bluuebunny/crossref_metadata_2025 huggingface dataset:
Examining Adolescent Academic Achievement: A Cross-Cultural Review
Authors: Fangzhou Yu  , Patterson Dannette
Published: May 2010

Adolescence is a pivotal developmental stage for establishing patterns of behaviors that can last a lifetime. Adolescents’ choices have a significant impact on future opportunities. Education can have tremendous influence on the overall success of an individual. For example, a quality education can affect employability, which indirectly influences economic status; therefore, influencing access to health care and community resources. This literature review will examine the effect of family, peers, and teachers as it relates to adolescent motivation to achieve academically. The authors have investigated adolescent academic motivation from a cross-cultural prospective, exploring four diverse ethnic groups: European Americans, African Americans, Asian Americans, and Hispanic Americans. The research indicates that though developmentally, adolescents share common characteristics, unique dynamics are considered by counselors when addressing academic motivation within ethnic groups.
Family Functioning and the Development of Trust and Intimacy Among Adolescents in Residential Treatment
Authors: Coll Kenneth M. , Powell Stephanie , Thobro Patti , Haas Robin
Published: May 2010

This study examined relations between family cohesion and adaptability (as measured by the Family Adaptability and Cohesion Scales-III) and the formation of trust and intimacy (assessed with the Measure of Psychosocial Development) among adolescents in residential treatment. Bivariate correlation revealed a significant association between family cohesion and adaptability and psychosocial stages of trust and intimacy. Regression analyses revealed that family cohesion predicted trust, and that trust is significantly influential in the formation of intimacy. Discussion and treatment implications are included.
Multiple Family Adventure-Based Therapy Groups: An Innovative Integration of Two Approaches
Authors: Swank Jacqueline Melissa , Daire Andrew Patrick
Published: May 2010

The adventure-based counseling (ABC) approach integrates counseling and experiential education in an outdoor environment and the Multiple Family Therapy Group (MFTG) treats multiple families concurrently. This article presents the history, theoretical basis, benefits, and challenges for each of these approaches. A proposed model integrates both approaches for an innovative, multi-month intervention for MFTGs. Additionally, the article presents treatment implications along with benefits, challenges, ethical considerations, and modifications for use with individual families.
An Interview With Larry Golden: Long-Time Marriage and Family Counselor and Counselor Educator
Authors: Juhnke Gerald A. , Fangzhou Yu
Published: May 2010

Larry Golden started the marriage and family therapy program at Our Lady of the Lake University and was founding chair of the Department of Counseling at the University of Texas at San Antonio. He has contributed substantially to the literature in marriage and family counseling. This interview secured his unique perspective on developments in the field.
Culture, Personality, Health, and Family Dynamics: Cultural Competence in the Selection of Culturally Sensitive Treatments
Authors: Sperry Len
Published: May 2010

Cultural sensitivity and cultural competence in the selection of culturally sensitive treatments is a requisite for effective counseling practice in working with diverse clients and their families, particularly when clients present with health issues or medical problems. Described here is a strategy for selecting culturally sensitive treatments (cultural interventions, culturally sensitive interventions, or culturally sensitive therapy) based on a comprehensive assessment of cultural factors, personality dynamics, family dynamics, and health or medical conditions. A case example is provided that illustrates this strategy.
Stepfamily Education: Benefits of a Group-Formatted Intervention
Authors: Skogrand Linda , Torres Eliza , Higginbotham Brian J.
Published: May 2010

This program evaluation was conducted by interviewing 40 low-income participants in a relationship education (RE) program for stepfamilies to determine specific benefits of a group-formatted intervention. The benefits that were most often identified were learning from others and having personal stepfamily challenges normalized. Participants also reported the group format facilitated social support. Participants enjoyed the opportunity to share their own approaches and solutions with the other stepfamilies. Identifiable benefits of group-formatted stepfamily education are delineated as are implementation considerations for working with large groups of low-income stepfamilies. Specifically, recommendations regarding trust and logistics are provided.
A Training Model for School, Family, and Community Collaboration
Authors: Stinchfield Tracy A. , Zyromski Brett
Published: May 2010

Several authors emphasize the importance of multidisciplinary approaches to working with students, families, and their communities. However, existing school—community collaboration programs have not provided a model for direct clinical services to families using collaborative partnerships with counselors. The authors propose one training model that would allow counselors from different specialties to work together as clinicians, with families, as they provide Parent Education programs.
Treating Diabetes With Severe Personality-Disordered Individuals and Families
Authors: Sperry Len
Published: May 2010

Diabetes is an increasingly common chronic medical condition that affects not only patients but also their families. Ensuring adherence to a treatment regimen in diabetic patients is particularly challenging for physicians as well as counselors providing health-focused counseling. However, that challenge is exponentially increased when the patient and one or more family members manifest personality-disordered behavior that interferes with and complicates diabetic treatment. Diabetes as a chronic medical condition is described in the context of individual and family borderline dynamics.
Drivers of Trust in Relational Service Exchange: Understanding the Importance of Cross-Cultural Differences
Authors: Schumann Jan H. , Wangenheim Florian v. , Stringfellow Anne , Zhilin Yang  , Praxmarer Sandra , Jiménez Fernando R. , Blazevic Vera , Shannon Randall M. , G. Shainesh , Komor Marcin
Published: May 2010

Customer trust is of vital importance for relationship marketing in services. Service providers increasingly market their services globally, yet few researchers have addressed differences in customer trust across cultures. Our research fills this void by proposing a model, based on existing trust literature, that suggests the overall feeling of trust in the service provider depends on customers’ beliefs about service providers’ ability, benevolence, predictability, and integrity. The model, tested in a banking context with data from 2,284 customers in 11 countries, explains trust well across culturally diverse countries. The results of a hierarchical linear model, however, show that customers differ in the way they build trust in their service provider across cultures. Moderating effects of the cultural values of the target group largely explain this variation. Only the effect of ability on trust is robust across countries. Global service firms should consider all four trust drivers when striving to build trust. The emphasis they put on each of these trust drivers, however, should differ across countries. When applying these principles to the design of marketing activities or market segmentation, marketing managers should collect data on the cultural values of their specific target groups in particular countries or cultural milieus.
Inhibition of neointimal formation and hyperplasia in vein grafts by external stent/sheath
Authors: Desai Mital , Mirzay-Razzaz Jalaledin , von Delft Dirk , Sarkar Sandip , Hamilton George , Seifalian Alexander M
Published: May 2010

Synthetic and to a lesser extent vein graft failure is still a major problem in the treatment of peripheral arterial disease, with neointimal hyperplasia being the main cause for graft occlusion in the medium and long term. This review aims to establish the current status of external stents or sheaths in the prevention of intimal hyperplasia in small diameter (< 6 mm) vein grafts.
Number of circulating endothelial progenitor cells as a marker of vascular endothelial function for type 2 diabetes
Authors: Liao Yun-fei , Chen Lu-Lu , Zeng Tian-shu , Li Yu-ming , Fan Yu  , Hu Li-jun , Ling Yue
Published: May 2010

Vascular endothelial dysfunction is an early marker of atherosclerosis seen in type 2 diabetes (T2DM). Circulating endothelial progenitor cell (EPC) is involved in the neovasculogenesis and maintenance of vascular homeostasis, whose impairment may have an important role in the pathogenesis of diabetic vasculopathy. This study was performed to investigate the relationship between vascular endothelial function and circulating EPC number in T2DM. A total of 46 newly diagnosed T2DM patients (DM group) and 51 healthy subjects (NG group) were recruited. Metformin was administered to all patients for 16 weeks. Endothelial function was assessed by flow-mediated brachial artery dilatation (FMD). EPC was defined by CD45 low/CD34+/VEGFR2+ and quantified by flow cytometry. The EPC number in the DM group was significantly lower than that in the NG group ( p < 0.001), and improved markedly after treatment ( p < 0.001). The results of FMD were consistent with EPC variations among the three groups ( p < 0.001). In multivariate regression analysis, the EPC number was an independent risk factor for FMD at baseline ( p < 0.05). The absolute changes of EPC number showed significant correlation with the changes of FMD before and after treatment ( r = 0.63, p < 0.001). This study demonstrated that the circulating EPC number was related to endothelial function and could be considered as a surrogate biological marker of endothelial function for T2DM.
Posttraumatic Growth, Optimism and Openness as Outcomes of a Cognitive-behavioural Intervention for Posttraumatic Stress Reactions
Authors: Knaevelsrud Christine , Liedl Alexandra , Maercker Andreas
Published: May 2010

The aim of this study was to examine the effect of an Internet-based CBT intervention on posttraumatic growth, openness and optimism. Ninety-six participants suffering from posttraumatic stress reactions were randomly assigned to either the treatment or a waiting-list control condition. We assessed posttraumatic stress reactions, depression and anxiety, posttraumatic growth, optimism and openness to new experiences. We found significant changes in posttraumatic growth in the treatment group. In addition regression analysis revealed that symptom improvements in posttraumatic stress reactions significantly predicted posttraumatic growth post-treatment. Our findings indicate the potential of psychotherapy to stimulate posttraumatic growth.
Validity of the Multidimensional Health Locus of Control Scales in American Sign Language
Authors: Athale Ninad , Aldridge Arianna , Malcarne Vanessa L. , Nakaji Melanie , Samady Waheeda , Robins Sadler Georgia
Published: May 2010

Few instruments have been translated and validated for people who use American Sign Language (ASL) as their preferred language. This study examined the reliability and validity of a new ASL version of the widely used Multidimensional Health Locus of Control (MHLC) scales. Deaf individuals ( N = 311) were shown the ASL version via videotape, and their responses were recorded. Confirmatory factor analysis supported the four-factor structure of the MHLC. Scale reliabilities (Cronbach’s alphas) ranged from 0.60 to 0.93. There were no apparent gender or ethnic differences. These results provide support for the new ASL version of the MHLC scales.
Interpersonal Issues in Expressing Lay Knowledge
Authors: De Kok Bregje , Widdicombe Sue
Published: May 2010

This article examines lay knowledge about causes of infertility. We use discursive psychology to analyse semi-structured interviews with purposively sampled Malawians with a fertility problem. We observe that respondents deny knowledge of causes, sometimes emphatically, but this co-occurs with descriptions of potential causes. We show that these respondents thereby address problematic interpersonal issues: namely that one is not entitled to medical knowledge and that negative inferences that may be drawn about someone who knows particular causes of infertility. These findings shed new light on previous observations, and have implications for the study of lay knowledge.
Anticipated longevity among lay people screened for cardiovascular risk factors: A cross-sectional questionnaire study
Authors: Halvorsen Peder A. , Selmer Randi M. , Kristiansen Ivar S.
Published: May 2010

Background: In terms of mental health and quality of life previous studies have largely failed to show long-term effects of cardiovascular risk information. Such information may still have an impact of a more subtle nature. We aimed to explore the potential impact of cardiovascular risk information on lay people’s anticipations of their own longevity. Methods: In 2002 11,284 Norwegians were invited to take part in a health survey. Participants (n = 6,845) received comprehensive written information about their personal risk factors for cardiovascular disease. About six months later we selected 752 high risk and 996 low risk individuals for a cross-sectional survey. Participants were mailed a questionnaire and informed about the life expectancy for women and men in Norway. Subsequently they were asked whether they expected to live longer, shorter than or approximately as long as the mean figures. Results: The response rate was 75% (n = 1,314). Whereas 210 respondents (16%) expected to live shorter than the mean, 198 (15%) expected to live longer. In a multivariate regression model high risk of cardiovascular disease (CVD) was associated with lower anticipated longevity (odds ratio 2.4, 95% confidence interval 1.7—3.3). Other predictors of low anticipation were use of lipid lowering drugs and a family history of heart attack before the age of 60. Higher age, male sex, better education and good self-reported health were associated with high anticipations. Conclusions: A CVD risk label was only moderately associated with lay people’s anticipated longevity. The majority expected to live as long as the mean, regardless of risk status.
Using Modeling and Simulation to Examine the Benefits of a Network Tasking Order
Authors: Compton Matthew D. , Hopkinson Kenneth M. , Peterson Gilbert L. , Moore James T.
Published: May 2010

The Global Information Grid (GIG) is the military’s computer and communications network which supports the myriad of military missions. Military missions are highly planned, passing through many hands in the strategy-to-task methodology to ensure completeness, accuracy, coordination, cohesion, and appropriateness. A benefit of this planning is the possibility to collect knowledge of future conditions that could be of use to network designers whose goals include optimizing and protecting the GIG. This advanced knowledge includes which networked military equipment will be involved, what their capabilities are, where they will be, when they will be there, and particulars on the required data flows. A Network Tasking Order process is proposed as a means of collecting this information, analyzing the information to generate network taskings, and disseminating those taskings. Tactical integration of assets in mobile networks is introduced as another planning variable in the battlefield; not unlike logistical considerations such as fuel, ammunition, water, and so on used currently in operation planning. Modeling and simulation is used to support the proposed benefits.
Hemi-hamate osteochondral transplantation in proximal interphalangeal dorsal fracture dislocations: a minimum 4 year follow-up in eight patients
Authors: Afendras G. , Abramo A. , Mrkonjic A. , Geijer M. , Kopylov P. , TägiL M.
Published: May 2010

Fracture dislocations of the PIP joint are challenging to treat. In hemi-hamate arthroplasty, the palmar lip joint surface is reconstructed using an osteochondral graft from the hamate and the immediate stability permits early movement. In the long term, collapse of non-vascularized osteochondral grafts might lead to degenerative arthritis. We examined the radiographic result after a minimum of 4 years with special reference to the development of osteoarthritis and its relation to clinical symptoms in eight patients, mean age 49 (25–66) years. After a mean of 60 (48–69) months, the arc of motion was 67° (45°–95°) at the PIP joint and grip strength was 91% of the uninjured side. The visual analogue score for pain (0–100) was 10 (0–70) mm. Severe arthritis (grade IV) was found in two and mild arthritis (grade II) in another two patients, but only one of these four cases had troublesome pain. The hemi-hamate technique is an attractive alternative to other treatment options, but some cases develop osteoarthritis in the medium term.
Will drivers for home energy efficiency harm occupant health?
Authors: Bone Angie , Murray Virginia , Myers Isabella , Dengel Andy , Crump Derrick
Published: May 2010

The UK government has committed to an 80% reduction in carbon emissions by 2050, with housing accounting for 27% of total current emissions. There are several drivers both to reduce emissions from homes and to reduce fuel poverty, promoting a range of building and behavioural measures in homes. The health benefits of warmer homes in winter have been described, but there has been less consideration of the potential negative impacts of some of these measures. We examine the changes in UK homes, and the possible consequences for health. The main concerns for health surround the potential for poor indoor air quality if ventilation is insufficient and the possible risks of overheating in heatwave conditions. This paper notes a limited evidence base and the need for further research on the health effects of energy-efficient homes, particularly with regard to ventilation.
The critical roles of platelet activation and reduced NO bioavailability in fatal pulmonary arterial hypertension in a murine hemolysis model
Authors: Hu Weiguo , Jin Richard , Zhang Jinyan , You Tao , Peng Zhihai , Ge Xiaowen , Bronson Roderick T. , Halperin Jose A. , Loscalzo Joseph , Qin Xuebin
Published: May 2010

Pulmonary arterial hypertension (PAH) is suspected to be a strong mortality determinant of hemolytic disorders. However, direct contribution of acute intravascular hemolysis to fatal PAH has not been investigated. The roles of nitric oxide (NO) insufficiency and platelet activation in hemolysis-associated fatal PAH have been suspected but not been experimentally studied. We recently generated a unique intravascular hemolysis mouse model in which the membrane toxin, intermedilysin (ILY), exclusively lyses the erythrocytes of transgenically expressing human CD59 mice (ThCD59RBC), thereby inducing ILY-dose–dependent massive hemolysis. Using this murine hemolysis model, we found that the acute increase in pulmonary arterial pressure leading to right ventricle failure caused sudden death. Reduced NO bioavailability and massive platelet activation/aggregation leading to the formation of massive thrombosis specifically in the pulmonary microvasculature played the critical roles in pathogenesis of acute hemolysis-associated fatal PAH. Therapeutic interventions enhancing NO bioactivity or inhibiting platelet activation prevented sudden death or prolonged survival time via the suppression of the acute increase in pulmonary arterial pressure and improvement of right ventricle function. These findings further highlight the importance of the inhibition of platelet activation and the enhancement of NO bioavailability for the treatment and prevention of hemolysis-associated (fatal) PAH.
Adenovirus capsid-display of the retro-oriented human complement inhibitor DAF reduces Ad vector–triggered immune responses in vitro and in vivo
Authors: Seregin Sergey S. , Aldhamen Yasser A. , Appledorn Daniel M. , Hartman Zachary C. , Schuldt Nathaniel J. , Scott Jeannine , Godbehere Sarah , Jiang Haixiang , Frank Michael M. , Amalfitano Andrea
Published: May 2010

Adenovirus (Ad) vectors are widely used in human clinical trials. However, at higher dosages, Ad vector–triggered innate toxicities remain a major obstacle to many applications. Ad interactions with the complement system significantly contribute to innate immune responses in several models of Ad-mediated gene transfer. We constructed a novel class of Ad vectors, genetically engineered to “capsid-display” native and retro-oriented versions of the human complement inhibitor decay-accelerating factor (DAF), as a fusion protein from the C-terminus of the Ad capsid protein IX. In contrast to conventional Ad vectors, DAF-displaying Ads dramatically minimized complement activation in vitro and complement-dependent immune responses in vivo. DAF-displaying Ads did not trigger thrombocytopenia, minimized endothelial cell activation, and had diminished inductions of proinflammatory cytokine and chemokine responses. The retro-oriented display of DAF facilitated the greatest improvements in vivo, with diminished activation of innate immune cells, such as dendritic and natural killer cells. In conclusion, Ad vectors can capsid-display proteins in a manner that not only retains the functionality of the displayed proteins but also potentially can be harnessed to improve the efficacy of this important gene transfer platform for numerous gene transfer applications.
Regulation of the cardiomyocyte transcriptome vs translatome by endothelin-1 and insulin: translational regulation of 5' terminal oligopyrimidine tract (TOP) mRNAs by insulin
Authors: Markou Thomais , Marshall Andrew K , Cullingford Timothy E , Tham El L , Sugden Peter H , Clerk Angela
Published: May 2010

Background

Changes in cellular phenotype result from underlying changes in mRNA transcription and translation. Endothelin-1 stimulates cardiomyocyte hypertrophy with associated changes in mRNA/protein expression and an increase in the rate of protein synthesis. Insulin also increases the rate of translation but does not promote overt cardiomyocyte hypertrophy. One mechanism of translational regulation is through 5' terminal oligopyrimidine tracts (TOPs) that, in response to growth stimuli, promote mRNA recruitment to polysomes for increased translation. TOP mRNAs include those encoding ribosomal proteins, but the full panoply remains to be established. Here, we used microarrays to compare the effects of endothelin-1 and insulin on the global transcriptome of neonatal rat cardiomyocytes, and on mRNA recruitment to polysomes (i.e. the translatome).

Results

Globally, endothelin-1 and insulin (1 h) promoted >1.5-fold significant (false discovery rate < 0.05) changes in expression of 341 and 38 RNAs, respectively. For these transcripts with this level of change there was little evidence of translational regulation. However, 1336 and 712 RNAs had >1.25-fold significant changes in expression in total and/or polysomal RNA induced by endothelin-1 or insulin, respectively, of which ~35% of endothelin-1-responsive and ~56% of insulin-responsive transcripts were translationally regulated. Of mRNAs for established proteins recruited to polysomes in response to insulin, 49 were known TOP mRNAs with a further 15 probable/possible TOP mRNAs, but 49 had no identifiable TOP sequences or other consistent features in the 5' untranslated region.

Conclusions

Endothelin-1, rather than insulin, substantially affects global transcript expression to promote cardiomyocyte hypertrophy. Effects on RNA recruitment to polysomes are subtle, with differential effects of endothelin-1 and insulin on specific transcripts. Furthermore, although insulin promotes recruitment of TOP mRNAs to cardiomyocyte polysomes, not all recruited mRNAs are TOP mRNAs.
Ex vivo infection of human embryonic spinal cord neurons prior to transplantation into adult mouse cord
Authors: Márton Gábor , Tombácz Dóra , Tóth Judit S , Szabó András , Boldogköi Zsolt , Dénes Ádám , Hornyák Ákos , Nógrádi Antal
Published: May 2010

Background

Genetically modified pseudorabies virus (Prv) proved suitable for the delivery of foreign genes to rodent embryonic neurons ex vivo and maintaining foreign gene expression after transplantation into spinal cord in our earlier study. The question arose of whether human embryonic neurons, which are known to be more resistant to Prv, could also be infected with a mutant Prv. Specifically, we investigated whether a mutant Prv with deleted ribonucleotide reductase and early protein 0 genes has the potential to deliver marker genes (gfp and β-gal) into human embryonic spinal cord neurons and whether the infected neurons maintain expression after transplantation into adult mouse cord.

Results

The results revealed that the mutant Prv effectively infected human embryonic spinal cord neurons ex vivo and the grafted cells exhibited reporter gene expression for several weeks. Grafting of infected human embryonic cells into the spinal cord of immunodeficient (rnu-/rnu-) mice resulted in the infection of some of the host neurons.

Discussion

These results suggest that Prv is suitable for the delivery of foreign genes into transplantable human cells. This delivery method may offer a new approach to use genetically modified cells for grafting in animal models where spinal cord neuronal loss or axon degeneration occurs.
Development and application of a biomarker assay for determining the pharmacodynamic activity of an antagonist candidate biotherapeutic antibody to IL21R in whole blood
Authors: Arai Maya , Jain Sadhana , Weaver Amy A , Hill Andrew A , Guo Yongjing , Bree Andrea G , Smith Michael F , Allen Scott W , LaVallie Edward R , Young Deborah , Bloom Laird , Adkins Karissa , O'Toole Margot
Published: May 2010

Background

In preparation for potential clinical development of Ab-01, an antagonistic antibody directed against the IL21R, studies were undertaken to address translational medicine needs that fall into four categories: 1) development of a pharmacodynamic biomarker assay suitable for use in the clinic, 2) demonstration that Ab-01 has the desired biological activity in vitro and in vivo in cynomolgus monkeys, the preferred safety study species, 3) pre-clinical in vivo proof-of-concept that the assay can be used to detect Ab-01 pharmacodynamic (PD) activity in treated subjects, and 4) comprehensive assessment of the agonistic potential of Ab-01 when cross-linked. This report and a recently published companion report address the first three of these needs. The fourth has been addressed in a separate study.

Methods

Genes that change RNA expression upon ex vivo rhIL21 stimulation of whole blood were identified in human and cynomolgus monkey. The inhibitory effects of exogenously added Ab-01 were measured ex vivo in human and monkey, and the in vivo inhibitory effects of Ab-01 treatment were measured in monkey.

Results

Stimulation of whole human blood for 2 hours with rhIL21 induced robust increases in RNA expression of 6 genes. This response was blocked by Ab-01, indicating that the assay is suitable for measuring Ab-01 activity in blood. rhIL21 induced expression of a similar set of genes in cynomolgus monkey blood. This response was blocked with Ab-01, thus demonstrating that Ab-01 has the desired activity in the species, and that safety studies done in cynomolgus monkeys are relevant. Proof -of-concept for using this assay system to detect PD activity in vivo was generated by measuring the response in monkey blood to ex vivo rhIL21 stimulation before and 5 minutes following in vivo Ab-01 administration.

Conclusions

A robust PD biomarker assay suitable for clinical use has been developed in human whole blood. The successful adaptation of the assay to cynomolgus monkeys has enabled the demonstration of Ab-01 activity both in vitro and in vivo in monkey, thus validating the use of this species in safety studies and establishing proof-of-concept for using this PD assay system to aid in dose selection in clinical studies.
Health and historical levels of freedom
Authors: Biggs Samantha L , Dell Evelyn M , Dixon Vanessa L , Joffres Michel R , Beyrer Chris , Wilson Kumanan , Orbinski James J , Edward Mills J
Published: May 2010

Background

The link between political freedom and health is unclear. We aimed to determine the association by exploring the relationship of historical and cumulative freedom levels with important health outcomes.

Methods

We obtained countrywide health indicators for life expectancy, infant mortality, maternal mortality ratio, % low birth weight babies, Gini coefficient (a measure of wealth inequality) and various markers of freedom based on political rights and civil liberties. We applied multivariable logistic regression to examine the association between health indicators and within-country years of freedom as determined by Freedom House rankings.

Results

The total proportion of free years from 1972-2005, the duration of current freedom level, and the Gini coefficient show independent positive associations with health indicators, which remain after the adjustment for national wealth, total government expenditure, and spending on health. Countries identified as having high total proportion of free years demonstrated significantly better health outcomes than countries with low levels of freedom (life expectancy, Odds Ratio [OR] 7.2, 95% Confidence Interval [CI], 2.3-22.6, infant mortality OR 19.6, 95% CI, 5.6-67.7, maternal mortality ratio, OR 24.3, 95% CI, 6.2-94.9, and % low birth weight babies OR 3.8, 95% CI, 1.4-10.8). This was also the case for infant mortality (OR 3.4, 95% CI, 1.0-8.4), maternal mortality ratio (OR 4.0, 95% CI, 1.2-12.8), and % low birth weight babies (OR 2.6, 95% CI, 1.0-6.6) among countries considered as having medium levels of freedom.

Interpretation

We found strong associations between country-level freedom and important health outcomes. The cumulative level of freedom over time shows stronger associations with all health indicators than the duration of current freedom level.
Four-dimensional dosimetry validation and study in lung radiotherapy using deformable image registration and Monte Carlo techniques
Authors: Huang Tzung-Chi , Liang Ji-An , Dilling Thomas , Wu Tung-Hsin , Zhang Geoffrey
Published: May 2010

Thoracic cancer treatment presents dosimetric difficulties due to respiratory motion and lung inhomogeneity. Monte Carlo and deformable image registration techniques have been proposed to be used in four-dimensional (4D) dose calculations to overcome the difficulties. This study validates the 4D Monte Carlo dosimetry with measurement, compares 4D dosimetry of different tumor sizes and tumor motion ranges, and demonstrates differences of dose-volume histograms (DVH) with the number of respiratory phases that are included in 4D dosimetry. BEAMnrc was used in dose calculations while an optical flow algorithm was used in deformable image registration and dose mapping. Calculated and measured doses of a moving phantom agreed within 3% at the center of the moving gross tumor volumes (GTV). 4D CT image sets of lung cancer cases were used in the analysis of 4D dosimetry. For a small tumor (12.5 cm3) with motion range of 1.5 cm, reduced tumor volume coverage was observed in the 4D dose with a beam margin of 1 cm. For large tumors and tumors with small motion range (around 1 cm), the 4D dosimetry did not differ appreciably from the static plans. The dose-volume histogram (DVH) analysis shows that the inclusion of only extreme respiratory phases in 4D dosimetry is a reasonable approximation of all-phase inclusion for lung cancer cases similar to the ones studied, which reduces the calculation in 4D dosimetry.
Diagnosis and mortality in 47,XYY persons: a registry study
Authors: Stochholm Kirstine , Juul Svend , Gravholt Claus H
Published: May 2010

Background

Sex chromosomal abnormalities are relatively common, yet many aspects of these syndromes remain unexplored. For instance epidemiological data in47,XYYpersons are still limited.

Methods

Using a national Danish registry, we identified 208 persons with47,XYYor a compatible karyotype, whereof 36 were deceased; all were diagnosed from 1968 to 2008. For further analyses, we identified age matched controls from the male background population (n = 20,078) in Statistics Denmark. We report nationwide prevalence data, data regarding age at diagnosis, as well as total and cause specific mortality data in these persons.

Results

The average prevalence was 14.2 47,XYY persons per 100,000, which is reduced compared to the expected 98 per 100,000. Their median age at diagnosis was 17.1 years. We found a significantly decreased lifespan from 77.9 years (controls) to 67.5 years (47,XYYpersons). Total mortality was significantly increased compared to controls, with a hazard ratio of 3.6 (2.6-5.1). Dividing the causes of deaths according to the International Classification of Diseases, we identified an increased hazard ratio in all informative chapters, with a significantly increased ratio in cancer, pulmonary, neurological and unspecified diseases, and trauma.

Conclusion

We here present national epidemiological data regarding47,XYYsyndrome, including prevalence and mortality data, showing a significantly delay to diagnosis, reduced life expectancy and an increased total and cause specific mortality.
Comparison of original (2003) and revised (2008) national guidelines for reporting of cerebrospinal fluid spectrophotometric scanning for suspected subarachnoid haemorrhage against patient outcome
Authors: Griffiths Melanie J , Chow Elaine , Panting Mark D , Ford Clare , Gama Rousseau
Published: May 2010

Background

National guidelines for cerebrospinal fluid (CSF) analysis and its reporting in suspected subarachnoid haemorrhage (SAH) were published in 2003, but revised in 2008 to give greater clarity in interpretation. It is not known whether the less ambiguous reporting of 2008 guidelines may lead to a false assurance and adversely affect patient outcome. We, therefore, re-interpreted scans reported under the 2003 guidelines, using the 2008 guidelines and compared these reports against final diagnosis and patient outcome obtained from a retrospective case-note review audit.

Methods

We identified requests for CSF xanthochromia studies from the laboratory system between September 2006 and August 2007. Spectroscopy scans were then retrieved and re-interpreted using the 2008 guidelines. The original reports and re-interpreted scans were compared against diagnosis and patient outcome using case-note review.

Results

We received 93 requests for CSF spectroscopy on 90 patients. Fourteen requests were not processed due to insufficient sample, but of these three patients had a repeat lumbar puncture (LP). Two further requests were not processed at the request of the clinician as they were no longer clinically indicated. Therefore, 77 spectroscopic scans were re-interpreted. The revised guidelines re-classified 11 previously equivocal scans into the not supportive of SAH category. On case-note review, one patient had a subsequent fatal SAH. The remaining 10 were given non-SAH final diagnoses and none had similar further inpatient episodes for at least 12 months and up to 18 months following LP.

Conclusions

The revised (2008) national guidelines for the analysis of CSF in suspected SAH offer greater clarity in reporting without adversely affecting patient outcome.
Elevated tumour marker: an indication for imaging?
Authors: McMahon Colm J , Crowley Vivion , McCarroll Nuala , Dunne Ruth , Keogan Mary T
Published: May 2010

Introduction

The purpose of this study was to evaluate the utility of imaging examinations in patients with elevated tumour markers when (a) the tumour marker is not validated for as a primary diagnostic test; (b) the patient had no personal history of cancer and (c) the patient had no other imaging indication.

Materials and methods

Patients without known cancer who had abnormal carcinoembryonic antigen, CA19-9, CA125 and/or CA15-3 serology over a one-year period were included. A retrospective medical record review was performed to assess the number of these cases who underwent imaging because of ‘elevated tumour marker’ in the absence of a clinical indication for imaging. The number and result of these imaging studies were evaluated.

Results

Eight hundred and nineteen patients were included. Of those, 25 patients (mean age: 67.8 [range 41–91] y), were imaged to evaluate: ‘elevated tumour marker’. They underwent 29 imaging studies (mean [±standard deviation (SD)] per patient = 1.2 [±0.4]), and had 42 elevated tumour marker serology tests (mean [±SD] per patient = 1.7 [±0.7]). Four patients had >1 imaging test. No patient had an imaging study which diagnosed a malignancy or explained the elevated tumour marker.

Conclusion

The non-judicious use of tumour markers can prompt further unnecessary investigations including imaging. In this study, there was no positive diagnostic yield for imaging performed for investigation of ‘elevated tumour marker’. ‘Elevated tumour marker’, in the absence of a known underlying malignancy, should not be considered an independent indication for imaging.
Cigarette smoking and serum liver enzymes: the role of alcohol and inflammation
Authors: Wannamethee S Goya , Shaper A Gerald
Published: May 2010

Background and aims

Smoking may affect the liver through inflammatory pathways and may aggravate the pathogenic effects of alcohol on the liver. We have examined the relationship between cigarette smoking and liver enzymes and the role of alcohol and C-reactive protein (CRP), a marker of inflammation.

Methods

The subjects consisted of 4595 men aged 40–59 y with no history of coronary heart disease drawn from general practices in 24 British towns.

Results

Cigarette smoking was significantly associated with increased levels of gamma-glutamyl transferase (GGT) and alkaline phosphatase (ALP) ( P < 0.0001) and was inversely associated with increased aspartate aminotransferase (AST) after adjustment for alcohol intake, body mass index and physical activity. Compared with never smokers, heavy cigarette smokers (≥40/day) were associated with increased odds of elevated GGT (≥23 IU/L) (adjusted odds ratio [OR] 1.56 [1.08, 2.27]), which was abolished after adjustment for CRP (adjusted OR 1.27 [0.87, 1.86]). There was a significant interaction between smoking and alcohol on GGT. In the absence of heavy drinking, there was no association between smoking and GGT after adjustment for CRP. Among heavy drinkers, smoking was associated with increased levels of GGT independent of CRP. Smoking was associated with increased odds of elevated ALP (≥11 IU/L) (adjusted OR 3.95 [2.77, 5.62]), which persisted after adjustment for CRP and white cell count (adjusted OR 2.90 [1.99–4.23]), possibly reflecting increased bone cell activity.

Conclusion

The findings suggest that cigarette smoking does not cause liver injury, but may enhance the effects of alcohol on liver cell injury in heavy drinkers.
Immunoglobulin interference in serum follicle-stimulating hormone assays: autoimmune and heterophilic antibody interference
Authors: Webster Rachel , Fahie-Wilson Michael , Barker Peter , Chatterjee V Krishna , Halsall David J
Published: May 2010

Interference in immunoassay caused by endogenous immunoglobulin is a cause of incorrect laboratory results that can drastically affect patient management. Two cases of immunoglobulin interference in serum follicle-stimulating hormone (FSH) assays are presented. These cases illustrate two common mechanisms for false-positive interference in two-site (sandwich) immunoassays. The first case describes a circulating autoimmune FSH immunoglobulin complex (‘macro’-FSH), which has not been previously described for FSH, and the second a cross-linking antibody directed against the assay reagents. Immunoglobulin interference was detected and characterized using a combination of method comparison, immunosubtraction and size exclusion chromatography.
Tubular proteinuria in acute kidney injury: a critical evaluation of current status and future promise
Authors: Parikh Chirag R , Lu Jonathan C , Coca Steven G , Devarajan Prasad
Published: May 2010

The diagnosis and prognosis of acute kidney injury (AKI) by current clinical means is inadequate. Biomarkers of kidney injury that are easily measured and unaffected by physiological variables could revolutionize the management of AKI. Our objective was to systematically review the diagnostic and prognostic utility of urine and serum biomarkers of AKI in humans. We searched MEDLINE, PubMed and EMBASE databases (January 2000–August 2009) for biomarker studies that could be classified into the following categories: (a) confirmation of the diagnosis of established AKI, (b) early prediction of AKI, and (c) prognostication of AKI. We identified 54 manuscripts published since 2000 that met our inclusion and exclusion criteria. Urinary interleukin-18 (IL-18), kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL) and N-acetyl- β-d-glucosaminidase (NAG) are potentially useful biomarkers for the diagnosis of established AKI. Urinary NGAL, IL-18, and liver-type fatty acid binding protein, and serum NGAL and cystatin C represent the most promising biomarkers for early prediction of AKI. Urinary cystatin C, α1-microglobulin, NAG and retinol-binding protein may be useful to predict severity and outcomes of AKI. In conclusion, we identified several studies of promising biomarkers for the diagnosis, prediction and prognostication of AKI. However, we note several limitations, including small sample sizes, inadequate gold standard, exclusion of patients with chronic kidney disease, incomplete statistical analyses, utilization of research-based assays and a paucity of studies examining prediction for clinical outcomes. Future studies will need to address these limitations in order for further progress to be made.
Increases in urinary creatinine and blood pressure during early pregnancy in pre-eclampsia
Authors: Kuromoto Koichi , Watanabe Mikio , Adachi Kazushige , Ohashi Kazutomo , Iwatani Yoshinori
Published: May 2010

Background

It is important to predict the development of pre-eclampsia (PE) during early pregnancy to prevent its occurrence later on. In this study, we studied urinary biochemical parameters and blood pressure (BP) during and after pregnancy to find useful parameters for predicting PE.

Methods

A case-control study was performed in 25 PE patients and 172 normotensive pregnant women. Twelve biochemical parameters were measured in spot urine, and the systolic and diastolic BPs were measured using an automated device during pregnancy and six to eight weeks after birth.

Results

A multiple logistic regression analysis showed that the combinations of urinary creatinine (Cr) and systolic BP (SBP) in the first trimester of pregnancy (8.9 ± 2.6 weeks), and of urinary inorganic phosphorus (IP)/Cr and SBP in the second trimester of pregnancy (19.0 ± 1.6 weeks) were useful for predicting PE. The area under the curve in the receiver operator characteristic curve of the combination of urinary Cr and SBP in the first trimester was 0.85 (95% confidence interval [CI] 0.74–0.96), and that of the combination of urinary IP/Cr and SBP in the second trimester was 0.91 (95% CI: 0.86–0.97). When used 249 mg/dL in urinary Cr and 128 mmHg in SBP as their cut-off points, the combination in the first trimester increased the accuracy (sensitivity 75% and specificity 95%) in predicting PE, as compared with that of urinary Cr (29%, 99%) or SBP (50%, 98%).

Conclusions

Combination of urinary Cr and SBP in early pregnancy and that of urinary IP/Cr and SBP in mid-pregnancy are useful for the prediction of PE.
High-dose hook effect in six automated human chorionic gonadotrophin assays
Authors: Al-Mahdili Huda A , Jones Graham R D
Published: May 2010

Background

The high-dose hook effect is a well-known phenomenon of two-site immunoassays including those for human chorionic gonadotrophin (hCG). We investigated the occurrence of a high-dose hook effect in six routinely available hCG assays using a sample with a total hCG concentration of approximately 3,600,000 IU/L.

Method

Dilutions of a sample with high hCG concentration were analysed using six common methods: Advia Centaur, Immulite 2000, Dimension RxL, Unicel DxI 800, Roche E170 and Abbott Architect. The measured concentrations and corresponding assay signals were obtained for each method. Performance was compared with manufacturer claims.

Results

Four of the tested platforms demonstrated a clear high-dose hook effect, while the other methods showed no hook effect at the highest level tested.

Conclusion

Our results indicate that the hook effect may occur in some hCG assays, although the risk of reporting falsely low results was in most cases at higher concentrations than those indicated in manufacturers' product information. Assay design plays a major role in its occurrence. Laboratories should be aware of the assay limitations in this regard.
Model of Migration and Use of Platforms: Role of Hierarchy, Current Generation, and Complementarities in Consumer Settings
Authors: Xu Xin , Venkatesh Viswanath , Tam Kar Yan , Hong Se-Joon
Published: May 2010

We develop and test a model of migration and use of platforms to explain consumers' reactions to the newest generation of an information and communication technology platform. We draw from information systems and consumer behavior research on adoption and use of technologies, and adapt and incorporate the construct of complementarity from macrolevel research on platform leadership, network effects, and innovation ecosystems. We conceptualize complementarities between the hardware and software platforms, software platform and applications, and applications and services. The complementarities are theorized to influence migration intention, with current generation of the consumer's platform being a key moderator. We empirically validated our model with data collected using two waves of surveys from 4,412 consumers (2,333 consumers in the second wave) before and after the introduction of the third generation (3G) mobile data services platform in Hong Kong. We explained 60% of the variance in migration intention that in turn was strongly correlated with migration to and use of 3G.
Lean and Hungry or Fat and Content? Entrepreneurs' Wealth and Start-Up Performance
Authors: Hvide Hans K. , Møen Jarle
Published: May 2010

If entrepreneurs are liquidity constrained and not able to borrow to operate on an efficient scale, economic theory predicts that entrepreneurs with more personal wealth should do better than those with less wealth. We test this hypothesis using a novel data set covering a large panel of start-ups from Norway. Consistent with liquidity constraints, we find a positive relation between founder prior wealth and start-up size. The relationship between prior wealth and start-up performance, as measured by profitability on assets, increases in the first three wealth quartiles. In the top wealth quartile, however, profitability drops sharply in wealth. Our findings are consistent with a luxury good interpretation of entrepreneurship and that higher wealth may induce a less alert or a less dedicated management. We conclude that an abundance of resources might do more harm than good for start-ups.