bluuebunny/crossref_metadata_2025 huggingface dataset:
Parametric instabilities in the out-of-plane dynamics of catenary-shaped slender structures transporting fluids
Authors: Chatjigeorgiou Ioannis K
Published: March 2012

The present study investigates the out-of-plane buckling behaviour of catenaries conveying fluids and subjected to end-imposed axial excitations. The mathematical formulation is generic with no restrictions in the amount of sag in the plane of reference. The theoretical model is treated using the Galerkin expansion and employing the actual mode shapes. It is shown that under a parametric excitation the physical model behaves as a multiple-degree-of-freedom system. The novelty of the present study is that it finds the equivalent system that governs the dynamics of the catenary, while in addition it accounts for the internal flow effects which arise from `compressive loading' and Coriolis forces. The stimulation of potential instabilities is investigated using the Floquet theory and the method of multiple scales.
Understanding the context of patient experiences in order to explore adherence to secondary prevention guidelines after heart surgery
Authors: Fix Gemmae M , Bokhour Barbara G
Published: March 2012

After coronary artery bypass surgery, many patients do not incorporate healthy behaviors into their postoperative lifestyle or enroll in cardiac rehabilitation, key aspects of secondary prevention. This qualitative study examined patients’ post-coronary artery bypass surgery experiences to explore barriers in adhering to dietary and activity guidelines. We conducted semi-structured, in-depth interviews with 30 male patients from a military veteran’s hospital, using emergent, thematic analysis to identify experiences that led to poor adherence. Results were grouped according to barriers to diet, activities, and enrolling in cardiac rehabilitation. Overall, understandings of postoperative health, priorities that diverged from guidelines, and the context of household members and other health conditions impacted postoperative health behaviors. Many participants were familiar with secondary prevention guidelines. However, postoperative perceptions of health as well as the context of recovery influenced self-management. Providers must consider a patient’s context when discussing secondary prevention. Venues such as cardiac rehabilitation may provide an opportunity to improve adherence to secondary prevention guidelines by expanding available class times, engaging patients’ household members, or tailoring recommendations to also address other health conditions.
The strategic plan as a genre
Authors: Cornut Francis , Giroux Hélène , Langley Ann
Published: March 2012

Despite the growing interest in developing a micro-level understanding of strategy practices, there are few studies focusing on the official textual expression of these practices in the form of strategic plans. Using a large corpus of strategic plans from public and third sector organizations, this article examines the particular features of the strategic plan genre of communication. This corpus is systematically compared with nine other corpora derived from the same general domain (business texts) or having similar expected characteristics. Our analysis combines linguistic analysis with an analysis of the moves characteristic of the genre. The article seeks to advance a genre-based view of strategy practices to study the professional and institutional practices of strategists.
The Pain of Labour
Authors: Labor Simona , Maguire Simon
Published: March 2012

• Labour is an emotional experience and involves both physiological and psychological mechanisms. • The pain of labour is severe but despite this its memory diminishes with time. • Labour pain has two components: visceral pain which occurs during the early first stage and the second stage of childbirth, and somatic pain which occurs during the late first stage and the second stage. • The pain of labour in the first stage is mediated by T10 to L1 spinal segments, whereas that in the second stage is carried by T12 to L1, and S2 to S4 spinal segments. • Pain relief in labour is complex and often challenging without regional analgesia. • Effective management of labour pain plays a relatively minor role in a woman's satisfaction with childbirth.
Acute Pain in the Emergency Department: The Challenges
Authors: Keating Liza , Smith Simon
Published: March 2012

• Acute pain is the reason that the majority of patients present to the emergency department. • Failure to adequately treat acute pain in the emergency department has been labelled a public health problem. • The College of Emergency Medicine has set standards for the timelines and adequacy in management of pain in both adults and children. • Joint Care Quality Commission and College of Emergency Medicine national audit demonstrates the gap between standards and current practice. • The new Department of Health clinical quality indicators for emergency medicine do not include a measure of pain. • Untreated pain can have short and long term effects, including sensitisation to pain episodes in later life. • A range of non-pharmacological and pharmacological interventions have been shown to be effective for procedural pain management in infants and children, and are most effective when used in combination. • Developmental changes in pain responses, analgesic response and drug pharmacokinetics need to be taken into account when planning procedural pain management for neonates. • Comprehensive evidence based guidelines are available to guide effective procedural pain management in neonates, infants and older children.
Persistent Dento-Alveolar Pain Disorder (PDAP): Working towards a Better Understanding
Authors: Nixdorf Donald , Moana-Filho Estephan
Published: March 2012

• New terminology, persistent dento-alveolar pain disorder (PDAP), and diagnostic criteria have been put forward to address the shortcomings of existing nomenclature, which are associated with unclear criteria. • Arriving at an accurate diagnosis of PDAP is based on excluding other possible aetiologies, and may involve different care providers. • Synthesis of published data suggests that PDAP has a frequency of occurrence following root canal therapy of around 1.6%. • The putative risk factors involved in PDAP are largely unknown, but seem to be similar to those being identified with other post-surgical chronic pain disorders. • The underlying mechanisms involved in the development of and/or perpetuating PDAP are unknown and the approach to treatment remains empiric in nature.
Actin-dependent activation of serum response factor in T cells by the viral oncoprotein tip
Authors: Katsch Kristin , de Jong Sarah Jill , Albrecht Jens-Christian , Steger Julia , Genth Harald , Posern Guido , Biesinger Brigitte
Published: March 2012

Serum response factor (SRF) acts as a multifunctional transcription factor regulated by mutually exclusive interactions with ternary complex factors (TCFs) or myocardin-related transcription factors (MRTFs). Binding of Rho- and actin-regulated MRTF:SRF complexes to target gene promoters requires an SRF-binding site only, whereas MAPK-regulated TCF:SRF complexes in addition rely on flanking sequences present in the serum response element (SRE). Here, we report on the activation of an SRE luciferase reporter by Tip, the viral oncoprotein essentially contributing to human T-cell transformation by Herpesvirus saimiri. SRE activation in Tip-expressing Jurkat T cells could not be attributed to triggering of the MAPK pathway. Therefore, we further analyzed the contribution of MRTF complexes. Indeed, Tip also activated a reporter construct responsive to MRTF:SRF. Activation of this reporter was abrogated by overexpression of a dominant negative mutant of the MRTF-family member MAL. Moreover, enrichment of monomeric actin suppressed the Tip-induced reporter activity. Further upstream, the Rho-family GTPase Rac, was found to be required for MRTF:SRF reporter activation by Tip. Initiation of this pathway was strictly dependent on Tip's ability to interact with Lck and on the activity of this Src-family kinase. Independent of Tip, T-cell stimulation orchestrates Src-family kinase, MAPK and actin pathways to induce SRF. These findings establish actin-regulated transcription in human T cells and suggest its role in viral oncogenesis.
Current status and future directions in the management of chronic hepatitis C
Authors: Aman Wosen , Mousa Shaymaa , Shiha Gamal , Mousa Shaker A
Published: March 2012

Hepatitis C virus (HCV) is endemic worldwide, and it causes cirrhosis and other complications that often lead to death; nevertheless, our knowledge of the disease and its mechanisms is limited. HCV is most common in underdeveloped nations, including many in Africa and Asia. The virus is usually transmitted by parenteral routes, but sexual, perinatal, and other types of transfer have been known to occur. Approximately 80% of individuals who contract hepatitis C develop a chronic infection, and very few are able to spontaneously clear the virus. Because hepatitis C is asymptomatic in the majority of patients, the presence of HCV RNA in the serum is the best diagnostic tool. Although serious complications from hepatitis C may not occur for 20 years, 1/5 of chronic patients eventually develop life - threatening cirrhosis. More research is needed on the different therapy options for the disease, and many factors, most importantly the genotype of the virus, must be taken into account before beginning any treatment. As there is no vaccine against HCV at present, the most effective and recommended therapy is pegylated-interferon-α-2a plus ribavirin. While interferon is marginally effective as a monotherapy, both adding the moiety and combining it with ribavirin have been shown to dramatically increase its potency. While there are numerous alternative and complementary medicines available for patients with hepatitis C, their efficacy is questionable. Currently, research is being done to investigate other possible treatments for hepatitis C, and progress is being made to develop a vaccine against HCV, despite the many challenges the virus presents. Until such a vaccination is available, prevention and control methods are important in containing and impeding the spread of the virus and mitigating its deleterious effects on the health of people and communities worldwide.
S gene mutations of HBV in children with HBV-associated glomerulonephritis
Authors: Lu Hongzhu , Zhu Hui , Zhou Jianhua
Published: March 2012

Background

Hepatitis B virus-associated glomerulonephritis (HBV-GN) is a kind of immune complex-induced glomerulonephritis. The present study was designed to determine whether mutation of Hepatitis B virus (HBV) S gene is associated with glomerulonephritis in Chinese children.

Methods

Total 53 subjects, including 30 HBV-GN, 5 nephrosis with HBV carriers (control group 1), and 18 HBV carriers (control group 2) were included in this study. Polymerase chain reaction (PCR) was used to detect the HBV-GN S gene mutation.

Results

(1) The serotype of HBV was adw in the majority (52/53) of subjects, and was adr in only 1 subject in the control group 2; (2) the genotype of HBV was the type B in 51 subjects, the type E in 1 HBV-GN child, and the type C in 1 HBV carrier; (3) Seventeen point mutations in the S gene of HBV were identified in 21 of 30 (70%) HBV-GN patients. Among them, 16 of 21 (76.2%) mutations may cause amino acid substitutions of the HBV proteins, which occur predominantly (11/16 mutations) at threonine, serine or tyrosine phosphorylation sites of mitogen-activated protein kinase (MAPK) or protein tyrosine kinase (PTK). (4) In addition, single nucleotide mutations without amino acid substitutions (same sense mutation) were found in 2 subjects in each control group and 5 subjects in HBV-GN group.

Conclusions

HBV S gene mutations and the subsequent amino acid substitutions in HBV proteins were found in most children with HBV-GN, suggesting that these mutations may play an important role in the pathogenesis of HBV-GN.
D-Lactate altered mitochondrial energy production in rat brain and heart but not liver
Authors: Ling Binbing , Peng Fei , Alcorn Jane , Lohmann Katharina , Bandy Brian , Zello Gordon A
Published: March 2012

Background

Substantially elevated blood D-lactate (DLA) concentrations are associated with neurocardiac toxicity in humans and animals. The neurological symptoms are similar to inherited or acquired abnormalities of pyruvate metabolism. We hypothesized that DLA interferes with mitochondrial utilization of L-lactate and pyruvate in brain and heart.

Methods

Respiration rates in rat brain, heart and liver mitochondria were measured using DLA, LLA and pyruvate independently and in combination.

Results

In brain mitochondria, state 3 respiration was 53% and 75% lower with DLA as substrate when compared with LLA and pyruvate, respectively (p < 0.05). Similarly in heart mitochondria, state 3 respiration was 39% and 86% lower with DLA as substrate when compared with LLA or pyruvate, respectively (p < 0.05). However, state 3 respiration rates were similar between DLA, LLA and pyruvate in liver mitochondria. Combined incubation of DLA with LLA or pyruvate markedly impaired state 3 respiration rates in brain and heart mitochondria (p < 0.05) but not in liver mitochondria. DLA dehydrogenase activities were 61% and 51% lower in brain and heart mitochondria compared to liver, respectively, whereas LLA dehydrogenase activities were similar across all three tissues. An LDH inhibitor blocked state 3 respiration with LLA as substrate in all three tissues. A monocarboxylate transporter inhibitor blocked respiration with all three substrates.

Conclusions

DLA was a poor respiratory substrate in brain and heart mitochondria and inhibited LLA and pyruvate usage in these tissues. Further studies are warranted to evaluate whether these findings support, in part, the possible neurological and cardiac toxicity caused by high DLA levels.
Impact of the cracks lost in the imaging process on computing linear elastic properties from 3D microtomographic images of Berea sandstone
Authors: Zhang Yang , Toksöz M. Nafi
Published: March 2012

With the current developments in imaging/computational techniques and resources, computational rock physics has been emerging as a new field of study. Properties of rocks are examined by carrying out extensive numerical simulations on rocks that have been digitized using high-resolution X-ray CT scans. The ultimate goal of computational rock physics is to supplement the traditional laboratory measurements, which are time consuming, with faster numerical simulations that allow the parameter space to be explored more thoroughly. We applied the finite-element method to compute the static effective elastic properties from 3D microtomographic images of Berea sandstone saturated with different fluids. From the computations, we found discrepancies between the numerical results and the laboratory measurements. The reason for such a problem is the loss of small features, such as fine cracks and micropores, in the digitized matrix during the imaging and aggregation process. We used a hybrid approach, combining the numerical computation and the effective media theories — the differential effective medium model and the Kuster-Toksöz model — to deduce the lost cracks by a very fast simulated annealing method. We analyzed the sensitivity of the inverted results — the distributions of crack aspect ratios and concentrations — to the clay content. We found that the inverted crack distribution is not so sensitive to clay content. Compared with the effect of cracks on the computed effective elastic properties, clay has only a secondary effect. Our approach can recover the lost cracks and is capable of predicting the effective elastic properties of the rocks from the microtomographic images for different fluid saturations. Compared with the traditional inversion schemes, based only on the effective media theories, this hybrid scheme has the advantage of utilizing the complex microstructures that are resolved in the imaging process, and it helps define the inversion space for crack distribution.
Hierarchical Bayesian lithology/fluid prediction: A North Sea case study
Authors: Rimstad Kjartan , Avseth Per , Omre Henning
Published: March 2012

Seismic 3D amplitude variation with offset (AVO) data from the Alvheim field in the North Sea are inverted into lithology/fluid classes, elastic properties, and porosity. Lithology/fluid maps over hydrocarbon prospects provide more reliable estimates of gas/oil volumes and improve the decision concerning further reservoir assessments. The Alvheim field is of turbidite origin with complex sand-lobe geometry and appears without clear fluid contacts across the field. The inversion is phrased in a Bayesian setting. The likelihood model contains a convolutional, linearized seismic model and a rock-physics model that capture vertical trends due to increased sand compaction and possible cementation. The likelihood model contains several global model parameters that are considered to be stochastic to adapt the model to the field under study and to include model uncertainty in the uncertainty assessments. The prior model on the lithology/fluid classes is a Markov random field that captures local vertical/horizontal continuity and vertical sorting of fluids. The predictions based on the posterior model are validated by observations in five wells used as blind tests. Hydrocarbon volumes with reliable gas/oil distributions are predicted. The spatial coupling provided by the prior model is crucial for reliable predictions; without the coupling, hydrocarbon volumes are severely underestimated. Depth trends in the rock-physics likelihood model improve the gas versus oil predictions. The porosity predictions reproduce contrasts observed in the wells, and mean square error is reduced by one-third compared to Gauss-linear predictions.
Force transduction and strain dynamics in actin stress fibres in response to nanonewton forces
Authors: Guolla Louise , Bertrand Martin , Haase Kristina , Pelling Andrew E.
Published: March 2012

It is becoming clear that mechanical stimuli are crucial factors in regulating the biology of the cell, but the short-term structural response of a cell to mechanical forces remains relatively poorly understood. We mechanically stimulated cells transiently expressing actin–EGFP with controlled forces (0–20 nN) in order to investigate the structural response of the cell. Two clear force-dependent responses were observed: a short-term (seconds) local deformation of actin stress fibres and a long-term (minutes) force-induced remodelling of stress fibres at cell edges, far from the point of contact. By photobleaching markers along stress fibres we were also able to quantify strain dynamics occurring along the fibres throughout the cell. The results reveal that the cell exhibits complex heterogeneous negative and positive strain fluctuations along stress fibres in resting cells that indicate localized contraction and stretch dynamics. The application of mechanical force results in the activation of myosin contractile activity reflected in an ~50% increase in strain fluctuations. This approach has allowed us to directly observe the activation of myosin in response to mechanical force and the effects of cytoskeletal crosslinking on local deformation and strain dynamics. The results demonstrate that force application does not result in simplistic isotropic deformation of the cytoarchitecture, but rather a complex and localized response that is highly dependent on an intact microtubule network. Direct visualization of force-propagation and stress fibre strain dynamics have revealed several crucial phenomena that take place and ultimately govern the downstream response of a cell to a mechanical stimulus.
A functional genetic screen reveals new regulators of β1-integrin activity
Authors: Pellinen Teijo , Rantala Juha K. , Arjonen Antti , Mpindi John-Patrick , Kallioniemi Olli , Ivaska Johanna
Published: March 2012

β1 integrins constitute a large group of widely distributed adhesion receptors, which regulate the ability of cells to interact with their surroundings. This regulation of the expression and activity of integrins is crucial for tissue homeostasis and development and contributes to inflammation and cancer. We report an RNA interference screen to uncover genes involved in the regulation of β1-integrin activity using cell spot microarray technology in cancer cell lines. Altogether, ten cancer and two normal cell lines were used to identify regulators of β1 integrin activity. Cell biological analysis of the identified β1-integrin regulatory genes revealed that modulation of integrin activity can influence cell invasion in a three-dimensional matrix. We demonstrate with loss-of-function and rescue experiments that CD9 activates and MMP8 inactivates β1 integrins and that both proteins associate with β1 integrins in cells. Furthermore, CD9 and MMP8 regulate cancer cell extravasation in vivo. Our discovery of new regulators of β1-integrin activity highlight the complexity of integrin activity regulation and provide a set of new genes involved in regulation of integrin function.
Induction of autophagy in ESCRT mutants is an adaptive response for cell survival in C. elegans
Authors: Djeddi Abderazak , Michelet Xavier , Culetto Emmanuel , Alberti Adriana , Barois Nicolas , Legouis Renaud
Published: March 2012

Endosomes and autophagosomes are two vesicular compartments involved in the degradation and recycling of cellular material. They both undergo a maturation process and finally fuse with the lysosome. In mammals, the convergence between endosomes and autophagosomes is a multistep process that can generate intermediate vesicles named amphisomes. Using knockdowns and mutants of the ESCRT machinery (ESCRT-0–ESCRT-III, ATPase VPS-4) and the autophagic pathway (LGG-1, LGG-2, ATG-7, TOR), we analyzed in vivo the functional links between endosomal maturation and autophagy in Caenorhabditis elegans. We report here that, despite a strong heterogeneity of their developmental phenotypes, all ESCRT mutants present an accumulation of abnormal endosomes and autophagosomes. We show that this accumulation of autophagosomes is secondary to the formation of enlarged endosomes and is due to the induction of the autophagic flux and not a blockage of fusion with lysosomes. We demonstrate that the induction of autophagy is not responsible for the lethality of ESCRT mutants but has a protective role on cellular degradation. We also show that increasing the basal level of autophagy reduces the formation of enlarged endosomes in ESCRT mutants. Together, our data indicate that the induction of autophagy is a protective response against the formation of an abnormal vesicular compartment.
N-WASP-mediated invadopodium formation is involved in intravasation and lung metastasis of mammary tumors
Authors: Gligorijevic Bojana , Wyckoff Jeffrey , Yamaguchi Hideki , Wang Yarong , Roussos Evanthia T. , Condeelis John
Published: March 2012

Invadopodia are proteolytic membrane protrusions formed by highly invasive cancer cells, commonly observed on substrate(s) mimicking extracellular matrix. Although invadopodia are proposed to have roles in cancer invasion and metastasis, direct evidence has not been available. We previously reported that neural Wiskott–Aldrich syndrome protein (N-WASP), a member of WASP family proteins that regulate reorganization of the actin cytoskeleton, is an essential component of invadopodia. Here, we report that N-WASP-mediated invadopodium formation is essential in breast cancer invasion, intravasation and lung metastasis. We established stable cell lines based on MTLn3 rat mammary adenocarcinoma cells that either overexpressed a dominant-negative (DN) N-WASP construct or in which N-WASP expression was silenced by a pSuper N-WASP shRNA. Both the N-WASP shRNA and DN N-WASP cells showed a markedly decreased ability to form invadopodia and degrade extracellular matrix. In addition, formation of invadopodia in primary tumors and collagen I degradation were reduced in the areas of invasion (collagen-rich areas in the invasive edge of the tumor) and in the areas of intravasation (blood-vessel-rich areas). Our results suggest that tumor cells in vivo that have a decreased activity of N-WASP also have a reduced ability to form invadopodia, migrate, invade, intravasate and disseminate to lung compared with tumor cells with parental N-WASP levels.
Orientation-based FRET sensor for real-time imaging of cellular forces
Authors: Meng Fanjie , Sachs Frederick
Published: March 2012

Mechanical stress is an unmapped source of free energy in cells. Mapping the stress fields in a heterogeneous time-dependent environment like that found in cells requires probes that are specific for different proteins and respond to biologically relevant forces with minimal disturbance to the host system. To meet these goals, we have designed a genetically encoded stress sensor with minimal volume and high sensitivity and dynamic range. The new FRET-based sensor, called cpstFRET, is designed to be modulated by the angles between the donor and acceptor rather than the distance between them. Relative to other probes, it is physically smaller and exhibits a greater dynamic range and sensitivity and expresses well. For in vivo testing, we measured stress gradients in time and space in non-erythroid spectrin in several different cell types and found that spectrin is under constitutive stress in some cells but not in others. Stresses appear to be generated by both F-actin and tubulin. The probe revealed, for the first time, that spectrin undergoes time-dependent force modulation during cell migration. cpstFRET can be employed in vitro, in vivo and in situ, and when incorporated into biologically expressed extracellular polymers such as collagen, it can report multidimensional stress fields.
New Geographies of Migration?: A Canada-U.S. Comparison of Highly Skilled Chinese and Indian Migration
Authors: Li Wei , Lo Lucia
Published: March 2012

This paper aims to understand how highly skilled Chinese and Indian migrants settle in Canada and the US and to speculate on how a changing geo-economic-political order would affect the flow of the highly-skilled migrants. We first lay out the theoretical corners of return migration, discuss the outcome of various immigrant recruitment and integration policies in Canada and the US, and examine their impacts on immigrants' decision to stay in Canada and the US, or return to their countries of origin. In particular, we review and synthesize existing research and current policy settings on (return) migration and development, review available data in Canada and the US, and investigate the ways in which social and economic environments in both receiving and sending countries can redraw the geographies of migration.
Vaccination-Induced Syphilis and the Hübner Malpractice Litigation
Authors: Benedek Thomas G.
Published: March 2012

This article examines smallpox vaccination in the 19th century as background for a notorious medical malpractice case that occupied Bavarian courts fromApril 1853 until May 1854. Dr. Georg Hübner, the defendant, was accused of having initiated a small epidemic of syphilis by using the lymph of a syphilitic infant to vaccinate 13 infants. The litigation and its published contemporaneous discussion demonstrate conflicts in the understanding of syphilis, the hazards of having to make a purely clinical diagnosis, the effect of obsolete legal wording in medical litigation, and the attitude of leading physicians to a guilty colleague. This case ultimately led to efforts to make arm-to-arm smallpox vaccination safer, and by 1898 to abandon the technique in favor of bovine sources that were sterilized and stabilized by various methods.
The Foundation of Physicianship
Authors: Fuks Abraham , Brawer James , Boudreau J. Donald
Published: March 2012

Although the practice of medicine continually changes in response to new biomedical understanding, novel technologies, and evolving cultural contexts, the ethical foundations of the clinical relationship between patient and physician paradoxically remain constant. There are fundamental characteristics with respect to character, behavior, and responsibilities that are descriptive of and necessary to the role of healer and that underpin the notion of physicianship . This article discusses the underlying characteristics or virtues that are necessary to the practice of medicine from the perspectives of three different philosophic traditions: the Aristotelian idea of phronesis as developed in the work of Edmund Pellegrino; the notion of alterity as framed by Emmanuel Levinas; and the attributes necessary to healing as laid out in the kabbala.
Teaching Within the Operating Theater
Authors: Carlile Graeme S.
Published: March 2012

All surgeons within teaching hospitals share in the collective responsibility for training more junior doctors. A large proportion of training focuses around developing good clinical practice and ensuring the trainee is reaching competency. Formal structured teaching sessions aim to improve the trainee's theoretical knowledge and wider understanding. But surgical trainees must also learn how to operate. In order to do this, a more experienced surgeon must teach and supervise them in how to perform common procedures. This article discusses effective teaching within the operating theater, drawing on the author's own reflective practice. It introduces the concepts of theater prerequisites, used for assessing the suitability of theater cases for teaching, and active observation as one of the methodologies for teaching in theater.
The Placebo Effect: How the Subconscious Fits in
Authors: Mommaerts J. L. , Devroey Dirk
Published: March 2012

The placebo effect is very well known, being replicated in many scientific studies. At the same time, its exact mechanisms still remain unknown. Quite a few hypothetical explanations for the placebo effect have been suggested, including faith, belief, hope, classical conditioning, conscious/subconscious expectation, endorphins, and the meaning response. This article argues that all these explanations may boil down to autosuggestion, in the sense of "communication with the subconscious." An important implication of this is that the placebo effect can in principle be used effectively without the placebo itself, through a direct use of autosuggestion. The benefits of such a strategy are clear: fewer side effects from medications, huge cost savings, no deception of patients, relief of burden on the physician's time, and healing in domains where medication or other therapies are problematic.
Interpreting Evidence: Why Values Can Matter As Much As Science
Authors: de Melo-Martín Inmaculada , Intemann Kristen
Published: March 2012

Despite increasing awareness of the ways in which non-epistemic values play roles in science, many scientists remain reluctant to acknowledge values at stake in their own work. Even when research clearly relates to risk assessment and establishing public policy, contexts in which the presence of values is less likely to be contentious, scientists tend to present such research as merely involving empirical questions about what the evidence is. As a result, debates over policy-related science tend to be framed as purely epistemic debates over the state of the evidence. We argue that this neglects the important ways that ethical and social values play legitimate roles in judgments about what we take to be evidence for a particular policy. Using the case of recent disputes about the relative safety of home birth, we argue that although the debate has been framed as a purely scientific one about the empirical evidence for home birth, it actually involves disagreements about underlying value assumptions. If our claims are correct, then in order to move the debate forward, scientists will need to engage in a critical discussion about the values at stake.
Ethics of the Heart: Ethical and Policy Challenges in the Treatment of Advanced Heart Failure
Authors: Fields Anjali V. , Kirkpatrick James N.
Published: March 2012

Heart failure is a major cause of morbidity and mortality in the United States and worldwide, accounting for immense health-care costs. Advanced therapies such as transplantation, ventricular assist devices, and implantable cardioverter defibrillators have had great success in significantly improving life expectancy and morbidity, however these advances have contributed substantially to the economic burden associated with this epidemic. Concomitantly, the accessibility of these advanced therapies is limited, due to a finite number of available organs for heart transplantation and, in the future, the economic costs associated with both transplant and device therapy. This article discusses ethical and policy challenges in the treatment of advanced heart failure, including decisions regarding procurement of hearts for transplant and allocation to recipients; and the complex issues surrounding the use of implantable cardioverter defibrillators and ventricular assist devices, including quality of life, advanced directive planning in the context of these devices, and resource utilization. Based on these challenges, we recommend that a discussion of these complex matters be incorporated into cardiovascular training programs.
Psychopathology, Neuroscience, and Moral Theory
Authors: Tankersley Dharol
Published: March 2012

Abstract: Moral theorists often invoke sociopaths and psychopaths as the quintessential example of a morally impaired agent. In the current debate, both moral rationalists, who argue that moral competence consists in the ability to apply a set of moral rules, and moral sentimentalists, who define moral competence as appropriate emotional responding, refer to evidence regarding these pathologies to support their theory. Neither experimental data on antisocial pathologies nor neuroscientific data provide definitive support for either moral theory, but both of these empirical literatures suggest a deep complexity in the mechanisms supporting moral competence, and perhaps an inadequacy of our current conceptions of "emotional" versus "rational" or "cognitive" systems, and how these contribute to psychopathology and influence "moral" capacities.
Conceptual Challenges in the Neuroimaging of Psychiatric Disorders
Authors: Kanaan Richard A. A. , McGuire Philip K.
Published: March 2012

Abstract: We consider the conceptual problems facing the application of functional imaging, particularly functional magnetic resonance imaging (fMRI), to psychiatric disorders. We first divide the problems facing the fMRI of normal function into problems of the task, power, and analysis. We then argue that each of these is more pronounced when fMRI is applied to psychiatric patients. Although fMRI has been instrumental in shaping the biological conception of psychiatry, the challenges it faces in delivering on the promise of a bridge from cognitive psychopathology to brain function are daunting.
Common genetic variants in metabolism and detoxification pathways and the risk of papillary thyroid cancer.
Authors: Aschebrook-Kilfoy Briseis , Neta Gila , Brenner Alina V , Hutchinson Amy , Pfeiffer Ruth M , Sturgis Erich M , Xu Li , Wheeler William , Doody Michele M , Chanock Stephen J , Sigurdson Alice J
Published: March 2012

Relationships are unclear between polymorphisms in genes involved in metabolism and detoxification of various chemicals and papillary thyroid cancer (PTC) risk as well as their potential modification by alcohol or tobacco intake. We evaluated associations between 1647 tagging single nucleotide polymorphisms (SNPs) in 132 candidate genes/regions involved in metabolism of exogenous and endogenous compounds (Phase I/II, oxidative stress, and metal binding pathways) and PTC risk in 344 PTC cases and 452 controls. For 15 selected regions and their respective SNPs, we also assessed interaction with alcohol and tobacco use. Logistic regression models were used to evaluate the main effect of SNPs (Ptrend) and interaction with alcohol/tobacco intake. Gene- and pathway-level associations and interactions (Pgene interaction) were evaluated by combiningPtrendvalues using the adaptive rank-truncated product method. While we found associations between PTC risk and nine SNPs (Ptrend≤0.01) and seven genes/regions (Pregion<0.05), none remained significant after correction for the false discovery rate. We found a significant interaction betweenUGT2B7andNAT1genes and alcohol intake (Pgene interaction=0.01 and 0.02 respectively) and between theCYP26B1gene and tobacco intake (Pgene interaction=0.02). Our results are suggestive of interaction between the genetic polymorphisms in several detoxification genes and alcohol or tobacco intake on risk of PTC. Larger studies with improved exposure assessment should address potential modification of PTC risk by alcohol and tobacco intake to confirm or refute our findings.
Reverse triangle inequality. Antinorms and semi-antinorms
Authors: Moszyńska Maria , Richter Wolf-Dieter
Published: March 2012

The paper concerns a biunique correspondence between some positively homogeneous functions on ℝn and some star-shaped sets with nonempty interior, symmetric with respect to the origin (Theorems 3.5 and 4.3).
Author, the Atheist, and the Academic Study of Religion
Authors: King Rebekka
Published: March 2012

Recently, there has been an upsurge in the publication of popular biblical criticisms, as exemplified by the popular works of scholars such as John Dominic Crossan, Marcus Borg, Bart Ehrman and the Jesus Seminar, as well as by theological thinkers such as Bishop John Shelby Spong. My paper draws upon two years of formal anthropological fieldwork conducted at five North American mainline liberal churches that feature reading and discussion groups involved in the study of biblical criticism at a lay or popular level. In offering an analysis of progressive Christianity that engages with the scholarly works of Pierre Bourdieu, I propose to do two things. First, I argue that the study of religion and biblical criticism by progressive Christians serves as an ideal venue in which they are able to construct, articulate and proudly assume an alternative, non-normative Christian identity. I suggest that this identity is one that is formed in opposition to an evangelical or fundamentalist representation of Christianity, which I term, following Jonathan Z. Smith, a ‘Protestant proximate other’ (Smith 2004: 253).
Extensive spinal cord involvement in magnetic resonance imaging evaluation on schistosomal myelitis
Authors: Vidal Claudio Henrique Fernandes , Ferreira Maria Lucia Brito , Azevedo Filho Hildo Rocha Cirne de , Gurgel Fernando Viana , Brainer-Lima Alessandra Mertens
Published: March 2012

The diagnosis of schistosomal myelitis (SM) is frequently presumptive because no findings from any complementary examination are pathognomonic for this disease. The present report describes some abnormalities seen on magnetic resonance imaging (MRI) evaluation of a series of SM patients and discusses their etiopathogenesis. Methods: This study evaluated SM patients at the time of their diagnosis. These patients routinely underwent MRI on all segments of the spinal cord. Results: Thirteen patients were evaluated. The MRI was abnormal in 12 (92.3%) of them. In 11 patients (84.61%), the damage reached two or more spinal segments. Conclusions: MRI was an important diagnostic aid in this sample, because of the high rate of abnormalities detected. The tissue damage observed on MRI was extensive in the majority of the patients.
Conversion of hydroxycinnamic acids into volatile phenols in a synthetic medium and in red wine by Dekkera bruxellensis
Authors: Cabrita Maria João , Palma Vera , Patão Raquel , Freitas Ana Maria Costa
Published: March 2012

The conversion of p-coumaric acid, ferulic acid, and caffeic acid into 4-ethylphenol, 4-ethylguaiacol and 4-ethylcatechol was studied in Dekkera bruxellensis ISA 1791 under defined conditions in a synthetic medium and in a red wine. Liquid chromatography (HPLC-DAD) was used to quantify the phenolic acids, and gas chromatography (GC) coupled to a FID detector was used to quantify volatile phenols using a novel analytical methodology that does not require sample derivatization. Identification was achieved by gas chromatography-mass detection (GC-MS). The results show that phenolic acids concentration decreases while volatile phenols concentration increases. The proportion of caffeic acid taken up by Dekkera bruxellensis is lower than that for p-coumaric or ferulic acid; therefore less 4-ethylcatechol is formed. More important, 4-ethylcathecol synthesis by Dekkera bruxellensis in wine has never been demonstrated so far. These results contribute decisively to a better understanding of the origin of the volatile phenols in wines. The accumulation of these compounds in wine is nowadays regarded as one of the key factors of quality control.
Suplementação de vitamina C não acelera o processo de consolidação de fratura da tíbia em ratos
Authors: Giordano Vincenzo , Albuquerque Rodrigo Pires e , Amaral Ney Pecegueiro do , Chame Cristiano Curcio , Souza Fabio de , Apfel Mara Íbis Rodrigues
Published: March 2012

OBJETIVO: Investigar a função da suplementação de ácido ascórbico na consolidação de fraturas da tíbia de ratos. MÉTODOS: Trinta ratos Wistar machos foram aleatoriamente divididos nos grupos Vitamina C (Grupo A) e sham (Grupo B), com 15 ratos em cada grupo. Ao grupo A foram administrados 200mg/kg de ácido ascórbico por dia intraperitonialmente e ao grupo B,5ml/kg de soro fisiológico intraperitonialmente uma vez ao dia. Os animais foram separados em duplas e colocados em gaiolas, com água e ração padrão ad libitum. As fraturas foram produzidas manualmente, não foram estabilizadas nem foi usado qualquer tipo de imobilização. Duas, quatro e seis semanas após a fratura, cinco ratos de cada grupo foram anestesiados e sacrificados por deslocamento cervical. O calo foi dissecado, preparado e analisado histologicamente. A análise histomorfológica foi realizada seis semanas após a fratura e o estágio de consolidação determinado a partir de escala de cinco pontos. RESULTADOS: Não houve diferenças histológicas e histomorfológicas entre os animais nos três diferentes estágios usados no experimento. Seis semanas após a fratura, os cinco animais de cada grupo apresentaram completa consolidação óssea. CONCLUSÃO: Nas condições estudadas, a suplementação de Vitamina C não acelerou o processo de consolidação de fraturas da tíbia de ratos. Nível de evidência II, estudo individual com delineamento experimental.
Tradução e validação da escala Knee Society Score: KSS para a Língua Portuguesa
Authors: Silva Adriana Lucia Pastore e , Demange Marco Kawamura , Gobbi Riccardo Gomes , Silva Tânia Fernanda Cardoso da , Pécora José Ricardo , Croci Alberto Tesconi
Published: March 2012

OBJETIVO: Traduzir, adaptar culturalmente e validar o "Knee Society Score" (KSS) para a língua portuguesa e verificar suas propriedades de medida, reprodutibilidade e validade. MÉTODO: Avaliados 70 pacientes de ambos os sexos, em estudo clínico transversal, idade entre 55 e 85 anos, osteoartrose primária submetidos a artroplastia total de joelho, com o questionário KSS pelo avaliador 1 (inglês) e após 30 minutos pelo avaliador 2 (português) no pré- operatório e após três e seis meses de pós-operatório. RESULTADOS: O índice alfa de Cronbach e a diagramação de Bland-Altman não detectaram diferença entre as médias das duas avaliações no pré-operatório (p=1,000), com três meses (p=0,991) e seis meses de pós-operatório (p=0,985) na pontuação do joelho e na nota da função do joelho, p=1,000 nos três períodos. CONCLUSÃO: A versão brasileira do Knee Society Score, o Escore da Sociedade do Joelho, mostrou ser um instrumento de fácil compreensão e aplicação; válido e confiável para medir a pontuação e função do joelho de pacientes brasileiros submetidos a ATJ. Nível de Evidências: Estudos diagnósticos - Nivel de Evidência I, Teste de critérios diagnósticos desenvolvidos anteriormente em pacientes consecutivos (com padrão de referência "ouro" aplicado).
Análise de reprodutibilidade da escala "American Knee Society Score" (AKSS)
Authors: Martimbianco Ana Luiza Cabrera , Calabrese Fernanda Rizzo , Iha Luiz Alberto Nakao , Petrilli Marcelo , Lira Neto Ozório , Carneiro Filho Mário
Published: March 2012

OBJETIVOS: Realizar a análise da reprodutibilidade da escala "American Knee Society Score" (AKSS), bem como verificar suas propriedades de medida, para avaliação dos pacientes com osteoartrite e/ou submetidos à artroplastia total de joelho. MÉTODOS: Primeiramente, o AKSS foi aplicado em conjunto com os questionários SF-36 e WOMAC (examinador 1). Os pacientes foram reavaliados após trinta minutos e, novamente, após duas semanas, sendo aplicado apenas o AKSS nas duas avaliações (examinador 2). RESULTADOS: Foram selecionados 58 indivíduos com média de idade de 67,4 anos. Na análise da reprodutibilidade, pelo ICC, houve forte correlação inter e intra-examinador para os dois componentes do AKSS. Na análise dos itens individuais houve boa correlação nos itens "Dor", "Amplitude de Movimento", "Contratura em flexão" e em todos os itens do AKSS Funcional. Na validação, através do coeficiente de Pearson, houve boa correlação entre os domínios AKSS Clínico "Dor", WOMAC "Dor" e o SF-36 "Dor", e boa correlação entre o AKSS Funcional e o domínio Capacidade Funcional do SF-36. CONCLUSÃO: A escala AKSS é útil e confiável para a avaliação dos indivíduos portadores de osteoartrite ou submetidos à ATJ. Tipo de Estudo: Estudos terapêuticos - Investigação dos resultados do tratamento. Nível de Evidência: IV
Tratamento cirúrgico de fraturas intra-articulares de calcâneo sanders II e III: revisão sistemática
Authors: Pelliccioni Adriano Augusto Antoniazzi , Bittar Cíntia Kelly , Zabeu José Luis Amim
Published: March 2012

OBJETIVO: Identificar técnica cirúrgica com melhor resultado para tratamento de fraturas intra-articulares do calcâneo tipo Sanders II e III. MÉTODOS: Revisão sistemática da literatura de estudos clínicos randomizados comparativos de cirurgias de fraturas intra-articulares do calcâneo Sanders II e III, avaliados pelo questionário da American Orthopaedic Foot and Ankle Society (AOFAS). Os estudos foram identificados e recuperados nas bases de dados LILACS, MEDLINE/Pubmed, Biblioteca Cochrane, SciELO, Embase, Science Direct, Scopus, Journals@Ovid, ISI Web of Knowledge, Evidence Based Medicine, além de consulta às referências dos estudos acessados. RESULTADOS: foram identificados três trabalhos randomizados avaliando três técnicas cirúrgicas: fixador externo, fixação percutânea com fio de Kirschner e fixação com parafuso canulado. Todas as técnicas compararam tratamento com redução aberta e fixação com placa e parafuso. Obteve-se as seguintes médias (AOFAS): 86,23 (placa e parafuso), 88,2 (fixação externa), 90,6 (fixação percutânea com fio de Kirschner) e 87,2 (fixação com parafuso canulado). CONCLUSÃO: fixação percutânea com fio de Kirschner apresentou melhores resultados e menor número de complicações, porém as evidências são insuficientes para afirmar superioridade desse tratamento em relação a outras técnicas cirúrgicas.