bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of the Idaho Technology FilmArray System to Real-Time PCR for Detection of Respiratory Pathogens in Children
Authors: Pierce Virginia M. , Elkan Michael , Leet Marilyn , McGowan Karin L. , Hodinka Richard L.
Published: November 2011

The FilmArray Respiratory Panel (RP) multiplexed nucleic acid amplification test (Idaho Technology, Inc., Salt Lake City, UT) was compared to laboratory-developed real-time PCR assays for the detection of various respiratory viruses and certain bacterial pathogens. A total of 215 frozen archived pediatric respiratory specimens previously characterized as either negative or positive for one or more pathogens by real-time PCR were examined using the FilmArray RP system. Overall agreement between the FilmArray RP and corresponding real-time PCR assays for shared analytes was 98.6% (kappa = 0.92 [95% confidence interval (CI), 0.89 to 0.94]). The combined positive percent agreement was 89.4% (95% CI, 85.4 to 92.6); the negative percent agreement was 99.6% (95% CI, 99.2 to 99.8). The mean real-time PCR threshold cycle (

C
T

) value for specimens with discordant results was 36.46 ± 4.54. Detection of coinfections and correct identification of influenza A virus subtypes were comparable to those of real-time PCR when using the FilmArray RP. The greatest comparative difference in sensitivity was observed for adenovirus; only 11 of 24 (45.8%; 95% CI, 27.9 to 64.9) clinical specimens positive for adenovirus by real-time PCR were also positive by the FilmArray RP. In addition, upon testing 20 characterized adenovirus serotypes prepared at high and low viral loads, the FilmArray RP did not detect serotypes 6 and 41 at either level and failed to detect serotypes 2, 20, 35, and 37 when viral loads were low. The FilmArray RP system is rapid and extremely user-friendly, with results available in just over 1 h with almost no labor involved. Its low throughput is a significant drawback for laboratories receiving large numbers of specimens, as only a single sample can be processed at a time with one instrument.
A Novel Real-Time PCR Method for Determination and Quantification of Each Cytomegalovirus Glycoprotein H Subtype in Clinical Samples
Authors: Ikuta Kazufumi , Ishioka Ken , Sato Yuka , Imamura Takashi , Asano Kimisato , Koyano Shin , Inoue Naoki , Suzutani Tatsuo
Published: November 2011

To investigate reinfection in patients with congenital cytomegalovirus (CMV) infection, we established a CMV subtype-specific real-time quantitative PCR method targeting the CMV gH epitope region that can be used for evaluating pathogenic CMV strains in cases of mixed CMV infection.
Mini-sternotomy for aortic valve replacement reduces the length of stay in the cardiac intensive care unit: meta-analysis of randomised controlled trials
Authors: Khoshbin E , Prayaga S , Kinsella J , Sutherland F W H
Published: November 2011

Background

Mini-sternotomy for isolated aortic valve replacement aims to reduce operative trauma hastening recovery and improving the cosmetic outcome of cardiac surgery. The short-term clinical benefits from the mini-sternotomy are presumed to arise because the incision is less extensive and the lower half of the chest cage remains intact. The basic conduct of virtually all other aspects of the aortic valve replacement procedure remains the same. Therefore, similar long-term outcomes are to be expected.

Objectives

To conduct a meta-analysis of the only available randomised controlled trials (RCT) in the published English literature.

Data sources

Electronic search for relevant publications in MEDLINE, EMBASE and CENTRAL databases were performed. Four studies met the criteria.

Study eligibility criteria

RCT comparing minimally invasive (inverted C or L (J)-shaped) hemi-sternotomy versus conventional sternotomy for adults undergoing isolated aortic valve replacement using standard cardiopulmonary bypass technique.

Methods

Outcome measures were the length of positive pressure ventilation, blood loss, intensive care unit (ICU) and hospital stay.

Results

The length of ICU stay was significantly shorter by 0.57 days in favour of the mini-sternotomy group (CI −0.95 to −0.2; p=0.003). There was no advantage in terms of duration of ventilation (CI −3.48 to 0.36; p=0.11). However, there was some evidence to suggest a reduction in blood loss and the length of stay in hospital in the mini-sternotomy group. This did not prove to be statistically significant (154.17 ml reduction (CI −324.51 to 16.17; p=0.08) and 2.03 days less (CI −4.12 to 0.05; p=0.06), respectively).

Limitations

This study includes a relatively small number of subjects (n=220) and outcome variables. The risk of bias was not assessed during this meta-analysis.

Conclusion

Mini-sternotomy for isolated aortic valve replacement significantly reduces the length of stay in the cardiac ICU. Other short-term benefits may include a reduction in blood loss or the length of hospital stay.
Incidence, time and determinants of tuberculosis treatment default in Yaounde, Cameroon: a retrospective hospital register-based cohort study
Authors: Pefura Yone Eric Walter , Kengne André Pascal , Kuaban Christopher
Published: November 2011

Objectives

High rates of antituberculosis treatment discontinuation have been reported in some areas of Africa. The aim of this study was to determine the rate, time to and determinants of antituberculosis treatment default in Yaounde.

Design

This was a retrospective cohort study based on hospital registers. Tuberculosis treatment default or antituberculosis treatment discontinuation was defined as any interruption of treatment for at least 2 months following treatment initiation. Sociodemographic and clinical predictors of treatment discontinuation were investigated with the use of Cox regressions models.

Setting

This study was carried out in the tuberculosis diagnosis and treatment centre at Yaounde Jamot Hospital, which serves as a referral centre for tuberculosis and respiratory diseases for the capital city of Cameroon (Yaounde) and surrounding areas.

Participants

All (1688) patients started on antituberculosis treatment at the centre between January and December 2009 were enrolled. Outcome measures were antituberculosis treatment default and time to treatment default.

Results

Of the 1688 included patients, 337 (20%) defaulted from treatment, 86 (5.1%) died, treatment failed in 6 (0.4%) and 104 (6.2%) were transferred. Therefore, treatment was successfully completed in 1154 (68.4%) patients. Median duration to treatment discontinuation was 90 days (IQR 30–150), and 62% of treatment discontinuation occurred during the continuation phase. Hospitalisation during the intensive phase (adjusted HR 0.69; 95% CI 0.54 to 0.89) and non-consenting for HIV screening (1.65; 1.24 to 2.21) were the main determinants of defaulting from treatment in multivariable analysis.

Conclusions

The default incidence rate is relatively high in this centre and treatment discontinuation occurs frequently during the continuation phase of treatment. Action is needed to improve adherence to treatment when received on an ambulatory basis, to clarify the association between HIV testing and antituberculosis treatment default, and to identify other potential determinants of treatment discontinuation in this setting.
Republished original viewpoint: Complaints, shame and defensive medicine
Authors: Cunningham Wayne , Wilson Hamish
Published: November 2011

While the complaints process is intended to improve healthcare, some doctors appear to practise defensive medicine after receiving a complaint. This response occurs in countries that use a tort-based medicolegal system as well as in countries with less professional liability. Defensive medicine is based on avoiding malpractice liability rather than considering a risk–benefit analysis for both investigations and treatment. There is also evidence that this style of practice is low quality in terms of decision-making, cost and patient outcomes. Western medical practice is based on biomedicine: determining medical failure using the underlying, taken-for-granted assumptions of biomedicine can potentially contribute to a response of shame after an adverse outcome or a complaint. Shame is implicated in the observable changes in practising behaviour after receipt of a complaint. Identifying and responding to shame is required if doctors are to respond to a complaint with an overall improvement in clinical practice. This will eventually improve the outcomes of the complaints process.
Cardiac autonomic function in acutely nitric oxide deficient hypertensive rats: role of the sympathetic nervous system and oxidative stress
Authors: Chaswal Meenakshi , Das Shobha , Prasad Jagdish , Katyal Anju , Fahim Mohammad
Published: November 2011

We evaluated the role of the sympathetic nervous system and oxidative stress in hemodynamic and autonomic control after acute inhibition of the synthesis of nitric oxide, using intravenous (i.v.) injection of 30 mg·kg–1 NG-nitro-l-arginine methyl ester (L-NAME) in adult Wistar rats. Baroreflex sensitivity (BRS) and heart rate variability (HRV) were measured as indices of cardiac autonomic control, before and after L-NAME treatment in rats with intact autonomic innervation, and in rats with chemical sympathectomy by 6-hydroxydopamine. Serum malondialdehyde (MDA) was measured as a marker of oxidative stress. In control rats, L-NAME treatment resulted in a significant rise in blood pressure, augmentation of BRS, and enhanced serum MDA. HRV showed an attenuation of total spectral power and high frequency spectral power, along with a rise of the low to high frequency ratio (LF:HF). Administration of L-NAME produced a pressor response even in sympathectomised rats, but augmented BRS was not observed, and the high frequency spectral power showed an increase, in addition to a significant decline of LF:HF and serum MDA. We therefore conclude that even though pressor response was unaffected, reversal of cardiac autonomic responses and decline in oxidative stress following sympathectomy in L-NAME-treated rats reflects a significant role for sympathetic innervation in acute L-NAME-induced hypertension.
Relaxant and contractile responses of detrusor muscle strips obtained from bladder outlet-obstructed rats treated with doxazosin enantiomers
Authors: Wang Miao , Ren Xue-Jiao , Zhao Qing-Hua , Lin Li-Xin , Wang Xue , Zhao Yan , Ren Lei-Ming
Published: November 2011

(–)Doxazosin, one of (±)doxazosin enantiomers, was speculated to have a pharmacological enantioselectivity between the cardiovascular system and the urinary system by comparison with (+)doxazosin. Therefore, to evaluate the potential benefits of (–)doxazosin in the treatment of benign prostate hyperplasia, we compared the effects of the 3 agents, using rat mesenteric artery preparations and obstructed bladder strips. Concentration–response curves for carbachol (contractile response) and isoprenaline (relaxant response) in detrusor muscle strips of the bladder outlet obstruction (BOO) rats were shifted to the left, with significant increases in the Emax values, and significant decreases in the EC50 values by comparison with the sham-operated rats (P < 0.05, n = 10). The enhanced responses in detrusor muscle strips of the BOO rats treated with (±)doxazosin and its enantiomers at 3 mg·(kg body mass)–1·day–1 for 2 weeks returned to normal levels, and the 3 agents inhibited the enhanced responses to carbachol and isoprenaline to the same extent. On the other hand, the 3 agents uncompetitively inhibited the vasoconstrictive response curves for NA in the rat isolated mesenteric artery, and the pKB value of (–)doxazosin at vascular α1-adrenoceptors was significantly smaller (P < 0.05, n = 6) than that of (+)doxazosin or (±)doxazosin. In conclusion, although (–)doxazosin inhibits vascular functional α1-adrenoceptors more weakly than (+)doxazosin, both agents equally ameliorate the enhanced responses in detrusor muscle of BOO rats, suggesting that the chiral carbon atom in the molecular structure of doxazosin does not affect its beneficial effects in the bladder smooth muscle of BOO rats.
Effect of DETA-NONOate and papaverine on vasodilation of human internal mammary artery
Authors: Rahimi Nastaran , Dehpour Ahmad R. , Javadi-Paydar Mehrak , Sohanaki Hamid , Rabbani Shahram , Ansari Mohammad , Tafti Seyed Hossein Ahmadi
Published: November 2011

In this study, the relaxatory effect of DETA-NONOate is compared with that of papaverine on isolated human internal mammary artery. We investigated the inhibitory effects of DETA-NONOate and papaverine on phenylephrine-induced contractile response in internal mammary artery segments. The internal mammary artery segments, taken from methodologically matched patients who underwent coronary artery bypass grafting, were prepared, placed in an organ bath, and contracted with phenylephrine (10−9 to 10−4 mol/L) to investigate their relaxatory response to DETA-NONOate or papaverine. Phenylephrine dose–response contraction was obtained after 1, 2, and 3 h in segments pre-incubated with DETA-NONOate or papaverine for 30 min. The EC50 that presented for internal mammary artery segments incubated with DETA-NONOate was 3.523 ± 1.2696 × 10–7 mol/L, and for papaverine was 3.467 ± 1.2145 × 10–6 mol/L. In segments pre-incubated with DETA-NONOate, the contractile response to phenylephrine was suppressed in the first 2 h post-incubation, compared with control responsive groups (p < 0.05), but this inhibition was revoked after 3 h post-incubation. We showed that DETA-NONOate has a more significant relaxative effect by comparison with papaverine; moreover, continuous and long-lasting nitric oxide production by DETA-NONOate might be of great importance for the outcome from coronary artery bypass grafting, when internal mammary artery is used as a conduit.
INTER-TESTER RELIABILITY OF SONOGRAPHERS IN DETECTING PATHOLOGICAL LESIONS IN THE ELBOW OF INDIVIDUALS WITH LATERAL EPICONDYLAR PAIN
Authors: Dones Valentin C. , Grimmer-Somers Karen , Thoirs Kerry , Gonzalez-Suarez Consuelo B.
Published: November 2011

Purpose: This research aims to determine the inter-tester reliability of sonographers in detecting presence of lesions in the elbows of participants with Lateral Epicondylar Pain (LEP) using the Musculoskeletal Ultrasound (MSUS) and in measuring the internal dimensions of the Radial Nerve at various points in the upper extremities. Methods: Two healthcare professionals who are experienced in MSUS and a musculoskeletal researcher agreed on the diagnostic sonographic features of LEP. Evidence of lesions was sought on the common extensor tendon (CET), lateral epicondyle, lateral collateral ligament, and distal biceps tendon. Measurements on the internal widest dimensions of the radial nerve at specified points were gathered. Results: There was perfect agreement between the two healthcare professionals in detecting bony irregularities on the lateral epicondyle and strong agreement on the presence of neovascularity in CET. The inter-tester reliability in assessing the internal architecture of the common extensor tendon ranged from poor (CET's margin and fibrillar pattern) to fair (for adjacent fluid and intratendinous calcifications). There were no significant differences between sonographers in measuring the Radial Nerve except for the Posterior Interosseous Nerve. Conclusions: Differences in MSUS assessment on CET's tendon margin and fibrillar pattern and the measurement of PIN between experienced healthcare professionals in MSUS scanning and interpretation highlight the need for standardized protocol.
INFORMATION SYSTEMS OUTSOURCING DECISIONS UNDER FUZZY GROUP DECISION MAKING APPROACH
Authors: NAZARI-SHIRKOUHI S. , ANSARINEJAD A. , MIRI-NARGESI SS. , DALFARD V. MAJAZI , REZAIE K.
Published: November 2011

During the last decade, information system (IS) outsourcing has emerged as a major issue for organizations. As outsourcing decisions are often based on multicriteria approaches and group decisions, this paper proposes a structured methodology based on Fuzzy group decision making approach to evaluate and select the appropriate information system project (ISP) in an actual case. To achieve our purpose, we argue that seven criteria consisting of risk, management, economics, technology, resource, quality, and strategy and five ISPs should be considered for outsourcing decisions. Fuzzy analytic hierarchy process (fuzzy AHP) to find the priority and ranking of each ISP is considered. Using fuzzy theory for selecting the proper IS project can reduce ambiguities and uncertainties that are inherent in the selection procedure. A sensitivity analysis is performed to check the steadiness of the priority ranking and help decision makers to understand different scenarios that show alternative potential developments or different viewpoints concerning the relative importance of the criteria. Our proposed methodology can be applied by a cross-functional team of practitioners and IT managers to select the proper IS project. Also, the proposed approach can effectively consider complex and qualitative decision variables involved in the IS outsourcing decision-making problem. Finally, conclusion and potential issues for future research are presented. The main findings of this research have showed that the combination of AHP method and fuzzy concept to rank and prioritize of IS projects to outsource is a useful and practical tool to make traceable and reliable decision. According to results, a priority of overall score for the five candidates of IS projects reflects that project of "development of the supplier relationship management information system" performs the best, and project of "facilities management" performs the worst according to the experts' judgment in case study.
SOME ISSUES ON MULTIPLICATIVE CONSISTENCY OF INTERVAL RECIPROCAL RELATIONS
Authors: XIA MEIMEI , XU ZESHUI
Published: November 2011

Consistency plays an important part in decision making with interval reciprocal relation also called interval fuzzy preference relation. In this paper, we give the definition of perfect multiplicative consistent interval reciprocal relation and discuss its properties. A method is proposed to construct a set of multiplicative consistent reciprocal relations from a perfect consistent interval reciprocal relation. Then we develop methods to get the perfect multiplicative consistent interval reciprocal relation from the inconsistent one and estimate the missing values from an incomplete interval reciprocal relation. Finally, a group decision-making method is proposed based on perfect multiplicative consistent interval reciprocal relations. Some examples are also given to compare the proposed methods with the existing ones.
SNIPPET-BASED UNSUPERVISED APPROACH FOR SENTIMENT CLASSIFICATION OF CHINESE ONLINE REVIEWS
Authors: LI YIJUN , YE QIANG , ZHANG ZIQIONG , WANG TIENAN
Published: November 2011

Sentiment classification seeks to identify general attitude of a piece of text of comments or reviews on certain subject, be it positive or negative. Most existing researches on sentiment classification employ supervised learning approaches that rely on annotated data. However, sentiment is expressed differently on different subjects in different domains, and having annotated corpora for every domain of interest is not always practical. This paper proposes an unsupervised learning approach for classifying text of online reviews as recommended or not recommended. The proposed method is based on search engine snippet, summary information on the result page of a search engine. A basic assumption is that terms with similar orientation tend to co-occur. The co-occurrence is measured by utilizing snippets returned from search engines, with a query consisting of the text and a seed positive or negative word. With the information of snippets, the proposed method may estimate the association of candidate terms more accurately. This allows us to reliably predict the sentiment orientation of customer reviews. Texts of customer reviews are then classified as recommended or not recommended if the average sentiment orientations of its phrases are positive or negative. The research data set of this study consists of 600 Chinese online reviews about travel destinations retrieved from Ctrip.com. Our approach achieves an accuracy of 76.5%. Factors that influence the accuracy of the sentiment classification of Chinese online reviews were discussed.
AN INTUITIONISTIC FUZZY GROUP DECISION-MAKING APPROACH BASED ON ENTROPY AND SIMILARITY MEASURES
Authors: WEI CUIPING , TANG XIJIN
Published: November 2011

In this paper, we study group decision-making problems based on intuitionistic preference relations. By measuring the uncertain information of intuitionistic preference relations and the average similarity degree of one individual intuitionistic preference relation to the others, we propose a new approach to assess the relative importance weights of experts. The approach takes both the objective and subjective information of experts into consideration. We then integrate the weights of experts into the individual intuitionistic preference relations and develop a relative similarity method to derive the priorities of alternatives. The comparison analysis with other methods by two numerical examples illustrates the practicality and effectiveness of the proposed methods.
PARTIALLY OBSERVABLE MARKOV DECISION PROCESSES AND PERIODIC POLICIES WITH APPLICATIONS
Authors: GOULIONIS JOHN , STENGOS D.
Published: November 2011

This paper treats the infinite horizon discounted cost control problem for partially observable Markov decision processes. Sondik studied the class of finitely transient policies and showed that their value functions over an infinite time horizon are piecewise linear (p.w.l) and can be computed exactly by solving a system of linear equations. However, the condition for finite transience is stronger than is needed to ensure p.w.l. value functions. In this paper, we introduce alternatively the class of periodic policies whose value functions turn out to be also p.w.l. Moreover, we examine a more general condition than finite transience and periodicity that ensures p.w.l. value functions. We implement these ideas in a replacement problem under Markovian deterioration, investigate for periodic policies and give numerical examples.
Synthesis and conformational analysis of porphyrin derivatives substituted with calix[4]arene subunits
Authors: Holler Michel , Schmitt Michel , Nierengarten Jean-François
Published: November 2011

The synthesis of a complete series of calix[4]arene-substituted porphyrins is described. A detailed conformational analysis based on variable-temperature 1H NMR experiments revealed dynamic phenomena arising from the restricted rotation around the calix[4]arene-porphyrin bond.
Symptom Suppression in Subjects with Perennial Allergic Rhinitis Treated with Mometasone Furoate Nasal Spray
Authors: Clement Peter , Gates Davis
Published: November 2011

Background: Allergic rhinitis (AR) carries a high symptom burden and impact on quality of life. The ability of an AR treatment to achieve and sustain symptom suppression would be expected to enhance quality of life and improve long-term outcomes. Methods: In this ad hoc analysis of data from 4 phase 3 clinical trials of mometasone furoate nasal spray (MFNS), subjects with perennial AR recorded the severity of nasal symptoms twice daily for 12 weeks on a 4-point scale to determine the total nasal symptom score. Results: In the pooled sample of 1,149 subjects, 580 received MFNS 200 µg per day and 569 received placebo. Significantly more subjects receiving MFNS achieved symptom suppression versus those receiving placebo: 63.3% (n = 367) versus 51.0% (n = 290; p < 0.001). Median time to suppression was significantly shorter with MFNS versus placebo (29 vs. 59 days; p < 0.001). Total suppression was achieved in a significantly greater percentage of patients receiving MFNS versus placebo (36.0 vs. 25.5%; p < 0.001). Conclusions: A high level of symptom relief is attained faster and sustained longer with MFNS. This analysis validates the importance of treatment adherence to achieve optimal, sustained symptom relief.
Use of Uric Acid-Lowering Agents Limits Experimental Cyclosporine Nephropathy
Authors: Mazali Fernanda Cristina , Johnson Richard J. , Mazzali Marilda
Published: November 2011

Background: Hyperuricemia frequently complicates cyclosporine (CsA) therapy. Previous studies have shown that hyperuricemia exacerbates interstitial and vascular lesions in the cyclosporine model. We tested the hypothesis that normalization of uric acid could prevent the development of cyclosporine toxicity. Methods: CsA nephropathy was induced by administering CsA (15 mg/kg/day) for 7 weeks to rats on a low salt diet (CsA group). The effect of preventing hyperuricemia was determined by concomitant treatment with a xanthine oxidase inhibitor, allopurinol (CsAALP), or with a uricosuric, benzbromarone (CsABENZ), in drinking water. Control groups included vehicle-treated rats. Results: CsA-treated rats developed mild hyperuricemia with arteriolar hyalinosis, tubular atrophy, striped interstitial fibrosis, increased cell proliferation and decreased VEGF expression. Treatment with allopurinol or benzbromarone limited renal disease, with reduced interstitial fibrosis, cell proliferation, macrophage infiltration, osteopontin expression and arteriolar hyalinosis, in association with restoration of VEGF expression. Both drugs provided comparable protection. Conclusions: An increase in uric acid exacerbates CsA nephropathy in the rat. Concomitant treatment with allopurinol or benzbromarone reduced the severity of renal disease. The similar protection observed with both drugs suggests that the effect is associated more with lowering uric acid levels than the antioxidant effect of allopurinol.
Brown (Eulemur fulvus) and Ring-Tailed Lemurs (Lemur catta) Use Human Head Orientation as a Cue to Gaze Direction in a Food Choice Task
Authors: Botting Jennifer L. , Wiper Mallory L. , Anderson James R.
Published: November 2011

Whilst the ability to follow human gaze has been demonstrated in monkeys and apes, there is little evidence that prosimians share this ability. The current study used a food choice paradigm to assess whether captive brown (Eulemur fulvus) and ring-tailed lemurs (Lemur catta) use human gaze direction as a cue when choosing between an attending or non-attending human. Four experiments assessed the use of body, head and eye cues by the lemurs. In experiment 1, the non-attending human stood with her back to a food item; 3 of the 5 lemurs preferentially chose the attending human with an equivalent food item in view. In experiments 2 and 3, which used head angles of 90°, 4 out of 5 lemurs preferentially chose the attending human. In experiment 4, in which the humans differed only by whether their eyes were open or shut, no significant preferences were found. This study provides the first tentative evidence that lemurs are capable of discriminating human gaze direction and can use both body and head direction to do so.
Ultrasound molecular imaging of arterial thrombi with novel microbubbles modified by cyclic RGD in vitro and in vivo
Authors: Liao Yulin , Yang Li , Huang Ruizhu , Wu Juefei , Xie Jiajia , Bundhoo Kaviraj , Liu Ying , Hu Guangquan , Liu Cheng , Bin Jianping
Published: November 2011

Despite immense potential, ultrasound molecular imaging (UMI) of arterial thrombi remains very challenging because the high-shear arterial flow limits binding of site-targeted microbubbles to the thrombi. The linear Arg-Gly-Asp (RGD) peptides have been successfully applied to evaluate venous, atrial, and arteriolar thrombi, but have thus far failed in the detection of arterial thrombi. Cyclic RGD (Arg-Gly-Asp-D-Phe-Cys) is a cyclic conformation of linear RGD peptides, which has much higher binding-affinity and selectivity for binding to the glycoprotein (GP) IIb/IIIa receptor than its linear counterpart and thus is likely to be an optimal targeted molecular probe for ultrasound molecular imaging of arterial thrombi. In this study, we sought to assess the feasibility of a novel microbubble conjugated with cyclic RGD (Mb-cyclic RGD) in UMI of arterial thrombi in vitro and in vivo. As expected, Mb-cyclic RGD had greater GP IIb/IIIa-targeted binding capability in all shear stress conditions. In addition, the shear stress at half-maximal detachment of Mb-cyclic RGD was 5.7-fold higher than that of microbubbles with nonspecific peptide (Mb-CON) (p<0.05). Mb-cyclic RGD enhanced the echogenicity of the platelet-rich thrombus in vitro whereas Mb-CON did not produce enhancement. In the in vivo setting, optimal signal enhancement of the abdominal aortic thrombus was displayed with Mb-cyclic RGD in all cases. Mean video intensity of the abdominal aortic thrombi with Mb-cyclic RGD was 3.2-fold higher than that with Mb-CON (p<0.05). The novel Mb-cyclic RGD facilitated excellent visualisation of arterial thrombi using UMI and showed great promise for clinical applications.
Receptor activator of NF-κB ligand (RANKL) increases the release of neutrophil products associated with coronary vulnerability
Authors: Bertolotto Maria , Lenglet Sébastien , Vuilleumier Nicolas , Galan Katia , Pagano Sabrina , Braunersreuther Vincent , Pelli Graziano , Pistoia Vito , Bianchi Giovanna , Cittadini Giuseppe , Viviani Giorgio Luciano , Pende Aldo , Roux-Lombard Pascale , Thomas Aurélien , Staub Christian , Ratib Osman , Dallegri Franco , Quercioli Alessandra , Mach François , Schindler Thomas Helmut , Montecucco Fabrizio
Published: November 2011

The “blood vulnerability”, resulting from the complex balance between serum molecules and inflammatory cell atherosclerotic activities, is a major determinant in the evaluation of the “global patient cardiovascular vulnerability”. In the present study, we focused on the role of the soluble receptor activator of nuclear factor kappa-B (NF-κB) ligand (RANKL, a potential marker of coronary calcification and vulnerability) in the release of neutrophilic proteases. Then, the association between these mediators and the degree of coronary calcification (assessed by coronary calcium score [CCS]) was investigated in 20 subjects (aged ≥65 years) asymptomatic for cardiovascular disease. Results showed that RANKL dose-dependently induced matrix metalloprotease (MMP)-8 and MMP-9 release from human primary neutrophils cultured in Teflon dishes (suspension condition, mimicking cells circulating in the blood stream). Conversely, when adherent to polystyrene, neutrophils became unresponsive to RANKL. RANKL did not influence the release of other neutrophilic products in suspension and adherence cultures as well as neutrophil migration. RANKL-induced release of MMPs was dependent on the activation of defined intracellular signalling pathways (PI3K/Akt and ERK1/2). In asymptomatic subjects, serum levels of RANKL, MMP-8 and MMP-9 positively correlated with CCS, reflecting a potential relationship between circulating RANKL and coronary calcification. In conclusion, RANKL increased the release of neutrophilic products potentially related to the “blood” vulnerability via defined intracellular pathways. Serum levels of RANKL might represent a potential biomarker of coronary calcification and related cardiovascular risk.
Impact of polymorphisms in genes involved in autoimmune disease on inhibitor development in Chinese patients with haemophilia A
Authors: Lu Yeling , Ding Qiulan , Dai Jing , Wang Hongli , Wang Xuefeng
Published: November 2011

One of the most severe and important complication in the treatment of haemophilia A (HA) patients is the formation of inhibitors. The mechanism that leads to factor (F)VIII inhibitor formation is complicated. Both genetic and environmental factors have been mentioned to play decisive roles. Recently, polymorphisms in the genes encoding interleukin-10 (IL-10), tumour necrosis factor-alpha (TNF-α), cytotoxic T-lymphocyte antigen-4 (CTLA-4), have been suggested to be contributing determinants of the inhibitor risk. In order to investigate the influence of the single nucleotide polymorphisms (SNPs) in the genes encoding for cytokines to the inhibitors development in Chinese HA patients, we genotyped 10 SNPs with high heterozygote rates in Chinese and a CA repeat microsatellite at the gene loci IL-10 as well in a separate, unrelated case-controlled cohort of 122 affected HA patients; 63 with inhibitors and 59 without inhibitors. The particular SNPs included in this study were as follows: –592C/A and –819C/T in IL-10, –590C/T in IL-4, –318C/T and 49A/G in CTLA-4, –827C/T in TNF-α, –1112C/T and 2044G/A in IL-13, 874A/T in interferon (IFN)-γ and –295T/C in IL-16. Our results demonstrated that –819T and –592A alleles in IL-10 were observed more frequently in patients with inhibitors. This indicated that –819C/T and –592A/C in IL-10 may influence the inhibitors development in HA patients. Furthermore, we concluded that the haplotype in IL-10 (TA, CA, CC at positions –819 and –582, respectively) may predispose FVIII inhibitor development in HA patients. In conclusion, the data reported in our study clearly highlight the participation of IL-10 in inhibitors formation in Chinese HA patients.
The anticoagulant function of coagulation factor V
Authors: Cramer Thomas J. , Gale Andrew J.
Published: November 2011

Almost two decades ago an anticoagulant function of factor V (FV) was discovered, as an anticoagulant cofactor for activated protein C (APC). A natural mutant of FV in which the R506 inactivation site was mutated to Gln (FVLeiden) was inactivated slower by APC, but also could not function as anticoagulant cofactor for APC in the inactivation of activated factor VIII (FVIIIa). This mutation is prevalent in populations of Caucasian descent, and increases the chance of thrombotic events in carriers. Characterisation of the FV anticoagulant effect has elucidated multiple properties of the anticoagulant function of FV: 1) Cleavage of FV at position 506 by APC is required for anticoagulant function. 2) The C-terminal part of the FV B domain is required and the B domain must have an intact connection with the A3 domain of FV. 3) FV must be bound to a negatively charged phospholipid membrane. 4) Protein S also needs to be present. 5) FV acts as a cofactor for inactivation of both FVa and FVIIIa. 6) The prothrombotic function of FVLeiden is a function of both reduced APC cofactor activity and resistance of FVa to APC inactivation. However, detailed structural and mechanistic properties remain to be further explored.
Who formulates self-regulatory action plans regarding fruit consumption? An application of the Big Five personality theory
Authors: de Bruijna Gert-Jan
Published: November 2011

Objective:

Action planning is regarded as an important correlate and predictor of health behaviour, but little is known about antecedents of action planning. Because personality constructs have been shown to moderate the effect of action planning interventions, the present study tested associations of personality dimensions with action planning and fruit consumption.

Design and setting:

Cross-sectional data collected with self-administered questionnaires in a university setting.

Method:

Undergraduate students ( n = 443; mean age = 21.45 (SD = 2.96) years, 68.7% females) who participated for course credits and completed measures of personality dimensions, action planning, intention, and fruit consumption based on validated questionnaires. The first set of analyses focused on antecedents of fruit consumption action planning employing stepwise regression analysis. The second set of analyses focused on intention and action planning as mediators of the personality–fruit consumption link using structural equation modelling.

Results:

Higher scores for fruit consumption action planning were found for more conscientiousness and less neurotic individuals. Further, more conscientious individuals consumed more fruits and this relationship was mediated by action planning.

Conclusion:

Findings provide support for action planning as a mediator in the Conscientiousness–fruit consumption link and suggest that personality influences may need to be taken into account when developing action planning strategies aimed at increasing fruit consumption.
The Relationship between the Perception and Production of Coarticulation during a Sound Change in Progress
Authors: Kleber Felicitas , Harrington Jonathan , Reubold Ulrich
Published: November 2011

The present study is concerned with lax /ʊ/-fronting in Standard British English and in particular with whether this sound change in progress can be attributed to a waning of the perceptual compensation for the coarticulatory effects of context. Younger and older speakers produced various monosyllables in which /ʊ/ occurred in different symmetrical consonantal contexts. The same speakers participated in a forced-choice perception experiment in which they categorized a synthetic /ᶦ-ʊ/ continuum embedded in fronting /s_t/ and non-fronting /w_l/ contexts. /ʊ/ was shown to be fronted for the younger age group in both production and perception. Although there was no conclusive evidence that younger listeners compensated less for coarticulation than did older listeners, the size of the coarticulatory influence of consonantal context on /ʊ/ in perception was found to be smaller than in production for the younger than for the older group. The findings are consistent with a model of sound change in which the perceptual compensation for coarticulation wanes ahead of changes that take place to coarticulatory relationships in speech production. As a result, the perception and production of coarticulation may be unusually misaligned with respect to each other for some speaker-listeners participating in a sound change in progress.
Immutable Mobiles Derailed: STS, Geopolitics, and Research Assessment
Authors: Stöckelová Tereza
Published: November 2011

Science policies and science studies largely share an understanding of scientific knowledge and objects as immutable mobiles. This article shows how the analysis of research assessment in a non-Anglophone country and its effects on social sciences can shed new light on this shared notion. The preference for immutable mobiles in assessment regimes pushes social scientists to publish in specialized, usually Anglophone journals, which can result in the attenuation of local relevance of the knowledge they produce and contribute to the performance of globally converging societies. The author argues that the observed consequences for the social sciences in non-Anglophone countries underscore a larger problem with both the policy ideal and the science and technology studies (STS) idea of immutable mobiles on two counts: the relation of the social and natural sciences to society and the engagement of sciences with the multiplicity of societies as well as natures.
When Contexts Meet
Authors: Singleton Vicky
Published: November 2011

The article discusses three versions of context. First, UK Government legislation, the British Cattle Tracing System (CTS), as a context that frames and guides good farming practices to promote accountability for cattle movements and to control disease. It describes how the legislative context creates particular constructions of farmers, cows, and good and bad farming practices. Second, the article creates context as the local farm-based practices of cattle movement and monitoring. Differences and similarities between the legislative requirements and the farm-based practices are discussed. The farming practices are primarily practices of responsibility and care that are embodied, relational, collective, and responsive. The article draws upon feminist insights into responsibility and accountability  that accountability is mundane practices of touch, regard, looking back, and becoming with. Thereby, the article creates a third context in which local farming practices, legislation, and feminism meet and interact with one another. Within this “meta-context” of interferences between contexts, accountability is revisioned as the very condition of farm-based practices of care and responsibility. At the same time, the article revisions context as emergent in interferences and enacts alternative versions of farmers, cows, and good and bad practices.
No Such Thing as Terroir?
Authors: Teil Geneviève
Published: November 2011

The sociology of science has shown that the scientific quest for truth, framed by the search for objectivity was granting objects of knowledge the form of independent and autonomous things, “data” already given and preexisting their observation. But do “real” objects only fit the form of data or things? If not, to which other form and objectivity do they fit? The author considers the question by examining the dispute between scientists and vintners on the issue of terroir, a complex combination of viticulture and wine-making practices and agro-climactic factors, which gives wines a particular taste, or terroir typicity. For scientists who are unable to reduce it to a stable list of determining factors, terroir is an unfounded notion, an imaginary social construction, and an economic barrier. Producers, on the other hand, along with the wider distribution network of terroir wines, consider terroir as a real object, although one whose manifestations cannot be evaluated using the same procedures as those of scientists. By analyzing how proof of terroir is implemented, the author uncovers a regime of existence of objects different from the scientific regime: a pluralist one governed by critical discussion from which objects emerge as distributed results of a production process.
The impact of off-pump coronary artery bypass surgery on postoperative renal function
Authors: Abu-Omar Y , Taghavi FJ , Navaratnarajah M , Ali A , Shahir A , Yu L-M , Choong CK , Taggart DP
Published: November 2011

Objectives: A number of risk factors have been recognised for postoperative renal dysfunction following on-pump coronary artery bypass surgery (CABG). There are, however, few studies that have evaluated the potential reno-protective effects of off-pump CABG in the presence of other confounding risk factors. The aim of this study was to determine if off-pump CABG reduces the risk of renal injury.

Methods: Serum creatinine values (preoperatively and day 1, 2 and 4 postoperatively) and other clinical data were prospectively collected on 1580 consecutive patients who underwent first-time CABG from 2002 to 2005. Creatinine clearance was calculated using the Cockcroft and Gault equation. The effect of on-pump vs. off-pump CABG on renal function was analysed, adjusting for age, gender, diabetes mellitus, left ventricular (LV) function and preoperative creatinine clearance, using multiple regression analysis.

Results: One thousand one hundred and forty-five (73%) patients underwent on-pump CABG and 435 (27%) underwent off-pump CABG. The two groups were similar with respect to age, gender and diabetes. Two hundred and seventy-four (17%) patients were females and 274 (17%) patients had diabetes. Multivariate analysis demonstrated significantly lower creatinine clearance postoperatively in patients with diabetes (P<0.001) and advanced age (P<0.001). The on-pump group had significantly lower postoperative creatinine clearance in comparison to the off-pump group (P= 0.01). The effect remained consistent after adjusting for potential risk factors (age, diabetes, gender, LV function and preoperative creatinine clearance) in the multivariate analysis.

Conclusion: Off-pump surgery is associated with a reduction in postoperative renal injury.
Urinary catheterization in acute stroke: clinical realities. A mixed methods study
Authors: Cowey Eileen , Smith Lorraine N , Booth Jo , Weir Christopher J
Published: November 2011

Objective: To determine what influences the decision to insert an indwelling urinary catheter in acute stroke patients.

Design: A prospective casenote review and semi-structured interviews were conducted and corporate catheterization policy in the study sites was investigated.

Setting: Three teaching hospitals, typical of stroke service provision in most developed countries.

Subjects: Casenotes from 70 consecutive acute stroke admissions; 50 doctors, nurses and physiotherapists working in acute stroke units and medical receiving units.

Results: Stroke patients were catheterized for output monitoring, relief of urinary retention or, especially for older patients, continence-related issues. Half of all catheterizations occurred in acute stroke units. Continence and catheterization were considered less important than other aspects of acute stroke care. No catheterization policy or standardized continence assessment tool was in use. Documentation was often lacking. Patients and relatives were not fully involved in the decision to catheterize. Continence assessment and catheterization practices varied widely. Complex unwritten rules relating to gender proliferated. Such rules demonstrated heuristic problem-solving could potentially cause conflict. Decisions to catheterize ‘belonged’ to doctors or nurses depending upon clinical indications. Clinical assessment and specialist referrals were often seen as ‘not my job’.

Conclusions: Clear corporate policy on catheterization is required to direct practice. Use of standardized continence assessment tools is recommended to set and monitor standards of care. Documentation relating to urinary catheterization needs to improve.
Does Anterior Cruciate Ligament Reconstruction Lead to Degenerative Disease?
Authors: Murray James R.D. , Lindh Amy M. , Hogan Niall A. , Trezies Alister J. , Hutchinson James W. , Parish Erin , Read John W. , Cross Mervyn V.
Published: November 2011

Background: Reporting of long-term outcome of anterior cruciate ligament (ACL) reconstruction with the patellar tendon (bone–patellar tendon–bone [BTB]) autograft is limited. There are concerns that degenerative joint disease is common in the long term, which may be associated with the procedure itself.

Hypotheses: (1) ACL reconstruction with BTB provides good long-term outcome. (2) There are additional factors to surgical reconstruction that can be associated with the development of degenerative disease.

Study Design: Case series; Level of evidence, 4.

Methods: Of 161 patients, 114 were eligible. Patient-centered outcome was by Lysholm and subjective International Knee Documentation Committee (IKDC) score; objective outcome measures were clinical examination and IKDC radiological grade.

Results: Mean average follow-up was 13 years. The IKDC radiological grades in the worst compartment were A = 15%, B = 51%, C = 19%, and D = 14% (n = 83). There was a significant difference between the injured versus contralateral uninjured knee (n = 42, P = .003). In a subgroup with no meniscal or chondral injury the IKDC grades were A = 38%, B = 55%, C = 7%, and D = 0% (n = 29). The mean subjective scores were 89 ± 11 (Lysholm) and 83 ± 15 (IKDC) (n = 114). Poor IKDC subjective outcome was associated with chondral injury ( P = .001), previous surgery ( P = .022), return to sport ( P = .013), and poor radiological grade in the ipsilateral medial compartment ( P = .004). A poor IKDC radiological grade was associated with chondral injury ( P = .002), meniscal injury ( P = .010) and meniscectomy ( P = .012), an IKDC subjective score of <85 ( P = .01), and poor radiological grade in the contralateral medial compartment ( P = .041).

Conclusion: At 13 years, BTB ACL reconstruction provides a good outcome. Chondral and meniscal damage at surgery were associated with a poor radiological outcome, indicating that injuries sustained during ACL rupture may be the main predictors of degenerative bone disease.