bluuebunny/crossref_metadata_2025 huggingface dataset:
The Role of Soluble Adhesion Molecules and Cytokines in Sudden Sensorineural Hearing Loss
Authors: Haubner Frank , Martin Ludwig , Steffens Thomas , Strutz Jürgen , Kleinjung Tobias
Published: January 2011

Objective

The underlying pathology of sudden sensorineural hearing loss (SSNHL) is still not completely understood. Inflammatory and vascular factors are part of the present discussion. The aim of this study was to learn more about the possible role of adhesion molecules and cytokines in patients with SSNHL. These molecules are thought to contribute to endothelial dysfunction.

Study Design

Case‐control study with planned data collection.

Setting

Tertiary referral center.

Subjects and Methods

Blood samples of 35 patients presenting with SSNHL of more than 30 dB in at least 3 contiguous frequencies were compared to a gender‐ and age‐matched control group of normal‐hearing subjects. Levels of the soluble adhesion molecules intercellular adhesion molecule (ICAM‐1), vascular cell adhesion molecule 1 (VCAM‐1), endothelial selectin (E‐selectin), and concentration of interleukin 6 (IL‐6), interleukin 8 (IL‐8), and monocyte chemoattractant protein 1 (MCP‐1) were measured using established enzyme‐linked immunosorbent assays. These parameters as well as fibrinogen and lipid values were statistically analyzed.

Results

Levels of soluble ICAM‐1, VCAM‐1, E‐selectin, IL‐6, IL‐8, and MCP‐1 were not significantly elevated in patients with SSNHL. The clinical chemistry and hematologic determinations showed no significant differences between patients and control subjects.

Conclusion

This study revealed no association concerning SSNHL and typical vascular risk factors such as lipids and fibrinogen. Soluble adhesion molecules were not elevated in the SSNHL group. The role of endothelial dysfunction represented by increased levels of soluble adhesion molecules in the pathogenesis of SSNHL remains unclear. Further studies are necessary to elucidate the vascular etiology of SSNHL.
Sinonasal Evaluation Preceding Hematopoietic Transplantation
Authors: Moeller Carl W. , Martin James , Welch Kevin C.
Published: January 2011

Objective

To determine the efficacy of sinonasal evaluation preceding hematopoietic cell transplant (HCT) and to correlate pretransplant findings with subsequent risk of post‐HCT complications based on radiographic, endoscopic, and microbiologic findings.

Study Design

Case series with chart review.

Setting

Academic tertiary care center.

Subjects and Methods

Seventy‐one patients underwent pre‐HCT sinonasal evaluation. Pre‐HCT imaging and endoscopic exams were evaluated via standardized scales. Middle meatus culture results were also recorded. Pre‐HCT intervention was noted, as was any post‐HCT evaluation and intervention.

Results

Seventy‐one patients underwent pre‐HCT evaluation. Sixty‐five percent of patients were asymptomatic at the time of evaluation. On computed tomography (CT) imaging, the average Lund‐Mackay score was 2.2 ± 3.7. Mean endoscopic grading score was 0.6 ± 1.6. The majority of cultures grew commensal organisms only. Four of 71 patients (6%) had evidence of chronic rhinosinusitis pre‐HCT; 3 patients underwent endoscopic sinus surgery, and 1 patient was treated medically. None developed rhinosinusitis following HCT. Four different patients were evaluated for sinonasal symptoms post‐HCT. Two were diagnosed with acute rhinosinusitis: 1 was treated medically, and 1 was treated surgically. No patient developed invasive fungal sinusitis.

Conclusions

All patients who required pre‐HCT medical or surgical intervention had symptoms of rhinosinusitis and positive endoscopy and/or CT imaging. Two patients who developed acute rhinosinusitis post‐HCT had no evidence of rhinosinusitis during pre‐HCT evaluation. Evaluation and studies are costly, time‐consuming, and not found to be predictive in this study.
Minocycline Attenuates Ototoxicity and Enhances Antitumor Activity of Cisplatin Treatment In Vitro
Authors: Du Bo , Zhang Yan , Tang Yong , Wang Ping
Published: January 2011

Objective

Some agents have been shown to prevent cisplatin‐induced ototoxicity. The objective is to show that the agent minocycline protects the cochlea against cisplatin damage and enhances the cytotoxicity of anticancer therapies.

Study Design

In vitro chemotherapeutic assessments of minocycline.

Setting

Research laboratory.

Subjects and Methods

Hep‐2 cells were cultured with and without 100 µM cisplatin, and cell growth inhibition was assessed. Autophagy in the samples was visually evaluated by electron microscopy and by beclin‐1 expression using Western blotting. In another experiment, cochlear basilar membranes of 3‐day‐old rats were isolated and cultured. The cultures were treated with the same concentration of cisplatin or cisplatin combined with minocycline. Immunofluorescence staining was used to identify changes in spiral ganglions.

Results

Cell growth was inhibited in a dose‐dependent manner following minocycline treatment. Furthermore, the combination of cisplatin and minocycline effectively increased tumor cell death (P <. 01). Autophagosomes were also evident in cells treated with minocycline. Beclin‐l protein expression was increased after minocycline treatment in Hep‐2 cells. In an experiment evaluating cochlear spiral ganglion neuron survival, it was found that the number of surviving cochlear neurons significantly increased in the minocycline pretreatment group compared with the group treated with cisplatin alone (P <. 01).

Conclusion

This study shows that minocycline alone, or in combination with chemotherapeutic drugs, inhibits the growth of tumor cells and attenuates ototoxicity. It is also shown that minocycline activates cell autophagy via the beclin‐1 signaling pathway, which may be an additional underlying cause of Hep‐2 cell death.
Cough
Authors: Altman Kenneth W. , Irwin Richard S.
Published: January 2011

Both acute and chronic cough are responsible for a significant portion of all ambulatory medical visits annually, over‐the‐counter self‐medication expenses in excess of $3.6 billion in the United States, and impaired quality of life. Yet otolaryngologists only see a small portion of these patients. The diagnosis of cough can be simple or profoundly challenging, and it may be a sentinel indicator of severe underlying disease. The list of diseases that may induce cough is growing, along with an appreciation of their interrelations. These include upper and lower airway diseases, related through the unified airway concept. Gastroesophageal reflux, aspiration, neurologic reflexes, tumor, and systemic diseases are also important. Otolaryngologists are playing an increasingly valuable role in the multidisciplinary approach to these challenging cough patients and master many procedures associated with their evaluation and treatment. There are also leadership opportunities in building coordinated teams to further patient care.
Applying the Transtheoretical Model to Health Care Proxy Completion
Authors: Finnell Deborah S. , Wu Yow-Wu Bill , Jezewski Mary Ann , Meeker Mary Ann , Sessanna Loralee , Lee Jongwon
Published: January 2011

Background. For many, an important health decision is whether or not to document end-of-life wishes using an advance directive (e.g., health care proxy). To date, interventions targeting this health behavior have had little effect on increasing advance directive completion rates. Health behavior models, such as the transtheoretical model (TTM) could be useful for understanding the health decision-making processes used along a continuum, from no intention to complete an advance directive to completing one and discussing it with an appointed advocate. Purpose. To explore the applicability of the TTM for a previously understudied health behavior—completing a health care proxy (HCP). Method. Four established TTM measures for completing a HCP (stages of change, processes of change, decisional balance, and self-efficacy) were administered to 566 adults with coverage from 1 of 2 health insurance companies. Separate analyses of variance were used to test the relationships between the independent variable (stages of change) and dependent variables (processes of change, decisional balance, self-efficacy scores). Results. Consistent with other TTM research both the experiential and the behavioral processes of change revealed the lowest scores in the precontemplation stage peaking in the preparation stage. The pattern of pros and cons was replicated from previous TTM studies, with the 2 scores crossing over just prior to the preparation stage. Self-efficacy scores incrementally increased across the stages of change with the largest effect evident from the precontemplation to preparation stage. Conclusion. The models developed from this study can be used to guide the development of stage-based interventions for promoting health care proxy completion.
Clinical profile of cluster headaches in Japan: Low prevalence of chronic cluster headache, and uncoupling of sense and behaviour of restlessness
Authors: Imai Noboru , Yagi Nobuyasu , Kuroda Ryou , Konishi Takashi , Serizawa Masahiro , Kobari Masahiro
Published: January 2011

Introduction: This study examined the clinical profile of cluster headaches in Japan and the potential presence of features peculiar to Japan. Most previous studies of cluster headaches have focused on Caucasian populations.

Methods: Subjects comprised 86 consecutive new cluster headache patients (68 males, 18 females; mean age, 38.4 ± 12.2 years; range, 17–73 years). Mean age at onset was 31.0 years and the ratio of males to females was 3.8:1.

Results: Chronic cluster headache was observed in 3.5% of patients. More than half of patients (68.9%) reported feelings of restlessness during headache episodes and 42.9% reported restless behaviour. Patients with uncoupling of feelings of restlessness and restless behaviour forced themselves to keep still. Similar findings were reported in a Taiwanese study.

Conclusion: Japanese patients in this study showed a relatively low prevalence of chronic cluster headaches, and uncoupling of a sense of restlessness and restless behaviour. These features of cluster headache may be more common in Japanese and Taiwanese patients than in Caucasian patients.
Lack of correlation between vasodilatation and pharmacologically induced immediate headache in healthy subjects
Authors: Ashina Messoud , Tfelt-Hansen Peer , Dalgaard Peter , Olesen Jes
Published: January 2011

Background: The causal relationship between experimental headache and vasodilatation has not been fully clarified. In the present study, we combined headache and vascular data from eight experimental studies and conducted detailed statistical analyses. Given that substances used in all these experiments were vasodilators we examined a possible correlation between headache scores and increases in arterial diameter.

Methods: We identified nine studies and retrieved raw data in 89 healthy subjects (46 females, 43 males), mean age 27 years (range 18–59 years). The following variables were collected: maximal median headache intensity scores on a verbal rating scale (VRS) during immediate headache (0–120 minutes); the mean velocity of blood flow in the middle cerebral artery (VmeanMCA); and the diameter of the frontal branch of the superficial temporal artery (STA) during the maximal median headache intensity.

Results: The scatter plots show no relationship between maximal headache score and the relative changes in VmeanMCA and diameter of the STA. The main analyses of covariance showed a significant effect only of heart rate on headache ( p = .014). The interaction tests were insignificant for all variables.

Conclusions: The major outcome is a finding of no linear relationship between experimental immediate headache and dilatation of the MCA or STA.
Controversies in fumonisin mycotoxicology and risk assessment
Authors: Gelderblom WCA , Marasas WFO
Published: January 2011

Fusarium verticillioides causes several animal diseases and the contamination maize suggests that it could adversely affect human health. The fumonisin B mycotoxins were characterized from the fungal culture material and shown to be the causative principle responsible for the major mycotoxicological effects of the fungus in experimental and farm animals. The main focus was on the toxicological effects in rats and mice, the outcome of which played an important role in setting risk assessment parameters for exposure of the fumonisins to humans. The International Agency for Research on Cancer characterized the fumonisins as Group 2B carcinogens. Several controversial findings regarding the toxicological effects of the culture material of the fungus, the genotoxicity and carcinogenicity of pure fumonisin B1 (FB1) in rats have been reported that should be clarified prior to assessing the risk in humans. The underlying differences between the diets with the high protein levels are likely to sensitize the kidneys to FB1-induced toxic and carcinogenic effects. Several other dietary factors, such as plant extracts (antioxidants) and dietary Fe, could either stimulate or inhibit cancer induction of FB1, which complicates the comparison of toxicological effects in experimental animals. Cognisance should be taken of the modulating role of dietary constituents as it will determine the outcome of toxicological assays and determine the threshold of an adverse effect in a specific target organ to be used in determining risk assessment parameters.
Taming pension fund capitalism in Europe: collective and state regulation in times of crisis
Authors: Ebbinghaus Bernhard , Wiß Tobias
Published: January 2011

The recent financial crisis has led to major losses among many pension funds across Europe, showing the problems in shifting responsibility for old-age income to private actors without sufficient regulation. The impact of the crisis on pension funds and future retirement benefits depends on good governance and effective regulation. There is a large cross-national variation in pension fund capitalism and its regulation across Europe. We compare private supplementary pensions in six countries (Denmark, Germany, the Netherlands, Sweden, Switzerland and the UK) and analyse how these different systems have reacted to the crisis. Whereas higher contributions and delayed indexation may be temporary measures, more important are the long-term consequences for individuals, in particular the diminished rates of return leading to lower pensions. The sponsoring firms, pension funds, the social partners and the state therefore need to adapt investment strategies and strengthen the supervisory mechanisms.
Being a Qualitative Researcher
Authors: Holloway Immy , Biley Francis C.
Published: January 2011

This article, from a keynote address, is the result of some of the things which I learned about qualitative research during my many years of doing and teaching it. The main point I make is that qualitative researchers should present a good story which is based on evidence but focused on meaning rather than measurement. In qualitative inquiry, the researchers’ selves are involved, their experiences become a resource. Researchers cannot distance themselves from the other participants, although they cannot fully present their meaning and experience. I also discuss voice, paradigm, and innovation as potentially problematic issues in qualitative research. These are terms often used but not always examined for their meaning in qualitative inquiry. If researchers are aware and sensitive, rather than overemotional or self-absorbed, qualitative research can be enlightening, person-centered, and humanistic.
An Experimental Study of Mechanically Fastened Composite Joints with Clearance
Authors: Esendemir Ümran
Published: January 2011

In this article, the bearing strengths, failure modes, and joint geometries of woven glass-epoxy prepreg composite mechanically fastened joints with clearance subjected to preload moments were studied experimentally. Two different geometrical parameters were investigated. Therefore; the edge distance-to-pin diameter (E/d) and width-to-pin diameter (W/d) ratios were systematically varied and corresponding failure modes and loads were defined. The preload moments were selected as 0 and 2 Nm. The experiments were also carried out under a clearance for the diameters of the pin and the circular hole for 5 and 5.2 mm, respectively. Damage of specimens with clearance was examined using scanning electron microscope. The experimental results obtained from joints with clearance were compared with the earlier results that were not including clearance. It was observed that the effect of clearance on the bearing strength of mechanically fastened joints is significant. The failure loads of the composite joints with preload moment were larger than those of the composite joints without preload moment. Also, if geometrical parameters of mechanically fastened composite joints are varied, the failure modes and loads are strictly influenced from this variation.
Introducing English and German Versions of the Adolescent Time Attitude Scale
Authors: Worrell Frank C. , Mello Zena R. , Buhl Monika
Published: January 2011

In this study, the authors report on the development of English and German versions of the Adolescent Time Attitude Scale (ATAS). The ATAS consists of six subscales assessing Past Positive, Past Negative, Present Positive, Present Negative, Future Positive, and Future Negative time attitudes. The authors describe the development of the scales and present data on the reliability and structural validity of ATAS scores in samples of American ( N = 300) and German ( N = 316) adolescents. Internal consistency estimates for scores on the English and German versions of the ATAS were in the .70 to .80 range. Confirmatory factor analyses indicated that a six-factor structure yielded the best fit for scores and that the scores were invariant across samples.
Practical Insights on Expanding Nurse Practitioner’s Role During and Post Hospitalization in U.S. Health Care
Authors: Kumar Sameer , McKewan Gregory W.
Published: January 2011

Aim: The purpose of this study is to investigate expanding the role of nurses in the current U.S. health care system from the standpoint of nurse–patient interactions and nursing interventions to improve patient care and reduce overall health care costs. Background: Many failures in nurse–patient interactions in the hospital and in postrelease setting can be eliminated with different forms of patient-centered care that include patient education, support, and counseling. Method: This study makes use of extensive review of literature from academic databases to analyze increased Nurse Practitioner (NP) role in nurse–patient interactions during patients’ in-hospital experience and postrelease environment. Conclusions: Expanding the role of nurses would improve the overall health care system in the United States and save money over the long run. Long-term follow-up with patients would promote a healthier lifestyle and reduce the likelihood of return to the hospital. NPs are uniquely positioned to potentially serve as change agents within health care systems. Implications: Nursing educators and managers will need to work closely with policy makers to implement the expanded role of nurses to improve the U.S. health care system.
Evidence That Music Listening Reduces Preoperative Patients’ Anxiety
Authors: Lee Kwo-Chen , Chao Yu-Huei , Yiin Jia-Jean , Hsieh Hsin-Yi , Dai Wen-Jan , Chao Yann-Fen
Published: January 2011

Background: Patients often exhibit preoperative fear and anxiety that may influence the process of induction and recovery from anesthesia. Music is thought to be an alternative to medication for relief of fear and anxiety. Objectives: The purpose of the present study was to explore the feasibility of using heart rate (HR) variability (HRV) for evaluating the efficacy of music listening to relieve the patients’ anxiety during their stay in the operation room waiting area and to compare the HRV measures with subjective Visual Analogue Scale (VAS) scores. Methods: In total, 140 patients were randomly assigned to the experimental ( n = 64) or control group ( n = 76). The intervention consisted of a 10-min period of exposure to relaxing music delivered through headphones. Anxiety levels were measured by VAS (a 10-point scale) and 5 min of HRV monitoring before and after the music intervention. Results: The music group demonstrated significant reductions in VAS scores, mean HR, low-frequency HRV, and low- to high-frequency ratio and an increase in high-frequency HRV, while patients in the control group showed no changes. The subjective results of patients’ VAS anxiety scores were consistent with the objective results of HRV parameters. Conclusions: Listening to music can significantly lower the anxiety levels of patients before surgery. The frequency-domain parameters of HRV can be indicators for monitoring the change in anxiety level of preoperative patients.
Fatigue in multiple sclerosis is closely related to sleep disorders: a polysomnographic cross-sectional study
Authors: Veauthier C , Radbruch H , Gaede G , Pfueller CF , Dörr J , Bellmann-Strobl J , Wernecke K-D , Zipp F , Paul F , Sieb JP
Published: January 2011

Background: Sleep disorders can cause tiredness. The relationship between sleep disorders and fatigue in patients with multiple sclerosis (MS) has not yet been investigated systematically.

Objective: To investigate the relationship between fatigue and sleep disorders in patients with MS.

Methods: Some 66 MS patients 20 to 66 years old were studied by overnight polysomnography. Using a cut-off point of 45 in the Modified Fatigue Impact Scale (MFIS), the entire cohort was stratified into a fatigued MS subgroup ( n = 26) and a non-fatigued MS subgroup ( n = 40).

Results: Of the fatigued MS patients, 96% ( n = 25) were suffering from a relevant sleep disorder, along with 60% of the non-fatigued MS patients ( n = 24) ( p = 0.001). Sleep-related breathing disorders were more frequent in the fatigued MS patients (27%) than in the non-fatigued MS patients (2.5%). Significantly higher MFIS values were detected in all (fatigued and non-fatigued) patients with relevant sleep disorders (mean MFIS 42.8; SD 18.3) than in patients without relevant sleep disorders (mean MFIS 20.5; SD 17.0) ( p < 0.001). Suffering from a sleep disorder was associated with an increased risk of fatigue in MS (odds ratio: 18.5; 95% CI 1.6–208; p = 0.018).

Conclusion: Our results demonstrate a clear and significant relationship between fatigue and sleep disorders.
The Road to Murder: The Enduring Criminogenic Effects of Juvenile Confinement Among a Sample of Adult Career Criminals
Authors: DeLisi Matt , Hochstetler Andy , Jones- Johnson Gloria , Caudill Jonathan W. , Marquart James W.
Published: January 2011

In the juvenile justice literature, deep-end interventions such as commitment to a confinement facility are reserved for the most severe delinquents but unfortunately have been shown to have negative consequences. The current study repurposes juvenile confinement within a criminal career context to empirically examine its role in homicide offending based on data from a sample of 445 male, adult habitual criminals. Poisson regression models indicated that juvenile confinement— measured both dimensionally and categorically—predicted murder arrests despite controls for juvenile homicide offending, juvenile violent delinquency, juvenile felony adjudications, juvenile non-compliance violations, juvenile arrest charges, onset, age, three racial/ethnic classifications, career arrests, career violent index arrests, and career property index arrests. Receiver operating characteristics—area under the curve (ROC-AUC) graphs showed that juvenile confinement predicted murder significantly but modestly better than chance although career violent offending was the strongest predictor of murder perpetration.
Percentages, Process, and Patterns of HIV Disclosure Among the Spouses of HIV-Infected Men in South India
Authors: Suhadev Mohanarani , Mahadevan Udaya , Dilip Meenalochani , Suryanarayanan Devaraj , Sikhamani Rajasekaran , Thomas Beena
Published: January 2011

Most studies have described the outcome of HIV status disclosure rather than the process of disclosure. Hence, a study was conducted among 201 women who accompanied their spouses and children to 3 hospitals at Chennai and Vellore, Tamil Nadu, India, during January to June 2007. Majority of the respondents were sero-positive (69%) and marriage was the only risk factor for them. Of 201 women, 49% did not know the reason for their husbands’ HIV infection. Confidentiality of the patient was often breached during disclosure as family members were drawn into the process without consulting the patient. Only for 117 (50%) respondents, HIV diagnosis was disclosed directly by the health providers. There was a considerable delay for men in disclosing their HIV status to their spouses. Apart from the spouses, 122 (61%) shared their diagnosis with other family members. Disgrace to self and family (54%), fear of discrimination (27%), and fear of rejection (9%) were reported for nondisclosure.
Morbidity Profiles of People Living With HIV/AIDS in Urban and Rural Inpatient and Outpatient Settings in Karnataka, South India
Authors: Rose Jeremy M. , Washington Reynold , Krishnamurthy J. , Pise Gajanan , Perumpil Mathew , Gurnani Vandana , Moses Stephen
Published: January 2011

We examined the morbidity profiles associated with people living with HIV infection in an urban HIV inpatient treatment site near the city of Bangalore, in southern Karnataka state, south India, and in a rural outpatient site in northern Karnataka. Data from March 2007 until July 2008 were analyzed. The urban cohort comprised 432 patients, and the most common comorbid conditions were unexplained prolonged fever (50.2%) and oral candidiasis (42.6%). The rural cohort comprised 2374 patients, and the most common comorbid conditions were unexplained prolonged fever (58.8%), minor mucocutaneous infections (58.4%), and recurrent upper respiratory tract infections (52.3%). With less than 1% of patients in rural areas on treatment for tuberculosis (vs over one third in the urban cohort), tuberculosis is likely significantly underdiagnosed in rural areas. In addition, only 2.6% of rural outpatients who were eligible for antiretroviral treatment (ART), per Government of India guidelines, were actually on ART, compared to 31.6% of the urban population.
Safety, Tolerability, and Efficacy of Second-Line Generic Protease Inhibitor Containing HAART after First-Line Failure among South Indian HIV-Infected Patients
Authors: Kumarasamy N. , Venkatesh Kartik K. , Devaleenal Bella , Poongulali S. , Yepthomi Tokugha , Solomon Suniti , Flanigan Timothy P. , Mayer Kenneth H.
Published: January 2011

Introduction: We describe the safety, tolerability, and efficacy of protease inhibitor (PI) containing highly active antiretroviral therapy (HAART) among patients switching from nonnucleoside reverse transcriptase inhibitor (NNRTI)-based HAART from a clinical setting in South India. Methods: We assessed a prospective cohort of 91 HIV-infected patients with at least 12 months of clinical follow-up on second-line ritonavir-boosted PI-based therapy between August 2003 and December 2008. Results: More than three fourths of patients met the World Health Organization (WHO) criteria for immunological failure at the time of switch. The median time to switch was 758 days. Patients demonstrated consistent increases in their CD4 counts during the first 12 months, by which time the median CD4 count was 322 cells/mm3. The most common adverse events within the first year after switch were nausea (14.8%), lipodystrophy (10.4%), and peripheral neuropathy (7.0%). Patients switching to atazanavir (ATV)-based regimens compared to those switching to indinavir (IDV)-based regimens had similar immunological and clinical outcomes. Conclusions: Given the therapeutic success of using second-line PI-containing HAART after experiencing treatment failure, further efforts must be taken to expand access to second-line HAART so that more patients can benefit from these drugs.
Single-Boosted Protease Inhibitor versus Double-Boosted Protease Inhibitors for the Salvage Therapy in HIV-Infected Patients
Authors: Manosuthi Weerawat , Chimsuntorn Sukanya , Thongyen Supeda , Nilkamhang Samruay , Sungkanuparph Somnuek
Published: January 2011

Objective: To compare treatment outcomes between the regimens of single-boosted protease inhibitor (PI) and double-boosted PIs for the salvage therapy in patients who failed nonnucleoside reverse transcriptase inhibitor (NNRTI)-based regimens. Methods: A total of 64 patients from 2 cohorts, 40 in twice daily ritonavir-boosted lopinavir (LPV/r) at 400/100 mg plus lamivudine (3TC) and 24 in once daily ritonavir-boosted atazanavir and saquinavir (ATV/SQV/r) at 300/1600/100 mg/d, were studied. Results: At 48 weeks, 30 (75%) patients in LPV/r group and 20 (83%) patients in ATV/SQV/r group achieved HIV-1 RNA at <400 copies/mL (P = .790). In all, 24 (60%) and 16 (67%) achieved HIV-1 RNA at <50 copies/mL (P = .541). Low-level viral rebound (51-400 copies/mL) was found in 6 (15%) in LPV/r group and 4 (17%) in ATV/SQV/r group (P = 1.000). Medians CD4 counts were 336 cells/mm3 and 330 cells/mm3 in the corresponding groups (P = 0.937). Conclusion: No additional benefit is found with double-boosted PIs compared to single-boosted PI in terms of treatment responses in HIV-infected patients failing NNRTI-based regimen.
The Emergency Department as a Potential Intervention Recruitment Venue Among Vulnerable Rural Residents
Authors: Tarasenko Yelena N. , Schoenberg Nancy E. , Bennett Keisa L.
Published: January 2011

Meeting the health care needs of rural residents is complicated by their substantial medical burdens that frequently outstrip patient and community resources. Nowhere is this more evident than in central Appalachia. Preventive procedures are often sacrificed as patients and providers attend to more pressing medical issues. We report the results of a pilot study designed to explore the need for and appropriateness of a potential intervention placed in an emergency department (ED), with the eventual goal of using the ED to link traditionally underserved patients to preventive services. We used a convenience sample of 49 ED patients to explore their characteristics and health needs and compare them with a sample of 120 case management clients participating in the Kentucky Homeplace Program (KHP), and a general sample of 3,165 Appalachian Kentuckians. The recruited ED patients had low socio-economic status, numerous health conditions, and several unmet health needs, including need for colorectal, cervical, and breast cancer screening. Compared to their KHP counterparts, more ED patients were uninsured. Participants in the ED and KHP groups had particularly low income, were less educated, and had less insurance coverage than an average Appalachian resident. Although case management services, including the KHP have been successful in increasing access to health care by those in need, certain segments of the population remain underserved and continue to be missed by such programs. Our study suggests the need for and appropriateness of reaching out to such underserved populations in the ED and involving them into potential interventions designed to enhance preventive health services.
Spontaneous Hepatic Rupture Associated With HELLP Syndrome
Authors: Smyth Britt C.
Published: January 2011

Hepatic rupture is a rare complication of severe preeclampsia with few cases having been reported in the literature. Most liver hematomas with subcapsular rupture occur antenatally but can occur in the postpartum period as well. Liver hematomas are a serious complication of severe preeclampsia but can be managed conservatively if the patient is stable. Hepatic rupture is a medical emergency and can be fatal if not properly diagnosed and treated. Sonography is an effective means of aiding in the diagnosis. Surgical intervention with delivery of the fetus and hepatic repair is essential for survival.
Hoxb4-YFP reporter mouse model: a novel tool for tracking HSC development and studying the role of Hoxb4 in hematopoiesis
Authors: Hills David , Gribi Ruby , Ure Jan , Buza-Vidas Natalija , Luc Sidinh , Jacobsen Sten Eirik W. , Medvinsky Alexander
Published: January 2011

Hoxb4 overexpression promotes dramatic expansion of bone marrow (BM) hematopoietic stem cells (HSCs) without leukemic transformation and induces development of definitive HSCs from early embryonic yolk sac and differentiating embryonic stem cells. Knockout studies of Hoxb4 showed little effect on hematopoiesis, but interpretation of these results is obscured by the lack of direct evidence that Hoxb4 is expressed in HSCs and possible compensatory effects of other (Hox) genes. To evaluate accurately the pattern of Hoxb4 expression and to gain a better understanding of the physiologic role of Hoxb4 in the hemato-poietic system, we generated a knock-in Hoxb4–yellow fluorescent protein (YFP) reporter mouse model. We show that BM Lin−Sca1+c-Kit+ cells express Hoxb4-YFP and demonstrate functionally in the long-term repopulation assay that definitive HSCs express Hoxb4. Similarly, aorta-gonad-mesonephrous–derived CD45+CD144+ cells, enriched for HSCs, express Hoxb4. Furthermore, yolk sac and placental HSC populations express Hoxb4. Unexpectedly, Hoxb4 expression in the fetal liver HSCs is lower than in the BM, reaching negligible levels in some HSCs, suggesting an insignificant role of Hoxb4 in expansion of fetal liver HSCs. Hoxb4 expression therefore would not appear to correlate with the cycling status of fetal liver HSCs, although highly proliferative HSCs from young BM show strong Hoxb4 expression.
Functional architecture of Weibel-Palade bodies
Authors: Valentijn Karine M. , Sadler J. Evan , Valentijn Jack A. , Voorberg Jan , Eikenboom Jeroen
Published: January 2011

Weibel-Palade bodies (WPBs) are elongated secretory organelles specific to endothelial cells that contain von Willebrand factor (VWF) and a variety of other proteins that contribute to inflammation, angiogenesis, and tissue repair. The remarkable architecture of WPBs is because of the unique properties of their major constituent VWF. VWF is stored inside WPBs as tubules, but on its release, forms strikingly long strings that arrest bleeding by recruiting blood platelets to sites of vascular injury. In recent years considerable progress has been made regarding the molecular events that underlie the packaging of VWF multimers into tubules and the processes leading to the formation of elongated WPBs. Mechanisms directing the conversion of tightly packaged VWF tubules into VWF strings on the surface of endothelial cells are starting to be unraveled. Several modes of exocytosis have now been described for WPBs, emphasizing the plasticity of these organelles. WPB exocytosis plays a role in the pathophysiology and treatment of von Willebrand disease and may have impact on common hematologic and cardiovascular disorders. This review summarizes the major advances made on the biogenesis and exocytosis of WPBs and places these recent discoveries in the context of von Willebrand disease.
Volumetry: an alternative to assess therapy response for malignant pleural mesothelioma?
Authors: Frauenfelder T. , Tutic M. , Weder W. , Götti R.P. , Stahel R.A. , Seifert B. , Opitz I.
Published: January 2011

The purpose of our study was to assess robustness of volumetric measurement of malignant pleural mesothelioma (MPM) before and after chemotherapy to modified RECIST (response evaluation criteria in solid tumours) criteria.

30 patients with digitally available chest computed tomography (CT) scans before and after three cycles of chemotherapy were included. Three readers independently assessed tumour response using two different methods: 1) the modified RECIST criteria; and 2) the tumour volumetric approach using dedicated software (Myrian®; Intrasense, Paris, France). Inter-rater reliability of unidimensional and volumetric measurements was assessed using intraclass correlation. Tumour response classification for modified RECIST was compared to the volumetric approach applying unidimensional RECIST volumetric equivalent criteria.

The determination of unidimensional tumour measurement (RECIST) revealed a low inter-rater reliability (0.55) and a low interobserver agreement for tumour response classification (general κ 0.33). Only 14 patients were classified equally. A high inter-rater reliability (0.99) and interobserver agreement (general κ 0.9) were found for absolute tumour volumes (volumetric measurements). 27 cases were classified equally. The number of cases classified as “stable disease” was higher for the volumetric approach using tumour-equivalent criteria compared to modified RECIST.

Volumetric measurement of MPM on CT using Myrian® software is a reliable, reproducible and sensitive method to measure tumour volume and, thus, therapy response after induction chemotherapy.
Variation in hydrogen cyanide production between different strains ofPseudomonas aeruginosa
Authors: Gilchrist F.J. , Alcock A. , Belcher J. , Brady M. , Jones A. , Smith D. , Španĕl P. , Webb K. , Lenney W.
Published: January 2011

There is increasing interest in using the cyanogenic properties ofPseudomonas aeruginosato develop a nonmicrobiological method for its detection. Prior to this, the variation in cyanide production between differentP. aeruginosastrains needs to be investigated.

Hydrogen cyanide (HCN) released into the gas phase by 96 genotypedP. aeruginosasamples was measured using selected ion flow tube-mass spectrometry after 24, 48, 72 and 96 h of incubation. The HCN produced by a range of non-P. aeruginosacultures and incubated blank plates was also measured.

AllP. aeruginosastrains produced more HCN than the control samples, which generated extremely low levels. Analysis across all time-points demonstrated that nonmucoid samples produced more HCN than the mucoid samples (p=0.003), but this relationship varied according to strain. There were clear differences in the headspace HCN concentration for different strains. Multivariate analysis of headspace HCN for the commonest strains (Liverpool, Midlands_1 and Stoke-on-Trent, UK) revealed a significant effect of strain (p<0.001) and a borderline interaction of strain and phenotype (p=0.051).

This evidence confirms that allP. aeruginosastrains produce HCN but to varying degrees and generates interest in the possible future clinical applications of the cyanogenic properties ofP. aeruginosa.
Bisphenol A induces otolith malformations during vertebrate embryogenesis
Authors: Gibert Yann , Sassi-Messai Sana , Fini Jean-Baptiste , Bernard Laure , Zalko Daniel , Cravedi Jean-Pierre , Balaguer Patrick , Andersson-Lendahl Monika , Demeneix Barbara , Laudet Vincent
Published: January 2011

Background

The plastic monomer and plasticizer bisphenol A (BPA), used for manufacturing polycarbonate plastic and epoxy resins, is produced at over 2.5 million metric tons per year. Concerns have been raised that BPA acts as an endocrine disruptor on both developmental and reproductive processes and a large body of evidence suggests that BPA interferes with estrogen and thyroid hormone signaling. Here, we investigated BPA effects during embryonic development using the zebrafish and Xenopus models.

Results

We report that BPA exposure leads to severe malformations of the otic vesicle. In zebrafish and in Xenopus embryos, exposure to BPA during the first developmental day resulted in dose-dependent defects in otolith formation. Defects included aggregation, multiplication and occasionally failure to form otoliths. As no effects on otolith development were seen with exposure to micromolar concentrations of thyroid hormone, 17-ß-estradiol or of the estrogen receptor antagonist ICI 182,780 we conclude that the effects of BPA are independent of estrogen receptors or thyroid-hormone receptors. Na+/K+ ATPases are crucial for otolith formation in zebrafish. Pharmacological inhibition of the major Na+/K+ ATPase with ouabain can rescue the BPA-induced otolith phenotype.

Conclusions

The data suggest that the spectrum of BPA action is wider than previously expected and argue for a systematic survey of the developmental effects of this endocrine disruptor.
A general scenario of Hoxgene inventory variation among major sarcopterygian lineages
Authors: Liang Dan , Wu Riga , Geng Jie , Wang Chaolin , Zhang Peng
Published: January 2011

Background

Hox genes are known to play a key role in shaping the body plan of metazoans. Evolutionary dynamics of these genes is therefore essential in explaining patterns of evolutionary diversity. Among extant sarcopterygians comprising both lobe-finned fishes and tetrapods, our knowledge of theHoxgenes and clusters has largely been restricted in several model organisms such as frogs, birds and mammals. Some evolutionary gaps still exist, especially for those groups with derived body morphology or occupying key positions on the tree of life, hindering our understanding of howHoxgene inventory varied along the sarcopterygian lineage.

Results

We determined theHoxgene inventory for six sarcopterygian groups: lungfishes, caecilians, salamanders, snakes, turtles and crocodiles by comprehensive PCR survey and genome walking. VariableHoxgenes in each of the six sarcopterygian group representatives, compared to the humanHoxgene inventory, were further validated for their presence/absence by PCR survey in a number of related species representing a broad evolutionary coverage of the group. Turtles, crocodiles, birds and placental mammals possess the same 39Hoxgenes.HoxD12is absent in snakes, amphibians and probably lungfishes.HoxB13is lost in frogs and caecilians. Lobe-finned fishes, amphibians and squamate reptiles possessHoxC3.HoxC1is only present in caecilians and lobe-finned fishes. Similar to coelacanths, lungfishes also possessHoxA14, which is only found in lobe-finned fishes to date. OurHoxgene variation data favor the lungfish-tetrapod, turtle-archosaur and frog-salamander relationships and imply that the loss ofHoxD12is not directly related to digit reduction.

Conclusions

Our newly determinedHoxinventory data provide a more complete scenario for evolutionary dynamics ofHoxgenes along the sarcopterygian lineage. Limbless, worm-like caecilians and snakes possess similarHoxgene inventories to animals with less derived body morphology, suggesting changes to their body morphology are likely due to other modifications rather than changes toHoxgene numbers. Furthermore, our results provide basis for future sequencing of the entireHoxclusters of these animals.
Proteome sequence features carry signatures of the environmental niche of prokaryotes
Authors: Smole Zlatko , Nikolic Nela , Supek Fran , Šmuc Tomislav , Sbalzarini Ivo F , Krisko Anita
Published: January 2011

Background

Prokaryotic environmental adaptations occur at different levels within cells to ensure the preservation of genome integrity, proper protein folding and function as well as membrane fluidity. Although specific composition and structure of cellular components suitable for the variety of extreme conditions has already been postulated, a systematic study describing such adaptations has not yet been performed. We therefore explored whether the environmental niche of a prokaryote could be deduced from the sequence of its proteome. Finally, we aimed at finding the precise differences between proteome sequences of prokaryotes from different environments.

Results

We analyzed the proteomes of 192 prokaryotes from different habitats. We collected detailed information about the optimal growth conditions of each microorganism. Furthermore, we selected 42 physico-chemical properties of amino acids and computed their values for each proteome. Further, on the same set of features we applied two fundamentally different machine learning methods, Support Vector Machines and Random Forests, to successfully classify between bacteria and archaea, halophiles and non-halophiles, as well as mesophiles, thermophiles and mesothermophiles. Finally, we performed feature selection by using Random Forests.

Conclusions

To our knowledge, this is the first time that three different classification cases (domain of life, halophilicity and thermophilicity) of proteome adaptation are successfully performed with the same set of 42 features. The characteristic features of a specific adaptation constitute a signature that may help understanding the mechanisms of adaptation to extreme environments.
Complete genome sequencing and analysis of a Lancefield group G Streptococcus dysgalactiae subsp. equisimilis strain causing streptococcal toxic shock syndrome (STSS)
Authors: Shimomura Yumi , Okumura Kayo , Murayama Somay Yamagata , Yagi Junji , Ubukata Kimiko , Kirikae Teruo , Miyoshi-Akiyama Tohru
Published: January 2011

Background

Streptococcus dysgalactiaesubsp.equisimilis(SDSE) causes invasive streptococcal infections, including streptococcal toxic shock syndrome (STSS), as does Lancefield group AStreptococcus pyogenes(GAS). We sequenced the entire genome of SDSE strain GGS_124 isolated from a patient with STSS.

Results

We found that GGS_124 consisted of a circular genome of 2,106,340 bp. Comparative analyses among bacterial genomes indicated that GGS_124 was most closely related to GAS. GGS_124 and GAS, but not other streptococci, shared a number of virulence factor genes, including genes encoding streptolysin O, NADase, and streptokinase A, distantly related to SIC (DRS), suggesting the importance of these factors in the development of invasive disease. GGS_124 contained 3 prophages, with one containing a virulence factor gene for streptodornase. All 3 prophages were significantly similar to GAS prophages that carry virulence factor genes, indicating that these prophages had transferred these genes between pathogens. SDSE was found to contain a gene encoding a superantigen, streptococcal exotoxin type G, but lacked several genes present in GAS that encode virulence factors, such as other superantigens, cysteine proteasespeB, and hyaluronan synthase operonhasABC. Similar to GGS_124, the SDSE strains contained larger numbers of clustered, regularly interspaced, short palindromic repeats (CRISPR) spacers than did GAS, suggesting that horizontal gene transfer via streptococcal phages between SDSE and GAS is somewhat restricted, although they share phage species.

Conclusion

Genome wide comparisons of SDSE with GAS indicate that SDSE is closely and quantitatively related to GAS. SDSE, however, lacks several virulence factors of GAS, including superantigens, SPE-B and thehasABCoperon. CRISPR spacers may limit the horizontal transfer of phage encoded GAS virulence genes into SDSE. These findings may provide clues for dissecting the pathological roles of the virulence factors in SDSE and GAS that cause STSS.