for spatial autocorrelation in noise levels.

Results

After individual-level adjustment, participants' noise exposure increased with neighbourhood educational level and dwelling value but also with proportion of non-French citizens, suggesting seemingly contradictory findings. However, when country of citizenship was defined according to its human development level, noise exposure in fact increased and decreased with the proportions of citizens from advantaged and disadvantaged countries, respectively. These findings were consistent with those reported for the other socioeconomic characteristics, suggesting higher road traffic noise exposure in advantaged neighbourhoods. Substantial collinearity between neighbourhood explanatory variables and spatial random effects caused identifiability problems that prevented successful control for spatial autocorrelation.

Conclusions

Contrary to previous literature, this study shows that people living in advantaged neighbourhoods were more exposed to road traffic noise in their residential environment than their deprived counterparts. This case study demonstrates the need to systematically perform sensitivity analyses with multiple socioeconomic characteristics to avoid incorrect inferences about an environmental injustice situation and the complexity of effectively controlling for spatial autocorrelation when fixed and random components of the model are correlated.
Use of briefings and debriefings as a tool in improving team work, efficiency, and communication in the operating theatre
Authors: Bethune Robert , Sasirekha Govindarajulu , Sahu Ajay , Cawthorn Simon , Pullyblank Anne
Published: January 2011

Introduction

Team work, communication, and efficiency in the operating theatre are widely recognised to be suboptimal. Poor communication is the single biggest cause of medical error. The surgical operating theatre is a potentially highly stressed environment where poor communication can lead to fatal errors. The objectives of this study were to assess the effects briefings and debriefings had on theatre start time, list lengths, and the staff's impression of these meetings.

Materials and methods

Briefings and debriefings were conducted before the start of theatre lists over a 6 month period in 2007 in a district general hospital in north Bristol, UK. Both quantitative and qualitative data were collected. Using the hospital theatre database, theatre start and finish time was found and list length calculated. A questionnaire was devised and used to assess staff attitude to the briefings and debriefings.

Results

Staff felt that the briefings highlighted potential problems, improved the team culture, and led to organisational change. Theatre start times tended to be earlier and lists lengths were shorter when briefings were conducted, although this only reached statistical significance on one type of list.

Discussion

Briefings and debriefings had a positive impact on teamwork and communication. The lists ran more efficiently and briefings did not delay the theatre start times—in fact, the lists tended to start earlier.
Prescribing in pregnancy and during breast feeding: using principles in clinical practice
Authors: Henderson Emma , Mackillop Lucy
Published: January 2011

Prescribing in pregnancy often causes uncertainty and anxiety for the clinician and may lead to the omission of necessary treatment. Many drugs have inadequate data to assure safety, and therefore the clinician is left with a dilemma as to where the balance of risks and benefits lie with respect to the mother and her fetus. Understanding under what circumstances women can be prescribed medication and using principles of prescribing in pregnancy to further clarify the potential risks will aid good clinical decision-making. An appreciation of the available resources and the conviction to find the best available evidence will best serve the patient and her fetus. Teratogenicity refers to the potential for a drug to cause fetal malformations and affects the embryo 3–8 weeks after conception. Teratogenic drugs are associated with an increased risk of malformations, but the majority of babies are born with no abnormalities. In addition, approximately 2–3% of infants are born with major malformations with no association with maternal medication, and this and other confounding factors need to be addressed during counselling of a woman. Fetotoxicity refers to the functional changes that can occur to the fetus as a result of medication in the second and third trimesters. These effects are more subtle and more difficult to assess and therefore there are fewer data to support or refute these types of associations. For the majority of drugs, the neonatal dose from breast feeding is a fraction of the dose exposure in utero.
Comparison of aortic dissection in Chinese patients with and without Marfan syndrome
Authors: Linggen Gao , Lin Zhang , Xiaohan Fan , Haiying Wu , Xianliang Zhou , Rutai Hui
Published: January 2011

Background

Aortic dissection is a life-threatening cardiovascular disease with high mortality. Little is known about comparisons of the clinical characteristics or the factors that influence the long-term prognosis of Chinese patients with aortic dissection with and without Marfan syndrome (MFS).

Methods

The authors studied the data of 246 patients with aortic dissection. The patients were hospitalised for aortic abnormalities from 2004 to 2008 in Fuwai Hospital. Medical charts were reviewed to obtain clinical data using a standardised data collection sheet.

Results

Of the 246 patients with acute aortic dissection, 56 had MFS. Compared with the non-MFS patients, those with MFS were considerably younger (mean±SD age 35.27±11.11 vs 54.11±11.96 years, p<0.001) and had pre-existing hypertension much less commonly (5.4% vs 80.0%, p<0.001). The patients with MFS presented with a wider ascending aorta diameter (63.60±9.00 vs 38.55±9.44 mm, p<0.001) and a lower body mass index (20.14±2.00 vs 25.62±3.41, p<0.001) than the non-MFS patients. Overall, 91.1% of the MFS patients underwent surgical treatment, whereas 55.78% of the non-MFS patients accepted medical treatment. However, mortality in the two groups did not differ significantly (6 vs 17, p=0.527). Multivariate analysis showed that the aortic diameter (OR=1.072) was a risk factor and surgical treatment (OR=0.006) was a protective factor for the survival of MFS patients with aortic dissection. With increased diastolic blood pressure, mortality decreased in non-MFS patients with aortic dissection (OR=0.905).

Conclusions

These clinical results could be useful for rapid assessment of the treatment and prognosis of patients with aortic dissection.
The efficacy of strabismus surgery in adults: a review for primary care physicians
Authors: Kushner Burton J
Published: January 2011

Many adult patients with strabismus are under the misconception that nothing can be done to correct the problem or that treatment is associated with a high degree of risk. Moreover, many optometrists, comprehensive ophthalmologists and primary care physicians are similarly misinformed. In fact, most adult patients with strabismus can be successfully treated, with ∼80% of patients achieving satisfactory alignment with one surgical procedure. In addition, adult strabismus surgery carries a relatively low risk, with serious complications being anecdotal and rare. The majority of adults will experience some improvement in binocular function after strabismus surgery even if the strabismus has been longstanding. Most commonly this takes the form of an expansion of binocular visual fields; however, some patients may also regain stereopsis. Consequently, strabismus surgery in adults is not merely cosmetic in most cases. There are many psychological and interpersonal benefits to adult strabismus surgery. These benefits are highlighted by the finding that the majority of adults with strabismus would trade a portion of their life expectancy to be rid of their ocular misalignment. Although adult strabismus surgery has been shown to be highly cost-effective, many adults with strabismus can be successfully managed by non-surgical means. If an adult with strabismus is under the impression, or was told, they cannot be treated, or that treatment is risky, they should consider a referral to an ophthalmologist specifically specialising in strabismus.
Some factors affecting pregnancy rate in ewes following laparoscopic artificial insemination
Authors: McCappin N. , Murray R. D.
Published: January 2011

The fertility of 646 ewes and gimmers bred by laparoscopic artificial insemination (LAI) in the autumn of 2006 was investigated using a questionnaire and individual ewe breeding records kept for 13 commercial sheep flocks that used LAI routinely. Overall, the pregnancy rate was 66 per cent, but it was highest in ewes bred for the fourth time. Technical aspects of LAI influenced fertility: pregnancy rates were 70 per cent for ewes bred using frozen semen compared with 58 per cent when fresh semen was used (P≤0.01), and 74 per cent of ewes that travelled to an artificial insemination centre for mating conceived, compared with 62 per cent that remained on their own farm (P<0.01). Higher doses of equine chorionic gonadotrophin (>400 iu) used for oestrus synchronisation reduced pregnancy rates to only 49 per cent (P<0.001). However, the largest effect was associated with shepherds gathering, handling and treating breeding ewes four to six weeks before mating; pregnancy rates were 54 per cent among ewes where this was carried out, compared with 74 per cent for ewes not treated in this way (P<0.01).
Muscarinic receptor agonists stimulate human colon cancer cell migration and invasion
Authors: Belo Angelica , Cheng Kunrong , Chahdi Ahmed , Shant Jasleen , Xie Guofeng , Khurana Sandeep , Raufman Jean-Pierre
Published: January 2011

Muscarinic receptors (CHRM) are overexpressed in colon cancer. To explore a role for muscarinic receptor signaling in colon cancer metastasis, we used human H508 and HT29 colon cancer cells that coexpress epidermal growth factor (ERBB) and CHRM3 receptors. In a wound closure model, following 8-h incubation of H508 cells with 100 μM ACh we observed a threefold increase in cell migration indistinguishable from the actions of epidermal growth factor (EGF). Atropine blocked the actions of ACh but not of EGF. In SNU-C4 colon cancer cells that express ERBB but not CHRM, EGF caused a threefold increase in migration; ACh had no effect. ACh-induced cell migration was attenuated by chemical inhibitors of ERBB1 activation, by anti-ERBB1 antibody, and by inhibitors of ERK and phosphatidylinositol 3-kinase (PI3K) signaling. Consistent with matrix metalloproteinase-7 (MMP7)-mediated release of an ERBB1 ligand, heparin binding epidermal growth factor-like growth factor (HBEGF), ACh-induced migration was inhibited by an MMP inhibitor and by anti-MMP7 and -HBEGF antibodies. ACh-induced cell migration was blocked by inhibiting RhoA and ROCK, key proteins that interact with the actin cytoskeleton. ACh-induced RhoA activation was attenuated by agents that inhibit ERBB1, ERK, and PI3K activation. Collectively, these findings indicate that ACh-induced cell migration is mediated by MMP7-mediated release of HBEGF, an ERBB ligand that activates ERBB1 and downstream ERK and PI3K signaling. In a cell invasion model, ACh-induced HT29 cell invasion was blocked by atropine. In concert with previous observations, these findings indicate that muscarinic receptor signaling plays a key role in colon cancer cell proliferation, survival, migration, and invasion.
Competition and convergence between auditory and cross-modal visual inputs to primary auditory cortical areas
Authors: Mao Yu-Ting , Hua Tian-Miao , Pallas Sarah L.
Published: January 2011

Sensory neocortex is capable of considerable plasticity after sensory deprivation or damage to input pathways, especially early in development. Although plasticity can often be restorative, sometimes novel, ectopic inputs invade the affected cortical area. Invading inputs from other sensory modalities may compromise the original function or even take over, imposing a new function and preventing recovery. Using ferrets whose retinal axons were rerouted into auditory thalamus at birth, we were able to examine the effect of varying the degree of ectopic, cross-modal input on reorganization of developing auditory cortex. In particular, we assayed whether the invading visual inputs and the existing auditory inputs competed for or shared postsynaptic targets and whether the convergence of input modalities would induce multisensory processing. We demonstrate that although the cross-modal inputs create new visual neurons in auditory cortex, some auditory processing remains. The degree of damage to auditory input to the medial geniculate nucleus was directly related to the proportion of visual neurons in auditory cortex, suggesting that the visual and residual auditory inputs compete for cortical territory. Visual neurons were not segregated from auditory neurons but shared target space even on individual target cells, substantially increasing the proportion of multisensory neurons. Thus spatial convergence of visual and auditory input modalities may be sufficient to expand multisensory representations. Together these findings argue that early, patterned visual activity does not drive segregation of visual and auditory afferents and suggest that auditory function might be compromised by converging visual inputs. These results indicate possible ways in which multisensory cortical areas may form during development and evolution. They also suggest that rehabilitative strategies designed to promote recovery of function after sensory deprivation or damage need to take into account that sensory cortex may become substantially more multisensory after alteration of its input during development.
Do premotor interneurons act in parallel on spinal motoneurons and on dorsal horn spinocerebellar and spinocervical tract neurons in the cat?
Authors: Krutki Piotr , Jelen Sabina , Jankowska Elzbieta
Published: January 2011

It has previously been established that ventral spinocerebellar tract (VSCT) neurons and dorsal spinocerebellar tract neurons located in Clarke's column (CC DSCT neurons) forward information on actions of premotor interneurons in reflex pathways from muscle afferents on α-motoneurons. Whether DSCT neurons located in the dorsal horn (dh DSCT neurons) and spinocervical tract (SCT) neurons are involved in forwarding similar feedback information has not yet been investigated. The aim of the present study was therefore to examine the input from premotor interneurons to these neurons. Electrical stimuli were applied within major hindlimb motor nuclei to activate axon-collaterals of interneurons projecting to these nuclei, and intracellular records were obtained from dh DSCT and SCT neurons. Direct actions of the stimulated interneurons were differentiated from indirect actions by latencies of postsynaptic potentials evoked by intraspinal stimuli and by the absence or presence of temporal facilitation. Direct actions of premotor interneurons were found in a smaller proportion of dh DSCT than of CC DSCT neurons. However, they were evoked by both excitatory and inhibitory interneurons, whereas only inhibitory premotor interneurons were previously found to affect CC DSCT neurons [as indicated by monosynaptic excitatory postsynaptic potentials (EPSPs) and inhibitory postsynaptic potentials (IPSPs) in dh DSCT and only IPSPs in CC DSCT neurons]. No effects of premotor interneurons were found in SCT neurons, since monosynaptic EPSPs or IPSPs were only evoked in them by stimuli applied outside motor nuclei. The study thus reveals a considerable differentiation of feedback information provided by different populations of ascending tract neurons.
Potent inhibition of anoxic depolarization by the sodium channel blocker dibucaine
Authors: Douglas Heather A. , Callaway Jennifer K. , Sword Jeremy , Kirov Sergei A. , Andrew R. David
Published: January 2011

Recurring waves of peri-infarct depolarizations (PIDs) propagate across gray matter in the hours and days following stroke, expanding the primary site of injury. Ischemic depolarization (termed anoxic depolarization or AD in live brain slices) is PID-like but immediately arises in the more metabolically compromised ischemic core. This causes dramatic neuronal and astrocyte swelling and dendritic beading with spine loss within minutes, resulting in acute cell death. AD is evoked in rodent neocortical slices by suppressing the Na+/K+-ATPase pump with either oxygen/glucose deprivation (OGD) or exposure to ouabain. The process driving AD and PIDs remains poorly understood. Here we show that dibucaine is a potent drug inhibiting AD because of its high binding affinity to the Na+ channel. Field recording reveals that, when superfused with ouabain (5 min), neocortical slices pretreated with 1 μM dibucaine for 45 min display either no AD or delayed AD onset compared with untreated controls. If ouabain exposure is extended to 10 min, 1 μM dibucaine is still able to delay AD onset by ∼60%. Likewise, it delays OGD-evoked AD onset by ∼54% but does not depress action potentials (APs) or evoked orthodromic field potentials. Increasing dibucaine to 10 μM inhibits AP firing, gradually putting the slice into a stasis that inhibits AD onset but also renders the slice functionally quiescent. Two-photon microscopy reveals that 10 μM dibucaine pretreatment prevents or helps reverse ouabain-induced structural neuronal damage. Although the therapeutic range of dibucaine is quite narrow, dibucaine-like drugs could prove therapeutically useful in inhibiting PIDs and their resultant neuronal damage.
Nonlinear effects of noradrenergic modulation of olfactory bulb function in adult rodents
Authors: Linster Christiane , Nai Qiang , Ennis Matthew
Published: January 2011

The mammalian main olfactory bulb receives a significant noradrenergic input from the locus coeruleus. Norepinephrine (NE) is involved in acquisition of conditioned odor preferences in neonatal animals, in some species-specific odor-dependent behaviors, and in adult odor perception. We provide a detailed review of the functional role of NE in adult rodent main olfactory bulb function. We include cellular, synaptic, network, and behavioral data and use computational simulations to tie these different types of data together.
Effects of cortical activation on sensory responses in barrel cortex
Authors: Hirata Akio , Castro-Alamancos Manuel A.
Published: January 2011

Neocortex network activity changes from a deactivated state during quiescence to an activated state during arousal and vigilance. In urethane-anesthetized rats, cortical activation is readily produced by either stimulating the brainstem reticular formation or by application of cholinergic agonists into the thalamus. We studied the effects of cortical activation on spontaneous activity and sensory responses in the barrel cortex. Cortical activation leads to a suppression of low-frequency sensory responses and to a reduction in their variability due to the abolishment of up and down membrane potential fluctuations in cortical cells. Overall, sensory responses become sharper and more reliable during cortical activation.
Developmental plasticity of descending motor pathways
Authors: Li Hsiu-Ling , Asante Curtis O.
Published: January 2011

Juvenile animal brains are highly plastic and thus often achieve better functional recovery after injury compared with adult brains. Recently, Umeda et al. (Umeda T, Takahashi M, Isa K, Isa T. J Neurophysiol 104: 1707–1716, 2010) have shown that the remodeling of both corticospinal and extra-pyramidal pathways can contribute to the recovery of grasping and reaching ability in hemidecorticated juvenile rats. They have further unveiled the strengthening of the cortico-reticulo-spinal pathway after injury, that mediates the fast excitation of ipsilateral motoneurons for functional recovery.
Interleukin-18 Gene Polymorphisms in Tunisian Patients with Inflammatory Bowel Disease
Authors: Ben Aleya Walid , Sfar Imen , Habibi Imen , Mouelhi Leila , Aouadi Houda , Makhlouf Mouna , Ayed-Jendoubi Salwa , Najjar Taoufik , Abdallah Taeib Ben , Ayed Khaled , Gorgi Yousr
Published: January 2011

Aim: Interleukin (IL)-18 can regulate the Th2-mediated immune response and it may be involved in the pathogenesis of Th1 and Th2 chronic inflammatory diseases. This study sought to detect a possible association between two single nucleotide polymorphisms (SNPs) (–137G/C and –607C/A) in the IL-18 gene promoter region and susceptibility to inflammatory bowel disease (IBD) including Crohn’s disease (CD) and ulcerative colitis (UC) in the Tunisian population. Methods: The (–137G/C and –607C/A) IL-18 polymorphism was analyzed in 105 patients with CD, 59 patients with UC, and 100 controls using the sequence-specific polymerase chain reaction method. Results: The distribution of allele and genotype frequencies illustrate that the –137G/G genotype frequency was significantly higher in UC than in controls (p value corrected (pc) = 0.038). On the other hand, we found a statistically significant association (pc = 0.033) between genotype AA of the IL-18 gene promoter (–607C/A) polymorphism in UC patients and the distal localization of the lesions. In CD, no significant differences were observed at positions –607 and –137. The analysis of IBD patients according to clinical behavior revealed no difference. Conclusion: The two SNPs at position –607 (C/A) and –137 (G/C) in the promoter region of the IL-18 gene was associated with the development of UC but not CD, providing a strong support for an IBD susceptibility gene in the region surrounding IL-18. It remains to be determined precisely how the IL-18 alleles influence the pathogenesis of IBD.
Equine Disorders of Sexual Development in 17 Mares Including XX, SRY-Negative, XY, SRY-Negative and XY, SRY-Positive Genotypes
Authors: Villagómez D.A.F. , Lear T.L. , Chenier T. , Lee S. , McGee R.B. , Cahill J. , Foster R.A. , Reyes E. , St John E. , King W.A.
Published: January 2011

We described the clinical, cytogenetic and molecular findings of 17 clinical equine cases presented for abnormal sexual development and infertility. Six horses with an enlarged clitoris had an XX, SRY-negative genotype, which displayed male-like behavior (adult individuals). Bilateral ovotestes were noted in 2 of those cases, while another case showed increased levels of circulating testosterone. Six horses with a female phenotype, including normal external genitalia, had an XY, SRY-negative genotype. These individuals had small gonads and an underdeveloped internal reproductive tract. Four horses with normal appearing external genitalia had an XY, SRY-positive genotype, 3 of them had hypoplastic testes and male-like behavior. In addition, one young filly with enlarged clitoris and hypoplastic testes had the same genotype but did not show male-like behavior due to her age. Three of these horses were related with 2 being siblings. These findings demonstrate the diversity of disorders of sexual development seen in the horse. Furthermore, they emphasize the need for further research to identify genes involved in abnormal sex determination and differentiation in the horse.