bluuebunny/crossref_metadata_2025 huggingface dataset:
Ci-Pem-1 localizes to the nucleus and represses somatic gene transcription in the germline of Ciona intestinalis embryos
Authors: Shirae-Kurabayashi Maki , Matsuda Kazuki , Nakamura Akira
Published: June 2011

In many animal embryos, germ-cell formation depends on maternal factors located in the germ plasm. To ensure the development of germ cells, germline progenitors must be prevented from differentiating inappropriately into somatic cells. A common mechanism for this appears to be the active repression of somatic gene transcription. Species-specific germ-plasm components, such as Pgc in Drosophila and PIE-1 in C. elegans, establish germline transcriptional quiescence by inhibiting general transcriptional machineries. In the ascidian Ciona intestinalis, although transcriptional repression in the germline has been proposed, the factors and mechanisms involved have been unknown. We found that the protein products of Ci-pem-1 RNA, which is an ascidian-specific component of the postplasm (the germ plasm equivalent in ascidians), localized to the nucleus of germline blastomeres, as well as to the postplasm. Morpholino oligonucleotide-mediated Ci-pem-1 knockdown resulted in the ectopic expression of several somatic genes that are usually silent in the germline. In the Ci-pem-1 knockdown embryos, the expression of both β-catenin- and GATAa-dependent genes was derepressed in the germline blastomeres, suggesting that Ci-Pem-1 broadly represses germline mRNA transcription. Immunoprecipitation assays showed that Ci-Pem-1 could interact with two C. intestinalis homologs of Groucho, which is a general co-repressor of mRNA transcription. These results suggest that Ci-pem-1 is the C. intestinalis version of a germ-plasm RNA whose protein product represses the transcription of somatic genes during specification of the germ-cell fate, and that this repression may be operated through interactions between Ci-Pem-1 and Groucho co-repressors.
A role for Notch signaling in trophoblast endovascular invasion and in the pathogenesis of pre-eclampsia
Authors: Hunkapiller Nathan M. , Gasperowicz Malgorzata , Kapidzic Mirhan , Plaks Vicki , Maltepe Emin , Kitajewski Jan , Cross Jay C. , Fisher Susan J.
Published: June 2011

Placental trophoblasts (TBs) invade and remodel uterine vessels with an arterial bias. This process, which involves vascular mimicry, re-routes maternal blood to the placenta, but fails in pre-eclampsia. We investigated Notch family members in both contexts, as they play important roles in arterial differentiation/function. Immunoanalyses of tissue sections showed step-wise modulation of Notch receptors/ligands during human TB invasion. Inhibition of Notch signaling reduced invasion of cultured human TBs and expression of the arterial marker EFNB2. In mouse placentas, Notch activity was highest in endovascular TBs. Conditional deletion of Notch2, the only receptor upregulated during mouse TB invasion, reduced arterial invasion, the size of maternal blood canals by 30-40% and placental perfusion by 23%. By E11.5, there was litter-wide lethality in proportion to the number of mutant offspring. In pre-eclampsia, expression of the Notch ligand JAG1 was absent in perivascular and endovascular TBs. We conclude that Notch signaling is crucial for TB vascular invasion.
Roles of Pathway-Based Models and their Contribution to the Redesign of Health-Care Systems
Authors: Mould Gillian , Bowers John
Published: June 2011

Care pathways provide a practical analytical tool that encompasses both organizational efficiency and individual patients' care. In the UK, constructing the care pathway has been a recommended starting point for the redesign of health-care systems. This paper examines the redesign cycle for health-care systems and looks at the role of pathway-based models in the design and operation phases of the cycle. In addition, the models provide further benefits for communicating recommended practice and audit of care and outcomes. The models span the classic care pathway with extensions to simulation modelling. An example of the use of care pathways in the redesign of an emergency department is used for illustration. This study shows the role of pathway models as: a tool for redesign, a catalyst for enhancing communication and as a repository for audit information. The final role of a tool for modelling contingencies was not implemented. From the example it can be concluded that sophisticated models can be useful, in some applications; however, the simpler approaches may often be the best, offering rapid, transparent recommendations based on a multidisciplinary approach.
Role of bisphosphonates in the management of postmenopausal osteoporosis: an update on recent safety anxieties
Authors: Hollick Rosemary J , Reid David M
Published: June 2011

Following their introduction in the 1990s, bisphosphonates have become the mainstay of treatment in the management of postmenopausal osteoporosis, and their use continues to rise. Commonly noted adverse effects in clinical practice include gastrointestinal side-effects, acute phase reactions (predominately seen with intravenous preparations) cutaneous reactions and more rarely, ocular side-effects. However, recent reports of potentially serious adverse effects of bisphosphonate therapy, including atypical subtrochanteric and femoral shaft fractures, atrial fibrillation, oesophageal carcinoma and osteonecrosis of the jaw, have prompted concerns regarding the long-term safety of this class of drugs. This review summarizes the benefits and potential adverse effects of bisphosphonates used in the treatment of postmenopausal osteoporosis. Although evidence of a definitive casual relationship between bisphosphonate therapy and serious adverse effects is lacking, concern remains particularly in relation to atypical subtrochanteric and femoral shaft fractures. This has important consequences in terms of determining optimum duration of therapy and how best to target therapy at those most at risk. Recently, attention has focused on individual fracture risk assessment in order to optimize the risk–benefit ratio of treatment for individual patients. A review of the role of hormone replacement therapy in younger women with significant risk of osteoporotic fractures may be timely in these circumstances.
Setting and maintaining standards in menopause care: audit of current practice in a specialist clinic
Authors: Lee Deborah J , Hillard Amanda J , Hillard Timothy C
Published: June 2011

Standards are an important way of demonstrating quality of care in any given setting. The British Menopause Society (BMS) has produced guidelines as to what should be recorded at the initial menopause consultation. A retrospective audit of case-notes of women attending Poole Menopause Centre was undertaken using these criteria as audit standards. Although areas of good practice were highlighted, the published criteria were met for only five of the 23 standards. An action plan to improve the documentation to achieve these standards has been formulated.
Blue Horizons Study Assesses Future Capabilities and Technologies for the United States Air Force
Authors: Geis John P. , Parnell Gregory S. , Newton Harry , Bresnick Terry
Published: June 2011

The purpose of the Blue Horizons study was to determine the capabilities and technologies in which the United States Air Force would need to invest to maintain dominant air, space, and cyberspace capabilities in the year 2030. The study used two methodologies, scenario analysis and multiobjective decision analysis, to evaluate 58 future-system concepts and 172 key enabling technologies. The paper outlines the study's key conclusions and recommendations to the Air Force, including recommendations on how future concepts and technologies would help it to prepare for disparate potential challenges, such as rising peer competitors, the problem of failed states, and continued insurgencies in far-flung parts of the world.
Delinquent Realities: Christianity, Formality, and Security in the Americas
Authors: O'Neill Kevin Lewis
Published: June 2011

In response to growing postwar violence in Guatemala, the United States Agency for International Development (USAID) cosponsored a reality television show in which ten former gang members were split into two teams, each of which was expected to build a sustainable business within Guatemala's formal economy. This competition modeled a kind of entrepreneurial self-fashioning that relied on Christian images and imperatives to "formalize" the show's reportedly delinquent participants. Based on several years of ethnographic fieldwork in Central and North America, this article explores how this Christian self-fashioning dramatizes an increasingly popular strategy for gang prevention and intervention throughout the Americas: regional security by way of good Christian living. Christianity today has become entangled with the geopolitics of American security, especially when it comes to efforts at gang abatement, linking the illegal activities of transnational criminal networks to the morality of individual men and women.
Farm Size, Modern Technology Adoption, and Efficiency of Small Holdings in Developing Countries: Evidence from Kenya
Authors: Nyariki Dickson M.
Published: June 2011

Low efficiency is a problem in most developing agriculture, and is one of the reasons for food insecurity. This paper provides information on smallholder production efficiency in one of the developing Sub-Saharan Countries: Kenya. It applies Data Envelopment Analysis (DEA) to farm-level seasonal panel data. The estimated indexes indicate high levels of inefficiency between farm sizes, seasons, and adopters and non-adopters of 'modern' farming technologies. A comparison of various farming practices shows that use of modern inputs and livestock-based capital could significantly improve farmers' performance. Tobit estimations show that the major factors influencing performance are the level of education, gender, market access and off-farm capital. Thus, policies aimed at improving education, rural infrastructure as well as assuring farmers of income through improved livelihood opportunities, and therefore reduced perceived uncertainty, could improve farm-level efficiency. The findings also provide support for prioritizing issues of farm production associated with women in policymaking.
Dickens, Natural History, and Our Mutual Friend
Authors: Ledger Sally
Published: June 2011

The paper argues that, well aware of the developments in contemporary science, including biology and political economy, Dickens believed in the significance of the scientific paradigm shifts for ordinary human life. Dickens's early fiction constituted, among other things, a passionate critique of para-Malthusian political economy. This critique is resumed in Our Mutual Friend , yet with the new awareness of the shift of dominant paradigms from political economy to Darwinist biological thinking. Whereas the legislature that grew out of political economy could be challenged and modified, Darwin's account of natural selection, a biological theory that had permanent ontological ramifications, had a claim to the stability of a natural law which disabled beliefs in Providential design. Darwin's work, however, did not deny the potential of benevolent sympathetic human agency. Dickens's novel pits such agency against the blind forces of the struggle for survival, even while subverting the confidence in overall ethical design trailed in by the residual elements of the traditional melodrama.
Old Signs, New Signs, Whose Signs?: Sociolinguistic Variation in the NZSL Lexicon
Authors: McKee Rachel , McKee David
Published: June 2011

Although New Zealand Sign Language (NZSL) is used by a closely networked national Deaf community, it exhibits considerable variation in the lexicon that has been anecdotally and empirically attributed to age and region. This article reports a quantitative study that examined the effects of age, region, gender, and ethnicity on variation in eighty target vocabulary items, across 138 Deaf NZSL users. The dataset consisted of 11,040 tokens, in which 249 distinct variants for the 80 items were identified. Findings confirmed that age group is the strongest social correlate of lexical variation. Marked diachronic variation and change, shown by the "apparent-time" method of comparing age groups, reflects the impact of the adoption of Australasian Signed English in deaf education from 1979 in replacing and supplementing the earlier lexicon. A strong leveling effect found in the lexicon of younger signers is also attributable to their use of this sign system in education. Some regional effects found, and a pattern of interaction between region and age group—with southern and older signers tending to conserve early variants. Gender and ethnicity played a minimal role in explaining variation in this analysis. Given the salience of gender and ethnicity in sociolinguistic variation studies generally, this finding may be explained by the particular socio-historical profile of the NZSL community, or by the likelihood that these identity characteristics are indexed by sub-lexical features, and/or by the decontextualized data elicitation method, which may not capture the potential use of lexical variants that respond to audience, topic and style considerations in discourse contexts.
Diagnostische Pfade bei Nierenerkrankungen1) / Diagnostic pathways for renal diseases
Authors: Hofmann Walter , Ehrich Jochen H.H. , Guder Walter G. , Keller Frieder , Scherberich Jürgen
Published: June 2011

Die Deutsche Vereinte Gesellschaft für Klinische Chemie und Laboratoriumsmedizin hat 2006 eine Arbeitsgruppe aus der Taufe gehoben, die gemeinsam mit Mitgliedern der Deutschen Gesellschaft für Nephrologie die bisher verfügbaren Empfehlungen zum Ausschluss, zur Erfassung und Differenzierung von Nierenerkrankungen als diagnostische Pfade strukturiert niederlegen. Die so geschaffene Grundlage soll dann mit EDV-Unterstützung als ein entsprechendes Konzept in der Klinik verfügbar bzw. anforderbar gemacht werden. Die vorliegende Arbeit enthält die Inhalte dieser Pfade betreffend die glomeruläre Filtrationsrate, Hämaturie, Leukozyturie und Proteinurie.
Hirnwelt oder Lebenswelt? Zur Kritik des Neurokonstruktivismus
Authors: Fuchs Thomas
Published: June 2011

From a neuroconstructivistic point of view, the human brain produces an internal simulation of the external world which appears in conscious experience as the phenomenal world. This concept implies in particular that the subjective body and the organic or objective body belong to fundamentally different realms, i.e. to the mental and the physical world. The spatiality of the subject-body has then to be declared an illusion, which is done by pointing to dissociations of the subject- and object-body as in the rubber hand illusion or in phantom limbs. This alleged virtuality of body experience may be refuted, however, namely by referring to the intersubjectivity of perception which certifies the coextensivity of subject-body and object-body. Subjectivity is thus shown to be embodied as well as spatially extended, that means, as bodily being-in-the-world.
Begegnungen im Vorraum der Macht. Carl Schmitt und Niklas Luhmann
Authors: Scholz Leander
Published: June 2011

Following Carl Schmitt′s diagnosis that the area of politics is becoming diffuse, this article analyses the transformation of the relationship between the powerholders and the subordinates under the condition of an increasing numbers of observers representing a powerful factor in their own right. In the perspective of Schmitt this factor threatens the relation of protection and obedience and therefore the whole fundament of politics. By contrast this article understands the system theory of power by Niklas Luhmann as an answer to the problem: including the observers in the process of the execution of power and transforming them into managers of political risk renders the reproduction of power possible under the condition of increasing observation.
Perspektiven einer kritischen Philosophie der Neurowissenschaften
Authors: Slaby Jan
Published: June 2011

This text presents a survey of problem areas surrounding recent developments in the cognitive, social and affective neurosciences and analyzes them from a critical philosophical perspective. Issues discussed include the public circulation of brain images, the stabilizing of types of persons on the grounds of alleged brain types, the re-formatting of humanities disciplines under the imperatives of scientific research and funding structures, the widespread construals of cerebral subjectivity and the tacit naturalization of social categories and conditions in the name of neural plasticity. A brief outline of the interdisciplinary initiative of critical neuroscience is provided to suggest a perspective for further analyses of these debated issues.
Rechtsverhältnis und aufrechter Gang. Rechtsethik im zweiten Versuch
Authors: Somek Alexander
Published: June 2011

The concept of law presupposes the concept of the legal relationship. Law authorizes, potentially or actually, the use of coercion in order to guarantee freedom from interference by others. But coercive norms also constitute internal negative liberty for their addressees. A legal obligation cannot require adopting, let alone endorsing, the internal perspective of the law-giver. Legal subjects remain strangers to one another. Reconciling legality with autonomy involves, therefore, conceiving of one′s self-determination from the perspective of someone whose reasoning remains ultimately secluded from others. Realizing this type of relation to oneself gives rise to the ethical legal obligation to assert oneself as a morally self-reliant individual.
Literary Experimentation in Rowland Hill's Village Dialogues: Transcending "Critical Attitudes" in the Face of Societal Ruination
Authors: Wallbank Adrian J.
Published: June 2011

Adrian J. Wallbank, "Literary Experimentation in Rowland Hill's Village Dialogues: Transcending 'Critical Attitudes' in the Face of Societal Ruination" (pp. 1–36)

In the aftermath of the French "Revolution Controversy," middle-class evangelical writers made a concerted effort to rehabilitate the moral fabric of British society. Hannah More's Cheap Repository Tracts (1795–98) are recognized as pivotal within this program, but in this essay I question whether they were really as influential as has been supposed. I argue that autobiographical evidence from the period demonstrates an increasing skepticism toward overt didacticism, and that despite their significant and undeniable penetration within working-class culture, the Cheap Repository Tracts, if not all "received ideologies," were increasingly being rejected by their readers. This essay examines the important contribution that Rowland Hill's Village Dialogues (1801) made to this arena. Hill, like many of his contemporaries, felt that British society was facing ruination, but he also recognized that overt moralizing and didacticism was no longer palatable or effective. I argue that Hill thus experimented with an array of literary techniques—many of which closely intersect with developments occurring within the novel and sometimes appear to contradict or undermine the avowed seriousness of evangelicalism—that not only attempt to circumvent what Jonathan Rose has described as the "critical attitudes" of early-nineteenth-century readers, but also effectively map the "transitional" nature of the shifting literary and social terrains of the period. In so doing, Hill contributed signally to the evolution of the dialogue form (which is often synonymous with mentoring and didacticism), since his use of conversational mimesis and satire predated the colloquialism of John Wilson's Noctes Ambrosianae (1822–35) and Walter Savage Landor's Imaginary Conversations (1824–29).
Functional characterization of the MTC-associated germline RET-K666E mutation: evidence of oncogenic potential enhanced by the G691S polymorphism
Authors: Borrello Maria Grazia , Aiello Antonella , Peissel Bernard , Rizzetti Maria Grazia , Mondellini Piera , Degl'Innocenti Debora , Catalano Veronica , Gobbo Morena , Collini Paola , Bongarzone Italia , Pierotti Marco A , Greco Angela , Seregni Ettore
Published: June 2011

Activating mutations of RET, a gene encoding two isoforms of a tyrosine kinase receptor physiologically expressed in several neural crest-derived cell lineages, are associated with the inherited forms of medullary thyroid carcinoma (MTC). The identification and characterization of novel RET mutations involved in MTC is valuable, as RET gene testing plays a crucial role in the management of these patients. In an MTC patient, we have identified a germline c.1996A>G transition in heterozygosis leading to K666E substitution. In addition, the conservative S904S (c.2712C>G) and the non-conservative functional G691S (c.2071G>A) polymorphisms have been identified. Through functional studies, we demonstrate for the first time that K666E is a gain-of-function mutation with oncogenic potential, based on its ability to transform NIH3T3 cells. It was not possible to define whether K666E is a de novo or inherited RET variant in the patient, as the family history was negative for MTC, and the carrier status of family members could not be tested. Our results, together with a recent report of co-segregation of the mutation in three MTC families, suggest that K666E is a causative MTC mutation. As we have shown that the same patient allele carries both K666E and G691S variants, the latter known to increase downstream RET signaling, a possible role for the G691S polymorphism has also been investigated. We have demonstrated that, although RET-G691S is not oncogenic per se, it enhances the transforming activity of the RET-K666E mutant, thus suggesting a modifier role for this functional polymorphism.
Preproghrelin expression is a key target for insulin action on adipogenesis
Authors: Gurriarán-Rodríguez Uxía , Al-Massadi Omar , Crujeiras Ana Belén , Mosteiro Carlos S , Amil-Diz María , Beiroa Daniel , Nogueiras Rubén , Seoane Luisa María , Gallego Rosalía , Pazos Yolanda , Casanueva Felipe F , Camiña Jesús P
Published: June 2011

This study aimed to investigate the role of preproghrelin-derived peptides in adipogenesis. Immunocytochemical analysis of 3T3-L1 adipocyte cells showed stronger preproghrelin expression compared with that observed in 3T3-L1 preadipocyte cells. Insulin promoted this expression throughout adipogenesis identifying mTORC1 as a critical downstream substrate for this profile. The role of preproghrelin-derived peptides on the differentiation process was supported by preproghrelin knockdown experiments, which revealed its contribution to adipogenesis. Neutralization of endogenous O-acyl ghrelin (acylated ghrelin), unacylated ghrelin, and obestatin by specific antibodies supported their adipogenic potential. Furthermore, a parallel increase in the expression of ghrelin-associated enzymatic machinery, prohormone convertase 1/3 (PC1/3) and membrane-bound O-acyltransferase 4 (MBOAT4), was dependent on the expression of preproghrelin in the course of insulin-induced adipogenesis. The coexpression of preproghrelin system and their receptors, GHSR1a and GPR39, during adipogenesis supports an autocrine/paracrine role for these peptides. Preproghrelin, PC1/3, and MBOAT4 exhibited dissimilar expression depending on the white fat depot, revealing their regulation in a positive energy balance situation in mice. The results underscore a key role for preproghrelin-derived peptides on adipogenesis through an autocrine/paracrine mechanism.
Implementation of a Multicenter Rapid Response System in Pediatric Academic Hospitals Is Effective
Authors: Kotsakis Afrothite , Lobos Anna-Theresa , Parshuram Christopher , Gilleland Jonathan , Gaiteiro Rose , Mohseni-Bod Hadi , Singh Ram , Bohn Desmond ,   on behalf of the Ontario Pediatric Critical Care Response Team Collaborative
Published: June 2011

OBJECTIVES:

This is the first large multicenter study to examine the effectiveness of a pediatric rapid response system (PRRS). The primary objective was to determine the effect of a PRRS using a physician-led team on the rate of actual cardiopulmonary arrests, defined as an event requiring chest compressions, epinephrine, or positive pressure ventilation. The secondary objectives were to determine the effect of PRRSs on the rate of PICU readmission within 48 hours of discharge and PICU mortality after readmission and urgent PICU admission.

METHODS:

A PRRS was developed, implemented, and evaluated in a standardized manner across 4 pediatric academic centers in Ontario, Canada. The team responded to activations for inpatients and followed patients discharged from the PICU for 48 hours. A 2-year, prospective, observational study was conducted after implementation, and outcomes were compared with data collected 2 years before implementation.

RESULTS:

After PRRS implementation, there were 55 963 hospital admissions and a team activation rate of 44 per 1000 hospital admissions. There were 7302 patients followed after PICU discharge. Implementation of the PRRS was not associated with a reduction in the rate of actual cardiopulmonary arrests (1.9 vs 1.8 per 1000 hospital admissions; P = .68) or PICU mortality after urgent admission (1.3 vs 1.1 per 1000 hospital admissions; P = .25). There was a reduction in the PICU mortality rate after readmission (0.3 vs 0.1 death per 1000 hospital admissions; P = .05).

CONCLUSION:

The standardized implementation of a multicenter PRRS was associated with a decrease in the rate of PICU mortality after readmission but not actual cardiopulmonary arrests.
Folic Acid Use in Pregnancy and the Development of Atopy, Asthma, and Lung Function in Childhood
Authors: Magdelijns Fabienne J. H. , Mommers Monique , Penders John , Smits Luc , Thijs Carel
Published: June 2011

BACKGROUND:

Recently, folic acid supplementation during pregnancy was implicated as a potential risk factor for atopic diseases in childhood.

OBJECTIVE:

To investigate whether folic acid supplementation and higher intracellular folic acid (ICF) levels during pregnancy increase the risk of childhood atopic diseases.

METHODS:

In the KOALA Birth Cohort Study (N = 2834), data on eczema and wheeze were collected by using repeated questionnaires at 3, 7, 12, and 24 months, 4 to 5 years, and 6 to 7 years after delivery. Atopic dermatitis and total and specific immunoglobulin E levels were determined at age 2 years and asthma and lung function at age 6 to 7 years. We defined folic acid use as stand-alone and/or multivitamin supplements according to the period of use before and/or during pregnancy. ICF levels were determined in blood samples taken at ∼35 weeks of pregnancy (n = 837). Multivariable logistic and linear regression analyses were conducted, with generalized estimating equation models for repeated outcomes.

RESULTS:

Maternal folic acid supplement use during pregnancy was not associated with increased risk of wheeze, lung function, asthma, or related atopic outcomes in the offspring. Maternal ICF level in late pregnancy was inversely associated with asthma risk at age 6 to 7 years in a dose-dependent manner (P for trend = .05).

CONCLUSIONS:

Our results do not confirm any meaningful association between folic acid supplement use during pregnancy and atopic diseases in the offspring. Higher ICF levels in pregnancy tended, at most, toward a small decreased risk for developing asthma.
Epidemiology of Sudden Death in Young, Competitive Athletes Due to Blunt Trauma
Authors: Thomas Mathew , Haas Tammy S. , Doerer Joseph J. , Hodges James S. , Aicher Brittany O. , Garberich Ross F. , Mueller Frederick O. , Cantu Robert C. , Maron Barry J.
Published: June 2011

BACKGROUND:

Sudden deaths of young competitive athletes are highly visible events that have a substantial effect on families and communities. Recent attention has focused predominantly on cardiovascular causes, and less on traumatic organ damage.

OBJECTIVE:

To define the clinical profile, epidemiology, and frequency of trauma-related deaths in young US athletes.

METHODS:

We analyzed the 30-year US National Registry of Sudden Death in Young Athletes (1980–2009) by using systematic identification and tracking strategies.

RESULTS:

Of 1827 deaths of athletes aged 21 years or younger, 261 (14%) were caused by trauma-related injuries, usually involving the head and/or neck (mean: 16 ± 2 years; 90% male) in 22 sports. The highest number of events in a single year was 16 (1986), with an average of 9 per year throughout 30 years. The mortality rate was 0.11 in 100 000 participations (95% confidence interval: 0.08–0.15). The largest number of deaths was in football (148 [57%]), including 17 high school athletes who sustained concussions shortly before fatal head trauma (“second-impact syndrome”). Football deaths were more frequent in defensive players, although the single most common position involved was running back (61% of offensive players).

CONCLUSIONS:

In a large community-based national registry, sudden deaths caused by blunt trauma in young athletes aged 21 years or younger were relatively uncommon with 16 or fewer per year, about fourfold less than cardiovascular deaths. These fatalities were most frequent in football, and an important proportion of deaths after head blows in high school football were associated with a recent history of symptomatic concussion.
Pediatric Submersion Events in Portable Above-Ground Pools in the United States, 2001–2009
Authors: Shields Brenda J. , Pollack-Nelson Carol , Smith Gary A.
Published: June 2011

OBJECTIVE:

The goal of this study was to describe the epidemiology of pediatric submersion events occurring in portable pools in the United States.

METHODS:

A retrospective analysis of fatal and nonfatal submersion events involving children younger than 12 years in portable pools was conducted using injury and fatality data compiled by the US Consumer Product Safety Commission from 2001 through 2009.

RESULTS:

There were 209 fatal and 35 nonfatal submersion cases reported to the commission from 2001 through 2009. The majority (94%) involved children younger than 5 years, 56% involved boys, 73% occurred in the child's own yard, and 81% occurred during the summer months. The number of submersion events increased rapidly from 2001 to 2005 and then leveled off from 2005 to 2009.

CONCLUSIONS:

The use of portable pools in residential settings poses a significant risk of submersion-related morbidity and mortality to children, especially in the <5-year-old age group. No single strategy will prevent all submersion deaths and injuries; therefore, layers of protection are recommended. Industry is advised to engage in development of protective devices that are effective and affordable for portable pools, including isolation fencing, pool alarms, and safety covers. A strong and pervasive consumer education campaign is needed to make consumers aware of the dangers of portable pools, because these small, inexpensive, consumer-installed pools may not generate the same sense of risk as an in-ground pool.
The Risk of Necrotizing Enterocolitis After Indomethacin Tocolysis
Authors: Sood Beena G. , Lulic-Botica Mirjana , Holzhausen Kelly A. , Pruder Sharon , Kellogg Holly , Salari Vali , Thomas Ron
Published: June 2011

BACKGROUND:

Postnatal indomethacin is reportedly associated with an increased incidence of necrotizing enterocolitis (NEC) in preterm infants. Because indomethacin readily crosses the placenta, we hypothesized that antenatal indomethacin (AI) would increase the risk for NEC in preterm infants.

OBJECTIVE:

The goal of this study was to explore the association between AI and NEC in preterm infants.

METHODS:

Medical records of preterm infants, 23 to 32 weeks' gestational age, without major congenital anomalies, were reviewed. Maternal and neonatal data were abstracted. Association of AI within 15 days before delivery (predictor variable) and classification of NEC according to modified Bell's stage 2a or higher in the first 15 days after delivery (early NEC [primary outcome variable]) was explored by using bivariate analyses, multivariate logistic regression, and propensity score analysis.

RESULTS:

Of 628 eligible infants, 63 received AI and 28 developed early NEC. AI exposure was significantly associated with multiple gestation, race, antenatal corticosteroids and magnesium sulfate, lower birth weight and gestational age, umbilical arterial catheter placement, respiratory distress syndrome, postnatal vasopressors and antibiotics, patent ductus arteriosus, sepsis, NEC, intraventricular hemorrhage, and mortality. On multivariate logistic regression controlling for covariates, AI was significantly associated with early NEC (adjusted odds ratio: 7.193 [95% confidence interval: 2.514–20.575]; number needed to harm: 5). The results remained significant when analyses were repeated using AI exposure within 5 days before delivery as a predictor variable; on analyses stratified according to gestational age; and on propensity score analysis.

CONCLUSIONS:

AI was associated with NEC in preterm infants in the first 15 days of life in this study, as were multiple other clinical factors.
Body composition, metabolic syndrome and insulin resistance in type 1 diabetes mellitus
Authors: Momesso Denise Prado , Bussade Isabela , Lima Giovanna A. Balarini , Fonseca Leniane Pereira Coelho , Russo Luis Augusto Tavares , Kupfer Rosane
Published: June 2011

OBJECTIVE: Our aim was to determine the relationship between body fat composition, metabolic syndrome (MS), and insulin resistance in type 1 diabetes (DM1). SUBJECTS AND METHODS: Forty-five DM1 women (36 ± 9 years; body mass index 24.6 ± 4.4 kg/m²) had body composition and insulin resistance determined by dual-energy X-ray absorptiometry and estimated glucose disposal ratio (eGDR), respectively. Twenty patients (45%) had MS according to World Health Organization (WHO) criteria. RESULTS: Women with DM1 and MS had increased central fat and lower eGDR than women without MS (41.9 ± 2.0 vs. 33.7 ± 1.8%; p = 0.004 and 4.99 ± 0.40 vs. 8.37 ± 0.39; p < 0.0001, respectively). Total body fat and peripheric fat were similar between the groups. Central fat negatively correlated with eGDR (r = -0.33; p = 0.03). CONCLUSION: Central fat deposition in young non-obese DM1 women was related to MS and insulin resistance. Thus, body fat composition analysis might be important to identify DM1 patients with increased metabolic risk.
Impaired functional and hemodynamic response to graded exercise testing and its recovery in patients with subclinical hyperthyroidism
Authors: Vigário Patrícia dos Santos , Chachamovitz Dhiãnah Santini de Oliveira , Teixeira Patrícia de Fátima dos Santos , Santos Mauro Augusto dos , Oliveira Fátima Palha de , Vaisman Mário
Published: June 2011

OBJECTIVE: To evaluate the functional and hemodynamic responses during exercise and its recovery in patients with subclinical hyperthyroidism (SCH). SUBJECTS AND METHODS: A cross-sectional study was carried out with 29 patients on TSH-suppressive therapy with levothyroxine for thyroid carcinoma and 35 euthyroid subjects. All volunteers underwent a cardiopulmonary exercise testing on a treadmill and functional and hemodynamic variables were measured during exercise and its recovery. RESULTS: SCH patients showed impaired functional response to exercise, marked by lower values for oxygen consumption and exercise duration in addition to premature achievement of the anaerobic threshold. Heart-rate and blood pressure recovery immediately after exercise were slower among SCH patients when compared to euthyroid subjects. CONCLUSION: SCH is associated with impaired functional and hemodynamic responses during exercise and its recovery.
Comparison of the hormonal responses to exhaustive incremental exercise in adolescent and young adult males
Authors: Hackney Anthony C. , Viru Mehis , VanBruggen Mitch , Janson Tamara , Karelson Kalle , Viru Atko
Published: June 2011

OBJECTIVE: Evaluate hormonal responses to incremental-stage exercise (EX) test to exhaustion in adolescents. SUBJECTS AND METHODS: Adolescents were tested at 16 years of age in Tanner Stage 4 (TS4) and at 17 years of age in Tanner Stage 5 (TS5) (n = 6). Adults were tested at 21 ± 1 y. (X ± SD) (n = 4) and served as controls. Blood samples were taken at rest, at the end of each EX stage. RESULTS: Main effects for EX in cortisol (p < 0.01, increasing with each EX stage) and for subject group for testosterone (T) occurred (p < 0.01; TS4 < TS5, adults). Interaction effect of group by EX stage occurred for GH (p < 0.05). GH increased in response to EX in all groups, however, the magnitude of increase was significantly less for TS5 and adults than TS4. CONCLUSIONS: Differences in T and GH responses for TS4 than those for TS5 and adults reflect the differing maturation levels of the endocrine system between Tanner Stages. TS5 adolescents are more similar to young adults in hormonal responses to EX than are TS4 adolescents.
Disfunções cognitivas em pacientes com hipotireoidismo subclínico
Authors: Fernandes Robertta Soares Miranda , Alvarenga Nathália Bueno , Silva Tamara Inácio da , Rocha Felipe Filardi da
Published: June 2011

OBJETIVO: Avaliar a presença de disfunções cognitivas em pacientes com hipotireoidismo subclínico (HS). SUJEITOS E MÉTODOS: Estudo seccional comparando os achados neuropsicológicos de 89 pacientes com HS e 178 indivíduos eutireoidianos. Para avaliação neuropsicológica, foram utilizados: Teste de Performance Contínua (CPT-II), Iowa Gambling Task, Teste de Stroop, Teste de Wisconsin (WCST), Teste da Figura Complexa de Rey-Osterreich, Teste de Fluência Verbal (categorias semântica e fonológica) e Teste de Aprendizagem Auditivo Verbal de Rey. RESULTADOS: Os pacientes mostraram pior desempenho na flexibilidade cognitiva (WCST) e na capacidade de manter atenção sustentada (erros por omissão no CPT-II). CONCLUSÕES: Esses déficits podem causar prejuízos na vida diária do paciente, constituindo possíveis indicações de tratamento.
Dimensões da imitação entre empresas: um estudo na indústria de transformação brasileira
Authors: Bataglia Walter , Silva Adilson Aderito da , Klement Claudia Fernanda Franceschi
Published: June 2011

O objetivo deste trabalho foi identificar as dimensões do construto imitação entre empresas e propor um procedimento operacional para sua mensuração nos setores empresariais. A imitação foi conceituada como cópia de competências. Sua operacionalização foi feita pela facilidade de compreendê-las. Colheram-se as percepções de 112 gestores de 14 setores da economia brasileira no Estado de São Paulo. Utilizou-se a base de dados da Federação da Indústria do estado de São Paulo (Fiesp). As dimensões subjacentes ao construto foram identificadas pela análise fatorial exploratória. Os resultados indicam que a imitação em um setor tende a ser maior quanto menos se realizam atividades de pesquisa e desenvolvimento (P&D), menor é a importância do grau de escolaridade nos processos produtivos, mais baixo é o conteúdo tecnológico dos produtos e processos e menos relevante é a montagem dos produtos
Transaction costs: an empirical analysis of their relationship with investment and foreign direct investment
Authors: Wink Junior Marcos Vinício , Sheng Hsia Hua , Eid Junior William
Published: June 2011

As stated by the New Institutional Economics theory, transaction costs play a relevant role in economics and, according to the extent of such costs, agents make investment decisions. Actually, transaction costs may represent a disincentive to entrepreneurship. This work aims to verify whether transaction costs are related to investment rate and foreign direct investment rate (FDI) in different business environments. The results suggest that foreign investors do not have precise information about other countries as domestic investors do; as it is observed, only the relation between transaction costs and investment rate is significant. Furthermore, there is evidence that the business environments of BRIC countries are less developed when compared to business environments of other countries in the study
Gestão da terceirização no setor brasileiro de distribuição de energia elétrica
Authors: Souza Leonardo Leocádio Coelho de , Maldonado Mauricio Uriona , Rados Gregorio Jean Varvakis
Published: June 2011

O setor brasileiro de distribuição de energia elétrica expandiu a terceirização para toda a cadeia de valor, incluindo serviços diretamente ligados ao core business das empresas. Diante desse cenário, este trabalho tem como objetivo analisar os modelos da gestão da terceirização desenvolvidos por duas distribuidoras brasileiras de energia elétrica. Foram realizadas visitas e entrevistas in loco, com stakeholders das distribuidoras e das empresas terceirizadas. A principal contribuição é que a terceirização requer níveis mais elaborados de gestão, sugerindo a expansão da capacidade técnico-gerencial da empresa.
A repartição tributária dos recursos do ICMS nos municípios da Região Metropolitana de Curitiba
Authors: Soares Maurélio , Gomes Ely do Carmo Oliveira , Toledo Filho Jorge Ribeiro de
Published: June 2011

O conhecimento da geração e da distribuição da receita pública contribui para a transparência das contas públicas, para o planejamento dos orçamentos públicos e para o fornecimento de informações de melhor qualidade aos diversos usuários da contabilidade pública. A concepção e a importância da aplicação da receita pública dimensionam a capacidade governamental em fixar sua despesa e, no momento de sua arrecadação, torna-se instrumento condicionante de execução orçamentária da despesa. O Imposto sobre a Circulação de Mercadorias e Serviços (ICMS) é uma das principais fontes de recursos, para compor o planejamento orçamentário dos estados e municípios, provenientes da produção e movimentação das riquezas econômicas. O presente estudo objetiva investigar a relação entre a arrecadação de ICMS oriunda do movimento econômico dos municípios da Região Metropolitana de Curitiba (RMC) e as transferências governamentais da cota-parte do ICMS repassada pelo governo estadual aos municípios. Os resultados indicam que, apesar dos dilemas a respeito da distribuição do imposto, comprova-se a importância que o tributo tem na política fiscal e nos orçamentos públicos, especialmente naqueles municípios de menor porte, em que sua existência depende em boa parte dessa fonte de recurso.
Qualidade de vida de cuidadores de crianças e adolescentes com sobrepeso ou obesidade
Authors: Melo Tatiana Rocha , Jansen Ann Kristine , Pinto Rogério de Melo Costa , Morales Rogério Rizo de , Morales Nívea Macedo , Prado Marília Martins , Silva Carlos Henrique Martins da
Published: June 2011

Este estudo avaliou a qualidade de vida relacionada à saúde (QVRS) de cuidadores de crianças e adolescentes com sobrepeso e obesidade. Trezentos e sessenta cuidadores de crianças e adolescentes com idade entre 9 e 12 anos, com diagnóstico de sobrepeso (n=96; idade média=11,1 anos), obesidade (n=62; idade média de 10,9 anos) e eutrofia (n=202; idade média de 10,7 anos), matriculadas em escolas públicas e particulares da cidade de Uberlândia (MG), foram convidados a responder o questionário The 36 item Short Form Questionnaire (SF-36). Os escores obtidos pelo questionário foram comparados segundo o índice de massa corpórea (IMC) das crianças e adolescentes e não foram encontradas diferenças significativas entre os cuidadores de crianças e adolescentes com sobrepeso, obesidade e eutrofia.Logo, os cuidadores de crianças e adolescentes com sobrepeso ou obesidade não apresentam prejuízo na sua QVRS.
Necessidades humanas básicas dos profissionais de enfermagem: situações de (in)satisfação no trabalho
Authors: Regis Lorena Fagundes Ladeia Vitoria , Porto Isaura Setenta
Published: June 2011

O cuidado está associado às ações da enfermagem considerando, sobretudo um conjunto de necessidades da equipe de enfermagem. Os objetivos desta pesquisa foram: caracterizar situações de (in)satisfações da equipe de enfermagem no trabalho e analisar as implicações destas (in)satisfações da equipe de enfermagem no trabalho. Adotou-se a teoria das necessidades humanas básicas de Maslow para compreender fatores motivacionais e utilizou-se uma metodologia qualitativa com aplicação de técnicas quantitativas. O método compôs-se de observação participante com registros em diário de campo associada à aplicação de um questionário para 18 participantes da equipe de enfermagem em um Hospital Público do Rio de Janeiro. O estudo indica que as necessidades básicas da equipe de enfermagem encontram-se comprometidas, principalmente as necessidades de segurança e fisiológicas, as mais primárias. O comprometimento das necessidades primárias do sujeito que cuida implica em prejuízo para a saúde e redução do desempenho no trabalho em cenários hospitalares.
Atributos mobilizados pela enfermeira na Saúde da Família: aproximação aos desempenhos na construção da competência gerencial
Authors: Kawata Lauren Suemi , Mishima Silvana Martins , Chirelli Mara Quaglio , Pereira Maria José Bistafa , Matumoto Silvia , Fortuna Cinira Magali
Published: June 2011

Estudo de caráter exploratório-descritivo, com abordagem qualitativa, objetivando identificar e analisar os atributos mobilizados nas situações de trabalho e que caracterizam os desempenhos das enfermeiras na área da competência gerencial na Saúde da Família, apoiado nos conceitos da competência dialógica. Para coleta de dados, foi realizada observação participante do trabalho das enfermeiras atuantes na Saúde da Família em quatro unidades vinculadas à Universidade de São Paulo em Ribeirão Preto - SP/Brasil, considerando-se uma semana típica de trabalho, totalizando 160 horas de observação. Através da análise de conteúdo, usando a técnica de análise temática, identificamos cinco temas relacionados a: supervisão, trabalho em equipe, controle social, organização do trabalho e planejamento. Os resultados apontam para um conjunto de atributos mobilizados pelas enfermeiras ainda centrado na organização do trabalho em saúde para o cuidado individual com raras incursões para um processo de planejamento sistematizado.
Acessibilidade e conteúdo de informação eletrônica sobre Cursos de Especialização em Administração em Enfermagem
Authors: Meneses Abel Silva de , Sanna Maria Cristina
Published: June 2011

Este estudo descritivo objetivou analisar a acessibilidade e o conteúdo da informação sobre Cursos de Especialização em Administração em Enfermagem disponível em sites de universidades federais brasileiras. De setembro de 2008 a abril de 2009, foram avaliados 19 cursos disponíveis nos sites das universidades federais brasileiras, segundo o nível de acesso à informação e o desenho curricular, frente à estrutura do conhecimento sobre Administração em Enfermagem: Bases Ideológicas e Teóricas, Métodos de Intervenção e Práticas de Administração de Recursos. Os resultados revelaram que, em plena era da sociedade do conhecimento, a acessibilidade por meio eletrônico aos programas de ensino ainda está aquém do que se espera dos conceitos de informação e navegabilidade. No tocante ao desenho dos cursos, percebeu-se que a maioria tem superado muito a carga horária mínima legal, e que está havendo valorização do estudo das Bases Ideológicas e Teóricas em detrimento das Práticas de Administração de Recursos.