bluuebunny/crossref_metadata_2025 huggingface dataset:
Simultaneous Detection and Differentiation of Staphylococcus Speciesin Blood Cultures Using Fluorescence in situ Hybridization
Authors: Wang Pei
Published: March 2010

Objective: To develop a new protocol for the simultaneous detection and differentiation of Staphylococcus aureus and coagulase-negative staphylococci (CoNS) in blood cultures using fluorescence in situ hybridization (FISH), without cultivation and biotyping. Materials and Methods: Oligonucleotide probes were used to target the variable regions of the 16S rRNA of S. aureus and CoNS, the probes were labeled with fluorochrome Cy3 (red signal) and fluorescein isothiocyanate (green signal), respectively. It is not possible to design one probe that will hybridize to all CoNS species. Therefore, in this study two differentially labeled probes (STA and SAU) were mixed and used to detect and differentiate S. aureus from CoNS rapidly in a single smear. Samples of 189 positive blood cultures with Gram-positive cocci in clusters and 11 Gram-positive cocci in chains or pairs were included. Results: The FISH assay showed 91.8% sensitivity and 100% specificity for S. aureus and 100% sensitivity and 93.3% specificity for CoNS when hybridized with STA and SAU probes. Meanwhile, the assay showed 91.8% sensitivity and 100% specificity for S. aureus and 100% sensitivity and 90% specificity for CoNS, when hybridized with the SAU probe only. Conclusion: Our data showed that the FISH technique was suitable for the simultaneous detection and differentiation of Staphylococcus sp. in blood cultures.
A Rare Cause of Small Bowel Transection: Metastatic Lung Cancer
Authors: Yildirim Mehmet , Tasli Funda , Bayam M. Emrah , Postaci Hakan
Published: March 2010

Objective: To present a case of small bowel perforation due to metastatic lung cancer. Case Presentation and Intervention: A 78-year-old male patient, who had been diagnosed with lung cancer 3 months earlier, presented to our clinic with acute abdominal pain. He underwent emergency laparotomy. At surgery, there was a circumferential lesion encompassing the ileum with complete transection. There was no obvious macroscopic appearance of metastatic disease. The involved bowel segment was resected and an ileostomy was performed. Postoperative pathologic analysis confirmed metastatic squamous cell carcinoma metastasis to the ileum, arising from the patient’s lung cancer. Conclusion: This case report showed that small bowel metastases should always be considered in the differential diagnosis of lung cancer patients presenting with acute abdominal pain.
Evaluation of a 6-Year Highly Active Antiretroviral Therapy in Chinese HIV-1-Infected Patients
Authors: Zhou Hua-ying , Zheng Yu-huang , He Yan , Chen Zi , Liu Meng , Yin Wei , Liu Chun
Published: March 2010

Objective: To evaluate the long-term efficacy and tolerability of nevirapine (NVP)-based regimens in the treatment of human immunodeficiency virus (HIV)-infected Chinese patients in routine clinical practice. Methods: From October 2002 to May 2004, 57 HIV-1-infected patients commenced antiretroviral therapy (ART), and were followed up to December 2008. These antiretroviral-naïve patients, who originally received two nucleoside reverse transcriptase inhibitors and NVP, had HIV RNA levels, T lymphocyte subsets and safety parameters assessed over 6 years. Results: Of the 57 patients, 34 patients participated in the long-term follow-up. After 5–6 years, >60% of the patients had HIV RNA levels <50 copies/µl, and the median increase in CD4 cell counts from baseline was 329 cells/µl. γ-Glutamyl transferase increased in 17 patients (29.8%); serum cholesterol and triglyceride levels were elevated in 15 patients (26.3%), and 25.0% (6/24) of the patients developed lipodystrophy (mainly females). Grade 3/4 adverse events occurred in 3 cases. Conclusion: ART with NVP-based regimens suppressed HIV viremia and produced continued CD4 cell increases in a majority of subjects for 6 years. Safety and tolerance were good with no unexpected long-term toxicity. Though based on a small group, this study demonstrates durable effects of ART in Chinese patients.
Clinical and Genetic Correlates of Circulating Angiopoietin-2 and Soluble Tie-2 in the Community
Authors: Lieb Wolfgang , Zachariah Justin P. , Xanthakis Vanessa , Safa Radwan , Chen Ming-Huei , Sullivan Lisa M. , Larson Martin G. , Smith Holly M. , Yang Qiong , Mitchell Gary F. , Vita Joseph A. , Sawyer Douglas B. , Vasan Ramachandran S.
Published: March 2010

Background—

Experimental studies suggest that endothelial growth factors play an important role in angiogenesis and vascular remodeling. The clinical and genetic correlates of circulating angiopoietin-2 (Ang-2) and its soluble receptor/regulator Tie-2 (sTie-2) have not been determined in a community-based sample.

Methods and Results—

Serum Ang-2 and sTie-2 were assayed in 3778 third-generation cohort participants of the Framingham Heart Study (mean age, 40±9 years; 53% women). Clinical correlates and heritability of both biomarkers were assessed using generalized estimating equations and variance-component analyses. Ang-2 levels were higher and sTie-2 levels were lower in women than in men. Ang-2 was positively related to age, smoking, systolic blood pressure, hypertension treatment, and diabetes (
P
<0.05 for all) but was inversely associated with total cholesterol and diastolic blood pressure (
P
<0.0001 for both), and sTie-2 was positively associated with body mass index, diabetes, and triglycerides but was inversely related to age, alcohol consumption, and glomerular filtration rate (
P
<0.05 for all). Both Ang-2 and sTie-2 were higher in participants with metabolic syndrome (
P
<0.005), with stronger associations of Ang-2 with blood pressure traits and of sTie-2 with obesity-dyslipidemia components. Heritability estimates for Ang-2 and sTie-2 were 27% and 56%, respectively (
P
<0.0001). A region on chromosome 9 was significantly linked to circulating sTie-2 levels (logarithm of the odds score, 8.31).

Conclusion—

Circulating levels of Ang-2 and sTie-2 are heritable traits associated with cardiovascular disease risk factors, including the metabolic syndrome. These observations are consistent with the notion that angiogenesis and vascular remodeling are determined in part by genetic influences and associated with metabolic risk factors.
Prevalence of Asymptomatic Coronary Artery Disease in Ischemic Stroke Patients
Authors: Calvet David , Touzé Emmanuel , Varenne Olivier , Sablayrolles Jean-Louis , Weber Simon , Mas Jean-Louis
Published: March 2010

Background—

Coronary artery disease (CAD) is a significant cause of morbidity and mortality in stroke patients. Some patients with asymptomatic CAD might benefit from specific prevention, but the prevalence of asymptomatic CAD is not well known. We assessed the prevalence of ≥50% asymptomatic CAD in patients with ischemic stroke or transient ischemic attack and whether the prevalence is related to traditional vascular risk factors and cervicocephalic atherosclerosis.

Methods and Results—

From January 2006 to February 2009, consecutive patients between 45 and 75 years of age with nondisabling, noncardioembolic ischemic stroke or transient ischemic attack and no prior history of CAD were enrolled in the study. All patients had a 64-section computed tomography coronary angiography and a detailed cervicocephalic arterial workup. Risk factors were assessed individually and through the Framingham Risk Score. Among 300 patients included in the study, 274 had computed tomography coronary angiography. The prevalence of ≥50% asymptomatic CAD was 18% (95% confidence interval [CI], 14 to 23; n=50). Asymptomatic CAD was independently associated with traditional risk factors assessed individually and through the Framingham Risk Score (odds ratio [OR], 2.6; 95% CI, 1.0 to 7.6 for a 10-year risk of coronary heart disease of 10% to 19%; and OR, 7.3; 95% CI, 2.8 to 19.1 for a 10 year-risk of coronary heart disease ≥20%), the presence of at least 1 ≥50% cervicocephalic artery stenosis (OR, 4.0; 95% CI, 1.4 to 11.2), excessive alcohol consumption (OR, 3.1; 95% CI 1.3 to 7.3), and ankle brachial index <0.9 (OR, 2.2; 95% CI, 0.9 to 5.2). The prevalence of ≥50% asymptomatic CAD was also related to the extent of cervicocephalic atherosclerosis.

Conclusions—

About one fifth of patients with nondisabling, noncardioembolic ischemic stroke or transient ischemic attack have ≥50% asymptomatic CAD. In addition to vascular risk factors, the presence of ≥50% cervicocephalic artery stenosis is strongly related to ≥50% asymptomatic CAD.
Relaxin Therapy Reverses Large Artery Remodeling and Improves Arterial Compliance in Senescent Spontaneously Hypertensive Rats
Authors: Xu Qi , Chakravorty Arindam , Bathgate Ross A.D. , Dart Anthony M. , Du Xiao-Jun
Published: March 2010

Hypertension and aging are associated with large artery structural remodeling and stiffening, which are known to increase cardiovascular risk. Relaxin is a peptide hormone with potent antifibrotic action in multiple organs. Although relaxin is able to reduce peripheral vascular resistance and improve arterial compliance in rats, it remains unclear whether the improvement in compliance is indirectly attributed to a vasodilatory action or whether relaxin is able to reverse arterial remodeling and stiffening directly in aged hypertensive animals. Senescent spontaneously hypertensive rats (17 months old) were treated with relaxin for 2 weeks (0.5 mg/kg per day) followed by a 1-week washout period. We determined large artery compliance using in vivo and in vitro techniques and quantified arterial remodeling by morphological and chemical means. Relaxin therapy significantly reversed aortic remodeling (ie, increases in vessel size, wall thickness, and collagen content) and improved arterial compliance, effects independent of its vasodilatory action. In relaxin-treated spontaneously hypertensive rats, arterial collagen content showed a greater reduction (−31%;
P
<0.05) than that of elastin (−8%), resulting in an increased elastin:collagen ratio (0.63±0.03 versus 0.47±0.02;
P
<0.05). In conclusion, our results demonstrated that relaxin is potent in mediating reversal of arterial remodeling and improving arterial structural compliance in aged hypertensive rats.
Sea Ice Response to Atmospheric and Oceanic Forcing in the Bering Sea
Authors: Zhang Jinlun , Woodgate Rebecca , Moritz Richard
Published: March 2010

A coupled sea ice–ocean model is developed to quantify the sea ice response to changes in atmospheric and oceanic forcing in the Bering Sea over the period 1970–2008. The model captures much of the observed spatiotemporal variability of sea ice and sea surface temperature (SST) and the basic features of the upper-ocean circulation in the Bering Sea. Model results suggest that tides affect the spatial redistribution of ice mass by up to 0.1 m or 15% in the central-eastern Bering Sea by modifying ice motion and deformation and ocean flows. The considerable interannual variability in the pattern and strength of winter northeasterly winds leads to southwestward ice mass advection during January–May, ranging from 0.9 × 1012 m3 in 1996 to 1.8 × 1012 m3 in 1976 and averaging 1.4 × 1012 m3, which is almost twice the January–May mean total ice volume in the Bering Sea. The large-scale southward ice mass advection is constrained by warm surface waters in the south that melt 1.5 × 1012 m3 of ice in mainly the ice-edge areas during January–May, with substantial interannual variability ranging from 0.94 × 1012 m3 in 1996 to 2.0 × 1012 m3 in 1976. Ice mass advection processes also enhance thermodynamic ice growth in the northern Bering Sea by increasing areas of open water and thin ice. Ice growth during January–May is 0.90 × 1012 m3 in 1996 and 2.1 × 1012 m3 in 1976, averaging 1.3 × 1012 m3 over 1970–2008. Thus, the substantial interannual variability of the Bering Sea ice cover is dominated by changes in the wind-driven ice mass advection and the ocean thermal front at the ice edge. The observed ecological regime shifts in the Bering Sea occurred with significant changes in sea ice, surface air temperature, and SST, which in turn are correlated with the Pacific decadal oscillation over 1970–2008 but not with other climate indices: Arctic Oscillation, North Pacific index, and El Niño–Southern Oscillation. This indicates that the PDO index may most effectively explain the regime shifts in the Bering Sea.
Weak Mixing in the Eastern North Atlantic: An Application of the Tracer-Contour Inverse Method
Authors: Zika Jan D. , McDougall Trevor J. , Sloyan Bernadette M.
Published: March 2010

The tracer-contour inverse method is used to infer mixing and circulation in the eastern North Atlantic. Solutions for the vertical mixing coefficient D, the along-isopycnal mixing coefficient K, and a geostrophic streamfunction Ψ are all direct outputs of the method. The method predicts a vertical mixing coefficient O(10−5 m2 s−1) in the upper 1000 m of the water column, consistent with in situ observations. The method predicts a depth-dependent along-isopycnal mixing coefficient that decreases from O(1000 m2 s−1) close to the mixed layer to O(100 m2 s−1) in the interior, which is also consistent with observations and previous hypotheses. The robustness of the result is tested with a rigorous sensitivity analysis including the use of two independently constructed datasets.

This study confirms the utility of the tracer-contour inverse method. The results presented support the hypothesis that vertical mixing is small in the thermocline of the subtropical Atlantic Ocean. A strong depth dependence of the along-isopycnal mixing coefficient is also demonstrated, supporting recent parameterizations for coarse-resolution ocean models.
Changes in Bone Mineral and Matrix in Response to a Soft Diet
Authors: Kingsmill V.J. , Boyde A. , Davis G.R. , Howell P.G.T. , Rawlinson S.C.F.
Published: March 2010

Alterations in the magnitude of habitual mechanical loads upon the skeleton may not only affect bone architecture, but also influence the nature of the bone matrix. We tested the hypothesis that changing the mechanical consistency of the diet affects both the mineral and non-mineralized moieties of bone matrix. Female rats were fed a soft diet (powdered chow as a paste), while control animals were fed the standard chow. After 8 or 20 wks, animals were killed. Cranial (mandible, maxilla, parietal, and frontal) bones and ulnae were analyzed for mineralization density by quantitative backscattered electron microscopy, and sulphated glycosaminoglycan levels with alcian blue staining were measured by microdensitometry. The soft diet group showed a significant increase in mineralization density distribution at almost all cranial sites and a reduction in alcian blue staining in alveolar bone. Altering the consistency of the diet significantly affects mineral concentration and glycosaminoglycan content of alveolar bone.
Doxycycline Effects on Serum Bone Biomarkers in Post-menopausal Women
Authors: Golub L.M. , Lee H.-M. , Stoner J.A. , Reinhardt R.A. , Sorsa T. , Goren A.D. , Payne J.B.
Published: March 2010

We previously demonstrated that subantimicrobial-dose-doxycycline (SDD) treatment of post-menopausal osteopenic women significantly reduced periodontal disease progression, and biomarkers of collagen destruction and bone resorption locally in periodontal pockets, in a double-blind placebo-controlled clinical trial. We now hypothesize that SDD may also improve biomarkers of bone loss systemically in the same women, consistent with previous studies on tetracyclines ( e.g., doxycycline) in organ culture and animal models of bone-deficiency disease. 128 post-menopausal osteopenic women with chronic periodontitis randomly received SDD or placebo tablets daily for 2 years adjunctive to periodontal maintenance therapy every 3-4 months. Blood was collected at baseline and at one- and two-year appointments, and sera were analyzed for bone resorption and bone formation/turnover biomarkers. In subsets of the study population, adjunctive SDD significantly reduced serum biomarkers of bone resorption (biomarkers of bone formation were unaffected), consistent with reduced risk of future systemic bone loss in these post-menopausal women not yet on anti-osteoporotic drugs.
Transcriptome Remodeling in Hypoxic Inflammation
Authors: Safronova O. , Morita I.
Published: March 2010

Hypoxia is an integral component of the inflamed tissue microenvironment. Today, the influence of hypoxia on the natural evolution of inflammatory responses is widely accepted; however, many molecular and cellular mechanisms mediating this relationship remain to be clarified. Hypoxic stress affects several independent transcriptional regulators related to inflammation in which HIF-1 and NF-κB play central roles. Transcription factors interact with both HATs and HDACs, which are components of large multiprotein co-regulatory complexes. This review summarizes the current knowledge on hypoxia-responsive transcriptional pathways in inflammation and their importance in the etiology of chronic inflammatory diseases, with the primary focus on transcriptional co-regulators and histone modifications in defining gene-specific transcriptional responses in hypoxia, and on the recent progress in the understanding of hypoxia-mediated epigenetic reprogramming. Furthermore, this review discusses the molecular cross-talk between glucocorticoid anti-inflammatory pathways and hypoxia.
Pathways Into Services for Offenders with Intellectual Disabilities
Authors: Lindsay William R. , O'Brien Gregory , Carson Derek , Holland Anthony J. , Taylor John L. , Wheeler Jessica R. , Middleton Claire , Price Karen , Steptoe Lesley , Johnston Susan
Published: March 2010

The patterns and pathways into intellectual disability (ID) offender services were studied through case file review for 477 participants referred in one calendar year to community generic, community forensic, and low, medium, and maximum secure services. Data were gathered on referral source, demographic information, index behavior, prior problem behaviors, diagnostic information, and abuse or deprivation. Community referrers tended to refer to community services and secure service referrers to secure services. Physical and verbal violence were the most frequent index behaviors, whereas contact sexual offenses were more prominent in maximum security. Age at first incident varied with security, with the youngest in maximum secure services. Attention-deficit/hyperactivity disorder or conduct disorder was the most frequently recorded diagnosis, and severe deprivation was the most frequent adverse developmental experience. Fire starting, theft, and road traffic offenses did not feature prominently. Generic community services accepted a number of referrals with forensic-type behavior and had higher proportions of both women and people with moderate or severe ID.
Management of the Metabolic Syndrome in Patients With Human Immunodeficiency Virus
Authors: Feigenbaum Kathryn , Longstaff Laura
Published: March 2010

Patients with human immunodeficiency virus (HIV) are an increasing subpopulation of patients seen in endocrine/ diabetes clinics. This article explores evidence-based treatment recommendations for patients with metabolic syndrome who are also positive for HIV. Patients infected with HIV may manifest metabolic abnormalities. They often present with low high-density lipoprotein (HDL-C), hypertension, visceral adiposity, and insulin resistance, among other symptoms consistent with features of the metabolic syndrome. The etiologies of the metabolic abnormalities are not completely understood. The role of highly active antiretroviral therapy (HAART) and the separate effect of HIV on patients who are surviving longer may contribute to the increased incidence of the development of the metabolic syndrome. The role of the health care team is to provide patient education to patients with HIV concerning lifestyle modification in order to prevent complications related to the metabolic syndrome.
The Role of Prejudice and the Need for Closure in Religious Fundamentalism
Authors: Brandt Mark J. , Reyna Christine
Published: March 2010

Religious fundamentalism has been consistently linked to prejudice toward a variety of outgroups. This article proposes that this is partially the case because fundamentalist ideology provides a sense of consistency and closure. Outgroups that challenge the epistemic certainty that fundamentalism provides are rejected in an effort to protect this certainty. Results from two studies, including one using a nationally representative sample, found that the need for closure was related to fundamentalism and partially mediated the relationship between fundamentalism and the derogation of lesbians and gays (Study 1) and value violators in general (Study 2). Furthermore, in Study 2, it was found that only some aspects of the need for closure explain the fundamentalism—prejudice relationship. Results are discussed in relation to past need for closure and ideology research as well as what this means for the study of fundamentalism.
The Etiology of the Multilevel Paradigm in Management Research
Authors: Mathieu John E. , Chen Gilad
Published: March 2010

As initially spawned through the meso movement in organizational behavior, the multilevel paradigm has permeated virtually every subdiscipline of management. The authors review its evolution from different disciplinary origins in terms of theory, measurement and construct validity, and design and analysis. They illustrate that although its origins are disparate and multidisciplinary, the modern-day multilevel paradigm is coherent and well entrenched in modern management research. They then raise five challenges to the current paradigm in terms of the following: first, the ambiguities surrounding the units of inquiry; second, the violations of the nesting assumption; third, the need to integrate the nested-arrangements approach with the longitudinal approach; fourth, the challenges associated with modeling current and future multilevel models; and, fifth, the role of multidisciplinary influences for multilevel management theory and investigations. Their hope is that this article will spark a paradigm shift in multilevel management research.
Separation as an Important Risk Factor for Suicide: A Systematic Review
Authors: Ide Naoko , Wyder Marianne , Kolves Kairi , De Leo Diego
Published: March 2010

Examining how different phases of relationship separation effects the development of suicidal behaviors has been largely ignored in suicide studies. The few studies conducted suggest that individuals experiencing the acute phase of marital/de facto separation may be at greater risk of suicide compared with those experiencing long-term separation (divorce). To clarify the effects of these factors on detection and prevention of suicidal behaviors, a critical review of the English-language literature on this topic from 1966 to 2008 was undertaken. No studies reliably indicate the impacts of acute separation versus long-term divorce on suicidality. Moreover, research has not specifically addressed the interaction between the psychosocial factors influencing suicidal behaviors in the context of a marital/de facto separation. Considering the large proportion of suicides that occur in the context of marital/de facto separation, our limited understanding of the factors involved in the development of these suicidal behaviors is of concern.
Marital Status, Hypertension, Coronary Heart Disease, Diabetes, and Death Among African American Women and Men: Incidence and Prevalence in the Atherosclerosis Risk in Communities (ARIC) Study Participants
Authors: Schwandt Hilary M. , Coresh Josef , Hindin Michelle J.
Published: March 2010

Heart disease is the leading cause of death in the United States, and African Americans disproportionately experience more cardiovascular disease, including coronary heart disease (CHD), hypertension, and diabetes. The literature documents a complex relationship between marital status and health, which varies by gender. We prospectively examine the relationship between African American men’s and women’s marital status and their risk of developing cardiovascular diseases and dying using the Atherosclerosis Risk in Communities (ARIC) data. After multivariable adjustment for individual characteristics and health status, we found that marital status was not associated with hypertension or new cases of CHD, but remaining single throughout the study period was associated with an increased risk of developing diabetes for women and an increased likelihood of death for men. Culturally appropriate interventions for African Americans are needed to decrease racial disparities in cardiovascular diseases and mortality.
The Effects of Mother’s Marital Status on Adolescent and Young Adult Health and Economic Well-Being Among African Americans
Authors: LaVeist Thomas A. , Zeno Tia L. , Fesahazion Ruth G.
Published: March 2010

This article explores the effects of being raised by married parents during childhood on health and well-being in adolescence and young adulthood in a longitudinal sample of African Americans. This study aims to address the following three questions: Does childhood with married patients lead to better health and well-being during adolescence? Does childhood with married patients lead to better health and well-being in young adulthood? Do the health effects of childhood with married patients differ for male and female? The authors found modest direct effects of childhood exposure to marriage on health for females. Having at least some childhood marriage exposure was also associated with several positive health behaviors. There is modest evidence that marriage bestows health benefits for children and that these benefits endure into young adulthood.
The Increasing Protection of Marriage on Infant Low Birth Weight Across Two Generations of African American Women
Authors: Barrington Debbie S.
Published: March 2010

This study used data from the Panel Study of Income Dynamics (PSID) on two generations of African American women who gave birth from 1967 to 2005 to describe changing relationships between marital status and low birth weight (LBW) across the generations. An increasing protection of marriage on infant LBW across the two generations was found after adjusting for socioeconomic and demographic confounding factors via (a) logistic regression using generalized estimating equations, (b) propensity score analyses taking into account the differential distribution of confounders across the generations, and (c) sensitivity analyses that adjusted for childhood health of the mother prior to marriage. Intergenerational findings also suggest that marriage across generations was most protective against infant LBW; the lowest risk for LBW was found among women who were both married when they gave birth to their infants and had mothers who were married at the time they themselves were born.
The impact of opioids, anticholinergic medications and disease progression on the prescription of laxatives in hospitalized palliative care patients: a retrospective analysis
Authors: Clark K. , Lam LT , Agar M. , Chye R. , Currow DC
Published: March 2010

Definitive risk factors for constipation in palliative care remain poorly defined. A retrospective analysis of 211 admissions to a palliative care unit was undertaken, with the main aim being to identify some factors, which influence laxative prescription. On univariate analysis, significant unadjusted associations were found between two or more prescribed laxatives and a diagnosis of malignancy, morphine equivalent dose, type of illness phase and the subsequent phase type, length of phase, anticholinergic load imposed by medications, symptom severity and functional status. Multiple ordinal logistic regressions revealed the prescription of one laxative to be significantly associated with oral morphine-equivalent dose, total anticholinergic load (odds ratio [OR] 1.4, 95% CI = 1.0—2.0), disease progression to terminal phase and death (OR 0.1, 95% CI = 0.0—0.3), and length of phase (OR 1.1, 95% CI = 1.0—1.2). Similar results were obtained for the prescription of two or more laxatives. Two additional measures of function, toileting (OR 3.6, 95% CI = 1.6—8.2) and transfer (OR 0.4 95% CI = 0.2—0.9), also became significant. Total anticholinergic load was significantly associated with the prescription of a single laxative (OR 1.4, 95% CI = 1.0—2.0) and two or more laxatives (OR 1.8, 95% CI = 1.3—2.5) for each unit increase in anticholinergic load. Opioids and in particular opioids prescribed at higher doses, the total anticholinergic load associated with prescribed medications, the degree of impaired physical function of a person, their length of stay in a palliative care unit and their proximity to death were all strongly related to the prescription of laxatives.
Current and planned palliative care service provision for chronic obstructive pulmonary disease patients in 239 UK hospital units: comparison with the gold standards framework
Authors: Buxton Katherine L , Stone Robert A , Buckingham Rhona J , Pursey Nancy A , Roberts Christopher M
Published: March 2010

Patients with chronic obstructive pulmonary disease report a symptom burden similar in magnitude to terminal cancer patients yet service provision and access has been reported as poor. In the absence of a specific national chronic obstructive pulmonary disease service framework the gold standards framework might support service developments. We surveyed 239 UK acute hospital units admitting chronic obstructive pulmonary disease patients, comprising 98% of all acute trusts, about their current and planned provision for palliative care services. Only 49% of units had a formal referral pathway for palliative care and only 13% had a policy of initiating end-of-life discussions with appropriate patients. Whilst 66% of units had plans to develop palliative care services, when mapped against the gold standards framework few were directly relevant and only three of the seven key standards were covered to any significant degree. We conclude that service provision remains poor and access is hindered by a lack of proactive initiation of discussion. Planned developments in chronic obstructive pulmonary disease palliative care services also lack a strategic framework that risks holistic design.
Cost variations in ambulatory and home-based palliative care
Authors: Guerriere Denise N , Zagorski Brandon , Fassbender Konrad , Masucci Lisa , Librach Lawrence , Coyte Peter C
Published: March 2010

Restructuring health care in Canada has emphasized the provision of ambulatory and home-based palliative care. Acquiring economic evidence is critical given this trend and its tremendous demands on family caregivers. The purposes of this study were: 1) to comprehensively assess the societal costs of home-based palliative care; and 2) to examine the socio-demographic and clinical factors that account for variations in costs over the course of the palliative trajectory. One hundred and thirty-six family caregivers were interviewed every two weeks from time of palliative referral until death. Information regarding appointments, travel and out-of-pocket expenses, time devoted to caregiving, as well as demographic and clinical characteristics were measured. The mean monthly cost of care per patient was $24,549 (2008 CDN$). Family caregivers’ time costs comprised most costs (70%). Multivariable linear regression indicated that costs were greater for patients who: had lower physical functioning (p < 0.001); lived with someone (p = 0.007); and when the patients approached death (p = 0.021). Information highlighting the variation in costs across individuals may aid policy makers and mangers in deciding how to allocate resources. Greater clarity regarding costs over the course of the palliative trajectory may improve access to care.
Role Model Behavior and Youth Violence: A Study of Positive and Negative Effects
Authors: Hurd Noelle M. , Zimmerman Marc A. , Reischl Thomas M.
Published: March 2010

The study investigated how role models’ behavior may positively or negatively influence African American early adolescents’ attitudes toward violence and violent behavior. Participants in this study included 331 African American seventh and eighth graders from low-income neighborhoods in an urban, Midwestern city. The study used a model developed and tested to assess the relationships between role model prosocial behavior, role model antisocial behavior, adolescents’ attitudes toward violence, and adolescents’ violent behavior. The model developed was assessed using structural equation modeling. Results revealed the following: (a) Role model prosocial behavior is indirectly related to less violent behavior through adolescents’ attitudes toward violence, (b) role model antisocial behavior is directly linked to increased violent behavior and indirectly linked to increased violent behavior through adolescents’ attitudes toward violence, and (c) role model antisocial behavior appear to have a stronger effect on African American early adolescents’ violent behavior than role model prosocial behavior. Possible explanations for study findings and implications are discussed.
Diagnostic Exercise
Authors: Foster A. P. , Twomey D. F. , Monie O. R. , Kiupel M. , Hoffmann I. , Willoughby K.
Published: March 2010

An 18-month-old cross-bred goat was presented with generalized erythema and thinning of the hair coat, as well as localized moderate scaling. Histopathological evaluation of skin biopsies showed hyperplasia and marked disruption of the infundibular epithelium owing to a predominant infiltrate of macrophages with multinucleated histiocytic giant cells and some lymphocytes, plasma cells, and eosinophils. Examination of peripheral blood and skin by polymerase chain reaction gave positive results for ovine herpesvirus type 2 consistent with a diagnosis of malignant catarrhal fever.
Retrospective Study of Spontaneous Osteosarcomas in the Nonobese Diabetic Strain and Nonobese Diabetic–Derived Substrains of Mice
Authors: Kavirayani A. M. , Foreman O.
Published: March 2010

In this retrospective study, spontaneous osteosarcomas were found in 85 of 1,202 (7.1%) nonobese diabetic (NOD) and NOD-derived mice. Gross tumors were evident at an average age of 155.8 days in male mice and 151.4 days in female mice. Compared with male mice, female mice had a statistically insignificant higher incidence: 56 cases (8.3% of 672) versus 28 cases (6.1% of 458). NOD/ShiLtJ mice had the highest incidence, with 39 cases among all the strains and substrains represented (3.2% of 1,202 necropsies), whereas NOD.SCID substrains had the highest incidence, with 16 cases among the various NOD-derived substrains (1.3% of 1,202 necropsies). There was a statistically significant difference in tumor incidence between NOD/ShiLtJ and NOD.SCID mice. Tumors were more frequent in the appendicular skeleton (55.7%) than in the axial skeleton (44.3%) and most often arose from the femurs. Histologically, osteoblastic osteosarcoma was the most common tumor type, with 79 cases (94%), followed by mixed osteosarcoma, with 5 cases (6%). Metastases were rare, with only 2 cases (2.3%).
Oblique Femoral Tunnel Placement Can Increase Risks of Short Femoral Tunnel and Cross-Pin Protrusion in Anterior Cruciate Ligament Reconstruction
Authors: Chang Chong Bum , Yoo Jae Ho , Chung Byung June , Seong Sang Cheol , Kim Tae Kyun
Published: March 2010

Background: A more horizontal femoral tunnel has been emphasized for contemporary anterior cruciate ligament (ACL) reconstruction. However, lowering the femoral tunnel may result in a shorter tunnel. In addition, a more horizontally placed femoral tunnel may have inadequate bone stock at the posterior portion of the tunnel, which can lead to protrusion of the cross-pin (Rigidfix) system for femoral fixation.

Hypothesis: A more horizontal femoral tunnel position, particularly via the anteromedial (AM) portal technique, will reduce femoral tunnel length, and a more horizontal femoral tunnel position and anterior-to-posterior pin insertion will increase the risk of Rigidfix pin protrusion.

Study Design: Controlled laboratory study.

Methods: In 10 cadaveric knees, we measured maximum lengths of the femoral tunnels at the positions of 11:30, 10:30, and 9:30 o’clock using the transtibial technique and at the 10:30 and 9:30 o’clock using the AM portal technique. Then, for each femoral tunnel via the transtibial technique at 11:30, 10:30, and 9:30 o’clock positions, tests were performed for 3 directions of Rigidfix pin insertion using the lateral epicondyle as an anatomical landmark, namely, 15° anterior to posterior (A-P), neutral, and 15° posterior to anterior (P-A). It was then determined whether pins protruded from the posterior cortex.

Results: The lengths of femoral tunnels produced using the transtibial technique became shorter as the femoral starting position became more horizontal (51.1 mm, 40.0 mm, and 34.2 mm on average at the 11:30, 10:30, and 9:30 o’clock position, respectively). Tunnels made using the AM portal technique were significantly shorter than those made using the transtibial technique: by 7.6 mm at the 10:30 o’clock and 4.5 mm at the 9:30 o’clock positions on average ( P < .001). In addition, increasing obliquity increased the likelihood of Rigidfix pin protrusion, especially when pins were inserted in the A-P direction.

Conclusion: The current effort to lower the femoral tunnel position in ACL reconstruction can shorten the tunnel length and compromise the graft fixation at the femur using the Rigidfix system.

Clinical Relevance: When an intended femoral tunnel position is more horizontal than the 10:30 o’clock position for ACL reconstruction, a surgeon needs to be cautious regarding a short femoral tunnel, particularly when using the AM portal technique, and possible protrusion of the cross-pin (Rigidfix) fixator.
Footwear Traction and Lower Extremity Joint Loading
Authors: Wannop John W. , Worobets Jay T. , Stefanyshyn Darren J.
Published: March 2010

Background: Traction is influenced by the sole architecture and playing surface, with increases in traction potentially leading to injury. The mechanism as to how or why increased traction could lead to injury remains unknown.

Purpose: This study was undertaken to determine how shoes of different sole designs and traction influence knee and ankle joint moments.

Study Design: Controlled laboratory study.

Methods: Traction testing was performed on 2 shoes of varying sole designs (tread vs smooth) using a robotic testing machine. All testing was conducted on a 60-cm × 90-cm piece of sample track surface. Kinematic and kinetic data were then collected on 13 recreational athletes performing running V-cuts in the 2 different shoe conditions. Five trials per condition were collected with reflective markers placed on the right shank and shoe of each participant. Kinematic and kinetic data were collected using an 8–high-speed camera system and force plate.

Results: The coefficient of translational traction and the peak moment of rotation were both significantly higher in the tread shoe compared with the smooth shoe (1.00 vs 0.87 and 23.87 N·m vs 16.12 N·m, respectively). The high-traction shoe had significantly higher peak ankle external rotation moments (89.58 N·m vs 80.17 N·m), peak knee external rotation moments (36.23 N·m vs 32.02 N·m), peak knee adduction moments (224.0 N·m vs 186.8 N·m), and knee adduction angular impulse (2.10 Nms vs 1.83 Nms) compared with the low-traction shoe.

Conclusion: Increased shoe traction significantly increased ankle and knee joint moments during a V-cut. Despite the significant difference in traction, no difference in performance was observed. These changes could have an effect on ankle and knee joint injury.

Clinical Relevance: Shoes with decreased traction could be used in sports to reduce the joint moments in the knee and ankle and potentially reduce injury without a loss in performance.
Chondrotoxicity of Low pH, Epinephrine, and Preservatives Found in Local Anesthetics Containing Epinephrine
Authors: Dragoo Jason L. , Korotkova Tatiana , Kim Hyeon Joo , Jagadish Anubhav
Published: March 2010

Background: Recent clinical and basic science investigations have revealed the chondrotoxicity of local anesthetics, especially those containing epinephrine, administered via an intra-articular pain pump. However, the exact mechanism of toxicity is unknown. This study evaluates the chondrotoxicity of low pH, epinephrine, and preservatives found in commonly used local anesthetics.

Hypothesis: The chondrotoxicity of local anesthetics containing epinephrine is due to low pH, epinephrine, or the preservative sodium metabisulfite.

Study Design: Controlled laboratory study.

Methods: Human chondrocytes were harvested and cultured in a custom bioreactor designed to simulate metabolism of medication. Pain pumps were used to infuse one of the following medications into the culture system: control media; media titrated to pH 4.5, 5.0, 5.5, 6.0, 6.5; media with 1:100000 or 1:200000 epinephrine only; media with 0.5 mg/mL of sodium metabisulfite preservative; media with 0.5 mg/mL of methylparaben preservative, 0.25% bupivacaine, 0.25% bupivacaine with epinephrine, 1% lidocaine, and 1% lidocaine with epinephrine. Cultures were perfused for 24 hours and then were stained with live/dead cell viability assay. The chondrocytes were then examined by fluorescence microscopy and counted, and the percentage of cell death was calculated.

Results: Cultures containing media titrated to pH 4.5 and 5.0 and local anesthetics containing epinephrine (pH 4.0-5.5) had high cell death rates compared with controls at all time points ( P < .001), while cultures containing 1:100000 and 1:200000 epinephrine alone had no increased death rate. Also, 0.5 mg/mL sodium metabisulfite preservative had a significant effect on cell death ( P < .034); however, the preservative methylparaben had no effect ( P > .05). The percentage of cell death was not significant for 1% lidocaine (12.5%; P > .943) and 0.25% bupivacaine (16.5%; P > .609).

Conclusion: The marked chondrotoxicity of local anesthetics containing epinephrine appears to be a combined effect of low pH, as these medications are titrated to pH 4.0 to 5.5 for product stability, and the preservative sodium metabisulfite. Extreme caution should be exercised when using intra-articular pain pumps with local anesthetics containing epinephrine.

Clinical Relevance: Understanding the causes of chondrotoxicity using local anesthetics containing epinephrine is critical to decrease complications associated with this class of medications.
Reducing Reading Failure for Kindergarten Urban Students
Authors: Yurick Amanda , Cartledge Gwendolyn , Kourea Lefki , Keyes Starr
Published: March 2010

Six instructional assistants taught the Early Reading Intervention (ERI) curriculum to 38 at-risk kindergarten students, and 32 nonrisk students served as comparisons. Student risk was determined based on performance on the Dynamic Indicators of Basic Early Literacy Skills subtests of Nonsense Word Fluency, Letter Naming Fluency, and Phoneme Segmentation Fluency (PSF). The Word Attack (WA) and Letter-Word Identification (LWID) subtests of the Woodcock–Johnson III Tests of Achievement were used to confirm risk status and also as pre- and posttest measures. Treatment students received between 6.85 and 13.70 hr of instruction, with varying degrees of treatment quality. Multiple linear regression was used to analyze the amount of variance in gain scores that could be explained by participation in ERI, treatment quality, and treatment duration. Results showed WA and LWID gains with large effect sizes for treatment students. Findings for treatment quality and duration were mixed, without clear indications of their effects on gain scores.
The Effects of Using the Transition Planning Inventory and a Structured IEP Process as a Transition Planning Intervention on IEP Meeting Outcomes
Authors: Rehfeldt Jason D. , Clark Gary M. , Lee Steven W.
Published: March 2010

This study examined two areas. First, the authors looked at whether secondary individualized education program (IEP) teams who used the Transition Planning Inventory (TPI) in conjunction with a structured IEP meeting that based discussions and decisions on TPI data as a planning intervention generated significantly more transition-related IEP goals. Second, the authors examined (a) whether parents reported after IEP meetings that they felt they had been heard and valued in their structured IEP process and (b) if all legally required transition-related IEP components had been discussed. From a convenience sample of three high schools in one large Midwestern suburban special education cooperative, 56 students and their families were randomly assigned to a control or an experimental (TPI and structured IEP process) group. Results indicated significantly more transition-related goals for the experimental group. In addition, parents of students in the experimental group were likely to report more satisfaction with the IEP process.
Affects of ionizing radiation on T-cell population lymphocyte: A risk factor of Irritable Bowel Syndrome
Authors: Sheikh Sajjadieh MR , Kuznetsova LV , Bojenko VB
Published: March 2010

Irritable bowel syndrome is observed mostly in Ukrainian children and may be related to adverse health effects as a result of the Chernobyl disaster. The aim of this study was to determine status of T-cell population lymphocytes in children with clinical symptom of irritable bowel syndrome. The test population consisted of 95 participants: 75 rural patients aged 4 to 18 who lived in a contaminated area exposed to natural environmental radiation with clinical symptom of irritable bowel syndrome (categorized in three groups) and 20 healthy urban participants from Kiev aged 5 to 15 as control group. Internal radiation activity has been measured by γ-ray spectrometry. Peripheral blood leukocytes were analyzed for T-lymphocytes subset such as T-lymphocytes (CD3+), T-helper (CD4+) and T-cytotoxic (CD8+) and then CD4/CD8 ratio was calculated. Percentage of CD3+ and CD4+ in all study groups decreased significantly in comparison to control group (p < 0.001). Percentage of CD8+ increased significantly in all study groups in comparison to control group (p < 0.05). The CD4/CD8 ratio decreased significantly all study groups in comparison to control group (p < 0.001). Cellular immune status of study groups that are residing in a contaminated area has changed. Our data have demonstrated that this change may be related to a higher incidence of children with irritable bowel syndrome.
Raspberries, Tablecloths, and Critical Thinking
Authors: Ozoliņa Liene
Published: March 2010

This article looks at three different sites in post-Soviet Latvia that have all been subject to liberal democratic reforms: the State Audit Office, a local municipality, and civic education classes in primary schools. These sites exemplify an introduction to the kind of accountability relations that are expected to exist in a liberal democracy. Through the lens of accountability, this article exposes how the democratic reform initiatives are taken up by Latvian citizens, in what has been called a “secondary production of knowledge,” to become part of their own tactics of survival and adjustment. The article reveals a sharp, morally charged juxtaposition of the “old” and the “new,” prevailing in the Latvian everyday reality. Governance reforms carry symbolic and moral urgency that stems from annihilation of the Soviet past. The reforms in this context serve as gestures to be made about one’s “modernness.” However, reorganization of governance practices on the ground reveals profound tensions when the new practices are endowed with locally relevant meanings. In this article, I attempt to demonstrate how the secondary production of knowledge coalesces into a sense of “cultural intimacy,” since often the individual’s deep commitment to the symbolic “new” has to coexist with awareness of one’s own incongruence with the new order.