bluuebunny/crossref_metadata_2025 huggingface dataset:
Lymphocyte subset changes between 3 and 15 months of age in infants born to HIV‐seropositive women in South Africa
Authors: Moodley D. , Bobat R. A. , Coovadia H. M. , Doorasamy T. , Munsamy S. , Gouws E.
Published: October 2009

Summary The evolution of T‐lymphocyte subsets during infancy in perinatally HIV‐infected African babies has not been previously described. In a hospital‐based cohort study, T‐lymphocyte subset changes were investigated in 72 South African black children born to HIV seropositive mothers. Sixteen (22.2%) children were classified as infected and 56 (77.8%) as uninfected by 18 months of age. Four (25%) of the infected infants died before the age of 9 months from HIV‐related disease.

The CD4 and CD8 T‐lymphocyte subsets, expressed in absolute numbers, as percentages, percentiles or as ratios, were clear indicators of HIV infection at all ages between 3 and 15 months. The most marked changes were a decreased percentage of CD4 cells and an increase in percentage of CD8 cells in the infected group. In the 4 infected infants who died, CD8 count and CD4:CD8 ratio clearly predicted poor clinical outcome at 3 months. Taken together, both CD4:CD8 ratio and CD4 percentage are reliable markers of HIV infection in an African paediatric population; however, a raised CD8 lymphocyte count rather than a CD4 count is a more specific prognostic marker of disease progression in HIV infected children.
Urban epidemic of bubonic plague in Majunga, Madagascar: epidemiological aspects
Authors: Boisier P. , Rasolomaharo M. , Ranaivoson G. , Rasoamanana B. , Rakoto L. , Andrianirina Z. , Andriamahefazafy B. , Chanteau S.
Published: October 2009

Summary After an absence of 62 years, an epidemic of plague occurred in the harbour city of Majunga (Madagascar) from July 1995 to March 1996, following sporadic cases in March and May 1995. By 15 March 1996, 617 clinically suspected cases of bubonic plague had been notified. Laboratory testing was carried out for 394 individuals: 60 (15.2%) were confirmed to have bubonic plague and 48 (12.2%) were considered as presumptive cases. The incidence was significantly higher in males in all age groups and in both sexes in the 5–19 age group. Twenty‐four deaths were related to plague, but early treatment with streptomycin has confirmed its effectiveness insofar as the case‐fatality ratio was only 8.7% among confirmed and presumptive cases admitted to hospital. The difficulty of clinically diagnosing bubonic plague was affirmed. The disease met favourable conditions through the poverty and low level of hygiene prevalent in most parts of Majunga.
Increasing prevalence of penicillinase‐producing Neisseria gonorrhoeae and the emergence of high‐level, plasmid‐mediated tetracycline resistance among gonococcal isolates in The Gambia
Authors: Adegbola R. A. , Sabally S. , Corrah T. , West B. , Mabey D.
Published: October 2009

Summary One hundred and three strains of Neisseria gonorrhoeae isolated from a periurban STD clinic in The Gambia were studied for antimicrobial susceptibility, plasmid profile, and serogroup using standard procedures. Seventy‐nine (77%) were penicillinase producers (PPNG) and fully resistant to penicillin (MIC ≥8 mg/l). One isolate showed chromosomally induced resistance to penicillin (MIC 2 mg/l). None of the isolates was sensitive to tetracycline; 16 (16%) showed intermediate resistance (MICs 1–8 mg/l) and 87 (84%) showed high‐level plasmid‐mediated resistance (TRNG) (MICs >10 mg/l). This is the first report of TRNG in The Gambia. Only 6 (6%) strains were fully sensitive to trimethoprim‐sulphamethoxazole (MIC <8 mg/l); 78 (76%) showed intermediate level resistance (MICs 8–16 mg/l) and 19 (18%) were fully resistant (MIC >32 mg/l). Indications of an increase in MIC to ciprofloxacin and ceftriaxone were found in 6 (6%) and 1 (1%) strains, respectively, although all remained fully sensitive (MICs 0.004–0.03 mg/1 and 0.001–0.015 mg/l). All PPNG and TRNG strains carried the 3.2 MDa and 25.2 MDa plasmids, respectively. All isolates carried the 2.6 MDa cryptic plasmid and 9 (3 PPNG and 6 non‐PPNG) carried the 24.5 MDa conjugative plasmid. Forty‐four (43%) strains were typed group W1, 58 (56%) W11/111 and 1 had cross‐reacting antigens. Because PPNG are frequently encountered and high‐level TRNG is now prevalent, the newer cephalosporins and quinolones must now be considered as first‐line drugs for the treatment of gonorrhoea in The Gambia.
Road traffic injuries in developing countries: a comprehensive review of epidemiological studies
Authors: Odero W. , Garner P. , Zwi A.
Published: October 2009

Summary Motor vehicle accidents are the leading cause of death in adolescents and young adults worldwide. Nearly three‐quarters of road deaths occur in developing countries and men comprise a mean 80% of casualties. This review summarizes studies on the epidemiology of motor vehicle accidents in developing countries and examines the evidence for association with alcohol.
Efficacy of artemisinin and mefloquine combinations against Plasmodium falciparum. In vitro simulation of in vivo pharmacokinetics
Authors: Bwijo B. , Alin M. Hassan , Abbas N. , Wernsdorfer W. , Björkman A.
Published: October 2009

Summary The activity of artemisinin in combination with mefloquine was tested in vitro against a chloroquine‐sensitive (F32) strain of Plasmodium falciparum. A method of repetitive dosing and extending the culture observation period to 28–30 days was used to mimic the in vivo pharmacokinetic situation. Plasmodium falciparum was exposed to artemisinin from 10‐8 to 10‐5 M, mefloquine from 3 × 10‐9 to 10‐5 M and their combinations. The exposure time for artemisinin was 3 hours twice daily and for mefloquine 24 hours. The drug‐dosing duration was 3 days.

Neither artemisinin nor mefloquine alone provided radical clearance of P. falciparum, even when maximum concentrations (10‐5 M) were applied. The antiparasitic activity of artemisinin and mefloquine were significantly higher when dosed alone. Effective concentrations for different degrees of inhibition (EC 50, 90 and 99) of both artemisinin and mefloquine respectively were significantly lower when used in combination. At concentrations normally reached in vivo, this effect was clearly synergistic (P= 0.016)

Our in vitro model of intermittent dosing of artemisinin and mefloquine combinations for 3 days provides significant evidence of positive interaction between the two compounds. Lower combination concentrations around the MIC‐values for the individual compounds showed synergistic effect, and high concentrations showed additive effect. This indicates that such drug combinations may provide radical clearance at concentrations lower than those required for single‐drug treatment.
Onchocerca volvulus:immunohistochemical and immunoelectron microscopical distribution of a polyamine oxidizing enzyme
Authors: Gutiérrez‐Peña Enrique J. , Büttner Dietrich W. , Müller Sylke
Published: October 2009

SummaryWe studied the distribution of a polyamine oxidizing enzyme (PAO) inOnchocerca volvulusand other nematode parasites by immunohistochemistry and electron microscopy with immunogold technique using a polyclonal antiserum raised against purified PAO fromAscaris suum.In adultO. volvulusthe protein was localized in the outer zone and the area of the basal labyrinth of the hypodermis and occasionally in the outer zone of the uterine epithelium. Further, the fluid in the body cavity was strongly stained. No specific labelling was observed in the cuticle, muscles, epithelia of intestine, ovaries, testis and vas deferens or in sperm, oocytes and embryos. Third‐stage larvae ofO. volvulusinSimulium soubrenseshowed strong staining; the same was observed inAnisakissp. larvae, where the inner and outer zone of the hypodermis were strongly labelled. All mature, intact and dead microfilariae in nodules, skin and lymph nodes were well stained and it was possible to show that the cytoplasm of the hypodermal cells, but not the mitochondria, nuclei or other organelles of muscle cells, was preferentially labelled by immunogold particles. Investigation of adultA. suumpresented specific labelling of the hypodermis, but the basal labyrinth was more strongly marked than the outer zone.
Effects of omalizumab on markers of inflammation in patients with allergic asthma
Authors: Holgate S. , Smith N. , Massanari M. , Jimenez P.
Published: October 2009

Asthma is a chronic inflammatory disease of the airways in which immunoglobulin E (IgE) plays a key role by activating a variety of inflammatory cells through interactions with FcɛRI and FcɛRII receptors. The role of IgE in allergic inflammation provided the rationale for developing omalizumab, a humanized monoclonal anti‐IgE antibody, for patients with moderate‐to‐severe or severe allergic asthma. The reductions in circulating levels of IgE resulting from omalizumab treatment leads to reductions in FcɛRI expression on mast cells, basophils and dendritic cells. This combined effect results in attenuation of several markers of inflammation, including peripheral and bronchial tissue eosinophilia and levels of granulocyte macrophage colony stimulating factor, interleukin (IL)‐2, IL‐4, IL‐5 and IL‐13. By blocking IgE binding to its receptors and diminishing dendritic cell FcɛRI receptor expression, omalizumab may also reduce allergen presentation to T cells and the production of Th2 cytokines. The anti‐inflammatory effects of omalizumab may, therefore, explain the reductions in asthma exacerbations and symptoms seen in clinical trials in patients with moderate‐to‐severe or severe, persistent, inadequately controlled allergic asthma.
Non‐classic cystic fibrosis associated with D1152H CFTR mutation
Authors: Burgel P‐R , Fajac I , Hubert D , Grenet D , Stremler N , Roussey M , Siret D , Languepin J , Mely L , Fanton A , Labbé A , Domblides P , Vic P , Dagorne M , Reynaud‐Gaubert M , Counil F , Varaigne F , Bienvenu T , Bellis G , Dusser D
Published: October 2009

Burgel P‐R, Fajac I, Hubert D, Grenet D, Stremler N, Roussey M, Siret D, Languepin J, Mely L, Fanton A, Labbé A, Domblides P, Vic P, Dagorne M, Reynaud‐Gaubert M, Counil F, Varaigne F, Bienvenu T, Bellis G, Dusser D. Non‐classic cystic fibrosis associated with D1152H CFTR mutation.

Background: Limited knowledge exists on phenotypes associated with the D1152H cystic fibrosis transmembrane conductance regulator (CFTR) mutation.

Methods: Subjects with a D1152H allele in trans with another CFTR mutation were identified using the French Cystic Fibrosis Registry. Phenotypic characteristics were compared with those of pancreatic insufficient (PI) and pancreatic sufficient (PS) cystic fibrosis (CF) subjects in the Registry (CF cohort).

Results: Forty‐two subjects with D1152H alleles were identified. Features leading to diagnosis included chronic sinopulmonary disease (n = 25), congenital absence of the vas deferens (n = 11), systematic neonatal screening (n = 4), and genetic counseling (n = 2). Median age at diagnosis was 33 [interquartile range (IQR, 24–41)] years in D1152H subjects. Median sweat chloride concentrations were 43.5 (39–63) mmol/l in D1152H subjects and were markedly lower than in PI and PS CF subjects (p < 0.05). Bronchiectasis was present in 67% of D1152H subjects, but Pseudomonas aeruginosa colonization and pancreatic insufficiency were present in <30% of subjects. Estimated rates of decline in forced expiratory volume in 1 s (FEV1) were lower in D1152H subjects vs PI CF subjects (p < 0.05). None of the D1152H subjects identified since 1999 had died or required lung transplantation.

Conclusions: When present in trans with a CF‐causing mutation, D1152H causes significant pulmonary disease, but all subjects had prolonged survival.
Two‐stage liver transplantation: an effective procedure in urgent conditions
Authors: Montalti Roberto , Busani Stefano , Masetti Michele , Girardis Massimo , Di Benedetto Fabrizio , Begliomini Bruno , Rompianesi Gianluca , Rinaldi Laura , Ballarin Roberto , Pasetto Alberto , Gerunda Giorgio E.
Published: October 2009

Montalti R, Busani S, Masetti M, Girardis M, Di Benedetto F, Begliomini B, Rompianesi G, Rinaldi L, Ballarin R, Pasetto A, Gerunda GE. Two‐stage liver transplantation: an effective procedure in urgent conditions. Clin Transplant 2010: 24: 122–126. © 2009 John Wiley & Sons A/S.

Abstract:  Temporary portocaval shunt and total hepatectomy is a technique used in the presence of toxic liver syndrome because of fulminant hepatic failure, hepatic trauma, primary non‐function (PNF), and eclampsia. We performed this technique on four patients. An indication for anhepatic state was severe hemodynamic instability in three of them. Etiologies of these three patients were as follows: PNF after liver transplantation, ischemic hepatitis after right hepatic artery embolization, and massive reperfusion syndrome during a liver transplantation. In the fourth patient, during the liver transplantation when hepatic artery was ligated, a kidney carcinoma in the donor graft was discovered. We decided to complete the hepatectomy and to construct a temporary portocaval shunt.

Mean anhepatic phases were 19 h and 15 min. All patients survived the two‐stage liver transplantation procedure without major complications. Our cases demonstrated that temporary portocaval shunt while awaiting urgent liver transplantation could be an effective “bridge” in selected patients who develop toxic liver syndrome; however, a short time between portocaval shunt and transplantation and careful intensive care managements are mandatory.
Chylopericardium in a child with impaired venous access following small bowel transplantation
Authors: Bhole V. , Gozzini S. , Stumper O. , Advani S. , Sullivan P. B. , Rodrigues A. F. , Gupte G. L.
Published: October 2009

Bhole V, Gozzini S, Stumper O, Advani S, Sullivan PB, Rodrigues AF, Gupte GL. Chylopericardium in a child with impaired venous access following small bowel transplantation. Pediatr Transplantation 2011: 15:e39–e41. © 2009 John Wiley & Sons A/S.

A 10‐yr‐old child with impaired venous access (bilateral occlusion of internal jugular veins, subclavian veins, and inominate veins) underwent an isolated small bowel transplant. He presented with lethargy, shortness of breath 13 months into his follow‐up and was diagnosed to have chylopericardium. MR venography and lymphangiography could not demonstrate the site of lymphatic leak. His chyloperciardium was treated with pericardiocentesis and MCT diet. The most likely cause for the chylopericardium was venous occlusion of the subclavian veins with backpressure resulting in a lymphatic leak. A brief review of literature along with treatment options is discussed.
NO synthesis and signaling in plants – where do we stand?
Authors: Moreau Magali , Lindermayr Christian , Durner Jörg , Klessig Daniel F.
Published: October 2009

Over the past 20 years, nitric oxide (NO) research has generated a lot of interest in various aspects of plant biology. It is now clear that NO plays a role in a wide range of physiological processes in plants. However, in spite of the significant progress that has been made in understanding NO biosynthesis and signaling in planta, several crucial questions remain unanswered. Here we highlight several challenges in NO plant research by summarizing the latest knowledge of NO synthesis and by focusing on the potential NO source(s) and players involved. Our goal is also to provide an overview of how our understanding of NO signaling has been enhanced by the identification of array of genes and proteins regulated by NO.
Real‐time ultrasound‐guided spinal anesthesia in patients with a challenging spinal anatomy: two case reports
Authors: CHIN K. J. , CHAN V. W. S. , RAMLOGAN R. , PERLAS A.
Published: October 2009

Spinal anesthesia may be challenging in patients with poorly palpable surface landmarks or abnormal spinal anatomy. Pre‐procedural ultrasound imaging of the lumbar spine can help by providing additional anatomical information, thus permitting a more accurate estimation of the appropriate needle insertion site and trajectory. However, actual needle insertion in the pre‐puncture ultrasound‐assisted technique remains a ‘blind’ procedure. We describe two patients with an abnormal spinal anatomy in whom ultrasound‐assisted spinal anesthesia was unsuccessful. Successful dural puncture was subsequently achieved using a technique of real‐time ultrasound‐guided spinal anesthesia. This may be a useful option in patients in whom landmark‐guided and ultrasound‐assisted techniques have failed.
Xenon and isoflurane improved biventricular function during right ventricular ischemia and reperfusion
Authors: HEIN M. , ROEHL A. B. , BAUMERT J. H. , BLEILEVENS C. , FISCHER S. , STEENDIJK P. , ROSSAINT R.
Published: October 2009

Background: Although anesthetics have some cardioprotective properties, these benefits are often counterbalanced by their negative inotropic effects. Xenon, on the other hand, does not influence myocardial contractility. Thus, xenon may be a superior treatment for the maintenance of global hemodynamics, especially during right ventricular ischemia, which is generally characterized by a high acute complication rate.

Methods: The effects of 70 vol% xenon and 0.9 vol% isoflurane on biventricular function were assessed in a porcine model (n=36) using the conductance catheter technique, and the expression of the type B natriuretic peptide (BNP) gene was measured. The animals underwent 90 min of right ventricular ischemia followed by 120 min of reperfusion. A barbiturate‐anesthetized group was included as a control.

Results: Cardiac output was compromised in unprotected animals during ischemia by 33±18% and during reperfusion by 53±17%. This was mainly due to impaired contractility in the left ventricle (LV) and increased stiffness. Isoflurane attenuated the increase in stiffness and resulted in a higher preload. In contrast, xenon increased the right ventricular afterload, which was compensated by an increase in contractility. Its effects on diastolic function were less pronounced. Upregulation of BNP mRNA expression was impeded in the remote area of the LV by both isoflurane and xenon.

Conclusions: Xenon and isoflurane demonstrated equipotent effects in preventing the hemodynamic compromise that is induced by right ventricular ischemia and reperfusion, although they acted through somewhat differential inotropic and vasodilatory effects.
Unilateral paravertebral block: an alternative to conventional spinal anaesthesia for inguinal hernia repair
Authors: BHATTACHARYA P. , MANDAL M. C. , MUKHOPADHYAY S. , DAS S. , PAL P. P. , BASU S. R.
Published: October 2009

Background: Inguinal herniorrhaphy can be successfully performed using general, regional or local anaesthesia. Paravertebral block (PVB) has been used for unilateral procedures such as thoracotomy, breast surgery, chest wall trauma, hernia repair or renal surgery.

Methods: We compared unilateral lumbar PVB with conventional spinal anaesthesia (SA) in 60 consenting ASA I and II males aged 18–65 years, scheduled for unilateral inguinal hernia repair. Patients were randomly assigned into two groups, P (n=30) or S (n=30) to receive either PVB or SA, respectively. Two patients (7%) in group P had to be converted to general anaesthesia due to block failure. During surgery, patients of both groups received intravenous infusion of propofol titrated to light sedation.

Results: The time to first post‐operative analgesic requirement (primary outcome measure) as 342 ± 73 min in group P and 222 ± 22 min in group S (P<0.0001). Time to ambulation was 234 ± 111 min in group P and 361 ± 32 min in group S (P<0.0001). Urinary retention requiring catheterization were found in zero (0%) patients in group P compared with five (16%) in group S (P=0.024).

Conclusion: It can be concluded that unilateral PVB is more efficacious than conventional SA in terms of prolonging post‐operative analgesia and reducing morbidities in patients undergoing elective unilateral inguinal hernia repair.
Neurolytic phenol blockade of the obturator nerve for severe adductor spasticity
Authors: AKKAYA T. , UNLU E. , ALPTEKIN A. , GUMUS H. I. , UMAY E. , CAKCI A.
Published: October 2009

Background: In this study, we present the 3‐month follow‐up results of a retrospective analysis of obturator nerve (ON) phenol neurolysis performed between 2000 and 2007 in patients with adductor spasticity.

Methods: The study was performed by retrospective investigation of the clinical follow‐up results of 80 ON phenol treatments in 62 patients. Neurolysis using 5–10 ml 6% phenol was applied with the guidance of fluoroscopy and a peripheral nerve stimulator. Pain, spasticity and hygiene were evaluated and the hip abduction range of motion (ROM) was measured at the end of the first week and in the first, second and third months following the intervention.

Results: The visual analogue scale scores decreased significantly in the first week, first month and the second month, but reached their initial values in the third month. A drastic increase in the ROM values was shown in hip abduction in the first week, first month and second month. An increase in the Ashworth Scale values was observed in the second and third months, but they did not reach their initial values. The hygiene score decreased drastically in the first week and the first and second months, but worsened in the third month. The success rate in nerve localization during ON neurolysis was 100%.

Conclusion: ON phenol blockade with fluoroscopy and peripheral nerve stimulator guidance in patients with adductor spasticity led to a decrease in spasticity and pain with an increase in the ROM of the hip and better hygiene with an efficacy lasting for about 3 months.
Histochemical Analysis of Glycoconjugates in the Skin of a Catfish (Arius Tenuispinis, Day)
Authors: Al‐Banaw A. , Kenngott R. , Al‐Hassan J. M. , Mehana N. , Sinowatz F.
Published: October 2009

A histochemical study using conventional carbohydrate histochemistry (periodic‐acid staining including diastase controls, alcian blue staining at pH 1 and 2.5) as well as using a battery of 14 fluorescein isothiocyanate (FITC)‐labelled lectins to identify glycoconjugates present in 10 different areas of the skin of a catfish (Arius tenuispinis) was carried out. The lectins used were: mannose‐binding lectins (Con A, LCA and PSA), galactose‐binding lectins (PNA, RCA), N‐acetylgalactosamine‐binding lectins (DBA, SBA, SJA and GSL I), N‐acetylglucosamine‐binding lectins (WGA and WGAs), fucose‐binding lectins (UEA) and lectins which bind to complex carbohydrate configurations (PHA E, PHA L). Conventional glycoconjugate staining (PAS staining, alcian blue at pH 1 and 2.5) showed that the mucous goblet cells contain a considerable amount of glycoconjugates in all locations of the skin, whereas the other unicellular gland type, the club cells, lacked these glycoconjugates. The glycoproteins found in goblet cells are neutral and therefore stain magenta when subjected to PAS staining. Alcian blue staining indicating acid glycoproteins was distinctly positive at pH 1, but gave only a comparable staining at pH 2.5. The mucus of the goblet cells therefore also contains acid glycoproteins rich in sulphate groups. Using FITC‐labelled lectins, the carbohydrate composition of the glycoproteins of goblet cells could be more fully characterized. A distinct staining of the mucus of goblet cells was found with the mannose‐binding lectins LCA and PSA; the galactosamine‐binding lectins DBA, SBA and GLS I; the glucosamine‐binding lectin WGA; and PHA E which stains glycoproteins with complex carbohydrate configurations. No reaction occurred with the fucose‐binding lectin UEA and the sialic acid‐specific lectin SNA. In addition, the galactose‐binding lectins PNA and RCA showed only a weak or completely negative staining of the mucus in the goblet cells. The specificity of the lectin staining could be proved by inhibiting binding of the lectins by competitive inhibition with the corresponding sugars. From these data, we can conclude that the mucus produced by the epidermal goblet cells of A. tenuispinis is rich in mannose, N‐acetylgalactosamine and N‐acetylglucosamine residues.
Evidence‐based management of heart failure in clinical practice: a review of device‐based therapy use
Authors: Thavapalachandran S. , Leong D. P. , Stiles M. K. , John B. , Dimitri H. , Lau D. H. , Psaltis P. J. , Brooks A. G. , Alasady M. , Lim H. S. , Young G. D. , Sanders P.
Published: October 2009

Background:  Heart failure is a growing health issue and is associated with significant mortality risk. Device therapy is efficacious in preventing sudden death in patients with heart failure; however, this evidence comes from rigorous clinical trials. It is unclear how device therapy is utilized in ‘real‐world’ practice. The primary objective was to characterize patterns of device use in patients with heart failure at risk of sudden death and to identify barriers to guideline‐driven prescription of implantable cardioverter–defibrillators.

Methods:  We report a cross‐sectional study of patients attending general cardiology clinic over a 3‐month period.

Results:  Of 1003 consecutive patients attending the cardiology clinic, 176 had heart failure. Of these, 66 were potentially eligible for device therapy, but only 16 of these had actually undergone device implantation. Potentially eligible non‐recipients were older (P < 0.001), more likely to have ischaemic cardiomyopathy (P= 0.002), less likely to be prescribed spironolactone (P= 0.005) or warfarin (P= 0.02), and less likely to have a widened QRS > 120 ms (P= 0.005). There was a high prevalence of underuse of evidence‐based pharmacotherapies among patients with heart failure.

Conclusion:  There is substantial underuse of device therapy in patients with heart failure. Strikingly, whereas patients with symptoms of heart failure were more likely to receive a device, those being managed for ischaemic heart disease were not. There is also a high prevalence of failure to prescribe evidence‐based pharmacotherapy in a tertiary hospital general cardiology clinic. This may be explained in part by the lack of a patient database to record treatment contraindications and to alert clinicians to possible gaps in patient therapy.
The occurrence of asthma in hospitalized patients with type 2 diabetes mellitus
Authors: Hashemzadeh M. , Movahed M. R.
Published: October 2009

Diabetes mellitus (DM) has been found to be associated with cardiovascular disease. The goal of this study is to evaluate the prevalence of asthma in patients with type II DM after adjusting for other comorbid conditions. We used patient treatment files of inpatients' admissions containing discharge diagnosis (Classification of Mental and Behavioural Disorders (ICD)‐9 codes) from Veterans Health Administration Hospitals. The patients were divided into two groups: ICD‐9 code for DM and a control group with hypertension but no DM. ICD‐9 codes for asthma were used to study the prevalence of asthma in DM patients versus the control. We performed uni‐ and multi‐variable analysis adjusting for comorbid conditions. Asthma was present in 13 242 (4.5%) of DM patients versus 16 038 (2.9%) in the control group. Using multi‐variable analysis, DM remained independently associated with asthma (odds ratio: 2.99; confidence interval: 2.92–3.06; P < 0.0001). The prevalence of asthma is significantly higher in hospitalized patients with type II DM independent of other comorbid conditions. The pathogenesis of this association is not known warranting further investigation.
Testing the outcome score of spontaneous intracerebral haemorrhage in haemodialysis patients
Authors: Huang B.‐R. , Lo Y.‐L. , Chang C.‐H. , Chen T.‐Y.
Published: October 2009

The aim of this study is to determine the predictive value of the spontaneous intracerebral haemorrhage (ICH) outcome score (which we described previously) in haemodialysis (HD) patients who develop spontaneous ICH. The validation cohort consisted of all HD patients with spontaneous ICH presenting to Chang Gung Memorial Hospital in Taiwan during 2005–2007. The data were collected from one hospital and prospectively analysed, and the predictive model was tested using an external validation dataset. The prognostic factors were confirmed by chi‐squared testing. We calculated the 30‐day mortality in different groups of the validation cohort divided according to outcome score and tested the predictive value of the outcome score. The overall mortality rate was 52.6% in 38 HD patients. The originally identified prognostic factors were Glasgow Coma Scale score, age ≥70 years, systolic blood pressure <130 or ≥200 mmHg, ICH volume ≥30 mL, presence of intraventricular haemorrhage and serum glucose ≥8.8 mmol/L. All but one (serum glucose ≥8.8 mmol/L (P= 0.07)) were subsequently found to be associated with 30‐day mortality. In patients scoring 6 and 7, mortality was 100%, but in patients scoring 0, it was only 11.1%. The 30‐day mortality in the validation cohort increased steadily with score and had good predictive value (correlation coefficient = 0.986, P < 0.001). Similar results in two different cohorts indicate that the ICH outcome score is a reliable outcome measure.
Are specialist physicians missing out on the e‐Health boat?
Authors: Osborn M. , Day R. , Westbrook J.
Published: October 2009

Background:  Nationally health systems are making increasing investments in the use of clinical information systems. Little is known about current computer use by specialist physicians, particularly outside the hospital setting.

Aims:  To identify the extent and reasons physician Fellows of the Royal Australasian College of Physicians (RACP) use computers in their work.

Methods:  A self‐administered survey was emailed from the RACP to all practising physicians in 2007 that were living in Australia and New Zealand who had consented to email contact with the College.

Results:  The survey was sent to a total of 7445 eligible physicians, 2328 physicians responded (31.3% response rate), but only 1266 responses (21.0%) were able to be analysed. Most 97.5% had access to computers at work and 96.5% used home computers for work purposes. Physicians in public hospitals (72.6%) were more likely to use computers for work (65.6%) than those in private hospitals (12.6%) or consulting rooms (27.3%). Overall physicians working in public hospitals used a wider range of applications with 70.5% using their computers for searching the internet, 53.7% for receiving results and 52.7% used their computers to engage in specific educational activities. Physicians working from their consulting rooms (33.6%) were more likely to use electronic prescribing (11%) compared with physicians working in public hospitals (5.7%).

Conclusions:  Fellows have not incorporated computers into their consulting rooms over which they have control. This is in contrast to general practitioners who have embraced computers after the provision of various incentives. The rate of use of computers by physicians for electronic prescribing in consulting rooms (11%) is very low in comparison with general practitioners (98%). One reason may be that physicians work in multiple locations whereas general practitioners are more likely to work from one location.
Stress‐life fatigue assessment of pipelines with plain dents
Authors: CUNHA S. B. , PASQUALINO I. P. , PINHEIRO B. C.
Published: October 2009

This paper presents a new algorithm for assessing the fatigue life of dented pipelines. The proposed methodology was conceived according to the current stress‐life fatigue theory and design practice: it employs S–N curves inferred from tensile test material properties and uses well established methodologies to deal with the stress concentration, the mean stress and the multi‐axial stress state that characterizes a dented pipe. Finite element analyses are carried out to model the denting process and to determine the stress concentration factors of several pipe‐dent geometries. Using dimensional analysis over the numerical results, a non‐dimensional number to characterize the pipe‐dent geometry is determined and linear interpolation expressions for the stress concentration factors of dented pipelines are developed. Fatigue tests are conducted with the application of cyclic internal pressure on small‐scale dented steel pipe models. In view of the fatigue test results, the more appropriate S–N curve and mean stress criteria are selected.
The genome and structural proteome of an ocean siphovirus: a new window into the cyanobacterial ‘mobilome’
Authors: Sullivan Matthew B. , Krastins Bryan , Hughes Jennifer L. , Kelly Libusha , Chase Michael , Sarracino David , Chisholm Sallie W.
Published: October 2009

Prochlorococcus, an abundant phototroph in the oceans, are infected by members of three families of viruses: myo‐, podo‐ and siphoviruses. Genomes of myo‐ and podoviruses isolated on Prochlorococcus contain DNA replication machinery and virion structural genes homologous to those from coliphages T4 and T7 respectively. They also contain a suite of genes of cyanobacterial origin, most notably photosynthesis genes, which are expressed during infection and appear integral to the evolutionary trajectory of both host and phage. Here we present the first genome of a cyanobacterial siphovirus, P‐SS2, which was isolated from Atlantic slope waters using a Prochlorococcus host (MIT9313). The P‐SS2 genome is larger than, and considerably divergent from, previously sequenced siphoviruses. It appears most closely related to lambdoid siphoviruses, with which it shares 13 functional homologues. The ∼108 kb P‐SS2 genome encodes 131 predicted proteins and notably lacks photosynthesis genes which have consistently been found in other marine cyanophage, but does contain 14 other cyanobacterial homologues. While only six structural proteins were identified from the genome sequence, 35 proteins were detected experimentally; these mapped onto capsid and tail structural modules in the genome. P‐SS2 is potentially capable of integration into its host as inferred from bioinformatically identified genetic machinery int, bet, exo and a 53 bp attachment site. The host attachment site appears to be a genomic island that is tied to insertion sequence (IS) activity that could facilitate mobility of a gene involved in the nitrogen‐stress response. The homologous region and a secondary IS‐element hot‐spot in Synechococcus RS9917 are further evidence of IS‐mediated genome evolution coincident with a probable relic prophage integration event. This siphovirus genome provides a glimpse into the biology of a deep‐photic zone phage as well as the ocean cyanobacterial prophage and IS element ‘mobilome’.
Zn pollution counteracts Cd toxicity in metal‐tolerant ectomycorrhizal fungi and their host plant, Pinus sylvestris
Authors: Krznaric Erik , Wevers Jan H. L. , Cloquet Christophe , Vangronsveld Jaco , Vanhaecke Frank , Colpaert Jan V.
Published: October 2009

Adaptive Zn and Cd tolerance have evolved in populations of the ectomycorrhizal fungus Suillus luteus. When exposed to high concentrations of both metals in vitro, a one‐sided antagonism was apparent in the Zn‐ and Cd‐tolerant isolates. Addition of high Zn concentrations restored growth of Cd‐stressed isolates, but not vice versa. The antagonistic effect was not detected in a S. luteus isolate from non‐contaminated land and in Paxillus involutus. The fungi were inoculated on pine seedlings and subsequently exposed to ecologically relevant Zn and Cd concentrations in single and mixed treatments. The applied doses severely reduced nutrient acquisition of non‐mycorrhizal pines and pines inoculated with metal‐sensitive S. luteus. Highest translocation of Zn and Cd to shoots occurred in the same plants. Seedlings inoculated with fungi collected from the polluted site reduced metal transfer to their host and maintained nutrient acquisition under high metal exposure. The isolate showing highest tolerance in vitro also offered best protection in symbiosis. The antagonistic effect of high Zn on Cd toxicity was confirmed in the plant experiment. The results indicate that a Zn‐ and Cd‐polluted soil has selected ectomycorrhizal fungi that are able to survive and protect their phytobiont from nutrient starvation and excessive metal uptake.
A Bayesian Monte Carlo Approach to Global Illumination
Authors: Brouillat Jonathan , Bouville Christian , Loos Brad , Hansen Charles , Bouatouch Kadi
Published: October 2009

Most Monte Carlo rendering algorithms rely on importance sampling to reduce the variance of estimates. Importance sampling is efficient when the proposal sample distribution is well‐suited to the form of the integrand but fails otherwise. The main reason is that the sample location information is not exploited. All sample values are given the same importance regardless of their proximity to one another. Two samples falling in a similar location will have equal importance whereas they are likely to contain redundant information. The Bayesian approach we propose in this paper uses both the location and value of the data to infer an integral value based on a prior probabilistic model of the integrand. The Bayesian estimate depends only on the sample values and locations, and not how these samples have been chosen. We show how this theory can be applied to the final gathering problem and present results that clearly demonstrate the benefits of Bayesian Monte Carlo.
Cognitive Management in an Enduring International Rivalry: The Case of India and Pakistan
Authors: Suedfeld Peter , Jhangiani Rajiv
Published: October 2009

Using integrative complexity scoring, the current study addresses how communications by leaders of India and Pakistan have revealed their information processing and decision‐making strategies. The hostility between India and Pakistan started with the official creation of the two states and has lasted through more than a half‐century. It has been marked by four full‐scale wars and almost constant ethnopolitical, terrorist, and guerrilla violence. It is one of the most enduring and bloody binational rivalries of recent decades. Shared aspects of history and culture make the comparisons relatively free of confounding factors. In common with previous findings, complexity scores have shown reliable associations with impending war and with continued peace (or low‐intensity conflict).
The Stock Market to the Rescue? Carbon Disclosure and the Future of Securities‐Related Climate Change Litigation
Authors: Erion Graham
Published: October 2009

This article considers the role that securities litigation can play in forcing public companies to disclose climate change risks to their investors and potential shareholders. Such disclosure can prove to be a strong incentive for companies to manage their greenhouse gas emissions and climate change exposure better. Securities regulators in North America have, for the most part, resisted efforts effectively to enforce obligations by companies to disclose climate change risks. This led to a recent action by the Office of the Attorney‐General in New York, which exemplifies the role that litigation can play in this area. Investors themselves may soon bring their own actions against companies over their carbon disclosure, the basis for which is already provided in securities legislation.
Preventing Transboundary Harm From Invasive Alien Species
Authors: Riley Sophie
Published: October 2009

The problem of invasive alien species (IAS) is the second biggest threat to biodiversity after loss of habitat. Although customary international law obliges States to prevent transboundary environmental harm such as IAS, international law does not clearly articulate these obligations in this context. A potentially helpful mechanism lies in the use of transboundary environmental impact assessment and risk analysis. However, the operation of these processes, within international environmental law, international quarantine law and international trade law has generated obligations that largely remain soft, ill‐defined and inconsistent. This situation is counter‐productive to preventing or minimizing transboundary harm caused by IAS.
Laws and policies to support the wellbeing of children: an international comparative analysis
Authors: Nicklett Emily J. , Perron Brian E.
Published: October 2009

Nicklett EJ, Perron BE. Laws and policies to support the wellbeing of children: an international comparative analysis

Int J Soc Welfare 2010: 3–7 © 2009 The Author(s), Journal compilation © 2009 Blackwell Publishing Ltd and the International Journal of Social Welfare.

The international community has raised concerns regarding the extent to which countries have implemented laws and policies to support the rights and wellbeing of children. This study evaluates the progress of least‐developed countries (LDCs) and middle‐income countries (MICs) in developing such legislation. Surveys were sent to 131 UNICEF country offices. Items included efforts to promote family preservation and family ties, family‐based care over institutionalization, and child participation in placement decisions. A total of 68 surveys were returned, reflecting a 52 percent response rate (LDC, n= 25; MIC, n= 43). Legislation that addressed abuse and neglect of children, maternity leave, removal of children from the family, family care, adoption, and guardianship was widespread. Chi‐square tests indicated that MICs had a substantially higher number of laws and policies related to child allowances, school feeding programs, maternity leave, and day care.
Traits of a representative welfare state: the Swedish example
Authors: Järkestig Berggren Ulrika , Blomberg Staffan , Petersson Jan
Published: October 2009

Järkestig Berggren U, Blomberg S, Petersson J. Traits of a representative welfare state: the Swedish example

Int J Soc Welfare 2010: 19: 402–411 © 2009 The Author(s), Journal compilation © 2009 Blackwell Publishing Ltd and the International Journal of Social Welfare.

The care manager reform and the case manager reform are new reforms in the social care services in Sweden, which are evolving during the 2000s. Together they shape the social care services introducing a new way of decision‐making where representatives for the organisation (care manager) and the users (case manager) negotiate. The reforms have been analysed in two studies with results presented in this article. Using the concepts of role, orientation, function and assignments, it is argued that the managers come to the negotiations on rights from different positions that are both conflicting and complementary. They further mediate the development towards a welfare mix, where the market, social networks and users interact to obtain the public welfare provision. Through this negotiated rights model, it is argued that traits of a representative welfare state emerge, with the distinction of moving the focus to the administrative practices and their differences away from political ideologies.
The contribution of neurogenic inflammation to sensitive skin: concepts, mechanisms and cosmeceutical intervention
Authors: Ferrer‐Montiel A. , Camprubí‐Robles M. , García‐Sanz N. , Sempere A. , Valente P. , Van Den Nest W. , Carreño C.
Published: October 2009

IFSCC Magazine, 11 (2008) (4) 311–315

This paper was presented as a keynote lecture at the IFSCC Congress 2008, Barcelona, Spain.

Cutaneous neurogenic inflammation is emerging as an underlying mechanism for several skin conditions. The intimate cross‐talk between the cutaneous immune system and the peripheral nervous system is fundamental for skin biology. However, an imbalance or dysfunction results in the onset of an inflammatory state that is reinforced by the synergic and complementary action of both systems. Cumulative evidence indicates that the thermoreceptor TRPV1 is a key player of neurogenic inflammation. This receptor is activated by both physical and chemical stimuli, and its activity is potentiated by pro‐inflammatory mediators. An increase in TRPV1 activity results in an increment of neuronal excitability that leads to the release of proalgesic agents that stimulate the immune system. Therefore, the TRPV1 receptor is being considered as a cosmeceutical target, and agents that reduce its activity will be useful cosmeceuticals.

Keywords:  Algogens, epidermis, immune system, nociceptor, sensitization
The IFSCC in its 50th year – how cosmetics have changed over the lifetime of the IFSCC and how they might look 50 years from now
Authors: Weys T.
Published: October 2009

IFSCC Magazine, 11 (2008) (4) 333–335.

This essay won the 2008 Maison G. de Navarre Young Scientist Prize.

Fifty years, a half century, five decades have been fifty interesting years in the cosmetic industry as well as in the IFSCC. On September 8, 1959, the International Federation Societies of Cosmetic Chemists (IFSCC) was established. At that time only eight countries joined the Federation, but today the IFSCC is the world's largest association of researchers in the field of cosmetics. Forty‐five Societies representing 53 countries have met the high standard of scientific and educational qualifications of the IFSCC. The number of individual members in the Federation exceeds 13 000 and is still growing. The IFSCC's first president was Maison G. de Navarre from the USA. Like the incredible growth and expansion of the IFSCC, development of the cosmetic industry has made it the fastest growing industry in the world!
Identification and quantitation of vitamins K1 and K3 in cosmetic products for facial skin protection
Authors: De Orsi D. , Giannini G. , Gagliardi L. , Carpani I. , Tonelli D.
Published: October 2009

J. Cosmet. Sci.,
59, 459–467 (November/December 2008)

Synopsis

A simple and rapid analytical method was developed for the determination of vitamins K1 and K3 in facial anti‐rash creams. The procedure is based on an ultrasonic extraction of the cosmetic sample with dimethylacetamide, in the presence of an internal standard, followed by HPLC separation. HPLC was performed using a C18 column and spectrophotometric detection at 333 nm. A linear gradient elution was carried out starting with 50% acetonitrile–methanol (75:25 v/v) and water up to 100% acetonitrile–methanol for 5 min. Linearity was established over the concentration range from 0.2 to 1.0 mg mL‐1 for vitamin K1 and from 0.02 to 0.1 mg mL‐1 for vitamin K3, with LOD values of 100 ng and 20 ng injected, respectively. The accuracy was verified by spiking experiments on model cosmetic samples. The proposed method has been successfully applied for the analysis of commercial samples of creams.