bluuebunny/crossref_metadata_2025 huggingface dataset:
ENDOSCOPIC SPHINCTEROTOMY PLUS ENDOPROSTHESES IN THE TREATMENT OF LARGE OR MULTIPLE COMMON BILE DUCT STONES
Authors: HONG WAN‐DONG , ZHU QI‐HUAI , HUANG QING‐KE
Published: February 2011

Background and Aim:  Little information is available on the outcomes of endoscopic sphincterotomy plus biliary stent placement without stone extraction as primary therapy at initial endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of large or multiple common bile duct (CBD) stones. The aim of the present study was to study the effect of biliary stents and sphincterotomy as primary therapy for patients with choledocholithiasis.

Methods:  Patients with large (≥20 mm) or multiple (≥3) CBD stones were retrospectively studied. The patients underwent endoscopic sphincterotomy and placement of plastic stents in the bile duct without stone extraction at the initial ERCP. Three or more months later, a second ERCP was carried out and stone removal was attempted. Differences in stone size and the largest CBD diameter before and after stenting were compared. Stone clearance and complications were also evaluated.

Results:  52 patients were enrolled. After a median of 124 days of biliary plastic stent placement the mean maximal stone diameter decreased from 16.6 mm to 10.0 mm (P < 0.01). The mean CBD diameter also decreased from 15.3 mm to 11.5 mm (P < 0.01). The total stone clearance at second ERCP was 94.2%, only 5.7% of which needed mechanical lithotripsy. Complications: pancreatitis in one (1.9%) at initial ERCP, cholangitis in two (3.8%) after 52 days and 84 days of placement of stent. No complications were recorded at second ERCP.

Conclusions:  Biliary plastic stents plus endoscopic sphincterotomy without stone extraction as primary therapy at initial ERCP is a safe and effective method in the management of large or multiple CBD stones.
Clinical results and issues of acute myeloid leukemia in elderly patients aged 75 years and older
Authors: Abe Shine , Kanaya Kiyoshi , Kikukawa Masayuki , Sakai Minoru , Akai Tomotaka , Takata Yusuke , Sakurai Hirofumi , Shin Kouichi , Mori Mayumi , Iwamoto Toshihiko
Published: February 2011

Aim:  Clinical outcomes of acute myeloid leukemia (AML) in elderly patients still remain unsatisfactory and the optimal treatment has yet to be clearly established. This report describes the results of a retrospective study of clinical outcomes and prognostic factors of AML in patients aged 75 years and older. In addition, we aimed to elucidate the situation of patients with AML accompanied by dementia, which has been largely ignored in previous studies.

Methods:  The subjects consisted of 31 patients with untreated AML (including previous myelodysplastic syndrome: AML/MDS). All patients underwent chemotherapy, with 25 undergoing conventional therapy and six undergoing low‐intensity therapy.

Results:  Complete remission was obtained in 16 of the 31 cases (51.6%), with a 3‐year survival rate of 11.5%. However, in seven cases, Alzheimer's disease (AD) was observed. Although we were able to perform induction therapy in each of these cases, consolidation therapy was difficult in cases of moderate AD.

Conclusion:  The results of this study suggest that even very elderly patients can benefit from chemotherapy. However, it is thought that the treatment selection for cases which are complicated by moderate to severe dementia should be determined carefully while considering the patient's quality of life. Geriatr Gerontol Int 2011; 11: 290–296.
Increased use of laparoscopy in acute right iliac fossa pain – is it good for patients?
Authors: Jones G. E. , Kreckler S. , Shah A. , Stechman M. J. , Handa A.
Published: February 2011

Aim  The use of laparoscopy, with or without appendicectomy, is becoming more common in the management of acute right iliac fossa (RIF) pain, but little is known of the ‘unintended’ consequences of this change. This study aimed to evaluate the impact of increased use of laparoscopy on the number and type of patients treated surgically and on the rate of negative appendicectomy.

Method  A prospective audit was carried out of admissions to a teaching hospital over two, 3‐month periods during 2007 and 2008. The management, investigations and outcome of patients presenting with RIF pain were studied.

Results  Admissions were stable over the two time‐periods. There was a significant increase in the number of laparoscopic operations performed, from 22.5% (14/62) in 2007 to 85.7% (72/84) in 2008 (P < 0.0001), and the percentage of patients undergoing surgery rose from 55.4% (n = 62) in 2007 to 71.2% (n = 84) in 2008 (P < 0.01). In 2008, female patients were more likely to have surgery, an increase from 37.1% to 66.2% (P < 0.001), and were more likely to have a laparoscopic procedure, an increase from 50% to 98% (P < 0.0001). The rate of histologically confirmed appendicitis did not increase significantly (50/122 vs 57/118; P = 0.25), but the number of patients with a normal appendix either left in situ because it was macroscopically normal or found to be histologically normal following excision, increased significantly, from 9.01% in 2007 to 21.2% in 2008 (P < 0.01). The diagnostic value of pelvic ultrasound decreased from 75.6% of examinations in 2007 to 54.5% in 2008 (P = 0.039).

Conclusion  An increase in laparoscopic procedures has resulted in more operations in women, an associated higher negative appendicectomy rate and decreased usefulness of pelvic ultrasound. Increased use of laparoscopy needs to be balanced against the diagnostic benefits of ‘negative’ laparoscopy.
History of foot ulcers increases mortality among patients with diabetes in Northern Thailand
Authors: Junrungsee S. , Kosachunhanun N. , Wongthanee A. , Rerkasem K.
Published: February 2011

Diabet. Med. 28, 608–611 (2011)

Aims  Studies within the Caucasian population with diabetes showed an increased mortality in patients with diabetic foot ulcers. However, there were no such studies based on Asian populations. We therefore designed our study on the association of foot ulcer with mortality within the Asian population.

Methods  Ninety‐seven Asian individuals with diabetes who had previously participated in the ‘Multidisciplinary Diabetic Foot Protocol’ between 2005 and 2007 at our centre were followed up in 2010 to ascertain their mortality rate. Cox proportional‐hazard regression analyses were used to estimate hazard ratios.

Results  Forty‐seven patients had a history of foot ulcer (group 1), while 50 had none (group 2). The mean follow‐up was 43.74 months. Twenty‐one patients died during this period (21.65%). The mortality rates in group 1 and group 2 were 15 (31.92%) and six (12.00%), respectively. Patients with a history of foot ulcer had higher mortality rates than those without (hazard ratio 3.51, 95% CI 1.03–11.96, P = 0.04).

Conclusions  Our study showed that history of foot ulcer increased mortality. This association appeared to be stronger in younger Asian patients than those in the Caucasian populations.
Agency Theory, Institutional Sensitivity, and Inductive Reasoning: Towards a Legal Perspective
Authors: Heracleous Loizos , Lan Luh Luh
Published: February 2011

abstract

Making agency theory institutionally sensitive is a reasonable suggestion, as far as normal science stands. However, we argue that such a move has already been taking place, that it cannot address important problems with agency theory, and that the time is ripe for a critical re‐examination of this theory. We suggest that inductive studies can not only be more sensitive to institutional features than deductive studies, but they can also offer deeper understanding of governance practices in specific contexts, as well as the potential for analytical or moderatum generalizations. Drawing from legal theory, we offer an alternative conception of the principal, and of the role and status of the board of directors. We contend that this reformulated agency theory has a greater potential of being institutionally sensitive because it recognizes various stakeholders as team members, rather than just adding specific institutional features as variables to the dominant conception of agency theory.
Firms as Systems of Interdependent Choices
Authors: Siggelkow Nicolaj
Published: February 2011

abstract

Managers within firms have to make choices along a large number of dimensions; for instance, how to configure activities involving manufacturing and marketing, and which organizational design to employ. Since these choices interact with each other, firms can be conceived of as systems of interdependent choices. In this article, I discuss research that addresses three questions that naturally arise in this context. First, how do such systems evolve over time? Second, what role does organizational design play in whether a firm will arrive at a consistent and high‐performing set of choices? Third, what are the consequences of cognitive limitations by decision makers when faced with such complex systems? The article concludes by sketching out possible future directions of research in this domain.
Transgenic maize plants expressing the Totivirus antifungal protein, KP4, are highly resistant to corn smut
Authors: Allen Aron , Islamovic Emir , Kaur Jagdeep , Gold Scott , Shah Dilip , Smith Thomas J.
Published: February 2011

The corn smut fungus, Ustilago maydis, is a global pathogen responsible for extensive agricultural losses. Control of corn smut using traditional breeding has met with limited success because natural resistance to U. maydis is organ specific and involves numerous maize genes. Here, we present a transgenic approach by constitutively expressing the Totivirus antifungal protein KP4, in maize. Transgenic maize plants expressed high levels of KP4 with no apparent negative impact on plant development and displayed robust resistance to U. maydis challenges to both the stem and ear tissues in the greenhouse. More broadly, these results demonstrate that a high level of organ independent fungal resistance can be afforded by transgenic expression of this family of antifungal proteins.
DEPRESSION, LISTLESSNESS, AND MORAL MOTIVATION
Authors: Cholbi Michael
Published: February 2011

Motivational internalism (MI) holds that, necessarily, if an agent judges that she is morally obligated to ø, then, that agent is, to at least some minimal extent, motivated to ø. Opponents of MI sometimes invoke depression as a counterexample on the grounds that depressed individuals appear to sincerely affirm moral judgments but are ‘listless’ and unmotivated by such judgments. Such listlessness is a credible counterexample to MI, I argue, only if the actual clinical disorder of depression, rather than a merely hypothetical example of such listlessness, is the source of this listlessness. However, empirical evidence concerning depression shows that, to the extent that the depressed are motivationally listless at all, they are abnormally listless only with respect to an important class of non‐moral judgments, namely, their prudential normative judgments (i.e., those concerning their own happiness and well‐being), not their moral judgments. Hence, depressed individuals do not constitute a counterexample to MI. This conclusion has important methodological implications concerning how supporters and opponents of MI can best defend their respective theses.
Moderated Paired Comparisons: A Generalized Bradley–Terry Model for Continuous Data Using a Discontinuous Penalized Likelihood Function
Authors: Stern Steven E.
Published: February 2011

Standard paired comparison models are widely used in circumstances where a measure of preference is available on a sequence or collection of pairwise comparisons between a group of objects or treatments. Typically, the measure of preference observations takes the form of simple binary outcomes, indicating which of the two objects or treatments in a particular comparison is preferred. Common examples of such situations include models of choice behaviour in politics or marketing, comparisons of medical treatments or in the realm of sports rankings. We investigate situations where the observed measure of preference for the paired comparisons is instead a continuous outcome indicating not simply the direction of preference but the degree of preference as well; in particular, we present, as a motivating example, a ranking analysis of the top 12 international limited overs cricket teams, with an appropriately defined margin of victory in individual matches playing the role of the measure of preference. We propose a new method, which is termed moderated paired comparisons, that is based on fitting a penalized likelihood model to the observed margins of victory. Importantly, the structure of the penalty function chosen allows for the model to assign differential importance to the information that is contained solely in the dichotomous win–loss outcome of a match as against that contained in the actual margin of the victory.
Affinity Models for Career Sequences
Authors: Scott Marc A.
Published: February 2011

We develop an affinity model for longitudinal categorical data in which the number of categories is large and we apply the technique to 20 years of labour market data for a contemporary cohort of young adult workers in the USA. The method provides a representation of the underlying complexity of the labour market that can then be augmented to include covariate effects. These can be understood as effects net of transition patterns associated with labour market sorting. We include in our model pairwise affinities to relate nominal categories representing types of job. The affinities capture complex relationships between these types of job and how they change over time. We evaluate the role of gender and education to illustrate the different types of questions and answers that are addressed by this methodology.
Selection of Ordinally Scaled Independent Variables with Applications to International Classification of Functioning Core Sets
Authors: Gertheiss Jan , Hogger Sara , Oberhauser Cornelia , Tutz Gerhard
Published: February 2011

Ordinal categorial variables arise commonly in regression modelling. Although the analysis of ordinal response variables has been well investigated, less work has been done concerning ordinal predictors. We consider so-called international classfication of functioning core sets for chronic widespread pain, in which many ordinal covariates are collected. The effect of specific international classification of functioning variables on a subjective measure of physical health is investigated, which requires strategies for variable selection. In this context, we propose methods for the selection of ordinally scaled independent variables in the classical linear model. The ordinal structure is taken into account by use of a difference penalty on adjacent dummy coefficients. It is shown how the group lasso can be used for the selection of ordinal predictors, and an alternative blockwise boosting procedure is proposed. Both methods are discussed in general, and applied to international classification of functioning core sets for chronic widespread pain.
Role of social welfare in European suicide prevention
Authors: Yur'yev Andriy , Värnik Airi , Värnik Peeter , Sisask Merike , Leppik Lauri
Published: February 2011

Yur'yev A, Värnik A, Värnik P, Sisask M, Leppik L. Role of social welfare in European suicide prevention

The aims of this study were to assess the relationship between suicide mortality and social expenditure in 26 European countries, explore attitudes towards welfare systems and their relationship with suicide mortality, and compare attitudes towards welfare provision in Eastern and Western Europe. The World Health Organization suicide data and Organisation for Economic Co‐operation and Development social expenditure data for 1980–2005 were used. Data on attitudes towards welfare systems were taken from the European Social Survey. Differences between mean scores for attitudes in Western and Eastern European countries were calculated. Correlations between social expenditure and suicide trends were negative in most countries for both genders. Inverse correlations between attitudes towards welfare provision and suicide mortality rates were demonstrated for males only. Differences in attitudes were found between Eastern and Western European countries; for example, confidence in the welfare system was found to be stronger in Western Europe. Higher social expenditure and greater confidence in welfare provision appear to have suicide‐preventive effects.
Student teachers' attitudes and beliefs about inclusion and inclusive practice
Authors: Beacham Nigel , Rouse Martyn
Published: February 2011

The beliefs and attitudes of teachers are an important element in the development of inclusive education and its associated practices. Teacher education is seen as crucial in helping to develop positive attitudes and beliefs that are thought to promote inclusion, although attempts to reform teacher education in order to address issues of inclusion are complex. The paper reports the findings from a set of surveys that studied student teachers' attitudes to, and beliefs about, inclusion and exclusion at the beginning and end of a newly reformed 1‐year professional graduate diploma course at the University of Aberdeen, which places inclusion at the heart of the programme. The findings from the surveys indicate that both primary and secondary student teachers' attitudes and beliefs towards the principles of inclusive education remain positive throughout the course and are largely undiminished by school experience. This contradicts some findings that are reported elsewhere, where attitudes and beliefs become more negative following experience in schools. Findings from this study also show that attitudes, beliefs and understandings of the principles of inclusion are enhanced by consideration of the ideas underpinning ‘Learning without Limits’.
Investigating the attitudes of head teachers of Cypriot primary schools towards inclusion
Authors: Hadjikakou Kika , Mnasonos Marina
Published: February 2011

This paper reports the results of a study that has been carried out for the first time in Cyprus, with the aim of exploring the views of head teachers on inclusion. Data were collected by means of questionnaires and a focus group meeting; 185 head teachers participated in this study. The findings indicated that overall, head teachers held positive attitudes towards inclusion of children with disabilities. The relationship among the head teachers' background factors, such as sex, administration experience, contacts with people with disabilities, possession of postgraduate titles in special education and attitudes towards inclusion were reported. This study has brought out that head teachers held overall positive attitudes towards inclusion. The findings are meaningful to the understanding of the effects of inclusion and entail various implications to facilitate it.
Potentiation of acute morphine‐induced analgesia measured by a thermal test in bone cancer‐bearing mice
Authors: González‐Rodríguez Sara , Llames Sara , Hidalgo Agustín , Baamonde Ana , Menéndez Luis
Published: February 2011

Agonists of μ‐opioid receptors are currently used in the management of cancer pain. However, several data suggest that the analgesic effect of morphine can diminish during the development of experimental tumors. By using a thermal test, we have studied whether the analgesic effect evoked by morphine is altered in mice bearing two painful bone tumors. The analgesic effect evoked by systemic morphine remained unaltered after the intratibial inoculation of B16‐F10 melanoma cells and was potentiated after the inoculation of NCTC 2472 osteosarcoma cells. Although the number of spinal μ‐opioid receptors measured by western blot studies was not augmented in osteosarcoma‐bearing mice, the analgesia evoked by intrathecal (i.t.) morphine was also enhanced. The analgesic response produced by the spinal administration of the Gi/o protein activator mastoparan was amplified, whereas the analgesic response evoked by the i.t. administration of the N‐type calcium channel blocker ω‐conotoxin remained unaltered. The efficacy of the GIRK channel blocker tertiapin‐Q to antagonize the analgesic effect produced by a maximal dose of morphine was also increased in osteosarcoma‐bearing mice. Our results seem to indicate that the analgesic effect of morphine on thermal nociception can be enhanced in response to the development of particular bone tumors in mice, being this potentiation probably related to a greater efficacy of the transduction system driven by Gi/o proteins and GIRK channels.
Modeling transfusion reactions and predicting in vivo cell survival with kodecytes
Authors: Oliver Caroline , Blake Deborah , Henry Stephen
Published: February 2011

BACKGROUND: The availability of suitable animal models is a limitation in research on transfusion reactions. KODE technology allows for the artificial attachment of incompatible blood group antigens, plus visualization and recovery constructs onto red blood cells (RBCs), making them potentially suitable to study both transfusion reactions and determine in vivo cell survival.

STUDY DESIGN AND METHODS: Function‐spacer‐lipid (FSL) constructs representing blood group A antigen (FSL‐A) and biotin (FSL‐biotin) together with FSL‐GB3 as a benign antigen were used to create a range of murine kodecytes. Compatible and incompatible kodecytes were transfused into naive or anti‐A hyperimmune mice. FSL‐biotin constructs simultaneously included in the same RBC were visualized with avidin Alexa Fluor 488 and fluorescence microscopy to determine circulating cell survival or to demonstrate recovery of kodecytes.

RESULTS: Using fluorescence microscopy of blood films, biotin, and GB3 + biotin kodecyte transfusions, all showed similar survival and were present in the circulation at more than 72 hours in naive and anti‐A–immunized mice. A + biotin kodecytes were also present in the circulation at more than 72 hours in naive mice but were mostly cleared within 6 minutes in anti‐A–immunized mice. Avidin agarose beads in gel cards were used to demonstrate recovery of A + biotin kodecytes from blood samples.

CONCLUSIONS: KODE technology not only enables the creation of artificial transfusion reactions in animal models, but also has the potential to be used clinically in man to determine 24‐hour cell survival. The ability to recover the kodecytes for further analysis has valuable research and diagnostic potential.
Distribution of parvovirus B19 DNA in blood compartments and persistence of virus in blood donors
Authors: Lee Tzong‐Hae , Kleinman Steven H. , Wen Li , Montalvo Lani , Todd Deborah S. , Wright David J. , Tobler Leslie H. , Busch Michael P. ,   for the NHLBI Retrovirus Epidemiology Donor Study‐II (REDS‐II)
Published: February 2011

BACKGROUND: Because the receptor for parvovirus B19 (B19V) is on red blood cells (RBCs), we investigated B19V distribution in blood by in vitro spiking experiments and evaluated viral compartmentalization and persistence in natural infection.

STUDY DESIGN AND METHODS: Two whole blood (WB) protocols (ultracentrifugation and a rapid RBC lysis and removal protocol) were evaluated using quantitative real‐time polymerase chain reaction. WB was spiked with known concentrations of B19V and recovery in various blood fractions was determined. The rapid RBC lysis and removal protocol was then used to compare B19V concentrations in 104 paired WB and plasma samples collected longitudinally from 43 B19V‐infected donors with frozen specimens in the REDS Allogeneic Donor and Recipient Repository (RADAR).

RESULTS: In B19V spiking experiments, approximately one‐third of viral DNA was recovered in plasma and two‐thirds was loosely bound to RBCs. In the immunoglobulin (Ig)M‐positive stage of infection in blood donors when plasma B19V DNA concentrations were greater than 100 IU/mL, median DNA concentrations were approximately 30‐fold higher in WB than in plasma. In contrast, when IgM was absent and when the B19V DNA concentration was lower, the median WB‐to‐plasma ratio was approximately 1. Analysis of longitudinal samples demonstrated persistent detection of B19V in WB but declining ratios of WB to plasma B19V with declining plasma viral load levels and loss of IgM reactivity.

CONCLUSIONS: The WB‐to‐plasma B19V DNA ratio varies by stage of infection, with 30‐fold higher concentrations of B19V DNA in WB relative to plasma during the IgM‐positive stage of infection followed by comparable levels during persistent infection when only IgG is present. Further study is required to determine if this is related to the presence of circulating DNA‐positive RBCs derived from B19V‐infected erythroblasts, B19V‐specific IgM‐mediated binding of virus to cells, or other factors.
Effect on the quality of blood components after simulated blood transfusions using volumetric infusion pumps
Authors: Lieshout‐Krikke Ryanne W. , van der Meer Pieter F. , Koopman Maria M.W. , de Korte Dirk
Published: February 2011

BACKGROUND: It is unknown whether the use of volumetric infusion pumps for the transfusion of red blood cells (RBCs) or platelet (PLT) concentrates (PCs) affects the quality of the blood components. We therefore investigated the in vitro quality of these components after use of infusion pumps.

STUDY DESIGN AND METHODS: Ten different volumetric infusion pumps were used to simulate transfusion with RBCs and PCs. To prevent donor‐dependent differences multiple units were pooled and divided into equal portions. The storage time of RBCs was 30 to 35 days (n = 10 experiments), and for PCs, either 2 (n = 5) or 7 days (n = 5). For RBCs an infusion rate of 100 or 300 mL/hr was used, and for PCs, 600 mL/hr. Transfusions without an infusion pump served as a reference.

RESULTS: None of the infusion pumps induced an increase of free hemoglobin, annexin A5 binding, or formation of echinocytes in RBCs compared to reference units. In 2‐ and 7‐day‐old PCs no effect was shown on PLT concentration, annexin A5 binding, mean PLT volume, and morphology score compared to the reference. The CD62P expression of 2‐day‐old PCs was significantly lower after transfusion compared to the reference, that is, 11.7 ± 2.1% versus 8.1 ± 1.3% (p < 0.01).

CONCLUSION: There was no adverse effect on the in vitro quality of RBCs or PCs after simulated transfusion using volumetric infusion pumps. A decrease in PLT activation was observed, which can probably be explained by capturing of activated or damaged PLTs in the 200‐µm filter present in the infusion system.
A comprehensive program to minimize platelet outdating
Authors: Fuller Alice K. , Uglik Kristin M. , Braine Hayden G. , King Karen E.
Published: February 2011

BACKGROUND: Platelet (PLT) transfusions are essential for patients who are bleeding or have an increased risk of bleeding due to a decreased number or abnormal function of circulating PLTs. A shelf life of 5 days for PLT products presents an inventory management challenge. In 2006, greater than 10% of apheresis PLTs made in the United States outdated. It is imperative to have a sufficient number of products for patients requiring transfusion, but outdating PLTs is a financial burden and a waste of a resource.

STUDY DESIGN AND METHODS: We present the approach used in our institution to anticipate inventory needs based on current patient census and usage. Strategies to predict usage and to identify changes in anticipated usage are examined. Annual outdating is reviewed for a 10‐year period from 2000 through 2009.

RESULTS: From January 1, 2000, through December 2009, there were 128,207 PLT transfusions given to 15,265 patients. The methods used to anticipate usage and adjust inventory resulted in an annual outdate rate of approximately 1% for the 10‐year period reviewed. In addition we have not faced situations where inventory was inadequate to meet the needs of the patients requiring transfusions.

CONCLUSION: We have identified three elements of our transfusion service that can minimize outdate: a knowledgeable proactive staff dedicated to PLT management, a comprehensive computer‐based transfusion history for each patient, and a strong two‐way relationship with the primary product supplier. Through our comprehensive program, based on the principles of providing optimal patient care, we have minimized PLT outdating for more than 10 years.
Fukuoka‐1 strain of transmissible spongiform encephalopathy agent infects murine bone marrow–derived cells with features of mesenchymal stem cells
Authors: Cervenakova Larisa , Akimov Sergey , Vasilyeva Irina , Yakovleva Oksana , McKenzie Carroll , Cervenak Juraj , Piccardo Pedro , Asher David M.
Published: February 2011

BACKGROUND: The possible risk of iatrogenic transmissible spongiform encephalopathies (TSEs, prion diseases) from transplantation of marrow‐derived mesenchymal stem cells (MSCs) is uncertain. While most cell lines resist infection, a few propagate TSE agents.

STUDY DESIGN AND METHODS: We generated MSC‐like (MSC‐L) cell cultures from bone marrow (BM) of mice inoculated with the human‐derived Fukuoka‐1 (Fu) strain of TSE agent. Cultured cells were characterized for various markers and cellular prion protein (PrPC) by fluorescence‐activated cell sorting and for PrPC and its pathologic TSE‐associated form (PrPTSE) by Western blotting (WB). Cell cultures were tested for their susceptibility to infection with Fu in vitro. The infectivity of one Fu‐infected cell culture was assayed in mice.

RESULTS: BM cells from Fu‐infected mice expressed neither PrPC nor PrPTSE after 3 days in culture as demonstrated by WB. Cells adherent to plastic and maintained under two different culture conditions became spontaneously immortalized and began to express PrPC at about the same time. One culture became transformed shortly after exposure to Fu in vitro and remained persistently infected, continuously generating PrPTSE through multiple passages; the infectivity of cultured cells was confirmed by intracerebral inoculation of lysates into mice. Both persistently TSE‐infected and uninfected cells expressed a number of typical MSC markers.

CONCLUSION: BM‐derived MSC‐L cells of mice became persistently infected with the Fu agent under certain conditions in culture—conditions that differ substantially from those currently used to develop investigational human stem cell therapies.
Economics of Disaster Risk, Social Vulnerability, and Mental Health Resilience
Authors: Zahran Sammy , Peek Lori , Snodgrass Jeffrey G. , Weiler Stephan , Hempel Lynn
Published: February 2011

We investigate the relationship between exposure to Hurricanes Katrina and/or Rita and mental health resilience by vulnerability status, with particular focus on the mental health outcomes of single mothers versus the general public. We advance a measurable notion of mental health resilience to disaster events. We also calculate the economic costs of poor mental health days added by natural disaster exposure. Negative binomial analyses show that hurricane exposure increases the expected count of poor mental health days for all persons by 18.7% (95% confidence interval [CI], 7.44–31.14%), and by 71.88% (95% CI, 39.48–211.82%) for single females with children. Monthly time‐series show that single mothers have lower event resilience, experiencing higher added mental stress. Results also show that the count of poor mental health days is sensitive to hurricane intensity, increasing by a factor of 1.06 (95% CI, 1.02–1.10) for every billion (U.S.$) dollars of damage added for all exposed persons, and by a factor of 1.08 (95% CI, 1.03–1.14) for single mothers. We estimate that single mothers, as a group, suffered over $130 million in productivity loss from added postdisaster stress and disability. Results illustrate the measurability of mental health resilience as a two‐dimensional concept of resistance capacity and recovery time. Overall, we show that natural disasters regressively tax disadvantaged population strata.
Apples to Apples: The Origin and Magnitude of Differences in Asbestos Cancer Risk Estimates Derived Using Varying Protocols
Authors: Berman D. Wayne
Published: February 2011

Given that new protocols for assessing asbestos‐related cancer risk have recently been published, questions arise concerning how they compare to the “IRIS” protocol currently used by regulators. The newest protocols incorporate findings from 20 additional years of literature. Thus, differences between the IRIS and newer Berman and Crump protocols are examined to evaluate whether these protocols can be reconciled. Risks estimated by applying these protocols to real exposure data from both laboratory and field studies are also compared to assess the relative health protectiveness of each protocol. The reliability of risks estimated using the two protocols are compared by evaluating the degree with which each potentially reproduces the known epidemiology study risks. Results indicate that the IRIS and Berman and Crump protocols can be reconciled; while environment‐specific variation within fiber type is apparently due primarily to size effects (not addressed by IRIS), the 10‐fold (average) difference between amphibole asbestos risks estimated using each protocol is attributable to an arbitrary selection of the lowest of available mesothelioma potency factors in the IRIS protocol. Thus, the IRIS protocol may substantially underestimate risk when exposure is primarily to amphibole asbestos. Moreover, while the Berman and Crump protocol is more reliable than the IRIS protocol overall (especially for predicting amphibole risk), evidence is presented suggesting a new fiber‐size‐related adjustment to the Berman and Crump protocol may ultimately succeed in reconciling the entire epidemiology database. However, additional data need to be developed before the performance of the adjusted protocol can be fully validated.
Ajmaline Challenge in Young Individuals with Suspected Brugada Syndrome
Authors: SORGENTE ANTONIO , SARKOZY ANDREA , DE ASMUNDIS CARLO , CHIERCHIA GIAN‐BATTISTA , CAPULZINI LUCIO , PAPARELLA GAETANO , HENKENS STEFAN , BRUGADA PEDRO
Published: February 2011

Background: The clinical characteristics and the results of ajmaline challenge in young individuals with suspected Brugada syndrome (BS) have not been systematically investigated.

Methods: Among a larger series of patients included in the BS database of our Department, 179 patients undergoing ajmaline challenge were included in the study and categorized in two groups according to age: group 1 (<18 years old) and group 2 (≥18 years old). Clinical features and results of the ajmaline challenge of each group were compared.

Results: Young individuals were more often asymptomatic compared to adult patients (P = 0.002). They showed a higher number of normal ECGs (P = 0.023), a lower percentage of Brugada type II electrocardiographic pattern compared to the adult population (P = 0.011), and a comparable amount of spontaneous Brugada type III electrocardiographic pattern (P = 0.695). Ajmaline provoked a higher degree of intraventricular conduction delay (P = 0.002) and higher degree of prolongation of the ventricular repolarization phase (P = 0.013) in young individuals but its pro‐arrhythmic risk was comparable in the two groups (P = 0.684). Furthermore, inducibility of ventricular arrhythmias in young patients with a positive ajmaline test was comparable to that of the adults with a positive ajmaline test (P = 0.694).

Conclusions: The present study demonstrates the low‐risk profile of the ajmaline test in young patients when performed by experienced physicians and nurses in an appropriate environment. (PACE 2011; 736–741)
Incidence and Significance of Pacemaker and Implantable Cardioverter‐Defibrillator Lead Masses Discovered during Transesophageal Echocardiography
Authors: DOWNEY BRIAN C. , JUSELIUS WHITNEY E. , PANDIAN NATESA G. , ESTES N. A. MARK , LINK MARK S.
Published: February 2011

Background: Pacemaker and implantable cardioverter‐defibrillator device infections are feared complications. The finding of a lead‐associated mass on transesophageal echocardiogram (TEE) raises concern for endocarditis. However, the incidence and clinical importance of lead masses is not currently known.

Methods: Consecutive patients with transvenous leads undergoing TEE from July 1, 2003, to June 30, 2005, were identified and assessed for a clinical diagnosis of endocarditis. An echocardiographer blinded to clinical information reviewed all TEEs.

Results: Of 177 TEEs performed on 153 patients, a visible mass on a device lead was observed in 25 (14%), including 11 TEEs showing a lead vegetation, 13 TEEs showing lead strands, and one study showing both. Seventeen patients were adjudicated to have endocarditis, of which eight had a mass seen on a lead during TEE. Thus, 72% of patients (18 of 25) with a lead‐associated mass did not have evidence of an infection. In TEEs performed for indications other than to rule out endocarditis, lead masses were seen in 13 of 136 studies (10%), with only one patient adjudicated to clinically have an infected device.

Conclusion: During this 2‐year study of consecutive patients with a tranvenous lead undergoing TEE, lead‐associated masses were found in 14% of patients. In 72% of patients, the mass did not prove to be secondary to infectious causes. Thus, masses attached to a device lead should be interpreted in the overall clinical context and, in the absence of concomitant evidence of endocarditis, should not mandate device and lead removal. (PACE 2011; 679–683)
Moving Up in Rural America: Economic Attainment of Nonmetro Latino Immigrants
Authors: Kandel William , Henderson Jamila , Koball Heather , Capps Randy
Published: February 2011

Abstract

Rapid Hispanic population growth represents a pronounced demographic transformation in many nonmetropolitan counties, particularly since 1990. Its considerable public policy implications stem largely from high proportions of new foreign‐born residents. Despite the pressing need for information on new immigrants in nonmetro counties and a bourgeoning scholarship on new rural destinations, few quantitative analyses have measured systematically the social and economic well‐being of Latino immigrants. This study analyzes the importance of place for economic well‐being, an important public policy issue related to rural Hispanic population growth. We consider four measures of economic mobility: full‐time, year‐round employment; home ownership; poverty status; and income exceeding the median national income. We conduct this analysis for 2000 and 2006–2007 to capture two salient periods of nonmetro Hispanic population growth, using a typology that distinguishes among nonmetropolitan areas by the categories of “traditional” immigrant destinations concentrated in the Southwest and Northwest, “new” immigrant destinations to capture recent and rapid Hispanic population growth in the Midwest and Southeast, and “all other” rural destinations as a reference category representing more typical nonmetro population trends. We also compare our results to those for metropolitan destinations. We find that place type matters little for stable employment but more so for wealth accumulation and income security and mobility. Compared with urban Latino immigrants, rural Latino immigrants exhibit higher rates of homeownership as well as greater likelihoods of falling into poverty and lower likelihoods of earning a measure of U.S. median income. From 2000 to 2006–2007, rural‐urban differences deteriorated slightly in favor of urban areas. We conclude by discussing implications of these findings and those of addressing rural immigrant economic well‐being more generally.
Skeletal Identification by Radiographic Comparison: Blind Tests of a Morphoscopic Method Using Antemortem Chest Radiographs*,†,‡
Authors: Stephan Carl N. , Winburn Allysha P. , Christensen Alexander F. , Tyrrell Andrew J.
Published: February 2011

Abstract: This study investigated the value of antemortem (AM) and postmortem (PM) radiographs of the claviculae and C3‐T4 vertebrae to identify skeletons of missing U.S. soldiers from past military operations. In total, 12 field‐recovered skeletons and AM chest radiographs of 1460 individuals were used. For each skeleton, examiners analyzed an array of AM chest radiographs (up to 1000 individuals) and attempted to identify the correct PM/AM radiographic match. When examiners were able to compare all images within a single test, only true‐positive identifications were made. When AM radiographs were presented one‐at‐a‐time, in sequential order, and without examiners having knowledge of array size, erroneous identifications resulted but they were almost exclusively made by untrained examiners (accuracy = 35% vs. 90% for trained examiners). This study demonstrates the value of chest radiographs for the identification of disarticulated and even eroded skeletons, but only when methods are wielded by trained examiners.
Rat Bite Fever, a Fatal Case of Streptobacillus moniliformis Infection in a 14‐Month‐Old Boy
Authors: Banerjee Priya , Ali Zabiullah , Fowler David R.
Published: February 2011

Abstract:  Streptobacillus moniliformis is the primary cause of rat bite fever in North America. Children under 12 years of age are primarily infected, presenting with an acute syndrome of fever, rash, and polyarthritis. Common vectors include rats and mice. Transmission is predominantly from a bite or scratch, but contact with or ingestion of food contaminated with feces or saliva has also been reported. We report a fatal case of S. moniliformis infection in a 14‐month‐old‐boy. At home, the child was exposed to filthy living conditions and the family had pet ferrets. Autopsy revealed a red‐pink, mostly confluent rash and a circumscribed area suspicious for a possible bite mark. Cerebrospinal fluid cultures were positive for S. moniliformis. This case highlighted key features, such as the morbiliform rash, but lacked lymphadenopathy or joint manifestations. It is important to consider rat or rodent exposure as a source of infection.
Visualization of Latent Fingermark Corrosion of Brass, Climatic Influence in a Comparison Between the U.K. and Iraq
Authors: Bond John W. , Eliopulos Louis N. , Brady Thomas F.
Published: February 2011

Abstract:  Through a comparison of fingermark sweat corrosion of α phase brass in both the U.K. and Iraq, we show how samples from Iraq have improved fingermark corrosion over U.K. samples that require no additional enhancement prior to visualization. Over 50% of Iraqi samples produced fingermark corrosion with full ridge detail compared with 0% from the U.K. X‐ray photoelectron spectroscopy analysis of the fingermark corrosion products showed that Iraqi samples exhibit more dezincification with the Zn:Cu ratio averaging 1:1.82 compared with 1:3.07 for U.K. samples. Auger spectroscopy showed the presence of both zinc oxide and copper (I) oxide. No copper (II) was observed on the surface of the corroded brass. Opportunities to exploit the optical properties of these thin film oxides to enhance the visualization of fingermark corrosion are considered, and the potential to use fingermark corrosion of metal as a means of visualizing fingerprints in war zones is discussed.
Evaluation of Age Estimation Technique: Testing Traits of the Acetabulum To Estimate Age at Death in Adult Males*
Authors: Calce Stephanie E. , Rogers Tracy L.
Published: February 2011

Abstract: This study evaluates the accuracy and precision of a skeletal age estimation method, using the acetabulum of 100 male ossa coxae from the Grant Collection (GRO) at the University of Toronto, Canada. Age at death was obtained using Bayesian inference and a computational application (IDADE2) that requires a reference population, close in geographic and temporal distribution to the target case, to calibrate age ranges from scores generated by the technique. The inaccuracy of this method is 8 years. The direction of bias indicates the acetabulum technique tends to underestimate age. The categories 46–65 and 76–90 years exhibit the smallest inaccuracy (0.2), suggesting that this method may be appropriate for individuals over 40 years. Eighty‐three percent of age estimates were ±12 years of known age; 79% were ±10 years of known age; and 62% were ±5 years of known age. Identifying a suitable reference population is the most significant limitation of this technique for forensic applications.
Identification of Group Affinity from Cross‐sectional Contours of the Human Midfacial Skeleton Using Digital Morphometrics and 3D Laser Scanning Technology*,‡
Authors: Sholts Sabrina B. , Walker Phillip L. , Kuzminsky Susan C. , Miller Kevin W.P. , Wärmländer Sebastian K.T.S.
Published: February 2011

Abstract:  Identifying group affinity from human crania is a long‐standing problem in forensic and physical anthropology. Many craniofacial differences used in forensic skeletal identification are difficult to quantify, although certain measurements of the midfacial skeleton have shown high predictive value for group classifications. This study presents a new method for analyzing midfacial shape variation between different geographic groups. Three‐dimensional laser scan models of 90 crania from three populations were used to obtain cross‐sectional midfacial contours defined by three standard craniometric landmarks. Elliptic Fourier transforms of the contours were used to extract Fourier coefficients for statistical analysis. After cross‐validation, discriminant functions based on the Fourier coefficients provided an average of 86% correct classifications for crania from the three groups. The high rate of accuracy of this method indicates its usefulness for identifying group affinities among human skeletal remains and demonstrates the advantages of digital 3D model‐based analysis in forensic research.
An application of IDEA to wheat farming efficiency
Authors: Hadi‐Vencheh A. , Matin R. Kazemi
Published: February 2011

Data Envelopment Analysis (DEA) is a nonparametric approach to evaluating the relative efficiency of decision making units (DMUs) that use multiple inputs to produce multiple outputs. An assumption underlying DEA is that all the data assume the form of specific numerical values. In some applications, however, the data may be imprecise. That is, all the input and output data cannot be exactly obtained due to the existence of uncertainty. They are only known to lie within specified intervals. A DEA model with imprecise data or, more compactly, an Imprecise DEA (IDEA) model proposed in this article to evaluate efficiency for each DMU. The article is illustrated with an application to Iranian wheat producer provinces.