bluuebunny/crossref_metadata_2025 huggingface dataset:
Organizational Decoration
Authors: Cox Julie Wolfram , Minahan Stella
Published: May 2006

The authors call for the introduction of a new metaphor, organizational decoration, to provide a way of conceiving organizational development (OD) as an aesthetic endeavor. First, this is a response to recent calls for fresh and more interdisciplinary approaches to thinking about the practice of OD. Second, it is a provocation, for their choice of decoration is also a call for greater humility in OD’s ambitions. Rather than seek a more strategic or architectural role for OD, organizational decoration works instead at the surface and in the realm of the aesthetic. And within that realm the authors have deliberately chosen decoration over design (a term far more familiar to OD) because decoration more closely represents the ordinary and often temporary contributions that the authors advocate. Implications of moving OD down-market are discussed.
The Russian nobility and the Russian countryside
Authors: Hughes Michael
Published: May 2006

This article examines changing attitudes towards the Russian countryside and the country estate among a section of the Russian nobility during the first half of the nineteenth century, making use of sources ranging from the works of major writers like Pushkin through to the memoir accounts of little-known authors. The article argues that the pastoral idyll presented in many fictional and non-fictional works often concealed an underlying ambivalence about the prosaic realities of country living. At the same time, though, it suggests that a complex array of factors was encouraging many members of Russian noble families to strengthen their emotional identification with the countryside and the country estate. The growth of such a ‘rural consciousness’ reflected a series of social, economic and political changes that had been taking place since the final decade of the eighteenth century.
A different political forum
Authors: Bradley Laura
Published: May 2006

Using new archive material, this article explores how East German theatre responded to the construction of the Berlin Wall in 1961. East Berlin's theatres and opera houses faced serious logistical difficulties, as they had previously relied heavily on Western practitioners. Even so, dramatists, directors and actors rallied in a strong public show of support for the Wall. Behind the scenes, most dissenters fell silent, in contrast to other professionals in East Berlin. But theatre productions were ambivalent: the political context invited spectators to read subversion into loyal stagings, and the Berliner Ensemble presented strong arguments both for and against repression in Brecht's Days of the Commune. When cultural politicians refused to repay artists’ loyalty with trust, intentionally subversive productions would start to transform theatre into a more critical political forum.
Pharmacotherapy of Acute Lung Injury and the Acute Respiratory Distress Syndrome
Authors: Cepkova Magda , Matthay Michael A.
Published: May 2006

Acute lung injury and the acute respiratory distress syndrome are common syndromes with a high mortality rate that affect both medical and surgical patients. Better understanding of the pathophysiology of acute lung injury and the acute respiratory distress syndrome and advances in supportive care and mechanical ventilation have led to improved clinical outcomes since the syndrome was first described in 1967. Although several promising pharmacological therapies, including surfactant, nitric oxide, glucocorticoids and lysofylline, have been studied in patients with acute lung injury and the acute respiratory distress syndrome, none of these pharmacological treatments reduced mortality. This article provides an overview of pharmacological therapies of acute lung injury and the acute respiratory distress syndrome tested in clinical trials and current recommendations for their use as well as a discussion of potential future pharmacological therapies including β2-adrenergic agonist therapy, keratinocyte growth factor, and activated protein C.
Agreement Among Adolescents, Parents, and Teachers on Adolescent Personality
Authors: Laidra Kaia , Allik Jüri , Harro Maarike , Merenäkk Liis , Harro Jaanus
Published: May 2006

Agreement between adolescents, mothers, fathers, and teachers on adolescents’ personality traits was investigated in a longitudinal study. The targets for personality ratings were the adolescents who participated in the European Youth Heart Study in Estonia. There were 593 participants in the first wave and 480 participants in the follow-up study 3 years later. Adolescents’ self-reports as well as father, mother, and teacher ratings were collected using questionnaires to measure the five-factor model of personality. In both waves, inter-rater agreement was highest between mothers and fathers, was low to moderate for parent-self ratings, and was lowest for ratings between self and teacher, mother and teacher, and father and teacher. Test-retest correlations were moderate for parent and self-ratings but failed to reach statistical significance for three of the five teacher-rated traits, suggesting lower reliability of teacher ratings. Possible explanations for the low agreement between teachers and other judges are discussed.
Promoting Positive Behaviour in Schools: The Youth Social Audit
Authors: Haines Kevin , Case Stephen
Published: May 2006

Local monitoring in Swansea, Wales has identified a strong link between school exclusion and youth offending. This precipitated the establishment of the Promoting Positive Behaviour (PPB) initiative. A questionnaire based on the Mooney Problem Checklist (MPCL) was completed by 162 (124 control and 38 experimental) Year 10 and Year 11 pupils in Swansea. The research investigated differences in the extent of problems experienced by pupils who had been excluded from school and those who had not. Results show that pupils in Swansea who have been excluded report a range of problems at higher levels than non-excluded pupils. This indicates that PPB’s focus upon reducing disaffection and maintaining young people in schools may ameliorate problems and prevent associated problem behaviours such as offending.
A Survey of Volunteer Appropriate Adult Services in England and Wales
Authors: Pierpoint Harriet
Published: May 2006

The Crime and Disorder Act 1998 (CDA) s. 38(4)(a) required local authorities to ensure the provision of appropriate adults for young people and CDA s. 39(7)(a) provided that it was Youth Offending Teams’ duty to co-ordinate such provision. Bearing in mind the virtual absence of any guidance, the first published national survey of Youth Offending Team managers was conducted to determine the nature of appropriate adult arrangements. This article reports on the issues that emerged concerning management, protocols, recruitment and selection, training, monitoring and support, which will be of particular interest to those engaged in the establishment and maintenance of appropriate adult services. Of broader interest, this article concludes that as appropriate adult arrangements differ between Youth Offending Teams (YOTs) across England and Wales, the nature and quality of services for young people in police custody inevitably varies.
Restorative Justice and Incarcerated Young Offenders
Authors: Williams Brian
Published: May 2006

Recent research on the use of, and attitudes towards, restorative justice practices in Young Offender Institutions, secure training centres and local authority secure units in England and Wales is reviewed. It shows that there is little such activity, largely due to the over crowding of the secure estate. However, there appears to be considerable willingness among those in positions of power to consider experimenting with more respectful ways of dealing with incarcerated young people and involving victims and the community more fully in restorative interventions.
Child Imprisonment: A Case for Abolition
Authors: Goldson Barry
Published: May 2006

In England and Wales the politicisation of crime and criminal justice policy in general, and youth crime and youth justice policy in particular, has given rise to a USA-inspired ‘new punitiveness’. Penal expansion and substantial growth in the population of child prisoners has consolidated. This article subjects child imprisonment to critical analysis by referring to: the damage and harm that it imposes; its spectacular failings in terms of youth crime prevention and community safety; and the enormous burden that it imposes on the public purse. Ultimately, there can be no rational justification for child imprisonment on the scale currently evident in England and Wales and, on this basis, a case is made for its abolition.
Leukemogenesis induced by wild-type and STI571-resistant BCR/ABL is potently suppressed by C/EBPα
Authors: Ferrari-Amorotti Giovanna , Keeshan Karen , Zattoni Michela , Guerzoni Clara , Iotti Giorgio , Cattelani Sara , Donato Nick J. , Calabretta Bruno
Published: May 2006

Chronic phase–to–blast crisis transition in chronic myelogenous leukemia (CML) is associated with differentiation arrest and down-regulation of C/EBPα, a transcription factor essential for granulocyte differentiation. Patients with CML in blast crisis (CML-BC) became rapidly resistant to therapy with the breakpoint cluster region–Abelson murine leukemia (BCR/ABL) kinase inhibitor imatinib (STI571) because of mutations in the kinase domain that interfere with drug binding. We show here that the restoration of C/EBPα activity in STI571-sensitive or -resistant 32D-BCR/ABL cells induced granulocyte differentiation, inhibited proliferation in vitro and in mice, and suppressed leukemogenesis. Moreover, activation of C/EBPα eradicated leukemia in 4 of 10 and in 6 of 7 mice injected with STI571-sensitive or -resistant 32D-BCR/ABL cells, respectively. Differentiation induction and proliferation inhibition were required for optimal suppression of leukemogenesis, as indicated by the effects of p42 C/EBPα, which were more potent than those of K298E C/EBPα, a mutant defective in DNA binding and transcription activation that failed to induce granulocyte differentiation. Activation of C/EBPα in blast cells from 4 patients with CML-BC, including one resistant to STI571 and BMS-354825 and carrying the T315I Abl kinase domain mutation, also induced granulocyte differentiation. Thus, these data indicate that C/EBPα has potent antileukemia effects even in cells resistant to ATP-binding competitive tyrosine kinase inhibitors, and they portend the development of anti-leukemia therapies that rely on C/EBPα activation.
JAK2V617F expression in murine hematopoietic cells leads to MPD mimicking human PV with secondary myelofibrosis
Authors: Lacout Catherine , Pisani Didier F. , Tulliez Micheline , Gachelin Françoise Moreau , Vainchenker William , Villeval Jean-Luc
Published: May 2006

A JAK2V617F mutation is frequently found in several BCR/ABL-negative myeloproliferative disorders. To address the contribution of this mutant to the pathogenesis of these different myeloproliferative disorders, we used an adoptive transfer of marrow cells transduced with a retrovirus expressing JAK2V617F in recipient irradiated mice. Hosts were analyzed during the 6 months after transplantation. For a period of 3 months, mice developed polycythemia, macrocytosis and usually peripheral blood granulocytosis. Transient thrombocytosis was only observed in a low-expresser group. All mice displayed trilineage hyperplasia in marrow and spleen along with an amplification of myeloid and erythroid progenitor cells and a formation of endogenous erythroid colonies. After 3 to 4 months, polycythemia regressed, abnormally shaped red blood cells and platelets were seen in circulation, and a deposition of reticulin fibers was observed in marrow and spleen. Development of fibrosis was associated with anemia, thrombocytopenia, high neutrophilia, and massive splenomegaly. These features mimic human polycythemia vera and its evolution toward myelofibrosis. This work demonstrates that JAK2V617F is sufficient for polycythemia and fibrosis development and offers an in vivo model to assess novel therapeutic approaches for JAK2V617F-positive pathologies. Questions remain regarding the exact contribution of JAK2V617F in other myeloproliferative disorders.
A novel mechanism for BCR-ABL action: stimulated secretion of CCN3 is involved in growth and differentiation regulation
Authors: McCallum Lynn , Price Susan , Planque Nathalie , Perbal Bernard , Pierce Andrew , Whetton Anthony D. , Irvine Alexandra E.
Published: May 2006

Chronic myeloid leukemia (CML) is characterized by the presence of the constitutively active BCR-ABL protein tyrosine kinase. Using a multipotent hemopoietic cell line, FDCP-Mix, expressing BCR-ABL tyrosine kinase, we investigated the initial effects of this kinase in primitive hematopoietic stem cells. We identified down-regulation of a novel gene, CCN3, as a direct consequence of BCR-ABL kinase activity. CCN3 has been reported to function as a tumor suppressor gene in solid tumors. Northern and Western blotting plus immunocytochemical analysis confirmed CCN3 expression is decreased and is tyrosine-phosphorylated in BCR-ABL kinase active FDCP-Mix cells. Decreased cellular CCN3 correlated with increased CCN3 secretion in BCR-ABL kinase active cells. In vitro treatment of human CML cell lines with imatinib or siRNA directed against BCR-ABL significantly reduced BCR-ABL while increasing CCN3 expression. Cells from patients responding to imatinib showed a similar decrease in BCR-ABL and increase in CCN3. CML CD34+ cells treated with imatinib in vitro demonstrated increased CCN3 protein. Transfecting CCN3 into BCR-ABL+ cells inhibited proliferation and decreased clonogenic potential. CCN3 plays an important role in internal and external cell-signaling pathways. Thus, BCR-ABL can regulate protein levels by governing secretion, a novel mechanism for this tyrosine kinase.
Construction of a nurse shark (Ginglymostoma cirratum) bacterial artificial chromosome (BAC) library and a preliminary genome survey
Authors: Luo Meizhong , Kim HyeRan , Kudrna Dave , Sisneros Nicholas B , Lee So-Jeong , Mueller Christopher , Collura Kristi , Zuccolo Andrea , Buckingham E Bryan , Grim Suzanne M , Yanagiya Kazuyo , Inoko Hidetoshi , Shiina Takashi , Flajnik Martin F , Wing Rod A , Ohta Yuko
Published: May 2006

Background

Sharks are members of the taxonomic class Chondrichthyes, the oldest living jawed vertebrates. Genomic studies of this group, in comparison to representative species in other vertebrate taxa, will allow us to theorize about the fundamental genetic, developmental, and functional characteristics in the common ancestor of all jawed vertebrates.

Aims

In order to obtain mapping and sequencing data for comparative genomics, we constructed a bacterial artificial chromosome (BAC) library for the nurse shark,Ginglymostoma cirratum.

Results

The BAC library consists of 313,344 clones with an average insert size of 144 kb, covering ~4.5 × 1010bp and thus providing an 11-fold coverage of the haploid genome. BAC end sequence analyses revealed, in addition to LINEs and SINEs commonly found in other animal and plant genomes, two new groups of nurse shark-specific repetitive elements, NSRE1 and NSRE2 that seem to be major components of the nurse shark genome. Screening the library with single-copy or multi-copy gene probes showed 6–28 primary positive clones per probe of which 50–90% were true positives, demonstrating that the BAC library is representative of the different regions of the nurse shark genome. Furthermore, some BAC clones contained multiple genes, making physical mapping feasible.

Conclusion

We have constructed a deep-coverage, high-quality, large insert, and publicly available BAC library for a cartilaginous fish. It will be very useful to the scientific community interested in shark genomic structure, comparative genomics, and functional studies. We found two new groups of repetitive elements specific to the nurse shark genome, which may contribute to the architecture and evolution of the nurse shark genome.
Chronic renal insufficiency among Asian Indians with type 2 diabetes: I. Role of RAAS gene polymorphisms
Authors: Prasad Pushplata , Tiwari Arun K , Kumar KM Prasanna , Ammini AC , Gupta Arvind , Gupta Rajeev , Sharma AK , Rao AR , Nagendra R , Chandra T Satish , Tiwari SC , Rastogi Priyanka , Gupta B Lal , Thelma BK
Published: May 2006

Background

Renal failure in diabetes is mediated by multiple pathways. Experimental and clinical evidences suggest that renin-angiotensin-aldosterone system (RAAS) has a crucial role in diabetic kidney disease. A relationship between the RAAS genotypes and chronic renal insufficiency (CRI) among type 2 diabetes subjects has therefore been speculated. We investigated the contribution of selected RAAS gene polymorphisms to CRI among type 2 diabetic Asian Indian subjects.

Methods

Twelve single nucleotide polymorphisms (SNPs) from six genes namely-renin (REN), angiotensinogen (ATG), angiotensin converting enzyme I (ACE), angiotensin II type 1 receptor (AT1) and aldosterone synthase (CYP11B2) gene from the RAAS pathway and one from chymase pathway were genotyped using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method and tested for their association with diabetic CRI using a case-control approach. Successive cases presenting to study centres with type 2 diabetes of ≥2 years duration and moderate CRI diagnosed by serum creatinine ≥3 mg/dl after exclusion of non-diabetic causes of CRI (n = 196) were compared with diabetes subjects with no evidence of renal disease (n = 225). Logistic regression analysis was carried out to correlate various clinical parameters with genotypes, and to study pair wise interactions between SNPs of different genes.

Results

Of the 12 SNPs genotyped, Glu53Stop in AGT and A>T (-777) in AT1 genes, were monomorphic and not included for further analysis. We observed a highly significant association of Met235Thr SNP in angiotensinogen gene with CRI (O.R. 2.68, 95%CI: 2.01–3.57 for Thr allele, O.R. 2.94, 95%CI: 1.88–4.59 for Thr/Thr genotype and O.R. 2.68, 95%CI: 1.97–3.64 for ACC haplotype). A significant allelic and genotypic association of T>C (-344) SNP in aldosterone synthase gene (O.R. 1.57, 95%CI: 1.16–2.14 and O.R. 1.81, 95%CI: 1.21–2.71 respectively), and genotypic association of GA genotype of G>A (-1903) in chymase gene (O.R. 2.06, 95%CI: 1.34–3.17) were also observed.

Conclusion

SNPs Met235Thr in angiotensinogen, T>C (-344) in aldosterone synthase, and G>A (-1903) in chymase genes are significantly associated with diabetic chronic renal insufficiency in Indian patients and warrant replication in larger sample sets. Use of such markers for prediction of susceptibility to diabetes specific renal disease in the ethnically Indian population appears promising.
Antenatal HIV testing in rural eastern Uganda in 2003: incomplete rollout of the prevention of mother-to-child transmission of HIV programme?
Authors: Karamagi Charles AS , Tumwine James K , Tylleskar Thorkild , Heggenhougen Kristian
Published: May 2006

Background

Uganda began to implement the prevention of mother-to-child transmission (PMTCT) of HIV programme in 2000, and by the end of 2003 it had expanded to cover 38 of the 56 districts including Mbale District. However, reports from Mbale Hospital showed that less than 10% of pregnant women accepted antenatal HIV testing. We therefore conducted a study to determine the proportion of pregnant women who tested for HIV and the gaps and barriers in PMTCT implementation.

Methods

The study was a cross sectional household survey of women aged 18 years or more, with children aged one year or less, who resided in Mbale Town or in the surrounding Bungokho County. We also conducted in-depth interviews with six health workers in Mbale Hospital.

Results

In 2003, we interviewed 457 women with a median age of 24 years. The prevalence of antenatal HIV testing was 10 percent. The barriers to antenatal HIV testing were unavailability of voluntary counselling and testing services (44%), lack of HIV counselling (42%) and perceived lack of benefits for HIV infected women and their infants. Primipara (OR 2.6, 95% CI 1.2–5.8), urban dwellers (OR 2.7, 95% CI 1.3–5.8), women having been counselled on HIV (OR 6.2, 95% CI 2.9–13.2), and women with husbands being their primary confidant (OR 2.3, 95% CI 1.0–5.5) were independently associated with HIV testing.

Conclusion

The major barriers to PMTCT implementation were unavailability of PMTCT services, particularly in rural clinics, and poor antenatal counselling and HIV testing services. We recommend that the focus of the prevention of mother-to-child transmission of HIV programme should shift to the district and sub-district levels, strengthen community mobilization, improve the quality of antenatal voluntary counselling and HIV testing services, use professional and peer counsellors to augment HIV counselling, and ensure follow-up care and support for HIV positive women and their infants.
High-throughput screening of cellulase F mutants from multiplexed plasmid sets using an automated plate assay on a functional proteomic robotic workcell
Authors: Hughes Stephen R , Riedmuller Steven B , Mertens Jeffrey A , Li Xin-Liang , Bischoff Kenneth M , Qureshi Nasib , Cotta Michael A , Farrelly Philip J
Published: May 2006

Background

The field of plasmid-based functional proteomics requires the rapid assay of proteins expressed from plasmid libraries. Automation is essential since large sets of mutant open reading frames are being cloned for evaluation. To date no integrated automated platform is available to carry out the entire process including production of plasmid libraries, expression of cloned genes, and functional testing of expressed proteins.

Results

We used a functional proteomic assay in a multiplexed setting on an integrated plasmid-based robotic workcell for high-throughput screening of mutants of cellulase F, an endoglucanase from the anaerobic fungus Orpinomyces PC-2. This allowed us to identify plasmids containing optimized clones expressing mutants with improved activity at lower pH. A plasmid library of mutagenized clones of the celF gene with targeted variations in the last four codons was constructed by site-directed PCR mutagenesis and transformed into Escherichia coli. A robotic picker integrated into the workcell was used to inoculate medium in a 96-well deep well plate, combining the transformants into a multiplexed set in each well, and the plate was incubated on the workcell. Plasmids were prepared from the multiplexed culture on the liquid handler component of the workcell and used for in vitro transcription/translation. The multiplexed expressed recombinant proteins were screened for improved activity and stability in an azo-carboxymethylcellulose plate assay. The multiplexed wells containing mutants with improved activity were identified and linked back to the corresponding multiplexed cultures stored in glycerol. Spread plates were prepared from the glycerol stocks and the workcell was used to pick single colonies from the spread plates, prepare plasmid, produce recombinant protein, and assay for activity. The screening assay and subsequent deconvolution of the multiplexed wells resulted in identification of improved CelF mutants and corresponding optimized clones in expression-ready plasmids.

Conclusion

The multiplex method using an integrated automated platform for high-throughput screening in a functional proteomic assay allows rapid identification of plasmids containing optimized clones ready for use in subsequent applications including transformations to produce improved strains or cell lines.
What Are the Etiology and Epidemiology of Out‐of‐hospital Pediatric Cardiopulmonary Arrest in Ontario, Canada?
Authors: Gerein Richard Bradley , Osmond Martin H. , Stiell Ian G. , Nesbitt Lisa P. , Burns Starla
Published: May 2006

Background:
Pediatric cardiopulmonary arrest (CPA) outside of the hospital has a very high mortality rate.

Objectives:
To evaluate the etiology and initial compromise of pediatric CPA cases in hopes of developing strategies to improve out‐of‐hospital resuscitation.

Methods:
The Ontario Prehospital Advanced Life Support (OPALS) study was a large multicenter initiative to evaluate the impact of emergency medical services (EMS) programs on 17 communities with 40,000 critically ill and injured patients who were older than 11 years. As part of this study, the authors conducted a retrospective observational cohort study that included all children younger than 18 years of age with out‐of‐hospital CPA, during an 11‐year period from 1991–2002. CPA was defined as patient being pulseless, apneic, and requiring chest compressions. Data were collected from ambulance call reports and centralized dispatch data and were reviewed by two independent investigators.

Results:
There were 503 children with CPA in the sample. Mean age was 5.6 years (range, 0–17 yr); 58.4% of patients were male, and 37.8% were younger than 1 year of age. Cardiopulmonary resuscitation (CPR) first was started by a bystander in 32.4% of cases, whereas 66.0% were unwitnessed arrests. Initial rhythms were asystole 77.2% of the time, pulseless electrical activity 16.4% of the time, and ventricular fibrillation or ventricular tachycardia 4% of the time. Annual incidence was 9.1/100,000 children. CPA was witnessed in 34.0% of cases; 80.7% of these were bystander‐witnessed, and 18.1% were EMS‐witnessed. Primary pathogenic cause of arrest was medical in 61.2% of cases, trauma in 37.2% of cases, and indeterminate in 1.6% of cases. Initial underlying physiologic compromise of witnessed arrests was judged to be respiratory in 39.8% of cases, sudden collapse (presumed electrical) in 16.4% of cases, progressive shock in 1.2% of cases, and indeterminate in 42.6% of cases. Presumed etiology was trauma, 37.6%; sudden infant death syndrome (SIDS), 20.3%; and respiratory disease, 11.6%, most commonly. Survival to hospital discharge was 2.0%.

Conclusions:
This is one of the largest population‐based, prospective cohorts of pediatric CPA reported to date, and it reveals that most pediatric arrests are unwitnessed and receive no bystander CPR. Those that are witnessed most often are caused by respiratory arrests or trauma. Trauma, SIDS, and respiratory disease are the most common etiologies overall. These data are vital to planning large resuscitation trials looking at specific interventions (i.e., increasing bystander CPR) and highlight the need for better strategies for prevention and early recognition.
Characteristics of Patients Who Leave Emergency Departments without Being Seen
Authors: Rowe Brian H. , Channan Peter , Bullard Michael , Blitz Sandra , Saunders L. Duncan , Rosychuk Rhonda J. , Lari Harris , Craig William R. , Holroyd Brian R.
Published: May 2006

Objectives:
Patients leaving the emergency department (ED) without being seen (LWBS) by a physician have become a growing concern in overcrowded EDs. The purpose of this study was to determine the acuity level, reasons, and outcomes of LWBS cases.

Methods:
LWBS patients (or their guardians) from two linked Canadian EDs (one adult, one pediatric), identified during 11 sampling periods of seven days' duration each, were contacted by telephone. Descriptive statistics are provided.

Results:
A total of 711 (4.5%) of 15,660 registered emergency patients left without being seen (50% male; median age, 33 years). Triage‐matched controls waited a median of 87 minutes before seeing a physician. Of the 711 LWBS cases, 512 (72%) were contacted and 498 agreed to participate. The most common major reason for leaving was “fed up with waiting” (44.8%). Overall, 60% of LWBS cases sought medical attention within one week; 14 patients were hospitalized, and one required urgent surgery. Triage level was not associated with the probability of subsequently seeking medical attention (61%, 61%, and 60% in triage levels 3, 4, and 5, respectively). Of the 198 (39%) who did not subsequently seek medical attention, 50 patients (26%) had been triaged as urgent and one patient died six days after ED registration.

Conclusions:
The most common reason for LWBS is impatience during peak ED periods. Many of these patients seek medical care within one week. Complications occurred rarely; however, “high‐risk” patients who leave without being seen do experience adverse health outcomes. Further research is required to examine ways to reduce LWBS cases.
Small Changes in Thyroxine Dosage Do Not Produce Measurable Changes in Hypothyroid Symptoms, Well-Being, or Quality of Life: Results of a Double-Blind, Randomized Clinical Trial
Authors: Walsh John P. , Ward Lynley C. , Burke Valerie , Bhagat Chotoo I. , Shiels Lauren , Henley David , Gillett Melissa J. , Gilbert Rhonda , Tanner Melissa , Stuckey Bronwyn G. A.
Published: May 2006

Context: In patients with primary hypothyroidism, anecdotal evidence suggests that well-being is optimized by fine adjustment of T4 dosage, aiming for a serum TSH concentration in the lower reference range. This has not been tested in a clinical trial.

Objective: Our objective was to test whether adjustment of T4 dosage aiming for a serum TSH concentration less than 2 mU/liter improves well-being compared with a serum TSH concentration in the upper reference range.

Design: We conducted a double-blind, randomized clinical trial with a crossover design.

Participants: Fifty-six subjects (52 females) with primary hypothyroidism taking T4 (≥100 μg/d) with baseline serum TSH 0.1–4.8 mU/liter participated.

Interventions: Each subject received three T4 doses (low, middle, and high in 25-μg increments) in random order.

Outcome Measures: Outcome measures included visual analog scales assessing well-being (the primary endpoint) and hypothyroid symptoms, quality of life instruments (General Health Questionnaire 28, Short Form 36, and Thyroid Symptom Questionnaire), cognitive function tests, and treatment preference.

Results: Mean (± sem) serum TSH concentrations were 2.8 ± 0.4, 1.0 ± 0.2, and 0.3 ± 0.1 mU/liter for the three treatments. There were no significant treatment effects on any of the instruments assessing well-being, symptoms, quality of life, or cognitive function and no significant treatment preference.

Conclusions: Small changes in T4 dosage do not produce measurable changes in hypothyroid symptoms, well-being, or quality of life, despite the expected changes in serum TSH and markers of thyroid hormone action. These data do not support the suggestion that the target TSH range for the treatment of primary hypothyroidism should differ from the general laboratory range.
Analyzing the Functional and Structural Consequences of Two Point Mutations (P94L and A368D) in the CYP11B1 Gene Causing Congenital Adrenal Hyperplasia Resulting from 11-Hydroxylase Deficiency
Authors: Krone Nils , Grischuk Yulia , Müller Marina , Volk Ruth Elisabeth , Grötzinger Joachim , Holterhus Paul-Martin , Sippell Wolfgang G. , Riepe Felix G.
Published: May 2006

Context: Congenital adrenal hyperplasia is a group of autosomal recessive inherited disorders of steroidogenesis. The deficiency of steroid 11-hydroxylase (CYP11B1) resulting from mutations in the CYP11B1 gene is the second most frequent cause.

Objective: We studied the functional and structural consequences of two CYP11B1 missense mutations, which were detected in a 1.8-yr-old boy with acne and precocious pseudopuberty, to prove their clinical relevance and study their impact on CYP11B1 function.

Results: The in vitro expression studies in COS-7 cells revealed an almost complete absence of CYP11B1 activity for the P94L mutant to 0.05% for the conversion of 11-deoxycortisol to cortisol. The A368D mutant severely reduced the CYP11B1 enzymatic activity to 1.17%. Intracellular localization studies by immunofluorescence revealed that the mutants were correctly localized. Introducing these mutations in a three-dimensional model structure of the CYP11B1 protein provides a possible explanation for the effects measured in vitro. We hypothesize that the A368D mutation interferes with structures important for substrate specificity and heme iron binding, thus explaining its major functional impact. However, according to structural analysis, we would expect only a minor effect of the P94L mutant on 11-hydroxylase activity, which contrasts with the observed major effect of this mutation both in vitro and in vivo.

Conclusion: Analyzing the in vitro enzyme function is a complementary procedure to genotyping and a valuable tool for understanding the clinical phenotype of 11-hydroxylase deficiency. This is the basis for accurate genetic counseling, prenatal diagnosis, and treatment. Moreover, the combination of in vitro enzyme function and molecular modeling provides valuable insights in cytochrome P450 structural-functional relationships, although one must be aware of the limitations of in silico-based methods.
Structure of Halo-toxin Produced by Phytopathogenic Bacterium, Pseudomonas syringae pv. mori
Authors: Kajimoto Tetsuya , Yokomizo Kazumi , Yahiro Kiyoshi , Umeda Toshiko , Shoji Shozo , Kubota Yukiho , Shibata Motoo , Takahashi Kokichi , Nohara Toshihiro
Published: May 2006

Halo-toxin was isolated from the incubated medium of pseudomonas syringae pv. mori which causes halo bright disease against the leaves of mulberry trees. The structure of this compound was revealed to be Pro-Phe-Pro-Gly-Pro-Ile by spectroscopic means and amino acid sequence analysis.
Redox System of Palladium–Trimethyl Ester of Coenzyme PQQ
Authors: Hirao Toshikazu , Murakami Toshihide , Ohno Mitsuru , Ohshiro Yoshiki
Published: May 2006

Trimethyl ester of coenzyme PQQ (PQQTME) and PdCl2 constitute an effective redox system on treatment with terminal olefin in DMF-H2O, which permits the PdCl2-PQQTME catalyzed Wacker oxidation reaction under oxygen.
Mechanism of Uranium Accumulation in the Kupferschiefer from Poland and Germany
Authors: Sun Yu-Zhuang , Jinxi Wang , Shifeng Li , Kankun Jin , Mingyue Lin
Published: May 2006

In order to investigate the mechanism of uranium accumulation in the Kupferschiefer, 88 samples from 10 sections were analysed by geochemical method. The results indicate that the higher uranium contents originated from and are transported from the underlying Rotliegendes into the Kupferschiefer by oxidized brines, and then precipitated when they encountered the organic matter, which occurred as reductant, in the Kupferschiefer.
Bearings for Noiseless Trains and to Protect Oil Platforms against Earthquakes
Authors: McClintock John
Published: May 2006

An elastomeric bearing is an elastic component that supports and guides the moving part of a machine or similar in conjunction with a static part, giving the moving part a certain freedom of movement by absorbing bumps and vibrations. They can be used to make high-speed trains noiseless and to protect oil platforms against earthquakes.
Moment Redistribution in RC Beams Retrofitted by Longitudinal Plating
Authors: Oehlers D. J. , Campbell L. , Haskett M. , Antram P. , Byrne R.
Published: May 2006

The ability to redistribute moment within a reinforced concrete frame or structure is an intrinsic requirement in design. This is generally dealt with using the established neutral axis depth factor, the ku approach, with fixed hinge lengths, which require the flexural member to fail by concrete crushing and which, in turn, requires large strains in the tension reinforcement. As longitudinally plated flexural members tend to fail by plate debonding or plate fracture before the concrete crushes, an alternative approach is presented which is based on variable hinge lengths, which can cope with beam failure at any tension reinforcement strain, and which can be applied to both longitudinally plated and unplated structures.
Determination of Equivalent Damping Relationships for Direct Displacement-Based Seismic Design Method
Authors: Li Yi-Hua , Wu Bo
Published: May 2006

The relationships between equivalent damping and ductility for the direct displacement-based seismic design (DBSD) method are proposed in the paper. First the concept of the DBSD is addressed to highlight the importance of the proper determination of equivalent damping. In the DBSD, the equivalent stiffness is taken as the secant stiffness at maximum deformation, so the appropriate equivalent damping should be determined based on such a prescription. Then various equivalent damping relationships proposed by different methods are outlined and the appropriate equivalent damping relationships for the DBSD are proposed with the aid of extensive dynamic time-history analyses of single-degree-of-freedom (SDOF) systems with different moderate hardening behavior. The influence of the hardening behavior on the equivalent damping would be reflected in the proposed relationships. Finally twenty-one SDOF systems are designed according to the DBSD procedure and analyzed to indicate that the proposed equivalent damping relationships are suitable for the DBSD.
Meta-Analysis of the Use of Rescue Antiemetics Following PONV Prophylactic Failure with 5-HT3 Antagonist/Dexamethasone Versus Single-Agent Therapies
Authors: Kovac Anthony L
Published: May 2006

Objective:

To assess the use of rescue antiemetic medication following 5-HT3 receptor antagonist (5-HT3RA) plus dexamethasone therapy versus monotherapy with a 5-HT3RA for prophylaxis of postoperative nausea and vomiting (PONV).

Data Sources:

Reports of randomized, controlled trials were identified via a MEDLINE search (1966–September 2005) using the key terms ondansetron, dolasetron, tropisetron, granisetron, 5-HT3, PONV, vomiting, emesis, and nausea.

Study Selection and Data Extraction:

Randomized, controlled trials of adult populations that had treatment arms comparing 5-HT3RA/dexamethasone combination therapy with 5-HT3RA or dexamethasone monotherapies versus placebo or 5-HT3RA versus dexamethasone or placebo were selected for analysis. Another criterion was that a proportion of patients required rescue medication 48 hours or less following surgery.

Data Synthesis:

Odds ratios (ORs) with 95% confidence interval were calculated to determine incidence rates for use of rescue medications within early (0–6 h), late (6–24 h), and overall (0–24 or 48 h) postoperative periods. Overall effect sizes were calculated by pooling ORs within fixed and random effects models.

Conclusions:

Prophylaxis with 5-HT3RA/dexamethasone was associated with lower use of rescue antiemetics than 5-HT3RA (ORpooled = 0.48; 95% CI 0.29 to 0.77) or dexamethasone (ORpooled = 0.26; 95% CI 0.12–0.57) monotherapy during the overall postoperative period. Insufficient data were available to assess rescue use during early or late postoperative periods. It appears that patients at high risk of PONV who are treated prophylactically with combination 5-HT3RA/dexamethasone therapy are overall less likely to require rescue medication than if treated with 5-HT3RAs or dexamethasone alone. Additional large prospective studies are needed to determine the optimal regimen and timing of administration of prophylactic antiemetic therapy for different surgical populations.
Meta-Analysis of the Safety of 5-HT3 Antagonists with Dexamethasone or Droperidol for Prevention of PONV
Authors: Leslie John B , Gan Tong J
Published: May 2006

Background:

Antiemetic guidelines recommend a combination of serotonin (5-HT3) with a second agent such as droperidol or dexamethasone. Physicians have been reluctant to employ these guidelines due to concerns over the black-box warning of droperidol and safety concerns with a steroid.

Objective:

To assess the safety profiles of 5-HT3 receptor antagonist (5-HT3RA) monotherapy and combination therapy with a steroid or droperidol for prophylaxis of postoperative nausea and vomiting (PONV).

Methods:

A MEDLINE search of English-language reports of randomized controlled trials (RCTs) was conducted (1966–September 2005) using the key terms 5-HT3, granisetron, ondansetron, dolasetron, tropisetron, PONV, postoperative, vomiting, emesis, and nausea. RCTs with treatment arms comparing 5-HT3RA monotherapy (granisetron, ondansetron, dolasetron, or tropisetron) with dexamethasone or droperidol or 5-HT3RA combinations and providing incidence data on adverse events were identified and reviewed. Within-study odds ratios with 95% confidence intervals were calculated to determine the incidence rates of all adverse events in RCTs using 5-HT3RA monotherapy and combination therapies. Overall effect sizes for frequently reported adverse events were estimated by pooling ORs using fixed- and random-effect models.

Results:

Pooled ORs (ORpooled) for adverse events with 5-HT3RA/dexamethasone versus 5-HT3RA for PONV prophylaxis were not significant for any reported adverse events or the overall incidence of adverse events; 5-HT3RA/droperidol versus 5-HT3RA was significant only for decreased headache incidence (fixed model: ORpooled 0.35; 95% CI 0.18 to 0.69). The ORpooled for 5-HT3RA/dexamethasone versus dexamethasone was not significant for any reported adverse events except headaches (fixed model ORpooled 1.75; 95% CI 1.01 to 3.03), none of which was serious. ORpooled for 5-HT3RA/droperidol versus droperidol was not significant for any reported adverse events. Avascular necrosis, occult infection, and delayed wound healing were not observed with either combination therapy. Cardiac abnormalities were observed with 5-HT3RA/droperidol therapy.

Conclusions:

This meta-analysis indicates that either therapy has a safety profile similar to that of dexamethasone, droperidol, or 5-HT3RA.
Comparison of Histopathologic Criteria and Skeletal Muscle Fixation Techniques for the Diagnosis of Polysaccharide Storage Myopathy in Horses
Authors: Firshman A. M. , Valberg S. J. , Bender J. B. , Annandale E. J. , Hayden D. W.
Published: May 2006

The purpose of the study reported here was to determine the effect of three methods of fixation of skeletal muscle biopsy specimens on the histopathologic appearance of muscle sections and to determine criteria that were most consistently associated with a diagnosis of polysaccharide storage myopathy (PSSM) in horses. Surgically excised semimembranosus muscle biopsy specimens were obtained from nine horses previously diagnosed with PSSM and from 15 control horses. Portions of each specimen were fixed in formalin, frozen immediately, and chilled for 24 hours prior to freezing. Sections stained with hematoxylin and eosin (HE), periodic acid-Schiff (PAS), and amylase-PAS were scored for histopathologic criteria by three investigators blinded to the sample origin. The presence of amylase-resistant, abnormal polysaccharide was found to be the most sensitive and specific diagnostic indicator for PSSM, and was readily detected regardless of the fixation technique or investigator. Other less-specific features associated with PSSM included atrophy and cytoplasmic and subsarcolemmal vacuoles; however, their histologic scores varied among fixation technique and investigators. Scores for subsarcolemmal and cytoplasmic amylase-sensitive glycogen in horses with PSSM were similar to those for control horses and varied among fixation techniques. In conclusion, PSSM is most accurately diagnosed in muscle biopsy specimens on the basis of appearance of amylase-resistant, abnormal polysaccharide, not amylase-sensitive glycogen, regardless of fixation technique. In general, frozen sections appeared to be better suited for studying myopathies because many histopathologic features of skeletal muscle were obscured by formalin fixation.
Intestinal Choristoma in the Subcutis of a Dog
Authors: Whitten K. A. , Belote D. A. , McLeod C. G.
Published: May 2006

A 2-year-old, spayed female, Labrador Retriever-cross presented with a subcutaneous mass of several weeks' duration in the right flank region. Surgical excision and histologic examination were performed. The 1.0-cm-diameter mass was circumscribed, unencapsulated, and cystic with a bilayer wall. The inner layer resembled intestinal mucosa, including a tall columnar lining epithelium, crypt-like glands containing scattered neuroendocrine cells that were strongly immunopositive for synaptophysin, and a supporting lamina propria-like fibrovascular tissue that contained lymphocytes and plasma cells. The outer layer was 1- to 2-mm thick and was composed of intersecting and blending bundles of smooth muscle and collagen. Given the presence of organized intestinal tissues in the subcutis, the lesion was consistent with intestinal choristoma.
Castelnuovo–Mumford regularity in biprojective spaces
Authors: Hoffman J. William , Wang Hao Hao
Published: May 2006

We define the concept of regularity for bigraded modules over a bigraded polynomial ring. In this setting we prove analogs of some of the classical results on m-regularity for graded modules over polynomial algebras.
Humor appreciation as an adaptive esthetic emotion
Authors: Weisfeld Glenn E
Published: May 2006

This article describes ethological analyses of the arts, and notes parallels between the arts and humor. Artists create novel, mentally challenging, informative stimulus arrays that exploit our evolved stimulus preferences. We appreciate these artistic offerings, and reward the artist. Similarly, jokes are informative, elegant, and appreciated. As in the arts and in primate social play, the humorist signals an intention to entertain and then provides the enriching experience. The recipient acknowledges this benefit, and returns the favor somehow; both parties gain in fitness. This explanation, that humor is edifying and mutually beneficial, is consistent with various features of humor and with evolutionary theory. For example, jokes often have a butt, from whom we can learn to avoid missteps. Similarly, jokes often pertain to fitness-salient topics such as sex. This theory is contrasted with other functional explanations. Research findings in neuroscience, genetics, and animal behavior are integrated with the theory.
Comedy theory and the postmodern
Authors: Pye Gillian
Published: May 2006

The “comic” and the “ironic” have been embraced by certain strands of contemporary literary theory as ambiguous, self-reflexive modes of expression that are particularly appropriate to the crisis of representation which characterizes the postmodern mood. This approach is implicitly based on an understanding of the comic as incongruity strategy and, following Freud, on the assumption that humor has important psychological functions. However, literary theory has been slow to integrate these two assumptions in an explicit manner and has not done enough to assimilate humor research in other areas of scholarship. Although the role of humor in interpersonal relationships is well documented in research in anthropology, linguistics or psychology, it is rarely applied systematically in analyses of the structural role of the comic in literary texts. At the same time, an over-reliance on the psychological dimensions of humor may produce a generalized approach that fails to take into account the specific nature of the comic as distinct from other modes of textual creativity. This can lead to a situation, typified by some postmodern criticism, in which the boundaries of the comic become undermined. This article critically examines theories by Susan Purdie, Jerry Flieger, and Jerry Palmer that exemplify some of these difficulties, but may also offer a means of conceiving of the comic in a more holistic manner.