bluuebunny/crossref_metadata_2025 huggingface dataset:
Cystic Fibrosis-Related Diabetes in Childhood
Authors: O’Riordan Stephen M.P. , Dattani Mehul T. , Hindmarsh Peter C.
Published: January 2010

Since the early 1990s the management of children with cystic fibrosis (CF) has come a long way and advances in both nutritional and medical care have resulted in a median age of survival of 30–35 years, as compared with a life expectancy of <1 year in the 1950s. The first definitive reports of glucose intolerance or diabetes in CF are from 1955. The combination of CF and related diabetes (CFRD) has a negative impact on survival. CFRD is now the most common complication of CF (50% of the CF patients will develop diabetes by the age of 30 years), and is associated with a 6-fold increase in morbidity and mortality. CFRD is usually asymptomatic and can remain undetected for up to 4 years prior to diagnosis. The objective of this report was to review the current literature (Medline and Pubmed searches) on CFRD in children and adolescents and provide a comprehensive report of incidence, prevalence and pathophysiology of insulin deficiency and insulin insensitivity. Along with survival and prognosis in CFRD the current management strategies in the diagnosis, monitoring and treatment of CFRD will also be addressed.
Genetic Polymorphisms in the Locus Control Region and Promoter of GH1 Are Related to Serum IGF-I Levels and Height in Patients with Isolated Growth Hormone Deficiency and Healthy Controls
Authors: de Graaff Laura C.G. , Argente Jesus , van Meurs Joyce B.J. , Uitterlinden André G. , Hokken-Koelega Anita C.S.
Published: January 2010

Background/Aims: Expression of the human growth hormone (GH) gene (GH1) is regulated by a locus control region (LCR) and the highly polymorphic GH1 promoter. We analyzed GH1 LCR/promoter single nucleotide polymorphisms (SNPs) in patients with isolated growth hormone deficiency (IGHD) in relation to clinical data. Methods: We directly sequenced the GH1 LCR/promoter of 62 Dutch IGHD patients without mutations or deletions in GH1 or GHRHR and of 72 controls with normal height. We related GH1 LCR/promoter SNPs to height, serum insulin-like growth factor 1 (IGF-I) levels and response to GH treatment. Results: In IGHD patients, promoter SNPs 6, 8 and 9 were associated with height and IGF-1 levels. In controls, SNPs 6 and 11 were associated with height. Homozygosity for the minor allele of SNP 9, associated with lower IGF-I levels in patients, was significantly more frequent among patients than among controls. Genotypes based on SNPs 6, 8, 9 and 11 explained 10.8% of IGF-I SDS variation in IGHD patients and 15.9% of height SDS variation in controls. Conclusion:GH1 Promoter SNPs 6, 8 and 9 were associated with height and IGF-1 levels among patients, and SNPs 6 and 11 with height in controls.
Preparation and Clinical Evaluation of Succinylated Collagen Punctal Plugs in Dry Eye Syndrome: A Pilot Study
Authors: Hadassah J. , Bhuvaneshwari Namita , Singh Deepti , Sehgal P.K.
Published: January 2010

Aim: This is a pilot study of 10 eyes of 6 patients. This paper describes the preparation and clinical evaluation of succinylated collagen punctal plugs (SCPP) in the treatment of dry eye syndrome (DES). Methods: SCPP were prepared from succinylated collagen with the exact dimensions of the punctum (length 1.5–2.5 mm, diameter 0.2–0.5 mm, water content between 50 and 55%). All the patients were clinically evaluated for best corrected visual acuity (BCVA), tear fluid levels (TFL), protein content, tear fluid osmolarity (TFO), fluorescence staining of the cornea and tear break-up time (TBUT) before and after punctal occlusion with SCPP. Results: TFL improved among all the patients after punctal occlusion with SCPP. BCVA showed improvement in case 4 (right eye/left eye), case 5 (left eye) and case 6 (right eye), who had developed dry eyes due to environmental conditions. Protein content increased on day 7 in all the patients and gradually decreased. TFO decreased on days 3 and 5 in all patients after punctal occlusion with SCPP, and showed the same levels on day 14. TFL, PC, TFO and TBUT showed significant improvement in all the patients after punctal occlusion with SCPP. Conclusion: All patients experienced symptomatic relief after punctal occlusion with SCPP. There was no discomfort, foreign body sensation, plug extrusion, corneal aberration, infection, or formation of pyogenic granuloma with SCPP. SCPP stands as a promising alternative to other punctal plugs in the treatment of DES.
Geographic and Ethnic Variation in Parkinson Disease: A Population-Based Study of US Medicare Beneficiaries
Authors: Wright Willis Allison , Evanoff Bradley A. , Lian Min , Criswell Susan R. , Racette Brad A.
Published: January 2010

Background: Parkinson disease is a common neurodegenerative disease. The racial, sex, age, and geographic distributions of Parkinson disease in the US are unknown. Methods: We performed a serial cross-sectional study of US Medicare beneficiaries aged 65 and older from the years 1995, and 2000–2005. Using over 450,000 Parkinson disease cases per year, we calculated Parkinson disease prevalence and annual incidence by race, age, sex, and county. Spatial analysis investigated the geographic distribution of Parkinson disease. Results: Age-standardized Parkinson disease prevalence (per 100,000) was 2,168.18 (±95.64) in White men, but 1,036.41 (±86.01) in Blacks, and 1,138.56 (±46.47) in Asians. The incidence ratio in Blacks as compared to Whites (0.74; 95% CI = 0.732–0.748) was higher than the prevalence ratio (0.58; 95% CI = 0.575–0.581), whereas the incidence ratio for Asians (0.69; 95% CI = 0.657–0.723) was similar to the prevalence ratio (0.62; 95% CI = 0.617–0.631). Bayesian mapping of Parkinson disease revealed a concentration in the Midwest and Northeast regions. Mean county incidence by quartile ranged from 279 to 3,111, and prevalence from 1,175 to 13,800 (per 100,000). Prevalence and incidence in urban counties were greater than in rural ones (p < 0.01). Cluster analysis supported a nonrandom distribution of both incident and prevalent Parkinson disease cases (p < 0.001). Conclusions: Parkinson disease is substantially more common in Whites, and is nonrandomly distributed in the Midwest and Northeastern US.
Incidence of Spinal Muscular Atrophy in Poland – More Frequent than Predicted?
Authors: Jedrzejowska Maria , Milewski Michal , Zimowski Janusz , Zagozdzon Pawel , Kostera-Pruszczyk Anna , Borkowska Janina , Sielska Danuta , Jurek Marta , Hausmanowa-Petrusewicz Irena
Published: January 2010

Background: The application of molecular methods has enhanced and enlarged the diagnostics of spinal muscular atrophy (SMA) and its carriership. It allows for reliable epidemiological studies which are of importance to demography and genetic counseling. Methods: This study sought to evaluate the incidence of SMA in Poland, on the basis of the prevalence of the SMN1 gene deletion carrier state in the general population, as well as an analysis of all cases of SMA diagnosed in the years 1998–2005. Results: The prevalence of the SMN1 gene deletion carrier state was estimated at 1 per 35 persons (17/600), yielding an incidence of SMA equal to 1 per 4,900. By contrast, the incidence of SMA based on the results of the meta-analysis was an estimated 1 per 7,127 in Warsaw and 1 per 9,320 persons across Poland, suggesting that some cases of SMA remain undiagnosed. SMA1 predominated among the diagnoses, accounting for 69% of all cases. Conclusion: A high prevalence of the SMN1 deletion carrier state in the general population indicates that SMA could be a more frequent disease than is predicted by the epidemiological data regarding diagnosed cases.
Risk Factors for Aneurysmal Subarachnoid Hemorrhage in an Indian Population
Authors: Koshy Linda , Easwer H.V. , Premkumar S. , Alapatt Jacob P. , Pillai A. Marthanda , Nair Suresh , Bhattacharya R.N. , Banerjee Moinak
Published: January 2010

Background: Aneurysmal subarachnoid hemorrhage (aSAH) has a mortality rate as high as 50%. The prevalence of intracranial aneurysms from various parts of India varies from 0.75 to 10.3%, with higher numbers of cases being diagnosed due to the increasing age of the population and improvements in imaging techniques. However, little is known about the attributable risk factors of aSAH in the Indian population. Methods: Using a case-control study we estimated the risk of factors such as hypertension, cigarette smoking, alcohol consumption, diabetes mellitus and family history of aSAH in a South Indian population. The population-attributable risk (PAR) of smoking, hypertension and alcohol use was estimated for the South Indian as well as for the general Indian population. Results: Our results showed that cigarette smoking (OR, 3.59; p < 0.001) and a history of hypertension (OR, 2.98; p < 0.001) were significant risk factors associated with aSAH. When patients were classified by gender, it was observed that being a smoker and having hypertension increased the risk for aSAH by nearly fourfold in men. Among women, hypertension and older age were significant risk factors. The PAR estimates indicated that smoking (OR, 3.59; 95% CI, 2.13–6.06) and hypertension (OR, 2.98; 95% CI, 1.73–5.12) are significant risk factors. Conclusions: Hypertension and smoking may be causal risk factors which might also modify the effect of genetic factors that could increase susceptibility to aSAH in the Indian population. Since these risk factors are amenable to effective modification, our findings will be useful for a gender-specific management of aSAH.
Angiographic Pattern of Symptomatic Severe M1 Stenosis: Comparison with Presenting Symptoms, Infarct Patterns, Perfusion Status, and Outcome after Recanalization
Authors: Choi Jin Woo , Kim Jae Kyun , Choi Byung Se , Lim Hyun-Kyung , Kim Sang Joon , Kim Jong Sung , Suh Dae Chul
Published: January 2010

Background: Several angiographic patterns distal to severe M1 stenosis have been identified. We have assessed the relationship between these angiographic patterns and patient presenting symptoms, infarct patterns, perfusion status and outcome after recanalization. Methods: Three angiographic patterns were retrospectively identified in 60 patients (M:F = 41:19; age range = 34–80 years, mean = 55) who underwent M1 stenting: (1) a normal pattern (n = 22); (2) a shift pattern of the borderzone of the anterior cerebral artery (ACA) and middle cerebral artery (MCA) down to the MCA side with decreased size of MCA branches (n = 16), and (3) a dilatation pattern of the MCA branches with slow flow and minimal shift of borderzone (n = 22). In addition, to analyze interreader agreement, we assessed the correlation between angiographic patterns and gender, presenting symptoms (stroke vs. TIA), infarct patterns on MRI (borderzone vs. non-borderzone infarcts), perfusion results and outcome after stenting by χ2 or Fisher’s exact test. Results: Blind review revealed an excellent interreader agreement in the assessment of angiographic patterns (ĸ = 0.681). The shift pattern was more common in women than in men (p = 0.007). The likelihood of stroke (25/60, 42%, p = 0.001), borderzone infarct (21/32, 66%, p = 0.010) and decreased perfusion (p < 0.001) were greatest in the dilatation pattern, followed by shift and normal patterns. The outcomes did not differ by angiographic pattern probably due to the low event rate (4/60, 6.7%) within 6 months. Conclusions: Patients with severe M1 stenosis had 3 different angiographic patterns, which correlated with presenting symptoms, infarct patterns and perfusion status. Differences in patterns may be related to variation in collateral circulation at the ACA-MCA borderzone and hypoperfusion status.
Preliminary Study to Establish a Relationship between Tactile Sensation and Surface Roughness
Authors: Ando M. , Eckert G.J. , Zero D.T.
Published: January 2010

This study evaluated the ability of tactile sensations to distinguish roughness. Five examiners experienced in visual examination participated. Tactile sensation was assessed by 3 standard references, the average roughnesses 0.49, 0.92 and 1.54 µm. The examiners evaluated the roughness using 2 different ends of sharp explorers (TU 17 SE and 23 SE), each with 2 different handles (Standard Handle and No. 6 Handle-Satin Steel), and 1 WHO probe using a 5-point response score. The examiners performed 3 evaluations to establish repeatability. Using the 23 SE explorer with the steel handle was the best option to distinguish between 3 roughnesses (p < 0.05). The intraexaminer intraclass correlation coefficients (ICC) were between 0.90 and 0.98, but the interexaminer ICC were only between 0 and 0.04, indicating that, although trained examiners could repeat their own scores, they were not consistent with each other in grading roughness.
‘A Low Risk Is Still a Risk’: Exploring Women’s Attitudes towards Genetic Testing for Breast Cancer Susceptibility in Order to Target Disease Prevention
Authors: Henneman L. , Timmermans D.R. , Bouwman C.M. , Cornel M.C. , Meijers-Heijboer H.
Published: January 2010

Background: Population breast cancer screening programs by mammography are offered to women based on age. It has been suggested that a screening program based on genetic risk profile could be more effective by targeting interventions at those at higher genetic risk. This study explores women’s attitudes towards genetic testing for breast cancer susceptibility in order to target breast cancer prevention. Methods: A qualitative study was conducted using 4 focus groups with 26 women aged 42–73 years. Women were selected irrespective of personal or family history of breast cancer. Discussions were audiotaped and content analyzed. Results: The results show that in general women are positive towards a breast cancer screening program based on genetic risk profile, provided that in the low-risk group, though less frequent, women are still offered mammography screening (i.e. right to screening (a)). Other themes that women addressed were: (b) value of the genetic risk information (e.g. possibilities for cancer prevention at younger ages, less screening burden for low-risk women), (c) personal autonomy (e.g. free choice to undergo testing), (d) dealing with test results (e.g. burden of risk, motivation to reduce the risk), (e) discrimination, and (f) financial aspects and priority (e.g. with respect to other health care programs). Conclusion: These results suggest that women currently offered breast cancer screening based on age have a positive attitude towards population susceptibility screening for breast cancer, but also identified issues that need to be discussed and studied further, especially if women in the low-risk group were no longer to be offered mammography screening.
Atypical Hemolytic Uremic Syndrome: Update on the Complement System and What Is New
Authors: Hirt-Minkowski Patricia , Dickenmann Michael , Schifferli Jürg A.
Published: January 2010

Atypical hemolytic uremic syndrome (aHUS) is a rare disease of microangiopathic hemolytic anemia, thrombocytopenia, and predominant renal impairment. It is characterized by the absence of Shiga toxin-producing bacteria as a triggering factor. During the last decade, aHUS has been demonstrated to be a disorder of the complement alternative pathway dysregulation, as there is a growing list of mutations and polymorphisms in the genes encoding the complement regulatory proteins that alone or in combination may lead to aHUS. Approximately 60% of aHUS patients have so-called ‘loss-of-function’ mutations in the genes encoding the complement regulatory proteins, which normally protect host cells from complement activation: complement factor H (CFH), factor I (CFI) and membrane cofactor protein (MCP or CD46), or have ‘gain-of-function’ mutations in the genes encoding the complement factor B or C3. In addition, approximately 10% of aHUS patients have a functional CFH deficiency due to anti-CFH antibodies. Recent advances in understanding the pathogenesis of aHUS have led to a revised classification of the syndrome. Normal plasma levels of CFH and CFI do not preclude the presence of a mutation in these genes. Further, genotype-phenotype correlations of aHUS have clinical significance in predicting renal recovery and transplant outcome. Therefore, it is important to make a comprehensive analysis and perform genetic screening of the complement system in patients with aHUS to allow a more precise approach, especially before transplantation. This may also provide opportunities for more specific treatments in the near future, as complement inhibition could represent a therapeutic target in these patients who have a considerably poor prognosis in terms of both mortality and progression to end-stage renal disease and a great risk of disease recurrence after transplantation.
Post-Transcriptional Regulation of Osteoblastic Platelet-Derived Growth Factor Receptor-Alpha Expression by Co-Cultured Primary Endothelial Cells
Authors: Finkenzeller Günter , Mehlhorn Alexander T. , Schmal Hagen , Stark G. Björn
Published: January 2010

Platelet-derived growth factor receptor (PDGFR) signaling plays an important role in osteoblast function. Inhibition of PDGFR activity leads to a suppression of osteoblast proliferation, whereas mineralized matrix production is enhanced. In previous experiments, we showed that co-cultivation of human primary endothelial cells and human primary osteoblasts (hOBs) leads to a cell contact-dependent downregulation of PDGFR-α expression in the osteoblasts. In this study, we investigated this effect in more detail, revealing that human umbilical vein endothelial cell (HUVEC)-mediated PDGFR-α downregulation is dependent on time and cell number. This effect was specific to endothelial cells and was not observed when hOBs were co-cultured with human primary chondrocytes or fibroblasts. Likewise, HUVEC-mediated suppression of PDGFR-α expression was only seen in hOBs and mesenchymal stem cells but not in immortalized osteoblastic cell lines. Functional inhibition of gap junctional communication between HUVECs and hOBs by 18α-glycyrrhetinic acid had no effect on HUVEC-mediated PDGFR-α downregulation, whereas inhibition of p38 mitogen-activated protein kinase (MAPK) prevented the HUVEC-mediated reduction in osteoblastic PDGFR-α expression. To delineate the molecular mechanism underlying the PDGFR-α downregulation, we examined the effect of HUVEC co-cultivation on osteoblastic PDGFR-α promoter activity as well as mRNA stability. Co-cultivation of HUVECs with hOBs significantly shortened the half-life of osteoblastic PDGFR-α mRNA, but did not decrease its promoter activity. In summary, our data show that PDGFR-α is downregulated in hOBs by co-cultivation with human primary endothelial cells through a p38 MAPK-dependent post-transcriptional mechanism.
Cardiac Progenitor Cell Cycling Stimulated by Pim-1 Kinase
Authors: Cottage Christopher T. , Bailey Brandi , Fischer Kimberlee M. , Avitabile Daniele , Collins Brett , Tuck Savilla , Quijada Pearl , Gude Natalie , Alvarez Roberto , Muraski John , Sussman Mark A.
Published: January 2010

Rationale:

Cardioprotective effects of Pim-1 kinase have been previously reported but the underlying mechanistic basis may involve a combination of cellular and molecular mechanisms that remain unresolved. The elucidation of the mechanistic basis for Pim-1 mediated cardioprotection provides important insights for designing therapeutic interventional strategies to treat heart disease.

Objective:

Effects of cardiac-specific Pim-1 kinase expression on the cardiac progenitor cell (CPC) population were examined to determine whether Pim-1 mediates beneficial effects through augmenting CPC activity.

Methods and Results:

Transgenic mice created with cardiac-specific Pim-1 overexpression (Pim-wt) exhibit enhanced Pim-1 expression in both cardiomyocytes and CPCs, both of which show increased proliferative activity assessed using 5-bromodeoxyuridine (BrdU), Ki-67, and c-Myc relative to nontransgenic controls. However, the total number of CPCs was not increased in the Pim-wt hearts during normal postnatal growth or after infarction challenge. These results suggest that Pim-1 overexpression leads to asymmetric division resulting in maintenance of the CPC population. Localization and quantitation of cell fate determinants Numb and α-adaptin by confocal microscopy were used to assess frequency of asymmetric division in the CPC population. Polarization of Numb in mitotic phospho-histone positive cells demonstrates asymmetric division in 65% of the CPC population in hearts of Pim-wt mice versus 26% in nontransgenic hearts after infarction challenge. Similarly, Pim-wt hearts had fewer cells with uniform α-adaptin staining indicative of symmetrically dividing CPCs, with 36% of the CPCs versus 73% in nontransgenic sections.

Conclusions:

These findings define a mechanistic basis for enhanced myocardial regeneration in transgenic mice overexpressing Pim-1 kinase.
Impact of Baseline Tissue Status (Diffusion-Weighted Imaging Lesion) Versus Perfusion Status (Severity of Hypoperfusion) on Hemorrhagic Transformation
Authors: Kim Jong Hun , Bang Oh Young , Liebeskind David S. , Ovbiagele Bruce , Kim Gyeong-Moon , Chung Chin Sang , Lee Kwang Ho , Saver Jeffrey L.
Published: January 2010

Background and Purpose—

The frequency of hemorrhagic transformation (HT) on gradient echo imaging and its impact on stroke outcomes continues to be debated. We investigated the factors associated with HTs and the influence of the HTs observed on gradient echo imaging on the early course after a stroke.

Methods—

We analyzed the data from a prospectively maintained registry of patients who were eligible for recanalization therapy. Serial diffusion-weighted imaging and perfusion-weighted imaging were performed, and HTs were assessed on follow-up gradient echo imaging.
T
max perfusion lesion maps were generated and hypoperfused regions were divided into severe (
T
max ≥8 seconds) delay and mild (
T
max ≥2 seconds but
T
max <8 seconds) delay. The factors associated with HTs, including the mode of recanalization therapy, pretreatment diffusion-weighted imaging and perfusion-weighted imaging lesion volumes, and reperfusion indices, were evaluated. The early clinical outcome was assessed during the first 7 days of admission.

Results—

A total of 184 patients were included in this study. HTs were noted in 73 (39.7%) patients. Multiple logistic regression analysis identified aggressive treatment (OR, 5.12; 95% CI, 1.73 to 15.18) and a large area of severe perfusion delay (OR for highest quartile of
T
max >8 seconds, 12.91; 95% CI, 3.69 to 45.17) as independent predictors of HTs. Neither risk factor profiles nor diffusion-weighted imaging lesion volumes were associated with HTs. There was a poor correlation between the radiological (HT types) and clinical (asymptomatic or symptomatic) categories of HTs. Even a parenchymal hematoma was not always associated with symptomatic worsening or affected the early clinical outcomes.

Conclusion—

The results of this study indicate that the perfusion status (severe perfusion delay) rather than the tissue status (diffusion-weighted imaging lesions) and aggressive treatment were independently associated with HTs. HT on gradient echo imaging was common but usually associated with severe hypoperfusion and not always associated with clinical deterioration.
Validity of Proxies and Correction for Proxy Use When Evaluating Social Determinants of Health in Stroke Patients
Authors: Skolarus Lesli E. , Sánchez Brisa N. , Morgenstern Lewis B. , Garcia Nelda M. , Smith Melinda A. , Brown Devin L. , Lisabeth Lynda D.
Published: January 2010

Background and Purpose—

The purpose of this study was to evaluate stroke patient–proxy agreement with respect to social determinants of health, including depression, optimism, and spirituality, and to explore approaches to minimize proxy-introduced bias.

Methods—

Stroke patient–proxy pairs from the Brain Attack Surveillance in Corpus Christi Project were interviewed (n=34). Evaluation of agreement between patient–proxy pairs included calculation of intraclass correlation coefficients, linear regression models (
ProxyResponse
=α

0

+α
1
PatientResponse
+δ, where α

0

=0 and α
1
=1 denotes no bias) and κ statistics. Bias introduced by proxies was quantified with simulation studies. In the simulated data, we applied 4 approaches to estimate regression coefficients of stroke outcome social determinants of health associations when only proxy data were available for some patients: (1) substituting proxy responses in place of patient responses; (2) including an indicator variable for proxy use; (3) using regression calibration with external validation; and (4) internal validation.

Results—

Agreement was fair for depression (intraclass correlation coefficient, 0.41) and optimism (intraclass correlation coefficient, 0.48) and moderate for spirituality (κ, 0.48 to 0.53). Responses of proxies were a biased measure of the patients’ responses for depression, with α

0

=4.88 (CI, 2.24 to 7.52) and α

1

=0.39 (CI, 0.09 to 0.69), and for optimism, with α

0

=3.82 (CI, −1.04 to 8.69) and α

1

=0.81 (CI, 0.41 to 1.22). Regression calibration with internal validation was the most accurate method to correct for proxy-induced bias.

Conclusion—

Fair/moderate patient–proxy agreement was observed for social determinants of health. Stroke researchers who plan to study social determinants of health may consider performing validation studies so corrections for proxy use can be made.
Therapeutic Milestone
Authors: Towfighi Amytis , Ovbiagele Bruce , Saver Jeffrey L.
Published: January 2010

Background and Purpose—

Stroke mortality rates declined for much of the second half of the 20th century, but recent trends and their relation to other organ- and disease-specific causes of death have not been characterized.

Methods—

Using the National Center for Health Statistics mortality data, leading organ- and disease-specific causes of death were assessed for the most recent 10-year period (1996 to 2005) in the United States with a specific focus on stroke deaths.

Results—

Age-adjusted stroke death rates declined by 25.4%; as a result, lung cancer (which only declined by 9.2%) surpassed stroke as the second leading cause of death in 2003. Despite a 31.9% decline in age-adjusted ischemic heart disease death rates, it remains the leading cause of death. Stroke is now the fifth leading cause of death in men and the fourth leading cause of death in whites but remains the second leading cause of death in women and blacks.

Conclusions—

With stroke death rates decreasing substantially in the United States from 1996 to 2005, stroke moved from the second to the third leading organ- and disease-specific cause of death. Women and blacks may warrant attention for targeted stroke prevention and treatment because they continue to have disproportionately high stroke death rates.
Recombinant Fv-Hsp70 Protein Mediates Neuroprotection After Focal Cerebral Ischemia in Rats
Authors: Zhan Xinhua , Ander Bradley P. , Liao Isaac H. , Hansen James E. , Kim Chester , Clements Douglas , Weisbart Richard H. , Nishimura Robert N. , Sharp Frank R.
Published: January 2010

Background and Purpose—

This study investigated the effects of intravenous recombinant Fv-Hsp70 protein on infarction volume and behavior after experimental ischemic stroke.

Methods—

Focal cerebral ischemia was produced by occluding the middle cerebral artery using the intraluminal suture technique. Rats subjected to 2 hours of focal ischemia were allowed to survive 24 hours. At 2¼ hours and 3 hours after onset of ischemia, Fv-Hsp70 recombinant protein (0.5 mg/kg) or saline was injected through the tail vein. Sensorimotor function and infarction volume were assessed at 24 hours after ischemia.

Results—

Administration of Fv-Hsp70 after focal cerebral ischemia significantly decreased infarct volume by 68% and significantly improved sensorimotor function compared with the saline-treated control group. Western blots showed Fv-Hsp70 in ischemic but not in control brain; and Fv-Hsp70 suppressed endogenous Hsp70.

Conclusion—

Fv-Hsp70 protected the ischemic brain in this experimental stroke model.
Timing and Utility of Ultrasound in Diarrhea-Associated Hemolytic Uremic Syndrome: 7-Year Experience of a Large Tertiary Care Hospital
Authors: Glatstein Miguel , Miller Elka , Garcia-Bournissen Facundo , Scolnik Dennis
Published: January 2010

The authors reviewed the clinical, laboratory, and imaging data from cases of diarrhea-associated hemolytic uremic syndrome (HUS D+), diagnosed at our institution, from 2001 to 2008. The timing and utility of ultrasonographic features of HUS D+ were analyzed. The aim of the study was to determine factors that could aid in the early diagnosis of this disease. A total of 13 children with HUS D+ were identified out of 23 patients with HUS diagnosed during this time period. Evidence of Escherichia coli 0157:H7 was found in 9 cases (70%). Ultrasound studies were ordered in 10 patients (71%), all of which showed renal sonographic findings compatible with HUS. Ultrasound was performed at a mean of 13 days after onset of the diarrhea. Of note, 2 patients whose ultrasounds were performed at the beginning of their diarrheal illness manifested ultrasonographic features suggestive of HUS when there was only a mild increase in serum creatinine and no decrease in hemoglobin or platelets, suggesting that ultrasonography can identify renal involvement early in the course of the disease before other systemic signs appear. Early renal ultrasound may be a useful adjunct in the initial evaluation in children with bloody diarrhea. Evidence of increased renal echogenicity in a patient with bloody diarrhea could aid in early recognition of HUS when other diagnoses such as intussusceptions are being entertained, potentially allowing early intervention.
Applying Practice Recommendations for the Prevention and Treatment of Obesity in Children and Adolescents
Authors: Dorsey Karen B. , Mauldon Maria , Magraw Ruth , Valka Julie , Yu Sunkyung , Krumholz Harlan M.
Published: January 2010

To describe pediatric clinicians’ adherence to practice recommendations for obesity prevention and treatment, we conducted a cross-sectional analysis of 227 medical records of 3- to 18-year-old patients (seen from September 2003 to April 2004) and a longitudinal analysis of data from 632 overweight and obese patients (followed through March 2006). The cross-sectional analysis showed that early practice adopters (n = 3) more frequently recorded BMI (91% of patients), a diagnosis (89%), and counseling (82%) compared with late adopters (n = 9; 34%, 51%, and 48% of patients, respectively; P < .001). The longitudinal analysis showed that among overweight and obese patients, documentation of BMI dropped from 96% at the first clinic visit to 27% by the fifth visit; documentation of individual risk behaviors fell from ≥72% at the first visit to ≤23% at the fifth visit. Despite initial adoption of screening and assessment practices, clinicians’ attention to weight management diminished over time.
Perceived Maternal Stress During Pregnancy and Its Relation to Infant Stress Reactivity at 2 Days and 10 Months of Postnatal Life
Authors: Leung Eman , Tasker Susan L. , Atkinson Leslie , Vaillancourt Tracy , Schulkin Jay , Schmidt Louis A.
Published: January 2010

Background. Although the negative impact of maternal stress during pregnancy on stress reactivity in offspring is well documented in nonhuman animals, we know little about these relations in humans and their lasting effects. Aim. The authors examined the relation between perceived maternal stress during pregnancy and stability of infant stress reactivity across the first year of postnatal life in humans. Study design. Perceived maternal stress during pregnancy was measured in the immediate postpartum period and again at 10 months after delivery in 84 mothers and examined in relation to behavioral and neuroendocrine stress reactivity measures in their healthy, full-term infants. Outcome measures. Salivary cortisol was collected between 24 to 48 hours of postnatal life in response to a heel stick and again at 10 months of age in response to a toy removal task in the same sample of infants. Behavioral reactivity was coded from direct observation during the toy removal task. Results . Perceived maternal stress during pregnancy and neonatal cortisol reactivity each remained stable across the first 10 months of postnatal life. Maternal stress during pregnancy predicted infant cortisol reactivity at 2 days and 10 months after birth as well as behavioral reactivity at 10 months. Neonatal cortisol reactivity predicted 10-month behavioral reactivity. Conclusion . These preliminary findings suggest that maternal stress during pregnancy may negatively affect neonatal stress reactivity within 24 to 48 hours after birth, and these influences may persist through the first year of postnatal life.
Adapting Pediatric Obesity Treatment Delivery for Low-Income Families: A Public—Private Partnership
Authors: Cluss Patricia A. , Ewing Linda J. , Long Kristin A. , Krieger William G. , Lovelace John
Published: January 2010

Objective. The objective was to evaluate the feasibility of delivering a pediatric weight management intervention adapted for low-income families.Academic researchers, a Medicaid health plan, a State Medicaid agency, and community pediatric providers partnered in the project. Methods. Participants were 48 families with 52 overweight/obese children aged 4 to 12 recruited from Medicaid health plan and providers’ offices. Elements of efficacious pediatric obesity interventions were modified for low literacy and implemented in person and telephonically with parents. Results. Families report ents in food shopping and preparation, and child eating and activity habits. The retention rate was 88%. Children grew significantly taller ( F = 7.1; P = .012) but did not gain significant weight ( F = 0.91; P = .35), with a trend toward decreased BMI ( F = 3.2; P = .08). Conclusions. The authors demonstrate the feasibility of delivering an adapted pediatric obesity intervention with low-income families. They also discuss implications for public—private partnerships among key stakeholders to address pediatric obesity in this high-risk population.
Making Oral Health a Priority in Your Preventive Pediatric Visits
Authors: Silk Hugh
Published: January 2010

Oral health is a prevalent health issue for children. Pediatricians have an important role in screening, educating, and making referrals during well-child visits. Advice must be age-specific to be effective. Topics to be covered include hygiene, diet, habits, fluoride, and referrals to dentists. Other members of the office can play a role in educating care givers. Special needs children and literacy issues demand extra attention in oral health management. There are many oral health resources available for pediatricians and parents.
Money, Lifestyle, or Values? Why Medical Students Choose Subspecialty Versus General Pediatric Careers
Authors: Newton Dale A. , Grayson Martha S. , Foster Thompson Lori
Published: January 2010

Although there are many published studies on factors associated with medical student career choice, few are specific to pediatric careers, and even fewer address the choice between general and subspecialty pediatric training. Fourth-year medical students surveyed at 2 schools reported their demographics, anticipated future income, the factors influencing their career choice, and their anticipated career. This study included the subset of 337 students planning pediatric careers. Results indicated that marital status, anticipated income, and career values are associated with pediatric career plans. Specifically, married students were more likely than unmarried students to pursue general pediatric careers ( P < .01). Compared with students planning subspecialties, those intending to pursue general pediatric careers anticipated lower incomes ($110 906 vs $135 984; P < .001) and rated lifestyle, comprehensive patient care, and working with the poor as more important ( P < .05) when choosing a career. Students planning subspecialty pediatric careers placed more value ( P < .05) on prestige, income, and research opportunities.
Antibiotic Prescription Pattern for Viral Respiratory Illness in Emergency Room and Ambulatory Care Settings
Authors: Nadeem Ahmed M. , Muyot Maria M. , Begum Shahana , Smith Patti , Little Charletta , Windemuller Fernando J.
Published: January 2010

Objective: To evaluate the current practice pattern of antibiotic prescription rate in viral respiratory tract infection diagnosed children among different specialty health care providers. Methods: The study was a retrospective case review study where a random sample of 1200 child care visits coded as viral respiratory infections in primary care provider’s office, convenient care clinic, or emergency room in 2006 were analyzed. Results: Overall, the antibiotic prescription rate was 30%. The prescription rate was 3.7 times (95% confidence interval [CI] = 1.90-7.31) higher for bronchitis patients and 2.5 times (95% CI = 1.46-4.30) higher for viral pharyngitis patients than for common cold patients. Antibiotics were written more by emergency physicians (odds ratio [OR] = 11.04; 95% CI = 5.78-21.10) and family practitioners (OR = 5.22; 95% CI = 2.99-9.10) than by pediatricians. Conclusion: Although not recommended, children seen in the emergency room and family practitioner’s office are more likely to receive antibiotic prescriptions than those seen in the pediatrician’s office.
School Socioeconomic Classification, Funding, and the New Jersey High School Proficiency Assessment (HSPA)
Authors: Bao D.H. , Romeo George C. , Harvey Roberta
Published: January 2010

This study examines the relationship between educational effectiveness, as measured by the New Jersey High School Proficiency Assessment (HSPA), and funding of school districts based on socioeconomic classification. Results indicate there is a strong relationship between performance in HSPA, socioeconomic classification, and the different sources of funding. Total cost per student for lower socioeconomic schools is not significantly different from that for higher socioeconomic schools. Higher socioeconomic status, however, leads to lower per student cost for administration, for operations, and for food services. Higher socioeconomic status also leads to higher per student cost for extracurricular activities and salaries.
Effective Urban Teaching Environments for the 21st Century
Authors: Galloway Charles , Lasley Thomas J.
Published: January 2010

Urban schools have historically struggled to create engaging learning environments for students. One of the emerging answers to this educational conundrum is the development of more personalized learning environments. Such environments draw on the natural interests of students but contextualize those interests within demanding academic structures. This article describes the historical context confronting urban educators and one of the emerging solutions: early colleges.
Mechanical Properties of Composite Materials Made of 3D Stitched Woven-knitted Preforms
Authors: Hong Hu  , Mingxing Zhang  , Fangueiro Raul , De Araujo Mario
Published: January 2010

This article presents an experimental investigation carried out to understand the mechanical behavior of composite materials made of 3D stitched woven-knitted basalt fabrics. The innovative preforms used consist of two outer layers of a plain woven fabric combined with two inner layers of weft-knitted fabrics. The weft-knitted fabrics selected for the study were varied plain knit, 1 × 1 rib, Milano, and interlock. The fabric layers were stitched together with Kevlar yarns. These 3D stitched preforms were impregnated with polyester resin using resin transfer molding, and the corresponding composites obtained were tested under tensile, bending, and impact loads. The results obtained show that the type of knitted structure significantly influences the mechanical performance of the 3D stitched woven-knitted composites. The composite using interlock structure as the inner layers has the best results concerning energy absorption and tensile strength. The varied plain knit structure has proved to be the best suited to impart stiffness as it provides the highest Young’s modulus among the above four knitted structures.
Effects of Maleic Anhydride Polypropylene on Tensile, Water Absorption, and Morphological Properties of Recycled Newspaper Filled Polypropylene/Natural Rubber Composites
Authors: Osman Hakimah , Ismail Hanafi , Mustapha Mariatti
Published: January 2010

This study focused on the effects of maleic anhydride-grafted polypropylene (MAPP) on tensile, water absorption, and morphological properties of recycled newspaper (RNP) filled polypropylene (PP)/natural rubber (NR) composites. The abbreviation MAPP will be used for its common name in this research work. For both uncompatibilized and MAPP-compatibilized RNP-filled composites, tensile strength and elongation at break (EB) increased at certain filler content, then decreased at higher filler content. Meanwhile, continuous increase of Young’s modulus has been observed in the case of uncompatibilized and compatibilized composites. At similar filler content, compatibilized composites show higher tensile strength and Young’s modulus but lower EB than uncompatibilized composites. Water absorption study indicates that the incorporation of MAPP reduced water uptakes of the composites. This may be attributed to the enhanced adhesion between the MAPP-compatibilized RNP and polymer matrix, as evidenced from morphology study with scanning electron microscopy. The chemical interaction between MAPP-compatibilized RNP and polymer matrix was confirmed with Fourier transform infrared analysis.
Thermal Stress Distribution in CF/EP Composite in Low Earth Orbit
Authors: Chun Lu  , Ping Chen  , Yu Gao  , Wen Qi  , Qi Yu
Published: January 2010

Thermal cycle in low earth orbit environment has a negative influence on thermal stress distribution in carbon fiber/epoxy (CF/EP) composite. In our experiment a 3D finite element analysis method was used to analyze thermal stress distribution and failure mechanism in CF/EP composite. Thermal stress distribution was characterized using Von Mises stress, composite potential failure zone was analyzed using parabolic failure criterion, and composite micro-cracking distribution was studied using birth and death technique. Results indicated that thermal stress at different parts of the composite are different: at composite free end zone, the maximum thermal stress 179.9 MPa located at fiber surface with the longest distance between two fibers; while in composite inner zone, the maximum thermal stress is 29.5 MPa located in EP matrix with the shortest distance between two fibers. Thermal stress concentration at composite free end zone induces micro-cracking between fiber and the matrix, besides as thermal cycle increase micro-cracking progress from composite free end zone to composite inner zone, which will degrade the mechanical performance.
On the Determination of the Fatigue Life of Laminated Graphite-Epoxy Composite by Means of Temperature Measurement
Authors: Minak Giangiacomo
Published: January 2010

The research dealt with the correlation between fatigue life of a CFRP laminate composite and the thermal analysis information obtained during the fatigue tests. This study was done for two different lamination sequences and three different loading frequencies. The damage progression was also evaluated by stiffness reduction and hysteresis loop areas increase measurements. The thermal energy, which is the amount of mechanical energy dissipated in the form of heat, evaluated in the first few load cycles was found to be a good parameter to predict fatigue life.
Efficacy of Sodium Valproate and Haloperidol in the Management of Acute Mania: A Randomized Open‐Label Comparative Study
Authors: Sekhar Susmit , Kalra Bhupinder , Mendhekar D. N. , Tekur Uma
Published: January 2010

This study was carried out to compare the efficacy of intravenous sodium valproate with intramuscular haloperidol in patients with acute mania. A total of 30 patients meeting DSM‐IV criteria for acute manic episodes were enrolled. They were randomly assigned to 2 groups of 15 patients each. Both groups were treated twice daily with haloperidol (10 mg, intramuscular) and sodium valproate (500 mg, intravenous). The patients were assessed on days 1, 5, 9, and 13. Improvement in symptoms was assessed by reduction in the Young Mania Rating Scale (YMRS). Outcome criterions for analysis were latency of response and remission; additional drugs were required for sedation. At the end of the 2‐week study period, overall response rate in both the groups was similar (P > .1). In comparison to haloperidol group, patients treated with sodium valproate showed faster response, and on day 5, significant reduction in YMRS score was observed in the group treated with sodium valproate (P < .05). Total amount of lorazepam was less in patients treated with sodium valproate. Extrapyramidal symptom episodes were observed in 60% of patients treated with haloperidol. Sodium valproate in the treatment of acute mania is as efficacious as haloperidol but provides a faster response. It is safer compared to haloperidol.
Trustees’ Perceptions of the Desired Qualifications for the Next Generation of Community College Presidents
Authors: Plinske Kathleen , Packard Walter J.
Published: January 2010

Although the authority for hiring a community college president resides with the board of trustees, few studies have directly explored trustees’ perceptions of the desired qualifications for presidents. Using a Delphi process, this study identified the characteristics, competencies, and professional experiences that Illinois community college trustees value in presidential candidates.
Predictive Toxicology Approaches for Small Molecule Oncology Drugs
Authors: Maziasz T. , Kadambi V.J. , Silverman L. , Fedyk E. , Alden C.L.
Published: January 2010

A daunting, unmet medical need exists for effective oncology chemotherapies, with cancer deaths in 2009 to exceed 560,000 in the United States alone. Because of the rapid demise of the majority of cancer patients with metastatic disease, oncology drug development must follow a much different paradigm than therapeutic candidates for less onerous diseases. The majority of drug candidates in development today are targeted at cancer therapy. Many of these candidate chemotherapeutic agents are active against novel targets, often presenting unique toxicological profiles. Since many of these novel targets are not unique to cancer cells, therapeutic margins may not exist. Decision making, in this event, is among the most challenging that any pharmaceutical toxicologist/pathologist or regulator will face. Nonclinical development scientists must compress timelines to present therapeutic options for cancer patients who have failed conventional therapy. In support of this goal, the U. S. Food and Drug Administration has created an oncology-specific paradigm for nonclinical testing and has introduced strategies to accelerate development and approval of successful candidates. Pharmaceutical toxicology testing strategies must not only satisfy regulation as the minimal expectation, but also attempt to reduce the current high attrition rates for oncologic candidates. A successful toxicology testing strategy represents the substance of this treatise.
Evidential Bodies: The Forensic and Abject Gazes in C.S.I.: Crime Scene Investigation
Authors: Pierson David P.
Published: January 2010

This essay argues that CBS-TV’s C.S.I.: Crime Scene Investigation constructs a multiplicity of gazes for viewers with a particular focus on the forensic and abject gazes.The abject gaze is both repulsive and attractive in its focus on the physiological effects of death on the human body. The abject nature of the corpse is mediated by the investigators’ forensic gaze, which seeks to control crime, death, and abjection. In C.S.I., the forensic gaze also promotes the secondary gazes of voyeurism and forensic science as visual spectacle. Ultimately, the series’ forensic gaze can be associated with the prevalence and proliferation of biological identification technologies in modern society.