bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of macrophage inhibitory cytokine-1 with nutritional status, body composition and bone mineral density in patients with anorexia nervosa: the influence of partial realimentation
Authors: Dostálová Ivana , Kaválková Petra , Papežová Hana , Domluvilová Daniela , Zikán Vít , Haluzík Martin
Published: April 2010

Background

Macrophage inhibitory cytokine-1 (MIC-1) is a key inducer of cancer-related anorexia and weight loss. However, its possible role in the etiopathogenesis of nutritional disorders of other etiology such as anorexia nervosa (AN) is currently unknown.

Methods

We measured fasting serum concentrations of MIC-1 in patients with AN before and after 2-month nutritional treatment and explored its relationship with nutritional status, metabolic and biochemical parameters. Sixteen previously untreated women with AN and twenty-five normal-weight age-matched control women participated in the study. We measured serum concentrations of MIC-1 and leptin by ELISA, free fatty acids by enzymatic colorimetric assay, and biochemical parameters by standard laboratory methods; determined resting energy expenditure by indirect calorimetry; and assessed bone mineral density and body fat content by dual-energy X-ray absorptiometry. ANOVA, unpaired t-test or Mann-Whitney test were used for groups comparison as appropriate. The comparisons of serum MIC-1 levels and other studied parameters in patients with AN before and after partial realimentation were assessed by paired t-test or Wilcoxon Signed Rank Test as appropriate.

Results

At baseline, fasting serum MIC-1 concentrations were significantly higher in patients with AN relative to controls. Partial realimentation significantly reduced serum MIC-1 concentrations in patients with AN but it still remained significantly higher compared to control group. In AN group, serum MIC-1 was inversely related to Buzby nutritional risk index, serum insulin-like growth factor-1, serum glucose, serum total protein, serum albumin, and lumbar bone mineral density and it significantly positively correlated with the duration of AN and age.

Conclusions

MIC-1 concentrations in AN patients are significantly higher relative to healthy women. Partial realimentation significantly decreased MIC-1 concentration in AN group. Clinical significance of these findings needs to be further clarified.
Why are we fat? Discussions on the socioeconomic dimensions and responses to obesity
Authors: Rayner Geof , Gracia Mabel , Young Elizabeth , Mauleon Jose R , Luque Emilio , Rivera-Ferre Marta G
Published: April 2010

This paper draws together contributions to a scientific table discussion on obesity at the European Science Open Forum 2008 which took place in Barcelona, Spain. Socioeconomic dimensions of global obesity, including those factors promoting it, those surrounding the social perceptions of obesity and those related to integral public health solutions, are discussed. It argues that although scientific accounts of obesity point to large-scale changes in dietary and physical environments, media representations of obesity, which context public policy, pre-eminently follow individualistic models of explanation. While the debate at the forum brought together a diversity of views, all the contributors agreed that this was a global issue requiring an equally global response. Furthermore, an integrated ecological model of obesity proposes that to be effective, policy will need to address not only human health but also planetary health, and that therefore, public health and environmental policies coincide.
Cortico-cerebral histogenesis in the opossum Monodelphis domestica: generation of a hexalaminar neocortex in the absence of a basal proliferative compartment
Authors: Puzzolo Elisa , Mallamaci Antonello
Published: April 2010

Background

The metatherian Monodelphis domestica, commonly known as the South-American short-tailed opossum, is an appealing animal model for developmental studies on cortico-cerebral development. Given its phylogenetic position, it can help in tracing evolutionary origins of key traits peculiar to the eutherian central nervous system. The capability of its pup to regenerate damaged cortico-spinal connections makes it an ideal substrate for regenerative studies. Recent sequencing of its genome and the ex utero accessibility of its developing cerebral cortex further enhance its experimental interest. However, at the moment, a comprehensive cellular and molecular characterization of its cortical development is missing.

Results

A systematic analysis of opossum cortico-cerebral development was performed, including: origin of cortical neurons; migration of these neurons from their birthplaces to their final layer destinations; and molecular differentiation of distinct neocortical laminae.

We observed that opossum projection neurons and interneurons are generated by pallial and subpallial precursors, respectively, similar to rodents. A six-layered cortex with a eutherian-like molecular profile is laid down, according to the inside-out rule. However, neocortical projection neurons are generated by apical neural precursors and almost no basal progenitors may be found in the neuronogenic neopallial primordium. In the opossum neocortex, Tbr2, the hallmark of eutherian basal progenitors, is transiently expressed by postmitotic progenies of apical precursors prior to the activation of more mature neuronal markers.

Conclusions

The neocortical developmental program predates Eutheria-Methatheria branching. However, in metatherians, unlike eutherians, a basal proliferative compartment is not needed for the formation of a six-layered neuronal blueprint.
Quantitative analysis of two isoflavones in Pueraria lobata flowers from eleven Chinese provinces using high performance liquid chromatography
Authors: Yao Meicun , Liao Yiting , Li George Q , Law Francis CP , Tang Yi
Published: April 2010

Background

Pueraria lobata flower (Gehua) is a medicinal herb to treat intoxication, hepatic and gastrointestinal tract lesion induced by alcohol. This study aims to develop a new HPLC method for the determination of two major isoflavones in P. lobata flowers, namely tectoridin and 6"-O-xylosyl-tectoridin.

Methods

A high performance liquid chromatography (HPLC) method with a C18 column (250 mm × 4.6 mm, 5 μm) was developed for the quantitative analysis of tectoridin and 6"-O-xylosyl-tectoridin, the main isoflavone components in P. lobata flower. A simple gradient of acetonitrile/water (0 min 15:85; 35 min 50:50; 36 min 15:85; 40 min 15:85; v/v) was used, and 265 nm was selected as detection wavelength. Tectoridin and 6"-O-xylosyl-tectoridin were used as the external standards in quality control of P. lobata flower for the first time. The method was applied to practical use in quality assessment of eleven batches of P. lobata flower samples in Chinese herbal medicine market.

Results

The peak area response was linear for tectoridin in the 11.8-236.4 μg/mL range with a correlation coefficient of 0.9996 (P < 0.001), and for 6"-O-xylosyl-tectoridin in the 10.33-185.99 μg/mL range with a correlation coefficient of 0.9984 (P < 0.001) respectively. The average recoveries were 102.7-103.7% for tectoridin and 95.7-103.2% for 6"-O-xylosyl-tectoridin (RSDs < 3%), and the intra-day and inter-day RSDs of the two components were less than 2%. This HPLC method was applied to assess the quality of P. lobata flower from eleven provinces in China. P. lobata flowers from northern China contained 26.46-43.28 mg/g of tectoridin and 30.90-48.23 mg/g of 6"-O-xylosyl-tectoridin comparing to 10.00-19.81 mg/g of tectoridin and 11.08-37.03 mg/g of 6"-O-xylosyl-tectoridin in those from southern China.

Conclusion

The results showed that P. lobata flowers from northern China contained more tectoridin and 6"-O-xylosyl-tectoridin than those from southern China.
Utilizing elementary mode analysis, pathway thermodynamics, and a genetic algorithm for metabolic flux determination and optimal metabolic network design
Authors: Boghigian Brett A , Shi Hai , Lee Kyongbum , Pfeifer Blaine A
Published: April 2010

Background

Microbial hosts offer a number of unique advantages when used as production systems for both native and heterologous small-molecules. These advantages include high selectivity and benign environmental impact; however, a principal drawback is low yield and/or productivity, which limits economic viability. Therefore a major challenge in developing a microbial production system is to maximize formation of a specific product while sustaining cell growth. Tools to rationally reconfigure microbial metabolism for these potentially conflicting objectives remain limited. Exhaustively exploring combinations of genetic modifications is both experimentally and computationally inefficient, and can become intractable when multiple gene deletions or insertions need to be considered. Alternatively, the search for desirable gene modifications may be solved heuristically as an evolutionary optimization problem. In this study, we combine a genetic algorithm and elementary mode analysis to develop an optimization framework for evolving metabolic networks with energetically favorable pathways for production of both biomass and a compound of interest.

Results

Utilization of thermodynamically-weighted elementary modes for flux reconstruction ofE. colicentral metabolism revealed two clusters of EMs with respect to their ΔGp°. For proof of principle testing, the algorithm was applied to ethanol and lycopene production inE. coli. The algorithm was used to optimize product formation, biomass formation, and product and biomass formation simultaneously. Predicted knockouts often matched those that have previously been implemented experimentally for improved product formation. The performance of a multi-objective genetic algorithm showed that it is better to couple the two objectives in a single objective genetic algorithm.

Conclusion

A computationally tractable framework is presented for the redesign of metabolic networks for maximal product formation combining elementary mode analysis (a form of convex analysis), pathway thermodynamics, and a genetic algorithm to optimize the production of two industrially-relevant products, ethanol and lycopene, fromE. coli. The designed algorithm can be applied to any small-scale model of cellular metabolism theoretically utilizing any substrate and applied towards the production of any product.
Mutation screening of melatonin-related genes in patients with autism spectrum disorders
Authors: Jonsson Lina , Ljunggren Elin , Bremer Anna , Pedersen Christin , Landén Mikael , Thuresson Kent , Giacobini MaiBritt , Melke Jonas
Published: April 2010

Background

One consistent finding in autism spectrum disorders (ASD) is a decreased level of the pineal gland hormone melatonin and it has recently been demonstrated that this decrease to a large extent is due to low activity of the acetylserotonin O-methyltransferase (ASMT), the last enzyme in the melatonin synthesis pathway. Moreover, mutations in the ASMT gene have been identified, including a splice site mutation, that were associated with low ASMT activity and melatonin secretion, suggesting that the low ASMT activity observed in autism is, at least partly, due to variation within the ASMT gene.

Methods

In the present study, we have investigated all the genes involved in the melatonin pathway by mutation screening of AA-NAT (arylalkylamine N-acetyltransferase), ASMT, MTNR1A, MTNR1B (melatonin receptor 1A and 1B) and GPR50 (G protein-coupled receptor 50), encoding both synthesis enzymes and the three main receptors of melatonin, in 109 patients with autism spectrum disorders (ASD). A cohort of 188 subjects from the general population was used as a comparison group and was genotyped for the variants identified in the patient sample.

Results

Several rare variants were identified in patients with ASD, including the previously reported splice site mutation in ASMT (IVS5+2T>C). Of the variants affecting protein sequence, only the V124I in the MTNR1B gene was absent in our comparison group. However, mutations were found in upstream regulatory regions in three of the genes investigated, ASMT, MTNR1A, and MTNR1B.

Conclusions

Our report of another ASD patient carrying the splice site mutation IVS5+2T>C, in ASMT further supports an involvement of this gene in autism. Moreover, our results also suggest that other melatonin related genes might be interesting candidates for further investigation in the search for genes involved in autism spectrum disorders and related neurobehavioral phenotypes. However, further studies of the novel variants identified in this study are warranted to shed light on their potential role in the pathophysiology of these disorders.
High occurrence of cyclosporiasis in Istanbul, Turkey, during a dry and warm summer
Authors: Ozdamar Melda , Hakko Elif , Turkoglu Salih
Published: April 2010

We evaluated the incidence of Cyclospora cayetanensis in immunocompetent, diarrheic patients during the summers of 2006-2009 in Istanbul. Stools from 1876 patients were examined using microscopic techniques. Cyclospora oocysts were observed in wet preparations by light and epifluorescence microscopy and in fecal smears that were stained by Kinyoun's modified acid-fast stain. Characteristic Cyclospora oocysts were observed in 2 patients in 2006, 17 in 2007, and one in 2009. Samples positive for Cyclospora were further analyzed by a single step polymerase chain reaction (PCR) with Cyclospora-specific primers from the ITS-1 region of the genome.

The majority of the Cyclospora positive cases (15) were clustered during about 15 days in June 2007, indicating an unusual incidence of cyclosporiasis in this time period. The climatic characteristics of 2007 could have played a role in this high occurrence rate.
Repercussions of mild diabetes on pregnancy in Wistar rats and on the fetal development
Authors: Saito Felipe H , Damasceno Débora C , Kempinas Wilma G , Morceli Glilciane , Sinzato Yuri K , Taylor Kristin N , Rudge Marilza VC
Published: April 2010

Background

Experimental models are necessary to elucidate diabetes pathophysiological mechanisms not yet understood in humans. Objective: To evaluate the repercussions of the mild diabetes, considering two methodologies, on the pregnancy of Wistar rats and on the development of their offspring.

Methods

In the 1st induction, female offspring were distributed into two experimental groups: Group streptozotocin (STZ, n = 67): received the β-cytotoxic agent (100 mg STZ/kg body weight - sc) on the 1st day of the life; and Non-diabetic Group (ND, n = 14): received the vehicle in a similar time period. In the adult life, the animals were mated. After a positive diagnosis of pregnancy (0), female rats from group STZ presenting with lower glycemia than 120 mg/dL received more 20 mg STZ/kg (ip) at day 7 of pregnancy (2nd induction). The female rats with glycemia higher than 120 mg/dL were discarded because they reproduced results already found in the literature. In the mornings of days 0, 7, 14 and 21 of the pregnancy glycemia was determined. At day 21 of pregnancy (at term), the female rats were anesthetized and killed for maternal reproductive performance and fetal development analysis. The data were analyzed using Student-Newman-Keuls, Chi-square and Zero-inflated Poisson (ZIP) Tests (p < 0.05).

Results

STZ rats presented increased rates of pre (STZ = 22.0%; ND = 5.1%) and post-implantation losses (STZ = 26.1%; ND = 5.7%), reduced rates of fetuses with appropriate weight for gestational age (STZ = 66%; ND = 93%) and reduced degree of development (ossification sites).

Conclusion

Mild diabetes led a negative impact on maternal reproductive performance and caused intrauterine growth restriction and impaired fetal development.
Integrin-independent role of CalDAG-GEFI in neutrophil chemotaxis
Authors: Carbo Carla , Duerschmied Daniel , Goerge Tobias , Hattori Hidenori , Sakai Jiro , Cifuni Stephen M , White Gilbert C , Chrzanowska-Wodnicka Magdalena , Luo Hongbo R , Wagner Denisa D
Published: April 2010

CalDAG-GEFI regulates neutrophil chemotaxis independent of integrin function by a mechanism that involves F-actin distribution and cell polarization.

Chemotaxis and integrin activation are essential processes for neutrophil transmigration in response to injury. CalDAG-GEFI plays a key role in the activation of β1, β2, and β3 integrins in platelets and neutrophils by exchanging a GDP for a GTP on Rap1. Here, we explored the role of CalDAG-GEFI and Rap1b in integrin-independent neutrophil chemotaxis. In a transwell assay, CalDAG-GEFI−/− neutrophils had a 46% reduction in transmigration compared with WT in response to a low concentration of LTB4. Visualization of migrating neutrophils in the presence of 10 mM EDTA revealed that CalDAG-GEFI−/− neutrophils had abnormal chemotactic behavior compared with WT neutrophils, including reduced speed and directionality. Interestingly, Rap1b−/− neutrophils had a similar phenotype in this assay, suggesting that CalDAG-GEFI may be acting through Rap1b. We investigated whether the deficit in integrin-independent chemotaxis in CalDAG-GEFI−/− neutrophils could be explained by defective cytoskeleton rearrangement. Indeed, we found that CalDAG-GEFI−/− neutrophils had reduced formation of F-actin pseudopodia after LTB4 stimulation, suggesting that they have a defect in polarization. Overall, our studies show that CalDAG-GEFI helps regulate neutrophil chemotaxis, independent of its established role in integrin activation, through a mechanism that involves actin cytoskeleton and cellular polarization.
Pivotal Advance: The pattern recognition receptor ligands lipopolysaccharide and polyinosine-polycytidylic acid stimulate factor B synthesis by the macrophage through distinct but overlapping mechanisms
Authors: Kaczorowski David J , Afrazi Amin , Scott Melanie J , Kwak Joon H , Gill Roop , Edmonds Rebecca D , Liu Yujian , Fan Jie , Billiar Timothy R
Published: April 2010

Stimulation of TLR4 by LPS results in factor B synthesis by macrophages, while factor B production in response to poly I:C is independent of TRL3 and TRIF.

TLRs and complement are critical to the host response in sepsis, trauma, and ischemia/reperfusion. We hypothesize that TLR stimulation leads to synthesis and release of complement components by macrophages, an important source of extrahepatic complement. RAW264.7 macrophages or peritoneal macrophages from WT and TLR4-, TLR3-, TRIF-, or MyD88-deficient mice were cultured under standard conditions. In some experiments, cells were pretreated with inhibitors of MAPKs or a NF-κB inhibitor. Cells were stimulated with TLR ligands at known stimulatory concentrations. Intratracheal and i.p. injections were also performed in mice. RT-PCR, Western blotting, and immunocytochemistry were used for analysis. Using a RT-PCR-based panel, we demonstrate that of 18 complement components tested, factor B of the alternative pathway is the most robustly up-regulated complement component in macrophages in response to LPS. This up-regulation results in release of factor B into the media. Up-regulation of factor B by LPS is dependent on TLR4, TRIF, JNK, and NF-κB. A screen of other TLR ligands demonstrated that stimulation with poly I:C (dsRNA analog) also results in up-regulation of factor B, which is dependent on JNK and NF-κB but independent of TLR3 and TRIF. Up-regulation of factor B is also observed after intratracheal and i.p. injection of LPS or poly I:C in vivo. PRR stimulation profoundly influences production and release of factor B by macrophages. Understanding the mechanisms of PRR-mediated complement production may lead to strategies aimed at preventing tissue damage in diverse settings, including sepsis, trauma, and ischemia/reperfusion.
An experimental study of train-induced structural and environmental vibrations of a rail transit elevated bridge with ladder tracks
Authors: Xia H , Chen J G , Xia C Y , Inoue H , Zenda Y , Qi L
Published: April 2010

The ladder track is a new type of elastically supported vibration-reduction track system that has been applied to several urban railways in China. A field experiment was carried out at the trial section of an elevated bridge on Beijing Metro Line 5 where the ladder track is installed. The vibration responses of rails, sleepers, bridge deck, and the surrounding ground surface were measured when the train traversed on the ladder track and on the common non-ballasted slab track. The data were analysed in the time domain and the frequency domain. The experimental results show that as compared to the common non-ballasted track, the ladder track has special vibration reduction characteristics.
Diagnostic laparoscopies in rural areas: a different use for the cystoscope
Authors: Gnanaraj J
Published: April 2010

Minimally invasive surgeries are gaining popularity even in rural areas. Diagnostic laparoscopies overcome the disadvantages of open surgical procedures and provide useful diagnostic information. We describe a method of carrying out diagnostic laparoscopies using the cystoscope in rural areas.
Trachoma visual impairment in a SAFE area in Ethiopia
Authors: Roba Assegid Aga , Zondervan Marcia , Patel Daksha
Published: April 2010

A cross-sectional survey of visual impairment (VI) was undertaken in the Enemor district in Southern Ethiopian where five years of trachoma control programme has been implemented using the SAFE (Surgery, Antibiotics, Face washing, Environmental hygiene) strategy. The prevalence of VI (presenting visual acuity in the better eye <6/18) in 451 people above 40 years of age was 22% (CI:17.6 to 27.6) and most of it was accounted for by cataract (67%) and trachoma (13%). Whereas cataract remains a prominent cause, contribution of trachoma among leading causes of VI is declining in communities where SAFE strategy has been implemented.
Adults With Intellectual and Developmental Disabilities and Participation in Decision Making: Ethical Considerations for Professional–Client Practice
Authors: Lotan Gurit , Ells Carolyn
Published: April 2010

In this article, the authors challenge professionals to re-examine assumptions about basic concepts and their implications in supporting adults with intellectual and developmental disabilities. The authors focus on decisions with significant implications, such as planning transition from school to adult life, changing living environments, and managing health issues. The analysis highlights important concepts that are less often addressed: autonomy, empowerment, participation in decision making, asymmetrical power, outer-directedness, and respect for persons. The authors suggest that professionals adopt a moral principle of respect for persons as an overarching guiding principle in their work with adults with intellectual and developmental disabilities. The value of self-determination and person-centered planning processes are placed in the larger scope of ethical practice. The authors offer a set of practical considerations that encourage respect for these individuals by involving them in the decision-making process in situations that have a large impact on them.
Sticks, Stones, and Stigma: A Study of Students' Use of the Derogatory Term “Retard”
Authors: Siperstein Gary N. , Pociask Sarah E. , Collins Melissa A.
Published: April 2010

The present study explored the prevalence of the derogatory invective “retard” (i.e., “r-word”) in everyday speech among American youth. A total of 1,169 youth between the ages of 8 and 18 years old participated in the present study. Results showed high prevalence of the r-word, as 92% of youth had heard someone use the word as a slang invective. Results also indicated that youth responded differently depending on who the word was directed toward (i.e., person with or without an intellectual disability), who said the word (i.e., friend vs. nonfriend), and who heard the word (i.e., females vs. males; younger vs. older youth). Implications for eliminating the r-word from everyday use are discussed.
Lowering the Risk of Secondary HIV Transmission: Insights From HIV‐Positive Youth and Health Care Providers
Authors: Leonard Amy D. , Markham Christine M. , Bui Thanh , Shegog Ross , Paul Mary E.
Published: April 2010

CONTEXT: Both perinatally and behaviorally infected HIV‐positive youth engage in sexually risky behaviors, and a better understanding of the perceptions of these youth and of health care providers regarding disclosure of HIV status and risk reduction would aid in the development of behavioral interventions for such youth.

METHODS: In spring 2007, some 20 HIV‐positive inner‐city youth (aged 13–24) and 15 health care providers who work with HIV‐infected youth participated in in‐depth, semistructured interviews. Youth were recruited at an HIV clinic, AIDS clinics and an AIDS service organization, and had received care from participating providers. Detailed contextual and thematic discourse analysis was performed on interview transcriptions.

RESULTS: Eighteen of the 20 youth had disclosed their HIV status to another individual at least once. Eleven reported being sexually active, and three of these had been perinatally infected. Qualitative analysis revealed four subthemes related to disclosure: stigma and emotions, trust issues, reasons for disclosing and strategies for addressing disclosure. Five subthemes were identified related to sexual risk reduction: dating challenges, attitudes toward condom use, self‐efficacy for condom use negotiation, pregnancy attitudes and sexual risk reduction strategies. Providers reported that access to more engaging and interactive educational tools within the clinic setting could enhance their risk reduction counseling with HIV‐positive youth.

CONCLUSIONS: HIV‐positive youth experience multiple challenges regarding disclosure and sexual risk reduction, and health care providers need innovative tools that can be used in clinic settings to improve adolescents' skills in reducing risky sexual behavior.
A counter example to an ideal membership test
Authors: Hauenstein Jonathan D.
Published: April 2010

An ideal membership test is presented by A. Leykin in Numerical primary decomposition using dual bases. A counter example is presented to demonstrate that the proposed test is invalid.
Dipeptidyl Peptidase‐4 Inhibitors for the Treatment of Type 2 Diabetes Mellitus
Authors: Neumiller Joshua J. , Wood Lindy , Campbell R. Keith
Published: April 2010

Type 2 diabetes mellitus traditionally has been characterized by insulin resistance and β‐cell dysfunction, leading to hyperglycemia and eventual micro‐ and macrovascular complications. Dipeptidyl peptidase‐4 (DPP‐4) inhibitors are a relatively new class of drugs available for the management of type 2 diabetes. In order to provide a comprehensive evaluation and comparison of the pharmacology, pharmacokinetics, efficacy, and safety of the DPP‐4 inhibitors—sitagliptin, vildagliptin, saxagliptin, and alogliptin—in the treatment of type 2 diabetes, we conducted a MEDLINE search (1966–July 2009) for pertinent English‐language articles. Abstracts of the annual meetings of the American Diabetes Association and European Association for the Study of Diabetes from 2005–2009 were also searched. As a drug class, the DPP‐4 inhibitors have become widely accepted in clinical practice because of their low risk of hypoglycemia, favorable adverse‐effect profile, and once‐daily dosing. They are weight neutral (do not cause weight gain or loss) and appear to decrease β‐cell apoptosis and increase β‐cell survival. Because clinical studies directly comparing agents from this class have not, to our knowledge, been conducted, making comparisons in terms of efficacy and safety will become difficult for clinicians as more agents become available. Based on information from preclinical, clinical, and postmarketing data, there does not appear to be a compelling advantage of one DPP‐4 inhibitor over another in terms of efficacy, safety, or ease of clinical use. Although theoretical advantages exist for agents with a higher specificity for DPP‐4 inhibition versus inhibition of other isoenzymes associated with toxicity comparative studies and/or increased clinical experience with this class of drug will determine the clinical advantages, if any, of one agent over another.
Identifying Medication Misadventures: Poor Agreement Among Medical Record, Physician, Nurse, and Patient Reports
Authors: Kaboli Peter J. , Glasgow Justin M. , Jaipaul C. Komal , Barry William A. , Strayer Jill R. , Mutnick Barbara , Rosenthal Gary E.
Published: April 2010

Study Objective. To analyze and compare four different methods of detecting medication misadventures in order to determine the optimal system for reporting clinically observed medication misadventures.

Design. Prospective cohort study.

Setting. Forty‐eight‐bed general internal medicine inpatient ward at a large academic teaching hospital with a decentralized pharmacy system.

Patients. One hundred twenty‐six patients (54% male, mean age 54 yrs) with 133 consecutive admissions to the ward (mean length of stay 7.8 days) over an 8–week period from December 2001–February 2002.

Intervention. Medication misadventures were detected by four methods: house staff (resident physicians) report during their morning conference, nursing report during shift change, patient report at the discharge interview, and standardized medical record review. All methods of reporting medication misadventures were compared with the hospital's existing electronic medication misadventure reporting system.

Measurements and Main Results. Overall, 63 patients (47% of 133 admissions) experienced at least one medication misadventure. Thirty‐seven adverse drug events (ADEs) and 69 medication errors were observed over 1035 patient bed‐days. Little overlap was noted among the four intervention methods, with nearly 80% of all 106 events detected by only a single method (medical record review 51% [54 events], patient interview 11% [12], house‐staff report 9% [10], nurse report 8% [9]). Of the 37 ADEs, 6 (16%) were due to medication errors and 10 (27%) were preventable. Of five life‐threatening ADEs, all were preventable, and all were reported in the medical record and the electronic reporting system; however, only two were reported by a nurse, two by a resident physician, and one by a patient.

Conclusion. Little overlap was noted among the individual medication misadventure reporting methods, suggesting the need to use multiple complementary methods to identify medication misadventures in hospitalized patients. These findings have important implications for development of surveillance systems, design of prevention initiatives, and future medication safety research.
Trimethoprim‐Sulfamethoxazole‐Induced Hepatotoxicity in a Pediatric Patient
Authors: Bell Tara L. , Foster Jennifer N. , Townsend Mary L.
Published: April 2010

Due to the escalating rates of community‐acquired methicillin‐resistant Staphylococcus aureus (CA‐MRSA) infection, trimethoprim‐sulfamethoxazole (TMP‐SMX) is being used increasingly in the pediatric population for skin and soft tissue infections. Although this combination agent has been associated with a hypersensitivity syndrome involving cutaneous skin eruptions, pediatric cases of TMP‐SMX‐induced hepatotoxicity are rare. We describe a relatively healthy, 9–year‐old boy who developed a CA‐MRSA skin and soft tissue infection and was treated with TMP‐SMX. After 14 days of therapy, he was taken to the emergency department with a 3–day history of fever, headache, and neck pain. He was diagnosed with a viral syndrome, acetaminophen was prescribed, and he was sent home. Three days later, the patient returned to the emergency department with fever, vomiting, decreased energy and appetitie, and suprapubic abdominal pain, and he was hospitalized. Laboratory test results revealed elevated liver function test values. After other potential causes of liver toxicity were excluded, TMP‐SMX was determined to be the cause of his acute liver toxicity. The drug was discontinued, his symptoms resolved, and his liver function tests returned to normal. Use of the Naranjo adverse drug reaction probability scale indicated a probable relationship (score of 5) between the patient's development of hepatotoxicity and the TMP‐SMX therapy. This rare adverse reaction to TMP‐SMX has been reported in adults; however, to our knowledge, it has been reported in only five other children. Due to the increasing use of TMP‐SMX in children, clinicians should be aware of this potentially life‐threatening, immune‐mediated hypersensitivity reaction. Fortunately, however, the hepatotoxicity appears to resolve after discontinuation of the TMP‐SMX therapy in most reported cases. This case report illustrates the importance of early detection of drug‐induced hepatotoxicity and timely drug discontinuation to prevent the need for liver transplantation.
Clinical Management of Hepatic Encephalopathy
Authors: Schiano Thomas D.
Published: April 2010

The number of patients with cirrhosis in the United States continues to rise, and 30–45% of these patients are expected to develop hepatic encephalopathy. A broad spectrum of clinical manifestations is seen with the disorder, including mental or personality changes, asterixis, decreased energy level, impaired cognition, impaired sleep‐wake cycle, decreased hand‐eye coordination, psychomotor retardation, and incessant talking. Hepatic encephalopathy is a clinical diagnosis, and several scoring systems have been used to determine the severity of hepatic encephalopathy. The West Haven Criteria appear to be the scoring system most frequently used. Minimal hepatic encephalopathy has been reported to affect 60–70% of patients with cirrhosis and is predictive of the development of overt hepatic encephalopathy. An estimated 10–50% of patients who have undergone a transjugular intrahepatic portosystemic shunt for variceal bleeding develop hepatic encephalopathy. A great amount of attention has centered on the role of ammonia in hepatic encephalopathy, but that role is still largely hypothetical. Lactulose has been used for many years to minimize the effects of hepatic encephalopathy; however, noncompliance with lactulose is a common cause of rehospitalization. The pathophysiology of hepatic encephalopathy is extremely complex, and formal treatment guidelines are grossly outdated. The survival rate after 3 years among patients with hepatic encephalopathy is only 25%.
Pharmacoeconomics of Hepatic Encephalopathy
Authors: Neff Guy
Published: April 2010

Understanding and appreciating the science of pharmacoeconomics have become even more important for health care providers and insurers during the recent economic downturn. Evaluating the true costs of any disease is complex; both direct costs, such as costs of drug therapy and the provision of care, and indirect costs, such as lost earnings and reduced quality of life, must be taken into account. With chronic liver disease, the most recent data indicate that direct costs were more than $2 billion whereas indirect costs were more than $450 million. Hepatic encephalopathy, a common complication of chronic liver disease, contributes to this economic burden. Although patients' length of stay during hospitalization for hepatic encephalopathy decreased from almost 9 days to 6 days (and has remained stable over the past few years) from 1993 to 2007, hospitalization costs rose from $13,000 to $30,000/hospital stay. In addition, 22% of patients were discharged directly to nursing homes or rehabilitation centers, which increases total costs. When assessing therapy for hepatic encephalopathy, it is important to consider the total costs of the disease, not just treatment costs. Although more expensive on a daily basis than lactulose, rifaximin has been shown to reduce hospitalization rates, has a better adverse‐effect profile, and increases patient compliance. One study found that rifaximin produced a cost savings/patient/year of more than $3000 over lactulose therapy.
The Holocene transgression as recorded by incised-valley infilling in a rocky coast context with low sediment supply (southern Brittany, western France)
Authors: Menier David , Tessier Bernadette , Proust Jean-Noël , Baltzer Agnès , Sorrel Philippe , Traini Camille
Published: April 2010

A combination of morphobathymetric studies, very high-resolution seismics, core sampling and radiocarbon age data is used to investigate the latest stage of the sedimentary infilling of incised valleys in southern Brittany, related to the Holocene transgression. Owing to the bedrock morphology of this highly irregular rocky coast, two main types of valleys are defined by topographic rocky highs parallel to the coastline: 1) wide and rather shallow incised valleys offshore from a topographic sill, 2) narrow and relatively deep valleys between the sill and the coast (ria-type valley). The sedimentary infilling in both types of valleys becomes highly differentiated as the transgression advances onto the coastal area. In the wide valley seaward of the topographic sill, the infilling consists mainly of offshore heterolithic facies while, in the ria-type valley, most of the infill is composed of brackish mudflat deposits and estuarine tidal muddy sands. As the transgression proceeds, the rocky highs are flooded and the whole area is finally covered by the offshore facies. Radiocarbon dating indicates that: 1) the marine ravinement surface is highly diachronous (a few thousand years cross-shore); 2) the top of the offshore facies, coarser and very shelly, represents an episode of condensed sedimentation from about 3000 to 4000 years ago, amalgamating the maximum flooding surface (MFS) and the highstand systems tract (HST). However, we observe a muddy drape, strongly bioturbated in places, in the most proximal areas, overlying the offshore facies. It is thought to represent the modern and most recent stage of sedimentary infilling. This mud cover is made of fine-grained sediments of fluvial and biological origin, and is interpreted as a prograding HST. It reflects an increased influx, partly due to human activities. Finally, the main features of incised valley sedimentary infilling in a rocky coast context with low sediment supply can be characterized by (i) the very strong control of bedrock morphology, (ii) the diachronous character of the transgression, (iii) the late position of the MFS, and (iv), the highly reduced volume of the HST.
Holocene evolution of a Languedocian lagoonal environment controlled by inherited coastal morphology (northern Gulf of Lions, France)
Authors: Raynal Olivier , Bouchette Frédéric , Certain Raphaël , Sabatier Pierre , Lofi Johanna , Seranne Michel , Dezileau Laurent , Briqueu Louis , Ferrer Pierre , Courp Thierry
Published: April 2010

The Maguelone shore extends along the northern coast of the Gulf of Lions margin, West of the Rhône delta and East of some high gradient coastal streams that have been providing most of the clastic sediments to the Gulf of Lions margin since the early Miocene. This 10 km wide area comprises an onshore small coastal watershed (15 km long) in low-lying carbonate hills, kilometer wide marshes, sandy beach and shoreface featuring local low sedimentation. Deposit architecture in such a coastal zone records dynamics of incised valley fill under the influence of rivers and wave/current hydrodynamics in a microtidal environment during an eustatic cycle.

A detailed analysis of about 250 km of very high resolution seismic profiles, tens of cores and outcrops data revealed the evolution of the Maguelone coastal system from Late-Quaternary to present-day. It highlighted also dominant denudation processes in the upstream catchments associated to the formation of incised valley seaward during Quaternary. Combination of this inherited morphology together with hydrodynamics controlled the lagoonal environment evolution since the last transgression. In particular, the Maguelone shore is characterized by the formation of built-over-rias lagoonal systems and records an evolution from partially protected lagoon to isolated lagoon environment. These two stages of lagoon evolution correspond to distinct deposit environments. Correlation of fauna contents with deposit geometry improves lagoonal environment models.
Stratigraphic organisation of a composite macrotidal wedge: the Holocene sedimentary infilling of the Mont-Saint-Michel Bay (NW France)
Authors: Tessier Bernadette , Billeaud Isabelle , Lesueur Patrick
Published: April 2010

The Mont-Saint-Michel Bay (NW France) is a composite macrotidal environment that was filled up in the course of the Holocene transgression and sea-level highstand. Three main sub-environments constitute the present-day landscape of the bay: 1) a wide embayment with extensive mud to sandflats in the south, 2) a sandy to muddy channel-and-shoal estuarine system in the east, 3) a wave-dominated sandy coast composed of beach and dune barrier in the north.

The Holocene infill of this composite macrotidal basin has been studied thanks to a set of vibrocores and VHR seismic data. The main results are summarized as follows: the TST is composed by a low-energy aggradational unit in the axis of the estuarine valley, and by high-energy sediment bodies (tidal dunes and banks) outside the valley; the HST (post 6500 yr B.P.) constitutes the main component of the infill. In the north, it is characterised by an aggradational unit made of back-barrier tidal lagoonal infill successions. In the embayment, it is represented by an aggradational unit composed of tidal-flat deposits. In the estuarine axis, the HST is constituted by a sand-dominated tidal channel-and-shoal belt.

The rate of the Holocene sea-level rise appears to be the main factor of control of the infill architecture of the Mont-Saint-Michel Bay since the most significant change occurred around 6500 yr B.P. when the transgression slowed down. The interaction between hydrodynamic agents and sediment supply exerts as well a key control, especially during the late Holocene, when transgression is slow. The impact of climate changes is recorded in the infill during this period. The rocky substrate hypsometry should be considered also as a major forcing parameter as it determines the potential of preservation of the infill in relation with the depth of ravinement by tidal currents.
Examining the Role and Methodology of Strategic Culture
Authors: Greathouse Craig B.
Published: April 2010

Strategic culture has become a concept of significant debate within security studies over the last decade. It represents an attempt to integrate cultural influences about how actors within the international system made decisions regarding the use of force. Learning more about how and why actors use force in the system is an important topic to which strategic culture may provide some answers but the process of applying it is difficult. This article examines some of the trends in the work on strategic culture including definitional and methodological and proposes some approaches which may make the concept more accessible for researchers within the field.
Climate Change: The Hottest Issue in Security Studies?
Authors: Parsons Rymn J
Published: April 2010

Security studies in the 21st Century have broadened to encompass a variety of transnational phenomena newly defined as threats. Climate change is one of these phenomena. In theoretical terms, climate change is being securitized. Climate change, in which man‐made global warming is a major factor, is an internationally recognized phenomenon that is projected to produce dramatic, accelerating, and long‐lasting human, economic, and political consequences with profound security implications. These will be most pronounced in places where the effects of climate change are greatest, particularly affecting weak states already especially vulnerable to environmental destabilization. National security establishments in the United States and elsewhere are hurriedly attempting to come to grips with climate change and how to respond to its strategic challenges. This paper, in the context of securitization theory, human security, and sustainable security, discusses the phenomena of global warming and climate change, examines the destabilizing effects of climate change, describes how such effects are being perceived as transnational threats to security, and argues that securitization of climate change is necessary, timely, and irreversible.
Chemical reaction effects on vertical oscillating plate with variable temperature
Authors: Muthucumaraswamy R.
Published: April 2010

Free convective flow of a viscous incompressible flow past an infinite vertical oscillating plate with variable temperature and uniform mass diffusion is presented here, taking into account of the homogeneous chemical reaction of first-order. The plate temperature is raised linearly with respect to time and the concentration level near the plate is raised to C?w. An exact solution to the dimensionless governing equations has been obtained by the Laplace transform method, when the plate is oscillating harmonically in its own plane. The effects of velocity and concentration are studied for different parameters like phase angle, chemical reaction parameter, Schmidt number and time are studied. It is observed that the velocity increases with decreasing phase angle ?t or chemical reaction parameter.
Biodiesel synthesis using K2CO3/Al-O-Si aerogel catalysts
Authors: Lukic Ivana , Krstic Jugoslav , Glisic Sandra , Jovanovic Dusan , Skala Dejan
Published: April 2010

In this study, catalysts for fatty acid methyl esters (FAME or biodiesel) synthesis with K2CO3 as the active component on an alumina/silica support were synthesized using the sol-gel method, which was followed by drying the ?dense? wet gels with supercritical carbon dioxide to obtain the aerogels. The prepared catalysts were characterized by XRD analysis, FTIR spectroscopy and N2 physisorption at 77 K, and tested in the methanolysis of sunflower oil. The effects of reaction variables, such as reaction time, temperature and methanol to oil molar ratio, on the yield of FAME were investigated. The aerogel catalysts with K2CO3 as the active component on an alumina/silica support exhibited good activity in the methanolysis of sunflower oil. The leaching of potassium when the catalyst was in contact with pure methanol under the working conditions of methanolysis was also tested in this study, indicating that it occurred only at higher temperatures, while at lower ones, it was negligible.
Identification of Body Fat Mass as a Major Determinant of Metabolic Rate in Mice
Authors: Kaiyala Karl J. , Morton Gregory J. , Leroux Brian G. , Ogimoto Kayoko , Wisse Brent , Schwartz Michael W.
Published: April 2010

OBJECTIVE

Analysis of energy expenditure (EE) in mice is essential to obesity research. Since EE varies with body mass, comparisons between lean and obese mice are confounded unless EE is normalized to account for body mass differences. We 1) assessed the validity of ratio-based EE normalization involving division of EE by either total body mass (TBM) or lean body mass (LBM), 2) compared the independent contributions of LBM and fat mass (FM) to EE, and 3) investigated whether leptin contributes to the link between FM and EE.

RESEARCH DESIGN AND METHODS

We used regression modeling of calorimetry and body composition data in 137 mice to estimate the independent contributions of LBM and FM to EE. Subcutaneous administration of leptin or vehicle to 28 obese ob/ob mice and 32 fasting wild-type mice was used to determine if FM affects EE via a leptin-dependent mechanism.

RESULTS

Division of EE by either TBM or LBM is confounded by body mass variation. The contribution of FM to EE is comparable to that of LBM in normal mice (expressed per gram of tissue) but is absent in leptin-deficient ob/ob mice. When leptin is administered at physiological doses, the plasma leptin concentration supplants FM as an independent determinant of EE in both ob/ob mice and normal mice rendered leptin-deficient by fasting.

CONCLUSIONS

The contribution of FM to EE is substantially greater than predicted from the metabolic cost of adipose tissue per se, and the mechanism underlying this effect is leptin dependent. Regression-based approaches that account for variation in both FM and LBM are recommended for normalization of EE in mice.