bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic factors in malignant ureteric obstruction
Authors: Lienert Andrew , Ing Andrew , Mark Stephen
Published: March 2009

OBJECTIVE

To validate a model to stratify patients with obstructive nephropathy due to malignant ureteric obstruction, associated with a poor prognosis, into different prognostic groups, as a recent report identified low serum albumin, degree of hydronephrosis and number of events related to metastatic disease as prognostic indicators before palliative decompression.

PATIENTS AND METHODS

We retrospectively review the charts to identify all patients who had a nephrostomy tube inserted for malignant ureteric obstruction. Laboratory and clinical factors that might influence prognosis were reviewed to attempt to externally validate the previously identified factors and model for risk stratification.

RESULTS

The median (range) age of the 49 patients identified was 71 (36–91) years, and the median survival was 174 (14–602) days. Tumours were of urological origin in 66% of patients. Patients with prostate cancer had nephrostomy tubes indwelling for a mean of 279 days, vs 190 days (P = 0.07) for patients with tumours not of prostatic origin. A serum albumin level of >30 g/L (P ≤ 0.001), serum sodium <135 mmol/L (P = 0.019) and three or more events related to dissemination of cancer (P = 0.04) were factors associated with a significantly shorter mean survival. Complications related to the nephrostomy tube were experienced by 39% of patients. The model proved useful in stratifying these patients into different risk groups (P = 0.002).

CONCLUSION

Consistent with a previous report we showed that a low serum albumin level and events related to metastatic disease were indicative of a poor prognosis. We also found that a low serum sodium level might be associated with a worse prognosis. We externally validated a model for stratifying patients into different prognostic groups. Palliative decompression is associated with significant morbidity.
Extracorporeal shock wave lithotripsy at 60 shock waves/min reduces renal injury in a porcine model
Authors: Connors Bret A. , Evan Andrew P. , Blomgren Philip M. , Handa Rajash K. , Willis Lynn R. , Gao Sujuan , McAteer James A. , Lingeman James E.
Published: March 2009

OBJECTIVE

To determine if extracorporeal shock wave lithotripsy (ESWL) at 60 shock waves (SWs)/min reduces renal damage and haemodynamic impairment compared to treatment at 120 SWs/min.

MATERIALS AND METHODS

One kidney in each of 19 juvenile pigs (7–8 weeks old) was treated at 120 or at 60 SWs/min (2000 SWs, 24 kV) with an unmodified HM‐3 lithotripter (Dornier Medical Systems, Kennesaw, GA, USA). Renal function was determined before and after ESWL treatment by inulin clearance, extraction and clearance of para‐aminohippuric acid. Both kidneys were then removed to measure parenchymal lesion size by sectioning the entire kidney and quantifying the size of the haemorrhagic lesion in each slice.

RESULTS

ESWL at 60 SWs/min significantly reduced the size of the acute morphological lesion compared to 120 SWs/min (0.42% vs 3.93% of functional renal volume, P = 0.011) and blunted the decrease in glomerular filtration rate and renal plasma flow normally seen after treatment at 120 SWs/min.

CONCLUSIONS

Treatment at a firing rate of 60 SWs/min produces less morphological injury and causes less alteration in renal haemodynamics than treatment at 120 SWs/min in the pig model of ESWL‐induced renal injury.
Transumbilical laparoscopic urological surgery: are special devices strictly necessary?
Authors: Branco Anibal W. , Kondo William , Stunitz Luciano C. , Filho Alcides J.B. , De George Marco A.
Published: March 2009

OBJECTIVE

To evaluate the safety and feasibility of transumbilical laparoscopic surgery using conventional laparoscopic instruments and ports.

PATIENTS AND METHODS

Since January 2008 we have been using laparoscopic transumbilical procedures. Patient selection was determined by any situation, pathological or not, for which laparoscopy was deemed appropriate as the standard of care in our practice. Exclusion criteria included patients who had undergone multiple abdominal procedures. The Veress needle was placed through the umbilicus, to allow insufflation with carbon dioxide. A 10‐mm trocar was placed in the peri‐umbilical site for the laparoscope, followed by placing two additional 5‐mm peri‐umbilical trocars. The entire procedure was done using conventional laparoscopic instruments. At the end of surgery the trocars were removed and all three peri‐umbilical skin incisions were united for specimen retrieval. Patients undergoing surgery using this approach were evaluated prospectively and data were collected during and after surgery for analysis.

RESULTS

Six procedures were performed using this technique (three nephrectomies, one adrenalectomy, one ureterolithotomy and one retroperitoneal mass resection). The mean operative duration and blood loss were 70.5 min and 108.3 mL, respectively. There were no complications during surgery and no patients needed a blood transfusion. Analgesia comprised metamizole (1 g intravenous every 6 h) and ketoprofen (100 mg intravenous every 12 h). The time to first oral intake was 8 h and the mean hospital stay was 28 h.

CONCLUSION

Laparoscopic transumbilical surgery seems to be feasible and safe even using conventional laparoscopic instruments, and can be considered a potential alternative for traditional laparoscopic urological procedures.
A REVIEW AND COMPARISON OF TESTS OF CROSS‐SECTION INDEPENDENCE IN PANELS
Authors: Moscone Francesco , Tosetti Elisa
Published: March 2009

AbstractIn this paper we review and compare diagnostic tests of cross‐section independence in the disturbances of panel regression models. We examine tests based on the sample pairwise correlation coefficient or on its transformations, and tests based on the theory of spacings. The ultimate goal is to shed some light on the appropriate use of existing diagnostic tests for cross‐equation error correlation. Our discussion is supported by means of a set of Monte Carlo experiments and a small empirical study on health. Results show that tests based on the average of pairwise correlation coefficients work well when the alternative hypothesis is a factor model with non‐zero mean loadings. Tests based on spacings are powerful in identifying various forms of strong cross‐section dependence, but have low power when they are used to capture spatial correlation.
Loneliness among school‐aged children and their parents
Authors: JUNTTILA NIINA , VAURAS MARJA
Published: March 2009

The aim of this study was to examine the existence of the intergenerational transmission of loneliness between parents and children, including an examination of its stability and of gender differences. The study consisted of an evaluation of loneliness in mothers (n= 834), fathers (n= 661) and their 10‐year‐old children (n= 981). Parent's self‐reported loneliness was measured once, and their children's social and emotional loneliness were assessed at three time‐points. The stability analysis indicated average stability in children's loneliness, especially their social loneliness. Boys were found to experience more emotional loneliness than girls. Structural equation modeling indicated no direct relationship between mothers’/fathers’ loneliness and their children's loneliness. However, mothers’ and fathers’ loneliness reduced their daughters’ peer‐evaluated cooperating skills, which consequently predicted higher levels of both social and emotional loneliness.
Differentiating between ADHD sub‐types on CCPT measures of sustained attention and vigilance
Authors: EGELAND JENS , JOHANSEN SUSANNE NORDBY , UELAND TORILL
Published: March 2009

The aim of the study was to test whether sustained attention and vigilance, often considered as the same phenomenon, dissociate on the Conners’ Continuous Performance Test, and whether subjects with ADHD‐Inattentive type and ADHD‐Combined type differ with regard to these measures. Sixty‐five healthy controls and 67 subjects with ADHD between 9 and 16 years of age participated in the study. The ADHD‐I group performed below control children on Hit Reaction Time Block Change, considered to measure sustained attention and the ADHD‐C group scored below controls on Hit Reaction Time Inter‐Stimulus‐Interval, considered to measure vigilance. Comparing the two clinical groups showed a test by group interaction, with ADHD‐I subjects performing below ADHD‐C subjects with regard to sustained attention and above ADHD‐C subjects with regard to vigilance. Sustained attention on the CCPT correlated specifically with parent and teacher ratings of inattention, but not with ratings of hyperactivity‐impulsivity, while vigilance correlated with all symptom ratings.
The Bureaucratic Politics of Welfare‐State Crisis: Sweden in the 1990s
Authors: DAHLSTRÖM CARL
Published: March 2009

This article suggests that key bureaucrats play a decisive role in times of welfare crisis. It argues that key bureaucrats, through their advice, define both the type of welfare crisis and the range of possible solutions, which have at least two important consequences: First, it broadens the distribution of welfare cuts, as key bureaucrats—contrary to politicians—have no interests in targeting special voter groups. Second, it enables political compromises, as both the government and the opposition trust the key bureaucrats' expertise. These suggestions are tested empirically in a case study of Sweden in the 1990s. It shows that key bureaucrats did indeed influence both the distribution of the cuts and enabled a compromise between the center‐right government and the Social Democratic opposition.
How New Economic Ideas Changed the Danish Welfare State: The Case of Neoliberal Ideas and Highly Organized Social Democratic Interests
Authors: LARSEN CHRISTIAN ALBREKT , ANDERSEN JØRGEN GOUL
Published: March 2009

The article argues that new economic ideas have exerted an independent causal effect on policy change in three major areas in the Danish welfare state: unemployment insurance, early retirement, and taxation. Thereby the Danish case bears resemblance to the paradigmatic shift from Keynesianism to monetarism in the United Kingdom. However, in the Danish case this paradigmatic shift did not coincide with a political shift to a right‐wing government. This makes it possible to disentangle the intimate relationship between ideas and interests. It is argued that the Danish case provides one of the clearest examples of the independent causal effects of economic ideas because the Social Democrats pursued policies that compromised with the party's historically rooted positions and with the preferences of their electorate. Ideas and solutions did not come in one fixed package, however. But the new paradigm established some basic premises that were not up for discussion.
Theorizing Implementation of Public Management Policy Reforms: A Case Study of Strategic Planning and Programming in the European Commission
Authors: BARZELAY MICHAEL , JACOBSEN ANNE SOFIE
Published: March 2009

As a measure to rectify the European Commission's “management deficit,” the institution's authorities decided to introduce new forms of commission‐wide strategic planning and programming in 2000. Drawing on semistructured interviews with Commission officials, this article tracks the key turning points, trajectories, and outcomes of events within the implementation stage of this part of the Commission managerial reform. As an instrumental case study, the article begins to theorize the process of implementing public management policy change. Major conceptual issues addressed include how reform decisions serve to activate the social mechanism of actor certification and how actor conduct amplifies such certification. Actor certification provides a link from reform choices to organizational change. In this respect and others, the research argument contrasts and integrates social theory mind‐sets deriving from institutionalism and social interactionism (processualism) in line with research trends in historical sociology, organization science, and public management.
Optimizing referral of patients with neuromuscular disorders to allied health care
Authors: Pieterse A. J. , Cup E. H. C. , Akkermans R. P. , Hendricks H. T. , Van Engelen B. G. M. , Van Der Wilt G. J. , Oostendorp R. A. B.
Published: March 2009

Background and purpose:  To report the predictive validity of the perceived limitations in activities and need questionnaire (PLAN‐Q), a screening instrument to support neurologists to select patients with neuromuscular disorders (NMD) for referral for a one‐off consultation by occupational therapist (OT), physical therapist (PT) and speech therapist (ST).

Methods:  In a cross‐sectional validation study, 102 patients with various NMD participated. Patients received a one‐off consultation by an expert OT, PT and ST and filled out the PLAN‐Q. Therapists rated the appropriateness of the one‐off consultations based on need, available treatment and patient’s motivation. Receiver Operation Characteristic analysis and multivariate logistic regression analysis were used to obtain a PLAN‐Q based prediction model for the appropriateness of the one‐off consultations.

Results:  Probability for a one‐off OT consultation increased from 64% to 78% (95% CI: 69–85%). Prior test probability for a one‐off ST consultation increased from 44% to 61% (95% CI: 48–73%). Prior test probability for one‐off PT consultation could not be increased.

Conclusion:  Screening patients with NMD using the PLAN‐Q may assist neurologists in selecting the appropriate patients for a one‐off consultation by OT and ST. Unlike our expectations the screening did not guide referral for a one‐off consultation by PT.
Surmounting City Silences: Knowledge Creation and the Design of Urban Democracy in the Everyday Economy
Authors: ETTLINGER NANCY
Published: March 2009

This essay presents segregation as a fundamental, longstanding and widespread problem that impedes democratic urban life and is intelligible from a critical geographic perspective. Ignorance is spatially produced by segregation at multiple scales so as to legitimize and perpetuate silence about problems among marginalized groups. This spatialized understanding explains inequality, problematizes and difference prompts an agenda that forefronts the creation of new social knowledges. The focus here is on the everyday economy as a crucial but commonly overlooked context for developing such knowledges. I re‐present a theory of knowledge creation developed for the pursuit of commercial competitiveness and reconfigure it to mesh socio‐political and economic goals. A central challenge is to change prevailing discourses by cultivating new practices that entail meaningful interaction among people otherwise segregated. Efficiency becomes a means to social as well as economic ends, as respect and trust grow from collaborative experience among people who might otherwise not interact.

Ce travail présente la ségrégation comme un problème fondamental, persistant et généralisé qui handicape la vie urbaine démocratique et qui peut être appréhendé d'un point de vue critique géographique. L'ignorance est le résultat, sur le plan spatial, d'une ségrégation à plusieurs échelons aux fins de justifier et de perpétuer le silence sur les problèmes qui existent dans les groupes marginalisés. Cette appréhension spatiale explique l'inégalité, tandis que la problématisation de la différence conduit à mettre en évidence la création de nouveaux savoirs sociaux. L'intérêt porte ici sur l'économie du quotidien, considérée comme un contexte essentiel, quoique très souvent négligé, pour le développement de ces savoirs. L'auteur revisite une théorie de la création du savoir élaborée dans le but d'accroître la compétitivité commerciale, et la reconfigure pour qu'elle concorde avec des objectifs sociopolitiques et économiques. L'un des principaux défis consiste à changer la rhétorique dominante en cultivant de nouvelles pratiques qui supposent une interaction porteuse de sens entre des gens par ailleurs ségrégués. L'efficience devient un moyen à des fins sociales et économiques, le respect et la confiance se nourrissant de la collaboration vécue entre des personnes qui, autrement, n'auraient peut‐être pas été en relation.
Modulation of stress proteins and apoptotic regulators in the anoxia tolerant turtle brain
Authors: Kesaraju Shailaja , Schmidt‐Kastner Rainald , Prentice Howard M. , Milton Sarah L.
Published: March 2009

Freshwater turtles survive prolonged anoxia and reoxygenation without overt brain damage by well‐described physiological processes, but little work has been done to investigate the molecular changes associated with anoxic survival. We examined stress proteins and apoptotic regulators in the turtle during early (1 h) and long‐term anoxia (4, 24 h) and reoxygenation. Western blot analyses showed changes within the first hour of anoxia; multiple stress proteins (Hsp72, Grp94, Hsp60, Hsp27, and HO‐1) increased while apoptotic regulators (Bcl‐2 and Bax) decreased. Levels of the ER stress protein Grp78 were unchanged. Stress proteins remained elevated in long‐term anoxia while the Bcl‐2/Bax ratio was unaltered. No changes in cleaved caspase 3 levels were observed during anoxia while apoptosis inducing factor increased significantly. Furthermore, we found no evidence for the anoxic translocation of Bax from the cytosol to mitochondria, nor movement of apoptosis inducing factor between the mitochondria and nucleus. Reoxygenation did not lead to further increases in stress proteins or apoptotic regulators except for HO‐1. The apparent protection against cell damage was corroborated with immunohistochemistry, which indicated no overt damage in the turtle brain subjected to anoxia and reoxygenation. The results suggest that molecular adaptations enhance pro‐survival mechanisms and suppress apoptotic pathways to confer anoxia tolerance in freshwater turtles.
Fasting Headache: A Review of the Literature and New Hypotheses
Authors: Torelli Paola , Evangelista Andrea , Bini Annamaria , Castellini Paola , Lambru Giorgio , Manzoni Gian Camillo
Published: March 2009

Headache is a common disorder in the general population. It is often highly debilitating for the people affected and highly costly to society. Although we know much about primary headaches, little is known about secondary headaches which, however, are a frequent occurrence in the general population. A study conducted on Denmark's general population found a lifetime prevalence rate of 22% for headache forms attributed to disorder of homeostasis, including fasting headache.

The purpose of this review was to analyze literature data on fasting headache, in order to evaluate its possible pathophysiological mechanisms and to suggest therapeutic strategies. We considered only English‐language articles published in scientific journals and searched for these articles on PubMed using “headache,”“fasting,”“Yom Kippur,”“Ramadan,”“hypoglycemia,” and “caffeine withdrawal” as key words, with no limitations to the year of publication. In most cases, fasting headache has the same clinical features as tension‐type headache and the probability of onset increases directly with the duration of fasting. Hypoglycemia and caffeine withdrawal have been especially implicated as causative factors, but much remains to be understood about this topic.
Isolated Unilateral Temporal Muscle Hypertrophy: A Rare Cause of Hemicranial Headache
Authors: Vordenbäumen Stefan , Groiss Stefan Jun , Dihné Marcel
Published: March 2009

A case of isolated unilateral hypertrophy of the Musculus temporalis identified by magnetic resonance imaging associated with recurrent hemicranial headache in a 22‐year‐old woman with Turkish ancestry is presented. Symptomatic relief was achieved by administration of acetaminophen. A review of the literature is presented and additional treatment options are discussed.
An Internet‐Based Migraine Headache Diary: Issues in Internet‐Based Research
Authors: Moloney Margaret F. , Aycock Dawn M. , Cotsonis George A. , Myerburg Stuart , Farino Christopher , Lentz Martha
Published: March 2009

Objective.— The primary purpose of this study was to explore the feasibility and acceptability of using an Internet‐based headache diary to obtain acceptable completion rates of daily diaries.

Background.— Migraine sufferers often perceive that headaches are unpredictable, but 70% have prodromal warning symptoms that may be identified via daily headache diaries. Although diaries are widely used for tracking headaches, Internet‐based diaries have not been used previously.

Methods.— A conventional headache diary was formatted for the Internet to collect daily headache data over 4 months using a time‐series design. Women between 18 and 55 years who were not pregnant or postmenopausal, and whose headaches met migraine criteria, were recruited primarily via the Internet, completed online consent forms, and were screened via telephone. They completed health history questionnaires and daily diary pages containing scales and open‐ended questions, which were saved to a database. Diaries were reviewed and participants were contacted weekly. Completion dates were tracked electronically. Follow‐up interviews addressed perceptions about study experiences, and participants received feedback about headache patterns.

Results.— The majority of participants were recruited from discussion boards and free classified web sites. Of the 101 participants enrolled, 24 withdrew prior to completing 4 months of diary entries. Participants (n = 77) had a mean age of 37.5 (±7.5) years and were primarily white (82%) and well‐educated (93%). They lived in 21 US states, and one in the UK. The majority (68%) completed at least 50% of their diary pages within 24 hours; 75% of all pages were completed within 2 days. At least 64 (83%) kept notes or printed pages when they lacked Internet access. In a follow‐up survey (n = 67), 87% would have been willing to continue the diary for another 2 months; 69% had not previously participated in any research. Participants also reported that the study helped them better understand their headache patterns, that the study was a major commitment but worthwhile, and that they felt they had helped others by participating.

Conclusion.— The Internet‐based headache diary is a feasible, acceptable data collection tool that can access geographically diverse populations who have not previously participated in research studies. Use of an Internet‐based approach was found to be feasible for recruitment and retention of such diverse populations.
Trigeminal Neuralgia in a Patient With Spontaneous Intracranial Hypotension
Authors: Cheshire William P. , Wharen Robert E.
Published: March 2009

Spontaneous intracranial hypotension and trigeminal neuralgia are examples of pain syndromes arising from shifting anatomical relationships in the posterior fossa. We report both conditions occurring in the same patient and resolving following surgical closure of a cervical nerve root sleeve dural defect. This case further elucidates the pathophysiologic basis of both forms of head pain.
Rizatriptan 10‐mg ODT for Early Treatment of Migraine and Impact of Migraine Education on Treatment Response
Authors: Cady Roger K. , Martin Vincent T. , Géraud Gilles , Rodgers Anthony , Zhang Ying , Ho Andrew P. , Hustad Carolyn M. , Ho Tony W. , Connor Kathryn M. , Ramsey Karen E.
Published: March 2009

Objective.— To examine the efficacy of rizatriptan 10‐mg orally disintegrating tablet (ODT) for treating migraines of mild intensity soon after onset, with or without patient‐specific migraine education.

Background.— Studies have shown rizatriptan tablet efficacy in early migraine treatment.

Methods.— In this randomized, placebo‐controlled, double‐blind, factorial design study, adults with a history of migraine were assigned to rizatriptan 10‐mg ODT ± patient education (personalized summary of early migraine signs and symptoms) or placebo ± patient education in a 1 : 1 : 1 : 1 ratio. Patients were instructed to treat 1 attack at the earliest time they knew that their headache was a migraine, while pain was mild. During the next 24 hours, patients assessed pain severity, associated symptoms, functional disability, use of rescue medication, and treatment satisfaction. The primary endpoint was pain freedom at 2 hours; a key secondary endpoint was 24‐hour sustained pain freedom.

Results.— Of 207 patients randomized to treatment, 188 (91%) treated a study migraine. Significantly more patients taking rizatriptan reported pain freedom at 2 hours compared with placebo (66.3% vs 28.1%, P < .001). Similarly, significantly more patients taking rizatriptan reported 24‐hour sustained pain freedom (52.2% vs 17.7%, P < .001). A greater proportion of patients in the rizatriptan + education group reported pain freedom at 2 hours compared with those in the rizatriptan + no education group (71.7% vs 60.9%, P = .430). Few adverse events were reported.

Conclusion.— Rizatriptan 10‐mg ODT, when taken early, while headache pain is mild, was superior to placebo at providing pain freedom at 2 hours and 24‐hour sustained pain freedom (NCT00516737).
IMPACTS OF SOLAR UV RADIATION ON THE PHOTOSYNTHESIS, GROWTH, AND UV‐ABSORBING COMPOUNDS IN GRACILARIA LEMANEIFORMIS (RHODOPHYTA) GROWN AT DIFFERENT NITRATE CONCENTRATIONS1
Authors: Zheng Yangqiao , Gao Kunshan
Published: March 2009

Solar ultraviolet radiation (UVR, 280–400 nm) is known to affect macroalgal physiology negatively, while nutrient availability may affect UV‐absorbing compounds (UVACs) and sensitivity to UVR. However, little is known about the interactive effects of UVR and nitrate availability on macroalgal growth and photosynthesis. We investigated the growth and photosynthesis of the red alga Gracilaria lemaneiformis (Bory) Grev. at different levels of nitrate (natural or enriched nitrate levels of 41 or 300 and 600 μM) under different solar radiation treatments with or without UVR. Nitrate‐enrichment enhanced the growth, resulted in higher concentrations of UVACs, and led to negligible photoinhibition of photosynthesis even at noon in the presence of UVR. Net photosynthesis during the noon period was severely inhibited by both ultraviolet‐A radiation (UVA) and ultraviolet‐B radiation (UVB) in the thalli grown in seawater without enriched nitrate. The absorptivity of UVACs changed in response to changes in the PAR dose when the thalli were shifted back and forth from solar radiation to indoor low light, and exposure to UVR significantly induced the synthesis of UVACs. The thalli exposed to PAR alone exhibited higher growth rates than those that received PAR + UVA or PAR + UVA + UVB at the ambient or enriched nitrate concentrations. UVR inhibited growth approximately five times as much as it inhibited photosynthesis within a range of 60–120 μg UVACs · g−1 (fwt) when the thalli were grown under nitrate‐enriched conditions. Such differential inhibition implies that other metabolic processes are more sensitive to solar UVR than photosynthesis.
PHYLOGENETIC POSITION OF ATTHEYA LONGICORNIS AND ATTHEYA SEPTENTRIONALIS (BACILLARIOPHYTA)1
Authors: Rampen Sebastiaan W. , Schouten Stefan , Elda Panoto F. , Brink Maaike , Andersen Robert A. , Muyzer Gerard , Abbas Ben , Sinninghe Damsté Jaap S.
Published: March 2009

The phylogenetic position of diatoms belonging to the genus Attheya is presently under debate. Species belonging to this genus have been placed in the subclasses Chaetocerotophycidae and Biddulphiophycidae, but published phylogenetic trees based on 18S rDNA, morphology, and sexual reproduction indicate that this group of diatoms may be a sister group of the pennates. To clarify the position of Attheya, we studied the morphology, 18S rDNA, 16S rDNA of the chloroplasts, the rbcL large subunit (LSU) sequences of the chloroplasts, and the sterol composition of three different strains of Attheya septentrionalis (Østrup) R. M. Crawford and one strain of Attheya longicornis R. M. Crawford et C. Gardner. These data were compared with data from more than 100 other diatom species, covering the whole phylogenetic tree, with special emphasis on species belonging to the genera that have been suggested to be related to the genus Attheya. All data suggest that the investigated Attheya species form a separate group of diatoms, and there is no indication that they belong to either the Chaetocerotophycidae or the Biddulphiophycidae. Despite applying these various approaches, we were unable to determine the exact phylogenetic position of the investigated Attheya species within the diatoms.
OCCURRENCE OF LOROXANTHIN, LOROXANTHIN DECENOATE, AND LOROXANTHIN DODECENOATE IN TETRASELMIS SPECIES (PRASINOPHYCEAE, CHLOROPHYTA)1
Authors: Garrido José L. , Rodríguez Francisco , Zapata Manuel
Published: March 2009

The pigment composition of six species of Tetraselmis (Prasinophyceae) was analyzed using improved HPLC methods. All pigment extracts showed three peaks corresponding to unknown carotenoids. The isolated pigments were analyzed using UV–Vis spectroscopy, electrospray ionization–mass spectrometry (ESI–MS), and when carotenoid esters were suspected, gas chromatography–mass spectrometry (GC–MS) of the methyl ester and dimethyloxazoline derivative of the corresponding fatty acid. The new pigments were determined to be loroxanthin, loroxanthin 19‐(2‐decenoate), and loroxanthin 19‐(2‐dodecenoate); this is the first time these pigments have been described in the genus Tetraselmis. Moreover, this is the first report of esterification of 2‐decenoic acid to loroxanthin. The relative contents of these pigments depended on the light regime, with the lowest proportions measured at the highest photon flux density assayed. The implications of the identification of these pigments in the genus Tetraselmis for the pigment types previously described in the class Prasinophyceae are discussed.
Vitamin D and Bone Physiology: Demonstration of Vitamin D Deficiency in an Implant Osseointegration Rat Model
Authors: Kelly James , Lin Audrey , Wang Chiachien J. , Park Sil , Nishimura Ichiro
Published: March 2009

Purpose: The patient population varies in nutritional deficiencies, which may confound the host response to biomaterials. The objective of this study was to evaluate the effect of a common deficiency of vitamin D on implant osseointegration in the rat model.

Materials and Methods: Male Sprague‐Dawley rats were maintained under the cessation of vitamin D intake and UV exposure. The serum levels of 1,25(OH)2D3, 25 OHD3, Ca, and P were determined. Miniature cylindrical Ti6Al4V implants (2‐mm long, 1‐mm diameter) were fabricated with double acid‐etched (DAE) surface or modified DAE with discrete crystalline deposition (DCD) of hydroxyapatite nanoparticles. DAE and DCD implants were placed in the femurs of vitamin D‐insufficient and control rats. After 14 days of healing, the femur‐implant samples were subjected to implant push‐in test and nondecalcified histology. The surfaces of recovered implant specimens after the push‐in test were further evaluated by scanning electron microscopy (SEM).

Results: The decreased serum level of 25 OHD3 demonstrated the establishment of vitamin D insufficiency in this model. The implant push‐in test revealed that DAE and DCD implants in the vitamin D‐insufficient group (15.94 ± 8.20 N, n = 7; 15.63 ± 3.96 N, n = 7, respectively) were significantly lower than those of the control group (24.99 ± 7.92 N, n = 7, p < 0.05; 37.48 ± 17.58 N, n = 7, p < 0.01, respectively). The transcortical bone‐to‐implant contact ratio (BIC) was also significantly decreased in the vitamin D‐insufficient group. SEM analyses further suggested that the calcified tissues remaining next to the implant surface after push‐in test appeared unusually fragmented.

Conclusions: The effect of vitamin D insufficiency significantly impairing the establishment of Ti6Al4V implant osseointegration in vivo was unexpectedly profound. The outcome of Ti‐based endosseous implants may be confounded by the increasing prevalence of vitamin D insufficiency in our patient population.
Acute Pain and Availability of Analgesia in the Prehospital Emergency Setting in Italy: A Problem to be Solved
Authors: Marinangeli Franco , Narducci Cristiano , Ursini Maria Laura , Paladini Antonella , Pasqualucci Alberto , Gatti Antonio , Varrassi Giustino
Published: March 2009

Objectives:  The treatment of acute pain in the prehospital emergency setting remains a significant problem. We evaluated the incidence, site, and possible cause of acute pain in the prehospital period and also the current state of prehospital pain management by evaluating analgesic availability in emergency vehicles in Italy.

Methods:  First aid volunteers documented the presence, intensity, and site of acute pain by questionnaire for over 3 months. Emergency service operations completed a questionnaire on analgesic availability in ambulances and helicopters.

Results:  Pain symptoms were present in two‐thirds of the patients (n = 383) and ranked as moderate to unbearable in 41.75%. Results of the analgesic availability survey indicate that 10.6% of the ambulance services carry no pain killers (including non‐steroidal anti‐inflammatory drugs [NSAIDs] and/or paracetamol) and 11.5% are without an opioid. The emergency helicopter survey showed a significant difference in analgesic availability compared with ambulances, with 97.6% having at least one opioid agent available (weak or strong). A wide geographical variation in the availability of analgesic agents in ambulance and helicopter services was seen.

Conclusions:  There is a high prevalence of pain among patients receiving prehospital emergency treatment in Italy and treatment for acute pain during emergency treatment of trauma patients is inadequate. All emergency vehicles, without distinction, should carry opioids and other analgesic drugs (NSAIDs and paracetamol) and there should be no geographic differences in the availability of pain medications.
The Use of Cerebral Oximetry as a Monitor of the Adequacy of Cerebral Perfusion in a Patient Undergoing Shoulder Surgery in the Beach Chair Position
Authors: Fischer Gregory W. , Torrillo Toni M. , Weiner Menachem M. , Rosenblatt Meg A.
Published: March 2009

Four cases of ischemic injury have been reported in patients undergoing orthopedic surgery in the upright position. We describe the use of cerebral oximetry as a monitor of the adequacy of cerebral perfusion in a 63‐year‐old woman who underwent arthroscopic rotator cuff surgery in a beach chair under general anesthesia. During positioning, a decrease in blood pressure was accompanied by a decrease in cerebral oxygen saturation (SctO2) and was treated with phenylephrine. When spontaneous ventilation resumed, an increase in end‐tidal carbon dioxide was accompanied by an increase in SctO2. Cerebral oximetry may prove useful as a guide monitor and manage nonsupine patients.
Promoting Diversity in Emergency Medicine: Summary Recommendations from the 2008 Council of Emergency Medicine Residency Directors (CORD) Academic Assembly Diversity Workgroup
Authors: Heron Sheryl L. , Lovell Elise O. , Wang Ernest , Bowman Steven H.
Published: March 2009

Although the U.S. population continues to become more diverse, ethnic and racial health care disparities persist. The benefits of a diverse medical workforce have been well described, but the percentage of emergency medicine (EM) residents from underrepresented groups (URGs) is small and has not significantly increased over the past 10 years. The Council of Emergency Medicine Resident Directors (CORD) requested that a panel of CORD members review the current state of ethnic and racial diversity in EM training programs. The objective of the discussion was to develop strategies to help EM residency programs examine and improve diversity in their respective institutions. Specific recommendations focus on URG applicant selection and recruitment strategies, cultural competence curriculum development, involvement of URG faculty, and the availability of institutional and national resources to improve and maintain diversity in EM training programs.
Emergency Medicine Career Choice: A Profile of Factors and Influences from the Association of American Medical Colleges (AAMC) Graduation Questionnaires
Authors: Boyd Jeremy S. , Clyne Brian , Reinert Steven E. , Zink Brian J.
Published: March 2009

Objectives:  This study sought to account for trends in medical student specialty choice by examining the importance of lifestyle factors. Emergency medicine (EM) is among several medical specialties classified as having a “controllable lifestyle.” The primary objective of this study was to determine if medical students choosing careers in EM have a different profile of influences, values, and expectations from students choosing other specialties or specialty groups. Of secondary interest was how much lifestyle influenced students choosing EM compared to students choosing controllable lifestyle (CL) specialties.

Methods:  Using data from the 2005 and 2006 Association of American Medical Colleges (AAMC) graduation questionnaire (GQ) supplemental surveys, we grouped responses according to desired specialty choice: EM (n = 963), CL (n = 3,681), primary care (PC; n = 3,191), or surgical specialty (SS; n = 1,694). The survey requires students to rate the influence of nine specific factors in determining their specialty choice: lifestyle, competitiveness, high level of educational debt, mentors and role models, options for fellowship training, salary expectations, length of residency training, family expectations, and medical school career planning activities. Using one‐way analysis of variance (ANOVA) and nonparametric statistics, we assessed responses among the four subgroups for differences in the importance attributed to these factors.

Results:  A total of 13,440 students completed the two supplemental surveys of the GQ. Of these students, 9,529 identified a specialty choice that fell within one of the four comparison groups and were included in the analysis. Compared to other specialty groups, students choosing EM reported lifestyle and length of residency as strong influences, while attributing less influence to mentors and options for fellowship training.

Conclusions:  Students choosing a career in EM have distinctly different priorities and influences than students entering PC and SS. The profile of students who choose EM is very similar to those choosing traditional CL specialties. A more thorough understanding of the values and priorities that shape medical student career selection may allow educators to provide better career counseling.
A study of the antigenicity of Rickettsia helvetica proteins using two‐dimensional gel electrophoresis
Authors: HAJEM NEDAA , WEINTRAUB ANDREJ , NIMTZ MANFRED , RÖMLING UTE , PÅHLSON CARL
Published: March 2009

Rickettsia helvetica is an obligate intracellular Gram‐negative microorganism found in Ixodes ricinus ticks. When R. helvetica was first discovered in 1979, little was known about its physiology and it fell into oblivion until it recently was suspected of being pathogenic to humans. However, all efforts to isolate R. helvetica from patients have been unsuccessful, although serological responses against R. helvetica can be demonstrated. The aim of our study was to investigate the protein profile of R. helvetica and study the antigenicity of its proteins using two‐dimensional (2D) immunoblot in order to characterize the immunological response against R. helvetica infection. Our results show that in addition to the known PS120 and OmpB antigenic R. helvetica proteins, three other antigens exist: a 60 kDa GroEL protein, a 10 kDa GroES protein and a hitherto unknown 35 kDa hypothetical protein that has similarities with ORF‐RC0799 of Rickettsia conorii. Furthermore, the lipopolysaccharide showed strong antigenicity. In this study, we present the first proteome map and the first 2D immunoblot profile of R. helvetica and finally we present the 35 kDa R. helvetica as an additional antigen to the previously known rickettsial antigens.
Excitatory amino acid transporters EAAT‐1 and EAAT‐2 in temporal lobe and hippocampus in intractable temporal lobe epilepsy
Authors: SARAC SINAN , AFZAL SHOAIB , BROHOLM HELLE , MADSEN FLEMMING F. , PLOUG THORKIL , LAURSEN HENNING
Published: March 2009

Intractable temporal lobe epilepsy (TLE) is an invalidating disease and many patients are resistant to medical treatment. Increased glutamate concentration has been found in epileptogenic foci and may induce local over‐excitation and cytotoxicity; one of the proposed mechanisms involves reduced extra‐cellular clearance of glutamate by excitatory amino acid transporters (EAAT‐1 to EAAT‐5). EAAT‐1 and EAAT‐2 are mainly expressed on astroglial cells for the reuptake of glutamate from the extra‐cellular space. We have studied the expression of EAAT‐1 and EAAT‐2 in the hippocampus and temporal lobe in 12 patients with TLE by immunhistochemistry and densitometry. The expression of EAAT‐1 and EAAT‐2 was reduced to approximately 40% and 25%, respectively, in CA1 of the hippocampus. In the same area, an increased expression of glial fibrillary acid protein (GFAP) at 90% reflected molecular rearrangements and upregulation of GFAP in the existing astrocytes as Ki‐67 staining failed to demonstrate any signs of astrocytic proliferation. The aetiology of the reduced expression of EAAT‐1 and EAAT‐2 remains unclear. The downregulation of EAAT‐1 and EAAT‐2 may be an adaptive response to neuronal death or it may be a causative event contributing to neuronal death. Further studies of the EAATs and their function are needed to clarify the mechanisms and significance of EAAT‐1 and EAAT‐2 disappearance in TLE.
Immunohistochemical profile of ephrin A4 expression in human osteosarcoma
Authors: ABDOU ASMAA GABER , EL‐WAHED MOSHIRA MOHAMMED  ABD , ASAAD NANCY YOUSSEF , SAMAKA REHAB MONIR , ABDALLAHA RANIA
Published: March 2009

Ephrin receptors and ephrin ligands constitute one of the largest groups of tyrosine kinases. The division of ephrin receptors into type A or type B is determined by their ligand‐binding specificities. Ephrin A4 as a ligand has a broad capacity to bind and stimulate different subtypes of ephrin A receptors. Little is known about the role of ephrins generally and ephrin A4 particularly in osteosarcoma. Ephrin A4 was immunohistochemically assessed on archival material from 46 primary osteosarcoma cases, 10 metastatic pulmonary lesions and 20 normal control bone specimens. Ephrin A4 was expressed in 100% of normal bone specimens, in 84.4% of primary osteosarcoma cases and in all metastatic pulmonary lesions. Cytoplasmic and nucleocytoplasmic patterns of ephrin A4 immunoreactivity were observed, with the predominance of the latter pattern in normal bone (100%), and in 43.5% of primary osteosarcoma cases, which showed a higher intensity of expression compared with normal bone (p<0.05). The cytoplasmic pattern is the only staining pattern seen in metastatic cases, which may suggest its role in enhancement of invasion and metastasis. The differences in the distribution of the two patterns of ephrin A4 may indicate a different biological activity of this molecule depending on its localization. The nuclear localization of ephrin A4 requires further investigation to clarify the mechanism and the significance of the nuclear trafficking of ephrin A4.
Occupational contact urticaria caused by cyclic acid anhydrides
Authors: Helaskoski Eva , Kuuliala Outi , Aalto‐Korte Kristiina
Published: March 2009

Background:  Cyclic acid anhydrides often cause allergic respiratory diseases, but contact urticaria because of these anhydrides has been considered rare.

Objective:  We describe 21 patients diagnosed with occupational contact urticaria at the Finnish Institute of Occupational Health during the period 1990–2006.

Method:  Prick test with human serum albumin (HSA)–acid anhydride conjugates, determination of specific immunoglobulin E (IgE), and open application were used in the diagnosis.

Results:  The majority of the patients worked in the manufacture of electrical machines and were exposed to an epoxy hardener containing methyl hexahydrophthalic anhydride. The largest prick test reaction was often noted for the acid anhydride the patient had been exposed to. The specific IgE results were mostly in line with the prick test reactions. Phthalic anhydride IgE was determined in 20 patients and was found positive in 19 patients. In open application, a positive test result often required the use of the undiluted hardener.

Conclusions:  Contact urticaria may be more common than previously believed. Prick tests with HSA–acid anhydride conjugates were a useful test method for detecting immediate sensitization to acid anhydrides. The determination of the specific IgE gave almost equal results. The open application test often had to be performed with the undiluted anhydride product to obtain a positive test result.
Expression of surface markers on the human monocytic leukaemia cell line, THP‐1, as indicators for the sensitizing potential of chemicals
Authors: An Susun , Kim Seoyoung , Huh Yong , Lee Tae Ryong , Kim Han‐Kon , Park Kui‐Lea , Eun Hee Chul
Published: March 2009

Background:  Evaluation of skin sensitization potential is an important part of the safety assessment of cosmetic ingredients and topical drugs. Recently, evaluation of changes in surface marker expression induced in dendritic cells (DC) or DC surrogate cell lines following exposure to chemicals represents one approach for in vitro test methods.

Objective:  The study aimed to test the change of expression patterns of surface markers on THP‐1 cells by chemicals as a predictive in vitro method for contact sensitization.

Methods:  We investigated the expression of CD54, CD86, CD83, CD80, and CD40 after a 1‐day exposure to sensitizers (1‐chloro‐2,4‐dinitrobenzene; 2,4‐dinitrofluorobenzene; benzocaine; 5‐chloro‐2‐methyl‐4‐isothiazolin‐3‐one; hexyl cinnamic aldehyde; eugenol; nickel sulfate hexahydrate; potassium dichromate; cobalt sulfate; 2‐mercaptobenzothiazole; and ammonium tetrachloroplatinate) and non‐sensitizers (sodium lauryl sulfate, benzalkonium chloride, lactic acid, salicylic acid, isopropanol, and dimethyl sulphoxide). The test concentrations were 0.1×, 0.5×, and 1× of the 50% inhibitory concentration, and the relative fluorescence intensity was used as an expression indicator.

Result and Conclusion:  By evaluating the expression patterns of CD54, CD86, and CD40, we could classify the chemicals as sensitizers or non‐sensitizers, but CD80 and CD83 showed non‐specific patterns of expression. These data suggest that the THP‐1 cells are good model for screening contact sensitizers and CD40 could be a useful marker complementary to CD54 and CD86.
Ecological significances of ontogenetic shifts in the stream‐dwelling catfish, Hatcheria macraei (Siluriformes, Trichomycteridae), in a Patagonian river
Authors: Barriga J. P. , Battini M. A.
Published: March 2009

Abstract –  The relationship between ontogenetic changes and both feeding and habitat preferences was studied in a stream catfish population of Argentine Patagonia. Fish capture, as well as habitat data recording, was performed during a 1‐year long period. Larvae–juvenile transition was determined between 22.4 and 29.4 mm standard length (SL), on the basis of the relative growth changes and morphogenesis, and juvenile–adult shift was established between 61 and 65 mm SL using a macroscopic criterion of gonadal development and gonadosomatic index. Spawning period was estimated to be in the summer season, from December to February. Larvae preferred shallow marginal pools and fed mainly on small Chironomidae larvae, while juveniles and adults inhabited riffles and preyed on Ephemeroptera nymphs and Chironomid larvae. Morphological constraints during the larval period were related to habitat and feeding preferences. A complete development of fins allowed juveniles to colonise faster water habitats while a bigger mouth gape permitted them to prey on new items and on a larger size prey range.