bluuebunny/crossref_metadata_2025 huggingface dataset:
Endothelial Dysfunction and the Risk of Hypertension
Authors: Shimbo Daichi , Muntner Paul , Mann Devin , Viera Anthony J. , Homma Shunichi , Polak Joseph F. , Barr R. Graham , Herrington David , Shea Steven
Published: March 2010

Hypertension is associated with impaired endothelial function in cross-sectional studies. However, few longitudinal data exist on whether endothelial dysfunction precedes the development of hypertension. We examined the cross-sectional and longitudinal relationships between endothelial-dependent brachial artery flow-mediated dilation (FMD) and hypertension prevalence and incidence in 3500 participants from the Multi-Ethnic Study of Atherosclerosis, an ethnically diverse, community-based cohort study. At baseline, the prevalence ratios (95% CI) of hypertension from the highest to the lowest quartile of FMD were 1.00 (referent), 1.26 (1.12 to 1.40), 1.35 (1.21 to 1.52), and 1.68 (1.50 to 1.87; linear trend
P
<0.001). This association remained (
P
=0.017) after adjustment for demographics (age, sex, and ethnicity), Multi-Ethnic Study of Atherosclerosis site, and other risk factors. Of the 1869 participants without hypertension at baseline, 584 (31.3%) developed hypertension over a median follow-up of 4.8 years. The unadjusted relative risks (95% CI) of incident hypertension from the highest to the lowest quartile of FMD were 1.00 (referent), 1.38 (1.14 to 1.67), 1.44 (1.19 to 1.74), and 1.64 (1.36 to 1.97; linear trend
P
<0.001). However, after adjustment for demographics and Multi-Ethnic Study of Atherosclerosis site, the relationship between FMD and incident hypertension was attenuated and not statistically significant: 1.00 (referent), 1.26 (1.04 to 1.52), 1.19 (0.98 to 1.44), and 1.18 (0.97 to 1.44). The longitudinal results also did not appreciably change after adjustment for additional risk factors and baseline blood pressure levels. In this sample, reduced FMD was not an independent predictor of hypertension incidence, suggesting that impaired endothelial function does not play a major role in the development of hypertension.
Hypoxia-Inducible Factor Prolyl-Hydroxylase 2 Senses High-Salt Intake to Increase Hypoxia Inducible Factor 1α Levels in the Renal Medulla
Authors: Wang Zhengchao , Zhu Qing , Xia Min , Li Pin-Lan , Hinton Shante J. , Li Ningjun
Published: March 2010

High salt induces the expression of transcription factor hypoxia-inducible factor (HIF) 1α and its target genes in the renal medulla, which is an important renal adaptive mechanism to high-salt intake. HIF prolyl-hydroxylase domain-containing proteins (PHDs) have been identified as major enzymes to promote the degradation of HIF-1α. PHD2 is the predominant isoform of PHDs in the kidney and is primarily expressed in the renal medulla. The present study tested the hypothesis that PHD2 responds to high salt and mediates high-salt–induced increase in HIF-1α levels in the renal medulla. In normotensive rats, high-salt intake (4% NaCl, 10 days) significantly inhibited PHD2 expressions and enzyme activities in the renal medulla. Renal medullary overexpression of the PHD2 transgene significantly decreased HIF-1α levels. PHD2 transgene also blocked high-salt–induced activation of HIF-1α target genes heme oxygenase 1 and NO synthase 2 in the renal medulla. In Dahl salt-sensitive hypertensive rats, however, high-salt intake did not inhibit the expression and activities of PHD2 in the renal medulla. Correspondingly, renal medullary HIF-1α levels were not upregulated by high-salt intake in these rats. After transfection of PHD2 small hairpin RNA, HIF-1α and its target genes were significantly upregulated by high-salt intake in Dahl salt-sensitive rats. Overexpression of PHD2 transgene in the renal medulla impaired renal sodium excretion after salt loading. These data suggest that high-salt intake inhibits PHD2 in the renal medulla, thereby upregulating the HIF-1α expression. The lack of PHD-mediated response to high salt may represent a pathogenic mechanism producing salt-sensitive hypertension.
The CALIPSO Mission
Authors: Winker D. M. , Pelon J. , Coakley J. A. , Ackerman S. A. , Charlson R. J. , Colarco P. R. , Flamant P. , Fu Q. , Hoff R. M. , Kittaka C. , Kubar T. L. , Le Treut H. , Mccormick M. P. , Mégie G. , Poole L. , Powell K. , Trepte C. , Vaughan M. A. , Wielicki B. A.
Published: March 2010

Aerosols and clouds have important effects on Earth's climate through their effects on the radiation budget and the cycling of water between the atmosphere and Earth's surface. Limitations in our understanding of the global distribution and properties of aerosols and clouds are partly responsible for the current uncertainties in modeling the global climate system and predicting climate change. The CALIPSO satellite was developed as a joint project between NASA and the French space agency CNES to provide needed capabilities to observe aerosols and clouds from space. CALIPSO carries CALIOP, a two-wavelength, polarization-sensitive lidar, along with two passive sensors operating in the visible and thermal infrared spectral regions. CALIOP is the first lidar to provide long-term atmospheric measurements from Earth's orbit. Its profiling and polarization capabilities offer unique measurement capabilities. Launched together with the CloudSat satellite in April 2006 and now flying in formation with the A-train satellite constellation, CALIPSO is now providing information on the distribution and properties of aerosols and clouds, which is fundamental to advancing our understanding and prediction of climate. This paper provides an overview of the CALIPSO mission and instruments, the data produced, and early results.
The Influence of Tropical Deforestation on the Northern Hemisphere Climate by Atmospheric Teleconnections
Authors: Snyder Peter K.
Published: March 2010

Numerous studies have identified the regional-scale climate response to tropical deforestation through changes to water, energy, and momentum fluxes between the land surface and the atmosphere. There has been little research, however, on the role of tropical deforestation on the global climate. Previous studies have focused on the climate response in the extratropics with little analysis of the mechanisms responsible for propagating the signal out of the tropics. A climate modeling study is presented of the physical processes that are important in transmitting a deforestation signal out of the tropics to the Northern Hemisphere extratropics in boreal winter. Using the Community Climate System Model, version 3 Integrated Biosphere Simulator (CCM3–IBIS) climate model and by imposing an exaggerated land surface forcing of complete tropical forest removal, the thermodynamic and dynamical atmospheric response is evaluated regionally within the tropics, globally as the climate signal propagates to the Northern Hemisphere, and then regionally in Eurasia where land–atmosphere feedbacks contribute to amplifying the climate signal and warming the surface and lower troposphere by 1–4 K. Model results indicate that removal of the tropical forests causes weakening of deep tropical convection that excites a Rossby wave train emanating northeastward away from the South American continent. Changes in European storm-track activity cause an intensification and northward shift in the Ferrel cell that leads to anomalous adiabatic warming over a broad region of Eurasia. Regional-scale land–atmosphere feedbacks are found to amplify the warming. While hypothetical, this approach illustrates the atmospheric mechanisms linking the tropics with Eurasia that may otherwise not be detectable with more realistic land-use change simulations.
Dynamical Mechanism for the Increase in Tropical Upwelling in the Lowermost Tropical Stratosphere during Warm ENSO Events
Authors: Calvo N. , Garcia R. R. , Randel W. J. , Marsh D. R.
Published: March 2010

The Brewer–Dobson circulation strengthens in the lowermost tropical stratosphere during warm El Niño–Southern Oscillation (ENSO) events. Dynamical analyses using the most recent version of the Whole Atmosphere Community Climate Model show that this is due mainly to anomalous forcing by orographic gravity waves, which maximizes in the Northern Hemisphere subtropics between 18 and 22 km, especially during the strongest warm ENSO episodes. Anomalies in the meridional gradient of temperature in the upper troposphere and lower stratosphere (UTLS) are produced during warm ENSO events, accompanied by anomalies in the location and intensity of the subtropical jets. This anomalous wind pattern alters the propagation and dissipation of the parameterized gravity waves, which ultimately force increases in tropical upwelling in the lowermost stratosphere. During cold ENSO events a similar signal, but of opposite sign, is present in the model simulations. The signals in ozone and water vapor produced by ENSO events in the UTLS are also investigated.
Was the North Pacific Wintertime Climate Less Stormy during the Mid-Holocene?
Authors: Chiang John C. H. , Fang Yue
Published: March 2010

Model evidence is presented to make the case that the midlatitude North Pacific wintertime transient eddy activity may have been significantly weaker during the mid-Holocene (∼6000 yr BP). A simulation of the mid-Holocene climate in an atmospheric general circulation model coupled to a reduced gravity ocean model showed significant reduction to transient eddy activity, up to 30% in the main storm-track region. The reduced baroclinic eddy activity is associated with basinwide climate changes over the northern and tropical Pacific, including a deepening of the Aleutian low, colder SSTs in the western and central North Pacific, a strengthening and southward shift of the subtropical jet, and a strengthened South Pacific convergence zone. These associated climate changes are consistently simulated across a range of Paleoclimate Modeling Intercomparison Project Phase II (PMIP2) coupled models forced with mid-Holocene climate forcings, suggesting they are a robust response to mid-Holocene orbital forcing. The authors link the mid-Holocene climate changes to two related modern-day analogs: (i) interannual variations in wintertime North Pacific storminess and (ii) the phenomenon of midwinter suppression whereby North Pacific transient eddy activity in today’s climate is reduced in midwinter. In both instances, the associated North Pacific climate conditions resemble those seen in the mid-Holocene simulations. While it remains to be seen which analog is dynamically more appropriate, the latter link—midwinter suppression—offers the simple physical interpretation that the mid-Holocene reduction in storminess is a consequence of a “more winterlike” climate resulting from the mid-Holocene precessional forcing.
Long-term dynamic modeling of global population and built-up area in a spatially explicit way: HYDE 3.1
Authors: Klein Goldewijk Kees , Beusen Arthur , Janssen Peter
Published: March 2010

This paper describes a tool for long-term global change studies; it is an update of the History Database of the Global Environment (HYDE) with estimates of some of the underlying demographic driving factors of global change. We estimate total and urban/rural population numbers, densities and fractions (including built-up area) for the Holocene, roughly the period 10 000 BC to AD 2000 with a spatial resolution of 5 min longitude/latitude. With a total global population increase from 2 to 6145 million people over that time span, resulting in a global population density increase of < 0.1 cap/km2 to almost 46 cap/km 2 and a urban built-up area evolving from almost zero to 0.5 million km2 (still only <0.5% of the total global land surface, but with a huge impact in terms of demands of food, services, building materials, etc.), it is clear that this must have had, and will continue to have, a profound influence on the Earth’s environment and its associated (climate) change. We hope that this data base can contribute to the Earth System Modelers community to gain better insight into long-term global change research.
Changing challenges and paradigms
Authors: Stevenson Donald E
Published: March 2010

Change comes as a surprise because things do not happen in a straight line. Concepts often evolve haphazardly, reacting to specific events. Assumptions are made but are not challenged, sometimes for political or social expedience. It has long been recognized that the dose makes the poison. Concepts of the relationship evolved from both events and the availability of exploratory tools. There are consequences to risk aversion. The general concept of hormesis is perhaps not unexpected. The acceptance of multiphasic dose-responses has the potential to unleash additional and productive insights into this relationship. The activities of BELLE and its Newsletter provide an excellent example of what can be achieved when dogmas are challenged by the accrual of information that has not been previously examined to see whether additional insights are possible. A forthcoming challenge will be the critical examination of all the inputs and assumptions that will be used in the increasing sophistication of biological modeling.
Radiation hormesis - A remedy for fear
Authors: Jaworowski Zbigniew
Published: March 2010

Personal reflections on radiation hormesis for the past 50 years are presented. The causes of ignoring and rejections of this phenomenon by international and national bodies and by radiation protection establishment are analyzed. The opposition against nuclear weapons and preparations for nuclear war was probably the main factor in inducing the concern for adverse effects of low doses of ionizing radiation, a byproduct of activism against the nuclear weapon tests. UNSCEAR was deeply involved in preparation of the scientific basis for cessation of nuclear test, and contributed to elaboration of the LNT assumption, which is in contradiction with the hormetic phenomenon. However, this authoritative body recognized also the existence of radiation hormesis, termed as ‘adaptive response.’ The political and vested interests behind exclusion of hormesis from the current risk assessment methodology are discussed.
The Contribution of Cities to Global Warming and their Potential Contributions to Solutions
Authors: Satterthwaite David
Published: March 2010

Cities are often considered to be major causes of climate change (through being centres of carbon intensive production and consumption). But as this article explains, the proportion of greenhouse gas emissions that are generated in cities is usually over-stated. In addition, blaming cities misses the point that they can be potential solutions as places where high living standards are achieved with much lower levels of greenhouse gas emissions per person. It also misses the very low greenhouse gas emissions per person in most cities in low-income nations and obscures the issue that it is not cities but high individual and household consumption that underpins most greenhouse gas emissions. The article ends by considering what can moderate, stop and reduce greenhouse gas emissions from two perspectives: where the emissions are produced; and where these are consumed.
The Further Integration of the Pearl River Delta
Authors: Yeung Yue-man
Published: March 2010

The Pearl River Delta has been a centre of rapid economic growth and systemic reform since China adopted its policy of openness and reform 30 years ago. Hong Kong and Macao have played critical roles in the economic and social transformation of the delta. Integration of the delta internally and with Hong Kong and Macao has since 1978 proceeded on an unguided basis. With the release of ‘the Outline of the Plan for the Reform and Development of the Pearl River Delta (2008–20)’ in early 2009, the delta is poised to enter another stage of further reforms and innovations, with the further integration of the delta being a matter of high priority. By 2020, the delta is anticipated to enter developed status and will become one of the leading mega urban-regions in the world.
The Challenge of Urban Redevelopment in Disaster-affected Communities
Authors: von Einsiedel Nathaniel , Bendimerad Fouad , Rodil Amillah S. , Deocariza Marino
Published: March 2010

The Philippines is one of the most disaster-prone countries in the world due to its hazard-prone location and vulnerable population. If it is to avoid a repeat of the loss of lives and devastation in every disaster, it must plan and manage more effectively, the further growth of its towns and cities as well as the natural environment. This can be achieved through disaster risk reduction-oriented planning and management. This article presents the challenges and issues that need to be addressed in planning for high-risk, low-income areas in the Philippines, and presents as an example, a redevelopment planning project of the community of Barangay Rizal in Makati City. The discussion highlights the hazards, vulnerabilities, socio-economic and other critical considerations in the area, and presents possible actions to reduce the risk and improve the socio-economic condition of the project site. The uniqueness/value of this project is that it addresses the challenges of making an existing low-income built-up community disaster-resilient. The lessons from and the replication ofthis project are relevant not only to the Philippines towns/cities but also to similar low-income, high-density communities in other developing countries.
Appreciative Inquiry as a Shadow Process
Authors: Fitzgerald Stephen P. , Oliver Christine , Hoxsey Joan C.
Published: March 2010

In this article, the relationship of Appreciative Inquiry (AI) with the shadow, defined as censored emotional and/or cognitive content (Shadow), is explored via three varieties of AI-Shadow relationships: (1) AI as generating Shadow through both its “light” and the censoring effect of polarizing norms, (2) AI as an intervention into the Shadow, and (3) AI itself as a Shadow process. These varieties of AI-Shadow relationships are then illustrated through two case stories. Finally, implications for our collective AI conversation are presented.
The Rise of the Knowledge Broker
Authors: Meyer Morgan
Published: March 2010

Knowledge brokers are people or organizations that move knowledge around and create connections between researchers and their various audiences. This commentary reviews some of the literature on knowledge brokering and lays out some thoughts on how to analyze and theorize this practice. Discussing the invisibility and interstitiality of knowledge brokers, the author argues that social scientists need to analyze more thoroughly their practices, the brokering devices they use, and the benefits and drawbacks of their double peripherality. The author also argues that knowledge brokers do not only move knowledge, but they also produce a new kind of knowledge: brokered knowledge.
Homicide in the High North: Alaska, 1999-2006
Authors: Shai Donna
Published: March 2010

This article focuses on homicides (murders and nonnegligent manslaughter) in Alaska from 1999 to 2006, through a comparison of homicides in Anchorage and in the rest of the state. Data used include the Supplementary Homicide Reports of the FBI Uniform Crime Reporting Program Data for Alaska, newspaper surveillance, and Alaska Vital Statistics. Geographic, cultural and demographic factors are used to help provide an explanation of Alaska’s unusual homicide pattern, a relatively high rate of female homicide victims. In addition, the article compares the Alaska findings to those of the United States as a whole, to place homicide in the state within a larger context. The general theoretical framework is a consideration of disorganization theory, which is used to better understand homicides in Alaska and the particular vulnerability of Alaskan Native women who migrate to Anchorage from rural villages. Topics examined include the gender and race of victims, the relationship between the victim and perpetrator, the time of year of the homicide, the location (home or elsewhere), the region of Alaska, and the weapon used in the homicide. Negligent manslaughter and child witnesses to murder are also discussed. A number of suggestions are made for the reduction of homicides in Alaska.
An Exploratory Analysis of Factors Associated With Repeat Homicide in Canada
Authors: Cale Jesse , Plecas Darryl , Cohen Irwin M. , Fortier Stephanie
Published: March 2010

The current study presents the results of the first Canadian national study on the characteristics of repeat homicide offenders and the factors associated with homicide recidivism. The research involves an analysis of National Parole Board (NPB) files for all homicide offenders in Canada who committed more than one homicide ( n = 86) between 1975 and 2005 and a matched sample of homicide offenders who only committed one homicide ( n = 84). Descriptive and bivariate analyses are used to examine and compare characteristics of single-time homicide offenders (SHOs) and repeat homicide offenders (RHOs). Logistic regression analysis reveals that RHOs lacked employment prior to their first homicide and became involved in alcohol and drug-influenced lifestyles. Furthermore, RHOs experience reductions in family and community support after release from custody for the first homicide. This reduction of support will likely reflect at-risk behavior and crime lifestyles associated with being unlawfully at large and alcohol and drug involvement.
Postcolonial Culture on Dependent Islands
Authors: Royle Stephen A.
Published: March 2010

This article first considers the significance of historical experience in academic studies, including postcolonial studies, concluding with Jane M. Jacobs that “the structures of power that gave rise to empire live on in a more disorganised fashion.” They live on in an organized way, too, in that many islands remain in a colonial relationship, being simultaneously colonial and postcolonial, although having tended “to slip the net of postcolonial theorising.” The article attempts to help fill this gap, especially through consideration of Brian Rourke’s ideas on cultural imposition applied to dependent islands and through investigation of why some islands have not progressed to independence. Case study detail is presented, especially for Bermuda and the Falkland Islands.
Determinants of Minor League Baseball Attendance
Authors: Gitter Seth R. , Rhoads Thomas A.
Published: March 2010

Like Major League Baseball (MLB), minor league baseball attendance may be influenced by the quality of the team. We use a data set encompassing all A, AA, and AAA minor league teams from 1992 to 2006 and find a positive relationship between a minor league team’s winning percentage and attendance. We also find evidence that minor and MLB are substitutes as increased ticket prices for the nearest MLB team lead to higher minor league attendance if that team is within 100 miles. Similarly, we find that during the MLB strike, minor league attendance increased. Finally, we find that a local or regional MLB team’s winning percentage only has a positive impact on minor league attendance when they are affiliated clubs.
“I Cheer, You Cheer, We Cheer”: Physical Technologies and the Normalized Body
Authors: Francombe Jessica
Published: March 2010

Located within a cultural space situated firmly in the political, technological, and historical context of the contemporary moment and predicated on the contention that all texts are dialogic, the author reads physical cultural technologies as constituents of the powerful techniques of self-regulation and self-surveillance of the young female body. “We Cheer” acts as a discursive technology, a noncentralized capillary-like force that works to “conduct the conduct” of subjects. Emanating from these media are digital discourses through which young girls are learning not only how to move their bodies appropriately but also how the have to be to fit the mould and “join the squad.” As a powerful and pervasive public pedagogy, “We Cheer” (re)establishes the position of the neoliberal girl norm, that is, a girl whose body is representative of her being (heterosexy) middle class, white, and a young consumer—citizen.
Oh Boy Comics! A Reflexive Ethnography of Comics and Childhood
Authors: Grube Vicky
Published: March 2010

This is a reflexive ethnography that interweaves a 1960s Midwest childhood with the culture of comic books and a critique of the 1960s and the nuclear family. My comic choices were more eclectic than my brother’s vast collection of Marvel, but both of us found in comics an escape from a strained childhood. The comic books, like all art, held meanings that were deeper than the pamphlet’s face value. What did this art form do for us? Certainly entertained, but even more. Becoming immersed in the lives of the characters, we were not alone. We lived lives balancing eggs on spoons, and we collected little pictured stories that offered clearer insights about family life than what the world was telling us.
The Joys of Victimage in George W. Bush’s War of Totality
Authors: Conley Donovan S.
Published: March 2010

This essay reexamines George W. Bush’s post-9/11 rhetoric of escalation for the way it articulated a war of totality with a nationalist sentiment of giddy victimage. My analysis pivots around a speech Mr. Bush delivered in the fall of 2005 at Norfolk Naval Base. Steeped in figures of amplification, the speech is a dramatic exemplar of Mr. Bush’s habit of articulating totality with pleasure. His performance conjoined the “whatever-it-takes” commitment of the nation’s socioeconomic and human resources with a dark strain of civic pathos. I thus argue that the challenge for critics of public discourse is figuring out how to disentangle the threads of sorrow and giddiness that produce rhetorics of escalation and wars of totality. This in turn requires grappling with the sensation of ecstatic victimage that dwells in the bosom of national trauma.
Poems From Headhunting and Other Sports Poems: A Collection in Progress
Authors: Raisor Philip
Published: March 2010

In sports we win, lose, or draw, but the significance of these conclusions to players, fans, and old farts “who remember when” is as varied and dramatic as the last second jump shot that makes grandmas yell at children and drum majors refuse to march. Each game rises out of cultural contexts and sinks back into them as the field is cleared. This arrangement of poems looks at the emotional part of the sports moment within that social and historical nexus.
Coda: Sticking to the Wall
Authors: Kotarba Joseph A.
Published: March 2010

This coda provides a response to and assessment of the essays in this collection, which take a creative stance by focusing attention on performance itself, as opposed to the composition on one hand or the audience on the other. The effect of such work is to nudge the performance scholar/ethnographer further along the path to becoming an ethnographic and/or performance critic. The scholars here take a very courageous leap on stage where they share the stage with the artist(s) in question. This collection contributes to the evolution of scholarly appreciation for performance—and the arts—by focusing on the stories surrounding creative work. Creative work is made important by the stories that surround it, that say, “I was there”—physically, politically, or emotionally. These stories “stick”—they hold our attention, they engage, they endure. By taking the writing of stories seriously, as the authors here clearly do, our work in performance criticism and ethnography will stick.
Anesthetic Experience With Endovascular Aortic Aneurysm Repair
Authors: Wax David B. , Garcia Christian , Campbell Neville , Marin Michael L. , Neustein Steven
Published: March 2010

Background: We endeavored to characterize the anesthesia experience with endovascular aneurysm repair (EVAR) at a large academic medical center in the United States. Methods: A retrospective review of electronic medical records was conducted for all patients undergoing elective EVAR from 2002 to 2007 in a large academic medical center. Results: A total of 522 cases met inclusion criteria, with 4% of cases using general anesthesia (GA), 92% regional anesthesia (RA), and 4% local anesthesia (LA). There was no statistically significant difference between the groups for duration of surgery or in-hospital mortality. In-hospital length of stay was longer for GA than LA or RA. Four cases were converted to open repair. Two mortalities occurred during the perioperative period (0.4% of cases). Conclusions: The vast majority of EVAR were successfully performed under RA, involved mild blood loss, involved infrequent need for conversion to GA, and resulted in brief in-hospital length of stay and low mortality rate.
Risk factors for coronary heart disease in connective tissue diseases
Authors: Al Husain Awal , Bruce Ian N.
Published: March 2010

Atherosclerosis and cardiovascular disease risk is enhanced in certain connective tissue diseases such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), systemic vasculitis and antiphospholipid syndrome. The reason for this accelerated process is likely to be multifactorial. Traditional risk factors are more prevalent in some of these patient groups compared with the general population (e.g. smoking in RA and hypertension in SLE). However, these factors do not fully explain that enhanced risk. Chronic inflammation associated with these disorders as well as some specific autoantibodies have been shown to contribute to this increased risk although their role remains controversial. The role of therapies is unclear and while steroids may exacerbate metabolic risk factors, the anti-inflammatory effects of traditional and more novel biological therapies may reduce overall cardiovascular risk in these populations. We recommend proactive screening for modifiable cardiovascular risk factors in patients with these conditions.
Dashboard Impact Evaluation for Primary Care and Community Health Programs
Authors: Rohrer James E.
Published: March 2010

Dashboard impact evaluations are studies that assess the short-term effects of health programs on performance indicators that are of interest to senior managers. Evaluations of this type can be performed rapidly and at relatively low cost if evaluators are experienced and independent, and use standard methods. Assessment of short-term impacts can provide valuable encouragement or raise concerns that call for close monitoring or redirection of program activities. Preliminary results can be in hand as early as 60 days after a program begins operations.
Lessons Learned From a Boston Community Health Center Promoting the Human Papilloma Virus Vaccine in a Minority Adult Population
Authors: Ricciotti Hope A. , Girouard Sasha , Pokorney Gail , Dodge Laura E. , Hacker Michele R.
Published: March 2010

This quality improvement study aims to examine knowledge and attitudes about human papillomavirus (HPV) vaccination among women ages 18 through 26 in a Boston community health center to increase uptake of the HPV vaccine in the local community. This cross-sectional study was conducted from August 2007 to July 2008 at an urban community health center in Roxbury, Massachusetts. Women offered HPV vaccines were asked to complete a questionnaire. Eighty-four percent of participants had heard of the HPV vaccine. A higher percentage (69%) of minority women in this study as compared with those in other studies knew the vaccine protects against cervical cancer. Forty-two percent of women came to their appointment for the purpose of being vaccinated. The remaining 58% came for another reason and received vaccination upon health care provider recommendation. Only 38% of participants reported perceived risk for HPV infection as a motivation for vaccination. These findings suggest that generalizations of attitudes and knowledge about the HPV vaccine should not be made with regard to race and ethnicity alone, but rather need to be based on surveys of the specific local population served. In addition, education about HPV risk should be continued, especially about risk factors for HPV infection.
Organizational Culture, Job Satisfaction, and Clinician Turnover in Primary Care
Authors: Hall Charles B. , Brazil Kevin , Wakefield Dorothy , Lerer Trudy , Tennen Howard
Published: March 2010

The purpose of this study is to examine how organizational culture and job satisfaction affect clinician turnover in primary care pediatric practices. One hundred thirty clinicians from 36 primary care pediatric practices completed the Primary Care Organizational Questionnaire (PCOQ), which evaluates interactions among members of the practice and job-related attributes measuring 8 organizational factors, along with a separate 3-item instrument measuring job satisfaction. Random effects logistic models were used to assess the associations between job satisfaction, the organizational factors from the PCOQ, and clinician turnover over the subsequent year. All 8 measured organizational factors from the PCOQ, particularly perceived effectiveness, were associated with job satisfaction. Five of the 8 organizational factors were also associated with clinician turnover. The effects of the organizational factors on turnover were substantially reduced in a model that included job satisfaction; only 1 organizational factor, communication between clinicians and nonclinicians, remained significant ( P = .05). This suggests that organizational culture affects subsequent clinician turnover primarily through its effect on job satisfaction. Organizational culture, in particular perceived effectiveness and communication, affects job satisfaction, which in turn affects clinician turnover in primary care pediatric practices. Strategies to improve job satisfaction through changes in organizational culture could potentially reduce clinician turnover.
Is Appropriate Management of Atrial Fibrillation in Primary Care a Utopia?
Authors: Lygidakis Charilaos , Argyriadou Stella , Lygera Anastasia
Published: March 2010

Objective:

The authors aimed at reporting on whether or not primary care doctors follow atrial fibrillation (AF) treatment protocols, and on the mental distress of such patients.

Methods:

A total of 138 patients with first detected or recurrent AF were examined in a health center. Demographic data were collected and their lifestyle and medical history for rhythm-related pathologies and chronic medication were investigated. Physical examination, electrocardiogram (EKG), and in selected cases, lab analysis were carried-out. CHADS2 index was used for assessing the stroke risk in patients with AF, while the General Health Questionnaire-12 (GHQ-12) for personal health perception was performed in all patients.

Results:

According to CHADS2 the majority of the patients had at least 1 risk factor and half of those receiving oral vitamin K antagonists presented an out-of-range international normalized ratio (INR). In 24 cases, patients used both aspirin and oral anticoagulants, while in 41 cases, medication was corrected according to index. GHQ-12 seemed to be significantly worse in paroxysmal and persistent cases, as well as in women with recurrent AF. Many paroxysmal AF patients under 75 years continued caffeine intake, whereas an extensive use of benzodiazepines was noticed in the majority of patients.

Conclusions:

Shortages and limitations of the peripheral or rural units and health centers and inadequate knowledge and application of the guidelines, seemed to be major factors responsible for mismanaging AF patients. More education in prehospital cardiology may contribute in improving management of arrhythmias in primary care.
c-Myc controls the development of CD8αα TCRαβ intestinal intraepithelial lymphocytes from thymic precursors by regulating IL-15–dependent survival
Authors: Jiang Wei , Ferrero Isabel , Laurenti Elisa , Trumpp Andreas , MacDonald H. Robson
Published: March 2010

The murine gut epithelium contains a large population of thymus-derived intraepithelial lymphocytes (IELs), including both conventional CD4+ and CD8αβ+ T cells (expressing T-cell receptor αβ [TCRαβ]) and unconventional CD8αα+ T cells (expressing either TCRαβ or TCRγδ). Whereas conventional IELs are widely accepted to arise from recirculation of activated CD4+ and CD8αβ+ T cells from the secondary lymphoid organs to the gut, the origin and developmental pathway of unconventional CD8αα IELs remain controversial. We show here that CD4-Cre-mediated inactivation of c-Myc, a broadly expressed transcription factor with a wide range of biologic activities, selectively impairs the development of CD8αα TCRαβ IELs. In the absence of c-Myc, CD4− CD8− TCRαβ+ thymic precursors of CD8αα TCRαβ IELs are present but fail to develop on adoptive transfer in immunoincompetent hosts. Residual c-Myc–deficient CD8αα TCRαβ IEL display reduced proliferation and increased apoptosis, which correlate with significantly decreased expression of interleukin-15 receptor subunits and lower levels of the antiapoptotic protein Bcl-2. Transgenic overexpression of human BCL-2 resulted in a pronounced rescue of CD8αα TCRαβ IEL in c-Myc–deficient mice. Taken together, our data support a model in which c-Myc controls the development of CD8αα TCRαβ IELs from thymic precursors by regulating interleukin-15 receptor expression and consequently Bcl-2–dependent survival.
Akt isoforms differentially regulate neutrophil functions
Authors: Chen Jia , Tang Haiyang , Hay Nissim , Xu Jingsong , Ye Richard D.
Published: March 2010

In neutrophils, the phosphoinositide 3-kinase/Akt signaling cascade is involved in migration, degranulation, and O2− production. However, it is unclear whether the Akt kinase isoforms have distinct functions in neutrophil activation. Here we report functional differences between the 2 major Akt isoforms in neutrophil activation on the basis of studies in which we used individual Akt1 and Akt2 knockout mice. Akt2−/− neutrophils exhibited decreased cell migration, granule enzyme release, and O2− production compared with wild-type and Akt1−/− neutrophils. Surprisingly, Akt2 deficiency and pharmacologic inhibition of Akt also abrogated phorbol ester-induced O2− production, which was unaffected by treatment with the phosphoinositide 3-kinase inhibitor LY294002. The decreased O2− production in Akt2−/− neutrophils was accompanied by reduced p47phox phosphorylation and its membrane translocation, suggesting that Akt2 is important for the assembly of phagocyte nicotinamide adenine dinucleotide phosphate oxidase. In wild-type neutrophils, Akt2 but not Akt1 translocated to plasma membrane upon chemoattractant stimulation and to the leading edge in polarized neutrophils. In the absence of Akt2, chemoattractant-induced Akt protein phosphorylation was significantly reduced. These results demonstrate a predominant role of Akt2 in regulating neutrophil functions and provide evidence for differential activation of the 2 Akt isoforms in neutrophils.
Identification during the follow-up of time-dependent prognostic factors for the competing risks of death and blast phase in primary myelofibrosis: a study of 172 patients
Authors: Morel Pierre , Duhamel Alain , Hivert Benedicte , Stalniekiewicz Laure , Demory Jean-Loup , Dupriez Brigitte
Published: March 2010

The median survival of patients with primary myelofibrosis ranges from 3.5 to 5.5 years, and most patients die from cause related to the disease, including blast phase (BP, in 5%-30% of cases). Because identification of high-risk patients might use information collected during the clinical course, we assessed the prognostic value of time-dependent covariates for 2 competing risks (death and BP) in a series of 172 patients. Significant (P < .01) adverse time-dependent prognostic factors for the risk of death were the time to onset of anemia (hemoglobin < 100 g/L [10 g/dL]), leukocytosis (leukocyte count > 30 × 109/L), thrombocytopenia (platelet count < 150 × 109/L), presence of circulating blasts, intermediate-high or high International Working Group for Myelofibrosis Research and Treatment score, and time to splenectomy. The first 3 dependent covariates and the time to chemotherapy initiation (P = .05) were prognostic factors for the risk of BP. The prognostic effect of onset of leukocytosis was significantly more pronounced for BP than for death. Thus, occurrence during the follow-up of characteristics associated with an adverse prognostic value at diagnosis also influenced the risks of death and BP. Patients with leukocytosis should be closely monitored. These data might efficiently help to evaluate the severity of the disease before treatment decision during the clinical course.
Protein engineering of conger eel galectins by tracing of molecular evolution using probable ancestral mutants
Authors: Konno Ayumu , Yonemaru Shintarou , Kitagawa Atsushi , Muramoto Koji , Shirai Tsuyoshi , Ogawa Tomohisa
Published: March 2010

Background

Conger eel galectins, congerin I (ConI) and congerin II (ConII), show the different molecular characteristics resulting from accelerating evolution. We recently reconstructed a probable ancestral form of congerins, Con-anc. It showed properties similar to those of ConII in terms of thermostability and carbohydrate recognition specificity, although it shares a higher sequence similarity with ConI than ConII.

Results

In this study, we have focused on the different amino acid residues between Con-anc and ConI, and have performed the protein engineering of Con-anc through site-directed mutagenesis, followed by the molecular evolution analysis of the mutants. This approach revealed the functional importance of loop structures of congerins: (1) N- and C-terminal and loop 5 regions that are involved in conferring a high thermostability to ConI; (2) loops 3, 5, and 6 that are responsible for stronger binding of ConI to most sugars; and (3) loops 5 and 6, and Thr38 residue in loop 3 contribute the specificity of ConI toward lacto-N-fucopentaose-containing sugars.

Conclusions

Thus, this methodology, with tracing of the molecular evolution using ancestral mutants, is a powerful tool for the analysis of not only the molecular evolutionary process, but also the structural elements of a protein responsible for its various functions.
Orchestrated transcription of biological processes in the marine picoeukaryote Ostreococcus exposed to light/dark cycles
Authors: Monnier Annabelle , Liverani Silvia , Bouvet Régis , Jesson Béline , Smith Jim Q , Mosser Jean , Corellou Florence , Bouget François-Yves
Published: March 2010

Background

Picoeukaryotes represent an important, yet poorly characterized component of marine phytoplankton. The recent genome availability for two species of Ostreococcus and Micromonas has led to the emergence of picophytoplankton comparative genomics. Sequencing has revealed many unexpected features about genome structure and led to several hypotheses on Ostreococcus biology and physiology. Despite the accumulation of genomic data, little is known about gene expression in eukaryotic picophytoplankton.

Results

We have conducted a genome-wide analysis of gene expression in Ostreococcus tauri cells exposed to light/dark cycles (L/D). A Bayesian Fourier Clustering method was implemented to cluster rhythmic genes according to their expression waveform. In a single L/D condition nearly all expressed genes displayed rhythmic patterns of expression. Clusters of genes were associated with the main biological processes such as transcription in the nucleus and the organelles, photosynthesis, DNA replication and mitosis.

Conclusions

Light/Dark time-dependent transcription of the genes involved in the main steps leading to protein synthesis (transcription basic machinery, ribosome biogenesis, translation and aminoacid synthesis) was observed, to an unprecedented extent in eukaryotes, suggesting a major input of transcriptional regulations in Ostreococcus. We propose that the diurnal co-regulation of genes involved in photoprotection, defence against oxidative stress and DNA repair might be an efficient mechanism, which protects cells against photo-damage thereby, contributing to the ability of O. tauri to grow under a wide range of light intensities.
Use of microarray technology to assess the time course of liver stress response after confinement exposure in gilthead sea bream (Sparus aurata L.)
Authors: Calduch-Giner Josep A , Davey Grace , Saera-Vila Alfonso , Houeix Benoit , Talbot Anita , Prunet Patrick , Cairns Michael T , Pérez-Sánchez Jaume
Published: March 2010

Background

Selection programs for growth and stress traits in cultured fish are fundamental to the improvement of aquaculture production. The gilthead sea bream (Sparus aurata) is the main aquacultured species in the Mediterranean area and there is considerable interest in the genetic improvement of this species. With the aim of increasing the genomic resources in gilthead sea bream and identifying genes and mechanisms underlying the physiology of the stress response, we developed a cDNA microarray for gilthead sea bream that is enriched by suppression substractive hybridization with stress and immunorelevant genes. This microarray is used to analyze the dynamics of gilthead sea bream liver expression profile after confinement exposure.

Results

Groups of confined and control juvenile fish were sampled at 6, 24, 72 and 120 h post exposure. GeneSpring analyses identified 202 annotated genes that appeared differentially expressed at least at one sampling time (P < 0.05). Gene expression results were validated by quantitative PCR of 10 target genes, and K-means clustering of differently expressed genes identified four major temporal gene expression profiles. Set 1 encompassed a rapid metabolic readjustment with enhanced uptake and intracellular transport of fatty acids as metabolic fuels. Set 2 was associated with a wide variety of tissue repair and remodeling processes that were mostly mediated by the stress response of the endoplasmic reticulum (ER). Sets 3 and 4 encompassed the re-establishment of cellular homeostasis with increased intracellular trafficking and scavenging of reactive oxygen species (ROS), accompanied by a bidirectional regulation of the immune system and a general decline of ROS production.

Conclusions

Collectively, these findings show the complex nature of the adaptive stress response with a clear indication that the ER is an important control point for homeostatic adjustments. The study also identifies metabolic pathways which could be analyzed in greater detail to provide new insights regarding the transcriptional regulation of the stress response in fish.