bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in health professionals' knowledge, attitudes and practice following provision of educational resources about prevention of prenatal alcohol exposure and fetal alcohol spectrum disorder
Authors: Payne Janet , France Kathryn , Henley Nadine , D'Antoine Heather , Bartu Anne , O'Leary Colleen , Elliott Elizabeth , Bower Carol
Published: April 2011

Payne J, France K, Henley N, d'Antoine H, Bartu A, O'Leary C, Elliott E, Bower C. Changes in health professionals' knowledge, attitudes and practice following provision of educational resources about prevention of prenatal alcohol exposure and fetal alcohol spectrum disorder. Paediatric and Perinatal Epidemiology 2011; 25: 316–327.

We provided health professionals in Western Australia (WA) with educational resources about prevention of prenatal alcohol exposure and fetal alcohol spectrum disorder and assessed changes in their knowledge, attitudes and practice concerning fetal alcohol syndrome (FAS) and alcohol consumption in pregnancy. Following our 2002 survey of health professionals in WA, we developed and distributed educational resources to 3348 health professionals in WA in 2007. Six months later we surveyed 1483 of these health professionals. Prevalence rate ratios [PRR] and 95% confidence intervals [CI] were calculated to compare 2007 results with results from the 2002 survey. Of the 1001 responding health professionals, 69.8% had seen the educational resources; of these 77.1% have used them and 48.5% said the resources had assisted them to change their practice or their intention to change their practice. Compared with 2002, there was an increase in the proportion who knew all the essential features of FAS from 11.7% to 15.8% [PRR 1.35; 95% CI 1.09, 1.67] and had diagnosed FAS, from 4.8% to 7.3% [PRR 1.52; 95% CI 1.08, 2.13]. In 2007, 98.1% of health professionals stated they would advise pregnant women to consider not drinking at all or advise them that no alcohol in pregnancy is the safest choice. Health professionals surveyed in 2007 have increased their knowledge, changed their attitudes and practice about FAS, and altered the advice they give to pregnant women about alcohol consumption since our survey in 2002. It is essential that we build on this change and continue to support health professionals' knowledge, attitudes and practice about the prevention of prenatal alcohol exposure and fetal alcohol spectrum disorder. The educational resources for health professionals may be ordered as hard copies and downloaded from the internet http://www.ichr.uwa.edu.au/alcoholandpregnancy
Maternal dietary glycaemic intake during pregnancy and the risk of birth defects
Authors: Yazdy Mahsa M. , Mitchell Allen A. , Liu Simin , Werler Martha M.
Published: April 2011

Yazdy MM, Mitchell AA, Liu S, Werler MM. Maternal dietary glycaemic intake during pregnancy and the risk of birth defects. Paediatric and Perinatal Epidemiology 2011; 25: 340–346.

High sugar intake has been linked to fetal anomalies in the presence and absence of insulin resistance. Using dietary data collected in the Boston University Slone Epidemiology Birth Defects Study, we examined whether high dietary glycaemic index (dGI) or load (dGL) increased the risk of birth defects. Non‐diabetic mothers of 1921 cases and 704 controls were interviewed within 6 months of delivery (1988–98) about pregnancy events and exposures, including a 99‐item food frequency questionnaire. Case groups included amniotic bands, craniosynostosis, gastroschisis, hypospadias, small intestinal defects, anorectal defects, limb reductions, omphalocele, cleft lip and/or palate, renal agenesis, and tracheoesophageal fistula. Cubic splines were used to determine cut‐point values for high dGI and dGL in relation to the risk of each birth defect. The cut‐points were used in logistic regression models to calculate odds ratios (OR) and 95% confidence intervals [CI]. Control mothers in the lowest quartile of glycaemic intake were more likely to be non‐Hispanic White, ≥30 years of age, have higher family income, have a normal body mass index and reside in Boston. Findings were null for most case groups. The anorectal defect case group was found to have elevated risks for dGL [adjusted OR: 2.4; 95% CI: 1.1, 4.9], while estimates for dGI were elevated for the amniotic band case group [adjusted OR: 3.0; 95% CI: 1.1, 8.1]. Because this is the first paper (to our knowledge) to explore dGI and dGL in relation to a spectrum of birth defects, additional studies are needed.
The effect of RBC transfusions on cytokine gene expression after cardiac surgery in patients developing post‐operative multiple organ failure
Authors: Sitniakowsky L. S. , Later A. F. L. , van de Watering L. M. G. , Bogaerts M. , Brand A. , Klautz R. J. M. , Smit N. P. M. , van Hilten J. A.
Published: April 2011

Aim: To determine the effect of red blood cell (RBC) transfusions during cardiac surgery on cytokine gene expression (GE) in relation to multiple organ failure (MOF) development after systemic inflammatory response syndrome (SIRS).

Background: RBC transfusion in cardiac surgery patients is dose‐dependently associated with post‐operative MOF, possibly acting as a second hit after cardiopulmonary bypass.

Methods: For this observational study, 29 patients divided into four groups of cardiac surgery patients were selected from a randomised controlled trial (RCT). Group 1: no‐RBC, no‐MOF (N = 8); group 2: MOF, no‐RBC (N = 7); group 3: RBC, no‐MOF (N = 6); group 4: RBC and MOF (N = 8). Selection was based on age, gender, number of (leukocyte‐depleted) RBC transfusions, type and duration of surgery.

A 114 cytokine GE array was applied to blood samples withdrawn before and 24 h after surgery. Expression of selected genes was confirmed with reverse transcriptase real time‐polymerase chain reaction (RT‐PCR).

Results: Nineteen of the 39 detectable genes showed a significant change in GE after surgery. Confirmed by RT‐PCR, transfused MOF patients exhibit significantly less downregulation of CD40 ligand than control patients. Patients who would develop MOF show significantly larger increases in GE of transforming growth factor‐α (TGF‐α), tumour necrosis factor (TNF)‐superfamily members 10 and 13B (TNFsf10/13B).

Conclusions: When tested at 24 h after surgery, cytokine GE in peripheral blood leucocytes showed no significant differences between those transfused and those not transfused. Some alterations were seen in those developing MOF compared to those who did not, but the findings offer no role of leukocyte depleted (LD) RBC transfusion in the development of MOF.
Tolerance of Auditory Disturbance by an Avian Urban Adapter, the Noisy Miner
Authors: Lowry Hélène , Lill Alan , Wong Bob B. M.
Published: April 2011

Urbanization creates challenges for wildlife, most notably through changes in resource availability and the frequent occurrence of sensory disturbance. Some native species, however, have been able to exploit and thrive in urban environments. Research, in this regard, has mostly focused on the ecological conditions that have allowed such species to prosper. In contrast, less attention has been devoted to evaluating how they cope with human proximity and disturbance. In a field experiment on a successful Australian ‘urban adapter’, the Noisy miner, Manorina melanocephala, we compared tolerance of a loud, startling sound stimulus by urban and rural individuals. We found group size differences between birds occupying urban and rural sites: more urban birds came into the testing area in response to the initial alarm‐call playback compared with rural birds. Urban and rural birds also differed significantly in their behavioural response profile to the test sound stimulus. Nearly half (47.5%) of the rural, but only 22.5% of the urban birds took flight and of those that did, only 1 of 9 urban individuals retreated >5 m, compared with 13 of 19 rural birds. About one‐third of urban, but only 5% of rural individuals responded to the sound stimulus with aggressive displays. The most frequent response to the stimulus, irrespective of habitat type, was to remain near the sound source and engage in visual surveillance. The high frequency of this response in both urban and rural individuals suggested that most noisy miners were quite ‘bold’, a temperament trait that is likely to be important in successful urban colonization by birds.
Recombination frequency variation in maize as revealed by genomewide single‐nucleotide polymorphisms
Authors: Farkhari Mohammad , Lu Yanli , Shah Trushar , Zhang Shihuang , Naghavi Mohammad R. , Rong Tingzhao , Xu Yunbi
Published: April 2011

With 2 tables

Recombination frequency greatly affects selection efficiency in plant breeding. A high‐density single‐nucleotide polymorphism (SNP) map integrated with physical map and other molecular maps is very useful for characterizing genetic recombination variation. In this study, recombination frequency in maize was investigated through SNP linkage maps constructed with three recombinant inbred line populations. The integrated map consisted of 1443 molecular markers, including 1155 SNPs, spanning 1346 cM. A 100‐fold difference in recombination frequency was observed between different chromosomal regions, ranging from an average of 0.09 cM/Mb for pericentromeric regions to 7.08 cM/Mb for telomeric regions. Recombination suppression in non‐centromeric regions identified nine recombination‐suppressed regions, one of which likely contained condensed heterochromatin (knobs). Recombination variation along chromosomes was highly predictable for pericentromeric and telomeric regions, but population‐specific with 4.5‐fold difference for the same marker interval across the three populations or specific chromosome regions because of the presence of knobs. As recombination variation can be identified and well characterized as shown in this study, the related information will facilitate future genetic studies, gene cloning and marker‐assisted plant breeding.
Predictors of growth in children based on 2007 Korean national growth charts
Authors: Joung Kyoung Hwa , Chung Sung Suk , Cho Soo Chul
Published: April 2011

Background:  Postnatal growth patterns in children are associated with various factors within the birth and infancy periods. The aim of the present study was to examine the correlation between growth patterns and parameters including gestational age (GA), birthweight (BW), sex, and feeding method in the records of 61 631 children aged 6–72 months.

Methods:  The data were obtained from the 2007 Korean National Growth Charts provided by the Korean Centers for Disease Control. Data were analyzed using descriptive statistics, Pearson's correlation, and multiple linear regression.

Results:  BW and sex were highly correlated with weight and height by 72 months (P < 0.01), with BW being the primary predictor (P < 0.001). Sex was the second predictor of weight and height in children by 66 months (P < 0.01). Feeding method was the predictor of weight in children aged 12–48 months and 60 months (P < 0.05), and was also influential in the height of children by 48 months (P < 0.05). GA was the predictor of weight at 12 months and from 30 to 42 months (P < 0.05).

Conclusion:  GA, BW, sex and feeding method were the predictors of weight and height among children at different times. Therefore, the present population‐based study strengthens the consideration of these factors for routine monitoring of growth patterns in Korean children.
Two‐stage vs mixed‐effect approach to pharmacodynamic modeling of propofol in children using state entropy
Authors: Hahn Jin‐Oh , Khosravi Sara , Dumont Guy A. , Ansermino John Mark
Published: April 2011

Objectives:  To compare the population pharmacodynamic (PD) models of propofol in children derived using two‐stage and mixed‐effect modeling approaches.

Methods:  Fifty‐two ASA 1 and 2 children aged 6–15 years presenting for gastrointestinal endoscopy were administered a loading dose of 4 mg·kg−1 of propofol intravenously at an infusion rate determined by a randomization schedule. Using the plasma concentration predicted by the Paedfusor pharmacokinetic (PK) model, the propofol effect on state entropy (SE) was modeled using the two‐stage and the mixed‐effect modeling approaches, and the final population PD models were compared with each other in terms of their prediction performance, using median percentage and absolute percentage errors as well as mean absolute weighted error as metrics. The effects of age and body weight as prospective covariates were examined.

Results:  The final population models were comparable with each other; the two‐stage and the mixed‐effect approaches resulted in a ke0 of 2.38 and 2.66 min−1, γ of 5.29 and 5.68, and EC50 of 4.73 and 4.84 μg·ml−1, respectively. The bootstrap estimates of the PD parameters were mean (sd) ke0 = 2.38 (0.10), γ = 5.30 (0.30), and EC50 = 4.73 (0.14). The PD parameters did not exhibit dependence on age and body weight. The parameters reported in this study in children were different from their adult counterparts reported in previous studies.

Conclusions:  Models derived using different mathematical approaches produced consistent model parameters. By virtue of its relative computational efficiency, the two‐stage approach can serve as an attractive alternative to the mixed‐effect approach in situations where data are not sparse.
Preoperative anxiety in adolescents undergoing surgery: a pilot study
Authors: Fortier Michelle A. , Martin Sarah R. , MacLaren Chorney Jill , Mayes Linda C. , Kain Zeev N.
Published: April 2011

Objectives:  The purpose of this study was to conduct a prospective assessment of preoperative anxiety in adolescents undergoing surgery.

Aim:  To systematically conduct a multimodal evaluation of preoperative anxiety in adolescents undergoing surgery.

Background:  The existing literature on preoperative anxiety in children has overwhelmingly ignored adolescents in the surgical setting, yet adolescents may be at risk for under treatment of preoperative anxiety.

Methods:  A total of 59 adolescents aged 11–18 were recruited. Behavioral and physiological manifestations of anxiety were assessed with a visual analog scale and an ambulatory physiological data recorder that collected heart rate (HR), skin conductance level (SCL), and blood pressure data. Baseline emotional and behavioral functioning (child behavior checklist [CBCL]) as well as temperament (early adolescent temperament questionnaire‐revised – parent version) and other potential risk factors were also assessed.

Results:  Over 80% of adolescents reported significant anxiety at the time of induction. Self‐reported anxiety increased significantly at each time point (holding, separation from parents, and mask introduction), P = 0.001. Significant increases in both HR (P = 0.02) and SCL (P < 0.001) were found from holding to mask introduction. Several risk factors were found to predict higher anxiety at mask introduction, including baseline anxiety and depression (CBCL, Internalizing, P = 0.04), somatizing problems (P = 0.05), and fearful temperament (P = 0.03).

Conclusions:  A large proportion of adolescents experience significant anxiety that increases from the preoperative holding area to anesthesia induction. Underlying baseline anxiety and depression as well somatization and fearful temperament are predictors of this phenomenon.
Is phylogeny driving tendon length in lizards?
Authors: Tulli María J. , Herrel Anthony , Vanhooydonck Bieke , Abdala Virginia
Published: April 2011

Tulli, M.J., Herrel, A., Vanhooydonck, B. and Abdala, V. 2012. Is phylogeny driving tendon length in lizards?—Acta Zoologica (Stockholm) 93: 319–329.

Tendons transmit tensile forces generated by muscles and are a crucial part of the musculoskeletal system in vertebrates. Because tendons and tendon cells respond to altered mechanical load by increasing collagen synthesis, we hypothesized that a correlation between tendon morphology and the loading regime imposed by locomotor style or habitat use exists. This makes tendons an interesting model for studying the relationship between morphology and environment. In this study, we compare the general morphology of the palmar flexor plate, the length of the digital tendons, and the length of the flexor carpi ulnaris tendon in species of lizards that exploit a variety of structural habitats. The results from statistical analyses show that phylogenetic relatedness has a major impact on our ability to detect differences between habitat groups, and no differences in tendon length could be detected between iguanian species occupying different habitats when taking into account the relatedness between species. Our data for lizards diverge from the general mammalian paradigm where variation in tendon is often associated with habitat use or locomotor style.
Pulmonary diffusing capacity for carbon monoxide: a marker of depressed hypercapnic drive in Type 1 diabetes mellitus?
Authors: Fuso L. , Paladini L. , Pitocco D. , Musella T. , Contu C. , Maugeri L. , Santamaria A. P. , Varone F. , Ghirlanda G. , Antonelli Incalzi R.
Published: April 2011

Diabet. Med. 28, 1407–1411 (2011)

Aims  Decreased chemosensitivity to hypercapnia, a common finding in Type 1 diabetes mellitus, seems related to autonomic neuropathy. We proposed to verify whether simple neuroautonomic cardiovascular tests or indexes of severity of diabetes and respiratory impairment can identify patients with such a dysfunction, but no clinical evidence of autonomic neuropathy.

Methods  Forty patients with Type 1 diabetes, 20 with autonomic neuropathy according to the results of a standardized test battery, were studied and compared with 40 normal subjects matched by age and sex. Spirometry and pulmonary diffusing capacity for carbon monoxide were performed. The chemosensitivity to hypercapnia was tested by the rebreathing method.

Results  There was no significant difference between patients with and without autonomic neuropathy in chemosensitivity to hypercapnia, as expressed by the ventilation response to increasing end‐tidal pressure of carbon dioxide; however, it was lower in the whole group of patients with diabetes than in control subjects (1.71 ± 0.80 vs. 2.45 ± 1.11 l−1 min−1 mmHg, respectively, P = 0.002). No significant correlation was found between ventilation response to increasing end‐tidal pressure of carbon dioxide and the results of autonomic tests. In patients with diabetes mellitus, the ventilatory response to hypercapnia significantly correlated with pulmonary diffusing capacity for carbon monoxide (Spearman’s rho = 0.387, P = 0.013) and this was the only variable significantly associated with ventilation response to increasing end‐tidal pressure of carbon dioxide in a multiple regression model.

Conclusions  Chemosensitivity to hypercapnia was depressed in patients with diabetes mellitus, irrespective of autonomic neuropathy, in comparison with control subjects. The correlation with pulmonary diffusing capacity for carbon monoxide suggests that microcirculatory damage might contribute to depress the central chemosensitivity.
Rhetorical Institutionalism: Language, Agency, and Structure in Institutional Theory since Alvesson 1993
Authors: Green Jr Sandy Edward , Li Yuan
Published: April 2011

abstract

In 1993, Mats Alvesson published ‘Organizations as Rhetoric’. In his paper, Alvesson proposed that knowledge was ambiguous and that rhetoric was therefore critical to the construction and operation of institutions and organizations. Moreover, he argued that in such an ambiguous and thus rhetorical world, knowledge operated as an institutionalized myth and rationality surrogate. Alvesson's insights helped inspire and initiate one of the most promising and growing areas of institutional research: rhetorical institutionalism. Rhetorical institutionalism is the deployment of linguistic approaches in general and rhetorical insights in particular to explain how institutions both constrain and enable agency. In this paper, we trace these original insights and discuss the benefits of continuing the integration of rhetorical ideas in institutional research. In addition, we propose and develop a rhetorical model of institutionalism that can spearhead research and conclude with some direct suggestions for future research.
Heavy burdens: Gendered livelihood strategies of porters in Accra, Ghana
Authors: Oberhauser Ann M. , Yeboah Muriel A.
Published: April 2011

Urban poverty is invariably linked to sociospatial dimensions of livelihood strategies. Gendered social relations, for example, have been seen to impact the ability of females to access resources, to gain assets, and to engage in viable income‐generating activities. Focussing on the livelihood strategies of the urban poor as they intersect with neoliberal economic reforms in contemporary Ghana, this paper draws on a field‐based survey of porters in Accra, mostly migrants from rural agricultural northern Ghana, whose primary livelihoods derive from transporting goods for clients in congested market areas of the urban industrial south. The paper highlights the gendered aspects of porters' livelihood experiences such as differences in migration patterns, reliance on physical labour and living conditions, which relatively few analyses have examined, especially as these relate to wider socioeconomic processes. The study illustrates how this perspective is important to understand the intersection of livelihood strategies, gender and national economic reforms in promoting both rural and urban development.
Transnational mining corporations and sustainable resource‐based livelihoods in Sierra Leone
Authors: Akiwumi Fenda A.
Published: April 2011

This paper draws from world‐systems and sustainable livelihoods approaches to analyze the connections between multinational exports of rutile (titanium oxide), diminished ecological resources and resource‐based livelihoods, and gendered household dynamics in a peripheralized mining region in Sierra Leone. The discussion focuses on how the extraction of mineral resources instigated by exogenous capital investors forces links to household transformation, particularly the vulnerability context of women. Using archival records and field survey data, the case study of rutile mining in southwestern Sierra Leone connects the low‐waged mining labour of traditional resource‐based subsistence communities and deepening marginalization of and financial pressures on women in mining households to global mineral markets. The study focuses on women's coping mechanisms that are embedded within traditional social networks in relation to an external intervention, a low‐tech mechanical cassava grater, intended to strengthen their livelihoods. It finds that the potential for this transformation is impeded by sociocultural, environmental and financial limitations.
Industrial land use and heavy metal contaminated wastewater used for irrigation in periurban Zambia
Authors: Kapungwe Evaristo Mwaba
Published: April 2011

Studies on urban and periurban agriculture in Zambia have not adequately tackled land use practices in relation to problems associated with wastewater irrigated farming. This study investigated land use practices in two wastewater irrigated farming areas in the industrial towns of Mufulira and Kafue respectively in the Copperbelt and Lusaka provinces of Zambia. Drawing on data from field interviews and focus group discussions, as well as laboratory analysis of the heavy metal content in the wastewater used for irrigation in farm plots at both sites, the study outlines the problems associated with wastewater irrigated farming, including the vulnerability context of those whose livelihoods depend on insecure access to vacant land for informal farming. The findings also confirm the heavy metal contamination of the wastewater used for farming, as well as seepage into the surrounding environment, from mining and industrial enterprises located amidst residential areas. The characteristics of mixed land use, high crop diversification, multiple cropping systems and multiple livelihood practices found in these areas of informal farming are similar to those noted in periurban farming in other developing economy contexts. Given that wastewater irrigated crop farming forms part of the livelihood portfolio among the majority of periurban populations, these preliminary results reinforce the need for municipal authorities to improve scrutiny of land use regulation, raise awareness among informal farmers of the hazards associated with using domestic sewage wastewater and untreated industrial effluents, and ensure improve treatment of the wastewater used for human consumption.
A spatio‐temporal analysis of the spread of sugarcane yellow leaf virus
Authors: Vaillant Jean , Puggioni Gavino , Waller Lance A. , Daugrois Jean
Published: April 2011

The spatio‐temporal dynamics of disease spread provide an area of acute scientific interest but substantial analytic challenges. Analytic approaches need to draw from current knowledge of disease systems yet be flexible enough to provide targeted inference without restrictive assumptions. We explore this balance in detail with respect to the observed pattern of spread of sugarcane yellow leaf virus, the causal agent of yellow leaf disease. This disease affects cultivated sugarcane plants and spreads via an aphid vector (Melanaphis sacchari). The system is of considerable economic interest, but presents several analytic complications. First, the plants begin as well separated individuals that grow into large plants with overlapping leaf canopies enabling increased vector access between neighbouring plants. The overlap between neighbouring plants first occurs within rows and then extends between rows, presenting another interesting spatial component to consider when modelling the propagation of infection. Second, the vector initially flies between plants but at some point sheds wings and shifts to walking between plants. We are particularly interested in how these two features of the system and their interrelation may impact the spatial spread of disease over time. In addition, we also explore the impact of potential immigration of infected vectors from outside of the study area. We treat our observed cane field as a spatial grid with regular spacing between rows and smaller spacing within rows. Our data consist of observed disease status of each of 1643 plants at each of six time points. We provide descriptive summaries of the temporal evolution of spatial pattern in infection, then propose hierarchical models to describe the pattern and capture the influence of the ecological and environmental factors listed above.
Dreaming experience as a useful diagnostic clue for syncopal episodes
Authors: Chiesa V. , Terranova P. , Vignoli A. , Canevini M. P.
Published: April 2011

Background:  The differential diagnosis between epileptic seizures and syncopes is a common occurrence in clinical practice. The manifestations of seizure and syncope sometimes overlap, and available diagnostic testing often not provides a conclusive answer. Syncope is often preceded by a symptom complex characterized by lightheadedness, generalized muscle weakness, giddiness, visual blurring, tinnitus, and gastrointestinal symptoms. These subjective symptoms are very important in guiding the diagnosis. In our experience, the impression of coming out of a dream after the syncopal episode is a subjective symptom commonly reported by patients, if questioned.

Methods:  To verify the occurrence of dreaming experience after syncope and after generalized tonic‐clonic seizures (GTCS) and its diagnostic value in differential diagnosis, we asked 100 patients with GTCS and diagnosis of idiopathic generalized epilepsy (Group 1) and 100 patients with a certain diagnosis of syncope (Group 2) whether they have never felt the impression of coming out of a dream after the loss of consciousness (GTCS or syncope, respectively).

Results:  In Group 1, nobody referred the dreaming experience, whereas in the syncope group, 19% of patients referred this subjective symptom.

Conclusions:  Dreaming experience seems to be an additional useful diagnostic clue for syncopal episodes, helping the clinician to differentiate them from seizures.
Qualitative and quantitative re‐evaluation of epidermal growth factor‐ErbB1 action on developing midbrain dopaminergic neurons in vivo and in vitro: target‐derived neurotrophic signaling (Part 1)
Authors: Iwakura Yuriko , Zheng Yingjun , Sibilia Maria , Abe Yuichi , Piao Ying‐shan , Yokomaku Daisaku , Wang Ran , Ishizuka Yuta , Takei Nobuyuki , Nawa Hiroyuki
Published: April 2011

J. Neurochem. (2011) 10.1111/j.1471‐4159.2011.07287.x

Although epidermal growth factor (EGF) receptor (ErbB1) is implicated in Parkinson’s disease and schizophrenia, the neurotrophic action of ErbB1 ligands on nigral dopaminergic neurons remains controversial. Here, we ascertained colocalization of ErbB1 and tyrosine hydroxylase (TH) immunoreactivity and then characterized the neurotrophic effects of ErbB1 ligands on this cell population. In mesencephalic culture, EGF and glial‐derived neurotrophic factor (GDNF) similarly promoted survival and neurite elongation of dopaminergic neurons and dopamine uptake. The EGF‐promoted dopamine uptake was not inhibited by GDNF‐neutralizing antibody or TrkB‐Fc, whereas EGF‐neutralizing antibody fully blocked the neurotrophic activity of the conditioned medium that was prepared from EGF‐stimulated mesencephalic cultures. The neurotrophic action of EGF was abolished by ErbB1 inhibitors and genetic disruption of erbB1 in culture. In vivo administration of ErbB1 inhibitors to rat neonates diminished TH and dopamine transporter (DAT) levels in the striatum and globus pallidus but not in the frontal cortex. In parallel, there was a reduction in the density of dopaminergic varicosities exhibiting intense TH immunoreactivity. In agreement, postnatal erbB1‐deficient mice exhibited similar decreases in TH levels. Although neurotrophic supports to dopaminergic neurons are redundant, these results confirm that ErbB1 ligands contribute to the phenotypic and functional development of nigral dopaminergic neurons.
The Potential of Cohesive Silicone for Facial Prosthetic Use: A Material Property Study and a Clinical Report
Authors: Koyama Shigeto , Sasaki Keiichi , Hanawa Soshi , Sato Naoko
Published: April 2011

Purpose: Prosthetic reconstruction of a facial defect can help to reduce disfigurement and restore the social functioning of the patient. Several methods for holding a prosthesis in place exist, including the use of osseointegrated implants and medical adhesive agents; however, since the treatment options for some patients may be restricted by various health conditions and other limitations, including allergies to adhesive agents, a history of radiation therapy, and financial issues, other options that suit individual demands are required. The objectives of this study were to test the hypothesis that adhesive characteristics could be bestowed on silicone elastomers by altering their catalyst/base silicone ratios (CBR) and to examine the effect of the thickness of the cohesive silicone layer of a prosthesis on its initial adhesive strength.

Materials and Methods: The adhesive strengths of specimens with CBRs ranking from 1/10 to 1/70 were examined by the rolling ball tack test. A tensile test was used to evaluate the tensile adhesive strengths of specimens made of layers of cohesive silicone (CBR 1/60) and normal silicone (CBR 1/10) with different thicknesses. Auricular prostheses containing cohesive silicone on the skin side were applied to a 50‐year‐old man with defects in both auricular regions and with reduced manual dexterity due to serious burns.

Results: The rolling distance was reduced with a decrease in CBR, and a thinner cohesive silicone (CBR 1/60) layer demonstrated a higher peak load. On clinical application, the adhesion of the auricular prosthesis containing cohesive silicone was improved by expanding the adhesive area and altering the thickness of the cohesive silicone layer, resulting in sufficient adhesion and easier handling than that achieved using an adhesive agent 1 year post delivery.

Conclusion: These results suggest that cohesive silicone can be used as a glueless retentive material for facial prostheses.
Nucleotide deletion in RHCE*cE (907delC) is responsible for a D– – haplotype in Hispanics
Authors: Westhoff Connie M. , Vege Sunitha , Nickle Pam , Singh Savita , Hue‐Roye Kim , Lomas‐Francis Christine , Reid Marion E.
Published: April 2011

BACKGROUND: Lack of Cc and Ee expression is associated with either hybrid alleles in which regions of RHCE are replaced by RHD or nucleotide deletion(s) in RHCE. The former have been found as D– – phenotypes, and the latter as Rhnull when accompanied by deletion of RHD. We investigated RH in eight samples, three presenting as D– –, whose c–E– red blood cell (RBC) typing was discordant with the RHCE genotype that predicted c+E+.

STUDY DESIGN AND METHODS: Serologic and molecular testing was performed by standard methods.

CASES AND RESULTS: RBCs from Patient 1 were D+C−E−c+e+w but DNA testing predicted E+. RBCs from Patients 2, 3, and 4 typed as D+C−E−c−e− but DNA testing predicted c+E+. All had alloantibodies strongly reactive with all RBCs tested except D– – and Rhnull. Patient 5 had anti‐c and anti‐E but DNA testing predicted she was c+E+. RBCs from three donors typed D+C+E−c−e+ with DNA testing predicting c+E+. All had RHCE*cE with deletion of nucleotide 907C in Exon 6 predicted to cause a premature stop codon at Amino Acid 303 (Leu303Stop). HphI polymerase chain reaction–restriction fragment length polymorphism was used to confirm the deletion and to screen 100 Hispanic, 100 Caucasian, and 100 African American donor samples. One additional example was found.

CONCLUSIONS: A novel allele, RHCE*cE 907delC (ISBT provisional designation RHCE*03N.02), silences c and E and in the homozygous state resulted in a D– – phenotype and production of anti‐Rh17. All eight probands were Hispanic. The allele is associated with discrepant molecular typing, with an approximate frequency of 0.005 in Hispanics.
Optimal preprocedural platelet transfusion threshold for central venous catheter insertions in patients with thrombocytopenia
Authors: Zeidler Kristin , Arn Kornelius , Senn Oliver , Schanz Urs , Stussi Georg
Published: April 2011

BACKGROUND: Patients with severe thrombocytopenia are at risk for bleeding during insertion of central venous catheters (CVCs). Although most guidelines recommend preprocedural platelet (PLT) transfusions at a threshold of less than 50 × 109/L, there is only weak evidence supporting such recommendations.

STUDY DESIGN AND METHODS: The current study aimed to establish a safe PLT transfusion trigger in patients with CVC placements. We performed a retrospective single‐center analysis of 604 CVC insertions in 193 patients with acute leukemia receiving intensive chemotherapy or stem cell transplantation.

RESULTS: A total of 48% of the patients had a bleeding risk during CVC insertions, mostly due to thrombocytopenia. The bleeding incidence was 32% with 96% Grade 1 and 4% Grade 2 bleedings requiring prolonged local compression. There were no Grade 3 to 4 bleedings. Hemoglobin levels were similar before and 24 and 48 hours after the CVC insertion in the bleeding and nonbleeding group and there was no difference in the red blood cell (p = 0.72) and PLT transfusion requirements (p = 0.057) after CVC insertion. In multivariate analysis, only patients with PLT counts of less than 20 × 109/L were at higher risk for bleeding before (p = 0.015) and after preprocedural PLT transfusions (p = 0.006) compared to patients with PLT counts of 100 × 109/L or more.

CONCLUSION: CVC placements can safely be performed in patients with PLT counts of 20 × 109/L or more without preprocedural PLT transfusions.
China's “Color Revolution” Is Red
Authors: LI ERIC
Published: April 2011

Do China's mandarins have anything to fear from the winds of freedom that have blown away Arab autocrats? The short answer is no—for now. The Chinese government has performed for its people, lifting hundreds of millions out of poverty during the same length of time Hosni Mubarak reigned in Egypt.

Though many in the West would like to think so, it is not likely that the rising middle class in China will one day also fill Tiananmen Square in protest. In the immediate future, the chaos and economic drift that will now engulf the liberated Middle East will remind them again that China was right not to go down the path of Gorbachev's glasnost and perestroika in Russia.

And it is not as if they will have a chance. The authorities are determined never to allow any two people who vent virtually on the Net to meet in the street.

In this section, we discuss the impact of the Arab revolt—and lack of it—on China's system of governance.
Why China Won't Follow Arab Revolt
Authors: BELL DANIEL A.
Published: April 2011

Do China's mandarins have anything to fear from the winds of freedom that have blown away Arab autocrats? The short answer is no—for now. The Chinese government has performed for its people, lifting hundreds of millions out of poverty during the same length of time Hosni Mubarak reigned in Egypt.

Though many in the West would like to think so, it is not likely that the rising middle class in China will one day also fill Tiananmen Square in protest. In the immediate future, the chaos and economic drift that will now engulf the liberated Middle East will remind them again that China was right not to go down the path of Gorbachev's glasnost and perestroika in Russia.

And it is not as if they will have a chance. The authorities are determined never to allow any two people who vent virtually on the Net to meet in the street.

In this section, we discuss the impact of the Arab revolt—and lack of it—on China's system of governance.
The Middle Income Transition in China and America's Need for Structural Change
Authors: SPENCE MICHAEL
Published: April 2011

The G‐20 supplanted the G‐8 as the executive committee of globalization as the emerging and advanced economies came together in the wake of the Wall Street crash to stave off depression. Now, each country is going its own way.

In this section we examine whether the G‐20 can be saved, and what the countries within it must do to bring the global economy into balance.
The Arab Revolution is Beyond America's Control
Authors: FULLER GRAHAM E.
Published: April 2011

The Great Arab Revolt of 2011 has moved swiftly from the peaceful overthrow of autocrats in the nation‐states of Tunisia and Egypt to brutal repression in the tribal societies of Libya, Syria, Bahrain and Yemen.

Meanwhile, the wired youth bulge of the Middle East that brought change is dissipating into an impotent diaspora while the organized interests of the old regimes and the once‐suppressed Islamists charge ahead to power. This section examines the revolt, the reaction and the power struggles in its aftermath.
How to Jump‐Start the Post‐Revolutionary Era in Egypt
Authors: ZEWAIL AHMED
Published: April 2011

The Great Arab Revolt of 2011 has moved swiftly from the peaceful overthrow of autocrats in the nation‐states of Tunisia and Egypt to brutal repression in the tribal societies of Libya, Syria, Bahrain and Yemen.

Meanwhile, the wired youth bulge of the Middle East that brought change is dissipating into an impotent diaspora while the organized interests of the old regimes and the once‐suppressed Islamists charge ahead to power. This section examines the revolt, the reaction and the power struggles in its aftermath.
The Tunisian Revolt: Learning from the Mistakes of the Iranian Revolution
Authors: BANI‐SADR ABOLHASSAN
Published: April 2011

The Great Arab Revolt of 2011 has moved swiftly from the peaceful overthrow of autocrats in the nation‐states of Tunisia and Egypt to brutal repression in the tribal societies of Libya, Syria, Bahrain and Yemen.

Meanwhile, the wired youth bulge of the Middle East that brought change is dissipating into an impotent diaspora while the organized interests of the old regimes and the once‐suppressed Islamists charge ahead to power. This section examines the revolt, the reaction and the power struggles in its aftermath.
Reading Gandhi in Cairo
Authors: JAHANBEGLOO RAMIN
Published: April 2011

The Great Arab Revolt of 2011 has moved swiftly from the peaceful overthrow of autocrats in the nation‐states of Tunisia and Egypt to brutal repression in the tribal societies of Libya, Syria, Bahrain and Yemen.

Meanwhile, the wired youth bulge of the Middle East that brought change is dissipating into an impotent diaspora while the organized interests of the old regimes and the once‐suppressed Islamists charge ahead to power. This section examines the revolt, the reaction and the power struggles in its aftermath.
Vitamin D Insufficiency and Sepsis Severity in Emergency Department Patients With Suspected Infection
Authors: Ginde Adit A. , Camargo Carlos A. , Shapiro Nathan I.
Published: April 2011

ACADEMIC EMERGENCY MEDICINE 2011; 18:551–554 © 2011 by the Society for Academic Emergency Medicine

Objectives:  Vitamin D is increasingly recognized as an important mediator of immune function and may have a preventive role in the pathogenesis of sepsis. We sought to evaluate the association between vitamin D status and sepsis severity and hypothesized that vitamin D insufficiency would be associated with increased sepsis severity.

Methods:  This was a pilot study of emergency department (ED) patients age ≥18 years evaluated for suspected infection at an urban, teaching hospital. The authors measured illness severity using the following assessments at baseline and 24 hours: 1) severe sepsis, defined as suspected infection plus two or more elements of systemic inflammatory response syndrome criteria and acute dysfunction of one or more organ systems; 2) Acute Physiology Age Chronic Health Evaluation (APACHE) II scores; and 3) Sepsis‐related Organ Failure Assessment (SOFA) scores. Vitamin D insufficiency was defined as baseline serum 25‐hydroxyvitamin D (25OHD) levels <75 nmol/L.

Results:  Eighty‐one patients were enrolled, with a median age of 62 years (interquartile range [IQR] = 48–76 years), 47% were female, and 77% were white. At baseline, 64 (79%) had 25OHD levels of <75 nmol/L, and 43 (53%) had severe sepsis. At 24 hours, 48 (59%) had severe sepsis. Patients with baseline 25OHD levels of <75 nmol/L, compared to patients with 25OHD levels of ≥75 nmol/L, were more likely to have severe sepsis (61% vs. 24%; p = 0.006) and SOFA scores ≥2 (44% vs. 18%; p = 0.049). Additionally, at 24 hours, those with 25OHD levels of <75 nmol/L were more likely to have severe sepsis (67% vs. 29%; p = 0.005), dysfunction of two or more organ systems (50% vs. 18%; p = 0.02), APACHE II score of ≥25 (19% vs. 0%; p = 0.06), and SOFA scores of ≥2 (63% vs. 29%; p = 0.02). Additionally, all four patients who died during the index hospitalization had 25OHD levels of <75 nmol/L.

Conclusions:  Vitamin D insufficiency was associated with higher sepsis severity in ED patients hospitalized for suspected infection. Larger observational studies, mechanistic studies, and ultimately randomized controlled trials are needed to determine causation and to evaluate if vitamin D supplementation can reduce the risk of sepsis as a preventive or therapeutic strategy.
The effects of ration size on migration by hatchery‐raised Atlantic salmon (Salmo salar) and brown trout (Salmo trutta)
Authors: Lans Linnea , Greenberg Larry A. , Karlsson Jens , Calles Olle , Schmitz Monika , Bergman Eva
Published: April 2011

Abstract –  The possibility to increase the proportion of migrating hatchery‐reared smolts by reducing their food ration was studied. Lake‐migrating, hatchery‐reared salmon (Salmo salar) and trout (Salmo trutta) smolts were either fed normal rations, based on recommendations from the fish‐farming industry, or reduced (15–20%) rations. They were released into the River Klarälven, western Sweden, and followed as they swam downstream to Lake Vänern, a distance of around 25 km. For both Atlantic salmon and brown trout, smolts fed a reduced ration migrated faster than fish fed a normal ration. Furthermore, a higher proportion of salmon smolts fed reduced rations migrated to the lake than fish fed normal rations in 2007 but not in 2006. This difference between years corresponded to greater treatment differences in size and smolt status in 2007 than in 2006. For trout, the proportion of migrating individuals and smolt development did not differ with ration size. Trout migrants fed a normal ration had a higher standard metabolic rate (SMR) than nonmigrants, whereas there was no difference in SMR between migrating and nonmigrating salmon. These results show that it is possible to use a reduced food ration to increase the migration speed of both Atlantic salmon and brown trout and to increase the proportion of migrating Atlantic salmon.
Physical activity interventions: effects of duration and intensity
Authors: Buchan D. S. , Ollis S. , Thomas N. E. , Buchanan N. , Cooper S.‐ M. , Malina R. M. , Baker J. S.
Published: April 2011

The purpose of this study was to examine the effects of exercising at different intensities over 7 weeks on components of physical fitness and CVD risk factors. Forty‐seven boys and 10 girls, (16.4±0.7 years of age) were divided into a moderate, high intensity, or a control group. All participants had indices of obesity and blood pressure recorded in addition to four physical performance measures pre‐ and post‐intervention. In addition, the intervention groups repeated the physical performance measures at the 4th week phase of the intervention. Following the intervention, significant improvements (P<0.05) in the high‐intensity group were found in the 20 MSFT, agility, CMJ and 10 m sprint post‐intervention. Participants in the moderate intensity group displayed significant improvements (P<0.05) in both the CMJ and 20 MSFT post‐intervention. Body fat % significantly improved (P<0.01) in the moderate group only post‐intervention. Interestingly, Systolic blood pressure significantly improved post‐intervention (112±10 vs 106±11 mmHg) (P=0.017) in the high intensity group. In conclusion, high‐intensity exercise over 7 weeks is a very time efficient means of improving important components of physical fitness in adolescents.
Outcome of anterior cruciate ligament reconstruction with emphasis on sex‐related differences
Authors: Ahldén M. , Sernert N. , Karlsson J. , Kartus J.
Published: April 2011

The aim of this retrospective study was to compare the results after arthroscopic anterior cruciate ligament (ACL) reconstruction using the four‐strand semitendinosus‐gracilis (ST/G) autograft in male (n=141) vs female (n=103) patients. The patients were operated on between 1996 and 2005, using interference screw fixation and drilling the femoral tunnel through the anteromedial portal. The pre‐operative assessments and demographics, apart from age (males 29 years, females 26 years; P=0.02), were comparable at the time of surgery. At 25 (23–36) months post‐operatively, no significant differences were found between the study groups in terms of anterior side‐to‐side knee laxity, manual Lachman test, Tegner activity level, Lysholm knee score, range of motion or donor‐site morbidity. Both study groups improved significantly in most clinical assessments and functional scores compared with their pre‐operative values. Two years after ACL reconstruction using ST/G autografts, there were no significant differences between male and female patients in terms of clinical outcome or functional scores.