bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimizing the Transition to Home Parenteral Nutrition in Pediatric Patients
Authors: Norman Johanna L. , Crill Catherine M.
Published: May 2011

Parenteral nutrition (PN) is commonly used in pediatric institutions in patients who either cannot be fed enterally or are unable to tolerate sufficient enteral calories to provide their nutrition requirements. Many pediatric patients, particularly those with short bowel syndrome or intestinal failure, will eventually require home PN (HPN) therapy. Although discharge to HPN is complex and can be associated with both immediate and long‐term complications, it can be successfully achieved through collaboration between healthcare providers within the institution and the home care company and HPN education of the patient and caregivers. This review describes the processes that clinicians and institutions should consider when preparing for HPN discharge and serves as a guide for the effective transition to HPN in pediatric patients.
Consent for Donation After Cardiac Death
Authors: Kalkbrenner Kathy J. , Hardart George E.
Published: May 2011

Context: Despite the increasing number of policies governing organ donation after cardiac death (DCD), nothing is presently known about the informed consent process for DCD. Without guidelines, organ procurement organizations (OPOs) are likely to structure the consent process similarly to that for organ donation after brain death (DBD), despite important ethical differences between the 2 modes of organ recovery. Objective: To describe informed consent practices used by OPOs for DCD. Design, Setting, and Participants: Cross-sectional, internet-based survey of the 58 OPOs in the United States. Main Outcome Measures: OPO policies and reported levels of physician participation in the consent process for DCD. Results: Seventeen OPOs completed the survey (29%). Responders and nonresponders did not differ by DCD volume over the last year or last 5 years. None of the OPO’s policies require physician involvement in obtaining written informed consent; 94% of policies require only the OPO representative to obtain written consent for DCD and 6% state that either the OPO representative or the treating physician may obtain consent; 71% of OPOs reported that discussions with family regarding DCD occur with the treating physician present less than 51% of the time and 82% indicated that the OPO representative is solely involved in obtaining consent for DCD in the majority of cases. A total of 24% of OPOs require physicians to participate in obtaining consent for procedures performed prior to death exclusively for organ preservation. No differences were found between the OPO consent practices for DCD and DBD. Conclusions: None of the OPOs responding to this survey have a policy requirement for physician involvement in obtaining consent for DCD. These findings raise questions about the role of physicians in DCD and how best to maintain a patient- and family-centered focus on care for patients at the end of life while supporting organ recovery efforts.
Multi-objective optimization of micro wire electric discharge machining parameters using grey relational analysis with Taguchi method
Authors: Somashekhar K P , Mathew J , Ramachandran N
Published: May 2011

Micro wire electric discharge machining (µ-WEDM) is an evolution of conventional wire EDM used for fabricating three-dimensional complex microcomponents, microstructures, and intricate profiles effectively with high-precision capabilities. Being a complex process, it is very difficult to determine optimal parameters for obtaining higher material removal rate (MRR) with minimum overcut (OC), and surface roughness (SR) is a challenging task in µ-WEDM for improving performance characteristics. In this study, a new approach for the optimization of the µ-WEDM process with multiple performance characteristics based on the statistical-based analysis of variance (ANOVA) and grey relational analysis (GRA) is attempted. Analysis of variance was used to study the significance of process parameters on grey relational grade (GRG) which showed capacitance to be the most significant factor. A GRG obtained from the GRA is used to optimize the µ-WEDM process. Optimum process parameters are determined by the GRG as the overall performance index. The process parameters, namely gap voltage, capacitance, and feed rate are optimized by considering multiple performance characteristics including MRR, OC, and SR. To validate the study, confirmation experiment has been carried out at optimal set of parameters, and predicted results have been found to be in good agreement with experimental findings. This approach showed improved machining performance in the µ-WEDM process.
Deinstitutionalizing the history of contemporary psychiatry
Authors: Eghigian Greg
Published: May 2011

While contemporary mental health services have been marked by the burgeoning of outpatient and preventive care, the historiography of psychiatry remains largely tied to the study of custodial and palliative treatment. The work in which contemporary psychiatry has been involved cannot be adequately understood as a singular, autonomous enterprise based in a residential facility. It has become a technoscience that operates in numerous settings and alongside multiple sciences, technologies and decision-makers. This paper explores what it might mean to ‘deinstitutionalize’ the history of contemporary psychiatry by examining the case of social therapy for sex offenders in West Germany.
Terra incognita : an historiographic approach to the first chlorpromazine trials using patient records of the Psychiatric University Clinic in Heidelberg
Authors: Balz Viola
Published: May 2011

Psychiatrists have often referred to the discovery of new psychopharmaceutical drugs in the 1950s as a ‘therapeutic revolution’, which allowed physicians to observe und measure therapeutic effectiveness easily. Contrary to this view, this article will argue that psychiatrists needed the patient’s subjective voice to evaluate the effects of the drugs. In a micro-analysis of hospital records of the first patient to be treated with chlorpromazine in the Heidelberg clinic in 1953, I show the different perspectives of doctors and patients on the diagnosis and treatment. The analysis points up how difficult it was to get an impression of the drug’s effectiveness. The article emphasizes the importance of the new perspective that includes the patient’s voice in the history of psychotropic drugs after 1945.
Experimental oleander (Nerium oleander) intoxication in broiler chickens (Gallus gallus)
Authors: Omidi Arash , Razavizadeh Alireza T , Movassaghi Ahmad R , Aslani Mohammad R
Published: May 2011

Dried leaves of oleander were orally given at a single dose of 500 mg/kg body weight to 20 clinically healthy male chickens. Clinical signs of toxicosis began to appear about 1 h after receiving the oleander and included hypersalivation, vomiting, diarrhea, deep depression, and sudden death. Also, hyperemia in the combs and wattles was obviously seen. Electrocardiograms (ECG) were repeatedly recorded at 30 min intervals. ECGs findings included increasing the QRS duration in some birds and various kinds of arrhythmias. Bradycardia was the most frequently detected finding (30.43%). During necropsy, there were congestion and hemorrhages in the visceral organs particularly in heart, liver, kidney, and lung. Histopathology revealed myocardial cell necrosis with hyperemia and hemorrhage, severe diffuse pulmonary congestion and edema, severe renal congestion and hemorrhage with tubular necrosis, and coagulative necrosis of hepatocytes with hyperemia and hemorrhage. There were also congestion, mild epithelial necrosis and desquamation with infiltration of mononuclear inflammatory cells in the proventriculus of all birds. There was also mild to moderate congestion in the intestines with scattered necrosis of surface enterocytes. The lack of information about the toxicity of oleanders in poultry was the main cause for this study. The results suggest that chickens appear to respond to oleander poisoning in a manner similar to other species.
The Dilemma Facing Strategic Choice of Entry Mode
Authors: Huang Zengyu , Han Xia , Roche Frank , Cassidy John
Published: May 2011

While a large body of research has dealt with firm’s choice of ownership mode when entering a foreign market, little attention has been paid to the ex-post performance after initial entry. This article combines the transactional cost economics, Dunning’s OLI paradigm as well as the institutional view as an integrative framework to examine the relationship of firm’s foreign market entry mode choice and performance outcomes. We suggest propositions for empirical study and also consider research implications in relation to these theoretical perspectives as an explanation for firm’s internationalization.
Disinvestment, Lending Relationships and Executive Compensation
Authors: Ghosh Saibal
Published: May 2011

The analysis employs data on federal government-owned public enterprises (PSEs) since 1980s that encompasses the partial privatization programme to examine the likelihood of privatization. The results indicate that employment-intensive, high-paying but less profitable firms are more likely to be privatized. In terms of lending relationships, the analysis indicates that private banks are the main bank for small firms, and foreign banks are the main bank for large, established firms. State-owned banks are more likely to be associated with leveraged PSEs as compared to other bank groups. In terms of compensation policies in PSEs, the evidence testifies that bigger, established and leveraged PSE firms pay higher salaries.
Corporate Consciousness
Authors: Dash Amarendra Kumar , Padhi Harapriya
Published: May 2011

The aim of this article is to analyze the scope and limits of media impact on corporate governance (CG) in India and how the mass media can be upgraded and incorporated in the ensuing CG reform agenda. Extant and premier literature on the impact of media on corporate governance is reviewed. The review reveals that research on the impact of media on corporate governance is basically done in the context of Western media and democracy. There is no attempt to gauge the influence of media reports on corporate governance in India, although the largest democracy of the world has experienced the biggest scandals of unethical governance in the last two decades. The article brings together the problems peculiar to the Indian situation indicating mass media’s scope for having some impact on corporate ethics, regulators’ responsibility and public opinion in India. A pioneering effort to study the role of media in addressing corporate governance issues and abuses in India, the article pleads for legal and institutional reforms fostering better flow of information and transparency.
Linking Technological Innovation, Technology Strategy and Organizational Factors
Authors: Dasgupta Meeta , Gupta R.K. , Sahay A.
Published: May 2011

The essence of business growth is technological innovation and successful management lies in skilful allocation of resources to bring about the technological change. Seeing the increasing importance of technological innovation and strategy guiding the acquisition and deployment of technological resources for competitive growth, the article attempts to summarize research in the area of technological innovation and technology strategy. Literature brings out the importance of organizational factors supporting technological innovation and technology strategy. A preliminary model has been proposed, suggesting a possible relationship between the three. The article in addition to providing a narrative of literature, also gives practical implications and directions for future research.
A Comparative Study of Knowledge Management Assessment in Business Excellence Awarded and Non-awarded Organizations in India
Authors: Chawla Deepak , Joshi Himanshu
Published: May 2011

The changing business scenario worldwide has transformed the way organizations compete and survive in the global marketplace. Globalization has forced economies to re-look at their organizational structures, core competencies, leadership, culture and strategy formulation and implementation. Indian organizations too have undergone transformations to become world class using knowledge as their core competency. An attempt has been made to understand how the various dimensions of Knowledge Management Assessment Tool (KMAT) distinguish between those organizations which have been awarded for business excellence awards and those which have not been awarded or trying to work for this award. A sample of 57 top and middle level executives of 16 private and public sector organizations from India participated in the study.1 The results show that organizations awarded for business excellence fare better on all dimensions of knowledge management as compared to non-awarded ones. Further, t-test is used to identify the statistical differences between the mean scores of the items that constitute each dimension of KMAT. The t-test results reveal that Knowledge Management Process, Culture and Measurement aspects of Knowledge Management are better structured in award-winning organizations. The article also emphasizes on the improvement areas in developing best practices of Knowledge Management for enhancing performance and excellence in business. Since Knowledge Management is a key element for achieving business excellence, the findings of the study can serve as input to organizations for developing knowledge intensive processes to facilitate business excellence.
Preschool Social–Emotional Skills Training
Authors: Conner Natalie W. , Fraser Mark W.
Published: May 2011

Objective: The purpose of this study was to pilot test a multicomponent program designed to prevent aggressive behavior in preschool children. The first program component was comprised of social–emotional skills training. It focused on improving the social information processing and emotional-regulation skills of children. The second component was a group-based parenting education. It focused on child development and discipline. Method: Participants, recruited from four preschools in high-risk neighborhoods within a large metropolitan area, were assigned to an intervention ( n = 31) or a waitlist comparison ( n = 36) condition. Using worker ratings and child puppet-play assessments, pretest and posttest data were collected on 14 child and caregiver/parent behaviors. Results: The gain scores of children in the intervention group differed significantly from those in the comparison group on academic competence, social competence, depression, and aggressive behavior. Caretaker gain scores differed significantly, favoring the intervention group on parental bonding, child supervision, communication, and developmental expectations. Conditioned on the limitations of the design, skills training for preschool children and their caregivers appears to promote social and academic skills.
Reflections on Organizational Memory and Forgetting
Authors: Casey Andrea J. , Olivera Fernando
Published: May 2011

Organizational memory plays a central role in theories of organizational learning and forgetting. However, we still know little about how knowledge becomes embedded in organizational memory or the reasons and processes through which organizational memory decays. The objective of this article is to clarify the relationship between organizational memory and forgetting, and identify areas that require development if we are to improve our understanding of these constructs. Specifically, we point to the importance of theorizing about (a) the dynamic nature of organizational memory and forgetting, (b) the role of time in theories and research of organizational memory and forgetting, and (c) the processes through which individuals maintain, discard, or remember knowledge, including the dynamics of power.
Agency in Voluntary Organizational Forgetting
Authors: Martin de Holan Pablo
Published: May 2011

This paper studies the different mechanism used in organizations to enact voluntary organizational forgetting. Based on a literature review, previous and original research, four main mechanisms are identified: assets and technologies, routines and procedures, structure and understandings. Each mechanism is discussed and implications are drawn for future research.
Solving the Ecological Problems of Capitalism: Capitalist and Socialist Possibilities
Authors: Jones Andrew W.
Published: May 2011

In this article, the author identifies three ecological problems of capitalism—growth, technology, and consumption—that must be solved to develop a sustainable society. Consistent with previous work, especially in the Marxist ecology tradition, the author argues that overcoming the growth problem requires an alternative to capitalism. This is necessary, though not sufficient: ecological sustainability also depends on overcoming the problems of technology and consumption, which requires an ongoing reform but of a sort only minimally attainable under capitalism. Yet, as the historical record demonstrates, there are no guarantees that socialist alternatives to capitalism will be ecologically sustainable. For socialism to be ecologically sustainable, it must (a) represent a revolutionary break from capitalist approaches toward growth and (b) involve the ongoing reform of technology and consumption, beyond what is possible in capitalism. Examples from the Soviet Union and Cuba illustrate the argument.
Talking Past Each Other? Cultural Framing of Skeptical and Convinced Logics in the Climate Change Debate
Authors: Hoffman Andrew J.
Published: May 2011

This article analyzes the extent to which two institutional logics around climate change—the climate change “convinced” and the climate change “skeptical” logics—are truly competing or talking past each other in a way that can be described as a logic schism. Drawing on the concept of framing from social movement theory, it uses qualitative field observations from the largest climate deniers conference in the United States and a data set of almost 800 op-eds from major news outlets over a 2-year period to examine how convinced and skeptical arguments of opposing logics employ frames and issue categories to make arguments about climate change. This article finds that the two logics are engaging in different debates on similar issues with the former focusing on solutions while the latter debates the definition of the problem. It concludes that the debate appears to be reaching a level of polarization where one might begin to question whether meaningful dialogue and problem solving has become unavailable to participants. The implications of such a logic schism is a shift from an integrative debate focused on addressing interests, to a distributive battle over concessionary agreements with each side pursuing its goals by demonizing the other. Avoiding such an outcome requires the activation of, as yet, dormant “broker” categories (technology, religion, and national security), the redefinition of existing ones (science, economics, risk, ideology), and the engagement of effective “climate brokers” to deliver them.
The Effects of Affluence, Economic Development, and Environmental Degradation on Environmental Concern: A Multilevel Analysis
Authors: Givens Jennifer E. , Jorgenson Andrew K.
Published: May 2011

The authors engage ecological modernization and treadmill of production theories as well as the longstanding postmaterialist values hypothesis and the objective problems subjective values hypothesis to assess the effects of national level affluence, economic growth, and environmental degradation on the likelihood of environmental concern of individuals in 38 nations. Results of multilevel logistic regression analyses indicate that a higher level of national affluence lessens the likelihood of individual-level proenvironmental concern, whereas contrarily, economic development and growth in environmental degradation both increase the likelihood of such values. The authors conclude by considering the theoretical implications of the findings and outlining future steps in this research agenda.
Using Implementation Checklists to Reinforce the Use of Child-Focused Intervention Strategies
Authors: Dinnebeil Laurie , Spino Margie , McInerney William
Published: May 2011

Sonja was preparing for her visit to the Hillcrest Child Development Center to see Nolan, a 3-year-old little boy on an individualized education program (IEP). Nolan attended Hillcrest full-time and was a member of Mr. David’s class. Nolan had difficulties interacting appropriately with his peers. His teachers, David and Ellen, were frustrated with his behavior and had used (unsuccessfully, in Sonja’s opinion) time-out to reduce his inappropriate behavior. For the past month Sonja had been working with David and Ellen to help Nolan learn other, more appropriate ways of interacting with his peers. She had tried all of the ways she knew to help David and Ellen. For example, she had explained repeatedly that sending Nolan to the time-out chair did not appear to be working since Nolan’s
Estimation of single-index models based on boosting techniques
Authors: Leitenstorfer Florian , Tutz Gerhard
Published: May 2011

In single-index models, the link or response function is not considered as fixed. The data determine the form of the unknown link function. In order to obtain a flexible form of the link function, we specify the link function as an expansion in basis function and propose to estimate parameters as well as the link function by weak learners within a boosting framework. It is shown that the method is a strong competitor to existing methods. The method is investigated in simulation studies and applied to real data.
Variable selection in additive models by non-negative garrote
Authors: Cantoni Eva , Flemming Joanna Mills , Ronchetti Elvezio
Published: May 2011

We adapt Breiman’s non-negative garrote method to perform variable selection in non-parametric additive models. The technique avoids methods of testing for which no general reliable distributional theory is available. In addition, it removes the need for a full search of all possible models, something which is computationally intensive, especially when the number of variables is moderate to high. The method has the advantages of being conceptually simple and computationally fast. It provides accurate predictions and is effective at identifying the variables generating the model. To illustrate our procedure, we analyse logbook data on blue sharks ( Prionace glauca) from the US pelagic longline fishery. In addition, we compare our proposal to a series of available alternatives by simulation. The results show that in all cases our methods perform better or as well as these alternatives.
Robust statistical modelling using the multivariate skew t distribution with complete and incomplete data
Authors: Lin Tsung-I , Lin Tzy-Chy
Published: May 2011

Missing data is inevitable in many situations that could hamper data analysis for scientific investigations. We establish flexible analytical tools for multivariate skew t models when fat-tailed, asymmetric and missing observations simultaneously occur in the input data. For the ease of computation and theoretical developments, two auxiliary indicator matrices are incorporated into the model for the determination of observed and missing components of each observation that can effectively reduce the computational complexity. Under the missing at random assumption, we present a Monte Carlo version of the expectation conditional maximization algorithm, which is performed to estimate the parameters and retrieve each missing observation with a single value. Additionally, a Metropolis–Hastings within Gibbs sampler with data augmentation is developed to account for the uncertainty of parameters as well as missing outcomes. The methodology is illustrated through two real data sets.
Non-invited Review: Prevention of microvascular diabetic complications by fenofibrate: lessons from FIELD and ACCORD
Authors: Hermans Michel P
Published: May 2011

Microvascular complications are common in type 2 diabetes in primary care. Intensified management of glycaemia or blood pressure had little effect on microvascular complication rates in recent large trials (ADVANCE, VADT, ACCORD). In 2005, the FIELD study demonstrated a significant reduction in the need for laser treatment for retinopathy, and of progression of renal dysfunction, with fenofibrate versus placebo. The FIELD ophthalmology sub-study showed that fenofibrate reduced the risk of new retinopathy and progression of retinopathy. Also, fenofibrate versus placebo significantly reduced the risk of non-traumatic, diabetes-related amputations in a post-hoc analysis from FIELD. Recently, the results of the ACCORD Lipid study were consistent with these findings, as fenofibrate significantly reduced progression of retinopathy and albuminuria, apparently independent of effects on lipids. These findings suggest a role for fenofibrate in the prevention of major diabetic microvascular complications.
Nash Conjectures and Talent Supply in Sports League Modeling
Authors: Winfree Jason , Fort Rodney
Published: May 2011

This paper attempts to resolve some of the confusion in the sports economics literature regarding conjectures, open and closed leagues, and the invariance principle in sports league modeling. Very few papers model talent level and talent investment by teams separately, which can create confusion regarding open and closed leagues. It is also important that researchers are able to differentiate between the level of talent investment a team makes and their actual talent level which depends on the type of league and the talent choices made by other teams.
Mistaking Style for Substance
Authors: Borooah Vani K. , Mangan John
Published: May 2011

The formation of the Indian Premier League (IPL) in 2008 sought to unlock the commercial potential that the popularity of T20 cricket offered by modeling itself on football’s English Premier League. The IPL acted as a holding company, securing the participation of players through a guaranteed base price and then selling these players to the various IPL franchises though an auction system which determined their final payment. There were thus two components to a player’s “value”: the base price determined by the IPL and the final price paid at the IPL auction by the winning bid for that player. The basic assumption made in this article is that the base price for a player is founded for the most part on the publicly available information about him. However, auction under IPL 2008 was characterized with large and unexpected base–final price differences. This raises the possibility that the bidding process was driven by the “irrational exuberance” created within the newly formed franchises. This article measures the scale of such exuberance and evaluates, on the basis of their IPL record, whether players were good or bad buys.
Aortic Aneurysm Pressure Sensors Can be of Value in the Acute Postoperative Setting
Authors: Gandhi Ripal T. , Katzen Barry T. , Tsoukas Athanassios I. , Geisbüsch Philipp
Published: May 2011

Purpose: To report on a case that demonstrates the use and current limits of abdominal aortic pressure sensor devices. Case report: An 83-year-old, high-risk patient underwent endovascular aortic repair (EVAR) of an infrarenal aortic aneurysm (maximum aneurysm diameter: 6.5 cm) with implantation of a pressure sensor device. At the end of the procedure and on the first postoperative day, the sensor detected persistent high pressures in the aneurysm sac, indicating an endoleak that could not be visualized on the intraoperative completion angiography but was confirmed on duplex ultrasound. During repeated angiography (postoperative day 6), again no endoleak could be detected, this time corresponding with the sensor reading that was unfortunately not interrogated again before the reintervention. Conclusion: Pressure sensor devices provide a useful, additional diagnostic tool in detecting and following endoleaks after EVAR and can help guide decisions regarding reinterventions.
Impact of Intercostal Artery Occlusion on Spinal Cord Ischemia Following Thoracic Endovascular Aortic Repair
Authors: Ullery Brant W. , Quatromoni Jon , Jackson Benjamin M. , Woo Edward Y. , Fairman Ronald M. , Desai Nimesh D. , Bavaria Joseph E. , Wang Grace J.
Published: May 2011

Objective: To evaluate intercostal artery patency following thoracic endovascular aortic repair (TEVAR) and its relationship with spinal cord ischemia (SCI). Methods: Patients with SCI (n = 7) and a matched control cohort (n = 18) were identified from a prospectively maintained database. Radiographic analysis of intercostal patency was assessed using 3-dimensional (3-D)-reconstructed images of pre- and postoperative CT angiograms (1-6 months, 6-12 months, and 1-5 years). Results: Patients with SCI had a higher incidence of perioperative hypotension (P < .01) and longer procedure duration (P = .01). While the mean number of patent intercostal arteries at each time interval was not significantly different between groups, both SCI (P = .002) and control (P <.001) groups demonstrated a significant reduction in patent intercostal arteries in the stented area of the aorta following TEVAR. Conclusion: TEVAR decreases intercostal artery patency in the area of aortic coverage. Our data suggest that intercostal artery patency, in conjunction with perioperative hypotension, is an important contributor to postoperative SCI.
Knowledge Sharing: The Influences of Learning Organization Culture, Organizational Commitment, and Organizational Citizenship Behaviors
Authors: Sung Jun Jo  , Joo Baek-Kyoo
Published: May 2011

This study investigated cultural (learning organization culture), psychological (organizational commitment), and behavioral (organizational citizenship behavior) antecedents of knowledge-sharing intention of employees. The authors’ structural equation model using data collected from 452 Korean workers showed that learning organization culture was significantly associated with organizational commitment, organizational citizenship behavior, and knowledge-sharing intention. Organizational citizenship behavior turned out to fully mediate the relationship between organizational commitment and knowledge-sharing intention. Theoretical and practical implications, limitations, and recommendations for future research are discussed.
Consumption of Purple/Blue Produce Is Associated With Increased Nutrient Intake and Reduced Risk for Metabolic Syndrome: Results From the National Health and Nutrition Examination Survey 1999-2002
Authors: McGill Carla R. , Wightman JoLynne D. , Fulgoni Sally A. , Fulgoni Victor L.
Published: May 2011

To determine the effect of consuming purple/blue fruit and vegetables (P/B) on nutrient intakes and physiological parameters, a secondary analysis of National Health and Nutrition Examination Survey (NHANES) 1999-2002 data for children aged 5 to 18 years (n = 6345) and adults 19+ years (n = 8827) was conducted. Compared with nonconsumers (n = 13 304), P/B consumers (n = 1559) had increased intakes of total fruit (P < .0001), dietary fiber (P ≤ .0001), vitamin C (P < .001), and potassium (P < .0001) and decreased intakes of added sugar (P < .0001). P/B consumers had higher energy intakes (P < .001), but among children, there were no differences in weight or body mass index (BMI) for age between groups; among adults, lower weight and BMI (P < .0001) were found as compared with nonconsumers. Adult P/B consumers had significantly reduced risk for 3 of the 5 risk factors that define the metabolic syndrome (MetS): elevated blood pressure, low HDL cholesterol, and increased waist circumference. An additional analysis for the subgroup of 100% grape juice (GJ) consumers was conducted. GJ consumers (n = 270) also had higher intakes of fruit (P < .001), vitamin C (P < .001), and potassium (P < .005) and lower intakes of added sugar (P < .01) compared with GJ nonconsumers (n = 14 902), with no differences in weight, BMI, or waist circumference. Consumption of P/B produce was associated with increased fruit and nutrient intakes and with reduced risk for MetS. GJ consumption was also associated with increased nutrient intake.
Immigration as a trigger to knife off from delinquency? Desistance and persistence among male adolescents from the Former Soviet Union in Germany
Authors: Zdun Steffen
Published: May 2011

Recent work on desistance from delinquency increasingly considers knifing off — an explicit change of one’s social environment and opportunity structure — but has largely ignored immigration as a cause of knifing off. Interviews with 26 migrants from the Former Soviet Union who were involved in delinquency prior to emigration to Germany show that differences between desisters and persisters with respect to delinquency, agency and the social and structural situation arise just after arrival. Desisters can progress quickly when their agency and motivation are acknowledged in society and when receiving support from new friends and society. Persistence appears to be fostered by quick and repeated negative experiences, and reinforced by making friends who share similar problems rather than providing support in the process of integration.
Optimizing clinical use of mesalazine (5-aminosalicylic acid) in inflammatory bowel disease
Authors: Williams Chadwick , Panaccione Remo , Ghosh Subrata , Rioux Kevin
Published: May 2011

Mesalazine [5-aminosalicylic acid (5-ASA)] has been used for over 30 years in the treatment of inflammatory bowel disease (IBD). It is a highly effective, safe, and well-tolerated drug for treatment of mild to moderate ulcerative colitis, which represents most patients with this disease. Recent studies of patient adherence to 5-ASA therapies in ulcerative colitis have highlighted the need for regimens that enable long-term compliance to significantly reduce the risk of troublesome and debilitating flares in the short term, and possibly colon cancer in the long term. Indeed, much of the recent innovation in clinical use of 5-ASA in colitis has come from studies of novel delivery mechanisms and simplified oral dosing schedules. These studies have provided much needed clarity on essential matters such as starting dose, dose escalation, and efficacy in terms of the ideal clinical endpoint - mucosal healing. Various manufacturers are re-evaluating their products to determine the safety and efficacy of such dosing regimens. Although once widely employed in the treatment of Crohn’s disease (CD), the accumulated body of evidence now suggests that there is a much more limited role for 5-ASA in this particular form of inflammatory bowel disease. Recent 5-ASA randomized-controlled trials, comparative studies, and outcomes research have led to refined treatment strategies and awareness for practitioners to better inform, engage and facilitate patients in optimal use of 5-ASA in inflammatory bowel disease.
Incidental Findings: A Case Study of Benign Liver Masses
Authors: Boodt Cheryl L.
Published: May 2011

Frequently, liver masses are found in the course of medical imaging examinations. This article presents a unique case study with multiple benign liver masses: hemangiomas, focal nodular hyperplasias (FNHs), and liver cell adenomas (LCAs). Most hemangiomas have a characteristic echogenic appearance on sonography and need no further workup. FNH may be difficult to visualize sonographically because it is composed of normal hepatocytes in an abnormal arrangement. LCAs and liver adenomatosis are more serious, requiring medical intervention and monitoring.
CD48 on hematopoietic progenitors regulates stem cells and suppresses tumor formation
Authors: Boles Nathan C. , Lin Kuanyin K. , Lukov Georgi L. , Bowman Teresa V. , Baldridge Megan T. , Goodell Margaret A.
Published: May 2011

The proliferation and differentiation of adult stem cells is balanced to ensure adequate generation of differentiated cells, stem cell homeostasis, and guard against malignant transformation. CD48 is broadly expressed on hematopoietic cells but excluded from quiescent long-term murine HSCs. Through its interactions with CD244 on progenitor cells, it influences HSC function by altering the BM cytokine milieu, particularly IFNγ. In CD48-null mice, the resultant misregulation of cytokine signaling produces a more quiescent HSC, a disproportionate number of short-term progenitors, and hyperactivation of Pak1, leading to hematologic malignancies similar to those found in patients with X-linked lymphoproliferative disease. CD48 plays a vital role as an environmental sensor for regulating HSC and progenitor cell numbers and inhibiting tumor development.
Organization and molecular evolution of a disease-resistance gene cluster in coffee trees
Authors: Ribas Alessandra F , Cenci Alberto , Combes Marie-Christine , Etienne Hervé , Lashermes Philippe
Published: May 2011

Background

Most disease-resistance (R) genes in plants encode NBS-LRR proteins and belong to one of the largest and most variable gene families among plant genomes. However, the specific evolutionary routes of NBS-LRR encoding genes remain elusive. Recently in coffee tree (Coffea arabica), a region spanning the S

H

3 locus that confers resistance to coffee leaf rust, one of the most serious coffee diseases, was identified and characterized. Using comparative sequence analysis, the purpose of the present study was to gain insight into the genomic organization and evolution of the S

H

3 locus.

Results

Sequence analysis of the S

H

3 region in three coffee genomes, Ea and Ca subgenomes from the allotetraploid C. arabica and Cc genome from the diploid C. canephora, revealed the presence of 5, 3 and 4 R genes in Ea, Ca, and Cc genomes, respectively. All these R-gene sequences appeared to be members of a CC-NBS-LRR (CNL) gene family that was only found at the S

H

3 locus in C. arabica. Furthermore, while homologs were found in several dicot species, comparative genomic analysis failed to find any CNL R-gene in the orthologous regions of other eudicot species. The orthology relationship among the S

H

3-CNL copies in the three analyzed genomes was determined and the duplication/deletion events that shaped the S

H

3 locus were traced back. Gene conversion events were detected between paralogs in all three genomes and also between the two sub-genomes of C. arabica. Significant positive selection was detected in the solvent-exposed residues of the S

H

3-CNL copies.

Conclusion

The ancestral S

H

3-CNL copy was inserted in the S

H

3 locus after the divergence between Solanales and Rubiales lineages. Moreover, the origin of most of the S

H

3-CNL copies predates the divergence between Coffea species. The S

H

3-CNL family appeared to evolve following the birth-and-death model, since duplications and deletions were inferred in the evolution of the S

H

3 locus. Gene conversion between paralog members, inter-subgenome sequence exchanges and positive selection appear to be the major forces acting on the evolution of S

H

3-CNL in coffee trees.
Pain, power and patience - A narrative study of general practitioners' relations with chronic pain patients
Authors: Kristiansson Mia Hemborg , Brorsson Annika , Wachtler Caroline , Troein Margareta
Published: May 2011

Background

Chronic pain patients are common in general practice. In this study "chronic pain" is defined as diffuse musculoskeletal pain not due to inflammatory diseases or cancer. Effective patient-physician relations improve treatment results. The relationship between doctors and chronic pain patients is often dysfunctional. Consultation training for physicians and medical students can improve the professional ability to build effective relations, but this demands a thorough understanding of the problems in the relation. Several studies have defined the issues that frequently cause problems, but few have described the process. The aim of this study was to understand and illustrate what GPs' experience in contact with chronic pain patients and what works and does not work in these consultations.

Methods

Our theoretical perspective is constructivist, based upon the relativist view that individuals construct realities to understand and navigate the world. Five Swedish General Practitioners (GPs), two male and three female, were interviewed and asked to tell a story about a difficult encounter with a chronic pain patient. Tapes of the interviews were transcribed and analysed using narrative analysis. Three GPs told narratives suited for our analytic tools and these were included in the final results.

Results

Each narrative highlights a certain dilemma and a strategy. The dilemmas were: power game; good intentions that fail when a patient is persuaded against her own conviction; persuasion of the unwilling; transferred tiredness; distrust and dissociation from the patient. Professional strategies of listening, encouraging and teamwork were central to handling difficult situations.

Conclusions

The narratives show that GP's consultations with chronic pain patients sometimes are characterized by conflicts and difficult situations. They are facilitated by methods such as active listening and teamwork, but still may remain hard to handle. This has not before been studied among Swedish GPs. Narratives based on experience are known to be successful in education and this study suggest how narratives can serve as a training of consultation for medical students, but also in Continuing Professional Development groups for experienced doctors in practice.
The association of serum lipids with the histological pattern of rectosigmoid adenoma in Taiwanese adults
Authors: Sun Zih-Jie , Huang Ying-Hsiang , Wu Jin-Shang , Yang Yi-Ching , Chang Ying-Fang , Lu Feng-Hwa , Chang Chih-Jen
Published: May 2011

Background

The mortality rate of colorectal cancer ranks third behind lung and hepatic cancer in Taiwan. Colorectal cancer mostly arises from adenomatous polyps of left colon. The aim of our study was to examine the association of serum lipids with the histological pattern of rectosigmoid adenoma.

Methods

There were 2,506 eligible examinees aged 20 and above who underwent sigmoidoscopy as a screening examination in National Cheng Kung University Hospital between January 2003 and October 2006. They were classified into three groups: tubular adenoma (333 subjects), villous-rich (tubulovillous/villous) adenoma (53 subjects) and normal (2,120 subjects). We defined high total cholesterol (TC) as a level ≧200 mg/dl, low high-density lipoprotein cholesterol (HDL-C) as a level <40 mg/dL, and high triglyceride (TG) as a level ≧200 mg/dl according to the third report of the National Cholesterol Education Program expert panel on detection, evaluation, and treatment of high blood cholesterol in adults. Adenoma histology was classified as tubular, tubulovillous and villous according to the proportion of villous part.

Results

Among the study population, 333 subjects (13.3%) had tubular adenomas and 53 subjects (2.1%) had villous-rich adenomas. The odds ratio (OR) for villous-rich adenoma in subjects with TG≧200 mg/dL compared to those with TG < 200 mg/dL was 3.20 (95% confidence interval [CI]:1.71-6.01), after adjusting for age, gender, general obesity, central obesity, diabetes, hypertension, smoking, and alcohol consumption. If further taking high TC and low HDL-C into consideration, the OR was 4.42 (95% CI:2.03-9.63).

Conclusions

Our study showed that subjects with high serum TG tended to have a higher risk of tubulovillous/villous adenoma in rectosigmoid colon. Therefore, reducing the serum TG level might be one method to prevent the incidence of colorectal cancer.
Adenoviral infectivity of exfoliated viable cells in urine: Implications for the detection of bladder cancer
Authors: Murali Anuradha , Kasman Laura , Voelkel-Johnson Christina
Published: May 2011

Background

Bladder cancer, the 5th most common malignancy in the USA, is often detected as a result of incidental findings or by presenting hematuria. Once diagnosed the disease is one of the costliest cancers to treat due to frequent, invasive and often lifelong follow-up procedures. Because cells are shed into urine, there has been an emerging effort to develop non-invasive tests for the detection of bladder cancer. Expression of survivin, a member of the inhibitor of apoptosis protein family, has been associated with bladder cancer. Therefore, the goal of this study was to determine the feasibility of transducing viable exfoliated cells obtained from urine with an adenoviral vector in which a reporter gene is under the control of the survivin promoter.

Methods

Exfoliated cells from urine were obtained from 36 human subjects (> 40 years old). An adenovirus in which GFP expression is under control of the survivin promoter (Ad.Surv.GFP) was generated. An adenovirus in which GFP is expressed from the CMV promoter served as a control. GFP expression was analyzed by fluorescent microscopy and quantified by flow cytometry.

Results

Short-term cultures from exfoliated cells in urine could be established in 16 of 31 samples. These cultures were successfully transduced with Ad.CMV.GFP. Analysis of GFP expression following transduction with Ad.Surv.GFP, indicated that the survivin promoter was preferentially active in UM-UC-3 bladder cancer cells compared to non-malignant UROtsa cells. Interestingly, baseline levels of GFP expression in cultures from exfoliated cells in urine exhibited higher baseline levels than UROtsa following transduction with Ad.Surv.GFP.

Conclusions

We demonstrated the feasibility of establishing and analysing short-term cultures isolated from exfoliated cells in voided urine by means of adenoviral transduction, thereby forming the foundation for future studies to determine the specificity and sensitivity of a non-invasive test based on survivin promoter activity.
Strain engineering for improved expression of recombinant proteins in bacteria
Authors: Makino Tomohiro , Skretas Georgios , Georgiou George
Published: May 2011

Protein expression in Escherichia coli represents the most facile approach for the preparation of non-glycosylated proteins for analytical and preparative purposes. So far, the optimization of recombinant expression has largely remained a matter of trial and error and has relied upon varying parameters, such as expression vector, media composition, growth temperature and chaperone co-expression. Recently several new approaches for the genome-scale engineering of E. coli to enhance recombinant protein expression have been developed. These methodologies now enable the generation of optimized E. coli expression strains in a manner analogous to metabolic engineering for the synthesis of low-molecular-weight compounds. In this review, we provide an overview of strain engineering approaches useful for enhancing the expression of hard-to-produce proteins, including heterologous membrane proteins.