bluuebunny/crossref_metadata_2025 huggingface dataset:
Integrated multi-level quality control for proteomic profiling studies using mass spectrometry
Authors: Cairns David A , Perkins David N , Stanley Anthea J , Thompson Douglas , Barrett Jennifer H , Selby Peter J , Banks Rosamonde E
Published: March 2009

Background

Proteomic profiling using mass spectrometry (MS) is one of the most promising methods for the analysis of complex biological samples such as urine, serum and tissue for biomarker discovery. Such experiments are often conducted using MALDI-TOF (matrix-assisted laser desorption/ionisation time-of-flight) and SELDI-TOF (surface-enhanced laser desorption/ionisation time-of-flight) MS. Using such profiling methods it is possible to identify changes in protein expression that differentiate disease states and individual proteins or patterns that may be useful as potential biomarkers. However, the incorporation of quality control (QC) processes that allow the identification of low quality spectra reliably and hence allow the removal of such data before further analysis is often overlooked. In this paper we describe rigorous methods for the assessment of quality of spectral data. These procedures are presented in a user-friendly, web-based program. The data obtained post-QC is then examined using variance components analysis to quantify the amount of variance due to some of the factors in the experimental design.

Results

Using data from a SELDI profiling study of serum from patients with different levels of renal function, we show how the algorithms described in this paper may be used to detect systematic variability within and between sample replicates, pooled samples and SELDI chips and spots. Manual inspection of those spectral data that were identified as being of poor quality confirmed the efficacy of the algorithms. Variance components analysis demonstrated the relatively small amount of technical variance attributable to day of profile generation and experimental array.

Conclusion

Using the techniques described in this paper it is possible to reliably detect poor quality data within proteomic profiling experiments undertaken by MS. The removal of these spectra at the initial stages of the analysis substantially improves the confidence of putative biomarker identification and allows inter-experimental comparisons to be carried out with greater confidence.
Primary care physicians' reported use of pre-screening discussions for prostate cancer screening: a cross-sectional survey
Authors: Linder Suzanne K , Hawley Sarah T , Cooper Crystale P , Scholl Lawrence E , Jibaja-Weiss Maria , Volk Robert J
Published: March 2009

Background

Professional medical organizations recommend individualized patient decision making about prostate cancer screening. Little is known about primary care physicians' use of pre-screening discussions to promote informed decision making for prostate cancer screening. The aim of this study is to explore physicians' use of pre-screening discussions and reasons why physicians would or would not try to persuade patients to be screened if they initially refuse testing.

Methods

Primary care physicians completed a self-administered survey about prostate cancer screening practices for informed decision making.

Results

Sixty-six physicians (75.9%) completed the survey, and 63 were used in the analysis. Thirteen physicians (20.6%) reported not using prescreening discussions, 45 (71.4%) reported the use of prescreening discussions, and 3 (4.8%) reported neither ordering the PSA test nor discussing it with patients. Sixty-nine percent of physicians who reported not having discussions indicated they were more likely to screen African American patients for prostate cancer, compared to 50% of physicians who reported the use of discussions (Chi-square(1) = 1.62, p = .20). Similarly, 91% of physicians who reported not having discussions indicated they are more likely to screen patients with a family history of prostate cancer, compared to 46% of those who reported the use of discussion (Chi-square(1) = 13.27, p < .001). Beliefs about the scientific evidence and efficacy of screening, ethical concerns regarding patient autonomy, and concerns about time constraints differed between physicians who would and would not try to persuade a patient to be tested.

Conclusion

Although guidelines recommend discussing the risks and benefits of prostate cancer screening, physicians report varying practice styles. Future research needs to consider the nature of discussions and the degree to which informed decision making is being achieved in clinical practice.
Research and development of a new RF-assisted device for bloodless rapid transection of the liver: Computational modeling and in vivo experiments
Authors: Burdío Fernando , Berjano Enrique J , Navarro Ana , Burdío José M , Grande Luis , Gonzalez Ana , Cruz Ignacio , Güemes Antonio , Sousa Ramón , Subirá Jorge , Castiella Tomás , Poves Ignasi , Lequerica Juan L
Published: March 2009

Background

Efficient and safe transection of biological tissue in liver surgery is strongly dependent on the ability to address both parenchymal division and hemostasis simultaneously. In addition to the conventional clamp crushing or finger fracture methods other techniques based on radiofrequency (RF) currents have been extensively employed to reduce intraoperative blood loss. In this paper we present our broad research plan for a new RF-assisted device for bloodless, rapid resection of the liver.

Methods

Our research plan includes computer modeling and in vivo studies. Computer modeling was based on the Finite Element Method (FEM) and allowed us to estimate the distribution of electrical power deposited in the tissue, along with assessing the effect of the characteristics of the device on the temperature profiles. Studies based on in vivo pig liver models provided a comparison of the performance of the new device with other techniques (saline-linked technology) currently employed in clinical practice. Finally, the plan includes a pilot clinical trial, in which both the new device and the accessory equipment are seen to comply with all safety requirements.

Results

The FEM results showed a high electrical gradient around the tip of the blade, responsible for the maximal increase of temperature at that point, where temperature reached 100°C in only 3.85 s. Other hot points with lower temperatures were located at the proximal edge of the device. Additional simulations with an electrically insulated blade produced more uniform and larger lesions (assessed as the 55°C isotherm) than the electrically conducting blade. The in vivo study, in turn, showed greater transection speed (3 ± 0 and 3 ± 1 cm2/min for the new device in the open and laparoscopic approaches respectively) and also lower blood loss (70 ± 74 and 26 ± 34 mL) during transection of the liver, as compared to saline-linked technology (2 ± 1 cm2/min with P = 0.002, and 527 ± 273 mL with P = 0.001).

Conclusion

A new RF-assisted device for bloodless, rapid liver resection was designed, built and tested. The results demonstrate the potential advantages of this device over others currently employed.
Lnk inhibits myeloproliferative disorder-associated JAK2 mutant, JAK2V617F
Authors: Gery Sigal , Cao Qi , Gueller Saskia , Xing Hongtao , Tefferi Ayalew , Koeffler H Phillip
Published: March 2009

The JAK2 mutation JAK2V617F is found frequently in patients with myeloproliferative disorders (MPD) and transforms hematopoietic cells to cytokine-independent proliferation when expressed with specific cytokine receptors. The Src homology 2 (SH2) and pleckstrin homology (PH) domain-containing adaptor protein Lnk (SH2B3) is a negative regulator of hematopoietic cytokine signaling. Here, we show that Lnk is a potent inhibitor of JAK2V617F constitutive activity. Lnk down-regulates JAK2V617F-mediated signaling and transformation in hematopoietic Ba/F3-erythropoietin receptor cells. Furthermore, in CFU assays, Lnk-deficient murine bone marrow cells are significantly more sensitive to transformation by JAK2V617F than wild-type (WT) cells. Lnk, through its SH2 and PH domains, interacts with WT and mutant JAK2 and is phosphorylated by constitutively activated JAK2V617F. Finally, we found that Lnk levels are high in CD34+ hematopoietic progenitors from MPD patients and that Lnk expression is induced following JAK2 activation. Our data suggest that JAK2V617F is susceptible to endogenous negative-feedback regulation, providing new insights into the molecular pathogenesis of MPD.
Autoantibodies in Type 2 Diabetes Induce Stress Fiber Formation and Apoptosis in Endothelial Cells
Authors: Zimering Mark B. , Pan Zui
Published: March 2009

Context: Macular edema contributes to visual impairment, and albuminuria is associated with increased cardiovascular mortality in adults with type 2 diabetes mellitus. These microvascular complications result from increased capillary leakage of plasma proteins whose causation is not completely understood.

Objective: The objective of the present study was to test whether plasma from type 2 diabetes with maculopathy/albuminuria or control subjects contains autoantibodies that can induce apoptosis or activate Rho kinase (ROCK) in endothelial cells.

Design: A cohort of Veterans Affairs Diabetes Trial adults (>40 yr of age) was randomized to standard vs. intensive glycemic treatment lasting 5–7.5 yr.

Setting: The study was conducted in outpatient clinics.

Patients: Case and age-matched control subjects who differed for the baseline presence of significant diabetic maculopathy and/or progression to macro-albuminuria were included in the study.

Intervention: Pharmacological and lifestyle interventions in the Veterans Affairs Diabetes Trial generally resulted in substantially improved glycemic, blood pressure, and lipid levels.

Results: Autoantibodies from patients with macular edema or progression to albuminuria potently induced caspase-dependent apoptosis in endothelial cells (up to 60%), whereas IgG from age-matched normal plasma caused much less apoptosis (<10%; P < 0.0001). The active inhibitory autoantibodies triggered stress fiber formation in endothelial cells likely through the activation of Rho guanosine 5′-triphosphatase, which could be nearly completed inhibited by 10 μm Y27632, a specific ROCK inhibitor.

Conclusions: These results suggest that autoantibodies from a subset of advanced type 2 diabetes may contribute to diabetic vascular complications by activating ROCK, inducing stress fiber formation and apoptosis in endothelial cells.
The class I bHLH factors E2-2A and E2-2B regulate EMT
Authors: Sobrado Verónica R. , Moreno-Bueno Gema , Cubillo Eva , Holt Liam J. , Nieto M. Angela , Portillo Francisco , Cano Amparo
Published: March 2009

Functional loss of the cell-cell adhesion molecule E-cadherin is an essential event for epithelial-mesenchymal transition (EMT), a process that allows cell migration during embryonic development and tumour invasion. In most carcinomas, transcriptional repression has emerged as the main mechanism responsible for E-cadherin downregulation. Here, we report the identification of class I bHLH factor E2-2 (TCF4/ITF2) as a new EMT regulator. Both isoforms of E2-2 (E2-2A and E2-2B) induce a full EMT when overexpressed in MDCK cells but without affecting the tumorigenic properties of parental cells, in contrast to other EMT inducers, such as Snail1 or class I bHLH E47. E-cadherin repression mediated by E2-2 is indirect and independent of proximal E-boxes of the promoter. Knockdown studies indicate that E2-2 expression is dispensable for maintenance of the EMT driven by Snail1 and E47. Comparative gene-profiling analysis reveals that E2-2 factors induce similar, yet distinct, genetic programs to that induced by E47 in MDCK cells. These results, together with the embryonic expression pattern of Tcf4 and E2A (which encodes E12/E47), support a distinct role for E2-2 and suggest an interesting interplay between E-cadherin repressors in the regulation of physiological and pathological EMT processes.
Laminin is required for Schwann cell morphogenesis
Authors: Yu Wei-Ming , Chen Zu-Lin , North Alison J. , Strickland Sidney
Published: March 2009

Development of the peripheral nervous system requires radial axonal sorting by Schwann cells (SCs). To accomplish sorting, SCs must both proliferate and undergo morphogenetic changes such as process extension. Signaling studies reveal pathways that control either proliferation or morphogenesis, and laminin is essential for SC proliferation. However, it is not clear whether laminin is also required for SC morphogenesis. By using a novel time-lapse live-cell-imaging technique, we demonstrated that laminins are required for SCs to form a bipolar shape as well as for process extension. These morphological deficits are accompanied by alterations in signaling pathways. Phosphorylation of Schwannomin at serine 518 and activation of Rho GTPase Cdc42 and Rac1 were all significantly decreased in SCs lacking laminins. Inhibiting Rac1 and/or Cdc42 activities in cultured SCs attenuated laminin-induced myelination, whereas forced activation of Rac1 and/or Cdc42 in vivo improved sorting and hypomyelinating phenotypes in SCs lacking laminins. These findings indicate that laminins play a pivotal role in regulating SC cytoskeletal signaling. Coupled with previous results demonstrating that laminin is critical for SC proliferation, this work identifies laminin signaling as a central regulator coordinating the processes of proliferation and morphogenesis in radial axonal sorting.
An interaction network of the mammalian COP9 signalosome identifies Dda1 as a core subunit of multiple Cul4-based E3 ligases
Authors: Olma Michael Hans , Roy Marcia , Le Bihan Thierry , Sumara Izabela , Maerki Sarah , Larsen Brett , Quadroni Manfredo , Peter Matthias , Tyers Mike , Pintard Lionel
Published: March 2009

The COP9 signalosome (CSN) is an evolutionarily conserved macromolecular complex that interacts with cullin-RING E3 ligases (CRLs) and regulates their activity by hydrolyzing cullin-Nedd8 conjugates. The CSN sequesters inactive CRL4Ddb2, which rapidly dissociates from the CSN upon DNA damage. Here we systematically define the protein interaction network of the mammalian CSN through mass spectrometric interrogation of the CSN subunits Csn1, Csn3, Csn4, Csn5, Csn6 and Csn7a. Notably, we identified a subset of CRL complexes that stably interact with the CSN and thus might similarly be activated by dissociation from the CSN in response to specific cues. In addition, we detected several new proteins in the CRL-CSN interactome, including Dda1, which we characterized as a chromatin-associated core subunit of multiple CRL4 proteins. Cells depleted of Dda1 spontaneously accumulated double-stranded DNA breaks in a similar way to Cul4A-, Cul4B- or Wdr23-depleted cells, indicating that Dda1 interacts physically and functionally with CRL4 complexes. This analysis identifies new components of the CRL family of E3 ligases and elaborates new connections between the CRL and CSN complexes.
Work-related hand fracture injuries in British Columbia, Canada: a population-based BC-linked health data-set study
Authors: Feehan Lynne M , Sheps Samuel S
Published: March 2009

Objective

To define population-based incidence, demographics and claim rates, as well as clinical presentation and claims duration and costs for work-related hand fractures in British Columbia (BC), Canada in 2001.

Methods

A BC-linked health data-set one-year retrospective review of all reported work-place hand fracture injuries in BC in 2001 with additional evaluation of individual health care and claims data from randomly selected individuals with a compensation claim in 2001.

Results

There were 14,654 hand fractures, of which 14% (2085) were work related; an annual incidence rate of 11/10,000 workers. Males accounted for 88% (1488/2085) of the fractures and the mean age was 39 (SD: ±12). Only 60% (290/482) of randomly selected people filed a compensation claim. Of these claims, 90% (260) had a validated hand fracture injury, 72% (218) were non-articular and 13% (38) had complex associated tissue injuries. About 69% (180) had no or simple closed reduction, 82% (213) had no additional fixation, 63% (163) were immobilized for at least 21 days and 9% (24) developed a secondary complication that required surgery. Average days off work was 46 (range 0–290) and average claims cost was $5500 CDN (range $145–$56,900).

Conclusions

Hand fractures are a common workplace injury in BC, with a significant proportion of workers not claiming compensation. These injuries generally presented clinically as simple fractures that were managed conservatively with few complications. Despite this, there was still a significant socioeconomic burden primarily due to lost work-place productivity due to time loss from work. These findings likely reflect similar trends for work-related hand fractures throughout Canada and other countries with similar health care and workers' compensation systems.
Does the culture of a medical practice affect the clinical management of diabetes by primary care providers?
Authors: Shackelton Rebecca , Link Carol , Marceau Lisa , McKinlay John
Published: March 2009

Objectives:

The financing and organization of primary care in the United States has changed dramatically in recent decades. Primary care physicians have shifted from solo practice to larger group practices. The culture of a medical practice is thought to have an important influence on physician behavior. This study examines the effects of practice culture and organizational structure (while controlling for patient and physician characteristics) on the quality of physician decision-making.

Methods:

Data were obtained from a balanced factorial experiment which employed a clinically authentic video-taped scenario of diabetes with emerging peripheral neuropathy.

Results:

Our findings show that several key practice culture variables significantly influence clinical decision-making with respect to diabetes. Practice culture may contribute more to whether essential examinations are performed than patient or physician variables or the structural characteristics of clinical organizations.

Conclusions:

Attention is beginning to focus on physician behavior in the context of different organizational environments. This study provides additional support for the suggestion that organization-level interventions (especially focused on practice culture) may offer an opportunity to reduce health care disparities and improve the quality of care.
Health policy websites
Authors: Light Kate , Misso Kate
Published: March 2009

This edition of What's on the web? looks at websites that focus on the needs of health policy-makers.

If you would like to alert readers to useful web pages or suggest topics for this column, please send details to:
Impact of pay for performance on quality of chronic disease management by social class group in England
Authors: Crawley Danielle , Ng Anthea , Mainous Arch G , Majeed Azeem , Millett Christopher
Published: March 2009

Summary

Objective

To examine associations between social class and achievement of selected national audit targets for coronary heart disease (CHD), diabetes and hypertension in England before and after the introduction of a major pay for performance programme in 2004.

Design

Secondary analysis of 2003 and 2006 national survey data for respondents with CHD and diabetes and hypertension.

Setting

England.

Main outcome measure

Achievement of national audit targets for blood pressure, blood glucose and cholesterol control.

Results

There were no significant differences in achievement of blood pressure targets in individuals from manual and non-manual occupational groups with diabetes (2003: 65.9% v 60.3%, 2006: 67.6% v 69.7%) or hypertension (2003: 66.2% v 66.2%, 2006: 72.8% v 71.9%) before or after the introduction of pay for performance. Achievement of the cholesterol target was also similar in individuals from manual and non-manual groups with diabetes (2003: 52.5% v 46.6%, 2006: 68.7% v 70.5%) or CHD (2003: 54.3% v 53.3%, 2006: 68.6% v 71.3%). Differences in achievement of the blood pressure target in CHD [75.8% v 84.5%; AOR 0.44 (0.21-0.90)] were evident between manual and non-manual occupational groups after the introduction of pay for performance.

Conclusion

The quality of chronic disease management in England was broadly equitable between socioeconomic groups before this major pay for performance programme and remained so after its introduction.
A comparison of low-molecular-weight heparin and combined therapy of low-molecular-weight heparin with an anti-inflammatory agent in the treatment of superficial vein thrombosis
Authors: Uncu H
Published: March 2009

Objectives

The optimal treatment of superficial vein thrombosis (SVT) of the leg has not been determined yet. The aim of this study is to evaluate the efficacy of low-molecular-weight heparin (LMWH) as compared with combined therapy of LMWH with an anti-inflammatory agent in treatment of SVT.

Methods

Fifty patients with SVT of the greater saphenous vein were randomly assigned to be treated with Ca-nadroparin 190 IUAxa/kg in a single dose or with same dose of Ca-nadroparin and 60 mg oral acemetacine twice daily for 10 days. The efficacy of the two treatments to relieve symptoms and signs was evaluated by using visual analogue scale.

Results

Significant improvements were achieved for both groups after the treatment in terms of all four symptoms ( P < 0.001). Treatment scores were in favour of LMWH with anti-inflammatory agent treatment group to relieve all four symptoms. The most significant and remarkable results obtained were for the reduction of pain and local tenderness ( P < 0.05). No patient experienced major complications or mortality in either group.

Conclusion

The results of this study suggest that the combined therapy of LMWH with an anti-inflammatory agent is more effective than LMWH. It may be an important option in the standard treatment of SVT.
Local versus general anaesthesia for varicose veins surgery: a prospective non-randomized controlled trial
Authors: Wall M L , Dealey C , Davies R S M , Simms M H
Published: March 2009

Objective

To compare the acceptability and outcome of primary varicose vein (VV) surgery (saphenofemoral or saphenopopliteal ligation/excision) under local anaesthesia (LA) with that of general anaesthesia (GA).

Methods

A non-randomized controlled trial of consecutive patients treated between April 2004 and March 2006 was performed. After complete informed consent individual patients were asked to select their preferred form of anaesthesia (LA or GA). Preoperative disease status and co-morbidities were recorded. Outcomes were assessed perioperatively and at six weeks and six months postoperatively using patient scoring systems including the Aberdeen varicose veins severity score (AVVSS).

Results

Seventy-two (LA 46[62%] and GA 26[38%]) patients participated; median (range) age was 48 (21–74) years versus 36 (21–59) years ( P = 0.0164), respectively. All procedures were performed as day cases. Median postoperative pain scores for LA and GA did not differ at 12 hours (4 versus 4; P = 0.48) and four days (5 versus 6; P = 0.44). Median improvement in the AVVSS at six weeks and six months for LA and GA cohorts were 5.7 versus 6.1 ( P = 0.875) and 6.5 versus 8.3 ( P = 0.131), respectively. Overall patient satisfaction did not show any intergroup difference at six weeks.

Conclusions

Surgical treatment of VV under LA can be performed safely with comparable results to GA in self-selected patients.
Complications of paediatric elbow trauma treatment by traditional bonesetters
Authors: Butt Mohammad Farooq , Dhar Shabir Ahmad , Gani Naseem Ul , Kawoosa Altaf A
Published: March 2009

This is a retrospective review of paediatric elbow trauma, which was initially treated by bonesetters and subsequently reported to the hospital for management. This paper describes the pattern of trauma and the complications of unscientific management. The report also recommends a basic training program for the bonesetters so as to make them aware of the potential complications involved in managing paediatric elbow trauma.
Clinical characteristics and outcome of Brucella endocarditis
Authors: Gunes Yilmaz , Tuncer Mustafa , Guntekin Unal , Akdag Serkan , Gumrukcuoglu Hasan Ali , Karahocagil Mustafa , Ekim Hasan
Published: March 2009

Brucella endocarditis, a rare complication of brucellosis, is the main cause of death attributable to this disease. There are difficulties in the diagnosis and uncertainty regarding many aspects of the treatment of Brucella endocarditis. We retrospectively examined the clinical characteristics and outcome of patients diagnosed with Brucella endocarditis. Of the six patients diagnosed as having Brucella endocarditis, four had valvular disease, one had aortic and mitral mechanic valve prosthesis (AVR + MVR) and one had secundum type atrial septal defect. Transesophageal echocardiography showed vegetations in four patients. Blood culture grew Brucella mellitensis only in two patients. Standard agglutination tests were elevated in all patients (range 1/320–1/10240). Four patients were managed with combined antibiotherapy and surgery. One refused further treatment and one refused an operation and follow-up was lost for that patient. Two patients died during follow-up; one having had a previous AVR + MVR operation refused further treatment and the other suffering renal failure. Due to the fulminant course of the disease, treatment should be initiated when there is a clinical suspicion, even if the culture results are unknown or negative. Agglutination titres aid in the diagnosis. A combination of antibiotherapy and surgery seems to be preferable treatment modality.
Can brucella endocarditis be treated successfully with medical therapy alone?
Authors: Mohandas Naveen , Balasubramanian R , Prasad Shiva BN
Published: March 2009

Human brucellosis is caused by one of the three species of Brucella: Brucella mellitensis, B. abortus, and B. suis. Worldwide, the incidence of human brucellosis ranges from <0.01 to >200 per 100,000 population. Cardiovascular complications occur in <2%, but accounts for most of the mortality. Brucella endocarditis usually involves normal native aortic valves in 75% of cases. A combination of antibiotics and valve replacement is the most acceptable treatment. So far only 15 adult cases have been reported as having been cured with medical therapy alone. We report another case treated successfully with antibiotics alone.
The use of Foley's catheter in the removal of a coin in the oesophagus
Authors: Bowa K , Bvulani B , Mukonge L
Published: March 2009

A coin in the oesophagus is a common paediatric emergency in Zambia. There are very few specialist surgeons and hospitals where endoscopic removal can be carried out in many resource-limited countries. The technique described here allows the removal of an ingested coin using an ordinary Foley's catheter. The use of this technique under fluoroscopic guidance has been described in literature. However, fluoroscopic facilities and trained radiologists are not commonly available in many parts of Africa. This technique is simple, safe and has a success rate close to that achieved by endoscopic removal.
Brucellosis in central Anatolia: evaluation of complications and relapse
Authors: Naz Hasan , Aykin Nevil , Cevik Figen , Bal Cengiz
Published: March 2009

Brucellosis is an infectious disease involving many organs and tissues. We investigated retrospectively the brucellosis cases at our hospital, in order to study the relationship between clinical, laboratory and therapy findings, and relapse rates. We found that relapse was related to a positive family history, living in a rural area and the presence of complications.
Presentation of trauma at the National Orthopaedic Hospital Enugu: a pilot study
Authors: Onah I I , Okwesili I C
Published: March 2009

This prospective study spanning three months was undertaken to provide insight to trauma care including intervention times in this centre. Improved organization of trauma care is needed urgently for improved outcomes.
Kawasaki disease: a clinical and epidemiological study of 70 children in Brazil
Authors: Magalhães Cristina M R , Vasconcelos Patricia A C , Pereira Marne R , Alves Natália R M , Gandolfi Lenora , Pratesi Riccardo
Published: March 2009

This is a prospective study of a cohort of 70 children with Kawasaki disease (KD) admitted from April 2002 to April 2007 to a tertiary hospital in Brasilia, Brazil. Of the 70 children, only 32 (45.7%) were referred during the acute phase of the disease and only 15 (21.4%) were referred with the correct diagnosis. Coronary aneurysms were detected in 13 (18.5%). A high suspicion index is essential in order to detect new cases as KD is probably underdiagnosed in Brazil and other developing countries, and an early diagnosis will dramatically decrease its life-threatening complications.
Do patients in rural Malawi benefit from upper gastrointestinal endoscopy?
Authors: Mothes Henning , Chagaluka Georg , Chiwewe Denis , Malunga Martin , Mwatibu Biswick , Wilhelm Torsten , Settmacher Utz
Published: March 2009

The aim of this study was to evaluate the benefits of upper gastrointestinal endoscopy at central hospital level in Malawi and to draw conclusions from its use in the treatment of patients presenting with dysphagia and dyspepsia to health institutions in rural Africa.

This retrospective study was carried out in order to investigate the endoscopic findings in 455 patients who presented to Zomba Central Hospital, Malawi, with upper gastrointestinal symptoms.

Fifty-six percent of patients presenting with dysphagia were found to have oesophageal carcinoma. In 50% of patients with epigastric pain and 44% with abdominal pain, an endoscopy did not reveal any pathological findings. The intended treatment was frequently altered as a result of performing the endoscopy. We were able to treat patients according to their specific diagnosis in a significantly higher number than before: 51% versus 18% of those presenting with dysphagia, 96% versus 24% of those with epigastric pain and 90% versus 39% of those with abdominal pain.

Upper gastrointestinal endoscopy is a feasible diagnostic tool in developing countries which improves the detection and treatment of diseases of the gastrointestinal tract.
Neurological disorders in rural Africa: a systematic approach
Authors: Winkler Andrea Sylvia , Mosser Philipp , Schmutzhard Erich
Published: March 2009

Empirical knowledge suggests that neurological disorders are common in sub-Saharan Africa. The aims of our study were to assess the hospital-based prevalence of neurological disorders in a rural African setting and to suggest a systematic approach to disease classification. Of 8676 admissions (over a period of eight months) 740 patients (8.5%) were given a neurological diagnosis; cases were grouped according to diagnostic certainty. We suggest three major categories for neurological disorders (group 1 = no diagnostic uncertainties; group 2 = minor diagnostic uncertainties; group 3 = major diagnostic uncertainties) with clinical implications.
Acalculous cholecystitis in a patient with Plasmodium falciparum infection after a trip to the Dominican Republic
Authors: Salinas A , Puerta A , Olmedo J , Martínez E , Blanch JJ , Mateos F , Tárraga I
Published: March 2009

Acalculous cholecystitis has been associated with several infectious agents, but its relation with Plasmodium falciparum infection has not been clearly defined. This is the first case of acalculous cholecystitis produced by Plasmodium falciparum infection that is directly documented and should be included among the differential diagnoses of acalculous cholecystitis.
Disseminated cryptococcosis in an HIV-negative patient
Authors: Rajpal S , Dwivedi S , Chaudhary SC
Published: March 2009

A young, unmarried, immunocompetent female presented with complaints of fever and altered sensorium, along with lesions over the face and trunk. A provisional diagnosis of disseminated herpes simplex with giant molluscum contagiosum was made. However, cutaneous biopsy of the lesions showed numerous cryptococcal organisms which stained positive to periodic acid-Schiff. This case is reported to sensitise physicians to keep cryptococcosis as a differential diagnosis in such types of skin lesions, as the lesions resemble that of molluscum contagiosum very closely.
Endomyocardial fibrosis: an enigmatic cause for a giant left atrium
Authors: Ker James
Published: March 2009

Endomyocardial fibrosis (EMF) was first described in 1948. It is an idiopathic disorder, characterized by the formation of fibrous tissue on the endocardial aspect of one or both ventricles, resulting in a restrictive cardiomyopathy with atrial enlargement. Originally described in Uganda, numerous cases have also been described in the Middle East.
Autoethnographic identification of realms of learning for art education in a post-digital age
Authors: Alexenberg Mel
Published: March 2009

Realms of learning for art education in a post-digital world are identified through autoethnography, a qualitative research methodology congruent with an emerging paradigm shift beyond the digital culture of the Information Age to a post-digital Conceptual Age that honours the ability
to create aesthetic significance, to discern patterns, to craft a meaningful narrative and to combine seemingly unrelated ideas into a novel creation. Realms of learning are brought to light through a narrative that highlights episodes in the life of an artist/ researcher/teacher that have
special significance for art education. This autoethnographic enquiry, at the intersections of art, science, technology and culture, identifies interweaving realms that create a colourful fabric of lifelong learning: from awesome immersion, playful exploration, aesthetic creativity and morphological
analysis, to interdisciplinary imagination, cybersomatic (computerbody) interactivity, polycultural collaboration, and holistic integration.
Thinking critically about critical thinking: towards a post-critical, dialogic pedagogy for popular visual culture
Authors: Duncum Paul
Published: March 2009

The influence of critical theory in art education has become commonplace, but its use in addressing students' popular culture in kindergarten to Year 12 classrooms is problematic. The now numerous reports by art teachers of their successfully inculcating critical consciousness towards
popular visual culture appears to have more to do with a reforming zeal or advocacy than evidence. Moreover, in echoing the modernist origins of critical theory, their attempts to facilitate critical thinking often take the form of unproblematic and authoritarian pedagogy. Lessons learned
from media education in the United Kingdom are employed to recommend that art teachers reject prima facie evidence of critical thinking among their students and learn to appreciate the complexity of student negotiations with popular culture. Taking their cue from media educators, it is proposed
that art educators adopt a post-critical pedagogy based on Bhaktin's notions of dialogue.
Male & Female BIGHEADS: Different ways of looking
Authors: Cruz Anglica Lima , Lessa Elisa , Dias Maria Flr
Published: March 2009

The educational activity discussed in this article came about as the result of an invitation to the Instituto de Estudos da Criana (Institute of Children's Studies) at Minho University to take part in some celebrations for International Children's Day. The choice of Bigheads
as a topic was determined by the fact that small-scale interdisciplinary projects had already been set up in the different arts departments and they shared an interest in local cultural patrimony. Grotesque Bighead figures are strongly rooted in the Portuguese popular imagination and, over
time, have come to represent stereotypical social types that have remained constant formally and symbolically, and have resisted innovation. The Visual Education, Drama and Music course teams at the Instituto worked together and deconstructed the tradition by taking the Bigheads out of their
local, plastic dimension into a global, multicultural space. The deconstruction of the Bighead figure by teachers and students went through three stages: first, discussing and planning curriculum content; second, planning and making; and third, taking part in and sharing this event with the
local community.
Shear Strength Estimation of Sandy Soils Using Shear Wave Velocity
Authors: Cha Minsu , Cho Gye-Chun
Published: March 2009

Typically, shear strength is associated with large strain phenomena, while shear wave propagation is associated with small strain phenomena. Yet, the effective stress and void ratio, both key determinants of sandy soil shear strength, are also the primary factors affecting shear wave velocity. This study presents a shear wave velocity-void ratio-shear strength correlation through experimental tests. Natural sands taken from various reclaimed or recently deposited sandy fields are used for reconstituting specimens at different void ratios in an oedometer cell. Shear wave velocities are measured while changing the state of the stress in the cell for each specimen prepared at a specific void ratio. The relationship between shear wave velocity and vertical effective stress is found at extreme values of void ratios (emin and emax). Direct shear tests are also performed on specimens with various void ratios. Experimental results show that the internal friction angle of each sand type increases with decreasing void ratio, rendering a unique relationship between friction angle and void ratio. Finally, a procedure is suggested to evaluate the in-situ shear strengths of a sandy soil based on in-situ shear wave velocities. Results show that the suggested method effectively estimates in-situ shear strength.
A Large Permeameter for Study of Internal Stability in Cohesionless Soils
Authors: Moffat RA , Fannin RJ
Published: March 2009

Results are reported from the commissioning of a large rigid-walled permeameter that was designed to examine hydromechanical conditions prevailing at the onset of seepage-induced failure in soils with a potential for internal instability. A technique of slurry mixing and discrete deposition is used to reconstitute a homogeneous, saturated test specimen. The test specimen is consolidated and then subject to seepage flow, under head-control, in either a downward or upward direction. Two arrays of pressure transducers, located on opposite sides of the specimen, establish the variation of hydraulic gradient along the specimen. The device is configured with a top and bottom load cell, and frictionless loading ram, in order to assess the influence of side-wall friction and thereby establish the distribution of vertical effective stress along the length of the specimen. Observations of hydraulic gradient and effective stress enable a characterization of the onset of instability, which is localized within the specimen. Results of multi-stage tests on glass beads are reported that illustrate novel features of the permeameter and instrumentation, the utility of the specimen reconstitution technique and a novel approach for quantifying the onset of internal instability.
Comparison of Chilled-mirror Measurements and Filter Paper Estimates of Total Soil Suction
Authors: Patrick Pamela K. , Olsen Harold W. , Higgins Jerry D.
Published: March 2009

A comparison of chilled-mirror total suction measurements with those estimated from filter paper total suction data show general agreement. However, there are significant discrepancies that are similar to those previously reported by others. The nature and magnitude of the discrepancies are consistent with: (a) possible errors in chilled-mirror total suction measurements due to incomplete equilibration in the sealed test chamber of the chilled-mirror device, and (b) possible errors in estimated filter paper total suction values due to natural variations of the zero-water-content intercept in the log total suction versus water content relationship. The possible errors in chilled-mirror measurements are easily avoided. The possible errors in estimated filter paper measurements can only be minimized by avoiding the need for an assumed zero-water-content intercept. This can be accomplished far more easily with the chilled-mirror device than with the filter paper method.
Large Dynamic Direct Shear Machine for Geosynthetic Clay Liners
Authors: Fox PJ , Nye CJ , Morrison TC , Hunter JG , Olsta JT
Published: March 2009

A large direct shear machina for static and dynamic shear strength testing of geosynthetic clay liners (GCLs) and GCL liner systems is described. The machine tests rectangular GCL specimens measuring 305 × 1067 mm and has a maximum shear displacement of 254 mm, which is sufficiently large to allow for the measurement of residual or near-residual shear strengths in most cases. The basic design concept for the device is to shear a GCL specimen between a bidirectional pullout plate and a stationary reaction plate, each covered with an aggressive gripping surface. The pullout plate is driven by a computer-controlled hydraulic actuator. The maximum normal stress is 2000 kPa, the maximum shear stress is 750 kPa, and the shearing system is capable of imposing general stress-controlled or displacement-controlled dynamic loading to a test specimen. The actuator has a maximum frequency of 4 Hz for sinusoidal loading with a displacement amplitude of 25 mm. The maximum displacement rate for burst loading (i.e., single thrust) at zero force is 1 m/s. The paper describes four main components of the machine: (1) the shearing system; (2) the normal stress and vertical displacement measurement system; (3) the specimen hydration system; and (4) the process control and data acquisition system. The performance of the machine is illustrated using displacement-controlled test data for the static and cyclic internal shear strength of a hydrated needle-punched GCL.
A New Centrifugal Testing Method: Descending Gravity Test
Authors: Cinicioglu O , Znidarčić D , Ko H-Y
Published: March 2009

This paper presents a new centrifugal testing method that has been developed to observe the effects of void ratio and overconsolidation ratio on the generation of undrained shear strength in cohesive soils. This new method provides soil profiles of constant overconsolidation ratio and varying void ratio throughout the sample profile. Combinations of this method with various in situ shear strength tests such as the cone penetration test and the vane shear test constitutes a new methodology which is named the “descending gravity test” (DGT). When DGT is repeated for different acceleration levels during centrifuge testing, it provides the void ratio-undrained shear strength relationship for various magnitudes of overconsolidation ratio. Therefore it renders the observation of the uncoupled effects of void ratio and overconsolidation ratio on the generation of shear strength feasible. Additionally the method requires the unloading of the clay cake, and since swelling of a sample is more rapid than its consolidation the test takes a relatively short time, hence the method is efficient.
An Innovative Laboratory Box for Testing Nail Pull-Out Resistance in Soil
Authors: Yin J-H , Su L-J
Published: March 2009

This paper introduces a new soil nail pull-out box with full instrumentation for investigating the soil nail pull-out shear resistance under different controlled conditions. The new box has overcome some limitations of previous pull-out boxes developed by other researchers, the first author, and his co-workers. The box has the following new features: (a) comprehensive transducers are installed, (b) an extension chamber is provided to house an extension part of the soil nail to keep the nail length inside the box constant throughout the testing, (c) a waterproof front cap is placed to cover and seal the soil nail head so that back water pressure can be applied to accelerate the saturation of the soil, and (d) a pressure grouting apparatus is constructed to make it possible to investigate the influence of the cement grouting pressure. The pull-out box can be used to study influences of (a) hole drilling process and stress release, (b) degree of saturation of the soil, (c) cement pressure grouting, (d) overburden pressure, etc. Two copies of such a new soil nail pull-out box have been constructed to accelerate the testing program. A series of soil nail pull-out tests has been conducted using the two boxes. This paper presents details of the new pull-out box, from design, boundary effect analysis, and instrumentation to setup. Typical results from soil nail pull-out tests are presented and discussed.
Large-scale Apparatus for Monotonic and Cyclic Soil-Structure Interface Test
Authors: Zhang G , Zhang J-M
Published: March 2009

A large-scale direct shear test apparatus was developed to investigate the monotonic and cyclic behavior of a soil-structure interface. The apparatus provides a constant sample size 50 cm in length and 36 cm in width. Three kinds of normal boundary conditions, namely, constant normal stress, constant normal stiffness, and constant normal displacement, can be directly applied on the interface with high accuracy. The apparatus is equipped with an automated loading system with capacity up to 200 kN in both directions. The stress and displacement of the interface can be automatically measured with the apparatus. In addition, the movement and crushing of soil particles near the structure can be observed and recorded. Therefore, this apparatus is suitable for monotonic and cyclic tests of the interface between structure and gravelly soil. The effectiveness of this apparatus was confirmed by tests of the interface between structure and gravel. The test results show that the steel-gravel interface exhibits significant change in the physical state and volumetric strain due to shear application.
Acoustic Compressional Wave Velocity as a Predictor of Glacio-marine Sediment Grain Size
Authors: Moran Kathryn , Altmann Veith , O’Regan Matthew , Ashmankas Cristin
Published: March 2009

We present relationships between the nondestructive measurement of acoustic compressional wave velocity and grain size and show that velocity can be used to assess some physical properties of glacio-marine sediments. For coarse-grained sediments, an increase in velocity is associated with an increase in the percentage of this size range. Within the fine-grained sediment size range, velocity is not an accurate predictor of grain-size. A median grain size of 4 μm and a sand content of 15 % are the limiting factors that distinguish this fine-grained behavior from coarse-grained behavior. However, in fine-grained glacio-marine sediment, the percent of sand (grain size >63 μm), can be predicted by compressional wave velocity. Therefore, with further refinement, acoustic velocity shows some potential as a predictor of grain size for marine sediments.
Design, Fabrication, and Assembly of a Large Oedometer
Authors: Ng AMY , Yeung AT , Lee PKK , Tham LG
Published: March 2009

A typical Casagrande-type oedometer cell is 76 mm in diameter and 19 mm high. It may perform satisfactorily in the measurements of consolidation parameters of homogeneous fine-grained soil specimens up to a maximum applied vertical stress of approximately 3 MPa. However, when it is required to evaluate the load-deformation characteristics of soil specimens containing relative large-diameter grain particles and/or at a considerably higher stress level, the existing apparatus is evidently inadequate. Therefore, an oedometer of 425 mm in internal diameter was designed, fabricated, and assembled at The University of Hong Kong. The consolidation stress that can be applied is up to 13.5 MPa. Specimen preparation and measurement procedure have to be developed to cope with the new apparatus. The design, fabrication, and assembly of the large oedometer are documented and discussed in this paper. Moreover, experimental procedure developed and measurement data demonstrating the applicability of the new apparatus are presented.