bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of Australian youth suicide prevention initiatives
Authors: Page Andrew , Taylor Richard , Gunnell David , Carter Greg , Morrell Stephen , Martin Graham
Published: November 2011

Background

After an epidemic rise in Australian young male suicide rates over the 1970s to 1990s, the period following the implementation of the original National Youth Suicide Prevention Strategy (NYSPS) in 1995 saw substantial declines in suicide in young men.

Aims

To investigate whether areas with locally targeted suicide prevention activity implemented after 1995 experienced lower rates of young adult suicide, compared with areas without such activity.

Method

Localities with or without identified suicide prevention activity were compared during the period of the NYSPS implementation (1995–1998) and a period subsequent to implementation (1999–2002) to establish whether annual average suicide rates were lower and declined more quickly in areas with suicide prevention activity over the period 1995–2002.

Results

Male suicide rates were lower in areas with targeted suicide prevention activity (and higher levels of funding) compared with areas receiving no activity both during (RR = 0.89, 95% CI 0.80–0.99,P= 0.030) and after (RR = 0.86, 95% CI 0.77–0.96,P= 0.009) implementation, with rates declining faster in areas with targeted activity than in those without (13%v.10% decline). However, these differences were reduced and were no longer statistically significant following adjustment for sociodemographic variables. There was no difference in female suicide rates between areas with or without targeted suicide prevention activity.

Conclusions

There was little discernible impact on suicide rates in areas receiving locally targeted suicide prevention activities in the period following the NYSPS.
Impact of positive images of a person with intellectual disability on attitudes: randomised controlled trial
Authors: Varughese Sabu John , Mendes Vania , Luty Jason
Published: November 2011

Aims and method

Tackling discrimination, stigma and inequalities in mental health is a major UK government objective yet people with intellectual disability (also known as learning disability in UK health services) continue to suffer serious stigma and discrimination. We examine the effect of viewing pictures of a person with intellectual disability on stigmatised attitudes. The 20-point Attitude to Mental Illness Questionnaire (AMIQ) was used to assess stigmatised attitudes. Members of the general public were randomised to complete the questionnaire having looked at a good (attractive) or bad (unattractive) photograph of a person with intellectual disability.

Results

Questionnaires were received from 187 participants (response rate 74%). The mean AMIQ stigma score for the bad photo group was 1.3 (s.e. = 0.3, median 1, interquartile range (IQR) = 0–3,n= 82). The mean AMIQ score for the good photo group was 2.8 (s.e. = 0.3, median 3, IQR = 1–5,n= 105). The difference in AMIQ stigma score was highly significant (two-sidedP= 0.0001, median difference 2, Mann–WhitneyU-test).

Clinical implications

Looking at a good (attractive) picture of a person with intellectual disability significantly reduces reported stigmatised attitudes, whereas a bad (unattractive) picture has no effect.
Probability and loss: two sides of the risk assessment coin
Authors: Large Matthew M. , Nielssen Olav B.
Published: November 2011

Risk assessment has been widely adopted in mental health settings in the hope of preventing harms such as violence to others and suicide. However, risk assessment in its current form is mainly concerned with the probability of adverse events, and does not address the other component of risk – the extent of the resulting loss. Although assessments of the probability of future harm based on actuarial instruments are generally more accurate than the categorisations made by clinicians, actuarial instruments are of little assistance in clinical decision-making because there is no instrument that can estimate the probability of all the harms associated with mental illness, or estimate the extent of the resulting losses. The inability of instruments to distinguish between the risk of common but less serious harms and comparatively rare catastrophic events is a particular limitation of the value of risk categorisations. We should admit that our ability to assess risk is severely limited, and make clinical decisions in a similar way to those in other areas of medicine – by informed consideration of the potential consequences of treatment and non-treatment.
Disease-Related Outcomes With Long-Term Follow-Up: An Updated Analysis of the Intergroup Exemestane Study
Authors: Bliss Judith M. , Kilburn Lucy S. , Coleman Robert E. , Forbes John F. , Coates Alan S. , Jones Stephen E. , Jassem Jacek , Delozier Thierry , Andersen Jørn , Paridaens Robert , van de Velde Cornelis J.H. , Lønning Per E. , Morden James , Reise Justine , Cisar Laura , Menschik Thomas , Coombes R. Charles
Published: November 2011

Purpose

Intergroup Exemestane Study (IES), an investigator-led study in 4,724 postmenopausal patients with early-stage breast cancer has demonstrated clinically important benefits from switching adjuvant endocrine therapy after 2 to 3 years of tamoxifen to exemestane. Now, with longer follow-up, a large number of non–breast cancer–related events have been reported. Exploratory analyses describe breast cancer–free survival (BCFS) and explore incidence and patterns of the different competing events.

Patients and Methods

Patients who were disease-free after 2 to 3 years of adjuvant tamoxifen were randomly assigned to continue tamoxifen or switch to exemestane to complete 5 years of adjuvant endocrine therapy. At this planned analysis, the median follow-up was 91 months. Principal analysis focuses on 4,052 patients with estrogen receptor (ER) –positive and 547 with ER-unknown tumors.

Results

In all, 930 BCFS events have been reported (exemestane, 423; tamoxifen, 507), giving an unadjusted hazard ratio (HR) of 0.81 (95% CI, 0.71 to 0.92; P = .001) in favor of exemestane in the ER-positive/ER unknown group. Analysis partitioned at 2.5 years after random assignment showed that the on-treatment benefit of switching to exemestane (HR, 0.60; 95% CI, 0.48 to 0.75; P < .001) was not lost post-treatment, but that there was no additional gain once treatment had ceased (HR, 0.94; 95% CI, 0.80 to 1.10; P = .60). Improvement in overall survival was demonstrated, with 352 deaths in the exemestane group versus 405 deaths in the tamoxifen group (HR, 0.86; 95% CI, 0.75 to 0.99; P = .04). Of these, 222 were reported as intercurrent deaths (exemestane, 107; tamoxifen, 115).

Conclusion

The protective effect of switching to exemestane compared with continuing on tamoxifen on risk of relapse or death was maintained for at least 5 years post-treatment and was associated with a continuing beneficial impact on overall survival.
Breast Cancer Risk for Noncarriers of Family-Specific BRCA1 and BRCA2 Mutations: Findings From the Breast Cancer Family Registry
Authors: Kurian Allison W. , Gong Gail D. , John Esther M. , Johnston David A. , Felberg Anna , West Dee W. , Miron Alexander , Andrulis Irene L. , Hopper John L. , Knight Julia A. , Ozcelik Hilmi , Dite Gillian S. , Apicella Carmel , Southey Melissa C. , Whittemore Alice S.
Published: November 2011

Purpose

Women with germline BRCA1 and BRCA2 mutations have five- to 20-fold increased risks of developing breast and ovarian cancer. A recent study claimed that women testing negative for their family-specific BRCA1 or BRCA2 mutation (noncarriers) have a five-fold increased risk of breast cancer. We estimated breast cancer risks for noncarriers by using a population-based sample of patients with breast cancer and their female first-degree relatives (FDRs).

Patients and Methods

Patients were women with breast cancer and their FDRs enrolled in the population-based component of the Breast Cancer Family Registry; patients with breast cancer were tested for BRCA1 and BRCA2 mutations, as were FDRs of identified mutation carriers. We used segregation analysis to fit a model that accommodates familial correlation in breast cancer risk due to unobserved shared risk factors.

Results

We studied 3,047 families; 160 had BRCA1 and 132 had BRCA2 mutations. There was no evidence of increased breast cancer risk for noncarriers of identified mutations compared with FDRs from families without BRCA1 or BRCA2 mutations: relative risk was 0.39 (95% CI, 0.04 to 3.81). Residual breast cancer correlation within families was strong, suggesting substantial risk heterogeneity in women without BRCA1 or BRCA2 mutations, with some 3.4% of them accounting for roughly one third of breast cancer cases.

Conclusion

These results support the practice of advising noncarriers that they do not have any increase in breast cancer risk attributable to the family-specific BRCA1 or BRCA2 mutation.
Cancer Immunotherapy Comes of Age
Authors: Topalian Suzanne L. , Weiner George J. , Pardoll Drew M.
Published: November 2011

Cancer immunotherapy comprises a variety of treatment approaches, incorporating the tremendous specificity of the adaptive immune system (T cells and antibodies) as well as the diverse and potent cytotoxic weaponry of both adaptive and innate immunity. Immunotherapy strategies include antitumor monoclonal antibodies, cancer vaccines, adoptive transfer of ex vivo activated T and natural killer cells, and administration of antibodies or recombinant proteins that either costimulate immune cells or block immune inhibitory pathways (so-called immune checkpoints). Although clear clinical efficacy has been demonstrated with antitumor antibodies since the late 1990s, other immunotherapies had not been shown to be effective until recently, when a spate of successes established the broad potential of this therapeutic modality. These successes are based on fundamental scientific advances demonstrating the toleragenic nature of cancer and the pivotal role of the tumor immune microenvironment in suppressing antitumor immunity. New therapies based on a sophisticated knowledge of immune-suppressive cells, soluble factors, and signaling pathways are designed to break tolerance and reactivate antitumor immunity to induce potent, long-lasting responses. Preclinical models indicate the importance of a complex integrated immune response in eliminating established tumors and validate the exploration of combinatorial treatment regimens, which are anticipated to be far more effective than monotherapies. Unlike conventional cancer therapies, most immunotherapies are active and dynamic, capable of inducing immune memory to propagate a successful rebalancing of the equilibrium between tumor and host.
Generation of a genetically encoded marker of rod photoreceptor outer segment growth and renewal
Authors: Willoughby John J. , Jensen Abbie M.
Published: November 2011

Vertebrate photoreceptors are specialized light sensing neurons. The photoreceptor outer segment is a highly modified cilium where photons of light are transduced into a chemical and electrical signal. The outer segment has the typical cilary axoneme but, in addition, it has a large number of densely packed, stacked, intramembranous discs. The molecular and cellular mechanisms that contribute to vertebrate photoreceptor outer segment morphogenesis are still largely unknown. Unlike typical cilia, the outer segment is continuously regenerated or renewed throughout the life of the animal through the combined process of distal outer segment shedding and proximal outer segment growth. The process of outer segment renewal was discovered over forty years ago, but we still lack an understanding of how photoreceptors renew their outer segments and few, if any, molecular mechanisms that regulate outer segment growth or shedding have been described. Our lack of progress in understanding how photoreceptors renew their outer segments has been hampered by the difficulty in measuring rates of renewal. We have created a new method that uses heat-shock induction of a fluorescent protein that can be used to rapidly measure outer segment growth rates. We describe this method, the stable transgenic line we created, and the growth rates observed in larval and adult rod photoreceptors using this new method. This new method will allow us to begin to define the genetic and molecular mechanisms that regulate rod outer segment renewal, a crucial aspect of photoreceptor function and, possibly, viability.
Effect of ageing and pulmonary inflammation on the incidence and number of cross-bridging structures in pneumothorax patients
Authors: Sasaki Tomoaki , Takahashi Koji , Aburano Tamio
Published: November 2011

Background

There is an improved prognosis for T4 non-small-cell lung cancer in patients who show particular patterns of direct mediastinal invasion. The particular patterns suggest the presence of direct pathways other than the pulmonary hilum between each of the lungs and the mediastinum/chest wall.

Purpose

To determine the incidence and number of such direct pathways in pneumothorax patients as well as the factors that affect the development of these pathways.

Material and Methods

Two radiologists independently analyzed multidetector computed tomographic images of 81 patients with pneumothorax to assess the incidence and distribution pattern of the cross-bridging structures in the pleural cavity.

Results

Cross-bridging structures were observed in the right pneumothorax in 34/54 (63%) patients and in the left pneumothorax in 19/32 (59%) patients. The number of cross-bridging structures was found to be positively correlated with ageing and pulmonary disease. The distribution patterns of cross-bridging structures were found to be specific in formation and often in repeated locations, regardless of the presence of pulmonary disease or the age of the patient.

Conclusion

Cross-bridging structures in pneumothoraces were found more frequently in older patients and in patients with pulmonary disease. However, some of the cross-bridging structures may have been congenital because of their specific formations and repeated locations.
Evaluation of cartilage surface injuries using 3D-double echo steady state (3D-DESS): Effect of changing flip angle from 40° to 90°
Authors: Moriya Susumu , Miki Yukio , Kanagaki Mitsunori , Yamamoto Akira , Okudaira Shuzo , Nakamura Shinichiro , Yokobayashi Tsuneo , Ishikawa Mitsunori
Published: November 2011

Background

In magnetic resonance imaging (MRI) with 3D-double-echo steady-state (3D-DESS) sequences, the cartilage-synovial fluid contrast is reported to be better with a flip angle of 90° than with the conventional flip angle of 40°, and the detection rate of knee cartilage injury may be improved.

Purpose

To compare the diagnostic performance and certainty of diagnosis with 3D-DESS images made using two flip angle settings, 40° and 90°, for knee cartilage surface lesions of Grade 2 or above confirmed by arthroscopy.

Material and Methods

Images were obtained with 3D-DESS flip angles of 40° and 90° at 1.0T in 13 consecutive patients (2 men, 11 women, age range 18–68 years) evaluated for superficial cartilage injury by arthroscopy. Two radiologists classified the presence or absence of cartilage damage of ≥Grade 2 as ‘positive ( p)’ or ‘negative ( n)’, respectively. The rate of agreement with arthroscopic diagnosis was then examined, and the diagnostic performance compared. Diagnostic confidence was assessed scoring the presence or absence of cartilage damage into three categories: 3 = can diagnose with absolute confidence; 2 = can diagnose with a level of certainty as probably present or probably absent; and 1 = cannot make a diagnosis.

Results

In a comparison of the rate of agreement between diagnosis by 3D-DESS images and arthroscopy, the rate of agreement was significantly higher and diagnostic performance was better in 90° images for the medial femoral condyle only. Diagnostic confidence was significantly better with 90° flip angle images than with 40° flip angle images for all six cartilage surfaces.

Conclusion

In evaluating knee cartilage surface lesions with 3D-DESS sequences, a flip angle setting of 90° is more effective than the conventional setting of 40°.
Longitudinal predictors of adherence to annual follow-up in a lung cancer screening programme
Authors: Wildstein Kimberly A , Faustini Yolanda , Yip Rowena , Henschke Claudia I , Ostroff Jamie S
Published: November 2011

Objective

To examine rates and factors associated with adherence to annual repeat lung cancer screening in two cohorts.

Participants and methods

The self-pay cohort ( n = 2083) was individuals aged 40 years and older with no prior cancer and a smoking history. Participants had to obtain a prescription from their doctor for the low dose, computerized tomography scan (CT), and were responsible for payment of $300 as these CT scans are not typically covered by insurance. The no-pay cohort ( n = 1304) was individuals aged 60 and older with a smoking history, and no prior cancer. The initial and one year repeat CT were provided free of charge. Rates of adherence for each cohort were analyzed by demographic variables, smoking history, family history of lung cancer, smoking status (former/current), perceived risk and worry of getting lung cancer and baseline screening CT.

Results

Adherence to annual follow-up was lower for the self-pay than for the no-pay cohort (62% vs. 88%). Both the self-pay and no-pay cohorts had higher adherence rates among Caucasians and those who had a college degree. A greater perceived risk of getting lung cancer increased adherence among the self-pay cohort. Non-calcified nodules found on baseline CT increased the adherence for the self-pay cohort, but decreased the adherence for the no-pay cohort.

Conclusions

These findings should be used in developing educational materials and targeted retention strategies to increase adherence with repeat lung cancer screening.
Minor influence of self-selection bias on the effectiveness of breast cancer screening in case-control studies in the Netherlands
Authors: Paap Ellen , Verbeek André , Puliti Donella , Broeders Mireille , Paci Eugenio
Published: November 2011

Background

Self-selection bias is considered to be a problem when evaluating the effectiveness of breast cancer service screening in case-control studies.

Objective

Using the incidence-based mortality method (IBM), a correction factor for the potential influence of self-selection can be derived from a group of non-screened women and a group of not-invited women.

Methods

Breast cancer patients, diagnosed in 1990–1995 and between the ages of 50 to 70, were selected from the Netherlands Cancer Registry and five screening regions in the Netherlands. Person-years were calculated for non-screened and not-invited women by using population data available on the number of women invited, the number of women screened and the total population. Incidence-based breast cancer mortality rates according to screening status were calculated for the five screening regions.

Results

Between 1990–1995, 15,541 patients were diagnosed with breast cancer. An analysis of ten-year follow-up after diagnosis resulted in 3903 breast cancer deaths, of which 2631 were not-invited and 345 were non-screened. Poisson regression analysis showed heterogeneity between the regions with a range of IBM ratios from 0.64 (95% CI: 0.46–0.90) to 1.08 (95% CI: 0.82–1.43).

Conclusions

Heterogeneity between the regions stresses the importance of a country- and/or region-specific estimate of self-selection. Adjusting for self-selection bias in the regional case-control studies would not change the breast cancer mortality reduction in three regions and would result in an even larger effect in two regions. Looking at the range of IBM ratios the overall influence of self-selection in the Netherlands is minor.
Single negative colposcopy: is it enough to rule out high-grade disease?
Authors: Mesher David , Tristram Amanda , Castanon Alejandra , Beer Helen , Ashman Suzanne , Fielder Hilary , Fiander Alison , Sasieni Peter
Published: November 2011

It has been proposed that women who have a negative colposcopic examination or who have no cervical intraepithelial neoplasia (CIN) on colposcopic biopsy can be safely returned to routine screening with the next visit being three or five years later. We present data regarding 551 women who had colposcopy in Wales for a low-grade cytological abnormality and who were followed through Cervical Screening Wales for subsequent CIN. Of 436 women declared CIN free initially, 26 (6.0%) had high-grade CIN diagnosed on follow-up. We suggest that additional screening at an interval of less than three years should be offered to women with a negative colposcopy or a biopsy without CIN.
Primary care strategies to improve childhood immunisation uptake in developed countries: systematic review
Authors: Williams Nia , Woodward Helen , Majeed Azeem , Saxena Sonia
Published: November 2011

Objectives

To conduct a systematic review of strategies to optimize immunisation uptake within preschool children in developed countries.

Design

Systematic review.

Setting

Developed countries

Participants

Preschool children who were due, or overdue, one or more of their routine primary immunisations.

Main outcome measures

Increase in the proportion of the target population up to date with standard recommended universal vaccinations.

Results

Forty-six studies were included for analysis, published between 1980 and 2009. Twenty-six studies were randomized controlled trials, 11 were before and after trials, and nine were controlled intervention trials. Parental reminders showed a statistically significant increase in immunisation rates in 34% of included intervention arms. These effects were reported with both generic and specific reminders and with all methods of reminders and recall. Strategies aimed at immunisation providers were also shown to improve immunisation rates with a median change in immunisation rates of 7% when reminders were used, 8% when educational programmes were used and 19% when feedback programmes were used.

Conclusion

General practitioners are uniquely positioned to influence parental decisions on childhood immunisation. A variety of strategies studied in primary care settings have been shown to improve immunisation rates, including parental and healthcare provider reminders.
Subcellular Distribution and Relative Expression of Fibrocyte Markers in the CD/1 Mouse Cochlea Assessed by Semiquantitative Immunogold Electron Microscopy
Authors: Mahendrasingam Shanthini , Bebb Catherine , Shepard Ella , Furness David N.
Published: November 2011

Spiral ligament fibrocytes function in cochlear homeostasis, maintaining the endocochlear potential by participating in potassium recycling, and fibrocyte degeneration contributes to hearing loss. Their superficial location makes them amenable to replacement by cellular transplantation. Fibrocyte cultures offer one source of transplantable cells, but determining what fibrocyte types they contain and what phenotype transplanted cells may adopt is problematic. Here, we use immunogold electron microscopy to assess the relative expression of markers in native fibrocytes of the CD/1 mouse spiral ligament. Caldesmon and aquaporin 1 are expressed more in type III fibrocytes than any other type. S-100 is strongly expressed in types I, II, and V fibrocytes, and α1Na,K-ATPase is expressed strongly only in types II and V. By combining caldesmon or aquaporin 1 with S-100 and α1Na,K-ATPase, a ratiometric analysis of immunogold density distinguishes all except type II and type V fibrocytes. Other putative markers (creatine kinase BB and connective tissue growth factor) did not provide additional useful analytical attributes. By labeling serial sections or by double or triple labeling with combinations of three antibodies, this technique could be used to distinguish all except type II and type V fibrocytes in culture or after cellular transplantation into the lateral wall.
Expression of Dentin Sialophosphoprotein in Non-mineralized Tissues
Authors: Prasad Monica , Zhu Qinglin , Sun Yao , Wang Xiaofang , Kulkarni Ashok , Boskey Adele , Feng Jian Q. , Qin Chunlin
Published: November 2011

Dentin sialophosphoprotein (DSPP) and its cleaved products, dentin phosphoprotein (DPP) and dentin sialoprotein (DSP), play important roles in biomineralization. Believed to be tooth specific, the authors’ group revealed its expression in bone, and more recently, they and other groups also showed its expression in a few types of soft tissues. In this study, the authors systematically examined the expression of DSPP in a variety of non-mineralized tissues using reverse-transcription polymerase chain reaction (RT-PCR), real-time PCR, Western immunoblotting, and immunohistochemistry analyses in wild-type mice as well as β-galactosidase assays in the Dspp lacZ knock-in mice. These approaches showed the presence of DSPP in the salivary glands, cartilage, liver, kidney, and brain and its absence in the heart and spleen. Real-time PCR showed that the expression levels of DSPP mRNA in salivary glands, cartilage, liver, and kidney were higher than in the bone. Interestingly, DSPP was observed in the pericytes of blood vessels in the dental pulp, which are believed to be able to differentiate into odontoblasts. On the basis of these observations, the authors conclude that DSPP and/or its cleaved products may fulfill important functions in certain non-mineralized tissues in addition to its role in biomineralization.
Human Breast Cancer Histoid
Authors: Kaur Pavinder , Ward Brenda , Saha Baisakhi , Young Lillian , Groshen Susan , Techy Geza , Lu Yani , Atkinson Roscoe , Taylor Clive R. , Ingram Marylou , Imam S. Ashraf
Published: November 2011

Progress in our understanding of heterotypic cellular interaction in the tumor microenvironment, which is recognized to play major roles in cancer progression, has been hampered due to unavailability of an appropriate in vitro co-culture model. The aim of this study was to generate an in vitro 3-dimensional human breast cancer model, which consists of cancer cells and fibroblasts. Breast cancer cells (UACC-893) and fibroblasts at various densities were co-cultured in a rotating suspension culture system to establish co-culture parameters. Subsequently, UACC-893, BT.20, or MDA.MB.453 were co-cultured with fibroblasts for 9 days. Co-cultures resulted in the generation of breast cancer histoid (BCH) with cancer cells showing the invasion of fibroblast spheroids, which were visualized by immunohistochemical (IHC) staining of sections (4 µm thick) of BCH. A reproducible quantitative expression of C-erbB.2 was detected in UACC-893 cancer cells in BCH sections by IHC staining and the Automated Cellular Imaging System. BCH sections also consistently exhibited qualitative expression of pancytokeratins, p53, Ki-67, or E-cadherin in cancer cells and that of vimentin or GSTPi in fibroblasts, fibronectin in the basement membrane and collagen IV in the extracellular matrix. The expression of the protein analytes and cellular architecture of BCH were markedly similar to those of breast cancer tissue.
Existence of Manserin, a Secretogranin II–Derived Neuropeptide, in the Rat Inner Ear
Authors: Ida-Eto Michiru , Oyabu Akiko , Ohkawara Takeshi , Tashiro Yasura , Narita Naoko , Narita Masaaki
Published: November 2011

Manserin is a 40–amino acid neuropeptide derived from rat brain. Manserin has been shown to distribute in the neuroendocrine system, such as the pituitary and adrenal glands, but it has been little studied in other organs. In this study, the authors examined localization of manserin in the inner ear of the adult Wistar rat using immunohistochemical analyses. Manserin immunoreactivity was detected in the neuronal terminals of the organ of Corti and type II spiral ganglion cells. In addition to being identified in the auditory system, manserin was detected at the synapses of the vestibular system, such as saccule, utricle, and semicircular canal. These results suggest that inner ear manserin may be involved in the function of peripheral auditory and vestibular systems.
Laboratory and Field Evaluation of Cement-Treated Reclaimed Asphalt Pavement Blends as Roadway Base Material
Authors: Nazarian Soheil , Yuan Deren , Hoyos Laureano , Puppala Anand
Published: November 2011

Reclaimed asphalt pavement (RAP) and granular base materials were collected throughout Texas to evaluate the properties of RAP and RAP blended with virgin or salvage aggregates for roadway base course application. Mixes containing RAP of 100 %, 75 %, and 50 % and treated with Portland cement of different dosages were utilized in a comprehensive laboratory testing program. The factors that affect the properties of cement-treated RAP mixes are identified and a mix design model based on typical RAP and granular base materials in Texas was proposed. The design model was verified by the data from the initial field trial on actual construction projects. The feasibility of using a modulus-based procedure for quality assurance/quality control during construction is discussed.
Diversity of Long Terminal Repeat Retrotransposon Genome Distribution in Natural Populations of the Wild Diploid WheatAegilops speltoides
Authors: Hosid Elena , Brodsky Leonid , Kalendar Ruslan , Raskina Olga , Belyayev Alexander
Published: November 2011

The environment can have a decisive influence on the structure of the genome, changing it in a certain direction. Therefore, the genomic distribution of environmentally sensitive transposable elements may vary measurably across a species area. In the present research, we aimed to detect and evaluate the level of LTR retrotransposon intraspecific variability in Aegilops speltoides (2n = 2x = 14), a wild cross-pollinated relative of cultivated wheat. The interretrotransposon amplified polymorphism (IRAP) protocol was applied to detect and evaluate the level of retrotransposon intraspecific variability in Ae. speltoides and closely related species. IRAP analysis revealed significant diversity in TE distribution. Various genotypes from the 13 explored populations significantly differ with respect to the patterns of the four explored LTR retrotransposons (WIS2, Wilma, Daniela, and Fatima). This diversity points to a constant ongoing process of LTR retrotransposon fraction restructuring in populations of Ae. speltoides throughout the species’ range and within single populations in time. Maximum changes were recorded in genotypes from small stressed populations. Principal component analysis showed that the dynamics of the Fatima element significantly differ from those of WIS2, Wilma, and Daniela. In terms of relationships between Sitopsis species, IRAP analysis revealed a grouping with Ae. sharonensis and Ae. longissima forming a separate unit, Ae. speltoides appearing as a dispersed group, and Ae. bicornis being in an intermediate position. IRAP display data revealed dynamic changes in LTR retrotransposon fractions in the genome of Ae. speltoides. The process is permanent and population specific, ultimately leading to the separation of small stressed populations from the main group.
Estimation of Quantitative Trait Locus Effects with Epistasis by Variational Bayes Algorithms
Authors: Li Zitong , Sillanpää Mikko J
Published: November 2011

Bayesian hierarchical shrinkage methods have been widely used for quantitative trait locus mapping. From the computational perspective, the application of the Markov chain Monte Carlo (MCMC) method is not optimal for high-dimensional problems such as the ones arising in epistatic analysis. Maximum a posteriori (MAP) estimation can be a faster alternative, but it usually produces only point estimates without providing any measures of uncertainty (i.e., interval estimates). The variational Bayes method, stemming from the mean field theory in theoretical physics, is regarded as a compromise between MAP and MCMC estimation, which can be efficiently computed and produces the uncertainty measures of the estimates. Furthermore, variational Bayes methods can be regarded as the extension of traditional expectation-maximization (EM) algorithms and can be applied to a broader class of Bayesian models. Thus, the use of variational Bayes algorithms based on three hierarchical shrinkage models including Bayesian adaptive shrinkage, Bayesian LASSO, and extended Bayesian LASSO is proposed here. These methods performed generally well and were found to be highly competitive with their MCMC counterparts in our example analyses. The use of posterior credible intervals and permutation tests are considered for decision making between quantitative trait loci (QTL) and non-QTL. The performance of the presented models is also compared with R/qtlbim and R/BhGLM packages, using a previously studied simulated public epistatic data set.
Oxygen and Oxidative Stress in the Neonatal Period
Authors: Escobar Javier , Cernada María , Vento Máximo
Published: November 2011

Aerobic metabolism in the mitochondria is highly efficient in providing energy for the living organisms. However, as byproducts, reactive oxygen species (ROS) are produced. Some of these chemical species are highly reactive-free radicals capable of causing functional and structural damage to cell components. To overcome free radical attack, cells have evolved both antioxidant defense and repairing systems. However, under certain circumstances the production of oxygen-free radicals overcomes antioxidant defense causing oxidative stress (OS) and damage. Newborn infants and especially preterm infants are endowed with an immature antioxidant defense and respiratory system and are therefore prone to OS. Too much oxygen may damage different organs (lung, brain, retina, and gastrointestinal tract), leading to severe acute and chronic conditions that will affect not only the survival but also the quality of life of these infants. Advances in our knowledge of oxygen metabolism, pathophysiology of oxygen-derived damage, and development of more efficient monitoring devices have drastically changed the scenario. We have learned that postnatal adaptation constitutes a slow adaptive process that needs more time than previously believed and that should be approached gently. Moreover, strict control of oxygen saturation as measured by pulse oximetry, while oxygen supplementation is needed, is also a relevant intervention contributing to reduce oxygen-derived deleterious consequences. Notwithstanding, the establishment of safe limits avoiding oxygen toxicity but not increasing the risk of mortality needs further studies. In this regard, the inclusion of new biomarkers may help clinicians to make better therapeutic decisions in the near future.
Pulmonary Care and Adjunctive Therapies for Prevention and Amelioration of Bronchopulmonary Dysplasia
Authors: Pfister Robert H. , Soll Roger F.
Published: November 2011

Shortly after the introduction of assisted ventilation in the newborn, bronchopulmonary dysplasia (BPD) was first described. Northway and coworkers described a group of preterm infants who developed chronic respiratory failure and characteristic radiographic changes after prolonged mechanical ventilation. The prevention and management of BPD in infants at risk is challenging due to the complex pathogenesis of multiple contributing factors that include prematurity, supplemental oxygen exposure, mechanical ventilation, patent ductus arterious, inflammation, genetic predisposition and postnatal infection. Treatment of existing BPD requires a coordinated approach including optimal nutrition, careful fluid management, evidence-based drug therapy, and gentle respiratory techniques aimed at minimizing lung injury. The best respiratory support strategy remains unclear and requires further investigation but includes avoidance of ventilator-induced lung injury (barotraumas and volutrauma), hyperoxemia, and hypocapnea. Among the available interventions antenatal steroids, caffeine, and surfactant have the best risk-benefit profile. Systemic postnatal corticosteroids should be used only in ventilated infants unable to be weaned from the ventilator. Quality improvement techniques may have a role towards improvement of hospital systems geared toward reduction of BPD.
Treating Teens: Considerations When Adolescents Want to Use Complementary and Alternative Medicine
Authors: Gilmour Joan , Harrison Christine , Asadi Leyla , Cohen Michael H. , Vohra Sunita
Published: November 2011

In this article we examine decision-making about complementary and alternative medicine use when the patient is an adolescent. A case scenario describes patient-parent conflict when a 14-year-old boy who was diagnosed with ulcerative colitis that has continued to progress even with medication refuses recommended surgery despite his physician's and parents' support for that option; he prefers homeopathy instead. We address (1) who has decision-making authority about treatment for young people, (2) how to determine if a young person can consent to or refuse treatment, (3) special considerations when counseling and treating adolescents (whether they can decide about treatment for themselves), and (4) parent-child conflicts about treatment. In addition, we suggest ways that health care providers can foster a trusting relationship with patients and parents.
Informed Consent: Advising Patients and Parents About Complementary and Alternative Medicine Therapies
Authors: Gilmour Joan , Harrison Christine , Asadi Leyla , Cohen Michael H. , Vohra Sunita
Published: November 2011

Although research on complementary and alternative medicine (CAM) therapies is still limited, systematic reviews have revealed sufficient evidence to conclude that CAM can be effective for certain conditions. In this article we discuss clinicians' responsibilities to inform parents/patients about CAM alternatives and use the example of acupuncture for chemotherapy-induced nausea and vomiting. Chemotherapy-induced nausea and vomiting remain significant adverse effects of cancer therapy, and some patients cannot find relief with standard therapies. When making decisions for a child with a life-threatening illness, parents must consider all reasonable options and decide what is in the child's best interests. A physician's failure to provide parents with relevant information regarding therapies with the prospect of therapeutic benefit impedes their ability to make an informed decision. Physicians have the ethical duty of beneficence; they must be aware of current research in pain and symptom management and other aspects of care. A physician's duty of care does not necessarily include the obligation to provide information about therapies outside the range of conventional treatment or those not yet supported in the medical literature. However, as CAM therapies such as acupuncture become better studied and their safety and efficacy are established, the scope of disclosure required may expand to include them. The legal and ethical obligation to obtain informed consent to treatment requires disclosure and discussion of therapies when there is reliable evidence of potential therapeutic benefit. At the same time, the more limited state of knowledge regarding effects of a particular therapy in the pediatric population must be factored into decision-making when treating a child.
Hospitals and Complementary and Alternative Medicine: Managing Responsibilities, Risk, and Potential Liability
Authors: Gilmour Joan , Harrison Christine , Asadi Leyla , Cohen Michael H. , Vohra Sunita
Published: November 2011

Patients and families increasingly press hospitals to facilitate provision of complementary and alternative medicine (CAM) therapies and products. At the same time, a growing number of hospitals and health care facilities have taken steps to integrate CAM and conventional care. In this article we consider institutional responsibilities when patients/parents use or are considering CAM. We (1) review hospitals' responsibilities to patients and parents, (2) explain how these principles apply in the case of CAM practitioners and products, (3) address institutional responsibilities for different models of service delivery, and (4) highlight issues that should be addressed when developing institutional policies to govern CAM use and propose ways to do so.
Providing a Primary Care Medical Home for Children and Youth With Cerebral Palsy
Authors: Liptak Gregory S. , Murphy Nancy A. ,   the Council on Children With Disabilities
Published: November 2011

This Clinical Report was reaffirmed November 2014 and August 2018.

All primary care providers will care for children with cerebral palsy in their practice. In addition to well-child and acute illness care, the role of the medical home in the management of these children includes diagnosis, planning for interventions, authorizing treatments, and follow-up. Optimizing health and well-being for children with cerebral palsy and their families entails family-centered care provided in the medical home; comanagement is the most common model. This report reviews the aspects of care specific to cerebral palsy that a medical home should provide beyond the routine health care needed by all children.
Acromegalic cardiomyopathy
Authors: Bencze Ágnes , Rácz Károly
Published: November 2011

Acromegaly is an endocrine disease with specific somatic changes due to an excess of growth hormone. The majority of cases are caused by growth hormone producing pituitary tumors. Cardiovascular complications, which can be detected even in the early stages of the disease, are considered as major contributing factors in the increased morbidity and mortality of the patients. In this review authors briefly summarize clinical characteristics of acromegalic cardiomyopathy. Orv. Hetil., 2011, 152, 1875–1878.
Microsatellite Diversity in Natural Populations of Ascomycetous Fungus, Emericella Nidulans, from Different Climatic-Edaphic Conditions in Israel
Authors: Hosid Elena , Yusim Eugenia , Grishkan Isabella , Frenkel Zakharia M. , Wasser Solomon P. , Nevo Eviatar , Korol Abraham
Published: October 2011

The genetic divergence of Israeli populations of the soil ascomycetous fungusEmericella nidulanswas studied on regional and local scales using fifteen microsatellite (SSR) markers. The study was performed in the framework of the "Evolution Canyon" research program at the Institute of Evolution, University of Haifa, in three "Evolution Canyons" (ECs): EC I (Mt. Carmel), EC II (western Upper Galilee), and EC III (the southern Negev desert). The first two canyons (EC I and EC II) are located in the northern part of Israel at a distance of 38 km apart; EC III is located southward at a distance of nearly 350 km from the northern ECs. In each canyon,E. nidulansstrains were isolated from opposite slopes and, in EC III, from the valley bottom. All three EC populations ofE. nidulanswere found to be genetically distinct. The estimated genetic divergences correspond to geographical distances and ecological differences between the three studied canyons. On a regional scale, simple sequence repeat (SSR) polymorphism tends to increase with severity of ecological conditions. In general, both environmental parameters (soil moisture and temperature) and genetic factors (predicted number of repeats in SSR markers, distance from marker to centromere, codon evolutionary chronologies, and hydrophobic vs. hydrophilic character of encoded amino acid) influenced genetic diversity ofE. nidulanspopulations.
Apical Thickening of Epicarp is Responsible for Embryo Protection in Acorns of Quercus Variabilis
Authors: Yi Xianfeng , Yang Yueqin
Published: October 2011

The present study explored the evolutionary role of epicarp thickness ofQ. variabilisacorns as a defensive mechanism against weevil infestation. Our results, based on two years' study, suggested that length and fresh mass of insect-damaged acorns were not different from those of intact ones, but width did differ. About 2, 18, and 79% of oviposition sites are distributed at the apical end, middle part, and basal end of acorns, respectively. About 5, 49, and 55% of eggs or larvae are infested at the apical end, middle part, and basal end, respectively. Similarly, about 10, 43, and 45% of emergence holes are found at the apical end, middle part, and basal end. Epicarp thickness varied among the three parts of acorns and was significantly negatively correlated with the appearance percentage of oviposition sites, infestation sites, and emergence sites, respectively. However, secondary metabolites and nutrition reserve showed no close correlation with the appearance percentage of oviposition sites, infestation sites, and emergence sites. Acorns with emergence holes at the apical end exhibited significantly lower seedling emergence and survival rates. Therefore, variation in epicarp thickness in individual acorns may be responsible for the weevil's preference for oviposition, infestation, and emergence, and acts as an alternative and important strategy protecting acorn embryos from pre-dispersal larval damage.
Effects of Fire History Upon Soil Macroarthropod Communities in Pinus Halepensis Stands in Attica, Greece
Authors: Radea Canella , Kazanis Dimitris , Arianoutsou Margarita
Published: October 2011

The composition of the soil macroarthropod community was studied in three forest stands which constitute a gradient of increased fire frequency. All stands were adjacent to each other, on the foothills of Mt. Penteli, Attica, Greece, and they shared similar physiography, climate, altitude, while their original pre-fire vegetation was a well-developedPinus halepensisforest. The stands were severely burned by a large fire early in summer 1995. Two of them had been burned previously: the first in 1978 and the second in 1978 and 1987. Sampling was carried out during the 2nd year after the last fire event. Although the phenology of soil macroarthropods was not altered in frequently burned stands, the number of taxa collected, as well as their population size, was extremely low. Canonical Correspondence Analysis showed that fire frequency does not directly affect soil arthropod communities, but influences them through increased abundance of specific plant groups, i.e., phrygana vegetation and legumes. Seasonality of climate seemed to be another significant factor controlling the structure of macroarthropod communities in the stands studied.
The Influence of Aromatic Plants on Microbial Biomass and Respiration in a Natural Ecosystem
Authors: Hassiotis Christos N. , Dina Evanthia I.
Published: October 2011

The influence of three aromatic plant species, laurel (Laurus nobilisL.), myrtle (Myrtus communisL.), and French lavender (Lavandula stoechasL.), on top soil microbial biomass, respiration rates, and bacterial colonies was investigated. Fresh, mature plant material was introduced into a typical Mediterranean habitat in Northern Greece. The essential oil chemical compositions from the aromatics used in the study were evaluated by GC-MS analysis. The major compounds constitutingL. nobilisessential oil were 1,8-cineole (48.1%), eugenol (12.3%), and α-pinene (6.0%);M. communisoil consisted of α-pinene (31.2%), myrtenyl acetate (19.3%), and 1,8-cineole (16.1%); andL. stoechasconsisted of fenchone (46.7%), camphor (9.9%), and 1,8-cineole (9.0%).L. nobilispresented the highest inhibition against bacterial colonies (44.9%) and lowered soil respiration and microbial biomass when compared to control soils. In contrast,M. comunnisandL. stoechaswere found to augment bacterial activity by 85.9% and 63.8%, respectively, and to increase soil respiration (1.5-fold) and microbial biomass (2.5-fold) compared to control soil samples. These two plants are proposed for further investigations in biodegradation programs.