bluuebunny/crossref_metadata_2025 huggingface dataset:
Protective measures and H5N1-seroprevalence among personnel tasked with bird collection during an outbreak of avian influenza A/H5N1 in wild birds, Ruegen, Germany, 2006
Authors: Cai Wei , Schweiger Brunhilde , Buchholz Udo , Buda Silke , Littmann Martina , Heusler Jörg , Haas Walter
Published: October 2009

Background

In Germany, the first outbreak of highly pathogenic avian influenza A/H5N1 occurred among wild birds on the island of Ruegen between February and April 2006. The aim of this study was to investigate the use of recommended protective measures and to measure H5N1-seroprevalence among personnel tasked with bird collection.

Methods

Inclusion criteria of our study were participation in collecting wild birds on Ruegen between February and March 2006. Study participants were asked to complete a questionnaire, and to provide blood samples. For evaluation of the use of protective measures, we developed a personal protective equipment (PPE)-score ranging between 0 and 9, where 9 corresponds to a consistent and complete use of PPE. Sera were tested by plaque neutralization (PN) and microneutralization (MN) assays. Reactive sera were reanalysed in the World Health Organization-Collaborating Centre (WHO-CC) using MN assay.

Results

Of the eligible personnel, consisting of firemen, government workers and veterinarians, 61% (97/154) participated in the study. Of those, 13% reported having always worn all PPE-devices during bird collection (PPE-score: 9). Adherence differed between firemen (mean PPE-score: 6.6) and government workers (mean PPE-score: 4.5; p = 0.006). The proportion of personnel always adherent to wearing PPE was lowest for masks (19%). Of the participants, 18% had received seasonal influenza vaccination prior to the outbreak. There were no reports of influenza-like illness. Five sera initially H5-reactive by PN assay were negative by WHO-CC confirmatory testing.

Conclusion

Gaps and variability in adherence demonstrate the risk of exposure to avian influenza under conditions of wild bird collection, and justify serological testing and regular training of task personnel.
The incidence and risk of developing a second primary esophageal cancer in patients with oral and pharyngeal carcinoma: a population-based study in Taiwan over a 25 year period
Authors: Lee Kuan-Der , Lu Chang-Hsien , Chen Ping-Tsung , Chan Chunghuang Hubert , Lin Jen-Tsun , Huang Cih-En , Chen Chih-Cheng , Chen Min-Chi
Published: October 2009

Background

The incidence of oral and pharyngeal (including oral cavity, oropharynx and hypopharynx) carcinoma increases rapidly in Asia and South Pacific because of betel quid chewing. Thus far, large-scale epidemiological studies are not available yet to stratify these patients by their risks of developing a second primary cancer in the digestive tract including esophagus, stomach, colon, and rectum.

Methods

A population-based study was conducted using the database from the Taiwan National Cancer Registry for the period 1979-2003. We quantified standardized incidence ratios (SIRs) and cumulative incidence of second primary cancers among 33,787 patients with initial diagnoses of oral and pharyngeal carcinoma.

Results

Among these four digestive tract organs, the esophagus was the only site of second cancer with excess risk in patients with oral and pharyngeal carcinoma. The incidence and risk of developing a second primary esophageal cancer differed by the site of the primary index tumor, most frequently seen in hypopharyngeal cancer (71/4,218 = 1.68%, SIR = 22.76, 95% CI 17.77-28.70), followed by oropharyngeal cancer (30/3,403 = 0.88%, SIR = 14.29, 95% CI 9.64-20.39) and the least in oral cavity cancer (99/26,166 = 0.38%, SIR = 5.57, 95% CI 4.53-6.78). In addition, the risk was extraordinarily high for patients with a follow-up interval ≤ 1 year and those with first primary cancer diagnosed at age ≤50. These patients may justify more close surveillance.

Conclusion

The present study represents the first population-based study in Asia attempting to stratify the patients of oral and pharyngeal carcinoma by their risk of developing a second esophageal cancer. It helps identify patients at high risk and tailor the application of intense follow-up surveillance to the estimated risk in each individual case.
Dietary supplementation by older adults in southern China: a hospital outpatient clinic study
Authors: Liang Wenbin , Lee Andy H , Binns Colin W
Published: October 2009

Background

There has been little knowledge about dietary supplementation by the Chinese elderly. The aim of this cross-sectional study was to investigate the usage of dietary supplements by older adults in southern China.

Methods

A total of 600 community-dwelling older adults were recruited from the outpatient clinics of three major hospitals in Foshan city between July 2007 and July 2008. Face-to-face interviews of participants were conducted to obtain information on demographics, lifestyle and dietary supplements use. Frequency and duration of usage were recorded for six categories of dietary supplements.

Results

Among the 446 consented participants (241 men and 205 women) who were over 55 years of age, 19.1% consumed one or more types of dietary supplements. The prevalence of usage was significantly higher (p = 0.008) for females (24.4%) than for males (14.5%). Dietary supplements were more likely to be consumed by non-smokers (p = 0.021) and those with hyperlipidemia (p = 0.003). The most popular supplement among users was calcium (53%). The majority (71%) of the users consumed supplements on a regular basis at one or more times per day, with an average duration of 2.95 (SD 4.80) years.

Conclusion

The overall prevalence of dietary supplementation in this older Chinese population was considerably lower than those in other Asia-Pacific countries.
An EIAV field isolate reveals much higher levels of subtype variability than currently reported for the equine lentivirus family
Authors: Craigo Jodi K , Barnes Shannon , Zhang Baoshan , Cook Sheila J , Howe Laryssa , Issel Charles J , Montelaro Ronald C
Published: October 2009

Background

Equine infectious anemia virus (EIAV), a lentivirus that infects horses, has been utilized as an animal model for the study of HIV. Furthermore, the disease associated with the equine lentivirus poses a significant challenge to veterinary medicine around the world. As with all lentiviruses, EIAV has been shown to have a high propensity for genomic sequence and antigenic variation, especially in its envelope (Env) proteins. Recent studies have demonstrated Env variation to be a major determinant of vaccine efficacy, emphasizing the importance of defining natural variation among field isolates of EIAV. To date, however, published EIAV sequences have been reported only for cell-adapted strains of virus, predominantly derived from a single primary virus isolate, EIAVWyoming(EIAVWY).

Results

We present here the first characterization of the Env protein of a natural primary isolate from Pennsylvania (EIAVPA) since the widely utilized and referenced EIAVWYstrain. The data demonstrated that the level of EIAVPAEnv amino acid sequence variation, approximately 40% as compared to EIAVWY, is much greater than current perceptions or published reports of natural EIAV variation between field isolates. This variation did not appear to give rise to changes in the predicted secondary structure of the proteins. While the EIAVPAEnv was serologically cross reactive with the Env proteins of the cell-adapted reference strain, EIAVPV(derivative of EIAVWY), the two variant Envs were shown to lack any cross neutralization by immune serum from horses infected with the respective virus strains.

Conclusion

Taking into account the significance of serum neutralization to universal vaccine efficacy, these findings are crucial considerations towards successful EIAV vaccine development and the potential inclusion of field isolate Envs in vaccine candidates.
A rare clinic presentation of abdominal pain: rupture of splenic artery aneurysm: a case report
Authors: Sarikaya Sezgin , Ekci Baki , Aktas Can , Cetin Asli , Ay Didem , Demirag Alp
Published: October 2009

Background

Splenic artery aneurysms (SAA) are uncommon but the most common visceral artery aneurysm. Splenic artery aneurysms are important to recognize because up to 25% may be complicated by rupture and the mortality rate after rupture is between 25% and 70%.

Case report

We present a patient who have abdominal pain. Previously healthy 22-year-old female admitted to emergency department with abdominal pain. Her physical examination reveals only left upper quadrant tenderness. Suddenly she developed hypovolemic shock. On emergent laparotomy massive blood collection within peritoneal cavity and retroperitoneal space at the left upper quadrant was detected. The source of bleeding was evident as rupture of splenic artery aneurysm. Splenectomy was performed following the ligation of splenic artery proximal to lesion. On the tenth day she was discharged from the hospital with complete recovery.

Conclusion

It is important to remember rupture of splenic artery aneurysm in patients with abdominal pain and hypovolemic shock status.
Animal models for clinical and gestational diabetes: maternal and fetal outcomes
Authors: Kiss Ana CI , Lima Paula HO , Sinzato Yuri K , Takaku Mariana , Takeno Marisa A , Rudge Marilza VC , Damasceno Débora C
Published: October 2009

Background

Diabetes in pregnant women is associated with an increased risk of maternal and neonatal morbidity and remains a significant medical challenge. Diabetes during pregnancy may be divided into clinical diabetes and gestational diabetes. Experimental models are developed with the purpose of enhancing understanding of the pathophysiological mechanisms of diseases that affect humans. With regard to diabetes in pregnancy, experimental findings from models will lead to the development of treatment strategies to maintain a normal metabolic intrauterine milieu, improving perinatal development by preventing fetal growth restriction or macrosomia. Based on animal models of diabetes during pregnancy previously reported in the medical literature, the present study aimed to compare the impact of streptozotocin-induced severe (glycemia >300 mg/dl) and mild diabetes (glycemia between 120 and 300 mg/dl) on glycemia and maternal reproductive and fetal outcomes ofWistarrats to evaluate whether the animal model reproduces the maternal and perinatal results of clinical and gestational diabetes in humans.

Methods

On day 5 of life, 96 femaleWistarrats were assigned to three experimental groups: control (n = 16), severe (n = 50) and mild diabetes (n = 30). At day 90 of life, rats were mated. On day 21 of pregnancy, rats were killed and their uterine horns were exposed to count implantation and fetus numbers to determine pre- and post-implantation loss rates. The fetuses were classified according to their birth weight.

Results

Severe and mild diabetic dams showed different glycemic responses during pregnancy, impairing fetal glycemia and weight, confirming that maternal glycemia is directly associated with fetal development. Newborns from severe diabetic mothers presented growth restriction, but mild diabetic mothers were not associated with an increased rate of macrosomic fetuses.

Conclusion

Experimental models of severe diabetes during pregnancy reproduced maternal and fetal outcomes of pregnant women presenting uncontrolled clinical diabetes. On the other hand, the mild diabetes model caused mild hyperglycemia during pregnancy, although it was not enough to reproduce the increased rate of macrosomic fetuses seen in women with gestational diabetes.
Randomized Phase III Trial on Gemcitabine Versus Mytomicin in Recurrent Superficial Bladder Cancer: Evaluation of Efficacy and Tolerance
Authors: Addeo Raffaele , Caraglia Michele , Bellini Sergio , Abbruzzese Alberto , Vincenzi Bruno , Montella Liliana , Miragliuolo Antonio , Guarrasi Rosario , Lanna Michele , Cennamo Gregorio , Faiola Vincenzo , Del Prete Salvatore
Published: October 2009

Purpose

Approximately 30% to 40% patients with a superficial bladder cancer treated with Bacille Calmette-Guerin (BCG) or epirubicin do not respond; of the initial responders, 35% have a relapse within 5 years. We compare the therapeutic efficacy and toxicity of intravescical infusions of gemcitabine (GEM) with mitomycin (MMC) in patients with a recurrent superficial bladder cancer.

Patients and Methods

Patients with a history of a previously treated, recurrent Ta-T1, G1-G3 bladder transitional cell carcinoma were enrolled in the study. The patients received a 6-week course of GEM infusions or 4-week course of MMC. In both arms, for the initial responders who remained free of recurrences, maintenance therapy consisted of 10 monthly treatments during the first year.

Results

A total of 120 patients were enrolled and randomly assigned to either the MMC or GEM treatment arm. At the end of the study, 109 patients (55 in MMC and 54 in GEM) were assessable. The median duration of follow-up was 36 months for either arm. In the GEM arm, 39 (72%) of 54 patients remained free of recurrence versus 33 (61%) of 55 in MMC arm. Among patients with recurrences, 10 in the MMC arm and six in the GEM arm also had a progressive disease by stage. The incidence of chemical cystitis in the MMC arm was statistically higher than in the GEM arm (P = .012).

Conclusion

This study demonstrates that GEM has better efficacy and lower toxicity than MMC; therefore, GEM appears as a logical candidate for intrabladder therapy in patients with refractory transitional cancer.
Clinically Driven Diagnostic Antifungal Approach in Neutropenic Patients: A Prospective Feasibility Study
Authors: Girmenia Corrado , Micozzi Alessandra , Gentile Giuseppe , Santilli Stefania , Arleo Eva , Cardarelli Luisa , Capria Saveria , Minotti Clara , Cartoni Claudio , Brocchieri Simonetta , Guerrisi Vito , Meloni Giovanna , Foà Robin , Martino Pietro
Published: October 2009

Purpose

Preemptive strategies in neutropenic patients based on serum galactomannan (GM) –guided triggering of diagnostic work-up may be time-consuming and expensive when applied to the entire population. We have assessed the feasibility of a clinically driven diagnostic strategy without GM screening.

Patients and Methods

Patients with neutropenic fever underwent a baseline diagnostic work-up (BDWU; three blood cultures and other examinations as indicated). An intensive diagnostic work-up (IDWU; GM for 3 days, chest computed tomography and other examinations as indicated) was reserved for patients with 4 days of persisting or relapsing fever or with other clinical findings possibly related to an invasive fungal diseaser (IFD). Antifungal therapy was administered to patients diagnosed with IFD and empirically (negative IDWU) only to those with persisting neutropenic fever and worsening clinical conditions.

Results

Of 220 neutropenia episodes, fever occurred in 159 cases and recurred in 28 cases. Overall, 49 IFDs were diagnosed (two by BDWU and 47 by IDWU) during 48 episodes (21.8%). Diagnostic-driven therapy was administered to 48 patients with IFDs; one patient with zygomycosis died without treatment. Only one patient received empirical therapy. IDWU was required in 40% of neutropenia episodes, and only 1.4 mean blood samples per neutropenia episode were tested for GM. Our strategy allowed a 43% reduction in antifungal treatments compared with a standard empirical approach. At 3-month follow-up, 63% of patients with IFD survived, and no undetected IFDs were found.

Conclusion

A clinically driven diagnostic approach in selected neutropenia episodes offered effective antifungal control and reduced the exposure to unnecessary antifungal treatment.
Outcome of Patients Treated for Relapsed or Refractory Acute Lymphoblastic Leukemia: A Therapeutic Advances in Childhood Leukemia Consortium Study
Authors: Ko Richard H. , Ji Lingyun , Barnette Phillip , Bostrom Bruce , Hutchinson Raymond , Raetz Elizabeth , Seibel Nita L. , Twist Clare J. , Eckroth Elena , Sposto Richard , Gaynon Paul S. , Loh Mignon L.
Published: October 2009

Purpose

Despite improvements in treatment, approximately 20% of patients with acute lymphoblastic leukemia (ALL) experience relapse and do poorly. The Therapeutic Advances in Childhood Leukemia (TACL) Consortium was assembled to assess novel drugs for children with resistant leukemia. We hypothesize that novel agents and combinations that fail to improve baseline complete remission rates in comparable populations are unlikely to contribute to better outcomes and should be abandoned. We sought to define response rates and disease-free survival (DFS) rates in patients treated at TACL institutions, which could serve as a comparator for future studies.

Patients and Methods

We performed a retrospective cohort review of patients with relapsed and refractory ALL previously treated at TACL institutions between the years of 1995 and 2004. Data regarding initial and relapsed disease characteristics, disease response, and survival were collected and compared with those of published reports.

Results

Complete remission (CR) rates (mean ± SE) were 83% ± 4% for early first marrow relapse, 93% ± 3% for late first marrow relapse, 44% ± 5% for second marrow relapse, and 27% ± 6% for third marrow relapse. Five-year DFS rates in CR2 and CR3 were 27% ± 4% and 15% ± 7% respectively.

Conclusion

We generally confirm a 40% CR rate for second and subsequent relapse, but our remission rate for early first relapse seems better than that reported in the literature (83% v approximately 70%). Our data may allow useful modeling of an expected remission rate for any population of patients who experience relapse.
Suicide Ideation in Adult Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study
Authors: Recklitis Christopher J. , Diller Lisa R. , Li Xiaochun , Najita Julie , Robison Leslie L. , Zeltzer Lonnie
Published: October 2009

Purpose

To evaluate risk of suicide ideation (SI) after childhood cancer, prevalence of SI in a cohort of adult survivors of pediatric cancers was compared with prevalence in a sibling comparison group. The relationship of SI to cancer treatment and current health was examined, and the hypothesis that poor physical health is significantly associated with suicidality, after adjusting for depression, was specifically tested.

Methods

Nine thousand one hundred twenty-six adult survivors of childhood cancer and 2,968 siblings enrolled onto the Childhood Cancer Survivor Study completed a survey describing their demographics and medical and psychological functioning, including SI in the prior week.

Results

Of survivors, 7.8% reported SI compared with 4.6% of controls (odds ratio = 1.79; 95% CI, 1.4 to 2.4). Suicidality was unrelated to age, age at diagnosis, sex, cancer therapy, recurrence, time since diagnosis, or second malignancy. SI was associated with primary CNS cancer diagnosis, depression, and poor health outcomes including chronic conditions, pain, and poor global health rating. A logistic regression analysis showed that poor current physical health was significantly associated with SI even after adjusting for cancer diagnosis and depression.

Conclusion

Adult survivors of childhood cancers are at increased risk for SI. Risk of SI is related to cancer diagnosis and post-treatment mental and physical health, even many years after completion of therapy. The association of suicidal symptoms with physical health problems is important because these may be treatable conditions for which survivors seek follow-up care and underscores the need for a multidisciplinary approach to survivor care.
Oestradiol assays: fitness for purpose?
Authors: Middle Jonathan G , Kane John W
Published: October 2009

In this review we discuss the analytical inadequacies of oestradiol assays in relation to the clinical requirements for performing them, and make recommendations for their improvement. The measurement of oestradiol can be requested in a number of clinical scenarios (precocious puberty, infertility, assisted conception, hormone replacement therapy). The very wide dynamic range of oestradiol concentrations is a huge challenge for routine assays, which they are unlikely to meet on theoretical as well as practical grounds. The EQA performance of oestradiol assays in terms of trueness, comparability, recovery and analytical sensitivity leaves much to be desired and indicates that calibration is compromised by poor analytical specificity. To make oestradiol assays fit for purpose requires concerted action by all stakeholders to define analytical quality specifications for the various clinical scenarios involved, and then to encourage concerted action by the diagnostic industry to use the steroid reference measurement system to improve specificity, trueness and traceability.
Developing community and social cohesion through grassroots bridge-building: an exploration
Authors: Harris Margaret , Young Patricia
Published: October 2009

In the context of the UK public policy goal to increase community and social cohesion, this article explores the nature of local ‘bridge-building’ – activities intended to increase interpersonal contacts between diverse ethnic, faith and nationality groups. We draw on earlier research in a range of fields to develop the bridge-building concept and present findings from a study that identified community-level projects with bridge-building as a specific aim. We show the range of groupings involved, the activities encompassed and their organisational features. We consider the actual and potential contribution of local bridge-building to cohesion in the light of earlier research and our own study.
Thematic Review: Reinventing governance, reinventing democracy?
Authors: Pierre Jon
Published: October 2009

Public service systems are transforming into market-like organisations of service delivery and in many countries there is experimentation with user boards, customer choice, and stakeholderism. Meanwhile, democratic governance looks surprisingly much like the way it did 25 or 50 years ago. This article reviews the transformation of governance from the vantage point of democratic values. The basic argument of the article is that western democracies are currently implementing governance reform and administrative reform to increase public sector efficiency without much reflection on the democratic ramifications of reform.
Measurement of ability emotional intelligence: Results for two new tests
Authors: Austin Elizabeth J.
Published: October 2009

Emotional intelligence (EI) has attracted considerable interest amongst both individual differences researchers and those in other areas of psychology who are interested in how EI relates to criteria such as well‐being and career success. Both trait (self‐report) and ability EI measures have been developed; the focus of this paper is on ability EI. The associations of two new ability EI tests with psychometric intelligence, emotion perception, and the Mayer–Salovey–Caruso EI test (MSCEIT) were examined. The new EI tests were the Situational Test of Emotion Management (STEM) and the Situational Test of Emotional Understanding (STEU). Only the STEU and the MSCEIT Understanding Emotions branch were significantly correlated with psychometric intelligence, suggesting that only understanding emotions can be regarded as a candidate new intelligence component. These understanding emotions tests were also positively correlated with emotion perception tests, and STEM and STEU scores were positively correlated with MSCEIT total score and most branch scores. Neither the STEM nor the STEU were significantly correlated with trait EI tests, confirming the distinctness of trait and ability EI. Taking the present results as a starting‐point, approaches to the development of new ability EI tests and models of EI are suggested.
Mastectomy, body deconstruction, and impact on identity: A qualitative study
Authors: Piot‐Ziegler C. , Sassi M.‐L. , Raffoul W. , Delaloye J.‐F.
Published: October 2009

Objectives.This qualitative study aims at understanding the consequences of body deconstruction through mastectomy on corporality and identity in women with breast cancer.

Design.Nineteen women were contacted through the hospital. All had to undergo mastectomy. Some were offered immediate breast reconstruction, others, because of cancer treatments, had no planned reconstruction. A qualitative reflexive methodological background was chosen.

Method.Women were invited to participate in three semi‐structured interviews, one shortly before or after mastectomy, and the other interviews later in their illness courses, after surgery. All interviews were transcribed verbatim. Thematic analysis was performed. The analysis of the first interview of each woman is presented in this article.

Results.Mastectomy provokes a painful experience of body deconstruction. Even when immediate reconstruction is proposed, contrasted feelings and dissonance are expressed when comparing the former healthy body to the present challenged body entity. Body transformations are accompanied with experiences of mutilation, strangeness, and modify the physical, emotional social, symbolic and relational dimensions of the woman's gendered identity. Although the opportunity of breast reconstruction is seen as a possible recovery of a lost physical symmetry and body integrity, grieving the past body and integrating a new corporality leads to a painful identity crisis.

Conclusion.With mastectomy, the roots of the woman's identity are challenged, leading to a re‐evaluation of her existential values. The consequences of mastectomy transform the woman's corporality and embodiment, and question her identity. Psychological support is discussed in the perspective of our results.
Postmenopausal women with osteopenia have higher cortical porosity and thinner cortices at the distal radius and tibia than women with normal aBMD: An in vivo HR-pQCT study
Authors: Nishiyama Kyle K , Macdonald Heather M , Buie Helen R , Hanley David A , Boyd Steven K
Published: October 2009

Increases in cortical porosity (Ct.Po) and decreases in cortical thickness (Ct.Th) are associated with increased bone fragility. The purpose of this study was to validate an autosegmentation method for high-resolution peripheral quantitative computed tomography (HR-pQCT) scans to measure Ct.Po and Ct.Th and use it to compare Ct.Po and Ct.Th between pre- and postmenopausal women with normal, osteopenic, and osteoporotic areal bone mineral density (aBMD). The Ct.Po and Ct.Th measurements were validated using cadaver forearms (n = 10) and micro-computed tomography (µCT) as the gold standard. The analysis was applied to distal radius and tibia HR-pQCT scans from a subset of participants from the Calgary, Alberta, cohort of the Canadian Multicentre Osteoporosis Study (n = 280, 18 to 90 years). Analysis of covariance compared Ct.Po and Ct.Th outcomes between 63 normal premenopausal (dual-energy X-ray absorptiometry femoral neck T-score > −1), 87 normal postmenopausal, 121 osteopenic postmenopausal, and 9 osteoporotic postmenopausal women. Linear regression analysis and Bland-Altman plots were used to assess the agreement between the HR-pQCT and µCT measurements, resulting in r2 values of 0.80 for Ct.Po and 0.98 for Ct.Th. At both sites, Ct.Po was higher in postmenopausal (all groups) than in premenopausal women (3.2% to 12.9%, p < .001). Ct.Th was not significantly different between normal premenopausal and postmenopausal women at either site; however, both osteopenic and osteoporotic women had thinner (−12.8% to −30.3%, p < .01), more porous (2.1% to 8.1%, p < .001) cortices than normal postmenopausal women. Our method offers promise as a valuable tool to measure Ct.Po and Ct.Th in vivo and investigate associations among cortical bone structure, age, and disease status. © 2010 American Society for Bone and Mineral Research.
Acute phosphate restriction leads to impaired fracture healing and resistance to BMP-2
Authors: Wigner Nathan A , Luderer Hilary F , Cox Megan K , Sooy Karen , Gerstenfeld Louis C , Demay Marie B
Published: October 2009

Hypophosphatemia leads to rickets and osteomalacia, the latter of which results in decreased biomechanical integrity of bones, accompanied by poor fracture healing. Impaired phosphate-dependent apoptosis of hypertrophic chondrocytes is the molecular basis for rickets. However, the underlying pathophysiology of impaired fracture healing has not been characterized previously. To address the role of phosphate in fracture repair, mice were placed on a phosphate-restricted diet 2 days prior to or 3 days after induction of a mid-diaphyseal femoral fracture to assess the effects of phosphate deficiency on the initial recruitment of mesenchymal stem cells and their subsequent differentiation. Histologic and micro-computed tomographic (µCT) analyses demonstrated that both phosphate restriction models dramatically impaired fracture healing primarily owing to a defect in differentiation along the chondrogenic lineage. Based on Sox9 and Sox5 mRNA levels, neither the initial recruitment of cells to the callus nor their lineage commitment was effected by hypophosphatemia. However, differentiation of these cells was impaired in association with impaired bone morphogenetic protein (BMP) signaling. In vivo ectopic bone-formation assays and in vitro investigations in ST2 stromal cells confirmed that phosphate restriction leads to BMP-2 resistance. Marrow ablation studies demonstrate that hypophosphatemia has different effects on injury-induced intramembranous bone formation compared with endochondral bone formation. Thus phosphate plays an important role in the skeleton that extends beyond mineralized matrix formation and growth plate maturation and is critical for endochondral bone repair. © 2010 American Society for Bone and Mineral Research
Different indices of fetal growth predict bone size and volumetric density at 4 years of age
Authors: Harvey Nicholas C , Mahon Pamela A , Robinson Sian M , Nisbet Corrine E , Javaid M Kassim , Crozier Sarah R , Inskip Hazel M , Godfrey Keith M , Arden Nigel K , Dennison Elaine M , Cooper Cyrus
Published: October 2009

We have demonstrated previously that higher birth weight is associated with greater peak and later-life bone mineral content and that maternal body build, diet, and lifestyle influence prenatal bone mineral accrual. To examine prenatal influences on bone health further, we related ultrasound measures of fetal growth to childhood bone size and density. We derived Z-scores for fetal femur length and abdominal circumference and conditional growth velocity from 19 to 34 weeks' gestation from ultrasound measurements in participants in the Southampton Women's Survey. A total of 380 of the offspring underwent dual-energy X-ray absorptiometry (DXA) at age 4 years [whole body minus head bone area (BA), bone mineral content (BMC), areal bone mineral density (aBMD), and estimated volumetric BMD (vBMD)]. Volumetric bone mineral density was estimated using BMC adjusted for BA, height, and weight. A higher velocity of 19- to 34-week fetal femur growth was strongly associated with greater childhood skeletal size (BA: r = 0.30, p < .0001) but not with volumetric density (vBMD: r = 0.03, p = .51). Conversely, a higher velocity of 19- to 34-week fetal abdominal growth was associated with greater childhood volumetric density (vBMD: r = 0.15, p = .004) but not with skeletal size (BA: r = 0.06, p = .21). Both fetal measurements were positively associated with BMC and aBMD, indices influenced by both size and density. The velocity of fetal femur length growth from 19 to 34 weeks' gestation predicted childhood skeletal size at age 4 years, whereas the velocity of abdominal growth (a measure of liver volume and adiposity) predicted volumetric density. These results suggest a discordance between influences on skeletal size and volumetric density. © 2010 American Society for Bone and Mineral Research
Vessel formation is induced prior to the appearance of cartilage in BMP-2-mediated heterotopic ossification
Authors: Dilling Christine Fouletier , Wada Aya M , Lazard Zawaunyka W , Salisbury Elizabeth A , Gannon Francis H , Vadakkan Tegy J , Gao Liang , Hirschi Karen , Dickinson Mary E , Davis Alan R , Olmsted-Davis Elizabeth A
Published: October 2009

Heterotopic ossification (HO), or endochondral bone formation at nonskeletal sites, often results from traumatic injury and can lead to devastating consequences. Alternatively, the ability to harness this phenomenon would greatly enhance current orthopedic tools for treating segmental bone defects. Thus, understanding the earliest events in this process potentially would allow us to design more targeted therapies to either block or enhance this process. Using a murine model of HO induced by delivery of adenovirus-transduced cells expressing bone morphogenetic protein 2 (BMP-2), we show here that one of the earliest stages in this process is the establishment of new vessels prior to the appearance of cartilage. As early as 48 hours after induction of HO, we observed the appearance of brown adipocytes expressing vascular endothelial growth factors (VEGFs) simultaneous with endothelial progenitor replication. This was determined by using a murine model that possesses the VEGF receptor 2 (Flk1) promoter containing an endothelial cell enhancer driving the expression of nuclear-localized yellow fluorescent protein (YFP). Expression of this marker has been shown previously to correlate with the establishment of new vasculature, and the nuclear localization of YFP expression allowed us to quantify changes in endothelial cell numbers. We found a significant increase in Flk1-H2B::YFP cells in BMP-2-treated animals compared with controls. The increase in endothelial progenitors occurred 3 days prior to the appearance of early cartilage. The data collectively suggest that vascular remodeling and growth may be essential to modify the microenvironment and enable engraftment of the necessary progenitors to form endochondral bone. © 2010 American Society for Bone and Mineral Research
War on Terror war on democracy?
Authors: Bondebjerg Ib
Published: October 2009

This article deals with the effect of 9/11 and the subsequent War on Terror in media in the United States, the United Kingdom and Denmark. The focus is particularly on documentary films and programmes and the investigative genre. Structural and long-term media developments in both the United States and Europe have, since 2000, undermined and weakened the role of critical, investigative documentaries. The effect of the War on Terror on media and democratic, public dialogue and criticism was clearly a further weakening of dissenting, documentary voices. The strong tradition in Europe for public service film and television cultures had to face up to severe political criticism and attacks on their independence when broadcasting critical documentaries on the War on Terror, and in the United States the independent voices were even more marginalized from the mainstream media.
Molecular Characterization of the Key Switch F Provides a Basis for Understanding the Rapid Divergence of the Sex-Determining Pathway in the Housefly
Authors: Hediger Monika , Henggeler Caroline , Meier Nicole , Perez Regina , Saccone Giuseppe , Bopp Daniel
Published: October 2009

The housefly, Musca domestica, is an excellent model system to study the diversification of the pathway that specifies the sexual fate. A number of different mechanisms have been described in the housefly, which reflects in part the broad diversity of sex-determining strategies used in insects. In this study we present the molecular identification and characterization of F, which acts as the master switch in the housefly pathway. We provide evidence that F corresponds to the transformer ortholog in Musca (Mdtra), which, as a result of alternative processing, expresses functional products only in individuals committed to the female fate. We demonstrate that, once activated, a self-sustaining feedback loop will maintain the female-promoting functions of Mdtra. Absence of Mdtra transcripts in eggs of Arrhenogenic (Ag) mutant females suggests that maternally deployed Mdtra activity initiates this self-sustaining loop in the zygote. When an M factor is paternally transmitted to the zygote, the establishment of the loop is prevented at an early stage before cellularization and splicing of Mdtra shifts irreversibly to the male nonproductive mode. On the basis of the analysis of two mutant alleles we can explain the different sex-determining systems in the housefly largely as deviations at the level of Mdtra regulation. This plasticity in the housefly pathway may provide a suitable framework to understand the evolution of sex-determining mechanisms in other insect species. For instance, while sex determination in a close relative, the tsetse fly Glossina morsitans, differs at the level of the instructive signal, we find that its tra ortholog, Gmtra, is regulated in a mode similar to that of Mdtra.
“Hypothesis of Seven Balances”: Molecular Mechanisms behind Alcoholic Liver Diseases and Association with PPARα
Authors: Moriya Takashi , Naito Hisao , Ito Yuki , Nakajima Tamie
Published: October 2009

“Hypothesis of Seven Balances”: Molecular Mechanisms behind Alcoholic Liver Diseases and Association with PPARα: Takashi Moriya,et al. Department of Occupational and Environmental Health, Nagoya University Graduate School of Medicine

Objectives

The purpose of this review to collate current leading scientific advances of molecular mechanisms in alcoholic liver diseases and to propose a working “hypothesis of seven balances” in relation to peroxisome proliferator activated receptor α (PPARα), which has important roles in fatty acid oxidation, oxidative stress, inflammatory responses, and possibly liver fibrosis.

Methods

We conducted an extensive literature review of over a hundred publications and collated the findings with evidence generated in our laboratory.

Results

Our research points to a working hypothesis of seven balances for alcoholic liver diseases consisting of: 1) ethanol oxidation balance in hepatocytes; 2) PPARα activities in liver; 3) fatty acid metabolism balance in hepatic mitochondria; 4) gastrointestinal response to ethanol, acetaldehyde and lipopolysaccharide (LPS); 5) Kupffer cells response to LPS, oxidative stress and inflammatory cytokines; 6) adiponectin levels in plasma interchangeably regulated by tumor necrosis factor‐α (TNF‐α); and 7) stellate cells response to all of the above promoting hepatic fibrosis. Cellular mechanisms behind alcoholic liver diseases reveal close temporal associations of PPARα, adiponectin, TNF‐α, cellular inflammation, proliferation, and potentially fibrosis as illustrated in “the hypothesis of seven balances.”

Conclusions

The regulation and adjustment of PPARα activation underlying the balance of molecular cascades might resolve the progression of alcoholic liver diseases by reducing oxidative stress and inflammatory effects induced by nuclear factor‐κB as well as the associated adiponectin pathway. Further elucidation of these pathways would reveal exciting new prospects for treating alcoholic liver diseases and other related liver disorders.
Outdoor Workers' Perceptions of the Risks of Excess Sun‐Exposure
Authors: McCool Judith P. , Reeder Anthony I. , Robinson Elizabeth M. , Petrie Keith J. , Gorman Des F.
Published: October 2009

Outdoor Workers' Perceptions of the Risks of Excess Sun‐Exposure: Judith P. McCool, et al. School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, New Zealand

Objectives

To describe the pattern of associations with sunscreen use of sun protection attitudes and knowledge in a large sample of New Zealand outdoor workers. We also examined the relationship between perceived skin type and perceived risk of developing skin cancer.

Methods

Outdoor workers from nine occupational groups (n=1,131) completed a questionnaire, which included measures of skin cancer related risk perceptions, knowledge and sunscreen use.

Results

Sunscreen use was associated with perceived prioritization of sun‐protection, concern about sun‐exposure, knowledge about the effects of sun‐exposure and perceived supportive workplace culture. These variables accounted for 37% of the variation in sunscreen use. Maori, younger workers and forestry workers least likely to report sunscreen use and sun‐exposure risk perception.

Conclusions

Interventions that strengthen knowledge about risks and values of sun protection are likely to increase sun protection efforts. However, interventions for outdoor workers need to take into account potential socio‐demographic, personal and workplace influences are required to prevent the risk of developing non‐melanoma skin cancers within this population group.
Coping Skills Training to Reduce Psychosocial Risk Factors for Medical Disorders: A Field Trial Evaluating Effectiveness in Multiple Worksites
Authors: Williams Virginia P. , Brenner Sharon L. , Helms Michael J. , Williams Redford B.
Published: October 2009

Coping Skills Training to Reduce Psychosocial Risk Factors for Medical Disorders: A Field Trial Evaluating Effectiveness in Multiple Worksites: Virginia P. Williams, et al. Williams LifeSkills, Inc., USA

Objective

To determine whether a commercial coping skills training program shown to reduce psychosocial risk factors in randomized clinical trials of patients with coronary heart disease is also effective in achieving similar improvements among stressed workers in a real world corporate setting.

Methods

Conduct an observational trial to evaluate the impact of the Williams LifeSkillsR Workshop on depression, social support, anxiety, and hostility in a sample of 110 employees working at multiple U.S. sites of a client of Williams LifeSkills, Inc.

Results

All psychosocial risk factors showed highly significant improvements from pre‐ to post‐training. Except for social support, these improvements were maintained at six months follow‐up.

Conclusions

These findings provide support for the effectiveness of the Williams LifeSkillsR Workshop by suggesting that its efficacy, as demonstrated in randomized clinical trials, generalizes to real world settings like the multiple U.S. work sites of a corporate client.
Occupational Exposure Levels of Bisphenol A among Chinese Workers
Authors: He Yonghua , Miao Maohua , Wu Chunhua , Yuan Wei , Gao Ersheng , Zhou Zhijun , Li De‐Kun
Published: October 2009

Occupational Exposure Levels of Bisphenol A among Chinese Workers: Yonghua He, et al. School of Public Health/WHO Collaborating Center for Occupational Health, Fudan University, PR China

Objectives

The purpose of this study was to assess ambient Bisphenol A (BPA) levels in workplaces and urine BPA levels of workers.

Methods

Workers in epoxy resin and BPA manufacturing factories were recruited. Personal samples for airborne BPA were taken in the workshops and spot urine samples were collected from workers before and after their shifts. The samples were assayed with high‐performance liquid chromatography with a fluorescence detector. TWA 8 of airborne PBA in the workplaces and biological BPA burden of the workers were calculated. Correlations between the external and the internal exposure levels were sought.

Results

Workers from the factories were occupationally exposed to BPA at median personal airborne levels of 6.67 µg/m3(or at the mean of 450 µg/m3). More than 90% of the workers who were occupationally exposed to BPA had detectable BPA levels in their blood samples. The medians of creatinine‐adjusted urinary BPA levels were 84.6 µg/g Cr and 111 µg/g Cr pre‐ and post‐shift (means of 4,630 µg/g Cr and 5,400 µg/g Cr), respectively. The urinary BPA concentration post‐shift was significantly associated with the urinary BPA level pre‐shift and personal airborne BPA levels.

Conclusions

It was indicated that workers in epoxy resin and BPA manufacturing factories are occupationally exposed to BPA at high levels. There is an urgent need to create occupational standards and take effective preventive measures to protect workers from the potential adverse effects of BPA.
A Medical Home Versus Temporary Housing: The Importance of a Stable Usual Source of Care
Authors: DeVoe Jennifer E. , Saultz John W. , Krois Lisa , Tillotson Carrie J.
Published: October 2009

OBJECTIVES: Little is known about how the stability of a usual source of care (USC) affects access to care. We examined the prevalence of USC changes among low-income children and how these changes were associated with unmet health care need.

METHODS: We conducted a cross-sectional survey of Oregon's food stamp program in 2005. We analyzed primary data from 2681 surveys and then weighted results to 84087 families, adjusting for oversampling and nonresponse. We then ascertained the percentage of children in the Oregon population who had ever changed a USC for insurance reasons, which characteristics were associated with USC change, and how USC change was associated with unmet need. We also conducted a posthoc analysis of data from the Medical Expenditure Panel Survey to confirm similarities between the Oregon sample and a comparable national sample.

RESULTS: Children without a USC in the Oregon population had greater odds of reporting an unmet health care need than those with a USC. This pattern was similar in national estimates. Among the Oregon sample, 23% had changed their USC because of insurance reasons, and 10% had no current USC. Compared with children with a stable USC, children who had changed their USC had greater odds of reporting unmet medical need, unmet prescription need, delayed care, unmet dental need, and unmet counseling need.

CONCLUSIONS: This study highlights the importance of ensuring stability with a USC. Moving low-income children into new medical homes could disturb existing USC relationships, thereby merely creating “temporary housing.”
Who Will Care for Me Next? Transitioning to Adulthood With Hydrocephalus
Authors: Simon Tamara D. , Lamb Sara , Murphy Nancy A. , Hom Bonnie , Walker Marion L. , Clark Edward B.
Published: October 2009

OBJECTIVES: Hydrocephalus is a prototypical chronic condition that follows children into adulthood. The objectives of this study were to (1) review how the health care needs of young adults with hydrocephalus are not being met, (2) estimate the numbers of adults with childhood-onset hydrocephalus, (3) describe a novel program to provide care for young adults with hydrocephalus and other chronic pediatric conditions, and (4) propose national strategies to promote successful hydrocephalus transition care.

RESULTS: Adults with hydrocephalus need continuous access to expert surgical and medical providers. Existing care models fail to meet this need. The number of young adults who have hydrocephalus, are aged 18 to 35 and need treatment in the United States is predicted to exceed 40000 annually within the next 2 decades. We are developing integrated teams of pediatric and adult medical and surgical specialists to provide continuous, coordinated, comprehensive care for individuals with hydrocephalus in a pediatric setting. This setting will train our future physician workforce on optimal transition care. Coordinated national efforts are also needed.

CONCLUSIONS: Providers need to implement appropriate management and transition care for individuals with hydrocephalus. We must work at local and national levels to transform the care model, improve the quality of health care delivery, and improve outcomes for young adults with hydrocephalus.