bluuebunny/crossref_metadata_2025 huggingface dataset:
The Trial of the Expert Witness
Authors: Schryer Catherine F. , Afros Elena , Mian Marcellina , Spafford Marlee , Lingard Lorelei
Published: March 2009

This article reports on forensic letters written by physicians specializing in identifying children who have experienced maltreatment. These writers face an extraordinary exigence in that they must provide an opinion as to whether a child has experienced abuse without specifically diagnosing abuse and thus crossing into a legal domain. Their credibility was also at issue because, in this jurisdiction, child abuse identification was not recognized as a medical subspecialty and because the status of expert witnesses is currently being challenged. Through an analysis of 72 forensic letters combined with interview data from six letter writers and five letter readers, we determined that these writers used linguistic and rhetorical strategies that allowed these letters to function as boundary objects or objects that traverse several communities of practice. The most salient strategy was the use of evaluative lexis—adjectives and adverbs which allowed for a range of interpretations and constrained those interpretations at the same time.
Locating Global Feminisms Elsewhere
Authors: Chowdhury Elora Halim
Published: March 2009

This article explores the trajectory of global feminism from the vantage point of the US, and its treatment of `Other Women' in the service of its own hegemonic (re)construction and simultaneous occlusion of multiple feminisms both within and beyond the US. It also offers reflections on locating global feminisms instead in `alternate' venues and avoiding reproducing the West as its predetermined default frame of reference. I am proposing to undertake a critique of global feminism in two ways: through how the discipline of women's studies is organized and how global feminism is deployed politically. The analytical tools that help me take on global feminism are to be found in US anti-racist feminism and transnational feminism. That is, US anti-racist and transnational feminisms can aid in the analysis and shifting the politics of feminism.
Rosario's development; interview with Miguel Lifschitz, mayor of Rosario, Argentina
Authors: Almansi Florencia
Published: March 2009

This paper draws on an interview with Miguel Lifschitz, who is in his second term as mayor of Rosario, Argentina's third largest city. It describes the city's strategic planning and the support it provided for local economic development and for the large expansion of public space — with the city government working with private landowners to restore the riverbank area and create many new parks and other public spaces. It also describes the municipal government's social policies, including the modernization and expansion of health care and the introduction of a city police force, and its support for participatory budgeting and decentralization, including the role of municipal district centres that concentrate many public services and support community programmes in each of the city's six districts. The mayor also describes the difficulties his administration has faced — for instance, its limited capacity to reduce unemployment (although the city government has done much to support local economic development) and the difficulties of working with national and provincial governments and neighbouring municipalities controlled by different political parties.
Social movements and the production of housing in Buenos Aires; when policies are effective
Authors: Scheinsohn Mariano , Cabrera Cecilia
Published: March 2009

This paper highlights some emerging issues that are critical to the popular housing development carried out within the context of political movements in Buenos Aires in recent years. We analyze the role of the political dimension — in terms of participation in the public domain and of the relationship with power structures — in generating efficient conditions for housing development. This kind of undertaking, framed within a politically organized social movement, has significant capacity for dialogue with the state. On the one hand this allows for mediations that operate as control guarantees, but on the other it generates power and public presence inequalities among active members. Another purpose of this paper is to analyze the potential capacity of this kind of social movement to go beyond the micro and sector levels in their activities, and generate economies of scale in their participation in urban development.
“This is no longer the city I once knew”. Evictions, the urban poor and the right to the city in millennial Delhi
Authors: Bhan Gautam
Published: March 2009

Millennial Delhi is changing rapidly. Between 1990 and 2003, 51,461 houses were demolished in Delhi under “slum clearance” schemes. Between 2004 and 2007 alone, however, at least 45,000 homes were demolished, and since the beginning of 2007, eviction notices have been served on at least three other large settlements. Fewer than 25 per cent of the households evicted in this latter time period have received any alternative resettlement sites. These evictions represent a shift not just in degree but also in kind. They were not ordered by the city's planning agency, its municipal bodies or by the city government. Instead, each was the result of a judicial ruling. What has this emergence of the judiciary into urban planning and government meant for the urban poor? This paper analyzes the dictums of verdicts on evictions in the Delhi High Court and the Supreme Court of India from 1985 to 2006. Using these judgments, it explores the “misrecognition” of the poor that became dramatically apparent in the early 1990s and that underlies and justifies evictions. This shift is then located in the larger political, economic and aesthetic transformations that are re-configuring the politics of public interest in Indian cities.
Getting the information base for Dharavi's redevelopment
Authors: Patel Sheela , Arputham Jockin , Burra Sundar , Savchuk Katia
Published: March 2009

This is the third in a series of papers chronicling the evolution of negotiations on plans to redevelop Dharavi, Mumbai's vast informal settlement, from the perspective of practitioners supporting Dharavi's residents in their struggle for inclusive development. This paper highlights progress that took place during 2008, including the completion of a baseline survey, constructive engagement with the government and positive amendments to the plan that emerged from this dialogue. The paper also highlights continuing challenges that residents and civil society face in working with the state to ensure that development benefits Dharavi's residents and enterprises.
Integrating Social Media Into Existing Work Environments
Authors: Stolley Karl
Published: March 2009

This article offers an example case of technical communicators integrating the social bookmarking site Delicious into existing work environments. Using activity theory to present conceptual foundations and concrete steps for integrating the functionalities of social media, the article builds on research within technical communication that argues for professional communicators to participate more fully in the design of communication systems and software. By examining the use of add-ons and tools created for Delicious, and the customized use of Rich Site Syndication (RSS) feeds that the site publishes, the author argues for addressing the context-sensitive needs of project teams by integrating the functionality of social media applications generally and repurposing their user-generated data.
Using Interagency Collaboration to Support Family-Centered Transition Practices
Authors: Branson Diane M. , Bingham Ann
Published: March 2009

Harry's mother, Lanie, looked around the table at all of the professionals who had come together to write Harry's Individualized Education Plan (IEP): Harry's service coordinator, the school district preschool coordinator, the early childhood preschool consultant, the child care center director, Harry's child care provider, and his physical therapist. She reflected back on the preparations that had led to this meeting: There were multiple conversations with Harry's service coordinator, a parent transition planning workshop sponsored by the school district that Lanie attended 3 months ago, and visits to several school district preschool programs to learn more about the continuum of services available for preschoolers. Lanie had initially dreaded thinking about Harry's transition at age 3; however, now that the time was closer, Lanie felt confident that both she and Harry were ready for any changes they might encounter.
Promoting Lifestyle Physical Activity: Experiences With the First Step Program
Authors: Tudor-Locke Catrine
Published: March 2009

The purpose of this article is to describe a pedometer-based physical activity intervention (and the research that has been conducted on this program) to provide insight into workable strategies focused on promoting lifestyle physical activity. The First Step Program (FSP) is a facilitated theory-based behavior modification program, originally developed for individuals with type 2 diabetes, that capitalizes on the unique properties of a pedometer to serve as a stimulus for walking and an instrument for individual goal setting, self-monitoring, and feedback. Formative evaluation revealed that participants were highly enthusiastic about the program, and pilot testing demonstrated an immediate and dramatic increase in walking behavior (by approximately 3700 steps/d or 34 minutes of walking per day). A randomized and controlled evaluation produced similar results, as have head-to-head comparisons of participant outcomes produced by professional versus peer delivery, and adaptations of the program to work site and community-based delivery. The effectiveness of the FSP can be explained by a thoughtful consideration of pedometer characteristics, program features, and the people who participate. Sustained delivery is contingent on funding sources and administrative structures that support formalized implementation.
Operation Iraqi Freedom strategic communication analysis and assessment
Authors: Cioppa Thomas M.
Published: March 2009

In support of Operation Iraqi Freedom, the Joint Campaign Plan describing purpose and objectives was revised in mid-2007 and designated strategic communication as an important enabler of operations. A flexible and responsive methodological approach was needed to monitor, measure, analyze, and assess strategic communication to ensure desired effects were being achieved. This article details the real-world application of strategic communication analysis by the Multi-National Force — Iraq (MNF—I) Communication Division to support MNF—I and United States Mission — Iraq (USM—I) senior leadership situational awareness and decision making. The seven critical methods used included an understanding of the Iraqi and Pan-Arab media; media penetration of key themes; alignment of key messages; understanding Iraqi perceptions; prevalence of misinformation and disinformation in media stories; resonance of press conferences and key themes and messages; and effect of embedded reporters. The goal was to assess the alignment among facts on the ground, media framing of events, and Iraqi perceptions, and to provide actionable recommendations to improve the alignment.
Regulation of iron homeostasis in anemia of chronic disease and iron deficiency anemia: diagnostic and therapeutic implications
Authors: Theurl Igor , Aigner Elmar , Theurl Milan , Nairz Manfred , Seifert Markus , Schroll Andrea , Sonnweber Thomas , Eberwein Lukas , Witcher Derrick R. , Murphy Anthony T. , Wroblewski Victor J. , Wurz Eva , Datz Christian , Weiss Guenter
Published: March 2009

The anemia of chronic disease (ACD) is characterized by macrophage iron retention induced by cytokines and the master regulator hepcidin. Hepcidin controls cellular iron efflux on binding to the iron export protein ferroportin. Many patients, however, present with both ACD and iron deficiency anemia (ACD/IDA), the latter resulting from chronic blood loss. We used a rat model of ACD resulting from chronic arthritis and mimicked ACD/IDA by additional phlebotomy to define differing iron-regulatory pathways. Iron retention during inflammation occurs in macrophages and the spleen, but not in the liver. In rats and humans with ACD, serum hepcidin concentrations are elevated, which is paralleled by reduced duodenal and macrophage expression of ferroportin. Individuals with ACD/IDA have significantly lower hepcidin levels than ACD subjects, and ACD/IDA persons, in contrast to ACD subjects, were able to absorb dietary iron from the gut and to mobilize iron from macrophages. Circulating hepcidin levels affect iron traffic in ACD and ACD/IDA and are more responsive to the erythropoietic demands for iron than to inflammation. Hepcidin determination may aid to differentiate between ACD and ACD/IDA and in selecting appropriate therapy for these patients.
Molecular determinants archetypical to the phylum Nematoda
Authors: Yin Yong , Martin John , Abubucker Sahar , Wang Zhengyuan , Wyrwicz Lucjan , Rychlewski Leszek , McCarter James P , Wilson Richard K , Mitreva Makedonka
Published: March 2009

Background

Nematoda diverged from other animals between 600–1,200 million years ago and has become one of the most diverse animal phyla on earth. Most nematodes are free-living animals, but many are parasites of plants and animals including humans, posing major ecological and economical challenges around the world.

Results

We investigated phylum-specific molecular characteristics in Nematoda by exploring over 214,000 polypeptides from 32 nematode species including 27 parasites. Over 50,000 nematode protein families were identified based on primary sequence, including ~10% with members from at least three different species. Nearly 1,600 of the multi-species families did not share homology to Pfam domains, including a total of 758 restricted to Nematoda. Majority of the 462 families that were conserved among both free-living and parasitic species contained members from multiple nematode clades, yet ~90% of the 296 parasite-specific families originated only from a single clade. Features of these protein families were revealed through extrapolation of essential functions from observed RNAi phenotypes inC. elegans, bioinformatics-based functional annotations, identification of distant homology based on protein folds, and prediction of expression at accessible nematode surfaces. In addition, we identified a group of nematode-restricted sequence features in energy-generating electron transfer complexes as potential targets for new chemicals with minimal or no toxicity to the host.

Conclusion

This study identified and characterized the molecular determinants that help in defining the phylum Nematoda, and therefore improved our understanding of nematode protein evolution and provided novel insights for the development of next generation parasite control strategies.
Multiple factors interact to produce responses resembling spectrum of human disease in Campylobacter jejuni infected C57BL/6 IL-10-/- mice
Authors: Bell Julia A , St Charles Jessica L , Murphy Alice J , Rathinam Vijay AK , Plovanich-Jones Anne E , Stanley Erin L , Wolf John E , Gettings Jenna R , Whittam Thomas S , Mansfield Linda S
Published: March 2009

Background

Campylobacter jejuniinfection produces a spectrum of clinical presentations in humans – including asymptomatic carriage, watery diarrhea, and bloody diarrhea – and has been epidemiologically associated with subsequent autoimmune neuropathies. This microorganism is genetically variable and possesses genetic mechanisms that may contribute to variability in nature. However, relationships between genetic variation in the pathogen and variation in disease manifestation in the host are not understood. We took a comparative experimental approach to explore differences among differentC. jejunistrains and studied the effect of diet on disease manifestation in an interleukin-10 deficient mouse model.

Results

In the comparative study, C57BL/6 interleukin-10-/-mice were infected with seven genetically distinctC. jejunistrains. Four strains colonized the mice and caused disease; one colonized with no disease; two did not colonize. A DNA:DNA microarray comparison of the strain that colonized mice without disease toC. jejuni11168 that caused disease revealed that putative virulence determinants, including loci encoding surface structures known to be involved inC. jejunipathogenesis, differed from or were absent in the strain that did not cause disease. In the experimental study, the five colonizing strains were passaged four times in mice. For three strains, serial passage produced increased incidence and degree of pathology and decreased time to develop pathology; disease shifted from watery to bloody diarrhea. Mice kept on an ~6% fat diet or switched from an ~12% fat diet to an ~6% fat diet just before infection with a non-adapted strain also exhibited increased incidence and severity of disease and decreased time to develop disease, although the effects of diet were only statistically significant in one experiment.

Conclusion

C. jejunistrain genetic background and adaptation of the strain to the host by serial passage contribute to differences in disease manifestations ofC. jejuniinfection in C57BL/6 IL-10-/-mice; differences in environmental factors such as diet may also affect disease manifestation. These results in mice reflect the spectrum of clinical presentations ofC. jejunigastroenteritis in humans and contribute to usefulness of the model in studying human disease.
Towards the Atlas of human African trypanosomiasis
Authors: Cecchi Giuliano , Paone Massimo , Franco José R , Fèvre Eric M , Diarra Abdoulaye , Ruiz José A , Mattioli Raffaele C , Simarro Pere P
Published: March 2009

Background

Updated, accurate and comprehensive information on the distribution of human African trypanosomiasis (HAT), also known as sleeping sickness, is critically important to plan and monitor control activities. We describe input data, methodology, preliminary results and future prospects of the HAT Atlas initiative, which will allow major improvements in the understanding of the spatial distribution of the disease.

Methods

Up-to-date as well as historical data collected by national sleeping sickness control programmes, non-governmental organizations and research institutes have been collated over many years by the HAT Control and Surveillance Programme of the World Health Organization. This body of information, unpublished for the most part, is now being screened, harmonized, and analysed by means of database management systems and geographical information systems (GIS). The number of new HAT cases and the number of people screened within a defined geographical entity were chosen as the key variables to map disease distribution in sub-Saharan Africa.

Results

At the time of writing, over 600 epidemiological reports and files from seventeen countries were collated and included in the data repository. The reports contain information on approximately 20,000 HAT cases, associated to over 7,000 different geographical entities. The oldest epidemiological records considered so far date back to 1985, the most recent having been gathered in 2008. Data from Cameroon, Central African Republic, Chad, Congo, Equatorial Guinea and Gabon from the year 2000 onwards were fully processed and the preliminary regional map of HAT distribution is presented.

Conclusion

The use of GIS tools and geo-referenced, village-level epidemiological data allow the production of maps that substantially improve on the spatial quality of previous cartographic products of similar scope. The significant differences between our preliminary outputs and earlier maps of HAT transmission areas demonstrate the strong need for this systematic approach to mapping sleeping sickness and point to the inaccuracy of any calculation of population at risk based on previous maps of HAT transmission areas. The Atlas of HAT will lay the basis for novel, evidence-based methodologies to estimate the population at risk and the burden of disease, ultimately leading to more efficient targeting of interventions. Also, the Atlas will help streamline future field data collection in those parts of Africa that still require it.
Omega 3 fatty acids reduce myeloid progenitor cell frequency in the bone marrow of mice and promote progenitor cell differentiation
Authors: Varney Melinda E , Hardman W Elaine , Sollars Vincent E
Published: March 2009

Background

Omega 3 fatty acids have been found to inhibit proliferation, induce apoptosis, and promote differentiation in various cell types. The processes of cell survival, expansion, and differentiation are of key importance in the regulation of hematopoiesis. We investigated the role of omega 3 fatty acids in controlling the frequency of various myeloid progenitor cells in the bone marrow of mice. Increased progenitor cell frequency and blocked differentiation are characteristics of hematopoietic disorders of the myeloid lineage, such as myeloproliferative diseases and myeloid leukemias.

Results

We found that increasing the proportion of omega 3 fatty acids relative to the proportion of omega 6 fatty acids in the diet caused increased differentiation and reduced the frequency of myeloid progenitor cells in the bone marrow of mice. Furthermore, this had no adverse effect on peripheral white blood cell counts.

Conclusion

Our results indicate that omega 3 fatty acids impact hematopoietic differentiation by reducing myeloid progenitor cell frequency in the bone marrow and promoting progenitor cell differentiation. Further exploration of this discovery could lead to the use of omega 3 fatty acids as a therapeutic option for patients that have various disorders of hematopoiesis.
Alterations in the glutathione metabolism could be implicated in the ischemia-induced small intestinal cell damage in horses
Authors: Marañón Gonzalo , Manley William , Cayado Patricia , García Cruz , de la Muela Mercedes Sánchez , Vara Elena
Published: March 2009

Background

Colic could be accompanied by changes in the morphology and physiology of organs and tissues, such as the intestine. This process might be, at least in part, due to the accumulation of oxidative damage induced by reactive oxygen (ROS) and reactive nitrogen species (RNS), secondary to intestinal ischemia. Glutathione (GSH), being the major intracellular thiol, provides protection against oxidative injury. The aim of this study was to investigate whether ischemia-induced intestinal injury could be related with alterations in GSH metabolism.

Results

Ischemia induced a significant increase in lipid hydroperoxides, nitric oxide and carbon monoxide, and a reduction in reduced glutathione, and adenosine triphosphate (ATP) content, as well as in methionine-adenosyl-transferase and methyl-transferase activities.

Conclusion

Our results suggest that ischemia induces harmful effects on equine small intestine, probably due to an increase in oxidative damage and proinflammatory molecules. This effect could be mediated, at least in part, by impairment in glutathione metabolism.
Critical care physician cognitive task analysis: an exploratory study
Authors: Fackler James C , Watts Charles , Grome Anna , Miller Thomas , Crandall Beth , Pronovost Peter
Published: March 2009

Introduction

For better or worse, the imposition of work-hour limitations on house-staff has imperiled continuity and/or improved decision-making. Regardless, the workflow of every physician team in every academic medical centre has been irrevocably altered. We explored the use of cognitive task analysis (CTA) techniques, most commonly used in other high-stress and time-sensitive environments, to analyse key cognitive activities in critical care medicine. The study objective was to assess the usefulness of CTA as an analytical tool in order that physician cognitive tasks may be understood and redistributed within the work-hour limited medical decision-making teams.

Methods

After approval from each Institutional Review Board, two intensive care units (ICUs) within major university teaching hospitals served as data collection sites for CTA observations and interviews of critical care providers.

Results

Five broad categories of cognitive activities were identified: pattern recognition; uncertainty management; strategic vs. tactical thinking; team coordination and maintenance of common ground; and creation and transfer of meaning through stories.

Conclusions

CTA within the framework of Naturalistic Decision Making is a useful tool to understand the critical care process of decision-making and communication. The separation of strategic and tactical thinking has implications for workflow redesign. Given the global push for work-hour limitations, such workflow redesign is occurring. Further work with CTA techniques will provide important insights toward rational, rather than random, workflow changes.
Proteolytic generation of kinins in tissues infected byTrypanosoma cruzidepends on CXC chemokine secretion by macrophages activated via Toll-like 2 receptors
Authors: Schmitz Veronica , Svensjö Erik , Serra Rafaela Rangel , Teixeira Mauro M , Scharfstein Julio
Published: March 2009

Previous analysis of the endogenous innate signals that steer T cell-dependent immunity in mice acutely infected by the protozoan Trypanosoma cruzi revealed that bradykinin (BK) or lysyl-BK, i.e., the short-lived peptides excised from plasma-borne kininogens through the activity of cruzipain, induces dendritic cell maturation via BK B2 receptors (B2R). Here, we used the s.c. model of T. cruzi infection to study the functional interplay of TLR2, CXCR2, and B2R in edema development. Using intravital microscopy, we found that repertaxin (CXCR2 antagonist) blocked tissue-culture trypomastigotes (TCT)-induced plasma leakage and leukocyte accumulation in the hamster cheek pouch topically exposed to TCT. Furthermore, we found that TCT-evoked paw edema in BALB/c mice was blocked by repertaxin or HOE-140 (B2R antagonist), suggesting that CXCR2 propels the extravascular activation of the kinin/B2R pathway. We then asked if TLR2-mediated sensing of TCT by innate sentinel cells could induce secretion of CXC chemokines, which would then evoke neutrophil-dependent plasma leakage via the CXCR2/B2R pathway. Consistent with this notion, in vitro studies revealed that TCT induce robust secretion of CXC chemokines by resident macrophages in a TLR2-dependent manner. In contrast, TLR2+/+ macrophages stimulated with insect-derived metacyclic trypomastigotes or epimastigotes, which lack the developmentally regulated TLR2 agonist displayed by TCT, failed to secrete keratinocyte-derived chemokine/MIP-2. Collectively, these results suggest that secretion of CXC chemokines by innate sentinel cells links TLR2-dependent recognition of TCT to the kinin system, a proteolytic web that potently amplifies vascular inflammation and innate immunity through the extravascular release of BK.
The E3 ubiquitin ligase LNX1p80 promotes the removal of claudins from tight junctions in MDCK cells
Authors: Takahashi Senye , Iwamoto Noriko , Sasaki Hiroyuki , Ohashi Masato , Oda Yukako , Tsukita Shoichiro , Furuse Mikio
Published: March 2009

The structural continuity of tight junctions (TJs) is consistently maintained even when epithelial cells divide and move within the cellular sheet. This process is associated with dynamic remodeling of TJs by coordinated internalization and generation of claudin-based TJ strands, but the molecular mechanism behind the regulated turnover of TJs remains largely unknown. In this study, we identified the p80 isoform of the E3 ubiquitin ligase ligand of Numb-protein X1 (LNX1p80) as a protein binding to claudin-1. Interestingly, the concentration of claudins in TJs was remarkably reduced when LNX1p80 was overexpressed in MDCK cells, and there was a reduction not only in the number of TJ strands but also in the amount of detergent-insoluble claudins. We also found that LNX1p80 promoted polyubiquitylation of claudins. This ubiquitylation is dependent on its RING-finger domain and is not mediated by Lys48 of ubiquitin, which is used for protein degradation by the proteasome. Furthermore, LNX1p80 was often colocalized with claudins in vesicular structures containing markers for late endosomes and lysosomes. These findings suggest that LNX1p80 is involved in the ubiquitylation, endocytosis and lysosomal degradation of claudins, and that the turnover of TJs is regulated by ubiquitylation.
The extracellular-matrix protein matrilin 2 participates in peripheral nerve regeneration
Authors: Malin Dmitry , Sonnenberg-Riethmacher Eva , Guseva Daria , Wagener Raimund , Aszódi Attila , Irintchev Audrey , Riethmacher Dieter
Published: March 2009

Matrilins are adaptor proteins of the extracellular matrix involved in the formation of both collagen-dependent and collagen-independent filamentous networks. Although their molecular structure and binding partners have been characterized, the functional roles of the four matrilin family members in vivo are still largely unknown. Here, we show that matrilin 2, expressed in pre-myelinating Schwann cells during normal development, profoundly influences the behaviour of glial cells and neurons in vitro. When offered as a uniform substrate, matrilin 2 increased neurite outgrowth of dorsal root ganglia (DRG) neurons and enhanced the migration of both cell line- and embryonic DRG-derived Schwann cells. Vice versa, axonal outgrowth and cell migration were decreased in DRG cultures prepared from matrilin-2-deficient mice compared with wild-type (wt) cultures. In stripe assays, matrilin 2 alone was sufficient to guide axonal growth and, interestingly, axons favoured the combination of matrilin 2 and laminin over laminin alone. In vivo, matrilin 2 was strongly upregulated in injured peripheral nerves of adult wild-type mice and failure of protein upregulation in knockout mice resulted in delayed regrowth of regenerating axons and delayed time-course of functional recovery. Strikingly, the functional recovery 2 months after nerve injury was inferior in matrilin-2-deficient mice compared with wild-type littermates, although motoneuron survival, quality of axonal regeneration, estimated by analyses of axonal diameters and degrees of myelination, and Schwann cell proliferation were not influenced by the mutation. These results show that matrilin 2 is a permissive substrate for axonal growth and cell migration, and that it is required for successful nerve regeneration.
Reprogramming to a muscle fate by fusion recapitulates differentiation
Authors: Pomerantz Jason H. , Mukherjee Semanti , Palermo Adam T. , Blau Helen M.
Published: March 2009

Fusion of mammalian cells to form stable, non-dividing heterokaryons results in nuclear reprogramming without the exchange of genetic material. In this report, we show that reprogramming in somatic cell heterokaryons involves activation of the canonical skeletal muscle transcription factors as well as contraction-excitation genes. Thus, the effect of heterokaryon formation on gene expression is to induce a recapitulation of differentiation. Heterokaryons formed with a relatively refractory cell type, the hepatocyte cell line HepG2, revealed the importance of both MyoD expression and other unidentified cytoplasmic components, neither of which are sufficient for efficient muscle gene activation, but are synergistic. We provide evidence that de-repression by transient histone deacetylase inhibition can induce MyoD expression and increase the extent and efficiency of muscle gene transcription. Taken together, the results suggest that understanding the mechanistic basis, using a combination of approaches, and taking into account cell history, will facilitate an increase in the efficiency and fidelity of conversion from one differentiated phenotype to another desired cell type. Inherent advantages of the heterokaryon system merit further investigation in the pursuit of directed cloning.
What is a priority?
Authors: Spicker Paul
Published: March 2009

What does it mean to say that something is a ‘priority’? Priority setting is used to balance competing claims for resources, but the nature of the exercise is ambiguous. The priorities which are claimed might be for time, resources, process, rights or service. The setting of priorities might refer to importance, relative value, precedence, special status or lexical ordering. And there are different ways of ranking priorities including simple ordering, optimization, triage and satisficing. There is a fundamental distinction between preference rankings and precedence rankings, which can lead to strongly different conclusions from the same initial information. Because there is no definitive understanding of what a priority is, there can be no authoritative formula for deciding between competing claims.
Feasibility and cost of obtaining informed consent for essential review of medical records in large-scale health services research
Authors: Noble Sian , Donovan Jenny , Turner Emma , Metcalfe Chris , Lane Athene , Rowlands Mari-Anne , Neal David , Hamdy Freddie , Ben-Shlomo Yoav , Martin Richard
Published: March 2009

Objective:

To evaluate the effectiveness and cost of obtaining consent for review of medical records within the passively observed non-intervention arm of a cluster randomized controlled trial, ‘Comparison Arm for ProtecT’.

Methods:

Two hundred and thirty men, who had been notified to the trial by cancer registries as having prostate cancer, were sent a consent form from their general practitioner or secondary care clinician. The consent rate of participants to the review of their medical records and the estimated costs of the process were evaluated.

Results:

One hundred and seventy-nine men (84%: 95% CI = 78%, 89%) consented to have their medical notes reviewed at an estimated cost of £123 (€172, $248) per person.

Conclusions:

A high consent rate for review of medical notes is achievable but at a cost. There needs to be renewed debate about the automatic need for consent to review medical records where the chance of personal harm is negligible and the purpose of the review is to provide robust evidence to save lives, prevent needless suffering, and improve the effectiveness and efficiency of health care delivery.
Trends in the epidemiology and prescribing of medication for eczema in England
Authors: Simpson Colin R , Newton John , Hippisley-Cox Julia , Sheikh Aziz
Published: March 2009

Summary

Background

The prevalence of eczema, particularly in younger children, increased substantially over the second half of the 20th century. Analysis of primary healthcare data-sets offers the possibility to advance understanding about the changing epidemiology of eczema.

Aim

To investigate recent trends in the recorded incidence, lifetime prevalence, prescribing and consulting behaviour of patients with eczema in England.

Methods

QRESEARCH is one of the world’s largest national aggregated health databases containing the records of over nine million patients. We extracted data on all patients with a recorded diagnosis of eczema and calculated annual age–sex standardized incidence and lifetime period prevalence rates for each year from 2001–2005. We also analysed the consulting behaviour of these patients when compared with the rest of the QRESEARCH database population. The number of eczema prescriptions issued to people in England was also estimated.

Results

The age–sex standardized incidence of eczema was 9.58 per 1000 person-years in 2001 and increased to 13.58 per 1000 patients in 2005 (p<0.001). By 2005, eczema affected an estimated 5,773,700 (95% confidence intervals [CI] 5,754,100–5,793,400) individuals in England, who, on average, consulted a general practitioner 4.02 (95% CI 4.01–4.03) times a year. During the study period, the number of eczema related prescriptions increased by 56.6% (95% CI 56.6–56.7), so by 2005 an estimated 13,690,300 (95% CI 13,643,200–13,737,600) prescriptions were issued.

Conclusions

Recorded incidence and lifetime prevalence of eczema in England continue to increase. Similar increases have also been observed in the estimated number of eczema prescriptions issued to the English population.
Five-year results of incompetent perforator vein closure using TRans-Luminal Occlusion of Perforator
Authors: Bacon J L , Dinneen A J , Marsh P , Holdstock J M , Price B A , Whiteley M S
Published: March 2009

In 2000, we developed a percutaneous method of treating incompetent perforator veins (IPV) using ultrasound-guided radiofrequency ablation (RFA), which we termed TRansluminal Occlusion of Perforator (TRLOP).

Objective

To audit the five-year outcome of the TRLOP technique as indicated by the rate of IPV closure on duplex ultrasound (DUS).

Methods

Patients underwent DUS five years post-TRLOP. Experienced vascular technologists documented the presence of IPVs using a two co-ordinate system, blinded to previous results. Results were then compared with preoperative scans. IPVs were classified as: closed; not closed/reopened; or de novo. Closed IPVs were defined as the absence of any IPV at or within 5 cm of a previous IPV in the vertical and horizontal plane. Any IPVs found outside the delineated area were defined as de novo IPVs.

Results

Of 67 patients invited, 37 attended DUS (55% participation rate; men to women ratio of 14:23, age 40–84; mean 64). Preoperative clinical, aetiological, anatomical and pathological classification: C2, 36.2%; C3, 27.6%; C4, 34.5%; C6, 1.7%. From 125 IPVs analysed, 101 were closed (81%), 24 were not closed/reopened (19%) and 14 de novo IPVs were found.

Discussion

Despite these results representing our learning curve for the procedure, we found TRLOP to be an effective treatment for IPVs. The closure rates described are comparable with the published clinical series data for subfascial endoscopic perforator surgery.
Decline in hospital mortality rate after the use of the World Health Organization protocol for management of severe malnutrition
Authors: Falbo Ana Rodrigues , Alves João Guilherme Bezerra , Filho Malaquias Batista , Caminha Maria de Fátima Costa , Cabral-Filho José Eulálio
Published: March 2009

We studied the implementation of the World Health Organization protocol for the treatment of malnourished children at the largest maternal and infant hospital in the northeast of Brazil. The implementation of the protocol resulted in a reduction in the mortality rate from 38.0% to 16.2%.
False negative serological tests may lead to misdiagnosis and mismanagement in osteoarticular brucellosis
Authors: Janmohammadi Nasser , Roushan Mohammad Reza Hasanjani
Published: March 2009

Non-specific clinical presentations and paraclinical findings in osteoarticular brucellosis may mimic many other diseases and other causes of arthritis which could lead to misdiagnosis and mismanagement. We studied retrospectively the records of 232 patients with osteoarticular brucellosis who were admitted to the three teaching hospitals of Babol Medical Sciences University from April 2001 to September 2006. The distribution of osteoarticular involvement and their management were evaluated to determine if any cases had been misdiagnosed because of false negative serologic tests and who had, as a result, undergone inappropriate surgical interventions. Of 232 patients, 138 (59%) were male and 94 (41%) were female. Polyarthritis, monoarthritis, spondylitis and sacroilitis were seen in 91 (39%), 60 (26%), 43 (18.5%) and 38 (16.5%) patients, respectively. Two hundred and twenty-nine (98.7%) patients were diagnosed correctly and treated successfully; three (1.3%) were misdiagnosed and had been given inappropriate surgical interventions. Of these three patients, two (3.3%) were suffering from monoarthritis (hip joint) and one (2.3%) had spondylitis.
Managing mycetomas
Authors: Ameen Mahreen
Published: March 2009

Mycetomas are chronic, granulomatous, subcutaneous infections caused by traumatic inoculation into the skin of either the actinomycetes bacteria or the eumycetes fungi, giving rise to actinomycetomas and eumycetomas, respectively. They are endemic in the tropics afflicting mainly those of low socio-economic status and men working in agriculture. The disease is slowly progressive and can cause bone involvement, which can result in considerable disability. Late presentation is not uncommon making them notoriously difficult to manage. This article highlights the important aspects of their management and developments in drug therapy.
Diagnosis of malaria in children's outpatient departments in Abuja, Nigeria
Authors: Nomhwange Terna I , Whitty Christopher JM
Published: March 2009

Over-diagnosis of malaria has previously been described, especially in East Africa. Abuja is the capital of the most populous country in Africa. Over-prescription of artemisinin-based combination therapy (ACT) antimalarials in Nigeria on the scale reported from other countries will result in substantial unnecessary use of this class of drug.

In a study of 1000 children seen in the outpatient paediatric clinics of four district hospitals in Abuja, 669 had history of fever, of whom 616 (92%) were diagnosed with malaria. Only 24 (3.8%) where confirmed by positive malaria slides. Of 82 malaria tests requested, 32 (40%) were not available when clinicians wrote their prescriptions. Of 256 children prescribed an ACT, 11 (4.4%) were test negative, eight (3.1%) test positive, in 11 (4.3%) the test was not available and the test was not requested for 219 (86%). The proportion of available negative slides for patients treated with an antimalarial was 23/26 (88%), which was similar to the 22/24 (91%) treated with an antimalarial who were test positive. Testing for malaria made almost no impact on ACT prescription or on all other antimalarials and antibiotics. Based on these findings there is high possibility of massive over prescription of antimalarials.
Atypical cerebrospinal fluid profile in tuberculous meningitis
Authors: Pinto Vitor Laerte , Lima Marco Antonio , Rolla Valéria Cavalcanti , Rebelo Maria Cristina , Bóia Marcio Neves
Published: March 2009

The aim of this study was to describe atypical cerebrospinal fluid (CSF) alterations in tuberculous meningitis (TBM) and to analyse the differences in outcome between patients with typical and atypical profiles. We did a retrospective study during the period of 2000 to 2005 including the cases of TBM assisted in a referral centre for infectious diseases in Rio de Janeiro State, Brazil. Neutrophilic plecytosis at the first spinal tap was found in 32.4% of TBM patients, who had a worse outcome when compared with those patients with typical CSF profiles. One factor that might have a major impact was the delay in starting empirical treatment (27.5 versus 11.6 days). We conclude that, in cases with clinical and epidemiological data compatible with TBM but with an atypical CSF profile, empirical treatment should be considered if CSF culture and direct examination for bacteria are negative.
Atypical bacterial pathogens in community-acquired pneumonia in children: a hospital-based study
Authors: Agarwal Jyotsna , Awasthi Shally , Rajput Anuradha , Tiwari Manoj , Jain Amita
Published: March 2009

A total of 243 children aged one month to five years with World Health Organization defined severe community acquired pneumonia were studied for the presence of atypical bacterial pathogens: 24 were found positive for mycoplasma infection. There was no significant association with any of the clinical, laboratory and radiological variables in children with pneumonia by the atypical pathogen.
Dengue encephalitis: an entity now common in dengue-prone regions
Authors: Matlani Monica , Chakravarti Anita , Rawal Ashish , Kashyap Bineeta , Gurtoo A
Published: March 2009

As well as dengue fever (DF) and dengue haemorrhagic fever-dengue shock syndrome (DHF/DSS), other atypical manifestations of dengue virus infection have also been reported. The frequency of CNS involvement in dengue remains unknown, although isolated cases with neurological manifestations have been reported in Southeast Asia, Malaysia, Burma, Puerto Rico and India. We present two cases of encephalitis associated with DF and DHF from New Delhi, India.
Working with Policy Makers on Their Choices: A Decision Analyst Reminisces
Authors: Brown Rex V.
Published: March 2009

As a decision consultant and researcher, I discuss 40 years of working with policy makers on energy, environmental and foreign policy, defense, and other national issues, making heavy use of applied decision theory. I focus attention on decisions with significant human interest—where clients have sought not only to improve their own decisions, but also to justify them and to influence the decisions of others. I reflect on political, administrative, legal, and personal considerations involved.
Using online communities to attract museum visitors
Authors: Liu Alison Hsiang-Yi
Published: March 2009

The rapid development of the World Wide Web has redefined the information age as one of participation and authorship. Among other developments, the global occurrence of blogging, originating at grassroots level then embraced by the establishment, has virtually created a new medium.
In the museum field, in which marketing has become a dominant concern, curators are considering whether or not online communities such as blog can be deployed and how their use can help to attract and open up new markets. This article focuses on their concerns from the perspective of an online
community and investigates ways of applying blogging to transform potential visitors into museum-goers, as well as for visitor studies. Three community websites are examined in detail and provide reference points for studying ways in which museums apply this new medium. The conclusions are
that museums can use online communities to engage potential visitors and create a virtuous circle between virtual and physical visits. When they are used creatively, online communities can also serve as visitor study tools by enabling them to participate in cultural debates and construct personal
and meaningful learning experiences.
(Doing) art as an interdisciplinary didactic principle
Authors: Kraus Anja
Published: March 2009

It is common to introduce works of art into lessons in primary and secondary schools in order to mediate ideas and theories about subjective realities. Pictures, sculptures, installations are understood to represent insights and imagination, or illustrate shared realities. In this paper
we interpret art works as translations of subjective intentions, even theories, in particular experiential settings. An art-work or artistic action that emphasizes its object character as a central theme is especially open to this kind of interpretation. It can serve to generate theories revealed
through the senses. In principle, art could be used in schools whenever interdependencies and contexts are the learning focus. In order to show this approach is not dependent on the age range of pupils, this paper offers two practical examples. One took place in the eighth grade of a secondary
school, one in the third grade of a primary school.
The art of embodiment: auto-ethnographic portraits of two women's surgical traumas
Authors: Morawski Cynthia M , Irwin Stephanie
Published: March 2009

Two educational researchers heed the responsibility to face their own traumatic pasts in working with women's experiential texts in the present. Using the notion of individual as both artist and image illustrated in the art of body biography, they come together to embody their own intrapersonal
stories of gynaecological and obstetrical traumas as auto-ethnographic texts. Using a palette of photographs, found objects, ink, fabric and more, they portray their past on the present canvas of life-size paper placed across the office floor. Pin pricks on the abdomen. The next slice and
stitch. Laproscopic cameras. The leg that lurched and twitched. With each expression of meaning, they delve into multiple layers of consciousness, connecting their recurring past to intrapersonal possibilities of women's education in the present. The art of embodiment plays a leading role.