bluuebunny/crossref_metadata_2025 huggingface dataset:
Influences motivating smokers in a radon-affected area to quit smoking
Authors: Groves-Kirkby Christopher J , Timson Karen , Shield George , Denman Antony R , Rogers Stephen , Campbell Jackie , Phillips Paul S , Ekberg Merryn
Published: July 2012

Aims:

Domestic radon gas concentrations in parts of the UK are sufficiently high to increase lung cancer risk among residents, and recent studies have confirmed that the risk of smokers developing lung cancer is significantly enhanced by the presence of radon. Despite campaigns encouraging residents of radon-affected areas (RAEs) to test and remediate their homes, public response to the risks posed by radon remains relatively modest, particularly among smokers and young families, limiting the health benefits and cost-effectiveness achievable by remediation. The observation that smokers, who are most at risk from radon, are not explicitly targeted by current radon remediation campaigns prompted an assessment of the value of smoking-cessation initiatives in reducing radon-induced lung cancers by reaching at-risk subgroups of the population hitherto uninfluenced by radon-awareness programmes. This study addresses the motivation of current quitters in a designated RAE using a postal questionnaire administered around one year after the cessation attempt.

Methods:

Residents of the Northamptonshire RAE who had joined the smoking-cessation programme between July and September 2006 and who remained verifiably tobacco free at four weeks, were subsequently invited to participate in a questionnaire-based investigation into factors affecting their decision to cease smoking. From an initial population of 445 eligible individuals, 205 of those contacted by telephone after 12 months agreed to complete postal questionnaires, and unsolicited questionnaires were sent to a further 112 participants for whom telephone contact had proved impossible. One hundred and three completed questionnaires were returned and analysed, the principal tools being χ2, Mann-Whitney and Kruskal-Wallis tests.

Results:

Individuals decide to quit smoking from self-interest, principally on health grounds, and regard the effects of their smoke on others, particularly children and unborn babies, as less significant. The risk of developing respiratory, coronary/cardiac or cancerous conditions provides the greatest motivation to the decision to quit, with knowledge of radon among the lowest-ranked influences.

Conclusions:

This study confirms that quitters place risks to their personal health as the highest factors influencing their decision to quit, and health professionals should be aware of this when designing smoking-cessation initiatives. As radon risk is ranked very low by quitters, there would appear to be the potential to raise radon awareness through smoking-cessation programmes, with the objective of increasing the uptake and success rate of such programmes and encouraging participation in radon-remediation programmes.
Clientelism, Elites, and the Media in Central and Eastern Europe
Authors: Örnebring Henrik
Published: July 2012

This article argues that the traditional political science definition of clientelism is insufficient for explaining how the media fit in with clientelistic systems in Central and Eastern Europe (CEE). It is suggested that a broader understanding of clientelism, looking in particular at how media are used as elite-to-elite communication tools as well as elite-to-mass communication tools, better explains the place of the media in the clientelistic systems of the CEE nations. Empirically, it is based on a set of 272 elite and expert interviews conducted across ten CEE countries (Bulgaria, the Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Romania, Slovakia, and Slovenia) in 2010 and 2011. The article presents some general findings on the nature and character of the linkages between political elites and the media, and the extent to which such linkages can be considered clientelistic. Then follows a discussion of specific practices of media instrumentalization, charting the many ways in which the media can function as a resource in conflicts and negotiations between clientelistic elite networks, directly as well as indirectly. Particular attention is given to the phenomena of advertorials and kompromat.
Distress During the Menopause Transition
Authors: Nosek Marcianna , Kennedy Holly Powell , Gudmundsdottir Maria
Published: July 2012

In 2010, nearly 400 million women worldwide were of menopause age (45-54). Although many women transition through menopause with ease, some experience distress and a subsequent decrease in quality of life. The purpose of this qualitative study was to examine the experiences of distress in women during the menopause transition. A narrative analysis methodology was used maintaining participants’ complete narratives when possible. In-person interviews of 15 midlife women were digitally audio recorded and transcribed verbatim. Women shared narratives of distress related to menstrual changes, emotional instability, vaginal dryness, and decreased libido affected by their relationships with self, partners, work, and family. Some experiences were presented against a backdrop of the past and influenced by concerns for the future. Detailed stories illuminated the effect that distressful symptoms had on quality of life and captured how intricately woven symptoms were with the women’s interpersonal and social lives.
WNT7B in fibroblastic foci of idiopathic pulmonary fibrosis
Authors: Meuten Travis , Hickey Ariel , Franklin Katherine , Grossi Brian , Tobias Jeremy , Newman Donna R , Jennings Samuel H , Correa Maria , Sannes Philip L
Published: July 2012

Background

Idiopathic pulmonary fibrosis (IPF) is a devastating interstitial pneumonia causing a loss of respiratory surface area due to a proliferative fibrotic response involving hyperplastic, hypertrophic, and metaplastic epithelium, cystic honeycomb change, septal expansion, and variable inflammation. Wnt (wingless) signaling glycoproteins are known to be involved in lung development and tissue repair, and are up-regulated in patients with IPF. Based on previous qRT-PCR data showing increased Wnt7B in lungs of IPF patients, a systematic, quantitative examination of its tissue site distribution was undertaken.

Methods

Tissue samples from the Lung Tissue Research Consortium (LTRC) of 39 patients diagnosed with mild to severe IPF/usual interstitial pneumonia (UIP) and 19 normal patients were examined for the immunolocalization of Wnt7B.

Results

In normal lung, moderate Wnt7B reactivity was confined to airway epithelium, smooth muscle of airways and vasculature, and macrophages. IPF lung showed strong Wnt7B reactivity in fibroblastic foci, dysplastic airway and alveolar epithelium, and in highly discrete subepithelial, basement membrane-associated regions. All reactive sites were sized and counted relative to specific microscopic regions. Those in the subepithelial sites were found in significantly greater numbers and larger relative area compared with the others. No reactive sites were present in normal patient controls.

Conclusions

The results demonstrate Wnt7B to be expressed at high concentrations in regions of active hyperplasia, metaplasia, and fibrotic change in IPF patients. In this context and its previously established biologic activities, Wnt7B would be expected to be of potential importance in the pathogenesis of IPF.
Erratum to: A linear classifier based on entity recognition tools and a statistical approach to method extraction in the protein-protein interaction literature
Authors: Lourenço Anália , Conover Michael , Wong Andrew , Nematzadeh Azadeh , Pan Fengxia , Shatkay Hagit , Rocha Luis M
Published: July 2012

Correction to A. Lourenço, M. Conover, A. Wong, A. Nematzadeh, F. Pan, H. Shatkay, and L.M. Rocha."A Linear Classifier Based on Entity Recognition Tools and a Statistical Approach to Method Extraction in the Protein-Protein Interaction Literature". BMC Bioinformatics 2011, 12(Suppl 8):S12. doi:http://10.1186/1471-2105-12-S8-S12.
Microbial transformation from normal oral microbiota to acute endodontic infections
Authors: Hsiao William W L , Li Kevin L , Liu Zhenqiu , Jones Cheron , Fraser-Liggett Claire M , Fouad Ashraf F
Published: July 2012

Background

Endodontic infections are a leading cause of oro-facial pain and tooth loss in western countries, and may lead to severe life-threatening infections. These infections are polymicrobial with high bacterial diversity. Understanding the spatial transition of microbiota from normal oral cavities through the infected root canal to the acute periapical abscess can improve our knowledge of the pathogenesis of endodontic infections and lead to more effective treatment. We obtained samples from the oral cavity, infected root canal and periapical abscess of 8 patients (5 with localized and 3 with systemic infections). Microbial populations in these samples were analyzed using next-generation sequencing of 16S rRNA amplicons. Bioinformatics tools and statistical tests with rigorous criteria were used to elucidate the spatial transition of the microbiota from normal to diseased sites.

Results

On average, 10,000 partial 16S rRNA gene sequences were obtained from each sample. All sequences fell into 11 different bacterial phyla. The microbial diversity in root canal and abscess samples was significantly lower than in the oral samples. Streptococcus was the most abundant genus in oral cavities while Prevotella and Fusobacterium were most abundant in diseased samples. The microbiota community structures of root canal and abscess samples were, however, more similar to each other than to the oral cavity microbiota. Using rigorous criteria and novel bioinformatics tools, we found that Granulicatella adiacens, Eubacterium yurii, Prevotella melaninogenica, Prevotella salivae, Streptococcus mitis, and Atopobium rimae were over-represented in diseased samples.

Conclusions

We used a novel approach and high-throughput methodologies to characterize the microbiota associated normal and diseased oral sites in the same individuals.
A national survey into perioperative anesthetic management of patients with a fractured neck of femur
Authors: Soinikoski Mirka , Kuusniemi Kristiina , Jalonen Jouko , Kuitunen Sari , Tuppurainen Tapani , Leino Kari
Published: July 2012

Background

We made a survey among Finnish anesthesiologists concerning the current perioperative anesthetic practice of hip fracture patients for further development in patient care.

Methods

All members of the Finnish Society of Anesthesiologists with a known e-mail address (786) were invited to participate in an internet-based survey.

Results

The overall response rate was 55% (423 responses); 298 respondents participated in the care of hip fracture patients. Preoperative analgesia was mostly managed with oxycodone and paracetamol; every fifth respondent applied an epidural infusion. Most respondents (98%) employed a spinal block with or without an epidural catheter for intraoperative anesthesia. Midazolam, propofol and/or fentanyl were used for additional sedation. General anesthesia was used rarely. Postoperatively, paracetamol and non-steroidal anti-inflammatory drugs and occasionally peroral oxycodone, were prescribed in addition to epidural analgesia.

Conclusions

The survey suggests that the impact of more individualised analgesia regimens, both preoperatively and postoperatively, should be investigated in further studies.
Worsening angle closure glaucoma and choroidal detachments subsequent to closure of a carotid cavernous fistula
Authors: Thinda Sumeer , Melson Mark R , Kuchtey Rachel W
Published: July 2012

Background

Carotid cavernous fistulas are abnormal communications between the cavernous sinus and the external or internal carotid arteries. Although rare, closure of carotid cavernous fistulas can lead to immediate ocular complications. To our knowledge, our case represents the first report of worsening angle closure glaucoma and choroidal detachments over an extended period of two months subsequent to closure of a carotid cavernous fistula.

Case presentation

A 70-year-old female with a history of primary angle closure glaucoma presented with 4 mm of proptosis, resistance to retropulsion, tortuous corkscrew blood vessels and an orbital bruit of the right eye. Diagnostic cerebral angiogram showed a small indirect Barrow type D right carotid cavernous fistula. Transarterial embolization was planned but repeat cerebral angiography prior to the procedure demonstrated spontaneous partial closure of the carotid cavernous fistula and the procedure was aborted. One month later, our patient was noted to have worsening vision and choroidal detachments of the right eye. She declined further testing and was thus started on self-administered manual carotid jugular compressions. One month later, she developed progressive worsening of her choroidal detachments and angle closure. She eventually opted for surgical intervention but repeat cerebral angiography showed significant thrombosis of the carotid cavernous fistula and no intervention was warranted. Examination two months later showed complete resolution of the choroidal detachments and open angles of both eyes.

Conclusions

Our patient demonstrated worsening angle closure glaucoma and choroidal detachments after spontaneous closure of her carotid cavernous fistula had been noted. Ocular complications, including acute angle closure, have been reported to occur immediately after closure of carotid cavernous fistulas, but not over months as in our patient. It is imperative that individuals who have undergone apparent closure of a carotid cavernous fistula be carefully monitored for worsening ocular complications.
Physical activity and fat mass gain in Mexican school-age children: a cohort study
Authors: Jáuregui Alejandra , Villalpando Salvador , Rangel-Baltazar Eduardo , Lara-Zamudio Yaveth A , Castillo-García Marcia M
Published: July 2012

Background

In México, the prevalence of unhealthy weight increased from 24% at 6 y to 33% at 12 y of age, opening a window of opportunity to better understand the pathogenesis of obesity. The objective of this study was to explore the association between time spent on medium, vigorous physical activity (MVPA) and concurrent gains in BMI, fat mass (FM) and fat-free mass (FFM), alternately, in a cohort of Mexican children followed from kindergarten (baseline) to 2nd grade elementary school (endline).

Methods

The MVPA (5-d accelerometry), BMI, FM and FFM (air displacement plethysmography) were measured at baseline and endline. Associations between gains in BMI, FM and FFM and changes in MVPA were examined using lagged and dynamic regression models, controlling for energy intake and demographic variables.

Results

A total of 205 children were analyzed. Gender affected the effect of MVPA on FM gain. In girls, a high baseline MVPA predicted a lower FM gain (-0.96 kg, p=0.025) compared to low/medium MVPA. Increasing, decreasing or having a persistently high MVPA predicted a lower FM gain (range -1.6 to -1.03 kg, p<0.05) compared to persistently low MVPA. In boys, increases in MVPA were associated with higher gains in BMI (+0.76 kg/m2, p=0.04) and FFM (+1.1 kg, p=0.01) compared to persistently low MVPA.

Conclusion

These results support a protective role of MVPA on FM gain in girls, suggesting that it may play a crucial role in the development of obesity. Further research on the gender effect of MVPA is warranted to better understand its role in the prevention and control of overweight and obesity.
Psychosocial factors associated with becoming a young father in Finland: a nationwide longitudinal study
Authors: Lehti Venla , Sourander Andre , Sillanmäki Lauri , Helenius Hans , Tamminen Tuula , Kumpulainen Kirsti , Almqvist Fredrik
Published: July 2012

Background

Little is known about the characteristics of boys who become fathers at young age. Some studies have suggested that antisocial adolescents are more likely to be young fathers. The aim of this study was to examine the associations of psychosocial factors in childhood with becoming a young father, and to assess if they are independent of criminal behavior in adolescence.

Methods

The baseline assessment in 1989 included 2,946 boys born in 1981. Information about psychiatric symptoms at age eight was collected with Rutter questionnaires from parents and teachers and with the Child Depression Inventory from the children themselves. Data on criminal offenses at age 16–20 was collected from a police register. Register-based follow-up data on becoming a father under the age of 22 was available for 2,721 boys.

Results

The factors measured at age eight, which were associated with becoming a young father independently of adolescent criminality, were conduct problems, being born to a young father and having a mother with a low educational level. Having repeatedly committed criminal offences in adolescence was associated with becoming a young father independently of psychosocial factors in childhood.

Conclusions

Antisocial tendencies both in childhood and adolescence are associated with becoming a young father. They should be taken into consideration when designing preventive or supportive interventions.
Increased expression of the yeast multidrug resistance ABC transporter Pdr18 leads to increased ethanol tolerance and ethanol production in high gravity alcoholic fermentation
Authors: Teixeira Miguel C , Godinho Cláudia P , Cabrito Tânia R , Mira Nuno P , Sá-Correia Isabel
Published: July 2012

Background

The understanding of the molecular basis of yeast tolerance to ethanol may guide the design of rational strategies to increase process performance in industrial alcoholic fermentations. A set of 21 genes encoding multidrug transporters from the ATP-Binding Cassette (ABC) Superfamily and Major Facilitator Superfamily (MFS) in S. cerevisiae were scrutinized for a role in ethanol stress resistance.

Results

A yeast multidrug resistance ABC transporter encoded by the PDR18 gene, proposed to play a role in the incorporation of ergosterol in the yeast plasma membrane, was found to confer resistance to growth inhibitory concentrations of ethanol. PDR18 expression was seen to contribute to decreased 3 H-ethanol intracellular concentrations and decreased plasma membrane permeabilization of yeast cells challenged with inhibitory ethanol concentrations. Given the increased tolerance to ethanol of cells expressing PDR18, the final concentration of ethanol produced during high gravity alcoholic fermentation by yeast cells devoid of PDR18 was lower than the final ethanol concentration produced by the corresponding parental strain. Moreover, an engineered yeast strain in which the PDR18 promoter was replaced in the genome by the stronger PDR5 promoter, leading to increased PDR18 mRNA levels during alcoholic fermentation, was able to attain a 6 % higher ethanol concentration and a 17 % higher ethanol production yield than the parental strain. The improved fermentative performance of yeast cells over-expressing PDR18 was found to correlate with their increased ethanol tolerance and ability to restrain plasma membrane permeabilization induced throughout high gravity fermentation.

Conclusions

PDR18 gene over-expression increases yeast ethanol tolerance and fermentation performance leading to the production of highly inhibitory concentrations of ethanol. PDR18 overexpression in industrial yeast strains appears to be a promising approach to improve alcoholic fermentation performance for sustainable bio-ethanol production.
Hydroxy decenoic acid down regulates gtfB and gtfC expression and prevents Streptococcus mutans adherence to the cell surfaces
Authors: Yousefi Behnam , Ghaderi Shahrooz , Rezapoor-Lactooyi Alireza , Amiri Niusha , Verdi Javad , Shoae-Hassani Alireza
Published: July 2012

Background

10- Hydroxy-2-decenoic acid, an unsaturated fatty acid is the most active and unique component to the royal jelly that has antimicrobial properties. Streptococcus mutans is associated with pathogenesis of oral cavity, gingivoperiodontal diseases and bacteremia following dental manipulations. In the oral cavity, S. mutans colonize the soft tissues including tongue, palate, and buccal mucosa. When considering the role of supragingival dental plaque in caries, the proportion of acid producing bacteria (particularly S. mutans), has direct relevance to the pathogenicity of the plaque. The genes that encode glucosyltransferases (gtf s) especially gtfB and gtfC are important in S. mutans colonization and pathogenesis. This study investigated the hydroxy-decenoic acid (HDA) effects on gtfB and gtfC expression and S. mutans adherence to cells surfaces.

Methods

Streptococcus mutans was treated by different concentrations of HPLC purified HDA supplied by Iran Beekeeping and Veterinary Association. Real time RT-PCR and western blot assays were conducted to evaluate gtfB and gtfC genes transcription and translation before and after HDA treatment. The bacterial attachment to the cell surfaces was evaluated microscopically.

Results

500 μg ml-1 of HDA inhibited gtfB and gtfC mRNA transcription and its expression. The same concentration of HDA decreased 60% the adherence of S. mutans to the surface of P19 cells.

Conclusion

Hydroxy-decenoic acid prevents gtfB and gtfC expression efficiently in the bactericide sub-concentrations and it could effectively reduce S. mutans adherence to the cell surfaces. In the future, therapeutic approaches to affecting S. mutans could be selective and it’s not necessary to put down the oral flora completely.
Electrodeposition of platinum and silver into chemically modified microporous silicon electrodes
Authors: Koda Ryo , Fukami Kazuhiro , Sakka Tetsuo , Ogata Yukio H
Published: July 2012

Electrodeposition of platinum and silver into hydrophobic and hydrophilic microporous silicon layers was investigated using chemically modified microporous silicon electrodes. Hydrophobic microporous silicon enhanced the electrodeposition of platinum in the porous layer. Meanwhile, hydrophilic one showed that platinum was hardly deposited within the porous layer, and a film of platinum on the top of the porous layer was observed. On the other hand, the electrodeposition of silver showed similar deposition behavior between these two chemically modified electrodes. It was also found that the electrodeposition of silver started at the pore opening and grew toward the pore bottom, while a uniform deposition from the pore bottom was observed in platinum electrodeposition. These electrodeposition behaviors are explained on the basis of the both effects, the difference in overpotential for metal deposition on silicon and on the deposited metal, and displacement deposition rate of metal.
Localization based on two-stage treatment for dealing with noisy and biased distance measurements
Authors: Cho Hyeonwoo , Lee Jewon , Kim Daehyun , Kim Sang Woo
Published: July 2012

Localization can be performed by trilateration in which the coordinates of a target are calculated by using the coordinates of reference points and the distances between each reference point and the target. Because the distances are measured on the basis of the time-of-flight of various kinds of signals, they contain errors which are the noise and bias. The presence of bias can become a major problem because its magnitude is generally unknown. In this article, we propose an algorithm that combines the Kalman filter (KF) and the least square (LS) algorithm to treat noisy and biased distances measured by chirp spread spectrum ranging defined in IEEE 802.15.4a. By using the KF, we remove the noise in the measured distance; hence, the noise-eliminated distance, which still contains bias, is obtained. The next step consists of the calculation of the target coordinates by using the weighted LS algorithm. This algorithm uses the noise-eliminated distance obtained by using the KF, and the weighting parameters of the algorithm are determined to reduce the effects of bias. To confirm the accuracy of the proposed algorithm, we present the results of indoor localization experiments.
Improved survival of patients with coronary artery disease and low ejection fraction with ICD implantation versus conventional therapy in a real world survey
Authors: Aschenbrenner Timo , Brockmeier Johannes , Bramlage Peter , Fimmers Rolf , Cuneo Alessandro , Hochreuther Stefan , Zemmrich Claudia , Tebbe Ulrich
Published: July 2012

Background

Coronary artery disease (CAD) is associated with an increased risk for sudden cardiac death. Randomized controlled trials have shown that implantable cardioverter defibrillators (ICD) improve life expectancy unless they are implanted within the first days after an acute myocardial infarction and guidelines recommend their use. We aimed to validate that these results also apply to patients of a typical community hospital in Germany.

Methods

This was a retrospective analysis of patients undergoing coronary angiography in the Lippe-Detmold Hospital between 2003 and 2006. They had to have significant CAD and an ejection fraction (EF) ≤ 35% and no acute myocardial infarction within 28 days of implantation and no history of ventricular fibrillation.

Results

213 patients were included; 70 of which received an ICD. Patients with an ICD implantation were younger (64.8 ± 9.9 vs. 67.9 ± 9.8 years; p = 0.034), had single vessel CAD more frequently (22.9 vs. 11.2%; p = 0.025) and a lower EF (26.7 ± 6.3 vs. 29.1 ± 4.6%; p = 0.006). Hospital readmissions were comparable between the ICD and the control group (68.6 vs. 72.0%; p = 0.602). ICD therapy was associated with a considerable survival benefit compared to conventional therapy (HR 0.52; 95%CI 0.29-0.93; p = 0.027) in a Cox-Proportional Hazards Regression analysis.

Conclusions

Appreciating the potential limitations of retrospective studies, we found that ICD use was associated with improved survival in patients with significant CAD and an EF <= 35% typical for a large tertiary hospital.
Correlation of SRSF1 and PRMT1 expression with clinical status of pediatric acute lymphoblastic leukemia
Authors: Zou Limin , Zhang Han , Du Chaohao , Liu Xiao , Zhu Shanshan , Zhang Wei , Li Zhigang , Gao Chao , Zhao Xiaoxi , Mei Mei , Bao Shilai , Zheng Huyong
Published: July 2012

Background

Acute lymphoblastic leukemia (ALL) is the most frequently-occurring malignant neoplasm in children, but the pathogenesis of the disease remains unclear. In a microarray assay using samples from 100 children with ALL, SFRS1 was found to be up-regulated. Serine/arginine-rich splicing factor 1 (SRSF1, also termed SF2/ASF), encoded by the SFRS1 gene, had been shown to be a pro-oncoprotein. Our previous study indicated that SRSF1 can be methylated by protein arginine methyltransferase 1 (PRMT1) in vitro; however, the biological function of SRSF1 and PRMT1 in pediatric ALL are presently unknown.

Methods

Matched, newly diagnosed (ND), complete remission (CR) and relapse (RE) bone marrow samples from 57 patients were collected in order to evaluate the expression patterns of SRSF1 and PRMT1. The potential oncogenic mechanism of SRSF1 and PRMT1 in leukemogenesis was also investigated.

Results

We identified significant up-regulation of SRSF1 and PRMT1 in the ND samples. Importantly, the expression of SRSF1 and PRMT1 returned to normal levels after CR, but rebounded in the RE samples. Our observation that SRSF1 could predict disease relapse was of particular interest, although the expression patterns of SRSF1 and PRMT1 were independent of the cytogenetic subtypes. In pre-B-cell lines, both SRSF1 and PRMT1 expression could be efficiently attenuated by the clinical chemotherapy agents arabinoside cytosine (Ara-c) or vincristine (VCR). Moreover, SRSF1 and PRMT1 were associated with each other in leukemia cells in vivo. Knock-down of SRSF1 resulted in an increase in early apoptosis, which could be further induced by chemotherapeutics.

Conclusions

Our results indicate that SRSF1 serves as an anti-apoptotic factor and potentially contributes to leukemogenesis in pediatric ALL patients by cooperating with PRMT1.
Disruption of Yarrowia lipolytica biofilms by rhamnolipid biosurfactant
Authors: Dusane Devendra H , Dam Sushovan , Nancharaiah Yarlagadda V , Kumar Ameeta Ravi , Venugopalan Vayalam P , Zinjarde Smita S
Published: July 2012

Background

Yarrowia lipolytica is an ascomycetous dimorphic fungus that exhibits biofilm mode of growth. Earlier work has shown that biosurfactants such as rhamnolipids are efficient dispersants of bacterial biofilms. However, their effectiveness against fungal biofilms (particularly Y. lipolytica) has not been investigated. The aim of this study was to determine the effect of rhamnolipid on a biofilm forming strain of Y. lipolytica. Two chemical surfactants, cetyl-trimethyl ammonium bromide (CTAB) and sodium dodecyl sulphate (SDS) were used as controls for comparison.

Results

The methylene blue dye exclusion assay indicated an increase in fungal cell permeability after rhamnolipid treatment. Microtiter plate assay showed that the surfactant coating decreased Y. lipolytica biofilm formation by 50%. Rhamnolipid treatment disrupted pre-formed biofilms in a more effective manner than the other two surfactants. Confocal laser scanning microscopic studies showed that biofilm formation onto glass surfaces was decreased by 67% after sub-minimum inhibitory concentration (sub-MIC) treatment with rhamnolipids. The disruption of biofilms after rhamnolipid treatment was significant (P<0.05) when compared to SDS and CTAB.

Conclusion

The results indicate a potential application of the biological surfactant to disrupt Y. lipolytica biofilms.
Premotor biomarkers for Parkinson's disease - a promising direction of research
Authors: Haas Brian R , Stewart Tessandra H , Zhang Jing
Published: July 2012

The second most serious neurodegenerative disease is Parkinson’s disease (PD). Over the past several decades, a strong body of evidence suggests that PD can begin years before the hallmark clinical motor symptoms appear. Biomarkers for PD are urgently needed to differentiate between neurodegenerative disorders, screen novel therapeutics, and predict eventual clinical PD before the onset of symptoms. Some clinical evaluations and neuroimaging techniques have been developed in the last several years with some success in this area. Moreover, other strategies have been utilized to identify biochemical and genetic markers associated with PD leading to the examination of PD progression and pathogenesis in cerebrospinal fluid, blood, or saliva. Finally, interesting results are surfacing from preliminary studies using known PD-associated genetic mutations to assess potential premotor PD biomarkers. The current review highlights recent advances and underscores areas of potential advancement.
Autoantibody profiling to follow evolution of lupus syndromes
Authors: Olsen Nancy J , Li Quan-Zhen , Quan Jiexia , Wang Ling , Mutwally Azza , Karp David R
Published: July 2012

Introduction

Identification of patients who are in early stages of lupus is currently done through clinical evaluation and is not greatly facilitated by available diagnostic tests. Profiling for patient characteristics and antibody specificities that predict disease would enhance the ability of physicians to identify and treat early cases prior to onset of organ damaging illness.

Methods

A group of 22 patients with 4 or fewer diagnostic criteria for lupus were studied for changes in clinical and autoantibody profiles after a mean follow up period of 2.4 years. An array with more than 80 autoantigens was used to profile immunoglobulin G (IgG) and immunoglobulin M (IgM) autoantibodies. Correlations with clinical disease progression were examined.

Results

3 of the 22 patients (14%) added sufficient criteria during follow up to satisfy a diagnosis of systemic lupus erythematosus (SLE) or to acquire a diagnosis of SLE renal disease. Patients who progressed were all females and were younger than those who did not progress (P=0.00054). IgG but not IgM autoreactivity showed greater increases in the progressor group than in the non-progressor group (P=0.047). IgG specificities that were higher at baseline in progressors included proliferating cell nuclear antigen (PCNA), beta 2 microglobulin, C1q and hemocyanin (P<0.019). Progressors had significant increases in La/SSB and liver cytosol type 1 (LC1) IgG autoantibodies over the period of evaluation (P≤0.0072). A quantitative risk profile generated from baseline demographic and autoantibody variables yielded highly different scores for the progressor and non-progressor groups (P=1.38 × 10-7)

Conclusions

In addition to demographic features, autoantibody profiles using an expanded array of specificities were correlated with the risk of progressive disease in patients with lupus. These findings suggest the feasibility of developing a simple diagnostic that could be applied by nonspecialists to screen for lupus and permit effective triage for specialty care.
Giant cell carcinoma causing rapidly progressive respiratory failure as the presenting feature of AIDS
Authors: Sugawara E , Yamamoto K , Umeda S , Suzuki S , Kurata M , Endo Y , Uchibori K , Akashi T , Inase N , Kitagawa M
Published: July 2012

The incidence of lung cancer has been increasing among HIV-positive patients. The majority of these cases were in patients previously diagnosed as HIV-positive and treated with highly active antiretroviral therapy (HAART). Here, we report a 56-year-old male patient with lung cancer, who was diagnosed as HIV-positive after the onset of neck pain and lumbago and thus, was not treated with anti-AIDS therapy. The patient developed rapidly progressive and fatal respiratory failure. Autopsy demonstrated giant cell carcinoma of the lung responsible for carcinomatous lymphangitis. This case highlighted the possibility that pulmonary carcinogenesis in HIV-positive patients is not necessarily associated with HAART therapy.
Pelvic inflammatory disease in adolescents between the time of testing and treatment and after treatment for gonorrhoeal and chlamydial infection
Authors: Risser W L , Risser J M , Benjamins L J
Published: July 2012

In incarcerated adolescents, 13% developed pelvic inflammatory disease (PID) between the time of testing and treatment for chlamydial and gonorrhoeal infection, and 13% developed PID in the 30 days following single-dose treatment for one or both of these infections.
HIV infection and sexual partnerships and behaviour among adolescent girls in Nairobi, Kenya
Authors: Rositch A F , Cherutich P , Brentlinger P , Kiarie J N , Nduati R , Farquhar C
Published: July 2012

Early sexual partnerships place young women in sub-Saharan Africa at high risk for HIV. Few studies have examined both individual- and partnership-level characteristics of sexual relationships among adolescent girls. A cross-sectional survey of sexual history and partnerships was conducted among 761 adolescent girls aged 15–19 years in Nairobi, Kenya. Rapid HIV testing was conducted and correlates of HIV infection were determined using multivariate logistic regression. The HIV prevalence was 7% and seropositive adolescents had a younger age at sexual debut ( P < 0.01), more sexual partners in 12 months ( P = 0.03), and were more likely to report transactional or non-consensual sex( P < 0.01). Girls who reported not knowing their partner's HIV status were 14 times as likely to be HIV-seropositive than girls who knew their partner's status (adjusted odds ratio: 14.2 [1.8, 109.3]). Public health messages to promote HIV testing and disclosure within partnerships could reduce sexual risk behaviours and HIV transmission among adolescents.
The use of telehealth to assist remote hospital resuscitation and aeromedical retrieval tasking: a 12-month case review
Authors: Sharpe Kate , Elcock Mark , Aitken Peter , Furyk Jeremy
Published: July 2012

We evaluated the use of telehealth for patients who had suffered a cardiac or respiratory arrest, and were medically coordinated from the Queensland coordination hub at Townsville. We conducted a review of all cardiac or respiratory arrest cases where teleheath had been used prior to aeromedical retrieval. The doctors involved in the cases completed an evaluation form about the use of telehealth during the resuscitation. During the 12-month study period 6460 patients were medically coordinated from Townsville. Telehealth was used 51 times, i.e. for 0.8% of all transfers. Of the 51 uses of telehealth, nine were for patients having a cardiac/respiratory arrest, i.e. 18% of telehealth use at Townsville was for patients undergoing resuscitation following cardiac or respiratory arrest. All eight medical coordinators and three of eight referring doctors responded to the survey. Most medical coordinators stated that telehealth assisted communication and aided assessment. Most medical coordinators and some referring doctors felt that it improved the quality of patient care. The free text comments on telehealth use for remote area resuscitation were generally very supportive. While the telehealth equipment was easy to use, minor audio problems reinforce the need for systems to be wholly reliable. A set of guidelines to aid future telehealth assisted resuscitation was produced. The present study suggests that telehealth use is beneficial during active resuscitation efforts.
Tele-EEG in the UK: a report of over 1000 patients
Authors: Coates Steven , Clarke Anne , Davison Geoffrey , Patterson Victor
Published: July 2012

Clinical neurophysiology is the medical specialty in the UK responsible for training doctors in the interpretation of electroencephalograms (EEGs). At present it is difficult to recruit doctors to train in clinical neurophysiology which causes difficulty in delivering services. We established a tele-EEG service to record and report on EEGs at a UK hospital which was unable to attract a resident clinical neurophysiologist. The EEGs were recorded in digital format and placed on a web server to be read by a clinical neurophysiologist in another part of the UK. Where possible this was done using NHS web servers and email, but a back-up system was established using other systems with suitable encryption. A total of 1007 EEGs were reported in 13 months from patients of all ages, epilepsy being the commonest reason for referral. All cases were reported within 24 h of recording. The back-up system was used in 60 cases. Tele-EEG is a feasible, secure, timely and effective method of providing an EEG service to hospitals which cannot recruit a resident clinical neurophysiologist.
Training the allied health assistant for the telerehabilitation assessment of dysphagia
Authors: Sharma Shobha , Ward Elizabeth C , Burns Clare , Theodoros Deborah , Russell Trevor
Published: July 2012

We examined the effect of knowledge and task specific training provided to an allied health assistant (AHA), prior to her involvement in facilitating assessments of dysphagia (swallowing disorders) via telerehabilitation. The AHA received four hours of training, which included basic theoretical information regarding dysphagia as well as hands-on training with simulated patients. A written test examining swallowing function and its evaluation was completed pre- and then immediately post-training, and then again after the 15th and 30th of 31 consecutive patient assessments. In addition, after each set of 5 clinical dysphagia assessments completed with patients following the training, two speech pathologists rated the AHA's competence in relation to performing the tasks and activities required of her during the telerehabilitation swallowing assessment. The AHA also self-rated the perceived level of confidence at these times. Before training, the assistant's knowledge of dysphagia theory was at 40%. Following training, all tests were above the 80% level. The AHA's performance was rated as competent on each evaluation post-training. The AHA also expressed overall satisfaction with the initial training provided and reported feeling confident after the initial sessions with patients. Thus for an AHA with previous clinical experience, competence and perceived comfort in providing assistance in the sessions was achieved with only a few hours of task specific training.
Satisfaction with telemedicine for teaching listening and spoken language to children with hearing loss
Authors: Constantinescu Gabriella
Published: July 2012

Auditory-Verbal Therapy (AVT) is an effective early intervention for children with hearing loss. The Hear and Say Centre in Brisbane offers AVT sessions to families soon after diagnosis, and about 20% of the families in Queensland participate via PC-based videoconferencing (Skype). Parent and therapist satisfaction with the telemedicine sessions was examined by questionnaire. All families had been enrolled in the telemedicine AVT programme for at least six months. Their average distance from the Hear and Say Centre was 600 km. Questionnaires were completed by 13 of the 17 parents and all five therapists. Parents and therapists generally expressed high satisfaction in the majority of the sections of the questionnaire, e.g. most rated the audio and video quality as good or excellent. All parents felt comfortable or as comfortable as face-to-face when discussing matters with the therapist online, and were satisfied or as satisfied as face-to-face with their level and their child's level of interaction/rapport with the therapist. All therapists were satisfied or very satisfied with the telemedicine AVT programme. The results demonstrate the potential of telemedicine service delivery for teaching listening and spoken language to children with hearing loss in rural and remote areas of Australia.
The treatment of unstable fractures of the ankle using the Acumed fibular nail
Authors: Bugler K. E. , Watson C. D. , Hardie A. R. , Appleton P. , McQueen M. M. , Court-Brown C. M. , White T. O.
Published: July 2012

Techniques for fixation of fractures of the lateral malleolus have remained essentially unchanged since the 1960s, but are associated with complication rates of up to 30%. The fibular nail is an alternative method of fixation requiring a minimal incision and tissue dissection, and has the potential to reduce the incidence of complications.

We reviewed the results of 105 patients with unstable fractures of the ankle that were fixed between 2002 and 2010 using the Acumed fibular nail. The mean age of the patients was 64.8 years (22 to 95), and 80 (76%) had significant systemic medical comorbidities. Various different configurations of locking screw were assessed over the study period as experience was gained with the device. Nailing without the use of locking screws gave satisfactory stability in only 66% of cases (4 of 6). Initial locking screw constructs rendered between 91% (10 of 11) and 96% (23 of 24) of ankles stable. Overall, seven patients had loss of fixation of the fracture and there were five post-operative wound infections related to the distal fibula. This lead to the development of the current technique with a screw across the syndesmosis in addition to a distal locking screw. In 21 patients treated with this technique there have been no significant complications and only one superficial wound infection. Good fracture reduction was achieved in all of these patients. The mean physical component Short-Form 12, Olerud and Molander score, and American Academy of Orthopaedic Surgeons Foot and Ankle outcome scores at a mean of six years post-injury were 46 (28 to 61), 65 (35 to 100) and 83 (52 to 99), respectively. There have been no cases of fibular nonunion.

Nailing of the fibula using our current technique gives good radiological and functional outcomes with minimal complications, and should be considered in the management of patients with an unstable ankle fracture.
Cost savings of using a cemented total hip replacement
Authors: Griffiths E. J. , Stevenson D. , Porteous M. J.
Published: July 2012

The debate whether to use cemented or uncemented components in primary total hip replacement (THR) has not yet been considered with reference to the cost implications to the National Health Service.

We obtained the number of cemented and uncemented components implanted in 2009 from the National Joint Registry for England and Wales. The cost of each component was established. The initial financial saving if all were cemented was then calculated. Subsequently the five-year rates of revision for each type of component were reviewed and the predicted number of revisions at five years for the actual components used was compared with the predicted number of revisions for a cemented THR. This was then multiplied by the mean cost of revision surgery to provide an indication of the savings over the first five years if all primary THRs were cemented.

The saving at primary THR was calculated to be £10 million with an additional saving during the first five years of between £5 million and £8.5 million. The use of cemented components in routine primary THR in the NHS as a whole can be justified on a financial level but we recognise individual patient factors must be considered when deciding which components to use.
More re-operations after uncemented than cemented hemiarthroplasty used in the treatment of displaced fractures of the femoral neck
Authors: Gjertsen J-E. , Lie S. A. , Vinje T. , Engesæter L. B. , Hallan G. , Matre K. , Furnes O.
Published: July 2012

Using data from the Norwegian Hip Fracture Register, 8639 cemented and 2477 uncemented primary hemiarthroplasties for displaced fractures of the femoral neck in patients aged > 70 years were included in a prospective observational study. A total of 218 re-operations were performed after cemented and 128 after uncemented procedures. Survival of the hemiarthroplasties was calculated using the Kaplan-Meier method and hazard rate ratios (HRR) for revision were calculated using Cox regression analyses. At five years the implant survival was 97% (95% confidence interval (CI) 97 to 97) for cemented and 91% (95% CI 87 to 94) for uncemented hemiarthroplasties. Uncemented hemiarthroplasties had a 2.1 times increased risk of revision compared with cemented prostheses (95% confidence interval 1.7 to 2.6, p < 0.001). The increased risk was mainly caused by revisions for peri-prosthetic fracture (HRR = 17), aseptic loosening (HRR = 17), haematoma formation (HRR = 5.3), superficial infection (HRR = 4.6) and dislocation (HRR = 1.8). More intra-operative complications, including intra-operative death, were reported for the cemented hemiarthroplasties. However, in a time-dependent analysis, the HRR for re-operation in both groups increased as follow-up increased.

This study showed that the risk for revision was higher for uncemented than for cemented hemiarthroplasties.
Exam Corner – August 2012
Authors: Khanduja V.
Published: July 2012

The FRCS (Tr & Orth) examination has three components: MCQs, Vivas and Clinical Examination. The Vivas are further divided into four sections comprising Basic Science, Adult Pathology, Hands and Children’s Orthopaedics and Trauma. The Clinical Examination section is divided into Upper and Lower limb cases. The aim of this section in the Journal is to focus specifically on the trainees preparing for the exam and to cater to all the sections of the exam. The vision is to complete the cycle of all relevant exam topics (as per the syllabus) in four years.