bluuebunny/crossref_metadata_2025 huggingface dataset:
Epidermoid Cyst of the Brainstem in Children
Authors: Gopalakrishnan C. V , Dhakoji Amit , Nair Suresh
Published: August 2011

Epidermoid cysts are rare, slow growing, space-occupying lesions of early adulthood. Among the various locations, involvement of the brainstem is quite exceptional. In children, these tumors are extremely uncommon; only 4 purely intrinsic brainstem epidermoids are reported in the literature. The pathogenesis of true intraaxial brainstem epidermoid is unclear and is usually not considered in the preoperative differential diagnosis of brainstem tumors. We report 2 additional cases of brainstem epidermoid cysts occurring in children, underlining their clinical characteristics, the difficulties faced in the diagnostic work-up, and the surgical treatment adopted. These tumors pose a surgical challenge and attempts at aggressive removal of the cyst wall are fraught with increased risks of morbidity and mortality. On the other hand, cases treated more conservatively show good or excellent results with minimal complications. Neurosurgical judgment at the time of surgery is warranted to ensure maximum resection while minimizing postoperative neurologic deficits.
The Diving Reflex in Healthy Infants in the First Year of Life
Authors: Pedroso Fleming S. , Riesgo Rudimar S. , Gatiboni Tanira , Rotta Newra T.
Published: September 2011

A cohort study was conducted with a random sample of 33 healthy infants evaluated at birth and at 1, 2, 3, 4, 5, 6, 9, and 12 months to determine the frequency of respiratory rate changes in response to air blown over the face (diving reflex) in the first year of life, and to standardize the description of diving reflex occurrence. All 33 infants remained neurologically normal throughout follow-up. Diving reflex was observed in 95.3% of newborns and in 100% of infants between 2 and 6 months of age. At 6 months, it started to decrease but persisted in 90% of the infants up to 12 months. The diving reflex is highly prevalent in the first year of life and can be easily elicited by applying a flow of air over the infant’s face, particularly during crying.
Enhancing biocompatibility and corrosion resistance of Mg implants via surface treatments
Authors: Jo Ji-Hoon , Hong Ji-Yeon , Shin Kwang-Seon , Kim Hyoun-Ee , Koh Young-Hag
Published: August 2011

Oxide coating layers were formed on a pure magnesium (Mg) substrate through anodization and micro-arc oxidation (MAO) in order to enhance the biocompatibility and reduce the degradation rate. A thin, smooth MgO coating layer was formed after the anodization. On the other hand, when the Mg was treated using the MAO process, a relatively thick, rough MgO layer was formed. The corrosion properties were investigated using electrochemical and ion release tests in a simulated body fluid. Both the anodization and the MAO treatment enhanced the corrosion resistance of the Mg specimens. However, the MgO layers that formed on the surface were not stable enough to render favorable environments for cell growth. The anodized and MAO-treated specimens were post-treated in a cell-culturing medium in order to improve the stability of the coating layer. The biocompatibility was evaluated using in vitro cell tests, including cell attachment, DNA measurement, and alkaline phosphatase (ALP) activity tests. The DNA levels of the surface-treated Mg were about 6–10 times higher than the bare Mg. The ALP activity levels were also more than double after either the anodization or the MAO followed by the post-treatments. These results demonstrated that the biocompatibility and the corrosion resistance of Mg were significantly improved by the series of surface treatments.
Data Matching to Allocate Doctors to Patients in a Microsimulation Model of the Primary Care Process in New Zealand
Authors: von Randow Martin , Davis Peter , Lay-Yee Roy , Pearson Janet
Published: August 2011

The authors aimed to use existing data to create a microsimulation model of the primary care process in New Zealand, including realistically simulating the allocation of general practitioners (GPs) to a population sample. This is important because GP behavior is likely to be a major determinant of future cost and service outcomes. Two nationally representative data sets were matched: a sample of GPs and their patients from the National Primary Medical Care Survey (NPMCS) and a population sample from the New Zealand Health Survey (NZHS). Matching involved first dividing the data sets into cells based on common variables. Further variables were then included in a distance function to guide matching within cells. A transportation optimization algorithm allocated GPs based on these—on similarities in patients’ attributes. Statistical matching performed well with high correlations for patient attributes and reduced average absolute rank differences on proportions of patients among GPs compared to random matching. Low Kullback–Leibler (K–L) divergences confirmed that our method of statistical matching had allocated GPs realistically. Models of primary care too frequently omit the role of the practitioner in driving health service outcomes. The authors developed a method to impute characteristics of GPs to a population-based microsimulation model of primary care.
Does belief matter in climate change action?
Authors: Vainio Annukka , Paloniemi Riikka
Published: August 2011

We studied environmental action and its predictors in a multi-scalar context of climate change politics. We asked how belief in climate change, post-materialist values, trust and knowledge predict people’s engagement in environmental action by testing two alternative structural equation models (SEM). In one of these models all these factors directly predicted climate-friendly action, and in the other the effect of political trust, post-materialist values and climate change knowledge on climate-friendly action was mediated by belief in climate change. The models were tested with Eurobarometer 69.2 survey data of adult people living in Finland ( N = 1,004). The SEM revealed that belief in climate change mediates the effect of post-material values, trust and knowledge on climate-friendly action. It is therefore important to recognize the role of belief in the public understanding of large-scale environmental problems. These results help political authorities to develop policies to encourage people’s engagement in climate-friendly action.
The frequency of doping in elite sport: Results of a replication study
Authors: Pitsch Werner , Emrich Eike
Published: August 2011

The difficulty of measuring the prevalence of doping in elite sport is a recurring topic in the scientific literature on doping. The Randomized Response Technique is a method for asking such embarrassing or even threatening questions while allowing the respondents to answer honestly. It was used to measure the prevalence of doping among German squad athletes by Pitsch et al. (2005, 2007). In a replication study with better sampling control, it was possible to replicate the general trend of the data from the 2005 study. Nevertheless, there are differences in the details between the two sets of findings. An additional explorative analysis reveals that gender has an important impact on doping decisions. Most theories of doping, especially those derived from systems theory or economic game theory address neither the central findings nor the influence of gender. Based on these findings, we will discuss questions of theory development in relation to empirical evidence.
Distinct Pharmacologic Substrate in Lidocaine-Sensitive, Repetitive Atrial Tachycardia
Authors: Chiale Pablo A. , Faivelis Luciano , Garro Hugo A. , Fernández Pablo A. , Herrera Paz Juan J. , Elizari Marcelo V.
Published: September 2011

Lidocaine-sensitive, repetitive atrial tachycardia is an uncommon arrhythmia. The electrophysiologic substrate is still unknown, and the pharmacologic responses have not been fully explored. The aim of this study was to investigate the effects of intravenous adenosine and verapamil in patients with lidocaine-sensitive atrial tachycardia. In 9 patients with repetitive uniform atrial tachycardia, the response to intravenous adenosine (12 mg), lidocaine (1 mg/kg body weight), and verapamil (10 mg) were sequentially investigated. Simultaneous 12-lead electrocardiogram (ECG) was recorded at baseline and continuously monitored thereafter. Tracings were obtained at regularly timed intervals right after the administration of each drug to evaluate changes in the arrhythmia characteristics. Repetitive atrial tachycardia was abolished by intravenous lidocaine in the 9 patients within the first 2 minutes after the end of injection. Adenosine suppressed the arrhythmia in 2 patients and shortened the runs of atrial ectopic activity in 1 patient, while verapamil was effective in 2 patients, 1 of them insensitive to adenosine and the other 1 sensitive to this agent. In 5 patients, the arrhythmia was abolished by radiofrequency ablation at different sites of the right atrium. Lidocaine-sensitive atrial tachycardia may eventually be also suppressed by adenosine and/or verapamil. This suggests that this enigmatic arrhythmia may be caused by different underlying electrophysiologic substrates and that at least in some cases, delayed afterdepolarizations seem to play a determining role.
Multiple-test assessment of devices to protect healthcare workers when administering cytotoxic drugs to patients
Authors: Queruau Lamerie Thomas , Carrez Laurent , Décaudin Bertrand , Bouchoud Lucie , Goossens Jean-François , Barthélémy Christine , Bonnabry Pascal , Odou Pascal
Published: August 2011

Purpose: Evaluation of containment safety devices designed and introduced to protect preparers and administrators of hazardous drugs, through a multiple-test assessment.

Methods: Six devices were compared: (1) Kis1 gravity-fed infusion set (Doran International, France), (2) Tevadaptor Spike Port Adapter (Teva Pharma AG, France), (3) Phaseal Infusion Adapter C100 (Carmel Pharma AB, France), (4) Codan Connect Z (Codan, France), (5) Pchimx with or without a cap (Doran International, France), and (6) Clave extension set 011-H1225 with or without Spiros (Hospira, France). Assessment of exposure to hazardous drugs was performed using quinine as fluorescent marker. Mechanical tests included tightness, tension tests, and estimation of the force required to connect the infusion device to the bag. Ergonomic tests were performed by six pharmaceutical technicians. Microbiological contamination was tested with media-fill, on connected bag.

Results: No cytotoxic contamination was detected when using Phaseal, Tevadaptor or the Clave extension set with Spiros, Pchimx with a cap or Connect Z devices. For mechanical tests, all devices complied with the norm. Microbiological growth was observed neither in bags nor in tubings. The ergonomic study revealed differences between the devices for potential cytotoxic contamination risk only, but not for handling.

Conclusions. The use of containment safety devices offers improved handling conditions of hazardous compounds. As this study takes various selection criteria into account, its results offer assistance in choosing the most suitable device.
Françafrique and regime theory
Authors: Bovcon Maja
Published: August 2011

I position Françafrique within the theoretical framework of International Relations, and analyse it using regime theory. I show how this approach elucidates the nature and structure of Françafrique, and why it is especially valuable for assessing the continuity and changes of Franco-African relations during the past two decades. This approach helps us to determine whether we may speak of the normalization, the incremental adaptation or, instead, the confusion of France’s African policy today. The question is discussed using the concrete example of France’s foreign policy towards Côte d’Ivoire since 2000. I argue that this dynamic model of the interaction between structure and agents, which takes into account the complexity of the interplay of the systemic and domestic factors in state actors’ foreign policy decision-making, contributes to a better understanding of the dynamics of North–South relations.
What’s not to trust? Rubrics of political party trustworthiness in Chile and Argentina
Authors: Carlin Ryan E
Published: August 2011

No political institutions enjoy less public trust than political parties. Understanding the implications of this phenomenon for representative democracy requires theoretically informed conceptualizations of party trust and distrust and theories about their underlying cognitive processes. In this vein, the present study conceptualizes party trust and distrust as perceived party trustworthiness, it models citizens' subjective standards as rubrics of party trustworthiness, and it derives rubric-based measures of party trust/distrust. The analyses identify rubrics that: (1) prize integrity and competence, (2) stress internal politics and competence, and (3) give priority to responsiveness and integrity. The rubric-based measures of party trust/distrust converge with a classic measure of party trust and, thus, bolster the conceptual validity and theoretical utility of this research. The results suggest new ways by which to measure party trust and distrust on public opinion surveys.
Ornery alligators and soap on a rope: Texas prosecutors and punishment reform in the Lone Star State
Authors: Campbell Michael C.
Published: August 2011

This article presents historical data on changes in punishment policy in Texas, examining how Texas’s prosecutors played an important role in shaping law and policy. This article helps parcel out the relative influence of various factors in driving more punitive policies by examining an unsettled period of legal and policy change when some state leaders were pushing back against the growing tide of prison expansion. Ultimately this period resulted in a new penal code that retained most of the harshest punishments for offenders, and created an additional layer of prison facilities to manage lower-level offenders. My findings emphasize how these legal changes reflected conflict between state and local government. It also suggests that important contextual factors deeply embedded in Texas’s history helped establish conditions more likely to lead to mass incarceration. These findings suggest that ‘top–down’ and ‘bottom–up’ theoretical accounts of punishment might omit important intervening institutional factors.
Is the Improvement of Prognosis of Patients With Metastatic Pulmonary Adenocarcinoma Treated With TCM Herbal Medicine due to Lag Time to Treatment Bias?
Authors: Guo Huiru , Liu Luming , Baak Jan P. A.
Published: August 2011

Background. Traditional Chinese herbal medicine was associated with improved prognosis in patients with performance score 0-1 at the time of diagnosis of stage IV pulmonary adenocarcinoma (PAC) treated with platinum-based chemotherapy (PBT). Objective. The authors investigated the effect of 1- to 4-month lag time to traditional Chinese medicine (TCM) treatment on the median and 1-year survival of PBT-PAC patients. Methods. The median lag time to treatment was 3 months. In the first 3 months, about 35% of the patients died, but thereafter the survival curve flattened off and the death of the next 35% to 40% of patients took 9 months. Leaving out patients with lag time up to 3 months therefore would be a reasonable choice. To be on the safe side, the effects of leaving out patients up to 4 months were investigated. The Kaplan–Meier survival curves were used. Results. The median and 1-year survival of the PBT-PAC patients was 5.0 months and 27%, respectively. Leaving out patients with 0-1 month follow-up, 0-2, 0-3, and 0-4 months follow-up changed the median and 1-year survival, respectively, to 5.5 months and 32%, 6.5 months and 36%, 9.0 months and 43%, and 10.0 months and 52%. The median survival of PBT + TCM in PAC patients was 22.6 months and 78%. Median lag time to TCM treatment was 3.0 months. With up to 4 months lag time to treatment due to combined patients’ and TCM doctor’s waiting time, the improved survival of PBT + TCM performance score 0-1 (fully ambulant) patients at the time of diagnosis still is significant ( P < .01, hazard ratio = 0.51). Moreover, the survival of patients treated by TCM doctors with little or more months lag time to treatment was not different ( P = .79). Conclusion. Increasing lag time to treatment up to 4 months improves the median and 1-year survival of PBT patients without TCM but is unlikely to explain the greatly improved prognosis of PBT + TCM treated patients with fully ambulant stage IV PAC.
Retrograde Transpopliteal Approach of Iliofemoral Lesions
Authors: Brountzos Elias N. , Moulakakis Konstantinos G. , D. Avgerinos Efthimios , Dalainas Ilias , G. Giannakopoulos Triantafillos , Kakisis John , Ptohis Nikolaos D. , Preza Ourania , Liapis Christos D.
Published: August 2011

Purpose: Aim of this study is to present our initial experience with the use of the retrograde popliteal artery access in patients with certain anatomic lesions. Methods: Between September 2008 and September 2010, 24 patients underwent a transpopliteal retrograde subintimal recanalization. Instead of its usage when antegrade recanalization failed, the “facedown” technique was preferred as a first choice in patients with common femoral artery stenosis or occlusion, proximal lesions of the superficial femoral artery (SFA) with no stump, severe obesity, tandem iliac, and SFA lesions. Results: Technical success was achieved in 91.7% of patients.The complication rate was 12.5%. The primary patency at 6, 12, and 18 months was 86.4%, 65.8%, and 65.8%, respectively. Conclusions: The retrograde popliteal artery approach can be considered as the primary SFA recanalization strategy in carefully selected patients, with competitive immediate and midterm results.
Are We Worrying About the Right Men and Are the Right Men Feeling Worried? Conscious But Not Unconscious Prostate Anxiety Predicts Screening Among Men From Three Ethnic Groups
Authors: Consedine Nathan S.
Published: August 2011

Anxieties regarding cancer and screening have been consistently linked in prostate screening behavior with cancer-related anxieties generally thought to be higher among minority men. To date, however, the literature linking cancer anxieties to screening among diverse men remains predicated on self-reported anxiety. Research has yet to consider how “accurate” the reporting of anxiety may be among distinct groups of men or the possibility that anxiety may influence prostate cancer (PC) screening behavior through conscious and nonconscious channels; the current study tested for discrepancies between self-report and Stroop-ascertained general- and prostate-specific anxiety and their links to screening among 180 U.S.-born African American, U.S.-born European American, and immigrant Jamaican men. Men provided self-report information regarding trait and prostate-related anxiety and completed an emotional Stroop task. Mixed model ANOVAs showed that while U.S.-born African Americans had few discrepancies between self-report and Stroop-ascertained anxiety, Jamaicans reported greater PC anxiety than indicated by Stroop performance, while the opposite was true among U.S.-born Europeans. As expected, self-reported (but not Stroop-ascertained) PC anxiety predicted screening in multivariate analysis. Although men from different age and ethnic groups varied in the discrepancy between self-reported and Stroop-ascertained PC anxiety, the influence of avoidance-producing emotions appears to operate predominantly through conscious channels.
Challenges in idiopathic pulmonary fibrosis trials: the point on end-points
Authors: Albera C.
Published: September 2011

Idiopathic pulmonary fibrosis (IPF) is the most common of the idiopathic interstitial pneumonias and is associated with both a variable clinical course and a poor prognosis. Investigators involved in clinical trials and clinicians reviewing the IPF literature are confronted with daunting challenges in selecting reliable outcome measures, interpreting the clinical and statistical importance of these findings, and applying this knowledge to the clinical care of their patients. In order to evaluate the efficacy of new treatment regimens, a number of studies have been performed, employing a range of clinical and surrogate end-points. In most studies, the primary end-point consists of a single outcome measure. A desirable single clinical end-point for IPF should be reliable, valid, responsive to changes in disease status, clinically meaningful, predictive of clinical outcome and responsive to treatment effect of a given intervention. Proper consideration and effective choice of outcome measures used in IPF studies will help establish effective and achievable drug development programmes and will enable clinicians and investigators to make informed critical decisions in recommending a treatment regimen to their IPF patients.
Physiological techniques for detecting expiratory flow limitation during tidal breathing
Authors: Koulouris N.G. , Hardavella G.
Published: September 2011

Patients with severe chronic obstructive pulmonary disease (COPD) often exhale along the same flow–volume curve during quiet breathing as they do during the forced expiratory vital capacity manoeuvre, and this has been taken as an indicator of expiratory flow limitation at rest (EFLT). Therefore, EFLT, namely attainment of maximal expiratory flow during tidal expiration, occurs when an increase in transpulmonary pressure causes no increase in expiratory flow. EFLTleads to small airway injury and promotes dynamic pulmonary hyperinflation, with concurrent dyspnoea and exercise limitation. In fact, EFLToccurs commonly in COPD patients (mainly in Global Initiative for Chronic Obstructive Lung Disease III and IV stage), in whom the latter symptoms are common, but is not exclusive to COPD, since it can also be detected in other pulmonary and nonpulmonary diseases like asthma, acute respiratory distress syndrome, heart failure and obesity,etc.The existing up to date physiological techniques of assessing EFLTare reviewed in the present work. Among the currently available techniques, the negative expiratory pressure has been validated in a wide variety of settings and disorders. Consequently, it should be regarded as a simple, noninvasive, practical and accurate new technique.
Emerging potential treatments: new hope for idiopathic pulmonary fibrosis patients?
Authors: Costabel U.
Published: September 2011

Currently, there are no approved pharmacological treatments for the management of patients with idiopathic pulmonary fibrosis (IPF) in the USA or Europe. Pirfenidone is an orally bio-available small molecule that exhibits antifibrotic and anti-inflammatory properties in a variety ofin vitroand animal models.

Pirfenidone has been evaluated in four randomised, double-blind, placebo-controlled clinical trials conducted in Japan, North America and Europe. The totality of the data from these trials indicates that pirfenidone is able to reduce the rate of decline in lung function, measured as change in per cent predicted forced vital capacity (FVC) or vital capacity. There was also an effect on secondary end-points of progression free survival, categorical change in per cent predicted FVC, and the 6-min walk test.

A recent meta-analysis of the three phase III studies in IPF demonstrated that pirfenidone significantly reduced the risk of disease progression by 30%. The efficacy of pirfenidone is associated with an acceptable tolerability and safety profile.
Night-time symptoms: a forgotten dimension of COPD
Authors: Agusti A. , Hedner J. , Marin J.M. , Barbé F. , Cazzola M. , Rennard S.
Published: September 2011

Sleep quality is often poor in patients with chronic obstructive pulmonary disease (COPD), but these night-time symptoms are frequently unnoticed by physicians and/or not reported by patients themselves. Therefore, the prevalence and clinical impact of sleep disturbances and night-time symptoms in COPD is not well understood and has not been a clinical focus to date. To address this gap, an expert panel meeting was convened in Barcelona, Spain, in March 2011 to discuss the aetiology, evolution, burden, long-term clinical consequences and optimal management of night-time symptoms in COPD. The term “night-time symptoms” in COPD has not been distinctly defined in an objective sense but epidemiological data suggests that the prevalence of nocturnal symptoms and symptomatic sleep disturbance may exceed 75% in patients with COPD. The panel concluded that night-time symptoms in COPD are prevalent and bothersome; that their cause(s) are multiple and include demographic factors, such as age and obesity, pharmacotherapy, disease-specific symptoms and the presence of comorbid sleep disorders, and other medical conditions; and that potential long-term consequences can include lung function changes, increased exacerbation frequency, emergence or worsening of cardiovascular disease, cognitive effects, depression, impaired quality of life and increased mortality. To date, few interventional studies have investigated them, but emerging data suggest that bronchodilator therapy can improve them if deployed appropriately. In summary, night-time symptoms in COPD warrant further clinical investigation with validated tools.
Evidence for acquisition of virulence effectors in pathogenic chytrids
Authors: Sun Guiling , Yang Zefeng , Kosch Tiffany , Summers Kyle , Huang Jinling
Published: August 2011

Background

The decline in amphibian populations across the world is frequently linked to the infection of the chytrid fungus Batrachochytrium dendrobatidis (Bd). This is particularly perplexing because Bd was only recently discovered in 1999 and no chytrid fungus had previously been identified as a vertebrate pathogen.

Results

In this study, we show that two large families of known virulence effector genes, crinkler (CRN) proteins and serine peptidases, were acquired by Bd from oomycete pathogens and bacteria, respectively. These two families have been duplicated after their acquisition by Bd. Additional selection analyses indicate that both families evolved under strong positive selection, suggesting that they are involved in the adaptation of Bd to its hosts.

Conclusions

We propose that the acquisition of virulence effectors, in combination with habitat disruption and climate change, may have driven the Bd epidemics and the decline in amphibian populations. This finding provides a starting point for biochemical investigations of chytridiomycosis.
Deep sequencing reveals as-yet-undiscovered small RNAs in Escherichia coli
Authors: Shinhara Atsuko , Matsui Motomu , Hiraoka Kiriko , Nomura Wataru , Hirano Reiko , Nakahigashi Kenji , Tomita Masaru , Mori Hirotada , Kanai Akio
Published: August 2011

Background

In Escherichia coli, approximately 100 regulatory small RNAs (sRNAs) have been identified experimentally and many more have been predicted by various methods. To provide a comprehensive overview of sRNAs, we analysed the low-molecular-weight RNAs (< 200 nt) of E. coli with deep sequencing, because the regulatory RNAs in bacteria are usually 50-200 nt in length.

Results

We discovered 229 novel candidate sRNAs (≥ 50 nt) with computational or experimental evidence of transcription initiation. Among them, the expression of seven intergenic sRNAs and three cis-antisense sRNAs was detected by northern blot analysis. Interestingly, five novel sRNAs are expressed from prophage regions and we note that these sRNAs have several specific characteristics. Furthermore, we conducted an evolutionary conservation analysis of the candidate sRNAs and summarised the data among closely related bacterial strains.

Conclusions

This comprehensive screen for E. coli sRNAs using a deep sequencing approach has shown that many as-yet-undiscovered sRNAs are potentially encoded in the E. coli genome. We constructed the Escherichia coli Small RNA Browser (ECSBrowser; http://rna.iab.keio.ac.jp/), which integrates the data for previously identified sRNAs and the novel sRNAs found in this study.
Profile of small interfering RNAs from cotton plants infected with the polerovirus Cotton leafroll dwarf virus
Authors: Silva Tatiane F , Romanel Elisson AC , Andrade Roberto RS , Farinelli Laurent , Østerås Magne , Deluen Cécile , Corrêa Régis L , Schrago Carlos EG , Vaslin Maite FS
Published: August 2011

Background

In response to infection, viral genomes are processed by Dicer-like (DCL) ribonuclease proteins into viral small RNAs (vsRNAs) of discrete sizes. vsRNAs are then used as guides for silencing the viral genome. The profile of vsRNAs produced during the infection process has been extensively studied for some groups of viruses. However, nothing is known about the vsRNAs produced during infections of members of the economically important family Luteoviridae, a group of phloem-restricted viruses. Here, we report the characterization of a population of vsRNAs from cotton plants infected with Cotton leafroll dwarf virus (CLRDV), a member of the genus Polerovirus, family Luteoviridae.

Results

Deep sequencing of small RNAs (sRNAs) from leaves of CLRDV-infected cotton plants revealed that the vsRNAs were 21- to 24-nucleotides (nt) long and that their sequences matched the viral genome, with higher frequencies of matches in the 3- region. There were equivalent amounts of sense and antisense vsRNAs, and the 22-nt class of small RNAs was predominant. During infection, cotton Dcl transcripts appeared to be up-regulated, while Dcl2 appeared to be down-regulated.

Conclusions

This is the first report on the profile of sRNAs in a plant infected with a virus from the family Luteoviridae. Our sequence data strongly suggest that virus-derived double-stranded RNA functions as one of the main precursors of vsRNAs. Judging by the profiled size classes, all cotton DCLs might be working to silence the virus. The possible causes for the unexpectedly high accumulation of 22-nt vsRNAs are discussed. CLRDV is the causal agent of Cotton blue disease, which occurs worldwide. Our results are an important contribution for understanding the molecular mechanisms involved in this and related diseases.
Diagnostic accuracy of procalcitonin in critically ill immunocompromised patients
Authors: Bele Nicolas , Darmon Michael , Coquet Isaline , Feugeas Jean-Paul , Legriel Stéphane , Adaoui Nadir , Schlemmer Benoît , Azoulay Élie
Published: August 2011

Background

Recognizing infection is crucial in immunocompromised patients with organ dysfunction. Our objective was to assess the diagnostic accuracy of procalcitonin (PCT) in critically ill immunocompromised patients.

Methods

This prospective, observational study included patients with suspected sepsis. Patients were classified into one of three diagnostic groups: no infection, bacterial sepsis, and nonbacterial sepsis.

Results

We included 119 patients with a median age of 54 years (interquartile range [IQR], 42-68 years). The general severity (SAPSII) and organ dysfunction (LOD) scores on day 1 were 45 (35-62.7) and 4 (2-6), respectively, and overall hospital mortality was 32.8%. Causes of immunodepression were hematological disorders (64 patients, 53.8%), HIV infection (31 patients, 26%), and solid cancers (26 patients, 21.8%). Bacterial sepsis was diagnosed in 58 patients and nonbacterial infections in nine patients (7.6%); 52 patients (43.7%) had no infection. PCT concentrations on the first ICU day were higher in the group with bacterial sepsis (4.42 [1.60-22.14] vs. 0.26 [0.09-1.26] ng/ml in patients without bacterial infection, P < 0.0001). PCT concentrations on day 1 that were > 0.5 ng/ml had 100% sensitivity but only 63% specificity for diagnosing bacterial sepsis. The area under the receiver operating characteristic (ROC) curve was 0.851 (0.78-0.92). In multivariate analyses, PCT concentrations > 0.5 ng/ml on day 1 independently predicted bacterial sepsis (odds ratio, 8.6; 95% confidence interval, 2.53-29.3; P = 0.0006). PCT concentrations were not significantly correlated with hospital mortality.

Conclusion

Despite limited specificity in critically ill immunocompromised patients, PCT concentrations may help to rule out bacterial infection.
Epidemiological and clinical characteristics of childhood pandemic 2009 H1N1 virus infection: an observational cohort study
Authors: Rhim Jung-Woo , Lee Kyung-Yil , Youn You-Sook , Kang Jin-Han , Kim Ji-Chang
Published: August 2011

Background

There was a pandemic influenza around the world in 2009 including South Korea since last pandemic occurred four decades ago. We aimed to evaluate the epidemiological and clinical characteristics of this infection in childhood.

Methods

We evaluated the epidemiologic characteristics of all the subjects infected with the 2009 H1N1 influenza A virus (2,971 patients, ≤ 15 years of age), and the clinical and laboratory findings of the inpatients (217 patients, 80 had pneumonia) between 1 September 2009 and 31 January 2010 in a single hospital throughout the epidemic.

Results

The age distribution of all the subjects was relatively even. Over 90% of cases occurred during a two-month period. Two hundred and five patients (94.5%) received oseltamivir within 48 h of fever onset, and 97% of inpatients defervesced within 48 h of medication. The group with pneumonia included more males than females, and had higher leukocytes counts with lower lymphocyte differentials than the group without pneumonia. The white blood cell count and lymphocyte differential were associated with the severity of pneumonia. Corticosteroid treatment for severe pneumonia patients was highly effective in preventing disease progression.

Conclusion

Children of all ages affected with even rates of infection, but males were predominant in pneumonia patients. Pneumonia patients showed lymphopenia and its severity was associated with the severity of illness. Our results suggest that the mechanism of lung injury in 2009 H1N1 virus infection may be associated with the host immune response.
Factors determining the survival of nasopharyngeal carcinoma with lung metastasis alone: does combined modality treatment benefit?
Authors: Cao Xun , He Li-Ru , Xie Fang-Yun , Chen You-Fang , Wen Zhe-Sheng
Published: August 2011

Background

Nasopharyngeal carcinoma (NPC) with lung metastasis alone has been reported as a relatively favorable prognostic group, and combined modality treatment might be indicated for selected cases. However, the prognostic factors determining survival of this group and the indication of combined therapy have not been thoroughly studied.

Methods

We retrospectively reviewed 246 patients of NPC with lung metastasis(es) alone presented at diagnosis or as the first failure after primary treatment from 1993 to 2008 in an academic tertiary hospital. Univariate and multivariate survival analyses of post-metastasis survival (PMS) and overall survival (OS) were carried out to determine the prognostic factors.

Results

The 3-year, 5-year, and 10-year of PMS and OS for the whole cohort were 34.3%, 17.0%, 8.6% and 67.8%, 45.4%, 18.5%, respectively. The median PMS (45.6 months vs. 23.7 months) and OS (73.7 months vs. 46.2 months) of patients treated with combined therapy was significantly longer than that of those treated with chemotherapy alone (P < 0.001). Age, disease-free interval (DFI) and treatment modality were evaluated as independent prognostic factors of OS, while only age and treatment modality retain their independent significance in PMS analysis. In stratified survival analysis, compared to chemotherapy alone, combined therapy could benefit the patients with DFI > 1 year, but not those with DFI ≤ 1 year.

Conclusions

Age ≤ 45 years, DFI > 1 year, and the combined therapy were good prognostic factors for NPC patients with lung metastasis(es) alone. The combination of local therapy and the basic chemotherapy should be considered for these patients with DFI > 1 year.
Diagnosis of lung cancer in individuals with solitary pulmonary nodules by plasma microRNA biomarkers
Authors: Shen Jun , Liu Ziling , Todd Nevins W , Zhang Howard , Liao Jipei , Yu Lei , Guarnera Maria A , Li Ruiyun , Cai Ling , Zhan Min , Jiang Feng
Published: August 2011

Background

Making a definitive preoperative diagnosis of solitary pulmonary nodules (SPNs) found by CT has been a clinical challenge. We previously demonstrated that microRNAs (miRNAs) could be used as biomarkers for lung cancer diagnosis. Here we investigate whether plasma microRNAs are useful in identifying lung cancer among individuals with CT-detected SPNs.

Methods

By using quantitative reverse transcriptase PCR analysis, we first determine plasma expressions of five miRNAs in a training set of 32 patients with malignant SPNs, 33 subjects with benign SPNs, and 29 healthy smokers to define a panel of miRNAs that has high diagnostic efficiency for lung cancer. We then validate the miRNA panel in a testing set of 76 patients with malignant SPNs and 80 patients with benign SPNs.

Results

In the training set, miR-21 and miR-210 display higher plasma expression levels, whereas miR-486-5p has lower expression level in patients with malignant SPNs, as compared to subjects with benign SPNs and healthy controls (all P ≤ 0.001). A logistic regression model with the best prediction was built on the basis of miR-21, miR-210, and miR-486-5p. The three miRNAs used in combination produced the area under receiver operating characteristic curve at 0.86 in distinguishing lung tumors from benign SPNs with 75.00% sensitivity and 84.95% specificity. Validation of the miRNA panel in the testing set confirms their diagnostic value that yields significant improvement over any single one.

Conclusions

The plasma miRNAs provide potential circulating biomarkers for noninvasively diagnosing lung cancer among individuals with SPNs, and could be further evaluated in clinical trials.
Synchronal algorithm and cyclic algorithm for fixed point problems and variational inequality problems in hilbert spaces
Authors: Tian Ming , Di Lanyun
Published: August 2011

We design synchronal algorithm and cyclic algorithm based on the general iterative algorithm proposed by Tian in 2010 for finding the common fixed point x* of finite family of strict pseudo-contractive mappings which is the solution of the variational inequality 〈(γ f - μF)x*, x - x*〉 ≤ 0, "Equation missing".

2000 Mathematics Subject Classification: 58E35; 47H09; 65J15.
HIV-1 protease inhibitor mutations affect the development of HIV-1 resistance to the maturation inhibitor bevirimat
Authors: Fun Axel , van Maarseveen Noortje M , Pokorná Jana , Maas Renée EM , Schipper Pauline J , Konvalinka Jan , Nijhuis Monique
Published: August 2011

Background

Maturation inhibitors are an experimental class of antiretrovirals that inhibit Human Immunodeficiency Virus (HIV) particle maturation, the structural rearrangement required to form infectious virus particles. This rearrangement is triggered by the ordered cleavage of the precursor Gag polyproteins into their functional counterparts by the viral enzyme protease. In contrast to protease inhibitors, maturation inhibitors impede particle maturation by targeting the substrate of protease (Gag) instead of the protease enzyme itself. Direct cross-resistance between protease and maturation inhibitors may seem unlikely, but the co-evolution of protease and its substrate, Gag, during protease inhibitor therapy, could potentially affect future maturation inhibitor therapy. Previous studies showed that there might also be an effect of protease inhibitor resistance mutations on the development of maturation inhibitor resistance, but the exact mechanism remains unclear. We used wild-type and protease inhibitor resistant viruses to determine the impact of protease inhibitor resistance mutations on the development of maturation inhibitor resistance.

Results

Our resistance selection studies demonstrated that the resistance profiles for the maturation inhibitor bevirimat are more diverse for viruses with a mutated protease compared to viruses with a wild-type protease. Viral replication did not appear to be a major factor during emergence of bevirimat resistance. In allin vitroselections, one of four mutations was selected: Gag V362I, A364V, S368N or V370A. The impact of these mutations on maturation inhibitor resistance and viral replication was analyzed in different protease backgrounds. The data suggest that the protease background affects development of HIV-1 resistance to bevirimat and the replication profiles of bevirimat-selected HIV-1. The protease-dependent bevirimat resistance and replication levels can be explained by differences in CA/p2 cleavage processing by the different proteases.

Conclusions

These findings highlight the complicated interactions between the viral protease and its substrate. By providing a better understanding of these interactions, we aim to help guide the development of second generation maturation inhibitors.
Simultaneous use of traditional Chinese medicine (Si-Ni-Tang) to treat septic shock patients: study protocol for a randomized controlled trial
Authors: Chen Huang-Chi , Chen Wen-Chi , Lin Kai-Huang , Chen Yung-Hsiang , Lo Lun-Chien , Lee Tsung-Chieh , Hsia Te-Chun , Wang Chu-Hsien , Wu Shin-Hwar , Hsu Hsin-Whae , Chang Yu-Jun , Huang Yu-Chuen , Ku Tien-Hsiung , Horng Ming-Hwarng
Published: August 2011

Background

Even though there are continually upgraded recommendations for managing sepsis, such as "Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock", mortality is still high. Si-Ni-Tang, a remedy documented in Shanghan Lun, a medical collection from ancient China, is used for treating patients with sepsis and septic shock. Using a well-designed clinical trial, we are eager to survey the effectiveness of the concurrent use of this remedy in restoring these patients' hemodynamic status, or "Yang Qi".

Methods/Design

Patients admitted to our medical intensive care units with the diagnosis of septic shock, defined as persistent hypotension induced by sepsis despite adequate fluid resuscitation, are eligible for participation. The inclusion criteria include: age from 20 to 85 years, conditions meeting the definition of septic shock, use of vasopressors within 24 hours of entering the study, and use of a nasogastric tube for feeding. The enrolled patients are randomly allocated either to the Si-Ni-Tang group or the placebo group. The prescription of the trial drugs (Si-Ni-Tang/placebo) is 2.25 grams 4 times a day for 7 days or till shock reversal (if shock reversal occurs in less than 7 days). Data, including duration of vasopressor infusion, gender, age, co-morbidities, APACHE II score, predicted mortality, ICU mortality, ICU length of stay, hospital mortality, hospital length of stay, source of sepsis, and culture results, are collected for the following analysis.

Discussion

Si-Ni-Tang is composed of processed Zingiber officinale, Glycyrrhiza uralensis, and Aconitum carmichaeli. Zingiber officinale and Glycyrrhiza uralensis are found to have the ability to reduce pro-inflammatory cytokine production, to inhibit lipopolisaccharide-induced macrophage activation and function, and to lessen the bacterial load and suppress acute and chronic inflammation. Aconitum carmichaeli is known to have vasopressor activity, and positive chronotropic and inotropic effects. As this remedy has a potential benefit in treating septic shock patients, we designed a double-blind, prospective, randomized controlled trial and would like to publish the results and conclusions later.

Trial Registration

ClinicalTrials.gov: NCT01223430
Inflammatory myopathy and severe rhabdomyolysis induced by leuprolide acetate therapy for prostate cancer: a case report
Authors: Bergner Michael , Rohacek Martin , Erne Paul
Published: August 2011

Introduction

Leuprolide acetate is a synthetic analog of gonadotropin-releasing hormone used for the treatment of prostate cancer. Its side effects are hot flashes, nausea, and fatigue. We report a case of a patient with proximal inflammatory myopathy accompanied by severe rhabdomyolysis and renal failure following the second application of leuprolide acetate. Drug withdrawal and steroid therapy resulted in remission within six weeks of the diagnosis. To the best of our knowledge, our case report describes the second case of leuprolide acetate-induced inflammatory myopathy and the first case of severe leuprolide acetate-induced rhabdomyolysis and renal failure in the literature.

Case presentation

A 64-year-old Swiss Caucasian man was admitted to the hospital because of progressive proximal muscle weakness, dyspnea, and oliguria. He had been treated twice with leuprolide acetate in monthly doses. We performed a muscle biopsy, which excluded other causes of myopathy. The patient's renal failure and rhabdomyolysis were treated with rehydration and steroid therapy.

Conclusion

The aim of our case report is to highlight the rare but severe side effects associated with leuprolide acetate therapy used to treat patients with inflammatory myopathy: severe rhabdomyolysis and renal failure.
Teaching Biology through Statistics: Application of Statistical Methods in Genetics and Zoology Courses
Authors: Colon-Berlingeri Migdalisel , Burrowes Patricia A.
Published: September 2011

Incorporation of mathematics into biology curricula is critical to underscore for undergraduate students the relevance of mathematics to most fields of biology and the usefulness of developing quantitative process skills demanded in modern biology. At our institution, we have made significant changes to better integrate mathematics into the undergraduate biology curriculum. The curricular revision included changes in the suggested course sequence, addition of statistics and precalculus as prerequisites to core science courses, and incorporating interdisciplinary (math–biology) learning activities in genetics and zoology courses. In this article, we describe the activities developed for these two courses and the assessment tools used to measure the learning that took place with respect to biology and statistics. We distinguished the effectiveness of these learning opportunities in helping students improve their understanding of the math and statistical concepts addressed and, more importantly, their ability to apply them to solve a biological problem. We also identified areas that need emphasis in both biology and mathematics courses. In light of our observations, we recommend best practices that biology and mathematics academic departments can implement to train undergraduates for the demands of modern biology.
Occupational psychiatry in the armed forces: should depressed soldiers carry guns?
Authors: McAllister Peter , Greenberg Neil , Henderson Max
Published: September 2011

The Defence Mental Health Services (DMHS) provide an occupationally focused service for the UK armed forces when deployed and when at home. Although much of the work is similar to that carried out by National Health Service community mental health teams, there are many unique aspects to working with the military. Although carrying out operational duties is a key function of the armed forces, the majority of cases managed by the DMHS are not related to traumatic exposures; instead, adjustment, mood and substance use disorders form the bulk of the case work. However, DMHS personnel carry out a considerable amount of psychological education and command liaison functions to support the concept that the psychological welfare of troops is primarily a chain of command responsibility. This article outlines the structure and function of the DMHS and its approach to risk management.
Treatment provision for Britain's problem gamblers: present gaps and future opportunities
Authors: George Sanju , Copello Alex
Published: September 2011

Despite Britain's high prevalence of problem gambling, its liberal gambling legislation, a rapidly expanding online gambling industry and the impending opening of casinos across the country, treatment provision is grossly inadequate. We discuss some of the present gaps and future opportunities in treating Britain's problem gamblers, and urge Britain's healthcare policy makers, gambling regulators, service commissioners and service providers to do more to help them.