bluuebunny/crossref_metadata_2025 huggingface dataset:
Privatizing Public Nursing Homes: Examining the Effects on Quality and Access
Authors: Amirkhanyan Anna
Published: June 2008

This study examines the effects of local government divestment on quality and access to care for Medicaid recipients in privatized nursing homes. The central hypotheses are concerned with the impact of new ownership on both aspects of organizational performance. The analysis indicates that privatization of nursing homes involves a complex set of trade‐offs. Changing organizational ownership to for‐profit increases the number of regulatory violations, decreases residents’ quality of life, but does not influence Medicaid admissions. While no decline in quality is found among divested nonprofit facilities, access to care declines in the comparison groups of nonprofit homes. The author concludes that as counties minimize their roles as service producers, federal, state and local governments should enhance their regulatory capacity by improving quality assurance mechanisms and providing adequate reimbursement for low‐income clients.
Policy Considerations for States Supporting Stem Cell Research: Evidence from a Survey of Stem Cell Scientists
Authors: Levine Aaron D.
Published: June 2008

Five states now provide funding for stem cell research, and many states are developing or debating stem cell research policies. Despite this interest, little data exist to help policy makers design policies or forecast the impact of new legislation. This article reports novel data from two surveys: one directed at those most affected by these policies—stem cell scientists—and one at a group of biomedical researchers working in less contentious fields. These data identified relatively high mobility among stem cell scientists, particularly in states with restrictive policies, and a strong preference for states with permissive policies. These findings suggest that state‐specific policies may prove to be effective recruiting tools. They also suggest specific recruitment strategies and highlight the importance of first‐mover advantage as states compete for the same limited pool of mobile scientists. This research aims to provide a factual basis to support ongoing policy formulation in the area.
Governing Interlocal Cooperation: City Council Interests and the Implications for Public Management
Authors: Zeemering Eric S.
Published: June 2008

Local government managers are described as key participants in the development of interlocal cooperation, but the interests of city councils in this process have gone largely unstudied. Here, the author addresses the theoretical importance of council‐manager relations in interlocal public service cooperation. Three propositions identify areas of shared council‐manager responsibility. Evidence from in‐depth interviews with city council members is used to assess each proposition. While interlocal partnership has been described as a managerial activity, council members take an interest in network development and agreement assessment. Managers, on the other hand, give greater attention to public participation and education. The evidence refines assumptions about council‐manager roles in the formation of cooperative agreements, with important implications for local government management.
Managing Emotional Intelligence in U.S. Cities: A Study of Social Skills among Public Managers
Authors: Berman Evan M. , West Jonathan P.
Published: June 2008

This study assesses perceptions of managerial emotional intelligence in local government, as well as the practices and polices affecting it. Though few cities offer training programs for managers that are called “emotional intelligence,” many cities engage in activities that target or address EI skills. This study finds improvement opportunities for managers to become better attuned to the feelings of others and themselves, to better know their own strengths and weaknesses, to better deal with their negative emotions and increase their adaptability, and to improve their communication and relationship skills. Feedback and mentoring processes are directly associated with increased perceptions of EI, while other practices such as training, selection and policy development are only indirectly associated with perceptions of EI. This study contributes to the knowledge base by increasing awareness about managerial EI skills, and providing specific examples of practices to further managerial EI.
Postsocialist spores: Disease, bodies, and the state in the Republic of Georgia
Authors: DUNN ELIZABETH CULLEN
Published: June 2008

The former Soviet Republic of Georgia has the world's highest rate of botulism—a rate over 90 times the U.S. rate. Why is Georgia disproportionately affected by this potentially fatal disease? I argue that unraveling the origins of hyperendemic botulism requires a new understanding of the state, one that sees it not only as an ensemble of actors, ideas, and objects but also as a phenomenon that creates discontiguous and variegated spaces. I trace the economic origins of botulism in Georgia to the organization of the Soviet state and the way it collapsed, examine how local ideas of purity and danger affect the range of possible solutions, and look at the ways that new kinds of state projects create isolation and disease as well as inclusion and health. [botulism, Georgia, state, epidemiology, public health, food safety, postsocialism]
“We have to think like capitalists but continue being socialists”: Medicalized subjectivities, emergent capital, and socialist entrepreneurs in post‐Soviet Cuba
Authors: BROTHERTON P. SEAN
Published: June 2008

Through an engagement with historical, epistemological, and ethnographic modes of analyses, I trace how individual bodily practices—that is, practices relating to the body and its health—in contemporary Cuba provide a fertile terrain for examining the multiple pathways through which political subjectivities are created and transformed. Specifically, I highlight the ways in which these practices serve as de facto access to basic health services and supplies and actively contribute to the daily functioning of Cuba's socialist health care system. I argue that scholars must move beyond contrasting rote descriptions of socialism vis‐à‐vis capitalism and, rather, look to new fields of inquiry that address the coproduction and coexistence of different forms of capital and new configurations of statecraft and subjectivity in 21st‐century Cuba. [Cuba, state, capital, bodily practices, subjectivity, socialism]
Molecular Characterization of Two Types of rDNA Units in a Single Strain of Candida albicans
Authors: MILETTI‐GONZÁLEZ KARL E. , LEIBOWITZ MICHAEL J.
Published: June 2008

ABSTRACT. Strains of the opportunistic fungal pathogen Candida albicans vary in the presence or absence of a self‐splicing group I intron ribozyme (Ca.LSU) in the 25S rRNA gene on chromosome R. Strains of C. albicans typically either lack or contain this ribozyme. However, some strains have both intron‐containing and intronless rRNA genes (rDNA). Pulsed‐field gel electrophoresis analysis of undigested and restricted DNA showed at least six different karyotypes among eight independent colonies of such a heteroallelic strain. In each case, the variation was in chromosome R, and was due to changes in the number of rDNA units. In strains with only one type of rDNA, chromosome R also varied considerably. Polymerase chain reaction amplification spanning the rDNA unit demonstrated that intron‐containing rDNA units are tandemly arrayed, and are immediately adjacent to intronless units in the same cluster. Both types of units were present in the rDNA clusters of both R chromosomes. Possible explanations of these results are loss of Ca.LSU group I intron through purifying selection and/or a relaxation of the commonly accepted concerted evolution of the rDNA units.
A Fatal Dichlorvos Poisoning: Concentrations in Biological Specimens
Authors: Abe Emuri , Duverneuil Charlotte , De La Grandmaison Geoffroy , Alvarez Jean‐Claude
Published: June 2008

Abstract:  A 54‐year‐old man was found dead with a bottle containing a brownish fluid near him. A toxicological screening was carried out in blood, urine, and stomach content. Only dichlorvos (2,2 dichlorovinyl O‐O dimethylphosphate or DDVP) was found. A simple and rapid method, using DDVP‐D6 as an internal standard, was developed for the determination of DDVP by gas chromatography/mass spectrometry (GC/MS). The method was linear from 1 to 10 mg/L. Intraday and interday precisions were all <15%. DDVP concentration in cardiac blood was approximately four times higher than in peripheral blood. A high concentration was found in the heart showing a cardiac tropism of DDVP, kidney and lung concentrations being much lower. No DDVP was found in liver. DDVP stomach content was 38 g. The amount presumed ingested was 82 g, c. 1000 mg/kg of body. The oral LD50 for DDVP ranges between 20 and 1090 mg/kg in animals but is not known for humans.
Elevated Morphine Concentrations Determined During Infant Death Investigations: Artifacts of Withdrawal of Care
Authors: Watterson James , Peaire Amy , Hinman Justin
Published: June 2008

Abstract:  Three cases are reported of elevated postmortem blood morphine concentrations (189–3036 ng/mL) that were observed during the course of death investigations involving three children ranging in age from 1 week to 2 years, all of whom underwent withdrawal of life support. In all three cases, the presence of opiates in postmortem blood was indicated by immunoassay (ELISA) and quantitative confirmatory analysis of free morphine concentrations in postmortem blood was performed by solid‐phase extraction followed by gas chromatography/mass spectrometry (GC/MS) in the selected ion monitoring mode. While the practice of withdrawing life support from terminally ill patients, with the accompanying administration of narcotics/analgesics has been reported in the medical literature, it has not been adequately described in the forensic literature. The implications of this practice on the forensic toxicological interpretation of morphine findings are discussed. To our knowledge, this is the first report of postmortem morphine concentrations arising directly from administration in conjunction with withdrawal of care in pediatric patients.
Increasing Ang1/Tie2 expression by simvastatin treatment induces vascular stabilization and neuroblast migration after stroke
Authors: Chen Jieli , Cui Xu , Zacharek Alex , Chopp Michael
Published: June 2008

In this study, we tested the hypothesis that the Angiopoietin 1 (Ang1)/Tie2 pathway mediates simvastatin‐induced vascular integrity and migration of neuroblasts after stroke. Rats were subjected to 2 hrs of middle cerebral artery occlusion (MCAo) and treated, starting 1 day after stroke with or without simvastatin (1 mg/kg, daily) for 7 days. Simvastatin treatment significantly decreased blood–brain barrier (BBB) leakage and concomitantly, increased Ang1, Tie2 and Occludin expression in the ischaemic border (IBZ) compared to the MCAo control group. Simvastatin also significantly increased doublecortin (DCX, a marker of migrating neuroblasts) expression in the IBZ compared to control MCAo rats. DCX was highly expressed around vessels. To further investigate the signalling pathway of simvastatin‐induced vascular stabilization and angiogenesis, rat brain microvascular endothelial cell (RBMEC) culture was employed. The data show that simvastatin treatment of RBMEC increased Ang1 and Tie2 gene and protein expression and promoted phosphorylated‐Tie2 activity. Simvastatin significantly increased endothelial capillary tube formation, an index of angiogenesis, compared to non‐treated control. Inhibition of Ang1 or knockdown of Tie2 gene expression in endothelial cells significantly attenuated simvastatin‐induced capillary tube formation. In addition, simvastatin significantly increased subventricular zone (SVZ) explant cell migration compared to non‐treatment control. Inhibition of Ang1 significantly attenuated simvastatin‐induced SVZ cell migration. Simvastatin treatment of stroke increases Ang1/Tie2 expression and thereby reduces BBB leakage and promotes vascular stabilization. Ang1/Tie2 expression induced by simvastatin treatment promotes neuroblast micro‐vascular coupling after stroke.
Adrenocortical carcinoma with delayed cutaneous metastasis
Authors: Satter Elizabeth K. , Barnette David J.
Published: June 2008

Adrenal cortical carcinoma (ACC) is an uncommon and aggressive malignancy. Patients often have metastatic disease at initial presentation, with the most common sites being the liver, local lymph nodes, lungs, peritoneum and bone. Despite a high frequency of metastases, there are only isolated reports of ACC that have metastasized to the skin. Herein, we report a case of an 82‐year‐old woman who presented with a cyst‐like lesion on her back, which on biopsy proved to be ACC metastatic from a primary tumor diagnosed 30 years previously.
Scrotal and penile papules and plaques as the initial manifestation of a cutaneous metastasis of adenocarcinoma of the prostate: case report and review of the literature
Authors: Wang Steven Q. , Mecca Patricia S. , Myskowski Patricia L. , Slovin Susan F.
Published: June 2008

Cutaneous metastasis of prostatic adenocarcinoma is a rare phenomenon. We present a 56‐year‐old African American man with metastatic disease in the skin and subcutis of the suprapubic and scrotal area 2 years after his initial diagnosis presenting as scrotal and penile edema and plaque like scrotal rash. We also review the literature on this subject.
Delayed reaction after an octopus bite showing a giant cell‐rich granulomatous dermatitis/panniculitis
Authors: Misago Noriyuki , Inoue Takuya , Narisawa Yutaka
Published: June 2008

Adequate clinical data and a sufficient workup, in addition to the histopathological findings, are frequently required to make a correct diagnosis of granulomatous dermatitis/panniculitis. These lesions with an unexpected etiology may include delayed hypersensitivity granulomatous reactions to various factors, such as metals or marine animal injuries. A 50‐year‐old male presented with multiple subcutaneous nodules on his right forearm 1 month following an octopus bite at his right wrist. After the disappearance of these lesions, which responded well to low‐dose oral prednisone, another type of skin lesion characterized by small, numerous papules reappeared on his right forearm. Histopathologically, a specimen from a subcutaneous nodule showed mostly lobular granulomatous panniculitis, which showed an extensive diffuse infiltrate composed of numerous multinucleated giant cells and epithelioid cells intermingling with lymphocytes and eosinophils. A specimen from a papule that subsequently developed disclosed a diffuse granulomatous dermatitis composed of similar cells and also showed granuloma annulare‐like features. This case is considered to be a delayed reaction after an octopus bite showing an unusual giant cell‐rich granulomatous dermatitis/panniculitis. Octopus bites should therefore be included among the marine animal injuries, which cause a delayed‐type reaction with granulomatous dermatitis/panniculitis.
Hyalinized collagen in a dermatofibrosarcoma protuberans after treatment with imatinib mesylate
Authors: Thomison John , McCarter Martin , McClain Damon , Golitz Loren E. , Goldenberg Gary
Published: June 2008

We report a novel histological finding in a dermatofibrosarcoma protuberans (DFSP) after treatment with imatinib mesylate: copious amounts of hyalinized collagen. A 57‐year‐old female was referred for evaluation and treatment of a 7 × 8 × 10 cm tumor on the right anterior shoulder. Histological evaluation of the incisional biopsy showed a highly cellular dermal neoplasm composed of spindle cells arranged in a storiform pattern with minimal collagen. A CD34 immunohistochemical stain was strongly positive, highlighting atypical spindle cells in the dermis. A diagnosis of DFSP was made and the patient was enrolled in the Southwest Oncology Group trial. She received imatinib mesylate 400 mg per day for 1 year. At the end of therapy, the DFSP decreased in size to 5.5 × 4 × 4 cm. The tumor was excised. Histological evaluation showed a residual dermal neoplasm composed of atypical spindle cells and a copious amount of hyalinized collagen. Areas of necrosis were not seen. A CD34 stain confirmed the presence of residual DFSP, highlighting atypical spindle cells. A procollagen I stain was strongly positive, confirming the presence of abundant collagen in the dermis. A similar finding has been reported in gastrointestinal stromal tumor, which shows deposition of myxohyaline stroma after treatment with imatinib mesylate.
Giant cell lichenoid dermatitis in a patient with baboon syndrome
Authors: Khelifa‐Hamdani Elhem , Touati‐Serraj Monia , Perriard Jacqueline , Chavaz Pierre , Saurat Jean‐Hilaire , Kaya Gürkan
Published: June 2008

Giant cell lichenoid dermatitis is a recently described pathological entity, which can be seen as an unusual lichenoid drug eruption, a manifestation of sarcoidosis or within herpes zoster scars. Histopathological findings include focal vacuolar alteration of the basal layer with cytoid bodies, dermal and intraepidermal multinucleated giant cells and a mixed chronic inflammatory infiltrate with a lichenoid pattern consisting of lymphocytes, histiocytes, eosinophils and plasma cells. Here, we report a giant cell lichenoid dermatitis in a 41‐year‐old male patient who developed, 3 days after intravenous treatment with amoxicillin‐clavulanic acid for erysipelas of the left leg, a clinical picture suggesting a baboon syndrome characterized by an erythematous and pruritic eruption on the axillary, inguinal and popliteal areas and the anterior side of elbows. This is the first reported case of giant cell lichenoid dermatitis in a patient with baboon syndrome.
Histoplasmosis clinically imitating cutaneous malignancy
Authors: Golda Nicholas , Feldman Mary
Published: June 2008

Disseminated histoplasmosis can have a varied presentation when it affects the skin. Presentation mimicking a cutaneous neoplasm is an uncommon manifestation. We present the case of an 86‐year‐old man presenting with a cutaneous lesion clinically suspicious for malignancy that was ultimately determined to be his first clinical manifestation of disseminated histoplasmosis after biopsy for histopathologic analysis. Microscopically, the lesion was a nodule with an eroded epidermis overlying a dense dermal inflammatory process. The infiltrate was characterized by numerous epithelioid histiocytes admixed with acute and chronic inflammation. On closer inspection, numerous 2–4 μm intracellular spores surrounded by a clear halo were identified. The organisms were highlighted with periodic acid schiff (PAS) stain. We present this case to highlight a unique presentation of disseminated histoplasmosis. Although this presentation is uncommon, it serves as a reminder that histopathologic confirmation of clinical diagnoses is important before undertaking more invasive procedures such as excision.
Pigmented dermatofibrosarcoma protuberans with prominent meningothelial‐like whorls
Authors: Wang Jian , Yang Wentao
Published: June 2008

Dermatofibrosarcoma protuberans (DFSP) is a locally aggressive skin tumor. In addition to the conventional type, several morphologic variants have been described. Recognition of these uncommon variants will facilitate the diagnosis. We report herein a peculiar case of pigmented DFSP (Bednar tumor) with prominent meningothelial‐like whorls, a distinctive pattern that has not been described previously in DFSP. The tumor occurred in a 40‐year‐old man who presented with a slowly growing mass on his left shoulder. The overall histological features were consistent with Bednar tumor. However, unexpected numerous meningothelial‐like whorls were found in some areas of the tumor. Like the tumor cells in typical areas of Bednar tumor these meningothelial‐like whorls were also positive for CD34 but negative for epithelial membrane antigen and S100 protein. The meningothelial‐like whorls in Bednar tumor represent an eccentric arrangement of the tumor cells. We propose the term ‘pigmented DFSP with prominent meningothelial‐like whorls’ to highlight the distinctive pattern of this novel DFSP variant.
Lichen planus of the nail matrix with predominant plasma cell infiltrate
Authors: Hall Rebecca , Wartman David , Jellinek Nathaniel , Robinson‐Bostom Leslie , Telang Gladys
Published: June 2008

Lichen planus (LP) is an inflammatory dermatitis of idiopathic origin that can involve the skin, mucous membranes, hair and nails. Histologically, LP is characterized by compact orthokeratosis, wedge‐shaped hypergranulosis, irregular acanthosis, damage to the basal cell layer and a band‐like inflammatory infiltrate in the upper dermis. Lymphocytes are the predominant cells making up the infiltrate, along with a few macrophages, eosinophils and plasma cells. In addition, melanophages are often found in the upper dermis adjacent to the damaged basal cells.1 We describe a patient with a lesion of the toenail clinically and histopathologically consistent with LP, but with a band‐like inflammatory infiltrate composed primarily of plasma cells. Previously, only three other cases of LP with plasma cell predominant infiltrate have been reported, none of which involved the nail matrix.
Smooth muscle hamartoma associated with a congenital pattern melanocytic nevus, a case report and review of the literature
Authors: Zarineh Alireza , Kozovska Milena E. , Brown William G. , Elder David E. , Rabkin Michael S.
Published: June 2008

Smooth muscle hamartoma (SMH) is a rare benign congenital or acquired lesion sometimes associated with Becker’s nevus (Becker’s melanosis). We report an unusual lesion with combined features of SMH and melanocytic nevus. The patient is a 49‐year‐old male with a history of a changing ‘mole’ on the left upper back. Clinical examination showed a solitary 1.2‐cm nodule with central gray pigmentation. Histological examination showed a relatively well‐circumscribed intradermal lesion. The superficial portion of the lesion consisted of melanocytes with nevoid morphology. The melanocytes had congenital pattern of distribution. Lesional melanocytes acquired a spindled morphology in the deeper dermis. The base of the lesion consisted of intersecting smooth muscle fascicles focally admixed with spindled melanocytes. The melanocytic component strongly expressed melanoma antigen recognized by T‐cells‐1 (MART‐1) and HMB‐45. The smooth muscle component was strongly positive for smooth muscle actin and h‐caldesmon. Neither components showed significant cytological atypia or mitotic activity. Unlike a recently reported case of SMH combined with a melanocytic nevus and basal cell carcinoma, the current lesion did not occur in association with a Becker’s nevus.
Solitary sclerotic fibroma of the skin: morphological characterization of the ‘plywood‐like pattern’
Authors: Nakashima Keiko , Yamada Nanako , Adachi Koji , Yoshida Yuichi , Yamamoto Osamu
Published: June 2008

Sclerotic fibroma is an uncommon skin tumor. Rapini and Golitz reported 11 cases of solitary sclerotic fibromas in patients without Cowden’s disease in 1989. We report a case of sclerotic fibroma that presented as an asymptomatic nodule in a 34‐year‐old Japanese man. Histopathological examination revealed typical features of sclerotic fibroma of the skin. Ultrastructural examination showed that spindle cells with myoid features had proliferated around the vasculature. They had segregated from the perivascular area by leaving the surrounding basal lamina, resulting in their phenotypical change to produce collagen accumulating in a concentrically lamellar fashion. We suggest a possible role of abnormal blood vessels and surrounding specific cells in the development of sclerotic fibroma.
Basal cell carcinomas arising within multiple trichoepitheliomas
Authors: Pincus Laura B. , McCalmont Timothy H. , Neuhaus Isaac M. , Kasper Richard , Oh Dennis H.
Published: June 2008

Although trichoepitheliomas (TEs) are commonly regarded as benign tumors of follicular origin, the natural history of multiple familial trichoepitheliomas (MFT) and their risk for malignancy has been unclear. We describe a 57‐year‐old male with numerous skin‐colored firm papules and plaques present on the central face since 6 years of age. Recently, some lesions had enlarged and ulcerated. Other family members were similarly affected. Biopsies from multiple lesions showed TEs both alone and associated with basal cell carcinoma (BCC) in the same section, suggesting the secondary development of BCCs within TEs. Many prior reports of BCCs arising within TEs in patients with presumed MFT were likely misdiagnosed cases of nevoid BCC. This report is a compelling example of MFT in which BCCs evolved secondarily. Awareness of the potential for the evolution of carcinoma in patients with MFT is important in the management of these patients.
The use of ITS DNA sequence analysis and MALDI‐TOF mass spectrometry in diagnosing an infection with Fusarium proliferatum
Authors: Seyfarth Florian , Ziemer Mirjana , Sayer Herbert G. , Burmester Anke , Erhard Marcel , Welker Martin , Schliemann Sibylle , Straube Eberhard , Hipler Uta‐Christina
Published: June 2008

Abstract:  Although mycoses are among the most common diseases worldwide, infections with Fusarium spp. occur only rarely. Mostly patients suffering from underlying immune deficiency are infected with this mould, resulting in a considerably decreasing prognosis. In immunocompromised patients, cutaneous manifestations are more often associated with Fusarium sp. than with Candida sp. or Aspergillus sp. We describe one patient with acute lymphoblastic leukaemia, who was first treated with chemotherapy after GMALL protocol 07/03. After relapse, the patient was successfully transplanted in second remission with a human leukocyte antigen (HLA)‐matched unrelated peripheral blood stem cell graft. Ten months later, the patient died from respiratory insufficiency and recurrence of leukaemia. Previously, Aspergillus antigen was detected in blood. In the latter course, disseminated papules appeared. One of these was examined histologically and mycologically. Conventional cultural diagnostics led to the diagnosis of a fusariosis, further supported by internal transcribed spacer (ITS) sequencing and matrix assisted laser desorption/ionisation–time‐of‐flight mass spectrometry (MALDI‐TOF) mass spectrometry, both determining the isolated strain as Fusarium proliferatum, which is a very infrequent pathogen within this genus. Our investigations underline the potential of MALDI‐TOF MS based identification of Fusarium species as an innovative, time and cost efficient alternative to ITS sequencing.
The Hepatitis C Virus Non‐Structural Protein NS5A Alters the Trafficking Profile of the Epidermal Growth Factor Receptor
Authors: Mankouri Jamel , Griffin Stephen , Harris Mark
Published: June 2008

Hepatitis C virus (HCV) frequently establishes a persistent infection, leading to chronic liver disease. The NS5A protein has been implicated in this process as it modulates a variety of intracellular signalling pathways that control cell survival and proliferation. In particular, NS5A associates with several proteins involved in the endocytosis of the epidermal growth factor receptor (EGFR) and has been previously shown to inhibit epidermal growth factor (EGF)‐stimulated activation of the Ras–Erk pathway by a mechanism that remains unclear. As EGFR signalling involves trafficking to late endosomes, we investigated whether NS5A perturbs EGFR signalling by altering receptor endocytosis. We demonstrate that NS5A partially localizes to early endosomes and, although it has no effect on EGF internalization, it colocalizes with the EGFR and alters its distribution. This redistribution correlates with a decrease in the amount of active EGF–EGFR ligand–receptor complexes present in the late endosomal signalling compartment and also results in a concomitant increase in the total levels of EGFR. These observations suggest that NS5A controls EGFR signalling by diverting the receptor away from late endosomes. This represents a novel mechanism by which a viral protein attenuates cell signalling and suggests that NS5A may perturb trafficking pathways to maintain an optimal environment for HCV persistence.
A lesson in treating the whole patient: Todd Nicholson’s story
Authors: Sibbald R. Gary , Coutts Pat , Norton Linda , Nicholson Todd
Published: June 2008

The authors present a patients story to demonstrate the usefulness of a complete patient approach, incorporating V.A.C. therapy, to achieving clinical success from the patients perspective. The article discusses why a total patient approach is important and therapeutic flexibility increases the chance of a successful outcome for all involved.
Effect of Hormone Replacement Therapy on Clitoral Artery Blood Flow in Healthy Postmenopausal Women
Authors: Alatas Erkan , Yagci Baki , Oztekin Ozer , Sabir Nuran
Published: June 2008

Introduction

Aging and the decline of ovarian hormonal secretion during menopause may alter libido, and sexual response and functioning. The effects of hormone replacement therapy (HRT) on the genital vascular hemodynamics have been widely studied. However, there is a lack of knowledge about the effect of HRT on basal clitoral blood flow.

Aim

The aims of this study were to measure clitoral artery blood flow and to determine whether HRT has a significant effect in clitoral artery blood flow in postmenopausal women.

Methods

Doppler sonography of clitoral arteries was performed in 25 postmenopausal women aged 51.3 ± 4.5 years who had been using a continuous combined HRT (0.625 mg of conjugated equine estrogens plus 2.5 mg medroxyprogesterone acetate, in 1 tablet daily) for 2.0 ± 1.1 years, and the clitoral artery peak systolic velocity, resistance index (RI), and pulsatility index (PI) were measured. Thirty-five postmenopausal women aged 50.0 ± 4.2 years who had not used HRT served as a control group.

Main Outcome Measures

Assessment of clitoral blood flow with color Doppler ultrasonography by measuring the peak systolic velocity, RI, and PI.

Results

Clitoral artery circulation was easily detectable by the color Doppler sonography. The clitoral artery peak systolic velocities were significantly higher in postmenopausal women taking HRT compared with the control group (11.8 ± 5.2 cm/second vs. 15.0 ± 5.4 cm/second, P = 0.025).

Conclusion

HRT improves blood flow to the clitoris. A clitoral blood flow evaluation may be proposed as a potential tool to assess the impact of HRT on the genital tissues and to investigate female sexual response disorders in postmenopausal women.
Prevalence and Sociocultural Predictors of Sexual Dysfunction among Chinese Men Who Have Sex with Men in Hong Kong
Authors: Lau Joseph T.F. , Kim Jean H. , Tsui Hi Yi
Published: June 2008

Introduction

Limited data are available on sexual dysfunction (SD) in men who have sex with men (MSM) population.

Aims

The study investigates the prevalence and associated sociocultural factors of SD in MSM.

Methods

With an informed consent, 324 MSM respondents were interviewed by trained peer workers in certain gay venues, and another 87 MSM self-administered the same questionnaire via a gay website.

Main Outcome Measures

Self-reported pain during intercourse, premature ejaculation, anxiety about sex, erectile dysfunction, no pleasure from sex, no orgasm, and hypoactive sexual desire were evaluated.

Results

Of all respondents, 42.5% had at least one of the seven studied SD for at least three consecutive months in the last 12 months (pain during sex, 13.8%; premature ejaculation, 10.4%; anxiety, 18.7%; erectile problems, 6.3%; no pleasure, 13.8%; no orgasm, 5.6%; hypoactive sexual desire, 8.3%), whereas 11.4% were dissatisfied with their sexual life. Except for erectile dysfunction, age had no significant effects on individual SD. The results of the multivariate analyses show that unemployment, venue of recruitment, substance use, number of HIV-related behaviors practiced, unprotected anal sex, self-perceived discrimination against MSM, self-identity of sexual orientation, experience of being discriminated because of one's MSM status, uneasy or shame feeling about one's sexual orientation/status, and the count variable of social support received regarding one's MSM status were associated with SD (multivariate OR = 1.68–5.57), whereas having no or few MSM friends and exposure to HIV-related education were associated with lower chances of having some SD problems (multivariate OR = 0.16–0.46). Only associations with P < 0.05 were considered statistically significant.

Conclusions

The prevalence of SD among MSM in Hong Kong is relatively high. SD in this group is associated with HIV-related behaviors as well as sociocultural factors related to social support and acceptance of one's MSM status. A more supportive environment is essential for the promotion of sexual health in MSM.
Influence of Microsilica Content on the Slag Resistance of Castables Containing Porous Corundum–Spinel Aggregates
Authors: Yan Wen , Li Nan , Han Bingqiang
Published: June 2008

Corrosion of five corundum–spinel castables containing the same porous aggregates and different matrices by converter slag (C/S=3) was conducted using the static crucible test through the counting pixels method, XRD, SEM, EDAX, and so on. It was found that the corrosion and penetration resistance depend on the microsilica content. Microsilica content strongly affects liquid phase formation in the matrix, changes the porosity, pore size distribution of matrix, and viscosity of slag penetrated, and thus affects its corrosion and penetration resistance. Increasing microsilica, decreasing the porosity, or increasing the viscosity of the penetrating slag improves, whereas increasing the pore size or liquid content reduces the penetration and corrosion resistance. The penetration resistance increased abruptly with an increase of the microsilica content from 0.65 to 1.95 wt%, but changed slightly with increase of the microsilica content from 1.95 to 3.90 wt%. The corrosion resistance increased with an increase of the microsilica content from 0 to 2.60 wt%, but slightly decreased with a further increase of the microsilica content to 3.90 wt%. 1.95–2.60 wt% microsilica leads to a compromise between low corrosion and low penetration.
Laminar‐Structured YAG/Nd:YAG/YAG Transparent Ceramics for Solid‐State Lasers
Authors: Li Jiang , Wu Yusong , Pan Yubai , Liu Wenbin , Huang Liping , Guo Jingkun
Published: June 2008

A laminar‐structured YAG/1.0 at.% Nd:YAG/YAG transparent ceramic was fabricated by a solid‐state reaction method and vacuum sintering using high‐purity α‐Al2O3, Y2O3, and Nd2O3 as raw materials with tetraethoxysilane as a sintering aid. The microstructure, the optical property, and the laser performance of the ceramic composite prepared were investigated in this paper. It is found that the sample exhibits a pore‐free structure and the average grain size is about 15 μm. There is no secondary phase both at the grain boundary and at the grain matrix. The optical transmittance of the sample (5.0 mm thick) is 80.2% at 1064 nm. The lasing sample is Φ16.2 mm × 5.0 mm in size, mirror polished on both sides and without a coating. A laser diode (808 nm) was used as a pump source with a maximum output of about 1000 mW, and the end‐pumped laser experiment was demonstrated. With 658 mW of maximum absorbed pump power, a laser output of 8 mW has been obtained with a slope efficiency of 4.0%.
Effect of Dental Heat Pressing on the Microstructure of SiO2–K2O–B2O3–MgO–F Glass–Ceramic
Authors: Zhao Yinghua , Chen Jihua , Fang Ming , Li Na , Sun Xiang , Xiao Yuhong , Wang Yingjie , Ma Xinpei , Wang Lei
Published: June 2008

The purpose of this study was to evaluate the effect of dental heat pressing on the microstructure of a glass–ceramic located in a SiO2–K2O–B2O3–MgO–F system. DTA, SEM and XRD techniques and mechanical testing methods were used. The results confirmed that the glass–ceramic could be successfully pressed with commercial dental equipment. The SEM observation revealed crystals aligned along the direction of pressing. The mechanical property along the direction of heat pressing was higher than that of the heat‐treated controls. It was concluded that dental heat‐pressing procedure led to an anisotropic structure, which could improve the mechanical property in the perpendicular direction.
Microhydrogel‐Mediated Synthesis of Sintered Hydroxyapatite Granules
Authors: Sinha Arvind , Nayar Suprabha , Kar Abhijit , Gunjan Manoj Kumar , Mahato Bhupeshawar , Das Gautam , Kumar Arun , Chabra Aman
Published: June 2008

Synthesis of macroporous hydroxyapatite (HA) granules with a controlled microarchitecture has been demonstrated by following a polymer microhydrogel mediated synthesis process coupled with sintering. The process is basically based on in situ nucleation and growth of HA nanoparticles in polymer (polyvinyl alcohol) microhydrogels. A systematic variation of polymer concentration has manifested a controlled evolution of a hierarchical macroporous granular structure after sintering.
Soral Crypsis: Protective Mimicry of a Coccid on an Indian Fern
Authors: Patra Biplab , Bera Subir , Hickey R. James
Published: June 2008

Herbivory with crypsis is not well documented in ferns. The present record of cryptic coloration of coccid Saissetia filicum Boisduval (Homoptera: Coccidae) to the sori of a fern species Asplenium nidus L. (Aspleniaceae) is unique. Predatory beetles (Jauravia sp., Coleoptera: Coccinellidae) that feed on the coccids, are suggested to be selective pressure for the development of the present homopteran soral crypsis. A higher rate of effective predation is noticed in the vegetative leaves than the fertile leaves. Aggressive ants were found harvesting honeydew secretions from the coccids and defending the trophobionts as well as the host fern from their natural enemies. In addition, a possible three‐way mutualistic relationship among the coccids, its host fern and the tending ant is suggested. Differential numbers of coccids on vegetative and fertile leaves is correlated with their phenol content and degree of predation by beetles. Such coloration mimicry by the coccids may enable them to obtain the necessary blend of sorus of the host fern needed to evade beetle detection and attack.
Effects of Elevated CO2 on Growth, Carbon Assimilation, Photosynthate Accumulation and Related Enzymes in Rice Leaves during Sink‐Source Transition
Authors: Li Jun‐Ying , Liu Xing‐Hua , Cai Qing‐Sheng , Gu Hui , Zhang Shan‐Shan , Wu Yan‐Yan , Wang Chun‐Jiao
Published: June 2008

To study the effects of growing rice (Oryza sativa L.) leaves under the treatment of the short‐term elevated CO2 during the period of sink‐source transition, several physiological processes such as dynamic changes in photosynthesis, photosynthate accumulation, enzyme activities (sucrose phosphate synthase (SPS), and sucrose synthase (SS)), and their specific gene (sps1 and RSus1) expressions in both mature and developing leaf were measured. Rice seedlings with fully expanded sixth leaf (marked as the source leaf, L6) were kept in elevated (700 μmol/mol
) and ambient (350 mol/L) CO2 until the 7th leaf (marked as the sink leaf, L7) fully expanded. The results demonstrated that elevated CO2 significantly increased the rate of leaf elongation and biomass accumulation of L7 during the treatment without affecting the growth of L6. However, in both developing and mature leaves, net photosynthetic assimilation rate (A), all kinds of photosynthate contents such as starch, sucrose and hexose, activities of SPS and SS and transcript levels of sps1 and RSus1 were significantly increased under elevated CO2 condition. Results suggested that the elevated CO2 had facilitated photosynthate assimilation, and increased photosynthate supplies from the source leaf to the sink leaf, which accelerated the growth and sink‐source transition in new developing sink leaves. The mechanisms of SPS regulation by the elevated CO2 was also discussed.
Response of Polygonum viviparum Species and Community Level to Long‐term Livestock Grazing in Alpine Shrub Meadow in Qinghai‐Tibet Plateau
Authors: Zhu Zhi‐Hong , Lundholm Jeremy , Li Yingnian , Wang Xiaoan
Published: June 2008

Grazing by domestic herbivores is generally recognized as a major ecological factor and an important evolutionary force in grasslands. Grazing has both extensive and profound effects on individual plants and communities. We investigated the response patterns of Polygonum viviparum species and the species diversity of an alpine shrub meadow in response to long‐term livestock grazing by a field manipulative experiment controlling livestock numbers on the Qinghai‐Tibet Plateau in China. Here, we hypothesize that within a range of grazing pressure, grazing can alter relative allocation to different plant parts without changing total biomass for some plant species if there is life history trade‐offs between plant traits. The same type of communities exposed to different grazing pressures may only alter relative species' abundances or species composition and not vary species diversity because plant species differ in resistant capability to herbivory. The results show that plant height and biomass of different organs differed among grazing treatments but total biomass remained constant. Biomass allocation and absolute investments to both reproduction and growth decreased and to belowground storage increased with increased grazing pressure, indicating the increasing in storage function was attained at a cost of reducing reproduction of bulbils and represented an optimal allocation and an adaptive response of the species to long‐term aboveground damage. Moreover, our results showed multiform response types for either species groups or single species along the gradient of grazing intensity. Heavy grazing caused a 13.2% increase in species richness. There was difference in species composition of about 18%–20% among grazing treatment. Shannon‐Wiener (H′) diversity index and species evenness (E) index did not differ among grazing treatments. These results support our hypothesis.
On active galactic nuclei as sources of ultra-high energy cosmic rays
Authors: George M. R. , Fabian A. C. , Baumgartner W. H. , Mushotzky R. F. , Tueller J.
Published: June 2008

We measure the correlation between sky coordinates of the Swift Burst Alert Telescope (BAT) catalogue of active galactic nuclei (AGN) with the arrival directions of the highest energy cosmic rays detected by the Auger Observatory. The statistically complete, hard X-ray catalogue helps to distinguish between AGN and other source candidates that follow the distribution of local large-scale structure. The positions of the full catalogue are marginally uncorrelated with the cosmic ray arrival directions, but when weighted by their hard X-ray flux, AGN within 100 Mpc are correlated at a significance level of 98 per cent. This correlation sharply decreases for sources beyond ∼100 Mpc, suggestive of a GZK suppression. We discuss the implications for determining the mechanism that accelerates particles to these extreme energies in excess of 1019 eV.
The burden of influenza in East and South‐East Asia: a review of the English language literature
Authors: Simmerman James M. , Uyeki Timothy M.
Published: June 2008

Abstract  While human infections with avian influenza A (H5NI) viruses in Asia have prompted concerns about an influenza pandemic, the burden of human influenza in East and Southeast Asia has received far less attention. We conducted a review of English language articles on influenza in 18 countries in East and Southeast Asia published from 1980 to 2006 that were indexed on PubMed. Articles that described human influenza‐associated illnesses among outpatients or hospitalized patients, influenza‐associated deaths, or influenza‐associated socioeconomic costs were reviewed. We found 35 articles from 9 countries that met criteria for inclusion in the review. The quality of articles varied substantially. Significant heterogeneity was noted in case definitions, sampling schemes and laboratory methods. Early studies relied on cell culture, had difficulties with specimen collection and handling, and reported a low burden of disease. The recent addition of PCR testing has greatly improved the proportion of respiratory illnesses diagnosed with influenza. These more recent studies reported that 11–26% of outpatient febrile illness and 6‐14% of hospitalized pneumonia cases had laboratory‐confirmed influenza infection. The influenza disease burden literature from East and Southeast Asia is limited but expanding. Recent studies using improved laboratory testing methods and indirect statistical approaches report a substantial burden of disease, similar to that of Europe and North America. Current increased international focus on influenza, coupled with unprecedented funding for surveillance and research, provide a unique opportunity to more comprehensively describe the burden of human influenza in the region.
Biotechnological applications of Listeria's sophisticated infection strategies
Authors: Barbuddhe Sukhadeo , Chakraborty Trinad
Published: June 2008

Listeria monocytogenes is a Gram‐positive bacterium that is able to survive both in the environment and to invade and multiply within eukaryotic cells. Currently L. monocytogenes represents one of the most well‐studied and characterized microorganisms in bacterial pathogenesis. A hallmark of L. monocytogenes virulence is its ability to breach bodily barriers such as the intestinal epithelium, the blood–brain barrier as well as the placental barrier to cause severe systemic disease. Curiously, this theme is repeated at the level of the interaction between the individual cell and the bacterium where its virulence factors contribute to the ability of the bacteria to breach cellular barriers. L. monocytogenes is a model to study metabolic requirements of bacteria growing in an intracellular environment, modulation of signalling pathways in the infected cell and interactions with cellular defences involving innate and adaptive immunity. Technical advances such as the creation of LISTERIA‐susceptible mouse strains, had added interest in the study of the natural pathogenesis of the disease via oral infection. The use of attenuated strains of L. monocytogenes as vaccines has gained considerable interest because they can be used to express heterologous antigens as well as to somatically deliver recombinant DNA to eukaryotic cells. A novel vaccine concept, the use of non‐viable but metabolically active bacteria to induced immunoprotective responses, has been developed with L. monocytogenes. In this mini‐review, we review the strategies used by L. monocytogenes to subvert the cellular functions at different stages of the infection cycle in the host and examine how these properties are being exploited in biotechnological and clinical applications.