bluuebunny/crossref_metadata_2025 huggingface dataset:
The multiple histories of secularism
Authors: Hashemi Nader
Published: April 2010

This article is intended to advance conceptual clarity on the topic of secularism in Muslim societies. It seeks to uncover unique historical developments that have influenced and shaped debate on this topic. In the first part, a distinction is made between the different social scientific categories of secularism, focusing on the philosophical, sociological and political dimensions of secularism. The second section provides a broad overview of the different histories of political secularism, and focuses on the two dominant models that have been bequeathed to us from the Western tradition of political thought: Anglo-American secularism and French secularism ( laïcité). In the final section, the political history of Muslim societies is briefly explored with the goal of providing a tentative answer to the question: historically, why did political secularism not emerge in Muslim societies?
Conflicted modernity
Authors: Rasmussen David M.
Published: April 2010

The recognition of conflict puts an end to the idea that cosmopolitanism may be legitimized by a comprehensive doctrine. The article argues that within the limits of a post-secular society, toleration must be conceived as a principle of justice, based on regard for the law, within a society in which not only others’ rights but also other cultures must be respected.
Secularizing traditional Catholicism
Authors: Thiebaut Carlos
Published: April 2010

Some cases of countries and cultures in which traditional Catholicism has played a major role in defining public culture are undergoing accelerated secularization processes; the result should be relevant for the diagnoses underlying contemporary post-secular proposals. It is argued, first, that in these countries (Spain has been taken as a main example), where the Catholic Church lost its institutional power, it is also losing its ethical hegemony. While public and political debates still retain the sense of symbolically laden, communal ethical accord, they are no longer understood with religious overtones. It is suggested, second, that laïcité — a non-aggressive stance concerning religion — could adequately describe this predicament, though it retains a trait of self-defence vis-à-vis the Church that is normally attached to the term ‘laicism’. It is proposed, third, that secularization takes place at the ethical level, in which no sense of loss can be attached to the secular citizen. It is at this level, where the conflicts around meanings and values, which can be framed in religious or secularized terms, set the agenda for legal and political discussions, and where the equal standing of religious and secular interpretations should be assessed.
Post-secular society, transnational religious civilizations and legal pluralism
Authors: Rosati Massimo
Published: April 2010

Taking for granted a radical criticism of the universalistic value of a post-Protestant understanding of religion and of the nexus between political democracy and secularization, the article aims first at framing the perspective of multicultural jurisdictions within contemporary processes of change of religious pluralism on a transnational scale; secondly at framing that perspective within the intellectual tradition of legal pluralism; and finally at inquiring into the compatibility of the new conceptual constellation ‘post-secular society plus legal pluralism’ with a liberal frame.
The violence of incarceration: a response from mainland Europe
Authors: Vervaet Luk
Published: April 2010

The publication of The Violence of Incarceration, a collection of essays on imprisonment and state violence in the US, UK and Australia, edited by Phil Scraton and Jude McCulloch, provides an opportunity to reflect on the steady convergence of mainland Europe s penal policies with those of the US. This convergence undermines any notion of a European moral high ground in relation to incarceration and reflects a general trend among western states of increasing acceptability of violence, war and even torture as solutions to social and political problems. From this perspective, the cruelties at Guantánamo and Abu Ghraib are not isolated examples of excess but, rather, have much in common with everyday practices in domestic US and European prisons; the focus of this article is this wider structural shift in incarceration practices, linked to, but going far beyond, the‘war on terror’.
'Reciprocal recognitions': race, class and subjectivity in Tony Harrison’s The Loiners
Authors: Nicholson Colin
Published: April 2010

Over the last four decades, the work of Tony Harrison has won him the status of England's alternative poet laureate, some of it reaching a mass audience through the medium of film and television. At its heart lies a radical republicanism often expressing itself through an impassioned dialectic between race, class and culture. Yet, despite the honours and critical acclaim that have punctuated his career, this aspect of his work has been less explored. Here, Nicholson examines the seminal influence on Harrison s poetry of his time in Nigeria, with particularly reference to his early collection The Loiners, and relates it to the analysis of colonialism developed by Frantz Fanon.
Cytotoxic and antioxidant effects of methoxylated stilbene analogues on HepG2 hepatoma and Chang liver cells: Implications for structure activity relationship
Authors: Hasiah AH , Ghazali AR , Weber JFF , Velu S. , Thomas NF , Inayat Hussain SH
Published: April 2010

Stilbenes possess a variety of biological activities including chemopreventive activity. This study was conducted to evaluate the structural activity relationships of six methoxylated stilbene analogues with respect to their cytotoxic effects and antioxidant activities on HepG2 hepatoma and Chang liver cells. The cytotoxic and total antioxidant activities of six stilbene analogues were determined by MTT and Ferric Reducing Antioxidant Power (FRAP) assays, respectively. We found that the cis-methoxylated stilbene: (Z)-3,4,4'-trimethoxystilbene was the most potent and selective antiproliferative agent (IC50 89 µM) in HepG2 cells. For the total antioxidant activity, compounds possessing hydroxyl groups at the 4' position namely (E)-3-methoxy-4'-hydroxystilbene, (E)-3,5-dimethoxy-4'-hydroxystilbene (pterostilbene), (E)-4-methoxy-4'-hydroxystilbene showed the highest antioxidant activity. Structure activity relationship studies of these compounds demonstrated that the cytotoxic effect and antioxidant activities of the tested compounds in this study were structurally dependent.
Developing Emotional Awareness in Cross-Cultural Communication: A Videoconferencing Approach
Authors: Ozcelik Hakan , Paprika Zita Zoltay
Published: April 2010

Cross-cultural interactions are inherently emotional processes because they involve a considerable amount of uncertainty and a potential for misunderstanding. This study aims to fill a gap in the literature by designing an easy-to-implement teaching module that brings emotions and emotional awareness more centrally into analysis of cross-cultural business communication. The business schools of a Hungarian university in Budapest and an American university in northern California collaborated in the teaching module by using videoconferencing and screen-capture technologies. The authors examined the effectiveness of this module based on their observations and an analysis of the qualitative data collected from the participating students. The results of the study suggest that the videoconferencing technology can be a viable tool to create real-time interactions between students in different countries in which they can experience, express, observe, and reflect on emotions. Students gained firsthand experience in videoconferencing and enhanced their understanding of cross-cultural communication by reflecting on their observations and emotions.
Development and Feasibility of an HIV and IPV Prevention Intervention Among Low-Income Mothers Receiving Services in a Missouri Day Care Center
Authors: Enriquez Maithe , Cheng An-Lin , Kelly Patricia J. , Witt Jacki , Coker Angela D. , Kashubeck-West Susan
Published: April 2010

This article outlines the development and feasibility of an HIV and IPV prevention intervention. Researchers formed a partnership with a group of women representative of the population that the intervention was intended to reach using methods derived from participatory action research. The use of health protective behaviors changed from pre- to postintervention in the clinically desirable direction. Results indicated that intervention delivery was feasible in the novel setting of a large urban day care center. This intervention has promise as a strategy to reduce HIV among low-income women; however, a controlled study is indicated to further examine intervention efficacy.
Exiting Prostitution: An Integrated Model
Authors: Baker Lynda M. , Dalla Rochelle L. , Williamson Celia
Published: April 2010

Exiting street-level prostitution is a complex, convoluted process. Few studies have described this process within any formal conceptual framework. This article reviews two general models and two prostitution-specific models and their applicability to the exiting process. Barriers encountered as women attempt to leave the streets are identified. Based on the four models, the barriers, the prostitution literature, and the authors’ experience with prostituted women, a new integrated six-stage model that is comprehensive in scope and sensitive to women’s attempts to exit prostitution is offered as a foundation for continued research on the process of women leaving the streets.
Studies of the Toxicological Potential of Capsinoids, XIII: Inhibitory Effects of Capsaicin and Capsinoids on Cytochrome P450 3A4 in Human Liver Microsomes
Authors: Takanohashi Toshiyuki , Isaka Mitsuyoshi , Ubukata Kazuyuki , Mihara Ryuichi , Bernard Bruce K.
Published: April 2010

This study evaluated potential effects of a number of capsinoids (ie, capsiate, dihydrocapsiate, nordihydrocapsiate) and a single capsaicinoid (ie, capsaicin) on liver microsomal cytochrome P450 3A4-mediated midazolam 1'-hydroxylase activity. Where possible, an inhibition curve was prepared; the concentration at which enzyme activity dropped to 50% was calculated. Capsaicin clearly inhibited cytochrome P450 3A4 activity, losing 50% of the activity at 21.5 μmol/L. No enzyme inhibition was observed in the presence of capsiate, dihydrocapsiate, or nordihydrocapsiate (<100 μmol/L). Preincubation increased the capsaicin inhibitory activity against cytochrome P450 3A4 in a time-dependent manner. Enzyme activity was slightly reduced by capsiate, dihydrocapsiate, and nordihydrocapsiate to the same level as that attained with tolbutamide, the negative control compound. Capsaicin was shown to inhibit cytochrome P450 3A4, probably through a mechanism-based inhibition. In contrast, capsiate, dihydrocapsiate, and nordihydrocapsiate did not inhibit cytochrome P450 3A4 activity and were unlikely to be mechanism-based inhibitors of CYP3A4.
A pooled analysis of the durability and predictors of treatment response of cilostazol in patients with intermittent claudication
Authors: Pande Reena L , Hiatt William R , Zhang Peter , Hittel Norbert , Creager Mark A
Published: April 2010

Pharmacologic therapy for intermittent claudication in patients with peripheral artery disease (PAD) is limited. We aimed to determine the durability of cilostazol treatment response over time, treatment effects in various subpopulations, and long-term safety. This analysis pooled original data from nine randomized, controlled trials evaluating cilostazol in intermittent claudication, including 1258 subjects treated with cilostazol 100 mg bid. Analysis of covariance was used to compare differences in walking distance, and a pooled random-effects weighted mean difference in maximal walking distance (MWD) was determined. Temporal effects were analyzed by compiling data at 4-week intervals in studies of 24 weeks in duration. Cilostazol was associated with a 50.7% improvement from baseline in MWD compared with placebo (24.3%), with an absolute improvement of 42.1 meters greater than the improvement with placebo ( p < 0.001) over a mean follow-up period of 20.4 weeks. Continued increases were demonstrated over the 24-week treatment period. These benefits were seen in all subgroups, after stratifying by age, sex, smoking status, duration of PAD, diabetes, hypertension, prior myocardial infarction, or beta-blocker use. Cilostazol did not increase the risk of all-cause mortality (RR 0.95 [0.68—1.35]). In conclusion, treatment with cilostazol achieves benefits in walking distance that are sustained at 24 weeks and observed irrespective of baseline clinical characteristics. Cilostazol demonstrated no increased risk of all-cause mortality.
Struggle and protest or passivity and control? The formation of class identity in two contemporary cultural practices
Authors: Casey Emma
Published: April 2010

This article draws on recent theoretical developments within sociology which have proposed new ways of looking at and understanding class. Drawing on two contemporary examples, namely the Gambling Bill and the recent ‘riots’ at Ikea in Edmonton in north London, the article demonstrates some of the ways in which class operates subjectively within the practice of everyday life. Using these examples, I show how class continuously informs identity and how, by looking at a range of contemporary cultural consumption practices, it is possible to gain a sense of how boundaries surrounding rights to middle-class identity are constantly tightened and refined. By presenting a range of responses to these consumer practices, I show how representations of the working class are often problematic and leave important questions about the everyday performance of class unanswered. The article thus offers an alternative understanding of class to those that have often positioned the working class as a dangerous deviant mob, as romantic rebels or simply as victims of an oppressive capitalist state. It concludes by arguing in favour of a renewed sociology of class and for ensuring that class features more prominently on the sociology of consumption agenda.
Liquid nitrogen pistachios: Molecular gastronomy, elBulli and foodies
Authors: de Solier Isabelle
Published: April 2010

‘Molecular gastronomy’ was invented by scientists to apply physics and chemistry to restaurant and home cooking, and is best known today through the world’s number one restaurant, elBulli, in Spain. This article examines molecular gastronomy as it is practised by three types of producers in different locations: by professional scientists in the laboratory, through a case study of its founders Nicholas Kurti and Hervé This; by professional chefs in the restaurant, through a case study of Ferran Adrià at elBulli; and by amateur ‘foodies’ in the home, through a case study of foodie called Rob. It argues that molecular gastronomy is particularized in each location, as it is tied to the scientist’s goal of ‘culinary enlightenment’, the chef ’s goal of ‘culinary creativity’, and the foodie’s goal of ‘gastronomic education’. In doing so, it contributes to debates about the shifting boundaries of science and expertise in late modernity.
Long-term Outcome and Risk of Heart Block After Surgical Treatment of Subaortic Stenosis
Authors: Jou Chuanchau J. , Etheridge Susan P. , Minich L. LuAnn , Saarel Elizabeth V. , Lambert Linda M. , Kouretas Peter C. , Holubkov Richard , Hawkins John A.
Published: April 2010

Although mortality following repair of subaortic obstruction is low, aggressive resection may increase morbidity. We sought to evaluate outcomes and risk of atrioventricular heart block (AVB) after subaortic resection in the current era. Simple obstruction was defined as a discrete subaortic membrane and complex as multilevel or diffuse narrowing. Limited resection included membranectomy and limited myomectomy. Aggressive resection included Konno, modified Konno, and Ross. Specified variables were obtained from a chart review. The 185 consecutive patients (1991-2008) ranged in age from 1 day to 21.8 years (5.1 ± 5.1 years) with 2 early and 4 late deaths. Actuarial survival was 97%, 95%, and 95% at 1, 5, and 10 years, respectively. Reoperations were required in 29 of 185 patients (15.7%); 2 required a third operation (1%). Freedom from reoperation in all patients was 97%, 83%, and 73% at 1, 5, and 10 years, respectively. Accessory mitral valve tissue ( P < .001) and age <3 months ( P = .004) predicted the need for reoperation. Transient or permanent high-degree AVB was documented in 33 of 185 patients (17.8%). Complex anatomy ( P = .01) and aggressive resection ( P < .001) increased the risk of acquiring AVB. The AVB was permanent in 21 of 185 (11.4%) patients, and pacemaker implantation was undertaken in 20 of 185 (10.8%) patients. Complex anatomy ( P = .04) and modified Konno procedure ( P = .03) increased the risk of acquiring a pacemaker. Aggressive resection lowered the frequency of recurrence but increased the risk of AVB. When aggressive resection is considered for long-term relief of subaortic obstruction, the risk of reobstruction must be balanced with the risk of AVB and the need for pacemaker implantation.
Morphology and Morphogenesis of Atrioventricular Septal Defect With Common Atrioventricular Junction
Authors: Anderson Robert H. , Wessels Andy , Vettukattil Joseph J.
Published: April 2010

For many years, the lesions now often described as atrioventricular septal defects were considered to represent atrioventricular canal malformations or endocardial cushion defects. It was also long recognized that patients with the so-called ostium primum defect should be included in this category. The phenotypic feature of these hearts is the presence of a common atrioventricular junction, as opposed to separate right and left atrioventricular junctions. The presence of the common atrioventricular junction underscores the associated phenotypic features, such as the presence of a trifoliate left atrioventricular valve, which has no resemblance to a cleft mitral valve; unwedging of the subaortic outflow tract; and disproportion between the inlet and outlet dimensions of the left ventricle. These features are comparable in patients having the so-called partial, intermediate, and complete variants of the malformation. Anatomical differentiation depends on the morphology of the leaflets of the common atrioventricular valve that bridge the ventricular septum. If these bridging leaflets are fused one to the other, then there are dual orifices, rather than a common orifice, within the common atrioventricular junction. The relationships of the bridging leaflets to the septal structures determine the potential for shunting across the atrioventricular septal defect, which can occur at atrial and ventricular levels or exclusively at either atrial or ventricular level. Rarely, the atrioventricular septal defect may close spontaneously. Recent evidence from studies of cardiac development shows that rather than being an endocardial cushion defect, the malformation results from failure of ingrowth into the developing heart from the dorsal mesenchymal tissues.
Intensive Care and Perioperative Management of Patients With Complete Atrioventricular Septal Defect
Authors: Pilchard Jessica , Dadlani Gul , Andropoulos Dean , Jacobs Jeffrey P. , Cooper David S.
Published: April 2010

Operative repair of an atrioventricular septal defect is not without risk. The purpose of this review is to highlight various key topics in the perioperative treatment of patients with atrioventricular septal defects, including challenges related to Down syndrome, postoperative arrhythmias, pulmonary hypertension, hypothyroidism, postoperative residual and recurrent lesions, including systemic atrioventricular valvar regurgitation and left ventricular outflow tract obstruction, sedation and analgesia, and vascular access.
Right Ventricle-to-Pulmonary Artery Shunt in Norwood Procedure: Early Results
Authors: Januszewska Katarzyna , Kozlik-Feldmann Rainer , Abicht Jan , Dalla-Pozza Robert , Malec Edward
Published: April 2010

The aim of this study was to evaluate experience and predictors of early mortality in patients with hypoplastic left heart syndrome (HLHS)–type defects undergoing Norwood procedure (NP) with right ventricle-to-pulmonary artery (RV-PA) shunt. Between 2001 and 2009, a consecutive series of 229 children with HLHS-type single ventricle underwent NP with application of RV-PA shunt. Demographic, echocardiographic, and clinical perioperative data were retrospectively analyzed. The mean duration of follow-up of survivors was 4.5 ± 2.1 years (60 days to 8.1 years). Follow-up was complete for 92.1% of patients. Major early postoperative complications included sepsis/generalized infection in 40 (17.5%), pericardial effusion in 9 (3.9%), and wound infection in 8 (3.5%). The early (30-day) survival was 87.8% (n = 201). In the late postoperative period, 12 (5.9%) died. Early nonsurvivors were more frequently older than 14 days ( P = .045) at initial surgery, had lower operative weight ( P = .024), had more frequent associated cardiac ( P < .001) and/or extracardiac anomalies ( P < .001), and were more likely to have a restrictive interatrial communication before operation ( P = .024). Use of the right RV-PA shunt has helped to mitigate some previously described predictors of early death after NP. Longer follow-up will be required to determine whether the RV-PA shunt modification confers an important survival benefit.
Anatomy of Common Atrioventricular Junction With Complex Associated Lesions
Authors: Anderson Robert H. , Spicer Diane
Published: April 2010

The essence of the lesion increasingly described as atrioventricular septal defect is the presence of a common atrioventricular junction. In most instances, the common junction is itself shared in more or less equal fashion between the cardiac chambers, producing the so-called balanced arrangement, which can be considered the default option. Complexity can be produced at various levels within this standard lesion. The most complex malformations are seen in the setting of visceral heterotaxy. Greatest complexity is seen with right isomerism. This always includes totally anomalous pulmonary venous connection, even when the pulmonary veins return to the heart. Still further complexity is often added by the presence of pulmonary stenosis or atresia. Imbalance can involve either the atrial or ventricular chambers. Imbalance at atrial level produces one form of double outlet atrium, but typically with balanced ventricles. Ventricular imbalance represents spectrums extending either to double inlet left or right ventricle through a common atrioventricular valve. Complexity at the level of the ventriculoarterial junctions is seen in the form of abnormal ventriculoarterial connections, notably tetralogy of Fallot or double outlet right ventricle. In these settings, the superior bridging leaflet is free-floating. Hypoplasia of the left atrioventricular valve is part of right ventricular dominance and is often associated with the so-called parachute malformation. Dual orifice is also a problem. In both these lesions, the zone of apposition between the bridging leaflets is the effective inlet to the left ventricle.
Atrioventricular Septal Defects: Lessons Learned About Patterns of Practice and Outcomes From the Congenital Heart Surgery Database of the Society of Thoracic Surgeons
Authors: Jacobs Jeffrey Phillip , Jacobs Marshall Lewis , Mavroudis Constantine , Chai Paul Jubeong , Tchervenkov Christo I. , Lacour-Gayet Francois G. , Walters Hal , Quintessenza James Anthony
Published: April 2010

During the 4-year time interval of 2005 through 2008, the Society of Thoracic Surgeons Congenital Heart Surgery Database documented data about 2882 operations to repair atrioventricular (AV) canal defects: partial, 623 (21.5%); intermediate, 342 (11.8%);. complete, 1917 (66.3%). Mean age at complete repair (years) was as follows: partial, 6.1; intermediate, 2.9; complete, 0.6. Median age at complete repair (years) was as follows: partial, 2.6; intermediate, 0.9; complete, 0.4. Down syndrome was present in 1767 patients (61.1%). Debanding of the pulmonary artery was rarely performed: partial, 1 (0.2%); intermediate, 0 (0.0%); complete, 66 (3.4%). Deep hypothermic circulatory arrest was rarely used: partial, 6 (1.0%); intermediate, 5 (1.5%); complete, 52 (2.7%). Discharge mortality was low: partial, 2 (0.3%); intermediate, 3 (0.9%); complete, 38 (2.0%). Atrioventricular block requiring permanent pacemaker occurred but was uncommon: partial, 6 (1.0%); intermediate, 2 (0.6%); complete, 29 (1.5%). Unplanned reoperation prior to hospital discharge occurred in 3.9% of complete AV canal repairs. The sternum was left open in 3.0% of complete AV canal repairs. Postoperative cardiac arrest occurred in 1.9% of complete AV canal repairs. Mean postoperative length of stay (days) was as follows: partial, 5.2; intermediate, 7; complete, 13.1. Median postoperative length of stay (days) was as follows: partial, 4; intermediate, 4; complete, 7. This review of data from the Society of Thoracic Surgeons Congenital Heart Surgery Database allows for unique documentation of patterns of practice and outcomes. From this review, we learned that 98% to 99% of patients survive complete repair of AV canal and 96% to 97% survive complete repair of AV canal with no major complications.
Polytetrafluoroethylene Bicuspid Pulmonary Valve Implantation: Experience With 126 Patients
Authors: Quintessenza James Anthony , Jacobs Jeffrey Phillip , Chai Paul Jubeong , Morell Victor O. , Lindberg Harald
Published: April 2010

This article reports our initial experience in 126 consecutive patients treated with placement of a surgically created polytetrafluoroethylene (PTFE) bicuspid pulmonary valve at The Congenital Heart Institute of Florida (CHIF). A bicuspid pulmonary valve is created with PTFE and sutured into the right ventricular outflow tract. PTFE bicuspid pulmonary valves were placed in 126 patients (age: range, 3.1-64.7 years, mean, 17.9 years; weight: range, 14.2-113.6 kg, mean, 55.4 kg). All patients had pulmonary insufficiency, pulmonary stenosis, or both, most commonly after previous repair of tetralogy of Fallot (71 patients). Follow-up was up to 8.3 years (range, 0-8.3 years, mean, 3.34 years). Operative mortality was 1 patient (0.8%). Late mortality was non–valve-related in 3 patients (2.4%). The initial 84 patents in this series received valves constructed from PTFE with 0.6-mm thickness. The next 42 patients received valves constructed from PTFE with 0.1-mm thickness. Six patients of 126 (4.8%) required replacement of the PTFE bicuspid pulmonary valve because of immobile and calcified leaflets. All 6 who required replacement of the PTFE bicuspid pulmonary valve initially received a valve constructed from porous 0.6-mm PTFE material. We currently use nonporous 0.1-mm PTFE, which does not allow cellular in-growth and thickening. Early echocardiographic follow-up of these valve leaflets made with 0.1-mm PTFE has demonstrated improved leaflet mobility and pliability and lower transvalvar gradients. PTFE bicuspid pulmonary valve implantation is safe and effective and demonstrates acceptable performance for the intermediate term. It is anticipated that using thinner 0.1-mm PTFE will improve valve function and durability. Long-term follow-up is necessary to determine the true value of this technique.
Ross-Konno Procedure in Children: Midterm Results
Authors: Hraška Viktor , Lilje Christian , Kantorová Andrea , Photiadis Joachim , Fink Christopher , Asfour Boulos , Lacour-Gayet Francois , Schneider Martin B. , Haun Christopher
Published: April 2010

The aim of this study was to analyze the midterm results following the Ross-Konno procedure in children. Between 1999 and 2008, 29 patients with complex left ventricular outflow tract obstruction underwent the Ross-Konno procedure. There were 12 (41%) infants (group A) and 17 (59%) older patients (group B). The median age at operation was 3.3 years (range, 6 days to 16 years). At 7 years of follow-up, survival was 96% (1 late death), with no differences between groups A and B. Freedom from aortic regurgitation ≥ mild was 81%, with no differences between groups A and B. No residual gradient was noted in the left ventricular outflow tract in either group. Freedom from mitral regurgitation ≥ mild was 100% in group B and 41% in group A ( P = .0029). The mitral regurgitation was associated with morphological abnormalities of the mitral valve and with development of endocardial fibroelastosis after failed intervention during the newborn period. Freedom from reoperation was 73% in group B and 24% in group A ( P = .0093). All patients are now in sinus rhythm, and 43% are without medication. With the technical aspects of this procedure well accomplished, mortality is low, and the functional outcome is encouraging. At midterm follow-up, there was no residual or recurrent outflow tract obstruction and an excellent function of the neoaortic valve. The higher incidence of mitral regurgitation in infants, which was associated with morphological abnormalities of mitral valve and development of endocardial fibroelastosis, is worrisome.
Unbalanced Atrioventricular Septal Defect: Definition and Decision Making
Authors: Overman David M. , Baffa Jeanne M. , Cohen Meryl S. , Mertens Luc , Gremmels David B. , Jegatheeswaran Anusha , McCrindle Brian W. , Blackstone Eugene H. , Morell Victor O. , Caldarone Christopher , Williams William G. , Pizarro Christian
Published: April 2010

Unbalanced atrioventricular septal defect is an uncommon lesion with widely varying anatomic manifestations. When unbalance is severe, diagnosis and treatment is straightforward, directed toward single-ventricle palliation. Milder forms, however, pose a challenge to current diagnostic and therapeutic approaches. The transition from anatomies that are capable of sustaining biventricular physiology to those that cannot is obscure, resulting in uneven application of surgical strategy and excess mortality. Imprecise assessments of ventricular competence have dominated clinical decision making in this regard. Malalignment of the atrioventricular junction and its attendant derangement of inflow physiology is a critical factor in determining the feasibility of biventricular repair in the setting of unbalanced atrioventricular septal defect. The atrioventricular valve index accurately identifies unbalanced atrioventricular septal defect and also brings into focus a zone of transition from anatomies that can support a biventricular end state and those that cannot.
CYT387, a novel JAK2 inhibitor, induces hematologic responses and normalizes inflammatory cytokines in murine myeloproliferative neoplasms
Authors: Tyner Jeffrey W. , Bumm Thomas G. , Deininger Jutta , Wood Lisa , Aichberger Karl J. , Loriaux Marc M. , Druker Brian J. , Burns Christopher J. , Fantino Emmanuelle , Deininger Michael W.
Published: April 2010

Activating alleles of Janus kinase 2 (JAK2) such as JAK2V617F are central to the pathogenesis of myeloproliferative neoplasms (MPN), suggesting that small molecule inhibitors targeting JAK2 may be therapeutically useful. We have identified an aminopyrimidine derivative (CYT387), which inhibits JAK1, JAK2, and tyrosine kinase 2 (TYK2) at low nanomolar concentrations, with few additional targets. Between 0.5 and 1.5μM CYT387 caused growth suppression and apoptosis in JAK2-dependent hematopoietic cell lines, while nonhematopoietic cell lines were unaffected. In a murine MPN model, CYT387 normalized white cell counts, hematocrit, spleen size, and restored physiologic levels of inflammatory cytokines. Despite the hematologic responses and reduction of the JAK2V617F allele burden, JAK2V617F cells persisted and MPN recurred upon cessation of treatment, suggesting that JAK2 inhibitors may be unable to eliminate JAK2V617F cells, consistent with preliminary results from clinical trials of JAK2 inhibitors in myelofibrosis. While the clinical benefit of JAK2 inhibitors may be substantial, not the least due to reduction of inflammatory cytokines and symptomatic improvement, our data add to increasing evidence that kinase inhibitor monotherapy of malignant disease is not curative, suggesting a need for drug combinations to optimally target the malignant cells.
Refinement of cytogenetic classification in acute myeloid leukemia: determination of prognostic significance of rare recurring chromosomal abnormalities among 5876 younger adult patients treated in the United Kingdom Medical Research Council trials
Authors: Grimwade David , Hills Robert K. , Moorman Anthony V. , Walker Helen , Chatters Stephen , Goldstone Anthony H. , Wheatley Keith , Harrison Christine J. , Burnett Alan K. ,   on behalf of the National Cancer Research Institute Adult Leukaemia Working Group
Published: April 2010

Diagnostic karyotype provides the framework for risk-stratification schemes in acute myeloid leukemia (AML); however, the prognostic significance of many rare recurring cytogenetic abnormalities remains uncertain. We studied the outcomes of 5876 patients (16-59 years of age) who were classified into 54 cytogenetic subgroups and treated in the Medical Research Council trials. In multivariable analysis, t(15;17)(q22;q21), t(8;21)(q22;q22), and inv(16)(p13q22)/t(16;16)(p13;q22) were the only abnormalities found to predict a relatively favorable prognosis (P < .001). In patients with t(15;17) treated with extended all-trans retinoic acid and anthracycline-based chemotherapy, additional cytogenetic changes did not have an impact on prognosis. Similarly, additional abnormalities did not have a significant adverse effect in t(8;21) AML; whereas in patients with inv(16), the presence of additional changes, particularly +22, predicted a better outcome (P = .004). In multivariable analyses, various abnormalities predicted a significantly poorer outcome, namely abn(3q) (excluding t(3;5)(q25;q34)), inv(3)(q21q26)/t(3;3)(q21;q26), add(5q)/del(5q), −5, −7, add(7q)/del(7q), t(6;11)(q27;q23), t(10;11)(p11∼13;q23), other t(11q23) (excluding t(9;11)(p21∼22;q23) and t(11;19)(q23;p13)), t(9;22)(q34;q11), −17, and abn(17p). Patients lacking the aforementioned favorable or adverse aberrations but with 4 or more unrelated abnormalities also exhibited a significantly poorer prognosis (designated “complex” karyotype group). These data allow more reliable prediction of outcome for patients with rarer abnormalities and may facilitate the development of consensus in reporting of karyotypic information in clinical trials involving younger adults with AML. This study is registered at http://www.isrctn.org as ISRCTN55678797 and ISRCTN17161961.
Effect of negative air ions on the potential for bacterial contamination of plastic medical equipment
Authors: Shepherd Simon J , Beggs Clive B , Smith Caroline F , Kerr Kevin G , Noakes Catherine J , Sleigh P Andrew
Published: April 2010

Background

In recent years there has been renewed interest in the use of air ionizers to control the spread of infection in hospitals and a number of researchers have investigated the biocidal action of ions in both air and nitrogen. By comparison, the physical action of air ions on bacterial dissemination and deposition has largely been ignored. However, there is clinical evidence that air ions might play an important role in preventing the transmission of Acinetobacter infection. Although the reasons for this are unclear, it is hypothesized that a physical effect may be responsible: the production of air ions may negatively charge items of plastic medical equipment so that they repel, rather than attract, airborne bacteria. By negatively charging both particles in the air and items of plastic equipment, the ionizers minimize electrostatic deposition on these items. In so doing they may help to interrupt the transmission of Acinetobacter infection in certain healthcare settings such as intensive care units.

Methods

A study was undertaken in a mechanically ventilated room under ambient conditions to accurately measure changes in surface potential exhibited by items of plastic medical equipment in the presence of negative air ions. Plastic items were suspended on nylon threads, either in free space or in contact with a table surface, and exposed to negative ions produced by an air ionizer. The charge build-up on the specimens was measured using an electric field mill while the ion concentration in the room air was recorded using a portable ion counter.

Results

The results of the study demonstrated that common items of equipment such as ventilator tubes rapidly developed a large negative charge (i.e. generally >-100V) in the presence of a negative air ionizer. While most items of equipment tested behaved in a similar manner to this, one item, a box from a urological collection and monitoring system (the only item made from styrene acrylonitrile), did however develop a positive charge in the presence of the ionizer.

Conclusion

The findings of the study suggest that the action of negative air ionizers significantly alters the electrostatic landscape of the clinical environment, and that this has the potential to cause any Acinetobacter-bearing particles in the air to be strongly repelled from some plastic surfaces and attracted to others. In so doing, this may prevent critical items of equipment from becoming contaminated with the bacterium.
A European project on incidence, treatment, and outcome of sarcoma
Authors: Mastrangelo Giuseppe , Fadda Emanuela , Cegolon Luca , Montesco Maria C , Ray-Coquard Isabel , Buja Alessandra , Fedeli Ugo , Frasson Alvise , Spolaore Paolo , Rossi Carlo R
Published: April 2010

Background

Sarcomas are rare tumors (1-2% of all cancers) of mesenchymal origin that may develop in soft tissues and viscera. Since the International Classification of Disease (ICD) attributes visceral sarcomas (VS) to the organ of origin, the incidence of sarcoma is grossly underestimated. The rarity of the disease and the variety of histological types (more than 70) or locations account for the difficulty in acquiring sufficient personal experience. In view of the above the European Commission funded the project called Connective Tissues Cancers Network (CONTICANET), to improve the prognosis of sarcoma patients by increasing the level of standardization of diagnostic and therapeutic procedures through a multicentre collaboration.

Methods/Design

Two protocols of epidemiological researches are here presented. The first investigation aims to build the population-based incidence of sarcoma in a two-year period, using the new 2002 WHO classification and the "second opinion" given by an expert regional pathologist on the initial diagnosis by a local pathologist. A three to five year survival rate will also be determined. Pathology reports and clinical records will be the sources of information.

The second study aims to compare the effects on survival or relapse-free period - allowing for histological subtypes, clinical stage, primary site, age and gender - when the disease was treated or not according to the clinical practice guidelines (CPGs).

Discussion

Within CONTICANET, each group was asked to design a particular study on a specific objective, the partners of the network being free to accept or not the proposed protocol. The first protocol was accepted by the other researchers, therefore the incidence of sarcoma will be assessed in three European regions, Rhone-Alpes and Aquitaine (France) and Veneto (Italy), where the geographic distribution of sarcoma will be compared after taking into account age and gender. The conformity of the clinical practice with the recommended guidelines will be investigated in a French (Rhone Alps) and Italian (Veneto) region since the CPGs were similar in both areas.
Female Genital Mutilation: perceptions of healthcare professionals and the perspective of the migrant families
Authors: Kaplan-Marcusán Adriana , del Rio Natividad Fernández , Moreno-Navarro Juana , Castany-Fàbregas Ma José , Nogueras Marta Ruiz , Muñoz-Ortiz Laura , Monguí-Avila Eliana , Torán-Monserrat Pere
Published: April 2010

Background

Female Genital Mutilation (FGM) is a traditional practice which is harmful to health and is profoundly rooted in many Sub-Saharan African countries. It is estimated that between 100 and 140 million women around the world have been victims of some form of FGM and that each year 3 million girls are at risk of being submitted to these practices. As a consequence of the migratory phenomena, the problems associated with FGM have extended to the Western countries receiving the immigrants. The practice of FGM has repercussions on the physical, psychic, sexual and reproductive health of women, severely deteriorating their current and future quality of life. Primary healthcare professionals are in a privileged position to detect and prevent these situations of risk which will be increasingly more present in Spain.

Methods/Design

The objective of the study is to describe the knowledge, attitudes and practices of the primary healthcare professionals, working in 25 health care centres in Barcelona and Girona regions, regarding FGM, as well as to investigate the perception of this subject among the migrant communities from countries with strong roots in these practices. A transversal descriptive study will be performed with a questionnaire to primary healthcare professionals and migrant healthcare users.

Using a questionnaire specifically designed for this study, we will evaluate the knowledge, attitudes and skills of the healthcare professionals to approach this problem. In a sub-study, performed with a similar methodology but with the participation of cultural mediators, the perceptions of the migrant families in relation to their position and expectancies in view of the result of preventive interventions will be determined.

Variables related to the socio-demographic aspects, knowledge of FGM (types, cultural origin, geographic distribution and ethnicity), evaluation of attitudes and beliefs towards FGM and previous contact or experience with cases or risk situations will be obtained.

Discussion

Knowledge of these harmful practices and a preventive approach from a transcultural perspective may represent a positive intervention model for integrative care of immigrants, respecting their values and culture while also being effective in eliminating the physical and psychic consequences of FGM.
Efficient recombinant expression and secretion of a thermostable GH26 mannan endo-1,4-β-mannosidase from Bacillus licheniformis in Escherichia coli
Authors: Songsiriritthigul Chomphunuch , Buranabanyat Bancha , Haltrich Dietmar , Yamabhai Montarop
Published: April 2010

Background

Mannans are one of the key polymers in hemicellulose, a major component of lignocellulose. The Mannan endo-1,4-β-mannosidase or 1,4-β-D-mannanase (EC 3.2.1.78), commonly named β-mannanase, is an enzyme that can catalyze random hydrolysis of β-1,4-mannosidic linkages in the main chain of mannans, glucomannans and galactomannans. The enzyme has found a number of applications in different industries, including food, feed, pharmaceutical, pulp/paper industries, as well as gas well stimulation and pretreatment of lignocellulosic biomass for the production of second generation biofuel. Bacillus licheniformis is a Gram-positive endospore-forming microorganism that is generally non-pathogenic and has been used extensively for large-scale industrial production of various enzymes; however, there has been no previous report on the cloning and expression of mannan endo-1,4-β-mannosidase gene (manB) from B. licheniformis.

Results

The mannan endo-1,4-β-mannosidase gene (manB), commonly known as β-mannanase, from Bacillus licheniformis strain DSM13 was cloned and overexpressed in Escherichia coli. The enzyme can be harvested from the cell lysate, periplasmic extract, or culture supernatant when using the pFLAG expression system. A total activity of approximately 50,000 units could be obtained from 1-l shake flask cultures. The recombinant enzyme was 6 × His-tagged at its C-terminus, and could be purified by one-step immobilized metal affinity chromatography (IMAC) to apparent homogeneity. The specific activity of the purified enzyme when using locust bean gum as substrate was 1672 ± 96 units/mg. The optimal pH of the enzyme was between pH 6.0 - 7.0; whereas the optimal temperature was at 50 - 60°C. The recombinant β-mannanase was stable within pH 5 - 12 after incubation for 30 min at 50°C, and within pH 6 - 9 after incubation at 50°C for 24 h. The enzyme was stable at temperatures up to 50°C with a half-life time of activity (τ1/2) of approximately 80 h at 50°C and pH 6.0. Analysis of hydrolytic products by thin layer chromatography revealed that the main products from the bioconversion of locus bean gum and mannan were various manno-oligosaccharide products (M2 - M6) and mannose.

Conclusion

Our study demonstrates an efficient expression and secretion system for the production of a relatively thermo- and alkali-stable recombinant β-mannanase from B. licheniformis strain DSM13, suitable for various biotechnological applications.
"Hypoxia-induced down-regulation of microRNA-449a/b impairs control over targeted SERPINE1 (PAI-1) mRNA - a mechanism involved in SERPINE1 (PAI-1) overexpression"
Authors: Muth Michaela , Theophile Katharina , Hussein Kais , Jacobi Christoph , Kreipe Hans , Bock Oliver
Published: April 2010

Background

In damaged organs tissue repair and replacement of cells by connective tissue provokes a response of fibroblasts to cellular stress factors such as hypoxia.

MicroRNAs (miRNA) are small non-coding RNA molecules which bind to their mRNA targets which eventually lead to repression of translation. Whether the response of fibroblasts to stress factors also involves the miRNA system is largely unknown.

Results

By miRNA profiling we identified down-regulation of miRNA-449a/b expression in hypoxic fibroblasts. Specific miRNA inhibitors and mimics showed direct evidence for targeting the serine protease inhibitor (serpin) protein (SERPINE1; plasminogen activator inhibitor-1, PAI-1) by miRNA-449a/b leading to SERPINE1 mRNA and protein up- and down-regulation, respectively. SERPINE1 expression in vivo could be located predominantly in areas of fibrosis and remodeling.

Conclusions

Our study offers serious lines of evidence for a novel hypoxia-dependent mechanism involving hypoxia-induced decrease of clustered miRNA-449a/b, hypoxia-induced amplification of concomitant increase of targeted SERPINE1 (PAI-1) and its overexpression in tissues showing a hypoxic environment.
Acquired craniomeningocele in an infant with craniosynostosis: a case report
Authors: El Khashab Mostafa , Nejat Farideh , Yazdani Shahrooz , Baradaran Nima
Published: April 2010

Introduction

Craniosynostosis can affect the skull in various ways. The most common forms are abnormal skull shape and beaten copper pattern, while Lückenschädel (or lacunar skull) is one of the least common forms.

Case presentation

We report the case of a 3-month-old Caucasian boy with multiple suture craniosynostosis and with acquired craniomeningocele presenting as a bulging mass in the lateral occipital area.

Conclusion

To the best of our knowledge, this is the first report of a patient with multiple suture craniosynostosis and acquired craniomeningocele.