bluuebunny/crossref_metadata_2025 huggingface dataset:
Pleural controversy: Pleurodesis versus indwelling pleural catheters for malignant effusions
Authors: MACEACHERN PAUL , TREMBLAY ALAIN
Published: May 2011

Malignant pleural effusions (MPE) are a common complication of advanced malignancy. The treatment of MPE should be focused on palliation of associated symptoms. The traditional approach to MPE has been to attempt pleurodesis by introducing a sclerosant into the pleural space. A more recent development in the treatment of MPE has been the use of indwelling pleural catheters (IPC) for ongoing drainage of the pleural space. Controversy exists as to which approach is superior. Pleurodesis approaches will have the advantage of a time‐limited course of treatment and high pleurodesis rate at the cost of a more invasive procedure requiring a general anaesthetic or conscious sedation (for thoracoscopic approaches) and an inpatient hospital stay. Use of IPC will allow the patient to be treated on an outpatient basis with a minimally invasive procedure, at the cost of long‐term need for catheter drainage and care. Symptom control appears similar between techniques. Complication rates between the two approaches cannot be easily compared, but studies suggest more frequent severe complications such as respiratory failure, arrhythmias and even mortality following pleurodesis, with infection rates similar between the two approaches. IPC will likely see increasing utilization in the future but patient preference and local resources and expertise will continue to play a significant part in treatment decisions. Randomized trials directly comparing the two approaches are needed and some are underway. Novel combination approaches utilizing both IPC and pleurodesis agents have the potential to further improve the care of these patients.
Outcome, risk, and error and the child with obstructive sleep apnea
Authors: Brown Karen A.
Published: May 2011

Adenotonsillectomy is the mainstay of treatment for pediatric obstructive sleep apnea syndrome (OSAS). However, there is evidence that the child with severe OSAS is at increased risk of respiratory compromise. The most difficult risk factor to assess is the severity of OSAS, and these difficulties are reviewed.
Disentangling the effects of geographic distance and environmental dissimilarity on global patterns of species turnover
Authors: Qian Hong , Ricklefs Robert E.
Published: May 2011

Aim  To distinguish the effects of geographic distance and environmental dissimilarity on global patterns of species turnover in four classes of terrestrial vertebrates (mammals, birds, reptiles and amphibians).

Location  Six hundred and sixty terrestrial ecoregions across the globe.

Methods  We calculated species turnover between each pair of ecoregions, using the Jaccard index (J). We selected seven variables to quantify environment in each ecoregion, and subjected the environmental values to a principal components analysis. For each realm, we applied multiple regression analysis relating the natural logarithm of the Jaccard index (lnJ) to geographic distance alone and in combination with differences in the environment variables measured as principal components (PC). We used partial correlations to partition variance in lnJ between unique contributions of distance and environmental PC scores, the covariation between distance and environment, and unexplained variance. To examine the latitude and species turnover relationship, we regressed lnJ on latitude with distance between ecoregions being included as a covariate.

Results  The natural logarithm of the Jaccard index (lnJ) decreased significantly with increasing geographic distance for all vertebrate classes in each zoogeographic realm, and the slopes of the relationships per 1000 km ranged from −0.251 to −1.043. With environmental differences included in the analysis, both geographic distance and environmental differences were substantial predictors of lnJ for every combination of taxon and realm. On average, the unique contribution of geographic distance to variation in species turnover between ecoregions was about 1.4 times that of the environmental differences between ecoregions. Species turnover generally decreased with increasing latitude when controlling for geographic distance. The value of lnJ for each vertebrate class was highly and positively correlated with those of the other vertebrate classes.

Main conclusions  Our analyses suggest that both dispersal‐based and niche‐based processes have played important roles in determining faunal similarities among vertebrate assemblages at the spatial scale examined. Furthermore, reptiles and amphibians exhibited greater distance‐independent faunal heterogeneity among ecoregions and greater turnover among ecoregions with respect to geographic and environmental distance than birds and mammals.
A NOTE ON ENDOGENOUS TIMING WITH STRATEGIC DELEGATION: UNILATERAL EXTERNALITY CASE
Authors: Choi Kangsik , Lu Yuanzhu
Published: May 2011

We investigate the endogenous choice of roles by managerial firms in the presence of unilateral externality. The choice over timing can be taken either by managers or by owners. It is shown that: (i) the choice of the timing by managers entails the same profit that owners would have achieved by specifying the timing in the delegation contract; and (ii) firms move simultaneously if the degree of unilateral externality is small, while sequentially if the degree of unilateral externality is large, with the firm generating unilateral externality as a follower; the owner of the follower firm delegates to restrict output, while his/her counterpart does not delegate it.
Facilitating the learning of all students: the ‘professional positive’ of inclusive practice in Australian primary schools
Authors: BOYLE CHRISTOPHER , SCRIVEN BROOKE , DURNING SARA , DOWNES CARISSA
Published: May 2011

This article considers the positive aspects of inclusion in Australian primary schools through a historical account of the nation's journey to adopting current policies and practices. The authors suggest that across the different states the picture is positive as there are clear attempts to make Australian schools as inclusive as possible. The importance of adequately resourcing schools to support teachers in the implementation of an inclusive environment is discussed as being second in importance to teacher attitudes to inclusion. The combination of these two factors has a direct influence on a school's ability to be effectively inclusive as it is the teacher at the ground level who must ensure inclusion is effective. As a result of improvements in teacher education programmes at universities, where inclusive education subjects are now compulsory, teaching in an inclusive environment is the ‘professional positive’ of teacher practice, which may potentially improve educational outcomes for all involved.
Spatio‐temporal smoothing and EM estimation for massive remote‐sensing data sets
Authors: Katzfuss Matthias , Cressie Noel
Published: May 2011

The use of satellite measurements in climate studies promises many new scientific insights if those data can be efficiently exploited. Due to sparseness of daily data sets, there is a need to fill spatial gaps and to borrow strength from adjacent days. Nonetheless, these satellites are typically capable of conducting on the order of 100,000 retrievals per day, which makes it impossible to apply traditional spatio‐temporal statistical methods, even in supercomputing environments. To overcome these challenges, we make use of a spatio‐temporal mixed‐effects model. For each massive daily data set, dimension reduction is achieved by essentially modelling the underlying process as a linear combination of spatial basis functions on the globe. The application of a dynamical autoregressive model in time, over the reduced space, allows rapid sequential computation of optimal smoothing predictions via the Kalman smoother; this is known as Fixed Rank Smoothing (FRS). The dimension‐reduced mixed‐effects model contains a number of unknown parameters, including covariance and propagator matrices, which describe the spatial and temporal dependence structure in the reduced‐dimensional process. We take an empirical‐Bayes approach to inference, which involves estimating the parameters and substituting them into the optimal predictors. Method‐of‐moments (MM) parameter estimation (currently used in FRS) is typically inefficient compared to maximum likelihood (ML) estimation and can result in large sampling variability. Here, we develop ML estimation via an expectation‐maximization (EM) algorithm, which offers stable computation of valid estimators and makes efficient use of spatial and temporal dependence in the data. The two parameter‐estimation approaches, MM and ML, are compared in a simulation study. We also apply our methodology to global satellite CO2 measurements: We optimally smooth the sparse daily CO2 maps obtained by the Atmospheric InfraRed Sounder (AIRS) instrument on the Aqua satellite; then, using FRS with EM‐estimated parameters, a complete sequence of the daily global CO2 fields can be obtained, together with their associated prediction uncertainties.
Influence of severity of the cutaneous manifestations and age on the prevalence of several cardiovascular risk factors in patients with psoriasis
Authors: Rosa D.J.F. , Machado R.F. , Matias F.A.T. , Cedrim S.D. , Noronha F.L. , Gaburri D. , Gamonal A.
Published: May 2011

Introduction  Psoriasis is a disease with proinflammatory state that has been associated with an increased risk of cardiovascular disease.

Method  This is a cross‐sectional, observational study, with analysis of 98 patients being treated for psoriasis. Several variables were analysed: gender, age, weight, height, Psoriasis Area and Severity Index (PASI), blood pressure, blood glucose, blood lipids, obesity, metabolic syndrome (MS) and Framingham score.

Results  Ninety‐eight patients were analysed (51 men; 52.0%). Age ranged from 12 years to 98 years. About 67% of the patients had dyslipidaemia, 14.3% had type 2 diabetes mellitus and 59.2% had systemic arterial hypertension. Forty‐four percentage of patients had the MS and 27.6% had a body mass index >30 kg/m2. The Psoriasis Area and Severiy Index were equal or over 10 in 27 patients, 18 of whom had dyslipidaemia (P = 0.929) and 14 of whom had the MS (P = 0.327). Seventy‐four patients were over the age of 40 years and, of these, 56 had dyslipidaemia (P = 0.002) and 41 had the MS (P < 0.001). For 89 patients, whose cardiovascular risk was calculated according to the Framingham criteria, 71.4% at high or moderate risk had a PASI below 10 (P = 0.945) and 100% at high or moderate risk were over the age of 40 years (P = 0.001).

Conclusion  There was strong evidence that psoriasis patients have an increased cardiovascular risk, chiefly those over the age of 40 years, probably because of the chronic inflammatory state. It seems that the severity of the cutaneous manifestations was not associated with a higher risk in these patients.
Effects of isotretinoin treatment on sleep in patients with severe acne: a pilot study
Authors: Ismailogullari S , Ferahbas A , Aksu M , Baydemir R , Utas S
Published: May 2011

Background  There are a few case reports in literature that isotretinoin treatment may alter sleep architecture. Also studies in mice suggest a role of retinoids in the contribution of delta oscillations to the sleep electroencephalography.

Objectives  The aim of this study was to investigate the effect of isotretinoin treatment on sleep architecture using polysomnography (PSG).

Patients and methods  Twelve severe acne vulgaris patients without any psychiatric and sleep disorders were treated with 0.5 mg/kg of isotretinoin. Clinician‐administered acne questionnaire, psychiatric examination, Epworth sleepiness scale and PSG recordings were performed after the first month of treatment.

Results  Sleep efficiency was increased from 83.5% (62.8–89.0%, quartiles) to 89.5% (81.5–93.5%, quartiles; P = 0.036) and sleep latency decreased from 18.0 min (11.1–36.3, quartiles) to 15.5 min (9.3–19.0, quartiles; P = 0.023) following 1‐month isotretinoin treatment. There were no significant changes in other sleep parameters of PSG and scores of Epworth sleepiness scale.

Conclusions  This study suggests that isotretinoin treatment slightly improves night‐time sleep without any effects on sleep stages and daytime sleepiness.
Alpha‐generation as basic response‐signature to transcranial magnetic stimulation (TMS) targeting the human resting motor cortex: A TMS/EEG co‐registration study
Authors: Veniero Domenica , Brignani Debora , Thut Gregor , Miniussi Carlo
Published: May 2011

The effects of repetitive transcranial magnetic stimulation (rTMS) on cortical excitability are usually inferred from indirect indexes, such as EMG responses. It has now become possible to directly evaluate rTMS impact by means of concurrent EEG recording. The aim of this study was to examine the modulation induced by high frequency rTMS (20 Hz) over left primary motor cortex on the ongoing oscillatory activity. Thirteen subjects underwent two sham and a real rTMS session while acquiring EEG. Event‐related desynchronization/synchronization was calculated for the α and β bands. rTMS induced a dose‐dependent increase in synchronization in both bands over central and parietal sites. The strongest effect found for the α band outlasted the end of the stimulation. Considering previous studies, our data suggest that α generation may represent an intrinsic induced response and a basic response signature to TMS targeting the human resting motor cortex.
NICE – impact on glaucoma case detection
Authors: Shah Shima , Murdoch Ian E
Published: May 2011

Citation information: Shah S & Murdoch IE. NICE – impact on glaucoma case detection. Ophthalmic Physiol Opt 2011, 31, 339–342. doi: 10.1111/j.1475‐1313.2011.00843.x

Aim:  To investigate the impact of publication of the National Institute of Clinical Excellence (NICE) guidelines (‘Glaucoma: diagnosis and management of chronic open angle glaucoma and ocular hypertension’) in April 2009, on the referrals for suspect glaucoma to Moorfields Community Eye Clinic (MCEC) at Ealing Hospital.

Methods:  The clinical data from all optometrist initiated referrals for suspect glaucoma and ocular hypertension were scrutinised by a Consultant Ophthalmologist for a 2 month period, 6 months after the publication of the NICE guidance. Each was then categorised into the following groups: glaucoma positive; glaucoma suspect; glaucoma negative; ocular hypertension (OHT) requiring further follow up in clinic; ocular hypertension to be followed up by community optometrist; other. The positive predictive value (PPV) was then calculated and a historical comparison made with previous studies.

Results:  A total of 110 new referrals were assessed during the collection period, which reflects a marked increase in numbers attending. However, there was no increase in absolute numbers of glaucoma and glaucoma suspects identified. The absolute numbers of ocular hypertensive patients rose. The PPV fell to 0.25, which is lower than found in previous studies.

Conclusions:  The rising number of new referrals and the unchanged absolute numbers of glaucoma and glaucoma suspects identified following publication of the NICE guidance, in addition to a lower PPV, makes us question what advantage in improved case detection this represents. Furthermore, is this a cost effective strategy? We believe the next step is to introduce a repeat review, with carefully considered clinical governance of any new scheme.
The short‐term influence of elevated intraocular pressure on axial length
Authors: Read Scott A , Collins Michael J , Annis‐Brown Teagan , Hayward Natasha M , Lillyman Kate , Sherwin Drew , Stockall Patrick
Published: May 2011

Citation information: Read SA, Collins MJ, Annis‐Brown T, Hayward NM, Lillyman K, Sherwin D & Stockall P. The short‐term influence of elevated intraocular pressure on axial length.Ophthalmic Physiol Opt2011,31, 398–403. doi: 10.1111/j.1475‐1313.2011.00845.x

Purpose: To investigate the influence of a short period of elevated IOP (induced through the wearing of standard swimming goggles) upon axial length.

Methods: Forty young adult subjects (20 myopes and 20 emmetropes, mean age 22 ± 2 years) had their IOP and axial length measured before, during and after a 3 min period of swimming goggle wear. IOP was measured using a non‐contact tonometer, and axial length with an optical biometer based upon the principle of partial coherence interferometry.

Results: A 3‐min period of swimming goggle wear was found to be associated with a significant increase in IOP (mean change 3.7 ± 2.6 mmHg,p < 0.0001) and a significant axial elongation of the eye (mean change in axial length of 18 ± 12 μm,p < 0.0001). Both IOP and axial length were found to return to baseline levels upon removal of the swimming goggles. A significant positive association was found between the changes in IOP and axial length (r2 = 0.37,p < 0.0001). There were no significant differences between the emmetropic and myopic subjects in terms of their magnitude of change in axial length and IOP during swimming goggle wear.

Conclusions: A small magnitude of elevation in IOP, induced through mechanical means and imposed for a short period of time was associated with a small but statistically significant axial elongation of the eye.
TRANSPORT AND SUBSISTENCE PATTERNS AT THE TRANSITION TO PASTORALISM, KOOBI FORA, KENYA
Authors: NDIEMA K. E. , DILLIAN C. D. , BRAUN D. R. , HARRIS J. W. K. , KIURA P. W.
Published: May 2011

The Turkana Basin in Kenya has an extensive record of Holocene activities relating to mobility and economy of foraging and herding communities. Obsidian is only known from a few key localities in northern Kenya. As such, the use of obsidian as a toolstone material, commonly used during the mid‐Holocene, provides one way to trace exchange, interaction and population movements during the transition to pastoralism. We employ X‐ray fluorescence to characterize obsidian artefacts from four Pastoral Neolithic assemblages. Data reveal a highly mobile and diversified population that used watercraft to access and transport obsidian resources. Specifically, the use of the North Island obsidian source in Lake Turkana indicates that boat use was significant during this transitional period. The incorporation of watercraft transport and aquatic resources in our analyses of Pastoral Neolithic sites affords a greater understanding of subsistence, mobility and economy in this important period in East African prehistory.
IDENTIFYING AND CLASSIFYING VEIN QUARTZ ARTEFACTS: AN EXPERIMENT CONDUCTED AT THE WORLD ARCHAEOLOGICAL CONGRESS, 2008
Authors: DRISCOLL K.
Published: May 2011

Worldwide, vein quartz was used as a raw material for stone tools, and in many regions quartz was the dominant raw material, if not the only raw material. While using quartz was not necessarily problematic for the communities in question, and was often preferred over other materials, the ‘problem’ with quartz is for archaeologists attempting to analyse the material, especially with coarse‐grained quartz. This paper presents the results of a quartz recognition experiment conducted on volunteer participants at the 2008 World Archaeological Congress (WAC) conference held in Dublin, Ireland. The results have shown that the identification and classification of vein quartz artefacts is particularly challenging, even for analysts with substantial experience in quartz artefact analysis.
Methylene blue inhibits function of the 5‐HT transporter
Authors: Oz Murat , Isaev Dmytro , Lorke Dietrich E , Hasan Muhammed , Petroianu Georg , Shippenberg Toni S
Published: May 2011

BACKGROUND AND PURPOSE Methylene blue (MB) is commonly employed as a treatment for methaemoglobinaemia, malaria and vasoplegic shock. An increasing number of studies indicate that MB can cause 5‐HT toxicity when administered with a 5‐HT reuptake inhibitor. MB is a potent inhibitor of monoamine oxidases, but other targets that may contribute to MB toxicity have not been identified. Given the role of the 5‐HT transporter (SERT) in the regulation of extracellular 5‐HT concentrations, the present study aimed to characterize the effect of MB on SERT.

EXPERIMENTAL APPROACH Live cell imaging, in conjunction with the fluorescent SERT substrate 4‐(4‐(dimethylamino)‐styryl)‐N‐methylpyridinium (ASP+), [3H]5‐HT uptake and whole‐cell patch‐clamp techniques were employed to examine the effects of MB on SERT function.

KEY RESULTS In EM4 cells expressing GFP‐tagged human SERT (hSERT), MB concentration‐dependently inhibited ASP+ accumulation (IC50: 1.4 ± 0.3 µM). A similar effect was observed in N2A cells. Uptake of [3H]5‐HT was decreased by MB pretreatment. Furthermore, patch‐clamp studies in hSERT expressing cells indicated that MB significantly inhibited 5‐HT‐evoked ion currents. Pretreatment with 8‐Br‐cGMP did not alter the inhibitory effect of MB on hSERT activity, and intracellular Ca2+ levels remained unchanged during MB application. Further experiments revealed that ASP+ binding to cell surface hSERT was reduced after MB treatment. In whole‐cell radioligand experiments, exposure to MB (10 µM; 10 min) did not alter surface binding of the SERT ligand [125I]RTI‐55.

CONCLUSIONS AND IMPLICATIONS MB modulated SERT function and suggested that SERT may be an additional target upon which MB acts to produce 5‐HT toxicity.
Ligand binding and activation of the secretin receptor, a prototypic family B G protein‐coupled receptor
Authors: Miller Laurence J , Dong Maoqing , Harikumar Kaleeckal G
Published: May 2011

The secretin receptor is a prototypic member of family B G protein‐coupled receptors that binds and responds to a linear 27‐residue peptide natural ligand. The carboxyl‐terminal region of this peptide assumes a helical conformation that occupies the peptide‐binding cleft within the structurally complex disulphide‐bonded amino‐terminal domain of this receptor. The amino terminus of secretin is directed toward the core helical bundle domain of this receptor that seems to be structurally distinct from the analogous region of family A G protein‐coupled receptors. This amino‐terminal region of secretin is critical for its biological activity, to stimulate Gs coupling and the agonist‐induced cAMP response. While the natural peptide ligand is known to span the two key receptor domains, with multiple residue‐residue approximation constraints well established, the orientation of the receptor amino terminus relative to the receptor core helical bundle domain is still unclear. Fluorescence studies have established that the mid‐region and carboxyl‐terminal end of secretin are protected by the receptor peptide‐binding cleft and the amino terminus of secretin is most exposed to the aqueous milieu as it is directed toward the receptor core, with the mid‐region of the peptide becoming more exposed upon receptor activation. Like other family B peptide hormone receptors, the secretin receptor is constitutively present in a structurally specific homo‐dimeric complex built around the lipid‐exposed face of transmembrane segment four. This complex is important for facilitating G protein association and achieving the high affinity state of this receptor.

LINKED ARTICLES This article is part of a themed section on Secretin Family (Class B) G Protein‐Coupled Receptors. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2012.166.issue‐1
The massacre of St Bartholomew on the English stage: Chapman, Marlowe, and the Duke of Guise
Authors: MCINTOSH SHONA
Published: May 2011

This article considers a passage in George Chapman's The Revenge of Bussy D'Ambois in which the hero of the play defends his patron, the Duke of Guise, for his participation in the St Bartholomew's Day Massacre. Investigating why Chapman would have his protagonist make such a controversial utterance, it argues that he was responding to earlier reports of the same period in news‐books, pamphlets, Marlowe's Massacre at Paris and his own earlier tragedy Bussy D'Ambois. It is suggested that the faction of Clermont and the Guise consistently voices opinions that might be understood in light of Andrew Hadfield's description of literary republicanism. Therefore, Chapman's reminder to the audience is part of an ongoing attempt to construct a double vision of the Guise: from one perspective he is an admirable character who virtuously resists a tyrannical monarch, but on the other hand echoes of his villainous reputation remain, as a defensive strategy on Chapman's part, to prevent him clashing with censors over the political opinions expressed by this character. Finally, the article suggests that this play constitutes a cautionary warning to Prince Henry not to heed the pro‐war voices urging him to attack Catholic Europe.
Immune‐mediated epilepsies
Authors: Granata Tiziana , Cross Helen , Theodore William , Avanzini Giuliano
Published: May 2011

A pathogenic role of immunity in epilepsies has long been suggested based on observations of the efficacy of immune‐modulating treatments and, more recently, by the finding of inflammation markers including autoantibodies in individuals with a number of epileptic disorders. Clinical and experimental data suggest that both innate and adaptive immunity may be involved in epilepsy. Innate immunity represents an immediate, nonspecific host response against pathogens via activation of resident brain immune cells and inflammatory mediators. These are hypothesized to contribute to seizures and epileptogenesis. Adaptive immunity employs activation of antigen‐specific B and T lymphocytes or antibodies in the context of viral infections and autoimmune disorders. In this article we critically review the evidence for pathogenic roles of adaptive immune responses in several types of epilepsy, and discuss potential mechanisms and therapeutic targets. We highlight future directions for preclinical and clinical research that are required for improved diagnosis and treatment of immune‐mediated epilepsies.
Autoantibodies and epilepsy
Authors: Bien Christian G. , Scheffer Ingrid E.
Published: May 2011

In a substantial number of patients with epilepsy, the etiology of the seizure disorder remains unknown. In recent years, the detection of autoantibodies has contributed to the etiologic understanding of a substantial number of so far unexplained epilepsies. The associated syndromes are mainly related to the temporal lobes (with presentation as limbic encephalitis or chronic mediotemporal lobe epilepsy) or to extended brain areas (presenting as diffuse encephalopathies with seizures). However, the full spectrum of autoantibody‐associated epilepsies is about to be determined. A promising example for this incipient expansion of the clinical spectrum is the description of a novel seizure type found in patients with antibodies to the voltage‐gated potassium channel (VGKC) complex. At present, the antibodies most relevant in epileptology are those directed to molecules on the surface of neurons, namely to components of the VGKC complex and to the N‐methyl‐d‐aspartate‐receptor; other antigenic targets located on the surface of neurons are the γ‐aminobutyric acid (GABA)B‐receptor and the α‐amino‐3‐hydroxy‐5‐methyl‐4‐isoxazolepropionic acid (AMPA)‐receptor. There are several reasons to believe that these antibodies are directly pathogenic to the brain. Other autoantibodies target intracellular antigens like those directed to the enzyme glutamic acid decarboxylase (GAD) and the onconeural antibodies. Most researchers think that these antibodies are markers of the immunopathological process rather than being pathogenically active by themselves. Especially the epilepsies associated with antibodies to surface antigens seem to respond to immunotherapies. This offers novel promising therapeutic avenues for the epileptologist. The precise pathogenic effects of autoantibodies still need to be elucidated.
Immuno‐ and antiinflammatory therapies in epileptic disorders
Authors: Özkara Çiğdem , Vigevano Federico
Published: May 2011

Several experimental and clinical studies demonstrated an immunologic basis for different forms of epilepsy. A wide range of immune abnormalities have been reported suggesting the existence of various subtypes of epileptic syndromes with different immunopathogenetic mechanisms. This evidence gives rise to the development of immunologic and immunomodulatory treatments such as usage of steroids, plasmapheresis, and intravenous immunoglobulins, which will be discussed briefly in this article.
Internal Fixation of a Fractured Axis in an Adult Horse
Authors: Gygax D. , Fürst A. , Picek S. , Kummer M.
Published: May 2011

Objective:To report internal fixation of a fractured axis with a dynamic compression plate (DCP).

Study Design:Case report.

Animals:A 7‐year‐old Warmblood gelding.

Method:Surgery was performed under anesthesia in sternal recumbency. After fracture reduction the complete transverse fracture in the cranial third of the axis was stabilized with a 7‐hole 4.5 mm DCP. Optimal positioning of the plate and the length of the screws were facilitated by fluoroscopy. Recovery from anesthesia was supervised in a pool.

Results:The horse had an excellent outcome and returned to its previous activity level.

Conclusion:Surgical treatment with fracture reduction and plate fixation enables normal bearing of the head and neck and improves neck flexibility soon after surgery.
Transfusion medicine in American undergraduate medical education
Authors: Karp Julie K. , Weston Christine M. , King Karen E.
Published: May 2011

BACKGROUND: Blood transfusion is the most common procedure performed in American hospitals, and transfusions are commonly ordered by physicians without formal training in transfusion medicine. Several transfusion medicine curricula have been proposed, including those developed through the Transfusion Medicine Academic Awards (TMAA). To our knowledge, no comprehensive study has assessed how transfusion medicine is incorporated into undergraduate medical education.

STUDY DESIGN AND METHODS: We conducted an online survey to determine the manner in which transfusion medicine is incorporated into American undergraduate medical education. The survey was e‐mailed to administrators of medical education at all of the 129 American medical schools accredited by the Association of American Medical Colleges.

RESULTS: Eighty‐six (67%) of the 129 identified medical school administrators responded. Seventy‐one (83%) of the 86 administrators reported that their undergraduate medical education curriculum provides didactic lectures in transfusion medicine, with 48% of medical schools providing 1 or 2 hours of lecture‐based instruction. A minority reported small group sessions devoted to transfusion medicine topics. While a slim majority reported the availability of transfusion medicine electives, only one of 84 administrators reported that such a rotation is required. Seventy‐six of 83 (92%) administrators were unfamiliar with either the 1989 or the 1995 TMAA transfusion medicine curricula.

CONCLUSION: Transfusion medicine content in American undergraduate medical education is variable and the influence of the TMAA program on contemporary medical school curricula is questionable. Future efforts in this area should focus on standardizing and improving undergraduate medical education in transfusion medicine.
Phase Stability oft′‐Zirconia‐Based Thermal Barrier Coatings: Mechanistic Insights
Authors: Krogstad Jessica A. , Krämer Stephan , Lipkin Don M. , Johnson Curtis A. , Mitchell David R. G. , Cairney Julie M. , Levi Carlos G.
Published: May 2011

The temperature capability of yttria‐stabilized zirconia thermal barrier coatings (TBCs) is ultimately tied to the rate of evolution of the “nontransformable”t′ phase into a depleted tetragonal form predisposed to the monoclinic transformation on cooling. Thet′ phase, however, has been shown to decompose in a small fraction of the time necessary to form the monoclinic phase. Instead, a modulated microstructure consisting of a coherent array of Y‐rich and Y‐lean lamellar phases develops early in the process, with mechanistic features suggestive of spinodal decomposition. Coarsening of this microstructure leads to loss of coherency and ultimately transformation into the monoclinic form, making the kinetics of this process, and not the initial decomposition, the critical factor in determining the phase stability of TBCs. Transmission electron microscopy is shown to be essential not only for characterizing the microstructure but also for proper interpretation of X‐ray diffraction analysis.
Combinatorial Nanopowder Synthesis Along the ZnO–Al2O3Tie Line Using Liquid‐Feed Flame Spray Pyrolysis
Authors: Kim Min , Lai Samson , Laine Richard M.
Published: May 2011

Liquid‐feed flame spray pyrolysis (LF‐FSP) of mixtures of alumatrane [Al(OCH2CH2)3N]/zinc acetate dihydrate [Zn(O2CCH3)2·2(H2O)] or zinc propionate [Zn(O2CCH2CH3)2]/aluminum acetylacetonate [Al(Acac)3] dissolved in EtOH in known molar ratios can be used to combinatorially generate nanopowders along the ZnO–Al2O3tie‐line. LF‐FSP was used to produce (ZnO)x(Al2O3)1−xpowders withx=0–1.0. Powders were characterized by X‐ray diffraction, scanning electron microscopy, transmission electron microscopy, Fourier transform infrared, thermal gravimetric analysis, differential thermal analysis, and BET. The resulting powders had average particle sizes (APSs) <100 nm with the majority being <50 nm. Analytical data suggest that at concentrations of interest for transparent conducting oxides, <10 mol% Al2O3the particle morphologies are combinations of plates and rods that grow withc/aratios close to 1. The spinel phase dominates at (ZnO)x(Al2O3)1−x(x=0.5 and 0.3). In the latter case, the currently accepted phase diagram for the ZnO–Al2O3couple indicates that phase separation should occur to form zinc spinel (ZnAl2O4) and α‐alumina. It appears that the rapid quenching during LF‐FSP helps to preserve the spinel phase at ambient temperature giving rise to kinetic nanopowder products along the ZnO2–Al2O3tie‐line. Finally, the solubility of ZnO in Al2O3and vice versa in the materials produced by LF‐FSP suggest apparent flame temperatures reached before quenching are 1700°–1800°C. Efforts to re‐pass the spinel phase powders, (ZnO)x(Al2O3)1−x,x=0.5 and 0.3 through the LF‐FSP system were made with the hope of generating core shell materials. However, instead thex=0.5 material generated materials closer to thex=0.3 composition and pure ZnO nanoparticles that coat the former materials. These results suggest that at LF‐FSP flame temperatures ZnO remains in the vapor phase for sufficient times that Al3+oxy‐ions generated promote nucleation of finer particles leaving essentially phase pure ZnO still in the vapor phase to condense giving the two distinct particle morphologies observed.
Excretion patterns of large and small proteins in pre‐eclamptic pregnancies
Authors: KRONBORG CAMILLA , VITTINGHUS ERIK , ALLEN JIM , KNUDSEN ULLA BRETH
Published: May 2011

Objective. Pre‐eclampsia is a serious pregnancy complication causing both fetal and maternal distress. Proteinuria is a diagnostic criterion frequently determined by albuminuria. We determined the protein excretion pattern of additional proteins, immunoglobulin G, transferrin, α1‐microglobulin and β2‐microglobulin, in urine samples collected prospectively during pre‐eclamptic and healthy pregnancies. Design. A prospective cohort study of 1 631 consecutive pregnant women. Setting. A Danish regional hospital. Sample. Thirty‐two women with pre‐eclampsia and 185 healthy control women were identified from the cohort. Urine samples were obtained from the 18th week until delivery and divided into six gestational intervals. Methods. Protein analyses of urine immunoglobulin G, transferrin, α1‐microglobulin and β2‐microglobulin were done with a sandwich ELISA method. Main Outcome Measures. Urine levels of specific proteins during pre‐eclamptic and healthy pregnancies. Results. Immunoglobulin G and transferrin were significantly increased in pre‐eclampsia after the 30th week of pregnancy. α1‐Microglobulin and β2‐microglobulin were differently excreted and found to be higher after the 36th week of pregnancy in pre‐eclampsia, but only α1‐microglobulin increased significantly. Conclusions. Immunoglobulin G, transferrin, α1‐ and β2‐microglobulin excretion patterns indicate initial glomerular damage followed by altered tubular handling of proteins.
Noninvasive measurement of fetal augmentation index by fetal aortic diameter pulse and flow velocity waveforms
Authors: MORI AKIRA , KONDO AKANE , HIRATA TAKAMICHI , TSUTSUI CHIHIRO
Published: May 2011

Objective. To study fetal systemic arterial stiffness in normal fetuses and compromised fetuses who had umbilical placental insufficiency (UPI). Design. Prospective study. Setting. University departments. Sample. A total of 118 normal fetuses (21–40 weeks) and 55 fetuses (UPI group) with evidence of potential compromise (high umbilical artery pulsatility index). Methods. A new real‐time noninvasive measurement system based on a combined Doppler ultrasound and echo‐tracking system was used as a measure of aortic/systemic arterial stiffness. The augmentation index (AI) of the fetal thoracic descending aorta was measured by using simultaneous measurements of diameter pulse and flow velocity waveforms. Main Outcome Measure. Augmentation index as a measure of stiffness. Results. In normal fetuses, successful measurements for obtaining the AI were achieved in 103 of 118 fetuses. In the normal group, the AI, as well as placental resistance, decreased during the second trimester; in contrast, an increase in the AI was observed during the third trimester. Using the AI values from the normal group, the UPI group was divided into two subgroups: 29 fetuses with a normal AI and 26 fetuses with a high AI. The clinical outcome was significantly worse in the latter subgroup compared with the normal subgroup. Conclusions. The increase of afterload caused by a high umbilical placental resistance was associated with a decrease of aortic distensibility in the compromised fetuses, suggesting an alteration of aortic wall structure.
Placental IGF‐I, IGFBP‐1, zinc, and iron, and maternal and infant anthropometry at birth
Authors: Akram Shahzad K , Carlsson‐Skwirut Christine , Bhutta Zulfiqar A , Söder Olle
Published: May 2011

Aim:  To correlate placental protein levels of insulin‐like growth factor (IGF)‐I and insulin‐like growth factor binding protein (IGFBP)‐1, with previously determined levels of IGF‐I and IGF‐II mRNA expression, and the micronutrients zinc and iron, and maternal and newborn anthropometry.

Methods:  Placental samples were collected from rural field sites in Pakistan. Samples were divided into small and large for gestational age groups (SGA and LGA, respectively). IGFBP‐1 levels were assessed using Western immunoblotting. IGF‐I protein levels were assessed using ELISA techniques. IGF mRNA expression, zinc, and iron, were quantified as previously described and were used for comparative purposes only.

Results:  Thirty‐three subjects were included (SGA, n = 12; LGA n = 21). Higher levels of IGFBP‐1 were seen in the SGA group (p < 0.01). IGFBP‐1 correlated positively with maternal and infant triceps skin‐fold thickness in the LGA and SGA groups, respectively (p < 0.05). Significantly lower IGF‐I protein levels were seen in the SGA group. IGF‐I levels correlated significantly with maternal and newborn anthropometry. IGFBP‐1 correlated significantly with IGF‐II mRNA expression (p < 0.05).

Conclusion:  Placental protein levels of IGF‐I and IGFBP‐1 appear to be associated with maternal anthropometry. Maternal anthropometry may thus influence IGFBP‐1 and IGF‐I levels and may possibly be used for screening of pregnancies, with the potential for timely identification of these high‐risk pregnancies.
PULMONARY ANGIOGRAPHY WITH 64‐MULTIDETECTOR‐ROW COMPUTED TOMOGRAPHY IN NORMAL DOGS
Authors: DREES RANDI , FRYDRYCHOWICZ ALEX , KEULER NICHOLAS S. , REEDER SCOTT B. , JOHNSON REBECCA
Published: May 2011

Pulmonary angiography using 64‐multidetector‐row computed tomography (MDCT) was used to evaluate pulmonary artery anatomy, and determine the sensitivity of pulmonary artery segment visualization in four Beagle dogs using images reconstructed to 0.625 mm and retro‐reconstructed to 1.25 and 2.5 mm slice thickness. Morphologically, characteristic features included a focal narrowing in the right cranial pulmonary artery in all dogs, which should not be mistaken as stenosis. While the right cranial pulmonary artery divided into two equally sized branches that were tracked into the periphery of the lung lobe in all dogs, only a single left cranial (cranial portion) lobar artery was present. Compared with 1.25 and 2.5 mm retro‐reconstructions, 0.625 mm reconstructions allowed for detection of significantly (P≤0.05) more pulmonary artery segments and sharper depiction of vessel margins. Clinical applications such as prevalence and significance of diameter changes, and detection of pulmonary arterial thrombembolism on lobar and sublobar level, using pulmonary angiography with 64‐MDCT applying 0.625 mm reconstruction slice thickness remain to be established.
Insensate foot of diabetic foot ulcer can have underlying silent neuropathic pain
Authors: Yunus YM , Rajbhandari SM
Published: May 2011

Subjects with diabetic foot ulcer (DFU) are believed to be less likely to complain of symptoms of painful diabetic peripheral neuropathy (PDPN). When we assessed this using Leeds Assessment of Neuropathic Symptoms and Signs questionnaire (s‐LANSS) we found that out of total 44 subjects with DFU, 19 (43·2%) had possible neuropathic discomfort. s‐LANSS score was significantly higher in DFU group (8·1 ± 7·7 versus 4·7 ± 4·6; P = 0·04). However, there was no difference in the perception of pain in 10‐point Likert scale (3·9 ± 3·6 versus 3·3 ± 3·0; P = NS) between these two groups. This study suggests that subjects with DFU may suffer from PDPN, but do not perceive it. Further studies are needed to assess if treatment of PDPN in these subjects is beneficial.
Brassinosteroid Enhances Jasmonate‐Induced Anthocyanin Accumulation in Arabidopsis Seedlings
Authors: Peng Zhihong , Han Chengyun , Yuan Libing , Zhang Kun , Huang Hongman , Ren Chunmei
Published: May 2011

Jasmonate (JA) regulates plant development, mediates defense responses, and induces anthocyanin biosynthesis as well. Previously, we isolated the psc1 mutant that partially suppressed coi1 insensitivity to JA, and found that brassinosteroid (BR) was involved in JA signaling and negatively regulated JA inhibition of root growth in Arabidopsis. In this study it was shown that JA‐induced anthocyanin accumulation was reduced in BR mutants or in wild type treated with brassinazole, an inhibitor of BR biosynthesis, whereas it was induced by an application of exogenous BR. It was also shown that the ‘late’ anthocyanin biosynthesis genes including DFR, LDOX, and UF3GT, were induced slightly by JA in the BR mutants relative to wild type. Furthermore, the expression level of JA‐induced Myb/bHLH transcription factors such as PAP1, PAP2, and GL3, which are components of the WD‐repeat/Myb/bHLH transcriptional complexes that mediate the ‘late’ anthocyanin biosynthesis genes, was lower in the BR mutants than that in wild type. These results suggested that BR affects JA‐induced anthocyanin accumulation by regulating the ‘late’ anthocyanin biosynthesis genes and this regulation might be mediated by the WD‐repeat/Myb/bHLH transcriptional complexes.
Pandemic influenza in Africa, lessons learned from 1968: a systematic review of the literature
Authors: Ortiz Justin R. , Lafond Kathryn E. , Wong Tiffany A. , Uyeki Timothy M.
Published: May 2011

Please cite this paper as: Ortiz et al. (2012) Pandemic influenza in Africa, lessons learned from 1968: a systematic review of the literature. Influenza and Other Respiratory Viruses 6(1), 11–24.

Background  To help understand the potential impact of the 2009 H1N1 pandemic in Africa, we reviewed published data from Africa of the two previous influenza pandemics.

Methods  We conducted a systematic search of three biomedical databases for articles in any language on 1957 H2N2 or 1968 H3N2 pandemic influenza virus infection in Africa published from January 1950 through August 2008.

Results  We identified 1327 potentially relevant articles, and 298 warranted further review. Fourteen studies on 1968 H3N2 influenza met inclusion criteria, while two studies identified describing 1957 H2N2 were excluded for data limitations. Among these 14 studies, community attack rates for symptomatic infection during all 1968 pandemic waves were around 20%. However, the proportion infected in communities ranged from 6% in isolated communities to 100% in enclosed populations. A total of 22–64% of sampled clinic patients and 8–72% of hospitalized patients had evidence of 1968 H3N2 virus infection. After the second pandemic wave, up to 41–75% of persons tested had serological evidence of 1968 H3N2 virus infection.

Conclusion  The 1968 H3N2 influenza pandemic, generally regarded as mild worldwide, appears to have had a substantial impact upon public health in Africa. Without more epidemiologic data the impact of the 2009 H1N1 pandemic in Africa cannot be assumed to have been mild. Assessment of the burden of 2009 H1N1 virus and future influenza pandemics in Africa should attempt to assess disease impact by a variety of methods, including substudies among specific populations.
Bioactive Dietary Polyphenols Inhibit Heme Iron Absorption in a Dose‐Dependent Manner in Human Intestinal Caco‐2 Cells
Authors: Ma Qianyi , Kim Eun‐Young , Lindsay Elizabeth Ann , Han Okhee
Published: May 2011

Abstract:  Although heme iron is an important form of dietary iron, its intestinal absorption mechanism remains elusive. Our previous study revealed that (‐)‐epigallocatechin‐3‐gallate (EGCG) and grape seed extract (GSE) markedly inhibited intestinal heme iron absorption by reducing the basolateral iron export in Caco‐2 cells. The aim of this study was to examine whether small amounts of EGCG, GSE, and green tea extract (GT) could inhibit heme iron absorption, and to test whether the inhibitory action of polyphenols could be offset by ascorbic acid. A heme‐55Fe absorption study was conducted by adding various concentrations of EGCG, GSE, and GT to Caco‐2 cells in the absence and presence of ascorbic acid. Polyphenolic compounds significantly inhibited heme‐55Fe absorption in a dose‐dependent manner. The addition of ascorbic acid did not modulate the inhibitory effect of dietary polyphenols on heme iron absorption when the cells were treated with polyphenols at a concentration of 46 mg/L. However, ascorbic acid was able to offset or reverse the inhibitory effects of polyphenolic compounds when lower concentrations of polyphenols were added (≤ 4.6 mg/L). Ascorbic acid modulated the heme iron absorption without changing the apical heme uptake, the expression of the proteins involved in heme metabolism and basolateral iron transport, and heme oxygenase activity, indicating that ascorbic acid may enhance heme iron absorption by modulating the intracellular distribution of 55Fe. These results imply that the regular consumption of dietary ascorbic acid can easily counteract the inhibitory effects of low concentrations of dietary polyphenols on heme iron absorption but cannot counteract the inhibitory actions of high concentrations of polyphenols.

Practical Application:  Bioactive dietary polyphenols inhibit heme iron absorption in a dose‐dependent manner. The small amounts of polyphenolic compounds present in foods are capable of reducing heme iron transport across the intestinal enterocyte. However, the inhibitory effects of dietary polyphenolic compounds on heme iron absorption can be offset by ascorbic acid and can possibly be avoided by decreasing the consumption of polyphenols while simultaneously taking ascorbic acid.