bluuebunny/crossref_metadata_2025 huggingface dataset:
Lessons Learned, Ignored, Forgotten and Reborn: Organizations and Management 1960 to Today
Authors: Miles Raymond E.
Published: August 2010

Current firm experiments within a set of knowledge driven segments of the global economy suggest the possible rebirth of the managerial values and commitments to participative leadership and collaborative creativity that flourished in the US in the 1960s. Potential barriers include a focus on short term profits and intellectual property protection that restrict both within and between firm knowledge sharing to drive innovations across complementary markets. While growing knowledge resources suggest possible achievements well beyond previous levels, the required collaborative capabilities appear to demand a recommitment among management scholars to field research and the sharing of insights with managers across levels and firms.
The Relationship Process in Healthy Couple Relationships: A Grounded Theory
Authors: Young Mark A. , Kleist David M.
Published: July 2010

This research focuses on the experiences of couples who self-identify as being part of a healthy relationship. Grounded theory, a form of qualitative research, was used to uncover the underlying relationship process in couple interactions. Six couples were interviewed for this study, using two rounds of interviews and a member check process. Results found that couples who were interviewed described their relationship in the context of security. Their relationship process consists of a circular relationship where one’s perceptions influence one’s expectations and how one interacts. When interactions meet the expectations in the relationship, the interactions confirm and strengthen the perceptions.
Health Information Technology and Quality of Health Care: Strategies for Reducing Disparities in Underresourced Settings
Authors: Millery Mari , Kukafka Rita
Published: July 2010

Health information technology (health IT) has potential for facilitating quality improvement and reducing quality disparities found in underresourced settings (URSs). With this systematic literature review, complemented by key informant interviews, the authors sought to identify evidence regarding health IT and quality outcomes in URSs. The review included 105 peer-reviewed studies (2004-2009) in all settings. Only 15 studies included URSs, and 8 focused on URSs. Based on literature across settings, most evidence was available for quality impact of order entry, clinical decision support systems, and computerized reminders. Study designs were predominantly quasi-experimental (37%) or descriptive (35%); 90% of the studies focused on the microsystem level of quality improvement, indicating a need for expanding research into patient experience and organizational and environmental levels. Key informants highlighted organizational partnerships and health IT champions and emphasized that for health IT to have an impact on quality, there must be an organizational culture of quality improvement.
Improving Communication Between Patients and Providers Using Health Information Technology and Other Quality Improvement Strategies: Focus on Asian Americans
Authors: Ngo-Metzger Quyen , Hayes Gillian R. , Yunan Chen  , Cygan Ralph , Garfield Craig F.
Published: July 2010

Disparities in provider—patient communication have been shown to exist among Asian Americans, especially those who are low-income and have limited English proficiency. These disparities have resulted in unmet health care needs and poor quality care. To identify strategies for improving provider—patient communication in this population, we conducted a systematic review of the literature and in-depth interviews with key informants. Little published literature on interventions focused on Asian Americans was found. Most interventions were conducted among White populations and occurred in the waiting room before patients’ visits with their providers. Interventions ranged from a leaflet encouraging patients to ask more questions, to more intensive face-to-face coaching before office visits. Health information technology (health IT) has not been widely used to improve communication, especially among patients with limited English proficiency. More research is needed using new health IT strategies to improve care for Asian Americans and other vulnerable populations.
An Assessment of the Health Behaviors of Dorm Students in Bangladesh
Authors: Chowdhury Nishat , Yasmin Hasina , Julker Nain Khandaker  , Hossain Forhad
Published: July 2010

The objective of the present study was to investigate three kinds of health behaviors—treatment-seeking behavior during sickness, self-medication, and noncompliance of both prescription and over-the-counter drugs—of 1,809 nonmedical dorm students of Dhaka University and Jahangirnagar University, two public universities located in Dhaka and Savar, respectively, Bangladesh. In this study, decreased treatment cost and short duration of illness strongly correlated with self-medication incidences ( p < .5). Noncompliance was found to be significantly more prevalent among those who were younger and newcomers to the dorms, of male gender, and those who were ill for short durations. Bangladesh government should recognize and enforce the distinction between prescription and nonprescription medicines and ensure that the users of self-medication are well informed and protected from its possible harm or long-term negative effects.
Constructive feedback in cross-race interactions
Authors: Ruscher Janet B. , Wallace Devin L. , Walker Kristin M. , Bell Lindsay H.
Published: July 2010

In two experiments, White college students provided a local high-school student with feedback on her substandard college admissions essay, via electronic mail. Motivation to provide appropriate feedback was manipulated by alleging comparison to experts or novices. Experiment 1 compared feedback to White versus Black recipients, with the expectation that accountability would attenuate previously observed positivity biases in cross-race feedback. Experiment 2 manipulated concern about being prejudiced by providing false scores on an Implicit Associations Task (IAT)-type task; this experiment examined whether accountability plus attenuated concern about prejudice could encourage feedback to Blacks that was objectively helpful. Feedback characteristics included evaluative connotation, communication style, subjective feedback helpfulness and objective feedback quality. Findings generally supported these hypotheses. We discuss the implications of our findings for intergroup contact situations, including the potential pitfalls that face feedback-givers responding to superior performance.
Refining the relationship between ingroup identification and identity management strategies in the sport context: The moderating role of gender and the mediating role of negative mood
Authors: Bernache-Assollant Iouri , Laurin Raphaël , Bouchet Patrick , Bodet Guillaume , Lacassagne Marie-Françoise
Published: July 2010

The aim of this exploratory research was to refine the relationship between ingroup identification and three classical identity-management strategies: individual mobility, social competition and social creativity. More specifically, in the particular context of sport spectators’ reactions to their team loss, we tested the moderating role of gender in differentiating the use of CORFing (distancing) strategy and the mediating role of negative mood in differentiating the use of social competition and social creativity strategies. To this end, 173 French physical education students were asked to watch an edited video clip about a defeat of the French national rugby union team. As expected, and consistent with past research, results first showed that the amount of team identification is a reliable determinant of the participants’ choice of an identity management strategy. Highly identified spectators were more associated with engaging themselves in ingroup-protective behaviors (i.e., blasting and boosting) than spectators low in team identification who, in contrast, privileged distancing strategies (i.e., CORFing). Moreover, results revealed that participant’s gender moderates the link between ingroup identification and CORFing strategy, and that negative mood mediates the ingroup identification—blasting strategy relationship. Theoretical implications of these moderating and mediating effects are then discussed.
Pseudoaneurysm of High Origin Ulnar Artery After Penetrating Trauma
Authors: Erdil Nevzat , Colak Cengiz , Donmez Koksal , Cihan Hasan , Battaloglu Bektas
Published: July 2010

High origin ulnar artery from the brachial artery is rare and lies superficially in the forearm. Its reported frequency ranges from 0.17% to 2%. Pseudoaneurysms of peripheral arteries are very rare, and mostly these are the result of penetrating injuries. Here, we report a case pseudoaneurysm of high origin ulnar artery from the brachial artery and its surgical approach method.
The Patients’ Perspective of Carotid Endarterectomy
Authors: Maruthappu Mahiben , Shalhoub Joseph , Thapar Ankur , Jayasooriya Gayani , Franklin Ian J. , Davies Alun H.
Published: July 2010

Introduction: No studies as yet have directly evaluated the patients’ perspective of carotid endarterectomy (CEA). Here, we determine patient satisfaction, understanding, and perception of CEA. Methods: Consecutive patients were identified from a prospectively maintained carotid database. A validated 10-point telephone questionnaire was conducted. Questions related to preoperative symptoms, experience of procedure, future interventions, and overall patient satisfaction. Results: Of the 192 patients included, 136 completed the questionnaire (71% response rate). Ninety-two percent were satisfied with the explanation received, however, only 48% understood that CEA aimed to prevent future stroke. Eighty-five percent of patients received local anesthesia (LA) CEA, with 16% reporting severe or unbearable pain. Most patients (83%) would repeat CEA if necessary and 67% stated a future preference for LA CEA. The majority of patients (96%) were satisfied with their treatment overall. Conclusions: Most patients were satisfied with CEA. Greater emphasis could be placed on improving preoperative information-giving and intraoperative analgesia.
A Novel Treatment Approach to a Type II Endoleak at Endograft Implantation Using Components of an Endosensor Monitoring Device
Authors: Louwers Lisa M. , Seder Christopher W. , Bove Paul G.
Published: July 2010

Purpose: There continues to be debate regarding optimal management of type II endoleaks following endovascular abdominal aortic aneurysm repair. Case Report: We present an intraoperative treatment approach to type II endoleaks using components of the EndoSure Intrasac Pressure Monitor System. Our technique can easily be reproduced with commercially available guidewires and catheters. We also present a literature review that identifies type II endoleak characteristics associated with a high rate of persistence (high-risk endoleaks) and could benefit from early treatment. Conclusions: If a high-risk type II endoleak is identified intraoperatively, those patients may benefit from our model of an early intervention strategy. Early definitive treatment of the endoleaks could result in lower morbidity and reintervention rates.
Changing From Conventional to Eversion Endarterectomy in Carotid Artery Disease—A Safe Transition Process in the Short and Long Term
Authors: Wistrand Jonatan , Mätzsch Thomas , Gonçalves Isabel , Riva Lorenzo , Dias Nuno V.
Published: July 2010

Objectives: To evaluate the transition process from conventional carotid endarterectomy (cCEA) to eversion carotid endarterectomy (eCEA). Methods: Patients operated with carotid endarterectomy (CEA; 164 patients, 171 CEA) in 2002-2003 were retrospectively included. Results: In 2002, cCEA was applied in 64 (80%) and eCEA in 16 (20%) patients. There was an inversion on the preponderant surgical technique in 2003 (cCEA in 34 patients [37%] and eCEA in 57 patients [63%]). Perioperative stroke or death occurred in 3 patients (3.8%) in 2002 and 5 (5.5%) in 2003 (P = .78). Perioperative myocardial infarction occurred in 2 patients (2.5%) in 2002 and 2 in 2003 (2.2%, P = 1.00). Median follow-up was 83 (79-86) and 70 (67-74) months for the 2002 and 2003 cohorts, respectively, and there were no differences in survival or ipsilateral stroke between the groups. Conclusions: The transition from cCEA to eCEA is possible without significant changes in morbidity and mortality perioperatively and during follow-up.
Damage Control in the Management of Ruptured Abdominal Aortic Aneurysm: Preliminary Results
Authors: Tadlock Matthew D. , Sise Michael J. , Riccoboni Steven T. , Sise C. Beth , Sack Daniel I. , Sise Robert G. , Yang Jack C. , Borut Jeffrey J. , King Bryan S.
Published: July 2010

Background: This study compared damage control measures (DCM), including operative techniques (DCO) and resuscitative measures (DCR), with standard treatment (ST) for ruptured abdominal aortic aneurysm (rAAA). Methods: Historical cohort study methodology was used to evaluate outcomes for rAAA repairs related to DCM or ST over a 74-month period at a level I trauma center. Results: Of 28 repairs, 13 (46.4%) were DCM. Compared to ST patients, DCM patients had a lower mean preoperative BP (64.6 vs. 83.2 mm Hg, P = .03) and greater intraoperative blood loss (4.6 vs. 2.1 liters, P = .033). Patients who had both DCR and DCO (DCO & DCR) received more plasma (6.8 vs 2.6 units, P = .039) and less crystalloid (2.8 vs 10.5 liters, P = .005) than those receiving DCO only. A modest decrease in mortality was seen in the DCO & DCR group compared to DCO only. No DCO-related graft infections were observed. Conclusion: DCR use may prove beneficial in the management of rAAA.
Acute Infectious Pseudoaneurysm of the Descending Thoracic Aorta and Review of Infectious Aortitis
Authors: Cevasco Marisa , Menard Matthew T. , Bafford Richard , McNamee Ciaran J.
Published: July 2010

Thoracic aortic wall disruptions may occur secondary to trauma, surgical interventions, infection, or autoimmune or idiopathic inflammatory disorders. Such vessel wall disruption can lead to aortic dissections, aneurysm development, or more commonly, pseudoaneurysm (PSA) formation. Although aortic wall infections as an antecedent to mycotic aneurysms have been recognized since the 17th century, there has been a temporal evolution in the development of this disease. Prior to the antibiotic era they were commonly associated with endocarditis or syphilis. More recently, however, they are associated with infection of a damaged atherosclerotic area of the aorta and secondary hematogenous or contiguous seeding. We report the first case of the rapid development of a pseudoaneurysm in the descending thoracic aorta attributable to an infection of a contiguous esophageal duplication cyst by a diagnostic esophageal ultrasound (EUS) fine-needle aspiration. A literature review of mycotic thoracic aortic aneurysms and pseudoaneurysms is also presented.
The Role of Foot Collateral Vessels on Ulcer Healing and Limb Salvage After Successful Endovascular and Surgical Distal Procedures According to an Angiosome Model
Authors: Varela César , Acín Francisco , de Haro Joaquín , Bleda Silvia , Esparza Leticia , March José Ramón
Published: July 2010

Objectives: Analyze the influence of the collateral distal vessels on ischemic ulcer healing and limb salvage after successful distal procedures, according to an angiosome model. Methods: Retrospective analysis of 76 ischemic ulcers revascularized by surgical (n = 41) and endovascular (n = 35) distal procedures. All interventions were primary procedures with single outflow vessel that remained patent during follow-up. Ulcers were classified according to an angiography angiosome study as ‘‘direct revascularization’’ ([DR] n = 45), ‘‘indirect revascularization’’ ([IR] n = 31), and IR ‘‘through collaterals’’ ([IRc] n = 18). Healing rates and limb salvage were compared according to the type of revascularization. Results: Ulcer healing rate at 12 months was higher in DR than in IR (92% vs 73%, P = .008) but similar to IRc (92% vs 85%). Limb salvage at 24 months was higher in DR than in IR (93% vs 72%, P = .02) but similar to IRc (93% vs 88%). Conclusion: Ulcer blood flow restoration through collateral vessels may give similar results to those obtained through its specific source artery.
Endovascular Retrieval of Inferior Vena Cava Filter Penetrating Into Aorta: An Unusual Presentation of Abdominal Pain
Authors: Yeung Louise Yeuk Yan , Hastings Geoffrey Steven , Alexander Jason Quinn
Published: July 2010

Inferior vena cava filters are commonly used in patients with contraindications to or failures of treatment with anticoagulation. However, these are not without complications. Serious complications include penetration of the filter struts into adjacent structures, including the aorta. The design of permanent filters makes retrieval in the instance of life-threatening complication complex, often requiring extensive surgical exploration. Retrievable filters may be more easily removed via endovascular methods, reducing the morbidity of surgical approaches.
Infrarenal Origin of the Superior Mesenteric Artery: Implications in Endovascular Repair of Abdominal Aortic Aneurysm
Authors: Rushton Fred W. , Roy William A. , Mitchell Marc E.
Published: July 2010

Endovascular aneurysm repair (EVAR) has become the preferred modality for the treatment of infrarenal abdominal aortic aneurysms (AAAs). A variety of anatomic factors must be considered when planning EVAR, including the relationship of the visceral arteries to the aneurysmal segment of the aorta. This report describes 2 patients with infrarenal AAA in whom the superior mesenteric artery was the most caudal visceral vessel, originating inferior to the renal arteries.
Lymphangiography in the Diagnosis, Localization, and Treatment of a Lymphaticopelvic Fistula Causing Chyluria: A Case Report
Authors: Deso Steven , Kabutey Nii-Kabu , Vilvendhan Rajendran , Kim Ducksoo , Guermazi Ali
Published: July 2010

We present a 25-year-old man with chyluria resulting from a posttraumatic, postinflammatory lymphaticopelvic fistula. This aberrant connection between the lymphatic system and the urinary tract is rarely seen in the United States and can be difficult to diagnose. In this particular case, lymphangiography and postprocedure computed tomography (CT) imaging were used to diagnose and localize a fistula involving the right renal pedicle lymphatics and right urinary collecting system. This fistula ultimately resolved after the procedure and did not require sclerotherapy or surgical intervention. Lymphangiography is now rarely performed at most centers due to advancements in alternative diagnostic imaging modalities. However, this procedure remains a useful tool for the investigation and treatment of chyluria and other chyle leaks.
Open Repair and Endovascular Covered Stent Placement in the Management of Bilateral Axillary Artery Aneurysms
Authors: Troutman Douglas A. , Mohan Chittur R. , Samhouri Farouq A. , Sohn Richard L.
Published: July 2010

A 72-year-old male with chronic obstructive pulmonary disease and hyperlipidemia presented with acute right upper limb ischemia. Arterial occlusion was found to be secondary to a thrombosed axillary artery aneurysm. An open repair was performed with a polytetrafluoroethylene (PTFE) graft. On further workup, the patient was found to have an asymptomatic axillary artery aneurysm on the left-hand side. Endovascular repair with a covered stent was chosen to treat this aneurysm.
Endovascular Management of Mycotic Aortic Aneurysms
Authors: Silverberg Daniel , Halak Moshe , Yakubovitch Dmitry , Reinitz Emanuel-Ronny , Garniek Alex , Rimon Uri , Schneiderman Jacob
Published: July 2010

Purpose: We report a single-center experience with the endovascular management of mycotic aortic aneurysms. Case reports: Four cases of mycotic aortic aneurysms are described; all treated with endovascular stent graft with variable configurations. All patients underwent successful placement of stent grafts for their aneurysms. No 30-day perioperative mortality was observed. One patient died during the follow-up period from a cause unrelated to the aneurysm. Conclusion: Repair of mycotic aneurysms can be accomplished with endovascular repair. This may be a valid alternative to open repair particularly in patients who are not candidates for conventional open repair.
Patients and providers view gout differently: a qualitative study
Authors: Harrold Leslie R. , Mazor Kathleen M. , Velten Sarah , Ockene Ira S. , Yood Robert A.
Published: July 2010

Objectives: We sought to examine patients’ and providers’ views on the treatment of gout to better understand why management is suboptimal.

Methods: In-depth telephone interviews were conducted with gout patients (n = 26) who initiated treatment with a urate-lowering drug (ULD) in the previous 6 months and with providers who care for gout patients (n = 15). The interviews were audiotaped and transcribed verbatim. Using qualitative methods, results were analysed and themes were identified. Interviews focused on the acute management, chronic management and prevention and improvement strategies.

Results: Providers viewed the majority of patients as having excellent relief with non-steroidal anti-inflammatories, colchicine and glucocorticoids, while some patients felt these medications were ineffective. Providers felt that most patients had a good understanding of the rationale for ULD therapy and that patients responded well. Some patients felt ULDs triggered, worsened or had no impact on their disease. Most providers thought medication adherence was relatively good. Some patients reported discontinuing medications. Discontinuations were largely purposeful and due to clinical or financial concerns. Most providers thought they had adequate skills to teach disease self-management behaviours. Patients requested more information and longer visit times.

Conclusions: Providers view gout as easily managed, while patients report challenges and purposeful non-adherence.
Review: Advances in the treatment of nonalcoholic fatty liver disease
Authors: Mehta Sanjeev R.
Published: July 2010

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in the Western world, and its prevalence is predicted to rise in the future in parallel with rising levels of obesity and type 2 diabetes mellitus. It is commonly associated with insulin resistance. Many patients have coexisting obesity, hypertension, dyslipidaemia or hyperglycaemia, and are at increased risk of developing cardiovascular disease. Although patients with simple steatosis have a good prognosis, a significant percentage will develop nonalcoholic steatohepatitis which may progress to cirrhosis, end-stage liver failure and hepatocellular carcinoma. Despite promising results from several pilot studies and small to medium randomized controlled trials, there is currently no pharmacological agent that is licensed for the treatment of NAFLD. At present the mainstay of treatment for all patients is lifestyle modification using a combination of diet, exercise and behavioural therapy. With recent advances in the understanding of the pathogenesis of NAFLD, the goal of treatment has shifted from simply trying to clear fat from the liver and prevent progressive liver damage to addressing and treating the metabolic risk factors for the condition. To reduce liver-related and cardiovascular morbidity and mortality, all patients with NAFLD should be invited to enrol in adequately powered, randomized controlled studies testing novel therapies, many of which are targeted at reducing insulin resistance or preventing progressive liver disease. Coexisting obesity, hypertension, dyslipidaemia or hyperglycaemia should be treated aggressively. Orlistat, bariatric surgery, angiotensin receptor blockers, statins, fibrates, metformin and thiazolidinediones should all be considered, but treatments should be carefully tailored to meet the specific requirements of each patient. The efficacy and safety of any new treatment, as well as its cost-effectiveness, will need to be carefully evaluated before it can be advocated for widespread clinical use.
Fibronectin and laminin promote differentiation of human mesenchymal stem cells into insulin producing cells through activating Akt and ERK
Authors: Lin Hsiao-Yun , Tsai Chih-Chien , Chen Ling-Lan , Chiou Shih-Hwa , Wang Yng-Jiin , Hung Shih-Chieh
Published: August 2010

Background

Islet transplantation provides a promising cure for Type 1 diabetes; however it is limited by a shortage of pancreas donors. Bone marrow-derived multipotent mesenchymal stem cells (MSCs) offer renewable cells for generating insulin-producing cells (IPCs).

Methods

We used a four-stage differentiation protocol, containing neuronal differentiation and IPC-conversion stages, and combined with pellet suspension culture to induce IPC differentiation.

Results

Here, we report adding extracellular matrix proteins (ECM) such as fibronectin (FN) or laminin (LAM) enhances pancreatic differentiation with increases in insulin and Glut2 gene expressions, proinsulin and insulin protein levels, and insulin release in response to elevated glucose concentration. Adding FN or LAM induced activation of Akt and ERK. Blocking Akt or ERK by adding LY294002 (PI3K specific inhibitor), PD98059 (MEK specific inhibitor) or knocking down Akt or ERK failed to abrogate FN or LAM-induced enhancement of IPC differentiation. Only blocking both of Akt and ERK or knocking down Akt and ERK inhibited the enhancement of IPC differentiation by adding ECM.

Conclusions

These data prove IPC differentiation by MSCs can be modulated by adding ECM, and these stimulatory effects were mediated through activation of Akt and ERK pathways.
Contralateral acupuncture versus ipsilateral acupuncture in the rehabilitation of post-stroke hemiplegic patients: a systematic review
Authors: Kim Mi-kyung , Choi Tae-Young , Lee Myeong Soo , Lee Hyangsook , Han Chang-ho
Published: July 2010

Background

Contralateral acupuncture (CAT) involves inserting needles in the meridian on the side opposite the disease location and is often used in post-stroke rehabilitation. The aim of this systematic review is to summarize and critically evaluate the evidence for and against the effectiveness of CAT for post-stroke rehabilitation as compared to ipsilateral acupuncture (IAT).

Methods

Seventeen databases were searched from their inceptions through June 2010. Prospective clinical trials were included if CAT was tested as the sole treatment or as an adjunct to other treatments for post-stroke rehabilitation and compared to IAT.

Results

Eight randomized clinical trials (RCTs) met our inclusion criteria. Four of them reported favorable effects of CAT compared to IAT for at least one outcome. A meta-analysis showed superior effects of CAT compared to IAT on recovery rate (n = 361; risk ratio (RR), 1.12; 95% confidence intervals (CIs), 1.04 to 1.22, P = 0.005). Subgroup analysis also showed favorable effects of using CAT on patients with cerebral infarction (n = 261; RR, 1.15; 95% CIs, 1.04 to 1.27, P = 0.006). Further analysis including patients with cerebral infarction and intracranial hemorrhage, however, failed to show these advantages (n = 100; RR, 1.11; 95% CIs, 0.85 to 1.46, P = 0.43).

Conclusion

The results of our systematic review and meta-analysis suggest that there is limited evidence for CAT being superior to IAT in the treatment of cerebral infarction. The total number of RCTs included in our analysis was low, however, and the RCTs included had a high risk of bias. Future RCTs appear to be warranted.
Malaria resurgence risk in southern Europe: climate assessment in an historically endemic area of rice fields at the Mediterranean shore of Spain
Authors: Sainz-Elipe Sandra , Latorre Jose Manuel , Escosa Raul , Masià Montserrat , Fuentes Marius Vicent , Mas-Coma Santiago , Bargues Maria Dolores
Published: July 2010

Background

International travel and immigration have been related with an increase of imported malaria cases. This fact and climate change, prolonging the period favouring vector development, require an analysis of the malaria transmission resurgence risk in areas of southern Europe. Such a study is made for the first time in Spain. The Ebro Delta historically endemic area was selected due to its rice field landscape, the presence of only one vector, Anopheles atroparvus, with densities similar to those it presented when malaria was present, in a situation which pronouncedly differs from already assessed potential resurgence areas in other Mediterranean countries, such as France and Italy, where many different Anopheles species coexist and a different vector species dominates.

Methods

The transmission risk was assessed analysing: 1) climate diagrams including the minimum temperature for Plasmodium falciparum and Plasmodium vivax development; 2) monthly evolution of the Gradient Model Risk (GMR) index, specifying transmission risk period and number of potential Plasmodium generations; 3) ecological characteristics using remote sensing images with the Eurasia Land Cover characteristics database and the monthly evolution of the Normalized Difference Vegetation Index (NDVI); 4) evaluation of A. atroparvus population dynamics.

Results

Climatological analyses and GMR index show that a transmission risk presently exists, lasting from May until September for P. falciparum, and from May until October for P. vivax. The GMR index shows that the temperature increase does not actually mean a transmission risk increase if accompanied by a precipitation decrease reducing the number of parasite generations and transmission period. Nevertheless, this limitation is offset by the artificial flooding of the rice fields. Maximum NDVI values and A. atroparvus maximum abundance correspond to months with maximum growth of the rice fields.

Conclusions

The Ebro Delta presents the ecological characteristics that favour transmission. The temperature increase has favoured a widening of the monthly potential transmission window with respect to when malaria was endemic. The combined application of modified climate diagrams and GMR index, together with spatial characterization conforms a useful tool for assessing potential areas at risk of malaria resurgence. NDVI is a good marker when dealing with a rice field area.
Cdk5 phosphorylates non-genotoxically overexpressed p53 following inhibition of PP2A to induce cell cycle arrest/apoptosis and inhibits tumor progression
Authors: Ajay Amrendra K , Upadhyay Ankur K , Singh Sandeep , Vijayakumar Maleppillil V , Kumari Ratna , Pandey Vimal , Boppana Ramanamurthy , Bhat Manoj K
Published: July 2010

Background

p53 is the most studied tumor suppressor and its overexpression may or may not cause cell death depending upon the genetic background of the cells. p53 is degraded by human papillomavirus (HPV) E6 protein in cervical carcinoma. Several stress activated kinases are known to phosphorylate p53 and, among them cyclin dependent kinase 5 (Cdk5) is one of the kinase studied in neuronal cell system. Recently, the involvement of Cdk5 in phosphorylating p53 has been shown in certain cancer types. Phosphorylation at specific serine residues in p53 is essential for it to cause cell growth inhibition. Activation of p53 under non stress conditions is poorly understood. Therefore, the activation of p53 and detection of upstream kinases that phosphorylate non-genotoxically overexpressed p53 will be of therapeutic importance for cancer treatment.

Results

To determine the non-genotoxic effect of p53; Tet-On system was utilized and p53 inducible HPV-positive HeLa cells were developed. p53 overexpression in HPV-positive cells did not induce cell cycle arrest or apoptosis. However, we demonstrate that overexpressed p53 can be activated to upregulate p21 and Bax which causes G2 arrest and apoptosis, by inhibiting protein phosphatase 2A. Additionally, we report that the upstream kinase cyclin dependent kinase 5 interacts with p53 to phosphorylate it at Serine20 and Serine46 residues thereby promoting its recruitment on p21 and bax promoters. Upregulation and translocation of Bax causes apoptosis through intrinsic mitochondrial pathway. Interestingly, overexpressed activated p53 specifically inhibits cell-growth and causes regression in vivo tumor growth as well.

Conclusion

Present study details the mechanism of activation of p53 and puts forth the possibility of p53 gene therapy to work in HPV positive cervical carcinoma.
An improved anion-exchange high-performance liquid chromatography method for measuring oxidized form of LDLs in human plasma
Authors: Kitano Soichi , Higashimoto Yuichiro , Harada Shoji , Sano Masaru , Kurata Tsunehiko , Yamaguchi Yu , Kunitomo Masaru , Haginaka Jun , Yamagishi Sho-ichi
Published: July 2010

Background

Circulating oxidized low-density lipoproteins (LDLs) (ox-LDLs) could be a sensitive marker to predict future cardiovascular events. However, a method to evaluate oxidized forms of LDLs systemically in human plasma is not yet established. In this study, we developed a novel and convenient high-performance liquid chromatography (HPLC) method for measuring ox-LDL levels in humans.

Methods

Human plasma lipoproteins were separated by a modified HPLC method using a diethylaminoethyl-type anion-exchange gel column with stepwise elution. Ox-LDLs were detected by postcolumn reaction with a regent containing cholesterol esterase and cholesterol oxidase. Particle size of each LDL fraction separated by HPLC was determined in 61 healthy subjects.

Results

Our HPLC method separated LDLs into three fractions, which were designated as LDL-1, LDL-2 and LDL-3, on the basis of their negative charges, with LDL-3 the most strongly retained fraction migrating fastest in the anodic direction, a property that reflects the net negative charge of the molecule. Western blot analysis revealed that apolipoprotein B100 in LDL-3 fraction was the most fragmented and oxidatively modified. When LDLs were oxidized in vitro by Cu2+ or 2,2-azo-bis (2-aminopropane)-2HCl or modified by various aldehydes, all of the LDL fractions migrated at the position of LDL-3. Further, among three fractions, particle size was smallest in LDL-3 fraction.

Conclusion

Here, we developed a convenient HPLC method and identified LDL-3 as oxidized LDL fractions, although ox-LDLs were present in LDL-2 fraction, albeit lesser concentrations than in LDL-3 subfraction. Measuring ox-LDL levels in human plasma by this method may be useful to evaluate atherosclerotic disorders.
Novel endoribonucleases as central players in various pathways of eukaryotic RNA metabolism
Authors: Tomecki Rafal , Dziembowski Andrzej
Published: July 2010

For a long time it has been assumed that the decay of RNA in eukaryotes is mainly carried out by exoribonucleases, which is in contrast to bacteria, where endoribonucleases are well documented to initiate RNA degradation. In recent years, several as yet unknown endonucleases have been described, which has changed our view on eukaryotic RNA metabolism. Most importantly, it was shown that the primary eukaryotic 3′ → 5′ exonuclease, the exosome complex has the ability to endonucleolytically cleave its physiological RNA substrates, and novel endonucleases involved in both nuclear and cytoplasmic RNA surveillance pathways were discovered concurrently. In addition, endoribonucleases responsible for long-known processing steps in the maturation pathways of various RNA classes were recently identified. Moreover, one of the most intensely studied RNA decay pathways—RNAi—is controlled and stimulated by the action of different endonucleases. Furthermore, endoribonucleolytic cleavages executed by various enzymes are also the hallmark of RNA degradation and processing in plant chloroplasts. Finally, multiple context-specific endoribonucleases control qualitative and/or quantitative changes of selected transcripts under particular conditions in different eukaryotic organisms. The aim of this review is to discuss the impact of all of these discoveries on our current understanding of eukaryotic RNA metabolism.
Total hip replacement in morbidly obese patients with osteoarthritis
Authors: Chee Y. H. , Teoh K. H. , Sabnis B. M. , Ballantyne J. A. , Brenkel I. J.
Published: July 2010

We compared 55 consecutive total hip replacements performed on 53 morbidly obese patients with osteoarthritis with a matched group of 55 total hip replacements in 53 non-obese patients. The groups were matched for age, gender, prosthesis type, laterality and preoperative Harris Hip Score. They were followed prospectively for five years and the outcomes were assessed using the Harris Hip Score, the Short-form 36 score and radiological findings.

Survival at five years using revision surgery as an endpoint, was 90.9% (95% confidence interval 82.9 to 98.9) for the morbidly obese and 100% for the non-obese patients. The Harris Hip and the Short-form 36 scores were significantly better in the non-obese group (p < 0.001). The morbidly obese patients had a higher rate of complications (22% vs 5%, p = 0.012), which included dislocation and both superficial and deep infection.

In light of these inferior results, morbidly obese patients should be advised to lose weight before undergoing a total hip replacement, and counselled regarding the complications. Despite these poorer results, however, the patients have improved function and quality of life.
The use of patient-reported outcome measures and patient satisfaction ratings to assess outcome in hemiarthroplasty of the shoulder
Authors: Rees J. L. , Dawson J. , Hand G. C. R. , Cooper C. , Judge A. , Price A. J. , Beard D. J. , Carr A. J.
Published: July 2010

We have compared the outcome of hemiarthroplasty of the shoulder in three distinct diagnostic groups, using survival analysis as used by the United Kingdom national joint registers, patient-reported outcome measures (PROMs) as recommended by Darzi in the 2008 NHS review, and transition and satisfaction questions.

A total of 72 hemiarthroplasties, 19 for primary osteoarthritis (OA) with an intact rotator cuff, 22 for OA with a torn rotator cuff, and 31 for rheumatoid arthritis (RA), were followed up for between three and eight years. All the patients survived, with no revisions or dislocations and no significant radiological evidence of loosening. The mean new Oxford shoulder score (minimum/worst 0, maximum/best 48) improved significantly for all groups (p < 0.001), in the OA group with an intact rotator cuff from 21.4 to 38.8 (effect size 2.9), in the OA group with a torn rotator cuff from 13.3 to 27.2 (effect size 2.1) and in the RA group from 13.7 to 28.0 (effect size 3.1). By this assessment, and for the survival analysis, there was no significant difference between the groups. However, when ratings using the patient satisfaction questions were analysed, eight (29.6%) of the RA group were ‘disappointed’, compared with one (9.1%) of the OA group with cuff intact and one (7.7%) of the OA group with cuff torn. All patients in the OA group with cuff torn indicated that they would undergo the operation again, compared to ten (90.9%) in the OA group with cuff intact and 20 (76.9%) in the RA group.

The use of revision rates alone does not fully represent outcome after hemiarthroplasty of the shoulder. Data from PROMs provides more information about change in pain and the ability to undertake activities and perform tasks. The additional use of satisfaction ratings shows that both the rates of revision surgery and PROMs need careful interpretation in the context of patient expectations.
Spondylolysis originates in the ventral aspect of the pars interarticularis
Authors: Terai T. , Sairyo K. , Goel V. K. , Ebraheim N. , Biyani A. , Faizan A. , Sakai T. , Yasui N.
Published: July 2010

Lumbar spondylolysis is a stress fracture of the pars interarticularis. We have evaluated the site of origin of the fracture clinically and biomechanically.

Ten adolescents with incomplete stress fractures of the pars (four bilateral) were included in our study. There were seven boys and three girls aged between 11 and 17 years. The site of the fracture was confirmed by axial and sagittal reconstructed CT. The maximum principal tensile stresses and their locations in the L5 pars during lumbar movement were calculated using a three-dimensional finite-element model of the L3-S1 segment.

In all ten patients the fracture line was seen only at the caudal-ventral aspect of the pars and did not spread completely to the craniodorsal aspect. According to the finite-element analysis, the higher stresses were found at the caudal-ventral aspect in all loading modes. In extension, the stress was twofold higher in the ventral than in the dorsal aspect.

Our radiological and biomechanical results were in agreement with our clinical observations.
A new barbed device for repair of flexor tendons
Authors: Hirpara K. M. , Sullivan P. J. , O’Sullivan M. E.
Published: July 2010

We split 100 porcine flexor tendons into five groups of 20 tendons for repair. Three groups were repaired using the Pennington modified Kessler technique, the cruciate or the Savage technique, one using one new device per tendon and the other with two new devices per tendon. Half of the tendons received supplemental circumferential Silfverskiöld type B cross-stitch. The repairs were loaded to failure and a record made of their bulk, the force required to produce a 3 mm gap, the maximum force applied before failure and the stiffness. When only one device was used repairs were equivalent to the Pennington modified Kessler for all parameters except the force to produce a 3 mm gap when supplemented with a circumferential repair, which was equivalent to the cruciate.

When two devices were used the repair strength was equivalent to the cruciate repair, and when the two-device repair was supplemented with a circumferential suture the force to produce a 3 mm gap was equivalent to that of the Savage six-strand technique.
The effect of injections of botulinum toxin type A combined with casting on the equinus gait of children with cerebral palsy
Authors: Hayek S. , Gershon A. , Wientroub S. , Yizhar Z.
Published: July 2010

Our aim was to evaluate the effect of adding inhibitory casting to the treatment of young children with cerebral palsy who received injections of botulinum neurotoxin A (BoNT-A) to gastrocnemius for equinus gait. Of the 20 patients in the series, 11 in group A had inhibitory casts applied on the day of the first set of BoNT-A injections and nine in group B did not have casting. Both groups received another BoNT-A injection four months later. The patients were followed for eight months and examined at five intervals.

Both groups showed significant improvement in gait parameters and function (p < 0.0001) and selective motor control (p = 0.041, − 0.036) throughout the study. Group A had significantly better passive dorsiflexion of the ankle (p = 0.029), observational gait score (p = 0.006) and selective motor control (p = 0.036). We conclude that the addition of inhibitory casting enhances and prolongs the results of treatment and mainly influences the passive range of movement, while BoNT-A mostly influences the dynamic motion. The second injection further improved the results of most parameters. The gross motor function measure, the selective motor control test and the modified Tardieu scale correlated well with the results of treatment.

We recommend the use of inhibitory casting whenever augmentation of the effect of treatment with BoNT-A is needed.
Uncemented custom computer-assisted design and manufacture of hydroxyapatite-coated femoral components
Authors: Muirhead-Allwood S. , Sandiford N. , Skinner J. A. , Hua J. , Kabir C. , Walker P. S.
Published: July 2010

We present the 10- to 17-year results of 112 computer-assisted design computer-assisted manufacture femoral components. The total hip replacements were performed between 1992 and 1998 in 111 patients, comprising 53 men and 58 women. Their mean age was 46.2 years (24.6 to 62.2) with a mean follow-up of 13 years (10 to 17). The mean Harris Hip Score improved from 42.4 (7 to 99) to 90.3 (38 to 100), the mean Oxford Hip Score from 43.1 (12 to 59) to 18.2 (12 to 51) and the mean Western Ontario MacMasters University Osteoarthritis Index score from 57.0 (7 to 96) to 11.9 (0 to 85). There was one revision due to failure of the acetabular component but no failures of the femoral component. There were no revisions for aseptic loosening. The worst-case survival in this cohort of custom femoral components at 13.2 years follow-up was 98.2% (95% confidence interval 95 to 99). Overall survival of this series of total hip replacements was 97.3% (95% confidence interval 95 to 99).

These results are comparable with the best medium- to long-term results for femoral components used in primary total hip replacement with any means of fixation.
Effect of laceration and trimming of a tendon on the coefficient of friction along the A2 pulley
Authors: Hajipour L. , Gulihar A. , Dias J.
Published: July 2010

We carried out lacerations of 50%, followed by trimming, in ten turkey flexor tendons in vitro and measured the coefficient of friction at the tendon-pulley interface with loads of 200 g and 400 g and in 10°, 30°, 50° and 70° of flexion. Laceration increased the coefficient of friction from 0.12 for the intact tendon to 0.3 at both the test loads. Trimming the laceration reduced the coefficient of friction to 0.2. An exponential increase in the gliding resistance was found at 50° and 70° of flexion (p = 0.02 and p = 0.003, respectively) following trimming compared to that of the intact tendon.

We concluded that trimming partially lacerated flexor tendons will reduce the gliding resistance at the tendon-pulley interface, but will lead to fragmentation and triggering of the tendon at higher degrees of flexion and loading. We recommend that higher degrees of flexion be avoided during early post-operative rehabilitation following trimming of a flexor tendon.
Chronic haematogenous osteomyelitis in children
Authors: Beckles V. L. L. , Jones H. Wynn , Harrison W. J.
Published: July 2010

We present a retrospective review of 167 patients aged 18 years and under who were treated for chronic haematogenous osteomyelitis at our elective orthopaedic hospital in Malawi over a period of four years. The median age at presentation was eight years (1 to 18). There were 239 hospital admissions for treatment during the period of the study. In 117 patients one admission was necessary, in 35 two, and in 15 more than two.

A surgical strategy of infection control followed by reconstruction and stabilisation was employed, based on the Beit CURE radiological classification of chronic haematogenous osteomyelitis as a guide to treatment. At a minimum follow-up of one year after the end of the study none of the patients had returned to our hospital with recurrent infection.

A total of 350 operations were performed on the 167 patients. This represented 6.7% of all children’s operations performed in our hospital during this period. One operation only was required in 110 patients and none required more than three. Below-knee amputation was performed in two patients with chronic calcaneal osteomyelitis as the best surgical option for function. The most common organism cultured from operative specimens was Staphylococcus aureus, and the tibia was the bone most commonly affected. Polyostotic osteomyelitis occurred in four patients. We believe this is the largest reported series of patients treated for chronic haematogenous osteomyelitis.