bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevention of human immunodeficiency virus mother–to–child transmission in Israel
Authors: Agmon-Levin N , Elbirt D , Asher I , Torten D , Cohen Y , Gradestein S , Werner B , Turner D , Chowers M , Gottesman G , Maayan S , Risenberg K , Levi I , Sthoeger Z
Published: June 2009

The objective of the study was to investigate the HIV-mother-to-child transmission (MTCT) rate in Israel. This was a retrospective study of HIV-infected pregnant women, mainly immigrants from Ethiopia, in six Israeli AIDS centres, in 2000–2005. Medical records of mothers and newborns were evaluated for HIV status, treatment and MTCT rates. Three hundred pregnancies of 241 HIV-infected women, resulting in 304 live births, were studied. In 86/241(36%) women, HIV diagnosis was made during the current pregnancy or shortly after labour. Thirty others were diagnosed during previous pregnancies. Highly active antiretroviral therapy (HAART) was prescribed in 76% of pregnancies. The mean viral load before labour was 23,000 ± 100,000 copies/mL with a mean CD4 of 406 ± 223 (range 4–1277) cells/mm3. Caesarian sections were preformed in 175/300 pregnancies (103/175 with viral load <1000 copies/mL). During labour, azidothymidine (AZT) was given to 80% and nevirapine to 8% of the women. Eighty-eight percent of the neonates received AZT for six weeks. The overall HIV-MTCT rate was 3.6%. MTCT correlated significantly with delayed HIV diagnosis, low CD4, lack of HAART during pregnancy and lack of perinatal treatment. HIV treatment of mothers and their newborns throughout pregnancy, labour and perinatal period are crucial for effective prevention of MTCT, emphasizing the need for early HIV screening, diagnosis and treatment.
HIV infection and associated risk factors among long–distance truck drivers travelling through Azerbaijan
Authors: Botros B A , Aliyev Q M , Saad M D , Michael A A , Sanchez J L , Carr J K , Earhart K C
Published: June 2009

The aim of this study was to assess HIV prevalence and associated risk behaviours among international truck drivers (TDs) in Azerbaijan. The subjects signed consent and completed a questionnaire. Blood was tested using two rapid HIV tests: Determine and OraQuick. Genotyping was performed on 13 positives. Overall, 3763 TDs from 21 countries were enrolled. Fifty-eight (1.54%) were HIV-positive. Highest prevalence was among Russians (2.88%), Ukrainians (1.66%) and Azerbaijani (1.09%). On univariate analysis, highest prevalence (60%) was among injecting drug users (IDUs) compared with 0.4% among non-IDUs (P < 0.001). The prevalence in men who had sex with men (MSM) (42.9%) was high (P ≤ 0.001). On multivariate analysis, IDUs and MSM remained as the main HIV independent risk factors. Additional risk factors include no condom use, no circumcision and a history of an sexually transmitted infection. Eleven of 13 samples were subtype A. In conclusion, HIV was highly associated with IDU and MSM. The detected HIV subtypes A and B are those predominant in the former Soviet Union.
Mondor's disease of the penis associated with primary syphilis
Authors: Rani R
Published: June 2009

A case of penile Mondor's disease associated with syphilitic chancre is reported. The aetiology and management of Mondor's disease is also discussed.
Comparison of HIV-1 prevalence and risk factors between pregnant, non-pregnant, all women and the general population in Tanzania: implications for second-generation surveillance
Authors: Mmbaga E J , Leyna G H , Mnyika K S , Klepp K-I
Published: June 2009

The aim of this study was to compare HIV-1 prevalence between pregnant, non-pregnant, all women and the general population (men and women) and investigate how well risk behaviours of pregnant women reflect those of all women in the general population in rural Kilimanjaro, Tanzania. A cross-sectional survey involving all individuals aged 15–44 years was conducted in Oria village between March and May of 2005. All consenting individuals were interviewed and offered HIV-1 and syphilis testing. The response proportion among women was found to be 73.7% (914/1241). Age-adjusted HIV-1 prevalence among pregnant women (n = 92) was 32.5% lower (5.4% versus 8.0%, P, 0.001) than that of all women but only 8.5% (5.4% versus 5.9%, P = 0.639) lower compared with that of the general population. HIV-1 risk factors among pregnant women were comparable to that of all women in the general population. In conclusion, pregnant women in the general population underestimate the HIV-1 magnitude among women but closely approximate that of the general population. HIV-1 risk factors are similar between pregnant and all women in the general population. Second-generation surveillance could utilize pregnant women risk behaviours to approximate that of all women in the general population.
Fourteen years of surveillance of HIV-1 prevalence among pregnant women attending antenatal care clinics in western Uganda
Authors: Kipp W , Chapman E , Jhangri G S , Veugelers P , Kilian A , Rubaale T , Kabagambe G
Published: June 2009

This study monitored long-term temporal trends in HIV-1 prevalence in antenatal clinic attendees living in western Uganda. Semi-annual data collection was done from 1991 to 2004. For each woman the following data were recorded: HIV-1 status, age, educational status, marital status, occupation and parity. The results show that the overall HIV-1 prevalence was 15.3% during the entire time period (urban 21.3%, semi-urban 12.7% and rural 7.1%). Between 1991 and 2004, we observed a gradual decline in the HIV-1 prevalence. The decline was most pronounced in urban women aged 15–19 years old and least pronounced in rural women aged 20–24 years. Women above 25 years of age did not show any decline in HIV-1 prevalence over time. The declining HIV-1 prevalence in the younger age groups (15–24 years) likely represents a declining risk for acquiring HIV infection as we have previously shown in the urban sub-sample of this data set.
Targeting of HIV pretest discussion and risk-reduction interventions in a low-prevalence setting
Authors: Howe B E C , Clutterbuck D
Published: June 2009

Genitourinary medicine clinic attendees who were newly diagnosed as HIV antibody positive in a population with low overall HIV prevalence were compared with HIV-ve control groups in a retrospective study. Demographics and clinical data from the clinic attendance at which the HIV test was performed were analysed. Of 25,627 HIV tests, 113 were positive. Seventy-eight percent had an identified risk factor for HIV and more than half had symptoms of, or were contacts of, a sexually transmitted infection (STI) or HIV. Only eight clients testing HIV+ve had attended for routine STI testing and only two of these had no identified risk factor. Groups shown to be at higher HIV risk included attendees with past history of STI, men-who-have-sex-with-men (MSM) and those requesting HIV test without an STI screen. MSM testing HIV-ve had high rates of HIV risk behaviour.
Breakage of arm of Multiload intrauterine device during removal
Authors: Mohanty K
Published: June 2009

We report a case of intrauterine device (IUD) removal five years after its insertion which was broken during the removal procedure. One of the arms of the IUD remained inside the uterus. We allowed three months for spontaneous expulsion. When this did not happen, we proceeded with a hysteroscopic removal. Because of its embebbed position in the myometrium this could not be removed during hysteroscopy and finally it was left in situ. The patient was monitored every three months for a period of 12 months. There was no problem. We report this case because doctors may find it necessary to remove the IUD in certain situations and be aware of such a breakage and various precautions to prevent this.
General practitioner involvement and patient outcomes in HIV management
Authors: Casserly S M , Scott G R , Macdougall M
Published: June 2009

We undertook this study to try to determine whether disease outcomes were poorer in patients with HIV infection whose general practitioner (GP) was unaware of their status compared with those whose GP was aware. The notes of 375 HIV-positive patients attending Edinburgh's genitourinary (GU) medicine clinic were reviewed. The GPs of 292 patients (78%) had been informed of their patient's HIV infection. Advancing disease was associated with disclosure of the status to GPs (P = 0.037) but no significant association was found between informing GPs and the viral load results of treated (P = 0.389) and untreated patients (P = 0.070). Twenty-three percent of patients had had one or more bacterial sexually transmitted infections (STIs) while receiving their HIV care at a GU medicine clinic. Patients diagnosed with an STI were less likely to disclose their HIV status to their GP (P < 0.0005). Nondisclosure of the HIV status to a GP may be a predictor of unsafe sexual practices.
Sexual health of adults working in pornographic films
Authors: Coyne K M , Banks A , Heggie C , Scott C J , Grover D , Evans C , Mandalia S , Mclean K A , Cohen C E
Published: June 2009

We report the frequency of sexually transmitted infections (STIs) diagnosed in performers in the adult pornographic film industry. Over a 13 month period, 445 STI screens were performed in 115 patients, 56 women and 59 men. All reported unprotected sex during filming. Seventy-five percent (86) had at least one sexual partner outside work, and 90% used condoms inconsistently with them. Women worked exclusively with women (23%), men only (38%) or both genders (39%). Almost all men (97%) worked exclusively heterosexually. Thirty-eight percent (44/115) were diagnosed with 77 STIs, including non-specific urethritis (51), gonorrhoea (10), chlamydia (6) and genital warts (6). Gonorrhoea was found exclusively at the pharynx in three heterosexual men. There were no cases of HIV, syphilis, hepatitis B or hepatitis C. Monthly screening and certification is a working requirement for this population but STIs are common in an industry where unprotected sex is the norm.
Why are HIV-positive mothers refusing to have their children screened for vertically transmitted HIV infection?
Authors: Eisenhut M , Kawsar M , Connan M , Balachandran T
Published: June 2009

A previous audit showed that the HIV status of the majority (73%) of children of HIV-positive mothers attending a genitourinary clinic in the United Kingdom was unknown because mothers did not take up the offer of testing. The objectives of a re-audit were to establish the impact of the audit process on the uptake of testing and reasons for not taking up the offer of screening of offspring. One year after the previous audit, 13/92 (14%) of children not previously tested had their HIV status established. The reason for not testing was, in 43/52 (82%) mothers, the perception that a well child can not be infected with HIV. This was the only reason for not having their children tested in 16 mothers (31%). The next most common theme was fear of disclosure to others, in 29 (56%). The barriers for screening included fear of feeling guilty if the child was found to be positive.
A brief review of potential mechanisms of immune reconstitution inflammatory syndrome in HIV following antiretroviral therapy
Authors: Mori S , Levin P
Published: June 2009

A subset of HIV-infected individuals who receive antiretroviral therapy (ART) develop a paradoxical pathological response that significantly increases morbidity and sometimes mortality. Following the induction of highly active ART, a rapid decline in the viral load results within weeks and coincides with a steep rise in the CD4+ T-cell counts and immune hyperactivation. Although no mechanistic pathway has been elucidated for the development of immune reconstitution inflammatory syndrome (IRIS), it is thought that change in the nature of the immune response is a predominant factor in the development of reconstitution disease. In this article, we review the current state of knowledge in this field and provide a model for the development of IRIS.
Considering the individual - principles of treatment choice
Authors: Waters L
Published: June 2009

Although several antiretroviral agents are available, realistic options for initial therapy remain limited, as many are not licensed for treatment-naive patients, as reflected in national and international guidelines. A variety of factors influence treatment choice. From the physicians’ perspective, it is important to consider age, sex, co-morbid conditions, concomitant drugs and potential for adherence. Meanwhile, patients are concerned about the impact of side-effects on their day-to-day life and long-term future, drug efficacy, future options and time available in clinics. Patients’ concerns may be alleviated by detailed discussion throughout treatment, including the importance of adherence, the pros and cons of different treatments and potential side-effects. Positive outcomes in terms of not just viral load and CD4 counts but also improved duration and quality of life should be emphasized. Treatment must be tailored to each patient to maximize benefits and minimize risks.
Sources of Variation in the Costs of Health Care for Asthma Patients in Australia
Authors: Kenny Patricia , Hall Jane , King Madeleine , Lancsar Emily
Published: June 2009

Objectives

Individuals with chronic conditions, such as asthma, on average incur high health care costs, though good control can reduce costs and improve health outcomes. However, there may be substantial variation between patients in their use of services and therefore costs. Our objective was to investigate the sources of such variation in health system and out-of-pocket costs for people with asthma.

Methods

A longitudinal observational study of 252 people with asthma in New South Wales, Australia, followed for three years, using six-monthly postal surveys and individual administrative data. Factors associated with costs were investigated using generalized linear mixed models.

Results

There was substantial variability in costs between individuals but relatively little within-person change over time for the majority. Costs to the health system and out-of-pocket costs were higher with increasing asthma-related health problems and increasing age. Health system costs were less for patients living outside the state capital (Sydney) and for those in the middle income group relative to high and low income groups.

Conclusions

Those with poorly-controlled asthma and the elderly require more carefully targeted strategies to improve their health and ensure appropriate use of resources. Access to appropriate services for those living outside of major cities should be improved. Co-payments for the middle-income groups and those living outside major cities should be reduced to improve equity in the use of services.
Patient and Hospital Characteristics Associated with Claims and Compensations for Patient Injuries in Coronary Artery Bypass Grafting in Finland
Authors: Järvelin Jutta , Rosenqvist Gunnar , Häkkinen Unto , Sintonen Harri
Published: June 2009

Objectives

To analyse the association between individual patients’ risk factors and rates of claims and compensations for patient injuries in an insurance scheme in which proof of negligence is not required. And to explore whether either hospital productivity or volume of procedures is related to claims and compensation rates.

Methods

A two-step sequential logistic regression was applied on data collected from administrative registers. It included 17,834 patients who had undergone coronary artery bypass grafting at public hospitals in Finland between 1998 and 2002. The main outcome measure was the odds of claiming and receiving compensation.

Results

Men were less likely to claim compensation (odds ratio [OR] 0.66; 95% confidence interval 0.54-0.81), but among those having claimed were more likely to receive compensation (OR 2.08; 1.15-3.75) than women. Patients with a co-morbidity were more likely to claim (OR 1.29; 1.06-1.57), but among those having claimed were less likely to receive compensation (OR 0.52; 0.31-0.86) than those without a co-morbidity. Advanced age reduced the probability of claiming (OR 0.71; 0.52-0.96).

Conclusions

Although high-risk patients file a claim more frequently than low-risk patients, the latter have a higher probability of getting their claims accepted and receiving compensation. This risk pattern is probably a reflection of compensation practices related to patient injuries involving an infection.
Reducing Waiting Times for Hospital Treatment: Lessons from the English NHS
Authors: Harrison Anthony , Appleby John
Published: June 2009

In recent years, the English NHS has achieved substantial reductions in waiting times for hospital treatment. This paper considers first whether the data used by the Government provide an accurate description of changes in waiting times and identifies some of the limitations of the measures used. It then attempts to identify how reductions have been achieved. It argues that some features of central government policy have been important - such as the use of targets - others, such as the introduction of new private sector capacity have not. It also shows that changes at local level have been critical to achieving the recorded improvements, but the precise impact of these is hard to identify.
Delivering Health Care Through Community Pharmacies: Are Working Conditions Deterring Female Pharmacists’ Participation?
Authors: Gidman Wendy , Day Jennie , Hassell Karen , Payne Katherine
Published: June 2009

Objective

Recent UK government policy has placed community pharmacists at the frontline of health care delivery in order to improve patient access. Community pharmacy has been beset by recruitment and retention problems which potentially threaten health service delivery. This is largely a consequence of an increased demand for pharmacists. Additionally, the proportion of female pharmacists in the profession has risen. Consequently, interrupted career patterns and part-time working practices have increased, shrinking the pool of available workers. This study aimed to examine the importance of factors influencing female community pharmacists’ work patterns.

Method

Q methodology was used in a sample of 40 female UK-based community pharmacists.

Results

Nine distinct factors emerged from a factor analysis of Q sorts: fulfilled pharmacists; family first or pharmacy shelved; low stress altruist; permanent part-time employees; focused on free time and finances; pressurized modernizers; wandering wage slaves; overloaded and under resourced for the new contract; and pin money part-timers. Female community pharmacists often worked below their potential and part-time at a practitioner level in response to a combination of domestic commitments and intensifying work place pressures.

Conclusions

Family-friendly flexible work environments, adequate staffing levels and improved management support, might be more effective in increasing workforce participation than enhanced salary levels in this group of workers.
Developing a Framework for Transferring Knowledge Into Action: A Thematic Analysis of the Literature
Authors: Ward Vicky , House Allan , Hamer Susan
Published: June 2009

Objectives

Although there is widespread agreement about the importance of transferring knowledge into action, we still lack high quality information about what works, in which settings and with whom. While there are a large number of models and theories for knowledge transfer interventions, the majority are untested, meaning that their applicability and relevance is largely unknown. This paper describes the development of a conceptual framework of translating knowledge into action and discusses how it can be used for developing a useful model of the knowledge transfer process.

Methods

A narrative review of the knowledge transfer literature identified 28 different models which explained all or part of the knowledge transfer process. The models were subjected to a thematic analysis to identify individual components and the types of processes used when transferring knowledge into action. The results were used to build a conceptual framework of the process.

Results

Five common components of the knowledge transfer process were identified: problem identification and communication; knowledge/research development and selection; analysis of context; knowledge transfer activities or interventions; and knowledge/research utilization. We also identified three types of knowledge transfer processes: a linear process; a cyclical process; and a dynamic multidirectional process. From these results a conceptual framework of knowledge transfer was developed. The framework illustrates the five common components of the knowledge transfer process and shows that they are connected via a complex, multidirectional set of interactions. As such the framework allows for the individual components to occur simultaneously or in any given order and to occur more than once during the knowledge transfer process.

Conclusion

Our framework provides a foundation for gathering evidence from case studies of knowledge transfer interventions. We propose that future empirical work is designed to test and refine the relevance, importance and applicability of each of the components in order to build a more useful model of knowledge transfer which can serve as a practical checklist for planning or evaluating knowledge transfer activities.
Tackling Climate Change Close to Home: Mobile Breast Screening as a Model
Authors: Bond Alan , Jones Andrew , Haynes Robin , Tam Matthew , Denton Erika , Ballantyne Mandy , Curtin John
Published: June 2009

Objective

Health services contribute significantly to carbon dioxide (CO2) emissions and, while services in the UK are beginning to address this, the focus has been on reducing energy consumption rather than road transport, a major component of emissions. We aimed to compare the distances travelled by patients attending mobile breast screening clinics compared to the distance they would need to travel if screening services were centralized.

Methods

Anonymized postcode records were analysed to determine driving distances potentially saved through attendance at 20 mobile breast screening clinics rather than at two centralized locations. Based on assumptions for the typical car used, the CO2 emissions were calculated for the current case of decentralized service through mobile clinics compared to a hypothetical case where only centralized services are available over one complete three-year cycle of breast screening invitations.

Results

The availability of mobile breast screening clinics for the 60,675 women who underwent screening over a three-year cycle led to a return journey distance savings of 1,429,908 km. Taking into account the CO2 emissions of the tractor unit used for moving the mobile clinics around, this equates to approximately 75 tonnes of CO2 saved in any one year.

Conclusions

Decentralizing health care delivery can potentially provide substantial reductions in emissions at the same time as improving the patient experience. Thus, the ‘care close to home’ agenda can simultaneously improve health outcomes and the environment.
National Clinical Guidance
Authors: Light Kate , Harden Melissa , Misso Kate
Published: June 2009

Anyone who participates in the provision of health care, whether a practitioner, manager or policy-maker, needs to ensure they are familiar with the most up-to-date guidance and rulings from their country's advisory organizations. This edition of What's on the Web looks at websites produced by national health care advisory organizations, especially those involved in advising on medicines and other interventions.

If you would like to alert readers to useful web pages or suggest topics for this column, please send details to:
Charles River altered Schaedler flora (CRASF®) remained stable for four years in a mouse colony housed in individually ventilated cages
Authors: Stehr Matthias , Greweling Marina C , Tischer Sabine , Singh Mahavir , Blöcker Helmut , Monner David A , Müller Werner
Published: June 2009

As recommendations for specific pathogen-free housing change, mouse facilities need to re-derive their colonies repeatedly in order to eliminate specified bacteria or viruses. This paper describes the establishment of a new mouse facility using as starting point a small colony of CD-1 mice colonized with the Charles River altered Schaedler flora (CRASF®) housed in individually ventilated cages (IVCs). The import of new strains was performed exclusively via embryo transfer using CD-1 mice as recipients. The integrity of the CRASF® in caecum samples of the original CD-1 colony and of three inbred mouse lines imported into the colony was proven by a quantitative realtime polymerase chain reaction approach. Furthermore, we searched for bacterial contaminants in the gut flora using non-specific 16S rRNA primers. The bacterial sequences found were closely related to but not exclusively sequences of altered Schaedler flora (ASF) members, suggesting that the ASF is heterogeneous rather than restricted to the eight defined bacteria. Moreover, no pathogens were found, neither using the non-specific 16S rRNA primers nor in routine quarterly health monitoring. As one effect of this defined gut flora, interleukin-10 knockout mice are devoid of colitis in our facility. In conclusion, our approach building up a mouse facility using foster mothers and embryo transfer as well as a strict barrier system and IVCs is suitable to maintain a colony free from contaminating bacteria over the long term. CRASF® remained stable for seven mouse generations and was efficiently transferred to the imported mouse strains.
Design and evaluation of a low-cost respiratory monitoring device for use with anaesthetized animals
Authors: Devonshire I M , Preston M J , Dommett E J , Murphy K L , Greenfield S A
Published: June 2009

This report describes a simple, non-invasive electronic device that employs a compact accelerometer integrated circuit to transduce movements in the chest wall of an anaesthetized animal into an analogue signal that can be used to calculate the rate and relative depth of respiration. The device requires amplification by signal processing hardware/software which are common to most experimental laboratories. We assessed the sensitivity of the device by its ability to detect changes in respiratory patterns produced by modulating the depth of anaesthesia in isoflurane-anaesthetized Wistar rats. It is widely accepted that many anaesthetic agents affect respiratory patterns, especially respiratory rate (RR), which is often used as an important index of anaesthetic depth. Respiratory parameters obtained with the device were compared with concurrently recorded electroencephalographic and cardiac measures. Different concentrations of anaesthetic agent produced four depths of anaesthesia, identified using established electroencephalographic criteria. The accelerometer was attached easily and securely to the location of maximal chest wall movement and produced a strong respiratory signal that was detectable in all four anaesthetic stages. Deepening the anaesthesia produced a gradual decrease in RR, a decrease in dominant spectral frequency of the electroencephalogram (EEG) but no change in the heart rate. There was a significant correlation between RR and the dominant spectral frequency of the EEG, indicating that one useful application of the monitor could be to identify anaesthetic stages. The results demonstrate that respiratory parameters can be recorded using a simply constructed, low-cost device and suggest an application in the monitoring of anaesthetic depth.
Evaluation of available diagnostic methods for Clostridium piliforme in laboratory rabbits (Oryctolagus cuniculus)
Authors: Pritt S , Henderson K S , Shek W R
Published: June 2009

Recent literature has indicated that animals seropositive for Clostridium piliforme may have negative findings on polymerase chain reaction (PCR) testing. This study examines and reports on the results of serology, PCR and histopathology tests performed on a group of 20 laboratory rabbits seropositive for C. piliforme using the latest available diagnostic methodologies. The presence of the organism was not confirmed by either PCR or histopathology in this group of 20 for C. piliforme seropositive rabbits. This presents challenges for laboratory animal veterinarians and scientists wishing to establish the presence of the organism with commonly available diagnostic methods and means that clinical signs of disease in addition to diagnostic results must be interpreted together.
A homogeneous cell-based bicistronic fluorescence assay for high-throughput identification of drugs that perturb viral gene recoding and read-through of nonsense stop codons
Authors: Cardno Tony S. , Poole Elizabeth S. , Mathew Suneeth F. , Graves Ryan , Tate Warren P.
Published: June 2009

Recoding mechanisms are programmed protein synthesis events used commonly by viruses but only very rarely in cells for cellular gene expression. For example, HIV-1 has an absolute reliance on frameshifting to produce the correct ratio of key proteins critical for infectivity. To exploit such recoding sites as therapeutic targets, a simple homogeneous assay capable of detecting small perturbations in these low-frequency (<5%) events is required. Current assays based on dual luciferase reporters use expensive substrates and are labor-intensive, both impediments for high-throughput screening. We have developed a cell-based bifluorophore assay able to measure accurately small recoding changes (<0.1%) with a high Z′-factor in 24- or 96-well formats that could be extended to 384 wells. In cases of nonsense mutations arising within coding regions of genes, the assay is suitable for assessing the potential of screened compounds to increase read-through at these nonprogrammed stop signals of variable termination efficiency.
SHAMS: Combining chemical modification of RNA with mass spectrometry to examine polypurine tract-containing RNA/DNA hybrids
Authors: Turner Kevin B. , Yi-Brunozzi Hye Young , Brinson Robert G. , Marino John P. , Fabris Daniele , Le Grice Stuart F.J.
Published: June 2009

Selective 2′-hydroxyl acylation analyzed by primer extension (SHAPE) has gained popularity as a facile method of examining RNA structure both in vitro and in vivo, exploiting accessibility of the ribose 2′-OH to acylation by N-methylisatoic anhydride (NMIA) in unpaired or flexible configurations. Subsequent primer extension terminates at the site of chemical modification, and these products are fractionated by high-resolution gel electrophoresis. When applying SHAPE to investigate structural features associated with the wild-type and analog-substituted polypurine tract (PPT)–containing RNA/DNA hybrids, their size (20–25 base pairs) rendered primer extension impractical. As an alternative method of detection, we reasoned that chemical modification could be combined with tandem mass spectrometry, relying on the mass increment of RNA fragments containing the NMIA adduct (Mr = 133 Da). Using this approach, we demonstrate both specific modification of the HIV-1 PPT RNA primer and variations in its acylation pattern induced by replacing template nucleotides with a non-hydrogen-bonding thymine isostere. Our selective 2′-hydroxyl acylation analyzed by mass spectrometry strategy (SHAMS) should find utility when examining the structure of small RNA fragments or RNA/DNA hybrids where primer extension cannot be performed.
Pathology-related mutation A7526G (A9G) helps in the understanding of the 3D structural core of human mitochondrial tRNAAsp
Authors: Messmer Marie , Gaudry Agnès , Sissler Marie , Florentz Catherine
Published: June 2009

More than 130 mutations in human mitochondrial tRNA (mt-tRNA) genes have been correlated with a variety of neurodegenerative and neuromuscular disorders. Their molecular impacts are of mosaic type, affecting various stages of tRNA biogenesis, structure, and/or functions in mt-translation. Knowledge of mammalian mt-tRNA structures per se remains scarce however. Primary and secondary structures deviate from classical tRNAs, while rules for three-dimensional (3D) folding are almost unknown. Here, we take advantage of a myopathy-related mutation A7526G (A9G) in mt-tRNAAsp to investigate both the primary molecular impact underlying the pathology and the role of nucleotide 9 in the network of 3D tertiary interactions. Experimental evidence is presented for existence of a 9-12-23 triple in human mt-tRNAAsp with a strongly conserved interaction scheme in mammalian mt-tRNAs. Mutation A7526G disrupts the triple interaction and in turn reduces aspartylation efficiency.
The GW182 protein family in animal cells: New insights into domains required for miRNA-mediated gene silencing
Authors: Eulalio Ana , Tritschler Felix , Izaurralde Elisa
Published: June 2009

GW182 family proteins interact directly with Argonaute proteins and are required for miRNA-mediated gene silencing in animal cells. The domains of the GW182 proteins have recently been studied to determine their role in silencing. These studies revealed that the middle and C-terminal regions function as an autonomous domain with a repressive function that is independent of both the interaction with Argonaute proteins and of P-body localization. Such findings reinforce the idea that GW182 proteins are key components of miRNA repressor complexes in metazoa.
Impact of Reporting Gram Stain Results From Blood Culture Bottles on the Selection of Antimicrobial Agents
Authors: Uehara Yuki , Yagoshi Michiko , Tanimichi Yumiko , Yamada Hiroko , Shimoguchi Kazuo , Yamamoto Sachiyo , Yanai Mitsuru , Kumasaka Kazunari
Published: June 2009

We assessed the usefulness of reporting direct blood Gram stain results compared with the results of positive blood cultures in 482 episodes and monitored impact on selection of antimicrobial treatment. We found that the reporting groups “Staphylococcus spp,” “Pseudomonas spp and related organisms,” and “yeasts” identified in this way matched perfectly with later culture identification. When the report indicated Staphylococcus spp or Pseudomonas spp and related organisms, physicians started or changed antimicrobials suitable for these bacteria more frequently than when “other streptococci” and “family Enterobacteriaceae” were reported (P < .05). Incorrect recognition of Acinetobacter spp as Enterobacteriaceae family is still the most challenging problem in this context. Gram stain results that definitively identify Staphylococcus spp, Pseudomonas spp and related organisms, and yeasts reliably can be rapidly provided by clinical laboratories; this information has a significant impact on early selection of effective antimicrobials. Further investigation is needed to assess the clinical impact of reporting Gram stain results in bacteremia.
FU-MK-1 Expression in Human Gallbladder Carcinoma
Authors: Ikeda Takeaki , Nakayama Yoshifuku , Hamada Yoshihiro , Takeshita Morishige , Iwasaki Hiroshi , Maeshiro Kensei , Yamashita Yuichi , Kuroki Masahide , Ikeda Seiyo
Published: June 2009

Gallbladder carcinoma is an aggressive type of neoplasm difficult to cure by conventional procedures. Because of the lack of reliable markers for assessing the prognosis, this retrospective study was designed to investigate the prognostic significance of MK-1 overexpression in human carcinoma of the gallbladder. Immunohistochemical staining using monoclonal antibody FU-MK-1 (MK-1 antigen) was performed on paraffin-embedded tissues from 63 patients who had undergone surgical resection for gallbladder carcinoma.

Expression of MK-1 was found in 50 (79%) of 63 tumor samples. All 21 papillary and 12 of 13 well-differentiated tubular adenocarcinomas but only 1 of 8 poorly differentiated adenocarcinomas were positive for FU-MK-1. Multivariate analysis showed that only MK-1 expression was an independent prognostic marker (P = .0473), and Kaplan-Meier curves showed that MK-1 expression was significantly related to increased overall survival (P < .0001). These results suggest that MK-1 expression is a prognostic marker in gallbladder carcinoma.
A Histologically Defined Subset of High-Grade Dysplasia in Barrett Mucosa Is Predictive of Associated Carcinoma
Authors: Zhu Weijian , Appelman Henry D. , Greenson Joel K. , Ramsburgh Stephen R. , Orringer Mark B. , Chang Andrew C. , McKenna Barbara J.
Published: June 2009

To ascertain the prevalence of carcinoma in esophagi resected for high-grade dysplasia (HGD) using current criteria and to evaluate histologic features that may predict concurrent carcinoma, we studied specimens from 127 esophagectomies performed for HGD, or HGD “suspicious” for carcinoma (HGD/S) in Barrett mucosa. Corresponding biopsy specimens in 69 cases were reviewed and reclassified.

Based on original diagnoses, carcinoma was present in 15 (17%) of 89 HGD and 28 (74%) of 38 HGD/S cases. By reclassification, only 1 (5%) of 21 cases with HGD had carcinoma in the resection specimen. Of 25 cases reclassified as HGD/S, 18 (72%) had carcinoma in the resection specimen, as did 17 (74%) of 23 reclassified as adenocarcinoma. With 1 additional select histologic feature, the risk of carcinoma was 39%; with 2 or more features, the risk increased to 83% to 88%.

Based on current criteria, no more than 5% of esophagectomies performed for a biopsy diagnosis of Barrett HGD harbor carcinoma. When HGD/S is diagnosed based on certain additional features, carcinoma is found in nearly 40% of cases with 1 feature and more than 80% with 2 or more features. Our findings highlight the evolution of diagnostic criteria for Barrett dysplasia.
Aberrant Expression of Cyclin A Correlates With Morphogenesis of Reed-Sternberg Cells in Hodgkin Lymphoma
Authors: Chang Kung-Chao , Chang Yao , Jones Dan , Su Ih-Jen
Published: June 2009

Reed-Sternberg (RS) cells represent a histopathologic hallmark for Hodgkin lymphoma (HL). Viral proteins may induce aberrant expression of cyclin A and lead to multinucleation in virus-infected cells. We investigated whether Epstein-Barr virus (EBV) latent membrane protein-1 (LMP1) and cyclin A are involved in the morphogenesis of RS cells. We immunohistochemically analyzed “individual” tumor cells in 34 HLs for the subcellular expression of cyclin A and HL-related markers. In LMP1+ and LMP1– HLs, multinucleated RS cells aberrantly expressed cyclin A in cytoplasm, while the mononuclear Hodgkin cells expressed cyclin A predominantly in nuclei (P < .001). No differential expression of CD15, CD30, or CD99 in HL cells was found. In vitro, EBV-LMP1 increased cytoplasmic cyclin A expression and multinucleation in an HL cell line. Therefore, the aberrant expression of cyclin A is commonly associated with RS cell morphologic features in HL, probably through LMP1 signaling or other similar mechanisms in EBV– cases.
Decorin Is Significantly Overexpressed in Nephrogenic Systemic Fibrosis
Authors: Gambichler Thilo , Kreuter Alexander , Skrygan Marina , Burkert Björn , Altmeyer Peter , Schieren Gisela
Published: June 2009

The role of the proteoglycans in the pathogenesis of nephrogenic systemic fibrosis (NSF) is unclear. We assessed expression of decorin, versican, and transforming growth factor β1 (TGF-β1) in skin specimens of 10 patients with biopsy-proven NSF and different control groups. Real-time reverse transcription–polymerase chain reaction studies and immunohistochemical analysis were performed on full-thickness skin specimens. The messenger RNA (mRNA) and protein levels of decorin were significantly higher in the skin lesions of patients with NSF than in skin lesions of patients with systemic sclerosis, patients undergoing hemodialysis, and healthy subjects. The versican mRNA levels in NSF lesions differed significantly only from the levels in healthy subjects. TGF-β1 mRNA expression was significantly overexpressed in NSF lesions compared with control skin specimens investigated. In NSF specimens, the mRNA expression of TGF-β1 and decorin were highly correlated (r = 0.92). Our results suggest that decorin and TGF-β1 may have a fundamental role in the pathogenesis of NSF. Conversely, versican seems less likely to be of pathogenetic significance in NSF.
Automated Cellular Imaging System III for Assessing HER2 Status in Breast Cancer Specimens
Authors: Minot Douglas M. , Kipp Benjamin R. , Root Renee M. , Meyer Reid G. , Reynolds Carol A. , Nassar Aziza , Henry Michael R. , Clayton Amy C.
Published: June 2009

The goal of this study was to assess the performance characteristics of the Automated Cellular Imaging System (ACIS III) for HER2 immunohistochemical analysis. The study was performed on 187 biopsy slides from patients who underwent HER2 testing between January and February 2008. Three scoring methods by the ACIS III were compared with the manual score and fluorescence in situ hybridization (FISH) results for HER2 amplification. The equal distribution score (EQD) method, in which 2 areas each of high-, moderate-, and low-intensity staining were measured, most closely matched the FISH HER2 amplification result. The numbers of immunohistochemically negative (0 or 1+)/FISH+ cases were equivalent for all methods. The EQD method had significantly fewer 2+ cases (n = 16) (P < .001) vs the manual method (n = 35) and yielded a higher positive predictive value (38%) for HER2 amplification compared with the manual method (20%). The EQD method may more accurately identify FISH-amplified HER2 cases with fewer 2+ cases that would be “reflexed” to FISH compared with the manual method.
Utility of CD56 Immunohistochemical Studies in Follow-up of Plasma Cell Myeloma
Authors: Harrington Alexandra M. , Hari Parameswaran , Kroft Steven H.
Published: June 2009

Although 70% to 80% of plasma cell myelomas (PCMs) express CD56, few data are available on the usefulness of CD56 immunohistochemical analysis in assessing residual disease. We retrospectively reviewed 127 PCM posttreatment bone marrow (BM) specimens, classifying them as positive or negative for residual disease (independent of CD56 immunohistochemical studies) based on abnormal plasma cell (PC) morphologic features or flow cytometry (FC) and/or light chain restriction by immunohistochemical studies (conventional criteria). CD56 immunohistochemical analysis was performed on these and 20 negative lymphoma staging BM specimens. Of 127 BM specimens, 74 were positive and 53 were negative for residual PCM by conventional criteria. Of 74 BM specimens positive by conventional criteria, 59 (80%) demonstrated CD56 (strong+) PCs in clusters and/or with cytologic atypia. Of the 53 BM specimens negative by conventional criteria, 3 showed CD56 (strong+) morphologically atypical PCs in clusters or scattered. CD56 immunohistochemical analysis is useful for detecting residual PCM, particularly in morphologically equivocal cases in which light chain restriction cannot be demonstrated, and may serve as a potential response criterion.
Differences in Recognition of the 1st WHO International Reference Reagents for hCG-Related Isoforms by Diagnostic Immunoassays for Human Chorionic Gonadotropin
Authors: Sturgeon Catharine M , Berger Peter , Bidart Jean-Michel , Birken Steven , Burns Chris , Norman Robert J , Stenman Ulf-Håkan ,   the IFCC Working Group on hCG
Published: June 2009

Background: The 1st WHO International Reference Reagents (IRRs) for 6 human chorionic gonadotropin (hCG)-related molecular variants, highly purified and calibrated in substance concentrations by the IFCC Working Group for hCG, permit experimental elucidation of what commercially available hCG methods measure in molar terms and enable assessment of their fitness for clinical purposes.

Methods: Pools containing known amounts of the IRRs spiked into normal human serum were issued to participants through the UK National External Quality Assessment Service for hCG for a period of 7 years. Among 16 assays used, 4 recognized only hCG, whereas 6 recognized hCG and its free β-subunit (hCGβ), and 6 recognized hCG, hCGβ, and the beta core fragment.

Results: Differences in calibration of current hCG assays are moderate. Mean recovery of the current International Standard (IS), hCG IS 75/589, was 107% (range 93% to 126%), whereas that of the IRR 99/688 for hCG was 139% (range 109%–164%). Between-method variation for the latter (CV 12.3%) was also greater than for IS 75/589 (CV 8.8%). Recognition of hCGβ varied markedly (CV 37%). Most assays overestimated it, but 2 RIAs produced results that were slight underestimations. Recognition of the beta core fragment was even more variable (CV 57%) and was closest to equimolarity for the RIAs.

Conclusions: Assays for hCG show considerable variation in their recognition of various forms of hCG, and this variablility is the most important cause of method-related differences in hCG results in serum and an even more important cause of method-related differences in urine measurements. Equimolar recognition of the major hCG isoforms is essential if between-method comparability for hCG is to be improved.
Book Reviews
Authors: Bonde Eva , Tapper Michael , Khelifa Nadja Ben , Vaughan Hunter
Published: June 2009

Theaters of Occupation: Hollywood and the Reeducation of Postwar Germany, Jennifer Fay, (2008) Minneapolis: University of Minnesota Press, 264 pp., ISBN 9780816647453 (pbk), $22.50

Licence to Thrill: A Cultural History of the James Bond Films, James
Chapman, (2007), (second revised edition) London and New York: I.B. Tauris, 336 pp., ISBN 978845115159 (pbk), $19.95/12.99

The James Bond Phenomenon: A Critical Reader, edited by Christoph Lindner, (2003) Manchester: Manchester University Press, 268pp., ISBN 0719065410
(pbk), 14.99

Wong Kar-wai, Peter Brunette, (2007) Urbana and Chicago: University of Illinois Press, 149 pp., ISBN 0252072375 (pbk), $16.95; ISBN 0252029925 (hbk), $35.00
Film Reviews
Authors: Neilan Christopher , Tognetti Gary
Published: June 2009

Soul Power (2008) USA Director Jeffrey Levy-Hinte Producers Jeffrey Levy-Hinte, David Sonenberg, Leon Gast Editor David Smith Cinematographers Paul Goldsmith (ASC), Kevin Keating, Albert Maysles, Roderick Young With James Brown, Don King,
Muhammed Ali, Bill Withers, BB King, Miriam Makeba, Celia Cruz, Fania All Stars and The Spinners Runtime 93 minutes

The Dark Knight (2008) USA/UK Director Christopher Nolan Screenplay Jonathan Nolan, Christopher Nolan Director of Photography Wally
Pfister Editor Lee Smith Production Designer Nathan Crowley Executive Producers Benjamin Melniker, Michael E. Uslan, Kevin De La Noy, Thomas Tull Produced by Charles Roven, Emma Thomas, Christopher Nolan Costume Designer Lindy Hemming Original Music
Hans Zimmer, James Newton Howarda

With Christian Bale (Bruce Wayne/Batman), Heath Ledger (The Joker), Aaron Eckhart (Harvey Dent/Two-Face), Michael Caine (Alfred Pennyworth), Maggie Gyllenhaal (Rachel Dawes), Gary Oldman (James Gordon), Morgan Freeman (Lucius Fox)
Festivals
Authors: Kramer Gary M , Palmer Tim , Bisschoff Lizelle , Pekerman Serazer
Published: June 2009

Philadelphia Film Festival, CineFest 09, 26 March6 April 2009 A report by Gary M. Kramer

VCU/University of Richmond French Film Festival Richmond, Virginia, 2729 March 2009 A report by Tim Palmer

Africa in Motion (AiM) film festival, 23 October to 2 November 2008
A report by Lizelle Bisschoff

International Film Festival Workshop, 4 April 2009, University of St Andrews A report by Serazer Pekerman