bluuebunny/crossref_metadata_2025 huggingface dataset:
Measuring Quality Improvement in Public Health
Authors: Joly Brenda M. , Booth Maureen , Mittal Prashant , Shaler George
Published: February 2012

There is growing interest and investment in improving the quality of public health services and outcomes. Following the lead of other sectors, efforts are underway to introduce systematic quality improvement (QI) tools and approaches to state and local public health agencies. Little is known, however, about how to describe and reliably measure the level of QI maturity within a public health agency. The authors describe the development of a QI Maturity Tool using research from the fields of organizational design, psychology, health care, and complexity theory. The 37-item assessment tool is based on four quality domains derived from the literature: (a) organizational culture, (b) capacity and competency, (c) practice, and (d) alignment and spread. The tool was designed to identify features of an organization that may be enhancing or impeding QI; monitor the impact of efforts to create a more favorable environment for QI; and define potential cohorts of public health agencies for evaluation purposes. The article presents initial steps in testing and validating the QI Maturity Tool including: (a) developing a theoretical framework, (b) assuring face and content validity, (c) determining the tool’s reliability based on estimates of internal consistency, (d) assessing the dimensionality, and (f) determining the construct validity of the instrument. The authors conclude that there is preliminary evidence that the QI Maturity Tool is a promising instrument. Further work is underway to explore whether self-reported survey results align with an agency’s actions and the products of their QI efforts.
In Utero and Lactational Exposure to Low-Dose Genistein-Vinclozolin Mixture Affects the Development and Growth Factor mRNA Expression of the Submandibular Salivary Gland in Immature Female Rats
Authors: Kouidhi Wided , Desmetz Catherine , Nahdi Afef , Bergès Raymond , Cravedi Jean-Pierre , Auger Jacques , May Michèle El , Canivenc-Lavier Marie Chantal
Published: February 2012

It has been suggested that hormonally controlled submandibular salivary gland (SSG) development and secretions may be affected by endocrine disruptor compounds. We investigated the effects of oral gestation-lactation exposure to 1 mg/kg body weight daily dose of the estrogenic soy-isoflavone genistein and/or the anti-androgenic food contaminant vinclozolin in female rats. The SSGs of female offspring were collected at postnatal day 35 to study gland morphogenesis and mRNA expression of sex-hormone receptors and endocrine growth factors as sex-dependent biomarkers. Because of high expression in neonatal SSG, mRNA expression of transforming growth factor α was also studied. Exposure to genistein, vinclozolin, or a genistein+vinclozolin mixture resulted in significantly lower numbers of striated ducts linked to an increase in their area and lower acinar proliferation (Ki-67–positive nuclei). Exposure to the mixture had the highest significant effects, which were particularly associated with repression of epidermal growth factor, nerve growth factor, and transforming growth factor α expression. In conclusion, early exposure to low doses of genistein and vinclozolin can affect glandular structure and endocrine gene mRNA expression in prepubertal SSG in female rats, and the effects are potentialized by the genistein+vinclozolin mixture. Our study provides the first evidence that SSG are targeted by both estrogenic and anti-androgenic disrupting compounds and are more sensitive to mixtures.
Prognostic Factors of Arthroscopic Pull-out Repair for a Posterior Root Tear of the Medial Meniscus
Authors: Moon Hong-Kyo , Koh Yong-Gon , Kim Yong-Chan , Park Young-Sik , Jo Seung-Bae , Kwon Sae-Kwang
Published: February 2012

Background: Repair of a posterior root tear of the medial meniscus (MRT) decreases peak contact pressure by restoring hoop tension and is expected to prevent progression to osteoarthritis.

Purpose: The purposes of this study were (1) to report the clinical and magnetic resonance imaging (MRI) results of arthroscopic pull-out repair of the MRT and (2) to identify prognostic factors of poor outcome.

Study Design: Case series; Level of evidence, 4.

Methods: Fifty-one patients (47 women, 4 men) who underwent arthroscopic pull-out repair of the MRT by a single surgeon were enrolled. Mean follow-up after surgery was 33 months (range, 24-44 months). To identify factors affecting final outcome, patient-specific factors, such as gender, age, body mass index, meniscus extrusion, extrusion increase, subchondral edema, degree of varus alignment (<5° or >5°), and cartilage status in the medial compartment (Outerbridge grade 1 or 2 lesion vs grade 3 or 4 lesion), were investigated. Final clinical outcomes were determined using a visual analog scale (VAS) for pain and patient satisfaction scores, American Knee Society (AKS) scores, and Lysholm scores, and MRI outcomes were determined by evaluating meniscus extrusion and articular cartilage status. Multiple regression analysis was performed to identify variables that independently affected clinical and MRI-determined outcomes.

Results: All clinical outcome measures significantly improved after surgery. Patients with Outerbridge grade 3 or 4 chondral lesions had poorer results than those with grade 1 or 2 lesions in terms of AKS function and Lysholm scores. Patients with varus alignment of >5° had poorer results than those with varus alignment of <5° in terms of VAS satisfaction, AKS function, and Lysholm scores. Mean meniscus extrusion increased from 3.6 mm preoperatively to 5.0 mm postoperatively. Chondral lesions progressed in 3 (9.7%) of 31 patients. Preoperative meniscus extrusion was found to be positively correlated with final extrusion.

Conclusion: At a mean follow-up of 33 months after pull-out repair, extrusion of the meniscus was found to have progressed. Nevertheless, this technique provided patients with a clinical benefit. Outerbridge grade 3 or 4 chondral lesions and varus alignment of >5° were found to independently predict an inferior clinical outcome.
Microstructure and finite element analysis of 3D five-directional braided composites
Authors: Li Jin-Chao , Chen Li , Zhang Yi-Fun , Pan Ning
Published: February 2012

Microstructure of 3D five-directional braided composites determines its mechanical properties. Microscopic evidence of the microstructure reveals that the cross-sections of the axial yarn are variable along its central axial due to the lateral compression from the adjacent braiding yarns. On the basis of microscopic observations, a dense but non-intersecting geometry internal unit cell model of 3D five-directional braided composites is established. By using the unti-cell model, a 3D mesomechanical FEA is proposed to predict the effective elastic properties of 3D five-directional braided composites. Compared with existing model, present model is more effective to calculate the mechanical properties of 3D five-directional braided composites with more than 50% fiber volume fraction.
Experimental studies on mechanical behavior and microstructural assessment of glass/epoxy composites at low temperatures
Authors: Sethi Sanghamitra , Panda P.K. , Nayak R. , Ray B.C.
Published: February 2012

A series of flexure tests with varying crosshead speed were conducted to study the mechanical behavior of glass/epoxy composites at low temperature. The micromechanics of damage growth and failures underpin the understanding of the revealed fractography. The three-point flexure test of heat-treated and untreated samples was carried out, which were further exposed to low and ultra-low working temperatures of −20°C, −40°C, −60°C, −80°C. The interlaminar shear strength was found to be affected by these conditionings. The unbalanced and inhomogeneous stress concentration within entangled chain of matrix reduces conformational isomerism which in turn reduces the ILSS value considerably at low crosshead speed. At increased crosshead speed (strain rate), the matrix becomes brittle and fracture strain decreases, but at very high strain rate, the fracture strain increases. The reason is anticipated to be adiabatic heating. Temperature-modulated differential scanning calorimetry shows increase in glass transition temperature ( Tg). A change in crosshead speed may result in variation of failure modes, which is observed in scanning electron microscope.
Transport properties of polyester composite reinforced with treated sisal fibers
Authors: Sreekumar P.A. , Agoudjil B. , Boudenne A. , Unnikrishnan G. , Ibos L. , Fois M. , Thomas S.
Published: February 2012

Thermal conductivity, diffusivity, relative permittivity, specific heat, and tensile properties of sisal/polyester composites were investigated as a function of fiber volume fraction and fiber surface modification. The composites were prepared by resin transfer molding (RTM) technique. Sisal fibers were subjected to various chemical and physical modifications such as mercerization, heating at 100°C, permanganate treatment, benzoylation, and silanization to improve the interfacial bonding with matrix. All treatments used in this study improved the relative permittivity, tensile strength, Young’s modulus, and reduced the elongation at break. The use of NaOH and silane treatments decreased the thermal conductivity. Beside these, a comparison between dielectric, mechanical, and thermal behaviors of the composites was reported in this paper. A linear dependence of the relative variation of dielectric permittivity, Young’s modulus, and thermal conductivity was also shown for untreated systems.
Socially Responsible Labeling
Authors: Hyllegard Karen H. , Yan Ruoh-Nan , Ogle Jennifer Paff , Lee Kyu-Hye
Published: February 2012

This study examined consumers' responses to apparel companies' use of hang tags to emphasize their socially responsible (SR) business practices. Informed by the theory of reasoned action, this research explored the impact of environmentally-friendly production and fair labor messages upon consumers' evaluations of hang tags as well as their attitudes and purchase intentions toward an apparel brand. Messages varied in content (eco-fashion vs. fair labor), explicitness (low vs. high), and third-party SR logo (absence vs. presence). Data were collected through an online survey of 764 adults. Findings suggest that apparel companies may benefit from using hang tags featuring explicit messages and logos to convey their SR business practices. The use of explicit messages and logos produced favorable evaluations of hang tags and positive attitudes toward the apparel brand, which predicted purchase intentions. Findings provide a basis for the development of policy regarding the regulation of information presented on hang tags.
The Association Between Pharmacologic Drug Intoxication and Forensic-Specific Intent
Authors: Yoshizuka Keith I. , Perry Paul J.
Published: February 2012

Two criminal cases are presented in which the counsel for the defendants requested an expert witness to opine whether their drug-intoxicated clients were capable of forming the specific intent necessary to commit the felonies for which they were charged. Intent from a legal standpoint is often times a poorly understood concept among expert witnesses. The application of a criminal defense of intoxication depends upon the nature of the crime the defendant is accused. The intoxication defense cannot be applied to general intent crimes. In cases where specific intent crimes are charged against the defendant, voluntary intoxication may be used to prove that the defendant could not possess the capacity to formulate the intent as a necessary element of the crime. Voluntary intoxication may be used as a defense in specific intent crimes to negate the critical element of intent required for the prosecution to prove in criminal cases. Without being able to prove intent, the prosecution has not met their burden of proving that every element of the crime has been met, thus resulting in an acquittal.
When Social Networking Is Not Working
Authors: Forest Amanda L. , Wood Joanne V.
Published: February 2012

The popular media have publicized the idea that social networking Web sites (e.g., Facebook) may enrich the interpersonal lives of people who struggle to make social connections. The opportunity that such sites provide for self-disclosure—a necessary component in the development of intimacy—could be especially beneficial for people with low self-esteem, who are normally hesitant to self-disclose and who have difficulty maintaining satisfying relationships. We suspected that posting on Facebook would reduce the perceived riskiness of self-disclosure, thus encouraging people with low self-esteem to express themselves more openly. In three studies, we examined whether such individuals see Facebook as a safe and appealing medium for self-disclosure, and whether their actual Facebook posts enabled them to reap social rewards. We found that although people with low self-esteem considered Facebook an appealing venue for self-disclosure, the low positivity and high negativity of their disclosures elicited undesirable responses from other people.
The Encyclical Letter (Caritas in Veritate)—A Shout-out to Social Entrepreneurship?
Authors: Simha Aditya , Carey Michael R.
Published: February 2012

Ever since Pope Benedict XVI’s recent social encyclical letter ( Caritas in Veritate) released in June 2009, it has been accessed and read by millions of folks across the globe. This article attempts to display a linkage between the central message of the Caritas in Veritate (Love in Truth) encyclical letter and social entrepreneurship. We provide evidence for our contention, that what Pope Benedict XVI suggests can be arrived at by utilising a social entrepreneurial solution, and that he is advocating that social entrepreneurship be encouraged and allowed to flourish.
Opportunity Recognition in Social Entrepreneurship
Authors: Lehner Othmar M. , Kansikas Juha
Published: February 2012

Opportunity recognition (OR) is at the very heart of entrepreneurship. However, research on OR in the context of social entrepreneurship is still in its early stages. First, this article identifies, codifies and analyses OR-relevant articles on social entrepreneurship (SE) through the lens of Sarasvathy’s three views of entrepreneurial opportunity recognition. In the second step, statistical methods are applied on the results to indicate possible correlations among different schools of thought in SE and views on OR. OR in social ventures is found to be a prevalent topic in SE literature and differences in OR between social and commercial ventures are found.
Logistic Predictive Model for SMEs Financing in India
Authors: Jain K.K. , Gupta P.K. , Mittal Sanjiv
Published: February 2012

Credit assessment risk for small and medium enterprises (SMEs) offers special challenges to practitioners, regulators and academics. The lenders’ design of the package of credit to SMEs may affect the propensity to default or lead to delinquency. Considering the fundamental role being played by small-sized industries in Indian economy and emphasis on inclusive economy, we aim to develop a default prediction model, specifically for SMEs. Apart from the conventional ‘ability to pay’ basis of analyzing borrower-centric default risk, there may be a set of other explanatory variables that can be modelled to assess the credit default. The study here examines the behaviour of relevant measures of default risk and explores the most significant variables of the financial package to construct a model for SMEs by applying multinomial logistic regression technique. The study is based on database covering two years of the time period from 2007 to 2009 on 2,864 SMEs pertaining to an emerging cluster obtained from a prominent financial institution in Delhi.
Bovine papular stomatitis affecting dairy cows and milkers in midwestern Brazil
Authors: de Sant’Ana Fabiano J. F. , Rabelo Rogério E. , Vulcani Valcinir A. S. , Cargnelutti Juliana F. , Flores Eduardo F.
Published: February 2012

Bovine papular stomatitis virus (BPSV) is a parapoxvirus associated with papular and erosive lesions on the muzzle, lips, and oral mucosa of cattle. Teats of milking cows are occasionally affected, and the infection is frequently transmitted to human beings. The present report describes an outbreak of BPSV infection affecting cows in midwestern Brazil, with human involvement. The disease was observed in neighboring small hand-milking farms, affecting 20 milking cows. The signs included painful reddish papules, ulcers, and scabby proliferative lesions on the teats, with a clinical course of 7–12 days. Affected cows presented severe local pain, not allowing the completion of milking. Histologically, acanthosis, spongiosis, and parakeratotic hyperkeratosis with adjacent focally extensive ulcers and multifocal inflammatory infiltrate were observed in the epidermis. Eosinophilic inclusion bodies were noted in the cytoplasm of epithelial cells. Personnel milking the affected cows developed lesions on the hands, painful papules that progressed to ulcerative and scabby lesions in 4–7 days. A polymerase chain reaction using a set of pan-parapoxvirus primers for the B2L gene performed on DNA extracted from scabs amplified a 590-bp product, which when sequenced, revealed similarities of 99%, 85%, and 84% with BPSV, Pseudocowpox virus, and Orf virus, respectively. A phylogenetic tree based on the B2L sequence was constructed, showing that the virus clustered with BPSV isolates. Although clinical cases compatible with BSPV infection have been frequently described in Brazil, the present report identifies the agent associated with cattle and human disease in the country.
Comparison of Q fever serology methods in cattle, goats, and sheep
Authors: Emery Michelle P. , Ostlund Eileen N. , Schmitt Beverly J.
Published: February 2012

Coxiella burnetii is an obligate intracellular bacterium that is responsible for the zoonotic disease Q fever. The distribution of this agent is worldwide except for New Zealand, and infection can be asymptomatic in both human beings and animals. Chronic exposures can produce abortions, stillbirths, and infertility issues in animals and endocarditis in human beings. A commercial enzyme-linked immunosorbent assay (ELISA) kit marketed in the European Union was purchased to compare C. burnetii antibody detection methods. The current study examined the agreement of ELISA and complement fixation results in over 668 diagnostic ruminant sera submitted to the National Veterinary Services Laboratories for Q fever serologic testing. The majority of combined sera (548) were negative on both tests. Fifty-seven of the combined sera were positive on both tests. There were 45 combined sera with low complement fixation titers at 1:10 and negative ELISA results. The results were surprising given the expectations that ELISA methods, by nature, amplify detection of antibody–antigen interactions leading to higher sensitivity. Potential mechanisms for these discrepant results are discussed.
An outbreak of pseudocowpox in fattening calves in southern Brazil
Authors: Cargnelutti Juliana F. , Flores Mariana M. , Teixeira Fábio R. M. , Weiblen Rudi , Flores Eduardo F.
Published: February 2012

Pseudocowpox virus is a parapoxvirus frequently associated with papulovesicular and scabby lesions on the teats and udders of milking cows and is often transmitted to human beings. An unusual outbreak of skin disease in fattening calves in southern Brazil is described. Fourteen of 17 male cattle (82%), aged 6–48 months, feeding on grass pastures were affected. Animals developed papules, vesicles, and scabby proliferative lesions on the muzzle in a clinical course of approximately 10–15 days. The scabby lesions often presented with exudation and bleeding. Histological examination of mucocutaneous tissue in detached scabs revealed acanthosis with thickening of the corneal layer and premature keratinization (parakeratotic hyperkeratosis). The dermis had multifocal lymphoplasmacytic infiltrates. Electron microscopic examination of scab specimens revealed typical parapoxvirus particles: oval shaped (260 nm × 160 nm), enveloped, and covered with a helical layer. Polymerase chain reaction using a set of pan-parapoxvirus primers for the B2L gene amplified a 590-bp product out of DNA extracted from scabs. Nucleotide sequencing of the amplicons revealed a nucleotide homology of 97% with Pseudocowpox virus and lower homology with other parapoxviruses: Bovine papular stomatitis virus (84%) and Orf virus (94%). A phylogenetic tree based on the B2L sequence was constructed, showing that the virus clustered with Pseudocowpox virus isolates.
OASIS Update
Authors: Niewenhous Susan S.
Published: February 2012

Centers for Medicare and Medicaid Services (CMS) continues to receive questions on the finer points of completing the CMS OASIS-C data sets. Particular queries addressed in the October 2011 CMS OCCB Q&As concern the timing and use of particular data sets (Transfer, Resumption, Recertification), description and treatment of pressure ulcers, independence in administering injectable medication and feeding oneself, and ADL issues such as transferring and ambulating with devices designed to assist the blind. Exploration of these issues is the subject of this article.
Web media and the quantitative content analysis: Methodological challenges in measuring online news content
Authors: Sjøvaag Helle , Stavelin Eirik
Published: February 2012

This article presents a method for quantitative content analysis of news online. The research design is based on a triangulation approach, using qualitative and quantitative measures combined with automated computer-assisted analysis. Used to perform a content analysis of the online news output of the Norwegian Broadcasting Corporation [NRK] from 2009, this approach revealed that methodologies designed for measuring broadcasting news content do not suffice in the online news environment. Online research methods need to be redesigned to account for the medium-specific news features on the internet. Computer-assisted coding methods can contribute depth and scale to such an analysis, as it can extract and assemble detailed data on large quantities of articles. Using a combination of automatic coding methods with established content analysis for television news, this article presents a new design for quantitative content analysis of news online.
New technology, old practices
Authors: Himelboim Itai , McCreery Steve
Published: February 2012

This study takes a journalistic professional approach to examine integration patterns of interactive features in news media websites. It draws from two aspects of journalistic work – the relationship with audiences and medium-related practices. Consequently, two frameworks are proposed for categorizing interactive features: the first is based on the relationships news media allow their audiences to have with news content – consuming content, influencing content, or passing it beyond the news site; the second is based on the characteristics of features – textual or visual. Findings from 100 news organizations show that, overall, news media preferred applying features that allow users to interact with content, but without the ability to influence it. In addition, the use of features was tightly related to the technology associated with a news organization; newspapers’ websites were more likely to use text-based features and vice versa.
Passion in breast cancer survivors: Examining links to emotional well-being
Authors: Burke Shaunna M. , Sabiston Catherine M. , Vallerand Robert J.
Published: February 2012

This study (1) identified the activities that breast cancer survivors report as passionate; (2) examined whether levels of passion differed based on the types of passionate activities reported and; (3) examined the association between harmonious and obsessive passion and emotional well-being. Early post-treatment breast cancer survivors (N = 177) reported passionate physical activities as most prevalent, and reported higher harmonious passion scores compared to women reporting relaxing and social leisure activities. Harmonious passion was associated with higher positive affect and lower cancer worry. Obsessive passion was linked to higher negative affect, cancer worry, and posttraumatic growth. Passion is important for enhanced well-being.
Debiasing comparative optimism and increasing worry for health outcomes
Authors: Rose Jason P
Published: February 2012

Comparative optimism – feeling at less personal risk for negative outcomes than one’s peers – has been linked to reduced prevention efforts. This study examined a novel debiasing technique aimed at simultaneously reducing both indirectly and directly measured comparative optimism. Before providing direct comparative estimates, participants provided absolute self and peer estimates in a joint format (same computer screen) or a separate format (different computer screens). Relative to the separate format condition, participants in the joint format condition showed (1) lower comparative optimism in absolute/indirect measures, (2) lower direct comparative optimism, and (3) heightened worry. Implications for risk perception screening are discussed.
Racial discrimination and health-promoting vs damaging behaviors among African-American adults
Authors: Corral Irma , Landrine Hope
Published: February 2012

Studies have found relationships between racial discrimination and increased health-damaging behaviors among African-Americans, but have not examined possible concomitant decreased health-promoting behaviors. We explored the role of discrimination in two health-promoting behaviors, consuming ≥ 5 fruits/vegetables daily (FVC) and physical activity (PA), for the first time, and likewise examined discrimination’s contribution to cigarette smoking, among a sample of N = 2118 African-American adults. Results revealed that discrimination contributed positively to smoking and to PA but was unrelated to FVC. These findings suggest that both adaptive and maladaptive health behaviors might be used to cope with the stress of discrimination.
Nationspeak as a tool in nature tourism work
Authors: Valkonen Jarno , Ruuska Petri
Published: February 2012

How are categories and stereotypes of nations used in nature tourism work by guides? In this article categories and stereotypes are studied in their context of use, and the characterizations are revealed as practical tools that are constantly monitored. The use of descriptions is flexible and part of mastery of the trade. Descriptions are enforced and deconstructed, or the explaining category is switched to other if the situation calls for it. Because categories and stereotypes are hazy, rationalization of them is a crucial part of the work. The practicality of tools is context-based: they are constructed within the special relationship of the guide and the customer in nature tourism.
Educational inequalities in disability pensioning – the impact of illness and occupational, psychosocial, and behavioural factors: The Nord-Trøndelag Health Study (HUNT)
Authors: Nilsen Sara Marie , Ernstsen Linda , Krokstad Steinar , Westin Steinar
Published: February 2012

Aims: Socioeconomic inequalities in disability pensioning are well established, but we know little about the causes. The main aim of this study was to disentangle educational inequalities in disability pensioning in Norwegian women and men. Methods: The baseline data consisted of 32,948 participants in the Norwegian Nord-Trøndelag Health Study (1995–97), 25–66 years old, without disability pension, and in paid work. Additional analyses were made for housewives and unemployed/laid-off persons. Information on the occurrence of disability pension was obtained from the National Insurance Administration database up to 2008. Data analyses were performed using Cox regression. Results: We found considerable educational inequalities in disability pensioning, and the incidence proportion by 2008 was higher in women (25–49 years 11%, 50–66 years 30%) than men (25–49 years 6%, 50–66 years 24%). Long-standing limiting illness and occupational, psychosocial, and behavioural factors were not sufficient to explain the educational inequalities: young men with primary education had a hazard ratio of 3.1 (95% CI 2.3–4.3) compared to young men with tertiary education. The corresponding numbers for young women were 2.7 (2.1–3.1). We found small educational inequalities in the oldest women in paid work and no inequalities in the oldest unemployed/laid-off women and housewives. Conclusions: Illness and occupational, psychosocial, and behavioural factors explained some of the educational inequalities in disability pensioning. However, considerable inequalities remain after accounting for these factors. The higher incidence of disability pensioning in women than men and the small or non-existing educational inequalities in the oldest women calls for a gender perspective in future research.
Optimal Mode for Maximal Aerobic Exercise Testing in Breast Cancer Survivors
Authors: Dolan Lianne B. , Lane Kirstin , McKenzie Donald C.
Published: February 2012

Purpose. To determine which mode of exercise is preferred by breast cancer survivors and to evaluate this response between graded exercise testing on a treadmill and on a cycle ergometer. Methods. Twelve breast cancer survivors completed 2 maximal aerobic stress tests on separate days. The women completed a ramp protocol on an electronically braked cycle ergometer and an incremental step protocol on a treadmill to volitional fatigue. Test order was randomized. Expired gases were collected for the determination of peak aerobic capacity (Vo2peak). Results. Exercise mode had a significant effect on the graded exercise response in breast cancer survivors, P = .003. Treadmill Vo2peak was significantly greater than bike Vo2peak (28.7 ± 4.7 vs 23.9 ± 4.7 mL/min/kg, respectively, P = .003) and VEmax was equivalent between exercise modes ( P = .731). Maximal heart rate was significantly higher by 11 bpm during the treadmill protocol ( P = .004), and Ve/VCo2 exhibited possible mode dependency ( P = .018). Conclusion. This patient population felt more comfortable and produced significantly greater Vo2peak values using the treadmill protocol. These results discuss the potential implications concerning the design and interpretation of exercise interventions for breast cancer survivors.
Robotic-Assisted Total Mesorectal Excision With the Aid of a Single-Port Device
Authors: Rodríguez Rosa M. Jiménez , Pavón José M. Díaz , de la Portilla Fernando , Sillero Emilio Prendes , Dussort Jean M. H.Cadet , Padillo Javier
Published: February 2012

Introduction and indications. Robotic surgery has numerous advantages in rectal cancer surgery. Studies have reported the advantages associated with single-port approaches, such as eliminating the need for additional incisions, as well as the difficulties inherent in this technique. The authors present a hybrid technique that they performed using a robotic total mesorectal excision with the aid of a single port-device. Materials and methods. The authors performed the technique on 2 patients using a single-port device through an umbilical incision and 3 accessory ports for the robotic arms. There was no need to place ports for the assistant’s equipment or for an assistant incision. Results and complications. The operation time was 177.5 minutes, and there were no intraoperative or postoperative complications. Both patients were discharged 7 days after the operation. Conclusions. This technical variation is an additional step forward for oncological surgery with minimal damage to the abdominal wall.
9/11 – A New Pearl Harbor? Analogies, Narratives, and Meanings of 9/11 in Civil Society
Authors: Connor Brian T.
Published: February 2012

Narrative analyses in the neo-Durkheimian tradition have tended to focus mostly on event-specific narratives in civil society in order to study meanings, strategies, and codes surrounding those events. Analysis of comparisons between the 9/11 attacks and those at Pearl Harbor can build on this tradition by expanding the discursive locations from which to understand the construction of meanings in civil society. Through examining specific analogies, narratives, and metanarratives, I show how the comparison of 9/11 to the attacks on Pearl Harbor has led to varying meanings of 9/11 based on the employment of various genre based narratives and metanarratives of the events and the nation.
Functional features of RUNX1 mutants in acute transformation of chronic myeloid leukemia and their contribution to inducing murine full-blown leukemia
Authors: Zhao Li-Juan , Wang Yue-Ying , Li Guo , Ma Li-Yuan , Xiong Shu-Min , Weng Xiang-Qin , Zhang Wei-Na , Wu Bo , Chen Zhu , Chen Sai-Juan
Published: February 2012

The BCR-ABL fusion protein generated by t(9;22)(q34;q11) in chronic myeloid leukemia (CML) plays an essential role in the pathogenesis of the myeloproliferative disorder status at the chronic phase of the disease, but progression from the chronic phase to blast crisis (BC) is believed to require additional mutations. To explore the underlying mechanisms for BC, which is characterized by a blockage of blood cell differentiation, we screened several genes crucial to hematopoiesis and identified 10 types of mutations in RUNX1 among 11 of 85 (12.9%) patients with acute transformation of CML. Most of the mutations occurred in the runt homology domain, including H78Q, W79C, R139G, D171G, R174Q, L71fs-ter94, and V91fs-ter94. Further studies indicated that RUNX1 mutants not only exhibited decreased transactivation activity but also had an inhibitory effect on the WT RUNX1. To investigate the leukemogenic effect of mutated RUNX1, H78Q and V91fs-ter94 were transduced into 32D cells or BCR-ABL–harboring murine cells, respectively. Consistent with the myeloblastic features of advanced CML patients with RUNX1 mutations, H78Q and V91fs-ter94 disturbed myeloid differentiation and induced a BC or accelerated phase–like phenotype in mice. These results suggest that RUNX1 abnormalities may promote acute myeloid leukemic transformation in a subset of CML patients.
TCR affinity and specificity requirements for human regulatory T-cell function
Authors: Plesa Gabriela , Zheng Lingjie , Medvec Andrew , Wilson Caleph B. , Robles-Oteiza Camila , Liddy Nathaniel , Bennett Alan D. , Gavarret Jessie , Vuidepot Annelise , Zhao Yangbing , Blazar Bruce R. , Jakobsen Bent K. , Riley James L.
Published: February 2012

We investigated whether TCRs restricted to the more ubiquitously expressed MHC class I molecules could be used to redirect human regulatory T cells (Tregs). Using a series of HLA-A2–restricted TCRs that recognize the same peptide-MHC class I complex (pMHC) with affinities varying up to 3500 fold, we observed that TCR affinity had no effect on the ability of the introduced TCRs to confer potent Ag-specific suppressive activity. Surprisingly, we found a naturally occurring, low-affinity MHC class I–restricted TCR specific for an NY-ESO-1 epitope that was unable to redirect a functional CD4 T-effector cell response could confer potent antigen-specific suppressive activity when expressed in Tregs and severely impair the expansion of highly functional HIV-1GAG–specific CD8 T cells expressing a high-affinity TCR. This suppressive activity was only observed when both Ags were presented by the same cell, and no suppression was observed when the target Ags were put in distinct cells. These studies underscore the clinical utility of using MHC class I–restricted TCRs to endow Tregs with specificity to control autoimmune disease and highlight the conditions in which this approach would have most therapeutic benefit.
Quantitative differences in HTLV-I antibody responses: classification and relative risk assessment for asymptomatic carriers and ATL and HAM/TSP patients from Jamaica
Authors: Enose-Akahata Yoshimi , Abrams Anna , Johnson Kory R. , Maloney Elizabeth M. , Jacobson Steven
Published: February 2012

Adult T-cell leukemia (ATL) and human T-cell lymphotropic virus type I (HTLV-I)–associated myelopathy/tropical spastic paraparesis (HAM/TSP) are known to be caused by HTLV-I infection. However, current methods used to determine HTLV-I infection do not differentiate between HTLV-I asymptomatic carriers (ACs) and ATL and HAM/TSP patients. Using the luciferase immunoprecipitation system, a highly sensitive, quantitative technology that can efficiently detect HTLV-I Ab responses, we examined Ab responses for HTLV-I in serum/plasma samples from 439 subjects in Jamaica, including HTLV-I–seronegative donors, ACs, and ATL and HAM/TSP patients. The Ab responses of HTLV-I–infected subjects differed significantly from those of seronegative donors for all 3 immunodominant proteins, Gag, Env, and Tax. HAM/TSP patients had significantly higher Ab responses for Gag and Env compared with ACs, and Ab responses for all 3 Ags were higher in HAM/TSP patients than in ATL patients. Moreover, immunoreactivities for HTLV-I Ags as determined by the luciferase immunoprecipitation system could distinguish HAM/TSP patients from ACs at a true-positive rate of 85.42% and from ATL patients at a true-positive rate of 75.00%, and modeled in conjunction with subject information to distinguish HAM/TSP patients from ACs (odds ratio = 14.12) and from ATL patients (odds ratio = 7.00). The relative risk assessment resulting from these significant differences between Ab responses in HTLV-I–infected groups may be a useful diagnostic tool in the future.
Evolution of the intercontinental disjunctions in six continents in the Ampelopsis clade of the grape family (Vitaceae)
Authors: Nie Ze-Long , Sun Hang , Manchester Steven R , Meng Ying , Luke Quentin , Wen Jun
Published: February 2012

Background

TheAmpelopsisclade (Ampelopsisand its close allies) of the grape family Vitaceae contains ca. 43 species disjunctly distributed in Asia, Europe, North America, South America, Africa, and Australia, and is a rare example to study both the Northern and the Southern Hemisphere intercontinental disjunctions. We reconstruct the temporal and spatial diversification of theAmpelopsisclade to explore the evolutionary processes that have resulted in their intercontinental disjunctions in six continents.

Results

The Bayesian molecular clock dating and the likelihood ancestral area analyses suggest that theAmpelopsisclade most likely originated in North America with its crown group dated at 41.2 Ma (95% HPD 23.4 - 61.0 Ma) in the middle Eocene. Two independent Laurasian migrations into Eurasia are inferred to have occurred in the early Miocene via the North Atlantic land bridges. The ancestor of the Southern Hemisphere lineage migrated from North America to South America in the early Oligocene. The Gondwanan-like pattern of intercontinental disjunction is best explained by two long-distance dispersals: once from South America to Africa estimated at 30.5 Ma (95% HPD 16.9 - 45.9 Ma), and the other from South America to Australia dated to 19.2 Ma (95% HPD 6.7 - 22.3 Ma).

Conclusions

The global disjunctions in theAmpelopsisclade are best explained by a diversification model of North American origin, two Laurasian migrations, one migration into South America, and two post-Gondwanan long-distance dispersals. These findings highlight the importance of both vicariance and long distance dispersal in shaping intercontinental disjunctions of flowering plants.
Evaluating the cost effectiveness of donepezil in the treatment of Alzheimer's disease in Germany using discrete event simulation
Authors: Hartz Susanne , Getsios Denis , Tao Sunning , Blume Steve , Maclaine Grant
Published: February 2012

Background

Previous cost-effectiveness studies of cholinesterase inhibitors have modeled Alzheimer's disease (AD) progression and treatment effects through single or global severity measures, or progression to "Full Time Care". This analysis evaluates the cost-effectiveness of donepezil versus memantine or no treatment in Germany by considering correlated changes in cognition, behavior and function.

Methods

Rates of change were modeled using trial and registry-based patient level data. A discrete event simulation projected outcomes for three identical patient groups: donepezil 10 mg, memantine 20 mg and no therapy. Patient mix, mortality and costs were developed using Germany-specific sources.

Results

Treatment of patients with mild to moderately severe AD with donepezil compared to no treatment was associated with 0.13 QALYs gained per patient, and 0.01 QALYs gained per caregiver and resulted in average savings of €7,007 and €9,893 per patient from the healthcare system and societal perspectives, respectively. In patients with moderate to moderately-severe AD, donepezil compared to memantine resulted in QALY gains averaging 0.01 per patient, and savings averaging €1,960 and €2,825 from the healthcare system and societal perspective, respectively.

In probabilistic sensitivity analyses, donepezil dominated no treatment in most replications and memantine in over 70% of the replications. Donepezil leads to savings in 95% of replications versus memantine.

Conclusions

Donepezil is highly cost-effective in patients with AD in Germany, leading to improvements in health outcomes and substantial savings compared to no treatment. This holds across a variety of sensitivity analyses.
Effects of partner proteins on BCA2 RING ligase activity
Authors: Bacopulos Stephanie , Amemiya Yutaka , Yang Wenyi , Zubovits Judit , Burger Angelika , Yaffe Martin , Seth Arun K
Published: February 2012

Background

BCA2 is an E3 ligase linked with hormone responsive breast cancers. We have demonstrated previously that the RING E3 ligase BCA2 has autoubiquitination activity and is a very unstable protein. Previously, only Rab7, tetherin, ubiquitin and UBC9 were known to directly interact with BCA2.

Methods

Here, additional BCA2 binding proteins were found using yeast two-hybrid and bacterial-II-hybrid screening techniques with Human breast and HeLa cDNA libraries. Co-expression of these proteins was analyzed through IHC of TMAs. Investigation of the molecular interactions and effects were examined through a series of in vivo and in vitro assays.

Results

Ten unique BCA2 interacting proteins were identified, two of which were hHR23a and 14-3-3sigma. Both hHR23a and 14-3-3sigma are co-expressed with BCA2 in breast cancer cell lines and patient breast tumors (n = 105). hHR23a and BCA2 expression was significantly correlated (P = < 0.0001 and P = 0.0113) in both nucleus and cytoplasm. BCA2 expression showed a statistically significant correlation with tumor grade. High cytoplasmic hHR23a trended towards negative nodal status. Binding to BCA2 by hHR23a and 14-3-3sigma was confirmed in vitro using tagged partner proteins and BCA2. hHR23a and 14-3-3sigma effect the autoubiquitination and auto-degradation activity of BCA2. Ubiquitination of hHR23a-bound BCA2 was found to be dramatically lower than that of free BCA2, suggesting that hHR23a promotes the stabilization of BCA2 by inactivating its autoubiquitination activity, without degradation of hHR23a. On the other hand, phosphorylated BCA2 protein is stabilized by interaction with 14-3-3sigma both with and without proteasome inhibitor MG-132 suggesting that BCA2 is regulated by multiple degradation pathways.

Conclusions

The interaction between BCA2 and hHR23a in breast cancer cells stabilizes BCA2. High expression of BCA2 is correlated with grade in breast cancer, suggesting regulation of this E3 ligase is important to cancer progression.
Construction of a cellulase hyper-expression system in Trichoderma reesei by promoter and enzyme engineering
Authors: Zou Gen , Shi Shaohua , Jiang Yanping , van den Brink Joost , de Vries Ronald P , Chen Ling , Zhang Jun , Ma Liang , Wang Chengshu , Zhou Zhihua
Published: February 2012

Background

Trichoderma reesei is the preferred organism for producing industrial cellulases. However, a more efficient heterologous expression system for enzymes from different organism is needed to further improve its cellulase mixture. The strong cbh1 promoter of T. reesei is frequently used in heterologous expression, however, the carbon catabolite repressor CREI may reduce its strength by binding to the cbh1 promoter at several binding sites. Another crucial point to enhance the production of heterologous enzymes is the stability of recombinant mRNA and the prevention of protein degradation within the endoplasmic reticulum, especially for the bacteria originated enzymes.

In this study, the CREI binding sites within the cbh1 promoter were replaced with the binding sites of transcription activator ACEII and the HAP2/3/5 complex to improve the promoter efficiency. To further improve heterologous expression efficiency of bacterial genes within T. reesei, a flexible polyglycine linker and a rigid α-helix linker were tested in the construction of fusion genes between cbh1 from T. reesei and e1, encoding an endoglucanase from Acidothermus cellulolyticus.

Results

The modified promoter resulted in an increased expression level of the green fluorescent protein reporter by 5.5-fold in inducing culture medium and 7.4-fold in repressing culture medium. The fusion genes of cbh1 and e1 were successfully expressed in T. reesei under the control of promoter pcbh1m2. The higher enzyme activities and thermostability of the fusion protein with rigid linker indicated that the rigid linker might be more suitable for the heterologous expression system in T. reesei. Compared to the parent strain RC30-8, the FPase and CMCase activities of the secreted enzyme mixture from the corresponding transformant R1 with the rigid linker increased by 39% and 30% at 60°C, respectively, and the reduced sugar concentration in the hydrolysate of pretreated corn stover (PCS) was dramatically increased by 40% at 55°C and 169% at 60°C when its enzyme mixture was used in the hydrolysis.

Conclusions

This study shows that optimizations of the promoter and linker for hybrid genes can dramatically improve the efficiency of heterologous expression of cellulase genes in T. reesei.
The magnitude and trend of artemether-lumefantrine stock-outs at public health facilities in Kenya
Authors: Sudoi Raymond K , Githinji Sophie , Nyandigisi Andrew , Muturi Alex , Snow Robert W , Zurovac Dejan
Published: February 2012

Background

Health facility stock-outs of artemether-lumefantrine (AL), the common first-line therapy for uncomplicated malaria across Africa, adversely affect effective malaria case-management. They have been previously reported on various scales in time and space, however the magnitude of the problem and trends over time are less clear. Here, 2010-2011 data are reported from public facilities in Kenya where alarming stock-outs were revealed in 2008.

Methods

Data were collected between January 2010 and June 2011 as part of 18 monthly cross-sectional surveys undertaken at nationally representative samples of public health facilities. The primary monitoring indicator was total stock-out of all four weight-specific AL packs. The secondary indicators were stock-outs of at least one AL pack and individual stock-outs for each AL pack. Monthly proportions and summary means of the proportions over the monitoring period were measured for each indicator. Stock-out trends were assessed using linear regression.

Results

The number of surveyed facilities across 18 time points ranged between 162 and 176 facilities. The stock-out means of the proportion of health facilities were 11.6% for total AL stock-out, 40.6% for stock-out of at least one AL pack, and between 20.5% and 27.4% for stock-outs of individual AL packs. Monthly decrease of the total AL stock-out was 0.005% (95% CI: -0.5 to +0.5; p = 0.983). Monthly decrease in the stock-out of at least one AL pack was 0.7% (95% CI: -1.5 to +0.3; p = 0.058) while stock-outs of individual AL packs decreased monthly between 0.2% for AL 24-pack and 0.7% for AL six-pack without statistical significance for any of the weight-specific packs.

Conclusions

Despite lower levels of AL stock-outs compared to the reports in 2008, the stock-outs at Kenyan facilities during 2010-2011 are still substantial and of particular worry for the most detrimental:- simultaneous absence of any AL pack. Only minor decrease was observed in the stock-outs of individual AL packs. Recently launched interventions to eliminate AL stock-outs in Kenya are fully justified.