bluuebunny/crossref_metadata_2025 huggingface dataset:
Regulation of chemokine responses in intestinal epithelial cells by stress andToxoplasma gondiiinfection
Authors: GOPAL R. , BIRDSELL D. , MONROY F. P.
Published: July 2010

Infection withToxoplasma gondiiinduces chemokine up‐regulation in several cell types. Here, we investigated the role of stress products (norepinephrine, NE) on chemokine production in mouse intestinal epithelial cells (IECs). Purified IECs were used to determine the expression levels of chemokines by real‐time PCR. There was significantly increased expression in CCL2, CCL3, CCL5, CXCL2, CXCL9 and CXCL10 in IECs following peroral infection withT. gondii(INF) on day eight post‐infection (PI) compared to infected mice subjected to cold‐water stress (INF+CWS).In vitrostudies using the MODE‐K cell line showed increased chemokine mRNA and protein expression in infected but not in cells exposed to parasite antigen. Down‐regulation of chemokine expression was more pronounced when active infection was used in combination with NE. Chemokine receptor expression was increased in IECs isolated from INF and decreased in the INF+CWS group. In MODE‐K cells, there was decreased mRNA expression of chemokine receptors when incubated with β‐adrenergic antagonists. Neither, adrenergic antagonists blocked the effect of infection on chemokine receptor expression. Cold‐water stress was able to decrease expression of chemokines and their receptors in IECsin vivoandin vitro. Cold‐water stress‐mediated modulation of innate intestinal responses are beneficial in C57BL/6 mice duringT. gondiiinfection.
Silicification of sulphate evaporites and their carbonate replacements in Eocene marine sediments, Tunisia: two diagenetic trends
Authors: HENCHIRI MOHSEN , SLIM‐S'HIMI NAJET
Published: July 2010

Samples of chert nodules, diagenetic carbonates and evaporites (gypsum/anhydrite) collected from the gypsiferous limestones of the Kef Eddour Member (Ypressian‐Priabonian) near Metlaoui and Sehib (Tunisia) show selective silicification with great variety in the silicified by‐products. Based on δ13C values, which support an organic origin for the carbon, carbonates replaced evaporites microbially through bacterial sulphate reduction. Observations and results suggest two scenarios for chert formation that are related to the rate and timing of diagenetic carbonate replacement of the evaporites (anhydrite/gypsum). In the absence of early diagenetic carbonate phases, silica with δ18O values from +25 to +28·6‰ [standard mean ocean water (SMOW)] replaced the outer parts of anhydrite nodules at pH < 9. In contrast, pore‐fluid pH values > 9 in the innermost parts of the anhydrite nodules prevented silica precipitation. The record of this chemical barrier is preserved in the microquartz rims and geode features that formed in the inner parts of the nodules after dissolution of the anhydrite nucleus. The microbial diagenetic replacement of evaporites (bacterial sulphate reduction) by carbonates (calcite, aragonite and dolomite) favoured silica replacement of carbonates rather than evaporites. Silica, with δ18O signature of +21 to +26‰ (SMOW), replaced carbonates on a volume‐for‐volume basis, yielding a more siliceous groundmass, and accounting for 90–95% of the nodules. The relatively higher δ18O values of quartz replacing anhydrite can be explained by a diagenetic fluid in equilibrium with mixed (meteoric/marine) to marine water. The lower δ18O values of the quartz that replaced the diagenetic carbonates are ascribed to flushing by meteoric water in a later diagenetic stage. The silica supply for chert formation could be derived from the reworked bio‐siliceous deposits (diatomites) to the west of the basin [vestiges of an opal‐CT precursor undetectable by X‐ray diffraction (XRD) were revealed by δ29Si magic‐angle‐spinning nuclear magnetic resonance investigations], diagenesis of the extraformational and overlying clay‐rich beds (the host limestones are clay‐poor as shown by XRD measurements), and minor volcanogenic and hydrothermal contributions during early diagenetic stages.
Prophylactic control of post‐operative nausea and vomiting using ondansetron and ramosetron after cardiac surgery
Authors: CHOI D. K. , CHIN J. H. , LEE E. H. , LIM O. B. , CHUNG C. H. , RO Y. J. , CHOI I. C.
Published: July 2010

Background: The aim of this study was to evaluate the efficacy of ondansetron and ramosetron in the reduction of post‐operative nausea and vomiting (PONV) associated with patient‐controlled analgesia (PCA) after cardiac surgery.

Methods: A total of 320 patients scheduled for elective cardiac surgery were enrolled. Patients were randomly assigned to one of four treatment regimens (n=80 in each group): no prophylactic antiemetics (group P); intravenous (i.v.) ondansetron 4 mg at the end of surgery and 12 mg added to PCA (group O); i.v. ramosetron 0.3 mg at the end of surgery and no antiemetics added to PCA (group R1); and i.v. ramosetron 0.3 mg at the end of surgery and 0.6 mg added to PCA (group R2).

Results: The incidence of PONV during the 48‐h post‐operative period was lower in groups O (46%), R1 (54%), and R2 (35%) compared with group P (71%, P<0.001). The incidence and severity of nausea were lower in groups O, R1, and R2 than in group P during the 24‐h post‐operative period, whereas the incidence and severity of nausea during 24–48 h after surgery were lower in groups O and R2, but not in group R1, than in group P. Compared with group P (53%), the frequency of rescue antiemetic usage was significantly lower in groups O (34%) and R2 (29%), but not in group R1 (43%).

Conclusion: The addition of either ondansetron or ramosetron to PCA can reduce the incidence of PONV during 48 h after cardiac surgery.
Behavioural and biomaterial coevolution in spider orb webs
Authors: SENSENIG A. , AGNARSSON I. , BLACKLEDGE T. A.
Published: July 2010

Mechanical performance of biological structures, such as tendons, byssal threads, muscles, and spider webs, is determined by a complex interplay between material quality (intrinsic material properties, larger scale morphology) and proximate behaviour. Spider orb webs are a system in which fibrous biomaterials—silks—are arranged in a complex design resulting from stereotypical behavioural patterns, to produce effective energy absorbing traps for flying prey. Orb webs show an impressive range of designs, some effective at capturing tiny insects such as midges, others that can occasionally stop even small birds. Here, we test whether material quality and behaviour (web design) co‐evolve to fine‐tune web function. We quantify the intrinsic material properties of the sticky capture silk and radial support threads, as well as their architectural arrangement in webs, across diverse species of orb‐weaving spiders to estimate the maximum potential performance of orb webs as energy absorbing traps. We find a dominant pattern of material and behavioural coevolution where evolutionary shifts to larger body sizes, a common result of fecundity selection in spiders, is repeatedly accompanied by improved web performance because of changes in both silk material and web spinning behaviours. Large spiders produce silk with improved material properties, and also use more silk, to make webs with superior stopping potential. After controlling for spider size, spiders spinning higher quality silk used it more sparsely in webs. This implies that improvements in silk quality enable ‘sparser’ architectural designs, or alternatively that spiders spinning lower quality silk compensate architecturally for the inferior material quality of their silk. In summary, spider silk material properties are fine‐tuned to the architectures of webs across millions of years of diversification, a coevolutionary pattern not yet clearly demonstrated for other important biomaterials such as tendon, mollusc byssal threads, and keratin.
REVIEW: The evolution of polyembryony in parasitoid wasps
Authors: SEGOLI M. , HARARI A. R. , ROSENHEIM J. A. , BOUSKILA A. , KEASAR T.
Published: July 2010

Polyembryony has evolved independently in four families of parasitoid wasps. We review three main hypotheses for the selective forces favouring this developmental mode in parasitoids: polyembryony (i) reduces the costs of egg limitation; (ii) reduces the genetic conflict among offspring; and (iii) allows offspring to adjust their numbers to the quality of the host. Using comparative data and verbal and mathematical arguments, we evaluate the relative importance of the different selective forces through different evolutionary stages and in the different groups of polyembryonic wasps. We conclude that reducing the cost of egg limitation is especially important when large broods are favoured. Reducing genetic conflict may be most important when broods are small, thus might have been important during, or immediately following, the initial transition from monoembryony to polyembryony. Empirical data provide little support for the brood‐size adjustment hypothesis, although it is likely to interact with other selective forces favouring polyembryony.
Requirement for ErbB2/ErbB signaling in developing cartilage and bone
Authors: Fisher Melanie C. , Clinton Gail M. , Maihle Nita J. , Dealy Caroline N.
Published: July 2010

During endochondral ossification, the skeletal elements of vertebrate limbs form and elongate via coordinated control of chondrocyte and osteoblast differentiation and proliferation. The role of signaling by the ErbB family of receptor tyrosine kinases, which consists of ErbB1 (epidermal growth factor receptor or EGFR), ErbB2, ErbB3 and ErbB4, has been little studied during cartilage and bone development. Signaling by the ErbB network generates a diverse array of cellular responses via formation of ErbB dimers activated by distinct ligands that produce distinct signal outputs. Herstatin is a soluble ErbB2 receptor that acts in a dominant negative fashion to inhibit ErbB signaling by binding to endogenous ErbB receptors, preventing functional dimer formation. Here, we examine the effects of Herstatin on limb skeletal element development in transgenic mice, achieved via Prx1 promoter‐driven expression in limb cartilage and bone. The limb skeletal elements of Prx1‐Herstatin embryos are shortened, and chondrocyte maturation and osteoblast differentiation are delayed. In addition, proliferation by chondrocytes and periosteal cells of Prx1‐Herstatin limb skeletal elements is markedly reduced. Our study identifies requirements for ErbB signaling in the maintenance of chondrocyte and osteoblast proliferation involved in the timely progression of chondrocyte maturation and periosteal osteoblast differentiation.
Stem cell system in asexual and sexual reproduction of Enchytraeus japonensis (Oligochaeta, Annelida)
Authors: Yoshida‐Noro Chikako , Tochinai Shin
Published: July 2010

Enchytraeus japonensis is a small oligochaete species that proliferates asexually via fragmentation and regeneration. As sexual reproduction can also be induced, it is a good model system for the study of both regenerative and germline stem cells. It has been shown by histological study that putative mesodermal stem cells called neoblasts, and dedifferentiated epidermal and endodermal cells are involved in blastema formation. Recently, we isolated three region‐specific marker genes expressed in the digestive tract and showed by in situ hybridization that morphallactic as well as epimorphic regulation of the body patterning occurs during regeneration. We also cloned two vasa‐related genes and analyzed their expression during development and in mature worms that undergo sexual reproduction. The results arising form these studies suggest that the origin and development of germline stem cells and neoblasts may be independent. Furthermore, we carried out functional analysis using RNA interference (RNAi) and showed that a novel gene termed grimp is required for mesodermal cell proliferation at the initial stages of regeneration. These findings indicate that the stem cell system in E. japonensis is regulated by both internal and external environmental factors.
An unusual presentation of Castleman's disease
Authors: BAYSUNGUR Volkan , TEZEL Cagatay , OKUR Erdal , ERGENE Gokhan , OZVARAN Kursat , HALEZEROGLU Semih
Published: July 2010

Castleman's disease is one of the heterogeneous group of lymphoproliferative disorders of unknown aetiology. It commonly presents as a mediastinal mass. It can be unicentric involving only a single site, or multicentric involving multiple sites. We report a patient with unicentric Castleman's disease, in which the mass was located in the posterior mediastinum and accompanied by a massive pleural effusion, which is extremely rare in unicentric disease. This case report highlights the imaging techniques used in the differential diagnosis and surgical considerations due to the hypervascular nature of the tumour.
Significance of the progression of respiratory symptoms for predicting community‐acquired pneumonia in general practice
Authors: NAKANISHI Masanori , YOSHIDA Yoshimasa , TAKEDA Nobuya , HIRANA Hirohumi , HORITA Takahiro , SHIMIZU Kazuhiko , HIRATANI Kazuyuki , TOYODA Shigeo , MATSUMURA Takayuki , SHINNO Eizi , KAWAI Satoru , FUTAMURA Akihiro , OTA Masanari , NATAZUKA Toshiki
Published: July 2010

Background and objective:  Early diagnosis improves outcomes in patients with community‐acquired pneumonia (CAP). However, prediction of CAP based on symptoms and signs is difficult. The present study investigated the evaluation of progression of symptoms as a factor for predicting the occurrence of CAP in general practice.

Methods:  Consecutive patients (n = 406) suspected of having CAP on routine clinical examination were studied retrospectively. Selection of patients with suspected CAP was based on progression of symptoms after 5 days, as well as published criteria. Diagnostic yields for the recommended criteria and our proposed criteria were then compared. Scoring systems for the prediction of CAP were designed, based on the results of multiple regression analysis. The diagnostic performance of these systems, including or excluding symptom progression, was compared using the areas under receiver operating characteristic curves.

Results:  The sensitivity and specificity of the recommended criteria and our proposed criteria were 0.75 and 0.44, and 0.93 and 0.38, respectively. Sputum production, dyspnoea, fever > 38°C, heart rate > 100 beats/min, decreased breath sounds, coarse crackles and progression of symptoms significantly increased the likelihood of CAP. Areas under receiver operating characteristic curves analysis showed that the diagnostic prediction of CAP was significantly improved when the scoring system included progression of symptoms.

Conclusions:  Progression of symptoms was a significant factor for predicting CAP and selecting patients who required CXR. Inclusion of progression of symptoms among the other recommended criteria, namely, dyspnoea, fever > 38°C, heart rate > 100 beats/min and abnormal chest findings, improved prediction of the incidence of CAP in general practice.
Reticular basement membrane fragmentation and potential epithelial mesenchymal transition is exaggerated in the airways of smokers with chronic obstructive pulmonary disease
Authors: SOHAL Sukhwinder S. , REID David , SOLTANI Amir , WARD Chris , WESTON Steven , MULLER H. Konrad , WOOD‐BAKER Richard , WALTERS Eugene H.
Published: July 2010

Background and objective: In COPD, the airways are chronically inflamed, and we have now observed fragmentation of the reticular basement membrane (Rbm). This appears to be a hallmark of the process known as epithelial mesenchymal transition (EMT), in which epithelial cells migrate through the Rbm and differentiate into fibroblasts. The aim of this study was to confirm the extent and relevance of Rbm fragmentation in smokers and patients with COPD, and to undertake a preliminary analysis of some classical markers of EMT.

Methods: Endobronchial biopsies from current smokers (CS;n = 17) and ex‐smokers with COPD (ES;n = 15), smokers with normal lung function (NS;n = 16) and never‐smoking control subjects (NC;n = 15) were stained for the EMT markers, S100A4, vimentin, epidermal growth factor receptor and matrix metalloproteinase‐9.

Results: Compared with NC, there was significant Rbm fragmentation in the CS, ES and NS groups, which was positively associated with smoking history in subjects with COPD. Staining for basal epithelial S100A4, epithelial epidermal growth factor receptor and matrix metalloproteinase‐9 in cells within Rbm clefts, and for S100A4 in Rbm cells, was increased in the CS, NS and ES groups compared with the NC group. There was also increased Rbm cell S100A4 staining in the CS group compared with the ES and NS groups. Basal epithelial cell staining for S100A4 was inversely correlated with airflow limitation. Double staining for both S100A4 and vimentin further strengthened the likelihood that these changes represented active EMT.

Conclusions: This is the first detailed description of fragmentation and cellularity of the Rbm in smokers, which were most marked in subjects with COPD. The data are consistent with active EMT in these subjects.
Spirometry and impulse oscillometry (IOS) for detection of respiratory abnormalities in metropolitan firefighters
Authors: SCHERMER Tjard , MALBON Winifred , NEWBURY Wendy , HOLTON Christine , SMITH Michael , MORGAN Michael , CROCKETT Alan
Published: July 2010

Background and objective:  As firefighters are at increased risk of adverse health effects, periodic examination of their respiratory health is important. The objective of this study was to establish whether the use of impulse oscillometry (IOS) reveals respiratory abnormalities in metropolitan firefighters that go undetected during routine respiratory health screening by spirometry and assessment of respiratory symptoms.

Methods:  This was a cross‐sectional analysis of spirometry, IOS and questionnaire data from 488 male firefighters. Abnormal spirometry was defined as FEV1, FEV1/FVC and/or FEF50 below the lower limit of normal. Abnormal IOS was defined as resistance at 5 Hz (R5), frequency dependence of resistance (ΔR5‐R20) and/or reactance area (AX) above the upper limit of normal. Respiratory symptoms, smoking history, exposures and medical history were assessed. Data were analysed using logistic and linear regression models.

Results:  The mean age of the firefighters was 43.8 (SD 8.4) years. There were 123 (25%) former smokers and 50 (10%) current smokers. Abnormal spirometry was detected in 12%, abnormal IOS in 9% and respiratory symptoms in 20% of firefighters. Current smoking was associated with all IOS parameters (OR for R5 = 3.1, OR for ΔR5‐R20 = 7.7, OR for AX = 4.3), and with FEF50 (OR = 9.1), chronic productive cough (OR = 4.0) and breathlessness (OR = 5.4) (P < 0.05 for all). Exposure during firefighting duties was associated with chronic productive cough (OR = 2.6), but not with spirometry or IOS parameters. Interaction terms in the linear regression models indicated associations between smoking and ΔR5‐R20, and also between smoking and AX, in the lowest and second lowest quartiles of spirometry parameters.

Conclusions:  Application of IOS for the assessment of respiratory health in firefighters identified airways dysfunction in some individuals, even when spirometry values were within the normal range and there were no respiratory symptoms.
Brief telephone intervention increases testing for osteoporosis in patients treated in emergency departments for wrist fractures
Authors: Kelly A‐M. , Clooney M. , Kerr D. , Ebeling P. R.
Published: July 2010

Previous studies show that identification and treatment of osteoporosis in patients with minimal trauma fractures treated as outpatients are poor. Our aim was to test two interventions designed to increase rates of identification and treatment. This prospective, action research study, using explicit medical record review and scripted telephone interview, was conducted at emergency departments (ED) of three hospitals from April 2007 to February 2008. Participants were patients aged over 50 years who were treated as outpatients with a minimal trauma wrist fracture. Data collected included demographic and fracture details, bone density testing and osteoporosis‐related medication change. There were two interventions staff education in ED and fracture clinic and information provided to patients by telephone by a research nurse. These interventions were applied to all patients sequentially. The outcome measure of interest was the proportion of patients who underwent bone density testing (DEXA scans) in the follow‐up period, analysed by intervention (clinic or phone). One hundred and seventeen patients were studied. Eighty‐six per cent were female; median age 64 years. Ten per cent (12/117) of the ED/clinic intervention group had undergone testing at follow up. At follow up after the telephone intervention 55% (65/117) had undergone testing (P < 0.001, χ2). Patients undergoing testing were significantly more likely to have an osteoporosis‐related medication change (relative risk 6.8, 95% CI 2.8–17.9). A brief telephone intervention and provision of information pack significantly improved testing rates for osteoporosis after minimal trauma wrist fracture. An ED/clinic‐based intervention resulted in low rates of testing. Treatment of clinical osteoporosis remains suboptimal.
Palliative medicine trainees and their mandatory oncology module
Authors: Landers A.
Published: July 2010

Palliative medicine trainees are currently required to complete 36 months of core and non‐core training, including a 6‐month oncology module. There are presently few published data from palliative medicine trainees regarding the structure and appropriateness of their curriculum. The aim of this study was to evaluate skills related to the Royal Australasian College of Physicians essential learning objectives and the experiences gained by the individuals during their oncology training. An investigator‐designed questionnaire was emailed out to all current Australasian trainees or first year consultants. A 45% response rate was achieved. Women were significantly more negative in their responses to the improvement of communication skills and the understanding of ethics. Chapter trainees rated improved leadership and future management skills lower than other respondents. Fifty‐eight per cent of the respondents believed the oncology module should remain mandatory. Although valuable, a more tailored and flexible approach to this part of training should be considered.
Effects of a heat‐ and steam‐generating sheet on relieving symptoms of primary dysmenorrhea in young women
Authors: Hosono Takayoshi , Takashima Yukari , Morita Yuki , Nishimura Yukako , Sugita Yoshiko , Isami Chika , Sakamoto Ichiro , Tagami Kyoko , Hidaka Yuki , Suzuki Atsushi
Published: July 2010

Aim:  To test the efficacy of heat‐ and steam‐generating (HSG) sheets for the relief of symptoms of primary dysmenorrhea in young women.

Materials & Methods:  Thirty‐four female university students were enrolled in this study. HSG sheets generate moist heat to keep the attached body area at 38.5 °C for 8 h. Subjects attached the HSG sheet to the lower abdominal or lumbar region for 5 to 8 h once a day on the first, second and third days of menstruation. Subjects documented symptoms of dysmenorrhea (abdominal pain, lumbago and lumbar dullness) on a self‐recording form using a 4‐score scale of 0 (mild) to 3 (severe) just before applying and after removing the HSG sheet. Either a small (54 cm2) or large (164 cm2) HSG sheet was used for warming.

Results:  By applying HSG sheets on the abdomen or lumbar region, 57 and 63% of subjects felt relief of abdominal pains, and 54 and 61% of subjects felt relief from lumbago on the first and second days of menstruation, respectively. Applying the HSG sheets was significantly effective to relieve symptoms compared to the control. Small and large HSG sheets were equally effective. Applying HSG sheets to the abdomen was as effective as that to the lumbar region except for cases of lumbago on the second day of menstruation. Applying HSG sheets two days prior to the onset of menstruation was more effective in relieving lumbar dullness on the second day of menstruation than those just before its onset.

Conclusion:  HSG sheets are useful as non‐pharmacological methods to relieve symptoms of primary dysmenorrhea.
Complete remission with intraperitoneal cisplatin followed by prolonged oral etoposide in a stage IIIc primary leiomyosarcoma of the fallopian tube patient
Authors: Kobayashi Yoichi , Tozawa Akiko , Okuma Yoshiaki , Kiguchi Kazushige , Ishizuka Bunpei
Published: July 2010

Leiomyosarcoma (LMS) of the fallopian tube is exceedingly uncommon. So far as we investigated, only eighteen cases of LMS of the fallopian tube have been reported. Here we report a nineteenth case which was International Federation of Gynecology and Obstetrics stage IIIc LMS of the fallopian tube successfully treated with intraperitoneal cisplatin followed by prolonged oral etoposide. A 70‐year‐old female was introduced to our institute due to intrapelvic tumor and ascites. Because of elevated serum lactate dehydrogenase and CA125 as well as the findings of pelvic magnetic resonance imaging and computerized tomography, the patient was suspected to have ovarian cancer. In laparotomy, the large pelvic tumor was seemed to originate from the right fallopian tube. Pathologically, the patient was diagnosed as stage IIIc fallopian tube LMS. At the end of the operation, cisplatin was given intraperitoneally followed by prolonged oral etoposide. Although a lot of dissemination was noted throughout the peritoneal cavity, the patient is alive without any evidence of recurrence for more than 6 years since the initial operation. In this uncommon entity, a cisplatin‐ and etoposide‐based regimen could be considered.
Early childhood stunting and later fine motor abilities
Authors: CHANG SUSAN M , WALKER SUSAN P , GRANTHAM‐MCGREGOR SALLY , POWELL CHRISTINE A
Published: July 2010

Aim  The aim of this study was to determine the effects of early childhood stunting (height for age 2SD or more below reference values) and interventions on fine motor abilities at 11 to 12 years, and the relationship between fine motor abilities and school achievement and intelligence.

Method  A cohort of stunted children who had participated in a randomized trial of psychosocial stimulation and/or nutritional supplementation in early childhood was compared with a group of non‐stunted children. Fine motor abilities were assessed in 116 stunted (67 males, 49 females) and 80 non‐stunted children (43 males, 37 females) at a mean age of 11 years 8 months (SD 4.3mo) and 11 years 9 months (SD 3.8mo) respectively. Testers were blind to the children’s group assignment.

Results  Two fine motor factors were derived: rapid sequential continuous movements (RSCM) and dexterity. No effect of the early intervention was found. RSCM scores were lower in the stunted group than in the non‐stunted group (p=0.01), but differences in dexterity were not significant (p=0.18) after adjusting for social background. Among stunted children, the RSCM score was significantly associated with IQ (p=0.04) and school achievement (all p<0.05).

Interpretation  Stunting in early childhood is associated with poor scores on tests of rapid sequential continuous hand movements in later childhood. Children with poorer scores are at greater risk for low IQs and low levels of school achievement.
Home economics as an integrated, holistic system: revisiting Bubolz and Sontag's 1988 human ecology approach
Authors: McGregor Sue L.T.
Published: July 2010

This article explores how Bubolz and Sontag's seminal work on integration in home economics and human ecology can inform contemporary home economics practice. They argue that the human ecology perspective can be used to view the whole of home economics, and the subprofessions (specializations) within the whole, as diverse yet unified. This article employs a spider plant as a metaphor to illustrate the value of embracing the notion of home economics as an integrated, holistic system.
Patients’ experiences of physical limitations in daily life activities when suffering from chronic heart failure; a phenomenographic analysis
Authors: Pihl Emma , Fridlund Bengt , Mårtensson Jan
Published: July 2010

Scand J Caring Sci; 2011; 25; 3–11
 
Patients’ experiences of physical limitations in daily life activities when suffering from chronic heart failure; a phenomenographic analysis

The aim of the study was to describe how patients suffering from chronic heart failure conceived their physical limitations in daily life activities. An explorative and qualitative design with a phenomenographic approach was chosen, a total of 15 patients were interviewed. The findings indicate that participants perceived a variety of structural aspects pertaining to physical limitations in activities of daily life which resulted in four referential aspects. Need of finding practical solutions in daily life focused on how life had to be changed and other ways of performing activities of daily life had to be invented. Having realistic expectations about the future was characterised by belief that the future itself would be marked by change in physical functioning, but an incentive to maintain functions and activities ensured good quality of or even increased capacity in daily life. Not believing in one’s own ability included the perception of having no opportunity to improve ability to perform activities of daily life. There were perceptions of undesired passivity, undefined fear of straining themselves or performing activities that could endanger their health in addition to uncertainty about the future. In Losing one’s social role in daily life, participants described losing their social network and their position in society and family because of limited physical capacity. A lack of important issues, mental and physical, occurred when physical capacity was lost. In conclusion, patients suffering from chronic heart failure found new solutions to manage activities in daily life, including willingness to change focus and identify other ways of doing important things. Patients had an incentive to maintain functions and activities to ensure a good quality of and strengthen their physical capacity in daily life. Inability to trust in their physical capacity in combination with experienced limitations in daily life prevented patients from attempting to increase activities.
Administrative Data and Economic Policy Evaluation*
Authors: DEARDEN LORRAINE
Published: July 2010

This article looks at the strengths and weaknesses of using administrative data for economic policy evaluation. It does this by looking at how school administrative data have been used to assess school effectiveness and the impact of month of birth on educational outcomes with varying degrees of success. It concludes that if there is some natural experiment in the way that education is delivered or an education initiative is introduced, then schools’ administrative data offer the opportunity of answering questions of extreme policy interest in a robust way – even without rich background information on the students and their families.
Adoption and Abandonment of Organic Farming: An Empirical Investigation of the Irish Drystock Sector
Authors: Läpple Doris
Published: July 2010

There is a considerable literature about the adoption of organic farming. However, possible abandonment of organic farming has received scant attention. Thus, relatively little is known about the exit decisions of farmers. In addition, most studies are based on a static framework where it is not possible to account for changes in farmer decisions over time. This article attempts to fill this gap in the literature by investigating the determinants that affect both adoption and abandonment of organic drystock farming over time. The use of duration analysis allows for the consideration of cross‐sectional and time‐varying factors over the study period from 1981 to 2008. Using this dynamic econometric framework revealed a significant time effect on entry and exit decisions. Overall, the results highlight that where no attempt is made to account for exit decisions and time effects, important information about sustainable farmer decisions may not be taken into consideration.
Correlation of liver biochemistry with liver stiffness in chronic hepatitis B and development of a predictive model for liver fibrosis
Authors: Fung James , Lai Ching‐Lung , Fong Daniel Yee‐Tak , Yuen John Chi‐Hang , Wong Danny Ka‐Ho , Yuen Man‐Fung
Published: July 2010

Aim: To correlate liver stiffness with demographical factors and routine liver biochemistry and to assess the predictive value of these as potential markers of fibrosis.

Methods: Transient elastography was performed in 1268 chronic hepatitis B (CHB) patients. According to a previous validated study for CHB, liver stiffness of >8.1 and >10.3 kPa were used as cut‐off values for defining severe fibrosis and cirrhosis respectively.

Results: Liver stiffness correlated positively with bilirubin, alkaline phosphatase (ALP), γ‐glutamyl transpeptidase (GGT), aspartate aminotransferase (AST), alanine aminotransferase (ALT), globulin, α‐fetoprotein (AFP) and HBV DNA levels and negatively with albumin and platelet levels (P<0.05 for all correlations). From 13 parameters (age, sex, platelet, AST, ALT, GGT, AFP, albumin, globulin, bilirubin, ALP, HBV DNA and hepatitis B e‐antigen), four best parameters (AST, platelet, GGT and AFP) were used to derive a liver stiffness model. Using log (index)=1.44+0.1490(GGT)+0.3308 log (AST)−0.5846 log (platelets)+0.1148 log (AFP+1) to predict both severe fibrosis and cirrhosis had area under the receiver operating characteristics curve of 0.85.

Conclusion: Routine liver biochemistry correlated well with liver stiffness in Asian CHB patients. A model using simple serum markers can predict liver stiffness, and further studies are required to validate the usefulness of these simple tests as non‐invasive markers of fibrosis in CHB.
Quantitative EEG in Patients With Alcohol‐Related Seizures
Authors: Sand Trond , Bjørk Marte , Bråthen Geir , Michler Ralf P. , Brodtkorb Eylert , Bovim Gunnar
Published: July 2010

Background:  To investigate whether quantitative electroencephalography (QEEG) recorded within a few days after a generalized seizure can improve the discrimination between alcohol‐related seizures (ARSs), seizures in epilepsy and other seizures. In addition, we wanted to evaluate the influence of various external factors on QEEG, e.g., drug use, time from seizure occurrence, and alcohol intake.

Methods:  An ARS was defined by (i) scores ≥8 in the Alcohol Use Disorders Identification Test (AUDIT) and (ii) no history of epilepsy. Twenty‐two ARS patients, 21 epileptic patients with seizures (ES), 30 AUDIT‐negative patients with seizures (OS), and 37 well‐controlled epileptic outpatients (EPO) were included. EEG from 79 sciatica patients (SC) served as an additional control group. EEG was recorded in relaxed wakefulness with eyes closed. Spectral analysis of ongoing resting EEG activity was performed. For the main analysis, spectral band amplitudes were averaged across 14 electrodes.

Results:  Major quantitative EEG abnormalities were mainly seen in the ES group. AUDIT score correlated negatively with QEEG band amplitudes in patients with seizures unrelated to alcohol, but not in the ARS group. Recent alcohol intake correlated negatively with delta and theta amplitude. We could not confirm that beta activity is increased in ARS subjects.

Conclusions:  A QEEG with slightly reduced alpha amplitude supports a clinical diagnosis of ARS. An abnormally slow QEEG profile and asymmetry in the temporal regions indicates ES. QEEG predicted the clinical diagnosis better than standard EEG.
Red blood cell (RBC) volume can be independently determined in vivo in humans using RBCs labeled at different densities of biotin
Authors: Mock Donald M. , Matthews Nell I. , Zhu Shan , Burmeister Leon F. , Zimmerman M. Bridget , Strauss Ronald G. , Schmidt Robert L. , Nalbant Demet , Cress Gretchen A. , Widness John A.
Published: July 2010

BACKGROUND: Anemia is a serious problem in critically ill neonates. To investigate the pathophysiology of anemia and responses to red blood cell (RBC) transfusions and erythropoietin therapy, repeated measurement of red blood cell volume (RCV) and blood volume is useful. To extend our previous sheep study in which RBCs were labeled at four different biotin densities, we assessed the validity of this multidensity method for in vivo measurement of circulating RCV in humans.

STUDY DESIGN AND METHODS: In eight healthy adults, autologous RBCs were biotinylated at each of four biotin densities (6, 18, 54, and 162 µg biotinylation reagent/mL RBC), mixed, and infused intravenously; blood was sampled at 10, 20, and 60 minutes. At each time, RCV was calculated from dilution of individual RBC populations enumerated by flow cytometry. RCV measurements from the population of RBCs biotinylated at 6 µg/mL were chosen as the reference values because this density had been previously validated against the 51Cr method in vitro and in vivo in humans.

RESULTS: Values for RCVs were not significantly different among the four densities of biotinylated RBCs at any of the three time points and did not change over 60 minutes.

CONCLUSIONS: These studies provide evidence that four densities of biotinylated RBCs can be used in vivo for simultaneous, independent, accurate measurements of RCV in humans. We speculate that this method will also be useful for repeated measurement of RCV and blood volume in infants and other patient populations in whom radioactive labels should be avoided.
Cardiac Sudden Death as a Result of Acute Coronary Artery Thrombosis During Chemotherapy for Testicular Carcinoma
Authors: Panella Michael , Ross Janice E. , Garvin Keene , Martin Alex
Published: July 2010

Abstract:  We report the first acute coronary fibrin thrombus arising upon atherosclerosis detected at autopsy in a man receiving chemotherapy for testicular carcinoma. The decedent was a smoker with no other known atherosclerotic risk factors. Histology revealed superficial atherosclerotic plaque erosion with endothelial necrosis and no intraplaque hemorrhage. A focus of intimal lymphoid infiltrates was noted away from the plaque. These findings raise the possibility of chemotherapy‐induced vascular damage as a factor in thrombogenesis. A review of Pubmed was performed which documented clinical reports of an association of chemotherapy with acute cardiac ischemia but no well described autopsy findings. Our case highlights the need for careful assessment of the coronary system in chemotherapy patients dying suddenly, particularly in the absence of significant atherosclerotic risk factors. Such postmortem examination will ensure thorough death investigation and may elucidate the pathogenesis of thrombosis with potential reduction in cardiac ischemic risks of chemotherapy patients.
Kynurenines, neurodegeneration and Alzheimer’s disease
Authors: Kincses Zsigmond Tamas , Toldi József , Vécsei László
Published: July 2010

Alzheimer’s disease

The kynurenine pathway

Relations of kynurenines to the pathomechanism of AD

A future therapeutic approach: modulating the kynurenine pathway

Concluding remarks

Alzheimer’s disease (AD) is one of the major causes of dementia. The pathogenesis of the disease is not entirely understood, but the amyloid β peptide (Aβ) and the formation of senile plaques seem to play pivotal roles. Oligomerization of the Aβ is thought to trigger a cascade of events, including oxidative stress, glutamate excitotoxicity and inflammation. The kynurenine (KYN) pathway is the major route for the metabolism of the essential amino acid tryptophan. Some of the metabolites of this pathway, such as 3‐hydroxykynurenine and quinolinic acid, are known to have neurotoxic properties, whereas others, such as kynurenic acid, are putative neuroprotectants. Among other routes, the KYN pathway has been shown to be involved in AD pathogenesis, and connections to other known mechanisms have also been demonstrated. Oxidative stress, glutamate excitotoxicity and the neuroinflammation involved in AD pathogenesis have been revealed to be connected to the KYN pathway. Intervention at these key steps may serve as the aim of potential therapy.
Anxiety and depression in children and adults: influence of serotonergic and neurotrophic genes?
Authors: Middeldorp C. M. , Slof‐Op ‘t Landt M. C. T. , Medland S. E. , van Beijsterveldt C. E. M. , Bartels M. , Willemsen G. , Hottenga J.‐J. , de Geus E. J. C. , Suchiman H. E. D. , Dolan C. V. , Neale M. C. , Slagboom P. E. , Boomsma D. I.
Published: July 2010

There are two major hypotheses regarding the etiology of anxiety and depression: the mono‐amine hypothesis and the hypothesis of an abnormal stress response acting partly via reduced neurogenesis. Association studies have focused on genes involved in these processes, but with inconclusive results. This study investigated the effect of 45 single nucleotide polymorphisms (SNPs) in genes encoding for serotonin receptors 1A, 1D, 2A, catechol‐O‐methyltransferase (COMT), tryptophane hydroxylase type 2 (TPH2), brain derived neurotrophic factor (BDNF), PlexinA2 and regulators of G‐protein‐coupled signaling (RGS) 2, 4, 16. Anxious depression (A/D) symptoms were assessed five times in 11 years in over 11 000 adults with 1504 subjects genotyped and at age 7, 10, 12 and during adolescence in over 20 000 twins with 1078 subjects genotyped. In both cohorts, a longitudinal model with one latent factor loading on all A/D measures over time was analysed. The genetic association effect modeled at the level of this latent factor was 60% and 70% heritable in the children and adults, respectively, and explained around 50% of the total phenotypic variance. Power analyses showed that the samples contained 80% power to detect an effect explaining between 1.4% and 3.6% of the variance. However, no SNP showed a consistent effect on A/D. To conclude, this longitudinal study in children and adults found no association of SNPs in the serotonergic system or core regulators of neurogenesis with A/D. Overall, there has been no convincing evidence, so far, for a role of genetic variation in these pathways in the development of anxiety and depression.
Amidst Fractured Faith and the Fragility of Reason
Authors: Admirand Peter
Published: July 2010

In his controversial Regensburg Address, Pope Benedict referred to ‘reason's grandeur’.

In this essay I will argue that the best way to engage ‘the whole breadth of reason’ is to remain in close, sympathetic dialogue with the challenges and evidence of what seems to gainsay reason's grandeur without being mired by what Benedict rightfully rebukes as the ‘self-imposed limitation of reason to the empirically verifiable’. Thus, in light of mass atrocities, many perpetrated in the name of reason or ‘God’, one must approach all theological and philosophical investigations with heightened humility and openness to the opposing views of the Other. Such an approach will also seek to flesh out a ‘Biblical faith’, which will not be bereft of elements of rupture, doubt, and loss.

A few questions will form the core of this essay: What is the relationship between admitting a fractured faith and recognising the fragility of reason? Why would such admissions ultimately strengthen one's religious identity and provide fertile grounds for ecumenism and interfaith dialogue? Lastly, as a Catholic theologian, why would I contend that such a stance is more in tune with both the spirit of the gospels and Catholic social teaching?
The Heart of Light: God as Mystery
Authors: Miller Richard W.
Published: July 2010

This paper addresses two questions concerning the attribution of mystery to God. First, if Christianity is neither rationalistic nor agnostic concerning the knowledge of God, then what is the proper understanding of mystery when it is attributed to God? Second, if mystery conditions all theological thinking, how can the proper understanding of mystery be applied systematically across the full range of theological reflection? The response to the first question has three parts. First, God is incomprehensible not because we do not have access to God. God communicates God's self and we can know God's essence but we cannot comprehend God. Second, Thomas Aquinas shows us how we can know God yet God remains incomprehensible. Third, I elucidate the analogy of proper proportionality in arguing that although we do not fully know what we are talking about when we speak of God our concepts are not meaningless. In responding to the second question, I argue, in response to Karl Rahner's use of mystery in his treatment of the problem of suffering, that God's power cannot be absolute but must be related to God's goodness if one is to preserve the mystery of God across the full range of theological reflection.
Teilhard de Chardin's Christocentric Trinitarianism
Authors: Sutton Agneta
Published: July 2010

Not only did Pierre Teilhard de Chardin speak about the work of the Holy Spirit in the human heart and see the Holy Spirit as the driving force of evolution, but the human union and community of persons joined by mutual love, in what he called the ‘noosphere’, was clearly analogous in his mind to the Trinitarian union of persons. Yet the Trinitarian dimension of Teilhard's writings has received little attention. On Teilhard's understanding, the Holy Spirit is the power through which evolution becomes the awakening of soul or spirit in matter, rather than being random variation and natural selection. It is also the Holy Spirit who promotes spiritual evolution in the human heart and opens human eyes to the divine presence in the world. Finally, Teilhard's concept of the ‘noosphere’ is analogous to that of the Trinity, understood as a personal unity where neither the individual person nor the Trinity as a whole would be complete without the other.
Capital at Home and at School: A Review and Synthesis
Authors: Parcel Toby L. , Dufur Mikaela J. , Cornell Zito Rena
Published: July 2010

Human, financial, and social capital from several contexts affects child and adolescent well‐being. Families and schools are among the most important, and research is increasingly studying how effects of capital across such contexts affect child and adolescent academic and social outcomes. Some research suggests that families may be more powerful than schools in promoting child and adolescent well‐being. Additional research is needed to more fully understand how capital across institutions interacts in producing child well‐being, when and why multiple institutions or levels of analysis are relevant, and how several contexts can form chains of causation. Theories of social capital may promote increased conversation among researchers who study the same outcomes yet focus their analyses on different contexts.
Coping With Overload and Stress: Men and Women in Dual‐Earner Families
Authors: Higgins Chris A. , Duxbury Linda E. , Lyons Sean T.
Published: July 2010

This study tested gender differences in a model positing relationships between work and family demands, overload, 4 coping mechanisms, and stress. The coping mechanisms were hypothesized to moderate the relationship between overload and stress. The sample consisted of 1,404 men and 1,623 women in dual‐earner families. Respondents relied on 2 coping strategies: scaling back and restructuring family roles. Men were more likely than women to respond to overload by scaling back and less likely to respond by work‐role restructuring. Coping by family‐role restructuring moderated the relationship between role overload and stress for both groups; however, the gender difference was not significant. Coping by work‐role restructuring moderated the relationship between overload and stress only for men.