bluuebunny/crossref_metadata_2025 huggingface dataset:
The Incidence of Anterior Cruciate Ligament Injuries among Competitive Alpine Skiers
Authors: Pujol Nicolas , Rousseaux Blanchi Marie Philippe , Chambat Pierre
Published: April 2007

Background

Little is known about the evolution of anterior cruciate ligament injury rates among elite alpine skiers.

Purpose

To evaluate epidemiologic aspects of anterior cruciate ligament injuries among competitive alpine skiers during the last 25 years.

Study Design

Descriptive epidemiology study.

Methods

Data were collected from elite French national teams (379 athletes: 188 women and 191 men) from 1980 to 2005.

Results

Fifty-three of the female skiers (28.2%) and 52 of the male skiers (27.2%) sustained at least 1 anterior cruciate ligament injury. The overall anterior cruciate ligament injury incidence was 8.5 per 100 skier-seasons. The primary anterior cruciate ligament injury rate was 5.7 per 100 skier-seasons. The prevalence of reinjury (same knee) was 19%. The prevalence of a bilateral injury (injury of the other knee) was 30.5%. At least 1 additional anterior cruciate ligament surgery (mean, 2.4 procedures) was required for 39% of the injured athletes. Men and women were similar with regard to primary anterior cruciate ligament injury rate (P = .21), career remaining after the injury (P = .44), and skiing specialty (P = .5). There were more anterior cruciate ligament injuries (primary, bilateral, reinjuries) among athletes ranking in the world Top 30 (P < .001). Anterior cruciate ligament-injured athletes had a career length of 7.5 years, whereas athletes with no anterior cruciate ligament injury had a career of 4.5 years (P < .001). Finally, injury rates remained constant over time.

Conclusion

Anterior cruciate ligament injury rates (primary injury, bilateral injury, reinjury) among national competitive alpine skiers are high and have not declined in the last 25 years. Finding a way to prevent anterior cruciate ligament injury in this population is a very important goal.
Incidence of Major Tendon Ruptures and Anterior Cruciate Ligament Tears in US Army Soldiers
Authors: White Daniel W. , Wenke Joseph C. , Mosely Dan S. , Mountcastle Sally B. , Basamania Carl J.
Published: April 2007

Background

Although a rare event, the prevalence of major tendon rupture has increased in recent decades. Identification of risk factors is important for prevention purposes.

Hypothesis

Race is a risk factor for major tendon ruptures.

Study Design

Cohort study (prevalence); Level of evidence, 2.

Methods

All patients admitted for surgical management of a rupture of a major tendon at Womack Army Medical Center, Fort Bragg, North Carolina, in 1995 and 1996 were identified and evaluated for risk factors.

Results

The authors identified 52 major tendon ruptures 29 Achilles, 12 patellar, 7 pectoralis major, and 4 quadriceps tendon ruptures. All patients were active-duty soldiers, and 1 was a female soldier. Forty-one tendon ruptures occurred among black soldiers, 8 occurred among white soldiers, and 3 occurred among Latino soldiers. The population at risk included 93 224 exposures during the 2-year period, of which 67.1% were white, 24.5% were black, and 8.4% were self-classified as other race. The rate ratio for tendon rupture, adjusted for gender and age, was 13.3 (95% confidence interval, 6.2-28.5) between blacks and whites and 2.9 (95% confidence interval, 0.8-10.9) between Latinos and whites.

Conclusion

The rate of major tendon rupture was 13 times greater for black men in this study population when compared with whites. Interventions among those at a higher risk for injury should be considered.
Deficits in Neuromuscular Control of the Trunk Predict Knee Injury Risk
Authors: Zazulak Bohdanna T. , Hewett Timothy E. , Reeves N. Peter , Goldberg Barry , Cholewicki Jacek
Published: April 2007

Background

Female athletes are at significantly greater risk of anterior cruciate ligament (ACL) injury than male athletes in the same high-risk sports. Decreased trunk (core) neuromuscular control may compromise dynamic knee stability.

Hypotheses

(1) Increased trunk displacement after sudden force release would be associated with increased knee injury risk; (2) coronal (lateral), not sagittal, plane displacement would be the strongest predictor of knee ligament injury; (3) logistic regression of factors related to core stability would accurately predict knee, ligament, and ACL injury risk; and (4) the predictive value of these models would differ between genders.

Study Design

Cohort study (prognosis); Level of evidence, 2.

Methods

In this study, 277 collegiate athletes (140 female and 137 male) were prospectively tested for trunk displacement after a sudden force release. Analysis of variance and multivariate logistic regression identified predictors of risk in athletes who sustained knee injury.

Results

Twenty-five athletes (11 female and 14 male) sustained knee injuries over a 3-year period. Trunk displacement was greater in athletes with knee, ligament, and ACL injuries than in uninjured athletes (P < .05). Lateral displacement was the strongest predictor of ligament injury (P = .009). A logistic regression model, consisting of trunk displacements, proprioception, and history of low back pain, predicted knee ligament injury with 91% sensitivity and 68% specificity (P = .001). This model predicted knee, ligament, and ACL injury risk in female athletes with 84%, 89%, and 91% accuracy, but only history of low back pain was a significant predictor of knee ligament injury risk in male athletes.

Conclusions

Factors related to core stability predicted risk of athletic knee, ligament, and ACL injuries with high sensitivity and moderate specificity in female, but not male, athletes.
The Routine Culture of Allograft Tissue in Anterior Cruciate Ligament Reconstruction
Authors: Guelich David R. , Lowe Walter R. , Wilson Bubba
Published: April 2007

Background

Allograft tissue is an acceptable alternative to autograft tissue in anterior cruciate ligament (ACL) reconstruction. However, several infections associated with tissue procurement have led some to consider routine intraoperative cultures of allograft tissue before implantation. A positive culture result presents a treatment dilemma in the asymptomatic patient.

Hypothesis

Treatment of culture swab—positive allograft tissue is unnecessary if there is no evidence of clinical infection.

Study Design

Cohort study (prognosis); Level of evidence, 2.

Methods

Retrospective analysis was performed on 247 cultures taken in 321 consecutive ACL reconstructions from a single surgeon. Allograft cultures were taken intraoperatively before antibiotic washing and implantation. All patients received standard prophylactic antibiotics consisting of intravenous vancomycin and perioperative cefazolin, and were routinely monitored in the postoperative period for signs of infection.

Results

Twenty-four of 247 (9.7%) cultures were positive after implantation. Sixteen of these (67%) grew organisms of high pathogenicity, whereas 8 (33%) were of low pathogenicity. Cultures were classified as poor, scant, or rare in all 24 patients. These patients did not receive additional antibiotics, and none went on to develop septic arthritis or wound complications. The 2 cases of septic arthritis had negative intraoperative cultures.

Conclusions

Treatment of low-virulence organisms or minimal growth high-virulence organisms is unnecessary if no evidence of clinical infection exists. The results may call into question the utility of routinely culturing allograft tissue as positive results did not correlate with infectious complications.
Emotions and feelings in the Bible: analysis of the Pentateuch's affective lexicon
Authors: Galati Dario , Miceli Renato , Tamietto Marco
Published: May 2007

English

This study aims to investigate how affective states are described in the Old Testament. Three psychology researchers were asked to read the first five books of the first Italian version (from the 18th century) of the Old Testament (Pentateuch, or Torah) and to select all the terms that referred to an emotion or a feeling. For each selected term, they also had to pinpoint its position in the text (i.e. book, chapter) and the various characteristics of the affective episode in which it appeared (i.e. experiencing subject, situational antecedent, intentional object, instrumental behaviors). The textual analysis showed that the affective terms most frequently cited referred to four categories: “fear, awe”, “anger, hate”, “affliction, pain, sadness” and “love, joy, happiness”. These categories were significantly associated with specific instrumental behaviors and characters of the narration. Multivariate analysis also indicated that the frequency of citation of the affective categories varied significantly as a function of the book in which they appeared. In the conclusions, the authors discuss the conception of emotions and feelings issuing from the Pentateuch analysis.

French

L'article se propose d'analyser de quelle manière les expériences affectives sont décrites et évaluées dans la Bible. On a demandé à trois chercheurs psychologues de lire les cinq premiers livres de la première version italienne (du 18ème siècle) de la Bible (le Pentateuque, ou Torah) et d'y sélectionner tous les termes se référant à des expériences affectives (émotions et sentiments). Pour chaque terme sélectionné, ils devaient aussi indiquer sa position dans le texte (livre, chapitre) et les différentes composantes de l'épisode au cours duquel l'émotion ou le sentiment étaient expérimentés (le sujet qui expérimentait l'expérience affective, la situation qui la causait, l'objet intentionnel auquel elle se référait, le comportement réactif du sujet, l'évaluation morale de l'expérience). Les résultats de la sélection ont mis en évidence que les termes affectifs les plus fréquents se réfèrent à quatre catégories d'émotions, à savoir, dans l'ordre, la peur, la colère, la tristesse, la joie. Ces émotions sont expérimentées à des fréquences différentes par les principaux personnages de la narration (Dieu, les hommes, le Peuple d'Israël). L'émotion le plus souvent expérimentée par Dieu est la colère et par les différents personnages humains, la peur. Aucune évaluation morale négative quant aux expériences affectives n'émerge de l'analyse du texte. L'analyse multivariée met en évidence le fait que la fréquence des citations des catégories émotionnelles change sensiblement en fonction des cinq livres du Pentateuque. Dans leurs conclusions, les auteurs examinent la conception implicite des émotions et des sentiments qui semble émerger du Pentateuque.
Reconsidering the Testament of Solomon
Authors: Schwarz Sarah L.
Published: May 2007

The Testament of Solomon ( TSol) as translated in modern editions comes from a body of Greek sources which integrate the tale of Solomon's construction of the Jerusalem Temple aided by demons with an encyclopedic collection of recipes for use in dealing with the demons in question. While the title suggests a relatively fixed text, the situation is in fact far more complex. This study argues that the text (or texts) in fullest form, as represented in late medieval manuscripts, is actually quite a late development in this tradition's history, and that most of the elements which eventually come together under the title TSol (and the like) circulated independently during the late antique period.
A Controlled Trial of a Novel Primary Prevention Program for Lyme Disease and Other Tick-Borne Illnesses
Authors: Daltroy Lawren H. , Phillips Charlotte , Lew Robert , Wright Elizabeth , Shadick Nancy A. , Liang Matthew H. ,   Members of the Robert B. Brigham Arthritis and Musculoskeletal Diseases Clinical Research Center
Published: April 2007

To evaluate a theory-based educational program to prevent Lyme disease and other tick-borne illnesses (TBI), a randomized controlled trial of an educational program was delivered to ferry passengers traveling to an endemic area in southeastern Massachusetts. Rates of TBI and precautionary and tick check behaviors were measured over three summers in 30,164 passengers. There were lower rates of TBI among participants receiving TBI education compared with control participants receiving bicycle safety education (relative risk [RR] = 0.79) and a 60% reduction in risk among those receiving TBI education who visited Nantucket Island for more than 2 weeks compared to control participants (RR = 0.41, 95% confidence intervals = 0.18 to 0.95, p < .038). TBI-educated participants were also significantly more likely to take precautions (use repellent, protective clothing, limit time in tick areas) and check themselves for ticks. The study demonstrates that a theory-based Lyme disease prevention program can increase precautionary behavior and result in a significant reduction in TBI.
Deep grey matter `black T2` on 3 tesla magnetic resonance imaging correlates with disability in multiple sclerosis
Authors: Zhang Y. , Zabad RK , Wei X. , Metz LM , Hill MD , Mitchell JR
Published: April 2007

T2 hypointensity (black T2, BT2) in the deep grey matter of multiple sclerosis (MS) patients correlate weakly with disability at 1.5 T. BT2 is likely to be caused by abnormal iron deposition. We compared the correlation between disability and deep grey matter BT2 measured on 3 T MRI and on 1.5 T MRI in 17 MS patients. We observed a significant correlation between expanded disability status scale and signal intensity on 3 T MRI in the globus pallidus and the caudate nucleus ( r = —0.5, P < 0.05). BT2 at 3 T may be a useful MRI measure associated with disability in MS and warrants further study. Multiple Sclerosis 2007; 13: 880—883. http://msj.sagepub.com
Optimal reference population for the multiple sclerosis functional composite
Authors: Fox R.J. , Lee J.-C. , Rudick R.A.
Published: April 2007

A reference population is used when integrating the individual components of the Multiple Sclerosis Functional Composite (MSFC) into a single composite score. The choice of reference populations may have a significant impact on the resulting MSFC score, yet the impact of different reference populations has not been evaluated. We evaluated the impact of different reference populations when deriving the Multiple Sclerosis Functional Composite (MSFC) in a group of MS patients followed longitudinally for two years. Reference populations included the study population at baseline ( n = 60), a group of healthy controls ( n = 18) and the National MS Society Task Force reference population ( n = variable). We found that the choice of reference population had a significant impact on the resulting MSFC Z-score, sometimes compromising the statistical sensitivity to change over time. Our results suggest that longitudinal studies employing a multisystem composite Z-score should use a reference population with similar patients, which can most easily be achieved by using the baseline measures of the population under study. These results have significant implications to sample size estimates for longitudinal clinical studies and therapeutic trials. Multiple Sclerosis 2007; 13: 909—914. http://msj.sagepub.com
Optic nerve magnetization transfer imaging and measures of axonal loss and demyelination in optic neuritis
Authors: Trip SA , Schlottmann PG , Jones SJ , Li W-Y. , Garway-Heath DF , Thompson AJ , Plant GT , Miller DH
Published: April 2007

Magnetization transfer imaging is an MRI technique that provides quantitative information about in vivo tissue integrity, including myelin and axonal content, and is expressed as the magnetization transfer ratio (MTR). The optic neuritis lesion can model the MS lesion in vivo and permits use of non-invasive markers of optic nerve myelination (visual evoked potential [VEP] latency) and retinal neuroaxonal loss (optical coherence tomography [OCT]) to provide further information about the in vivo substrates of optic nerve MTR. Twenty-five patients with optic neuritis were studied using an optic nerve MTR sequence, quantitative visual function testing, VEPs and OCT, along with 15 controls. MTR was reduced in affected nerves compared to both clinically unaffected nerves from patients and control nerves ( P < 0.001). Whole-nerve MTR correlated modestly with central-field VEP latency but more strongly when lesion-only MTR was measured, when a modest correlation with whole-field VEP latency emerged. OCT-quantified retinal neuroaxonal loss also correlated with MTR. In conclusion, markers of optic nerve myelination and axonal loss both correlate with optic nerve MTR. Because axonal loss following optic neuritis also results in myelin loss, the relative contributions of the two pathological conditions to the MTR measures cannot be estimated from this study. Multiple Sclerosis 2007; 13: 875—879. http://msj.sagepub.com
An association between autoreactive antibodies and anti-interferon-β antibodies in multiple sclerosis
Authors: Garg N. , Weinstock-Guttman B. , Bhasi K. , Locke J. , Ramanathan M.
Published: April 2007

Approximately 5—25% of interferon-β (IFN-β) treated multiple sclerosis (MS) patients develop anti-IFN-β neutralizing antibodies (NAb) but the patient-specific variables associated with the risk of developing anti-IFN-β antibodies are poorly understood. Anti-IFN-β NAb are a subset of anti-IFN-β binding antibodies (BAb) and all patients with NAb generally have high levels of associated BAb. The purpose of this research was to assess the association between autoreactive antibodies (ARAB) and the risk of developing anti-IFN-β BAb in MS patients. This was a retrospective study that included consecutive patients diagnosed with clinically definite MS evaluated at our center and considered appropriate for IFN-β therapy. The patients were tested for various subtypes of antiphospholipid antibodies (APLA) including anti-phosphatidylethanolamine (APE), anti-phosphatidylserine (APS), and anti-cardiolipin (ACA) antibodies, and other ARAB, antinuclear and anti-neutrophilic cytoplasmic antibodies, anti-thyroid peroxidase antibodies (ATA), anti-SS-A and anti-SS-B antibodies. BAb levels were assessed using a commercial binding ELISA assay. A total of 33 patients (mean age: 45.4 years, 85% female) were enrolled; 15 patients were negative and 18 patients were positive for BAb. APLA or ATA were present in 95% (17 of 18 patients) of patients positive for BAb. In comparison, APLA or ATA occurred in only 27% (four of 15 patients) of patients in the BAb negative group. The associations between the occurrence of BAb and the occurrence of high APLA or ATA were significant (χ2 = 13.4, P<0.001in Fisher exact test). The odds ratio for the association was 46.8 (with a 95% confidence interval range of 4.6—475). No significant correlations were found for other ARAB. The presence of autoreactive antibodies, particularly APLA and ATA is associated with increased risk of occurrence of IFN-β BAb in MS patients on long-term IFN-β therapy. Multiple Sclerosis 2007; 13: 895—899. http://msj.sagepub.com
Quantification of subtle blood-brain barrier disruption in non-enhancing lesions in multiple sclerosis: a study of disease and lesion subtypes
Authors: Soon D. , Tozer DJ , Altmann DR , Tofts PS , Miller DH
Published: April 2007

Few attempts have been made to detect subtle blood-brain barrier (BBB) leakage in visibly non-enhancing MRI lesions in multiple sclerosis (MS). For 19 patients, longitudinal relaxation time (T1) maps were generated from MRI scans obtained before, and at 20, 40 and 60 minutes after injection of gadolinium (Gd)-DTPA (0.3 mmol/kg). Regions of interest (ROI) were placed around non-enhancing lesions, and in paired contralateral normal appearing brain tissue (NABT). Post-Gd rate of R1 (=1/T1) rise (ΔR1/Δt), was used to quantify leakage. ΔR1/Δt was greater in lesions than paired NABT ( P ≤ 0.001 at all post-Gd timepoints). ΔR1/Δt was greater in T1 hypointense than isointense lesions ( P = 0.001 and 0.01 for first and second timepoints respectively), and negatively related to lesion cross sectional area ( P ≤ 0.001 at all post-Gd timepoints). Relapsing remitting (RRMS) lesions had a greater initial ΔR1/Δt than secondary progressive (SPMS) lesions ( P = 0.04), but this was not seen in subsequent timepoints. ΔR1/Δt in visibly enhancing lesions was significantly greater than in visibly non-enhancing lesions, with no overlap in the normal ranges of the two populations. Subtle BBB leakage is a consistent feature in non-enhancing lesions, and is distinct from the overt BBB leakage observed in visibly enhancing lesions. It is detectable using quantitative contrast-enhanced MRI. It is apparent in all clinical and lesion subtypes studied, and greater in T1 hypointense and smaller lesions. Larger initial ΔR1/Δt in RRMS than SPMS lesions may reflect differences in blood volume rather than BBB leakage. Multiple Sclerosis 2007; 13: 884—894. http://msj.sagepub.com
The long-term effect of AHSCT on MRI measures of MS evolution: a five-year follow-up study
Authors: Roccatagliata L. , Rocca MA , Valsasina P. , Bonzano L. , Sormani MP , Saccardi R. , Mancardi GL , Filippi M. ,   for the Italian GITMO-NEURO Intergroup on Autologous Stem Cell Transplantation
Published: April 2007

Using MRI, we measured disease activity and brain atrophy in nine multiple sclerosis patients treated with autologous hematopoietic stem cell transplantation (AHSCT) for a mean follow up of 63 months. We show that AHSCT is associated to a longlasting suppression of inflammation and to a marked decrease of the rate of brain atrophy after the second year following treatment. Multiple Sclerosis 2007; 13 : 1068—1070. http://msj.sagepub.com
Fatigue in multiple sclerosis: association with disease-related, behavioural and psychosocial factors
Authors: Trojan DA , Arnold D. , Collet J-P. , Shapiro S. , Bar-Or A. , Robinson A. , Le Cruguel J-P. , Ducruet T. , Narayanan S. , Arcelin K. , Wong AN , Tartaglia MC , Lapierre Y. , Caramanos Z. , Da Costa D.
Published: April 2007

We determined biopsychosocial correlates of general, physical, and mental fatigue in MS patients, by evaluating the additional contribution of potentially modifiable factors after accounting for non-modifiable disease-related factors. Fifty-three ambulatory MS patients, along with 28 normal controls were recruited for a cross-sectional study. Subjects completed the Multidimensional Fatigue Inventory (MFI) and Fatigue Severity Scale. Potential correlates evaluated were: disease-related factors (disease duration and type, immunomodulating treatment, muscle strength, pain, forced vital capacity (FVC), respiratory muscle strength, body mass index, disability, fibromyalgia), behavioural factors (physical activity, sleep quality) and psychosocial factors (depression, stress, self-efficacy). Multivariate models were calculated for MFI General, Physical, and Mental Fatigue. Age-adjusted multivariate models with non-modifiable factors included the following predictors ( P ≤ 0.10) of 1) MFI General and Mental Fatigue: none; and 2) MFI Physical Fatigue: FVC and disability. The following potentially modifiable predictors ( P ≤ 0.10) made an additional contribution to the models 1) MFI General Fatigue: sleep quality, self-efficacy, pain; 2) MFI Physical Fatigue: self-efficacy, physical activity; and 3) MFI Mental Fatigue: stress, self-efficacy. Fatigue in MS is multidimensional. Correlates of general and physical fatigue are disease-related, behavioural and psychosocial factors. Correlates of mental fatigue are psychosocial factors. Potentially modifiable factors account for a considerable portion of fatigue. Multiple Sclerosis 2007; 13: 985—995. http://msj.sagepub.com
Retinopathy in a multiple sclerosis patient undergoing interferon-therapy
Authors: Saito Hitomi , Suzuki Mariko , Asakawa Takehiro , Kato Satoshi
Published: April 2007

A 30-year old male developed retinopathy, with flame-shaped retinal hemorrhages and soft exudates in both eyes, while receiving interferon- β injections as a preventive therapy for multiple sclerosis (MS). After discontinuing interferon injections upon presentation of the retinopathy, the retinopathy subsided without specific therapy. Visual acuity remained stable throughout the course of observation. Though assumed to be related to interferon therapy, the ocular findings of retinopathy disappeared without specific treatment. This clinical course of retinopathy is very similar to the interferon-induced retinopathy observed in type C hepatitis patients, but there are far fewer reports on MS-related interferon retinopathy. Multiple Sclerosis 2007; 13: 939—940. http://msj.sagepub.com
Comparing a self report questionnaire with physician assessment for determining multiple sclerosis clinical disease course: a validation study
Authors: Bamer A.M. , Cetin K. , Amtmann D. , Bowen J.D. , Johnson K.L.
Published: April 2007

Determining multiple sclerosis (MS) clinical course is important in research and clinical practice. However, many patients do not know their clinical course, limiting the option to use self-report in research studies including surveys. In order to address this, we developed a self-report item to be used in self-administered mailed surveys displaying graphically the courses of MS. The validity of this item was then evaluated by comparing physician-assessed disease clinical course to patient response on the self-report item on 94 of 99 consecutive patients seen in an MS specialty clinic. Kappa statistics were calculated comparing self-assessed versus physician-assessed MS clinical course for the four common MS clinical courses (κ=0.45) and for relapsing remitting versus other courses (κ=0.62) indicating substantial agreement. Subsequent administration of the item by mail to 1371 individuals with MS in Washington and Montana determined that while most individuals responded as intended to the item, persons with less than a high school education ( P=0.009) or over the age of 60 ( P = 0.002) were significantly more likely to leave the item blank. It appears that this item may be used to obtain a rough estimate of MS clinical course in research using self-report surveys where physician assessments are impractical. Multiple Sclerosis 2007; 13: 1033—1037. http://msj.sagepub.com
The Politics of International Norms: Subsidiarity and the Imperfect Competence Regime of the European Union
Authors: Van Kersbergen Kees , Verbeek Bertjan
Published: May 2007

Theories on the role of norms in international relations generally neglect the possibility that after their adoption a new battle over their precise meaning ensues, especially when a norm remains vague and illusive. Norm implementation is not only a matter of internalization and compliance, but also of redefinition. Building on insights from rationalist and constructivist approaches, this article advances the idea of recurrent battles for and over norms in international politics. It argues that the analytical tools of international regime theory are instrumental in tracking such battles. This framework is applied to the history and role of subsidiarity as a norm in the competence regime of the European Union between 1991 and 2005. Its main finding is that the issue of subsidiarity was not a matter of norm internalization, but concerned a recurrent battle between old and newly empowered actors over its precise meaning, eventually favouring the member states' prerogative.
The European Union in the Legacies of Imperial Rule? EU Accession Politics Viewed from a Historical Comparative Perspective
Authors: Behr Hartmut
Published: May 2007

International Relations benefits from historical comparative research. Although a historical comparative method can be fruitfully applied to the study of the European Union (EU), it is rarely undertaken. In this article, EU accession politics, particularly its 2004 enlargement, is compared with 19th century `standards of civilization' developed by European states concluding treaties with non-European nations. This article argues that EU accession politics operates in the legacies of 19th-century imperial rule. Understanding the EU in terms of an (new) empire might enrich the discussion of the perception and categorization of the EU as an international order.
Research on the Cost of Providing Family Therapy: A Summary and Progress Report
Authors: Crane D. Russell
Published: May 2007

This article provides a summary of effectiveness research on the costs of including family therapy in mental health services. Data was available from four different sources: 1) a large western Health Maintenance Organization with 180,000 subscribers in the local Utah region; 2) the Medicaid system of the entire State of Kansas in the United States; 3) a US health insurance company with several million subscribers; and 4) a Family Therapy training clinic. Results suggest that family therapy reduces the number of health care visits, especially for high utilizers. These results were also replicated in a graduate student training clinic. Also, studies of two different health care systems (and a cost projection study) suggest that including family therapy as a treatment option does not significantly increase health care costs.
Are generational savings unjust?
Authors: Gaspart Frédéric , Gosseries Axel
Published: May 2007

In this article, we explore the implications of a Rawlsian theory for intergenerational issues. First, we confront Rawls's way of locating his `just savings' principle in his Theory of Justice with an alternative way of doing so. We argue that both sides of his intergenerational principle, as they apply to the accumulation phase and the steady-state stage, can be dealt with on the bases, respectively, of the principle of equal liberty (and its priority) and of the difference principle. We then proceed by focusing on the implications of applying maximin to his steady-state stage. One central claim is that, in principle, Rawlsians should consider not only generational dissavings, but also generational savings, as unfair. This principle suffers a series of exceptions on which we focus in the fourth section of the article. In some cases, growth can be maximin compatible.
Antarctic exposure: archives of the feeling body
Authors: Yusoff Kathryn
Published: May 2007

This article examines attempts to capture and form knowledge about the Antarctic landscape through expeditionary photography and embodied practice. It begins with a visual piece. As an antidote to contemporary investment in heroic Antarctic narratives, Action Man, Antarctic Inertia takes the original 1970s special issue Antarctic Action Man on another kind of journey, restaging his adventures through the landscape. Concentrating on the excessive expenditure of explorers' accounts, as opposed to the heroic destinations of the original, this visual mapping considers non-productive landscape encounters in order to explore other possibilities of staging history and geography. The written essay that forms the second part of this article concentrates on the anxieties of representation that emerge from the interplay between mark making and being marked, and the marks that fall beyond this visual register. Using the metaphor of light, which includes both the light cast on a photographic plate and the dubious physical light of the Antarctic landscape, I examine how this marker both constitutes a trace of history and a fleeting form of knowledge production. As a mode of representation, landscape photography simultaneously illuminates and obscures the histories of encounter with landscape. The argument proceeds by looking at how the photographic frame both arrests landscape and points to a subtle beyond (Barthes). Using narratives from the Heroic era (1890s—1910s) expeditions, I then consider how landscape exposure collides with photographic exposure to present other inhabitations that are in excess of the photograph. In these other narratives, the landscape writes through the body to disrupt the heroic narrative of a contained and purposeful body in the landscape. This Antarctic `look back' ultimately points the way to new geographies of visual culture that expand understand ings of the Antarctic landscape. At the same time, by exceeding the visual, this approach provides the grounds for a renewed ethics of engagement with the ability of landscape to inscribe the explorer's body as he inscribes the surface of the continent through embodied journeys and representational practice. In conclusion, I argue for a reciprocal dialogue between landscape and vision, one that acknowledges that vision is entangled with pain, blindness and excess as much as with a clear sighting of encounter.
Degradation of Aliphatic Polyesters in the Presence of Inorganic Fillers
Authors: Chouzouri G. , Xanthos M.
Published: May 2007

Aliphatic polyesters are melt mixed with bioactive fillers and converted into sheets in order to compare their degradation behavior in a phosphate buffer saline (PBS) solution as a function of processing method, polymer type, and crystallinity and type of filler. The samples are tested for weight changes, pH, intrinsic viscosity (IV), and thermal and mechanical property changes as a function of time. The study establishes that although the fillers appear to enhance the polymer degradation, they also have an effect on crystallinity after several immersion periods. Intrinsic viscosity measurements show degradation in the form of molecular weight reduction even after short periods of immersion.
Allogeneic cytotoxic T-cell therapy for EBV-positive posttransplantation lymphoproliferative disease: results of a phase 2 multicenter clinical trial
Authors: Haque Tanzina , Wilkie Gwen M. , Jones Marie M. , Higgins Craig D. , Urquhart Gillian , Wingate Phoebe , Burns David , McAulay Karen , Turner Marc , Bellamy Christopher , Amlot Peter L. , Kelly Deirdre , MacGilchrist Alastair , Gandhi Maher K. , Swerdlow Anthony J. , Crawford Dorothy H.
Published: April 2007

We present the results of a multicenter clinical trial using Epstein-Barr virus (EBV)–specific cytotoxic T lymphocytes (CTLs) generated from EBV-seropositive blood donors to treat patients with EBV-positive posttransplantation lymphoproliferative disease (PTLD) on the basis of the best HLA match and specific in vitro cytotoxicity. Thirty-three PTLD patients who had failed on conventional therapy were enrolled. No adverse effects of CTL infusions were observed and the response rate (complete or partial) in 33 patients was 64% at 5 weeks and 52% at 6 months. Fourteen patients achieved a complete remission, 3 showed a partial response, and 16 had no response at 6 months (5 died before completing treatment). At 5 weeks, there was a significant trend toward better responses with higher numbers of CD4+ cells in infused CTL lines (P = .001) that were maintained at 6 months (P = .001). Patients receiving CTLs with closer HLA matching responded better at 6 months (P = .048). Female patients responded better than male patients, but the differences were not statistically significant. Our results show that allogeneic CTLs are a safe and rapid therapy for PTLD, bypassing the need to grow CTLs for individual patients. The response rate in this poor prognosis patient group is encouraging.
Very short telomere length by flow fluorescence in situ hybridization identifies patients with dyskeratosis congenita
Authors: Alter Blanche P. , Baerlocher Gabriela M. , Savage Sharon A. , Chanock Stephen J. , Weksler Babette B. , Willner Judith P. , Peters June A. , Giri Neelam , Lansdorp Peter M.
Published: April 2007

Dyskeratosis congenita (DC) is an inherited bone marrow failure syndrome in which the known susceptibility genes (DKC1, TERC, and TERT) belong to the telomere maintenance pathway; patients with DC have very short telomeres. We used multicolor flow fluorescence in situ hybridization analysis of median telomere length in total blood leukocytes, granulocytes, lymphocytes, and several lymphocyte subsets to confirm the diagnosis of DC, distinguish patients with DC from unaffected family members, identify clinically silent DC carriers, and discriminate between patients with DC and those with other bone marrow failure disorders. We defined “very short” telomeres as below the first percentile measured among 400 healthy control subjects over the entire age range. Diagnostic sensitivity and specificity of very short telomeres for DC were more than 90% for total lymphocytes, CD45RA+/CD20− naive T cells, and CD20+ B cells. Granulocyte and total leukocyte assays were not specific; CD45RA− memory T cells and CD57+ NK/NKT were not sensitive. We observed very short telomeres in a clinically normal family member who subsequently developed DC. We propose adding leukocyte subset flow fluorescence in situ hybridization telomere length measurement to the evaluation of patients and families suspected to have DC, because the correct diagnosis will substantially affect patient management.
The ring-infected erythrocyte surface antigen (RESA) of Plasmodium falciparum stabilizes spectrin tetramers and suppresses further invasion
Authors: Pei Xinhong , Guo Xinhua , Coppel Ross , Bhattacharjee Souvik , Haldar Kasturi , Gratzer Walter , Mohandas Narla , An Xiuli
Published: April 2007

The malaria parasite Plasmodium falciparum releases the ring-infected erythrocyte surface antigen (RESA) inside the red cell on entry. The protein migrates to the host cell membrane, where it binds to spectrin, but neither the nature of the interaction nor its functional consequences have previously been defined. Here, we identify the binding motifs involved in the interaction and describe a possible function. We have found that spectrin binds to a 108–amino acid fragment (residues 663-770) of RESA, and that this RESA fragment binds to repeat 16 of the β-chain, close to the labile dimer-dimer self-association site. We further show that the RESA fragment stabilizes the spectrin tetramer against dissociation into its constituent dimers, both in situ and in solution. This is accompanied by enhanced resistance of the cell to both mechanical and thermal degradation. Resealed erythrocytes containing RESA663-770 display resistance to invasion by merozoites of P falciparum. We infer that the evolutionary advantage of RESA to the parasite lies in its ability to prevent invasion of cells that are already host to a developing parasite, as well as possibly to guard the cell against thermal damage at the elevated body temperatures prevailing in febrile crises.
Toll-like receptor 2 signaling is a mediator of apoptosis in herpes simplex virus-infected microglia
Authors: Aravalli Rajagopal N , Hu Shuxian , Lokensgard James R
Published: May 2007

Background

Information regarding the response of brain cells to infection with herpes simplex virus (HSV)-1 is needed for a complete understanding of viral neuropathogenesis. We have recently demonstrated that microglial cells respond to HSV infection by producing a number of proinflammatory cytokines and chemokines through a mechanism involving Toll-like receptor 2 (TLR2). Following this cytokine burst, microglial cells rapidly undergo cell death by apoptosis. We hypothesized that TLR2 signaling might mediate the cell death process as well.

Methods

To test this hypothesis, we investigated HSV-induced cell death of microglia obtained from both wild-type and TLR2-/-mice. Cell death was studied by oligonucleosomal ELISA and TUNEL staining, and the mechanisms of apoptosis were further analyzed using murine apoptosis-specific microarrays. The data obtained from microarray analysis were then validated using quantitative real-time PCR assays.

Results

HSV infection induced apoptotic cell death in microglial cells from wild-type as well as TLR2 cells. However, the cell death at 24 h p.i. was markedly lower in knockout cells. Furthermore, microarray analyses clearly showed that the expression of pro-apoptotic genes was down-regulated at the time when wild-type cells were actively undergoing apoptosis, indicating a differential response to HSV in cells with or without TLR2.

Conclusion

We demonstrate here that HSV induces an apoptotic response in microglial cells which is mediated through TLR2 signaling.
LPS induces rapid IL-10 release by M-CSF-conditioned tolerogenic dendritic cell precursors
Authors: Kwan Wing-Hong , Boix Charlotte , Gougelet Nicolas , Fridman Wolf H , Mueller Chris G F
Published: May 2007

Dendritic cells (DC) obtained by culturing myeloid precursors in GM-CSF undergo maturation and induce an efficient T cell response when stimulated with microbial products. DC precursors themselves also recognize microbial products, and it remains unclear how these stimulated DC precursors modulate the immune response. We show here that M-CSF-conditioned human DC precursors responded to LPS, Mycobacteria bovis, and inflammatory cytokines by a rapid and robust production of IL-10, largely superior to that observed with immature DC or monocytes. The endogenous IL-10 restrained the DC precursors from converting into professional APC, as blocking the IL-10 receptor in the presence of LPS resulted in the formation of efficient T cell stimulators. LPS stimulation concomitant with DC differentiation gave rise to immature DC, which were tolerant to a secondary LPS exposure. Furthermore, the LPS-activated DC precursors reduced bystander DC maturation and anti-CD3/CD28-triggered T cell activation. These data suggest that when exposed to inflammatory or microbial signals, M-CSF-conditioned DC precursors can participate in the modulation of inflammation and immune response by rapid release of IL-10.
The inflammasome in pathogen recognition and inflammation
Authors: Sutterwala Fayyaz S , Ogura Yasunori , Flavell Richard A
Published: May 2007

The nucleotide-binding oligomerization domain-like receptor (NLR) family of proteins is involved in the regulation of innate immune responses and cell death pathways. Some NLR family members promote the activation of proinflammatory caspases within multiprotein complexes, called inflammasomes. Recent studies analyzing mice deficient in various components of the inflammasome have provided insight into the role of these molecules in host defense against pathogens and in autoinflammatory disorders. Here, we review these studies and propose that membrane disruption leads to activation of the inflammasome.
Emergency Department Operational Changes in Response to Pay‐for‐performance and Antibiotic Timing in Pneumonia
Authors: Pines Jesse M. , Hollander Judd E. , Lee Hoi , Everett Worth W. , Uscher‐Pines Lori , Metlay Joshua P.
Published: May 2007

Background:The percentage of adult patients admitted with pneumonia who receive antibiotics within four hours of hospital arrival is publicly reported as a quality and pay‐for‐performance measure by the Department of Health and Human Services and is called PN‐5b.

Objectives:To determine attitudes among physician leaders at emergency medicine training programs toward using PN‐5b as a quality measure for pay for performance, and to determine what operational changes academic emergency departments (EDs) have made to ensure early antibiotic administration for patients with pneumonia.

Methods:The authors administered an online questionnaire to 129 chairpersons and medical directors of 135 academic ED training programs in the United States on attitudes toward performance measurement in pneumonia and changes that academic EDs have made in response to PN‐5b; one response was sought from each institution. Respondents were identified through the Society for Academic Emergency Medicine Web site and e‐mailed five times to maximize survey participation.

Results:Ninety chairpersons and medical directors (70%) completed the survey; 47% were medical directors, 51% were chairpersons, and 2% were medical directors and chairpersons. Forty‐five (50%) did not agree that PN‐5b was an accurate quality measure, and 61 (69%) did not agree that pay for performance targeting this measure would lead to improved pneumonia care. The most common strategy to address PN‐5b was to provide information to providers on the importance of early treatment with antibiotics (n = 63; 70%). For patients with suspected pneumonia, 46 (51%) automate chest radiograph (CXR) ordering at triage, 37 (41%) prioritize patients with suspected pneumonia, and 33 (37%) administer antibiotics before obtaining CXR results. Overall ED changes include improved turnaround time for CXR (n= 33; 37%), prioritized CXRs over other radiographs (n= 13; 14%), and improved inpatient bed availability (n= 12; 13%). Of 13 strategies identified to improve PN‐5b, the median number that programs have implemented is five (interquartile range, 5–7). All sites reported engaging in at least three operational changes to address PN‐5b.

Conclusions:All EDs in this study have addressed early antibiotic administration with multiple operational changes despite mixed sentiment that these changes will improve care. Future research is needed to measure the impact of pay‐for‐performance initiatives.
Prognostic Significance of Immune Subset Measurement in Individuals With AIDS-Associated Kaposi's Sarcoma
Authors: Stebbing Justin , Sanitt Adam , Teague Alastair , Powles Tom , Nelson Mark , Gazzard Brian , Bower Mark
Published: May 2007

Purpose

A prognostic index for AIDS-associated Kaposi's sarcoma (KS) diagnosed in the era of highly active antiretroviral therapy (HAART) was based on routine clinical and laboratory characteristics. Because immune subset measurement is often performed in HIV-positive individuals, we examined whether these were predictive of mortality independently of the prognostic index, or could predict time to progression of KS.

Patients and Methods

We performed univariate and multivariate Cox regression analyses on a data set of 326 individuals with AIDS-associated KS to identify immune subset covariates predictive of overall survival and time to progression. Adaptive (CD8 T cell and CD19 B cell) and innate (CD16/56 natural-killer cell) immune parameters were studied by flow cytometry.

Results

In univariate analyses, all three immune subsets had significant effects on overall survival (P < .025). In multivariate analyses including the prognostic index, only CD8 counts remained significant (P = .026), although its effect on the overall prognostic index is small. An increase of 100 cells/mm3 in the CD8 count confers a 5% improvement in overall survival. Individuals with a higher CD8 count did not have an increased time to progression. Patients who were already on HAART at the time of KS diagnosis did not have a shorter time to progression than those who were antiretroviral naïve at KS diagnosis.

Conclusion

The CD8 count appears to provide independent prognostic information in individuals with AIDS-associated KS. Measurement of the CD8 count is clinically useful in patients with KS.
Human and mouse protein-noncoding snoRNA host genes with dissimilar nucleotide sequences show chromosomal synteny
Authors: Tanaka-Fujita Ritsuko , Soeno Yuuichi , Satoh Hitoshi , Nakamura Yoshikazu , Mori Shigeo
Published: April 2007

snoRNAs are small protein-noncoding RNAs essential for pre-rRNA processing and ribosome biogenesis, and are encoded intronically in host genes (HGs) that are either protein coding or noncoding. mRNAs of protein-noncoding HGs differ in their nucleotide sequences among species. Although the reason for such sequential divergence has not been well explained, we present evidence here that such structurally different HGs have evolved from a common ancestral gene. We first identified two novel protein-noncoding HGs (mU50HG-a and mU50HG-b) that intronically encode a mouse ortholog of a human snoRNA, hU50. The sequences of mU50HG mRNA differed from that of hU50HG. However, a chromosome mapping study revealed that mU50HG is located at 9E3-1, the murine segment syntenic to human 6q15, where hU50HG is located. Synteny is a phenomenon whereby gene orthologs are arranged in the same order at equivalent chromosomal loci in different species; synteny between two species means it is highly likely that the genes have evolved from a common ancestral gene. We then extended this mapping study to other protein-noncoding snoRNA-HGs, and found again that they are syntenic, implying that they have evolved from genes of common ancestral species. Furthermore, on these syntenic segments, exons of adjacent protein-coding genes were found to be far better conserved than those of noncoding HGs, suggesting that the exons of protein-noncoding snoRNA-HGs have been much more fragile during evolution.