bluuebunny/crossref_metadata_2025 huggingface dataset:
Motor function after selective dorsal rhizotomy: a 10‐year practice‐based follow‐up study
Authors: JOSENBY ANNIKA LUNDKVIST , WAGNER PHILIPPE , JARNLO GUN‐BRITT , WESTBOM LENA , NORDMARK EVA
Published: March 2012

Aim  The aim of this study was to explore changes in motor function up to 10 years after selective dorsal rhizotomy (SDR).

Method  The participants comprised 29 children (20 males, nine females) with bilateral spastic diplegia who were consecutively operated on at a median age of 4 years and 3 months and followed until a median age of 15 years. SDR was combined with physiotherapy and regular follow‐up visits. The distribution of preoperative Gross Motor Function Classification System (GMFCS) levels was as follows: I, n=1; II, n=7; III, n=8; IV, n=12; and V, n=1. Muscle tone in hip flexors, hip adductors, knee flexors, and plantar flexors was assessed with the modified Ashworth scale, passive range of motion in hip abduction, popliteal angle, maximum knee extension, dorsiflexion of the foot was measured with a goniometer, and gross motor function was assessed using the Gross Motor Function Measure (GMFM‐66). The results were compared with preoperative values, taking into account age at the time of SDR.

Results  After 10 years, muscle tone in hip flexors, hip adductors, knee flexors and plantar flexors was normalized in 19, 24, 13 and 23 participants respectively; mean change in passive range of motion ranged from −2.0° to 8.6°, and the mean increase in GMFM‐66 was 10.6. Changes in GMFM‐66 were associated with preoperative GMFCS level and GMFM‐66 scores.

Interpretation  Children who underwent SDR and physiotherapy and were regularly followed up by an experienced team showed improved gross motor function for up to 10 years postoperatively.
Phosphoproteome profiling of substantia nigra and cortex regions of Alzheimer’s disease patients
Authors: Zahid Saadia , Oellerich Michael , Asif Abdul R , Ahmed Nikhat
Published: March 2012

J. Neurochem. (2012) 121, 954–963.

Alzheimer’s disease (AD) is the most common form of dementia and cognitive impairment usually characterized by widespread neurodegeneration throughout the association cortex, limbic system and hippocampus. Aberrant protein phosphorylation is a defining pathological hallmark of AD and implicated in the dysregulation of major cellular processes through highly dynamic and complex signaling pathways. Here in, we demonstrate 81 proteins, of 600 spots selected, unambiguously identified as phosphorylated, providing a partial phosphoproteome profile of AD substantia nigra and cortex and respective control brain regions. More importantly, abnormal phosphorylation signal intensity of nine physiologically important proteins observed can profoundly affect cell metabolism, signal transduction, cytoskeleton integration, and synaptic function and accounts for biological and morphological alterations. Our studies employed two‐dimensional gel electrophoresis for protein separation, Pro‐Q® Diamond phosphoprotein staining and electrospray ionization quadrupole time of flight tandem MS for protein identification. NetPhosk 1.0 is used for the confirmation of protein modification status as well known/putative phosphoproteins. A further insight into the links among the identified phosphoproteins and functional roles STRING 8.3, KEGG and REACTOME pathway databases were applied. The present quantitative phosphoproteomic analysis can be supportive in establishing a broad database of potential protein targets of abnormal phosphorylation in AD brain.
Combined therapy with PJ34, a poly(ADP‐ribose)polymerase inhibitor, reduces tissue plasminogen activator‐induced hemorrhagic transformations in cerebral ischemia in mice
Authors: Haddad Marianne , Beray‐Berthat Virginie , Coqueran Bérard , Plotkine Michel , Marchand‐Leroux Catherine , Margaill Isabelle
Published: March 2012

Recombinant tissue‐type plasminogen activator (rt‐PA) is presently the only pharmacological treatment approved for thrombolysis in patients suffering from ischemic stroke. Although reperfusion of ischemic tissue is essential, the use of rt‐PA is limited due to its narrow therapeutic window and risk of hemorrhagic transformations. Recent studies have shown that rt‐PA amplifies the post‐ischemic activation of the nuclear enzyme poly(ADP‐ribose)polymerase (PARP). This enzyme has been shown to contribute to both the breakdown of the blood brain barrier and spontaneous hemorrhagic transformations after ischemia. We therefore examined the capacity of PJ34 (N‐(6‐oxo‐5,6‐dihydrophenanthridin‐2‐yl)‐2‐(N,N‐dimethylamino) acetamide hydrochloride), a potent inhibitor of PARP, to reduce the hemorrhagic transformations that occur after rt‐PA in mice with permanent focal cerebral ischemia. Ischemia was produced by intraluminal occlusion of the left middle cerebral artery and treated with vehicle, rt‐PA (10 mg/kg, i.v., 6 h after occlusion) or rt‐PA plus PJ34 (3, 6 or 12 mg/kg, i.p., at ischemia onset and 4 h later). Hemorrhagic transformations, neurological examination, and infarct volumes were evaluated 48 h after the onset of ischemia. Delayed administration of rt‐PA resulted in increased hemorrhagic transformations and aggravated the neurological deficit. Giving PJ34 (3 mg/kg) markedly reduced the hemorrhagic transformations, an effect not owing to a modification of matrix metalloprotease activity. Furthermore, PJ34 improved the neurological functions of rt‐PA‐treated ischemic mice. To conclude, the PARP inhibitor PJ34 makes rt‐PA safer in experimental ischemic stroke.
Contrast‐Enhanced 3D FIESTA Imaging in Tolosa‐Hunt Syndrome
Authors: Okawa Satoshi , Hanazono Akira , Sugawara Masashiro , Takahashi Satoshi , Otani Takahiro , Hanyu Noriaki , Suzuki Akira , Mizoi Kazuo , Ohnishi Hirohide
Published: March 2012

(Headache 2012;52:822‐824)
Ethics in Electrophysiology: Who Speaks for this Man?
Authors: BEAUREGARD LOU‐ANNE M.
Published: March 2012

In this case, a patient who is incapable of participating in health‐care decisions requires a pacemaker generator replacement. Because the pacemaker may no longer be necessary, the issues of surrogacy and surrogate decision‐making are considered. Where there are no involved family members, each state has procedures for finding an appropriate ombudsman for the patient who can assist in healthcare choices. (PACE 2012;XX:1–3)
On the Spatial Foundations of the Conceptual System and Its Enrichment
Authors: Mandler Jean M.
Published: March 2012

A theory of how concept formation begins is presented that accounts for conceptual activity in the first year of life, shows how increasing conceptual complexity comes about, and predicts the order in which new types of information accrue to the conceptual system. In a compromise between nativist and empiricist views, it offers a single domain‐general mechanism that redescribes attended spatiotemporal information into an iconic form. The outputs of this mechanism consist of types of spatial information that we know infants attend to in the first months of life. These primitives form the initial basis of concept formation, allow explicit preverbal thought, such as recall, inferences, and simple mental problem solving, and support early language learning. The theory details how spatial concepts become associated with bodily feelings of force and trying. It also explains why concepts of emotions, sensory concepts such as color, and theory of mind concepts are necessarily later acquisitions because they lack contact with spatial descriptions to interpret unstructured internal experiences. Finally, commonalities between the concepts of preverbal infants and nonhuman primates are discussed.
Interaction between NO and COX pathways modulating hepatic endothelial cells from control and cirrhotic rats
Authors: Rosado Eugenio , Rodríguez‐Vilarrupla Aina , Gracia‐Sancho Jorge , Monclús Montserrat , Bosch Jaume , García‐Pagán Joan‐Carles
Published: March 2012

Reduced intrahepatic nitric oxide (NO) bioavailability and increased cyclooxygenase‐1 (COX‐1)‐derived vasoconstrictor prostanoids modulate the hepatic vascular tone in cirrhosis. We aimed at investigating the reciprocal interactions between NO and COX in the hepatic endothelium of control and cirrhotic rats. NO bioavailability (DAF‐FM‐DA staining), superoxide (O2−) content (DHE staining), prostanoid production (PGI2 and TXA2 by enzyme immunoassays) as well as COX expression (Western Blot), were determined in hepatic endothelial cells (HEC) from control and cirrhotic rats submitted to different experimental conditions: COX activation, COX inhibition, NO activation and NO inhibition. In control and cirrhotic HEC, COX activation with arachidonic acid reduced NO bioavailability and increased O2− levels. These effects were abolished by pre‐treating HEC with the COX inhibitor indomethacin. In control, but not in cirrhotic HEC, scavenging of O2− by superoxide dismutase (SOD) incubation partially restored the decrease in NO bioavailability promoted by COX activation. NO supplementation produced a significant and parallel reduction in PGI2 and TXA2 production in control HEC, whereas it only reduced TXA2 production in cirrhotic HEC. By contrast, in control and cirrhotic HEC, NO inhibition did not modify COX expression or activity. Our results demonstrate that NO and COX systems are closely interrelated in HEC. This is especially relevant in cirrhotic HEC where COX inhibition increases NO bioavailability and NO supplementation induces a reduction in TXA2. These strategies may have beneficial effects ameliorating the vasoconstrictor/vasodilator imbalance of the intrahepatic circulation of cirrhotic livers.
Mesenchymal stem cells conditioned with glucose depletion augments their ability to repair‐infarcted myocardium
Authors: Choudhery Mahmood S. , Khan Mohsin , Mahmood Ruhma , Mohsin Sadia , Akhtar Shoaib , Ali Fatima , Khan Shaheen N. , Riazuddin Sheikh
Published: March 2012

Mesenchymal stem cells (MSCs) are an attractive candidate for autologous cell therapy, but their ability to repair damaged myocardium is severely compromised with advanced age. Development of viable autologous cell therapy for treatment of heart failure in the elderly requires the need to address MSC ageing. In this study, MSCs from young (2 months) and aged (24 months) C57BL/6 mice were characterized for gene expression of IGF‐1, FGF‐2, VEGF, SIRT‐1, AKT, p16INK4a, p21 and p53 along with measurements of population doubling (PD), superoxide dismutase (SOD) activity and apoptosis. Aged MSCs displayed senescent features compared with cells isolated from young animals and therefore were pre‐conditioned with glucose depletion to enhance age affected function. Pre‐conditioning of aged MSCs led to an increase in expression of IGF‐1, AKT and SIRT‐1 concomitant with enhanced viability, proliferation and delayed senescence. To determine the myocardial repair capability of pre‐conditioned aged MSCs, myocardial infarction (MI) was induced in 24 months old C57BL/6 wild type mice and GFP expressing untreated and pre‐conditioned aged MSCs were transplanted. Hearts transplanted with pre‐conditioned aged MSCs showed increased expression of paracrine factors, such as IGF‐1, FGF‐2, VEGF and SDF‐1α. This was associated with significantly improved cardiac performance as measured by dp/dtmax, dp/dtmin, LVEDP and LVDP, declined left ventricle (LV) fibrosis and apoptosis as measured by Masson's Trichrome and TUNEL assays, respectively, after 30 days of transplantation. In conclusion, pre‐conditioning of aged MSCs with glucose depletion can enhance proliferation, delay senescence and restore the ability of aged cells to repair senescent infarcted myocardium.
Determinants and costs of natal dispersal in a lekking species
Authors: Hardouin Loïc A. , Nevoux Marie , Robert Alexandre , Gimenez Olivier , Lacroix Frederic , Hingrat Yves
Published: March 2012

Avoidance of competition and inbreeding have been invoked as the major ultimate causes of natal dispersal, but proximate factors such as sex, body condition or birth date can also be important. Natal dispersal is expected to be of particular importance to understanding the ecological and evolutionary implications of dispersal strategies, since 1) numerous evidences suggest that individual differences in dispersal strategies are expressed early in life (i.e. at the onset of dispersal movement), 2) ultimate and proximate factors are more likely to act during this stage and 3) this stage is associated with the highest mortality rates in most vertebrates. We analysed the natal dispersal (hereafter, dispersal) behaviour in 100 marked individuals of a lekking species, the North African houbara bustardsChlamydotis undulata undulata, during four years. We investigated the effects of proximate factors on dispersal pattern and distance, as well as the mortality cost associated with movement using multievent models, allowing uncertainty in sex assignment and mixture of live recaptures and dead recoveries. Overall, males exhibited longer dispersal distances than females, contrary to the common pattern in birds. Moreover, males in poorer body condition moved further than those in better condition, whereas distance was independent of body condition in females. Finally, survival rates during dispersal were lower for females than for males and were negatively correlated with the distances covered with a similar distance‐survival slope in the two sexes. Collectively, our results suggest that 1) there is substantial dispersal cost in both sexes, 2) dispersal is strongly male‐biased, 3) this bias is unlikely to be explained by differential movement costs of each sex, and 4) dispersal differences found across different categories of individuals are in broad agreement with both the inbreeding avoidance and intraspecific competition mechanisms for dispersal.
Adaptive strategies for managing uncertainty may explain personality‐related differences in behavioural plasticity
Authors: Mathot Kimberley J. , Wright J. , Kempenaers B. , Dingemanse N. J.
Published: March 2012

There is growing evidence that individuals within populations show consistent differences in their behaviour across contexts (personality), and that personality is associated with the extent to which individuals adjust their behaviour as function of changing conditions (behavioural plasticity). We propose an evolutionary explanation for a link between personality and plasticity based upon how individuals manage uncertainty. Individuals can employ three categories of tactics to manage uncertainty. They can 1) gather information (sample) to reduce uncertainty, 2) show strategic (state‐dependent) preferences for options that differ in their associated variances in rewards (i.e. variance‐sensitivity), or 3) invest in insurance to mitigate the consequences of uncertainty. We explicitly outline how individual differences in the use of any of these tactics can generate personality‐related differences in behavioural plasticity. For example, sampling effort is likely to co‐vary with individual activity and exploration behaviours, while simultaneously creating population variation in reactions to changes in environmental conditions. Individual differences in the use of insurance may be associated with differences in risk‐taking behaviours, such as boldness in the face of predation, thereby influencing the degree of adaptive plasticity across individuals. Population variation in responsiveness to environmental changes may also reflect individual differences in variance‐sensitivity, because stochastic change in the environment increases variances in rewards, which may both attract and benefit variance‐prone individuals, but not variance‐averse individuals. We review the existing evidence that individual variation in strategies for managing uncertainty exist, and describe how positive‐feedbacks between sampling, variance‐sensitivity and insurance can maintain and exaggerate even small initial differences between individuals in the relative use of these tactics. Given the pervasiveness of the problem of uncertainty, alternative strategies for managing uncertainty may provide a powerful explanation for consistent differences in behaviour and behavioural plasticity for a wide range of traits.
Transient Complex Interactions of Mammalian Peroxisomes Without Exchange of Matrix or Membrane Marker Proteins
Authors: Bonekamp Nina A. , Sampaio Paula , de Abreu Fernão Vistulo , Lüers Georg H. , Schrader Michael
Published: March 2012

Peroxisomes and mitochondria show a much closer interrelationship than previously anticipated. They co‐operate in the metabolism of fatty acids and reactive oxygen species, but also share components of their fission machinery. If peroxisomes – like mitochondria – also fuse in mammalian cells is a matter of debate and was not yet systematically investigated. To examine potential peroxisomal fusion and interactions in mammalian cells, we established an in vivo fusion assay based on hybridoma formation by cell fusion. Fluorescence microscopy in time course experiments revealed a merge of different peroxisomal markers in fused cells. However, live cell imaging revealed that peroxisomes were engaged in transient and long‐term contacts, without exchanging matrix or membrane markers. Computational analysis showed that transient peroxisomal interactions are complex and can potentially contribute to the homogenization of the peroxisomal compartment. However, peroxisomal interactions do not increase after fatty acid or H2O2 treatment. Additionally, we provide the first evidence that mitochondrial fusion proteins do not localize to peroxisomes. We conclude that mammalian peroxisomes do not fuse with each other in a mechanism similar to mitochondrial fusion. However, they show an extensive degree of interaction, the implication of which is discussed.
Reduction of BDNF expression in Fmr1 knockout mice worsens cognitive deficits but improves hyperactivity and sensorimotor deficits
Authors: Uutela M. , Lindholm J. , Louhivuori V. , Wei H. , Louhivuori L. M. , Pertovaara A. , Åkerman K. , Castrén E. , Castrén M. L.
Published: March 2012

Fragile X syndrome (FXS) is a common cause of inherited intellectual disability and a well‐characterized form of autism spectrum disorder. As brain‐derived neurotrophic factor (BDNF) is implicated in the pathophysiology of FXS we examined the effects of reduced BDNF expression on the behavioral phenotype of an animal model of FXS, Fmr1 knockout (KO) mice, crossed with mice carrying a deletion of one copy of the Bdnf gene (Bdnf+/−). Fmr1 KO mice showed age‐dependent alterations in hippocampal BDNF expression that declined after the age of 4 months compared to wild‐type controls. Mild deficits in water maze learning in Bdnf+/− and Fmr1 KO mice were exaggerated and contextual fear learning significantly impaired in double transgenics. Reduced BDNF expression did not alter basal nociceptive responses or central hypersensitivity in Fmr1 KO mice. Paradoxically, the locomotor hyperactivity and deficits in sensorimotor learning and startle responses characteristic of Fmr1 KO mice were ameliorated by reducing BNDF, suggesting changes in simultaneously and in parallel working hippocampus‐dependent and striatum‐dependent systems. Furthermore, the obesity normally seen in Bdnf+/− mice was eliminated by the absence of fragile X mental retardation protein 1 (FMRP). Reduced BDNF decreased the survival of newborn cells in the ventral part of the hippocampus both in the presence and absence of FMRP. Since a short neurite phenotype characteristic of newborn cells lacking FMRP was not found in cells derived from double mutant mice, changes in neuronal maturation likely contributed to the behavioral phenotype. Our results show that the absence of FMRP modifies the diverse effects of BDNF on the FXS phenotype.
Son Preference, Sex Selection, and Kinship in Vietnam
Authors: Guilmoto Christophe Z.
Published: March 2012

This article examines the recent rise in the sex ratio at birth in Vietnam and relates its emergence to kinship systems and ethnic composition using 2009 census micro‐data. Presentation of the main socioeconomic and ethnic differentials in birth masculinity is followed by a review of the three intermediate factors leading to increases in the sex ratio at birth: prenatal technology, declining fertility, and gender bias. An indirect measurement of fertility behavior is used to demonstrate the close association between levels of the sex ratio at birth and the intensity of son preference. Data on household composition indicate that Vietnam is characterized by the co‐existence of kinship patterns typical of East and Southeast Asia. Son preference in Vietnam is found to be related to the prevalence of more traditional patrilineal systems. The article concludes by considering the implications of the cultural dimensions of prenatal sex selection for policy responses and for the likely future change in the sex ratio at birth.
A non‐lethal approach to estimate whole‐body 13C and 15N stable isotope ratios of freshwater amphipods using walking legs
Authors: Wilhelm Frank M. , Nelson Daniel
Published: March 2012

To analyze the stable isotope ratios of small‐bodied invertebrates, the entire animal is typically sacrificed and processed, which is problematic for threatened or endangered species. Appendages which are regenerated could be used to infer whole‐body isotope ratios, but differences in turnover rates and isotopic signatures among tissues may confound such an approach. We tested the hypothesis that the δ13C and δ15N of whole‐body tissue for freshwater amphipods could be predicted from the δ13C and δ15N of walking legs, with the goal of estimating body δ13C and δ15N of Gammarus acherondytes, a United States federally endangered species. To test this, we analyzed the δ13C and δ15N of walking legs and bodies of five species of amphipods from geographically distant areas (Idaho, Illinois, and Washington) in the United States. The general relationships of whole‐body isotope ratios of C and N as a function of leg isotope ratios were linear and had slopes of one. In the range of the data, leg δ13C was slightly lower than body δ13C, indicating some tissue‐specific fractionation, while δ15N was similar for legs and bodies. Our data suggest that legs can be used to predict body isotope ratios in freshwater amphipods. This approach provides an additional tool to help researchers understand the biology of small, endangered invertebrates without sacrificing individuals. This is especially useful in cave ecosystems where populations are naturally sparse.
Extra‐oesophageal reflux: state of the knowledge base
Authors: Ah‐See K. , Wilson J.
Published: March 2012

Clin. Otolaryngol. 2012, 37, 9–16
Professional policy work in federal states: Institutional autonomy andCanadian policy analysis
Authors: Howlett Michael , Wellstead Adam M.
Published: March 2012

Despite all the attention paid to the topic of policy analysis, the actual work of policy analysts in government is little investigated and little known (Colebatch,,;Colebatch andRadin). This is true not only at the national level, which has been the subject of most existing studies, but especially at the sub‐national level, where substantial powers rest. In order to address this gap, this article presents evidence from the first, large‐scale set of surveys ofCanadian federal, provincial and territorial policy analysts, examining the similarities and differences in their policy work. While many similarities exist in areas related to overall governance trends, such as consultation and participation work overtaking more technical policy evaluations, there are significant differences in the nature of policy work and attitudes, which are linked to the lesser autonomy from political masters experienced by sub‐national analysts. The results suggest that sub‐national policy work must be studied carefully in its own right.
Septic osteitis of the axial border of the proximal sesamoid bones in two foals
Authors: Lawrence C. P. , Fraser B. S. L.
Published: March 2012

This case report describes the history, clinical findings, clinical pathology and diagnostic imaging of 2 cases of septic osteitis of the proximal sesamoid bones in foals. Treatment with doxycycline (10 mg/kg bwt per os b.i.d.) was successful in treating both of these cases.
Quality assurance for image‐guided radiation therapy utilizing CT‐based technologies: A report of the AAPM TG‐179
Authors: Bissonnette Jean‐Pierre , Balter Peter A. , Dong Lei , Langen Katja M. , Lovelock D. Michael , Miften Moyed , Moseley Douglas J. , Pouliot Jean , Sonke Jan‐Jakob , Yoo Sua
Published: March 2012

Purpose:

Commercial CT‐based image‐guided radiotherapy (IGRT) systems allow widespread management of geometric variations in patient setup and internal organ motion. This document provides consensus recommendations for quality assurance protocols that ensure patient safety and patient treatment fidelity for such systems.

Methods:

The AAPM TG‐179 reviews clinical implementation and quality assurance aspects for commercially available CT‐based IGRT, each with their unique capabilities and underlying physics. The systems described are kilovolt and megavolt cone‐beam CT, fan‐beam MVCT, and CT‐on‐rails. A summary of the literature describing current clinical usage is also provided.

Results:

This report proposes a generic quality assurance program for CT‐based IGRT systems in an effort to provide a vendor‐independent program for clinical users. Published data from long‐term, repeated quality control tests form the basis of the proposed test frequencies and tolerances.

Conclusion:

A program for quality control of CT‐based image‐guidance systems has been produced, with focus on geometry, image quality, image dose, system operation, and safety. Agreement and clarification with respect to reports from the AAPM TG‐101, TG‐104, TG‐142, and TG‐148 has been addressed.
Transforming the Untransformable: Application of Direct Transformation To Manipulate Genetically Staphylococcus aureus and Staphylococcus epidermidis
Authors: Monk Ian R. , Shah Ishita M. , Xu Min , Tan Man-Wah , Foster Timothy J.
Published: March 2012

The strong restriction barrier present in
Staphylococcus aureus
and
Staphylococcus epidermidis
has limited functional genomic analysis to a small subset of strains that are amenable to genetic manipulation. Recently, a conserved type IV restriction system termed SauUSI (which specifically recognizes cytosine methylated DNA) was identified as the major barrier to transformation with foreign DNA. Here we have independently corroborated these findings in a widely used laboratory strain of
S. aureus
. Additionally, we have constructed a DNA cytosine methyltransferase mutant in the high-efficiency
Escherichia coli
cloning strain DH10B (called DC10B). Plasmids isolated from DC10B can be directly transformed into clinical isolates of
S. aureus
and
S. epidermidis
. We also show that the loss of restriction (both type I and IV) in an
S. aureus
USA300 strain does not have an impact on virulence. Circumventing the SauUSI restriction barrier, combined with an improved deletion and transformation protocol, has allowed the genetic manipulation of previously untransformable strains of these important opportunistic pathogens.

IMPORTANCE
Staphylococcal infections place a huge burden on the health care sector due both to their severity and also to the economic impact of treating the infections because of prolonged hospitalization. To improve the understanding of
Staphylococcus aureus
and
Staphylococcus epidermidis
infections, we have developed a series of improved techniques that allow the genetic manipulation of strains that were previously refractory to transformation. These developments will speed up the process of mutant construction and increase our understanding of these species as a whole, rather than just a small subset of strains that could previously be manipulated.
Using quality improvement to accelerate highly active antiretroviral treatment coverage in South Africa
Authors: Webster Patty D , Sibanyoni Maria , Malekutu Dinah , Mate Kedar S , Venter W D Francois , Barker Pierre M , Moleko Winnie
Published: March 2012

Introduction

The authors report on a health systems strengthening intervention using quality improvement (QI) methods at the subdistrict level to accelerate highly active antiretroviral treatment (HAART) initiation in South Africa.

Methods

Using a phased scale-up design between August 2006 and November 2009, 14 primary healthcare clinics, one community health centre, one district hospital and one tertiary hospital in a subdistrict were recruited into a ‘learning network’ using QI methods to facilitate cross-facility learning/mentorship/support. Clinic teams consisting of nurses, counsellors, clerks and/or doctors set collective and individual performance targets, analysed their care systems using ‘real-time’ data feedback, and designed/implemented a set of simple changes to improve HIV testing and HAART initiation rates across the region.

Data analysis

Primary clinic data were used to measure HAART initiation rates (primary outcome) and HIV testing (secondary outcome). We analysed data variation/trends using an interrupted time series design. Logistic regression analysis was applied to examine trends in HAART initiation during the intervention phases.

Results

Clinics in the learning network increased HIV testing by 301.8% from 891/month (SD=94.2) to 3580/month (SD=327.7) (p<0.0001). Monthly HAART initiations increased by 185.5% from 179/month (SD=17.22) to 511/month (SD=44.93) (p<0.0001). During the pilot (phase I), the monthly rate of HAART initiations increased by 3.6 patients. In the prototype collaborative (phase II), there was no acceleration in the rate of increase (3.3/month, p=0.92). Significant acceleration was observed in the rate of increase during the QI scale up (phase III) (10.1/month, p<0.001). The proportion of estimated need for HAART met in the region increased from 35.8% to 72.4% at a time of rapid population growth.

Conclusion

A QI approach, using learning networks to teach simple data-driven methods for addressing system failures, with increased training and resource inputs, can assist districts to quickly reach universal coverage targets.
Management of distal radius fractures in emergency departments in England and Wales
Authors: Sprot Harry , Metcalfe Andrew , Odutola Adekoyejo , Palan Jeya , White Simon
Published: March 2012

Aims

To examine variations and consistencies in the emergency management of distal radial fractures across England and Wales.

Methods

A survey was conducted of emergency departments (ED) in England and Wales regarding the acute management of patients with distal radius fractures. The study investigated the use of anaesthesia, the person performing both the anaesthetic and the manipulation, the use of resuscitation facilities and monitoring, the cast applied, the follow-up and the management of complex injuries or those in younger patients.

Results

Surveys were conducted in 105 units, giving a response rate of 91% of ED in England and Wales. The most frequent anaesthetic types were haematoma block (50%), intravenous benzodiazepines (20%), Bier's block (17%) and a small minority using other techniques such as brachial plexus blocks (2%). Basic cardiorespiratory monitoring was variable, and 10% of trusts did not routinely monitor patients undergoing Bier's blocks or manipulation with sedatives. Only 50% of ED would manipulate comminuted fractures or fractures in young adult patients.

Conclusion

There are significant regional variations. The use of monitoring is highly variable and there are no consistent standards when administering potentially potent anaesthetic medications. The low percentage of units attempting reduction of complex fractures or fractures in young patients will disadvantage training in ED as well as patients. Guidelines are required to improve care, which is highly inconsistent at present.
Preparedness to care for victims of violence and their families in emergency departments
Authors: Linnarsson Josefin Rahmqvist , Benzein Eva , Årestedt Kristofer , Erlingsson Christen
Published: March 2012

Objective

To describe the preparedness to provide care for victims of violence and their families in emergency departments (EDs) in Sweden.

Methods

A web-based questionnaire was sent to all hospital EDs in Sweden (N=66).

Results

A total of 46 out of 66 (70%) heads of EDs completed the questionnaire. The results show that most of the EDs are prepared to care for women and children who are victims of violence. However, there seems to be a lack of preparedness to care for other groups of patients, such as victimised men. Very few EDs have routines to identify victims of violence among patients. Results also indicate that nurses play a key role in the care for victims of violence; however, family members are rarely included in care.

Conclusions

A lack of general preparedness in EDs to care for all victims of violence, regardless of gender and age, can lead to many patients not receiving appropriate care and treatment. To correct this there is a need to implement guidelines and routines about the care for victims of violence. Further research can shed more light on which measures are needed to improve quality of care for these patients and their families.
NAD+/NADH and skeletal muscle mitochondrial adaptations to exercise
Authors: White Amanda T. , Schenk Simon
Published: March 2012

The pyridine nucleotides, NAD+and NADH, are coenzymes that provide oxidoreductive power for the generation of ATP by mitochondria. In skeletal muscle, exercise perturbs the levels of NAD+, NADH, and consequently, the NAD+/NADH ratio, and initial research in this area focused on the contribution of redox control to ATP production. More recently, numerous signaling pathways that are sensitive to perturbations in NAD+(H) have come to the fore, as has an appreciation for the potential importance of compartmentation of NAD+(H) metabolism and its subsequent effects on various signaling pathways. These pathways, which include the sirtuin (SIRT) proteins SIRT1 and SIRT3, the poly(ADP-ribose) polymerase (PARP) proteins PARP1 and PARP2, and COOH-terminal binding protein (CtBP), are of particular interest because they potentially link changes in cellular redox state to both immediate, metabolic-related changes and transcriptional adaptations to exercise. In this review, we discuss what is known, and not known, about the contribution of NAD+(H) metabolism and these aforementioned proteins to mitochondrial adaptations to acute and chronic endurance exercise.
Timing-dependent modulation of the posterior parietal cortex–primary motor cortex pathway by sensorimotor training
Authors: Karabanov Anke , Jin Seung-Hyun , Joutsen Atte , Poston Brach , Aizen Joshua , Ellenstein Aviva , Hallett Mark
Published: March 2012

Interplay between posterior parietal cortex (PPC) and ipsilateral primary motor cortex (M1) is crucial during execution of movements. The purpose of the study was to determine whether functional PPC–M1 connectivity in humans can be modulated by sensorimotor training. Seventeen participants performed a sensorimotor training task that involved tapping the index finger in synchrony to a rhythmic sequence. To explore differences in training modality, one group ( n = 8) learned by visual and the other ( n = 9) by auditory stimuli. Transcranial magnetic stimulation (TMS) was used to assess PPC–M1 connectivity before and after training, whereas electroencephalography (EEG) was used to assess PPC–M1 connectivity during training. Facilitation from PPC to M1 was quantified using paired-pulse TMS at conditioning-test intervals of 2, 4, 6, and 8 ms by measuring motor-evoked potentials (MEPs). TMS was applied at baseline and at four time points (0, 30, 60, and 180 min) after training. For EEG, task-related power and coherence were calculated for early and late training phases. The conditioned MEP was facilitated at a 2-ms conditioning-test interval before training. However, facilitation was abolished immediately following training, but returned to baseline at subsequent time points. Regional EEG activity and interregional connectivity between PPC and M1 showed an initial increase during early training followed by a significant decrease in the late phases. The findings indicate that parietal–motor interactions are activated during early sensorimotor training when sensory information has to be integrated into a coherent movement plan. Once the sequence is encoded and movements become automatized, PPC–M1 connectivity returns to baseline.
Functional characterization of dI6 interneurons in the neonatal mouse spinal cord
Authors: Dyck Jason , Lanuza Guillermo M. , Gosgnach Simon
Published: March 2012

Our understanding of the neural control of locomotion has been greatly enhanced by the ability to identify and manipulate genetically defined populations of interneurons that comprise the locomotor central pattern generator (CPG). To date, the dI6 interneurons are one of the few populations that settle in the ventral region of the postnatal spinal cord that have not been investigated. In the present study, we utilized a novel transgenic mouse line to electrophysiologically characterize dI6 interneurons located close to the central canal and study their function during fictive locomotion. The majority of dI6 cells investigated were found to be rhythmically active during fictive locomotion and could be divided into two electrophysiologically distinct populations of interneurons. The first population fired rhythmic trains of action potentials that were loosely coupled to ventral root output and contained several intrinsic membrane properties of rhythm-generating neurons, raising the possibility that these cells may be involved in the generation of rhythmic activity in the locomotor CPG. The second population fired rhythmic trains of action potentials that were tightly coupled to ventral root output and lacked intrinsic oscillatory mechanisms, indicating that these neurons may be driven by a rhythm-generating network. Together these results indicate that dI6 neurons comprise an important component of the locomotor CPG that participate in multiple facets of motor behavior.
Reversal of Jaundice in Two Patients with Inoperable Cholangiocarcinoma Treated with Cisplatin and Gemcitabine Combination
Authors: Criel Maarten , Geurs Filip , Ponette Siegfried , Bulte Katrien , Ponette Johan
Published: March 2012

Two patients are presented with severe jaundice, due to inoperable cholangiocarcinoma. The chemotherapeutic approach in patients with severe jaundice is discussed. Many schedules of chemotherapy were developed in this tumor type with normal serum bilirubin. We report here the first successful use of cisplatin and gemcitabine combination chemotherapy in these patients. Tolerability was good and liver function tests gradually improved.
Coupling Schemes in Terahertz Planar Metamaterials
Authors: Roy Chowdhury Dibakar , Singh Ranjan , Taylor Antoinette J. , Chen Hou-Tong , Zhang Weili , Azad Abul K.
Published: March 2012

We present a review of the different coupling schemes in a planar array of terahertz metamaterials. The gap-to-gap near-field capacitive coupling between split-ring resonators in a unit cell leads to either blue shift or red shift of the fundamental inductive-capacitive (LC) resonance, depending on the position of the split gap. The inductive coupling is enhanced by decreasing the inter resonator distance resulting in strong blue shifts of theLCresonance. We observe theLCresonance tuning only when the split-ring resonators are in close proximity of each other; otherwise, they appear to be uncoupled. Conversely, the higher-order resonances are sensitive to the smallest change in the inter particle distance or split-ring resonator orientation and undergo tremendous resonance line reshaping giving rise to a sharp subradiant resonance mode which produces hot spots useful for sensing applications. Most of the coupling schemes in a metamaterial are based on a near-field effect, though there also exists a mechanism to couple the resonators through the excitation of lowest-order lattice mode which facilitates the long-range radiative or diffractive coupling in the split-ring resonator plane leading to resonance line narrowing of the fundamental as well as the higher order resonance modes.
The Host Genera of Ant-Parasitic Lycaenidae Butterflies: A Review
Authors: Fiedler Konrad
Published: March 2012

Numerous butterfly species in the family Lycaenidae maintain myrmecophilous associations with trophobiotic ants, but only a minority of ant-associated butterflies are parasites of ants.Camponotus,Crematogaster,Myrmica, andOecophyllaare the most frequently parasitized ant genera. The distribution of ant-parasitic representatives of the Lycaenidae suggests that onlyCamponotusandCrematogasterhave multiply been invaded as hosts by different independent butterfly lineages. A general linear model reveals that the number of associated nonparasitic lycaenid butterfly species is the single best predictor of the frequency of parasitic interactions to occur within an ant genus. Neither species richness of invaded ant genera nor their ecological prevalence or geographical distribution contributed significantly to that model. Some large and dominant ant genera, which comprise important visitors of ant-mutualistic lycaenids, have no (Formica,Dolichoderus) or very few ant-parasitic butterflies (Lasius,Polyrhachis) associated with them.
Global Exponential Stability of Antiperiodic Solutions for Discrete‐Time Neural Networks with Mixed Delays and Impulses
Authors: Chen Xiaofeng , Song Qiankun
Published: March 2012

The problem on global exponential stability of antiperiodic solution is investigated for a class of impulsive discrete‐time neural networks with time‐varying discrete delays and distributed delays. By constructing an appropriate Lyapunov‐Krasovskii functional, and using the contraction mapping principle and the matrix inequality techniques, a new delay‐dependent criterion for checking the existence, uniqueness, and global exponential stability of anti‐periodic solution is derived in linear matrix inequalities (LMIs). Two simulation examples are given to show the effectiveness of the proposed result.
Cascadable Current-Mode First-Order and Second-Order Multifunction Filters Employing Grounded Capacitors
Authors: Horng Jiun-Wei , Hou Chun-Li , Tseng Ching-Yao , Chang Ryan , Yang Dun-Yih
Published: March 2012

A configuration for realizing low input and high output impedances current-mode multifunction filters using multiple output second-generation current conveyors (MOCCIIs) is presented. From the proposed circuit configuration, first-order allpass, highpass, lowpass and second-order allpass, notch, bandpass filters can be obtained. The simulation results confirm the theoretical analysis.
Function of Serum Complement in Drinking Water Arsenic Toxicity
Authors: Islam Laila N. , Zahid M. Shamim Hasan , Nabi A. H. M. Nurun , Hossain Mahmud
Published: March 2012

Serum complement function was evaluated in 125 affected subjects suffering from drinking water arsenic toxicity. Their mean duration of exposure was7.4±5.3 yrs, and the levels of arsenic in drinking water and urine samples were216±211and223±302 μg/L, respectively. The mean bactericidal activity of complement from the arsenic patients was 92% and that in the unexposed controls was 99% (P<0.01), but heat-inactivated serum showed slightly elevated activity than in controls. In patients, the mean complement C3 was 1.56 g/L, and C4 was 0.29 g/L compared to 1.68 g/L and 0.25 g/L, respectively, in the controls. The mean IgG in the arsenic patients was 24.3 g/L that was highly significantly elevated (P<0.001). Arsenic patients showed a significant direct correlation between C3 and bactericidal activity (P=0.014). Elevated levels of C4 indicated underutilization and possibly impaired activity of the classical complement pathway. We conclude reduced function of serum complement in drinking water arsenic toxicity.
The Intrinsic Room-Temperature Ferromagnetism in ZnO:Co Thin Films Deposited by PLD
Authors: Wang C. C. , Man B. Y. , Liu M. , Chen C. S. , Jiang S. Z. , Yang S. Y. , Xu S. C. , Gao X. G. , Hu B.
Published: March 2012

c-axis preferential orientated ZnO:Co thin films were synthesized onc-plane sapphire substrates by using pulsed laser deposition (PLD) technique in an oxygen-deficient ambient. X-ray diffraction spectra, scanning electron microscopy, X-ray photoelectron spectroscopy, energy dispersive spectroscopy, UV-vis transmittance spectra, and Raman spectra were used for characterization. Ferromagnetic behavior was clearly observed at room temperature and verified to be the intrinsic property of the material. The presence of second phase was ruled out.
Computer Modeling and Simulation of Ultrasonic Signal Processing and Measurements
Authors: Gandole Y. B.
Published: March 2012

The system for simulation, measurement, and processing in Graphical User Interface implementation is presented. The received signal from the simulation is compared to that of an actual measurement in the time domain. The comparison of simulated, experimental data clearly shows that acoustic wave propagation can be modeled. The feasibility has been demonstrated in an ultrasound transducer setup for material property investigations. The results of simulation are compared to experimental measurements. The simulation result has good agreement with the experimental data which confirms the validity of the model. The simulation tool therefore provides a way to predict the received signal before anything is built. Furthermore, the use of an ultrasonic simulation package allows for the development of the associated electronics to amplify and process the received ultrasonic signals. Such a virtual design and testing procedure not only can save us time and money, but also can provide better understanding on design failures and allow us to modify designs more efficiently and economically.
Fuzzy Case‐Based Reasoning in Product Style Acquisition Incorporating Valence‐Arousal‐Based Emotional Cellular Model
Authors: Shi Fuqian , Xu Jiang , Sun Shouqian
Published: March 2012

Emotional cellular (EC), proposed in our previous works, is a kind of semantic cell that contains kernel and shell and the kernel is formalized by a triple‐ L = , where P denotes a typical set of positive examples relative to word‐L, d is a pseudodistance measure on emotional two‐dimensional space: valence‐arousal, and δ is a probability density function on positive real number field. The basic idea of EC model is to assume that the neighborhood radius of each semantic concept is uncertain, and this uncertainty will be measured by one‐dimensional density function δ. In this paper, product form features were evaluated by using ECs and to establish the product style database, fuzzy case based reasoning (FCBR) model under a defined similarity measurement based on fuzzy nearest neighbors (FNN) incorporating EC was applied to extract product styles. A mathematical formalized inference system for product style was also proposed, and it also includes uncertainty measurement tool emotional cellular. A case study of style acquisition of mobile phones illustrated the effectiveness of the proposed methodology.
Permeability of Electrospun Superhydrophobic Nanofiber Mats
Authors: Patel Sarfaraz U. , Manzo Gabriel M. , Patel Shagufta U. , Kulkarni Prashant S. , Chase George G.
Published: March 2012

This paper discusses the fabrication and characterization of electrospun nanofiber mats made up of poly(4-methyl-1-pentene) polymer. The polymer was electrospun in different weight concentrations. The mats were characterized by their basis weight, fiber diameter distribution, contact angles, contact angle hysteresis, and air permeability. All of the electrospun nonwoven fiber mats had water contact angles greater than 150 degrees making them superhydrophobic. The permeabilities of the mats were empirically fitted to the mat basis weight by a linear relation. The experimentally measured air permeabilities were significantly larger than the permeabilities predicted by the Kuwabara model for fibrous media.